bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pentavalent vaccination in rural Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County.
Authors: Ogero Morris , Orwa James , Odhiambo Rachael , Agoi Felix , Lusambili Adelaide , Obure Jerim , Temmerman Marleen , Luchters Stanley , Ngugi Anthony 
Published: September 2020

Abstract
BackgroundThere is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.MethodsCoordinates of health facilities, information on land cover, digital elevation models, and road networks were used to compute spatial accessibility to immunizing health facilities for eligible children within the Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of travel time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other a priori identified confounding factors.ResultsSpatial access to health facilities that offer immunization services significantly affected DTP3 coverage, with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).ConclusionIncreased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high-resolution maps to identify areas where distance and travel time may impede the achievement of high immunization coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county.
Developing a national set of health equity indicators using a consensus building process
Authors: Wilf-Miron Rachel , Avni Shlomit , Valinsky Liora , Myers Vicki , Ziv Arnona , Peretz Gidi , Luxenburg Osnat , Saban Mor , Feder-Bubis Paula 
Published: September 2020

Abstract
BackgroundConsiderable health disparities documented in Israel between communities, populations and regions, undermine the rights of all citizens to attain the best possible health. The first step towards health equity is to agree on a set of national indicators, reflecting equity in health services provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We sought to describe the process of reaching a consensus on a defined set of national equity indicators. MethodsThe study was conducted between January 2019 and June 2020, in a multistage design: A) Identifying appropriate disparity measures. B) Agreement on the screening criteria and relative weighting. C) Constructing the consultation framework as an on-line, 3-round Delphi technique.ResultsThirty measures of disparity, presented to participants, represented the following domains: Health promotion (11 indicators); acute and chronic morbidity (11), life expectancy and mortality (2), health infrastructures and affordability of care (4); education and employment (2). Three scoring rounds took place between February-May 2020. Of the 77 individuals contacted, 75 (97%) expressed willingness to participate, and 55 (73%) completed all three rounds. The leading ten indicators selected were: Diabetes care, childhood obesity, adult obesity, distribution of healthcare personnel, fatal childhood injuries, smoking, infant mortality, inability to afford care, access to mental health services, and distribution of hospital beds. Agreement among raters, measured as intra-class correlation coefficient was 0.75.ConclusionThe Delphi technique provided a cost–effective, feasible and acceptable method for reaching a consensus with a variety of experts and public representatives. Equity indicators chosen by a broad range of people from different sectors are more likely to be accepted and ultimately implemented. The diverse set of clinical and system indicators should be used to guide governmental decision-making and inter-sectoral strategies, furthering the pursuit of a more equitable healthcare system.
Level of Commitment and associated factors to Use District Health Information System (DHIS2) for decision making among health providers in a resource limited settings: Cross-sectional survey
Authors: Kanfe Shuma Gosha , Mengiste Nebyu Demeke , Tilahun Binyam , Ahmed Mohammedjud Hassen , Endehabtu Berhanu Fikadie 
Published: September 2020

Abstract
Background: Changing information use culture, one of the transformation agenda of the Ministry of Health of Ethiopia, can’t be real unless health providers have commitment to use locally collected data for evidence based decision making. Performance Monitoring Team (PMT) members’ commitment has a very paramount influence on district health information system data (DHIS2) utilization for decision making. Evidence is limited on performance monitoring team members’ commitment to use DHIS2 data. Therefore, this study will fill the evidence gap.Objective: This study aimed to assess the level of commitment and its associated factors among Performance Monitoring Team members to use DHIS2 data for decision making at health facilities in Ilu Aba Bora Zone of Oromia national regional state, Ethiopia 2020G.C.Method: Cross sectional quantitative study supplemented by qualitative methods was conducted to assess commitment level of PMT members’ to use DHIS2 data. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done. Thematic analysis was conducted for qualitative part Result: Overall 121(45.8%) of the respondents had commitment to use DHIS2 data (95% CI: [40.00, 52.8]). Feedback [AOR= 1.85, 95% CI: (1.02, 3.33)], Supervision [AOR= 2.84, 95% CI: (1.50, 5.37)], Information use culture [AOR=1.92,95% CI: (1.03, 3.59)] ,Motivation [AOR=1.80, 95% CI: (1.00, 3.25)] ,Health need [AOR=3.96, 95% CI: (2.11, 7.41)] and Competency [AOR=2.41, 95% CI:(1.27,4.55)] were variables associated with level of commitment to use DHIS2 data. Conclusion: In general, less than half of the study participants had commitment to use DHIS2 data for decision making. Information use culture, Motivation, Competency, Health need, Supervision and Feedback were the most determinant factors. Providing regular supportive supervision and feedback, increasing motivation and changing attitude will help to bring cultural transformation of data use.
GDM progenies exhibit sex disparity in metabolism after respective therapies of insulin, glibenclamide and metformin in dams during pregnancy
Authors: Lu Yao , Jjang Zhengxuan , Jia Yajing , Liu Juan , Xu Yuxin , Wu Qingsi , Chen Keyang 
Published: September 2020

Abstract
Background： The drug treatments for the pregnant women with gestational diabetes mellitus (GDM) have been concerned with their effects on both mothers and offspring. The aim of this study was to compare the intergenerational effects of insulin, glibenclamide and metformin on glucose and lipid metabolism in the offspring born to GDM mice. Methods: The murine GDM was induced by high fat diet. The offspring were grouped based on the treatments in maternal mice. ITT and GTT were performed at 4th week and 8th week of age, respectively. Serum levels of TC, TG, HDL-C and LDL-C plus hepatic levels of TG and TC, were respectively determined by enzymatic kits. Western blotting was conducted to detect related proteins in the livers from offspring. Results: The normalization of the dyslipidemia, hepatic lipid abnormality and insulin insensitivity elicited by the respective therapies of insulin, glibenclamide and metformin during maternal pregnancy still persisted in the male adult offspring. Specifically, the decreases in plasma TC, TG, LDL-C levels (29%, 37.8% and 57.7%, respectively, p˂0.05) and hepatic lipid contents (TC 31.3% and TG 39.2%, p˂0.05), the increases in hepatic phosphorylation levels of AKT, CPT1A ,PPAR- α and PPAR-γ (57.1%, 91.7% , 68% and 173.3%, respectively, p˂0.05) and the inhibition of G6Pase, PEPCK, HMGCS1 (35.7%, 68.8% and 77.3% respectively, p˂0.05) were still observed in the male offspring born to treated GDM mice from 4th to 8th week of age. Unexpectedly, the female progeny born to untreated GDM mice showed an autonomous recovery in glucose and lipid metabolism. Conclusions: Respective treatments in GDM mice during pregnancy with insulin, glibenclamide and metformin have the long-term persisted effects in male offspring, while female progenies born to untreated dams showed an autonomous inhibition of intergenerational relay of glucose and lipid dysregulation. Our current findings may shed a new light into GDM clinical practice.
Characteristics and Outcome of Children Admitted with Sars- Cov-2 Infection:&nbsp;Experiences from a Pediatric Public Hospital in Western India&nbsp;&nbsp;
Authors: Rao Sudha , Gavali Vrushabh , Prabhu Shakuntala S , Mathur Radhika , Dabre Larissa Robert , Prabhu Sanjay B , Bodhanwala Minnie 
Published: September 2020

Abstract
BackgroundSARS-CoV-2 infection in children is asymptomatic or mildly symptomatic. Clinical characteristics and outcome of children admitted with COVID 19, especially with underlying illnesses, has not been studied. ObjectiveTo study the clinical characteristics and outcome of children admitted, with SARS-CoV-2 infection, to a paediatric multispecialty hospital in Mumbai, the epicentre of the COVID19 pandemic in India. Design and SettingRetrospective observational study of medical records of 969 children admitted between 19 March and 7 August 2020.ParticipantsClinico-demographic characteristics and outcome of COVID 19 positive children admitted during the study period. Variables compared between children who were previously healthy (Group I) and children with co-morbidity (Group II).Main outcomeCOVID 19 disease severity characterisation and factors predicting outcome as discharge or death was studied.Results123 (71M) tested SARS-CoV-2-positive by RT-PCR with median age of presentation of 3 years [IQR 0.7– 6 years]. 47 (38%) had co-morbidities and were more severely affected (p = 0.0146). MIS-C/ KD was common in Group I. Thirty nine (31.7 %) needed intensive care. Fourteen (11.4%) died. Male sex, respiratory manifestation, pulseox saturation <94% at admission, need for ventilation, inotrope, hospital stay of <10 days were independent mortality predictors. Regression analysis revealed oxygen saturation <94% at admission (OR 35.9, 95% CI 1.5-856) and hospital stay <10 days (OR 9.1, 95% CI 1.04 -99.1) as predictors of mortality.ConclusionCOVID 19 in children although considered mild, presence of co-morbidities causes severe disease. Pulseox saturation <94% on admission, hospital stay <10days are predictors of mortality.
Vulnerabilities of High-Security Forensic Psychiatry Residences in Italy during the COVID-19 pandemic: a qualitative survey and a proposal for recovery and prevention
Authors: Pozza Andrea , Ferretti Fabio , Carabellese Fulvio , Gualtieri Giacomo , Masti Alessandra , Carabellese Felice , Coluccia Anna 
Published: September 2020

Abstract
Italy is the first European country severely hit by the COVID-19 pandemic after the outbreak in Wuhan. In our healthcare context, the closing of forensic psychiatric hospitals in 2014 completed the long transition from a containment approach for offenders with severe mental disorders to a model oriented to recovery and community reintegration. High-Security Forensic Psychiatry Residences (REMS) were implemented by regional health authorities. Within these settings, inpatients with severe psychiatric disorders who committed a criminal offense, without criminal responsibility but still considered socially dangerous, are held, and treated. The current COVID-19 emergency represents a severe stressful event which has a potentially negative impact on the recovery process of the inpatients and on the work-related health of the psychiatric professionals. The present paper consists of two sections. In the first one, we discuss the organizational and clinical issues emerged in the forensic psychiatry system in Italy. We identify vulnerable groups and processes and suggest long-term prevention strategies at both clinical and organizational levels. Within the second section, we present the findings of a qualitative exploratory survey conducted in four different REMS immediately after the stop of the lockdown. Based on a qualitative approach, this survey explored the COVID-19 effects on mental health of REMS inpatients and healthcare workers. Thematic analysis showed five key themes: “Intervention and prevention strategies during the lockdown decision making”; “Inpatients’ reactions to the pandemic”; “Psychological reactions of the healthcare staff”; “Recovery process and relations with community mental health services”; “Lessons for the future learned from the COVID-19”.
Unrecognized liver injury assessed by fibrosis indexes is associated with mortality in critically ill COVID-19 patients
Authors: Romero-Cristobal Mario , Clemente Ana , Piñeiro Patricia , Cedeño Jamil , Rayón Laura , Río Julia Del , Ramos Clara , Hernández Diego-Andrés , Cova Miguel , Caballero Aranzazu , Garutti Ignacio , García-Olivares Pablo , Hortal Javier , Guerrero Jose-Eugenio , García Rita , Bañares Rafael , Rincón Diego 
Published: September 2020

Abstract
Background Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indexes with the prognosis of critically ill COVID-19 patients.Methods Observational study in 214 patients with COVID-19 consecutively admitted to the ICU. Pre-admission liver fibrosis indexes were calculated. In-hospital mortality and predictive factors were explored with Kaplan-Meier and Cox regression analysis.Results The mean age was 59.58 (13.79) years. Sixteen patients (7.48%) had previously recognized chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indexes were higher in non-survivors [Forns: 6.04 (1.42) vs 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) vs 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis (p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11-1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99-1.72); p = 0.051] were independently related to survival after adjusting for the Charlson Comorbidity Index, APACHE II and ferritin.Conclusion Unrecognized liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.
Cyberchondria, Uncertainty, and Psychological Distress among Omanis during COVID-19: An Online Cross-Sectional Survey
Authors: Dameery Khloud Al , Quteshat Mohammed , Harthy Ibtisam Al , Khalaf Atika 
Published: September 2020

Abstract
Background: Frequent surfing on the internet for self-diagnosis and treatment in association with quarantine during the COVID-19 pandemic leaves people with uncertainty and psychological distress. The aim was to explore the relationship between cyberchondria, psychological distress, and uncertainty in Oman. Methods: A descriptive correlational study was designed. Data was collected through an online survey from 393 Omani participants using the short-form version of the Cyberchondria Severity Scale, the Kessler Psychological Distress Scale, and the Intolerance of Uncertainty Scale. Descriptive and correlational analyses were conducted.Results: The majority of the participants were aged between 18-26 and 45-54 years (32.8% and 30.8% respectively). Almost three-quarters of the participants were female (n= 291, 74%) and half were single (n= 218, 55.5%). No significant associations were found between cyberchondria and the socio-demographic factors or the COVID-19 status. However, significant positive fair correlation was found between cyberchondriac experiences and psychological distress (rs =0.373), and cyberchondria and uncertainty (rs = 0.442).Conclusions: To the best of our knowledge, this study is the first of its kind investigating the relationship between cyberchondria, physiological distress, and uncertainty in the Omani population. Policy makers and stakeholders are encouraged to facilitate the reporting and observation of accurate and up-to-date information distributed to the population to avoid misleading information, and thus reduce the distress and uncertainty related to cyberchondriac behaviors.
Pulmonary embolism in patients with severe COVID-19 treated with intermediate- to full-dose enoxaparin
Authors: Scarduelli Cleante , Inglese Francesco , Beccaria Massimiliano , Spreafico Fabio , Garuti Martina , Costanzo Domenica di , Pecoriello Antonietta , Cervi Giulia , Greco Graziana , Squeri Fabrizio , Galavotti Vanni , Donno Giuseppe de , Lucchini Giuseppe , Borghi Claudio 
Published: September 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) may predispose patients to venous thromboembolism (VTE) due to inflammation, hypoxia, immobilization, and diffuse intravascular coagulation, despite standard thrombopropylaxis. Our retrospective study reports the incidence of pulmonary embolism (PE) in patients with COVID-19 and severe respiratory failure(SRF) treated with intermediate to full-dose enoxaparin. .Methods: This retrospective case series analysed data from patients with COVID-19 pneumonia and severe respiratory failure (SRF) admitted to our Respiratory Intensive Care Unit (RICU) between February 27 and April 20, 2020 for non-invasive positive-pressure ventilation. All patients received at least intermediate-dose enoxaparin (40 mg twice daily). If PE was suspected or diagnosed, patients were treated with full-dose enoxaparin (1 mg/kg twice daily). Computed tomography pulmonary angiography (CTPA) was used to detect PE in patients with elevated D-dimer levels (> 3000 ng/mL) and/or other clinical indicators, including sudden worsening of cardiopulmonary status.Results: Ninety-two patients (71 males, 21 females; mean age 58 ± 11 years) with COVID-19 pneumonia and SRF (mean arterial oxygen partial pressure/fractional inspired oxygen [PaO2/FiO2] of 143 ± 45 mm Hg) were admitted to our RICU. Twenty-two patients underwent CTPA (24%), with PEs detected in 11 (12%). Mean PaO2/FiO2 and mean D-dimer levels did not significantly differ between patients with or without PE. Eleven patients (12%) died in the hospital, with a mean age of 70 ± 11 years for deceased patients and 56 ± 11 years for surviving patients (p < 0.0001).Conclusions: PE was diagnosed in 12% of patients despite intermediate to full-dose enoxaparin treatment. However the incidence of PE in our patients was lower than that previously reported. We hypothesize that this reduced PE incidence may have been secondary to the higher than prophylactic enoxaparin dose that was used.
Ground of the modes of agglutination of aspen lead of
Authors: Чубинский А.Н. , Коваленко И.В. , Русаков Д.С. , Варанкина Г.С. 
Published: September 2020

Качество формирования клеевых соединений древесины при склеивании шпона зависит от многих факторов, основными из которых являются плотность и влажность древесины, ее поверхностные свойства, вид клея и его характеристики, режимы склеивания. Фанера, склеенная из осинового шпона по применяемым на практике режимам, характеризуется меньшей прочностью, по сравнению с березовой фанерой. Применение древесины осины в промышленном производстве материалов и изделий ограничено из-за ее низких механических свойств, подверженности поражению коррозионно-деструктивной гнили, отсутствия должного обоснования технологии ее переработки. Невостребованная осина осложняет условия хозяйствования в лесу, ухудшает породный состав древостоев, препятствует восстановлению хвойных пород древесины. Прочность склеивания древесины и прочность фанеры возрастает с увеличением давления прессования, однако приводит к увеличению остаточной деформации и вероятности возникновения «пузырей» в склеиваемом пакете шпона. Поэтому обоснование давление прессования и расхода клея для склеивания шпона на основе свойств и строения древесины осины является актуальной задачей. Снижение давления по закону релаксирующих напряжений позволяет уменьшить давление парогазовой смеси в пакете шпона, уменьшает вероятность разрушения клеевого соединения при снятии внешнего усилия. Одним из эффективных способов повышения прочности клеевого соединения является применение лигносульфонатов в качестве модификатора для синтетических смол.
The quality of the formation of adhesive joints when gluing wood veneers depends on many factors, the main ones are the density and moisture content of wood, its surface properties, type of adhesive and its characteristics, bonding modes. Plywood glued veneers of aspen on applied practice modes, characterized by lower strength in comparison with birch plywood. The use of aspen wood in manufacturing of materials and products is limited due to its low mechanical properties, corrosion susceptibility destructive lesion decay, its lack of proper justification processing technology. Unclaimed aspen difficult economic conditions in the forest, degrades the species composition of forest stands and prevents restoration of softwood. The adhesion of wood and plywood strength increases with increasing compaction pressure, however, leads to an increase in permanent deformation, and the likelihood of «bubbles» in the package are glued veneer. That is why the support of the pressing and glue flow pressure for bonding the veneer on the basis of structure and properties of aspen wood is an urgent task. Reducing pressure legally relaxing stress to reduce the pressure of the gas mixture in the veneer package, reduces the probability of failure of the adhesive joint when removing the external force. One effective way of increasing the bonding strength is the use of lignosulfonate as a modifier for synthetic resins.