bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cross sectional study of unmet need for health services amongst urban refugees and asylum seekers in Thailand in comparison with Thai population, 2019
Authors: SUPHANCHAIMAT RAPEEPONG , Sinam Pigunkaew , Phaiyarom Mathudara , Pudpong Nareerut , Julchoo Sataporn , Kunpeuk Watinee , Thammawijaya Panithee 
Published: November 2020

Abstract
BackgroundAlthough the Thai government has introduced policies to promote the health of migrants, it is still the case that urban refugees and asylum seekers (URAS) seem to be neglected. This study aimed to explore the degree of healthcare access through the perspective of unmet need in URAS, relative to the Thai population.MethodsA cross-sectional survey, using a self-reporting questionnaire adapted from the Thai Health and Welfare Survey (HWS), was performed in late 2019, with 181 URAS completing the survey. The respondents were were randomly selected from the roster of the Bangkok Refugee Center. The data of the URAS survey were combined with data of the Thai population (n=2,941) from the HWS. Unmet need for health services was defined as the status of needing healthcare in the past twelve months but failing to receive it. Bivariate analysis was conducted to explore the demographic and unmet need difference between URAS and Thais. Multivariable logistic regression and mixed-effects (ME) model were performed to determine factors associated with unmet need.ResultsOverall, URAS were young, less educated and living in more economically deprived households, compared with Thais. About 98% of URAS were uninsured by any of the existing health insurance schemes. The prevalence of unmet need among URAS was significantly higher than among Thais in both outpatient (OP) and inpatient (IP) services (54.1% versus 2.1% and 28.0% versus 2.1%, respectively). Being uninsured showed the strongest association with unmet need, especially for OP care. The association between insurance status and unmet need was more pronounced in the ME model, relative to multivariable logistic regression. URAS migrating from Arab nations suffered from unmet need to a greater extent, compared with those originating from non-Arab nations.ConclusionThe prevalence of unmet need in URAS was drastically high, relative to the prevalence in Thais. Factors correlated with unmet need included advanced age, lower educational achievement, and, most evidently, being uninsured. Policy makers should consider a policy option to enrol URAS in the nationwide public insurance scheme to create health security for Thai society.
Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis
Authors: Zhang Ge , Li Ming , Qu Xiangyang , Cao Yujiang , Liu Xing , Luo Cong , Zhang Yuan 
Published: November 2020

Abstract
Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Mehtods: The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.
Use of Gracile and Semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears
Authors: Protais Marie , Laurent-Perrot Maxime , Artuso Mickaël , Moody M. Christian , Sautet Alain , Soubeyrand Marc 
Published: November 2020

Abstract
Purpose
Irreparable rotator cuff tears are common and difficult to treat. Techniques for "filling the loss of substance" require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula.
Methods
This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SE) and upper infraspinatus (IE) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed.
Results
The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases.
Conclusion
This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial "spacer" effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.
Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data
Authors: Sharma Narayan , Schwendimann René , Endrich Olga , Ausserhofer Dietmar , Simon Michael 
Published: November 2020

Abstract
Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights might improve the prediction of in-hospital mortality. The present study, therefore, aimed to derive a set of new Swiss Elixhauser comorbidity weightings, to validate and compare them against those of the Charlson and Elixhauser-based van Walraven weightings in an adult in-patient population-based cohort of general hospitals. Methods: Retrospective analysis was conducted with routine data of 102 Swiss general hospitals (2012–2017) for 6.09 million inpatient cases. To derive the Swiss weightings for the Elixhauser comorbidity index, we randomly halved the inpatient data and validated the results of part 1 alongside the established weighting systems in part 2, to predict in-hospital mortality. Charlson and van Walraven weightings were applied to Charlson and Elixhauser comorbidity indices. Derivation and validation of weightings were conducted with generalized additive models adjusted for age, gender and hospital types. Results: Overall, the Elixhauser indices, c-statistic with Swiss weights (0.867, 95% CI: 0.865–0.868) and van Walraven’s weights (0.863, 95% CI: 0.862-0.864) had substantial advantage over Charlson’s weights (0.850, 95% CI: 0.849–0.851) and in the derivation and validation groups. The net reclassification improvement of new Swiss weights improved the predictive performance by 1.6% on the Elixhauser-van Walraven and 4.9% on the Charlson weightings.Conclusions: All weightings confirmed previous results with the national dataset. The new Swiss weightings model improved slightly the prediction of in-hospital mortality in Swiss hospitals. The newly derive weights support patient population-based analysis of in-hospital mortality and seek country or specific cohort-based weightings.
Optimal timing of ureteroscopic lithotripsy after the initial drainage treatment and risk factors for postoperative febrile urinary tract infection in patients with obstructive pyelonephritis: a retrospective study
Authors: Itami Yoshitaka , Miyake Makito , Owari Takuya , Iwamoto Takashi , Gotoh Daisuke , Momose Hitoshi , Fujimoto Kiyohide , Hirao Shuya 
Published: November 2020

Abstract
Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment.Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined.Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to sepsis (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL.Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.
Improving case detection of tuberculosis in hospitalised Kenyan children– employing the Behaviour Change Wheel to aid intervention design and implementation
Authors: Oliwa Jacquie Narotso , Nzinga Jacinta , Masini Enos , Hensbroek Michaël Boele van , Jones Caroline , English Mike , Hoog Anja van't 
Published: November 2020

Abstract
Background The true burden of tuberculosis in children remains unknown, but approximately 65% go undetected each year. Guidelines for tuberculosis clinical decision-making are in place in Kenya and the National Tuberculosis programme conducts several trainings on them yearly. By 2018, there were 183 GeneXpert® machines in Kenyan public hospitals. Despite these efforts, diagnostic tests are underused and there is observed under detection of tuberculosis in children. We describe the process of designing a contextually appropriate, theory-informed intervention to improve case detection of TB in children and implementation guided by the Behaviour Change Wheel.Methods We used an iterative process, going back and forth from quantitative and qualitative empiric data to reviewing literature, and applying the Behaviour Change Wheel guide. The key questions reflected on included: i) what is the problem we are trying to solve; ii) what behaviours are we trying to change and in what way; iii) what will it take to bring about desired change; iv) what types of interventions are likely to bring about desired change; v) what should be the specific intervention content and how should this be implemented?Results The following behaviour change intervention functions were identified: i) training: imparting practical skills; ii) modelling: providing an example for people to aspire/imitate; iii) persuasion: using communication to induce positive or negative feelings or stimulate action; iv) environmental restructuring: changing the physical or social context; and v) education: increasing knowledge or understanding. The process resulted in a multi-faceted intervention package composed of redesigning of child tuberculosis training; careful selection of champions; use of audit and feedback linked to group problem solving; and work flow restructuring with role specification.Conclusion The intervention components were selected for their effectiveness (from literature), affordability, acceptability and practicability and designed so that TB programme officers and hospital managers can be supported to implement them with relative ease, alongside their daily duties. This work contributes to the field of implementation science by utilising clear definitions and descriptions of underlying mechanisms of interventions that will guide others to do likewise in their settings for similar problems.
Efficacy of EUS-guided FNB using a Franseen needle for tissue acquisition and microsatellite instability evaluation in unresectable pancreatic lesions
Authors: Sugimoto Mitsuru , Irie Hiroki , Takagi Tadayuki , Suzuki Rei , Konno Naoki , Asama Hiroyuki , Sato Yuki , Nakamura Jun , Takasumi Mika , Hashimoto Minami , Kato Tsunetaka , Kobashi Ryoichiro , Kobayashi Yasuyuki , Hashimoto Yuko , Hikichi Takuto , Ohira Hiromasa 
Published: November 2020

Abstract
Background: The efficacy of immune checkpoint blockade in the treatment of microsatellite instability (MSI)-high tumors was recently reported. Therefore, the acquisition of histological specimens is desired in cases of unresectable solid pancreatic lesions (UR SPLs). This study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for UR SPL tissue acquisition and MSI evaluation.Methods: A total of 195 SPL patients who underwent EUS-guided fine-needle aspiration (EUS-FNA) or EUS-FNB (EUS-FNAB) between January 2017 and March 2020 were enrolled in this study. Among them, 89 SPL patients (FNB: 28, FNA: 61) underwent EUS-FNAB using a 22-G needle (UR SPLs: 58, FNB: 22, FNA: 36) (UR SPLs after starting MSI evaluation: 23, FNB: 9, FNA: 14).Results: The puncture number was significantly lower with FNB than with FNA (median (range): 3 (2-5) vs 4 (1-8), P < 0.01, UR SPLs: 3 (2-5) vs 4 (1-8), P = 0.036). Histological specimen acquisition was more commonly achieved with FNB than with FNA (92.9% (26/28) vs 68.9% (42/61), P = 0.015, UR SPLs: 100% (22/22) vs 72.2% (26/36), P < 0.01). The histological specimen required for MSI evaluation was acquired more often with FNB than with FNA (88.9% (8/9) vs 35.7% (5/14), P = 0.03).Conclusions: EUS-FNB using a Franseen needle is efficient for histological specimen acquisition and sampling the required amount of specimen for MSI evaluation in UR SPL patients.Trial registrationNot applicable
Maternal factors of newborn low birthweight in malaria endemic settings of Nanoro, rural Burkina Faso
Authors: Lingani Moussa , Zango Serge H. , Valéa Innocent , Valia Daniel , Sanou Maïmouna , Samandoulougou Sékou O. , Robert Annie , Tinto Halidou , Dramaix Michèle , Donnen Philippe 
Published: November 2020

Abstract
Background. In sub-Saharan Africa, the intermittent preventive treatment of malaria in pregnancy using sulphadoxine pyrimethamine (IPTp-SP) strategy is recommended to limit malaria adverse effects on birth outcomes. Ten year after IPTp-SP was adopted in Burkina Faso, we assessed the magnitude and maternal factors of low birthweight (LBW) in Nanoro.Methods. A secondary analysis of data from a cross-sectional study was carried out in women who gave birth at Nanoro peripheral health centers using a binary multivariate logistic regression. Maternal socio-demographic factors, gyneco-obstetrical history and relevant medical characteristics were evaluated to identify associated factors. A p-value less than 0.05 was considered statistically significant.Results. Of 291 delivery records examined, 14 % of women received three or more doses of SP while 80% used bed nets the night before their admission for delivery. Malaria was detected in 36.1% and anemia in 52.9% of women. The average neonate birthweight was 2933 g and 12 % were born with a low birthweight. By multivariate analysis, first delivery (OR = 8.84, [95% CI: 3.72-21.01]), and being multiparous with history of stillbirth (OR = 5.03, [95% CI: 1.54-16.40]) were significantly associated with an increased risk of LBW.Conclusion. LBW was still prevalent in rural Nanoro and the uptake of three or more doses of SP for the IPTp was low. In addition, to improving the coverage of the 3-dose IPTp-SP, it may be necessary to target interventions aiming to reduce maternal anemia such as adequate nutrients uptake to mitigate the issue of adverse birth outcomes.
Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study
Authors: Yu Yue , Yao Ren-qi , Zhang Yu-feng , Wang Su-yu , Xi Wang , Wang Jun-nan , Huang Xiao-yi , Yao Yong-ming , Wang Zhinong 
Published: November 2020

Abstract
Background: The clinical efficiency of routine oxygen therapy is uncertain in patients with acute heart failure (AHF) who do not have hypoxemia. The aim of this study was to investigate the association between oxygen therapy and clinical outcomes in normoxemic patients hospitalized with AHF using real-world data.Methods: Normoxemic patients diagnosed with AHF on ICU admission from the electronic ICU (eICU) Collaborative Research Database were included in the current study, in which the study population was divided into the oxygen therapy group and the ambient-air group. Propensity score matching (PSM) was applied to create a balanced covariate distribution between patients receiving supplemental oxygen and those exposed to ambient air. Linear regression and logistic regression models were performed to assess the associations between oxygen therapy and length of stay (LOS), and all-cause in-hospital as well as ICU mortality rates, respectively. A series of sensitivity and subgroup analyses were conducted to further validate the robustness of our findings.Results: A total of 2,922 normoxemic patients with AHF were finally included in the analysis. Overall, 42.1% (1,230/2,922) patients were exposed to oxygen therapy, and 57.9% (1,692/2,922) patients did not receive oxygen therapy (defined as the ambient-air group). After PSM analysis, 1,122 pairs of patients were matched: each patient receiving oxygen therapy was matched with a patient without receiving supplemental oxygen. The multivariable logistic model showed that there was no significant interaction between the ambient air and oxygen group for all-cause in-hospital mortality (odds ratio [OR] 1.30; 95% confidence interval [CI] 0.92-1.82; P＝0.138) or ICU mortality (OR 1.39; 95% CI 0.83-2.32; P＝0.206) in the post-PSM cohorts. In addition, linear regression analysis revealed that oxygen therapy was associated with prolonged ICU LOS (OR 1.11; 95% CI 1.06-1.15; P＜0.001) and hospital LOS (OR 1.06; 95% CI 1.01-1.10; P＝0.009) after PSM. Furthermore, the absence of an effect of supplemental oxygen on mortality was consistent in all subgroups.Conclusions: Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality.
The Practice of China CDC’s Emergency Operations Center (EOC)
Authors: Ding Fan , Li Qun , Jin Lianmei 
Published: November 2020

Abstract
Background: The EOC of Chinese Center for disease Control and Prevention (China CDC) was officially established in 2016, which has become the core department for the public health emergencies and risk response. In recent years, we have continued to improve and summarize the EOC's role and functions in different events. And we also want to share the construction status and operation management experience of the EOC of China CDC. It is also to promote the construction of global emergency operation management system.Main text: We searched the websites of WHO, USCDC and ECDC for the EOC-related concepts. And through expert interviews and personal communication with experts, we collected relevant opinions and identify additional published literature, then described the current situation of construction of China CDC’s EOC. For EOC, different organizations / agencies have different definitions. In China, the EOC is a place where CDC organizes and conducts the related emergency response work. And it is also an important part of public health emergency system construction. The China CDC’s EOC had developed a series of incident action plan (IAP) and the standardized forms for each incident. The event-specific data, context-specific data and event management data are usually obtained by different system and channel. The China CDC’s EOC would improve the staff’s abilities through an ongoing series of training and exercises. Comparing with before, the efficiency of incident response has been greatly increased after the establishment of EOC.Conclusions: The China CDC’s EOC is still growing and groping phase. It is necessary to continue theoretical learning and practice to continuously improve the capacity of the construction and operations of the EOC system. We need continued close collaboration and partnership with international organizations to enable more to be accomplished through leveraging individual institutional strengths. The standardize approach to respond to public health emergencies meet global standards needs.
Epidemiology of interdigital infections of toe web spaces in Shanghai, China: Etiology, risk factors, and therapeutic approaches
Authors: Yu Qian , Li Wei , Kan Siyue , Liu Xiaoping , Yang Hong , Gao Zhiqin , Chen Jian , Yang Lianjuan 
Published: November 2020

Abstract
Background

Interdigital infections are frequently misdiagnosed as tinea pedis and remain intractable to treatments because of high recurrence rates and potential complications. We aimed to understand the epidemiology of interdigital infections in Shanghai, China.
Methods

We conducted a cross-sectional study at Shanghai Dermatology Hospital from January 2019 to December 2019, enrolling 57 patients with acute interdigital inflammation. Patients received antibiotic therapy and underwent long-term follow-up. Clinical features and medical histories, including blood, bacterial, and mycologic examination results, cultures and drug susceptibility test results, and follow-up data were analyzed for pathogenic agents.
Results

We found Pseudomonas aeruginosa (40.35%), Staphylococcus aureus (36.84%), and other bacteria (22.8%). Compared to other bacteria, P. aeruginosa interdigital infection were more inclined to co-infect with fungal agents. Further, P. aeruginosa interdigital infections were frequently seen in the spring and autumn and in patients aged 60–69 years. However, interdigital infections caused by S. aureus occurred more frequently in the summer and in patients aged 31–40 years. We found that levofloxacin had excellent therapeutic effects.
Conclusion

Our findings may inform treatment and diagnostic guidelines and, subsequently, help reduce the rate of recurrence and improve patient outcomes following interdigital infections.