bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: a systematic review
Authors: Williams H. M. , Hunter K. , Clapham K. , Ryder C. , Kimble R. , Griffin B. 
Published: March 2020

Abstract
Background
Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear.

Methods
A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health.

Results
Of the 3178 identified references, 17 were eligible. These include distraction based techniques (n = 8), hypnosis/familiar imagery (n = 2), therapeutic approaches (n = 4), and patient preparation/procedural control (n = 3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers or focused on reducing their symptoms.

Conclusions
The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.
The application of lateral-rectus approach on toddlers’ unstable pelvic fractures
Authors: Liu Yuancheng , Zhan Xiaorui , Huang Fuming , Wen Xiangyuan , Chen Yuhui , Yang Cheng , Fan Shicai 
Published: March 2020

Abstract
Background
Pelvic fractures are rare in toddlers but are often associated with other injuries that make treatment difficult. Conservative treatment has been used with moderate success, but it is unclear if surgical correction could confer additional benefits and improve patient outcomes. The purpose of this study was to report authors’ experience using the lateral-rectus approach (LRA) for surgical correction of unstable pelvic fractures in two toddlers.

Methods
We retrospectively analyzed the cases of two toddlers with unstable pelvic fractures who underwent surgery through the LRA between April 2016 and October 2018. Patients’ characteristics, fracture type, mechanism of injury, Injury Severity Score (ISS), operative time, intra-operative blood loss, and post-operative complications were assessed. Pelvic asymmetry, degree of deformity, Cole scoring criteria and modified Barthel Index (MBI) were used to evaluate radiographic and functional outcomes.

Results
Successful surgical treatment was performed using the LRA, external fixation, and sacroiliac screw fixation. Surgery duration was 180 min on average, with an average intra-operative bleeding of 250 ml. There were no iatrogenic nerve injuries or infections. Pelvic asymmetry a week after surgery was 0.5 cm on average and dropped to 0.3 cm on average at the end of the follow-up period. The deformity index of the pelvis dropped from an average of 0.035 a week after surgery to 0.02 at the end of the follow-up period. The mean MBI was 100 in the last follow-up, and Cole scoring criteria categorized both patients as being in excellent condition. All patients achieved radiological bone union without discrepancy in length of the lower limbs. Neither patient had loss of reduction nor evidence of low back pain during the mean follow-up period of 22 months.

Conclusions
Pelvic fracture in toddlers is rare, and surgical treatment requires careful consideration. The lateral-rectus approach was proven as a viable alternative for managing unstable pelvic fractures in toddlers, with minimal blood loss and risk of nerve injury. Furthermore, anterior external fixation and posterior sacroiliac screw fixation would be adequate for this population, with excellent final outcome.
Prevalence and risk factors of obstetric fistula: implementation of a need-based preventive action plan in a South-eastern rural community of India
Authors: Swain Dharitri , Parida Swayam Pragyan , Jena Saubhagya Kumar , Das Mahasweta , Das Hrushikesh 
Published: March 2020

Abstract
Background
The study was conducted to estimate the prevalence and risk factors of obstetric fistula in the rural area of the south eastern community of India and the training of community health workers for its prevention.

Methods
A population-based cross-sectional analytical study was conducted in the south eastern rural community of India. A total of 3939 women were included in the study and Probability proportional to size sampling was used in the study. Frequency distribution and logistic regression were computed to analyse the data using STATA version 11.2.

Results
Out of 3939 participants interviewed, 23.7% women reported obstetric fistula symptoms whereas after clinical diagnosis and speculum examination the obstetric morbidity pattern was: Obstetric fistula 0.3%, stress urinary incontinence 20.0%, pelvic inflammatory diseases 1.2%, uterine prolapse 1.4% and urinary tract infection 3.8%. The awareness level of the rural women regarding the obstetric fistula was assessed by a structured knowledge questionnaire and found to be very poor, hence community based fistula training was implemented among community health workers as a health system based strategy for its prevention. Obstetric fistula found to be more prevalent among women of poor educational level, low socioeconomic status, less no of antenatal visits, delay in accessing the emergency obstetric care and prolonged labour (p ≤ 0.05).

Conclusion
Finding of the study indicated that the prevalence and risk of developing obstetric fistula was associated with less number of antenatal visits, prolonged labour, delay in timely intervention, delay in accessing emergency obstetric care and more number of movements from home to the delivery place. Finally, our study suggests that emphasis needs to be placed on training of community health workers to facilitate early screening for identification and referral of women with obstetric fistula.
Where to enhance rural palliative care? Developing a spatial model to identify suitable communities most in need of service enhancement
Authors: Schuurman Nadine , Martin Michael E. , Crooks Valorie A. , Randall Ellen 
Published: March 2020

Abstract
Background
In Canada, access to palliative care is a growing concern, particularly in rural communities. These communities have constrained health care services and accessing local palliative care can be challenging. The Site Suitability Model (SSM) was developed to identify rural “candidate” communities with need for palliative care services and existing health service capacity that could be enhanced to support a secondary palliative care hub. The purpose of this study was to test the feasibility of implementing the SSM in Ontario by generating a ranked summary of rural “candidate” communities as potential secondary palliative care hubs.

Methods
Using Census data combined with community-level data, the SSM was applied to assess the suitability of 12 communities as rural secondary palliative care hubs. Scores from 0 to 1 were generated for four equally-weighted components: (1) population as the total population living within a 1-h drive of a candidate community; (2) isolation as travel time from that community to the nearest community with palliative care services; (3) vulnerability as community need based on a palliative care index score; and (4) community readiness as five dimensions of fit between a candidate community and a secondary palliative care hub. Component scores were summed for the SSM score and adjusted to range from 0 to 1.

Results
Population scores for the 12 communities ranged widely (0.19–1.00), as did isolation scores (0.16–0.94). Vulnerability scores ranged more narrowly (0.27–0.35), while community readiness scores ranged from 0.4–1.0. These component scores revealed information about each community’s particular strengths and weaknesses. Final SSM scores ranged from a low of 0.33 to a high of 0.76.

Conclusions
The SSM was readily implemented in Ontario. Final scores generated a ranked list based on the relative suitability of candidate communities to become secondary palliative care hubs. This list provides information for policy makers to make allocation decisions regarding rural palliative services. The calculation of each community’s scores also generates information for local policy makers about how best to provide these services within their communities. The multi-factorial structure of the model enables decision makers to adapt the relative weights of its components.
From malaria control to elimination within a decade: lessons learned from Timor Leste, a newly independent country
Authors: Manel Yapabandara A. M. G. , do Rosario de Fatima Mota Maria , Sarmento Raul , Bosco Johanes don , Wickremasinghe Rajitha 
Published: March 2020

Abstract
Background
Timor Leste has made remarkable progress from malaria control to malaria elimination in a span of 10 years during which organized malaria control efforts were instituted. The good practices and possible factors that have contributed to the remarkable transition from malaria control to elimination in a newly independent country devastated by civil unrest which left the entire administrative structure including the health sector in a disrupted non-functional state are highlighted.

Methods
Data from the National Malaria Control Programme were reviewed. A literature search was carried out using the key words “malaria”, “Timor Leste”, “East Timor”, and “malaria control” and “malaria elimination”. All relevant manuscripts and reports that were identified in the search were reviewed. Key personnel of the NMCP, WHO and the GFATM involved in the project were interviewed.

Results
With the setting up of the National Malaria Control Programme just after independence in 2003 with two officers, the programme expanded over the years and strategic malaria control activities in an organized manner commenced in 2009 with funding from the Global Fund to fight AIDS, Tuberculosis and Malaria. The incidence of malaria declined dramatically from 223,002 cases in 2006 with the last indigenous case being reported in June 2017. The decline in malaria was associated with strategic application of key evidence-based interventions taking into account the burden of disease, characteristics of vectors, and stratification of risk areas ensuring universal access to malaria prevention, and quality assured diagnostic tools and effective anti-malarial medicines at point of care, intensified surveillance, monitoring and evaluation, and capacity building, including training of staff, with adequate programme funding. The programme was provided with technical expertise and sustained political commitment that ensured uninterrupted implementation of interventions based on national strategic plans. The incorporation of the malaria control programme within an evolving health system helped the transition from malaria control to malaria elimination.

Conclusion
Universal access to quality assured malaria diagnosis and treatment and focussed vector control, implemented throughout the country in an organized manner with adequate funding and political commitment were key to the successful interruption of malaria transmission in the country. All the practices or factors listed did not work in isolation but rather synergistically in an integrated manner. Malaria elimination is possible even in tropical areas of South and Southeast Asia.
Factors impacting referral of JIA patients to a tertiary level pediatric rheumatology center in North India: a retrospective cohort study
Authors: Agarwal Manjari , Freychet Caroline , Jain Sumidha , Shivpuri Abhay , Singh Anju , Dinand Veronique , Sawhney Sujata 
Published: March 2020

Abstract
Background
JIA studies demonstrate that there is a “window of opportunity” early in the disease course during which appropriate management improves outcomes. No data is available regarding patients’ pathway, before first pediatric rheumatology (PR) evaluation in India, a country where health-care costs are self- paid by patients and where a significant shortage of pediatric rheumatologists (PRsts) is known. This study aimed to describe time from onset of symptoms to first PR visit of JIA patients to a tertiary center in India and factors that impact this.

Methods
This retrospective study is from data collected at the PR center, Sir Ganga Ram Hospital (SGRH) in New Delhi. JIA patients fulfilling ILAR 2004 criteria and seen at least twice from 1st October 2013 to 30th September 2018 were included. Data collected were: demographic details, history of disease, referral practitioner, clinical and laboratory features, treatments. Mann-Whitney U-test, Chi square and logistic regression were used as appropriate to study factors that determined time to first PR visit.

Results
Five hundred and twenty patients were included: 396 were diagnosed at this PR center (group A), 124 were previously diagnosed as JIA and managed by non PRsts before first PR visit (group B). Median time from symptom onset to first PR visit was 4.1 months and median distance travelled 119.5 km. Despite ongoing treatment, group B patients had more aggressive disease and resided further away as compared to Group A patients.
On univariate analysis, factors that predicted PR visit within 3 months were private patients, short distance to travel, family history of inflammatory disease, history of fever, history of acute uveitis or high ESR. On multivariate analysis all these factors were significant except high ESR and acute uveitis.

Conclusion
Time to first PR assessment at this center was comparable to that seen in western countries. Cost of care and long distance to the center delayed consultation; acuity of complaints and family history of rheumatologic condition hastened referral.
Possible solutions to improve referral to PR centers would be to increase the number of PRsts and to improve medical insurance coverage.
Non-invasive prenatal screening for Emanuel syndrome
Authors: Luo Yuqin , Lin Jie , Sun Yixi , Qian Yeqing , Wang Liya , Chen Min , Dong Minyue , Jin Fan 
Published: March 2020

Abstract
Objective
The aim of this study was to validate the results of two Emanuel syndromes detected by non-invasive prenatal screening (NIPS) screening using invasive methods, providing clinical performance of NIPS on chromosome microduplication detection.

Methods
NIPS was performed to diagnose the Emanuel syndrome. Amniocentesis or cordocentesis was performed to confirm the positive screening result of Emanuel syndrome cases. Fetal sample was detected by karyotyping, fluorescence in situ hybridization (FISH), and single nucleotide polymorphism array (SNP Array). Parental karyotyping and FISH were also carried out.

Results
Two cases with chromosomal abnormalities of 11q23.3q25 and 22q11.1q11.21 were found by NIPS. Chromosomal karyotyping showed that the two fetuses each have a small supernumerary marker chromosome (sSMC), SNP Array further demonstrated double duplications approximately 18 Mb in 11q23.3q25 and 3 Mb in 22q11.1q11.21. FISH confirmed that the small supernumerary marker chromosome (sSMC) was ish der(22)t(11;22) (TUPLE1+, ARSA-). Ultrasound scan and MRI showed some structure malformations in two fetuses. The two mothers were found to be a balanced carrier: 46,XX, t(11;22)(q23.3;q11.2).

Conclusion
NIPS could effectively identify Emanuel syndrome, which may indicate risks of a parent being a balanced rearrangement carrier. The followed confirmation test for positive sample is necessary and ensures the accuracy of the diagnosis.
Artificial intelligence algorithm to predict the need for critical care in prehospital emergency medical services
Authors: Kang Da-Young , Cho Kyung-Jae , Kwon Oyeon , Kwon Joon-myoung , Jeon Ki-Hyun , Park Hyunho , Lee Yeha , Park Jinsik , Oh Byung-Hee 
Published: March 2020

Abstract
Background
In emergency medical services (EMSs), accurately predicting the severity of a patient’s medical condition is important for the early identification of those who are vulnerable and at high-risk. In this study, we developed and validated an artificial intelligence (AI) algorithm based on deep learning to predict the need for critical care during EMS.

Methods
We conducted a retrospective observation cohort study. The algorithm was established using development data from the Korean national emergency department information system, which were collected during visits in real time from 151 emergency departments (EDs). We validated the algorithm using EMS run sheets from two EDs. The study subjects comprised adult patients who visited EDs. The endpoint was critical care, and we used age, sex, chief complaint, symptom onset to arrival time, trauma, and initial vital signs as the predicted variables.

Results
The number of patients in the development data was 8,981,181, and the validation data comprised 2604 EMS run sheets from two hospitals. The area under the receiver operating characteristic curve of the algorithm to predict the critical care was 0.867 (95% confidence interval, [0.864–0.871]). This result outperformed the Emergency Severity Index (0.839 [0.831–0.846]), Korean Triage and Acuity System (0.824 [0.815–0.832]), National Early Warning Score (0.741 [0.734–0.748]), and Modified Early Warning Score (0.696 [0.691–0.699]).

Conclusions
The AI algorithm accurately predicted the need for the critical care of patients using information during EMS and outperformed the conventional triage tools and early warning scores.
Factors associated with the access and continuum of vaccination services among children aged 12–23 months in the emerging regions of Ethiopia: evidence from the 2016 Ethiopian demography and health survey
Authors: Debie Ayal , Lakew Ayenew Molla 
Published: March 2020

Abstract
Background
Child vaccination is an instrument for saving millions of lives. Only one in twenty children has access to childhood vaccination in hard to reach areas in developing countries. Although studies have been done on childhood vaccination, factors associated with access and continuum were not considered in Ethiopia. Therefore, this study aimed to identify the factors associated with the access and continuum of childhood vaccination in the emerging regions of Ethiopia based on the 2016 EDHS datasets.

Methods
The two-stage stratified sampling technique was used for the survey carried out on 642 mothers of children aged 12–23 months. Access is the provision of services in shorter waiting times and flexibly at all times and alternative methods of communication. Accordingly, continuum of care reflects the extent to which a series of discrete health care events are being experienced by people coherently and interconnected over time. As a result, access and continuum of childhood vaccination are determined using pentavalent-1 and measles vaccination status of children, respectively. A binary logistic regression model was fitted to identify the factors associated with access and continuum of the vaccination.

Results
Overall, 25.1% of children aged 12–23 months received all of the recommended childhood vaccines. Sixty-two percent of children accessed and 46.9% had continuum of childhood vaccination in the emerging regions of Ethiopia. Pentavalent_1 to 3 and BCG to measles dropout rates were 33.42 and 17.53%, respectively. Mothers’ formal education (AOR = 1.99; 95%CI: 1.20, 3.31), ANC (AOR = 4.13; 95%CI: 2.75,6.19), health facility delivery of last birth (AOR = 1.58; 95%CI: 1.19, 2.82), rich wealth (AOR = 1.57; 95%CI: 1.19, 3.14) and average child birth weight (AOR = 1.67; 95%CI: 1.03, 2.72) were positively associated with childhood access to vaccination. On the other hand, mothers’ ANC attendance (AOR = 3.68; 95%CI: 2.48, 5.47) and rich wealth (AOR = 2.07; 95%CI: 1.15, 3.71) were positively associated with the continuum of the services. On the contrary, children with rural resident mothers (AOR = 0.33; 95%CI: 0.14, 0.76) and small birth weight (AOR = 0.51; 95%CI: 0.33, 0.81) were negatively associated to the access and continuum of childhood vaccination, respectively.

Conclusion
Childhood vaccination status was low in the emerging regions of Ethiopia. Variables such as maternal education, birth weight of children, ANC, health facility delivery and wealth were associated with the access and continuum of the vaccination. Therefore, empowering women with education and strengthening maternal healthcare services might enhance childhood vaccination. In addition, the government needs to design a compensation mechanism for the cost relating to childhood vaccination to improve the access and continuum of the service.
Possible influence of Plasmodium/Trypanosoma co-infections on the vectorial capacity of Anopheles mosquitoes
Authors: Fofana Maty , Mitri Christian , Diallo Diawo , Rotureau Brice , Diagne Cheikh Tidiane , Gaye Alioune , Ba Yamar , Dieme Constentin , Diallo Mawlouth , Dia Ibrahima 
Published: March 2020

Abstract
Objective
In tropical Africa, trypanosomiasis is present in endemic areas with many other diseases including malaria. Because malaria vectors become more anthropo-zoophilic under the current insecticide pressure, they may be exposed to trypanosome parasites. By collecting mosquitoes in six study sites with distinct malaria infection prevalence and blood sample from cattle, we tried to assess the influence of malaria-trypanosomiasis co-endemicity on the vectorial capacity of Anopheles.

Results
Overall, all animal infections were due to Trypanosoma vivax (infection rates from 2.6 to 10.5%) in villages where the lowest Plasmodium prevalence were observed at the beginning of the study. An. gambiae s.l. displayed trophic preferences for human-animal hosts. Over 84 mosquitoes, only one was infected by Plasmodium falciparum (infection rate: 4.5%) in a site that displayed the highest prevalence at the beginning of the study. Thus, Anopheles could be exposed to Trypanosoma when they feed on infected animals. No Plasmodium infection was observed in the Trypanosoma-infected animals sites. This can be due to an interaction between both parasites as observed in mice and highlights the need of further studies considering Trypanosoma/Plasmodium mixed infections to better characterize the role of these infections in the dynamic of malaria transmission and the mechanisms involved.