bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a structured e-learning-based approach to CT anatomy of the paranasal sinuses for medical students
Authors: Krahe Anna Marleen , Ketterer Manuel Christoph , Offergeld Christian , Hildenbrand Tanja 
Published: June 2020

Abstract
Background: Computed tomography (CT) anatomy is not an integral part of undergraduate medical training in many countries. Radiology seems to be well suited for new online based teaching methods. The aim of the study was to evaluate whether e-learning is appropriate to introduce complex learning contents such as sinus CT anatomy in novices and to assess the usefulness of a sinus CT checklist to identify relevant anatomical variants in medical students. Material: Medical students were asked to assess sinus CT scans for anatomical variants before and after the implementation of the CLOSE mnemonic. Sinus CT anatomy and the CLOSE mnemonic were introduced by e-learning. The rate of correctly identified variants and the results of the individual CLOSE items were recorded and compared with those of otolaryngology residents. A questionnaire was distributed for subjective evaluation of the usefulness of the checklist and e-learning.Results: Ten students took part in the study. The rate of correctly identified variants improved significantly from 33.3% to 61.1%. The analysis of the individual CLOSE items showed a significant improvement for C, S and E in students and C, L and S in otolaryngology residents. The students identified more anatomical variants compared to the residents. The subjective evaluation of the CLOSE mnemonic and e-learning was very positive.Conclusion: E-learning was able to transfer complex learning contents in previously non-trained medical students and was evaluated as an appropriate introduction to the topics. The structured assessment of paranasal sinus CT scans using the CLOSE criteria can significantly improve the recognition of anatomical variants.
Plasma levels of long-acting injectable antipsychotics in outpatient care: a retrospective analysis
Authors: Hýža Martin , Petr Šilhán , Eva Češková , Tomáš Skřont , Ivana Kacířová , Romana Uřinovská , Milan Grundmann 
Published: June 2020

Abstract
Background
The antipsychotic efficacy in schizophrenia depends on its availability in the organism. Although therapeutic outcomes remain still far from satisfactory, therapeutic drug monitoring is not a common part of clinical practice during a treatment with long-acting injectable antipsychotics (LAI AP). The real effectiveness of LAI AP is thus uncertain.
Methods
We made a retrospective evaluation of plasma levels of LAI AP. Collection of blood samples was performed just before the drug application and one week later. Fourty patients with a stabilized clinical condition and steady-state plasma levels were included.
Results
In the observed cohort of patients, flupentixol decanoate (n = 23) was the most often used drug, followed by fluphenazine decanoate (n = 7), haloperidol decanoate (n = 5), paliperidon palmitate (n = 3), and risperidone microspheres (n = 2). Just 5 of 40 patients were treated with a monotherapy. At the time before the application, 60% of the patients did not reach the therapeutic reference range (TRR) and 20% of the patients had an undetectable plasma level. At the time of collection of the second blood samples performed after 7 days, 24% of the patients were under the TRR.
Conclusion
We have found the surprisingly high incidence of plasma levels under the TRR in patients treated with LAI AP. Notwithstanding the individual variability in pharmacokinetics, it seems the LAI AP may be underdosed in the usual clinical practice.
Predictors of dropout from maternal continuum of care in Ethiopia: evidence from the 2016 population-based health survey
Authors: Boltena Minyahil Tadesse , Mohamedsanni Afrah , Asamoah Benedict Oppong , Lemma Lire , Gebre Meklit Tesfaye , Khatib Ziad , Temesgen Kababa , Kebede Abraham Sahlemichael 
Published: June 2020

Abstract
IntroductionIntegrated primary health care service provided by skilled birth attendants is linked to safe childbirth and postnatal care, vitally improves maternal, newborn, and child health outcomes. Despite a significant reduction in maternal and neonatal mortality in Ethiopia, low maternal service utilization, and dropout from the maternal continuum of care continues to be a major challenge. Therefore, this study aimed to investigate the individual and community predictors of dropout from the maternal continuum of care in Ethiopia.MethodsWe used data from the 2016 Ethiopian demographic and health survey (EDHS). Women who had a birth in the 5 years preceding the survey were included. Dropout from the maternal continuum of care was the outcome of this study. This includes, attending less than four antenatal care visits (<4 ANC), a dropout from skilled birth attendance (SBA) after having 4 or more ANC, and dropout from postnatal care (PNC) after having SBA. Multilevel logistic regression analysis was employed. The mixed effect and variation in the outcome were expressed by the intracluster correlation coefficient (ICC).ResultsHigher dropouts from SBA to PNC (85%) and from ≥4 ANC to SBA (43.4%) in the maternal continuum of care were observed. Women from the poorest wealth quantile (AOR=2.31,95% CI 1.69,3.16), not covered by health insurance (AOR=1.44, 95% CI, 1.01,2.06), and residing in a community with high poverty (AOR=1.28,95% CI, 1.01,1.63) were more likely to attend inadequate ANC. On the other side, distance from a health facility (AOR=1.45, 95% CI, 1.12,1.88), lower community media exposure (AOR=1.6, 95% CI, 1.14,2.23) and rural residency (AOR=3.03, 95% CI, 1.75,5.26) were associated with dropout from SBA after attending ANC visits. Living in Somali, Harari, and Dire Dawa significantly associated with drop out from the PNC after SBA.ConclusionThe pattern of dropout from the maternal continuum of care was higher in Ethiopia. Maternal education, wealth index, community media exposure, and distance from a health facility were the factors associated with dropouts from the maternal continuum of care. Home care strategies and contextual understanding of the barriers to the PNC service is needed.
Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria
Authors: Solanke Lukman Bola , Oduyoye Olumuyiwa Adebisi , Oni Tosin Olajide 
Published: June 2020

Abstract
Background: Advanced Maternal Age (AMA) pregnancy refers to pregnancy in women aged 35 years or older at the time of delivery. Existing studies have been more concerned with the obstetrics implication of AMA pregnancy. The associated social factors such as the individual and community level factors have remained largely unexplored particularly in population-based studies. This study examines the individual and community level factors associated with AMA pregnancy in Nigeria.Methods: Data were extracted from the 2018 Nigeria Demographic and Health Survey. A weighted sample of 13,105 women was analysed. The outcome variable was AMA pregnancy. The explanatory variables were individual characteristics (age, marital status, media exposure, current contraceptive use, period spent schooling, female autonomy, remarriage and income group) and community characteristics (proportion who delayed marriage in community, community level of female higher education, proportion of female in professional occupation in community, proportion of divorced or separated women in community, proportion of women in commuter marriage, type of community and geo-political zone of residence). Three mixed-effects multilevel logistic regression models were estimated. Results: Findings reveal 10.9% prevalence of AMA pregnancy in Nigeria. While the odds of AMA pregnancy were lower among women in very advanced (AOR=0.592, p<0.001; 95% CI: 0.509-0.688) and extremely advanced (AOR=0.290, p<0.001; 95% CI: 0.239-0.353) (AOR=1.794, p<0.001; 95% CI: 1.580-2.008) age groups, the odds were higher among women who had high exposure to mass media (AOR=1.794, p<0.001; 95% CI: 1.580-2.008), long schooling period (AOR=2.680, p<0.001; 95% CI: 2.058-3.488), remarried (AOR=2.269, p<0.001; 95% CI: 1.915-2.688) and from richest households (AOR=1.271, p<0.05; 95% CI: 1.098-1.472). The values of the Intra-Class Correlation (ICC) across the three fitted models reveal significant effects of the community characteristics on the odds of AMA pregnancy.Conclusion: Individual and community characteristics have important effects on AMA pregnancy. Health planners and authorities in the country should include AMA pregnancy as one of the priority areas of women’s health and safe motherhood strategies in addition to raising awareness of the obstetrics implication of AMA pregnancy through community-based public health education programme.
Influence of Socio-Economic, Demographic and Climate Factors on the Regional Distribution of Dengue in the United States and Mexico
Authors: Watts Matthew , Kotsilla Panagiota , Mortyn P Graham , Monteys Victor Sarto i , Brancati Cesira Urzi 
Published: June 2020

Abstract
Background: Dengue is one of the important vector-borne diseases in the world today; it infects tens of millions of people each year and has been on the rise since the 1950s. In this study, we develop a set of indicators that help us examine the impact of socio-economic and demographic factors on the occurrence of dengue in regions of the United States and Mexico. Methods: We assess the relationship between dengue occurrence in humans, climate factors (temperature and minimum quarterly rainfall), socio-economic factors (such as household income, regional rates of education, housing overcrowding, life expectancy, and medical resources), and demographic factors (such as migration flows, age structure of the population, and population density). Areas at risk of dengue are first selected based on the predicted presence of at least one of the two mosquito vectors responsible for dengue’s transmission: Aedes aegypti and Aedes albopictus. In those regions where the vectors had a high probability of presence, we assess the impact of the composite socio-economic indicators (derived through factor analysis to account for collinearity), and three composite demographic indicators (also derived from factor analysis) on the regional distribution of dengue cases, controlling for climate and spatial correlation. Results: We found that an increase of one unit in one of our socio-economic indicators representing labour force with at least secondary education, better broadband access, and rooms per inhabitant, a higher proportions of active physicians is related to a drop in the occurrence of dengue, whereas the demographic indicators such as population density, age structure of the population and population growth showed no significant impact after taking climate into account. More importantly, our socio-economic indicator can also explain differences in the occurrence of dengue across Mexico, whereas simpler measures, such as regional GDP could not. Conclusions: These results suggest that the set of indicators developed is a better indicator than GDP at predicting the distribution of dengue, by capturing information that is much more tailored to poverty related conditions which aid dengue transmission. Given that data for these indicators are available at a sub-national scale for OECD countries and selected OECD non-member economies, these indices may help us better understand factors responsible for the global distribution of dengue and also, given a warming climate, may help us to better predict vulnerable populations.
Evaluation of the Content Validity Index of the Australian Canadian hand OA Index, the Patient-Rated Wrist/Hand Evaluation and the Thumb Disability Exam in people with hand arthritis
Authors: Bobos Pavlos , MacDermid Joy C , Boutsikari Eleni C. , Lalone Emily A. , Ferreira Louis , Grewal Ruby 
Published: June 2020

Abstract
BackgroundThe Australian Canadian hand OA Index (AUSCAN), the Patient-Rated Wrist/Hand Evaluation (PRWHE) and the Thumb Disability Exam (TDX) are patient-reported outcome measures (PROM) used to assess pain and hand function in patients with hand arthritis. This study evaluated the content validity of PRWHE, AUSCAN and TDX. MethodsThis study enrolled participants with hand arthritis to rate the items of all 3 PROM in terms of relevance and clarity. The Content Validity Index (CVI) was computed for each item in each scale (I-CVI) as well as for the overall scale (S-CVI). Kappa was used to determine the inter-rater agreement among the experts. ResultsOverall, 64 individuals with hand arthritis (27% with OA, 67% with rheumatoid arthritis and 6% with psoriatic arthritis) participated in the study. The I-CVI for all items and all scales was very high (I-CVI > 0.76) and the modified Kappa agreement among the raters demonstrated excellent agreement (k>0.76).The S-CVI for all PROMs was found very high for relevance (PRWHE = 0.85, 95% CI 0.82 to 0.88; TDX = 0.87, 95% CI 0.85 to 0.89 and AUSCAN = 0.92, 95% CI 0.90 to 0.94) and for clarity (PRWHE = 0.95, 95% CI 0.93 to 0.97; TDX = 0.91, 95% CI 0.89 to 0.94 and AUSCAN = 0.99, 95% CI 0.98 to 1.00) respectively. ConclusionsThis study demonstrated very high content validity indices for the PRWHE, AUSCAN, and TDX; with strong consensus across reviewers. This augments prior statistical evidence supporting statistical measurement properties, to provide support for the content validity.
A Systematic Review and Metanalyis of Soil Transmitted Helminths Infections Among Preschool and School-age Children in Ethiopia: Evaluation of Neglected Tropica Diseases (NTDS) Elimination Program by 2020
Authors: Chelkeba Legese , Melaku Tsegaye , Emana Daniel , Jimma Worku 
Published: June 2020

Abstract
Background: Comprehensive nationwide on prevalence, geographic distribution of different species and time trends of soil-transmitted helminths (STHs) are lacking. Therefore, the aim of this study was to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia. Methods: The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on data published between 1995 to Fabruary 2020 for studies describing rate of STHs infection among preschool and school-age in Ethiopian. We followed Patient, intervention, Comparsion and Outcome (PICO) approach to identify the studies. Endnote citation manager software version X9 for Windows was utilized to collect and organize search outcomes (into relevant and irrelevant studies) and for removal duplicate articles . We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using ‘metaprop’ command using STATA software version 14.Results: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48 % (95%CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95%CI : 31% - 58%) in SNNPR, 34%((95%CI : 28% - 41%) in Amhara region, 31% (95%CI : 19% - 43%) in Oromia region and 10% (95%CI : 7% - 12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI:30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI:25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A. lumbricoides was the predominant species with a prevalence of 17%. Conclusion: Southern Nations Nationalities and Peoples Region , Amhara and Oromia regions carry the highest burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring mass drug administration (MDA) once annually with Albendazole or Mebendazole. Prevalence of SHTs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia.
Design and study of Solid Waste Management in Ranchi, Jharkhand
Authors: Aman Ankish , Srivast PK 
Published: June 2020

Abstract
Solid waste management (SWM) have becomes a very serious concern globally. The lack of individual responsibilities as well as proper attitude and approach leads to this issue. Rapid industrialization, increase in population and further increase in standard of living and poor waste management have increased the serous health issue. Ranchi city need to be taken care by various new SWM techniques, proper management skill and adequate care the diseases and improve medical conditions. This paper deals with the proper description of the current MSWM process and the real time scenario where every individual is a source of waste creation. The effect of growing population of last ten years outcome of waste quality and quantity generated throughout these years have been discussed. It is observed that more than 4000 tons of waste per month is being generated. Researches shows that the disposal of solid waste requires 2,700,000 m2 area for the landfill up to the year 2030. Far sustainable development and effective management it is suggested that implementation of newer technologies, training of common people, and effective implementation of government policies will help to come out of these current issues.
Achene morphology and pericarp anatomy of Anemone Hepatica and Pulsatilla (Anemoninae, Ranunculaceae)
Authors: Ghimire Balkrishna , Son Dong Chan , Yum Dabin , Kim Jae Hyun , Jeong Mi Jin 
Published: June 2020

Abstract
Background

Fruit morphological characters have contributing useful taxonomic data and thus used to discriminate the species in different taxonomic rank. The fruit and seed morphology and anatomy in the family Ranunculaceae has been a long history and proved to be a great value for its phylogeny.
Methods

Achene morphology and pericarp anatomy of 12 taxa representing three genera (Anemone, Hepatica, and Pulsatilla) of tribe Anemoninae were investigated using microtome and light microscopy (LM) to evaluate taxonomic implications of achene characters.
Results

The achenes of Anemone were elliptical or obovoid and beaked, whereas the achene of Hepatica and Pulsatilla were obovoid and elliptical, respectively. Noticeable variations in both quantitative and qualitative features of achenes were observed among the species of three genera. One-way ANOVA indicated that the quantitative achene variables among the species were highly significant (P < 0.001). Pearson’s correlation coefficient also showed a significant correlation between different achene variables. The pericarp structure, particularly the number of cell layers and cell form in exocarp and endocarp seems to very useful for species delimitation in Amenome and Hepatica. The nature of endotesta could provide a substantial proof for sub-generic classification in Anemone. The UPGMA analysis also showed the utility of achene features for taxonomic groupings of the species within studied genera.
Conclusion

Although the sampling specimens represented a limited range of taxa the achene features and pericarp anatomy provide a reasonable source for the taxonomic treatment of studied genera within the tribe.
Impact of barometric pressure on adhesive small bowel obstruction: A retrospective study
Authors: Yamamoto Yuta , Miyagawa Yusuke , Kitazawa Masato , Tanaka Hiokazu , Kuroiwa Masatsugu , Hondo Nao , Koyama Makoto , Nakamura Satoshi , Tokumaru Shigeo , Muranaka Futoshi , Soejima Yuji 
Published: June 2020

Abstract
Background
Adhesive small bowel obstruction (ASBO) is one of the most common causes of postoperative morbidity. According to Boyle’s law, decreased barometric pressure causes the volume of intestinal gas to expand. We aimed to elucidate the relationship between barometric pressure and ASBO.
Methods
We divided 215 admissions of 120 patients with ASBO into three groups: fasting group with response to fasting (n = 51); decompression group with successful treatment of gastrointestinal decompression (n = 104); and surgery group that required emergency or elective surgery to treat ASBO (n = 60). We compared and examined clinical backgrounds, findings on admission, and barometric pressure during the peri-onset period (29 days: from 14 days before to 14 days after the onset of ASBO).
Results
There were significant difference among the three groups in gender, history of ASBO, hospital length of stay, and barometric pressure on the onset day of ASBO. Barometric pressure on the onset day was significantly higher in the fasting group than in the decompression group (p = 0.005). During pre-onset day 5 to post-onset day 2, fluctuations in the barometric pressure in the fasting and decompression groups showed reciprocal changes with a symmetrical axis overlapping the median barometric pressure in Matsumoto City, and the fluctuations tapered over time after onset. In the fasting group, the barometric pressure on the onset day was significantly higher than that on pre-onset days 14, 11, 7, 4, 3, 2; post-onset days 3, 10; and the median pressure in Matsumoto City. Conversely, in the decompression group, the barometric pressure on the onset day was lower than that on pre-onset days 14, 5 − 2; post-onset days 1, 2, 7, 8, 11, 13, 14; and the median pressure in Matsumoto City. In the surgery group, the barometric pressure on the onset day was equivalent to those on the other days.
Conclusion
ASBO with response to conservative treatment is vulnerable to barometric pressure. Additionally, ASBO successfully treated with fasting and decompression is associated with a different barometric pressure on the onset day and reciprocal fluctuations in the barometric pressure during the peri-onset period.
Estimating the impact of donor programs on child mortality in low- and middle-income countries: a synthetic control analysis of child health programs funded by the United States Agency for International Development
Authors: Weiss William M. , Bhumika Piya , Andrus Althea , Cohen Robert 
Published: June 2020

Abstract
Background Significant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes. Methods This study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016. Results In the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses. Conclusions The synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.