bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with malnutrition in children < 5 years in western Kenya: a hospital-based unmatched case control study
Authors: Gudu Edwin , Obonyo Mark , Omballa Victor , Oyugi Elvis , Kiilu Cecilia , Githuku Jane , Gura Zeinab , Ransom James 
Published: July 2020

Abstract
Background
Globally, under-nutrition accounts for > 3 million deaths annually among children < 5 years, with Kenya having ~ 35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged < 5 years in western Kenya.

Methods
We conducted a hospital-based unmatched case-control study between May and June 2017. Cases were defined as children aged 6–59 months with either z-score for weight-for-height ≤ −2SD or ≥ +2SD; weight-for-age ≤ −2SD or ≥ +2SD; or height-for-age ≤ −2SD. Controls were children aged 6–59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select controls. Data from interviews and clinical records were collected and entered into Epi-Info, which was used to run unconditional logistic regression analyses.

Results
A total of 94 cases and 281 controls were recruited. Of the cases, 84% (79/94) were under-nourished. Mother not having attended ante-natal clinic (OR = 7.9; 95% CI: 1.5–41.2), deworming (OR = 0.8; 95% CI: 0.4–1.2), and pre-lacteal feeding (OR = 1.8; 95% CI: 1.1–3.0) were associated with under-nutrition. Delayed developmental milestones (AOR = 13.9; 95% CI: 2.8–68.6); low birth weight (AOR = 3.3; 95% CI: 1.4–7.6), and paternal lack of formal education (AOR = 4.9; 95% CI: 1.3–18.9) were independently associated with under-nutrition.

Conclusion
Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.
Ameliorative effect of Psidium guajava (l.) leaf aqueous extract on aluminium nitrate-induced liver damage in female Wistar rats
Authors: Afolabi Aanuoluwapo Adeyimika , Ashamu Ebenezer Adeola , Oluranti Olufemi Idowu 
Published: July 2020

Abstract
Background
Aluminium nitrate and other aluminium-containing compounds have been demonstrated to cause several health challenges. Psidium guajava L) is a well known cultivated tree with hepatoprotective nature and radical scavenging ability.

Methods
Twenty-five (25) female Wistar rats with average weight of 195 g were grouped into five groups (n = 5), with their weights measured and recorded weekly throughout the period of 21 days of the research. Control (group A), 32.5 mg/kg AL only (group B), 30 mg/kg AL + 250 mg/kg PGLE (group C), 20 mg/kg AL + 500 mg/kg PGLE (group D) and 10 mg/kg AL + 750 mg/kg PGLE (group E). Histological examination of the liver was done using Hematoxylin and Eosin stain.

Results
Various degenerative changes were observed in the liver architecture following aluminum nitrate administration when compared with the control group. Significant regenerative changes similar to control were observed following administration of high dose of Psidium guajava.

Conclusion
The results obtained in this study revealed that aqueous extract of Psidium guajava leaves possess good hepato-protective properties.
3D printed spermathecae as experimental models to understand sperm dynamics in leaf beetles
Authors: Matsumura Yoko , Gürke Sinje , Tramsen Halvor T. , Gorb Stanislav N. 
Published: July 2020

AbstractBackgroundPostcopulatory mate choice occurs ubiquitously in the animal kingdom. However, it is usually a major challenge to visualise the process taking place in a body. This fact makes it difficult to understand the mechanisms of the process. By focusing on the shape of female sperm storage organs (spermathecae), we aimed to elucidate their functional morphology using six representative beetle species and to simulate sperm dynamics in artificial spermathecae with different structural features.ResultsMorphology and material gradients were studied using micro-computed tomography (μCT) and confocal laser scanning microscopy. This study shows a diversity of external and internal structures of the spermathecae among species. Despite the diversity, all species possess a common pumping region, which is composed of a sclerotised chamber, muscles and a resilin-enriched region. By focusing on the speciesAgelastica alni, whose spermatheca is relatively simple in shape with an internal protuberance, we simulated sperm dynamics by establishing a fabrication method to create enlarged, transparent, flexible and low-cost 3D models of biological structures based on μCT data. This experiment shows that the internal protuberance in the species functions as an efficient mixing device of stored sperm.ConclusionsThe observed spermathecal musculature implies that the sclerotised chamber of the spermatheca with muscles works as a pumping organ. Our fluid dynamics tests based on 3D printed spermathecae show that a tiny structural difference causes entirely different fluid dynamics in the spermatheca models. This result suggests that structural variations of the spermatheca strongly affect sperm dynamics. However, fluid dynamics tests still require essential measurements including sperm viscosity and the velocity of pumping cycles of the spermatheca.
Harmonising data systems for cash transfer programming in emergencies in Somalia
Authors: Owino Boniface 
Published: July 2020

AbstractQuality data and information are fundamental for effective implementation of cash transfer programmes in emergency contexts. Establishing a robust information system can facilitate the equitable and responsive distribution of humanitarian cash-based assistance, while enhancing the effectiveness and efficiency of its delivery. This study presents findings on how various humanitarian agencies are collecting and using registration and identification data in cash transfer programmes in Somalia and identifies opportunities, risks and barriers to establishing an effective integrated data system. The study is based on a systematic review of published and grey literature, as well as on key informant interviews with representatives of humanitarian agencies, donors and government officials in Somalia. The study finds that the collection of registration and identification data is largely based on individual agencies’ policies, guidelines and standard operating procedures, resulting in multiple non-interoperable data systems. Progress is being made to harmonise/integrate data systems, including using harmonised registration forms, a common database and data sharing agreements in various consortia; bilateral agreements to share registration platforms; and initiatives by donors and the government to enhance interoperability. Despite this progress, the harmonisation of data systems is still constrained by a number of technical, political, financial and organisational factors, as well as legal, fiduciary, reputational and data protection risks. The study concludes that harmonising data systems presents both long-term opportunities and short-term risks for developing a robust integrated data system for providing cash-based assistance in humanitarian contexts and supporting implementation of social protection programmes.
SAFEE: A Debriefing Tool to Identify Latent Conditions in Simulation-based Hospital Design Testing
Authors: Colman Nora , Dalpiaz Ashley , Walter Sarah , Chambers Misty S. , Hebbar Kiran B. 
Published: July 2020

AbstractIn the process of hospital planning and design, the ability to mitigate risk is imperative and practical as design decisions made early can lead to unintended downstream effects that may lead to patient harm. Simulation has been applied as a strategy to identify system gaps and safety threats with the goal to mitigate risk and improve patient outcomes. Early in the pre-construction phase of design development for a new free-standing children’s hospital, Simulation-based Hospital Design Testing (SbHDT) was conducted in a full-scale mock-up. This allowed healthcare teams and architects to actively witness care providing an avenue to study the interaction of humans with their environment, enabling effectively identification of latent conditions that may lay dormant in proposed design features. In order to successfully identify latent conditions in the physical environment and understand the impact of those latent conditions, a specific debriefing framework focused on the built environment was developed and implemented. This article provides a rationale for an approach to debriefing that specifically focuses on the built environment and describes SAFEE, a debriefing guide for simulationists looking to conduct SbHDT.
Biological indicators for pollution detection in terrestrial and aquatic ecosystems
Authors: Zaghloul Alaa , Saber Mohamed , Gadow Samir , Awad Fikry 
Published: July 2020

AbstractEnvironmental pollution from varied sources is now deemed as one of the most serious problems everywhere. Several pollutants, however, could be perceived by certain biological indicators, each one is used to identify assured single or a category of pollutants. The current review presents the use of biotas, i.e., plants, microorganisms, and animals, to perceive ecosystems pollutants. The most significant biological indicators are presented. The plant indicators described belong to higher plants; the microbial indicators were represented by bacteria, fungi, algae, planktons, lichens, helminthes eggs and enzymes and the animal ones were earthworms, macro-invertebrates, frogs & toads, insects and animal toxins.
Continuous video electroencephalogram for herpes simplex encephalitis: a case report and literature review
Authors: Lin Wanhui , Chen Shenggen , Lin Hanbin , Liu Changyun , Huang Huapin 
Published: July 2020

Abstract
Background
Electroencephalogram (EEG) is an important tool for the diagnosis of herpes simplex virus encephalitis (HSE). However, the diagnosis of non-convulsive status epilepticus (NCSE) in HSE is challenging without the help of continuous video EEG (CVEEG), and whether EEG is a predictor of outcome remains controversial.

Case presentation
A 63-year-old woman presented with a 5 day history of fever, coma and seizures. Results of EEG, magnetic resonance imaging and polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) were suggestive of herpes simplex encephalitis-1 (HSE-1). Preliminary EEG showed periodic discharges at the prefrontal and temporal lobes, which were particularly synchronized with intermittent lip smacking movements, and the discharges were terminated by diazepam. After 2-week treatment with acyclovir, high-dose hormone pulse therapy and high-dose immunoglobulin therapy, the CSF was improved, but the patient’s consciousness became worsen, consistent with the diffuse slow waves in the delta range and low voltage of EEG activity. In the following 1 month, the patient had non-responsiveness to pain and sound as shown by CVEEG with diffuse slow waves. Sometimes paroxysmal very slow waves (0.5–1 Hz) were synchronized with intermittent paroxysmal eye movements, pupil abnormality, and sweating in the frontal area. After 2 months of treatment, the EEG abnormalities improved to have alpha rhythm.

Conclusion
The CVEEG not only helps identify NCSE but can also be used to monitor HSE progression.
Multi-factorial barriers and facilitators to high adherence to lung-protective ventilation using a computerized protocol: a mixed methods study
Authors: Knighton Andrew J. , Kean Jacob , Wolfe Doug , Allen Lauren , Jacobs Jason , Carpenter Lori , Winberg Carrie , Berry Jay G. , Peltan Ithan D. , Grissom Colin K. , Srivastava Raj 
Published: July 2020

Abstract
Background
Lung-protective ventilation (LPV) improves outcomes for patients with acute respiratory distress syndrome (ARDS) through the administration of low tidal volumes (≤ 6.5 ml/kg predicted body weight [PBW]) with co-titration of positive end-expiratory pressure and fraction of inspired oxygen. Many patients with ARDS, however, are not managed with LPV. The purpose of this study was to understand the implementation barriers and facilitators to the use of LPV and a computerized LPV clinical decision support (CDS) tool in intensive care units (ICUs) in preparation for a pilot hybrid implementation-effectiveness clinical trial.

Methods
We performed an explanatory sequential mixed methods study from June 2018 to March 2019 to evaluate the variation in LPV adherence across 17 ICUs in an integrated healthcare system with > 4000 mechanically ventilated patients annually. We analyzed 47 key informant interviews of ICU physicians, respiratory therapists (RTs), and nurses in 3 of the ICUs using a qualitative content analysis paradigm to investigate site variation as defined by adherence level (low, medium, high) and to identify barriers and facilitators to LPV and LPV CDS tool use.

Results
Forty-two percent of patients had an initial set tidal volume of ≤ 6.5 ml/kg PBW during the measurement period (site range 21–80%). LPV CDS tool use was 28% (site range 6–91%). This study’s main findings revealed multi-factorial facilitators and barriers to use that varied by ICU site adherence level. The primary facilitator was that LPV and the LPV CDS tool could be used on all mechanically ventilated patients. Barriers included a persistent gap between clinician attitudes regarding the use of LPV and actual use, the perceived loss of autonomy associated with using a computerized protocol, the nature of physician-RT interaction in ventilation management, and the lack of clear organization measures of success.

Conclusions
Variation in adherence to LPV persists in ICUs within a healthcare delivery system that was an early adopter of LPV. Potentially promising strategies to increase adherence to LPV and the LPV CDS tool for ARDS patients include initiating low tidal ventilation on all mechanically ventilated patients, establishing and measuring adherence measures, and focused education addressing the physician-RT interaction. These strategies represent a blueprint for a future hybrid implementation-effectiveness trial.
Chemical profiling of a polyherbal formulation by tandem mass spectroscopic analysis with multiple ionization techniques
Authors: C. T. Sulaiman , P. R. Ramesh , K. Mahesh , K. M. Madhu , E. M. Anandan , M. Praveen , Balachandran Indira 
Published: July 2020

AbstractBackgroundGugguluthiktham Kashayam(GTK) is the decoction form ofPanchatikta Guggulu Ghrita, a classical Ayurvedic formulation used for treating various diseases like skin disorders, ulcers, sinus, asthma, cardiac diseases, arthritis, and cancer.ResultsTandem mass spectroscopic analysis of GTK was carried out by different ionization techniques such as electro spray ionization (ESI) and atmospheric pressure chemical ionization (APCI) in both positive and negative modes using Quadrupole Time-of-Flight (Q-TOF) mass spectroscopy. Data processing of molecular ions obtained by ESI and APCI mass fragmentation led to the identification of several phytoconstituents belonging to various classes of compounds such as phenolics, flavonoids, and coumarins.ConclusionThe study concluded that GTK contains variety of phytochemicals with numerous biological properties that might be responsible for its various therapeutic effects.
Process evaluation of a district mental healthcare plan in Nepal: a mixed-methods case study
Authors: Luitel Nagendra P. , Breuer Erica , Adhikari Anup , Kohrt Brandon A. , Lund Crick , Komproe Ivan H. , Jordans Mark J. D. 
Published: July 2020

Background
The PRogramme for Improving Mental Health carE (PRIME) evaluated the process and outcomes of the implementation of a mental healthcare plan (MHCP) in Chitwan, Nepal.

Aims
To describe the process of implementation, the barriers and facilitating factors, and to evaluate the process indicators of the MHCP.

Method
A case study design that combined qualitative and quantitative methods based on a programme theory of change (ToC) was used and included: (a) district-, community- and health-facility profiles; (b) monthly implementation logs; (c) pre- and post-training evaluation; (d) out-patient clinical data and (e) qualitative interviews with patients and caregivers.

Results
The MHCP was able to achieve most of the indicators outlined by the ToC. Of the total 32 indicators, 21 (66%) were fully achieved, 10 (31%) partially achieved and 1 (3%) were not achieved at all. The proportion of primary care patients that received mental health services increased by 1200% over the 3-year implementation period. Major barriers included frequent transfer of trained health workers, lack of confidential space for consultation, no mental health supervision in the existing system, and stigma. Involvement of Ministry of Health, procurement of new psychotropic medicines through PRIME, motivation of health workers and the development of a new supervision system were key facilitating factors.

Conclusions
Effective implementation of mental health services in primary care settings require interventions to increase demand for services and to ensure there is clinical supervision for health workers, private rooms for consultations, a separate cadre of psychosocial workers and a regular supply of psychotropic medicines.
Genomic Profiles of De Novo High- and Low-Volume Metastatic Prostate Cancer: Results From a 2-Stage Feasibility and Prevalence Study in the STAMPEDE Trial
Authors: Gilson Clare , Ingleby Fiona , Gilbert Duncan C. , Parry Marina A. , Atako Nafisah B. , Ali Adnan , Hoyle Alex , Clarke Noel W. , Gannon Melissa , Wanstall Chris , Brawley Christopher , Mason Malcolm D. , Malik Zafar , Simmons Andrew , Loehr Andrea , Parry-Jones Alison , Eeles Rosalind , Kote-Jarai Zsofia , James Nicholas D. , Amos Claire , Parmar Mahesh K. B. , Langley Ruth E. , Sydes Matthew R. , Attard Gerhardt , Chowdhury Simon ,   for the STAMPEDE Investigators
Published: July 2020

PURPOSEThe STAMPEDE trial recruits men with newly diagnosed, high-risk, hormone-sensitive prostate cancer. To ascertain the feasibility of targeted next-generation sequencing (tNGS) and the prevalence of baseline genomic aberrations, we sequenced tumor and germline DNA from patients with metastatic prostate cancer (mPCa) starting long-term androgen-deprivation therapy (ADT).METHODSIn a 2-stage approach, archival, formalin-fixed, paraffin-embedded (FFPE) prostate tumor core biopsy samples were retrospectively subjected to 2 tNGS assays. Prospective enrollment enabled validation using tNGS in tumor and germline DNA.RESULTSIn stage 1, tNGS data were obtained from 185 tumors from 287 patients (65%); 98% had de novo mPCa. We observed PI3K pathway aberrations in 43%, due to PTEN copy-number loss (34%) and/or activating mutations in PIK3 genes or AKT (18%) and TP53 mutation or loss in 33%. No androgen receptor ( AR) aberrations were detected; RB1 loss was observed in < 1%. In stage 2, 93 (92%) of 101 FFPE tumors (biopsy obtained within 8 months) were successfully sequenced prospectively. The prevalence of DNA damage repair (DDR) deficiency was 14% (somatic) and 5% (germline). BRCA2 mutations and mismatch repair gene mutations were exclusive to high-volume disease. Aberrant DDR (22% v 15%), Wnt pathway (16% v 4%), and chromatin remodeling (16% v 8%) were all more common in high-volume compared with low-volume disease, but the small numbers limited statistical comparisons.CONCLUSIONProspective genomic characterization is feasible using residual diagnostic tumor samples and reveals that the genomic landscapes of de novo high-volume mPCa and advanced metastatic prostate cancer have notable similarities (PI3K pathway, DDR, Wnt, chromatin remodeling) and differences ( AR, RB1). These results will inform the design and conduct of biomarker-directed trials in men with metastatic hormone-sensitive prostate cancer.
Role of family support and self-care practices in blood pressure control in individuals with hypertension: results from a cross-sectional study in Kollam District, Kerala
Authors: Chacko Susanna , Jeemon Panniyammakal 
Published: July 2020

Background: Despite the availability of effective drugs, blood pressure (BP) control rate is sub-optimal in individuals with hypertension in low- and middle-income countries (LMICs). The role of self-care in the management of BP is less studied in LMIC settings.Methods: We conducted a community-based, cross-sectional study in individuals with hypertension in Kollam district, Kerala. A multistage cluster sampling method was used for the selection of study participants. We measured self-care by using an adapted Hypertension Self-Care Activity Level Effects (H-SCALE) scale. Descriptive statistics were used to summarise the data and logistic regression analysis was conducted to identify factors associated with BP control.Results: In total, 690 individuals with hypertension (women=60%) and a mean age of 57±8 years participated in the study. More than half (54%) of the participants were adherent to anti-hypertensive medications. However, the adherence rate was much lower for the dietary approach to stop hypertension (DASH) diet (12.8%), recommended level of physical activity (24%) and weight management (11.4%). Overall BP control was achieved in two of five individuals (38.4%, 95% CI: 34.7-42.0%). Among self-care activities, adherence to medications (AOR: 1.8, 95% CI: 1.3-2.5), DASH diet (AOR: 1.5, 95% CI: 1.0-2.4), and non-smoking status (AOR: 3.3, 95% CI: 1.7-6.4) were associated with control of BP. Additionally, good family support to self-care (AOR: 1.9, 95% CI: 1.1-3.1) was associated with better control of BP.Conclusion:In individuals with hypertension, the BP control rate is achieved in two of five individuals. Adoption of self-care activities are sub-optimal. Both family support and adherence to self-care activities are associated with BP control. Family based interventions to improve adherence to self-care activities could have a significant public health impact in achieving better population-level BP control rates in Kerala, India.
philosophical dialogue with children about complex social issues: a debate about texts and practices
Authors: Williams Steve 
Published: July 2020

In this article, I report on my reading of a debate between two practitioners and scholars of philosophy with children – Karin Murris and Darren Chetty. The parts of their exchanges I have chosen to focus on relate to a children's book called Tusk Tusk by David McKee. Their respective arguments raise questions for me about the relationship between the starting text (or stimulus) and issues of importance in the wider world. Although Chetty sees benefits in using picture books, he appears to believe there is an over-reliance on fables and other magical tales and that alternative starting points could be more suitable for exploring complex social issues with historical dimensions. Murris, on the other hand, seems to appreciate the lack of historical perspective that is evident in many of her preferred picture books. She values their ‘universal’ and ‘magical’ aspects because they stimulate ‘rhizomatic’ dialogues that are spontaneous and non-hierarchical. In this commentary I trace what, to me, are the most significant lines of argument put forward by Chetty and Murris. In response, I suggest some practical ideas for choosing texts and ‘reading against the text’ – a term both writers use. I also ask and answer the question: ‘In sessions of philosophical dialogue, should adults bring to children for consideration issues they regard as important or refrain from doing so?’