bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study
Authors: Murarkar Sujata Kapil , Gothankar Jayashree Sachin , Doke Prakash , Pore Prasad , Lalwani Sanjay , Dhumale Girish , Quraishi Sanjay , Patil Reshma Sudhir , Waghachavare Vivek , Dhobale Randhir , Rasote Kirti , Palkar Sonali , Malshe Nandini 
Published: September 2020

Abstract
Background Undernutrition among under five children in India is a major public health problem.Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas.Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3,671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. Results The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37).Overall prevalence of stunting among children under five was 45.9 %, wasting was 17.1% and 35.4% children were underweight.Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area.In the rural areas exclusive breast feeding(p<0.001) and acute diarrhea (p=0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p<0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding(p<0.05) was associated with wasting, sex of the child (p<0.05) and type of family(p<0.05)were associated with stunting,and low income of the family(p<0.05) was associated with underweight.Conclusions Factors like sex of the child, birth order,exclusive breast feeding ,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.Trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.
Development And Validation Of A New Method For Visual Acuity Assesment On Tablet In Pediatric Population: eMOVA Test
Authors: STOLL NOEMIE , Foggia Elsa Di , Speeg-Schatz Claude , Meunier Hélène , Rimele Adam , Ance Pascal , Moreau Pierre-Henri , Sauer Arnaud 
Published: September 2020

Abstract
IntroductionAmblyopia is a major public health concern. Its screening and management require reliable methods of visual acuity assessment. New technologies offer nowadays many tests available on different app stores for smartphone or tablet but most of them often lack of scientific validation for a medical use. The aim of our study was to attempt validating a tablet-based visual acuity test adapted to the pediatric population: the eMOVA test (electronic Measurement Of Visual Acuity) by comparing visual acuity measured with more conventional test.MethodsA cohort of 100 children aged 3 to 8 attending the ophthalmic-pediatric for eye examination between September 2016 and June 2017 were included in the study. Near visual acuity was assessed on participants using both the eMOVA test and a Standard test (Rossano-Weiss test). Duration of each test, its comprehension, its acceptability and the attention of the child during the test was also investigated.ResultsThe eMOVA test overestimated visual acuity by 0.06 logMAR. This difference, statistically significant, was not clinically relevant. The duration of the eMOVA test was longer than the reference test, but less painful and preferred by children and their parents compared to standard tests.ConclusionThe eMOVA test appears as a reliable test to assess near visual acuity in children. By its portability and efficiency, this application proved to be a relevant tool to be used for children eye examination in daily routine at the hospital.
Socio-cultural and economic barriers, and facilitators influencing men’s involvement in antenatal care including HIV testing: A qualitative study from urban Blantyre, Malawi
Authors: Sakala Doreen , Kumwenda Moses K. , Conserve Donaldson F. , Ebenso Bassey , Choko Augustine Talumba 
Published: September 2020

Abstract
Background Male partner involvement in antenatal care (ANC) is associated with positive maternal and neonatal outcomes. However, only a handful of men attend ANC with their partners. This study aimed to understand the underlying barriers and facilitators influencing men’s ANC attendance including HIV testing in Blantyre, Malawi.Methods Data were collected during a formative qualitative study of a cluster-randomised trial. Six focus group discussions (FGDs) with 42 men and women and 20 in-depth interviews (IDIs) were conducted at three primary health centres in urban Blantyre, Malawi. FGD participants were purposively sampled with IDI participants subsequently sampled after FGD participation. Thematic analysis was used to analyse the data.Results The economic requirement to provide for their families exerted pressure on men and often negatively affected their decision to attend ANC together with their pregnant partners despite obvious benefits. Peer pressure and the fear to be seen by peers queueing for services at ANC, an environment traditionally viewed as a space for women and children made men feel treated as trespassers and with some level of hostility rendering them feeling emasculated when they attend ANC. Health system problems associated with overall organization of the ANC services, which favours women created resistance among men to be involved. An association between ANC and HIV testing services discouraged men from attending ANC because of their fear of testing HIV-positive in the presence of their partners. The availability of a male friendly clinic offering a private, quick, supportive/sensitive and flexible service was considered to be an important incentive that would facilitate male men’s ANC attendance. Men described compensation to cover transport and opportunity cost for attending the clinic as a motivator to attending ANC services and accepting an HIV test. Conclusion Peer and economic influences were the most influential barriers of men attending ANC and testing for HIV with their pregnant partners. Addressing these socio-economic barriers and having a male friendly clinic are promising interventions to promote male ANC attendance in this setting.
Health status of female Moldovan immigrants to Italy by health literacy level and age group
Authors: Vianello Francesca Alice , Zaccagnini Federica , Pinato Carlo , Maculan Pietro , Buja Alessandra 
Published: September 2020

Abstract
Background: Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan immigrant women, and their access to health care services in northern Italy, by age group and health literacy level. Methods: We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables ( lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. Results: Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls. Conclusions: The reported prevalence of some diseases was higher among Moldovan immigrant women than among Italian resident women. Health literacy was associated with the immigrant women’s lifestyle and the use of primary health care services, as previously seen for the autochthonous population.
The Impact of Stage of Labor on Adverse Maternal and Neonatal Outcomes in Multiparous Women: A Retrospective Cohort Study
Authors: Wang Li , Wang Hongxia , Jia Lu , Qing Wenjie , Li Fan , Zhou Jie 
Published: September 2020

Abstract
Background: The correlation between stage of labor and adverse delivery outcomes has been widely studied. Most of studies focused on nulliparous women, it was not very clear what impact the stage of labor duration had on multiparous women.Methods: A retrospective cohort study was conducted among all the multiparous women of cephalic, term, singleton births, who planned vaginal delivery. The total stage of labor covered the first stage and the second stage in this study, and they were divided into subgroups. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (III and IV degree), hospitalization stay ≥90th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery. Results: There were 7109 parturients included in this study. The duration of first stage was 6.2(3.6-10.0) hours, the second stage was 0.3(0.2-0.7) hour, the total stage was 6.9(4.1-10.7) hours in multiparous women. At the first stage, the rates of overall adverse outcome were 21%, 23.4%, 28.8%, 35.5%, 38.4% in subgroups <6h, 6-11.9h, 12-17.9h, 18-23.9h, ≥24h, which increased significantly (X2=57.64, P<0.001), and ARR (95% CI) were 1.10 (0.92,1.31), 1.33 (1.04,1.70), 1.80 (1.21,2.68), 2.57 (1.60,4.15) compared with subgroup <6h (ARR=1); At the second stage, the rates of overall adverse outcome were 20.0%, 30.7%, 38.5%, 61.2%, 69.6% in subgroups <1h, 1-1.9h, 2-2.9h, 3-3.9h, ≥4h (X2=349.70, P<0.001), and ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08) compared with subgroup <1h (ARR=1)). At the total stage, the rates of overall adverse outcome were 21.5%, 30.8%, 42.4% in subgroups <12h, 12-23.9h, ≥24h (X2=84.90, P<0.001), and ARR (95% CI) were 1.41 (1.16,1.72), 3.17 (2.10,4.80) compared with subgroup <12h (ARR=1).Conclusions: The prolonged stage of labor may lead to increased adverse outcomes in multiparous women, it was an independent risk factor of adverse maternal and neonatal outcomes.
Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis
Authors: Rosenbaum Janet E. , Jennings Jacky , Ellen Jonathan , Borkovic Laurel , Scott Jo-Ann , Wylie Charleen , Rompalo Anne 
Published: September 2020

Abstract
Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti
Authors: Moise Kenny , Achille Aude Mélody , Batumbo Doudou , Bourdeau Bertiny , Rebaudet Stanislas , Lerebours Gérald , Henrys Jean Hugues , Raccurt Christian 
Published: September 2020

Abstract
Introduction: Religious pilgrimages are among the anthropogenic factors known to be associated with the
transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017.

Materials/Methods: An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual
cholera incidence of communal sections against variables such as the number of patronal
festivities, population density and annual precipitation rates. The number of cases in the week of
the festivity as well as one and two weeks later was weighted against patronal festivities and
weekly precipitation rates.

Results: In total, 3 633 suspected cholera cases were continuously reported in three communes in Haiti
(Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017.
After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR=0.4277 (97.5% CI: 0.2798-0.6193), p=0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% one week following patronal festivities.

Conclusion: This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an
association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.
The modules of mental health programs implemented in schools in low- and middle-income countries: Findings from a systematic literature review
Authors: Gimba Solomon Musa , Harris Paul , Saito Amornrat , Udah Hyacinth , Martin Averil , Wheeler Amanda J. 
Published: September 2020

Abstract
Background Secondary schools in low- and middle-income countries (LMICs) provide promotional, preventive, and early intervention services. Nevertheless, literature indicates that the modules of these services are either adapted or modified from existing mental health programs in developed countries. The aim of this review was to identify the modules of school-based mental health programs (SBMHP) that have been implemented in LMICs to guide the development of a culturally sensitive comprehensive mental health program for adolescents in a LMIC. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was used to guide this review. The following databases were searched in September 2018, to identify the relevant literature: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and ERIC. The search was conducted by the first author and reviewed by the authors.Results The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for rating the quality of evidence and strength of recommendations was used to assess the quality of the 11 studies. Most of the studies had adequate quality ratings. Following the screening process, a total of 11 papers were identified and reviewed for quality. The systematic review highlighted that the mental health programs provided in schools included: an introduction module, a communication and relationship module, a psychoeducation module, a cognitive skills module, a behavioral skills module, establishing social networks for recovery and help seeking behavioral activities and a summary/conclusion module. Two programs were found to be universal in nature. Five programs were directed at key risk factors or at-risk groups, and four were early intervention programs. The review also revealed that only one program out of the 11 programs included modules for parents. Five programs were significantly effective across all measured outcomes, and were measured after a period that ranged from three months to four years.Conclusion A total of 11 papers were identified and reviewed for quality. Most of the papers included in the review were of adequate quality. All the identified programs (two universal, five selective and four indicated) were adapted or modified from existing programs from high income countries (HICs). The characteristics of the programs in LMICs was also highlighted in this review. The dearth of comprehensive programs in LMICs was also revealed. The review revealed seven modules in total.
Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study
Authors: Yu Ying , Li Yunqian , Jin Zheng , Zhao Shuai , Chen Fan 
Published: September 2020

Abstract
Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.
Predictors of Outpatients’ No-Show: Big Data Analytics using Apache Spark
Authors: Daghistani Tahani , AlGhamdi Huda , Alshammari Riyad , AlHazme Raed H. 
Published: September 2020

Abstract
Outpatients who fail to attend their appointments have a negative impact on the healthcare outcome. Thus, healthcare organizations facing new opportunities, one of them is to improve the quality of healthcare. The main challenges is predictive analysis using techniques capable of handle the huge data generated. We propose a big data framework for identifying subject outpatients’ no-show via feature engineering and machine learning (MLlib) in the Spark platform. This study evaluates the performance of five machine learning techniques, using the (2,011,813) outpatients’ visits data. Conducting several experiments and using different validation methods, the Gradient Boosting (GB) performed best, resulting in an increase of accuracy and ROC to 79% and 81%, respectively. In addition, we showed that exploring and evaluating the performance of the machine learning models using various evaluation methods is critical as the accuracy of prediction can significantly differ. The aim of this paper is exploring factors that affect no-show rate and can be used to formulate predictions using big data machine learning techniques.
Multiple Sclerosis incidence rate in southern Iran: A Bayesian epidemiological study
Authors: Asmarian Naeimehossadat , Sharafi Zahra , Mousavi Amin , Jacques Reis , Tamayo Ibon , Bind Marie-Abèle , abutorabi-zarchi Marzie , Moradian Mohammad Javad , Izadi Sadegh 
Published: September 2020

Abstract
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.3 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the effects of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The effects of percentage of vitamin D intake, smoking, percentage of people with normal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province. Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.8 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D3 intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in Vitamin D3 intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.Conclusion: Spatial analysis of MS revealed low incidence rate of this disease in the south and south east of Fars province, which is due to the effects of different covariates. As suggested by previous studies, vitamin D and smoking, among all covaiates, might be associated with high incidence of MS.