bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Cost-Effectiveness of Contraceptive Methods from a Health Provider Perspective: Case Study of Kiambu County Hospital, Kenya
Authors: Ngacha James Kiragu , Ayah Richard 
Published: November 2020

Abstract
Background: Kenya’s Contraceptive Prevalence Rate at 53% is low, with wide disparity among the 47 counties that make up the country (2% - 76%). Significant financial investment is required to maintain this level of contraceptive use and increase it to levels seen in more developed countries. This is in the context of a growing population, declining donor funding, limited fiscal space and competing health challenges. Studies have shown that long-term contraceptive methods are more cost-effective than short-term methods. However, it is unclear if this applies in Sub-Saharan Africa; with limited financial resources, lower social economic status among users, and publicly managed commodity supply chains, in vertical programs largely dependent on donor funding. This study assessed the cost-effectiveness of contraceptive methods used in Kenya.Methods: A cross-sectional study was undertaken in a county referral hospital in mid-2018. Purposive sampling of 5 Family Planning clinic providers and systematic sampling of 15 service delivery sessions per method was done. Questionnaire aided interviews were done to determine inputs required to provide services and direct observation to measure time taken to provide each method. Cost per method was determined using Activity Based Costing, effectiveness via couple year protection conversion factors, and cost-effectiveness was expressed as cost per couple year protection. Results: The Intra-Uterine Copper Device was most cost-effective at 4.87 US dollars per couple year protection followed by the 2-Rod Implant at 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, while the Combined Oral Contraceptive Pills were least cost-effective at 38.60 US dollars per couple year protection. Long-term methods attracted a higher initial cost of service delivery when compared to short-term methods.Conclusion: Long-term contraceptive methods are more cost-effective. As such, investing in long-term contraceptives would save costs despite higher initial cost of service delivery. It is recommended, therefore, that Sub-Saharan Africa countries allocate more domestic financial resources towards availability of contraceptive services, preferably with multi-year planning and budget commitment. The resources should be invested in a wide range of interventions shown to increase uptake of long-term methods, including reduction of cost barriers for the younger population, thereby increasing Contraceptive Prevalence Rates.
Effects of Sanitary Pad Distribution and Reproductive Health Education on Primary School Attendance and Reproductive Health Knowledge and Attitudes in Kenya: A Cluster Randomized Controlled Trial
Authors: Austrian Karen , Kangwana Beth , Muthengi Eunice , Soler-Hampejsek Erica 
Published: November 2020

Abstract
Background: Adolescent girls’ risk of school dropout and reproductive health (RH) challenges may be exacerbated by girls’ attitudes toward their bodies and inability to manage their menstruation. We assessed effects of sanitary pad distribution and RH education on girls in primary grade 7 in Kilifi, Kenya.Methods: 140 primary schools were randomly assigned to one of four study arms: 1) control; 2) sanitary pad distribution; 3) RH education; or 4) both sanitary pad distribution and RH education. Outcomes were school attendance, school engagement, RH knowledge and attitudes, gender norms, and self-efficacy. For outcomes measured both at baseline and endline, difference-in-differences (DID) models were estimated and for outcomes without baseline data available, analysis of covariance models were used. Results: There was no evidence of an effect on primary school attendance on arm 2 (coefficient [coef] 0.37, 95% CI -0.73, 1.46), arm 3 (coef 0.14, 95% CI -0.99, 1.26) or arm 4 (coef 0.58, 95% CI -.37, 1.52). There was increased positive RH attitudes for girls in arm 3 (DID coef. 0.63, 95% CI 0.40-0.86) and arm 4 (DID coef. 0.85, 95% CI 0.64, -1.07). There was also an increase in RH knowledge, gender norms and self-efficacy in arms 3 and 4.Conclusions: The findings suggest that neither sanitary pad distribution nor RH education, on their own or together, were sufficient to improve primary school attendance. However, as the RH education intervention improved RH outcomes, the evidence suggests that sanitary pad distribution and RH education can be positioned in broader RH programming for girls. Trial Registration: ISRCTN, ISRCTN10894523. Registered 22 August 2017 - Retrospectively registered, http://www.isrctn.com/ISRCTN10894523
The Personal and Professional Impact of COVID-19 on Faculty and Staff at an Academic Institution and a Blueprint for the Future: A Multi-Methods Study
Authors: Gottenborg Emily , Yu Amy , Naderi Roxana , Keniston Angela , McBeth Lauren , Morrison Katherine , Schwartz David , Burden Marisha 
Published: November 2020

Abstract
Background: The Coronavirus Disease 2019 (COVID-19) caused unprecedented challenges within medical centers, revealing inequities embedded in the medical community and exposing fragile social support systems. While faculty and staff faced extraordinary demands in workplace duties, personal responsibilities also increased. The goal of this study was to understand the impact of the COVID-19 pandemic on personal and professional activities of faculty and staff in order to illuminate current challenges and explore solutions. Methods:This is a multi-methods, prospective, observational study of faculty and staff within the Department of Medicine at the University of Colorado, School of Medicine, comprised of four separate sites. Participants received a preliminary department-wide survey followed by an invitation to participate in focus groups addressing: (1) the impact on personal and professional activities, on (2) career advancement and promotion, and (3) potential strategies to assist faculty and staff. Qualitative analysis was performed for thematic content of the focus groups.Results: One hundred and fifty-one faculty and staff responded to the initial survey (11%), 28 faculty and staff participated in focus groups. Prior to the pandemic, male respondents spent 20.5 hours (+/- 18.2) on home responsibilities while women spent 28.8 hours (+/-17.9), and since, time spent on these responsibilities rose to 32.4 hours (+/- 18.4) and 49.6 hours (+/-29.0), respectively. Qualitative analysis of focus group transcripts revealed thematic domains: (1) changing domestic responsibilities, (2) changing workplace expectations, (3) the untenable nature of a return to “normal,” (4) an opportunity to address pre-existing inequities and (5) internal conflict and guilt. Solutions were offered and included an emphasis on the importance of community.Conclusions: The COVID-19 pandemic created burdens for already challenged faculty and staff in both their personal and professional lives, and for women in particular. Swift action and advocacy by academic institutions is needed to support the lives and careers of our colleagues.
Health Economic Evaluation of the Psychiatric Emergency Response Team (PAM) in Stockholm County
Authors: Carlborg Andreas , Sibbel Rainer , Helgesson Magnus 
Published: November 2020

Abstract
Background: The Psychiatric Response Team (the PAM unit) started as a suicide prevention project during the spring of 2015 to handle acute psychiatric patients previously handled by the police. Since 2017, the PAM has been a permanent service within the health care organization of Stockholm County. Method: Health economic estimates, based on different scenarios, were designed to investigate the economic evaluation of the PAM unit from both a health-care and a societal perspective. Another aim was to present an economic model that can be applied and developed in future studies to evaluate suicide-prevention projects. Potential savings achieved by the PAM unit were examined by measuring direct and indirect costs based on three different scenarios: restrictive, likely and optimistic. Costs were compared to the potential savings from changes in processes using the PAM unit. Estimates of potential savings from production losses were made using the friction-cost and human-capital methods. An estimate of human value was made using figures from previous studies in traffic-injury prevention. Different theoretical health economic methods of calculation are presented. Results: Total cost for the PAM unit during its first two years of operation was 13.2 million Swedish kronor (SEK). Comparatively, direct savings from a health-care perspective were estimated at 2.8-5.1 million SEK, while direct savings from a societal perspective were estimated at 5.9-10.6 million SEK. The estimate of indirect savings differs depending on approach adopted: from 1.0-1.5 million SEK (friction-cost) to 52.0-103.9 million SEK (human-capital). Further, if estimates of human value are included, there are additional savings ranging from 52.3 to 82.1 million SEK. Conclusion: The direct cost saving of the PAM unit, estimated on different scenarios, does not make it viable from a purely economic perspective. However, there are large indirect cost savings from avoidance of future production losses and savings in human value. The rescuing of a single patient from suicide by the PAM unit during one year would, under most estimated scenarios, justify the total cost of the intervention.
Mass Media Influence on Changing lifestyle of Community People During COVID-19 Pandemic in Bangladesh: A Cross Sectional Survey
Authors: I Abu Reza Md. Towfiqul , Islam Md. Nazrul , Hossain Md. Sajjat , Prodhan Md. Tabiur Rahman , Chowdhury Mohammad Hasan , Mamun Hasan Al 
Published: November 2020

Abstract
AimA huge amount of information associated with the novel coronavirus disease 2019 (COVID-19) outbreak was circulated by mass media in Bangladesh. To date, there is no example on how the lifestyle of the community people in Bangladesh may influence mass media intervention during a pandemic. We aimed to assess mass media influence on changing the lifestyle behavior of people during the early phase of the COVID-19 pandemic. Subject and methodsAn online cross-sectional survey with a limited face-to-face interview among 2080 Bangladeshi respondents was conducted between March 26 and April 1, 2020. Datasets were analyzed through a set of statistical methods such as classical test theory assessment, principal component analysis, Pearson’s correlation coefficient, and stepwise multiple regression model. ResultsThe results showed that there was a positive significant relationship between the composite lifestyle score and the social media is trustworthy during the COVID-19 pandemic (r=0.508, p < 0.01), while there was a negative relationship between the composite lifestyle score of the respondents and the daily online media platforms usage in COVID-19 period (r=−0.201, p < 0.01). The results also disclosed that knowledge level, media credibility, and media check-in had the largest contribution to influence the changing lifestyle of the community people. We also found that social media was highly used media as expected during the COVID-19 outbreak while the administrative action has little influence on the changing lifestyle behavior.ConclusionOur outcomes stress the significance of the reliability of information shared via mass media outlets and practical strategies to counter misinformation during the COVID-19 outbreak.
Interferon Inducible Transmembrane Protein 3 Inhibits Influenza Virus Replication and Inflammation by Interacting With ABHD16A
Authors: Liang Chen , Zhu Limei , Chen Jun 
Published: November 2020

Abstract
Background: Studies have shown that human interferon inducible transmembrane proteins (IFITM) family proteins have broad-spectrum antiviral capabilities. Preliminary studies in our laboratory have preliminarily proved that IFITMs have the effect of inhibiting influenza viruses. In order to further study its mechanism and role in the occurrence and development of influenza, relevant studies have been carried out.Methods: Fluorescence quantitative polymerase chain reaction (PCR) detection, yeast two-hybrid test and optical confocal microscopy were used to investigate the effect of hIFITM3 on influenza virus replication, the interaction with human abhydrolase domain containing 16A (hABHD16A) and the expression of inflammation-related factors.Results: In HEK293 cells, overexpression of hIFITM3 protein significantly inhibited the replication of influenza virus at 24h, 48h, and 72h; yeast two-hybrid experiment proved that IFITM3 interacts with ABHD16A; laser confocal microscopy observations showed that IFITM3 and ABHD16A co-localized in cell membrane area; the expression level of inflammation-related factors in cells overexpressing hIFITM3 or hABHD16A was detected by fluorescence quantitative PCR, and the results showed that the mRNA levels of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-a and cyclooxygenase 2 (COX2) were significantly increased . But when IFITM3/ABHD16A was co-expressed, the mRNA expression levels of these cytokines were significantly reduced except for COX2. When influenza virus infected cells co-expressing IFITM3/ABHD16A, the expression level of inflammatory factors decreased compared with the control group, indicating that IFITM3 can play an important role in regulating inflammation balance.Conclusions: This study confirmed that hIFITM3 has an effect of inhibiting influenza virus replication. Furthermore, it was found that hIFITM3 interacts with hABHD16A, following which it can better inhibit the replication of influenza virus and the inflammatory response caused by the disease process.
Household Smoke-Exposure Risks from Cooking Fuels and Cooking Places in Tanzania: A Cross-sectional Study
Authors: Ahamad Mazbahul G , Tanin Fahian , Shrestha Nawaraj 
Published: November 2020

Abstract
Background: Household smoke-exposure risk (SER) can be defined using cooking fuels (smoke and no smoke-producing) and cooking places (indoor and outdoor), which represents different levels of household air pollution. The study explored the prevalence and geographical variation of smoke-exposure risks (SERs) resulting from indoor and outdoor cooking practices using smoke-producing and no smoke-producing cooking fuels in Tanzania. We further investigated social and spatial factors associated with different levels of SER. Methods: We constructed an indicator variable, the household SER, using country-level cross-sectional data on cooking fuels and places from 2015–16 Tanzania Demographic and Health Survey, and estimated zone-level average SERs. An ordered logistic regression model was employed to assess the social and spatial characteristics associated with household SER.Results: Approximately 76.4% of total 12,425 households that practiced indoor cooking using smoke-producing fuels were at high SER. High-level SER was more prevalent in the Central, Southern highlights, and Southwest highlands zones. Overall, wealthier households, female-headed households, and having higher education levels among household members were more likely to be in very low SER category. However, older household heads and larger family sizes were less likely to be in very low SER category. Conclusions: The significant prevalence of high smoke-exposure risk is a major public health concern in Tanzania, which requires simultaneous adoption of improved cooking stoves and clean fuels to minimize the adverse effects attributed to household SER.
Association Between Maternal Exposure to Indoor Air Pollution and Offspring Congenital Heart Disease: A Multi-Hospital Case-Control Study in East China
Authors: Sun Jing , Wang Jian , Yang Jing , Shi Xin , Li Shujing , Cheng Jinping , Chen Sun , Sun Kun , Wu Yurong 
Published: November 2020

Abstract
Background: Previous research has suggested an association between maternal exposure to ambient air pollutants and the risk of congenital heart defects (CHDs). However, the effect of individual prenatal exposure to indoor air pollutants on CHD occurrence has not been reported.Methods: We carried out a hospital-based case-control study to investigate the association between personal air pollution exposure during pregnancy and the risk of CHDs in offspring. A total of 32 cases and 74 controls were included in this study from two hospitals in East China. We investigated maternal and residential environmental characteristics using a questionnaire and obtained personal indoor air samples to assess particulate matter (PM) and volatile organic compounds (VOCs) from 22–30 gestational weeks; formaldehyde, benzene, toluene, xylene, total VOCs (TVOCs), PM10, and PM2.5 were assessed. Logistic regression was performed to assess associations and interactions among individual indoor air pollutants and CHDs after adjusting for confounders. The potential residential environmental factors affecting the risks of indoor air pollutants on CHDs were also assessed.Results: Median TVOC (0.430 vs. 0.005 mg/m3, P < 0.001), PM2.5 (12.00 vs. 8.00 µg/m3, P=0.037) and PM10 (13.50 vs. 8.00 µg/m3, P=0.028) exposure levels in cases were significantly higher than those in controls. In a regression model adjusted for confounders, exposure to high levels of indoor TVOCs, PM2.5 and PM10 during pregnancy was associated with risks for CHDs and the occurrence of some major CHD subtypes in offspring. These risk effects were enhanced among pregnant woman living in a newly renovated house or near heavy-traffic roads but were mitigated by household usage of smoke ventilators when cooking. We observed a positive interaction of maternal exposure to TVOCs and PM2.5 in regard to the risk for CHDs.Conclusions: Maternal exposure to indoor VOCs and PMs may increase the risk of giving birth to foetuses with CHDs.
Wheat Gluten Hydrolysates Promotes Fermentation Performance of Brewer’s Yeast in Very High Gravity Worts
Authors: Yang Huirong , Coldea Teodora Emilia , Zeng Yingjie , Zhao Haifeng 
Published: November 2020

Abstract
The effects of wheat gluten hydrolysates (WGH) and their ethanol elution fractions obtained on XAD-16 resin on physiological activity and fermentation performance of brewer’s yeast during very-high-gravity (VHG) worts fermentation were investigated. The results showed that the addition of WGH and their elution fractions in VHG worts significantly enhanced yeast biomass and viability, and further increased the fermentability, ethanol yield and productivity of yeast. Supplementation with 40% ethanol fraction exhibited the highest biomass (6.9 g/L dry cell), cell viability, fermentability (82.05%), ethanol titer (12.19%, v/v) and ethanol productivity during VHG worts fermentation. In addition, 40% ethanol fraction supplementation also caused the most consumption of amino acid and the highest accumulation of intracellular glycerol and trehalose, 15.39% of increase in cell-membrane integrity, 39.61% of enhancement in mitochondrial membrane potential (MMP), and 18.94% of reduction in intracellular reactive oxygen species (ROS) level in yeast under VHG conditions. Therefore, WGH supplementation was an efficient method to improve fermentation performance of brewer’s yeast during VHG worts.
Use of Taguchi Design for Optimization of Diesel-oil Biodegradation Using Consortium of Pseudomonas Stutzeri, Cellulosimicrobium Cellulans, Acinetobacter Baumannii and Pseudomonas Balearica Isolated From Tarball in Terengganu Beach, Malaysia
Authors: Nkem Bruno Martins , Halimoon Normala , Yus Fatimah Md , Johari Wan Lutfi Wan 
Published: November 2020

Abstract
Consortium of bacteria capable of degrading oily hydrocarbons were isolated from tarball on beaches in Terengganu, Malaysia and classified as Pseudomonas stutzeri, Cellulosimicrobium cellulans, Acinetobacter baumannii and Pseudomonas balearica. Taguchi design was used to optimize diesel-oil biodegradation using these bacteria as consortium. Maximum diesel-oil biodegradation by experimental runs was 93.6% with individual n-alkanes degraded between 87.6% – 97.6% in 30 days. Optimal settings were 2.5 mL (1.248 OD600nm) inoculum size; 12% (v/v) initial diesel-oil in minimal salt media with 7.0 pH, 30.0 gL-1 NaCl and 2.0 gL-1 NH4NO3 concentration, incubated at 42oC temperature and 150 rpm agitation speed. Parameters significantly improved diesel-oil removal by consortium as indicated by model determination coefficient (R2 = 90.89%; P < 0.001) with synergistic effect of agitation speed significantly contributing 81.03%. Taguchi design established optimal settings of investigated parameters that produced significant improvement on diesel-oil removal by consortium. This can be used to design novel bioremediation strategy that can achieve optimal decontamination of oil pollution in shorter time.
Optimization of Process Parameters by Statistical Experimental Design for Production of Α-mannosidase From Moss Hyophilla Nymaniana (Fleish.) Menzel
Authors: Mishra Rashmi , Chandra Ramesh 
Published: November 2020

Abstract
Alpha mannosidases are enzymes with varied applications preferably used in the preparation of important compounds of food and pharmaceutical industries. The production of enzymes is influenced by medium compositions as some of the constituents of the medium directly affect the enzyme synthesis. In the present study, the components of the culture medium are optimized by classical and Taguchi method for α-mannosidase from the suspension culture of the moss Hyophilla nymaniana (Fleish.) Menzel. One factor at a time approach was used in the preliminary screening of factors before proceeding optimization studies. Implementation of Taguchi Design of Experiment generated 16 experimental runs based on five factors sugar, temperature, pH, rpm, and nitrogen source. Analysis of variance (ANOVA) was performed on the obtained results and the optimum condition suggested by statistical calculations was validated in a verification test. The ANOVA result showed that the NH4NO3 contributed maximum on mannosidase production followed by temperature and RPM. Predicted results showed an enhanced mannosidase (63 %) can be achieved with pH 5.8, temperature 26 °C, RPM 120, maltose 1.5 %, and NH4NO3 2 % as carbon and nitrogen source, respectively.
Catatonia Associated With Late Paraphrenia Successfully Treated With Lithium: A Case Report
Authors: Sugawara Hiroko , Takamatsu Junpei , Hashimoto Mamoru , Ikeda Manabu 
Published: November 2020

Abstract
Background: Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late paraphrenia classified as very-late-onset schizophrenia-like psychosis, which was successfully treated with lithium. Case presentation: A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy.Conclusions: Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.