bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rapid assessment of the impact of COVID-19 on the utilization of hospital services in Ondo State of South Western Nigeria
Authors: Mahmud Mahmud Zubairu 
Published: October 2021

Abstract
Background

There is no doubt that COVID_19 has impacted on all facets of human activities everywhere, including ONDO state, Nigeria. However, empirical evidence of the extent of this impact in ONDO is lacking. The objective of this study was to evaluate the impact of COVID_19 epidemic on the utilization of hospital services & determine the existence of community transmission of COVID_19 in ONDO state using a proxy “Respiratory Tract Infections, RTIs”.
Methods

The study used resident clinicians to conduct peer review of hospital utilization records. The review was retrospectively for the months of January to May for four consecutive years (2018 to 2021). The team reviewed outpatient records from 11 health facilities before the advent of COVID_19 (2018) to date (2021). Thousands of such records were scrutinized to reveal six parameters: number of antenatal visits; number of live births and total number of infants served BCG; number RDTs conducted for Malaria, number of RTIs seen and total number of patients for all other illnesses.
Results

Results showed a decline in all parameters investigated except RTIs. Indeed, the proportion of RTIs - related hospital visits increased by about 22.8%.
Discussion

The decline in the utilization of hospital services is expected given the lock down measures implemented to halt transmission of COVID_19 that makes it difficult to access health facilities. The rise in the incidence of RTIs may probably be that, they were COVID cases that were undetected due to limited COVID_19 testing capacity.
Conclusion

The study concludes that COVID_19 epidemic impacted negatively on all aspect of hospital services except RTIs. The increment is statistically significant. As the most prominent of all symptoms of COVID_19 presents as respiratory tract disorder, a continued rise in RTIs despite declining rates of confirmed COVID19 cases in the state at the moment suggests that, there’s an ongoing community transmission.
Actors Affecting Loan Repayment Performance of Micro and Small Enterprises: Evidence from Somali Region, Ethiopia
Authors: Kiros Yitbarek 
Published: October 2021

Abstract
Viable Micro Finance Institutions (MFIs) that reach large number of poor people who are not served by the formal financial institutions have been a prime element for growth of Ethiopia. To operate successfully MFIs have to make sure that loan they disburse have to be repaid back so as to have financially sustainable and viable operation and contribute its own share in poverty reduction of the country. In light of this, this research study was carried to investigate the factors affecting loan settlement of Micro and Small Enterprises(MSEs) financed by Somali Micro-finance institution taking lender characteristics in to consideration. Both primary and secondary data was employed used. The primary data was collected by distributing questionnaire and through interview. A total of 175 Micro and Small Enterprises (MSEs) were selected using purposive sampling technique. The secondary data was acquired from various issues of annual reports of Somali Micro Finance institution and other concerned institutions. Both descriptive analysis and econometric model (binary logistic regression) was employed to analyze the effect of the literature driven variables on loan repayment (dependent variable) by borrowers. The binary logistic regression result revealed that among the variables hypothesized to affect loan repayment period, grace period, and timeliness of loan release have statistically significant effect on loan repayment by the borrowers Whereas loan size have statistically insignificant effect on loan repayment performance by the borrowers.
Lung Tissue Biomechanics Imaged with Synchrotron Phase Contrast Microtomography in Live Rats
Authors: Cercos-Pita Jose-Luis , Fardin Luca , Leclerc Hugo , Maury Bertrand , Perchiazzi Gaetano , Bravin Alberto , Bayat Sam 
Published: October 2021

Abstract
The magnitude and distribution of strain imposed on the peripheral airspaces by mechanical ventilation at the microscopic level and the consequent deformations are unknown despite their importance for understanding the mechanisms occurring at the onset of ventilator-induced lung injury. Here a 4-Dimensional (3D + time) image acquisition and processing technique is developed to assess pulmonary acinar biomechanics at microscopic resolution. Synchrotron radiation phase contrast CT with an isotropic voxel size of 6 µm3 is applied in live anesthetized rats under controlled mechanical ventilation. Video animations of regional acinar and vascular strain are acquired in vivo. Maps of strain distribution due to positive-pressure breaths in lung acini and blood vessels are derived based on CT images. Regional strain within the lung peripheral airspaces takes average values of 0.09 ± 0.02. Fitting the expression S=kVn, to the changes in peripheral airspace area (S) and volume (V) during a positive pressure breath yields an exponent n = 0.82±0.03, suggesting predominant alveolar expansion rather than ductal expansion or alveolar recruitment. We conclude that this methodology can be used to assess acinar conformational changes during positive pressure breaths in intact peripheral lung airspaces
Perceived Roles, Benefits and Barriers of Virtual Global Health Partnership Initiatives: A Cross-Sectional Exploratory Study
Authors: Umphrey Lisa , Paasi George , Windsor William , Abongo Grace , Evert Jessica , Haq Heather , Keating Elizabeth , Lam Suet Kam , McHenry Megan , Ndila Carolyne , Nwobu Charles , Olson Daniel , Rule Amy , Tam Reena , Olupot-Olupot Peter 
Published: October 2021

Abstract
BACKGROUNDVirtual global health partnership initiatives (VGHPIs) evolved rapidly during the COVID-19 pandemic to ensure partnership continuity, however the current landscape for VGHPI use and preference is unknown. This study aimed to increase understanding of GH partners’ perspectives on VGHPIs.METHODSFrom 15 October to 30 November 2020, authors conducted an online, international survey using snowball sampling to document pandemic-related changes in partnership activities; preferences for VGHPIs; and perceived acceptability and barriers. Analysis stratified responses by country income classification and partnership type. RESULTSA total of 128 respondents described 219 partnerships. 152/219 (69%) partnerships were transnational, 157/219 (72%) were of >5 years duration, and 127/219 (60%) included bidirectional site visits. High-income country (HIC) partners sent significantly more learners to low- to middle-income country (LMIC) partner sites (P<0.01). Participants commented on pandemic-related disruptions affecting 217/219 (99%) partnerships; 195/217 (90%) were disruption to activities; 122/217 (56%) to communication; 73/217 (34%) to access to professional support; and 72/217 (33%) to funding. Respondents indicated that VGHPIs would be important to 206/219 (94%) of their partnerships moving forward. There were overall differences in resource availability, technological capacity, and VGHPI preferences between LMIC and HIC respondents, with a statistically significant difference in VGHPI acceptability (p<0.001). There was no significant difference between groups regarding VGHPIs’ perceived barriers. CONCLUSIONSThe pandemic disrupted essential partnership elements, compounding differences between LMIC and HIC partners in their resources and preferences for partnership activities. VGHPIs have the potential to bridge new and existing gaps and maximize gains, bi-directionality, and equity in partnerships during and after COVID-19.
Persistent Neuropathy in Lepromatous Leprosy Patients
Authors: Penna Patricia , Vital Robson , PITTA IZABELA , Hacker Mariana , Salles Ana , Pinheiro Roberta , Antunes Sérgio , Sarno Euzenir , Jardim Marcia 
Published: October 2021

Abstract
Lepromatous leprosy (LL) patients have evidence of extensive peripheral nerve damage as soon as a diagnosis is made, but most of them have few or no symptoms related to peripheral neuropathy. Usually, they do not have the cardinal signal of leprosy neuritis. However, disability caused by peripheral nerve injuries has consequences throughout the entire life of these patients and the pathophysiological mechanisms of nerve damage are still poorly understood. The objective of this study was to evaluate the outcome of peripheral neuropathy in a group of LL patients in an attempt to understand the mechanisms of nerve damage. We evaluated medical records of 14 LL patients that had undergone a neurological evaluation at the beginning of Leprosy treatment then worsened at least 4 years after the end of treatment and underwent nerve biopsy. The symptoms at the beginning of treatment were compared with those at the time of the biopsy. Pain was a symptom in only one patient at the beginning and was a complaint in 9 patients by the time of biopsy. Neurological examination showed that the majority of patients already had alterations in medium and large caliber fibers at the beginning of the treatment, and pain increased by the time of biopsy, while neurological symptoms and signs deteriorated independently of the use of prednisone or thalidomide. Nerve Conduction Studies demonstrated that sensory nerves were the most affected. LL patients can develop a silent progressive degenerative peripheral neuropathy, which continues to develop despite high dose long term corticoid therapy.
A Novel Technique for Low Rectal Cancer: Pushing The Anus in Laparoscopic Radical Resection
Authors: Yang Rui , Yang Yuyi , Li Jianxin , Yang Qingqiang 
Published: October 2021

Abstract
Background
In sphincter-preserving surgery for low rectal cancer, it is significant to reduce the number of stapler cartilages and the incidence of anastomotic leakage. On this basis, we have developed a safer and more economical technique— pushing the anus in laparoscopic radical resection of low rectal cancer.
Method
From January 2015 to July 2020, 213 consecutive patients with rectal cancer received laparoscopic radical surgery. For 151 of these patients, the surgeon used the stapler cartilages (Ethicon Intraluminal Linear Staplers EC60A, Ethicon, USA) to transect the edge of tumor of the rectum (Conventional Surgery Group). And for another 62 patients, besides applying the stapler cartilages, the surgeon had the assistants push the anus forward from the perineum during the process of transecting the rectum (Pushing the Anus Group). The postoperative outcomes and complications were compared between the two groups.
Results
In terms of the number of the stapler cartilages, the Pushing the Anus Group was less than the Conventional Surgery Group (P<0.001). Moreover, the incidence of anastomotic leakage in the Pushing the Anus Group is lower than that in the Conventional Surgery Group (P=0.043).
Conclusions
With pushing the anus forward during the process of transecting the rectum, the sphincter-preserving surgery can be performed more safely and economically.
Social and Behaviour Change Communication Intervention Improves Coverage and Acceptance of Ivermectin Mass Drug Administration in Onchocerciasis Endemic Communities in Ghana: A Quasi Experimental Design
Authors: Osei Francis Adjei , Newton Sam , Nyanor Isaac , Osei-Yeboah Eugene , Amuzu Evans Xorse , Mensah Nicholas Karikari , Nyarko Obed Ofori , Amanor Ernest , Odoom Samuel Frimpong , Abubakar Suraj Yawnumah , Dongyele Mathias , Mohammed Aliyu , Asare Ofeibea , Boadi Stephanie , Furu Peter , Meyrowitsch Dan Wolf , Owusu-Dabo Ellis 
Published: October 2021

Abstract
BackgroundPoor community awareness and social mobilization serve as a major barrier by increasing absenteeism and downplaying the relevance of the ivermectin mass distribution by community members. Inadequate awareness also creates confusion among community members especially when one intervention is mistaken for the other. MethodsWe designed a targeted Social and Behaviour Change Communication (SBCC) intervention with clearly defined and tailored messages of ivermectin MDA program targeting onchocerciasis in endemic communities in Ghana. Quasi experiment was conducted with a total sample size of 2008 at baseline and 2113 at endline. ResultsAt baseline, 63.9% respondents did not receive Ivermectin during the previous year (2019) MDA programme and more than half of them (53.3%) were not aware of the drug distribution. The communities that received the intervention at endline revealed a significantly higher increase in coverage (SATT=0.123, 95% CI=0. 0.073, 0.173, p<0.001). At baseline, uptake rate of 91.0% was recorded. Post the intervention, there was an increase in the proportion of respondents who ingested the MDA drugs (ivermectin) from 91.0% to 95.45%. Previous uptake of MDA drugs (AOR=10.67; 95%CI: 5.59-20.38, p<0.001), Perceived benefit of MDA drug (AOR=4.13; 95%CI: 1.69-10.15, p<0.001) and being aware of the MDA programme (AOR=2.28; 95%CI: 1.00-5.02, p=0.049) was associated with improved receipt of Ivermectin. ConclusionThe findings of this study reveal that SBCC intervention improves ivermectin coverage and uptake rate in mass drug administration. Further research with technological innovations which can enhance SBCC is recommended taking hind sight of the limitations of the study due to the COVID-19 pandemic.
Unlike Periodontitis, Caries Does Not Associate With Intracranial Aneurysms or Aneurysmal Subarachnoid Hemorrhage
Authors: Hallikainen Joona , Pessi Tanja , Vehkalahti Miira , Suominen Anna Liisa , Frösen Juhana , Pyysalo Mikko 
Published: October 2021

Abstract
Background:Periodontal infections have been associated to the formation and rupture of intracranial aneurysms (IA). In this study we investigated whether also caries (tooth decay) associates to IA pathology.Methods:A total of 166 patients with either IA or aneurysmal subarachnoid hemorrhage (aSAH) underwent oral examination in Kuopio University Hospital and Tampere University Hospital. Findings were compared to age, gender and geographically matched controls acquired from cross-sectional Health 2000 Survey. This study consisted three sequential steps. First step was a comparison of the caries prevalence and number of missing teeth in IA and aSAH patients with the control population, second step was a multivariate analysis with demographic factors and third step was a prospective 13-year follow-up of participants with any caries or missing teeth.Results:In logistic regression adjusted for known risk factors and demographic data, caries (OR: 0.412 95%Cl 0.2-0.9, p=0.028) was associated with lack of IAs, while age (OR:1.029 95%Cl 1.0-1.1 p=0.039), current smoking (OR:2.7 95%Cl 1.4-5.1, p=0.003) and severe periodontitis (OR:4.3 95%Cl 2.3-12.5, p<0.001) associated with IA formation. Severe periodontitis associated also to aSAH in logistic regression (OR: 5.4, 95%Cl 1.9-15.5, p=0.002). In the cox-regression, severe periodontitis at baseline increased the risk of aSAH (HR: 11.9, 95%Cl 1.2-114.7, p=0.032) during a 13-year follow-up.Conclusion:Unlike periodontitis, caries does not increase the risk of IAs and aSAHs. However, cariogenic bacteria may participate to IA pathology by disseminating to circulation via inflamed gingival tissue.
Deep Learning for Ultra-Widefield Imaging: A Scoping Review
Authors: Bhambra Nishaant , Antaki Fares , Malt Farida El , Xu AnQi , Duval Renaud 
Published: October 2021

Abstract
Purpose: This article is a scoping review of published and peer-reviewed articles using deep-learning (DL) applied to ultra-widefield (UWF) imaging. This study provides an overview of the published uses of DL and UWF imaging for the detection of ophthalmic and systemic diseases, generative image synthesis, quality assessment of images, and segmentation and localization of ophthalmic image features. Methods: A literature search was performed up to August 31st, 20201 using PubMed, Embase, Cochrane Library, and Google Scholar. The inclusion criteria were as follows: (1) Deep Learning, (2) Ultra-Widefield Imaging. The exclusion criteria were as follows: (1) articles published in any language other than English, (2) articles not peer-reviewed (usually preprints) (3) no full-text availability (4) articles using machine learning algorithms other than deep learning. No study design was excluded from consideration.Results: A total of 36 studies were included. 23 studies discussed ophthalmic disease detection and classification, 5 discussed segmentation and localization of UWF images, 3 discussed generative image synthesis, 3 discussed ophthalmic image quality assessment, and 2 discussed detecting systemic diseases via UWFI.Conclusion: The application of DL to UWFI has demonstrated significant effectiveness in the diagnosis and detection of ophthalmic diseases including diabetic retinopathy, retinal detachment, and glaucoma. DL has been used with UWFI to also diagnose systemic diseases like Alzheimer’s, and also applied in the generation of synthetic ophthalmic images. This scoping review highlights and discusses the current uses of DL with UWFI, and the future of DL applications in this field.
Effects of a new respiratory muscle training device in community-dwelling elderly men: an open-label, randomized, non-inferiority trial
Authors: Kim Sang Hun , Shin Myung-Jun , Lee Jang Mi , Huh Sungchul , Shin Yong Beom 
Published: October 2021

Abstract
Background: Respiratory muscle training (RMT) has various clinical benefits in older adults, but the low adherence to training remains a difficult issue to resolve. The present study aimed to confirm the efficacy of a new device compared to the Threshold IMT device (Philips Respironics Inc) and to determine whether home-based training was different from rehabilitation center training.Methods: This four-arm, multicenter, prospective, parallel, non-inferiority trial randomized 80 active community-dwelling elderly males (mean age = 72.9 years) to center-based groups (new IMT/PEP device or Threshold IMT device; 16 supervised sessions) or home-based groups (new IMT/PEPdevice or Threshold IMT device; 2 supervised sessions and individual sessions). Participants in all groups performed RMT twice a day for eight weeks. Assessments were performed at baseline and post-training. The primary outcomes were maximum inspiratory pressure and maximal expiratory pressure. The secondary outcomes included forced vital capacity and forced expiratory volume in the first second, peak cough flow, diaphragm thickness, VO2 peak, the International Physical Activity Questionnaire score, electromyographic activities of the sternocleidomastoid muscle, and skeletal muscle mass and phase angle measured by bioimpedance analysis. In addition, adherence rates to each protocol were also compared.Results: The maximal inspiratory pressure improved among all groups post-training. Furthermore, the non-inferiority of the IMT/PEP device was validated. However, the maximal expiratory pressure showed improvement only in the IMT/PEP groups. A statistically significant improvement in diaphragm thickness was found. However, no consistent improvement was shown in other secondary outcomes. No significant difference in training adherence rate between protocols was observed (mean adherence rate of 91%–99%).Conclusion: Compared to the Threshold IMT, using the new IMT/PEP device showed no significant difference in maximal inspiratory pressure but improved maximal expiratory pressure in the elderly. The IMT/PEP devices reduced training time and improved usability, associated with exercise adherence, provided distinct advantages in this cohort. If preceded by proper education, home-based RMT alone is expected to provide sufficient effect in the elderly.Trial registration: This trial was registered in the database cris.nih.go.kr with the number KCT0003901 on 10/05/2019.
3D Isotope Density Measurements by Energy-Resolved Neutron Imaging
Authors: Losko Adrian Simon , Vogel Sven 
Published: October 2021

Abstract
Tools for three-dimensional elemental characterization are available on length scales ranging from individual atoms, using electrons as a probe, to micrometers with X-rays. However, for larger volumes up to millimeters or centimeters, quantitative measurements of elemental or isotope densities were hitherto only possible on the surface. Here, a novel quantitative elemental characterization method based on energy-resolved neutron imaging, utilizing the known neutron absorption cross sections with their ‘finger-print’ absorption resonance signatures, is demonstrated. Enabled by a pixilated time-of-flight neutron transmission detector installed at an intense short-pulsed spallation neutron source, for this demonstration 3.25 million state-of-the-art nuclear physics neutron transmission analyses were conducted to derive isotopic densities for five isotopes in 3D in a volume of 0.25 cm3. The tomographic reconstruction of the isotope densities provides elemental maps similar to X-ray microprobe maps for any cross-section in the probed volume. The bulk isotopic density of a U-20Pu-10Zr-3Np-2Am nuclear transmutation fuel sample was measured, agrees well with mass-spectrometry and is evidence of the accuracy of the method.
Impact of single-port laparoscopic approach on postoperative pain and cosmesis for acute appendicitis: a comparison with multi-port laparoscopic approach
Authors: Kim Kyeong Eui , Cho In Soo , Bae Sung Uk , Jeong Woon Kyung , Kim Hyung Jin , Baek Seong Kyu 
Published: October 2021

Abstract
Background: Acute appendicitis is the most common surgical abdominal emergency. Single-port laparoscopic appendectomy (SPLA) has been suggested potential advantages including less postoperative pain and better cosmesis. The aim of this study was to compare the postoperative pain and cosmetic outcomes between SPLA and multi-port laparoscopic appendectomy (MPLA) for acute appendicitis.Materials and methods: The study included 47 patients who underwent SPLA and 51 patients who underwent MPLA for acute appendicitis between August 2014 and November 2017. The patient scar assessment questionnaire (PSAQ) was used to assess cosmetic outcomes. Results: MPLA involved a longer median operative time than MPLA (60 vs. 47.5 minutes, p=0.02). There were no apparent differences in the time before diet tolerance, length of hospital stay, inflammatory laboratory findings including C-reactive protein and white blood cell count, and postoperative complication rate. SPLA patients had a smaller total incision length (2.0 vs. 2.5 cm, p<0.001) and the total number of analgesics used on postoperative day 0 in the SPLA group was significantly lower than that of the MPLA group (1 vs. 1, p=0.011). The PSAQ scores showed that the SPLA group had a better overall outcome than the MPLA group with respect to total score (48 vs. 55; p = 0.026), appearance (15 vs. 18; p = 0.002) and consciousness (8 vs. 10; p = 0.005), but not in the satisfaction with appearance and symptoms subscales.Conclusion: SPLA is safe and feasible and provides better cosmetic outcomes and less analgesic requirements on the day of surgery compared to MPLA.
On the Frontlines: an Exploratory Analysis of Unequal Exposure to Air Pollution and COVID-19 in the United States
Authors: Vila Daniel Enrique , McDermott Thomas K.J. 
Published: October 2021

Abstract
Recent literature has suggested a link between poor air quality and worse COVID-19 outcomes. In the United States, this link is particularly noteworthy because of residential sorting along ethnic lines within the US population; minorities are disproportionately exposed to health hazards, including air pollution. The impacts of the COVID-19 pandemic have also been disproportionately concentrated amongst minorities. We explore the association between air quality and COVID-19 outcomes, using county level data for the United States from the first wave of the pandemic in 2020, and test whether exposure to more polluted air can account for some of the observed disparities in COVID-19 outcomes among minorities.