bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Practice of Participatory Budgeting during the COVID-19 Pandemic in Zimbabwe’s Local Government Sector: A Case of Chitungwiza Municipality
Authors: Mukushwa Zvimekria Clive , Mapuva Jephias , Mutema Edson P. 
Published: July 2021

Abstract
The experiences of participatory budgeting on the backdrop of the COVID-19 pandemic in Zimbabwe is widely discussed and acknowledged, yet there is paucity of literature of the interface between the two variables. This study therefore seeks to examine how Chitungwiza Municipality has interfaced with Residents and Stakeholders in the participatory budgeting processes during the COVID-19 pandemic. Using informant interviews, non-participant observation, focus group discussions and analytical desk research, the paper argues that COVID-19 pandemic and associated lockdowns has become the most recent threat to the practice of local democracy, particularly to those local government institutions that largely rely more on physical meetings as engaging platforms for participatory budgeting. The study prescribes policy recommendations to improve urban participatory governance within the context of COVID-19 pandemic situation.
Below-Cloud Evaporation of Precipitation Isotopes over Mountains, Oases, and Deserts in Arid Areas
Authors: Zhu Guofeng , Zhang Zhuanxia , Guo Huiwen , Zhang Yu , Yong Leilei , Wan Qiaozhuo , Sun Zhigang , Ma Huiying 
Published: July 2021

AbstractAs raindrops fall from the cloud base to the ground, evaporation below those clouds affects the rain’s isotope ratio, reduces precipitation in arid areas, and impacts the local climate. Therefore, in arid areas with scarce water resources and fragile ecological environments, the below-cloud evaporation is an issue of great concern. Based on 406 event-based precipitation samples collected from nine stations in the Shiyang River basin (SRB) in the northwest arid area, global meteorological water line (GMWL) and local meteorological water line (LMWL) are compared, and the Stewart model is used to study the effect of spatial and temporal variation of below-cloud evaporation on isotope values in different geomorphic units at the SRB. Furthermore, factors influencing below-cloud evaporation are analyzed. The results show that 1) the change of d-excess (Δd) in precipitation at the SRB and the residual ratio of raindrop evaporation (f) vary in time and space. With regard to temporal variation, the intensity of below-cloud evaporation is described by summer < autumn < winter < spring. Regarding spatial variation, the below-cloud evaporation in mountain areas is weaker than in oases and deserts. The intensity of below-cloud evaporation in mountain areas increases with decreasing altitude, and the below-cloud evaporation in oasis and desert areas is affected by local climatic conditions. 2) Below-cloud evaporation is also affected by local transpiration evaporation, especially around reservoirs. Reservoirs increase the relative humidity of the air nearby, weakening below-cloud evaporation. This study deepens our understanding of the water cycle process in arid areas.
Association Between Severity of COVID-19 Respiratory Disease and Risk of Obstructive Sleep Apnea
Authors: Iannella Giannicola , Vicini Claudio , Lechien Jerome R. , Ravaglia Claudia , Poletti Venerino , di Cesare Simona , Amicarelli Elena , Gardelli Lucia , Grosso Carmela , Patacca Aria , Magistrelli Eleonora , De Benedetto Michele , Toraldo Domenico Maurizio , Arigliani Michele , Cammaroto Giovanni , Meccariello Giuseppe , De Vito Andrea , Magliulo Giuseppe , Greco Antonio , de Vincentiis Marco , Ralli Massimo , Pace Annalisa , Montincone Valentina , Maniaci Antonino , Cocuzza Salvatore , Seligardi Matteo , di Giacinto Ida , Corso Ruggero Massimo 
Published: July 2021

Objectives: The purpose of this observational retrospective study was to evaluate, in patients with a severe acute respiratory syndrome coronavirus 2 infection, the association between the severity of coronavirus disease 2019 (COVID-19) respiratory illness and the risk of infected patients to develop obstructive sleep apnea (OSA). Methods: Ninety-six patients with confirmed COVID-19 infection were enrolled in the study. The STOP-BANG questionnaire to investigate the risk of the OSA syndrome was filled in by the patients at admission. The enrolled patients were divided into 2 groups according to the respiratory disease: group 1 (72 patients), hospitalized patients undergoing conventional oxygen therapy; group 2 (24 patients), patients requiring enhanced respiratory support. STOP-BANG results of these 2 groups were compared to observe whether patients with high OSA risk more frequently presented a severe form of COVID-19. Results: 41.6% of the patients in group 2 had a STOP-BANG score between 5 and 8 (high risk of having apnea); in contrast, 20.8% of the patients in group 1 had a STOP-BANG score between 5 and 8, with a statistically significant difference between the 2 groups ( P = .05). A complementary trend was observed regarding the proportion of patients in the range 0 to 2, which classifies patients at a low risk of OSA (48.6% vs 20.8% for groups 1 and 2, P = .01). Conclusions: According to our data, the chances of having a severe case of COVID-19 should be considered in patients at high risk of OSA. Current Knowledge/Study Rationale: Emerging research suggests that OSA could represent a potentially important risk factor for the severe forms of COVID-19. The purpose of this observational retrospective study was to evaluate the potential association between OSA and the severity of COVID-19 disease. Study Impact: According to our data, the likelihood of contracting a severe form of COVID-19 disease should be considered in patients at high risk of OSA.
Effect of Using N95 and Surgical Masks on Otoacoustic Emission in Cochlear Outer Hair Cells
Authors: Alagoz Sedat , Bal Kemal Koray , Ozdas Talih , Delibas Vedat , Kuran Gokhan , Ekici Nur Yucel , Gorgulu Orhan , Oztornacı Ragıp Onur 
Published: July 2021

Introduction: Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. Material and Methods: Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emission and oxygen saturation were measured in both groups before and after mask use. Results: Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. Conclusion: We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values.
‘Made in China 2025’: Poised for Success?
Authors: Agarwala Nitin , Chaudhary Rana Divyank 
Published: July 2021

In the last 70 years, due to reforms and policies, China has moved from an agrarian economy to being a manufacturing superpower. However, this has been possible due to technology transfers into China with the core technologies remaining with the West in the name of competitiveness and national security. To achieve true technological independence and self-reliance, China proposed the ‘Made in China 2025’ policy in 2015 which has since been opposed vehemently by the West. This notwithstanding, China has continued its effort of self-reliance. Hence, it is essential to evaluate if these efforts are bearing the required results. Using qualitative research, the authors look at the factors leading China to adopt ‘Made in China 2025’ and the opposition faced by it through tariff and non-tariff measures. Various supporting policies of Made in China 2025 (MIC25) and the advancements made have been examined. The article thus aims to address the ethos of initiating MIC25, the difficulties China is facing in realising its dreams due to restrictions by the US and its allies and how China is making an all-out effort to make it a success. The primary question that the article aims to answer is whether the efforts of China towards MIC25 are poised for success and how it will affect the developed nations.
Developing Strategies for Integrating Indigenous Health and Modern Health Systems for Improved Adolescent Sexual Health Outcomes in Umguza and Mberengwa Districts in Zimbabwe
Authors: Nunu Wilfred Njabulo , Makhado Lufuno , Mabunda Jabu Tsakani , Lebese Rachel Tsakani 
Published: July 2021

Background: Strategies to improve sexual health outcomes have evolved over the years due to technology’s evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents’ sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers. Methods: A multi-stage approach was utilised, with Phase 1 focussing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phase used the Build, Overcome, Eliminate and Minimise framework to build the strategies. Results: A total of 5 strategies were proposed to facilitate this integration, and these included revival of committees that were inclusive of all stakeholders; allocating Indigenous Health System space in clinics to work in; establishing adolescent-friendly clinics; intensifying information dissemination on sexual health-related issues, and developing clear Terms of Reference and procedures to govern this integration and ensure it is a success. Conclusions: Implementing these strategies could facilitate this integration and ensure that programs are planned and implemented in a complementary manner, thereby reducing conflicts between the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents.
Analysis of Outcomes After Endovascular Abdominal Aortic Aneurysm Repair in Patients With Abnormal Findings on the First Postoperative Computed Tomography Angiography
Authors: Geraedts Anna C. M. , Mulay Sana , van Dieren Susan , Koelemay Mark J. W. , Balm Ron , Balm R. , Elshof J. W. , Elsman B. H. P. , Hamming J. F. , Koelemay M. J. W. , Kropman R. H. J. , Poyck P. P. , Schurink G. W. H. , de Smet A. A. E. A , van Sterkenburg S. M. , Ünlü C. , Vahl A. C. , Verhagen H. J. M. , Vriens P. W. H. E. , de Vries J. P. P. M. , Wever J. J. , Wisselink W. , Zeebregts C. J. 
Published: July 2021

Purpose: Lifelong follow-up after endovascular abdominal aortic aneurysm repair (EVAR) is recommended due to a continued risk of complications, especially if the first postoperative imaging shows abnormal findings. We studied the long-term outcomes in patients with abnormalities on the first postoperative computed tomography angiography (CTA) following EVAR. Materials and Methods: This is a retrospective study of all consecutive patients who underwent elective EVAR for nonruptured abdominal aortic aneurysm (AAA) between January 2007 and January 2012 in 16 Dutch hospitals with follow-up until December 2018. Patients were included if the first postoperative CTA showed one of the following abnormal findings: endoleak type I–IV, endograft kinking, infection, or limb occlusion. AAA diameter, complications, and secondary interventions during follow-up were registered. Primary endpoint was overall survival, and other endpoints were secondary interventions and intervention-free survival. Kaplan-Meier analyses were used to estimate overall and intervention-free survival. Cox regression analyses were used to identify the association of independent determinants with survival and secondary interventions. Results: A total of 502 patients had abnormal findings on the first postoperative CTA after EVAR and had a median follow-up (interquartile range IQR) of 83.0 months (59.0). The estimated overall survival rate at 1, 5, and 10 years was 84.7%, 51.0%, and 30.8%, respectively. Age [hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.05 to 1.10] and American Society of Anesthesiologists (ASA) classification (ASA IV HR 3.20, 95% CI 1.99 to 5.15) were significantly associated with all-cause mortality. Overall, 167 of the 502 patients (33.3%) underwent 238 secondary interventions in total. Fifty-eight patients (12%) underwent an intervention based on a finding on the first postoperative CTA. Overall survival was 38.4% for patients with secondary interventions and 44.5% for patients without (log rank; p=0.166). The intervention-free survival rate at 1, 5, and 10 years was 82.9%, 61.3%, and 45.6%, respectively. Conclusions: Patients with abnormalities on the first postoperative CTA after elective EVAR for infrarenal AAA cannot be discharged from regular imaging follow-up due to a high risk of secondary interventions. Patients who had a secondary intervention had similar overall survival as those without secondary interventions.
Rehabilitation of intubated COVID-19 patients in a Singapore regional hospital with early intensive care unit and sustained post-intensive care unit rehabilitation
Authors: Chen Dominic Enhan , Goh Sze Wei , Chan Hiu Nam , Goh Huai Zhi , Ong Sing Yee , Sim Sara , Ho Vui Kian 
Published: July 2021

Background A proportion of patients with COVID-19 become critically ill, but few studies describe the functional outcomes and rehabilitation process of these patients. Objective To describe the complications encountered and functional outcomes of critically ill COVID-19 patients requiring intubation and subsequent intensive care unit (ICU) management and rehabilitation. Methods Retrospective case note review was conducted on all patients requiring intubation and ICU admission and subsequently discharged from our hospital from February 15, 2020 to May 1, 2020. Demographics, preexisting medical conditions, complications encountered in ICU, ICU and General Ward Length of Stay, number of therapy sessions delivered, nutritional data, and functional outcomes on discharge were collected from electronic medical records and entered in a deidentified database. Results Most patients developed significant breathlessness affecting post-ICU rehabilitation, a few patients developed ICU associated delirium while no patient developed ICU-associated weakness. All patients survived and could walk 20 m within 12 days post-extubation. Conclusion Early ICU and sustained post-ICU rehabilitation of critically ill, intubated COVID-19 patients is feasible. Further studies could look into the outcomes of this group of patients, in particular the effect of nutrition and pulmonary training on functional outcomes. We strongly recommend an interdisciplinary rehabilitation team approach in managing critically ill COVID-19 patients.
Rituximab versus mitoxantrone: comparing effectiveness and safety in advanced relapsing multiple sclerosis
Authors: Zrzavy Tobias , Daniels Esther , Stuka Niklas , Weber Dennis , Winkelmann Alexander , Rauschka Helmut , Hecker Michael , Aboulenein-Djamshidian Fahmy , Meister Stefanie , Leutmezer Fritz , Berger Thomas , Bsteh Gabriel , Zettl Uwe Klaus , Rommer Paulus 
Published: July 2021

Background: Rituximab (RTX), a CD20 depleting agent, is a frequently used off-label treatment for multiple sclerosis (MS), while mitoxantrone (MTX) is approved, albeit rarely used for active relapsing MS (RMS). However, observational data comparing RTX and MTX effectiveness and safety are scarce. Objective: We aimed to compare effectiveness and safety of MTX and RTX in patients with active RMS. Methods: From combined retrospective clinical data of three MS centers, we selected patients who had received at least one infusion of RTX or MTX and had at least a 6-month clinical follow-up available. Treatment groups were compared by propensity score (PS)-adjusted regression and inverse PS-weighted generalized estimated equation models regarding disability progression, relapse activity, and adverse events (AEs). Results: We included 292 RMS patients (mean age 41.8 years, 71.6% female) who received RTX (119 patients, mean age 36.8 years, 74.8% female) or MTX (173 patients mean age 45.3 years, 69.4% female). Using both PS methods, we did not find a significant effect favoring RTX or MTX treatment regarding the probability of disability worsening or relapse occurrence. However, RTX treatment was associated with a significantly lower probability of severe AEs and AEs. Conclusions: RTX shows comparable effectiveness but a favorable safety profile compared with MTX in active RMS.
Profile of COVID-19 Patients at Zero Delay COVID-19 Ward, in a Tertiary Care Hospital in South India
Authors: Ethirajan Theranirajan , Zahir Hussain S. , Rajendran Karthick , Ramachandran Arunkumar , Natarajan Murugan , Venugopalan Nisha , Elumalai Kathiravan , Annamalai Ganesh , Mathiyalagan Guhan , Panneerselvam Priyadarshini , Pamarthi Jayakrishna , Rajaram Muthukumaran , Anandan Gayathri , Natarajan Gopalakrishnan 
Published: July 2021

Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health crisis. During the huge surge in COVID-19 cases, most of the patients arrived at Rajiv Gandhi Government General Hospital, Chennai were severe due to late presentation and also available evidence demonstrated that the delay in treatment is directly associated with increased mortality or poor patient outcome. As an innovative concept, Zero Delay COVID-19 Ward was set up to provide the required critical care for all severe COVID-19 cases. The experience of setting up of such Zero Delay COVID-19 Ward and profile of admitted COVID-19 patients are described in this paper. Methods: A total of 4515 laboratory-confirmed COVID-19 patients admitted at Zero Delay COVID-19 Ward was analyzed retrospectively from 7th July to 31st December 2020. Results: At the time of admission the frequency of dyspnea was 85.6% among them 99.1% improved after the oxygen therapy and other management at Zero Delay COVID-19 Ward. Of the 4515 COVID-19 individuals, about 1829 (40.5%) had comorbidity, 227 (5%) had died. Multivariable logistic regression analysis, COVID-19 death was more likely to be associated with comorbidity (OR: 18.687; 95% CI: 11.229-31.1) than other variables. Conclusions: Comorbidity is an independent high risk factor for mortality of COVID-19 patients. From our observation, it is strongly recommended that effective zero delay covid-19 ward model will help for the prevention of mortality in current/expected waves of COVID-19.
Inequality and Inequity in the Use of Oral Health Services in Australian Adults
Authors: Ju X. , Do L.G. , Brennan D.S. , Luzzi L. , Jamieson L.M. 
Published: July 2021

Objective: Social determinants drive disparities in dental visiting. This study aimed to measure inequality and inequity in dental visiting among Australian adults. Methods: Data were obtained from the National Study of Adult Oral Health (2017 to 2018). Participants were Australian adults aged ≥30 y. The outcome of interest was dental visiting in the last 12 mo. Disparity indicators included education and income. Other sociodemographic characteristics included age, gender, Indigenous status, main language, place of birth, residential location, health card and dental insurance status, and individual’s self-rated and impaired oral health. To characterize inequality in dental service use, we examined bivariate relationships using indices of inequality: the absolute and relative concentration indexes and the slope and relative indexes of inequality. Inequalities were depicted through concentration curves. Indirect standardization with a nonlinear model was used to measure inequity. Results: A total of 9,919 Australian adults were included. Bivariate analysis showed a gradient by education and income on dental visiting, with 48% of those with lowest educational attainment/income having not visited a dentist in the last 12 mo. The concentration curves showed pro–low education and pro–poor income inequalities. All measures of absolute and relative indices were negative, indicating that from the bottom to the top of the socioeconomic ladder (education and income), the prevalence of no dental visiting decreased: absolute and relative concentration index estimates were approximately 2.5% and 5.0%, while the slope and relative indexes of inequality estimates were 14% to 18% and 0.4%, respectively. After need standardization, the group with the highest education or income had almost 1.5-times less probability of not having a dental visit in the previous year than those with the lowest education or income. Conclusion: The use of oral health services exhibited socioeconomic inequalities and inequities, disproportionately burdening disadvantaged Australian adults. Knowledge Transfer Statement: The results of this study can be used by policy makers when planning a dental labor force in relation to the capacity of supply dental services to 1) reduce the inequality and inequity in the use of oral health services and 2) meet identified oral health needs across the Australian population, which is important for preventive dental care.
Diabetes Self-Management Education and Support Culturally Tailored for African Americans: COVID-19-Related Factors Influencing Restart of the TX STRIDE Study
Authors: Steinhardt Mary A. , Brown Sharon A. , Lehrer H. Matthew , Dubois Susan K. , Wright Jaylen I. , Whyne Erum Z. , Sumlin Lisa L. , Harrison Louis , Woo Jihun 
Published: July 2021

Purpose The purpose of this substudy was to determine the most acceptable way to restart the Texas Strength Through Resilience in Diabetes Education (TX STRIDE) study safely using remote technologies. Following the emergence of COVID-19, all in-person TX STRIDE intervention and data collection sessions were paused. Methods Qualitative descriptive methods using telephone interviews were conducted during the research pause. A structured interview guide was developed to facilitate data collection and coding. Forty-seven of 59 Cohort 1 participants were interviewed (mean age = 60.7 years; 79% female; mean time diagnosed with type 2 diabetes = 11 years). Results Data categories and subcategories were generated from the interview responses and included: personal experiences with COVID-19, effects of COVID-19 on diabetes self-management, psychosocial and financial effects of COVID-19, and recommendations for program restart. Although some participants lacked technological knowledge, they expressed eagerness to learn how to use remote meeting platforms to resume intervention and at-home data-collection sessions. Six months after the in-person intervention was paused, TX STRIDE restarted remotely with data collection and class sessions held via Zoom. A majority of participants (72.9%) transitioned to the virtual platform restart. Conclusions Qualitative findings guided the appropriate implementation of technology for the study, which facilitated a successful restart. High retention of participants through the study transition provides evidence that participants are invested in learning how to manage their diabetes despite the challenges and distractions imposed by COVID-19.