bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda
Authors: Mwanga-Amumpaire Juliet , Ndeezi Grace , Källander Karin , Obua Celestino , Migisha Richard , Nkeramahame Juvenal , Stålsby Lundborg Cecilia , Kalyango Joan Nakayaga , Alfvén Tobias 
Published: October 2021

Background
Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds.

Methods
We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections.

Results
Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed.

Conclusion
Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.
Cost-effectiveness of mandatory folic acid fortification of flours in prevention of neural tube defects: A systematic review
Authors: Rodrigues Viviane Belini , Silva Everton Nunes da , Santos Maria Leonor Pacheco 
Published: October 2021

Background
Neural tube defects (NTDs) constitute the most frequent group among congenital malformations and are the main cause of neonatal morbimortality. Folic acid (FA) can reduce the risk of pregnancies affected by NTDs.

Objective
We aimed to investigate whether mandatory folic acid (FA) fortification of flours is cost-effective as compared to non-mandatory fortification, and to verify whether FA dosage, cost composition, and the quality of economic studies influence the cost-effectiveness of outcomes.

Methods
We conducted a systematic review. The protocol was registered on PROSPERO (CRD 42018115682). A search was conducted using the electronic databases MEDLINE/PubMed, Web of Science, Embase, Scopus, and EBSCO/CINAHL between January 2019 and October 2020 and updated in February 2021. Eligible studies comprised original economic analyses of mandatory FA fortification of wheat and corn flours (maize flours) compared to strategies of non-mandatory fortification in flours and/or use of FA supplements for NTD prevention. The Drummond verification list was used for quality analysis.

Results
A total of 7,859 studies were identified, of which 13 were selected. Most (77%; n = 10) studies originated from high-income countries, while three (23%) were from upper-middle-income countries. Results of a cost-effectiveness analysis showed that fortification is cost-effective for NTD prevention, except for in one study in New Zealand. The cost-benefit analysis yielded a median ratio of 17.5:1 (0.98:1 to 417.1:1), meaning that for each monetary unit spent in the program, there would be a return of 17.5 monetary units. Even in the most unfavorable case of mandatory fortification, the investment in the program would virtually payoff at a ratio of 1:0.98. All FA dosages were cost-effective and offered positive health gains, except in one study. The outcomes of two studies showed that FA dosages above 300 μg/100 g have a higher CBA ratio. The studies with the inclusion of “loss of consumer choice” in the analysis may alter the fortification cost-efficacy ratio.

Conclusion
We expect the findings to be useful for public agencies in different countries in decision-making on the implementation and/or continuity of FA fortification as a public policy in NTD prevention.
Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture
Authors: Chung Hye Gyo , Chang Jong-In , Lee Kwang Hyuk , Park Joo Kyung , Lee Kyu Taek , Lee Jong Kyun 
Published: October 2021

Background
Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are commonly used diagnostic modalities in biliary strictures. We compared the diagnostic yield of EUS and ERCP-based tissue sampling in intrinsic biliary strictures without extrinsic mass outside the bile duct.

Methods
A total of 85 patients who underwent ERCP and EUS for diagnosis of suspected biliary strictures confined to the bile duct were analyzed retrospectively at Samsung Medical Center, Seoul, Korea, between 2010 and 2018.

Results
Seventy-one patients were diagnosed with malignancy and 14 patients were diagnosed with benign strictures. EUS-based tissue sampling was more sensitive and accurate than ERCP-based tissue sampling (p = 0.038). The overall sensitivity and accuracy were 67.6% (95% confidence interval (CI) 56.1–77.3) and 72.9% (95% CI 62.7–81.2) for ERCP-based sampling, and 80.3% (95% CI 69.6–87.9) and 83.5% (95% CI 74.2–89.9) for EUS-based sampling, respectively. EUS-based sampling was superior to ERCP-based sampling in distal bile duct strictures (accuracy: 87.0% vs. 72.5%, p = 0.007), but not in perihilar strictures. In cases without intraductal mass, EUS-based tissue sampling was also superior to ERCP-based sampling (accuracy: 83.3% vs. 69.7%, p = 0.029), but not in cases with mass.

Conclusion
EUS-based tissue sampling was superior to ERCP-based method in intrinsic biliary stricture with no mass outside the bile duct, particularly in those without intraductal mass or those with strictures located in distal bile duct. Therefore, EUS-based sampling should be considered for making a pathological diagnosis of suspected distal bile duct strictures even in lesions without definite mass.
The influence of maternal blood glucose during pregnancy on weight outcomes at birth and preschool age in offspring exposed to hyperglycemia first detected during pregnancy, in a South African cohort
Authors: Chivese Tawanda , Haynes Magret C. , van Zyl Hetta , Kyriacos Una , Levitt Naomi S. , Norris Shane A. 
Published: October 2021

Introduction
Little is known about the influence of hyperglycemia first detected in pregnancy (HFDP) on weight outcomes in exposed offspring in Africa. We investigated the influence of maternal blood glucose concentrations during pregnancy on offspring weight outcomes at birth and preschool age, in offspring exposed to HFDP, in South Africa.

Research design and methods
Women diagnosed with HFDP had data routinely collected during the pregnancy and at delivery, at a referral hospital, and the offspring followed up at preschool age. Maternal fasting, oral glucose tolerance test 1 and 2-hour blood glucose were measured at diagnosis of HFDP and 2-hour postprandial blood glucose during the third trimester. Offspring were classified as either those exposed to diabetes first recognized in pregnancy (DIP) or gestational diabetes (GDM). At birth, neonates were classified into macrosomia, low birth weight (LBW), large for gestational age (LGA), appropriate (AGA) and small for gestational age (SGA)groups. At preschool age, offspring had height and weight measured and Z-scores for weight, height and BMI calculated.

Results
Four hundred and forty-three neonates were included in the study at birth, with 165 exposed to DIP and 278 exposed to GDM. At birth, the prevalence of LGA, macrosomia and LBW were 29.6%, 12.2% and 7.5%, respectively, with a higher prevalence of LGA and macrosomia in neonates exposed to DIP. At pre-school age, the combined prevalence of overweight and obesity was 26.5%. Maternal third trimester 2-hour postprandial blood glucose was significantly associated with z-scores for weight at birth and preschool age, and both SGA and LGA at birth.

Conclusion
In offspring exposed to HFDP, there is a high prevalence of LGA and macrosomia at birth, and overweight and obesity at preschool age, with higher prevalence in those exposed to DIP, compared to GDM. Maternal blood glucose control during the pregnancy influences offspring weight at birth and preschool age.
Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19
Authors: Austria Bienvenida , Haque Rehana , Mittal Sukriti , Scott Jamie , Vengassery Aninditha , Maltz Daniel , Li Wentian , Greenwald Blaine , Freudenberg-Hua Yun 
Published: October 2021

Objectives
Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups.

Design
Retrospective observational study.

Participants
Outpatients at a geriatric psychiatric clinic in New York City.

Measurements
Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital.

Results
A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher’s exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4–96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different.

Conclusion
We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.
External quality assessment of serum indices: Spanish SEQC-ML program
Authors: Gómez Rioja Rubén , Ventura Monserrat , Llopis María Antonia , Bauça Josep Miquel , Caballero Garralda Andrea , Ibarz Mercedes , Martinez Debora , Gómez Carolina , Salas Gómez-Pablos Paloma , García del Pino Isabel , Delgado Jose , Puente Juan Jose , Marzana Iciar 
Published: October 2021

Abstract

Objectives
Serum indices included in clinical chemistry instruments are widely used by laboratories to assess the quality of samples. Instruments that report quantitative results allow an evaluation of their diagnostic performance in a similar way to other biochemical tests. The Spanish Society of Laboratory Medicine (SEQC-ML) launched a monthly External Quality program of serum indices in 2018 using three lyophilized materials of simultaneous annual distribution. We present the results of the first three years of the program.

Methods
The use of four different quality control materials with different concentrations in three alternate months allows an annual evaluation of the participant’s accuracy. Assigned values are established by consensus among homogeneous groups, considering necessary at least 10 participants for a comparison at instrument level. The average percentage difference results per instrument allow the assessment of bias among groups.

Results
The imprecision of the three indices ranges between 3 and 9%, with no major differences among instruments. Significant differences were observed in all indices among instruments with more than 10 participants (Roche Cobas, Abbott Architect, Abbott Alinity and Siemens Advia). The 90th percentile of the distribution of percentage differences was used as the analytical performance specification (APS). An improvement in performance was observed in the first three years of the program, probably due to the learning curve effect. In 2020, APS of 7.8, 12.2 and 9.7% were proposed for hemolytic, icteric and lipemic indices, respectively.

Conclusions
Serum indices have a great impact on the quality and the reliability of laboratory test results. Participation in proficiency testing programs for serum indices is helpful to encourage harmonization among providers and laboratories.
On convergence of associative copulas and related results
Authors: Kasper Thimo M. , Fuchs Sebastian , Trutschnig Wolfgang 
Published: October 2021

AbstractTriggered by a recent article establishing the surprising result that within the class of bivariate Archimedean copulas 𝒞ardifferent notions of convergence - standard uniform convergence, convergence with respect to the metricD1, and so-called weak conditional convergence - coincide, in the current contribution we tackle the natural question, whether the obtained equivalence also holds in the larger class of associative copulas 𝒞a. Building upon the fact that each associative copula can be expressed as (finite or countably infinite) ordinal sum of Archimedean copulas and the minimum copulaMwe show that standard uniform convergence and convergence with respect toD1are indeed equivalent in 𝒞a. It remains an open question whether the equivalence also extends to weak conditional convergence. As by-products of some preliminary steps needed for the proof of the main result we answer two conjectures going back to Durante et al. and show that, in the language of Baire categories, when working withD1a typical associative copula is Archimedean and a typical Archimedean copula is strict.
Fe3+ and Ce3+ modified nano-TiO2 for degradation of exhaust gas in tunnels
Authors: Luo Yin , Wu Jianmin , Qin Zhong , Zhang Hengcong 
Published: October 2021

Abstract
To solve the environmental pollution caused by automobile exhaust in a tunnel, this study has developed a modified nano-TiO2 based on Fe3+ and Ce3+. The modified nano-TiO2 is prepared by the sol–gel method, and the modification adopts Fe3+ single-doping, Ce3+ sing-doping, and co-doping. The properties were also characterized by X-ray diffraction analysis, UV-vis diffuse reflectance analysis, fluorescence spectroscopy analysis, specific surface area analysis, and paramagnetic resonance popper analysis. The analyses showed that the doping of ions would change the energy band structure of nano-TiO2 and produce crystal defects, thus improving the photocatalytic activity. Then, a self-fabricated exhaust gas degradation device was used to carry out the exhaust gas degradation experiments. The results showed that the modification improves the catalytic efficiency of nano-TiO2, and Fe3+, Ce3+ co-doping > Ce3+ single-doping > Fe3+ single-doping > pure TiO2. At the dosage of 0.5%, the maximum degradation efficiencies of NO and CO before compensation are 53.85% and 16.39%, respectively, and the maximum degradation rates are 1.04 and 0.93 ppm·min−1. After compensation, the maximum degradation efficiencies of NO and CO are 20.14% and 6.04%, respectively. The maximum degradation rate is 0.40 and 0.41 ppm·min−1, respectively.
Analysis of enzyme activity and microbial community structure changes in the anaerobic digestion process of cattle manure at sub-mesophilic temperatures
Authors: Zhen Xiaofei , Luo Miao , Dong Haiying , Fang Lei , Wang Weiwei , Feng Lei , Yu Qin 
Published: October 2021

Abstract
To improve the biogas potential in anaerobic digestion of cattle manure in cold regions, we investigated, in this study, the potential of the anaerobic digestion of cattle manure through sequencing batch anaerobic digestion experiments at sub-mesophilic temperatures (15°C, 20°C, 25°C, and 37°C) for 50 days. Specifically, the changes in the biogas yield, pH, sCOD concentration, enzyme activity, and microbial community structure were examined. The maximum daily yield of biogas was 19.18 mL·gVS−1, which was recorded on day 6 at 37°C, and the final biogas accumulation yield at this temperature was 403.64 mL·gTS−1. The concentration of sCOD gradually increased as enzyme activity increased. The maximum activities of cellulase, hemicellulase, protease, and amylase were recorded in the 37°C experimental group. The decrease in temperature severely limited the activity of different types of enzymes, resulting in a decrease in the activity of microorganisms, which greatly influenced the methanogenic reaction. The dominant bacteria at the phylum level were Bacteroidetes and Proteobacteria, and the dominant methanogen at the genus level was Methanosaeta.
The effects of visual realism and visuospatial abilities on memorizing soccer tactics
Authors: Ben Mahfoudh Hatem , Zoudji Bachir , Ait El Cadi Abdessamad 
Published: October 2021

Abstract

Objectives
Dynamic visualizations have become valuable assets in acquiring and improving sports skills. However, their instructional efficiency depends on their design and on learners’ cognitive abilities. Intending to improve learning sessions using these technologies, this study investigates the effects of visual realism and visuospatial abilities (VSA) on the memorization of soccer scenes.

Methods
Twenty-four soccer beginners first performed a multitask VSA test followed by the memorization and reproduction of three dynamic sequences with different levels of realism. An eye-tracking system was used in the memorization phase to record gaze behavior and identify the involved cognitive processes.

Results
Findings revealed that increasing visual realism disrupted learners’ memorization performance and visual processing. Moreover, learners with high-VSA were more efficient in memorizing soccer scenes than those with low-VSA and benefited more from reduced visual realism than low-VSA. Learners’ visual processing revealed that high-VSA were more focused on creating a mental representation of the content whereas low-VSA were rather visually guided when memorizing the scene.

Conclusions
Results imply considering learners’ VSA and adapting presentations’ visual realism to optimize tactical learning among beginners.
A pilot of a modified diabetes prevention program in Quito, Ecuador
Authors: Alvear Durán Susana , Sanchez-del-Hierro Galo , Gomez-Correa Diego , Enriquez Andrés , Sanchez Enver , Belec Melissa , Casapulla Sharon , Grijalva Mario J. , Shubrook Jay H. 
Published: October 2021

Abstract

Context
Diabetes has become a global noninfectious pandemic with rates rapidly rising around the globe. The major drivers of this increase in type 2 diabetes are obesity, an increase in processed foods, and a decrease in physical activity. In the United States, the National Diabetes Prevention Program (NDPP) has proven to be an effective lifestyle intervention to delay or prevent new-onset type 2 diabetes. However, there is limited evidence that such a lifestyle program will work in a South American community.

Objectives
This pilot program aims to determine if a modified version of the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Program (DPP) would be feasible in an Ecuadorian population. The goals of this pilot program were a 7% weight loss, >150 min of physical activity per week, and a reduction of fat calories to yield a reduced risk of type 2 diabetes. This program was led by family medicine physicians and was offered to people with prediabetes in Quito, Ecuador.

Methods
The program was modified to include only the first half of the DPP curriculum, which included a schedule of 16 classes in the first 6 months. Further, the program was provided in Spanish and modified to be more culturally specific to this population. Participants were recruited from the faculty and staff of Pontifical Catholic University of Ecuador (Pontificia Universidad Católica del Ecuador [PUCE]) in Quito. Outcomes measured included A1c reduction, weight loss, increase in physical activity minutes, and progression to type 2 diabetes mellitus (T2DM).

Results
The sample included 33 people with prediabetes. The mean age of the participants was 52 years (range, 41–66 years), the mean body mass index (BMI) was 27.6 kg/m2 (range, 21.0–40.3 kg/m2), and the mean HbA1C was 6.2% (range, 5.7–6.4%). The attendance was 97.8% at 6 months. The mean weight loss was 3.4 kg per participant (range, 1.5 kg weight gain to 8.3 kg weight loss); in percentage points, this was a mean weight loss of 3.6% (range, 2.3% gain to 11.8% weight loss). Three-fourths of the participants lost weight (78.3%). The majority of participants (75.8%) met the target physical activity level of 150 min per week, and all participants increased their physical activity levels from baseline. No participants progressed to type 2 diabetes during this study.

Conclusions
The DPP 6 month pilot was effective in this population with prediabetes in Ecuador. The largest changes were made in physical activity time. Holding the program at worksites and providing lunch were key factors in the very high retention rate in this study.
Improving the precision of micro-EDM for blind holes in titanium alloy by fixed reference axial compensation
Authors: Lin Chaohui , Li Jiaming , Liang Shiyong , Zhang Yonghui , Gou Junfeng , Liu Jiangwen , Li Yao 
Published: October 2021

Abstract
During the electrical discharge machining (EDM) process, the tool electrode wear is inevitable, which affects the process precision of the micro-hole. In the present experimental investigation, a fixed reference axial compensation (FRAC) method is proposed to enhance the machining precision of micro-hole. The effect of pulse power, compensation methods, and electrode materials on the depth and roundness factor of micro-hole are explored. The experiment results show that the FRAC method can realize the accurate compensation and reach the expected depth hole processing. When the FRAC is used, the depth deviation is less than 0.43%, and the minimum difference from the expected depth is only 0.106 µm. In addition, the micro-holes of tungsten steel and brass electrodes machine by the FRAC method were close to the expected depth, the difference from the expected depth less than 0.7%, but the bottom of micro-hole produced a cone. However, compared to tungsten steel and brass electrodes, the copper electrode has a better processing performance, the roundness factor is up to 79.8%. When the long-pulse power supply is applied, the expected depth of 400–1,600 µm blind holes with a better processing shape, and the phenomenon of the cone at the bottom are not apparent. Therefore, the proposed FRAC method can be utilized in many high-end manufacturing fields to improve the precision of the micro-hole for micro features.