bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness and public health impact of RTS,S/AS01E malaria vaccine in Malawi, using a Markov static model
Authors: Ndeketa Latif , Mategula Donnie , Terlouw Dianne J. , Bar-Zeev Naor , Sauboin Christophe J. , Biernaux Sophie 
Published: August 2021

Background: The RTS,S/AS01E malaria vaccine is being assessed in Malawi, Ghana and Kenya as part of a large-scale pilot implementation programme. Even if impactful, its incorporation into immunisation programmes will depend on demonstrating cost-effectiveness. We analysed the cost-effectiveness and public health impact of the RTS,S/AS01E malaria vaccine use in Malawi. Methods: We calculated the Incremental Cost Effectiveness Ratio (ICER) per disability-adjusted life year (DALY) averted by vaccination and compared it to Malawi’s mean per capita Gross Domestic Product. We used a previously validated Markov model, which simulated malaria progression in a 2017 Malawian birth cohort for 15 years. We used a 46% vaccine efficacy, 75% vaccine coverage, USD5 estimated cost per vaccine dose, published local treatment costs for clinical malaria and Malawi specific malaria indicators for interventions such as bed net and antimalarial use. We took a healthcare provider, household and societal perspective. Costs were discounted at 3% per year, no discounting was applied to DALYs. For public health impact, we calculated the DALYs, and malaria events averted. Results: The ICER/DALY averted was USD115 and USD109 for the health system perspective and societal perspective respectively, lower than GDP per capita of USD398.6 for Malawi. Sensitivity analyses exploring the impact of variation in vaccine costs, vaccine coverage rate and coverage of four doses showed vaccine implementation would be cost-effective across a wide range of different outcomes. RTS,S/AS01 was predicted to avert a median of 93,940 (range 20,490–126,540) clinical cases and 394 (127–708) deaths for the three-dose schedule, or 116,480 (31,450–160,410) clinical cases and 484 (189–859) deaths for the four-dose schedule, per 100 000 fully vaccinated children. Conclusions: We predict the introduction of the RTS,S/AS01 vaccine in the Malawian expanded programme of immunisation (EPI) likely to be highly cost effective.
Giving children a voice through partnership: a child rights-based approach to the co-design of postgraduate nurse education
Authors: Allan Elaine , Luders Sadullah 
Published: August 2021

BackgroundThere is an increasing need for the voice of children and young people to be more evident in planning and designing services, including the delivery of higher education, for school nurses to ultimately influence service delivery.AimTo raise awareness of the importance of children's rights by embedding them in postgraduate school nurse education to influence school nurse service delivery.MethodsA model was developed through direct partnership with representatives of the Children's Parliament in Scotland. This model facilitated the inclusion of children and young people's opinions in the co-design of postgraduate nurse education in order to incorporate children and young people's rights and opinions and improve the delivery of the school nurse service in Aberdeen.ResultsIn a supported environment, children and young people were able to negotiate relationships with multiagency professionals on an equal basis, building connections and trust with them in partnership, based on their perceptions of school nurses' daily actions and characteristics. Their negotiation of relationships identified various change management categories for improving the delivery of higher education and services.ConclusionsChildren and young people have clear opinions and views when consulted in an inclusive age-appropriate way through rights-based participation. It is important that listening and taking due cognisance of children's voices becomes the norm in influencing higher education, and that children and young people have a direct influence on improving children's services.
Parental perceptions of the impact of COVID-19 restrictions on family-centred care at a paediatric intensive care unit
Authors: Bannerman Kieran , Aitken Lorna , Donnelly Peter , Kidson Christopher 
Published: August 2021

Background/Aims Restrictions to clinical practice necessitated by the COVID-19 global pandemic exerted pressures on staff, families and patients within the paediatric intensive care unit of the Royal Hospital for Children in Glasgow. The authors sought to explore parents' experiences during this pandemic. Methods A single centre study was performed using a questionnaire distributed to parents of patients in the 22-bed paediatric intensive care unit. The key areas targeted were visiting restrictions, ward round changes, facilities closures and the need to wear personal protective equipment. Free text responses were reviewed by two authors independently and common themes identified. Results The findings offer insight into family perceptions that illustrate the negative repercussions of the restrictions to parents. Understanding on the part of the parents was demonstrated throughout; however, restrictions and pandemic interventions also resulted in isolation, distress, exclusion and anxiety. Conclusions There are no current studies exploring parental perceptions of COVID-19 interventions within paediatric intensive care units. These findings offer insights that illustrate the unique challenges faced by those who strive to deliver family-centred care, and the additional stress that this can put upon parents. The authors propose adaptive strategies to enhance family-centred care at paediatric intensive care units.
People living with diabetes are unaware of their foot risk status or why they are referred to a multidisciplinary foot team
Authors: Walton Daina V , Edmonds Michael E , Bates Maureen , Vas Prashanth R J , Petrova Nina L , Manu Chris A 
Published: August 2021

Aim:People with active diabetic foot disease should be rapidly referred by health professionals along a pathway of care to a multidisciplinary foot team. The aim was to investigate patients' self-reported understanding of their foot risk status and reasons for their referral to a multidisciplinary foot team.Method:This seven-month service evaluation included consecutive newly referred patients. Participants completed a questionnaire which asked firstly about their understanding of their foot risk status, secondly about their pathway of care before presentation to the multidisciplinary foot team, and thirdly about their interest in diabetes-related foot education and preferred learning style.Results:There were 202 participants; 65% were male, mean age was 64±15 years (mean±standard deviation (SD)), 86% had type 2 diabetes, and mean HbA1c was 65±23mmol/mol (8.3±3.7%). Only 4% of participants knew their current foot risk status and 52% did not know why their care had been escalated to a multidisciplinary foot clinic. Participants with type 2 diabetes more readily expressed an interest in further foot education compared with participants with type 1 diabetes, (70% versus 29%, p=0.001).Conclusions:These findings show that people with diabetes and foot disease are less aware of their foot risk status or why they are referred to a multidisciplinary team. Participants indicated a variable interest in further learning about foot complications. These findings indicate possible communication and educational barriers between patients and health professionals which may contribute to delayed presentation or suboptimal engagement.
Quercus infectoria gall extract aids wound healing in a streptozocin-induced diabetic mouse model
Authors: Dardmah Farhad , Farahpour Mohammad Reza 
Published: August 2021

Objective: Quercus infectoria galls have commonly been used for different therapeutic purposes. This study was conducted to investigate the effects of topical application of an ointment prepared from Quercus infectoria gall hydroethanolic extract on open wound healing in a streptozocin-induced diabetic BALB/c mouse model. Method: After induction of diabetes, two circular wounds (5mm) were created on the dorsum of the mice which were then divided into three groups. The mice were treated with soft yellow paraffin (control-sham group) and therapeutic doses of 5% and 10% of an ointment prepared from Quercus infectoria, respectively. To evaluate the effects of the therapeutic ointment on the wound healing process, wound area, histological parameters, mRNA levels of vascular endothelial growth factor (VEGF), Bcl-2 and p53, plasma levels of interleukin-6 (IL-6) and tumour necrosis factor (TNF)-α, and tissue antioxidant capacity were investigated. Results: The mice (n=54) were divided into three equal groups. Wound area and concentrations of IL-6 and TNF-α were significantly decreased in both ointment-treated groups compared to the control group (p<0.05). Moreover, angiogenesis, fibroblast distribution per mm2 of wound tissue, collagen deposition, rapid re-epithelialisation, and the expression of VEGF, Bcl-2 and p53 mRNA, were significantly increased (p<0.05). The administration of the ointment reduced malondialdehyde concentration and increased total antioxidant capacity compared with the control group (p<0.05). Conclusion: Our study suggests that an ointment prepared from Quercus infectoria gall hydroethanolic extract accelerated open wound healing in a diabetic animal model by shortening the inflammatory phase, inducing apoptosis, up-regulating the expression of Bcl-2 and p53 mRNA, antioxidant properties and cellular proliferation.
Surgical wounds in reduction mammoplasty: a comparison of Monocryl and Prolene sutures on scars
Authors: Rezaei Ezzatollah , Farhadi Hamed , Khaniki Saeedeh Hajebi , Zarei Hamzeh , Hojjati Yavar Shams 
Published: August 2021

Objective: The type of suture material affects the quality of scars. The aim of this study was to find the superior suture material for reduction mammoplasty between Prolene and Monocryl based on the comparison of scars. Method: A prospective observational study was conducted at a university-based hospital in Mashhad, Iran between October 2015 and September 2017. Monocryl and Prolene suture materials, used for closing the outermost layer in mammoplasty, were compared. Patients' incision scars were assessed objectively according to the Patient and Observer Scar Assessment (POSAS) criteria. The relevant CONSORT guideline was used for reporting this study. Results: Seventy-eight women with a mean age of 36.8±9.5 years were entered into the study. The frequency of wound healing in both groups was 97.4% 1 month after surgery and by the third visit, 3 months after surgery, only one patient had a stretched scar. Moreover, wound inflammation in the first two visits was less frequent in the Prolene group that healed completely 3 months after surgery (after excluding the one patient with wide scar inflammation). The frequency of itching of the wound in the Monocryl group was 24.4%, 11.5% and 12.8% in the three follow-up visits, respectively, and the values for the Prolene group were 24.4%, 9.0% and 6.4%, respectively. No significant difference was seen between the two groups in terms of wound healing, inflammation and itching (p>0.05). Overall, 94.8% of patients were satisfied with the surgery. Conclusions: Our study revealed that there was no significant difference between Monocryl and Prolene. Hence, either of the two suture materials can be used for wound closure in reduction mammoplasty.
Variation in Tensile Properties of Single Vascular Bundles in Moso Bamboo
Authors: Shang Lili , Liu Xing'e , Jiang Zehui , Tian Genlin , Yang Shumin 
Published: August 2021

Abstract
Moso bamboo (Phyllostachys edulis), an apt example of an anisotropic, functionally graded composite material, is the most important commercial bamboo species of China. This species has excellent mechanical properties due to its unique vascular bundle structure. This article examines the variation in mechanical properties of single vascular bundles with respect to their location within a bamboo culm. The mechanical exfoliation method was used to prepare the single vascular bundle. This study found that moso bamboo has superior stiffness and strength. Additionally, the variation in properties was large in the radial direction but minimal in longitudinal direction. The large variation in mechanical properties of vascular bundles can be ascribed to the synergistic effect of the fibrous sheath and parenchyma rather than to changes in fibrous sheath properties. This study provides a basis for the structure application for moso bamboo.
Cavity-enhanced frequency doubling with a third-order quasi-phase-matched PPKTP crystal
Authors: Niu Su-Jian , Yang Chen , Li Yan , Ge Zheng , Liu Shi-Kai , Zhou Zhi-Yuan , Shi Bao-Sen 
Published: August 2021

Blue lasers are very useful for applications in fundamental sciences and advanced technologies. Although the frequency doubling with a first-order quasi-phase-matched (QPM) crystal is an effective approach to obtain blue and UV lasers, the crystal should be poled with a short period, which is technically difficult to fabricate compared with a long period. Using a third-order QPM can be an alternative way to generate blue light, in which the poling period is 3 times larger than that in first-order QPM. In this work, we report on the generation of a 402.5 nm laser by using cavity-enhanced second-harmonic generation and a periodically poled KTP (PPKTP) crystal with a poling period of 10.02 µm. About 36.49 mW output power and 15.3% conversion efficiency are achieved in our experiment.
DeepG4: A deep learning approach to predict cell-type specific active G-quadruplex regions
Authors: Rocher Vincent , Genais Matthieu , Nassereddine Elissar , Mourad Raphael 
Published: August 2021

DNA is a complex molecule carrying the instructions an organism needs to develop, live and reproduce. In 1953, Watson and Crick discovered that DNA is composed of two chains forming a double-helix. Later on, other structures of DNA were discovered and shown to play important roles in the cell, in particular G-quadruplex (G4). Following genome sequencing, several bioinformatic algorithms were developed to map G4s in vitro based on a canonical sequence motif, G-richness and G-skewness or alternatively sequence features including k-mers, and more recently machine/deep learning. Recently, new sequencing techniques were developed to map G4s in vitro (G4-seq) and G4s in vivo (G4 ChIP-seq) at few hundred base resolution. Here, we propose a novel convolutional neural network (DeepG4) to map cell-type specific active G4 regions (e.g. regions within which G4s form both in vitro and in vivo). DeepG4 is very accurate to predict active G4 regions in different cell types. Moreover, DeepG4 identifies key DNA motifs that are predictive of G4 region activity. We found that such motifs do not follow a very flexible sequence pattern as current algorithms seek for. Instead, active G4 regions are determined by numerous specific motifs. Moreover, among those motifs, we identified known transcription factors (TFs) which could play important roles in G4 activity by contributing either directly to G4 structures themselves or indirectly by participating in G4 formation in the vicinity. In addition, we used DeepG4 to predict active G4 regions in a large number of tissues and cancers, thereby providing a comprehensive resource for researchers.
Availability: https://github.com/morphos30/DeepG4.
Livestock herding and Fulani ethnicity are a combined risk factor for development of early adverse reactions to antivenom treatment: Findings from a cross-sectional study in Nigeria
Authors: Menzies Stefanie K. , Thomas Aniekan O. , Tianyi Frank-Leonel , Abubakar Saidu B. , Nasidi Abdulsalami , Durfa Nandul , Patel Rohit , Trelfa Anna , Lalloo David G. , Habib Abdulrazaq G. , Harrison Robert A. 
Published: August 2021

Background
Adverse reactions to antivenom considerably complicate the clinical management of snakebite envenomed patients because it necessitates a temporary suspension of life-saving antivenom, increases costs and can compromise patient outcomes. This study sought to explore the association between cattle-herding occupation and ethnic group and the occurrence of early adverse reactions to antivenom.

Methods
This cross-sectional study was conducted between the 25th April and 11th July 2011 at the Kaltungo General Hospital in north east Nigeria. The exposure variable of cattle-herding occupation showed a strong correlation with the ethnic group variable, thus these were combined into a new variable with three categories (Fulani and herder, either Fulani or herder, and neither Fulani nor herder). The outcome variable was the occurrence of early adverse reactions, defined as any new symptoms occurring within 6 hours of antivenom administration. Odds Ratios were estimated using multivariable logistic regression models controlling for potential confounders.

Results
Among 231 envenomed snakebite victims, the overall incidence of early adverse reactions was 11.9% (95% confidence intervals: 8.0–16.9%). Patients who were Fulani and herders had a higher incidence of early adverse reactions compared to patients who were neither Fulani nor herders (20% vs 5.7%). After adjusting for age and gender, victims who were Fulani and herders were 5.9 times more likely to have an early adverse reaction, compared to victims who were neither Fulani nor herders (95% CI: 1.88–18.59; p = 0.002).

Interpretation
To the best of our knowledge, this is the first study to provide evidence of higher odds of early adverse reactions among patients from a particular occupation and/or ethnic group. We recommend that snake envenomed patients of Fulani origin be especially closely monitored for adverse reactions, that hospitals receiving these patients be appropriately resourced to manage both envenoming and adverse reactions and that premedication with adrenaline should be considered. Our findings provide an argument for speculation on the influence of immunological or lifestyle-related differences on the occurrence of early adverse reactions to antivenom.
Zoonotic risk factors associated with seroprevalence of Ebola virus GP antibodies in the absence of diagnosed Ebola virus disease in the Democratic Republic of Congo
Authors: Bratcher Anna , Hoff Nicole A. , Doshi Reena H. , Gadoth Adva , Halbrook Megan , Mukadi Patrick , Musene Kamy , Ilunga-Kebela Benoit , Spencer D’Andre , Bramble Matthew S. , McIlwan David , Kelly J. Daniel , Mukadi Daniel , Kingebeni Placide Mbala , Ahuka Steve , Okitolonda-Wemakoy Emile , Muyembe-Tamfum Jean-Jacques , Rimoin Anne W. 
Published: August 2021

Background
Ebola virus (EBOV) is a zoonotic filovirus spread through exposure to infected bodily fluids of a human or animal. Though EBOV is capable of causing severe disease, referred to as Ebola Virus Disease (EVD), individuals who have never been diagnosed with confirmed, probable or suspected EVD can have detectable EBOV antigen-specific antibodies in their blood. This study aims to identify risk factors associated with detectable antibody levels in the absence of an EVD diagnosis.

Methodology
Data was collected from September 2015 to August 2017 from 1,366 consenting individuals across four study sites in the DRC (Boende, Kabondo-Dianda, Kikwit, and Yambuku). Seroreactivity was determined to EBOV GP IgG using Zaire Ebola Virus Glycoprotein (EBOV GP antigen) ELISA kits (Alpha Diagnostic International, Inc.) in Kinshasa, DRC; any result above 4.7 units/mL was considered seroreactive. Among the respondents, 113 (8.3%) were considered seroreactive. Several zoonotic exposures were associated with EBOV seroreactivity after controlling for age, sex, healthcare worker status, location, and history of contact with an EVD case, namely: ever having contact with bats, ever having contact with rodents, and ever eating non-human primate meat. Contact with monkeys or non-human primates was not associated with seroreactivity.

Conclusions
This analysis suggests that some zoonotic exposures that have been linked to EVD outbreaks can also be associated with EBOV GP seroreactivity in the absence of diagnosed EVD. Future investigations should seek to clarify the relationships between zoonotic exposures, seroreactivity, asymptomatic infection, and EVD.
Evaluation of a point-of-care diagnostic to identify glucose-6-phosphate dehydrogenase deficiency in Brazil
Authors: Zobrist Stephanie , Brito Marcelo , Garbin Eduardo , Monteiro Wuelton M. , Clementino Freitas Suellen , Macedo Marcela , Soares Moura Aline , Advani Nicole , Kahn Maria , Pal Sampa , Gerth-Guyette Emily , Bansil Pooja , Domingo Gonzalo J. , Pereira Dhelio , Lacerda Marcus VG 
Published: August 2021

Background
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common enzyme deficiency, prevalent in many malaria-endemic countries. G6PD-deficient individuals are susceptible to hemolysis during oxidative stress, which can occur from exposure to certain medications, including 8-aminoquinolines used to treat Plasmodium vivax malaria. Accordingly, access to point-of-care (POC) G6PD testing in Brazil is critical for safe treatment of P. vivax malaria.

Methodology/Principal findings
This study evaluated the performance of the semi-quantitative, POC STANDARD G6PD Test (SD Biosensor, Republic of Korea). Participants were recruited at clinics and through an enriched sample in Manaus and Porto Velho, Brazil. G6PD and hemoglobin measurements were obtained from capillary samples at the POC using the STANDARD and HemoCue 201+ (HemoCue AB, Sweden) tests. A thick blood slide was prepared for malaria microscopy. At the laboratories, the STANDARD and HemoCue tests were repeated on venous samples and a quantitative spectrophotometric G6PD reference assay was performed (Pointe Scientific, Canton, MI). G6PD was also assessed by fluorescent spot test. In Manaus, a complete blood count was performed.
Samples were analyzed from 1,736 participants. In comparison to spectrophotometry, the STANDARD G6PD Test performed equivalently in determining G6PD status in venous and capillary specimens under varied operating temperatures. Using the manufacturer-recommended reference value thresholds, the test’s sensitivity at the <30% threshold on both specimen types was 100% (95% confidence interval [CI] venous 93.6%–100.0%; capillary 93.8%–100.0%). Specificity was 98.6% on venous specimens (95% CI 97.9%–99.1%) and 97.8% on capillary (95% CI 97.0%–98.5%). At the 70% threshold, the test’s sensitivity was 96.9% on venous specimens (95% CI 83.8%–99.9%) and 94.3% on capillary (95% CI 80.8%–99.3%). Specificity was 96.5% (95% CI 95.0%–97.6%) and 92.3% (95% CI 90.3%–94.0%) on venous and capillary specimens, respectively.

Conclusion/Significance
The STANDARD G6PD Test is a promising tool to aid in POC detection of G6PD deficiency in Brazil.

Trial registration
This study was registered with ClinicalTrials.gov (identifier: NCT04033640).