bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of basic public health services utilization by married female migrants in China: associations of social support, discrimination and sociodemographic factors
Authors: Hu Xin , Sun Mei , Tang Siyuan , Lommel Lisa L. 
Published: September 2021

Abstract
Background
Utilization of basic public health services (BPHS) allows for disease prevention and management and is an essential component for protecting health. Disparities in utilization exist between rural-to-urban migrants and their local counterparts in China. This study sought to determine the frequency of BPHS utilization and whether social support, discrimination, and sociodemographic features were risk factors for low BPHS utilization by Chinese female migrants.

Methods
Data were derived from a survey of female rural-to-urban migrants at nine work sites in Changsha, China. The association between social support, discrimination, sociodemographic factors and BPHS utilization was obtained using Chi-square and logistic regression analysis.

Results
Between December 2017 and April 2018, 307 female participants completed the survey. A total of 24.7% reported having had health education, 26.1% had breast and cervical cancer screening, 27.2% had established a health care record, and 40.9% had received basic contraceptive services. Two factors were associated with the reduced likelihood of BPHS utilization: Length of migration and health record establishment (OR = 0.53; 95% CI = 0.31, 0.92) and years of education and basic contraceptive service use (OR = 0.36; 95% CI = 0.20, 0.67). The remaining six factors were associated with an increased likelihood of BPHS utilization: Living circumstances and health record establishment (OR = 2.11; 95% CI = 1.17, 3.80), health education (OR = 2.71; 95% CI = 1.51, 4.87) and cancer screening (OR = 2.38; 95% CI = 1.30, 4.36). Utilization of social support was associated with health record establishment (OR = 1.24; 95% CI = 1.06, 1.44), basic contraceptive service use (OR = 1.21; 95% CI = 1.04, 1.42) and cancer screening (OR = 1.29; 95% CI = 1.10, 1.51). Objective social support was associated with health education utilization (OR = 1.15; 95% CI = 1.04, 1.26), while subjective social support was associated with basic contraceptive service use (OR = 1.11; 95% CI = 1.05, 1.18) and cancer screening (OR = 1.10; 95% CI = 1.02, 1.17). Family location was associated with basic contraceptive service use (OR = 1.96; 95% CI = 1.12, 3.44) and migration time in Changsha was associated with basic contraceptive service use (OR = 2.24; 95% CI = 1.18, 4.27).

Conclusions
Overall, there was low utilization rate for four BPHS by Chinese female migrants, and social support appears to be an important factor in this setting. Government, community, and workplace education efforts for enhancing BPHS utilization among female rural-to-urban migrants are recommended.
Do women empowerment indicators predict receipt of quality antenatal care in Cameroon? Evidence from a nationwide survey
Authors: Ameyaw Edward Kwabena , Dickson Kwamena Sekyi , Adde Kenneth Setorwu , Ezezika Obidimma 
Published: September 2021

Abstract
Background
World Health Organisation (WHO) recommends quality antenatal care (ANC) for all pregnant women, as one of the strategies for achieving targets 3.1 and 3.2 of the sustainable development goals. Maternal mortality ratio remains high in Cameroon (782 maternal deaths per 100,000 live births). Extant literature suggest a positive association between women empowerment indicators and maternal healthcare utilisation in general. In Cameroon, this association has not received scholarly attention. To fill this knowledge gap, we investigated the association between women empowerment indicators and quality ANC in Cameroon.

Methods
Data of 4615 women of reproductive age were analysed from the women’s file of the 2018 Cameroon Demographic and Health Survey. Quality ANC (measured by six indicators) was the outcome of interest. Binary Logistic Regression was conducted. All results of the Binary Logistic Regression analysis were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were done using Stata version 14.

Results
In all, 13.5% of the respondents received quality ANC. Women with low knowledge level (aOR = 0.66, CI 0.45, 0.98) had a lesser likelihood of receiving quality ANC compared to those with medium knowledge level. Women who highly approved wife beating (aOR = 0.54, CI 0.35, 0.83) had lesser odds of receiving quality ANC compared to those with low approval of wife beating.

Conclusion
The study has pointed to the need for multifaceted approaches aimed at enhancing the knowledge base of women. The Ministry of Public Health should collaborate and intensify female’s reproductive health education. The study suggests that women advocacy and maternal healthcare interventions in Cameroon must strive to identify women who approve of wife beating and motivate them to disapprove all forms of violence.
Online education at the medical School of Tongji University during the COVID-19 pandemic: a cross-sectional study
Authors: Song Yaxiang , Wang Shu , Liu Yixian , Liu Xinying , Peng Ai 
Published: September 2021

Abstract
Background
The global reputation of coronavirus disease (COVID-19) has led universities in China to conduct online teaching. However, the actual feedback from medical teachers and students regarding online education remains unclear.

Methods
A prospective questionnaire survey examined the current opinions of online education from teachers and students at the Medical School of Tongji University.

Results
A total of 488 valid questionnaires were collected (223 males, 45.7%; 265 females, 54.3%), including 394 students (80.7%) and 94 teachers (19.3%). Most teachers and students were “in favor of online teaching,” had “positive views for online education,” were “satisfied with online teaching,” and “expected for regular online education,” although students thought that “too much learning tasks had been assigned” (90.4% teachers vs. 43.1% students, P < 0.001) and “less teaching effect than in offline classes” (68.1% teachers vs. 43.4% students). Compared to female counterpart, male students had higher “learning interest” (27.6% vs. 14.9%), “learning attention” (29.2% vs. 14.4%), “learning efficiency” (30.2% vs. 16.7%), and “better learning effect” (27.6% vs. 15.3%). Furthermore, male students had a significantly rise in attendance rate. Compared with male teachers, female teachers had less “experience in online educational course recording” (25.9% vs. 50%) and “past training for online teaching” (53.7% vs. 77.5%). Furthermore, they tended to be more “resistant to online teaching” (44.4% vs. 22.5%) and less “ready for online teaching” (70.4% vs. 87.5%). There was no significant difference in the acceptance of online teaching among teachers in different age groups.

Conclusions
Most teachers and students supported and were satisfied with the implementation of online education during the pandemic. Although teachers were less adaptable to online education, they still had positive opinions. Sex influenced the acceptance of online teaching. Male teachers and students showed better adaptability than their female counterparts. Although online teaching has advantages, it still cannot completely replace traditional offline teaching. As online education is a trend for future learning, universities should make more efforts to improve it, especially to provide more attention to female teachers and students.
Qualitative research to inform economic modelling: a case study in older people’s views on implementing the NICE falls prevention guideline
Authors: Kwon Joseph , Lee Yujin , Young Tracey , Squires Hazel , Harris Janet 
Published: September 2021

Abstract
Background
High prevalence of falls among older persons makes falls prevention a public health priority. Yet community-based falls prevention face complexity in implementation and any commissioning strategy should be subject to economic evaluation to ensure cost-effective use of healthcare resources. The study aims to capture the views of older people on implementing the National Institute for Health and Care Excellence (NICE) guideline on community-based falls prevention and explore how the qualitative data can be used to inform commissioning strategies and conceptual modelling of falls prevention economic evaluation in the local area of Sheffield.

Methods
Focus group and interview participants (n = 27) were recruited from Sheffield, England, and comprised falls prevention service users and eligible non-users of varying falls risks. Topics concerned key components of the NICE-recommended falls prevention pathway, including falls risk screening, multifactorial risk assessment and treatment uptake and adherence. Views on other topics concerning falls prevention were also invited. Framework analysis was applied for data analysis, involving data familiarisation, identifying themes, indexing, charting and mapping and interpretation. The qualitative data were mapped to three frameworks: (1) facilitators and barriers to implementing the NICE-recommended pathway and contextual factors; (2) intervention-related causal mechanisms for formulating commissioning strategies spanning context, priority setting, need, supply and demand; and (3) methodological and evaluative challenges for public health economic modelling.

Results
Two cross-component factors were identified: health motives of older persons; and professional competence. Participants highlighted the need for intersectoral approaches and prioritising the vulnerable groups. The local commissioning strategy should consider the socioeconomic, linguistic, geographical, legal and cultural contexts, priority setting challenges, supply-side mechanisms spanning provider, organisation, funding and policy (including intersectoral) and health and non-health demand motives. Methodological and evaluative challenges identified included: incorporating non-health outcomes and societal intervention costs; considering dynamic complexity; considering social determinants of health; and conducting equity analyses.

Conclusions
Holistic qualitative research can inform how commissioned falls prevention pathways can be feasible and effective. Qualitative data can inform commissioning strategies and conceptual modelling for economic evaluations of falls prevention and other geriatric interventions. This would improve the structural validity of quantitative models used to inform geriatric public health policies.
Bio-efficacy and wash-fastness of a lambda-cyhalothrin long-lasting insecticide treatment kit (ICON® Maxx) against mosquitoes on various polymer materials
Authors: Tungu Patrick K. , Sudi Wema S. , Kaur Harparkash , Magesa Stephen M. , Rowland Mark 
Published: September 2021

Abstract
Background
Long-lasting efficacy of insecticide-treated nets is a balance between adhesion, retention and migration of insecticide to the surface of netting fibres. ICON® Maxx is a twin-sachet ‘home-treatment kit’ of pyrethroid plus binding agent, recommended by the World Health Organization (WHO) for long-lasting, wash-fast treatment of polyester nets. While knitted polyester netting is widely used, fine woven polyethylene netting is increasingly available and nets made of cotton and nylon are common in Africa and Asia. It is important to investigate whether ICON Maxx is able to fulfill the WHO criteria of long-lasting treatment on a range of domestic fabrics to widen the scope for malaria protection.

Methods
This study was a controlled comparison of the bio-efficacy and wash-fastness of lambda-cyhalothrin CS, with or without binder, on nets made of cotton, polyethylene, nylon, dyed and undyed polyester. Evaluation compared an array of bioassays: WHO cone and cylinder, median time to knockdown and WHO tunnel tests using Anopheles mosquitoes. Chemical assay revealed further insight.

Results
ICON Maxx treated polyethylene and polyester netting met the WHO cone and tunnel test bio-efficacy criteria for LLIN after 20 standardized washes. Although nylon and cotton netting failed to meet the WHO cone and cylinder criteria, both materials passed the WHO tunnel test criterion of 80% mortality after 20 washes. All materials treated with standard lambda-cyhalothrin CS without binder failed to meet any of the WHO bio-efficacy criteria within 5 washes.

Conclusion
The bio-efficacy of ICON Maxx against mosquitoes on netting washed up to 20 times demonstrated wash durability on a range of synthetic polymer and natural fibres: polyester, polyethylene, nylon and cotton. This raises the prospect of making insecticide-binder kits into an effective approach for turning untreated nets, curtains, military clothing, blankets—and tents and tarpaulins as used in disasters and humanitarian emergencies—into effective malaria prevention products. It may provide a solution to the problem of reduced LLIN coverage between campaigns by converting commercially sourced untreated nets into LLINs through community or home treatment. It may also open the door to binding of non-pyrethroid insecticides to nets and textiles for control of pyrethroid resistant vectors.
Design, validation and implementation of the post-acute (long) COVID-19 quality of life (PAC-19QoL) instrument
Authors: Jandhyala Ravi 
Published: September 2021

Abstract
Background
The novel coronavirus (SARS-CoV-2) has led to a global pandemic, resulting in a disease termed COVID-19, which commonly presents in adults as a typical infection of the upper respiratory tract. Although the disease is often acute, one in ten patients can continue to be affected for weeks or months, resulting in a state called long COVID. Existing evidence suggests there are no patient-centred instruments for capturing the impact of long COVID on the quality of life of people affected.

Methods
The Jandhyala Method was used to identify indicators of long COVID quality of life. The resulting post-acute (long) COVID-19 Quality of Life (PAC-19QoL) instrument was validated with a control group of unaffected participants and finally implemented in the dedicated patient registry, PAC-19QoLReg.

Participants
15 participants suffering from long COVID, who have been positively diagnosed with COVID-19, either via diagnostic or antibody tests and a validation control group of 16 healthy participants who have not suffered from COVID-19.

Main outcome measures
Indicators submitted by participants with long COVID that address the specific impact of the illness on their quality of life.

Results
Forty-four Quality of Life Indicators (QoLI) across four domains, namely, psychological, physical, social, and work, were agreed by the participants with long COVID to be relevant for the assessment of their quality of life (CI > 0.5). The validation stage identified 35/44 QoLIs that differentiated between the two groups, with a statistically significant difference between the mean QoLI Likert Scores (p < 0.05).

Conclusions
The PAC-19QoL instrument and PAC-19QoLReg prospective observational cohort clinical study will enable an understanding of disease progression, on and off treatment, on the quality of life of patients with long COVID beyond simple symptomatology.
Trial registration: ClinicalTrials.gov Identifier NCT04586413; 14th October 2020.
Axillary ultrasound and fine-needle aspiration cytology to predict clinically relevant nodal burden in breast cancer patients
Authors: Buzatto Isabela Panzeri Carlotti , dos Reis Francisco José Cândido , de Andrade Jurandyr Moreira , Rodrigues Tamara Cristina Gomes Ferraz , Borba Jéssica Maria Camargo , Netto Amanda Homse , Polydoro Marina Sconzo , Tiezzi Daniel Guimarães 
Published: September 2021

Abstract
Background
Axillary lymph node involvement is one important prognostic factor in breast cancer, but the way to access this information has been modified over the years. This study evaluated if axillary ultrasound (US) coupled with fine-needle aspiration cytology (FNAC) can accurately predict clinically relevant node metastasis in patients with breast cancer, and thus assist clinical decisions

Methods
This is a cross-sectional study with retrospective data collection of 241 individuals (239 women and 2 men) with unilateral operable breast cancer who were submitted to preoperative axillary assessment by physical exam, US and FNAC if suspicious nodes by imaging. We calculated sensitivity, specificity, and accuracy of the methods. We compared the patient's characteristics using chi-square test, parametrics and non-parametrics statistics according to the variable.

Results
The most sensible method was US (0.59; 95% CI, 0.50–0.69), and the most specific was US coupled with FNAC (0.97; 95% CI, 0.92–0.99). Only 2.7% of the patients with normal axillary US had more than 2 metastatic nodes in the axillary lymph node dissection, against 50% of the patients with suspicious lymph nodes in the US and positive FNAC.

Conclusions
Axillary US coupled with FNAC can sort patients who have a few metastatic nodes at most from those with heavy axillary burden and could be one more tool to initially evaluate patients and define treatment strategies.
Temporal trend of comorbidity and increasing impacts on mortality, length of stay, and hospital costs of first stroke in Tianjin, North of China
Authors: Hao Ruixiao , Qi Xuemei , Xia Xiaoshuang , Wang Lin , Li Xin 
Published: September 2021

Abstract
Background
Stroke patients have a high incidence of comorbidity. Previous studies have shown that comorbidity can impact on the short-term and long-term mortality after stroke.

Methods
Our study aimed to explore the trend of comorbidity among patients with first stroke from 2010 to 2020, and the influence of comorbidity on admission mortality, length of stay and hospitalization costs. 5988 eligible patients were enrolled in our study, and divided into 4 comorbidity burden groups according to Charlson comorbidity index (CCI): none, moderate, severe, very severe. Survival analysis was expressed by Kaplan–Meier curve. Cox regression model was used to analyze the effect of comorbidity on 7-day and in-hospital mortality. Generalized linear model (GLM) was used to analyze the association between comorbidity and hospitalization days and cost.

Results
Compared to patients without comorbidity, those with very severe comorbidity were more likely to be male (342, 57.7%), suffer from ischemic stroke (565, 95.3%), afford higher expense (Midian, 19339.3RMB, IQR13020.7–27485.9RMB), and have a higher in-hospital mortality (60, 10.1%). From 2010 to 2020, proportion of patients with severe and very severe comorbidity increased 12.9%. The heaviest comorbidity burden increased the risk of 7-day mortality (adjusted hazard ratio, 3.51, 95% CI 2.22–5.53) and in-hospital mortality (adjusted hazard ratio, 3.83, 95% CI 2.70–5.45). Patients with very severe comorbidity had a 12% longer LOS and extra 27% expense than those without comorbidity.

Conclusions
Comorbidity burden showed an increasing trend year in past eleven years. The heavy comorbidity burden increased in-hospital mortality, LOS, and hospitalization cost, especially in patients aged 55 years or more. The findings also provide some reference on improvement of health care reform policies and allocation of resources.
Diversification through gustatory courtship: an X-ray micro-computed tomography study on dwarf spiders
Authors: Lin Shou-Wang , Lopardo Lara , Uhl Gabriele 
Published: September 2021

Abstract
Background
Sexual selection has been considered to promote diversification and speciation. Sexually dimorphic species have been used to explore the supposed effect, however, with mixed results. In dwarf spiders (Erigoninae), many species are sexually dimorphic—males possess marked prosomal modifications. These male traits vary from moderate elevations to bizarre shapes in various prosomal regions. Previous studies established that male dwarf spiders produce substances in these prosomal modifications that are taken up by the females. These substances can act as nuptial gifts, which increase the mating probability of males and the oviposition rate in females. Therefore, these dimorphic traits have evolved in the context of sexual selection. Here, we explore the evolutionary lability of this gustatory trait complex with the aim of assessing the role of this trait complex in species divergence by investigating (1) if erigonine modified prosomata are inherently linked to nuptial-gift-producing glands, (2) if the evolution of the glands evolution preceded that of the modified prosomal shapes, and by assessing (3) the occurrence of convergent/divergent evolution and cryptic differentiation.

Results
We reconstructed the position and extent of the glandular tissue along with the muscular anatomy in the anterior part of the prosoma of 76 erigonine spiders and three outgroup species using X-ray micro-computed tomography. In all but one case, modified prosomata are associated with gustatory glands. We incorporated the location of glands and muscles into an existing matrix of somatic and genitalic morphological traits of these taxa and reanalyzed their phylogenetic relationship. Our analysis supports that the possession of glandular equipment is the ancestral state and that the manifold modifications of the prosomal shape have evolved convergently multiple times. We found differences in gland position between species with both modified and unmodified prosomata, and reported on seven cases of gland loss.

Conclusions
Our findings suggest that the occurrence of gustatory glands in sexually monomorphic ancestors has set the stage for the evolution of diverse dimorphic external modifications in dwarf spiders. Differences among congeners suggest that the gland position is highly susceptible to evolutionary changes. The multiple incidences might reflect costs of glandular tissue maintenance and nuptial feeding. Our results indicate divergent evolutionary patterns of gustatory-courtship-related traits, and thus a likely facilitating effect of sexual selection on speciation.