bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of vaccination dropout among children 12-23 months age in north Gondar zone, northwest Ethiopia, 2019
Authors: Chanie Muluken Genetu , Ewunetie Gojjam Eshetie , Molla Asnakew , Muche Amare 
Published: February 2021

Background
Vaccination is a proven tool in preventing and eradicating childhood infectious diseases. Each year, vaccination averts an estimated 2–3 million deaths from vaccine preventable diseases. Even though immunization coverage is increasing globally, many children in developing countries still dropout vaccination. The objective of this study was to identify determinants of vaccination dropout among children age 12–23 months in North Gondar, North west Ethiopia.

Methods
Community based unmatched case-control study was conducted in north Gondar from March 1–27, 2019 among 366 children age 12–23 months (92 cases and 274 controls). Multistage sampling was used for reaching to the community. Data were collected from mothers who had 12–23 months age children using a pretested structured face to face interview. Data were entered using Epi info v. 7 and exported to SPSS v. 20 for analysis. On multivariable logistic regression variables with P-value <0.05 at 95% CI were considered statistically significant.

Result
Counseling for mothers about vaccination (AOR = 7.2, 95% CI: (2.93–17.5)); fear of vaccine side effects (AOR = 3.5, 95% CI: (1.56–8.12)); PNC attended (AOR = 3.6, 95% CI: (1.52–8.39)) and mothers not received tetanus toxoid vaccination (AOR = 2.4, 95% CI: (1.03–5.35)) were found risk factors of vaccination dropout.

Conclusion
Counseling on vaccination, fear of vaccine side effects, PNC attended and mothers’ tetanus toxoid vaccination status during ANC visit were found risk factors. Management bodies and health workers need to consider “reaching every community” approach, Counsel every mother at any opportunity, and provide TT vaccination for all pregnant mothers helps to reduce vaccination dropout among children.
Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: Cox-gamma shared frailty model
Authors: Dewau Reta , Muche Amare , Fentaw Zinabu , Yalew Melaku , Bitew Gedamnesh , Amsalu Erkihun Tadesse , Arefaynie Mastewal , Mekonen Asnakew Molla 
Published: February 2021

BackgroundTimely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother’s time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia.MethodsA community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value <0.05. For data management and analysis Stata 14 was used.ResultsThe median time to first ANC was 5 months with IQR (3,-). The independent predictors of time to first ANC visit were primary education [AHR: 1.24 (95%CI, 1.13–1.35)], secondary education [AHR: 1.28(95% CI, 1.11–1.47)], higher education [AHR: 1.43 (1.19–1.72)] as compared to women with no formal education. Having media exposure [AHR: 1.13 (95% CI, 1.03–1.24)], early initiation of ANC increases by 25% [AHR: 1.25 (95% CI, 1.12–1.40)] in poorer, 32% [AHR: 1.32 (95% CI, 1.17–1.49)] in middle, 37% [AHR: 1.37 (95% CI, 1.20–1.56)] in richer and 41% [AHR: 1.41 (95%CI, 1.1.19–1.67)] in richest households as compared to poorest household wealth index. Living in city administration, media exposure and community women literacy were also enabler factors, while, long distance from health facility and nomadic region residency were hindering factors of early ANC visit.ConclusionsThe current study revealed that women’s time to first antenatal care visit was by far late in Ethiopia as compared to the world health organization recommendation (WHO). The predictors of time to first ANC visit were education status of women, having media exposure, level of household wealth index, community women literacy ad distance to health facility. It is vital that maternal and child health policies and strategies better to be directed at women development and also designing and applying interventions that intended to increase timely initiation ANC among pregnant-women. Researchers also recommended conducting studies using a stronger design like a cohort to establish temporality and reduce biases.
Recognition of child maltreatment in emergency departments in Europe: Should we do better?
Authors: Hoedeman F. , Puiman P. J. , Smits A. W. , Dekker M. I. , Diderich-Lolkes de Beer H. , Laribi S. , Lauwaert D. , Oostenbrink R. , Parri N. , García-Castrillo Riesgo L. , Moll H. A. 
Published: February 2021

Objectives
To evaluate the different policies to recognize child maltreatment in emergency departments (EDs) in Europe in order to define areas of improvement.

Methods
A survey was conducted on the recognition of child maltreatment in EDs in European countries with a focus on screening methods, parental risk factors, training and hospital policies. The survey was distributed through different key members from the EUSEM, REPEM and the EuSEN. A summary score based on the NICE guideline (4 questions on child characteristics, 4 questions on parental characteristics and 5 questions on hospital policy) was calculated.

Results
We analysed 185 completed surveys, representing 148 hospitals from 29 European countries. Of the respondents, 28.6% used a screening tool, and 31.8% had guidelines on parental risk factors. A total of 42.2% did not follow training based on child characteristics, and 57.6% did not follow training on parental characteristics. A total of 71.9% indicated that there was a need for training. 50.8% of the respondents reported a standardized policy for the detection of child maltreatment. Translating the survey results to NICE summary scores of the EDs in Europe, we found that 25.6% (34/133) met most, 22.6% (30/133) met some and 51.9% (69/133) met few of the NICE guideline recommendations. More specifically, with respect to hospital policies, 33.8% (45/133) met most, 15.0% (20/133) met some and 51.1% (68/133) met few of the NICE guideline recommendations.

Conclusion
There is high variability regarding policies for child maltreatment detection and only a quarter of the EDs met most of the NICE guideline recommendations for child maltreatment. There is a need for the use of screening tools, training of ED staff and implementation of local hospital policies.
Sex and gender differences in presentation, treatment and outcomes in acute coronary syndrome, a 10 year study from a multi-ethnic Asian population: The Malaysian National Cardiovascular Disease Database—Acute Coronary Syndrome (NCVD-ACS) registry
Authors: Lee Chuey Yan , Liu Kien Ting , Lu Hou Tee , Mohd Ali Rosli , Fong Alan Yean Yip , Wan Ahmad Wan Azman 
Published: February 2021

BackgroundSex and gender differences in acute coronary syndrome (ACS) have been well studied in the western population. However, limited studies have examined the trends of these differences in a multi-ethnic Asian population.ObjectivesTo study the trends in sex and gender differences in ACS using the Malaysian NCVD-ACS Registry.MethodsData from 24 hospitals involving 35,232 ACS patients (79.44% men and 20.56% women) from 1st.Jan 2012 to 31st.Dec 2016 were analysed. Data were collected on demographic characteristics, coronary risk factors, anthropometrics, treatments and outcomes. Analyses were done for ACS as a whole and separately for ST-segment elevation myocardial infarction (STEMI), Non-STEMI and unstable angina. These were then compared to published data from March 2006 to February 2010 which included 13,591 ACS patients (75.8% men and 24.2% women).ResultsWomen were older and more likely to have diabetes mellitus, hypertension, dyslipidemia, previous heart failure and renal failure than men. Women remained less likely to receive aspirin, beta-blocker, angiotensin-converting enzyme inhibitor (ACE-I) and statin. Women were less likely to undergo angiography and percutaneous coronary intervention (PCI) despite an overall increase. In the STEMI cohort, despite a marked increase in presentation with Killip class IV, women were less likely to received primary PCI or fibrinolysis and had longer median door-to-needle and door-to-balloon time compared to men, although these had improved. Women had higher unadjusted in-hospital, 30-Day and 1-year mortality rates compared to men for the STEMI and NSTEMI cohorts. After multivariate adjustments, 1-year mortality remained significantly higher for women with STEMI (adjusted OR: 1.31 (1.09–1.57), p<0.003) but were no longer significant for NSTEMI cohort.ConclusionWomen continued to have longer system delays, receive less aggressive pharmacotherapies and invasive treatments with poorer outcome. There is an urgent need for increased effort from all stakeholders if we are to narrow this gap.
Added body mass alters plantar shear stresses, postural control, and gait kinetics: Implications for obesity
Authors: Jeong Hwigeum , Johnson A. Wayne , Feland J. Brent , Petersen Spencer R. , Staten Jared M. , Bruening Dustin A. 
Published: February 2021

Context
Obesity is a growing global health concern. The increased body mass and altered mass distribution associated with obesity may be related to increases in plantar shear that putatively leads to physical functional deficits. Therefore, measurement of plantar shear may provide unique insights on the effects of body mass and body distribution on physical function or performance.

Purpose
1) To investigate the effects of body mass and distribution on plantar shear. 2) To examine how altered plantar shear influences postural control and gait kinetics.

Hypothesis
1) a weighted vest forward distributed (FV) would shift the center of pressure (CoP) location forward during standing compared with a weighted vest evenly distributed (EV), 2) FV would increase plantar shear spreading forces more than EV during standing, 3) FV would increase postural sway during standing while EV would not, and 4) FV would elicit greater compensatory changes during walking than EV.

Methods
Twenty healthy young males participated in four different tests: 1) static test (for measuring plantar shear and CoP location without acceleration, 2) bilateral-foot standing postural control test, 3) single-foot standing postural test, and 4) walking test. All tests were executed in three different weight conditions: 1) unweighted (NV), 2) EV with 20% added body mass, and 3) FV, also with 20% added body mass. Plantar shear stresses were measured using a pressure/shear device, and several shear and postural control metrics were extracted. Repeated measures ANOVAs with Holms post hoc test were used to compare each metric among the three conditions (α = 0.05).

Results
FV and EV increased both AP and ML plantar shear forces compared to NV. FV shifted CoP forward in single-foot trials. FV and EV showed decreased CoP range and velocity and increased Time-to-Boundary (TTB) during postural control compared to NV. EV and FV showed increased breaking impulse and propulsive impulse compared to NV. In addition, EV showed even greater impulses than FV. While EV increased ML plantar shear spreading force, FV increased AP plantar shear spreading force during walking.

Conclusion
Added body mass increases plantar shear spreading forces. Body mass distribution had greater effects during dynamic tasks. In addition, healthy young individuals seem to quickly adapt to external stimuli to control postural stability. However, as this is a first step study, follow-up studies are necessary to further support the clinical role of plantar shear in other populations such as elderly and individuals with obesity or diabetes.
SafeNET: Initial development and validation of a real-time tool for predicting mortality risk at the time of hospital transfer to a higher level of care
Authors: Altieri Dunn Stefanie C. , Bellon Johanna E. , Bilderback Andrew , Borrebach Jeffrey D. , Hodges Jacob C. , Wisniewski Mary Kay , Harinstein Matthew E. , Minnier Tamra E. , Nelson Joel B. , Hall Daniel E. 
Published: February 2021

Background
Processes for transferring patients to higher acuity facilities lack a standardized approach to prognostication, increasing the risk for low value care that imposes significant burdens on patients and their families with unclear benefits. We sought to develop a rapid and feasible tool for predicting mortality using variables readily available at the time of hospital transfer.

Methods and findings
All work was carried out at a single, large, multi-hospital integrated healthcare system. We used a retrospective cohort for model development consisting of patients aged 18 years or older transferred into the healthcare system from another hospital, hospice, skilled nursing or other healthcare facility with an admission priority of direct emergency admit. The cohort was randomly divided into training and test sets to develop first a 54-variable, and then a 14-variable gradient boosting model to predict the primary outcome of all cause in-hospital mortality. Secondary outcomes included 30-day and 90-day mortality and transition to comfort measures only or hospice care. For model validation, we used a prospective cohort consisting of all patients transferred to a single, tertiary care hospital from one of the 3 referring hospitals, excluding patients transferred for myocardial infarction or maternal labor and delivery. Prospective validation was performed by using a web-based tool to calculate the risk of mortality at the time of transfer. Observed outcomes were compared to predicted outcomes to assess model performance.
The development cohort included 20,985 patients with 1,937 (9.2%) in-hospital mortalities, 2,884 (13.7%) 30-day mortalities, and 3,899 (18.6%) 90-day mortalities. The 14-variable gradient boosting model effectively predicted in-hospital, 30-day and 90-day mortality (c = 0.903 [95% CI:0.891–0.916]), c = 0.877 [95% CI:0.864–0.890]), and c = 0.869 [95% CI:0.857–0.881], respectively). The tool was proven feasible and valid for bedside implementation in a prospective cohort of 679 sequentially transferred patients for whom the bedside nurse calculated a SafeNET score at the time of transfer, taking only 4–5 minutes per patient with discrimination consistent with the development sample for in-hospital, 30-day and 90-day mortality (c = 0.836 [95%CI: 0.751–0.921], 0.815 [95% CI: 0.730–0.900], and 0.794 [95% CI: 0.725–0.864], respectively).

Conclusions
The SafeNET algorithm is feasible and valid for real-time, bedside mortality risk prediction at the time of hospital transfer. Work is ongoing to build pathways triggered by this score that direct needed resources to the patients at greatest risk of poor outcomes.
Impact of load expectations on neuromuscular and postural strategies during a freestyle lifting task in individuals with and without chronic low back pain
Authors: Daneau Catherine , Tétreau Charles , Deroche Thomas , Mainville Camille , Cantin Vincent , Descarreaux Martin 
Published: February 2021

Objective
This study aimed to investigate how load expectations modulate neuromuscular and postural strategies in the anticipation of a freestyle lifting task with varying expected loads in individuals with and without chronic low back pain (cLBP).

Methods
Forty-seven participants, 28 with cLBP pain and 19 without, were recruited and completed a series of freestyle lifting trials (3 sets of box lifted for a total of 36 lifts). Verbal cues were used to modulate their expectations about the boxes’ weight: no expectation, lighter or heavier load expectations. Following each set, participants rated their perceived exertion on a visual analog scale. During the lifting protocol, kinematics (time to maximal flexion, angular velocity and joint angles), electromyography muscle activity (erector spinae and quadriceps) and center of pressure displacement were simultaneously recorded.

Results
Results showed that time to maximal knee flexion was modulated by load expectations in both groups (mean lighter load expectations = 1.15 ± 0.32 sec.; mean heavier load expectations = 1.06 ± 0.31 sec.). Results also showed a load expectations X group interaction for that time to maximal hip and lumbar flexion. Time to maximal hip flexion decreased with heavier load expectations (mean lighter load expectations = 1.20 ± 0.36; mean heavier load expectations = 1.16 ± 0.33) for cLBP only. Time to maximal lumbar flexion increased with heavier load expectation (mean lighter load expectations = 1.41 ± 0.27 sec.; mean lighter load expectations = 1.46 ± 0.29 sec.) for participants without LBP. However, no difference in lumbar, hip nor knee angles were observed between groups or conditions. Results highlighted significant load expectation effects for erector spinae electromyography activity, as lower muscle activations was observed for both groups with heavier load expectations (mean = 0.32 ± 0.15), compared to lighter load expectations (mean = 0.52 ± 0.27). Force plates analyses did not reveal any significant load expectation effects.

Conclusion
Present findings showed that load expectations modulate movement strategies and muscle activation similarly but not identically in individuals with chronic low back pain and healthy adults during freestyle lifting. Results of the present study partially differ from previous studies and suggest only minor differences in lifting strategies between healthy individuals and individuals with cLBP experiencing low level of pain and disability. More studies are needed to investigate the potential role of load expectations in the development and persistence of chronic low back pain.
The influence of apparatus competence, leadership style, tri hita karana culture and society participation on the effectiveness of village fund management
Authors: Rasmini Ni Ketut , Mimba Putu Sri Harta 
Published: February 2021

This study aims to determine the effect of the apparatus competence, leadership style, Tri Hita Karana culture and society participation on the effectiveness of village fund management. The sample of this study were taken from 100 villages in Tabanan Regency with the number of respondents as many as 300 respondents.Â Â The method for determining the sample were the proportionate stratified random sampling and data collection using a questionnaire. Data were analyzed using multiple linear regression analysis. This study shows that the apparatus competence, leadership style, and society participation have a positive effect on the effectiveness of village fund management. Meanwhile the Tri Hita Karana culture not significantly affect the effectiveness of village fund management. This indicate that the better the apparatus competence, leadership style, and society participation, the better the effectiveness of village fund management..
QUALITY CULTURE TO IMPROVE KNOWLEDGE SHARING AND THE POSITIVE EFFECT ON ENGAGEMENT OF ACADEMIC STAFF
Authors: Herminingsih Anik , Rizki Mochammad 
Published: February 2021

The Ministry of Research, Technology, and Higher Education has a vision that contains the quality of higher education, by quality assurance implementation that aims to build a quality culture of higher education. Quality culture is an organizational value system that produces a conducive environment for the formation and continuous improvement of quality. The effects of quality culture on employee behaviors had been gained researchers attention, and as important factors for fostering knowledge sharing behaviors. This study conducted at Universitas Mercu Buana with 144 lecturers as samples. Data analysis by structural equation model and processed with AMOS software. The result of this study showed that quality culture affected positively human resource management practices, knowledge sharing among lecturers, then affected lecturer' engagement
Challenges Facing the Directorate of Criminal Investigation On Management of Criminal Gang Activities in Nairobi County, Kenya
Authors: Egesa Natwoli Robert 
Published: February 2021

Abstract
This paper uses data collected for an MA Thesis on the challenges facing the Directorate of Criminal Investigation Department on management of criminal gang activities, in Nairobi County, Kenya. This study has been necessitated by continued concern among policymakers, security pundits and citizens about the rising criminal gang activities in the country, more pertinently in Nairobi County. Although there are few studies that tried to scratch this area, there has never been a detailed and systematic inquiry and analysis of this problem. The study was guided by several specific objectives; the first objective examined the tactical challenges that the police face in policing gang related activities in Nairobi County, Kenya; assessed the effect of corruption in undermining the war against gang related activities in Nairobi County, Kenya; and finally explored other technological challenges that the police face in policing gang related activities in Nairobi County, Kenya. The study adopted descriptive research design and purposive sampling technique to collect data. Interview schedules and key informants (K.I) guide were the main tools used to collect data using the interview method of data collection. 60 officers of the Special Crime Prevention Unit were the main respondents. Major challenges faced by the DCI officers when dealing with criminal gang activities especially within Nairobi County include; poor relationship between police and the general public as reported by 89.1% of the respondents, increased involvement of women in gang activities which is exacerbated by low ratio of female-male officers for undercover operations and 90.9%. of respondents indicated due to woman innocence will create a greater challenge. Others include; gang related activities with networks and markets especially for stolen vehicles across the borders as a result of corruption along the borders by both police, custom and military officers. Further, 85.5% indicated that cross border gang activities were worsened by lack of harmonized law for the regulation and prevention of these activities that led to enhanced proliferation of weapons as well as drugs to and from the neighboring countries. Major recommendations for policy considerations included; increased recruitment and deployment of female officers to beef up their ratio in undercover operations. Harmonized laws for the neighboring East African community countries and increased cooperation between the security organs of these countries in order to have a coordinated approach of tracking and apprehending criminals who escape to neighboring countries. The study also recommends mandatory training for DCI officers in computer/ technological skills to be able to intercept, interpret and or decode gang related communication and cybercrime related activities.
A Translation into English of AL-FUZAI’s1 “Breakdown Time”2
Authors: Dohal Gassim H. 
Published: February 2021

Khalil I. Al-Fuzai (1940- ) is a Saudi writer who published few collections of stories. In these stories he manages to introduce his Arabian society in a simple, frank way (see Dohal 2013). One of these stories is “Breakdown Time.” I chose to translate this story for it is a good representation of what Al-Fuzai has written (Dohal, 2018 & 2019). In addition, it is about the Arabian culture; it tells how a man can propose for a woman’s hand.