bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Spatio-temporal Bayesian model to estimate risk and influencing factors related to tuberculosis in Chongqing, China, 2014–2020
Authors: Chen Zhi-Yi , Deng Xin-Yi , Zou Yang , He Ying , Chen Sai-Juan , Wang Qiu-Ting , Xing Dian-Guo , Zhang Yan 
Published: March 2023

Abstract
Background
Tuberculosis (TB) is a serious infectious disease that is one of the leading causes of death worldwide. This study aimed to investigate the spatial and temporal distribution patterns and potential influencing factors of TB incidence risk, and to provide a scientific basis for the prevention and control of TB.

Methods
We collected reported cases of TB in 38 districts and counties in Chongqing from 2014 to 2020 and data on environment, population characteristics and economic factors during the same period. By constructing a Bayesian spatio-temporal model, we explored the spatio-temporal distribution pattern of TB incidence risk and potential influencing factors, identified key areas and key populations affected by TB, compared the spatio-temporal distribution characteristics of TB in populations with different characteristics, and explored the differences in the influence of various social and environmental factors.

Results
The high-risk areas for TB incidence in Chongqing from 2014 to 2020 were mainly concentrated in southeastern and northeastern regions of Chongqing, and the overall relative risk (RR) of TB showed a decreasing trend during the study period, while RR of TB in main urban area and southeast of Chongqing showed an increasing trend. The RR of TB was relatively high in the main urban area for the female population and the population aged 0–29 years, and the RR of TB for the population aged 30–44 years in the main urban area and the population aged 60 years or older in southeast of Chongqing had an increasing trend, respectively. For each 1 μg/m3 increase in SO2 and 1% increase in the number of low-income per 1000 non-agricultural households (LINA per 1000 persons), the RR of TB increased by 0.35% (95% CI: 0.08–0.61%) and 0.07% (95% CI: 0.05–0.10%), respectively. And LINA per 1000 persons had the greatest impact on the female population and the over 60 years old age group. Although each 1% increase in urbanization rate (UR) was associated with 0.15% (95% CI: 0.11–0.17%) reduction in the RR of TB in the whole population, the RR increased by 0.18% (95% CI: 0.16–0.21%) in the female population and 0.37% (95% CI: 0.34–0.45%) in the 0–29 age group.

Conclusion
This study showed that high-risk areas for TB were concentrated in the southeastern and northeastern regions of Chongqing, and that the elderly population was a key population for TB incidence. There were spatial and temporal differences in the incidence of TB in populations with different characteristics, and various socio-environmental factors had different effects on different populations. Local governments should focus on areas and populations at high risk of TB and develop targeted prevention interventions based on the characteristics of different populations.
Factors associated with stunting: gut inflammation and child and maternal-related contributors among under-five children in Hawassa City, Sidama Region, Ethiopia
Authors: Lefebo Berhanu Kibemo , Kassa Dejene Hailu , Tarekegn Baye Gelaw 
Published: March 2023

Abstract
Background
Under-nutrition remains a major global public health challenge, particularly among children under the age of five. Among the manifestations of under-nutrition, stunting accounts for the larger proportion, which is associated with multiple factors. In Ethiopia, however, the link between intestinal inflammation and childhood stunting was not well investigated. Therefore, the present study aimed to determine the association between gut inflammation and childhood stunting.

Method
A community-based cross-sectional study was conducted and a total of 82 children were included in the study. Anthropometric data were collected by measuring weight in underwear and without shoes with an electronic scale to the nearest 0.1 kg and their height in the Frankfort plane with a telescopic height instrument. Environmental risk factors for enteric bacterial exposure, access to improved sources of drinking water, and the presence of facilities for hygiene and sanitation conditions were assessed using a questionnaire. Gut inflammation was tested through fecal leukocyte count and each sample was stained with methylene blue. Stool samples were inoculated on MacConkey agar, Salmonella-Shigella agar, and Xylose Lysine Deoxycholate agar after enrichment with Selenite cystine broth and incubated at 37 °C for 18–24 h. Binary and multiple logistic regressions and Chi-square models were used to analyze the data.

Result
Data from the current study revealed that gut inflammation was (AOR: 5.28, 95% CI: 1.32–22.25) associated with stunting. On the other hand, children with reported diarrhea within the last week were 6 times more likely for the probability of being stunted (AOR: 6.21, 95% CI: 2.68–26.83). The findings of this study also demonstrated that children from a household with a family size of more than 5 members were three times more likely to be stunted than their counterparts (AOR: 3.21, 95% CI: 1.20 -10.13). Facts of the current study demonstrated that breastfeeding for 24 months and below was negatively associated (AOR: 0.3; 95% CI: -0.46-0.89) with gut inflammation. Detection of E.coli and Shigella species in the stool samples of children and Menaheria residents were positively associated with gut inflammation (AOR: 5.4, 95% CI: 1.32–22.25; AOR: 5, 95% CI: 1.47–24.21), respectively.

Conclusion
Therefore, there was a strong correlation between stunting and gastrointestinal inflammation. Moreover, stunting was associated with diarrhea, breastfeeding duration, residence, and family size. Similarly, intestinal inflammation was linked to residence, breastfeeding duration, and the prevalence of bacterial infections such as E. coli and Shigella species.
Dietary diversity and micronutrients adequacy among the women of reproductive age at St. Martin’s island in Bangladesh
Authors: Islam Md. Hafizul , Jubayer Ahmed , Nowar Abira , Nayan Md. Moniruzzaman , Islam Saiful 
Published: March 2023

AbstractMinimum dietary diversity for women, an important dimension of diet quality, has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), women of reproductive age (WRA) particularly are at high risk of inadequate micronutrient intake resulting from poor diversified diets. Therefore, the present study aimed to assess dietary diversity and micronutrients adequacy in the diets of WRA of St. Martin’s island, along with their socio-economic determinants. A cross-sectional study was conducted on a representative sample of 201 WRA living at St. Martin’s island. Utilizing the Estimated Average Requirement (EAR) cut-point approach, the adequacy of micronutrient intake was evaluated from observed 24-h recall dietary data. The recent guideline of FAO was employed to evaluate Minimum Dietary Diversity for Women (MDD-W). Binary logistic regression and multiple linear regression analyses were performed to identify socio-economic determinants of MDD-W and micronutrients adequacy. The mean (SD) dietary diversity score was 4.25 (1.17) and about 40.3% of the participants met the MDD-W cut-off. Starchy staples (100%), meat/poultry/fish (87%), and other vegetables (79%) were consumed more frequently, while, the least reported food groups were dairy (2%), nuts and seeds (11%), and vitamin A-rich fruits and vegetables (11%). Except for Niacin, intake of all micronutrients was inadequate, with an inadequacy prevalence of 36–100%. Educational level, and decision-making role of women were significantly related to their dietary diversity. On the other hand, age, decision-making role, and MDD-W were important determinants of micronutrient adequacy. In conclusion, the WRA of St. Martin's island consumed neither a sufficient amount of micronutrients nor an adequate diversity of foods. In addition, several socio-economic components are linked with dietary diversity and micronutrient adequacy. Therefore, attention is needed to decide on the best strategies to improve the quality of diet and dietary diversity for WRA in this setting.
How does parents’ social support impact children’s health practice? Examining a mediating role of health knowledge
Authors: Straughan Paulin Tay , Xu Chengwei 
Published: March 2023

AbstractBackgroundFamily environmental factors play a vital role in shaping children’s health practices (e.g., obesity prevention). It is still unclear how parents’ social support affects children’s obesity-related health practices. The present study argues that whether parents’ social support positively associates with children’s obesity-related health practice depends on if it could promote parents’ obesity-related health knowledge. Thus, we hypothesize that health knowledge mediates the relationship between parents’ social support and children’s health practice regarding weight management.MethodsTo test the hypothesis, we conducted a questionnaire survey and collected a nationally representative sample of 1488 household responses in Singapore. The survey included questions about parents’ social support, health knowledge, children’s health practices, and socio-demographic variables. All participants have at least one child 14 years old or younger. In the sample, 66.1% of the respondents are female, and 93.7% are below 50 years old. Structural equation modeling (SEM) via Stata was used to examine the associations between parents’ social support, health knowledge, and children’s health practice.ResultsThe results of our analysis support our hypothesis. Specifically, (1) parents’ social support shows a positive relationship with health knowledge (Coef. = 0.17,p < 0.001 for BMI knowledge and Coef. = 0.18,p < 0.001 for nutrition knowledge); (2) parents’ social support (total effect of social support = 0.081,p = 0.071) and health knowledge positively associate with children’s obesity-related health practice (coefficient of BMI knowledge = 0.10,p < 0.01; coefficient of nutrition knowledge = 0.31,p < 0.001); and (3) the effects of parents’ social support on children’s health practice is fully mediated by parents’ health knowledge (mediating effect = 100%,p = 0.007).ConclusionThe present study provides fresh evidence from a multicultural context to understand the relationships between parents’ social support, health knowledge, and children’s obesity-related health practice. Our findings support the argument that social support from parents’ social networks does not necessarily promote health outcomes. The only social support that carries proper health knowledge can facilitate good health practice.
COVID-19 vaccine hesitancy: a systematic review of barriers to the uptake of COVID-19 vaccine among adults in Nigeria
Authors: Babatope Tolulope , Ilyenkova Vera , Marais Debbi 
Published: March 2023

Abstract
Background
Since the outbreak of coronavirus (COVID-19) disease was reported in 2019, huge human and material resources have been expended globally to combat the spread of the disease. Achieving herd immunity through mass vaccination remains an important strategy to adopt in the war against this disease since it is practically impossible for 60–70% of the population to achieve immunity through natural infection alone. Unfortunately, there have been widespread reports of COVID-19 vaccine hesitancy. This study aims to systematically review the literature to provide an up-to-date assessment of COVID-19 vaccine acceptance rates and also explore factors impacting COVID-19 vaccine hesitancy among adults in Nigeria.

Main body of the abstract
A systematic search of indexed electronic peer-reviewed literature published from 2019 onwards was conducted in Science Direct, PubMed, ProQuest, and EBSCOhost databases and reported according to the PRISMA checklist and Synthesis without meta-analysis (SWiM) in systematic review reporting guidelines. Fifteen out of the 148 studies retrieved, met the inclusion criteria and these were critically appraised using the Centre for Evidence-Based Medicine Critical Appraisal checklist and Mixed Methods Appraisal Tool, version 2018. Basic descriptive statistic (percentage) was employed in the analysis of acceptance rates of the COVID-19 vaccine among various subgroups of adults in Nigeria, while a thematic analysis of the facilitators and barriers to the uptake of the COVID-19 vaccine in Nigeria was conducted. Acceptance rates ranging from 24.3% to 49.5% were observed across the four studies conducted among the high-risk populations in Nigeria, while the acceptance rates among the low-risk populations ranged from 26.0% to 86.2%. Themes such as socio-demographic factors, perception of risk factors, and concerns about the vaccine's safety and efficacy act interchangeably as facilitators and barriers to the uptake of COVID-19 vaccines, whereas political factors, conspiracy theories, and cost primarily act as barriers to vaccine uptake.

Short conclusion
Substantial heterogeneity was observed in COVID-19 vaccine acceptance rates among adults in Nigeria. More than half of the studies reviewed reported acceptance rates below 60.0%. A multidisciplinary approach is recommended in engaging important stakeholders, to effectively address COVID-19 vaccine hesitancy in Nigeria.
Knowledge on hypertension in Myanmar: levels and groups at risk
Authors: Pardoel Zinzi E. , Lensink Robert , Postma Maarten , Win Hla Hla , Swe Khin Hnin , Stein Claire , Febrinasari Ratih , My Hanh Hoang , Koot Jaap A.R. , Landsman Johanna A. , Reijneveld Sijmen A. 
Published: March 2023

Background: Non-communicable diseases, specifically the burden of hypertension, have become a major public health threat to low- and middle-income countries, such as Myanmar. Inadequate knowledge of hypertension and its management among people may hinder its effective prevention and treatment with some groups at particular increased risks, but evidence on this is lacking for Myanmar. The aims of this study were therefore to assess the level of knowledge of risk factors, symptoms and complications of hypertension, by hypertension treatment status, community group-membership, and sociodemographic and socioeconomic factors in Myanmar. Methods: Data was collected through structured questionnaires in 2020 on a random sample of 660 participants, stratified by region and existence of community groups. Knowledge of hypertension was measured with the ‘Knowledge’ part of a validated ‘Knowledge, Attitude and Practice’ survey questionnaire and categorised into ill-informed and reasonably to well-informed about hypertension. Results: The majority of respondents seem reasonably to well-informed about risk factors, symptoms and complications of hypertension. This did not vary by hypertension treatment status and community group membership. People with jobs (B=0.96; 95%-confidence interval 0.343 to 1.572) and higher education (B=1.96; 0.060 to 3.868) had more hypertension knowledge than people without jobs or low education. Adherence to treatment among hypertensive people was low. Conclusion: This study shows a majority of participants in this study in Myanmar seem reasonably to well-informed, with no differences by hypertension status, treatment status, and community group-membership. People without jobs and low education have less hypertension knowledge, making them priority groups for tailored education on health care level as well as community level, lowering the burden of hypertension. Almost half of the hypertensive patients did not take their medicines and therefore, adherence to treatment of hypertension should be an important element for future health education.
Hospital Boarding Crises: The Impact of Urgent vs. Prevention Responses on Length of Stay
Authors: Adepoju Temidayo , Carson Anita L. , Jin Helen S. , Manasseh Christopher S. 
Published: March 2023

Healthcare policy makers use wait-time metrics to encourage hospital managers to improve patient experience. In 2002, Massachusetts mandated that hospital managers develop processes to respond to boarding crises, which occur when emergency department (ED) patients experience long waits for inpatient beds. Performance improvement theory suggests that patients would be better served by preventing boarding crises rather than responding urgently after they occur. To empirically test this theory, we use data from a Massachusetts hospital that has two physician-based processes related to boarding and patient flow. First, to comply with the state mandate, the hospital developed processes to identify when the hospital is in a boarding crisis, a code yellow (CY), and subsequently request that physicians prioritize patient discharge (urgent response). Second, physicians can use predischarge orders, optional written communication about discharge barriers, to avoid discharge delays for patients approaching discharge (prevention response). Our data supports the existence of a trade-off between these two responses. Counter to our hypothesis, the state-mandated urgent response does not have any impact on length of stay (LOS). We also find that a CY has no impact on ED hourly occupancy, marginally decreases ED wait times, and increases boarding time. The prevention response is associated with a 26% reduction in LOS. Furthermore, we find that the urgent response reduces the likelihood of physicians’ ability to use the prevention response by 27.3%. We conclude that the state policy has unintended negative consequences that stymie hospital efforts to create longer term improvement. This paper was accepted by Stefan Scholtes, healthcare management. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4724 .
A retrospective study of risk factors, causative micro-organisms and healthcare resources consumption associated with prosthetic joint infections (PJI) using the Clinical Practice Research Datalink (CPRD) Aurum database
Authors: Perni Stefano , Bojan Bsmah , Prokopovich Polina 
Published: March 2023

Background
Prosthetic joint infection (PJI) is a serious complication after joint replacement surgery and it is associated with risk of mortality and morbidity along with high direct costs.

Methods
The Clinical Practice Research Datalink (CPRD) data were utilized to quantify PJI incidence after hip or knee replacement up to 5 years after implant and a variety of risk factors related to patient characteristics, medical and treatment history along with characteristics of the original surgery were analyzed through Cox proportional hazard.

Results
221,826 patients (individual joints 283,789) met all the inclusion and exclusion criteria of the study; during the study follow-up period (5 years), 707 and 695 PJIs were diagnosed in hip and knee, respectively. Patients undergoing joint replacement surgery during an unscheduled hospitalization had greater risk of PJI than patients whose surgery was elective; similarly, the risk of developing PJI after a secondary hip or knee replacement was about 4 times greater than after primary arthroplasty when adjusted for all other variables considered. A previous diagnosis of PJI, even in a different joint, increased the risk of a further PJI. Distribution of average LoS per each hospitalization caused by PJI exhibited a right skewed profile with median duration [IQR] duration of 16 days [8–32] and 13 days [7.25–32] for hip and knee, respectively. PJIs causative micro-organisms were dependent on the time between initial surgery and infection offset; early PJI were more likely to be multispecies than later (years after surgery); the identification of Gram- pathogens decreased with increasing post-surgery follow-up.

Conclusions
This study offers a contemporary assessment of the budgetary and capacity (number and duration of hospitalizations along with the number of Accident and Emergency (A&E) visits) posed by PJIs in UK for the national healthcare system (NHS). The results to provide risk management and planning tools to health providers and policy makers in order to fully assess technologies aimed at controlling and preventing PJI. The findings add to the existing evidence-based knowledge surrounding the epidemiology and burden of PJI by quantifying patterns of PJI in patients with a relatively broad set of prevalent comorbidities.
Reducing elderly home health care cost by developing a cloud based digital platform
Authors: Baijal Shobhit 
Published: March 2023

The population among elderly people is increasing day by day in the United States
and also around the world. There are many devices, products and services which are available
for elderly people to get care. But, none of them offer affordable services, especially in the USA
where the average cost is enormously high. This has resulted in more elderly people working till
their last breath in order to survive as they don't have enough savings to get care. This paper
provides an overview of possible solutions where the cost of elderly care can be reduced using
a cloud based digital application that can provide a marketplace of caregivers (Nurses,
Veterans, Law Enforcements Officers, College Students) to serve the elderly people. Another
solution which this paper will talk about is a wearable sensor device where it can track the real
time data and through machine learning algorithm it can learn to predict/monitor the elderly’s
health condition and send SOS.
Life Cycle Assessment Based Analysis of Water Bottle Designs for Defence Application
Authors: Pandey Vidya Shanker , Agrawal Anil Kumar , Dubey Ashish 
Published: March 2023

This paper presents the successful implementation of the Life Cycle Assessment (LCA) approach for the sustainable development of a defence product. Alternative designs of this product are evaluated from the environmental burden perspective. The products considered are water bottles used by the armed forces in places like the Siachen glacier, where the environmental factors are of great concern. From the environmental degradation perspective, the suitability of three existing bottle types has been analysed using LCA and Life Cycle Impact Assessment (LCIA) approaches on SimaPro software for each of its components and the bottle as a whole. Using this software, uncertainty analysis has also been carried out by conducting a Monte Carlo simulation for a reasonable confidence level. The latest design was found to have the least environmental burden, being 82.62% less compared to the first design. To augment the environmental performance further, the best design was again reviewed by carrying out component level analysis to identify feasible alternative materials that would be functionally equivalent but with lower environmental impact. It suggested switching to lower impact material for the cap and cap cover for the proposed design. With the adoption of the changed material, the environmental performance improved by 10.61 % as compared to the best design and 84.46 % compared to the earliest design.