bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobile phone use among mothers seeking postnatal services in Kakamega County, Kenya
Authors: Ngigi Charles Kiragu , Osero Justus Os , Wanyoro Anthony K 
Published: June 2022

Background/Aims Mobile phone use is increasing globally, with Kenya having increased use in rural and urban areas. Despite the widespread use of mobile phones, their use in health delivery services, such as to enhance postnatal care attendance, is low. Kenya is exploring interventions such as the use of mobile health to improve uptake. This study aimed to determine mobile phone use among postnatal mothers in Kakamega County, Kenya. Methods This was a descriptive cross-sectional study using quantitative data. It was carried out among 240 postnatal mothers in Kakamega County. Systematic sampling was used to recruit the participants from three hospitals and data were collected using questionnaires. Data were analysed using the Chi squared test to determine associations between sociodemographic characteristics and perceptions of mobile phone use to improve postnatal care attendance. Results The majority of participants (87.0%) owned a mobile phone. Over half (53.0%) used their mobile phone many times a day, with 61.0% sending SMS many times a day and 65.0% making voice calls many times a day. Almost all participants (93.0%) said they would recommend the use of an SMS or voice call service for postnatal care attendance to their friends. Frequency of mobile phone use (P=0.000), SMS use (P=0.042) and voice call use (P=0.007) were all significantly associated with perception of mobile phone use to improve postnatal care attendance, as was antenatal care visits (P=0.005). Conclusions The majority of participants owned mobile phones and felt positive about mobile phone use to improve postnatal care. The county government of Kakamega should integrate mobile phone technology with the delivery of postnatal services to improve attendance.
The true length of training in vascular surgery
Authors: Chan E , Shelmerdine L , Patel SR , Travers HC ,   On behalf of the Rouleaux Club
Published: June 2022

INTRODUCTION Workforce planning in vascular surgery remains challenging since there are no data on career path intentions of trainees. The Rouleaux Club, which is the UK vascular trainee association, undertook a snapshot survey of the vascular surgery trainee workforce to help guide the allocation of the future vascular surgery workforce. METHODS An anonymous survey was sent to national training number (NTN) and non-NTN vascular surgery trainees. The survey was open for four weeks from 26 September to 23 October 2020. Data were analysed by two Rouleaux Club executive committee members using Microsoft Excel®. RESULTS The survey was completed by 147 trainees (130 NTN and 17 non-NTN trainees). When taking into consideration time out of training and less than full-time training, the average predicted Certificate of Completion of Training date for NTN trainees is delayed by one year. Eleven per cent of NTN trainees had completed or were in less than full-time training at the time of the survey. Time out of training was taken by 75% and parental leave by 28%. Just under half (47%) of NTN trainees were planning on taking parental leave in the future. Over half (51%) of NTN trainees expected to retire aged between 61 and 65 years. CONCLUSIONS Our findings suggest that vascular surgery training is not a simple six-year higher surgical training experience and may vary considerably between individuals. Future vascular workforce planning needs to take these factors into consideration. Action must be taken now to recruit and retain the future workforce so that the demand for vascular surgeons can be met.
Creating a dental trauma care pathway in a district general hospital
Authors: Fard Rana , Musa Afsha , McConville Bethan , Thomas Rhema , Rasaratnam Lakshmi 
Published: June 2022

INTRODUCTION Traumatic dental injuries occur frequently in children and adults. Many of these present to the hospital emergency department for acute management by maxillofacial dental core trainees. METHODS A quality improvement project was carried out at East Kent Hospitals University NHS Foundation Trust to introduce a defined multidisciplinary care pathway for the management of dental trauma patients to improve the quality of care and patient related outcome measures. This consisted of four main components including staff and patient education, departmental facilities and a four-cycle audit. RESULTS The recorded history of ‘when, where and what’ generally improved over the four audit cycles, as did documentation relating to medical history, medications, allergies and tetanus. By the fourth cycle, all areas had 100% compliance. CONCLUSIONS There has been an improvement in the acute management of dental trauma in the trust. This quality improvement project has highlighted the benefit of a multidisciplinary approach with appropriate long-term patient follow-up. In addition, it has been successful in implementing a dental trauma care pathway.
The Use of an Incremental Learning Algorithm for Diagnosing COVID-19 from Chest X-ray Images
Authors: Amami Rimah , Saif Suleiman Ali Al , Amami Rim , Eleraky Hassan Ahmed , Melouli Fatma , Baazaoui Mariem 
Published: June 2022

The new Coronavirus or simply Covid-19 causes an acute deadly disease. It has spread rapidly across the world, which has caused serious consequences for health professionals and researchers. This is due to many reasons including the lack of vaccine, shortage of testing kits and resources. Therefore, the main purpose of this study is to present an inexpensive alternative diagnostic tool for the detection of Covid-19 infection by using chest radiographs and Deep Convolutional Neural Network (DCNN) technique. In this paper, we have proposed a reliable and economical solution to detect COVID-19. This will be achieved by using X-rays of patients and an Incremental-DCNN (I-DCNN) based on ResNet-101 architecture. The datasets used in this study were collected from publicly available chest radiographs on medical repositories. The proposed I-DCNN method will help in diagnosing the positive Covid-19 patient by utilising three chest X-ray imagery groups, these will be: Covid-19, viral pneumonia, and healthy cases. Furthermore, the main contribution of this paper resides on the use of incremental learning in order to accommodate the detection system. This has high computational energy requirements, time consuming challenges, while working with large-scale and regularly evolving images. The incremental learning process will allow the recognition system to learn new datasets, while keeping the convolutional layers learned previously. The overall Covid-19 detection rate obtained using the proposed I-DCNN was of 98.70\% which undeniably can contribute effectively to the detection of COVID-19 infection.
Artificial intelligence in differentiating tropical infections: A step ahead
Authors: Shenoy Shreelaxmi , Rajan Asha K. , Rashid Muhammed , Chandran Viji Pulikkel , Poojari Pooja Gopal , Kunhikatta Vijayanarayana , Acharya Dinesh , Nair Sreedharan , Varma Muralidhar , Thunga Girish 
Published: June 2022

Background and objectiveDifferentiating tropical infections are difficult due to its homogenous nature of clinical and laboratorial presentations among them. Sophisticated differential tests and prediction tools are better ways to tackle this issue. Here, we aimed to develop a clinician assisted decision making tool to differentiate the common tropical infections.MethodologyA cross sectional study through 9 item self-administered questionnaire were performed to understand the need of developing a decision making tool and its parameters. The most significant differential parameters among the identified infections were measured through a retrospective study and decision tree was developed. Based on the parameters identified, a multinomial logistic regression model and a machine learning model were developed which could better differentiate the infection.ResultsA total of 40 physicians involved in the management of tropical infections were included for need analysis. Dengue, malaria, leptospirosis and scrub typhus were the common tropical infections in our settings. Sodium, total bilirubin, albumin, lymphocytes and platelets were the laboratory parameters; and abdominal pain, arthralgia, myalgia and urine output were the clinical presentation identified as better predictors. In multinomial logistic regression analysis with dengue as a reference revealed a predictability of 60.7%, 62.5% and 66% for dengue, malaria and leptospirosis, respectively, whereas, scrub typhus showed only 38% of predictability. The multi classification machine learning model observed to have an overall predictability of 55–60%, whereas a binary classification machine learning algorithms showed an average of 79–84% for one vs other and 69–88% for one vs one disease category.ConclusionThis is a first of its kind study where both statistical and machine learning approaches were explored simultaneously for differentiating tropical infections. Machine learning techniques in healthcare sectors will aid in early detection and better patient care.
Effects of multitask training on cognition and motor control in people with schizophrenia spectrum disorders
Authors: Chien Tzu-Yun , Chern Jen-Suh , Wang San-Ping , Yang Yu 
Published: June 2022

Schizophrenia spectrum disorder (SSD) is a disabling mental illness that causes considerable deficits in motor and cognitive functions. The purpose of this study was to examine the effects of combining traditional multitask training (TMT) and video games--a new form of multitask training (video game multitask training VGMT)--on cognition and motor control performance in people with SSD. This was a quasi-experimental, pretest-posttest design study. A total of 25 patients participated in this study voluntarily (13 males and 12 females, average age = 59.61 years, SD– 11.46 years). All participants underwent two stages of training. The first stage involved TMT, and the second stage involved VGMT. Each training stage was 12 weeks long, with sessions twice a week that lasted for 40 minutes. Cognition, upper extremity motor and postural control performance, and functional mobility and subjective balance confidence were measured at three times: before and after the first-stage training and after the second-stage training. The results revealed that TMT and the combination of TMT and VGMT improved SSD patient’s cognition, upper extremity motor control, functional mobility and postural control performance. The subjective confidence of balance during the performance of daily activities was also mildly improved. Training with multitasks in the form of video games tended to further improve the outcome measures. Patients with SSD could benefit from regular participation in various forms of multitasking activities. Whether video games training are better than TMT in improving the functional ability of people with SSD needs further investigation.Study protocol registration:Clinicaltrials.gov, ID:NCT04629898. Registered brief title: Level of Immersion of Virtual Reality and Cognition and Motor Performance in Patients of Schizophrenia Spectrum Disorder.
A co-creation roadmap towards sustainable quality of care: A multi-method study
Authors: Claessens Fien , Seys Deborah , Brouwers Jonas , Van Wilder Astrid , Jans Anneke , Castro Eva Marie , Bruyneel Luk , De Ridder Dirk , Vanhaecht Kris 
Published: June 2022

Objective
Hospitals demonstrated increased efforts into quality improvement over the past years. Their growing commitment to quality combined with a heterogeneity in perceptions among healthcare stakeholders cause concerns on the sustainable incorporation of quality into the daily workflow. Questions are raised on the drivers for a sustainable hospital quality policy. We aimed to identify drivers and incorporate them into a new, unique roadmap towards sustainable quality of care in hospitals.

Design
A multi-method design guided by an eight-phase approach to develop a conceptual framework consists of multiple, iterative phases of data collection, synthesis and validation. Starting with a narrative review followed by a qualitative in-depth analysis and including feedback of national and international healthcare stakeholders.

Setting
Hospitals.

Results
The narrative review included 59 relevant papers focusing on quality improvement and the sustainability of these improved quality results. By integrating, synthesising and resynthesizing concepts during thematic and content analysis, the narrative review evolved to an integrated, co-creation roadmap. The Flanders Quality Model (FlaQuM) is presented as a driver diagram that features six primary drivers for a sustainable quality policy: (1) Quality Design and Planning, (2) Quality Control, (3) Quality Improvement, (4) Quality Leadership, (5) Quality Culture and (6) Quality Context. Six primary drivers are described in 19 building blocks (secondary drivers) and 104 evidence-based action fields.

Conclusions
The framework suggests that a manageable number of drivers, building blocks and action fields may support the sustainable incorporation of quality into the daily workflow. Therefore, FlaQuM can serve as a useful roadmap for future sustainable quality policies in hospitals and for future empirical and theoretical work in sustainable quality management.
Exploring parental understanding of child sexual abuse and prevention as a measure for HIV prevention in Rwampara district
Authors: Kamukama Aloysious , Luwaga Rachel , Tugume Rodrick , Kanyemibwa Margaret , Birungi Betrace , Ndyamuhika Obed , Ampire Diana , Nduhukire Timothy , Shindell Deborah Lowell 
Published: June 2022

Background
Worldwide, more than 95 million children are sexually abused each year with children in sub-Saharan Africa experiencing sexual assault at higher rates than those in more developed areas. In Uganda, 20% of young people indicated that their sexual debut was non-consensual. The risk for transmission of HIV to children through Child Sexual Abuse is high because of greater mucosal tissue damage and the often repetitive nature of abuse. This contributes significantly to the burden of HIV in Uganda. Despite these risks, studies have shown gaps in active parental involvement in child sexual abuse prevention despite their being the primary protectors of children. Against this background we sought to explore parental understanding of childhood sexual abuse and prevention as a measure for HIV prevention in Rwampara District, South Western Uganda.

Methods
A phenomenological study was carried out in four health centers that serve the communities of Rwampara district. A total of 25 (n = 25) parents or guardians of children aged 9–14 years were purposively selected to participate in the study. The participants were subjected to in-depth semi-structured interviews which were recorded, transcribed, and translated for thematic analysis.

Results
Parents’ understanding of child sexual abuse was limited to penetrative sex between a man and a child. Three of the parents interviewed reported to have had children who had been sexually abused while one of the parents had been abused when she was young. The children reported to have been abused were female and were between 3-14years. We also identified gaps in the sensitization of parents regarding home-based prevention of child sexual abuse and psychological support for the victims of abuse.

Conclusion
Our study shows that child sexual abuse exists in rural western Uganda. There remains a significant gap in the awareness of parents regarding the extent of sexual abuse, signs of sexual abuse, case handling, and psychological support for victims of sexual abuse. This significantly affects the capacity of parents as the primary protectors of children to identify and protect the children against the multiple forms of child sexual abuse.
Forecast of myocardial infarction incidence, events and prevalence in England to 2035 using a microsimulation model with endogenous disease outcomes
Authors: Scarborough Peter , Kaur Asha , Cobiac Linda J. 
Published: June 2022

Background
Models that forecast non-communicable disease rates are poorly designed to predict future changes in trend because they are based on exogenous measures of disease rates. We introduce microPRIME, which forecasts myocardial infarction (MI) incidence, events and prevalence in England to 2035. microPRIME can forecast changes in trend as all MI rates emerge from competing trends in risk factors and treatment.

Materials and methods
microPRIME is a microsimulation of MI events within a sample of 114,000 agents representative of England. We simulate 37 annual time points from 1998 to 2035, where agents can have an MI event, die from an MI, or die from an unrelated cause. The probability of each event is a function of age, sex, BMI, blood pressure, cholesterol, smoking, diabetes and previous MI. This function does not change over time. Instead population-level changes in MI rates are due to competing trends in risk factors and treatment. Uncertainty estimates are based on 450 model runs that use parameters calibrated against external measures of MI rates between 1999 and 2011.

Findings
Forecasted MI incidence rates fall for men and women of different age groups before plateauing in the mid 2020s. Age-standardised event rates show a similar pattern, with a non-significant upturn by 2035, larger for men than women. Prevalence in men decreases for the oldest age groups, with peaks of prevalence rates in 2019 for 85 and older at 25.8% (23.3–28.3). For women, prevalence rates are more stable. Prevalence in over 85s is estimated as 14.5% (12.6–16.5) in 2019, and then plateaus thereafter.

Conclusion
We may see an increase in event rates from MI in England for men before 2035 but increases for women are unlikely. Prevalence rates may fall in older men, and are likely to remain stable in women over the next decade and a half.
Efficacy and safety of oral Chinese medicine on cancer-related fatigue for lung cancer patients after chemotherapy: Protocol for systematic review and meta-analysis
Authors: Li Peijin , Wang Qian , Liu Lixing , Zhou Rui , Liu Tingting , Wang Yue , Feng Li 
Published: June 2022

Introduction
Lung cancer has the highest mortality rate of about 18.0% among malignant tumors worldwide, and chemotherapy is the main treatment. 80% of patients receiving chemotherapy suffers from cancer-related fatigue, which is the most severe symptom, with a large effect on quality of life as well as prognosis. Oral Chinese medicine, a kind of complementary and alternative medicine, has been proved to benefit lung cancer patients. However, no studies have reviewed whether it can reduce fatigue in lung cancer patients after chemotherapy, which is the purpose of our study.

Methods
Two reviewers will systematically and independently retrieve papers, select studies for inclusion, extract data, and assess risk of bias. The following nine databases will be searched: China National Knowledge Infrastructure, Wan Fang database, Chinese Scientific Journals Database, Chinese biomedical literature service system, PubMed, Web of Science, OVID, Scopus, and EMBASE from inception to February, 2022. Included studies will only be randomized controlled trials. Primary outcome is cancer-related fatigue. Secondary outcomes are quality of life, immunologic function, and the incidence of adverse events. We will use RoB 2 tool to assess the risk of bias and RevMan to analyze data. Risk ratios will be calculated for dichotomous data and mean differences for continuous data. Random-effect model will be used to integrate statistical effects. Meta-regression, subgroup and sensitivity analyses will be carried out. We will evaluate the strength and overall quality of evidence with four levels: very low, low, moderate, and high.

Results
The review of current evidence of oral Chinese medicine on cancer-related fatigue for lung cancer patients after chemotherapy will be narratively summarized and quantitatively analyzed.

Conclusion
The definitive conclusion will help physicians to determine whether oral Chinese medicine is an effective treatment for reducing fatigue in lung cancer patients after chemotherapy in clinical settings.

Systematic review registration
PROSPERO CRD42021292576.
Comparison of the effect of skin closure materials on skin closure during cesarean delivery
Authors: Huang Ye , Yin Xinbo , Wei Junni , Li Suhong 
Published: June 2022

Objective
To compare the effect of skin closure materials on skin closure during cesarean delivery.

Methods
We searched EMBASE、PubMed、Scopus、Cochrane CENTRAL for randomized controlled trials (RCTs) on the use of closure materials for skin closing effect during cesarean delivery. The outcomes were time to skin closure of dermal and epidermal layer, skin separation rate and wound complications(wound infection, hematoma,seroma, reclosure, readmission) reported as an odds ratio (OR) and surface under the cumulative ranking curve analysis (SUCRA) score.

Results
Twenty -six RCTs met the inclusion criteria. In the network meta-analysis (NMA) for time to skin closure of dermal and epidermal layer, pooled network OR values indicated that staple (network SMD, -337.50; 95% CrI: -416.99 to -263.18) was superior to absorbable suture. In the Skin separation NMA, pooled network OR values indicated that the absorbable suture (network OR, 0.37; 95% CrI: 0.19 to 0.70) were superior to staple. In the wound complications NMA, pooled network OR values indicated that the no interventions were superior to staple.

Conclusion
In conclusion, our network meta-analysis showed that the risk of skin separation with absorbable suture after cesarean delivery was reduced compared with staple, and does not increase the risk of wound complications, but the wound closure time would slightly prolonged.
Knowledge, attitudes, and practices regarding tick-borne diseases among an at-risk population living in Niigata prefecture, Japan
Authors: Narita Taichi , Abeywickrama Hansani Madushika , Sato Marcello Otake , Watanabe Kozo , Arai Reiko , Tamura Tsutomu , Sato Megumi 
Published: June 2022

Objective
This study examined the knowledge, attitudes, and practices (KAP) of an at-risk population living in Niigata prefecture regarding tick-borne diseases (TBDs) and preventive strategies.

Methods
A cross-sectional questionnaire-based study was conducted to assess the KAP of the community.

Results
In total, 186 responses were received. Among the respondents, 130 (69·9%) were men, and the mean age was 51.1 (14·3). Nine (4·8%) respondents reported having experienced tick bites. Of the respondents, 44 (23.7%) knew about both scrub typhus and severe fever with thrombocytopenia syndrome, while 156 (83·9%) and 71 (38·2%) recognized limiting skin exposure and use of insect repellents as preventive measures, respectively. The attitudes towards TBDs: being worried about tick bites (p = 0·018) and interested in preventing TBDs (p = 0·001), were significantly higher among women than men. About 75% of the respondents reported taking preventive measures against tick bites, and limiting skin exposure was the most frequently applied method (69·9%). Insect repellents were used by 58 (31·2%) respondents. Age (p = 0·049), being worried about tick bites (p = 0·046), and knowledge of ticks score (p = 0·024) were the significant independent predictors of practicing countermeasures.

Conclusion
We identified gaps in knowledge and practices regarding TBDs. Public health interventions should be implemented to improve public awareness of TBDs.