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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Bulow, Alison; Bellemare, Alixandra; Anderson, Judy E; Leiter, Jeff R S; +2 Authors

    Background Adolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females. Purpose To examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females. Study Design Prospective cohort. Methods Twenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring. Results Healthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score. Conclusions Adolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population. Level of Evidence Level 3.

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    International Journal of Sports Physical Therapy
    Article
    License: CC BY ND SA
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    International Journal of Sports Physical Therapy
    Article . 2021
    License: CC BY NC SA
    Data sources: Crossref
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    DOAJ
    Article . 2021
    Data sources: DOAJ
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ International Journa...arrow_drop_down
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      International Journal of Sports Physical Therapy
      Article
      License: CC BY ND SA
      Data sources: UnpayWall
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      International Journal of Sports Physical Therapy
      Article . 2021
      License: CC BY NC SA
      Data sources: Crossref
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      DOAJ
      Article . 2021
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Maria Skaalum Petersen; Cecilie Bo Hansen; Marnar Fríðheim Kristiansen; Jógvan Páll Fjallsbak; +12 Authors

    AbstractOnly a few studies have assessed the long-term duration of the humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In this nationwide longitudinal study from the Faroe Islands with close to full participation of all individuals on the Islands with PCR confirmed COVID-19 during the two waves of infections in the spring and autumn 2020 (n=172 & n=233), samples were drawn at three longitudinal time points (3, 7 and 12 months and 1, 3 and 7 months after disease onset, respectively).Serum was analyzed with a direct quantitative IgG antibody binding ELISA to detect anti–SARS-CoV-2 spike RBD antibodies and a commercially available qualitative sandwich RBD ELISA kit measuring total antibody binding.The seropositive rate in the convalescent individuals was above 95 % at all sampling time points for both assays. There was an overall decline in IgG titers over time in both waves (p < 0.001). Pairwise comparison showed that IgG declined significantly from the first sample until approximately 7 months in both waves (p < 0.001). After that, the antibody level still declined significantly (p < 0.001), but decelerated with an altered slope remaining fairly stable from 7 months to 12 months after infection. Interestingly, the IgG titers followed a U-shaped curve with higher antibody levels among the oldest (67+) and the youngest (0– 17) age groups compared to intermediate groups (p < 0.001).Our results indicate that COVID-19 convalescent individuals are likely to be protected from reinfection up to 12 months after symptom onset and maybe even longer. We believe our results can add to the understanding of natural immunity and the expected durability of SARS-CoV-2 vaccine immune responses.

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    https://www.medrxiv.org/conten...
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ https://www.medrxiv....arrow_drop_down
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      https://www.medrxiv.org/conten...
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Allison C. Rosenthal; Colleen Ramsower; Raphael Mwangi; Matthew J. Maurer; +15 Authors

    Abstract BACKGROUND: Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma with variable clinical outcomes. Commonly used risk stratification tools (Ki67 IHC, MIPI) in newly diagnosed MCL are not frequently used when selecting therapy, resulting in treatment choice being dictated by age and co-morbidities rather than disease biology. The MCL35 risk score was developed as a more reliable measure of proliferation and has been shown to be prognostic and can risk stratify younger transplant eligible MCL patients into three groups with significantly different overall survival (OS; Scott et al. 2017; Holte et al. 2018) but has not been evaluated in older transplant ineligible patients. We report results evaluating the prognostic value of the MCL35 assay in older MCL patients (≥65) treated with frontline bendamustine/rituximab (BR). METHODS: Archived tissue samples from 119 patients age ≥65 years treated with BR from collaborating Lymphoma/Leukemia Molecular Profiling Project (LLMPP) sites and the LEO/MER cohort were collected and analyzed using the MCL35 assay and stratified into three distinct risk groups (low, standard, and high risk). Association between MCL35 proliferation scores and OS were estimated by the Kaplan-Meier method and hazard ratios were calculated. Associations between Ki67, s-MIPI, p53 IHC status, morphology and OS were also evaluated. RESULTS: The MCL35 assay was run on tissue samples from 119 patients. Median patient age was 74 (range 65-93) and 69.5% were male. Ki67 was &lt;30% in 29 patients (24%) and ≥30% in 90 patients (76%). Simplified MIPI (s-MIPI) score was 0-3 in 21 patients (24%), 4-5 in 42 patients (48%) and ≥6 in 25 patients (28%). Thirty-one did not have sufficient data to calculate a s-MIPI score. MCL35 was low risk in 51 patients (43%), standard risk in 39 patients (33%) and high risk in 29 patients (24%). Eleven patients had blastic morphology, 7 had pleomorphic morphology and the remainder were classic morphology (n=56). Of 57 samples with p53 IHC staining 7 (12.3%) were positive. At a median follow up of 33.4 months, 82 patients were alive and 35 had died. Patients with high risk MCL35 score had inferior OS compared to low risk (HR 2.27, 95% CI: 1.03-5.00; p=0.042) while standard risk was not statistically significant compared to low risk (HR 0.87, 95% CI: 0.37-2.0; p=0.740)(Figure 1). Ki67 IHC using a cutoff of ≥ 30% and 10%-29% was not significantly associated with OS compared to Ki67 &lt;10% ( Ki67 ≥ 30% vs. Ki67 &lt; 10%, HR 0.87, 95% CI: 0.12-6.41; p=0.892, Ki67 ≥ 10%-29% vs. Ki67 &lt; 10%, HR 0.32, 95% CI: 0.04-2.83; p=0.303), however high s-MIPI score (≥6) (s-MIPI ≥6 vs. s-MIPI 0-3, HR 3.86, 95% CI 1.20-12.5; p=0.024) and positive p53 IHC (HR: 9.51, 3.26-27.7; p &lt;0.001) were both associated with poor OS. Eighteen cases were blastic/pleomorphic by morphology, 12 of which were in the high-risk group by MCL35, and this subset also had worse survival than classic MCL (p=0.0052). CONCLUSIONS: These results suggest high risk MCL35 score is a prognostic biomarker of poor OS in patients &gt;65 with MCL treated with BR. Conversely, Ki67 was not significantly associated with OS in these patients. Additional clinical validation using a larger sample size from the E1411 study is planned. If similar results are found, the MCL35 assay in combination with s-MIPI and p53 status may have utility in stratifying patients into risk adapted treatment arms in future prospective clinical trial designs. Figure 1 Figure 1. Disclosures Maurer: BMS: Research Funding; Genentech: Research Funding; Morphosys: Membership on an entity's Board of Directors or advisory committees, Research Funding; Kite Pharma: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Nanostring: Research Funding. Villa: Janssen: Honoraria; Gilead: Honoraria; AstraZeneca: Honoraria; AbbVie: Honoraria; Seattle Genetics: Honoraria; Celgene: Honoraria; Lundbeck: Honoraria; Roche: Honoraria; NanoString Technologies: Honoraria. Habermann: Seagen: Other: Data Monitoring Committee; Incyte: Other: Scientific Advisory Board; Tess Therapeutics: Other: Data Monitoring Committee; Morphosys: Other: Scientific Advisory Board; Loxo Oncology: Other: Scientific Advisory Board; Eli Lilly & Co.,: Other: Scientific Advisor. Cohen: Janssen, Adicet, Astra Zeneca, Genentech, Aptitude Health, Cellectar, Kite/Gilead, Loxo, BeiGene, Adaptive: Consultancy; Genentech, BMS/Celgene, LAM, BioINvent, LOXO, Astra Zeneca, Novartis, M2Gen, Takeda: Research Funding. Hill: Celgene (BMS): Consultancy, Honoraria, Research Funding; Epizyme: Consultancy, Honoraria; Gentenech: Consultancy, Honoraria, Research Funding; Pfizer: Consultancy, Honoraria; Kite, a Gilead Company: Consultancy, Honoraria, Other: Travel Support, Research Funding; Karyopharm: Consultancy, Honoraria, Research Funding; AstraZenica: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Research Funding; Novartis: Consultancy, Honoraria, Research Funding; Beigene: Consultancy, Honoraria, Research Funding; Incyte/Morphysis: Consultancy, Honoraria, Research Funding. Raess: Scopio Labs: Research Funding. Scott: Celgene: Consultancy; NanoString Technologies: Patents & Royalties: Patent describing measuring the proliferation signature in MCL using gene expression profiling.; BC Cancer: Patents & Royalties: Patent describing assigning DLBCL COO by gene expression profiling--licensed to NanoString Technologies. Patent describing measuring the proliferation signature in MCL using gene expression profiling. ; Rich/Genentech: Research Funding; Janssen: Consultancy, Research Funding; Incyte: Consultancy; Abbvie: Consultancy; AstraZeneca: Consultancy. Rimsza: NanoString Technologies: Other: Fee-for-service contract.

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    Blood
    Article . 2021
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      Blood
      Article . 2021
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    Authors: Aravind, Ganesh; Luca, Bartolini; Ravinder-Jeet, Singh; Abdulaziz S, Al-Sultan; +3 Authors

    OBJECTIVE: To explore differences in antithrombotic management of patients with acutely symptomatic carotid stenosis (“hot carotid”) awaiting revascularization with endarterectomy or stenting (CEA/CAS). METHODS: We used a worldwide electronic survey with practice-related questions and clinical questions about 3 representative scenarios. Respondents chose their preferred antithrombotic regimen (1) in general, (2) if the patient was already on aspirin, or (3) had associated intraluminal thrombus (ILT) and identified clinical/imaging factors that increased or decreased their enthusiasm for additional antithrombotic agents. Responses among different groups were compared using multivariable logistic regression. RESULTS: We received 668 responses from 71 countries. The majority favored CT angiography (70.2%) to evaluate carotid stenosis, CEA (69.1%) over CAS, an aspirin-containing regimen (88.5%), and a clopidogrel-containing regimen (64.4%) if already on aspirin. Whereas diverse antithrombotic regimens were chosen, monotherapy was favored by 54.4%–70.6% of respondents across 3 scenarios. The preferred dual therapy was low-dose aspirin (75–100 mg) plus clopidogrel (22.2%) or high-dose aspirin (160–325 mg) plus clopidogrel if already on aspirin (12.2%). Respondents favoring CAS more often chose ≥2 agents (adjusted odds ratio [aOR] vs CEA: 2.00, 95% confidence interval 1.36–2.95, p = 0.001) or clopidogrel-containing regimens (aOR: 1.77, 1.16–2.70, p = 0.008). Regional differences included respondents from Europe less commonly choosing multiple agents if already on aspirin (aOR vs United States/Canada: 0.57, 0.35–0.93, p = 0.023), those from Asia more often favoring multiple agents (aOR: 1.95, 1.11–3.43, p = 0.020), vs those from the United States/Canada preferentially choosing heparin-containing regimens with ILT (aOR vs rest: 3.35, 2.23–5.03, p < 0.001). Factors increasing enthusiasm for ≥2 antithrombotics included multiple TIAs (57.2%), ILT (58.5%), and ulcerated plaque (57.4%); 56.3% identified MRI microbleeds as decreasing enthusiasm. CONCLUSIONS: Our results highlight the heterogeneous management and community equipoise surrounding optimal antithrombotic regimens for hot carotids.

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    Europe PubMed Central
    Other literature type . 2021
    Data sources: PubMed Central
    Neurology Clinical Practice
    Article . 2021
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      Europe PubMed Central
      Other literature type . 2021
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      Neurology Clinical Practice
      Article . 2021
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    Authors: Arief Priyo Nugroho; Diyan Ermawan Effendi; Zulfa Auliyati Agustina; Asep Kusnali; +3 Authors

    Background: Maternal and child health (MCH) routine data is essential in making a good health-relatedpolicy. However, the quality of MCH routine data in Indonesia is doubted, and thus the Indonesian governmentrelies heavily on the survey data for policymaking. This condition raises questions about where the problemsexist in routine data recording stages. This study aims to explore the barriers and strategies of MCH routinedata recording by the administrators in the primary healthcare center.Method: This study was qualitativeresearch conducted in Buru Regency, Ambon City, Purworejo Regency, and Surakarta City from May toNovember 2020. The data collections were intended to understand administrators’ efforts to deal with the datarecording problems. Data triangulation was performed through in-depth interviews with primary healthcarecenter staff and observations on daily routine data administration practices.Results: The study demonstratedchallenges in the MCH routine data administration context. The first problem is behavioral contexts lead toincorrect input and delay data submission. Second, technical determinant shows the lack of integration thatleads to repetitive data recording and data fragmentation. The third was the organizational problem suchas lack of inter and intra-departmental coordination in data sharing, infrastructure, and human resourceshortage.Conclusion: The findings elucidate the problem of administrative structures in the implementationof routine data policy. A comprehensive response to cope with routine data policy implementation contextis needed. Existing maternal and child healthcare routine data requires structural administration refinementthat provides a context for implementing reliable routine data recording of maternal and child health.

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    Indian Journal of Forensic Medicine & Toxicology
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      Indian Journal of Forensic Medicine & Toxicology
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    Authors: Karin Wuertz-Kozak; Sonja Haeckel; Sebastian Wangler; Christina Wapp;

    AbstractBackgroundMesenchymal stromal cells (MSCs) have been introduced as promising cell source for regenerative medicine. Besides their multilineage differentiation capacity, MSCs release a wide spectrum of bioactive factors. This secretome holds immunomodulatory and regenerative capacities. In intervertebral disc (IVD) cells, application of MSC secretome has been shown to decrease the apoptosis rate, induce proliferation, and promote production of extracellular matrix (ECM). For clinical translation of secretome-based treatment, characterization of the secretome composition is needed to better understand the induced biological processes and identify potentially effective secretomes.MethodsThis study aimed to investigate the proteome released by bone marrow-derived MSCs following exposure to a healthy, traumatic, or degenerative human IVD environment by mass spectroscopy and quantitative immunoassay analyses. Exposure of MSCs to the proinflammatory stimulus interleukin 1β (IL-1β) was used as control.ResultsCompared to MSC baseline secretome, there were 224 significantly up- or downregulated proteins following healthy, 179 following traumatic, 223 following degenerative IVD, and 160 proteins following IL-1β stimulus. Stimulation of MSCs with IVD conditioned media induced a more complex MSC secretome, involving more biological processes, compared to stimulation with IL-1β. The MSC response to stimulation with IVD conditioned medium was dependent on their pathological status.ConclusionsThe MSC secretome seemed to match the primary need of the IVD: homeostasis maintenance in the case of healthy IVDs, versus immunomodulation, adjustment of ECM synthesis and degradation disbalance, and ECM (re) organization in the case of traumatic and degenerative IVDs. These findings highlight the importance of cell preconditioning in the development of tailored secretome therapies.Graphical abstractThe secretome of human bone marrow-derived mesenchymal stromal cells (MSCs) stimulated with intervertebral disc (IVD) conditioned medium was analyzed by proteomic profiling. Depending on the pathological state of the IVD, the MSC secretome protein composition indicated immunomodulatory or anabolic activity of the secretome. These findings may have implications for tailored secretome therapy for the IVD and other tissues.

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    Stem Cell Research &amp; Therapy
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      Stem Cell Research &amp; Therapy
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    Authors: Dianeh Rabi; razan Rabi; Arkan Jarrar; Sarah Maharma; +2 Authors

    AbstractPurposeOcular manifestations were reported in many recent observations that studied either the effect of COVID-19 directly on eyes or of face mask use. Hence, this study aimed to investigate the effect of COVID-19 on the eyes and make a clear comparison of its direct and indirect effect from face mask-wearing.MethodsThis was a cross-sectional study of both written and web-based questionnaires, distributed among a group of COVID-19 patients and a matched control group, the questionnaire consisted of common demographic data, COVID-19 infection history and its symptoms, focusing on ocular symptoms and the presence of conditions related to or cause eye symptoms. As well as the use of face masks that were assessed in terms of the complained ocular manifestationResultsOf 618 participants, 252 had COVID-19 and 366 never had COVID-19. Ocular manifestation among COVID-19 incidence was 44%, significantly higher than non-infected participants’ incidence (35.8%), adjusted odds ratio, 95% confidence interval (AOR, 95%CI); 1.45 (1.02-2.06)). Eye discharges (p-value = 0.033) and photosensitivity (p-value = 0.003) were noted more commonly among COVID-19 participants compared to healthy control. When comparing long periods of face mask use with each ocular symptom; dry eye based on OSDI, forging body sensation, eye pain and eye discharges, were found significantly common among extended periods of face mask use.ConclusionCOVID-19 pandemic affected eyes, both directly from the virus or from its preventive measure of face mask use.

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    Authors: Zau Ring; Zaw Myo Tun; Clarence C. Tam;

    AbstractBackgroundTetanus toxoid vaccination is a life-saving maternal and child health intervention. Understanding gaps in maternal vaccination coverage is key to informing progress towards universal health coverage. We assessed maternal tetanus vaccination coverage in Myanmar and investigated factors associated with being unvaccinated.MethodWe analysed 2015-16 Demographic and Health Survey data including women aged 15-49 years with at least one childbirth in the last five years. The outcome was self-reported receipt of tetanus vaccine at least once during the last pregnancy. We used logistic regression models to assess factors associated with being unvaccinated.ResultsOverall maternal tetanus vaccination coverage was 85.7%. Sub-national coverage was lowest in the predominantly ethnic minority states of Shan, Kayin, and Chin at 69.6%, 77.4%, and 79.9%, respectively. Factors associated with a lack of vaccination were: not receiving antenatal care (odds ratio (OR): 18.99, 95% confidence interval (CI): 14.21, 25.39); receiving antenatal care at home (OR: 2.05, 95% CI: 1.46, 2.88), private and non-governmental organization clinics (OR: 2.88, 95% CI: 1.81, 4.58, compared to public facilities); and not wanting to go to a health facility alone (OR: 1.53, 95% CI: 1.14, 2.06). Higher educational attainment was associated with lower odds of being unvaccinated (OR: 0.48, 95% CI: 0.32, 0.70 for secondary relative to no education).InterpretationWe identified regional, structural, and individual differences in maternal tetanus vaccination coverage. Achieving universal coverage of maternal tetanus vaccination will largely depend on the ability to provide accessible antenatal care to most women who do not currently receive it.

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    Authors: Davide Chicco; Valery V. Starovoitov; Giuseppe Jurman;

    To assess the quality of a binary classification, researchers often take advantage of a four-entry contingency table called confusion matrix, containing true positives, true negatives, false positives, and false negatives. To recap the four values of a confusion matrix in a unique score, researchers and statisticians have developed several rates and metrics. In the past, several scientific studies already showed why the Matthews correlation coefficient (MCC) is more informative and trustworthy than confusion-entropy error, accuracy, F1 score, bookmaker informedness, markedness, and balanced accuracy. In this study, we compare the MCC with the diagnostic odds ratio (DOR), a statistical rate employed sometimes in biomedical sciences. After examining the properties of the MCC and of the DOR, we describe the relationships between them, by also taking advantage of an innovative geometrical plot called confusion tetrahedron, presented here for the first time. We then report some use cases where the MCC and the DOR produce discordant outcomes, and explain why the Matthews correlation coefficient is more informative and reliable between the two. Our results can have a strong impact in computer science and statistics, because they clearly explain why the trustworthiness of the information provided by the Matthews correlation coefficient is higher than the one generated by the diagnostic odds ratio.

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    IEEE Access
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      Article . 2021
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    Authors: Aneesa Abdul Rashid; Cheong Ai Theng; Ranita Hisham Shanmugam; Nurainul Hana Shamsuddin; +1 Authors

    Introduction: This is a part of a bigger study entitled “Exploring the Views of Healthcare Practitioners on the Teddy Bear Hospital (TBH) as a Personal Safety Module Towards Prevention of Child Sexual Abuse (CSA): A Qualitative Study”. TBH is a make-believe-play hospital utilising soft toys to demonstrate a pretend clinical setting with the aim to educate children on health issues. Studies has shown its effectiveness and reducing anxiety towards the hospital setting and increasing health-related knowledge. IMAM Children’s and Teen Super teen (IMACATS) is one of the non-governmental organisations (NGO) which has adopted this concept to tailor to the local community. The volunteers are healthcare practitioners who are engaged with children in their practice. Objective: To explore the views of healthcare professional towards TBH by IMACATS in Malaysia. Methods: In-depth qualitative audio recorded interviews were conducted with a purposive sample of 18 healthcare professionals. The data obtained were transcribed and analysed thematically. Results: Three themes were derived from the interviews: i) Awareness of the TBH concept. Seven participants have volunteered in TBH previously. However, there was a speculation that many doctors are still unknowing of this concept. ii) Benefits of TBH. This includes reducing children’s anxiety, changing children’s presumption on healthcare, increasing children’s health knowledge and encouraging healthy behaviour and bridging the gap between the public and healthcare. iii) Suggestion of Module for future TBH: (a) More school-based programmes should be organised in addition to hospital and community based; (b) Ministry of Health (MOH) should encourage children health screening using this concept; (c) A module for hospitalised children should be conducted. Conclusion: Participants interviewed suggested for TBH to be organised in a wider scale as it is an approachable concept for educating children. There are many ways in which it can benefit this community. International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S18

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    International Journal of Human and Health Sciences
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      International Journal of Human and Health Sciences
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    Authors: Bulow, Alison; Bellemare, Alixandra; Anderson, Judy E; Leiter, Jeff R S; +2 Authors

    Background Adolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females. Purpose To examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females. Study Design Prospective cohort. Methods Twenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring. Results Healthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score. Conclusions Adolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population. Level of Evidence Level 3.

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    International Journal of Sports Physical Therapy
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    International Journal of Sports Physical Therapy
    Article . 2021
    License: CC BY NC SA
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    Article . 2021
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      International Journal of Sports Physical Therapy
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      International Journal of Sports Physical Therapy
      Article . 2021
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      DOAJ
      Article . 2021
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    Authors: Maria Skaalum Petersen; Cecilie Bo Hansen; Marnar Fríðheim Kristiansen; Jógvan Páll Fjallsbak; +12 Authors

    AbstractOnly a few studies have assessed the long-term duration of the humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In this nationwide longitudinal study from the Faroe Islands with close to full participation of all individuals on the Islands with PCR confirmed COVID-19 during the two waves of infections in the spring and autumn 2020 (n=172 & n=233), samples were drawn at three longitudinal time points (3, 7 and 12 months and 1, 3 and 7 months after disease onset, respectively).Serum was analyzed with a direct quantitative IgG antibody binding ELISA to detect anti–SARS-CoV-2 spike RBD antibodies and a commercially available qualitative sandwich RBD ELISA kit measuring total antibody binding.The seropositive rate in the convalescent individuals was above 95 % at all sampling time points for both assays. There was an overall decline in IgG titers over time in both waves (p < 0.001). Pairwise comparison showed that IgG declined significantly from the first sample until approximately 7 months in both waves (p < 0.001). After that, the antibody level still declined significantly (p < 0.001), but decelerated with an altered slope remaining fairly stable from 7 months to 12 months after infection. Interestingly, the IgG titers followed a U-shaped curve with higher antibody levels among the oldest (67+) and the youngest (0– 17) age groups compared to intermediate groups (p < 0.001).Our results indicate that COVID-19 convalescent individuals are likely to be protected from reinfection up to 12 months after symptom onset and maybe even longer. We believe our results can add to the understanding of natural immunity and the expected durability of SARS-CoV-2 vaccine immune responses.

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    https://www.medrxiv.org/conten...
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    Authors: Allison C. Rosenthal; Colleen Ramsower; Raphael Mwangi; Matthew J. Maurer; +15 Authors

    Abstract BACKGROUND: Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma with variable clinical outcomes. Commonly used risk stratification tools (Ki67 IHC, MIPI) in newly diagnosed MCL are not frequently used when selecting therapy, resulting in treatment choice being dictated by age and co-morbidities rather than disease biology. The MCL35 risk score was developed as a more reliable measure of proliferation and has been shown to be prognostic and can risk stratify younger transplant eligible MCL patients into three groups with significantly different overall survival (OS; Scott et al. 2017; Holte et al. 2018) but has not been evaluated in older transplant ineligible patients. We report results evaluating the prognostic value of the MCL35 assay in older MCL patients (≥65) treated with frontline bendamustine/rituximab (BR). METHODS: Archived tissue samples from 119 patients age ≥65 years treated with BR from collaborating Lymphoma/Leukemia Molecular Profiling Project (LLMPP) sites and the LEO/MER cohort were collected and analyzed using the MCL35 assay and stratified into three distinct risk groups (low, standard, and high risk). Association between MCL35 proliferation scores and OS were estimated by the Kaplan-Meier method and hazard ratios were calculated. Associations between Ki67, s-MIPI, p53 IHC status, morphology and OS were also evaluated. RESULTS: The MCL35 assay was run on tissue samples from 119 patients. Median patient age was 74 (range 65-93) and 69.5% were male. Ki67 was &lt;30% in 29 patients (24%) and ≥30% in 90 patients (76%). Simplified MIPI (s-MIPI) score was 0-3 in 21 patients (24%), 4-5 in 42 patients (48%) and ≥6 in 25 patients (28%). Thirty-one did not have sufficient data to calculate a s-MIPI score. MCL35 was low risk in 51 patients (43%), standard risk in 39 patients (33%) and high risk in 29 patients (24%). Eleven patients had blastic morphology, 7 had pleomorphic morphology and the remainder were classic morphology (n=56). Of 57 samples with p53 IHC staining 7 (12.3%) were positive. At a median follow up of 33.4 months, 82 patients were alive and 35 had died. Patients with high risk MCL35 score had inferior OS compared to low risk (HR 2.27, 95% CI: 1.03-5.00; p=0.042) while standard risk was not statistically significant compared to low risk (HR 0.87, 95% CI: 0.37-2.0; p=0.740)(Figure 1). Ki67 IHC using a cutoff of ≥ 30% and 10%-29% was not significantly associated with OS compared to Ki67 &lt;10% ( Ki67 ≥ 30% vs. Ki67 &lt; 10%, HR 0.87, 95% CI: 0.12-6.41; p=0.892, Ki67 ≥ 10%-29% vs. Ki67 &lt; 10%, HR 0.32, 95% CI: 0.04-2.83; p=0.303), however high s-MIPI score (≥6) (s-MIPI ≥6 vs. s-MIPI 0-3, HR 3.86, 95% CI 1.20-12.5; p=0.024) and positive p53 IHC (HR: 9.51, 3.26-27.7; p &lt;0.001) were both associated with poor OS. Eighteen cases were blastic/pleomorphic by morphology, 12 of which were in the high-risk group by MCL35, and this subset also had worse survival than classic MCL (p=0.0052). CONCLUSIONS: These results suggest high risk MCL35 score is a prognostic biomarker of poor OS in patients &gt;65 with MCL treated with BR. Conversely, Ki67 was not significantly associated with OS in these patients. Additional clinical validation using a larger sample size from the E1411 study is planned. If similar results are found, the MCL35 assay in combination with s-MIPI and p53 status may have utility in stratifying patients into risk adapted treatment arms in future prospective clinical trial designs. Figure 1 Figure 1. Disclosures Maurer: BMS: Research Funding; Genentech: Research Funding; Morphosys: Membership on an entity's Board of Directors or advisory committees, Research Funding; Kite Pharma: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Nanostring: Research Funding. Villa: Janssen: Honoraria; Gilead: Honoraria; AstraZeneca: Honoraria; AbbVie: Honoraria; Seattle Genetics: Honoraria; Celgene: Honoraria; Lundbeck: Honoraria; Roche: Honoraria; NanoString Technologies: Honoraria. Habermann: Seagen: Other: Data Monitoring Committee; Incyte: Other: Scientific Advisory Board; Tess Therapeutics: Other: Data Monitoring Committee; Morphosys: Other: Scientific Advisory Board; Loxo Oncology: Other: Scientific Advisory Board; Eli Lilly & Co.,: Other: Scientific Advisor. Cohen: Janssen, Adicet, Astra Zeneca, Genentech, Aptitude Health, Cellectar, Kite/Gilead, Loxo, BeiGene, Adaptive: Consultancy; Genentech, BMS/Celgene, LAM, BioINvent, LOXO, Astra Zeneca, Novartis, M2Gen, Takeda: Research Funding. Hill: Celgene (BMS): Consultancy, Honoraria, Research Funding; Epizyme: Consultancy, Honoraria; Gentenech: Consultancy, Honoraria, Research Funding; Pfizer: Consultancy, Honoraria; Kite, a Gilead Company: Consultancy, Honoraria, Other: Travel Support, Research Funding; Karyopharm: Consultancy, Honoraria, Research Funding; AstraZenica: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Research Funding; Novartis: Consultancy, Honoraria, Research Funding; Beigene: Consultancy, Honoraria, Research Funding; Incyte/Morphysis: Consultancy, Honoraria, Research Funding. Raess: Scopio Labs: Research Funding. Scott: Celgene: Consultancy; NanoString Technologies: Patents & Royalties: Patent describing measuring the proliferation signature in MCL using gene expression profiling.; BC Cancer: Patents & Royalties: Patent describing assigning DLBCL COO by gene expression profiling--licensed to NanoString Technologies. Patent describing measuring the proliferation signature in MCL using gene expression profiling. ; Rich/Genentech: Research Funding; Janssen: Consultancy, Research Funding; Incyte: Consultancy; Abbvie: Consultancy; AstraZeneca: Consultancy. Rimsza: NanoString Technologies: Other: Fee-for-service contract.

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    Blood
    Article . 2021
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      Blood
      Article . 2021
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    Authors: Aravind, Ganesh; Luca, Bartolini; Ravinder-Jeet, Singh; Abdulaziz S, Al-Sultan; +3 Authors

    OBJECTIVE: To explore differences in antithrombotic management of patients with acutely symptomatic carotid stenosis (“hot carotid”) awaiting revascularization with endarterectomy or stenting (CEA/CAS). METHODS: We used a worldwide electronic survey with practice-related questions and clinical questions about 3 representative scenarios. Respondents chose their preferred antithrombotic regimen (1) in general, (2) if the patient was already on aspirin, or (3) had associated intraluminal thrombus (ILT) and identified clinical/imaging factors that increased or decreased their enthusiasm for additional antithrombotic agents. Responses among different groups were compared using multivariable logistic regression. RESULTS: We received 668 responses from 71 countries. The majority favored CT angiography (70.2%) to evaluate carotid stenosis, CEA (69.1%) over CAS, an aspirin-containing regimen (88.5%), and a clopidogrel-containing regimen (64.4%) if already on aspirin. Whereas diverse antithrombotic regimens were chosen, monotherapy was favored by 54.4%–70.6% of respondents across 3 scenarios. The preferred dual therapy was low-dose aspirin (75–100 mg) plus clopidogrel (22.2%) or high-dose aspirin (160–325 mg) plus clopidogrel if already on aspirin (12.2%). Respondents favoring CAS more often chose ≥2 agents (adjusted odds ratio [aOR] vs CEA: 2.00, 95% confidence interval 1.36–2.95, p = 0.001) or clopidogrel-containing regimens (aOR: 1.77, 1.16–2.70, p = 0.008). Regional differences included respondents from Europe less commonly choosing multiple agents if already on aspirin (aOR vs United States/Canada: 0.57, 0.35–0.93, p = 0.023), those from Asia more often favoring multiple agents (aOR: 1.95, 1.11–3.43, p = 0.020), vs those from the United States/Canada preferentially choosing heparin-containing regimens with ILT (aOR vs rest: 3.35, 2.23–5.03, p < 0.001). Factors increasing enthusiasm for ≥2 antithrombotics included multiple TIAs (57.2%), ILT (58.5%), and ulcerated plaque (57.4%); 56.3% identified MRI microbleeds as decreasing enthusiasm. CONCLUSIONS: Our results highlight the heterogeneous management and community equipoise surrounding optimal antithrombotic regimens for hot carotids.

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    Europe PubMed Central
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    Neurology Clinical Practice
    Article . 2021
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      Europe PubMed Central
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    Authors: Arief Priyo Nugroho; Diyan Ermawan Effendi; Zulfa Auliyati Agustina; Asep Kusnali; +3 Authors

    Background: Maternal and child health (MCH) routine data is essential in making a good health-relatedpolicy. However, the quality of MCH routine data in Indonesia is doubted, and thus the Indonesian governmentrelies heavily on the survey data for policymaking. This condition raises questions about where the problemsexist in routine data recording stages. This study aims to explore the barriers and strategies of MCH routinedata recording by the administrators in the primary healthcare center.Method: This study was qualitativeresearch conducted in Buru Regency, Ambon City, Purworejo Regency, and Surakarta City from May toNovember 2020. The data collections were intended to understand administrators’ efforts to deal with the datarecording problems. Data triangulation was performed through in-depth interviews with primary healthcarecenter staff and observations on daily routine data administration practices.Results: The study demonstratedchallenges in the MCH routine data administration context. The first problem is behavioral contexts lead toincorrect input and delay data submission. Second, technical determinant shows the lack of integration thatleads to repetitive data recording and data fragmentation. The third was the organizational problem suchas lack of inter and intra-departmental coordination in data sharing, infrastructure, and human resourceshortage.Conclusion: The findings elucidate the problem of administrative structures in the implementationof routine data policy. A comprehensive response to cope with routine data policy implementation contextis needed. Existing maternal and child healthcare routine data requires structural administration refinementthat provides a context for implementing reliable routine data recording of maternal and child health.

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    Indian Journal of Forensic Medicine & Toxicology
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      Indian Journal of Forensic Medicine & Toxicology
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    Authors: Karin Wuertz-Kozak; Sonja Haeckel; Sebastian Wangler; Christina Wapp;

    AbstractBackgroundMesenchymal stromal cells (MSCs) have been introduced as promising cell source for regenerative medicine. Besides their multilineage differentiation capacity, MSCs release a wide spectrum of bioactive factors. This secretome holds immunomodulatory and regenerative capacities. In intervertebral disc (IVD) cells, application of MSC secretome has been shown to decrease the apoptosis rate, induce proliferation, and promote production of extracellular matrix (ECM). For clinical translation of secretome-based treatment, characterization of the secretome composition is needed to better understand the induced biological processes and identify potentially effective secretomes.MethodsThis study aimed to investigate the proteome released by bone marrow-derived MSCs following exposure to a healthy, traumatic, or degenerative human IVD environment by mass spectroscopy and quantitative immunoassay analyses. Exposure of MSCs to the proinflammatory stimulus interleukin 1β (IL-1β) was used as control.ResultsCompared to MSC baseline secretome, there were 224 significantly up- or downregulated proteins following healthy, 179 following traumatic, 223 following degenerative IVD, and 160 proteins following IL-1β stimulus. Stimulation of MSCs with IVD conditioned media induced a more complex MSC secretome, involving more biological processes, compared to stimulation with IL-1β. The MSC response to stimulation with IVD conditioned medium was dependent on their pathological status.ConclusionsThe MSC secretome seemed to match the primary need of the IVD: homeostasis maintenance in the case of healthy IVDs, versus immunomodulation, adjustment of ECM synthesis and degradation disbalance, and ECM (re) organization in the case of traumatic and degenerative IVDs. These findings highlight the importance of cell preconditioning in the development of tailored secretome therapies.Graphical abstractThe secretome of human bone marrow-derived mesenchymal stromal cells (MSCs) stimulated with intervertebral disc (IVD) conditioned medium was analyzed by proteomic profiling. Depending on the pathological state of the IVD, the MSC secretome protein composition indicated immunomodulatory or anabolic activity of the secretome. These findings may have implications for tailored secretome therapy for the IVD and other tissues.

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    Stem Cell Research &amp; Therapy
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      Stem Cell Research &amp; Therapy
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    Authors: Dianeh Rabi; razan Rabi; Arkan Jarrar; Sarah Maharma; +2 Authors

    AbstractPurposeOcular manifestations were reported in many recent observations that studied either the effect of COVID-19 directly on eyes or of face mask use. Hence, this study aimed to investigate the effect of COVID-19 on the eyes and make a clear comparison of its direct and indirect effect from face mask-wearing.MethodsThis was a cross-sectional study of both written and web-based questionnaires, distributed among a group of COVID-19 patients and a matched control group, the questionnaire consisted of common demographic data, COVID-19 infection history and its symptoms, focusing on ocular symptoms and the presence of conditions related to or cause eye symptoms. As well as the use of face masks that were assessed in terms of the complained ocular manifestationResultsOf 618 participants, 252 had COVID-19 and 366 never had COVID-19. Ocular manifestation among COVID-19 incidence was 44%, significantly higher than non-infected participants’ incidence (35.8%), adjusted odds ratio, 95% confidence interval (AOR, 95%CI); 1.45 (1.02-2.06)). Eye discharges (p-value = 0.033) and photosensitivity (p-value = 0.003) were noted more commonly among COVID-19 participants compared to healthy control. When comparing long periods of face mask use with each ocular symptom; dry eye based on OSDI, forging body sensation, eye pain and eye discharges, were found significantly common among extended periods of face mask use.ConclusionCOVID-19 pandemic affected eyes, both directly from the virus or from its preventive measure of face mask use.

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    Authors: Zau Ring; Zaw Myo Tun; Clarence C. Tam;

    AbstractBackgroundTetanus toxoid vaccination is a life-saving maternal and child health intervention. Understanding gaps in maternal vaccination coverage is key to informing progress towards universal health coverage. We assessed maternal tetanus vaccination coverage in Myanmar and investigated factors associated with being unvaccinated.MethodWe analysed 2015-16 Demographic and Health Survey data including women aged 15-49 years with at least one childbirth in the last five years. The outcome was self-reported receipt of tetanus vaccine at least once during the last pregnancy. We used logistic regression models to assess factors associated with being unvaccinated.ResultsOverall maternal tetanus vaccination coverage was 85.7%. Sub-national coverage was lowest in the predominantly ethnic minority states of Shan, Kayin, and Chin at 69.6%, 77.4%, and 79.9%, respectively. Factors associated with a lack of vaccination were: not receiving antenatal care (odds ratio (OR): 18.99, 95% confidence interval (CI): 14.21, 25.39); receiving antenatal care at home (OR: 2.05, 95% CI: 1.46, 2.88), private and non-governmental organization clinics (OR: 2.88, 95% CI: 1.81, 4.58, compared to public facilities); and not wanting to go to a health facility alone (OR: 1.53, 95% CI: 1.14, 2.06). Higher educational attainment was associated with lower odds of being unvaccinated (OR: 0.48, 95% CI: 0.32, 0.70 for secondary relative to no education).InterpretationWe identified regional, structural, and individual differences in maternal tetanus vaccination coverage. Achieving universal coverage of maternal tetanus vaccination will largely depend on the ability to provide accessible antenatal care to most women who do not currently receive it.

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    Authors: Davide Chicco; Valery V. Starovoitov; Giuseppe Jurman;

    To assess the quality of a binary classification, researchers often take advantage of a four-entry contingency table called confusion matrix, containing true positives, true negatives, false positives, and false negatives. To recap the four values of a confusion matrix in a unique score, researchers and statisticians have developed several rates and metrics. In the past, several scientific studies already showed why the Matthews correlation coefficient (MCC) is more informative and trustworthy than confusion-entropy error, accuracy, F1 score, bookmaker informedness, markedness, and balanced accuracy. In this study, we compare the MCC with the diagnostic odds ratio (DOR), a statistical rate employed sometimes in biomedical sciences. After examining the properties of the MCC and of the DOR, we describe the relationships between them, by also taking advantage of an innovative geometrical plot called confusion tetrahedron, presented here for the first time. We then report some use cases where the MCC and the DOR produce discordant outcomes, and explain why the Matthews correlation coefficient is more informative and reliable between the two. Our results can have a strong impact in computer science and statistics, because they clearly explain why the trustworthiness of the information provided by the Matthews correlation coefficient is higher than the one generated by the diagnostic odds ratio.

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    IEEE Access
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      Article . 2021
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    Authors: Aneesa Abdul Rashid; Cheong Ai Theng; Ranita Hisham Shanmugam; Nurainul Hana Shamsuddin; +1 Authors

    Introduction: This is a part of a bigger study entitled “Exploring the Views of Healthcare Practitioners on the Teddy Bear Hospital (TBH) as a Personal Safety Module Towards Prevention of Child Sexual Abuse (CSA): A Qualitative Study”. TBH is a make-believe-play hospital utilising soft toys to demonstrate a pretend clinical setting with the aim to educate children on health issues. Studies has shown its effectiveness and reducing anxiety towards the hospital setting and increasing health-related knowledge. IMAM Children’s and Teen Super teen (IMACATS) is one of the non-governmental organisations (NGO) which has adopted this concept to tailor to the local community. The volunteers are healthcare practitioners who are engaged with children in their practice. Objective: To explore the views of healthcare professional towards TBH by IMACATS in Malaysia. Methods: In-depth qualitative audio recorded interviews were conducted with a purposive sample of 18 healthcare professionals. The data obtained were transcribed and analysed thematically. Results: Three themes were derived from the interviews: i) Awareness of the TBH concept. Seven participants have volunteered in TBH previously. However, there was a speculation that many doctors are still unknowing of this concept. ii) Benefits of TBH. This includes reducing children’s anxiety, changing children’s presumption on healthcare, increasing children’s health knowledge and encouraging healthy behaviour and bridging the gap between the public and healthcare. iii) Suggestion of Module for future TBH: (a) More school-based programmes should be organised in addition to hospital and community based; (b) Ministry of Health (MOH) should encourage children health screening using this concept; (c) A module for hospitalised children should be conducted. Conclusion: Participants interviewed suggested for TBH to be organised in a wider scale as it is an approachable concept for educating children. There are many ways in which it can benefit this community. International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S18

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    International Journal of Human and Health Sciences
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