bluuebunny/crossref_metadata_2025_split huggingface dataset:
Setting-up of natural delivery centers; an affordable policy to improve the quality of maternity care
Authors: Aghazadeh-Attari Javad , Alinia Cyrus , Entezar-Mahdi Rasool , Mirza‐Aghazadeh-Attari Mohammad , Mohebbi Iraj 
Published: December 2019

Abstract
Background: Since there is no comprehensive model to measure the quality of maternity care and also health systems are facing the challenge of increasing the cost of such care, We developed a quality of maternity care model, measured the quality of care in a normal delivery center (NDC) compared to a mixed delivery center (MDC). It also compared the performance of midwives against gynecologists for uncomplicated pregnant mothers.Methods: A theory-based maternity care model is used to compare the quality of maternity care for the delivery centers. This model consists of three dimensions of the structure, process, and output. Mothers who have given birth in the delivery centers were the primary data source in Urmia city, Iran in 2018. A total of 164 mothers from the NDC and 215 mothers from MDC were randomly selected and interviewed.Results: The mean age of mothers in the NDC and MDC was 24.7 and 27.1 years, respectively. The findings show that NDC significantly had better performance compared to MDC in all three dimensions. However, we observed significant differences in some outcome variables (the experience of pain and follow-up) in favor of MDC.Conclusions: Midwives in NCD provide a higher quality of care than gynecologists in general hospital. The policy of setting up natural childbirth centers run by trained midwives can have positive effects, such as decreasing cesarean rates and cost of care and also increasing the quality of childbirth care.
The Geriatric Nutrition Risk Index versus the Mini-Nutritional Assessment Short Form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study
Authors: Zhao Yanli , Ge Ning , Xie Dongmei , Gao Langli , Wang Yanyan , Liao Yulin , Yue Jirong 
Published: December 2019

Abstract
Backgrounds: Malnutrition has been shown to be associated with a poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods : Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariate logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receive Operator Characteristic curves (ROC) analyses and the area under the curve (AUC). Results : Multivariate analysis revealed that high nutritional risk (GNRI < 92) and malnutrition/ risk of malnutrition (MNA-SF < 8 and MNA-SF=8-11) were significantly associated with POD. Linear regression analysis showed that low/high nutritional risk (GNRI=92-98 and GNRI < 92) and malnutrition (MNA-SF < 8) were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores (AUC=0.718, P <0.001, 95%CI: 0.64-0.80) for POD was better than GNRI scores (AUC=0.606, P= 0.019, 95%CI: 0.52-0.69), whereas, GNRI scores (AUC=0.611, P= 0.006, 95%CI: 0.54-0.69) had larger AUC when predicting prolonged LOS as compared to MNA-SF scores (AUC=0.533, P= 0.421, 95%CI: 0.45-0.62). Conclusion : The GNRI was more effective than the MNA-SF at predicting prolonged LOS, but the MNA-SF was a superior predictor of POD in older non-cardiac surgical patients.
Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study
Authors: Manis Derek R. , McArthur Caitlin , Costa Andrew P. 
Published: December 2019

Abstract
Background Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients.Methods We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1 – March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument – Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls.Results Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism.Conclusions Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.
Increasing prevalence of anticholinergic medication use in older people in England over 20 years: Cognitive Function and Ageing Study I and II
Authors: Grossi Carlota , Richardson Kathryn , Savva George , Fox Chris , Arthur Antony , Loke Yoon , Steel Nicholas , Brayne Carol , Matthews Fiona , Robinson Lousie , Myint Phyo , Maidment Ian 
Published: December 2019

Abstract
Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality. The characteristics of the population who use anticholinergic medication are not known. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects. Key words: cognitive impairment, anticholinergic burden, polypharmacy
Diagnostic accuracy of Xpert Xpress Flu/RSV for detection of Influenza and Respiratory syncytial virus: systematic review and meta-analysis
Authors: Guo Xu-Guang , Liu Ye-Ling , Xie Tian-Ao , Lin Geng-Ling , Lin Qin-Rong , Fan Shu-Jin , Li Zhen-Xing , Ouyang Shi , Zhu Guo-Dong , Ji Tian-Xing , Pan Zhi-Yong , Xia Yong , Wu Li-Juan 
Published: December 2019

Abstract
Background: Xpert Xpress Flu/RSV assay is a fast and automated real-time nucleic acid amplification method, recently approved by the USA, Europe and China for detection and differentiation of influenza (Flu) A, Flu B and RSV virus from nasopharyngeal swabs. Nevertheless, there are still no systematic reviews and meta-analysis on the accuracy of identification of influenza virus by The Xpert Xpress Flu/RSV assay. The aim of this meta-analysis was to verify the accuracy of Xpert Xpress Flu/RSV for detecting Flu and RSV.Materials and Methods: The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched using the following keywords: Xpert Xpress Flu/RSV, Flu and RSV up to April 2019. Four researchers screened and extracted documents according to inclusion and exclusion criteria. The quality of original research was assessed using the QUADAS-2 guidelines. Meta-DiSc 1.4 software was used to analyze the sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic ratio (DOR), and Summary receiver operating characteristic curves (SROC). Deek’s funnel plot asymmetry test was used to evaluate the publication bias by Stata 12.0.Results: Nine studies with 22 fourfold tables were included in this meta-analysis. The sensitivity of Xpert Xpress Flu/RSV for detection of Flu A, Flu B, and RSV was 0.96, 0.98, 0.98; the specificity was 0.97, 0.99, 0.99; +LR was 80.65, 163.74, 237.35; -LR was 0.02 , 0.03, 0.05；DOR was 4806.90, 6266.78, 5254.41, respectively. AUC was all over 0.9. In addition, no publication bias for FluA, Flu B, and RSV was found. Conclusions: Compared to the traditional PCR approach, Xpert Xpress Flu/RSV resulted as a valuable method for Flu and RSV diagnosis in the clinic, offering high sensitivity and specificity. Nonetheless, further research is necessary to determine whether Xpert Xpress Flu/RSV can be used as a clinical diagnostic standard for the identification of Flu and RSV. Keywords: Xpert Xpress Flu/RSV; influenza virus; respiratory syncytial virus; PCR
Assessing the determinants of Ebola Virus Disease Transmission in Baka Community of the Tropical Rainforest of Cameroon
Authors: Wirsiy Frankline Sevidzem , Bock Alphonse Um , Akoachere Jane-Francis Kihla Tatah 
Published: December 2019

Abstract
Background: Ebola virus disease (EVD) is a severe, often fatal illness in humans and nonhuman primates caused by the Ebola virus. Treatment and vaccine are under development, hence prevention is paramount. Design of effective prevention interventions requires an understanding of the factors that expose communities at risk. It was based on this that we investigated the Baka community (Pygmies) of Abong-Mbang Health District in tropical rain forest of Cameroon.Methods: A cross-sectional study was conducted with participants randomly selected from13 villages in Abong-Mbang by multi-stage cluster sampling. A questionnaire was administered to them to collected demographic information, data on knowledge of EVD, their feeding and health-seeking behaviour. Data was analyzed using the chi-square test. Knowledge of EVD was assessed using an 8 item Morisky Scale. An adapted Threat Capability Basic Risk Assessment Guide was used to determine their risk of exposure to infection.Results: A total of 510 participants, most of who were hunters (31.4%), farmers (29.8%), and had primary education (62.7%), were included in this study. Although 83.3% participants had heard of EVD, most did not know its cause. Their source of information was mainly informal discussions in the community (49%). Misconceptions were identified with regards to knowledge on the cause and mode of transmission. Only 43.1% accepted EVD could be transmitted from human-to-human. Generally, participants’ knowledge on EVD was poor. Demographic factors such as level of education, occupation and ethnic group significantly affected knowledge on EVD. The majority of participants were at a very high risk of exposure to infection as they consumed various forms of bush meat and were involved in other risky practices as scarification and touching of corpses. Although over half of participants seek medical care, most of them preferred traditional medicine. Socio-cultural and service related factors were deterrent factors to medical care. Conclusion: Participants generally had poor knowledge of EVD and were at high risk of to infection. We recommend rigorous sensitization campaigns in study area to educate the population on EVD and clarify the misconceptions identified. EVD surveillance is recommended particularly as outbreaks continue to be reported in the Congo Basin
Value of mNGS in guiding clinical prognosis of ARDS caused by severe pneumonia
Authors: Zhang Peng , Chen Yan , Li Shuyun , Li Chaoliang , Zhang Shuang , Zheng Weihao , Chen Yantang , Ma Jie , Zhang Xin , Huang Yanming , Liu Shengming 
Published: December 2019

Abstract
Background ARDS caused by severe pneumonia develops rapidly, causes complex pathogens, and has high morbidity and mortality. Convenient and efficient methods are needed in clinical practice for the detection of pathogen of ARDS caused by severe pneumonia.Methods This study retrospectively assessed the data of 105 patients with ARDS caused by severe pneumonia. Patients were divided into NGS group and no-NGS group. Clinical characteristics, laboratory examination, ICU cost and prognosis in the two groups were compared. Meanwhile, compared patients in NGS group, mNGS and routine detection methods had different detection efficiency for bacteria, fungi, viruses, unusual pathogens and co-infections.Results The mortality rate of NGS group was significantly lower than that of no-NGS group (21.43% VS 49.06%, P<0.05). In NGS group, the pathogen detected by Metagenomics NGS (mNGS) method was consistent with sputum culture by 31.1%. More than half (62.5%) of the inconsistencies were caused by negative sputum culture. The efficiency of mNGS method for unusual pathogens, only bacteria or co-infection is better than that of serological antibody test plus PCR. The positive rate of mNGS detection of unusual pathogens was significantly higher than that of sputum culture (22.22% vs 0, P <0.01). The overall positive rate of mNGS detection of ARDS caused by severe pneumonia (91.11%) was greater than that of serological antibody test plus PCR (31.11%) and sputum culture (62.22%). The clinical data of immunosuppressive patients in the two groups were compared, and it was found that the ICU time (P< 0.01), ventilator time (P < 0.05) and ICU cost (P < 0.01) in NGS group were significantly lower than those in no-NGS group.Conclusion mNGS technology has special significance for the treatment and prognosis of ARDS caused by severe pneumonia. MNGS technology is superior to routine pathogen detection methods for the detection of unusual pathogens and co-infection. For patients with severe disease, immunosuppression, or cases that cannot be diagnosed by routine methods, mNGS technology can be used to provide more diagnostic evidence for clinical diagnosis and to guide clinical medication.
The impact of Clonorchis sinensis infection on immune response in mice with type II collagen-induced arthritis
Authors: li xiangyang , Yang Ying , Qin Su-Ping , Kong Fan-Yun , Yan Chao , Cheng Wan-Peng , Pan Wei , Yu Qian , Hua Hui , Zheng Kui-Yang , Tang Ren-Xian 
Published: December 2019

Abstract
Background Clonorchis sinensis infection could trigger strong immune responses in mice and human. However, whether the C.sinensis infection has an impact on arthritis is unknown. Here we investigated the effect of C.sinensis infection on type II collagen-induced arthritis in BALB/c mice.Results The mice were firstly infected with 45 C.sinensis metacercariae by oral gavage. Four weeks later, the arthritis in mice was induced by type II collagen. Joint inflammation with severe redness and swelling in hind paws were observed in type II collagen-induced arthritis (CIA) mice. In addition, the physical activity was significantly reduced, but the respiratory exchange ratio was increased in CIA mice. Compared with CIA mice, C.sinensis infection could increase the severity of arthritis in CIA mice, based on the results of disease score and pathological changes. Compared to CIA mice, increased neutrophils and Ly6C hi monocytes, decreased B cells and CD4+T cells were found in C.sinensis infected CIA mice. Besides these, C.sinensis infected mice also displayed significant higher levels of serum IL-4 and IL-17 than those in CIA mice. Taken together, our data suggest that C.sinensis infection have a bad effect on arthritis, and could induce the abnormality of immune response in mice with CIA.
Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study
Authors: Snowden Austyn , Young Jenny , Savinc Jan 
Published: December 2019

Abstract
Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.
Complete genome sequencing and comparative genomic analyses of Bacillus sp. S3, a novel hyper Sb(III)-oxidizing bacterium
Authors: Li Jiaokun , Gu Tianyuan , Zeng Weimin , Yu Runlan , Liu Yuandong , Wu Xueling , Shen Li , Qiu Guanzhou , Li Liang Zhi 
Published: December 2019

Abstract
Background: Antimonite [Sb(III)]-oxidizing bacterium have great potential in the environmental bioremediation of Sb-polluted sites. Bacillus sp. S3 isolated from antimony-contaminated soil showed high Sb(III) resistance and Sb(III) oxidation efficiency. However, very little genomic information and evolutionary relationships that bacterial oxidation of Sb(III) is available. Results: Here, we identified a 5579638 bp chromosome with 40.30% GC content and a 241339 bp plasmid with 36.74% GC content in the complete genome of Bacillus sp. S3. Genomic annotation showed that Bacillus sp. S3 contains key aioB gene potentially encoding As(III)/Sb(III) oxidase, is not shared with other Bacillus strains. Further, a series of genes associated with Sb(III) and other heavy metal(loid) were also ascertained, reflecting adaptive advantage for growth in the harsh eco-environment. It is noteworthy that Bacillus sp. S3 is a novel species within the Bacillus genus as indicated by phylogenetic relationship and the average nucleotide identities (ANI) analysis. The presence of genomic plasticity demonstrated a high number of mobile genetic elements (MGEs) that were mainly distributed on chromosomes within the Bacillus genus. The core genome contained 554 core genes and many unique genes were dissected in analyzed genomes, indicating a conserved core but adaptive pan repertoire. Whole genomic alignment indicates that frequently genomic reshuffling and rearrangements, genetic gain and loss, and other recombination events occurred during the evolutionary history of Bacillus genus. In addition, the origin and evolution analysis of Sb(III)-resistance genes revealed that evolutionary relationships and events of horizontal gene transfer (HGT) among the Bacillus genus. The assessment of functionality of heavy metal(loid) resistance genes emphasized its indispensable roles in the harsh eco-environment of Bacillus genus. The real-time Quantitative PCR(RT-qPCR) results of Sb(III)-related genes indicated that the Sb(III) resistance was constantly increased under the Sb(III) stress. Conclusions: The insights provided in this study shed light on the molecular details of Bacillus sp. S3 coping with Sb(III), which extended our understanding on the evolutionary relationship between Bacillus sp. S3 and other closely related species and will enrich the Sb(III) resistance genetic data sources.
Identification and characteristics of a novel cecropin from the armyworm, Mythimna separata
Authors: Lian Kaiqi , Zhang Mingliang , Liang Xiuli , Zhou Lingling , Shi Zhiqi , Tang Yajie , Wang Xueping , Song Yuwei , Zhang Yuanchen 
Published: December 2019

Abstract
Background: The recent emergence of antibiotic-resistant strains of bacteria has increased the need to develop effective alternatives to antibiotics. Antimicrobial peptides have been considered as a promising product with several advantages.Results: In this present study, we identified a novel cecropin from the armyworm, Mythimna separata (armyworm cecropin 1, AC-1) by transcriptome sequencing and multi-sequence alignment analysis. The AC-1 precursor comprised 63 amino acid residues, containing a conserved cleavage site of the signal peptide, Ala23-Pro24, while the mature AC-1 included 39 amino acid residues. Chemically-synthesized AC-1 exhibited low hemolytic activity against chicken red blood cells and low cytotoxicity against swine testis cells, but effective antimicrobial activity against Salmonella, Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa. Its antimicrobial activity against Salmonella remained after incubation for 1 h at 100 °C or in 250 mM NaCl solution, implying good thermal- and salt-resistant stabilities.Conclusions: This study identified a novel antimicrobial peptide that may represent a potential alternative to antibiotics.