bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Effect of Dexmedetomidine Intravenous Infusion on Labor Pain Management in Primipar Term Pregnant Women
Authors: Delavari Abasali , Esmailzadeh Arezoo , Dehgan Mahdi , Lak Marzieh 
Published: November 2020

Abstract
Background: The pain of labor is very severe. Most women prefer painless labor to routine labor if they are aware of the methods of analgesia. The aim of this study was to evaluate the effect of Dexmedetomidine intravenous infusion on labor pain management in primipar term pregnant women. Methods: In this Non-randomized clinical trial with control group, all primipar term pregnant women were enrolled in the study. In the intervention group, after the active phase of labor, Dexmedetomidine was given according to the protocol and continued until phase two of labor. The control group received no intervention to reduce pain. Patients in both groups were evaluated for, fetal heart rate, Apgar scores, vital signs, pain intensity and sedation score. Results: There were no significant difference in primary fetal heart rate, primary maternal hemodynamics, and mean Apgar scores of 1 and 5 minutes, between the two groups (p>0.05). There was no significant difference in the mean of fetal heart rate in different stages between two groups. Intra-group analysis in the intervention group showed that mean systolic and diastolic blood pressure were significantly decreased after drug administration but were in normal range. The active phase of labor in the intervention group was significantly shorter than the control group (p = 0.002). The mean VAS score after Dexmedetomidine administration decreased significantly from 9.25 at baseline to 4.61 after drug administration, 3.88 during labor and 1.88 after placental expulsion. The mean RSS score after Dexmedetomidine administration increased significantly from 1 at baseline to 2.05 after drug administration, 2.22 during labor and 2.05 after placental expulsion. Conclusion: Based on results, it seems that administration of Dexmedetomidine to manage labor pain with careful monitoring of mother and fetus is recommended. Due to limited studies, further larger and multicenter studies are needed to be performed.Trial registration: This study was registered on Iranian registry of clinical trials, identification number IRCT20161022030421N5, registered on February 2, 2019, https://irct.ir/trial/40134.
Use and Quality of Cesarean Delivery in a Low and Middle Income Setting: National Results from Two Emergency Obstetric and Newborn Care Assessments
Authors: Beyene Misrak Getnet , Zemedu Theodros Getachew , Gebregiorgis Azmach Hadush , Ruano Ana Lorena , Bailey Patricia E 
Published: November 2020

Abstract
Background: Cesarean delivery (CD) rates have reached epidemic levels in many high and middle income countries while increasingly, low income countries are challenged both by high urban CD rates and high unmet need in rural areas. The managing authority of health care institutions often plays a role in these disparities. This paper shows changes between 2008 and 2016 in CD rates and the capacity of the Ethiopian health system to deliver quality CD services, highlighting the role of the management sector.Methods: We compare results from two national cross-sectional emergency obstetric and newborn care assessments using descriptive statistics. The sample includes 111 hospitals in 2008 and 316 hospitals in 2016, and 275 CD case reviews in 2008 and 568 in 2016. Our primary outcome measures include population- and institutional-based CD rates; hospital readiness to perform CD; quality of clinical management; and the relative size of Robson classification groupsResults: The national population-based rate increased (< 1% to 2.7%) as did all regional rates. Rates ranged from 24% in urban settings to less than 1% in several rural regions. The institutional rate was 54% in the private for-profit sector in 2016, up from 46% in 2008. Hospital readiness to perform CDs increased in public and for-profit hospitals. Only half of the women whose cases were reviewed received uterotonics after delivery of the baby, but use of prophylactic antibiotics was high. Partograph use increased from 9% to 42% in public hospitals, but was negligible or declined elsewhere. In 2016, a third of case reviews from the public sector were among low-risk nulliparous women (Robson group 1).Conclusions: Between 2008 and 2016, government increased the availability of CD services, improved public hospital readiness and some aspects of clinical quality. Strategies tailored to further reduce the high unmet need for CD and what appears to be an increasing number of unnecessary cesareans are discussed. Adherence to best practices and universal coverage of water and electricity will improve the quality of hospital services while the use of the Robson classification system may serve as a useful quality improvement tool.
A Remote Management System for Control and Surveillance of Echinococcosis: Design and Implementation Based on Internet of Things
Authors: Yang Shi-Jie , Xiao Ning , Li Jing-Zhong , Feng Yu , Ma Jun-Ying , Quzhen Gong-Sang , Yu Qing , Zhang Ting , Yi Shi-Cheng , Zhou Xiao-Nong 
Published: November 2020

Abstract
Background: As a neglected cross-species parasitic disease transmitted between canines and livestock, echinococcosis remains a global public health concern with a heavy disease burden. In China, especially in the epidemic pastoral communities on the Qinghai-Tibet Plateau, the harsh climate, low socio-economic status, poor overall hygiene, and remote and insufficient access to all owned dogs exacerbate the difficulty in implementing the ambitious control programme for echinococcosis. New methods and tools are urgently needed to increase the deworming coverage and frequency, promote real-time scientific surveillance, and prevent transmission of echinococcosis. Methods: We propose the remote management system (RMS) based on IoT as a novel tool to control smart deworming devices to deliver efficient PZQ baits to dogs regularly and automatically and also as a smart digital management platform to monitor, analyse, and display the epidemic trends of echinococcosis dynamically, in real time. The RMS is an excellent alternative to existing manual deworming methods and management for surveillance of echinococcosis.Results: The smart collars are fully capable of anti-collision, waterproof, and cold-proof performance, and the battery’s energy is sufficient. The RMS can accurately analyse the monitoring data and parameters including positive rates of canine faeces, and the prevalence of echinococcosis in the general population livestock, and children. The data of dogs deworming and surveillance for echinococcosis is able to be controlled using RMS and has expanded gradually in townships to the whole Hezuo region. A total of 48 administrators (3, 3, 8, 11, 23 at the provincial, municipal, county, township, village levels, respectively) participated in the questionnaire survey, with 93.8% of its overall satisfaction rate.Conclusion: The existing difficulties and challenges in the way of prevention and control for echinococcosis can partially be resolved using the innovative, IoT-based technologies and tools. The proposed RMS to advance the upgrade of existing manual prevention and control models for echinococcosis, especially in the current ongoing COVID-19 pandemic, as social distance and community blockade continue.
Seroprevalence and Molecular Diagnosis of Brucellosis Among Patients at Selected Hospitals of Abbottabad, Pakistan
Authors: Hassan Laiba , Ali Shahzad , Syed Muhammad Ali , Shah Asim Ali , Abbasi Shahid Ahmad , Tabassum Sadia , Saeed Usama , Melzer Falk , Khan Aman Ullah , El-Adawy Hosny , Neubauer Heinrich 
Published: November 2020

Abstract
Background: Brucellosis is a neglected disease of ruminants with zoonotic potential. It causes severe health problems in humans and economic loss. Only a limited number of studies have been conducted in Pakistan to determine the prevalence of human brucellosis and related risk factors. The objectives of the current cross-sectional study were to determine prevalence of Brucella infection in sera collected from patients at three hospitals of Abbottabad. Risk factors were investigated. Methods: A total of 500 blood samples were collected. A questionnaire was filled in for each patient to obtain information on age, gender, living area, brucellosis associated symptoms, associated risk factors, pregnancy and abortion history. Serum agglutination test (SAT) was performed to detect antibodies against brucellae. A genus specific BCSP-31 gene RT-PCR was used to detect Brucella DNA in the sample. Statistical analysis was done to determine odd ratios, risk ratios, 95% confidence intervals and p values. Results: A total of 13.6% (n=68) patients were found to be SAT positive. DNA was found in 11.4% (n=57) samples. The prevalence of brucellosis was reported to be higher in women (14.6%, n=44) than in man (12.1%, n=24). The age group of 25-50 years was found to be at higher risk for brucellosis (14.5%, n=50). “Animal contact” was reported as the main risk factor followed by “consumption of raw animal products”. About 9.9% pregnant women (n=13) were found brucellosis positive. Of these 23.8% (n=5) had an abortion history. Conclusions: The present study reports a striking prevalence of brucellosis among patients including pregnant women at three hospitals of Abbottabad. These findings must foster strategies for controlling human brucellosis at household level, raising of awareness about brucellosis in hospital and family doctors and finally in setting up an eradication program in the dairy industry.
Factors Associated With Delayed Diagnosis of Cervical Cancer in Tikur Anbesa Specialized Hospital, Ethiopia, 2019: Cross-Sectional Study
Authors: Zeleke Shegaw , Anley Mesfin , Kefale Demewoz 
Published: November 2020

Abstract
BackgroundCervical cancer is a preventable and curable disease if detected early enough. But, several numbers of women in Ethiopia strive for treatment when the disease has extended to last stage. Cervical cancer is the second most common cancer morbidity and the leading cause of women mortality related to cancer in Ethiopia. Delayed in diagnosis is the main reason for cervical cancer mortality in Ethiopia. The main objective of this study was to assess factors associated with delayed diagnoses of cervical cancer in Tikur Anbesa Specialized Hospital, Ethiopia. MethodsInstitution based cross-sectional study was conducted. Randomly selected 422 cervical cancer patients were interviewed and their medical records were reviewed. Data was entered using Epi data version 3.1 and analyzed using SPSS version 22. Bivariate and multivariate analysis was conducted to examine the association between independent and the outcome variables. ResultA total of 422 women were enrolled in our study yielding a response rate of 97.1%. The mean age of the women was 50 years (SD ±11.5). Half of the participants (50%) were can’t read and write, and 66.3% of participants income were <500 Ethiopian Birr (approximately 14 USD). Most (86.3%) of the women had delayed diagnosis of cervical cancer. Women who have <500 Ethiopian Birr (14 USD) income (adjusted OR=3.79, CI: 1.48, 9.67), haven’t awareness of cervical cancer disease (adjusted OR=1.33, CI: 1.05, 2.71) and haven’t awareness about cervical cancer screening (adjusted OR=1.64, CI: 1.16, 4.07) were more likely for delayed diagnosis of cervical cancer. ConclusionOur study reports a high prevalence of delayed diagnosis of women with cervical cancer. High level of illiteracy, low socioeconomic status, lack of awareness, traditional healers and absence of routine screening program, were accountable for delayed diagnosis of cervical cancer. Raising awareness, increasing access and improving health services for cancer should be promoted and advocated to decrease the usual delay of cervical cancer diagnosis.
Internet use and well-being during the COVID-19 outbreak: Examining the role of gender, age, motives for using the internet and relational resources in an Italian adult sample.
Authors: Venuleo Claudia , Marino Claudia , Ferrante Lucrezia , Rollo Simone , Schimmenti Adriano 
Published: November 2020

Abstract
The COVID-19 outbreak introduced self-isolation and social distancing as measures to reduce the spreading of the pandemic. As a consequence, internet usage has increased globally. The current study aims to show whether internet worked as a resource for well-being or as an amplifier of psychological distress and problematic internet use (PIU), considering the role of gender, age, motives for using the internet and online/offline relational resources. Five hundred and seventy-three adult participants (M: 40.28; SD: 16.43; 64% women) completed a form on sociodemographic characteristics and Internet use, and completed standardized measures on loneliness, online social support, well-being and PIU. A principal component analysis was computed to identify the main motives Internet use; ANOVA and Pearson’s r correlations were computed to examine (dis)similarities in motivational components with respect to gender, agegroup and psychosocial measures. A multivariate multiple regression analysis was performed to assess the contribution of the hypothesized predictors on overall well-being and PIU.Three principal motives for Internet use were detected: leisure and social interaction, knowledge, learning/working. Significant differences were found among them with respect to gender and age group and online/offline relational resources. Differences were found in the likelihood of PIU and well-being related to all the variables considered, with the exception of online social support for PIU and gender and age for well-being. These findings call for further research aimed to disentangle the correlates of PIU in a time of physical distancing, as well as for innovative efforts tailored to blunt the impacts of social isolation and bolster social connectivity.
ITRAQ-based quantitative proteomic analysis of Fusarium moniliforme (Fusarium verticillioides) in response to Phloridzin inducers
Authors: Zhang Rong , Jiang Weitao , Liu Xin , Duan Yanan , Xiang Li , Wang Yanfang , Jiang Yuanmao , Shen Xiang , Chen Xuesen , Yin Chengmiao , Mao zhiquan 
Published: November 2020

Abstract
Background: Apple replant disease (ARD) has been reported from all major fruit-growing regions of the world, and is often caused by biotic factors (pathogen fungi) and abiotic factors (phenolic compounds). In order to clarify the proteomic differences of Fusarium moniliforme under the action of phloridzin, and to explore the potential mechanism of F. moniliforme as the pathogen of ARD, the role of Fusarium spp in ARD was further clarified.Methods: In this paper, the quantitative proteomics method iTRAQ analysis technology was used to analyze the proteomic differences of F. moniliforme before and after phloridzin treatment. The differentially expressed protein was validated by qRT-PCR analysis.Results: A total of 4535 proteins were detected, and 293 proteins were found with more than 1.2 times (P<0.05) differences. In-depth data analysis revealed that 59 proteins were found with more than 1.5 times (P<0.05) differences, and most proteins were consistent with the result of qRT-PCR. Differentially expressed proteins were influenced a variety of cellular processes, particularly metabolic processes. Among these metabolic pathways, a total of 8 significantly enriched KEGG pathways were identified with at least 2 affiliated proteins with different abundance in conidia and mycelium. Functional pathway analysis indicated that up-regulated proteins were mainly distributed in amino sugar, nucleotide sugar metabolism, glycolysis/ gluconeogenesis and phagosome pathways.Conclusions: This study is the first to perform quantitative proteomic investigation by iTRAQ labeling and LC-MS/MS to identify differentially expressed proteins in F. moniliforme under phloridzin conditions. The results confirmed that F. moniliforme presented a unique protein profile that indicated the adaptive mechanisms of this species to phloridzin environments. The results deepened our understanding of the proteome in F. moniliforme in response to phloridzin inducers and provide a basis for further exploration for improving the efficiency of the fungi as biocontrol agents to control ARD.
Racial and ethnic patterns and&nbsp;differences&nbsp;in&nbsp;health care expenditures among&nbsp;Medicare beneficiaries&nbsp;with and without cognitive&nbsp;deficits&nbsp;or&nbsp;Alzheimer's disease and related dementias
Authors: Park Sungchul , Chen Jie 
Published: November 2020

Abstract
Background: Numerous studies have documented racial and ethnic differences in the prevalence and incidence of Alzheimer's disease and related dementias (ADRD). Less is known, however, about racial and ethnic differences in health care expenditures among older adults at risk for ADRD (cognitive deficits without ADRD) or with ADRD. In particular, there is limited evidence that racial and ethnic differences in health care expenditures change over the trajectory of ADRD or differ by types of service.Methods: We examined racial and ethnic patterns and differences in health care expenditures (total health care expenditures, out-of-pocket expenditures, and six service-specific expenditures) among Medicare beneficiaries without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Using the 1996-2017 Medical Expenditure Panel Survey, we performed multivariable regression models to estimate expenditure differences among racial and ethnic groups without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Models accounted for survey weights and adjusted for various demographic, socioeconomic, and health characteristics.Results: Black, Asians, and Latinos without cognitive deficits had lower total health care expenditures than whites without cognitive deficits ($10,236, $9,497, $9,597, and $11,541, respectively). There were no racial and ethnic differences in total health care expenditures among those with cognitive deficits without ADRD and those with ADRD. Across all three groups, however, Blacks, Asians, and Latinos consistently had lower out-of-pocket expenditures than whites (except for Asians with cognitive deficits without ADRD). Furthermore, service-specific health care expenditures varied by racial and ethnic groups.Conclusions: Our study did not find significant racial and ethnic differences in total health care expenditures among Medicare beneficiaries with cognitive deficits and/or ADRD. However, we documented significant differences in out-of-pocket expenditures and service-specific expenditures. We speculated that the differences may be attributable to racial and ethnic differences in access to care and/or preferences based on family structure and cultural/economic factors. Particularly, heterogeneous patterns of service-specific expenditures by racial and ethnic groups underscore the importance of future research in identifying determinants leading to variations in service-specific expenditures among racial and ethnic groups.
Near-Falls in Singapore Community-Dwelling Older Adults: A Feasibility Study
Authors: SOH SHAWN LENG-HSIEN , TAN CHEE-WEE , LANE JUDITH , YEH TING-TING , SOON BENJAMIN 
Published: November 2020

Abstract
BackgroundA near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods.MethodsThis study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls.ResultsThirty older adults were recruited in five weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. Use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. ConclusionsThe study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registrationClinicalTrials identifier: NCT04087551. Registered 12th September 2019