bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence Factors of Medical Disputes in Shanghai and Implications - From the Perspective of Doctor, Patient and Disease (Observational Study)
Authors: Liu Yu , Yu Fei , Zhao Feng , Yang Xingchen , Ji Guangyao , Pan Xiao , Leng Feng , Dan Dongdong , Wang Pei , Bai Yonghai 
Published: January 2021

Abstract
Objective Based on the cases collected in eight hospitals in Shanghai in recent three years, causes of medical disputes in Shanghai and influence factors of medical dispute levels were discussed, and targeted suggestions were put forward. Methods Multistage sampling were used to collect 561 cases of medical disputes occurred in two Class A Tertiary hospitals, two Class A Secondary hospitals and four community hospitals in Shanghai in recent three years. On the basis of questionnaire, the causes of medical disputes were analyzed by descriptive statistics and the factors affecting the level of medical dispute were analyzed by means of one-way ANOVA and Logistic regression analysis.Results Factors of doctor and patient are involved in the causes of medical disputes, with 87.1% disputes related to doctors and 13.9% related to patients. The doctor’s factors include lack of communication (28.82%), low technical level (16.91%), lack of sense of responsibility (8.86%), defective case records (6.92%), imperfect operation (6.44%), inadequate experience (6.44%), inadequate condition evaluation (5.8%), irregular management process (4.03%), violation of diagnosis and treatment regulation (4.03%), misdiagnosis and mistreatment (3.54%), belated diagnosis and treatment (2.58%), postoperative complications (2.42%), equipment problems (1.13%), missed diagnosis (0.81%), poor condition monitoring (0.48%), unreasonable charge (0.48%) and poor service attitude (0.32%). The patient's factors include misunderstanding of medical behavior (43.48%), high expectation of prognosis (25%), bad attitude (13.04%), inadequate medical knowledge (7.61%), disturbance (6.52%), poor compliance (3.62%) and mistrust (1.09%). Among all medical disputes, there are 406 cases of level-4 medical disputes (78%), 95 cases of level-3 medical disputes (18%), 19 cases of level-2 medical disputes (4%), and no level-1 medical dispute. Meanwhile, the classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and low technical level are the reasons for the level differences in medical disputes.Conclusion Factors of doctor in medical disputes in Shanghai mainly include inadequate communication and low technical level while the patient’s factors mainly contain misunderstanding of medical behavior and high expectation of the prognosis. Level-3 and 4 medical disputes take up the major part in all medical disputes. The classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and doctor’s deficient technical level are high-risk factors requiring critical attention in medical disputes.
Oblique Incidence Ultrasonic Reflectometry Device Based on c-axis Tilted ScAlN Films for Evaluating Viscoelastic Properties of Liquids Above 100 MHz
Authors: Kinoshita Sarina , Yanagitani Takahiko 
Published: January 2021

Abstract
Ultrasound-based evaluation of fluid properties allows for real-time measurement of small amounts of liquid samples. The ultrasonic reflection method is used to obtain the complex reflection coefficient, which can be used to evaluate the viscoelastic properties of liquids. However, this method has not been used with shear waves at frequencies above 100 MHz because shear-mode piezoelectric films are difficult to obtain at such frequencies. We propose using the oblique incidence reflectometry with quasi-shear waves excited by c-axis tilted scandium aluminum nitride (ScAlN) thin films to realize high-sensitivity evaluation of the viscoelastic properties of liquids in the above 100 MHz. In experiments, the shear elasticity and shear viscosity of glycerin solutions were estimated from their complex reflection coefficients.
Neonatal COVID-19 in French Guiana, a Case-Control study.
Authors: Elenga Narcisse , Marie-Josephine Wandji , Siban Julie , Nacher Mathieu , Demar Magalie 
Published: January 2021

Abstract
BackgroundThis study aims to assess the risk of transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV-2) to newborns in the context of breastfeeding practice as part of routine care.MethodsIn this prospective study, we identified neonates born between May 14th and August 31st, 2020, to mothers who tested positive for SARS-CoV-2 at the time of delivery. From the cohort of 974 deliveries, we performed a nested case-control study. ResultsDuring the study period, 133 (13.7%) were positive by RT‐PCR for SARS‐CoV‐2. Among the 35 pregnant women with symptomatic COVID-19 (26.3%), cough was the most common symptom, occurring in half of the cases. Among them, 3 developed fever as other symptoms during hospitalization and 4 have progressed to critical pneumonia requiring transfer to intensive care unit. Among the neonates born from mothers with positive RT‐PCR for SARS‐CoV‐2, 32 were tested for SARS-COV-2 at 48 hours-7 days. Of them, 3 asymptomatic neonates tested positive. There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups Most infants were breastfed at birth, regardless of their mothers' COVID-19 status. In COVID-19-positive pregnant women admitted to intensive care unit, the proportion of preterm births ( OR=12.5 [1.7-90.5]), fetal death in utero (OR=25.9 [2.2-305]) and admission in neonatal intensive care unit admission (OR=13.4 [3.0-60]), appeared higher than the controls. No maternal deaths were recorded.ConclusionsOur data suggest that under breastfeeding conditions with rigorous hygiene precautions and parental education, the risk of vertical transmission of the SARS-COV-2 virus is unlikely.
Improving malaria preventive practices and pregnancy outcomes through a health education intervention: a randomized controlled trial
Authors: BALAMI AHMED DAHIRU , Said Salmiah Muhammad , Zulkefli Nor Afiah Muhammad , Norsa’adah Bachok , AUDU BALA MUHAMMAD 
Published: January 2021

Abstract
BackgroundThe prevalence of malaria in pregnancy and its complications, remain very high in Nigeria. This study aimed to determine the effects of a malaria health educational intervention based on the information-motivation-behavioural skills (IMB) model on malaria preventive practices and pregnancy outcomes. MethodsThe study was a randomized controlled parallel-group study, where 372 randomly selected antenatal care attendees were randomly assigned to one of either two groups after collecting baseline data. The intervention group then received a four-hour health education intervention in Hausa language, which was developed based on the IMB model, while the control group received a similarly designed health education on breastfeeding. Follow up data were then collected from the participants at a first (two months post-intervention) and second (four months post-intervention) follow up, and at the end of their pregnancies. ResultsFor both groups, reported ITN use had increased from baseline (Intervention: Often – 14.0%, Almost always – 9.1; Control: Often – 12.4%; Almost always 16.1%) to the time of second follow up (Intervention: Often – 28.10%, Almost always – 24.5; Control: Often – 17.2%; Almost always 19.5%). Reported IPTp uptake at second follow up was also higher for the intervention group (Intervention: Two doses – 59.0%, Three doses 22.3%; Control group: Two doses – 48.4%, Three doses – 7.0%). The drop in the haematocrit levels was greater for the control group (32.42% to 30.63%) compared to the intervention group (33.09% to 31.93%). The Generalized Linear Mixed Models (GLMM) analysis revealed that the intervention had significantly improved reported ITN use, reported IPTp uptake, and haematocrit levels, but had no significant effect on the incidence of reported malaria diagnosis or babies’ birth weights. ConclusionsThe intervention was effective in improving ITN use, IPTp uptake, and haematocrit levels. It is, therefore, recommended for the modules to be adopted and incorporated into the routine antenatal care programmes in health centres with predominantly Hausa speaking clients.
Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis
Authors: Hart Libor , Polášková Alexandra , Schalek Petr 
Published: January 2021

Abstract
Background: Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Upper respiratory tract infection (RTI) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (0.2 - 2 %), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. Methods: We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis.Results: In a retrospective study of a total of 1,465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. Conclusion: Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.
Using augmented reality technology for balance training in the elderly. A feasibility pilot study
Authors: Blomqvist Sven , Seipel Stefen , Engström Maria 
Published: January 2021

Abstract
BackgroundImpaired balance leading to falls is common in the elderly, and there is strong evidence that balance training reduces falls and increases independence. Reduced resources in health care will result in fewer people getting help with rehabilitation training. In this regard, the new technology augmented reality (AR) could be helpful. With AR, the elderly can receive help with instructions and get feedback on their progression in balance training. The purpose of this pilot study was to examine the feasibility of using AR-based visual-interactive tools in balance training of the elderly.MethodsSeven elderly participants (66-88 years old) with impaired balance trained under supervision of a physiotherapist twice a week for six weeks using AR-based visual-interactive guidance, which was facilitated through a Microsoft HoloLens holographic display. Afterwards, participants and physiotherapists were interviewed about the new technology and their experience of the training. Also, fear of falling and balance ability were measured before and after training. ResultsFive participants experienced the new technology as positive in terms of increased motivation and feedback. Experiences were mixed regarding the physical and technical aspects of the HoloLens and the design of the HoloLens application. Participants also described issues that needed to be further improved, for example, the training program was difficult and monotonous. Further, the HoloLens hardware was felt to be heavy, the application's menu was difficult to control with different hand manoeuvres, and the calibration took a long time. Suggestions for improvements were described. Results of the balance tests and self-assessment instruments indicated no improvements in balance performance after AR training.ConclusionsThe study showed that training with the new technology is, to some extent, feasible for the elderly, but needs further development. Also, the technology seemed to stimulate increased motivation, which is a prerequisite for adherence to training. However, the new technology and training requires further development and testing in a larger context.
“I was tricked”: Understanding reasons for unintended pregnancy among sexually active adolescent girls
Authors: Ajayi Anthony Idowu , Odunga Sally Atieno , Oduor Clement , Ouedraogo Ramatou , Ushie Boniface Ayanbekongshie , Wado Yohannes Dibaba 
Published: January 2021

Abstract
Background: While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15-19 in two Kenya counties with the highest rate of teenage pregnancy. Methods: We used the “In Their Hands” (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls’ reasons for having unintended pregnancy. Results: Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR:1.64, 95% CI:1.22-2.20), had primary or no formal education (AOR:1.50 95% CI:1.11-2.02), and had never used contraceptive (AOR:1.69 95% CI-1.25-2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies.Conclusion: A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.
Is There a Health Inequality in Gambling Related Harms? A Systematic Review
Authors: Raybould Jodie , Larkin Michael , Tunney Richard 
Published: January 2021

Abstract
Background: Here we present a systematic review of the existing research into gambling harms, in order to determine whether there are differences in the presentation of these across demographic groups such as age, gender, culture, and socioeconomic status, or gambling behaviour categories such as risk severity and participation frequency. Primary and Secondary Outcome Measures: Inclusion criteria were: 1) focus on gambling harms; 2) focus on harms to the gambler rather than affected others; 3) discussion of specific listed harms and not just harms in general terms. Exclusion criteria were: 1) research of non-human subjects; 2) not written in English; 3) not an empirical study; 3) not available as a full article. Methods: We conducted a systematic search using the Web of Science and Scopus databases in August 2020. Assessment of quality took place using Standard Quality Assessment Criteria. Results: A total of 59 studies published between 1994 and 2020 met the inclusion criteria. These were categorised into thematic groups for comparison and discussion. There were replicated differences found in groups defined by age, socioeconomic status, education level, ethnicity and culture, risk severity, and gambling behaviours. Conclusion: Harms appear to be dependent on specific social, demographic and environmental conditions that suggests there is a health inequality in gambling related harms. Further investigation is required to develop standardised measurement tools and to understand confounding variables and co-morbidities. With a robust understanding of harms distribution in the population, Primary Care Workers will be better equipped to identify those who are at risk, or who are showing signs of Gambling Disorder, and to target prevention and intervention programmes appropriately.
Community and healthcare providers’ perceptions of quality of private sector outpatient malaria care in North-western Ethiopia: a qualitative study
Authors: Argaw Mesele Damte , Mavundla Thandisizwe Redford , Gidebo Kassa Daka 
Published: January 2021

Abstract
BackgroundsMalaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate adult malaria patients and healthcare providers’ perception of the quality of malaria management at private sector outpatient facilities.

MethodsAn exploratory, descriptive, contextual and qualitative research methodology was conducted with 101 participants ( 33 in-depth interviews (INIs) and ten focus group discussions (FGDs) with 68 participants). All interview and focus group discussions were audio recorded, transcribed verbatim and analysed, using eight steps of Tesch (1990).

Results
During data analysis a single theme, two categories and six sub-categories emerged, namely (1) perceived quality of malaria management at outpatient facilities; (a) essential resources; (a1) safe outpatient services; (a2) anti-malaria drugs and supplies; (a3) health workers; (b) factors influencing service utilisation; (b1) physical accessibility; (b2) “art of care’’; and (b3) efficient malaria diagnosis and treatment services. Both FGDs and INIs participants had a positive perception of the quality of malaria outpatient services at private health facilities. The positive perceptions include safe and clean facility; availability of supplies and comprehensive services; convenient working hours; short waiting hours and motivated, competent and compassionate health workers. However, some participants raised their safety concerns due to perceived poor infection control practices, small working areas, interruption of antimalaria supplies and inefficient malaria diagnosis and treatment services.
Conclusion Both community members and healthcare providers had more positive perceptions towards outpatient malaria services offered at private health facilities. However, positive behaviour must be maintained and concerns must be dealt with by enhancing functional public private partnership for malaria care services to improve private sector malaria case management; build the service providers’ capacity; ensure uninterrupted anti-malaria supplies and empower the community with early health seeking behaviour.
Comparative chloroplast genomes: insights into the evolution of the chloroplast genome of Camellia sinensis and the phylogeny of Camellia
Authors: li LI , Hu Yunfei , He Min , Zhang Bo , Wu Wei , Cai Pumo , Huo Da , Hong Yongcong 
Published: January 2021

Abstract
Background: Chloroplast genome resources can provide useful information for the evolution of plant species. Tea plant (Camellia sinensis) is among the most economically valuable member of Camellia. Here, we determined the chloroplast genome of the first natural triploid Chinary type tea (‘Wuyi narcissus’ cultivar of Camellia sinensis var. sinensis, CWN) and conducted the genome comparison with the diploid Chinary type tea (Camellia sinensis var. sinensis, CSS) and two types of diploid Assamica type teas (Camellia sinensis var. assamica: Chinese Assamica type tea, CSA and Indian Assamica type tea, CIA). Further, the evolutionary mechanism of the chloroplast genome of Camellia sinensis and the relationships of Camellia species based on chloroplast genome were discussed.Results: Comparative analysis showed the evolutionary dynamics of chloroplast genome of Camellia sinensis were the repeats and insertion-deletions (indels), and distribution of the repeats, indels and substitutions were significantly correlated. Chinese tea and Indian tea had significant differences in the structural characteristic and the codon usage of the chloroplast genome. Analysis of sequence characterized amplified region (SCAR) using sequences of the intergenic spacers (trnE/trnT) showed none of 292 different Camellia sinensis cultivars had similar sequence characteristic to triploid CWN, but the other four Camellia species did. Estimations of the divergence time showed that CIA diverged from the common ancestor of two Assamica type teas about 6.2 Mya (CI: 4.4-8.1 Mya). CSS and CSA diverged to each other about 0.8 Mya (CI: 0.4-1.5 Mya). Moreover, phylogenetic clustering was not exactly consistent with the current taxonomy of Camellia.Conclusions: The repeat-induced and indel-induced mutations were two important dynamics contributed to the diversification of the chloroplast genome in Camellia sinensis, which were not mutually exclusive. Chinese tea and Indian tea might have undergone different selection pressures. Chloroplast transfer occurred during the polyploid evolution in Camellia sinensis. In addition, our results supported the three different domestication origins of Chinary type tea, Chinese Assamica type tea and Indian Assamica type tea. And, the current classification of some Camellia species might need to be further discussed.
Reconstructing the household transmission of influenza in the suburbs of Tokyo based on clinical cases
Authors: Saito Masaya Masayoshi , Hirotsu Nobuo , Hamada Hiroka , Takei Mio , Honda Keisuke , Baba Takamichi , Hasegawa Takahiro , Kitanishi Yoshitake 
Published: January 2021

Abstract
BackgroundInfluenza is a public health issue that needs to be addressed strategically. The assessment of detailed infectious profiles is an important part of this effort. Household transmission data play a key role in estimating such profiles. We used diagnostic and questionnaire-based data on influenza patients at a Japanese clinic to estimate the detailed infectious period (as well as incubation period, symptomatic and infectious periods, and extended infectious period after recovery) and the secondary attack ratio (SAR) of influenza for households of various sizes based on a modified Cauchemez-type model.ResultsThe data were from enrolled patients with confirmed influenza who were treated at the Hirotsu Clinic (Kawasaki, Japan) with a neuraminidase inhibitor (NAI) during six northern hemisphere influenza seasons between 2010 and 2016. A total of 2,342 outpatients, representing 1,807 households, were included. For influenza type A, the average incubation period was 1.43 days (95% probability interval: 0.03-5.32 days). The estimated average symptomatic and infective period was 1.76 days (0.33-4.62 days); the extended infective period after recovery was 0.25 days. The estimated SAR rose from 20% to 32% as household size increased from 3 to 5. For influenza type B, the average incubation period, average symptomatic and infective period, and extended infective period were estimated as 1.66 days (0.21-4.61), 2.62 days (0.54-5.75) and 1.00 days, respectively. The SAR increased from 12% to 21% as household size increased from 3 to 5.ConclusionAll estimated periods of influenza type B were longer than the corresponding periods for type A. However, the SAR for type B was less than that for type A. These results may reflect Japanese demographics and treatment policy. Understanding the infectious profiles of influenza is necessary for assessing public health measures.