bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary extracellular vesicle analysis and detection of low abundance immunoglobulin oligomers in samples isolated from patients with significant urine proteinuria
Authors: Cooper Shawna A. , Dick Christopher , Misra Pinaki , Leung Nelson , Schinstock Carrie , Ramirez-Alvarado Marina 
Published: September 2019

Abstract
Urinary extracellular vesicles (uEVs) have been used as a biomarker tool for detection of low abundance immunoglobulin-based targets in uEVs with heterogeneous high protein mixtures. This protocol outlines a pre-incubation method to minimize non-specific secondary antibody binding. Additionally, we include our approach for standardization of uEV amounts used for sample comparison. We propose that these and knowledge of the detection limit for target proteins are strategies applicable to other laboratories working with complex heterogeneous samples.
Labor pain control and associated factors among women who gave birth at Leku primary hospital, southern Ethiopia
Authors: Siyoum Melese , Mekonnen Shewangizaw 
Published: September 2019

Abstract
Objective: To assess Labor pain control and associated factors among women who give birth at Leku primary Hospital, Southern Ethiopia, 2018/19. A systematic random sampling technique was used to select 404 mothers who gave birth at Leku Hospital during the data collection period. Data were collected by two first degree midwives immediately after delivery using Labor Agentry Scale (LAS). Results: In this study, 404 mothers were participated making the response rate of 100%. Among the participants, 104 (25.7%) of mothers reported Mild control of labor pain. Maternal age of 19 to 24year AOR=5.85(95%CI 2.14, 15.98), being farmer AOR=2.5(1.14, 5.57), primi-para AOR=0.13(0.06, 0.3), good family support AOR=2.8(1.49, 5.3), short duration of labor (<12hrs) AOR=3.2(1.65, 6.23) and history of pregnancy loss AOR=0.06(0.03, 0.14) were significantly associated with greater control of labor pain. In general, compared to other studies, the level of labor pain control is good in this study area. Enhancing factors of labor pain control have to be strengthened to increase greater control of labor pain. Qualitative research is highly recommended to identify cultural factors related to labor pain control and management. Keywords: labor analgesia, labor pain, labor pain control, southern Ethiopia, Leku
A Probabilistic Approach for Economic Evaluation of Occupational Health and Safety Interventions: A Case Study of Silica Exposure Reduction Interventions in the Construction Sector
Authors: Mofidi Amirabbas , Tompa Emile , Mortazavi SeyedBagher , Esfahanipour Akbar , Demers Paul A. 
Published: September 2019

Abstract
Background: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situation.
Methods: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables effects interventions net benefit.
Results: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention.
Conclusions: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.
Who were the tuberculosis patients who died precociously due to the disease in Southern Brazil? A retrospective cohort study
Authors: Santos Danielle Talita dos , Alves Luana Seles , Crispim Juliane Almeida , Alves Josilene Dália , Ramos Denisse Andrea Cartagena , Alonso Jonas Bodini , Assis Ivaneliza Simionato de , Ramos Antonio Vieira , Dessunti Elma Mathias , Pinto Ione Carvalho , Palha Pedro Fredemir , Arcêncio Ricardo Alexandre , Nunes Carla 
Published: September 2019

Abstract
BACKGROUND

A diagnosis of tuberculosis (TB) is no sign that the disease will be treated successfully, as death still occurs among those who are diagnosed by health services. The study aimed to identify the TB patients who died precociously due to the disease and associated factors in Southern Brazil.METHODS

We conducted a retrospective cohort study, where all deaths from TB were gathered, including cases of TB/HIV joint infection (ICD A15.0–A15.9 and ICD B20.0), which occurred between 2008 and 2015 in Southern Brazil. Techniques for survival analysis were applied, including the Kaplan-Meier test and Cox’s regression, from which the mean, median and IC 95 of survival (in days) were estimated; the hazard ratio (HR) obtained and the associated causative factors identified.RESULTS

A total of 205 were found: 131 of these resulted from TB alone, while 74 had origins in joint infection of TB/HIV and only 179 deaths were included in the survival analysis. The first group had a median survival of 19 days, and the second group had a median survival of 28 days; however, the difference was not statistically significant. The median survival for the whole sample was 22 days, with 59.1% of these individuals dying within 30 days and 72.5% passing away within 60 days after diagnosis (minimum = 1, maximum = 349, SD = 68.8 and mean = 50 days). The use of alcohol (HR 1.9, IC 95 1.2–3.1) was associated with precocious death in the studied patients.CONCLUSION

Most of the deaths occurred prematurely (within 2 months), which evidenced that the diagnoses have been made too late, when the disease was already in its advanced stages. The use of alcohol was associated with the precocious deaths. Although the diagnostic and treatment are free in Brazil and the patients have gotten the diagnosis, they died. Early, sensitive diagnosis, with social support and a comprehensive care might reduce the early mortality among with patients with addiction problems.
Time to improve the communication of evidence-based medicine to pregnant women: a review of an exemplary framework related to the prevention of gestational diabetes
Authors: Arabin Birgit , Behnam Susann , Ellermann Christin , Jenny Mirjam A 
Published: September 2019

Abstract
BACKGROUND
Medical specialists are frequently challenged to understand and explain the best evidence even when study results are contradictive. During pregnancy, communication of evidence should motivate women to realize life style changes in favor of themselves and their offspring.
MAIN BODY
On the topic of prevention of gestational diabetes alone, we found 17 systematic reviews/meta-analyses. Outcomes, reporting and methodological quality differed according to PRISMA, ROBIS and AMSTAR tools.
CONCLUSIONS
We propose a methodology to select and transform the best evidence into a format illustrating benefits and harms of interventions as fact boxes and icon arrays, which may be applied in other fields of obstetrics.
Comparative analysis of maternal and fetal outcomes of pregnancies complicated and not complicated with hyperemesis gravidarum necessitating hospitalization
Authors: Günay Taner , Hocaoğlu Meryem , Bör Ergül Demirçivi , Turgut Abdulkadir 
Published: September 2019

Abstract
Background Hyperemesis gravidarum is considered to be one of the most common causes of hospitalization during the first half of pregnancy, and is a potentially life-threatening condition. The purpose of this study to evaluate maternal and fetal outcomes of pregnancies complicated and not complicated with hyperemesis gravidarum necessitating hospitalization.Methods A total of 386 women with singleton deliveries between March 2015 and March 2019 were included in this retrospective single-center study. Of 386 women, 186 women who were hospitalized with hyperemesis gravidarum within the first 20 weeks of gestation comprised the hyperemetic pregnancy group, while 200 women without hyperemesis gravidarum during pregnancy served as a control group. Fisher’s exact test, Pearson Chi-Square test, Fisher Freeman Halton Test (Monte Carlo) and Mann-Whitney U test were used for data analysis.Results No significant difference was noted between the hyperemesis gravidarum and control groups in terms of maternal characteristics, gestational age (median 38.6 and 39.0 weeks, respectively), type of delivery (normal spontaneous delivery in 78.0% and 80.0%, respectively), fetal gender (female: 53.2% and 48.5%, respectively), birthweight (median 3250 g and 3275 g, respectively) and 5-min APGAR scores (≥7 in 97.3% and 97.5%, respectively). Adverse pregnancy outcomes were also similar between groups including preterm birth (8.1% and 11.0%, respectively), SGA (5.9% and 9.5%, respectively), hypertensive disorder (5.4% and 7.5%, respectively), placental abruption (1.1% and 0.5%, respectively), stillbirth (0.0% and 0.5%, respectively) and GDM (3.8% and 2.5%, respectively). Weight loss during pregnancy was evident in 94.0% of women in the hyperemesis gravidarum group, while none of women in the control group had weight loss during pregnancy (p<0.001).Conclusion The findings of this study revealed that pregnancies complicated with hyperemesis gravidarum were not associated with increased risk for adverse fetal and maternal outcomes compared with the healthy control pregnancies.
Client perceived quality of postnatal care following a normal delivery provided by public sector specialized care institutions in Sri Lanka: A cross sectional study
Authors: Wickramasinghe Sashimali , Gunathunga Wasantha , Hemachandra Nilmini 
Published: September 2019

Abstract
Background

Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes.

Methods

A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions.

Results

The median score obtained for the questionnaire was 108, (96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (38-45), 33 (30-35) and 32 (28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing KMC (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions.

Conclusions

Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.
Effectiveness of Alpha-Fetoprotein Variants L2 and L3 as Substitutes of Alpha-Fetoprotein in Screening for Fetal Trisomy 18
Authors: Huang Jianxia , Chen Yiming , Hu Wensheng 
Published: September 2019

Abstract
Purpose

To evaluate the effectiveness of alpha-fetoprotein variants (AFP-L2, AFP-L3) for fetal screening of Trisomy 18 in place of alpha fetoprotein (AFP).

Methods

A case-control study was conducted. The case group included 39 pregnant women diagnosed by karyotype analysis of amniotic fluid cells as bearing Trisomy 18 fetuses. The control group included 48 pregnant women with clinically normal and healthy fetal development. The serum AFP-L2 and AFP-L3 concentrations were detected. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value, area under the curve (AUC), and assess the screening performance of AFP-L2 and AFP-L3.

Results

The AFP-L2 and AFP-L3 concentrations in pregnant women with Trisomy 18 fetuses were 7.95±3.57 ng/mL , and 2.53±1.80 ng/mL, respectively, which was significantly higher than those of the control group (3.73±1.63 ng/mL [3.26~4.20], t=6.820, P<0.001, and 0.84±0.60 ng/mL [0.66~1.01], t=5. 588, P<0.001, respectively). The AUC for AFP-L2 and AFP-L3 in screened Trisomy 18 fetuses was 0.848 (95% CI: 0.767-0.930, P < 0.001) and 0.806 (95% CI: 0.707-0.905, P < 0.001), respectively. The optimal cutoff values of AFP-L2 and AFP-L3 for Trisomy 18 fetuses were determined to be 6.340 ng/mL and 1.705 ng/mL, respectively. The corresponding sensitivity, specificity, and Youden index values were 0.615, 1.000, 0.615; 0.6410, 0.958, and 0.599, respectively. Comparisons across multiple modeling methods showed that the highest AUC of screened Trisomy 18 fetuses (0.992 and 0.986) was yielded by AFP-L2 + AFP-L3 + free β-HCG, and AFP-L2 + free β-HCG, with 1.000 sensitivity indicated in both instances. The sensitivities of the four Trisomy 18 screening combinations were all 1.000. In the control group, false positive rates of 22.92%, 8.33%, 12.50%, and 12.50% were observed. The series test showed that the sensitivities of Trisomy 18 screening was 69.23%, 61.54%, 64.10%, and 43.59%, respectively, while a 3.28% false positive rate was found in the control group AFP + free β-HCG marker combination.

Conclusion
AFP-L2 and AFP-L3 showed high sensitivity and specificity in the screening of fetuses for Trisomy 18. The new indicators did not bring about a significant improvement in screening efficiency but false positive rate was reduced compared to AFP.
Women´s expectations and experiences of labour induction—a questionnaire-based analysis of a randomised controlled trial
Authors: Strandberg Moa , Wallström Tove , Wiberg-Itzel Eva 
Published: September 2019

Abstract
Background: Although the induction of labour is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman. This study analysed the expectations and experiences of women included in a randomised controlled trial comparing different routes of labour induction. The primary aim of this questionnaire-based study was to evaluate women’s general satisfaction with induced labours and identify factors associated with a negative experience. The secondary aim was to compare the orally administrated misoprostol (OMS) to a misoprostol vaginal insert (MVI), while focusing on general maternal satisfaction. Methods Primiparous women (n = 196) with a singleton foetus in cephalic presentation, ≥ 37 weeks of gestation, with a Bishop´s score ≤ 4 planning labour induction were randomly allocated to receive either OMS (Cytotec®) or MVI (Misodel®). Data were collected by validated questionnaires, the Wijma Delivery Expectation/Experience Questionnaire (A+B). The pre-labour part of the questionnaire (W-DEQ version A) was given to participants to complete within one hour before the start of induction, and the post-labour part of the questionnaire (W-DEQ version B) was administered after birth and collected before the women were discharged from hospital. Background characteristics and delivery outcomes were extracted from maternity files and correlated to the results from the questionnaires. Results The mean score of the post-labour questionnaire (W-DEQ B) was 61.2 (22.9) and OMS and MVI generated comparable experiences among the participating women with a W-DEQ B score of 59.4 (21.0) and 62.7 (24.7), respectively (p = 0.48). It was found that 11.8% (17/143) reported a severe fear of childbirth (W-DEQ A score ≥ 85). Women that stated a severe fear before the start of induction had a 3.7 times increased risk of experiencing labour induction negatively (OR 3.7 [95% CI; 1.04–13.41]). Conclusion Severe fear of childbirth was a risk factor for a negative experience of labour induction. OMS compared to MVI generated comparable results among participating women in this randomised controlled trial.
Perioperative worries associated with low acceptance of day surgery among outpatients in Zhejiang Province, China: a survey research
Authors: Feng Tonghui , Li Yujia , Zhou Daipeng , Xu Peng , Lu Xing , Xia Yanfei , Wang Hongmei 
Published: September 2019

Abstract
Background Day surgery practice started rather late in mainland China, as it is not until 2001 when day surgery was officially launched. At present, Chinese patients’ cognition and attitudes towards day surgery are blurred with only few relevent research. The goal of this study was to investigate the situation of outpatients’ perioperative worries and its relationship with outpatients’ acceptance of day surgery in Zhejiang Province, China. Methods A total of 412 outpatients in Zhejiang Hospital were evaluated by a cross-sectional questionnaire survey between January 2019 to February 2019. To evaluate outpatients’ perioperative worries and acceptance of day surgery, 412 valid respondents out of all 420 outpatients were divided by 1. demographic characteristics, 2. been with or without worries. The correlation between worries and patient acceptance of day surgery was analyzed. Multinomial Logistic regression model was used to assess the relationship between them. Results Of the 412 outpatients, 83.5% reported perioperative worries about day surgery. Outpatients with worries were significantly older, with a higher incidence of comorbidities than those without worries. Age, educated degree, comorbidities, financial status, and surgery type were important factors of patient acceptance of day surgery. Outpatients without worries significantly scored higher in acceptance of day surgery than those with worries. The score of acceptance of day surgery was negatively correlated with perioperative worries. Compared with outpatients been worried about day surgery, those without worries had a lower risk of refusing day surgery. Conclusions The prevalence rate of perioperative worries about day surgery among Zhejiang outpatients was relatively high, and outpatients’ acceptance of day surgery was negatively associated with perioperative worries. We suggest developing and utilizing a perioperative care process to address outpatients’ perioperative worries, so as to improve outpatients’ acceptance of day surgery.
Access to health care for people with disabilities in rural Malawi what are the barriers?
Authors: Harrison Josephine , Thomson Rachael , Banda Hastings T. , Mbera Grace B. , Gregorius Stefanie , Stenberg Berthe , Marshall Tim 
Published: September 2019

Abstract
Introduction

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside an impairment, on health care accessibility is explored.

Method

Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Questions, were recruited. People with cognitive impairments were excluded. Each of the selected participants underwent an individual in-depth interview and full recordings of these were then transcribed and translated.

Findings and discussion

Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Other barriers identified were distance to a facility, which was most hindering for the participants with a chronic lung condition, and unfavourable health seeking behaviour, whilst ‘time’ was found to be a common underlying factor. Attitudinal factors were not found to influence health care accessibility for this cohort.

Conclusions

This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.
Methods and Tools for the Assessment of an Organizational Climate for Creative and Innovative Activity of Firms
Authors: Dubina Igor , Demidova Dariya 
Published: September 2019

This paper reviews foreign methods for assessing an organizational climate, i.e. a complex of organizational, managerial, economic, socio-psychological, and other conditions. Organizational climate affects staff creativity and organizational innovation. The authors propose methods and tools for assessing the creative and innovative climate of Russian organizations. The methods can become an important element of systemic and regular monitoring of the organizational climate and its improvement. The survey of respondents (employees) was performed on the Google Forms platform; data processing and presentation of the results were performed with the help of Google Tables tools. The proposed methodology makes it possible to check the reliability and accuracy of the results. It offers a set of rules for automatic conclusions about the state of organizational climate based on the data obtained from interviewing the staff. The proposed methods and instruments may be put into practice of organizations in order to obtain reliable estimates of their organizational climate.