bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multilevel analysis of the predictors of completion of the continuum of maternity care in Ethiopia; using the recent 2019 Ethiopia mini demographic and health survey
Authors: Abebe Gossa Fetene , Belachew Dereje Zeleke , Girma Desalegn , Aydiko Alemseged , Negesse Yilkal 
Published: September 2022

Abstract
Background
Despite the significant benefit of the continuum of care to avert maternal and neonatal mortality and morbidity, still the dropout from the continuum of care remains high and continued to become a challenge in Ethiopia. Therefore, this study aimed to assess the level of completion along the continuum of maternity care and its predictors among reproductive-age women in Ethiopia.

Methods
A secondary data analysis was done using the 2019 mini Ethiopian demographic health survey. A total weighted sample of 2,905 women aged 15–49 years who gave birth in the last five years preceding the survey and who had antenatal care visits was included. A multilevel mixed-effects logistic regression model was used to examine the predictors that affect the completion of the continuum of maternity care services. Finally, statistical significance was declared at a p-value < 0.05.

Results
In this study, the overall prevalence of completion along the continuum of maternity care was 12.9% (95%CI: 11.1 – 14.9%). Attending higher education (AOR = 2.03: 95%CI; 1.14 - 3.61), belonged to medium wealth status (AOR = 1.69: 95%CI; 1.07 - 2.66), belonged to rich wealth status (AOR = 2.05: 95%CI; 1.32, 3.17), and informed about danger signs during pregnancy (AOR = 2.23: 95%CI; 1.61, 3.10) were positively associated with the completion of the maternity continuum of care. However, late initiaton of first antenatal care visits (AOR = 0.66: 95%CI; 0.49, 0.89), being rural resident (AOR = 0.67: 95%CI; 0.42 - 0.93), lived in the Afar (AOR = 0.36: 95%CI; 0.12 – 0.83) and Gambella (AOR = 0.52: 95%CI; 0.19 – 0.95) regional states were negatively associated with the completion of the continuum of maternity care.

Conclusion
Despite most of the women using at least one of the maternity services, the level of completion along the continuum of care after antenatal care booking remains low in Ethiopia. Therefore, enhancing female education and economic transitions with special consideration given to rural, Afar, and Gambella regional state residents. Counseling towards the danger signs of pregnancy and its complications during antenatal care follow-upshould be strengthened. . Furthermore, the identified predictors should be considered when designing new policies or updating policies and strategies on maternity services uptake to step-up its full utilization, which in turn helps in the achievement of the sustainable development goals of ending preventable causes of maternal, neonatal, and child death by 2030.
Modifiable factors of depressive-symptom trajectories from caregiving through bereavement
Authors: Wen Fur-Hsing , Chou Wen-Chi , Su Po-Jung , Hou Ming-Mo , Shen Wen-Chi , Hsu Mei Huang , Tang Siew Tzuh 
Published: September 2022

AbstractBackground/purposeThe purpose of this secondary-analysis study was to identify never-before-examined factors associated with distinct depressive-symptom trajectories among family caregivers from end-of-life caregiving through the first 2 bereavement years.Participants/methodsParticipants (N=661) were family caregivers who provided end-of-life caregiving for terminally ill cancer patients. Multinomial logistic regressions were conducted to identify modifiable factors associated with caregivers’seven previously identified depressive-symptom trajectories: minimal-impact resilience, recovery, preloss-depressive-only, delayed symptomatic, relief, prolonged symptomatic, and chronically persistent distressed. Drawing from the stress-appraisal-coping model, modifiable time-varying factors associated with distinct depressive-symptom trajectories were examined in three domains: (1) stressors, (2) stress appraisal, and (3) available resources (internal coping capacity and external social support).ResultsProfound objective caregiving demands were associated with caregivers’ increased likelihood of belonging to more distressing depressive-symptom trajectories than to the minimal-impact-resilience trajectory. But, stronger negative appraisal of end-of-life caregiving increased odds of caregiver membership in preloss-depressive-only and relief trajectories over the recovery, delayed, and prolonged-symptomatic trajectories. Stronger internal coping capacity and perceived social support buffered the tremendous stress of end-of-life caregiving and permanent loss of a relative, as evidenced by higher odds of being in the minimal-impact-resilience and recovery trajectories.ConclusionFamily caregivers’ distinct depressive-symptom trajectories were linked to their preloss caregiving demands, appraisal of negative caregiving impact, personal coping capacity, and perceived social support. Our results highlight actionable opportunities to improve end-of-life-care quality by boosting family caregivers’ coping capacity and enhancing their social support to help them adequately manage daily caregiving loads/burdens thus relieving the emotional toll before patient death and throughout bereavement.
‘Painting my pain’: the use of pain drawings to assess multisite pain in women with primary dysmenorrhea
Authors: Rodrigues Jéssica Cordeiro , Avila Mariana Arias , dos Reis Felipe Jose Jandre , Carlessi Roberta Moraes , Godoy Amanda Garcia , Arruda Guilherme Tavares , Driusso Patricia 
Published: September 2022

Abstract
Background
To verify the use of pain drawing to assess multisite pain in with primary dysmenorrhea (PD) and to assess its divergent validity, test–retest reliability, intra- and inter-rater reliability and measurement errors.

Methods
Cross-sectional study. Adult women with self-reported PD three months prior to the study. Women answered the Numerical Rating Scale (NRS) and the pain drawing during two consecutive menstruations. The pain drawings were digitalized and assessed for the calculation of total pain area (%). Intra- and inter-rater reliability and the test–retest reliability between the first and the second menstruations were assessed with the intraclass correlation coefficient (ICC). Measurement errors were calculated with the standard error of measurement (SEM), smallest detectable change (SDC) and the Bland–Altman plot. Spearman correlation (rho) was used to check the correlation between the total pain area and pain intensity of the two menstruations.

Results
Fifty-six women (24.1 ± 3.1 years old) participated of the study. Their average pain was 6.2 points and they presented pain in the abdomen (100%), low back (78.6%), head (55.4%) and lower limbs (50%). All reliability measures were considered excellent (ICC > 0.75) for the total pain area; test–retest SEM and SDC were 5.7% and 15.7%, respectively. Inter-rater SEM and SDC were 8% and 22.1%, respectively. Correlation between total pain area and pain intensity was moderate in the first (rho = 0.30; p = 0.021) and in the second menstruations (rho = 0.40; p = 0.002).

Conclusion
Women with PD presented multisite pain, which could be assessed with the pain drawing, considered a reliable measurement.
Factors facilitating and hindering counselling about generic substitution and a reference price system in community pharmacies - a survey among Finnish dispensers
Authors: Rainio Riikka , Ahonen Riitta , Lämsä Elina , Timonen Johanna 
Published: September 2022

Abstract
Background
Pharmacies play the key role in implementing generic substitution (GS) and counselling customers about it. This study aimed to explore dispensers’ perceptions of the factors that facilitate or hinder counselling customers on GS and the reference price system (RPS) in community pharmacies. It also studied dispensers’ opinions about the benefits and problems of these systems and discusses them from the counselling point of view.

Methods
A postal survey was conducted among Finnish community pharmacy dispensers in spring 2018. The research questions were studied through open-ended questions and analyzed both qualitatively and quantitatively. The questions were analyzed first with inductive content analysis by two researchers independently. The responses were encoded and categorized according to the analytical framework, which was inductively developed alongside the analysis. The categorized responses were further analyzed using frequencies and percentages.

Results
The response rate was 50.8% (n = 498). Of the respondents, 75.9% reported factors that facilitated counselling about GS and RPS. The most commonly mentioned factors included customers’ characteristics (36.5%), the information systems used in the pharmacy (28.3%), and the features of interchangeable medicines (21.7%). Of the respondents, 89.0% reported factors that hindered counselling, of which customers’ characteristics (45.8%), the unavailability of medicines and other availability issues (32.5%), the features of interchangeable medicines (22.6%) and time pressure in the pharmacy (22.1%) were the most commonly reported. The benefits of the systems focused on cost savings for customers and society (74.4%). The most commonly reported problems concerned medicine availability (31.9%), changes in medicine prices and in reference price band (28.9%), as well as how GS is time-consuming and increases workload (24.2%).

Conclusions
Finnish dispensers reported more hindering than facilitating factors in GS and RPS counselling. Customers’ characteristics were the most often mentioned in both cases. Customers’ knowledge could be increased by providing information and education. However, developing simpler regulations for GS and RPS, intelligent assisting software, and solutions for secured medicine availability would facilitate implementation of GS. Simplified price counselling would also guarantee the time needed and focus on instructions on the correct and safe use of medicines.
The influence factors of medical disputes in Shanghai and implications - from the perspective of doctor, patient and disease
Authors: Liu Yu , Wang Pei , Bai Yonghai 
Published: September 2022

Abstract
Objective
This study aimed to explore the causes and factors behind medical disputes that occurred across eight hospitals in Shanghai over a three-year period (January 2018 to December 2020), thus providing targeted suggestions for amelioration.

Methods
Stratified sampling was employed to collect 561 cases in which medical disputes occurred at two tertiary hospitals, two secondary hospitals, and four primary hospitals in Shanghai. The causes were analyzed using descriptive statistics, while the factors affecting the dispute level (i.e., 1 through 4, with 1 being most severe) were analyzed via one-way ANOVA and logistic regression analyses.

Results
Doctors and patients variously contributed to the medical disputes; 86.1% were related to doctors, while 13.9% were related to patients. For doctors, there are seventeen factors that influenced medical disputes. In particular, the insufficient communication (28.82%) is the most prominent factor in the doctors’ factors. For patients, there are seven factors that influenced medical disputes. In particular, the misunderstanding of medical behavior (43.48%) is the most prominent factor in the patients’ factors. Of all investigated medical disputes, 406 were level 4 (78%), 95 were level 3 (18%), and 19 were level 2 (4%); there were no level 1 disputes. The reasons for different level placements included the disease classification, treatment effect, diagnosis and treatment regulation violations by doctors, and low technical levels.

Conclusions
In addition to strengthening training about clinical and communication skills, the hospitals should establish quality control mechanisms for case records and construct rapid, standardized referral mechanisms. The doctors should attach great importance to the quality and urgency of treatment given to critically ill patients, who must be informed about their prognoses in a timely manner to avoid medical disputes and physical deterioration. The patients should actively cooperate with their doctors in the treatment process, moderate any unrealistic expectations that patients may have about the outcomes. During the COVID-19 pandemic particularly, doctors and patients should strengthen empathy and mutual trust more, then defeat disease together.
Designing multi-epitope-based vaccine targeting surface immunogenic protein of Streptococcus agalactiae using immunoinformatics to control mastitis in dairy cattle
Authors: Pathak Rajesh Kumar , Lim Byeonghwi , Kim Do-Young , Kim Jun-Mo 
Published: September 2022

Abstract
Background
Milk provides energy as well as the basic nutrients required by the body. In particular, milk is beneficial for bone growth and development in children. Based on scientific evidence, cattle milk is an excellent and highly nutritious dietary component that is abundant in vitamins, calcium, potassium, and protein, among other minerals. However, the commercial productivity of cattle milk is markedly affected by mastitis. Mastitis is an economically important disease that is characterized by inflammation of the mammary gland. This disease is frequently caused by microorganisms and is detected as abnormalities in the udder and milk. Streptococcus agalactiae is a prominent cause of mastitis. Antibiotics are rarely used to treat this infection, and other available treatments take a long time to exhibit a therapeutic effect. Vaccination is recommended to protect cattle from mastitis. Accordingly, the present study sought to design a multi-epitope vaccine using immunoinformatics.

Results
The vaccine was designed to be antigenic, immunogenic, non-toxic, and non-allergic, and had a binding affinity with Toll-like receptor 2 (TLR2) and TLR4 based on structural modeling, docking, and molecular dynamics simulation studies. Besides, the designed vaccine was successfully expressed in E. coli. expression vector (pET28a) depicts its easy purification for production on a larger scale, which was determined through in silico cloning. Further, immune simulation analysis revealed the effectiveness of the vaccine with an increase in the population of B and T cells in response to vaccination.

Conclusion
This multi-epitope vaccine is expected to be effective at generating an immune response, thereby paving the way for further experimental studies to combat mastitis.
Time-series analysis of presentations to four syringe dispensing machines and a needle and syringe programme during COVID-19 lockdowns in Melbourne, Australia
Authors: O’Keefe Daniel , Livingston Michael , Cossar Reece D. , Kerr Phoebe , Jacka David , Dietze Paul 
Published: September 2022

Abstract
Background
Australian harm reduction services are provided via a mix of modalities, including fixed-site needle and syringe programmes (NSP) and syringe-dispensing machines (SDMs). SDMs are cost-effective and provide 24-h anonymous access to needles/syringes, often to underserved geographic areas, and can attract clientele who may choose not to use NSPs. The introduction of COVID-19 control measures saw disruptions and adaptations to the provision of harm reduction services. It is possible that SDMs filled the gap in otherwise disrupted harm reduction services in Melbourne. In this paper, we use data from four SDMs and an NSP to explore changes to harm reduction usage during periods of COVID-19 lockdowns in Melbourne, Australia, in 2020.

Methods
Our data span September 2017–December 2020. We analysed daily counts of SDM use and monthly counts of NSP use, according to unique presentations to both. Auto-regressive integrated moving average (ARIMA) time-series models were fitted to the data with the effects of lockdowns estimated via a step function.

Results
Across the study period, we estimated 85,851 SDM presentations and 29,051 NSP presentations. Usage across both the SDMs and the NSP declined during the COVID-19 lockdowns, but only the decline in SDM usage was significant in ARIMA analysis.

Conclusions
The slight, but significant decline in SDM use suggests barriers to access, though this may have been mitigated by SDM users acquiring needles/syringes from other sources. The decline, however, may be a concern if it led to lowered needle/syringe coverage and a subsequent increase in injecting risk. Further work is needed to properly explore potential changes in preference for needle/syringe acquisition site and associated barriers. Importantly, this work adds to the body of literature around the impacts of COVID-19 on harm reduction provision and potential areas of improvement.
Pancreaticoduodenal and choledochal hemangiomatosis with vascular variation in a child: a rare disease with challenge starts from diagnosis—a case report
Authors: Tian Daguang , Zhu Hong , Wei Xiaoping 
Published: September 2022

Abstract
Background
Visceral hemangiomatosis is a benign tumor (rarer than hemangioma) that has not been reported to occur in the pancreas, duodenum, or choledoch. It can be easily confused with other pancreatic tumors or choledocholithiasis. Herein, we describe a case of a child with pancreaticoduodenal and choledochal hemangiomatosis and the key characteristics for the accurate diagnosis of pancreatic tumors based on previous reports and our findings.

Case presentation
We report a case of a 2-year and 9-month-old child who presented with repeated and fluctuating jaundice for 3 months with a history of endoscopic stone removal in a local hospital, following the diagnosis of choledocholithiasis. An abdominal computed tomography revealed a previously undiagnosed pancreatic head tumor and celio-mesenteric trunk (a rare vascular variation). This was misdiagnosed as a pancreatic neuroendocrine tumor. Since the patient’s parents refused FNA biopsy and insisted on surgery, pancreaticoduodenectomy was performed; however, postoperatively, the child was correctly diagnosed with pancreaticoduodenal and choledochal hemangiomatosis. Although the patient was in good condition and had gained 4 kg in weight 3 months postoperatively, pancreaticoduodenectomy could have been avoided if an accurate diagnosis had been established before or during the operation.

Conclusion
Our report highlights the difficulty in diagnosing visceral hemangiomatosis. Radiologists, endoscopists, and surgeons should consider this possibility in cases of repeated and fluctuating jaundice that cannot be explained by choledocholithiasis alone.
Mitochondria transfer restores fibroblasts-like synoviocytes (FLS) plasticity in LPS-induced, in vitro synovitis model
Authors: Kornicka-Garbowska K. , Groborz S. , Lynda B. , Galuppo L. , Marycz K. 
Published: September 2022

Abstract
Background
Synovitis (SI) is one of the most common and serious orthopedic diseases in horses of different age, breed and sex, which contributes to the development of osteoarthritis. The burden of SI includes economic loss and represents a real challenge for current veterinary health care. At the molecular level, fibroblasts-like synoviocytes (FLS) are recognized as major cell populations involved in SI pathogenesis. In the course of SI, FLSs are losing their protective and pro-regenerative cytological features, become highly proliferative and initiate various stress signaling pathways.

Methods
Fibroblast-like synoviocytes were treated with LPS in order to generate SI in vitro model. Mitochondria were isolated from peripheral blood derived mononuclear cells and co-cultured with FLS. After 24 h of culture, cells were subjected to RT-qPCR, western blot, cytometric and confocal microscopy analysis.

Results
Mitochondrial transfer (MT) was observed in vitro studies using confocal microscopy. Further studies revealed, that MT to LPS-treated FLS reduced cell proliferation, modulated apoptosis and decreased inflammatory response. Overall, MT Resulted in the considerable recovery of recipient cells cytophysiological properties.

Conclusions
Presented data provides evidence that mitochondria transfersignificantly modulate FLS proliferative and metabolic activity through improved mitochondrial biogenesis and dynamics in activated FLS. Obtained results for the first time demonstrate that horizontal MT might be considered as a therapeutic tool for synovitis treatment; however, further clinical studies are strongly required.
Identification and analysis of mitochondria-related key genes of heart failure
Authors: Yu Haozhen , Yu Mujun , Li Zhuang , Zhang Enhu , Ma Heng 
Published: September 2022

AbstractMitochondria-induced cell death is a vital mechanism of heart failure (HF). Thus, identification of mitochondria-related genes (Mito-RGs) based on transcriptome sequencing data of HF might provide novel diagnostic markers and therapeutic targets for HF. First, bioinformatics analysis was conducted on the GSE57338, GSE76701, GSE136547, and GSE77399 datasets in the Gene Expression Omnibus. Next, we analyzed HF-Mito differentially expressed genes (DEGs) using the protein–protein interaction (PPI) network for obtaining critical genes and exploring their functions. Subsequently, immune cell scores of the HF and normal groups were compared. The potential alteration mechanisms of the key genes were investigated by constructing a competing endogenous RNA network. Finally, we predicted potential therapeutic agents and validated the expression levels of the key genes. Twenty-three HF-Mito DEGs were acquired in the GSE57338 dataset, and the PPI network obtained four key genes, including IFIT3, XAF1, RSAD2, and MX1. According to gene set enrichment analysis, the key genes showed high enrichment in myogenesis and hypoxia. Immune cell analysis demonstrated that aDCs, B cells, and 20 other immune cell types varied between the HF and normal groups. Moreover, we observed that H19 might affect the expression of IFIT3, AXF1, and RSAD2. PCGEM1 might regulate RSAD2 expression. A total of 515 potential therapeutic drugs targeting the key genes, such as tretinoin, silicon dioxide, and bisphenol A, were acquired. Finally, IFIT3, RSAD2, and MX1 expression increased in HF samples compared with normal samples in the GSE76701 dataset, conforming to the GSE57338 dataset analysis. This work screened four key genes, namely, IFIT3, XAF1, RSAD2, and MX1, which can be further explored in subsequent studies for their specific molecular mechanisms in HF.