Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

Butorphanol in epidural:Could this be the breakthrough solution for safe and effective labor analgesia that we've been waiting for?

The authors have conducted a comprehensive investigation into the safety and effectiveness of butorphanol for epidural analgesia during labor.Their critical analysis of the paper and discussion of the technique's advantages and disadvantages provide a thorough understanding of the topic.

Rural labor migration and farmers’arrangements of rice production systems in Central China:Insight from the intergenerational division of labor

Rice production is crucial for food security in China,and its relationship with rural labor migration has been studied extensively.Labor migration in rural China has taken new forms in recent years.There has been a discernible trend wherein adult children have started migrating to cities while their elderly parents return to villages to re-engage in on-farm work.The phenomenon has notably shaped the intergenerational division of labor(IDL)within households.However,it remains to be seen how farmers adjust their rice production systems in response to the IDL.The age of 60 years for employment injury insurance is the eligibility threshold for off-farm employment and is used to obtain a source of exogenous variation in the IDL.Based on a representative household survey of 1,752 rice farmers in the Hubei Province of Central China,our fuzzy regression discontinuity analysis reveals that farmers in IDL households are more likely to adopt ratoon rice(RR)than single cropping rice(SR)or double cropping rice(DR).The effect of the IDL varies under different levels of operational scales and specialized agricultural service availability.Further analysis suggests that farmers’arrangements are associated with two potential mechanisms of downward intergenerational transfer.Monetary transfer for urban housing purchases increases RR in IDL households,and time transfer for intergenerational childcare significantly promotes SR in IDL households.This study enhances the understanding of the relationship between rural labor migration and rice production in China,providing a reference for adjusting rice production systems to ensure food security.

Requirements ranking based on crowd-sourcing high-end product USs

Based on the characteristics of high-end products,crowd-sourcing user stories can be seen as an effective means of gathering requirements,involving a large user base and generating a substantial amount of unstructured feedback.The key challenge lies in transforming abstract user needs into specific ones,requiring integration and analysis.Therefore,we propose a topic mining-based approach to categorize,summarize,and rank product requirements from user stories.Specifically,after determining the number of story categories based on py LDAvis,we initially classify“I want to”phrases within user stories.Subsequently,classic topic models are applied to each category to generate their names,defining each post-classification user story category as a requirement.Furthermore,a weighted ranking function is devised to calculate the importance of each requirement.Finally,we validate the effectiveness and feasibility of the proposed method using 2966 crowd-sourced user stories related to smart home systems.

Fibromyalgia Being Strongly Associated with Manual Labor Among Male Patients Attending Rheumatology Clinic

Introduction: Fibromyalgia is a common chronic pain syndrome, associated with different risk factors, including trauma. Many patients with the current or past history of manual labor attend our rheumatology clinic/s. Should manual labor be considered a risk factor for the development of fibromyalgia? Patients and Methods: A prospective study, where all male patients seen at the rheumatology clinic/s with the diagnosis of fibromyalgia were asked about their present and past type of job/s. Manual job was defined as a job where the participant had a strenuous physical activity of more than 2 hours during the working day. A similar number of Ethnic- and age-matched female patients from the same clinic/s were recruited as a control group. Results: 69 and 40 Arab and Jewish male participants were recruited, respectively. 54% of the Arab male patients and 20% of the Jewish male patients were considered manual laborers. Construction and renovation accounted for 46% of the type of jobs practiced by Arab patients. Only 4% of Arab female patients were considered manual laborers. Conclusion: Manual labor seems to be a risk factor for the development of fibromyalgia among male laborers.

The Function and Realization of Labor Rights in the Labor Code System

The fundamental right-based and human right-based nature of labor rights forms the subjective and objective theory of labor rights.The derived objective protection function and subjective realization function constitute the theoretical basis of the labor code system.The objective function of labor rights requires the labor code to provide corresponding institutional guarantees,while the subjective function demands that the code ensure the full realization of labor rights.The dual functions of labor rights are reflected in the structural framework and content logic of the labor code separately:on the one hand,labor rights can serve as the structural thread for narrating and systematically organizing the labor code,with the specific types of labor rights protection and functional systems jointly forming the framework of the code;on the other hand,the content arrangement of the labor code is guided by the value of realizing labor rights,exploring the pathways for the code’s realization of labor rights in different situations.

Advances in epidural labor analgesia:Effectiveness and treatment strategies of butorphanol

In this editorial,we provide a critical review of the article by Tang et al published in the World J Clin Cases,focusing on the utilization of butorphanol for epidural analgesia during labor.Our discussion encompasses recent research developments in epidural labor analgesia,specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches.Epidural analgesia is widely acknowledged as the primary method for pain management during labor,offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process.Among the various drugs utilized for epidural labor analgesia,butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties.As a synthetic opioid analgesic,butorphanol exhibits both agonistic and antagonistic activity on opioid receptors,striking a balance between analgesia and minimizing side effects.Nevertheless,the safety and efficacy of butorphanol in epidural labor analgesia remains controversial.While certain studies have reported positive outcomes with butorphanol,including effective pain relief and a reduced incidence of side effects,others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics.In addition,the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified.Through comprehensive synthesis and analysis of existing literature,we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia,delineate areas of consensus and controversy,and propose future avenues for research and clinical practice in this domain.

Association of Squatting Activities of Pregnant Women during the Antenatal Period and Labor Outcomes

Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, Sri Lanka, during the period 1st of February to 28th of May 2017 were invited into the study. Those who were already in active stage of labor (at least more than two moderate contractions per 10 minutes) on admission were excluded. Demographic data such as age, ethnicity, religion, educational level, occupation, latrine type in use, and booking Body mass index (BMI) were collected via an interviewer administered questionnaire. Data related to labor (modified Bishop score at onset of active labor, labor augmentation, pain relief, labor duration, mode of delivery, episiotomy or tears) and neonatal outcome (birth weight, APGAR score at 1, 5, 10 minutes) were collected from delivery notes. A pre tested interviewer administered questionnaire was used to obtain data regarding routine squatting activities during the previous 6 months. Pain visual analogue scale was used on day after delivery to assess the degree of labour pain. Duration of each squatting activity per day and number of days engaged with the activity per week;were used to calculate total squatting hours per week. In the absence of an accepted threshold for adequate squatting, we employed the sample mean as an operational data-driven threshold to define “more” against “less” squatting activities. Women who did not have squatting activities were considered as the controls. We used chi-square and Fisher’s exact tests to compare characteristics and outcomes between those engaging in more and less levels of squatting activity. We fitted a series of logistic regression models with each dichotomized outcome as the dependent variable, more/less squatting activity as the main independent variable of interest, and age, gestation period, BMI and patient’s occupation as covariates. The resulting adjusted odds ratios (AOR) and their 95% confidence intervals (CI) and statistical significance (p < 0.05) were used to draw conclusions of adjusted associations. Results: We recruited 430 women into this study. Overall, 68% of the women were of 20 - 30 years old, 47% had normal body mass index and 65% were housewives. The most frequent squatting activities were for urination/defecation and clothes washing (146 and 62 minutes/week, respectively). Mean total time was 246 minutes per week, of which more than 147 women (34%) achieved above this level of squatting activities. Those with more squatting activities had a greater modified Bishop Score ≥ 6/10 (92% vs 82%;p < 0.01);labor duration of <6 hours (82% vs 56%;p < 0.01), less likely for labour augmentation (39% vs 51%;p < 0.01) and pain relief (53% vs 65%;p = 0.013). Similar results were obtained after adjustments for maternal age, BMI, gestational age and occupation. However, there were no significant differences in the mode of delivery (normal vaginal vs instrumental vs caesarean), episiotomy rate, birth weight and neonatal Apgar scores. Conclusion: Squatting activities of more than 246 minutes per week may improve labor outcome. Women should be encouraged to increase squatting exercises or incorporate more habitual squatting activities antenatally.

Is Induction of Labor with Early Rupture of Membranes Associated with an Increased Rate of Clinical Chorioamnionitis?

Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.

Transcending Labor Relations:A Study on the Mechanisms for Protecting Social Insurance Rights and Interests of Workers in New Business Forms——An Empirical Analysis Based on Judicial Cases

With the rise of new business forms,the traditional industrial-era model of binding social insurance to labor relations is facing unprecedented challenges.In the context of these new business forms,whether the protection of workers’social insurance rights and interests can be“decoupled from labor relations”has become a hotly debated topic in academia,with“the ability to establish labor relations”emerging as a key variable influencing government departments’policy choices on classified social insurance coverage.Based on this,the paper constructs a theoretical model of the correlation between social insurance and labor relations to analyze cases concerning the protection of social insurance rights and interests of workers in new business forms.It examines the advantages and disadvantages of binding social insurance to labor relations and suggests promoting social insurance policy innovation by transcending labor relations.The paper advocates abandoning the path dependency that starts with labor relations and clarifying the theoretical basis that workers’access to social insurance rights should be based on labor rather than employment.To adapt to the profit model of new business forms,it proposes establishing a rule of“proportional responsibility for commissions,”where the social insurance contribution base is determined by the proportion and amount of corporate commissions.By reasonably setting rates,it will protect the healthy development of new business forms in a balanced manner.In this way,enterprises can share social insurance responsibilities according to unified rules without worrying about being classified as having a labor relationship,which helps fully protect workers’social insurance rights and interests and promotes fair competition and healthy development among enterprises.

Research Progress on the Relationship between Emotional Labor, Organizational Commitment, and Work Engagement of Clinical Nurses

This paper reviews the concepts of emotional labor,organizational commitment,and work engagement among nurses.By integrating motivation theory,social exchange theory,and the job demands-resources model,it elaborates on the current research status and theoretical support for the interrelationships between these concepts in pairs.Through these theoretical frameworks,the paper explores potential causal relationships between emotional labor,organizational commitment,and work engagement,proposing that organizational commitment may mediate the relationship between emotional labor and work engagement.This study provides insights into the complex dynamics of emotional management,organizational identification,and work engagement in nursing,laying a foundation for further research in this domain.

Research on the Implementation System of Integrated Labor Education in Primary,Secondary,and Tertiary Schools from the Perspective of“Three-Pronged Education”

The integrated implementation system of labor education in primary,secondary,and tertiary schools from the perspective of“three-pronged education”refers to the overall design of labor education goals,content,implementation process,and guarantees from macro,meso,and micro dimensions,in order to achieve a comprehensive education pattern of full staff education,full process education,and all-round education.The core essence is that labor education runs through the entire process of national education and is an important component of quality education.In specific practice,it is necessary to follow the overall principle of“putting morality first”and pay attention to ideological and value guidance;adhere to the overall requirements of“comprehensive promotion”and achieve an organic connection between educational goals and content in each stage;following the overall idea of“comprehensive implementation,”explore and innovate in curriculum implementation,teaching methods,organizational management,and other aspects.

Research on Strategies for Enhancing the Effectiveness of University Labor Education in the Context of“Sanquan Education”

The concept of“Sanquan education”emphasizes educating all members,the whole process,and all-round education,and guides ideological values throughout the entire process and every link of education and teaching.Under the guidance of this concept,labor education in colleges and universities needs to pay more attention to the cultivation of students’comprehensive literacy,not just simple skill training,but also the cultivation of students’ideological and moral character,practical skills,and innovative consciousness.This article analyzes the current status of labor education practice in colleges and universities,conducts in-depth research on the connotation of labor education under the“Sanquan education,”and proposes effective strategies to improve the effectiveness of labor education in colleges and universities,creating a“five-in-one”education pattern,focusing on multi-level and whole-process education,realizing all-round education in the first,second,third,and fourth classrooms,providing theoretical support and practical guidance for cultivating high-quality talents.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective:To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor.Methods:According to the order of admission,74 elderly women were divided into the control group and the observation group.In addition to the routine perinatal nursing interventions,the observation group strengthened the implementation of midwives’psychological nursing interventions.The duration of labor,mode of delivery,psychological state,and stress response indexes of the two groups were analyzed and compared.Results:The observation group had a shorter duration of all labor stages and total duration of labor than the control group,a lower cesarean section rate than the control group,and a higher degree of improvement in anxiety,depression,and stress response indexes in the 3-day postpartum period as compared to the control group(P<0.05).Conclusion:The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor,reduce the cesarean section rate,and improve the psychological state and stress indicators,which is worth promoting.

A Study on the Correlation of Body Mass Management During Pregnancy with Adverse Pregnancy Outcomes and Labor Progression

Objective:To investigate the effects of body mass management during pregnancy on adverse pregnancy outcomes,duration of labor,and neonatal birth weight.Methods:472 pregnant women who visited Beijing Anzhen Hospital from January to December 2023 were selected,and the pregnant women were divided into 236 each in the observation group and the control group.Body mass of pregnant women was measured and BMI was calculated in early and late pregnancy respectively,and the pregnant women in the control group were guided by routine management,while the observation group was guided by body mass management during pregnancy.The growth of maternal body mass,mode of delivery,postpartum hemorrhage,neonatal score,neonatal blood glucose at birth,and umbilical artery blood,as well as the comparison of the duration of labor,were observed.Results:The observation group was significantly better than the control group in terms of mode of delivery,postpartum hemorrhage,and body mass growth,with statistically significant differences(P<0.05),and there was no statistical significance in terms of neonatal scores,neonatal blood glucose at birth,and umbilical artery blood(P>0.05);the time of the first stage of labor and the time of the second stage of labor of the mothers in the observation group was significantly better than that of the control group,with statistical differences(P<0.05),and the time of the third stage of labor of the mothers in the observation group was statistically better than that of the control group.There was no statistically significant difference between the time of the third stage of labor in the observation group and the control group(P>0.05),and the time of the total stage of labor in the observation group was statistically better than that in the control group(P<0.05).Conclusion:Body mass management during pregnancy can effectively improve maternal control of weight gain,reduce labor time,and decrease the occurrence of adverse pregnancy outcomes.

Contribution of the MERISE-Type Conceptual Data Model to the Construction of Monitoring and Evaluation Indicators of the Effectiveness of Training in Relation to the Needs of the Labor Market in the Republic of Congo

This study proposes the use of the MERISE conceptual data model to create indicators for monitoring and evaluating the effectiveness of vocational training in the Republic of Congo. The importance of MERISE for structuring and analyzing data is underlined, as it enables the measurement of the adequacy between training and the needs of the labor market. The innovation of the study lies in the adaptation of the MERISE model to the local context, the development of innovative indicators, and the integration of a participatory approach including all relevant stakeholders. Contextual adaptation and local innovation: The study suggests adapting MERISE to the specific context of the Republic of Congo, considering the local particularities of the labor market. Development of innovative indicators and new measurement tools: It proposes creating indicators to assess skills matching and employer satisfaction, which are crucial for evaluating the effectiveness of vocational training. Participatory approach and inclusion of stakeholders: The study emphasizes actively involving training centers, employers, and recruitment agencies in the evaluation process. This participatory approach ensures that the perspectives of all stakeholders are considered, leading to more relevant and practical outcomes. Using the MERISE model allows for: • Rigorous data structuring, organization, and standardization: Clearly defining entities and relationships facilitates data organization and standardization, crucial for effective data analysis. • Facilitation of monitoring, analysis, and relevant indicators: Developing both quantitative and qualitative indicators helps measure the effectiveness of training in relation to the labor market, allowing for a comprehensive evaluation. • Improved communication and common language: By providing a common language for different stakeholders, MERISE enhances communication and collaboration, ensuring that all parties have a shared understanding. The study’s approach and contribution to existing research lie in: • Structured theoretical and practical framework and holistic approach: The study offers a structured framework for data collection and analysis, covering both quantitative and qualitative aspects, thus providing a comprehensive view of the training system. • Reproducible methodology and international comparison: The proposed methodology can be replicated in other contexts, facilitating international comparison and the adoption of best practices. • Extension of knowledge and new perspective: By integrating a participatory approach and developing indicators adapted to local needs, the study extends existing research and offers new perspectives on vocational training evaluation.

Research on the Implementation Path of Labor Education in Colleges and Universities from an International Perspective

Universities shoulder the important mission of talent cultivation,scientific research,social service,cultural heritage and innovation,and international exchange and cooperation.International exchange and cooperation have become the fifth major function of universities.Based on the background of the globalization era,undergraduate colleges and universities should pay more attention to the cultivation of students’intercultural communication and understanding ability while cultivating their professional skills,and take expanding students’international vision and enhancing the international competitiveness of China’s education as important tasks.Labor education is an important content of the national education system,which has the comprehensive nurturing value of cultivating morality,increasing intelligence,strengthening physical fitness,and cultivating beauty.Higher education institutions should further optimize the system of labor education,expand students’space and field of thinking in the process of labor education,and broaden students’international perspectives.

The Practical Path of Labor Curriculum in Compulsory Education in China from the Perspective of Overlapping Influence Domain Theory

Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.

平台灵活就业人员劳动权益保护的立法困境与对策

以人力资源和社会保障部颁布的规范性文件为代表,中国关于平台灵活就业人员劳动权益保护的立法取得了重要的成就,但也存在着程序重于实体、形式重于实质、立法重点与实践需要有所偏离等困境。应以实质公平为理念,促进平台与灵活就业人员的利益平衡,在尊重平台组织管理权力的基础上激励其履行社会责任;合理规制平台的利益分配权和劳动规则制定权,强化平台利益分配和规则制定的公平性;完善社会保险、职业伤害保障和纠纷解决领域的公共产品供给。

企业所得税税率变动的劳动雇佣效应

通过减税降费着力稳预期、稳增长、稳就业是当前政府工作的重要内容。为回应企业所得税减税是否有助于稳就业这一重大现实问题,本文构建了一个简单的理论模型来分析企业所得税税率变动对企业劳动雇佣行为的影响,并以2008年我国企业所得税法正式实施为政策冲击进行因果识别。研究发现,企业所得税税率下降显著提高了企业劳动雇佣规模,税率上升则未产生明显影响。进一步分析发现,税率下降对企业雇佣的正向影响主要体现在面临较强融资约束的企业、税收遵从程度较高的企业以及产品市场竞争程度较高的企业。机制分析表明,税率下降促进了企业投资,由于资本-劳动互补,最终引起企业雇佣规模上升。本文的研究加深了对减税降费政策劳动雇佣效应的理解,有助于后续减税政策的出台与调整,也为税收征管改革和市场化建设提供了政策启示。