bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association between Care Left Undone and Temporary Nursing Staff ratios in Acute Settings: A cross- sectional survey of registered nurses
Authors: Senek Michaela , ROBERTSON STEVE , RYAN TONY , RN RACHEL KING , WOOD EMILY , TOD ANGELA 
Published: February 2020

Abstract
Background The shortage of health workers is a global phenomenon. To meet increasing patient demands on UK health services, providers are increasingly relying on temporary staff to fill permanent posts. This study examines the occurrence of ‘care left undone’, understaffing and temporary staffing across acute sector settings. Methods Staffing and ‘care left undone’ measures were derived from the responses of 13, 218 registered nurses across the UK. A locally smoothed scatterplot smoothing regression analysis (Loess) was used to model the relationship between any ‘care left undone’ events and full complement, modest and severely understaffed shifts, and proportions of temporary staff. Results Occurrence of ‘care left undone’ was highest in Emergency Departments and lowest in Theatre settings. The odds of ‘care left undone’ increase with increasing proportion of temporary staff. This trend is the same in all understaffing categories. On shifts with a full quota of nursing staff, an increase in the proportion of temporary staff from 0 to 10 per cent increases the odds of care left undone by 6 per cent (OR= 1.06,95% CI, 1.04-1.09 ). Within the full quota staffing category, the difference becomes statistically significant (p<0.05) on shifts with a proportion of temporary nursing staff of 40 per cent or more. On shifts with a full quota of nursing staff the odds of a ‘care left undone’ event is 10 per cent more with the proportion of temporary nursing staff at 50 per cent, compared to shifts with modest understaffing of 25 per cent or less with no temporary nursing staff (OR=1.1, 95%CI, 0.96-1.25). Conclusion The odds of a ‘care left undone’ event is similar for fully staffed shifts with a high temporary nursing staff ratio compared to severely understaffed shifts with no temporary nursing staff. Increasing the proportion of temporary nurse staff is associated with higher rates of self-reported care left undone by nursing staff. This has significant implications for nurse managers and policy makers.
The proteomic response is linked to regional lung volumes in ventilator-induced lung injury
Authors: Yen Seiha , Song Yong , Preissner Melissa , Bennett Ellen , Wilson Richard , Pavez Macarena , Dubsky Stephen , Dargaville Peter A. , Fouras Andreas , Zosky Graeme R. 
Published: February 2020

Abstract
Background: It is unclear how acid induced lung injury alters the regional lung volume response to mechanical ventilation (MV) and how this impacts protein expression. Using a mouse model, we investigated the separate and combined effects of acid aspiration and MV on regional lung volumes and how these were associated with the proteome.Methods: Adult BALB/c mice were divided into four groups: intratracheal saline, intratracheal acid, Saline/MV or Acid/MV. Specific tidal volume (sVt) and specific end-expiratory volume (sEEV) were measured at baseline and after 2 hours of ventilation using dynamic high-resolution four-dimensional computed tomography (4DCT) images. Lung tissue was dissected into 10 regions corresponding to the image segmentation for label-free quantitative proteomic analysis. Results: Acid aspiration significantly reduced sVt and caused further reductions in sVt and sEEV after 2 hours of ventilation. Proteomic analysis revealed 42 dysregulated proteins in both Saline/MV and Acid/MV groups, and 37 differentially expressed proteins in the Acid/MV group. Mapping of the overlapping proteins showed significant enrichment of complement/coagulation cascades (CCC). Analysis of 37 unique proteins in the Acid/MV group identified 6 additional CCC proteins and 7 down-regulated proteins involved in the mitochondrial respiratory chain (MRC). Regional MRC protein levels were positively correlated with sEEV, while the CCC protein levels were negatively associated with sVt. Conclusions: High tidal stretch was associated with increased expression of CCC proteins while low lung volumes were negatively associated with MRC protein expression, suggesting that overstretch and low lung volumes activate different injury pathways.
Care at the Critical Care Medical Center is associated with improved outcomes in patients with accidental hypothermia: A report from the J-Point registry
Authors: Fujimoto Yoshihiro , Matsuyama Tasuku , Morita Sachiko , Ehara Naoki , Miyamae Nobuhiro , Okada Yohei , Jo Takaaki , Sumida Yasuyuki , Okada Nobunaga , Watanabe Makoto , Nozawa Masahiro , Tsuruoka Ayumu , Okumura Yoshiki , Kitamura Tetsuhisa , Takegami Tetsurou 
Published: February 2020

Abstract
Background: The recommendation that patients with accidental hypothermia (AH) should be transported to specialized centers which can provide extracorporeal life support has not been validated, and the efficacy still remains unclear.Methods: This was a multicenter retrospective cohort study of patients with a body temperature of ≤35°C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into the two groups based on the point of care delivery: Critical Care Medical Center (CCMC) or non-CCMC. The primary outcome of this study was in-hospital death. In-hospital death was compared between AH patients at the CCMC and non-CCMC via a multivariable logistic regression analysis. Subgroup analyses were conducted according to patients with severe hypothermia (<28°C) or systolic blood pressure of <90 mmHg.Results: A total of 537 patients were included; 413 patients (76.9%) in the CCMC and 124 patients (23.1%) in the non-CCMC group. The in-hospital death rate was lower in the CCMC group than in the non-CCMC group (22.3% versus 31.5%, p<0.001). The multivariable logistic regression analysis showed that the adjusted odds ratio (AOR) of the CCMC group was 0.54 (95% confidence interval: 0.32-0.90). In subgroup analyses, patients with systolic blood pressure <90 mmHg in the CCMC group were less likely to experience in-hospital death (AOR 0.36, 95% CI 0.23-0.56). However, no such association was observed among patients with severe hypothermia (AOR 1.08, 95% CI 0.63-1.85)Conclusions: Our multicenter study indicated that Care at CCMC was associated with improved outcomes in patients with AH. Optimizing the transport of patients with AH to specialized centers is likely to be beneficial.
Initiation into street, challenges, means of survival and perceived strategies to alleviate its plights among street children in Addis Ababa, Ethiopia 2019
Authors: Chimdessa Ayana Fite 
Published: February 2020

Abstract
Background: The life and health of street children is becoming a global concern. There is a wide range of legislation relevant to street children. However, poor design and implementation of policies, strategies and traditional response by most governments in Africa has been subjugated. This made street children defenseless to harassments, child trafficking and health problems.Methodology: A phenomenological study design was employed to explore difficulties of street life experience and perceived strategies to alleviate them. The study was conducted from January to March 2019. A Time-Space Sampling (TSS) was used to recruit participants. Pre-tested interview guide was used for data collection. Data was analyzed by using framework analysis software. A code book was developed under three themes (Initiation into street life, means of survival and perceived strategies) with different sub-themes and categories.Results: A total of 103 street children age 10-18 years took part in the study. Complexity of push and pull factors pose to a risk of flee to the street. Street children face widespread challenges i.e. social network fragmentation, child trafficking, harassments and shortage of basic needs. Furthermore, absences of complete and representative data on street children as well as strategies are hardly available. Thus, street children have been considered as felon, out laws and having a mentality of committing crime by both law keeping bodies and the society. These in turn is affecting street children’s’ acceptance by their community and get legal protection under the law that made them more susceptible to harassments, denial of access to education and health services. To survive, they use different mechanisms including group formation - where, every individual within the group has his or her mandate for collective security, share available resources and vital information that might be useful for the group. Conclusion: Lack of policies and strategies targeting street children has made them prone to many problems. Therefore, call for different stakeholders in supporting to design and implement clear, case based and contextualized strategic policies to address and prevent plights of street children. Intervention targeting positively perceived street children’s proposed strategies has to be considered.
Routine colonoscopy may not be needed for uncomplicated acute right colonic diverticulitis
Authors: Lee Kil-yong , Lee Jaeim , Park Youn Young , Oh Seong Taek 
Published: February 2020

Abstract
BACKGROUND

Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography imaging, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Therefore, or aim in this study was to evaluate the incidence of colon cancer, detected by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis.

METHODS

Included were patients with uncomplicated right colon diverticulitis (modified Hinchey stage Ia) diagnosed by computed tomography imaging, between 2011 and 2017, and who underwent follow-up colonoscopy surveillance after treatment. The primary outcome was the incidence of colon cancer, with the detection rate of adenoma being the secondary outcome. Information for analysis was retrieved, retrospectively, from patients’ medical records.

RESULTS

The study group included 330 consecutive patients, with a mean age of 41.9 years, and 51.9% being men. For the primary outcome, the rate of colon cancer on follow-up colonoscopy was 0.3% (1/330 cases). The rate of adenoma detection was 20.3% (67/330 cases), with advanced adenoma identified in 9 of these cases (13.4%).

CONCLUSION

In patients with acute uncomplicated right colonic diverticulitis, routine colonoscopy after conservative treatment may not be necessary.
Health Risk Behavior And Associated Factors Among Myanmar Migrant Workers In Samut Sakhon Province, Thailand
Authors: Paratthakonkun Chirawat , Soonthornworasiri Ngamphol , Maneekan Pannamas , Toraksa Kanittha , Zaw Aung Phone , Thu Sai Wai Yan Myint , Arthan Dumrongkiet 
Published: February 2020

Abstract
Background: Thailand has recently experienced large cross-border migration from nearby countries, in particular from Myanmar that have different lifestyle and health behaviors compared with the local community. The aim of this study was to explore the prevalence of health-risk behaviors and related factors amongst Myanmar migrant workers in Thailand. Methods: The cross-sectional secondary data analysis was performed by using the primary data from questionnaire survey obtained from Samut Sakhon Hospital. This study explored the health-risk behaviors amongst 1,205 Myanmar migrant workers in Thailand by using a structured questionnaire, and analyzing the related factors by using logistic regression. Results: Lack of exercise was considered to be the most common unhealthy behavior (81.5%) followed by smoking (22.5%), betel quid chewing (18.9%) and alcohol drinking (10.2%). Advancing age (AOR = 1.03, 95%CI 1.02-1.05)) and being male (AOR = 8.29, 95%CI 5.54-12.40)) were significant risk factors for workers having a smoking habit. Additionally, being Mon ethnic led to a lower chance of having a smoking habit compared with the Burmese ethnic group (AOR= 0.518, 95% CI: 0.315-0.851). The odds of having a smoking habit was four times greater in workers who drank alcohol (AOR = 4.08, 95%CI 2.58-6.47)). Additionally, odds of drinking alcohol increased with advancing age, 1.03 (95%CI 1.00-1.05), male gender, 9.30 (95%CI 4.39-19.73), having a smoking habit, 4.23 (95%CI 2.67-6.70) and being a fisherman, 3.08 (95%CI 1.51-6.29). Conclusions: The findings can be used for developing appropriate policies, special health promotion programs and mass communication to prevent treated diseases in migrant workers. Keywords : Exercise, Smoking, Alcohol drinking, Betel quid chewing, Myanmar migrant workers
Women’s decision-making capacity and HIV testing in sub-Saharan Africa: A multi-country analysis of Demographic and Health Surveys
Authors: Seidu Abdul-Aziz , Oduro Joseph Kojo , Ahinkorah Bright Opoku , Budu Eugene , Appiah Francis , Baatiema Linus , Ameyaw Edward Kwabena , Sambah Francis 
Published: February 2020

Abstract
IntroductionGlobal commitment to stop HIV and ensure access to HIV treatment call for women empowering as these efforts play a major role in mother to child transmission. We explored the association between women decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Materials and methodsWe used data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2016 in 30 countries within SSA. At the descriptive level, we calculated the prevalence of women who had undergone HIV testing and decision-making capacity in each of the countries as well as prevalence of HIV testing across their socio-demographic characteristics. We used Binary Logistic Regression to explore the likelihood of HIV testing by decision-making capacity and socio-demographic characteristics at 5% margin of error. The results were presented as Crude Odds Ratios (CORs) and Adjusted Odds Ratios (AORs). ResultsWe found that overall, 10.0% of women had decision-making with Nigeria (4.5%) and Zimbabwe (21.3%) recording the least and the highest respectively. In terms of HIV testing, the prevalence of HIV testing in the 30 SSA countries was 64.4%, with Guinea (12.8%) having the least. The highest occurred in Lesotho (99%) and Rwanda (99%). Women who had capacity to make decisions had higher likelihood of HIV testing [AOR=1.04, CI=1.02–1.09]. Women from Rwanda had the highest likelihood of HIV testing [AOR=53.92, CI=41.31–70.37] with women from Guinea having the least likelihood [AOR=0.10, CI=0.08–0.11]. Other determinants to HIV testing were level of education, wealth status, believing that a healthy-looking person can have HIV, watching television almost every day, age and place of residence.Conclusion SSA countries intending to improve HIV testing need to incorporate women decision-making capacity strategies in terms of education and counselling into the available policies. This is essential because our study indicates that as women are able to make decisions in their households, the possibility for them to test for their HIV status increases.
Estimation of pathogenic potential of an environmental Pseudomonas aeruginosa isolate using comparative genomics
Authors: Berger Carola , Rückert Christian , Blom Jochen , Rabaey Korneel , Kalinowski Jörn , Rosenbaum Miriam A. 
Published: February 2020

Abstract
BackgroundNew strains of Pseudomonas aeruginosa are continuously being isolated and sequenced to increase the genomic accessibility of this important pathogen. This has led to the generation of an impressive dataset of closed P. aeruginosa genomes. To understand the difference between the strains, investigations are focused on the accessory genome, thereby constantly extending the known pan genome of P. aeruginosa as a species. Apart from follow-up studies, many of the publicly available genomes are only used in their original publication while additional in silico information, based on comparison to previously published genomes, is not being explored. In this study, we defined and investigated the genome of the environmental isolate P. aeruginosa KRP1 and compared it to more than 100 publicly available closed P. aeruginosa genomes. ResultsPseudomonas spp. KRP1 could clearly be identified as a P. aeruginosa isolate, via comparative genomics. By using different genomic island prediction programs, we could identify a total of 25 genomic islands that cover ~12% of the genome of P. aeruginosa KRP1. Based on intra-strain comparisons, we are able to predict the pathogenic potential of this environmental isolate. It shares a substantial amount of its genomic information with the highly virulent PSE9 and LESB58 strains. For both of these clones, their increased virulence has been directly linked to their accessory genome before. ConclusionsHere we show, how the integrated use of previously published genomic data today, can help to replace expensive and time consuming wetlab work to determine the pathogenetic potential of environmental isolates. This knowledge is vital to understand what makes an isolate a potential pathogen as it helps design effective treatment.
Response of DREB transcription factor to drought stress based on DNA methylation in wheat
Authors: Zhu Yanqiu , Wang Huihui , Jia Wenjing , Wei Xiaoyan , Duan Zhikun , Qi Qianting , Jiang Lina , Zhou Yanqing , Duan Hongying 
Published: February 2020

Abstract
Background: The growth and development of wheat are seriously influenced by drought stress, and the research on drought resistance mechanism of wheat is very important. Dehydration responsive element binding protein (DREB) plays an important role in plant response to drought stress, but epigenetic regulation for gene expression of DREB transcription factor is less studied, especially the regulatory role of DNA methylation has not been reported.Results: In this research, DREB2, DREB6 and Wdreb2 were cloned from wheat in this study, their CDS sequence was composed of 732bp, 837bp or 1035bp, respectively, one 712bp intron was found in DREB6. Although AP2/EREBP domain of DREB2, DREB6 and Wdreb2 had 73.25% identity, they belong to different types of DREB transcription factor, and the expression of Wdreb2 was significantly higher, yet was the lowest in DREB2. Under drought stress, the expression of DREB2, DREB6 and Wdreb2 could be induced, but had different trends along with the increase of stress time, and their expression had tissue specificity, was obviously higher in leaf. Promoter of DREB2, DREB6 and Wdreb2 in leaf was further studied, some elements related to adverse stress were found, and the promoter of DREB2 and Wdreb2 was slightly methylated, but DREB6 promoter was mildly methylated. Compared with the control, the level of promoter methylation decreased in DREB2 and DREB6 as stressed for 2h, then increased along with the increase of stress time, which was opposite in Wdreb2 promoter, the status of promoter methylation also had significant change under drought stress. Further analysis showed that promoter methylation of DREB6 or Wdreb2 was negatively correlated with their expression, especially was significant in Wdreb2. Conclusions: DREB2, DREB6 and Wdreb2 might function differently in response to drought stress, and promoter methylation had more significant effects on gene expression of Wdreb2 and DREB6.
Measuring Clinical Uncertainty and Equipoise by Applying the Agreement Study Methodology to Patient Management Decisions
Authors: FAHED Robert , DARSAUT Tim E. , FARZIN Behzad , CHAGNON Miguel , Raymond Jean 
Published: February 2020

Abstract
Background: Clinical dilemmas in the treatment of patients translate into disagreements in decision-making. Such disagreements can reveal clinical uncertainty that should be addressed through care research. Our goal was to explore the use of reliability study methods to measure the degree of clinical uncertainty and equipoise regarding the use of rival management options prior to the conduct of randomized trials. Methods: The study design resembles an inter-/intra-observer diagnostic reliability study. A portfolio of a sufficient number of diverse individual patients sharing a similar clinical problem and covering a wide spectrum of clinical presentations can be independently submitted to a variety of clinicians who manage that problem. Clinicians are asked to choose one of the predefined management options that are involved in the clinical dilemma. Intra-rater agreement can be assessed at a later time with a second evaluation. Results: Descriptive statistics are presented, and results analyzed using kappa statistics. Interpretation of results can be facilitated by providing examples or by translating the results into clinically meaningful summary sentences. Reporting should follow standard guidelines. Conclusions: Measuring the uncertainty regarding management options for clinical problems may reveal disagreements, provide an empirical foundation for the notion of equipoise, and inform or facilitate the design/conduct of clinical trials to address the clinical dilemma.
VALENCIAN RECONQUEST CHURCHES. STUDY OF THE ARCHAEOLOGICAL REMAINS FOUND IN THE ALGEMESÍ CAPILLA DE LA COMUNIÓN
Authors: SENTAMANS J. García , PLAZAOLA I. Fernández , MONTESINOS J. V. Ferrandis , LANDETE A. Sáez 
Published: February 2020

Abstract
The present paper deals with the examination and research to the vestiges of an ancient church discovered in the basement of the Algemesí Communion Chapel, dating back to the beginnings of Christianity in the city. Considering the disposition of the constructive elements and the documented historical facts that date back to the first parish in the 13th century, it was deduced that the remains found were part of a temple with diaphragmatic arches and a woody roof. These facts are the paradigm of the ecclesiastical architecture that prevailed, by its execution speed, in the kingdom of Valencia after Jaime I reconquest. The study includes the comparison with other buildings of the same nature that allowed reconstructing its hypothetical volume, as well as the analysis of the techniques and materials that shaped its structure. Its identification ascribes another example to the Valencian protogothic architecture.
RESEARCH OF SINGLE ROOM DECENTRALIZED HEAT RECOVERY UNIT
Authors: KOPER Piotr , PALMOWSKA Agnieszka , MYSZKOWSKA Agnieszka 
Published: February 2020

Abstract
Mechanical ventilation systems with heat recovery units are one of the key elements of low energy residential buildings and it has gained increasing interest during the last years. This research presents experimental investigation of the work of the compact recuperator, as a part of the decentralized, single pipe ventilation system, in real conditions. An experimental study was carried out to obtain data for tested unit efficiency calculation, for supply and exhaust mode. The scope of measurement encompassed the air temperature and airflow rate. Tested recuperator fulfilled its role of ventilation with heat recovery, however, some deficiencies were indicated. As a result of measurements it has been noticed that it is possible to improve the device in the future. This possibility of improvement of this device was suggested in the conclusions.