bluuebunny/crossref_metadata_2025_split huggingface dataset:
The risk factors related to operative duration and its relationship with clinical outcome in pediatric patients undergone Roux-en-Y hepaticojejunostomy
Authors: Li Ang , Gao Kai , Liu Qingshuang , Chen Jingyu , Guo Chunbao 
Published: March 2020

Abstract
Background: The operative duration might be important for perioperative morbidity and the involvement has not been fully characterized in pediatric patients. We here determined the perioperative variables in association with operative duration and its influence on the clinical outcome in the pediatric patients.Methods: We retrospectively reviewed 701 patients who underwent elective choledochal cysts followed by Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the median operating time (165 min), patients were separated into two groups, including a long-time group (>165 min) and a short-time group (<165 min). The independent risk factors for the operative time were determined usng the multivariable logistic regression analyses. To adjust for any potential selection bios, propensity score matching was performed for the long-time and short-time groups. In the 192 matched patients, perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay were analyzed.Results: The operating time was often increased by excision difficulty caused by the lager choledochal cyst size (OR=1.56; 95% CI, 1.09-2.23; p<0.001), the greater BMI(OR=1.02; 95% CI, 1.00-1.15; p=0.018), older age (OR=1.17; 95% CI, 1.02-1.39; p=0.012) under multivariate analysis. The long-time surgical duration was associated with delay for gastrointestinal functional recovery, measured with the first defecation (p=0.027) and first bowel movement (p=0.019). Moreover, a significant decrease in serum albumin were presented in the long-time group compared with the short time group (p=0.0035). The total length of postoperative hospital stay was longer in patients with long-time group (7.51±2.03 days) than patients with short-time group (6.72±1.54 days, p = 0.006).Conclusions: Our data demonstrated that short operating time was associated with favorable postoperative results. The influencing factors for operating time could be ameliorated in the perioperative period to gain a better outcome after major abdominal operations.
Exploring Determinants of Hand Hygiene among Hospital Nurses: A Qualitative Study
Authors: Ghaffari Mohtasham , Rakhshanderou Sakineh , Safari-Moradabadi Ali , Barkati Hassan 
Published: March 2020

Abstract
Background: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. Methods: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. Results: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). Conclusion: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.
Barriers and challenges against the utilization of novel teaching methods for nursing students from the perspective of nursing instructors
Authors: bijani Mostafa , Moradi Zahra , Karimi Shahnaz , Fereidouni Zhila , Nikrooz Leila , Hatami Mahmood , Naghizadeh Mohammad Mehdi 
Published: March 2020

Abstract
Background: The first step in efficient application of novel teaching methods is identification of barriers and challenges in order to perform appropriate interventions. Various studies have emphasized the utilization of novel methods in instruction of nursing students. However, there are barriers and challenges against the use of these techniques. Therefore, the present study aimed to investigate the challenges and executive barriers against the utilization of novel approaches in instructing nursing students from the perspective of nursing instructors. Methods: In this descriptive-analytical study, 150 nursing instructors were selected through census from three nursing schools in Fars province, southwest of Iran in 2019. The study data were entered into the SPSS 22 software and were analyzed using statistical tests, frequency distribution, mean, standard deviation, t-test, and one-way ANOVA. Results: The effective challenges against the utilization of novel teaching methods were classified into three domains as follows: challenges related to students, challenges related to instructors, and structural-managerial challenges. Considering the challenges associated with students, the highest score was related to the students’ lack of familiarity with novel teaching methods. Regarding the challenges associated with instructors, the highest scores were related to the instructors’ unfamiliarity with novel teaching methods and lack of mastery and skills. Finally, the large number of students and lack of support and encouragement on the part of educational institutions obtained the highest scores in the field of structural-managerial challenges. The results of independent t-test revealed a significant relationship between gender and educational degree in all three domains (p<0.001). The results also showed a significant relationship between work experience and the scores of the three domains (p<0.001). Conclusion: Application of novel approaches in nursing education requires infrastructures as well as elimination of executive barriers. Instructors’ and students’ familiarity with novel techniques and their execution processes and educational institutions’ support could contribute to the effectiveness of these methods, as well.
The association between clinical phenotype of Parkinson’s disease and LRRK2 variants in China
Authors: cui shishuang , li gen , lin yiqi , he yixi , zhang pingchen , he guiying , sun qian , tan yuyan , chen shengdi 
Published: March 2020

Abstract
Introduction: LRRK2 G2385R and LRRK2 S1647T have been identified as the most common risk variants for PD in the Chinese population. The aim of the study was to explore the correlation of LRRK2 G2385R, LRRK2 S1647T and their haplotypes with symptoms. Method: Demographic variables, disease-related variables and motor and non-motor assessments was collected in the study. Peripheral blood samples were collected, and DNA was extracted. SNaPShot technique was used to analysis DNA genotype. Chi square test and ANOVA was used to test the between-group differences. Risk analysis was performed by logistic regression model or Cochran-Armitage model. Results: 502 PD patients were enrolled in the study. The scores of PDSS and MoCA were significant higher in LRRK2 S1647T variants carriers genotype after adjustment. The scores of BPI, attention in NMSS, cardiovascular in SCOPA-AUT was significant lower in LRRK2 G2385R variants carriers adjusted for H-Y stage and gender. LRRK2 ARG 2385 was associated with reduced risk of sialorrhea (p=0.049, additive model) and postural hypotension (p=0.030, additive model; OR=0.35, 95%CI: 0.10-0.89, adjusted P=0.050, dominant model). rs11564148A rs34778348A was also found associated with a reduced risk with postural hypotension adjusted for H-Y staging and gender. Conclusion: Our study indicated that LRRK2 S1647T variants carriers presented better motor symptoms, sleep quality and cognition. LRRK2 G2385R variants carriers presented better autonomic function and cognition and had a reduced risk of sialorrhea and postural hypotension. rs11564148A - rs34778348A was associated with reduced risk with postural hypotension.
The effect of driving simulator program on elderly drivers
Authors: Kim Deokju 
Published: March 2020

Abstract
Background: The purpose of the present study was to present evidence for driving interventions for the elderly by conducting programs that can improve visual perception and cognitive function in a driving simulator for elderly drivers and analyse their effects.Methods: Three elderly subjects who were 65 years or older, did not have physical and cognitive impairments, and were able to drive themselves participated in the present study. A total of 12 intervention sessions, of which subjects participated in 10 sessions of nine different visual perception and cognitive function programs available in a driving simulator, were conducted and pre- and post-program assessments were conducted (two assessments in total). The assessments included the evaluation of visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy.Results: The results showed positive effects of the driving simulator program on the visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy of all subjects. Changes in the simulator results showed remarkable improvement in the response evaluation, judgment evaluation, and predictive power evaluation, but showed difficulties in interference tasks and depth perception in common.Conclusions: The results showed positive effects of driving simulator training on the driving ability of the elderly, and consistent provision of such training is expected to improve the quality of life of the elderly by securing the safety of driving and actively supporting social participation.
Outcomes Evaluation after Application of Multidisciplinary Protocol of Shared Hospital Care in Patients Aged 65 Years and Older and Operated for Hip Fracture
Authors: Marín Jorge Salvador , Martinez Francisco Javier Ferrández , Ripoll José Miguel Seguí , Rico José Antonio Quesada , Beltrán Domingo Orozco , Munuera María Concepción Carratalá , López José Fernando Martínez , Campos Juan Carlos Marzo 
Published: March 2020

Abstract
Purpose: In geriatric patients, hip fracture is considered the greatest complication of osteoporosis in terms of morbidity, mortality, and cost. The aim of this study is to assess the effects of a multidisciplinary shared care protocol (trauma services, internal medicine, emergencies, anesthesia, nursing, hematology, pharmacy, rehabilitation, home hospitalization unit, and social services) on hospital stay and in-hospital mortality in inpatients aged 65 years or older and operated for hip fracture.Methods: Retrospective cohort study between January 2011 and December 2017. The unexposed group was made up of patients who did not receive care according to the multidisciplinary protocol, while the exposed group did. We excluded patients with polytrauma, conservative treatment, bilateral hip fracture, pathological fracture, or previous fracture already included in the series. Variables analyzed were demographic data, medical comorbidities, Charlson index, hemoglobin levels, hematocrit and blood transfusion, antiplatelet drugs, length of surgical delay, length of hospital stay, in-hospital mortality, and a composite risk outcome considering in-hospital mortality and/or hospital stay of more than 10 days. We fit a multivariable logistic regression model to calculate the odds ratio (OR) of experiencing outcomes.Results: The cohort included 681 patients: 310 were unexposed and 371, exposed. Compared to the unexposed group, patients receiving protocolized multidisciplinary care showed significantly lower in-hospital mortality (3.5% versus 7.7%; p = 0.015) and were less likely to have a hospital stay of more than 10 (16.4% versus 24.2%; p = 0.012). Mean length of hospital stay was 0.7 fewer days in the exposed group. Multivariable analysis showed the composite risk outcome was 51% lower in the exposed group, after adjusting for age, sex, heart failure, days to surgery, blood transfusion after surgery, and postoperative hemoglobin levels.Conclusion: Implementing the multidisciplinary shared care protocol halved the risk of in-hospital mortality and/or a hospital admission of more than 10 days in patients over 65 years with proximal femur fracture. It also reduced mean length of hospital stay.
Comparative effectiveness of low-level laser therapy and transcutaneous electric nerve stimulation in the treatment of pain caused by temporomandibular joint disorders: a systematic review and network meta-analysis
Authors: Ren Hui , Liu Jingying , Liu Yang , Yu Caiyun , Bao Guangjie , Kang Hong 
Published: March 2020

Abstract
Background: The comparative effectiveness of low-level laser therapy (LLLT) and transcutaneous electric nerve stimulation (TENS) in the treatment of pain caused by temporomandibular joint disorders (TMD) has not been evaluated.Methods: PubMed, Cochrane Library and Embase were searched from their inception until 27 October 2019. Randomized controlled trials (RCTs) that compared the effects of LLLT or TENS or placebo group for TMD patients’ pain reduction were included. The reviewers assessed the risk of bias of individual studies with the Cochrane risk of bias tool, excluding RCTs with a high risk of bias in any domain. Then the reviewers did network meta-analysis and assessed the quality of evidence contributing to network estimate using the GRADE framework.Results: 20 RCTs with 758 patients with TMD were included. In the pair-wise meta-analysis, LLLT and TENs showed a significant pain reduction in the visual analogue scale (VAS) compared with placebo immediately after treatment [mean difference (MD)=1.99, 95% confidence interval (CI):(1.07,2.92); MD=2.16, 95%CI:(0.27,4.04), respectively]. As for pain reduction one month after treatment, LLLT performed better and there was no statistically significant difference for TENS as compared with placebo. Conclusion: The results of this meta-analysis showed the short-term efficacy of LLLT is more positive than TENS in the treatment of pain caused by temporomandibular joint disorders.
Impact of water quality on Chronic Kidney Disease of unknown etiology (CKDu) in Thunukkai Division in Mullaitivu District, Sri Lanka
Authors: Gobalarajah Kalaivani , Prabagar Subramaniam , Jayawardena Uthpala , Gobalarajah Rasiah , Rajendra Subramaniam , Prabagar Jasotha 
Published: March 2020

Abstract
Background

Increase in the number of cases in Chronic Kidney Disease of Unknown etiology (CKDu) in Sri Lanka has become an environmental health issue of national concern. Even though, Northern Province is not identified as a high risk province, there is an increasing trend of CKDu after the end of civil war in the Northern territory.

Methods

The present study was conducted in Thunukkai Division in Mullaitivu District to investigate the socio demographic and clinical pattern of CKDu patients and to evaluate the quality of their water sources. The samples were selected by using stratified purposive random sampling method which represented 29% of total CKDu patients in Thunukkai Division. Pretested structured questionnaire was administrated to collect the data from CKDu patients.

Results

Among the patients, 80% of them were male with an age range of 30-80, majority (88%) involved in farming. 26% and 20% of people were engaged in smoking and taking alcohol, respectively. 17% and 43% were suffered with diabetes and hypertension, respectively. Physicochemical characteristics of more than 50% of the water samples recorded higher electric conductivity, salinity, total dissolved solids, total hardness and Na levels compared to drinking water standards in Sri Lanka.

Conclusions

The association between serum creatine excreted by CKDu patients and water quality parameters were determined by using regression model, revealing a significant negative relationship with phosphate and positive relationship with Total Dissolved Solid and arsenic content of the drinking water. Thus, the study suggests, total dissolved solid and arsenic in drinking water have a positive correlation with CKDu in Thunukkai region in the Mullaitivu District.
Teaching scientific principles in undergraduate medical education – a scoping review on international examples
Authors: Vonneilich Nico , Kurth Sven 
Published: March 2020

Abstract
Background The constant growth of medical scientific knowledge, stronger calls for evidence based medicine and changing roles of physicians are examples for the relevance of teaching scientific principles in undergraduate medical education. The acquisition of scientific skills is comparably weak in undergraduate medical education. This scoping review addresses the following questions: Which examples on teaching scientific principles in undergraduate medical education can be identified in international literature? What is known regarding their educational success and how can they be integrated into undergraduate medical curricula? Methods A systematic scoping review search was conducted in PubMed. Criteria for eligibility were English or German language, publication in a peer-reviewed journal, publication date after 1 st of January 2000 and the publications had to report educational interventions in undergraduate medical education on one of the following basic scientific principles: searching literature, formulating scientific questions, reading and critical appraisal of literature, writing, presentation and understanding of the research process. After full-text screening, 29 studies were included in the analysis. Results Educational interventions focused on literature search (N=14), critical appraisal of scientific publications (N=13) and the formulation of scientific questions (N=13). Evaluation data were included in 16 publications. Outcomes included measures of student satisfaction, student knowledge and scientific competence based on tested instruments. Results were quite heterogeneous regarding the success of educational interventions. Conclusions Publications in this field of medical education vary considerably regarding reporting of results and inclusion of evaluation data, making a comprehensive analysis of the educational interventions a difficult task. Nevertheless, some ideas for the implementation of scientific principles in undergraduate medical education can be named. Student knowledge of and student attitude towards scientific principles in medical education can be fostered by integrating different didactic approaches, by including self-study time and by integrating these principles vertically in undergraduate medical curricula along with clinical aspects.
Headache, Outpatient management and referral to Specialty Clinics, clinical Audit
Authors: Mohammed Sallam Taha , Ragab Abdelgalil Ali , Tayyab Syed Muhammad 
Published: March 2020

Background:
Headache is one of the most common presenting symptom for patients attending the outpatient
clinics. The key stone in primary management of cases presented with headache, and then subsequent proper
referral to specialty clinics, depends on careful history taking and clinical examination.

Objective:
The aim of this audit is to get a comprehensive idea about patients presented with headache in the
Outpatient Department (OPD) clinics including patients age, gender, primary management and subsequent referral
to specialty clinics in Hatta hospital. So we can reevaluate and improve our clinical approach in dealing with
patients having headache.

Method:
This study is a retrospective study based on hospital settings and was conducted in 2015 over one year in
Hatta hospital, Dubai. We collected information about patients who attended the OPD with headache as the
primary complaint.

Results:
One hundred eighty patients above the age of 4 years were selected. Females patients were 125(69.4%)
while males were 55(30.6%).The age of most patients suffering from headache range from 15 – 40 years.
Hypertension was found in 20 cases, while diabetes mellitus was diagnosed in 6 cases. Radiological studies (Plain
X‐ray and/or Computerized Tomography) were done in 114 patients (63.3%). Most common causes of headache
encountered in this study were tension headache, migraine and sinusitis.

Conclusion:
The history and clinical examinations usually permit a definitive diagnosis for patients with headache.
Radiological and blood investigations were overused in assessment of patients. Change of life style is important as
part of management plan.
Social Media and Medical Professionalism in the United Arab Emirates
Authors: Han Aaron 
Published: March 2020

:
Social media is increasingly used as a platform by medical providers. The
positive contribution is also balanced by risks and governed by codes of professionalism
by the medical community. The values of medical professionalism include universal
tenets and also those unique to the Arab world and the United Arab Emirates. We
propose that institutional guidelines and self governance in the medical community is
important, as well as further dialogue on this important subject.
Project Manager Interventions in Occupational Health and Safety During the Pre-construction Phase in the Gaza Strip
Authors: Tayeh Bassam A. , Yaghi Rola O. , Abu Aisheh Yazan I. 
Published: March 2020

Background:
Construction industry is classified as one of the most dangerous industries, where workers are exposed to accidents and risks.

Objective:
This study inspected the role of project manager in promoting Occupational Health and Safety (OHS) during the pre-construction phase in the construction projects in the Gaza Strip. Previous studies were reviewed in order to extract the impact of inadequate health and safety interventions in the construction projects throughout the world, and their applicability in the Gaza Strip was determined.

Methods:
This was achieved through a pilot study and a draft questionnaire. The questionnaire was developed in order to assess and evaluate the perception of project managers on the extent of their roles in promoting health and safety in the pre-construction phase. The sample size was 101, out of which, 77 completed questionnaires were returned by the respondents.

Results:
The study revealed that two project parameters, mainly affected by inadequate health and safety interventions, were quality and labour productivity. The main stage during which a project manager played a significant role in promoting health and safety was the planning stage, with “identifying specific safety issues from prior experience” being the highest sub-factor, which was followed by the designing stage, with “plan works at the design phase through a time schedule, citing the duration of processes, divided into steps and any process priority” being the highest sub-factor.

Conclusion:
Finally, there was the tendering stage, with “make ensure that facilities are provided on site for first aid and emergency medical treatment in the event of an accident” being the highest sub-factor. The results of this study show great awareness of a project manager in promoting health and safety in the pre-construction phase.