bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea
Authors: Kidanemariam Betiel Yihdego , Elsholz Traudl , Simel Laban L. , Tesfamariam Eyasu H. , Andemeskel Yonatan Mehari 
Published: October 2020

Abstract
Background: Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and reducing the need for medication. This study aimed to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals.Methods: This was a descriptive cross sectional study conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVA were used to analyze the data. Statistical significance level was set at P < 0.05.Results: The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were mostly used while, cognitive-behavioral (5.9%) and physical methods (5.8%) were hardly used. The results also showed that, characteristics such as, age (p=0.013), level of education (p=0.012), work experience (p=0.001) and place of work (p=0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals were the only determinants of the non-pharmacological methods at multivariable level with a statistical significance of (p<0.001). On the perceived barriers; heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%), nurse’s lack of knowledge (50%) and experience (40.3%) were identified.Conclusion: The use of non-pharmacological methods in the studied hospitals varied greatly on the knowledge and experience of the nurses. Therefore, it is recommended that exposure and training for all health care providers at all level is a paramount importance in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.
Probing time-dependent afterslip and viscoelastic relaxation following the 2015 Mw 7.8 Gorkha earthquake based on the 3-D Finite Element Model
Authors: Su Lina , Shi Fuqiang , Gan Weijun , Su Xiaoning , Yan Junyi 
Published: October 2020

Abstract
We analyzed daily displacement time series from 34 continuous GPS stations in Nepal and 5 continuous GPS stations in South Tibet, China, and extracted the first 4.8 years of postseismic motion after the 2015 Mw7.8 Gorkha earthquake. With the longer duration GPS observations, we find that postseismic displacements mainly exhibit southward and uplift motion. To study the postseismic afterslip and viscoelastic relaxation, we built a 3-D spherical finite element model (FEM) with heterogeneous material properties and surface topography across the Himalayan range, accounting for the strong variations in material properties and surface elevation along central Himalayan arc. On the basis of the FEM, we reveal that the predicted viscoelastic relaxation of cm level moves southward to the north of the Gorkha earthquake rupture, but in an opposite direction to the observed postseismic deformation in the south; the postseismic deformation excluding viscoelastic relaxation is well explained by afterslip downdip of the coseismic rupture. The afterslip is dominant during 4.8 years after the 2015 Mw7.8 Gorkha earthquake; the contribution by the viscoelastic relaxation gradually increases slightly. The lack of slip on a shallow portion and western segment of the MHT during and after the 2015 Gorkha earthquake implies continued seismic hazard in the future.
The effect of perineural dexamethasone on rebound pain after ropivacaine single-injection nerve block: A randomized controlled trial
Authors: Fang Jie , Shi Yuncen , Du Fang , Xue Zhanggang , Cang Jing , Zhang Xiaoguang 
Published: October 2020

Abstract
Background: Rebound pain after a single-shot nerve block challenges the real benefit of this technique. We aimed to investigate whether perineural dexamethasone addition decreased the incidence of rebound pain after a single-shot nerve block.Methods: We randomly allocated 132 patients scheduled for open reduction internal fixation of an upper extremity closed fracture under single-shot peripheral nerve block and sedation into two groups. Patients in the dexamethasone group received nerve block with 0.375% ropivacaine and 8 mg dexamethasone, while those in the control group received ropivacaine only. Sixty-three patients in the dexamethasone group and 60 patients in the control group were analyzed for the incidence of rebound pain 48 h after block administration, which was the primary outcome. The secondary outcomes included the highest self-reported numeric rating scale (NRS) score, the pain intensity at 8 h, 12 h, 24 h, and 48 h after the block, sufentanil consumption, sleep quality on the night of surgery, patient satisfaction with the pain therapy, blood glucose at 6 h after the block, and pain and paresthesia at 30 days after surgery.Results: The incidence of rebound pain was significantly lower in the dexamethasone group (7 [11.1%] of 63 patients) than in the control group (28 [48.8%] of 60 patients; relative risk (RR) of 0.238, 95% CI 0.113-0.504, p=0.001). Dexamethasone decreased opioid consumption 24 h after surgery (p<0.001) and improved the sleep quality score on the night of surgery (p=0.01) and satisfaction with pain therapy (p=0.001). Multivariate logistic regression analysis showed that only group allocation was significantly associated with the occurrence of rebound pain[OR=0.062, 95% CI (0.015-0.256)]. Patients in the dexamethasone group reported later onset pain (19.7±6.6 h vs 14.7±4.8 h since block administration, mean±SD, p<0.001) and lower peak NRS scores [5 (3, 6) vs 8 (5, 9), median (IQR), p<0.001] than those in the control group.Conclusions: The perineural administration of 8 mg dexamethasone reduces rebound pain after a single-shot nerve block in patients receiving ORIF for an upper limb fracture.Trial registration: This study was retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17011365) on May 11th, 2017.
Impact of a Diagnostic Therapeutic Educational Pathway (DTEP) Self-Management Program for Asthma Management in Preschool Children
Authors: Guarnaccia Sebastiano , Quecchia Cristina , Festa Andrea , Magoni Michele , Zenoni Giuseppe , D'Agata Emanuele , Brivio Valentina , Zanardini Elena , Scarcella Carmelo , Gretter Valeria , Facchetti Susanna , Gasparotti Cinzia , Pluda Ada , Frassine Malica , Limina Rosa Maria , Spiazzi Raffaele , Badolato Raffaele , Bender Bruce , Donato Francesco 
Published: October 2020

Abstract
BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have yet been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that a real-world assessment of the integrated DTEP program for preschool children provides evidence for improved wheezing control and reduction of adverse therapeutic related outcomes.
Genome sequencing, assembly, and annotation of the self-flocculating microalga Scenedesmus obliquus AS-6-11
Authors: Chen Bailing , Mhuantong Wuttichai , Ho Shih-Hsin , Chang Jo-Shu , Zhao Xinqing , Bai Fengwu 
Published: October 2020

Abstract
Background: Scenedesmus obliquus belongs to green microalgae and is widely used in aquaculture as feed, which is also explored for lipid production and bioremediation. However, genomic studies of this microalga have been very limited. Cell self-flocculation of microalgal cells can be used as a simple and economic method for harvesting biomass, and it is of great importance to perform genome-scale studies for the self-flocculating S. obliquus strains to promote their biotechnological applications.Results: We employed the Pacific Biosciences sequencing platform for sequencing the genome of the self-flocculat ing microalga S. obliquus AS-6-11, and used the MECAT software for de novo genome assembly. The estimated genome size of S. obliquus AS-6-11 is 172.3 Mbp with an N50 of 94,410 bp, and 31,964 protein-coding genes were identified. Gene Ontology (GO) and KEGG pathway analyses revealed 65 GO terms and 428 biosynthetic pathways. Comparing to the genome sequences of the well-studied green microalgae Chlamydomonas reinhardtii, Chlorella variabilis, Volvox carteri and Micractinium conductrix, the genome of S. obliquus AS-6-11 encodes more unique proteins, including one gene that encodes D-mannose binding lectin. Genes encoding the glycosylphosphatidylinositol (GPI)-anchored cell wall proteins, and proteins with fasciclin domains that are commonly found in cell wall proteins might be responsible for the self-flocculating phenotype, and were analyzed in detail. Four genes encoding both GPI-anchored cell wall proteins and fasciclin domain proteins are the most interesting targets for further studies.Conclusions: To our best knowledge, this is the first report on the in-depth annotation of the S. obliquus genome, and the results will facilitate functional genomic studies and metabolic engineering of this important microalga. The comparative genomic analysis here also provides new insights into the evolution of green microalgae. Furthermore, identification of the potential genes encoding self-flocculating proteins will benefit studies on the molecular mechanism underlying this phenotype for its better control and biotechnological applications as well.
Addition of routine blood biomarkers to TIMI risk score improves predictive performance of 1-year mortality in patients with ST-segment elevation myocardial infarction
Authors: Oh Pyung Chun , Eom Young Sil , Moon Jeonggeun , Jang Ho-Jun , Kim Tae-Hoon , Suh Jon , Kong Min Gyu , Park Sang-Don , Kwon Sung Woo , Suh Soon Yong , Lee Kyounghoon , Han Seung Hwan , Ahn Taehoon , Kang Woong Chol 
Published: October 2020

Abstract
Background: Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods: A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase >twice the normal upper limit and glucose <90 or >250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR, 2.019; 95% CI, 1.104-3.695), dysglycemia (HR, 2.535; 95% CI, 1.324-3.923), anemia (HR, 2.071; 95% CI, 1.093-3.923), and high NLR (HR, 3.651; 95% CI, 1.927-6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p<0.001), and the NRI and IDI were estimated at 0.203 (95% CI, 0.130-0.275; p<0.001) and 0.089 (95% CI, 0.060-0.119; p<0.001), respectively. Conclusions: The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.
Assessing Health Literacy in Iran: An Image in Two Frames
Authors: Rastegari Hoda , Schulz Peter J. 
Published: October 2020

Abstract
Background: The aim of this study is to draw a comprehensive picture of patients’ functional and critical health literacy and its association with socio-demographic variables and self-efficacy. We investigated the referrals to Isfahan health centers, in particular the dimensions of reading ability, numeracy and eHealth literacy using two different measures, NVS for the functional and the eHEALS for critical aspects. Methods: For testing individuals with low health literacy, the NVS is a reliable and quick screening tool. eHEALS helps to measure patients’ capabilities in Internet searches. Both of tools are validated in Persian. The measures were administered to a random sample (N = 384), which resembled Iran residents in terms, educational attainment and self-efficacy but not age and gender. Pearson’s correlation coefficient, χ2-test, independent t-test and regression were also used to assess the association between health literacy measures, self-efficacy and predictor variables. Results: More than 60% of our respondents had an inadequate or marginal level of health literacy with NVS, and with eHEALS, more than 50% were classified accordingly. NVS and eHEALS scores showed an association with higher education one of the predictors of health literacy. Higher eHEALS scores were associated with higher self-efficacy. eHEALS provides a valid self-reported assessment of patients’ eHealth literacy, and NVS provides a useful appraisal of patients’ functional health literacy. Conclusions: In our sample, more than 50% of patients had a low level of literacy. eHEALS provides a valid self-reported assessment of patients’ eHealth literacy, and NVS provides a useful appraisal of patients’ functional health literacy. Determining health literacy in patients leads to a better understanding of their perception, application and decision-making in health problems.
Construction of Anti-codon Table of the Plant Kingdom and Evolution of tRNA Selenocysteine (tRNASec)
Authors: Mohanta Tapan Kumar Kumar , Mishra Awdhesh Kumar , Hashem Abeer , Abd_Allah Elsayed Fathi , Khan Abdul Latif , Al-Harrasi Ahmed 
Published: October 2020

Abstract
Background The tRNAs act as a bridge between the coding mRNA and incoming amino acids during protein translation. The anti-codon of tRNA recognizes the codon of the mRNA and deliver the amino acid into the protein translation chain. However, we did not know about the exact abundance of anti-codons in the genome and whether the frequency of abundance remains same across the plant lineage or not. Results Therefore, we analysed the tRNAnome of 128 species and reported an anti-codon table of the plant kingdom. We found that CAU anti-codon of tRNAMet has highest (5.039%) whereas GCG anti-codon of tRNAArg has lowest (0.004%) abundance. However, when we compared the anti-codon frequencies according to the tRNA isotypes, we found tRNALeu (7.808%) has highest abundance followed by tRNASer (7.668%) and tRNAGly (7.523%). Similarly, suppressor tRNA (0.036%) has lowest abundance followed by tRNASec (0.066%) and tRNAHis (2.109). The genome of Ipomoea nil, Papaver somniferum, and Zea mays encoded the highest number of anti-codons at 59 each whereas the genome of Ostreococcus tauri was found to encode only 18 isoacceptors. The tRNASec genes undergone losses more frequently than duplication and we found that tRNASec showed anti-codon switch during the course of evolution.Conclusion The anti-codon table of the plant tRNA will enable us to understand the synonymous codon usage of the plant kingdom and can be very helpful to understand which codon is preferred over other during the translation.
Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey
Authors: Orwa James , Gatimu Samwel Maina , Mantel Michaela , Luchters Stanley , Mugerwa Micheal A. , Brownie Sharon , Subi Leonard , Mrema Secilia , Nyaga Lucy , Edwards Grace , Mwasha Loveluck , Isangula Kahabi , Selestine Edna , Jadavji Sofia , Pell Rachel , Mbekenga Columba , Temmerman Marleen 
Published: October 2020

Abstract
Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7% and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
Incident reports involving hospital administrative staff: analysis of data from the Japan Council for Quality Healthcare nationwide database
Authors: Akiyama Naomi , Akiyama Tomoya , Hayashida Kenshi , Shiroiwa Takeru , Koeda Keisuke 
Published: October 2020

Abstract
Background: Task shifting and task sharing in healthcare are rapidly becoming more common as the shortage of physicians increases. However, research has not yet examined the changing roles of hospital administrative staff. This study clarified: (1) the adverse incidents caused by hospital administrative staff, and the direct and indirect impact of these incidents on patient care; and (2) the incidents that directly involved hospital administrative staff. Methods: This study used case report data from the Japan Council for Quality Healthcare collected from April 1, 2010 to March 31, 2019, including a total of 30,823 reports. In April 2020, only the 88 self-reported incidents by hospital administrative staff were downloaded, excluding incidents reported by those in medical and co-medical occupations. Data from three reports implicating pharmacists were rejected and the quantitative and textual data from the remaining 85 case reports were analyzed in terms of whether they impacted patient care directly or indirectly.Results: Thirty-nine reports (45.9%) involved direct impact on patient care, while 46 (54.1%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n=24, 61.5%); followed by errors related to system administration, information, and documentation (n=7, 17.9%). Most reported errors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n=22, 47.8%), or to reception (n=9, 19.6%). Almost all errors occurred during weekdays. Most frequent incidents involved outpatients (n=23, 27.1%), or occurred next to examination/operation rooms (n=12, 14.1%). Further, a total of 14 cases (16.5%) involved patient misidentification. Conclusions: Incidents involving hospital administrative staff, the most common of which are medication errors from incorrect prescriptions, can lead to severe consequences for patients. Given that administrative staff now form a part of medical treatment teams, improvements in patient care may require further submission and review of incident reports involving administrative staff.