bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Sedation Protocol on Sedation Level and Pharmacological and Non-Pharmacological Interventions on Mechanically Ventilated Patients
Authors: Namadian Masoumeh , Taran Zahra 
Published: July 2021

Background:
The use of analgesics and sedatives to provide sedation for Patients in Intensive Care Unit (ICU) is inevitable. The present study aimed to determine the effect of sedation protocol using the Richmond Agitation- Sedation Scale on sedation level and amount of pharmacological and non-pharmacological interventions on patients under mechanical ventilation.

Materials and Methods:
This randomized clinical trial was conducted on 79 patients under mechanical ventilation in Zanjan. The patients were recruited using the blocking randomized sampling method. In the experiment group, the sedation was provided hourly, using the Richmond sedation Protocol, during the mechanical ventilation period. The level of sedation and pharmacological and nonpharmacological interventions were compared in the two groups using Fisher exact test.

Results:
Totally, 40 patients in the experiment and 39 patients in the control groups were evaluated. No significant difference was found between the two groups in terms of confounding variables (age, sex, level of consciousness, Acute Physiologic and Chronic Health Evaluation (APACHE) II criterion, underlying disease, and cause of hospitalization). The level of sedation in the experiment group was significantly closer to the ideal score of the Richmond Scale compared to the control group (p < 0.001). The experimental group received significantly more non-pharmacological interventions and fewer pharmacological interventions compared to the control group (P < 0.001).

Conclusions:
Using a sedation protocol could provide better sedation levels in patients under mechanical ventilation, and reduce the use of sedative medications, and consequently, the cost of hospitalization. Further research is suggested.
The Patients' Experiences of Burden of Neurofibromatosis
Authors: Foji Samira , Mohammadi Eesa , Sanagoo Akram , Jouybari Leila 
Published: July 2021

Background:
Neurofibromatosis Type 1 (NF1) is a common autosomal disorder; the criteria for the diagnosis of NF1 includes café au lait spots, freckling, and Neurofibromas (NF). Skin symptoms have a major impact on patients' Quality of Life (QOL) but little is known about the burden of the disease on patients. The aim of this study was to explore the experiences of patients with NF.

Materials and Methods:
Using purposive sampling, 20 participants were enrolled in this qualitative content analysis study. The study was carried out between 2019 and 2020. Unstructured interviews and field notes were used to gather data. Data collection was stopped when data saturation was achieved.

Results:
Data analysis revealed 14 subcategories and 4 categories including “failing and falling behind in life”, “deprivation and restriction”, “social isolation”, and “ineffective adaptation to the disease”, which indicate the perception of patients with NF.

Conclusions:
In addition to the physical burden due to physical complications and problems, NF imposes a high degree of psychological and social burden on patients causing mental conflicts, which in turn results in them failing and falling behind in life. These findings illustrate the need to develop strategies and use multidisciplinary approaches to support patients, and thus to reduce the burden of NF.
The Effect of Reducing the Fasting Time on Postoperative Pain in Orthopaedic Patients
Authors: Torabikhah Mohsen , Yousefi Hojatollah , Ansari Amir-Hossein Monazami , Musarezaie Amir 
Published: July 2021

Background:
Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients.

Materials and Methods:
This randomized control trial was conducted between November 2017 and December 2018. Sixty-four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi-square and t-test.

Results:
The mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p > 0.05). The amount of the consumed morphine (t
61= -2.10, p = 0.039), pethidine (t
62= -2.25, p = 0.028), and diclofenac (t
62= -2.51, p = 0.015) were significantly different between the two groups.

Conclusions:
The pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.
Relationship between Cognitive-Behavioral Processes and Stages of Change in Nutrient Use in Overweight Women Referring to Health Centers in Isfahan
Authors: Namazi Nayerhe , Mostafavidarani Firozeh , Alavinaini Amirmansour , Boroumandfar Zahra 
Published: July 2021

Background:
The positive impact of post-needs assessment training on the correction of eating habits is remarkable. The aim of present study was to determine the relationship between cognitive-behavioral processes and stages of change in nutrient use in overweight women referring to health centers in Isfahan.

Materials and Methods:
The present study was a cross-sectional study conducted in 2017 during a three-month period. Using systematic random sampling, 260 overweight women referring to Isfahan comprehensive health centers were chosen. Data collection was performed by a four-part researcher-made questionnaire including demographic information form, stages of change of behavior, cognitive and behavioral processes questionnaire, and standard 168-item Food Frequency Questionnaire. After confirming its validity and reliability, it was completed by the researcher. Data were then entered N4 software perfect and analyzed using descriptive and analytical tests (ANOVA and Bonferroni Post-Hoc).

Results:
59.30% of the subjects were in an inactive and 40.70% in an active phase. There was a significant difference with respect to different stages of change and the use of all behavior change processes (F4= 11.42, p < 0.001). The rate of using cognitive and behavioral processes increased during the nutrient change behavior (p < 0.001).

Conclusions:
The results of the study showed that moving away from pre-contemplation stage to maintenance phase increases the rate of using these processes that is due to the stability and improvement of changed behavior. Therefore, health plans should be designed based on the stage of the target group.
The Relationship between Nursing Students' Quality of Life with their Academic Achievement Motivation in Isfahan University of Medical Sciences, Iran
Authors: Emamjomeh Seyedeh Mahtab , Toghyani Ali , Bahrami Masoud 
Published: July 2021

Background:
Quality of Life (QoL) and academic achievement motivation are important aspects of students' living and studying. There is a lack of studies to address the QoL of nursing students and its relationship with their academic achievement motivation in Iran. Therefore, the present study was conducted to investigate this relationship.

Materials and Methods:
This was a correlational study conducted with baccalaureate nursing students of Isfahan University of Medical Sciences, Iran, from December 2019 to February 2020. Data collection tools consisted of three parts: a demographic questionnaire, the World Health Organization QoL-Brief Questionnaire (WHOQOL-BREF), and the Hermans Achievement Motivation Questionnaire. Pearson correlation coefficient and standard multiple regression were used to evaluate the correlation between QoL mean domain scores and academic achievement motivation score.

Results:
The QoL mean (SD) domain scores of physical, psychological, social, environmental, and academic achievement motivation score were 14.95 (2.43), 13.42 (2.74), 13.96 (3.39), 13.62 (2.54), and 84.40 (7.73), respectively. Pearson correlations between physical, psychological, social, and environmental QoL mean domain scores with academic achievement motivation score was 0.30, 0.35, 0.12, and 0.22 (p < 0.05), respectively. Using standard multiple regression, psychological mean domain score (ß = 0.31) was the only statistically significant predictor of academic achievement motivation.

Conclusions:
Relationships exist between academic achievement motivation and QoL domains of nursing students, particularly in the psychological domain. This information provides policymakers to plan multi-faceted arrangements to improve nursing students' academic achievement motivation and QoL particularly in most neglected areas as the psychological aspect.
Identification and Isolation of Japanese Encephalitis Virus Genotype IV from Culex vishnui Collected in Bali, Indonesia in 2019
Authors: Faizah Astri Nur , Kobayashi Daisuke , Maekawa Yoshihide , Amoa-Bosompem Michael , Fauziyah Shifa , Mulyatno Kris Cahyo , Subekti Sri , Rohmah Etik Ainun , Lusida Maria Inge , Mori Yasuko , Miura Kozue , Hirayama Kazuhiro , Isawa Haruhiko , Sawabe Kyoko 
Published: July 2021

ABSTRACT.
Japanese encephalitis virus (JEV) is transmitted between swine, migratory birds, and Culex mosquitoes, and has circulated indigenously in Asia for almost a century. Despite being the country with the highest JEV diversity, surveillance targeting of Indonesia’s vectors is scarce. This study collected mosquitoes from several locations in Tabanan Regency, Bali Island, Indonesia. We captured and classified 3,032 adult Culex mosquitoes into seven species, with Culex vishnui subgroup mosquitoes making up approximately 90% of the total. Japanese encephalitis virus was identified by next-generation sequencing (NGS) analysis of a Cx. vishnui mosquito pool. Genetic and phylogenetic analysis revealed the JEV as genotype (G) IV. The nucleotide identity was 99% with other JEV GIV isolates obtained from swine sera in 2017 on Bali Island and from a human patient in Australia with a travel history to Bali in 2019. This finding indicated that JEV GIV persists in restricted areas and is circulating between swine-mosquito vectors.
Performance of a New Microfluidic Dengue NS1 Immuno-magnetic Agglutination Assay for the Rapid Diagnosis of Dengue Infection in Adults
Authors: Wongsawat Ekkarat , Suputtamongkol Yupin , Assanasaen Susan , Silpasakorn Saowaluk , Avirutnan Panisadee , Puttikhunt Chunya , Angkasekwinai Nasikarn , Yamasmith Eakkawit , Prommool Tanapan , Niwattayakul Kanigar 
Published: July 2021

ABSTRACT.
Dengue (DENV) infections are a public health concern worldwide and thus early diagnosis is important to ensure appropriate clinical management. The rapid diagnostic test (RDT) targets nonstructural protein 1 (NS1) detection and is the main tool used for diagnostic purpose. In this study, we evaluated the performance of a new rapid and semi-quantitative microfluidic DENV NS1 immuno-magnetic agglutination assay or IMA (ViroTrack Dengue Acute, BluSense Diagnostics, Copenhagen, Denmark). We studied 233 subjects confirmed to have DENV infection (by a real-time reverse transcriptase polymerase chain reaction) and 200 control samples were taken from patients with confirmed diagnoses of other febrile illnesses, in Thailand. Samples were tested using the NS1 antigen (Ag) detection methods: in-house NS1 Ag ELISA (ELISA), SD BIOLINE Dengue NS1 Ag RDT (ICT), and ViroTrack Dengue Acute (IMA). Sensitivities of these tests were 86.3%, 78.9%, and 85.5%, respectively. All tests showed high specificity (100%, 99%, and 97% for ELISA, ICT, and IMA, respectively). The sensitivities of both RDTs were affected by the low sensitivity to DENV-2 and DENV-4. NS1 Ag was detected in every patient on day 1 and day 2 after onset of illness by ELISA and IMA with a decline in detection rates over time after day 6 of illness. NS1 detection rate using ICT decreased from 100% on day 1 of illness to 98.6% on day 2 after onset of illness. By day 6, the detection rate was 45.9%. Thus, IMA performed better than ICT for early and rapid diagnosis of DENV infections in endemic countries.
Disparities in Physical Accessibility among Rural Thais Under Universal Health Coverage
Authors: Rojjananukulpong Rattanakarun , Ahmad Mokbul Morshed , Saqib Shahab E. 
Published: July 2021

ABSTRACT.
This study aims to explore various barriers in accessing outpatient care among the participants from different age groups and to identify determinants associated with physician visits. The study had adopted Andersen’s Behavioral Model (ABM) of Health Services Use. A cross-sectional study design was adopted to collect data from 417 participants through a questionnaire survey. Poisson regression models were used to explore determinants for explaining the differences in outpatient care use. The regression results revealed that divergent relationships existed among age groups. Children and elderly participants tended to decrease the probability of seeking care. Elderly participants confronted more difficulties in access and were dependent on family members. Despite free care provisions, participants visited and spent their out-of-pocket expenditure mostly at non-universal health coverage (non-UHC) facilities. Convenience and the availability of specialist physicians led the higher-income parents to seek care of their children at non-UHC facilities. Highly educated people of working age preferred more self-care or institutionalized care to save time. Children up to the primary level of education were more likely to visit a doctor. We concluded that investments in education or well-informed health services provision would improve health care utilization. Findings of Andersen’s Behavioral Model variables suggested that improvements in the quality of services, medical professional skills, and efficient resource allocation may induce seeking care at UHC facilities. Consequently, it will reduce the number of referred cases, caseloads at tertiary care units, and visits to non-UHC facilities at longer distances.
Accuracy of Two Circulating Antigen Tests for the Diagnosis and Surveillance of Schistosoma mansoni Infection in Low-Endemicity Settings of Côte d’Ivoire
Authors: Assaré Rufin K. , Tra-Bi Mathieu I. , Coulibaly Jean T. , Corstjens Paul L. A. M. , Ouattara Mamadou , Hürlimann Eveline , van Dam Govert J. , Utzinger Jürg , N’Goran Eliézer K. 
Published: July 2021

ABSTRACT.
In low-endemicity settings, current tools for the diagnosis and surveillance of schistosomiasis are often inaccurate in detecting true infection. We assessed the accuracy of an up-converting phosphor lateral flow circulating anodic antigen (UCP-LF CAA) test and a point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for the diagnosis of Schistosoma mansoni. Our study was conducted in eight schools of western Côte d’Ivoire. Fifty children, aged 9–12 years, were enrolled per school. From each child, a single urine specimen and two stool specimens were collected over consecutive days for diagnostic work-up. Urine samples were subjected to UCP-LF CAA and POC-CCA tests. From each stool sample, triplicate Kato-Katz thick smears were examined. Overall, 378 children had complete data records. The prevalence of S. mansoni, as assessed by six Kato-Katz thick smears, was 4.0%. The UCP-LF CAA and POC-CCA tests revealed S. mansoni prevalence of 25.4% and 30.7%, respectively, when considering trace results as positive, and prevalence of 23.3% and 10.9% when considering trace results as negative. In the latter case, based on a composite “gold” standard, the sensitivity of UCP-LF CAA (80.7%) was considerably higher than that of POC-CCA (37.6%) and six Kato-Katz thick smears (13.8%). The negative predictive value of UCP-LF CAA, POC-CCA, and six Kato-Katz thick smears was 92.8%, 79.8%, and 74.1%, respectively. Our results confirm that UCP-LF CAA is more accurate than Kato-Katz and POC-CCA for the diagnosis of S. mansoni in low-endemicity settings.
Serological Differences after Acute Zika Virus Infections between Children and Adults: Implication for Use of a Serological Test
Authors: Wongsawat Jurai , Suttha Patama , Chanama Sumalee , Srisopa Somkid , Yonchoho Nichapa , Limpanadusadee Putiporn 
Published: July 2021

ABSTRACT.
Information is limited regarding differential serological responses after acute Zika virus (ZIKV) infections and prevalence of cross-reactivity with anti-dengue virus (DENV) assays comparing children and adults. Early convalescent sera from a cohort of suspected mild DENV cases between December 2016 and September 2018 at Bamrasnaradura Infectious Diseases Institute in Thailand were tested for nonstructural protein 1 (NS1)–based anti-ZIKV IgM and IgG ELISAs (Euroimmun), and in-house anti-DENV IgM- and IgG-capture ELISAs. ZIKV cases were identified by positive real-time reverse transcriptase-polymerase chain reaction on urine. Sera from 26 (10 children and 16 adults) ZIKV and 227 (153 children and 74 adults) non-ZIKA cases collected at the median duration of 18 days (interquartile range [IQR] 18,19) post-onset of symptoms were tested. Comparing pediatric ZIKV to adult ZIKV cases, the mean anti-ZIKV IgM ratio was higher (2.12 versus 1.27 units, respectively; P = 0.07), whereas mean anti-ZIKV IgG ratio was lower (3.13 versus 4.24 units, respectively; P = 0.03). Sensitivity of anti-ZIKV IgM and specificity of anti-ZIKV IgG in pediatric ZIKV were higher than in adult ZIKV cases (80.0% versus 43.7% and 79.1% versus 43.2%, respectively). No cross-reactivity with anti-DENV IgM- and IgG-capture ELISA were reported in pediatric ZIKV cases in our study, whereas 25% and 12.5% were found in adult ZIKV cases, respectively. Age-related ZIKV serological differences have been observed. Positive NS1-based anti-ZIKV IgM and IgG ELISA at the early convalescent phase could be useful for ZIKV diagnosis in children, even in a dengue endemic setting.
The Burden of Snakebite in Rural Communities in Kenya: A Household Survey
Authors: Ooms Gaby I. , van Oirschot Janneke , Waldmann Benjamin , Okemo Dorothy , Mantel-Teeuwisse Aukje K. , van den Ham Hendrika A. , Reed Tim 
Published: July 2021

ABSTRACT.
Annually, about 2.7 million snakebite envenomings occur worldwide, primarily affecting those living in rural regions. Effective treatment exists but is scarce, and traditional treatments are commonly used. To inform context-specific policies in Kenya, this study aimed to determine the health-seeking behavior and the health, social, and economic burden of snakebites in rural communities. Nonprobability sampling was used to survey 382 respondents from four snakebite-endemic counties, from February to August 2020, using a structured questionnaire. Descriptive statistics, Fisher’s exact tests, binary logistic regressions, and Mantel-Haenszel tests were used for analysis. Life-time experience with snakebites included 13.1% of respondents who reported being personally bitten and 37.4% who reported knowing of a community member being bitten. Respondents reported death after a snakebite in 9.1% of bitten community members and in 14.6% of bitten family members. Risk of snakebite was not significantly associated with sex, educational level, or occupation. Snakebite victims were most often walking (38%) or farming (24%) when bitten. Of those bitten, 58% went to a health facility, 30% sought traditional treatment, and 12% first went to a traditional healer before visiting a facility. Significant differences existed in perceptions on the financial consequences of snakebites among those who had been personally bitten and those who had observed a snakebite. Most commonly mentioned preventive measures were wearing shoes and carrying a light in the dark. Community engagement, including engagement with traditional healers, is needed to reduce snakebites. This should be done through education and sensitization to improve used preventive measures and effective health-seeking behavior.
STUDENTS’ EXPERIENCES ON LEARNING LISTENING THROUGH TECHNOLOGY-BASED TOOL
Authors: Chi Pham Kim 
Published: July 2021

<p>Using technology tools in the classroom can now be facilitated students' engagement and self-directed learning to support a learner-centred environment in educational contexts under varied perspectives. In language learning, evaluating a particular language skill focused on technology is crucial in students' experience. EFL students face several difficulties as noise, accent, vocabulary, and pronunciation while listening. Therefore, employing listening with technology is significantly necessary to enhance students' listening skills. However, rare research has provided the students' reflection under constructivist perspectives after studying with the technology-based listening tool. Thus, the current study narrows this empirical gap. Semi-structured interviews and observation were instruments employed to collect data. Using thematic analysis (Braun and Clarke, 2006), the results of this study indicated that five themes were individualised listening, collaborative learning, self-directed learning, consideration of errors, and pronunciation improvement. Students were more engaged when listening to tasks independently, considering their errors for further improvement, and self-directed learning in this study. Additionally, they mostly perceived themselves to improve their listening and pronunciation in the future. Teachers should pay close attention to speakers' voices, accents, and feedback when designing and implementing tasks to maximise learners' listening learning process. This study has implications on using BookWidgets as a potential pedagogical tool for English courses.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0781/a.php" alt="Hit counter" /></p>
SOCIOECONOMIC AND CULTURAL CHALLENGES OF SYRIAN REFUGEE STUDENTS IN TURKISH UNIVERSITIES
Authors: Cam Yasin , Aydin Kemal 
Published: July 2021

<p>In this study, the economic and social problems faced by Syrian students who were forcefully migrated to Turkey and studied in Osmaniye Ata University were examined. Many people who immigrated to Turkey due to the civil war that began in Syria in 2011 and were children in those years have started their university education today. The problems faced by Syrian asylum-seeking students studying at universities in the city of Osmaniye in their ability to meet their vital needs, sources of income, participation in education and adaptation processes were examined. The data of the study was obtained through in-depth interview and survey work, then analyzed through a statistical package program. As a result of the study, it was observed that Syrian students studying at Osmaniye Korkut Ata University faced many different economic problems in the city of Osmaniye where they lived. Many problems that Syrian students experience in their educational lives are financial, and financial concerns directly affect their social lives. In addition, it was revealed that as their stay in Turkey extended, they may experience anxiety about resettlement when they are sent back to their country.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0779/a.php" alt="Hit counter" /></p>