bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived Job Demands: A Qualitative Study of Stress in Healthcare Workers after Organizational Changes
Authors: Zeinolabedini Masoume , Heidarnia Alireza , Nejad Ghodratollah Shakeri , Motlagh Mohammad Esmaeil 
Published: March 2021

Abstract
BackgroundHealth care workers (HCWs) are at risk for occupational stress. The negative effects of stress HCWs subsequently affect the quality of their job performance. Since 2014, there have been extensive changes in the primary health care system in Iran. Because evidence has shown that organizational change can cause stress in employees, this study was designed and conducted to explore the perceived job demands by HCWs in primary care centers after extensive organizational change.MethodA qualitative study was designed with a content analysis approach. Study data were collected through 11 semi-structured individual interviews and a focus group with HCWs.ResultsParticipants reported high stress at work. They reported various factors as stressful job demands. These factors included: organization's supervisory function (Weakness of the monitoring process, Unfair policies, Apply regulatory pressure), Role features (Role load, Role conflicts, Role ambiguity(,Workload )High workload, Not having time, Great variety of tasks), job insecurity (Lack of job security due to employment status, Concerns about payments, Lack of physical security, Uncertain job future), Working with clients (Different characteristics of clients, Harassment of clients to achieve their expectations, Tensions in client relationships, Lack of knowledge of clients about health care work instructions), Perceived job content (Annoying work with different units of the organization, Monotonous and repetitive tasks, Meaningless tasks, No attractive and no excitement).ConclusionCurrently, HCWs working in health centers are faced with various stressful situations. Most of the factors identified in this study overlap in increasing stress. The impact of workload and organizational oversight on occupational stress seems to be more pronounced. Given the important role of HCWs in promoting health, the design and implementation of effective interventions by policymakers to control stress in HCWs is essential.
The diagnostic value of HPV E6/E7 mRNA test in young women with cervical squamous intraepithelial lesion: A Retrospective Analysis
Authors: Wang Jing , Xu Xiaomin 
Published: March 2021

Abstract
Background At present, the HPV DNA test is used to triage young female patients with abnormal cytology. Still, it is not suitable to precisely identify the population with persistent HPV infection. The purpose of this study was to evaluate the diagnostic value of HPV E6/E7 mRNA test in young women with abnormal cytology by comparing HPV DNA test.Methods A total of 258 young women aged 20 to 29 years,with squamous cell abnormalities on the cervical cytology, were enrolled in this study between January 2015 and December 2019.All patients were subject to HPV DNA test, HPV E6/E7mRNA test,colposcopy biopsy, and histopathological examination.A comparative analysis of the diagnostic performance of the HPV DNA test and HPV E6/E7mRNA test was conducted according to the histological diagnosis(CIN II and CIN II+were defined as high-grade squamous intraepithelial lesion+(HSIL+)).Results The results showed that HPV E6/E7 mRNA test had a higher specificity of 47.3%(40.0%-55.1%) for HSIL+ compared to HPV DNA test that had specificity of 16.0% (11.0%-22.6%)in young women(P<0.01). The HPV E6/E7 mRNA test presented high rates of specificity,positive predictive value (PPV), and negative predictive value(NPV), which were 92.1%(86.0%-96.0%), 62.1%(42.4%-78.7%), 92.1%(85.9%-95.8%), respectively, compared to that of HPV DNA,which were 15.8%(10.4%-23.2%),14.6%(9.40%-21.9%), and 71.0%(51.8%-85.1%),respectively(P<0.01)in young women with mildly abnormal cytology(ASC-US and LSIL). Yet, with severe abnormal cytology(ASC-H and HSIL), HR-HPV test was similar to HPV E6/E7 mRNA test in sensitivity(χ2=0.98,P=0.322),specificity(χ2=0.938,P=0.333),PPV(χ2=0.074,P=0.786) and NPV(χ2=0.00,P=1.000).Conclusions Compared to the HPV DNA test,the HPV E6 /E7mRNA test has better clinical value in screening cervical cancer and predicting the risk of HSIL+ in young women, especially those with mild abnormal cytology.
Differences in characteristics between definite vestibular migraines, migraines with vestibular symptoms that do not meet vestibular migraine criteria, and migraines without vestibular symptoms: A cross-sectional study through the lens of central sensitization
Authors: Toriyama Toshihide , Hanaoka Yoshiki , Horiuchi Tetsuyoshi 
Published: March 2021

Abstract
Background: The demographic and clinical characteristics of vestibular migraine (VM) based on the International Classification of Headache Disorders (ICHD)-III beta are not well documented, and the underlying pathophysiology remains largely unknown. Based on evidence that central sensitization is involved in VM pathogenesis, we hypothesized that cutaneous allodynia (CA), which is a clinical manifestation of central sensitization, and interictal widespread pressure hyperalgesia (IWPH), which may be an accelerator for central sensitization, are more frequently associated with VM patients compared with non-VM patients. The aim of this study was as follows: 1) to assess differences in demographic and clinical characteristics among VM patients, patients with migraine with vestibular symptoms not meeting VM criteria (MwVS), and patients with migraine without vestibular symptoms (MwoVS); and 2) to evaluate whether VM patients were more frequently associated with CA/IWPH compared with the other two groups.Methods: This cross-sectional study enrolled consecutive migraine patients, aged 18–65. The comprehensive interview form included diagnostic questions of migraine and VM, demographic characteristics, migraine-specific variables, migraine-associated symptoms, and CA. IWPH occurrence was investigated using a manual tender point survey and clinical parameters were compared.Results: A total of 245 episodic migraineurs (mean age = 39.5 ± 11.3 years, 81.2% women) were enrolled. Based on ICHD-III beta criteria, 65 (26.5%), 74 (30.2%), and 106 (43.3%) patients were assigned to the VM group, MwVS group, or MwoVS group, respectively. Pairwise comparisons demonstrated no significant differences between the VM and MwVS groups, except for higher occurrence of headache disability in the VM group. Compared with the MwoVS group, the VM group was significantly associated with aura, severe disability, depression, tinnitus, sleep disorders, multimodal CA, and IWPH.Conclusions: There were no significant differences in clinical features between VM and MwVS groups, except for disability, which was possibly caused by criteria selection bias. VM and MwVS may be on the same disease process spectrum. Widespread multimodal CA, including clinical manifestations of thalamic sensitization, was significantly associated with VM patients compared with MwoVS patients, which indicates that thalamic sensitization may play a key role VM pathogenesis. Furthermore, IWPH may enhance susceptibility to thalamic sensitization.
MicroRNA-221 Targets FBXW11 to Inhibit NPC Cell Proliferation by Regulating PTEN Signaling
Authors: Liu Jun , Song Chengyi , Liang Zhuoping , Long Xiang , Guo Min , Xu Jianle 
Published: March 2021

Abstract
Background: In the current study, we aim to demonstrate the biological function and molecular regulatory mechanisms of miR-221 in human nasopharyngeal carcinoma (NPC). Methods: The quantitative real time-polymerase chain reaction was used to measure the expression of miR-221 in NPC clinical tissues and cells. And the flow cytometry assay was used to demonstrate the role of miR-221 on cell cycle, and the potential target of miR-221 was predicted and identified using luciferase reporter assay.Results: Our results demonstrate that miR-221 expression was significantly decreased in NPC tissues and cell lines. We also confirmed that inhibition of miR-221 could induce G1/S cell cycle transition through upregulation of the cyclin D-CDK4/6 complex but not cyclin E-CDK2 complexes. Furthermore, luciferase reporter assay demonstrated that miR-221 could directly bind to the 3’-UTR of FBXW11. FBXW11 expression was found to increase in NPC, and was inversely correlated with miR-221 expression; thus, FBXW11 expression interfered in the biological function of miR-221. We further confirmed that miR-221 targeted FBXW11 to inhibit proliferation and promote apoptosis in NPC cell lines through regulating the PTEN signaling pathway. Conclusion: our findings suggest that miR-221 plays an important role as a tumor suppressive factor in the occurrence and progression of NPC.
SARS-CoV-2 Reinfection within the first 3 months of COVID-19 Recovery in A Referral Hospital, Tehran, Iran
Authors: Sadr Sara , Bafrani Melika Arab , Abdollahi Alireza , SeyedAlinaghi SeyedAhmad , Mohammadnejad Esmaeil , Hossienzade Roghieh , Golestan fereshteh Shahmari , Ahmadinejad Zahra , Salehi Mohamadreza , Javaherian Mohammad , Kimyaee Elahe , Jafari Fatemeh , Ghiasvand Fereshteh 
Published: March 2021

Abstract
ObjectivesPossibility of reinfection with SARS-CoV-2 changes our view on herd immunity and vaccination, and can impact quarantine policies. We performed follow-up studies on recovered patients to assess possible development of reinfections.MethodDuring a 6-month period, 202 PCR-confirmed recovering COVID-19 patients entered this study. Follow-up RT-PCR tests and symptoms assessment were performed one month after the initial Positive results. patients who tested negative were tested again one and three months later. The Serum IgG and IgM levels were measured in the last follow-up session.ResultsIn the first two follow-up sessions, 82 (out of 202) and 44 patients participated with four and three asymptomatic patients testing positive. In the last session, 32 patients were tested and four were positive, three of them were mildly symptomatic and all of them were positive for IgG.ConclusionA positive RT-PCR in a recovering patient may represent reinfection. While we did not have the resources to prove reinfection by genetic sequencing of the infective viruses, we believe presence of mild symptoms in the three patients who tested positive over 100 days after becoming asymptomatic, can be diagnosed as reinfection. The IgG may have abated the symptoms of the reinfection, without providing complete protection.
­Trends and Zonal Variability of Extreme Rainfall Events Over East Africa During 1960-2017
Authors: Ojara Moses.A , Lou Yunsheng , Babaousmail Hasssen , Wasswa Peter 
Published: March 2021

Abstract
East African countries (Uganda, Kenya, Tanzania, Rwanda, and Burundi) are prone to weather extreme events. In this regard; the past occurrence of extreme rainfall events is analyzed for 25 stations following the Expert Team on Climate Change Detection and Indices (ETCCDI) regression method. Detrended Fluctuation Analysis (DFA) is used to show the future development of extreme events. Pearson’s correlation analysis is performed to show the relationship of extreme events between different rainfall zones and their association with El Niño -Southern Oscillation (ENSO and Indian Ocean dipole (IOD) IOD-DMI indices. Results revealed that the consecutive wet day's index (CWD) was decreasing trend in 72% of the stations analyzed, moreover consecutive dry days (CDD) index also indicated a positive trend in 44% of the stations analyzed. Heavy rainfall days index (R10mm) showed a positive trend at 52% of the stations and was statistically significant at a few stations. In light of the extremely heavy rainfall days (R25mm) index, 56% of the stations revealed a decreasing trend for the index and statistically significant trend at some stations. Further, a low correlation coefficient of extreme rainfall events in the regions; and between rainfall extreme indices with the atmospheric teleconnection indices (Dipole Mode Index-DMI and Nino 3.4) (r = -0.1 to r = 0.35). Most rainfall zones showed a positive correlation between the R95p index and DMI, while 5/8 of the rainfall zones experienced a negative correlation between Nino 3.4 index and the R95p. In light of the highly variable trends of extremes events, we recommend planning adaptation and mitigation measures that consider the occurrence of such high variability. Measures such as rainwater harvesting, stored and used during needs, planned settlement, and improved drainage systems management supported by accurate climate and weather forecasts is highly advised.
Unpacking the black box of the effectiveness of task forces in maternal and neonatal health in Morocco : A realist evaluation protocol&nbsp;
Authors: Belrhiti Zakaria , Moulki Rachid , Mowafaq Safwane , Chrifi Hassan , Assarag Bouchra 
Published: March 2021

Abstract
Background In low and middle incomes countries (LMICs), health policies failed to reduce significantly maternal and neonatal mortality rates. This was attributed to inequitable access to care and to poor governance of local health systems. In Morocco, there are still regional disparities with access to maternal care, and poor governance of regional maternal and neonatal health programmes (RMNHP). To address these governance issues, the ministry of health implemented in 2017 a multi-actor’s governance structure called “regional task forces”(RTF). They aim at enabling collective concerted actions, active engagement of local community partners and better coordination between health systems managers and frontline workers in the monitoring, assessment and implementation of RMNHP. In this study, we aimed at analysing how regional taskforces were implemented in six heath regions and identify the mechanisms and contextual conditions underlying their effectiveness.Methods We adopted the realist evaluation as a suitable approach to decipher complex intertwined social phenomena. We adopted a multiple embedded case study design that allows a flexible exploration of different levels of analysis and takes into consideration the role of context. First, we developed an initial programme theory based on a literature review and policy document analysis as follows: ”A taskforce is effective whenever there is a fit between its intrinsic technocratic, political, democratic and learning capacities and the characteristics of the institutional context, the complexity of health problems and the engagement and leadership of actors”. Our programme theory will be refined using 10 to 12 individual interviews (IDI) with policy implementers. We will use secondary documents, and 4 to 6 interviews with taskforces members (clinicians, managers, and midwives). We will then carry two in-depth case studies in one low and one high performing taskforce using additional 6 to 12 interviews, 3 focus group discussions with senior managers, clinicians, and midwives. Qualitative data analysis will be informed by Intervention Context Actor Mechanism Outcome (ICAMO) hypothesis coding. We will then compare the different ICAMOs across cases using qualitative comparative analysis . DiscussionThe resulting programme theory will guide the reinforcement of regional governance of MNH programmes in Morocco.
EVALUASI HUBUNGAN BIAYA INVESTASI TERHADAP KUALITAS KENYAMAN PADA PERUMAHAN
Authors: Ilfiani Pratiwi Dian , Siswosukarto Suprapto , Sulistyo Djoko 
Published: March 2021

ABSTRACTThe demand for housing has never stopped because the population growth always increased. Technical Guidelines for the Construction of Healthy Houses issued by the Minister of Regional Regional Development states that a house as a place of residence must meet indoor health and comfort requirements which is influenced by lighting, airing, air temperature and humidity. This study uses natural lighting, natural ventilation, room humidity and acoustic comfort as variables. The object of this study is limited to the building area of a maximum of 70 m2 with four sample that maintain the original house shape from the design of the developer. Three out of four houses showed the relation between investment and indoor comfort, the higher investment improve indoor comfort. But, one of them showed different pattern, this is because the investment value is influenced by the accessibility of site and buildings.This study found that indoor comfort is influenced by design factors and micro climates. While home investment is influenced by the design and accessibility of site and buildings.Keywords: indoor comfort, lighting, natural ventilation, humidity, acoustic comfort ABSTRAK Tuntutan adanya sebuah rumah tidak pernah berhenti karena pertumbuhan penduduk yang selalu meningkat. Pedoman Teknis Pembangunan Rumah Sederhana Sehat yang dikeluarkan oleh Menteri Permukiman dan Prasarana Wilayah (2002) menyatakan bahwa rumah sebagai tempat tinggal yang memenuhi syarat kesehatan dan kenyamanan dipengaruhi aspek pencahayaan, penghawaan, serta suhu udara dan kelembaban dalam ruangan. Adapun variabel yang diangkat terdiri dari pencahayaan alami, penghawaan alami, kelembaban ruang dan kebisingan. Objek dari penelitian ini dibatasi pada dengan luas bangunan maksimal 70 m2 dengan empat sampel rumah yang mempertahankan bentuk rumah asli dari desain pengembang. Dari empat rumah, tiga diantara menunjukkan hubungan bahwa semakin tinggi investasi semakin baik kualitas kenyamanan di dalamnya. Akan tetapi satu diantaranya memperlihatkan pola yang berbeda, hal tersebut dikarenakan nilai investasi yang dipengaruhi oleh nilai aksesibilitas lahan dan bangunan. Penelitian ini pada akhirnya mendapatkan hasil bahwa kenyamanan dalam ruang dipengaruhi oleh faktor desain rumah dan iklim mikro. Sedangkan investasi rumah dipengaruhi oleh desain dan nilai aksesibilitas lahan dan bangunan. Kata kunci: kenyamanan dalam ruang, pencahayaan, penghawaan, kelembaban, kebisingan
ANALISIS REGANGAN BAJA TULANGAN PADA STRUKTUR PILE CAP EMPAT TIANG METODE STRUT AND TIE MODEL
Authors: Sukarman Sukarman , Sulistyo Djoko , Irawati Inggar Septhia 
Published: March 2021

ABSTRACTPile cap is one of the many types of structures that are entirely Disturbed-region. The structure undergoes a non-linear strain because it was meeting point of the pile and column with centralized forces. In addition, geometry changes occur at the meeting between the column, pile cap, and pile, so the Bernoulli concept is no longer suitable for this condition. Pile cap testing consists of two groups of specimens and each group consists of three specimens. The first group was designed using the STM method (SNI 2847: 2013 Appendix A) and the second group was designed using conventional methods (SNI 2847: 2013 Article 15). Loading is the application of a centralized static load that is channeled through a centric column until the pile cap structure has collapsed. The results show that: (1) The flexural reinforcement which experiences the first yield condition both on the pile cap testing of the STM method and in the conventional method was the X direction flexural reinforcement (outsidest flexural reinforcement). (2) The average strain of the yield conditions and load on the pile cap STM method were 2242 με and 528.97 kN, whereas the conventional method were 2436 με and 437.03 kN. (3) Increasing the load capacity of the yield conditions (Py) of the pile cap STM method and conventional method on the plan load (Pn) were 32.2% and 9.3%.Keywords: pile cap, four piles, Strut and Tie Model (STM) ABSTRAK Pile cap merupakan salah satu dari jenis struktur yang sepenuhnya merupakan daerah terganggu (Disturbed-region). Struktur tersebut mengalami regangan non-linear karena merupakan titik pertemuan pile dan kolom dengan gaya-gaya terpusat. Selain itu, terjadi perubahan geometri pada pertemuan antara kolom, pile cap, dan pile, sehingga konsep Bernoulli tidak cocok lagi pada kondisi tersebut. Pengujian pile cap terdiri dari dua kelompok benda uji dan masing-masing kelompok terdiri dari tiga buah benda uji. Kelompok pertama dirancang menggunakan metode STM (SNI 2847:2013 Lampiran A) dan kelompok kedua dirancang menggunakan metode konvensional (SNI 2847:2013 Pasal 15). Pembebanan berupa penerapan beban statik terpusat yang disalurkan melalui kolom sentris sampai struktur pile cap mengalami keruntuhan. Hasil menunjukkan bahwa: (1) Tulangan lentur yang mengalami kondisi leleh terlebih dahulu baik pada pengujian benda uji pile cap metode STM maupun pada metode konvensional adalah tulangan lentur arah X (tulangan lentur terluar). (2) Rata-rata regangan kondisi leleh dan beban pada benda uji pile cap metode STM adalah 2242 με dan 528,97 kN, sedangkan pada metode konvensional adalah 2436 με dan 437,03 kN . (3) Peningkatan kapasitas beban kondisi leleh (Py) pada benda uji pile cap metode STM dan metode konvensional terhadap beban rencana (Pn) adalah 32,2 % dan 9,3 %. Kata kunci: pile cap, empat tiang, Strut-and-Tie Model (STM)
PENGARUH BIAYA LIFE CYCLE COST PADA HARGA SEWA KAMAR BUDGET HOTEL DI KOTA YOGYAKARTA (Studi Kasus Hotel Musafira, Hotel Asana Grove, dan Hotel Nagari)
Authors: Dwiyanto Titis , Siswato M. Fauzie , Priyosulistyo Hrc. 
Published: March 2021

ABSTRAK Persaingan pasar yang terjadi menyebabkan harga sewa yang ditentukan oleh budget hotel kepada konsumen terbilang rendah. Dengan anggapan bahwa lahan hotel tersebut merupakan lahan sewa, penentuan harga sewa kamar menjadi salah satu keputusan penting karena harga yang ditawarkan harus bisa menutup semua biaya yang dikeluarkan. Kajian ini dilakukan dengan metode wawancara dan analisis data sekunder untuk mendapatkan biaya keseluruhan dari awal hotel dan diprediksi sampai periode 25 tahun dengan metode Future Worth Method, Simple Payback Method dan Discounted Payback Method untuk menentukan harga pokok produksi. Hasil kajian menunjukkan bahwa harga pokok produksi sewa hotel dengan penghitungan life cycle cost lebih tinggi rata - rata 13.31% jika dibandingkan dengan harga sewa kamar hotel yang ditawarkan, oleh karena itu target tingkat hunian hotel per tahun harus ditingkatkan rata – rata sebesar 12.59% untuk menutup selisih kekurangan biaya life cycle cost bangunan budget hotel jika ingin tetap mempertahankan harga sewa yang ditawarkan saat ini. Kata kunci: budget hotel, life cycle cost, harga sewa kamar ABSTRACTDue to market competition among budget hotel managements the room rate may have gone below rational basis. Assuming that the rent of land area used by the hotel was considered, the price of the room rate may become a significant and important decision, since such a cost shall be able to cope the overall cost including cost of building construction as well as operational and maintenance cost. This research was conducted by interview and by analyzing the secondary data, collected from three budget hotels. The overall cost including planning, designing, construction and maintenance for life period of 25 years was analyzed using Future Worth Method, Simple Payback Method, and Discounted Payback Method in determining the basic production cost. This research concludes that the basic production cost, where life cycle cost is considered, is 13,31% higher than that average room rate as being offered. Therefore, targeted occupancy of the room in the coming years shall be increased by 12,59%, if available room rate is maintained the same.Keywords: budget hotel, life cycle cost, room rate