bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of self-medication practice in Pokhara valley of Nepal
Authors: Paudel Sabita , Aryal Bijay 
Published: September 2019

Abstract
Background Self-medication (SM) is the practice of consuming medication without the consultation of physician. The drugs most commonly self-medicated are paracetamol, analgesics, ranitidine, oral rehydration solution, antibiotics, etc. The objective of the study is to assess the SM status and its causes in Pokhara valley of Nepal. Method The study was conducted among the people residing in Pokhara metropolitan city. The study duration was of four months from April to June, 2018. The study population were patients attending health camps at four different areas. Structured questionnaire was used to collect demographics of the patients and the details of the usage of self-medication.Result Out of 200 patients, 38.2% patients were found to be self-medicating. The most common illness sought for SM was ache (headache, body ache) in 50% followed by cough and cold in 31% and gastritis in 23%. Paracetamol was the drug consumed by 16 subjects followed by cough syrup (n=14) and nimesulide (n=11). Lack of knowledge about the disadvantages of SM led to self-medication in 65% of respondents. The paramedics most commonly consulted for medication were pharmacists (60%). Conclusion The trend of SM is high in Pokhara valley. It’s high time the regulatory agencies should solve the problems. The federal government should formulate strict guidelines for appropriate use of the medications.
Men’s grief following pregnancy loss and neonatal loss: A systematic review and emerging theoretical model
Authors: Obst Kate , Due Clemence , Oxlad Melissa , Middleton Philippa 
Published: September 2019

Abstract
Background Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men’s grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men’s grief, this systematic review sought to summarise and appraise the literature focusing on men’s experiences of grief following pregnancy loss and neonatal loss.Methods Systematic searches were completed across four databases (PsycINFO, PubMed, Embase and CINAHL), guided by two research questions: 1) what are men’s experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men’s grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men’s grief, published between 1998 and October 2018. Eligibility for loss type included any definition of miscarriage or stillbirth, and neonatal death up to 28 days after a live birth.Results A final sample of 46 articles were identified, of which 26 were qualitative, 19 quantitative, and one mixed methods. Findings indicate that men’s grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent support needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience.Conclusion To refine an emerging socio-ecological model of men’s grief, cohort studies are needed among varied groups of bereaved men to confirm grief-predictor relationships. There remains a need to promote genuine and consistent involvement of fathers as equal partners throughout pregnancy and childbirth. Likewise, engaging men early in the grief process is essential to providing recognition and validation to their experience, and improving awareness of available support services.
Leadership Training Programs in Graduate Medical Education: A Systematic Review
Authors: Kumar Bharat , Swee Melissa , Suneja Manish 
Published: September 2019

Abstract
Background : With the increasing recognition that leadership skills can be acquired, there is a heightened focus on incorporating leadership training as a part of graduate medical education. However, there is considerable lack of agreement regarding how to facilitate acquisition of these skills to resident, chief resident, and fellow physicians. Methods : Articles were identified through a search of Ovid MEDLINE, EMBASE, CINAHL, ERIC, PsycNet, Cochrane Systemic Reviews, and Cochrane Central Register of Controlled Trials from 1948 to 2019. Additional sources were identified through contacting authors and scanning references. We included articles that described and evaluated leadership training programs in the United States and Canada. Methodological quality was assessed via the MERSQI (Medical Education Research Study Quality Instrument). Results : 15 studies, which collectively included 639 residents, chief residents, and fellows, met the eligibility criteria. The format, content, and duration of these programs varied considerably. The majority focused on conflict management, interpersonal skills, and stress management. Twelve were prospective case series and three were retrospective. Seven used pre- and post-test surveys, while seven used course evaluations. Only three had follow-up evaluations after six months to one year. MERSQI scores ranged from 6 to 9. Conclusions : Despite interest in incorporating structured leadership training into graduate medical education curricula, there is a lack of evidence evaluating its effectiveness. High-quality well-designed studies are required in order to determine if these programs have a lasting effect on the acquisition of leadership skills.
The dynamics of Klebsiella pneumoniae drug-resistant profile in a regional burn center: a retrospective study between 2009 and 2018
Authors: Wang Wei , Zou Jin Li , Chen Kaisen 
Published: September 2019

Abstract
BACKGROUND: The aim is to observe drug-resistant trends of Klebsiella pneumoniae (K.pneumoniae) isolated from Jiangxi burn center in recent 10 years, and to analyze its causes and provide general information on preventive measures. METHODS: All data were collected by Hospital Laboratory Information System (LIS) and electronic cases. SPSS23.0 software was used to analyze bacterial isolation rate and drug-resistant trend . A chi-square test had been adopted to observe drug-resistant difference of K.pneumoniae in ICU ward and non-ICU ward. RESULTS: During 10 years, 593 K.pneumoniae isolates were acquired from the burn center, which mainly from wound secretion, bloodstream, sputum. The resistance rate of K.pneumoniae to many drugs, including 3 or 4 generation cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and even tegacycline showed an obvious upward trend (P < 0.05) in this period. The isolated K.pneumoniae was mainly concentrated in 1-3 weeks and carbapenem-resistant K.pneumoniae was mostly acquired in later stage after their hospitalization. CONCLUSION: We should pay attention to the increasing trend of K.pneumoniae in the burn center. Some measures should be taken to reduce isolated rate and drug- resistant rate in the future.
Prevalence and Molecular Characterization of Carbapenem resistance Gram negative bacilli among hospitalized patients in Khartoum state
Authors: Elbadawi Hana Salaheldin , Elhag Kamal , Mahgoub Elsheikh , Altayb Hisham N , Hamid Muzamil Mahdi Abdel 
Published: September 2019

Abstract
Background Carbapenems are broad-spectrum β-lactam antibiotics widely prescribed for the treatment of multidrug-resistant gram negative bacilli in systemic infections. In the past ten years the Carbapenem resistance among gram-negative bacilli is rapidly expanding across nosocomial infection isolates. This study was conducted to determine the prevalence and to characterize Carbapenem resistance genes among Gram negative bacilli (GNB) isolated from patients treated in hospitals in Khartoum state, Sudan.Methods A cross-sectional laboratory based study was conducted over six months at the microbiology department in Soba University Hospital and Institute of Endemic Diseases, University of Khartoum. A total of 206 GNB isolates from different clinical specimens were analyzed for carbapenem resistance genes using phenotypic tests and affirmed by genes detection. Multiplex PCR was performed for each strain to detect the carbapenemase genes, including those encoding the NDM-, VIM-, and IMP -type Metallo-beta-lactamases, the class A KPC-type carbapenemases, and the class D OXA-48 enzyme. In addition to CTXM, TEM and SHV. DNA sequencing and bioinformatics analysis were used to detect genes subtypes.Results Of 206 isolates, 171 (83%) positive phenotypically and 121 (70.7%) from 171 isolates were confirmed for present one or more carbapenemase gene. NDM-types were the most predominant genes, blaNDM 107(88.4%), followed by blaIMP 7 (5.7%), blaOXA-48 5(4.1%), blaVIM 2 (1.6%) and blaKPC 0 (0%). Co- resistance genes with NDM producing Gram-negative bacilli were detected in 87 (81.3%) of all NDM positive isolates. Correlation between phenotypic and genotypic resistance was observed (P- value < 0.001). Carbapenemase genes were mostly detected in the K. pneumoniae 70 (42.6%), followed by P. aeruginosa 33 (20%), A. baumannii 30 (18.2%) and E. coli with 18 strains (10.9%). NDM-1 was detected in 75 isolates (70%), other subtypes of NDM were identified by sequencing were NDM- 5 and NDM-6.Conclusions The prevalence of carbapenemase producing bacilli was fond to be high in Khartoum hospitals. NDM was found to be the most prevalent carbapenemase genes among clinical isolates and belong to Indian lineage. For prevention infection control and regular surveillance must be enhanced.
Characterization of bacterial communities associated with the pine wilt disease insect vectors Monochamus alternatus Hope and host trees Pinus massoniana
Authors: Guo Yajie , Lin Qiannan , Chen lvyi , Rebeca Carballar-Lejarazú , Shao Ensi , Liang Guanghong , Hu Xia , Wang Rong , Xu Lei , Zhang Feiping , Wu Songqing 
Published: September 2019

Abstract
Background Pine wilt disease (PWD) is a destructive disease caused by the pinewood nematode Bursaphelenchus xylophilus . Monochamus alternatus Hope is the main vector of this disease. The symbiotic microorganisms can play an important role in the transmission cycle mechanism. However, the role of bacterial microorganisms in the transmission of pine wood nematode by M. alternatus is not clear currently. The main purpose of this study is to reveal the composition and diversity of microbial flora in the gut of M. alternatus , as well as healthy and infected Pinus massoniana and its peripheral environment to discover the important microbial flora contributing to the transmission cycle.Methods In this study, total DNA was extracted from 60 samples, including 20 samples of M. alternatus gut from different larval instars, healthy P. massoniana , nematode-infected P. massoniana and their peripheral environment (needles, bark, phloem, xylem, root, surface soil and rhizosphere soil), by triplicate. Samples were used for 16S rDNA Amplicon sequencing to determine the composition and diversity of microbial flora in each sample.Results Infection of pinewood nematode resulted in an increase of the microbial community in the nematode-infected P. massoniana and its peripheral environment when compared with healthy P. massoniana , the microbial community in different tissues changed. Among them, Gryllotalpicola and Cellulomonas showed to be endemic microorganisms in nematode-infected P. massoniana , which can be used as indicators to detect the disease. Serratia was shown as an opportunistic pathogen, and was found to be enriched in M. alternatus gut and was also detected in the host plant tissues.Conclusions This study clarified the change of microbial community in the transmission of pine wilt disease by M. alternatus . An important theoretical basis for the prevention of pine wilt disease was structured by our research.
Genome- wide characterization, expression profile analysis of WRKY family genes in Santalum album and functional identification of their role in abiotic stress
Authors: Yan Haifeng , Li Mingzhi , Xiong Yuping , Zhang Yueya , Liang Hanzhi , Li Yuan , Zhang Xinhua , Niu Meiyun , Guo Beiyi , Silva Jaime A. Teixeira da , Ma Guohua 
Published: September 2019

Abstract
Background: WRKY proteins are a large superfamily of transcription factors that are involved in diverse biological processes including development, as well as biotic and abiotic stress responses in plants. WRKY family proteins have been extensively characterized and analyzed in many plant species, including Arabidopsis , rice and poplar. However, knowledge on WRKY transcription factors in S antalum album is scarce.
Results: Based on S . albu m genome and transcriptome data, 64 SaWRKY genes were identified in this study. A phylogenetic analysis based on the structures of WRKY protein sequences divided these genes into three major groups (I, II, III) together with WRKY protein sequences from Arabidopsis . Tissue-specific expression patterns showed that 37 SaWRKY genes were expressed in at least one of five tissues (leaves, roots, heartwood, sapwood, or the transition zone) while the remaining four genes were weakly expressed in all of these tissues. Analysis of the expression profiles of the 42 SaWRKY genes after callus was stimulated by salicylic acid (SA) and methyl jasmonate (MeJA) revealed that 34 and 19 SaWRKY genes, respectively were significantly induced. The function of SaWRKY1 , which was significantly up-regulated by SA and MeJA, was analyzed. SaWRKY1 was localized in the nucleus and its overexpression improved salt tolerance in transgenic Arabidopsis .
Conclusions: Our study provides important information to further identify the functions of SaWRKY genes and to understand the roles of SaWRKY family genes involved in development and in SA- and MeJA-mediated stress responses.
The Spatial Mixed effect Ordinal Logistic Regression Modeling of Cancer disease: West Amhara, Ethiopia
Authors: Tesfaw Lijalem Melie , Muluneh Essey Kebede 
Published: September 2019

Abstract
Background: There are numerous patients that are suffering with cancer disease in
Ethiopia. However, as far as our knowledge concerned there was no any study that have
been conducted to determine the factors on cancer disease. The main objective of this study
was to assess the distribution risk of cancer disease by taking into account the spatial effect.
It was also aimed to determine the effects of some common clinical patients characteristics,
complications of cancer disease and prognostic factor on current patient status, and finally
predict the patient status.
Methods: The data was obtained from 415 cancer patients. Statistical models were used to
investigate the spatial difference of incidence of cancer across different districts and different
disk factors identified using spatial mixed OLR model.
Results: The findings of this study shows that only 1.45% cured of patients who have
taken treatment were cured and 46.02% improved while the rest have shown no change and
even worse status after they getting treatment. Prognostic factor (stage and grade of cancer
tumor), complication of cancer disease such as anemia during diagnosis and treatment of
patients given in the hospital had significant effect on the patient status.
Conclusion: Patients without anemia complication at diagnosis were more likely to fall in
the lower patient category than patients with anemia complication during diagnosis. Most of
the patients had advanced stage (IV) and grade of cancer tumor that dismantle the capability
of the treatment to be less effective. There was negative spatial effect on the incidence of
cancer indicate that districts with higher cancer incidence usually surrounded by districts
with lower incidence.
Keywords: Incidence of cancer, Patient Status, Spatial (Mixed) OLR
Effect of Oxygen Pneumoperitoneum on Hypoxia Tolerance in Beagle Dogs: An Experimental Study
Authors: CAO Jiangbei , ZHANG Yongyi , WANG Wei , LI Hao , MI Weidong 
Published: September 2019

Abstract
Background: When an airway is difficult to manage during surgery, it can be fatal. Thus, peritoneum oxygenation may be theoretically feasible as an alternative route to supply oxygen. The objective of this study is to investigate whether artificial oxygen pneumoperitoneum combined with abdominal lifting and compression is effective in systemic oxygenation and hypoxia tolerance in a beagle dog model of asphyxia. Methods: Latin Square design was adopted. Eight adult female beagle dogs were divided into four subgroups; they received four treatments in sequence in four sessions at 1-week intervals. The pre-treatment procedures included general anesthesia and a pause in ventilation to establish an asphyxia model. Each subgroup was subjected to the treatments as follows: negative control(A), artificial oxygen pneumoperitoneum(B), artificial oxygen pneumoperitoneum combined with abdominal lifting and compression from the 1st minute after asphyxia(C), or the same as C but starting the method from the 5th minute(D). Vital signs, important organ functions, and arterial blood gas were monitored. Hypoxia tolerance was assessed by the asphyxia time (from pause to restoration of ventilation) and PaO2 levels at 0, 6, 7, 8, 9, and 10 minutes after asphyxia onset. Results: The physiological status of the beagles was approximately identical before each experiment and the treatments did not aggravate the impact of hypoxia. The asphyxia time for treatments A, B, C, and D were 9.65 ± 1.10 min, 11.18± 0.50min, 11.45 ± 0.79min, and 11.70 ± 0.99min, respectively; the time was lengthened in treatments B, C, and D, compared with that in treatment A (P<0.01). Moreover, PaO2 levels at 9 and 10 min were higher in treatments B, C, and D than in treatment A (P<0.01). Conclusions: Artificial oxygen pneumoperitoneum combined with abdominal lifting and compression appears safe and effective and may improve systemic oxygenation and enhance hypoxia tolerance.
On the use of the Trans-Theoretical Model for Blood Donation among Spanish Adults
Authors: Sardi Lamyae , Idri Ali , de Gea Juan Manuel Carrillo , Toval Ángel , Fernández-Alemán José Luis 
Published: September 2019

Abstract
Background Relying solely on altruistic appeals may fail to fulfil the increasing demand for blood supplies. Current research has largely been attempted to determine and understand motives that serve as blood donation drivers. The Trans-Theoretical Model of behaviour change (TTM) can be used to conceptualise the process of intentional blood donation behaviour.Methods A cross sectional survey of Spanish adults was conducted. The final sample consisted of 504 individuals who were administered a self-report questionnaire including the measures of demographic characteristics, Stages of Change, Processes of Change, Self-efficacy and Decisional Balance. Data were analysed by frequency analysis, MANOVA/ANOVA and correlation analysis. Results Findings indicated that most of the behavioural and cognitive processes of change, self-efficacy and physical cons differentiated participants across the stages of change of blood donation. In contrast, eligibility cons and pros were less influential in stage transitions. Furthermore, significant correlations were observed between TTM constructs except for the physical cons and the processes of change. Conclusions The present study extensively supports and replicates the applicability of the TTM to blood donation behaviour change and offers important implications for the development of effective stage-matched interventions to increase blood donation.
Assessment of Knowledge, Attitude and Practice towards rabies and associated factors among household heads in Mekelle city, Ethiopia
Authors: Hagos Weldegerima Gebremedhin , Muchie Kindie Fentahun , Gebru Goyitom Gebremedhn , Mezgebe Gebreamlak Gebremariam , Reda Kebede Ambaye , Dachew Berihun Assefa 
Published: September 2019

Abstract
Background: Rabies has a worldwide distribution in continental regions of Africa, Asia and the Latin America. Globally, the case fatality rate is 100% once a clinical sign is developed. Poor public awareness towards rabies is one of the major obstacles in any prevention and control scheme of the diseases. The aim of this study was to assess knowledge, attitude and practice (KAP) about rabies and associated factors among household heads in Mekelle city, Northern Ethiopia, 2016. Methods: A community based cross sectional study was conducted from October to November 2016 with a total of 633 study participants. Data were collected using a pre-tested structured questionnaire in Enderta district, Tigray regional state, Ethiopia. Data was entered to EPI-Info 3.5.4 and coded, cleaned and analyzed using SPSS version 20 software. Bivariable and multivariable analysis was done to identify factors associated with knowledge, attitude and practice about rabies. Variables having p< 0.05 was considered as statistically significant at 95%CI. Results: Of 633 study participants, 357 (56.4%) were females and 239 (37.8%) were 18-35 years old. Among the study participants, 56.1% (95%CI=52.2, 59.9), 56.2% (95%CI=52.4, 60.1) and 61.3% (95%CI=57.5, 65.1) had good level of knowledge, attitude and practice on the prevention and control of rabies respectively. Being female (AOR=1.50, 95%CI=1.05, 2.13), dog owner (AOR=1.68, 95%CI=1.17, 2.41) and participants who had training on rabies (AOR=2.22, 95%CI=1.53, 3.21) were found to have good knowledge. Married participants (AOR=2.19, 95%CI=1.16, 4.16), participants who owned dog (AOR=2.64, 95%CI=1.80, 3.86) and those encountered dog bite (AOR=2.24, 95%CI=1.23, 4.10) were found to have positive attitude towards rabies. Similarly dog ownership (AOR=11.85, 95%CI=7.16, 19.6) was found to be associated with good practice. Conclusion: This study showed that more than half of the respondents had good knowledge, attitude and practice about the prevention and control of rabies. Key words: Attitude, Community, Knowledge, Practice, Rabies
Dietary Vitamin A intakes among Pregnant Women Attending Antenatal Care in Health Facilities: As a connotation for the progress of Vitamin A Deficiency in Dessie Town, North East Ethiopia: A cross-sectional Study
Authors: Koricho Zenebech , Mekonnen tefera Chane , Atomssa Gudina Egata , Tadesse Sisay Eshete 
Published: September 2019

Abstract
Vitamin A plays an important role in vision, cellular differentiation, embryonic development, reproduction, growth, and the immune system. Women who live in developing countries face a risk of undernutrition during pregnancy due to poverty, poor diet quality and quantity, and high fertility rate. This poor dietary problem could reflect women’s high risk of vitamin A deficiency. The major aim of this study was to determine the adequacy of vitamin A among pregnant women following antenatal care in health facilities of Dessie Town, Ethiopia, January 2017. Health facility-based cross-sectional study was conducted among 390 women that attended antenatal care in Dessie Town. The food groups from FAO based on 24 hour dietary recall was used to measure dietary intake Vitamin A and dietary diversity of women. Adequacy of vitamin A was determined from nutrient adequacy ratio after obtaining reports of nutrient intake from food composition table version III and IV in terms of B carotene and retinol equivalent respectively, based on the estimated average requirement recommendation of vitamin A, 370 RE/day for pregnant women. Multivariable Logistic regression analysis was done to identify associated factors of vitamin A adequacy.