bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Importance of Humorous Advertisement on Consumer Purchase Decisions
Authors: Agwu Edwin
Published: January 2022

Humour as an advertisement appeal informs and guides customers’ on the important decisions they make before the purchase of various goods and services. Humour is majorly used to sell products. The inclusion of humors in advertisements in both the print and electronic media has become a must for various product advertisements in most organizations. Humours it is believed attracts customers to the products being showcased. Furthermore, the use of celebrities in humours has also added colours as such well-known figures often endear such products to the customers and gives it a lasting remembrance and ease of reference and recall in many circles. Audiences in different cultures respond differently to humour and possesses different behaviour in purchases.
Research on Statistical Characteristics Modeling of Matching Probability and Measurement Error Based on Machine Learning
Authors: Li Shuan-zhu , He Run-feng , Pan Bao-zhu
Published: January 2022

In view of the problems of the current modeling methods for the statistical characteristics of matching probability and measurement error, the modeling method of matching probability and measurement error statistical characteristics based on machine learning is proposed. According to the requirements of total sequence matching probability and system matching times, the sequence matching probability is calculated. The measurement error is analyzed in the process of acquisition and matching, and the measurable interference parameters are obtained. According to the analysis results, the mean value of matching measurement error is standardized, and the matching probability and measurement error statistical characteristics are established sex model. The experimental results show that the matching probability and measurement error statistical model of this method has high accuracy, and has good application effect in practical application.
Exploring Variety in Factors That Stimulate Project Owners to Address Sustainability
Authors: Barneveld Marco , Silvius Gilbert
Published: January 2022

Concerns about sustainability drive organizations to assume responsibility for societal impacts. Reducing negative impacts requires organizational change. Given the ability of information technology/systems to optimize business processes, it is an important contributor to more sustainable business practices. Projects play an instrumental role in the transition of organizations towards sustainability. Within projects, the project owner bears the responsibility of aligning the project with the strategies of the organization. However, in the assignment and governance of projects, project owners need to balance different interests and limitations. The study reported in this article focuses on the factors that stimulate project owners to address sustainability. Deploying Q-methodology, the study found 4 distinct stimulus patterns of project owners. The findings confirm that the behavior of managers is influenced by both rational and emotional factors. With these findings, organizations can fine-tune their organizational change efforts, in order to realize their sustainability strategies.
Examining the Critical Success Factors in IT Projects
Authors: Radhakrishnan Abirami , Davis John Stephen , David Dessa
Published: January 2022

Many companies experience IT project failures in relatively new areas such as Big Data, Data Science, Enterprise Systems, Blockchain, Cloud Computing, IT security, and IoT. Because of inadequate research in identifying critical success factors for these projects, we conducted a Delphi study employing separate panels for each of two kinds of project implementations, those using a predictive lifecycle approach and those using an adaptive lifecycle approach. We found common critical success factors: user/client involvement, senior management support, effective monitoring and control, effective communication and feedback, good change and configuration management, having a competent project manager, proper project leadership, and excellent vendor performance. Both predictive and adaptive lifecycle IT projects had certain unique critical success factors. The findings provide guidance to IT Project Managers.
A Study of the Impact of Different Styles of Leadership on Project Quality Performance
Authors: Bonkoungou Wendendate , Raisinghani Mahesh S. , Idemudia Efosa Carroll
Published: January 2022

Leadership is among the significant factors that affect project quality performance. There are different types of leadership styles . This paper examines the impact of different styles of leadership of project managers and how these styles affect project quality performance in the software industry. The author describes the topic background, the significance, and rationale of the study, the research objectives, the research questions and the statement of the problem. The literature review includes the appropriate scholarly citation that explains the existing relationship between the variables involved in the study. The research methodology which includes the sampling frame, sampling technique, representation of the target population, data collection instrument and data analysis and findings are also given. The paper is concluded by providing the most effective style of leadership for project managers and gives recommendations for further research. Our research has a lot of research and managerial implications
The Role of Building Information Modeling in Offsite Construction Projects
Authors: Meng Xianhai , Li Yongjuan , Meng Junyu
Published: January 2022

Offsite construction (OSC) and building information modeling (BIM) are two new and promising developments in the construction industry. However, few studies to date provide general empirical evidence for the role of BIM in OSC projects. Based on a comprehensive literature review, this research performs an investigation in the UK construction industry into OSC in the context of BIM with a large and representative sample of empirical data. The analysis of empirical data demonstrates that working with BIM makes OSC easier and more effective. With regards to the integration of OSC and BIM, there are no significant differences in attitudes between project parties. It is found in this research that BIM plays various important roles in OSC design, manufacturing, transportation and construction, which significantly contribute to OSC project success. This research presents a model to conceptualize BIM-driven OSC. It also identifies the need for further transforming from BIM-driven OSC to more advanced digital-driven OSC through the integration of OSC and multiple digital technologies.
Achieving Strategic Alignment of Big Data Projects in Saudi Firms
Authors: Abanumay Razan , Mezghani Karim
Published: January 2022

Big data projects can fail due to the lack of alignment between the big data project strategy and the overall business strategy. This research considers organizational culture as an enabler of a better alignment between the two. To test the research hypothesis, a questionnaire was collected from several dozen IT decision-makers in Saudi organizations who have implemented big data projects. Statistical analysis using PLS indicates that the alignment of big data projects and overall business strategy is highly influenced by the five dimensions of organizational culture identified by Smit et al. (2008), namely strategy, leadership, adaptability, coordination, and team relationships
Measuring the Quality of Higher Education in Bangladesh
Authors: Khanam Fahima , Al-Zadid Md. Omar , Ullah Mahmud
Published: January 2022

Ensuring the quality of higher education is the major concern of a developing country like Bangladesh. Despite having many universities as options, people are still fascinated to study in the University of Dhaka. This paper attempts to determine the quality of higher education in Bangladesh by measuring the service quality of the University of Dhaka based on the responses of the students. To evaluate its overall service quality 5 variables have been considered, such as tangibility, responsiveness, assurance, reliability, and empathy. The study conducted a survey of 200 respondents including current and past university students. The result shows there is a mediocre level of satisfaction among the respondents on quality issues. Why the students are not overall satisfied and specifically on which criteria they are not satisfied have been clearly demonstrated in this paper. The study has also recommended along with the findings what new adjustments the university authority make in this context.
Turnaround Strategy Implementation for Service Efficacy and Citizenry Satisfaction in Government Organizations
Authors: Baporikar Neeta
Published: January 2022

The Government Enterprise (GE) implemented a turnaround strategy to enhance service efficacy and citizenry satisfaction in 2014. However, this GE takes too long like three months to issue any key documents such as birth, death, marriage certificates, passports, and work permits today. This reflects that the efficacy of services and the satisfaction of citizens is questionable. Hence, the main objective of the research was to investigate the turnaround strategy implementation in GE. Adopting the qualitative descriptive research design, questionnaires administered to the management and staff members, and interviews conducted with clients, thematic analysis has been undertaken. Findings reveal that the turnaround strategy did improve service efficacy and citizenry satisfaction for some time but there was a relapse. Recommendations include the adoption of customer service strategies along with the revival of the turnaround strategy and top management new team who can introduce with fresh ideas, staff training with constant monitoring, and control measures.
Cutting Edge: l-Arginine Transfer from Antigen-Presenting Cells Sustains CD4+ T Cell Viability and Proliferation
Authors: Crowther Rebecca R , Schmidt Stephanie M , Lange Shannon M , McKell Melanie C , Robillard Michelle C , Zhao Junfang , Haffey Wendy D , Wyder Michael A , Greis Kenneth D , Setchell Kenneth D R , Qualls Joseph E
Published: January 2022

Metabolomics analyses suggest changes in amino acid abundance, particularly l-arginine (L-ARG), occur in patients with tuberculosis. Immune cells require L-ARG to fuel effector functions following infection. We have previously described an L-ARG synthesis pathway in immune cells; however, its role in APCs has yet to be uncovered. Using a coculture system with mycobacterial-specific CD4+ T cells, we show APC L-ARG synthesis supported T cell viability and proliferation, and activated T cells contained APC-derived L-ARG. We hypothesize that APCs supply L-ARG to support T cell activation under nutrient-limiting conditions. This work expands the current model of APC–T cell interactions and provides insight into the effects of nutrient availability in immune cells.
Exon–Intron Circular RNA circRNF217 Promotes Innate Immunity and Antibacterial Activity in Teleost Fish by Reducing miR-130-3p Function
Authors: Zheng Weiwei , Su Hui , Lv Xing , Xin Shiying , Xu Tianjun
Published: January 2022

Circular RNA (circRNA) is produced by splicing head to tail and is widely distributed in multicellular organisms, and circRNA reportedly can participate in various cell biological processes. In this study, we discovered a novel exon–intron circRNA derived from probable E3 ubiquitin-protein ligase RNF217 (RNF217) gene, namely, circRNF217, which was related to the antibacterial responses in teleost fish. Results indicated that circRNF217 played essential roles in host antibacterial immunity and inhibited the Vibrio anguillarum invasion into cells. Our study also found a microRNA miR-130-3p, which could inhibit antibacterial immune response and promote V. anguillarum invasion into cells by targeting NOD1. Moreover, we also found that the antibacterial effect inhibited by miR-130-3p could be reversed with circRNF217. In mechanism, our data revealed that circRNF217 was a competing endogenous RNA of NOD1 by sponging miR-130-3p, leading to activation of the NF-κB pathway and then enhancing the innate antibacterial responses. In addition, we also found that circRNF217 can promote the antiviral response caused by Siniperca chuatsi rhabdovirus through targeting NOD1. Our study provides new insights for understanding the impact of circRNA on host–pathogen interactions and formulating fish disease prevention to resist the severely harmful V. anguillarum infection.
γδ T Cells Activated in Different Inflammatory Environments Are Functionally Distinct
Authors: Sun Deming , Chan Nymph , Shao Hui , Born Willi K , Kaplan Henry J
Published: January 2022

γδ T cells are important immunoregulatory cells in experimental autoimmune uveitis (EAU), and the activation status of γδ T cells determines their disease-enhancing or inhibitory effects. Because γδ T cells can be activated via various pathways, we questioned whether the nature of their activation might impact their function. In this study, we show that γδ T cells activated under different inflammatory conditions differ greatly in their functions. Whereas anti-CD3 treatment activated both IFN-γ+ and IL-17+ γδ T cells, cytokines preferentially activated IL-17+ γδ T cells. γδ T cells continued to express high levels of surface CD73 after exposure to inflammatory cytokines, but they downregulated surface CD73 after exposure to dendritic cells. Although both CD73high and CD73low cells have a disease-enhancing effect, the CD73low γδ T cells are less inhibitory. We also show that polarized activation not only applies to αβ T cells and myeloid cells, but also to γδ T cells. After activation under Th17-polarizing conditions, γδ T cells predominantly expressed IL-17 (gdT17), but after activation under Th1 polarizing conditions (gdT1) they mainly expressed IFN-γ. The pro-Th17 activity of γδ T cells was associated with gdT17, but not gdT1. Our results demonstrate that the functional activity of γδ T cells is strikingly modulated by their activation level, as well as the pathway through which they were activated.
Un servizio integrato per adolescenti a Roma
Authors: Vanzetto M. , Rodinò R. , Santoro M. M. , Frascarelli T.
Published: January 2022

Dal marzo 1993 la Cooperativa sociale "Animazione Verderocca" (ANVER) ha attivato un Servizio Integrato per adolescenti, completamente gratuito, nei locali del suo poliambulatorio. Si è voluto creare nel territorio un Servizio che fosse aperto a tutti e di facile accesso, che diventasse punto di riferimento per risolvere dubbi e problemi adolescenziali, ma anche proposta per un cambiamento di comportamenti a rischio e quindi tentativo per una prevenzione primaria delle devianze giovanili. Una équipe interdisciplinare costituisce la caratteristica fondamentale di questo Servizio. Essa, tenendo presente il concetto globale di salute, intende fornire un aiuto all'adolescente a spostare il focus di attenzione dal sintomo alla totalità della persona. In un anno di attività hanno fruito del Servizio Integrato 71 giovani, 64 femmine (90%) e 7 maschi (10%). Il tipo di intervento vuole essere qualitativo più che quantitativo e le 368 prestazioni complessive effettuate ne confermano la consistenza. La domanda di partenza dell'adolescente ha trovato nell'équipe o nella consulenza psicologica una sua ridefinizione basata non solo sulla analisi della domanda, ma anche sulla formulazione stessa dell'intetvento. Evidentemente tale riformulazione "agita" e "proposta" dagli operatori del Servizio Integrato è vissuta dall'utenza come una corretta lettura o integrazione della propria richiesta vista la costanza nel tempo del ritorno e la pubblicità che gli adolescenti stessi fanno del Servizio ai propri amici.
Implicazioni etiche nel trattamento farmacologico dell'anziano
Authors: Cavazzuti F. , Nardi R. , D'Anastasio C.
Published: January 2022

In età senile la prescrizione di un trattamento farmacologico implica numerosi problemi etici poiché la patologia iatrogenica da farmaci assume maggiore importanza e gravità rispetto alle età precedenti. Un eccesso di medicamenti espone l'anziano ad una più elevata percentuale di effetti collaterali e sono frequenti in età senile l'autoprescrizione di medicamenti e la scarsa adesione al trattamento farmacologico instaurato dal medico. Gli Autori ribadiscono alcuni principi etici nella prescrizione di farmaci a pazienti anziani per indurre, nel rispetto della persona, minimi rischi con il massimo di benefici. E' necessario abituarsi ad una corretta anamnesi farmacologica, circoscrivere l'obiettivo terapeutico principale, non prescrivere più farmaci di quanto il soggetto possa tollerare. E' anche indispensabile semplificare lo schema di trattamento e fornire tutte le informazioni possibili al paziente ed ai familiari per migliorare l'adesione alla terapia prescritta. Occorre infine controllare la comparsa di eventuali effetti collaterali, tenendo presente che l'anziano è sempre un soggetto ad alto rischio di patologia iatrogenica da farmaci e di inadeguata compliance al trattamento. Nella "cura globale" del paziente in età senile l'obiettivo principale è di recuperare il massimo dell'autonomia consentita e di mantenerla il più a lungo possibile. Ciò significa non soltanto una terapia farmacologica, ma anche la prescrizione di interventi riabilitativi, di attività motoria, di attività occupazionali e socializzanti. L'età avanzata e molto avanzata non è mai un ostacolo ad un trattamento farmacologico, ma occorrono più prudenza, maggiori controlli e verifiche ed una nuova cultura meno medicalizzante. Gli Autori elencano i criteri utili per migliorare l'adesione alla terapia con farmaci, i possibili livelli di responsabilit  del medico nell'indurre i rischi di una patologia da medicamenti in età senile e le ipotesi di soluzione dei problemi etici connessi. Presenza di patologia multipla non significa sempre poliprescrizione. I farmaci vanno limitati alle patologie emergenti, creando delle priorità di trattamento per problemi clinici, riducendo i dosaggi ed evitando medicamenti di non comprovata utilità ed efficacia.
Using observation to better understand the healthcare context
Authors: Weston Lauren E. , Krein Sarah , Harrod Molly
Published: January 2022

Despite potential to capture rich contextual information, observation remains an underutilized data collection method. This paper provides a practical guide for using observation to understand complex issues in healthcare settings. Observation is a qualitative data collection method comprised of viewing and documenting phenomena in the usual environment. Drawing on our recent work using observation to better understand personal protective equipment use among healthcare personnel, we describe when to consider collecting data via observation, how to prepare and perform observation, and how to analyze resulting data. Observation data are documented in field notes that contain detailed information about setting, participants, and activity associated with the topic of interest. Field notes can be analyzed alone or triangulated with other types of data using theoretical or conceptual frameworks or by identifying themes. Observation is a valuable data collection method for health services researchers to identify key components involved in a topic of interest, a vital step in forming relevant questions, measuring appropriate variables, and designing effective interventions. Used with other methods or alone, observation yields the detailed data needed to address context-specific factors across a wide range of healthcare research topics and settings.
Knowledge and Attitude of Nurses Toward Delirium
Authors: Grover Sandeep , Mehra Aseem , Sharma Neha , Sahoo Swapnajeet , Dua Devakshi
Published: January 2022

Aim:

This cross-sectional study aimed to evaluate the attitude, practice, and knowledge among the nurses about the delirium in a tertiary care hospital.

Materials and Methods:

The study included 138 nurses working in a tertiary care multispecialty hospital in North India. The knowledge and attitude toward delirium were assessed by using a self-designed questionnaire (33 questions), of which 26 items specifically evaluated the knowledge and attitude toward various aspects of delirium.

Results:

The majority of the participants were females (83.3%), had done graduation (92.8%) in nursing, were junior nursing staff, and were directly in contact with the patient's care. The study shows that the majority of the nurses have poor knowledge about the etiology, prevalence, symptoms, and not aware of the screen procedure and instruments for delirium. Further, they lacked knowledge about the pharmacological and nonpharmacological management of delirium. A majority (83.3%) of the nurses opined that the psychiatry ward is the best place to manage patients with delirium. The majority of the nurses routinely did not screen their patients with delirium and did not know the screening instruments (84.4%) available for delirium. A majority (92.8%) of the nurses opined that they were never trained specifically to assess and manage delirium, and 98.6% expressed willingness for training.

Conclusion:

This study suggests that nurses working in intensive care unit and emergency settings in a tertiary care hospital in India have poor knowledge, negative attitudes, and poor practices about delirium.
Use of Haloperidol in Amiodarone Induced Delirium
Authors: Sharma Rachit , Singh Ranveer , Sharma Markanday
Published: January 2022

Amiodarone, a versatile Class III antiarrhythmic drug, is considered one of the most effective agents in counteracting supraventricular and ventricular tachyarrhythmia. Delirium related to amiodarone therapy is infrequently associated with amiodarone. Although the prevalence of this disorder is extremely low, it is worthy of note the time-dependent relationship between the onset of therapy and the beginning of psychiatric symptoms. We report the case of an older woman who was diagnosed with a case of decompensated dilated cardiomyopathy with atrial fibrillation. She developed delirium after treatment with amiodarone. It also highlights the use of antipsychotic, despite continuous use of amiodarone.
Regulation and Role of AMP-Activated Protein Kinase at the Cellular Level and Relevance to Diabetes Mellitus
Authors: Kulkarni Paresh P.
Published: January 2022

Adenosine Mono phosphate -activated protein kinase (AMPK) is a metabolic master switch that senses the cellular AMP levels. However, it is now also regarded as a nutrient-sensing enzyme due to its ability to detect glucose deprivation inside the cell. Under conditions of energy deprivation, AMPK is activated, which in turn switches on all the energy-producing metabolic pathways, while switching off energy-consuming metabolic pathways and cellular processes. There is a growing interest in AMPK due to its role in a wide array of pathological processes including diabetes mellitus. It is the therapeutic target of one of the most commonly prescribed classes of antidiabetic drugs, namely the biguanides such as metformin. The current article presents a review of AMPK structure, triggers, and mechanisms of its activation as well as its role in cell metabolism, mitochondrial homeostasis, autophagy, and cell proliferation. It also briefly addresses the relevance of AMPK to pathogenesis and management of diabetes mellitus.
Association of Vitamin D with Macrophage Migration Inhibitory Factor and Interleukin-8 in Diabetic Foot Infection
Authors: Tiwari Shalbha , Pratyush Daliparthy D. , Gupta Sanjeev K. , Singh Surya K.
Published: January 2022

Background:

Diabetic foot wound is an important health challenge throughout the world. Interleukin 8 (IL8) and macrophage-migration inhibitory factor (MIF) play a significant role in host defense and in wound healing. Immune perturbation and Vitamin D deficiency also contribute to nonhealing of diabetic foot wounds. We aimed to evaluate the serum concentration of IL8 and MIF in diabetic patients with and without foot infection and its association with Vitamin D status.

Material and Methods:

Serum concentrations of 25 dihydroxyvitamin Vitamin D and cytokines (IL8 and MIF) were measured by radioimmunoassay and enzyme-linked immunosorbent assay, respectively, from 100 subjects with diabetes and foot infection as cases and 73 subjects with diabetes without foot infection as controls. Data were presented as mean (± standard error of mean [SE]) unless otherwise indicated and were analyzed by SPSS 16.0.

Results:

There was no significant difference in the mean (±SE) of age, duration of diabetes, hemoglobin A1C, and body mass index between the two groups. The mean (±SE) concentration of IL8 was significantly higher and MIF was significantly lower in cases than controls. Vitamin D correlated negatively with IL8 (r = −0.191) and positively (r = 0.1) with MIF. However, only the former correlation was statistically significant (P = 0.01). IL8 was also significantly high in patients with severe Vitamin D deficiency (<10 ng/ml) compared to patients with Vitamin D more than 10 ng/ml.

Conclusion:

Serum concentration of IL8 is significantly higher in diabetic foot infections compared to controls. Severe Vitamin D deficiency was associated with IL8 concentration in patients with diabetes.
Insulin Resistance in Early and Advanced Diabetic Kidney Disease
Authors: Purandare Vedavati B. , Kakrani Arjun L. , Bale Charan B. , Tiwari Shalbha , Unnikrishnan Ambika G.
Published: January 2022

Background:

Insulin resistance (IR) is commonly seen in diabetic kidney disease (DKD) and could contribute to the progression of renal disease and cardiovascular risk. In this study, we aim to measure homeostasis model assessment IR (HOMA-IR) in DKD and see the effect of advancing kidney disease on HOMA IR.

Material and Methods:

We recruited 120 subjects with type 2 diabetes mellitus and divided them into people without kidney disease (controls; n = 20), early DKD (n = 40), and advanced DKD (n = 60). Biochemical tests including fasting plasma glucose and fasting serum C-peptide were done in 120 subjects. IR was calculated by the HOMA model in 109 subjects. Data were presented as median (interquartile range [IQR]). Univariable and multivariable analysis was done.

Results:

Median of HOMA-IR in the control group was 2.0 (IQR: 1.5–2.8; n = 20), early DKD group was 2.3 (1.8–2.9; n = 37), and advanced DKD group was 3.67 (1.6–3.9; n = 52). P = 0.03 indicated a significant increase in the HOMA IR with advancing kidney disease.

Conclusion:

In patients with DKD, with advancing kidney disease, there was a significant increase in the HOMA IR, a marker of IR. IR is a modifiable metabolic risk factor, and if it is managed by novel therapeutic ways, it might improve clinical outcomes in DKD.
Glycation
Authors: Bansode Sneha B. , Joshi Rakesh S. , Giri Ashok P. , Kulkarni Mahesh J.
Published: January 2022

Diabetes is considered as a risk factor for the severity of coronavirus disease 2019 (COVID-19). The mortality rate of COVID-19 was found to be high among patients with diabetes. The exact molecular mechanism involved in diabetes-associated COVID-19 severity is not established. In this review, we discuss the exacerbated formation of advanced glycation end products (AGEs), AGE-receptor for AGE (RAGE) signaling induced spike in inflammatory cytokines, and the role of metformin, an antidiabetic drug with glycation inhibition property. The commonality between these two diseases is exacerbated immune response. AGEs interact with RAGE, leading to oxidative stress, activation of the pro-inflammatory pathway, and production of inflammatory cytokines, which may aberrantly activate the immune response. Based on these pieces of evidence, we propose a role for glycation in the pathogenesis of COVID-19 severity.
Young and Evolving
Authors: Fogelberg Katherine , Hunt Julie , Baillie Sarah
Published: January 2022

Narrative inquiry is a qualitative research approach that tells the story of lived experiences through the eyes of those who experienced it, as interpreted by the researcher(s). Veterinary educational research (VER) is a relatively new and emerging field with an increasing number of faculty champions spread around the world. The lived experiences of some of the faculties who were involved in VER from the early days and have produced a body of work contributing to the growth of the discipline tell a collective story that outlines the challenges and benefits of being trailblazers for a new field of inquiry. The specific challenges identified included lack of resources, a sense of isolation, lack of respect for the discipline, and having to acquire the skills and knowledge necessary for successful transition from a clinical to an education focus. Their individual narratives also provided an overall positive outlook on the field, from influencing school policies to better, more satisfying teaching and leadership roles and from the excitement of learning a new discipline to nurturing future veterinary education researchers; the participants were generally upbeat about the value their contributions have made and will continue to make. This study provides a narrative that weaves together the individual stories of these VER trailblazers, based on semi-structured interviews conducted during 2020; it demonstrates the ongoing need to support those who choose to pursue VER, cultivate a culture in which veterinary medicine values such research, and begin training veterinarians to engage in it early in their careers.
Impact of Online Courses and Grading Framework on Student Learning and Motivation
Authors: Stowe Devorah M , Schoenfeld-Tacher Regina M , Hammond Sarah , Hedgpeth Mari-Wells , Neel Jennifer A
Published: January 2022

Background:

At our institution, the COVID-19 pandemic led to an abrupt change from traditional in-person instruction to remote teaching along with a concurrent change from letter grades to satisfactory/marginal/unsatisfactory grading.

Objectives:

The aims of this study were to explore the effects of changes in instructional delivery on students’ learning and retention of the material and to assess students’ motivation to learn.

Methods:

The study consisted of two phases. Phase 1 involved the administration of an academic motivation survey and a clinical pathology exam using online platforms. Phase 2 involved conducting a focus group to further explore student experiences during the change in course instruction.

Results:

The academic motivation survey revealed that both prior to and during the pandemic, the main drivers for student achievement were an interest in learning the content due to anticipated relevance in clinical practice, as well as a desire to master course goals. While the students predicted feeling more confident in their data interpretation ability in the traditionally taught topics vs. topics modified due to social distancing, the data from the content exam suggests that students showed better retention of topics taught in a modified manner. Lastly, the focus group revealed that participants perceived online learning to be more challenging due to the lack of in-person contact and increased frustration with technical issues.

Conclusion:

While moving courses online may make it more difficult to engage with the materials, peers, and instructors, there did not appear to be adverse effects on the overall student learning or content retention.
Impact of Voice Conservation Sensitization Program in Nursing Trainees
Authors: Yeshoda Krishna , Rajasudhakar Rathinaswamy , Lokheshwar Shanmugasundaram
Published: January 2022

Introduction:

Vocal hygiene sensitization programs help in propagating the information about conservation of voice in a swift manner to a target population. Nurses being bridge between patients and doctors help patients understand or convey important information. Hence, nursing trainees formed the target group for the sensitization program on voice conservation and care.

Materials and Methods:

Ninety-two nursing trainees and their faculty participated in a one-day sensitization program on vocal hygiene. The program consisted of two lectures on the anatomy and physiology of voice and vocal hygiene for voice conservation and voice care. Participants’ familiarity of the topic was assessed using a questionnaire before and after the lectures.

Results:

There was a significant increase in percent correct response from 77.41% to 91.46% after the program. Out of 10 questions, eight had increase in scores, one had decreased score, and one question remained the same.

Conclusion:

Improved percent correct response scores of the participants in the post test implied better awareness about the voice production mechanism and conservation of voice and its care. The results could imply that such programs could improve dissemination of information pertaining to voice use, conservation of voice, and helping in reducing the occurrence of voice problems in different groups of professional voice users.
Near-peer Learning in Medical Education
Authors: Spratte Brooke Namboodri , Hollis Alison Nancy , Hollis Emily Susan , Cole Yasemin Cunan , Bennett William Cannon , Alexander Seth Mckenzie , Parton Trevor , Beck Dallaghan Gary L
Published: January 2022

Background:

The coronavirus disease-2019 stressed health science education across many science disciplines. At one public medical school, faculty educators responded with the design and delivery of an online COVID-19 pandemic course for clinical phase students. However, faculty resources were limited, and no official course was offered to preclinical students, despite reported interest. Subsequently, clinical students created an 8-week online, student-run curriculum. We aimed to assess how effectively the course improved medical student knowledge on COVID-19, created community, and improved other professional skills.

Methods:

Participants and instructors completed four surveys—two pre-course surveys and two post-course surveys. Average ratings for each question were calculated and analyzed using independent sample t tests.

Results:

Of the 188 students in the preclinical cohort, 143 enrolled in the course with 63.64% attending all, 91% attending ≥7 out of 8, and 96% attending ≥6 out of 8 sessions. Students and instructors reported an overall mean increase in knowledge on all course topics, peer teaching, learning in an online format, and overall preparedness with regards to a public health crisis. Overall, 79.2% of student participants and instructors reported being satisfied with the experience.

Conclusion:

Peer teaching and learning offers a valuable educational experience for participants and instructors alike. Student-driven curricula may provide an effective teaching model for medical education, contributing to efforts that improve student confidence and leadership skills, provide role models for junior students, and prepare students for their future role as educations.
Decision-Making Experiences and Decisional Regret in Patients Receiving Implanted Cardioverter-Defibrillators
Authors: Pourshams Idean Ahmad , Lin Bryant , Wang Paul J. , Stafford Randall S.
Published: January 2022

Background:

Patient education before the placement of an implantable cardioverter-defibrillator (ICD) is strongly recommended to prevent or mitigate feelings of regret and frustration in ICD recipients. Medicare guidelines for ICDs require a shared decision-making approach that focuses on patients' health goals, values, and preferences before implantation. However, many patients are not fully informed of what to expect when recovering from ICD placement or living with an ICD long-term.

Objectives:

Our objective is to understand decision-making processes and decisional regret in patients requiring ICDs using in-depth interviews.

Methods:

Nineteen patients at Stanford University Medical Center were recruited to participate in individual interviews using closed-ended and open-ended questions to engage dialogue. Notes taken during interviews were assessed and used to identify major themes.

Results:

Participants described a lack of adequate education about ICD postoperative recovery and long-term, postimplantation considerations such as avoiding electromagnetic fields, false-positive ICD shocks, and the esthetic effect of ICD implantation. In addition, feelings of fear and anxiety were prevalent in participants' recollections of accepting an ICD.

Conclusion:

Further improvement in patient education before ICD placement is needed. The decision-making process can be simplified and patient regret and frustration minimized by providing reliable information that is accessible and interactive.
Socioeconomic and Clinical Factors Associated with Disease-Related Knowledge of Cardiac Rehabilitation Patients in Brazil
Authors: Loures Jessica B. , Chaves Gabriela S.S. , Ribas Renata C. , Britto Raquel R. , Marchiori Marian P. , Ghisi Gabriela L.M.
Published: January 2022

Objective:

The objective of this study was to identify socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation (CR) patients.

Methods:

Adults with coronary artery disease (CAD) were recruited during CR Phase 1 and completed questionnaires on the 1st day of Phase 2. Disease-related knowledge was assessed by the short version of the CAD Education Questionnaire. Socioeconomic status was defined by educational level, family income, and employment status. MannWhitney U and Spearman correlation were calculated to determine the association of knowledge with socioeconomic factors, number of risk factors, and wait time between hospital discharge and start of outpatient CR.

Results:

A convenience sample of 39 patients were recruited. Overall, the mean knowledge was 12.00 ± 3.3, which corresponds to 60% of possible scores. Monthly family income and number of risk factors influenced medical condition knowledge (P < 0.05), and employment status influenced total knowledge (P = 0.005) and risk factor knowledge (P = 0.002). Participants with three or more risk factors presented significantly higher knowledge (P = 0.02). Those that waited more than 17 weeks to start the CR presented significantly lower knowledge (P = 0.04).

Conclusion:

Participants with low income and unemployed were more likely to have inadequate disease-related knowledge; however, the entire sample presented low understanding of their condition. Public health strategies and educational interventions must continue to focus on these vulnerable groups.
Free Vascularized Supraclavicular Autologous Heterotopic Lymph Node Transfers Without Skin Paddle for Lymphedema Lower Limb
Authors: Mir Mohd Altaf , Praveen AJ , Maurya Rajesh Kumar
Published: January 2022

Free vascularized lymph node transfer (VLNT) is one of the new and highly efficacious procedures in the cases of lymphedema. In this case, we present a case of lower-limb lymphedema which was managed by this procedure where a supraclavicular LN was harvested and transferred to the lower leg. VLNT from the supraclavicular region is a very effective treatment for physiological restoration of the lymphatic flow in established cases of lower-limb lymphedema because of well-hidden favorable scar and minimal chances of secondary iatrogenic lymphedema in the donor region unlike other sites such as groin and axilla. The VLNT should be preferred over manual lymphatic drainage because it is very effective treatment for physiological restoration of the lymphatic flow, however, the further analytical studies are required to confirm statistically the effectiveness of the same over other modalities.
Vicissitudes in the Placental Cotyledon Number in a Singleton Pregnancy with Gestational Diabetes
Authors: Elamin Abdalla Ahmed , Mohammed Ahmed Mohammed Noah , El Elhaj Abubaker , Ahmed Hussien Tarig Mahmoud , Abdelrahman Mohamed Abdelrahim Awadelkarim , Mohamed Hamza , Idris Saadeldin Ahmed
Published: January 2022

Background:

Placenta is a transient organ during pregnancy, connects the fetus to the uterine wall. Pregnancy is frequently complicated by gestational diabetes, which might cause morphological changes in the placenta (weight, diameter, and cotyledons number); consequently, it may affect both fetus and mother.

Aim:

The aim of this study was to determine the difference in placental cotyledons number between pregnant with gestational diabetes versus without gestational diabetes, then correlate it with the weight and diameter between groups.

Materials and Methods:

A comparative study (gestational diabetes Group A and nongestational diabetes Group B) included mothers with a singleton baby delivered at term (37–40 weeks) after acceptance of the informed consent. Women with pregestational diabetes and other chronic diseases and those with intrauterine fetal death were excluded. Postdelivery placentae were accurately prepared and examined in detail. The placental weight, diameter, and cotyledons number were recorded and analyzed by SPSS version 21. The correlation was measured between the two groups in terms of cotyledons count, placental diameter, and weight.

Results:

The study included 385 participants (128 Group A and 257 Group B). Placental number of cotyledons, weight, and diameter in Group A were higher than in Group B, and the difference was significant (P = 0.000, P = 0.021, and P = 0.000, respectively). In Group A, there was a significant correlation between the placental weight, diameter, and number of its cotyledons (r = 0.23, P = 0.011). Cotyledon count was significantly affected by diabetic control (P = 0.021).

Conclusions:

Gestational diabetes increases placental cotyledons number, weight, and diameter.
Serum Creatinine versus Corrected Cockcroft-Gault Equation According to Poggio Reference Values in Patients with Arterial Hypertension
Authors: Šečić Damir , Turohan Adnan , Begić Edin , Rebić Damir , Pepić Esad , Begić Zijo , Iglica Amer , Begić Nedim , Metović Azra , Mušanović Jasmin
Published: January 2022

Introduction:

Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients.

Materials and Methods:

The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values.

Results:

There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion.

Conclusion:

There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.
An Autopsy Case of the Decomposed Body with Kronlein's Shot and the Importance of Skull Reconstruction
Authors: Gupta Mayank , Tiwari Praveen Kumar
Published: January 2022

In forensic medicine, firearm-related fatalities are regular. The range and velocity of the bullet, the characteristics of the wounds, and the probability of recovery are vital components of forensic analyses. While examining gunshot wounds to the skull, focus on the critical difference between bullet entry and exit points and the distance between the muzzle and the bullet entrance is vital. Determining bullet injury in cases of extreme decay has been a difficult challenge. The police send a corpse in the later stages of decomposition for re-postmortem examination, with a history of severe blunt force injuries to the head in our case report. Following the reconstruction of the skull, it is determined that some regions are bone deficient. A bullet entry wound is present on the left side's upper border of the defect, formed like an arc (representing the upper 1/3rd of a circle), and a corresponding exit wound was discovered on the right side's lower border of the defect, shaped like an arc (representing the lower 1/3rd of a circle). The bullet passed left to right backward and downward. It is noteworthy that in cases of advanced decomposition, where identifying the characteristics of a bullet wound is nearly impossible, fully skeletonizing the body and reconstructing it will provide critical hints to establishing the cause of death.
Rare Presentation of Hibernoma as a Cystic Swelling
Authors: Sawarkar Prashant , Mehra Bhupendra , Dubhashi Siddharth Pramod , Kamal Fatema
Published: January 2022

Hibernoma is a rare benign tumor of brown fat origin. It presents as a painless, slowly growing soft tissue tumor mimicking lipoma or liposarcoma, usually affecting adults, with a slight male predominance and a peak of incidence between the third and fourth decades of life. This is a case report of 35-year male, who presented with a mobile, fluctuant and transilluminant, swelling of 7 cm × 5 cm, on medial aspect of the right upper leg. Ultrasonography showed well-defined cystic lesion of varied echotexture with dense internal echoes and septation. Lesion was excised in-toto. On gross examination, it was a subcutaneous, multiseptate cyst containing clear serous fluid with cholesterol crystals with a solid area of 3 cm × 2 cm. Histopathological examination revealed large tumor cells with abundant granular (multivacuolated) cytoplasm. Postoperative recovery period was uneventful. We present this case as cystic degeneration in case of hibernoma.
Trauma to Thrombus
Authors: Lavadi Raj Swaroop , Aditya Challapalli , Tejaswi Karri NST , Nambakam Tanuja Subramanyam , Lokare Shweta Meghnath
Published: January 2022

Internal jugular vein (IJV) thrombosis is associated with several etiologies. Trauma is a rarely recorded causative factor. This case presents one such example of how trauma causes IJV thrombosis. A middle-aged woman presented to the general medicine outpatient department with complaints of pain in the base of the left side of the neck and swelling of the left arm and neck for six days. The symptoms had occurred following a trivial trauma to the left side of the neck due to pressure from a 25 L water can. Before the patient came to our hospital, she went to a local clinic, where magnetic resonance imaging was done and showed findings suspicious of thrombosis in her left IJV with extension into adjacent veins. A venous Doppler confirmed the findings. The patient was then treated conservatively with low-molecular-weight heparin, muscle relaxants, and antibiotics. Although uncommon, vascular injuries should also be thought of following minor trauma and not just musculoskeletal events. This case report proposes that IJV thrombosis can also occur without the classical etiological factors.