bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study to assess the influence of anaesthetic type on incomplete excision rate for non-melanoma skin cancers
Authors: Page Daniel W. , Watter Henry , Ng Guat Shi , Silva Munasinghe 
Published: February 2021

Background: Australia has the highest incidence of non-melanoma skin cancers (NMSC) in the world estimated to be 2448/100,000 population with the state of Queensland carrying the highest burden of disease. Surgical excision is the primary treatment and makes up a large proportion of general surgical lists in regional Queensland where they are typically removed using either local anaesthetic (LA) alone, local anaesthetic and sedation (LAS), or general anaesthesia (GA). There is little in the literature to suggest if anaesthetic type effects the rate of incomplete excision. The purpose of this study is to establish if anaesthetic type impacts the rate of incomplete excision of NMSC.Methods: A retrospective audit was performed, incorporating a total of 194 squamous and basal cell carcinoma lesions excised between October 2019 and October 2020 at two hospitals in regional Queensland, Australia. Data was recorded for the type of anaesthetic used and the histopathology of the lesions including type of lesion and clearance of microscopic margins.Results: Of the 194 excised lesions 39 of them had involved margins (20.1%). The rate of involved margins under LA, GA and LAS were found to be 19.79, 18.52 and 22.73% respectively. When comparing these modalities with each other: LA vs. GA, LAS vs. GA and LA vs. LAS no significant difference was found in the rate of incomplete excision of NMSC with p values (<0.05) of 1, 0.62 and 0.82 respectively.Conclusions: Modality of anaesthetic used for excision of NMSC does not affect the outcome of incomplete excision of NMSC.
Knowledge and experience of healthcare workers during the COVID-19 pandemic: a cross-sectional study in Tema, Ghana
Authors: Opare-Addo Mercy N. A. , Mensah Josephine , Donkor Janice Osei , Amoako-Adusei Amos , Opoku-Bona Angela 
Published: February 2021

Background: Coronavirus Disease 2019 is a pandemic caused by a novel human coronavirus previously known as 2019-nCov. Healthcare workers are essential in the response to and management of such infectious diseases. Methods: A hospital-based cross-sectional study was conducted at Tema General Hospital, Ghana. Data was collected from healthcare workers using a structured questionnaire. Descriptive statistics was done for all socio-demographic characteristics of respondents. Level of knowledge about coronavirus disease and factors influencing participants’ willingness to work were summarized as frequencies, percentages and charts. Chi-square test was used to test for association between level of knowledge and all independent variables. Results: A total of 157 healthcare workers participated in this study. The news media (135, 85.99%) was the commonest source of information for participants. Almost half of participants (47.8%) had been tested for coronavirus disease, and 91.08% had sufficient knowledge about the disease. Occupation (p=0.047) was significantly associated with participants’ level of knowledge. A total of 46.49% disagreed with adequacy of personal protective equipment provided, with 70.06% admitting they have had to use their own personal protective equipment at work. A sense of duty (20, 31.8%) and motivation (14, 22.2%) positively influenced participants’ ability to work while challenges faced included fear of contracting and transmitting the virus (98.7%) and stigmatization (70.7%). Conclusions: The healthcare workers had sufficient knowledge about coronavirus disease. Insufficient personal protective equipment was evident during the pandemic. Measures must be established to ensure that barriers to work are eliminated while factors that enhance work output are encouraged.
Stress coping strategies of university students
Authors: Yavuz Hatunoglu Bedri 
Published: February 2021

The purpose of this study is to examine university students' strategies for coping with stress in terms of various variables. The study was carried out with 215 girls, 86 boys and 301 people studying at Ağrı İbrahim Çeçen University in the 2019-2020 academic year. According to the research findings; It was found that students resort to social support, which does not show a desperate approach to the events in which they are more optimistic and confident in their strategies to deal with stress. It has been observed that students have positive behaviors in their strategies to cope with stress, their irrational beliefs and personal control of university students and their thoughts about being externally supervised, and especially believing in luck and striving, are related to their styles of coping with stress. Opinions differed between university students' genders and the faculty variables they studied.

Keywords: Stress, Stress Coping, Stress Coping Strategy, University students,
Epidemiology of Opportunistic Infections in HIV Infected Patients on Treatment in Accredited HIV Treatment Centers in Cameroon
Authors: Kouanfack Ornella Sybile D. , Kouanfack Charles , Billong Serges Clotaire , Cumber Samuel N. , Nkfusai Claude N. , Bede Fala , Wepngong Emerson , Hubert Chombong , Tsague Georges Georges N. K. , Singwe Madeleine N. 
Published: February 2021

Background: The African continent accounts for over 70% of people infected with Human Immunodeficiency Virus (HIV). The HIV sero-prevalence rate in Africa is estimated at 4.3%. In developed countries, such as France, pneumocystis is indicative of AIDS in 30% of patients; however, in Africa, pulmonary tuberculosis (TB) is the most-documented opportunistic infection (OI) and the leading cause of death in HIV-infected patients. In 2016, Cameroon had 32,000 new cases of OI and 29,000 deaths as a result of these infections. However, there is little existing data on the epidemiological profile of OIs in Cameroon, which is why we conducted this study in accredited HIV treatment centers and care/ treatment units in the two cities of Douala and Yaounde, Cameroon.
Methods: This was a retrospective descriptive and analytical study carried out in 12 accredited HIV treatment centers in the cities of Yaound
Risk and Protective Factors Associated Mental Health among Female Military Veterans: Results from the Veterans’ Health Study
Authors: Adams Richard , Hu Yirui , Figley Charles R. , Urosevich Thomas G. , Hoffman Stuart N. , Kirchner H. Lester , Dugan Ryan J. , Boscarino Joseph J. , Withey Carrie A. , Boscarino Joseph A. 
Published: February 2021

Abstract
Background: This study focuses on factors that may affect female veterans’ mental health, compared to men, and is part of a large study assessing the prevalence of mental health disorders and treatment seeking among formerly deployed US military service members.Methods: We surveyed a random sample of 1,730 veterans who were patients in a large non-VA hospital system in the US. Based on previous research, women were hypothesized to be at higher risk for psychological problems. We adjusted our models for confounding factors, including history of childhood abuse, combat exposure, stressful life events, alcohol misuse, psychological resources, and social support. Results: Among the veterans studied, 5% (N=85) were female, 96% were White, 22.9% were Iraq/Afghanistan veterans, and the mean age was 59 years old. Compared to males, female veterans were younger, unmarried, college graduates, have less combat exposure, but more likely to have lifetime PTSD (29% vs. 12%.), lifetime depression (46% vs. 21%), lifetime suicide ideation (27% vs. 11%), to have ever used psychological services (67 vs. 47%). Females were more likely to have low psychological resilience and use psychotropic medicines. Using multivariate logistic regression analyses that controlled for risk and protective factors, female veterans had greater risk for lifetime PTSD, lifetime depression, and lifetime suicidal thoughts, compared to males. Since 95% of the population in this study were male and these results may have been statistically biased, we reran our analyses using propensity score matching. The results were consistent.Conclusion: Using a sample of post-deployment veterans receiving services from a non-VA healthcare system, we find that female veterans are at greater risk for lifetime psychological problems, compared to male veterans. We discuss these findings and their implications for service providers.
Manuscript of Kitab Sifat Dua Puluh: The Portrait of Moderate Islamic Theological Doctrines from Interior Borneo
Authors: Amin Faizal , Ichwan Moh. Nor 
Published: February 2021

The construction of religious moderation is not only derived from the context of practices but also the texts of its theological doctrines. Manuscripts of Kitab Sifat Dua Puluh from West Kalimantan is a primary source to study the basis of Islamic religious moderation in Interior Borneo. The texts of the manuscript are no longer presented as a copy of al-Sanūsī’s Umm al-Barāhīn but it has become a corpus that accommodates local genius and tradition. This article aims to examine the moderation of Islamic theological doctrine derived from the texts of the manuscript of twenty attributes of God. The texts of a manuscript considered as one of the sustainable best practices of South-East Asian localisations of Islam because it was one of the basic references for the local Dayak Muslim community learning Islam in interior Boneo. This article is based on the results of philological studies on the manuscript collection written by Abang Ahmad Tahir (1860-1945) in Kapuas Hulu, West Kalimantan, Indonesia. The moderate Islamic theological doctrine in Abang Ahmad Tahir’s manuscript collection can be seen through three indicators namely the simplicity of the narrative articulation and arguments of the attributes of God, the synthesis of Islamic theological doctrine with Sufi doctrine, and the content of the text that gives no room for hate speech against local tradition and different systems of belief of the indigenous offspring of West Kalimantan.
Should Echocardiographic Evaluation Be Performed Routinely in the First 72 Hours in Extremely Low Birth Weight Babies?
Authors: Colak Ruya , Alkan Ozdemir Senem , Yangin Ergon Ezgi , Kulali Ferit , Kalkanli Oguz Han , Gokmen Yildirim Tulin , Yilmazer Murat Muhtar , Zihni Cuneyt , Calkavur Sebnem 
Published: February 2021

Objective: Hemodynamically significant patent ductus arteriosus(hsPDA) is resulting in severe mortality and morbidity in infants with extremely low birth weight(ELBW). In our study, we aimed to evaluate the necessity of performing routine echocardiography(ECHO) in the first 72hours in ELBW infants.Study Design:This study was planned retrospectively and observationally.Between June2016 and December2018,36 patients diagnosed with hemodynamically significant PDA(hsPDA) who were hospitalized in the neonatal intensive care unit(NICU),with ≤28Gw or ≤1000g were included in this study.These babies were routinely performed ECHO for PDA between 24-72hours,although they were asymptomatic in the period from June2016 to December2017(n:23).Between January2018 and December2018, patients without PDA symptoms were expected to complete 72hours for routine PDA screening (n:13).The patients were divided into 2 groups as early ECHO group(EEG)(n=23) and late ECHO group (LEG)(n=13).In the presence of at least one of the clinical signs of systemic hypoperfusion and/or pulmonary hyperperfusion, symptomatic PDA was accepted and closure treatment was applied with ibuprofen(n: 23) or paracetamol(n: 5).While the two groups were compared in terms of demographic features,ECHO findings,and the state of taking closure therapy,patients receiving closure therapy were compared in terms of mortality and premature morbidity.Results:The average birth weight of 36 patients was 855.9(± 241.5)g, and the average week of birth was 26.4(± 2.1)Gw.It was observed that the two groups were similar in terms of demographic characteristics.Although the findings of ECHO and treatment rates were similar between the two groups,it was observed that the EEG had earlier closure treatment(p = 0.03). In patients receiving closure treatment, performing early(n:17)and late(n:11) echocardiography showed no statistical difference in the long-term results.Conclusion:Performing early ECHO without symptoms in infants with ELBW may provoke the clinician to give PDA closure treatment earlier. In infants with ELBW,unnecessary closure treatment can be prevented by closely monitoring the symptoms of PDA and performing ECHO when necessary.
Biochar produced from the co-pyrolysis of sewage sludge and waste tires for cadmium and tetracycline adsorption from water
Authors: Fan Xiulei , Zhang Jiajun , Xie Ya , Xu Dezhi , Liu Yu , Liu Jiaqiang , Hou Jun 
Published: February 2021

Abstract
Application of sewage sludge biochar as an adsorbent for pollutant removal has obtained special attention due to their low cost and surface functionality. In this research, sludge–tire composite biochar (STB) was successfully prepared through co-pyrolysis at 300, 500 and 700 °C, respectively. Cadmium (Cd) and tetracycline (TC) were selected as the target pollutant. The results indicated that STB has the highest surface area (49.71 m2/g), more inorganic minerals (Kaolinite) as well as relatively stable physicochemical properties with 10% tire particles (TP) at 700 °C. The adsorption results indicated that the pseudo-second-order equation and Langmuir isotherm model could better describe the adsorption of Cd2+ and TC by STB. The maximum adsorption capacity of Cd2+ and TC was 50.25 mg/g and 90.09 mg/g, respectively. The main mechanism of the adsorption process of STB for Cd mainly involves anion binding adsorption and ion exchange. The main mechanism of the adsorption process of STB for TC mainly involves complexation and cation exchange. The present study could set a scientific foundation for further research on the recycle of sewage sludge and tires.
The Development of an Escape Room–Based Serious Game to Trigger Social Interaction and Communication Between High-Functioning Children With Autism and Their Peers: Iterative Design Approach
Authors: Terlouw Gijs , Kuipers Derek , van 't Veer Job , Prins Jelle T , Pierie Jean Pierre E N 
Published: February 2021

Background
Children with autism spectrum disorder (ASD) have social deficits that affect social interactions, communication, and relationships with peers. Many existing interventions focus mainly on improving social skills in clinical settings. In addition to the direct instruction–based programs, activity-based programs could be of added value, especially to bridge the relational gap between children with ASD and their peers.

Objective
The aim of this study is to describe an iterative design process for the development of an escape room–based serious game as a boundary object. The purpose of the serious game is to facilitate direct communication between high-functioning children with ASD and their peers, for the development of social skills on the one hand and strengthening relationships with peers through a fun and engaging activity on the other hand.

Methods
This study is structured around the Design Research Framework to develop an escape room through an iterative-incremental process. With a pool of 37 children, including 23 children diagnosed with ASD (5 girls) and 14 children (7 girls) attending special primary education for other additional needs, 4 testing sessions around different prototypes were conducted. The beta prototype was subsequently reviewed by experts (n=12). During the design research process, we examined in small steps whether the developed prototypes are feasible and whether they have the potential to achieve the formulated goals of different stakeholders.

Results
By testing various prototypes, several insights were found and used to improve the design. Insights were gained in finding a fitting and appealing theme for the children, composing the content, and addressing different constraints in applying the goals from the children’s and therapeutic perspectives. Eventually, a multiplayer virtual escape room, AScapeD, was developed. Three children can play the serious game in the same room on tablets. The first test shows that the game enacts equal cooperation and communication among the children.

Conclusions
This paper presents an iterative design process for AScapeD. AScapeD enacts equal cooperation and communication in a playful way between children with ASD and their peers. The conceptual structure of an escape room contributes to the natural emergence of communication and cooperation. The iterative design process has been beneficial for finding a constructive game structure to address all formulated goals, and it contributed to the design of a serious game as a boundary object that mediates the various objectives of different stakeholders. We present 5 lessons learned from the design process. The developed prototype is feasible and has the potential to achieve the goals of the serious game.
Tabletop Board Game Elements and Gamification Interventions for Health Behavior Change: Realist Review and Proposal of a Game Design Framework
Authors: Epstein Daniel S , Zemski Adam , Enticott Joanne , Barton Christopher 
Published: February 2021

Background
Games, when used as interventional tools, can influence behavior change by incentivizing, reinforcing, educating, providing feedback loops, prompting, persuading, or providing meaning, fun, and community. However, not all game elements will appeal to all consumers equally, and different elements might work for different people and in different contexts.

Objective
The aim of this study was to conduct a realist review of tabletop games targeting behavior change and to propose a framework for designing effective behavior change games.

Methods
A realist review was conducted to inform program theory in the development of tabletop games for health behavior change. The context, mechanisms used to change behavior, and outcomes of included studies were reviewed through a realist lens.

Results
Thirty-one papers met the eligibility criteria and were included in the review. Several design methods were identified that enhanced the efficacy of the games to change behavior. These included design by local teams, pilot testing, clearly defined targets of behavior change, conscious attention to all aspects of game design, including game mechanics, dynamics, aesthetics, and the elicitation of emotions. Delivery with other mediums, leveraging behavioral insights, prior training for delivery, and repeated play were also important. Some design elements that were found to reduce efficacy included limited replayability or lack of fun for immersive engagement.

Conclusions
Game designers need to consider all aspects of the context and the mechanisms to achieve the desired behavior change outcomes. Careful design thinking should include consideration of the game mechanics, dynamics, aesthetics, emotions, and contexts of the game and the players. People who know the players and the contexts well should design the games or have significant input. Testing in real-world settings is likely to lead to better outcomes. Careful selection and purposeful design of the behavior change mechanisms at play is essential. Fun and enjoyment of the player should be considered, as without engagement, there will be no desired intervention effect.
Barriers to the Large-Scale Adoption of a COVID-19 Contact Tracing App in Germany: Survey Study
Authors: Blom Annelies G , Wenz Alexander , Cornesse Carina , Rettig Tobias , Fikel Marina , Friedel Sabine , Möhring Katja , Naumann Elias , Reifenscheid Maximiliane , Krieger Ulrich 
Published: February 2021

Background
During the COVID-19 pandemic, one way to reduce further transmissions of SARS-CoV-2 is the widespread use of contact tracing apps. Such apps keep track of proximity contacts and warn contacts of persons who tested positive for an infection.

Objective
In this study, we analyzed potential barriers to the large-scale adoption of the official contact tracing app that was introduced in Germany on June 16, 2020.

Methods
Survey data were collected from 3276 adults during the week the app was introduced using an offline-recruited, probability-based online panel of the general adult population in Germany.

Results
We estimate that 81% of the population aged 18 to 77 years possess the devices and ability to install the official app and that 35% are also willing to install and use it. Potential spreaders show high access to devices required to install the app (92%) and high ability to install the app (91%) but low willingness (31%) to correctly adopt the app, whereas for vulnerable groups, the main barrier is access (62%).

Conclusions
The findings suggest a pessimistic view on the effectiveness of app-based contact tracing to contain the COVID-19 pandemic. We recommend targeting information campaigns at groups with a high potential to spread the virus but who are unwilling to install and correctly use the app, in particular men and those aged between 30 and 59 years. In addition, vulnerable groups, in particular older individuals and those in lower-income households, may be provided with equipment and support to overcome their barriers to app adoption.
Therapeutic Efficacy of Moxifloxacin Mucoadhesive Hydrogel for Bacterial Keratitis
Authors: Bhoi Nipuna Kumar , Singhai A. K. , Jain Gaurav , Mishra Subhendu S. 
Published: February 2021

Bacterial keratitis is a hypothetically devastating corneal infection due to the opportunity of fast development; corneal devastation either to be completed in 24–48 hours with even more contagious bacterial aetiological agents. Moxifloxacin mucoadhesive Hydrogel was prepared by using polymer Hydroxy Propyl Methyl Cellulose E50 LV by hydration method. Moxifloxacin was dissolved in small quantity of water and Benzalkonium Chloride was added to the Polymer solution. The formulations were evaluated for clarity, pH measurement, spread-ability test, drug content estimation, viscosity study, in vitro diffusion study and antibacterial activity. The developed formulation exhibits the sustained release over a period of 10 hour. The optimized formulation was further evaluated with antimicrobial activity. The results of the in-vitro antimicrobial activity of hydrogel were satisfactory.
Keywords: Corneal Infection, Hydrogel, Moxifloxacin, invitro release
In vitro antioxidant activity and gastroprotective effect of ethanolic extract from Cucumis melo L. var. inodorus fruit on ethanol-induced gastric ulcer in rats
Authors: Bouaziz Amel , Bentahar Assia , Djidel Saliha , Dahamna Saliha , Khennouf Seddik 
Published: February 2021

The aim of this study was to estimate the content of polyphenols, flavonoids and tannins and to evaluate the antioxidant property and the antiulcer activity of the ethanolic extract of melon (Cucumis melo L. var. inodorus) pulp on ethanol-induced gastric ulcers in rats. Ferric reducing power and hydroxyl radical scavenging tests were applied to evaluate the in vitro antioxidant activity. The polyphenolic and flavonoids contents of melon extract were found to be 56.5 ± 2.49 mg GAE/g of dry extract and 0.43 ± 0.09 mg QE/ g of dry extract, respectively. Whereas the tannins content was 48. 30 ± 0. 9 mg ETA/ g of dry extract. Melon pulp extract exhibited a good reducing potential with an EC50 of 4.23 ± 0.08 mg/ml and high hydroxyl radical scavenging activity with IC50 of 1.83± 0.09 mg/ml. Oral administration of the melon pulp extract at doses of 200 and 600 mg/kg to rats reduced gastric mucosal lesions dose-dependently with percentage protection of 56.56 and 93.79% compared to omeprazole (95.92 %) as reference drug. These results showed that the melon pulp extract had a good antioxidant activity and gastroprotective potential suggesting it use as an adjuvant in the treatment of gastric ulcer.
Keywords: Cucumis melo var. inodorus, Polyphenols, Flavonoids, Tannins, Ulcer, Rat.