bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eliciting preferences of professors and medical group students for evaluation methods of theoretical courses
Authors: Kazemi Karyan Ali , Rezaei Satar , Etesami Shokooh , Pezhman Leyla , Matin Behzad Karami , Delavari Sajad 
Published: February 2021

BACKGROUND:
Evaluation has become an inseparable part of education process which gives feedback to students and professors to improve education quality. This study aimed to elicit preferences of professors and students about attributes of evaluation methods in theoretical courses in Kermanshah University of Medical Sciences, Iran, in 2018.

MATERIALS AND METHODS:
Discrete choice experiment (DCE) method used for eliciting preferences of participants of the study. A narrative literature review and interview with eight professors and ten students conducted to determine attributes and levels of evaluation methods in the university. Furthermore, experimental design used for making final choice sets of the evaluation methods. We included 213 students and 30 professors in the study. Conditional logistic regression model performed to data analysis.

RESULTS:
Most of the professors (36.67%) preferred to allocate up to 30% of evolution scores to midterm examination. However, the most percentage of students (30.45%) were agree to include midterm examination up to 15% of total scores. The majority of students prefer to examination questions compromise just presented materials, while 70% of professors prefer to include additional texts for evaluation examinations. In case of quiz examination, professors in comparison with students prefer that quiz should have higher proportion of total scores. DCE analysis indicated that professors and students preferred a mix of questions in examinations. In addition, additional resources beyond what is taught in class made utility for professors and disutility for students. Quiz, also, increased the utility of an evaluation package in professors.

CONCLUSION:
The findings showed that there is a gap between preferences of professors and students regarding some attributes of evaluation methods such as student's discipline, examination materials, and quiz. Further studies are needed to examining other attributes of evaluation methods in theatrical and practical courses in Iran and other contexts.
Impact of knowledge, attitude, and practices of Type 2 diabetic patients
Authors: Le Nghiep Ke , Turnbull Niruwan , Van Dam Cuong , Khiewkhern Santisith , Thiabrithi Surasak 
Published: February 2021

BACKGROUND:
Disease knowledge, appropriate attitude, and proper practices play an important role in disease control and reduction of diabetes-related complications and deaths. This study aims to investigate the impact of knowledge, attitude, and practices (KAPs) of Type 2 diabetic patients' outcomes.

MATERIALS AND METHODS:
A cross-sectional research was conducted on a group of 102 Type 2 diabetic participants in 17 communities in Tam Binh District, Vinh Long Province, Vietnam. The research tool employed the KAP questionnaire using IBM SPSS 22 to analyze the data.

RESULTS:
The participants' average age was 57.02 ± 6.323 years. The proportion of women was 76.5% (three times higher than men). The knowledge score of the participants was low (30.04 ± 12.823), the attitude toward score of diabetics was moderate (61.544 ± 29.99), and the practice of self-care score was low (50.59 ± 14.881). There were also some significant relationships between KAPs with ethnicity, marital status, diabetic duration, location, employment status, and treatment method. In addition, there were only significant differences between the self-care practice groups and patients' attitude toward Type 2 diabetes.

CONCLUSION:
There is a significant relationship between KAP with some participants' characteristics. The KAPs of the diabetic patients in Tam Binh district are still low. This result showed that although the patient's attitude towards disease was good, it was not enough for them to practice good self-control due to poor knowledge.
Social media effects among freshman medical students during COVID-19 lock-down
Authors: Gupta Ankit , Jagzape Arunita , Kumar Mahendra 
Published: February 2021

BACKGROUND:
Lockdown was imposed as a preventive measure for coronavirus disease pandemic. Social media was the most common tool available for the masses, including the 1st year medical students during the lockdown. The objectives of the present study were to determine the extent of use of social media and the effects on mind-body and social distancing.

MATERIALS AND METHODS:
It was mixed research conducted on 1st-year medical students using convenience sampling. The quantitative aspect of E-survey was administered through Google forms sent via E-mail, and structured telephonic interview was conducted as a qualitative aspect on randomly selected 10 students based on predecided interview questions. This study was reported as per the Checklist for Reporting Results of Internet E-Surveys. The analysis was performed using percentages and paired t-test with significance at P < 0.05, Chi-square test with Yate's correction. Qualitative responses were analyzed using coding and categorization.

RESULTS:
The response rate was 88%. Time spent on social media for >4 h increased from 1.1% to 47.72% during lockdown. Forty three (48.86%) of the students reported increased mood fluctuations. The relation between mood fluctuations and time spent on social media of >4 h was significant χ2= 6.41 with P < 0.05. Average hours of sleep after using social media before lockdown increased significantly from 6.68 h to 8.10 h during lockdown using paired t-test, where “t” was 6.84. There was a positive impact on communication with friends and family.

CONCLUSION:
Due to the increased extent of use of social media during lockdown, negative mind-body effects have surfaced but emerged as boon in terms of communication.
Predictive factors of quality of life among the elderly in Iran
Authors: Nazari Soghra , Kamali Koorosh , Hajimiri Khadijeh 
Published: February 2021

BACKGROUND:
This study aimed to identify the quality of life (QoL) and its predictive factors based on the Andersen's behavioral model among the elderly in Iran.

MATERIALS AND METHODS:
A quantitative cross-sectional study was conducted on 400 people aged 60+ resident in Zanjan, Iran, in 2019. Data were collected based on the Andersen's behavioral model constructs by the questionnaires. Path analysis was used to determine both direct and indirect effects of variables and also for estimating the values of coefficients in the underpinning linear model.

RESULTS:
In this study, 50% of the participants were female, and 83% were married. The participant's QoL was 37.4 (9.8). The results confirmed that financial level and physical activity were the most significant predictor of the elder's QoL. Chronic diseases and activities of daily living as need factors affect the QoL of participant indirectly.

CONCLUSION:
The results showed that the participant's QoL was at a moderate level. Utilizing of primary health-care services was the weakest predictors of QoL. Sex, marital status, and education level were not reliable predictors of QoL in elders. Other predisposing, enabling, and need factors should be investigated to find the main determinants to improve elder's QoL.
Translational cultural adaptation and psychometric study of the Persian version of pediatric inventory for parents
Authors: Khanjari Sedigheh , Tehrani Fereshteh Javaheri , Panahi Shabnam Shariat , Saidee Ahmad 
Published: February 2021

BACKGROUND:
Cancer, as a life-threatening disease in children, poses several challenges for parents. It is necessary to have a tool that can comprehensively examine the stressful events for parents of children with cancer. The aim this present study was done with the aim of study the Persian version of pediatric inventory for parents (PIP).

MATERIALS AND METHODS:
The study was a conducted based on methodological research design. Four hundred and fifteen parents of children with cancer referring to Alia Asghar Children's Hospital and Children's Medical Centre in Tehran answered the Persian version of PIP questionnaire in 2019. a confirmatory factor analysis was carried out using LISREL (software version 8.8) to test the construct validity of PIP. The two tools of parental stress scale and state-trait anxiety inventory (STAI-Y) were used for concurrent validity purposes.

RESULTS:
The results showed that, the overall score of the questionnaire was higher than the average and related to emotional distress. The internal correlation coefficient (Cronbach's alpha) in both parts of the PIP was between 0.808 and 0.957 and acceptable. Concurrent validity analysis indicated positive and significant correlation of this tool in the difficulty section of the scale with both Parental Stress Scale and STAI-Y. The results of confirmatory factor analysis indicated that the factor loads of all items except three items in the frequency section were more than 0.3 and were appropriate.

CONCLUSION:
The Persian version of PIP can be available to health and family experts as a valid and reliable tool to assess stressful events of parents of children with cancer.
Students’ perspectives on the virtual teaching challenges in the COVID-19 pandemic
Authors: Mortazavi Forough , Salehabadi Raha , Sharifzadeh Masoume , Ghardashi Fatemeh 
Published: February 2021

BACKGROUND:
The COVID-19 pandemic led to the closure of crowded places such as universities and replaced face-to-face learning with virtual education. The purpose of this qualitative study was to investigate the challenges of virtual learning from the students' perspectives.

MATERIALS AND METHODS:
This qualitative descriptive study was conducted on students of Sabzevar University of Medical Sciences. Purposeful sampling was performed by semi-structured group interviews on the Internet in the WhatsApp social network. Fifty-two nursing, midwifery, hygiene, and paramedical students were interviewed. Every interview was started by asking the question “what is your experience about virtual teaching?” The data were analyzed using MAXQDA software version 2020. According to the steps of qualitative content analysis, content analysis was performed and the themes were extracted.

RESULTS:
Fifty-two students were interviewed in eight group sessions. Qualitative data analysis leads to the extraction of 23 codes, 7 categories, and the 2 main themes; dissatisfaction with virtual education with 4 categories (lack of feedback, communication channel problems, the unpreparedness of the message receiver, and weakness in educational content) and solutions to the modification of virtual teaching with three categories (possibility of receiving feedback, channel improvement, and strengthening educational content) were extracted. The highest frequency of code was related to the dissatisfaction with the uploaded contents.

CONCLUSIONS:
Virtual education has created a negative experience among students for various reasons, including the lack of distance learning infrastructure and the lack of a standard for preparing quality content. Therefore, it is necessary for the officials of the Education Development Center to supervise the prepared contents and improve distance learning infrastructure.
Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic
Authors: Chopra Deepti , Bhandari Bharti , Sidhu Jaspreet Kaur , Jakhar Kiran , Jamil Fariza , Gupta Rakesh 
Published: February 2021

BACKGROUND:
Amidst corona virus disease-2019 (COVID-19) pandemic, disruption to the usual ways of life can lead to anxiety and feeling of being unsafe, which may be associated with self-medication. The study was planned to investigate the prevalence of anxiety and self-medication during COVID-19 pandemic.

MATERIALS AND METHODS:
In this cross-sectional study, data were collected through an anonymous online survey with questionnaire consisting of four sections: demographic data of the participants, validated COVID-19 Anxiety Inventory Items, Self-rating Anxiety Scale, and self-medication practices during COVID-19 pandemic. The data were organized and analyzed using Windows Microsoft excel and SPSS software (Version 21). Descriptive statistics were calculated for all patient characteristics and survey responses. Analytical analysis included relationship between various parameters using Chi-square test.

RESULTS:
A total of 1100 responses were received. Approximately half of the participants were worried about getting severely ill. Majority reported reduced social contact (71.3%, n = 784) and also communicated that the pandemic has influenced their use of safety measures (86.5%, n = 951). The prevalence of mild-to-moderate, moderate-to severe, and extremely severe anxiety cases were 23.1%, 4.7%, and 0.54%, respectively. One-fourth of the responders reported self-medication, out of which 60% were found to be anxious. Nonsteroidal anti-inflammatory drugs were most commonly used.

CONCLUSIONS:
Rising to the present challenge will require integration across different sectors with the immediate aim of getting people safely through the pandemic. As the world focuses on containing and delaying the spread of the COVID-19, with burdened health-care systems, we should not miss out on people with anxiety disorders and self-medication problem, which may worsen with the pandemic.
COVID-19 and the “Stay at home” recommendation
Authors: Shojaei Amirahmad , Salari Pooneh 
Published: February 2021

BACKGROUND:
Facing a devastating infectious outbreak like COVID-19, the command of “stay at home” was recommended by some officials as a self-voluntary quarantine strategy for controlling the outbreak, but the people perceived and act differently. In this study, we aimed at ethnographic evaluation of public response to this command.

MATERIALS AND METHODS:
This research used ethnography for observing the public response to the recommendation of “stay at home” in the COVID-19 outbreak. Data were collected via observing public behavior and documentation; then, the data were qualitatively analyzed.

RESULTS:
Our findings showed 10 different ignored dimensions in this moral statement including lack of legal and administrative support, diverse perception and contradictory reactions of the people to the epidemiological forecasting and recommendations, different response to moral statements, various perceptions of the people about health and wellbeing, feeling exhausted of staying at home, not including justice and fairness in the moral statement, not clarifying the meaning of necessary matters, not considering the COVID-19 infected patients and their requirements, assigning the responsibility of government to the public, and halting other scientific activities and investigations in charge of COVID-19.

CONCLUSIONS:
Taken together, the officials should take an active role in implementing this moral statement by strict regulations, public education about the disease, its control, and the importance of quarantine, considering justice and fairness in implementation.
Serum levels of visfatin, sirtuin-1, and interleukin-6 in stable and acute exacerbation of chronic obstructive pulmonary disease
Authors: Ghobadi Hassan , Mokhtari Sara , Aslani Mohammad Reza 
Published: February 2021

Background:
Visfatin is an adipokine that increased under inflammatory conditions. Moreover, sirtuin-1 possesses regulatory effects on inflammatory factors. In this study, we aimed to evaluate the serum level of visfatin in patients with stable and acute exacerbation of chronic obstructive pulmonary disease (AE-COPD).

Materials and Methods:
In a case–control study, thirty patients with stable COPD (S-COPD), thirty patients with AE-COPD, and thirty control subjects were enrolled. Pulmonary function tests and blood sampling were performed on all participants. Serum visfatin, sirtuin-1, and interleukin (IL)-6 levels were measured using the sandwich ELISA method and assessed their association with study parameters.

Results:
The findings of the current study revealed that serum levels of visfatin in AE-COPD patients were higher than those of healthy controls and S-COPD (for healthy control; standardized mean difference [SMD] = 2.63, 95% confidence interval [CI] =1.31–2.83, P < 0.001, and for S-COPD; SMD = 1.53, 95% CI = 0.21–2.85, P < 0.05). On the other hand, the serum levels of sirtuin-1 were higher in healthy controls compared to the S-COPD and AE-COPD patients (for S-COPD; SMD = 1.56, 95% CI = 0.018–3.11, P < 0.05, for AE-COPD; SMD = 1.50, 95% CI = 0.048–3.04, P < 0.05).

Conclusion:
Elevated visfatin and IL-6 levels demonstrated their pro-inflammatory effects in patients with COPD, especially in AE-COPD patients. In addition, the negative association found between serum visfatin and sirtuin-1 levels suggested the pathophysiologic and therapeutic roles of these factors in COPD patients.
Comparison between Plusoptix A09 and gold standard cycloplegic refraction in preschool children and agreement to detect refractive amblyogenic risk factors
Authors: Thomas Jyothi , Rajashekar B. , Kamath Asha , Gogate Parikshit 
Published: February 2021

BACKGROUND:
The preschool children hardly complain about their vision problems. It is of paramount importance to screen them with an objective tool and compare with the gold standard technique.

AIM:
To compare the values obtained with Plusoptix A09 and cycloplegic refraction in 3–6 years children and agreement to detect refractive amblyogenic risk factors.

SUBJECTS AND METHODS:
A cross-sectional study was conducted in the Outpatient Department of Ophthalmology in a tertiary care hospital. Informed consent from parents and verbal assent from children were obtained. Each subject had monocular vision assessment with Lea symbol chart, stereo acuity measurement with Frisby, refractive screening with Plusoptix A09, squint assessment, and anterior segment evaluation before administering Homatropine hydrobromide (homide) 2% eye drops. Cycloplegic refraction and posterior segment evaluation were performed for final diagnosis.

STATISTICAL ANALYSIS:
Descriptive statistics were used to summarize the data. Spearman correlation coefficient and kappa statistics were also employed.

RESULTS:
In total, data of 94 children were analyzed. The correlation values obtained between plusoptix and cyclorefraction values for spherical, cylindrical, spherical equivalent were 0.508 (P < 0.0001), 0.779 (P < 0.0001), and 0.407 (P < 0.0001), respectively. Refractive errors were seen in 32% and amblyopia in 17% of eyes. Kappa value was κ = 0.974 in detecting refractive amblyogenic risk factors.

CONCLUSION:
Good correlation was found between the plusoptix and cyclorefraction values. Cylindrical values showed a better correlation. Refractive errors and amblyopia were the major ocular disorders observed. There was significant agreement between the refractive techniques in detecting amblyogenic risk factors.
Comparison between two intravitreal injection techniques with respect to fluid reflux, intraocular pressure, and therapeutic effect
Authors: Tanwar Shashi , Sharma Arun Kumar , Srivastava Rajat Mohan , Katiyar Vishal , Agrawal Siddharth , Gupta Sanjiv Kumar 
Published: February 2021

CONTEXT:
Effect of fluid reflux on intraocular pressure (IOP) and therapeutic benefits.

AIMS:
The aim of this study is to compare two intravitreal injection techniques in terms of fluid reflux, short-term IOP changes, and therapeutic effect.

SETTINGS AND DESIGN:
A prospective, double-blinded, randomized interventional study.

SUBJECTS AND METHODS:
Sixty eyes were randomly allocated to two groups (direct intravitreal injection technique and oblique intravitreal injection technique). IOP was measured before and immediately after the injection of 0.1 ml comprising of bevacizumab (1.25 mg/0.05 ml) and dexamethasone (0.2 mg/0.05 ml) and then at 30 min after the injection. Occurrence and amount of vitreous reflux were recorded. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed preinjection and 6 weeks postinjection.

RESULTS:
IOP (mmHg ± standard deviation) increased significantly immediately after injection to 24.30 ± 3.02 (direct intravitreal injection) and 31.50 ± 3.49 (oblique intravitreal injection). These pressure rise differed significantly between both groups (mean difference: 7.2, P < 0.0001). Thirty minutes after injection, there was no significant difference in IOP increase between the groups. Occurrence and amount of fluid reflux were significantly higher with direct intravitreal injection. There was no significant difference in BCVA and CMT outcome between both groups.

CONCLUSIONS:
Direct intravitreal injection technique has lower rise in IOP and higher incidence of fluid reflux than the oblique intravitreal technique. Fluid reflux does not cause a therapeutic compromise in terms of BCVA or CMT changes, so the reflux fluid must be the vitreous not the drug. Thus, direct injection technique seems to be the preferred technique.
DETERMINANTS OF CREDIT RISK
Authors: Riyazahmed K. , Baranwal Gunja 
Published: February 2021

This study aims to empirically examine the impact of managerial effectiveness on the credit risk of the Indian public and private sector banks. We consider the return on assets as a proxy for managerial effectiveness and gross non-performing assets (GNPA) to total advances as a proxy for credit risk. The study uses fixed effects and dynamic panel data models to examine the impact. The econometric model estimations suggest a negative impact of return on assets on credit risk. Further, we analyze the impact of return on assets by the information of microeconomic and macro-economic variables in dynamic generalized methods of moments (GMM) approach. The results remain the same after using dynamic GMM modelled with lagged credit risk and lagged return on assets. Further, the effect of macroeconomic variables such as repo rate and reverse repo rate confirms the theory. Heterogeneity checks at regions and sector levels substantiate the robustness of results.
JEL Classification Codes: G20, G21.
LEVERAGE INDUCED FINANCIAL DISTRESS OF MANUFACTURING FIRMS IN BANGLADESH: A COMPARISON BETWEEN LISTED MNCS AND DOMESTIC FIRMS BY APPLYING ALTMAN’S Z SCORE MODEL
Authors: Rahman Syed Mohammad Khaled , Islam Md. Khairul , Hossain Md. Mofazzal 
Published: February 2021

Financial distress arises from excessive debt capital. The purpose of the study was to determine Altman's Z score and analyze as well as compare the effect of debt on Z scores of listed MNCs & domestic companies of Bangladesh over 24 years (1996-2019). The study was based on secondary data. Seven local companies and seven MNCs were selected as a sample from six manufacturing industrial sectors. It was found that on average one local firm was in the grey zone and the rest 13 firms were in the safe zone (Z scores>2.99). MNCs’ Z scores were significantly higher than that of domestic companies. The grand mean of the Z score of MNCs was 5.398 while that of domestic companies was 4.155. In the case of domestic companies, Z score changes by 0.01 or 0.24% for a 1% change of total debt in opposite direction. MNCs’ Z score decreases by 0.005 or 0.073% for a 1% increase of total debt. Domestic companies should increase Z score by redesigning the capital structure and improving basic earning power. The study has practical implications for corporate managers, policymakers, investors, and government because future strategy, policy, and business performance depend on the zone in which the firms are situated.
JEL Classification Codes: G30, G32, G39.