bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophils to lymphocytes ratio between benign and malignant thyroid nodule
Authors: Haider Nazia , Mahmood Zahid , Khalid Fizzah , Razzak Saad Abdul 
Published: September 2021

Objectives: To determine the relationship of Neutrophils to lymphocytes ratio (NLR) values with the benign and malignant thyroid nodules.
Methods: In this cross-sectional clinical study conducted from September 1st 2020 to February 28th 2021, we included 216 patients who underwent thyroidectomy at Jinnah Postgraduate Medical Centre Karachi Pakistan. After thyroidectomy specimens were sent for pathologic examination. Patients were divided into two categories based on histopathologic results; Malignant nodule and benign nodules. Data of complete blood count was obtained from the pre-operative lab investigations and NLR was calculated.
Results: There were 42 (26%) men, and 116 (74%) women of 158 in the BTN group, 18 (31%) men, and 40 (69%) women of 58 in the MTN group. The mean age of 48±6 years in the BTN group as well as 47 ±8 years in the MTN group (p-value 0.32). The mean neutrophil count in the BTN group was 4.26±2.8 versus 4.41±2.2 (x 1000/mm3) the malignance thyroid group (p-value = 0.71). The mean lymphocyte count was 3.81±0.9 (x 1000/mm3) in the BTN group and 3.61±1.2 (x 1000/mm3) in the malignance group (p-value = 0.18). The mean NLR value for the benign thyroid nodular group was 1.19±2.2 and 1.22±1.8 in the malignant thyroid nodular group (p-value = 0.92).
Conclusion: According to the results of this study, we concluded that preoperative period biochemistry laboratory results such as neutrophils count, lymphocyte count, and NLR value don’t provide enough evidence to differentiate between benign and malignant thyroid carcinoma.
doi: https://doi.org/10.12669/pjms.37.7.4503
How to cite this:Haider N, Mahmood Z, Khalid F, Razzak SA. Neutrophils to lymphocytes ratio between benign and malignant thyroid nodule. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4503
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Standard of Scientific Pedagogical Expertise: a Creative Dimension
Authors: Bychkov Anatoliy 
Published: September 2021

Pedagogical expertise is considered as a system-forming scientific technology in education, which has a significant impact on the practice of teaching and the formation of a creative personality, actually becoming a method of scientific cognition in the context of improving the quality of education. It is advisable to design all programs of higher pedagogical education according to the deductive principle-from the general content component presented in the structure of technologies of pedagogical expertise of educational projects and programs, to private methodological practice-oriented recommendations proposed by experts as an indicative basis for teacher actions.
The role of an expert and his personal qualities are of particular importance in the composition of pedagogical expertise. Based on the professional analysis of the expert's activity, his personal portrait is formed. In pedagogical expertise, the ratio of the objective (various normative documents regulating the activities of an expert) and the subjective is crucial, when the quality of the examination depends on the competence, experience of an expert specialist, his wisdom, intuition and creative insight. The analytical review of the mistakes of pedagogical experts should be used as the basis of the methodology for training teachers and expert specialists in the field of education.
Widespread closure of HIV prevention and care services places youth at higher risk during the COVID-19 pandemic
Authors: Stephenson Rob , Walsh Alison R. , Chavanduka Tanaka M. D. , Sallabank Gregory , Horvath Keith J. , Castel Amanda D. , Bonar Erin E. , Hightow-Weidman Lisa , Bauermeister Jose A. , Sullivan Patrick S. 
Published: September 2021

Background
Central to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based organization closures. In this paper, we use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth.

Methods
We identified and mapped LGBTQ+ friendly services offering at least one of the following HIV-related services: HIV testing; STI testing; PrEP/PEP; HIV treatment and care; and other HIV-related services in 109 counties across four major interstate corridors heavily affected by HIV US Census regions: Pacific (San Francisco, CA to San Diego, CA); South-Atlantic (Washington, DC to Atlanta, GA); East-North-Central (Chicago, IL to Detroit, MI); and East-South-Central (Memphis, TN to New Orleans, LA).

Results
There were a total of 831 LGBTQ+ youth-friendly HIV service providers across the 109 counties. There was a range of LGBTQ+ youth-friendly HIV-service provider availability across counties (range: 0–14.33 per 10,000 youth aged 13–24 (IQR: 2.13), median: 1.09); 9 (8.26%) analyzed counties did not have any LGBTQ+ youth-friendly HIV service providers. The Pearson correlation coefficient for the correlation between county HIV prevalence and LGBTQ+ youth-friendly HIV service provider density was 0.16 (p = 0.09), suggesting only a small, non-statistically significant linear relationship between a county’s available LGBTQ+ youth-friendly HIV service providers and their HIV burden.

Conclusions
As the COVID-19 pandemic continues, we must find novel, affordable ways to continue to provide sexual health, mental health and other support services to LGBTQ+ youth.
Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement
Authors: Ornelas-Dorian Carolina , Torres Jacqueline M. , Sun Jennifer , Aleman Alexis , Cordova Emmanuel , Orue Aristides , Taira Breena R. , Anderson Erik , Rodriguez Robert M. 
Published: September 2021

Study objectives
Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought to assess provider and system-level policies on caring for undocumented patients in three California EDs.

Methods
We recruited 41 ED providers and administrators from three California EDs (in San Francisco, Oakland, and Sylmar) with large immigrant populations. Participants were recruited using a trusted gatekeeper and snowball sampling. We conducted semi-structured interviews and analyzed the transcripts using constructivist grounded theory.

Results
We interviewed 10 physicians, 11 nurses, 9 social workers, and 11 administrators, and identified 7 themes. Providers described existing policies and recent policy changes that facilitate access to care for undocumented patients. Providers reported that current training and communication around policies is limited, there are variations between who asks about and documents status, and there remains uncertainty around policy details, laws, and jurisdiction of staff. Providers also stated they are taking an active role in building safety and trust and see their role as supporting undocumented patients.

Conclusions
This study introduces ED-level health system perspectives and recommendations for caring for undocumented patients. There is a need for active, multi-disciplinary ED policy training, clear policy details including the extent of providers’ roles, protocols on the screening and documentation of status, and continual reassessment of our health systems to reduce fear and build safety and trust with our undocumented communities.
Investigating myotoxicity following Australian red-bellied black snake (Pseudechis porphyriacus) envenomation
Authors: Sanhajariya Suchaya , Duffull Stephen B. , Isbister Geoffrey K. 
Published: September 2021

Background
Myotoxicity is one of the common clinical manifestations of red-bellied black snake (Pseudechis porphyriacus) envenomation characterised by elevated creatine kinase (CK) concentrations of greater than 1000 U/L. This study aimed to investigate the occurrence of myotoxicity in patients following envenomation.

Methods/Principal findings
Patient characteristics and serial blood samples (timed venom concentrations and CK concentrations, pre- and post- antivenom) from 114 patients (median age 41, 2-90y; 80 male) were extracted from the Australian Snakebite Project database. Patients were categorised into three groups based on peak CK concentrations [no myotoxicity (<1000 U/L), mild (1000–10,000 U/L) and severe (>10,000 U/L)]. The odds of (mild or severe) myotoxicity was lower in patients that received early antivenom (within 6 hours post-bite) compared to those that received late or no antivenom (odd ratio was 0.186; 95% confidence interval, 0.052–0.664). A population pharmacokinetic-pharmacodynamic (PKPD) model was developed to describe the relationship between the time course of venom (a mixture of toxins) and effect (elevated CK). In addition, a kinetic-pharmacodynamic (KPD) model was developed to describe the relationship between time course of a theoretical toxin and effect. Model development and parameter estimation was performed using NONMEM v7.3. No single set of parameter values from either the PKPD or KPD models were found that could accurately describe the time course of different levels of severity of myotoxicity. The predicted theoretical toxin half-life from the KPD model was 11 ± 3.9 hours compared to the half-life of venom of 5.3 ± 0.36 hours. This indicates that the putative causative toxin’s concentration-time profile does not parallel that of venom.

Conclusion
Early antivenom administration reduces the incidence of myotoxicity. The venom concentration profile does not appear to be the driver for myotoxicity following envenomation. Additional factors that affect the sensitivity of the patient to snake venom/toxins must be explored to understand the relationship with myotoxicity.
AIR-BT, a new badminton-specific incremental easy-to-use test
Authors: Abián-Vicén Javier , Bravo-Sánchez Alfredo , Abián Pablo 
Published: September 2021

Background
Badminton is a highly demanding sport characterized by intermittent efforts with energy being provided by both the aerobic and anaerobic systems. To date, no incremental badminton field test has been developed that can be easily used by badminton coaches that requires accessible material for anyone.

Objectives
The purpose of this study was to develop a practical and reliable easy-to use intermittent endurance badminton test for estimating maximal oxygen uptake (VO2max).

Methods
Thirty six Spanish badminton players (age: 24.1±10.3 years) performed, on different days of the same week, four incremental protocols to exhaustion in randomized order: a treadmill incremental test, a Yo-Yo intermittent recovery level 1 test (Yo-Yo IR1) and twice the Abian intermittent recovery badminton test (AIR-BT). Oxygen uptake was determined with a breath-by-breath gas analyzer during the incremental treadmill test, and performance in the Yo-yo IR1 and AIR-BT was recorded.

Results
Significant correlations (p<0.001) for Pearson’s product moment coefficient were found between the performance in the AIR-BT and the two non-specific incremental tests (VO2max in the Treadmill Test: r = 0.87, distance in the Yo-Yo IR1: r = 0.86). The regression equation to calculate the VO2max from the AIR-BT time [VO2max = 0.023*(AIR-BT time in seconds)+31.334] showed an adjusted R2 of 0.76 and a SEE of 3.34 ml·kg-1·min-1. There was no significant difference between VO2max obtained by the incremental treadmill test and VO2max calculated using the regression equation (p = 0.644). A paired t-test reported no significant differences between day 1 and day 2 in the AIR-BT time (p = 0.753), the Pearson correlation coefficient between both days was: r = 0.88 (p<0.001) and the intraclass correlation coefficient was 0.875.

Conclusions
The AIR-BT is a valid and reliable on-court test for assessing VO2max in badminton players and may be utilized by coaches and physical trainers for cross-sectional comparison of players and for evaluation of longitudinal changes.
Exploring women’s decisions of where to give birth in the Peruvian Amazon; why do women continue to give birth at home? A qualitative study
Authors: Gardiner Esme , Lai Jo Freda , Khanna Divya , Meza Graciella , de Wildt Gilles , Taylor Beck 
Published: September 2021

Background
Despite improvements in maternal mortality globally, hundreds of women continue to die daily. The World Health Organisation therefore advises all women in low-and-middle income countries to give birth in healthcare facilities. Barriers to seeking intrapartum care have been described in Thaddeus and Maine’s Three Delays Model, however these decisions are complex and often unique to different settings. Loreto, a rural province in Peru has one of the highest homebirth rates in the country at 31.8%. The aim of this study was to explore facilitators and barriers to facility births and explore women’s experiences of intrapartum care in Amazonian Peru.

Methods
Through purposive sampling, postnatal women were recruited for semi-structured interviews (n = 25). Interviews were transcribed verbatim and thematically analysed. A combination of deductive and inductive coding was used. Analytical triangulation was undertaken, and data saturation was used to determine when no further interviews were necessary.

Results
Five themes were generated from the data: 1) Financial barriers; 2) Accessing care; 3) Fear of healthcare facilities; 4) Importance of seeking care and 5) Comfort and traditions of home. Generally, participants realised the importance of seeking skilled care however barriers persisted, across all areas of the Three Delays Model. Barriers identified included fear of healthcare facilities and interventions, direct and indirect costs, continuation of daily activities, distance and availability of transport. Women who delivered in healthcare facilities had mixed experiences, many reporting good attention, however a selection experienced poor treatment including abusive behaviour.

Conclusion
Despite free care, women continue to face barriers seeking obstetric care in Amazonian Peru, including fear of hospitals, cost and availability of transport. However, women accessing care do not always receive positive care experiences highlighting implications for changes in accessibility and provision of care. Minimising these barriers is critical to improve maternal and neonatal outcomes in rural Peru.
Factors associated with violence against women following the COVID-19 lockdown in France: Results from a prospective online survey
Authors: Peraud William , Quintard Bruno , Constant Aymery 
Published: September 2021

Background
The aim of this research was to investigate the impact of the first COVID-19 lockdown (March 17th—May 11th 2020) on violence against women in France.

Methods
A prospective survey was conducted online between April 2th 2020 and July 5th 2020. Female respondents were recruited from social media networks using the snowball sampling method. Data were collected three times: during (2–19 April) and at the end (11–25 May) of the first lockdown, and following the first lockdown (20 June– 05 July). Sociodemographic variables, lockdown living conditions, financial impact of COVID, and history of psychiatric disorder were evaluated, together with changes in psychological distress over the lockdown period, and the risk of being assaulted post lockdown.

Results
Psychological distress was elevated and remained stable for most of the 1538 female respondents during lockdown. More than 7% of women were affected by physical or sexual violence post lockdown. Unwanted sexual contact accounted for the majority of abuse, but physical and sexual assault were also prevalent. The risk of being abused was higher for participants who had changed anxiety/insomnia symptoms over the lockdown period, and a history of abuse.

Discussion
Women who experienced changes in anxiety/insomnia symptoms during the COVID-19 lockdown were at higher risk than others of being assaulted post lockdown, especially when they were already socially vulnerable. While social and psychological factors accounting for these changes warrant further investigation, communication and preventive measures during pandemics should include initiatives tailored to women more vulnerable to violence.
Virological failure and associated factors among children receiving anti-retroviral therapy, Northwest Ethiopia
Authors: Bayleyegn Biruk , Kifle Zemene Demelash , Geremew Demeke 
Published: September 2021

Background
Virological failure is under-recognized issue among children living with human immunodeficiency virus in developing countries. This partly may lead to failure to achieve the global goal of 90-90-90 targets in most developing countries including Ethiopia.

Objectives
This study aimed to assess the virological failure and its predictors among children receiving antiretroviral therapy at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Methods
An institutional based cross-sectional study was conducted among 253 study cohorts from January 2020-April 2021. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview, while detailed clinical data of the children were collected by reviewing the medical record. About 5 ml of blood were collected for the analysis of complete blood count and viral load quantification. Data were analyzed using SPSS version 20 and variables at p-value < 0.05 in the multivariable analysis were considered as statistically significant.

Results
In this study, the viral load suppression rate among antiretroviral therapy experienced children was 68.8%. Meanwhile, the overall virological failure among study participants was 19.4%. Children living without family (AOR = 3.63; 95%CI: 1.27–10.24), children with unemployed family (AOR = 4.95; 95%CI: 1.74–14.12), being wasted (AOR = 3.02; 95%CI: 1.19–7.67) being stunted (AOR = 2.38;95%CI:1.03–5.46), anemia (AOR = 5.50:95%CI;1.37–22.04) and being lymphopenic (AOR = 2.69:95%CI;1.04–7.75) were significantly associated with virological failure among children under treatment.

Conclusion
Higher virological failure among children was noteworthy in the present study. Caretakers other than immediate family, unemployed family, wasted, stunted, anemia, and lymphopenia were significant independent predictors of virological failure. Hence, standard, and optimal management of children under treatment should be warranted.
Community’s misconception about COVID-19 and its associated factors in Satkhira, Bangladesh: A cross-sectional study
Authors: Bakebillah Md. , Billah Md. Arif , Wubishet Befikadu L. , Khan Md. Nuruzzaman 
Published: September 2021

Introduction
Misconception related to coronavirus disease-2019 (COVID-19) have been spread out broadly and the the World Health Organization declared these as a major challenge to fight against the pandemic. This study aimed to assess COVID-19 related misconception among rural people in Bangladesh and associated socio-demographic and media related factors.

Methods
Multistage sampling method was used to collect data (n = 210) from three unions of Satkhira District, Bangladesh. The dependent variable was the presence of COVID-19 related misconception (Yes, No) which was generated based on respondents’ responses to a set of six questions on various types of misconception. Exposure variables were respondents’ socio-demographic characteristics, mass media and social media exposure. Descriptive statistics were used to describe the characteristics of the respondents. Bivariate and multivariate logistic regression models were used to determine the factors associated with COVID-19 misconception.

Results
More than half of the study respondents had one or more COVID-19 related misconception. Over 50% of the total respondents considered this disease as a punishment from God. Besides, many of the respondents reported that they do not think the virus causing COVID-19 is dangerous (59%) and it is a disease (19%). Around 7% reported they believe the virus is the part of a virus war (7.2%). The bivariate analysis found the presence of socio-demographic factors of the respondents, as well as the factors related to social and mass media, were significantly associated with the COVID-19’s misconception. However, once all factors considered together in the multivariate model, misconception were found to be lower among secondary (AOR, 0.33, 95% CI: 0.13–0.84) and tertiary (AOR, 0.29, 95% CI: 0.09–0.92) educated respondents compared to the respondents with primary education.

Conclusion
This study obtained a very higher percentage of misconception about the COVID-19 among the respondents of Satkhira district in Bangladesh. This could be a potential challenge to fight against this pandemic which is now ongoing. Prioritizing mass and social media to disseminate evidence-based information as well as educate people about this disease are necessary.
The Effect of Variations in Electrolyte Temperature and Current Strength on the Synthesis of Manganese Dioxide from Manganese Sulfate Precursors by Electrolysis Method
Authors: Adi Endani Rizta Febian 
Published: September 2021

The development of science and technology today in the field of electronics, especially energy storage increases the demand for the use of lithium secondary batteries. The development of lithium batteries is focused on energy storage capacity by using manganese dioxide (MnO2) as a lithium battery cathode material. Manganese dioxide was chosen as the cathode material for lithium batteries because it has a high storage capacity of about 615 mAh/g compared to other materials such as graphite which has a storage capacity of 372 mAh/g and has a low toxicity of 0.14 mg/kg. MnO2 was synthesized by electrolysis method from manganese sulfate (MnSO4) precursor which was obtained from Trenggalek manganese ore leaching process. The electrolysis process was carried out for 5 hours using variations in electrolyte temperature of 30, 40, 50 and 60oC as well as variations in current strength of 2, 3, 4 and 5 A to determine the effect of electrolyte temperature and current strength on mass gain, structural polymorphy and morphology of MnO2 formed. The highest mass gain was obtained at the use of an electrolyte temperature of 60oC and a current of 5 A, which was 11.4 grams with the polymorphy structure of the MnO2 compound formed was α-MnO2 polymorphy. SEM image shows that the MnO2 particles have a spiny round shape and tend to agglomerate with particle diameter values ranging from 50 nm - 170 nm. Keywords: Electrolysis, MnO2, MnSO4, Electrolyte temperature, Current strength