bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower Gastrointestinal Endoscopy
Authors: Ashour Guheina A. R. , Muftah Abir A , Gheryani Nabeia A 
Published: October 2021

Background:
Histopathological examination of endoscopic biopsy specimens support diagnosis, monitoring the course of the diseases and recognize complications. The aim of this study was to determine the type and frequency of histopathological change in colonic biopsies and its correlations with age and sex.

Materials and Methods:
Two hundred and fifty-eight colonic biopsies were collected from January 2016 to December 2017. The tissue was subjected to histopathological examination, the data collected and statistically analyzed.

Results:
Neoplastic colonic lesions form 52% and nonneoplastic form 48%. Cases of adenocarcinoma form 39.1%, nonspecific colitis form 29.1%, adenoma form 12.8%, ulcerative colitis was seen in 7.4% of cases, hyperplastic polyps form 6.2%, and Crohn's disease from 5.4%. Most of adenocarcinomas were moderately differentiated, the grade was higher in females (P = 0.032). Most of nonspecific colitis cases showed mild inflammation. Most of the adenomas were tubular type. More than 90% of neoplastic lesions were in patients above 40 years and 45.5% of inflammatory bowel disease (IBD) cases were present in the age group of between 20 and 39 years (P = 0.001). Most of the cases of adenomas were seen in the age group between 40 and 80 years and (P = 0.018)

Conclusion:
Adenocarcinoma is the most frequent abnormality, mainly above 40 years of age. IBDs were seen below 40 years of age. In general, in all lesions, males were more affected than females except in cases of IBD and moderately differentiated adenocarcinoma.
Assessment of Adherence to Antiretroviral Therapy, Associated Factors, and Relationship to CD4 Cell Count Recovery among HIV-Positive Adolescents
Authors: Ogbuefi Nonso Anthony , Ugochukwu Ebelechuku Francesca , Onubogu Chinyere Ukamaka , Edokwe Emeka Stephen , Okeke Kenneth Nchekwube 
Published: October 2021

Background:
Adherence to antiretroviral therapy (ART) in HIV-positive adolescents (HPAs) is an enormous challenge in pediatric HIV management. Suboptimal adherence (OA) encourages treatment failure and HIV transmission. Several factors are inimical to OA, among HPA.

Objective:
The factors which influence adherence to ART in HPA accessing care in Nnewi, Nigeria, were determined.

Subjects and Methods:
One hundred and fifty HPAs, aged 10–19 years, who had been on ART for at least 6 months were recruited; 75 each for groups 10–14 and 15–19 years. Sociodemographic data were collected using interviewer-administered questionnaires. Relevant clinical data were retrieved from medical records, and current CD4 cell counts assayed.

Results:
There were 77 males and 73 females. OA to ART was defined as intake of ≥95% of antiretrovirals over a given period. Using pill count (PC), 74.7% (112/150) had OA. Using the preceding 28-day self-report (P28DSR), 84.0% (126/150) had OA, while for the preceding seven-day self-report (P7DSR), it was 89.3% (134/150). Factors significantly associated with sub-OA were tertiary education, missed clinic visits, travel time to facility ≤1 h, persistent feeling of sadness, and fear of death. Subjects with OA had a significantly higher rate of CD4 cell count recovery compared to those having sub-OA.

Conclusion:
Sub-OA is common in HPA and can be assessed with a combination of PC and preceding P28DSR, in resource-poor settings. As OA is crucial to CD4 cell count recovery, the latter can be useful in monitoring adherence in HPA.
Predictors of Anemia in Type 2 Diabetes Mellitus Without Renal Disease
Authors: Yorke Ernest , Barnes Nana Ama , Akpalu Josephine , Boafo Eunice , Amoah Albert G. B. 
Published: October 2021

Background:
Among type 2 diabetes mellitus (T2DM) patients without renal disease, hemoglobin levels tend to be lower than their counterparts without diabetes mellitus with a similar estimated glomerular filtration rate. Low hemoglobin levels have been associated with increased morbidity.

Objective:
We sought to determine the predictors of anemia among T2DM patients without renal disease attending the diabetes center at a tertiary teaching hospital in Accra, Ghana.

Materials and Methods:
One hundred and ninety-five type 2 diabetes patients aged 35 years and above without overt nephropathy and 184 controls without diabetes were recruited from the National Diabetes Management and Research Center and Orthopedic Outpatients Clinic of the KBTH, respectively. Both groups had full blood count, red cell indices, serum creatinine, and glycated hemoglobin determination as well as medical history and anthropometric measurements.

Results:
Seventy-nine percent of cases and 75.5% controls were females. The prevalence of anemia among participants with diabetes mellitus was 53.1% compared with 20.5% among controls (P = 0.00). In both groups, more males than females were anemic (68.3% cases, 51.1% controls). The mean duration of diabetes was 9.6 ± 6.22 years among the cases. Logistic regression revealed male gender and diabetes duration >10 years as significant predictors of anemia without renal disease in individuals with T2DM.

Conclusion:
The prevalence of anemia among T2DM participants without overt renal disease was two and half times the rate in control participants without diabetes mellitus. Physicians would be aware and take appropriate steps to identify and manage it to reduce associated morbidity.
Pattern of Diabetic Retinopathy in a Tertiary Healthcare Facility in Southern Nigeria
Authors: Agweye Chineze Thelma , Ibanga Affiong Andem , Udoh Martha-Mary Ekong , Enang Ofem E , Nwajei Anthony Ikechukwu , Nkanga Dennis George 
Published: October 2021

Objective:
The objective is to determine the pattern and prevalence of diabetic retinopathy (DR) among patients living with diabetes mellitus.

Methodology:
Descriptive cross-sectional study in a tertiary hospital. Questionnaires were used to obtain data from eligible participants. Visual acuity measurement, fundal examination, and photography were performed together with fasting blood glucose and glycated hemoglobin A1c. The Statistical Package for Social Sciences (SPSS) for Windows version 20 was used for data analysis.

Results:
Overall 200 patients were enrolled of which 75.5% were female. The participant's mean age was 53.8 ± 11.7 years. DR was present in 53/200 (26.5%) of participants, of which 52 (98.1%) had nonproliferative DR (NPDR), and 1 (1.9%) had proliferative DR (PDR). NPDR was mild in 44/53 (83.0%) and moderate in 8/53 (15.1%) patients. Evidence of sight-threatening DR was found in 37/200 (18.5%) of participants (36 had diabetic macular edema and 1 had PDR + DMO).

Conclusions:
DR was present in 26.5% of the study participants, and 18.5% had sight-threatening DR mainly due to DMO. This finding underscores the need for routine screening of all people living with diabetes to detect early DMO and provide treatment to prevent visual loss.
Prevalence and Predictors of Gaming Disorder among Undergraduate Medical Students in Enugu, Nigeria
Authors: Chime Onyinye H. , Chinawa Awoere T. , Nduagubam Obinna O. 
Published: October 2021

Objective:
The objective of the study was to determine the factors and predictors of gaming disorder among medical students in Enugu, Nigeria.

Methods:
A cross-sectional study design involving undergraduate medical students in Enugu. Addiction to video games was measured using a Video game Addiction Test. This was used to obtain information from 400 respondents.

Results:
Addiction to video games was recorded in 158 students (39.5%). On both bivariate analyses, gender and academic level were associated with being addicted to video games while on the multivariate analysis being male (adjusted odds ratio [AOR] = 3.95, confidence interval [CI] = 2.52–6.20) in 300 academic levels and below (AOR = 2.03, CI = 1.29–3.19) and sponsorship were predictors.

Conclusion:
The majority of students in this study are not addicted to video games. Being males predicted video game addiction. Since this disorder is yet to be fully explored in this setting, there is a need for health-care workers to create awareness about the effects and means to mitigate against the disorder in this setting. Further research is needed on the physical and psychological health effects of this form of addiction on the players.
Postgraduate Career and Emigration Intentions
Authors: Ezeike Azuka Chinweokwu , Ebong Akanimo Onaolapo 
Published: October 2021

Background:
Postgraduate career decisions and emigration intentions of medical graduates determine the quality of a nation's health system. Evaluating these choices help in developing evidence-based health plans and reforms.

Objective:
The aim of this study was to evaluate the postgraduate career and emigration intentions of House Officers in National Hospital Abuja.

Methodology:
This was a cross-sectional study of postgraduate career and emigration intentions of medical interns done in National Hospital Abuja from June to July 2020. Using a structured questionnaire, information was obtained on the sociodemographic data, undergraduate and internship experience, postgraduate career intention, specialty preference, and emigration intentions of the interns. Data were analyzed with SPSS version 23.

Results:
A total of 90 questionnaires were distributed with a 76% response rate. The mean age of the respondents was 26.23 ± 1.77 years with mean internship duration of 10.51 ± 1.58 months. Most were single 63 (91.3%) and 44 (63.8%) were females. While 52 (75.4%) opted to specialize, 50 (78.1%) had intention to emigrate. Surgery (32.7%) and obstetrics and gynecology (28.9%) were the most commonly desired specialties. Personal interest was the greatest determining factor for specialty choice (90.4%), while better working conditions were the most commonly reported driving force for emigration (51.6%), and the United Kingdom (52%) was the most commonly desired emigration destination.

Conclusion:
A high number of respondents had interest in specialization with a greater interest in the surgical specialties. Most also had the intention to immigrate to Western countries with the United Kingdom as the most preferred destination.
Clinical Presentation of COVID-19-Positive and -Negative Patients in Lagos Nigeria
Authors: Adejumo Olusola Adedeji , Ogunniyan Tope , Adesola Sunday , Gordon Igbodo , Oluwadun Oluwayemisi Bamidele , Oladokun Oluwaseun David , Abdulsalam Ismail Adeshina , Falana Ayodeji Anthony , Anderson Omolebi Shina , Anumah Alphonsis , Dawodu Olusola Taiwo , Owuna Henry John , Osoba Efunshade Ganiat , Disu Ahmed Ola-Ayinde , Adetola Adeife Valentina , Oloniniyi Nifemi Bukola , Fadoju Patrick Kayode , Ogunsanya Ayodele Oloruntoba , Osundaro Oluwatomilola Aanuoluwapo , Bowale Abimbola 
Published: October 2021

Background:
A lot has been documented about the pathophysiology and clinical presentation of coronavirus disease 2019 (COVID-19). We compared the clinical features of real-time reverse transcriptase polymerase-chain-reaction (RT-PCR) confirmed COVID-19 positive and negative patients admitted in Lagos State.

Methods:
Medical records of all patients admitted in 15 isolation centres across Lagos state between 27th February 2020 and 30th September 2020, were abstracted and reviewed. We compared the clinical features, co-morbidities and clinical outcomes of COVID-19 positive and negative patients.

Results:
A total of 3157 records of patients admitted in 15 isolation centres in Lagos State were reviewed of which 302 (9.6%) tested negative to RT-PCR COVID-19. There was no gender difference between COVID-19 positive and negative patients (P = 0.687). The average age of the negative patients was higher (46.8 ± 18.3 years) than positive patients (41.9 ± 15.5 years) (P < 0.001). A higher proportion of the COVID-19 negative patients had co-morbidity (38.1% vs. 27.8%), were symptomatic (67.5% vs. 44.6%) and higher mortality (21.9% vs. 6.6%) than positive patients (P < 0.001). The percentages with hypertension (26.2% vs. 21.0%, P = 0.038), diabetes (17.2% vs. 9.4%, P < 0.001), cardiovascular disease (2.3% vs. 0.9%, P < 0.029) and cancer (2.3% vs. 0.5%, P < 0.002) were more among patients without COVID-19. More patients without COVID-19 presented with fever (36.1% vs. 18.8%), cough (33.7% vs. 23.1%) and breathlessness (40.8% vs. 16.1%) than the positive patients (P < 0.001).

Conclusion:
Anosmia and dysgeusia were strongly associated with COVID-19. Clinical decision-making should only be used to prioritise testing and isolation of patients suspected to have COVID-19, especially in settings with limited access to diagnostic kits.
Global Health Education during the COVID-19 Pandemic: Challenges, Adaptations, and Lessons Learned
Authors: Krohn Kristina M. , Sundberg Michael A. , Quadri Nasreen S. , Stauffer William M. , Dhawan Adriana , Pogemiller Hope , Tchonang Leuche Viviane , Kesler Sarah , Gebreslasse Tsige H. , Shaughnessy Megan K. , Pritt Bobbi , Habib Alma , Scudder Beth , Sponsler Sarah , Dunlop Stephen , Hendel-Paterson Brett 
Published: October 2021

ABSTRACT.
Global health education programs should strive continually to improve the quality of education, increase access, create communities that foster excellence in global health practices, and ensure sustainability. The COVID-19 pandemic forced the University of Minnesota’s extensive global health education programs, which includes a decade of hybrid online and in-person programing, to move completely online. We share our experience, a working framework for evaluating global health educational programming, and lessons learned. Over the decades we have moved from a predominantly passive, lecture-based, in-person course to a hybrid online (passive) course with an intensive hands-on 2-week requirement. The pandemic forced us to explore new active online learning models. We retained our on-demand, online passive didactics, which used experts’ time efficiently and was widely accessible and well received. In addition, we developed a highly effective synchronous online component that we felt replaced some of the hands-on activities effectively and led us to develop new and innovative “hands-on” experiences. This new, fully online model combining quality asynchronous and synchronous learning provided many unanticipated advantages, such as increasing access while decreasing our carbon footprint dramatically. By sharing our experience, lessons learned, and resources, we hope to inspire other programs likewise to innovate to improve quality, access, community, and sustainability in global health, especially if these innovations can help decrease negative aspects of global health education such as its environmental impact.
An Examination of the Relationship between Generation, Gender, Subject Area, and Technology Efficacy among Secondary Teachers in the United States
Authors: Woods Kimberly , Wendt Jillian L. , Barrios Amy , Lunde Rebecca 
Published: October 2021

The current study uses a correlation design and multiple linear regression to determine whether generation, gender, and subject area predict teachers’ technology efficacy as measured by the Technology Proficiency Self-Assessment for 21st Century Leaning (TPSA C-21). An online survey was provided to all participants. The survey consisted of demographic questions and a technology self-efficacy instrument. Results demonstrate that gender and generation are statistically significant predictors of technology efficacy, namely on the Total, WWW, Integrated Applications, and Emerging Technologies Skills subscales of the TPSA C-21. The subject area variable, however, did not demonstrate a statistically significant ability to predict teacher technology efficacy scores on any subscale of the TPSA C-21. The findings of the current study add to the existing body of literature by enhancing understanding of the teachers’ perceptions of technology efficacy in one geographic location in the US. These findings are timely, especially given the largely technology dependent nature of education—whether in physical classrooms or in virtual settings and the increasing necessity of using technological tools in education settings. Implications are discussed, including suggestions for future research.
An Action Research Study on the Development of Object-Oriented Programming Course
Authors: Yildirim Osman Gazi , Ozdener Nesrin 
Published: October 2021

Computer games are effective instructional tools used in programming courses to increase students' motivation and engagement. This participatory action research aims to redesign the Object-Oriented Programming course in which the first author is both the instructor and researcher to make it more effective and efficient. In the first step of the action research, data were collected for the definition and solution of the problem through questionnaires and semi-structured interviews. After this step, an action plan was created, and the Object-Oriented Programming course was redesigned as part of the action plan. In line with the objectives of the action plan, The Karting Microgame Template, a game prototype prepared by Unity 3D, was integrated into the course, and students were expected to add various game components (bonus collection system, a scoring system, collision mechanisms, etc.) to this game prototype using C # programming language. After the action plan creation phase, an action plan was implemented. The implementation phase was conducted in the 2019-2020 spring semester with 29 post-secondary students enrolling in Computer Technology Department at a vocational college in Turkey. After the implementation phase, data were collected through the Object-Oriented Programming achievement test, student and researcher diaries, and focus group interviews on measuring this implementation's effectiveness. This paper describes the difficulties encountered during the study, the students' views on this implementation, and the researchers' experiences in this process.
Inversión máxima para incrementar la disponibilidad de agua en comunidades de la zona limítrofe entre Quintana Roo y Campeche, México
Authors: Rivero Roberto Mena , Azamar Ricardo Enrique Vega , Gutiérrez Flor Virginia Cruz , Parra David Gustavo Rejón , Gómez Fermín Téllez 
Published: October 2021

La baja disponibilidad de agua potable de buena calidad puede ser complementada con agua proveniente de la lluvia, si esta última es recolectada en cantidad suficiente para cubrir la demanda, aprovechándose esta combinación para resolver el problema de abastecimiento, todo esto sujeto a restricciones de inversión. El presente trabajo tiene por objetivo presentar un análisis de los sistemas de captación de agua de lluvia existentes en la zona limítrofe entre los estados mexicanos de Quintana Roo y Campeche para estimar los montos de inversión máxima que justifiquen un proyecto de mejora en la disponibilidad de agua de lluvia. En esta investigación se identificó el nivel de aprovechamiento y los requerimientos de los sistemas de captación de agua pluvial en techos (SCAPT) y se determinó el monto de inversión máxima para solucionar esta situación problemática. Los resultados muestran que los SCAPT no se aprovechan debido a limitaciones o subutilización en la superficie de captación y/o capacidad de almacenamiento, por lo que se recurre al suministro de agua en pipas. Se concluye que se puede sustituir el acarreo en pipas por agua de lluvia con un adecuado dimensionamiento de la superficie y el volumen de captación, asegurando el consumo de agua mínimo recomendado, con una inversión menor de la que se requeriría para la implementación de un sistema de abastecimiento de agua convencional.

Low availability of good quality drinking water can be complemented with rainwater, if the latter is collected in sufficient quantity to cover the demand, taking advantage of this combination to solve the supply problem, all of this subject to investment restrictions. The present work aims to present an analysis of the existing rainwater harvesting (RWH) systems in the border area between the Mexican states of Quintana Roo and Campeche to estimate the maximum investment amount that justifies a project to improve rainwater availability. In this research, the use level and the requirements of rooftop rainwater harvesting (RTRWH) systems were identified and the maximum investment amount needed to solve this problematic situation was determined. Results show that RTRWH systems are not used due to insufficient or underutilized catchment area and / or storage capacity, so water is supplied in tankers. It is concluded that transport in tankers can be replaced by RTRWH with an adequate dimensioning of surface and catchment volume, ensuring the minimum recommended water supply, with a lower investment than that required for the implementation of a conventional water supply system.
Hakikat Pendidikan Karakter Kemandirian bagi Anak Usia Dini Menurut Perspektif Islam
Authors: Zulkhaidir Zulkhaidir , Mubarok Zahid 
Published: October 2021

Pendidikan karakter kemandirian bagi anak usia dini seharusnya mendapatkan perhatian yang serius oleh semua pihak yang peduli dengan perkembangan anak-anak usia dini. Pemerintah, Guru dan orang tua harus memahami dengan benar apa yang menjadi tujuan pendidikan karakter kemandirian bagi anak usia dini tersebut. Bagaimana metode yang digunakan sebagai pendukung agar tercapainya target agar anak tumbuh dan berkembang menjadi mandiri sesuai dengan usianya. Anak yang sehat, lingkungan fisik yang nyaman, ketersediaan permainan edukatif, keseimbangan lingkungan sosial anak, orang tua yang cakap dalam mendampingi anak dalam mencari solusi yang sedang dihadapi oleh mereka, serta orang tua yang meletakkan tujuan pendidikan yang realistis, adalah modal utama dalam mewujudkan anak-anak usia dini yang mandiri. Ajaran Islam sesungguhnya telah meletakkan dasar-dasar pendidikan anak usia dini jauh sebelum anak dilahir. Sebagai contoh seorang laki-laki dan perempuan yang ingin menikah agar memperhatikan kualitas akhlak dan agama calon mereka masing-masing. Seseorang yang memahami ajaran agama tentunya akan mencurahkan seluruh tanggung jawab terhadap Istri dan pendidikan anak-anaknya sedini mungkin, termasuk mengajarkan karakter mandiri sebagaimana yang telah dijarkan oleh Rasulullah Saw.
Menanamkan Pola Hidup Sehat pada Anak Usia DiniMenanamkan Pola Hidup Sehat pada Anak Usia Dini
Authors: Maturidi Maturidi , Purba Asnan 
Published: October 2021

Penelitian ini bertujuan mencari bagaimana menanamkan pola hidup sehat pada anak usiaPenelitian ini bertujuan mencari bagaimana menanamkan pola hidup sehat pada anak usiadini di PAUD Darussalam, kesehatan menjadi pangkal utama dalam segala gerak langkahmanusia karena akal yang sehat terdapat pada jiwa yang kuat atau sehat, pola hidup sehatperlu ditanamkan dari sedini mungkin, untuk menjadikan anak usia dini terbiasa hidupsehat. Dalam hal ini Paud Darussalam sudah menerapkan pola hidup sehat kepada parapeserta didik dalam pelaksanaan kegiatan pola hidup sehat antara lain, membuat bukupenghubung sebagai jejak rekam dan laporan kepada peserta didik dari kesehatan, makandan gosok gigi, dalam menanamkan pola hidup sehat juga di Paud membiasakan gosokgigi, menjaga kesehatan, makanan yang sehat, tidak jajan sembarangan, tidak membuangsembarangan, selalu mencuci tangan dan bagi para wali murid diadakan parenting untukmembuka wawasan mereka dalam menanamkan pola sehat kepada anak didik