bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction of Early Clinical Exposure(ECE) in 1st year M.B.B.S Students in the Department of Physiology
Authors: Avjot K. Miglani , Rajiv Arora  
Published: February 2021

Background: Medical council of India regulations on Graduate Medical education 2012 states that “Indian Medical Graduate should possess requisite knowledge, skills, attitudes, values and responsiveness, so that he or she may function appropriately and effectively as a physician of the community while being globally relevant”1.
Early Clinical exposure (ECE) is a teaching learning methodology, which orients medical students towards actual clinical scenarios and helps them correlate their theoretical knowledge with real life situations in the first year of medical college.
Methodology: The project was done in the department of physiology at PIMS Medical College, Jalandhar. The ECE program was used as a supplement to the traditional lectures in Nervous System Physiology. One hundred and fifty (150) first year MBBS students participated in early clinical exposure program conducted in the year 2017–18. A Feedback questionnaire (including both open and closed ended questions), after getting validated by the faculty were filled by the students. Students were also encouraged to give their written open comments anonymously.
Post session feedback from the students was taken by Questionnaire graded on Likert’s scale.
Results: All the students commented that ECE helped them in their understanding of Nervous system Physiology. Most (63%) appreciated the synchronization of classroom knowledge with clinical exposures, and thought that integrated teaching helped in better understanding of practical applications of physiology (65%)
Hyperbolically Lipschitz continuity, area distortion and coefficient estimates for -quasiconformal harmonic mappings of unit disk
Authors: Zhong Deguang , Yuan Wenjun 
Published: February 2021

UDC 517.51
We study the hyperbolically Lipschitz continuity, Euclidean and hyperbolic area distortion theorem, and coefficient estimate for the classes of -quasiconformal harmonic mappings from the unit disk onto itself.
Le système seigneurial ou la transsubstantiation de la valeur d’usage en valeur d’échange
Authors: Demade Julien 
Published: February 2021

Si, puisque la monnaie y fait désormais fonction d’équivalent général, la valeur d’échange est au cœur du système seigneurial ( xii e - xvii e siècles), c’est cependant d’une façon qui n’a rien à voir avec le rôle que lui donnera le capitalisme : alors que dans ce dernier elle représente la forme normale de rapport à la valeur – de même que dans le système domanial ( v e - xi e siècles) la valeur d’usage était la forme normale de rapport à la valeur –, dans le système seigneurial le rapport à la valeur est bifide parce qu’il oppose une production effectuée comme valeur d’usage à une ponction réalisée comme valeur d’échange. La domination, dans le système seigneurial, repose donc sur la maîtrise de la valeur d’échange en tant que cette valeur d’échange n’est pas généralisée.
Démolition controversée, entre revendication et droit d’auteur. L’histoire d’un ensemble de logements sociaux à Bollate (Milan)
Authors: Merlini Chiara 
Published: February 2021

Le discours sur la démolition recourt généralement à des registres émotionnels et génère des conflits. Cela est particulièrement évident dans les débats autour de l’avenir des quartiers de logements sociaux, fortement influencé par des images stigmatisantes et sur lequel l’investissement symbolique est considérable, tant pour les habitants que pour les institutions publiques. Lorsque l’objet en question est une « architecture d’auteur », la controverse met nettement en lumière un conflit entre différentes valeurs : d’une part, les valeurs de confort et d’habitabilité, soutenues essentiellement par les habitants, d’autre part la valeur culturelle, qui reconnaît dans un artefact un patrimoine collectif, soutenu avant tout par les élites intellectuelles. C’est ce qui ressort du cas étudié ici : une hypothèse de démolition concernant un ensemble de logements sociaux construit à Bollate, près de Milan, par l’architecte Guido Canella entre 1974 et 1980. La mobilisation directe de l’architecte, qui pallie l’absence de reconnaissance collective par la revendication d’un « droit d’auteur », est une spécificité intéressante de cette histoire.
Maintaining essential health services during the pandemic in Bangladesh
Authors: Wangmo Sangay , Sarkar Shila , Islam Tasmia , Rahman Md Habibur , Landry Mark 
Published: February 2021

In the initial phase of the coronavirus disease 2019 crisis, Bangladesh’s health systems faced competing demands to respond to the pandemic and concurrently maintain the continuity of essential health service delivery, particularly at the primary care level. Bangladesh’s established network of primary care health facilities, the country’s backbone for delivering essential health services, routinely feed data into the national health information system, the District Health Information Software 2 platform, which provides near real-time data on the utilization of essential health services, visualized through user-friendly integrated dashboards. Trend analyses of these data showed that by April and May 2020 there had been sharp reductions in the utilization of key essential health services across all levels of care.
Early and continuous monitoring and analysis of these data informed public health policy-makers and health facility managers on rapid response strategies to restore the availability and use of essential health services. Through corrective policy measures and targeted interventions, Bangladesh’s primary health care network provided a critical platform for Bangladesh to build back most of its essential health services by October 2020. Bangladesh’s experience highlights the critical role of primary-level health facilities as a touchpoint for monitoring population access to services and as a staging point for implementation of strategies and interventions that rebuild and strengthen health service delivery towards achieving universal health coverage and more resilient health systems.
The effect of direct observation of procedural skills/mini-clinical evaluation exercise on the satisfaction and clinical skills of nursing students in dialysis
Authors: Jafarpoor Hasanali , Hosseini Meimanat , Sohrabi Maryam , Mehmannavazan Masoomeh 
Published: February 2021

BACKGROUND:
Since the purpose of medicine science is health promotion, education of this group is very important. The use of new evaluation methods is one of the first educational needs. Given that many conventional clinical evaluation methods are not able to fully evaluation students in the clinical settings and only evaluate limited information, This study is designed to evaluate the impact of direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (mini-CEX) on nursing students and their clinical satisfaction skills.

MATERIALS AND METHODS:
This quasi-experimental study was conducted in 2018 to evaluate the dialysis unit of the 6th semester nursing students of Babol University of Medical Sciences in Iran. Samples were selected by the census method and then random allocation. Data collection was performed using two questionnaires and two checklists to evaluate the clinical skills and satisfaction of the two groups of testing and control. Moreover, the data were analysed with using the SPSS software (version 18, IBM SPSS Inc., Chicago, IL, USA) through the descriptive and analytical statistics (Chi-square test and t-test).

RESULTS:
The results showed that the intervention group compared with the control evaluation score of 13/73 ± 2/44, 11/74 ± 2/43, P < 0.002, respectively. Furthermore, the mean score of satisfaction of the intervention group with the DOPS method compared to the traditional method of the control group was 72/50 ± 7/31, 63/48 ± 9/31, P < 0.001, respectively. As well as, the mean score of satisfaction with the mini-CEX method of the intervention group compared to the traditional method of the control group was 73/28 ± 7/78, 63/48 ± 9/31, P < 0.002, respectively.

CONCLUSIONS:
The results of this study showed that students who were evaluated by DOPS and mini-CEX methods had a higher score of clinical performance evaluation and higher level of satisfaction. Nursing professors can improve the learning process and the satisfaction of nursing students by using direct feedback on such evaluation methods.
The main factors of supplier-induced demand in health care
Authors: Seyedin Hesam , Afshari Mahnaz , Isfahani Parvaneh , Hasanzadeh Ebrahim , Radinmanesh Maryam , Bahador Rasoul Corani 
Published: February 2021

BACKGROUND:
Induced demand is a major challenge for financing health promotion, whereby providers exploit patients' information gap to manipulate their demand for health care. The purpose of this study was to identify the factors associated with induced demand for health-care services in hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018.

MATERIALS AND METHODS:
In this qualitative study, semi-structured interviews were conducted with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze the data.

RESULTS:
Overall, 24 subthemes or factors were identified and classified into the health system, the insurer, health-care provider, and health-care recipient themes. Poor monitoring and control, the fee-for-service payment system, limited role of insurance companies, insufficient monitoring of insurance companies, the educational nature of our health centers, health-care providers' interests, and patients' information gap were some important factors in induced demand for health-care services.

CONCLUSION:
Our results showed that there are many factors that contribute to induced demand for health care. Given the four levels of factors identified in this study, health policymakers and managers must develop strategies at each level to reduce induced demand for health care.
Effect of Information, Education, and Communication activity on health literacy of cardiovascular diseases among school-going adolescents in Delhi
Authors: Yadav Srishti , Khokhar Anita 
Published: February 2021

BACKGROUND:
Heart attack and stroke account for >80% of deaths due to cardio-vascular diseases (CVDs) in India. Adolescents are the most susceptible group to adopt risky behaviors causing CVDs such as use of tobacco and alcohol, sedentary lifestyle, and unhealthy diet. This study was conducted to assess the health literacy of CVDs such as heart attack and stroke among school-going adolescents and change in health literacy after different information, education, and communication (IEC) activities.

MATERIALS AND METHODS:
It was a school-based interventional study conducted in two schools among students of classes 6, 7, and 8. The educational interventions were done in the form of pamphlets, posters, and lectures on heart attack and stroke. The postintervention data were collected 2 weeks after the first intervention and 3 months after the last intervention.

RESULTS:
There were a higher proportion of students with satisfactory level of knowledge of heart attack and stroke both at 2 weeks and 3 months after the interventions in both the schools, and the results were statistically significant (P < 0.05).

CONCLUSION:
The health literacy regarding CVDs has improved when compared to baseline after IEC activities among school-going adolescents.
Knowledge of COVID-19 and its implications in dental treatment, and practices of personal protective equipment among dentists
Authors: Bains Vivek Kumar , Bains Rhythm , Gupta Vivek , Salaria Sanjeev Kumar 
Published: February 2021

BACKGROUND:
Oral health-care providers are always at a risk of transmitting or acquiring airborne, saliva-borne, or blood-borne infections due to their proximity to the patient's mouth, contact with saliva, and handling of sharp instruments. the aim this study was to evaluate the knowledge of the dentists regarding COVID-19, methods to prevent its transmission, and implications of COVID-19 in dental treatment.

MATERIALS AND METHODS:
It was a cross-sectional online survey. There were 35 questions in total, divided into sections of knowledge of COVID-19, practices of personal protective equipment (PPE), and knowledge of implications of COVID-19 in dental treatment. Both convenience sampling and snowball sampling were used, so that maximal participation could be ensured. The results were analyzed using descriptive statistics and making comparisons among various groups. The data were summarized as proportions and percentages (%). All the associations were tested using the Chi-square test, ANOVA, and Pearson's correlation coefficient. Statistical analyses were performed using SPSS version 19.0.

RESULTS:
26.8% of respondents had a high knowledge, 61.5% had good knowledge, 10.1% had low knowledge, and 6 (1.5%) had nil knowledge about COVID-19. No significant association was found between qualification and knowledge level among the respondents (P = 0.053). Both graduates and postgraduates had low knowledge regarding effective PPE components (P = 0.053), donning (P = 0.888), and doffing (P = 0.745). Only 52.9% of postgraduates and 43.7% graduates answered correctly about the sequence of donning, and 47.9% of postgraduates and 46.1% of graduates had knowledge regarding correct doffing sequence of PPE. Furthermore, knowledge was low regarding the implications of COVID-19 in dental treatment.

CONCLUSION:
Although the dentists were found to have high/good knowledge scores regarding COVID-19, there was a lack of knowledge regarding hand hygiene, proper use of PPE, and implications of COVID-19 in dental treatment. Thus, they need to be trained and sensitized regarding the same.
Medical record documentation quality in the hospital accreditation
Authors: Sharifi Saiedeh , Zahiri Mansour , Dargahi Hosein , Faraji-Khiavi Farzad 
Published: February 2021

BACKGROUND:
Medical records constitute a legal and professional document regarding the activities of medical staff in hospitals. This study was conducted with the aim of identifying the factors that affect the quality of medical records by implementing the accreditation models in hospitals.

MATERIALS AND METHODS:
This was a qualitative study. The data were collected via 28 semi-structured interviews. The research population included administrators and supervisors of nursing, medical records and accreditation in educational hospitals in Ahvaz, southwest Iran. Content analysis method was used to analyze the data. Descriptive statistics were used to present demographic characteristics of interviewees.

RESULTS:
Facilitators and barriers to improve the quality of documentation were categorized into three levels: organizational, environmental, and personal, all achieved after the implementation of accreditation model in hospitals. Six facilitating factors were identified including organizational structure, organizational culture, management support, individual characteristics, and perceived benefits science and technology. The barriers included five factors including program structure, organizational structure, beliefs, justice, and individual characteristics.

CONCLUSIONS:
The identification of factors affects the quality of medical record documentation and it seems that health managers and policymakers should take measures to improve the quality of medical recording documentation through strengthening the facilitators and overcoming the barriers in the program since the purpose of accreditation is to improve the quality in hospitals.
Workplace physiotherapy for musculoskeletal pain-relief in office workers
Authors: Fortún-Rabadán Rocío , Jiménez-Sánchez Carolina , Flores-Yaben Olatz , Bellosta-López Pablo 
Published: February 2021

BACKGROUND:
Musculoskeletal pain is highly prevalent among office workers and causes high costs to the public health system. Strategies including education and exercise are recommended, with major benefits when conducted by physical therapists in the occupational environment. However, the required investment is uncommon among companies. This study aimed to evaluate the efficacy of a multimodal physiotherapy intervention to relieve musculoskeletal pain in office workers.

MATERIALS AND METHODS:
The study employed a single group study with a pre-post study design and was conducted at Universidad San Jorge in 2018. Outcome variables were: workplace ergonomics (INSHT Guide), existence and severity of musculoskeletal disorders (Nordic Musculoskeletal Questionnaire), musculoskeletal pain intensity (Numeric Rating Scale), and Clinical Global Impression Scale. Office workers in a university setting (n = 24, 19 females) were assessed at baseline, after 4 weeks of in-person sessions and following 3 weeks of autonomous performance. The physiotherapy program included education, ergonomic supervision, self-treatment, strengthening, and stretching exercises. A repeated-measures ANOVA or Friedman test (with post hoc comparisons) and Chi-squared test were used to compare the study variables.

RESULTS:
At baseline, cervical spine (54%), shoulder (42%), and lumbar regions (37.5%) were the most symptomatic regions according to the Nordic Musculoskeletal Questionnaire. Even if the proportion of symptomatic areas did not decrease significantly after the intervention, a great reduction of musculoskeletal pain intensity was observed after the program in the cervical (P < 0.001), lower back (P = 0.005), shoulder (P = 0.006) regions, and in the overall pain level (P < 0.001).

CONCLUSIONS:
These results support that a multimodal physiotherapy program can relieve work-related musculoskeletal pain in office workers and serve as a basis for future controlled trials.
Specific causes of recurrence after surgery and mortality in patients with colorectal cancer
Authors: Safari Malihe , Mahjub Hossein , Esmaeili Habib , Abbasi Mohammad , Roshanaei Ghodratollah 
Published: February 2021

Background:
In situation where there are more than one cause of occurring the outcome such as recurrence after surgery and death, the assumption of classical survival analyses are not satisfied. To cover this issue, this study aimed at utilizing competing risks survival analysis to assess the specific risk factors of local-distance recurrence and mortality in patients with colorectal cancer (CRC) undergoing surgery.

Materials and Methods:
In this retrospective cohort study, 254 patients with CRC undergoing resection surgery were studied. Data of the outcome from the available documents in the hospital were gathered. Furthermore, based on pathological report, the diagnosis of CRC was considered. We model the risk factors on the hazard of recurrence and death using competing risk survival in R3.6.1 software.

Results:
A total of 114 patients had local or distant recurrence (21 local recurrences, 72 distant recurrences, and 21 local and distant recurrence). Pathological stage (adjusted hazard ratio [AHR] = 4.28 and 5.37 for stage 3 and 4, respectively), tumor site (AHR = 2.45), recurrence (AHR = 3.92) and age (AHR = 3.15 for age >70) was related to hazard of death. Also based on cause-specific hazard model, pathological stage (AHR = 7.62 for stage 4), age (AHR = 1.46 for age >70), T stage (AHR = 1.8 and 2.7 for T3 and T4, respectively), N stage (AHR = 2.59 for N2), and white blood cells (AHR = 1.95) increased the hazard of recurrence in patients with CRC.

Conclusion:
This study showed that older age, higher pathological, rectum tumor site and presence of recurrence were independent risk factors for mortality among CRC patients. Also age, higher T/N stage, higher pathological stage and higher values of WBC were significantly related to higher hazard of local/distance recurrence of patients with CRC.
Identification of high-risk and low-risk clusters and estimation of the relative risk of acute lymphoblastic leukemia in provinces of Iran during 2006–2014 period
Authors: Pordanjani Sajjad Rahimi , Kavousi Amir , Mirbagheri Babak , Shahsavani Abbas , Etemad Koorosh 
Published: February 2021

Background:
The present study was conducted to determine the epidemiological status, identify high-risk and low-risk clusters, and estimate the relative risk (RR) of acute lymphoblastic leukemia (ALL) in provinces of Iran.

Materials and Methods:
This is an ecological study carried out using an Exploratory Multiple-Group design on 3769 children under 15 years of age with ALL from 2006 to 2014. Data analysis was performed using Mann–Whitney U, Global Moran's I and Kuldorff's purely spatial scan statistic tests at a significance level of 0.05.

Results:
The average annual incidence rate of ALL during 2006–2014 period was 2.25/100,000 children under 15 years of age. The most likely high-risk cluster with log-likelihood ratio (LLR) =327.47 is located in the southwestern part of Iran with a radius of 294.93 km and a centrality of 30.77 N and 50.83 E, which contained 1276 patients with a RR of 2.56. It includes Fars, Bushehr, Kohgiluyeh and Boyer-Ahmad, Khuzestan and Chahar Mahall and Bakhtiari provinces. On the other hand, the most likely low-risk cluster with 517 patients, and a RR 0.49 and LLR = 227.03 was identified in the northwestern part of Iran with a radius of 270.38 km and a centrality of 37.25 N and 49.49 E. It includes Zanjan, Qazvin, Gilan and East Azerbaijan, Ardabil, Alborz and Tehran provinces.

Conclusion:
High-risk clusters were observed in Southwestern, central, and eastern Iran, while low-risk clusters were identified in Northern and Western Iran.
Medical Healthy Detection Dengan Parameter Tinggi Badan dan Berat Badan
Authors: Loniza Erika , Fahrurrozi Fahrurrozi , Rahmasari Desy 
Published: February 2021

Pemeliharaan kesehatan adalah upaya penanggulangan dan pencegahan gangguan kesehatan. Salah satu dari sekian banyak yang menyebabkan kesehatan terganggu adalah masalah obesitas atau kegemukan, dan masalah obesitas merupakan hal yang paling banyak terdapat dikalangan masyarakat lokal bahkan di dunia. Penelitian ini bertujuan untuk membuat dan mendesain alat ukur tinggi dan berat badan serta Indeks Massa Tubuh objek dengan tampilan hasil pada LCD dan tersimpan di SD Card. Pada sensor ultrasonic maskimal tinggi badan yang dapat diukur yaitu sebesar 200cm dan pada sensor load cell maksimal berat badan yang dapat di ukur yaitu sebesar 150kg, dalam pembuatan alat tersebut semua sistem dikontrol oleh minimum system arduino Uno. Dari penelitian yang dilakukan terhadap 5 orang sebagai objek pengukuran didapatkan hasil pengukuran rata-rata berat badan sebesar 51,76 kg dengan rata-rata persentase error sebesar 0,6% dan rata-rata tinggi badan sebesar 159,4 cm dengan rata-rata persentase error sebesar 0,2%. Setelah dilakukan penelitian secara umum dapat disimpulkan bahwa alat Medichal Healthy Detection dapat digunakan dengan baik dan masih dalam nilai ambang batas toleransi +- 1%.