bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in implementation of Competency Based Medical Education – A Cross Sectional survey among medical faculty in India
Authors: Catherine A.Precilla , Gopalakrishnan Shivkumar 
Published: July 2021

Abstract
Background. In India, Competency Based Medical Education (CBME) is gaining foothold to transform the medical student into a doctor fulfilling community and societal needs. With that end in view the teaching faculty are getting sensitized and trained by the National Faculty Development Program (FDP). Objectives. To assess the awareness about FDP among teaching faculty in medical colleges. To study the attitude & perceived barriers to implementation of CBME. Methods. This questionnaire based multicentric cross sectional study was conducted among teaching faculties in Indian medical institutes. Electronic media [Google forms] was used to disseminate the questionaire. Attitudinal and perceptional differences were internally compared among the faculties.Results. Among 251 participants 90.2% faculties from private institutes had undergone FDP significantly more than those from Government sector (p=0.008). We observed that 92.4% were aware, 80.2 % had undergone Curriculum Implementation Support Program (CISP) and 95.2% did agree that CBME will improve the medical education system. Major challenges perceived were high student to faculty ratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popular solutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extra remuneration (35.9 %) and increase administrative support (30.7%). There were significant difference of opinions between teaching faculty of government and private sector (p=0.017).Conclusion. Most of the medical faculty are aware of the need and have acquired a positive attitude to enforcement of CBME. However significant barriers do exist in the form of manpower and resources which need to be addressed.
Analysis of reliability of the drill pipe in the clamping mechanism
Authors: Afandiyev Emin Musa , Nuriyev Mahammadali Nuraddin 
Published: July 2021

In oilfield equipment, a significant place is occupied by clamping mechanisms used to grip pipes during tripping operations. They are mainly divided into 2 groups. The first includes mechanisms with a forced clamping of the part. The second group includes self-clamping devices with a wedge mechanism. Here, the clamping force increases in proportion to the axial shear force. In these clamping devices, clamping jaws serve as a common element. In addition to smooth jaws, there may be jaws with notches on the inner cylindrical surface. Such notches contribute to an increase in the coefficient of adhesion when clamping cylindrical parts, in particular pipes. During the operation of clamping devices with corrugated jaws, the teeth of the notch are introduced into the pipe walls under the action of the clamping force. The shearing force can then displace the pipe relative to the jaws. The adhesion coefficient µ is the ratio of the shear force P to the clamping force Q, i.e. P/Q. Exceeding the shear force P of the limit value causes the pipe to be clamped to move. The correct choice of the place of load application is also of great importance.
Optimum clamping performance can be achieved by clamping workpieces without slipping from shear forces. At the same time, it is necessary to ensure reliability, efficiency, productivity. Therefore, all factors that determine the holding capacity of clamping mechanisms should be considered. These factors include the coefficient of adhesion, the design of the working surfaces of the clamping elements, the type of notch of the corrugated jaws and the place of application of the clamping force
Analysis of kinetics of local hydraulic losses on the laterals of radial wells at Belgrade groundwater source
Authors: Mitrinović David , Pušić Milenko , Popović Miodrag , Kovačević Srđan , Dimkić Milan 
Published: July 2021

Abstract
An analysis of the dynamics of the process of biochemical colmation of laterals of radial wells at the Belgrade groundwater source is presented. A very good correlation between the rate of forming of the colmations and the concentration of bivalent iron was obtained, on the basis of which the maximum recommended flows and velocities were defined, which are in good agreement with the values from previous articles and studies. The effects of regenerations on yield and the total volume of extracted water (up to 2 times higher than in the case of no regeneration) were investigated using a mathematical and software model. A correlation was developed linking the ratio of the amounts of water extracted with and without regeneration, to the aquifer hydraulic resistance, the coefficient of local hydraulic losses reduction due to regeneration, and the number of regenerations. The factor equal to the square root of the number of regenerations increased by one was added to the expressions for the maximum recommended values of inlet velocities and flows per lateral. The differences in flows and extracted volumes between operating modes with constant flow between regenerations and a constant, minimal water level were also examined using the model. The ratio between the total extracted volumes when the drawdown is kept equal to maximum and when the flow between the regenerations is kept constant reaches up to 1.25.
Comparison of Granulomatosis with Polyangiitis Clinical Features in Patients Depending on Involvement or Absence of Kidney Involvement
Authors: Puchala Mateusz , Rydzewski Andrzej , Kowalik Ilona , Wisłowska Małgorzata 
Published: July 2021

Background:
GPA is necrotizing inflammation of the small vessels with granulomas.
Kidney involvement deteriorated its prognosis.

Objective:
Comparison of GPA patients with Kidney (KI) and without Kidney Involvement (nKI).

Material and methods:
We conducted a cross-sectional study of 50 consecutive adult GPA patients,
25 KI from Nephrology and 25 nKI from the Rheumatology Department of Central Clinical
Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory,
serological, imaging, histopathological data, BVAS and treatment.

Results:
The mean age of KI patients was statistically older than nKI (67.3±9.5 vs. 55.1±15.9,
p=0.002). Generalized, severe, disease resistance was observed respectively in 92% vs. 44%,
p<0.001. The number of red blood cells (3.47 vs. 4.41T/l, p<0.001), hemoglobin (10.0 vs. 12.9
g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89 mg/dl, p<0.001), lower
GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs. 2.0 mg/l, p<0.001), BVAS
(16.6±4.4 vs. 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs. 15.2CU, p=0.017).
Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI
(p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs. 18.2% KI,
(p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic
glomerulonephritis in 17.6%, and pauci-immune crescentic glomerulonephritis in 70.6%.

Conclusions:
In patients with KI we found generalized, severe, resistant GPA, higher BVAS more
frequently than inpatients without KI. The results of laboratory parameters were worse in patients
with KI. Aggressive immunosuppressive treatment is often used in the KI group.
Current Treatments and Therapeutic Options for COVID-19 Patients: A
Systematic Review
Authors: Mehraeen Esmaeil , Najafi Zeinab , Hayati Bagher , Javaherian Mohammad , Rahimi Sajad , Dadras Omid , SeyedAlinaghi SeyedAhmad , Ghadimi Maryam , Sabatier Jean-Marc 
Published: July 2021

Introduction:
COVID-19 is the third rising epidemic in the 21st century that quickly turned
into a worldwide pandemic. Many clinical studies have been achieved to investigate treatments to confront
COVID-19. Therefore, we conducted a systematic review to describe the recent treatment strategies
to treat COVID-19 patients.

Methods:
A systematic search was performed in the databases of PubMed, Scopus, Embase, Science
direct, Up to date, and Web of Science using the keywords of Coronavirus, COVID-19, SARS-CoV-2,
Novel Coronavirus, 2019-nCoV, Treatment, Medicine, Therapy, Intervention, Drug, Medications, and
Cure. All the relevant articles were collected from December 2019 to July 2020.

Results:
We included 58 studies including 38 articles (eleven reviews, ten editorial documents, three
case reports, one mix method, one cohort study), and 19 published clinical trials. Review of
studies showed that Lopinavir/Ritonavir (n=16), Remdesivir (n=13), Convalescent plasma
(n=11), Chloroquine (n=11), Ribavirin (n=9), Hydroxychloroquine sulfate (n=8), Traditional Chinese
Medicine (TCM) (n=8), and Arbidol (n=7), were the most frequently therapies used to treat COVID-19
patients.

Conclusion:
In the absence of definitive treatment protocols, recently proposed approaches have appeared
to be an effective therapy for accelerating the recovery of COVID-19 patients. Some of these
treatments may have been in the early stages of testing. However, future preclinical and clinical trials
are warranted to validate findings.
Concrete damage due to oxidation of pyrrhotite-bearing aggregate: a review
Authors: Duchesne Josée , Rodrigues Andrea , Fournier Benoit 
Published: July 2021

Oxidation of pyrrhotite-bearing aggregates is one of the major causes of concrete damage in numerous buildings in Trois-Rivières in Canada and Connecticut in the USA. In the presence of moisture and oxygen, pyrrhotite oxidizes to generate iron-and sulfate-rich secondary minerals that cause internal sulfate attack. Iron sulfides are accessory minerals of different rock types. The distribution of sulfides is often very heterogeneous in terms of aggregate particles, even at the level of the quarries in which some areas may contain copious amounts than others, which complicates the sampling method. Pyrrhotite is a complex mineral with varying chemical composition, crystallographic structure, and specific surface area. These factors influence the reactivity of pyrrhotite. Therefore, it is challenging to control the quality of the aggregate sources.
In this study, recent advances in the identification and quantification of pyrrhotite to diagnose complicated cases are presented, and a performance-based approach for the quality control of new sources of aggregates is introduced. The performance-based approach is preferred because it eliminates the influence of the oxidation of pyrrhotite.
Web-Based Return of Individual Patient-Reported Outcome Results Among Patients With Lymphoma: Randomized Controlled Trial
Authors: Oerlemans Simone , Arts Lindy Paulina Johanna , Kieffer Jacobien M , Prins Judith , Hoogendoorn Mels , van der Poel Marjolein , Koster Ad , Lensen Chantal , Stevens Wendy Bernadina Catharina , Issa Djamila , Pruijt Johannes F M , Oosterveld Margriet , van der Griend René , Nijziel Marten , Tick Lidwine , Posthuma Eduardus F M , van de Poll-Franse Lonneke V 
Published: July 2021

Background
There has been a cultural shift toward patient engagement in health, with a growing demand from patients to access their results.

Objective
The Lymphoma Intervention (LIVE) trial is conducted to examine the impact of return of individual patient-reported outcome (PRO) results and a web-based self-management intervention on psychological distress, self-management, satisfaction with information, and health care use in a population-based setting.

Methods
Return of PRO results included comparison with age- and sex-matched peers and was built into the Patient-Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship registry. The self-management intervention is an adaptation of a fully automated evidence-based intervention for breast cancer survivors. Patients with lymphoma who completed the web-based questionnaire were equally randomized to care as usual, return of PRO results, and return of PRO results plus self-management intervention. Patients completed questionnaires 9 to 18 months after diagnosis (T0; n=227), 4 months (T1; n=190), 12 months (T2; n=170), and 24 months (T3; n=98).

Results
Of all invited patients, 51.1% (456/892) responded and web-based participants (n=227) were randomly assigned to care as usual (n=76), return of PRO results (n=74), or return of PRO results and access to Living with lymphoma (n=77). Return of PRO results was viewed by 76.7% (115/150) of those with access. No statistically significant differences were observed for psychological distress, self-management, satisfaction with information provision, and health care use between patients who received PRO results and those who did not (P>.05). Use of the self-management intervention was low (2/76, 3%), and an effect could therefore not be determined.

Conclusions
Return of individual PRO results seems to meet patients’ wishes but had no beneficial effects on patient outcome. No negative effects were found when individual PRO results were disclosed, and the return of individual PRO results can therefore be safely implemented in daily clinical practice.

Trial Registration
Netherlands Trial Register NTR5953; https://www.trialregister.nl/trial/5790

International Registered Report Identifier (IRRID)
RR2-10.1186/s13063-017-1943-2
It Is Not Just the FEV1 That Matters, but the Personal Goals We Reach Along the Way: Qualitative, Multicenter, Prospective, Observational Study
Authors: Oppelaar Martinus C , van den Wijngaart Lara S , Merkus Peter J F M , Croonen Ellen A , Hugen Cindy A C , Brouwer Marianne L , Boehmer Annemie L M , Roukema Jolt 
Published: July 2021

Background
The COVID-19 pandemic has boosted the use of forced expiratory volume in 1 second (FEV1) telemonitoring in pediatric asthma, but a consensus on its most efficient and effective implementation is still lacking. To find answers, it is important to study how such an intervention is perceived, experienced, and used by both patients and health care professionals (HCPs).

Objective
The aim of this study was to provide perspectives on how FEV1 home monitoring should be used in pediatric asthma.

Methods
This is a qualitative, multicenter, prospective, observational study which included patients with asthma aged 6-16 and HCPs. Primary outcomes were results of 2 surveys that were sent to all participants at study start and after 3-4 months. Secondary outcomes consisted of FEV1 device usage during 4 months after receiving the FEV1 device.

Results
A total of 39 participants (26 patients and 13 HCPs) were included in this study. Survey response rates were 97% (38/39) at the start and 87% (34/39) at the end of the study. Both patients and HCPs were receptive toward online FEV1 home monitoring and found it contributive to asthma control, self-management, and disease perception. The main concerns were about reliability of the FEV1 device and validity of home-performed lung function maneuvers. FEV1 devices were used with a median frequency of 7.5 (IQR 3.3-25.5) during the 4-month study period.

Conclusions
Patients and HCPs are receptive toward online FEV1 home monitoring. Frequency of measurements varied largely among individuals, yet perceived benefits remained similar. This emphasizes that online FEV1 home monitoring strategies should be used as a means to reach individual goals, rather than being a goal on their own.
Statistical Approach to Optimize Production of Biosurfactant by Achromobacter Xylos
Authors: Golamari Siva Reddy  , Kadiyala Himavarshini  , Asapu Devi Prasanna  , Singavarapu Harini  , Narra Sai Nikitha  , Gadde Nayana Sphoorthi  , Mannam Bhuvaneswari  
Published: July 2021

This study aimed to optimize medium composition biosurfactant production of achromobacter xylos using response surface quadratic model . Lipoprotein and lipopeptides are used in many industries such as petroleum refining, pharmaceutical, mining, agriculture and bioprocess industries. The point of this assessment was to pull out and portray the biosurfactant passing on restriction of microorganisms from oil corrupted soil and considering their advancement energy at various temperatures and pH. The separation and growth study was directed in MSM medium using lamp fuel oil as sole carbon hotspot for bacterial turn of events. Confined strains were found to be Gram positive bacillus and in general Gram's positive minuscule life forms can convey lipopeptides type biosurfactants. The ideal conditions for achromobacteria xylos growth were discovered to be at pH seven (7) and temperature 30oC. Central composite design (CCD) was utilized to pick the following medium components (MgSO4, NaNO3, CaCl2, (NH4)2SO4, FeSO4, and KH2PO4). Central composite arrangement (CCD) of RSM was utilized to analyze the four parts at five stages, and biosurfactant fixation was evaluated as reaction. Backslide coefficients were directed by backslide examination, and the quadratic model condition was settled. R2 an impetus for bio-surfactant was endeavored to be 0.7527, showing that the quadratic model was basic with the exploratory outcomes. Confirmation of the numerical model was driven by playing out the assessment with the normal overhauled values, and bio-surfactant production was found to be 10.53 g/L. Underwriting of the normal quadratic model was 97.3% exact with the test results facilitated under the ideal conditions. CaCl2, (NH4)2SO4, FeSO4, and KH2PO4 were perceived as successful portions for bio-surfactant delivering 98% of achromobacter xylos microorganism.
Assessment of VO2 Max Reliability with Garmin Smart Watch among Swimmers
Authors: Sivaguru Muthusamy  , Ambusam Subramaniam  , K. Balasubramanian  , Vinosh Kumar Purushothaman  , Rajkumar Krishnan Vasanthi  
Published: July 2021

Maximal aerobic capacity (VO2 max) is one of the important factors that influence swimming performance. Currently, the Garmin Forerunner Fitness Watch 935 used to measure VO2 max are expensive, require skilled-trained personnel, not feasible for large-scale use, and land-based, which will not be accurate in measuring water-based activity. In order to measure the swimming performance, there is a need for an affordable, feasible, and reliable device. Therefore, the current study aimed to examine the intra- rater reliability of Garmin Forerunner Fitness Watch 935 accuracy in measuring the VO2 max among collegiate swimmers during the 200m swimming task. The VO2 max measurement of 10 collegiate swimmers was taken with Garmin Forerunner for two trials. The intra-class correlation coefficient (ICC), standard error of measurements (SEMs), and Bland-Altman plot was used in the current study to establish the inter-rater reliability measurement. The intra-rater reliability of Garmin Forerunner showed high reliability and accuracy with an intra-class correlation coefficient (2,1) of 0.869 and standard error of measurements of 0.231 ml/kg/min. Further, the results were strengthened with Bland-Altman plot showed an acceptable agreement between the two trials. The Garmin Forerunner would be a simple, objective and useful device to be used by physiotherapists, trainers and other sports-related disciplines to assess and improve the swimming performance by targeting the heart rate and VO2 max.
Normal Sexual Development and Puberty
Authors: French Amanda 
Published: July 2021

Puberty is the hormonally mediated process of physical changes that occur during the transition of childhood to adulthood. Activation of the hypothalamic-pituitary-gonadal axis triggers the onset of puberty. Gonadotropin hormone-releasing hormone (GnRH) is the major regulator of the reproductive axis. GnRH stimulates the anterior pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn activate the gonads to produce sex steroids. Thelarche is stimulated by estrogen and is usually the first sign of puberty in girls. Adrenarche, although associated temporally with puberty, is mediated by the adrenal cortex and is unrelated to pubertal maturation. A growth spurt occurs mid-puberty. Menarche, usually occurring 2-3 years after thelarche, is considered the end of puberty. After menarche, only about 1-2 additional inches of height are accrued. Understanding what is considered the normal timeline of sexual development allows better recognition of precocious or delayed puberty, both of which may be associated with serious underlying health issues
This review contains 4 tables, 5 figures, and 29 references.
Keywords: puberty, pubertal development, hypothalamic-pituitary-gonadal axis, thelarche, menarche, normal sexual development
POTENSI DAN PENGEMASAN PAKET EKOWISATA DI KABUPATEN BERAU PROVINSI KALIMANTAN TIMUR
Authors: Fariz Aji Muhammad , Sudana I Putu , Dewi N.G.A.S. 
Published: July 2021

This research was conducted to determine the potential of ecotourism in Berau Regency, East Kalimantan Province so that it can be packaged into an ecotourism package that covers the whole area of Berau Regencey starting from the urban zone, the inland zone and the water zone. This Research was conducted in Berau Regency because Berau Regency has 159 tourist attractions and also its location is close to the location of the new capital. The ecotourism package packaging made in this study is based on the lack of variety of products and tour packages circulating in Berau Regency so that this research is expected to add variety as well as introduce new potentials that can be found in Berau Regency. Data collection techniques used in this study are in-depth interviews, observation, documentation, and literature study. After conducting research in Berau Regency, there are 17 ecoutourism potentials which can be packaged into 4 kinds of ecoutourism packgaes, with details of theree full-day ecotourism packages and one 2-day 1 night ecoutourism packages and the ecotourism package itinerary in this study is made in the form of descriptions, tables, and graphs as well as the type of ecotourism package in this study is ready made tour. The titles of the ecotourism packages in this study are (1) Berau Culture and City Tour, (2) Berau Mangrove and Sangalaki Island Tour, (3) Orangutan University and Merabu Forest Tour, (2) Mirror Lake and Whale Shark Tour.
FAKTOR YANG MEMPENGARUHI KEPUTUSAN WISATAWAN MANCANEGARA MEMILIH PAKET VOLUNTOURISM DI IVHQ UBUD, BALI
Authors: Permatasari Liyanti Intan , Eka Mahadewi Ni Putu , Sasrawan Mananda I Gusti Putu Bagus 
Published: July 2021

The development of voluntourism in the world can be recognise from the existence of organizations that provide volunteer travel program. Bali as the icon of Indonesia tourism also become one of destination for voluntourism. Tourist that decide in choosing voluntourism package have its own tourist characteristic. With the presence of tourists who choose the voluntourism package, it is necessary to examine the factors that influence purchasing decisions and their dominant factors. The purpose of this study is to determine tourist characteristic, the factors and dominant factors that influence foreign tourist decision choosing voluntourism package in IVHq Ubud, Bali. Data collection in this research using questionnaire and distributed online by google form to user of volunteer program in IVHq Ubud with total sample of 44 respondents. Sampling technique in this research using purposive sampling. Data analysis technique using likert scale and factor analysis including validity test, and reliability test then the data processed by the Statistical Package for the Social Science (SPSS) version 18.0 program. The result of analysis factors show that there are five factors including image factors with eigen value of 6.040, external factor with eigen value of 2.378 , psychology with eigen value of 1.681, physical evidence factor with eigen value of 1.427, and product factor dengan eigen value 1.025. The dominant factor infuencing foreign tourist decision choosing voluntourism package in IVHq Ubud, Bali is brand/image factor with eigen value of 6.040.