bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deploying an e-Learning Environment in Zanzibar: Feasibility Assessment
Authors: Groeneveld Caspar , Kibga Elia , Kaye Tom 
Published: September 2021

The Zanzibar Ministry of Education and Vocational Training (MoEVT) and the World Bank (the Bank) approached the EdTech Hub (the Hub) in April 2020 to explore the feasibility of implementing a Virtual Learning Environment (VLE). The Hub was requested to focus primarily on the deployment of a VLE in lower secondary education, and this report consequently focuses primarily on this group. The report is structured in four sections:

An introduction to provide the background and guiding principles for the engagement with a short overview of the methodology applied.

An analysis of the Zanzibar education system with a particular focus on elements relevant to deploying a VLE. This includes the status of ICT infrastructure, and a summary of the stakeholders who will play a role in using or implementing a VLE.

A third section that discusses types of VLEs and content organisation, and their applicability to the Zanzibar ecosystem.

A conclusion with recommendations for Zanzibar, including short- and long-term steps.

In this collaboration with Zanzibar’s MoEVT, the Hub team sought to understand the purpose of the proposed VLE. Based on discussions and user scenarios, we identified two main education challenges a VLE may help to resolve. In the short term, students cannot go to school during the COVID-19 crisis, but need access to educational content. There is content, but no flexible and versatile platform to disseminate content to all students. In the long term, a mechanism to provide students with access to quality, curriculum-aligned content in school, or remotely, is required.
The Fragility of Statistical Findings in Achilles Tendon Injury Research: A Systematic Review
Authors: Parisien Robert L. , Danford Nicholas C. , Jarin Ian J. , Li Xinning , Trofa David P. , Vosseller J. Turner 
Published: September 2021

Introduction:
Probability analysis with the reporting of P values is often used to determine the statistical significance of study findings in the Achilles literature. The purpose of this study was to determine the utility of applying a fragility analysis to comparative trials evaluating Achilles tendon injuries.

Methods:
We identified all dichotomous outcome data for comparative studies of Achilles tendon injuries published in 11 orthopaedic journals from 2000 to 2020. The fragility index (FI) was determined by the number of event reversals required to change a P value from less than 0.05 to greater than 0.05, or vice-versa. The associated fragility quotient was determined by dividing the FI by the sample size.

Results:
Of the 51,357 studies screened, 1,487 met the search criteria, with 51 comparative studies and 177 total outcome events included for analysis. The overall FI was only 4 with an associated fragility quotient of 0.048. One-half of the studies failed to report lost to follow-up data, with an additional 21.6% reporting loss to follow-up of greater than or equal to 4.

Conclusion:
Our fragility analysis suggests that Achilles tendon injury outcomes are not as statistically stable as previously thought and should be interpreted with caution.
The Geographic Movement Patterns and Career and Personal Interests of Orthopaedic Surgery Residents in the United States
Authors: Sherman Nathan C. , Sorenson Jacob C. , Khwaja Ansab M. , DeSilva Gregory L. 
Published: September 2021

Background:
Orthopaedic surgery continues to be a highly desired residency specialty for graduating medical students in the United States. The geographic preferences and trajectories of orthopaedic surgery applicants are not well understood.

Objective:
The primary objective of this study was to determine the geographic movement patterns of orthopaedic residents from university through residency. A secondary objective was to trend the career and personal interests of orthopaedic residents.

Methods:
One hundred eighty-seven orthopaedic surgery programs and 3672 residents were identified through the Electronic Residency Application Service website and Google searches and included for study. Program provided information, including the residents' medical school, undergraduate institution, career interests, and personal interests was then gathered. All data were recorded between the dates of March 25, 2020, and April 2, 2020.

Results:
A minority of orthopaedic residents (46.2%; n = 1,569/3,398) were training in the same geographic region of their medical school; however, analysis revealed a statistically significant strength of association for home region over a different US census bureau region (χ2 = 127.4, df = 8, Cramer's V = 0.2, P < 0.001). The average distance between orthopaedic residents' medical school and residency program was 666 miles. Male residents were more interested in arthroplasty, spine, and sports, whereas female residents were more interested in hand and pediatrics. The residents leading interests were in arthroplasty (24.4%), sports (21.7%), and trauma (21.3%).

Conclusion:
Orthopaedic surgery residents are more likely to train in a geographical region that is different from their medical school or undergraduate institution. The reported career interests of male and female orthopaedic residents showed significant differences, but personal interests seem to be similar between genders.
The IPA, a Modified Numerical System for Pain Assessment and Intervention
Authors: Vaidya Rahul , Washington Austen , Stine Sasha , Geamanu Andreea , Hudson Ian 
Published: September 2021

Introduction:
The objective of this study was to (1) construct a pain scale that improves communication between healthcare providers and patients (Interventional Pain Assessment [IPA] tool) and (2) to validate this new pain scale with the numeric rating scale of 0 to 10 Numerical Rating System (NRS).

Methods:
The IPA uses only three categories: 0 = “I have no pain,” 1 = “My pain is tolerable (no intervention needed),” and 2 = “my pain is intolerable, (intervention needed).” An Institutional Review Board–approved study was done on 322 consecutive patients who were recovering from fracture treatment. We compared ratings of the IPA with NRS. We also asked patients which scale they preferred. Statistical analysis included Kendall rank correlation (Kendall τ) and Spearman rho to determine correlation with the NRS.

Results:
The IPA exhibited a statistically significant association with the NRS (τ = 0.58, P < 0.0001). Discordant answers were provided by 23.6% patients; 4.7% regarded their mild-to-moderate pain as intolerable (15/322) while 18.9% reported their severe pain as tolerable (61/322). Eighty-two percent of patients preferred the IPA.

Conclusion:
The IPA is a valid pain scale and has exhibited strong correlation with the NRS 0 to 10, displays simple minimally clinical important difference calculation, and provides meaningful information on the effect of pain control modulation.
Hof van Justitie sluit zich voor het zwijgrecht en het nemo tenetur-beginsel voor natuurlijke personen aan bij het EHRM
Authors: Traousis M.A.A. 
Published: September 2021

Hof van Justitie sluit zich voor het zwijgrecht en het nemo tenetur-beginsel voor natuurlijke personen aan bij het EHRM.
In het arrest DB/Consob oordeelt de Grote kamer van het Hof van Justitie over de reikwijdte van het zwijgrecht en het nemo tenetur-beginsel voor natuurlijke personen. Eerder is dit al gedaan voor rechtspersonen in het kader van het mededingingsrecht, maar voor natuurlijke personen breidt het Hof van Justitie dit nu uit door aan te sluiten bij de rechtspraak van het EHRM. Dit leidt ertoe dat iemand geen boete mag krijgen omdat hij weigert te antwoorden, wanneer die antwoorden mogelijk tegen hem zouden kunnen worden gebruikt bij een criminal charge.HvJ 2 februari 2021, zaak C-481/19, ECLI:EU:C:2021:84 (DB/Commissione Nazionale per le Società e la Borsa (Consob)).
Facebook Ireland: one-stop-shop confirmed
Authors: Temme M.O.G. 
Published: September 2021

Facebook Ireland: one-stop-shop confirmed. Het arrest van het Hof van Justitie in zaak C-645/19
Dit artikel behandelt het arrest van het Hof van Justitie van 15 juni 2021 in de zaak Facebook Ireland. Het Hof van Justitie bepaalt dat hoewel de leidende toezichthoudende autoriteit voor de grensoverschrijdende verwerking van persoonsgegevens in principe als de one-stop-shop in de zin van artikel 56 AVG moet worden aangemerkt, een betrokken toezichthoudende autoriteit in bepaalde omstandigheden gebruik kan maken van haar bevoegdheid als bedoeld in artikel 58 lid 5 AVG en een rechtsvordering kan instellen. De uitzonderingen op het één-loketmechanisme volgen uit de AVG.HvJ 15 juni 2021, zaak C-645/19, ECLI:EU:C:2021:483 (Facebook Ireland Ltd, Facebook Inc. en Facebook Belgium BVBA/Gegevensbeschermingsautoriteit (België)).
Inflamed Right Inguinal Appendix in a Sixty-four-year-old Man: A Case Report and Review of the Literature
Authors: Ogbetere Friday Emeakpor 
Published: September 2021

The vermiform appendix has varied locations ranging from retrocaecal, pelvic, paracolic to pre-ileal and postileal. Inguinal appendix or Amyand’s hernia is an extremely rare occurrence with potentially fatal complications. Rarer still is the presence of an inflamed appendix in the inguinal canal in the elderly. Due to its rarity, the pathophysiology and risk factors of the condition are still unclear. Some theorize that it is secondary to a patent processus vaginalis or perhaps the presence of a fibrous band between the hernia sac and testes. Reported herein is a 64-year-old man who presented with a painful irreducible right inguinal swelling. An incarcerated inguinal hernia with the hernia sac harbouring an inflamed vermiform appendix was discovered at surgery. Appendectomy and a primary suture repair of the hernia were carried out. The postoperative period was uneventful. Surgical management of inflamed inguinal appendix carries a risk of septic complications. It is pertinent that every surgeon performing a hernia repair must be aware of this condition and the appropriate treatment modalities.
Effect of Assertiveness Technique in Reducing Verbal Victimization among Junior Secondary School Students in Anambra State
Authors: Nwadinobi V. N. , Akunne L. I. , Etele A. V. 
Published: September 2021

Aims: The purpose of this study is to determine the effect of assertiveness technique in reducing verbal victimization among junior secondary school students in Anambra state.
Study Design: The design adopted for this study is pure experimental design.
Place and Duration of Study: The target population is 1182 junior secondary students identified to be verbally victimized. The duration is between January 2021 and June 2021.
Methodology: The design adopted for this study is the pure experimental. Two secondary schools where adopted for the study, from the two secondary schools, one group served as treatment/experimental group and the other school served as control group with participants randomly assigned. These participants were identified by administering a structured questionnaire structured by the researchers. The population for the study comprised 1182 junior secondary students identified to be verbally victimized. The sample was drawn using the purposive sampling technique, this was to identify schools with students that are verbally victimized. A total of 104 students (54 male and 50 female) were drawn and randomly assigned to the experimental and control groups as sample for the study. The instrument for data collection was the bullying victimization scale (BVS), the scale was developed and validated based on Elvis (1996) questionnaire and normalized for Nigerian cultural situation. Data collected for this study were organized in table and were analyzed. Data relating to the answering of research questions were analyzed using the mean. While the data relating to the testing of hypotheses at 0.05 level of significance was analyzed using Analysis of co-variance (ANCOVA).
Results: At 0.05 level of significance, the analysis of the data collected revealed that the experimental group had a mean gain difference of 3.29 over the control group, the result further revealed that male students had a mean gain difference of 21.54 over the female students. This indicates that assertiveness technique was more effective on male junior secondary school students than their female counterparts. The findings revealed there was no difference in the mean post test scores of students who received treatment using assertiveness technique and those in the control group (p = 0.416, 0.05). also there was a significant difference in the mean post test scores of male and female secondary school students (p=0.026, 0.05).
Conclusion: Through the findings that emerged from the study, it is concluded that the assertiveness technique is effective in reducing verbal victimization among junior secondary school students in Anambra state. Hence, counsellors in secondary schools should adopt assertiveness counselling techniques during counselling sessions to reduce the increased rate of verbal victimization in schools.
The Role of Religiosity and Spirituality in Motivating and Improving Students’ Performance in Indonesia
Authors: Ariani Dorothea Wahyu 
Published: September 2021

Aims: This study aimed to investigate the relationship model of religiosity, spirituality, intrinsic motivation, and extrinsic motivation with students' performance in Indonesian students based on different beliefs or religions in the country.
Methodology: This study used a survey method with a questionnaire conducted on 628 students as a sample. The relationship between all variables was tested using Pearson’s correlation and the direct relationship between the independent variables on the dependent variable using multiple linear regression analysis. Furthermore, the mediating model test was conducted using structural equation modeling with a two-step approach.
Results: The findings showed that motivation, religiosity, and spirituality affected students’ performance. Furthermore, intrinsic and extrinsic motivation serially mediated the relationship model between religiosity and spirituality with students' performance.
Conclusion: This paper addressed the need to understand how to motivate and improve students' performance from a religious and spiritual perspective. The findings of this paper can be used to identify curriculum preparation that includes religiosity in it to increase students' motivation and performance. Furthermore, this paper has demonstrated that religiosity and spirituality are very important for students in Indonesia because they can increase motivation so that student achievement becomes better.
To Assess Competency in Interpretation of Cardiac Arrhythmias among Emergency Medical Professionals in Pune, India
Authors: Rishipathak Parag , Bhandari Monesh , Hinduja Anand 
Published: September 2021

Introduction: The annual number of deaths from Cardiovascular Disease (CVD) in India is projected to rise from 2.26 over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.
Electrocardiography (ECG) is a non-invasive tool which is extensively used to understand and analyze a patient’s cardiac condition. It provides information about cardiac condition and helps in diagnosing acute coronary syndromes and cardiac arrhythmias. Emergency Medical Professionals (EMP’s) handle numerous cases of medical as well as trauma emergencies daily and are the first responders prior to hospitalization and the only reliable resource to help in revival of the patient. As it is of high priority, to give the upmost necessary care to the patients, being able to interpret and honing the skills to interpret ECG is of utmost importance and necessary.
Despite its immense clinical value, there continues to be a lack of a comprehensive ECG interpretation curriculum in medical education programs. The goal should be to encourage the development of organized curriculum in undergraduate and postgraduate medical education programs, and to ensure the acquisition of level-appropriate ECG interpretation skills while maintaining patient safety.
Objective: To assess competency in interpretation of cardiac arrhythmias among Emergency Medical Professionals
Study Design:
Place of Study: Symbiosis Centre for Health Skills (SCHS), Pune India in May 2021.
Methodology: The present study was conducted in May 2021, amongst 200 Emergency Medical Professionals (EMPs) employed in various hospitals in the city of Pune, India. American Heart Association (AHA) – Pre-course Self-Assessment questions were utilized for the study to assess ECG interpretation competency among Emergency Medical Professionals.
Conclusion: The present study highlights the poor ECG competence amongst EMP’s. and is limited by its small sample size and interpretation of only three kinds of cardiac rhythms. Yet the study offers, insight on the current gaps in competence and offers simple solutions to improve the scenario.
Development and Validation of a Novel RP-HPLC Analytical Method for Sitagliptin Determination in Human Plasma
Authors: Pamu Sagar , Patyar Sazal , Thakkalapally Lakshmi 
Published: September 2021

Background: Different bio-analytic methods have been developed for determining drug concentration in plasma, but methods for sitagliptin determination are still very rare. In this study, RP-HPLC based method has been developed for assessing sitagliptin concentration in plasma.
Aim: To develop and validate RP-HPLC based analytical method for estimating sitagliptin in human plasma for pharmacokinetic applications.
Methods: In the present study, the mobile phase composed of acetonitrile: 0.5% triethanolamine (20:80) with pH 6.5 has been utilized. Samples of plasma containing sitagliptin and internal standard (IS)-rosiglitazone were extracted with dichloromethane:diethyl ether (4:6; v/v) at pH 7.4. The rate of flow was 1 ml/min. The retention time was about 5,232 and 6,903 minutes respectively for sitagliptin and rosiglitazone.
Results: At concentrations of 100-3200 ng/ml in plasma, calibration curves of sitagliptin were linear. The inter- and intra-day precision and accuracy ranged in between 93.56-98.56% and 1.09-4.55% respectively. For specificity, the study findings showed no co-eluting peaks occurring with IS drug (rosiglitazone) and confirmed that no percentage of interferences at analyte (sitagliptin) retention in presence of rosiglitazone. The sitagliptin recovery was 96.442%. Chromatographic separations were performed on HI Qsil C-18 HS column (250mm x 4.6mm x 5μm). The stability of stock solutions of sitagliptin and IS at room temperature was 98.06% and 100.79% respectively while under refrigerated conditions stability was 98.19% and 96.59% respectively. Freeze-thaw stability for sitagliptin was performed with low & high QC and shown as 98.26% for and 97.45% respectively. The limits of detection and quantification were 8.592 ng/ml and 28.641 ng/ml respectively.
Conclusion: A simple, sensitive and accurate method was developed for bio analytical estimation of sitagliptin in human plasma using liquid-liquid extraction technique. The validation results of linearity, accuracy, precision, stability, selectivity, ruggedness, LOD and LOQ were good under acceptable limit and can be applied for pharmacokinetic studies.
Development and Validation of RP-HPLC Chromatographic Dissolution Method for the Simultaneous Estimation of Ramipril and Hydrochlorothiazide from Solid Dosage Formulation
Authors: Raut Prabhakar V. , Padwal Sudhakar L. , Bachute Madhusudhan T. , Polshettiwar Satish A. 
Published: September 2021

The present study describes the dissolution method development and validation of Ramipril and Hydrochlorothiazide in tablet dosage form by HPLC Method.
A simple, rapid, selective, reproducible and isocratic reversed-phase high performance liquid chromatographic (RP-HPLC) method has been developed and validated as per ICH guidelines.
Analysis was performed on a Thermo, Sunniest C8 (150 mm x 4.6 mm, 5 µm) with the mobile phase consisting of mixing 500 mL of buffer solution and 500 mL of acetonitrile at a flow rate of 1.0mL/min. UV detection was performed at 210nm and the Run time for Ramipril and Hydrochlorothiazide were 10 minutes. The calibration curve was linear (correlation coefficient = 1.000) in the selected range for both analytes.
The optimized dissolution conditions include the USP Type 1 (Basket) rotation rate of 100 rpm and 750 mL of 0.1 N Hydrochloric acid as dissolution medium, at 37.0 ± 0.5°C. The method was validated for precision, linearity, specificity, accuracy, limit of quantitation and ruggedness. The system suitability parameters, such as theoretical plate, tailing factor and relative standard deviation (RSD) between six standard replicates were well within the limits. The stability result shows that the drug is stable in the prescribed dissolution medium.
Compression of Hamstring and Quadriceps Muscles Strength in Patients with Osteoarthritis of Knee and Normal individual
Authors: Shukla M. , Parmar L. 
Published: September 2021

Objectives: 1. To assess the strength of hamstring and quadriceps in patients with knee OA with 1 RM.

To compare the strength of hamstring and quadriceps with normal individuals.

Research Design: Observational study.
Introduction: Quadriceps and hamstring muscle weakness is commonly found in knee OA which may alter normal Quadriceps/Hamstrings ratio i.e. (2:1). So the purpose of the study was to check the strength of the quadriceps and hamstring muscle in OA knee patients and compare it with normal individual.
Method: 20 diagnosed knee OA patients and 21 normal individuals were recruited. Quadriceps and hamstring muscle strength was measured in both case and normal group by using 1 RM method. Q/H ratio was obtained from the muscle strength and both were compared between two groups by using T test.
Materials: Quadriceps table, Metal weight plate, Plinth, Sand bag.
Results & Discussion: Quadriceps and hamstring strength were reduced significantly (p=<0.001) in patients with knee OA compare to normal individual. There was negative co relation between pain and muscle strength seen. No alteration in Q/H ratio (Rt knee p=0.130; Lt knee p=0.722) between the case & control found because both the muscle strength reduced similarly.
Conclusion: Quadriceps and hamstring muscle strength is significantly reduced in OA knee.
Patients compare to normal individuals but no alteration in Q/H ratio seen in both groups.
The Situation and Preventive Measures Related to COVID-19 Infection for Medical Staff
Authors: Sherzad Abdul Ghafar , Tu Yan , Liu Weitao , Azimee M. Azim , Arash Nemat , Assady Abdullah , Raufi Nahid , Huang Ying , Xu Xingbo , Alsarhang Osama , Zeng Qingchun 
Published: September 2021

The novel coronavirus, or COVID-19, emerged from Wuhan, Hubei Province, China, and has recently spread all over the world. During the COVID-19 pandemic, healthcare workers struggle against this microscopic enemy due to their job responsibilities, thus leading to be infected in some of them, even some of them are died in line of duty. As of 2 February 2021, 37 million cases of COVID-19 among health workers from 183 countries and regions were reported to the World Health Organization (WHO), a figure that represents 36% of the total cases globally. The median age of these cases was 42 years and 68% were women. On May 24, 2021, the World Health Organization (WHO) stated that at least 115,000 healthcare workers have died due to COVID-19 worldwide since the pandemic began last year. It is important to pay attention to the situation related to COVID-19 infection for medical staff and their preventive measures. This paper reviews the literature on all available information about the situation and preventive measures (The primary prevention of COVID-19 is to break the chain of transmission from infected to healthy people, secondary preventive measures comprise the use of health screening and recognition activities to ascertain those infected with COVID-19 and tertiary prevention consists of treatment and proper rehabilitation) related to COVID-19 infection for medical staff.