bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nipple adenoma: A clinicopathological study over a period of six years in tertiary care center
Authors: Afshan H S Fathima , Daniel M Nirmal , Raj A Santhosh , Singh Priyanka , Sigamani Elanthenral 
Published: August 2024

ABSTRACT

Background:
Nipple adenoma (NA) is a rare benign neoplasm of the nipple arising from the lactiferous duct. Often seen in middle aged women, presenting as a nodule, erosive, or ulcerative lesion and associated with serous or bloody discharge. Histologically, they comprise closely arranged tubules with papillary infoldings centered around the lactiferous ducts. It is most likely clinically confused with Paget’s disease and histologically with invasive breast carcinoma or its precursor lesions. The aid of immunohistochemistry is valuable in differentiating these entities and to definitively exclude malignancy.

Materials and Methods:
All cases with available slides and blocks, diagnosed as nipple adenoma, during the period of January 2015 to December 2021, will be identified through an appropriate query search from the pathology database. Clinico-radiological details and histopathology will be studied and analyzed. The available follow up data and clinical outcome will be assessed.

Results:
Sixteen cases of nipple adenoma were studied and the median age at diagnosis was found to be 37 years. Nipple discharge and swelling were the most common presentations. Ultrasound imaging was done in 14 cases with the median size of lesion being 0.8cms. Seven underwent excision biopsy followed by histopathological examination. The most common histological pattern observed is “adenosis” pattern. Immunostains p63, smooth muscle myosin heavy chain (SMMHC) and CK5/6 were performed. Nine cases were on follow up but none had recurrence.

Conclusion:
NA is a benign entity with varied histological patterns. Histopathological examination with the aid of immunohistochemistry helps in diagnosis and to rule out other mimickers. Surgical excision is the treatment of choice.
Allocation of Financial Resources to Primary Healthcare: A Scoping Review Protocol
Authors: Mahdiyan Somayeh , Rezayatmand Reza , Amini-Rarani Mostafa , Shaarbafchizadeh Nasrin 
Published: August 2024

Abstract

Background:
Countries possessing robust primary healthcare (PHC) systems typically yield superior health outcomes, reduced inequality, and diminished healthcare expenses for their citizens. Moreover, PHC demonstrates a direct correlation with the efficient utilization of resources. However, the allocation of financial resources dedicated to PHC varies significantly among countries and lacks explicit clarity. Therefore, this paper aims to conduct a review of published literature to ascertain the extent of resource allocation to PHC across diverse nations. In addition, it aims to explore associated factors, challenges, and mechanisms influencing this allocation.

Methods:
This scoping review protocol will adopt the Joanna Briggs Institute’s scoping review methodology, which was updated in 2020. It will leverage library studies and refer to reputable databases. The inclusion criteria will include studies conducted between January 2000 and December 2023, focusing on criteria, amounts, mechanisms, and challenges associated with financial resource allocation to PHC globally. In addition, studies must be published in either English and Persian. Studies lacking full-text availability will be excluded from the review. Mendeley software will be utilized to organize and manage the collected studies. The study selection process will be visually depicted using the PRISMA-SCR diagram. Conventional content analysis will be employed to analyze the studies.

Conclusions:
Considering the position and role of primary health care in promoting the health of society, by implementing this protocol, the data obtained from the proposed scoping review will enable the managers and officials of the health system to follow the experiences of different countries in the field of scientific and fair allocation of financial resources to PHC, reinforcing Universal Health Coverage (UHC).
Intrahospital Mortality Rate after the Implementation of the Second Phase of the Health Sector Reform in Comparison with Before that in Iran
Authors: Iravani Mojtaba , Khadivi Reza 
Published: August 2024

Abstract

Background:
The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).

Methods:
In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the exposed hospitals and 20 profit, nonprofit, and charity hospitals as the control hospitals.

Results:
After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant (P value = 0.348). The frequency of hospitalization increased in Social Security Organization’s (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were −42.96%, −34.76%, and −18.47% in the private, charity, and SSO hospitals, respectively, but was not significant (P value > 0.05).

Conclusions:
The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.
Lumbar Pedicle Dimensions Using CT Scan in Adults of South-Eastern Nigeria as Related to Transpedicular Fixation
Authors: Nkwerem Sunday Patrick , Ohaegbulam Samuel C. , Mezue Wilfred , Emejulu Jude-Kennedy Chinedu , Ndubuisi Chika Anele , Nkwerem Geraldine Ifechukwu 
Published: August 2024

Abstract

Background:
Transpedicular fixation depends on accuracy of the entry points, angle of insertion and pedicular isthmus width for adequate screw insertion. Preoperative measurements of pedicle dimensions reduce the chances of failure during insertion. These pedicle dimensions (transverse diameter, longitudinal diameter, and maximum length of purchase [MLP]) vary with sex and race. Such data, from a large-scale study, are not available for our population.

Objective:
The study aims to evaluate the dimensions of pedicle that are relevant for pedicle screw fixation in Southeast Nigerian population.

Materials and Methods:
A prospective multi-slice CT based clinical anatomy study done at Memfys Hospital for Neurosurgery, Enugu. This study is on the lumbar pedicle dimensions that are related to transpedicular fixation (transverse and longitudinal diameters of the pedicle, MLP, pedicle transverse and longitudinal angles of inclination). Sample size (273) was calculated with the confidence interval formula based on the number of patients that present for images. Consent and ethical approval were obtained.

Results:
The mean values are as follow: LD1 8.22 mm, LD2 7.73 mm, LD3 7.40 mm, LD4 7.16 mm, LD5 6.87 mm TD1 5.05 mm, TD2 5.31 mm, TD3 6.72 mm, TD4 8.27 mm, TD5 11.31 mm, MLP1 46.60 mm, MLP2 47.97 mm, MLP3 47.14 mm, MLP4 45.54 mm, MLP5 43.47 mm TA1 17.8°, TA2 19.34°, TA3 20.80°, TA4 22.00°, TA5 25.70° LA1 19.42°, LA2 18.61°, LA3 18.00°, LA4 17.09°, LA5 16.40°. Unlike transverse diameter, transverse angle, longitudinal dimension, longitudinal angle (LA), MLP there was significant correlation between age and mean LA. The mean values also correlated significantly with the gender.

Conclusion:
The mean values varied with the different vertebral levels and was good correlations between some of the parameters with age and gender.
Is Close Supervision by a Senior Surgeon Necessary During the Initial Days of Performing Endoscopic Lumbar Discectomy? A Retrospective Comparative Study between Two Fellowship Trained Surgeons to Assess the Learning Curve
Authors: Ifthekar Syed , Lee Shih-Min , Lee Sang-Ho , Shin Sang-Ha , Bae Junseok 
Published: August 2024

Abstract

Objectives:
Endoscopic lumbar discectomy is a minimally invasive technique with a steep learning curve. The studies in the literature base the learning curve on the operative duration. We conducted this study to determine the learning curve based on the presence or absence of supervision by an experienced surgeon.

Materials and Methods:
This study involved two spine surgeons (surgeon A and surgeon B), who after their fellowship training from the same institute started practising in two different hospitals with different settings. The data of the first 80 patients operated by these two surgeons were extracted, and the patients were followed up for a minimum of 1 year. The data were split into first 30 cases and late 50 cases, which were compared to see the difference between the two surgeons.

Results:
The first 30 cases were evaluated between the two surgeons, and the most significant difference between the two was the operative duration. There was difference between the two surgeons in approach towards migrated and foraminal/extra foraminal discs (P = 0.02). The surgeon B started operating on upper lumbar levels in his later 50 cases, but the foraminal and extraforaminal disc herniations were rarely treated by surgeon B.

Conclusions:
Endoscopic discectomy when supervised by senior faculty helps to reduce the operative duration especially in the initial phases of a surgeon’s career. The surgeon under the supervision of a senior faculty performs more of migrated and foraminal herniated discs.
Computed Tomographic Scan for Head Injury Patients: Any Justification for Adapting Routine Cranio-Cervical Examination Irrespective of Clinical Severity?
Authors: Muhammad Isa Hassan , Saleh Mohammed Kabir , Adamu Mansur Yahuza , Ismail Anas 
Published: August 2024

Abstract

Background and Objective:
This study aimed to assess the prevalence of concomitant cervical spine and head injury at our University Teaching Hospital in Nigeria and attempted to justify examining patients’ head and cervical spine using computed tomography (CT) scan at presentation irrespective of the head injury severity by clinical assessment using Glasgow Coma Scale (GCS).

Patients and Methods:
All eligible patients, 1–80 years of age who presented with head injuries in the accident and emergency (A&E) unit during the study period, were included if they satisfied the inclusion criteria. Post-resuscitation GCS was assessed clinically, and head and cervical spine injury (CSI) were observed radiologically on cranio-cervical CT scan for all patients. The presence of cervical spine fractures, subluxation or dislocation was considered a confirmation of CSI.

Results:
There were 143 patients with head injuries studied; 90.2% of them were males. The mean age of the patients was 28.87 ± 15.93 years. The most common cause of injury was road traffic accidents in 110 (76.90%). The prevalence of CSI was 11.2%. Majority of the patients with CSI in this study (56.25%) had a mild head injury, 25% had a moderate head injury, and 18.75% had a severe head injury. The lower cervical spine was the most frequently injured segment in this study, involving 10 patients. Multi-level cervical vertebral body fractures of C3 to C6 were the most common form of CSI in this segment.

Conclusion:
The prevalence of concomitant cervical spine and head injury was significant in this study. This was confirmed among study subjects with a clinical diagnosis of mild-to-moderate head injury as compared with moderate-to-severe head injury. Therefore, all patients who sustained a head injury irrespective of severity are required to have a complete and rapid evaluation of the cervical spine.
Cardiovascular disease and antineutrophil cytoplasmic antibodies-associated vasculitis: A systematic review
Authors: Mohamed Amal H. , Abdalgani Nagla 
Published: August 2024

ABSTRACT
Recent evidence suggests that cardiovascular disease and antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) are interconnected. This investigation aims to examine the epidemiology, potential risk, and cardiovascular events among AAV sufferers to shed light on the intricate relationship between these seemingly unrelated conditions. A systematic review following PRISMA criteria encompassed 18 relevant studies with a pooled sample size of 21,291 ANCA-associated vasculitis patients. Studies were retrieved from PubMed, Embase, and Cochrane Library. Inclusion criteria focused on longitudinal studies reporting cardiovascular events in AAV patients. Data extraction and synthesis were performed, focusing on prevalence, types of cardiovascular events, comparison with control groups, and identification of risk factors and independent predictors. The study found that patients with ANCA-associated vasculitis had a mean age of 57.5 years, with 47% being male. The mean follow-up duration was 4.77 years. Overall, 1350 cardiovascular events were reported across the studies, yielding a pooled prevalence of 6.3%. Major adverse cardiovascular events, ischemic heart disease, stroke, venous thromboembolism, and acute coronary syndromes were the specific events. Comparison with control groups demonstrated a higher cardiovascular risk in AAV patients. Age, systolic blood pressure, estimated glomerular filtration rate, and the Birmingham Vasculitis Activity Score were independent predictors. In conclusion, ANCA-associated vasculitis patients have elevated cardiovascular risk and a variety of manifestations. AAV-specific variables,such as inflammation and disease activity, and conventional risk factors, play a role in cardiovascular complications. The study challenges conventional assessment timelines by highlighting the importance of early and proactive cardiovascular risk management.
Beyond jaundice: Exploring the mysterious nature of Gilbert’s syndrome: A case report and literature review
Authors: Elmakki Erwa , Al Ageeli Essam , Awaji Ali , Basamad Abdulgader K. 
Published: August 2024

ABSTRACT
Jaundice is a well-known condition that is commonly encountered during daily clinical practice. However, recurrent episodes of jaundice in which the unconjugated bilirubin is predominant without evidence of hemolysis have very restricted differential diagnoses, the most common of which is Gilbert’s syndrome (GS). Here, we reported a case of GS in a young adult in whom the recurrent attacks of jaundice were triggered by stressful situations. GS is a benign inherited condition that does not lead to liver cell injury; hence reassurance and avoidance of the triggering factors including a wide list of medications represent the cornerstones for the management of this condition.
A case of struma ovarii with coexistent Brenner tumor presenting with thyrotoxicosis
Authors: Archana M. P. , Jabbar Puthiyaveettil K. , Nair Abilash 
Published: August 2024

ABSTRACT
Struma ovarii is an ovarian tumor, characterized by the presence of thyroid tissue comprising >50% of the overall mass. Although struma ovarii does not usually secrete thyroid hormones, there are cases in which it produces thyroid hormones, which results in hyperthyroidism. Here, we report the case of a 73-year-old female who presented with a right ovarian mass and symptoms suggestive of thyrotoxicosis. Her thyroid function test showed suppressed thyroid-stimulating hormone and elevated T3 and T4 levels. We suspected thyroiditis initially. Later, in view of persistent thyrotoxicosis, she was started on antithyroid drugs. Tc99 pertechnetate thyroid uptake scan showed absent uptake in the neck. A possibility of struma ovarii was considered. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathology revealed >80% thyroid tissue suggestive of struma ovarii with a coexistent Brenner tumor. Postoperatively, her thyrotoxicosis got resolved. To conclude, in any case of thyrotoxicosis that is persisting and with absent uptake in the neck, rare cases such as struma ovarii should be considered. Struma ovarii with a coexistent Brenner tumor is a very rare finding.
Analisis Kualitas Kehidupan Kerja Dan Upah Tenaga Kerja Di Daerah Rawan Gempa Dan Tsunami
Authors: Farlis Fiko , Riski Tri Rachmat , Rahman Fathur 
Published: August 2024

The research was conducted in Padang, a city prone to natural disasters like earthquakes and tsunamis. A major earthquake in 2009 and the risk of a tsunami emphasized the ongoing disaster threat. The study examines labor conditions related to quality of work life (QWL) and wages, focusing on how QWL is affected by disasters like earthquakes and the environment, particularly for coastal workers. Factors considered include social support, work nature, age, and workplace location (altitude and proximity to the beach). The research focused on 384 employees in Padang across various job categories, selected through Probability Sampling and Area Sampling based on BNPB evacuation maps. Quantitative methods 3SLS and STATA software were used for analysis, revealing that QWL in earthquake and tsunami-prone areas is influenced by location, worker age, and social support, while wages are affected by location and job characteristics. The study indicates that the work environment impacts safety perceptions, which in turn affect QWL. Workers prefer locations farther from the coast, at higher altitudes, and near tsunami shelters or safe zones to enhance their work life quality.

Abstrak
Penelitian ini dilakukan di Padang, kota yang rentan terhadap bencana alam seperti gempa bumi dan tsunami. Terjadinya gempa besar pada tahun 2009 dan ancaman tsunami menyoroti risiko bencana yang tinggi dan berpotensi masih terjadi. Penelitian ini menyelidiki kondisi tenaga kerja mengenai kualitas kehidupan kerja (QWL) dan Upah. Diyakini bahwa QWL dipengaruhi oleh gempa bumi dan lingkungan rawan bencana, terutama bagi pekerja di daerah pesisir, akibatnya mempengaruhi upah. Faktor-faktor seperti dukungan sosial, karakteristik pekerjaan, usia, dan lokasi tempat kerja (ketinggian dan kedekatan dengan pantai) diperhitungkan dalam penelitian ini. Populasi karyawan di Padang menjadi fokus, dengan sampel 384 pekerja di berbagai kategori pekerjaan, dipilih menggunakan teknik Probability Sampling dan Area Sampling berdasarkan peta evakuasi BNPB. Analisis melibatkan metode kuantitatif yang menggunakan sistem persamaan simultan dengan perangkat lunak STATA dan pendekatan estimasi 3SLS. Temuan mengungkapkan bahwa QWL di daerah yang berisiko gempa bumi dan tsunami dipengaruhi oleh lokasi geografis, usia pekerja, dan dukungan sosial, sedangkan upah dipengaruhi oleh lokasi dan karakteristik pekerjaan. Studi ini menunjukkan bahwa lingkungan kerja berdampak pada perasaan aman, kemudian mempengaruhi QWL. Pekerja cenderung lebih memilih lokasi yang terletak jauh dari garis pantai, di ketinggian yang lebih tinggi atau area aman dari tsunami, sehingga meningkatkan kualitas kehidupan kerja mereka
Keputusan Pembelian Smartphone Berdasarkan Customer Relationsip Management dan Marketing Mix Mahasiswa Fakultas Ekonomi dan Bisnis Universitas Dharma Andalas Padang
Authors: Yendra Nofri , Rosa Yenni Del , Rahman Ardi Abdillah , Rismanda Rachyta 
Published: August 2024

The purpose of the study was to determine the effect of customer relationship management and marketing mix on smartphone purchasing decisions of students of the Faculty of Economics, Dharma Andalas University Padang. The research sample of 281 people was determined using the Slovin formula with proportional sampling technique . The data collection method uses a questionnaire with the dependent variable of purchasing decisions (Y), and the independent variable customer relationship management consists of customer orientation variables (X1), knowledge management (X2), organization (X3), technology (X4) and marketing mix consists of product variables (X5), price (X6), place (X7), promotion (X8), people (X9), physical evidence (X10) and process (X11). Partial hypothesis testing shows that all customer relationship management variables have a significant positive effect on smartphone purchasing decisions except the variables of organization, people, physical evidence and process have a negative effect. then all marketing mix variables have a significant positive effect on smartphone purchasing decisions except the variables of place, people and process have a significant negative effect. Simultaneous hypothesis testing shows that all customer relationship management and marketing mix variables have a significant positive effect on smartphone purchasing decisions of students of the Faculty of Economics, Dharma Andalas University Padang.

Abstrak
Tujuan penelitian untuk mengetahui pengaruh customer relationship management dan marketing mix terhadap keputusan pembelian smartphone mahasiswa Fakultas Ekonomi Universitas Dharma Andalas Padang. Sampel penelitian sebanyak 281 orang ditentukan memakai rumus Slovin dengan teknik sampling alokasi proportional sampling. Metode pengumpulan data menggunakan angket. Variabel terikat keputusan pembelian (Y), variabel bebas customer relationship management terdiri dari variabel orientasi pelanggan (X1), manajemen pengetahuan (X2), organisasi (X3), teknologi (X4) dan marketing mix terdiri dari variabel produk (X5), harga (X6), tempat (X7), promosi (X8), orang (X9), bukti fisik (X10) dan proses (X11). Uji hipotesis parsial menunjukkan bahwa semua variabel customer relationship management berpengaruh positif signifikan terhadap keputusan pembelian smartphone kecuali variabel organisasi, orang, bukti fisik dan proses berpengaruh negatif. Juga semua variabel marketing mix berpengaruh positif signifikan terhadap keputusan pembelian smartphone kecuali variabel tempat, orang dan proses berpengaruh negatif signifikan. Uji hipotesis secara simultan pada tingkat signifikansi 5% menunjukkan semua variabel customer relationship management dan marketing mix berpengaruh positif signifikan terhadap keputusan pembelian smartphone mahasiswa Fakultas Ekonomi Universitas Dharma Andalas Padang