bluuebunny/crossref_metadata_2025_split huggingface dataset:
New insights on rural doctors’ clinical courage in the context of the unfolding COVID-19 pandemic
Authors: Campbell David , Williams Susan , Konkin Jill , White Isabella , Couper Ian , Stewart Ruth , Walters Lucie 
Published: October 2023

Introduction:
Rural doctors typically work in low-resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors’ work in this context. In this paper, we draw on rural doctors’ experiences during the unfolding COVID pandemic to re-examine our understanding of the attributes of clinical courage.

Methods:
Semi-structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID-19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage.

Results:
Thirteen interviews from rural doctors during the unfolding COVID-19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities.

Conclusion:
This study extended our understanding that rural doctors’ experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries.

Introduction:
Les médecins ruraux travaillent généralement dans des environnements à faibles ressources et avec un soutien professionnel limité. Ils sont parfois poussés aux limites de leur champ d’action habituel pour fournir les soins médicaux dont leur communauté a besoin. Dans une étude phénoménologique précédente, et dans ce contexte, nous avons décrit le concept de courage clinique comme étant à la base du travail des médecins ruraux. Dans cet article, nous nous appuyons sur les expériences des médecins ruraux au cours de la pandémie de COVID pour réexaminer notre compréhension des attributs du courage clinique.

Méthodes:
Des entretiens semi-structurés ont été menés avec des médecins ruraux de 11 pays ayant une expérience de la préparation ou de la prise en charge de patients atteints de COVID-19. Les entretiens ont été transcrits mot à mot et codés à l’aide de NVivo. Une analyse thématique déductive a été entreprise pour identifier les idées et les réponses communes liées aux caractéristiques du courage clinique.

Résultats:
Treize entretiens avec des médecins ruraux, durant la pandémie de COVID-19, ont confirmé et enrichi notre compréhension des attributs du courage clinique, en particulier le rôle de leadership que les médecins ruraux peuvent jouer au sein de leurs communautés.

Conclusion:
Cette étude nous a permis de mieux comprendre que l’expérience des médecins ruraux en matière de courage clinique est la même pour tous les participants dans de nombreuses régions du monde, y compris dans les pays en développement.
A study to assess the unique oral health challenges faced by elderly individuals, including denture use, dry mouth, and periodontal diseases
Authors: Chavda Ravindra Mandanbhai , Patel Eshita D , Shah Shreeja H , Shah Saloni K , Sheth Sona , Munia Vipul 
Published: October 2023

Abstract

Background:
This study investigates oral health challenges among elderly individuals in India, focusing on denture use, dry mouth, and periodontal diseases.

Materials and Methods:
A cross-sectional study involved 1000 elderly participants (aged 65 years and older) residing in various Indian communities. Data on demographic characteristics, denture use, dry mouth symptoms, and history of periodontal diseases were collected through interviews and oral examinations. Statistical analysis was performed to assess associations and differences among variables.

Results:
Among the participants, 65% did not use dentures, whereas 55% reported mild to severe dry mouth symptoms. Regarding periodontal diseases, 30% had gingivitis, and 20% had some form of periodontitis, with 10% experiencing severe periodontitis. Demographic factors such as age, education, and income showed significant correlations with oral health indicators.

Conclusion:
This study highlights the prevalence of oral health challenges among elderly individuals in India, emphasizing the need for tailored interventions. addressing denture-related issues, managing dry mouth symptoms, and combatting periodontal diseases are crucial for enhancing the quality of life and overall well-being of the elderly population.
Prevalence of malocclusion and orthodontic treatment needs among 12–15 years old schoolchildren in Imphal East, Manipur by using Dental Aesthetic Index (DAI)
Authors: Khanam Shamilah , Atom Jenny , Bharali Dharitri , Deka Barsha Priya , Sarma Shruti M , Sheela  
Published: October 2023

AbstractBackground:Epidemiologically, the prevalence of malocclusion varies from country to country. Studies of occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the etiology of malocclusion.Aim:The present study aims to assess the prevalence of malocclusion and orthodontic treatment needs among 12–15 years old schoolchildren of Imphal East, Manipur by using the Dental Aesthetic Index (DAI).Result:Among 12 years old the mean DAI score was 22.69 ± 6.518, among 13 years old it was 21.98 ± 5.965, among 14 years old it was 22.13 ± 5.364 and among 15 years old it was 21.93 ± 5.811. About the gender-wise distribution of DAI score among school children. The mean value for male is 21.95 ± 5.819 and for female is 22.56 ± 5.975 with no significant difference between them.Conclusion:The DAI was found to be reproducible and valid. The finding of the present study remains significant in providing one of the first baseline data on the malocclusion status of school-going children of Manipur.
Urinary Diagnostic Cytology Beyond the Research of Neoplastic Cells: Usefulness of Erythrocyte Morphology Evaluation to Recognize Microhematuria Source
Authors: Del Sordo Rachele , Covarelli Carla , Annese Lucia C. , Mandarano Martina , Bellezza Guido , Sidoni Angelo 
Published: October 2023

Background:
Urine cytology is useful to diagnose urinary neoplasms, whereas its role in the study of microhematuria is debatable. Usually, standard urinalysis (dipstick test and sediment examination with bright field microscope) detects the presence of microhematuria, but only urinalysis with phase-contrast microscopy (PCM) (dipstick test and sediment examination with PCM) allows the observation of red blood cell (RBC) morphology and identify their source. Usually glomerular diseases show RBCs with morphological alterations in high percentages, whereas on urologic bleeding, RBCs are rather homogeneous without morphological alterations.

Aims:
We compare, for the first time, RBC morphology observed in urine cytology and in urinalysis with PCM, to verify whether urinary cytology allows the recognition of the source of bleeding.

Methods and Material:
A total of 60 patients who had performed both urine cytology and urinalysis with PCM for microhematuria, detected with standard urinalysis, were investigated. Urine cytology showed RBCs and were negative for neoplastic cells or for inflammatory events. Urine samples were processed with the automated method ThinPrep®. RBCs with abnormal and variable shapes were defined as deformed. RBCs of the same spherical shape were defined as non-deformed.

Results:
Fifty-six urine cytology with RBCs deformed were confirmed in 55 urinalysis with PCM. One case showed RBCs non deformed in urine cytology and in urine sediment. Overall, agreement, between RBC morphology in urine cytology and urinalysis with PCM, was found in 56/60 cases (93%).

Conclusions:
Therefore, since sediment examination with PCM is available in only few laboratories, we propose that cytopathologist always reports, in urine cytology, any morphological abnormalities of RBCs in order to provide information of the hematuria origin and correctly refer the patient to a nephrologist rather than a urologist.
Cervical Cytology and Histology Correlation as an Analytic Quality Assurance Exercise: Experience from an Accredited Cytology Laboratory
Authors: Belekar Shubhangi V. , Kamal Meherbano , Warke Aishwarya S. 
Published: October 2023

Context:
The performance parameters of cervical cytology in any accredited cytology laboratory requires implementation of quality control exercise, which ensures acceptable performance by a laboratory. This study aims to assess the analytical aspect of quality control measures by evaluating the frequency and accuracy of epithelial abnormalities as detected in cervical Pap smears using histopathologic diagnosis as the gold standard.

Methods:
A retrospective diagnostic test study from 2018 to 2020 was conducted. Out of the total 6000 Pap smears, histopathologic correlation was available in 150 cases in the form of colposcopic-directed biopsy (CDB) and loop electrosurgical excision procedure (LEEP) tissue in 105 cases. The quality control measures analyzed were Atypical Squamous Cell: Squamous Intraepithelial Lesion (ASC: SIL) ratio, cyto-histo correlation, and study parameters like sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears as against CDB and LEEP.

Results:
4.5% smears were reported as inadequate, 92.3% as Negative for intraepithelial lesion or malignancy (NILM), followed by epithelial abnormality found in 3.21%. The ASC: SIL ratio was 1.3:1. Concordance rate against CDB was 100% in Squamous cell carcinoma (SCC), 82.35% in high-grade squamous intraepithelial lesion (HSIL), 82% in atypical squamous cells of undetermined significance (ASCUS), 65.6% in low-grade squamous intraepithelial lesion (LSIL), and 50% in Atypical Squamous Cell ,High grade Squamous Intraepithelial Lesion can not be ruled out (ASC-H). Total concordance rate was 84.15%. Sensitivity of Pap smear was 65% for LSIL and 82% for HSIL. Specificity, positive predictive value, and negative predictive value were 63.63%, 90%, and 75%, respectively. Concordance rate was 96% with LEEP.

Conclusion:
Quality control measures give an insight of performance of any accredited cytology laboratory. This exercise needs to be conducted on a regular basis, so that relevant steps can be taken in case of major discrepancy.
Programmed Death Ligand-1 Testing in Adenocarcinoma Lung: A Comparative Study of Cell Block versus Biopsy
Authors: Shukla Saumya , Pandey Rahul K. , Gupta Vani , Husain Nuzhat , Gupta Anurag , Kant Surya 
Published: October 2023

Background:
Immunotherapy currently stands as a novel treatment option, specifically in cases of advanced non-small cell lung carcinoma (NSCLC). Expression of programmed death ligand-1 (PD-L1) in tumor cells forms the mainstay for the use of anti-PD-L1 monoclonal antibodies in the treatment of NSCLC.

Aims:
The objectives of the study were to assess utility of cell blocks for testing of PD-L1 in adenocarcinoma lung and to compare the expression of PD-L1 in cell blocks and the corresponding biopsy specimens.

Materials and Methods:
The current study was a prospective case series that included 20 cases of NSCLC–adenocarcinoma lung. Cases included in the study had biopsies performed from lung masses, along with which cell blocks were prepared from fine needle aspiration cytology (FNAC) samples. Testing for PD-L1 was done using the monoclonal PD-L1 antibody, SP-263 clone on the Ventana Benchmark XT system. PD-L1 expression was assessed only in the tumor cells, and cases with >1% expression, cytoplasmic or membranous, in tumor cells were categorized as positive.

Results:
PD-L1 expression was identified in the biopsy samples of tumor cells of 20% of cases (n = 4/20). In the corresponding cell blocks, PD-L1 expression was identified in the tumor cells of 15% of cases (n = 3/20). Sensitivity and specificity of cell blocks were 75% and 100%, respectively. Positive and negative predictive values were 100% and 94.12%, respectively.

Conclusion:
PD-L1 testing has both predictive and prognostic implications. PD-L1 testing in cell block samples is a potential alternative, specifically in cases where biopsy tissue is minimal or unavailable.
Conventional versus Liquid-based Cytology: “Man versus Machine”
Authors: Pathuthara Saleem , Dighe Swati , Uke Maya , Prabhudesai Neelam , Deodhar Kedar , Desai Sangeeta B. 
Published: October 2023

Background:
Liquid-based cytology (LBC) can improve adequacy, monolayer quality with a clean background compared to conventional smears (CS).

Aims and Objectives:
The objective was to compare the quality and diagnostic yield of CS and LBC in routine cytological investigations.

Materials and Methods:
This retrospective study consisted of 306 samples (255 gynecological, 39 nongynecological, and 12 fine needle aspiration cytology [FNAC]) during a 2-year period (2019–2020). From each patient, two samples were collected in the same manner in the same sitting and processed by CS and LBC (ThinPrep® 2000, Hologic Inc.). Both CS and LBC were compared for adequacy, quality, representativeness, inflammation, hemorrhage, necrosis, preservation, reactive changes, organisms, atypia/dysplasia/malignancy, and preparation/screening time. Statistical analysis was performed.

Results:
No statistically significant difference was noted for adequacy, representativeness, reactive changes, preservation, and atypia/dysplasia/malignancy. CS was better in cellularity and diagnosis of inflammation and organisms, whereas LBC had a clean background and the difference was statistically significant (P = 0.0005).

Conclusions:
CS was equivalent to LBC in adequacy, representativeness, reactive changes, and atypia/dysplasia/malignancy. Adequacy comparable to LBC can be achieved in CS by careful sample collection, processing, and screening by trained cytotechnologists. CS was better in detecting organisms and inflammation than LBC. The advantages of LBC were monolayer smear, clean background, and lesser screening time, but the demerit was higher cost and longer processing time. Therefore, LBC is best suited to those laboratories having high sample inadequacy rates, lack of competent cytotechnologists, and no financial constraints. Either man or machine, appropriate and adequate sample collection by trained personnel forms the cornerstone for ensuring adequacy in both CS and LBC.
Association of rs6323 with neuropsychiatric disorders: a mini-review
Authors: Karmakar Arijit 
Published: October 2023

Abstract
A data mining analysis was conducted on the National Center for Biotechnology Information database to identify the most extensively studied single-nucleotide variant within the MAO-A gene, which encodes monoamine oxidase A—an enzyme found in mitochondria involved in metabolizing neurotransmitters such as dopamine, norepinephrine, and serotonin. These neurochemicals play crucial roles in the development of various neuropsychiatric disorders. The analysis revealed that the single-nucleotide variant rs6323 has been the subject of significant research concerning its association with human neuropsychiatric disorders and behavioral problems. A thorough literature review was performed, examining original research articles linked to PubMed to evaluate the connection between rs6323 and different neuropsychiatric disorders and behavioral attributes. Multiple studies on diverse ethnic populations across various countries have reported a link between rs6323 and neuropsychiatric disorders and related behavioral characteristics. This review provides valuable insights into the association between rs6323 and neuropsychiatric disorders.
Imaging features of peritoneal inclusion cysts
Authors: Ghonge Nitin P , Dube Sanchita , Qaseem Syed M Danish 
Published: October 2023

Abstract
Peritoneal inclusion cysts (PICs) are well-known medical conditions typically observed in the female pelvis, with occasional occurrences in males. These cysts can present with diverse imaging characteristics, sometimes resembling other adnexal masses in the female pelvis. However, establishing a confident diagnosis of a PIC relies on the correlation between imaging findings and the patient’s medical history and clinical presentation. This review explores the underlying causes and various imaging features of PICs. It also discusses distinguishing them from other adnexal pathologies using different imaging techniques, as accurate diagnosis is crucial for ruling out malignancy and avoiding unnecessary medical interventions.
A study examining the level of awareness regarding lifestyle risks and management practices among diabetes patients in Eastern India
Authors: Dasgupta Sarbari , Ray Sulagna 
Published: October 2023

Abstract

Background:
Diabetes mellitus (DM) is a well-recognized metabolic condition requiring patients to know its associated risks. Embracing a healthy lifestyle can play a vital role in mitigating the potential for adverse health outcomes and increasing overall well-being.

Objective:
In this study, researchers examined the level of awareness concerning lifestyle risks, as well as knowledge and practices related to diabetes management, among patients residing in both urban and rural areas of Eastern India.

Materials and Methods:
The study randomly selected 86 participants from both urban and rural areas who were visiting the endocrinology outpatient department of a hospital in Kolkata. Data for the analysis were exclusively obtained through a questionnaire survey.

Results:
The correlation matrix analysis uncovered significant positive relationships (P < 0.05) among various parameters, offering valuable insights into lifestyle risks associated with diabetes and potential preventive measures for this condition. In the urban patient group, principal component analysis (PCA) indicated that DM-related knowledge explained approximately 46.36% of the total variation in principal component 1 (PC1), showing favorable associations with other parameters. Conversely, for the rural patients, PCA revealed that lifestyle management practices accounted for approximately 50.55% of the total variation in PC1, with relatively higher favorable associations with other parameters.

Conclusion:
This study investigated the influence of lifestyle risk factors and self-management parameters, including knowledge and practices, on managing DM among patients residing in urban and rural areas. The findings revealed that patients in urban areas had a higher awareness level than those in rural areas. Importantly, this study is the first to establish an association between parameters related to PCA concerning lifestyle risk knowledge and management practices.
Spectrum of histopathological lesions of heart: An autopsy study at tertiary care center
Authors: Pandey Varsha , Kulkarni Vishal , Bhaskar Vanita , Mire Veenapani 
Published: October 2023

Abstract

Background:
There has been a notable rise in cardiac-related fatalities globally, especially in the last five decades. In India, ischemic heart disease has become prevalent, affecting roughly 10% of the population. For forensic specialists, establishing the cause of death in individuals previously in good health can be complex. Autopsies are crucial in evaluating the underlying factors responsible for such deaths. This research seeks to identify and scrutinize a wide range of histopathological heart abnormalities that significantly influence the determination of the cause of death.

Materials and Methods:
This study was conducted in the Department of Pathology from January 2020 to December 2020. During this period, we received a total of 209 whole heart specimens. Of these, 208 specimens underwent comprehensive examinations, including macroscopic and microscopic observations.

Results:
Out of the 208 cases examined, 94 showed evidence of both early and advanced atherosclerosis, whereas 65 showed early and late signs of myocardial infarction. Myocardial hypertrophy was evident in 29 patients. Isolated instances of myocarditis and pericarditis were observed in one case each. Fatty streaks were identified in 32 cases; three showed red blood cells with sickle cell morphology. Heart rupture was detected in one case, and another revealed metastasis from a poorly differentiated tumor. Notably, in 90 cases, the cause of death remained undetermined despite thorough macroscopic and microscopic autopsies.

Conclusion:
The primary reason for cardiovascular fatalities is atherosclerosis-related myocardial infarction.
Otitis media and its associated risk factors: An investigation into patients’ knowledge, attitudes, practices, and information sources at a hospital setting
Authors: Ramesh Padma , Pimparkar Mrunal , Pimpalkhute Ketki , Anam Nidhi 
Published: October 2023

Abstract

Background:
Otitis media (OM) is a substantial healthcare issue globally, including in India. Despite its widespread occurrence, there has been only one prior investigation into the knowledge, attitude, practices, and sources of information (KAPS), as well as information sources regarding OM among patients in India, and this study dates back to 2009. This article unveils the findings of a recent KAPS study conducted among patients residing in Navi Mumbai, Maharashtra, India.

Objectives:
The primary goal of this study was to evaluate the KAPS regarding OM and its associated risk factors, with a specific focus on individuals diagnosed with this ailment.

Settings and Design:
This research was conducted in the Ear, Nose, and Throat (ENT) Outpatient Department (OPD) of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. A cross-sectional study, the KAPS study, was conducted on 91 patients diagnosed with OM.

Materials and Methods:
This study used a cross-sectional methodology to assess KAPS. The research included 91 patients diagnosed with OM receiving care at the ENT-OPD of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India.

Statistical Analysis:
Descriptive statistics were used, and data normality was evaluated. Independent T-tests and analysis of variance methods were employed to compare means, followed by post hoc analysis using the Bonferroni test. Pearson coefficient test was utilized to estimate correlations, and associations were examined using the Chi-square test.

Results:
Most participants (47.3%) exhibited a low level of knowledge, with an average Knowledge score of 11.98 ± 4.64 out of a possible 23. The mean Attitude score was 5.37 ± 1.37 out of seven. Regarding Attitude scores, there were significant differences in educational level (P = 0.003) and socioeconomic status (P = 0.0001). The mean Practice score was 0.51 ± 0.6 out of a maximum score of three. There was a significant correlation between Knowledge and Attitude scores (P < 0.0001). Only 17.6% of the participants reported receiving any education on ear health.

Conclusion:
Most patients in the study demonstrated a lack of comprehensive knowledge. While a positive attitude was common among the majority, the average Practice score remained relatively modest. This research underscores the significance of community education initiatives focused on OM to boost awareness and reduce the burden of this condition.