bluuebunny/crossref_metadata_2025_split huggingface dataset:
Difficulties encountered in testing, scoring, and interpreting balance performance in older adults using clinical evaluation tools: a cross-sectional study
Authors: Desai Poonam A , Mullerpatan Rajani 
Published: December 2023

Abstract

Background:
Balance impairment is one of the primary intrinsic risk factors contributing to falls in older adults. Prior research has consolidated the prevalent clinical tools for detecting balance issues in this demographic. Nevertheless, only a few studies have recognized the constraints associated with current balance assessment methods.

Materials and Methods:
The current research was initiated due to a shortage of comprehensive knowledge concerning the hurdles clinicians faced when interpreting balance test results and the obstacles older adults encountered while undertaking these assessments. The methodology involved assessing the static and dynamic balance capabilities of 661 older individuals through tests including the four stage balance test (FSBT), star excursion balance test (SEBT), Four Square step test (FSST), timed up and go (TUG) test, and Tinetti performance-oriented mobility assessment (TPOMA).

Results:
All older adults were able to complete the TUG and TPOMA tests. . Fifteen percent encountered difficulty completing the entire FSBT; however, they managed to execute the initial two stages of this test. Additionally, 5% of older adults who utilized walking aids could not complete the FSST. Thirty four percent of young-old individuals and 56.3% of old-old individuals were unable to execute the SEBT in posterior directions. Moreover, 1% of 60-64-year-old and 2% of >/75-year-old individuals were unable to perform SET in all 8 directions.

Conclusion:
TPOMA and TUG emerged as the most suitable clinical assessment tool for older adults. Within the FSBT, maintaining tandem and one-leg stance positions posed challenges, whereas the SEBT proved to be the most demanding dynamic balance test for older adults. These current findings will aid clinicians in selecting the most suitable balance assessment tool for routine clinical evaluations of older adults.
Cenobamate is an effective treatment for drug resistance focal epilepsy: a critical review
Authors: Hiremath Jayasheela S , Nyamagoud Sanatkumar Bharamu , Bullapur Prasannakumar C 
Published: December 2023

AbstractCenobamate, recently approved anticonvulsant by the Food and Drug Administration (FDA), stands as a potential remedy for drug-resistant epilepsy (DRE). It shows promise in enhancing seizure management efficacy. An in-depth analysis of various literature sources, encompassing clinical trials, preclinical investigations, and pharmacokinetic evaluations, assesses cenobamate’s safety, and effectiveness. The focus lies in its supplementary role for DRE treatment and its advantages for challenging patient groups. Cenobamate operates through a dual mechanism of action, selectively curtailing persistent sodium currents and positively influencing Gamma-aminobutyric acid (GABA) receptors to hinder seizure initiation and spread. Pharmacokinetic studies reveal swift absorption, dose-dependent effects, and the necessity for tailored dosing approaches. Clinical trials demonstrate enhanced seizure control linked to escalating doses, notably at 200 and 400 mg, though lower doses might encounter response and tolerance hurdles. Safety evaluations indicate predominantly mild to moderate adverse events, with rare occurrences of hypersensitivity reactions. Moreover, cenobamate demonstrates significant interactions with other drugs, necessitating adjustments in dosages for certain concurrent antiseizure medications. Cenobamate emerges as a hopeful therapeutic avenue for DRE, offering optimism to patients grappling with insufficient seizure control. Understanding its mechanisms, pharmacokinetics, and personalized dosing is crucial for optimal clinical outcomes. While managing drug interactions poses challenges, cenobamate signifies substantial progress in meeting the needs of individuals facing challenging focal epilepsy. Ongoing research and clinical insights will refine its role, ultimately advancing epilepsy care.
Barriers to hand hygiene compliance in intensive care units to prevent the spread of healthcare-associated infections
Authors: Singh Gurjeet , Singh Raksha , Burri Ranga Reddy 
Published: December 2023

Abstract

Background:
Healthcare-associated infections cause significant challenges to the provision of health care. This is due to the strain on individuals, their families, and health services. Hand hygiene measures are cost-effective to reduce the spread of healthcare-associated infections and effectively prevent the transmission of microorganisms during patient care. The hands of healthcare workers have been proven to be the main route of transmission of healthcare-associated infections. Maintaining proper hand hygiene is a straightforward method for averting healthcare-associated infections. Despite its significance, evidence suggests a need for enhanced compliance among healthcare workers concerning hand hygiene practices. Multiple factors influence hand hygiene adherence. Hence, this study sought to elucidate healthcare workers’ encounters with obstacles impeding hand hygiene compliance within intensive care units (ICUs).

Materials and Methods:
Conducted via purposive sampling, this qualitative study involved 50 professionals, including doctors, anesthesiologists, nurses, physiotherapists, and attendants employed in ICUs. The study utilized semi-structured individual interviews to collect data, whereas data analysis was carried out using the Lundman and Graneheim method.

Results:
In this study, the primary theme of “obstacles hindering hand hygiene adherence” is segmented into three principal categories:
1.barriers linked to healthcare providers encompass subcategories, such as workload, inadequate knowledge, inappropriate attitudes, and incorrect behavioral patterns;
2.barriers associated with management are delineated through subcategories involving inadequate planning and training and improper departmental physical space design; and
3.barriers related to equipment and facilities, consisting of subcategories centered on insufficient availability of equipment and equipment of subpar quality.

Conclusion:
The outcomes of this study offer valuable insights that can assist relevant authorities in implementing effective strategies to eliminate obstacles in hand hygiene practices. These findings aim to encourage the cultivation of the correct attitudes and behaviors among healthcare workers.
A comparative study of bone marrow aspiration and trephine biopsy: Experience in a tertiary care center
Authors: Sharda Bela , Malukani Kamal , Varma Amit V 
Published: December 2023

Abstract

Introduction:
A bone marrow examination involves the pathological analysis of samples from the bone marrow, which are obtained through bone marrow aspiration (BMA) and biopsy procedures. This examination is employed for the diagnosis of various hematological and nonhematological conditions. Both aspirate and biopsy samples are essential, offering a comprehensive bone marrow assessment.

Objectives:
In this study, we aim to compare the simultaneous evaluation of bone marrow aspirates and biopsies and to study diagnostic accuracy and concordance rate.

Materials and Methods:
This research was performed at the Department of Pathology, Shri Aurobindo Medical College, and Postgraduate Institute in Indore, Madhya Pradesh, India. The study was conducted from January 2019 to December 2019 and evaluated 200 patients. In 170 instances, bone marrow biopsy (BMB) and BMA procedures were conducted simultaneously, with 14 cases excluded due to issues like hemodilution or inadequate samples. Microscopic examinations were carried out on both aspirate slides and trephine biopsy sections, with the findings meticulously documented.

Results:
In the present research, the most prevalent clinical reason for performing a bone marrow examination was anemia (28.2%), closely followed by acute leukemias (21.9%). Among the 156 cases examined, BMA and biopsy led to a definitive diagnosis in 116 patients (74.3%), while biopsy alone diagnosed 27 cases (17.3%).

Conclusion:
While BMB continues to be the established benchmark for bone marrow analysis due to its heightened reliability and sensitivity, the combined use of both BMA and BMB enhances diagnostic yield significantly.
Influence of boot stud shapes and pitch surfaces on rugby players’ sprinting performance
Authors: Turiman Sharul Nizam , Johari Nasrul Hadi 
Published: December 2023

Introduction:
In rugby, a player’s sprinting prowess emerges as a pivotal determinant for bridging the gap to opponents and eluding their pursuit. Hence, a proper rugby boot assumes paramount importance in enhancing sprinting capabilities. However, the tropical climate conditions in Malaysia, with high temperatures, humidity and heavy rainfall, possess the potential to rapidly degrade rugby pitch conditions, thereby exerting a pronounced impact on sprinting performance.

Aims:
This study aims to investigate the influence of different boot studs and pitch surfaces on the sprinting performance of junior rugby players.

Methods:
A cohort of 36 rugby players completed the sprinting tests with different boot stud shapes, i.e. cone, triangular and blade shapes, on normal, puddle and muddy surfaces. Fully automated timing gates were placed at the 0 m and 40 m mark along the track. Data obtained from the experiments were recorded for the statistical analysis using the repeated-measure analysis of variance.

Results:
The results revealed that the players’ sprinting performance declined by an average of 1.26% on the puddle pitch surface and by 16.51% on the muddy pitch surface using all types of boots. It was also discovered that the sprinting performance of players in the overweight and obese categories dropped by an average of 8.5% and 12.73% on all types of pitch surfaces, respectively. On muddy pitch surfaces, players in all positions and body mass index categories who used boots with cone and triangle studs had better sprinting performance when compared to blade studs.

Conclusions:
In essence, this study demonstrated the sprinting evaluation framework on various pitch conditions. Furthermore, it imparts invaluable technical insights to rugby players and coaches in selecting appropriate boots, particularly within Malaysia’s distinctive climatic and pitch conditions.
Effects of proprioceptive training using BOSU® balance trainer on core strength and static balance in young competitive rhythmic gymnasts
Authors: Yee Claudia Ng Jia , Ler Hui Yin , Yunliang Zhang 
Published: December 2023

Purpose:
The study aimed to examine the effects of eight weeks of proprioceptive training using a BOSU® balance trainer on core strength and static balance in young rhythmic gymnasts.

Methods:
Twenty-three young competitive female rhythmic gymnasts, (age: 9.7 ± 1.9 yrs; weight; 26.1 ± 6.5 kg; height: 131.2 ± 10.9 cm; years of experience in RG: 3.5 ± 1.7) were assigned into an experimental group (EG, n = 12) and a control group (CG, n = 11). Both groups underwent a series of tests included the side bridge test, the stork stand balance test, and the rhythmic gymnastics balance test before and after the experimental intervention. All participants engaged in regular rhythmic gymnastics training throughout the intervention period with EG supplemented with BOSU® balance trainer proprioceptive training. The intervention programme consisted of six sets of exercises that focused on improving core strength and static balance. Training volume was kept consistent throughout the experiment, with each exercise performed for 30 s followed by a 45-s rest in 2 sets, 3 times a week.

Results:
Results showed that EG improved core strength significantly for right (P < 0.001) and left (P = 0.038) sides. However, there was no significant difference found in static balance (Stork Stand Balance Test and Rhythmic Gymnastics Balance Test) between EG and CG.

Conclusion:
The study concluded that proprioceptive training using BOSU® balance trainer implemented for 8 weeks on young competitive rhythmic gymnasts improved core strength but not in static balance
Descriptive study on beliefs, attitudes and behaviour of Malaysian elite athletes towards doping
Authors: Kumar Nishel , Cheong Jadeera Phaik Geok , Razman Rizal 
Published: December 2023

Background:
Little is known about the beliefs, attitudes and practices of Malaysian elite athletes towards doping, despite a consistent number of positive doping cases, some of which involve high-profile Malaysian athletes. In the Malaysian context, only studies on Malaysian student–athletes and nutritional supplement intake amongst Malaysian elite athletes have been carried out.

Aims:
As such, this study aimed to explore doping beliefs, attitudes and behaviour of Malaysian elite athletes, using a survey developed by the World Anti-Doping Agency.

Methods:
The survey, which was designed based on the Sport Drug Control Model for anti-doping organisations, contained 52 questions. Participants of the survey were 220 athletes (137 males and 83 females) with ages ranging between 15 and 45 years.

Results:
The results showed that 85% of Malaysian athletes did not intend to use performance-enhancing substances (PESs) even though it could provide an added advantage. It was also revealed that a large percentage of Malaysian elite athletes (89%) had never considered using PES, with a small percentage of athletes (2%) admitting that they had used PES knowingly throughout their sporting career. As for the intention to dope, 90% of the athletes felt confident that they could refuse the use of banned substances and overcome any pressure to consume.

Conclusions:
The findings will enable the mapping of the most suitable approach towards educating athletes about the effects of doping. The exploration is in alignment with the formation of the Anti-Doping Agency of Malaysia in 2007, whose mission was to implement anti-doping rules and create strategies to improve awareness and education amongst athletes and coaches about substance abuse in sports. Down the road from education and mutual trust, it is possible to establish cleaner sports and zero doping in Malaysia.
Students’ Perception of Interactive Progressive Drawing Using a Graphic Tablet in Histology Education: A Mixed-Method Evaluation Study
Authors: Sreenivasan Srividya 
Published: December 2023

Abstract

Background:
It is important that relevant diagrams that are clear and visible are drawn by the teacher of histology for a better understanding of the subject. It is also desirable that the student see the buildup of the diagram. To achieve the same in an electronic format, a graphic tablet was used for interactive progressive drawing (IPD) in histology education.

Aim and Objective:
To assess students’ perception of usefulness and effectiveness of IPD, in histology education.

Methodology:
Students were taught histology by IPD, using a graphic tablet in a classroom setting. Their perception about the method of teaching and the quality of the diagrams was obtained by an online questionnaire having open-ended and closed-ended questions. The mean and standard deviation of ratings on the Likert scale about student perception were calculated. The percentage of students who gave a rating of 4 out of 5 or above for the questions was measured as an indicator of satisfaction of the students. The answers to the open-ended questions were categorized and analyzed by the grounded theory approach.

Results:
A total of 137 (54.8%) students responded to the questionnaire. Seventy-eight percent of students preferred the diagrams drawn such over textbook illustrations and perceived the innovation to be helpful in improving basic understanding on a scale of 4/5 or above.

Conclusion:
Teaching histology by IPD using a graphic tablet was perceived by students to be better than teaching using a Power Point presentation.
The conundrum of National Exit Test in India
Authors: Vishnu B. 
Published: December 2023

Abstract
National Exit Test (NExT) is a common medical licentiate examination and postgraduate (PG) examination about to be implemented in the country for the first time, so it is important to discuss the advantages, concerns and fear about the exam among the students. All these years’ medical qualifying exams were through descriptive theory and practical examination through Competency Based Medical Education (CBME) and separate PG entrance examination after internship. Standardizing the medical examination throughout the country will ensure uniform quality of medical graduates and by merging the qualifying examination and PG examination will narrow down the gap reducing the time taken for the each graduate to enter specialty are the main advantages of the NExT. There are various concerns about competitive part of NExT like CBME curriculum and the medical teachers training suitability for teaching PG competitive exams. Core competencies of the CBME curriculum focuses on ‘Must Know’ and the medical education emphasizes the teachers to educate the students on core competencies. For every advantage there are more concerns and fear about the NExT exam among the students. Like any exam NExT has its own merits and drawback when implemented for the first time, by identifying the concerns and correcting them will develop competent medical graduates uniform throughout the country.
Sonographic Evaluation of Deep Vein Thrombosis in Hospitalized Neurosurgical Trauma Patients in Ibadan, Nigeria
Authors: Efidi R , Rimande J , Agunloye A , Ogunseyinde A , Akinola R , Ogbole G 
Published: December 2023

Background:
Deep vein thrombosis (DVT) is a major cause of morbidity and mortality in hospitalized trauma patients. Ultrasonography (US) has replaced venography as the initial diagnostic tool for DVT.

Aims:
The study aimed to determine the incidence of lower limb DVT in hospitalized neurosurgical trauma patients in hospitalized neurosurgical patients. It also aimed to determine the effect of combined thrombo-prophylaxis on the incidence of lower limb deep DVT relative to a single regimen.

Patients and Methods:
This was a prospective study of 154 adult neurotrauma patients who consecutively had lower limb Doppler ultrasound, initially within 72 hours of admissions and subsequently weekly or when DVT was suspected for the first 3 weeks of admission. The study spanned a 12-month period. The data generated were analyzed using the statistical package for social sciences software version 20, Chicago IL. Inc. Chi-square test was used to compare the outcome (DVT incidence) between single and combined prophylaxis groups.

Results:
The study participants consisted of 116 (75.3%) and 38 (24.7%) cases of head and spine injuries, respectively, with a mean age of 38.8 ± 6.3 years and 85.1% being males. A total of four cases of DVT were detected during the study period, with the majority of the cases (3) detected within the first week of admission, giving an incidence of 2.6%. All four cases of DVT were detected in patients on single thrombo-prophylaxis (4/55 = 7.3%), while none was found in those on a combined regimen (0/34, P = 0.046).

Conclusion:
Most cases of DVT developed in the first week of hospitalization. Combined thrombo-prophylaxis was more effective than single regimen at reducing rate of DVT in neurosurgical trauma patients. Routine Doppler ultrasound DVT surveillance should be part of the management protocol for neurosurgical trauma patients on admission to increase DVT detection and prevent possible fatal pulmonary embolism.
Micro-CT Study on the Supplementary Effect of XP-Endo Finisher R after Endodontic Retreatment with Mtwo-R
Authors: Tsenova-Ilieva I , Dogandzhiyska V , Raykovska M , Karova E 
Published: December 2023

Background:
During the course of a non-surgical orthograde endodontic retreatment, supplementary instrumentation is usually required for better removal of root canal filling material.

Aim:
The aim of this study was to assess the effectiveness of XP-Endo Finisher R in endodontic retreatment of oval root canals.

Materials and Methods:
The study was performed on extracted mandibular incisors preliminary cut at the cementoenamel junction. The root canals of 12 extracted lower central incisors were initially shaped with the rotary nickel–titanium system XP-Endo Shaper (30/.04) and filled with continuous waves of condensation. Root canal retreatment was performed with the МTwo Retreatment – R1 (15/.05) and R2 (25/.05) files, followed by the XP-Endo Finisher R (30/.00). Three micro-computed tomography scans were performed during the course of the experiment: 1) after the filling of the root canals, 2) after the first retreatment procedures, and 3) after the supplementary shaping. Kolmogorov–Smirnov test for normality and Friedman and Kruskal–Wallis tests for comparison of several independent samples.

Results:
There were no statistically significant differences in the percentage of removed obturation material in the different parts of the root canal after the use of Mtwo-R (P = 0.649) and XP-Endo Finisher R (P = 0.934). The additional instrumentation with XP-FR reduced the percentage of the remaining root canal filling insignificantly (P = 0.190).

Conclusions:
The combined action of Mtwo-R retreatment files and XP-Endo Finisher R resulted in significant reduction of the amount of root canal filling material. Nevertheless, none of the examined rotary systems guaranteed its complete removal.
Prognostic Effect of Preoperative Inflammatory Markers on Morbidity and Overall Survival in Pancreatic Adenocarsinoma
Authors: Çaparlar MA , Durhan A , Süleymanov M , Binarbaşı C , Koşmaz K 
Published: December 2023

Background/Aim:
His study aimed to evaluate the availability of common diagnostic tests and biochemical markers in predicting poor prognosis in patients with pancreatic adenocarcinoma (PAC). The primary outcome measure was to identify predictive prognostic factors. The secondary outcome measure was to compare predictive measures in patients who survived or did not survive in the follow-up period.

Materials and Methods:
Medical data of 51 patients were obtained who underwent resection surgery for PAC between January 2016 and May 2022. There were two groups according to the mortality in the follow-up period group general mortality positive (GMP; n = 29) and group general mortality negative (GMN; n = 22). Stage IIb was the most common stage in subgroups.

Results:
Preoperative diagnostic tests revealed that aspartate aminotransferase (AST) level, De Ritis ratio (DRR), carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA 19-9), immature granulocyte (IG) count, and IG ratio (IG%) are higher, and hemoglobin (Hgb) levels are lower in the GMP group (P < 0.05). In univariate analysis, seven variables, including AST ≥20.5 (P = 0.001), DRR ≥1.05 (P ≤ 0.001), CEA ≥3.32 (P = 0.02), IG count ≥0.06 (P < 0.01), Hgb ≤11.75 (P = 0.01), poor differentiation (P < 0.001) and existence of life-threatening complication (P < 0.01) were identified. In multivariate analysis, only DRR (≥1.05;100% specificity and 72% sensitivity) and poor differentiation (P = 0.019) were found to be independent prognostic factors for overall survival. The median overall survival of patients with the DRR ≥1.05 and poor tumor differentiation was lower, and the mortality rate was higher than the patients with DRR and without poor tumor differentiation (10.65 ± 3.11 months vs. 61.86 ± 5.36 months and 100% vs. 26.7%, P < 0.001).

Conclusion:
Pretreatment high DRR, high IG counts and IG%, and poor differentiation of the tumor might be used as independent predictors of poor prognosis and mortality in patients with PAC.