bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noncommunicable Diseases Healthcare-Specific Service Readiness at the Primary Health-care Centers in Ekiti State, Nigeria
Authors: Adeniran Adeyinka , Oluwole Esther O. , Chieme Chisom Florence , Ojo Omobola Yetunde , Ilesanmi Marcus M. , Olujobi Babatunde A. , Ogundimu Opeyemi , Durojaiye Temitope 
Published: December 2023

Background:
Noncommunicable diseases (NCDs) have been highlighted as a major challenge for sustainable development and an alarming public health challenge of global concern. This study was aimed at assessing the PHC facilities' readiness to provide NCDs management services in Ekiti state, Nigeria.

Methodology:
A descriptive cross-sectional study was conducted among PHCs in Ekiti state between August and October 2020 in 177 PHC facilities using some components of the World Health Organization's Service Availability and Readiness Assessment tool. Analysis was done using STATA SE 12. Statistical significance was set at a P < 0.05.

Results:
Majority (95%) of the primary health-care facilities were located in rural areas. Approximately 19% were in Ekiti North II and Ekiti Central II constituencies, and the majority (95%) were health centers. Only 29.4% offer management of NCDs. Among the spacers for inhalers available in 1.7% of the facilities, none were functioning and only 1.4% had equipment for NCD management and control, and 6% had trained staff and guidelines for NCD management. NCD-specific service readiness index was just 11% among the health care, facilities studied. Health-care facilities in the urban areas and the Ekiti North I had statistically significant higher NCD service readiness compared to the rural areas and the other federal constituencies, respectively (P < 0.05).

Conclusion:
The overall NCD-specific service readiness in Ekiti State was extremely low. The government should provide sufficient tools and equipment with trained workers that will offer adequate management of NCDs in the state.
Epidemiological Analysis of Adult Thyroid Cancer in Najran, Saudi Arabia
Authors: Assiri Abdullah Mufarreh , Alqannass Ali Mahdi , Alyami Saleh Yousef , Alalhareth Hamza Abdullah , Alhashel Salem Mohammed , Alsulayyi Turki Saeed , Hussein Hossam Adel 
Published: December 2023

Abstract

Background and Aims:
Thyroid cancer (TC) is the second most common neoplasm occurring in adult Saudi women. Therefore, this study aimed to discuss the demography, classification, and management of TC among adults in Najran, Saudi Arabia.

Materials and Methods:
This retrospective study reviewed 88 patients with histopathologically identified TC at Najran King Khalid Hospital between January 2018 and September 2022. Descriptive data analysis was performed, focusing on the clinical and pathological information, treatment strategies, comorbidities, and demographics.

Results:
This study included 88 patients with TC. Female sex (81.8%), age 30–44 years (46.6%), and Saudi nationality (77.3%) were not significantly associated with the histopathological diagnosis (P = 0.064, P = 0.313, and P = 0.603, respectively). Comorbidities were identified in 52 patients (59.1%), with thyroid diseases being the most common (21.6%), followed by hypertension (16.1%). Total thyroidectomy showed statistically significant results in 63/71 papillary carcinoma patients (88.7%), and hemithyroidectomy was significant in 9/14 follicular carcinoma patients (64.3%) (P < 0.001). Statistically significant results were reported with no neck dissection in the papillary, follicular, and coexisting papillary and follicular TC cases (P = 0.046), while bilateral dissection showed significant results in the medullary carcinoma case (P = 0.001).

Conclusion:
Our study examined the demographic and clinicopathological data of TC between 2018 and 2022 in Najran. We found that Saudi nationals, women, and individuals aged 30–44 years comprised the majority of those affected. The most frequent type of TC was papillary carcinoma.
Psychologic Welfare and Burnout of Medical Students after COVID-19 Pandemic Lockdown in Poland
Authors: Korolkiewicz Pawel K. , Gaba Gursimran , Salloum Amir , Witkowska Natalia , Brosz Maciej , Bidzan Leszek , Grabowski Jakub 
Published: December 2023

Abstract

Objectives:
In this study, we intended to examine the psychological welfare, burnout, and stress-related coping mechanisms of medical students at the Medical University of Gdańsk, Gdańsk, Poland. Under the hypothesis that depressive symptoms and screening for problem alcohol drinking would predict the risk of burnout, we intended to study the relationship between selected variables (e.g., demographic and socioeconomic) and burnout risk and the effects of abandonment of social isolation restrictions related to the COVID-19 pandemic lockdown.

Methods:
Medical students completed an online survey assessing general mental health and stress coping mechanisms. We used copies of the Patient Health Questionnaire 9-item (PHQ-9); Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire; and the Oldenburg Burnout Inventory (OLBI), to quantify depressive symptoms, screen for problematic alcohol drinking, and assess the risk of burnout.

Results:
The mean total OLBI score ± standard deviation was 44.6 ± 7.3 (N = 700), with 91.1% of participants scoring ≥ 35 points. Female students had significantly higher total and exhaustion domain OLBI scores than their male counterparts (p < 0.05). About 76% of all respondents reported high levels of studies-related stress and 44% of survey participants agreed/strongly agreed that they considered dropping out of university courses due to the stress. The suicidal/self-harm ideations were found in 33.6% of students. Most students (64.4%) were screened positively for moderate-to-severe depressive symptoms, and 19% of them for risky alcohol use. Students with OLBI scores ≥ 35 achieved notably higher PHQ-9 and CAGE results. The results of multivariate regression analysis showed that PHQ-9 (p < 0.05) and CAGE (p < 0.05) questionnaire significantly predicted the OLBI score.

Conclusion:
Medical students are a vulnerable group at risk of developing mental health problems. A great number of survey participants screened positively for the presence of depressive symptoms, risky alcohol use, and burnout. The PHQ-9, and CAGE results, was significant predictor of OLBI outcomes. The improvement of COVID-19 pandemic-related social isolation restrictions did not produce a marked improvement in somatic/mental health-related quantifiers as compared to the time of strict social restrictions.
Blood Cytokine Levels in Patients with Alcohol Dependence during Early Withdrawal Treatment
Authors: Hsu Shu-Hao , Kao Chung-Feng , Chang Hu-Ming , Meng Shih-Chun , Shi Jia-Lin , Huang Ming-Chyi 
Published: December 2023

Abstract

Objectives:
Alcohol is known to modulate the immune system, which is associated with the pathophysiology of alcohol dependence (AD). Interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), and tumor necrosis factor-alpha (TNF-α) are widely studied immune molecules in neuropsychiatric disorders. In this study, we intended to investigate the differences of blood levels of cytokines between patients with AD during early withdrawal and healthy control (HC).

Methods:
In this study, we included 85 patients diagnosed with AD according to the DSM-IV criteria and 49 HC participants. Blood samples were collected from the AD group and HC group on the first and seventh days of withdrawal. Blood levels of IL-6, sIL-6R, and TNF-α were measured using the enzyme-linked immunosorbent assay.

Results:
The baseline blood TNF-α levels in the AD group were significantly higher than those in the HC group (3.0 ± 1.6 pg/mL vs. 1.5 ± 0.9 pg/mL, p < 0.001), while blood sIL-6R levels were significantly lower (153.0 ± 37.0 pg/mL vs. 171.4 ± 39.6 pg/mL, p < 0.01). The baseline blood IL-6 and TNF-α levels were correlated with alcohol consumption amount and duration of AD. After one week of alcohol withdrawal, the blood TNF-α level of the AD group was still higher than that of the control group, whereas the blood IL-6 and IL-6R were normalized.

Conclusion:
Our findings suggest blood cytokines are dysregulated in patients with AD.
İhsaniye (Afyonkarahisar) İlçesi Jeomorfosit ve Kültürel Sitler Envanteri
Authors: Özdemir Mehmet Ali , Kaymak Hülya 
Published: December 2023

Afyonkarahisar ilinin kuzeyinde yer alan İhsaniye çevresi, Kapadokya’dan sonra piroklastiklerin en yaygın olduğu volkanik alanlardan biridir. Bu coğrafya, çok ilgi çekici, büyüleyici topoğrafya şekillerine sahip olmakla birlikte, bu şekiller ile ilgili yapılan çalışmaların sayısı oldukça azdır. Bu çalışmanın amacı, tüf topoğrafyasında gelişmiş jeomorfositleri ortaya koymak, bunların oluşum mekanizmalarını kısaca açıklamak ve kültürel unsurlarla birlikte turizm potansiyelini değerlendirmektir.
Ayazini metropolisi, Avdalaz kalesi, Aslantaş, Maltaş açık hava tapınağı, kaya yerleşmeleri, kaya mezarları, kaya kiliseleri gibi kültürel eserler bakımından zengin Dağlık Frigya’nın bir parçası olan ve farklı medeniyetlere ait önemli kültürel eserleriyle tanınan İhsaniye çevresi, aynı zamanda ilgi çekici, nadir ve büyüleyici jeomorfositlere sahiptir. Bilimsel, estetik, ekolojik, kültürel, ekonomik değere sahip bu jeomorfositler aynı zamanda önemli jeomiras alanını oluşturmaktadır. Yöredeki tüf platoları, mesa ve bütler, kanyonlar, sarp yamaçlar, peribacaları, mağaralar, kuesta gibi yer şekillerinin yanı sıra kale tepeler, sütun yapıları, çekirdektaşları, ayrışmış kaya blokları ve bunlar üzerinde daha mikro ölçekte tafoni ve balpeteği yapıları, oluklar, gnammalar gibi çok çeşitli yer şekilleri tespit edilmiştir. Bu makro ve mikro boyuttaki yer şekilleri, Alt Miyosen-Pliyosen volkanizmasının ürünü olan tüflerin eksojen süreçlerle işlenmesi sonucu meydana gelmiştir. Flüvyal ve selcik erozyonu, rüzgâr deflasyonu ve diferansiyel ayrışma sahadaki şekilleri oluşturan eksojen süreçlerdir.
Araştırma sahası, jeomorfosit niteliğindeki çok zengin yer şekilleri ve jeoarkeolojik eserleriyle önemli bir jeomorfoturizm potansiyeline sahiptir. Tüm jeomorfolojik ve kültürel miras destinasyonları ile birlikte UNESCO Dünya Mirası Geçici Listesi’nde yer alan Dağlık Frigya’nın bir bölümünün tanıtılmasının amaçlandığı bu çalışma, gelecekte bölgenin jeopark alanı yapılmasının bilimsel temellerini oluşturacaktır.
Descolonizar o conhecimento: A perspectiva de Lewis Gordon
Authors: Nas Elen 
Published: December 2023

O texto oferece um comentário que objetiva contextualizar a entrevista concedida por Lewis Gordon em Janeiro de 2023 e publicada como podcast, de modo a amplificar o acesso ao pensamento de Lewis Gordon para a língua Portuguesa. Na entrevista ele fala sobre as disputas de narrativa na filosofia e ciência, o apagamento e apropriação das influências Orientais e do Sul nos sistemas de conhecimento e de como a universalização de teorias e conceitos reforçam ideias de ‘perfeição’ e verdade que refletem o privilégio branco do Norte Global. Lewis Gordon oferece-nos elementos para refletir sobre a necessidade da metafilosofia e metaética para a crítica decolonial e lembra que nos espaços de privilégio não se deve esperar aprovação desde que as perspectivas hegemônicas tendem a resistir à inclusões que tragam diversidade ao campo epistêmico.
Should a waiting period between consecutive IVF cycles be advised for normal or low responders?
Authors: Friedler Shevach , Ganelin Lia , Grin Leonti , Meltcer Simion , Zaks Svetlana , Rabinson Jacob , Lazer Tal , Michailov Yulia , Saar-Ryss Bozhena 
Published: December 2023

The purpose of this study is to examine the impact of the time elapsed between repeated oocyte retrievals, on the number of oocytes retrieved, according to the ovarian response of the patient. This retrospective cohort study, found no correlation between the time interval between consecutive oocyte retrievals of 30 up to 180 days and the number of oocytes or mature (MII) oocytes retrieved, neither in patients with low response with up to 4 oocytes retrieved nor those with 5 oocytes or more.
Ethos, cenografia e dimensão moral dos enunciados
Authors: Gomes da Silva Edvania , Souza Figueredo Talita 
Published: December 2023

Neste artigo, analisamos uma live do ex-presidente Jair Bolsonaro a fim de verificar se as formulações selecionadas como corpus estão ou não ajustadas aos valores vigentes na sociedade brasileira contemporânea. Como aporte teórico, recorremos aos conceitos de cenografia e ethos, de Maingueneau (2005); e à noção de virtude discursiva, de Paveau (2015). Os resultados indicam que há um desajuste[1] em relação aos agentes, ao mundo e à memória, o que pode ser comprovado pelo ethos e pela cenografia que emergem da live analisada, e também pelos dados complementares, os quais indicam a existência de contradiscursos que rechaçam as teses defendidas pelo principal locutor da live.

[1] Todas as vezes que falamos em desajuste aqui estamos fazendo referência ao que Paveau (2015) chama de ajustes do ambiente, que explicitaremos na fundamentação teórica deste artigo. Logo, o desajuste de que tratamos está relacionado à falta de ajuste do ambiente.
Implementasi Ideologi Pendidikan Matematika pada Pendidikan Guru Penggerak
Authors: Panjaitan Sorta Corie Ivana , Dewi Izwita , Simamora Elmanani 
Published: December 2023

Peran penting guru dalam pendidikan mendasari Kementerian Pendidikan, Kebudayaan Riset dan Teknologi mengeluarkan Program Guru Penggerak pada episode ke-5 Merdeka Belajar. Matematika sebagai mata pelajaran yang diajarkan pada peserta didik dari tingkat paling menengah sampai pada perguruan tinggi memerlukan guru atau pendidik yang handal dan profesional. Filosofi atau Ideologi matematika menyadarkan guru untuk menjadi lebih profesional. Guru yang memahami asal usul maupun metode pengembangan Ideologi Pendidikan secara khusus pendidikan matematika akan mampu mempersiapkan diri memberikan pembelajaran yang lebih baik di kelas. Melihat bagaimana implementasi ideologi Pendidikan Matematika pada Program Pendidikan Guru Penggerak, lebih spesifik pada materi-materi pendidikan dan latihan yang diterima saat mengikuti pendidikan guru penggerak, secara epistemologi dan etis semakin mengokohkan pandangan setiap guru terkhusus guru matematika diharapkan mengikuti program guru penggerak untuk menjadi lebih profesional pada bidangnya. Ideologi Pancasila sejalan dengan Ideologi Pendidikan Matematika Progressive Educator dan Public Educator.
Dose of Protamine for Heparin Reversal in CABG Surgery
Authors: Shah Syed Ali Raza Ali , Naqvi Syeda Sarah , Kirmani Syed Muzaffar Hasan , Hussain Syed Aqeel , Malik Imran Bashir , Farooq Muhammad Umar 
Published: December 2023

Objective: To determine the dose of Protamine required for reversal of Heparin effect in Coronary Artery Bypass Grafting (CABG).
Study Design: Quasi-experimental study.
Place and Duration of Study: Adult Cardiac Surgery Unit, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from May to Dec 2022.
Methodology: Total 382 patients were included in this study through consecutive sampling and were divided into two groups (n=191 participants in each group). After induction of anesthesia, baseline Activated Clotting Time (ACT) was measured. About 300units/kg of unfractionated Heparin was given non-randomly before establishing Cardiopulmonary Bypass (CPB). After termination of CPB, Protamine was administered in doses of 1 mg/kg and 1.5 mg/kg to Group-A and Group-B respectively. Protamine was diluted in 20ml of saline, and administered at a rate of 100ml/hr. Once Protamine was administered, blood sample was taken after 5min for ACT measurement. If this ACT was within 10% of baseline, it was taken as sign for reversal of Heparin effect. Student t-test and Chi-square test were applied to compare the groups and level of significance taken was p<0.05.
Results: Majority cases were males 287(75.1%), whereas 95(24.9%) were females. Statistically significant mean differences were noted between Cardiopulmonary Bypass (CPB) time, ACT after Protamine administration, and requirement for extra Protamine administration between two groups (p<0.05). However, no significant differences were noted between age, weight and ACT before Heparin administration ....
Conclusion: Classical doses of 3mg/kg of Protamine in CABG patients may actually be exposing patients to higher than required ..........
Andexanet Alfa (Ondexxya)
Authors: CADTH  
Published: December 2023

CADTH recommends that Ondexxya should not be reimbursed by public drug plans for adult patients treated with factor Xa (FXa) inhibitors (rivaroxaban or apixaban) when rapid reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding.

Evidence from a clinical trial (ANNEXA-4) demonstrated that Ondexxya treatment could reduce the activity of FXa inhibitors in the blood and improve imaging and laboratory markers of bleeding; however, without a control group, there is uncertainty in how much the observed benefits were due to Ondexxya treatment rather than chance. Clinical outcomes such as neurologic status and mortality were also uncertain.
No evidence was submitted at the time of the review that directly compared Ondexxya to usual care for managing bleeding related to an FXa inhibitor. Observational evidence comparing Ondexxya and prothrombin complex concentrate, which is part of the usual care, was uncertain due to limitations of study design and analysis.
Based on the evidence reviewed, the CADTH Canadian Plasma Protein Product Expert Committee (CPEC) was not convinced that treatment with Ondexxya would achieve outcomes that are clinically important to patients or meet needs not already addressed by other available treatments.
A pediatrician's guide to gastrointestinal allergies
Authors: Конобейцев О.Х. 
Published: December 2023

Введение. Аллергия на коровье молоко является одной из наиболее распространенных пищевых аллергий у детей. Гастроинтестинальные формы пищевой аллергии требуют особого внимания амбулаторного педиатра, но остаются по-прежнему плохо распознаваемыми. В основном гастроинтестинальные формы пищевой аллергии встречаются у детей первых лет жизни и часто имеют неспецифические признаки – беспокойное поведение, изменения паттернов стула или срыгиваний, что ведет к ошибочной трактовке клинических симптомов. Постановка диагноза затрудняется отсроченным появлением симптомов по причине не-IgE-опосредованного типа аллергической реакции в большинстве случаев и, соответственно, отсутствия информативности при классическом подходе к диагностике аллергии. Две наиболее частые формы гастроинтестинальной пищевой аллергии, встречающиеся в практике педиатра: аллергический проктоколит, характерный для первых месяцев жизни и имеющий самый благоприятный прогноз, и синдром энтероколита в ответ на пищевые белки, часто встречающийся во втором полугодии на фоне введения прикормов. Они не требуют специализированных методов диагностики в условиях стационара. Элиминационная диета является основным инструментом для диагностики и диетотерапии аллергического компонента данных состояний. Цель работы. Предоставить клинический алгоритм для амбулаторного педиатра по тактике ведения детей с не-IgE-опосредованной гастроинтестинальной пищевой аллергией.
Background. Cow's milk allergy is one of the most common food allergies in children. Gastrointestinal forms of food allergy require special attention from the pediatrician, but they still remain poorly recognized. Mostly, gastrointestinal forms of food allergies occur in children of the first years of life, and often have nonspecific signs – restless behavior, changes in stool patterns or regurgitation, which leads to an erroneous interpretation of clinical symptoms. The diagnosis is complicated by the delayed onset of symptoms due to the non-IgE-mediated type of allergic reaction in most cases, therefore, the lack of information content in the classical approach to diagnosing allergies. The two most common forms of gastrointestinal food allergies encountered in pediatric practice: allergic proctocolitis (FPIAP), characteristic of the first months of life and having the most favorable prognosis, and food protein enterocolitis syndrome (FPIES), often occurring in the second half of the year, against the background of the introduction of complementary foods. They do not require specialized diagnostic methods in a hospital setting. The elimination diet is the main tool for diagnosis and dietary therapy of these allergic conditions. Objective. To provide a clinical algorithm for outpatient pediatricians on the management of children with non-IgE-mediated gastrointestinal food allergy.
Nanoparticle ranking analysis: determining new particle formation (NPF) event occurrence and intensity based on the concentration spectrum of formed (sub-5 nm) particles
Authors: Aliaga Diego , Tuovinen Santeri , Zhang Tinghan , Lampilahti Janne , Li Xinyang , Ahonen Lauri , Kokkonen Tom , Nieminen Tuomo , Hakala Simo , Paasonen Pauli , Bianchi Federico , Worsnop Doug , Kerminen Veli-Matti , Kulmala Markku 
Published: December 2023

Abstract. Here we introduce a new method, termed “nanoparticle ranking analysis”, for characterizing new particle formation (NPF) from atmospheric observations. Using daily variations of the particle number concentration at sizes immediately above the continuous mode of molecular clusters, here in practice 2.5–5 nm (i.e. ΔN2.5−5), we can determine the occurrence probability and estimate the strength of atmospheric NPF events. After determining the value of ΔN2.5−5 for all the days during a period under consideration, the next step of the analysis is to rank the days based on this simple metric. The analysis is completed by grouping the days either into a number of percentile intervals based on their ranking or into a few modes in the distribution of log (ΔN2.5−5) values. Using 5 years (2018–2022) of data from the SMEAR II station in Hyytiälä, Finland, we found that the days with higher (lower) ranking values had, on average, both higher (lower) probability of NPF events and higher (lower) particle formation rates. The new method provides probabilistic information about the occurrence and intensity of NPF events and is expected to serve as a valuable tool to define the origin of newly formed particles at many types of environments that are affected by multiple sources of aerosol precursors.