bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Virtual Visit: A Telehealth Curriculum for Internal Medicine Residents Featuring a Virtual Physical Examination
Authors: McConnell Megan , Kumar Puneet , Mullur Rashmi 
Published: October 2023

Background
During the COVID-19 pandemic, medical professionals were obligated to adapt to virtual care. Most resident physicians had no formal telehealth training. The virtual physical examination remained underutilized.

Objective
We describe a needs assessment leading to the creation of a telehealth curriculum for internal medicine (IM) and internal medicine pediatric (IM/P) residents, and report changes in residents’ confidence level as well as feasibility data. We hypothesized that residents’ confidence in delivering virtual care would significantly improve after implementing a telehealth curriculum.

Methods
A needs-based assessment for all University of California Los Angeles (UCLA) IM and IM/P residents was conducted in July 2020. Specific competencies were identified: (1) telehealth legal guidelines; (2) virtual physical examination; (3) health equity; and (4) telehealth chronic disease management. The curriculum was presented via 3 synchronous interactive online interventions between November 2020 and March 2021. Pre- and post-intervention learner assessments were conducted.

Results
Out of all 180 residents, 146 UCLA IM and IM/P residents completed pre- and post-Virtual Physical Examination curriculum surveys, which were not uniquely linked to individuals. Residents reported statistically significant increased confidence levels in performing a targeted virtual physical examination (P&lt;.001; 95% CI 0.97-1.35), engaging patients or caregivers to assist in virtual examinations (P&lt;.001; 95% CI 0.76-1.21), and using remote monitoring devices (P&lt;.001; 95% CI 0.58-1.03).

Conclusions
Our results demonstrate that, within our IM and IM/P residency programs, a formalized telehealth curriculum significantly improved residents’ confidence in delivering virtual care.
Evaluation of an Individualized Learning Plan Template for the Transition to Residency
Authors: Pincavage Amber T. , Gandhi Ashish , Falk Eli , DiMarino Lauren , Carbajal Douglas Ruiz , Ayyala Uma , Chandrasekar Jayaram , Dentino Andrew N. , Ferris Allison H. , Forster Richard M. , Hemmer Paul A. , Masucci Nancy , Surkis William D. , O Valerie , Choe John H. 
Published: October 2023

Background Specialty-specific individualized learning plans (ILPs) have been promoted to improve the undergraduate to graduate medical education transition, yet few pilots have been described.
Objective To create and report on the feasibility and acceptability of a pilot internal medicine (IM) ILP template.
Methods The ILP was created by a group of diverse IM expert stakeholders and contained questions to stimulate self-reflection and collect self-reported readiness data from incoming interns. US IM residency programs were invited to pilot the ILP with interns in spring 2022. Data was used at the programs’ discretion. The pilot was evaluated by a post-pilot survey of programs to elicit perceptions of the impact and value of the ILP and analyze anonymous ILP data from 3 institutions.
Results Fifty-two IM residency programs agreed to participate with a survey response rate of 87% (45 of 52). Of responding programs, 89% (40 of 45) collected ILPs, thus we report on data from these 40 programs. A total of 995 interns enrolled with 782 completing ILPs (79%). One hundred eleven ILPs were analyzed (14%). Most programs found the ILP valuable to understand incoming interns’ competencies (26 of 40, 65%) and areas for improvement (24 of 40, 60%) and thought it should continue (29 of 40, 73%). Programs estimated the ILP took interns 29.2±14.9 minutes and 21.6±10.3 minutes for faculty mentors to complete. The most common barrier was faculty mentor participation.
Conclusions An ILP based on interns’ self-reported data was feasible and valuable to IM residency programs in understanding interns’ competencies and areas for improvement.
Value of dynamic contrast-enhanced magnetic resonance imaging in combination with mammography for screening early-stage breast cancer
Authors: Su Weiwei , Hou Xiaoming , Yu Bo 
Published: October 2023

Objective: To study the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in combination with mammography for screening early-stage breast cancer.
Methods: Ninety-three female patients visiting Zhejiang Zhuji Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were enrolled to receive DCE-MRI and mammography. The diagnostic efficiencies of different methods were assessed with pathological diagnosis as the golden standard. The factors affecting diagnostic sensitivity were investigated based on clinicopathological characteristics.
Results: Forty-one patients were diagnosed as malignant pathological changes by DCE-MRI, and the signs were unclear boundary with surrounding tissues and irregular or unsmooth edges. The maximum linear slope and ratio of the maximum linear SlopeR of malignant pathological changes were significantly larger than those of benign pathological changes (P<0.05). Forty-five patients were diagnosed as malignant pathological changes by mammography combined with DCE-MRI. Compared to single diagnosis method, the combined diagnosis had significantly increased sensitivity, specificity, accuracy, positive predictive value and negative predictive value, and decreased rates of missed diagnosis and misdiagnosis (P<0.05). Lesion diameter was an independent risk factor affecting the diagnostic sensitivity (P<0.05).
Conclusion: Mammography and DCE-MRI play key roles in the early diagnosis of breast cancer, and their combination can increase the diagnostic efficiency.
Keywords: Breast cancer; diagnosis; magnetic resonance imaging; mammography.
Alisma Shugan Decoction attenuates hepatic fibrosis and endoplasmic reticulum stress in mice with carbon tetrachloride-induced fibrosis
Authors: Sun Yun-Feng , Pan Hong-Hua , Xia Zhong-Ni , Yu Zhong-Min , Li Cheng-Le , Wang Xiao-Dong , Shen Sheng-Hui 
Published: October 2023

Background: Over the years, Alisma Shugan Decoction (ASD), because of its potent anti-inflammation activity, has been used in traditional Chinese medicine (TCM) for treatment of many inflammation-associated disorders including those of the heart, blood vessel and brain.
Methods: Herein, we examined the probable therapeutic effect of ASD in carbon tetrachloride (CCl4)-induced liver injury and fibrosis mice models.
Results: Our results demonstrate that ASD dose-dependently reduced the fibrosis-related increased collagen deposition secondary to liver tissue exposure to CCl4. Data from our biochemical analyses showed significantly less liver damage biomarkers including ALT, AST and hydroxyproline in the ASD-treated samples, suggesting hepato-protective effect of ASD. Furthermore, we demonstrated that treatment with ASD significantly reversed CCl4-induced elevation of TNF-α, IL-6, IL-1β and MP-1. Interestingly, NF-κB signalling, a principal regulator of inflammation was markedly suppressed by ASD treatment. In addition, treatment with ASD deregulated stress signalling pathways by suppressing the expression of markers of unfolded protein response, such as ATF6, IRE and GRP78.
Conclusion: In conclusion, the present study provides preclinical evidence for the use of ASD as an efficacious therapeutic option in cases of chemical-induced liver damage and/or fibrosis. Further large-cohort validation of these findings is warranted.
Keywords: Alisma Shugan Decoction; liver injury; fibrosis; anti-inflammation; unfolded protein response signalling.
Prevalence and demographic risk factors for overweight and obesity among healthcare workers at Uasin Gishu County hospital, Kenya
Authors: Sum Jepchumba Rael , Munyaka Ann , Kamuhu Regina 
Published: October 2023

Background: Healthcare workers are under continual pressure to be an example to the public on Body Mass Index (BMI). While prior studies have focused on the general population, data on overweight and obesity is limited among healthcare workers.
Objective: This study aimed at determining the prevalence of and demographic risk factors associated with overweight and obesity among healthcare workers.
Methods: This cross-sectional study was done on healthcare workers aged 20 years and above comprehensively sampled in Uasin Gishu County hospital. A WHO step-wise questionnaire and anthropometric measurements were used to collect data and logistic regression was performed among variables.
Results: The mean age and BMI were 36.96±9.96 years and 27.18±5.04 respectively. 63.4% of respondents had their BMI above 25 kg/m2, 35% were overweight and 28.4% were obese. Females were more likely to become overweight and obese than males with an odds ratio [OR] of 2.8 (95% confidence interval [Cl] = 1.3-6.0, P = 0.008). Age, education and physical activity were found related to BMI and gender was found to be associated with BMI.
Conclusion: High prevalence of obesity among healthcare workers is of concern, especially on the issue of central obesity. Intervention among the health workers should be considered.
Keywords: Prevalence; BMI; overweight; obesity; demographic risk factors; healthcare workers.
Prevalence, severity, and correlates of erectile dysfunction among male adult patients of a primary care clinic in North-West Nigeria
Authors: Z Muhammad Abdullahi , A Grema Bukar , Shuaibu Abdulrahman , C Michael Godpower 
Published: October 2023

Background: Erectile dysfunction (ED) is a common sexual problem that profoundly affects intimate relationships. It is poorly studied in North-western Nigeria.
Objectives: To assess the prevalence, severity and predictors of ED among adult males attending a primary care clinic in Northwest Nigeria.
Methods: A cross-section of 392 males (aged ≥25 years) were randomly selected from attendees of a family medicine clinic in Kano, Nigeria. Information regarding their biodata, lifestyle factors, and clinical characteristics was obtained using a structured questionnaire. The International Index of Erectile Function Questionnaire (version 5) and Patient Health Questionnaire-2 assessed ED and depression, respectively.
Results: The participants' mean age was 45±14.1 years (range: 26-86 years). Most participants were married (88.8%), had one sexual partner (71.7%), had tertiary education (44.4%) and were traders (49.7%). The prevalence of ED was 52.3% (205/392) [comprising mild (36.0%), mild-to-moderate (14.3%), moderate (1.5%) and severe (0.5%)]. Age, body mass index (BMI), marital status, number of sexual partners, monthly income, type of exercise, hypertension history, blood pressure reading, antihypertensive and peptic ulcer drug use were associated with ED (P<0.05). However, age (≥50years) (OR= 1.91, 95%CI [1.28-2.85], P=0.001) and overweight/obesity (OR =1.81, 95%CI [1.18-2.77], P=0.007) were the predictors of ED in this population.
Conclusion: ED prevalence was high, although mainly of the mild form. Age (≥50years) and overweight/obesity predicted ED. Hence, the need for early screening, objective grading of ED, identification of modifiable risk factors (e.g., overweight/obesity) and commencing proper treatment and prevention in this setting.
Keywords: Correlates; erectile dysfunction; obesity; primary care; severity; Northwest Nigeria.
Impact of maternal demographics on knowledge of exclusive breastfeeding among nursing mothers in Ifelodun local government, Nigeria
Authors: Aminat Adeola Odebode , Adijat Mojisola Abdulraheem , Jamila Yusuf 
Published: October 2023

Background: Breastfeeding remains the recommended feeding plan for infants however; several factors seem to affect its knowledge and practice.
Objectives: This study aimed at investigating the impact of maternal demographics of age, educational status, religious affiliation and number of parities on knowledge of exclusive breastfeeding among nursing mothers in Ifelodun Local government area, Nigeria.
Methods: The study employed a descriptive survey method. A total of 206 nursing mothers in Ifelodun Local Government were selected through purposive and random sampling techniques. The participants responded to a researcher-designed questionnairetitled Knowledge of Exclusive Breastfeeding Questionnaire. The psychometric properties of the instrument were established. The data collected were analysed using both descriptive and inferential statistics. For the demographic data, percentage was employed while chi-square statistical tool was employed to test the hypotheses at 0.05 significant level.
Results: Nursing mothers in Ifelodun Local Government Area have high knowledge of exclusive breastfeeding (N=76.8%). Also, maternal demographics of age (X2= 25P=0.03), educational status (X2= 62.72; P=0.00), religious affiliation (X2= 11.01; P=0.01) and number of parity (X2= 84.01; P=0.02) have significant impact on mothers’ knowledge of exclusive breastfeeding.
Conclusions: Nursing mothers in Ifelodun Local Government Area, have knowledge of exclusive breast feeding especially those who are older, literate, Christian; and multi-parous. Maternal demographics should be considered when educating nursing mothers on exclusive breastfeeding.
Keywords: Maternal demographics; exclusive breastfeeding; nursing mothers; Ifelodun local government area.
Clinical nursing application of parenteral nutrition combined with enteral nutrition support in neurosurgery
Authors: Huang Meiying , Yang Sha , Gu Aixia , Xu Mingxia , Sha Cong 
Published: October 2023

Background: To explore the clinical nursing effect of parenteral nutrition combined with enteral nutrition support in neurosurgery.
Methodology: 200 neurosurgical patients were randomly divided into two groups. The time of parenteral nutrition combined with enteral nutrition support in our hospital (January 2021) was used as the cut-off point, the PN group and the PN+EN group were divided according to the cut-off point. Nutritional status, immune status, occurrence of adverse events, prognosis-related indicators were compared between the two groups.
Results: Nutritional status and immune status at 7 days of nutritional support in the PN+EN group were higher than those in the PN group, The difference was statistically significant. The total incidence of adverse events in the PN+EN group (3.00%) was significantly lower than that in the PN group (11.00%), and the difference was statistically significant. The average ICU treatment time, average hospital stay and emerging infection rate in the PN+EN group were lower than those in the PN group, and the differences were statistically significant (P < 0.05).
Conclusion: Parenteral nutrition combined with enteral nutrition support in neurosurgery can achieve a more ideal intervention effect. It is beneficial to the prognosis of patients and has a certain value of promotion and application.
Keywords: Neurosurgery; parenteral nutrition support; enteral nutrition support; nursing effect.
Correlation between protein expression profiling of inflammation and bone metabolism in rheumatoid arthritis patients
Authors: Wang Jie , Liu Jian 
Published: October 2023

Objective: In patients with rheumatoid arthritis (RA), osteoarthrosis significantly reduces self-perception. However, the intrinsicrelationship between bone metabolism and SPP and cell activity at the molecular level remains unclear. The purpose of thisstudy was to understand the relationship between RA bone metabolic indicators and immune inflammation-related proteins.
Methods: A total of 30 patients with RA and 30 healthy controls were recruited. Four bone metabolism measures and nineproteins expression measures were collected from RA patients and healthy controls. Spearman Correlation Analysis and Logistic-regression Analysis were adopted for associations between bone metabolism and proteins.
Results: We screened and verified 3 key proteins, namely interleukin-11 (IL-11), interleukin-17 (IL-17) and programmed celldeath-2 (PD-L2) related to immunity and inflammation through microarray analysis. Levels of IL-2, IL-5, IL-11, IL-17, CTLA4,TNF-β were higher in RA patients than in the control group (P<0.05), meanwhile, the levels of IL-8, PD-L2, TNF-β and B7-2were low in RA patients (P>0.05).The results of Spearman Correlation Test suggested that sharp score was positively correlatedwith age, CCP was positively correlated with RF, SDS score was positively correlated with RF, IL-17 was positively correlatedwith CCP, BGP was positively correlated with BALP, RANKL was positively correlated with BALP, VAS score was negativelycorrelated with CRP, TCM score was negatively correlated with SF-36 score.
Conclusion: BALP, BGP, OPG, RANKL were strongly associated with immune inflammation-related proteins and poor SPPin RA patients, which can be used to predict poor SPP in RA patients, although the underlying mechanisms need to be furtherexplored.Keywords: Rheumatoid arthritis; bone destruction; self-perception of patient; protein expression profiling.
Problem gambling among secondary school adolescents in Enugu, Nigeria
Authors: T Chinawa Awoere , N Ossai Edmund , C Odinka Paul , C Nduaguba Obinna , I Odinka Jaclyn , E Aronu Ann , M Chinawa Josephat 
Published: October 2023

Background: Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction.
Objectives: To determine the pattern of problem gambling and factors that predict gambling among adolescents that attendedsecondary schools in southeast Nigeria.
Methodology: This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary schooladolescents from eight secondary schools in Enugu State, Nigeria.
Results: The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was aweak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a veryweak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5;(95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling whencompared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8).
Conclusion: The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internetaddiction. The male respondents were more likely to have problem gambling than their female folk.
Keywords: Problem gambling; secondary school; adolescents; internet addiction; gambling severity index.
Invitro senitivity profile of <i>Plasmodium falcifarum</i> clinical isolates to choloroquine and artemisin combination theraphy from Kano and Jigawa States, Nigeria
Authors: Safiyanu Mahmud , Imam Abdullahi Abdulkadir , Alhassan Adamu Jibril , Manu Abdulsalami Yayo , Usman Umma Lawan 
Published: October 2023

Malaria continues to cause unacceptably high level of disease and death especially in Africa, with Nigeria bearing the largest burden. Accumulated efforts have been put in place to manage transmission but emergence of Plasmodium falcifarum resistant species has been a major obstacle to the control efforts. This study aimed to evaluate the sensitivity of Plasmodium falcifarum isolate to previously used choloroquine and currently in use Artemisinin and Dihydroartemisinin- amodiaquine in Kano and Jigawa States, Nigeria. Sensitivity of parasite to the drugs was carried out using WHO invitro Micro test procedure. The results revealed high resistance to chloroquine in all the study sites, reduced susceptibility to artemisinin in Hadejia and reduced susceptibility to Dihydro-artemisinin- amodiaquine in Kura and Kano Municiapal. The geometric IC50 values for artemisinin and Dihyrodroartemisiniamodiaquine were found to be below the resistant threshold cut off values as 3.66nM and 1.29nM respectively, while that of chloroquine were far above the threshold value (504.66nM). These indicate that, the P. falcifarum is still resistant to choloroquine and Artemisin and its derivatives are still effective for malaria treatment in the states.
Optimal solution techniques for control problem of evolution equations
Authors: Apanapudor J.S. , Umukoro J. , Okwonu F.Z. , Okposo N. 
Published: October 2023

A lot of optimal solution techniques exist in literature and have been employed to solve optimization problems. However, in this work, two optimal solution techniques namely the Steepest Descent Method (SDM) and the Extended Conjugate Gradient Method (ECGM) were applied to two evolution equations to determine which best approximates the system to its analytic solution. Comparisons were also carried out between the SDM and the ECGM for optimal solution and convergence. In doing so, the Liberty Basic Programming Language (LBPL) was employed to perform various numerical iterations on the respective algorithms of the techniques. It was discovered that the SDM proved to be a better technique in obtaining an optimal solution than the ECGM.
PERENCANAAN DAN PERANCANGAN GEDUNG BALE BANJAR BUALU KELURAHAN BENOA, KABUPATEN BADUNG
Authors: Putu Gede Wahyu Satya Nugraha  , I Gusti Agung Gede Nodya Dharmastika  
Published: October 2023

Banjar Bualu didirikan sekitar tahun 1905 dan merupakan banjar pertama yang dibentuk di kawasan Desa Adat Bualu. Terdapat 8 banjar yang ada di wilayah Desa Adat Bualu, nama-nama Banjar tersebut antara lain adalah Banjar Bualu, Banjar Mumbul, Banjar Pande, Banjar Balekembar, Banjar Peken, Banjar Penyarikan, Banjar Celuk, Banjar Terora. Banjar Bualu memiliki potensi wisata berbasis pariwisata, seni budaya, sampai kegiatan sosial ekonomi masyarakat pedesaan. Potensi di bidang pariwisata ini dikarenakan letaknya sangat dekat dengan kawasan perhotelan ITDC dan juga objek wisata pantai di sekitarnya. Pada bidang perekonomian, posisi Bale Banjar Bualu yang strategis karena berada di pinggir jalan sangat bagus untuk tempat UMKM dan bisnis.
Hasil penelusuran Tim PKM terdapat beberapa permasalahan yang ada di Banjar Bualu antara lain: Pertama, umur bangunan Bale Banjar Bualu yang sudah melebihi 30 tahun sehingga terjadi kerusakan di beberapa titik sehingga dapat membahayakan civitas yang ada di dalamnya. Kedua, kebutuhan ruang terbuka saat digelarnya ritual upacara keagamaan oleh pengempon Pura Semer Kembar yang letaknya di belakang Bale Banjar Bualu. Selain itu kebutuhan ruang untuk kegiatan rapat, kesenian dan kegiatan adat. Ketiga, kebutuhan akan pemasukan tambahan untuk meringankan beban operasional Banjar Bualu.
Berdasarkan permasalahan ini, solusi yang ditawarkan Tim PKM antara lain: 1) Pembuatan Perencanaan Desain Konseptual Gedung Banjar Bualu, berupa gambar konsep desain; 2) Pembuatan area terbuka sebagai palemahan ritual agama Pura Semer Kembar yang terletak di belakang Bale Banjar Bualu, selain itu kebutuhan ruang terbuka untuk kegiatan banjar seperti rapat, kesenian dan kegiatan adat; 3) Pembuatan fasilitas berupa ruko sebagai sumber pemasukan tambahan bagi Banjar Bualu untuk meringankan biaya operasional.