bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of retrograde transillumination and conventional technique for flexible videoscopy by novice anaesthesia residents: A randomised controlled trial
Authors: Gopalakrishnan Sri Showmiya , Rudingwa Priya , Kuberan Aswini , Mishra Sandeep Kumar , Panneerselvam Sakthirajan , Jha Ajay Kumar 
Published: February 2023

ABSTRACT

Background and Aims:
Retrograde transillumination technique has been found helpful for performing direct and video laryngoscopy by better identification of glottis. The usefulness of this technique during flexible videoscopy by novices has not been evaluated. So, we aimed to compare the retrograde transillumination and conventional technique of flexible videoscopy by novices. The primary outcomes were the time required to visualise the glottis from the point of insertion of the scope into the nostril (T1) and the time needed to see tracheal rings after glottis visualisation (T2). The secondary outcomes were incidence of desaturation with peripheral oxygen saturation (SpO2) <92% and the ease of performance of flexible videoscopy using retrograde transillumination.

Methods:
A total of 92 surgical patients who are undergoing general anaesthesia with normal airway parameters were randomised into two groups, Group C (Conventional flexible videoscopy- Ambu® aScope™ 3 Broncho Slim) and Group R (Flexible videoscopy aided by retrograde transillumination through the cricothyroid space using an OTICA LED vein finder).

Results:
The time to visualise glottis from scope insertion into the nose (T1) (median [interquartile range]) in group C and group R was (19.23 [13.6-30.5] versus 22.50 [17.8-25.5] seconds; P value = 0.417) and time to visualise the tracheal rings (T2) was (13.07 [9.1-20.00] versus 12.13 [9.0-19.1] seconds; P value = 0.714) were comparable in both the groups. 61% of residents found the retrograde transillumination to be very helpful. No incidence of desaturation was noted in either group.

Conclusion:
Retrograde transillumination-aided flexible videoscopy does not shorten the time but facilitates glottis and tracheal rings visualisation among novice anaesthesia residents.
The Perspectives of Patients and Spine Surgeons on the Effectiveness and Reliability of Telemedicine Consultations for Spine Ailments—A Glimpse at the Indian Scenario
Authors: Viswanathan Vibhu Krishnan , Shetty Ajoy P. , Murugan Chandhan , Kavishkar Rohit A. , Kanna Rishi M. , Rajasekaran Shanmuganathan B. 
Published: February 2023

Introduction:
In view of the ongoing pandemic, telemedicine has been increasingly adopted worldwide. This study was planned to evaluate the effectiveness of telemedicine for patients with spine ailments, and to assess the satisfaction rates and concerns of spine surgeons and patients regarding telemedicine consultations in the Indian scenario.

Materials and Methods:
Telemedicine appointments for spine patients were conducted through “Zoom Healthcare” online platform between April and December 2020 in a tertiary-care spine center. Questionnaires (including nine and five questions, respectively) were filled by patients and doctors after their consultations. The questionnaire included questions on overall satisfaction, time consumption, ease of setting-up appointment, ease of communication, influence on decision-making, and patient preference.

Results:
Overall, 70.1%, 23.6%, and 6.3% of patients replied that they were “very satisfied,” “satisfied,” and dissatisfied,” respectively, with their telemedicine appointments. Among postoperative follow-up patients, 69%, 30.2%, and 0.8% expressed that they were “very satisfied,” “satisfied,” and dissatisfied,” respectively, with telemedicine. At the end of session, 88.5% patients opined that they would still prefer a telemedicine appointment for the completed consultation, and 93.4% were happy to use telemedicine for future visits. In all, 100%, 94.1%, and 75% of patients, who belonged to other countries, other cities, and same city, respectively, were satisfied or very satisfied from telemedicine consultations. The doctor’s responses were “very satisfied” or “satisfied” on 96.5% of occasions overall. The doctors required approximately 24.1 min for conducting a telemedicine appointment. Three major concerns for doctors included difficulty in procuring good-quality magnetic resonance imaging (17%), problems with connectivity (14.6%), and difficulty in eliciting certain physical findings (13.2%).

Conclusion:
Telemedicine is an effective alternative to in-person visits for the assessment of patients with spine ailments. Patients belonging to more distant geographic locations (as compared with local residents) and those requiring postoperative follow-ups can be significantly benefited by this modality.
Marketing training strategies that pharmaceutical sales managers use to reduce unethical behavior
Authors: Sawad Aseel Bin , Andrews Kate 
Published: February 2023

BACKGROUND:
Some pharmaceutical company sales representatives are using bribes to encourage increasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony charge related to bribing doctors to prescribe the company's medications. Using Hunt and Vitell's general theory of marketing ethics, the purpose of this qualitative multiple case study was to explore strategies some sales managers in the pharmaceutical industry used to improve marketing training to reduce unethical sales representative behavior.

MATERIALS AND METHODS:
Data were collected from company reports and documents provided by sales managers and semistructured interviews with five sales managers of different pharmaceutical companies in the northeast region of the United States. Data were analyzed using thematic analysis and Yin's 5-step process of compiling, disassembling, reassembling, interpreting, and concluding thematic data analysis.

RESULTS:
Three themes emerged from data analysis: developing ethical standards, developing organizational policy, and implementing training and development programs. A key recommendation is that pharmaceutical sales managers identify ethical standards to inculcate in their business practices to achieve ethical marketing training that can result in sales representatives’ ethical behavior. The implications for positive social change include the potential for sales managers to develop strategies to reduce unethical behavior in the pharmaceutical industry.

CONCLUSION:
Reducing unethical behavior may lead to more trust between patients and physicians, improving patient satisfaction and promoting prosperity for the community through enhancing the quality of health care.
Individual counseling in mothers bereaved by pregnancy loss
Authors: Haghighi Mahmonir , Oladbaniadam Khatereh , Mohaddesi Hamideh , Rasuli Javad 
Published: February 2023

BACKGROUND:
The loss of a pregnancy can result in grief, guilt, self-doubt, anxiety, and post-traumatic stress disorder (PTSD). Considering the side effects mentioned for mental health and the fact that the symptoms will linger if left untreated and even adversely affect the subsequent pregnancies. The current study was designed to assess the impact of individual counseling on stress, anxiety, and depression in mothers with pregnancy loss.

MATERIALS AND METHODS:
The study commenced 100 women who experienced pregnancy loss (in Urmia/2018-2019); they were enrolled using convenience sampling and block randomization. The intervention group received four individual counseling sessions (weekly sessions with a duration of 1 h) based on Warden's principles. The control group received routine care. The Depression Anxiety Stress Scale (DASS-42) was filled out at baseline, the pre- and post-intervention. Analyses were performed using the Chi-square, paired, or individual t-tests, when necessary. P value < 0.05 was considered significant.

RESULTS:
There were no significant differences regarding socio-demographic characteristics and clinical features between groups at baseline. Intra-group analysis showed that all outcome measures in the intervention group were significantly improved. According to inter-groups analysis, a significant association was found between pre-test and post-test in the intervention group (P < 0.05).

CONCLUSION:
Results of this study can clarify the psychological effects of pregnancy loss in these mothers and help the officials and responsible parties to plan the treatment and rehabilitation of these women and include them in the healthcare system.
Presenting a conceptual model for designing hospital architecture with a patient-centered approach based on the patient's lived experience of sense of place in the therapeutic space
Authors: Ghalehnoei Mansour Pagiri , Massoud Mohammad , Yarmohammadian Mohammad H. 
Published: February 2023

BACKGROUND:
In recent years, among managers and designers of health-care spaces, there has been a growing tendency to move toward hospital design by combining patient perceptions and expectations of the physical environment of the care area. The main idea of this study was to present a conceptual model of hospital architecture in our country with a patient-centered approach based on some factors that were affecting the sense of place. This model determined the architectural features of treatment spaces from a patient's lived experience that could have a positive mental effect on patients as well. The main question of the research was how to adapt the objective perception to the patient's mental perception to create a sense of place in the hospital space?

MATERIALS AND METHODS:
This research was qualitative with a phenomenological approach, conducted between July and December 2020. Purposeful sampling consisted of 23 patients, 13 males in the male surgery unit and 10 females in the gynecology unit, who were interviewed in-depth. They were hospitalized for at least 3 days in two hospitals (Dr. Pirooz in Lahijan and Ghaem in Rasht). The data were analyzed by the Colaizzi method.

RESULTS:
The results consisted of 530 primary codes, 57 subthemes, and 7 main themes. The main themes were hospital location, access to hospital, hospital identity, hospital dependency, hospital attachment, human interactions in the hospital, and hospital evaluation.

CONCLUSION:
The hospital form guided the patient, and the hospital function directed and obviated the patient's needs. The healing environment and human interactions with it caused the patient to be satisfied with the hospital environment.
The effect of decision-aid-based counseling on cervical cancer screening behavior among women
Authors: Malekzadeh Elnaz , Nourizadeh Roghaiyeh , Farshbaf-Khalili Azizeh , Mehrabi Esmat , Hakimi Sevil 
Published: February 2023

BACKGROUND:
Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women's participation in cervical cancer screening remains low in middle- and low-income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision-aid-based counseling on cervical cancer screening behavior among women.

MATERIALS AND METHODS:
This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision-making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent t-test, ANCOVA tests were used.

RESULTS:
A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P = 0.001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95% confidence interval [CI]: 14.59–21.25; P < 0.001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD: −4.97; 95% CI: 1.09–8.04; P < 0.002]).

CONCLUSIONS:
This study revealed that evidence-based information communicated between clients and clinicians has very important role in clients’ health-related behavior. It is recommended, health care providers apply decision-aid-based counseling for promoting the cervical cancer screening behavior among women.
Awareness and understanding of COVID-19 among pregnant woman in Northern India
Authors: Jhirwal Manisha , Singh Pratibha , Sharma Charu , Kathuria Priyanka , Shekhar Shashank , Meena Satya Prakash 
Published: February 2023

BACKGROUND:
The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has become a public health concern worldwide. It is important for pregnant women to know about the mode of transmission, symptoms, and preventive measures against COVID-19. The aim of this study was to evaluate the awareness and outlook of pregnant women and practical measures taken by them against COVID-19.

MATERIALS AND METHODS:
This cross-sectional questionnaire-based study was conducted for 1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to 109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID-19 infection. The Chi-square test or Fischer's exact test was used to compare categorical data.

RESULTS:
Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had average knowledge and 2 (1.8%) had poor knowledge about COVID-19. Majority of them had a positive attitude for the protective measures taken for the prevention of disease.

CONCLUSIONS:
Since there is no valid treatment for COVID-19, prevention is the only key to curve this infection. In the present study, 94.5% pregnant women had overall good knowledge score about the mode of transmission, symptoms, and preventive measures against COVID-19.
Comparative Evaluation of Buccal Infiltration Technique with Buccal Plus Palatal Infiltration Technique Using 4% Articaine in Patients with Irreversible Pulpitis of Maxillary 1st Molars
Authors: Syed Gufaran A. , Shrivastava Anuprabha , Sisodia Suruchi , Sisodiya Bhanupratap , Gupta Kanishk , Sapri Ahmed Saaduddin , AboShetaih Mohamed , Alghamdi Sulaiman Ibrahim S. 
Published: February 2023

Introduction:
The purpose of this study was to evaluate and compare the buccal infiltration (BI) technique with the buccal plus palatal infiltration (BPI) technique using 4% articaine with 1:100,000 epinephrine

Methods:
A total of 50 adult patients received BI, and the other 50 adult patients received BPI with 4% articaine with 1:100,000 epinephrine. During RCT procedure, when the patient experienced pain, the treatment was stopped and the extent of the procedure was documented. When a patient reported “no pain” (0 mm) or “weak/mild pain” (0 <= 54 mm), the anesthesia was considered successful

Results:
Statistical analysis using unpaired t-test showed that the mean pain scores in both groups were comparable

Conclusion:
The pain scores in both groups were comparable, but BI is better than BPI as a painful and traumatic palatal injection was avoided.
A Scoping Review of Indigenous Health Curricular Content in Graduate Medical Education
Authors: Rashid Marghalara , Nguyen Julie , Foulds Jessica L. , Dennett Liz , Cardinal Nicole , Forgie Sarah E. 
Published: February 2023

ABSTRACT

Background
Graduate medical education is refocusing on the reconciliation process with Indigenous peoples and integrating Indigenous healing practices, cultural humility training, and courses on Indigenous health issues in their curricula. Physicians and all health care workers must be able to recognize, respect, and address the distinct health needs of all Indigenous peoples.

Objective
The aim of this scoping review was to explore and describe what exists in the current literature on the impact and challenges associated with Indigenous curricula developed for resident physicians.

Methods
The search was conducted using 9 bibliographic databases from inception until April 19, 2021. Two reviewers independently screened for inclusion using Covidence. Three reviewers extracted data and all 3 checked for completeness and accuracy.

Results
Eleven reports were included. Our included reports consisted of qualitative research (n=2), commentaries (n=1), special articles (n=3), systematic reviews (n=1), innovation reports (n=1), published abstracts (n=1), and program evaluation papers (n=2). Findings are presented by 3 themes: (1) Misunderstandings and cultural bias toward Indigenous people; (2) Increasing community-driven Indigenous partnerships to create a safe environment; and (3) Challenges in implementing Indigenous health curricula.

Conclusions
Themes identified related to Indigenous involvement, culturally competent care, common misconceptions about Indigenous peoples, as well as challenges and barriers to implementing Indigenous curricula for residency programs. A collaborative approach involving stakeholders with training in the community is a viable path forward. But comprehensive program evaluation, a source of stable funding, and further research focusing on effective Indigenous curricula for residents are needed.
The Carbon Footprint and Cost of Virtual Residency Interviews
Authors: Domingo Alexander , Singer Justin , Cois Adrian , Hatfield Joanna , Rdesinski Rebecca E. , Cheng Anthony , Aylor Megan , Sullenbarger John , Walker Sara , Hervey Shane , Stenson Amy 
Published: February 2023

ABSTRACT

Background
The shift from in-person to virtual residency interviews may impact greenhouse gas emissions (GHGE) and costs but the direction and amount of this change is not yet clear.

Objective
To estimate GHGE and financial impacts of virtual interviews among applicants and programs.

Methods
In 2020-2021 we sent a postinterview survey to 1429 applicants from 7 residency programs and 1 clinical psychology program at 1 institution. The survey collected origin of travel and transit type if in-person interviews had been held and excluded responses if the applicant would not have participated in an in-person interview, or if travel type or original city was missing. We used the International Civil Aviation Organization calculator to estimate flight-related GHGE in metric tons of carbon dioxide equivalent (MTCO2e) and Google Maps to estimate ground travel, with a standard CO2e per mile. Flight, hotel, and airport taxi costs were estimated using Expedia.com, Hotels.com, Uber, and Lyft. We aggregated these data and calculated median and interquartile ranges (IQRs) for applicant GHGE and cost savings, and assumed no cost or GHGE from virtual interviews. We used Wilcoxon signed rank sum tests to compare in-person 2019-2020 and virtual 2020-2021 GME program interview budgets.

Results
The survey response rate was 565, or 40% of applicants; 543 remained after the exclusion criteria were applied. Reduction in applicant travel due to virtual interviews led to median estimated GHGE savings of 0.47 (IQR 0.30-0.61) MTCO2e and $490 (IQR $392-$544) per applicant, per interview. Programs savings ranged from $7,615 to $33,670 for the interview season.

Conclusions
Virtual interviews in 8 GME programs were associated with lower estimated GHGE and costs, for applicants and programs, compared with in-person interviews.
“Patients Are the People Who Teach Me the Most”: Exploring the Development of Communication Skills During Internal Medicine Residency
Authors: Burke Gabriel , Melvin Lindsay , Ginsburg Shiphra 
Published: February 2023

ABSTRACT

Background
Physician-patient communication training is a vital component of medical education, yet physicians do not always achieve the communication expertise expected of them. Despite extensive literature on the efficacy of various training interventions, little is known about how residents believe they learn to communicate.

Objective
To understand residents' perspectives on the development of their communication skills.

Methods
Between November 2020 and January 2021 recruitment emails were sent to all 225 internal medicine residents at the University of Toronto; one-on-one interviews were conducted with 15 residents. Participants were asked to reflect on communication skills development. Interviews were conducted and analyzed using constructivist grounded theory.

Results
Participants credited the majority of their skills development to unsupervised interactions with patients, without explicit guidance from an attending physician. Attendings' contributions were primarily seen through role modeling, with little perceived learning coming from feedback on observed interactions. This was partly explained by residents' proclivity to alter their communication styles when observed, rendering feedback less relevant to their authentic practice, and by receiving generically positive feedback lacking in constructive features. Time constraints led to communication styles that prioritized efficiency at the cost of patient-centeredness.

Conclusions
These findings suggest that current models of communication training and assessment may fall short due to overreliance on observation by attendings and examiners, which may fail to unearth the authentic and largely self-taught communication behaviors of residents. Further research is required to ascertain the feasibility and potential value of other forms of communication training and assessment, such as through patient feedback.
Abundance for slc surfaces over arbitrary fields
Authors: Posva Quentin 
Published: February 2023

We prove the abundance conjecture for projective slc surfaces over arbitrary fields of positive characteristic. The proof relies on abundance for lc surfaces over abritrary fields, proved by Tanaka, and on the technique of Hacon and Xu to descend semi-ampleness from the normalization. We also present applications to dlt threefold pairs, and to mixed characteristic families of surfaces.Comment: 22 pages. Comments welcome anytime. v2: some proofs in Sections 3.1 and 3.2 have been clarified. v4: Final version, to appear in Epijournal de Geometrie algebrique
Curatorial Directing and Actor Agency
Authors: Villarreal Amanda Rose 
Published: February 2023

In lieu of an abstract, here is an excerpt:
recognition that digital performance will remain as a practice far beyond the pandemic, and in response to Rikard and Pace’s call for theatre educators to reconsider what consent looks like in on-camera classrooms, this article engages with the genre of digital performance that W.B. Worthen’s analysis of performances created during the pandemic names as “Zoom Theatre” (2021). Worthen highlights Zoom Theatre as “the defining genre of theatre during the pandemic,” describing this genre as that in which “actors in different places all perform live, but remotely, typically from their homes, gathered on a screen” (183). Due to this merging of liveness and digitally captured performance, intimacy practitioners engaging with this form of performance need to consider ways in which intimacy choreography and intimacy coordination must merge. This article focuses on the ways in which the framing of Zoom Theatre can complicate Laura Mulvey’s concept of the Male Gaze (1975), introducing the concepts of agentic framing and curatorial directing as tools for creating consent-based performance within the unique contexts of Zoom Theatre.