bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microcystic Meningioma – A Diagnostic Dilemma During Intraoperative Squash Smear Study
Authors: Kaur Sukhpreet , Karode Rahul , Gulwani Hanni V. 
Published: February 2023

Background:
Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature.

Objectives:
The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis.

Material and Methods:
Cytological features of five cases of MM were reviewed and noted from the records.

Results:
There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case.

Conclusion:
Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.
Pharmacological Evaluation of Scopoletin in the Carbon Tetrachloride- Induced Hepatotoxicity Model in Wistar Rats
Authors: Sharma Swati , Anand Aishwarya , Bhatia Alka , Sharma Vishal , Singh Anupam K. , Banerjee Dibyajyoti , Patil Amol N. 
Published: February 2023

Background:
Several phyto-chemicals have been identified and suggested as potential therapeutic options for hepatotoxicity management

Objective:
To assess the hepatoprotective effect of scopoletin, a pure phyto-chemical, in carbon tetrachloride (CCl4)-induced hepatotoxicity model in Wistar rats

Methods:
Thirty-six rats in total, six in each group, were utilized in this study. Animals in group 1 received normal saline; those in group 2 received carbon tetrachloride in olive oil (0.5 ml/kg, i.p. in ratio 1:1); those in groups 3, 4, and 5 received oral scopoletin (1 mg/kg, 5 mg/kg, 10 mg/kg dose-wise groups); and those in group 6 received N-acetyl cysteine (NAC) 150 mg/kg. Blood sampling was performed on day -3, day 1, and day 7 of the CCl4 administration. Rats were sacrificed on day 7 of the experiment for histological examination and oxidative stress measurement of the liver

Results:
The 5 mg/kg scopoletin group showed a maximum reduction in AST levels [727.33 ± 29.15 in medium dose (MD) group vs 1526.66 ± 60.72 in the experimental control (EC) group (P < 0.001) and ALT levels of 532.66 ± 24.23 in MD group vs 894.83 ± 52.47 in EC (P < 0.01)]. The dose-dependent action was not observed with scopoletin doses. The protective effect of scopoletin was confirmed by MDA and GSH levels (P < 0.05) coupled with histo-pathological findings. In the present study, a reversible model of CCl4-induced hepatotoxicity was observed to get normalized in a week’s time

Conclusion:
The study confirms the hepatoprotective action of scopoletin in an acute model of hepatic injury with the putative anti-oxidant mechanism.
E-learning during the COVID-19 Pandemic in Various Healthcare Institutes of India
Authors: Kumar Surender , Singh Bishnupati , Mahuli Amit Vasant , Singh Ankita , Mahadevan Vallabh , Ranjan Madhu 
Published: February 2023

Introduction:
A multicentric study on the benefits and outcomes of e-learning was lacking during the pandemic. This study aimed to find out the participation, satisfaction, and insights of dental and medical undergraduate learners toward digital learning during the COVID-19 pandemic in various healthcare institutes of India.

Material and Methods:
A questionnaire-based cross-sectional study was conducted using Google Forms online on e-learning among students from the first to the final year of MBBS and BDS courses in five healthcare institutions

Results:
Most participants (72.7%) reported cellular data as their mode of internet connection. Seventy point eight percent of participants stated online classes did not affect health. Eyestrain (54.6%) was the most common, followed by headache and fatigue, whereas only 21.2% chose obesity and disturbed sleep as a consequence of e-learning

Conclusion:
Most students had experience in digital learning, in which the use of smart phones with cellular data was the most common mode of digital learning during the pandemic.
Investigating the Role of EPA and DHA on Cellular Oxidative Stress; Profiling Antidiabetic and Antihypertensive Potential
Authors: Aldhafiri Fahad K. 
Published: February 2023

Background:
Polyunsaturated fatty acids (PUFAs) remain part of the diet and are essential for growth and development. Furthermore, omega − 3 fatty acids boost various cardiovascular disease risk factors as well as lower blood pressure and cholesterol levels. The effects of PUFAs on glycemia in type 2 diabetes patients are unclear. In the present study, the anti-diabetic and anti-hypertensive potential of eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA)—two polyunsaturated fatty acids—were examined.

Material and Methods:
Using 3T3-L1 pre-adipocyte cells fed with PUFAs, the antioxidant capacity of EPA and DHA was assessed using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay/test. The DPPH activity of EPA and DHA was 49.72 and 50.51%, respectively, indicating a reduction in oxidative stress. The number, size, and total lipid content of adipocytes in adipose tissue were used to study the anti-diabetic effect of EPA and DHA. Both PUFAs were revealed to have a much lower capacity for cell lysis of 3T3-L1 pre-adipocytes when compared to propylene glycol monomethyl ether acetate (PMA). In 3T3-L1 pre-adipocyte cells that had been treated with EPA and DHA, the gene expression profiles for ATP synthase 6 were examined

Results:
The results demonstrated a similar trend of reducing total lipid content in 3T3-L1 pre-adipocyte cells treated with EPA and DHA. The amount of cell lysis was then examined for 3T3-L1 pre-adipocyte cells exposed to DHA and EPA, and the results showed 38.45% and 41.26%, respectively. In the 3T3-L1 pre-adipocyte cells, treatment with PUFAs, EPA, and DHA dramatically lowered total lipid content after 48 hours. The study also revealed that exposing 3T3-L1 pre-adipocyte cells to EPA at 90 g/ml for 48 hours reduced the total lipid content by a significant amount

Conclusion:
According to the findings, EPA and DHA therapy reversed oxidative stress in mitochondria and upregulated the ATP synthase 6 gene. This discovery shows how EPA and DHA have anti-diabetic and hypertension properties.
Clinical Assessment of Residents: A Survey of Clinician Educators Regarding Resident Assessment Burden and Modifiable Factors
Authors: Tierney Aaron A. , Rosner Benjamin I. 
Published: February 2023

ABSTRACT

Background
A fundamental role of the clinician educator is to provide thoughtful assessments for resident development. A gap in the literature exists about whether the completion of assessments contributes to clinician educator burden.

Objective
We sought to understand the degree to which completing resident assessments contributes to clinician educator burden, the drivers behind such perception, and whether modifiable factors exist.

Methods
In October 2020, we conducted a cross-sectional study of adult hospital medicine clinician educators to explore burden associated with resident assessment. The authors developed a 10-item electronic survey (Likert type and sliding scale responses), asking about demographics, context, frequency and degree of burden, burdensome aspects of assessments, estimated time for assessments, and percentage of assessments turned in late or never. We conducted subgroup analyses for differences in responses based on sex and number of years practicing, and regression analyses for predictors of burden degree.

Results
Fifty of 81 (62%) surveyed faculty responded. Two percent (1 of 50) reported no burden, while 42% (21 of 50) reported infrequent (“never,” “rarely,” “sometimes”) and 56% (28 of 50) reported frequent (“often,” “always”) burden. Of those experiencing burden, 67% (33 of 49) reported slight or moderate, and 33% (16 of 49) reported significant or extreme burden. Potentially modifiable causes included assessment request boluses, lag time between resident service and assessment requests, and technology involved. Female clinician educators estimated submitting a higher percentage of late assessments than males (65% vs 41%, P=.02). Number of years practicing was inversely associated with assessment time (β=-0.28, P=.01).

Conclusions
Our findings suggest that resident assessments are a source of burden among adult hospital medicine clinician educators and that several potentially modifiable factors may underlie this burden.
When Global Becomes Virtual: A Survey of Virtual Global Health Education Activities During the COVID-19 Pandemic Among Pediatric Educators
Authors: Lam Suet Kam , Winter Jameel , Van Genderen Kristin , Lauden Stephanie M. , Windsor William , Umphrey Lisa 
Published: February 2023

ABSTRACT

Background
During the COVID-19 pandemic, global health education activities were disrupted. Transitioning to virtual options has allowed educators and trainees to continue global health education and partnerships, though the acceptability and implementation of this transition is unknown.

Objective
To evaluate current and planned virtual global health education activities (VGHEAs) of a group of US global health educators during the COVID-19 pandemic and to assess perceived benefits and challenges of VGHEAs.

Methods
A cross-sectional study of pediatric faculty and trainees involved in global health education from 8 institutions in the United States were surveyed anonymously about their global health education activities in 2021. Authors used representative convenience sampling and invited at least 1 faculty member and 2 trainees from each institution in the Midwest Consortium of Global Child Health Educators.

Results
All 8 institutions responded to the survey, with 38 faculty and trainee participants. Institutional implementation of virtual education activities was variable. Respondents reported that VGHEAs allowed them to maintain partnerships with low-middle income countries, though they noted that unreliable internet connections presented challenges. One program reported funding cuts to its global health program during the pandemic.

Conclusions
The COVID-19 pandemic created challenges for global health education programs. Educators and trainees are interested in using potentially cost-saving VGHEAs to maintain international collaborations, continue global health education efforts, and even increase access to equitable educational activities despite pandemic disruptions.
Faculty Perceptions of Frame of Reference Training to Improve Workplace-Based Assessment
Authors: Kogan Jennifer R. , Conforti Lisa N. , Holmboe Eric S. 
Published: February 2023

ABSTRACT

Background
Workplace-based assessment (WBA) is a key assessment strategy in competency-based medical education. However, its full potential has not been actualized secondary to concerns with reliability, validity, and accuracy. Frame of reference training (FORT), a rater training technique that helps assessors distinguish between learner performance levels, can improve the accuracy and reliability of WBA, but the effect size is variable. Understanding FORT benefits and challenges help improve this rater training technique.

Objective
To explore faculty's perceptions of the benefits and challenges associated with FORT.

Methods
Subjects were internal medicine and family medicine physicians (n=41) who participated in a rater training intervention in 2018 consisting of in-person FORT followed by asynchronous online spaced learning. We assessed participants' perceptions of FORT in post-workshop focus groups and an end-of-study survey. Focus groups and survey free text responses were coded using thematic analysis.

Results
All subjects participated in 1 of 4 focus groups and completed the survey. Four benefits of FORT were identified: (1) opportunity to apply skills frameworks via deliberate practice; (2) demonstration of the importance of certain evidence-based clinical skills; (3) practice that improved the ability to discriminate between resident skill levels; and (4) highlighting the importance of direct observation and the dangers using proxy information in assessment. Challenges included time constraints and task repetitiveness.

Conclusions
Participants believe that FORT training serves multiple purposes, including helping them distinguish between learner skill levels while demonstrating the impact of evidence-based clinical skills and the importance of direct observation.
Urinary Symptoms Are Unrelated to Leukocyte Esterase and Nitrite Among Indwelling Catheter Users
Authors: Rounds Amanda K. , Tractenberg Rochelle E. , Groah Suzanne L. , Frost Jamie K. , Ljungberg Inger H. , Navia Herminio , Pham Cynthia T. 
Published: February 2023

Objectives
To explore the association between dipstick results and urinary symptoms.

Method
This was a prospective 12-month observational study of real-time self-administered urine dipstick results and symptoms in a community setting that included 52 spinal cord injury/disease (SCI/D) participants with neurogenic lower urinary tract dysfunction (NLUTD) who use an indwelling catheter. Symptoms were collected using the Urinary Symptom Questionnaire for Neurogenic Bladder–Indwelling Catheter (USQNB-IDC). The USQNB-IDC includes actionable (A), bladder (B1), urine quality (B2), and other (C) symptoms; analyses focused on A, B1, and B2 symptoms. Dipstick results include nitrite (NIT +/−), and leukocyte esterase (LE; negative, trace, small, moderate, or large). Dipstick outcomes were defined as strong positive (LE = moderate/large and NIT+), inflammation positive (LE = moderate/large and NIT−), negative (LE = negative/trace and NIT−), and indeterminate (all others).

Results
Nitrite positive dipsticks and moderate or large LE positive dipsticks were each observed in over 50% of the sample in every week. Strong positive dipstick results were observed in 35% to 60% of participants in every week. A, B1, or B2 symptoms co-occurred less than 50% of the time with strong positive dipsticks, but they also co-occurred with negative dipsticks. Participants were asymptomatic with a strong positive dipstick an average of 30.2% of the weeks. On average, 73% of the time a person had a negative dipstick, they also had no key symptoms (95% CI, .597-.865).

Conclusion
No association was observed between A, B1, and B2 symptoms and positive dipstick. A negative dipstick with the absence of key symptoms may better support clinical decision-making.
Key Success Factors For Supply Chain Management Innovation From Cross-Border Medical Cooperation Under “Belt And Road”
Authors: Xiaoqi Liu , Samart Deebhjarn, Amnuay Saengnoree  
Published: February 2023

Aim: This article aims to identify key success factors (KSFs) of supply chain management (SCM) innovation and the effect on improving stakeholders value of cross-border medical cooperation platforms between China and countries along the “Belt and Road.”
Methodology:In this study, a combination of quantitative and qualitative methods was used for analysis. For qualitative analysis, the Delphi method achieved two results: firstly, a consensus was reached on the key success factors of SCM innovation, with a consensus rate of over 80%; secondly, the index system of the influence factors of SCM innovation on stakeholder value was improved.
Results:For quantitative analysis, the Regression Analysis results showed that the five factors of SCM innovation have different degrees of effect on the value of the three groups of stakeholders, which are shown as the improvement of stakeholder value.The results of this study are recommended forstrategy formulation and innovation implementation in supply chain management.
Conclusion:Each of the five criteria impacted the shareholder value of pharmaceutical corporations, medical care providers, and patients to varying degrees. The results of Regression Analysis revealed a substantial association between SCM innovation and the value of stakeholders. The three hypotheses tested in this study have been confirmed. Five KSF-based SCM innovation has a substantial impact on enhancing the stakeholder value of pharmaceutical businesses, medical care agencies, and patients. This article is intended to assist businesses and individuals in the cross-border medical services market in enhancing the quality and degree of supply chain management.
COMPARISON OF EXAMINATION OF SODIUM ELECTROLYTE LEVELS IN SERUM USING RED CAP VACUUM TUBES AND YELLOW CAP VACUUM TUBES AT TOTO KABILA HOSPITAL BONE BOLANGO DISTRICT
Authors: Husain Sri Tinsia Husain , Diah Astini Paramita  , Gayatri D. Soga  
Published: February 2023

Sodium is an essential nutrient for maintaining blood volume, regulating water balance in cells and maintaining nerve function. Sodium examination generally uses serum as a specimen. Serum is a liquid component of blood that no longer contains blood cells and clotting factors. The purpose of this study was to compare the results of examining sodium electrolyte levels in serum using a red-covered vacuum tube and a yellow covered vacuum tube at Toto Kabila Hospital, Bone Bolango Regency.
The method in this study uses a quantitative approach with a descriptive type of research. The sampling technique used in this study was purposive sampling with a total sample of 30 patients.
Comparison ResultsExamination of sodium electrolyte levels in serum using a red lid vacuum tube and a yellow lid vacuum tube contained 9 Normal Samples and 21 Abnormal Samples with the Mann-Whitney Test results showing that the significant value was > 0.05 or P = 0.312, so it can be concluded that there was no the difference between the red cap vacuum canister and the yellow cap vacuum canister.
Older Adults Receiving Rehabilitation Services Are More Likely to Get Bathing and Toileting Equipment Installed
Authors: Simning Adam , Caprio Thomas V. , Lam Kenneth 
Published: February 2023

AbstractImportance: Adaptive equipment, such as shower grab bars and modified toilet seating, is effective but underused in the United States. To change this, a better understanding of how equipment ends up being installed is needed. We hypothesized that rehabilitation services were a major mechanism.Objective: To examine the association between receipt of rehabilitation services and installation of adaptive equipment.Design: Observational cohort of the National Health and Aging Trends Study in 2015 and 2016.Setting: Community.Participants: A total of 416 community-dwelling adults age 65 yr or older who needed bathing equipment and 454 who needed toileting equipment.Outcomes and Measures: Study outcomes were the installation of bathing or toileting equipment. The primary independent variable was the receipt of rehabilitation services between 2015 and 2016.Results: Among older adults who needed equipment in 2015, 34.3% had bathing equipment and 19.2% had toileting equipment installed by 2016. In multivariate logistic regression analyses, rehabilitation services were associated with installation of bathing (odds ratio [OR] = 5.07, 95% confidence interval [CI] [2.60, 9.89]) and toileting equipment (OR = 2.67, 95% CI [1.48, 4.84]).Conclusions and Relevance: A minority of those in need have adaptive equipment installed within a year. In the current health care system, rehabilitation providers play a major role in equipment installation.What This Article Adds: Rehabilitation providers are involved in the installation of adaptive bathroom equipment among older persons who need it. Still, most in need of equipment do not have it after a year, suggesting that further work is needed to increase access to rehabilitation providers and develop other avenues for obtaining equipment.
DEFINING COMMUNITY RESILIENCE IN COMMUNITY BASED TOURISM: MISO WALAI AND PULAU MABUL IN SABAH, MALAYSIA
Authors: Lew Alan A. 
Published: February 2023

'Sustainable development' has been a popular conceptual framework since the World Commission on Environment and Development (WCED) issued its report to the United Nations in 1987 (Hall & Lew, 2009).Â Â Also known as theÂ Brundtland Report, its goal was to define a global agenda to deal with the deterioration of natural and social environments.Â Although still maintaining its dominant role as the preferred development paradigm for most actions taken by governments and enterprises today, the world remains mostly non-sustainable with ever increasing levels of greenhouse gasses, global temperatures, biodiversity losses, human populations, income disparities and social inequities (Lew, 2012)
KEPEMIMPINAN TRANSAKSIONAL MEMBERIKAN PENGARUH PADA PELAYANAN PANGGILAN 112 MELALUI KUALITAS KEBIJAKAN SEBAGAI MODERASI
Authors: Marwiyah Siti , Busthomi Ach. Noor , Lailatul Fitria Nurul Jannah 
Published: February 2023

Pemerintah memberikan intervensi terhadap suatu kebijakan terutama pada sektor pelayanan publik. Intervensi pemerintah salah satunya dapat diwujudkan dari sikap kepemimpinan dalam menyelenggarakan pelayanan kegawatdaruratan. Pelayanan publik dengan penanganan kegawatdaruratan dibutuhkan oleh masyarakat. Seperti di Kota Probolinggo terdapat panggilan 112 Kota Probolinggo. Bahkan pelayanan ini tertuang pada kebijakan panggilan kegawatdaruratan dengan NTPD 112 Kota Probolinggo. Sehingga penulis melakukan riset mendalam guna mengetahui dan menganalisa pengaruh kepemimpinan transaksional terhadap kualitas pelayanan panggilan 112 di Kota Probolinggo serta diperkuat dengan kualitas kebijakan penanganan kegawatdaruratan di Kota Probolinggo. Riset ini menerapkan riset kuantitatif dengan orientasinya variabel teoritis melalui pengolahan angka yang ditindaklanjuti dengan analisa. Penghimpunan data dengan kuesioner, wawancara, pengamatan langsung, dan dokumentasi lain. Riset ini menunjukkan kepemimpinan transaksional memberikan pengaruh secara langsung, nilai positif dan signifikan pada kualitas pelayanan panggilan 112 di Kota Probolinggo. Ditambah dengan kualitas kebijakan mampu memoderasi kepemimpinan transaksional terhadap kualitas pelayanan panggilan 112 Kota Probolinggo.
Kata kunci: kebijakan; kegawatdaruratan; kepemimpinan; Pelayanan; 112