bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitudes and practices concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou of Burkina Faso
Authors: Dabilgou Alfred Anselme , Dravé Alassane , Kyelem Julie Marie Adeline Wendlamita , Kinda Fatimata , Napon Christian , Millogo Athanase , Kaboré Jean 
Published: May 2023

Abstract
Background
In developing countries, there is a lack of epilepsy knowledge among health workers. The objective of this study was to assess the knowledge, attitude and practice concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou.

Methods
We carried out a cross-sectional study in the health districts of Ouagadougou from August 1st to September 15th, 2017. All nurses and midwives working in three health districts were included in this study.

Results
A total of 213 participants with a mean age of 39.5 years were included in the survey; 79.81% of them had a general certification in secondary education and 62% had a professional experience of more than 10 years. About 99% of the participants had not received training on epilepsy-related care during the last six months. In addition, 74.5% of the participants had a good knowledge on epilepsy and 65% had a good practice toward epilepsy. The level of knowledge was associated with the workplace, years of training, and the professional experience. The level of knowledge about epilepsy was also associated with the level of education, while there was a significant link between professional status and nurses' level of practice in the management of seizures.

Conclusions
Efforts must be made to provide continuing education for nurses in order to improve their knowledge on epilepsy.
Physical Examination in Medical Oncology Guiding the Development of a Protocol for Teleoncology Care in a Public Health Care Oncology Service
Authors: Nazareth Aguiar Pedro , Stival Mirella , Magalhães Filho Marcos Aurelio Fonseca , del Giglio Auro 
Published: May 2023

PURPOSE We aimed to define clinical variables that could predict changes in physical examination (PE) findings and consequently lead to significant differences in clinical management. This knowledge is important because of the growing popularity of teleoncology consultations, in which there is no possibility of PE, aside from inspection. METHODS This prospective study was conducted in two public hospitals in Brazil. Clinical variables and findings of PE, as well as the management plan determined at the end of the medical appointment, were systematically recorded. RESULTS A total of 368 in-person clinical evaluations of patients with cancer were included. PE was normal or had alterations already seen in previous consultations in 87% of the cases. Among patients with new changes in PE (n = 49), cancer treatment was maintained in 59%, complementary examinations and specialist appointments were requested in 31%, and oncological therapy was modified directly after PE in 10%. Of the total 368 visits, only 12 (3%) had a change in oncological management, five directly after PE abnormalities and 7 after complementary assessment. The presence of symptoms and reasons for consultation other than follow-up showed a positive association with alterations in PE and consequent changes in clinical management by univariate and multivariate analysis ( P < .05). CONCLUSION Considering changes in clinical management, PE on every encounter for medical oncology surveillance visits may not be necessary. We envision that teleoncology will be a safe modality in most cases, given the large percentage of asymptomatic patients with no changes in PE during face-to-face care. However, for patients with advanced disease and symptoms, however, we suggest priority for in-person care.
Profile of the Oncology Physician Workforce and the Characteristics of Attrition
Authors: Tuia Jordan , Haslam Alyson , Prasad Vinay 
Published: May 2023

PURPOSE To determine the prevalence of attrition and the frequency of transition from a primarily clinical role to an industry-related role among oncology physicians. METHODS We tracked yearly Centers for Medicare & Medicaid Services (CMS) billing between 2015 and 2022 to estimate attrition of oncology physicians. A subanalysis of a random sample of 300 oncologists with fewer than 30 years of experience and who had stopped billing were used to conduct a more thorough assessment of current employment. Employment was primarily found through LinkedIn; otherwise a secondary search was done through a Google search. Type of employer was categorized as industry (pharmaceutical or biotechnology), nonindustry (academic/clinical/government), others, or no information found. The results are provided separately by sex. RESULTS Of the 16,870 oncologists who billed to CMS in 2015, 3,558 (21%) had stopped billing by 2022. Among a randomly selected 300 oncologists, we found current employment information for 223 (74%); 78 of the 223 (35%) were most recently employed within industry. Among all CMS-billing oncologists, 30% (5,126 of 16,870) identified as female. Women stopped billing at the rate of 18% (929 of 5,126) by 2022. Surgical oncologists had the lowest overall attrition (17%, 149 of 855). Radiation oncologists had 21% (881 of 4,244) overall attrition and 7% (5 of 71) sampled attrition to industry. CONCLUSION By 2022, 21% of oncology physicians billing to CMS in 2015 had stopped. 78 of the 300 sampled physicians were found to be working in industry. In total, 1 in 17 oncologists (5%) moved to industry over a 5-year period.
Effects of Yukawa confining potential on Klein-Gordon oscillator
Authors: Ikot A. N. , Amadi P. O. , Okorie U. S. , Horchani R. , Okpara N. , Obagboye L. 
Published: May 2023

Abstract
In this paper, we study the quantum dynamics of relativistic Klein-Gordon oscillator with Yukawa confining potential. We obtain approximate bound state energy spectrum and the corresponding wave function expressed in terms of biconfluent Hun function using the extended Nikiforov-Uvarov method. The effects of the screening parameter on the energy spectrum of the Klein-Gordon oscillator are discussed in details.
Shift in Calcium From Peripheral Bone to Axial Bone After Tumor Resection in Patients With Tumor-Induced Osteomalacia
Authors: Ni Xiaolin , Zhang Zaizhu , Guan Wenmin , Chi Yue , Li Xiang , Gong Yiyi , Pang Qianqian , Yu Wei , Wu Huanwen , Huo Li , Liu Yong , Jin Jin , Zhou Xi , Lv Wei , Zhou Lian , Xia Yu , Liu Wei , Jiajue Ruizhi , Cui Lijia , Wang Ou , Li Mei , Xing Xiaoping , Jiang Yan , Xia Weibo 
Published: May 2023

Abstract

Context
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by excessive production of fibroblast growth factor 23 (FGF23) by a tumor. After successful tumor resection, patients can recover from hypophosphatemia quicky. However, data on the changes in bone mineral density (BMD) and microstructure in the short term after surgery remained unclear.

Objective
This work aimed to investigate the postoperative changes in BMD and microstructure both in peripheral and axial bone in TIO patients.

Methods
We evaluated BMD and microarchitecture in 22 TIO patients using high-resolution peripheral quantitative computed tomography (HR-pQCT) and dual-energy x-ray absorptiometry (DXA) before and 3 months after surgery in this retrospective study.

Results
In this study, a total of 22 TIO patients who had recovered serum phosphate levels postoperatively were enrolled. After surgery, areal BMD (aBMD) increased by 21.6% in the femoral neck, by 18.9% in the total hip, and by 29.5% in the lumbar spine. Moreover, TBS increased by 14.1% (all P &lt; .001). In contrast, trabecular or cortical volumetric BMD (vBMD), and microstructure of trabecular bone (trabecular number, separation and bone volume ratio) and cortical bone (cortical thickness and porosity) at the distal radius or tibia were further deteriorated. Correlation analyses found that changes in femoral neck and total hip aBMD were both conversely associated with changes in trabecular vBMD and bone volume ratio, while positively correlated with change in trabecular separation at the distal radius.

Conclusion
Although aBMD and microstructure in the axial bone were improved, vBMD and microstructure in the peripheral bone were further impaired shortly after surgery. Correlation of improvement of aBMD in the total hip and femoral neck with deterioration of vBMD and microstructure at the distal radius indicated a shift in calcium from the peripheral bone to the axial bone in the short term after tumor resection in TIO patients.
The brain on time: links between development and neurodegeneration
Authors: Shabani Khadijeh , Hassan Bassem A. 
Published: May 2023

ABSTRACT
Neurodegenerative diseases are characterized by the progressive loss of structure or function of neurons. In this Spotlight, we explore the idea that genetic forms of neurodegenerative disorders might be rooted in neural development. Focusing on Alzheimer's, Parkinson's and Huntington's disease, we first provide a brief overview of the pathology for these diseases. Although neurodegenerative diseases are generally thought of as late-onset diseases, we discuss recent evidence promoting the notion that they might be considered neurodevelopmental disorders. With this view in mind, we consider the suitability of animal models for studying these diseases, highlighting human-specific features of human brain development. We conclude by proposing that one such feature, human-specific regulation of neurogenic time, might be key to understanding the etiology and pathophysiology of human neurodegenerative disease.
Oxidative stress induces chromosomal instability through replication stress in fibroblasts from aged mice
Authors: Chen Guan , Li Zhenhua , Iemura Kenji , Tanaka Kozo 
Published: May 2023

ABSTRACT
Chromosomal aneuploidy has been associated with aging. However, whether and how chromosomal instability (CIN), a condition frequently seen in cancer cells in which chromosome missegregation occurs at a high rate, is associated with aging is not fully understood. Here, we found that primary fibroblasts isolated from aged mice (24 months old) exhibit an increased level of chromosome missegregation and micronucleation compared with that from young mice (2 months old), concomitant with an increased rate of aneuploid cells, suggesting the emergence of CIN. Reactive oxygen species were increased in fibroblasts from aged mice, which was accompanied with mitochondrial functional decline, indicating that they are under oxidative stress. Intriguingly, antioxidant treatments reduced chromosome missegregation and micronucleation rates in cells from aged mice, suggesting a link between oxidative stress and CIN. As a cause of CIN, we found that cells from aged mice are under replication stress, which was ameliorated by antioxidant treatments. Microtubule stabilization is a potential cause of CIN promoted by replication stress. Our data demonstrate the emergence of CIN with age, and suggest an unprecedented link between oxidative stress and CIN in aging.
A sensation for inflation: initial swim bladder inflation in larval zebrafish is mediated by the mechanosensory lateral line
Authors: Venuto Alexandra , Thibodeau-Beganny Stacey , Trapani Josef G. , Erickson Timothy 
Published: May 2023

ABSTRACT
Larval zebrafish achieve neutral buoyancy by swimming up to the surface and taking in air through their mouths to inflate their swim bladders. We define this behavior as ‘surfacing’. Little is known about the sensory basis for this underappreciated behavior of larval fish. A strong candidate is the mechanosensory lateral line, a hair cell-based sensory system that detects hydrodynamic information from sources such as water currents, predators, prey and surface waves. However, a role for the lateral line in mediating initial inflation of the swim bladder has not been reported. To explore the connection between the lateral line and surfacing, we used a genetic mutant (lhfpl5b−/−) that renders the zebrafish lateral line insensitive to mechanical stimuli. We observed that approximately half of these lateral line mutants over-inflate their swim bladders during initial inflation and become positively buoyant. Thus, we hypothesized that larval zebrafish use their lateral line to moderate interactions with the air–water interface during surfacing to regulate swim bladder inflation. To test the hypothesis that lateral line defects are responsible for swim bladder over-inflation, we showed that exogenous air is required for the hyperinflation phenotype and transgenic rescue of hair cell function restores normal inflation. We also found that chemical ablation of anterior lateral line hair cells in wild-type larvae causes hyperinflation. Furthermore, we show that manipulation of lateral line sensory information results in abnormal inflation. Finally, we report spatial and temporal differences in the surfacing behavior between wild-type and lateral line mutant larvae. In summary, we propose a novel sensory basis for achieving neutral buoyancy where larval zebrafish use their lateral line to sense the air–water interface and regulate initial swim bladder inflation.
Student experiences of simulation-based learning and its impact on their performance in objective structured clinical examination in Pediatrics - A mixed method study
Authors: Saeed Sana , Afzal Azam , Khalid Farah , Jehan Fyezah 
Published: May 2023

Objective: This study aims to assess the effectiveness of integrating simulation for teaching pediatric clinical examination skills to undergraduate, MBBS Year-IV medical students at The Aga Khan University, Karachi, Pakistan.
Methods: In this mixed method study, the Objective Structured Clinical Examination (OSCE) scores of the students who were taught using simulation (batch 2017-2018) were compared with the batch of the academic year 2016-2017 (taught via traditional methods). In order to explore the experiences of the intervention group, a questionnaire with four open-ended questions was administered at the end of the clerkship.
Results: Students who were taught by simulation, scored significantly higher on the clinical skills stations in Objective Structured Clinical Examination, than in the pre-intervention group (p-value <0.01). The students quoted safety of the learning environment, opportunities for deliberate practice, debriefing and facilitation skills maximized quoted that their experience of learning through simulation, however, some challenges were identified for future improvement.
Conclusion: The result of the study suggested simulation as a useful instructional strategy for teaching examination skills to students in their early years. The student gained confidence through deliberate practice and feedback without compromising patient safety, which translated into improved performance in the high-stakes OSCE examination at the end of the clerkship.
doi: https://doi.org/10.12669/pjms.39.4.7287
How to cite this: Saeed S, Afzal A, Khalid F, Jehan F. Student experiences of simulation-based learning and its impact on their performance in objective structured clinical examination in Pediatrics - A mixed method study. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7287
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Accident severity prediction modeling for road safety using random forest algorithm: an analysis of Indian highways
Authors: Khanum Humera , Garg Anshul , Faheem Mir Iqbal 
Published: May 2023

Background: Road accidents claim around 1.35 million lives annually, with countries like India facing a significant impact. In 2019, India reported 449,002 road accidents, causing 151,113 deaths and 451,361 injuries. Accident severity modeling helps understand contributing factors and develop preventive strategies. AI models, such as random forest, offer adaptability and higher predictive accuracy compared to traditional statistical models. This study aims to develop a predictive model for traffic accident severity on Indian highways using the random forest algorithm. Methods: A multi-step methodology was employed, involving data collection and preparation, feature selection, training a random forest model, tuning parameters, and evaluating the model using accuracy and F1 score. Data sources included MoRTH and NHAI. Results: The classification model had hyperparameters ’max depth’: 10, ’max features’: ’sqrt’, and ’n estimators’: 100. The model achieved an overall accuracy of 67% and a weighted average F1-score of 0.64 on the training set, with a macro average F1-score of 0.53. Using grid search, a random forest Classifier was fitted with optimal parameters, resulting in 41.47% accuracy on test data. Conclusions: The random forest classifier model predicted traffic accident severity with 67% accuracy on the training set and 41.47% on the test set, suggesting possible bias or imbalance in the dataset. No clear patterns were found between the day of the week and accident occurrence or severity. Performance can be improved by addressing dataset imbalance and refining model hyperparameters. The model often underestimated accident severity, highlighting the influence of external factors. Adopting a sophisticated data recording system in line with MoRTH and IRC guidelines and integrating machine learning techniques can enhance road safety modeling, decision-making, and accident prevention efforts.
Large Ranking Games with Diffusion Control
Authors: Ankirchner Stefan , Kazi-Tani Nabil , Wendt Julian , Zhou Chao 
Published: May 2023

We consider a symmetric stochastic differential game where each player can control the diffusion intensity of an individual dynamic state process, and the players whose states at a deterministic finite time horizon are among the best [Formula: see text] of all states receive a fixed prize. Within the mean field limit version of the game, we compute an explicit equilibrium, a threshold strategy that consists of choosing the maximal fluctuation intensity when the state is below a given threshold and the minimal intensity otherwise. We show that for large n, the symmetric n-tuple of the threshold strategy provides an approximate Nash equilibrium of the n-player game. We also derive the rate at which the approximate equilibrium reward and the best-response reward converge to each other, as the number of players n tends to infinity. Finally, we compare the approximate equilibrium for large games with the equilibrium of the two-player case. Funding: Support from the Deutsche Forschungsgemeinschaft [Grant AN 1024/5-1] is acknowledged. The research of N. Kazi-Tani is supported by the Agence Nationale de la Recherche [Grant ANR-21-CE46-0002-03]. The research of C. Zhou is supported by the National Natural Science Foundation of China [Grant 11871364], the Singapore Ministry of Education [Grants A-8000453-00-00, A-0004273-00-00 and A-0004277-00-00] and the MERLION 2020 award [Grant A-0004589-00-00].
The changing epidemiology of radial head replacement over a 22-year period in Scotland
Authors: Stirling PHC , Malhas A , Rymaszewski LA , Paton M , McEachan JE , Jenkins PJ 
Published: May 2023

Background Radial head replacement is used to confer joint stability in the management of acute unstable elbow fractures and dislocations associated with instability. We determined the annual incidence of radial head replacement over a 22-year period in a defined population. Materials and methods Hospital episode statistics were collected prospectively at a national level. This database was retrospectively examined to determine the annual incidence of radial head replacement over the study period in adults over 16 years of age. Results A total of 615 radial head replacements were performed over the 22 years studied. The overall incidence was 0.65/100,000/year (95% confidence interval, CI, 0.50–0.71). The average adult population during the period was 4,270,593. There was a steady and statistically significant increase in the incidence of radial head replacement over the study period (r 2  = 0.816; p < 0.0001). This incidence was significantly greater in women than men (odds ratio 1.46, 95% CI 1.25–1.72; p < 0.001). The peak incidence in men was 0.87/100,000 population/year in the fifth decade of life while in women the peak incidence was in the seventh decade of life (1.38/100,000 population/year). Conclusion The incidence of radial head replacement has increased steadily over 22 years. We hypothesise that this represents an evolving understanding of the role of radial head replacement in acute trauma in the context of emerging literature during the study period.
Forklift-related lower limb injuries: a retrospective case series study with patient-reported outcome measures (PROMs)
Authors: Bage T , Ibrahim M , Baden J , Filobbos G 
Published: May 2023

Aim Forklift trucks can cause serious lower limb trauma with long-lasting sequelae to patients. The aim of this study was to analyse a case series of patients with forklift-related injuries over 7 years at a level 1 major trauma centre in the UK and present their patient-reported outcome measures (PROMs) with long-term follow-up. To the best of the authors' knowledge, this is the largest case series study in the UK describing forklift injuries. Methods Retrospective case note analysis of 19 patients over 7 years. Data including demographics, injury mechanism, pattern of injury, management, length of hospital stay, number of operations and complications were extracted from the notes. We used ‘Enneking score’ as a validated tool for PROMs. Results Seventeen men and two women with mean age of 47 years; 20% had bilateral injuries and 34% had multi-level fractures. The mean number of theatre sessions was 5.21, while the mean length of hospital stay was 30.10 days. There was one mortality. Twelve patients (63%) required reconstruction with free tissue transfer, with one flap failure. The mean long-term Enneking percentage score was 57.33%. The mean Enneking score for patients in this study is lower than our institute’s score for Gustilo 3B, highlighting the gravity of these injuries. Conclusion Forklifts can cause grave injuries with massive energy transfer. This study highlights the seriousness of those injuries, thus guiding patient counselling and optimising planning of management.