bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of insulinoma presenting with deep vein thrombosis, successfully treated with minimally invasive procedures including microwave ablation
Authors: Jayawickreme Kushalee Poornima , Muthukuda Dimuthu T , Kariyawasam Chithranga , Piyarisi Lalitha , Abeywickrama Buddhi A 
Published: May 2022

Summary
Treatment of insulinoma can be challenging, while surgical resection is considered the first line. When surgery is contraindicated or is refused, minimally invasive procedures such as selective arterial embolization, local ablative techniques including alcohol ablation, radiofrequency ablation and microwave ablation are being used of late. The world’s first microwave ablation of insulinoma was performed in 2015, after which there have been only a handful of reported cases. A 78-year-old female presented with painful swelling of the left lower limb. She was drowsy and was previously misdiagnosed as epilepsy when she had similar episodes since 2 years ago. She had hypoglycaemia with high serum insulin and C-peptide, and mildly high adjusted calcium, serum prolactin. MRI did not show pituitary adenoma. Lower limb venous duplex scan showed left lower limb deep vein thrombosis for which she was treated with anticoagulation. CT of the abdomen showed a tumour measuring 1.8 cm, located in the antero-superior aspect of the body of the pancreas, with the superior surface being abutted by the splenic artery and the inferior surface being 3 mm above the pancreatic duct, suggestive of an insulinoma. Selective transcatheter arterial embolization of the pancreatic tumour was attempted but was abandoned due to multiple small feeding arteries. Microwave ablation of the tumour was performed successfully. Since there was a possibility of the ablation being compromised due to the heat sink at the splenic artery, 2 mL of 99% alcohol was injected into the rim of the tumour near the artery. She was subsequently normoglycaemic. She defaulted follow up for repeat imaging of pancreas and screening for MEN1 syndrome due to the impact of the COVID-19 pandemic. Minimally invasive procedures are preferred over surgery in selected patients with insulinoma, out of which microwave ablation could be preferentially recommended due to its efficacy and minimal complications. We report the first case of MWA performed in combination with AA in successfully treating insulinoma to our knowledge. This is also the first reported case of DVT associated with isolated insulinoma prior to intervention, though it is rarely reported in MEN1 syndrome.

Learning points

Novel therapeutic minimally invasive procedures are successful in treating selected cases of insulinoma.

Microwave ablation could be recommended preferentially over selective trans-arterial embolization, and radiofrequency ablation in treating insulinoma due to its efficacy and minimal complications.

We report the first case of microwave ablation performed in combination with alcohol ablation in successfully treating insulinoma to our knowledge.
Adrenal gland haemorrhages following motor vehicle accident with resultant adrenal insufficiency
Authors: Szwarcbard Naomi , Davis Anna , Bach Leon A , Hackman Kathryn 
Published: May 2022

Summary
Adrenal gland haemorrhage is an uncommon, yet likely under-diagnosed complication of high-impact trauma, such as motor vehicle accidents (MVA). It usually occurs with multi-trauma and is associated with additional injuries to the ribs, liver, kidney, spleen and vertebrae. Trauma cases with resultant adrenal gland injury have higher mortality rates. Primary adrenal insufficiency as a result of bilateral adrenal haemorrhage is potentially fatal. We report three cases of life-threatening adrenal insufficiency following adrenal injuries sustained in MVA’s. Case 1 was a 60-year-old-male who presented with acute haemodynamic instability on admission. Case 2 was an 88-year-old female on anticoagulation for atrial fibrillation, who developed haemodynamic instability 10 days into her admission. Case 3 was a 46-year-old male who developed hyponatraemia 2 weeks post-MVA. All were commenced on stress dose hydrocortisone replacement with improvement in clinical status. Only case 1 has had complete adrenal axis recovery, whereas the other patients remain on maintenance hydrocortisone replacement. Our cases demonstrate acute and subacute presentations of adrenal insufficiency following traumatic bilateral adrenal haemorrhages and highlight the importance of assessing adrenal morphology and function in any trauma patient with haemodynamic instability or hyponatraemia.

Learning points

Adrenal gland haemorrhage is an under-diagnosed consequence of high-impact trauma.

Trauma patients with adrenal haemorrhage have a significantly increased mortality risk.

Bilateral adrenal gland haemorrhage can result in life-threatening adrenal insufficiency requiring urgent glucocorticoid replacement.

Biochemical assessment of the adrenocortical axis should be considered in all patients presenting with high-impact trauma following motor vehicle accidents.

Given the potential for delayed presentation, any patients with new haemodynamic instability should have repeat biochemistry and/or imaging performed, even if initial adrenal imaging and investigations were normal.
Residents’ Perspective on Need for Point-of-Care Ultrasound Education During Pediatric Residency
Authors: Meggitt Austin , Way David P. , Iyer Maya S. , Mahan John D. , Gold Delia 
Published: May 2022

OBJECTIVES
Many medical disciplines incorporate point-of-care ultrasound (POCUS) into their practice. Despite well-defined applications, POCUS has not been widely adopted in pediatrics and is not commonly taught during residency. Our objective was to profile the current state of POCUS education in pediatric residency training from the resident perspective.

METHODS
We surveyed pediatric trainees about their POCUS education, general opinions about POCUS, and perceived barriers to POCUS training in residency. We distributed the survey to a random sample of Ohio pediatric residents, stratified by program size and training level. Descriptive statistics were used to characterize responses.

RESULTS
We sampled 66.4% of the population (371 of 559) of Ohio pediatric residents and achieved a response rate of 59.3%. Only 15% of respondents received POCUS training during residency, with 85% having never performed a POCUS scan. Most (86%) desired POCUS education and 67% believed it should be required during residency. Residents felt that POCUS would be useful for procedural guidance (95%), clinical diagnosis (94%), and patient safety (74%). Most residents (61%) believed POCUS education would benefit their careers, particularly those planning on subspecialization. Barriers to POCUS education included lack of an established curriculum (75%), competing educational priorities (58%), and a shortage of qualified instructors (52%).

CONCLUSIONS
Although Ohio pediatric residents do not receive formal POCUS education in residency, they desire such training and believe it would benefit their future practice. Consensus on scope of practice, development of a standardized curriculum, and increased faculty training in POCUS may help address this educational gap.
Perceived Servant Leadership Style of Principals Correlates with Job Satisfaction of Secondary School Teachers in Pakistan
Authors: Ahmad Saghir , Batool Ayesha , Abdullah Dr. Nauman Ahmed 
Published: May 2022

Servant leadership is a type of leadership that encourages people to work together. A leader intends to help the institution’s personnel favorably. The school leader interacts with teachers and administrative staff as a collegial friend rather than a boss and tries to make things as easy as possible for them. The major goal of this study was to see if there was a correlation between servant leadership and job satisfaction among secondary school teachers in Pakistani settings. The study’s participants were male and female public sector secondary school teachers from the districts of Lahore and Kasur, of Punjab province, Pakistan. The sample was chosen using a stratified random sampling technique. A total of 510 teachers participated in the study as a sample. In this study, adapted questionnaires with responses measured on a five-point Likert type scale was used. Both variables, perceived servant leadership style of principals and work satisfaction of teachers showed a strong association. Further sub-factors correlations showed significant results. It is proposed that school principals adopt servant leadership style as it would be more beneficial for them to ease and comfort the school employees that might improve the institutional performance.
Gendered Labor Market (dis)advantages in Nordic Welfare States. Introduction to the Theme of the Special Issue
Authors: Mustosmäki Armi , Reisel Liza , Sihto Tiina , Teigen Mari 
Published: May 2022

Gender equality has been named as one of the normative foundations of Nordic wel- fare states. This is reflected in how, year after year, Nordic states rank among the most gender egalitarian countries in the world (see, e.g., World Economic Forum 2020). In Nordic countries, the state has been, and continues to be, a central actor in shaping women’s citizenship, labor market opportunities, and caring roles. Especially publicly funded welfare services and policies that facilitate the reconciliation of work and care have played a major part in advancing women’s labor market participation (see, e.g., Bergquist et al. 1999; Borchorst & Siim 2002; Ellingsæter & Leira 2006; Siim & Stoltz 2015). The institutional framework of Nordic welfare state policies has been central to what has been called the ‘social democratic public service route’ (Walby 2004).One of the important building blocks of gender equality has been the aim of making policies in Nordic countries ‘women-friendly’. More than 30 years ago, Helga Hernes (1987) identified the Nordic countries as ‘potentially women-friendly societies’. She char- acterized women-friendly societies as those that ‘would not force harder choices on women than on men’ (ibid., 15), particularly in relation to work and care. Hernes also envisaged that woman-friendliness should be achieved without increasing other forms of inequality, such as class or ethnicity-based inequalities among different groups of women.However, achieving gender equality in working life and the sort of womenfriendliness that Hernes envisaged at the societal level has in many ways also proved to be challenging, as the ties between the state and gender equality goals are more complex than what they might seem at first glance. Gender disparities have proven persistent also within the Nordic context. When we issued a call for this special issue, we were inter- ested in various forms of gendered labor market (dis)advantage in Nordic countries. Furthermore, we asked how gender segregation, welfare state policies, labor market policies, and various labor market actors interact to produce, maintain, challenge, or change gender equality in the labor market in the Nordic countries and beyond. The five articles presented in this special issue address the issue of gendered labor market (dis)advantages in Nordic countries from several vantage points, focusing on both on ‘traditional’ questions, such as corporate power and sustainable employment, and ‘emerging’ questions such as intersectionality, gender culture, and aesthetic work.
Assessment of functional literacy of students in computer science based on the criteria-based approach
Authors: Yesengazyevna Sagimbayeva Ainur , Sailaugul Avdarsol , Meruert Yerekesheva , Mynturganovna Baiganova Altynzer , Daurenbekov Kuanysh 
Published: May 2022

Everyone uses a traditional five-point grading system to assess students' activities, however, it is not always possible to objectively evaluate students’ work using this method. Therefore, the authors use the criteria-based student assessment system in our lessons. The purpose of this article was to compile a model of a system for assessing students' functional literacy based on a criteria-based approach. An experiment was conducted on 32 people and data was collected using observation and interviews. As a result of the study, it was revealed that the assessment system makes it possible to determine how successfully one or another educational material is mastered, or a certain practical skill is formed. Based on the conducted practical experiment, the effectiveness of the content-structural model of the system for assessing the functional literacy of students based on the criteria-based approach in computer science has been proved.
Keywords: Criteria-based assessment; computer literacy; integrated information; self-assessment procedures.
A training programme on constructive thinking skills for reducing psychological defeatism and attitude towards intellectual extremism of university students
Authors: Abdellatif Mohamed Sayed 
Published: May 2022

The purpose of the present study is to investigate the effectiveness of a training programme on constructive thinking skills in reducing the psychological defeatism level and attitude towards intellectual extremism among university students and to examine the continuity of its effectiveness after the follow-up period. A quasi-experimental research design with one training and one control group and three measurements (pre, post and follow-up) was used. Twenty students participated in the research with 12 in the experimental group and 8 in the control group. The training programme on constructive thinking skills was applied to the experimental group over a period of 16 sessions. No application was conducted on the control group. The psychological defeatism scale, the attitude towards intellectual extremism scale and the constructive thinking scale were applied to the participants. Data were analysed by Mann–Whitney and Wilcoxon tests. The findings of this research indicated that the training programme on constructive thinking skills has caused a significant decrease in the experimental group's psychological defeatism and attitude towards intellectual extremism levels. Besides, there were no significant differences between the mean scores of the experimental group in the post and follow-up measurements of the psychological defeatism and the attitude towards intellectual extremism a month later. Research findings were discussed within the context of the related literature and some suggestions were provided for researchers and stakeholders.
Keywords: Attitude towards intellectual extremism, constructive thinking skills, psychological defeatism, university students.
The effectiveness of a realistic counselling programme to develop taking-responsibility among hearing-impaired students
Authors: Alremawi Sameer Abdulkareem Ahmad 
Published: May 2022

This study aimed at identifying the effectiveness of a realistic counselling programme for developing taking responsibility among a sample of hearing-impaired students. The sample consisted of 26 hearing-impaired students. To verify the effectiveness of the programme, the participants were randomised equally into two groups: the experimental group 13 male and female students who underwent the realistic programme and 13 students within the control group who were not subjected to the counselling programme. The researchers developed a valid and reliable scale to measure taking responsibility to achieve the purposes of this study. The findings indicated that the level of taking responsibility for the hearing-impaired students expected to graduate from the Jordanian universities was moderate, and there were significant differences between the post-test performance mean scores of the participants in the experimental and control groups in taking responsibility in favour of the experimental group due to the counselling programme.

Keywords: Counselling programme, hearing impaired, realistic therapy, taking responsibility, Jordan.
Mind skills training effect on prospective counsellor’ performance
Authors: Hidayah Nur , Ramli M. , Fauzan Lutfi , Rahman Diniy Hidayatur , Hanafi Husni 
Published: May 2022

Counselling practicum is essential to hone the skills and competencies needed. One competency to be had by the prospective counsellors is mind skills, which are metacognition skills to manage their thoughts to give adaptive responses and performance. This study aims to identify the effect of mind skills training on prospective counsellors’ performance. This study used a correlation research design to measure 50 prospective counsellors’ performance. The data result showed the variance of the mind skills and counselling performance scores. The Pearson analysis results showed significant correlations. Linear regression analysis showed that the mind skills had an effect and contributed to 12.5% of the prospective counsellors’ performance. The results showed that the mind skills (rules, perceptions, self-talk, visual images, explanation and expectations) had their role and function in leading counsellors on their best performance. The implication of these results for prospective counsellors’ education could include the mind skills training on the practicum course.

Keywords: counselor education; counseling performance; counseling practicum; metacognitions; mind skills;
Obstacles in using the E-learning strategy in teaching high school courses (Tawjihi class) from the point of view of educational supervisors in Al-Balqa governorate
Authors: Alsaaideh Maha Hamed 
Published: May 2022

This study aimed to reveal the obstacles in the use of e-learning strategies in the teaching of high secondary school courses from the point of view of educational supervisors, and its relationship to the variables years of experience and training courses (ICDL, INTEL & ICDL). The study sample consisted of (64) supervisors who work in the directorates of education in Al-Balqa governorate. To collect data, the study tool (the questionnaire) was applied electronically to all of them. The results of the study showed that the obstacles to using the e-learning strategy in teaching high school courses from the educational supervisors’ point of view came to a high degree, while at the level of the scale domains they came in succession as follows in the first order: Related to the administrative, financial and infrastructure aspect of the school environment, then the obstacles related to the educational content of the high school course, followed by the obstacles related to high school students, finally the obstacles related to high school teachers. And there were statistically significant differences in the obstacles related to the administrative, financial and infrastructure aspects of the school environment, and the differences in favor of the group of less than five years. The study recommended equipping school environments with the requirements of e-learning and providing support from various societal bodies to enhance and improve e-learning for students and teachers in government schools.
Keywords: Obstacles; e-learning strategy; high school class; educational supervisors.
Influence of High-Temperature Treatment on Strength and Failure Behaviors of a Quartz-Rich Sandstone under True Triaxial Condition
Authors: Li Xiaoshuang , Peng Jun , Xie Yulin , Li Qihang , Zhou Tao , Wang Jiawen , Zheng Wenbo 
Published: May 2022

Abstract
In this paper, the effect of high temperature on the mechanical properties of quartz-rich sandstone was studied by true triaxial pressure experiment. The density, P-wave velocity, elastic modulus, peak stress, peak strain, and failure mode of quartz-rich sandstone before and after heat treatment were analyzed and compared. It was found that the color of quartz-rich sandstone changes greatly when heated to 500°C. In detail, the brittleness of quartz-rich sandstone gradually decreased and the ductility increased at high temperature. Although the density, P-wave velocity, and elastic modulus fluctuate, they showed a decreasing trend as a whole. In addition, the peak stress and peak strain showed an overall upward trend with the increase of temperature, and 500°C was the high-temperature failure threshold of quartz-rich sandstone. The failure mode of quartz-rich sandstone at high temperature changes from shear failure to shear-tension combined failure, and the number of cracks increases. Therefore, these research results can provide a certain reference for high-temperature underground operation.
Low-grade fibromyxoid sarcoma rapidly arising from the chest wall that was difficult to distinguish from lung tumours: A case report
Authors: Narukami Eri , Yamamoto Marino , Okada Hironobu , Miyazaki Ryohei , Bunno Yujiro , Iguchi Mitsuko , Anayama Takashi 
Published: May 2022

Abstract
Background: Low-grade fibromyxoid sarcoma (LGFMS) is a rare mesenchymal tumour, predominantly arising in the limbs and trunks of young adults.　This tumour rarely arises in the chest cavity.Case presentation: An 84-year-old Japanese woman visited our hospital because of a right intrathoracic mass that was discovered on routine chest radiography. Based on computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography findings, primary lung cancer with chest wall invasion was suspected. Chest CT performed 3 years prior did not reveal any abnormalities. CT-guided needle biopsy did not provide a definitive diagnosis. During the operation, the mass was detected in the right lower lobe of the lung and suspected to have invaded the chest wall directly at the sixth–eighth ribs. Right lower lobectomy and combined resection of the ribs were performed. Microscopically, it was a low-grade spindle cell tumour arising from the pleura and demonstrating focal invasion of the lung. Immunohistochemically, the tumour was positive for MUC4, negative for CD34 and β-catenin, and finally diagnosed as LGFMS. The patient has been well for 5 months after surgery.Conclusions: LGFMS may be histomorphologically diagnosed as a low-grade tumour by needle biopsy; however, in the current case, it was clinically highly malignant because of the appearance of an 8-cm mass over 3 years. Therefore, postoperative, long-term regular medical imaging is recommended, considering the highly malignant nature of the tumour and high risk of local recurrence and pulmonary metastasis.
A continuously tunable and filter-less QPSK modulated millimeter-wave signal generation with frequency quadrupling just based on an MZM
Authors: Wang Dongfei , Li Zichen , Ding Haiyang 
Published: May 2022

Abstract
In this paper, we propose a new frequency quadrupling scheme to generate quadrature phase shift keying (QPSK) modulated vector millimeter-wave signal, in which optical filter is needless. To eliminate constellation overlapping of the generated vector millimeter-wave signal caused by phase multiplication in the process of frequency multiplication, precoding assisted technique is adopted. The principle and feasibility of the proposed scheme is deduced by detailed mathematical formula. Simulations are done to generate 40 GHz QPSK modulated vector millimeter-wave signals using a 10 GHz radio frequency source and the BER performance is analyzed in detail. The results show that BER of the generated 5/10-Gbaud/s vector millimeter-wave signal is below 3.8 x 10-3, when the input optical power for into photo-detector is higher than -20.67dBm.