bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge on cervical cancer, human papilloma virus and vaccine, and attitudes towards immunisation following the introduction of vaccine to the National Immunisation Programme, Sri Lanka
Authors: Gunasekera K. , Batuwanthudawa R. , Senaratne C. 
Published: June 2022

Background: The human papilloma virus (HPV) vaccine was introduced to the National Immunisation Programme of Sri Lanka in 2017. Although the vaccination uptake increased initially, there is no published data on the continued uptake of the vaccine. Uptake of the HPV vaccine in countries that were initially high have declined. Factors for low compliance could be poor knowledge and/or attitudes.
Objectives: The aim of this study was to ascertain knowledge of cervical cancer, HPV and its vaccine, and the attitudes towards HPV immunisation in this post-vaccination era, as well as to identify areas that need strengthening.
Methods: A cross-sectional, pre-tested questionnaire based survey of 1716 individuals over 18 years of age, from six districts in Sri Lanka, was conducted in 2019. Ethical approval was granted by the Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura.
SPSS statistical software was used for the analysis. A cut off of 50% was considered as a satisfactory level for knowledge and attitude. The Univariate Chi square analysis was used for associations between categorical variables. Odds ratios, with 95% confidence intervals determined the size of the effect of these factors on knowledge and attitudes of the participants.
Results: Satisfactory knowledge (50% cut off) of cervical cancer, HPV and of vaccine was detected only in 54%, 20% and 19% participants respectively. Ninety-seven percent of those who were aware of the HPV vaccine (455/471) and 89% (1527/1716) of all participants were in favour of giving the vaccine to their daughters. Factors significantly affecting overall knowledge (all three domains) were age 30-65 years (OR 2.0; 95% CI 1.1,3.3), knowing a patient with cancer (OR 2.0; 95% CI 1.5,2.7) and undergoing cervical screening (OR 3.3; 95% CI 2.3,4.7). Good knowledge of vaccine was significantly associated (OR 4.3; 95% CI 1.3,15.1) with a favourable attitude towards vaccination.
Conclusions: Despite overall poor knowledge, a favourable attitude was seen among the majority (89%) of respondents towards HPV vaccination.
Measles disease outbreak and genotype identification in Libya, 2018
Authors: Alkoshi Salem 
Published: June 2022

Background: There is no data published related to measles outbreaks in Libya. The study aims to report a descriptive analysis of measles outbreaks that occurred in 2018.
Methods: Retrospective data of measles outbreaks in 2018 were analysed to describe the characteristics of the outbreaks and their incidence in Libya. Data aggregations of seven outbreaks were extracted during the period January to December 2018 from the National Measles Surveillance Programme which is the official institute responsible for measles surveillance in the country. Data were categorised as confirmed measles cases, district distribution, deaths, age distribution, sex ratio, monthly trends, and measles vaccination status in the outbreaks. Also, the measles virus genotype was identified and compared with the reference strain.
Results: A total of 934 confirmed measles cases were detected in seven outbreaks in different locations of the country in 2018. The biggest outbreak was found in Zliten (449 measles cases, 48.0%) followed by Benghazi (374 measles cases, 40.0%). The majority were below 15 years (811 measles cases, 87.0%). The incidence rate of cases was 223/million population. The peak of occurrence began in June 2018 and continued to December. Children with measles who had completed two doses of vaccines were 18.0%, whilst 62.0% were unvaccinated. The genotype sequence was identified in three outbreaks being B3.
Conclusion: A significant measles incidence was detected in many outbreaks mainly in the age group below 15 years. The immunity building programme must be evaluated to address the weakness of routine immunisation.
Evaluation of sample pooling method for SARS CoV-2 RNA detection; a laboratory based simulated study
Authors: Wijesuriya P. A. S. L. , Muthugala M. A. R. V. , Herath H. M. T. U. 
Published: June 2022

Real time RT-PCR is considered as the gold standard test to detect COVID-19. The use of sample pooling strategy increases testing capacity and spares resources. However, the effectiveness of sample pooling should be evaluated in the setting before being implemented. Forty five samples including 20 high positives (Ct<20), 20 low positives (Ct 20-40) and 05 negative samples were used to prepare 1:1, 1:3 and 1:5 simulated sample pools which were then subjected to viral RNA extraction followed by real time RT-PCR. Sensitivity and specificity of sample pooling technique in the detection of SARS-CoV-2 RNA was 100% without significant variation of Ct values. According to our results, pooling of up to 6 samples will not have an effect on the final result in clinical samples and hence can be adopted in the given context for the diagnosis of COVID-19 by RT-PCR.
Health Technology Assessment in technological innovation processes; implementation of a management model for hospital technological governance at the Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo in Alessandria
Authors: Bolgeo Tatiana , Bertolotti Marinella , Maconi Antonio 
Published: June 2022

Objectives. Definition of a hospital-based technology governance model (hospital-based Health Technology Assessment (HTA)), involving health professionals at different organizational levels; applying HTA as a rational support tool at corporate organizational level for decisions concerning acquisitions, disposal, monitoring of technologies; implementation of the HTA methodology to create an organizational context favorable to the transfer of scientific evidence in clinical practice and managerial decision-making processes.
Methods. At the end of 2014, the AO Hospital of Alessandria established a Technology Assessment Unit to analyze the requests for the supply of medical and non-medical equipment, involved in healthcare pathway processes. A training course has started, aimed at creating specific skills, to support the clinician requesting the adoption of a new technology.
Results. Over the last 5 years, testing the form deployment has concerned: 56 requests examined by NVT; 226 cases concerning gathering information using the forms; 24 IT instances managed by ICT; 62 requests examined through facilitator support.
Conclusions: To implement at micro level, the HTA methodology within the clinical-organizational structure governance, including decisions concerning clinical practice protocols, auditing and quality monitoring of healthcare performance.
Similar Concussion Rates in Spring Football and Preseason: Findings From the Concussion Assessment, Research and Education Consortium
Authors: Broglio Steven P. , Perkins Susan M. , Riggen Larry , Stemper Brian D. , Shah Alok , McAllister Thomas W. , McCrea Michael ,   CARE Consortium Investigators
Published: June 2022

Context
Increasing attention has been directed toward identifying aspects of football participation for targeted policy change that reduces the concussion risk. Prior researchers evaluated concussion risks during the preseason and regular seasons, leaving the spring season largely unexplored.

Design
In this nationally representative observational investigation of 19 National Collegiate Athletic Association Division I collegiate football programs, we assessed concussion rates and head impact exposures during the preseason, regular season, and spring practices from 2014 to 2019. All participating programs recorded the incidence of concussions, and a subset (n = 6) also measured head impact exposures.

Results
Analyses by time of year and session type indicated that concussion rates and head impact exposures during all practice sessions and contact practices were higher in the spring and preseason than those in the regular season (P &lt; .05). Concussion rates during the spring season and preseason were statistically similar.

Conclusions
We identified comparable concussion risks in the spring season and preseason, highlighting the need for targeted policy interventions to protect athlete health and safety.
The application of sigma metrics in the laboratory to assess quality control processes in South Africa
Authors: Van Heerden Marli , George Jaya A. , Khoza Siyabonga 
Published: June 2022

Background: Laboratories use quality control processes to monitor and evaluate analytical performance in terms of precision and bias. Sigma metrics provide an objective assessment of laboratory quality using the total allowable error as an additional parameter.Objective: This study aimed to determine the sigma metrics of analytes when using different total allowable error guidelines.Methods: A retrospective analysis was performed on 19 general chemistry analytes at Charlotte Maxeke Johannesburg Academic Hospital in South Africa between January 2017 and December 2017. Sigma metrics were calculated on two identical analysers, using internal quality control data and total allowable error guidelines from the Ricos biological variation database and three alternative sources (the Royal College of Pathologists of Australasia, the Clinical Laboratory Improvements Amendment, and the European Federation of Clinical Chemistry and Laboratory Medicine).Results: The sigma performance was similar on both analysers but varied based on the guideline used, with the Clinical Laboratory Improvements Amendment guidelines resulting in the best sigma metrics (53% of analytes on one analyser and 46% on the other had acceptable sigma metrics) and the Royal College of Pathologists of Australia guidelines being the most stringent (21% and 23%). Sodium and chloride performed poorly across all guidelines (sigma 3). There were also month-to-month variations that may result in acceptable sigma despite poor performance during certain months.Conclusion: The sigma varies greatly depending on the total allowable error, but could be a valuable tool to save time and decrease costs in high-volume laboratories. Sigma metrics calculations need to be standardised.
Mentor-learner web-based interprofessional collaborative distance learning
Authors: Avinash Bhagyalakshmi , Ali Irfan , Sahoo Rashmi Rekha , Hegde Vijaya , Nagpal Deepak , Mohammed Ciraj Ali , Jain Animesh , Kukkamalla Anand , Rai Sharada 
Published: June 2022

Introduction:
Web-based (Web) interprofessional collaborative distance learning is an important tool for enhancing the knowledge of learners. Foundation for Advancement of International Medical Education and Research (FAIMER) fellowship adopts mentor-learner (ML) based teaching-learning methodology wherein learners from various interprofessional fields collaborate for knowledge construction and problem-solving.

Materials and Methods:
This was an educational intervention study conducted as a part of the FAIMER fellowship. This study duration was 1 month. We offered a Web ML interprofessional collaborative distance-learning to cover the concepts of Questionnaire Designing for educational purposes to the fellows enrolled for the fellowship. The fellows were tutored via online/e-learning methods and activities. The fellows underwent assessment of their knowledge of the topic both before and after the course. Statistical analysis was performed and the mean of overall scores was obtained. The means were compared by two-tailed paired t-test.

Results:
Thirty four FAIMER fellows completed the entire module during the study period. The mean score for knowledge of the topic was significantly higher on the final assessment than on the initial assessment (P < 0.001).

Conclusion:
The use of, (ML-Web) interprofessional collaborative distance learning through a digital platform can promote teaching and learning in the educational field, increasing knowledge significantly.

The following core competencies are addressed in the article:
Practice-based learning and improvement, Medical knowledge, Interpersonal and communication skills.
Paternal depression
Authors: Dhillon Harpreet Singh , Sasidharan Shibu , Dhillon Gurpreet Kaur , Babitha M. 
Published: June 2022

ABSTRACT
Maternal mental health during and after pregnancy is a well researched entity. However, father's mental health during the same period and even while raising the children has not been given due consideration. Recent studies have tried to explore the prevalence, risk factors, symptoms and implications of paternal depression on the children, marriage and the whole family. In this short communication, we aim to bring to the fore the recommendations for prevention and management of paternal depression.
Estimation of Invitro Antifungal Activity of Ethanolic Crude Extract of Punicagranatum peel and Woodfordiafruticosa Leaves on Isolates of Candida Species
Authors: Bhavana Sujanamulk , Maloth Kotya N. , Koothati Ramesh K , Chintamaneni Rajalakshmi , Kumar K. Navadeepak , Anusha Nayanala Venkata 
Published: June 2022

Introduction:
The Candida species which are opportunistic fungi especially the species of C. albicans, C. glabrata, C. tropicalis have been causing oral candidiasis. Due to resistance of conventional antifungal agents, the scientists are in verge of exploring novel antifungal drugs such as traditional medicinal plants. Hence we aimed in studying the antifungal effect of Woodfordia fruiticosa and Punicagranatum which are plants of Lythraceae on Candida species.

Materials and Methods:
The ethanolic extracts of both the plants were prepared using soxhlet extraction method and the obtained metabolites were confirmed by Thin Layer Chromatography. The Paper discs were prepared by Whatman filter paper No. 1 The disc was moistened with 10 μL from the prepared stock solution. Were kept at 4°C for 3 hours for diffusion and incubated for 48 hours. Then the diameters of the circular inhibition zones were measured.

Results:
The obtained data was expressed as mean and standard deviation. Chloroform fraction of Woodfordia fruticosa showed superior antifungal effect when compared to Punicagranatum peel.

Conclusion:
The invitro antimicrobial activity of Woodfordia leaf depicted superior antifungal activity against Candida isolates with effective anticandidal effect when compared to Punica peel. In future both of these plants could serve as basis for the new anti-candidal agents.
Piloting of “Blended learning” - An Innovative Educational Intervention in Oral Medicine and Radiology
Authors: Naik Zameera , Kumar S Lokesh , Bagewadi Anjana S. , Keluskar Vaishali 
Published: June 2022

Context:
Various universities have set in a wave of adapting to the newer concepts of teaching–learning to keep pace with the millennial learners. Blended learning is a new teaching–learning method that combines online activity along with face-to-face activity. Flipped classroom approach is the use of Web-enabled strategies that free up class time to allow teachers to spend more time guiding their students.

Aim:
To assess the impact of flipped classroom approach on the teaching–learning outcomes of dental undergraduates.

Settings and Design:
A prospective comparative educational intervention was conducted in the Oral Medicine and Radiology department of a private dental college in Belagavi.

Methods and Materials:
Forty third-year undergraduates were equally allocated into the traditional learning group (20) and flipped classroom learning group (20). A pretest/posttest format was employed with mandatory feedback. For flipped classroom approach, an audio/video lecture of 10 minutes duration was shared through learning management software. The assessment was MCQs and case-based.

Statistical Analysis:
Mann–Whitney U and Wilcoxon matched-pairs tests were used for intergroup and intragroup comparisons, respectively.

Results:
The mean posttest score was significantly higher in flipped classroom method than in the traditional method (P = 0.0001). Performance on case-based questions was highly statistically significant in the flipped classroom group with a mean rank of 29.8 (P < 0.001). Intragroup comparison between the mean pretest and posttest scores in the flipped classroom showed a high statistical significance (P = 0.0001).

Conclusions:
Flipped classroom teaching should be recommended as it has the advantages of providing students with a pace of learning, peer learning, instant feedback, and using classroom time effectively. Faculty have to invest time, but nothing is greater than a meaningful teaching–learning experience.
Preoperative preparation and premedication of bariatric surgical patient
Authors: Varbanova Marina , Maggard Brittany , Lenhardt Rainer 
Published: June 2022

ABSTRACT
The prevalence of obesity has tripled worldwide over the past four decades. The United States has the highest rates of obesity, with 88% of the population being overweight and 36% obese. The UK has the sixth highest prevalence of obesity. The problem of obesity is not isolated to the developed world and has increasingly become an issue in the developing world as well. Obesity carries an increased risk of many serious diseases and health conditions, including type 2 diabetes, heart disease, stroke, sleep apnea, and certain cancers. Our ability to take care of this population safely throughout the perioperative period begins with a thorough and in-depth preoperative assessment and meticulous preparation. The preoperative assessment begins with being able to identify patients who suffer from obesity by using diagnostic criteria and, furthermore, being able to identify patients whose obesity is causing pathologic and physiologic changes. A detailed and thorough anesthesia assessment should be performed, and the anesthesia plan individualized and tailored to the specific patient's risk factors and comorbidities. The important components of the preoperative anesthesia assessment and patient preparation in the patient suffering from obesity include history and physical examination, airway assessment, medical comorbidities evaluation, functional status determination, risk assessment, preoperative testing, current weight loss medication, and review of any prior weight loss surgeries and their implications on the upcoming anesthetic. The preoperative evaluation of this population should occur with sufficient time before the planned operation to allow for modifications of the preoperative management without needing to delay surgery as the perioperative management of patients suffering from obesity presents significant practical and organizational challenges.
Comparison of ultrasound-guided residual gastric volume measurement between diabetic and non-diabetic patients scheduled for elective surgery under general anesthesia
Authors: Haramgatti Avinash , Sharma Sanjeev , Kumar Amit , Jilowa Sarita 
Published: June 2022

ABSTRACT

Background and Aims:
The presence of gastric content increases the risk of aspiration during general anesthesia. Diabetic patients have delayed gastric emptying; however, despite adequate fasting because of diabetic gastroparesis these patients have a high risk of aspiration. This study aimed to compare ultrasound-guided measurement of residual gastric volume between diabetic and non-diabetic patients scheduled for elective surgery under general anesthesia.

Methods:
This prospective observational study included 80 patients divided into two groups of 40 diabetic patients with a minimum of 8 years history of diabetes and 40 nondiabetic patients aged >18 years, American Society of Anesthesiologists’ physical status I–II kept with similar fasting intervals. Before induction of general anesthesia, gastric ultrasound was performed using standard gastric scanning protocol to measure craniocaudal (CC) and anteroposterior (AP) diameters followed by calculation of antral cross-sectional area (CSA) and gastric volume in semi-sitting (SS) and right lateral decubitus (RLD) position using curved array probe. The gastric antrum volume (GV) was classified as Grade 0, 1, or 2, and risk stratification for aspiration was done. The nasogastric tube was inserted after induction of anesthesia to aspirate and compare the gastric content.

Results:
In the semi-sitting position, the mean CC and AP diameters were 16.38 ± 3.31 mm and 10.1 ± 2.53 mm in the non-diabetic group and 25.19 ± 4.08 mm and 15.8 ± 3.51 mm in the diabetic group, respectively. In RLD, CC was 1.91 ± 0.38 cm and AP was 1.19 ± 0.34 cm in the non-diabetic group as compared to the CC of 2.78 ± 0.4 cm and AP of 1.81 ± 0.39 cm in the diabetic group. The calculated CSA of 318.23 ± 97.14 mm2 and 4 ± 1.1 cm2 in diabetic were significantly higher than 133.12 ± 58.56 mm2 and 1.83 ± 0.83 cm2 of non-diabetic, in SS (p < 0.0001) and RLD (p < 0.0001) positions, respectively. The GV of 15.48 ± 11.18 ml in the diabetic group was significantly higher than (-) 9.77 ± 18.56 ml in the non-diabetic group (p < 0.0001). Despite the differences in CSA and GV between diabetic and non-diabetic groups, both groups showed a low gastric residual volume (<1.5 ml/kg). The gastric tube aspirate in the non-diabetic and diabetic groups was 0.3 ± 0.78 ml and 1.24 ± 1.46 ml, respectively, and was statistically significant (p = 0.0006).

Conclusion:
Patients with long-standing diabetes showed higher gastric residual and antral CSA when compared with non-diabetic patients. The clinical significance of these findings needs further evidence for the formulation of specific guidelines for diabetic patients.
Perioperative Pain Management in Bariatric Anesthesia
Authors: Eipe Naveen , Budiansky Adele S. 
Published: June 2022

ABSTRACT
Weight loss (bariatric) surgery is the most commonly performed elective surgical procedure in patients with morbid obesity. In this review, we provide an evidence-based update on perioperative pain management in bariatric anesthesia. We mention some newer preoperative aspects—medical optimization, physical preparation, patient education, and psychosocial factors—that can all improve pain management. In the intraoperative period, with bariatric surgery being almost universally performed laparoscopically, we emphasize the use of non-opioid adjuvant infusions (ketamine, lidocaine, and dexmedetomidine) and suggest some novel regional anesthesia techniques to reduce pain, opioid requirements, and side effects. We discuss some postoperative strategies that additionally focus on patient safety and identify patients at risk of persistent pain and opioid use after bariatric surgery. This review suggests that the use of a structured, step-wise, severity-based, opioid-sparing multimodal analgesic protocol within an enhanced recovery after surgery (ERAS) framework can improve postoperative pain management. Overall, by incorporating all these aspects throughout the perioperative journey ensures improved patient safety and outcomes from pain management in bariatric anesthesia.