Miracle-dz/UniFAR-FTUs huggingface dataset:
Cephalometric predictors of future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate despite long-term use of facemask with miniplate

Objective To investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP). Methods The sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < –3°; Wits-appraisal < –5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed. Results In FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies. Conclusions Despite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.
Hand(y) hygiene insights: Applying three theoretical models to investigate hospital patients’ and visitors’ hand hygiene behavior

Background Improving hand hygiene in hospitals is the most efficient method to prevent healthcare-associated infections. The hand hygiene behavior of hospital patients and visitors is not well-researched, although they pose a risk for the transmission of pathogens. Therefore, the present study had three aims: (1) Finding a suitable theoretical model to explain patients’ and visitors’ hand hygiene practice; (2) Identifying important predictors for their hand hygiene behavior; and (3) Comparing the essential determinants of hand hygiene behavior between healthcare professionals from the literature to our non-professional sample. Methods In total N = 1,605 patients and visitors were surveyed on their hand hygiene practice in hospitals. The employed questionnaires were based on three theoretical models: a) the Theory of Planned Behavior (TPB); b) the Health Action Process Approach (HAPA); and c) the Theoretical Domains Framework (TDF). Structural equation modeling was used to analyze the data. To compare our results to the determinants of healthcare workers’ hand hygiene behavior, we searched for studies that used one of the three theoretical models. Results Among patients, 52% of the variance in the hand hygiene behavior was accounted for by the TDF domains, 44% by a modified HAPA model, and 40% by the TPB factors. Among visitors, these figures were 59%, 37%, and 55%, respectively. Two clusters of variables surfaced as being essential determinants of behavior: self-regulatory processes and social influence processes. The critical determinants for healthcare professionals’ hand hygiene reported in the literature were similar to the findings from our non-professional sample. Conclusions The TDF was identified as the most suitable model to explain patients’ and visitors’ hand hygiene practices. Patients and visitors should be included in existing behavior change intervention strategies. Newly planned interventions should focus on targeting self-regulatory and social influence processes to improve effectiveness.
Normative distribution of posterior circulation tissue time-to-maximum: Effects of anatomic variation, tracer kinetics, and implications for patient selection in posterior circulation ischemic stroke

The generalization of perfusion-based, anterior circulation large vessel occlusion selection criteria to posterior circulation stroke is not straightforward due to physiologic delay, which we posit produces physiologic prolongation of the posterior circulation perfusion time-to-maximum (Tmax). To assess normative Tmax distributions, patients undergoing CTA/CTP for suspected ischemic stroke between 1/2018-3/2019 were retrospectively identified. Subjects with any cerebrovascular stenoses, or with follow-up MRI or final clinical diagnosis of stroke were excluded. Posterior circulation anatomic variations were identified. CTP were processed in RAPID and segmented in a custom pipeline permitting manually-enforced arterial input function (AIF) and perfusion estimations constrained to pre-specified vascular territories. Seventy-one subjects (mean 64 ± 19 years) met inclusion. Median Tmax was significantly greater in the cerebellar hemispheres (right: 3.0 s, left: 2.9 s) and PCA territories (right: 2.9 s; left: 3.3 s) than in the anterior circulation (right: 2.4 s; left: 2.3 s, p < 0.001). Fetal PCA disposition eliminated ipsilateral PCA Tmax delays (p = 0.012). Median territorial Tmax was significantly lower with basilar versus any anterior circulation AIF for all vascular territories (p < 0.001). Significant baseline delays in posterior circulation Tmax are observed even without steno-occlusive disease and vary with anatomic variation and AIF selection. The potential for overestimation of at-risk volumes in the posterior circulation merits caution in future trials.
Variability in the assessment of children’s primary healthcare in 30 European countries

Abstract Background The high variability in the types and number of measures adopted to evaluate childcare across European countries makes it necessary to investigate country practices to identify trends in setting national priorities in the assessment of child well-being. Objective This paper intends to investigate country practices under the lens of variability to explore possible trends in setting national priority in the evaluation of childcare. In particular, it analyses variability considering to what extent this depends on the tendency of adopting a broad vision (i.e. selecting measures for a larger variety of aspects) or whether this is influenced by the choice of adopting an in-depth approach (i.e. using more measures to analyse a specific aspect) Methods An ad hoc questionnaire was administered to a national expert in each country and yielded 352 measures. To analyse variability, the breadth in the number of aspects considered was explored using a convergence index, while the depth in the distribution of measures in each aspect was investigated by computing a coefficient of variation. Countries were grouped by adopting a hierarchical clustering approach. Results There is a high variability across countries in the selection of measures that cover different aspects of childcare. Preferences in the distribution of measures are significant even at the domain level and in countries that use a limited number of measures and become more evident at the category and sub-category levels. The statistical analysis clusters countries in four main groups and two outliers. The in-depth distribution of measures focused on a specific aspect shows a homogeneous pattern, with the identification of two main groups of countries. Conclusions A limited set of measures are shared across countries hampering a robust comparison of paediatric models. The selection of measures shows that the evaluation is closely related to national priorities as resulting from the number and types of measures adopted. Moreover, a range of a reasonable number of measures can be hypothesized to address the quality of childcare under a multi-dimensional perspective.
Evaluating the social and ecological effectiveness of partially protected marine areas

Marine protected areas (MPAs) are a primary tool for the stewardship, conservation, and restoration of marine ecosystems, yet 69% of global MPAs are only partially protected (i.e., are open to some form of fishing). Although fully protected areas have well‐documented outcomes, including increased fish diversity and biomass, the effectiveness of partially protected areas is contested. Partially protected areas may provide benefits in some contexts and may be warranted for social reasons, yet social outcomes often depend on MPAs achieving their ecological goals to distinguish them from open areas and justify the cost of protection. We assessed the social perceptions and ecological effectiveness of 18 partially protected areas and 19 fully protected areas compared with 19 open areas along 7000 km of coast of southern Australia. We used mixed methods, gathering data via semistructured interviews, site surveys, and Reef Life (underwater visual census) surveys. We analyzed qualitative data in accordance with grounded theory and quantitative data with multivariate and univariate linear mixed‐effects models. We found no social or ecological benefits for partially protected areas relative to open areas in our study. Partially protected areas had no more fish, invertebrates, or algae than open areas; were poorly understood by coastal users; were not more attractive than open areas; and were not perceived to have better marine life than open areas. These findings provide an important counterpoint to some large‐scale meta‐analyses that conclude partially protected areas can be ecologically effective but that draw this conclusion based on narrower measures. We argue that partially protected areas act as red herrings in marine conservation because they create an illusion of protection and consume scarce conservation resources yet provide little or no social or ecological gain over open areas. Fully protected areas, by contrast, have more fish species and biomass and are well understood, supported, and valued by the public. They are perceived to have better marine life and be improving over time in keeping with actual ecological results. Conservation outcomes can be improved by upgrading partially protected areas to higher levels of protection including conversion to fully protected areas.
Matching action to need: an analysis of Global Burden of Disease 2017 and population health data to focus adolescent health policy and actions in Myanmar

ABSTRACT Background: Myanmar is a country undergoing rapid transitions in health. Its national strategic policy for young people’s health is being revised but there is a paucity of population data to inform local priorities and needs. Objective: In this paper we describe a comprehensive profile of adolescent health in Myanmar to focus policy and health actions. Methods: We used available primary data, and modelled estimates from the GBD 2017, to describe health outcomes (mortality and morbidity), health risks and determinants for adolescents in Myanmar between 1990–2017. A governance group of key stakeholders guided the framing of the study, interpretation of findings, and recommendations. Results: Overall health has improved for adolescents in Myanmar since 1990, however adolescent mortality remains high, particularly so for older adolescent males; all-cause mortality rate for 10–24 years was 70 per 100,000 for females and 149 per 100,000 for males (16,095 adolescent deaths in 2017). Overall, the dominant health problems were injuries for males and non-communicable disease for females in a context of ongoing burden of communicable and nutritional diseases for both sexes, and reproductive health needs for females. Health risks relating to undernutrition (thinness and anaemia) remain prevalent, with other health risks (overweight, binge alcohol use, and substance use) relatively low by global and regional standards but increasing. Gains have been made in social determinants such as adolescent fertility and modern contraception use; however, advances have been more limited in secondary education completion and engagement in employment and post education training. Conclusions: These results highlight the need to focus current efforts on addressing disease and mortality experienced by adolescents in Myanmar, with a specific focus on injury, mental health and non-communicable disease.
Sex Differences in Body Composition and Fitness Scores in Military Reserve Officers' Training Corps Cadets.

INTRODUCTION The cadets in the U.S. Army Reserve Officers' Training Corps (ROTC) consist of students from varied backgrounds. As part of collegiate ROTC programs, cadets must pass fitness tests and adhere to body composition standards in addition to completing their education. The previous fitness test of record was the Army Physical Fitness Test (APFT), but it was recently changed to the Army Combat Fitness Test (ACFT) to better test soldiers for combat capabilities. As part of the standardized scoring, the ACFT is no longer separated by sex or age as in the APFT, but rather by job duty. The purpose of this study was to characterize the modern ROTC cadet based on body composition measures and APFT and ACFT scores and then determine how those factors are related. MATERIALS AND METHODS We calculated body mass index (BMI), fat mass, fat-free mass (FFM), fat-free mass index (FFMI), and fat mass index (FMI) (n = 68, 42 males, 26 females). We used Pearson correlations to compare the scores to body composition assessments and Student's t-tests to determine if there were differences between sexes. We hypothesized that those with higher FFM and FFMI will have a higher passing rate on the ACFT and that males would perform better on the ACFT because of having more FFM. RESULTS We found that cadets, regardless of sex, were borderline overweight using BMI standards and that BMI did not correlate with any fitness tests. When comparing sexes, both males and females had high passing rates on the APFT, but females struggled to pass the ACFT mostly because of the leg tuck. We also found that ACFT scores were strongly correlated with FFM and FFMI, yet no body composition measures were correlated with APFT scores. CONCLUSIONS It is clear from our data that structured training programs and nutrition guidance are needed with an emphasis on changing body composition to increase lean mass and strength to increase the performance of ROTC cadets on the ACFT.
Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya

Objective To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. Study design In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. Results 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independently associated with mortality were gestation <28 weeks (adjusted odds ratio 11.58; 95% confidence interval 4.73–28.39), VLBW (6.92; 4.06–11.79), congenital anomaly (4.93; 2.42–10.05), abdominal condition (2.86; 1.40–5.83), birth asphyxia (2.44; 1.52–3.92), respiratory condition (1.46; 1.08–2.28) and maternal antibiotics within 24 hours before or after birth (1.91; 1.28–2.85). Mortality was reduced if mothers received a partial (0.51; 0.28–0.93) or full treatment course (0.44; 0.21–0.92) of dexamethasone before preterm delivery. Conclusion Greater efforts are needed to address the very high burden of illnesses and mortality in hospitalized newborns in sub-Saharan Africa. Interventions need to address priority issues during pregnancy and delivery as well as in the newborn.
Resilience, depression and anxiety and hazardous alcohol use behaviour among community dwelling older adults

ABSTRACT Introduction We examined the psychometric properties of the CD-RISC, including factor structure. Secondly, we examined if resilience factors moderate the association between negative affect and hazardous alcohol use. Method The sample population consisted of 1,368 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behaviour, depression and anxiety and resilience by using respectively the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI) and the Connor-Davidson Resilience Scale (CD-RISC). Results Of the total sample (N 1.368), 80.1% reported using alcohol. The total sample and the drinking sample reported, respectively, a mean of 65.75 (SD 15.40) and 65.79 (SD 15.90) on the CD-RISC. Concerning the CD-RISC, exploratory factor analysis presents four factors of which three with a good reliability. Moderation analyses reflects that older adults with higher levels of resilient characteristics didn’t report an association between negative affect and hazardous drinking. Alternatively, low resilient older adults did report an positive and significant association between negative affect and hazardous drinking. Conclusion The CD-RISC appeared to be a reliable instrument, containing three factors. In our sample, high resilience moderated the association between negative affect and hazardous drinking and may serve as a buffer against hazardous drinking.
Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial.

BACKGROUND AND AIMS Evidence for efficacy of brief alcohol interventions (BAIs) is mostly limited to primary care and at-risk drinkers. The aim was to test the efficacy of a BAI addressing the full spectrum of alcohol use in a general population sample and across alcohol risk groups. DESIGN Two-parallel-group randomized controlled trial (allocation ratio 1:1) with post-baseline assessments at months 3, 6, and 12. SETTING One municipal registry office in Germany responsible for registration, passport and vehicle admission issues. PARTICIPANTS 1,646 proactively recruited 18-to-64-year-old adults with past year alcohol use (56% women, 66% low-risk drinkers) were randomized to intervention (n = 815) or control (n = 831). INTERVENTION AND COMPARATOR The intervention consisted of assessment plus computer-generated individualized feedback letters at baseline, month 3, and month 6. Comparator was assessment only. MEASUREMENTS Primary outcome was change in the self-reported number of drinks/week from baseline to 12 months. Changes at 3 and 6 months were secondary outcomes. Moderator was alcohol risk group (low-risk vs. at-risk drinking) according to the Alcohol Use Disorders Identification Test-Consumption, with scores ≤3 (women) and ≤4 (men) indicating low-risk drinking. FINDINGS For the whole sample, significant group differences were observed neither at 12-month follow-up (incidence rate ratio [IRR] = 1.01, 95% confidence interval [CI] = 0.87-1.17, Bayes factor [BE] = 0.52) nor at previous assessments (month 3: IRR = 1.01, 95% CI = 0.92-1.12, BE = 0.41; month 6: IRR = 0.93, 95% CI = 0.81-1.07, BE = 1.10). Moderator analyses revealed that low-risk drinkers were more likely to benefit from BAI only at month 6 than at-risk drinkers (IRR = 0.77, 95% CI = 0.70-0.86). CONCLUSIONS In a randomized controlled trial, there was no clear evidence for efficacy of a computer-based brief alcohol intervention in a general population sample, but there was some evidence of medium-term benefits in the large but understudied group of low-risk drinkers.
Changes in the Equity of the Long-Term Care System in Korea Based on Coulter Index Differences for the Years 2000, 2008, and 2015

ABSTRACT In this study, we examined the adequacy of supply and demand under private expansion of the long-term care (LTC) infrastructure after the introduction of long-term care insurance (LTCI) for the older people in Korea. We used Coulter’s coefficient of inequality (Coulter index) to analyze the equity of LTC services by region. In addition, we analyzed the trend of equity changes through equity analysis for three time points: 2000, 2008, and 2015. We found that the level of inequity in LTC service infrastructure in Korea is lower in 2015 compared with 2000, but the differences among regions are high. The adjustment factors in 2015 showed prominent shortages of facilities in urban areas and oversupply in suburban areas. Based on these results, we propose an LTC service infrastructure that meets the demand and improves service access according to regional characteristics.
RANCIDITY OF WALNUTS AND ALMONDS AFFECTED BY SHORT TIME HEAT TREATMENTS FOR INSECT CONTROL

Short time heat treatments effectively control insect contamination of nuts containing substantial quantities of polyunsaturated fatty acids susceptible to oxidative rancidity. Walnut kernels contain greater concentrations of polyunsaturated fatty acids than almond kernels. The objectives of this research were to investigate the lipid stability of shelled walnuts and almonds as affected by short time heat treatments and accelerated storage temperatures. Heating treatments were at 55C for 2 min, 55C for 10 min, 60C for 2 min or 60C for 10 min to simulate predetermined deinfestation treatments. Untreated control and heat treated shelled walnut and almond kernels were stored at 25C for 5, 15, 30 and 60 days or 35C for 2, 5, 10 and 20 days to simulate the shelf lives of walnut and almond kernels at 4C for 2 years. Oils extracted from untreated and short time heat treated walnut kernels exhibited higher peroxide values than oils extracted from untreated and short time heat treated almond kernels under equivalent conditions. Oils extracted from untreated walnut kernels exhibited significantly (P ± 0.05) higher peroxide values than oils extracted from short time heat treated walnut kernels after 5, 15, 30, and 60 days of storage at 25C, or after 2, 5, 10, or 20 days of storage at 35C. Oils extracted from untreated almond kernels exhibited higher peroxide values than oils extracted from short time heat treated almond kernels after 5, 15, 30, or 60 days of storage at 25C, or after 2, 5, 10 or 20 days of storage at 35C. Oils extracted from untreated walnut kernels and oils extracted from short time heat treated walnut kernels exhibited higher peroxide values than oils extracted from almond kernels after storage at 25C or 35C. Short time heat treatment does not enhance development of rancidity during accelerated storage of walnut or almond kernels.