bluuebunny/crossref_metadata_2025 huggingface dataset:
Dermatological conditions in skin of colour
Authors: Pathak Anjali , Perry Michael
Published: June 2022

The UK has rapidly diversifying demographics in common with most advanced, globalised economies. There is therefore an emerging, integral need for clinicians to recognise and manage skin and hair conditions across all ethnicities. When we discuss skin of colour, we refer to a spectrum of diverse geographic ancestral origins, including, but not limited to, those of Asian, African, Middle Eastern or Hispanic/Latino descent, as well as people of mixed heritage. Patients with darker skin phototypes (Fitzpatrick IV-VI) may experience additional complications and present differently to lighter skin counterparts. Knowledge of these nuances will undoubtably lead to better care and outcomes for patients. In this article, we explore skin and hair conditions that are common and important in patients with skin of colour.
A system for automated acquisition of digital flexion using a 3-D camera and custom gantry
Authors: Brogan David M , Anaz Aws , Skubic Marjorie , Dy Christopher J , Bridgeman Jay
Published: June 2022

Introduction

Automated measurement of digital range of motion (ROM) may improve the accuracy of reporting and increase clinical efficiency. We hypothesize that a 3-D camera on a custom gantry will produce ROM measurements similar to those obtained with a manual goniometer.

Methods

A 3-D camera mounted on a custom gantry, was mechanized to rotate 200° around a platform. The video was processed to segment each digit and calculate joint angles in people with no history of any hand conditions or surgery to validate the system. A second-generation prototype was then assessed in people with different hand conditions. Metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint flexion were measured repeatedly with a goniometer and the automated system. The average difference between manual and automatic measurements was calculated along with intraclass correlation coefficients (ICC).

Results

In the initial validation, 1,488 manual and 1,488 automated joint measurements were obtained and the measurement algorithm was refined. In people with hand conditions, 688 manual and 688 automated joint measurements were compared. Average acquisition time was 7 s per hand, with an additional 2–3 s required for data processing. ICC between manual and automated data in the clinical study ranged from 0.65 to 0.85 for the MCP joints, and 0.22 to 0.66 for PIP joints.

Discussion

The automated system resulted in rapid data acquisition, with reliability varying by type of joint and location. It has the potential to improve efficiency in the collection of physical exam findings. Further developments of the system are needed to measure thumb and distal phalangeal motions.
Epistemic confidence conditions the effectiveness of corrective cues against political misperceptions
Authors: Anson Ian G
Published: June 2022

Does epistemic confidence affect Americans’ willingness to defend misperceptions in the face of correction? Individuals with excessive confidence in their political knowledge are expected to resist the effects of corrective cues against political misperceptions. In this study, I assess the effects of confidence on skepticism towards five common political misperceptions in observational and experimental settings. In Study 1, I observationally assess the effects of epistemic confidence on resistance to corrective cues. In Study 2, I temper excessive confidence among a random subset of respondents using a specialized experimental treatment, before exposing them to a corrective cue. Together, the results show that corrections can reduce support for misperceptions among those with modest confidence. However, in the presence of excessive epistemic confidence, these treatments are ineffective. The present findings suggest that epistemic confidence complicates the work of fact-checkers and science communicators in modern democratic politics.
Whole-body magnetic resonance imaging findings and patterns of chronic nonbacterial osteomyelitis in a series of Greek pediatric patients
Authors: Papakonstantinou Olympia , Prountzos Spyridon , Karavasilis Eustratios , Atsali Erato , Bizimi Vasiliki , Alexopoulou Efthymia , Fotis Lampros
Published: June 2022

Background:

Chronic nonbacterial osteomyelitis (CNO) is a pediatric autoinflammatory disorder presenting with sterile inflammatory bone lesions. Whole-body MRI (WBMRI) has most recently emerged for disease assessment, but data are limited.

Purpose:

The purpose is to evaluate the imaging findings and patterns of CNO on WBMRI in a series of Greek pediatric patients.

Material and Methods:

Whole-body magnetic resonance imaging studies of all children with documented CNO, performed in a single tertiary center, were retrospectively reviewed. WBMRI included coronal T1 and short-tau inversion recovery (STIR), whole spine sagittal STIR, and ankle/foot sagittal STIR images. High signal intensity lesions on STIR images corresponding to bone marrow edema were recorded. The SPSS v.20 statistical package was used for descriptive statistics.

Results:

Twenty children were included (mean age: 12, range: 6–16 years) with 1–31 lesions (mean: 11.8) on WBMRI. Two children had unifocal disease localized at the clavicle, three paucifocal (1–4 lesions), and 15 multifocal bone involvement. All but two children presented with ankle pain and exhibited lesions at the bones of the ankle joint (90%) followed by the knee (50%) and pelvis (10%). The tibia was the most frequently affected bone (70%) followed by calcaneus (60%), fibula (50%), femur (45%), talus, and metatarsals (45%). No lesions in the cervical, thoracic, lumbar spine, and mandible were documented. Only small sacral lesions were seen in 25% of patients with the extensive peripheral disease. Bilateral metaphyseal and epiphyseal involvement with transphyseal extension were common, but the periosteal reaction and well-defined lesion margins were rare.

Conclusion:

Frequent involvement of the foot and ankle and paucity of substantial spinal involvement were seen in Greek pediatric patients with CNO.
Hearing-Aid Directionality Improves Neural Speech Tracking in Older Hearing-Impaired Listeners
Authors: Petersen Eline Borch
Published: June 2022

In recent years, a growing body of literature has explored the effect of hearing impairment on the neural processing of speech, particularly related to the neural tracking of speech envelopes. However, only limited work has focused on the potential usage of the method for evaluating the effect of hearing aids designed to amplify and process the auditory input provided to hearing-impaired listeners. The current study investigates how directional sound processing in hearing-aids, denoted directionality, affects the neural tracking and encoding of speech in EEG recorded from 11 older hearing-impaired listeners. Behaviorally, the task performance improved when directionality was applied, while subjective ratings of listening effort were not affected. The reconstruction of the to-be-attended speech envelopes improved significantly when applying directionality, as well as when removing the background noise altogether. When inspecting the modelled response of the neural encoding of speech, a faster transition was observed between the early bottom-up response and the later top-down attentional-driven responses when directionality was applied. In summary, hearing-aid directionality affects both the neural speech tracking and neural encoding of to-be-attended speech. This result shows that hearing-aid signal processing impacts the neural processing of sounds and that neural speech tracking is indicative of the benefits associated with applying hearing-aid processing algorithms.
Education of Future Public Health Professionals Through Integrated Workshops
Authors: Sibbald Shannon , El-Aloul Lina , Shelley Jacob
Published: June 2022

An important feature of public health education is integrating and synthesizing complex concepts across a variety of disciplines. Novel and effective approaches are required to successfully integrate learning and knowledge across Master of Public Health (MPH) programs. The MPH program at Western University uses Integrated Workshops (IWs) as a unique approach to integrating learning and knowledge. Occurring three times over the course of the 1-year program, these workshops provide an opportunity to reflect on past learning and integrate interdisciplinary knowledge from across courses to solve a complex public health problem. IWs are designed for learners to explore the intricacies of a problem by synthesizing their current knowledge along with new information delivered from experts and stakeholders. Learners pull information from across subjects and seek out new information (as needed) to problem-solve under time constraints—basic information is provided 12 hours in advance and new information is added during the workshop, in real-time. Learners develop key public health skills in critical thinking and decision making with incomplete data. Integrated workshops are an effective approach to training the next generation of public health leaders to handle the intricate problems at the heart of public health today.
Syntactic development and verbal short-term memory of children with autism spectrum disorders having intellectual disabilities and children with down syndrome
Authors: Koizumi Manami , Kojima Michio
Published: June 2022

Background and aims

Previous studies suggest that syntactic development in children with intellectual disabilities (ID) is positively correlated with verbal short-term memory (VSTM). This study investigated the characteristics of syntactic development and their relationships of VSTM in children with ID based on type.

Methods

The participants were children with ID ( N = 34), including 14 children with autism spectrum disorders (ASD), 20 with Down syndrome (DS), with chronological ages from 8 years 10 months to 18 years 4 months and nonverbal mental ages (MA) of over 4 years, and typically developing (TD) children ( N = 21) with chronological ages from 5 years 0 months to 5 years 10 months. They were assessed using VSTM, syntactic comprehension, and expression tasks.

Results

The results showed that both the ASD and DS groups performed significantly lower on the syntactic comprehension task and the syntactic expression task than the TD group with the same nonverbal MA in the complex aspect of grammatical structure. In the VSTM task, the ASD group showed significantly lower performance in sentence and story repetition tasks than the TD group of the same nonverbal MA. The DS group showed significantly lower performance in forward digit span, and word, nonword, sentence, and story repetition tasks than the TD group of the same nonverbal MA.

Conclusions

These results suggest that children with ASD have difficulty in understanding and remembering linguistic information with complex semantic structures, and children with DS have a small capacity for VSTM, affecting their syntactic development.
Inequality of School Enrolment and Literacy Status Between Scheduled Tribe and Non-Scheduled Tribe Community: A Critical Study in West Bengal
Authors: Biswas Bapan , Sharma Kaushal Kumar
Published: June 2022

Historically, the Scheduled Tribe (ST) community is deprived of primary education and suffers from a lower literacy rate in India, particularly in West Bengal. From this perspective, the study aims to find the trend of the primary gross-enrolment ratio (PGER) of 7–14 years aged children and the overall literacy rate in the ST community as compared to its non-ST counterpart. The study also focuses on gendered literacy disparity in ST and non-ST communities. Gendered literacy disparity is measured using modified Sopher’s disparity index of Kundu and Rao ( Educational planning: A long term perspective, 1986 [pp. 435–466], NIEPA). Besides, paired sample t-test is applied for the empirical result. Apart from this, a comparative analysis of rural and urban Bengal is made. The study reveals that in India as a whole and particularly in West Bengal, the literacy rate and PGER have yet not achieved its desired goal. The condition was worse in the ST community in the previous census and has created a wide PGER and literacy gap with the non-ST community. Gendered literacy disparity exists in both the communities, though the level is very high in the ST community.
Assessment of Psychological Distress in Health Care Workers During the First two Waves of COVID-19: A Follow-up of a Canadian Longitudinal Study
Authors: Dufour Marie-Michèle , Bergeron Nicolas , Guay Stéphane , Geoffrion Steve
Published: June 2022

Background

Health care workers (HCW) exposed to COVID-19 risk experiencing psychological distress. Little is known regarding longitudinal perspectives and evolutions of psychological distress within this population. The objective of this study is to extend the results of our previous study to the pandemic‘s second wave.

Method

This prospective cohort study was conducted from May 8, 2020, to January 24, 2021, and includes 787 HCW. Symptoms of anxiety and depression were assessed using the Generalised Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics illustrated the evolution of psychological distress indicators, whereas latent class analysis helped identify trajectories.

Results

The results showed that a lower proportion of HCW exceeded the clinical threshold during the second wave (36,5% vs. 31,1%). As in the first wave, most of our sample fell onto the resilient trajectory (67.22%). We adapted the name of the remaining trajectories to better suit their evolution: rapid recovery (15.76%), slow recovery (9.66%), and delayed (7.37%).

Conclusion

Approximately two-thirds of the HCW did not manifest significant distress. For those who did, the distress was transient. We observed a trend of positive adaptability among HCW, considering that the proportion of HCW experiencing psychological distress exceeding clinical threshold remained lower than during the first wave. Our data highlight the dynamic nature of psychological distress. To be able to detect psychological distress as it arises, HCW should use self-monitoring as an essential tool. This vigilance would allow institutions to offer timely support and resources for those experiencing psychological distress.
Genome sequencing reveals underdiagnosis of primary ciliary dyskinesia in bronchiectasis
Authors: Shoemark Amelia , Griffin Helen , Wheway Gabrielle , Hogg Claire , Lucas Jane S. ,   Genomics England Research Consortium, Camps Carme , Taylor Jenny , Carroll Mary , Loebinger Michael R. , Chalmers James D. , Morris-Rosendahl Deborah , Mitchison Hannah M. , De Soyza Anthony ,   The Genomics England Research Consortium:, Brown D. , Ambrose J.C. , Arumugam P. , Bevers R. , Bleda M. , Boardman-Pretty F. , Boustred C.R. , Brittain H. , Caulfield M.J. , Chan G.C. , Fowler T. , Giess A. , Hamblin A. , Henderson S. , Hubbard T.J.P. , Jackson R. , Jones L.J. , Kasperaviciute D. , Kayikci M. , Kousathanas A. , Lahnstein L. , Leigh S.E.A. , Leong I.U.S. , Lopez F.J. , Maleady-Crowe F , McEntagart M. , Minneci F. , Moutsianas L. , Mueller M. , Murugaesu N. , Need A.C. , O'Donovan P. , Odhams C.A. , Patch C. , Perez-Gil D. , Pereira M.B. , Pullinger J. , Rahim T. , Rendon A. , Rogers T. , Savage K. , Sawant K. , Scott R.H. , Siddiq A. , Sieghart A. , Smith S.C. , Sosinsky A. , Stuckey A. , Tanguy M. , Taylor Tavares A.L. , Thomas E.R.A. , Thompson S.R. , Tucci A. , Welland M.J. , Williams E. , Witkowska K. , Wood S.M.
Published: June 2022

Background

Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60–80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis.

Methods

This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK.

Results

Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5–10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing.

Conclusions

PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.
High serum levels of N-epsilon-carboxymethyllysine are associated with poor coronary collateralization in type 2 diabetic patients with chronic total occlusion of coronary artery
Authors: Li Le-Ying , Chen Shuai , Li Fei-Fei , Wu Zhi-Ming , Shen Ying , Ding Feng-Hua , Wang Xiao-Qun , Shen Wei-Feng , Chen Qiu-Jing , Dai Yang , Lu Lin
Published: June 2022

Background

The formation of advanced glycation end-products (AGEs) is a crucial risk factor for the pathogenesis of cardiovascular diseases in diabetes. We investigated whether N-epsilon-carboxymethyllysine (CML), a major form of AGEs in vivo, was associated with poor coronary collateral vessel (CCV) formation in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) of coronary artery.

Methods

This study consisted of 242 T2DM patients with coronary angiographically documented CTO. Blood samples were obtained and demographic/clinical characteristics were documented. The coronary collateralization of these patients was defined according to Rentrop or Werner classification. Serum CML levels were evaluated using ELISA assay. Receiver operating characteristic curve and multivariable regression analysis were performed.

Results

242 patients were categorized into poor CCV group or good CCV group (107 vs. 135 by the Rentrop classification or 193 vs. 49 by the Werner classification, respectively). Serum CML levels were significantly higher in poor CCV group than in good CCV group (110.0 ± 83.35 vs. 62.95 ± 58.83 ng/ml by the Rentrop classification and 94.75 ± 78.29 ng/ml vs. 40.37 ± 28.69 ng/ml by Werner classification, both P < 0.001). Moreover, these CML levels were also significantly different across the Rentrop and Werner classification subgroups (P < 0.001). In multivariable logistic regression, CML levels (P < 0.001) remained independent determinants of poor CCV according to the Rentrop or Werner classification after adjustment of traditional risk factors.

Conclusions

This study suggests that higher serum CML level is associated with poor collateralization in T2DM patients with CTO.
Development and validation of reassigned CEA, CYFRA21-1 and NSE-based models for lung cancer diagnosis and prognosis prediction
Authors: Yuan Jingmin , Sun Yan , Wang Ke , Wang Zhiyi , Li Duo , Fan Meng , Bu Xiang , Chen Jun , Wu Zhiquan , Geng Hui , Wu Jiamei , Xu Ying , Chen Mingwei , Ren Hui
Published: June 2022

Background

The majority of lung cancer(LC) patients are diagnosed at advanced stage with a poor prognosis. However, there is still no ideal diagnostic and prognostic prediction model for lung cancer.

Methods

Data of CEA, CYFRA21-1 and NSE test of patients with LC and benign lung diseases (BLDs) or healthy people from Physical Examination Center was collected. Samples were divided into three data sets as needed. Reassign three kinds of tumor markers (TMs) according to their distribution characteristics in different populations. Diagnostic and prognostic models were thus established, and independent validation was conducted with other data sets.

Results

The diagnostic prediction model showed good discrimination ability: the area under the receiver operating characteristic curve (AUC) differentiated LC from healthy people and BLDs (diagnosed within 2 months), being 0.88 and 0.84 respectively. Meanwhile, the prognostic prediction model did great in prediction: AUC in training data set and test data set were 0.85 and 0.8 respectively.

Conclusion

Reassigned CEA, CYFRA21-1 and NSE can effectively predict the diagnosis and prognosis of LC. Compared with the same TMs that were considered individually, this diagnostic prediction model can identify high-risk population for LC screening more accurately. The prognostic prediction model could be helpful in making more scientific treatment and follow-up plans for patients.
Exploring the digital footprint of depression: a PRISMA systematic literature review of the empirical evidence
Authors: Zarate Daniel , Stavropoulos Vasileios , Ball Michelle , de Sena Collier Gabriel , Jacobson Nicholas C.
Published: June 2022

Background

This PRISMA systematic literature review examined the use of digital data collection methods (including ecological momentary assessment [EMA], experience sampling method [ESM], digital biomarkers, passive sensing, mobile sensing, ambulatory assessment, and time-series analysis), emphasizing on digital phenotyping (DP) to study depression. DP is defined as the use of digital data to profile health information objectively.

Aims

Four distinct yet interrelated goals underpin this study: (a) to identify empirical research examining the use of DP to study depression; (b) to describe the different methods and technology employed; (c) to integrate the evidence regarding the efficacy of digital data in the examination, diagnosis, and monitoring of depression and (d) to clarify DP definitions and digital mental health records terminology.

Results

Overall, 118 studies were assessed as eligible. Considering the terms employed, “EMA”, “ESM”, and “DP” were the most predominant. A variety of DP data sources were reported, including voice, language, keyboard typing kinematics, mobile phone calls and texts, geocoded activity, actigraphy sensor-related recordings (i.e., steps, sleep, circadian rhythm), and self-reported apps’ information. Reviewed studies employed subjectively and objectively recorded digital data in combination with interviews and psychometric scales.

Conclusions

Findings suggest links between a person’s digital records and depression. Future research recommendations include (a) deriving consensus regarding the DP definition and (b) expanding the literature to consider a person’s broader contextual and developmental circumstances in relation to their digital data/records.
Influencing factors of attitudes towards death and demands for death education among community-dwelling Chinese older adults: a cross-sectional study
Authors: Lei Lei , Zhao Hongyan , Ran Lijuan , Wang Lihua , Luo Yu
Published: June 2022

Background

Considering older adults are getting closer to the end-of-life and face death more directly. Attitudes to death not only affect the physical and mental health of older adults, but also affect their acceptance of hospice care, even the quality of death. This study aims to explore the status, influencing factors of attitudes toward death and demands of death education among the community-dwelling older adults in southwestern China.

Methods

A cross-sectional survey was adopted to investigate 683 community-dwelling older adults in Chongqing, China. Non-parametric test and multiple linear regression analysis was used to explore the influencing factors of different attitudes toward death of older adults in community.

Results

The multiple linear regression models showed that different dimensions of death attitudes were affected by one or more factors including number of diseases, discussion about life and death, marital status, and average income per month. And community-dwelling older adults have high level demand for death education.

Conclusions

Under the taboo culture of death in China, this study is one of the few studies on the attitudes toward death and the demands for death education of the community-dwelling older adults. This study contributes to enrich the global death studies and provide reference for the death education for older adults.
The impact of the union of lesser trochanter fragments after intramedullary fixation of trochanteric femoral fractures: an X-ray based study
Authors: You Jiongming , Wang Feng , Li Feng , Wu Yinsheng , Wang Yong , Chen Zifei
Published: June 2022

Background

Displacement of the lesser trochanter (LT) is not uncommon after managing intertrochanteric femoral fractures and the influence of nonunion of the LT-fragment on clinical outcomes remains controversial. This study aimed to investigate the relationship between the displacement distance and union of the LT-fragment and evaluate the influence of LT-fragment nonunion on hip function and complications.

Methods

This retrospective study included patients with intertrochanteric fractures and displaced LT treated with intramedullary fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2015 to July 2017. The patients were grouped as union and nonunion of the LT-fragment at 1 year. The LT-fragment displacement distance of LT was measured by the anterior–posterior radiographs.

Results

Thirty-one and 22 patients showed union and nonunion at 1 year, respectively. The nonunion group had a higher postoperative complication rate than the union group (59% vs. 29%, P = 0.047), especially mechanical complications (45% vs. 6%, P = 0.001). There was no significant difference in hip function between the two groups (P > 0.05). The receiver operating characteristic (ROC) curve revealed an area under the curve of 0.933 of displacement ratio. Patients with a displacement ratio > 0.35 were more likely to have nonunion of the LT-fragment.

Conclusions

The displacement ratio might be a reliable predictor of LT-fragment union. The incidence of postoperative complications might increase with LT-fragment nonunion.
Outcomes and management of delayed complication after severe blunt liver injury
Authors: Kagoura Masaaki , Monden Kazuteru , Sadamori Hiroshi , Hioki Masayoshi , Ohno Satoshi , Takakura Norihisa
Published: June 2022

Background

The treatment of delayed complications after liver trauma such as bile leakage (BL) and hepatic artery pseudoaneurysms (HAPs) is difficult. The purpose of this study is to investigate the outcomes and management of post-traumatic BL and HAPs.

Methods

We retrospectively evaluated patients diagnosed with blunt liver injury, graded by the American Association for the Surgery of Trauma Liver Injury Scale, who were admitted to our hospital between April 2010 and December 2019. Patient characteristics and treatments were analyzed.

Results

A total of 176 patients with blunt liver injury were evaluated. Patients were diagnosed with grade I–II liver injury (n = 127) and with grade III-V injury (n = 49). BL was not observed in patients with grade I–II injury. Eight patients with grade III-V injury developed BL: surgical intervention was not needed for six patients with peripheral bile duct injury, but hepaticojejunostomy was needed for two patients with central bile duct injury. Out of 10 patients with HAPs, only three with grade I–II injury and one with grade III–V were treated conservatively; the rest six with grade III-V injury required transcatheter arterial embolization (TAE). All pseudoaneurysms disappeared.

Conclusions

Severe blunt liver injury causing peripheral bile duct injury can be treated conservatively. In contrast, the central bile duct injury requires surgical treatment. HAPs with grade I–II injury might disappear spontaneously. HAPs with grade III–V injury should be considered TAE.
Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate
Authors: Yu Xinlei , Huang Yiping , Li Weiran
Published: June 2022

Background

Secondary alveolar bone grafting (SABG) is an integral part of the treatment for cleft lip and alveolus and cleft lip and palate. However, the outcome of SABG was not satisfactory as expected, factors that affecting the outcome were still controversial. The aims of this study were to summarize a new method for the classification of alveolar cleft morphology in patients with unilateral cleft lip and alveolus or unilateral cleft lip and palate, to evaluate the correlation between the morphology and SABG outcomes, to identify factors that might predict the outcomes.

Methods

The characteristics of the cleft morphologies of 120 patients who underwent SABG were observed using the preoperative Cone-Beam Computed Tomography (CBCT) images. 52 patients who had CBCT scans performed at least 6 months after SABG were included for the evaluation of outcomes. Both categorical and continuous evaluation methods were measured. Correlations between cleft morphology and SABG outcomes were assessed using the Pearson correlation coefficient in SPSS 27.0.0.

Results

A new method for the classification of cleft morphology was summarized:type I, prism type (labial defect size ≥ palatal defect size; nasal defect size ≥ occlusal defect size); type II, prism’ type (labial defect ≥ palatal defect; nasal defect < occlusal defect); type III, inverted prism type (palatal defect ≥ labial defect); type IV, funnel type (presented as a significantly narrow defect area in the middle towards the vertical dimension); and type V, undefinable (extremely irregular morphology can’t be defined as any of the above types). Categorical evaluation showed 8 failure, 11 poor, 12 moderate, and 21 good results, while the average bone filling rate was 59.24 ± 30.68%. There was a significant correlation between the cleft morphology and categorical/continuous evaluation outcome (p < 0.05).

Conclusion

The new method for the classification of alveolar cleft morphology summarized in this study was comprehensive and convenient for clinical application. Both categorical and continuous methods should be used for radiographic assessments in patients undergoing SABG. The chances of a successful procedure might be better when the patient has type I or IV morphology, in which the shape is like a funnel in the relatively palatal or occlusal area towards the vertical dimension. A relatively great amount of bone resorption was observed in most patients.

Trial registration Chinese clinical trial registry; registration number: ChiCTR2100054438.
Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students during COVID-19 pandemic: a randomised controlled trial
Authors: Moll-Khosrawi Parisa , Falb Alexander , Pinnschmidt Hans , Zöllner Christian , Issleib Malte
Published: June 2022

Background

Virtual reality (VR) is a computer-generated simulation technique which yields plenty of benefits and its application in medical education is growing. This study explored the effectiveness of a VR Basic Life Support (BLS) training compared to a web-based training during the COVID-19 pandemic, in which face-to-face trainings were disrupted or reduced.

Methods

This randomised, double-blinded, controlled study, enrolled 1styear medical students. The control group took part in web-based BLS training, the intervention group received an additional individual VR BLS training. The primary endpoint was the no-flow time-an indicator for the quality of BLS-, assessed during a structural clinical examination, in which also the overall quality of BLS (secondary outcome) was rated. The tertiary outcome was the learning gain of the undergraduates, assessed with a comparative self-assessment (CSA).

Results

Data from 88 undergraduates (n = 46 intervention- andn = 42 control group) were analysed. The intervention group had a significant lower no-flow time (p = .009) with a difference between the two groups of 28% (95%-CI [8%;43%]). The overall BLS performance of the intervention group was also significantly better than the control group with a mean difference of 15.44 points (95%-CI [21.049.83]),p < .001. In the CSA the undergraduates of the intervention group reported a significant higher learning gain.

Conclusion

VR proved to be effective in enhancing process quality of BLS, therefore, the integration of VR into resuscitation trainings should be considered. Further research needs to explore which combination of instructional designs leads to deliberate practice and mastery learning of BLS.
Relational aspects of building capacity in economic evaluation in an Australian Primary Health Network using an embedded researcher approach
Authors: Piper Donella , Jorm Christine , Iedema Rick , Goodwin Nicholas , Searles Andrew , McFayden Lisa
Published: June 2022

Background

Health organisations are increasingly implementing ‘embedded researcher’ models to translate research into practice. This paper examines the impact of an embedded researcher model known as the embedded Economist (eE) Program that was implemented in an Australian Primary Health Network (PHN) located in regional New South Wales, Australia. The site, participants, program aims and design are described. Insights into the facilitators, challenges and barriers to the integration of economic evaluation perspectives into the work of the PHN are provided.

Methods

The eE Program consisted of embedding a lead health economist on site, supported by offsite economists, part-time, for fifteen weeks to collaborate with PHN staff. Evaluation of the eE at the PHN included qualitative data collection via semi-structured interviews (N= 34), observations (N=8) and a field diary kept by the embedded economists. A thematic analysis was undertaken through the triangulation of this data.

Results

The eE Program successfully met its aims of increasing PHN staff awareness of the value of economic evaluation principles in decision-making and their capacity to access and apply these principles. There was also evidence that the program resulted in PHN staff applying economic evaluations when commissioning service providers. Evaluation of the eE identified two key facilitators for achieving these results. First, a highly receptive organisational context characterised by a work ethic, and site processes and procedures that were dedicated to improvement. Second was the development of trusted relationships between the embedded economist and PHN staff that was enabled through: the commitment of the economist to bi-directional learning; facilitating access to economic tools and techniques; personality traits (likeable and enthusiastic); and because the eE provided ongoing support for PHN projects beyond the fifteen-week embedding period.

Conclusions

This study provides the first detailed case description of an embedded health economics program. The results demonstrate how the process, context and relational factors of engaging and embedding the support of a health economist works and why. The findings reinforce international evidence in this area and are of practical utility to the future deployment of such programs.
Small extracellular vesicles derived from dermal fibroblasts promote fibroblast activity and skin development through carrying miR-218 and ITGBL1
Authors: Zou Qin , Zhang Mei , Yuan Rong , Wang Yifei , Gong Zhengyin , Shi Rui , Li Yujing , Fei Kaixin , Luo Chenggang , Xiong Ying , Zheng Ting , Zhu Li , Tang Guoqing , Li Mingzhou , Li Xuewei , Jiang Yanzhi
Published: June 2022

Skin thickness is closely related to the appearance of human skin, such as sagging and wrinkling, which primarily depends on the level of collagen I synthesized by dermal fibroblasts (DFs). Small extracellular vesicles (SEVs), especially those derived from human DFs (HDFs), are crucial orchestrators in shaping physiological and pathological development of skin. However, the limited supply of human skin prevents the production of a large amount of HDFs-SEVs, and pig skin is used as a model of human skin. In this study, SEVs derived from DFs of Chenghua pigs (CH-SEVs), considered to have superior skin thickness, and Large White pigs (LW-SEVs) were collected to compare their effects on DFs and skin tissue. Our results showed that, compared with LW-SEVs, CH-SEVs more effectively promoted fibroblast proliferation, migration, collagen synthesis and contraction; in addition, in mouse model injected with both SEVs, compared with LW-SEVs, CH-SEVs increased the skin thickness and collagen I content more effectively. Some differentially expressed miRNAs and proteins were found between CH-SEVs and LW-SEVs by small RNA-seq and LC–MS/MS analysis. Interestingly, we identified that CH-SEVs were enriched in miRNA-218 and ITGBL1 protein, which played important roles in promoting fibroblast activity via activation of the downstream TGFβ1-SMAD2/3 pathway in vitro. Furthermore, overexpression of miRNA-218 and ITGBL1 protein increased the thickness and collagen I content of mouse skin in vivo. These results indicate that CH-SEVs can effectively stimulate fibroblast activity and promote skin development and thus have the potential to protect against and repair skin damage.

Graphical Abstract
Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center
Authors: Zhang Yuchao , Li Zhen , Ren Bingnan , Wu Wenbin , Liu Yanli , Wang Xingling , Guan Yichun , Jia Liting
Published: June 2022

Purpose

The present study investigated the role of β-hCG in predicting reproductive outcomes and established optimal β-hCG cutoff values in women undergoing cleavage embryo transfer.

Methods

The patients were transferred with fresh or frozen-thawed embryos and had serum β-hCG levels tested on the 14th day post-embryo transfer. Serum β-hCG levels were compared between different groups. Different cutoff values of β-hCG were established and used to divide the patients into different groups. Reproductive outcomes between groups based on β-hCG levels were compared.

Results

Significant discrepancies in general characteristics were observed in the subgroups. The cutoff values of β-hCG for predicting the presence/absence of pregnancy, biochemical pregnancy/clinical pregnancy, presence/absence of adverse pregnancy outcomes, and singleton/twin live birth in the cleavage groups were 89.6, 241.1, 585.9, and 981.1 mIU/L, respectively. Biochemical pregnancy rates and adverse pregnancy outcome rates significantly decreased from the low β-hCG group to the higher β-hCG group in sequence. Significantly higher full-term live birth rates were observed in the highest β-hCG group (P < 0.001).

Conclusion

Serum β-hCG levels were strongly associated with reproductive outcomes. However, the interpretation of β-hCG levels must consider the number and quality of embryos and transfer protocols. When β-hCG was tested on a fixed day post-ET, different cutoff values were required for the prediction of early clinical outcomes. The association between β-hCG and obstetric outcomes must be investigated.
A novel synthesis method of cyclopentadecanone and cyclopentadecanolide from vegetable oil
Authors: Liu Pin , Li Weiguang , Liu Xiongmin
Published: June 2022

Malania oleifera Chum is a unique renewable plant resource in China, its fruit oil has a high content of 15-tetracosenic acid, and it is a good raw material for the synthesis of cyclopentadecanone and cyclopentadecanolide. A Novel synthesis method of cyclopentadecanone and cyclopentadecanolide from vegetable oil was designed, and the synthesis yields of c cyclopentadecanone and cyclopentadecanolide were 38.5% and 63.0%, respectively. The effect of different ester groups on cyclization of α,ω-difatty acid alkyl ester in cyclopentadecanone synthesis, and effect of catalysts on cyclization ofω-hydroxycarboxylic acid triglyceride in cyclopentadecanolide synthesis were investigated. The designed synthesis strategy has the characteristics of less synthesis steps and high utilization efficiency of 15-tetracosenic acid, which has simple and economic.
Mitochondrial phylogenomics provides insights into the taxonomy and phylogeny of fleas
Authors: Zhang Yu , Fu Yi-Tian , Yao Chaoqun , Deng Yuan-Ping , Nie Yu , Liu Guo-Hua
Published: June 2022

Background

Fleas (Insecta: Siphonaptera) are obligatory hematophagous ectoparasites of humans and animals and serve as vectors of many disease-causing agents. Despite past and current research efforts on fleas due to their medical and veterinary importance, correct identification and robust phylogenetic analysis of these ectoparasites have often proved challenging.

Methods

We decoded the complete mitochondrial (mt) genome of the human flea Pulex irritans and nearly complete mt genome of the dog flea Ctenocephalides canis, and subsequently used this information to reconstruct the phylogeny of fleas among Endopterygota insects.

Results

The complete mt genome of P. irritans was 20,337 bp, whereas the clearly sequenced coding region of the C. canis mt genome was 15,609 bp. Both mt genomes were found to contain 37 genes, including 13 protein-coding genes, 22 transfer RNA genes and two ribosomal RNA genes. The coding region of the C. canis mt genome was only 93.5% identical to that of the cat flea C. felis, unequivocally confirming that they are distinct species. Our phylogenomic analyses of the mt genomes showed a sister relationship between the order Siphonaptera and orders Diptera + Mecoptera + Megaloptera + Neuroptera and positively support the hypothesis that the fleas in the order Siphonaptera are monophyletic.

Conclusions

Our results demonstrate that the mt genomes of P. irritans and C. canis are different. The phylogenetic tree shows that fleas are monophyletic and strongly support an order-level objective. These mt genomes provide novel molecular markers for studying the taxonomy and phylogeny of fleas in the future.
Long-standing temporomandibular joint dislocation treated by intraoral condylectomy: a case report and review of the literature
Authors: Uetsuki Ryo , Ono Shigehiro , Tada Misato , Okuda Satoshi , Takechi Masaaki
Published: June 2022

Background

Noninvasive management by closed reduction is a desirable treatment for temporomandibular joint dislocation. However, reduction of long-standing temporomandibular joint dislocation is often difficult. Various conservative treatments have been attempted, but these often render poor outcomes. This article reports the case of long-standing temporomandibular joint dislocation that was successfully closed using intraoral condylectomy.

Case presentation

A 69-year-old Japanese man who sustained an injury in a car collision was unable to close his mouth. Owing to the diagnosis of long-standing temporomandibular joint dislocation, intraoral condylectomy was performed. In the case of temporomandibular joint dislocation, it is convenient to reach the condyle from the oral cavity because sufficient opening is maintained. The condyle can be clearly visualized using an approach similar to sagittal split ramus osteotomy, and the operation using surgical instruments can be facilitated by resecting the coronoid process. By separating the surrounding soft tissue and pulling the cut condyle with sufficient visual field, the condyle can be resected while addressing the hemostasis. During the 12-month postoperative follow-up period, no temporomandibular joint dislocation recurred and the occlusion remained stable.

Conclusions

The limited intraoral incision of this surgical technique provides sufficient access for condylectomy. The results of this case report suggest that condylectomy by intraoral approach could become the treatment of choice for long-standing temporomandibular joint dislocation.
The role of participatory scenarios in ecological restoration: a systematic map protocol
Authors: Moore Eleanor , Howson Pete , Grainger Matthew , Teh Yit Arn , Pfeifer Marion
Published: June 2022

Background

The scale of land degradation worldwide has led the UN to declare the Decade of Ecosystem Restoration and movements such as the Bonn Challenge (https://www.bonnchallenge.org/), have placed ecological restoration on the global policy agenda. Achieving such ambitious policy targets and restoration goals will necessitate complex trade-offs against limited time, competing knowledge, costs, resources, and varying societal preferences among different stakeholders.

Participatory scenarios are a tool to navigate uncertainties surrounding future trajectories and simultaneously incorporate different stakeholder perspectives. They can provide a path to identify collaborative solutions best suited for the local cultures and societies they are tied to. However, there is no systematic understanding of how participatory scenarios are being used in ecological restoration planning to navigate trade-offs in restoration outcomes. We will fill this research gap by mapping the existing evidence from participatory restoration scenarios to answer the primary research question ‘How are outcomes explored in participatory ecological restoration scenarios?’. This will be done through five sub-questions focussing on characteristics of the evidence base, types of study design, how outcomes and trade-offs in those are explored, and an examination of the role of participants in the scenario process and outcome determination.

Methods

This protocol outlines the methods for a systematic map to identify studies that have used participatory scenarios in restoration planning. A comprehensive and reproducible search strategy will be undertaken across bibliographic databases, web-based engines, and targeted searches in organisational online libraries. Searches will be done online in English, but results in all languages will be screened. Search results will go through a two-step screening process of against pre-determined criteria of inclusion and exclusion, for title and abstract and then full-text. Data will be extracted from eligible studies using a standardised data extraction spreadsheet where details on study characteristics, design and outcomes will be recorded. A searchable database of studies and mapping outcomes will be available upon completion of the work. The aim is to inform how scenarios can be better used as a decision-making tool to increase stakeholder participation and account for trade-offs in restoration outcomes across social, ecological, and economic dimensions.