bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality improvement in urological care: Core methodological principles
Authors: Olaitan Ademola , Tien Tony , Russ Stephanie , Tapper Josephine , Herrington Eldrid , Green James , Chaudhri Saurabh
Published: January 2023

Objectives:

The aim of this article is to summarise core quality improvement (QI) methodologies and concepts to assist urology teams in conducting well-designed improvement projects.

Materials and Methods:

We provide an introduction to the methodological foundations of QI, including the model for improvement, plan-do-study-act, lean and six sigma and present some useful QI tools such as process modelling and pareto charts with examples of how they might be applied to urological care. We also introduce the concept of measurement for QI and describe how this differs from the more traditional measurement approaches used in research.

Results:

The key to successful QI work undoubtedly lies in the careful planning and appropriate selection of the available QI tools and methods, alongside pragmatic approaches to measurement that yield enough data to spot meaningful variation in outcomes.

Conclusions:

To support these core methods, QI leadership and stakeholder engagement will be critical to embedding QI into urological care and ensuring that improvements can be sustained once QI projects come to an end.

Level of evidence:

Not applicable.
Bibliometric analysis on the adoption of artificial intelligence applications in the e-health sector
Authors: Shaikh Abdul Khalique , Alhashmi Saadat M , Khalique Nadia , Khedr Ahmed M. , Raahemifar Kaamran , Bukhari Sadaf
Published: January 2023

Artificial Intelligent (AI) applications in e-health have evolved considerably in the last 25 years. To track the current research progress in this field, there is a need to analyze the most recent trend of adopting AI applications in e-health. This bibliometric analysis study covers AI applications in e-health. It differs from the existing literature review as the journal articles are obtained from the Scopus database from its beginning to late 2021 (25 years), which depicts the most recent trend of AI in e-health. The bibliometric analysis is employed to find the statistical and quantitative analysis of available literature of a specific field of study for a particular period. An extensive global literature review is performed to identify the significant research area, authors, or their relationship through published articles. It also provides the researchers with an overview of the work evolution of specific research fields. The study's main contribution highlights the essential authors, journals, institutes, keywords, and states in developing the AI field in e-health.
Antecedents of Primary School Quality: The Case of Remote Areas Schools in Indonesia
Authors: Juharyanto Juharyanto , Arifin Imron , Sultoni Sultoni , Adha Maulana Amirul , Qureshi Muhammad Imran
Published: January 2023

The policy of developing remote area schools’ quality in Indonesia is getting stronger. The government has set minimum service standards as a reference for schools’ development quality while remaining based on local, national, global, and 21st-century values. This study revealed efforts to improve the 21st-century school’s quality through the contribution of superior leadership, school climate, total quality management implementation, and the school principal’s performance approached quantitatively and analyzed descriptively using Structural Equation Modeling. Participants involved in the study were 147 remote area principals and teachers in two provinces in Indonesia. Results show that (1) school climate had the most dominant contribution to school quality and (2) there was a significant simultaneous effect among superior leadership, school climate, total quality management implementation, and the school principal’s performance on the school quality. Implications of the study’s findings from a theoretical and practical lens as well as recommendations for future studies are also discussed.
Institutional Quality, Foreign Direct Investment, and Regional Integration: Empirical Evidence From CEN-SAD
Authors: Kwaw-Nimeson Enoch , Tian Ze
Published: January 2023

This study investigates the institutional quality effects on the foreign direct investment (FDI)–regional integration nexus in the Community of Sahel-Saharan States (CEN-SAD). The novelty of our approach extends the regional integration theory in Africa by employing the Africa Regional Integration Index (ARII) and utilizes a dynamic panel data model based on the one-step system generalized method of moments (SYS-GMM) estimation to explore the institutional quality effects on the relationship between FDI location advantages and inflows and dimensions of regional integration. Our study highlights macroeconomic integration as the strongest indicator of regional integration as well as the most crucial determinant of FDI in CEN-SAD. We also discovered that FDI inflows into the lower-middle income countries (LMICs) were only slightly higher than in low-income countries (LICs). Our results infer that institutional reforms augment FDI location advantages and enhance FDI inflows irrespective of the level of integration in the Community.
Isolated Adductor Magnus Injuries in Athletes: A Case Series
Authors: Mechó Sandra , Balius Ramon , Bossy Mireia , Valle Xavier , Pedret Carles , Ruiz-Cotorro Ángel , Rodas Gil
Published: January 2023

Background:

Little is known about injuries to the adductor magnus (AM) muscle and how to manage them.

Purpose:

To describe the injury mechanisms of the AM and its histoarchitecture, clinical characteristics, and imaging features in elite athletes.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 11 competitive athletes with an AM injury were included in the study. Each case was clinically assessed, and the diagnosis and classification were made by magnetic resonance imaging (MRI) according to the British Athletics Muscle Injury Classification (BAMIC) and mechanism, location, grade, and reinjury (MLG-R) classification. A 1-year follow-up was performed, and return-to-play (RTP) time was recorded.

Results:

Different mechanisms of injury were found; most of the athletes (10/11) had flexion and internal rotation of the hip with extension or slight flexion of the knee. Symptoms consisted of pain in the posteromedial (7/11) or medial (4/11) thigh during adduction and flexion of the knee. Clinically, there was a suspicion of an injury to the AM in only 3 athletes. According to MRI, 5 lesions were located in the ischiocondylar portion (3 in the proximal and 2 in the distal myoconnective junction) and 6 in the pubofemoral portion (4 in the distal and 2 in the proximal myoconnective junction). Most of the ischiocondylar lesions were myotendinous (3/5), and most of the pubofemoral lesions were myofascial (5/6). The BAMIC and MLG-R classification coincided in distinguishing injuries of moderate and mild severity. The management was nonoperative in all cases. The mean RTP time was 14 days (range, 0-35 days) and was longer in the ischiocondylar cases than in the pubofemoral cases (21 vs 8 days, respectively). Only 1 recurrence, at <10 months, was recorded.

Conclusion:

Posteromedial thigh pain after an eccentric contraction during forced adduction of the thigh from hip internal rotation should raise a suspicion of AM lesions. The identification of the affected portion was possible on MRI. An injury in the ischiocondylar portion entailed a longer RTP time than an injury in the pubofemoral portion.
Decarbonisation of Global Economies; Is Net Zero Emission Achievable? The Case for Hydrogen and Fuel Cell Technology for Innovative Futures
Authors: Khokhar Hassan Naeem
Published: January 2023

The Net Zero Emission goal by 2050 as per the Paris Agreement limits the global temperature rise to 1.5°C which requires the decarbonisation of the energy sectors. This article evaluates one of the key technologies, the fuel cells that can abate the global emissions of the highest emitting sectors, the transport and power industry. The article compares the fuel cells to incumbent technologies in terms of cost competitiveness, maturity, infrastructure availability, economic barriers in deployment at scale and the public policies for decarbonisation. The global energy demand is expected to increase almost 50% by 2050. If the emissions remain unabated the levels are expected to be doubled when compared to preindustrial levels, and a 35% increase to present emission levels which would result in an increase in global temp of 4.5°C–5.7°C.
Visualizing the uneven accessibility to nucleic acid testing services in Shenzhen under China’s COVID control measures
Authors: Chen Zifeng
Published: January 2023

Under China’s “dynamic zero” COVID-19 policy, Shenzhen required its residents to present a negative nucleic acid testing result within 24 or 48 h to access most public spaces and transit until most recently. The uneven accessibility to testing services could render certain groups vulnerable to mobility disadvantage (e.g., denied access to public transport). Using data of nucleic acid testing services and residents’ positioning points, I created a cartogram to capture the spatial distribution of people’s activities and that of testing services in Shenzhen. The cartogram indicates that the nucleic acid testing services were spatially concentrated in a way inconsistent with the distribution of people’s daily activities. Several girds exhibit high presence of activities but low or no provision of testing services that were necessary for residents to accessing public spaces and transport. The cartogram casts light to potential consequence of regular nucleic acid testing on mobility equality.
Knowledge, perception and acceptance of generic drugs in the general Lebanese population: A cross-sectional survey among adults
Authors: Hatem Georges , Itani Rana , Ajrouche Roula , Abbas Nour , Farah Rita , Goossens Mathijs , Awada Sanaa
Published: January 2023

Background:

Many governments encouraged generic use to enhance health equality and minimise health expenditure. The lack of knowledge and acceptance of generic medicines are the main barriers to their use.

Objectives:

This study aimed to assess population knowledge and perception towards generic drugs, identify their primary sources of information and examine which variables are independently related to their acceptance.

Design:

An observational cross-sectional study was performed targeting the Lebanese adult population.

Methods:

Overall, 385 patients participated in the study. Data were collected using a uniform survey from six public healthcare centres.

Results:

The participants reported a distrust towards generic drugs; they either said that they were not as effective as the brand (36.9%), were of less quality than the brand (38.5%) or had more side effects than the brand (38.4%). Around 52% said they would never buy a generic drug, and two-thirds (68.6%) preferred using a brand drug over a generic one. After adjusting for socio-demographics, a high income (odds ratio (OR) = 3.7), knowing that brands and generics have the same active ingredients (OR = 2.28) and that brands and generics were equally effective (OR = 6.46) were the strongest independent predictors for the willingness to buy generic drugs.

Conclusion:

A lack of knowledge and misperceptions about generic drugs limited the use of generic drugs, and therefore must be addressed.
Gata2-regulated Gfi1b expression controls endothelial programming during endothelial-to-hematopoietic transition
Authors: Koyunlar Cansu , Gioacchino Emanuele , Vadgama Disha , de Looper Hans , Zink Joke , ter Borg Mariette N. D. , Hoogenboezem Remco , Havermans Marije , Sanders Mathijs A. , Bindels Eric , Dzierzak Elaine , Touw Ivo P. , de Pater Emma
Published: January 2023

The first hematopoietic stem cells (HSCs) are formed through endothelial-to-hematopoietic transition (EHT) during embryonic development. The transcription factor GATA2 is a crucial regulator of EHT and HSC function throughout life. Because patients with GATA2 haploinsufficiency have inborn mutations, prenatal defects are likely to influence disease development. In mice, Gata2 haploinsufficiency (Gata2+/−) reduces the number and functionality of embryonic hematopoietic stem and progenitor cells (HSPCs) generated through EHT. However, the embryonic HSPC pool is heterogeneous and the mechanisms underlying this defect in Gata2+/− embryos remain unclear. Here, we investigated whether Gata2 haploinsufficiency selectively affects a cellular subset undergoing EHT. We showed that Gata2+/− HSPCs initiate, but cannot fully activate, hematopoietic programming during EHT. In addition, due to the reduced activity of the endothelial repressor Gfi1b, Gata2+/− HSPCs cannot repress endothelial identity to complete maturation. Finally, we showed that hematopoietic-specific induction of gfi1b could restore HSC production in gata2b-null (gata2b−/−) zebrafish embryos. This study illustrates the pivotal role of Gata2 in the regulation of the transcriptional network governing HSPC identity throughout the EHT.
Kindlin-3 deficiency leads to impaired erythropoiesis and erythrocyte cytoskeleton
Authors: Szpak Dorota , Turpin Chloe , Goreke Utku , Bialkowska Katarzyna , Bledzka Kamila M. , Verbovetskiy Dmitriy , Mohandas Narla , Gurkan Umut A. , Qin Jun , Plow Edward F. , Pluskota Elzbieta
Published: January 2023

Kindlin-3 (K3) is critical for the activation of integrin adhesion receptors in hematopoietic cells. In humans and mice, K3 deficiency is associated with impaired immunity and bone development, bleeding, and aberrant erythrocyte shape. To delineate how K3 deficiency (K3KO) contributes to anemia and misshaped erythrocytes, mice deficient in erythroid (K3KO∖EpoR-cre) or myeloid cell K3 (K3KO∖Lyz2cre), knockin mice expressing mutant K3 (Q597W598 to AA) with reduced integrin-activation function (K3KI), and control wild-type (WT) K3 mice were studied. Both K3-deficient strains and K3KI mice showed anemia at baseline, reduced response to erythropoietin stimulation, and compromised recovery after phenylhydrazine (PHZ)-induced hemolytic anemia as compared with K3WT. Erythroid K3KO and K3 (Q597W598 to AA) showed arrested erythroid differentiation at proerythroblast stage, whereas macrophage K3KO showed decreased erythroblast numbers at all developmental stages of terminal erythroid differentiation because of reduced erythroblastic island (EBI) formation attributable to decreased expression and activation of erythroblast integrin α4β1 and macrophage αVβ3. Peripheral blood smears of K3KO∖EpoR-cre mice, but not of the other mouse strains, showed numerous aberrant tear drop–shaped erythrocytes. K3 deficiency in these erythrocytes led to disorganized actin cytoskeleton, reduced deformability, and increased osmotic fragility. Mechanistically, K3 directly interacted with F-actin through an actin-binding site K3-LK48. Taken together, these findings document that erythroid and macrophage K3 are critical contributors to erythropoiesis in an integrin-dependent manner, whereas F-actin binding to K3 maintains the membrane cytoskeletal integrity and erythrocyte biconcave shape. The dual function of K3 in erythrocytes and in EBIs establish an important functional role for K3 in normal erythroid function.
A signature of immune-related genes correlating with clinical prognosis and immune microenvironment in sepsis
Authors: Chen Zhong-Hua , Zhang Wen-Yuan , Ye Hui , Guo Yu-Qian , Zhang Kai , Fang Xiang-Ming
Published: January 2023

Background

Immune-related genes (IRGs) remain poorly understood in their function in the onset and progression of sepsis.

Methods

GSE65682 was obtained from the Gene Expression Omnibus database. The IRGs associated with survival were screened for subsequent modeling using univariate Cox regression analysis and least absolute shrinkage and selection operator in the training cohort. Then, we assessed the reliability of the 7 IRGs signature's independent predictive value in the training and validation cohorts following the creation of a signature applying multivariable Cox regression analysis. After that, we utilized the E-MTAB-4451 external dataset in order to do an independent validation of the prognostic signature. Finally, the CIBERSORT algorithm and single-sample gene set enrichment analysis was utilized to investigate and characterize the properties of the immune microenvironment.

Results

Based on 7 IRGs signature, patients could be separated into low-risk and high-risk groups. Patients in the low-risk group had a remarkably increased 28-day survival compared to those in the high-risk group (P < 0.001). In multivariable Cox regression analyses, the risk score calculated by this signature was an independent predictor of 28-day survival (P < 0.001). The signature's predictive ability was confirmed by receiver operating characteristic curve analysis with the area under the curve reaching 0.876 (95% confidence interval 0.793–0.946). Moreover, both the validation set and the external dataset demonstrated that the signature had strong clinical prediction performance. In addition, patients in the high-risk group were characterized by a decreased neutrophil count and by reduced inflammation-promoting function.

Conclusion

We developed a 7 IRGs signature as a novel prognostic marker for predicting sepsis patients’ 28-day survival, indicating possibilities for individualized reasonable resource distribution of intensive care unit.
Molecular and physiological mechanisms of tea (Camellia sinensis (L.) O. Kuntze) leaf and root in response to nitrogen deficiency
Authors: Lin Zheng-He , Chen Chang-Song , Zhao Shui-Qing , Liu Yuan , Zhong Qiu-Sheng , Ruan Qi-Chun , Chen Zhi-Hui , You Xiao-Mei , Shan Rui-Yang , Li Xin-Lei , Zhang Ya-Zhen
Published: January 2023

Background

As an economically important crop, tea is strongly nitrogen (N)-dependent. However, the physiological and molecular mechanisms underlying the response of N deficiency in tea are not fully understood. Tea cultivar “Chunlv2” [Camellia sinensis (L.) O. Kuntze] were cultured with a nutrient solution with 0 mM [N-deficiency] or 3 mM (Control) NH4NO3 in 6 L pottery pots containing clean river sands.

Results

N deficiency significantly decreased N content, dry weight, chlorophyll (Chl) content, L-theanine and the activities of N metabolism-related enzymes, but increased the content of total flavonoids and polyphenols in tea leaves. N deficiency delayed the sprouting time of tea buds. By using the RNA-seq technique and subsequent bioinformatics analysis, 3050 up-regulated and 2688 down-regulated differentially expressed genes (DEGs) were isolated in tea leaves in response to N deficiency. However, only 1025 genes were up-regulated and 744 down-regulated in roots. Gene ontology (GO) term enrichment analysis showed that 205 DEGs in tea leaves were enriched in seven GO terms and 152 DEGs in tea roots were enriched in 11 GO items based on P < 0.05. In tea leaves, most GO-enriched DEGs were involved in chlorophyll a/b binding activities, photosynthetic performance, and transport activities. But most of the DEGs in tea roots were involved in the metabolism of carbohydrates and plant hormones with regard to the GO terms of biological processes. N deficiency significantly increased the expression level of phosphate transporter genes, which indicated that N deficiency might impair phosphorus metabolism in tea leaves. Furthermore, some DEGs, such as probable anion transporter 3 and high-affinity nitrate transporter 2.7, might be of great potential in improving the tolerance of N deficiency in tea plants and further study could work on this area in the future.

Conclusions

Our results indicated N deficiency inhibited the growth of tea plant, which might be due to altered N metabolism and expression levels of DEGs involved in the photosynthetic performance, transport activity and oxidation–reduction processes.
Laryngeal mask airway facilitates a safe and smooth emergence from anesthesia in patients undergoing craniotomy: a prospective randomized controlled study
Authors: Wei Cheng-Fong , Chung Yung-Tai
Published: January 2023

Background

Endotracheal extubation under deep anesthesia (deep extubation) has been proved to present stable hemodynamics and steady intracranial pressure during emergence from anesthesia in patients undergoing craniotomy. This study aims to examine, in comparison with deep extubation, if a laryngeal mask airway (LMA) could provide a safer and smoother emergence from anesthesia in patients undergoing craniotomy.

Methods

This prospective randomized controlled study was conducted on patients undergoing elective craniotomy for brain tumors. After the complement of the surgical procedure, the patients had anesthesia maintained with end-tidal sevoflurane concentration 2.5% and also fully regained muscle power (Time Zero), they were randomly assigned to ETT Group (n = 29) for deep extubation or to LMA Group (n = 29), where the endotracheal tube was replaced by a laryngeal mask airway. The primary outcomes were respiratory complications, airway interventions and hemodynamic changes through emergence from anesthesia till 30 min following Time Zero. The secondary outcomes were re-operation incidence in 24 h, stay time in the intensive care unit and postoperative hospital days.

Results

At 5 min before Time Zero either oxygen partial pressures (PaO2) or carbon dioxide partial pressures (PaCO2) between the two groups were comparable. No significant PaCO2 change was noted in both groups in 5 min after Time Zero, yet there was a remarkably lower PaO2 in ETT Group at that time point, 188.9 (± 71.1) in ETT Group vs 264.4 (± 85.4) in LMA Group. In ETT Group, coughs and snores were considerably more frequent, and thus more interventions were needed to maintain adequate respiration. From Time Zero on, blood pressures (systolic, diastolic and mean) and heart rates in ETT Group were generally higher than those in LMA Group, but the differences were insignificant at all time points except heart rate at 10 min after Time Zero. The secondary outcomes between the two groups were similar.

Conclusions

Compared with deep extubation, a LMA, as a temporary airway replacement, facilitates a safer and smoother emergence from anesthesia for patients undergoing craniotomy, in terms of better oxygen saturation, fewer respiratory complications and fewer airway interventions.

Trial registration

The study was conducted after receiving approval from Institutional Review Board of Chang Gung Memorial Hospital, Linkou Branch, Taiwan (registration number 202102115A3; January 27, 2022), and the clinicaltrials.gov (NCT05253404) on 23 February 2022.
Perceptions of ophthalmologists on the impact of trachoma in Egypt: a mixed-methods, nationwide survey
Authors: Nayel Yassin , Taylor Matilda , Montasser Ahmed S. , Elsherif Mohamed , Diab Mostafa M.
Published: January 2023

Purpose

Understanding the perception and practices of ophthalmologists for trachoma is important to develop interventions aimed at disease elimination in Egypt. The survey investigated: (1) the views and practice patterns of Egyptian ophthalmologists for trachoma and (2) the influence of geographic location, setting, and years of practice on ophthalmologists’ perceptions.

Methods

A questionnaire sent to ophthalmologists currently working in Egypt collected information on: (1) demographics, (2) caseload and practice patterns for trachoma, (3) 13 Likert scale questions regarding the current state of trachoma, and (4) two open-ended written response questions.

Results

Of the 500 recipients, 194 ophthalmologists participated. 98% of the respondents reported seeing trachoma patients in their practice. 28.8% agreed that trachoma is currently an active health problem in Egypt, with ophthalmologists in public practice having significantly higher agreement scores compared to private practitioners (p = 0.030). Rural ophthalmologists were significantly more likely to agree that a targeted trachoma control program is needed in their location of practice compared to their urban counterparts (p < 0.001). Open-ended questions revealed recurrent themes, including the rural distribution of trachoma patients and the high volume of patients with corneal opacity.

Conclusion

Ophthalmologists’ experiences with trachoma in Egypt differed based on practice setting, years in practice, and location, and the overall perception of the impact of the disease remains low. However, there was widespread agreement that trachoma is present in communities across the country. Practitioners in rural areas and in the public sector shared a disproportionate burden of the trachoma caseload. The perspectives of such ophthalmologists must be emphasized in decision-making related to trachoma interventions.
Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 “long haulers”
Authors: Rothstein Ted L.
Published: January 2023

Objective

COVID-19 (SARS-CoV-2) has been associated with neurological sequelae even in those patients with mild respiratory symptoms. Patients experiencing cognitive symptoms such as “brain fog” and other neurologic sequelae for 8 or more weeks define “long haulers”. There is limited information regarding damage to grey matter (GM) structures occurring in COVID-19 “long haulers”. Advanced imaging techniques can quantify brain volume depletions related to COVID-19 infection which is important as conventional Brain MRI often fails to identify disease correlates. 3-dimensional voxel-based morphometry (3D VBM) analyzes, segments and quantifies key brain volumes allowing comparisons between COVID-19 “long haulers” and normative data drawn from healthy controls, with values based on percentages of intracranial volume.

Methods

This is a retrospective single center study which analyzed 24 consecutive COVID-19 infected patients with long term neurologic symptoms. Each patient underwent Brain MRI with 3D VBM at median time of 85 days following laboratory confirmation. All patients had relatively mild respiratory symptoms not requiring oxygen supplementation, hospitalization, or assisted ventilation. 3D VBM was obtained for whole brain and forebrain parenchyma, cortical grey matter (CGM), hippocampus, and thalamus.

Results

The results demonstrate a statistically significant depletion of CGM volume in 24 COVID-19 infected patients. Reduced CGM volume likely influences their long term neurological sequelae and may impair post COVID-19 patient’s quality of life and productivity.

Conclusion

This study contributes to understanding effects of COVID-19 infection on patient’s neurocognitive and neurological function, with potential for producing serious long term personal and economic consequences, and ongoing challenges to public health systems.
Single internal carotid cavernous sinus aneurysm presented as bilateral painful ophthalmoplegia: a case report
Authors: Zhang Wanwan , Xie Yinyin , Zhang Jiwei , Wang Cui , Lian Yajun , Liu Hongbo , Xie Nanchang
Published: January 2023

Background

Intracranial aneurysms are the most common vascular cause of painful ophthalmoplegia. Symptoms include retro-orbital pain, diplopia, ophthalmoplegia, trigeminal neuropathy, or a combination of these. Most single aneurysms cause ipsilateral, painful ophthalmoplegia. Here, we report the first, to our knowledge, case of bilateral painful ophthalmoplegia possibly caused by an aneurysm of the cavernous segment of the left internal carotid artery.

Case presentation

A 62-year-old male patient presented with headache and bilateral ptosis. Laboratory tests revealed hypopituitary function. Computerized tomography angiography showed a large aneurysm in the cavernous sinus segment of the left internal carotid artery. Aneurysm embolization was performed in the Nerve Interventional Department. Four months after surgery, the patient's symptoms returned to normal.

Conclusions

This case suggests that patients with bilateral painful ophthalmoplegia should be screened for aneurysms using computed tomography angiography or magnetic resonance angiography immediately.
Large ciliary body melanocytoma with pseudocysts: a case report
Authors: Simpson Allie , Mamalis Nick , Gee Christopher , Harrie Roger P.
Published: January 2023

Background

To describe the correlation between standardized A-scan echography and histopathology in a ciliary body melanocytoma.

Case presentation

We present a case of a large ciliary body melanocytoma with significant growth, vision loss, and elevated intraocular pressure that was diagnosed clinically as a melanoma, but the standardized A-scan findings correlated to the histopathological description of a melanocytoma with multiple pseudocysts.

Conclusions

The reflectivity of this melanocytoma by standardized A-scan was consistent with multiple pseudocysts on pathological evaluation. This echographic pattern guided the differential diagnosis. Standardized A-scan is an important diagnostic tool in the differentiation of ciliary body melanocytomas from melanomas.
Screen-viewing behaviours of children before and after the 2020–21 COVID-19 lockdowns in the UK: a mixed methods study
Authors: Salway Ruth , Walker Robert , Sansum Kate , House Danielle , Emm-Collison Lydia , Reid Tom , Breheny Katie , Williams Joanna G. , de Vocht Frank , Hollingworth William , Foster Charlie , Jago Russell
Published: January 2023

Background

Restrictions during the COVID-19 pandemic have led to increased screen-viewing among children, especially during strict periods of lockdown. However, the extent to which screen-viewing patterns in UK school children have changed post lockdowns is unclear. The aim of this paper is to examine how screen-viewing changed in 10–11-year-old children over the 2020–21 COVID-19 pandemic, how this compares to before the pandemic, and the influences on screen-viewing behaviour.

Methods

This is a mixed methods study with 10–11-year-olds from 50 schools in the Greater Bristol area, UK. Cross-sectional questionnaire data on minutes of weekday and weekend television (TV) viewing and total leisure screen-viewing were collected pre-COVID-19 in 2017–18 (N = 1,296) and again post-lockdowns in 2021 (N = 393). Data were modelled using Poisson mixed models, adjusted for age, gender, household education and seasonality, with interactions by gender and household education. Qualitative data were drawn from six focus groups (47 children) and 21 one-to-one parent interviews that explored screen-viewing behaviour during the pandemic and analysed using the framework method.

Results

Total leisure screen-viewing was 11% (95% CI: 12%-18%) higher post-lockdown compared to pre-COVID-19 on weekdays, and 8% (95% CI: 6%-10%) on weekends, equating to around 12–15 min. TV-viewing (including streaming) was higher by 68% (95% CI: 63%-74%) on weekdays and 80% (95% CI: 75%-85%) on weekend days. Differences in both were higher for girls and children from households with lower educational attainment. Qualitative themes reflected an unavoidable increase in screen-based activities during lockdowns, the resulting habitualisation of screen-viewing post-lockdown, and the role of the parent in reducing post-2020/21 lockdown screen-viewing.

Conclusions

Although screen-viewing was higher post-lockdown compared to pre-COVID-19, the high increases reported during lockdowns were not, on average, sustained post-lockdown. This may be attributed to a combination of short-term fluctuations during periods of strict restrictions, parental support in regulating post-lockdown behaviour and age-related, rather than COVID-19-specific, increases in screen-viewing. However, socio-economic differences in our sample suggest that not all families were able to break the COVID-19-related adoption of screen-viewing, and that some groups may need additional support in managing a healthy balance of screen-viewing and other activities following the lockdowns.
Ecological study of the association between socioeconomic inequality and food deserts and swamps around schools in Rio de Janeiro, Brazil
Authors: Andretti Bernardo , Cardoso Letícia Oliveira , Honório Olivia Souza , de Castro Junior Paulo César Pereira , Tavares Letícia Ferreira , da Costa Gaspar da Silva Isabela , Mendes Larissa Loures
Published: January 2023

Background

Previous research suggests that unhealthy community food environments around schools contribute to unhealthy eating habits and negative health outcomes among the youth. However, little is known about how socioeconomic inequalities in those community food environments are associated with food deserts and food swamps across schools’ neighborhoods.

Methods

An ecological study was carried out in all 3,159 public and private schools in Rio de Janeiro, Brazil. Three measures of socioeconomic inequality were evaluated: per capita income, segregation index and deprivation index. The community school food environment was analyzed by metrics of food swamps and food deserts.

Results

Food deserts and food swamps were simultaneously more prevalent in neighborhoods of the lowest income, high deprivation, and high segregation. Spatial socioeconomic disparities at the neighborhoods of schools were associated with food deserts and food swamps in Rio de Janeiro.

Conclusions

Our results point to a spatial socioeconomic inequality of establishments that sell food around schools in a Brazilian metropolis, indicating that the areas of greatest deprivation of food services are also the areas with the worst socioeconomic characteristics.
Gender differences in knowledge, attitudes, and practices with respect to type 1 diabetes among Saudi public-school teachers
Authors: Aljefree Najlaa M. , Almoraie Noha M. , Althaiban Maha A. , Hanbazaza Mahitab A. , Wazzan Huda A. , Shatwan Israa M.
Published: January 2023

Background

Children with type 1 diabetes mellitus (T1DM) need carefully monitoring even during school hours to avoid emergencies. Hence, it is crucial for teachers to have appropriate knowledge and positive attitudes toward diabetes to effectively manage the disease and its complications. This study aimed to compare the knowledge, attitudes, and practices with respect to T1DM among Saudi male and female public-school teachers living in Jeddah and to identify the associated factors.

Methods

A cross-sectional study was conducted among primary, intermediate, and secondary public-school teachers working in Jeddah, Saudi Arabia between October 2021 and March 2022. Data were collected through an online survey. The survey included information on the socio-demographics of school teachers, the presence of chronic diseases, teachers’ health behaviours, and knowledge, attitude, and practice with respect to T1DM.

Results

This study included 378 school teachers. The majority of school teachers from both genders were married, held a bachelor’s degree, and aged 45–54 years. Male school teachers were married (P = 0.02), held postgraduate certificates (P < 0.001), smoked cigarette and shisha (P < 0.001), and were physically active (P < 0.001) compared to female school teachers. Regarding teachers’ knowledge of T1DM, it was found that female teachers were significantly more knowledgeable of T1DM children’s and its symptoms than male teachers (P = 0.03;P = 0.01, respectively). However, male teachers were more willing to accommodate T1DM students in their classes and attend programs to support T1DM students as compared to female teachers (P = 0.004;P = 0.004, respectively). Moreover, the study showed poor practice scores for T1DM. In addition, the knowledge, attitudes, and practice scores toward T1DM were significantly associated with advanced age (P = 0.002), and extended years of teaching experience (P ≤ 0.002). Also, diabetic teachers had the highest knowledge (P = 0.03) and attitude (P = 0.02) scores compared to non-diabetic teachers. Male teachers who were married (P = 0.002), shisha smokers (P = 0.01), and had never practiced activity (P = 0.03) had better attitudes and practices toward T1DM. Similarly, female teachers who held bachelor’s certificates had better attitudes toward T1DM (P = 0.02).

Conclusion

The present study revealed moderate knowledge, favorable attitudes, and poor practices related to T1DM among school teachers in Jeddah. It is crucial for policymakers to provide school teachers with training for necessary diabetes care for diabetic students.
Mathematical analysis in the design of digital artery-based V–Y advancement flap in treating proximal interphalangeal joint flexion contracture
Authors: Su Po-Han , Hsu Cheng-En , Ho Tsung-Yu , Wei Bor-Han , Wang Wei-Chih , Chiu Yung-Cheng
Published: January 2023

Background

The digital artery-based V–Y advancement flap is a widely used flap for soft tissue coverage in the treatment of flexion contracture of the proximal interphalangeal (PIP) joint. A standard method for the flap design and a mathematical method to predict the advance distance have not been well established. In this study, we proposed a simplified method for the design of V–Y advancement flaps based on digital arteries and used a geometric model to predict the advance distance for the flexion contracture correction surgery.

Methods

According to the general concept of hand flap design and law of cosine, we proposed three principles in the design of the digital artery-based V–Y advancement flap that should be followed. Since 2021 to 2022, finger geometric data of 120 fingers (index, middle, ring, and small fingers) from 30 healthy participants were collected and analysed to evaluate the necessary advance distance and flap tip angle for PIP flexion contracture correction of different fingers by our flap design method.

Results

The middle finger needed a significantly longer advance distance compared to other fingers in the same degree flexion contracture correction. The ring finger had the largest length-to width ratio and smallest flap tip angle among the four fingers in the V–Y flap design. No vertical scar crossed the flexion creases and flap tip angle < 20° was found in the tentative V–Y flap design for the 120 fingers.

Conclusions

Our flap design method provides a proper advance distance and flap length-to-width ratio without common skin complications in the flap design for PIP flexion contracture of index, middle, ring and small fingers. This geometric model provides a mathematical basis for prediction of advance distance and flap tip angle in the design of a digital artery-based V–Y advancement flap.
Structural validity and reliability of the “Oral Health Assessment Tool” applied by speech-language therapists in a population of older Chilean people
Authors: Morales Camilo , Henríquez Felipe , Muñoz Sergio
Published: January 2023

Background

A good state of oral health allows people to communicate and eat. This topic is relevant in older people given its close relationship with their general health. At present, health challenges are directed at detecting and preventing oral disorders and are seen to exclusively by dentists, because the existing instruments can only be applied by them. However, speech-language therapists undergo similar training, which would allow them to collaborate in these processes. In this context, the Oral Health Assessment Tool (OHAT) is a detection instrument with good psychometric properties that is currently available for non-dental use. The objective of this study is the translation into Chilean Spanish of the OHAT and a structural validation of that version for application by these professionals.

Materials and methods

A mixed qualitative-quantitative study was carried out. The OHAT instrument was adapted to Chilean Spanish and subsequently subject to structural validity and evaluation of internal consistency reliability, as well as a valuation of its reproducibility in 286 older people (166 female, 120 male) from different health contexts.

Results

The cultural adaptation of the instrument proved to be semantically consistent with the original instrument. Its application was considered to be speedy and simple in the pre-test. The confirmatory factor analysis evidenced the unidimensionality of the OHAT. In addition, the instrument shows good internal consistency and test–retest reliability.

Conclusions

The OHAT instrument was considered to possess adequate structural validity and test–retest reliability properties. Its usefulness in the context of oral health disorders of this population in Chile is discussed.
Effect of argon plasma pre-treatment of healing abutments on peri-implant microbiome and soft tissue integration: a proof-of-concept randomized study
Authors: Canullo Luigi , Rakic Mia , Corvino Emilio , Burton Maria , Krumbeck Janina A. , Chittoor Prem Aishani , Ravidà Andrea , Ignjatović Nenad , Sculean Anton , Menini Maria , Pesce Paolo
Published: January 2023

Purpose

Biofilm-free implant surface is ultimate prerequisite for successful soft and bone tissue integration. Objective of the study was to estimate the effects of argon plasma healing abutment pre-treatment (PT) on peri-implant soft-tissue phenotype (PiSP), inflammation, plaque accumulation and the microbiome (PiM) between non-treated (NPT) and treated (PT) abutments following 3-months healing period. The hypothesis was that cell-conductive and antimicrobial properties of PT would yield optimal conditions for soft tissue integration.

Material and Methods

Two months following second-phase surgery, microbiological and clinical parameters were assessed around thirty-six healing abutments with two types of microtopography, smooth surface (MACHINED) and ultrathin threaded microsurface (ROUGH). A two level randomization schema was used to achieve equal distribution and abutments were randomly divided into rough and machined groups, and then divided into PT and NPT groups. PiM was assessed using next-generation DNA sequencing.

Results

PiM bacterial composition was highly diverse already two months post-implantation, consisting of key-stone pathogens, early and late colonizers, while the mycobiome was less diverse. PT was associated with lower plaque accumulation and inflammation without significant impact on PiSP, while in NPT clinical parameters were increased and associated with periopathogens. NPT mostly harbored late colonizers, while PT exerted higher abundance of early colonizers suggesting less advanced plaque formation. Interaction analysis in PT demonstrated S. mitis co-occurrence with pro-healthy Rothia dentocariosa and co-exclusion with Parvimonas micra, Porphyromonas endodontalis and Prevotella oris. PiSP parameters were generally similar between the groups, but significant association between PiM and keratinized mucosa width was observed in both groups, with remarkably more expressed diversity in NPT compared to PT. PT resulted in significantly lower BOP and PI around rough and machined abutments, respectively, without specific effect on PiM and PiSP.

Conclusions

PT contributed to significantly the less advanced biofilm accumulation and inflammation without specific effects on PiSP.
Deep learning-based prediction of mandibular growth trend in children with anterior crossbite using cephalometric radiographs
Authors: Zhang Jia-Nan , Lu Hai-Ping , Hou Jia , Wang Qiong , Yu Feng-Yang , Zhong Chong , Huang Cheng-Yi , Chen Si
Published: January 2023

Background

It is difficult for orthodontists to accurately predict the growth trend of the mandible in children with anterior crossbite. This study aims to develop a deep learning model to automatically predict the mandibular growth result into normal or overdeveloped using cephalometric radiographs.

Methods

A deep convolutional neural network (CNN) model was constructed based on the algorithm ResNet50 and trained on the basis of 256 cephalometric radiographs. The prediction behavior of the model was tested on 40 cephalograms and visualized by equipped with Grad-CAM. The prediction performance of the CNN model was compared with that of three junior orthodontists.

Results

The deep-learning model showed a good prediction accuracy about 85%, much higher when compared with the 54.2% of the junior orthodontists. The sensitivity and specificity of the model was 0.95 and 0.75 respectively, higher than that of the junior orthodontists (0.62 and 0.47 respectively). The area under the curve value of the deep-learning model was 0.9775. Visual inspection showed that the model mainly focused on the characteristics of special regions including chin, lower edge of the mandible, incisor teeth, airway and condyle to conduct the prediction.

Conclusions

The deep-learning CNN model could predict the growth trend of the mandible in anterior crossbite children with relatively high accuracy using cephalometric images. The deep learning model made the prediction decision mainly by identifying the characteristics of the regions of chin, lower edge of the mandible, incisor teeth area, airway and condyle in cephalometric images.
The nutritional content required to design an educational application for infertile women
Authors: Langarizadeh Mostafa , Nadjarzadeh Azadeh , Maghsoudi Banafshe , Fatemi Aghda Seyed Ali
Published: January 2023

Background

Infertility has been considered as a critical health problem for couples and society. Given the worldwide exponential rise of infertility, mobile phone-based applications are drastic ways to deliver nutrition educational content to women with infertility. The present study aimed to prepare the required educational content for designing a mobile phone-based nutrition educational application for women with infertility.

Methods

Educational contents were initially determined based on the literature review and library studies. As a result, a researcher-made questionnaire was designed containing 28 items in six dimensions. To ensure about the questionnaire’s validity, a panel of experts (15 nutritionists and 5 infertility specialists) was asked to review the items, make revisions (if necessary), and confirm the final contents. The questionnaire reliability was also corroborated using the KR-20 coefficient (0.89).

Results

While the amount of consumed calories per meal and between meals were not significantly effective on fertility, factors such as main definitions, disease and treatment instructions, personal activities and habits, and menstruation were deemed necessary by the respondents. Participants also suggested adding sections entailing introductions to different types of diets, users' suggestions and opinions, and of the address and contact information of senior nutrition centers to the questionnaire.

Conclusions

Followed by obtaining the required valid and reliable contents, a mobile phone- based nutrition education application can be designed to improve the patients' knowledge and facilitate their treatment process.
Employability in health professional education: a scoping review
Authors: Leadbeatter Delyse , Nanayakkara Shanika , Zhou Xiaoyan , Gao Jinlong
Published: January 2023

Background

The concept of employability can help educators understand the variability in the career outcome of graduates. Within the health professional education (HPE) literature, various conceptions of employability are used and implied. This review considers how the concept ‘employability’ is depicted and characterised in HPE literature.

Methods

A scoping review was conducted. The authors searched Medline, Web of Science and Scopus databases for English language literature relevant to employability in HPE. Arksey and O'Malley’s review protocol and the criteria defined in the preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews Checklist (PRISMA-ScR) were used with methodological guidance provided by Levac et al. and Peters et al. with the exception of formal stakeholder consultation.

Results

The search resulted in 158 articles, of which 34 articles were included in this review. Charting the included articles revealed that within the set of articles, there is much diversity in study design, geographical setting and health profession. Three conceptions of employability were identified: acquiring a professional job, sustaining employment and thriving in the workforce.

Conclusion

Conceptions of employability in HPE are largely focused on listing skills and capabilities for entry into employment and sustaining a career. To address gaps in research, structural contributions to employability and institutional strategies to promote conditions for thriving in disruption should be explored.