bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the language demands of informed consent documents in patient recruitment to cancer trials using tools from corpus and computational linguistics
Authors: Isaacs Talia , Murdoch Jamie , Demjén Zsófia , Stevenson Fiona
Published: October 2020

Obtaining informed consent (IC) is an ethical imperative, signifying participants’ understanding of the conditions and implications of research participation. One setting where the stakes for understanding are high is randomized controlled trials (RCTs), which test the effectiveness and safety of medical interventions. However, the use of legalese and medicalese in ethical forms coupled with the need to explain RCT-related concepts (e.g. randomization) can increase patients’ cognitive load when reading text. There is a need to systematically examine the language demands of IC documents, including whether the processes intended to safeguard patients by providing clear information might do the opposite through complex, inaccessible language. Therefore, the goal of this study is to build an open-access corpus of patient information sheets (PIS) and consent forms (CF) and analyze each genre using an interdisciplinary approach to capture multidimensional measures of language quality beyond traditional readability measures. A search of publicly-available online IC documents for UK-based cancer RCTs (2000-17) yielded corpora of 27 PIS and 23 CF. Textual analysis using the computational tool, Coh-Metrix, revealed different linguistic dimensions relating to the complexity of IC documents, particularly low word concreteness for PIS and low referential and deep cohesion for CF, although both had high narrativity. Key part-of-speech analyses using Wmatrix corpus software revealed a contrast between the overrepresentation of the pronoun ‘you’ plus modal verbs in PIS and ‘I’ in CF, exposing the contradiction inherent in conveying uncertainty to patients using tentative language in PIS while making them affirm certainty in their understanding in CF.
Ritual, fusion, and conflict: The roots of agro-pastoral violence in rural Cameroon
Authors: Buhrmester Michael D. , Zeitlyn David , Whitehouse Harvey
Published: October 2020

Herder–farmer conflicts in West Africa have caused thousands of deaths in recent years. Many conflicts are triggered by localized events that rapidly spiral out of control. What leads specific interpersonal conflicts to scale up into intergroup violence? We propose that such conflicts are rooted in identity and ritual dynamics. We present evidence that participants in Mambila traditions of masquerade initiation in Cameroon report especially strong identity fusion, a visceral sense of oneness with the ingroup. Results showed that men strongly fused to their ethnic ingroup were especially willing to fight and die for it. Overall, our findings provide evidence that when ordinary conflicts develop between groups that differ sharply on ethnic and religious lines, there is grave risk that fused persons will escalate violence. Understanding these processes may inform future development of new strategies to prevent or ameliorate intergroup conflicts of this kind.
Surgical treatment is effective in treating thymoma accompanied with non-myasthenia gravis autoimmune diseases: a single-center clinical experience
Authors: Liu Lei , Zhang Jiaqi , Wang Guige , Guo Chao , Chen Yeye , Huang Cheng , Li Shanqing
Published: October 2020

Background and Aims:

Although thymoma is inextricably linked to autoimmune disease, its best treatment method remains unclear. In this study, we sought to evaluate therapeutic effect of surgical resection of thymoma on non-myasthenia gravis autoimmune diseases.

Materials and Methods:

This was a retrospective study covering 32 patients with thymoma accompanied with non-myasthenia gravis autoimmune disease. The relationships between surgical treatment, thymoma pathological type, and prognosis of autoimmune diseases were analyzed from postoperative follow-up data.

Results:

In total, 32 patients in this study underwent surgical treatment. The mean age of the patients was 51.7 years. By the last follow-up, 2 patients had died, while the other 30 patients showed no sign of tumor recurrence and metastasis. According to the postoperative follow-up data, 22 patients (68.75%) showed improvement or even complete recovery of autoimmune disease symptoms, 9 patients (28.13%) showed no significant change, and only 1 patient’s (3.12%) postoperative symptom was aggravated. Female patients and patients aged 50 and older were more likely to combine with non-organ-specific autoimmune diseases (p = 0.036, p = 0.017).

Conclusions:

In conclusion, this study presents that surgical treatment achieves a satisfactory prognosis for thymoma combined with non-myasthenia gravis autoimmune disease.
An effective health indicator for bearing using corrected conditional entropy through diversity-driven multi-parent evolutionary algorithm
Authors: Chauhan Sumika , Singh Manmohan , Kumar Aggarwal Ashwani
Published: October 2020

The bearing vibration signal possesses nonlinear and non-stationary characteristics; hence; it is difficult to diagnosis the faults in the bearing under different working conditions. In this article, a new scheme has been proposed based on complete ensemble empirical mode decomposition with adaptive noise and corrected conditional entropy to recognize the different class of faults in bearing. The mode with minimum corrected conditional entropy is treated as a prominent mode from which sensitive features are extracted. A filter-based feature selection scheme is used for the same and for ranking the features based on variance to reduce the redundancy of data set. This data set is made input to support vector machine. The performance of the support vector machine classifier is improved by optimizing its parameters to obtain maximum classification accuracy. To address this issue, an evolutionary algorithm (diversity-driven multi-parent evolutionary algorithm) is used. With optimized support vector machine parameters, the support vector machine is trained to build a classification model with 10-fold cross-validation. After training, the built model is tested against test data set for fitness evaluation. The support vector machine classifier gives 100% accuracy at regularization and kernel parameter’s value of 1.3343 and of 782.6329, respectively, with 27.93 s of training time for a single iteration.
An integrated light management system with real-time light measurement and human perception
Authors: Tsesmelis T , Hasan I , Cristani M , Bue A Del , Galasso F
Published: October 2020

Illumination is important for well-being, productivity and safety across several environments, including offices, retail shops and industrial warehouses. Current techniques for setting up lighting require extensive and expert support and need to be repeated if the scene changes. Here we propose the first fully automated light management system which measures lighting in real-time, leveraging an RGBD sensor and a radiosity-based light propagation model. Thanks to the integration of light distribution and perception curves into the radiosity, we outperform a commercial software (Relux) on a newly introduced dataset. Furthermore, our proposed light management system is the first to estimate both the presence and the attention of the people in the environment, as well as their light perception. Our new light management system adapts lighting to the scene and human activity and it is capable of energy savings of up to 66%, as we experimentally quantify, without compromising the lighting quality.
Critical intellectuals in postdigital times
Authors: Jandrić Petar , McLaren Peter
Published: October 2020

This article starts with a brief analysis of what it means to be an intellectual within the US tradition of critical pedagogy. Pointing toward important socio-technological transformations which have taken place in the past few decades, the article situates the concept of the intellectual into the contemporary postdigital context. The article looks into two main areas of intellectual work which seem to have undergone significant transformations—automation and post-truth. It develops possible responses to recent challenges in these areas and shows that contemporary intellectuals working in the tradition of critical pedagogy need to take technology seriously. Heading toward the conclusion, the article promotes Greta Thunberg as an important example of a postdigital intellectual. Our analyses show that critical pedagogy has an important role in the development of contemporary intellectual work. Aiming at constantly transforming challenges, however, old theories require constant reconceptualization in and for our postdigital context. Within this mash-up of questions and answers old and new, we identify a starting point for this reconceptualization in the notion of critical praxis.
Sex-Related Anatomical Feasibility Differences in Endovascular Repair of Thoracoabdominal Aortic Aneurysms With a Multibranched Stent-Graft
Authors: Grandi Alessandro , Carta Niccolò , Cambiaghi Tommaso , Bilman Victor , Melissano Germano , Chiesa Roberto , Bertoglio Luca
Published: October 2020

Purpose:

To evaluate the potential anatomical feasibility of using the off-the-shelf multibranched Zenith t-Branch for the treatment of thoracoabdominal aortic aneurysms (TAAAs) in female patients.

Materials and Methods:

A total of 268 patients (median age 68 years; 69 women) with degenerative TAAA treated at a single institution by means of open or endovascular repair between 2007 and 2019 were retrospectively analyzed to determine the feasibility of using the Zenith t-Branch based on the manufacturer’s instructions for use. The factors determining overall anatomical feasibility were divided into vascular access, aortic anatomy, and visceral vessels. The results were stratified by sex and compared. A logistic regression model was constructed to determine any association between feasibility and clinical factors or potential confounding variables; results are expressed as the odds ratio (OR) with 95% confidence interval (CI).

Results:

The overall anatomical feasibility was 39% (22% women vs 45% men, p=0.001). The feasibility was negatively influenced by female sex (p<0.001) in multivariable analysis (OR 2.9, 95% CI 1.5 to 5.4, p=0.001). Vascular access feasibility was 82% (61% women vs 89% men, p<0.001). Aorta feasibility was 65% (52% women vs 69% men, p<0.001), and visceral vessel feasibility was 74% (78% women vs 73% men, p=0.260). An access diameter ≤8.5 mm excluded 17% of the patients (39% women vs 9% men, p<0.001). The aortic feasibility was limited by the infrarenal aortic diameter in 16% of patients (45% women vs 6% men, p<0.001) and the aortic lumen at the visceral vessels in 17% patients (19% women vs 17% men, p=0.741). The visceral vessel feasibility was mainly limited by inadequate numbers or diameters of target vessels. Location and orientation of the target vessels were adequate in 96% of patients.

Conclusion:

A little more than a third of an all-comers cohort of patients with degenerative TAAA could have been treated with on-label use of the Zenith t-Branch. However, only 22% of women could have been treated because of sex-related anatomical limitations. New generations of multibranched devices should address these differences.
Development of alkali-treated surface-modified coir fibre filter for 1µm to 10 µm particle filtration and process optimization
Authors: Gobi N , Aarthi R , Farzin A , Pazhanishankar R , Monnisha G
Published: October 2020

Filtration of Particulate Matter (PM) 2.5 and PM 10 particles are focused by the filters used in Heating, Ventilation and Air Conditioning (HVAC) systems. Synthetic fibres/filaments are widely used to construct the filters for air conditioning filters and cleanroom filters which is not biodegradable. Natural fibres are easily biodegradable, exhibit better filtration characteristics as like synthetic fibres. In this research, alkali-treated coir fibres are used to construct the filter for filtering the particle range of 1.0 µm to 10 µm. Box- Behnken experimental design was used for the experimental plan and the experiments were conducted to construct the filters. The change in fibre properties by alkali-treatment was observed and the treatment with 5% and 10% alkali increases the crystallinity index of fibres. The influence of independent variables on the performance of developed filters was analyzed in detail. 5% NaOH treated fibre sample with 20% resin proportion and 60 g fibre content in the unit area was identified by a quality factor as the best combination of independent variables for constructing filter.
Blood Cell Count Biomarkers, Risk, and Outcomes of Ischemia-Related Lower Limb Amputations: A Systematic Review
Authors: Dettori Paola , Mangoni Arduino Aleksander , Zinellu Angelo , Carru Ciriaco , Paliogiannis Panagiotis
Published: October 2020

Lower limb amputations due to ischemia represent an important health care and social issue. However, there are currently no specific biomarkers able to predict the risk of amputation and postamputation complications and prognosis. We conducted a systematic review of studies investigating whether blood cell count indexes of systemic inflammation are linked to the risk and the outcome of lower limb amputations due to ischemia. Overall, in 22 studies involving 8832 patients selected for review, several blood cell count indexes, particularly the neutrophil lymphocyte ratio, showed some promise in terms of predicting amputations and general outcomes of conservative and surgical treatments, as well as postamputation complications and prognosis. However, largely due to methodological limitations, further prospective studies are required to establish the clinical utility and applicability of blood cell indexes in the routine management of patients with ischemia-related lower limb amputations.
Epigallocatechin gallate decreases plasma triglyceride, blood pressure, and serum kisspeptin in obese human subjects
Authors: Chatree Saimai , Sitticharoon Chantacha , Maikaew Pailin , Pongwattanapakin Kitchaya , Keadkraichaiwat Issarawan , Churintaraphan Malika , Sripong Chanakarn , Sririwichitchai Rungnapa , Tapechum Sompol
Published: October 2020

Obesity is one of major risk factors increasing chronic diseases including type II diabetes, cardiovascular diseases, and hypertension. The effects of epigallocatechin gallate (EGCG), the major active compound in green tea, on reduced obesity and improved metabolic profiles are still controversial. Furthermore, the effects of EGCG on human adipocyte lipolysis and browning of white adipocytes have not been elucidated. This study aimed to investigate the effects of EGCG on obesity, lipolysis, and browning of human white adipocytes. The results showed that, when compared to the baseline values, EGCG significantly decreased fasting plasma triglyceride levels ( P < 0.05), systolic blood pressure ( P < 0.05), diastolic blood pressure ( P < 0.05), and serum kisspeptin levels ( P < 0.05) after 8 weeks of supplement. On the other hand, supplement of EGCG in obese human subjects for 4 or 8 weeks did not decrease body weight, body mass index, waist and hip circumferences, nor total body fat mass or percentage when compared to their baseline values. The study in human adipocytes showed that EGCG did not increase the glycerol release when compared to vehicle, suggesting that it had no lipolytic effect. Furthermore, treatment of EGCG did not enhance uncoupling protein 1 ( UCP1) mRNA expression in human white adipocytes when compared with treatment of pioglitazone, the peroxisome proliferator-activated receptor γ (PPAR-γ) agonist, suggesting that EGCG did not augment the browning effect of PPAR-γ on white adipocytes. This study revealed that EGCG reduced 2 metabolic risk factors which are triglyceride and blood pressure in the human experiment. We also showed a novel evidence that EGCG decreased kisspeptin levels. However, EGCG had no effects on obesity reduction in humans, lipolysis, nor browning of human white adipocytes.
History of and Insights Into Spinal Cord Stimulation in Parkinson Disease
Authors: Garcia Bruno Braz , Junior Edson Ricardo , Araújo Mariana Ferreira Pereira de , Simplício Hougelle
Published: October 2020

Background

Current available therapies for Parkinson disease (PD) have strong limitations, and patients usually present with refractory symptoms despite all efforts. Deep brain stimulation (DBS), which has been used in PD patients for decades (since 1987), has best indications for symptoms like tremor, motor fluctuations, or dyskinesia. However, postural instability and gait disturbances (PIGD) have restricted benefits with DBS. In 2009, spinal cord stimulation (SCS), a well-established therapy for chronic pain, has emerged as a potential alternative therapy that may help control unresponsive symptoms such as bradykinesia, PIGD, and freezing of gait.

Methods

The main studies regarding SCS in PD are reviewed here from the first studies in animal models to the latest clinical trials.

Conclusions

Despite promising findings, the heterogeneity of methodologies used and small samples in human studies pose a challenging problem to be addressed in order to have robust clinical evidence to support SCS as a viable PD treatment
Recreate and Retain: How Entrance Into a Campus Recreation Facility Impacts Retention
Authors: Milton Paul R. , Williamson Lisa M. , Brubaker Kenneth , Papania Michael
Published: October 2020

This study explored the rates of retention among students who entered a campus recreation facility. The purpose of the study was to determine the statistical significance of the rates of retention within several commonly studied demographic categories. Recent research in the field reported that student participation in campus recreation programs contributes to student retention. The researchers in this study also sought to determine whether there was a significant impact on campus recreation participants to return not only to the campus recreation center but to the university during the following fall term. Data were collected during a specific spring and subsequent fall semester to determine whether those who entered the recreation center during the spring enrolled in the fall term. Student entries were initially categorized by the number of visits 1–30, 31–60, 61–90, and 91–120 and were compared to students who did not enter. A χ2 analysis was conducted to compare the data collected from spring to fall terms and the results were separated by gender and overall participation. This suggests a positive relationship between entry into the recreation center and student retention from the spring to fall terms.
Knowledge and Habits of Exercise in Medical Students
Authors: Recker Andrew J. , Sugimoto Sam F. , Halvorson Elizabeth E. , Skelton Joseph A.
Published: October 2020

Objective. To examine the exercise habits, knowledge, and self-efficacy of incoming medical students. Methods. Mixed-methods study consisting of (1) cross-sectional surveys and (2) qualitative key-informant interviews. (1) International Physical Activity Questionnaire (IPAQ), American Adult’s Knowledge of Exercise Recommendations Survey (AAKERS), and Self-Efficacy for Exercise Scale (SEES) to assess student’s physical activity level, knowledge of exercise recommendations, and self-efficacy for exercise. (2) Scripted questions explored exercise habits, sources of exercise knowledge, attitude toward exercise. Results. (1) Results of IPAQ classified students as 50% having high, 40% moderate, and 10% low levels of physical activity (n = 132). AAKERS demonstrated a mean total score of 16.2/20 (n = 130) (81% correct), similar to the national average (mean = 16/20) (n = 2002). SEES mean score of 48.5/90 (n = 128) is similar to previous studies (mean = 48.6/90, 52.75/90). (2) Interviews revealed that most students have a consistent exercise routine. Few students received formal education in exercise (10%), while the rest cited either peers, sports, or internet as primary sources of exercise knowledge. Less than half stated they would be comfortable designing an exercise routine for patients. Conclusions. Incoming medical students live an active lifestyle but have limited knowledge and formal training in exercise. Student’s knowledge is predominantly self-taught from independent resources.
The oral health status of patients with peripheral vascular disorders: A systematic review
Authors: Almoosawy Sayed Abdulmotaleb , McGowan Mhairi , Hijazi Karolin , Patey Rona , Bachoo Paul , Cherukara George
Published: October 2020

Objectives

Periodontal disease and tooth loss were found to be associated with several peripheral vascular disorders. Nonetheless, an evaluation of the literature on the broader domains of oral health in individuals with peripheral vascular disorders is lacking. This systematic review aims to collate the current evidence on the oral health status of individuals with peripheral vascular disorders.

Methods

Five electronic databases were searched for studies assessing oral health parameters in individuals with peripheral vascular disorders. Outcome measures considered were periodontal health, dentition status, caries indices, oral prostheses, oral pathologies and oral hygiene behaviours. The Newcastle-Ottawa scale was used to appraise the quality of the studies.

Results

From 3025 records identified, 24 studies involving 1232 participants with peripheral vascular disorders were included in this review. In nine studies, periodontitis was significantly more prevalent in peripheral vascular disorders compared to non-peripheral vascular disorders participants. A further six studies reported individuals with peripheral vascular disorders also had significantly fewer teeth and increased rates of edentulism. Only one study reported a higher incidence of dental caries in peripheral vascular disorders participants. Other aspects of oral health such as oral prosthesis, oral pathology and oral hygiene behaviours were seldom assessed.

Conclusions

The scarcity of studies reporting on broader domains limited our ability to arrive at a conclusion regarding the oral health status of individuals with peripheral vascular disorders. Future studies ought to assess these domains in individuals with peripheral vascular disorders and controls to gain a more complete understanding of oral health and its potential association with peripheral vascular disorders.
Charting the Diversity of Strategic Processes in Visuospatial Short-Term Memory
Authors: Gonthier Corentin
Published: October 2020

Despite the abundant literature on visuospatial short-term memory, researchers have devoted little attention to strategic processes: What procedures do subjects implement to memorize visuospatial material? Evidence for various strategies exists, but it is spread across a variety of fields. This integrative review of the literature brings together scattered evidence to provide an overview of strategic processes in visuospatial memory tasks. The diversity of strategies and their proposed operating mechanisms are reviewed and discussed. The evidence leads to proposing seven broad strategic processes used in visuospatial short-term memory, each with multiple variants. Strategies can vary across individuals, but the same subjects also appear to use multiple strategies depending on the perceptual features of to-be-remembered displays. These results point to a view of visuospatial strategies as a functional library of facilitatory processes on which subjects can draw to support visuospatial short-term memory performance. Implications are discussed for the difference between visual and spatial tasks, for the appropriate measurement of strategic behaviors, and for the interpretation of performance in visuospatial memory tasks.
Minimal path set importance in complex systems
Authors: Aggarwal Sudhanshu
Published: October 2020

To find the best mode for system design in reliability optimization, risk engineers around the world use the importance measure as a basic tool. This paper introduces a new importance measure taking into account minimal path sets of the system. It helps to optimize the system designs that occur in many situations. For instance, this importance measure can be used (a) in identifying important components of any complex system and (b) solving constrained redundancy optimization problems. This is illustrated by providing two heuristic algorithms. In the first algorithm, this measure is used to find important components of any complex system ensuring improved system reliability. The second algorithm is used to solve a constrained redundancy optimization problem for any general coherent system giving (near) optimal solutions in 1-neighborhood. The results show that the new importance measure is easily applicable, unlike the classical ones. Hence, it serves as a very useful tool in measuring the important component(s) and solving constrained redundancy optimization problems of complex systems. Thus, it can be considered as a good alternative to the existing importance measures.
Bloggers on FIRE Performing Identity and Building Community: Considerations for Cyber-Autoethnography
Authors: Lapadat Judith C.
Published: October 2020

As a research approach, autoethnography has revolutionized qualitative inquiry. To date, most autoethnographies represent the lives of academics and are published in the research press for a small audience of other academics. However, in the digital world, a subset of blogs has emerged in which the self-narratives are substantially similar to autoethnographies in content, quality, and level of social commentary, but with a broader scope and audience. For example, FIRE bloggers write about how they are striving to reach the goal of Financial Independence and Early Retirement (FIRE). They share detailed accounts of their financial circumstances, personal stories, strategies, and social insights. Through an analysis of FIRE blog texts, I examine digital presentation and performance of identity, relational aspects of online communication, and strategies these bloggers and their followers use to create community. The success of bloggers in bringing together people around the world to form communities with shared aims points to possibilities for how cyber-autoethnographers might broaden the reach of autoethnography while also building a collaborative sense of agency to accomplish personal and political goals. My interest in this cyber-community is theoretical, but intersects with challenges I have grappled with in my personal transition to retirement.
Circulating markers of angiogenesis and endotheliopathy in COVID‐19
Authors: Pine Alexander B. , Meizlish Matthew L. , Goshua George , Chang C‐Hong , Zhang Hanming , Bishai Jason , Bahel Parveen , Patel Amisha , Gbyli Rana , Kwan Jennifer M. , Won Christine H. , Price Christina , Dela Cruz Charles S. , Halene Stephanie , van Dijk David , Hwa John , Lee Alfred I. , Chun Hyung J.
Published: October 2020

Increase in thrombotic and microvascular complications is emerging to be a key feature of patients with critical illness associated with COVID‐19 infection. While endotheliopathy is thought to be a key factor of COVID‐19‐associated coagulopathy, markers indicative of this process that are prognostic of disease severity have not been well‐established in this patient population. Using plasma profiling of patients with COVID‐19, we identified circulating markers that segregated with disease severity: markers of angiogenesis (VEGF‐A, PDGF‐AA and PDGF‐AB/BB) were elevated in hospitalized patients with non‐critical COVID‐19 infection, while markers of endothelial injury (angiopoietin‐2, FLT‐3L, PAI‐1) were elevated in patients with critical COVID‐19 infection. In survival analysis, elevated markers of endothelial injury (angiopoietin‐2, follistatin, PAI‐1) were strongly predictive of in‐hospital mortality. Our findings demonstrate that non‐critical and critical phases of COVID‐19 disease may be driven by distinct mechanisms involving key aspects of endothelial cell function, and identify drivers of COVID‐19 pathogenesis and potential targets for future therapies.
Capacity, Consent and Dentistry – Who Decides and How Do They Do it?
Authors: Greening Paul
Published: October 2020

Dental interventions can only occur within a legal framework. This means either the patient gives their informed consent to the procedure or, if this is not possible, an assessment is made whether they lack the ability to consent, in which case a decision on treatment is made under the Mental Capacity Act (MCA).1 This article takes a brief look at how the MCA sets out the test of capacity, who makes decisions when the patient is unable to do so and how ‘best interest’ decisions are made in a way that protects the rights of the patient and protects the dental professional from legal liability.
An Evaluation of A Practice-Based Minor Oral Surgery Service
Authors: Dyer Thomas Anthony , Lau Jessica Ga Lai , Anthony Dyer Thomas , Ga Lai Jessica
Published: October 2020

Aim

To report the findings of a service evaluation of an NHS practice-based minor oral surgery service.

Method

A service evaluation including a retrospective analysis of activity and outcome data and assessment of patient and practitioner satisfaction.

Results

623 appointments were arranged, with a mean waiting time of 43 days. Treatment provided included: surgical removal of third molars and non-third molars, surgical endodontics and other surgical and oral medicine cases (29.7%, 44.1%, 3.0% and 23.4% of cases respectively). Antibiotics were prescribed at 16.1 % of treatment appointments and 1.9% required appointments for post-operative complications. All participants reported overall satisfaction with their care and strongly agreed/agreed with positive attitudinal statements about the oral surgeon's communication/information giving, technical competence and understanding and acceptance; 77.5% were seen on time and none were seen more than 15 minutes late; 87.5% felt the standard of the service was better than expected than at a hospital and none felt it was worse. Over 80 of practitioners agreed that waiting times were better than expected at a hospital, urgent problems were seen quickly and the referral process was easy and understandable. All practitioners strongly agreed/agreed they that they were happy with the service provided.

Conclusions

A range of minor oral surgery procedures can be provided with low complication rates, acceptable waiting times and accessibility, and high patient and referring practitioner satisfaction from a practice-based specialist oral surgery service.
Chronic Pain and Overview or Differential Diagnoses of Nonodontogenic Orofacial Pain
Authors: Renton Tara
Published: October 2020

Orofacial pain is defined as pain arising from the regions of the face and mouth. Dental pain is the most common inflammatory pain presenting in this region; however, chronic pain conditions presenting frequently, including temporomandibular joint disorders (TMDs), primary headaches (neurovascular), neuropathic pain and idiopathic pain conditions, can often mimic toothache. Dentists are familiar with TMDs but have no training or experience in diagnosing or treating headaches that mainly present in the first trigeminal division. The anatomical complexity of the region and the potential possible diagnoses, mean that correct diagnosis is often delayed resulting in patients often undergoing inappropriate surgical and medical treatments that themselves may complicate the presentation of the pain by changing its phenotype and further complicating diagnosis and appropriate management.

Due to the variable pain presentation of toothache, it can mimic many different chronic episodic orofacial pain conditions, resulting in many inappropriately prescribed courses of antibiotics and surgical interventions. Dentists are not the only profession to fall foul of the misdiagnosis but ear, nose and throat (ENT) and maxillofacial surgeons fall into the same trap.
Quality of life of older adults in nursing homes in Vietnam
Authors: Dung Vu , Thi Mai Lan Nguyen , Thu Trang Vu , Xuan Cu Truong , Minh Thien Le , Sy Thu Nguyen , Dinh Man Phung , Minh Long Dau , Trong Ngo Phan , Minh Nguyet Le
Published: October 2020

This study evaluated the quality of life of older adults in Vietnam. A survey was conducted on 291 old people at eight public and private nursing homes using cluster sampling. Quality of life was predicted by gender, duration of stay, center activities and community tangible support, and connection with family. Results were consistent across the four subscales of the Quality of Life Index. Quality of life of Vietnamese older adults depends not only on the quality of services provided by the nursing homes but also on family and community connections.
Effect of tobacco use on disease activity and DMT discontinuation in multiple sclerosis patients treated with dimethyl fumarate or fingolimod
Authors: Hersh Carrie M , Harris Haleigh , Ayers Malissa , Conway Devon
Published: October 2020

Background

Tobacco exposure is a modifiable risk factor for multiple sclerosis (MS). Studies evaluating the relationship between tobacco, disease activity, and disease modifying therapy (DMT) persistence yielded conflicting results. We sought to address this issue with data from clinical practice.

Objective

To compare 24-month disease outcomes in tobacco versus non-tobacco users treated with dimethyl fumarate (DMF) or fingolimod (FTY) in clinical practice.

Methods

We retrospectively identified 659 MS patients treated with DMF or FTY, stratified by patient-reported tobacco use. DMT discontinuation and measures of disease activity at 24 months were assessed using propensity score (PS) weighting. Outcome estimates were calculated as tobacco vs non-tobacco use.

Results

164 tobacco users (DMF n = 101; FTY n = 63) and 495 non-tobacco users (DMF n = 294; FTY n = 201) were identified. Tobacco (39.4%) and non-tobacco (34.4%) users were equally likely to discontinue DMT (OR = 1.17, 95% CI 0.79, 1.75), but tobacco users discontinued therapy earlier (HR = 1.53, 95% CI 1.06, 2.43). There were no differences in ARR (rate ratio = 1.39, 95% CI 0.97, 1.96). However, tobacco users had decreased odds of NEDA-2 (OR = 0.61, 95% CI 0.44, 0.83).

Conclusion

Our findings suggest that tobacco is a negative risk factor for inflammatory disease activity and earlier DMF and FTY discontinuation.
Enlarged perivascular spaces are not associated with vascular co-morbidities, clinical outcomes, and brain volumes in people with secondary progressive multiple sclerosis
Authors: Wooliscroft Lindsey , Boespflug Erin , Hildebrand Andrea , Shangraw Kathleen , Silbermann Elizabeth , Bourdette Dennis , Spain Rebecca
Published: October 2020

Background

In secondary progressive multiple sclerosis (SPMS) significance of enlarged perivascular spaces (ePVS) is unknown. Objectives, Methods: Analysis of associations between vascular co-morbidities, clinical outcomes, and volumetrics with categorical ePVS scores in midbrain, basal ganglia (BG), and centrum semiovale (CSO) in SPMS(n-46). Results, Conclusion: In BG, advancing age (Z = 2.68) and lower Expanded Disability Status Scale (Z = −2.04) were associated with increasing ePVS score. In CSO, advancing age (Z = 2.66) and male gender (Z = 2.45) were associated with increasing ePVS score. No associations between ePVS score and vascular co-morbidities or volumetrics existed; ePVS may not be an informative marker for SPMS.
China’s Experiences in Developing Lifelong Education, 1978–2017
Authors: Wu (吴遵民) Zunmin
Published: October 2020

Purpose:

This study systematically reviews the China’s progress in lifelong education (LLE) policies, theories, and practices in the 40 years since its reform and opening-up and provides several guidelines for developing LLE going forward.

Design/Approach/Methods:

This study analyzes the characteristics of LLE in China through a review of its developmental process and prospects at the policy, theoretical, and practical levels.

Findings:

While following the goals of LLE set by the United Nations Educational, Scientific, and Cultural Organization, China has developed and implemented LLE with distinctly Chinese characteristics. The development of LLE in China has focused on protecting citizens’ learning rights, improving civic literacy, and enhancing human resources. This study reveals four aspects of China’s experiences of LLE development. First, as the primary actor in promoting LLE, the government took responsibility for providing guidance and leadership in the development and implementation of LLE. Second, the people’s enthusiastic response to and expectation of the further enhancement of their spiritual cultivation and quality of life established LLE’s practical status. Third, the socioeconomic and political context consolidated the value foundation of LLE development. Fourth, the positive responses of the academic community and follow-up studies promoted policy-oriented processes and practice-based scientific development.

Originality/Value:

In addition to suggestions for the creation of an LLE system with Chinese characteristics, this study reveals several core theoretical topics of LLE development in China that warrant further research.
Effect of Tobacco Cessation on Weight in a Veteran Population
Authors: Zhou Crystal , Tran Nicole G. , Chen Timothy C.
Published: October 2020

Introduction/Objectives:

Weight gain concerns remain a barrier to tobacco cessation. Literature suggests that weight gain can occur after stopping tobacco, but continuing tobacco can have far worse outcomes. Limited information is available regarding weight gain in military personnel. The objective of this study was to evaluate weight change in veterans that stopped tobacco for a minimum of 12 months enrolled in a pharmacist managed telephone tobacco cessation clinic (PMTTCC).

Methods:

A retrospective analysis of veterans who had been tobacco-free for 12 months enrolled in a PMTTCC were included in this analysis. Primary outcomes were change in weight (kg) and body mass index (BMI) from baseline. Descriptive data were utilized where appropriate and paired t-tests were utilized for the primary outcomes.

Results:

Seventy-seven patients were screened and 10 were excluded. Sixty-seven veterans met inclusion criteria and were mostly male (91%, n = 61) and Caucasian (74.6%, n = 50). At 12 months post cessation, the mean weight gain was (1.81 kg ± 6.83, P = .03) and BMI (0.51 ± 2.23 kg/m2, P = .06).

Conclusions:

Veterans appeared to have minimal weight gain despite statistical significance and no statistical change with BMI after 12 months of being tobacco-free. Results suggest that the long-term weight gain is minimal, and a comprehensive tobacco cessation program can be helpful to improve weight outcomes.
Can We Agree What Skilled Mindfulness-Based Teaching Looks Like? Lessons From Studying the MBI:TAC
Authors: S Crane Rebecca , Hecht Frederick M , Brewer Judson , Griffith Gemma M , Hartogensis Wendy , Koerbel Lynn , Moran Patricia , Sansom Sophie , Yiangou Alison , Kuyken Willem
Published: October 2020

Background

The Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) is a widely used tool for assessing fidelity in mindfulness-based program (MBP) research and training. It also supports MBP teacher reflective and skill development. MBI:TAC assessors review MBP teaching and rate the teaching on 6 domains. The MBI:TAC yields individual domain and overall scores, using 6 levels of competence. Although the MBI:TAC is widely used in MBP research and training, research is at an early stage.

Objective

We developed and tested a method of training MBI:TAC assessors to use the tool reliably and examined interrater reliability of the tool.

Methods

A total of 31 international senior MBP teachers were recruited to join an online training to build their skills in using the MBI:TAC. The training systematically and iteratively built familiarity and skills in assessing the 6 MBI:TAC domains. Qualitative and quantitative data on trainee’s experience of the training were gathered. Interrater reliability in using the tool was tested each week of the training. At the end of the training, interrater reliability was tested by asking trainees to individually assess videos that they had not previously seen. Their ratings were compared to benchmark assessments, which had been established via consensus agreement between 4 expert users of the MBI:TAC.

Results

The training was well received and appreciated, with some challenges experienced in applying the assessment methodology. Participants’ ratings became progressively more in line with one another and the benchmark ratings during the training. At the end, interrater reliability was high (ranging from 0.67 to 1.0).

Conclusion

It is possible for senior MBP trainers, coming from different regions in the world, to align toward common understandings of the elements of MBP teaching competence and program integrity. An assessor training methodology was tested, and the learning from this project has led to refinements for future delivery.
A bibliometric analysis of multimorbidity from 2005 to 2019
Authors: Ahmed Mohamed Ali Ag , Almirall José , Ngangue Patrice , Poitras Marie-Eve , Fortin Martin
Published: October 2020

Context:

Multimorbidity is frequently seen in primary care. We aimed to identify and analyze publications on multimorbidity, including those that most influenced this field.

Method:

A bibliometric analysis of publications from 2005 to 2019 in the PubMed database containing “multimorbidity” or “multi-morbidity” identified with the tool iCite. We analyzed the number of publications, total citations, the article-level metric Relative Citation Ratio (RCR), type of study, and journals with the most cited articles.

Results:

The number of publications using “multimorbidity” has continuously increased since 2005 (2005–2009: 138; 2010–2014: 823; 2015–2019: 3068). The median number of total citations per article was 3. The median RCR was 1.04. Articles with RCR at or above the 97th percentile (RCR = 7.43) were analyzed in detail (n = 104). In 34 publications of this subgroup (33%), the word multimorbidity was used but was not the subject of study. The remaining top 70 publications included 32 observational studies, 22 reviews, five guideline statements, three analysis papers, two randomized trials, three qualitative studies, two measurement development reports, and one conceptual framework development report. The publications were produced by authors from 32 countries. They were published in 37 different journals, ranging from one to four articles in the same journal.

Conclusions:

We found a continuous increase in the number of publications about multimorbidity since 2005. However, our study suggests that the numbers should be considered only a general trend because multimorbidity was not the main subject in 33% of publications in a subgroup of 104 analyzed in detail.
Risk factors of dysphagia in patients with ossification of the anterior longitudinal ligament
Authors: Nishimura Hirosuke , Endo Kenji , Aihara Takato , Murata Kazuma , Suzuki Hidekazu , Matsuoka Yuji , Takamatsu Taichiro , Maekawa Asato , Sawaji Yasunobu , Tsuji Hanako , Yamamoto Kengo
Published: October 2020

Introduction:

Cervical ossification of the anterior longitudinal ligament (OALL) occasionally leads to dysphagia by the anterior osteophyte. A recent report explained that the dysphagia after an occipito-cervical fusion is caused by the narrowing of pharyngeal space due to the cranio-cervical malalignment. The purpose of this study was to evaluate the cranio-cervical alignment in patients with OALL complaining of the dysphagia.

Subjects and methods:

The subjects were 11 cases with complaining of dysphagia due to cervical OALL who underwent anterior cervical OALL resection and as control, age-matched 12 cases without dysphagia who have diffuse idiopathic skeletal hyperostosis in cervical spine. All subjects were male, and the mean age was 59.5 ± 9.1 years. The subjects were divided into two groups according to the symptoms of dysphagia (dysphagia, group A; control, group B). The O–C2 angle, C2–C7 angle, and the maximum thickness of OALL and the cranio-cervical alignment (pharyngeal inlet angle; PIA) and swallowing line (S-line) were measured before and after the operation on the lateral cervical radiogram at the sitting position.

Results:

Group A showed significantly large maximum thickness of OALL, small cervical range of motion, small O–C2 angle, large C2–C7 angle, and small PIA. The S-line crossed the anterior apex of cervical osteophyte in group A. After OALL resection, dysphagia had improved, PIA had increased, and the S-line uncrossed the apex of cervical vertebrae in all cases.

Conclusion:

The prevalence of dysphagia in patients with cervical OALL was influenced by the thickness of osteophyte, cervical mobility, and cranio-cervical alignment.
Prospective Frontal Plane Angles Used to Predict ACL Strain and Identify Those at High Risk for Sports-Related ACL Injury
Authors: Bates Nathaniel A. , Myer Gregory D. , Hale Rena F. , Schilaty Nathan D. , Hewett Timothy E.
Published: October 2020

Background:

Knee abduction moment during landing has been associated with anterior cruciate ligament (ACL) injury. However, accurately capturing this measurement is expensive and technically rigorous. Less complex variables that lend themselves to easier clinical integration are desirable.

Purpose:

To corroborate in vitro cadaveric simulation and in vivo knee abduction angles from landing tasks to allow for estimation of ACL strain in live participants during a landing task.

Study Design:

Descriptive laboratory study.

Methods:

A total of 205 female high school athletes previously underwent prospective 3-dimensional motion analysis and subsequent injury tracking. Differences in knee abduction angle between those who went on to develop ACL injury and healthy controls were assessed using Student t tests and receiver operating characteristic analysis. A total of 11 cadaveric specimens underwent mechanical impact simulation while instrumented to record ACL strain and knee abduction angle. Pearson correlation coefficients were calculated between these variables. The resultant linear regression model was used to estimate ACL strain in the 205 high school athletes based on their knee abduction angles.

Results:

Knee abduction angle was greater for athletes who went on to develop injury than for healthy controls ( P < .01). Knee abduction angle at initial contact predicted ACL injury status with 78% sensitivity and 83% specificity, with a threshold of 4.6° of knee abduction. ACL strain was significantly correlated with knee abduction angle during cadaveric simulation ( P < .01). Subsequent estimates of peak ACL strain in the high school athletes were greater for those who went on to injury (7.7-8.1% ± 1.5%) than for healthy controls (4.1-4.5% ± 3.6%) ( P < .01).

Conclusion:

Knee abduction angle exhibited comparable reliability with knee abduction moment for ACL injury risk identification. Cadaveric simulation data can be extrapolated to estimate in vivo ACL strain. Athletes who went on to ACL injury exhibited greater knee abduction and greater ACL strain than did healthy controls during landing.

Clinical Relevance:

These important associations between the in vivo and cadaveric environments allow clinicians to estimate peak ACL strain from observed knee abduction angles. Neuromuscular control of knee abduction angle during dynamic tasks is imperative for knee joint health. The present associations are an important step toward the establishment of a minimal clinically important difference value for ACL strain during landing.