bluuebunny/crossref_metadata_2025_split huggingface dataset:
An audit of the British Thoracic Society asthma discharge care bundle in a teaching hospital
Authors: Awli Yawoa Foli , Addis Gulen 
Published: July 2021

Background: The UK asthma mortality rate has risen by 33% over a decade. The national enquiry into 195 asthma-related deaths revealed that most of these deaths were preventable. The Asthma Discharge Care Bundle (ADCB) is recommended for use when discharging patients with an acute asthma attack and/or exacerbation. Aim: To review the implementation of the British Thoracic Society (BTS) bundle in a teaching hospital. Methods: A 12-month retrospective audit was conducted on 86 adult patients treated for asthma attacks. Findings: The results of the audit indicated that the hospital has complied with the ADCB. In total, 85% of patients had their inhaler technique checked, but 62% of them were not provided with any written inhaler use instructions. The respiratory clinical nurse specialists were more compliant with most of the bundle statements than the medical team. Conclusion: The findings highlighted the need for asthma education sessions for all health professionals with emphasis on record-keeping skills.
Run-through training: a trainee and trainer perspective
Authors: Brierley CA , Sandler PJ 
Published: July 2021

A run-through training pilot has been conducted in orthodontics during which trainees completed 2 years of higher training in the same units in which the first 3 years of specialist training was conducted. This article outlines a trainee and trainer's experience of run-through training in orthodontics. CPD/Clinical Relevance: Young dentists hoping to pursue orthodontic specialist training would be aware of the different training pathways available.
The continued development of multiple supernumerary teeth: do they influence orthodontic treatment?
Authors: Oliver Graham , Hamilton Sean , Read Natalie , Atack Nikki 
Published: July 2021

Supernumerary teeth occur in approximately 1–2% of the population. Multiple supernumerary teeth are less common and usually associated with certain medical conditions. Most supernumeraries develop at a similar time to the normal series; however, this article describes the presentation and management of three patients who developed multiple supernumerary teeth during active orthodontic treatment in the permanent dentition. CPD/Clinical Relevance: These cases show development of multiple supernumerary teeth in the both the maxilla and mandible demonstrating a variation of types and effects on the dentition. In particular, multiple supernumeraries in the anterior maxilla and supplementals in the mandibular premolar regions highlight that supernumerary teeth may develop a considerable time after the development of the permanent dentition. These can develop during orthodontic treatment. Consideration, therefore, may be given to closer and longer monitoring of dental development in patients with multiple supernumerary teeth.
Misbehaving mandibular canines
Authors: Hameed Othman , Grewal Sukhraj S , Taylor Nigel G 
Published: July 2021

The incidence of permanent canines failing to erupt in the mandible is not as common, and, therefore, not as well reported, as that in the maxilla. Mandibular canines have important functional and aesthetic purposes and knowledge of this uncommon condition is essential for those involved with the management of these cases. This article explores the aetiology, assessment and treatment options available to manage this condition, using examples from treated cases within our department. CPD/Clinical Relevance: An understanding of the aetiology, assessment and various treatment options available to manage impacted and transmigrated mandibular canines will inform better treatment planning.
History of interceptive orthodontics
Authors: Tsipkis Alan , Noar Joseph 
Published: July 2021

Interceptive orthodontics refers to all interventions and treatments that can be performed during the primary or mixed dentition with the aim of eliminating or minimizing dento-alveolar and skeletal disharmonies that can interfere with the normal growth and development of occlusion, function, aesthetics and the psychological wellbeing of children. The main purpose of interceptive orthodontics is to prepare an environment that will not interfere with the occlusal development in order to reduce the future need for prolonged complex mechanical orthodontic treatment. According to the American Association of Orthodontics the most suitable age for screening the paediatric population for interceptive intervention is 7 years of age. CPD/Clinical Relevance: To review the progress made in the field of interceptive orthodontics and discuss the current principles of early orthodontic intervention.
Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
Authors: Biddle Mairiosa , Kennedy Ian W. , Wright Pauline M. , Ritchie Neil D. , Meek R. M. D. , Rooney Brian P. 
Published: July 2021

AimsPeriprosthetic hip and knee infection remains one of the most severe complications following arthroplasty, with an incidence between 0.5% to 1%. This study compares the outcomes of revision surgery for periprosthetic joint infection (PJI) following hip and knee arthroplasty prior to and after implementation of a specialist PJI multidisciplinary team (MDT).MethodsData was retrospectively analyzed from a single centre. In all, 29 consecutive joints prior to the implementation of an infection MDT in November 2016 were compared with 29 consecutive joints subsequent to the MDT conception. All individuals who underwent a debridement antibiotics and implant retention (DAIR) procedure, a one-stage revision, or a two-stage revision for an acute or chronic PJI in this time period were included. The definition of successfully treated PJI was based on the Delphi international multidisciplinary consensus.ResultsThere were no statistically significant differences in patient demographics or comorbidities between the groups. There was also no significant difference in length of overall hospital stay (p = 0.530). The time taken for formal microbiology advice was significantly shorter in the post MDT group (p = 0.0001). There was a significant difference in failure rates between the two groups (p = 0.001), with 12 individuals (41.38%) pre-MDT requiring further revision surgery compared with one individual (6.67%) post-MDT inception.ConclusionOur standardized multidisciplinary approach for periprosthetic knee and hip joint infection shows a significant reduction in failure rates following revision surgery. Following implementation of our MDT, our success rate in treating PJI is 96.55%, higher than what current literature suggests. We advocate the role of a specialist infection MDT in the management of patients with a PJI to allow an individualized patient-centred approach and care plan, thereby reducing postoperative complications and failure rates.Cite this article: Bone Jt Open 2021;2(7):509–514.
Shockwave enhancement from temporally separated filaments interacting with a water droplet
Authors: Peña Jessica , Kerrigan Haley , Richardson Martin 
Published: July 2021

Many applications of filamentation require propagation through
aerosol-dense environments. The shockwave produced from a
filament–droplet interaction is one mechanism of clearing a path
through a dense cloud of aerosols. Here, we show an enhanced shockwave
resulting from the interaction of two temporally separated filaments
with a single water droplet. The expanding shockwave is imaged with an
ultrafast shadowgraphy technique, and Sedov–Taylor analysis determines
the energy coupled into the shockwave. For an optimal temporal spacing
between the filaments of 400 ps, the shockwave energy increased by 3
times and its radius increased by 1.23 times compared to the shockwave
generated by the interaction of a droplet with a single filament.
Self-referenced distribution of millimeter waves over 10  km optical fiber with high frequency stability
Authors: Yu Chunlong , Guo Hao , An Zhuoyan , Li Yihan , Zheng Zheng 
Published: July 2021

In this Letter, an actively stabilized photonic system for millimeter-wave (mmW) signal distribution is proposed and experimentally demonstrated. By interlocking two baseband RF signals obtained from a dual-heterodyne detection through a single carrier compensation module, the phase fluctuations induced by the fiber transmission link is suppressed without the need of a local frequency reference. In the proof-of-concept experiment, a 108 GHz mmW is transmitted over a 10 km fiber link with a performance matching that of the back-to-back case. The feedback system reduces the phase noise of the delivered mmW signal by 37 dB and 28 dB at 0.1 Hz and 1 Hz frequency offset, respectively, and the long-term stability is improved by nearly two orders of magnitude.
Anisotropy of 2PA, 3PA, and Kerr effect in nonpolar ZnO
Authors: Hua Shijia , Zhang Wending 
Published: July 2021

Anisotropic optical nonlinearity plays an important role in polarization-dependent optoelectronic devices. Taking the advantage of in-plane crystallographic axis, the polarization dependence of third- and fifth-order nonlinearity in nonpolar ZnO has been investigated by

z

scan. Here, we established the theory model of anisotropic relation of fifth-order nonlinearity in hexagonal wurtzite crystal. Both two-photon absorption (2PA) and three-photon absorption (3PA) coefficients exhibit anisotropic oscillations with a period of 180°, and the polarization modulation factor and anisotropy coefficient

(

r

p

,

σ

)

are measured as (2.10, 1.84) for

β

2

, and (1.66, 1.33) for

β

3

, respectively. This is the first time, to the best of our knowledge, that the anisotropy of the fifth-order optical nonlinear effect has been characterized and confirmed. It is verified that the self-defocusing effect at 500 nm is isotropy, while the self-focusing effect at 800 nm exhibits significant anisotropy. The maximum value of the nonlinear figure of merit is 5.84 along the [0010] crystalline direction, nearly 1.6 times the minimum value, revealing that ZnO exhibits potential for nonlinear applications containing polarization-related all-optical switching components.
Patients’ E-Readiness to use E-Health technologies for oral health
Authors: Jagde Arishdeep Kaur , Shrivastava Richa , Feine Jocelyne , Emami Elham 
Published: July 2021

Introduction
Scientific evidence highlights the importance of E-Readiness in the adoption and implementation of E-Oral Health technologies. However, to our knowledge, there is no study investigating the perspective of patients in this regard. Therefore, the objective of this study was to explore patients’ E-Readiness in the field of dentistry.

Materials and methods
A qualitative study was conducted using interpretive descriptive methodology. Purposeful sampling with maximum variation and snowball techniques were used to recruit the study participants via McGill University dental clinics and affiliated hospitals, as well as private or public dental care organizations. A total of 15 face-to-face, semi-structured and 60 to 90-minute audio recorded interviews were conducted. Data collection and analyses were performed concurrently, and interviews were continued until saturation was reached. Activity theory was used as the conceptual framework, and thematic analysis was used to analyze data. Data analysis was conducted both manually and with the use of “ATLAS-ti” software.

Results
Four major themes emerged from the study; unlocking barriers, E-Oral Health awareness, inquisitiveness for E-Oral Health technology and enduring oral health benefits. These themes correspond with all three types of readiness (core, engagement and structural).

Conclusion
The study results suggest that dental patients consider E-Oral Health as a facilitator to access to care, and they are ready to learn and use E-Oral Health technology. There is a need to implement and support E-Oral Health technologies to improve patient care.
Psychological stress and associated factors among municipal solid waste collectors in Hanoi, Vietnam: A cross-sectional study
Authors: Nguyen Quynh Thuy , Nguyen Bang Van , Do Ha Thi Thu , Nguyen Bich Ngoc , Nguyen Van Thanh , Vu Son Thai , Tran Thuy Thi Thu 
Published: July 2021

IntroductionIn low and middle-income countries, the manually operated municipal waste collection system prominently depended on the performance of waste collectors (WC). Most of the literature has focused on the impact of waste collection tasks on WCs’ physical health, while little was known about the psychological effects of work-related stress. This study aimed to examine the prevalence of psychological stress and related factors among waste collectors in Hanoi, Vietnam.MethodsA cross-sectional survey was conducted among 802 WCs in 2017. The questionnaire included the 7-item Stress component of the 21-item Depression, Anxiety and Stress Scale, and questions on demographics and work conditions. Descriptive and multivariate logistics regression analyses were conducted to examine the factors related to psychological stress among WCs.ResultsResults showed that 13.4% of WCs reported stress symptoms; among them, 3.3% of WCs experienced severe stress. Factors related to lower odds of self-reported psychological stress included self-perceived frequent exposure to high and low temperatures in the working environment (OR = 0.51 and 0.52, respectively). Factors associated with the increased likelihood of symptoms included frequent exposure to hot/flammable objects (OR = 2.41), working a night shift in the last three months (OR = 1.82), education lever lower than high school (OR = 1.82), and having an insufficient monthly income (OR = 1.99).ConclusionThe high percentage of workers with severe stress implies the need for mental health prevention and treatment for WCs who participated in this study.
Identification and validation of a novel ferroptosis-related gene model for predicting the prognosis of gastric cancer patients
Authors: Liu Gang , Ma Jian-ying , Hu Gang , Jin Huan 
Published: July 2021

Background
Ferroptosis is a novel form of regulated cell death that plays a critical role in tumorigenesis. The purpose of this study was to establish a ferroptosis-associated gene (FRG) signature and assess its clinical outcome in gastric cancer (GC).

Methods
Differentially expressed FRGs were identified using gene expression profiles from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. Univariate and least absolute shrinkage and selection operator (LASSO) Cox regression analyses were performed to construct a prognostic signature. The model was validated using an independent GEO dataset, and a genomic-clinicopathologic nomogram integrating risk scores and clinicopathological features was established.

Results
An 8-FRG signature was constructed to calculate the risk score and classify GC patients into two risk groups (high- and low-risk) according to the median value of the risk score. The signature showed a robust predictive capacity in the stratification analysis. A high-risk score was associated with advanced clinicopathological features and an unfavorable prognosis. The predictive accuracy of the signature was confirmed using an independent GSE84437 dataset. Patients in the two groups showed different enrichment of immune cells and immune-related pathways. Finally, we established a genomic-clinicopathologic nomogram (based on risk score, age, and tumor stage) to predict the overall survival (OS) of GC patients.

Conclusions
The novel FRG signature may be a reliable tool for assisting clinicians in predicting the OS of GC patients and may facilitate personalized treatment.
Self-reported gender differentials in the knowledge of tuberculosis transmission and curative possibility using national representative data in Ghana
Authors: Boah Michael , Kpordoxah Mary Rachael , Adokiya Martin Nyaaba 
Published: July 2021

Background
Health-seeking behaviour, stigma, and discrimination towards people affected by tuberculosis (TB) are influenced by awareness of the disease. Gender differentials in the diagnosis and treatment of TB have been reported in other settings of the world. However, little is known about the gender differences in the knowledge of TB transmission and curative possibility in Ghana.

Methods
The analysed data were a weighted sample of 9,396 women aged 15–49 years and 4,388 men aged 15–59 years, obtained from the 2014 Ghana Demographic and Health Survey. The dependent variable, correct knowledge regarding TB transmission and cure was derived from questions on the transmission of the disease and the possibility of a cure. A design-based multivariate logistic regression model in Stata 13.0/SE was used to identify the correlates of reporting correct knowledge.

Results
Overall, the mean knowledge score was 6.1±0.9 (maximum = 7). Of the 13,784 respondents, 45.7% (95% CI: 44.0–47.3) reported correct knowledge regarding TB transmission and cure. Men had significantly higher knowledge than women (50.9% versus 43.2%). Misconceptions, including TB transmitted through sharing utensils (13.3%), food (6.9%), touching a person with TB (4.5%), sexual contact (4.1%), and mosquito bites (0.4%) were noted. About 30% (33% women and 25% men) of the total sample would keep the information secret when a household member is affected with TB. In the adjusted analysis, age, gender, education, region, place of residence, wealth quintile, frequency of reading newspaper/magazine, listening to the radio, and watching television were significantly associated with reporting correct knowledge.

Conclusions
There was low knowledge regarding TB transmission and cure. Misconceptions regarding the transmission of TB prevailed among the participants. Gender differential in knowledge was observed. Comparatively, females were less likely to be aware of TB and report correct knowledge regarding TB transmission but were more likely to conceal information when a household member was affected by the disease.
Incidence and trends of limb amputation in first nations and general population in Saskatchewan, 2006–2019
Authors: Essien Samuel Kwaku , Linassi Gary , Larocque Margaret , Zucker-Levin Audrey 
Published: July 2021

Background
There is conflicting evidence whether limb amputation (LA) disproportionately affects indigenous populations. To better understand this disparity, we compared the LA incidence rate between First Nations persons registered under the Indian Act of Canada (RI) and the general population (GP) in Saskatchewan.

Methods
We used Saskatchewan’s retrospective administrative data containing hospital discharge LA cases, demographic characteristics (age and sex), and residents population reported in the database stratified by RI and GP from 2006–2019. The LA cases for each stratified group were first disaggregated into three broad categories: overall LA (all reported LA), primary LA (first reported LA), and subsequent LA (revision or contralateral LA), with each category further split into the level of amputation defined as major amputation (through/above the ankle/wrist joint) and minor amputation (below the ankle/wrist joint). LA rates were calculated using LA cases as the numerator and resident population as the denominator. Joinpoint and negative binomial regressions were performed to explore the trends further.

Results
Overall, there were 1347 RI and 4520 GP LA cases reported in Saskatchewan from 2006–2019. Primary LA made up approximately 64.5% (869) of RI and 74.5% (3369) of GP cases, while subsequent LA constituted 35.5% (478) of RI and 25.5% (1151) of GP cases. The average age-adjusted LA rate was 153.9 ± 17.3 per 100,000 in the RI cohort and 31.1 ± 2.3 per 100,000 in the GP cohort. Overall and primary LA rates for the GP Group declined 0.7% and 1.0%, while subsequent LA increased 0.1%. An increased LA rate for all categories (overall 4.9%, primary 5.1%, and subsequent 4.6%) was identified in the RI group. Overall, minor and major LA increased by 6.2% and 3.3%, respectively, in the RI group compared to a 0.8% rise in minor LA and a 6.3% decline in major LA in the GP group. RI females and males were 1.98–1.66 times higher risk of LA than their GP counterparts likewise, RI aged 0–49 years and 50+ years were 2.04–5.33 times higher risk of LA than their GP cohort. Diabetes mellitus (DM) was the most prevalent amputation predisposing factor in both groups with 81.5% of RI and 54.1% of GP diagnosed with DM. Also, the highest proportion of LA was found in the lowest income quintile for both groups (68.7% for RI and 45.3% for GP).

Conclusion
Saskatchewan’s indigenous individuals, specifically First Nations persons registered under the Indian Act of Canada, experience LA at a higher rate than the general population. This disparity exists for all variables examined, including overall, primary, and subsequent LA rates, level of amputation, sex, and age. Amplification of the disparities will continue if the rates of change maintain their current trajectories. These results underscore the need for a better understanding of underlying causes to develop a targeted intervention in these groups.
ADVERSE CHILDHOOD EXPERIENCE DAN DELIBERATE SELF HARM PADA REMAJA DI INDONESIA
Authors: Paramita Anindya Dewi , Faradiba Andi Tenri , Mustofa Khintan Sucitasari 
Published: July 2021

Self-injurious behavior or acts of self-harm that are commonly found in adolescents are form of channeling negative emotions to deal with emotional pain. One reason for this pain was exposure to unpleasant experiences called adverse childhood experiences. This study aims to explore the detrimental effect of experience on self-harm in adolescents. This study used two measuring instruments, the Deliberate Self-Harm Inventory (DSHI) was used to measure DSH and Adverse Childhood Experience Quesionnaire (ACE.Q) was used to measure ACE. There were 168 respondents in the study who participated filling online questionnaire and they were gathered through non-probability sampling technique. The result showed that there was a positive correlation between adverse childhood experiences on self-harm with a sig value of 0.035 <0.05. This means that the higher the ACE, the higher the DSH. Perilaku melukai diri sendiri atau deliberate self-harm (DSH) banyak ditemukan pada remaja sebagai bentuk penyaluran emosi secara negatif untuk mengatasi rasa sakit secara emosional. Salah satu penyebab rasa sakit tersebut adalah adanya paparan pengalaman tidak menyenangkan yang disebut dengan adverse childhood experience (ACE). Penelitian ini bertujuan untuk mengetahui pengaruh adverse childhood experience terhadap deliberate self-harm pada remaja di Indonesia. Penelitian ini menggunakan dua alat ukur, yaitu Deliberate Self-Harm Inventory (DSHI) untuk mengukur DSH dan Adverse Childhood Experience Quesionnaire (ACE.Q) untuk mengukur ACE. Terdapat 168 responden dalam penelitian ini yang diperoleh secara online melalui teknik non-probability sampling. Hasil penelitian menunjukkan bahwa terdapat korelasi positif antara adverse childhood experience terhadap deliberate self-harm dengan nilai sig 0,035 < 0,05. Artinya, semakin tinggi adverse childhood experience maka semakin tinggi pula kecenderungan melakukan deliberate self-harm