bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep Quality Assessment in Adolescents with and without Type 1 Diabetes Using the Pittsburg Sleep Quality Index
Authors: Çömlek Fatma Ö. , Çelik Halime , Keskin Burcu , Süt Necdet , Dilek Emine , Tütüncüler Filiz 
Published: October 2021

Background and Aims:Many diseases, especially chronic diseases, can lead to sleep disturbances. Our study aimed to evaluate sleep characteristics and the relationship between sleep disorders and diabetes-related variables in type 1 diabetes adolescents and to compare these results with a non-diabetic group of similar age and gender.Methods:This cross-sectional study collected data from 40 healthy adolescents and 50 patients of the same age group with type 1 diabetes mellitus from January 2019 to June 2019. Subjects were asked to complete the Pittsburgh Uyku Kalitesi Anketi (PUKA). Patients who had nocturnal hypoglycemia in the preceding one month were excluded.Results:Total scores for PUKA were not significantly different between the two groups (P= 0.197). No significant relationship was found between sleep quality, duration of diabetes, and HbA1c levels in the diabetes group (P= 0.59,P= 0.41, respectively). Poor sleep quality (PUKA score ≥5) in girls without diabetes was higher (95% confidence interval: 1.26–11.61) than in the diabetes group (P= 0.031).Conclusion:In our study, the prevalence of sleep disorders in T1D patients was not higher than the non-diabetic population. However, the girls in the non-diabetic group had significant poor sleep quality. We hypothesize that this may be due to diabetes management bringing order and discipline to an adolescents life.
Thyroid Dysfunction in COVID-19
Authors: Dabas Aashima , Singh Harpreet , Goswami Binita , Kumar Kunal , Dubey Abhishek , Jhamb Urmila , Yadav Sangeeta , Garg Sandeep 
Published: October 2021

Objective:The aim of this study was to evaluate thyroid dysfunction in COVID-19 and study its association with disease severity in COVID-19.Methods:Patients with confirmed COVID-19 infection who were admitted to dedicated COVID hospital were recruited over 3 months period. Those with pre-existing thyroid disease were excluded. The thyroid function tests were performed and correlated with interleukin-6 levels.Results:A total of 164 patients (14 children) with mean(SD) age 53.85 (19.54) years were recruited. The proportion of patients with mild, moderate and severe disease were 22 (13.4%), 78 (47.6%) and 64 (39.0%), respectively, among which 12 (54.5%), 56 (71.8%) and 43 (67.2%) patients had thyroid dysfunction, respectively;P= 0.309. Eighty eight (53.7%) had sick euthyroid (84 had low fT3 only), 14 had overt hypothyroidism and 9 had thyroiditis. Median (IQR) levels of serum fT3 showed significant decline from mild category [4.54 (3.81, 5.27)], to moderate [3.95 (3.67, 4.24)] and severe category [3.56 (3.22, 3.89)];P= 0.011. Low fT3 had significant risk [odds ratio (95% CI)] of death [2.634 (1.01, 6.87);P= 0.031] and elevated IL-6 [2.575 (1.084, 6.118);P= 0.021].Conclusion:Sick euthyroid was seen in the majority of patients hospitalized with COVID. Low fT3 was associated with death and increased inflammation, suggesting poor prognosis.
Risk of Developing Type 2 Diabetes Mellitus in South Asian Women with History of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Gadve Sharvil S , Chavanda Sneha , Datta Mukherjee Aridita , Aziz Sahid , Joshi Ameya , Patwardhan Milind 
Published: October 2021

Background:Gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) represent two different components of the spectrum of diabetes mellitus (DM). Women with GDM have a high chance of developing T2DM in later life and this relative risk depends on a number of factors including ethnicity.Aim:To compare and estimate the risk of developing T2DM in South Asian women with a history of GDM compared to those without a history of GDM.Methods:This is a systematic review of PubMed and MEDLINE articles reporting the progression of GDM to T2DM that were published in English from 2000 to 2020. We performed meta-analysis to calculate risk ratios (RR).Results:We selected 6 studies considering the inclusion and exclusion criteria after sorting 25 full-text articles. Of the 44165 South Asian women assessed, 3095 had GDM and 41070 were without GDM. 995 women in GDM group and 1525 women in non-GDM group had developed T2DM. The RR of women with GDM over non-GDM in developing T2DM was 10.81 (95% confidence interval (CI): 7.61–15.35) suggesting that women with GDM are at 10.81 times more risk of developing T2DM than non-GDM. The cumulative incidence of T2DM in GDM group was 17.34% at 5 years of follow-up and 33% at more than 10 years of follow-up.Conclusion:The risk of developing T2DM in later life is higher in South Asian women with GDM than without GDM. Therefore, lifestyle and pharmacological interventions, patient communication, timely screening, and long-term follow-up of GDM patients are important to reduce the risk.
Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children
Authors: Shah Nikhil , Khadilkar Vaman , Lohiya Nikhil , Prasad Hemchand K. , Patil Prashant , Gondhalekar Ketan , Khadilkar Anuradha 
Published: October 2021

Background:There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of the TW-3 method an attractive option in Indian children.Objectives:1) To assess the relationship of BA with chronological age (CA) as assessed by different methods (GP, GR, and TW-3) in healthy Indian children 2) To assess which of the three methods of BA assessment is more suitable in Indian children.Methodology:X-rays of 851 children (438 boys and 413 girls, aged 2–16.5 years) were analyzed by four independent observers using three different methods of BA estimation (GP, GR, and TW-3). Mean BAs were converted toZ-scores. For purpose of deciding which method of BA was most suitable in our cohort, a test of proportions and root mean square (RMS) deviations were computed.Results:Using the test of proportions, the TW-3 method was most suitable overall (P< 0.05). TW-3 method was again most applicable in prepubertal boys (P< 0.05), in prepubertal girls (although not significant,P> 0.1), and pubertal girls (P< 0.05). However, in pubertal boys, the GR atlas method was most suitable (P< 0.05). The same results were obtained when root mean square (RMS) deviations were computed. Interestingly, BA was underestimated in Indian boys irrespective of the method used. In Indian girls, however, the BA was underestimated till the pubertal growth spurt, after which there was rapid advancement of BA.Conclusions:Among the three methods (GP, GR, and TW-3), the BAs estimated by the TW-3 method were closest to CAs. Hence, it seems reasonable to recommend the use of the TW-3 method for BA estimation in the Indian population till an Indian standard bone age atlas is developed.
The Relation between Chaotic Feature of Surface EEG and Muscle Force
Authors: Rahatabad Fereidoun Nowshiravan , Rangraz Parisa , Dalir Masood , Nasrabadi Ali Motie 
Published: October 2021

Background:
Nonlinear dynamics, especially the chaos characteristics, are useful in analyzing bio-potentials with many complexities. In this study, the evaluation of arm-tip force estimation method from the electroencephalography (EEG) signal in the vertical plane has been studied and chaos characteristics, including fractal dimension, Lyapunov exponent, entropy, and correlation dimension characteristics of EEG signals have been measured and analyzed at different levels of forces.

Method:
Electromyography signal was recorded with the help of the BIOPEC device (the Mp-100 model) and from the forearm muscle with surface electrodes, and the EEG signals were recorded from five major motor-related cortical areas according to 10–20 standard three times in a normal healthy 33-year-old male, athlete and right handed simultaneously with importing a force to 10 sinkers weighing from 10 to 100 Newton with step 10 Newton.

Results:
The findings confirm that force estimation through EEG signals is feasible, especially using fractal dimension feature. The R-squared values for Fractal dimension, Lyapunov exponent, and entropy and correlation dimension features for linear trend line were 0.93, 0.7, 0.86, and 0.41, respectively.

Conclusion:
The linear increase of characteristics especially fractal dimension and entropy, together with the results from other EEG and neuroimaging studies, suggests that under normal conditions, brain recruits motor neurons at a linear progress when increasing the force.
Generative Adversarial Network Image Synthesis Method for Skin Lesion Generation and Classification
Authors: Mutepfe Freedom , Kalejahi Behnam Kiani , Meshgini Saeed , Danishvar Sebelan 
Published: October 2021

Background:
One of the common limitations in the treatment of cancer is in the early detection of this disease. The customary medical practice of cancer examination is a visual examination by the dermatologist followed by an invasive biopsy. Nonetheless, this symptomatic approach is timeconsuming and prone to human errors. An automated machine learning model is essential to capacitate fast diagnoses and early treatment.

Objective:
The key objective of this study is to establish a fully automatic model that helps Dermatologists in skin cancer handling process in a way that could improve skin lesion classification accuracy.

Method:
The work is conducted following an implementation of a Deep Convolutional Generative Adversarial Network (DCGAN) using the Python-based deep learning library Keras. We incorporated effective image filtering and enhancement algorithms such as bilateral filter to enhance feature detection and extraction during training. The Deep Convolutional Generative Adversarial Network (DCGAN) needed slightly more fine-tuning to ripe a better return. Hyperparameter optimization was utilized for selecting the best-performed hyperparameter combinations and several network hyperparameters. In this work, we decreased the learning rate from the default 0.001 to 0.0002, and the momentum for Adam optimization algorithm from 0.9 to 0.5, in trying to reduce the instability issues related to GAN models and at each iteration the weights of the discriminative and generative network were updated to balance the loss between them. We endeavour to address a binary classification which predicts two classes present in our dataset, namely benign and malignant. More so, some wellknown metrics such as the receiver operating characteristic -area under the curve and confusion matrix were incorporated for evaluating the results and classification accuracy.

Results:
The model generated very conceivable lesions during the early stages of the experiment and we could easily visualise a smooth transition in resolution along the way. Thus, we have achieved an overall test accuracy of 93.5% after fine-tuning most parameters of our network.

Conclusion:
This classification model provides spatial intelligence that could be useful in the future for cancer risk prediction. Unfortunately, it is difficult to generate high quality images that are much like the synthetic real samples and to compare different classification methods given the fact that some methods use non-public datasets for training.
Wearable Device for Yogic Breathing with Real-Time Heart Rate and Posture Monitoring
Authors: Puranik Anmol , Kanthi M. , Nayak Anupama V. 
Published: October 2021

Background:
Yogic breathing also called as “Pranayama” is practiced with inhalation (Pooraka), holding the breath for some time (Kumbhaka) and then exhalation (Rechaka). The effective methods of yogic breathing keep oneself healthy and also improves immunity power. The yogic breathing can be practiced irrespective of one's age and gender and even in the office which helps to reduce the stress. To get the best results through yoga, a person has to follow certain timings and sit in a correct posture. Although many devices are existing in the market to monitor heart rate, posture and breathing during physical activity, there is a need of a device which is simple, cheap, and easy to use without an additional requirement of a smartphone. Moreover, the proposed device is able to evaluate the breathing data by transmitting it to a webpage through a Wi-Fi hotspot of the Microcontroller.

Methods:
The developed device has two subsystems: (i) A wrist subsystem to measure the heart rate, visual aid of breathing and vibration feedback for kapalabhati. (ii) A waist subsystem to monitor the posture with help of flex sensor and the results are displayed on the display of the wrist device. It also provides vibration feedback. The inertial measurement unit is used for breath detection. The subsystems are communicated through SPI communication. The breathing data are transmitted to a webpage through a Wi-Fi hotspot of the microcontroller.

Results:
The various yogic breathing and normal breathing exercises are tested on different normal subjects using the developed device and analyzed. The heart rate and beats per minute are evaluated. The heart rate sensor is validated using a standard medical device and it is observed that there was a 97.4% accuracy.

Conclusion:
The results show that the device is able to accurately monitor different kinds of breathing and additionally provide heart rate and posture information while performing the breathing exercises.
Design and Development of a 3-Axis Accelerometer Biofeedback System for Real-Time Correction of Neck Posture for Long-Time Computer Users
Authors: Shirvani Hossein , Salesi Mahmood , Samadi Mohammad , Shamsoddini Alireza 
Published: October 2021

Background:
Due to long-term use of computers and not maintaining the correct position and angle of the body while working with it, various skeletal and muscular problems and pain in the neck area occurs. This study aims to use a biofeedbck system to alert the computer users of an inappropriate angle of their necks, and as a result help them to establish a correct neck position.

Method:
The user's neck angle is measured using a three dimensional accelerometer and the signal is processed, digitalized, and sent to the computer. User friendly software is designed to process the received data and warn the users when their neck angle is inappropriate.

Results:
The results show that the application of the biofeedback system reduces the users' total time with inappropriate neck angle to <50%.

Conclusion:
results demonstrated that training with the biofeedback system has been sufficient to make the habit of maintaining the neck in the correct angle.
Social Media Behavior in Plastic Surgery Practice in Turkey
Authors: Emüler Deniz Sezgin , Ayhan Mehmet Sühan 
Published: October 2021

Background:
It's a widely accepted fact that social media platforms have revolutionized the way human beings communicate. Nevertheless, there is little evidence describing how the plastic surgery community has adopted social media.

Aims and Objectives:
This study aims to identify through objective data the social media activity of the members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations in social media.

Materials and Methods:
An anonymous survey containing 26 questions on the use of social media was distributed to members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons and prevalent patterns of social media implementation were elucidated.

Results:
88.9% of respondents were social media users and 56.95% of the users were using social media both for personal and professional posts. Reasons for using social media included the beliefs that they can accurately inform their patients (55,89%), communicate effectively with the patients (48,48%), and that they can raise awareness among patients (47,47%). 28,96% reported that it is an effective tool in promoting and advertising their practice. Most respondents (54,70%) stated that social media had positive effects on their practice, whereas 44,95% percent reported that it had neither a positive nor a negative impact.

Conclusions:
This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. There is a definite oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as the experience with social media in plastic surgery evolves.
The Primary Role of Dorsal Metacarpal Artery Perforator Flap for Hand and Finger Soft-Tissue Reconstruction
Authors: Yasar Emrah Kagan , Demir Can Ilker , Aytac Yusuf Alper , Alagoz Murat Sahin 
Published: October 2021

Background:
The authors present their experience about the soft-tissue reconstruction of hands and fingers with dorsal metacarpal artery (DMA) perforator flap.

Materials and Methods:
Patients who were treated by DMA perforator flaps from 2017 to 2019 were evaluated.

Results:
There were 17 patients with average age of 36 years. DMA flaps were harvested in a fasciocutaneus fashion in all patients except one. The mean flap size was 3.3 cm × 1.8 cm, and the largest flap was 5 cm × 2 cm. The donor area was repaired primarily except for one patient. The bridge skin incision was used to prevent complications caused by compression or edema. The average time for returning to work was 48 days.

Conclusion:
The DMA perforator flap allows repair of soft-tissue defects of the distal hand and finger neither with sacrificing any major artery nor a major donor site morbidity. Rapid learning curve and relatively stable anatomical structure are the other important entities that make the DMA perforator flap convenient.
Dynamic External Fixators for the Proximal Interphalangeal Joint Injuries
Authors: Kaplan Ahmet , Ergani Hasan Murat , Yasar Burak , Duru Çagdas 
Published: October 2021

Backgrounds:
Proximal interphalangeal (PIP) joint injuries can cause scar contractures by different mechanisms, leading to significant functional loss, the most important thing in the treatment process is to maintain joint mobility, in this way, scar formation will be reduced. Dynamic external fixators have been used for this purpose. Although it is an old method, it has many unknown aspects.

Materials and Methods:
Nineteen patients participated in our study. The patients were divided into two groups as those who were treated immediately after the injury and those who applied in the late period. All patients were treated with pin and rubber traction systems (PRTS). After 6 weeks of traction, the fixator was removed. Patients were assessed with X-rays for the amount of distraction, Visual Analog Scale score for pain and quick DASH scores for satisfaction. The patients were also examined for passive and active range of motion (AROM) in all controls.

Results:
We compared the preoperative and postoperative data of the patients and also we compared the amount of distraction with functional gain. There was no relationship between the increase in PIP joint space distance and posttreatment PIP joint AROM values. Hence, the amount of distraction on the joint space distance has no direct effect on the functional results. Another important result of the study is that the loss of extension in the PIP joint, which can be unregarded in the early period, negatively affects the late results. The other important result of our study is that successful results can be obtained when applied in combination with surgery in delayed cases.

Conclusion:
The use of PRTS has an important role in the treatment of PIP joint injuries. In our study, we have shown that satisfactory results can be obtained in both acute and delayed cases when combined with additional surgery or applied alone. The change in joint space distance during the patient follow-up is not an important issue in terms of range of motion. Another important result we obtained from the study is the demonstration that PRTS can be successfully used in untreated joint dislocations in a single stage.
Effect of Medical Qigong Therapy on Distress, Fatigue, and Quality of Life in Head and Neck Cancer Patients Undergoing Intensity-Modulated Radiation Therapy
Authors: Sagaonkar Priyanka S. , Pattanshetty Renu 
Published: October 2021

Background:
Cancer of Head and Neck (HNC) is the 2nd common cancer in India leading to around 8% of the global cancer mortality. Intensity-modulated radiation therapy (IMRT) is advanced method minimizing exposure of radiation to adjacent normal structures but is associated with higher fatigue indirectly elevating distress levels. Medical Qigong (MQ), a meditative mind therapy has numerous health benefits. The purpose of the current study was to investigate effect of MQ therapy on distress, fatigue, and quality of life in HNC patients undergoing IMRT.

Materials and Methods:
This experimental study was conducted on 16 Hospitalized HNC subjects undergoing IMRT aged 18–65 years. All the subjects performed Qigong Walk Cycle for 5 weekdays for 4 weeks from initiation of IMRT. Scores of Brief Fatigue Inventory (BFI), 6 min walk distance (6MWD), Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) were documented at the baseline and at end of 4th week and compared.

Results:
IBM SPSS Statistics version 23.0; Indian version of Windows was used for statistical analysis. The 16 HNC subjects majorly rural residents (62.5%) of mean age group 47.68 ± 10.25 years with tobacco chewing as prevalent habit (94%) with maximum cases recorded in stage III of the disease. The pre and post test score comparison of serum cortisol, BFI and 6MWD found high statistical significance with P = 0.001 while that of the total and all components of FACT HN was found to be significant with P ≤ 0.05.

Conclusion:
MQ therapy was effective in managing the levels of distress and fatigue thereby improving quality of life of all HNC subjects.