bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed tomography radiomics to predict EBER positivity in Epstein–Barr virus-associated gastric adenocarcinomas: a retrospective study
Authors: Zhang Cheng , Wen Hai-lin , Zhang Rong , Xie Shu-yi , Xie Chuan-miao 
Published: July 2021

Background The relevance of Epstein–Barr virus (EBV) in gastric carcinoma has been represented by the existence of EBV-encoded small RNA (EBER) in the tumor cells and has prognostic significance in gastric cancer, while gastric adenocarcinoma represents the most frequently occurring gastric malignancy. Purpose To observe the capacity of radiomic features extracted from contrast-enhanced computed tomography (CE-CT) images to differentiate EBER-positive gastric adenocarcinoma from EBER-negative ones. Material and Methods A total of 54 patients with gastric adenocarcinoma (EBER-positive: 27, EBER-negative: 27) were retrospectively examined. Radiomic imaging features were extracted from all regions of interest (ROI) delineated by two experienced radiologists on late arterial phase CT images. We distinguished related radiomic features through the two-tailed t test and applied them to construct a decision tree model to evaluate whether EBER in situ hybridization positive had appeared. Results Nine radiomics features were significantly related to EBER in situ hybridization status ( P < 0.05), four of which were used to build the decision tree through backward elimination: Correlation_ AllDirection_offset7, Correlation_ angle135_offset7, RunLengthNonuniformity_ AllDirection_offset1_SD, and HighGreyLevelRunEmphasis_ AllDiretion_offset1_SD. The decision tree model consisted of seven decision nodes and six terminal nodes, three of which demonstrated positive EBER in situ hybridization. The specificity, sensitivity, and accuracy of the model were 84%, 80%, and 81.7%, respectively. The area under the curve of the decision tree model was 0.87. Conclusion Radiomics based on CE-CT could be applied to predict EBER in situ hybridization status preoperatively in patients with gastric adenocarcinoma.
Predictors for in-flight medical interventions during helicopter interfacility transport in Hong Kong
Authors: Cheung Arthur Chi Kin , Lam Rex Pui Kin , Fok Patrick Wai Fung , Ng Ethan Pak Hang , Chaang Vi Ka , Rainer Timothy Hudson 
Published: July 2021

Introduction:Interfacility transport with helicopter from remote island clinics to urban hospitals account for a significant portion of the Hong Kong Government Flying Service missions. Currently, doctor and nurse escorts are deployed as volunteers only during the daytime from every Friday to Monday and on public holidays. While most transport runs smoothly, patient deterioration can occur during flight, warranting medical interventions on-board. Yet, little is known about the pattern and any clinical predictors of such interventions during helicopter interfacility transport missions.Methods:We collected Government Flying Service callout records from 1 January to 31 December 2016, and retrieved demographic, clinical and operational data. Interfacility transport mission was dispatched based on ‘Casualty Evacuation’ categories, which range from A+ (unstable), A (borderline) to B (stable). Univariate and multivariable logistic regression were used to identify independent predictors for in-flight medical interventions.Results:Of 1734 callout records, 386 interfacility transport missions escorted by volunteer doctors or nurses or both had complete flight medical records for analysis and 14.9% required in-flight medical interventions. Most interventions were related to oxygen therapy, intravenous fluid and administration of medications. Multivariable logistic regression showed that an age ⩾70 years, Casualty Evacuation A+ category, and any pre-flight emergency medical interventions were independent predictors for in-flight medical interventions.Conclusion:This study identified a few clinical predictors of in-flight medical interventions in an urban helicopter interfacility transport missions setting. Crewman training that focuses on the relevant procedural capabilities and clinical judgement is necessary to address the in-flight medical needs of interfacility transport missions.
Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom
Authors: Costa Bruna , Ardouin Kenny , Stock Nicola Marie 
Published: July 2021

Objectives: Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. Design: A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research CAR at the University of the West of England (UWE). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter’s Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. Results: Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. Conclusions: Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.
Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate
Authors: Staudt Christine B. , Bollhalder Julia , Eichenberger Martina , La Scala Giorgio , Herzog Georges , Wiedemeier Daniel B. , Antonarakis Gregory S. 
Published: July 2021

Objective: To evaluate final posttreatment occlusion in patients with complete unilateral cleft lip and palate (cUCLP) by comparing (1) 3 treatment centers, (2) males and females, (3) cleft and noncleft sides, (4) right- and left-sided clefts, and (5) orthodontic treatment with/without orthognathic surgery (OS). Design: Retrospective cohort study. Patients: Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4 years) with cUCLP from 3 centers in Switzerland. Main Outcome Measure: Occlusal assessment using the modified Huddart/Bodenham (MHB) index. Results: Our sample comprised 35 males and 21 females, 46 with left- and 10 with right-sided clefts, of which 32 had undergone OS. The final posttreatment occlusion showed a median MHB score of 0 (interquartile range: −1.0 to 2.0) in the total sample and did not seem to depend on treatment center, sex, or OS. The MHB scores for the anterior buccal and the buccal segments were more negative on the cleft than on the noncleft side ( P = .002 and P = .006, respectively). When the cleft was on the left side, the MHB score tended to be more positive in the labial ( P = .046) and anterior buccal segments ( P = .034). Conclusions: This study shows a very satisfactory final posttreatment occlusion in patients with cUCLP. The more constricted buccal occlusion on the cleft side emphasizes the attention that should be given in correcting the more medially positioned lesser maxillary segment. The influence of cleft-sidedness should be analyzed further on a sample including more patients with right-sided clefts.
The Effect of Exercise Interventions to Improve Psychosocial Aspects and Glycemic Control in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Mohammad Rahimi Gholam Rasul , Aminzadeh Reza , Azimkhani Amin , Saatchian Vahid 
Published: July 2021

Background: Type 2 diabetes mellitus (T2DM) patients have a raised risk of developing depression compared with non-diabetic people. Objective: The objective of this meta-analysis was to investigate the impacts of exercise training interventions to improve psychosocial aspects and glycemic control in T2DM patients. Data sources: PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched. Study selection: The selection criteria were randomized controlled trials (RCTs) using an exercise intervention with or without dietary advice on psychological aspects and glycemic control in T2DM patients, up to January 2021. Meta-analyses were performed using the random-effects model. The analysis included 17 RCTs with 2,127 participants. Results: In the pooled analysis, improvements were seen in depression, standard mean difference (SMD) −0.65 (95% confidence interval (CI) −1.03 to −0.28, p = 0.0006), mental health SMD: 0.53 (95% CI 0.31 to 0.76, p < 0.00001), and HbA1c, weighted mean difference (WMD) −0.51% (95% CI −0.97 to −0.04, p = 0.03). There were no significant differences between the intervention and control groups for bodily pain, social functioning, and fasting glucose (all p > 0.05). Conclusion: Our systematic review and meta-analysis displayed that exercise training interventions decreased depression and HbA1c and increased mental health in individuals with T2DM. Further longer-term and high-quality clinical trials are required to additional assess and confirm the findings presented here.
Animation supported communication on intensive care; a service improvement initiative
Authors: Wachtl Marta , Ledesma Frances , Malcolm Hannah , Toal Connor , Kavanagh Charlotte , Hadley Julia , Pennington James , Shepherd Stephen , Wald David S 
Published: July 2021

Objective COVID-19 has created unique challenges for families of patients admitted to intensive care units. Restricted visiting, language barriers and time constraints have limited communication, resulting in a lack of understanding and anxiety. We introduced digital animations to support communication and assessed the impact on families of patients admitted to intensive care. Methods Multi-language animations explaining mechanical ventilation, ( www.explainmyprocedure.com/icu ) were introduced at two London intensive care units during the COVID-19 pandemic. Web-links were sent by email. Reported understanding of the treatment, its benefits, risks and alternatives was assessed among family contacts of 71 consecutive patients admitted to intensive care; 39 before the animations were introduced (no animation group) and 32 afterwards (animation group). Reported understanding in the two groups was assessed by telephone questionnaire and compared. Results Following introduction, all relatives reported they had watched the animation. The proportions who reported complete understanding of mechanical ventilation, its benefits, risks and alternatives, in the no animation group (n = 39) were, respectively, 15%, 28%, 0% and 3% and in the animation group (n = 32), 94%, 97%, 84% and 66% (p < 0.0001 for all comparisons). Conclusion Family use of online multi-language animations explaining mechanical ventilation is feasible, acceptable and associated with substantial improvement in understanding. The approach is not limited to mechanical ventilation, or to use in a pandemic, and has the potential to be applied to a wide range of treatment and recovery pathways on intensive care.
The Display of Medical Information: Content, Format, and Subjective Experience
Authors: Devlin Ann Sloan , Anderson Alaina , Carlson Katie , DiPalo Maggie , Hession-Kunz Sarah , Zou Amy 
Published: July 2021

Objectives: To address a gap in the literature by investigating the subjective experience of participants to the form and content of medical information displayed in a healthcare setting. Background: Artwork can enhance the experience of patients, but much less is known about how individuals react to displays of medical information in the form of posters or pamphlets, especially those about unsettling conditions (e.g., skin cancer). Methods: In a 2 × 2 × 2 between-subjects design, researchers investigated the content of medical information (skin cancer vs. skin care) that was on display in a simulated exam room, whether the form was a pamphlet or a poster, and reason for the visit (routine annual skin check or evaluating a mole) on measures of subjective experience, including anxiety. Results: Viewing material about skin cancer produced greater anxiety and greater arousal than did viewing material about sunscreen, and given the choice of four images (pamphlet and poster for sunscreen, pamphlet and poster for skin cancer), the sunscreen poster was recommended to improve the patient’s experience and lower stress. In terms of display format, posters are judged to provide more visual engagement than are pamphlets. Conclusions: Exam rooms should offer multiple opportunities for visual engagement without images that produce anxiety. More research is needed to understand the subjective experience of the patient’s interaction with the content and format of medical information.
Neurocognitive and Neurophysiological Functions Related to ACL Injury: A Framework for Neurocognitive Approaches in Rehabilitation and Return-to-Sports Tests
Authors: Piskin Daghan , Benjaminse Anne , Dimitrakis Panagiotis , Gokeler Alli 
Published: July 2021

Context: Only 55% of the athletes return to competitive sports after an anterior cruciate ligament (ACL) injury. Athletes younger than 25 years who return to sports have a second injury rate of 23%. There may be a mismatch between rehabilitation contents and the demands an athlete faces after returning to sports. Current return-to-sports (RTS) tests utilize closed and predictable motor skills; however, demands on the field are different. Neurocognitive functions are essential to manage dynamic sport situations and may fluctuate after peripheral injuries. Most RTS and rehabilitation paradigms appear to lack this aspect, which might be linked to increased risk of second injury. Objective: This systematic and scoping review aims to map existing evidence about neurocognitive and neurophysiological functions in athletes, which could be linked to ACL injury in an integrated fashion and bring an extensive perspective to assessment and rehabilitation approaches. Data Sources: PubMed and Cochrane databases were searched to identify relevant studies published between 2005 and 2020 using the keywords ACL, brain, cortical, neuroplasticity, cognitive, cognition, neurocognition, and athletes. Study Selection: Studies investigating either neurocognitive or neurophysiological functions in athletes and linking these to ACL injury regardless of their design and technique were included. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: The demographic, temporal, neurological, and behavioral data revealing possible injury-related aspects were extracted and summarized. Results: A total of 16 studies were included in this review. Deficits in different neurocognitive domains and changes in neurophysiological functions could be a predisposing risk factor for, or a consequence caused by, ACL injuries. Conclusion: Clinicians should view ACL injuries not only as a musculoskeletal but also as a neural lesion with neurocognitive and neurophysiological aspects. Rehabilitation and RTS paradigms should consider these changes for assessment and interventions after injury.
The Impact of the COVID-19 Pandemic on Breast Reconstruction: A Canadian Perspective
Authors: Illmann Caroline F. , Doherty Christopher , Wheelock Margaret , Vorstenbosch Joshua , Lipa Joan E. , Zhong Toni , Isaac Kathryn V. 
Published: July 2021

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.
Problems, complications, and reinterventions in 4893 onlay humeral lateralized reverse shoulder arthroplasties: a systematic review (part I—complications)
Authors: Ascione Francesco , Schiavone Panni Alfredo , Braile Adriano , Corona Katia , Toro Giuseppe , Capuano Nicola , Romano Alfonso M. 
Published: July 2021

Abstract
Background
Several modifications to the original Grammont reverse shoulder arthroplasty (RSA) design have been proposed to prevent distinctive issues, such as both glenoid and humeral lateralization. The aim of this systematic review was to determine rates of problems, complications, reoperations, and revisions after onlay lateralized humeral stem RSA, hypothesizing that these are design related.

Methods
This systematic review was performed in accordance with the PRISMA statement guidelines. A literature search was conducted (01.01.2000–14.04.2020) using PubMed, Cochrane Reviews, Scopus, and Google Scholar employing several combinations of keywords: “reverse shoulder arthroplasty,” “reverse shoulder prosthesis,” “inverse shoulder arthroplasty,” “inverse shoulder prosthesis,” “problems,” “complications,” “results,” “outcomes,” “reoperation,” “revision.”

Results
Thirty-one studies with 4893 RSA met inclusion criteria. The 892 postoperative problems and 296 postoperative complications represented overall problem and complication rates of 22.7% and 7.5%, respectively. Forty-one reoperations and 63 revisions resulted, with an overall reoperation rate of 1.7% and overall revision rate of 2.6%.

Conclusions
Problem, complication, and reintervention rates proved acceptable when implanting a high humeral lateralization stem in RSA. The most frequent problem was scapular notching (12.6%), and the most common postoperative complication was scapular stress fracture (1.8%). An overall humeral complication rate of 1.9% was identified, whereas short stems reported no humeral fractures or stem loosening. Infections (1.3%) proved to be the most common reason for component revision, and instability had a complication rate of 0.8%.

Level of evidence
Systematic review IV
Assessment of the sanitary quality of ready to eat sesame, a low moisture street food from Burkina Faso
Authors: Compaoré Muller K. A. , Bazie Bazoin Sylvain Raoul , Nikiema Marguerite E. M. , Dakené Virginie Marie , Dembélé René , Kpoda Dissinviel Stéphane , Kabré Elie , Barro Nicolas 
Published: July 2021

Abstract
Background
Microbial contamination of edible low moisture food poses a significant public health risk for human. In this study, the microbial quality of sweet dehulled sesame seed croquettes, salted dehulled sesame seed and the raw sesame seed, sold under ambient conditions were examined. The samples were collected in the cities of Burkina Faso. The first type is sweet dehulled sesame seed croquettes (n1 = 25); the second type is salted dehulled sesame seed (n2 = 25) and the third type is raw sesame seed (n3 = 25). Assessment of the microbial quality was based on the total aerobic mesophilic bacteria, the thermotolerant coliforms, the yeasts and moulds, the E. coli, and the Salmonella spp. using ISO methods.

Results
The results showed the presence of microorganisms varying from <1.0 to 1.72 × 105 CFU g− 1 for thermotolerant coliforms, from <1.0 to 6,12 × 106 CFU g− 1 for the total mesophilic aerobic flora and from <1.0 to 8.10 × 105 CFU g− 1 for yeasts and moulds. The higher contaminations rates were mostly observed in raw sesame seed samples. No E coli or Salmonella pathogens were detected. Based on international standards of dehydrated food, 50.67% of the ready to eat sesame are satisficing while 17.33% are acceptable and 32% are not satisficing.

Conclusion
Attention should be emphasized on the processing practices, especially in crowded places where RTE sesames seeds are mostly sold. The high numbers of all microbial groups in these sesame seed samples suggested that the production of RTE sesame seed should be improved by better hygiene. This study highlights also that RTE sesame seed might harbor a wide range of microorganisms when processes are weak of hygiene.