bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the Routine Removal of Titanium Plates and Screws Following Miniplate Osteosynthesis of Maxillofacial Bone Fractures Justified? A Fifteen-Year Experience in a Maxillofacial Centre, Saudi Arabia
Authors: Daniels John Spencer , Albakry Ibrahim , Braimah Ramat Oyebunmi , Samara Mohammed Ismail 
Published: December 2021

Background Routine removal of titanium miniplates in the maxillofacial region is still controversial. This current study hopes to share our experience with the different reasons for maxillofacial plates and screws removal following miniplate osteosynthesis. Methods This was a retrospective study of plates and screws removal following Open Reduction and Internal Fixation (ORIF) of maxillofacial fractures at King Khalid Hospital, Kingdom of Saudi Arabia, from 2005-2019. Information collected includes demographics, etiology and pattern of maxillofacial fractures, treatment modalities as well as reasons for plates and screws removal. Data was stored and analyzed using IBM SPSS Statistics for windows Version 25 (Armonk, NY: IBM Corp). Results A total of 985 patients with maxillofacial bone fractures had ORIF during the study period out of which 149 had miniplates and screws removed, giving a prevalence rate of 15.1%. There were 141 (94.6%) males and 8 (5.4%) females, with a M:F of 17.6:1. Their ages ranged from 4-65 years with mean (SD) at 24.6 (12.2) years. The age group from 16-30 years had the most cases of plates removal with statistical significance ( P = .000). Young age (43 (28.8%)) constituted the majority of reasons responsible for plate removal. The angle of the mandible is the site with the largest number of plate removal with 34 (22.8%) cases followed by the parasymphyseal site with 21 (14.1%) cases. Conclusion With removal rate of 15.1%, this study concluded that there is no evidence to support routine removal of asymptomatic plates and screws in maxillofacial region.
Higher body mass index indicated better overall survival in pancreatic ductal adenocarcinoma patients: a real-world study of 2010 patients
Authors: Fu Ningzhen , Jiang Yu , Qin Kai , Chen Hao , Deng Xiaxing , Shen Baiyong 
Published: December 2021

AbstractBackgroundThe association between body mass index (BMI) and the overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) patients remains controversial and unclear,MethodA total of 2010 patients from a high-volume center were enrolled in the study. The OS of PDAC patients was evaluated based on restricted cubic spline (RCS), propensity score (PS) and multivariable risk adjustment analyses.ResultBMI was linearly related to the OS (totalP = 0.004, nonlinearP = 0.124). BMI was analyzed as categorical data based on X-tile software-defined cutoffs and World Health Organization (WHO)-recommended cutoffs. Adjusted with confounding covariates, higher BMI manifested as a positive prognostic predictor. Furthermore, BMI was proven to be associated with the OS in the PS analysis. (UnderweightXtilevs. NormalXtileP = 0.003, OverweightXtilevs. NormalXtileP = 0.019; UnderweightWHOvs. NormalWHOP < 0.001, OverweightWHOvs. NormalWHOP = 0.024). It was also revealed that patients with higher BMI benefitted more from chemotherapy. (Adjusted hazard ratio (aHR): UnderweightXtilevs. NormalXtilevs. OverweightXtile: 0.565 vs. 0.474 vs. 0.409; UnderweightWHOvs. NormalWHOvs. OverweightWHO: 0.613 vs. 0.464 vs. 0.425).ConclusionAmong PDAC patients, there was a positive association between BMI and the OS, especially in patients treated with chemotherapy.
Primary orbital melanoma arising in an atypical diffuse (plaque-like) blue naevus/melanocytosis: a case report and review of literature
Authors: Dickens Tracey-Anne , Franchina Maria , Gajdatsy Adam , Mesbah Ardakani Nima 
Published: December 2021

AbstractBackgroundPrimary orbital melanoma is a rare disease and can occasionally develop from a pre-existing neoplasm of the blue naevus family of melanocytic lesions.Case presentationHerein we report a rare case of primary orbital melanoma arising from an unusual atypical diffuse (plaque-like) blue naevus/melanocytosis. A 27 year old man presented with mild pain and swelling of the left eye. Magnetic Resonance Imaging revealed a left lateral episcleral orbital mass and an incisional biopsy confirmed the diagnosis of malignant melanoma. Skin-sparing total left orbital exenteration was performed. Histopathological examination of the exenteration specimen revealed a primary orbital melanoma arising in a pre-existing blue naevus like melanocytosis.We demonstrate the evidence for histological progression, characterise the molecular profile of this tumour and discuss the related literature.ConclusionsThis case emphasises the importance of a meticulous clinicopathological correlation in recognising such a tumour as a primary orbital melanoma rather than a metastasis, which is managed differently.
Increased risk of Parkinson’s disease among patients with age-related macular degeneration
Authors: Chen Po-Yu Jay , Wan Lei , Lai Jung-Nien , Chen Chih Sheng , Chen Jamie Jiin-Yi , Yen Wu Ming , Chiu Lu-Ting , Hu Kai-Chieh , Tien Peng-Tai , Lin Hui-Ju 
Published: December 2021

Abstract
Background
This study aimed to investigate the risk of Parkinson’s disease (PD) among patients with age-related macular degeneration (AMD) and its association with confounding comorbidities.

Methods
A population-based retrospective cohort study was conducted using Longitudinal Health Insurance Database 2000 (LHID2000). We established AMD and non-AMD cohorts from January 1, 2000 to December 31, 2012 to determine the diagnosis of PD. A total of 20,848 patients were enrolled, with 10,424 AMD patients and 10,424 controls matched for age, sex, and index year at a 1:1 ratio. The follow-up period was from the index date of AMD diagnosis to the diagnosis of PD, death, withdrawal from the insurance program, or end of 2013. Multivariable Cox regression analysis was performed to examine the hazard ratio (HR) and 95% confidence interval (CI) for the risk of PD between the AMD and non-AMD cohorts.

Result
After adjusting for potential confounders, there was a higher risk of developing PD in the AMD cohort than in the non-AMD cohort (adjusted HR = 1.35, 95% CI = 1.16–1.58). A significant association could be observed in both female (aHR = 1.42, 95% CI = 1.13–1.80) and male (aHR = 1.28, 95% CI = 1.05–1.57) patients, aged more than 60 years (60–69: aHR = 1.51, 95% CI = 1.09–2.09, 70–79: aHR = 1.30, 95% CI = 1.05–1.60; 80–100: aHR = 1.40, 95% CI = 1.01–1.95), and with more than one comorbidity (aHR = 1.40, 95% CI = 1.20–1.64). A significant association between increased risk of PD and AMD was observed among patients with comorbidities of osteoporosis (aHR = 1.68, 95% CI = 1.22–2.33), diabetes (aHR = 1.41, 95% CI = 1.12–1.78) and hypertension (aHR = 1.36, 95% CI = 1.15–1.62) and medications of statin (aHR = 1.42, 95% CI = 1.19–1.69) and calcium channel blocker (CCB) (aHR = 1.32, 95% CI = 1.11–1.58). The cumulative incidence of PD was significantly higher over the 12-year follow-up period in AMD cohort (log-rank test, p < 0.001).

Conclusions
Patients with AMD may exhibit a higher risk of PD than those without AMD.
Association of circulating let-7b-5p with major depressive disorder: a nested case-control study
Authors: Roumans Sanne , Sundquist Kristina , Memon Ashfaque A. , Hedelius Anna , Sundquist Jan , Wang Xiao 
Published: December 2021

Abstract
Background
Major depressive disorder (MDD) is one of the most common psychiatric disorders and is a great disease burden. However, its underlying pathophysiology and aetiology remain poorly understood. Available evidence suggests that circulating microRNAs (miRNAs) are associated with MDD, but it is still unknown whether miRNAs can predict subsequent incident MDD.

Methods
In this nested case-control study, a total of 104 individuals, who were free of MDD at baseline, from the Women’s Health in Lund Area (WHILA) cohort were included. Among them, 52 individuals developed MDD (cases) during the 5 years follow-up and 52 individuals did not develop MDD (controls). Plasma expression levels of miR-17-5p, miR-134-5p, miR-144-5p, let-7b-5p and let-7c-5p at baseline were assessed using qRT-PCR. Logistic regression was used to estimate the odds of developing MDD among individuals with different levels of miRNA expression.

Results
Plasma expression levels of let-7b-5p were significantly lower (p = 0.02) at baseline in cases compared to controls. After adjustment for age and BMI, let-7b-5p was negatively associated with odds for developing MDD (OR = 0.33, p = 0.03, 95% CI = 0.12–0.91). Moreover, let-7b-5p expression levels showed a trend over time with larger differences between cases and controls for the earlier cases (MDD diagnosis <2 years from baseline) than MDD cases developed later (MDD diagnosis 2–5 years from baseline).

Conclusions
These findings show that lower plasma levels of let-7b-5p are associated with a higher future risk of MDD. Results need to be validated in a large cohort to examine its potential as a peripheral biomarker for MDD.
Translation and validation of the Canadian assessment of physical literacy-2 in a Danish sample
Authors: Elsborg Peter , Melby Paulina S. , Kurtzhals Mette , Tremblay Mark S. , Nielsen Glen , Bentsen Peter 
Published: December 2021

Abstract
Background
The aim of this study was to translate the Canadian Assessment of Physical Literacy, second edition (CAPL-2) into Danish language, adapt it to Danish context and to test the measurement properties on a sample of Danish school children.

Methods
The CAPL-2 measurement tool was translated into Danish language and adapted for the Danish context. This Danish version of the CAPL-2 was then tested on 891 Danish school children from 50 classes in 12 different schools.

Results
Confirmatory factor analysis using the four-factor model, as suggested by the CAPL-2 original developers, showed an acceptable model fit for the Danish version (CFI = .973; TLI = .957; RMSEA = 0.040 (90% CI 0.033–0.054); SRMR = 0.040). Positive significant correlations between the domains were found. The domains as well as the total CAPL-2 score were found to be positively associated with physical education teachers’ assessment of their pupil’s in four central aspects of PL (i.e. enjoyment, confidence, motor skills, and diversity) indicating predictive validity. High internal consistency of the instrument used to measure motivation and confidence domain were found.

Conclusion
The translated and context-adapted Danish version of CAPL-2 is a valid and reliable measurement tool ready to use in Danish research studies.
Numbers of close contacts of individuals infected with SARS-CoV-2 and their association with government intervention strategies
Authors: McAloon Conor G. , Wall Patrick , Butler Francis , Codd Mary , Gormley Eamonn , Walsh Cathal , Duggan Jim , Murphy T. Brendan , Nolan Philip , Smyth Breda , O’Brien Katie , Teljeur Conor , Green Martin J. , O’Grady Luke , Culhane Kieran , Buckley Claire , Carroll Ciara , Doyle Sarah , Martin Jennifer , More Simon J. 
Published: December 2021

Abstract
Background
Contact tracing is conducted with the primary purpose of interrupting transmission from individuals who are likely to be infectious to others. Secondary analyses of data on the numbers of close contacts of confirmed cases could also: provide an early signal of increases in contact patterns that might precede larger than expected case numbers; evaluate the impact of government interventions on the number of contacts of confirmed cases; or provide data information on contact rates between age cohorts for the purpose of epidemiological modelling. We analysed data from 140,204 close contacts of 39,861 cases in Ireland from 1st May to 1st December 2020.

Results
Negative binomial regression models highlighted greater numbers of contacts within specific population demographics, after correcting for temporal associations. Separate segmented regression models of the number of cases over time and the average number of contacts per case indicated that a breakpoint indicating a rapid decrease in the number of contacts per case in October 2020 preceded a breakpoint indicating a reduction in the number of cases by 11 days.

Conclusions
We found that the number of contacts per infected case was overdispersed, the mean varied considerable over time and was temporally associated with government interventions. Analysis of the reported number of contacts per individual in contact tracing data may be a useful early indicator of changes in behaviour in response to, or indeed despite, government restrictions. This study provides useful information for triangulating assumptions regarding the contact mixing rates between different age cohorts for epidemiological modelling.
Socio-environmental and psychosocial predictors of smoking susceptibility among adolescents with contrasting socio-cultural characteristics: a comparative analysis
Authors: Tate Christopher , Kumar Rajnish , Murray Jennifer M. , Sanchez-Franco Sharon , Montgomery Shannon C. , Montes Felipe , Dunne Laura , Sarmiento Olga L. , Kee Frank , Hunter Ruth F. 
Published: December 2021

Abstract
Background
Despite a steady decline in adolescent smoking globally, it remains a prevalent risk factor for non-communicable disease. Previous research points to differences in socio-environmental and psychosocial risk factors for smoking and how they vary across different settings with disparate social and cultural characteristics. As a result, smoking rates have remained disproportionately higher in some settings while decreasing in others. This study explored the socio-environmental and psychosocial risk factors for smoking susceptibility in a high-income and upper-middle income setting.

Methods
Cross-sectional data were obtained from 1,573 male and female adolescents aged 11-15 years who completed self-administered questionnaires in schools in Northern Ireland and Bogotá, Colombia. Using logistic regression analysis, we examined how socio-environmental and psychosocial predictors of smoking susceptibility compared across the two countries.

Results
In Northern Ireland, reduced odds of smoking susceptibility were significantly associated with less family smoking (OR: 0.64, 95% CI: 0.41-1.00); having access to information about smoking in school (OR: 0.75, 95% CI: 0.59-0.96); negative attitudes towards smoking (OR: 0.35, 95% CI: 0.23-0.51); higher levels of openness (OR: 0.59, 95% CI: 0.50-0.69); and higher levels of self-reported wellbeing (OR: 0.57, 95% CI: 0.44-0.74). Increased odds of smoking susceptibility were associated with reporting less smoking of a mother (OR: 1.37, 95% CI: 1.06-1.76); higher levels of extraversion (OR: 1.40, 95% CI: 1.04-1.90); and receiving pocket money (OR: 1.20, 95% CI: 1.06-1.37). In Bogotá, reduced odds of smoking susceptibility were significantly associated with reporting less smoking among friends (OR: 0.86, 95% CI: 0.76-0.98); higher levels of self-efficacy (OR: 0.58, 95% CI: 0.40-0.83); greater perceived behavioural control to quit smoking (OR: 0.71, 95% CI: 0.56-0.90); and lower levels of truancy (OR: 0.69, 95% CI: 0.52-0.92). In Bogotá, no factors were associated with increased odds of smoking susceptibility in the final model.

Conclusions
The findings illustrate that there were differences in predictors of adolescent smoking susceptibility across the two settings. By using a comparative approach we demonstrate that smoking interventions and policies must be sensitive to the cultural and normative context within which they are implemented.
Identification and detection of pathogenic bacteria from patients with hospital-acquired pneumonia in southwestern Iran; evaluation of biofilm production and molecular typing of bacterial isolates
Authors: Mazloomirad Farzad , Hasanzadeh Sajad , Sharifi Asghar , Nikbakht Gordafarin , Roustaei Narges , Khoramrooz Seyed Sajjad 
Published: December 2021

Abstract
Background
Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection in intensive care units (ICUs). The present study aims to determine the prevalence of pathogenic bacteria, their biofilm formation, and molecular typing from patients with HAP in southwestern Iran.

Methods
Fifty-eight patients with HAP participated in this cross-sectional study. Sputum and endotracheal aspirate were collected from each patient for isolation and detection of bacteria. Biofilm formation was evaluated using Congo red agar or Microtiter plate assay. The antimicrobial susceptibility patterns of the isolates were investigated. The multiplex polymerase chain reaction (M-PCR) technique was used to determine the Staphylococcal Cassette Chromosome mec (SCCmec) types of methicillin-resistant Staphylococcus aureus (MRSA) strains. All S. aureus isolates were typed using the agr typing method. A repetitive element sequence-based PCR (rep-PCR) typing method was used for typing of Gram-negative bacteria. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 15 and the chi-square test.

Results
Bacteria were isolated in 52 (89.7%) of patients. Acinetobacter baumannii (A. baumannii) was the most prevalent organism (37%), followed by S. aureus, Pseudomonas aeruginosa (P. aeruginosa), and Escherichia coli (E. coli). Using the PCR method, 56 bacteria were detected. A. baumannii was the most prevalent (35.7%) organism. A. baumannii and P. aeruginosa were biofilm-producing. All Gram-negative isolates were colistin-sensitive, and most of the A. baumannii isolates were multidrug-resistant (MDR). MRSA was identified in 12 (80%) S. aureus isolates, and 91.6% of MRSA were SCCmec type III. The agr type III was the most predominant. The rep-PCR analysis showed seven different patterns in 20 A. baumannii, six patterns in 13 P. aeruginosa, and four patterns in 6 E. coli.

Conclusion
A. baumannii was more prevalent than S. aureus in ventilator-associated pneumonia (VAP), while S. aureus is a major pathogen in non-ventilator hospital-acquired pneumonia (NV-HAP), possibly due to the tendency of the former to aquatic environments. Based on the rep-PCR typing method, it was concluded that bacteria were transmitted from patients or healthcare workers among different wards. Colistin can be used as a treatment in Gram-negative MDR isolates.
Application of online case-based learning in the teaching of clinical anesthesia for residents during the COVID-19 epidemic
Authors: Duan Yi , Li Zuozhi , Wang Xiaoyu , Gao Zhifeng , Zhang Huan 
Published: December 2021

Abstract
Objective
COVID-19 prevention and control demand a reduction in crowd gathering, which has a significant impact on traditional teaching and offline case-based learning (CBL). In order to mitigate the impact of the COVID-19 outbreak on clinical teaching, we aimed to compare the effects of an online CBL with traditional teaching model on learning outcomes of anesthesia residents.

Methods
Residents rotated in the Department of Anesthesiology in Beijing Tsinghua Changgung Hospital from January 2020 to February 2021 were included in Group W (n = 19), which implemented the W-CBL teaching model. The performance of residents was evaluated with theory test and 2 survey questionnaires (A and B) were conducted after 1 month of rotating. All 20 residents rotating in the Department of Anesthesiology at our hospital from January 2018 to December 2019 were included in Group C, which implemented the traditional teaching model. Their examination results were acquired through the teaching files and survey questionnaire (A) were administered through WeChat.

Results
During the 1-month rotation, a total of 10 cases were discussed in Group W. The average score for theory test was higher in Group W than that in Group C (84.57 ± 4.87 vs. 79.35 ± 3.70, P = 0.001). The satisfaction rate was also in favor of Group W regarding to clinical thinking, communication skills, learning interest and self-learning ability (P < 0.05).

Conclusions
Online CBL based on WeChat platform is an effective and acceptable teaching strategy in comparison to lecture-based learning (LBL) among residents embarking on clinical anesthesia courses.
A mental models approach for defining explainable artificial intelligence
Authors: Merry Michael , Riddle Pat , Warren Jim 
Published: December 2021

Abstract
Background
Wide-ranging concerns exist regarding the use of black-box modelling methods in sensitive contexts such as healthcare. Despite performance gains and hype, uptake of artificial intelligence (AI) is hindered by these concerns. Explainable AI is thought to help alleviate these concerns. However, existing definitions for explainable are not forming a solid foundation for this work.

Methods
We critique recent reviews on the literature regarding: the agency of an AI within a team; mental models, especially as they apply to healthcare, and the practical aspects of their elicitation; and existing and current definitions of explainability, especially from the perspective of AI researchers. On the basis of this literature, we create a new definition of explainable, and supporting terms, providing definitions that can be objectively evaluated. Finally, we apply the new definition of explainable to three existing models, demonstrating how it can apply to previous research, and providing guidance for future research on the basis of this definition.

Results
Existing definitions of explanation are premised on global applicability and don’t address the question ‘understandable by whom?’. Eliciting mental models can be likened to creating explainable AI if one considers the AI as a member of a team. On this basis, we define explainability in terms of the context of the model, comprising the purpose, audience, and language of the model and explanation. As examples, this definition is applied to regression models, neural nets, and human mental models in operating-room teams.

Conclusions
Existing definitions of explanation have limitations for ensuring that the concerns for practical applications are resolved. Defining explainability in terms of the context of their application forces evaluations to be aligned with the practical goals of the model. Further, it will allow researchers to explicitly distinguish between explanations for technical and lay audiences, allowing different evaluations to be applied to each.