bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical presentation of cholecystitis with torsion of the gallbladder diagnosed preoperatively in an unusual location
Authors: Kalyanasundaram Sowmiya , Fernando Suresh 
Published: November 2021

Objective: An 87-year-old attended the emergency department with sharp upper abdominal pain, radiating to back with a pain score of 10/10. On examination, severe epigastric tenderness was noted. Past surgical history: bilateral salphingo-oopherectomy. Repair for paraumblical hernia and right total hip replacement. No history of cholecystectomy. Inflammatory markers were raised. Cholecystitis/gall bladder perforation was suspected and contrast CT was performed. Methods: CT abdomen and pelvis – in comparison to the previous CT scan which was done in 2018, where gall bladder was in the correct anatomical location, the gall bladder was not seen in the gall bladder fossa in the current study. However, a gall bladder like suspicious structure was noticed within the upper abdomen to the left of midline anterior to the gastric pylorus with significant inflammatory changes. Therefore, considering the clinical picture and CT findings, it was suggestive of acute cholecystitis with torsion of gall bladder. Results: Patient was started on i.v. antibiotics and laparoscopic assessment was carried out on the following day. Intraoperatively, the surgeons were unable to locate the gall bladder in its normal anatomical position, but incidentally found a mass in the left upper abdomen which appeared gangrenous. This was removed and sent for histopathology. Histology report confirmed that the specimen was gall bladder with features suggestive of pre-existing chronic cholecystitis, with recent venous infarction. Conclusion: Torsion of gall bladder is a very rare entity and if left untreated could lead to fatal sequelae of gangrene and perforation resulting in biliary peritonitis. There is evidence which suggest that torsion of gall bladder is more common in elderly females due to loss of visceral fat but the pre-operative diagnosis using imaging modalities has always been challenging. But in this particular case, the radiologist was able to make the precise diagnosis pre-operatively using the cross-sectional study of an advanced imaging modality like the CT scan with contrast which also helped the surgeons in making the decision for immediate surgery rather than planning for routine conservative management for acute cholecystitis. The importance of cross-sectional study with intravenous contrast in diagnosing unusual presentation of gall bladder related and potentially life-threatening abdominal pathology has been highlighted in this case study. It is also evident that how imaging modalities play a significant role in altering acute management plan.
Diagnostic efficacy of CBCT, MRI and CBCT–MRI fused images in determining anterior disc displacement and bone changes of temporomandibular joint
Authors: Wang Ying-Hui , Ma Ruo-Han , Li Jia-Jun , Mu Chuang-Chuang , Zhao Yan-Ping , Meng Juan-Hong , Li Gang 
Published: November 2021

Objectives: To evaluate the diagnostic efficacy of CBCT–MRI fused image for anterior disc displacement and bone changes of temporomandibular joint (TMJ), which are the main imaging manifestations of temporomandibular disorders (TMD). Methods: Two hundred and thirty-one TMJs of 120 patients who were diagnosed with TMD were selected for the study. The anterior disc displacement, bone defect and bone hyperplasia evaluated by three experts were used as a reference standard. Three residents individually evaluated all the three sets of images, which were CBCT images, MRI images and CBCT-MRI fused images from individual CBCT and MRI images in a random order for the above-mentioned three imaging manifestations with a five-point scale. Each set of images was observed at least 1 week apart. A second evaluation was performed 4 weeks later. Intra- and interobserver agreements were assessed using the intraclass correlation coefficient (ICC). The areas under the ROC curves (AUCs) of the three image sets were compared with a Z test, and p < 0.05 was considered statistically significant. Results: One hundred and forty-five cases were determined as anterior disc displacement, 84 cases as bone defect and 40 cases as bone hyperplasia. The intra- and interobserver agreements in the CBCT-MRI fused image set (0.76–0.91) were good to excellent, and the diagnostic accuracy for bone changes was significantly higher than that of MRI image set (p＜0.05). Conclusions CBCT-MRI fused images can display the disc and surrounding bone structures simultaneously and significantly improve the observers’ reliability and diagnostic accuracy, especially for inexperienced residents.
Three-dimensional verification of the radiographic visibility of the root pulp used for forensic age estimation in mandibular third molars
Authors: Gunacar Dilara Nil , Bayrak Seval , Sinanoglu Enver Alper 
Published: November 2021

ObjectivesThe aim of this study was to assess the reliability of panoramic radiography (OPG) using age estimation method using cone beam computed tomography (CBCT) verification in the evaluation of radiographic visibility of root pulp (RPV) of mandibular third molars for age estimation.MethodsCBCT and OPG images of 429 mandibular third molars from 290 patients were evaluated. RPV of fully mineralized mandibular third molars was evaluated as stages 0, 1, 2, and 3 for both imaging methods. Descriptive statistics were performed separately for stages by age for both genders. The consistency of these scores with chronological age was evaluated for both imaging methods. The reliability of OPG evaluation was also analyzed with CBCT scores. Results Spearman’s rho correlation demonstrated a positive correlation between RPV and chronological age for both genders and for OPG and CBCT evaluation. Considering the minimum ages of both imaging methods, all stages were above the age of 18 except for the female group of Stage 2 and all Stage 0. For the comparison of OPG and CBCT RPV Staging scores, the κ score was found to be 0.312 (p < 0.001), indicating a fair agreement.ConclusionIn conclusion, the absence of Stage 3 at age of 18 and under might have a forensic value for RPV age estimation method. Considering the fair agreement in the verification of OPG scores, it is not possible to determine the exact age with the RPV detected in OPG images, the use of CBCT for the RPV evaluation is recommended to available cases.
A scoping review protocol of evidence-based guidance and guidelines published by general practitioner professional organisations
Authors: O'Brien Emer , Clyne Barbara , Smith Susan M. , O'Herlihy Noirin , Harkins Velma , Wallace Emma 
Published: November 2021

Introduction:General practitioners (GPs) strive to use a patient centered approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. In order to achieve this standard of care, GPs require relevant, up to date and high quality evidence. Currently there is a gap in the literature regarding the role of GP professional organisations internationally in producing and publishing evidence based guidance and clinical guidelines for GPs. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally in terms of topic content, the structure and methods used to develop guidance and ways of disseminating this guidance, to support general practice clinical decision making.Methods:This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted.Conclusions:This scoping review will examine current practice internationally regarding the role of General Practice professional organisations in producing and publishing clinical guidelines and evidence based guidance to support general practitioner’s clinical decision making to benefit patient care.
An opt-out approach to hepatitis C virus testing in English prisons: the literature underpinning the policy
Authors: Jack Kathryn 
Published: November 2021

Background: The World Health Organization's aim to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030 is dependent on testing people. HCV prevalence is higher in prisons, so to increase test uptake an ‘opt-out’ approach to blood-borne virus testing in English and Welsh prisons was introduced. Aims: This literature review examines the evidence behind the introduction of this public health policy. Methods: Four healthcare databases were searched for publications between January 2000 and February 2020 on the opt-out approach to blood-borne virus testing in prisons. Findings: Sixteen studies published between 2009 and 2019 were included. Analysis of their findings showed that an increase in HCV test uptake in prisons occurs when an opt-out approach is used in combination with additional interventions. Contextual differences between UK and US prisons may affect HCV test uptake. Conclusion: An opt-out approach to HCV testing in prisons can increase test uptake as part of a complex of interventions.
Integrated orbital angular momentum mode generator with wide spectral tunability [Invited]
Authors: Song Du-Ri , Yan Lu , He Tao , Ramachandran Siddharth 
Published: November 2021

We demonstrate tunable generation of orbital angular momentum (OAM)
modes with low loss (0.7 dB) and high efficiency (

>

90

%

) over a 230 nm in the visible and
near-infrared spectral range using all-fiber acousto-optic-induced
long period gratings. This represents tuning over almost 33% of the
carrier frequency, and measured output OAM mode purities are as high
as 99%. Our device construction allows accessing any wavelength in the
range we probed (591–818 nm) with at most a 55 µs response time. The
high-speed tunability, large spectral coverage, and high mode purity
can be potentially useful in numerous applications requiring
spectrally diverse OAM light.
Studying the influence of 3.1 THz irradiation on the endocytosis of neuronal cells
Authors: Hu Erling , Wang Leilei , Zhang Qi , Li Peng , Zhang Peng , Wu Dai , Lu Xiaoyun 
Published: November 2021

Although more and more attention has been paid to the biological effects of electromagnetic radiation in the terahertz (THz) frequencies range with the rapid development of THz technology, the effects of THz irradiation on many biological processes remain unknown. In this study, we explored the influence of THz irradiation at the frequency of 3.1 THz on the endocytosis of neuronal cells. To determine the changes of endocytosis, a membrane-selective fluorescent dye FM4-64 was used to stain HT22 cells under two kinds of THz irradiation conditions including pre-irradiating cells followed by FM4-64 staining and simultaneously irradiating and FM4-64 dyeing cells. The results showed that 3.1 THz irradiation could alter the endocytosis of HT22 cells via enhancing this process when cells are in a resting state, and, to the contrary, inhibiting this process when cells were in an excited state. Finally, in the presence of dynasore, an inhibitor of GTPase dynamin, THz irradiation dramatically increased the FM4-64 fluorescence intensity comparing to the unirradiated group in both physiological states. These findings demonstrated that THz irradiation could alter the endocytic process of neuronal cells in either a positive or negative way, suggesting that it has the possibility of affecting the substance exchange and signal transmission.
Presbyopia developed earlier during the COVID-19 pandemic
Authors: Negishi Kazuno , Ayaki Masahiko 
Published: November 2021

Purpose
The aim of this cohort study was to evaluate the development and progression of presbyopia and the status of dry eye-related symptoms from 2017 to 2020, to assess the impact of the COVID-19 pandemic.

Methods
Near add power at 30 cm was measured in 339 participants aged between 40 and 55 from 2017 to 2021 at Japanese eye clinics. Regression analysis of near add power and age was analyzed to compare 2017 with later years up to the pandemic. The prevalence of dry eye-related signs and six common symptoms were compared.

Results
The number and mean age (y) of participants were 183 (48.6±4.1) in 2017, 46 (51.3±7.5) in 2019, and 110 (49.2±3.7) in 2020–21, respectively. The mean progression rate of near add power (D/y) was 0.13 for 2017, 0.09 for 2019 (P = 0.028, vs 2017), and 0.08 for 2020–21 (P<0.001, vs 2017). The slope (rate of presbyopia progression) became flatter from 2017 to 2021 and the estimated near add power at the age of 40 increased from 2017 to 2020–2021, implicating presbyopia developed earlier and worsened during the study period. The 2017 values were comparable with previous studies described in 1922 and 2019. The standardized correlation coefficient between age and near add power was 0.816 for 2017, 0.671 for 2019 (P = 0.084, vs 2017), and 0.572 for 2020–21 (P<0.001, vs 2017). Multiple regression analysis revealed age and COVID-19 pandemic were significantly correlated with near add power. The prevalence of dryness irritation, and pain was greater in 2020–21 than in 2017 with no difference in the prevalence of eye fatigue, blurring, and photophobia. There was no difference in the prevalence of short tear break-up time and positive corneal staining among 2017, 2019 and 2020–21.

Conclusion
Estimated presbyopia developed earlier and progressed slower from 2017 to 2021, the COVID-19 pandemic. Stress and rapid digitalization related to strict infection control and quarantine might be contributing factors.
Exploring the awareness, attitudes, and actions (AAA) of UK adults at high risk of severe illness from COVID-19
Authors: Flint Stuart W. , Brown Adrian , Sanders George , Tahrani Abd A. 
Published: November 2021

Background
People at high risk of severe illness from COVID-19 have experienced greater restrictions during the pandemic, yet there is a paucity of research exploring their lived experience.

Objectives
This study explored the impact of COVID-19 on people identified as at high risk of severe illness by UK Government, and in particular, the impact of the first lockdown on access to healthcare, medications and use of technological platforms.

Methods
1038 UK adults who identified as at high risk of severe illness from COVID-19 in line with UK Government guidance or self-identified with acute or other chronic health conditions, completed the Awareness, Attitudes and Actions survey which explored the impact of COVID-19 on access to healthcare, management of long-term health condition, mental health, and health behaviours.

Results
Most participants reported feelings of vulnerability, anxiety and isolation, noticed that other people changed their behaviour towards them including a feeling of being stigmatised by people not categorised as high risk. Participants described the largely negative impact that the COVID-19 lockdown had on to health-related behaviours and access to healthcare, which had resulted in large declines in mental health and wellbeing. Participants also indicated disappointment at the UK Governments response and handling of the COVID-19 lockdown.

Implications
This study provides novel evidence of the lived experience of the first COVID-19 lockdown for people identified as at high risk of severe illness. In the context of behavioural health interventions, the ubiquity of digital technologies and their adoption into day-to-day life translates into greater potential reach than traditional interventions, and consequently, greater potential for positive public health impact. Findings should be considered by policymakers and healthcare professionals to support people now and as we transition through the recovery phase with a particular emphasis on supporting mental health and changes to the management of long-term health conditions.
Population-based comparative survival analysis of surgery with or without adjuvant radiotherapy and non-operative primary radiotherapy in patients with early-stage oral tongue squamous cell carcinoma
Authors: Lim Yu Jin , Kong Moonkyoo 
Published: November 2021

Purpose
Although recent clinical guidelines do allow primary radiotherapy for selected patients with early-stage oral tongue cancer, there has been little knowledge on the treatment outcomes of non-operative radiotherapy using modern treatment techniques. This study evaluated recent prognostic differences between primary radiotherapy and surgical resection in T1‒2N0 oral tongue squamous cell carcinoma.

Methods
Patients diagnosed with T1‒2N0 oral tongue squamous cell carcinoma were identified from the Surveillance, Epidemiology, and End Results database. After propensity score matching, the disease-specific survival of primary radiotherapy and surgery was compared.

Results
From a total of 8,458 patients initially identified, we defined matched cohorts: cohort A, comparing surgery alone vs. primary radiotherapy (n = 230 vs. 230), and cohort B, comparing surgery plus adjuvant radiotherapy vs. primary radiotherapy (n = 230 vs. 230). The 7-year disease-specific survival rates were 77% vs. 35% (cohort A) and 65% vs. 35% (cohort B) (P < 0.001 for all comparisons). Primary radiotherapy was independently associated with worse disease-specific survival in both cohorts A (hazard ratio 4.06; 95% confidence interval 2.53‒6.52) and B (hazard ratio 2.81; 95% confidence interval 1.96‒4.04). Time-course hazard rate function plots showed a distinct short-term risk increment in disease-specific mortality in the primary radiotherapy group.

Conclusion
In the contemporary treatment era, the use of radiotherapy as a definitive treatment resulted in an inferior prognosis in patients with T1‒2N0 oral tongue squamous cell carcinoma. The present population-based data suggest that primary radiotherapy cannot be used as an alternative to surgical management and it needs to be avoided as much as possible in early-stage tumors.
Prevalence and associated risk factors for dry eye disease among Brazilian undergraduate students
Authors: Yang Isabela , Wakamatsu Tais , Sacho Isabella Batistela Inhesta , Fazzi José Henrique , de Aquino Asafe César , Ayub Gabriel , Rebello Pedro Albuquerque , Gomes José Álvaro Pereira , Alves Monica 
Published: November 2021

Purpose
Dry eye is a common, complex, and multifactorial disease of the ocular surface and tear film that results in discomfort and visual disturbances. Prevalence rates vary and largely rely on studies involving older populations. This study sought to evaluate dry eye among a sample of young students in Brazil.

Methods
Cross-sectional survey included 2,140 students using 2 self-applicable questionnaires of dry eye symptoms: the Ocular Surface Disease Index (OSDI) and the Women’s Health Study (WHS) questionnaire and a list of risk factors associated with dry eye. Participants with dry eye symptoms underwent a clinical evaluation.

Results
Participants were 23.4±5.2 years of age, 56.1% female and 43.9% male, 34.4% had an OSDI score greater than 22, and 23.5% had dry eye according to the WHS. Dry eye frequency differed consistently between the sexes: 42.6% women and 24.0% men based on the OSDI, and 27.1% women and 18.5% men based on the WHS. Univariate and multivariate analyses demonstrated that female sex, contact lens wear, the screen use for more than 6 hours per day, less than 6 hours of sleep a night, and certain medications were relevant related risk factors for dry eye. Despite symptoms, clinical evaluations demonstrated mild signs of dry eye.

Conclusions
Dry eye symptoms were found to be a prevalent condition among Brazilian undergraduate students. Compared to the rates of dry eye among the general Brazilian population over 40 years of age, students present at higher dry eye symptoms rates and distinct odds for related risk factors were identified.
Seclusion in an enriched environment versus seclusion as usual: A quasi-experimental study using mixed methods
Authors: van der Venne Cornelia G. J. M. , van Meijel Berno , Deen Mathijs , Olff Miranda , Mulder Cornelis L. 
Published: November 2021

Background
For patients, seclusion during psychiatric treatment is often a traumatic experience. To prevent such experiences, adjustments in the design of seclusion rooms have been recommended.

Methods
As there have been no empirical studies on the matter, we used a quasi-experimental design to compare the experiences in seclusion of two groups of patients: 26 who had been secluded in a room designed according to the principles of healing environment, a so called ‘Enriched Environment Seclusion room’ (EES), and 27 who had been secluded in a regular seclusion (RS) room. The enrichment included audio-visual facilities, a fixed toilet, a couch and a self-service system to adjust light, colour, blinds and temperature according to the patient’s preferences. Insight into their experiences was obtained using the Patient View-of-Seclusion Questionnaire, which comprises nine statements on seclusion, supplemented with open-ended questions.

Results
The responses regarding seclusion experiences between the two groups did not differ significantly (U = 280.00, p = .21, r = -.17). Although those who had been secluded in the specially designed room had greatly appreciated the opportunities for distraction, and those who had been secluded in a regular seclusion room expressed the need for more distracting activities during seclusion, both groups described seclusion as a dreadful experience. If seclusion cannot be avoided, patients recommend facilities for distraction (such as those provided in an enriched environment seclusion room) to be available.

Conclusion
Whatever the physical environment and facilities of a seclusion room, we may thus conclude that seclusion is a burdensome experience.
Adaptation and validity of the Sleep Quality Scale among Chinese drivers
Authors: Chen Shuang , Sun Long , Zhang Changlu 
Published: November 2021

Purpose
Poor sleep quality is closed related with driving accidents. However, due to the lack of a valid instrument for assessing drivers’ sleep quality, few studies have examined drivers’ sleep quality and its associations with driving behaviours and traffic accidents in China. The aim of this paper is to revise the Sleep Quality Scale (SQS) and assess its reliability and validity in Chinese drivers.

Methods
522 Chinese drivers aged from 18 to 56 years old agreed to complete the SQS, Daytime Sleepiness Perception Scale version 4 (DSPS-4), Self-report of Risky Driving Behavior (RD-SR) and Self-assessment of the Likelihood of Being Involved in a Risky Driving Situation (RD-SA).

Results
The final Chinese version of the SQS contained 23 items across four factors: difficulty in getting up, difficulty in falling asleep, sleep recovery and daytime dysfunction. Second, man scored lower on the difficulty in falling asleep factor but higher on the sleep recovery factor than women. Third, low to moderate correlations were found between the SQS factors and the DSPS-4, RD-SA and RD-SR, indicating that the validity of the revised scale was satisfactory. More importantly, daytime dysfunction factor is an effective predictor of violation involvement and accident involvement.

Conclusion
The revised SQS has acceptable reliability and validity and can be used as a tool to measure the sleep quality of Chinese drivers.