bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards Simulation Aided Online Teaching: Material Design for Applied Fluid Mechanics
Authors: Altuger-Genc Gonca , Han Yue , Genc Yegin 
Published: January 2019

Learning is shifting from synchronous in-class settings to asynchronous online platforms in an attempt to make education accessible to wider audience. However, certain vital components of engineering education, such as laboratory work and hands-on practices, are harder to conduct online. Understanding how technology can help offering such components online can impact the quality of online education a great deal. The goal of this study is to improve the effectiveness of online courses in engineering. Particularly, we aim to transform some of the hands-on practices that are fundamental for engineering education into online setting. We first explored existing literature and found that real-time experimentation can be carried out with the help of online modules. We then designed two simulations for a fluid mechanics lab. We expect these simulations to be used to support teaching and evaluation of fluid mechanics through various assignments that utilize these simulations. This study surveys how online modules have been studied in effort to relax the time and location constraints of in-class education. Drawing upon the literature review it proposes a novel approach to incorporate simulations to ground learning of abstract concepts such as buoyancy.
Reengineering the Communication Process to Reduce Patient No-Show Rates in Hospital Outpatient Clinics
Authors: Al Shammari Mastourah D. , Al Harbi Talal , Al Saawi Abdulmohsen , Al-Surimi Khaled 
Published: January 2019

Abstract
Background: Patient “no-shows” cause significant concern for healthcare organizations as it affects continuity of care provided to the patient, quality of care, waiting times for new patients, and wastes clinic resources. This project aimed to reduce the rate of no-shows in a general pediatric clinic to less than 10% to be consistent with the international benchmark range of 5%–10% of primary care clinics. Materials and Methods: A multidisciplinary team was formed to address the rate of no-shows using a quality improvement–driven approach in August 2017. Retrospective data analysis showed that 33% of patients who were referred to the general pediatric clinic at King Abdullah Specialist Children Hospital did not show up for their appointments in March 2017. Results: The impact of reengineering the patients' appointment communication process led to a noticeable reduction in the rate of no-shows in the general pediatric clinic, reaching 14% in 1 month (November to December 2017) compared with the baseline of 33%. Data analysis for the post-intervention period showed a progressive decline in the no-show rate, reaching below 10% in the general pediatric clinic, indicating a big shift in the rate of no-shows among the patients attending the general pediatric clinic. Conclusion: Reengineering the communication process and increasing awareness to update contact information are effective strategies for improving communication with patients and reducing the rate of no-shows for scheduled appointments. The next step is to share project findings with healthcare workers and leaders to sustain the improvement.
Investigation of the dorsolateral branch of the posterior intercostal artery for use as the pedicle of a free flap: A cadaveric study and case series
Authors: Nam Su Bong , Seo Jung Yeol , Park Tae Seo , Sung Ji Yoon , Kim Joo Hyoung , Lee Jae Woo , Kim Min Wook , Oh Heung Chan 
Published: January 2019

Background The dorsolateral branch of the posterior intercostal artery (DLBPI) can be easily found while harvesting a latissimus dorsi (LD) musculocutaneous flap for breast reconstruction. However, it remains unknown whether this branch can be used for a free flap and whether this branch alone can provide perfusion to the skin. We examined whether the DLBPI could be reliably found and whether it could provide sufficient perfusion.
Methods We dissected 10 fresh cadavers and counted DLBPIs with a diameter larger than 2 mm. For each DLBPI, the following parameters were measured: distance from the lateral margin of the LD muscle, level of the intercostal space, distance from the spinal process, and distance from the inferior angle of the scapula.
Results The DLBPI was easily found in all cadavers and was reliably located in the specified area. The average number of DLBPIs was 1.65. They were located between the seventh and eleventh intercostal spaces. The average length of the DLBPI between the intercostal space and the LD muscle was 4.82 cm. To assess the perfusion of the DLBPIs, a lead oxide mixture was injected through the branch and observed using X-rays, and it showed good perfusion.
Conclusions The DLBPI can be used as a pedicle in free flaps for small defects. DLBPI flaps have some limitations, such as a short pedicle. However, an advantage of this branch is that it can be reliably located through simple dissection. For women, it has the advantage of concealing the donor scar underneath the bra band.
Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting
Authors: Lee Kyung Jin , Kim Yong Woo , Kim Jin Soo , Roh Si Young , Lee Dong Chul 
Published: January 2019

Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting.
Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up.
Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed.
Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.
Venous malformations of the head and neck: A retrospective review of 82 cases
Authors: Park Hannara , Kim Jin Soo , Park Hyochun , Kim Ji Yoon , Huh Seung , Lee Jong Min , Lee Sang Yub , Lee Seok Jong , Lee Joon Seok , Lee Jeong Woo , Chung Ho Yun 
Published: January 2019

Background Venous malformations (VMs) are a common type of vascular malformation. However, their causes and management remain unclear, and few studies specific to VMs of the head and neck have been reported. This study describes our experiences with VMs of the head and neck.
Methods This retrospective study included 82 patients who underwent treatment for head and neck VMs, among 222 who visited our vascular anomalies center. Medical records between 2003 and 2016 were reviewed to identify common features in the diagnosis and treatment. The diagnosis of suspected head and neck VMs was based on the results of imaging studies or biopsies, and the VMs were analyzed based on magnetic resonance imaging, computed tomography, and Doppler sonography findings.
Results VMs were slightly more common in female patients (59.8%), and 45.1% of patients developed initial symptoms at the age of 10 or younger. Lesions were slightly more common on the right side (47.3%). The main sites involved were the cheek (27.7%) and lip area (25.5%). The muscle layer was commonly involved, in 98.7% of cases. Small lesions less than 5 cm in diameter accounted for 60.8% of cases, and well-defined types were slightly more prevalent at 55.4%. Improvement was observed in 77.1% of treated patients.
Conclusions Early and accurate diagnosis and appropriate treatment according to individual symptoms are important for successful treatment of VMs. If treatment is delayed, the lesions can worsen, or recurrence becomes more likely. Therefore, VMs require a multidisciplinary approach for early and accurate diagnosis.
Fasciotomy in compartment syndrome from snakebite
Authors: Kim Yong Hun , Choi Jin-hee , Kim Jiye , Chung Yoon Kyu 
Published: January 2019

Background Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings.
Methods The medical records of patients who visited the trauma center of Wonju Severance Christian Hospital from January 2010 to December 2015 for the management of venomous snakebite were retrospectively reviewed. Starting in 2014, fasciotomy was performed in patients with an intracompartmental pressure of more than 40 mmHg in addition to the clinical symptoms of compartment syndrome.
Results A total of 158 patients with snakebite came to the hospital within 48 hours for treatment. Most patients (110 patients) were bitten at the upper extremities (69.6%). Since 2014, 33 out of 59 patients were suspected to have compartment syndrome, and their intracompartmental pressures were measured. Seventeen of those patients had a high intracompartmental pressure (average, 49.6 mmHg; range, 37–88 mmHg), and fasciotomy was performed.
Conclusions In this study, as many as 10.8% of all cases were in need of fasciotomy when compartment syndrome was diagnosed by measuring the intracompartmental pressure. Previously, it was reported that fasciotomy was not required in many cases of compartment syndrome originating from snakebite. However, some patients may develop very severe compartment syndrome, requiring fasciotomy.
Surgical correction for Tessier number 7 craniofacial cleft using a medially overcorrected design
Authors: Ryu Jeong Yeop , Eo Pil Seon , Tian Lulu , Lee Joon Seok , Lee Jeong Woo , Choi Kang Young , Yang Jung Dug , Chung Ho Yun , Cho Byung Chae 
Published: January 2019

Background Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure.
Methods A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry.
Results Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was 78.273±72.219 months and the mean ratio of the lengths of both sides of the lip was 1.048±0.071. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred.
Conclusions For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.
A new suoid with tubulidentate, hypselorhizic cheek teeth from the early Miocene of Córcoles, Spain
Authors: Pickford Martin , Morales Jorge 
Published: January 2019

Excavations at Córcoles, Guadalajara, Spain (MN 4) in October 1987, yielded a mandible and several isolated teeth of a strange suiform with tubulidentate cheek teeth, initially interpreted to be the remains of Tubulidentata. The specimens are complete enough to remove any doubt about which Order (Artiodactyla) and Superfamily (Suoidea) they belong to. They are here attributed to the Family Doliochoeridae, being related to the genera Bransatochoerus (MP 30) and Lorancahyus (MN 2) both of which have hypsorhizic cheek teeth, the latter with tubules in the teeth, but not to the fully-expressed extent seen in the fossils from Córcoles and the molars retain a distinct and large pulp cavity, which is absent in the Córcoles species. It is inferred that these suoids comprise an evolutionary lineage which went extinct in the early Miocene (ca MN 4b or MN 5) and that the dental specialisations imply ingestion of food to which soil was adhering, which caused excessive abrasion of the teeth, not only occlusally, but also on the lingual aspects of the cheek teeth. Examination of the occlusal and lingual surfaces of the teeth con?rm the presence of many pits and large scratches on them, in contrast to the buccal and distal surfaces of the teeth which have few scratches or none, respectively.
Physical Activity and All-Cause Mortality by Age in 4 Multinational Megacohorts
Authors: Martinez-Gomez David , Luo Mengyun , Huang Yu , Rodríguez-Artalejo Fernando , Ekelund Ulf , Sotos-Prieto Mercedes , Ding Ding , Lao Xiang-Qian , Cabanas-Sánchez Verónica 
Published: November 2024

ImportancePhysical activity (PA) guidelines recommend the same amount of PA through adulthood to live longer.ObjectiveTo explore whether there is an age-dependent association between PA and all-cause mortality and to investigate the age-dependent associations between other modifiable health factors (high educational level, not smoking, not regularly consuming alcohol, healthy body weight, and living without hypertension and diabetes) and mortality.Design, Setting, and ParticipantsThis cohort study used a pooled analysis of 4 population-based prospective cohorts (National Health Interview Survey, 1997-2018; UK Biobank, 2006-2010; China Kadoorie Biobank, 2004-2008; and Mei Jau, 1997-2016). Data were analyzed from June 2022 to September 2024.ExposuresSelf-reported leisure-time PA.Main Outcomes and MeasuresThe primary outcome was deaths identified through follow-up linkage to national death registries. Analyses were performed for the total sample and by age groups (20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years). Cox proportional hazards regression models with stratification by study were used to calculate mortality hazard ratios and their 95% CIs for the pooled dataset and by age group.ResultsA heterogeneous sample of 2 011 186 individuals (mean [SD] age, 49.1 [14.3] years; age range, 20-97 years; 1 105 581 women [55.0%]) were included. After a median (IQR) follow-up of 11.5 (9.3-13.5) years, 177 436 deaths occurred. The association between PA and mortality in the total sample showed a nonlinear dose-response pattern, but age modified this association (P for interaction &amp;lt;.001); PA was consistently associated with a lower risk of mortality across all age groups, but the reduction in risk was greater in older vs younger age groups, especially at high levels of PA. The hazard ratio for mortality associated with meeting the recommended PA in the total sample was 0.78 (95% CI, 0.77-0.79). This inverse association between meeting PA recommendations and mortality was somewhat greater as age increased (P for interaction &amp;lt;.001). Age also modified the associations of the other modifiable health factors with mortality (all P for interaction &amp;lt;.001), but the magnitude of associations was greater in younger vs older age groups.Conclusions and RelevanceIn this pooled analysis of cohort studies, the association between PA and mortality risk remained consistent across the adult lifespan, which contrasts with other modifiable health factors, for which associations with mortality risk diminished with age. Given these findings, the promotion of regular PA is essential at all stages of adult life.
Predictive Power of Polygenic Risk Scores for Intraocular Pressure or Vertical Cup-Disc Ratio
Authors: He Weixiong , Lee Samantha Sze-Yee , Diaz Torres Santiago , Han Xikun , Gharahkhani Puya , Hunter Michael , Balartnasingam Chandrakumar , Craig Jamie E. , Hewitt Alex W. , Mackey David A. , MacGregor Stuart 
Published: November 2024

ImportanceEarly detection of glaucoma is essential to timely monitoring and treatment, and primary open-angle glaucoma risk can be assessed by measuring intraocular pressure (IOP) or optic nerve head vertical cup-disc ratio (VCDR). Polygenic risk scores (PRSs) could provide a link between genetic effects estimated from genome-wide association studies (GWASs) and clinical applications to provide estimates of an individual’s genetic risk by combining many identified variants into a score.ObjectiveTo construct IOP and VCDR PRSs with clinically relevant predictive power.Design, Setting, and ParticipantsThis genetic association study evaluated the PRSs for 6959 of 51 338 individuals in the Canadian Longitudinal Study on Aging (CLSA; 2010 to 2015 with data from 11 centers in Canada) and 4960 of 5107 individuals the community-based Busselton Healthy Aging Study (BHAS; 2010 to 2015 in Busselton, Western Australia) with an artificial intelligence grading approach used to obtain precise VCDR estimates for the CLSA dataset. Data for approximately 500 000 individuals in UK Biobank from 2006 to 2010 were used to validate the power of the PRS. Data were analyzed from June to November 2023.Main Outcomes and MeasuresIOP and VCDR PRSs and phenotypic variance (R2) explained by each PRS.ResultsParticipants in CLSA were aged 45 to 85 years; those in BHAS, 46 to 64 years; and those in UK Biobank, 40 to 69 years. The VCDR PRS explained 22.0% (95% CI, 20.1-23.9) and 19.7% (95% CI, 16.3-23.3) of the phenotypic variance in VCDR in CLSA and BHAS, respectively, while the IOP PRS explained 12.9% (95% CI, 11.3-14.6) and 9.6% (95% CI, 8.1-11.2) of phenotypic variance in CLSA and BHAS IOP measurements. The VCDR PRS variance explained 5.2% (95% CI, 3.6-7.1), 12.1% (95% CI, 7.5-17.5), and 14.3% (95% CI, 9.3-19.9), and the IOP PRS variance explained 2.3% (95% CI, 1.5-3.3), 3.2% (95% CI, 1.3-5.8), and 7.5% (95% CI, 6.2-8.9) (P &amp;lt; .001) across African, East Asian, and South Asian populations, respectively.Conclusions and RelevanceVCDR and IOP PRSs derived using a large recently published multitrait GWAS exhibited validity across independent cohorts. The findings suggest that an IOP PRS has the potential to identify individuals who may benefit from more intensive IOP-lowering treatments, which could be crucial in managing glaucoma risk more effectively. Individuals with a high VCDR PRS may be at risk of developing glaucoma even if their IOP measures fall within the normal range, suggesting that these PRSs could help in early detection and intervention, particularly among those who might otherwise be considered at low risk based on IOP alone.
Oncological Outcomes of Patients With Oral Potentially Malignant Disorders
Authors: Villa Alessandro , Lodolo Michele , Ha Patrick 
Published: November 2024

ImportanceUnderstanding the clinical course and malignant transformation rate of oral potentially malignant disorders (OPMDs)—including oral leukoplakia, oral erythroplakia, oral submucous fibrosis, and oral lichen planus—is crucial for early detection and improved survival rates in patients with oral cancer.ObjectiveTo evaluate the progression of oral cancer from OPMDs using a large US electronic medical database.Design, Setting, and ParticipantsThis retrospective cohort study used data from the University of California, San Francisco’s PatientExploreR database between January 1973 and March 2024. Patients with oral leukoplakia, oral erythroplakia, oral submucous fibrosis, and oral lichen planus were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes and keywords. Demographics, tobacco and alcohol use, HIV status, and other known risk factors for oral cancer were recorded to identify factors associated with malignant transformation. Logistic regression and descriptive analyses were used.ExposureDiagnosis of oral leukoplakia, oral erythroplakia, oral submucous fibrosis, or oral lichen planus.Main Outcomes and MeasuresIncidence of oral cancer, malignant transformation rate, median time to progression, and associations between demographics and risk factors and the development of oral cancer.ResultsAmong 4 225 251 individuals in the database, 4371 were diagnosed with oral cancer (median [IQR] age, 63 [53-71] years; 2610 [59.9%] male; 0.1% of the cohort), and 110 (2.5%) had a preceding OPMD. Oral leukoplakia was found in 1124 patients, with 94 (8.4%) undergoing malignant transformation (median [IQR] time to progression, 25 [7-129] months). HIV-positive patients with oral leukoplakia were more likely to develop oral cancer (odds ratio, 3.80; 95% CI, 1.35-10.70). Of 22 patients with oral erythroplakia, 11 (50.0%) developed oral cancer (median [IQR] time to progression, 3.7 [0.2-334] months). Those who smoked tobacco with oral erythroplakia showed a higher malignant transformation rate (odds ratio, 3.75; 95% CI, 0.54-26.05). Of the 78 patients with oral submucous fibrosis, 4 (5.1%) underwent malignant transformation (median [IQR] time to progression, 36 [36-48] months). Only 1 patient with oral lichen planus developed oral cancer after 5 years.Conclusions and RelevanceThis cohort study showed that OPMDs have notable but varying propensities to progress to oral cancer. Early detection and monitoring of OPMDs are crucial for improving patient outcomes. However, the risk, etiopathogenesis, and clinical presentation vary for each OPMD and should, therefore, be considered distinct diseases.