bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomically correct models for visually impaired learners: Teachers’ perspectives
Authors: Ubisi Lindokuhle , Tsabedze Wandile 
Published: August 2024

Background: Despite anatomically correct models (ACMs) being recommended internationally for their ability to serve as real-life, age-appropriate, and practical models in comprehensive sexuality education (CSE) for learners with visual impairment, there is still limited research exploring South African teachers’ views regarding their use. Objectives: The aim of this study was to explore how South African teachers of learners with visual impairment view the use of ACMs during their CSE lessons. Method: This study used a qualitative approach and an exploratory, multiple case study research design. A total of 36 teachers from five schools for the blind were convenience sampled and data were generated via focus group discussions. The theory of planned behaviour underpinned this study, while data were analysed thematically. Results: Most teachers reacted with fear and resistance towards the use of ACMs in their teaching. Their responses were based on embarrassment, shame, and discomfort in handling the models. Part of the reason for this was that most teachers had not received prior teacher education about the use of the models. Some teachers falsely believed that ACMs were pleasure-enhancing devices. Others recommended their use only for blind learners, while yet others stated that they would use ACMs because of their practical value. Conclusion: Findings suggest that future research is needed on how best to engage the teachers of learners with visual impairment in self-awareness and desensitisation teacher training. Recommendations for a critical teaching framework, revisions to the CSE curriculum, as well as guidelines for teacher education are provided to facilitate teachers’ use of learners with visual impairment ACMs in their CSE lessons.
Exploring influencing factors and predictive analysis of sarcopenia in the Chinese population using the body composition analyzer
Authors: Li Shaotian , Zou Jingfeng , Wang Liping , Nie Guqiao , Peng Wen 
Published: August 2024

Objective: Employing body composition analysis, this study aims to examine the influencing factors and conduct predictive analysis regarding sarcopenia incidence in the middle-aged and elderly population in China. Methods: This study recruited inpatients from the General Medicine Department of Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, as the subjects for a single-center retrospective study. Diagnosis was conducted according to the 2019 criteria from the Asian Working Group for Sarcopenia. Binary logistic regression analysis was utilized to identify factors influencing sarcopenia, and predictive modeling for sarcopenia occurrence was performed based on the area under the ROC curve (AUC). Results: This study comprised 1258 hospitalized patients, of whom 340 were diagnosed with sarcopenia and 918 were not, resulting in a prevalence of 27%. The baseline characteristics showed statistically significant differences between the two groups. Binary logistic regression analysis revealed that low protein, low total body water, low minerals, low basal metabolic rate, and age were risk factors for sarcopenia (OR > 1, P < 0.05). Conversely, being male, having a higher BMI, greater fat-free mass index, and a higher InBody score were identified as protective factors against sarcopenia (OR < 1, P < 0.05). The AUC values for predicting sarcopenia occurrence based on low protein, low total body water, low minerals, low basal metabolic rate, and age were 0.871, 0.846, 0.757, 0.645, and 0.649, respectively, indicating their significance as predictive indicators. Combining these five indicators into a new predictive model for sarcopenia yielded an area under the curve (AUC) value of 0.932, demonstrating excellent sensitivity and specificity concurrently. Conclusion: The results of body composition analysis indicate that sarcopenia occurrence in the middle-aged and elderly population in China is associated with factors such as low protein, low total body water, low minerals, low basal metabolic rate, age, gender, BMI, fat-free mass index, and InBody score. The combination of specific body composition indicators facilitates the effective prediction of sarcopenia. Clinical practitioners should proactively identify the risk factors influencing sarcopenia, accurately predict.
Effect of a seven-strain probiotic on dietary intake, inflammatory markers, and T-cells in severe traumatic brain injury patients: A randomized, double-blind, placebo-controlled trial
Authors: Abbaszadeh Seyed Hamze , Yousefi Mehdi , Arefhosseini Seyed Rafie , Mahmoodpoor Ata , Mameghani Mehrangiz Ebrahimi 
Published: August 2024

Background Inflammatory processes are key factors in pathological events associated with severe traumatic brain injury (STBI). The aim of this trial was to determine the effect of probiotics on anthropometric measures, disease severity, inflammatory markers, and T cells in patients with STBI. Methods Forty adult patients with STBI were enrolled in this parallel randomized, double-blind, placebo-controlled trial. Energy and protein status, Acute Physiology and Chronic Health Evaluation (APACHE II) score, Sequential Organ Failure Assessment (SOFA), interleukin 10 (IL-10), interleukin 1β (IL-1β), tumor necrosis factor-alpha (TNF-α), transforming growth factor beta (TGF-β), T-helper 17 (Th17), and T- Regulator (T-reg) cells were assessed at baseline (day 1), and week 2 (day 14) for each patient. Results Probiotic supplementation led to a substantial reduction in the serum levels of TNF-α (from 10.15 ± 6.52 to 5.05 ± 3.27) ( P = 0.034), IL-1β (from 11.84 ± 7.74 to 5.87 ± 3.77) ( P < 0.001), and Th17 cells (from 5.19 ± 1.69 to 2.67 ± 1.89) ( P < 0.001) and a substantial increase in the serum levels of IL-10 (from 3.35 ± 1.45 to 6.17 ± 2.04) ( P = 0.038), TGF-β (from 30.5 ± 15.27 to 46.25 ± 21.05) ( P < 0.001), and T-reg cells (from 2.83 ± 1.43 to 4.29 ± 1.89) ( P < 0.001) compared with the placebo group. Furthermore, no notable changes were observed in energy and protein intake and also, terms of SOFA and APACHE II scores following probiotic treatment compared with the placebo. Conclusions Probiotics could reduce inflammation and improve cellular immunity and may be considered as an adjunctive therapy in STBI patients.
Using learning-by-concordance to develop reasoning in epistaxis management with online feedback: A pilot study
Authors: Verillaud Benjamin , Veleur Marine , Kania Romain , Zagury-Orly Ivry , Fernandez Nicolas , Charlin Bernard 
Published: August 2024

Background Epistaxis is a recurring cause for referral to emergency departments. Its management can be complex; hence, it is critical to provide appropriate support to Otolaryngology-Head and Neck Surgery (OHNS) residents to develop clinical reasoning skills to manage such cases. Learning-by-Concordance (LbC) is a recently developed educational tool that encourages learners to think through simulated clinical scenarios. A panel of ENTs provides insightful feedback to residents, reflecting a diversity of opinions about practice. Our study aimed to assess LbC's feasibility and perceived value for training OHNS residents in epistaxis management. Methods In this qualitative study, three OHNS surgeons, including two faculty members and one resident, wrote the LbC scenarios. The LbC tool was made available to participants through an online platform. A panel of four OHNS faculty provided feedback on answers to LbC questions. Otolaryngology-Head and Neck Surgery residents participated and provided their opinion on the value of this educational tool through an online questionnaire. Results A total of 10 one-hour sessions were required to create and upload the training tool. To provide insightful feedback embedded in the learning tool, the four panelists needed 60 min each. Of the 37 participating residents, 25 (68%) completed the training. Overall satisfaction was high: 88% appreciated the training method, and 92% wanted to use this type of training again. Most residents felt the training enabled them to improve their clinical reasoning when encountering a patient with epistaxis (92%) and their knowledge about epistaxis (96%). Conclusion Findings suggest that OHNS residents could benefit from clinical reasoning exercises with panelist feedback using the LbC approach for clinical presentations that require complex approaches to manage conditions such as epistaxis.
Navigating the New Frontier: Recommendations to Address the Crisis and Potential of AI in the Classroom
Authors: Slade Joseph J. , Byers Stephanie M. , Becker-Blease Kathryn A. , Gurung Regan A. R. 
Published: August 2024

Introduction The integration of artificial intelligence (AI) into higher education ushers in a new era of teaching and learning possibilities for both educators and students. Statement of the Problem These technologies not only offer unparalleled opportunities for personalized learning and instructional support, but also introduce challenges related to academic integrity. Literature Review The literature highlights AI's versatile applications in education, from facilitating research to acting as a tutor. Teaching Implications Educators can create AI-informed assignments that encourage active learning, critical thinking, and creativity. AI tools can be integrated as supports rather than substitutes for learning and foster an ethical framework within which students can explore AI's capabilities. Conclusion This review of AI's impact on education and the discussion of teaching strategies underscore the need for a nuanced approach to integrating AI in the classroom. By acknowledging both the challenges and opportunities presented by AI, educators can enhance teaching and learning while upholding academic standards.
A systematic review and meta-analysis of randomized controlled trials to reduce burden, stress, and strain in informal stroke caregivers
Authors: Jammal Melissa , Kolt Gregory S , Liu Karen P Y , Guagliano Justin M , Dennaoui Nariman , George Emma S 
Published: August 2024

Objectives To understand the nature and effectiveness of interventions aimed at improving informal stroke caregiver burden, stress, and strain. Data sources In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of CENTRAL, CINAHL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted in May 2022. Review methods Studies were eligible if they included an intervention designed for informal stroke caregivers, reported on caregiver burden, strain, or stress, were published in English, and used a randomized controlled trial design. An updated search was conducted in June 2024. The methodological quality of studies was appraised using the Cochrane risk-of-bias tool for randomized trials. The data were pooled, and a meta-analysis was completed for caregiver burden and strain outcomes. Results Nineteen studies met inclusion criteria and were meta-analyzed. Interventions ranged from 4 days to 12 months. Most studies incorporated educational and/or support components. Meta-analyses revealed nonsignificant effects on caregiver burden or strain. Significant between-group differences for caregiver strain and burden were, however, found in seven studies. Conclusion Limited studies, small sample sizes, and conflicting results made definitive conclusions on the most effective intervention characteristics for improving caregiver outcomes difficult. Of the 19 studies, seven found significant between-group differences for caregiver outcomes postintervention, and these tended to incorporate educational components and comprised between seven and nine sessions. Further high-quality research is required to identify optimal format, duration, and frequency for improving caregiver outcomes.
Differences in palliative care needs between cancer patients and non-cancer patients at the start of specialized palliative care: A nationwide register-based study
Authors: Hansen Maiken Bang , Rojas-Concha Leslye , Petersen Morten Aagaard , Adsersen Mathilde , Groenvold Mogens 
Published: August 2024

Background: Patients with non-cancer disease are less likely to receive specialized palliative care than cancer patients. To be able to provide the best specialized palliative care, it is important to understand palliative care needs of non-cancer patients and whether the type and level of needs differ from those of cancer patients. Large studies including both cancer and non-cancer patients, using validated needs-assessment-tools, are needed to understand differences in palliative care needs at admittance to specialized palliative care. Aims: To compare palliative care needs at the start of palliative care for cancer and non-cancer disease. Design: Six-year nationwide register-based study. Setting/participants: This study included patients from all Danish specialized palliative care services (hospice care, hospital-based palliative care, home-based palliative care, or consultation) who completed a need-assessment-questionnaire. Ordinal logistic regression was performed to study the association between diagnosis and needs. Results: Cancer patients had a higher probability of receiving specialized palliative care. Of the 44,315 palliative care admissions included in this study, 93.3% were on cancer patients. Independent of diagnosis patients experienced on average six needs and high levels of fatigue and impaired physical functioning. Non-cancer patients had significantly higher odds of insomnia, fatigue and impaired emotional functioning, physical functioning, and quality of life whereas cancer patients had higher odds of pain (except for patients with neurological disease). Conclusions: The higher levels of several symptoms/problems among non-cancer patients compared to cancer patients suggests that referral to specialized palliative care should be improved for non-cancer patients perhaps by improving identification of palliative needs.
Investigating the Prevalence and Predictors of Apathy among the Canadian Long-Term Care Residents: A Secondary Data Analysis
Authors: Agboji Aderonke , Freeman Shannon , Banner Davina , Armstrong Joshua , Martin-Khan Melinda 
Published: August 2024

Background In long-term care facilities (LTCF), apathy is a prevalent issue, leading to cognitive decline, functional impairment, and increased mortality risk. Despite its significance, apathy often remains underrecognized and undermanaged in these settings. Recognizing and addressing the predictors of apathy is critical for early intervention and improved care outcomes. Purpose This study aims to assess the prevalence of apathy and identify its associated risk factors among newly admitted residents in the Canadian LTCF, using the InterRAI Minimum Data Set (MDS 2.0). Methods We conducted a cross-sectional analysis of MDS 2.0 admission assessment data between 2015 and 2019, covering 157,596 residents across six Canadian provinces and one territory. Apathy was measured using the Apathy Index of the MDS 2.0, with the biopsychosocial model guiding the analysis. Results The prevalence of apathy was 12.5% (19,758 individuals). The most significant predictors include cognitive impairments, specific age groups, hearing impairments, vision impairments, facility size and location. Conclusions The findings of this study underscore the need for tailored strategies in LTCF to address apathy, considering individual, institutional, and regional variations. Emphasis on environmental and personal factors is crucial in the management and prevention of apathy in these settings.
Susceptibility of hepato-splanchnic perfusion to intra-abdominal pressure in peritoneal dialysis patients
Authors: Ribitsch Werner , Lehner Thomas A , Sauseng Notburga , Rosenkranz Alexander R , Schneditz Daniel 
Published: August 2024

BackgroundThe impact of peritoneal filling on hepato-splanchnic perfusion during peritoneal dialysis has not been fully elucidated yet.MethodsMeasurements were done in 20 prevalent peritoneal dialysis patients during a peritoneal equilibration test (PET) with 2L of standard dialysate. Data were obtained in the drained state at baseline ( T0), after instillation ( T1), and after 2 h of dwell time ( T2). Intra-abdominal pressure (IAP) was measured by Durand's approach. The hepatic clearance index (KI) of indocyanine-green (ICG) was determined as an indirect measure of hepato-splanchnic blood flow. Cardiac index (CI), heart rate (HR), and total peripheral resistance index (TPRI) were derived from continuous arterial pulse analysis. Fluid volume overload (VO) was evaluated by multifrequency bioimpedance analysis. Ejection fraction (EF) was obtained from echocardiographic examination.ResultsIAP was 5.8 ± 3.5 mmHg at baseline ( T0), rose to 9.4 ± 2.8 mmHg after instillation of dialysate ( T1), and further to 9.7 ± 2.8 mmHg after 2 h of dwell time ( p < 0.001). KI slightly declined from 0.60 ± 0.22 L/min/m2at T0to 0.53 ± 0.15 L/min/m2at T1( p = 0.075), and returned to 0.59 ± 0.22 L/min/m2at T2( p = 0.052). CI, HR, and TPRI did not change significantly. In five patients with an EF < 40% KI was significantly lower at T1(0.42 ± 0.12 L/min/m2; p = 0.039), and further decreased at T2(0.40 ± 0.04 L/min/m2; p = 0.016) compared to patients with normal EF ( T1: 0.58 ± 0.15 L/min/m2and T2: 0.67 ± 0.22 L/min/m2).ConclusionsOverall, hepatic clearance of ICG as a marker of hepato-splanchnic blood flow is not affected by the filling of the peritoneal cavity.
Facial Expressions of Emotion in Children with Cleft Lip and Palate
Authors: Fujiki Robert Brinton , Zhao Fangyun , Niedenthal Paula M. , Thibeault Susan L. 
Published: August 2024

ObjectiveTo examine the facial movements children with cleft lip and palate (CLP) employ to express basic emotions. Ability of observers to interpret facial expressions of children with CLP was also considered.DesignProspective case-control design.SettingOutpatient craniofacial anomalies clinic.PatientsTwenty-five children with CLP (age 8 to 12) and 25 age/sex-matched controls.Outcome MeasuresChildren were video recorded making facial expressions representing anger, disgust, fear, happiness, sadness, and surprise. Magnitude of children's facial movements was quantified and compared using OpenFace. Subsequently, emotion videos were presented to 19 adults who were asked to identify the emotion conveyed in each facial expression. Accuracy of emotion recognition was compared across groups.ResultsCompared with controls, children with CLP employed significantly ( P < .05) smaller magnitude superior and lateral perioral movements to express disgust (Cohen's d = .50), happiness (Cohen's d = 1.1), and fear (Cohen's d = .93). For disgust and sadness, children with CLP employed significantly greater magnitude movements of the nose and chin, presumably to compensate for reduced perioral range of motion. For anger, happiness, and sadness, children with CLP employed smaller magnitude movements of the upper face when compared with controls. Observers identified disgust (OR = 1.26), and fear (OR = 2.44) significantly less accurately in children with CLP when compared with controls.ConclusionsChildren with CLP employed different facial movements to express certain emotions. Observers less accurately identified some emotions conveyed by facial expressions in children with CLP when compared with controls, likely due in part to differences in facial movements. Future research should explore the implications of these differences for social communication.
Cleft Lip Repair Comparison Between Inpatient and Outpatient Surgeries: A Multi-Surgeon Experience
Authors: Howell Haven M. , Galarza Laura I. , Humphries Laura S. , Hoppe Ian C. 
Published: August 2024

Objective Great variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. This study's aim is to investigate the authors’ institutional experience to see if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performed as outpatient. Design This study reviewed patients who underwent CL repair between 2012 and 2023 at the authors’ institution. Data collected included patient demographics, perioperative details, ED visits and readmissions within thirty days of surgery, and complications. Results One hundred forty-five patients met inclusion measures. When the surgery was performed as outpatient, there was no significant difference in returning to the ED (p = 0.767) or readmission to the hospital (p = 0.447) within thirty days as compared to inpatient surgeries. Outpatients did not have more postoperative complications (p = 0.698). Bilateral cleft lips were more likely to be performed as inpatient (p = 0.001). Inpatients had a lower weight at time of repair (p = 0.033). Patients with a respiratory (p = .006), gastrointestinal (p = 0.003), or hematologic (p = 0.013) comorbidity had a higher readmission rate. Patients were more likely to be readmitted if they had a younger gestational age (p = 0.005). Conclusion There was no increased return to the ED or readmission for patients undergoing inpatient versus outpatient CL repair. CL repair can be performed safely in an outpatient setting with careful patient selection.
The Source of Nasal Rustle (Nasal Turbulence): An Overview of Current Evidence
Authors: Rollins Michael , Kummer Ann 
Published: August 2024

Objective Nasal rustle (also called nasal turbulence) refers to a loud distracting sound that sometimes occurs with audible nasal emission (ANE) during the production of pressure-sensitive consonants in patients with velopharyngeal insufficiency (VPI). This article examines evidence for two hypotheses of causality: vibration of the soft palate ( velar flutter) and periodic motion of mucus above the velopharyngeal port ( turbulent mucus). Conclusion A review of the relevant literature shows inconclusive evidence to support velar flutter as a cause of nasal rustle. In contrast, clinical observations and research involving high-speed nasopharyngoscopy suggest that nasal rustle is the result of turbulent mucus above a small velopharyngeal opening. Therefore, it is our contention that a plausible explanation for nasal rustle is one of turbulent mucus and not velar flutter.