bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three-dimensional Analysis of Maxillary Morphology in Infants with Unilateral Cleft Lip and Palate
Authors: Zheng Jie , Kuang Wenying , Yuan Shiyu , He Hong , Yuan Wenjun 
Published: February 2024

Objective To three-dimensionally (3D) analyze the maxillary morphology of infants with unilateral cleft lip and palate (UCLP) and preliminarily classify the alveolar arch to assist in personalization of sequence therapy. Design Retrospective study. Setting Patients with UCLP referred to outpatients’ clinic. Participants 84 nonsyndromic infants with complete UCLP were recruited (58 boys, 26 girls, mean age 29.48 days). Main Outcome Measure Morphometric analysis was conducted on 3D maxillary models. Principal component analysis (PCA) and cluster analysis were combined to classify maxillary phenotypes preliminarily. The Wilcoxon Signed Rank test and the Kruskal-Wallis test were used to compare differences between variables. A P value less than .05 was considered statistically significant. Results The maxilla was divided into three types: narrow, homogenous and broad, accounting for 9.52%, 23.81% and 66.67% respectively. The alveolar cleft site (median value) was located in 61% of the total length of the alveolar arch. In the comparison of anterior and total alveolar lengths, the non-cleft side had longer alveolar bone than the affected side, a difference of approximately 2 mm. Pairwise comparisons of variables describing alveolar symmetry revealed significant differences in all subjects; whereas type C had poorer arch symmetry than types A and B, mainly in terms of anterior and overall symmetry. Conclusions In infants with UCLP, the maxillary alveolar arch was inherently asymmetrical with partially bone missing (about 2 mm). Significant differences in alveolar bone morphology and symmetry exist between different types of infants, with individuals with broad clefts (type C, the largest proportion) having the worst maxillary development.
Pollution characteristics and health risk assessment of fine particulate matter and its metal elements during Chinese New Year
Authors: Liu Xinru , Bai Li , Cui Yongbo , Xu Xiuling 
Published: February 2024

The Chinese Lunar New Year is a significant festival in China that leads to indoor and outdoor air pollution with distinct characteristics compared to normal times. In this study, indoor and outdoor air samples were collected and analysed to investigate the indoor and outdoor pollution of PM2.5 and its metal elements during the Chinese New Year. The findings reveal that there is a notable positive correlation between indoor and outdoor PM2.5 concentrations during the Chinese New Year, with outdoor concentrations being higher on average. The levels of PM2.5 concentrations indoors and outdoors started to increase on Chinese New Year’s Eve and peaked after the early hours of the Chinese New Year. The total concentrations of six metal elements (Cd, Cr, Ni, Cu, Pb and Zn) in indoor and outdoor PM2.5 during the Chinese New Year in 2022 were 738.73 ± 134.93 mg/kg and 1124.38 ± 553.14 mg/kg, respectively. Principal component analysis suggests that the main sources of indoor metal elements were from outdoor combustion sources and human activities, while outdoor sources were fireworks displays and emissions from coal combustion. Based on the U.S. EPA risk assessment carried out, both indoor and outdoor PM2.5 metal elements could pose a carcinogenic risk to adults.
Preparedness for infection prevention and control practice among undergraduate health sciences students: A systematic review protocol
Authors: Mukona Doreen M , George Rebecca , James Joemol , Joseph Smitha , Mukasa Jean , Timberlake Charity , Monaco Beatrice , Abdulla Salimbabu , Khalaf Atika , Burnett Emma 
Published: February 2024

Introduction The World Health Organization (WHO) advocates for the strengthening of education and training in infection prevention and control (IPC) in higher educational institutions (HEIs). This is fundamental to ensure health science students are confident and competent in clinical practice. Aim Explore the preparedness of undergraduate health science students for IPC practice. Search strategy The PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, ProQuest, Scopus, Web of Science, ClinicalKey, and Google Scholar databases and grey literature will be searched for relevant articles. Inclusion criteria Quantitative, and mixed methods studies on teaching and learning, technological methods, strengths and limitations, and challenges of IPC practice in HEI undergraduate curricula. Participant characteristics Undergraduate health science students including medical, nursing, pharmacy, dental, physiotherapy, radiology, medical imaging, and paramedicine. Setting and time frame Studies published anywhere in the world, in English, and from 2010 to 2023. Search terms Preparedness, health science students, infection prevention and control, technology, higher education institutions. Data extraction The data extracted will be recorded on a data extraction form. Assessment of risk of bias This will be conducted according to the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Ethics and dissemination No ethical approval was required for this protocol. Interim findings will be presented at relevant local and international conferences and a manuscript will be published in a peer reviewed journal. Discussion This systematic review will provide a baseline for recommendations for developing innovative ways to improve IPC teaching and learning in HEI.
Multivariate prognostic index and triplet regimen efficacy predictive index in locally advanced and metastatic gastric cancer: pooled analysis from three clinical trials using individual patient data
Authors: Feng Wan-Jing , Zhao Xiao-Ying , He Yi-Fu , Huang Ming-Zhu , Chen Zhi-Yu , Wang Yu-Sheng , Zhu Xiao-Dong , Guo Wei-Jian 
Published: February 2024

Background: To construct an effective prognostic index to predict overall survival (OS) and triplet regimen efficacy for advanced gastric cancer (AGC) patients treated with platinum-based and fluorouracil-based chemotherapy. Objectives: Between 2011 and 2021, 679 patients from two randomized phase III trials and one phase II trial were enrolled. Designs: We collected 11 baseline clinicopathological and 14 hematological parameters to establish a prognostic index. Methods: Univariate and multivariate Cox analyses were used to screen prognostic factors, and a prognostic index nomogram was conducted. Results: Seven prognostic factors were identified: primary tumor site in the non-proximal gastric area, signet-ring cell carcinoma (SRCC)/mucinous carcinoma, peritoneal metastasis, neutrophil count higher than the upper limit of normal value (ULN), lymphocyte count lower than the lower limit of normal value, lactate dehydrogenase level higher than the ULN, and alkaline phosphatase level higher than the ULN as significant for prognosis. A prognostic nomogram named the Fudan advanced gastric cancer prognostic risk score (FARS) index was constructed, and patients in the high-risk group had significantly shorter OS than those in the low-risk group (median OS, 15.5 versus 8.0 months, p < 0.001). The areas under the curve of the FARS index for 1-, 2-, and 3-year OS were 0.70, 0.72, and 0.77, respectively. A validation and external cohort verified the prognostic value of the FARS index. Moreover, three triplet regimen efficacy parameters were identified: SRCC/mucinous adenocarcinoma, primary tumor location in the non-proximal gastric area, and peripheral neutrophil count higher than the ULN; a TRIS index was subsequently conducted. In patients with any two of the three parameters, the triplet regimen showed significantly longer OS than the doublet regimen ( p = 0.018). Conclusion: The constructed FARS index to predict the OS of AGC patients and the TRIS index to screen out the dominant population for triplet regimens can be used to aid clinical decision-making and individual risk stratification.
Classification of chronic ankle instability using machine learning technique based on ankle kinematics during heel rise in delivery workers
Authors: Hwang Ui-jae , Kwon Oh-yun , Kim Jun-hee , Gwak Gyeong-tae 
Published: February 2024

Objective Ankle injuries in delivery workers (DWs) are often caused by trips, and high recurrence rates of ankle sprains are related to chronic ankle instability (CAI). Heel rise requires joint angles and moments similar to those of the terminal stance phase of walking that the foot supinates. Thus, our study aimed to develop, determine, and compare the predictive performance of statistical machine learning models to classify DWs with and without CAI using ankle kinematics during heel rise. Methods In total, 203 DWs were screened for eligibility. Seven predictors were included in our study (age, work duration, body mass index, calcaneal stance position angle [CSPA] in the initial and terminal positions during heel rise, calcaneal movement during heel rise [CMHR], and plantar flexion angle during heel rise). Six machine learning algorithms, including logistic regression, decision tree, AdaBoost, Extreme Gradient boosting machines, random forest, and support vector machine, were trained. Results The random forest model (area under the curve [AUC], 0.967 [excellent]; F1, 0.889; accuracy, 0.925) confirmed the best predictive performance in the test datasets among the six machine learning models. For Shapley Additive Explanations, old age, low CMHR, high CSPA in the initial position, high PFA, long work duration, low CSPA in the terminal position, and high body mass index were the most important predictors of CAI in the random forest model. Conclusion Ankle kinematics during heel rise can be considered in the classification of DWs with and without CAI.
Perceptions of the COVID-19 Vaccination Within a Convenience Sample of Sudanese Americans
Authors: Freese Jonathan , Abuzaid Fatima , Sayles Harlan , Abdellatif Mujtaba , Fadul Nada 
Published: February 2024

Introduction: Sudanese American and other immigrant and refugee communities are at greater risk for exposure to COVID-19. This survey sought to better characterize COVID-19 vaccination practices, motivators, and drivers for hesitancy among Sudanese Americans. Methods: We developed an online, cross-sectional survey in English and Arabic distributed by Sudanese American community leaders in April 2022 with data stored anonymously in REDCap. Inclusion criteria were self-reporting being born within Sudan and living in the US within the last 2 years. Descriptive analysis tested survey responses for possible associations between the primary outcome, self-reported vaccination status, and questions regarding vaccination history, perspectives on vaccination, and demographic characteristics using Fishers Exact and Chi Squared Tests. Results: Of 111 survey responses received, 107 met inclusion criteria. 93% of respondents reported COVID-19 vaccine uptake with the primary motivation to protect oneself from disease. The most cited reason for vaccine hesitancy was belief it had not been studied enough. The group that reported vaccination had higher levels of education (.032) and were more likely to perceive that COVID-19 vaccinations were able to reduce spread (.001), decrease severe outcomes (.004), and benefits outweighing their risks (.004). Discussion and Conclusions: This survey population of Sudanese Americans demonstrated high levels of vaccine uptake (93%), far greater than either the corresponding US (78%) or Sudanese population (15%). It is likely that high levels of educational attainment moderated vaccine uptake, though our survey may not have had the power to fully evaluate vaccine hesitancy.
Range of motion at 6 weeks is an independent risk factor for non-healing at 6 months after arthroscopic supraspinatus repair.
Authors: Nabergoj Marko , Laedermann Alexandre , Bothorel Hugo , Pernoud Anthony , Collin Philippe , Martinho Tiago 
Published: February 2024

PURPOSE: This study aimed to analyze the effect of the range of motion (ROM) progression pattern on healing after supraspinatus (SSN) repair. HYPOTHESIS: We hypothesized that a faster ROM recovery in the immediate postoperative period would be detrimental for tendon healing. Methods: This was a retrospective study of prospective collected data. All primary arthroscopic SSN repairs for full-thickness tears, with retraction Patte grade < 2, fatty infiltration Goutallier grade < 3 and no glenohumeral osteoarthritis were eligible. Patients who did not attend all follow-ups were excluded. One surgeon performed all arthroscopic repairs using a double-row technique. All patients followed the same rehabilitation protocol with an abduction pillow and passive ROM for 6 weeks. One observer assessed all patients preoperatively and at 1.5, 3 and 6 months postoperatively. Collected outcome measures included: ROM, Visual Analogue Scale (VAS) for pain and Constant Score (CS). Repair integrity was evaluated at 6 months by ultrasound. 2 groups were established based on repair integrity (healed/non-healed). A multivariable analysis was performed to assess potential confounding factors and ROC curve analysis was used to identify predictive thresholds for non-healing. Results: Of 1397 consecutive SSN repairs, 169 were excluded and 1207 were finally included. The overall healing rate was 87.3%. All preoperative outcome measures were similar between groups. Non-healed repairs at 6 months were slightly younger (57.8±7.9 vs 61.6±8.8, p < 0.001) and had a faster postoperative ROM recovery pattern. This difference was most distinct at 6 weeks in passive anterior elevation (AE) (143±22 vs 128±26, p < 0.001) and external rotation (ER) (32±17 vs 23±17,p < 0.001) but was fully compensated by 6 months. VAS pain and CS at each follow-up were similar between groups. Multivariable analysis confirmed 6-weeks passive EA (OR:1.36) and ER (OR:1.16) as independent risk factors for non-healing. The non-healing rate increased when 6-weeks passive EA >140° (20.4 vs 7.9%) and ER > 30° (18.4 vs 8.8%). Conclusions: In a large cohort of isolated arthroscopic SSN repairs treated with the same surgical technique and rehabilitation protocol, a faster postoperative ROM progression pattern, reflected by higher 6-weeks AE and ER, was associated with an increased rate of non-healing. This study illustrates the benefit of a conservative rehabilitation protocol on tendon healing without affecting ROM at 6 months.
Development of a multilayer film for the first US Food and Drug Administration cleared aseptically-produced intravenous solution bags with a short history of key medical device milestones
Authors: Czuba Len 
Published: February 2024

Flexible intravenous solution containers (IV bags) were introduced to the marketplace in the early 1970s. These new containers were designed to replace glass IV bottles and were quickly adopted widely for delivering medical solutions to patients throughout the world. The 40 years during which commercially available IV solutions in glass bottles were used, the healthcare industry grew dramatically with better patient outcomes while also reducing operational costs. These early developments then led to the rapid expansion of new medical devices that have been further developed to improve healthcare and reduce overall costs of the products and devices. It is not an exaggeration to suggest that the medical device industry was founded on the development of the flexible poly (vinyl chloride) (PVC) plastic IV tubing and bag. After the IV bag product lines grew to serve many markets, a new unmet need was discovered for an aseptically produced premixed drug container. This article will review how a new film was developed and used to produce the required aseptically made IV premixed drug product. It was, after the Food and Drug Administration (FDA) gave “clearance to market”, a ground-breaking product, never before thought possible for the highly FDA-regulated and controlled industry.
kalis: a modern implementation of the Li & Stephens model for local ancestry inference in R
Authors: Aslett Louis J. M. , Christ Ryan R. 
Published: February 2024

Abstract
Background
Approximating the recent phylogeny of N phased haplotypes at a set of variants along the genome is a core problem in modern population genomics and central to performing genome-wide screens for association, selection, introgression, and other signals. The Li & Stephens (LS) model provides a simple yet powerful hidden Markov model for inferring the recent ancestry at a given variant, represented as an $$N \times N$$

N
×
N

distance matrix based on posterior decodings.

Results
We provide a high-performance engine to make these posterior decodings readily accessible with minimal pre-processing via an easy to use package kalis, in the statistical programming language . kalis enables investigators to rapidly resolve the ancestry at loci of interest and developers to build a range of variant-specific ancestral inference pipelines on top. kalis exploits both multi-core parallelism and modern CPU vector instruction sets to enable scaling to hundreds of thousands of genomes.

Conclusions
The resulting distance matrices accessible via kalis enable local ancestry, selection, and association studies in modern large scale genomic datasets.
Trends in low-value GP care during the COVID-19 pandemic: a retrospective cohort study
Authors: Müskens Joris L. J. M. , Olde Hartman Tim C. , Schers Henk J. , Akkermans Reinier P. , Westert Gert P. , Kool Rudolf B. , van Dulmen Simone A. 
Published: February 2024

Abstract
Background
Several studies showed that during the pandemic patients have refrained from visiting their general practitioner (GP). This resulted in medical care being delayed, postponed or completely forgone. The provision of low-value care, i.e. care which offers no net benefit for the patient, also could have been affected. We therefore assessed the impact of the COVID-19 restrictions on three types of low-value GP care: 1) imaging for back or knee problems, 2) antibiotics for otitis media acuta (OMA), and 3) repeated opioid prescriptions, without a prior GP visit.

Methods
We performed a retrospective cohort study using registration data from GPs part of an academic GP network over the period 2017–2022. The COVID-19 period was defined as the period between April 2020 to December 2021. The periods before (January 2017 to April 2020) and after the COVID-19 period (January 2022 to December 2022) are the pre- and post-restrictions periods. The three clinical practices examined were selected by two practicing GPs from a top 30 of recommendations originating from the Dutch GP guidelines, based on their perceived prevalence and relevance in practice (van Dulmen et al., BMC Primary Care 23:141, 2022). Multilevel Poisson regression models were built to examine changes in the incidence rates (IR) of both registered episodes and episodes receiving low-value treatment.

Results
During the COVID-19 restrictions period, the IRs of episodes of all three types of GP care decreased significantly. The IR of episodes of back or knee pain decreased by 12%, OMA episodes by 54% and opioid prescription rate by 13%. Only the IR of OMA episodes remained significantly lower (22%) during the post-restrictions period. The provision of low-value care also changed. The IR of imaging for back or knee pain and low-value prescription of antibiotics for OMA both decreased significantly during the COVID-restrictions period (by 21% and 78%), but only the low-value prescription rate of antibiotics for OMA remained significantly lower (by 63%) during the post-restrictions period. The IR of inappropriately repeated opioid prescriptions remained unchanged over all three periods.

Conclusions
This study shows that both the rate of episodes as well as the rate at which low-value care was provided have generally been affected by the COVID-19 restrictions. Furthermore, it shows that the magnitude of the impact of the restrictions varies depending on the type of low-value care.
This indicates that deimplementation of low-value care requires tailored (multiple) interventions and may not be achieved through a single disruption or intervention alone.
Micropulse transscleral cyclophotocoagulation (MP-CPC): efficacy endpoints for the treatment of refractory paediatric glaucoma - a retrospective case-series
Authors: Balbaid Nasser , AlJodai Mohammed , Fairaq Ghadeer , AlEnzi Maram , AlShahwan Sami 
Published: February 2024

Abstract
Background
This study evaluates the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-CPC) in paediatric patients.

Methods
This retrospective case-series recruited 44 eyes for glaucoma patients who were younger than 17 years and were treated with MP-CPC and followed for at least one year. Pre- and post-intervention intraocular pressure (IOP) was compared out to at least one year postoperatively. Success rates at 6 months and 1 year postoperatively were assessed. P < 0.05 was considered statistically significant.

Results
There were 35 (79.5%) eyes with a history of glaucoma surgery. IOP decreased statistically significantly from a baseline of 32.7 (standard deviation:8.7 mmHg) to 23.2 (8.6) and 21.7 (7.9) mmHg at the 6 months and 1-year follow-up, respectively (P < 0.0001, all comparisons). Overall success was noted in 19 (47.5%) eyes at the 6 months follow-up, and 23 (53.5%) eyes at 1 year.

Conclusions
MP-CPC reduces IOP and the burden of medications in paediatric patients with glaucoma. Additionally, its safety profile favours the use of MP-CPC as an adjunctive modality for refractory glaucoma.