bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors and management outcomes in epistaxis: a tertiary centre experience
Authors: Hughes Jed M. , Teh Bing Mei , Hart Cameron J. , Gibbs Harry H. , Aung Ar Kar 
Published: December 2022

AbstractBackgroundRisk factors and outcomes associated with severe epistaxis are not well understood. This study explores the associations between epistaxis severity, comorbidities, use of antiplatelets or anticoagulants and management outcomes.MethodsThis is a retrospective cross‐sectional study of all epistaxis cases presenting to the emergency department at a tertiary academic hospital from January 2016 to December 2019. Epistaxis severity was defined as mild (no intervention), moderate (required cautery and/or packing) and severe (clinical instability with reversal products, surgical or radiological intervention). Univariable and multivariable regression analyses were undertaken, with risk factors and management outcomes analysed according to severity.ResultsA total of 543 patients with epistaxis (54.2% male, mean age 74.4 ± 15.7 years) were included in this study, with 14.7% (80) having severe epistaxis. Of these presentations 216 (39.8%) were on antiplatelets, while 207 (38.1%) were on anticoagulants. In univariate analyses, clopidogrel use, hereditary haemorrhagic telangiectasia (HHT), haematological malignancy, bleeding disorders and chronic liver disease (CLD) were associated with moderate to severe epistaxis (P < 0.05), while the use of rivaroxaban was inversely associated severity (P = 0.002). Only HHT, haematological malignancy and CLD remained significant in multivariate models. Cautery as first‐line management was infrequently utilized while anticoagulation was frequently withheld. A longer length of stay (1.1 days vs. 4.3 days; P < 0.001) and higher 2‐week readmission rates (2.2% vs. 12.5%; P < 0.001) were noted with severe epistaxis compared with mild presentations.ConclusionEpistaxis severity is associated with certain clinical conditions and poor outcomes. Despite recommended guidelines, variations in first‐line management were evident.
Induction to neonatal resuscitation: A UK‐wide survey on practice
Authors: Hodgson Joshua , Hurley Aoife , Fawke Joe 
Published: December 2022

AbstractAimTo assess the perceived quality, and variation in quality, of Neonatal Induction Programmes in preparing medical staff to attend deliveries and deliver neonatal resuscitation if required. To delineate the components of an induction programme and the systems processes that would optimise medical staff training in delivering neonatal resuscitation.MethodsWe conducted a nationwide (United Kingdom [UK]) survey of all junior doctors working within paediatric/neonatal posts as well as the persons responsible for organising their local Neonatal Induction Programme.ResultsWe received 237 respondents from diverse roles. Practitioners feel only somewhat effectively prepared to attend deliveries and deliver neonatal resuscitation. More concerningly, they report moderate‐to‐high levels of variation across different centres. Practical training is considered more important than theoretical; and basic topics more useful than advanced. The preferred approach to neonatal resuscitation training is a locally determined programme within a framework of national standards/recommendations.ConclusionPractitioners feel that the quality, and particularly variation in quality, of neonatal resuscitation training at induction across the United Kingdom is suboptimal. Staff indicated the utility of a framework of national standards, and indeed this survey has been instrumental in the publication of such standards by the Royal College of Paediatrics and Child Health.
Army ant males lose seasonality at a site on the equator
Authors: Tozetto Leonardo , Forrister Dale L. , Duval Megan , Hays Tobias , Garwood Nancy C. , Castro Ronald Vargas , Lattke John E. , Sendoya Sebastian , Longino John T. 
Published: December 2022

AbstractArmy ants are keystone predators in the tropics and subtropics. During reproduction, males fly between colonies to mate with unmated, wingless queens. The males of most species are attracted to lights, and thus their presence and the timing of reproduction can be monitored using light traps. Previous studies examined the seasonality of army ant male reproduction and its relationship to climate factors at individual sites, but less is known about variation among sites. We examined army ant male flight seasonality at three sites: (1) La Selva Biological Station in Costa Rica, a site with weak temperature seasonality and moderate rainfall and day length seasonality, (2) Yasuní National Park, Ecuador, a site with no temperature or day length seasonality and very weak rainfall seasonality, and (3) the state of Paraná in southern Brazil, a site with very strong temperature, rainfall, and day length seasonality. Army ants showed strong seasonality at the La Selva and Paraná sites, and very weak to no seasonality at the Yasuní site. At La Selva and Paraná, flight times varied among species, but were very predictable from year to year, which suggests day length or temperature as predictable cues rather than rainfall. Lack of seasonal cues near the equator may be a challenge for army ant species that need to synchronize colony reproduction, and thus may have conservation implications for minimum population sizes needed to ensure stable populations.Abstract in Spanish is available with online material.
BRCA1 haploinsufficiency impairs iron metabolism to promote chrysotile‐induced mesothelioma via ferroptosis resistance
Authors: Luo Yaguang , Akatsuka Shinya , Motooka Yashiro , Kong Yingyi , Zheng Hao , Mashimo Tomoji , Imaoka Tatsuhiko , Toyokuni Shinya 
Published: December 2022

AbstractMalignant mesothelioma (MM) is still a social burden associated with asbestos exposure. Local iron accumulation thereby represents the major pathogenesis, followed by oxidative DNA strand breaks and genomic alterations in the mesothelium. BRCA1 is a critical component of homologous recombination repair directed to DNA double‐stranded breaks, whereas BRCA1 germline mutation is an established risk for breast/ovarian cancer, its role in MM development remains to be elucidated. Murine Brca1 mutant models so far have not reproduced human phenotypes. However, a rat Brca1 mutant model (Mut; L63X/+ ) recently reproduced them at least partially. Here we describe the differential induction of MM in Brca1 mutant rats by intraperitoneal injection of chrysotile or crocidolite. Only Mut males injected with chrysotile revealed a promotional effect on mesothelial carcinogenesis in comparison with wild‐type and/or females, with all the MMs Brca1 haploinsufficient. Array‐based comparative genomic hybridization of MMs disclosed a greater extent of chromosomal deletions in Brca1 mutants, including Cdkn2a/2b accompanied by Tfr2 amplification, in comparison with wild‐type tumors. Mutant MMs indicated iron metabolism dysregulation, such as an increase in catalytic Fe(II) and Ki67‐index as well as a decrease in Fe(III) and ferritin expression. Simultaneously, mutant MMs revealed ferroptosis resistance by upregulation of Slc7A11 and Gpx4. At an early carcinogenic stage of 4 weeks, induced Brca1 expression in mesothelial cells was significantly suppressed in chrysotile/Mut in comparison with crocidolite/Mut, whereas significant preference to iron with a decrease in Fe(III) has been already established. In conclusion, chrysotile exposure can be a higher risk for MM in BRCA1 mutant males, considering the rat results.
Childhood neurodevelopmental disorders and maternal diabetes: A population‐based cohort study
Authors: Chen Kuan‐Ru , Yu Tsung , Lien Yueh‐Ju , Chou Yen‐Yin , Kuo Pao‐Lin 
Published: December 2022

AbstractAimTo assess the risk of a wide spectrum of neurodevelopmental disorders (NDDs) in offspring of mothers with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM).MethodThis retrospective cohort study included 877 233 singletons born between 2004 and 2008 in Taiwan. Children were followed up to 2015 for diagnoses of NDDs, including autism spectrum disorder (ASD), attention‐deficit/hyperactivity disorder (ADHD), developmental delay, intellectual disability, cerebral palsy, and epilepsy/infantile spasms using health insurance claims data. We performed Cox regression models to estimate the relative risks of NDDs associated with maternal diabetes. Covariates included parental age, year of birth, child sex, family income, urbanization level, hypertensive disorder, and preterm delivery status.ResultsIn utero there were 338 (0.04%) children exposed to T1DM, 8749 (1.00%) to T2DM, and 90 200 (10.28%) to GDM. The effect of T1DM on NDDs was the largest, followed by T2DM, then GDM. T1DM was associated with an increased risk of developmental delay, intellectual disability, and epilepsy/intellectual spasms in offspring. T2DM was associated with an increased risk of ASD, ADHD, developmental delay, intellectual disability, cerebral palsy, and epilepsy/intellectual spasms. GDM was associated with an increased risk of ASD, ADHD, and developmental delay.InterpretationMaternal diabetes during pregnancy, including T1DM, T2DM, and GDM, is associated with an increased risk of some NDDs in offspring.
Early type 2 diabetes treatment intensification with glucagon‐like peptide‐1 receptor agonists in primary care: An Australian perspective on guidelines and the global evidence
Authors: Rasalam Roy , Abdo Sarah , Deed Gary , O'Brien Richard , Overland Jane 
Published: December 2022

AbstractEarly and intensive management of type 2 diabetes has been shown to delay disease progression, reduce the risk of cardiorenal complications and prolong time to treatment failure. Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) are being increasingly recognized for their potential in early disease management, with recent guideline updates recommending second‐line use of this injectable drug class alongside oral glucose‐lowering drugs. GLP‐1RAs target at least six of the eight core defects implicated in the pathogenesis of type 2 diabetes and offer significant glycaemic and weight‐related improvements over other second‐line agents in head‐to‐head trials. In addition, placebo‐controlled clinical trials have shown cardiovascular protection with GLP‐1RA use. Even so, this therapeutic class is underused in primary care, largely owing to clinical inertia and patient‐related barriers to early intensification with GLP‐1RAs. Fortunately, clinicians can overcome barriers to treatment acceptance through patient education and training, and management of treatment expectations. In this review we comment on global and Australian guideline updates and evidence in support of early intensification with this therapeutic class, and provide clinicians with practical advice for GLP‐1RA use in primary care.
Simulated skill complexity and perceived cognitive load during preclinical dental training
Authors: Al‐Saud Loulwa M. 
Published: December 2022

AbstractIntroductionCognitive Load theory (CLT) focuses on the information processing aspect of learning and how the working memory handles the mental effort associated with new task. The aim of this study is to investigate the association between the perceived cognitive load and performance amongst dental students during preclinical simulation training at various levels of procedural task complexity. Additionally, some cognitive load‐modifying factors were examined.Materials and MethodsThis cross‐sectional study evaluated the perceived cognitive load amongst second‐year dental students (n = 34), using the validated National Aeronautics and Space Administration's Task Load Index (NASA TLX index) after training on four dental tasks at two levels of complexity, in addition to structured online anonymous questionnaire about demographics, feedback and performance. The NASA TLX raw scores and the weighted global score were calculated for each exercise. Descriptive statistics and Pearson's correlations between performance and the corresponding NASA TLX‐weighted score were calculated. Mean differences in the perceived cognitive load across the exercise levels were assessed using RM‐ANOVA with Bonferroni corrections at p < .05.ResultsReduced performance was significantly associated with higher cognitive load particularly in high complexity dental task (class II—mirror vision). Simulated exercise complexity significantly influenced the students' perceived mental demand, physical demand and temporal demand; all were significantly higher for class II‐ mirror vision task than for direct vision tasks. The majority of participants (82.1%) preferred detailed feedback from instructors, and more than half of the participants (60.7%) preferred continuous feedback throughout the training session.ConclusionComplex dental tasks are associated with higher cognitive load in novice dental students during preclinical training. The NASA TLX index is a useful instrument to explore the level of perceived cognitive load associated with performance of simulated complex dental skills. Cognitive load theory is relevant to simulation‐based dental education to improve the preclinical instructional efficiency and to enhance students learning.
Residual stress effects on fatigue crack growth in different regions of aluminum alloy 7050 friction stir weld
Authors: Jin Yuhua , Ma Yueming , Chen Yongsheng , Wang Xijing , Guo Tingbiao 
Published: December 2022

AbstractDifferent distribution of residual stress in each microregion of the joint had an intensely significant influence on the fatigue crack growth. The friction stir welding (FSW) finite element model was developed. The residual stress was imported to the fracture mechanical model by the submodel technique. The residual Krs (stress intensity factor from residual stress) approaches were used to predict the fatigue crack growth rate (FCGR) in different regions of aluminum alloy 7050 friction stir welded joints. The FRANC3D in conjunction with ABAQUS, the M‐integral method was used to calculate Krs, considering the effect of Krs on the effective stress ratio, the Paris–Walker formula was used to predict the FCGR in different regions of the FSW joints. The predicting results and experimental values aligned with the better, demonstrating that the established model could accurately predict the FCGR in different regions of the FSW joints.
‘It's like a never‐ending diabetes youth camp’: Co‐designing a digital social network for young people with type 1 diabetes
Authors: Ramfelt Kerstin , Andersson Gäre Boel , Andersson Ann‐Christine , Petersson Christina 
Published: December 2022

AbstractIntroductionLiving with a chronic condition such as type 1 diabetes (T1D) affects everyday life and support from others experiencing a similar situation can be helpful. A way to receive such support is to use an online network where people can connect and share experiences. Research has described the benefits of using such tools for connecting patients. The aim of this study was to describe the co‐design of a social network for young people with T1D and to describe their experiences when using this network.MethodsA co‐design approach was used, following three steps adapted from Sanders and Stappers (2008). In all, 36 adolescents with T1D participated. Data in the form of recordings and notes from telephone interviews, workshops and focus groups were collected and then analysed using content analysis. Numerical data from the digital platform were also used.FindingsFor the interpersonal values, supporting, learning and relating to emerge, the framework of the network must be appealing and user‐friendly. The limits of time and place are eliminated, and there is a possibility for many more to join in.ConclusionCo‐design ensures that what stakeholders think is important forms the basis for the design. The interpersonal values that are promoted are ones that only the exchange of lived knowledge and experience can generate. It is complementary to the support that healthcare professionals can offer; thus, this kind of social network is important for improved, coproduced care.Patient or Public ContributionThe participants in the present study were persons living with T1D. They were active co‐creators from the start to the end. An adult person with experience of living with T1D was involved as an advisor in the research team when drafting the manuscript.
Assessing the quality of YouTube™ videos on fixed dental implant home‐care and maintenance protocols
Authors: Özişçi Özlem 
Published: December 2022

AbstractObjectivesThe implant's supporting structure differs from that of the teeth when plaque accumulates, making it more prone to inflammation and bone loss. To ensure the implant's longevity, an effective maintenance protocol should be followed. This study aimed to evaluate the information on oral hygiene procedures at home for implant‐supported fixed prosthesis.MethodsThe keywords ‘cleaning dental implant,’ ‘how to clean dental implant,’ and ‘dental implant hygiene’ used to search for videos on YouTube™. Following the exclusions, two researchers independently analysed the remaining 100 videos for demographic data and content usefulness.ResultsIn terms of usefulness score distribution, 53.52% of the videos were considered slightly useful, 38.4% moderately useful and 8.1% very useful. The video content had the least quantity of knowledge about toothpaste choice (11.1%), but the greatest quantity of knowledge on flossing (68.7%).ConclusionsAccording to the study's findings, there is presently no evidence‐based information on YouTube™ on dental implant oral hygiene protocols for home care procedures hygiene education. Therefore, dental care professionals should analyse the information's quality and reliability before recommending it to patients.
Smartphone‐based infrared thermography to assess progress in thoracic surgical incision healing: A preliminary study
Authors: Li Fanfan , Wang Min , Wang Ting , Wang Xiaolan , Ma Xiaoli , He Hua , Ma Guojing , Zhao Dan , Yue Qin , Wang Panpan , Ma Minjie 
Published: December 2022

AbstractImmediate assessment of surgical incisions is an important component of wound management, and the development of relevant technologies has the potential to address these challenges. Smartphone‐based handheld thermal imagers can collect infrared radiation from the skin to monitor local blood perfusion and metabolic levels in incisions. Here, we used this imaging technology for early assessment of healing progress and potential for predicting the healing status of thoracic surgical incisions. Thermal image acquisition and temperature extraction were performed on 40 patients for 7 consecutive days postoperatively, and visualised early warning information was observed, with temperature and temperature readings showing non‐linear trajectory changes during the measurement period, and temperature readings on day 4 achieving high prediction of healing status at 1–2 months capability with sensitivities and specificities of 91.67% and 85.71%, respectively, suggesting a promising clinical application of portable thermography for assessing incision healing dynamics and providing a scientific basis for later artificial intelligence‐driven decision algorithms.
Effect of Ketone Bodies on the Mitogenic Response of Bovine Milk Lymphocytes*
Authors: Kluciński W. , Miernik‐Degórska E. , Degórski A. , Targowski S. , Winnicka A. 
Published: December 2022

SummaryThe effect of increasing concentrations of beta‐hydroxybutyrate, acetoacetate and acetone on the activity in vitro of T‐lymphocytes isolated from milk and peripheral blood was studied, using cells obtained from 25 clinically healthy cows.The activity of milk and peripheral blood lymphocytes was determined by incorporation of 3H‐ labelled thymidine into these cells after stimulation with mitogens (PHA and Con A).It was found that beta‐hydroxybutyrate and acetoacetate in concentrations from 0.1 to 4.8mmol/l significantly inhibited the blastic transformation of milk and blood T‐lymphocytes stimulated with PHA or Con A.Increasing concentrations of acetone had no significant effect on the activity of milk or blood T‐ lymphocytes.
Prevalence and associations of fatigue in childhood atopic dermatitis: A cross‐sectional study
Authors: Rangel Stephanie M. , Kim Theodore , Sheth Anjani , Blumstein Alli , Lai Jin‐Shei , Cella David , Paller Amy S. , Silverberg Jonathan I. 
Published: December 2022

AbstractBackgroundFatigue is a symptom that can negatively impact patients' quality of life. However, the relationship of AD with fatigue has not been fully studied, especially in children.ObjectiveTo determine the prevalence of fatigue in AD patients, and whether AD severity, demographics and comorbidities are associated with increased fatigue in children.MethodsA cross‐sectional observational study was performed among 248 children with AD. Paediatric patients (ages 8–17 years) and parents (of children ages 0–17 years) completed a questionnaire, including demographics, history of atopic comorbidities and validated severity measures of AD, itch, pain, sleep disturbance, sleep‐related impairment and fatigue. AD severity was also assessed by clinician‐reported Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and Investigator's Global Assessment (IGA). Fatigue was assessed using Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue T‐score.ResultsMost children with AD had no (38.6%) or mild (32.1%) fatigue, with fewer having moderate (27.2%) or severe (2%) fatigue. Moderate/severe PROMIS Pediatric fatigue T‐scores were increased with moderate (25.7%/1.4%) and severe (39.3%/5.4%) IGA vs. mild IGA (18.0%/0.0%) and those with 5–6 (44.4%/0.0%) and 7 (44.2%/5.2%) nights of SD from eczema. Moderate–severe PROMIS Pediatric Fatigue T‐scores were associated with history of hay fever (adjusted OR [95% Cl]: 2.803 [1.395–5.632]) and family income (<$100,000: 3.049 [1.294–7.181]), but inversely with Black (0.40 [0.168–0.969]) and AAPI (0.285 [0.094–0.859]) race. In multivariable regression models controlling for demographic factors, PROMIS Pediatric Fatigue T‐score was significant with more severe scores for IGA, POEM, EASI, SCORAD, NRS‐itch, SCORAD‐itch, average itch in the past 7 days, PROMIS Pediatric Pain severity, PROMIS Pediatric SD, PROMIS Pediatric SRI, SCORAD‐sleep and more frequent SD from AD.ConclusionsFatigue is a common yet underappreciated symptom in children with AD, particularly those with moderate–severe AD, and warrants more attention in clinical practice and trials.
Rehabilitation of long‐term mandibular defects by whole‐process digital fibula flap combining with implants: A case report
Authors: Li Jian , Li Xue , Ma Kai , Sun Jian , Bai Na , Liu Yanshan 
Published: December 2022

AbstractCurrently, the gold standard and workhorse in mandibular reconstruction is the free vascularized fibula flap. Particularly for patients who have had mandibulectomy for a long time, it is still difficult to precisely reconstruct the mandibular contour and successfully restore the patient's chewing function and esthetics. For the restoration and rehabilitation of long‐term mandibular abnormalities, three‐dimensional (3D) virtual surgical planning (VSP) and 3D‐printed surgical guides are essential. Digital design and manufacturing were used to improve the accuracy of prostheses and facilitate occlusal reconstruction. Therefore, equipped with the methods of 3D VSP, 3D‐printed surgical guides, free vascularized fibular flap, and immediate dental implants, this clinical report provides a feasible solution for mandibular reconstruction.