bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of maxillofacial fractures in northwest China: an 11-year retrospective study of 2240 patients
Authors: Mao Jingjing , Li Xiaojie , Cao Kun , Xue Jiawen , Wang Min , Yan Di , Zhou Zhongwei 
Published: May 2023

AbstractBackgroundThe aim of this study was to determine the epidemiological pattern of maxillofacial fractures in northwestern China by retrospectively analysing the demographics, aetiologies, concomitant injuries, fracture sites, and management.MethodsA 10-year retrospective analysis of 2240 patients with maxillofacial fractures admitted to the General Hospital of Ningxia Medical University was conducted. The extracted data included sex, age, aetiology, fracture site, concomitant injuries, time of treatment, therapeutic approaches and complications. Statistical analyses were performed, including descriptive analysis and the chi-square test. Logistic regression was used to determine the impact factors of maxillofacial fractures and concomitant injuries. P values < 0.05 were considered statistically significant.ResultsThe age of the included patients ranged from 1 to 85 years, and the mean age was 35.88 ± 15.69 years. The male-to-female ratio was 3.9:1. The most frequent aetiology of maxillofacial fractures was road traffic accidents (RTAs) (56.3%), and the most common fracture sites were the anterior wall of the maxillary sinus, arcus zygomaticus and mandibular body. A total of 1147 patients (51.2%) were affected by concomitant injuries, with craniocerebral injury being the most common. Logistic regression analyses revealed increased risks of mid-facial fractures in elderly individuals (odds ratio (OR) = 1.029, P < 0.001) and females (OR = 0.719, P = 0.005). Younger patients had a higher risk of mandibular fractures (OR = 0.973, P < 0.001). RTAs increased the risk for mid-facial fractures and high falls increased the risk for mandibular fractures.ConclusionsThe maxillofacial fracture pattern is correlated with sex, age and aetiology. Patients were mainly young and middle-aged males, and the main cause of injury was RTAs, mostly causing compound fractures. Medical staff must be systematically educated to comprehensively examine patients with injuries resulting from RTAs. The management of patients with fractures requires thorough consideration of the patient’s age, aetiology, fracture site, and concomitant injuries.
The efficacy of manual toothbrushes in patients with fixed orthodontic appliances: a randomized clinical trial
Authors: Farook Fathima Fazrina , Alrumi Abdulmajeed , Aldalaan Khaled , Ababneh Khansa , Alshammari Abdulsalam , Al-Khamees Amani Abdullah , Albalawi Farraj 
Published: May 2023

AbstractObjectiveThis study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment.BackgroundManual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited.MethodsThe experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley–Hein Plaque Index.ResultsOf the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18–23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value < .001). The treatment differences were statistically significant (p-value < .001) favoring the FT toothbrush over the OT and CA types of toothbrush designs. On the contrary, the difference between the OT and CA types was not statistically significant.ConclusionsPlaque was significantly removed by the conventional FT toothbrush after a single brushing compared to the OT and CA types.
Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach
Authors: Andrikos Dimitrios , Andrikos Argyrios , Naem Antoine , Ebertz Olga , Devassy Rajesh , De Wilde Rudy Leon , Khamou Michael , Krentel Harald 
Published: May 2023

Abstract
Background
Advanced cancer of the cervical stump, occurring years after a laparoscopic supracervical hysterectomy (LASH), is a rare but serious clinical condition. Many patients who undergo a LASH are unaware of this possible complication. Upon diagnosis of advanced cervical stump cancer, a holistic approach including imaging, laparoscopic surgery and multimodal oncological therapy is required.

Case presentation
A 58-year-old patient presented to our department with the suspicion of advanced cervical stump cancer eight years after LASH. She reported pelvic pain, irregular vaginal bleedings and irregular discharge. Gynaecological examination revealed a locally advanced tumor of the uterine cervix with suspicion of infiltration of the left parametria and bladder. After thorough diagnostic imaging and laparoscopic staging, the tumor stage was determined as FIGO IIIB and the patient was treated with combined radiochemotherapy. The patient presented with tumor recurrence 5 months after the completion of therapy and she is currently being treated with multichemotherapy and immunotherapy regimens as palliative treatment.

Conclusion
Patients should be made aware about the risk of cervical stump carcinoma after LASH and the necessity for regular screening. Cervical cancer after LASH is often diagnosed at advanced stages and the treatment requires an interdisciplinary approach.
Would anti-choking devices be correctly and quickly managed by health science students? A manikin crossover trial
Authors: Cardalda-Serantes Borja , Carballo-Fazanes Aida , Rodríguez-Ruiz Emilio , Abelairas-Gómez Cristian , Rodríguez-Núñez Antonio 
Published: May 2023

Abstract
Background
The brand-new anti-choking devices (LifeVac® and DeCHOKER®) have been recently developed to treat Foreign Body Airway Obstruction (FBAO). However, the scientific evidence around these devices that are available to the public is limited. Therefore, this study aimed to assess the ability to use the LifeVac® and DeCHOKER® devices in an adult FBAO simulated scenario, by untrained health science students.

Methods
Forty-three health science students were asked to solve an FBAO event in three simulated scenarios: 1) using the LifeVac®, 2) using the DeCHOKER®, and 3) following the recommendations of the current FBAO protocol. A simulation-based assessment was used to analyze the correct compliance rate in the three scenarios based on the correct execution of the required steps, and the time it took to complete each one.

Results
Participants achieved correct compliance rates between 80–100%, similar in both devices (p = 0.192). Overall test times were significantly shorter with LifeVac® than DeCHOKER® device (36.6 sec. [31.9–44.4] vs. 50.4 s [36.7–66.9], p < 0.001). Regarding the recommended protocol, a 50% correct compliance rate was obtained in those with prior training vs. 31.3% without training, (p = 0.002).

Conclusions
Untrained health science students are able to quickly and adequately use the brand-new anti-choking devices but have more difficulties in applying the current recommended FBAO protocol.
Covid-19 distance and online learning: a systematic literature review in pharmacy education
Authors: Muhaimin Muhaimin , Habibi Akhmad , Riady Yasir , Alqahtani Turki Mesfer , Chaerunisaa Anis Yohana , Wijaya Tommy Tanu , Milanda Tiana , Yusop Farrah Dina , Albelbisi Nour Awni 
Published: May 2023

AbstractThe Covid-19 outbreak necessitated the implementation of social distancing mechanisms, such as the enforcement of lockdowns in numerous nations. The lockdown has disrupted many parts of everyday life, but this unusual event has particularly affected education. The temporary closure of educational institutions ushered in dozens of new reforms, including a shift into the distance and online learning. This study investigates the transition from traditional education in physical classrooms to online and distance and online learning in pharmacy education during Covid-19, especially about the challenges and benefits of distance and online learning. We did Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for literature sources between 2020 and 2022 (n.14). The study elaborates on how the transition has influenced teachers and students of pharmacy education. The research also summarizes several recommendations, which may assist in minimizing the adverse impacts of lockdown and encourage streamlined processes to distance and online learning, particularly in pharmacy education.
Reshaping internationalization of medical education in 2023
Authors: Wu Anette 
Published: May 2023

AbstractThe global COVID-19 pandemic has shown the need for internationalization of medical education, in order to facilitate global collaborative problem solving in healthcare. In 2023, it is time to reshape IoME within the context of our time, and share new visions, ideas, and formats. This collection of articles reports on theories and actions in IoME.
Accessing healthcare during the COVID-19 pandemic: a qualitative exploration of the experiences of parents and carers of children with chronic illness to inform future policies in times of crisis
Authors: Reed Dominic , Wolfe Ingrid , Greenwood Jenny , Lignou Sapfo 
Published: May 2023

Abstract
Background
The purpose of thispaper is to explore the experiences of parents and carers of children with chronic health conditions in accessing healthcare during the Covid-19 pandemic. Children with chronic conditions typically rely on both planned and unplanned care, and contact with healthcare professionals over extensive periods of time. Their distinct care needs render these children vulnerable to even to minor changes in healthcare provision. The wide-ranging care disruptions during the pandemic were therefore likely drastically to affect their health and wellbeing; an assessment of the effects of Covid-19 policies on healthcare access and quality of care delivered for this group is needed.

Methods
From 25/01/2022 to 25/05/2022, four focus groups were held with parents/carers of children with diabetes, neurodivergence, mental health conditions, and medical complexities to explore their experiences in navigating the healthcare system during the pandemic. Interviews were transcribed and then subjected to thematic analysis using NVivo qualitative research software.

Results
Our results indicate that children with chronic health conditions (and their parents/carers) experienced difficulties accessing healthcare during the pandemic. Problems with late diagnosis, prolonged waiting times, and deficiencies with telemedicine were identified, as were impacts of healthcare disruptions on children’s wellbeing, and the wellbeing of wider families. We found that children with neurodivergence and those with mental health conditions were particularly affected with their health needs repeatedly de-prioritised. Furthermore, the loss of contact with multi-specialty clinical teams profoundly affected parents and carers, leaving them feeling isolated in managing their children’s health. These diminished relationships became another vector for uncertainty in supporting children’s health.

Conclusion
The effects of healthcare disruptions on the welfare of children with chronic conditions (and their families), are well evidenced in this work, providing deeper understandings of the relationships between these children, their families and clinicians. The evidence in this paper aims to inform future policy and ethical guidelines so that the needs of children with long-term health conditions can be properly considered in times of crisis.
Insomnia and job stressors among healthcare workers who served COVID-19 patients in Bangladesh
Authors: Rahman Farzana , Dalal Koustuv , Hasan Mehedi , Islam Tariful , Tuli Samiha Nahar , Akter Asma , Tanvir K M , Islam Khairul , Rahman Ashikur , Nabi Mohammad Hayatun , Rahman Mohammad Lutfor , Hossain Hawlader Mohammad Delwer 
Published: May 2023

AbstractBackgroundThe global outbreak of COVID-19 has created unprecedented havoc among health care workers, resulting in significant psychological strains like insomnia. This study aimed to analyze insomnia prevalence and job stressors among Bangladeshi health care workers in COVID-19 units.MethodologyWe conducted this cross-sectional study to assess insomnia severity from January to March 2021 among 454 health care workers working in multiple hospitals in Dhaka city with active COVID-dedicated units. We selected 25 hospitals conveniently. We used a structured questionnaire for face-to-face interviews containing sociodemographic variables and job stressors. The severity of insomnia was measured by the Insomnia Severity Scale (ISS). The scale has seven items to evaluate the rate of insomnia, which was categorized as the absence of Insomnia (0–7); sub-threshold Insomnia (8–14); moderate clinical Insomnia (15–21); and severe clinical Insomnia (22–28). To identify clinical insomnia, a cut-off value of 15 was decided primarily. A cut-off score of 15 was initially proposed for identifying clinical insomnia. We performed a chi-square test and adjusted logistic regression to explore the association of different independent variables with clinically significant insomnia using the software SPSS version 25.0.Results61.5% of our study participants were females. 44.9% were doctors, 33.9% were nurses, and 21.1% were other health care workers. Insomnia was more dominant among doctors and nurses (16.2% and 13.6%, respectively) than others (4.2%). We found clinically significant insomnia was associated with several job stressors (p < 0.05). In binary logistic regression, having sick leave (OR = 0.248, 95% CI = 0.116, 0.532) and being entitled to risk allowance (OR = 0.367, 95% CI = 0.124.1.081) showed lower odds of developing Insomnia. Previously diagnosed with COVID-19-positive health care workers had an OR of 2.596 (95% CI = 1.248, 5.399), pointing at negative experiences influencing insomnia. In addition, we observed that any training on risk and hazard increased the chances of suffering from Insomnia (OR = 1.923, 95% CI = 0.934, 3.958).ConclusionIt is evident from the findings that the volatile existence and ambiguity of COVID-19 have induced significant adverse psychological effects and subsequently directed our HCWs toward disturbed sleep and insomnia. The study recommends the imperativeness to formulate and implement collaborative interventions to help HCWs cope with this crisis and mitigate the mental stresses they experience during the pandemic.
Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study
Authors: Roozbeh Jamshid , Malekmakan Leila , Mashayekh Mina , Dehghani Anahita , Ansari Soroush , Akbarialiabad Hossein , Mahmudpour Mehdi 
Published: May 2023

Abstract
Background
Needle stick injury (NSI) is the most common cause of infection with blood-borne pathogens (BBP) among healthcare workers (HCWs). This study aimed to assess the prevalence of NSI and it’s contributing factors among HCWs of hemodialysis (HD) units in southwest Iran.

Methods
A cross-sectional study was performed in 13 HD centers in Shiraz, Iran. A total of 122 employees were enrolled in our study. We used self-administrated questionnaires to collect data about demographics, experiences regarding NSIs, and general health status. The statistical tests used in this study were Chi-square and Independent T-test. A P-value < 0.05 is considered significant.

Results
The mean age of the study population was 36.1 ± 7.8 years (72.1%: women). Exposure to NSIs was reported by 23.0% of them at least once during the previous six months. NSI prevalence was significantly higher among those with higher age (p = 0.033), work experience > 10 years (p = 0.040), and those who graduated earlier (p = 0.031). The intravenous injection was the most common procedure leading to NSI, and being in a hurry was the most common cause. The average general health was 3.7 ± 3.2, higher among those not exposed to NSI (p = 0.042).

Conclusion
NSI is a prevalent hazard in HCWs of HD units. The high rate of NSI and unreported cases, besides the lack of adequate information, indicates the necessity of implementing protocols and strategies for improving the safety of this personnel. It is difficult to compare the result of this study with those performed among HCWs in other settings; hence, further studies are needed to determine whether HCWs of these units are more exposed to NSIs.
A novel 1p13.2 deletion associates with neurodevelopmental disorders in a three-generation pedigree
Authors: Yu Lihua , Ding Hongke , Liu Min , Liu Ling , Zhang Qi , Lu Jian , Guo Fangfang , Zhang Yan 
Published: May 2023

Abstract
Background
A multitude of studies have highlighted that copy number variants (CNVs) are associated with neurodevelopmental disorders (NDDs) characterized by a wide range of clinical characteristics. Benefiting from CNV calling from WES data, WES has emerged as a more powerful and cost-effective molecular diagnostic tool, which has been widely used for the diagnosis of genetic diseases, especially NDDs. To our knowledge, isolated deletions on chromosome 1p13.2 are rare. To date, only a few patients were reported with 1p13.2 deletions and most of them were sporadic. Besides, the correlation between 1p13.2 deletions and NDDs remained unclear.

Case presentation
Here, we first reported five members in a three-generation Chinese family who presented with NDDs and carried a novel 1.41 Mb heterozygous 1p13.2 deletion with precise breakpoints. The diagnostic deletion contained 12 protein-coding genes and was observed to segregate with NDDs among the members of our reported family. Whether those genes contribute to the patient’s phenotypes is still inconclusive.

Conclusions
We hypothesized that the NDD phenotype of our patients was caused by the diagnostic 1p13.2 deletion. However, further in-depth functional experiments are still needed to establish a 1p13.2 deletion-NDDs relationship. Our study might supplement the spectrum of 1p13.2 deletion-NDDs.
Cell surface GRP78: a potential mechanism of therapeutic resistant tumors
Authors: Amaresan Rajalakshmi , Gopal Udhayakumar 
Published: May 2023

AbstractGRP78 is a protein that acts as a chaperone within the endoplasmic reticulum (ER) and has multiple functions. It is induced by stress and abets cells from survival. Despite, multiple Stress conditions like ER, chronic psychological and nutritional stress, hypoxia, chemotherapy, radiation therapy, and drug resistance induce cell surface GRP78 (CS-GRP78) expression in cancer cells. Further, CS-GRP78 is associated with increased malignancy and resistance to anti-cancer therapies and is considered a high-value druggable target. Recent preclinical research suggests that targeting CS-GRP78 with anti-GRP78 monoclonal antibodies (Mab) in combination with other agents may be effective in reversing the failure of chemotherapy, radiotherapy, or targeted therapies and increasing the efficacy of solid tumors treatment. This article will review recent evidence on the role of CS-GRP78 in developing resistance to anti-cancer treatments and the potential benefits of combining anti-GRP78 Mab with other cancer therapies for specific patient populations. Furthermore, our limited understanding of how CS-GRP78 regulated in human studies is a major drawback for designing effective CS-GRP78-targeted therapies. Hence, more research is still warranted to translate these potential therapies into clinical applications.
Not all screens are created equal: examination of surface features and other physical properties of commonly used screen materials for smoking drugs
Authors: Diak Bradley J. , Miskovic Miroslav , Zurba Nadia , Beaumont Denise 
Published: May 2023

AbstractBackgroundBrass screens are considered an essential part of the safer drug smoking/inhalation supplies and are widely distributed by harm reduction programs in Canada. However, the use of commercially available steel wools as screens for smoking crack cocaine remains a common practice among people who smoke drugs in Canada. Use of these steel wool materials is associated with different adverse effects on health. This study aims to determine what changes folding and heating have on several filter materials, including brass screens and commercially available steel wool products, and examine the implications of these changes on health of people who smoke drugs.MethodsThis study investigated the microscopic differences, studied by optical and scanning electron microscopy, between four screen and four steel wool filter materials used in a simulated drug consumption process. New materials were manipulated, compacted into its own Pyrex® straight stem using a push stick and then heated with a butane lighter simulating a common method in preparing drugs for consumption. The materials were studied in the as-received (new), as-pressed (compressed and inserted into the stem tube but without heating) and as-heated (compressed and inserted into the stem tube and heated with a butane lighter) conditions.ResultsThe steel wool materials with the smallest wire thicknesses were found to be the easiest to prepare for pipe use, but degrade significantly during shaping and heating, making them wholly unsuitable as a safe filter material. In contrast the brass and stainless steel screen materials remain mostly unchanged by the simulated drug consumption process. After the stainless steel pellet screen, the Brass Impact 2.0 screen material had the best characteristics of the materials tested due to its mesh wire diameter, pitch, alloy choice and its pre-strained state.ConclusionCommonly used steel wool alternatives degrade during the handling and stem insertion, and heating the screens in the stem. Debris is generated by wool deformation on insertion and after heating that easily separates from the screen and can be inhaled during drug consumption. The brass and stainless steel screen materials are safer to use as they remain mostly stable during the simulated drug consumption process.