bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral health-related quality of life and oral manifestations of Syrian children with congenital heart disease: a case-control study
Authors: Bsesa Shouq Sharar , Srour Samir , Dashash Mayssoon 
Published: May 2023

Abstract
Background
There was an immense need for studies evaluating the oral health status of Syrian children with congenital heart disease (CHD) and its impact on their quality of life. No contemporary data are available. The objective of this study was to investigate oral manifestations and oral health-related quality of life (OHRQoL) of children with CHD and compare them with healthy controls aged 4–12 years.

Methods
A case-control study was undertaken. A total of 200 patients with CHD and 100 healthy children belonging to the same patient’s family were included. Decayed, missed, and filled permanent teeth index (DMFT) and decayed, missed, and filled primary teeth index (dmft), Oral Hygiene Index (OHI), Papillary Marginal Gingivitis Index (PMGI), and dental abnormalities were recorded. The Arabic version of the Child Oral Health-Related Quality of Life Questionnaire (COHRQoL, 36-item) which was divided into 4 different domains (Oral Symptoms, Functional Limitations, Emotional Well-Being, Social Well-Being) were studied. Chi-square test and independent- t-test were used to perform statistical analysis.

Results
CHD patients experienced more periodontitis, dental caries, poor oral health, and enamel defects. The dmft mean was significantly higher in CHD patients than in healthy children (5.245 vs. 2.660, P < 0.05). No significant difference was found between patients and controls in the DMFT Mean (P = 0.731). There was a significant difference between CHD patients and healthy children in the mean of the OHI (5.954 vs. 1.871, P < 0.05), and PMGI (1.689 vs. 1.170, P < 0.05). CHD patients have significantly higher enamel opacities (8% vs. 2%) and hypocalcification (10.5% vs. 2%) than controls. Also, the 4 COHRQoL domains, showed significant differences between CHD children and controls.

Conclusions
Evidence about the oral health and COHRQoL of children with CHD was provided. Further preventive measures are still required to improve the health and quality of life of this vulnerable group of children.
Structural empowerment of midwifery students following simulation-based training of management of obstetric emergencies
Authors: Janighorban Mojgan , yousefi hojatollah , yamani Nikoo 
Published: May 2023

AbstractBackgroundHaving the ability of managing obstetric emergencies is the necessary capability for providing care during labor and delivery.Simulation is considered to be a valuable strategy for empowering midwifery students in managing emergencies. So, this study was conducted to determine the structural empowerment of midwifery students following the simulation-based training of management of midwifery emergencies.MethodsThis semi-experimental research was conducted from August 2017 to June 2019 in the Faculty of Nursing and Midwifery, Isfahan, Iran. 42 subjects of the third-year midwifery students were included in the study through convenience sampling method (n = 22 in the intervention group, n = 20 in the control group). Six simulation-based educational sessions were considered for the intervention group. Conditions for Learning Effectiveness Questionnaire, was used at the beginning of the study, one week after it and one year later. Repeated measures ANOVA was used to analyze the data.ResultsIn the intervention group, the significant difference was observed between the mean score of the students’ structural empowerment before and after the intervention (MD=-28.41, SD = 3.25) (p < 0.001), before and one year after the study (MD=-12.45, SD = 3.47) (p = 0.003), and immediately after and one year after the study (MD = 15.95,SD = 3.67) (p < 0.001). In the control group, no significant difference was observed. Before the intervention, there was no significant difference between the mean score of the students’ structural empowerment in the control and intervention groups (MD = 2.89, SD = 3.50) (p = 0.415); but, immediately after the intervention, the mean score of structural empowerment in the students of the intervention group was significantly higher than those of the control group (MD = 25.40, SD = 4.94 ) (p < 0.001). One year after the study, there was no significant difference between the two groups in terms of the mean score of the structural empowerment (MD = 6.89, SD = 3.58 ) (p = 0.061).ConclusionSimulation contributed to the structural empowerment of midwifery students by providing the opportunity for personal and professional growth and strengthening of the formal and informal power in the area of midwifery emergency management but these benefits were not seen at one year.
The genetic landscape and possible therapeutics of neurofibromatosis type 2
Authors: Ghalavand Mohammad Amin , Asghari Alimohamad , Farhadi Mohammad , Taghizadeh-Hesary Farzad , Garshasbi Masoud , Falah Masoumeh 
Published: May 2023

AbstractNeurofibromatosis type 2 (NF2) is a genetic condition marked by the development of multiple benign tumors in the nervous system. The most common tumors associated with NF2 are bilateral vestibular schwannoma, meningioma, and ependymoma. The clinical manifestations of NF2 depend on the site of involvement. Vestibular schwannoma can present with hearing loss, dizziness, and tinnitus, while spinal tumor leads to debilitating pain, muscle weakness, or paresthesias. Clinical diagnosis of NF2 is based on the Manchester criteria, which have been updated in the last decade. NF2 is caused by loss-of-function mutations in the NF2 gene on chromosome 22, leading the merlin protein to malfunction. Over half of NF2 patients have de novo mutations, and half of this group are mosaic. NF2 can be managed by surgery, stereotactic radiosurgery, monoclonal antibody bevacizumab, and close observation. However, the nature of multiple tumors and the necessity of multiple surgeries over the lifetime, inoperable tumors like meningiomatosis with infiltration of the sinus or in the area of the lower cranial nerves, the complications caused by the operation, the malignancies induced by radiotherapy, and inefficiency of cytotoxic chemotherapy due to the benign nature of NF-related tumors have led a march toward exploring targeted therapies. Recent advances in genetics and molecular biology have allowed identifying and targeting of underlying pathways in the pathogenesis of NF2. In this review, we explain the clinicopathological characteristics of NF2, its genetic and molecular background, and the current knowledge and challenges of implementing genetics to develop efficient therapies.
Changes of equality of medical service utilization in China between 1993 and 2018: findings from six waves of nationwide household interview survey
Authors: Wu Ming , Huang Ju , Fu Hongqiao , Xie Xueqin , Wu Shiyong 
Published: May 2023

Abstract
Background
Changes in China’s health care system in the last three decades was remarkable. The current study aims on examine the change of equality of health care utilization in mainland China based on a nationwide household interview survey.

Methods
We used household interview data extracted from six waves of National Health Service Survey between 1993 and 2018. Changes of health care utilization were descripted. Equality of the utilization were examined with univariate meta-regression across urban and rural areas, socioeconomic development regions and income groups.

Results
The proportion of outpatient visits within last two weeks experienced a decrease from 17.0% in 1993 to 13.0% in 2013 and bounced back to 24.0% in 2018. The age-standardized trend remained unchanged. Hospitalization in the last 12 month increased from 2.6% in 1998 to 13.8% in 2018. The perceived unmet need of hospital admission fell from 35.9% in 1998 to 21.5% in 2018. The gaps in health care utilization between urban and rural areas, across regions and by income groups have been narrowed, implying improved equality of using medical services in the last two and a half decades.

Conclusion
China has experienced significant increases in health care utilization over the past 25 years. Meanwhile, the unmet needs for health care decreased remarkably and the equality of health care utilization improved significantly. These results imply significant achievements in health service accessibility in China.
Assessment of equity and efficiency of magnetic resonance imaging services in Henan Province, China
Authors: Huang Xiaoling , Wei Yan , Sun Hui , Huang Jiaqi , Chen Yingyao , Cheng Jingliang 
Published: May 2023

Abstract
Background
By evaluating equity and effectiveness, this study provides evidence-based knowledge for scientific decision-making and the optimization of magnetic resonance imaging (MRI) configuration and utilization at the provincial level.

Methods
Using data from 2017, we applied a Gini coefficient to analyze the equity of MRI services in 11 sample cities in Henan province. An agglomeration degree was then applied to measure equity from the perspective of population and geography, and a data envelopment analysis was used to evaluate MRI efficiency.

Results
The overall Gini coefficient of MRI allocation by population in the 11 sample cities is 0.117; however, equity varies considerably among the sample cities. The sample’s comprehensive efficiency is only 0.732, indicating the overall ineffectiveness of provincial MRI utilization. The pure technical and scale efficiencies of four sample cities are below 1, indicating lower MRI effectiveness than the rest.

Conclusions
Although the overall equity of configuration at the provincial level is relatively good, equity varies at the municipal level. Our results demonstrate a low MRI utilization efficiency; accordingly, policymakers should dynamically adjust the policy based on equity and efficiency.
Low-Intensity mental health Support via a Telehealth Enabled Network for adults with diabetes (LISTEN): protocol for a hybrid type 1 effectiveness implementation trial
Authors: Holloway Edith E. , Gray Shikha , Mihalopoulos Cathrine , Versace Vincent L. , Le Gautier Roslyn , Chatterton Mary Lou , Hagger Virginia , Halliday Jennifer , Henshaw Kim , Harrap Benjamin , Manallack Sarah , Black Taryn , Van Bruggen Natasha , Hines Carolyn , O’Neil Adrienne , Skinner Timothy C. , Speight Jane , Hendrieckx Christel 
Published: May 2023

Abstract
Background
Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs).

Methods
A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes (N = 454) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN—a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between-group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes.

Discussion
It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required.

Trial registration
This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on 1 February, 2022.
Determinants of point-of-care ultrasound lung sliding amplitude in mechanically ventilated patients
Authors: Briganti David N. , Choi Christine E. , Nguyen Julien , Lanks Charles W. 
Published: May 2023

Abstract
Background
Although lung sliding seen by point-of-care ultrasound (POCUS) is known to be affected to varying degrees by different physiologic and pathologic processes, it is typically only reported qualitatively in the critical care setting. Lung sliding amplitude quantitatively expresses the amount of pleural movement seen by POCUS but its determinants in mechanically ventilated patients are largely unknown.

Methods
This was a single-center, prospective, observational pilot study examining 40 hemithoraces in 20 adult patients receiving mechanical ventilation. Each subject had lung sliding amplitude measured in both B-mode and by pulsed wave Doppler at their bilateral lung apices and bases. Differences in lung sliding amplitude were correlated with anatomical location (apex vs base) as well as physiologic parameters including positive end expiratory pressure (PEEP), driving pressure, tidal volume and the ratio of arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (FiO2).

Results
POCUS lung sliding amplitude was significantly lower at the lung apex compared to the lung base in both B-mode (3.6 ± 2.0 mm vs 8.6 ± 4.3 mm; p < 0.001) and the pulsed wave Doppler mode (10.3 ± 4.6 cm/s vs 13.9 ± 5.5 cm/s; p < 0.001) corresponding to expected distribution of ventilation to the lung bases. Inter-rater reliability of B-mode measurements was excellent (ICC = 0.91) and distance traversed in B-mode had a significant positive correlation with pleural line velocity (r2 = 0.32; p < 0.001). There was a non-statistically significant trend towards lower lung sliding amplitude for PEEP ≥ 10 cmH2O, as well as for driving pressure ≥ 15 cmH2O in both ultrasound modes.

Conclusion
POCUS lung sliding amplitude was significantly lower at the lung apex than the lung base in mechanically ventilated patients. This was true when using both B-mode and pulsed wave Doppler. Lung sliding amplitude did not correlate with PEEP, driving pressure, tidal volume or PaO2:FiO2 ratio. Our findings suggest that lung sliding amplitude can be quantified in mechanically ventilated patients in a physiologically predictable way and with high inter-rater reliability. A better understanding of POCUS derived lung sliding amplitude and its determinants may aid in the more accurate diagnosis of lung pathologies, including pneumothorax, and could serve as a means of further reducing radiation exposure and improving outcomes in critically ill patients.
Indigenous landscaping and biophilic urbanism: case studies in Noongar Six Seasons
Authors: Cabanek Agata , Newman Peter , Nannup Noel 
Published: May 2023

Abstract
Background
Indigenous landscaping has had a revival with Indigenous cultures as an important part of multiculturalism. The landscape elements are generally gleaned from Indigenous Elders and from anthropological texts and pre-invasion history texts (e.g. explorers’ notebooks) that enable an understanding of the ecological, food, and medicine aspects of their propagation. The purpose of this study was to examine how Indigenous landscaping (knowledge, values, management methods, use) can assist with biophilic urbanism, the new approach to bringing natural systems into the built environment. This emphasizes the importance of place meanings in biophilic design. It will illustrate this in Western Australia using the Noongar People’s Six Seasons of distinct landscape each with importance for providing a living environment (shelter, food, medicine, and spiritual nourishment) and as a basic requirement for biodiversity management over 60,000 years.

Results
The study presents key reasons to include Indigenous interpretive landscaping into biophilic urbanism. Case studies in Six Seasons Gardens are used to show how integrating a cultural element into landscaping can bring many advantages. From the analysis of the case studies, we identified qualities of Indigenous Local Native Gardens. Several reasons for prioritising Indigenous landscaping in urban settings are proposed. These highlight cultural, educational, and professional values that can be achieved.

Conclusions
In this paper, we presented three case studies of urban indigenous and native gardens. We highlighted implications for adding indigenous dimensions to the management of the natural and built environments and brought to attention how indigenous landscaping is a conveyor of meaning, inclusive culture, and the importance of biodiversity. The future of biophilic urbanism will depend on whether sufficient contact with historians, anthropologists, and remnant indigenous communities can be made in order to emphasize the value for all aspects of biophilic urbanism in creating a deeper sense of place.
Early diagnosis of congenital muscular pathologies using next-generation sequencing: experiences from a tertiary center in Morocco
Authors: El Kadiri Youssef , Ratbi Ilham , Ouhenach Mouna , Chafai Elalaoui Siham , Cherkaoui Jaouad Imane , Zrhidri Abdelali , Sahli Maryem , Birouk Nazha , Sefiani Abdelaziz , Lyahyai Jaber 
Published: May 2023

Abstract
Background
Congenital muscular dystrophies (CMD) and congenital myopathies (CM) are clinically and genetically heterogeneous groups of neuromuscular disorders resulting in prenatal or early-onset hypotonia, muscle weakness, myogenic pattern, and dystrophic or myopathic features on muscle biopsy. In this study, we provide a genetic and molecular characterization of CMD and CM in Moroccan patients.

Patients and methods
In this cohort, we investigated 23 Moroccan patients from 21 families who consented to genetic testing. Firstly, genetic analysis in the probands was conducted by next-generation sequencing (NGS) technology using two approaches: targeted NGS gene panel and clinical exome sequencing to study the mutational spectrum and to achieve an accurate diagnosis of these hereditary myopathies in Morocco.

Results
NGS data analysis revealed 16 pathogenic variants harbored in 17 unrelated patients that were genetically resolved. The phenotypic forms identified were in order: LAMA2-related CMD (52.94%), LMNA-CMD (23.53%), and RYR1-related congenital myopathy (17.65%). The congenital titinopathy group was less frequent (5.88%). Here, we identified two novel recessive variants in LAMA2 gene: c.2164G > A (p.Glu722Lys), and c.(6992 + 1_6993-1)_(7300 + 1_7301-1)del p.(Pro2332Glnfs*10). Additionally, we expanded the phenotypic spectrum of a known heterozygous LMNA c.1718C > T p.(Ser573Leu) variant, and we report it for the first time to a form of CMD.

Conclusions
The introduction of the NGS tool in clinical practice allowed us to improve the diagnosis and the management of these neuromuscular diseases and to highlight the importance of molecular genetic diagnosis of these disorders that are underestimated in the Moroccan population.
Health Data Sharing Perspectives of Patients Receiving Care in CancerLinQ-Participating Oncology Practices
Authors: Jagsi Reshma , Suresh Krithika , Krenz Chris D. , Jones Rochelle D. , Griffith Kent A. , Perry Lydia , Hawley Sarah T. , Zikmund-Fisher Brian , Spector-Bagdady Kayte , Platt Jodyn , De Vries Raymond , Bradbury Angela R. , Bansal Pranshu , Kaime Melissa , Patel Monaliben , Schilsky Richard L. , Miller Robert S. , Spence Rebecca 
Published: May 2023

PURPOSE CancerLinQ seeks to use data sharing technology to improve quality of care, improve health outcomes, and advance evidence-based research. Understanding the experiences and concerns of patients is vital to ensure its trustworthiness and success. METHODS In a survey of 1,200 patients receiving care in four CancerLinQ-participating practices, we evaluated awareness and attitudes regarding participation in data sharing. RESULTS Of 684 surveys received (response rate 57%), 678 confirmed cancer diagnosis and constituted the analytic sample; 54% were female, and 70% were 60 years and older; 84% were White. Half (52%) were aware of the existence of nationwide databases focused on patients with cancer before the survey. A minority (27%) indicated that their doctors or staff had informed them about such databases, 61% of whom indicated that doctors or staff had explained how to opt out of data sharing. Members of racial/ethnic minority groups were less likely to be comfortable with research (88% v 95%; P = .002) or quality improvement uses (91% v 95%; P = .03) of shared data. Most respondents desired to know how their health information was used (70%), especially those of minority race/ethnicity (78% v 67% of non-Hispanic White respondents; P = .01). Under half (45%) felt that electronic health information was sufficiently protected by current law, and most (74%) favored an official body for data governance and oversight with representation of patients (72%) and physicians (94%). Minority race/ethnicity was associated with increased concern about data sharing (odds ratio [OR], 2.92; P < .001). Women were less concerned about data sharing than men (OR, 0.61; P = .001), and higher trust in oncologist was negatively associated with concern (OR, 0.75; P = .03). CONCLUSION Engaging patients and respecting their perspectives is essential as systems like CancerLinQ evolve.
Clinical Impact of Androgen Receptor–Suppressing miR-146b Expression in Papillary Thyroid Cancer Aggressiveness
Authors: Chou Chen-Kai , Chi Shun-Yu , Hung Yi-Yung , Yang Yi-Chien , Fu Hung-Chun , Wang Jia-He , Chen Chueh-Chen , Kang Hong-Yo 
Published: May 2023

Abstract

Context
Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Dysregulated expression of miR-146b and androgen receptor (AR) has been shown to play critical roles in tumorigenesis in PTC. However, the mechanistic and clinical association between AR and miR-146b is not fully understood.

Objective
The purpose was to investigate miR-146b as the potential AR target miRNA and its involvement in advanced tumor characteristics of PTC.

Methods
Expression of AR and miR-146b were assessed in frozen and formalin-fixed paraffin-embedded tissue samples from PTC and adjacent normal thyroid specimens by quantitative real-time polymerase chain reaction, and their correlation was examined. Human thyroid cancer cell lines BCPAP and TPC-1 were used to evaluate the effect of AR on miR-146b signaling. Chromatin immunoprecipitation (ChIP) assays were performed to determine whether AR binds to the miR-146b promoter region.

Results
Pearson correlation analysis confirmed significant inverse correlation between miR-146b and AR expression. Overexpressing AR BCPAP and TPC-1 cells showed relatively lower miR-146b expression. ChIP assay revealed that AR might bind to the androgen receptor element located on the promoter region of miRNA-146b gene, and overexpression of AR suppresses miR-146b-mediated tumor aggressiveness. The low AR/high miR-146b PTC patient group was associated with advanced tumor characteristics, including higher tumor stage, lymph node metastasis, and worse treatment response.

Conclusion
To sum up, miR-146b is a molecular target of AR transcriptional repression; therefore, AR suppresses miR-146b expression to reduce PTC tumor aggressiveness.