bluuebunny/crossref_metadata_2025_split huggingface dataset:
A graphite foreign body granuloma causing palatal perforation. Case report and literature review
Authors: Tosiou Athina , Kalogirou Eleni-Marina , Vlachodimitropoulos Dimitrios , Tosios Konstantinos 
Published: June 2023

Abstract

Purpose To present an unusual case of a graphite foreign body granuloma causing palatal perforation and review the literature on graphite deposition in the oral mucosa. Methods A 62-year-old female patient presented with a macule on the hard palate clinically consistent with a blue nevus. During excisional biopsy a black nodular mass was found beneath the macule that extended through a tunnel-like palatal deficit towards the nasal cavity. Oroantral communication was verified by a computed tomography scan indicating a diagnosis of malignant melanoma. Results Microscopic examination showed a graphite foreign body granuloma. It was suggested that the core was implanted in a thin area of the palatal bone and the foreign body granuloma caused the tunnel-like resorption. Conclusion Graphite tattoo may be included in the differential diagnosis of solitary pigmented lesions of the oral mucosa and should be excised, as it may cause tissue destruction though the development of a foreign body granuloma reaction.
Association of blood-cell-based inflammatory markers with gut microbiota and cancer incidence in the Rotterdam Study
Authors: Najjary Shiva , Kros Johan M. , Stricker Bruno H. , Ruiter Rikje , Shuai Yu , Kraaij Robert , Steen Kristel Van , Spek Peter van der , Eijck Casper H.J. Van , Ikram M. Arfan , Ahmad Shahzad 
Published: June 2023

Abstract
Background
Gut microbiota play a crucial role in defining the immune response. The immune response – gut microbiota interaction is implicated in various human diseases including cancer. Identifying the link between gut microbiota and systemic inflammatory markers, and their association with cancer, will be important to our understanding of cancer etiology.
Results
The current study was performed on 8,090 participants from the population-based Rotterdam Study. We found a significant association (false discovery rate [FDR] ≤ 0.05) between three gut-microbial taxa, namely the family Streptococcaceae, genus Streptococcus, and the order Lactobacillales with lymphocytes. In addition, we identified 95 gut-microbial taxa associated with inflammatory markers (P-value < 0.05). Analyzing the cancer data, we observed a significant association between higher SII levels at baseline (HR: 1.65 [95% CI; 1.10–2.46, P -value ≤ 0.05]) and the higher count of lymphocytes (HR: 1.38 [95% CI; 1.15–1.65, P-value ≤ 0.05]) and granulocytes (HR: 1.69 [95% CI; 1.40–2.03, P -value ≤ 0.05]) with increased risk of lung cancer after adjusting for age, sex, body mass index (BMI), and study cohort. This association was lost for SII and lymphocytes after additional adjustment for smoking (SII = HR:1.46 [95%CI; 0.96–2.22, P -value = 0.07] and lymphocytes = HR: 1.19 [95%CI; 0.97–1.46, P -value = 0.08]). In the stratified analysis, higher count of lymphocytes and granulocytes at baseline were associated with an increased risk of lung cancer in smokers after adjusting for age, sex, BMI, and study cohort (HR: 1.33 [95%CI; 1.09–1.62, P-value ≤ 0.05] and HR: 1.57 [95%CI; 1.28–1.92, P-value ≤ 0.05], respectively).
Conclusion
Our study revealed a positive association between gut-microbiota, higher SII levels and higher count of lymphocytes and granulocytes with an increased risk of developing lung cancer.
Cost utility Analysis of Adult Patients with Severe Aplastic Anemia Based on Single-center Cohort Study
Authors: chen lin , fang liwei , kuang zhexiang , xu jing , wang chuan 
Published: June 2023

Abstract
Objective
The purpose of this study is to objectively evaluate the efficacy of cyclosporine A + ALG and cyclosporine A + TPO-RA in the treatment of SAA patients, and to provide scientific data support for maximizing the therapeutic benefit of SAA patients.
Method
Cost-utility analysis was used to compare the quality of life adjusted years and total cost of the two schemes. The patient utility value was obtained from EQ-5D-3L and Japanese TTO conversion, and the total cost of treatment was obtained from electronic questionnaire survey and medical information data.
Results
A total of 26 adult patients were included in the study, including 17 with cyclosporine A + ALG and 9 with cyclosporine A + TPO-RA. In terms of QALY, patients with cyclosporine A + ALG regimen had higher intuitive feelings than those with cyclosporine A + TPO-RA regimen from admission to 6 months of follow-up, and the quality of life of patients with the former regimen was also significantly higher than that of the latter, with a difference of 0. 08 QALY (P < 0.01). In terms of total cost, the total cost of the former was twice that of the latter.Each QALY obtained by the two regimens was 687,000 yuan and 450,000 yuan, respectively.Compared with the cyclosporine A + TPO-RA regimen, the total cost of each QALY increased by the cyclosporine A + ALG regimen was 1.51 million yuan.
Conclusion
On the premise of ensuring the effectiveness of diagnosis and treatment, CsA + TPO-RA can be used as a good treatment option, which can reduce the economic pressure of SAA patients, reduce the burden of disease, reduce the pressure of medical insurance funds, and achieve multi-benefits.
Substantially improved performance in Sb 2 Se 3 solar cells on CdS buffered TiO 2 electron transport layer
Authors: Sun Shuo , Zhang Siyu , Han Yuanyuan , Tan Haidong , Wen Jian , Liu Xingyun , Sun Yuxia , Liu Hongri 
Published: June 2023

Abstract
The strong Ti-O bonds in TiO2 and poor compatibility to Sb2Se3 result in poor performance when used as electron transport layers (ETL) for Sb2Se3 solar cells. Therefore, cadmium sulfide is usually used as a buffer layer to improve its compatibility. In the present work, we deposited a layer of CdS by spin coating method on TiO2 ETL and fabricated TiO2/CdS dual ETL. The CdS layer improved the electronic properties of TiO2 and grain orientation of Sb2Se3 thin films. As a result, the average short circuit current and fill factor of Sb2Se3 solar cells were improved, and the final champion power conversion efficiency was enhanced from 2.6–4.71%. This study supplied a route for the application of titanium dioxide as a broadband gap electron transfer material in Sb2Se3 solar cells.
Developement of the INpaTiEnt Rehabilitation App Compliance quesTionnaire [INTERACT]
Authors: Hakam Hassan Tarek , Prill Robert , Lettner Jonathan , Mühlensiepen Felix , Salzmann Mikhail , Kopf Sebastian , Becker Roland 
Published: June 2023

Abstract
Background
In a previously translated and validated survey, the research team at the center of orthopaedics and trauma surgery cross-culturally adapted non-compliance items of a survey that targeted patients in rehabilitative care in private practice. However, the elements of the previously mentioned questionnaire neither take into account the burdens encountered in an inpatient hospital setting nor the effects of a mobile app-based telerehabilitation program on the early postoperative rehabilitative period. The purpose of this study is to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period.
Methods
For this purpose, a literature search was conducted to identify elements that prevent patients from performing their prescribed physical therapy exercises. These items were then evaluated by the expert review technique as described by Ikart. Afterwards, the synthesized survey was handed out to patients for the assessment of the quality of its items.
Results
The results of the expert review technique identified some conceptual and grammatical problems. This lead to the adjustment of some of the elements. The quality of the resulting questionnaire was deemed to be good as patients were able to fully understand the concepts and answer accordingly. A statistical analysis was done to evaluate the responses.
Conclusion
The items of the second questionnaire have proven to be reliable to asses the compliance of patients in an in-hospital setting. These items will be added to the cross-culturally adapted items of a previous questionnaire. The items of the system usability score will be further added to evaluate the experience of patients with an app-based rehabilitation program.
Registration:
The adoption and validation of questionnaire items does not need to be registered.
Rectified Artificial Neural Networks for Long-term Force Sensing in Piezoelectric Touch Panels
Authors: Liu Yong , Gao Shuo , Huang Anbiao , Wang Wenshuo 
Published: June 2023

Abstract
Human-machine interface based on force touch panel has attract enormous attention, for the merits of high human-machine interaction efficiency. Many studies and re- searches are devoted to diverse force touch technologies. Broad applications in both actual use and research have been developed, such as 3D Touch and force-based keystroke authentication. The fruitful results are based on the assumption that users’ touch habits remain unchanged along the time, thus a stationary customized force sensing model can be build. However, in long- term use, users’ touch habits changed due to time-drifting and specific-event, causing stationary force sensing model’s performance decreased. To address this issue, a rectified artificial neural network for long-term force sensing in piezoelectric touch panels is presented in this paper. With additional information of touching time and sign of specific-event, the predictions of force level are rectified, achieving an accuracy of 94.79% on long-term data set. The proposed technique enables customized force sensing in long-term use and enhancing human-machine interactive efficiency.
Social and ethnic-racial inequities in the occurrence of food deserts in a Brazilian capital
Authors: Borges Daniely Casagrande , Vargas Júlio Celso Borello , Honório Olivia Souza , Mendes Larissa Loures , Canuto Raquel 
Published: June 2023

Abstract

This study described the occurrence of food deserts and its relationship with the socioeconomic characteristics of the area. This is an ecological study based on secondary data from the city of Porto Alegre/Brazil. Food deserts were defined based on the density of establishments that sell healthy foods. The socioeconomic variables analyzed were the Health Vulnerability Index, percentage of illiterate people, percentage of people with per capita income of up to half a minimum wage, and percentage of households made up of people who identify as Black, Brown, or Indigenous. Statistical and spatial analyses were conducted using census tracts as units of analysis. Almost half of the census tracts were classified as food deserts (n = 1150/48.3%), with higher concentration in the peripheral areas of the city. Tracts with a high risk of health vulnerability (very high HVI), those with the highest percentage of black and indigenous peoples (Quartile 4), the highest percentage of illiterate people (Quartile 4), and the highest percentage of people living on less than ⅕ minimum wage (Quartile 4), were about twice as likely to be classified as a food desert. For all variables, a dose-response relationship was observed. The results show that in the city of Porto Alegre food deserts were associated with worse environmental and social conditions, and a greater presence of ethnic-racial minority groups. Social and ethnic-racial inequities might shape the city environment, making access to healthy foods more difficult for the most vulnerable populations, with possible repercussions on food consumption, food security and other health outcomes.
Accounting for sex differences as a continuous variable in cancer treatments
Authors: Rubin Joshua , Yang Wei 
Published: June 2023

Abstract
The significant sex differences that exist in cancer mechanisms, incidence, and survival, have yet to impact clinical practice. We propose that one barrier to translation is that sex differences in cancer phenotypes resemble sex differences in height: highly overlapping, but distinct, male and female population distributions that vary continuously between female- and male- skewed extremes. A consequence of this variance is that sex-specific treatments are rendered unrealistic, and our translational goal should be adaptation of treatment to the variable sex-effect on targetable pathways. To develop a tool that could advance this goal, we applied a Bayesian Nearest Neighbor (BNN) analysis to 8370 cancer transcriptomes from 26 different adult and 4 different pediatric cancer types to establish patient-specific Transcriptomic Indices (TI). TI precisely positions a patient’s whole transcriptome on axes of mechanistic phenotypes like cell cycle signaling and immunity that exhibit skewing in the cancer population relative to sex-identified extremes (poles). Importantly, the TI approach reveals that even when TI values are identical, underlying mechanisms in male and female individuals can differ in identifiable ways. Thus, cancer type, patient sex, and TI value provides a novel and patient- specific mechanistic identifier that can be used for precision cancer treatment planning.
Editorial
Authors: Domínguez Partida Gabriel 
Published: June 2023

"En el mundo actual, la virtualidad se presenta como una necesidad y no ya como una novel invención. En consecuencia, la investigación de la comunicación ha incluido estas nuevas tecnologías digitales como un área de estudio con el afán extender el conocimiento y aplicación de las teorías seminales del proceso comunicativo. Aunque esta incorporación se ha hecho con cierta reticencia, cada vez es más común encontrar voces académicas que reivindiquen el rol de estas tecnologías y la complejidad de sus aplicaciones, alejándose de la inclusiva influencia negativa en las audiencias. Uno de esos medios es los videojuegos."--Editorial
La otredad latina en los videojuegos: de la selva a la pantalla
Authors: Bernstein Gastón 
Published: June 2023

Aquí no sólo nos interesa repensar las distintas representaciones de personajes latinos y de Latinoamérica que hacen los videojuegos producidos en países del “Primer Mundo” -y los estereotipos que estos acarrean-, sino también y principalmente qué sucede con los videojuegos producidos en América Latina y qué tipo de representación proponen en respuesta: pareciera que no es tarea sencilla escapar del autoborramiento (eliminar adrede las marcas de la propia cultura) o la autoexotización (alinearse al estereotipo de otredad impuesto por la cultura hegemónica), al menos para la gran mayoría de videojuegos latinoamericanos. En este trabajo se investigan algunos casos particulares y fnalmente se proponen algunos juegos como modelo alternativo a seguir en cuanto a representación de latinos por latinos se refere.
Evaluating the Effectiveness of Interactive Virtual Patients for Medical Education in Zambia: Randomized Controlled Trial
Authors: Horst Rebecca , Witsch Lea-Mara , Hazunga Rayford , Namuziya Natasha , Syakantu Gardner , Ahmed Yusuf , Cherkaoui Omar , Andreadis Petros , Neuhann Florian , Barteit Sandra 
Published: June 2023

Background
Zambia is facing a severe shortage of health care workers, particularly in rural areas. Innovative educational programs and infrastructure have been established to bridge this gap; however, they encounter substantial challenges because of constraints in physical and human resources. In response to these shortcomings, strategies such as web-based and blended learning approaches have been implemented, using virtual patients (VPs) as a means to promote interactive learning at the Levy Mwanawasa Medical University (LMMU) in Zambia.

Objective
This study aimed to evaluate the students’ knowledge acquisition and acceptance of 2 VP medical topics as a learning tool on a Zambian higher education e-learning platform.

Methods
Using a mixed methods design, we assessed knowledge acquisition using pre- and posttests. In a randomized controlled trial setting, students were assigned (1:1) to 2 medical topics (topic 1: appendicitis and topic 2: severe acute malnutrition) and then to 4 different learning tools within their respective exposure groups: VPs, textbook content, preselected e-learning materials, and self-guided internet materials. Acceptance was evaluated using a 15-item questionnaire with a 5-point Likert scale.

Results
A total of 63 third- and fourth-year Bachelor of Science clinical science students participated in the study. In the severe acute malnutrition–focused group, participants demonstrated a significant increase in knowledge within the textbook group (P=.01) and the VP group (P=.01). No substantial knowledge gain was observed in the e-learning group or the self-guided internet group. For the appendicitis-focused group, no statistically significant difference in knowledge acquisition was detected among the 4 intervention groups (P=.62). The acceptance of learning materials exhibited no substantial difference between the VP medical topics and other learning materials.

Conclusions
In the context of LMMU, our study found that VPs were well accepted and noninferior to traditional teaching methods. VPs have the potential to serve as an engaging learning resource and can be integrated into blended learning approaches at LMMU. However, further research is required to investigate the long-term knowledge gain and the acceptance and effectiveness of VPs in medical education.

Trial Registration
Pan African Clinical Trials Registry (PACTR) PACTR202211594568574; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=20413
Economic Evaluation of Digital Therapeutic Care Apps for Unsupervised Treatment of Low Back Pain: Monte Carlo Simulation
Authors: Lewkowicz Daniel , Bottinger Erwin , Siegel Martin 
Published: June 2023

BackgroundDigital therapeutic care (DTC) programs are unsupervised app-based treatments that provide video exercises and educational material to patients with nonspecific low back pain during episodes of pain and functional disability. German statutory health insurance can reimburse DTC programs since 2019, but evidence on efficacy and reasonable pricing remains scarce. This paper presents a probabilistic sensitivity analysis (PSA) to evaluate the efficacy and cost-utility of a DTC app against treatment as usual (TAU) in Germany.ObjectiveThe aim of this study was to perform a PSA in the form of a Monte Carlo simulation based on the deterministic base case analysis to account for model assumptions and parameter uncertainty. We also intend to explore to what extent the results in this probabilistic analysis differ from the results in the base case analysis and to what extent a shortage of outcome data concerning quality-of-life (QoL) metrics impacts the overall results.MethodsThe PSA builds upon a state-transition Markov chain with a 4-week cycle length over a model time horizon of 3 years from a recently published deterministic cost-utility analysis. A Monte Carlo simulation with 10,000 iterations and a cohort size of 10,000 was employed to evaluate the cost-utility from a societal perspective. Quality-adjusted life years (QALYs) were derived from Veterans RAND 6-Dimension (VR-6D) and Short-Form 6-Dimension (SF-6D) single utility scores. Finally, we also simulated reducing the price for a 3-month app prescription to analyze at which price threshold DTC would result in being the dominant strategy over TAU in Germany.ResultsThe Monte Carlo simulation yielded on average a €135.97 (a currency exchange rate of EUR €1=US $1.069 is applicable) incremental cost and 0.004 incremental QALYs per person and year for the unsupervised DTC app strategy compared to in-person physiotherapy in Germany. The corresponding incremental cost-utility ratio (ICUR) amounts to an additional €34,315.19 per additional QALY. DTC yielded more QALYs in 54.96% of the iterations. DTC dominates TAU in 24.04% of the iterations for QALYs. Reducing the app price in the simulation from currently €239.96 to €164.61 for a 3-month prescription could yield a negative ICUR and thus make DTC the dominant strategy, even though the estimated probability of DTC being more effective than TAU is only 54.96%.ConclusionsDecision-makers should be cautious when considering the reimbursement of DTC apps since no significant treatment effect was found, and the probability of cost-effectiveness remains below 60% even for an infinite willingness-to-pay threshold. More app-based studies involving the utilization of QoL outcome parameters are urgently needed to account for the low and limited precision of the available QoL input parameters, which are crucial to making profound recommendations concerning the cost-utility of novel apps.
A Web-Based Instrument for Infantile Atopic Dermatitis Identification (Electronic Version of the Modified Child Eczema Questionnaire): Development and Implementation
Authors: Fang Heping , Chen Lin , Li Juan , Ren Luo , Yin Yu , Chen Danleng , Yin Huaying , Liu Enmei , Hu Yan , Luo Xiaoyan 
Published: June 2023

Background
Atopic dermatitis (AD) is a chronic inflammatory cutaneous disease that affects 30.48% of young children; thus, there is a need for epidemiological studies in community settings. Web-based questionnaires (WBQs) are more convenient, time-saving, and efficient than traditional surveys, but the reliability of identifying AD through WBQs and whether AD can be identified without the attendance of doctors, especially in community or similar settings, remains unknown.

Objective
This study aimed to develop and validate a web-based instrument for infantile AD identification (electronic version of the modified Child Eczema Questionnaire [eCEQ]) and to clarify the possibility of conducting WBQs to identify infantile AD without the attendance of doctors in a community-representative population.

Methods
This study was divided into 2 phases. Phase 1 investigated 205 children younger than 2 years to develop and validate the eCEQ by comparison with the diagnoses of dermatologists. Phase 2 recruited 1375 children younger than 2 years to implement the eCEQ and verify the obtained prevalence by comparison with the previously published prevalence.

Results
In phase 1, a total of 195 questionnaires were analyzed from children with a median age of 8.8 (IQR 4.5-15.0) months. The identification values of the eCEQ according to the appropriate rules were acceptable (logic rule: sensitivity 89.2%, specificity 91.5%, positive predictive value 97.1%, and negative predictive value 72.9%; statistic rule: sensitivity 90.5%, specificity 89.4%, positive predictive value 96.4%, and negative predictive value 75%). In phase 2, a total of 837 questionnaires were analyzed from children with a median age of 8.4 (IQR 5.2-14.6) months. The prevalence of infantile AD obtained by the eCEQ (logic rule) was 31.9% (267/837), which was close to the published prevalence (30.48%). Based on the results of phase 2, only 20.2% (54/267) of the participants identified by the eCEQ had previously received a diagnosis from doctors. Additionally, among the participants who were not diagnosed by doctors but were identified by the eCEQ, only 6.1% (13/213) were actually aware of the possible presence of AD.

Conclusions
Infantile AD can be identified without the attendance of doctors by using the eCEQ, which can be easily applied to community-based epidemiological studies and provide acceptable identification reliability. In addition, the eCEQ can also be applied to the field of public health to improve the health awareness of the general population.