bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of knowledge, attitude, and behavior related to children’s oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study
Authors: Jafari Saba , Memarpour Mahtab , Pakniyat Jahromi Maryam , Vossoughi Mehrdad , Hamidi Seyed Ahmadreza 
Published: August 2023

Background:
Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran.

Methods:
This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson’s correlation tests and path analysis.

Results:
Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum.

Conclusions:
Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians’ interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.
Prediction of negative axillary node clearance by sentinel node-positive to total node ratio: a retrospective cohort study
Authors: Rosen Jemima , Manley Lara R. , Patel Arun , Gandamihardja Tasha , Rao Ahsan 
Published: August 2023

Introduction:
Increasing evidence suggests that de-escalation of axillary surgery is safe, without significantly impacting patient outcome. Obtaining positive lymph nodes at a sentinel lymph node biopsy (SNB) can guide decisions toward the requirement of axillary nodal clearance (ANC). However, methods to predict how many further nodes will be positive are not available. This study investigates the feasibility of predicting the likelihood of a negative ANC based on the ratio between positive nodes and the total number of lymph nodes excised at SNB.

Methods:
Retrospective data from January 2017 to March 2022 was collected from electronic medical records. Patients with oestrogen receptor (ER) positive and HER2 negative receptor disease were included in the study. ER-negative and HER2-positive disease was excluded, alongside patients who had chemotherapy before ANC.

Results:
Of 102 patients, 58.8% (n=60) had no macrometastasis at ANC. On average, 2.76 lymph nodes were removed at SNB. A higher SNB ratio of positive to total nodes [OR 11.09 (CI 95% 2.33–52.72), P=0.002] had a significant association with positive nodes during ANC. SNB ratio less than or equal to 0.33 (1/3) had a specificity of 79.2% in identifying cases that later had a negative completion ANC, with a 95.8% specificity of no further upgrade of nodal staging.

Conclusion:
A low SNB ratio of less than 0.33 (1/3) has a high specificity in excluding the upgradation of nodal staging on completion of ANC, with a false-negative rate of less than 5%. This may be used to identify patients with a low risk of axillary metastasis, who can avoid ANC.
Assessment of manual operation note documentation practice: a cross-sectional study
Authors: Tegegne Nega Getachew , Fentie Demeke Yilkal , Tegegne Biresaw Ayen , Admassie Belete Muluadam 
Published: August 2023

Background:
Operation note documentation captures the key findings and subtle elements of a surgical strategy and is crucial for patient safety. Poor operation note documentation can negatively influence postoperative patient care. This study aimed to assess manual operation note documentation practice.

Methods:
An institutional-based, cross-sectional study was conducted from 30 March to 30 April 2022, on 240 operation notes of patient data. Data were entered and analyzed by SPSS version 20. According to the RCSE, the Royal College of Surgeons of England, the practice of operation note documentation was rated excellent for each variable when it met 100%, good if it met more than 50%, and poor if it met less than 50% of the operation notes of patient data.

Results:
All operation notes (n=240) were handwritten. The practice of manual operation note documentation was deemed excellent in two (7.69%), good in 18 (69.2%), and poor in six (23.1%). Residents wrote 84.2% of the operation notes and surgeons and assistants were identified in greater than 94% of the notes, while anesthesia team members were identified in 90.8%. Estimated blood loss was documented in 4.2% of the notes, and the closure technique was described in 64.2%. The operation note templates did not include antibiotic prophylaxis, runner nurse name, or gauze and instrument counts. The urgency of the surgery and time of documentation had a negative relationship, and the seniority of the operation note writer had a positive relationship with manual operative note documentation practice.

Conclusions and recommendations:
Compared to the standard, all operation note documentation was incomplete and below the standard. We recommend that this comprehensive and specialized hospital administrator implement a new format for operation notes that incorporates RCSE requirements.
A cerebral lymphoma mimicking a meningioma: case report
Authors: Joudar Imane , Nasri Siham , Aichouni Narjisse , Kamaoui Imane , Skiker Imane 
Published: August 2023

Introduction:
Cerebral lymphoma is a rare and aggressive brain tumor. It accounts for 1% of all non-Hodgkin’s lymphomas (NHL) and 2% of all brain tumors. Untreated brain lymphoma has a very poor prognosis, with an overall life expectancy of around 1.5 months.

Case presentation:
The authors report the case of a 35-year-old patient, with no previous pathological history, who presented for 3 weeks with deafness and recently aggravated otalgia. In MRI, brain imaging revealed a formation initially suggestive of an aggressive meningioma, and the histological study of the operative specimen was in favor of a diffuse large-cell non-germ-center B NHL.

Clinical discussion:
Primary central nervous system lymphoma is an extra-nodal NHL localized to the brain, meninges, spinal cord, and eyes. In 90% of cases, these are diffuse large B-cell lymphomas, the other types being poorly characterized low-grade lymphomas, T-cell lymphomas, and Burkitt’s lymphomas. MRI with gadolinium contrast is the gold standard for diagnosis which enhancement is homogeneous and well-limited, frequently associated with perilesional vascular edema. In T2-weighted sequences, there is a weak signal with restricted diffusion on diffusion-weighted imaging. The management of brain lymphoma is currently based on chemotherapy with high-dose methotrexate combined with the other agents, mainly rituximab.

Conclusion:
Cerebral lymphoma remains a non-negligible entity of central nervous system tumors, which can be confused with several other tumors, mainly glial and meningioma.
Gastric lipoma in the pyloric antrum: a rare case report
Authors: Hussein Al-janabi Moatasem A. , Mohammad Jollanar G. , Mohsen Aya Y. , Alabbas Zeina , Rasheed Omeed , Kannan Samir , Daoud Ali K. 
Published: August 2023

Introduction and importance:
Gastric lipoma (GI) is a rare benign tumor of the stomach that arises from adipose tissue. It is often asymptomatic and is incidentally diagnosed on endoscopy or imaging studies.

Case presentation:
A 66-year-old male presented with epigastric pain and acid reflux. Upper gastrointestinal endoscopy revealed a 3-cm submucosal lesion in the pyloric antrum. The patient underwent a subtotal gastrectomy. The specimen was sent to the pathology department. Based on the microscopic findings, the diagnosis was a submucosal GI.

Discussion:
The diagnosis of GIs is usually made incidentally during imaging studies. Treatment options include endoscopic or surgical resection; however, conservative management can be considered in asymptomatic patients. Periodic radiological surveillance is recommended to monitor growth and assess for any malignant transformation.

Conclusion:
GI is a rare tumor that is usually asymptomatic but can present with nonspecific gastrointestinal symptoms. The diagnosis is confirmed through histological examination, and imaging techniques such as computed tomography or MRI can be useful in preoperative evaluation. Surgical resection remains the primary treatment, while endoscopic resection may be considered in certain cases.
Assessment of functional and cosmetic outcomes of Extended-Tubularized incised plate for mid-shaft and distal hypospadias as a modification of Snodgrass repair: a cross-sectional study
Authors: Alwaeli Hayder H. , Hasan Al-Timimi Hasanain F. , Ismail Mohammed B. 
Published: August 2023

Background:
Hypospadias is a congenital abnormality of anterior urethral and penile development where the urethral meatus is ectopically located on the ventral aspect of the penis. It is a relatively common condition affecting ~1 in 250 male birth. Extended-Tubularized Incised Plate (E-TIP) is a modification of Snodgrass repair by extending the midline incision to the apical part of the glans resulting in a more normal appearing location of the meatus and straight urinary stream without increasing the risk of complications.

Aim of study:
To evaluate functional and cosmetic outcomes of E-TIP repair for mid-shaft and distal hypospadias as a modification of Snodgrass repair.

Patient and method:
A prospective cross-sectional study including 53 cases of mid-to-distal hypospadias repaired with the E-TIP technique between November 2019 and February 2022 in Baghdad. The authors start with the standard technique described by Snodgrass, but the midline incision of the urethral plate extended up to the apical part of the glans tip, and tabularization started distally creating a slit-like a neomeatus. Outcome assessment depended on an objective evaluation of the following parameters: maximum flow rate, post-void residual, Hypospadias Objective Score Evaluation (HOSE) score, and direction of the urinary stream.

Results:
The mean age was 3.4±2.1 years, ranging from 0.6 to 9 years. The mean duration of follow-up was 14.4±6.9 months, and the location of the meatus was coronal in 16 patients (30%), subcoronal in 25 (47%), and mid-distal shaft in 12 (23%). The glans width was greater than or equal to 14 mm in 46 patients (87%) and less than 14 mm in 7 (13%). Q.max was above the fifth percentile of age-related uroflowmetry nomograms for healthy children 5–15 years old in 29 boys (93.5%) and below the fifth percentile in 2 (6.5%). Post-void residual urine was less than 10% of voided volume in 28 out of 31 boys (90%) and greater than 10% in 3 (10%). Regarding cosmetic outcomes, 50 boys (94%) had good penile appearance and their HOSE score greater than or equal to 14 with a slit-like meatus located at the tip of the glans, while 3 (6%) of them their score was less than 14. The overall mean HOSE score postoperatively for all patients was 15±0.9. Six patients (11%) had a deviated urinary stream and 47 (89%) had a straight stream.

Conclusion:
E-TIP repair is a good alternative to standard Snodgrass repair for mid-shaft to distal hypospadias with a good functional and cosmetic outcome, particularly the neomeatus position at the tip of the glans, which is similar to the normal one without increasing the risk of meatal stenosis.
Challenging diagnosis of sarcomatoid hepatic mesothelioma: a case report with review of literature
Authors: Mehta Kahan , Mehta Samir , Joshi Maurya , Bharadwaj Hareesha R. , Ardeshana Ghanshyam , Tenkorang Pearl O. 
Published: August 2023

Introduction:
Mesothelioma is a rare and aggressive cancer that is primarily caused by asbestos exposure. However, cases of mesothelioma without asbestos exposure suggest the involvement of other risk factors. Sarcomatoid mesothelioma, which is characterized by spindle-shaped cells, is a particularly aggressive subtype with limited treatment options.

Case presentation:
The authors present a case of a 72-year-old man with no history of asbestos exposure who presented with abdominal pain, fatigue, and weight loss. Imaging revealed a large cystic mass in the liver. A Liver biopsy confirmed the diagnosis of sarcomatoid mesothelioma. Immunohistochemistry results further supported this diagnosis. Due to the advanced stage and tumor size, surgical resection was not feasible. Palliative chemotherapy was initiated, but the patient’s condition deteriorated rapidly, leading to his demise.

Conclusion:
This case highlights the complexity of mesothelioma and the need for further research to identify the nonasbestos-related risk factors. Understanding alternative causative agents and mechanisms is crucial for the early detection, the development of targeted therapies, and improving patient outcomes. The presented case contributes to the existing literature and aligns with the Surgical CAse REport (SCARE) Criteria.
Long-Term Outcomes following Hybrid Breast Reconstruction
Authors: Silverstein Max L. , Momeni Arash 
Published: August 2023

Background:
Hybrid breast reconstruction combines free tissue transfer with implant placement. Various mesh products have been successfully used to secure the implant position in these reconstructions. In this study, the authors investigate the impact of mesh type on long-term outcomes following hybrid breast reconstruction.

Methods:
A retrospective analysis of all patients with at least 24 months of follow-up after immediate bilateral prepectoral hybrid breast reconstruction was performed. Univariate and multivariable regression analyses were used to evaluate long-term outcomes and compare breasts reconstructed with polyglactin mesh versus acellular dermal matrix (ADM).

Results:
Thirty-nine patients (78 breasts) who underwent hybrid breast reconstruction with an average follow-up period of 50.4 months (range, 27 to 73 months) were included in the study. Postoperative complications included hematoma (n = 2 [2.6%]), mastectomy skin necrosis (n = 12 [15.4%]), and fat necrosis (n = 6 [7.7%]). There were no instances of implant infection, implant exposure, or flap failure. Polyglactin mesh and ADM were used in 24 breasts and 54 breasts, respectively. Implant malposition and capsular contracture occurred more frequently in the polyglactin cohort leading to 10 (41.7%) instances of reoperation for implant replacement compared with only 1 (1.9%) in the ADM cohort (P < 0.001). On multivariable regression analysis, polyglactin mesh was associated with a 36-fold greater probability of requiring implant replacement compared with ADM (P = 0.006).

Conclusion:
ADM (versus polyglactin mesh) is associated with lower rates of capsular contracture and implant malposition in the context of hybrid breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
18F-FES Uptake in Radiation Pneumonitis
Authors: Mahalik Aparna , Chaudhary Beena , Kumar Rakesh , Tripathi Madhavi , Bal Chandrasekhar 
Published: August 2023

Abstract

18F-FDG uptake in radiation pneumonitis is well documented; however, the same is less so for 18F-floroestradiol (FES), which specifically binds to the estrogen receptors in vivo. We observed increased FES uptake in the right lung of an estrogen receptor positive breast cancer patient who had undergone right modified radical mastectomy followed by radiation therapy to chest wall. The possibility of FES uptake in radiation pneumonitis must therefore be kept in mind while interpreting FES PET.
Young Healthcare Workers’ Employment Status and Mental Distress over SARS-CoV-2 in Bolivia
Authors: John Lea , Solís-Soto María Teresa , Mühlhäusser Mira , Radon Katja 
Published: August 2023

AbstractBackgroundHealthcare workers (HCW) have been particularly affected by the SARS-CoV-2 pandemic as it influenced employment conditions and unemployment/insecure employment. Their deterioration is associated with mental distress.ObjectiveThe aim of the study was to assess the trajectory of mental distress among HCW graduates during the COVID-19 pandemic in relation to their employment status.MethodsWe compared the change in mental distress over time among recent HCW graduates who were formally employed, to those who were unemployed/insecurely employed during the pandemic. In 2018 and 2022, we prospectively surveyed HCW who were in their final year of study in 2018 in Bolivia. Information was collected on socio-demographic characteristics, employment status, and mental distress. Mental distress was assessed using the 12-item General Health Questionnaire. Generalized Estimating Equations were implemented to examine changes in mental distress over time and the role of employment status in this development. Of the 663 HCW at baseline, 116 could be followed up.FindingsOver the course of the pandemic, formal employment after graduation did not change the odds of mental distress (odds ratio (OR)=0.93 [95% confidence interval (CI) 0.13−6.83]). In contrast, unemployment/insecure employment statistically significantly increased the odds of mental distress (OR=2.10 [CI 1.05−4.24]) over time.ConclusionsEspecially in countries with limited social support for unemployed/insecurely employed citizens, interventions and policies to prevent mental distress among newly graduated HCW are important. This is particularly relevant in the face of crises such as the COVID-19 pandemic.
Design and dynamic analysis of alpha solar rotary mechanism for China Space Station
Authors: Zhu Jinyao , Niu Cong , Chen Jinbao , Wang Chen , Liu Dianfu , Yang Decai 
Published: August 2023

Purpose
The purpose of this study is to describe the proposed alpha solar rotary mechanism (ASRM) and how it is used to accurately modify the solar array of the China Space Station (CSS) in orbit to maintain continuous tracking of the sun to provide power. It also highlights the need to evaluate the performance of the ASRM and predict potential failure modes in various extreme scenarios.

Design/methodology/approach
To evaluate the performance of the ASRM, a dynamic model was created and tested under normal and faulty conditions. In addition, a multidirectional stiffness test was conducted on the prototype to verify the accuracy of the ASRM's dynamic model. The high-precision ASRM model was then used to predict potential failure modes and damaged parts in various extreme scenarios.

Findings
The simulation results were in good agreement with the test results, with a maximum error of less than 8.85%. The high-precision ASRM's model was able to accurately predict potential failure modes and damaged parts in extreme scenarios, demonstrating the effectiveness of the proposed model and simulation evaluation test.

Originality/value
The proposed high-precision ASRM model and simulation evaluation test provide an effective way to evaluate the structural safety and optimize the design of the spacecraft. This information can be used to improve the performance and reliability of the CSS's solar array and ensure continuous power supply to the station.
Optimal strategies for a multi-channel recycling supply chain in the clothing industry: considering consumer types
Authors: Huang He , Wang Weining , Yin Yujie 
Published: August 2023

PurposeThis study aims to focus on the clothing recycling supply chain and aims to provide optimal decisions and managerial insights into supply chain strategies, thereby facilitating the sustainable development of the clothing industry.Design/methodology/approachBased on previous single- and dual-channel studies, game theory was employed to analyze multiple recycling channels. Concurrently, clothing consumer types were integrated into the analytical models to observe their impact on supply chain strategies. Three market scenarios were modeled for comparative analysis, and numerical experiments were conducted.FindingsThe intervention of fashion retailers in the clothing recycling market has intensified competition across the entire market. The proportions of various consumer types, their preferences for online platforms and their preference for the retailer’s channel influence the optimal decisions and profits of supply chain members. The diversity of recycling channels may enhance the recycling volume of clothes; however, it should meet certain conditions.Originality/valueThis study extends the existing theory from a channel dimension by exploring multiple channels. Furthermore, by investigating the classifications of clothing consumers and their influence on supply chain strategies, the theory is enhanced from the consumer perspective.
Systematic review of religiosity and social responsibility
Authors: Amer Mahmoud 
Published: August 2023

PurposeThe objective of this study is to establish a link between religiosity and Corporate Social Responsibility (CSR) by conducting a systematic literature review in the field of CSR and religiosity. This will be achieved by screening all available electronic databases.Design/methodology/approachThis paper is a literature review paper using the systematic review – Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, with a practical focus on empirical research to summarize the total effect or outcome of these empirical findings. The methodology includes inclusion and exclusion criteria for the final selection of articles.FindingsIn this paper, 31 articles published in well-known CSR journals after the year 2015 were included. The majority of the literature confirms a positive direct/indirect relationship between religiosity and CSR.Research limitations/implicationsThis paper is limited to the considered databases and the identified searching protocols. Changes in the referred databases or search protocols may affect the results, as results outside these limitations were not considered in this study.Practical implicationsThis study can serve as a guide for researchers in applying the PRISMA approach. Furthermore, it contributes to the field of religiosity and CSR by offering a comprehensive review of the most recent related publications.Originality/valueThis article is unique as it applies the PRISMA framework to conduct the literature review. It is also the first literature study in the field of religiosity and CSR.