bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a corrective model of short-term radon concentrations to estimate annual effective doses in the primary schools of the Doukkala-Abda region, Morocco
Authors: Ouakkas Saad , Boukhair Aziz , Abdo Maged Ahmed Saleh , Benjelloun Mohammed 
Published: April 2022

In order to assess the radiological impact of radon on >250,000 students, the total annual effective dose was estimated inside 204 Moroccan primary schools sampled in the Doukkala-Abda region. The measurement of indoor radon concentrations was conducted using the LR115 detector for each month, each season and throughout the year. The evolution of indoor radon concentrations showed a decrease in annual average radon concentrations of 20–26% and 10–14%, respectively, compared to the monthly and seasonal annual average radon concentrations. For this purpose, a corrective model of short-term radon concentrations was developed to calculate the seasonal correction factors in order to estimate the annual indoor radon concentrations. For the qualitative evaluation of these factors, a percentage of deviation between the measured and estimated annual radon concentrations was calculated. Almost half of the estimated annual concentrations were 10% less than the measured concentration and the majority of these estimated values were within 40%. The estimated total annual effective doses received by students, except those in the Sidi Bennour city, were higher than the world average (1.15 mSv/y). Nevertheless, all these doses remained below the permissible limit recommended by the International Commission on Radiological Protection (3–10 mSv/y).
Eyes wide open to avoid misleading diagnosis and treatment planning
Authors: Pinheiro Isabela Sales , Campos Marcio José da Silva , Reis Luisa Gatti , Mota Júnior Sergio Luiz , Vitral Robert Willer Farinazzo 
Published: April 2022

Introduction: The treatment of impacted and transposed teeth is a challenge for clinical practice. A precise assessment of the relative position of the transposed tooth could lessen the risks of adverse effects, such as root resorption and periodontal problems. Description of the case: An 18-year-old patient went to the Orthodontic Department of the Federal University of Juiz de Fora, Brazil for a re-evaluation of the orthodontic treatment to which she had been receiving since the age of 12. Attempted traction of an impacted maxillary canine resulted in root resorption, marked mobility and alteration in the position of adjacent teeth as well as loss of alveolar bone in the anterior region of the maxilla. This tooth was not only partially transposed, but it also had ankylosis, external and internal tooth resorption, which indicated the need for tooth extraction. A change was made to the treatment plan, with the extraction of the canine, bone graft and mesial movement of the posterior teeth. Results: All the spaces were closed at the end of treatment, with normal overbite and overjet. At the follow-up, the teeth position, the shape of dental arches, disocclusion guides and dental occlusion were preserved. The bone graft in the maxilla showed height and mineral density stability. Conclusion: The presence of the maxillary permanent canines in the dental arch is important for both aesthetics and a functional occlusion. However, despite the importance of their maintenance in the arch, it is well advised that each case be analysed individually.
Ultrasound Use by Upper Extremity Surgeons in 2020: A Survey of ASSH Members
Authors: Demino Cory , Koesarie Kathleen , Smith Jay , Fowler John R. 
Published: April 2022

Background: The use of musculoskeletal ultrasound (US) among hand surgeons appears to be increasing. The purpose of this study was to determine the utilization patterns and attitudes regarding US among American Society for Surgery of the Hand (ASSH) members in 2020 as well as the changes in usage patterns since a previous survey in 2015. Methods: In 2020, an updated and expanded 27-question survey was distributed to 4852 members of the ASSH. Questions assessed respondent demographics, training, and practice patterns, and access, utilization, training, and opinions pertaining to US. Results: A total of 418 surveys (8.6%) were analyzed. Compared to 2015, there was an increase in the percentage of respondents using US for diagnostic purposes (51%-68%), as well as having personal access to US machines (43% to 58%). US use to assist in diagnosing carpal tunnel syndrome increased from 19% to 27%. The most common reason for using US was convenience and practice efficiency, while the most common reasons for not using US was no machine access. In 2020, 33% of respondents performed US-guided injections. Conclusions: Compared to 2015, the majority of responding upper extremity surgeons now have personal access to US machines. Utilization of diagnostic US appears to be increasing, and two-thirds of respondents believed that US use will continue to increase among upper extremity surgeons.
Nurses in clinical trials: perceptions of impact on the research enterprise
Authors: Jones Carolynn T , Griffith Catherine A , Fisher Cheryl A , Grinke Kathleen A , Keller Rosemary , Lee Hyacinth , Purdom Michelle , Turba Elyce 
Published: April 2022

Background Clinical Research Nurses practice across a wide spectrum of roles and settings within the global research enterprise. Clinical Research Nurses working with clinical trials face a dual fidelity in their role, balancing integrity of the protocol and quality care for participants. Aims The purpose of this study was to describe Clinical Research Nurses’ experiences in clinical trials, educational preparation, and career pathways, to gain a deeper understanding of clinical research nursing contributions to the clinical research enterprise. Methods An internet-based survey was conducted to collect demographic data and free text responses to four open-ended queries related to the experience of nurses working in clinical trials research, educational preparation, and role pathways. Qualitative content analysis was used to analyze free text responses. The study was guided by the Clinical Research Nursing Domain of Practice and Duffy’s Quality Caring Model of relationship centered professional encounters. Results Forty clinical research nurses responded to the open-ended questions with themes related to dual fidelity to study participants and protocols, relationships and nursing care, interdisciplinary team membership and contributing to science, emerging from the data. Gaps in educational preparation and professional pathways were identified. Conclusion This study provides insights to unique clinical research nurse practice contributions in the clinical trial research enterprise within a context of Duffy’s Quality Caring Model.
Who’s included? The role of the Clinical Research Nurse in enabling research participation for under-represented and under-served groups
Authors: Beer Kelly , Gentgall Melanie , Templeton Nicola , Whitehouse Claire , Straiton Nicola 
Published: April 2022

Background There is a global call for more inclusive clinical research that is representative of all populations, particularly those historically under-represented or under-served. A lack of broad representation results in disproportionate health outcomes and limits the applicability and translation of research findings. Aim Identify and describe barriers to participation across the research lifecycle and consider the role of the Clinical Research Nurse (CRN) in promoting inclusivity, including for Aboriginal and Torres Strait Islander Peoples within Australia. Discussion Review of recent literature and best practice identified barriers to research participation across the research process; at system, participant and practitioner levels. This discussion paper explores the role of the CRN; acting as enablers, facilitators and navigators, to mitigate participation barriers. Conclusion With their comprehensive understanding of the research process, clinical care pathways, reflective practices and participant-centred approaches, CRNs are uniquely positioned to advocate for greater equity in access to clinical research and to motivate stakeholders across the research enterprise to embed inclusive approaches in the design, conduct and dissemination of research. Implications for Practice An in-depth understanding of the research process, self, and cultural norms of the populations they serve is essential for CRNs to effectively advocate for equity in access to research.
Evolution of quality indicators in acute stroke during the RACECAT Trial: Impact in the general population
Authors: Olivé-Gadea Marta , Pérez de la Ossa Natalia , Jovin Tudor , Abilleira Sonia , Jiménez Xavier , Cardona Pere , Chamorro Angel , Flores Alan , Silva Yolanda , Purroy Francesc , Martí-Fabregas Joan , Rodríguez-Campello Ana , Zaragoza Josep , Krupinski Jerzy , Canovas David , Gomez Choco Manuel , Mas Natalia , Palomeras Ernest , Cocho Dolores , Aragonès Josep M , Repullo Carmen , Sanjurjo Eduard , Carrion Dolores , Catena Esther , Costa Xavier , Almendros M Cruz , Barceló Miquel , Monedero Jordi , Rybyeva Maria , Diaz Gloria , Ribó Marc 
Published: April 2022

Background: Acute ischemic stroke patients not referred directly to a comprehensive stroke center (CSC) have reduced access to endovascular treatment (EVT). The RACECAT trial is a population-based cluster-randomized trial, designed to compare mothership and drip-and-ship strategies in acute ischemic stroke patients outside the catchment area of a CSC. Aims: To analyze the evolution of performance indicators in the regions that participated in RACECAT. Methods: This retrospective longitudinal observational study included all stroke alerts evaluated by emergency medical services in Catalonia between February 2016 and February 2020. Cases were classified geographically according to the nearest SC: local SC (Local-SC) and CSC catchment areas. We analyzed the evolution of EVT rates and relevant workflow times in Local-SC versus CSC catchment areas over three study periods: P1 (February 2016 to April 2017: before RACECAT initiation), P2 (May 2017 to September 2018), and P3 (October 2018 to February 2020). Results: We included 20603 stroke alerts, 10,694 (51.9%) of which were activated within Local-SC catchment areas. The proportion of patients receiving EVT within Local-SC catchment areas increased (P1 vs. P3: 7.5% (95% confidence interval (CI), 6.4–8.7) to 22.5% (95% CI, 20.8–24.4) p < 0.001). Inequalities in the odds of receiving EVT were reduced for patients from CSC versus Local-SC catchment areas (P1: odds ratio (OR) 3.9 (95% CI, 3.2–5) vs. P3: OR 1.5 (95% CI, 1.3–1.7) In Local-SC, door-to-image (P1: 24 (interquartile range (IQR) 15–36), P2: 24 (15–35), P3: 21 (13–32) min, p < 0.001) and door-to-needle times (P1: 42 (31–60), P2: 41 (29–58), P3: 35 (25–50) p < 0.001) reduced. Time from Local-SC arrival to groin puncture also decreased over time (P1: 188 [151–229], P2: 190 (157–233), P3: 168 (127–215) min, p < 0.001). Conclusion: An increase in EVT rates in Local-SC regions with a significant decrease in workflow times occurred during the period of the RACECAT trial.
Local failure resistance of polypropylene fiber reinforced concrete plates subjected to projectile impact
Authors: Beppu Masuhiro , Mori Koki , Ichino Hiroyoshi , Muroga Yoichiro 
Published: April 2022

This study investigated local failure characteristics of polypropylene fiber reinforced concrete (PPFRC) plates subjected to projectile impact. Flexural and compression tests for two types of PPFRC specimens (PPFRC1 and PPFRC2) were conducted to examine mechanical properties of the PPFRC. The average flexural strength of PPFRC1 and PPFRC2 at a strain rate of 10−1/s were 12.2 N/mm2 and 10.4 N/mm2, respectively. The average compressive strength of PPFRC1 and PPFRC2 at a strain rate of 100/s were 58 N/mm2 and 74.9 N/mm2, respectively. Projectile impact tests for 60 mm- and 80 mm-thick PPFRC plates were conducted by using a 50 g-mass projectile collided at velocities corresponding to 193–423 m/s. Experimental results exhibited that the PPFRC plate had a higher effect of suppressing local failure than a plain concrete plate. Comparison of the tests results with the modified NDRC formula revealed that the limit scabbing thickness was 15–20% smaller than that of a plain concrete plate.
Factors influencing height gain in children born small for gestational age treated with recombinant growth hormone: what extent is puberty involved?
Authors: Arroyo Ruiz Ramón , Ballester Pérez Aránzazu , Leiva-Gea Isabel , Martínez-Aedo MªJosé , López-Siguero Juan Pedro 
Published: April 2022

Objective: The objective was to analyze the efficacy of recombinant human growth hormone (rhGH) treatment in children born small for gestational age (SGA) without catch-up growth treated before the onset of puberty, with follow-up until adult height. The influence of demographic and auxological factors on the final response evaluated as adult height and height gain was assessed. Patients and methods: A prospective longitudinal observational study performed in a tertiary hospital, involving SGA patients, who started treatment with rhGH between October 2003 and April 2015. Potential response predictors were evaluated by multiple regression analysis and receiver operating characteristic curves. Results: Of the initial 96 patients included, 61 patients (28 boys and 33 girls) reached adult height. Adult height gain in standard deviation (SDS) was 0.99 (0.8) and 1.49 (0.94), respectively ( p < 0.05). An adult height greater than −2 SDS was reached in 75% of the girls but only in 53% of the boys. The pubertal height gain was 22.6 (5.8) cm in boys and 18.8 (4.5) cm in girls. The multiple regression model obtained for total height gain explained 42% of the variability in this variable including sex, height gain during the first year, and the difference from target height at the start of treatment. A first-year height gain of 0.69 SDS was the optimal point for assessing a final height gain greater than 1.5 SDS with a specificity of 70% and a sensitivity of 71%. Conclusion: Most SGA patients achieve normalization of height above −2 SD, the percentage being higher in girls. According to our predictive model, height gain in the first year is the most important variable for predicting good response to treatment. During puberty, there is a loss of height SDS, probably due to a lower total pubertal gain with respect to the reference population, which is more marked in boys.
Is Peroneus longus autograft a better alternative to the Hamstring autograft for anterior cruciate ligament reconstruction? – A randomised control study
Authors: Vijay C. , Santosh M.S. , Avinash Chandra , Adarsh T. 
Published: April 2022

Purpose The anterior cruciate ligament in the knee is commonly prone to injuries. Reconstruction of this ligament with hamstring tendon has been time-tested but peroneus longus autograft is also gaining popularity. However, very limited literature is available comparing the two grafts. This study aims to compare the functional outcome and donor site morbidity between hamstrings and peroneus longus autograft in anterior cruciate ligament reconstruction. Methods A prospective randomised study was conducted on 45 patients, who underwent anterior cruciate ligament reconstruction. Patients were assigned into Hamstring group and the Peroneus longus group. Functional outcome was assessed using Lysholm score and Modified Cincinnati scores for the knee joint and American Orthopedics Foot and Ankle Scoring for ankle joint. Donor site morbidity was assessed by measuring flexion and extension strength of the knee and plantar flexion and eversion strength of the ankle by handheld dynamometer preoperatively and postoperatively at 6 months and 1 year follow up. Results Functional outcome of the knee showed significant improvement in peroneus longus group (p-value 0.002) compared to hamstring group. Even though there was minimal reduction in functional outcome of the ankle at 6 months follow-up in peroneus longus group, it improved at one year follow-up. While assessing the donor site morbidity at the knee joint, knee flexion strength showed improvement in the group (p-value 0.02) but reduced in the hamstring group where the hamstring tendon was harvested. Knee extension strength in the hamstring group scored marginally better than the peroneus longus group, which was not statistically significant (p-value 0.5). Conclusion Autologous peroneus longus tendon can be used as a graft of choice in anterior cruciate ligament reconstruction which showed promising results without compromising on the ankle function. Its usage as an alternative source of the graft may be more useful in multi-ligament injuries of the knee joint.
Assessment of the Quality of Current American Dental Association Clinical Practice Guidelines
Authors: London S.D. , Chamut S. , Fontelo P. , Iafolla T. , Dye B.A. 
Published: April 2022

Introduction: The American Dental Association (ADA) defines evidence-based dentistry (EBD) as “an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences.” Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Therefore, ADA CPGs are the most rigorous examples of EBD to inform clinical practice. CPGs should be of the highest level of quality to ensure the appropriateness and timeliness of clinical recommendations. Objectives: The aim of this study was to measure the methodological rigor and transparency of the ADA CPGs. Methods: Each ADA CPG was appraised by 4 independent assessors using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Quantitative quality scores were obtained for 6 domains and overall quality. In addition, assessors provided a qualitative analysis by providing comments for each item and an appraisal of the full recommendation. Results: A quality score of 75% was used as the threshold for high-quality guidelines. Using this metric, 6 of the current 10 current ADA CPGs were considered to be of high quality, 1 was slightly below the quality threshold, and 3 were considered marginal. Even among those evaluated to be high quality in overall assessment, certain domains did not reach the quality threshold of 75%. Conclusion: Overall, the ADA CPGs collectively provide high-quality guidance for the clinician. While the AGREE appraisal guidelines have been used in CPG development since 2016, there is still room for improvement in certain domains (i.e., stakeholder involvement, rigor of development, applicability, and editorial independence). Knowledge Transfer Statement: The results of this study summarize the methodological rigor and transparency of the 10 current ADA clinical practice guidelines. Since adoption of AGREE standards (2016), CPGs have been uniformly of high quality. The quality of older CPGs was somewhat lower but overall deemed acceptable. Thus, ADA CPGs may be used with confidence to inform practitioners of treatment options supported by rigorous evidence-based dentistry standards. However, there is still room for improvement in methodological quality.
A longitudinal analysis of immune escapes from HLA-B*13-restricted T-cell responses at early stage of CRF01_AE subtype HIV-1 infection and implications for vaccine design
Authors: Zhang Hui , He Chuan , Jiang Fanming , Cao Shuang , Zhao Bin , Ding Haibo , Dong Tao , Han Xiaoxu , Shang Hong 
Published: April 2022

Abstract
Background
Identifying immunogens which can elicit effective T cell responses against human immunodeficiency virus type 1 (HIV-1) is important for developing a T-cell based vaccine. It has been reported that human leukocyte antigen (HLA)-B*13-restricted T-cell responses contributed to HIV control in subtype B′ and C infected individuals. However, the kinetics of B*13-restricted T-cell responses, viral evolution within epitopes, and the impact on disease progression in CRF01_AE subtype HIV-1-infected men who have sex with men (MSM) are not known.

Results
Interferon-γ ELISPOT assays and deep sequencing of viral RNAs were done in 14 early HLA-B*13-positive CRF01_AE subtype HIV-1-infected MSM. We found that responses to RQEILDLWV (Nef106–114, RV9), GQMREPRGSDI (Gag226–236, GI11), GQDQWTYQI (Pol487–498, GI9), and VQNAQGQMV (Gag135–143, VV9) were dominant. A higher relative magnitude of Gag-specific T-cell responses, contributed to viral control, whereas Nef-specific T-cell responses were associated with rapid disease progression. GI11 (Gag) was conserved and strong GI11 (Gag)-specific T-cell responses showed cross-reactivity with a dominant variant, M228I, found in 3/12 patients; GI11 (Gag)-specific T-cell responses were positively associated with CD4 T-cell counts (R = 0.716, P = 0.046). Interestingly, the GI9 (Pol) epitope was also conserved, but GI9 (Pol)-specific T-cell responses did not influence disease progression (P > 0.05), while a D490G variant identified in one patient did not affect CD4 T-cell counts. All the other epitopes studied [VV9 (Gag), RQYDQILIEI (Pol113–122, RI10), HQSLSPRTL (Gag144–152, HL9), and RQANFLGRL (Gag429–437, RL9)] developed escape mutations within 1 year of infection, which may have contributed to overall disease progression. Intriguingly, we found early RV9 (Nef)-specific T-cell responses were associated with rapid disease progression, likely due to escape mutations.

Conclusions
Our study strongly suggested the inclusion of GI11 (Gag) and exclusion of RV9 (Nef) for T-cell-based vaccine design for B*13-positive CRF01_AE subtype HIV-1-infected MSM and high-risk individuals.