bluuebunny/crossref_metadata_2025_split huggingface dataset:
A non-randomized concurrent controlled trial of myofunctional treatment in the mixed dentition children with functional mouth breathing assessed by cephalometric radiographs and study models
Authors: Habumugisha Janvier , Cheng Bo , Ma Shu-Yu , Zhao Min-Yue , Bu Wen-Qing , Wang Gao-Li , Liu Qiong , Zou Rui , Wang Fei 
Published: August 2022

AbstractObjectivesThis study aimed to examine the clinical effects of myofunctional treatment on children with functional mouth breathing by cephalometric radiographs and study models.MethodsA total of 224 children (6–10 years old; 114 males and 110 females; SNA°: 82.24 ± 1.67°; ANB°: 2.79 ± 0.80°, 28° < SN-GoGn° < 37°) formed three groups: MB-M group (mouth breathers with myofunctional treatment,n = 75); MB-N group (mouth breathers with no treatment,n = 70); NB group (nasal breathers with no treatment,n = 79). A blind evaluation of cephalometric radiographs and study models was conducted at T1(pre-study) and T2 (post-study), respectively.ResultsTwo hundred four children (MB-M:66, MB-N:68, NB:70) completed the present study. At T1, MB-M and MB-N groups, compared to their NB counterpart, had greater anterior lower facial height(P < 0.01) and overjet(P < 0.001) but shorter overbite and maxillary canines width (P < 0.001). At T2, the MB-N group exhibited a higher ANB angle, anterior lower facial height, and overjet, but shorter overbite and maxillary canines width (P < 0.001). From T1 to T2, the anterior lower facial height increased, overbite and the maxillary canines width further decreased in the MB-N group (P < 0.001). However, in the MB-M group, the incisors were retracted, overbite increased (P < 0.001), anterior lower facial height increased insignificantly (P > 0.05), and maxillary canines width increased slightly (P < 0.05). In the NB and MB-M groups, the mandible showed a normal tendency to grow forward, whereas, in the MB-N group, the mandible showed a tendency to grow downward (P < 0.001).ConclusionsMouth breathers demonstrated increased anterior facial height and overjet but reduced overbite and maxillary arch width, which improved significantly following myofunctional treatment.Trial registrationTCTR:TCTR20220401001. Registered 1stApril 2022-Retrospectively registered.
Health care utilization in young adults with childhood physical disabilities: a nationally representative prospective cohort study
Authors: Fergus Kirkpatrick B. , Zambeli-Ljepović Alan , Hampson Lindsay A. , Copp Hillary L. , Nagata Jason M. 
Published: August 2022

Abstract
Background
Young people with physical disabilities face barriers to accessing health care; however, few studies have followed adolescents with physical disabilities longitudinally through the transition of care into adulthood. The objective of this study was to investigate differences in health care utilization between adolescents with physical disabilities and those without during the transition period from adolescent to adult care.

Methods
We utilized the National Longitudinal Study of Adolescent to Adult Health, a prospective cohort study following adolescents ages 11–18 at baseline (1994–1995) through adulthood. Baseline physical disability status was defined as difficulty using limbs, using assistive devices or braces, or having an artificial limb; controls met none of these criteria. Health care utilization outcomes were measured seven years after baseline (ages 18–26). These included yearly physical check-ups, unmet health care needs, and utilization of last-resort medical care, such as emergency departments, inpatient hospital wards, and inpatient mental health facilities. Multiple logistic regression models were used to predict health care utilization, controlling for age, sex, race/ethnicity, insurance status, and history of depression.

Results
Thirteen thousand four hundred thirty-six participants met inclusion criteria, including 4.2% with a physical disability and 95.8% without. Half (50%) of the sample were women, and the average age at baseline was 15.9 years (SE = 0.12). In logistic regression models, those with a disability had higher odds of unmet health care needs in the past year (Odds Ratio (OR) 1.41 95% CI 1.07–1.87), two or more emergency department visits in the past five years (OR 1.34 95% CI 1.06–1.70), and any hospitalizations in the past five years (OR 1.36 95% CI 1.07–1.72). No statistically significant differences in preventive yearly check-ups or admission to mental health facilities were noted.

Conclusions
Young adults with physical disabilities are at higher risk of having unmet health care needs and using last-resort health care services compared to their non-disabled peers.
The impact of lockdown on young people with genetic neurodevelopmental disabilities: a study with the international participatory database GenIDA
Authors: Coutelle Romain , Boedec Morgane , Vermeulen Karlijn , Kummeling Joost , Koolen David A. , Kleefstra Tjitske , Fournier Camille , Colin Florent , Strehle Axelle , Geneviève David , Burger Pauline , Mandel Jean-Louis 
Published: August 2022

AbstractBackgroundPrevious publications suggested that lockdown is likely to impact daily living issues of individuals with intellectual disabilities. The authors notably suspected an intensification of behavioural, eating and sleep problems.MethodsTo test these hypotheses, we conducted an international online survey about the impact of COVID-19-associated first lockdown on people with genetic neurodevelopmental disorders. This survey was carried out using GenIDA, an international participatory database collecting medical information on genetic neurodevelopmental disorders. Patients’ relatives took part in this online survey from 30/04/2020 to 09/06/2020. This survey adapted from GenIDA standard questionnaire requested information on diagnosis, lifestyle and was based on yes/no answers to questions regarding behaviour, diet, and sleep, in the 6-months period before lockdown and during lockdown. We also asked relatives to evaluate the intensity of these problems by severity level. Finally, relatives could freely comment in open fields on the medical and/or quality of life problems they had encountered during lockdown.ResultsIn total 199 participants—144 children and 45 adults—with neurodevelopmental disorders (intellectual disability (79.4%) and/or autism spectrum disorder (21.6%)) of various genetic origins, with near-equal male/female (96/103) contribution and originating mainly from Europe and Northern America, were included. The average lockdown duration at time of the survey was 57 days. We did not find differences in the frequency of behavioural, eating and sleep problems before and during lockdown. Moreover, there was no apparent difference in the intensity of eating and sleep disorders between both periods. However, for persons with behavioural problems at both periods, relatives reported an increase in aggressivity, self-aggressivity, depressiveness, stereotypies, and restricted interests during lockdown, all of which might be interpreted as consequences of a lack of stimulation or a reaction to unexpected changes in daily habits.ConclusionsOur results support previous studies that suggest that the negative impact of lockdown does not depend on the intellectual disability per se but on the associated comorbidities such as behavioural disorders. This study addresses the need for prevention of behavioural disturbance in the vulnerable population with genetic neurodevelopmental disabilities.
Design and implementation of a health systems science curriculum at a large teaching hospital
Authors: Harcher Elizabeth , Fakolade Adeola , Gordon Dana , Nedorost Susan 
Published: August 2022

Abstract
Background
Physicians must increasingly lead change for improvement in the value of health care for individuals and populations. Leadership, stewardship, and population health competencies are not explicitly part of the Accreditation Council for Graduate Medical Education (ACGME) requirements and are best appreciated in the context of Health Systems Science (HSS).
HSS education is best approached at the institutional level, yet almost all graduate medical education (GME) curriculum is at the program level. We describe the process of designing and implementing an institutional HSS GME curriculum in a hospital-based sponsoring institution.

Methods
A group of diverse stakeholders drafted a curriculum to build competencies in leadership, stewardship, and population health, which was further refined by our Graduate Medical Education Committee (GMEC) and Resident Forum in the academic years 2015–2017. The refined curriculum was implemented at the institutional level of a large urban teaching hospital with over 80 ACGME accredited programs in the 2017–2018 academic year, participation was tracked and impact surveys were conducted.

Results
All programs participate in at least parts of the curriculum with sustained use. Annual surveys show a progression in assessment of our target competencies and/or opportunities to reflect and provide feedback. The annual program review meeting and GMEC meetings are used to troubleshoot and identify new curricular opportunities.

Conclusion
This innovative institutional curriculum has been sustained for over four years and we believe that other training institutions with similar goals will find our experience implementing an institutional curriculum translatable to their clinical learning environment.
Non-pharmacological delirium prevention practices among critical care nurses: a qualitative study
Authors: Liang Surui , Chau Janita Pak Chun , Lo Suzanne Hoi Shan , Zhao Jie , Liu Wenhui 
Published: August 2022

Abstract
Background
Delirium is common among critically ill patients, leading to increased mortality, physical dependence, and cognitive impairment. Evidence suggests non-pharmacological delirium prevention practices are effective in preventing delirium. However, only a few studies explore the actual implementation and its associated challenges among critical care nurses.

Aim
To explore critical care nurses’ perceptions of current non-pharmacological delirium prevention practices in adult intensive care settings, including delirium screening, early mobilisation, sleep promotion, family engagement, and sensory stimulation.

Methods
A qualitative design adopting a thematic analysis approach. Semi-structured interviews with 20 critical care nurses were conducted in ten acute hospitals in mainland China.

Results
Three themes emerged: (a) importance of family engagement; (b) influence of organisational factors, and (c) suggestions on implementation. The implementation of non-pharmacological delirium prevention practices was limited by a strict ICU visitation policy, lack of routine delirium screening and delirium training, light and noise disturbances during nighttime hours, frequent resuscitation and new admissions and strict visitation policy. Case-based training, adopting a sensory stimulation protocol, and family engagement may be enablers.

Conclusion
ICU care routine that lacks delirium assessment and the strict family visitation policy made it challenging to implement the complete bundle of non-pharmacological practices. Resource deficiency (understaffing, lack of training) and ICU environment (frequent resuscitation) also limited the implementation of non-pharmacological practices. Clinicians could implement case-based training and sensory-stimulation programs and improve communication with family caregivers by instructing family caregivers to recognise delirium symptoms and delirium prevention strategies.
Healthcare providers’ experiences in hospital resuscitation of patients with COVID-19: a qualitative study
Authors: Goodarzi Afshin , Khodaveisi Masoud , Abdi Alireza , Salimi Rasoul , Oshvandi Khodayar 
Published: August 2022

Abstract
Background
The COVID-19 epidemic has globally challenged medical practices, including cardiopulmonary resuscitation (CPR). Numerous challenges affect healthcare providers (HCPs) who are members of the resuscitation team and the resuscitation process in COVID-19 patients. As a result, HCPs may experience different dilemmas about CPR. Failure to recognize these experiences can harm both HCPs and patients. This study aimed to explore the HCP’s experiences of CPR in patients with COVID-19.

Methods
A qualitative study was conducted using semi-structured interviews with 26 participants in the emergency departments of Besat, Golestan, and Imam Reza hospitals (in the west of Iran) using the hermeneutic phenomenology approach. The data were analyzed using the 6-step Smith interpretative phenomenological analysis (IPA) method.

Results
The mean age of the participants was 38 years. Most of them (61.5%) were male and had a Bachelor’s degree in nursing (46.1%).The data analysis resulted in extracting four super-ordinate and nine sub-ordinate themes. “Human aspects of Care”, “Perceived Psychological Effects of Resuscitation in COVID-19”, “HCP’s perceptions of factors affecting the resuscitation process in COVID-19”, and “Perceived differences in COVID-19 resuscitation compared to non-COVID patients” were super-ordinate themes.

Conclusions
The participants experienced a wide range of difficult feelings and emotions while resuscitating the patients with COVID-19, suggesting the effect of the COVID-19 epidemic on HCPs and the resuscitation process. They experienced stress and fear, and the resuscitation process was influenced by their compassion, underlying patient conditions, resuscitation futility, and participants’ fatigue or lack of oxygen due to the use of personal protective equipment (PPE).
Validity and reliability study of clinician attitude towards rural health extension program in Ethiopia: exploratory and confirmatory factor analysis
Authors: Gebremedhin Merhawi , Gebrewahd Esie , Stafford Lauryn K. 
Published: August 2022

Abstract
Background
The Ethiopian health extension program (HEP) is an innovative community-based strategy aimed at disease prevention and health promotion. While health extension workers (HEWs) are its front-line workers, the involvement of clinicians remains an integral part. The goals of this study were to: (1) assess the correlation of clinician attitude with predictors and (2) assess the reliability and validity of the survey instrument.

Methods
A cross-sectional study design was utilized to collect data from a sample of 1239 clinicians using 28 items of attitude questions. Exploratory factor analysis (EFA) was applied to create the latent variables. Oblique Promax type rotation with factor loading (> 0.5) was used. Cronbach’s alpha was used to assess reliability, with a level of > 0.7 suggesting good reliability. Confirmatory factor analysis (CFA) was undertaken, with the values of Root Mean Square Error Administration (RMSEA) < 0.08, Standardized Root Mean Square Residual (SRMR) < 0.05, comparative fit index (CFI) 0.9–0.95, and Tucker-Lewis index (TLI) 0.9–0.95 suggesting acceptable model fit. A linear regression analysis was conducted.

Results
EFA produced two latent variables which explained 93.2% of the total variance. The latent variables were labeled as perceived attitude towards the skill of HEWs (F1), and perceived attitude towards the impact of HEP (F2). Internal reliability for the 28 items was reported with a Cronbach’s alpha of 0.94, and for F1 and F2 it was 0.91 and 0.90, respectively. CFA was done and RMSEA was reported at 0.04, SRMR was 0.03, and CFI and TLI were each 0.97. The value of clinician attitude increased by 3.5, 95% CI (1.5, 5.3), P-value < 0.001 for those who have been exposed to the HEP program than non-exposed. Similarly, clinician attitude was lower for degree holders compared to those with diplomas by − 2.7, 95% CI (− 4.4, − 0.94), P-value < 0.002.

Conclusion
Clinician attitude increased as exposure to HEP increased. Clinician attitude towards HEP has two latent variables. Furthermore, the assessment tool demonstrated good reliability and validity. In conclusion, it is worthy valued for clinicians to receive orientation about HEP, and researchers and program evaluators can use this assessment tool.
Papillary renal neoplasm with reverse polarity may be a novel renal cell tumor entity with low malignant potential
Authors: Yang Tong , Kang Enhao , Zhang Longxiao , Zhuang Jie , Li Yujun , Jiang Yanxia , Wang Han , Yu Wenjuan , Zhang Wei 
Published: August 2022

Abstract
Aims
This study retrospectively investigated the morphological, immunohistochemical and molecular genetic features of papillary renal neoplasm with reverse polarity (PRNRP), a recently described renal tumor.

Methods and results
Eleven cases of PRNRP were collected, and 16 cases of type I and 9 cases of type II papillary renal cell carcinoma were included as a control series. Pathological features were evaluated based on HE staining and immunohistochemistry. KRAS exon 2 and BRAF V600E mutations were detected by Real-time PCR and Sanger sequencing. Fluorescence in situ hybridization was conducted for identification of chromosomal abnormalities.
Hemosiderin deposition was found in a small amount of tumor cells in 6 cases. Multifocal or patchy necrosis (5/11), small focal invasion of the pseudocapsules or renal parenchyma (6/11), and breakthrough of renal capsule with nerve invasion (1/11) were revealed, inconsistent with the previous view that the tumor lacks necrosis and intercellular hemosiderin. Immunohistochemical staining (diffusely positive for CK7 and GATA3, negative for CD117 and vimentin, and negative to weakly positive for P504S) and high frequency of KRAS mutations in exon 2 (9/10) supported the identification and inclusion of our cases. Chromosome 7 trisomy (1/7), chromosome 17 trisomy (0/7) and chromosome Y deletion (0/5 male patients) were seldom detected in this tumor.
All patients were alive without metastasis or recurrence at the end of the follow-up.

Conclusion
Our findings may highlight the possibility of a low malignant potential of this emerging entity. We suggest that the tumor be classified as a novel renal cell tumor subtype independent of papillary renal cell carcinoma.
A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
Authors: Das Rina , Sobi Rukaeya Amin , Sultana Al-Afroza , Nahar Baitun , Bardhan Pradip Kumar , Luke Laura , Fontaine Olivier , Ahmed Tahmeed 
Published: August 2022

Abstract
Background
Diarrhea is the second deadliest disease for under-five children globally and the situation is more serious in developing countries. Oral rehydration solution (ORS) is being used as a standard treatment for acute watery diarrhea for a long time. Our objective is to compare the efficacy of amino acid-based ORS “VS002A” compared to standard glucose-based WHO-ORS in infants and young children suffering from acute non-cholera watery diarrhea.

Methods
It is a randomized, double-blind, two-cell clinical trial at Dhaka Hospital of icddr,b. A total of 312 male children aged 6–36 months old with acute non-bloody watery diarrhea are included in this study. Intervention arm participants get amino acid-based ORS (VS002A) and the control arm gets standard glucose-based WHO-ORS. The primary efficacy endpoint is the duration of diarrhea in the hospital.

Discussion
Oral rehydration therapy (ORT) with the present ORS formulation has certain limitations - it does not reduce the volume, frequency, or duration of diarrhea. Additionally, the failure of present standard ORS to significantly reduce stool output likely contributes to the relatively limited use of ORS by mothers as they do not feel that ORS is helping their child recover from the episode of diarrhea. Certain neutral amino acids (e.g., glycine, L-alanine, L-glutamine) can enhance the absorption of sodium ions and water from the gut. By using this concept, a shelf-stable, sugar-free amino acid-based hydration medicinal food named ‘VS002A’ that effectively rehydrates, and improves the barrier function of the bowel following infections targeting the gastrointestinal tract has been developed. If the trial shows significant benefits of VS002A use, this may provide evidence to support consideration of the use of VS002A in the present WHO diarrhea management guidelines. Conversely, if there is no evidence of benefit, these results will reaffirm the current guidelines.

Trial registration
ClinicalTrials.gov NCT04677296. Registered on December 21, 2020.
A novel theatre-based behaviour change approach for influencing community uptake of schistosomiasis control measures
Authors: Sule May N. , Mosha Justina , Soboka Teshome Emana , Kinung’hi Safari M. , Sfynia Chrysoula , Rafiq Kamran , Dower Alex , Comparet Marianne , Bewley Emma , Angelo Teckla , Beshah Feleke Zewge , Templeton Michael R. 
Published: August 2022

Abstract
Background
Appropriate behaviour change with regard to safe water contact practices will facilitate the elimination of schistosomiasis as a public health concern. Various approaches to effecting this change have been trialled in the field but with limited sustainable outcomes. Our case study assessed the effectiveness of a novel theatre-based behaviour change technique (BCT), in combination with cohort awareness raising and capacity training intervention workshops.

Methodology
Our study was carried out in four rural communities in the Mwanza region of Tanzania and in the semi-urban town of Kemise, Ethiopia. We adapted the Risk, Attitude, Norms, Ability and Self-regulation (RANAS) framework and four phases using a mixed methods approach. Participatory project phase engagement and qualitative formative data were used to guide the design of an acceptable, holistic intervention. Initial baseline (BL) data were collected using quantitative questionnaire surveys with 804 participants in Tanzania and 617 in Ethiopia, followed by the theatre-based BCT and capacity training intervention workshops. A post-intervention (PI) survey was carried out after 6 months, with a participant return rate of 65% in Tanzania and 60% in Ethiopia.

Results
The intervention achieved a significant improvement in the knowledge of schistosomiasis transmission being associated with poorly managed sanitation and risky water contact. Participants in Tanzania increased their uptake of preventive chemotherapy (males: BL, 56%; PI, 73%, females: BL, 43%; PI, 50%). There was a significant increase in the selection of sanitation (Tanzania: BL, 13%; PI, 21%, Ethiopia: BL, 63%; PI, 90%), safe water and avoiding/minimising contact with infested waters as prevention methods in Tanzania and Ethiopia. Some of the participants in Tanzania followed on from the study by building their own latrines.

Conclusions
This study showed that substantial positive behaviour changes in schistosomiasis control can be achieved using theatre-based BCT intervention and disease awareness training. With the appropriate sensitisation, education and stakeholder engagement approaches, community members were more open to minimising risk-associated contact with contaminated water sources and were mobilised to implement preventive measures.

Graphical Abstract