bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age- and sex-dependent differences in the morphology and composition of paraspinal muscles between subjects with and without lumbar degenerative diseases
Authors: Huang Rufeng , Pan Fumin , Kong Chao , Lu Shibao 
Published: August 2022

Abstract
Background
The quality of the paraspinal muscles has been recommended as a surrogate marker for the evaluation of the severity of the lumbar degenerative diseases (LDD). The purpose of this study is to determine the age- and sex-dependent differences in the morphology and composition of the paraspinal muscles between LDD and asymptomatic subjects.

Methods
We analyzed data from 370 patients and 327 asymptomatic volunteers aged between 18–85 years. The measurement of the cross-sectional area (CSA) of the erector spinae, multifidus, and psoas at the L4/5-disc level was performed by the magnetic resonance imaging (MRI). The fatty infiltration ratio (FI %) of the multifidus and erector spinae was calculated.

Results
FI % of the lumbar paraspinal muscles were significantly and positively correlated with the severity of LDD instead of the CSA. Males had greater CSA than females, and females showed higher FI % than males in the paraspinal muscles. With the increase of age, the CSA of the lumbar paraspinal muscles gradually decreased, and the psoas showed the most significant decreasing trend. However, the FI % gradually increased in both LDD and asymptomatic groups with aging.

Conclusion
Age- and sex-dependent differences were found in the morphology and composition of the paraspinal muscles between subjects with and without LDD. Further long-term follow up investigations and basic studies will continue to confirm the natural history of the paraspinal muscles with aging and their association with LDD.
Intestinal-type adenocarcinoma presenting as a female periurethral mass
Authors: Zeng Ting , Liu Qiang , Zhu Shuxia , Xu Ruihua 
Published: August 2022

Abstract
Background
The periurethral mass in the female is a rare clinical entity and most of the lesions are benign. We present an unusual case of a periurethral mass found to be intestinal-type adenocarcinoma which has not been previously reported in the literature.

Case presentation
A 58-year-old woman was referred to our hospital with acute urinary retention. She complained of frequency, urgency and progressive obstructive urinary symptoms for the last 3 months. A pelvic magnetic resonance imaging scan showed a soft tissue mass of 5 × 4 cm surrounding the entire urethra. A needle biopsy was done and revealed adenocarcinoma with intestinal-type features. The tumor was removed by a simultaneous laparoscopic abdominal and transperineal approach. The pathological results showed a positive surgical margin and urethra and vagina wall invasion. The neoplastic cells were positive for CK20, CDX-2, CerbB-2, MSH2, MSH6, MLH1, PMS2 and P53. The patient received adjuvant systemic chemotherapy comprising S-1 and oxaliplatin. Follow-up with pelvic MRI 6 months after surgery showed no signs of local recurrence.

Conclusions
We have reported the first case of the primary periurethral adenocarcinoma of intestinal type. There are currently no standardized protocols for the diagnosis, clinical course, and treatment of this rare tumor. This case study can aid decision-making regarding the diagnosis and treatment of this tumor.
Effect of two artificial aging protocols on color and gloss of single-shade versus multi-shade resin composites
Authors: El-Rashidy Aiah A. , Abdelraouf Rasha M. , Habib Nour A. 
Published: August 2022

AbstractThe long-term color stability and gloss retention of resin composites are among the crucial factors that affect the clinical longevity of esthetic restorations, especially in anterior teeth. This study evaluated the effect of artificial aging by immersion in different storage media and thermocycling on color and gloss of dental single-shade resin composite (Omnichroma) versus multi-shade one (Filtek Z350XT). One hundred resin-composite disc-shaped specimens were used, 50 from each group, Omnichroma and Filtek Z350XT. Ten specimens from each material acted as control group (incubated in saliva). For each material, 40 specimens were divided according to the artificial-aging protocol (immersion at 37 °C for 12 days or thermocycling for 10,000 cycles) and storage media (tea, red wine). Color and gloss were measured before and after artificial aging. Color difference (∆E00) was compared with perceptibility threshold and acceptability threshold. Data were statistically analyzed; independent t test was used to compare results between two tested materials, while two-way ANOVA was used to compare results among the different immersion media within the same material. Artificial aging (immersion or thermocycling) in tea and red wine led to significant color changes and gloss reduction in both materials (P < 0.05), in contrast to control group. Red wine produced highest color differences. Both dental resin-composites; the single-shade (Omnichroma) and multi-shade (Filtek Z350XT) displayed unacceptable discoloration and gloss reduction after artificial-aging in tea and red-wine by immersion or thermocycling simulating one-year clinical-service.
Maximum surgical blood order schedule for flap reconstruction in oral and maxillofacial cancer patients
Authors: Zhao Yili , Li Xueer , Wang Yuepeng , Chen Yanhong , Li Dandan , Jiang Qiming , Wang Yan 
Published: August 2022

Abstract
Background
We established a MSBOS for flap reconstruction in oral and maxillofacial cancer patients.

Method
We enrolled 2080 cases of oral and maxillofacial flap reconstruction from January 1, 2010 to December 31, 2021. Patient data were collected, including age, sex, BMI, preoperative Hb levels, ASA grade, T stage, flap type, tumor location, and bone flap. Scoring criteria were established based on a multivariate model of independent risk variables and their odds ratios. Two flap-type groups were divided into low-risk, intermediate-risk and high-risk groups by the scoring criteria, and analyzed using univariate and multivariate logistic regression. Perioperative transfusion analysis identified independent risk factors at various Hb levels. The cumulative percentage of patients requiring perioperative blood transfusion for each surgical procedure was calculated to establish the MSBOS.

Results
(1) Regression analysis showed that BMI, tumor T staging, ASA grade, preoperative Hb level (male: Hb < 130 g/L, female: Hb < 120 g/L), and bone flap were independent risk factors for perioperative blood transfusion. (2) Regression analysis showed that independent risk factors for perioperative transfusion included the following: BMI, tumor T3–T4 stage, ASA III, IV grade, and free flap/pediculated flap/bone flap in patients with different Hb levels; T3–T4 stage, ASA grade III–IV in mildly anemic patients; and ASA grade III–IV in moderately anemic patients. (3) A MSBOS was established for flap reconstruction in head and neck cancer patients.

Conclusion
A MSBOS for head and neck cancer procedures was reduced by approximately 30% perioperative blood preparation while ensuring that clinical blood use standards were met. It help optimize blood inventory, and save blood resources.
Advanced undergraduate medical students’ perceptions of basic medical competences and specific competences for different medical specialties – a qualitative study
Authors: Zelesniack Elena , Oubaid Viktor , Harendza Sigrid 
Published: August 2022

Abstract
Background
Medical graduates should have acquired basic competences that enable them to practice medicine independently as physicians and to enter postgraduate training in any specialty they wish. Little is known about advanced undergraduate medical students' perceptions of basic medical competences needed to start postgraduate training and about specialty-specific competences. This qualitative study aims to identify medical students’ perceptions of basic medical competences and specific competence requirements for different specialties.

Methods
In December 2020, sixty-four advanced undergraduate medical students participated in the role of a resident in a competence-based telemedicine training simulating a first day in postgraduate training. After the training, eight focus group interviews were conducted about students’ perceptions of basic medical competences and specialty-specific competences using a semi-structured interview guide. The interviews were transcribed and analysed thematically according to the six steps of Braun and Clarke. The analysis was carried out by an inductive search for themes, which were deductively assigned to the six competence areas of the requirement-tracking questionnaire (R-Track).

Results
Regarding basic medical competences, four R-Track competence areas could be identified as main themes. The students considered ‘Social-interactive competences’ to be particularly relevant for basic clinical work, including ‘Structuring information’, ‘Tactfulness’, and ‘Stress resistance’. Students especially emphasized ‘Concentration’ as an important aspect of the competence area ‘Mental abilities’. Among ‘Personality traits’, ‘Honesty’ was mentioned most frequently, and students were also aware that ‘Expertise’ is particularly important for ‘Motivation’. For different specialties, some competence areas were newly added to the competences needed for the respective specialty. For surgery, the competence areas ‘Sensory abilities’ and ‘Psychomotor & multitasking abilities’ were mentioned anew. ‘Sensory abilities’ were also newly attributed to radiology. ‘Mental abilities’ were mentioned as new competence area for psychiatry and internal medicine, while for anaesthesiology, 'Psychomotor & multitasking abilities' were newly added.

Conclusions
Advanced students seem to be well aware of basic competences needed for clinical practice. Good consensus between students and physicians was only found for psychiatry-specific competences. Medical schools should support their students in matching their perceptions of competences needed for specific specialties with specialty-specific requirements for a realistic choice of a specialty for postgraduate training.
The evaluation of an evidence-based model of feedback implemented on an undergraduate dental clinical learning environment
Authors: Davis Siobhan , Duane Brett , Loxley Andrew , Quigley Duana 
Published: August 2022

Abstract
Objectives
Dental graduates must graduate with high levels of clinical skills. Education in the clinical environment needs to be more than didactic supervision of practice by clinical teachers. Appropriate feedback in this context, is therefore critical to the development of student competence and confidence. This study was conducted to enhance and develop the assessment and feedback processes during clinical sessions in a Dental University Hospital in an effort to contribute to the development of students’ self-assessment skills, reflective ability and clinical competence.

Methods
A new evidence-based model of feedback was introduced between clinical teachers and dental students. The implementation of this model was evaluated by students through a survey and focus groups. Descriptive and inferential statistics were applied to the quantitative data, while thematic analysis applied to the qualitative data.

Results
Findings from the survey indicated that students perceived the new model of feedback to be a positive addition to their learning experiences. The majority indicated a preference to continue using it. Quantitative analysis also demonstrated that students placed a high value on the feedback they received through the new model and associated it with improved individual performance. Five themes generated from the qualitative analysis echoed the perception that the model of feedback enhanced learning opportunities, especially when it was focused on individual performance and incorporated peer feedback. Students’ preferences in relation to feedback processes were also gleamed from quantitative and qualitative analyses, that is, provision of positive and constructive feedback, both in dialogue and in written formats, delivered during and after each clinical session and addressing their individual competency learning goals for the future. Some challenges to be addressed were also identified (e.g., time constraints, inter-personal issues, and non-conducive environments).

Conclusions
Feedback is central to learning and remains a complex and challenging area. By adopting effective and evidence-based feedback practices through the introduction of a feedback model, students can be supported in regulating their own learning in the clinical learning environment.
COVID-19 pandemic and its impact on dental education: digitalization – progress or regress? Example of an online hands-on course
Authors: Oetter Nicolai , Möst Tobias , Weber Manuel , Buchbender Mayte , Rohde Maximilian , Foerster Yannick , Bauerschmitz Charlotte , Röschmann Nico , Adler Werner , Rau Andrea , Meyerolbersleben Marion , Kesting Marco , Lutz Rainer 
Published: August 2022

AbstractBackgroundDue to the SARS-CoV-2 pandemic and the accompanying contact restrictions, a new challenge arose for dental education. Despite the limited overall situation, it must be ensured that, in addition to theoretical content, practical skills in particular continue to be taught. Therefore, the aim of this study was to develop and implement an online hands-on course for dental students that ensures practical training, even during the pandemic.MethodsThe newly developed course was held from April 2020 to March 2021. A total of six groups (each consisting of approximately 40–50 students) took part in the course. The participating students were in their 3rd, 4th or 5th year of study. The course taught theoretical basics (via an online platform) and promoted the learning of practical/surgical techniques on models such as bananas, pork bellies, or chicken thighs with live demonstrations (via ZOOM) and interactive post-preparation by students at home (and in a rotating small group of 3–7 students on site). Student self-evaluation (at the beginning and end of the course) and course evaluation were performed using questionnaires. The learning success was analyzed (through self-evaluations) using Wilcoxon signed-rank tests (significance level alpha = 0.05).ResultsConcerning students´ self-evaluations, the theoretical knowledge, general surgical skills (such as surgical instrument handling), and specific surgical skills (such as performing a kite flap) improved during the course, with significant results (p < 0.001 for each). About 60% of the students rated the course overall as excellent (grades 9 or 10 on a Likert scale of 1 to 10). The technical implementation of the course was rated with a median of 9 (= very good, on a Likert scale of 1 to 10). 38.5% described the applicability of the skills learned for their later professional life as extremely good.ConclusionsThe results of this work suggest that, within the limitations of this study, the introduced concept of an online hands-on course could be an appropriate form of teaching practical dental skills, even during a pandemic. Further research is needed in the field of digital education for dental students.
Developing and evaluating an educational web-based tool for health professions education: the Flipped Classroom Navigator
Authors: Youhasan Punithalingam , Henning Marcus A. , Chen Yan , Lyndon Mataroria P. 
Published: August 2022

Abstract
Background
Flipped classroom pedagogy is a blended learning approach applied in undergraduate health professions education. However, teachers and students may require training to effectively engage in flipped classroom pedagogy. Thus, this study aimed to design, develop, and evaluate a web-based tool for fostering flipped classroom pedagogy in undergraduate health professions education.

Methods
This is an educational design-based research with a descriptive evaluation component which was conducted in two steps: (i) design & development and (ii) evaluation of an educational website. An expert panel was formed to evaluate the website by using a website evaluation questionnaire (WEQ). Descriptive statistics were employed to calculate the experts’ agreement level.

Results
An innovative website design was used to provide access to a range of digital devices. The development process occurred concurrently in two steps: (i) website development and (ii) learning content development. The educational website was branded as the Flipped Classroom Navigator (FCN). Based on WEQ scores, the FCN obtained a good level of agreement (≥ 80%) for its’ ease of use, hyperlinks, structure, relevance, comprehension, completeness, and layout.

Conclusions
The FCN is an effective method for providing training to promote flipped classroom pedagogy in health professions education. The FCN achieved good evaluation scores and comments from experts. However, it is also necessary to obtain acceptance from the end-users, which could be the focus of future research. Nonetheless, the expert panel pinpointed areas for further development before introducing the FCN to end-users.
“The team needs to feel cared for”: staff perceptions of compassionate care, aids and barriers in adolescent mental health wards
Authors: Maddox Lucy , Barreto Manuela 
Published: August 2022

AbstractBackgroundCompassion is vital in healthcare. Current understandings of the nature of compassionate care, its aids and barriers, are more theoretically developed than grounded in staff experience. This study explores staff perceptions of compassionate care in child and adolescent mental health wards.MethodsThree focus groups were conducted with a total of 35 staff from adolescent mental health wards (10–12 people in each group), on the nature of compassionate care, aids and barriers. Transcripts were analysed using thematic analysis. A follow-up survey with 36 workers from other UK child and adolescent mental health wards was completed and means and standard deviations of responses were analysed to confirm wider resonance of themes.ResultsElements of compassionate care fell into six themes relating to individual, team and organisational factors: emotional connection, sense of being valued, attention to the whole person, understanding, good communication, and practical help/resources. Aids and barriers mirrored each other, and showed that what staff think is key to the nature of compassionate care for patients is also what they feel they need to receive to be able to show compassionate care.ConclusionsThis study suggests that staff need the same elements of compassion as those which they seek to provide. A greater emphasis needs to be placed on providing staff with individual, team and organisational level resources which help them to feel compassionately held within the interconnected systems in which they work, in order to be able to continue to provide high level compassionate care. Staff need to be nourished, valued and compassionately cared for in order to be able to care compassionately for the patients they look after.
The role of job aids in supporting task sharing family planning services to community pharmacists and patent proprietary medicine vendors in Kaduna and Lagos, Nigeria
Authors: Baruwa Sikiru , Tobey Elizabeth , Okafor Emeka , Afolabi Kayode , Akomolafe Toyin O. , Ubuane Innocent , Anyanti Jennifer , Jain Aparna 
Published: August 2022

Abstract
Background
CPs and PPMVs are an important source of modern contraceptives in Nigeria, yet many lack the requisite knowledge and skills to capably provide these services. This skills gap might be addressed through targeted family planning (FP) training. This study measures family planning knowledge retention of CPs and PPMVs after receiving training in FP counseling and services in Kaduna and Lagos States, in Nigeria.

Methods
In a quasi-experimental longitudinal design without a comparison group, 559 CPs and PPMVs who were enrolled in the IntegratE project between January and December 2019, completed a self-administered questionnaire to assess their knowledge related to the provision of FP counseling, and injectable and implant contraceptive services at three points in time: 1) before the training; 2) immediately after the training; and 3) 9-months after the training in Kaduna and Lagos states, Nigeria. Adjusted multivariate logistic regression analysis was used to assess the effect of provider characteristics and receipt of job aids on FP knowledge retention 9 months after the training. 95% confidence intervals and p-values were used to assess statistical significance.

Results
Majority of study participants were females (60.3%) and between 30 and 49 years old (63.4%). The study revealed the importance of jobs aids as influence on knowledge retention. CPs and PPMVs who reported having the Balanced Counseling Strategy plus (BCS+) counseling cards, were more likely to retain knowledge (AOR: 2.92; 95% CI: 1.01–8.40, p-value = 0.05) at 9 months follow-up. Similarly, in terms of knowledge of injectable contraceptives, CPs and Tier 2 PPMVs who reported receiving the Medical Eligibility Criteria (MEC) Wheel were 2.1 times more likely to retain knowledge of injectable contraceptives 9-months later on (95% CI: 1.14–3.99, p-value = 0.02).

Conclusion
Community Pharmacists and Proprietary Medicine Vendors had good retention of family planning knowledge, especially when combined with job aids. Training and providing them with job aids on FP will therefore support task shifting and task sharing on family planning services provision in Nigeria.
Effectiveness of the 10-valent pneumococcal conjugate vaccine on pediatric pneumonia confirmed by ultrasound: a matched case–control study
Authors: Checkley William , Hossen Shakir , McCollum Eric D. , Pervaiz Farhan , Miele Catherine H. , Chavez Miguel A. , Moulton Lawrence H. , Simmons Nicole , Roy Arunangshu D. , Chowdhury Nabidul H. , Ahmed Salahuddin , Begum Nazma , Quaiyum Abdul , Santosham Mathuram , Baqui Abdullah H. 
Published: August 2022

Abstract
Background
Bangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV10) for children aged < 1 year in March 2015. Previous vaccine effectiveness (VE) studies for pneumonia have used invasive pneumococcal disease or chest X-rays. None have used ultrasound. We sought to determine the VE of PCV10 against sonographically-confirmed pneumonia in three subdistrict health complexes in Bangladesh.

Methods
We conducted a matched case–control study between July 2015 and September 2017 in three subdistricts of Sylhet, Bangladesh. Cases were vaccine-eligible children aged 3–35 months with sonographically-confirmed pneumonia, who were matched with two types of controls by age, sex, week of diagnosis, subdistrict health complex (clinic controls) or distance from subdistrict health complex (community controls) and had an illness unlikely due to Streptococcus pneumoniae (clinic controls) or were healthy (community controls). VE was measured using multivariable conditional logistic regression.

Results
We evaluated 8926 children (average age 13.3 months, 58% boys) with clinical pneumonia by ultrasound; 2470 had pneumonia with consolidations ≥ 1 cm; 1893 pneumonia cases were matched with 4238 clinic controls; and 1832 were matched with 3636 community controls. VE increased with the threshold used for consolidation size on ultrasound: the adjusted VE of ≥ 2 doses vs. non-recipients of PCV10 against pneumonia increased from 15.8% (95% CI 1.6–28.0%) for consolidations ≥ 1 cm to 29.6% (12.8–43.2%) for consolidations ≥ 1.5 cm using clinic controls and from 2.7% (− 14.2–17.2%) to 23.5% (4.4–38.8%) using community controls, respectively.

Conclusions
PCV10 was effective at reducing sonographically-confirmed pneumonia in children aged 3–35 months of age when compared to unvaccinated children. VE increased with the threshold used for consolidation size on ultrasound in clinic and community controls alike. This study provides evidence that lung ultrasound is a useful alternative to chest X-ray for case–control studies evaluating the effectiveness of vaccines against pneumonia.