bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to Recovery and Determinants of Uncomplicated Severe Acute Malnutrition Among 6 to 59 Months Children From the Outpatient Therapeutic Feeding Program in North Shewa Zone of Oromia Region, Ethiopia: A Prospective Follow-up Study
Authors: Bekalu Amare , Sahlu Degemu , Tadesse Addisu Waleligne , Asmare Biachew , Hune Yidersail , Tilahun Bayou 
Published: June 2022

Background: Community-based management of acute malnutrition is implementing in Ethiopia but there is scarce information in our study set up regarding the time to recovery and its predictors of severe acute malnutrition among 6 to 59 months children, so this study aimed to assess the time to recovery and its predictors for uncomplicated severe acute malnutrition among 6 to 59 children managed at the outpatient therapeutic program in north Shewa zone, Ethiopia. Methods: A health post-based prospective follow-up study was conducted on 6 to 59 months children from November 20/2020 to February 20/2021. A total of 423 children had included in the study. A structured interviewer-administered questionnaire had used. The median time to recovery had calculated using the Kaplan-Meier curve. Bi-variable and multi-variable Cox regression models with a 95% confidence interval (CI) were done. Finally, the variable that had a P-value < .05 in the multi-variable analysis was declared as the predictors of time to recovery. Proportional hazard assumption was checked graphically and using Schoenfeld residual test. Result: From the total 423 Children, 327 (77.3%) recovered. The median time to recovery was 42 (IQR 14) days. Children from food secure households; AHR = 9.6 with 95% CI (8.1-18.5), mild food insecure; AHR = 6.5 with 95% CI (3.1, 13.8), moderate food insecure; AHR = 2.5 with 95% CI (1.2-5.3). Mothers who traveled less than 2 hours walking distance to the health post; AHR = 2.6 with 95% CI (1.8-18.7). Children who received the correct dose of the RUTF AHR = 1.6 with 95% CI (1.1-2.3), children who measured their weight weekly AHR = 1.5 with 95% CI (1.1-2.0), and children treated by health extension worker who took the Nutrition-related training AHR = 2.1 with 95% CI (1.0-4.5) were predictors of time to recovery. Conclusion: The median time to recovery was within the acceptable range of the Ethiopian protocol for the management of uncomplicated SAM in the Outpatient setup. Household food security status, the distance between home and health posts, the correct dose of RUTF, weekly weight measurement per protocol, and HEWs nutrition-related training status were the significant predictors of time to recovery.
Mechanical properties of cast half-grouted sleeve splice with rebar bonding defects
Authors: Che Wenpeng , Chen Jianwei , Liu Ziye , Tian Wenling 
Published: June 2022

This paper describes an experimental study on the mechanical properties of cast half-grouted sleeve splice with rebar bonding defects, i.e. strip off ribs or mortar coatings of connecting rebar, which may lead to inadequate cohesiveness between the rebar and grout. A total of 12 groups of specimens were tested to study the effects of bonding defects on the bearing capacity, failure modes, and strain distribution of the grouted sleeve splice. The strip off rib length-to-embedded length ratios (0.3, 0.5, and 1), the proportion of mortar coating surface area along the embedded length (0.5 and 1), and the rebar diameter (12 mm and 20 mm) were investigated. The test results show that the failure modes of the specimens can be divided into rebar tensile failure and rebar bond slip failure. The load-displacement responses of the specimens occurring due to rebar failure were similar. Moreover, the bond strength between the rebar and grout decreased significantly, while the strip off rib length increased. When the strip off rib length coefficient reached 100%, compared with a specimen with no defects, the average tensile capacity of the sleeves splice of 12 mm and 20 mm diameter rebars were decreased by 26.5% and 58.3%, respectively. The mortar coating had no significant effect on the connection performance of the specimens. To evaluate the performance of the specimens, based on the experimental data, simple ratios comprising the yield, strength, ductility and capacity ratios were discussed and proposed.
Role extension in advanced ultrasound practice: A framework approach and case study
Authors: Reeve Ruth , Higginson Antony , Ball Christopher , Beable Richard , Smith Mike 
Published: June 2022

Introduction: Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles. Topic Description: This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound. The authors illustrate this via the example of a gastrointestinal ultrasound role, developed in an NHS department. Discussion: The framework approach comprises three elements, each interdependent upon and inform each other: (A) Scope of practice, (B) Education and competency and (C) Governance. (A) Defines (and communicates) the role extension and area(s) of subsequent ultrasound imaging, interpretation and reporting. By identifying the why, how and what is required this informs (B) the education and assessment of competency for those taking on new roles or areas of expertise. (C) Is informed by (A) and is an ongoing process of quality assurance to safeguard high standards in clinical care. In supporting role extension, this approach can facilitate new workforce configurations, skill expansion and enable increasing service demands to be met. Summary: By defining and aligning the components of scope of practice, education/competency and governance, role development in ultrasound can be initiated and sustained. Role extension utilising this approach brings benefits for patients, clinicians and departments.
Aesthetic correction of short nail deformity in congenital brachydactyly Type D by distraction lengthening
Authors: Jiang Yongkang , Hou Zhidian , Huang Lei , A. Chi Jialun , Zhang Yingfan , Sun Wenhai 
Published: June 2022

Brachydactyly Type D is a congenital condition of the thumb in which there is a short and broad thumbnail. Although the thumb function is often unaffected, some patients seek surgery for cosmetic improvement. This study aimed to describe our method of distraction lengthening to correct nail deformity in brachydactyly Type D. A total of 163 thumbs in 95 patients underwent this surgery between 2018 and 2021.The mean thumbnail length improved from 9 mm to 15 mm, with a mean percentage increase of 62%. The ratio of nail length to width changed from 0.6 to 1.1, which was equal to normal. The mean increased fingernail length/width ratio was 0.5, with a percentage change of 78%. No obvious surgical scar was observed. The thumb function was not significantly affected. We conclude that aesthetic correction of short nail deformity in brachydactyly Type D can be achieved by distraction lengthening with high satisfaction and without functional impairment. Level of evidence: IV
The effect of health promotion training provided to elderly individuals during the COVID-19 pandemic on healthy lifestyle behaviors
Authors: Polat Filiz , Karasu Fatma 
Published: June 2022

Background: One of the areas most affected by the COVID-19 pandemic is health promotion. In order to improve the quality of life of elderly individuals, it is important to develop and implement effective intervention strategies that can prevent negative health outcomes. Purpose: The aim of this study is to determine the effect of health promotion training provided to elderly individuals on healthy lifestyle behaviors. Methods: This study was conducted as a randomized-controlled experimental study. The study was completed with 140 elderly individuals over 65 years of age, including 70 participants in intervention group and 70 participants in control group. The data were collected using the Information Form and the Healthy Lifestyle Behaviors Scale-I. Training was provided to the intervention group as one session a week for three weeks. Percentage, arithmetic mean, and standard deviation as well as chi-square, dependent samples t-test, and independent samples t-test were used to assess the data. Findings: While the pretest mean score of the intervention group for the overall Healthy Lifestyle Behaviors Scale-I was 103.90 ± 16.96, their posttest mean score was 136.17 ± 19.60 and it was found that there was a statistically significant difference between the results ( p = 0.000). While the pretest mean score of the control group for the overall Healthy Lifestyle Behaviors Scale-I was 107.22 ± 21.09, their posttest mean score was 106.57 ± 21.49 and it was found that there was no statistically significant difference between the results ( p = 0.609). Conclusion: It was observed that healthy lifestyle behaviors of elderly individuals in the intervention group improved positively.
Cost-effectiveness of ribociclib for premenopausal or perimenopausal women with HR+/HER2− advanced breast cancer: a Brazilian public health care system perspective
Authors: Rosa Daniela Dornelles , Magliano Carlos Alberto da Silva , Simon Sergio D. , Amorim Gilberto , Reinert Tomás , Landeiro Luciana , Gagliato Débora de Melo , Exman Pedro , Argolo Daniel , Guilgen Gisah , Mano Max , Testa Laura , Liedke Pedro , Barroso Romualdo , Sasse Mariana , Buehler Anna Maria 
Published: June 2022

Introduction: The MONALEESA-7 trial compared ribociclib plus endocrine therapy (ET) with placebo as first-line treatment of advanced luminal/HER2-negative breast cancer (ABC) in premenopausal and perimenopausal women (age <50 years) and showed significant benefits to progression-free survival and overall survival. This study aimed to compare the cost-effectiveness of ribociclib + ET versus ET alone in patients with ABC from the perspective of the Brazilian public national health system. Methods: We calculated the incremental cost-effectiveness ratio (ICER) using a Markov model with progression-free survival, post-progression survival, and death states. We expressed ICER as incremental costs per progression-free life-year (PFLY) and quality-adjusted life-year (QALY) gained in a 10-year time horizon. We used parametric survival distributions fit to MONALEESA-7 data to generate survival distributions for progression-free and post-progression survival. The largest British preference study in breast cancer served as the basis to estimate health-state utilities. We estimated direct costs (ABC treatment, follow-up, monitoring, and adverse events) using Brazilian-specific values from public sources. An expert consensus panel determined the resource patterns required. We applied annual discounts of 5% to costs and QALYs. Results: Ribociclib + ET resulted in an incremental gain of 1.03 PFLYs and 0.80 QALYs at a cost of $37,319.31. The ICER of ribociclib + ET versus ET was $36,379.41 per PFLY gained and $46,590.79 per QALY gained. In deterministic sensitivity analysis, results were primarily affected by the annual discount rate, followed by the cost of ribociclib. In probabilistic sensitivity analysis, simulations agreed with the base-case. Conclusion: Ribociclib increased PFLYs and QALYs in patients with HR+/HER2− ABC when added to ET. Because Brazil does not have a formally defined cost-effectiveness threshold, other domains need to be considered for incorporation decisions, such as disease burden and humanistic impact on this young, economically active population. These findings may be useful in discussions for incorporation of ribociclib into the Brazilian public health system.
Effects of Micro Architectural Environmental Interventions on Handwashing Compliance of Adolescents: A School-Based Intervention Trial
Authors: Bai Xiaoxia , Li Xinxin , Yan Ding , Yang Hui , Tu Kun 
Published: June 2022

Purpose: Aimed to explore more practical interventions for handwashing compliance (HWC) and protect the minor’ health with the pandemic background, this study tested whether micro architectural interventions would promote HWC of adolescents through active experience. Background: Despite the well-documented benefits of handwashing (HW), low compliance is common among adolescents. HW space in schools has always been treated as attached spaces of little matter, which is unfavorable to public health. According to environment behavior perspective, personal motivation of HWC may be motivated by active environment. Method: A school-based investigation and a 30-week environmental behavior experiment were conducted when students returned to school after the COVID-19 pandemic closure in 2020 in China to evaluate the effects of active environment interventions selected by previous survey on promoting adolescents’ HW rate. Digital infrared counters were used to unobtrusively document their behavior. Results: Results in summer revealed a positive effect on all intervention groups. The effects of combined interventions were higher than the effect of any single intervention. However, HW rates of all groups declined sharply in the coldest month and the between-group differences decreased. Significant correlations were found between HW rates and satisfaction with the intervention schemes. Conclusions: Findings suggest that architectural environmental intervention may potentially be a positive, friendly, and one-time investment mean to expand the HWC intervention scope from passive policies to positive experience, and HW space design for adolescents should be treated as a public health strategy.
A Systematic Review of Cervical Ganglioneuromas
Authors: Saadat Saad , Fritz Christian , Tran Deanna , Parry Nathan , Yuhan Brian T. , Bolduan Alyssa , Thorpe Eric 
Published: June 2022

ObjectiveTo perform a systematic review of the literature evaluating clinical characteristics and management of cervical ganglioneuromas (CGNs).Data SourcesPubMed, Embase, and Cochrane Library databases were searched. Data such as patient demographics, imaging, and treatments were obtained.Review MethodsPertinent studies were downloaded, and the full text was reviewed by 4 authors (N.P., S.S., C.F., D.T.). Results were reported via the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta‐analyses).ResultsFifty‐two studies with 58 patients were identified in the literature. Of the 58 patients, 22 were adults and 36 were pediatric. The most common reported location of CGN was within the parapharyngeal space (76%), followed by the retropharyngeal (19%) and paravertebral/prevertebral (7%) spaces. The most common presenting symptoms included a nontender mass (29.3%), dysphagia (17.2%), and hoarseness (10.3%). Interestingly, the average tumor volume for patients with postoperative Horner’s syndrome was 183 mm3 (n = 21, 47.7%) vs 946 mm3 in patients without Horner’s syndrome (n = 23, 52.3%). This represents a statistically significant finding (P =. 018). There exists no significant difference in tumor volumes between adult and pediatric patients with Horner’s syndrome (P =. 645).ConclusionCGN is a rare tumor of the sympathetic nervous system. Management should involve complete surgical excision with biopsy. We found that patients with small‐volume CGNs are significantly more likely to experience postoperative Horner’s syndrome. This finding is independent of age and should therefore be taken into consideration in any patient with suspected CGN.
Management of biliary stones in bariatric surgery
Authors: Tustumi Francisco , Pinheiro Filho João Emílio Lemos , Stolzemburg Lucas Cata Preta , Serigiolle Leonardo Carvalho , Costa Thiago Nogueira , Pajecki Denis , Santo Marco Aurélio , Nahas Sérgio Carlos 
Published: June 2022

Morbidly obese and post-bariatric surgery patients are at increased risk for biliary stones formation. The complications related to biliary stones may impose complexity on their management. This study aimed to review the management of biliary conditions in obese and bariatric patients. In this study, a narrative review was performed of the medical, surgical, and endoscopic procedures for the management of biliary stones and their related complications. Knowing the main prophylactic and therapeutic interventions options is essential for clinicians to properly manage the biliary stones in patients candidates or submitted to bariatric surgery. Plain Language Summary Management of biliary stones in bariatric surgery The complications related to biliary stones may impose complexity on their management. Knowing the main prophylactic and therapeutic intervention options is essential for clinicians to properly manage the biliary stones in patient candidates or submitted to bariatric surgery. This study reviewed the main tools clinicians can handle to properly manage candidates for bariatric surgery or patients submitted to bariatric surgery.
Measuring evolution learning: impacts of student participation incentives and test timing
Authors: Sbeglia Gena C. , Nehm Ross H. 
Published: June 2022

AbstractBackgroundPolicy documents likeVision and Changeand theNext Generation Science Standardsemphasize the importance of using constructed-response assessments to measure student learning, but little work has examined the extent to which administration conditions (e.g., participation incentives, end-of-course timing) bias inferences about learning using such instruments. This study investigates potential biases in the measurement of evolution understanding (one time point) and learning (pre-post) using a constructed-response instrument.MethodsThe constructed-response ACORNS instrument (Assessment of COntextual Reasoning about Natural Selection) was administered at the beginning of the semester, during the final exam, and at end of the semester to large samples of North American undergraduates (N = 488–1379, 68–96% participation rate). Three ACORNS scores were studied: number of evolutionary core concepts (CC), presence of evolutionary misconceptions (MIS), and presence of normative scientific reasoning across contexts (MODC). Hierarchical logistic and linear models (HLMs) were used to study the impact of participation incentives (regular credit vs. extra credit) and end-of-course timing (final exam vs. post-test) on inferences about evolution understanding (single time point) and learning (pre-post) derived from the three ACORNS scores. The analyses also explored whether results were generalizable across race/ethnicity and gender.ResultsVariation in participation incentives and end-of-course ACORNS administration timing did not meaningfully impact inferences about evolution understanding (i.e., interpretations of CC, MIS, and MODC magnitudes at a single time point); all comparisons were either insignificant or, if significant, considered to be small effect sizes. Furthermore, participation incentives and end-of-course timing did not meaningfully impact inferences about evolutionlearning(i.e., interpretations of CC, MIS, and MODC changes through time). These findings were consistent across race/ethnicity and gender groups.ConclusionInferences about evolution understanding and learning derived from ACORNS scores were in most cases robust to variations in participation incentives and end-of-course timing, suggesting that educators may have some flexibility in terms of when and how they deploy the ACORNS instrument.
Acute multifocal retinitis in a patient with Q fever (Coxiella Burnetii infection) with endocarditis
Authors: Mahmoud Anis , Abid Fatma , Khairallah Molka , Affes Sofien , Mbarek Sameh , Amor Hassen Ibn Hadj , Khalifa Anis Ben Hadj , Mesaoud Riadh , Khairallah Moncef 
Published: June 2022

Abstract
Objective
To report acute multifocal retinitis in association with serologically-proven Coxiella (C) Burnetii infection (Q fever) with endocarditis.

Material and methods
A single case report documented with multimodal imaging.

Results
A 67-year-old cattle breeder presented with a 2-week history of persistent fever, headache, and floaters in both eyes. On examination, his best-corrected visual acuity was 20/20, and there was 1+ vitreous cells in both eyes. Bilateral fundus examination showed multiple small superficial white retinal lesions scattered in the posterior pole and midperiphery associated with a few retinal hemorrhages. These retinal lesions did not stain on fluorescein angiography (FA) and showed focal hyperreflectivity and thickening primarily involving the inner retinal layers on optical coherence tomography (OCT). There also was a band-like hyper-reflective area in the middle retina consistent with paramacular acute middle maculopathy. Transthoracic echocardiogram (TTE) showed a mobile echodensity on the anterior aortic leaflet consistent with a diagnosis of endocarditis. Elisa assays performed on paired serum samples collected 2 weeks apart showed increase in antibodies against C burnetii from 60 IU/ml to 255 IU/ml. The patient was treated with doxycycline 100 mg twice a day for 18 months, with subsequent resolution of the endocarditis. Sequential ocular examinations showed gradual resolution of all acute retinal findings without visible scars.

Conclusion
Acute Q fever, caused by C burnetii infection, should be considered in the differential diagnosis of acute multifocal retinitis. A systematic cardiac assessment with echocardiography is essential for early diagnosis of associated endocarditis and for prompt administration of appropriate antibiotic treatment to improve clinical outcomes.
A novel role for CFTR interaction with LH and FGF in azoospermia and epididymal maldevelopment caused by cryptorchidism
Authors: Hadziselimovic Faruk , Verkauskas Gilvydas , Stadler Michael 
Published: June 2022

AbstractCryptorchidism occurs frequently in children with cystic fibrosis. Among boys with cryptorchidism and abrogated mini-puberty, the development of the epididymis and the vas deferens is frequently impaired. This finding suggests that a common cause underlies the abnormal development of Ad spermatogonia and the epididymis. The cystic fibrosis transmembrane conductance regulator (CFTR) is an ATP-binding cassette transporter protein that acts as a chloride channel. The CFTR gene has been associated with spermatogenesis and male fertility. In boys with cryptorchidism, prepubertal hypogonadotropic hypogonadism induces suboptimal expression of the ankyrin-like protein gene, ASZ1, the P-element induced wimpy testis-like gene, PIWIL, and CFTR. The abrogated expression of these gene leads to transposon reactivation, and ultimately, infertility. Curative gonadotropin-releasing hormone agonist (GnRHa) treatment stimulates the expression of CFTR and PIWIL3, which play important roles in the development of Ad spermatogonia and fertility. Furthermore, GnRHa stimulates the expression of the epididymal androgen-sensitive genes, CRISP1, WFDC8, SPINK13, and PAX2, which thereby promotes epididymal development. This review focuses on molecular evidence that favors a role for CFTR in cryptorchidism-induced infertility. Based on information available in the literature, we interpreted our RNA-Seq expression data obtained from samples before and after randomized GnRHa treatment in boys with bilateral cryptorchidism. We propose that, in boys with cryptorchidism, CFTR expression is controlled by luteinizing hormone and testosterone. Moreover, CFTR regulates the activities of genes that are important for fertility and Wolffian duct differentiation.