bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural behaviours after guided growth for idiopathic genu valgum correction: comparison between percutaneous transphyseal screw and tension-band plate
Authors: Park Byoung Kyu , Kim Hyun Woo , Park Hoon , Lee Seung-Kyu , Park Kun-Bo 
Published: December 2022

Abstract
Background
Percutaneous epiphysiodesis using a transphyseal screw (PETS) or tension-band plating (TBP) has shown favourable correction results; however, the physeal behaviours in terms of rebound, stable correction, or overcorrection after guided growth have not been completely understood. In patients with idiopathic genu valgum, we therefore asked: (1) How is the correction maintained after implant removal of guided growth? (2) Is there any difference in the natural behaviours after PETS or TBP removal at the femur and tibia?

Methods
We retrospectively reviewed 73 skeletally immature limbs with idiopathic genu valgum treated with PETS or TBP. PETS was performed in 23 distal femurs and 13 proximal tibias, and TBP was performed in 27 distal femurs and ten proximal tibias. Mechanical axis deviation (MAD), mechanical lateral distal femoral angle (mLDFA), and mechanical medial proximal tibial angle were measured at pre-correction, implant removal, and final follow-up. Changes of ≤ 3° in mechanical angles after implant removal were considered stable. Comparisons between the implant, anatomical site, and existence of rebound were performed.

Results
The mean MAD improved from − 18.8 mm to 11.3 mm at implant removal and decreased to -0.2 mm at the final follow-up. At the final follow-up, 39 limbs (53.4%) remained stable and only 12 (16.4%) were overcorrected. However, 22 limbs (30.1%) showed rebound. TBP was more common, and the correction period was longer in the rebound group (p < 0.001 and 0.013, respectively). In femurs treated with PETS, the mean mLDFA increased from 86.9° at implant removal to 88.4° at the final follow-up (p = 0.031), demonstrating overcorrection. However, a significant rebound from 89.7° to 87.1° was noted at the femur in the TBP group (p < 0.001). The correction of the proximal tibia did not change after implant removal.

Conclusion
The rebound was more common than overcorrection after guided growth; however, approximately half the cases demonstrated stable correction. The overcorrection occurred after PETS in the distal femur, while cases with TBP had a higher probability of rebound. The proximal tibia was stable after implant removal. The subsequent physeal behaviours after each implant removal should be considered in the guided growth.
Comparison of proprioception recovery following anterior cruciate ligament reconstruction using an artificial graft versus an autograft
Authors: Xu Changli , Liu Tianze , Wang Miao , Liu Chang , Li Bo , Lian Qiujian , Chen Tongjiang , Chen Fengmei , Qiao Suchi , Wang Zhiwei 
Published: December 2022

Abstract
Background
To compare proprioception recovery after anterior cruciate ligament reconstruction (ACLR) with a hamstring tendon autograft versus the artificial Ligament Advanced Reinforcement System (LARS).

Material and methods
Forty patients (9 females, 31 males) with anterior cruciate ligament (ACL) rupture were enrolled in this prospective study. Patients were randomized to two groups, 1) ACLR using a hamstring tendon autograft (n = 20) or 2) ACLR using artificial LARS (n = 20). Proprioception was assessed with knee joint position sense (JPS) passive-passive test at 45° and 75° flexions, with the contralateral healthy knee as a control baseline to calculate the JPS error. Knee JPS absolute error was used as the main outcome variable and defined as the absolute difference between the reproduction and target angles.

Results
JPS error in both groups at 3 months after ACLR was significantly higher than that at 12 months. However, no significant difference in JPS error was detected between the LARS and autograft groups at either 3 or 12 months after ACLR. Analyzing JPS data by grouping patients according to whether ACLR was performed more or less than 1 year following injury regardless of graft type showed a statistically significant difference between the groups at 3 months, but not at 12 months, after ACLR. Patients receiving the graft within 1 year of injury had a lower JPS error than those receiving the graft more than 1 year after injury at 3 months. No complications were associated with either ACLR method.

Conclusion
ACLR with a hamstring tendon autograft or LARS artificial graft is similarly safe and effective for recovering knee proprioception.
Comparison of sealer penetration of sonic activation versus conventional needle irrigation: a systematic review and meta-analysis of randomized controlled trials
Authors: Tan Li , Liu Qiong , Chen Yun , Zhao Ya-Qiong , Zhao Jie , Dusenge Marie Aimee , Feng Yao , Ye Qin , Hu Jing , Ou-Yang Ze-Yue , Zhou Ying-Hui , Guo Yue , Feng Yun-Zhi 
Published: December 2022

AbstractBackgroundMost existing studies comparing the efficiency of sonic irrigation (SI) and conventional needle irrigation (CNI) in increasing the penetration of sealers into dentine tubules are controversial; and this study aimed to determine whether the use of SI can lead to greater sealing ability than CNI, during the root canal treatment.MethodsThe EMBASE, PubMed, and Cochrane Library databases were used to find confocal laser scanning microscopy studies evaluating percentage and maximum depth of sealer penetration following the use of SI or CNI in mature permanent teeth until October 2022. The critical estimative checklist of randomized controlled trials of the standardized Joanna Briggs Institute was adopted to independently score the quality of each study. The random-effect model for meta-analysis was used to analyse for each canal segment (apical, middle, coronal). The results are shown in the forest plots as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs).ResultsNinety-seven articles were included in the preliminary screening, and nine of them were included in this study. Eight studies were included in the meta-analysis.The meta-analysis exhibited great increases in the coronal (WMD: 8.09, 95% CI 2.78–13.40/WMD: 165.32, 95% CI 128.85–201.80), and middle segments (WMD: 8.81, 95% CI 5.76–11.87/WMD: 132.98, 95% CI 68.71–197.25) for the percentage and maximum depth of sealer penetration, respectively. The percentage of sealer penetration in the apical thirds region was nonsignificant (WMD: 4.73, 95% CI − 2.34–11.80). However, the maximum depth of sealer penetration in the apical thirds region was significant (WMD: 121.46, 95% CI 86.55–156.38). Chi-squared analysis revealed heterogeneity scores of 0.0–70.0% and 44.0–90.0% for the percentage and maximum depth of sealer penetration, respectively.DiscussionThis review verified that SI significantly improves tubular dentin sealer penetration in most areas of the root canal; thus, SI may lead to better filling efficiency and anti-reinfection effects than CNI during and after the root canal therapy. Nevertheless, a large heterogeneity in the current data comparing the irrigation efficiency of SI versus CNI in the apical third of the root canal was found, implying the necessity to standardize root canal irrigation procedures and obtain more accurate results in this area.Trial Registration: INPLASY database (INPLASY202270116).
Evaluation of implant site preparation with piezosurgery versus conventional drills in terms of operation time, implant stability and bone density (randomized controlled clinical trial- split mouth design)
Authors: Arakji Hani , Osman Essam , Aboelsaad Nayer , Shokry Mohamed 
Published: December 2022

Abstract
Background
The preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation.

Methods
Twelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months.

Results
a significant difference in terms of time of surgery (p < 0.005) and in implant stability at 4 months (p = 0.024) on the study side, while a non-statistical significance in terms of bone density was detected (p = 0.468).

Conclusion
The piezoelectric implant site drilling protocol seemed to be a reliable and repeatable technique. Despite the limited sample size and lengthier operative time, the piezoelectric inserts enhanced bone quality and implant stability.
Clinical trial registration Current Controlled Trials (ClinicalTrials.gov) https://clinicaltrials.gov/ct2/show/NCT05512273; the date of registration: 23/08/2022. Retrospectively registered.
Effect of a bioactive pit and fissure sealant on demineralized human enamel: in vitro study
Authors: Salma Rehab Samir , AbdElfatah Omnia M. 
Published: December 2022

Abstract
Background
Incorporation of bioactive agent into pit and fissure sealant would halt demineralization and promote further remineralization. The aim was to assess the effect of bioactive and fluoride fissure sealants on calcium and phosphate content and surface topography of artificially demineralized enamel in young permanent teeth.

Methods
30 sound extracted premolars free from cracks or any developmental anomalies were used. They were divided into group I bioactive fissure sealant, group II fluoride fissure sealant and group III no material applied. Each tooth was divided into halves in a buccolingual direction and evaluated by energy dispersive X-ray spectrometer (EDX) at baseline, demineralization and after applying the material. Another set of 7 sound extracted premolars was evaluated by scanning electron microscopy (SEM) at the same phases.

Results
EDX showed that regaining calcium to demineralized enamel was significantly higher with bioactive sealant than either fluoride or the control group. SEM revealed minerals deposits with formation of distinct white zone at tooth/sealant interface for both pit and fissure sealant groups. Whereas no white zone formation was detected in control group.

Conclusions
Incorporating bioactive material into pit and fissure sealant through microcapsules provided better results than incorporating fluoride by enhancing the biological process of remineralization. Clinical relevance: The more use of bioactive pit and fissure sealant would maintain the occlusal surfaces as sound structures and decrease the need for operative procedures to restore teeth cavitation.
Evaluation of the CNC® prosthetic system in recurrent breast cancer patients with chemotherapy-induced alopecia: a pilot study
Authors: Petruzzi Alessandra , Mancuso Anna Maria , Alfieri Sara , Esposito Antonella , Infante Gabriele , Miceli Rosalba , Ospitali Stefano , Ripamonti Carla Ida , Borreani Claudia 
Published: December 2022

Abstract
Background
Chemotherapy-induced alopecia (CIA), although generally reversible, is felt as extremely distressing by patients with breast cancer. A certified medical device (Capelli Naturali a Contatto®—CNC®) was produced to provide patients with a personalized scalp prosthesis, reproducing the patient’s original hair, resistant to any type of everyday or sporting activity, and hairdressing.

Aims
The present study aimed to evaluate the impact of the CNC® device on the patient’s perception of their body image, psychological wellbeing, satisfaction, strengths and weakness of the CNC® device.

Method
A pilot study was carried out on 21 patients affected by CIA due to recurrent breast cancer. A mixed quantitative/qualitative method was used, including administering a questionnaire and a focus group.

Results
Based on the Body Image Scale, body image perception improved after 3 and 6 months using the device in the 20 patients who answered the questionnaire. No significant change over time emerged for the six dimensions investigated by the Italian version of the Psychological Well-Being Scale. The thematic analysis of the focus groups showed six themes: definition of the prosthetic device, acceptance of the proposal, experience with the conventional wig, strengths, weaknesses, economic issues.

Conclusion
Compared to the previous experience of CIA and the standard wig, the use of the CNC® device improved everyday life and may be proposed to women undergoing chemotherapy and expecting alopecia to prevent discomfort, social embarrassment, and compromised body image.
Use of a simulated patient case and structured debrief to explore trainee responses to a “non-compliant patient”
Authors: Sous Waseem , Frank Kay , Cronkright Peter , Germain Lauren J. 
Published: December 2022

Abstract
Background
Labeling a patient “non-compliant” is a form of dehumanization that can deprive the patient of positive human qualities and/or agency in the mind of a physician. The term “non-compliant” is frequently used in medical record documentation and has been shown to compromise care, particularly for marginalized communities. There is limited literature on the impact of the label on medical trainees. We aimed to explore how internal medicine residents and fellows (trainees) perceive the term “non-compliant patient” and its impact on their practice after interacting with a simulated refugee patient who has not followed a physician’s recommendations.

Methods
Kolb’s experiential learning cycle guided the design of the educational session which was part of a required communication skills curriculum for trainees. A scenario was created to simulate a refugee patient who had not adhered to their treatment plan and could potentially be labeled as “non-compliant.” Trainees participated in the 3-h session consisting of a remote simulated patient encounter immediately followed by a virtual structured debrief session that was recorded and transcribed. Thematic analysis of debrief transcripts was conducted starting with the use of provisional codes from the literature on the doctor-patient relationship and de/humanization.

Results
In group debrief sessions, trainees reflected upon the standardized patient case and chose to also discuss similar cases they had experienced in clinical practice. Trainees indicated that the term “non-compliant patient” served as a biasing function and described how this bias negatively impacted the doctor-patient relationship. Trainees described how marginalized communities might be more susceptible to the negative connotation associated with the term “non-compliant patient.” For some trainees, the term triggered further investigation of underlying barriers to care and exploration of the social determinants of health.

Conclusions
The use of the phrase “non-compliant patient,” though common in medical practice, may lead to patient dehumanization among trainees. A simulated refugee patient encounter followed by a facilitated group debrief allowed participants to verbalize and reflect on the meaning and possible impact of the label.
Online flipped classroom with team-based learning promoted learning activity in a clinical laboratory immunology class: response to the COVID-19 pandemic
Authors: Feng Yonghui , Zhao Bin , Zheng Jun , Fu Yajing , Jiang Yongjun 
Published: December 2022

AbstractBackgroundGiven the rapid development of clinical immunology technologies, students majoring in laboratory medicine should master the technological principles and application of clinical laboratory immunology. However, many are required to take online courses due to COVID-19 restrictions, which highlights the need to revisit teaching strategies. Recently, various medical education courses (such as Biochemistry, Physiology, etc.) have implemented the flipped classroom (FC) and team-based learning (TBL) methods, resulting in more positive teaching evaluations. To promote the students' mastery of the difficult knowledge effectively during the online teaching work, we evaluated the performance of online FC-TBL in a clinical laboratory immunology course.MethodsSixty-two third-year students from two classes majoring in Laboratory Medicine were recruited and divided into two groups, including one group with traditional lecture-based learning teaching strategy (LBL group) and the other group with LBL or online FC combined with TBL teaching strategy (FC-TBL group). We selected three chapters to conduct FC-TBL teaching in class. All participants took in-class quizzes and final examinations that targeted the same knowledge points. Finally, all participants completed anonymous questionnaires asking for their perceptions of the respective teaching models. In addition, we conducted a survey of teaching suggestions by a FC-TBL class of students majoring in Laboratory Medicine.ResultsThe FC-TBL group (vs LBL group) had significantly higher scores on the in-class quizzes and final examinations, and also reported high satisfaction with the FC-TBL model. These findings indicate that FC-TBL is suitable for clinical laboratory immunology, as the participants quickly gained essential knowledge. Specifically, FC-TBL helped to “increase learning motivation,” “promote self-directed learning skills,” “extend more related knowledge,” “enhance problem-solving abilities,” “enhance clinical reasoning abilities,” and “enhance communication skills.” For participants’ suggestions, 48.38% (15/31) students held positive attitude to FC-TBL teaching strategy compared to 25.81% (8/31) students who considered FC-TBL teaching strategy still needs continuous improvement, and 25.81% (8/31) students reported that they believed FC-TBL teaching strategy was perfect and no further suggestions.ConclusionsOnline FC-TBL effectively enhanced learning activity among students of a clinical laboratory immunology course. This is particularly useful in the COVID-19 context.
Ethical issues with geographical variations in the provision of health care services
Authors: Hofmann Bjørn 
Published: December 2022

AbstractGeographical variations are documented for a wide range of health care services. As many such variations cannot be explained by demographical or epidemiological differences, they are problematic with respect to distributive justice, quality of care, and health policy. Despite much attention, geographical variations prevail. One reason for this can be that the ethical issues of geographical variations are rarely addressed explicitly. Accordingly, the objective of this article is to analyse the ethical aspects of geographical variations in the provision of health services. Applying a principlist approach the article identifies and addresses four specific ethical issues: injustice, harm, lack of beneficence, and paternalism. Then it investigates the normative leap from the description of geographical variations to the prescription of right care. Lastly, the article argues that professional approaches such as developing guidelines, checklists, appropriateness criteria, and standards of care are important measures when addressing geographical variations, but that such efforts should be accompanied and supported by ethical analysis. Hence, geographical variations are not only a healthcare provision, management, or a policy making problem, but an ethical one. Addressing the ethical issues with geographical variations is key for handling this crucial problem in the provision of health services.
Validity and reliability of the measurement instrument of the nursing outcome health-related Physical Fitness (2004), proposed and transculturally adapted to the Spanish context
Authors: Rojas-Navarrete Jessica , Leal-Costa César , de La Morena Valenzuela Gonzalo , Morales-Moreno Isabel , Jiménez-Ruiz Ismael , Echevarría-Pérez Paloma 
Published: December 2022

Abstract
Background
Presently, physical inactivity is the main public health problem in many countries worldwide. Physical activity promotes the maintenance or improvement of one’s physical condition. Physical fitness has been established as the main biological marker of the state of health of an individual, and therefore, there is a clear need to measure health-related physical fitness through the use of a reliable and valid instrument. This study is a continuation of the transcultural adaptation process and a new proposal of the nursing outcome Physical Fitness (2004), found in the 5th Edition of the Nursing Outcomes Classification. The objective of this study was to examine the validity and reliability of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context.

Methods
An instrumental study to validate the nursing outcome Physical Fitness (2004), from the 5th Edition of the Nursing Outcome Classification was carried out. It took place between the months of May, 2016 to May, 2017. On the first stage, the instrument proposed Health-Related Physical Fitness survey was administered to 160 adults who used the Health Services of Murcia, Spain by three independent evaluators. After 4 weeks, it was administered again to 33 participants to calculate the intra-rater reliability. Lastly, the SF-12v2 Health Survey was administered to obtain external evidence of validity.

Results
The inter-rater reliability of the nursing outcome proposed obtained high values (between 0.91–0.99) in the evaluations performed by the three evaluators. As for the intra-rater reliability, high values were obtained (0.94–1), except for the item “balance”, which was moderate (0.56). Lastly, a positive and statistically significant correlation (p < 0.05) was obtained between the Physical Component Summary, and the dimensions Physical Functioning and General Health from the SF-12v2 Health Survey, and the global score of the Health-Related Physical Fitness proposed instrument.

Conclusions
The validity and reliability results of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context, were adequate for its use by nurses with adults who use the Health Services of Murcia. However, this instrument must be analyzed with more diverse samples of health services users.