bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency of biofilm removal by combination of water jet and cold plasma: an in-vitro study
Authors: Matthes Rutger , Jablonowski Lukasz , Pitchika Vinay , Holtfreter Birte , Eberhard Christian , Seifert Leo , Gerling Torsten , Vilardell Scholten Laura , Schlüter Rabea , Kocher Thomas 
Published: May 2022

Abstract
Background
Peri-implantitis therapy is a major problem in implantology. Because of challenging rough implant surface and implant geometry, microorganisms can hide and survive in implant microstructures and impede debridement. We developed a new water jet (WJ) device and a new cold atmospheric pressure plasma (CAP) device to overcome these problems and investigated aspects of efficacy in vitro and safety with the aim to create the prerequisites for a clinical pilot study with these medical devices.

Methods
We compared the efficiency of a single treatment with a WJ or curette and cotton swab (CC) without or with adjunctive use of CAP (WJ + CAP, CC + CAP) to remove biofilm in vitro from rough titanium discs. Treatment efficacy was evaluated by measuring turbidity up to 72 h for bacterial re-growth or spreading of osteoblast-like cells (MG-63) after 5 days with scanning electron microscopy. With respect to application safety, the WJ and CAP instruments were examined according to basic regulations for medical devices.

Results
After 96 h of incubation all WJ and CC treated disks were turbid but 67% of WJ + CAP and 46% CC + CAP treated specimens were still clear. The increase in turbidity after WJ treatment was delayed by about 20 h compared to CC treatment. In combination with CAP the cell coverage significantly increased to 82% (WJ + CAP) or 72% (CC + CAP), compared to single treatment 11% (WJ) or 10% (CC).

Conclusion
The newly developed water jet device effectively removes biofilm from rough titanium surfaces in vitro and, in combination with the new CAP device, biologically acceptable surfaces allow osteoblasts to grow. WJ in combination with CAP leads to cleaner surfaces than the usage of curette and cotton swabs with or without subsequent plasma treatment. Our next step will be a clinical pilot study with these new devices to assess the clinical healing process.
Survival analysis of three types of maxillary and mandibular bonded orthodontic retainers: a retrospective cohort
Authors: Rezaei Navid , Bagheri Zahra , Golshah Amin 
Published: May 2022

AbstractBackgroundRetention is an important aspect of orthodontic treatment. This study aimed to analyze the survival of three types of maxillary and mandibular bonded orthodontic retainers.MethodsThis retrospective cohort study evaluated the records of 118 orthodontic patients (90 females, 28 males, mean age of 22.34 ± 6.44 years) retrieved from a private orthodontic office. Data regarding the retainer failure, dental caries, unwanted tooth movements, maximum pocket depth (PD), and bleeding on probing (BOP) recorded at the follow-up sessions were extracted from patient records. Three types of retainer wires namely Bond-A-Braid, Orthoflex, and Retainium were compared regarding the abovementioned parameters. Data were analyzed by ANOVA, Chi-square, Monte-Carlo Chi-square, and Kruskal Wallis tests, the log rank test, and the Cox regression model.ResultsThe frequency of retainer failure was not significantly different between males and females, different age groups, or different treatment durations (P > 0.05). Wire fracture was the most common failure type in both the maxilla and mandible. Also, the frequency of failure was not significantly different between the maxillary and mandibular retainers (P > 0.05). The frequency of failure, and survival of the three types of retainer wires were not significantly different during a 5-year period (P > 0.05).ConclusionsThe three types of orthodontic retainers had comparable survival rates. Their failure rate was not correlated with the age or gender of patients or the treatment duration.
Pre-clerkship EPA assessments: a thematic analysis of rater cognition
Authors: Meyer Eric G. , Harvey Emily , Durning Steven J. , Uijtdehaage Sebastian 
Published: May 2022

Abstract
Background
Entrustable Professional Activities (EPAs) assessments measure learners’ competence with an entrustment or supervisory scale. Designed for workplace-based assessment EPA assessments have also been proposed for undergraduate medical education (UME), where assessments frequently occur outside the workplace and may be less intuitive, raising validity concerns. This study explored how assessors make entrustment determinations in UME, with additional specific comparison based on familiarity with prior performance in the context of longitudinal student-assessor relationships.

Methods
A qualitative approach using think-alouds was employed. Assessors assessed two students (familiar and unfamiliar) completing a history and physical examination using a supervisory scale and then thought-aloud after each assessment. We conducted a thematic analysis of assessors’ response processes and compared them based on their familiarity with a student.

Results
Four themes and fifteen subthemes were identified. The most prevalent theme related to “student performance.” The other three themes included “frame of reference,” “assessor uncertainty,” and “the patient.” “Previous student performance” and “affective reactions” were subthemes more likely to inform scoring when faculty were familiar with a student, while unfamiliar faculty were more likely to reference “self” and “lack confidence in their ability to assess.”

Conclusions
Student performance appears to be assessors’ main consideration for all students, providing some validity evidence for the response process in EPA assessments. Several problematic themes could be addressed with faculty development while others appear to be inherent to entrustment and may be more challenging to mitigate. Differences based on assessor familiarity with student merits further research on how trust develops over time.
Coping with personal care and stigma: experiences of persons living with schizophrenia
Authors: Commey Isaac Tetteh , Ninnoni Jerry Paul K. , Ampofo Evelyn Asamoah 
Published: May 2022

AbstractLiving with a chronic mental condition such as schizophrenia impacts significantly on the individual’s social functioning and activities of daily living. However, there is little data on the experiences of people living with schizophrenia, especially in Ghana regarding personal care and stigma. This study explored qualitatively the experiences of people living with schizophrenia in Southern Ghana. Nine people with schizophrenia were purposively recruited for this study. Data were collected using semi-structured interviews and analysed thematically following a descriptive phenomenological data analysis framework. The study revealed that people with schizophrenia are capable of performing some activities of daily living, such as maintenance of personal and environmental hygiene and medication management. However, some participants narrated their experiences of stigma and thus, resorted to certain strategies such as spirituality, medication adherence and mental fortitude to cope with schizophrenia. In conclusion, it was evident that people with schizophrenia, in their lucid intervals, can undertake various activities of daily living, including personal care, however, living with schizophrenia impacts on psychological well-being enormously, and thus, education, counselling, and client adherence to the treatment may improve quality of life.
Perceptions and experiences of maternity care workers during COVID-19 pandemic in Lagos State, Nigeria; a qualitative study
Authors: Leung Charlotte , Olufunlayo Tolulope , Olateju Zahra , MacArthur Christine , Taylor Beck 
Published: May 2022

Abstract
Background
The COVID-19 (coronavirus disease 2019) pandemic challenges provision and access to essential maternity care in low-resilience health systems. The aim of this study was to explore maternity healthcare workers’ experiences of, and perceptions about providing maternity care during the COVID-19 outbreak in Lagos State, Nigeria.

Methods
This qualitative study conducted individual, remote, semi-structured interviews with midwives and traditional birth attendants (TBAs). Eligible participants spoke English, and provided maternity care during COVID-19 in Lagos, Nigeria. Participants were recruited via purposive and snowball sampling, from primary health facilities in seven Local Government Areas of Lagos State. Interview transcripts were analysed thematically following the framework method.

Results
Sixteen midwives (n = 11) and TBAs (n = 5) were interviewed from March to April 2021. Two overarching themes were identified from the data. ‘Maternity care workers’ willingness and ability to work during the COVID-19 pandemic’ outlined negative influences (fear and uncertainty, risk of infection, burnout, transport difficulties), and positive influences (professional duty, faith, family and employer support). Suggestions to improve ability to work included adequate protective equipment, training, financial support, and workplace flexibility. ‘Perceived impact of COVID-19 on women’s access and uptake of maternity care’ highlighted reduced access and uptake of antenatal and immunisation services by women. Challenges included overstretched health services, movement and cost barriers, and community fear of health facilities. Participants reported delayed healthcare seeking and unattended home births. Midwives and TBAs identified a need for community outreach to raise awareness for women to safely access maternity services. Participants highlighted the responsibility of the government to improve staff welfare, and to implement public health campaigns.

Conclusions
Despite disruption to maternity care access and delivery due to COVID-19, midwives and TBAs in Lagos remained committed to their role in caring for women and babies. Nevertheless, participants highlighted issues of understaffing and mistrust in Lagos’ underfunded maternity care system. Our findings suggest that future resilience during outbreaks depends on equipping maternity care workers with adequate working conditions and training, to rebuild public trust and improve access to maternity care.
Influence of different pretreatments and drying methods on the chemical compositions and bioactivities of Smilacis Glabrae Rhizoma
Authors: Qiao Juanjuan , Lu Gengyu , Wu Gang , Liu Hui , Wang Wanli , Zhang Tianmao , Xie Guoyong , Qin Minjian 
Published: May 2022

Abstract
Background
The processing of medicinal plant materials is one of the important factors influencing the components and biological activities of TCMs. Smilax glabra Roxb. is an herbal vine widely distributed in China, and its dried rhizome (Smilacis Glabrae Rhizoma, SGR) is often used in traditional medicines and functional foods. The processing methods of fresh cutting for SGR slices have been included in ancient Chinese herbal works, some local standards of TCMs, and the current Chinese Pharmacopoeia. Nevertheless, to date, the scientific basis for the processing of fresh medicinal materials for SGR slices has not been revealed.

Methods
To optimize the processing method for preparing SGR slices from the fresh rhizomes, the chemical compositions of the un-pretreated and pretreated (boiling, steaming) samples before and after drying (sun-drying, shade-drying, oven-drying), and the contents of astilbin isomers in dried SGR were analyzed by UHPLC-Q-TOF-MS/MS and UHPLC-DAD methods, respectively. Then, the antioxidant, anti-inflammatory, xanthine oxidase and α-glucosidase inhibitory activities of the prepared SGR slices were investigated by biological assays.

Results
A total of fifty-two compounds were identified from the un-pretreated and pretreated samples and a total of forty-nine compounds were identified from the subsequently dried samples. After pretreated by boiling and steaming, the contents of neoastilbin, neoisoastilbin, and isoastilbin in the prepared samples all increased. As a quality marker of SGR, the content of astilbin was unchanged or decreased slightly compared with that in the un-pretreated samples. During the drying process, the contents of the four astilbin stereoisomers in the un-pretreated samples increased significantly, while those in the pretreated samples had a slight increase or decrease. The effects of different processing methods were sorted according to the bioactivities of the prepared SGR. As a result, SGR slices prepared with no pretreatment followed by a sun-drying process have a higher astilbin content, better bioactivities and more energy savings, representing the optimum processing method for SGR slices.

Conclusions
This study reveals the scientific basis for the processing of fresh medicinal materials for SGR slices. The results provide scientific information for the quality control of SGR and its rational applications in herbal medicines and functional foods.

Graphical abstract
Pain catastrophising, body mass index and depressive symptoms are associated with pain severity in tertiary referral orthopaedic foot/ankle patients
Authors: Holt Matthew , Swalwell Caitlin L. , Silveira Gayle H. , Tippett Vivienne , Walsh Tom P. , Platt Simon R. 
Published: May 2022

AbstractIntroductionPatients with chronic foot/ankle pain are often referred for orthopaedic assessment. Psychological vulnerabilities influence pain states (including foot and ankle), therefore this study aimed to establish the prevalence and relative importance of compromised psychological health to perceived foot/ankle pain severity in people referred to an orthopaedic foot and ankle clinic with non‐urgent presentations.MethodsPatients with triaged non‐urgent foot/ankle referrals to the Department of Orthopaedics at Gold Coast University Hospital were recruited over a 12‐month period and completed the Manchester‐Oxford Foot and Ankle Questionnaire which was the primary measure. Participants also completed questionnaires assessing their anthropometric, demographic and health characteristics (Self‐Administered Comorbidity Questionnaire) as well as measures of health‐related quality of life (EuroQol‐5‐Dimensions‐5‐Level Questionnaire and EQ Visual Analogue Scale) and psychological health (Center for Epidemiological Studies‐Depression scale, Pain Catastrophizing Scale and Central Sensitization Inventory). Descriptive statistics were used to summarise participant characteristics and a hierarchical multiple linear regression was employed to establish the extent to which psychological variables explain additional variance in foot/ankle pain severity beyond the effects of participant characteristics (age, sex, body mass index (BMI)).ResultsOne hundred and seventy‐two adults were recruited ((64.0% female), median (IQR) age 60.9 (17.7) years and BMI 27.6 (7.5) kg/m2). Specific psychological comorbidities were prevalent including depressive symptoms (48%), central sensitisation (38%) and pain catastrophising (24%). Age, sex and BMI accounted for 11.7% of the variance in MOXFQ‐index and psychological variables accounted for an additional 28.2%. Pain catastrophising was the most significant independent predictor of foot/ankle pain severity (accounting for 14.4% of variance), followed by BMI (10.7%) and depressive symptoms (2.3%).ConclusionsThis study demonstrated that specific psychological comorbidities and increased BMI are common in this cohort and that these factors are associated with the symptoms for which patients are seeking orthopaedic assessment. This knowledge should prompt clinicians to routinely consider the psychosocial components of patient presentations and develop non‐operative and pre‐operative treatment strategies which consider these factors with the goal of improving overall patient outcomes.
A mathematical model for the corneal transparency problem
Authors: Araújo Adérito , Barbeiro Sílvia , Bernardes Rui , Morgado Miguel , Sakić Sunčica 
Published: May 2022

AbstractUnderstanding the physical basis of corneal transparency has been a subject of interest amongst physicists, basic scientists and ophthalmologists. Impairment of corneal clarity is a significant cause of visual morbidity worldwide. Thus, it is essential to understand the mechanisms behind corneal transparency and how the alterations due to corneal pathologies affect vision. We use Maxwell’s equations to model light propagation in ocular tissues and a nodal discontinuous Galerkin method combined with an explicit Runge-Kutta method to simulate light propagation in normal and pathological corneas. Our simulation results illustrate that an increase in the diameter of some fibres causes an increase in backscattering. Thus, these may represent some of the physical changes in the cornea that might result in loss of transparency and visual morbidity.
How much do government and households spend on an episode of hospitalisation in India? A comparison for public and private hospitals in Chhattisgarh state
Authors: Garg Samir , Tripathi Narayan , Ranjan Alok , Bebarta Kirtti Kumar 
Published: May 2022

AbstractBackgroundImprovements in the financing of healthcare services are important for developing countries like India to make progress towards universal health coverage. Inpatient-care contributes to a big share of total health expenditure in India. India has a mixed health-system with a sizeable presence of private hospitals. Existing studies show that out-of-pocket expenditure (OOPE) incurred per hospitalisation in private hospitals was greater than public facilities. But, such comparisons have not taken into account the healthcare spending by government.MethodsFor a valid comparison between public and for-profit private providers, this study in Indian state of Chhattisgarh assessed the combined spending by government and households per episode of hospitalisation. The supply-side and demand-side spending from public and private sources was taken into account. The study used two datasets: a) household survey for data on hospital utilisation, OOPE, cash incentives received by patients and claims raised under publicly funded health insurance (PFHI) schemes (n = 903 hospitalisation episodes) b) survey of public facilities to find supply-side government spending per hospitalisation (n = 64 facilities).ResultsTaking into account all relevant demand and supply side expenditures, the average total spending per day of hospitalisation was INR 2833 for public hospitals and INR 6788 for private hospitals. Adjusted model for logarithmic transformation of OOPE while controlling for variables including case-mix showed that a hospitalisation in private hospitals was significantly more expensive than public hospitals (coefficient = 2.9,p < 0.001). Hospitalisations in private hospitals were more likely to result in a PFHI claim (adjusted-odds-ratio = 1.45,p = 0.02) and involve a greater amount than public hospitals (coefficient = 0.27,p < 0.001). Propensity-score matching models confirmed the above results.Overall, supply-side public spending contributed to 16% of total spending, demand-side spending through PFHI to 16%, cash incentives to 1% and OOPE to 67%. OOPE constituted 31% of total spending per episode in public and 86% in private hospitals.ConclusionsGovernment and households put together spent substantially more per hospitalisation in private hospitals than public hospitals in Chhattisgarh. This has important implications for the allocative efficiency and the desired public-private provider-mix. Using public resources for purchasing inpatient care services from private providers may not be a suitable strategy for such contexts.
Development and evaluation of the accuracy of an indicator of the appropriateness of interventional cardiology generated from a French registry
Authors: Francis-Oliviero Florence , Coste Pierre , Lesaine Emilie , Perez Corinne , Casteigt François , Clerc Jean-Marie , Delarche Nicolas , Hassan Akil , Larnaudie Bernard , Leymarie Jean-Louis , Salmi Louis-Rachid , Saillour-Glenisson Florence 
Published: May 2022

Abstract
Background
Development of appropriateness indicators of medical interventions has become a major quality-of-care issue, especially in the domain of interventional cardiology (IC). The objective of this study was to develop and evaluate the accuracy of an indicator of the appropriateness of interventional cardiology acts (invasive coronary angiographies (ICA) and percutaneous coronary interventions (PCI)) in patients with coronary stable disease and silent ischemia, automated from a French registry.

Methods
All ICA and PCI recorded in a Regional IC Registry (ACIRA) and operated for a stable coronary artery disease or silent ischemia from January 1st to December 31th 2013 in eight IC hospitals of Aquitaine, southwestern France, were included.
The indicator was developed to reflect European guidelines. Classification of appropriateness by the indicator, measured on the registry database, was compared to the classification of a reference standard (expert judgment applied through complete record review) on a random sample of 300 interventions.
Accuracy parameters were estimated. A second version of the indicator was defined, based on the analysis of false negative and positive results, and its accuracy estimated.

Results
The second indicator accuracy was: sensitivity 63.5% (95% confidence interval CI [51.7–75.3]), specificity 76.0% (95%CI [70.4–81.6]), PPV 43.0% (95% CI [33.0–53.0]) and NPV 88.0% (95% CI [83.4–92.6]). When stratified on the type of act, parameters were better for ICA alone than for PCI.

Conclusions
Accuracy of the indicator should raise with improvement of database quality. Despite its average accuracy, it is already used as a benchmark indicator for cardiologists. It is sent annually to each IC center with value of the indicator at the region level to allow a comparison.
Laparoscopic complete excision of an enormous simple hepatic cyst occupying the entire abdomen in a child: a case report and literature review
Authors: Matsushita Nozomi , Kaneko Kenitiro , Kato Shoko , Odashima Takayuki , Kondo Remi , Fukuyama Takahiro , Saito Takuya , Fukami Yasuyuki , Komatsu Shunichiro , Sano Tsuyoshi 
Published: May 2022

Abstract
Background
Simple hepatic cysts are common lesions in adults, but rare in children. Because of their benign nature, simple hepatic cysts may not be detected until they grow too large to be diagnosed and resected in a minimally invasive manner.

Case presentation
An 18-month-old girl presented with an enormous cyst occupying the entire abdomen. The beak sign on computed tomography revealed the hepatic origin of the cyst. The cyst was decompressed through the umbilicus, which was opened by the three-triangular-skin-flap technique, thus creating a working space that enabled laparoscopic surgery. The cyst was excised en bloc together with the attached hepatic parenchyma.

Conclusions
Giant simple hepatic cysts occupying the entire abdomen are rare in children. Of 14 reported cases, only 1 underwent laparoscopic treatment. We have herein reported another case of a giant simple hepatic cyst in which the beak sign on imaging and the three-triangular-skin-flap umbilical opening technique were useful for its diagnosis and laparoscopic excision, respectively. Complete excision is desirable because there is a possibility of recurrence or other diseases that require total removal, including hydatid cysts and mesenchymal hamartomas.