bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial
Authors: Alaki Sumer M. , Abdulhadi Bashaer S. , AbdElBaki Medhat A. , Alamoudi Najlaa M. 
Published: November 2020

Abstract

Background
Providing restorations to anterior teeth in children is a challenging task due to the need for high esthetics, strength, and durability. This study was done to compare prefabricated primary zirconia with resin composite strip crowns on primary maxillary central and lateral incisors with regards to gingival health, plaque accumulation, recurrent caries, restoration failure, and opposing teeth wear over a period of 3, 6 and 12 months.

Methods
Children attending the King Abdulaziz University, Faculty of Dentistry (KAUFD) clinics who needed restorations were screened for inclusion criteria. A total of 120 teeth were treated; 60 with zirconia and 60 with strip crowns. Randomization was done by simple random allocation using SPSS software version 20.0 (Armonk, NY; IBM Corp.). A simple descriptive statistic was used for analysis by Wilcoxon Signed-Rank test and Chi-square test. Level of significance was set at (α = 0.05) and level of confidence at (95%). The presented research was registered retrospectively at ClinicalTrials.gov in 6th of August 2017, under registration number NCT03184012.

Results
Zirconia crowns showed significantly less gingival bleeding at the 3- and 6-months follow up periods (p < 0.006, p < 0.001; respectively), less plaque accumulation at all follow up visits (p < 0.001), no restoration failure (p < 0.001), but more wear to opposing teeth (p < 0.02). No significant difference was found between the two crowns with regards to recurrent caries (p < 0.135).

Conclusion
Based on our data we conclude that overtime teeth covered with zirconia crowns show better gingival health and less bleeding, plaque accumulation as well as less loss of material. On the other hand, zirconia can cause more loss of opposing tooth structure.
Introducing cross-cultural education in palliative care: focus groups with experts on practical strategies
Authors: Semlali Imane , Tamches Emmanuel , Singy Pascal , Weber Orest 
Published: November 2020

Abstract
Background
The linguistic and cultural diversity found in European societies creates specific challenges to palliative care clinicians. Patients’ heterogeneous habits, beliefs and social situations, and in many cases language barriers, add complexity to clinicians’ work. Cross-cultural teaching helps palliative care specialists deal with issues that arise from such diversity. This study aimed to provide interested educators and decision makers with ideas for how to implement cross-cultural training in palliative care.

Methods
We conducted four focus groups in French- and Italian-speaking Switzerland. All groups consisted of a mix of experts in palliative care and/or cross-cultural teaching. The interdisciplinary research team submitted the data for thematic content analysis.

Results
Focus-group participants saw a clear need for courses addressing cross-cultural issues in end-of-life care, including in medical disciplines outside of palliative care (e.g. geriatrics, oncology, intensive care). We found that these courses should be embedded in existing training offerings and should appear at all stages of curricula for end-of-life specialists. Two trends emerged related to course content. One focuses on clinicians’ acquisition of cultural expertise and tools allowing them to deal with complex situations on their own; the other stresses the importance of clinicians’ reflections and learning to collaborate with other professionals in complex situations. These trends evoke recent debates in the literature: the quest for expertise and tools is related to traditional twentieth century work on cross-cultural competence, whereas reflection and collaboration are central to more recent research that promotes cultural sensitivity and humility in clinicians.

Conclusion
This study offers new insights into cross-cultural courses in palliative and end-of-life care. Basic knowledge on culture in medicine, variable practices related to death and dying, communication techniques, self-reflection on cultural references and aptitude for interprofessional collaboration are central to preparing clinicians in end-of-life settings to work with linguistically and culturally diverse patients.
A qualitative study of clinical narrative competence of medical personnel
Authors: Chu Shao-Yin , Wen Chin-Chen , Lin Chi-Wei 
Published: November 2020

AbstractBackgroundMedicine practiced with narrative competence is called narrative medicine, which has been proposed and used as a model of humane and effective medical practice. Despite the in-depth discussions of narrative medicine, the study of narrative competence in literature is limited; therefore, this study aims to explore the dimensions and connotations of the clinical narrative competence of medical personnel.MethodsThis qualitative study used in-depth interviews to collect participants’ experience and perspectives regarding narrative competence, followed by thematic analysis of the transcripts.Through purposive sampling, this study successfully recruited 15 participants (nine males and six females in 2018–2019) who were engaged in narrative medicine or medical humanity education from different medical schools and hospitals across Taiwan. The authors performed manual thematic analysis to identify the themes and concepts of narrative competence through a six-step theme generation process.ResultsThere were four major themes of narrative competence generalized and conceptualized: narrative horizon, narrative construction (including narrative listening, narrative understanding, narrative thinking, and narrative representation), medical relationship (including empathy, communication, affiliation, and inter-subjectivity), and narrative medical care (including responsive care, balanced act, and medical reflection). These four themes were further integrated into a conceptual framework and presented in a diagram.ConclusionsCultivating narrative competence in medical education can complement traditional biomedical orientation. Regardless of their treatment orientation, narrative medicine-informed health practitioners may take advantage of their multi-dimensional narrative competence, as presented in this article, to enhance their awareness and preparation in different areas of competence in medical services. In addition, the results of this study can be used as a framework for the development of the behavioral indicators of narrative competence, which can be taken as the basis for medical education curriculum design.
Attitudes and concerns of undergraduate university health sciences students in Croatia regarding complete switch to e-learning during COVID-19 pandemic: a survey
Authors: Puljak Livia , Čivljak Marta , Haramina Ana , Mališa Snježana , Čavić Dalibor , Klinec Dinko , Aranza Diana , Mesarić Jasna , Skitarelić Nataša , Zoranić Sanja , Majstorović Dijana , Neuberg Marijana , Mikšić Štefica , Ivanišević Kata 
Published: November 2020

Abstract

Background
Croatia has closed all educational institutions after 32 cases of SARS-CoV-2 infection were confirmed and switched to exclusive e-learning. Health sciences university students may have been particularly affected with this change due to a lack of practical education. It is not known how health sciences students and schools have adjusted to exclusive e-learning. This study aimed to explore attitudes and concerns of health sciences students in Croatia regarding the complete switch to e-learning during the COVID-19 pandemic.

Methods
Eligible participants were students from 9 institutions offering university-level health sciences education in Croatia enrolled in the academic year 2019/2010, and participating in e-learning. Data were collected with a questionnaire distributed via email during April/May 2020.

Results
A total of 2520 students (aged 25.7 ± 7.7 years) responded to the questionnaire (70.3% response rate). General satisfaction with exclusive e-learning was rated with average grade of 3.7 out of 5. Compared with previous education, exclusive e-learning was rated with average grade of 3.2 out of 5. Compared to classroom learning, equal or higher motivation to attend exclusive e-learning was reported by 64.4% of participants. With a longer duration of exclusive e-learning, equal or higher motivation was reported by 65.5% of participants. Less than half of the students indicated they felt deprived or concerned due to the lack of practical lessons. Most participants indicated that in the future, they would prefer to combine classic classroom and e-learning (N = 1403; 55.7%).

Conclusions
Most health sciences students were satisfied with the exclusive e-learning, as well as their personal and institutional adjustment to it. Students’ feedback can help institutions to improve the exclusive e-learning experience for students in the time of the pandemic.
Medical identity; perspectives of students from two countries
Authors: Gilligan Conor , Loda Teresa , Junne Florian , Zipfel Stephan , Kelly Brian , Horton Graeme , Herrmann-Werner Anne 
Published: November 2020

Abstract

Background
The development of professional identity is a fundamental element of medical education. There is evidence that in Germany, students’ perceptions of the ideal and real doctor differ, and that of themselves as physicians falls between these constructs. We sought to compare students’ perceptions of themselves, the ideal doctor, and the ‘real’ doctor and investigate differences from first to final year in the relationships between these constructs, as well as differences between Australian and German cohorts.

Method
Students in the first and final years of their medical program at one Australian and one German university were invited to complete the Osgood and Hofstatter polarity profile, involving the description of their mental image of the ideal and real doctor, and the doctor they hope to become, with adjectives provided.

Results
One hundred sixty-seven students completed the survey in Australia (121 year 1, 46 year 5) and 188 in Germany (164 year 1, 24 year 6). The perception of the ideal doctor was consistent across all respondents, but that of the real doctor and self-image differed between country and year. Differences existed between country cohorts in perceptions of ‘confidence’, ‘strength’, ‘capability’ and ‘security’.

Conclusions
The pattern previously reported among German students was maintained, but a different pattern emerged among Australian students. Differences between countries could reflect cultural differences or variations in the overt and hidden curricula of medical schools. Some of the constructs within the profiles are amenable to educational interventions to improve students’ confidence and sense of capability.
Implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia
Authors: Adraro Zerihun , Mengistu Daniel 
Published: November 2020

Abstract

Background
The nursing process was initially adopted from the general system theory, and was developed and implemented in the field of education. There is a demand to implement the nursing process in practical care in every health institution, but the perception remains that it is time-consuming and impractical. If the nursing process is not valued and not used, nurses may continue to intervene on the basis of a medical diagnosis rather than on the basis of a rational nursing Process steps. In any of the steps, oversight or omission can result in less than optimal nursing care. The purpose of this study was to assess implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia.

Methods
An institution-based cross-sectional descriptive study was conducted from March 10 to April 1, 2015 in three hospitals in southwest Ethiopia using self-administered questionnaires. This study included a total of 138 nurses using simple random sampling. Data were classified, coded and entered into epidemiological information version 3.5.3, and exported to the statistical package for social science version 20 for analysis, descriptive statistics were used to describe the variables, bivariable and multivariable logistic regression were used to see the effect of each variable on the dependent variable.

Result
The nursing process was found to be 73.9% implemented. Compared to a Bachelor of Science nurses’, the likelihood of implementing the nursing process was less likely among diploma nurses. Nurses working in administratively supported hospitals implemented the nursing process more compared to those without administrative support. The nursing process had been implemented higher by trained nurses compared to untrained nurses.

Conclusion
The implementation of nursing process was good where; nearly seven in every ten nurses implemented the nursing process. Low educational qualification, lack of training, and non-supportive hospital administration were predictors of the nursing process implementation. The health service management, in collaboration with Ethiopian nursing/professional associations and international governmental and non-governmental organizations should give continuous on the job professional development education, and develop nursing practice guidelines.
“Vital”: HIV counselling and testing staff’s views of addressing mental health with HIV in Uganda
Authors: Martin Faith , Nalukenge Winfred , Lazarus Oucul , Birungi Josephine , Seeley Janet 
Published: November 2020

AbstractBackgroundMental health is linked to HIV outcomes, including linkage into care and adherence to medication. Integrated care for mental and physical health is recommended. HIV testing and counselling sessions represent an opportunity to implement interventions to address mental health, however it is first necessary to understand the roles, current practice, knowledge and attitudes of the testing and counselling staff.MethodsThis qualitative study used semi-structured interviews with HIV testing and counselling staff at four centres of a HIV healthcare provider charity in Uganda. Interviews focused on their current practice, perceptions of mental health and their role in supporting this, challenges of this work, training and support needs, and views of potential greater emphasis on mental health work in their role. Data were audio-recorded, transcribed verbatim, and analysed thematically.ResultsData from twenty-one testing and counselling staff revealed five themes. Clients presented to counselling staff with needs spanning bio-psycho-social domains, where psychological health was intertwined with HIV management, medication adherence, and seen as “inseparable” from HIV itself. Mental health was largely thought about as “madness”, identifiable from extreme behaviour. As such, common mental health problems of anxiety and depression were not often seen as part of mental health. Approaches to intervening with mental health were seen as behavioural, with some ideas about changing thinking styles. Participants demonstrated significant practice of common techniques to address mental health. Needs were identified for further training in suicide risk assessment and identification of depression, together with greater clinical supervision. Participants described significant conflict within their roles, particularly balancing time demands and need to achieve testing targets against the need to offer adequate mental health support to clients in need.ConclusionsHIV testing and counselling staff described a diverse role that already includes addressing mental health. Mental health is “vital” to their work, however the time needed to address it is at odds with current testing targets. They require more training and resources to effectively address mental health, which is vital to optimising HIV outcomes. Interventions to integrate mental health support into HIV testing and counselling sessions need to be further researched and optimised.
Mendelian randomization study of inflammatory bowel disease and bone mineral density
Authors: Wu Fashuai , Huang Yu , Hu Jialu , Shao Zengwu 
Published: November 2020

AbstractBackgroundRecently, the association between inflammatory bowel disease (including ulcerative colitis and Crohn’s disease) and BMD has attracted great interest in the research community. However, the results of the published epidemiological observational studies on the relationship between inflammatory bowel disease and BMD are still inconclusive. Here, we performed a two-sample Mendelian randomization analysis to investigate the causal link between inflammatory bowel disease and level of BMD using publically available GWAS summary statistics.MethodsA series of quality control steps were taken in our analysis to select eligible instrumental SNPs which were strongly associated with exposure. To make the conclusions more robust and reliable, we utilized several robust analytical methods (inverse-variance weighting, MR-PRESSO method, mode-based estimate method, weighted median, MR-Egger regression, and MR.RAPS method) that are based on different assumptions of two-sample MR analysis. The MR-Egger intercept test, Cochran’sQtest, and “leave-one-out” sensitivity analysis were performed to evaluate the horizontal pleiotropy, heterogeneities, and stability of these genetic variants on BMD. Outlier variants identified by the MR-PRESSO outlier test were removed step-by-step to reduce heterogeneity and the effect of horizontal pleiotropy.ResultsOur two-sample Mendelian randomization analysis with two groups of exposure GWAS summary statistics and four groups of outcome GWAS summary statistics suggested a definitively causal effect of genetically predicted ulcerative colitis on TB-BMD and FA-BMD but not on FN-BMD or LS-BMD (after Bonferroni correction), and we merely determined a causal effect of Crohn’s disease on FN-BMD but not on the others, which was somewhat inconsistent with many published observational researches. The causal effect of inflammatory bowel disease on TB-BMD was significant and robust but not on FA-BMD, FN-BMD, and LS-BMD, which might result from the cumulative effect of ulcerative colitis and Crohn’s disease on BMDs.ConclusionsOur Mendelian randomization analysis supported the causal effect of ulcerative colitis on TB-BMD and FA-BMD. As to Crohn’s disease, only the definitively causal effect of it on decreased FN-BMD was observed. Updated MR analysis is warranted to confirm our findings when a more advanced method to get less biased estimates and better precision or GWAS summary data with more ulcerative colitis and Crohn’s disease patients was available.
Comparison of global and regional myocardial strains in patients with heart failure with a preserved ejection fraction vs hypertension vs age-matched control
Authors: Kim Hyung Yoon , Park Sung-Ji , Lee Sang-Chol , Chang Shin Yi , Kim Eun-Kyoung , Chang Sung-A , Choi Jin-Oh , Park Seung Woo , Kim Sung-Mok , Choe Yeon Hyeon , Oh Jae K. 
Published: November 2020

Abstract

Background
With an increasing clinical importance of the treatment of the heart failure (HF) with preserved ejection fraction (HFpEF), it is important to be certain of the diagnosis of HF. We investigated global and regional left ventricular (LV) strains using speckle tracking echocardiography (STE) in patients with HFpEF and compared those parameters with that of patients with hypertension and normal subjects.

Methods
Peak longitudinal, circumferential and radial strains were assessed globally and regionally for each study groups using STE. Diastolic strain rate was also determined.

Results
There were 50 patients in HFpEF group, 56 patients in hypertension group and 46 age-matched normal subjects. In patients with HFpEF, global peak longitudinal, circumferential and radial strain and strain rate were reduced compared to both hypertension patients and normal controls (− 15.5 ± 5.3 vs − 17.7 ± 3.1 and − 19.9 ± 2.0; − 9.7 ± 2.2 vs − 19.3 ± 3.1 and − 20.5 ± 3.3; 17.7 ± 8.2 vs 38.4 ± 12.4 and 43.6 ± 11.9, respectively, P <  0.001, for all). The diagnostic performance of global circumferential strain to predict the HFpEF was greatest among strain parameters (area under the curve = 0.997).

Conclusions
In the speckle tracking echocardiography, impaired peak global strain and homogeneously reduced regional strain was observed in HFpEF patients compared to the hypertension patients and normal subjects in decreasing order. This can provide early information on the initiation of LV deformation of HFpEF in patients with hypertension or normal subjects.
Revealing oral microbiota composition and functionality associated with heavy cigarette smoking
Authors: Al Bataineh Mohammad Tahseen , Dash Nihar Ranjan , Elkhazendar Mohammed , Alnusairat Dua’a Mohammad Hasan , Darwish Islam Mohammad Ismail , Al-Hajjaj Mohamed Saleh , Hamid Qutayba 
Published: November 2020

AbstractBackgroundHeavy tobacco smoking, a hallmark feature of lung cancer, is drastically predominant in Middle Eastern populations. The precise links between nicotine dependence and the functional contribution of the oral microbiota remain unknown in these populations.MethodsWe evaluated the composition and functional capabilities of oral microbiota with relation to cigarette smoking in 105 adults through shotgun metagenomics using buccal swabs.ResultsThe oral microbiota composition in our study subjects was dominated by the phylaFirmicutes,Proteobacteria,Actinobacteria, andBacteroidetes, in addition to the generaPrevotellaandVeillonella,similar to previously described westernized cohorts. Furthermore, the smoker's oral microbiota represented a significant abundance ofVeillonella dispar,Leptotrichiaspp. andPrevotella pleuritidiswhen compared to non-smokers. Within the smoking groups, differential relative abundance testing unveiled relative abundance ofStreptobacillus hongkongensis,Fusobacterium massiliense,Prevotella biviain high nicotine dependent compared to low nicotine dependent profiles based on Fagerström Test for Nicotine Dependence. Functional profiling showed marked differences between smokers and non-smokers. Smokers exhibited an enrichment of Tricarballylate utilization and Lactate racemization when compared to the non-smokers. According to their nicotine dependence, enrichment of Xanthosine utilization, p-Aminobenzoyl-Glutamate utilization, and multidrug efflux pump inCampylobacter jejunibiosynthesis modules were detected in the high nicotine dependent group.ConclusionsThese compositional and functional differences may provide critical insight on how variations in the oral microbiota could predispose to respiratory illnesses and smoke cessation relapse in cigarette smokers. In particular, the observed enrichment ofFusobacteriumandPrevotellain the oral microbiota possibly suggests an intriguing linkage to gut and lung cancers.