bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescription Patterns of Dentists in Primary Care in Bahrain During COVID-19: A Cross Sectional Study.
Authors: Sivaramakrishnan Gowri , Alsobaiei Muneera , AlSulaiti Fatema , Sridha Kannan 
Published: December 2020

Abstract
Background: Dentists have always been attributed to the ever rising global problem of antibiotic resistance. The recent pandemic due to COVID-19 has caused greater concern and primary dental care practices were suspended in the Ministry of Health in Bahrain between February to August 2020. Dental emergencies were addressed using a triage system and dentists were advised on avoiding invasive and aerosol generating procedures. This means that many dentists opted to prescribe medications without undertaking the necessary dental intervention. Aim: To identify the prescription and drug utilization of primary care dental practitioners during the temporary suspension of routine dental practices due to COVID-19.Method: Anonymized data from out-patient dental prescriptions from February 2020 to August 2020 were collected. Necessary data regarding the number, type and indication for prescription were collected and analyzed using appropriate statistical tests.Results: An average of two medications were prescribed for each patient, that included systemic and local analgesics and anti-microbials. 33.4% of patients were only prescribed medications without any dental intervention. Approximately 35% of the records showed inappropriate diagnosis and their rationale for prescription could not be determined. 100% of the patients with acute or chronic periapical abscess and 41% with gingivitis or periodontitis were prescribed medications without any dental intervention. Amoxicillin and amoxicillin/clavulanic acid amongst the antimicrobial class; and ibuprofen and acetaminophen amongst the analgesics accounted for 90% of prescribed drugs. Chlorhexidine mouth rinse seemed to be on the regular list for any diagnoses, prescribed between 7 and 14 days, twice or thrice daily. Conclusion: Suspension of dental practices can cause more harm in terms of overuse and unindicated prescription practices in primary dental care. The awareness of the recent guidelines is important to prevent unintended use. Effective infection control practices based on guideline should be in place to contain COVID-19 transmission rather than suspension of dental care.
Adherence Of Facemask During COVID Pandemic Among South Asian Countries-An Observational Study
Authors: Abid Khadijah , Imran Abira , Bari Yashfika , Ziadi Tooba , Khambati Zainab , Younus Maryam , Billah Abul Hasan Baki , Khura Bikash , Jabbar Abdul 
Published: December 2020

Abstract
Background: The novel coronavirus outbreak, caused by SARS-CoV-2, has proven to be an attack on the global healthcare system, demanding utmost attention from both the healthcare and government officials around the world. The use of face masks is so pivotal in lowering the risk of contracting respiratory viruses, it is crucial to know how many people are actually complying with this protective healthcare policy and what socio-demographic factors (if any) are influencing it. So, the aim was to investigate the adherence rate of face masks among the people of South Asian countries namely Pakistan, Bangladesh, and India, and also to examine correlations between face mask adherence and socio-demographic factors.Methodology: This was an observational study conducted from 15 July 2020 to 15 September 2020. Individuals of age more than 14 years of either gender, who had accessibility to the internet and understood English participated in the study. The three South-Asian countries such as Pakistan, India, and Bangladesh were targeted. The online survey form included questions regarding socio-demographics and the type of face mask they wore. Face mask adherence was classified as “yes” when any type of face mask was worn and “no” when no face mask was used. Statistical software SPSS version 25 was used to analyze data.Results: The mean age of the participants was 31.32±9.83 years. Out of all these participants, there were 826 (46.3%) males and 959 (53.7%) were females. Univariate analysis showed that females, Muslims, education level till graduate, employed, monthly income and Bangladeshi participants had higher odds of face mask adherence (p<0.05). The multivariate analysis showed that females, Muslims, urban residents, secondary level education, employed, monthly income $100 - $300, and Bangladeshi were strongly associated with face mask adherence (p<0.05).Conclusion: Among all three countries, Bangladeshi had high face mask adherence than Pakistan and India. The socio-demographic factors associated with facemask usage were gender, religion, locality, education, employment status, monthly income, and nationality.
OB Nest Randomized Controlled Trial: A Cost Comparison of Reduced Visit Compared to Traditional Prenatal Care
Authors: Theiler Regan , Tobah Yvonne Butler , Hathcock Matthew , Famuyide Abimbola 
Published: December 2020

Abstract
BackgroundTraditional prenatal care includes up to 13 in person office visits, and the cost of this care is not well-described. Alternative models are being explored to better meet the needs of patients and providers. OB Nest is a telemedicine-enhanced program with a reduced frequency of in-person prenatal visits. The cost implications of connected care services added to prenatal care packages are unclear.MethodsUsing data from the OB Nest randomized, controlled trial we analyzed the provider and staff time associated with prenatal care in the traditional and OB Nest models. Fewer visits were required for OB Nest, but given the compensatory increase in connected care activity and supplies, the actual cost difference is not known.Nursing and provider staff time was prospectively recorded for all patients enrolled in the OB Nest clinical trial. Published 2015 national wages for healthcare workers were used to calculate the actual labor cost of providing either traditional or OB Nest prenatal care in 2015 US dollars. Overhead expenses and opportunity costs were not considered.ResultsTotal provider cost was decreased caring for the OB Nest participants, but nursing cost was increased. OB Nest care required an average of 160.8 (+/- 45.0) minutes provider time and 87.8 (+/- 25.1) minutes nursing time, compared to 215.0 (+/- 71.6) and 99.6 (+/- 29.7) minutes for traditional prenatal care (P<0.01). This translated into decreased provider cost and increased nursing cost (P<0.01). Supply costs increased, travel costs declined, and overhead costs declined in the OB Nest model. ConclusionsIn this trial, labor cost for OB Nest prenatal care was 34% higher than for traditional prenatal care. The increased cost is largely attributable to additional nursing connected care time, and in some practice settings may be offset by decreased overhead costs and increased provider billing opportunities. Future efforts will be focused on development of digital solutions for some routine nursing tasks to decrease the overall cost of the model. Trial Registrations: ClinicalTrials.gov Identifier: NCT02082275
What A Disaster! The Hydrofluoric Acid Leak in Gumi City in 2012: Lessons What We Have Earned From Review of the Past Hospital’s Disaster Response
Authors: Shin Heejun , Oh Se Kwang , Lee Han You , Chung Heajin , Yoon Seong Yong , Choi Sung Yong , Kim Jae Hyuk 
Published: December 2020

Abstract
Objective: This study aimed to analyze the characteristics of hydrogen fluoride–exposed patients (HFEPs) treated at an emergency department (ED) at a local university hospital, and to review the hospital's disaster response according to staff, stuff, space, and system (4Ss).Method: This is retrospective observational chart review and descriptive study included 199 HFEPs among 2628 of total ED patient who visited a local university emergency medical center for treatment between September 27 and October 20, 2012, following an HF leak at the Hub Globe factory in Gumi City, Republic of Korea. Descriptive results concerning 4Ss were obtained from interview with ED specialist staff physician on duty during the study period. According to the criteria of the American Burn Association, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition. Result: During the first 24 h after the accident, 161 (80.9%) HFEPs were treated in the ED. Among the 55 (27.6%) patients in the MBG, 8 (4% of the HFEPs) came to the ED during the acute phase (within the first 8 h after the leak began). During the acute phase, the ED was staffed with three doctors and three nurses. Among the total 2628 patients in the ED during the study period, 262 (9.97%) patients, including 167 (83.92%) of the 199 HFEPs, were there during the subacute phase, defined as the 24 h after the acute phase. During the subacute phase, the ED staff consisted of six doctors and 10 nurses. No concepts according to 4Ss that allowed for the expansion of ED space with securing disaster reserve beds or an increase in manpower with duty time adjustments or duty relocation for ED working personnel were in place as well as reinforcement of logistics such as antidote or PPE or disaster related measures of administration department or decontamination zone setup or decontamination or disaster related diagnostic testing measures or unification and management of the entrances and exits of hospital or implementation of previously designated disaster triage.Conclusion: Hospital disaster response was insufficient for all aspects of 4Ss. Detailed guidance for hospital disaster management plan establishment is required.
Using a Distribution-Based Approach and Systematic Review Methods to Derive Minimum Clinically Important Differences
Authors: Watt Jennifer , Veroniki Areti Angeliki , Tricco Andrea , Straus Sharon 
Published: December 2020

Abstract
Background Clinical interpretation of changes measured on a scale is dependent on knowing the minimum clinically important difference (MCID) for that scale: the threshold above which clinicians, patients, and researchers perceive an outcome difference. Until now, approaches to determining MCIDs were based upon individual studies or surveys of experts. However, the comparison of meta-analytic treatment effects to a MCID derived from a distribution of standard deviations (SDs) associated with all trial-specific outcomes in a meta-analysis could improve our clinical understanding of meta-analytic treatment effects. Methods We approximated MCIDs using a distribution-based approach that pooled SDs associated with baseline mean or mean change values for two scales (i.e. Mini-Mental State Exam [MMSE] and Alzheimer Disease Assessment Scale – Cognitive Subscale [ADAS-Cog]), as reported in parallel randomized trials (RCTs) that were included in a systematic review of cognitive enhancing medications for dementia (i.e. cholinesterase inhibitors and memantine). We excluded RCTs that did not report baseline or mean change SD values. We derived MCIDs at 0.4 and 0.5 SDs of the pooled SD and compared our derived MCIDs to previously published MCIDs for the MMSE and ADAS-Cog.Results We showed that MCIDs derived from a distribution-based approach approximated published MCIDs for the MMSE and ADAS-Cog. For the MMSE (51 RCTs, 12449 patients), we derived a MCID of 1.6 at 0.4 SDs and 2 at 0.5 SDs using baseline SDs and we derived a MCID of 1.4 at 0.4 SDs and 1.8 at 0.5 SDs using mean change SDs. For the ADAS-Cog (37 RCTs, 10006 patients), we derived a MCID of 4 at 0.4 SDs and 5 at 0.5 SDs using baseline SDs and we derived a MCID of 2.6 at 0.4 SDs and 3.2 at 0.5 SDs using mean change SDs. Conclusion A distribution-based approach using data included in a systematic review approximated known MCIDs. Our approach performed better when we derived MCIDs from baseline as opposed to mean change SDs. This approach could facilitate clinical interpretation of outcome measures reported in RCTs and systematic reviews of interventions. Future research should focus on the generalizability of this method to other clinical scenarios.
Winter Wonderland Cave, Utah, USA: A Natural Laboratory for the Study of Cryogenic Cave Carbonate and Thawing Permafrost
Authors: Munroe Jeffrey , Kimble Kristin , Spötl Christoph , Marks Gabriela Serrato , McGee David , Herron David 
Published: December 2020

Abstract
Winter Wonderland Cave contains perennial ice associated with two types of cryogenic cave carbonate (CCC) formed during the freezing of water. CCCfine is characterized by relatively enriched δ13C values, whereas CCCcoarse exhibits notably depleted δ18O values indicating precipitation under (semi)closed-system conditions in a pool of residual water beneath an ice lid. Previous work has concluded that CCCcoarse forms during permafrost thaw, making the presence of this precipitate a valuable indicator of past cryospheric change. Available geochronologic evidence indicates that CCC formation in this cave is a Late Holocene or contemporary process, and field observations suggest that the cave thermal regime recently changed in a manner that permits the ingress of liquid water. This is the first documented occurence of CCCcoarse in the Western Hemisphere and one of only a few locations where these minerals have been found in association with ice. Winter Wonderland Cave is a natural laboratory for studying CCC genesis.
Comparison of Changes in 2015 to 2019 for Socioeconomic Inequalities and Inequities in Health Services Utilization Among Patients With Hypertension in Pearl River Delta Region of China
Authors: Liu Yan , Cheng Mengjiao , Peng Xin , Huang Junxuan , Liu Nan , Ma Jinxiang , Wang Pei-Xi 
Published: December 2020

Abstract
BackgroundAssessing inequities in health services utilization contributes to build effective strategies for promotion of health equity. This study aimed to evaluate the socioeconomic inequalities and inequities in health services utilization among hypertensive patients and explore the changes between 2015 and 2019 in Pearl River Delta region of China. MethodsThe cross-sectional surveys were conducted using the questionnaire. In total, 830 and 1166 hypertensive patients in 2015 and 2019 were interviewed, respectively. The concentration index (CI) and the horizontal inequity (HI) were used to access the socioeconomic inequalities and inequities in health services use. The contribution of influential factors to the overall unfairness was estimated via the concentration index decomposition. Oaxaca-type decomposition technique was utilized to measure the changes in socioeconomic inequalities between the observation periods. ResultsFrom 2015 to 2019, the CIs for outpatient and inpatient utilization decreased from 0.1498 to 0.1198, 0.1982 to 0.1648, respectively, and the HIs for outpatient and inpatient utilization decreased from 0.1478 to 0.1078, 0.1956 to 0.1390, respectively, i.e. obvious pro-rich inequities in utilization of health services by hypertensive patients existed in Pearl River Delta Region even after controlling different needs, but they decreased over time. The inequities in inpatient utilization were higher compared with that in outpatient utilization. Economic status contributed the maximum ratio of the socioeconomic inequalities in the use of health services in these two years (107.54% in 2015, 106.92% in 2019). Oaxaca decomposition revealed that factors such as residential location, registration, health insurance and time to the nearest health facilities, employment status and educational level, etc. made positive contributions to decline the inequalities. While factors pushed the equalities toward deterioration included health needs, economic status and household size. Conclusion﻿There were certain decline in the socioeconomic inequalities and inequities in health services utilization by hypertensive patients in Pearl River Delta Region of China by comparison of 2015 and 2019. Although the pro-rich inequities persists, it does suggest that government policies have improved health equity over time.
The Impact of Illness Awareness on the Difference in the Economic Burden of Disease Among Middle-Aged and Elderly Diabetic Patients in Rural Areas
Authors: Liu Li , Deng Jing , Yu Xue 
Published: December 2020

Abstract
BackgroundThere are many explorations in China on the awareness of diabetes and the economic burden of disease, but the impact of awareness of illness on the economic burden of disease has not yet been empirically studied. We aim to explore the status of illness awareness and its influencing factors in rural middle-aged and elderly diabetic patients, and to further explore the impact of illness awareness on the economic burden of patients.MethodsTaking rural middle-aged and elderly diabetes as the object, the multiple regression model was used to analyze the patient's economic burden of disease and illness awareness, the propensity score matching method (PSM) was used to solve the influence of sample selection bias, and to explore the economic burden of disease awareness on patients Impact.ResultsIllness awareness is an important factor affecting the economic burden of disease in middle-aged and elderly diabetes in rural areas. Illness awareness increased the economic burden of disease by 94.3%; the number of other chronic diseases, education level, location, self-rated health status, and smoking are Influencing factors of patients' awareness of illness.ConclusionIn the short term, awareness of illness increases the overall treatment costs of patients, but from the perspective of long-term development, changes in lifestyle and medical behavior based on awareness of illness can help improve the health of patients and effectively reduce the risk of middle-aged and elderly diabetic patients in rural areas. The economic burden of disease.
Lung Diffusion Capacity Affects Stroke Volume in Systemic Sclerosis
Authors: Someya Fujiko , Mugii Naoki 
Published: December 2020

Abstract
Objective: In our previous cross-sectional study, we reported impaired stroke volume in patients with systemic sclerosis; however, no cardiac parameter using echocardiography was found to be related to stroke volume reduction. As few studies have focused on the hemodynamic clinical course, the patients were re-evaluated in a median interval of 18 months, and correlations between stroke volume and cardiopulmonary parameters were analyzed.Results: Seventeen patients who were able to complete the 6-minute walk test wearing a non-invasive impedance cardiograph device were assigned for re-evaluation, and individual changes in the stroke volume were noted. The stroke volume was not related to cardiac parameters, but it was significantly related to the diffusion capacity of the lung for carbon monoxide after walking in the first evaluation (r = 0.63, p = 0.006), and at rest in the re-evaluation (r = 0.72, p = 0.001). Significant relation was also found between the distance walked and the stroke volume after walking in the first evaluation and re-evaluation, and at rest in the re-evaluation. Thus, a limited lung diffusion capacity may affect stroke volume due to the exercise intolerance in systemic sclerosis without pathological heart involvement.
Effect of Ambient Fine Particulate (PM2.5) on Hospital Admissions for Respiratory and Cardiovascular Diseases in Wuhan, China
Authors: Ren Zhan , Liu Xingyuan , Liu Tianyu , Chen Dieyi , Jiao Kuizhuang , Wang Xiaodie , Suo Jingdong , Yang Haomin , Liao Jingling , Ma Lu 
Published: December 2020

Abstract
Background: The positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of megalopolis. In addition, due to the lack of accurate methods of assessing individual PM2.5 exposure, further studies are still necessary to be launched in China.Methods: The study was conducted in Wuhan, a megacity in central China with about 10.8929 million population. Daily hospital admission records, from October 2016 to December 2018, were obtained from Wuhan Information center of Health and Family Planning, which administrates all the hospitals in Wuhan. The daily air pollution concentration and weather variable in Wuhan during the study period were collected. We developed Land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposures to PM2.5. We also conducted stratification analyses by age, sex and season.Results: A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 for total cardiovascular diseases and 159,365 for total respiratory diseases. We found short-term PM2.5 exposure was associated with increased risk of cardiorespiratory hospital admission in Wuhan. Per 10 μg/m3 increase of PM2.5 at lag0~2 days was associated with 1.23% (95%CI: 1.01–1.45%) and 1.95% (95%CI: 1.63–2.27%) elevated risk of admission from cardiovascular and respiratory diseases respectively. The elderly were at higher PM-induced risks. The associations appeared to be more evident in the cold season than in the warm season.Conclusions: This study contributed evidence to support the short-term effects of PM2.5 on cardiorespiratory hospital admission, which may be helpful for air pollution control and disease prevention in Wuhan.
A Novel Landmark Based on Nutrient Foramen for Pedicle Screw Insertion in the Battlefield Emergency&nbsp;
Authors: Lu Lantao , Zhu Jian , Sun Kaiqiang , Sun Jingchuan , Shi Jiangang 
Published: December 2020

Abstract
Background: Spinal injuries is with high frequency in the modern wars and some patients with severe spinal injures have to accept the emergency spinal surgery. Nutrient foramen is easy to identify intraoperatively. The purpose of this study was to investigate the feasibility and reliability of using the nutrient foramen to guide the pedicle screw placement.Methods: Nine dried human vertebral bone were involved in this study. The anatomical association to the pedicles and bony landmarks were measured in the vertebrae for C6-T6. We also determined the frequency with which the nutrient foramina were present in 86 cadaveric vertebrae. We identified the pedicle location, base of the superior articular process, base of inferior articular process, base of transverse process, and the posterior median line with respect to the nutrient foramenResults: The overall presence of the nutrient foramina was 63% in the specimens. The nutrient foramina located cranially and laterally on the lamina, and the nutrient foramen was located near to the pedicle. Conclusion: The location of nutrient foramen can be used for identifying the entry point for pedicle screws in the cervicothoracic junction. The nutrient foramen is easy to identify during operation and with a high frequency of occurrence. Therefore, the nutrient foramen could be used as a reliable landmark to guide the entry point localization in emergency spinal surgeries in the battlefield.