bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with malaria infection in Mudzi District, Mashonaland East Zimbabwe, 2019: a case-control study
Authors: Masango T. T. , Nyadzayo T. K. , Gombe N. T. , Juru T. P. , Shambira G. , Chiwanda S. , Tshimanga M. T. 
Published: November 2020

Abstract
Background
Kondo Rural Health Centre recorded 27 malaria patients between the 27th of January 2019 and the 2nd of February 2019 against an epidemic threshold of 19 with the malaria outbreak being confirmed on the 5th of February 2019. Indoor residual spraying as part of integrated vector management control activities had been done in the district before the onset of the rainy season as well as social behaviour change communication but residents were contracting malaria. We, therefore, investigated the risk factors associated with this outbreak to recommend scientifically effective prevention and control measures.

Methods
We conducted a 1:1 unmatched case-control study. A case was a resident of Mudzi from the 4th of February 2019 who had a positive rapid diagnostic test for malaria randomly selected from the clinic’s line list whilst controls were randomly selected from the neighbourhood of cases. Pretested interviewer-administered questionnaires were used to collect information on demographic characteristics, knowledge and practices of residents in malaria prevention. Data were analysed using Epi info 7.

Results
A total of 567 confirmed malaria cases was recorded with an overall attack rate of 71.7 per 1000 population. Sixty-three case-control pairs were interviewed. The majority of cases 78% (49/63) were from Makaza, Chanetsa and Nyarongo villages which are within 3 km from Vhombodzi dam. A stagnant water body near a house [aOR = 8.0, 95%CI = (2.3–28.6)], engaging in outdoor activities before dawn or after dusk [aOR = 8.3, 95%CI = (1.1–62.7)] and having a house with open eaves [aOR = 5.4, 95%CI = (1.2–23.3)] were independent risk factors associated with contracting malaria. Wearing long-sleeved clothes when outdoors at night [aOR = 0.2, 95%CI = (0.1–0.4)] was protective.

Conclusion
A stagnant water pool close to the homestead and engaging in outdoor activities before dawn and after dusk were modifiable risk factors associated with the malaria outbreak despite the community being knowledgeable on the transmission and prevention of malaria. Community sensitisation and mobilisation in the destruction of stagnant water bodies and cutting of tall grass around homesteads were recommended measures to contain the outbreak.
Diagnosis and treatment of intramedullary osteosclerosis: a report of three cases and literature review
Authors: Abe Kensaku , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Miwa Shinji , Igarashi Kentaro , Higuchi Takashi , Taniguchi Yuta , Yonezawa Hirotaka , Araki Yoshihiro , Morinaga Sei , Asano Yohei , Tsuchiya Hiroyuki 
Published: November 2020

AbstractBackgroundIntramedullary osteosclerosis (IMOS) is a rare condition without specific radiological findings except for the osteosclerotic lesion and is not associated with family history and infection, trauma, or systemic illness. Although the diagnosis of IMOS is confirmed after excluding other osteosclerotic lesions, IMOS is not well known because of its rarity and no specific feature. Therefore, these situations might result in delayed diagnosis. Hence, this case report aimed to investigate three cases of IMOS and discuss imaging findings and clinical outcomes.Case presentationAll three cases were examined between 2015 and 2019. The location of osteosclerotic lesions were femoral diaphyses in the 60-year-old man (Case 1) and 41-year-old woman (Case 2) and tibial diaphysis in the 44-year-old woman (Case 3). All cases complained of severe pain and showed massive diaphyseal osteosclerotic lesions in plain radiograms and computed tomography (CT) scans. Cases 2 and 3 were examined using the triphasic bone scan, and a fusiform-shaped intense area of the tracer uptake on delayed bone image was detected in both cases without (Case 2) or slightly increased vascularity (Case 3) on the blood pool image, which was reported as a specific finding of IMOS. Open biopsy was performed in all cases, and histologic section showed trabecular bone sclerosis with hypocellular fibrous tissues, finally diagnosed as IMOS. The pain was sharply improved after biopsy and kept at the latest follow-up periods (34, 33, and 6 months in Cases 1, 2, and 3, respectively).ConclusionsMassive sclerotic lesions with severe pain in the diaphyseal region of long bones should be considered as IMOS to avoid the delayed diagnosis, although other sclerotic bony lesions should be carefully excluded. Triphasic bone scan with a fusiform-shaped intense area of tracer uptake on delayed bone image and without or slightly increased vascularity on the blood pool image will help confirm IMOS. The role of open biopsy was to confirm the diagnosis of IMOS and to give the severe pain relief immediately in the three cases, although more cases and long-term follow-up are necessary.
Effect of crown to implant ratio and implantoplasty on the fracture resistance of narrow dental implants with marginal bone loss: an in vitro study
Authors: Leitão-Almeida Bruno , Camps-Font Octavi , Correia André , Mir-Mari Javier , Figueiredo Rui , Valmaseda-Castellón Eduard 
Published: November 2020

Abstract
Background
Peri-implantitis is a biological complication that affects soft and hard tissues around dental implants. Implantoplasty (IP) polishes the exposed implant surface, to decontaminate it and make it less prone to bacterial colonization. This study investigates whether a higher clinical crown-to-implant-ratio (CIR) reduces implant fracture resistance and whether implants are more fracture-prone after IP in the presence of 50% of bone loss.

Methods
Forty-eight narrow platform (3.5 mm) 15 mm long titanium dental implants with a rough surface and hexagonal external connection were placed in standardized bone-like resin casts leaving 7.5 mm exposed. Half were selected for IP. The IP and control groups were each divided into 3 subgroups with different clinical CIRs (2:1, 2.5:1 and 3:1). The implant wall width measurements were calculated using the software ImageJ v.1.51 through the analysis of plain x-ray examination of all the samples using standardized mounts. A fracture test was performed and scanning electron microscopy was used to evaluate maximum compression force (Fmax) and implant fractures.

Results
IP significantly reduced the implant wall width (P < 0.001) in all reference points of each subgroup. Fmax was significantly higher in the 2:1 subgroup (control = 1276.16 N ± 169.75; IP = 1211.70 N ± 281.64) compared with the 2.5:1 (control = 815.22 N ± 185.58, P < 0.001; IP = 621.68 N ± 186.28, P < 0.001) and the 3:1 subgroup (control = 606.55 N ± 111.48, P < 0.001; IP = 465.95 N ± 68.57, P < 0.001). Only the 2.5:1 subgroup showed a significant reduction (P = 0.037) of the Fmax between the controls and the IP implants. Most fractures were located in the platform area. Only 5 implants with IP of the 2:1 CIR subgroup had a different fracture location (4 fractures in the implant body and 1 in the prosthetic screw).

Conclusions
IP significantly reduces the fracture resistance of implants with a 2.5:1 CIR. The results also suggest that the CIR seems to be a more relevant variable when considering the resistance to fracture of implants, since significant reductions were observed when unfavorable CIR subgroups (2.5:1 and 3:1 CIR) were compared with the 2:1 CIR samples.
Comparative evaluation of volumetric changes of three different retrograde calcium silicate materials placed under different pH condititions
Authors: Kwon So Yeon , Seo Min-Seock 
Published: November 2020

AbstractBackgroundThe present study aimed to compare the volumetric changes of three calcium silicate cements after retrofilling and placing under different pH conditions via micro-computed tomography (micro-CT) scan.MethodsForty-two extracted human single-rooted teeth were randomly assigned to three groups according to the retrofilling materials used (Biodentine, Endocem MTA, and ProRoot MTA). Each group was divided into two subgroups according to the setting condition. The teeth in one group were immersed in normal saline for 5 days at room temperature, and the teeth in the other group were immersed in butyric acid (pH = 5.4) for 5 days at room temperature. The volume ratios of the retrofilling material were calculated via micro-CT imaging.ResultsThe volume ratios of the Biodentine and Endocem MTA groups were significantly different between the two setting environment, and these groups had significantly lower filled volume ratio (Vf, %) in the acidic environment than in the saline environment (pH = 5.4). Meanwhile, the volume ratio of the ProRoot MTA group did not significantly differ between the two setting environments. All materials under the acidic setting condition had relative radiolucency in the area in contact with the acidic solution.ConclusionThe Vf ratio of the Biodentine and Endocem MTA cements was significantly lower in the acidic environment than in the saline environment. No statistically significant difference was observed in the Vf ratio of ProRoot MTA between the two setting environments.
Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase
Authors: Mélin M. , Amieva H. , Frasca M. , Ouvrard C. , Berger V. , Hoarau H. , Roumiguière C. , Paternostre B. , Stadelmaier N. , Raoux N. , Bergua V. , Burucoa B. 
Published: November 2020

AbstractBackgroundIn the absence of extant recommendations, the aim of this study was to formalise support practices used by an interdisciplinary team in a palliative-care unit (PCU) for the relatives of patients in the agonal phase preceding death. The secondary objective was to understand the expectations of relatives during this phase in terms of the support provided by professionals and volunteers.MethodsThirty-two people took part in this study; all were interviewed through focus groups (FGs). Each FG comprised one category of individuals working in the PCU: nurses, care- assistants, doctors, psychologists, other professionals, palliative-care volunteers, and relatives. Groups were surveyed using an interview guide, and the interviews were recorded and transcribed to enable identification and characterization of all practices. Care practices were classified into four categories: current consensual practices (i.e. performed by all team members), occasional consensual practices, non-consensual practices (performed by one or a few participants), and practices to be developed.ResultsIn total, 215 practices were mentioned by professionals and palliative-care volunteers: 150 current consensual practices, 48 occasional consensual practices, 1 non-consensual practice, 16 practices yet to be developed, and 29 practices for relatives. Many practices were mentioned by different categories of participants; thus, after cross-checking, the number of practices decreased from 215 to 52. A list of practices deemed desirable by all was drawn up and then validated by the entire interprofessional team. These practices were organised around four themes: providing care and ensuring comfort; communicating, informing, and explaining; interacting; and mobilising interdisciplinary skills.ConclusionsThese results underline the importance of the quality of care provided to patients, the attention given to the relatives themselves, and they highlight the importance of the helping relationship. Following this study, which established a list of varied practices aimed at supporting the relatives of patients in agonal phase, it will be important to set up a broader study seeking to establish a consensus on these practices with an interprofessional group of experts from other PCUs using broad surveys and an adapted methodology. Such studies will make it possible to develop training modules for teams working with relatives.
Evaluation of immunomodulatory effects of Boswellia sacra essential oil on T-cells and dendritic cells
Authors: Aldahlawi Alia M. , Alzahrani Amani T. , Elshal Mohamed F. 
Published: November 2020

AbstractBackgroundBoswellia sacraresin has been commonly used as analgesic, antimicrobial, and anti-inflammatory properties, which reflect its immunomodulatory activity. Dendritic cells (DCs) are specialized antigen-presenting cells (APCs) and sentinel cells that regulate the immune response. This study aims at investigating whether crude essential oil extracted fromBoswellia sacraresin (BSEO), has a potential effect on the phenotype and functions of human monocyte-derived DCs.MethodsOil extract from the resin ofBoswellia sacrawas prepared by hydrodistillation using a custom made hydrodistiller. BSEO-mediated cell viability has been initially studied on human skin dermis cells (HSD) and DC precursors using quantitative and qualitative assays before applying on DCs. Human DCs were generated from differentiated peripheral blood monocytes cultured in media containing both GM-CSF and IL-4. DCs were exposed to 5 μg/mL or 10 μg/mL of BSEO in vitro. Morphological, phonotypical, and functional properties studied with microscopy, flow cytometry, and ELISA.ResultsCrude BSEO was found to interfere with the maturation and differentiation of DCs from precursor cells in the presence or absence of lipopolysaccharide (LPS). BSEO-treated DCs, cultured in the presence of LPS, reduced the ability of allogeneic T cells to proliferate compared to that co-cultured with LPS-stimulated DCs only. In addition, the endocytic capacity and secretion of IL-10 by DCs treated with BSEO was enhanced in comparison to LPS treated cells. Analysis of the chemical composition of BESO using GC-MS (Clarus 500 GC/MS, PerkinElmer, Shelton, CT) revealed the presence of compounds with several biological activities including antibacterial, antioxidant, and anti-inflammatory properties.ConclusionResults indicated that BSEO deviates the differentiation of monocytes into immature DCs. Furthermore, stimulation of immature DCs with BSEO was unable to generate full DC maturation. However, these findings may potentially be employed to generate DCs with tolerogenic properties that are able to induce tolerance in diseases with hypersensitivity, autoimmunity as well as transplantation.
Knowledge self-monitoring, efficiency, and determinants of self-confidence statement in multiple choice questions in medical students
Authors: Tabibzadeh Nahid , Mullaert Jimmy , Zafrani Lara , Balagny Pauline , Frija-Masson Justine , Marin Stéphanie , Lefort Agnès , Vidal-Petiot Emmanuelle , Flamant Martin 
Published: November 2020

Abstract
Background
Multiple-choice question (MCQ) tests are commonly used to evaluate medical students, but they do not assess self-confidence nor penalize lucky guess or harmful behaviors. Based on a scoring method according to the appropriateness of confidence in answers, the study aimed at assessing knowledge self-monitoring and efficiency, and the determinants of self-confidence.

Methods
A cross-sectional study of 842 s- and third-year medical students who were asked to state their level of confidence (A: very confident, B: moderately confident and C: not confident) during 12 tests (106,806 events). A bonus was applied if the level of confidence matched with the correctness of the answer, and a penalty was applied in the case of inappropriate confidence.

Results
Level A was selected more appropriately by the top 20% students whereas level C was selected more appropriately by the lower 20% students. Efficiency of higher-performing students was higher when correct (among correct answers, rate of A statement), but worse when incorrect compared to the bottom 20% students (among incorrect answers, rate of C statement). B and C statements were independently associated with female and male gender, respectively (OR for male vs female = 0.89 [0.82–0.96], p = 0.004, for level B and 1.15 [1.01–1.32], p = 0.047, for level C).

Conclusion
While both addressing the gender confidence gap, knowledge self-monitoring might improve awareness of students’ knowledge whereas efficiency might evaluate appropriate behavior in clinical practice. These results suggest differential feedback during training in higher versus lower-performing students, and potentially harmful behavior in decision-making during clinical practice in higher-performing students.
Measuring student satisfaction as the first assessment of the Program of Combined Studies in Medicine, an MD/PhD-like program of the Faculty of Medicine, National Autonomous University of Mexico
Authors: Martínez-Flisser Gina , Flisser Ana , Castro-Guerrero Mario Alberto , Plett-Torres Tanya 
Published: November 2020

AbstractBackgroundThe Program of Combined Studies in Medicine (PECEM, by its acronym in Spanish) is a program for simultaneous bachelor and doctorate studies (MD/PhD) that enrolls students who show academic excellence and interest in scientific research. The initial doctoral training comprises seven six-month research stays in different laboratories or clinical or computer areas with different high-quality scientific advisors who provide students with a unique experience for their scientific training. Therefore, satisfaction in this stage is decisive for students’ performance and physical and psychological health. The aim of the present study was to administer a questionnaire to measure students’ satisfaction with their research experience as a service-product bundle.MethodsStudents answered an online questionnaire that evaluated three dimensions: perceived quality of the advisor, skills development, and infrastructure and support. Several satisfiers were also evaluated: recommendation of the advisor to peers, fulfillment of student expectations and satisfaction with the program. Correlations were calculated using Fisher’s exact test. The significance was set atp < 0.05.ResultsThe high quality of the advisor, skills development and guidance during the stay were satisfiers correlated to the students’ recommendation of their advisors to their peers and to the fulfillment of the students’ scientific expectations. Conversely, skills development and infrastructure and support were satisfiers for a good to excellent experience as a PECEM student. A lack of direct interaction with the advisor’s workgroup was related to dissatisfaction.ConclusionsThe nontangible products of the service, such as a positive interaction between the student, the advisor and the advisor’s workgroup as well as support obtained during the research stay, were satisfiers. These data indicate that promoting a fruitful bond between the student and advisor is a priority to ensure the quality of our innovative MD/PhD program.
Undergraduate medical students’ attitudes towards medical errors and patient safety: a multi-center cross-sectional study in the Gaza Strip, Palestine
Authors: Alser Mohammed , Böttcher Bettina , Alfaqawi Maha , Jlambo Abdallah , Abuzubaida Walaa , Abu-El-Noor Nasser 
Published: November 2020

Abstract
Background
In undergraduate medical education, patient safety concepts and understanding of medical errors are under-represented. This problem is more evident in low-income settings. The aim of this study was to explore undergraduate medical students’ attitudes towards patient safety in the low-income setting of the Gaza Strip.

Methods
A cross-sectional, descriptive study included medical students of the two medical schools in the Gaza Strip with 338 medical students completing the Attitudes to Patient Safety Questionnaire-IV (APSQ-IV), which examines patient attitudes in 29 items over 10 domains. Results are represented as means ± standard deviations for each item and domain as well as percentage of positive responses to specific items.

Results
Medical students reported slightly positive patient safety attitudes (4.7 ± 0.5 of 7) with the most positive attitudes in the domains of situational awareness, importance of patient safety in the curriculum, error inevitability and team functioning. While no negative attitudes were reported, neutral attitudes were found in the domains of professional incompetence as a cause of error and error reporting confidence. Study year and gender had no significant association with patient safety attitudes, except for disclosure responsibility, where male students displayed significantly more positive attitudes. The study university was significantly associated with three of the 10 examined domains, all of which involved understanding of medical errors, for which students of University 2 (who had undergone limited patient safety training) held significantly more positive attitudes, compared with students of University 1 (who did not have structured patient safety training).

Conclusion
Medical students’ patient safety attitudes were very similar among students from both universities, except for understanding of medical error, for which students, who had received structured training in this topic, displayed significantly more positive attitudes. This underlines the power of the ‘hidden curriculum’, where students adjust to prevalent cultures in local hospitals, while they do their clinical training. Furthermore, it highlights the need for a systematic inclusion of patient safety content in local undergraduate curricula.
WeChat-based intervention to support breastfeeding for Chinese mothers: protocol of a randomised controlled trial
Authors: Tang Li , Lee Andy H. , Binns Colin W. , Duan Lian , Liu Yi , Li Chunrong 
Published: November 2020

Abstract
Background
Exclusive breastfeeding for the first 6 months of life is the optimal way to feed infants. However, recent studies suggest that exclusive breastfeeding rates in China remain low and are well below the recommended target. There has been evidence that a lack of awareness of, or exposure to, breastfeeding information is associated with poor breastfeeding practices. WeChat, the most widely used social networking platform in China, has shown some potential to promote health behaviours. We thus hypothesised that a breastfeeding intervention program delivered via WeChat would achieve at least a 10% increase in exclusive breastfeeding prevalence at 6 months compared to the control group.

Methods
A two-arm, parallel, multicentre randomised controlled trial of 1000 pregnant women will be conducted at four maternity hospitals of Chengdu, China. Eligible women who consent to participate in the trial will be recruited at 28–30 weeks of gestation, and randomly allocated to either the intervention group (participants receive breastfeeding-related information from WeChat) or the control group (participants receive non-breastfeeding information from WeChat) using a central randomisation system on a 1:1 ratio at each participating site. The primary outcomes are exclusive breastfeeding rate and full breastfeeding rate at 6 months postpartum. All randomised participants will be included in the outcome analyses with missing data being imputed based on the best-case and worst-case scenarios. Multilevel mixed regression models will be used in the primary analyses to assess the effectiveness of intervention program on the breastfeeding rates.

Discussion
This trial uses the most widely used social media program as a means of delivering messages to mothers to increase exclusive breastfeeding in China. Increasing exclusive breastfeeding will contribute to meeting the health and environmental goals of the Sustainable Development Guidelines.
Trial registration ClinicalTrials.gov, NCT04499404. Registered 5 August 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04499404