bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of dental caries and its association with body mass index among school-age children in Shenzhen, China
Authors: Cheng Yi-hong , Liao Yi , Chen Ding-yan , Wang Yun , Wu Yu 
Published: December 2019

Abstract
Background
Dental caries and overweight/obesity are health problems with shared risk factors, but the relationships between caries and BMI need to be further explored. The objective was to evaluate the current status of dental caries and the association between dental caries and Body Mass Index (BMI) among primary and secondary school students in Shenzhen, China, during the 2016–2017 academic year.

Methods
A population-based, cross-sectional study that enrolled a total of 1,196,004 students was conducted in Shenzhen. Physical and dental examinations were given to all primary and secondary school students by certified physicians and dentists following the national specification for student health examinations, and dental caries was diagnosed using WHO criteria. Descriptive analysis was applied to assess current oral health status and a multifactorial, logistic regression model was employed to evaluate the relationship between dental caries and obesity.

Results
A total of 1,196,004 students participated in the census. Mean age of the participants was 10.3 years, ranging from 6 to 20 years. The prevalence of dental caries was 41.15% in the present study, which was higher among girls (42.88%) than that in boys (39.77%) with a p-value of < 0.001. Students in public schools showed a significantly lower (p < 0.001) caries prevalence (37.36%) compared with those in private schools (47.96%). The caries restoration rate of students in Shenzhen was only 10.30%, which means only one out of ten students with caries received restorations. The mean dmft and DMFT scores were 0.97 and 0.33, respectively. More girls (10.96%) had their teeth filled than boys (9.78%). The restoration rate was higher (p < 0.001) in public schools (11.73%) than in private ones (8.35%). Children who were overweight or obese had a lower risk of experiencing caries compared to those who were within a normal weight (OR = 0.74/0.64). Caries was inversely associated with BMI among primary and secondary school students in Shenzhen.

Conclusions
The prevalence of dental caries among primary and secondary school children was found to be related to sex, type of schools, region, and BMI. Further studies and more government support are required to confirm the findings of this study and to address current oral health problems.
Microhardness of glass carbomer and high-viscous glass Ionomer cement in different thickness and thermo-light curing durations after thermocycling aging
Authors: Buldur Mehmet , Sirin Karaarslan Emine 
Published: December 2019

Abstract
Background
The objective of our study was to compare the upper and lower surface microhardness and surface changes of Glass Carbomer Cement (GCP) and EQUIA Forte (EF) in different thickness after thermo-light curing durations and aging.

Methods
A total of 504 samples (5 mm-diameter) were prepared by using GCP-252 (GCP Dental, and Vianen, Netherlands) and EF-252 (EQUIA Forte, GC, Tokyo, Japan). Three different thickness samples (2, 4, and 6 mm) were prepared with 84 samples in each subgroup. The samples were prepared by three curing procedures (Non-exposed, 60s, 90s). Their varnishes were applied to the upper surfaces of half of each subgroup (n = 7). The upper microhardness measurements were evaluated before and after aging. To compare the effect of different thicknesses, the bottom surfaces of the samples were evaluated before aging in terms of microhardness measurements. Also, the upper surfaces were analyzed in the SEM before and after aging.

Results
The upper surface values of all the samples were higher than the bottom values (p < 0.05). There were no significant differences between the varnished and non-varnished samples in both materials (p > 0.05). Although this increase was not significant in some groups, temperature variations increased the surface microhardness values of both materials except for the non-exposed-varnished EF samples. The highest microhardnesses values were recorded in the non-exposed-varnished EF (125.6 ± 6.79) and unvarnished GCP (88.1 ± 7.59) samples which were thermo-light cured for 90 s before aging. The bottom hardness values were affected by thickness variations in both GCP and EF materials (p < 0.05). The sample deformations and microcracks after aging were greater than before in all the materials. Thermo-light curing in 90 s to the samples reduced the cracks in both the materials before and after aging.

Conclusions
Thermal aging adversely affected the microhardness of the materials, which is important for clinical success. The thermo-light curing process improved the microhardness of the GCP group without varnish application. Varnish application increased the microhardness of the EF group without applying thermo-light curing. The microhardness of the bottom surfaces decreased with increasing thickness. The thermo-light curing did not increase the bottom surface microhardness of all the samples.
Virtual patients versus small-group teaching in the training of oral and maxillofacial surgery: a randomized controlled trial
Authors: Seifert Lukas B. , Socolan Octavian , Sader Robert , Rüsseler Miriam , Sterz Jasmina 
Published: December 2019

AbstractBackgroundComputerized virtual patients (VP) have spread into many areas of healthcare delivery and medical education. They provide various advantages like flexibility in pace and space of learning, a high degree of teaching reproducibility and a cost effectiveness. However, the educational benefit of VP as an additive or also as an alternative to traditional teaching formats remains unclear. Moreover, there are no randomized-controlled studies that investigated the use of VP in a dental curriculum. Therefore, this study investigates VP as an alternative to lecturer-led small-group teaching in a curricular, randomized and controlled setting.MethodsRandomized and controlled cohort study. Four VP cases were created according to previously published design principles and compared with lecturer-led small group teaching (SGT) within the Oral and Maxillofacial Surgery clerkship for dental students at the Department for Cranio-, Oral and Maxillofacial Plastic Surgery, Goethe University, Frankfurt, Germany. Clinical competence was measured prior (T0), directly (T1) and 6 weeks (T2) after the intervention using theoretical tests and a self-assessment questionnaire. Furthermore, VP design was evaluated using a validated toolkit.ResultsFifty-seven students (VP = 32; SGT = 25) agreed to participate in the study. No competence differences were found at T0 (p = 0.56). The VP group outperformed (p < .0001) the SGT group at T1. At T2 there was no difference between both groups (p = 0.55). Both interventions led to a significant growth in self-assessed competence. The VP group felt better prepared to diagnose and treat real patients and regarded VP cases as a rewarding learning experience.ConclusionsVP cases are an effective alternative to lecture-led SGT in terms of learning efficacy in the short and long-term as well as self-assessed competence growth and student satisfaction. Furthermore, integrating VP cases within a curricular Oral and Maxillofacial Surgery Clerkship is feasible and leads to substantial growth of clinical competence in undergraduate dental students.
Factors associated with using alternative sources of primary care: a cross-sectional study
Authors: Reed Charlie , Rabito Felicia A. , Werthmann Derek , Smith Shannon , Carlson John C. 
Published: December 2019

Abstract
Background
Mobile (MHCs), Community (CHCs), and School-based health clinics (SBHCs) are understudied alternative sources of health care delivery used to provide more accessible primary care to disenfranchised populations. However, providing access does not guarantee utilization. This study explored the utilization of these alternative sources of health care and assessed factors associated with residential segregation that may influence their utilization.

Methods
A cross-sectional study design assessed the associations between travel distance, perceived quality of care, satisfaction-adjusted distance (SAD) and patient utilization of alternative health care clinics. Adults (n = 165), child caregivers (n = 124), and adult caregivers (n = 7) residing in New Orleans, Louisiana between 2014 and 2015 were conveniently sampled. Data were obtained via face-to face interviews using standardized questionnaires and geospatial data geocoded using GIS mapping tools. Multivariate regression models were used to predict alternative care utilization.

Results
Overall 49.4% of respondents reported ever using a MCH, CHC, or SBHC. Travel distance was not significantly associated with using either MCH, CHC, or SBHC (OR = 0.91, 0.74–1.11 p > .05). Controlling for covariates, higher perceived quality of care (OR = 1.02, 1.01–1.04 p < .01) and lower SAD (OR = 0.81, 0.73–0.91 p < .01) were significantly associated with utilization.

Conclusions
Provision of primary care via alternative health clinics may overcome some barriers to care but have yet to be fully integrated as regular sources of care. Perceived quality and mixed-methods measures are useful indicators of access to care. Future health delivery research is needed to understand the multiple mechanisms by which residential segregation influences health-seeking behavior.
The heterogeneous health state profiles of high-risk healthcare utilizers and their longitudinal hospital readmission and mortality patterns
Authors: Ng Shawn Choon Wee , Kwan Yu Heng , Yan Shi , Tan Chuen Seng , Low Lian Leng 
Published: December 2019

AbstractBackgroundHigh-risk patients are most vulnerable during transitions of care. Due to the high burden of resource allocation for such patients, we propose that segmentation of this heterogeneous population into distinct subgroups will enable improved healthcare resource planning. In this study, we segmented a high-risk population with the aim to identify and characterize a patient subgroup with the highest 30-day and 90-day hospital readmission and mortality.MethodsWe extracted data from our transitional care program (TCP), a Hospital-to-Home program launched by the Singapore Ministry of Health, from June to November 2018. Latent class analysis (LCA) was used to determine the optimal number and characteristics of latent subgroups, assessed based on model fit and clinical interpretability. Regression analysis was performed to assess the association of class membership on 30- and 90-day all-cause readmission and mortality.ResultsAmong 752 patients, a 3-class best fit model was selected: Class 1 “Frail, cognitively impaired and physically dependent”, Class 2 “Pre-frail, but largely physically independent” and Class 3 “Physically independent”. The 3 classes have distinct demographics, medical and socioeconomic characteristics (p <  0.05), 30- and 90-day readmission (p <  0.05) and mortality (p <  0.01). Class 1 patients have the highest age-adjusted 90-day readmission (OR = 2.04, 95%CI: 1.21–3.46,p = 0.008), 30- (OR = 6.92, 95%CI: 1.76–27.21,p = 0.006) and 90-day mortality (OR = 11.51, 95%CI: 4.57–29.02,p <  0.001).ConclusionsWe identified a subgroup with the highest readmission and mortality risk amongst high-risk patients. We also found a lack of interventions in our TCP that specifically addresses increased frailty and poor cognition, which are prominent features in this subgroup. These findings will help to inform future program modifications and strengthen existing transitional healthcare structures currently utilized in this patient cohort.
Determination of rheology and surface tension of airway surface liquid: a review of clinical relevance and measurement techniques
Authors: Chen Zhenglong , Zhong Ming , Luo Yuzhou , Deng Linhong , Hu Zhaoyan , Song Yuanlin 
Published: December 2019

AbstractBy airway surface liquid, we mean a thin fluid continuum consisting of the airway lining layer and the alveolar lining layer, which not only serves as a protective barrier against foreign particles but also contributes to maintaining normal respiratory mechanics. In recent years, measurements of the rheological properties of airway surface liquid have attracted considerable clinical attention due to new advances in microrheology instruments and methods. This article reviews the clinical relevance of measurements of airway surface liquid viscoelasticity and surface tension from four main aspects: maintaining the stability of the airways and alveoli, preventing ventilator-induced lung injury, optimizing surfactant replacement therapy for respiratory syndrome distress, and characterizing the barrier properties of airway mucus to improve drug and gene delivery. Primary measuring techniques and methods suitable for determining the viscoelasticity and surface tension of airway surface liquid are then introduced with respect to principles, advantages and limitations. Cone and plate viscometers and particle tracking microrheometers are the most commonly used instruments for measuring the bulk viscosity and microviscosity of airway surface liquid, respectively, and pendant drop methods are particularly suitable for the measurement of airway surface liquid surface tension in vitro. Currently, in vivo and in situ measurements of the viscoelasticity and surface tension of the airway surface liquid in humans still presents many challenges.
Primary immunodeficiency-related bronchiectasis in adults: comparison with bronchiectasis of other etiologies in a French reference center
Authors: Goussault Hélène , Salvator Hélène , Catherinot Emilie , Chabi Marie-Laure , Tcherakian Colas , Chabrol Alexandre , Didier Morgane , Rivaud Elisabeth , Fischer Alain , Suarez Felipe , Hermine Olivier , Lanternier Fanny , Lortholary Olivier , Mahlaoui Nizar , Devillier Philippe , Couderc Louis-Jean 
Published: December 2019

Abstract
Background
Bronchiectasis is a heterogeneous disease depending on etiology. It represents the most frequent non-infectious pulmonary complication of primary immunodeficiencies (PID). We investigated whether bronchiectasis associated with PID had a distinct course in comparison to bronchiectasis of other causes.

Methods
Retrospective single-center study of adult patients diagnosed with non-cystic fibrosis bronchiectasis with more than 5 years of follow-up and at least 4 pulmonary functional tests available at one year apart. They were divided into three groups: PID- related bronchiectasis, idiopathic/post infectious-related bronchiectasis and other causes of bronchiectasis. Respiratory functional data and clinical outcomes were compared.

Results
Of 329 patients with bronchiectasis diagnosed in Foch Hospital (Suresnes, France), 98 patients fulfilled the selected criteria (20 PID-related cases, 39 idiopathic or post-infectious cases, and 39 cases with other causes). Median time of follow-up was 9.5 years. Groups were similar concerning initial characteristics (female 70.4%, never smokers 59.2%, mild severity bronchiectasis according to the FACED score and median FEV1 at diagnosis 73.5% predicted values [Q1–Q3: 53.75–90.5]), except PID patients who were younger (median age of 51.5 vs 62 years, p = 0.02). Eighty-five percent of PID patients received immunoglobulin substitution (median trough level was measured at 10.5 g/dl [10;10.92]). Global median FEV1 annual decline was 25.03 ml/year [8.16;43.9] and 19.82 ml/year [16.08;48.02] in the PID patients group. Forty-five percent of patients had bacterial colonization, pneumoniae occurred in 56% of patients and median exacerbation annual rate was 0.8 [0.3–1.4]. Hemoptysis occurred in 31.6% of patients. Global mortality rate was 11.2%. We did not record any significant difference for all clinical and functional outcomes between patients with PID and other etiologies. The median decline in FEV1 was similar in the three groups.

Conclusions
The course of PID-related bronchiectasis was similar to bronchiectasis of other causes. Provided that patients receive immunoglobulin replacement, the course of PID-related bronchiectasis seems to be independent of the underlying immune disorder.
Inhaled corticosteroids and FEV1 decline in chronic obstructive pulmonary disease: a systematic review
Authors: Whittaker Hannah R. , Jarvis Debbie , Sheikh Mohamed R. , Kiddle Steven J. , Quint Jennifer K. 
Published: December 2019

AbstractRate of FEV1 decline in COPD is heterogeneous and the extent to which inhaled corticosteroids (ICS) influence the rate of decline is unclear. The majority of previous reviews have investigated specific ICS and non-ICS inhalers and have consisted of randomised control trials (RCTs), which have specific inclusion and exclusion criteria and short follow up times. We aimed to investigate the association between change in FEV1 and ICS-containing medications in COPD patients over longer follow up times.MEDLINE and EMBASE were searched and literature comparing change in FEV1 in COPD patients taking ICS-containing medications with patients taking non-ICS-containing medications were identified. Titles, abstract, and full texts were screened and information extracted using the PICO checklist. Risk of bias was assessed using the Cochrane Risk of Bias tool and a descriptive synthesis of the literature was carried out due to high heterogeneity of included studies.Seventeen studies met our inclusion criteria. We found that the difference in change in FEV1 in people using ICS and non-ICS containing medications depended on the study follow-up time. Shorter follow-up studies (1 year or less) were more likely to report an increase in FEV1 from baseline in both patients on ICS and in patients on non-ICS-containing medications, with the majority of these studies showing a greater increase in FEV1 in patients on ICS-containing medications. Longer follow-up studies (greater than 1 year) were more likely to report a decline in FEV1 from baseline in patients on ICS and in patients on non-ICS containing medications but rates of FEV1 decline were similar.Further studies are needed to better understand changes in FEV1 when ICS-containing medications are prescribed and to determine whether ICS-containing medications influence rate of decline in FEV1 in the long term. Results from inclusive trials and observational patient cohorts may provide information more generalisable to a population of COPD patients.
Who buys nets? Factors associated with ownership and use of purchased mosquito nets in sub-Saharan Africa
Authors: Olapeju Bolanle , Choiriyyah Ifta , Bertram Kathryn , Piccinini Danielle , Harig Hunter , Selby Richmond Ato , Lynch Matthew , Koenker Hannah 
Published: December 2019

Abstract
Background
Public sector strategies to promote insecticide-treated net (ITN) access have resulted in increased ITN ownership across sub-Saharan Africa. However, the current status of the private sector distribution channel for nets has not been fully explored. This multi-country study explored the prevalence of net purchases and the characteristics of households that had purchased nets and used such nets in sub-Saharan Africa.

Methods
Data from recent Malaria Indicator Survey (MIS) or Demographic and Health Survey (DHS) in 16 countries were analysed to explore the prevalence of purchased nets. Purchased nets were defined as nets obtained from shops/markets or pharmacies. Additional sub-analysis of factors associated with ownership and use of purchased nets was conducted in seven countries with over 10% of nets reported as purchased. Key outcomes included: prevalence of purchased nets out of all nets, household ownership of a purchased net, and whether a purchased net was used the previous night. Analytical methods included country level tests of association and multivariable logistic regressions.

Results
Among all nets, the proportion of purchased nets in the study countries ranged from 0.8 to 32.7% and most (median = 77%) of these purchased nets were ITNs. Although the private nets are presumed to be from the retail, non-public sector, the prevalence of treated purchased nets suggests that some purchased nets may be “leaked” ITNs from public sector distributions, and thus, may be an informal sector rather than part of the formal “private sector”. Urban, wealthier households as well as those with educated heads were more likely to own purchased nets. Use of such nets was, however, lower in wealthier households. In addition, net use was higher in households owning insufficient nets for their family size, and when the nets were newer than 24 months.

Conclusion
The formal and informal private sector have played a role in bolstering net access rates in some settings. Study findings can help relevant malaria control stakeholders gain insight on the contribution of purchased nets on their overall ITN strategy, identify potential target populations for private sector nets as well as inform the design and distribution of private sector insecticide-treated nets that appeal to their target groups.
High Plasmodium falciparum genetic diversity and temporal stability despite control efforts in high transmission settings along the international border between Zambia and the Democratic Republic of the Congo
Authors: Pringle Julia C. , Wesolowski Amy , Berube Sophie , Kobayashi Tamaki , Gebhardt Mary E. , Mulenga Modest , Chaponda Mike , Bobanga Thierry , Juliano Jonathan J. , Meshnick Steven , Moss William J. , Carpi Giovanna , Norris Douglas E. 
Published: December 2019

Abstract
Background
While the utility of parasite genotyping for malaria elimination has been extensively documented in low to moderate transmission settings, it has been less well-characterized in holoendemic regions. High malaria burden settings have received renewed attention acknowledging their critical role in malaria elimination. Defining the role for parasite genomics in driving these high burden settings towards elimination will enhance future control programme planning.

Methods
Amplicon deep sequencing was used to characterize parasite population genetic diversity at polymorphic Plasmodium falciparum loci, Pfama1 and Pfcsp, at two timepoints in June–July 2016 and January–March 2017 in a high transmission region along the international border between Luapula Province, Zambia and Haut-Katanga Province, the Democratic Republic of the Congo (DRC).

Results
High genetic diversity was observed across both seasons and in both countries. No evidence of population structure was observed between parasite populations on either side of the border, suggesting that this region may be one contiguous transmission zone. Despite a decline in parasite prevalence at the sampling locations in Haut-Katanga Province, no genetic signatures of a population bottleneck were detected, suggesting that larger declines in transmission may be required to reduce parasite genetic diversity. Analysing rare variants may be a suitable alternative approach for detecting epidemiologically important genetic signatures in highly diverse populations; however, the challenge is distinguishing true signals from potential artifacts introduced by small sample sizes.

Conclusions
Continuing to explore and document the utility of various parasite genotyping approaches for understanding malaria transmission in holoendemic settings will be valuable to future control and elimination programmes, empowering evidence-based selection of tools and methods to address pertinent questions, thus enabling more efficient resource allocation.