bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phone-based audience response system as an adjunct in orthodontic teaching of undergraduate dental students: a cross-over randomised controlled trial
Authors: Alharbi Fahad , Alazmi Khulud , Momani Bashar R. El , Al-Muzian Lubna , Wertheimer Mark , Almukhtar Anas , Almuzian Mohammed 
Published: November 2020

Abstract
Background: The advent of electronic teaching facilities improves tutor-student communication. This study aims to explore the effectiveness of Phone-Based Audience Response System (PB-ARS), as an adjunctive pedagogy tool to enhance the retention of orthodontic information by dental students; and to explore the students’ perception of PB-ARS. Methods: This cross-over clustered randomised control trial included 34 males who were in the final year of their undergraduate dental training. Participants were allocated to one of two event groups (G1 and G2) using computer-generated randomisation. Both groups simultaneously attended two different traditional lectures (L 1 and L2) a week apart. During L1, PB-ARS was used as an adjunct to conventional presentation to teach G1 participants, (PB-ARS group) while G2’s participants acted as a control group (CG), and were taught using a traditional presentation. In the second week (L2), the interventions were crossed-over. Participants from both groups completed pre- and post-lecture multiple-choice questionnaires (MCQ) to assess their short-term retention of information. Their performance in the final MCQ exam (10 weeks following L2) was tracked to assess the long-term retention of the information. Participants also completed post-lecture questionnaires to evaluate their perceptions. Results: 29 and 31 participants from the CG and PB-ARS group completed this trial, respectively. Although 87.5% of students in the PB-ARS group showed an improvement in their immediate post-lecture scores compared with 79.3% for the CG, it was statistically insignificant (p= 0.465). Similarly, the intervention showed an insignificant effect on the long-term retention of the knowledge (p=0.560).There was a mildly but favourable attitude of students towards the use of PB-ARS. However, the difference in the overall level of satisfaction between both groups was statistically insignificant (p=0.183).Conclusion: PB-ARS has a minimal and insignificant effect on the short- and long-term retention of orthodontic knowledge by male undergraduate dental students. PB-ARS was the preferred adjunct tool to conventional classroom teaching. Due to the limitations of this trial, a long-term randomised controlled trial with a larger sample size is recommended.
High prevalence of cardiovascular risk factors in adults living in Greece: The EMENO National Health Examination Survey&nbsp;
Authors: Touloumi Giota , Karakosta Argiro , Kalpourtzi Natasa , Gavana Magda , Vantarakis Apostolos , Kantzanou Maria , Hajichristodoulou Christos , Chlouverakis Grigoris , Trypsianis Grigoris , Voulgari Paraskevi V. , Alamanos Yannis , Makrilakis Konstantinos , Liatis Stavros , Chatzipanagiotou Stylianos , Stergiou George 
Published: November 2020

Abstract
Background: Nationwide data on cardiovascular risk factors prevalence is lacking in Greece. This work presents the findings of the national health examination survey EMENO (2013-2016) regarding the prevalence of hypertension, hypercholesterolemia, diabetes, obesity and smoking.Methods: A random sample of adults (≥18 years) was drawn by multistage stratified random sampling based on 2011 Census. All EMENO participants with ≥1 measurement of interest [blood pressure (BP), fasting glucose, HbA1c, total cholesterol (TC), Body Mass Index (BMI)] were included. Hypertension was defined as BP≥140/90mmHg and/or antihypertensive treatment; diabetes as fasting glucose≥126mg/dL and/or HbA1c≥6.5% or self-reported diabetes; hypercholesterolemia as TC≥190mg/dL. Sampling weights were applied to adjust for study design and post-stratification weights to match sample age and sex distribution to population one. Non-response was adjusted by inverse probability weighting. Results: Of 6,006 EMENO participants, 4,822 were included (51.5% females, median age:47.9 years). The prevalence of hypertension was 39.2%, higher in men (42.4%) than in women (36.1%); of hypercholesterolemia 60.2%, similar in men (59.5%) and women (60.9%); of diabetes 11.6%, similar men (12.4%) and women (10.9%); of obesity 32.1%, higher in women (33.5% vs 30.2%), although in subjects aged 18-40 year it was higher in men; of current smoking 38.2%, higher in men (44.0%) than in women (32.7%). The prevalence of all risk factors increased substantially with age, except smoking, which followed an inverse U shape.Conclusions: The burden of cardiovascular risk factors among Greek adults is alarming. There is considerable preventive potential and actions at health care and societal level are urgently needed.
Typology of Psychiatric Emergency Services in the United Kingdom: A narrative literature Review
Authors: Odejimi Opeyemi , Bagchi Dhruba , Tadros George 
Published: November 2020

Abstract
Background: Mental health crisis requiring emergency access to psychiatric service can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 hours. Presently, several types of PESs are available in the United Kingdom (UK) with the aim of providing prompt and effective assessment and management of patients. Therefore, this study aims to provide a detailed narrative literature review of the various types of Psychiatric Emergency Service (PES) currently available in the UKMethod: Electronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was conducted. Studies were included if it described a mental health service in the UK that provides immediate response in mental health crisis within the first 24 hours. Excluded studies did not describe a PES, non-English, and were not conducted in UK. Results: Nine types of PESs were found. Amongst the 9 services, more papers described crisis resolution home treatment. Majority of the papers reported services within England than other countries within the UK. Conclusion: All types of PESs were described as beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of the various types of PESs. This may help inform researchers, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PESs meet the needs as well as aid recovery during crisis.
Repetitive Transcranial Magnetic Stimulation on Chronic Tinnitus: A Systematic Review and Meta-Analysis
Authors: Liang Zhengrong , Cheng Gui , Huang Lingfei , Zhang Tao , Yang Haidi , Jia Haiying 
Published: November 2020

Abstract
Background: Although the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic tinnitus have been frequently examined, the results remain contradictory. Therefore, we performed a systematic review and meta-analysed clinical trials examining the effects of rTMS to evaluate its clinical efficacy and safety.Methods: Studies of rTMS for chronic tinnitus were retrieved from PubMed, Embase, and Cochrane Library through April 2020. Review Manager 5.3 software was employed for data synthesis, and Stata 13.0 software was used for analyses of publication bias and sensitivity.Results: Twenty-nine randomized studies involving 1,228 chronic tinnitus patients were included. Compared with sham-rTMS, rTMS exhibited significant improvements in the tinnitus handicap inventory (THI) scores at 1 week (mean difference [MD]: -7.92, 95% confidence interval [CI]: -14.18, -1.66), 1 month (MD: -8.52, 95% CI: -12.49, -4.55), and 6 months (MD: -6.53, 95% CI: -11.406, -1.66) post intervention; there were significant mean changes in THI scores at 1 month (MD: -14.86, 95% CI: -21.42, -8.29) and 6 months (MD: -16.37, 95% CI: -20.64, -12.11) post intervention, and the tinnitus questionnaire (TQ) score at 1 week post intervention (MD: -8.54, 95% CI: -15.56, -1.52). Nonsignificant efficacy of rTMS was found regarding the THI score 2 weeks post intervention (MD: -1.51, 95% CI: -13.42, -10.40); the mean change in TQ scores 1 month post intervention (MD: -3.67, 95% CI: -8.56, 1.22); TQ scores 1 (MD: -8.97, 95% CI: -20.41, 2.48) and 6 months (MD: -7.02, 95% CI: -18.18, 4.13) post intervention; and adverse events (odds ratios [OR]: 1.11, 95% CI: 0.51, 2.42). Egger's and Begg's tests indicated no publication bias (P = 0.925).Conclusion: This meta-analysis demonstrated that rTMS is effective for chronic tinnitus; however, its safety needs more validation. Restrained by the insufficient number of included studies and the small sample size, more large randomized double-blind multi-centre trials are needed for further verification.
The HIV Epidemic in Colombia: Spatial and Temporal Trends Analysis
Authors: Montana Jhon Freddy , Ferreira Glenda Roberta Oliveira Naiff , Cunha Carlos Leonardo Figueiredo , de Queiroz Ana Angelica Rego , Fernandes Wellington Augusto Andrade , Polaro Sandra Helena Isse , Gonçalves Lucia Hisako Takase , Couto Danielle Costa Carrara , Gir Elucir , Reis Renata Karina , Sorensen Wiliam , Botelho Elia Pinheiro 
Published: November 2020

Abstract
BACKGROUND – Colombia has the fourth highest incidence rate of HIV/AIDS among all Latin American countries and it has been increasing since the 1980s. However, the number of studies that addressed this trend is limited. Here, we employed spatial and temporal trend analyses to study the behaviour of the epidemic in the Colombian territory.METHODS – Our sample included 72,994 cases of HIV/AIDS and 21,898 AIDS-related deaths reported to the National Ministry of Health between 2008 and 2016. We employed the joinpoint regression model to analyse the annual HIV/AIDS incidence and AIDS mortality rates. In the spatial analysis, we used univariate autocorrelation techniques and the Kernel density estimator. RESULTS – While the HIV/AIDS incidence had an increasing trend in Colombia, the AIDS mortality rate was stable. HIV/AIDS incidence and AIDS mortality showed a downward trend in the 0–14 age group. An upward trend was observed for HIV/AIDS incidence in people older than 15 years and with the highest trend in the 65 years and above group. AIDS mortality showed an increasing trend among people aged 65 years or older. The comparison between the sexes showed an upward trend of HIV/AIDS incidence in all age groups and AIDS-mortality rates in 65-year-old and above in men, while in women, the incidence was upward among those aged 45 years and above and concerning the AIDS-mortality rate in the 45–64 group. The high–high clusters of HIV/AIDS incidence and AIDS mortality were located in the Andean and Caribbean regions.CONCLUSION – Our study found an upward trend in HIV/AIDS incidence and a stable trend in the AIDS mortality rate in Colombia. The downward trend in HIV/AIDS incidence and AIDS mortality rate in the 0–14 age group reflects the downwards mother-to-child HIV transmission. The upward trend in HIV/AIDS incidence and AIDS mortality rates in older and younger women, respectively, compared with men may be due to late diagnosis and treatment. The Caribbean and the ‘coffee belt’ regions were the most impacted by the HIV epidemic, most likely due to sexual tourism. Our results provide crucial information that may help Colombian health authorities fight HIV.
Epidemiological scenario of leprosy in a province in China: long delay in diagnosis and high rate of deformity.
Authors: Zhang Qing-Ping , Li Ge , Li Chao , Lin Zhao-Xing , Chen Ping 
Published: November 2020

Abstract
Background: This epidemiological study aimed to analyze both the distribution and the characteristics of leprosy in an endemic province in the Chinese Northwest. Methods: The medical records of leprosy in the province of Shaanxi, China, 1998-2018 were collected from the leprosy management information system in China (LEPMIS). Epidemiological variables were analyzed in this study. Results: 477 new cases were diagnosed between 1998-2018 in this area. The average rate of annual detection was 0.070/100,000 population, and the average annual prevalence was 0.305/100,000 population. The mean age of new patients was 46.7 years, and the ratio of male to female was 2.5:1. There were 399 cases (83.6%) of multibacillary (MB) forms. 148 cases (31.0%) had grade 2 disability. The mean delay in diagnosis for new cases was 62.0 months. Conclusion: The epidemiological study showed that the characteristics of the new leprosy cases in our province were still long delay in diagnosis and high rate of deformity, which indicated the need of actions of stimulating early diagnosis and treatment, and strengthening the detection of leprosy in low prevalent areas.
Identifying and Supporting Students at Risk of Failing the National Medical Licensure Examination in Japan Using a Predictive Pass Rate
Authors: Tsunekawa Koji , Suzuki Yasuyuki , Shioiri Toshiki 
Published: November 2020

Abstract
Background Students who fail to pass the National Medical Licensure Examination (NMLE) pose a huge problem from the educational standpoint of healthcare professionals. In the present study, we developed a formula of predictive pass rate (PPR)” which reliably predicts medical students who will fail the NMLE in Japan, and provides an adequate academic support for them. Methods Six consecutive cohorts of 531 medical students between 2012 and 2017, Gifu University Graduate School of Medicine, were investigated. Using 7 variables before the admission to medical school and 10 variables after admission, we developed a prediction formula to obtain the PPR for the NMLE using logistic regression analysis. In a new cohort of 106 medical students in 2018, we applied the formula for PPR to them to confirm the capability of the PPR and predicted students who will have a strong likelihood of failing the NMLE. Results Medical students who passed the NMLE had the following characteristics: younger age at admission, graduates of high schools located in the surrounding area, high scores in the graduation examination and in the comprehensive computer-based test provided by the Common Achievement Test Organization in Japan. However, total score of examination in pre-clinical medical sciences and Pre-CC OSCE score in the 4th year were not correlated with the PPR. Ninety-one out of 531 students had a strong likelihood of failing the NMLE between 2012 and 2017 and 33 of these 91 students failed NMLE. Using the PPR, we predicted 12 out of 106 students will have a strong likelihood of failing the NMLE. Actually, five of these 12 students failed NMLE. Conclusions The PPR can be used to predict medical students who have a higher probability of failing the NMLE. This prediction would enable focused support and guidance by faculty members. Prospective and longitudinal studies for larger and different cohorts would be necessary.
Prevalence and determinants of intimate partner violence against mothers of children under-five years in central Malawi
Authors: Chilanga Emmanuel , Collin-Vezina Delphine , Khan Mohammad Nuruzzaman , Riley Liam 
Published: November 2020

Abstract
Background Intimate partner violence (IPV) against women is a global human rights violation and a public health problem. The phenomenon is linked to adverse health effects for women and children. Mothers of young children in Malawi can be particularly at risk because of gender-based power imbalances. The objectives of this study were to examine the prevalence and the risk factors of IPV against mothers of children under-five years of age in rural Malawi.Methods A multistage, cross-sectional study design was used. A sample of 538 mothers of young children was randomly selected from postnatal clinics in Dowa district. The WHO's Violence against women screening instrument was used to collect data. Logistic regressions were used to determine risk factors that were associated with IPV against mothers. Results Overall prevalence of all four forms of IPV against mothers of under-five children was 60.2%. The prevalence of IPV controlling behavior, psychological, physical, and sexual violence were 74.7%, 49.4%, 43.7% and 73.2% respectively. In multivariate analyses, mothers whose partners had extra marital affairs were more likely to experience controlling behavior (AOR: 4.97, 95% CI: 2.59-8.55, P = 0.001), psychological (AOR: 2.14, 95% CI: 1.486-3.472, P = 0.001) and physical (AOR: 2.29, 95% CI: 1.48-3.94, P = 0.001) violence than mothers whose partners did not have extra marital affairs. Mothers whose partners consume alcohol were more likely to experience sexual violence (AOR: 2.00, 95% CI: 1.17-3.41, P = 0.001) than mothers whose partners did not drink. Finally, mothers who spent more than 30 minutes drawing water were at greater risk of experiencing IPV than mothers who spent less than 30 minutes. Conclusion This study found a significantly higher prevalence of IPV against mothers of under-five children in rural Malawi compared to women in the general population. Micro and macro-level programs aimed at mitigating the partners’ potential risk behaviors identified in this study are suggested. Public health programs that support increased household access to safe water are also recommended to help undermine IPV against mothers.
Umbilical cord-derived Wharton’s Jelly for Regenerative Medicine Applications in Orthopedic Surgery: A Systematic Review Protocol
Authors: Main Benjamin J. , Valk Josiah A. , Maffulli Nicola , Rodriguez Hugo C. , Gupta Manu , Stone Ian W. , III Saadiq F. El-Amin , Gupta Ashim 
Published: November 2020

Abstract
Background: Musculoskeletal injuries and conditions affect millions of individuals. These ailments are typically managed by immobilization, physiotherapy or activity modification. Regenerative medicine has experienced tremendous growth in the past decades, especially in musculoskeletal medicine. Umbilical cord-derived Wharton’s Jelly is an exciting new option for such therapies. Wharton’s jelly is a connective tissue located within the umbilical cord largely composed of mesenchymal stem cells and extracellular matrix components, including collagen, chondroitin sulfate, hyaluronic acid and sulfated proteoglycans. Wharton’s Jelly is a promising and applicable biologic source for orthopedic regenerative application.Methods: A systematic search will be conducted in PubMed, ScienceDirect and Google Scholar databases of English, Italian, French, Spanish and Portuguese language articles published to date. References will be screened and assessed for eligibility by two independent reviewers as per PRISMA guidelines. Articles will be considered without exclusion to sex, activity or age. Studies will be included if they used culture-expanded, mesenchymal stem/stromal cells of mesenchymal stem cells and/or connective tissue obtained from Wharton’s Jelly. Studies will be excluded if Wharton’s Jelly is not the sole experimental examined cell type. Placebos, conventional non-operative therapies including steroids injections, exercise and NSAIDs will be compared. The study selection process will be performed independently by two reviewers using a reference software. Data synthesis and meta-analysis will be performed separately for clinical and pre-clinical studies.Discussion: The results will be published in relevant peer-reviewed scientific journals. Investigators will present results at national or international conferences.Trial registration: The Protocol was registered on PROSPERO international prospective register of systematic reviews prior to commencement, CRD42020182487.
Global, regional, and national burdens of bladder cancer in 2017: estimates from the 2017 Global Burden of Disease study
Authors: He Hairong , Xie Hongjun , Chen Yule , Li Chengzhuo , Han Didi , Xu Fengshuo , Lyu Jun 
Published: November 2020

Abstract
Background: The aim of this study is to describe the prevalence and mortality of bladder cancer (BCa) using data obtained in the Global Burden of Disease study performed in 2017 (GBD 2017).Methods: Data on BCa for 2017, including prevalence, mortality, and disability-adjusted life years (DALYs), were obtained from GBD 2017 at the global, regional, and national levels. We also analyzed the association of BCa burden with the country development level.Results: There were 2.63 million BCa cases estimated from the GBD 2017 data, with 200,000 persons dying of BCa, resulting in 3.60 million DALYs in 2017. The age-standardized prevalence (ASP) of BCa was 32.91/100,000 persons, and age-standardized death rate (ASDR) was 2.57/100,000 persons. The ASP and ASDR of BCa were higher in males than in females, and higher in people older than 60 years. The ASP and ASDR of BCa were higher in Western Europe and Central Europe than in South Asia, Andean Latin America, and Central Latin America, and higher in countries with a higher sociodemographic index (SDI). Correlation analysis identified that the ASP and ASDR of BCa were positively correlated with the country SDI (P<0.0001 and ρ=0.68 for ASP, and P=0.0048 and ρ=0.20 for ASDR). In addition, 33.72% deaths and 36.80% DALYs caused by BCa could be attributed to smoking globally.Conclusion: The prevalence and mortality of BCa were very high in 2017, especially in high-SDI countries. Smoking-cessation strategies should be strengthened to control the burden associated with BCa.
Quality of life during the epidemic of COVID-19 and its associated factors among enterprise workers in East China
Authors: Chen Xiaoxiao , Xu Qian , Lin Haijiang , Zhu Jianfu , Chen Yue , Zhao QI , Fu Chaowei , Wang Na 
Published: November 2020

Abstract
Background: The COVID-19 related lockdown and home confinement might have an important impact on the quality of life in enterprise workers. We investigated the quality of life during the epidemic in enterprise workers who just returned to work, and assessed its potential influencing factors to have a better understanding of the impact of COVID-19 epidemic lockdown and home confinement.Methods: This was a cross-sectional study of enterprise workers conducted in Deqing and Taizhou, Zhejiang Province, China. The Chinese version of EQ5D was used to assess life quality, and information about general characteristics and COVID-19 related factors was collected by a structured questionnaire, which was distributed through the social application “WeChat”.Results: A total of 2,435 participants were enrolled, 59.5% of which worked in Deqing. About 50% of the participants reported worries about the COVID-2019 epidemic and 40.1% had a centralized or home quarantine during the epidemic. The mean EQ-5D score and VAS were 0.990 and 93.5. Multiple logistic regression showed that the quality of life measures was related to physical activities (ORad=0.46) and keeping home ventilation (ORad=0.04) in Deqing, and were related to wearing a mask when going out (ORad=0.35), keeping home ventilation (ORad=0.16), unmarried status (ORad=2.38) and having a centralized or home quarantine (ORad=1.64) in Taizhou,Conclusions: The quality of life for returning enterprise workers in areas with different risks of COVID-19 was affected by different factors. Associated factors identified from this study would help develop proper intervention measures for enterprise workers to reduce the impact of large-scale public health events like the COVID-19 on their quality of life.