bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Child Oral Health–Related Behaviors Can First-time Mothers Actualize? A Pragmatic Prospective Study
Authors: Alvey J. , Divaris K. , Lytle L. , Vann W.F. , Lee J.Y. 
Published: December 2019

Introduction: First-time pregnant women are considered to be receptive to health information, rendering the prenatal period an opportune time to provide helpful information on the importance of child-related oral health. However, little is known about pregnant women’s knowledge of child oral health–related behaviors (COHBs) during pregnancy and their implementation after birth. We sought to address this knowledge gap by a prospective investigation of intended and actualized oral health behaviors among first-time pregnant women. Methods: We examined relationships between intended and actualized COHBs and their correlations with changes in oral health knowledge, health literacy, general self-efficacy, and dental neglect in a cohort of first-time pregnant clients at Women, Infants, and Children sites in North Carolina—participants of a large community-based study. The COHBs were related to diet (i.e., frequency of fruit juice and sweet snacks consumption and nighttime bottle-feeding) and oral hygiene practices (e.g., performance of daily oral hygiene and use of fluoridated toothpaste). Analyses relied on descriptive statistics and bivariate tests (Student’s t and McNemar’s). Data were collected from 48 participants (White, 44%; African American, 40%; Native American, 17%) at baseline and again at least 12 months after the birth of their first child. Results: On average, most mothers actualized 3 of 5 COHBs (range, 1 to 4). Significant differences between before and after birth were noted for frequency of sweet snacks consumption and putting the baby in bed with a bottle. No correlation was found between knowledge, literacy, self-efficacy, neglect, and sociodemographic characteristics and COHB actualization. Conclusion: Our findings suggest that first-time mothers in the studied population are likely to implement some but not all positive intended COHBs during pregnancy. Interventions are needed to assist women in implementing these practices. We support that, for prenatal interventional efforts to reap positive benefits, messaging should be personalized and include specific guidance on how to implement these recommendations. Knowledge Transfer Statement: A knowledge gap exists in our understanding of the relationship between first-time mothers’ intended and actualized child oral health behaviors, with implications in the optimal timing of infant and early childhood oral health messaging. Our findings suggest that first-time mothers are likely to implement some but not all positive behaviors that they intended to adopt during pregnancy. Interventions are needed to assist women in implementing these practices.
Functional assessments of foot strength: a comparative and repeatability study
Authors: Bruening Dustin A. , Ridge Sarah T. , Jacobs Julia L. , Olsen Mark T. , Griffin Dallin W. , Ferguson Drew H. , Bassett Kirk E. , Johnson A. Wayne 
Published: December 2019

Abstract
Background
Evaluating the strength of the small muscles of the foot may be useful in a variety of clinical applications but is challenging from a methodology standpoint. Previous efforts have focused primarily on the functional movement of toe flexion, but clear methodology guidelines are lacking. A novel foot doming test has also been proposed, but not fully evaluated. The purposes of the present study were to assess the repeatability and comparability of several functional foot strength assessment techniques.

Methods
Forty healthy volunteers were evaluated across two testing days, with a two-week doming motion practice period between them. Seven different measurements were taken using a custom toe flexion dynamometer (seated), custom doming dynamometer (standing), and a pressure mat (standing). Measurements from the doming dynamometer were evaluated for reliability (ICCs) and a learning effect (paired t-tests), while measurements from the toe flexion dynamometer and pressure mat were evaluated for reliability and comparability (correlations). Electromyography was also used to descriptively assess the extent of muscle isolation in all measurements.

Results
Doming showed excellent within-session reliability (ICCs > 0.944), but a clear learning effect was present, with strength (p < 0.001) and muscle activity increasing between sessions. Both intrinsic and extrinsic muscles were engaged during this test. All toe flexion tests also showed excellent reliability (ICCs > 0.945). Seated toe flexion tests using the dynamometer were moderately correlated to standing toe flexion tests on a pressure mat (r > 0.54); however, there were some differences in muscle activity. The former may better isolate the toe flexors, while the latter appeared to be more functional for many pathologies. On the pressure mat, reciprocal motion appeared to display slightly greater forces and reliability than isolated toe flexion.

Conclusions
This study further refines potential methodology for foot strength testing. These devices and protocols can be duplicated in the clinic to evaluate and monitor rehabilitation progress in clinical populations associated with foot muscle weakness.
Biometric handwriting analysis to support Parkinson’s Disease assessment and grading
Authors: Cascarano Giacomo Donato , Loconsole Claudio , Brunetti Antonio , Lattarulo Antonio , Buongiorno Domenico , Losavio Giacomo , Sciascio Eugenio Di , Bevilacqua Vitoantonio 
Published: December 2019

Abstract
Background
Handwriting represents one of the major symptom in Parkinson’s Disease (PD) patients. The computer-aided analysis of the handwriting allows for the identification of promising patterns that might be useful in PD detection and rating. In this study, we propose an innovative set of features extracted by geometrical, dynamical and muscle activation signals acquired during handwriting tasks, and evaluate the contribution of such features in detecting and rating PD by means of artificial neural networks.

Methods
Eleven healthy subjects and twenty-one PD patients were enrolled in this study. Each involved subject was asked to write three different patterns on a graphic tablet while wearing the Myo Armband used to collect the muscle activation signals of the main forearm muscles. We have then extracted several features related to the written pattern, the movement of the pen and the pressure exerted with the pen and the muscle activations. The computed features have been used to classify healthy subjects versus PD patients and to discriminate mild PD patients from moderate PD patients by using an artificial neural network (ANN).

Results
After the training and evaluation of different ANN topologies, the obtained results showed that the proposed features have high relevance in PD detection and rating. In particular, we found that our approach both detect and rate (mild and moderate PD) with a classification accuracy higher than 90%.

Conclusions
In this paper we have investigated the representativeness of a set of proposed features related to handwriting tasks in PD detection and rating. In particular, we used an ANN to classify healthy subjects and PD patients (PD detection), and to classify mild and moderate PD patients (PD rating). The implemented and tested methods showed promising results proven by the high level of accuracy, sensitivity and specificity. Such results suggest the usability of the proposed setup in clinical settings to support the medical decision about Parkinson’s Disease.
Antimicrobial efficacy of 0.8% Hyaluronic Acid and 0.2% Chlorhexidine against Porphyromonas gingivalis strains: An in-vitro study
Authors: Binshabaib Munerah , Aabed Kawther , Alotaibi Fitoon , Alwaqid Milaf , Alfraidy Aljohara , Alharthi Shatha 
Published: December 2019

Objective: The aim of the present in-vitro study was to assess antimicrobial efficacy of 0.8% hyaluronic acid (HA) and 0.2% Chlorhexidine gluconate (CHX) against Porphyromonas gingivalis (P. gingivalis).
Methods: The study was performed between December 2018 and March 2019 at the College of Dentistry at the Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. The P. gingivalis biofilms were formed and grown for 72 hours at 37°C under anaerobic conditions on glass slides coated with human saliva. The slides were individually positioned and exposed to 0.8% HA or 0.2% CHX. Therapeutically, the biofilms were divided into 3 groups as follows: (a) negative group; (b) 0.8% HA group and (c) 0.2% CHX group. P-values less than 0.05 were considered statistically significant.
Results: In the 0.8% HA group, P. gingivalis CFUs/ml were significantly higher at baseline than at 24- (P<0.05), 48 (P<0.05) and 72 hours (P<0.05) intervals. In the 0.2% CHX group, P. gingivalis CFUs/ml were significantly higher at baseline than at 72 hours interval (P<0.05). In the CHX group, there was no difference in P. gingivalis CFUs/ml between baseline, 24- and 48-hours intervals. At 48- and 72-hours intervals, the P. gingivalis CFUs/ml were significantly higher in the 0.2% CHX group compared with the 0.8% HA group.
Conclusion: In-vitro, 0.8% HA is more effective in reducing the P. gingivalis CFUs/ml compared with 0.2% CHX.
doi: https://doi.org/10.12669/pjms.36.2.1456
How to cite this:Binshabaib M, Aabed K, Alotaibi F, Alwaqid M, Alfraidy A, Alharthi S. Antimicrobial efficacy of 0.8% Hyaluronic Acid and 0.2% Chlorhexidine against Porphyromonas gingivalis strains: An in-vitro study. Pak J Med Sci. 2020;36(2):111-114. doi: https://doi.org/10.12669/pjms.36.2.1456
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Post parotidectomy facial nerve palsy: A retrospective analysis
Authors: Hafeez Siddiqui Dr. Atif , Shakil Saad , Rahim Danish ur , Shaikh Irfan Ahmed 
Published: December 2019

Background & Objectives: Transient paralysis of facial nerve is seen to vary from 15 % to 66 % in post-parotid surgery. The objective of this study was to find out the complications in post-parotidectomy with regards to facial nerve dysfunction since it is a vital structure encountered in parotid surgeries.
Methods: This was a retrospective study through non probability convenient sampling technique carried from September 2010 to January 2019 in the Department of Otorhinolaryngology, Dow University of Health Sciences, Dr. Ruth K.M.Pfau Civil Hospital, Karachi. Clinical data were recorded from 75 patients and out of them 70 patients had undergone surgery with parotid gland tumours and were reported on the morphology, age, sex, surgical procedure and complications, particularly facial nerve dysfunctions. In most cases ante-grade technique was performed to identify the facial nerve, whereas retrograde technique was used in recurring tumours, and in difficult cases. The stimulator of the nerve has not been used. The nature or severity of Facial nerve dysfunction was assessed in terms of either it is, permanent or temporary, total or incomplete in respect to its branches.
Results: Among total 75 patients; the mean age was 38.75 ± 9.26 years with male to female ratio of 1:1. Majority of the patients were diagnosed as pleomorphic adenoma, i.e. 78.6% after which 12% were diagnosed as mucoepidermoid carcinoma. 88.6% of patients had superficial parotidectomy and 11.4% of patients had total parotidectomy. About 75% of patients had no complications. 5(7.1%) patients had complete facial nerve palsy. Damage to the mandibular, buccal and temporozygomatic branch was observed in 10(14%), 2(3%) and 1(1.4%) patients respectively.
Conclusion: The most prevalent benign parotid tumour in this study was pleomorphic adenoma. After performing parotid surgery, it was predicted that the rate of complications related to the facial nerve injury was reduced as compared to the previous studies.
doi: https://doi.org/10.12669/pjms.36.2.1706
How to cite this:Siddiqui AH, Shakil S, Danish-ur-Rahim, Shaikh IA. Post parotidectomy facial nerve palsy: A retrospective analysis. Pak J Med Sci. 2020;36(2):126-130. doi: https://doi.org/10.12669/pjms.36.2.1706
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Postoperative pain management for circumcision; Comparison of frequently used methods
Authors: Münevveroglu Caglar , Gunduz Mehmet 
Published: December 2019

Objective: To determine the ideal method for postoperative pain management after circumcision by comparing the most frequently used different methods like; dorsal penile block, caudal epidural block, subcutaneous ring block, intravenous paracetamol and intravenous tramadol HCl.
Methods: Between May 1st 2015 to May 1st 2016, 500 children between 2-10 year old were circumcised at the department of pediatric surgery of Istanbul Medipol University Health Care Practice & Research Center Sefakoy Hospital. Five groups were formed according to postoperative analgesia methods which were planned to be compared; Group-I. penile block, Group-II. Caudal epidural block, Group-III. subcutaneous ring block, Group-IV as intravenous paracetamol and Group-V as intravenous tramadol HCl. In order to evaluate the postoperative pain levels of children, Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) was filled at 30, 60, 120, 180 minutes after circumcision by a researcher who does not know which method was applied.
Results: No significant difference is found between the groups (p>0.05). In the statistical analysis, no significant difference was found in the effect of analgesia methods on CHEOPS scores between 30, 60, 120 and 180 minutes (p>0.05). In parallel with this result, no significant difference was found in the effect of heart beat rates and respiration rate averages between 30, 60, 120 and 180 minutes (p>0.05).
Conclusion: It has been shown that none of the five method has any superiority in reducing pain after circumcision and that all five methods can be used. However, we think that side effects of regional anesthesia and systemic analgesic applications should not be ignored.
doi: https://doi.org/10.12669/pjms.36.2.505
How to cite this:Munevveroglu C, Gunduz M. Postoperative pain management for circumcision; Comparison of frequently used methods. Pak J Med Sci. 2020;36(2):91-95. doi: https://doi.org/10.12669/pjms.36.2.505
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Issues of Safety and Civil Liability Insurance for Nuclear Damage from Small Nuclear Power Plants
Authors: Demin V. , Golosnaya A. , Korolev S. , Kuznetsov V. , Makarov V. , Shmelev V. 
Published: December 2019

Purpose: To study the possibility of achieving assured safety for the environment and public in all modes of operation of small nuclear power plants (SNPP) and providing real civil liability insurance for nuclear risks at reasonable financial costs.
Material and methods: Particular attention on small nuclear power plants is driven by regional development, local communities and productions, which are not covered by centralized transport and energy supply. The peculiar properties and benefits of energy production at SNPP are considered, including: the possibility of locating in remote regions; the short construction period and the modular structure of SNPP; availability of potential to improve safety and reliability; reducing the size of the sanitary protection zone up to the boundaries of the technological site; the reality of liability insurance (full financial responsibility of the operator) for nuclear damage to third parties caused by an accident at SNPP at reasonable financial costs; industrial serial production; ability to move the entire nuclear power plants with small modular reactors in the assembled form, etc.
A comparative analysis of the technical characteristics of the SNPP and a conventional nuclear power plant from a safety perspective is made.
Results: The results of the SNPP safety analysis performed on the basis of the design documentation of the floating nuclear power plant “Akademik Lomonosov” is presented, with particular attention to assessing the consequences of design and beyond design basis accidents, in terms of probabilistic safety analysis and assessment of the maximum possible damage to third parties. The maximum possible damage to third parties from severe accidents is estimated to be about 0.5 billion RUR, which is hundreds of times less than damage from a catastrophic accident at a conventional NPP. Estimated costs for insurance of damage to third parties from an accident at SNPP will not exceed 1 kopeck/kWh. Possible approaches to civil liability insurance for nuclear risks and aspects of legal support are considered.
Conclusions: The results of the analysis allow to conclude that it is possible to provide in the future: the achievement of practically assured safety of the SNPP for the environment and the public in normal operation and possible design and beyond design basis accidents; real civil liability insurance for nuclear risks of SNPP at reasonable financial costs.
Effect of General Impact of Weak Low Frequency Vortex Magnetic Field on the System of Natural Antitumor Resistance of the Body
Authors: Rybakov Yu. , Gukasov V. , Kozlov Yu. 
Published: December 2019

Purpose: Experimental study of the antitumor mechanism of increasing the functional activity of phagocytes with a general effect on the body of a weak low-frequency vortex magnetic field (VMP).
Material and methods: The functional activity of phagocytes was assessed upon activation by the intensity of chemiluminescence (CHL) on a Biolumat instrument (model LB 9500, by Berthold, Germany). Samples for in vitro and in vivo experiments were prepared according to generally accepted protocols. The impact of the VMP (Vmax = 3.0 mTl, f = 100 Hz) was performed using a Magnitoturbotron magnetotherapeutic installation (developed by NPF Az).
Results: It was found in vitro experiments that the exposure of a suspension of VMP cells stimulated an increase in CHL by 58 % relative to the control, while the main contribution to the intensity of the signal of the CHL was made by neutrophils. In the study of the blood CHL of mice with subcutaneously inoculated melanoma B-16, it was established that the value of the specific CHL in the experiment with VFM by the end of the observation period (day 17) increased sharply (3 times) relative to the beginning of the observation and to the control at the same observation period was 3.3 times more. Experiments with whole blood of healthy donors and patients with breast cancer showed that the CHL curves over time were biphasic in nature and had two maxima, but the phase ratio was different. At donors, the main luminescence developed by the 100th minute, and a maximum of 30–40 min was mild. In patients with breast cancer, the first maximum at 30–40 min was the main, the second maximum was weak and came later than that of donors. Experiments with the effects of VMP on the organism of healthy and patients with breast cancer of people showed an increase in the functional activity of neutrophils as a result of exposure to VMP, but in patients with breast cancer, the level of CHL was significantly (3 times) higher than of healthy donors. Based on the research, it was concluded that exposure to the VMP is able to form a priming neutrophil.
Сonclusion: It is shown that the overall effect of weak low-frequency VFM increases the level of nonspecific resistance of the organism to the tumor process, which expands the possibilities of rehabilitation of patients, allows expanding the compensatory capabilities of the body and reduce the risk of disease.
Experiences of wearing support garments by people living with a urostomy
Authors: Taylor Claire , Munro Julie , Goodman William , Beeken Rebecca J , Dames Nicola , Oliphant Raymond , Watson Angus JM , Hubbard Gill 
Published: December 2019

Background: support garments are commonly worn by people with a urostomy but there are no published data about their experiences of doing so. Aims: to identify the views of people living with a urostomy on the role of support garments. Methods: a cross-sectional survey of the stoma population's experiences of support garments was conducted in 2018. Recruitment was by social media. The free-text responses provided by a sub-sample of 58 people out of 103 respondents with a urostomy, were analysed. Findings: thematic analysis revealed four themes: physical self-management; psychosocial self-management; lifestyle; and healthcare advice and support. There were mixed feelings about the value of support garments. Many cited a sense of reassurance and confidence and being able to be more sociable and active; others reported discomfort and uncertainty about their value. Conclusion: these findings add new understanding of experiences of support garments and provide novel theoretical insights about life with a urostomy.
Non–Institutional Federalism in Spain
Authors: Villalonga Joan Rosselló 
Published: December 2019

Spain has advanced significantly regarding die assignment of responsibilities on public expenditure and tax powers across regional governments. However, regions do not participate significantly in the decentralization process. The lack of federal insitutions in which regions are represented motivates non-cooperative behaviours and fosters competition between all levels of government. The consequence is that the provision of public goods and services is rather inefficient.
We illustrate our argument using a very simple static model with externalities in which the normative recommendation of decentralization does not guarantee the efficient provision of public goods. The adequate design of federal institutions would allow reducing such inefficiencies.
Finally we try to identify die political characteristics of the Spanish regime that may explain the lack of institutional mechanisms of cooperation-coordination between governments. This type of analysis could be easily extended to the present situation in Italy.
The Regulatory Management in the Energy and Electronic Communications Sectors: Towards Institutional Convergence?
Authors: da Empoli Stefano 
Published: December 2019

Regulatory authorities in the energy and electronic communications sectors have followed a parallel pattern due to the liberalization process that has interested the two sectors during the last decade in Europe. The reason can be partly traced back to a same legislative origin (EU directives promoted by the European Commission). In some European countries, a single authority is envisioned as a conclusion to such a common institutional path. This article inquires if institutional convergence may be justified by similar regulatory needs. Based on several critical factors, it is argued, however, that a different institutional design for the two regulatory authorities would be a more efficient solution.
These findings are then applied to the Italian case, where the Energy Authority (AEEG) and the Communications Authority (AGCOM) were set up during the late 90s. In this case, no particular convergence can be found. However, differences reflect a heavily inefficient institutional design.