bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing trends in incidence of preterm birth among 2.5 million newborns in Guangzhou, China, 2001 to 2016: an age-period-cohort analysis
Authors: Lu Jinhua , Wei Dongmei , Shen Songying , Xia Xiaoyan , He Jianrong , Sun Yan , Lam Kin Bong Hubert , Bao Wei , Xia Huimin , Qiu Xiu 
Published: November 2020

Abstract

Background
The incidence of preterm birth (PTB, < 37 weeks of gestation) has been increasing in China and many other countries in recent years. However, the causes of the increase were not well understood. The current study aims to examine the contribution of maternal age, period of delivery, and maternal birth cohorts to long-term trends in preterm birth in Guangzhou, China.

Methods
In a retrospective population-based study, data were obtained from 2,535,000 singleton live births with 20–43 gestational weeks from 2001 to 2016 and recorded in the Guangzhou Perinatal Health Care and Delivery Surveillance System, in China. The age-period-cohort models were applied to investigate the temporal changes in incidences of PTB, stratified by parity.

Results
The incidence of preterm birth steadily increased from 5.1% in 2001 to 5.9% in 2016, with larger rise in primiparous mothers (from 5.0 to 5.9%) compared to multiparous mothers (from 5.6 to 5.9%). A J-shaped and a V-shaped relationship were found between maternal age and PTB among primiparous and multiparous mothers, respectively. A linear cohort effect was found among primiparous mothers with the lowest risk of PTB [risk ratio (RR) = 0.81, 95% confidence interval (CI): 0.74 to 0.89] in 1961 and the highest risk (RR = 1.06, 95% CI: 1.00 to 1.13) in 1997 compared to the mothers born in 1981. An inverse U-shaped association between maternal birth cohort and PTB was found in multiparous mothers. There were weak decreasing period effects on the trend of overall PTB among multiparous mothers and on the trend of extremely (< 27 weeks) or very (28–31 weeks) PTB among both parity groups during the period of 2001–2012.

Conclusions
Our findings showed the PTB incidences had been increasing in the past 16 years in Guangzhou, China and both maternal age and cohort effects contributed to these trends. Further studies are recommended on the impact of altered maternal age and parity on premature births and corresponding public education and public health policies.
Long-term incidence of cardiovascular outcomes in the middle-aged and elderly with different patterns of physical activity: Tehran lipid and glucose study
Authors: Naseri Parisa , Amiri Parisa , Masihay-Akbar Hasti , Jalali-Farahani Sara , Khalili Davood , Azizi Fereidoun 
Published: November 2020

Abstract

Background
Following the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up.

Methods
This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models.

Results
Adherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women.

Conclusions
Adhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.
RETRACTED ARTICLE: Fluoride exposure and intelligence in school-age children: evidence from different windows of exposure susceptibility
Authors: Xu Kaihong , An Ning , Huang Hui , Duan Leizhen , Ma Jun , Ding Jizhe , He Tongkun , Zhu Jingyuan , Li Zhiyuan , Cheng Xuemin , Zhou Guoyu , Ba Yue 
Published: November 2020

Abstract
Background
The intellectual loss induced by fluoride exposure has been extensively studied, but the association between fluoride exposure in different susceptibility windows and children’s intelligence is rarely reported. Hence, we conducted a cross-sectional study to explore the association between fluoride exposure in prenatal and childhood periods and intelligence quotient (IQ).

Methods
We recruited 633 local children aged 7–13 years old randomly from four primary schools in Kaifeng, China in 2017. The children were divided into four groups, of which included: control group (CG, n = 228), only prenatal excessive fluoride exposure group (PFG, n = 107), only childhood excessive fluoride exposure group (CFG, n = 157), both prenatal and childhood excessive fluoride exposure group (BFG, n = 141). The concentrations of urinary fluoride (UF) and urinary creatinine (UCr) were determined by fluoride ion-selective electrode assay and a creatinine assay kit (picric acid method), respectively. The concentration of UCr-adjusted urinary fluoride (CUF) was calculated. IQ score was assessed using the second revision of the Combined Raven’s Test-The Rural in China (CRT-RC2). Threshold and saturation effects analysis, multiple linear regression analysis and logistic regression analysis were conducted to analyze the association between fluoride exposure and IQ.

Results
The mean IQ score in PFG was respectively lower than those in CG, CFG and BFG (P < 0.05). The odds of developing excellent intelligence among children in PFG decreased by 51.1% compared with children in CG (OR = 0.489, 95% CI: 0.279, 0.858). For all the children, CUF concentration of ≥1.7 mg/L was negatively associated with IQ scores (β = − 4.965, 95% CI: − 9.198, − 0.732, P = 0.022). In children without prenatal fluoride exposure, every 1.0 mg/L increment in the CUF concentration of ≥2.1 mg/L was related to a reduction of 11.4 points in children’s IQ scores (95% CI: − 19.2, − 3.5, P = 0.005).

Conclusions
Prenatal and childhood excessive fluoride exposures may impair the intelligence development of school children. Furthermore, children with prenatal fluoride exposure had lower IQ scores than children who were not prenatally exposed; therefore the reduction of IQ scores at higher levels of fluoride exposure in childhood does not become that evident.
Effects of a work-related stress model based mental health promotion program on job stress, stress reactions and coping profiles of women workers: a control groups study
Authors: Ornek Ozlem Koseoglu , Esin Melek Nihal 
Published: November 2020

AbstractBackgroundWork-related stress and its detrimental effects on human health have rapidly increased during the past several years. It causes many different stress reactions, related diseases and unhealthy behavior among workers, but especially women workers. Thus, the aim of this study was to examine the effects of the work-related stress model based Workplace Mental Health Promotion Programme on the job stress, social support, reactions, salivary immunoglobulin A and Cortisol levels, work absenteeism, job performance and coping profiles of women workers.MethodsThis study had a “pre-test post-test non-equivalent control groups” design and included 70 women workers (35 in each study group) selected by randomized sampling from two factories. The programme was delivered as an intervention including 12 weeks of follow-up. Reminder messages, videos, and WhatsApp texts were used at the follow-up stage. The research measurements were; the assessment form, the Brief Job Stress Questionnaire, the Brief Coping Profile Scale, salivary ELISA kits, and a self-reported check-list.ResultsThere were no differences in sociodemographic characteristics, general health or working conditions between the Intervention and control groups(p > .05). Three months after the intervention, there was a significant decrease in job stress(p ≤ .001), physical and mental reactions’ scores(p ≤ .001) and work absenteeism(p < .05), and there was an increase in job performance(p < .05), social support(p ≤ .001) among the intervention group. The programme showed positive effects on coping profiles(p < .05). After the intervention salivary-cortisol and IgA levels showed a statistically significant decrease(p < .05). A majority of effect sizes were very large (ηp2 > .14).ConclusionsWork-ProMentH was found to be effective and useful in job stress management and promotion of effective coping profiles. It enables its users to holistically assess worker stress and to plan and examine intervention programmes via a systematic approach. There is a need for more empirical studies that may support the data of the present study, but it is thought that the intervention can be maintained for the long-term. We recommend that occupational health professionals at workplaces should consider using this model-based cost-effective intervention, which seems easy and practical to apply in real-life situations.Trial registrationISRCTN registration ID:ISRCTN14333710(2020/10/03, retrospective registration).
Relationship between mothers’ enjoyment and sedentary behavior and physical activity of mother–child dyads using a movement-to-music video program: a secondary analysis of a randomized controlled trial
Authors: Tuominen Pipsa P. A. , Raitanen Jani , Husu Pauliina , Luoto Riitta M. , Kujala Urho M. 
Published: November 2020

Abstract

Background
Parental support and participation in physical activity (PA) with children and parents’ acting as a role model for less sedentary behaviors (SB) are critical factors for children’s healthier lifestyle. The purpose of the study was to assess the relationship between mothers’ enjoyment and participants’ sedentary behavior (SB) and physical activity (PA) as a secondary analysis of a randomized controlled trial (RCT) using data from Moving Sound RCT in the Pirkanmaa area of Finland.

Methods
The participants were 108 mother–child dyads (child age 5–7 years) who completed the eight-week exercise intervention using a movement-to-music video program in their homes. Mothers’ enjoyment was examined using a modified version of the enjoyment in sport questionnaire. The proportion of SB, standing, light PA, moderate-to-vigorous PA, and Total PA were derived from accelerometers at baseline and during the final week of the intervention. Analyses were performed using linear mixed-effect models for (1) intervention and control groups, (2) groups based on mothers’ enjoyment.

Results
The results highlighted that mothers’ enjoyment of exercise with their children was overall high. Although there was no difference between the intervention and control groups, mothers in the intervention group increased their enjoyment during the intervention (p = 0.007). With mothers’ higher enjoyment at baseline, children’s light PA increased (p < 0.001), and with mothers’ lower enjoyment, children’s SB increased (p = 0.010). Further, if mothers’ enjoyment decreased during the study, their own LPA increased (p = 0.049), and their children’s SB increased (p = 0.013). If mothers’ enjoyment remained stable, children’s light PA (p = 0.002) and Total PA (p = 0.034) increased.

Conclusions
In this RCT, no differences were found between the intervention and control groups or groups based on mothers’ enjoyment, possibly due to the low power of the study. However, mothers’ enjoyment of exercise with their children increased within the intervention group, and mothers’ enjoyment influenced children’s SB and PA. For future studies, it would be essential to focus on children’s enjoyment and factors behind the behavior change.

Trial registration
The study is registered at ClinicalTrials.gov, registration number NTC02270138, on October 2, 2014.
Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture
Authors: Lv Rong , Jin Chongrui , Shu Huiquan , Wang Lin , Sa Yinglong 
Published: November 2020

Abstract

Background
Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap.

Methods
We retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior ureth
roplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children.

Results
Operation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period.

Conclusions
Our method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair.
Dental implant location via surface scanner: a pilot study
Authors: Zhou Miao , Zhou Hui , Li Shu-yi , Geng Yuan-ming 
Published: November 2020

Abstract

Purpose
Implant location is performed after placement to verify that the safety of neighboring anatomic structure and the realizability of prosthetic plan. Routine postoperative location is based on radiological scanning and raises the concerns on radiation exposure and inconveniency in practice. In the present study a location method based on surface scanning was introduced and the accuracy of this method was assessed in vitro.

Material and methods
A total of 40 implants were placed in 10 resin mandible models. The models were scanned with intraoral scanner (IS group) and extraoral scanner (ES group). The implant position was located with fusing the images of surface scanning and cone beam computerized tomography (CBCT) after implant placement. Deviations were measured between positions located by surface scanner and postoperative CBCT with the parameters: central deviation at apex (cda), central deviation at hex (cdh), horizontal deviation at apex (hda), horizontal deviation at hex (hdh), vertical deviation at apex (vda), vertical deviation at hex (vdh) and angular deviation (ad).

Results
In IS group, the mean value of cda, cdh, hda, hdh, vda, vdh and ad was 0.27 mm, 0.23 mm, 0.12 mm, 0.10 mm, 0.21 mm, 0.19 mm and 0.72°, respectively. In ES group, the mean value of cda, cdh, hda, hdh, vda, vdh and ad was 0.28 mm, 0.25 mm 0.14 mm, 0.11 mm, 0.22 mm, 0.20 mm and 0.68°, respectively. The implant deviations in IS and ES groups were of no significant difference for any of the measurements.

Conclusions
Dental implant can be located via surface scanner with acceptable accuracy for postoperative verification. Further clinical investigation is needed to assess the feasibility of the method.
An innovative risk-scoring system of dental procedures and safety protocols in the COVID-19 era
Authors: Bizzoca M. E. , Campisi G. , Lo Muzio Lorenzo 
Published: November 2020

Abstract

Background
The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice.

Methods
The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air–water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols.

Results
Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1–3), medium (4–5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level.

Conclusions
The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners.
3D-analysis of unwanted tooth movements despite bonded orthodontic retainers: a pilot study
Authors: Klaus Katharina , Xirouchaki Faidra , Ruf Sabine 
Published: November 2020

AbstractBackgroundRecently, reports of unwanted tooth movements despite intact orthodontic bonded retainers have increased. These movements are not subject to relapse but are classified as a new developed malocclusion. The aims of the present pilot study were to analyze the prevalence of unwanted tooth movements despite intact bonded cuspid-to-cuspid retainers and to identify possible predisposing factors.Materials and methodsPlaster casts of all patients finishing orthodontic treatment during three consecutive years were assessed before treatment (T0), after multibracket appliance debonding (T1) and after two years of retention (T2). After multibracket appliance treatment, all patients received a cuspid-to-cuspid flexible spiral wire retainer bonded to each tooth of the retained segment in the upper and lower jaw. The study group (SG) consisted of 44 patients (16 male, 28 female) with tooth movements (T1–T2) of the retained segment despite intact bonded cuspid-to-cuspid retainer and the control group (CG) of 43 patients (19 male, 24 female) without unwanted tooth movements. The casts of the SG were digitized, superimposed and measured. Using the Chi-square test, Fisher´s exact test and Mann–Whitney-U-test (p < 0.05), mandibular plane angle, incisor proclination, oral dysfunctions or habits (T0) and intercanine distance, overjet and interincisal relationship (T0, T1, T2) were compared between SG and CG.ResultsThe prevalence of patients with unwanted tooth movements in one or both jaws was 27.0%. Maxillary retainers were affected more often (20.9%) than mandibular retainers (14.1%). The median amount of tooth movements was 0 to 0.66 mm with large interindividual variations. Oral dysfunctions or habits at T0, such as a lack of interincisal contact at all time points, were associated with unwanted tooth movements.ConclusionUnwanted tooth movements occurred more often with maxillary than mandibular retainers. Patients with oral dysfunctions/habits and without interincisal contact had a higher prevalence of unwanted tooth movements.
The relationship between learner engagement and teaching effectiveness: a novel assessment of student engagement in continuing medical education
Authors: Stephenson Christopher R. , Bonnes Sara L. , Sawatsky Adam P. , Richards Lukas W. , Schleck Cathy D. , Mandrekar Jayawant N. , Beckman Thomas J. , Wittich Christopher M. 
Published: November 2020

Abstract

Background
Continuing medical education (CME) often uses passive educational models including lectures. However, numerous studies have questioned the effectiveness of these less engaging educational strategies. Studies outside of CME suggest that engaged learning is associated with improved educational outcomes. However, measuring participants’ engagement can be challenging. We developed and determined the validity evidence for a novel instrument to assess learner engagement in CME.

Methods
We conducted a cross-sectional validation study at a large, didactic-style CME conference. Content validity evidence was established through review of literature and previously published engagement scales and conceptual frameworks on engagement, along with an iterative process involving experts in the field, to develop an eight-item Learner Engagement Instrument (LEI). Response process validity was established by vetting LEI items on item clarity and perceived meaning prior to implementation, as well as using a well-developed online platform with clear instructions. Internal structure validity evidence was based on factor analysis and calculating internal consistency reliability. Relations to other variables validity evidence was determined by examining associations between LEI and previously validated CME Teaching Effectiveness (CMETE) instrument scores. Following each presentation, all participants were invited to complete the LEI and the CMETE.

Results
51 out of 206 participants completed the LEI and CMETE (response rate 25%) Correlations between the LEI and the CMETE overall scores were strong (r = 0.80). Internal consistency reliability for the LEI was excellent (Cronbach’s alpha = 0.96). To support validity to internal structure, a factor analysis was performed and revealed a two dimensional instrument consisting of internal and external engagement domains. The internal consistency reliabilities were 0.96 for the internal engagement domain and 0.95 for the external engagement domain.

Conclusion
Engagement, as measured by the LEI, is strongly related to teaching effectiveness. The LEI is supported by robust validity evidence including content, response process, internal structure, and relations to other variables. Given the relationship between learner engagement and teaching effectiveness, identifying more engaging and interactive methods for teaching in CME is recommended.