bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of combined education to promote self efficacy and self-care oral health&nbsp;behaviors among students: A randomized controlled trial
Authors: Hashemi Zahra Sadat , khorsandi Mahboobeh , Shamsi Mohsen , Moradzadeh Rahmatollah 
Published: October 2020

Abstract
Background: In order to prevent oral diseases, the use of appropriate educational methods at childhood is one of the most important strategies for imrpving oral health knowledge. Therefore, the present study aimed to evaluate the effect of animations and games as a streagy for improving oral health self-efficacy and self-care behaviors among 6-12-aged students. Methods: In this interventional study, 82 students were selected based on cluster random sampling including 38 for the case and 44 for control group). The case group received four sessions of combined learning per week including animations and games while the control group received routine school education. The data were collected in six domains including demographics, self-care, knowledge, attitude, behavior and self-efficacy before and 5 months after the intervention using a questionnaire. SPSS version 20 was used for data analysis.Results: Five months after the intervention, the mean score of self-care, self-efficacy, behavior increased from 3.8 to 4.8, 36.8 to 48.9, and 17.07 to 18.29, respectively indicating a significant change (p < 0.05). However, no significant change was reported in these variables in the control group (p >0.05)Conclusion: The use of animation combiend with other stragies for oral health self-care education can positively influence the students' performance and self-efficacyIRCT registration number: This trial was registered at IRCT. IRCT2017042133565N1 Registration date: 2017-05-17 https://en.irct.ir/trial/25851Name of RCT: The effect of combine education methods on self efficacy and self-care oral health behavior among 6-12-aged school children.
A cross-sectional study on associations of physical symptoms, health self-efficacy and suicidal ideation among Chinese hospitalized cancer patients following diagnosis.
Authors: Xu Qingyi , Jia Shuhua , Fukasawa Maiko , Lin Lin , Na Jun , Mu Zhen , Li Bo , Li Ningning , Zhao Tong , Ju Zaishuang , He Meng , Yu Lianzheng , Kawakami Norito , Jiang Chao 
Published: October 2020

Abstract
Background: Epidemiological studies have shown elevated suicide risk in cancer patients compare with the general population. This study was performed to examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology settings in two general hospitals in northeast China via face-to-face interviews. Suicidal ideation was measured by using four items from the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation.Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were positively associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling for significant socio-demographic, clinical characteristics and depression. Conclusions: These findings demonstrate the associations between insomnia、lack of appetite and suicidal ideation and highlight the potential moderating role of health self-efficacy in the identification and prevention of suicide among cancer patients.
Does the IOFix implant Improve Union Rates?
Authors: segal david , Ohana Nissim , Nyska Meir , Palmanovich Ezequiel 
Published: October 2020

Abstract
BACKGROUNDFirst metatarso-phalangeal joint fusion is the current gold standard for severe hallux rigidus. Data regarding the union rate and the re-operation rate when IOFix (an Intra-osseous fixation device, Extremity medical, New Jersey, USA) is used for hallux rigidus fusion is limited but promising. The aim of this study was to review our outcomes with the IOFix implant. METHODSWe have conducted a retrospective chart review, following the approval of the hospital IRB committee. Exclusion criteria included bilateral operations on the same patient, multiple surgeries, charcot foot or other structural foot abnormalities (except hallux valgus), rheumatoid arthritis and a recent foot trauma. We collected demographic data, physical examination documentation, functional score evaluations (AOFAS), and Plain radiographic studies. RESULTS Thirty patients were included in the study. The mean age was 60.36±9.12 (range 36 to 77) years, 18 (60%) female patients and 12 (40%) male. Fourteen (53.33%) were left side pathologies. The average follow up period was 36.2±12.31 (range 12 to 54) months. Union was obtained in 28 (93.33%) patients, of whom none had requested a hardware removal due to a prominent hardware during a minimum of 2 year follow up period. The mean postoperative AOFAS score was 80.5±10.87 (range 35 to 90). A more stringent inclusion criteria and fusion definitions would have led to an exclusion of two more patients and a dropout of two patients from the “fused” group, which would have led to a fusion rate of 85.71%.CONCLUSIONSThis is the largest series of hallux rigidus patients that were operated with an IOFix device. The rates of fusion and hardware removal in MTPJ1 arthrodesis performed with an IOFix implant were found to be similar at most when compared to previously described rates that were obtained with other cheaper and more simple fixation devices.
The Binding Behaviors between Cyclopentanocucurbit[6]uril and Three Amino Acids in the Solid and the Solution Phases
Authors: Cheng Si Yuan , Zhao Wei Wei , Yang Xi Nan , Wei Lian Tong , Tao Zhu , Ma Peihua 
Published: October 2020

Abstract
Binding behaviors between CyP 6 Q[6] and three amino acids have been investigated by means of X-ray crystallography, proton nuclear magnetic resonance ( 1 H NMR) spectroscopy, amino acids and isothermal titration calorimetry (ITC). The results showed that CyP 6 Q[6] forms a 1:2 inclusion complex with glycine, but 1:1 complexes with both leucine and lysine. Whereas the carboxyl group of glycine can enter the interior of the cavity of CyP 6 Q[6], only the alkyl chains of leucine and lysine can enter this cavity. Interestingly, leucine can adopt two different self-assembly modes upon its interaction with cucurbituril, depending on the external conditions, whereas glycine and lysine do not exhibit such behavior.
Explanation and Prediction of Clinical Data with Imbalanced Class Distribution based on Pattern Discovery and Disentanglement
Authors: Zhou Peiyuan , Wong Andrew K.C. 
Published: October 2020

Abstract
Background: Statistical data analysis, especially the advanced machine learning (ML) methods, have attracted considerable interest in clinical practices. We are looking for interpretability of the diagnostic/prognostic results that will bring confidence to doctors, patients and their relatives in therapeutics and clinical practice. When datasets are imbalanced in diagnostic categories, we notice that the ordinary ML methods might produce results overwhelmed by the majority classes diminishing prediction accuracy. Hence, we need methods that could produce explicit transparent and interpretable results in decision-making, without sacrificing accuracy, even for data with imbalanced groups. Methods: In order to interpret the clinical patterns and conduct diagnostic prediction of patients with high accuracy, we develop a novel method, Pattern Discovery and Disentanglement for Clinical Data Analysis (cPDD), which is able to discover patterns (correlated traits/indicants) and use them to classify clinical data even if the class distribution is imbalanced. In the most general setting, a relational dataset is a large table such that each column represents an attribute (trait/indicant), and each row contains a set of attribute values (AVs) of an entity (patient). Compared to the existing pattern discovery approaches, cPDD can discover a small succinct set of statistically significant high-order patterns from clinical data for interpreting and predicting the disease class of the patients even with groups small and rare.Results: Experiments on synthetic and thoracic clinical dataset showed that cPDD can 1) discover fewer patterns compared to other existing pattern discovery methods; 2) allow the users to interpret succinct sets of patterns coming from uncorrelated sources, even the groups are rare/small; and 3) obtain better performance in prediction compared to other interpretable classification approaches. Conclusions: In conclusion, cPDD discovers fewer patterns with greater comprehensive coverage to improve the interpretability of patterns discovered. Experimental results on synthetic data validated that cPDD discovers all patterns implanted in the data, displays them precisely and succinctly with statistical support for interpretation and prediction, a capability which the traditional ML methods lack. The success of cPDD as a novel interpretable method in solving the imbalanced class problem shows its great potential to clinical data analysis for years to come.
Association of Patient-Centered Medical Home designation and quality indicators within HRSA-funded community health center delivery sites
Authors: Bell Nathaniel , Wilkerson Rebecca , Mayfield-Smith Kathy , Fede Ana Lòpez-De 
Published: October 2020

Abstract
Background: Patient-Centered Medical Home (PCMH) adoption is an important strategy to help improve primary care quality within Health Resources and Service Administration (HRSA) community health centers (CHC), but evidence of its effect thus far remains mixed. A limitation of previous evaluations has been the inability to account for the proportion of CHC delivery sites that are designated medical homes.Methods: Retrospective cross-sectional study using HRSA Uniform Data System (UDS) and certification files from the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC). Datasets were linked through geocoding and an approximate string-matching algorithm. Predicted probability scores were regressed onto 11 clinical performance measures using 10% increments in site-level designation using 10% increments in site designation and regressed onto 11 clinical performance measures using beta logistic regression.Results: The geocoding and approximate string-matching algorithm identified 2,615 of the 6,851 (41.8%) delivery sites included in the analyses as having been designated through the NCQA and/or JC. In total, 74.7% (n=777) of the 1,039 CHCs that met the inclusion criteria for the analysis managed at least one NCQA- and/or JC-designated site. A proportional increase in site-level designation showed a positive association with adherence scores for the majority of all indicators, but primarily among CHCs that designated at least 50% of its delivery sites. Once this threshold was achieved, there was a stepwise percentage point increase in adherence scores, ranging from 1.9% to 11.8% improvement, depending on the measure.Conclusion: Geocoding and approximate string-matching techniques offer a reliable approach for monitoring the association between site-level PCMH designation and clinical performance within HRSA’s CHC delivery sites. The model also offers preliminary evidence of a stepwise increase in quality metrics once half of a CHC’s delivery sites become designated medical homes.
Homology analysis between clinically isolated extraintestinal and enteral Klebsiella pneumoniae among Neonates
Authors: Chen Chun-mei , Wang Min , Li Xian-ping , Li Peng-ling , Tian Jing-jing , Zhang Kan , Luo Can 
Published: October 2020

Abstract
Background: Klebsiella pneumoniae is a leading cause of hospital-associated (HA) infections . It has been reported that gastrointestinal colonization (GI) is likely to be a common and significant reservoir for the transmission and infections of K. pneumoniae in both adults and neonates. However, the homologous relationship between clinically isolated extraintestinal and enteral K. pneumoniae in neonates hasn’t been characterized yet. Results: 43 isolates from 21 neonatal patients were collected in this study. The proportion of carbapenem resistance was 62.8%. There were 12 patients (12/21, 57.4%) whose antibiotic resistance phenotypes, genotypes, and ST types (STs) were concordant. Six sequence types were detected using MLST, with ST37 and ST54 being the dominant types. The results of MLST were consist with the results of PFGE. Conclusions: These data showed that there might be a close homologous relationship between EXKP and EKP in neonates，indicating that the K. pneumoniae from the GI tract is possibly to be a significant reservoir for causing extraintestinal infections.
Relaxometric learning: a pattern recognition method for T2 relaxation curves based on machine learning supported by an analytical framework
Authors: Date Yasuhiro , Wei Feifei , Tsuboi Yuuri , Ito Kengo , Sakata Kenji , Kikuchi Jun 
Published: October 2020

Abstract
Nuclear magnetic resonance (NMR)-based relaxometry is widely used in various fields of research because of its advantages such as simple sample preparation, easy handling, and relatively low cost compared with metabolomics approaches. However, there have been no reports on the application of the T2 relaxation curves in metabolomics studies involving the evaluation of metabolic mixtures, such as geographical origin determination and feature extraction by pattern recognition and data mining. In this study, we describe a data mining method for relaxometric data (i.e., relaxometric learning). This method is based on a machine learning algorithm supported by the analytical framework optimized for the relaxation curve analyses. In the analytical framework, we incorporated a variable optimization approach and bootstrap resampling-based matrixing to enhance the classification performance and balance the sample size between groups, respectively. The relaxometric learning enabled the extraction of features related to the physical properties of fish muscle and the determination of the geographical origin of the fish by improving the classification performance. Our results suggest that relaxometric learning is a powerful and versatile alternative to conventional metabolomics approaches for evaluating fleshiness of chemical mixtures in food and for other biological and chemical research requiring a nondestructive, cost-effective, and time-saving method.
A novel ELISA method to determine human MrgX2 in chronic urticaria
Authors: Ding Yuanyuan , Zhang Tao , Liu Rui , Che Delu , Wang Nan , He Langchong 
Published: October 2020

Abstract
BACKGROUND: Mas-related G-protein coupled receptor member X2 (MrgX2) directly mediates drug-induced pseudo allergic reactions. Skin mast cell MrgX2 is upregulated in severe chronic urticaria (CU). Mast cells and leukocytes are key effector cells in allergic reactions and undergo degranulation upon stimulation. It is unknown whether circulating MrgX2 expression can be detected occurs in the whole blood of CU patients and reflects pseudo-allergic reaction. There is no effective method for its detection. Therefore, an enzyme-linked immuno-sorbent assay (ELISA) for MrgX2 was developed.METHODS: Monoclonal and polyclonal MrgX2 specific antibodies were obtained from rabbits and mice immunized by MrgX2 peptides prepared. Indirect ELISA and Dot blot were used to determine antibody titers before a sandwich ELISA for MrgX2 was established. The whole blood from healthy subjects and CU patients was used to detect MrgX2 concentrations. The use of feasibility of this MrgX2-ELISA as a clinical detection tool was explored and diagnostic purposes was assessed.RESULTS: The sandwich antibody ELISA method for MrgX2 was established with good linearity regression (R2 = 0.9910). The lowest detection limit was 3.125 ng/mL. The quantification limit was 6.25 ng/mL. The sandwich ELISA for MrgX2 have good stability and high specificity. The initial truncation value of MrgX2 was 60.91 ng/mL (95% confidence interval). The whole blood MrgX2 concentrations in CU patients (median 98.01 ± 4.317 ng/mL, n = 75) was significantly increased compared to healthy subjects (58.09 ± 1.418 ng/mL, n = 75), with significant difference (p <0.0001) and higher accuracy of (AUC = 0.8795). Comprehensive the frequency analysis of MrgX2 expression in 75 CU patients reference frequency distribution and ROC curve analysis, determined the threshold for CU patients as 71.23 ng/mL, with 81.33% sensitivity and 90.67% specificity.CONCLUSION: MrgX2-ELISA provides a useful and convenient method for detecting MrgX2 in whole blood samples. The MrgX2-ELISA will help improve the understanding of the role of MrgX2 in regulating chronic urticaria.
Measuring the quality of nursing clinical placements. Development of the Placement Evaluation Tool (PET): A mixed methods co-design project
Authors: Cooper Simon , Cant Robyn , Waters Donna , Luders Elise , Henderson Amanda , Willetts Georgina , Tower Marion , Searl Kerry Reid , Ryan Colleen , Hood Kerry 
Published: October 2020

Abstract
Background: The quality of nursing clinical placements has been found to vary. Placement evaluation tools for nursing students are available but lack contemporary reviews of clinical settings. Therefore, the aim of this study was to develop a feasible, valid and reliable clinical placement evaluation tool applicable to nursing student placements in Australia.Methods: An exploratory mixed methods co-design project. Phase 1 included a literature review; expert rating of potential question items and Nominal Group Technique meetings with a range of stakeholders for item development. Phase 2 included on-line pilot testing of the Placement Evaluation Tool (PET) with 1,263 nursing students, across all year levels at six Australian Universities and one further education college in 2019-20, to confirm validity, reliability and feasibility.Results: The PET included 19-items (rated on a 5-point agreement scale) and one global satisfaction rating (a 10-point scale). Placements were generally positively rated. The total scale score (19 items) revealed a median student rating of 81 points from a maximum of 95 and a median global satisfaction rating of 9/10. Criterion validity was confirmed by item correlation: Intra-class Correlation Co-efficient ICC = .709; scale total to global score r = .722; and items to total score ranging from .609 to .832. Strong concurrent validity was demonstrated with the Clinical Learning Environment and Supervision Scale (r= .834). Internal reliability was identified and confirmed in two subscale factors: Clinical Environment (Cronbach’s alpha = .94) and Learning Support (alpha = .96). Based on the short time taken to complete the survey (median 3.5 minutes) and students’ comments, the tool was deemed applicable and feasible.Conclusions: The PET was found to be valid, reliable and feasible. Use of the tool as a quality assurance measure is likely to improve education and practice in clinical environments. Further international evaluation of the instrument is required to fully determine its psychometric properties.
Smartphone application for celiac patients: assessing its effect on gastrointestinal symptoms in a randomized controlled clinical trial
Authors: Nikniaz Zeinab , Shirmohammadi Masood , Maserrat Elham , Namvar Zahra Akbari 
Published: October 2020

Abstract
Background: We aimed to study the effectiveness of information provided via smartphone application on gastrointestinal symptoms in patients with celiac disease (CD).Methods: In the present randomized controlled clinical trial, 60 patients with CD were randomly assigned to receive education through a smartphone application (n=30) or conventional clinical education (n=30). The patients were asked to use it for obtaining the required information for three months. We assessed gastrointestinal symptoms using the gastrointestinal symptom rating scale (GSRS) questionnaire at baseline and three months after interventions. The GSRS total score, celiac disease GSRS (CD-GSRS) score, abdominal pain, reflux, diarrhea, constipation, and indigestion scores were calculated.Results: Out of 60 randomized patients, 58 patients completed the study. The mean age of the participants was 37.49±9.32 years, and the mean disease duration was 4.57±3.36 years. There were no significant differences between the two groups regarding the baseline values. In comparison to baseline, the mean CD-GSRS score (p=0.001) and indigestion subscore score (p<0.001) were significantly decreased in the intervention group. The results of the between-group comparisons showed that although the mean GSRS and CD-GSRS total scores were lower in the intervention group than in the standard care group, the differences were not statistically significant. In terms of GSRS subscores, there was a significant difference between the two groups only in the mean score of indigestion (P=0.002).Conclusion: According to the results, using smartphone application for providing information to patients with celiac disease had only a significant positive effect on indigestion symptoms compared with routine clinic education, and we did not observe any significant differences in GSRS and CD-GSRS scores between the two groups.Trial registration: The protocol of the study was registered in the Iranian registry of clinical trials (IRCT code: IRCT20170117032004N2). trial registry webpage: https://www.irct.ir/user/trial/40187/view. Trial registry date: 2019.6.26