bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of dental caries in deciduous teeth and oral health related quality of life among preschool children aged 4–6 years in Kisarawe, Tanzania
Authors: Masumo Ray M. , Ndekero Tumaini S. , Carneiro Lorna C. 
Published: February 2020

Abstract
Background
Preschool years are a critical period in the development of a healthy child. The consequences of poor oral health in preschool children reach beyond dental problems, with oral health-related quality of life (OHRQoL) being associated with overall systematic health as well as one’s quality of life. The purpose of this study was to assess the prevalence of dental caries and its impacts on the OHRQoL in a sample of preschool children in Kisarawe.

Methods
A cross-sectional based study was conducted in 2017. A total of 1106 preschool children completed a face-to-face interview, using a translated Kiswahili version of the Michigan Oral Health-related Quality of Life Scale (MOHRQoL) –Child Version (2003), and underwent clinical oral examination using WHO (1997) criteria.

Results
The decayed component was the most prevalent (dft = 2.08) and the Significant Caries Index (SiC) was 5.54 double of the (dft), showing polarization of dental caries in the studied population. After adjusting for appropriate covariates, preschool children of age 5 and 6 years old were more likely to have decayed tooth [Adjusted OR = 3.02, (95% CI =2.01–4.54)] and [Adjusted OR = 2.23, (95% CI = 1.55–3.20)] respectively. Preschool children without visible plaque on the buccal surface of upper anterior teeth were less likely to have decayed teeth [Adjusted OR = 0.21, (95% CI = 0.09–0.45)]. Regarding measurements of oral health-related quality of life using the MOHRQoL, only preschool children who reported on ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth [Adjusted OR = 1.74, (95% CI = 1.12–2.71)] and [Adjusted OR = 1.87, (95% CI = 1.11–3.15)], respectively.

Conclusion
Findings from this study suggest that dental caries affects a significant portion of preschool children and, was associated with poor oral hygiene. The overall impacts of dental caries prevalence to OHRQoL were low in this sample of preschool children. Children having caries (independent variable) were shown to report more frequently that ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth among preschool children in Kisarawe, Tanzania.
Pilot study of the influence of self-coding on empathy within an introductory motivational interviewing training
Authors: Simper Trevor , Agley Jon , DeSalle Mallori , Todd Jennifer , Dutta Tapati 
Published: February 2020

Abstract
Background
Motivational interviewing (MI) is a framework for addressing behavior change that is often used by healthcare professionals. Expression of empathy during MI is associated with positive client outcomes, while absence of empathy may produce iatrogenic effects. Although training in MI is linked to increased therapeutic empathy in learners, no research has investigated individual training components’ contribution to this increase. The objective of this study was to test whether a self-coding MI exercise using smartphones completed at hour 6 of an 8-h MI training was superior in engendering empathy to training as usual (watching an MI expert perform in a video clip for the same duration at the same point in the training).

Methods
This was a pilot study at two sites using randomization and control groups with 1:1 allocation. Allocation was achieved via computerized assignment (site 1, United Kingdom) or facedown playing card distribution (site 2, United States). Participants were 58 students attending a university class at one of two universities, of which an 8-h segment was dedicated to a standardized MI training. Fifty-five students consented to participate and were randomized. The intervention was an MI self-coding exercise using smartphone recording and a standardized scoring sheet. Students were encouraged to reflect on areas of potential improvement based on their self-coding results. The main outcome measure was score on the Helpful Responses Questionnaire, a measure of therapeutic empathy, collected prior to and immediately following the 8-h training. Questionnaire coding was completed by 2 blinded external reviewers and assessed for interrater reliability, and students were assigned averaged empathy scores from 6 to 30. Analyses were conducted via repeated-measures ANOVA using the general linear model.

Results
Fifty-five students were randomized, and 2 were subsequently excluded from analysis at site 2 due to incomplete questionnaires. The study itself was feasible, and overall therapeutic empathy increased significantly and substantially among students. However, the intervention was not superior to the control condition in this study.

Conclusions
Replacing a single passive learning exercise with an active learning exercise in an MI training did not result in a substantive boost to therapeutic empathy. However, consistently with prior research, this study identified significant overall increases in empathy following introductory MI training. A much larger study examining the impact of selected exercises and approaches would likely be useful and informative.
Implementation challenges for an ethical introduction of noninvasive prenatal testing: a qualitative study of healthcare professionals’ views from Lebanon and Quebec
Authors: Haidar Hazar , Vanstone Meredith , Laberge Anne-Marie , Bibeau Gilles , Ghulmiyyah Labib , Ravitsky Vardit 
Published: February 2020

Abstract
Background
The clinical introduction of non-invasive prenatal testing for fetal aneuploidies is currently transforming the landscape of prenatal screening in many countries. Since it is noninvasive, safe and allows the early detection of abnormalities, NIPT expanded rapidly and the test is currently commercially available in most of the world. As NIPT is being introduced globally, its clinical implementation should consider various challenges, including the role of the surrounding social and cultural contexts. We conducted a qualitative study with healthcare professionals in Lebanon and Quebec as case studies, to highlight the relevance of cultural contexts and to explore the concerns that should be taken into account for an ethical implementation of NIPT.

Methods
We conducted semi-structured interviews with 20 healthcare professionals (HCPs), 10 from each country, practicing in the field of prenatal screening and follow up diagnostic testing, including obstetricians and gynecologists, nurses, medical geneticists and, genetic counselors. We aimed to 1) explore HCPs’ perceptions and views regarding issues raised by NIPT and 2) to shed light on ways in which the introduction of the same technology (NIPT) in two different contexts (Lebanon and Quebec) raises common and different challenges that are influenced by the cultural norms and legal policies in place.

Results
We identified challenges to the ethical implementation of NIPT. Some are common to both contexts, including financial/economic, social, and organizational/ educational challenges. Others are specific to each context. For example, challenges for Lebanon include abortion policy and financial profit, and in Quebec challenges include lobbying by Disability rights associations and geographical access to NIPT.

Conclusions
Our findings highlight the need to consider specific issues related to various cultural contexts when developing frameworks that can guide an ethically sound implementation of NIPT. Further, they show that healthcare professional education and training remain paramount in order to provide NIPT counseling in a way that supports pregnant women and couples’ choice.
A qualitative study of physician perspectives on adaptation to electronic health records
Authors: Sieck Cynthia J. , Pearl Nicole , Bright Tiffani J. , Yen Po-Yin 
Published: February 2020

Abstract
Background
Electronic Health Records (EHRs) have the potential to improve many aspects of care and their use has increased in the last decade. Because of this, acceptance and adoption of EHRs is less of a concern than adaptation to use. To understand this issue more deeply, we conducted a qualitative study of physician perspectives on EHR use to identify factors that facilitate adaptation.

Methods
We conducted semi-structured interviews with 9 physicians across a range of inpatient disciplines at a large Academic Medical Center. Interviews were conducted by phone, lasting approximately 30 min, and were transcribed verbatim for analysis. We utilized inductive and deductive methods in our analysis.

Results
We identified 4 major themes related to EHR adaptation: impact of EHR changes on physicians, how physicians managed these changes, factors that facilitated adaptation to using the EHR and adapting to using the EHR in the patient encounter. Within these themes, physicians felt that a positive mindset toward change, providing upgrade training that was tailored to their role, and the opportunity to learn from colleagues were important facilitators of adaptation.

Conclusions
As EHR use moves beyond implementation, physicians continue to be required to adapt to the technology and to its frequent changes. Our study provides actionable findings that allow healthcare systems to focus on factors that facilitate the adaptation process for physicians.
Avatar-based versus conventional vital sign display in a central monitor for monitoring multiple patients: a multicenter computer-based laboratory study
Authors: Garot Olivier , Rössler Julian , Pfarr Juliane , Ganter Michael T. , Spahn Donat R. , Nöthiger Christoph B. , Tscholl David W. 
Published: February 2020

AbstractBackgroundMaintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms.MethodsA prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 s. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Administration Task-Load-Index (NASA TLX) questionnaire.ResultsIn the 10-s scenarios, the median number of remembered vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a mean of differences of 4 vital signs, 95% confidence interval (CI) 2 to 6,p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a mean of differences of 6 points, 95% CI 0.5 to 11,p = 0.034. In the 30-s scenarios, vital sign perception and workload did not differ significantly.ConclusionsIn central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, help to increase situation awareness and enhance patient safety.
Integration of mathematical model predictions into routine workflows to support clinical decision making in haematology
Authors: Hoffmann Katja , Cazemier Katja , Baldow Christoph , Schuster Silvio , Kheifetz Yuri , Schirm Sibylle , Horn Matthias , Ernst Thomas , Volgmann Constanze , Thiede Christian , Hochhaus Andreas , Bornhäuser Martin , Suttorp Meinolf , Scholz Markus , Glauche Ingmar , Loeffler Markus , Roeder Ingo 
Published: February 2020

Abstract
Background
Individualization and patient-specific optimization of treatment is a major goal of modern health care. One way to achieve this goal is the application of high-resolution diagnostics together with the application of targeted therapies. However, the rising number of different treatment modalities also induces new challenges: Whereas randomized clinical trials focus on proving average treatment effects in specific groups of patients, direct conclusions at the individual patient level are problematic. Thus, the identification of the best patient-specific treatment options remains an open question. Systems medicine, specifically mechanistic mathematical models, can substantially support individual treatment optimization. In addition to providing a better general understanding of disease mechanisms and treatment effects, these models allow for an identification of patient-specific parameterizations and, therefore, provide individualized predictions for the effect of different treatment modalities.

Results
In the following we describe a software framework that facilitates the integration of mathematical models and computer simulations into routine clinical processes to support decision-making. This is achieved by combining standard data management and data exploration tools, with the generation and visualization of mathematical model predictions for treatment options at an individual patient level.

Conclusions
By integrating model results in an audit trail compatible manner into established clinical workflows, our framework has the potential to foster the use of systems-medical approaches in clinical practice. We illustrate the framework application by two use cases from the field of haematological oncology.
Working with patients suffering from chronic diseases can be a balancing act for health care professionals - a meta-synthesis of qualitative studies
Authors: Holmen Heidi , Larsen Marie Hamilton , Sallinen Merja Helena , Thoresen Lisbeth , Ahlsen Birgitte , Andersen Marit Helen , Borge Christine Råheim , Eik Hedda , Wahl Astrid Klopstad , Mengshoel Anne Marit 
Published: February 2020

Abstract
Background
The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD).

Method
A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes.

Results
Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 sub-categories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions.

Conclusion
Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support.

Trial registration
PROSPERO number: CRD42019119052.
Disparities in length of stay for hip fracture treatment between patients treated in safety-net and non-safety-net hospitals
Authors: Coffield Edward , Thirunavukkarasu Saeyoan , Ho Emily , Munnangi Swapna , Angus L.D. George 
Published: February 2020

Abstract
Background
Length of hospital stay (LOS) for hip fracture treatments is associated with mortality. In addition to patient demographic and clinical factors, hospital and payer type may also influence LOS, and thus mortality, among hip fracture patients; accordingly, outcome disparities between groups may arise from where patients are treated and from their health insurance type. The purpose of this study was to examine if where hip fracture patients are treated and how they pay for their care is associated with outcome disparities between patient groups. Specifically, we examined whether LOS differed between patients treated at safety-net and non-safety-net hospitals and whether LOS was associated with patients’ insurance type within each hospital category.

Methods
A sample of 48,948 hip fracture patients was extracted from New York State’s Statewide Planning and Research Cooperative System (SPARCS), 2014–2016. Using means comparison and X2 tests, differences between safety-net and non-safety-net hospitals on LOS and patient characteristics were examined. Relationships between LOS and hospital category (safety-net or non-safety-net) and LOS and insurance type were further evaluated through negative binomial regression models.

Results
LOS was statistically (p ≤ 0.001) longer in safety-net hospitals (7.37 days) relative to non-safety-net hospitals (6.34 days). Treatment in a safety-net hospital was associated with a LOS that was 11.7% (p = 0.003) longer than in a non-safety-net hospital. Having Medicaid was associated with a longer LOS relative to having commercial health insurance.

Conclusion
Where hip fracture patients are treated is associated with LOS and may influence outcome disparities between groups. Future research should examine whether outcome differences between safety-net and non-safety-net hospitals are associated with resource availability and hospital payer mix.
Evaluation of in-vivo anti-Salmonella activity of Uvaria chamae, Lantana camara and Phyllantus amarus used in Benin, West Africa
Authors: Legba Boris , Dougnon Victorien , Chabi Yossounon , Gbaguidi Carène , Aniambossou Alidah , Deguenon Esther , Dougnon Jacques , Kpodekon Marc , Baba-Moussa Lamine 
Published: February 2020

AbstractBackgroundUvaria chamae (Annonaceae), Phyllantus amarus (Phyllantaceae)andLantana camara (Verbenaceae)are empirically alleged to be used as Beninese medicinal plants in the treatment of salmonellosis. This study aimed to produce scientific data on in vitro and in vivoefficacyofUvaria chamae, Lantana camaraandPhyllantus amaruson multiresistantSalmonella sppisolated in Benin.ResultsAfter performing in vitro tests on aqueous and ethanolic extracts of these plants, only the aqueous extract ofUvaria chamae(leaves) showed the best anti-Salmonella’s activity and was used for this in vivo experiment. The induction of salmonellosis revealed 9 × 108 CFU/ml was the optimal concentration triggering and maintaining symptoms in chicks. This infective concentration was used for in vivo assessment. Twenty-four hours post inoculation, the symptoms of salmonellosis (wet cloaca, diarrhea stools and somnolence) were observed in infected groups.After 7 days of treatment, the reduction of bacterial load at 100 mg/L, 200 mg/L, 400 mg/L of the extract was respectively 85%, 52.38% and 98% forUvaria chamae, Phyllantus amarusandLantana camarain the chick’s groups infected withSalmonellaTyphimurium ATCC 14028. On the other hand, colistin completely cancelled the bacterial load (reduction rate of 100%).With the groups infected withSalmonella spp(virulent strain), the reduction rate of bacterial load at 100 mg/L, 200 mg/L, 400 mg/L of extract was 0%, 98.66%, and 99.33%. The extracts at 200 and 400 mg/L were more active than colistin, which reduced the bacterial load by 33.33%.The toxicity tests did not show any negative effect of Colistin and theUvaria chamae’s extract on the biochemical and hematological parameters of the chicks.ConclusionThe aqueous extract ofUvaria chamaeis active in vitro and in vivo on multiresistant strains ofSalmonella enterica. This plant is a good candidate for the development of an improved traditional medicine for the management of salmonellosis.
Prognostic utility of heart-type fatty acid-binding protein in patients with stable coronary artery disease and impaired glucose metabolism: a cohort study
Authors: Zhang Hui-Wen , Jin Jing-Lu , Cao Ye-Xuan , Liu Hui-Hui , Zhang Yan , Guo Yuan-Lin , Wu Na-Qiong , Gao Ying , Xu Rui-Xia , Hua Qi , Li Yan-Fang , Cui Chuan-Jue , Liu Geng , Dong Qian , Sun Jing , Li Jian-Jun 
Published: February 2020

Abstract
Background
Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM.

Methods
A total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan–Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs.

Results
During the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p < 0.001). Interestingly, H-FABP levels were also elevated in DM and pre-DM groups compared with NGR group (p < 0.001), when combined glucose metabolism status with H-FABP stratification, patients in the highest tertile of H-FABP appeared to have higher risk of CVEs with pre-DM (adjusted hazard ratio [HR]: 1.855, 95% confidential intervals [CIs] 1.076–3.214; p = 0.033) and DM (adjusted HR: 2.560, 95% CIs 1.409–4.650; p = 0.002). The Kaplan–Meier curve indicated that DM patients with the highest H-FABP levels were associated with the greatest risk of CVEs (p < 0.05).

Conclusions
Our data firstly showed that elevated H-FABP levels were associated with worse outcomes in CAD patients with pre-DM and DM, which provided the novel information that H-FABP might be a prognostic marker for clinical outcomes among patients with CAD and IGM.