bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bonding Effectiveness of Contemporary Materials in Luting Glass-Ceramic to Dentine: An In Vitro Study
Authors: Mutlu Alev , Atay Ayse , Çal Ebru 
Published: November 2020

Aim: To evaluate the shear bond strength (SBS) of resin cements, flowable composites, and a preheated composite in luting glass-ceramic to dentin. Materials and Methods: In total, 108 noncaries human third molar teeth embedded in acrylic blocks, grinded from the occlusal surfaces until dentin was exposed, and divided into 9 randomized groups ( n = 12). In total, 108 ceramic samples prepared in disc shape (3mm × 3mm) from IPS e. max CAD (Ivoclar Vivadent) blocks. Four adhesive resin cements: Variolink Esthetic DC (Ivoclar Vivadent), G-CEM LinkForce (GC), Panavia V5 (Kuraray Noritake), Maxcem Elite Chroma (Kerr), and three flowable composites: G-ænial Universal Flo (GC), Herculite XRV Ultra Flow (Kerr), Vertise Flow (Kerr), and one preheated composite: Enamel Plus HRI (Micerium) luted to the prepared occlusal surfaces of the teeth with total-etch, self-etch, and self-adhesive protocols. Then samples were thermocyled (5,000 cycles, 5–55°C, dwell time 20 s). SBS test was performed in a universal testing machine (at 0.5 mm/min). Failure modes were examined under a stereomicroscope at ×25 magnification. Data were analyzed using Kruskal–Wallis and Dunn–Bonferroni tests ( α = 0.05). Results: There were statistically significant differences among material types ( P < .05). Highest SBS values found in G-ænial Universal Flo (15.43 ± 5.67), and the lowest values obtained in Maxcem Elite Choroma (SA) (1.25 ± 1.47). There were no significant differences between self-etch (Panavia V5, Maxcem Elite Choroma [SE]) and self-adhesive (Maxcem Elite Choroma [SA], Vertise Flow) protocols ( P > .05). Conclusion: Flowable composites can be alternatives to resin cements when bonded with total-etch procedures. Bond strength of self-etch and self-adhesive applications is still to be developed.
A Radiographic Assessment of Dental Morbidity in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplant: A Retrospective Study
Authors: Wazzan Taggreed , Jagtap Rohan , Mona Mahmoud , Katz Joseph 
Published: November 2020

Aim: To assess the dental and oral morbidity in multiple myeloma patients as expressed in dental radiographs before autologous stem cell transplant. Materials and Methods: A retrospective study involving 79 multiple myeloma patients was designed to collect data prior to their autologous stem cell transplant. Patients were seen at the oral medicine clinic at the University of Florida College of Dentistry during the years 2010–2013. Through available patient data and interpretation of radiographs, the following variables were recorded: age, gender, carious lesions, periodontal disease, and periapical radiolucency. In addition, the incidence of root fragment retention and the presence of punched-out osteolytic lesions were recorded. Cochran–Mantel–Haenszel (CMH) tests and logistic regression were performed for descriptive analysis and presentation of the data. Results: Seventy-nine multiple myeloma patients were recruited for this study. Ages ranged from 28 to 79 years (mean = 61, SD = 9.6), including 41 (51.9%) females and 38 (48.1%) males. The results demonstrated dental decay in 64.56% of patients, periodontal disease in 62.03%, apical rarefying osteitis in 13.92% of patients, and punched-out lesions in 24.05% of patients. Conclusion: Our study indicates high dental morbidity in multiple myeloma patients prior to autologous stem cell transplant. The elimination of foci of infection is highly recommended prior to autologous stem cell transplant for this high-risk population because of the potential risk of bacteremia/septicemia from oral bacteria associated with dental morbidity.
Toothbrushing Performance and Oral Cleanliness after Brushing in 12-Year-Old Children
Authors: Weik U. , Cordes O. , Weber J. , Krämer N. , Pieper K. , Margraf-Stiksrud J. , Deinzer R. 
Published: November 2020

Objectives: Nationwide prevention programs in Germany aim to promote oral health. The group prevention program starts in kindergarten and ends when the children are about 12 y old. While in a recent study, toothbrushing behavior of 12-y-old children was analyzed, the present study’s objective was to examine the children’s ability to achieve oral cleanliness and to analyze how toothbrushing behavior and compliance with the toothbrushing recommendations taught in the group prevention programs predict oral cleanliness. Methods: Twelve-year-old randomly selected children ( N = 174) were asked to brush their teeth to the best of their abilities, and simultaneously a video was recorded for behavioral analyses. Plaque levels were measured before and immediately after toothbrushing. In addition, dental status and gingival bleeding were assessed. Results: After brushing to the best of their abilities, there was plaque on 50% (±24.72%) of all measured sites at the gingival margin (Marginal Plaque Index). Regression analyses revealed approximately 22% of the variance of marginal plaque on the outer surfaces to be explained by the time brushed by circular movements (β = −0.41; P < 0.001) and the number of sextants brushed for at least 7.5 s (β = −0.171; P < 0.05). Circular movements explained most additional variance (Δ R2 = 0.113; P < 0.001). With respect to inner surfaces, none of the behavioral aspects explained any variance of oral cleanliness. Conclusion: Despite regular group prevention measures, 12-y-old children show limited skills to clean their teeth adequately. Furthermore, none of the recommended behaviors relates to oral cleanliness after toothbrushing at inner surfaces. As a consequence, it is necessary to explore further which behavioral sequences effectively improve oral cleanliness. Knowledge Transfer Statement: This study illustrates that children’s compliance to toothbrushing recommendations is not necessarily related to toothbrushing effectiveness. Clinicians should therefore assess the effectivity of recommendations individually and provide individual guidance for improvement.
Map-based assessment of older adults’ life space: validity and reliability
Authors: Hinrichs Timo , Zanda Adriana , Fillekes Michelle P. , Bereuter Pia , Portegijs Erja , Rantanen Taina , Schmidt-Trucksäss Arno , Zeller Andreas W. , Weibel Robert 
Published: November 2020

Abstract
Background
Map-based tools have recently found their way into health-related research. They can potentially be used to quantify older adults’ life-space. This study aimed to evaluate the validity (vs. GPS) and the test-retest reliability of a map-based life-space assessment (MBA).

Methods
Life-space of one full week was assessed by GPS and by MBA. MBA was repeated after approximately 3 weeks. Distance-related (mean and maximum distance from home) and area-related (convex hull, standard deviational ellipse) life-space indicators were calculated. Intraclass correlations (MBA vs. GPS and test-retest) were calculated in addition to Bland-Altman analyses (MBA vs. GPS).

Results
Fifty-eight older adults (mean age 74, standard deviation 5.5 years; 39.7% women) participated in the study. Bland-Altman analyses showed the highest agreement between methods for the maximum distance from home. Intraclass correlation coefficients ranged between 0.19 (95% confidence interval 0 to 0.47) for convex hull and 0.72 (95% confidence interval 0.52 to 0.84) for maximum distance from home. Intraclass correlation coefficients for test-retest reliability ranged between 0.04 (95% confidence interval 0 to 0.30) for convex hull and 0.43 (95% confidence interval 0.19 to 0.62) for mean distance from home.

Conclusions
While acceptable validity and reliability were found for the distance-related life-space parameters, MBA cannot be recommended for the assessment of area-related life-space parameters.
Increasing system-wide implementation of opioid prescribing guidelines in primary care: findings from a non-randomized stepped-wedge quality improvement project
Authors: Zgierska Aleksandra E. , Robinson James M. , Lennon Robert P. , Smith Paul D. , Nisbet Kate , Ales Mary W. , Boss Deanne , Tuan Wen-Jan , Vidaver Regina M. , Hahn David L. 
Published: November 2020

AbstractBackgroundClinician utilization of practice guidelines can reduce inappropriate opioid prescribing and harm in chronic non-cancer pain; yet, implementation of “opioid guidelines” is subpar. We hypothesized that a multi-component quality improvement (QI) augmentation of “routine” system-level implementation efforts would increase clinician adherence to the opioid guideline-driven policy recommendations.MethodsOpioid policy was implemented system-wide in 26 primary care clinics. A convenience sample of 9 clinics received the QI augmentation (one-hour academic detailing; 2 online educational modules; 4–6 monthly one-hour practice facilitation sessions) in this non-randomized stepped-wedge QI project. The QI participants were volunteer clinic staff. The target patient population was adults with chronic non-cancer pain treated with long-term opioids. The outcomes included the clinic-level percentage of target patients with a current treatment agreement (primary outcome), rates of opioid-benzodiazepine co-prescribing, urine drug testing, depression and opioid misuse risk screening, and prescription drug monitoring database check; additional measures included daily morphine-equivalent dose (MED), and the percentages of all target patients and patients prescribed ≥90 mg/day MED. T-test, mixed-regression and stepped-wedge-based analyses evaluated the QI impact, with significance and effect size assessed with two-tailedp < 0.05, 95% confidence intervals and/or Cohen’sd.ResultsTwo-hundred-fifteen QI participants, a subset of clinical staff, received at least one QI component; 1255 patients in the QI and 1632 patients in the 17 comparison clinics were prescribed long-term opioids. At baseline, more QI than comparison clinic patients were screened for depression (8.1% vs 1.1%,p = 0.019) and prescribed ≥90 mg/day MED (23.0% vs 15.5%,p = 0.038). The stepped-wedge analysis did not show statistically significant changes in outcomes in the QI clinics, when accounting for the comparison clinics’ trends. The Cohen’sdvalues favored the QI clinics in all outcomes except opioid-benzodiazepine co-prescribing. Subgroup analysis showed that patients prescribed ≥90 mg/day MED in the QI compared to comparison clinics improved urine drug screening rates (38.8% vs 19.1%,p = 0.02), but not other outcomes (p ≥ 0.05).ConclusionsAugmenting routine policy implementation with targeted QI intervention, delivered to volunteer clinic staff, did not additionally improve clinic-level, opioid guideline-concordant care metrics. However, the observed effect sizes suggested this approach may be effective, especially in higher-risk patients, if broadly implemented.Trial registrationNot applicable.
Value of Galectin-3 assay in children with heart failure secondary to congenital heart diseases: a prospective study
Authors: Saleh Nagwan , Khattab Ahmed , Rizk Mohamed , Salem Sherif , Abo-Haded Hany 
Published: November 2020

Abstract
Background
Galectin-3 is a new biomarker, which plays an important role in tissue inflammation, cardiac remodeling, and fibrosis. It can be readily measured in the circulation to detect early heart failure (HF). This study aimed to assess the value of galectin-3 assay in early diagnosis of children with heart failure secondary to congenital heart disease (CHD) and correlate it with the patients’ outcome.

Methods
This prospective cohort study included 75 children diagnosed to have CHD; {Group A: 45 CHD children with HF symptoms and reduced ejection fraction (REF) and Group B: 30 CHD children with no HF symptoms and normal ejection fraction (NEF)}. They were compared to 40 age- and sex-matched controls (Group C). Children with CHD undergone history taking, Ross HF classification, Echocardiographic assessment and laboratory investigations including serum galactin-3 level.

Results
Galectin-3 serum level increased in CHD children, and it showed significant increase in (Gp A) compared to Gp B or Gp C (p = ≤ 0.001). In addition, serum level of Galactin-3 was correlated positively with Ross classification (r = 0.68, p = 0.018) and negatively correlated to EF% (r= -0.61, p ≤ 0.001). Galactin-3 showed better diagnostic value than Ross HF classification in early diagnosis of HF in CHD children with a cut point (≥ 10.4), significantly had 96.7% sensitivity, 90% specificity, 91% positive predictive value, 93.2% negative predictive value, with area under the curve (AUC = 0.96) and 93% accuracy. While there was a significant correlation between Ross HF classification and HF outcome in (Gp A) children (p = 0.05), we did not find any significant correlation between serum galectin-3 level and HF mortality in same group (p = 0.08).

Conclusions
Galectin-3 assay is a promising marker for early diagnosis of HF in children with CHD; but it has no role in detecting HF mortality.
Effectiveness of Alberta Family Integrated Care on infant length of stay in level II neonatal intensive care units: a cluster randomized controlled trial
Authors:   the Alberta FICare Level II NICU Study Team, Benzies Karen M. , Aziz Khalid , Shah Vibhuti , Faris Peter , Isaranuwatchai Wanrudee , Scotland Jeanne , Larocque Jill , Mrklas Kelly J. , Naugler Christopher , Stelfox H. Thomas , Chari Radha , Soraisham Amuchou Singh , Akierman Albert Richard , Phillipos Ernest , Amin Harish , Hoch Jeffrey S. , Zanoni Pilar , Kurilova Jana , Lodha Abhay 
Published: November 2020

Abstract
Background
Parents of infants in neonatal intensive care units (NICUs) are often unintentionally marginalized in pursuit of optimal clinical care. Family Integrated Care (FICare) was developed to support families as part of their infants’ care team in level III NICUs. We adapted the model for level II NICUs in Alberta, Canada, and evaluated whether the new Alberta FICare™ model decreased hospital length of stay (LOS) in preterm infants without concomitant increases in readmissions and emergency department visits.

Methods
In this pragmatic cluster randomized controlled trial conducted between December 15, 2015 and July 28, 2018, 10 level II NICUs were randomized to provide Alberta FICare™ (n = 5) or standard care (n = 5). Alberta FICare™ is a psychoeducational intervention with 3 components: Relational Communication, Parent Education, and Parent Support. We enrolled mothers and their singleton or twin infants born between 32 0/7 and 34 6/7 weeks gestation. The primary outcome was infant hospital LOS. We used a linear regression model to conduct weighted site-level analysis comparing adjusted mean LOS between groups, accounting for site geographic area (urban/regional) and infant risk factors. Secondary outcomes included proportions of infants with readmissions and emergency department visits to 2 months corrected age, type of feeding at discharge, and maternal psychosocial distress and parenting self-efficacy at discharge.

Results
We enrolled 654 mothers and 765 infants (543 singletons/111 twin cases). Intention to treat analysis included 353 infants/308 mothers in the Alberta FICare™ group and 365 infants/306 mothers in the standard care group. The unadjusted difference between groups in infant hospital LOS (1.96 days) was not statistically significant. Accounting for site geographic area and infant risk factors, infant hospital LOS was 2.55 days shorter (95% CI, − 4.44 to − 0.66) in the Alberta FICare™ group than standard care group, P = .02. Secondary outcomes were not significantly different between groups.

Conclusions
Alberta FICare™ is effective in reducing preterm infant LOS in level II NICUs, without concomitant increases in readmissions or emergency department visits. A small number of sites in a single jurisdiction and select group infants limit generalizability of findings.

Trial registration
ClinicalTrials.gov Identifier NCT02879799, retrospectively registered August 26, 2016.
Antibiotic therapy alone does not have a high success rate in cases of unexpected positive cultures in intraoperative samples from hip and knee prosthesis revision
Authors: Fink Bernd , Schlumberger Michael 
Published: November 2020

Abstract
Background
Unexpectedly positive bacterial cultures during prosthesis revision surgery still occur on occasion despite good preoperative diagnostics. In such cases a six-week antibiotic therapy without further surgical intervention is recommended. The aim of this study was to find out how successful this procedure is.

Methods
In a study of 508 patients, who required revision surgery of total hip (THA, n = 231) or knee arthroplasties (TKA, n = 277) because of component loosening, biopsy was carried out before their surgery. The collected tissue samples (5) from the biopsy and the revision surgery procedure itself were analyzed according the criteria of the International Consensus Meeting (ICM). Tests revealed 11 patients (7 THA, 4 TKA) with unexpectedly positive bacterial cultures from tissue samples obtained during the revision surgery due to false negative preoperative diagnostic results. These 11 patients were treated with 6 weeks antibiotic therapy and examined with a follow-up of at least 2 years (42.2 ± 16.5 months).

Results
Five patients (2 TKA, 3 THA) became reinfected, resulting in a success rate of 54.5%.

Conclusion
Antibiotic therapy alone of an unexpected positive intraoperative bacterial culture in prosthesis revision surgery seems to be less successful than previously assumed.
Is the Apert foot an overlooked aspect of this rare genetic disease? Clinical findings and treatment options for foot deformities in Apert syndrome
Authors: Stauffer Alexandra , Farr Sebastian 
Published: November 2020

AbstractBackgroundApert syndrome is characterised by the presence of craniosynostosis, midface retrusion and syndactyly of hands and feet, thus, synonymously referred to as acrocephalosyndactyly type I. Considering these multidisciplinary issues, frequently requiring surgical interventions at an early age, deformities of the feet have often been neglected and seem to be underestimated in the management of Apert syndrome. Typical Apert foot features range from complete fusion of the toes and a central nail mass to syndactyly of the second to fifth toe with a medially deviated great toe; however, no clear treatment algorithms were presented so far. This article reviews the current existing literature regarding the treatment approach of foot deformities in Apert syndrome.State-of-the-art topic reviewOverall, the main focus in the literature seems to be on the surgical approach to syndactyly separation of the toes and the management of the great toe deformity (hallux varus). Although the functional benefit of syndactyly separation in the foot has yet to be determined, some authors perform syndactyly separation usually in a staged procedure. Realignment of the great toe and first ray can be performed by multiple means including but not limited to second ray deletion, resection of the proximal phalanx delta bone on one side, corrective open wedge osteotomy, osteotomy of the osseous fusion between metatarsals I and II, and metatarsal I lengthening using gradual osteodistraction. Tarsal fusions and other anatomical variants may be present and have to be corrected on an individual basis. Shoe fitting problems are frequently mentioned as indication for surgery while insole support may be helpful to alleviate abnormal plantar pressures.ConclusionThere is a particular need for multicenter studies to better elaborate surgical indications and treatment plans for this rare entity. Plantar pressure measurements using pedobarography should be enforced in order to document the biomechanical foot development and abnormalities during growth, and to help with indication setting. Treatment options may include conservative means (i.e. insoles, orthopedic shoes) or surgery to improve biomechanics and normalize plantar pressures.Level of evidenceLevel V.
Head and neck cutaneous melanoma: 5-year survival analysis in a Serbian university center
Authors: Višnjić Aleksandar , Kovačević Predrag , Veličkov Asen , Stojanović Mariola , Mladenović Stefan 
Published: November 2020

Abstract
Background
Head and neck melanoma (HNM) is specific from the anatomical and etiopathogenetic aspects. In addition to morphopathological parameters, rich vascularization and lymphatic drainage of the head and neck affect the occurrence of lymphogenic and hematogenous metastases, as well as the metastases on both sides of the neck.

Methods
A retrospective cross-sectional study included cutaneous melanoma patients who underwent surgery at a clinical center over a 10-year period. The clinical follow-up was at least 60 months. The Kaplan-Meier method was used for the survival analysis. The predictor effect of certain independent variables on a given dichotomous dependent variable (survival) was measured by the Cox regression analysis.

Results
The analysis of demographic and clinical characteristics of 116 patients with HNM revealed that there was no statistically significant difference in age and gender in the total sample. Thirty-three (28.45%) patients were already in stage III or IV of the disease at the first examination, which affected the overall survival rate. The overall 5-year survival was 30.2%. No statistically significant difference in 5-year survival was found in relation to age and location. The period without melanoma progression decreased progressively in the advanced stage. Forty-nine patients (42%) underwent surgery for lymphogenic metastases in the parotid region and/or neck during the follow-up.

Conclusions
Patients with HNM included in this study frequently presented an advanced stage of the disease at the first examination, which is reflected in a low rate of 5-year survival. Early diagnosis and adequate primary treatment can ensure longer survival.
Statistical stopping criteria for automated screening in systematic reviews
Authors: Callaghan Max W , Müller-Hansen Finn 
Published: November 2020

AbstractActive learning for systematic review screening promises to reduce the human effort required to identify relevant documents for a systematic review. Machines and humans work together, with humans providing training data, and the machine optimising the documents that the humans screen. This enables the identification of all relevant documents after viewing only a fraction of the total documents. However, current approaches lack robust stopping criteria, so that reviewers do not know when they have seen all or a certain proportion of relevant documents. This means that such systems are hard to implement in live reviews. This paper introduces a workflow with flexible statistical stopping criteria, which offer real work reductions on the basis of rejecting a hypothesis of having missed a given recall target with a given level of confidence. The stopping criteria are shown on test datasets to achieve a reliable level of recall, while still providing work reductions of on average 17%. Other methods proposed previously are shown to provide inconsistent recall and work reductions across datasets.