bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting
Authors: Araujo Mariana Pinheiro , Innes Nicola Patricia , Bonifácio Clarissa Calil , Hesse Daniela , Olegário Isabel Cristina , Mendes Fausto Medeiros , Raggio Daniela Prócida 
Published: November 2020

Abstract

Background
Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months.

Methods
Children (5–10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. Primary outcome: restoration survival over 36-months (using Kaplan–Meier survival analysis, log rank test, and Cox regression). Secondary outcomes: (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months).

Results
One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. Primary outcome: restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17–0.47); HT = 93.4% (0.05; 0.72–0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007).

Conclusions
Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child’s tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%).

Trial registration
This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.
A novel method for 3D face symmetry reference plane based on weighted Procrustes analysis algorithm
Authors: Zhu Yujia , Zheng Shengwen , Yang Guosheng , Fu Xiangling , Xiao Ning , Wen Aonan , Wang Yong , Zhao Yijiao 
Published: November 2020

Abstract

Background
We aimed to establish a novel method, using the weighted Procrustes analysis (WPA) algorithm, which assigns weight to facial anatomical landmarks, to construct a three-dimensional facial symmetry reference plane (SRP) for mandibular deviation patients.

Methods
Three-dimensional facial SRPs were independently extracted from 15 mandibular deviation patients using both our WPA algorithm and the standard PA algorithm. A reference plane was defined to serve as the ground truth. To determine whether the WPA SRP or the PA SRP was closer to the ground truth, we measured the position error of mirrored landmarks, the facial asymmetry index (FAI) error, and the angle error for the global face and each facial third partition.

Results
The average angle error between the WPA SRP and the ground truth was 1.66 ± 0.81°, which was smaller than that between the PA SRP and the ground truth. The position error of the mirrored landmarks constructed using the WPA algorithm in the global face (3.64 ± 1.53 mm) and each facial partition was lower than that constructed using the PA algorithm. The average FAI error of the WPA SRP was − 7.77 ± 17.02 mm, which was smaller than that of the PA SRP.

Conclusions
This novel automatic algorithm, based on weighted anatomic landmarks, can provide a more adaptable SRP than the standard PA algorithm when applied to severe mandibular deviation patients and can better simulate the diagnosis strategies of clinical experts.
Assessment of oral health status and treatment needs among people of Foklyan area, Dharan, Nepal
Authors: Singh A. , Shrestha A. , Bhagat T. K. , Baral D. D. 
Published: November 2020

AbstractBackgroundOral diseases are a major public health problem globally due to high prevalence and significant social impact. Foklyan is a peri urban area with people belonging to indigenous population of low socioeconomic status. This study was conducted to assess the oral health status and treatment needs among the people of Foklyan area, Dharan.MethodsCross-sectional house to house survey was conducted on 310 randomly selected participants. The participants were stratified into five age groups as per WHO Basic Oral Health Survey Methods 1997 and further categorized by gender. WHO Oral Health Assessment form 1997, WHO oral health assessment questionnaire for adult/children 2013 and questionnaire for oral hygiene practice and cost as a treatment barrier were used. The examinations were done as per WHO standard guidelines.ResultsMost of the participants were from low socioeconomic background (71.3%). About 40% of the participants deferred dental visit due to financial burden. Although 99% of the participants brushed their teeth, there was high caries experience (DMFT: 3.18 ± 5.85; dft: 2.40 ± 2.65). Mean sextant score for bleeding was 5.58 in 35–44 years age group and 5.61 in 65–74 years age group. Tobacco consumption was seen in 70.9% of the adults. Prevalence of alcohol consumption was 58.8% among adult age groups.ConclusionThe prevalence of dental caries, periodontal diseases, and prosthetic needs were more compared to national data. There is a need for oral health promotion in this area.
Factors associated with underrepresented minority physician scientist trainee career choices
Authors: Siebert Aisha L. , Chou Shinnyi , Toubat Omar , Adami Alexander J. , Kim Hajwa , Daye Dania , Kwan Jennifer M. 
Published: November 2020

Abstract

Background
Recently, there have been concerted efforts to improve racial and ethnic diversity in the physician-scientist workforce. Identifying factors associated with career choices among those underrepresented in medicine and science is a necessary first step to advance this objective. The aim of the present study was to assess the attitudes and factors associated with academic and research career interests among underrepresented predoctoral physician-scientists.

Methods
A cross-sectional 70-question survey was distributed to all predoctoral single degree (MD or DO) and dual degree (MD/PhD or DO/PhD) trainees at 32 medical schools in the United States from 2012 to 2014. Main outcomes included factors important to advancement in academic medicine, intended medical specialty, and future career plans. To test the post-hoc hypothesis of whether trainees from underrepresented groups have differing perceptions of career trajectories and obstacles than their counterparts, we evaluated responses according to self-identified race/ethnic status using Chi-square and Fisher’s exact tests. All tests were two-sided and significance level of < 0.05 was used.

Results
There were a total of 4433 responses representing all predoctoral training stages. The response rate was 27%. Most respondents were single degree trainees (MD/DO 79% vs MD/DO-PhD 21%). Most respondents self-identified as White (67%), followed by Multi-racial or Other (14.3%), Asian or Pacific Islander (10.4%), Hispanic (6%), and Black or African American (4.1%). Desired career sector, career intention, and clinical specialty interest differed across race/ethnic groups. With respect to career selection factors, anticipated non-work related responsibilities during residency were also significantly different between these groups. By multivariable regression analysis, Black or African American trainees were significantly less likely than White trainees to indicate a career in academia (OR 0.496, 95% CI 0.322–0.764) and basic research (OR 0.314, 95% CI 0.115–0.857), while Multi-racial or Other trainees were also less likely than White trainees to indicate a career in academia (OR 0.763, 95% CI 0.594–0.980).

Conclusions
These data represent the first in-depth survey of career aspirations, perceptions, and interests between demographically underrepresented and non-underrepresented predoctoral physician-scientist trainees. Our results identify key differences between these cohorts, which may guide efforts to improve diversity within the physician-scientist workforce.
Health care utilization and HIV clinical outcomes among newly enrolled patients following Affordable Care Act implementation in a California integrated health system: a longitudinal study
Authors: Satre Derek D. , Parthasarathy Sujaya , Silverberg Michael J. , Horberg Michael , Young-Wolff Kelly C. , Williams Emily C. , Volberding Paul , Campbell Cynthia I. 
Published: November 2020

Abstract

Background
The Affordable Care Act (ACA) has increased insurance coverage for people with HIV (PWH) in the United States. To inform health policy, it is useful to investigate how enrollment through ACA Exchanges, deductible levels, and demographic factors are associated with health care utilization and HIV clinical outcomes among individuals newly enrolled in insurance coverage following implementation of the ACA.

Methods
Among PWH newly enrolled in an integrated health care system (Kaiser Permanente Northern California) in 2014 (N = 880), we examined use of health care and modeled associations between enrollment mechanisms (enrolled in a Qualified Health Plan through the California Exchange vs. other sources), deductibles (none, $1–$999 and > = $1000), receipt of benefits from the California AIDS Drug Assistance Program (ADAP), demographic factors, and three-year patterns of health service utilization (primary care, psychiatry, substance treatment, emergency, inpatient) and HIV outcomes (CD4 counts; viral suppression at HIV RNA < 75 copies/mL).

Results
Health care use was greatest immediately after enrollment and decreased over 3 years. Those with high deductibles were less likely to use primary care (OR = 0.64, 95% CI = 0.49–0.84, p < 0.01) or psychiatry OR = 0.59, 95% CI = 0.37, 0.94, p = 0.03) than those with no deductible. Enrollment via the Exchange was associated with fewer psychiatry visits (rate ratio [RR] = 0.40, 95% CI = 0.18–0.86; p = 0.02), but ADAP was associated with more psychiatry visits (RR = 2.22, 95% CI = 1.24–4.71; p = 0.01). Those with high deductibles were less likely to have viral suppression (OR = 0.65, 95% CI = 0.42–1.00; p = 0.05), but ADAP enrollment was associated with viral suppression (OR = 2.20, 95% CI = 1.32–3.66, p < 0.01). Black (OR = 0.35, 95% CI = 0.21–0.58, p < 0.01) and Hispanic (OR = 0.50, 95% CI = 0.29–0.85, p = 0.01) PWH were less likely to be virally suppressed.

Conclusions
In this sample of PWH newly enrolled in an integrated health care system in California, findings suggest that enrollment via the Exchange and higher deductibles were negatively associated with some aspects of service utilization, high deductibles were associated with worse HIV outcomes, but support from ADAP appeared to help patients achieve viral suppression. Race/ethnic disparities remain important to address even among those with access to insurance coverage.
Health variations among breast-cancer patients from different disease states: evidence from China
Authors: Yang Qing , Yu Xuexin , Zhang Wei 
Published: November 2020

Abstract

Background
This study aimed to obtain health utility parameters among Chinese breast cancer patients in different disease states for subsequent health economics model. In addition, we aimed to explore the feasibility of establishing a breast cancer health utility mapping model in China.

Methods
Multiple patient-reported health attributes were assessed, including quality of life, which was measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument; health utility and self-rated health, which were measured by the EuroQol-5 Dimension-5 Level (EQ-5D-5L) questionnaire. Multivariate regression models, including a linear regression model, an ordinal logistic regression model and a Tobit model, were employed to analyze health differences among 446 breast cancer patients. Subgroup analyses were performed to examine differences in multiple dimensions of health derived from the FACT-B and EQ-5D-5L instruments. A mapping function was used to estimate health utility from quality of life. Rank correlation analyses were employed to examine the correlation between estimated and observed health utility values.

Results
A total of 446 breast cancer patients with different disease states were analyzed. The health utility values of breast cancer patients in the P state (without cancer recurrence and metastasis), R state (with cancer recurrence within a year), S state (with primary and recurrent breast cancer for the second year and above), and M state (metastatic cancer) were 0.81 (SD ± 0.23), 0.90 (SD ± 0.12), 0.78 (SD ± 0.31), and 0.74 (SD ± 0.27), respectively. There were positive correlations between all scores, including every domain of the FACT-B instrument (p < 0.001). Results from multivariate analysis suggested that patients in the R and M states had lower scores for overall quality of life (R, β = − 9.45, p < 0.01; M, β = − 6.72, p < 0.05). Patients in the M state had lower health utility values than patients in the P state (β = − 0.11, p < 0.05). Estimated health utility values, which were derived from quality of life by using a mapping function, were significantly correlated with directly measured health utility values (p < 0.001).

Conclusions
We obtained the health utility and health-related quality of life (HRQoL) scores of Chinese breast cancer patients in different disease states. Mapping health utility values from quality of life using four disease states could be feasible in health economic modelling, but the mapping function may need further revision.
Pain is a common problem in patients with ILD
Authors: Shen Qinxue , Guo Ting , Song Min , Guo Wei , Zhang Yi , Duan Wang , Peng Yating , Ni Shanshan , Ouyang Xiaoli , Peng Hong 
Published: November 2020

Abstract
Background
As it is less known about the prevalence and characteristics of pain in the patients with interstitial lung disease (ILD), this paper aims at determining the characteristics of the pain in the patients with ILD.

Methods
Subjects with ILD and health controls with the matched ages and genders completed Short Form McGill Pain Questionnaire (SF-MPQ) and part of the Brief Pain Inventory (BPI) Short Form to elicit the characteristics of the pain. The patients with ILD were also assessed through Pulmonary Function Test, Six Minutes Walking Test (6MWT), modified Medical Research Council Dyspnea Scale (mMRC) for state of the illness and measured health-related quality of life (HRQoL) by Short Form-36 (SF-36) and psychological associations by Hospital Anxiety and Depression Scale (HADS).

Results
A total of 63 subjects with ILD and 63 healthy controls (HC) were recruited in our study. The prevalence of the pain was 61.9% in ILD versus 25.3% in HC (P = 0.005) and the median score of the pain rank index (PRI) in ILD was higher than that in HC (P = 0.014). Chest (46.1%) accounted for the highest of overall pain locations in subjects with ILD. Associated clinical factors for pain intensity in the patients with ILD included exposure history of risk factors of ILD, with a longer distance of 6MWD (≥ 250 m), and a higher mMRC score (2–4). The patients with ILD and pain are more likely to suffer impaired HRQoL (P = 0.0014) and psychological problems (P = 0.0017, P = 0.044).

Conclusion
The pain is common in those with ILD and the pain intensity is associated with exposure history, 6MWD, and mMRC score. The patients with ILD and pain were possibly to suffer depression, anxiety, and impaired HRQoL.
Association between serum calcium and prognosis in patients with acute pulmonary embolism and the optimization of pulmonary embolism severity index
Authors: Wang Xin , Xiang Yongbo , Zhang Ting , Yang Yuqing , Sun Xuefeng , Shi Juhong 
Published: November 2020

Abstract

Introduction
Calcium is an important coagulation factor and hypocalcemia is related to progression and poor prognosis of many cardiopulmonary diseases. However, influence of hypocalcemia on pulmonary thromboembolism (PTE) prognosis has never been reported. This study aimed to explore its prognostic value and optimize the pulmonary embolism severity index (PESI), the widely used prognosis assessment model, based on the value.

Methods
PTE patients’ variables in PESI and other related clinical characteristics including admission serum calcium were collected. Associations between these variables and PTE mortality were assessed by logistic regression and cox analysis. Variables significantly associated with 30-day PTE mortality were included to develop a new prognosis prediction rule and then its validity was compared with PESI and simplified PESI (sPESI).

Results
496 PTE patients were included and 49.48% patients had hypocalcemia (serum calcium ≤ 2.13 mmol/L) in admission, showing higher 7-day (P = 0.021), 14-day (P = 0.002), 30-day (13.03% vs 4.98%, P = 0.002) mortalities than patients without hypocalcemia. Adjusting for variables in PESI, hypocalcemia was further revealed to be an independent predictor of 30-day mortality (P = 0.014).
The optimal prediction rule contained hypocalcemia and 5 variables in PESI and sPESI, showing higher predictive validity [sensitivity (Sen): 0.930, specificity (Spec): 0.390, area under curve (AUC): 0.800] than PESI (Sen: 0.814, Spec: 0.367, AUC: 0.716) and sPESI (Sen: 0.907, Spec: 0.216, AUC: 0.703).

Conclusions
Hypocalcemia is an independent predictor of the mortality following acute PTE. Based on hypocalcemia, the optimal prediction rule showed higher validity than PESI and sPESI.
Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo
Authors: Arinaitwe Emmanuel , Nankabirwa Joaniter I. , Krezanoski Paul , Rek John , Kamya Victor , Epstein Adrienne , Rosenthal Philip J. , Drakeley Chris , Kamya Moses R. , Dorsey Grant , Staedke Sarah G. 
Published: November 2020

Abstract

Background
The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognized as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda.

Methods
Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within 4 weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual.

Results
Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI 0.60–0.89, p = 0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52–0.83, p = 0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67–1.40, p = 0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31–2.46, p < 0.001) and duration of travel (> 7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07–3.64, p = 0.03).

Conclusions
Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than 1 week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.
Rural–urban variation in insecticide-treated net utilization among pregnant women: evidence from 2018 Nigeria Demographic and Health Survey
Authors: Ameyaw Edward Kwabena , Adde Kenneth Setorwu , Dare Shadrach , Yaya Sanni 
Published: November 2020

Abstract

Background
In 2018, Nigeria accounted for the highest prevalence of malaria worldwide. Pregnant women and children under five years bear the highest risk of malaria. Geographical factors affect utilization of insecticide-treated nets (ITN), yet existing literature have paid little attention to the rural–urban dimension of ITN utilization in Nigeria. This study aimed at investigating the rural–urban variation in ITN utilization among pregnant women in Nigeria using data from the 2018 Demographic and Health Survey.

Methods
A total of 2909 pregnant women were included in the study. The prevalence of ITN utilization for rural and urban pregnant women of Nigeria were presented with descriptive statistics. Chi-square test was employed to assess the association between residence, socio-demographic characteristics and ITN utilization at 95% level of significance. Subsequently, binary logistic regression was used to assess the influence of residence on ITN utilization.

Results
Eight out of ten of the rural residents utilized ITN (86.1%) compared with 74.1% among urban residents. Relative to urban pregnant women, those in rural Nigeria had higher odds of utilizing ITNs both in the crude [cOR = 2.17, CI = 1.66–2.84] and adjusted models [aOR = 1.18, CI = 1.05–1.24]. Pregnant women aged 40–44 had lower odds of ITN utilization compared to those aged 15–19 [aOR = 0.63, CI = 0.44–0.92]. Poorer pregnant women had higher odds of ITN utilization compared with poorest pregnant women [aOR = 1.09, CI = 1.04–1.32]. Across regions, those in the south [aOR = 0.26, CI = 0.14–0.49] and south-west [aOR = 0.29, CI = 0.16–0.54] had lower odds of ITN use compared to their counterparts in the north-west region.

Conclusion
The high use of ITNs among pregnant women in Nigeria may be due to the prioritization of rural communities by previous interventions. This is a dimension worth considering to enhance the attainment of the national anti-malarial initiatives. Since possession of ITN is not a guarantee for utilization, women in urban locations need constant reminder of ITN use through messages delivered at ANC and radio advertisements. Moreover, subsequent mass ITN campaigns ought to take cognizance of variations ITN use across regions and pragmatic steps be taken to increase the availability of ITN in households since there is a moderately high use in households with at least one ITN in Nigeria.