bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between developmental dental anomalies, early childhood caries and oral hygiene status of 3–5-year-old children in Ile-Ife, Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Michael , Adeniyi Abiola , El Tantawi Maha , Finlayson Tracy L. 
Published: December 2019

Abstract
Background
To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3–5-year-old children resident in Ile-Ife, Nigeria.

Methods
This was a cross-sectional study. We analyzed data for 3–5-year-olds extracted from the dataset of a household survey collected to determine the association between ECC and maternal psychosocial wellbeing in children 0–5-year-old. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodens, hypodontia, macrodontia, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status.

Results
Of the 918 children examined, 75 (8.2%) had developmental dental anomalies, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent developmental dental anomalies was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p < 0.001) and a borderline association between ECC and hypomineralized second primary molars (p = 0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91–4.56; p = 0.09) and ECC (PR: 2.02; 95% CI: 0.92–4.46; p = 0.08) who had developmental dental anomalies was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance.

Conclusions
Enamel hypoplasia and hypomineralized second primary molars are developmental dental anomalies associated with ECC. developmental dental anomalies also increases the probability of having poor oral hygiene in the population studied.
The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators
Authors: Marek Ewa , Łagocka Ryta , Kot Katarzyna , Woźniak Krzysztof , Lipski Mariusz 
Published: December 2019

AbstractBackgroundAccurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal.MethodsTwenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification.ResultsStatistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested.ConclusionThe EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.
Social inequalities in the burden of care: a dyadic analysis in the caregiving partners of persons with a physical disability
Authors:   for the SwiSCI Study Group, Tough Hannah , Brinkhof Martin W. G. , Siegrist Johannes , Fekete Christine 
Published: December 2019

Abstract
Background
Socioeconomic position (SEP) is an important contextual factor in the Stress Process Model of caregiving. However, the basic assumption that low SEP is associated with greater caregiver burden has so far lacked empirical support. The objective of this study was to investigate social inequalities in the caregiver burden among caregiving partners of persons with a physical disability, i.e., spinal cord injury (SCI), applying a dyadic approach. More specifically, we investigated 1) the association of the caregivers’ SEP with caregiver burden (‘actor effect’); 2) the association of the care-receivers’ SEP with caregiver burden (‘partner effect’), and 3) potential mediators of the association between SEP and caregiver burden.

Methods
Cross-sectional survey data from 118 couples of persons with SCI and their partners living in Switzerland was used. We firstly employed logistic regression to investigate the actor and partner effects of SEP on objective (hours of caregiving) and subjective caregiver burden (Zarit Burden Interview). We additionally used structural equation modelling to explore whether unfulfilled support needs, psychosocial resources and the care-receivers health status mediated the association between SEP and caregiver burden. SEP was operationalized by household income, education, subjective social position, financial strain and home ownership.

Results
We observed a consistent trend towards higher objective and subjective burden in lower SEP groups. Caregivers with higher subjective social positon and home ownership indicated lower subjective burden, and caregivers with higher education and absence of financial strain reported lower objective burden. Further evidence suggested a partner effect of SEP on caregiver burden, whereby objective caregiver burden was reduced in couples where the care-receiver had a higher educational level. The negative association between SEP and subjective burden was partially mediated by the unfulfilled support needs and deprived psychological resources of the caregiver, and the poor health status of the care-receiver. Similar mediation effects were not supported for objective burden.

Conclusions
Our study, in the context of SCI, provides support for the contextual role of SEP in the Stress Process Model of caregiving. To reduce subjective caregiver burden, policy programs may target the strengthening of psychosocial resources, or the improvement of access to support services for caregivers with low SEP.
The state of enrollment on the National Health Insurance Scheme in rural Ghana after eight years of implementation
Authors: Kwarteng Anthony , Akazili James , Welaga Paul , Dalinjong Philip Ayizem , Asante Kwaku Poku , Sarpong Doris , Arthur Samuelina , Bangha Martin , Goudge Jane , Sankoh Osman 
Published: December 2019

Abstract
Background
In 2004, Ghana implemented a national health insurance scheme (NHIS) as a step towards achieving universal health coverage. In this paper, we assessed the level of enrollment and factors associated with NHIS membership in two predominantly rural districts of northern Ghana after eight years of implementation, with focus on the poor and vulnerable populations.

Methods
A cross-sectional survey was conducted from July 2012 to December 2012 among 11,175 randomly sampled households with their heads as respondents. Information on NHIS status, category of membership and socio-demographic characteristics of household members was obtained using a structured questionnaire. Principal component analysis was used to compute wealth index from household assets as estimates of socio-economic status (SES). The factors associated with NHIS enrollment were assessed using logistic regression models. The reasons behind enrollment decisions of each household member were further investigated against their SES.

Results
Approximately half of the sampled population of 39,262 were registered with a valid NHIS card; 53.2% of these were through voluntary subscriptions by payment of premium whilst the remaining (46.8%) comprising of children below the ages of 18 years, elderly 70 years and above, pregnant women and formal sector workers were exempt from premium payment. Despite an exemption policy to ameliorate the poor and vulnerable households against catastrophic health care expenditures, only 0.5% of NHIS membership representing 1.2% of total exemptions granted on accounts of poverty and other social vulnerabilities was applied for the poor. Yet, cost of premium was the main barrier to NHIS registration (92.6%) and non-renewal (78.8%), with members of the lowest SES being worst affected. Children below the ages of 18 years, females, urban residents and those with higher education and SES were significantly more likely to be enrolled with the scheme.

Conclusions
Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment.
Survival benefits of neoadjuvant chemo(radio)therapy versus surgery first in patients with resectable or borderline resectable pancreatic cancer: a systematic review and meta-analysis
Authors: Pan Long , Fang Jing , Tong Chenhao , Chen Mingyu , Zhang Bin , Juengpanich Sarun , Wang Yifan , Cai Xiujun 
Published: December 2019

Abstract
Background
Pancreatic adenocarcinoma is a highly lethal malignancy. Neoadjuvant chemo(radio)therapy [NAC(R)T] is recommended to use for borderline resectable pancreatic cancer (BRPC) and high-risk resectable pancreatic cancer (RPC), but no high-level evidence exists.

Methods
We searched PubMed, EMBASE, Web of Science, and Cochrane library to identify trials comparing survival data of NAC(R)T with SF for RPC or BRPC. Overall survival (OS) was synthesized in analysis of all the patients (intention-to-treat [ITT] analysis) and resected patients respectively.

Results
The meta-analysis included 17 trials with 2286 participants. For BRPC, NAC(R)T improved OS both in ITT analysis (HR, 0.49; 95% CI, 0.37–0.65; P < 0.001) and in analysis of resected patients (HR, 0.66; 95% CI, 0.51–0.85; P = 0.001) in comparison to SF, accompanied with comparable overall resection rate [odds ratio (OR), 0.69; 95% Cl, 0.41–1.16; P = 0.159]. Disease-free survival, R0 rate, and recurrence were also in favor of NAC(R)T. For RPC, OS in analysis of resected patients was higher with NAC(R)T (HR, 0.75; 95% CI, 0.63–0.89; P = 0.001), but OS in ITT analysis was similar (HR, 1.02; 95% CI, 0.85–1.22; P = 0.818). The overall resection rate (OR, 0.50; 95% Cl, 0.25–0.99; P = 0.048) was lower, but R0 rate was higher with NAC(R)T. No differences in disease-free survival and recurrence between NAC(R)T and SF. Survival benefits of NAC(R)T basically persisted across sensitivity and subgroup analyses.

Conclusions
This meta-analysis demonstrates that NAC(R)T can provide survival benefits in BRPC patients and a subgroup of RPC patients compared with SF. Future research should focus on investigating the potential biomarkers to screen the subgroup of RPC patients who can benefit from neoadjuvant therapy.

Trial registration
CRD42018103086.
Is in vivo and ex vivo irradiation equally reliable for individual Radiosensitivity testing by three colour fluorescence in situ hybridization?
Authors: Mayo Theresa , Haderlein Marlen , Schuster Barbara , Wiesmüller Anna , Hummel Christian , Bachl Maximilian , Schmidt Manfred , Fietkau Rainer , Distel Luitpold 
Published: December 2019

Abstract
Background
Individual radiosensitivity is influencing the outcome of radiation therapy. A general ex vivo testing is very work-intensive. It is of interest to see if a significant prediction concerning the sensitivity can be made by in vivo irradiation during radiation treatment.

Methods
Blood samples of 274 patients with rectal cancer and 43 lung cancer patients receiving radiotherapy were examined after 2 Gy ex vivo and in vivo ionizing radiation. Chromosomes # 1, 2 and 4 were stained by the 3-color-fluorescence in situ hybridization. Chromosomal aberrations were analyzed as breaks per metaphase (B/M). The deposited energy per session was calculated for each patient.

Results
Weak correlation could be found between the chromosomal aberrations ex and in vivo. Though receiving significantly smaller deposited energy during radiation therapy (RT) the lung cancer cohort displayed B/M values similar to the rectal cancer cohort. Considering the individual deposit energy differences improved slightly the correlation.

Conclusions
As various factors influence the induction of chromosomal aberrations it seems not feasible to estimate individual radiosensitivity via in vivo irradiation. An ex vivo estimation of individual radiosensitivity should be preferred.
Decision-makers impact on the internationalization of high-technology firms in emerging markets
Authors: Neubert Michael , Van Der Krogt Augustinus Stijn 
Published: December 2019

AbstractThis study examines the impact of decision-makers from Paraguayan software firms on internationalization. It aims to have a better understanding about the (non-) rational decision logic of the CEOs and founders shaping the internationalization processes of 45 Paraguayan software firms. This study uses an observational, comparative descriptive, and a descriptive, correlational-research design based on a survey with the CEOs and founders of 45 Paraguayan software firms. The results suggest a significant correlational impact of decision-makers’ characteristics on the software firm’s internationalization and calls for further collaboration with high-tech firms from different industries in emerging as well as developed markets.
Toxicological implications of the fruit of Harungana madagascariensis on wistar rats
Authors: Shorinwa Olusayo Aderonke , Monsi Barizonmdu 
Published: December 2019

Abstract
Background
The unopened buds of the fruit of Harungana madagascariensis is used in the treatment of anaemia and skin diseases in traditional medicine. Hence, this study aims to scientifically evaluate the effects of oral administration of the fruit extract of Harungana madagascariensis on haematological, biochemical and histological parameters in Wistar rats.

Methods
Phytochemical screening of the ethanol fruit extract of H. madagascariensis was carried out. Acute toxicity test was done using Lorke’s method. Sub-acute toxicity studies were done using 24 rats of both sexes which were randomized into four groups of six rats each. Animals in groups A, B, C were administered with the extract at doses of 250, 500 and 1000 mg/kg, respectively while group D animals were given distilled water (5 mg/kg) and served as the control group. All administrations were done through the oral route for 30 consecutive days. Body weights of the animals were taken weekly during the study. The animals were sacrificed under diethyl ether anaesthesia and blood samples collected for evaluation of haematological (red blood cell, haemoglobin, packed cell volume and white blood cell) and biochemical (alanine transferase, alanine aminotransferase, alkaline phosphatase, urea, creatinine, total cholesterol and total protein) parameters. Histological examination was conducted on the liver and kidney of the animals.

Results
Preliminary phytochemical screening of the extract revealed the presence of alkaloids, anthraquinones, steroidal nucleus, saponins, carbohydrates, flavonoids, and tannins. Acute toxicity test showed that the LD50 was greater than 5000 mg/kg. There was no statistically significant (P < 0.05) difference in the RBC, HB, PCV and WBC of the extract treated groups when compared to the control group. There was however, a statistically significant (P < 0.05) difference in the creatinine level of the 500 mg/kg extract –treated group and the control. There was no statistically significant (P < 0.05) difference in other biochemical parameters of the extract treated groups and the control group except for a marginal increase in the total protein in the group treated with 1000 mg/kg of the extract (60 g/L) compared with control (54.80 g/L). Histopathological examination showed alterations in the morphology of the liver and kidney in extract treated groups as compared to the control groups.

Conclusion
The findings have revealed that the ethanol fruit extract of H. madagascariensis should be used with caution especially during prolonged usage as the histology showed it has nephrotoxic and hepatotoxic potentials. Further studies will be done to establish the effects of the extract on white blood cells.
The work of the Konrad-Adenauer-Stiftung (KAS) in Northeast Asia
Authors: Samse Stefan , Brauer Rabea , Badenheim Alexander , Hefele Peter , Merkle David 
Published: December 2019

AbstractNortheast Asia contains several geopolitical hot spots, which alone or in combination, have a high risk potential for regional and global security. The rising assertiveness of the PR China, shifting economic weights, the need for a comprehensive economic transformation in an age of digitalisation and demographic shifts - these challenges shape the future of all Northeast Asian nations.The Konrad-Adenauer-Stiftung (KAS), one of the largest political foundations of Germany, takes up these challenges not only with and within the respective societies, but also by developing platforms in the region and with Europe.The article describes key issues, the target groups, and the methodological approaches taken by KAS in each of the Northeast Asian countries. It shows the diversity of the approaches, and highlights the opportunities and limits for a German political foundation in the region.
Black rain in Hiroshima: a critique to the Life Span Study of A-bomb survivors, basis of the linear no-threshold model
Authors: Sutou Shizuyo 
Published: December 2019

AbstractIonizing radiation is regulated by the linear no-threshold model (LNT), which asserts that the lowest doses of ionizing radiation are hazardous in proportion to the dose and dose rate. LNT is based on the data of the Life Span Study (LSS) of A-bomb survivors in Hiroshima and Nagasaki. Radiation doses of the survivors were estimated by using initial radiation (5% of blast energy) and residual radiation (10%) was neglected. The major component of residual radiation was fallout, most of which must be brought down to the ground by black rain. The rain was highly radioactive. There are three major black rain maps reporting that black rain covered wide areas of Hiroshima-City. The three lead to an important conclusion that not only A-bomb survivors but also not-in-the-city control subjects (NIC) were irradiated with residual radiation to a greater or lesser degree. This means that exposure doses in LSS were largely underestimated and that use of NIC as the negative control is faulty. Thus, LNT based on LSS is invalid. In addition, LSS ignores radiation hormesis ─ ionizing radiation is not always hazardous, but beneficial depending on doses and dose rates. Indeed, when LSS data of longevity were examined, a clear J-shaped dose-response, a hallmark of radiation hormesis, is apparent. Also, cancer mortality ratios are in the increasing order: NIC (exposed to residual radiation), A-bomb survivors (exposed to both initial and residual radiations), and the Japanese in general (no exposure). Thus, low dose radiation (LDR) is hormetic. Obstinate application of invalid LNT to regulation-unnecessary LDR has been causing tremendous human, social, and economic losses in Fukushima. Also, LNT prevents clinical application of radiation hormesis to age-associated diseases such as Alzheimer’s disease and cancers.
Rapid, efficient, and economical synthesis of PET tracers in a droplet microreactor: application to O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET)
Authors: Lisova Ksenia , Chen Bao Ying , Wang Jia , Fong Kelly Mun-Ming , Clark Peter M. , van Dam R. Michael 
Published: December 2019

Abstract
Background
Conventional scale production of small batches of PET tracers (e.g. for preclinical imaging) is an inefficient use of resources. Using O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET), we demonstrate that simple microvolume radiosynthesis techniques can improve the efficiency of production by consuming tiny amounts of precursor, and maintaining high molar activity of the tracers even with low starting activity.

Procedures
The synthesis was carried out in microvolume droplets manipulated on a disposable patterned silicon “chip” affixed to a heater. A droplet of [18F]fluoride containing TBAHCO3 was first deposited onto a chip and dried at 100 °C. Subsequently, a droplet containing 60 nmol of precursor was added to the chip and the fluorination reaction was performed at 90 °C for 5 min. Removal of protecting groups was accomplished with a droplet of HCl heated at 90 °C for 3 min. Finally, the crude product was collected in a methanol-water mixture, purified via analytical-scale radio-HPLC and formulated in saline. As a demonstration, using [18F]FET produced on the chip, we prepared aliquots with different molar activities to explore the impact on preclinical PET imaging of tumor-bearing mice.

Results
The microdroplet synthesis exhibited an overall decay-corrected radiochemical yield of 55 ± 7% (n = 4) after purification and formulation. When automated, the synthesis could be completed in 35 min. Starting with < 370 MBq of activity, ~ 150 MBq of [18F]FET could be produced, sufficient for multiple in vivo experiments, with high molar activities (48–119 GBq/μmol). The demonstration imaging study revealed the uptake of [18F]FET in subcutaneous tumors, but no significant differences in tumor uptake as a result of molar activity differences (ranging 0.37–48 GBq/μmol) were observed.

Conclusions
A microdroplet synthesis of [18F]FET was developed demonstrating low reagent consumption, high yield, and high molar activity. The approach can be expanded to tracers other than [18F]FET, and adapted to produce higher quantities of the tracer sufficient for clinical PET imaging.