bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis
Authors: Kusumoto Junya , Uda Atsushi , Kimura Takeshi , Furudoi Shungo , Yoshii Ryosuke , Matsumura Megumi , Miyara Takayuki , Akashi Masaya 
Published: January 2021

Abstract
Background
In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital.

Methods
The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018.

Results
After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466).

Conclusions
This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.
Evaluation of the risk factors of dental caries in children with very low birth weight and normal birth weight
Authors: Koberova Romana , Radochova Vladimira , Zemankova Jana , Ryskova Lenka , Broukal Zdeněk , Merglova Vlasta 
Published: January 2021

AbstractBackgroundHealth problems of premature infants can affect both general and oral health. The enamel defects, poor dietary and oral hygiene habits may predispose these children to dental caries. This study was conducted to assess the impact of very low birth weight and prematurity on caries risk in early childhood.MethodsThe study cohort consists of 189 of one year old infants. Anamnestic data were obtained from hospital records, feeding practice, bed-time sugar drinks and oral hygiene onset from questionnaires. Saliva samples of children and their mothers were collected for the detection of cariogenic pathogens.ResultsVLBW newborns had significantly shorter gestation age (29.6 vs. 38.8)) and lower mean birthweight (1124 g vs 3315 g) compared to NBW ones (p < 0.0001). Statistical significance has been found in the presence of early morbidity (p < 0.0001) and regular medication intake (p = 0.007). VLBW children got more frequently sweetened drinks during the day and night (p = 0.007). Regular oral hygiene practice was more frequent in full term group (p = 0.002). There was statistical difference in the presence of enamel hypoplasia in VLBW children (p = 0.033) but no statistical difference in the presence of hypomineralization (p = 0.0736) in comparison to NBW individuals. Proportional representation and count ofS. mutansdid not reveal statistical difference neither in both groups of children (p = 0.484) nor in both groups of mothers (p = 0.385).ConclusionsThe study confirmed anamnestic and medical differences between both groups. The proportional representation and count ofS. mutansdid not reveal statistical difference neither in VLBW and NBW children, nor in their mothers.
Assessment of implant surface and instrument insert changes due to instrumentation with different tips for ultrasonic-driven debridement
Authors: Sahrmann Philipp , Winkler Sophie , Gubler Andrea , Attin Thomas 
Published: January 2021

Abstract
Background
To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonic-driven scaler tips of different materials.

Methods
Experiments were performed on two moderately rough surfaces (I—Inicell® and II—SLA®), one surface without pre-treatment (III) and one smooth machined surface (IV). Scaler tips made of steel (A), PEEK (B), titanium (C), carbon (D) and resin (E) were used for instrumentation with a standardized pressure of 100 g for ten seconds and under continuous automatic motion. Each combination of scaler tip and implant surface was performed three times on 8 titanium discs. After instrumentation roughness was assessed by profilometry, morphological changes were assessed by scanning electron microscopy, and element distribution on the utmost surface by energy dispersive X-ray spectroscopy.

Results
The surface roughness of discs I and II were significantly reduced by instrumentation with all tips except E. For disc III and IV roughness was enhanced by tip A and C and, only for IV, by tip D. Instrumentation with tips B, D and E left extensive residuals on surface I, II and III. The element analysis of these deposits proved consistent with the elemental composition of the respective tip materials.

Conclusion
All ultrasonic instruments led to microscopic alterations of all types of implants surfaces assessed in the present study. The least change of implant surfaces might result from resin or carbon tips on machined surfaces.
The use of internet platforms for oral health information and associated factors among adolescents from Jakarta: a cross sectional study
Authors: Maharani Diah Ayu , El Tantawi Maha , Yoseph Marsha Griselda , Rahardjo Anton 
Published: January 2021

Abstract
Background
The growth of the internet has increased its use to obtain health information including oral health information (OHI). This study assessed Indonesian adolescents’ use of different internet platforms to obtain OHI and factors associated with this use.

Methods
A cross-sectional study surveyed middle school students in five regions in Jakarta in 2019. Participants completed a questionnaire that assessed demographics, oral health practices (toothbrushing and dental visits), the presence of dental pain, using internet platform to obtain OHI and type of information searched for. Multinomial logistic regression was used to assess the association between using the internet for OHI (Google, Social Media (SM), both or none) and the independent factors: demographics, oral health practice, dental pain and whether participants search for causes, symptoms, prevention or treatment of oral diseases (ODs).

Results
Most of the 521 participants were female (55.7%) with mean age = 13.4 years. Almost all of them (93.7%) searched the internet for OHI through Google (40.7%) or Google with SM (36.1%). Searching for OHI over SM was significantly associated with toothbrushing (OR = 4.12, 95% CI = 1.43, 11.89) and less dental visits (OR = 0.16, 95% CI = 0.05, 0.60). Searching Google for OHI was significantly associated with looking for information about causes (OR = 3.69, 95% CI = 1.33, 10.26) and treatment (OR = 6.17, 95% CI = 2.23, 17.03) of ODs.

Conclusions
Most adolescents used Google to seek OHI. Oral health practices and types of OHI searched for differed by internet platform. Dental health professionals should consider using internet-based interventions to promote oral health to this age group.
Rationale and design of the validation of bladder health instrument for evaluation in women (VIEW) protocol
Authors:   for the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, Lukacz Emily S. , Constantine Melissa L. , Kane Low Lisa , Lowder Jerry L. , Markland Alayne D. , Mueller Elizabeth R. , Newman Diane K. , Rickey Leslie M. , Rockwood Todd , Rudser Kyle 
Published: January 2021

Abstract
Background
Bladder health is an understudied state and difficult to measure due to lack of valid and reliable instruments. While condition specific questionnaires assess presence, severity and degree of bother from lower urinary tract symptoms, the absence of symptoms is insufficient to assume bladder health. This study describes the methodology used to validate a novel bladder health instrument to measure the spectrum of bladder health from very healthy to very unhealthy in population based and clinical research.

Methods
Three samples of women are being recruited: a sample from a nationally representative general population and two locally recruited clinical center samples—women with a targeted range of symptom severity and type, and a postpartum group. The general population sample includes 694 women, 18 years or older, randomly selected from a US Postal delivery sequence file. Participants are randomly assigned to electronic or paper versions of the bladder health instrument along with a battery of criterion questionnaires and a demographic survey; followed by a retest or a two-day voiding symptom diary. A total of 354 women around 7 clinical centers are being recruited across a spectrum of self-reported symptoms and randomized to mode of completion. They complete the two-day voiding symptom diary as well as a one-day frequency volume diary prior to an in-person evaluation with a standardized cough stress test, non-invasive urine flowmetry, chemical urine analysis and post void residual measurement. Independent judge ratings of bladder health are obtained by interview with a qualified health care provider. A total of 154 postpartum women recruited around 6 of the centers are completing similar assessments within 6–12 weeks postpartum. Dimensional validity will be evaluated using factor analysis and principal components analysis with varimax rotation, and internal consistency with Cronbach’s alpha. Criterion validity will be assessed using multitrait-multimethod matrix including correlations across multiple data sources and multiple types of measures.

Discussion
We aim to validate a bladder health instrument to measure the degree of bladder health within the general population and among women (including postpartum) recruited from local clinical centers.

Trial registration NCT04016298 Posted July 11, 2019 (https://www.clinicaltrials.gov/ct2/show/NCT04016298?cond=bladder+health&draw=2&rank=1).
Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program
Authors: Agarwal Sanjay K. , Antunez-Flores Oscar , Foster Warren G. , Hermes Ashwaq , Golshan Shahrokh , Soliman Ahmed M. , Arnold Amanda , Luna Rebecca 
Published: January 2021

Abstract
Background
Women with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall dissatisfaction with care. The emergence of multidisciplinary endometriosis centers aims to reduce diagnostic delays, improve pain management, and promote patient satisfaction; however, baseline data at the time of presentation to a multidisciplinary center are lacking.

Methods
A real-world, retrospective, single-site, cross-sectional study of women with surgically confirmed and/or clinically diagnosed endometriosis generated baseline data for a planned longitudinal assessment of multidisciplinary care of endometriosis. The primary objective was to determine the proportion of patients experiencing mild, moderate, or severe pain for dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia at entry into a multidisciplinary endometriosis clinic. Also explored were relationships between pain scores and clinical endpoints obtained from electronic medical records.

Results
More than half (59%) of the study participants (n = 638) reported experiencing pelvic pain for ≥ 5 years. Pain intensity was highest for patients reporting dysmenorrhea, followed by NMPP, and dyspareunia. Significant correlations were observed between total pelvic pain and patient age (r = –0.22, p < 0.001, n = 506) and number of previous healthcare providers (r = 0.16, p = 0.006, n = 292); number of previous providers and duration of pain (r = 0.21, p = < 0.0001, n = 279); and duration of pain and years since diagnosis (r = 0.60, p < 0.001, n = 302). Mean pain scores differed significantly by age group for dysmenorrhea (p < 0.001), NMPP (p = 0.005), and total pelvic pain (p < 0.001), but not for dyspareunia (p = 0.06), with the highest mean pain scores reported among those < 30 years of age.

Conclusion
These real-world data indicate that in the single-provider model of care, unresolved pelvic pain is common among women with endometriosis. Alternative care models, including a multidisciplinary approach, need to be evaluated for improvements in clinical outcomes. These data also highlight the importance of addressing NMPP, which may be particularly troublesome for patients.
Understanding the key processes of excellence as a prerequisite to establishing academic centres of excellence in Africa
Authors: Fekadu Abebaw , Oppenheim Claire , Manyazewal Tsegahun , Nislow Corey , Woldeamanuel Yimtubezinash , Hailu Asrat , Belete Anteneh , Wondimagegn Dawit , Hanlon Charlotte , Gebremariam Tsige , Collins Asha , Larson Christopher J. , Gebreyes Wondwossen , Aklilu Eleni , Muula Adamson S. , Mugus Sabina , Caffrey Conor R. , Giday Mirutse , Yimer Getnet , Davey Gail , Medhin Girmay , Makonnen Eyasu 
Published: January 2021

AbstractBackgroundAfrica’s economic transformation relies on a radical transformation of its higher education institutions. The establishment of regional higher education Centres of Excellence (CoE) across Africa through a World Bank support aims to stimulate the needed transformation in education and research. However,excellenceis a vague, and often indiscriminately used concept in academic circles. More importantly, the manner in which aspiring institutions can achieve academic excellence is described inadequately. The main objective of this paper is to describe the core processes of excellence as a prerequisite to establishing academic CoE in Africa.MethodsThe paper relies on our collaborative discussions and real-world insight into the pursuit of academic excellence, a narrative review using Pubmed search for a contextual understanding of CoEs in Africa supplemented by a Google search for definitions of CoEs in academic contexts.ResultsWe identified three key, synergistic processes of excellence central to institutionalizing academic CoEs: participatory leadership, knowledge management, and inter-disciplinary collaboration. (1) Participatory leadership encourages innovations to originate from the different parts of the organization, and facilitates ownership as well as a culture of excellence. (2) Centers of Excellence arefuture-orientedin that they are constantly seeking to achieve best practices, informed by the most up-to-date and cutting-edge research and information available. As such, the process by which centres facilitate the flow of knowledge within and outside the organization, or knowledge management, is critical to their success. (3) Such centres also rely on expertise from different disciplines and ‘engaged’ scholarship. This multidisciplinarity leads to improved research productivity and enhances the production of problem-solving innovations.ConclusionParticipatory leadership, knowledge management, and inter-disciplinary collaborations are prerequisites to establishing academic CoEs in Africa. Future studies need to extend our findings to understand the processes key to productivity, competitiveness, institutionalization, and sustainability of academic CoEs in Africa.
Evaluating pharmacy students’ knowledge and skills in reproductive, maternal, new-born and child health care at a South African university
Authors: Egieyeh Elizabeth , van Huyssteen Mea , Coetzee Renier , Bheekie Angeni 
Published: January 2021

AbstractBackgroundMaternal and child mortality is a global concern and one of South Africa’s quadruple burdens of disease. As easily accessible frontline healthcare workers, pharmacists play an important role in the continuum of maternal and child health (MCH) care according to recommendations by international health regulatory bodies. Pharmacy schools are obliged to train pharmacy students to meet the priority health needs of the population so that graduates are ‘fit for purpose’. The baseline study aimed to evaluate the knowledge and skills of 2017 final year pharmacy students who were exposed to a fragmented MCH care curriculum at a university in South Africa to inform curriculum review.MethodsA descriptive, quantitative, non-randomized study was conducted among final year pharmacy students using a self-administered structured questionnaire. The questionnaire was designed in sections to assess participants’ knowledge of reproductive and sexual health (RSH), maternal and antenatal care (MAC), neonatal and child care (NCC) and skills related to infant growth assessment procedures. Data was analysed descriptively using frequencies and percentages. A score of 50% in each section of the questionnaire indicated a pass. Participants assessed their exposure to MCH topics in the curriculum.ResultsOf the 89 available students, 61% consented to participate in the study. The average scores attained for each section were; 62.4% for RSH, 54.5% for MAC, 50.4% for NCC and 25.3% for infant growth assessment. The pass rate was 78% for RSH, 56% for MAC, 57% for NCC, and 19% for infant growth assessment. About 13% of the participants passed all the knowledge and the skills sections. Age, gender, being a parent or doing locums did not have any influence on participants’ performance. Participants reported that they had more on-campus curriculum content exposure to RSH compared to other MCH care topics.ConclusionFinal year pharmacy students showed adequate knowledge of RSH with adequate curriculum exposure. Average knowledge of MAC, NCC and poor skills in infant growth assessment which corresponded to curriculum exposure was observed. The results suggest the need for improvement in the current curriculum in the affected areas to adequately equip students to render desirable services.
Applying probability calibration to ensemble methods to predict 2-year mortality in patients with DLBCL
Authors: Fan Shuanglong , Zhao Zhiqiang , Yu Hongmei , Wang Lei , Zheng Chuchu , Huang Xueqian , Yang Zhenhuan , Xing Meng , Lu Qing , Luo Yanhong 
Published: January 2021

AbstractBackgroundUnder the influences of chemotherapy regimens, clinical staging, immunologic expressions and other factors, the survival rates of patients with diffuse large B-cell lymphoma (DLBCL) are different. The accurate prediction of mortality hazards is key to precision medicine, which can help clinicians make optimal therapeutic decisions to extend the survival times of individual patients with DLBCL. Thus, we have developed a predictive model to predict the mortality hazard of DLBCL patients within 2 years of treatment.MethodsWe evaluated 406 patients with DLBCL and collected 17 variables from each patient. The predictive variables were selected by the Cox model, the logistic model and the random forest algorithm. Five classifiers were chosen as the base models for ensemble learning: the naïve Bayes, logistic regression, random forest, support vector machine and feedforward neural network models. We first calibrated the biased outputs from the five base models by using probability calibration methods (including shape-restricted polynomial regression, Platt scaling and isotonic regression). Then, we aggregated the outputs from the various base models to predict the 2-year mortality of DLBCL patients by using three strategies (stacking, simple averaging and weighted averaging). Finally, we assessed model performance over 300 hold-out tests.ResultsGender, stage, IPI, KPS and rituximab were significant factors for predicting the deaths of DLBCL patients within 2 years of treatment. The stacking model that first calibrated the base model by shape-restricted polynomial regression performed best (AUC = 0.820, ECE = 8.983, MCE = 21.265) in all methods. In contrast, the performance of the stacking model without undergoing probability calibration is inferior (AUC = 0.806, ECE = 9.866, MCE = 24.850). In the simple averaging model and weighted averaging model, the prediction error of the ensemble model also decreased with probability calibration.ConclusionsAmong all the methods compared, the proposed model has the lowest prediction error when predicting the 2-year mortality of DLBCL patients. These promising results may indicate that our modeling strategy of applying probability calibration to ensemble learning is successful.
Clinical learning environment of nursing and midwifery students in Ghana
Authors: Ziba Florence Assibi , Yakong Vida Nyagre , Ali Zakari 
Published: January 2021

Abstract
Background
Data on student experience of the clinical learning environment in Ghana are scarce. We therefore aimed to assess students’ evaluation of the clinical learning environment and the factors that influence their learning experience.

Methods
This was a cross-sectional survey of 225 undergraduate nursing and midwifery students. We used the Clinical Learning Environment and Supervision + Nurse Teacher (CLES +T) evaluation scale to assess students’ experience of their clinical placement. The association between student demographic characteristics and clinical placement experience was determined using t-test or ANOVA.

Results
Most of the sampled students were Nurses (67%) and in the third year of training (81%). More students received supervision from a nurse (57%) during clinical placement and team supervision (67%) was the most common during clinical placement. Nursing students were more likely to rate their clinical experience better than midwifery students (p=0.002). Students who had increased contact with private supervisors were also more likely to rate their experience higher (p=0.002). Clinical experience was also rated higher by students who received successful supervision compared to those who had unsuccessful or team supervision (p=0.001).

Conclusion
Team supervision is high in health facilities where students undertake clinical placement in Ghana. Frequent contact with private supervisor and successful supervision are associated with better rating of clinical experience among Ghanaian undergraduate nursing and midwifery students.