bluuebunny/crossref_metadata_2025_split huggingface dataset:
Оцінка стану стоматологічного здоров᾽я та якості життя дітей-дошкільнят за результатами анкетування батьків
Authors: Godovanets O. I. , Kotelban A. V. , Moroz P. V. 
Published: February 2021

Резюме. Карієс тимчасових зубів є важливою соціальною проблемою дитячого віку в усіх країнах світу, адже поширеність цього захворювання коливається від 25 до 72 %. Вважається, що основною причиною руйнування зубів є результат життєдіяльності карієсогенних мікроорганізмів за умови високої насиченості вуглеводами та зниженої карієсорезистентності зубів. Неповноцінна гігієна ротової порожнини, несприятливі умови для самоочищення зубів, надмірне споживання солодощів, недостатнє надходження фторидів є одними з найвагоміших чинників ризику розвитку карієсу.
Мета дослідження – оцінити ставлення батьків дітей 3-х та 6-ти років до стоматологічного здоров᾽я та якості життя дітей за модифікованими критеріями EGOHID.
Матеріали і методи. Із цією метою за допомогою Google-форми проведено опитування 257 батьків дітей віком 3 та 6 років (122 хлопців та 135 дівчат). Суб᾽єктивна оцінка стоматологічного здоров᾽я включала запитання щодо частоти чищення зубів, оцінки стану зубів та ясен, засобів та предметів догляду за ротовою порожниною та перевірки ефективності чищення зубів, особливостей харчування, перш за все вживання солодощів, а також назагал чи батьки звертають увагу на вигляд молочних зубів у дітей, кратність відвідування лікарів загального профілю, у тому числі й стоматолога.
Результати досліджень та їх обговорення. Ми встановили, що більше половини (57,26 %) батьків вперше звертаються до стоматолога задля лікування їхніх дітей, а для профілактичного огляду – тільки 25,67 %. Догляд за ротовою порожниною з появою першого зуба розпочали 56,62 % батьків, після року – 37,43 % опитаних, із двох років – 16,05 %. Тільки половина респондентів (49,36 %) чистить зуби дітям двічі на день, решта – лише 1 раз. Тішить, що більшість батьків (67,67 %) все-таки чистять зуби своїм дітям самі, однак ефективність чищення зубів перевіряють спеціальним розчином тільки 3,22 % опитаних. Щодо складу зубної пасти, то лише 47,93 % батьків дітей вказують на використання кальційумісної зубної пасти, решту не знають склад пасти. Допоміжних засобів для чищення зубів 99,14 % опитаних батьків не використовують. 55,52 % респондентів вказують на споживання дітьми солодощів 1 раз на день, третя частина (відповідно 30,84 %) – декілька разів на день, решту – рідше. 46,23 % опитаних вважають, що звертатися до лікарів-стоматологів потрібно тільки в разі гострого болю. На потребу в лікуванні молочних зубів вказали 65,76 % батьків, решту вважають це необов᾽язковим. На вибір засобів та предметів гігієни ротової порожнини найчастіше впливає телебачення (41,89 %) та навколишні люди (у 32,45 %).
Висновки. У результаті суб᾽єктивного опитування ми встановили недостатню увагу батьків до стану здоров᾽я зубів дітей, неповноцінний догляд за ротовою порожниною та недоліки в харчуванні.
Lower Risk of Dementia in Patients With Atrial Fibrillation Taking Non‐Vitamin K Antagonist Oral Anticoagulants: A Nationwide Population‐Based Cohort Study
Authors: Hsu Jin‐Yi , Liu Peter Pin‐Sung , Liu An‐Bang , Lin Shu‐Man , Huang Huei‐Kai , Loh Ching‐Hui 
Published: February 2021

Background
A higher risk of developing dementia is observed in patients with atrial fibrillation (AF). Results are inconsistent regarding the risk of dementia when patients with AF use different anticoagulants. We aimed to investigate the risk of dementia in patients with AF receiving non‐vitamin K antagonist oral anticoagulants (NOACs) compared with those receiving warfarin.

Methods and Results

We conducted a nationwide population‐based cohort study of incident cases using the Taiwan National Health Insurance Research Database. We initially enlisted all incident cases of AF and then selected those treated with either NOACs or warfarin for at least 90 days between 2012 and 2016. First‐ever diagnosis of dementia was the primary outcome. We performed propensity score matching to minimize the difference between each cohort. We used the Fine and Gray competing risk regression model to calculate the hazard ratio (HR) for dementia. We recruited 12 068 patients with AF (6034 patients in each cohort). The mean follow‐up time was 3.27 and 3.08 years in the groups using NOACs and warfarin, respectively. Compared with the HR for the group using warfarin, the HR for dementia was 0.82 (95% CI, 0.73–0.92;
P
=0.0004) in the group using NOACs. Subgroup analysis demonstrated that users of NOAC aged 65 to 74 years, with a high risk of stroke or bleeding were associated with a lower risk of dementia than users of warfarin with similar characteristics.

Conclusions
Patients with AF using NOACs were associated with a lower risk of dementia than those using warfarin. Further randomized clinical trials are greatly needed to prove these findings.
Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial
Authors: Law Zhe Kang , Desborough Michael , Roberts Ian , Al‐Shahi Salman Rustam , England Timothy J. , Werring David J. , Robinson Thompson , Krishnan Kailash , Dineen Robert , Laska Ann Charlotte , Peters Nils , Egea‐Guerrero Juan Jose , Karlinski Michal , Christensen Hanne , Roffe Christine , Bereczki Daniel , Ozturk Serefnur , Thanabalan Jegan , Collins Rónán , Beridze Maia , Bath Philip M. , Sprigg Nikola 
Published: February 2021

Background
Antiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain.

Methods and Results
This is an exploratory analysis of the TICH‐2 (Tranexamic Acid in Intracerebral Hemorrhage‐2) double‐blind, randomized, placebo‐controlled trial, which studied the efficacy of tranexamic acid in patients with spontaneous ICH within 8 hours of onset. Multivariable logistic regression and ordinal regression were performed to explore the relationship between pre‐ICH antiplatelet therapy, and 24‐hour hematoma expansion and day 90 modified Rankin Scale score, as well as the effect of tranexamic acid. Of 2325 patients, 611 (26.3%) had pre‐ICH antiplatelet therapy. They were older (mean age, 75.7 versus 66.5 years), more likely to have ischemic heart disease (25.4% versus 2.7%), ischemic stroke (36.2% versus 6.3%), intraventricular hemorrhage (40.2% versus 27.5%), and larger baseline hematoma volume (mean, 28.1 versus 22.6 mL) than the no‐antiplatelet group. Pre‐ICH antiplatelet therapy was associated with a significantly increased risk of hematoma expansion (adjusted odds ratio [OR], 1.28; 95% CI, 1.01–1.63), a shift toward unfavorable outcome in modified Rankin Scale (adjusted common OR, 1.58; 95% CI, 1.32–1.91) and a higher risk of death at day 90 (adjusted OR, 1.63; 95% CI, 1.25–2.11). Tranexamic acid reduced the risk of hematoma expansion in the overall patients with ICH (adjusted OR, 0.76; 95% CI, 0.62–0.93) and antiplatelet subgroup (adjusted OR, 0.61; 95% CI, 0.41–0.91) with no significant interaction between pre‐ICH antiplatelet therapy and tranexamic acid (P interaction=0.248).

Conclusions
Antiplatelet therapy is independently associated with hematoma expansion and unfavorable functional outcome. Tranexamic acid reduced hematoma expansion regardless of prior antiplatelet therapy use.

Registration

URL:
https://www.isrctn.com
; Unique identifier: ISRCTN93732214.
Association Between Asymptomatic Proximal Deep Vein Thrombosis and Mortality in Acutely Ill Medical Patients
Authors: Raskob Gary E. , Spyropoulos Alex C. , Cohen Alexander T. , Weitz Jeffrey I. , Ageno Walter , De Sanctis Yoriko , Lu Wentao , Xu Jianfeng , Albanese John , Sugarmann Chiara , Weber Traci , Lipardi Concetta , Spiro Theodore E. , Barnathan Elliot S. 
Published: February 2021

Background
Asymptomatic proximal deep vein thrombosis (DVT) is an end point frequently used to evaluate the efficacy of anticoagulant thromboprophylaxis in medical patients. Recently, the clinical relevance of asymptomatic DVT has been challenged.

Methods and Results

The objective of this study was to evaluate the relationship between asymptomatic proximal DVT and all‐cause mortality (ACM) using a cohort analysis of a randomized trial for the prevention of venous thromboembolism (VTE) in acutely ill medical patients. Patients who received at least 1 dose of study drug and had an adequate compression ultrasound examination of the legs on either day 10 or day 35 were categorized into 1 of 3 cohorts: no VTE, asymptomatic proximal DVT, or symptomatic DVT. Cox proportional hazards model, with adjustment for significant independent predictors of mortality, were used to compare the incidences of ACM. Of the 7036 patients, 6776 had no VTE, 236 had asymptomatic DVT, and 24 had symptomatic VTE. The incidence of ACM was 4.8% in patients without VTE. Both asymptomatic proximal DVT (mortality, 11.4%; hazard ratio [HR], 2.31; 95% CI, 1.52–3.51;
P
<0.0001) and symptomatic VTE (mortality, 29.2%; HR, 9.42; 95% CI, 4.18–21.20;
P
<0.0001) were independently associated with significant increases in ACM. The analysis was post hoc, and ultrasound results were not available for all patients. Adjustment for baseline variables significantly associated with ACM may not fully compensate for differences.

Conclusions
Asymptomatic proximal DVT is associated with higher ACM than no VTE and remains a relevant end point to evaluate the efficacy of anticoagulant thromboprophylaxis in medical patients.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00571649.
Optimal Carotid Plaque Features on Computed Tomography Angiography Associated With Ischemic Stroke
Authors: Baradaran Hediyeh , Eisenmenger Laura B. , Hinckley Peter J. , de Havenon Adam H. , Stoddard Gregory J. , Treiman Lauren S. , Treiman Gerald S. , Parker Dennis L. , Scott McNally Joseph 
Published: February 2021

Background
Stenosis has historically been the major factor used to determine carotid stroke sources. Recent evidence suggests that specific plaque features detected on imaging may be more highly associated with ischemic stroke than stenosis. We sought to determine computed tomography angiography (CTA) imaging features of carotid plaque that optimally discriminate ipsilateral stroke sources.

Methods and Results

In this institutional review board–approved retrospective cross‐sectional study, 494 ipsilateral carotid CTA‐brain magnetic resonance imaging pairs were available for analysis after excluding patients with alternative stroke sources. Carotid CTA and clinical markers were recorded, a multivariable Poisson regression model was fitted, and backward elimination was performed with a 2‐sided threshold of
P
<0.10. Discriminatory value was determined using receiver operating characteristic analysis, area under the curve, and bootstrap validation. The final CTA carotid‐source stroke prediction model included intraluminal thrombus (prevalence ratio, 2.8 [
P
<0.001]; 95% CI, 1.6–4.9), maximum soft plaque thickness (prevalence ratio, 1.2 [
P
<0.001]; 95% CI, 1.1–1.4), and the rim sign (prevalence ratio, 2.0 [
P
=0.007]; 95% CI, 1.2–3.3). The final discriminatory value (area under the curve=78.3%) was higher than intraluminal thrombus (56.4%,
P
<0.001), maximum soft plaque thickness (76.4%,
P
=0.007), or rim sign alone (69.9%,
P
=0.001). Furthermore, NASCET (North American Symptomatic Carotid Endarterectomy Trial) stenosis categories (cutoffs of 50% and 70%) had lower stroke discrimination (area under the curve=67.4%,
P
<0.001).

Conclusions
Optimal discrimination of ipsilateral carotid sources of stroke requires information on intraluminal thrombus, maximum soft plaque thickness, and the rim sign. These results argue against the sole use of carotid stenosis to determine stroke sources on CTA, and instead suggest these alternative markers may better diagnose vulnerable carotid plaque and guide treatment decisions.
Plasma d-glutamate levels for detecting mild cognitive impairment and Alzheimer’s disease: Machine learning approaches
Authors: Chang Chun-Hung , Lin Chieh-Hsin , Liu Chieh-Yu , Huang Chih-Sheng , Chen Shaw-Ji , Lin Wen-Cheng , Yang Hui-Ting , Lane Hsien-Yuan 
Published: February 2021

Background: d-glutamate, which is involved in N-methyl-d-aspartate receptor modulation, may be associated with cognitive ageing. Aims: This study aimed to use peripheral plasma d-glutamate levels to differentiate patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) from healthy individuals and to evaluate its prediction ability using machine learning. Methods: Overall, 31 healthy controls, 21 patients with MCI and 133 patients with AD were recruited. Serum d-glutamate levels were measured using high-performance liquid chromatography (HPLC). Cognitive deficit severity was assessed using the Clinical Dementia Rating scale and the Mini-Mental Status Examination (MMSE). We employed four machine learning algorithms (support vector machine, logistic regression, random forest and naïve Bayes) to build an optimal predictive model to distinguish patients with MCI or AD from healthy controls. Results: The MCI and AD groups had lower plasma d-glutamate levels (1097.79 ± 283.99 and 785.10 ± 720.06 ng/mL, respectively) compared to healthy controls (1620.08 ± 548.80 ng/mL). The naïve Bayes model and random forest model appeared to be the best models for determining MCI and AD susceptibility, respectively (area under the receiver operating characteristic curve: 0.8207 and 0.7900; sensitivity: 0.8438 and 0.6997; and specificity: 0.8158 and 0.9188, respectively). The total MMSE score was positively correlated with d-glutamate levels ( r = 0.368, p < 0.001). Multivariate regression analysis indicated that d-glutamate levels were significantly associated with the total MMSE score ( B = 0.003, 95% confidence interval 0.002–0.005, p < 0.001). Conclusions: Peripheral plasma d-glutamate levels were associated with cognitive impairment and may therefore be a suitable peripheral biomarker for detecting MCI and AD. Rapid and cost-effective HPLC for biomarkers and machine learning algorithms may assist physicians in diagnosing MCI and AD in outpatient clinics.
Assessment of burnout among emergency medicine healthcare workers in a teaching hospital in Malaysia during COVID‐19 pandemic
Authors: Zakaria Mohd Idzwan , Remeli Ruzaina , Ahmad Shahamir Mohd Fitri , Md Yusuf Mohd Hafyzuddin , Azizah Ariffin Mohammad Aizuddin , Noor Azhar Abdul Muhaimin 
Published: February 2021

Introduction:Burnout is a syndrome occurring from an overwhelming workplace stress. The study was done at a large teaching hospital identified as a COVID‐19 treating hospital. During COVID‐19 pandemic, the country was in Movement Control Order since 18 March 2020 to contain the spread of the virus, and thus, it has increased the job workload and responsibility. The purpose of this study was to identify the prevalence of burnout among emergency healthcare worker in this hospital and to identify the factors contributed to the burnout.Methods:A cross‐sectional study was conducted using a questionnaire among emergency healthcare worker from 8 May 2020 to 15 May 2020 during the Conditional Movement Control Order. The questionnaire was adapted from Michelle Post, Public Welfare, Vol. 39, No. 1, 1981, American Public Welfare Association and distributed via Google Forms. It consisted of 28 questions and was rated based on a five‐point Likert‐type scale. The questions were then summed up to determine the burnout levels.Results:There were 216 respondents with 65.7% were nurses, 17.1% were doctors, and the rest were assistant medical officer. 51.3% of the respondents had burnout with 61.2% of nurses, 35.1% of doctors, and 29.6% of assistant medical officer. There was weak correlation (r = 0.148) with the years of experience working in emergency department and the level of burnout (p = 0.03). Among the burnout features were fatigue with 52.2% and frequent physical illness and feel unappreciated with 48.6% and 45.9%, respectively. The job‐related issues which predisposed to burnout were demand coping with an angry public with 70.2%, job overload 63.9%, lack clear guideline or rapid program changes 54%, and pay too little 53.1%.Conclusion:Emergency healthcare worker has a high rate of burnout especially among the nurses. The factors leading to burnout were frequent exposure to angry public, job overload, lack of clear guidelines, and perception of underpaid.
Practical tips for performing resuscitative endovascular balloon occlusion of the aorta
Authors: Chang Sung Wook , Ma Dae Sung , Chang Ye Rim , Kim Dong Hun 
Published: February 2021

Background: Hemorrhage is the leading cause of death in trauma settings. Non-compressible torso hemorrhage, which is caused by abdominopelvic and thoracic injuries, is an important cause of subsequent organ dysfunction and poor outcomes in multiple trauma patients. The management of hemodynamically unstable patients with non-compressible torso hemorrhage has changed, and the concept of damage control resuscitation has been developed in the last decades. Currently, resuscitative endovascular balloon occlusion of the aorta (REBOA) as a method of temporary stabilization is the modern evolution of bleeding control, and it is in the middle of a paradigm shift as a treatment for non-compressible torso hemorrhage. Despite its effectiveness in patients with hemorrhagic shock, the application of REBOA remains limited because of lack of experience and troubleshooting guidelines. Objectives: The aim of study was to provide useful tips for the implementing a step-by-step procedure for REBOA in various hospital settings and capabilities. Methods: We introduced REBOA procedures using a REBOA-customized 7 Fr balloon catheter through the animation models or radiography from preparation to access, catheter management, and device removal after procedure completed. Results: We have described REBOA procedures as follows: identification of the common femoral artery, arterial access for placement of a guidewire, precautions during a sheath insertion, guidewire and balloon positioning in the aorta, occlusion zones and adjustment of balloon location, REBOA strategy for extending the occlusion time, balloon deflation and removal, sheath removal, and medical records. Conclusion: We believe that the practical tips mentioned in this article will help in performing the REBOA procedure systematically and developing an effective REBOA framework.
Risk factors for venous thromboembolism after carbon monoxide poisoning: A nationwide population‐based study
Authors: Cho Yongil , Lim Tae Ho , Ko Byuk Sung , Kang Hyunggoo , Oh Jaehoon , Lee Heekyung 
Published: February 2021

Introduction:The risk of venous thromboembolism increases after acute carbon monoxide poisoning. However, studies on the characteristics of patients who develop venous thromboembolism after carbon monoxide poisoning are rare. The aim of this study was to identify the risk factors for venous thromboembolism within 3 months after carbon monoxide poisoning.Methods:This is a population‐based study that employed nationwide claims data from South Korea. Among the carbon monoxide poisoning patients (⩾18 years), the characteristics of the groups with and without venous thromboembolism (pulmonary embolism or deep vein thrombosis) were identified. All the significant variables in the univariable analysis were included in the multivariable logistic regression to determine the risk factors for venous thromboembolism occurrence.Results:Among the 24,232 carbon monoxide poisoning patients, 130 subjects developed venous thromboembolism within 90 days of their carbon monoxide poisoning diagnosis. The significant risk factors for venous thromboembolism in the multivariable analysis were age (adjusted odds ratio (aOR) = 1.01; 95% confidence interval (CI) = 1.003–1.03), intensive care unit admission (aOR = 3.80; 95% CI = 2.34–6.12), length of stay (aOR = 1.02; 95% CI = 1.0001–1.04), congestive heart failure (aOR = 2.17; 95% CI = 1.36–3.42), and cancer (aOR = 1.94; 95% CI = 1.10–3.22). The adjusted odds ratios for intensive care unit admission for patients with pulmonary embolism and deep vein thrombosis were 3.05 (95% CI = 1.61–5.61) and 5.60 (95% CI = 2.89–10.90), respectively.Conclusion:Patients with older age, intensive care unit admission, a longer length of stay, congestive heart failure, or cancer are at greater risk of developing venous thromboembolism after carbon monoxide poisoning. In particular, intensive care unit admission was the strongest risk factor for venous thromboembolism, pulmonary embolism, and deep vein thrombosis. Monitoring and administering prophylactic treatments to prevent venous thromboembolism would be helpful in high‐risk in carbon monoxide poisoning patients.
Realist Review of Interventions Influencing Waste Management and Minimization Practices in New Zealand: Protocol and Initial Program Theory
Authors: Sharma Sudesh Raj , Walton Mat , Baker Virginia , Hepi Maria , Manning Suzanne 
Published: February 2021

Background: The effects of waste on the environment and human health continue to increase despite behavioral, technological and policy actions for the management and minimization of waste. We plan to undertake a realist review of waste management and minimization interventions within New Zealand to inform effective approaches to waste minimization and management interventions. This protocol paper describes the steps of the realist review, including the objectives, theoretical frameworks and steps used. Methods: Realist review is a theory guided approach that seeks to understand the context-mechanism-outcome configuration of an intervention and generate insights on what works for whom, under what conditions and how. The protocol presents an integrated working theoretical framework comprising of three social theories (Social Learning Theory, Collective Action Theory and Social Practice theory), set within an indigenous Māori implementation framework, He Pikinga Waiora. The initial program theory generated from a first stage rapid review is presented. This initial program theory will be tested through a full literature review and analysis, as well as participatory sense making workshops with key stakeholders. Discussion: The review will help to generate insights on the generative causal mechanisms of waste minimization interventions in the context of New Zealand. This protocol emphasizes the initial program theory of change as a starting point for further review and design of improved interventions for waste minimization. Through identifying and testing the program theory, with insights from both indigenous and social practice theories, the proposed review will support the design of policies, programs and activities required to achieve the desired outcome of waste minimization in the context of New Zealand.