bluuebunny/crossref_metadata_2025_split huggingface dataset:
Root Resorption of Maxillary Posterior Teeth after Rapid Maxillary Expansion: A Comprehensive Review of the Current Evidence from in-vitro and in-vivo Studies
Authors: Ronsivalle Vincenzo , Casella Federica , Fichera Grazia , Bennici Orazio , Conforte Cristina , Lo Giudice Antonino 
Published: March 2021

Background:
The application of heavy forces to the dentition, as those produced during a Rapid Maxillary Expansion (RME), has been associated in the literature with the development of root resorption of maxillary posterior teeth.

Objective:
The aim of the present manuscript was to report the available data from in-vitro and in-vivo studies that can elucidate the biological processes of resorption and repair of radicular cementum after RME.

Methods:
Studies evaluating the occurrence of root resorption after RME by means of histological and radiographic methodology were included. We detailed the changes of the radicular anatomy after RME and provided a synthesis of the most valuable scientific evidence showing the biological processes behind the potential modifications of radicular anatomy. Results. Loss of cementum material and reduction of radicular volumes were seen after rapid maxillary expansion. A small radicular volumetric recovery of anchored teeth occurred after the retention period; this reparative phenomenon was caused by cementum deposition without the reattachment of periodontal fibers, supporting the detrimental effects associated with RR.

Conclusion:Retention period and the timing of radiographic examination could influence the extension of radicular resorption detected after RME since root resorption and cementum repair may occur at the same time at this stage.
Knowledge, Attitude, and Practice of Primigravida Women on Birth Preparedness
Authors: Alatawi Munirah , Faheem Wafaa A. , Alabdulaziz Hawa 
Published: March 2021

Background:Preparedness for birth involves advance planning and preparation for delivery. Birth Preparedness (BP) includes preparation for normal delivery, readiness to deal with complications, and postnatal and newborn care. Inadequate knowledge and insufficient preparation for quick intervention in case of emergencies lead to a delay in receiving health services. This situation, wherein the potential for poor maternal and fetal outcomes is great, is an especially worrying concern for women of childbearing age.Aim:This study aimed to assess the BP knowledge, attitude, and practice of primigravida women.Methods:An exploratory descriptive cross-sectional study was conducted. Two hundred primigravida women constituted the study sample. A self-administered questionnaire was used to collect the data.Results:Approximately two-thirds of the primigravida women (65.0%) had a moderate level of knowledge of BP, and 96.5% had a favorable attitude toward BP. A good level of practice was observed in 58.5% of the primigravida women. Univariate analyses revealed that the level of knowledge had a significant and strong association with the level of attitude, whereas the level of practice showed a good but not statistically significant association with the level of attitude.Conclusion:Primigravida women had a moderate level of BP knowledge, good BP practice, and a highly favorable attitude toward BP. Hence, antenatal care clinics are vitally important for pregnant women because they can provide BP education. Governmental institutions and their affiliates that are assigned to the sector of maternal health should develop strategies to improve BP at the individual and community levels.
Assessment Practices of Student’s Clinical Competences in Nurse Education
Authors: El Idrissi WISSAM El Machtani , Chemsi Ghizlane , Kababi KHADIJA El , Radid Mohamed 
Published: March 2021

Background:
Clinical competence in nursing practices includes all the theoretical and clinical knowledge used by the student in a clinical setting. It also involves psychomotor as well as problem-solving skills. The assessment focuses on evaluating the student's ability to provide both safe and competent care for the patients. However, it requires the use of several assessment methods that must be varied according to the components of the clinical competence.
Several studies have revealed that the evaluation of this competency is mostly limited to knowledge testing or the acquisition of technical skills verification.

Aims:
This study has two objectives. Firstly, it aims to analyze the assessment practices related to clinical competence and adopted by teachers in higher institutes of nursing and health technology in Morocco. Secondly, it seeks to identify the difficulties faced by them in using a variety of appropriate assessment tools to target all the components of clinical competence.

Methods:
Based on the theoretical model adapted from the Miller’s pyramid by Mehay and Burns in 2009, relating to the assessment of clinical competence, a self-administered questionnaire was shared with 129 nursing teachers.

Results:
The results indicate that 98.06% of participants use a given tool to assess clinical competence; however, using the appropriate tools to evaluate all its components is limited, and the assessment tools are not characterized by variety.

Conclusion:
Reflecting on the evaluation of clinical competences, a clinical assessment model could be proposed to be in accordance with the theoretical model and to measure its impact on nursing students' learning.
Nutrition-related Knowledge and Behaviour and Financial Difficulties during the COVID-19 Quarantine in Saudi Arabia
Authors: Almoraie Noha M. , Hanbazaza Mahitab A. , Aljefree Najlaa M. , Shatwan Israa M. 
Published: March 2021

Background:
Coronavirus disease 2019 (COVID-19) is a severe global public health issue. Evaluating clinical readiness during a pandemic requires substantial awareness of public knowledge and the ability to predict behaviour when working with a highly pathogenic virus.

Objective:
This study examined nutrition-related knowledge and behaviours and financial difficulties related to COVID-19 among adults in Saudi Arabia.

Methods:
A cross-sectional study was conducted among 968 participants via an online questionnaire focusing on demographics, nutrition-related knowledge regarding COVID-19, nutrition-related behaviours, and financial difficulties under COVID-19 quarantine.

Results:
Female participants showed higher scores in knowledge (3.15 ± 0.87) and nutrition-related behaviour (5.49 ± 1.2) during COVID-19. Those aged 40 to 49 years had the highest knowledge score, while older participants (>50) showed more adherence to positive nutrition-related behaviour (P < 0.0001 for both). Higher education indicated higher knowledge scores (3.4 2 ± 0.86; P = 0.001) but not behaviour scores. High-income participants had the highest knowledge score (3.29 ± 0.96; P = 0.001), while middle income participants had the highest behaviour scores (5.52 ± 1.23; P = 0.01). Low-income participants faced more difficulties with food source availability, compared to high-income participants.

Conclusion:
This study’s results help in providing guidelines for planning and designing health education programmes for vulnerable groups.
Assessing the Feasibility of an Open-Source Virtual Reality Mirror Visual Feedback Module for Complex Regional Pain Syndrome: Pilot Usability Study
Authors: Won Andrea Stevenson , Barreau Ariana C , Gaertner Mark , Stone Tristan , Zhu Joshua , Wang Cheng Yao , Mackey Sean 
Published: March 2021

Background
Complex regional pain syndrome (CRPS) is a rare and severe chronic pain condition, with effective treatment options not established for many patients. The underlying pathophysiology remains unclear, but there is a growing appreciation for the role of central mechanisms which have formed the basis for brain-based therapies such as transcranial magnetic stimulation and mirror visual feedback (MVF). MVF has been deployed in the treatment of CRPS using both conventional mirrors and virtual reality (VR).

Objective
The aim of this study was to further investigate the use of VR in the treatment of patients with unilateral upper limb CRPS. VR has the potential advantage of more flexible and more motivating tasks, as well as the option of tracking patient improvement through the use of movement data.

Methods
We describe the development, acceptability, feasibility, and usability of an open-source VR program MVF module designed to be used with consumer VR systems for the treatment of CRPS. The development team was an interdisciplinary group of physical therapists, pain researchers, and VR researchers. Patients recruited from a pain clinic completed 3-5 visits each to trial the system and assessed their experiences in pre- and post-treatment questionnaires.

Results
All 9 (100%) participants were able to use the system for 3, 4, or 5 trials each. None of the participants quit any trial due to cybersickness. All 9 (100%) participants reported interest in using the module in the future. Participants’ reported average pain scores in the affected limb were not significantly different from baseline during treatment or after treatment (P=.16). We did not find a statistically significant effect on participants’ self-reported average pain scores.

Conclusions
We propose that this module could be a useful starting point for modification and testing for other researchers. We share modifications to make this module usable with standalone headsets and finger tracking. Next steps include adapting this module for at-home use, or for use with participants with lower limb pain.
Chatbot-Based Assessment of Employees’ Mental Health: Design Process and Pilot Implementation
Authors: Hungerbuehler Ines , Daley Kate , Cavanagh Kate , Garcia Claro Heloísa , Kapps Michael 
Published: March 2021

Background
Stress, burnout, and mental health problems such as depression and anxiety are common, and can significantly impact workplaces through absenteeism and reduced productivity. To address this issue, organizations must first understand the extent of the difficulties by mapping the mental health of their workforce. Online surveys are a cost-effective and scalable approach to achieve this but typically have low response rates, in part due to a lack of interactivity. Chatbots offer one potential solution, enhancing engagement through simulated natural human conversation and use of interactive features.

Objective
The aim of this study was to explore if a text-based chatbot is a feasible approach to engage and motivate employees to complete a workplace mental health assessment. This paper describes the design process and results of a pilot implementation.

Methods
A fully automated chatbot (“Viki”) was developed to evaluate employee risks of suffering from depression, anxiety, stress, insomnia, burnout, and work-related stress. Viki uses a conversation style and gamification features to enhance engagement. A cross-sectional analysis was performed to gain first insights of a pilot implementation within a small to medium–sized enterprise (120 employees).

Results
The response rate was 64.2% (77/120). In total, 98 employees started the assessment, 77 of whom (79%) completed it. The majority of participants scored in the mild range for anxiety (20/40, 50%) and depression (16/28, 57%), in the moderate range for stress (10/22, 46%), and at the subthreshold level for insomnia (14/20, 70%) as defined by their questionnaire scores.

Conclusions
A chatbot-based workplace mental health assessment seems to be a highly engaging and effective way to collect anonymized mental health data among employees with response rates comparable to those of face-to-face interviews.
Measuring Stress in Health Professionals Over the Phone Using Automatic Speech Analysis During the COVID-19 Pandemic: Observational Pilot Study
Authors: König Alexandra , Riviere Kevin , Linz Nicklas , Lindsay Hali , Elbaum Julia , Fabre Roxane , Derreumaux Alexandre , Robert Philippe 
Published: March 2021

BackgroundDuring the COVID-19 pandemic, health professionals have been directly confronted with the suffering of patients and their families. By making them main actors in the management of this health crisis, they have been exposed to various psychosocial risks (stress, trauma, fatigue, etc). Paradoxically, stress-related symptoms are often underreported in this vulnerable population but are potentially detectable through passive monitoring of changes in speech behavior.ObjectiveThis study aims to investigate the use of rapid and remote measures of stress levels in health professionals working during the COVID-19 outbreak. This was done through the analysis of participants’ speech behavior during a short phone call conversation and, in particular, via positive, negative, and neutral storytelling tasks.MethodsSpeech samples from 89 health care professionals were collected over the phone during positive, negative, and neutral storytelling tasks; various voice features were extracted and compared with classical stress measures via standard questionnaires. Additionally, a regression analysis was performed.ResultsCertain speech characteristics correlated with stress levels in both genders; mainly, spectral (ie, formant) features, such as the mel-frequency cepstral coefficient, and prosodic characteristics, such as the fundamental frequency, appeared to be sensitive to stress. Overall, for both male and female participants, using vocal features from the positive tasks for regression yielded the most accurate prediction results of stress scores (mean absolute error 5.31).ConclusionsAutomatic speech analysis could help with early detection of subtle signs of stress in vulnerable populations over the phone. By combining the use of this technology with timely intervention strategies, it could contribute to the prevention of burnout and the development of comorbidities, such as depression or anxiety.
Intention to Adopt mHealth Apps Among Informal Caregivers: Cross-Sectional Study
Authors: Ghahramani Fereshteh , Wang Jingguo 
Published: March 2021

Background
Caregiving responsibility can change caregivers’ lives; modify their emotions; and make them feel frustrated, fearful, and nervous, thereby imposing physical and mental stress. Caregiving-related mobile apps provide a platform for obtaining valuable and trusted information, connecting more easily with other caregivers, monitoring medications, and managing appointments, and assessing health requirements and conditions of care receivers. Such apps also incorporate valuable resources that address care for the caregivers. Despite the potential benefits of caregiving-related apps, only a limited number of caregivers have adopted and used them.

Objective
The aim of this study is to explore the important factors that affect caregivers’ intentions to integrate related mobile apps into their routine caregiving responsibilities.

Methods
Using the protection motivation theory, we conducted a cross-sectional study among 249 participants. Purposive sampling was used to target participants who met 4 inclusion criteria: US residents, owning and using a smartphone, informal caregivers (individuals who give care to a friend or family member without payment) who provided at least 8 hours of care per week in the past year, and those currently not using any mobile app for caregiving purposes. We created a survey using Qualtrics and posted it on Amazon’s Mechanical Turk website. Participants received monetary compensation after successful completion of the survey.

Results
We found that capabilities and skills of caregivers to use mobile apps, the app’s effectiveness in responding to the needs of caregivers, the degree of control of caregivers over their responsibilities, and the decisions they make for their care receivers can predict their willingness to adopt caregiving-related apps. In addition, the severity of health status and vulnerability of care receivers to unexpected health changes indirectly shape their caregivers’ decisions to adopt and use mobile apps for caregiving purposes.

Conclusions
This study explores the important factors that affect informal caregivers’ intentions to adopt related mobile apps into their routine caregiving responsibilities. The results contribute to both mobile health adoption and the caregiving literature, and they offer significant implications for developers, health care practitioners, and policy makers.
Testing a Novel Web-Based Neurocognitive Battery in the General Community: Validation and Usability Study
Authors: Capizzi Riley , Fisher Melissa , Biagianti Bruno , Ghiasi Neelufaer , Currie Ariel , Fitzpatrick Karrie , Albertini Nicholas , Vinogradov Sophia 
Published: March 2021

Background
In recent years, there has been increased interest in the development of remote psychological assessments. These platforms increase accessibility and allow clinicians to monitor important health metrics, thereby informing patient-centered treatment.

Objective
In this study, we report the properties and usability of a new web-based neurocognitive assessment battery and present a normative data set for future use.

Methods
A total of 781 participants completed a portion of 8 tasks that captured performance in auditory processing, visual-spatial working memory, visual-spatial learning, cognitive flexibility, and emotional processing. A subset of individuals (n=195) completed a 5-question survey measuring the acceptability of the tasks.

Results
Between 252 and 426 participants completed each task. Younger individuals outperformed their older counterparts in 6 of the 8 tasks. Therefore, central tendency data metrics were presented using 7 different age bins. The broad majority of participants found the tasks interesting and enjoyable and endorsed some interest in playing them at home. Only 1 of 195 individuals endorsed not at all for the statement, “I understood the instructions.” Older individuals were less likely to understand the instructions; however, 72% (49/68) of individuals over the age of 60 years still felt that they mostly or very much understood the instructions.

Conclusions
Overall, the tasks were found to be widely acceptable to the participants. The use of web-based neurocognitive tasks such as these may increase the ability to deploy precise data-informed interventions to a wider population.
Use of Endoscopic Images in the Prediction of Submucosal Invasion of Gastric Neoplasms: Automated Deep Learning Model Development and Usability Study
Authors: Bang Chang Seok , Lim Hyun , Jeong Hae Min , Hwang Sung Hyeon 
Published: March 2021

Background
In a previous study, we examined the use of deep learning models to classify the invasion depth (mucosa-confined versus submucosa-invaded) of gastric neoplasms using endoscopic images. The external test accuracy reached 77.3%. However, model establishment is labor intense, requiring high performance. Automated deep learning (AutoDL) models, which enable fast searching of optimal neural architectures and hyperparameters without complex coding, have been developed.

Objective
The objective of this study was to establish AutoDL models to classify the invasion depth of gastric neoplasms. Additionally, endoscopist–artificial intelligence interactions were explored.

Methods
The same 2899 endoscopic images that were employed to establish the previous model were used. A prospective multicenter validation using 206 and 1597 novel images was conducted. The primary outcome was external test accuracy. Neuro-T, Create ML Image Classifier, and AutoML Vision were used in establishing the models. Three doctors with different levels of endoscopy expertise were asked to classify the invasion depth of gastric neoplasms for each image without AutoDL support, with faulty AutoDL support, and with best performance AutoDL support in sequence.

Results
The Neuro-T–based model reached 89.3% (95% CI 85.1%-93.5%) external test accuracy. For the model establishment time, Create ML Image Classifier showed the fastest time of 13 minutes while reaching 82.0% (95% CI 76.8%-87.2%) external test accuracy. While the expert endoscopist's decisions were not influenced by AutoDL, the faulty AutoDL misled the endoscopy trainee and the general physician. However, this was corrected by the support of the best performance AutoDL model. The trainee gained the most benefit from the AutoDL support.

Conclusions
AutoDL is deemed useful for the on-site establishment of customized deep learning models. An inexperienced endoscopist with at least a certain level of expertise can benefit from AutoDL support.
Factors Associated With Perceived Trust of False Abortion Websites: Cross-sectional Online Survey
Authors: Chaiken Sarina Rebecca , Han Lisa , Darney Blair G , Han Leo 
Published: March 2021

Background
Most patients use the internet to search for health information. While there is a vast repository of searchable information online, much of the content is unregulated and therefore potentially incorrect, conflicting, or confusing. Abortion information online is particularly prone to being inaccurate as antichoice websites publish purposefully misleading information in formats that appear as neutral resources. To understand how antichoice websites appear neutral, we need to understand the specific website features of antichoice websites that impart an impression of trustworthiness.

Objective
We sought to identify the characteristics of false or misleading abortion websites that make these websites appear trustworthy to the public.

Methods
We conducted a cross-sectional study using Amazon’s Mechanical Turk platform. We used validated questionnaires to ask participants to rate 11 antichoice websites and one neutral website identified by experts, focusing on website content, creators, and design. We collected sociodemographic data and participant views on abortion. We used a composite measure of “mean overall trust” as our primary outcome. Using correlation matrices, we determined which website characteristics were most associated with mean overall trust. Finally, we used linear regression to identify participant characteristics associated with overall trust.

Results
Our analytic sample included 498 participants aged from 22 to 70 years, and 50.1% (247/493) identified as female. Across 11 antichoice websites, creator confidence (“I believe that the creators of this website are honest and trustworthy”) had the highest correlation coefficient (strongest relationship) with mean overall trust (coefficient=0.70). Professional appearance (coefficient=0.59), look and feel (coefficient=0.59), perception that the information is created by experts (coefficient=0.59), association with a trustworthy organization (coefficient=0.58), valued features and functionalities (coefficient=0.54), and interactive capabilities (coefficient=0.52) all demonstrated strong relationships with mean overall trust. At the individual level, prochoice leaning was associated with higher overall trust of the neutral website (B=−0.43, 95% CI −0.87 to 0.01) and lower mean overall trust of the antichoice websites (B=0.52, 95% CI 0.05 to 0.99).

Conclusions
The mean overall trust of antichoice websites is most associated with design characteristics and perceived trustworthiness of website creators. Those who believe that access to abortion should be limited are more likely to have higher mean overall trust for antichoice websites.