bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study)
Authors: Cesareo Roberto , Manfrini Silvia , Pasqualini Valerio , Ambrogi Cesare , Sanson Gianfranco , Gallo Andrea , Pozzilli Paolo , Pedone Claudio , Crescenzi Anna , Palermo Andrea 
Published: February 2021

Abstract

Context
Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign nonfunctioning thyroid nodules (BNTNs)

Objective
To compare the efficacy and safety of both treatments at 12-month follow-up in patients with solid or predominantly solid BNTN.

Methods
This was a single-center, 12-month, randomized, superiority, open-label, parallel-group trial conducted in an outpatient clinic. Sixty patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems were randomly assigned (1:1 ratio) to receive either a single session of RFA or LA. Twenty-9 patients per group completed the study. The main outcome measures were VRR and proportion of nodules with more than 50% reduction (technical success rate).

Results
At 12 months, VRR was 70.9 ± 16.9% and 60.0 ± 19.0% in the RFA and LA groups, respectively (P = .024). This effect was confirmed in the linear regression model that was adjusted for age, sex, nodule baseline volume, and proportion of cellular components (RFA treatment: β = .390; P = .009). No significant between-group difference was observed in the technical success rate at 12 months after treatment. A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3 ± 0.8, P &lt; .001; and LA: 4.6 ± 2.1 and 1.6 ± 0.8, respectively, P &lt; .001) and cosmetic (RFA: 3.4 ± 0.6 and 1.3 ± 0.5, P &lt; .001; and LA: 3.4 ± 0.5 and 1.4 ± 0.6, P &lt; .001) scores although the between-group differences were not significant.

Conclusion
RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.
Beware of chicken bones: An uncommon presentation of a foreign body in the palate
Authors: Martin Dinesh , Naraynsingh Candy 
Published: February 2021

This paper describes a case of an intra-osseous foreign body impaction in the hard palate, a chicken bone fragment, in an adult male. The presentation mimicked that of an odontogenic lesion. Though palatal soft tissue foreign bodies in toddlers are well reported, the literature is sparse on cases involving adults. The location of the foreign body, and radiographic presentation, resulted in a diagnostic challenge to the attending clinician. This appears to be the first reported case of an animal bone presenting in this way in an adult.CPD/Clinical Relevance: The case highlights the importance of credible history reporting, 3D imaging and developing accurate differentials in the diagnostic pathway when faced with an atypical clinical presentation.
Redeployment of dental teams during the covid-19 pandemic: A review of experiences and lessons learned
Authors: Platais Christopher , Siodlak Francesca , Toor Ishpinder , Ormondroyd Louise 
Published: February 2021

The COVID-19 pandemic has spread across the globe, causing millions of cases and disrupting the lives of people worldwide. The increase in the number of critically unwell patients has put healthcare systems under immense strain, requiring them to adapt their service provision to cope with increased demand. At Guy's and St Thomas' NHS Foundation Trust (GSTFT) in London, redeployment of healthcare staff has been used to relieve pressure on the most overburdened hospital sectors, and this saw clinical dental teams involved in auxiliary medical roles throughout much of 2020. On the cusp of the New Year, COVID-19 cases continued to soar and GSTFT opted to cancel routine care and re-implement a second round of clinical redeployment. Here, we discuss our experiences and present positive feedback of early-career dentists being redeployed to medical wards during the UK's greatest health crisis of recent years. CPD/Clinical Relevance: Clinical dental teams can positively contribute to the national COVID-19 response through the provision of urgent dental care, inpatient mouthcare services and auxiliary medical roles.
Cervical margin relocation and indirect restorations: Case report and literature review
Authors: Butt Aftab 
Published: February 2021

Coronal margin relocation (CMR) is a technique that is being increasingly used to manage subgingival defects in cavities in posterior teeth. The aim of this case report and literature review is to arm the dental practitioner with up-to-date scientific literature on this topic, such that they can appropriately incorporate CMR into their practice. Inclusion criteria for the literature review were the use of composite as the material used for CMR and a subsequent indirect restoration. Medline was searched and manual search of bibliographies was carried out. This yielded nine in vitro studies and 12 clinical reports that were considered in this review. CPD/Clinical Relevance: The CMR technique is being used more widely in dental practice and it is important for dental practitioners to be aware of the evidence base on which to guide their practice.
Predictors of skilled maternal health services utilizations: A case of rural women in Ethiopia
Authors: Tsegaye Berhan , Shudura Elsabet , Yoseph Amanuel , Tamiso Alemu 
Published: February 2021

Background
Maternal health services are affected by complex factors from one setting to another. Consequently, health planners should prioritize different interventions and design appropriate programs to enhance maternal health services utilization. Results of prior studies are conflicting. Furthermore, only few studies were done from antenatal to postnatal continuum of care in Ethiopia.

Objectives
This study aimed to assess prevalence and predictors of skilled maternal health services utilization at Dale-Wonsho health and demographic surveillance site of the Hawassa University, South Ethiopia, in 2019.

Methods
A community based cross sectional study was conducted from January 1–30; 2019. A total of 682 women who gave birth in the last twelve months were selected by using a two stage sampling technique. Data were collected through face to face interview. Data were entered into Epidata version 3.1. Then, they were exported and analyzed by SPSS version 22. Bi-variable logistic regression analysis was done and variables with p-value less than 0.05 were considered as candidate for multivariable logistic regression analysis. Adjusted Odds Ratios (AOR) with 95% CI were computed, and p-value less than 0.01 was computed to determine the level of significance.

Result
Prevalence of antenatal care, institutional delivery and postnatal care utilizations were 69.1%, 52.1% and 32.7% respectively. Educated women (AOR = 4.72, 95%CI,2.82,7.9), household training (AOR = 8.52,95%CI = 5.5,13.1), middle wealth quantile(AOR = 0.8,95%CI,0.4–0.7), being richest wealth quantile (AOR = 0.16;95%CI = 0.06,0.41) and pregnancy plan (AOR = 3.65,95%CI,1.67–8.0) were factors positively associated with antenatal care utilization. Husband education (AOR = 4.96,95CI,3.08–8.0), and antenatal care (AOR = 5.9; 95%CI,3.87,9.1) were factors associated with institutional delivery. Maternal education (AOR = 2.5,95CI,1.4–4.4), information about postnatal care service utilization (AOR = 3.6,95CI,2.1,6.2) and women autonomy(AOR = 6.1,95CI,3.8,9.7) were positively associated with postnatal care service.

Conclusion
Prevalence of antenatal care, institutional delivery and postnatal care services were lower than the targeted plan. Policy makers should focus on capacity building of women both economically and academically. So, women should be more autonomous to utilize health services effectively. Moreover, awareness creation among women should be enhanced about maternal health service.
Parent–adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal
Authors: Bhatta Bharat Raj , Kiriya Junko , Shibanuma Akira , Jimba Masamine 
Published: February 2021

Background
Adolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent–adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent–adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal.

Methods
This was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15–19 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent–adolescent communication and service utilization.

Results
We analyzed the data from 594 students. Students with a higher score of parent–adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29–2.23, p<0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65–62.08, p<0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28–6.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02–0.66, p = 0.01).

Conclusion
Students with a higher score on parent–adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.
Effects of dietary phosphates from organic and inorganic sources on parameters of phosphorus homeostasis in healthy adult dogs
Authors: Dobenecker Britta , Reese Sven , Herbst Sarah 
Published: February 2021

BackgroundThe impact of dietary phosphorus (P) excess, especially on renal and cardiovascular health, has been investigated in several species, but little is known in dogs.ObjectiveThe aim of this study was to examine effects of different P sources on concentration and postprandial kinetics of selected parameters of P homeostasis in dogs.MethodsEight beagles received one control diet (P 0.5% dry matter [DM]) and three high P diets (poultry meal, NaH2PO4,and KH2PO4; P 1.7% DM) for 18d. Urine samples were collected pre- and postprandially while faeces were collected quantitatively for 5d and analysed for minerals. On day 18, blood was sampled 1h pre- and 0.5, 1, 1.5, 2, 3, 5 and 7h postprandially.ResultsPi (KH2PO4, NaH2PO4) but not organic P caused an increased apparent P digestibility and significantly influenced kinetics of serum FGF23, parathyroid hormone, P, CrossLaps and bonespecific alkaline phosphatase, demonstrating a disrupted calcium (Ca) and P homeostasis with potential harm for renal, cardiovascular and skeletal health.ConclusionsResults of feeding Pi to dogs indicate distinct disturbances of Ca and P metabolism, in contrast to organic sources. The use of Pi in food can therefore not be considered as safe. Further research, especially on dose and long-term effects, is warranted.
Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname
Authors: Juliana Amadu E. , Tang Ming-Jan , Kemps Lex , Noort Albert C. , Hermelijn Sandra , Plötz Frans B. , Zonneveld Rens , Wilschut Jan C. 
Published: February 2021

Background
Viruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries.

Methods
Between 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS).

Results
Of a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS.

Conclusions
Viruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.
Observational study of haloperidol in hospitalized patients with COVID-19
Authors: Hoertel Nicolas , Sánchez-Rico Marina , Vernet Raphaël , Jannot Anne-Sophie , Neuraz Antoine , Blanco Carlos , Lemogne Cédric , Airagnes Guillaume , Paris Nicolas , Daniel Christel , Gramfort Alexandre , Lemaitre Guillaume , Bernaux Mélodie , Bellamine Ali , Beeker Nathanaël , Limosin Frédéric ,   on behalf of the AP-HP/Universities/INSERM Covid-19 research collaboration and AP-HP Covid CDR Initiative
Published: February 2021

Background
Haloperidol, a widely used antipsychotic, has been suggested as potentially useful for patients with COVID-19 on the grounds of its in-vitro antiviral effects against SARS-CoV-2, possibly through sigma-1 receptor antagonist effect.

Methods
We examined the associations of haloperidol use with intubation or death and time to discharge home among adult patients hospitalized for COVID-19 at Assistance Publique-Hôpitaux de Paris (AP-HP) Greater Paris University hospitals. Study baseline was defined as the date of hospital admission. The primary endpoint was a composite of intubation or death and the secondary endpoint was discharge home among survivors in time-to-event analyses. In the primary analyses, we compared these two outcomes between patients receiving and not receiving haloperidol using univariate Cox regression models in matched analytic samples based on patient characteristics and other psychotropic medications. Sensitivity analyses included propensity score analyses with inverse probability weighting and multivariable Cox regression models.

Results
Of 15,121 adult inpatients with a positive COVID-19 PT-PCR test, 39 patients (0.03%) received haloperidol within the first 48 hours of admission. Over a mean follow-up of 13.8 days (SD = 17.9), 2,024 patients (13.4%) had a primary end-point event and 10,179 patients (77.6%) were discharged home at the time of study end on May 1st. The primary endpoint occurred in 9 patients (23.1%) who received haloperidol and 2,015 patients (13.4%) who did not. The secondary endpoint of discharge home occurred in 16 patients (61.5%) who received haloperidol and 9,907 patients (85.8%) who did not. There were no significant associations between haloperidol use and the primary (HR, 0.80; 95% CI, 0.39 to 1.62, p = 0.531) and secondary (HR, 1.30; 95% CI, 0.74 to 2.28, p = 0.355) endpoints. Results were similar in multiple sensitivity analyses.

Conclusion
Findings from this multicenter observational study suggest that haloperidol use prescribed at a mean dose of 4.5 mg per day (SD = 5.2) for a mean duration of 8.4 days (SD = 7.2) may not be associated with risk of intubation or death, or with time to discharge home, among adult patients hospitalized for COVID-19.
The development and validation of a resource consumption score of an emergency department consultation
Authors: Müller Martin , Schechter Clyde B. , Hautz Wolf E. , Sauter Thomas C. , Exadaktylos Aristomenis K. , Stock Stephanie , Birrenbach Tanja 
Published: February 2021

BackgroundEmergency Department (ED) visits and health care costs are increasing globally, but little is known about contributing factors of ED resource consumption. This study aims to analyse and to predict the total ED resource consumption out of the patient and consultation characteristics in order to execute performance analysis and evaluate quality improvements.MethodsCharacteristics of ED visits of a large Swiss university hospital were summarized according to acute patient condition factors (e.g. chief complaint, resuscitation bay use, vital parameter deviations), chronic patient conditions (e.g. age, comorbidities, drug intake), and contextual factors (e.g. night-time admission). Univariable and multivariable linear regression analyses were conducted with the total ED resource consumption as the dependent variable.ResultsIn total, 164,729 visits were included in the analysis. Physician resources accounted for the largest proportion (54.8%), followed by radiology (19.2%), and laboratory work-up (16.2%). In the multivariable final model, chief complaint had the highest impact on the total ED resource consumption, followed by resuscitation bay use and admission by ambulance. The impact of age group was small. The multivariable final model was validated (R2of 0.54) and a scoring system was derived out of the predictors.ConclusionsMore than half of the variation in total ED resource consumption can be predicted by our suggested model in the internal validation, but further studies are needed for external validation. The score developed can be used to calculate benchmarks of an ED and provides leaders in emergency care with a tool that allows them to evaluate resource decisions and to estimate effects of organizational changes.
Hepatitis B virus infection and associated risk factors among medical students in eastern Ethiopia
Authors: Tesfa Tewodros , Hawulte Behailu , Tolera Abebe , Abate Degu 
Published: February 2021

Background
Hepatitis B virus (HBV) is a highly contagious pathogen that has become a severe public health problem and a major cause of morbidity and mortality, particularly in developing countries. Medical students are at high occupational risk during their training. However, no facility-based studies were found among medical students in eastern Ethiopia. Thus, this study aimed to investigate the seroprevalence of Hepatitis B Virus and associated factors among medical students in eastern Ethiopia.

Methods
A facility-based cross-sectional study was conducted among 407 randomly selected medical students from March to June 2018. A pretested and structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. A 5ml blood was collected, and the serum was analyzed for Hepatitis B surface antigen (HBsAg) using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Outcome and explanatory variables were described using descriptive summary measures. Binary and multivariable logistic regression was conducted at 95% CI and an association at P-value < 0.05 was declared statistically significant.

Results
The seroprevalence of hepatitis B virus surface antigen was 11.5% (95%CI = 8.6, 14.7). Poor knowledge of universal precaution guideline (AOR = 2.58; 95% CI = [1.35–4.93]), history of needle stick injury (AOR = 2.11; 95% CI = [1.07–4.18]) and never been vaccinated for HBV (AOR = 2.34; 95% CI = [1.17–4.69]) were found statistically significantly associated with HBsAg positivity after multivariate analysis.

Conclusion
Hepatitis B virus infection rate is high among health care trainees in eastern Ethiopia. Improvement at health care practice centers safety through training on universal precaution guidelines, and scaling up HBV vaccination is mandatory.
Closing delivery gaps in the treatment of tuberculosis infection: Lessons from implementation research in Peru
Authors: Yuen Courtney M. , Millones Ana Karina , Puma Daniela , Jimenez Judith , Galea Jerome T. , Calderon Roger , Pages Gabriela S. , Brooks Meredith B. , Lecca Leonid , Nicholson Tom , Becerra Mercedes C. , Keshavjee Salmaan 
Published: February 2021

Background
Targeted testing and treatment of TB infection to prevent disease is a pillar of TB elimination. Despite recent global commitments to greatly expand access to preventive treatment for TB infection, there remains a lack of research on how best to expand preventive treatment programs in settings with high TB burdens.

Methods
We conducted implementation research in Lima, Peru, around a multifaceted intervention to deliver TB preventive treatment to close contacts of all ages, health care workers, and people in congregate settings. Key interventions included use of the interferon gamma release assay (IGRA), specialist support for generalist physicians at primary-level health facilities, and treatment support by community health workers. We applied a convergent mixed methods approach to evaluate feasibility and acceptability based on a care cascade framework.

Findings
During April 2019-January 2020, we enrolled 1,002 household contacts, 148 non-household contacts, 107 residents and staff of congregate settings, and 357 health care workers. Cumulative completion of the TB preventive care cascade was 34% for contacts <5 years old, 28% for contacts 5–19 years old, 18% for contacts ≥20 years old, 0% for people in congregate settings, and 4% of health care workers. IGRA testing was acceptable to adults exposed to TB. Preventive treatment was acceptable to contacts, but less acceptable to physicians, who frequently had doubts about prescribing preventive treatment for adults. Community-based treatment support was both acceptable and feasible, and periodic home-visits or calls were identified as facilitators of adherence.

Conclusions
We attempted to close the gap in TB preventive treatment in Peru by expanding preventive services to adult contacts and other risk groups. While suboptimal, care cascade completion for adult contacts was consistent with what has been observed in high-income settings. The major losses in the care cascade occurred in completing evaluations and having doctors prescribe preventive treatment.