bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the well‐being of dentistry students
Authors: Stormon Nicole , Sexton Christopher , Ford Pauline J. , Eley Diann S. 
Published: January 2021

AbstractIntroductionThe transactional model of stress is a framework describing the process for coping with stressful events as a relationship between the individual person and environment. This study aimed to investigate the associations between personality, learning environment and experiences of mental health for a cohort of Australian dentistry students.Materials and methodsStudents were invited in 2017 to complete an online questionnaire including the Depression, Anxiety and Stress Scale (DASS‐21), The Dundee Ready Education Environment Measure (DREEM) and Cloninger’s Temperament and Character Inventory (TCIR‐140). Students were followed‐up one year later, and generalised estimating equations were used.ResultsA total of 219 (response 73.5%) students participated in the study. Two personality profiles of dentistry students were identified. Group 1 were significantly higher in the traits persistence, self‐directedness, cooperativeness and reward dependence, whereas Group 2 were significantly higher in harm avoidance. Students with Group 2 personality had a 3.12 (CI:1.72‐5.65) increased odds of depression compared to Group 1 students. Compared to students with positive perceptions of the learning environment, students with negative perceptions had increased odds of stress (3.48, CI: 1.85‐6.53), depression (2.71, CI: 1.57‐ 4.65) and anxiety (2.59, CI: 1.56‐4.28).ConclusionStudents with personalities high in levels of self‐directedness, cooperativeness and persistence and low in harm avoidance, as found in Group 1, demonstrate high levels of general well‐being. Positive perceptions of the dentistry learning environment were found to be an important influence on students stress. This study highlighted a number of factors important to student well‐being and provides direction for further investigation of interventions aimed at enhancing student well‐being.
Seizures in autoimmune encephalitis—A systematic review and quantitative synthesis
Authors: Yeshokumar Anusha K. , Coughlin Arielle , Fastman Jarrett , Psaila Kendall , Harmon Michael , Randell Taylor , Schorr Emily M. , Han Helen , Hoang Hai , Soudant Celine , Jette Nathalie 
Published: January 2021

AbstractObjectiveThis study aimed to evaluate the proportion of patients with seizures and electroencephalography (EEG) abnormalities in autoimmune encephalitis (AE) and its most common subtypes.MethodsThis systematic review followed Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) standards and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). We searched Medline All, Embase, and PsychINFO in Ovid from inception to June 2019 for articles pertaining to AE and seizure. Included studies reported seizure and/or EEG data in cohorts of ≥10 AE patients. Patient demographics, antibody type, seizure incidence, and EEG findings were extracted. Review of studies and data extraction were performed in duplicate. In addition to descriptive analysis, quantitative synthesis stratified by autoantibody subtype was performed with logistic regression and chi‐square analyses.ResultsOur search yielded 3856 abstracts: 1616 were selected for full‐text review and 118 studies met eligibility criteria. Of 3722 antibody‐positive AE patients, 2601 (69.9%) had clinical seizures during the course of their illness. Of the 2025 patients with antibody‐positive AE and available EEG data, 1718 (84.8%) had some EEG abnormality (eg, epileptiform discharges, slowing, and so on). Anti‐ N‐methyl‐d‐aspartate (NMDA) receptor encephalitis (anti‐NMDARE) was the most commonly reported type of AE (1985/3722, 53.3%). Of the anti‐NMDARE patients with available seizure or EEG data, 71.8% (n = 1425/1985) had clinical seizures during their illness, and 89.7% (n = 1172/1306) had EEG abnormalities. For all AE patients and in the anti‐NMDARE subpopulation, seizures were more common in younger patients (p < .05).SignificanceThis systematic review provides an estimate of the proportion of AE patients with seizures, confirming the magnitude of seizure burden in this population. Prospective studies are needed to understand population‐based prevalence of seizures, identify factors associated with seizures, and evaluate particular EEG findings as biomarkers of seizures and outcomes in AE.
Short selling, agency, and corporate investment
Authors: Nezafat Mahdi , Shen Tao , Wang Qinghai 
Published: January 2021

AbstractIn this article, we examine corporate investment decisions in a model with short selling. We show that high short‐selling activities can cause firms to overinvest and that the agency problems between managers and shareholders drive this overinvestment. Empirically, we find that short interest is positively associated with subsequent corporate investment and that the effect of short‐selling activities on investment is stronger when the sensitivity of chief executive officer compensation to stock price performance is greater. The results are not explained by short‐sale constraints or firm overvaluation. Additionally, short‐selling‐induced corporate investments can partly explain the negative relation between both short interest and corporate investment with subsequent stock returns.
Participation of nurse managers in the health policy process: a qualitative study of barriers and facilitators
Authors: Hajizadeh A. , Zamanzadeh V. , Khodayari‐Zarnaq R. 
Published: January 2021

AimTo explore the barriers and facilitators concerning nurse managers’ participation in the health policy‐making process.BackgroundDespite encouragement for participation in policy‐making, nurse managers are seldom involved in this process.MethodsA qualitative descriptive research design based on purposive sampling was conducted. Semi‐structured one‐to‐one interviews were conducted with nurse managers and key informants (n = 16). Interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was applied to study reporting.FindingsThree levels of barriers were found to nurse managers’ participation in health policy‐making. The individual level included weakness in characteristics of nurse managers, and the organizational level constituted the inefficient structure. In addition, the environment‐related level encompassed external barriers to the organization. Finally, three facilitators with the potential were identified for improving nurse managers’ participation in the policy‐making process, including improvements in collaboration and communication, governmental and non‐governmental organizational activities, and reforms in the health policy‐making process.ConclusionNurse managers need to use the window of opportunity to participate in health policy‐making. More importantly, they should be informed about health policy in order to meet the demands of the rapidly changing healthcare environment. Drawing upon their professional organizations and positions, nurse leaders require to network and make a space to stimulate their participation in the policy.Implications for nursing policy and health policyNurse managers need to develop political skills and utilize strategies to help their participation in health policy‐making, leading to better implementation of policies, efficiency, and effectiveness in the health system.
Efficacy of a topical concentrated surfactant gel on microbial communities in non‐healing diabetic foot ulcers with chronic biofilm infections: A proof‐of‐concept study
Authors: Malone Matthew , Radzieta Michael , Schwarzer Saskia , Jensen Slade O. , Lavery Lawrence A. 
Published: January 2021

AbstractThis proof‐of‐concept study sought to determine the effects of standard of care (SOC) and a topically applied concentrated surfactant gel (SG) on the total microbial load, community composition, and community diversity in non‐healing diabetic foot ulcers (DFUs) with chronic biofilm infections. SOC was provided in addition to a topical concentrated SG, applied every 2 days for 6 weeks. Wound swabs were obtained from the base of ulcers at baseline (week 0), week 1, mid‐point (week 3), and end of treatment (week 6). DNA sequencing and real‐time quantitative polymerase chain reaction (qPCR) were employed to determine the total microbial load, community composition, and diversity of patient samples. Tissue specimens were obtained at baseline and scanning electron microscopy and peptide nucleic acid fluorescent in situ hybridisation with confocal laser scanning microscopy were used to confirm the presence of biofilm in all 10 DFUs with suspected chronic biofilm infections. The application of SG resulted in 7 of 10 samples achieving a reduction in mean log10 total microbial load from baseline to end of treatment (0.8 Log10 16S copies, ±0.6), and 3 of 10 samples demonstrated an increase in mean Log10 total microbial load (0.6 log10 16S copies, ±0.8) from baseline to end of treatment. Composition changes in microbial communities were driven by changes to the most dominant bacteria. Corynebacterium sp. and Streptococcus sp. frequently reduced in relative abundance in patient samples from week 0 to week 6 but did not disappear. In contrast, Staphylococcus sp., Finegoldia sp., and Fusobacterium sp., relative abundances frequently increased in patient samples from week 0 to week 6. The application of a concentrated SG resulted in varying shifts to diversity (increase or decrease) between week 0 and week 6 samples at the individual patient level. Any shifts in community diversity were independent to changes in the total microbial loads. SOC and a topical concentrated SG directly affect the microbial loads and community composition of DFUs with chronic biofilm infections.
Effects of community of inquiry, learning presence and mentor presence on K‐12 online learning outcomes
Authors: Zhang Yining , Lin Chin‐Hsi 
Published: January 2021

AbstractThis study extends the community of inquiry (CoI) framework and self‐regulated learning (SRL) theory through an exploration of the structural relationships among existing CoI variables, learning presence (i.e., self‐efficacy and online SRL strategy) and learning outcomes in the context of K‐12 online learning. To help understand the influence of K‐12 mentoring – which is unique to online learning in the U.S. – mentor presence is also included. Structural equation modelling of 696 online 8th through 12th graders' survey responses and final grades showed that adding learning presence to the CoI framework helped to explain how these learners translated their online‐learning perceptions into cognitive and affective learning outcomes. We also found that mentor presence significantly and positively predicted online SRL strategy, one of the two components of learning presence. Lastly, we established a connection between the CoI model and various types of learning outcomes that are indicators of K‐12 online learning success – though it should be noted that important differences existed between a model based on final grades and two other outcome models. It is hoped that the processes identified in this study will be useful and relevant to K‐12 online‐learning institutions and educators seeking to improve their offering via a wide range of approaches.
A new transseptal solution for enabling left atrial access of large delivery sheaths
Authors: Inohara Taku , Gilhofer Thomas , Al‐Dujaili Saja , Leung Linus , Yeung Darwin , Tsang Michael , Saw Jacqueline 
Published: January 2021

AbstractBackgroundTransseptal access for large sheaths may be encumbered by tissue resistance against the sheath–dilator stepped interface. The ExpanSure Large Access Transseptal Dilator (Baylis Medical) is designed as a single introducer and dilation device with a smooth sheath–dilator transition to support transseptal puncture. It may facilitate ease and efficiency of interatrial crossing.MethodsThis study experimentally evaluated the crossing force of ExpanSure relative to a conventional 8.5 F Swartz SL1 transseptal sheath and dilator in a benchtop septum model. Its ability to reduce the subsequent crossing force of a 14 F WATCHMAN delivery sheath was also tested. The clinical use of ExpanSure, including procedure time, was then validated in a series of left atrial appendage closure (LAAC) procedures.ResultsIn a benchtop septum model (N = 12), less peak force (1.90 ± 0.08 N vs. 2.36 ± 0.09 N; p < .001) and overall work (17.3 ± 1.2 mJ vs. 28.0 ± 1.9 mJ; p < .001) were required to advance ExpanSure relative to a conventional SL1 transseptal sheath and dilator system. Peak force (2.34 ± 0.24 N vs. 2.65 ± 0.21 N; p < .003) and overall work (28.5 ± 3.9 mJ vs. 35.4 ± 2.1 mJ; p < .001) to advance a WATCHMAN sheath were also significantly lower after using ExpanSure than after using a conventional transseptal system. In 19 LAAC procedures, ExpanSure crossed the septum smoothly and integrated readily, which enabled efficient procedure completion (mean total procedure time 37.6 ± 13.5 min), with 100% success and no procedure‐related complications.ConclusionExperimental force measurements, combined with early clinical experience using ExpanSure, suggest that the tapered design with smooth transition without dilator–sheath step‐up and the larger diameter, both facilitated ease and efficiency of interatrial crossing.
Reduction in the QRS area after cardiac resynchronization therapy is associated with survival and echocardiographic response
Authors: Ghossein Mohammed A. , van Stipdonk Antonius M. W. , Plesinger Filip , Kloosterman Mariëlle , Wouters Philippe C. , Salden Odette A. E. , Meine Mathias , Maass Alexander H. , Prinzen Frits W. , Vernooy Kevin 
Published: January 2021

AbstractIntroductionRecent studies have shown that the baseline QRS area is associated with the clinical response after cardiac resynchronization therapy (CRT). In this study, we investigated the association of QRS area reduction (∆QRS area) after CRT with the outcome. We hypothesize that a larger ∆QRS area is associated with a better survival and echocardiographic response.Methods and ResultsElectrocardiograms (ECG) obtained before and 2–12 months after CRT from 1299 patients in a multi‐center CRT‐registry were analyzed. The QRS area was calculated from vectorcardiograms that were synthesized from 12‐lead ECGs. The primary endpoint was a combination of all‐cause mortality, heart transplantation, and left ventricular (LV) assist device implantation. The secondary endpoint was the echocardiographic response, defined as LV end‐systolic volume reduction ≥ of 15%. Patients with ∆QRS area above the optimal cut‐off value (62 µVs) had a lower risk of reaching the primary endpoint (hazard ratio: 0.43; confidence interval [CI] 0.33–0.56, p < .001), and a higher chance of echocardiographic response (odds ratio [OR] 3.3;CI 2.4–4.6, p < .0001). In multivariable analysis, ∆QRS area was independently associated with both endpoints. In patients with baseline QRS area ≥109 µVs, survival, and echocardiographic response were better when the ∆QRS area was ≥62 µVs (p < .0001). Logistic regression showed that in patients with baseline QRS area ≥109 µVs, ∆QRS area was the only significant predictor of survival (OR: 0.981; CI: 0.967–0.994, p = .006).Conclusion∆QRS area is an independent determinant of CRT response, especially in patients with a large baseline QRS area. Failure to achieve a large QRS area reduction with CRT is associated with a poor clinical outcome.
Do psychological factors predict changes in oral health‐related quality of life and clinical status after periodontal treatment?
Authors: Rawlinson Andrew , Vettore Mario V. , Baker Sarah R. , Robinson Peter G. 
Published: January 2021

AbstractAimsTo determine psychological factors predicting changes in OHRQoL and clinical status after periodontal treatment.MethodsCohort of 140 patients with chronic periodontitis receiving non‐surgical treatment consisting of scaling, root surface debridement and instruction in plaque control. Participants self‐completed questionnaires enquiring about sense of coherence, locus of control, self‐esteem and task‐specific self‐efficacy before treatment, and the Oral Health Impact Profile—14 before treatment, at oral hygiene review and end of study. Relationships among OHRQoL, clinical changes, individual factors (demographic and psychological) and environmental characteristics were analysed using latent growth curve modelling guided by the Wilson and Cleary model.ResultsOHRQoL and periodontal status improved after treatment. Being male and having a greater sense of coherence predicted better OHRQoL before treatment. Stronger internal dimension of locus of control predicted a greater rate of improvement in OHRQoL, whereas greater external dimensions predicted a slower rate of improvement. Greater task‐specific self‐efficacy predicted less gains in probing attachment and reductions in probing depth.ConclusionsKnowledge of psychological factors may be helpful in explaining individual differences in OHRQoL and clinical responses to periodontal treatment, and in identifying where health‐promoting interventions may strengthen relevant factors to improve these outcomes.
Existential uncertainty in health care: A concept analysis
Authors: Dwan Conor , Willig Carla 
Published: January 2021

AbstractRationale, aims and objectivesAccording to an influential taxonomy of varieties of uncertainty in health care, existential uncertainty is a key aspect of uncertainty for patients. Although the term “existential uncertainty” appears across a number of disciplines in the research literature, its use is diffuse and inconsistent. To date there has not been a systematic attempt to define it. The aim of this study is to generate a theoretically‐informed conceptualisation of existential uncertainty within the context of an established taxonomy.MethodExistential uncertainty was subjected to a concept analysis, which drew on existing uses of the term across multiple disciplines as well as insights from uncertainty theory more broadly and from the existential therapy literature to generate a tentative definition of the concept. Antecedents, consequences, and empirical referents of existential uncertainty were also identified. A model case was described as well as a borderline case and a related case in order to illustrate and delineate the concept.ResultsExistential uncertainty is conceptualised as an awareness of the undetermined but finite nature of one's own being‐in‐the‐world, concerned primarily with identity, meaning, and choice. This awareness is fundamental and ineradicable, and manifests at different levels of consciousness.ConclusionHumans rely on identity, worldview, and a sense of meaning in life as ways of managing the ineradicable uncertainty of our being‐in‐the‐world, and these can be challenged by a serious diagnosis. It is important that medical professionals acknowledge issues around existential uncertainty as well as issues around scientific uncertainty, and recognise when patients might be struggling with these. Further research is required to identify ways of measuring existential uncertainty and to develop appropriate interventions, but it is hoped that this conceptualisation provides a useful first step towards that goal.
The 2014 Tokwe‐Mukorsi floods: Were the civil protection authorities in Zimbabwe prepared for the disaster?
Authors: Mavhura Emmanuel 
Published: January 2021

AbstractFlood preparedness involves building capacities that enable minimising losses through effective response and recovery. While there are many preparedness assessments at household and community level, very few have been conducted at institutional level. This study assessed the households' perspectives of the preparedness of civil protection institutions in Zimbabwe during the 2014 Tokwe‐Mukorsi flood disaster and identified the capacity building needs of the civil protection institutions. It used a 5‐point Likert scale to measure six preparedness indicators: emergency plans, early warning systems, evacuation, resources, disaster knowledge, and relocation camp management. Data came from a cross‐sectional survey involving 656 household‐heads who were randomly selected among the affected villagers of Tokwe‐Mukorsi. The findings revealed various gaps in preparedness both at indicator and at variable level. While some indicators showed incipient levels of development in all their variables, others had a combination of low and developed variables. The preparedness elements that critically need immediate attention include the development of emergency plans, evacuation of populations at risk and the prepositioning of resources. However, it is pertinent to mention that civil protection systems in Zimbabwe need to strengthen most of their preparedness elements. As such, this study recommends strengthening preparedness activities in civil protection systems.
Synbiotics supplement is effective for Melasma improvement
Authors: Piyavatin Piyanat , Chaichalotornkul Sirinthip , Nararatwanchai Thamthiwat , Bumrungpert Akkarach , Saiwichai Tawee 
Published: January 2021

AbstractBackgroundMelasma is a disorder of melanogenesis among humans causing localized, chronic acquired hypermelanosis of the skin requiring a combination of treatments. Related studies have shown probiotics contribute distinct advantages for skin disorders possibly including melasma because of its anti‐inflammatory activities, anti‐oxidation properties, ultraviolet protection, and tyrosinase activity inhibition.AimsThe study aimed to investigate the effects of synbiotics supplement on improving melasma (evaluated from mMASI score).MethodsThis research comprised an experimental study employing a prospective, double‐blind, randomized controlled trial among 57 Thai participants divided in 2 groups (29 for the experimental and 28 for the placebo groups). The participants were aged 30‐50 years old, had Fitzpatrick skin type III–VI, with facial melasma on both sides of the face and attending Mae Fah Luang University Hospital, Bangkok from January‐December 2019. Participants were randomly treated with oral synbiotics or placebo, 1 sachet daily for 12 weeks. Melasma severity and skin health were evaluated at 4 visits for each participant (baseline, weeks 4, 8, and 12, respectively).ResultsSeverity of melasma scored by mMASI of the synbiotics group was 7.54 ± 0.79, 7.36 ± 0.80, 7.16 ± 0.73, and 6.98 ± 0.72 at baseline, weeks 4, 8, and 12, respectively, and 7.51 ± 0.86, 7.52 ± 0.88, 7.54 ± 0.86, and 7.54 ± 0.89 at baseline, weeks 4, 8, and 12, respectively, in the placebo group. Comparing between two groups at week 12, melasma score in the synbiotics supplement group was significantly lower than that in the placebo group (P = .008).ConclusionOral synbiotics supplementation for 12 weeks improved the severity of melasma score.