bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental perception on oral health-related quality of life and dental features of ectodermal dysplasia and isolated hypodontia in children
Authors: Crossan Emily , O’Connell Anne C. 
Published: October 2021

Abstract
Background
Children missing 6 or more permanent teeth often present with complex dental care needs and significant impacts on their oral health related quality of life (OHRQoL). The most important facet in the overall care for these children is the child’s own experience, but parents primarily make the decisions regarding their child’s dental management. Understanding the parental perspective could have a positive impact on planning and provision of care for these patient groups in the future. The study compared the parental perspectives on OHRQoL impact and dental experience for children with ectodermal dysplasia (ED), severe isolated hypodontia (IH), and matched controls following assessment of their dental features.

Design
A cross-sectional study of 172 children (mean age: 12.4 years old) was conducted; 86 with severe hypodontia (≥ 6 missing teeth; ED: 29; IH: 57) and 86 age and gender matched controls. The Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS) and a supplemental questionnaire were used to gather information on parental perceptions of OHRQoL and dental experiences, respectively. Clinical examinations were used to assess and compare the dental features between children with ED, IH and their respective controls.

Results
Higher scores (p < 0.05) were found in P-CPQ and FIS scores between the children with ED, IH and their respective controls. P-CPQ scores for males with ED had a moderate correlation with functional limitations (Rs = 0.576; p = 0.001*), oral symptoms (Rs = 0.444; p = 0.016*) and overall QoL (Rs = 0.499; p = 0.006*). The ED group reported earlier awareness of issues, the youngest attendance (3.24 years) and highest perceived number of appointments (“20 or more”; 58.6%). The mean number of missing teeth in the ED group was almost twice that of the IH group (ED: 20.17; IH: 10.68) and the median number of missing teeth (Radiographically: ED = 21; IH = 9; Clinically: ED = 11; IH = 6), was significantly greater in the ED group when compared to the IH group (p < 0.001*).

Conclusion
Parents of children with ED and IH perceive a greater impact on QoL, for both the child and their family. Children with ED need earlier intervention and more extensive treatment than children with IH and their controls.
Metal ions leachables from fake orthodontic braces incubated in simulated body fluid
Authors: Haleem Riyam , Shafiai Noor Ayuni Ahmad , Noor Siti Noor Fazliah Mohd 
Published: October 2021

Abstract
Background
The demand for fake braces usage in Southeast Asia are increasing but lack of certification and information on fake braces as medical devices from regulated bodies raised a concern towards its safety. The aim of this study was to determine the types of metal ion leachable from removable fake braces based on heavy metal ions present in metallic materials, immersed in simulated body fluid (SBF) and analysed using inductively coupled plasma atomic emission spectroscopy.

Methods
Three sets of fake braces and one control were dissembled to only their brackets and archwires and immersed separately in SBF. They were placed in an incubator shaker at a temperature of 37 °C at 50 rpm. A 3.0 ml measurement of SBF was taken out from the sample containers at days 7, 14 and 28 and kept at − 20 °C for further analysis. Data were analysed using SPSS version 26.0 (IBM, Armonk, USA) (P < 0.05). Descriptive and one-way ANOVA analyses with Bonferroni post hoc tests were used to assess the significant differences between the metal ions released in SBF from the control samples and fake braces.

Results
All 23 elements under investigation except Si ions were detected from the control samples and fake braces. There were significant increased K ions and reduced levels of Mg ions from the fake archwires and brackets. Most ions released were less than 10 mg/L (Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Mo, Cd, Pb, Al) or 1 mg/L (Li, Ba) into the SBF medium.

Conclusion
There were significant release of Ca and K ions from the fake samples. Elements such as Li, Ba, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Mo, Cd and Sb had increased in concentration at day 7 and the concentration plateaued until day 28.
Relationship between loci of control and health-promoting behaviors in Pakistani women with polycystic ovary syndrome: coping strategies as mediators
Authors: Fatima Iram , Yaqoob Sahar , Jamil Farhat , Butt Amna 
Published: October 2021

Abstract
Background/Objectives
Understanding the factors that promote healthy lifestyle behaviors in women with polycystic ovary syndrome is of substantial importance. Health-promoting lifestyle behaviors (HPLB) have been observed to be effective in managing various symptoms related to PCOS. This study aimed to examine the relationship between loci of control and health-promoting lifestyle behaviors in Pakistani women with polycystic ovary syndrome and the mediating role of coping strategies.

Method
A correlational study was carried out with 145 unmarried women with polycystic ovary syndrome diagnosed by a gynecologist using the Rotterdam Criteria of 2003 (M age = 24.75 years). Participants were recruited from public sector hospitals in Lahore, Punjab, Pakistan and a series of hierarchical regression analyses were used to analyze results.

Results
Findings suggest that women with internal and powerful others locus of control use more active practical coping strategies and less active distractive coping strategies. These women also get more involved in health-promoting behaviors. On the other hand, those with a high level of chance locus of control use less active practical coping strategies and more active distractive coping strategies. In turn, they engage less in health-promoting behaviors.

Conclusion
Health professionals should consider the effects of different types of locus of control and coping strategies when planning interventions for women with polycystic ovary syndrome.
Understanding family planning decision-making: perspectives of providers and community stakeholders from Istanbul, Turkey
Authors: Karadon Duygu , Esmer Yilmaz , Okcuoglu Bahar Ayca , Kurutas Sebahat , Baykal Simay Sevval , Huber-Krum Sarah , Canning David , Shah Iqbal 
Published: October 2021

Abstract
Background
A number of factors may determine family planning decisions; however, some may be dependent on the social and cultural context. To understand these factors, we conducted a qualitative study with family planning providers and community stakeholders in a diverse, low-income neighborhood of Istanbul, Turkey.

Methods
We used purposeful sampling to recruit 16 respondents (eight family planning service providers and eight community stakeholders) based on their potential role and influence on matters related to sexual and reproductive health issues. Interviews were audio-recorded with participants' permission and subsequently transcribed in Turkish and translated into English for analysis. We applied a multi-stage analytical strategy, following the principles of the constant comparative method to develop a codebook and identify key themes.

Results
Results indicate that family planning decision-making—that is, decision on whether or not to avoid a pregnancy—is largely considered a women’s issue although men do not actively object to family planning or play a passive role in actual use of methods. Many respondents indicated that women generally prefer to use family planning methods that do not have side-effects and are convenient to use. Although women trust healthcare providers and the information that they receive from them, they prefer to obtain contraceptive advice from friends and family members. Additionally, attitude of men toward childbearing, fertility desires, characteristics of providers, and religious beliefs of the couple exert considerable influence on family planning decisions.

Conclusions
Numerous factors influence family planning decision-making in Turkey. Women have a strong preference for traditional methods compared to modern contraceptives. Additionally, religious factors play a leading role in the choice of the particular method, such as withdrawal. Besides, there is a lack of men’s involvement in family planning decision-making. Public health interventions should focus on incorporating men into their efforts and understanding how providers can better provide information to women about contraception.
Significance of the viral load of high-risk HPV in the diagnosis and prediction of cervical lesions: a retrospective study
Authors: Liu Yang , Xu Changjun , Pan Jing , Sun Chunyi , Zhou Honglin , Meng Yushi 
Published: October 2021

Abstract
Background
The significance of HPV viral load in the detection of cervical lesions is still controversial. This study analyzed the correlation between the high-risk HPV viral load and different cervical lesion degrees.

Methods
This retrospective study included women positive for high-risk HPV DNA and screened for cervical lesions between 01/2015 and 06/2018. The high-risk HPV DNA load was measured by the second-generation Hybrid Capture technology and classified as low, moderate, and high. Colposcopy and biopsy were performed in all patients. The patients were grouped as normal, cervical intraepithelial neoplasia (CIN) grade 1, CIN grade 2, CIN grade 3, and cervical cancer. Multivariable logistic regression was performed to explore the association between high-risk HPV DNA load and cervical lesions. The odds ratios (ORs) represent the odds for increasing from low to high viral load.

Results
Finally, 265 patients were grouped as normal (n = 125), CIN 1 (n = 51), CIN 2 (n = 23), CIN 3 (n = 46), and cervical cancer (n = 20). Among them, 139 (52.5%) had a low viral load, 90 (34.0) had a moderate viral load, and 36 (13.4%) had a high viral load. Taking the normal control group as a reference, a high viral load was an independent factor for CIN 1 (OR = 3.568, 95% CI: 1.164–10.941, P = 0.026), CIN 2 (OR = 6.939, 95% CI: 1.793–26.852, P = 0.005), CIN 3 (OR = 7.052, 95% CI: 2.304–21.586, P = 0.001), and cervical cancer (OR = 8.266, 95% CI: 2.120–32.233, P = 0.002).

Conclusions
Among women who underwent cervical biopsy, higher high-risk HPV viral load in cervical lesions was associated with a higher risk of high-grade cervical lesions.
Effect of educational intervention on improvement of physical activities of middle-aged women
Authors: Rakhshani Tayebeh , Khiyali Zahra , Masrurpour Fatemeh , Khani Jeihooni Ali 
Published: October 2021

AbstractBackgroundRegular physical activity has important health benefits for women. The present study aimed to investigate the effect of theory-based educational interventions on the improvement of physical activities of middle-aged women.MethodsThis experimental study was conducted on 160 middle-aged women referred to Ahwaz health centers Iran in 2017 who were selected through the cluster sampling method. They were randomly divided into two groups: intervention (n = 80) and control (n = 80). The educational intervention for the experimental group consisted of 4 consultation and 4 follow-up sessions. The study outcomes included physical activity change, self-efficacy, decision-making balance, and the International Physical Activity Questionnaire, which were measured before the intervention and 2 months after that. The data were analyzed using the SPSS19 software as well as the Chi-square, independent t-test and paired t-test.ResultsAfter the intervention, the mean scores of preparedness for change, decision-making balance, perceived self-efficacy, pre-thinking, thinking, preparation, practice and maintenance were significantly different in both the experimental and control groups (Pvalue < 0.05). The t-test showed that after the educational intervention, the mean score of physical activity was significantly higher in the experimental group than in the control group (726.3 ± 201.6 and 339.8 ± 90.2, respectively) (Pvalue < 0.001).ConclusionThe findings of this study showed that the theory-based educational intervention was effective on the improvement of the middle-aged women’s physical activities. Therefore, it is suggested that a theory-based educational program be designed and implemented in order to increase the physical activities of this group.
Self-administered subcutaneous medroxyprogesterone acetate for improving contraceptive outcomes: a systematic review and meta-analysis
Authors: Nabhan Ashraf , Elshafeey Farida , Mehrain Luna Marion , Kabra Rita , Elshabrawy Amal 
Published: October 2021

Abstract
Background
Subcutaneous depot medroxyprogesterone acetate is an easy-to-use injectable contraceptive. A trained person can administer it, including women through self-injection. The objective of this systematic review and meta-analysis was to assess the effectiveness and safety of self-injection versus provider-administered subcutaneous depot medroxyprogesterone acetate for improving continuation of contraceptive use.

Methods
We searched for randomized controlled trials on November 1, 2020 in Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, Embase, Web of Science, Scopus, Open Grey, clinical trials registries, and reference lists of relevant studies. We did not impose any search restrictions. We included randomized trials comparing self- versus provider-administered subcutaneous depot medroxyprogesterone acetate. Two authors independently screened trials, extracted data, and assessed the risk of bias in the included studies. We used risk ratio and 95% confidence intervals for dichotomous outcomes.

Results
We identified 3 randomized trials (9 reports; 1264 participants). The risk of bias in the included studies was low except for performance bias and detection bias of participant-reported outcomes in unmasked trials. Self-administration, compared to provider-administration, increased continuation of contraceptive use (risk ratio 1.35; 95% confidence intervals 1.10–1.66); moderate-certainty evidence). Self-injection appears to be making more of an impact on continuation for younger women compared to women 25 years and older and on women living in low and middle income compared to high income countries. There was no subgroup difference by the type of care provider (community health worker vs. clinic-based provider).

Conclusions
Self-injection of subcutaneous depot medroxyprogesterone acetate probably improves continuation of contraceptive use. The effects on other outcomes remain uncertain because of the very low certainty of evidence.
Effect of physical activity and exercise on endometriosis-associated symptoms: a systematic review
Authors: Tennfjord Merete Kolberg , Gabrielsen Rakel , Tellum Tina 
Published: October 2021

Abstract
Background
Endometriosis is a common benign gynecological disease that has the potential to debilitate due to pain and reduced quality of life. Treatment modalities such as hormones and surgery have limitations and do not treat all dimensions of the problems caused by endometriosis, and physical activity (PA) and exercise have been suggested as alternative treatments. Aim of this study was to perform a systematic review and meta-analysis to assess the effect of PA and exercise on endometriosis-associated symptoms.

Methods
Eleven databases were searched systematically. Study selection, quality assessment, and data extraction were carried out by two independent researchers in accordance with PRISMA guidelines. Eligibility criteria were women with diagnosed endometriosis receiving an intervention (PA and/or exercise). The primary outcome was pain intensity, but all outcomes were accepted.

Results
This study screened 1045 citations for eligibility. Four interventional studies were identified, of which one showed fatal design flaws and so was excluded. Three studies, two randomized controlled trials (RCT) and one pre-post study with no control group, involving 109 patients were included in a descriptive synthesis. The interventions included flexibility and strength training, cardiovascular fitness, and yoga, and were performed from one to four times per week for a total duration of 8–24 weeks, with or without supervision. Only one study found improvements in pain intensity. One study showed decreases in stress levels. Due to the heterogeneity of the study outcomes and measures, as well as confounding factors, a quantitative meta-analysis could not be performed.

Conclusion
The effect of PA and exercise as treatments for endometrioses-associated symptoms could not be determined due to significant limitations of the included studies. Future research should be based on RCTs of high methodological quality, measuring and reporting relevant core outcomes such as pain, improvements in symptoms and quality of life, and acceptability and satisfaction from the perspectives of patients. Furthermore, these outcomes need to be measured using reliable and validated tools.

Trial registration number

CRD42021233138.
Anti-apoptotic effect of Buchholzia coriacea Engl. stem back extracts on AsPC-1 and mechanisms of action
Authors: Onohuean Hope , Adisa Rahmat Adetutu , Alagbonsi Abdullateef Isiaka 
Published: October 2021

Abstract
Ethnopharmacological relevance
Buchholzia coriacea Engl. is popularly called wonderful cola due to its wide ethnomedicinal use for the treatment of various ailments. We investigated the possible cytotoxic effect of its various fractions on human pancreatic cancer cell (AsPC-1) and also determined its mechanisms of action.

Materials and methods
The AsPC-1 cells were cultivated and separately treated with 5-fluorouracil (5-FU) or Buchholzia coriacea Engl. bark (BC) (ethanol, aqueous, chloroform or ethyl acetate extract) for 72 h. Cell viability, caspase 3 and mitochondrial membrane potential (ΔΨm) were determined in vitro after the treatment. Nitric oxide (NO) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals’ scavenging property, ferric reducing power and lipid peroxidation assays were also done to examine the antioxidant effect of BC in vitro.

Results
Various extracts of BC, especially at 2500 μg/ml and 5000 μg/ml, increased the AsPC-1 viability while 5-FU decreased it. The activity of caspase 3 was increased by 5-FU but reduced by all concentrations of various extracts of BC. Incubation of AsPC-1 with 5-FU showed the majority of cells having the monomeric form of JC-1 dye (bright green fluorescence), which indicated de-energized mitochondria. However, fluorescence photomicrograph of cells incubated with different concentrations (20, 40 and 100 μg/ml) of BC extracts (aqueous, ethanol, chloroform and ethyl acetate) showed strong JC-1 aggregation (yellow), which indicated mitochondria with intact membrane potentials. BC extracts also scavenged NO and DPPH radicals, inhibited lipid peroxidation and increased ferric reduction, though not as much as ascorbic acid.

Conclusion
This study suggests that BC elicits anti-apoptotic activity in AsPC-1 by increasing cell viability, decreasing caspase 3 activity, stabilizing the ∆Ψm, and scavenging free radicals. Even though BC is used ethnomedicinally as anti-cancer agent, our findings in the present study suggest that it has pro-cancer potential in-vitro, especially on pancreatic cells. Its anti-apoptotic activity in AsPC-1 could be of clinical significance, especially to counteract the effect of apoptotic agents on pancreatic cells.
Familiarity and genetic literacy among medical students in Indonesia
Authors: Swandayani Yolanda Marthia , Cayami Ferdy Kurniawan , Winarni Tri Indah , Utari Agustini 
Published: October 2021

Abstract
Background
There is a lack of genetic knowledge among health care professionals especially in some developing countries such as Indonesia. Based on our experience, genetic disorders receive less attention in medical education and professionals. This study aims to determine the familiarity and literacy of genetics among medical students in Indonesia.

Methods
A total of 1003 Indonesian medical (pre-clinical and clinical) students completed the Rapid Estimate of Adult Literacy in Genetics (REAL-G) questionnaire with a total score of seven for familiarity and eight for genetic literacy. The Mann-Whitney U test was used to compare the familiarity and genetic literacy scores between pre-clinical and clinical students.

Results
The average scores of familiarity and genetic literacy were 5.63 ± 0.96 and 6.37 ± 0.83, respectively. Genetic familiarity was higher (p = 0.043) among clinical students than pre-clinical students, while there was no significant difference in genetic literacy (p = 0.362) between pre-clinical and clinical students. Genetic familiarity does not impact the level of genetic literacy. However, medical students’ genetic literacy is influenced by demographic characteristics, such as age, sex, university type, genetic learning experience, university accreditation, and university location.

Conclusions
In general, Indonesian medical students have relatively good familiarity and literacy in genetics although further study is necessary to accurately measure the genetic familiarity and literacy in medical students and general public.
A Spanish adaptation of the Quality in Psychiatric Care—Inpatient (QPC-IP) instrument: Psychometric properties and factor structure
Authors: Sanchez-Balcells Sara , Lluch-Canut Maria-Teresa , Domínguez del Campo Marta , Moreno-Poyato A. R. , Tomás-Jiménez M. , Lundqvist Lars-Olov , Schröder Agneta , Puig-Llobet Montserrat , Roldan-Merino J. F. 
Published: October 2021

AbstractBackground and aimWestern countries share an interest in evaluating and improving quality of care in the healthcare field. The aim was to develop and examine the psychometric properties and factor structure of the Spanish version of the Quality in Psychiatric Care–Inpatient (QPC-IP) instrument.MethodsA psychometric study was conducted, translating the QPC-IPS instrument into Spanish, revision of the instrument by a panel of experts, and assessing its psychometric properties. 150 psychiatric inpatients completed the QPC-IP. Test-retest reliability was assessed by re-administering the questionnaire to 75 of these patients.ResultsAfter conducting pilot testing and a cognitive interview with 30 inpatients, it was determined that the QPC-IPS was adequate and could be self-administered. A Cronbach’s alpha of 0.94 was obtained for the full instrument and values of 0.52–0.89 for the various dimensions of the questionnaire. Test re test reliability: The Intraclass Correlation Coefficient for the full questionnaire was 0.69, while for the individual dimensions values between 0.62 and 0.74 were obtained, indicating acceptable temporal stability. Convergent validity was analysed using 10-point numerical satisfaction scale, giving a positive correlation (0.49). Confirmatory factor analysis revealed six factors consistent with the original scale. The Spanish version yielded adequate results in terms of validity and reliability.ConclusionOur findings provide evidence of the convergent validity, reliability, temporal stability and construct validity of the Spanish QPC-IP for measuring patient quality in psychiatric care in Spanish hospitals. Hospital administrators can use this tool to assess and identify areas for improvement to enhance quality in psychiatric care.