bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the independent influence of sexual transmission on HBV infection in China: a modeling study
Authors: Li Miaolei , Zu Jian , Shen Mingwang , Zhuang Guihua , Chen Siyuan , Wang Fuzhen , Zheng Hui , Zhang Guomin 
Published: February 2021

AbstractBackgroundThe long-term impact of sexual transmission on the hepatitis B virus (HBV) infection in China remains unclear. This study aims to estimate the independent influence of sexual transmission on HBV infection.MethodsBased on the natural history of HBV infection and three national serosurvey data of hepatitis B in China, we developed an age- and sex-specific discrete model to describe the transmission dynamics of HBV. The initial conditions of the model were determined according to the age- and sex-specific national serosurvey data in 1992. Based on the national survey data of hepatitis B in 1992 and 2006, by using the Markov Chain Monte Carlo (MCMC) method, we estimated the age- and sex-specific seroclearance rates of hepatitis B surface antigen (HBsAg) and the horizontal transmission rates as well as their 95% confidence intervals (CI). Then we used the age- and sex-specific national serosurvey data of hepatitis B in 2014 to test the accuracy of our model-based estimation. Finally, we evaluated the independent impact of sexual transmission on HBV infection and discussed the long-term effect of promotion of condom use in China.ResultsWe estimated that the annual rates of HBsAg seroclearance for males and females aged 1–59 years were respectively 1.04% (95% CI, 0.49–1.59%) and 1.92% (95% CI, 1.11–2.73%). Due to sexual transmission, in 2014, the total number of chronic HBV infections in people aged 0–100 years increased 292,581, of which males increased 189,200 and females increased 103,381. In 2006, the acute HBV infections due to sexual transmission accounted for 24.76% (male: 31.33%, female: 17.94%) and in 2014, which accounted for 34.59% (male: 42.93%, female: 25.73%). However, if the condom usage rate was increased by 10% annually starting in 2019, then compared with current practice, the total number of acute HBV infections from 2019 to 2035 would be reduced by 16.68% (male: 21.49%, female: 11.93%). The HBsAg prevalence in people aged 1–59 years in 2035 would be reduced to 2.01% (male: 2.40%, female: 1.58%).ConclusionsSexual transmission has become the predominant route of acute HBV infection in China, especially for men. The promotion of condom use plays a significant role in reducing the cases of acute HBV infection.
Leisure-time physical activity and its correlates in a multi-ethnic sample of adults over age 50 in Singapore
Authors: Fong Joelle H. 
Published: February 2021

Abstract
Background
To examine the prevalence and correlates of regular leisure-time physical activity (LTPA) among community-dwelling adults in Singapore.

Methods
Data was sourced from the 2018–2019 Singapore Life Panel, which asked respondents about their current LTPA participation at various time-points over a seven-month period. The final sample comprised 7684 subjects over age 50. We applied logistic regression models in our analysis.

Results
39.8% of the respondents engaged in regular LTPA, with significantly higher proportions of men than women doing so. Factors positively associated with regular LTPA in both genders were age, education, retired, income, and satisfaction with social life, whereas a negative association was found with self-rated health. The correlates of sustained LTPA participation were relatively consistent with factors predicting current participation.

Conclusions
Regular participation in recreational physical activities is important to promoting health and well-being among middle-aged and older adults as populations age. Our findings indicated that positive perceptions of social relationships and being retired are important supporting factors. The urgent development of physical activity promotion strategies and interventions are required to foster greater overall LTPA participation.
A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure
Authors: Saito Kenta , Matsuo Yoichi , Ueda Goro , Omi Kan , Hayashi Yuichi , Imafuji Hiroyuki , Tsuboi Ken , Morimoto Mamoru , Ogawa Ryo , Takahashi Hiroki , Naitoh Itaru , Hayashi Kazuki , Kataoka Hiromi , Takiguchi Shuji 
Published: February 2021

Abstract
Background
The treatment of chronic pancreatitis requires a surgical approach in patients who are refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Indeed, suboptimal procedures lead to recurrent pancreatitis. We used a laparoscopic hybrid approach for patients with severe stenosis of the pancreatic duct. In this report, we present the feasibility and outcomes of our approach.

Methods
We selected a laparoscopic approach for the distal pancreatectomy, which is relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We recorded the operative outcomes, postoperative complications, and recurrence of pancreatitis.

Results
We performed the laparoscopic hybrid approach on 3patients between January and December 2018. There were no major intraoperative complications (Clavien-Dindo classification IIIa or more) and the postoperative course was uneventful in all patients. There were no recurrences of pancreatitis and no postoperative pain in all patients in > 2 years of follow-up.

Conclusion
Our hybrid method with a focus on complete ductal compression with safety and minimal invasiveness might be the optimal approach for the surgical treatment of chronic pancreatitis that requires a pancreatectomy with the Frey procedure.
Improved access in minimally invasive temporomandibular joint surgery through a novel endaural template
Authors: Krause Matthias , Kamal Mohammad , Kruber Daniel , Halama Dirk , Hierl Thomas , Lethaus Bernd , Bartella Alexander K. 
Published: February 2021

Abstract
Background
Digitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety of these procedures. Given the TMJ anatomy, the template fitting and intraoperative overview are the most important issues for a safe surgery. This article is a technical advance article that aims to describe an endaural surgical template based on the Moses approach as a possible solution in TMJ surgery.

Methods
Three patients with internal derangement were treated with the guidance of a MITMJS template based on cone beam computed tomography (CBCT) and a surface imprint of the periauricular region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient.

Results
The template design and clinical use were satisfactory for MITMJS. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively.

Conclusion
Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points to improved access in arthroscopy or arthrocentesis of TMJ surgery through endaural access with an increased level of safety during surgery.
Low‐level laser therapy using laser diode 940 nm in the mandibular impacted third molar surgery: double-blind randomized clinical trial
Authors: Momeni Ehsan , Barati Hoda , Arbabi Melika Rajaei , Jalali Behrouz , Moosavi Mahdieh-Sadat 
Published: February 2021

AbstractBackgroundThe effect of low-level laser therapy (LLLT) on pain mitigation following the third molar surgery is still controversial. The absence of a standard method for using laser among the studies is related to the types of sample selection, sample size, control, and LLLT parameters, which make pain mitigation following surgery more controversial. Therefore, this study aimed to determine the effect of LLLT on reducing pain, swelling, and trismus following the mandibular impacted third molar surgery.MethodsThis study was performed on 25 healthy subjects. After the surgery, amoxicillin 500 mg was prescribed every 8 h for a 7-day period besides oral Ibuprofen (Gelofen) 400 mg every 12 h for a 3-day period. The intraoral Laser diode 940 nm was applied immediately after suture on the tested side, while on the placebo side, a fiber tip was used with no laser radiation following surgery. Eventually, the pain score was evaluated by VAS index from the 1st to the 7th-day post-surgery and then analyzed by SPSS 24.ResultsThe results indicate that the mean swelling and trismus before, during, 2 days after, and 7 days after the intervention did not differ significantly between the two studied groups. However, the results show that on the sixth and seventh days, the pain was significantly lower in the intervention group compared to the control group.ConclusionsThe results suggest that although the pain, swelling, and trismus following surgery were lower on the radiated side, only pain was found to be significant on the radiated side (p < 0.05).The registration number of the clinical trial in a Primary Registry in the WHO Registry Network is IRCT20141209020258N110 and the date of retrospective registration is 04/05/2019. The related URL ishttps://www.irct.ir/trial/36321.
Combination effect of laser diode for photodynamic therapy with doxycycline on a wistar rat model of periodontitis
Authors: Astuti Suryani Dyah , Utomo Irawan Budi , Setiawatie Ernie Maduratna , Khasanah Miratul , Purnobasuki Hery , Arifianto Deny , Alamsyah Kartika Anggraini 
Published: February 2021

Abstract
Background
Periodontitis is a chronic inflammatory disease characterized by progressive damage on the structure of tooth-supporting tissues. The aim of the study is determining the combination photodynamic effect of diode laser 405 nm treatments and the administration of doxycycline 0.1% within 1, 3, 5, and 7 days on a Wistar rat model of periodontitis.

Methods
Samples were induced with Porphyromonas gingivalis ATCC33277 to allow periodontitis development and were treated with combination of doxycycline and laser diode, then statistical analysis was carried out (One-Way ANOVA test and the post-hoc Duncan test; Kruskal–Wallis test and Mann–Whitney follow-up test for non-parametric data). Samples were divided into five groups, laser exposure used was 405-nm diode laser with energy density of 8 J/cm2. The expression level of histomorphometric was calculated by measuring the number of macrophages, lymphocytes, fibroblasts and the distance between the CEJ-AV.

Results
The results showed that the combination treatment of doxycycline and laser exposure yielded immunomodulatory effects. The expression level of fibroblast and the distance between CEJ-AV bone showed that the combination of doxycycline and laser therapy exerted healing effect in rat models of periodontitis on day 5 and 7.

Conclusion
The combination of doxycycline 0.1% and diode laser therapy provides a healing effect in rats models of periodontitis.
Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Authors: Adedimeji Adebola , Ajeh Rogers , Pierz Amanda , Nkeng Relindis , Ndenkeh Jackson , Fuhngwa Norbert , Nsame Denis , Nji Miriam , Dzudie Anastase , Anastos Kathryn M. , Castle Philip E. 
Published: February 2021

Abstract
Background
Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of socio-contextual determinants of access to screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a low-income, high HIV prevalence context.

Methods
We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage purposive sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening.

Results
Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information, excessive cost of cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs.

Conclusion
In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.
Perceptions of Ecuadorian indigenous healers on their relationship with the formal health care system: barriers and opportunities
Authors: Bautista-Valarezo Estefanía , Duque Víctor , Verhoeven Veronique , Mejia Chicaiza Jorge , Hendrickx Kristin , Maldonado-Rengel Ruth , Michels Nele R.M. 
Published: February 2021

Abstract
Background
The new paradigm of intercultural policies focuses on rethinking the common public culture. In Ecuador, the “Buen Vivir” plan seeks to incorporate the ancestral medical knowledge, experience and beliefs of traditional healers into the formal health services. This study explores views on the formal health system from the perspective of the healers belonging to the Kichwa and Shuar ethnicities in the South of Ecuador.

Methods
A qualitative study with a phenomenological approach was performed. Focus groups were conducted in three locations in Southern Ecuador. Shuar, Kichwa and Mestizo ethnic groups were included in the research.

Results
Eleven focus groups with a total of 110 participants belonging to the Shuar, Kichwa and Mestizo ethnic groups participated in the study. Six themes were created through analysis: 1) conflicts with health professionals, 2) acceptance of traditional healers, 3) respect, 4) work as a team, 5) environment and patient care, and 6) salary and recognition.

Conclusion
This study indicated the perceived barriers compromising respectful collaboration between health staff and traditional healers from an indigenous perspective. Power inequalities and a historically unidirectional relationship and, in addition, differences in health beliefs, seem to create misunderstandings regarding each other’s approach when faced with health and disease. However, insight in these barriers can create opportunities towards collaboration, which will have a positive effect on patient confidence in one or both systems and support continuity between traditional healers and the formal health system.
Health management students’ self-regulation and digital concept mapping in online learning environments
Authors: Alt Dorit , Naamati-Schneider Lior 
Published: February 2021

Abstract
Background
Self-regulation of learning is considered one of the key capabilities deemed essential for the healthcare system and its workers to cope successfully with the current challenges they are facing. Therefore, healthcare curricula are increasingly called upon to support self-regulation as a central learning outcome. With scant relevant publications describing how students of medicine and other healthcare professions regulate their learning, this study set out to design and assess a problem-based learning using digital concept mapping in an online course and to evaluate the set of connections between this intervention and Health Management students’ self-regulation of learning.

Method
Students of a Management of Health Service Organizations program (100) were presented with an ill-structured problem, relevant to their course content (accreditation process within hospitals) and were asked to argue for or against the implementation of the accreditation process. The participants were asked to detail five arguments to establish their decision by using Mindomo, a popular digital platform for designing concept maps. The students were given predefined criteria that allowed them to self-assess their maps. Data for the analysis were gathered by two measurements: Concept mapping for problem-based learning scale and the Online self-regulated learning scale and were analyzed by using Partial Least Squares - Structural Equation Modeling.

Results
The analyses showed that at the beginning of the process, students’ online self-regulation was found lower than at the end of the intervention, and only two self-regulation sub-factors: Goal setting and Task strategies, were positively linked to students’ perceptions of the intervention. After the intervention, the analyses showed that it increased the levels of four Online self-regulation sub-factors: Goal setting, Task strategies, Environment structuring, and Time management.

Conclusions
Teachers need to recognize and account for different types of learners and encourage and scaffold students’ effective use of self-regulation strategies. Low self-regulated learners might fail to see the advantages of concept mapping in problem-solving activities. Combining these teaching and learning tools together with the use of advanced technology in an online course that encourages active learning enables the development and acquisition of abilities of self-directed learning among students in the medical and health management professions.
Efficacy-specific herbal group detection from traditional Chinese medicine prescriptions via hierarchical attentive neural network model
Authors: Chen Li , Liu Xinglong , Zhang Siyuan , Yi Hong , Lu Yongmei , Yao Pan 
Published: February 2021

Abstract
Background
Mining massive prescriptions in Traditional Chinese Medicine (TCM) accumulated in the lengthy period of several thousand years to discover essential herbal groups for distinct efficacies is of significance for TCM modernization, thus starting to draw attentions recently. However, most existing methods for the task treat herbs with different surface forms orthogonally and determine efficacy-specific herbal groups based on the raw frequencies an herbal group occur in a collection of prescriptions. Such methods entirely overlook the fact that prescriptions in TCM are formed empirically by different people at different historical stages, and thus full of herbs with different surface forms expressing the same material, or even noisy and redundant herbs.

Methods
We propose a two-stage approach for efficacy-specific herbal group detection from prescriptions in TCM. For the first stage we devise a hierarchical attentive neural network model to capture essential herbs in a prescription for its efficacy, where herbs are encoded with dense real-valued vectors learned automatically to identify their differences on the semantical level. For the second stage, frequent patterns are mined to discover essential herbal groups for an efficacy from distilled prescriptions obtained in the first stage.

Results
We verify the effectiveness of our proposed approach from two aspects, the first one is the ability of the hierarchical attentive neural network model to distill a prescription, and the second one is the accuracy in discovering efficacy-specific herbal groups.

Conclusion
The experimental results demonstrate that the hierarchical attentive neural network model is capable to capture herbs in a prescription essential to its efficacy, and the distilled prescriptions significantly could improve the performance of efficacy-specific herbal group detection.
Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda
Authors: Reponen Elina , Rundall Thomas G. , Shortell Stephen M. , Blodgett Janet C. , Juarez Angelica , Jokela Ritva , Mäkijärvi Markku , Torkki Paulus 
Published: February 2021

AbstractBackgroundReliable benchmarking in Lean healthcare requires widely relevant and applicable domains for outcome metrics and careful attention to contextual levels. These levels have been poorly defined and no framework to facilitate performance benchmarking exists.MethodsWe systematically searched the Pubmed, Scopus, and Web of Science databases to identify original articles reporting benchmarking on different contextual levels in Lean healthcare and critically appraised the articles. Scarcity and heterogeneity of articles prevented quantitative meta-analyses. We developed a new, widely applicable conceptual framework for benchmarking drawing on the principles of ten commonly used healthcare quality frameworks and four value statements, and suggest an agenda for future research on benchmarking in Lean healthcare.ResultsWe identified 22 articles on benchmarking in Lean healthcare on 4 contextual levels: intra-organizational (6 articles), regional (4), national (10), and international (2). We further categorized the articles by the domains in the proposed conceptual framework: patients (6), employed and affiliated staff (2), costs (2), and service provision (16). After critical appraisal, only one fifth of the articles were categorized as high quality.ConclusionsWhen making evidence-informed decisions based on current scarce literature on benchmarking in healthcare, leaders and managers should carefully consider the influence of context. The proposed conceptual framework may facilitate performance benchmarking and spreading best practices in Lean healthcare. Future research on benchmarking in Lean healthcare should include international benchmarking, defining essential factors influencing Lean initiatives on different levels of context; patient-centered benchmarking; and system-level benchmarking with a balanced set of outcomes and quality measures.