bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individualized Numeric Rating Scale to Assess Pain in Critically Ill Children With Neurodevelopmental Disabilities
Authors: Rowe Shaneel , Best Kaitlin M. 
Published: July 2024

Background
Pain is a significant burden for children with neurodevelopmental disabilities but is difficult for clinicians to identify. No pain assessment tools for children with neurodevelopmental disabilities have been validated for use in pediatric intensive care units. The Individualized Numeric Rating Scale (INRS) is an adapted 0-to-10 rating that includes parents’ input on their child’s pain indicators.

Objectives
To evaluate the reliability, validity, and feasibility and acceptability of use of the INRS for assessing pain in critically ill children with neurodevelopmental disabilities.

Methods
This observational study enrolled critically ill patients with neurodevelopmental disabilities aged 3 to 17 years in 2 pediatric intensive care units at a children’s hospital using a prospective repeated-measures cohort design. Structured parent interviews were used to populate each patient’s INRS. Bedside nurses assessed pain using the INRS throughout the study. The research team completed independent INRS ratings using video clips. Participating parents and nurses completed feasibility and acceptability surveys. Psychometric properties of the INRS and survey responses were evaluated with appropriate statistical methods.

Results
For 481 paired INRS pain ratings in 34 patients, interrater reliability between nurse and research team ratings was moderate (weighted κ = 0.56). Parents said that creating the INRS was easy, made them feel more involved in care, and helped them communicate with nurses.

Conclusions
The INRS has adequate measurement properties for assessing pain in critically ill children with neurodevelopmental disabilities. It furthers goals of patient- and family-centered care but may have implementation barriers.
Evaluation of serum testosterone levels in pre-eclampsia
Authors: Nandhini N. E. , Ponnudhali D. 
Published: July 2024

Background:
Pre-eclampsia (PE) is a multi-system disorder that affects 3%–6% of human pregnancies and causes substantial maternal and foetal mortality and morbidity. Various studies have implicated testosterone as a causative factor in the pathogenesis of PE. The present study evaluated the association of serum testosterone levels with PE and maternal and foetal outcomes.

Aim:
The objectives of the study were to assess serum testosterone levels in PE compared to normotensive pregnant mothers, to look for its association with PE and to identify its utility as a biomarker for PE.

Materials and Methods:
A prospective cohort study was conducted in the 2nd trimester pregnant mothers (n = 110) attending the outpatient department at Vinayaka Mission’s Kirupananda Variyar Medical College Hospital, Salem. Serum testosterone, uric acid, high-sensitivity C-reactive protein (hsCRP) and creatinine were evaluated and compared amongst the pre-eclamptic and normal pregnant women.

Results:
The mean serum testosterone level was higher in PE women (2.625 ± 1.40 ng/dL) when compared to normal pregnant women (1.217 ± 0.258 ng/dL) (P < 0.001). Serum testosterone was found to be positively correlated with uric acid (r = 0.517, P < 0.001), hsCRP (r = 0.307, P < 0.001), systolic blood pressure (BP) (r = 0.480, P < 0.000) and diastolic BP (r = 0.544 P < 0.001). Receiver operating characteristic curve analysis for serum testosterone levels was done (area under the curve = 0.815), with sensitivity and specificity of 78.18% and 78.18%, respectively.

Conclusion:
This study attempted to identify the association between serum testosterone levels, PE and pregnancy outcomes in a small South Indian population. Serum testosterone levels were found to be significantly elevated in pre-eclamptic women compared to normal pregnancies and could be used as a predictive biomarker. Serum uric acid and hsCRP also showed a significant positive association with PE.
Why do young Indians choose to become doctors?
Authors: Kumar Nitin , Tiwari Parmanand , Nundy Samiran 
Published: July 2024

Background:
Being a doctor is physically and mentally challenging but immensely satisfying, as it is one of the most sought-after professions in India. Every year, about 20 lakh candidates appear for the National Eligibility and Entrance Test, commonly known as the NEET examination, of whom only 80,000 (4%) can secure a seat in a medical college (about 43,000 in government colleges and 37,000 in private institutions). Through a mailed questionnaire, we compared why our students became doctors in India and how they differed from their compatriots in Western countries.

Aims:
Was the motivation to become a doctor not altruistic but more influenced by financial rewards and social status, and did it change over the years? Was there a difference in the ambitions of those who regretted taking medicine as a career?

Materials

and
Methods: We prepared a questionnaire using Google Forms and sent it through WhatsApp and email to 1000 doctors who had completed their final MBBS examination, including a 1-year compulsory internship, and were working in India as residents, medical officers, consultants in public or private hospitals or running their establishments. The results we received automatically over the Google Forms were analysed.

Results:
Out of 1000 questionnaires sent to doctors all over India, we received 265 responses. ‘Self-interest/passion for the profession, to relieve suffering’, ‘financial security’ and ‘prestige associated with the profession’ were the most common motivating factors. Seventy-one respondents (26.8%) regretted taking medicine as a career, and they were especially those candidates who joined medicine due to their ‘parent’s wishes’ (P = 0.009), ‘as a means to go abroad’ (P = 0.03) and ‘not sure’ (P < 0.001). Out of those who regretted choosing medicine as a career, only eight wanted to change to a non-medical job.

Conclusions:
India, a developing country with the world’s largest population, grapples with healthcare challenges. Medical students, often burdened by family expectations, struggle with intrinsic motivation. To address this, we can implement strategies such as lifestyle adjustments, mentorship improvements and granting more autonomy. In addition, compulsory internships can guide students towards their desired career paths.
Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels
Authors: Amaravathi Eraballi , Ramarao Nagendra Hongasandra , Raghuram Nagarathna , Pradhan Balaram 
Published: July 2024

Objectives:
This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP) in improving quality of life (QOL) and stress levels in patients after 5 years of coronary artery bypass graft (CABG).

Methodology:
Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP), and follow-up was done for 5 years.

Intervention:
In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP) continued conventional cardiac rehabilitation only.

Outcome Measures:
World Health Organization (WHO)-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS), and Hospital Anxiety and Depression Scale (HADS) were assessed before surgery and at the end of the 5th year after CABG. As data were not normally distributed, Mann–Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons.

Results:
At the end of 5 years, mental health (P = 0.05), perceived stress (P = 0.01), and negative affect (NA) (P = 0.05) have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046), environmental health (P = 0.04), perceived stress (P = 0.001), and NA (P = 0.02) in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences.

Conclusion:
Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG.
Comparison of microtensile bond strength of prepared teeth treated with proanthocyanidin, Camellia sinensis – Polyphenols, and metal crowns luted with resin-modified glass ionomer cement: An in vitro study
Authors: Gayathrie B , Krishnan Murugesan , Srinivasan Suganya , Raza Fathima Banu , Muthukumar Balasubramanium 
Published: July 2024

Aim:
The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC).

Setting and Design:
This was an in vitro study.

Materials and Methods:
Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated.

Statistical Analysis:
The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD.

Results:
Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin.

Conclusion:

C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.
An evaluation of antagonist enamel wear opposing full-coverage zirconia crowns versus other ceramics full-coverage crowns and natural enamel – An umbrella review
Authors: Shah Naisargi , Nerkar Harshada , Badwaik Praveen , Ahuja Bhavna , Malu Rahul , Bhanushali Nikhil 
Published: July 2024

Aim:
The aim of this umbrella review was to systematically review the systematic reviews on antagonist enamel wear opposing zirconia crowns compared to other ceramics and natural enamel.

Settings and Design:
This was an umbrella review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Materials and Methods:
An electronic search of PubMed, Cochrane Central, EBSCOhost, and Google Scholar search engines for articles published from January 1, 2013, to January 1, 2023, was conducted using keywords “enamel wear,” “zirconia,” “feldspathic,” “dental ceramics,” and “Y-TZP” to identify systematic reviews on antagonist enamel wear opposing zirconia crowns compared to other ceramics and natural enamel.

Statistical Analysis Used:
Qualitative analysis.

Results:
A total of 86 articles were obtained through electronic search, of which four articles were selected after abstract screening that met the inclusion criteria for evaluating antagonist enamel wear. As compared to feldspathic groups, zirconia had substantially less antagonist wear, while surface polishing exhibited less enamel wear than glazing. Because of the heterogeneity in study design, measurement methods, and outcome variables, a meta-analysis was not possible.

Conclusions:
Over time, the opposing enamel wear caused by polished monolithic zirconia will be either equal to or less than that of natural enamel wear. Polished monolithic zirconia also maintains lower values of enamel wear compared to metal ceramics, feldspathic porcelains, and lithium disilicate.
A comparative evaluation of marginal fit and microleakage of computer-aided design/computer-aided manufacturing-milled zirconia and prefabricated posterior occlusal veneers: An in vitrostudy
Authors: Bhati Vasundhra , Kapoor Vikram , Pasricha Neeta , Raman Shrimant , Sirana Pallavi 
Published: July 2024

Aims:
The aim of this study was to compare the marginal fit of prefabricated occlusal veneers with computer-aided design/computer-aided manufacturing (CAD-CAM)-milled zirconia occlusal veneers in the posterior teeth.

Settings and Design:
Forty extracted human maxillary premolars were divided into two groups of 20 each. Group 1 was prepared to receive prefabricated occlusal veneers, and Group 2 was prepared to receive CAD-CAM-milled zirconia occlusal veneers.

Materials and Methods:
Prefabricated samples (Edelweiss) were selected for Group 1, whereas for Group 2, the tooth preparations were scanned, and occlusal veneers were fabricated using Exocad designing software and milling machine. After luting, both the groups were submerged in dye, sectioned, and evaluated for marginal fit and microleakage under a stereomicroscope using the microscope imaging software and its measurement tool.

Statistical Analysis Used:
Data collected were subjected to statistical analysis using SPSS 27.0. Intragroup and intergroup comparison was done using the Mann–Whitney U test. The Chi-square test was applied to check the depth of penetration of dye based on percentages.

Results:
The marginal gap of zirconia occlusal veneers fabricated with CAD-CAM is higher compared to that of prefabricated occlusal veneers. Similarly, the depth of penetration of dye is higher in CAD-CAM-milled zirconia occlusal veneers than prefabricated occlusal veneers.

Conclusion:
The marginal fit of prefabricated occlusal veneer is better than the marginal fit of zirconia occlusal veneers fabricated with CAD-CAM. Similarly, it can also be concluded that the microleakage of prefabricated occlusal veneer is less compared to the CAD-CAM-milled zirconia occlusal veneers.
Relationship Between Body Mass Index, Occlusion, and Dental Caries among School Children in Riyadh
Authors: Lingam Amara S. , Al Hussein Sara A. , Alghunaim Maha K. , Abdelrahim Rawa Kamal , Koppolu Pradeep , Done Vasanthi , Habib Shaimaa F K , Samran Hagar , Alghawazi Abdulaziz M. 
Published: July 2024

ABSTRACT

Background:
Malocclusion and lifestyle diseases like obesity can lead to poor oral hygiene and food stagnation, resulting in increased caries incidence.

Objectives:
To evaluate the interrelationship of age, body mass index (BMI), occlusion, and dental decay in children aged between 5 and 14.

Methodology:
Our study included 423 school students aged 5-14 visiting dental clinics. Correlation between BMI and DMFT index using Spearman’s correlation coefficient and the association of BMI with gender, age group, and occlusion using the Chi-square test were assessed.

Results:
The study comprised a larger sample of students aged above 10 years (n = 217) and between 6 and 10 years (n = 183), with Angle’s Class I and II malocclusion being predominant. A weak positive correlation was found between BMI and the missing component of the DMFT index, while significant statistical associations were observed between underweight students below 5 years (8.5%) and obesity in those between 6 and 8 years (53.3%) (P < 0.05).

Conclusion:
Dental practitioners must pay attention to the BMI of children and consider diet as a major intervention for dental caries prophylaxis.
A Study on Materials Used and Longevity of Implant-Supported Prostheses
Authors: Perti Sonali , Singh Rashi , Choithani Kishan K. , Duseja Sareen , Mitthra Suresh , Dewan Harisha , Tiwari Rahul 
Published: July 2024

ABSTRACT

Objective:
This retrospective research was directed to investigate the longevity and maintenance requirements of implant-supported prostheses in subjects treated at a tertiary care center.

Methods:
Patient records of individuals who received implant-supported prostheses between January 2018 and December 2020 were retrospectively analyzed. Demographic information, implant type, prosthetic design, and follow-up data were collected. The primary outcomes assessed were prosthetic survival rates and the incidence of complications requiring maintenance interventions. Statistical analysis was performed to identify associations between demographic and clinical variables and the observed outcomes.

Results:
The research included 150 subjects with an average follow-up duration of 3 years. The overall survival rate of implant-supported prostheses was 90%, with 20% requiring maintenance interventions. Common complications included peri-implantitis (10%), prosthetic fracture (6%), and screw loosening (4%). Significant associations were found between smoking status and peri-implantitis (P < 0.05) and between prosthetic design and prosthetic fracture (P < 0.01).

Conclusion:
Implant-supported prostheses demonstrated a high overall longevity rate, with a subset of subjects requiring maintenance interventions due to complications. Peri-implantitis, prosthetic fracture, and screw loosening were the most prevalent complications, emphasizing the importance of tailored patient care and risk stratification.
Laser Surgery versus Non-laser Surgery in Periodontitis: A Comparative Study
Authors: Rao Reema M. , Roy Shovan , Mondal Arnab , Tate Jignesh , Bharath K , Pendyala Siva Kumar , Pandey Pritee , Tiwari Heena D. 
Published: July 2024

ABSTRACT

Objective:
The purpose of this research is to estimate the effectiveness of non-laser surgery and laser surgery in the management of periodontitis.

Methods:
One hundred participants with a chronic periodontitis diagnosis participated in a randomized controlled experiment. Two cohorts of patients were created: Cohort B underwent non-laser surgery and Cohort A underwent laser surgery. Pre- and postoperative assessments were conducted at 3, 6, and 12 months for clinical criteria such as “pocket depth (PD), gingival index (GI), and clinical attachment level (CAL)”.

Results:
There was a noticeable improvement in clinical parameters following both laser and non-laser operations. However, laser surgery showed superior results in terms of decreased PD and raised CAL.

Conclusion:
In conclusion, compared to non-laser surgery, laser surgery seems to be a more successful treatment option for periodontitis. Larger sample sizes and longstanding follow-up are required for future research in order to validate these results and evaluate the longstanding sustainability of the treatment effects.
Flap Versus Flapless Implant Placement in Immediate Functional Loading: A Comparative Study
Authors: Javiya Piyush , Anjan T , Duseja Shilpa , Basavarajaiah Jeevan Matada , Tate Jignesh , Puthenkandathil Rahul , Baig Fawaz Abdul Hamid 
Published: July 2024

ABSTRACT

Background:
Dental implants are now the typical tooth replacement method. Because it speeds up therapy, quick functional loading—attaching prosthetic restorations to implants following surgery—has become popular. Flapless implant implantation reduces surgical stress and expedites recovery.

Methods:
A prospective comparative study of 100 flap and flapless dental implant patients was done. Patient-reported outcomes, implant survival, peri-implant parameters, and surgical complications were assessed. Statistical analysis compared the two groups’ results.

Results:
Both flap and flapless methods exhibited good implant survival and similar peri-implant characteristics. Patients reported equal postoperative comfort and satisfaction in both groups. Surgical complications were similar for flap and flapless surgeries.

Conclusion:
In immediate functional loading, flap and flapless implant insertion are equally effective and safe. Both methods yield dependable implant survival, peri-implant health, patient comfort, and surgical safety. Dental professionals should evaluate patient variables and anatomical aspects while choosing an implant implantation surgery. Implant dentistry needs further study on long-term results and treatment regimens.
Efficiency of Different Approaches in Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Comparative Study
Authors: Abhishek M P , Mouli Sileveru Chandra , Shariff Mudassar Ahmed , Sravani Maryada , Malik Kirti , Dadwal Himani , Anand Rahul 
Published: July 2024

ABSTRACT

Objective:
Current research compared traditional FESS, balloon sinuplasty, and powered instruments for CRS efficiency.

Methods:
A prospective comparison analysis of 150 CRS patients who received FESS. The surgical method divided the patients into three groups: Group A (conventional FESS, n = 50), Group B (balloon sinuplasty, n = 50), and Group C (powered instrumentation, n = 50). Primary outcome measures included symptom alleviation, measured preoperatively and six months postoperatively using the “22-item Sino-Nasal Outcome Test (SNOT-22)”. Preoperative and six-month postoperative “Short Form 36 (SF-36)” Health Surveys assessed postoperative complications and the quality of life.

Results:
Balloon sinuplasty relieved symptoms better than FESS and powered instrumentation. Mean SNOT-22 scores reduced by 62.1% in the balloon sinuplasty group, much higher than the standard FESS and powered instrumentation groups (49.1% and 45.8%, respectively) (P < 0.001). Balloon sinuplasty had fewer postoperative problems than FESS and powered instrumentation, including bleeding, infection, and synechia.

Conclusion:
Balloon sinuplasty treats CRS better than FESS and powered instrumentation and has fewer postoperative sequelae. These data imply that balloon sinuplasty may be a preferred FESS surgical strategy for CRS, but patient-specific characteristics and disease severity must be considered. Current findings need to be confirmed by larger studies with longer follow-up periods to determine the best FESS surgical strategy for CRS.
Long-Term Outcomes of Conservative versus Surgical Management of Dental Caries
Authors: Parmar Digvijaysinh , Alghamdi Nuha , Bellam Swetha , Kaur Jasmine , Panda Abikshyeet , Yedla Rasangnya , Roja Nallamilli Lalitha Sri 
Published: July 2024

ABSTRACT

Introduction:
The management of dental caries presents challenges for oral health professionals, with options including conservative and surgical interventions. However, debate persists regarding the long-term efficacy of these strategies.

Methods:
This retrospective cohort research involved 500 subjects diagnosed with dental caries at the University Dental Clinic between January 1, 2018, and December 31, 2020. Data on demographics, dental history, treatments, and follow-up were collected from patient records. Subjects were categorized into conservative and surgical groups based on treatment received. Outcome measures included tooth survival, caries recurrence, and patient satisfaction.

Results:
The research included 300 subjects, with 60% under conservative management and 40% under surgical management. Demographics were comparable between groups, and both groups showed similar outcomes in tooth survival, caries recurrence, and patient satisfaction. Statistical analysis revealed no significant differences in these outcomes between groups.

Conclusion:
Conservative and surgical management approaches demonstrate comparable long-term outcomes in treating dental caries, emphasizing the importance of personalized treatment decisions. Further research with larger samples and prospective designs is needed to validate these findings and guide evidence-based practice in dental caries management.