bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative evaluation of light cure calcium silicate and resin-modified glass ionomer as indirect pulp capping agent in primary molars: A randomized clinical trial
Authors: Bhatt Roshni A. , Patel Megha C. , Bhatt Rohan , Patel Chhaya , Joshi Kaushal R. , Makwani Disha 
Published: October 2023

Background:
Minimally invasive techniques should be employed to maintain pulp vitality without affecting physiological tooth resorption for pediatric patients. This study aims to evaluate clinical and radiographic success of light cure calcium silicate and resin-modified glass ionomer (RMGI) as indirect pulp-capping agent in primary molars in children between 5 and 9 years.

Materials and Methods:
In this randomized clinical trial study, 40 primary molars with the International Caries Detection and Assessment System criteria 4–6 score were divided randomly into two groups after computerized randomization method. After caries excavation by minimally invasive dentistry principle, affected dentin was lined by either light cure calcium silicate (Group I) or RMGI (Group II) liner followed by composite restoration. Clinical success was determined with the absence of symptoms and bitewing radiographs were taken at baseline, 3, and 6 months' interval to measure increase in dentin increment using ImageJ software. Statistical analysis for intergroup comparison was done using Paired t-test, and Independent t-test was used for intragroup comparison. The level of statistical significance was set at P < 0.05.

Results:
Change in dentin increment seen from baseline to 6 months in Group I was 0.19 mm and in Group II was 0.20 mm (P = 0.924). Intragroup increment was statistically significant during all follow-up intervals for both the groups (Group I – P ≤ 0.001, Group II – P = 0.009). For baseline remaining dentin thickness >1.5 mm, statistically significant increase was observed in the dentin increment at 3 months' interval between both the groups.

Conclusion:
Both TheraCal LC and Vitrebond show acceptable clinical and radiographic results when used in primary molars as indirect pulp treatment agents. Both the liners are equivalent to each other in terms of feasibility and cost-effectiveness but TheraCal LC can be preferred due to better handling and avoiding the manipulation step thereby reducing treatment time.
Evaluation of pain response in children to the SoftClamp™ as an alternative to the metal rubber dam clamp: A randomized clinical trial
Authors: Pottammal Namitha , Rao Ashwin , Natarajan Srikant , Karuna Y. M. , Nayak Anupama P. , Rao Shweta 
Published: October 2023

Background:
The use of a rubber dam is more important than ever in today's COVID-19 era to limit cross infections. In children, the placement of the metal clamp to retain the rubber dam is perceived to be painful and often requiring a local anesthetic injection. This dissuades many clinicians from placing the rubber dam. Hence, this study evaluated the pain response of children to a SoftClamp™ compared to the conventional metal clamp.

Materials and Methods:
This was a randomized controlled, equal allocation ratio, split-mouth clinical trial. Forty-two children aged between 8 and 12 years, having two permanent mandibular molars in need of sealants, were divided into Groups A and B (metal clamp and SoftClamp™, respectively). The pain response was recorded using both an objective and a subjective scale i.e., the Faces Legs Activity Cry Consolability (FLACC) scale and the Wong Baker Faces Pain Rating Scale (WBFPRS). The level of significance was set at 5% (P < 0.05). The pain response recorded from the WBFPRS and the FLACC scale for the metal and the SoftClamp™ were analyzed using the Wilcoxon signed rank test. The difference in pain response between genders and between two age groups (below and above 10 years of age) was analyzed using the Mann–Whitney U-test.

Results:
The children reported mild discomfort to clamp placement in both the scales. The P values for the FLACC and WBFPRS scores comparing the pain response to the metal and SoftClamp™ were 0.311 and 0.149, respectively.

Conclusion:
There was no significant difference in the pain response of children to both the clamps. Good rubber dam application practices in children through the use of behavior guidance and a proper topical anesthesia technique may play a far more important role regardless of the clamp used. But the SoftClamp™, with its more child friendly appearance could be a viable alternative to the metal clamp in children.
Comparison of shear bond strength of rebonded stainless steel brackets with three different enamel surface conditioning methods
Authors: Safarzadeh Saba , Kachuie Marzieh , Birang Reza , Sadeghian Saeid 
Published: October 2023

Background:
During the orthodontic bonding process, the need for repositioning or rebonding of orthodontic brackets on the enamel surface occurs frequently. The aim of this study is to compare the shear bond strength (SBS) in rebonding orthodontic stainless steel brackets with three different methods of enamel surface conditioning methods.

Materials and Methods:
In this in vitro study, 80 human premolars that were extracted for orthodontic purposes were randomly divided into four groups and underwent orthodontic bonding procedure (N = 20). Except for the control group, three other groups underwent debonding and rebonding process in which after removing the remaining adhesive with tungsten-carbide bur, enamel surface conditioned by three different methods including re-etching with phosphoric acid, sandblasting + acid etching, and Erbium-doped Yttrium–Aluminum–Garnet laser. Then, the SBS of the bracket to the enamel surface was compared between different groups. Scanning Electron microscopy images were also obtained from a number of samples. Statistical analysis was performed by Kruskal–Wallis and Mann–Whitney tests.

Results:
The highest SBS was observed in the primary bond (control group) with an average of 29,440 MPa. There was a significant difference between the studied groups (P < 0.001) and only the group that was re-etched with phosphoric acid had no significant difference with the control group (P = 0.708) ∝ =0.05.

Conclusion:
Rebonding of brackets using phosphoric acid for reconditioning of the enamel surface creates bond strength comparable to the primary bond. Other groups had significantly lower SBS than the control group.
Chest CT features in COVID-19 patients
Authors: Taghavi Mohammadreza , Shokri Azar , Niloofar Parastoo , Poorbarat Salar , Mollazadeh Samaneh , Milani Hamed 
Published: October 2023

Objective:
To derive the pooled estimate of chest computed tomography (CT) findings in coronavirus disease 2019 (COVID-19) patients.

Methods:
A comprehensive systematic search was conducted according to the PRISMA checklist from January 2020 to September 2020 in electronic databases including PubMed, Google Scholar, and Scopus based on search terms in title and texts. Original descriptive studies with epidemiological parameters of interest were included into the systematic review and meta-analysis.

Results:
Totally 54 articles comprised of 4 879 patients with a mean age of 49.05 years were eligible for this study. The pooled prevalence for abnormal CT images was 86.0%. Pooled prevalence for ground-glass opacity was 68.0%, 71.0% for bilateral abnormalities, 47.0% for mixed ground-glass opacity and consolidation and 29.0% for consolidation. In addition, 64.0% of lesions were peripheral, and 12.0% were central while 28.0% were both central and peripheral. Furthermore, 61.0% of lower lungs were involved, and 7.0% and 5.0% of the cases presented with pleural effusion and pericardial effusion, respectively. Besides, 11% of the cases showed lymphadenopathy, and 37% had air broncho gram sign. The pooled prevalence of other chest CT findings ranged from 8.0% to 65.0%.

Conclusions:
Chest CT can be used as predictive tools for the detection of COVID-19 disease along with clinical manifestations and the RT-PCR method.
Drug dependence and its risk factors in emergency department patients
Authors: Yavuz Erdal , Turgut Kasim , Gulacti Umut , Lok Ugur , Altunisik Erman 
Published: October 2023

Objective:
To determine the characteristics and risk factors of drug dependence among patients who were administered drugs with addictive potential (DAP) in an emergency department (ED).

Methods:
This retrospective cross-sectional study included patients who were administered DAP 3 or more times in the emergency room between September 1, 2019 and March 1, 2020. The demographic and baseline information were recorded. All the prescibed DAP, the reasons to use these drugs, secondary drug dependence, the department where DAP were first prescribed, types of doctors who preferred to prescribed DAP, and the risk factors for the development of drug dependence were determined.

Results:
A total of 3 000 patients were screened from medical records, and among them, 80 patients developed drug dependence. Drug dependence only developed for tramadol (n=57, 71.3%), diazepam (n=11, 13.8%), and biperiden (n=12, 15.0%). Tramadol was the most frequently prescribed drug (n=57, 71.3%). The most common reason for drug dependence was psychiatric disorders (n=29, 36.3%). Drug dependence developed in renal colic patients due to the administration of tramadol (n=7, 100%). On the contrary, dependence to biperiden were mainly developed in patients with psychiatric complaints (n=12, 41.4%). The rate of secondary drug dependence was 15% (n=12). Of the Biperiden users, 41.7% developed secondary drug dependence on diazepam. Most DAP were first prescribed in the ED (n=52, 65%), and the specialist preferred to prescribe DAP (n=43, 53.8%). For the development of dependence, the presence of renal colic (OR: 3.387, 95% confidence interval (CI): 1.473-7.788, P=0.004) and low back pain (OR: 5.778, 95% CI: 2.779-12.014, P<0.001) were the risk factors.

Conclusions:
Most DAP were first prescribed in the ED compared to other departments, and specialist are preferred to use DAP. Tramadol is the most commonly used drugs caused drug dependence. Psychiatric disorder patients are easier to develope drug dependence. Furthermore, renal colic and low back pain patients needs more attention to avert drug dependence.
Effect of traditional Chinese preparation Xuebijing on inflammatory markers in patients with ventilator-associated pneumonia
Authors: Zhang Hong-wei , Wei Li-you , Wang Ji-xuan , Liu Shu-zheng , Xing Dan , Zhang Rui , Guo Hui , Chen Li-juan , Zhang Jing 
Published: October 2023

Objective:
To observe the effect of Xuebijing, a complex traditional Chinese preparation, on inflammation and prognosis of patients with pneumonia.

Methods:
The patients with ventilator-associated pneumonia in the intensive care unit (ICU) were randomly divided into the control group and the treatment group with 35 cases in each group. Both groups were given routine treatment such as anti-inflammatory drugs, rehydration, expectorant, and nutritional support, while the treatment group was additionally given Xuebijing injection. Serum C-reactive protein (CRP), clinical pulmonary infection score (CPIS), acute physiology, and chronic health score II (APACHE II) were recorded before treatment, the 3rd and 7th day after treatment. The duration of antibiotic use, mechanical ventilation, ICU stay, and mortality during 28 days was recorded.

Results:
There was no significant difference in CRP, CPIS, and APACHE II between the two groups before treatment (P>0.05). The improvement of CRP, CPIS, and APACHE II in the treatment group was better than those in the control group on the 3 and 7 days after treatment, and the differences were statistically significant (P<0.05). The duration of antibiotic use, mechanical ventilation, and ICU stay in the treatment group were less than those in the control group (P<0.05). The 28-day mortality of the treatment group was lower than that of the control group, but the difference was not statistically significant (P>0.05).

Conclusions:
Xuebijing injection can improve the inflammatory indexes of patients with ventilator-associated pneumonia, and can partly improve the prognosis.
Predictors of antenatal health service utilization among left-behind wives of male outmigrants: Evidence from Patna District, India
Authors: Afzal Fahad , Das Arindam 
Published: October 2023

Objective:
To analyze the sociological support system available for left-behind wives of male outmigrants and develop a model that predicts the antenatal care (ANC) services utilization.

Methods:
A cross-sectional survey was conducted in rural regions of the Patna district, India. The sample size (n=328) was estimated using Cochran's formula. Five parameters of the social support system were identified (autonomy, spousal support, family support, social circle support, and government support). The score for each was calculated as a composite score using multiple variables; these served as independent variables. The respondents were categorized as efficient and non-efficient users of ANC service based on established criteria.

Results:
The regression results showed that four out of five social parameters had a significant effect on ANC behavior. Spousal support was the strongest predictor (standardized regression coefficient β=0.57, OR 1.16, 95% CI 1.08-1.79, P=0.007). Government support was found to be the second strongest predictor (β=0.40, OR 1.49, 95% CI 1.04-2.14, P=0.027), followed by family support (β=0.31, OR 1.36, 95% CI 1.23-2.57, P=0.034) and autonomy (β=0.11, OR 1.32, 95% CI 1.11-2.26, P=0.030). The social circle support was found to be non-significant in predicting ANC behavior (P>0.05).

Conclusions:
The policymakers could focus on the identified predictors to strengthen and modify the existing policies for left-behind wives of male outmigrants. The need of the hour is a strategic intervention for behavioral modification of not only the left-behind wives but also their family members along with reinforcement of the existing social-security net. One strategy we suggest is to launch an awareness campaign focusing on husbands (male outmigrants) and family members.
Artificial intelligence in psychiatry, present trends, and challenges: An updated review
Authors: Avula Vijaya Chandra Reddy , Amalakanti Sridhar 
Published: October 2023

Abstract
Artificial intelligence (AI) represents a revolutionary fusion of computer science and human-like problem-solving capabilities. In medicine, AI promises transformative changes, automating medical documentation, streamlining health insurance processes, and enhancing medical image analysis. The rising prevalence of mental illness across the world underscores the need for AI in psychiatry, where innovative approaches, such as speech analysis and real-time mental health assessments, are emerging. However, challenges loom. AI’s performance in radiology remains inconsistent. Biased training data, workflow disruptions, and a lack of validation standards pose hurdles. Speech recognition systems suffer from word errors, impacting clinical notes’ accuracy. The black-box nature of AI algorithms and their opacity in clinical settings require attention, particularly in safeguarding patient safety. Establishing guidelines for responsible AI use in mental health, addressing confidentiality, and handling critical situations is crucial. In conclusion, while AI holds immense promise in revolutionizing psychiatry and medicine, recognizing and addressing its challenges is imperative for its responsible and effective integration into clinical practice.
Knowledge about Rheumatoid Arthritis among Senior Undergraduate Medical Students of a Medical College in South India
Authors: Marwaha Drishti , Kumar N. Ajith , Sreelakshmi Charakkulam Vijay , Priyadarshan Dhevarsh , Surendran Sandeep 
Published: October 2023

Background:
Rheumatoid arthritis (RA) is the most common form of autoimmune inflammatory arthritis with an Indian prevalence of around 0.75%. Nearly 55% of Indians resort to primary health-care centers as their first point of contact. MBBS students must be well equipped to diagnose and treat patients with RA within the community and refer the relevant cases appropriately to higher medical facilities.

Materials and Methods:
A cross-sectional study was conducted assessing the basic knowledge of RA in senior medical undergraduate students in two domains. The first domain included assessment, clinical features, and diagnosis of RA while the second domain included treatment, radiological features, and therapeutics of RA. The total score was summed up for each domain. Self-assessment of knowledge was also inquired. The questionnaire was validated after a pilot study. The analysis was done using SPSS software using Pearson’s Chi-square test for correlation and paired t-test for comparison with basic descriptive statistics.

Results:
A total of 142 students participated, classified by year of study. There were 69% of female respondents. The mean self-assessment value was 4.82 ± 1.944, and the mean score in the questionnaire was 7.27 ± 2.183. The mean score out of 9 for Domain A was 5.09 ± 1.63 and for Domain B out of 4 was 2.17 ± 0.977. Students performed better in Domain B. A significant association was found between final assessment score and year of study (P < 0.01) as well as self-assessment and year of study (P < 0.01).

Conclusion:
Participants had less confidence in themselves as compared to how they performed. Female students performed better. Awareness about Domain B was higher, and senior students performed better.
Reproductive Risk Factors Associated with Female Infertility in Sonepat District of Haryana: A Community Based Cross-Sectional Study
Authors: Kataria Deepika , Rani Babita , Punia Anita , Jha S. K. , Narendran M. , Singh Jagmohan 
Published: October 2023

Background:
Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.

Aims:
The aim of this study was to estimate the prevalence of infertility and its association with reproductive risk factors amongst women of reproductive age group (18–49 years) in district Sonepat, Haryana.

Settings and Design:
This observational community-based cross-sectional study was conducted amongst 444 reproductive age group (18–49 years) women residing in district Sonepat, from August 2021 to May 2022.

Materials and Methods:
A simple random sampling technique was used to select the study subjects. After taking written informed consent, all the participants were interviewed using a pre-designed, pre-tested semi-structured questionnaire for desired information. Statistical Analysis Used: Mean and standard deviation (SD) were calculated for quantitative data. Percentages and proportions were calculated for qualitative data.

Results:
Out of 444 study population, majority of women were fertile (88.7%), while 6.3% of women were secondary infertile and 5% of women were primary infertile. Most women were aged between 30 and 39 years. The difference of occurrence of infertility in relation to genital discharge (P = 0.049), genital ulcer/sores (P ≤ 0.001), groin swelling (P ≤ 0.001), warts (P = 0.015), menstrual cycle duration (P ≤ 0.001) and menstrual flow amount (P = 0.048) was statistically significant. The mean age of menarche for the female with infertility was 14.34 years (standard deviation = 1.40).

Conclusion:
Almost all of the symptoms of sexually transmitted infection/reproductive tract infection were high amongst infertile females. Awareness generation about the preventable risk factors and provision of infertility care services at primary healthcare facilities will be of use in addressing infertility in Sonepat.
Does the flatting of the curve of spee affect the chewing force distribution in the mandible? (3D finite element study)
Authors: Hasan Lamiaa A. , Al Qassar Sarmad S. Salih , Alrawi Mohammad N. , Alhajar Emad H. 
Published: October 2023

OBJECTIVE:
To search the effects of Curve of Spee (COS) flatting on the stresses and displacement on the different mandible landmarks and lower teeth during posterior teeth loading using three-dimensional (3D) finite element analysis.

MATERIALS AND METHODS:
Three-dimensional hemi mandibular model was created from real selected mandible. The lower teeth was aligned originally in a curved form with 2.4 mm depth at the cusp tip of the second premolar. Another replica with flat aligned teeth was formed to confirm the analysis by up righting premolars and molars. A load was applied at mesio-buccal cusp of the lower first molar on both models, and the resultant stresses and displacements on the mandibular landmarks and the lower teeth were tested.

RESULTS:
Von mises over the mandible was higher in flat than in curve model. The highest stress levels were detected at the Mesio-buccal cusp tip of first molar for flat and curved simulation (5053, 3304) Mpa respectively. Mesio-distally, the teeth displacement was higher in curve model than in flat one. The maximum distal displacement, in flat model, was seen in central and lateral incisors. While, in curve model, the maximum distal displacement was grasped within first and second premolars.

CONCLUSIONS:
Flatting the COS magnify the stresses over whole mandible and reduce lower teeth displacement mesio-distally. We speculated that the readjustment of the COS after orthodontic treatment could reduce the stress and displacements on the lower anterior teeth and decrease the lower anterior teeth crowding relapse.
UTILITY OF ULTRASOUND ELASTOGRAPHY IN DIFFERENTIATING BENIGN FROM MALIGNANT THYROID NODULES
Authors: Kulkarni Adway , Maldar Aasim N. , Shingare Awesh , Chauhan Phulrenu H. , Wadhwani Raju 
Published: October 2023

Background:
Ultrasound elastography is an imaging technique used for the evaluation of tissue stiffness by measuring the degree of tissue deformation in response to the application of external force.

Methodology:
In this prospective comparative study, a total of 52 thyroid nodules from 44 euthyroid patients undergoing fine needle aspiration cytology (FNAC) were assessed. Elastography was performed by a single experienced sonologist, wherein the nodules were graded as per elastography scoring (ES), and the strain ratio (SR) for each nodule was computed. Final histopathology findings of the patients undergoing surgery were compared to elastography findings, and measures of diagnostic accuracy to differentiate between benign and malignant nodules were determined.

Results:
Thirty (68.2%) females and 14 (31.8%) males, with a mean age of 45.18±11.23 years, were assessed. Fourteen (31.8%) patients underwent thyroidectomy, and histopathology was reported for 18 (34.6%) nodules. In all, nine (17.3%) nodules were malignant, and 43 (82.7%) nodules were considered benign. ES demonstrated a sensitivity of 88.9%, specificity of 88.3%, PPV of 61.5% and NPV of 97.4% to identify benign thyroid nodules. The mean SR for benign nodules was significantly lower as compared to malignant nodules (2.72±0.62 vs. 4.52±0.75, P<0.0001). The optimal cut-point value for SR to differentiate benign and malignant thyroid nodules was determined to be 3.8, with the sensitivity, specificity, PPV, and NPV being 88.9%, 95.4%, 80%, and 94.6%, respectively. Of the six nodules classified as Bethesda category-III or IV on FNAC, histopathological diagnosis was follicular carcinoma in one nodule (Bethesda category-IV), four were diagnosed with follicular adenoma, and one with colloid goitre. The ES of the nodule with follicular carcinoma was malignant, while amongst the rest, two nodules were classified as benign, and three nodules as malignant. The SR of the follicular carcinoma was 4.3, while the mean strain ratio in remaining nodules was 3.48 (P=0.001).

Conclusion:
Ultrasound elastography has good diagnostic efficacy for the differentiation of benign from malignant thyroid nodules. It can potentially reduce the rates of unnecessary fine needle-aspiration biopsy. However, whether elastography score or strain ratio will be useful in diagnosis of nodules which are indeterminate on FNAC is open to further studies.