bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rubric vs. numeric rating scale: agreement among evaluators on endodontic treatments performed by dental students
Authors: Escribano Nuria , Belliard Virginia , Baracco Bruno , Da Silva Dayana , Ceballos Laura , Fuentes M. Victoria 
Published: March 2023

Abstract
Background
Students´ assessment should be carried out in an effective and objective manner, which reduces the possibility of different evaluators giving different scores, thus influencing the qualification obtained and the consistency of education. The aim of the present study was to determine the agreement among four evaluators and compare the overall scores awarded when assessing portfolios of endodontic preclinical treatments performed by dental students by using an analytic rubric and a numeric rating scale.

Methods
A random sample of 42 portfolios performed by fourth-year dental students at preclinical endodontic practices were blindly assessed by four evaluators using two different evaluation methods: an analytic rubric specifically designed and a numeric rating scale. Six categories were analyzed: radiographic assessment, access preparation, shaping procedure, obturation, content of the portfolio, and presentation of the portfolio. The maximum global score was 10 points. The overall scores obtained with both methods from each evaluator were compared by Student’s t, while agreement among evaluators was measured by Intraclass correlation coefficients (ICC). The influence of the difficulty of the endodontic treatment on the evaluators´ scores was analyzed by one-way ANOVA. Statistical tests were performed at a pre-set alpha of 0.05 using Stata 16.

Results
Difficulty of canal treatment did not influence the scores of evaluators, irrespective of the evaluation method used. When the analytic rubric was used, inter-evaluator agreement was substantial for radiographic assessment, access preparation, shaping procedure, obturation, and overall scores. Inter-evaluator agreement ranged from moderate to fair with the numeric rating scale. Mean higher overall scores were achieved when numeric rating scale was used. Presentation and content of the portfolio showed slight and fair agreement, respectively, among evaluators, regardless the evaluation method applied.

Conclusions
Assessment guided by an analytic rubric allowed evaluators to reach higher levels of agreement than those obtained when using a numeric rating scale. However, the rubric negatively affected overall scores.
The impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease
Authors: Lin Ling , Song Qing , Duan Jiaxi , Liu Cong , Cheng Wei , Zhou Aiyuan , Peng Yating , Zhou Zijing , Zeng Yuqin , Chen Yan , Cai Shan , Chen Ping 
Published: March 2023

Abstract
Purpose
Study the impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease (COPD) patients.

Methods
This was a prospective study. Patients with COPD were recruited into the study and followed up for one year. Pittsburgh sleep quality index (PSQI) was collected at baseline. Symptom change was assessed with Minimum clinically important difference (MCID) in COPD Assessment Test (CAT) at 6-month visit, which is an indicator to assess symptom improvement. Exacerbation was recorded during the one-year visit. PSQI score > 5 was defined as poor sleep quality, whereas PSQI score ≤ 5 was defined as good sleep quality. MCID was defined as attaining a CAT decrease ≥ 2.

Results
A total of 461 patients were enrolled for final analysis. Two hundred twenty-eight (49.4%) patients had poor sleep quality. Overall, 224 (48.6%) patients attained MCID at 6-month visit and the incidence of exacerbation during the one-year visit was 39.3%. Fewer patients with impaired sleep quality achieved MCID than patients with good sleep quality. Good sleepers were significantly more likely to attain MCID (OR: 3.112, p < 0.001) than poor sleepers. Fewer poor sleepers in GOLD A and D groups attained MCID with ICS/LABA, and fewer poor sleepers in the GOLD D group attained MCID with ICS/LABA/LAMA than good sleepers. Poor sleep quality was a greater risk factor of future exacerbation in Cox regression analysis. The ROC curves showed that PSQI score had a predictive capacity for future exacerbation. More patients with poor sleep quality experienced future exacerbation in GOLD B and D group with treatment of ICS/LABA/LAMA compared to good sleepers.

Conclusions
COPD patients with impaired sleep quality were less likely to achieve symptom improvement and were at increased risk of future exacerbation compared to patients with good sleep quality. Besides, sleep disturbance may affect the symptom improvement and future exacerbation of patients with different inhaled medication or in different GOLD groups.
Effects of air pollution on restricted activity days: systematic review and meta-analysis
Authors: Orellano Pablo , Reynoso Julieta , Quaranta Nancy 
Published: March 2023

Abstract
Background
The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of these outcomes that can be translated into economic costs is the number of days of restricted activity. The aim of this study was to assess the effect of outdoor exposure to particulate matter with an aerodynamic diameter less than or equal to 10 and 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on restricted activity days.

Methods
Observational epidemiological studies with different study designs were included, and pooled relative risks (RR) with 95% confidence intervals (95%CI) were calculated for an increase of 10 μg/m3 of the pollutant of interest. Random-effects models were chosen because of the environmental differences between the studies. Heterogeneity was estimated using prediction intervals (PI) and I-Squared (I2) values, while risk of bias was assessed using a tool developed by the World Health Organization specifically designed for air pollution studies, and based on different domains. Subgroup and sensitivity analyses were performed where possible. The protocol for this review was registered with PROSPERO (CRD42022339607).

Results
We included 18 articles in the quantitative analysis. Associations between pollutants and restricted activity days in time-series studies of short-term exposures, measured as work-loss days, school-loss days, or both were significant for PM10 (RR: 1.0191; 95%CI: 1.0058–1.0326; 80%PI: 0.9979–1.0408; I2: 71%) and PM2.5 (RR: 1.0166; 95%CI: 1.0050–1.0283; 80%PI: 0.9944–1.0397; I2: 99%), but not for NO2 or O3. Some degree of heterogeneity between studies was observed, but sensitivity analysis showed no differences in the direction of the pooled relative risks when studies with a high risk of bias were excluded. Cross-sectional studies also showed significant associations for PM2.5 and restricted activity days. We could not perform the analysis for long-term exposures because only two studies analysed this type of association.

Conclusion
Restricted activity days and related outcomes were associated with some of the pollutants under evaluation, as shown in studies with different designs. In some cases, we were able to calculate pooled relative risks that can be used for quantitative modelling.
SARS-CoV2 mutations and impact on mortality: observational study in a sub-saharan Africa hospital
Authors: Makulo Jean-Robert , Wumba Roger , Mandina Madone Ndona , Mbala Placide , Aziza Adrienne Amuri , Nlandu Yannick Mayamba , Kabwe Benjanmin , Mangala Donatien , Bepouka Ben Izizag , Odio Jerome Ossam , Longokolo Murielle , Mukenge Eric , Kamwiziku Guyguy , Kingand Eddy Lusamaki , Bashengezi Constantin , Kabanda Gilbert , Longo-Mbenza Benjamin 
Published: March 2023

SummaryBackgroundOne year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves.MethodThe present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct < 25 to ensure the chances to generate complete genome sequence. RNA extraction was performed using the Viral RNA Mini Kit (Qiagen). Depending on the platform, we used the iVar bioinformatics or artic environments to generate consensus genomes from the raw sequencing output in FASTQ format.ResultsDuring the study period, the original strain of the virus was no longer circulating. The Delta VOC was predominant from June (92%) until November 2021 (3rd wave). The Omicron VOC, which appeared in December 2021, became largely predominant one month later (96%) corresponding the 4th wave. In-hospital mortality associated with COVID-19 fell during the 2nd wave (7% vs. 21% 1st wave), had risen during the 3rd (16%) wave before falling again during the 4th wave (7%) (p < 0.001).ConclusionThe Delta (during the 3rd wave) and Omicron VOCs (during the 4th wave) were very predominant among patients followed for Covid-19 in our hospital. Contrary to data in the general population, hospital mortality associated with severe and critical forms of COVID-19 had increased during the 3rd wave of the pandemic in Kinshasa.
Epithelioid and spindle rhabdomyosarcoma with TFCP2 rearrangement in abdominal wall: a distinctive entity with poor prognosis
Authors: Li Yuan , Li Dan , Wang Jingyu , Tang Jinlong 
Published: March 2023

AbstractBackgroundEpithelioid and spindle rhabdomyosarcoma (ES-RMS) with TFCP2 rearrangement is a recently discovered rare variant of rhabdomyosarcoma composed of epithelioid and spindle cells, because it shows extraordinarily adverse prognosis and is easily misdiagnosed as other epithelioid or spindle cell tumors.MethodsA rare case of ES-RMS with TFCP2 rearrangement was presented and English literatures in Pubmed online up to 01 July 2022 were gathered by two authors for a systematic review according to the inclusion and exclusion criteria.Case presentation/resultsWe report a case of ES-RMS in an early 30s-years-old female, the neoplastic cells are remarkably immunoreactive with CK(AE1/AE3), and partially with ALK protein. Unexpectedly, the tumor shows TFCP2 rearrangement with coexistence of increased copy numbers of EWSR1 and ROS1 gene and MET gene mutation. Besides, Next-generation sequencing for genetic mutational profiling revealed frequent MET exon14 mutations in chromosome 7, most of which are C > T nonsynonymous SNV, and exon42 of ROS1 in chromosome 6 showed frequent G > T mutation up to 57.54%. In addition, neither MyoD1 mutation nor gene fusions were detected. Moreover, the patient shows high tumor mutational burden (TMB) up to 14.11 counts/Mb. Finally, as many cases of ES-RMS including our case had local progression or metastasis, we find, similar to epithelioid rhabdomyosarcoma (median survival time is 10 month), ES-RMS shows a more aggressive behavior and adverse prognosis (median survival time is 17 month) than spindle cell/sclerosing rhabdomyosarcoma (median survival time is 65 month) according previous studies.ConclusionsES-RMS with TFCP2 rearrangement is a rare malignant tumor and easily confused with other epithelioid or spindle cell tumors, it may harbor additional gene alteration in addition to TFCP2 rearrangement, such as MET mutation, increased copy numbers of EWSR1 and ROS1 gene, high TMB. Most importantly, it may show very poor outcome with extensive metastasis.
Challenges and opportunities for implementation and dissemination of a task- sharing counselling intervention for depression at primary health care level in South Africa
Authors: Selohilwe One , Fairall Lara , Bhana Arvin , Kathree Tasneem , Zani Babalwa , Folb Naomi , Lund Crick , Thornicroft Graham , Petersen Inge 
Published: March 2023

Abstract
Background
The treatment gap for mental health services is a growing public health concern. A lay-counselling service located at primary health care (PHC) level could potentially help to close the large treatment gap for common mental disorders in South Africa. The aim of this study was to understand multilevel factors contributing to implementation and potential dissemination of such a service for depression at PHC level.

Methods
Process qualitative data of the lay-counselling service for patients with depressive symptoms was collected alongside a pragmatic randomized controlled trial evaluating a collaborative care model that included a lay-counselling service for patients with depressive symptoms. Semi-structured key informant interviews (SSI) were conducted with a purposive sample of PHC providers (lay-counsellors, nurse practitioners, operational managers), lay-counsellor supervisors, district and provincial managers, and patients in receipt of services. A total of 86 interviews were conducted. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection as well as Framework Analysis to determine barriers and facilitators for implementation and dissemination of the lay-counselling service.

Results
Facilitators identified include supervision and support available for counsellors; person focused counselling approach; organizational integration of the counsellor within facilities. Barriers included lack of organizational support of the counselling service, including lack of counselling dedicated space; high counsellor turnover, resulting in a counsellor not available all the time; lack of an identified cadre to deliver the intervention in the system; and treatment of mental health conditions including counselling not included within mental health indicators.

Conclusions
Several system level issues need to be addressed to promote integration and dissemination of lay-counselling services within PHC facilities in South Africa. Key system requirements are facility organizational readiness for improvement of integration of lay-counselling services; formal recognition of counselling services provided by lay counsellors as well as inclusion of lay counselling as a treatment modality within mental health treatment data element definitions and the need for diversification of the roles of psychologists to include training and supervision of lay counsellors was also emphasized.
Early introduction of 3D modeling modules promotes the development of simulation skills in downstream biomedical engineering curricula
Authors: Jia Mary S. , Rao Raj R. , Elsaadany Mostafa 
Published: March 2023

Abstract
Background

Recent advancements in additive manufacturing have made 3D design a desirable skill in combating the historically slow development of biomedical products. Due to the broad applicability of additive manufacturing to biomedical engineering, 3D design and 3D printing are attractive educational tools for biomedical engineering students. However, due to the multidisciplinary nature of biomedical engineering, finding a suitable spot in the curriculum to teach students basic and application-based skills for 3D manufacturing is difficult. Furthermore, prior training in fundamental 3D design skills may be needed to support the use of application-based supplementary content.

Results
We designed a SolidWorks Simulations toolkit to complement a sophomore (2nd-year)-level Biomechanics course and distributed this assignment to students with and without prior training in 3D design delivered in an introductory biomedical engineering course. Using short videos, example-based problem solving, and step-by-step tutorials, students completed this as an extra-credit assignment and completed a survey gauging student opinion on SolidWorks and 3D design, confidence in each target skill, and the effectiveness of assignment delivery. The compilation of survey responses suggests that the assignment effectively increased positive responses in student opinion on interest in and likeliness to use SolidWorks in both groups. However, confidence in the target assignment skills was higher in the trained group and fewer problems occurred in operating SolidWorks for trained students. Further, analyzing the distribution of student grades with respect to survey responses suggests that responses had no relationship with initial class grade.

Conclusion
These data collectively indicate that prior training provided to the students had a positive impact on the effectiveness of the assignment although increases in student opinion on the utility of 3D design were observed in both trained and untrained students. Our work has generated and identified a useful educational supplement to enrich existing biomedical engineering course materials with practical skills.
Menstrual characteristics and dysmenorrhea among Palestinian adolescent refugee camp dwellers in the West Bank and Jordan: a cross-sectional study
Authors: Ghandour Rula , Hammoudeh Weeam , Stigum Hein , Giacaman Rita , Fjeld Heidi , Holmboe-Ottesen Gerd 
Published: March 2023

AbstractBackgroundWomen and girls experience menstruation throughout their reproductive years. Normal adolescent menstrual cycles gauge current and future reproductive health. Dysmenorrhea (painful menstruation) is the most prevalent menstrual disturbance in adolescents that can be debilitating. This study examines the menstrual characteristics of adolescent girls living in Palestinian refugee camps in the West Bank of the Israeli-occupied Palestinian territory and Jordan, including estimates of dysmenorrhea levels and associated factors.MethodsA household survey of 15 to 18-year-old adolescent girls was conducted. Trained field workers collected data on general menstrual characteristics and dysmenorrhea level using Working ability, Location, Intensity, Days of pain Dysmenorrhea scale (WaLIDD), in addition to demographic, socio-economic, and health characteristics. The link between dysmenorrhea and other participant characteristics was assessed using a multiple linear regression model. Additionally, data on how adolescent girls cope with their menstrual pain was collected.Results2737 girls participated in the study. Mean age was 16.8 ± 1.1 years. Mean age-at-menarche was 13.1 ± 1.2; mean bleeding duration was 5.3 ± 1.5 days, and mean cycle length was 28.1 ± 6.2 days. Around 6% of participating girls reported heavy menstrual bleeding. High dysmenorrhea levels were reported (96%), with 41% reporting severe symptoms. Higher dysmenorrhea levels were associated with older age, earlier age-at-menarche, longer bleeding durations, heavier menstrual flow, skipping breakfast regularly, and limited physical activity patterns. Eighty nine percent used non-pharmacological approaches to ease menstrual pain and 25% used medications.ConclusionThe study indicates regular menstrual patterns in terms of length, duration, and intensity of bleeding and a slightly higher age-at-menarche than the global average. However, an alarmingly high prevalence of dysmenorrhea among participants was found that tends to vary with different population characteristics, some of which are modifiable and can be targeted for better menstrual health.This research emphasizes the need for integrated efforts to assist adolescents with menstrual challenges such as dysmenorrhea and irregular periods to achieve informed recommendations and effective actions.
Reported health, social support, stress and associations with choline intake in pregnant women in central South Africa: the NuEMI study 2018–2019
Authors: Robb Liska , Jordaan Elizabeth Margaretha , Joubert Gina , Ngounda Jennifer , Walsh Corinna May 
Published: March 2023

Abstract
Background
The health and well-being of pregnant women can influence pregnancy outcomes and are closely associated with social support and experiences of stress. Poor nutrition predisposes to poor health with choline intake affecting pregnancy outcome. This study determined reported health, social support, and stress and how these factors are associated with choline intake in pregnancy.

Methods
A cross sectional study was performed. Pregnant women in their second and third trimesters attending a high-risk antenatal clinic at a regional hospital in Bloemfontein, South Africa, were included. Trained fieldworkers obtained information during structured interviews using standardised questionnaires. Logistic regression with backward selection (p < 0.05) was used to select significant independent factors associated with choline intake. Variables with a p-value < 0.15 in bivariate analysis were considered for inclusion in the model.

Results
Median age and gestation in the sample (N = 682) were 31.8 years and 32.0 weeks, respectively. Most participants (84.7%) consumed less than the adequate intake (AI) of 450 mg of choline per day. Most participants (69.0%) were either overweight or obese. One in eight participants (12.6%) reported not having anyone that could help them in times of need, more than one third (36.0%) reported having unpayable debt and one in twelve (8.4%) reported experiencing physical abuse by their partners. Normotensive participants and those using anti-retroviral therapy (ART) (thus HIV-infected), were more likely to consume choline in amounts below the AI (p = 0.042 and p = 0.011, respectively). Logistic regression analysis showed that the odds of consuming choline in amounts below the AI were lower for participants that were not using ART versus those using ART, with an odds ratio of 0.53.

Conclusion
HIV-infected participants were more likely to consume choline in levels below the AI. This vulnerable group should be the focus of targeted efforts to improve choline intake.
An enhanced random forest approach using CoClust clustering: MIMIC-III and SMS spam collection application
Authors: Ilhan Taskin Zeynep , Yildirak Kasirga , Aladag Cagdas Hakan 
Published: March 2023

AbstractThe random forest algorithm could be enhanced and produce better results with a well-designed and organized feature selection phase. The dependency structure between the variables is considered to be the most important criterion behind selecting the variables to be used in the algorithm during the feature selection phase. As the dependency structure is mostly nonlinear, making use of a tool that considers nonlinearity would be a more beneficial approach. Copula-Based Clustering technique (CoClust) clusters variables with copulas according to nonlinear dependency. We show that it is possible to achieve a remarkable improvement in CPU times and accuracy by adding the CoClust-based feature selection step to the random forest technique. We work with two different large datasets, namely, the MIMIC-III Sepsis Dataset and the SMS Spam Collection Dataset. The first dataset is large in terms of rows referring to individual IDs, while the latter is an example of longer column length data with many variables to be considered. In the proposed approach, first, random forest is employed without adding the CoClust step. Then, random forest is repeated in the clusters obtained with CoClust. The obtained results are compared in terms of CPU time, accuracy and ROC (receiver operating characteristic) curve. CoClust clustering results are compared with K-means and hierarchical clustering techniques. The Random Forest, Gradient Boosting and Logistic Regression results obtained with these clusters and the success of RF and CoClust working together are examined.