bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective evaluation of hematological parameters in preoperative renal cell cancer patients
Authors: Demir Ozden , Demirag Guzin , Aslan Gokhan 
Published: December 2022

Abstract
Background
Of all the genitourinary cancers, renal cell carcinoma (RCC) is still the most common malignancy with high mortality rates. There are still insufficient biomarkers to predict disease prognosis. Systemic inflammation markers play an important role in tumor development and growth. There are studies which show the relationship of fibrinogen and albumin individually with cancer prognosis in many cancers. Fibrinogen/albumin ratio(FAR), on the other hand, has prognostic importance like other inflammation indicators in cancer. Therefore, we investigated whether FAR had a potential value in evaluating the prognosis of patients with nonmetastatic kidney cancer or not.

Methods
A total of 72 patients who had nephrectomy operation at 19 Mayıs University, Faculty of Medicine between January 2019 and January 2021 and who did not have distant metastasis were included in the study. FAR was calculated from the blood taken from the patients before the nephrectomy operation. The cut-off value was found for this FAR by receiver operating characteristic(ROC) curve analysis. The patients were divided into 2 groups as high- and low-FAR according to this cut-off value. Kaplan Meier test was used to evaluate the predictive value of clinicopathological parameters for overall survival (OS). The Log-rank test was used to determine whether there was a relationship between the preoperative FAR and the clinico-pathological data of the patients.

Results
The best cutoff value for the FAR was 0.114. A FAR > 0.114 was associated with higher Fuhrman Grade (FG) (P < 0.0001) and later pathological T stage (P < 0.0001). Patients with a high FAR (> 0.114) had worse OS [Std. Error 2.932, 95% confidence interval (CI): 73.659–85.154, P < 0.0001]. In addition, a positive significant correlation was found between high grade and platelet lymphocyte ratio (p < 0,020). Furthermore, a significant correlation was found between the pathology t stage of the patients and the platelet lymphocyte ratio (p: 0.020).

Conclusions
The preoperative FAR is an independent prognostic factor of OS in renal cancer patients. A FAR > 0.114 was significantly related to decreased survival in renal cancer patients. In addition, the platelet-lymphocyte ratio seems to be related to OS, as well as FAR. Further studies are required on this subject.
Robot-assisted partial nephrectomy: Can retroperitoneal approach suit for renal tumors of all locations?—A large retrospective cohort study
Authors: Lyu Xiangjun , Jia Zhuo , Ao Liyan , Ren Changhao , Wu Yangyang , Xu Yunlai , Chen Ke , Gao Yu , Wang Baojun , Ma Xin , Zhang Xu 
Published: December 2022

Abstract
Background
This study aimed to explore the appropriate location of renal tumors for retroperitoneal approach.

Materials and Methods
We retrospectively analyzed 1040 patients with renal tumor who were treated at our institution from Janurary 2015 to June 2020 and had underwent retroperitoneal robotic assisted-laparoscopic partial nephrectomy (rRAPN). Clinical features and postoperative outcomes were evaluated.

Results
Patients with incomplete data were excluded, and we included 896 patients in total. The median tumor size was 3.0 (range: 0.8–10.0) cm. The median RENAL Nephrometry Score was 7 (range: 4–11), and the median PADUA Nephrometry Score was 8 (range: 6–14). The median surgical time was 120 min, and the median warm ischemia time was 18 min. The median estimated blood loss was 50 ml. The follow-up time was 20.2 (range: 12–69) months. The mean change of eGFR 1 year after operation was 14.6% ± 19.0% compared with preoperative estimated glomerular filtration rate (eGFR). When compared the tumor at different locations, as superior or inferior pole, anterior of posterior face of kidney, there were no significant differences of intra- and post-operative outcomes such as surgical time, warm ischemia time, estimated blood loss, removal time of drainage tube and catheter, postoperative feeding time and hospital stay, and changes of eGFR one year after surgery. We also compared tumors at special locations as endophytic or exophytic, anterior of posterior hilus of kidney, there were no significant differences in surgical time, warm ischemia time, estimated blood loss and changes of eGFR. There was no significant difference in intraoperative features and postoperative outcomes when tumor larger than 4 cm was located at different positions of kidney. Though the surgical time was longer when BMI ≥ 28 (132.6 min vs. 122.5 min, p = 0.004), no significant differences were observed in warm ischemia time, estimated blood loss, changes in eGFR. Twenty-seven patients (3.0%) had tumor progression, including 8 (0.9%) recurrence, 19 (2.1%) metastasis, and 9 (1.0%) death.

Conclusion
Retroperitoneal approach for RAPN has confirmed acceptable intra- and postoperative outcomes and suits for renal tumors of all different locations. Large tumor size and obesity are not contraindications for rRAPN.
Survival analysis of pulpectomy in primary molars performed under dental general anaesthesia: a two-year retrospective study
Authors: Xie Yongting , Wang Yan , Ma Qizhao , Li Jing , Chen Yandi , Yang Ran , Huang Ruijie , Zhang Qiong , Zou Jing 
Published: December 2022

Abstract
Background
To retrospectively investigate the success rate of primary-molar pulpectomy performed under general anaesthesia and the potential risk factors that affect the 24-month success rate.

Methods
The case data and two-year follow-up records of children (aged 3–6 years) who received pulpectomy in primary molars performed under general anaesthesia were reviewed and assessed. Potential risk factors included age, gender, decayed-missing-filled teeth, endodontic diagnosis, tooth location, and postobturation sealing of the pulp chamber floor with MTA. With a two-year follow-up period, the outcomes of all the primary molars were classified into success and failure. Survival analysis was used to assess the outcomes. The Kaplan–Meier method was used to analyse the success rate. Univariate and multivariate Cox proportional hazards regression models were used to evaluate the potential risk factors associated with the overall survival of primary molars.

Results
A total of 410 teeth from 163 children (88 boys and 75 girls) were included in this study. The overall two-year success rate was 66.1% for all primary molars. The mean overall survival time for this study was 22.1 (95% CI, 21.73‒22.48) months. Multivariate Cox regression analysis demonstrated that endodontic diagnosis (irreversible pulpitis or periapical periodontitis), tooth location (maxillary or mandibular primary molar), and postobturation sealing of the pulp chamber floor (MTA or no-MTA) were significant risk factors for overall survival in this study (P < .05). The differences in success rates were not statistically significant in terms of age, gender, and decayed-missing-filled teeth (P > .05).

Conclusions
When compared to teeth diagnosed with irreversible pulpitis, those with periapical periodontitis failed more frequently. Postobturation sealing of the pulp chamber floor with MTA improved the success rate of pulpectomy in primary molars, especially when the inflammation did not spread to the periradicular area.
Health visiting teams and children’s oral health: a scoping review
Authors: El-Yousfi Sarab , Marshman Zoe , Albers Patricia N. , Watt Samantha , Kipping Ruth , Williams Joanna G. 
Published: December 2022

Abstract
Background
Recent policies have recommended early-life interventions to prevent caries. The four nations of the UK each have a national universal children’s health programme, through which health visitors and their wider team (HVTs) promote health in the early years. HVT visits offer an opportunity to support parents to improve their child’s oral health. A scoping review was conducted to provide a descriptive synthesis of the current literature related to the role of HVTs in improving the oral health of children 0–5 years old and to identify significant gaps for future research. This review informed the feasibility study of the First Dental Steps Intervention, a targeted health visitor-led infant oral health intervention in England.

Methods
Electronic database searches for peer-reviewed literature were performed using Medline via Ovid and Web of Science (1946–2021). The quality of included intervention studies was assessed using the Effective Public Health Practice Project tool. Additionally, a grey literature search was conducted (key organisations, bibliographic and thesis databases, forwards and backwards citation, Google).

Results
Thirty-nine publications, published between 1980 and 2021, were included. The majority of included papers were from the UK. The quality of intervention studies (n = 7) ranged from weak to strong. Thematic analysis identified the following themes: (1) professional knowledge, education, and training; (2) involvement of HVs in the delivery of oral health interventions; (3) effectiveness of interventions; (4) perspectives of HVs providing oral health advice and acceptability; and (5) barriers and facilitators to promoting oral health. The grey literature search identified 125 sources. HVT involvement was reported in a variety of source types: reports, guidance documents, evaluations, reviews, and training resources. HVTs were involved in oral health by providing oral health packs, brushing and oral health advice, registration and attendance, oral health training, risk assessment, and referral to dental services.

Conclusion
The current literature suggests that HVTs are well placed to improve children’s oral health. Facilitators and barriers are encountered by HVTs in promoting oral health which should be considered by commissioners. There is a need for future high-quality studies that address the inadequacies found and provide further evidence of the effectiveness of HVT’s oral health interventions.
Assessment of early wound healing, pain intensity, quality of life and related influencing factors during periodontal surgery: a cross-sectional study
Authors: Yuan Hongmei , Liu Qian , Tang Tian , Qin Huan , Zhao Lei , Chen Wen , Guo Shujuan 
Published: December 2022

Abstract
Background
This cross-sectional study assessed early wound healing, pain intensity, quality of life, surgical satisfaction, and related factors during periodontal surgery.

Methods
A total of 369 patients completed the questionnaire before undergoing periodontal surgery (baseline), immediately after the operation (phase I), on the day of suture removal (phase II), and one month later (phase III). The Early Wound Healing Score (EHS) was assessed, and the short-form McGill Pain Questionnaire (SF-MPQ), tooth hypersensitivity visual analog scale (VAS), oral health-related quality of life measure (OHQoL-UK), and surgical satisfaction VAS were administered and analysed.

Results
The EHS was 8.41 ± 2.74 and was influenced by disease severity and surgical factors. Scores on the SF-MPQ, pain intensity scores, and OHQoL-UK scores were significantly increased in phase I and decreased later. Tooth sensitivity decreased significantly one month after periodontal surgery. Psychological factors were positively related to SF-MPQ, pain intensity, OHQoL-UK and tooth sensitivity VAS scores in all phases, while disease severity and surgical factors were only related to these scores at baseline or in phases I/II/III. Surgical acceptance and reoperation willingness continuously decreased after surgery, and all these scores were related to surgical satisfaction.

Conclusions
EHS, pain intensity and quality of life were closely related to disease severity, psychological factors and surgical factors in phase I (i.e., immediately after surgery). The findings suggest that surgical details should be enhanced and that behavioural and psychological interventions measures should be implemented to improve outcomes during periodontal operation and during the early postoperative period as well as to improve patient-oriented periodontal surgery experiences.
Trialregistration This cross-sectional study did not include interventions with human participants, and all the experimental procedures involving humans in this study were approved by the Ethics Committee of West China College of Stomatology, Sichuan University (WCHSIRB-D-2020–284).
Validation of response processes in medical assessment using an explanatory item response model
Authors: Vattanavanit Veerapong , Ngudgratoke Sungworn , Khaninphasut Purimpratch 
Published: December 2022

Abstract
Background
Response process validation is a crucial source of test validity. The expected cognitive load scale was created based on the reflection of the mental effort by which borderline students solve an item defined by experts. The stem length affects the students’ extraneous cognitive load. The purposes of this study were to develop an exam for medical students and corroborate the response process validity by analyzing the correlation between the expected cognitive load, stem length, and the difficulty.

Methods
This was a correlational study. Five medical teachers as the experts and 183 third-year medical students were enrolled from the Faculty of Medicine, Prince of Songkla University, Thailand. The instruments used were a medical physiology exam and a three-level expected cognitive load evaluation form judged by medical teachers. Data were analyzed using an explanatory item response model.

Results
The test consists of 20 items and 21 possible scores. The median score was 8, with a quartile deviation of 1.5. Nine items had long stems (more than two lines). Sixteen items were judged as high (level 2 or 3) expected cognitive load. When adding the expected cognitive load in a Rasch model, the expected cognitive load significantly correlated with item difficulty. In the Rasch model that included both the expected cognitive load and stem length, a long stem had a greater effect on item difficulty than low expected cognitive load. However, the Rasch model showed the best fit.

Conclusions
The long stem had a stronger correlation with test difficulty than expected cognitive load, which indirectly implied response process validity. We suggest incorporating stem length and expected cognitive load to create an appropriate distribution of the difficulty of the entire test.
Geographical variation in compulsory hospitalisation – ethical challenges
Authors: Hofstad Tore , Husum Tonje Lossius , Rugkåsa Jorun , Hofmann Bjørn Morten 
Published: December 2022

Abstract
Background
Compulsory hospitalisation in mental health care restricts patients’ liberty and is experienced as harmful by many. Such hospitalisations continue to be used due to their assumed benefit, despite limited scientific evidence. Observed geographical variation in compulsory hospitalisation raises concern that rates are higher and lower than necessary in some areas.

Methods/discussion
We present a specific normative ethical analysis of how geographical variation in compulsory hospitalisation challenges four core principles of health care ethics. We then consider the theoretical possibility of a “right”, or appropriate, level of compulsory hospitalisation, as a general norm for assessing the moral divergence, i.e., too little, or too much. Finally, we discuss implications of our analysis and how they can inform the future direction of mental health services.
The COVID-19 pandemic’s impact on mental health care use among Norwegian students in higher education: a nation-wide register-based pre-post cohort study
Authors: Grøsland Mari , Larsen Vilde Bergstad , Reneflot Anne , Hart Rannveig Kaldager 
Published: December 2022

Abstract
Background
The COVID-19 pandemic, and its associated social distancing measures, gave profound changes to the everyday and academic life of students in higher education. The current study is the first to use nation-wide data to evaluate the long-term effect of the pandemic and its countermeasures on university students’ mental health care use.

Methods
Using nation-wide individual-level data, we studied mental health consultations in primary care (data available from January 2017 to February 2022) and dispensed prescription drugs used to treat anxiety, depression, and sleep disturbances (data available from October 2018 to February 2021) for first-year undergraduate university students. We compared changes over time in mental health care use in a pandemic cohort (12,501 first-year students enrolled in 2019) to the same change in a pre-pandemic cohort (25,990 first-year students enrolled in 2017 and 2018). Event study and difference-in-difference models allowed us to separate the impact of the pandemic, experienced by the pandemic cohort only, from secular and seasonal changes experienced by all cohorts.

Results
The percentage of students with a mental health consultation temporarily decreased during the first period of strict social distancing measures in March 2020. At the end of the second round with strict measures in April 2021, the level of mental health consultations increased by 73% (95% CI 40–106.3). There was also a 42% (95% CI 5.7–79.5) increase in mental health consultations in November 2021. No similar increases were observed for dispensed prescription drugs between March 2020 and February 2021.

Conclusions
The COVID-19 pandemic was associated with increases in mental health consultations in primary care among students, especially during/after longer periods of strict social distancing measures. The benefits of social distancing measures in future pandemic preparedness should be weighed against the cost of potentially worsening mental health in vulnerable groups.
Modular structures and the delivery of inpatient care in hospitals: a Network Science perspective on healthcare function and dysfunction
Authors: Ben-Tovim David I. , Bajger Mariusz , Bui Viet Duong , Qin Shaowen , Thompson Campbell H. 
Published: December 2022

AbstractBackgroundReinforced by the COVID-19 pandemic, the capacity of health systems to cope with increasing healthcare demands has been an abiding concern of both governments and the public. Health systems are made up from non-identical human and physical components interacting in diverse ways in varying locations. It is challenging to represent the function and dysfunction of such systems in a scientific manner. We describe a Network Science approach to that dilemma.General hospitals with large emergency caseloads are the resource intensive components of health systems. We propose that the care-delivery services in such entities are modular, and that their structure and function can be usefully analysed by contemporary Network Science. We explore that possibility in a study of Australian hospitals during 2019 and 2020.MethodsWe accessed monthly snapshots of whole of hospital administrative patient level data in two general hospitals during 2019 and 2020. We represented the organisations inpatient services as network graphs and explored their graph structural characteristics using the Louvain algorithm and other methods. We related graph topological features to aspects of observable function and dysfunction in the delivery of care.ResultsWe constructed a series of whole of institution bipartite hospital graphs with clinical unit and labelled wards as nodes, and patients treated by units in particular wards as edges. Examples of the graphs are provided. Algorithmic identification of community structures confirmed the modular structure of the graphs. Their functional implications were readily identified by domain experts. Topological graph features could be related to functional and dysfunctional issues such as COVID-19 related service changes and levels of hospital congestion.Discussion and conclusionsContemporary Network Science is one of the fastest growing areas of current scientific and technical advance. Network Science confirms the modular nature of healthcare service structures. It holds considerable promise for understanding function and dysfunction in healthcare systems, and for reconceptualising issues such as hospital capacity in new and interesting ways.
Child abuse knowledge and attitudes among dental and oral health therapists in Aotearoa New Zealand: a cross-sectional study
Authors: Han Heuiwon , Lees Amanda B. , Morse Zac , Koziol-McLain Jane 
Published: December 2022

Abstract
Background
Child abuse and neglect are significant social and health issues in New Zealand. As the government provides free oral care to children and adolescents, oral health practitioners are positioned to respond to child protection concerns. However, research on the knowledge and attitudes of oral health practitioners is limited. This study aimed to understand the knowledge and attitudes of New Zealand dental and oral health therapists in detecting and reporting child abuse and neglect.

Methods
In this descriptive exploratory cross-sectional study, we invited registered New Zealand dental and oral health therapists treating children and adolescents to the anonymous online survey.

Results
Among the 92 dental and oral health therapists, 72% agreed that they could recognise the signs and symptoms of child abuse and neglect. Yet, only 48% agreed they were familiar with the reporting process. During their professional careers, 62% had at least 1 suspected case; and only 21% had ever reported their concerns. Fear of false reporting (70%) was the most significant barrier.

Conclusions
Participants understood child abuse and neglect as significant social issues; however, the knowledge and attitudes to respond were limited. Efforts to enhance the knowledge and attitudes will be necessary to promote child safety and wellbeing.
Job morale of physicians and dentists in Kazakhstan: a qualitative study
Authors: Sabitova Alina , Hickling Lauren M. , Toleubayev Medet , Jovanović Nikolina , Priebe Stefan 
Published: December 2022

Abstract
Background
Job morale is thought to be particularly low in Kazakhstan, adversely affecting job motivation, job satisfaction and burnout rates. Previous research suggests that high job morale has a better effect on patient outcomes and care quality. We, therefore, conducted a qualitative study to explore experiences underpinning positive and negative job morale, and to generate potential strategies for improving job morale of physicians and dentists working in public healthcare settings in Kazakhstan prior to the COVID-19 pandemic.

Methods
Three focus groups containing 23 participants and 30 individual interviews were conducted, evidencing respondents' explanations of what affects job morale, and possible strategies to improve it. Data was synthesised using a thematic analysis.

Results
The themes about what influences job morale were: being unfairly rewarded for work; feeling vulnerable and undervalued; poor working styles and practices; and high internal value-based motivation. Various strategies were identified by participants to improve job morale, and these included: ensuring adequate and equitable financial income; improving the current malpractice system; eliminating poor working styles and practices; and creating a shared responsibility for health.

Conclusions
The current study has found that despite prevailing threats, job morale amongst physicians and dentists working in public healthcare settings in Astana have been prevented from becoming negative by their strong sense of calling to medicine and the satisfaction of helping patients recover. Emphasising this rather traditional understanding of the role of physicians and dentists may be a way to improve job morale throughout training and practice.