bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pattern, frequency and causes of dental extraction among children/adolescents Syrian refugees: an observational study
Authors: Salim Nesreen A , Sawair Faleh A , Meyad Fatima Hafedh , Satterthwaite Julian D , Abukaraky Ashraf , Sartawi Samiha 
Published: February 2022

AbstractBackgroundThe Syrian conflict has had a massive impact on the dental health of refugees. Dental extraction is a good indicator of socioeconomic position and degree of oral hygiene, however there is a scarcity of evidence in the scientific literature that characterizes the reasons for extraction in refugees.Aims and methodsThe current study looked at the extraction causes and related sociodemographic variables of 322 Syrian refugees (46.3% females, 53.7% males) who were treated in a dental clinic in Zaatari camp (Jordan), from September to December 2019. All child Syrian refugees (aged 4–16) visiting the facility were eligible to participate. A validated semi-structured survey was used to collect clinical and sociodemographic data from the research sample. Chi-square test, Independent sample t-test, and ANOVA test were used to examine associations between the different variables. The significance level was set atP < 0.05.ResultsThe total number of teeth extracted was 397: 25 (6.3%) permanent teeth, 371 (93.5%) primary teeth, and one mesiodens (0.2%). Overall, lower teeth were most commonly extracted (56.9%). The most common teeth that required extraction were the lower primary molars, with lower left primary second molars being the most commonly extracted (15.9%). As the level of parental education increased, the mean number of extracted teeth decreased (P = 0.035), additionally, as the frequency of toothbrushing increased extractions due to caries decreased significantly (P = 0.027).ConclusionsDental caries and pulpal diseases were discovered to be the most prevalent causes for primary and permanent tooth extraction, with no difference between males and females. The lower left primary molar was the most commonly afflicted tooth.
A pragmatic randomized controlled trial of a group self-management support program versus treatment-as-usual for anxiety disorders: study protocol
Authors: Roberge Pasquale , Houle Janie , Provost Jean-Rémy , Coulombe Simon , Beaudin Annie , Bower Peter , Lemyre Félix Camirand , Drapeau Martin , Drouin Marc-Simon , Hudon Catherine , Provencher Martin D. , Vasiliadis Helen-Maria 
Published: February 2022

Abstract
Background
The integration of a personal recovery-oriented practice in mental health services is an emerging principle in policy planning. Self-management support (SMS) is an intervention promoting recovery that aims at educating patients on the nature of their mental disorder, improving their strategies to manage their day-to-day symptoms, fostering self-efficacy and empowerment, preventing relapse, and promoting well-being. While SMS is well established for chronic physical conditions, there is a lack of evidence to support the implementation of structured SMS programs for common mental disorders, and particularly for anxiety disorders. This study aims to examine the effectiveness of a group-based self-management support program for anxiety disorders as an add-on to treatment-as-usual in community-based care settings.

Methods/design
We will conduct a multicentre pragmatic randomized controlled trial with a pre-treatment, post-treatment (4-month post-randomization), and follow-ups at 8, 12 and 24-months.

Treatment and control groups
a) group self-management support (10 weekly 2.5-h group web-based sessions with 10–15 patients with two trained facilitators); b) treatment-as-usual. Participants will include adults meeting DSM-5 criteria for Panic Disorder, Agoraphobia, Social Anxiety Disorder, and/or Generalized Anxiety Disorder. The primary outcome measure will be the Beck Anxiety Inventory; secondary outcome measures will comprise self-reported instruments for anxiety and depressive symptoms, recovery, self-management, quality of life, and service utilisation.

Statistical analysis
Data will be analysed based on intention-to-treat with a mixed effects regression model accounting for between and within-subject variations in the effects of the intervention.

Discussion
This study will contribute to the limited knowledge base regarding the effectiveness of structured group self-management support for anxiety disorders. It is expected that changes in patients’ self-management behaviour will lead to better anxiety management and, consequently, to improved patient outcomes.

Trial registration
ClinicalTrials.gov: NCT05124639. Prospectively registered 18 November 2021.
Compliance with COVID-19-preventive behaviours among employees returning to work in the post-epidemic period
Authors: Liu Jie , Tong Yan , Li Shaoqiong , Tian Zhiqiang , He Lu , Zheng Jianzhong 
Published: February 2022

Abstract
Background
The COVID-19 pandemic has underscored the importance of behaviours such as social distancing in controlling pandemics. Currently, the epidemic is under control in China and production has resumed in various industries. This study investigates the behavioural compliance and related factors for COVID-19 prevention among employees returning to the workplace and provide strategic recommendations for improving individual-level preventive behaviour to prevent a new outbreak.

Methods
A cross-sectional study design was used. Data were gathered from returning employees in China using an online questionnaire survey, from March to May, 2020. The questionnaire covered participants’ COVID-19-related knowledge, compliance with recommended preventive behaviours, and levels of depression and anxiety. Univariate and multi-factor methods were used to analyse the data and identify factors influencing behaviour compliance.

Results
Of the 1300 participants completing the full survey, more than half were male (71.92%) and 61% were aged between 31 and 50 years. Six hundred and ninety-eight (53.7%) participants showed high compliance, while 602 (46.3%) showed low compliance. In models adjusted for demographic and socio-economic factors, high education level (odds ratio [OR] = 0.23, 95% confidence interval [CI]: 0.07–0.70), office staff (OR = 0.51, 95% CI: 0.33–0.78), higher knowledge of COVID-19 (OR = 0.74, 95% CI: 0.67–0.81), and quarantining (OR = 0.74, 95% CI: 0.57–0.96) predicted better compliance with preventive behaviours (P <  0.05), while high anxiety levels (OR = 1.55, 95% CI: 1.10–2.18) predicted lower compliance with preventive behaviours (P <  0.05).

Conclusion
For employees returning to work during the post-COVID-19-epidemic period, compliance with recommended preventive behaviours requires improvement. Consequently, comprehensive intervention measures, including the provision of health education and psychological counselling, as well as the continuance of a strict isolation policy, could enhance such compliance.
Association of sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh: a multilevel analysis
Authors: Anam Md Rifat , Akter Shamima , Hossain Fahima , Bonny Sharmin Quazi , Akter Jahanara , Zhang Cherri , Rahman Md. Mizanur , Mian Md. Abul Basher 
Published: February 2022

Abstract
Background
Sleep deprivation is widely recognized as a potential contributor to childhood obesity. However, few studies have addressed this issue in low-income settings. The aim of this study was to determine the association of both sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh.

Methods
A cross-sectional study was conducted in four randomly selected schools in Gazipur, Bangladesh, from May to August 2019. Using a self-administered semi-structured questionnaire, data on sleep duration and sleep quality were collected from 1,044 adolescents between 13 and 17 years of age. The body mass indices of the study participants were evaluated using their objectively-assessed anthropometric measurements (weight and height). Multilevel logistic regression was used for data analysis.

Results
The prevalence of underweight, overweight and obesity in adolescents in this study were 14.9, 18 and 7.1%, respectively. More than 15% of the students reported sleep disturbance and poor sleep quality. After adjusting for confounders, reduced (<7 h/day) total sleep duration (OR=1.73, 95% CI=1.21-2.47), weekend sleep duration (OR=1.46, 95% CI=1.00-2.12), and night sleep duration (OR=1.55, 95% CI=1.06-2.28) were found to be significantly associated with overweight or obesity in Bangladeshi adolescents. Similarly, significant positive associations were evident between short duration of total sleep (OR=0.33, 95% CI=0.20-0.54), weekday sleep (OR=0.55, 95% CI=0.35-0.84), weekend sleep (OR=0.53, 95% CI=0.31-0.89), and night sleep (OR=0.56, 95% CI=0.36-0.87), and underweight in study participants. Adolescents with short sleep duration were found less likely to be underweight and more likely to be overweight/obese.

Conclusions
Study findings denoted short sleep duration to be associated with overweight/obesity and underweight among adolescents of Bangladesh. Adequate sleep may therefore serve as an effective obesity prevention strategy in the growing stages.
Associations between thyroid function and gestational diabetes mellitus in Chinese pregnant women: a retrospective cohort study
Authors: Chen Geng-dong , Gou Xiao-Yan , Pang Ting-ting , Li Peng-sheng , Zhou Zi-xing , Lin Dong-xin , Fan Da-zhi , Guo Xiao-ling , Wang Li-juan , Liu Zheng-ping 
Published: February 2022

Abstract
Background
Thyroid function is known to be closely linked with type 2 diabetes, but data on the association between thyroid function and gestational diabetes mellitus (GDM) are inconsistent.

Methods
A total of 2849 pregnant women were included in this retrospective study. Serum concentrations of thyroid indicators (free tetraiodothyronine, FT4; thyroid-stimulating hormone, TSH; and thyroid peroxidase antibody, TPO Ab) were obtained from a clinical laboratory. The presence of GDM were drawn from medical records. The clinical subtypes of thyroid function (euthyroidism, subclinical hypothyroidism, hyperthyroidism, and isolated hypothyroxinemia) were categorized according to the thresholds of the 2.5th/97.5th and 10th/90th percentiles of TSH and FT4 concentrations. A concentration of > 34 IU/L was defined as indicating TPO Ab-positivity.

Results
Two hundred and thirty-five (8.25%) of the 2849 women were TPO Ab-positive. Higher serum concentrations of FT4 (top vs. bottom tertiles) was found to be negatively associated with the risk of GDM. The corresponding odds (OR) values (top tertile vs. bottom tertile) were 0.71 [95% confidence interval (CI): 0.54, 0.93]. No significant associations were observed between the extremely 2.5th/97.5th or 10th/90th percentiles of FT4 concentration, TSH concentration, thyroid function subtypes (vs. euthyroidism), TPO Ab-positivity (vs. -negativity), and the GDM risk. The corresponding results remained similar when TPO Ab-positive subjects were excluded.

Conclusions
A negative association with the risk of GDM was observed for the highest FT4 concentrations tertile. No significant associations were found between the TSH concentration, thyroid function subtypes, TPO Ab positivity, and the GDM risk.
The impact of the COVID-19 pandemic on the lifestyle and behaviours, mental health and education of students studying healthcare-related courses at a British university
Authors: Gadi Nishita , Saleh Saman , Johnson Jo-Anne , Trinidade Aaron 
Published: February 2022

Abstract
Background
The COVID-19 pandemic has affected most industries, including health education. In this study, we surveyed students studying healthcare-related courses at our university on how their lifestyles and behaviours, mental health and education had been affected by the pandemic.

Methods
Mixed methods cross-sectional study.

Results
Two hundred thirty-three students responded to the questionnaire. Lifestyle and behaviours: 51.5% of the participants changed their diet (n=120); 45.5% (n=106) exercised less; 66.5% (n=155) experienced a change in sleep; 51.1% (n=119) reported a change in appetite. Mental health: 84.2% (n=196) reported worrying too much about different things; 61.9% (n=144) could not stop or control worrying; 71.2% experienced trouble relaxing on several days or more (n=166). At least sometimes, 72.1% (n=168) felt unable to cope with things they had to do; 8.5% (n=20) never, or almost never, felt confident about handling personal problems. Education: 65.7% (n=153) struggled to complete learning outcomes with online delivery; 82% (n=191) worried about practical skills being affected; 60.5% (n=141) worried about the impact of COVID-19 on their future career. Almost half (48.9%, n=114) believed that online teaching should be part of the standard curriculum.

Conclusion
In general, there was a negative impact on behaviours, lifestyle and mental health and virtual education was perceived as necessary in making up for the loss of face to face experiences. Students’ mental health and educational needs have been affected by the current pandemic and healthcare educational facilities must respond to these needs to ensure students continue to receive the support they need.
Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women
Authors: Yang Qian , Þórðardóttir Edda Björk , Hauksdóttir Arna , Aspelund Thor , Jakobsdóttir Jóhanna , Halldorsdottir Thorhildur , Tomasson Gunnar , Rúnarsdóttir Harpa , Danielsdottir Hilda Björk , Bertone-Johnson Elizabeth R. , Sjölander Arvid , Fang Fang , Lu Donghao , Valdimarsdóttir Unnur Anna 
Published: February 2022

Abstract
Background
Childhood abuse and neglect have been associated with premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). However, the associations of other adverse childhood experiences (ACEs) and the cumulative number of ACEs with PMDs remain to be explored.

Methods
To evaluate the associations of the cumulative number and types of ACEs with PMDs, we conducted a cross-sectional analysis with a subsample of menstruating women within the Stress-And-Gene-Analysis (SAGA) cohort, assessed for PMDs and ACEs (N=11,973). The cumulative and individual exposure of 13 types of ACEs was evaluated by a modified ACE-International Questionnaire. A modified version of the Premenstrual Symptom Screening Tool was used to identify probable cases of PMDs, further sub-grouped into PMS and PMDD. Prevalence ratios (PRs) of PMDs in relation to varying ACEs were estimated using Poisson regression.

Results
At a mean age of 34.0 years (standard deviation (SD) 9.1), 3235 (27%) met the criteria of probable PMDs, including 2501 (21%) for PMS and 734 (6%) for PMDD. The number of ACEs was linearly associated with PMDs (fully-adjusted PR 1.12 per ACE, 95% CI 1.11–1.13). Specifically, the PR for PMDs was 2.46 (95% CI 2.21–2.74) for women with 4 or more ACEs compared with women with no ACEs. A stronger association was observed for probable PMDD compared to PMS (p for difference <0.001). The associations between ACEs and PMDs were stronger among women without PTSD, anxiety, or depression, and without childhood deprivation and were stronger among women a lower level of social support (p for interaction<0.001). All types of ACEs were positively associated with PMDs (PRs ranged from 1.11 to 1.51); the associations of sexual abuse, emotional neglect, family violence, mental illness of a household member, and peer and collective violence were independent of other ACEs.

Conclusions
Our findings suggest that childhood adverse experiences are associated with PMDs in a dose-dependent manner. If confirmed by prospective data, our findings support the importance of early intervention for girls exposed to ACEs to minimize risks of PMDs and other morbidities in adulthood.
Independent and combined effects of sleep quality and night sleep duration on health-related quality of life in rural areas: a large-scale cross-sectional study
Authors: Liao Wei , Liu Xiaotian , Kang Ning , Wang Lulu , Zhai Zhihan , Yang Jing , Wu Xueyan , Mei Yongxia , Sang Shengxiang , Wang Chongjian , Li Yuqian 
Published: February 2022

Abstract
Background
The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. This study aimed to explore the independent and combined effects of sleep quality and night sleep duration on HRQoL.

Methods
A total of 21,926 eligible participants from the Henan rural cohort study were selected. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality and night sleep duration. The Tobit regression model, generalized linear model (GLM), and logistic regression model were performed to assess the associations of sleep quality and night sleep duration with HRQoL. The restricted cubic spline was applied to identify the dose–response relationships of sleep quality and night sleep duration with HRQoL.

Results
After multivariable adjustment, the Tobit regression and GLM indicated that the regression coefficients [95% confidence interval (CI)] for poor sleep quality were − 0.124 (− 0.133, − 0.114) and − 6.25 (− 6.71, − 5.78) on utility index and VAS score, respectively. Compared with the reference group (7 h-), participants with short sleep duration (< 6 h) or long sleep duration (≥10 h) reported a lower HRQoL. A U-shape relationship between night sleep duration and HRQoL was observed, along with a J-shape relationship between sleep quality and HRQoL (P for non-linear < 0.001). Furthermore, individuals with longer night sleep duration (≥10 h) and poorer sleep quality were strongly associated with lower HRQoL (utility index [odds ratio (OR) (95% CI)]: 6.626 (3.548, 8.920), VAS score [OR (95% CI)]: 2.962 (1.916, 4.578)).

Conclusion
Poor sleep quality and extreme night sleep duration were independently and combinedly associated with low HRQoL, suggesting that maintaining good sleep quality and appropriate night sleep duration was important.
Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.
The double S technique to achieve aesthetic flat closure after conventional mastectomy
Authors: Steffens Daniel , Kappos Elisabeth A. , Lunger Alexander , Schwab Fabienne D. , Zehnpfennig Lea , Weber Walter Paul , Haug Martin , Heinzelmann-Schwarz Viola , Kurzeder Christian 
Published: February 2022

Abstract
Background
Lateral excess tissue after mastectomy is a frequent problem, which should be included into preoperative planning. Women with lateral tissue abundance are frequently impaired cosmetically and functionally. We suggest a novel oncoplastic mastectomy technique to eliminate the above mentioned.

Methods
Surgical technique
Two small horizontal lines are drawn, one line above and one line below the Nipple Areola Complex. These lines should represent the possible skin excision and allow tight skin closure. Consecutively, two ending points of the incision are planned, one close to the xyphoid area and the other one in the anterior axillary line. These points are then interconnected in an s-shaped manner to form a double s-shaped skin excision.

Results
The double S-shaped technique is an easy reproducible technique which not only allows good access to the lateral side of the mastectomy, but also and mainly the reduction of lateral fat and skin.

Conclusion
The double S mastectomy allows for simultaneous removal of access in the axillary region, eliminating skin, and fat as needed and preventing the lateral dog ear
Design and experimental testing of a force-augmenting exoskeleton for the human hand
Authors: Triolo Emily R. , BuSha Brett F. 
Published: February 2022

Abstract
Background
Many older Americans suffer from long-term upper limb dysfunction, decreased grip strength, and/or a reduced ability to hold objects due to injuries and a variety of age-related illnesses. The objective of this study was to design and build a five-fingered powered assistive exoskeleton for the human hand, and to validate its ability to augment the gripping and pinching efforts of the wearer and assist in performing ADLs.

Methods
The exoskeleton device was designed using CAD software and 3-D printed in ABS. Each finger’s movement efforts were individually monitored by a force sensing resistor at each fingertip, and proportionally augmented via the microcontroller-based control scheme, linear actuators, and rigid exoskeleton structure. The force production of the device and the force augmenting capability were assessed on ten healthy individuals with one 5-digit grasping test, three pinching tests, and two functional tests.

Results
Use of the device significantly decreased the forearm muscle activity necessary to maintain a grasping effort (67%, p < 0.001), the larger of two pinching efforts (30%, p < 0.05), and the palmer pinching effort (67%, p < 0.001); however, no benefit by wearing the device was identified while maintaining a minimal pinching effort or attempting one of the functional tests.

Conclusion
The exoskeleton device allowed subjects to maintain independent control of each digit, and while wearing the exoskeleton, in both the unpowered and powered states, subjects were able to grasp, hold, and move objects such as a water bottle, bag, smartphone, or dry-erase marker.
Daily cannabis use during the novel coronavirus disease (COVID-19) pandemic in Canada: a repeated cross-sectional study from May 2020 to December 2020
Authors: Imtiaz Sameer , Wells Samantha , Rehm Jürgen , Wickens Christine M. , Hamilton Hayley , Nigatu Yeshambel T. , Jankowicz Damian , Elton-Marshall Tara 
Published: February 2022

Abstract
Background
Daily cannabis use is most strongly implicated in the cannabis-attributable burden of disease. In the context of the novel coronavirus disease (COVID-19) pandemic in Canada, we characterized trends in daily cannabis use in the overall sample and various population subgroups, and examined risk characteristics associated with daily cannabis use.

Methods
A cross-sectional design was operationalized using data from six waves of a national, online survey of adults residing in Canada who spoke English (N = 6,021; May-08 2020 to December-01 2020). Trends were characterized using the Cochran-Armitage test and risk characteristics were identified using chi-square test and logistic regression analysis.

Results
Daily cannabis use in the overall sample remained stable (5.34% – 6.10%; p = 0.30). This pattern of findings extended to various population subgroups as well. The odds of daily cannabis use were higher for those who: were males (Odds Ratio; 95% Confidence Interval: 1.46; 1.15 – 1.85), were between 18 – 29 years (2.36; 1.56 – 3.57), 30 – 39 years (2.65; 1.93 – 3.64) or 40–49 years (1.74; 1.19 – 2.54), self-identified as white (1.97; 1.47 – 2.64), had less than college or university completion (1.78; 1.39 – 2.28), engaged in heavy episodic drinking (2.05; 1.62 – 2.61), had a job that increased the risk of contracting COVID-19 (1.38; 1.01 – 1.88), experienced loneliness 5–7 days in the past week (1.86; 1.26 – 2.73) and felt very worried (2.08; 1.21 – 3.58) or somewhat worried (1.83; 1.11 – 3.01) about the pandemic’s impact on their financial situation.

Conclusions
Daily cannabis use did not change in the overall sample or various population subgroups during the pandemic. Pandemic-related risks and impacts were associated with daily cannabis use.