bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precision with semi-precision attachment using CAD/CAM technology for a mandibulectomy patient: A case report
Authors: Thakur Preeti , Cleetus Annie , Huda Irfanul , Anand Santosh , Kadao Mohan 
Published: February 2025

Rehabilitation of mandibular defects post-marginal mandibulectomy presents significant challenges due to altered anatomy, reduced denture-bearing areas, and compromised muscle attachments that affect tongue mobility, speech, and mastication. Traditional implant-supported options may be unsuitable for patients with insufficient bone support, necessitating alternative prosthetic approaches to restore function and aesthetics.A 17-year-old male underwent a marginal mandibulectomy for odontogenic keratocyst, resulting in a Cantor and Curtis Type V defect. Examination revealed limited residual dentition and insufficient bone volume for implants. The patient reported difficulties with mastication and speech, requiring a stable, retentive prosthesis that would not exacerbate the altered mandibular anatomy.A removable cast partial denture with semi-precision attachments was fabricated using CAD/CAM technology for accuracy and ease of customization. This approach provided necessary retention, stability, and comfort while accommodating the anatomical limitations. The patient reported significant improvements in mastication, speech, and aesthetics, along with high satisfaction.Semi-precision attachments offer enhanced stability in cases where conventional direct retainers may be insufficient, distributing occlusal loads effectively across limited supporting structures. CAD/CAM technology facilitated precise attachment placement and minimized chairside adjustments, further improving patient comfort and prosthesis function.For patients with mandibular defects unsuitable for implants, a removable prosthesis with semi-precision attachments, designed with CAD/CAM technology, provides a reliable, conservative alternative. This approach achieves satisfactory functional and aesthetic outcomes, demonstrating the value of modern digital design and attachment-retained prostheses in complex rehabilitative cases.
A novel technique to stabilize the bite-block with the rubber dam frame using a connector
Authors: Choudhary Deebah , Gaur Aditi , Rao Ajay Singh , Karande Rutvi 
Published: February 2025

The present article describes a novel technique by which the bite-block can be easily and adequately stabilized with the help of the rubber dam frame which not only eliminates the possibilities of untoward complications but also gives freedom to the operator to work for longer hours without the fear of causing any TMJ-related problems to the patients.Bite-block or mouth prop can be efficiently stabilized with rubber dam isolation.
Detectability of Chiari Malformation and Other Craniovertebral Junction Anomalies Using Computed Tomography
Authors: Mikhailova M. N. , Kostrova O Yu. , Svyatochevskiy P. A. , Merkulova L. M. , Struchko G. Yu. , Pavlov Yu. I. , Semenov A. Yu. 
Published: February 2025

Background. Due to development of new diagnostic technologies, craniovertebral junction anomalies have begun to be detected more frequently. The most clinically significant is the Chiari malformation (CM), or Arnold–Chiari anomaly.Objective: to analyze the incidence of various types of CM, Kimmerle anomaly (KA) and other craniovertebral anomalies, assess its dependence on craniometric parameters according to the protocols of radiological studies and neurosurgical department data for 5 years.Material and methods. The results of computed tomography (CT) and Doppler ultrasound performed in patients of the Republican Clinical Hospital (Chuvash Republic) in 2017–2021 were studied. Craniometry was carried out using CT data, and the incidence of craniovertebral anomalies was assessed depending on skull shape. Discharge reports of patients from the neurosurgical department were analyzed for the same period.Results. According to CT results, detection rate for CM causing hospitalization in the neurosurgical department was 7.6–7.8 cases per year. CM was 1.5–3 times more common in female patients, but in males it manifested at a younger age. The likelihood of this pathology was highest in persons with brachycephalic scull. CM was combined with other anomalies of skull and spine bone structure (platybasia, basilar impression, spina bifida posterior) in 18.4% of observations, and with KA in 31% of cases. Surgical decompression of craniovertebral junction was required in 77% of patients, 2/3 of which had signs of syringomyelia.Conclusion. CM is more often found in female patients, however, its clinical manifestations, which cause hospitalization in neurosurgical department, occur in males at a younger, most able-bodied age. The likelihood of detecting this anomaly is higher in patients with brachycrania. In almost half of CM patients, it may be combined with other craniovertebral junction anomalies, most commonly with KA.
Comparative Effects of Time-Restricted Eating and the Ketogenic Diet on QRISK3-Assessed Cardiovascular Risk in Individuals with Obesity: A Longitudinal Analysis of Metabolic, Anthropometric and Lifestyle Factors
Authors: Pescari Denisa , Mihuta Monica Simina , Bena Andreea , Stoian Dana 
Published: February 2025

Background/Objectives: Obesity is a growing public health issue, particularly among young adults, with long-term dietary strategies still under debate. This study evaluates the impact of the ketogenic diet (KD) and time-restricted eating (TRE) on QRISK3 cardiovascular risk scores over three months in individuals with obesity. Methods: Forty-nine participants were assigned to either a KD (n=23) with a controlled macronutrient composition or TRE (n=26) without specific macronutrient distribution. A certified clinical nutritionist prescribed and monitored the dietary interventions. Anthropometric measurements, body composition analysis, and QRISK3 scores were assessed at baseline and after 12 weeks to evaluate cardiovascular risk modifications. Results: Both interventions significantly reduced BMI (TRE: p &amp;lt; 0.001, KD: p &amp;lt; 0.001), waist circumference (WC) (TRE: p &amp;lt; 0.001, KD: p &amp;lt; 0.001), and waist-to-hip ratio (WHR) (TRE: p &amp;lt; 0.001, KD: p &amp;lt; 0.001). However, the KD led to superior metabolic improvements, including increased HDL-C (p &amp;lt; 0.001) and a lower TC/HDL-C ratio (p &amp;lt; 0.001), while TRE showed no significant HDL-C changes (p = 0.30). Systolic blood pressure improved significantly only in the KD group (p &amp;lt; 0.001). QRISK3 scores declined in both groups (TRE: p = 0.05, KD: p &amp;lt; 0.001), with a greater reduction in KD. Linear regression (adjusted R² = 0.975) identified baseline QRISK (p &amp;lt; 0.001) as the strongest predictor of final QRISK scores, while fasting glucose (p = 0.015) and atrial fibrillation (p = 0.048) were associated with increased cardiovascular risk. Interaction analysis (adjusted R² = 0.495) showed that older participants in the KD group experienced a more pronounced QRISK reduction (p = 0.011); Conclusions: The ketogenic diet proved to be more effective than time-restricted eating in reducing cardiovascular risk, improving lipid profile, and enhancing glycemic control. These findings support KD as a superior dietary intervention for individuals with obesity and metabolic dysfunction.
Pengaruh Kualitas Audit, Prior Opinion, dan Pertumbuhan Perusahaan Terhadap Opini Going Concern
Authors: Primoso Pebrianto  , Ayatulloh Michael Musyaffi  , Tri Hesti Utaminingtyas  
Published: February 2025

This study aims to explore the relationship between going concern audit opinion and audit quality, past opinion, and firm growth. Samples of 24 businesses and 72 sets of data were obtained from mining companies that were listed on the Indonesia Stock Exchange in 2020–2022 over the course of the three-year study period. For data analysis, logistic regression was used with SPSS version 29. The findings demonstrated that going concern opinion is not impacted by audit quality or business progress, but rather is impacted by prior opinion.
Health-Care Costs for Patients with a Lower-Extremity Fracture Have Increased Disproportionately Over the Past 10 Years
Authors: Raats J.H. , Chang Y. , Brameier D.T. , Ponds N. , Weaver M.J. 
Published: February 2025

Background:
Increasing U.S. health-care costs raise concerns regarding the sustainability of the U.S. health-care system, with the potential for negative effects on the mental and physical health of patients. Orthopaedic injuries often impose considerable financial burdens on patients and hospitals, but the trends in, and drivers of, costs remain unclear. This study evaluated the total expenditure and out-of-pocket (OOP) costs of patients with a lower-extremity (LE) fracture in the non-institutionalized U.S. population from 2010 to 2021.

Methods:
A total of 3,016 participants with an LE fracture from the Medical Expenditure Panel Survey (MEPS) were propensity score matched with 15,080 MEPS participants with no LE fracture. Patients with an LE fracture were predominantly between 40 and 64 years old (43.2%), female (66.0%), and White (78.8%). Total expenditure and OOP costs were compared between the groups. A multivariable regression analysis was performed to identify factors that were associated with costs. Outcomes were adjusted on the basis of the 2022 Consumer Price Index.

Results:
Patients with an LE fracture had greater total expenses than the control group ($20,230 [95% confidence interval (CI), $18,916 to $21,543] versus $10,678 [95% CI, $10,302 to $11,053]; p < 0.001) as well as greater OOP costs ($1,634 [95% CI, $1,516 to $1,753] versus $1,089 [95% CI, $1,050 to $1,128]; p < 0.001). Between 2010 and 2021, total expenses increased more for patients with an LE fracture than for the control group (101.2% versus 51.4%; p < 0.001), whereas OOP costs increased to a lesser degree in both groups (61.1% versus 44.5%; p = 0.17). In the LE fracture group, total expenditure was driven by inpatient care, office-based visits, and prescription costs, whereas OOP costs were driven by office-based visits, prescription costs, and “other” sources. Femoral fracture, hospitalization, and certain comorbidities were associated with higher total expenses. Hospitalization, uninsured status, and a higher income level were associated with increased OOP costs, whereas African American or Hispanic background and a lower educational level were associated with lower OOP costs.

Conclusions:
An LE fracture was associated with considerable total expenditure and OOP costs, which increased disproportionately compared with general health-care costs over the past decade. Post-hospitalization care was the biggest driver of both total expenses and OOP costs. Due to limitations inherent to the MEPS database, the impact of financial burden on not only payers but also individuals and their medical decision-making remains unclear and requires further investigation.

Level of Evidence:
Economic Level III. See Instructions for Authors for a complete description of levels of evidence.
Micro-credentials for recognition of workplace learning
Authors: Martinez-Marroquin Elisa , Male Sally 
Published: February 2025

In this provocation paper, we argue that designing micro-credentials for alignment with formal qualifications in terms of volume of learning and learning outcomes may leave employers’ needs unmet and continue the disconnect between employers’ and education providers’ perceptions on graduates’ work-readiness. We encourage the design of micro-credentials for greater recognition and portability of on-the-job learning, be it for credit into formal qualifications or not. We argue also that micro-credentials give an opportunity to better embed workplace informal learning into formal qualifications. This differs and complements previous calls for standardization of micro-credentials in terms of learning outcomes and duration of learning activities. Micro-credentials could be described in terms of other outcomes related to employability rather than traditional learning outcomes and duration of learning activities. The paper refers to the engineering discipline as an illustrative example to demonstrate the need that micro-credentials could address.
Metabolic engineering of Escherichia coli for N-acetyl-leucine production from glucose
Authors: Wang Qiuli , Yang Jin , Guo Wei , Li Yongdong , Pan Hong , Guo Daoyi 
Published: February 2025

Abstract

N-acetyl-L-leucine is recognized as an effective and safe medication for managing vertigo and related symptoms. It has also been shown to have potential therapeutic benefits for GM2 gangliosidoses, Niemann-Pick disease type C, and traumatic brain injuries. Up to now, there has been no documentation on its biological production. In this study, we demonstrated for the first time the development of a N-acetyl-L-leucine biosynthetic pathway in Escherichia coli. Firstly, we verified an N-acetyltransferase capable of efficiently acetylating L-leucine to produce N-acetyl-L-leucine in vivo. Subsequently, we developed a modified E. coli strain capable of synthesizing N-acetyl-L-leucine from glucose. Then, we further increased the production of N-acetyl-L-leucine to 496 mg/L by enhancing the availability of 2-ketoisovalerate precursor. Finally, the titer of N-acetyl-L-leucine reached 1516 mg/L under fed-batch fermentation in shake flasks.
Mapping needles, reducing harm: Findings from a geospatial, community-based needle collection and naloxone training initiative in Saskatchewan, Canada
Authors: Pang Nelson , Varghese Shiny Mary , Reddy Vidya Dhar , Acoose Tashia , Hidlebaugh Erin , Kwan Sandra , Rowe Megan , Medeiros Priscilla , Shuper Paul , Ibáñez-Carrasco Francisco , Grace Daniel , Eaton Andrew 
Published: February 2025

Abstract

Background
The opioid crisis is a major public health issue in Canada, with prairie provinces such as Saskatchewan experiencing particularly high rates of opioid-related harms. Factors contributing to this crisis include an unstable drug supply, limited access to harm reduction services, and structural challenges such as poverty and housing instability. The rise of fentanyl has further exacerbated overdose risks, particularly among people who use drugs. Harm reduction programs, such as opioid overdose education and naloxone distribution, have proven effective in reducing overdose fatalities and improving community health. While geospatial analysis has shown promise in identifying areas of high need for targeted harm reduction interventions, its integration into harm reduction strategies remains underexplored.
Methods
This study utilized data from 44 participants who completed pop-up naloxone training sessions in Regina, Saskatchewan, between August 2023 and September 2024. Additionally, data sources include geospatial information on discarded needles from the ReportNeedles.ca platform and survey responses evaluating opioid overdose and naloxone administration using a modified Opioid Overdose Knowledge Scale. Naloxone training sessions were targeted to areas with a high number of discarded needles determined by the ReportNeedles.ca platform. Geospatial analyses were conducted using ArcGIS to map needle prevalence and assess the accessibility of harm reduction services based on walk-time buffers.
Results
Between August 2023 and August 2024, 315 reports on ReportNeedles.ca led to the disposal of 2,836 needles. Geospatial analysis revealed clustering of discarded needles in Regina's city center, with some seasonal variation. Pop-up training sites expanded the accessibility of naloxone services, with 70% of participants reporting living within a 15-minute walk to pop-up Naloxone trainings. However, geospatial analysis revealed gaps in service accessibility specifically in suburban areas. Participants in pop-up naloxone trainings demonstrated strong knowledge of overdose recognition and naloxone administration.
Conclusions
This study the potential benefit in integrating geospatial analysis with harm reduction interventions to address the opioid crisis. By identifying needle prevalence hotspots and utilizing pop-up naloxone training service providers can improve service accessibility.
Sampling Intensification for Forest Inventories within a specific domain
Authors: Duong Trinh H.K. , Chauvet Guillaume , Bouriaud Olivier 
Published: February 2025

Abstract

National Forest Inventories (NFIs) are large-scale surveys that typically employ low sampling intensity, sufficient for national-level estimations. However, this low sampling intensity can make it difficult to produce reliable estimates for specific domains of interest under a design-based approach due to limited sample sizes.NFIs use models (model-assisted or model-based approaches) for small area estimation to make estimations in the domain of interest with minimal or no sample.However the reduced sample size can also be challenging for fitting models.Increasing the sampling intensity would represent resolve these issues.In this paper, we propose solutions to complement an existing NFI sample in order to improve estimation.We compare several sampling designs of intensification.This intensification poses the issue of integrating two dependent and non-overlapping samples with varying sampling intensities: the regular NFI sample and the intensified sample.We provide estimators of totals and ratios, and associated variance estimators for the domain of interest and the entire territory using a conditional approach.Our results show that intensification reduces the variance for an estimation at the level of both the domain of interest and the whole territory, that the choice of sampling designs considered has a limited impact on the estimation of the outcome.
Acceptability and safety of a probiotic beverage supplementation (Bio-K+) and feasibility of the proposed protocol in children with a diagnosis of autism spectrum disorder
Authors: Gaougaou Ghizlane , Zahra Riham , Morel Sophia , Bélanger Véronique , Knoth Inga Sophia , Cousineau Dominique , D’Arc Baudouin Forgeot , Grzywacz Kelly , Rousseau Guy , Déziel Eric , Godbout Roger , Lippé Sarah , Millette Mathieu , Marcil Valérie 
Published: February 2025

Abstract

Background. Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders defined by stereotyped behavior and challenges in social communication and social interaction. ASD is associated with various comorbidities, including anxiety, gastrointestinal (GI) symptoms and sleep disorders. Evidence supports an association between intestinal dysbiosis and the severity of ASD-related symptoms. Probiotic intake was suggested to restore microbial homeostasis and decrease neurobehavioral, GI and sleep symptoms in individuals diagnosed with autism.
Methods. This study aims to evaluate the acceptability and safety of a Bio-K+ probiotics beverage in autistic children aged 4 to 11 years and the feasibility of the proposed research protocol to measure its impact on behaviors and comorbidities. The 30-week study consisted of daily supplementation with Bio-K+ probiotics for 14 weeks. Acceptability and safety were monitored throughout the study. Feasibility was assessed by comparing recruitment and completion rates to pre-established thresholds. Preliminary impact of supplementation on behaviors (Autism Treatment Evaluation Checklist (ATEC) score), GI symptoms and sleep disorders was evaluated.
Results. Of the 23 children recruited (mean age 6.7 ± 2.2 years, 70% males), 65% had GI problems and 91% had sleep disorders. Probiotic supplementation was accepted by all participants and no product-related adverse event was reported. Feasibility rates exceeded pre-established thresholds for almost all study outcomes including recruitment rate, compliance, electroencephalography, actigraphy and completion of questionnaires. Preliminary data suggest an improvement in behaviors associated with autism assessed with the total ATEC score, and in GI symptoms and sleep disorders.
Conclusion. This study demonstrates probiotic beverage acceptability and safety and protocol feasibility in autistic children. It supports the need for placebo-controlled studies to determine its efficacy.
The Role of Academic Challenge and Support in Promoting Sustainable Student Development in Higher Education
Authors: Zhao Lei , Zhu Ruijie , He Yuqi 
Published: February 2025

Abstract

The reconciliation between the academic challenge students face and the academic support they receive within a university environment has been identified as a significant factor in their sustainable development. This study sought to explore the pathways through which academic support and academic challenge affect the sustainable development of college students in China. Subsequently, a questionnaire survey was conducted on undergraduate learning and development among 1,104 students at a comprehensive, research-oriented, key national university in China, and the data were analysed using the challenge–support theory as a framework. The results indicated that the academic challenges posed by learning strategies and academic expectations positively affected student sustainable development. Academic support was also found to have a positive effect on student sustainable development and mediate the relationship between academic expectations and student sustainable development, as well as between learning strategies and student sustainable development. The study’s results can be used as a practical guide for higher education institutions to promote student sustainable development based on the challenge–support theory.
Fasciitis-panniculitis syndrome with autoantibodies reacting to adipocyte pericellular fibers: A case report
Authors: Uehara Yu , Enya Takuji , Miyazaki Kohei , Hakata Yoshiyuki , Kawahara Sachiyo , Miyazawa Masaaki , Sugimoto Keisuke 
Published: February 2025

Abstract

Background: Fasciitis-panniculitis syndrome (FPS) typically presents with swelling and skin hardening. Its histopathological characteristics include inflammatory cell infiltration and fibrous thickening of the subcutaneous tissue and fascia. Panniculitides in children are rare and only a small number of juvenile FPS cases have been reported. We encountered a case of a 10-year-old boy in which autoantibodies reactive to adipocyte pericellular fibers were detected in relapsing FPS.
Case presentation: The patient developed a high fever and skin swelling with pain and erythema on the right side of his body following an abrasion injury on his right wrist at the age of 5 years, and was suspected of having streptococcal toxic shock-like syndrome, for which he received antimicrobials, immunoglobulin therapy, debridement, and plasma exchange. The same manifestations with similar magnetic resonance imaging (MRI) findings of high signal on short tau inversion recovery showing the spread of inflammation in the fat tissue and fascia was observed twice at the age of 6 years. Serological analyses for conventional autoantibodies, bone marrow aspiration, and whole-exome sequencing examination were non-remarkable. Prednisolone was effective in ameliorating the above putative autoinflammatory syndrome. The patient was admitted at the age of 10 years with similar clinical and MRI findings indicative of recurrence of the same disease. En bloc biopsy from the skin to the fascia showed thickening of collagen fibers, infiltration of inflammatory cells composed mainly of neutrophils and lymphocytes, and necrotizing vasculitis in the fat tissue and fascia. Immunohistochemical staining of the en bloc biopsy sections indicated infiltration of T lymphocytes and macrophages in the perivascular connective tissue and fibrinoid necrosis, supporting the diagnosis of FPS.Induction therapy with prednisolone resulted in a remission. IgG purified from the patient's serum reacted with pericellular basement membranes in the subcutaneous fat tissue by immunohistochemistry. The patient is currently taking famotidine to prevent relapses and is making good progress in his recovery.
Conclusions: Although pathogenic autoantibodies have not been described in FPS, our results suggest that fat-tissue-reactive autoantibodies may be involved in the pathogenesis of FPS.