bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the effectiveness of advanced platelet rich fibrin in treating gingival recession: a systematic review and meta-analysis
Authors: Saleh Wafaa , Abdelhaleem Marwa , Elmeadawy Samah 
Published: November 2024

Abstract
Objectives
The literature lacks comprehensive evidence on the efficacy of advanced platelet rich fibrin(A-PRF) in treating gingival recession. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of A-PRF in the treatment of gingival recession.

Materials and methods
We adhered to the guidelines of PRISMA in searching the following databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus to include all the eligible studies according to the prespecified inclusion and exclusion criteria. We conducted our search up to February 28, 2024. We conducted a meta-analysis of the primary and secondary clinical outcomes to measure the changes from baseline to 6 months after surgery.

Results
Our review included 10 randomized clinical trials in which 146 participants with 457 recession defects were included. We found that combination of A-PRF with various surgical techniques, such as coronally advanced flap (CAF) connective tissue graft (CTG), VISTA, tunneling, and pinhole surgical technique, demonstrated promising outcomes but varied by comparison group. We observed that CTG with CAF showed a higher reduction in recession depth in comparison to A-PRF with CAF. This review indicated no statistical or clinical differences in recession width, width of keratinized gingiva, probing depth, and clinical attachment level between the study and control groups.

Conclusions
Due to the less invasive nature of A-PRF, it provides a better clinical option to improve the outcomes of treating gingival recession. However, more well-designed RCTs with standardized approaches are needed to confirm these results.
Automated pipeline for linear and volumetric assessment of facial swelling after third molar surgery
Authors: Barone Selene , Zaffino Paolo , Salviati Marianna , Destito Michela , Antonelli Alessandro , Bennardo Francesco , Cevidanes Lucia , Spadea Maria Francesca , Giudice Amerigo 
Published: November 2024

Abstract
Background
Extraction of mandibular third molars (M3Ms) is a routine procedure in oral and maxillofacial surgery, often associated with postoperative symptoms like pain, facial swelling, and trismus. This study aimed to introduce a standardized and automated protocol for swelling analysis following M3M surgery, presenting results regarding clinical conditions immediately and one-week after surgery.

Methods
In a prospective study, 35 patients were enrolled (mean age: 24.4 ± 5.8 years) for removal of 54 M3Ms. Facial swelling was evaluated through 3D facial scans before surgery (T0), at three days (T1), and seven days (T2) post-surgery. The open-source software 3DSlicer facilitated automated analysis, including data anonymization, orientation, surface registration, qualitative comparisons, linear measurements, and volumetric quantification. Pairwise superimposition of facial models enabled qualitative, vectorial, and quantitative assessments, comparing initial conditions with swelling development at T1 and T2. Additionally, changes between T1 and T2 were also evaluated. Secondary outcomes encompassed clinical evaluations of pain, trismus (maximum mouth opening), and surgery time. Statistical analysis involved the paired Student t-test to assess longitudinal changes and analysis of variance to evaluate outcome variables concerning difficulty scores. Linear regression models correlated primary outcome variables with secondary study variables (α < 0.05).

Results
Longitudinal analysis demonstrated significant but variable facial swelling, pain, and trismus at T1, followed by improvement at T2 (p < 0.001). Linear and volumetric differences correlated positively with surgery time (p < 0.05). A direct proportionality between linear and volume differences was observed, higher values at T1 correlated with higher values at T2 (p < 0.05).

Conclusions
An innovative digital workflow for precise quantification of postoperative facial changes was implemented, incorporating volumetric measurements that surpass linear assessments. Clinical conditions demonstrated a direct correlation with surgery time, deteriorating immediately and improving one-week after surgery.
Validation of the Hungarian version of the General Oral Health Assessment Index (GOHAI) in clinical and general populations
Authors: Oszlánszky Judit , Mensch Károly , Hermann Péter , Zrubka Zsombor 
Published: November 2024

Abstract
Background
COSMIN (Consensus-based Standards for the selection of health Measurement INstruments) provides a framework for selecting and validating patient-reported outcome measurements (PROMs). This study aims to validate the Hungarian version of the GOHAI and, for the first time, to assess its Standard Error of Measurement (SEM), Smallest Detectable Change (SDC), and Measurement Invariance (MI) across general and clinical populations as well as different age groups, following COSMIN guidelines.

Materials and methods
The translation was performed using a forward-backward process. A mixed sample (n = 306) was recruited in Budapest from May 2023 to February 2024, consisting of the general population (45.1%), recruited from health kiosks and a nursing home, and the clinical population (54.9%), sourced from Semmelweis University’s care units. The sample was further divided into two age groups: 18–64 years old (54.9%) and 65 + years old (45.1%). GOHAI was administered twice to 108 stable participants. For both the additive score (ADD-GOHAI) and simple count (SC-GOHAI), structural validity and measurement invariance by subgroups were assessed via Confirmatory Factor Analysis (CFA). Internal consistency was evaluated using Cronbach’s alpha, and test-retest reliability was measured using the intraclass correlation coefficient (ICC). SEM was calculated using the SEM agreement formula, and SDC using: $$\:SDC=1.96*\sqrt{2}*SEM$$. Convergent and known-group validity were tested against predefined hypotheses for structural validity.

Results
Contrary to a three factor model, a single-factor model showed good fit in all subgroups for both scoring methods, with adequate internal consistency (Cronbach 𝛼: 0.76–0.85). Four of the six hypotheses for convergent validity and all ten hypotheses for known-groups validity supported the predefined criteria. Measurement invariance between clinical and general populations, or by age, was not demonstrated, so GOHAI’s different measurement properties should be considered when comparing subpopulations. Test-retest reliability was adequate (ICC: 0.87–0.96). SDC was ≈5 points using ADD-GOHAI and 2–3 points using SC-GOHAI.

Conclusion
The Hungarian version of GOHAI demonstrates satisfactory psychometric properties across both general and clinical populations, as well as among both younger and older age groups. While the measurement properties of SC-GOHAI may be more stable between populations, ADD-GOHAI seems more suitable for individual follow-up. However, observed changes must be considered in relation to the measurement error associated with GOHAI.
Paramedic perceptions of decision-making when managing mental health-related presentations: a qualitative study
Authors: Emond Kate , Mnatzaganian George , Savic Michael , Lubman Dan I. , Bish Melanie 
Published: November 2024

Abstract
Background
Mental health presentations account for a considerable proportion of paramedic workload; however, the decision-making involved in managing these cases is poorly understood. This study aimed to explore how paramedics perceive their clinical decision-making when managing mental health presentations.

Methods
A qualitative descriptive study design was employed. Overall, 73 paramedics participated in semi structured interviews, and data were analyzed from transcribed interviews in NVivo.

Results
Four themes emerged that reflected participants’ perceptions: the assessment process, experience, the use of documents and standard procedures, and consultation with other healthcare providers. There were conflicting perceptions about the clinical decision-making process, with perception of role having a potential impact. The dual process theory of clinical decision-making, which includes both analytical and intuitive approaches, was evident in the decision-making process.

Conclusion
Incorporating dual process theory into education and training, which highlights the strengths and weaknesses of analytical and intuitive decision-making, may reduce clinical errors made by cognitive bias. To further support clinical decision-making, additional education and training are warranted to promote critical thinking and clarify the scope of practice and roles when attending to mental health-related presentations.
The relation between resident-related factors and care problems in nursing homes: a multi-level analysis
Authors: Bouchmal Suleyman , Goërtz Yvonne M. J. , Hacking Coen , Winkens Bjorn , Aarts Sil 
Published: November 2024

Abstract
Background
Care problems such as decubitus and fall incidents are prevalent in nursing homes. Yet, research regarding explanatory factors on these care problems is scarce. The aim of this study is twofold: (1) to identify the degree to which a diverse set of resident-related factors (e.g., care dependency levels) are associated with the sum of six care problems (pressure ulcers, incontinence, malnutrition, falls, freedom restriction, and pain), and (2) to investigate which resident-related factors are associated with each of these six care problems individually.

Methods
Data were collected (2016–2023) using the International Prevalence Measurements of Care Quality (LPZ). Factors such as age, number of diagnoses, and length of stay were included. While respecting nested data within eight organizations, the associations between thirteen resident-related factors and the six care problems were determined using multilevel analyses.

Results
A total of 3043 residents were included (mean age 81.9; SD: 10.5). The most prevalent care problem was incontinence (n = 1834; 60.3%). Nurse proxy-rated confusion (r = 0.227; p < 0.001) and aggression (r = 0.285; p = 0.001) were associated strongest with the sum of the six care problems; and higher after correcting for the residents’ care dependency levels (respectively r = 0.504; 0.584 — both p < 0.001). Pre-admission risk assessments for pressure ulcers (OR 7.03), malnutrition (OR 3.57), and falls (OR 3.93) were strongest associated with individual care problems such as pressure ulcers, and falls.

Conclusions
This study shows the association between several resident-related factors and care problems such as gender, years since admission, and care dependency level. Factors such as proxy-rated aggression and confusion were strongest associated with the presence of care problems, while pre-admission risk assessments were strongest associated with several individual care problems. The findings underscore the importance of prioritizing early pre-assessments, as they empower care professionals to take into account resident-specific factors and their influence on the emergence of care problems.
Long-term survival of asexual Zymoseptoria tritici spores in the environment
Authors: Kay William T. , O’Neill Paul , Gurr Sarah J. , Fones Helen N. 
Published: November 2024

Abstract
Background
The fungal phytopathogen Zymoseptoria tritici, causal agent of the economically damaging Septoria tritici blotch of wheat, is different from most foliar fungal pathogens in that its germination occurs slowly and apparently randomly after arrival on the leaf surface and is followed by a potentially prolonged period of epiphytic growth and even reproduction, during which no feeding structures are formed by the fungus. Thus, understanding the cues for germination and the mechanisms that underpin survival in low-nutrient environments could provide key new avenues for disease control.

Results
In this work, we examine survival, culturability and virulence of spores following transfer from a high nutrient environment to water. We find that a sub-population of Z. tritici spores can survive and remain virulent for at least 7 weeks in water alone, during which time multicellular structures split to single cells. The fungus relies heavily on stored lipids; however, if cell suspensions in water are dried, the cells survive without lipid utilisation. Changes in gene expression in the first hours after suspension in water reflect adaptation to stress, while longer term starvation (7 days) induces changes particularly in primary metabolism and cytochrome P450 (CYP) gene expression. Importantly, we also found that Z. tritici spores are equally or better able to survive in soil as in water, and that rain-splash occurring 49 days after soil inoculation can transfer cells to wheat seedlings growing in inoculated soil and cause Septoria leaf blotch disease.

Conclusions
Z. tritici blastospores can survive in water or soil for long periods, potentially spanning the intercrop period for UK winter wheat. They rely on internal lipid stores, with no external nutrition, and although a large proportion of spores do not survive for such an extended period, those that do remain as virulent as spores grown on rich media. Thus, Z. tritici has exceptional survival strategies, which are likely to be important in understanding its population genetics and in developing novel routes for Septoria leaf blotch control.
Intestinal fatty acid binding protein is associated with coronary artery disease in long-term type 1 diabetes—the Dialong study
Authors: Narum Marte , Seljeflot Ingebjørg , Bratseth Vibeke , Berg Tore Julsrud , Sveen Kari Anne 
Published: November 2024

Abstract
Background
Individuals with type 1 diabetes are at increased risk of accelerated atherosclerosis, causing coronary artery disease (CAD). The underlying mechanisms remain unclear, but new theories proposed are damage of gut mucosa causing leakage and translocation of gut microbiota products into the circulation, leading to inflammatory responses and atherosclerosis. We therefore aimed to study the associations between gut related inflammatory biomarkers and coronary atherosclerosis in individuals with long-term type 1 diabetes.

Methods
In this cross-sectional, controlled study of 102 participants with type 1 diabetes and 63 control subjects, we measured circulating levels of intestinal fatty acid binding protein (I-FABP), soluble cluster of differentiation 14 (sCD14), lipopolysaccharide binding protein (LBP) and interleukin 18 (IL-18) by enzyme-linked immunosorbent assay (ELISA), and further gene expression of CD14 and toll-like receptor 4 (TLR4) by real time PCR in circulating leukocytes and peripheral blood mononuclear cells (PBMCs). The participants had either established coronary heart disease (CHD) or underwent computed tomography coronary angiography (CTCA) to assess for coronary atherosclerosis, including total, calcified and soft/mixed plaque volumes.

Results
In the diabetes group, the levels of I-FABP were significantly higher in participants with established CHD or significant stenosis on CTCA compared to the participants with normal arteries or non-significant stenosis, with median 1.67 ng/ml (interquartile range [IQR] 1.02–2.32) vs. median 1.09 ng/ml (IQR 0.82–1.58), p = 0.003. I-FABP was associated with significant coronary artery stenosis by CTCA (> 50%) or previously established CHD in the adjusted analysis (odds ratio [OR] = 2.32, 95% confidence interval [CI]: 1.09–4.95; p = 0.029). The levels of I-FABP correlated also to total coronary plaque volume (r = 0.22, p < 0.05). This association remained significant after adjusting for age, sex, persistent albuminuria, eGFR, statin treatment, diabetes duration and mean time-weighted variables; HbA1c, LDL-cholesterol and systolic blood pressure (OR = 1.97, 95% CI: 1.28–3.01; p = 0.002).

Conclusions
In this cohort of individuals with long-term type 1 diabetes I-FABP associated significantly with coronary artery stenosis, suggesting a potential role of gut mucosa damage in the process of atherosclerosis in type 1 diabetes.
Arthrospira maxima and biosynthesized zinc oxide nanoparticles as antibacterials against carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii: a review article
Authors: Selim Mohamed I. , El‑banna Tarek , Sonbol Fatma , Elekhnawy Engy 
Published: November 2024

AbstractCarbapenem resistance among bacteria, especially Klebsiella pneumoniae and Acinetobacter baumannii, constitutes a dreadful threat to public health all over the world that requires developing new medications urgently. Carbapenem resistance emerges as a serious problem as this class is used as a last-line option to clear the multidrug-resistant bacteria. Arthrospira maxima (Spirulina) is a well-known cyanobacterium used as a food supplement as it is rich in protein, essential minerals and vitamins and previous studies showed it may have some antimicrobial activity against different organisms. Biosynthesized (green) zinc oxide nanoparticles have been investigated by several researchers as antibacterials because of their safety in health. In this article, previous studies were analyzed to get to a conclusion about their activity as antibacterials.
“They pulled that funding away and we’re not recovering. it’s getting worse”: deaths of despair in post-austerity north east England
Authors: Price Timothy 
Published: November 2024

Abstract
Background
Deaths related to suicide, drug misuse, and alcohol-specific causes, known collectively as “deaths of despair” are of growing interest to researchers in England. Rates of death from these causes are highest in deprived northern communities and are closely tied to the social determinants of health and the policy decisions that have shaped them. The aim of this paper is to explore how stakeholders and community members living in Middlesbrough and South Tyneside, two Northern towns with above average rates of deaths of despair, understood the relationship between austerity policies and rates of deaths from these causes in their areas.

Methods
I conducted interviews and one focus group with a total of 54 stakeholders and community members in Middlesbrough and South Tyneside. Data were analysed using the iterative categorisation technique and the findings were interpreted through thematic analysis.

Results
The findings highlight four primary ways through which austerity exacerbated rates of deaths of despair in Middlesbrough and South Tyneside: reduced access to mental health services, diminished substance abuse treatment capacity, loss of youth services, and the closure of community institutions. Participants linked these cuts to rising social isolation, declining mental health, and increased substance misuse, which collectively deepened geographic inequalities in deaths of despair.

Conclusions
This study underscores the urgent need for reinvestment in local services to reduce inequalities and prevent further unnecessary deaths due to drug, suicide, and alcohol-specific causes. Prioritising the restoration and enhancement of services lost to austerity is critical. Such reinvestment will not only help to alleviate some of the most immediate need but also form a foundation for addressing the wider structural inequalities that perpetuate deaths of despair.
Prevalence of depressive symptoms among children and adolescents in china: a systematic review and meta-analysis
Authors: Zhou Jia , Liu Yiang , Ma Jingyao , Feng Zizhao , Hu Jie , Hu Jia , Dong Bin 
Published: November 2024

Abstract
Background
Depression is a significant health concern among children and adolescents. Previous epidemiological studies on depressive symptoms in this population have yielded inconsistent findings. This study aims to systematically estimate the prevalence of depressive symptoms among Chinese children and adolescents.

Method
A comprehensive literature search was conducted in both English (PubMed, EMBASE) and Chinese (China National Knowledge Infrastructure, WANFANG) databases from their inception until October 15, 2024. This meta-analysis employed a random-effects model to estimate the pooled prevalence of depressive symptoms.

Results
A total of 439 eligible studies, comprising 1,497,524 participants, were included in the analysis. The pooled point prevalence of depressive symptoms among children and adolescents was found to be 26.17% (95% CI 25.00–27.41%), with significant heterogeneity among studies (I2 = 100%, p < 0.001). The most commonly used scales were the SDS and CES-D; the SDS reported a higher prevalence (28.80%, 95% CI 26.88–30.85%) compared to the CES-D (24.50%, 95% CI 22.49–26.68%). There was no clear temporal trend in the prevalence of depressive symptoms over time (r = 0.03, P = 0.74). The highest pooled prevalence was observed in high school students (28.23%, 95% CI 25.58–31.15%), followed by undergraduate students (27.72%, 95% CI 25.79–29.79%) and middle school students (24.15%, 95% CI 21.61–27.00%). Among the provinces, Inner Mongolia exhibited the lowest prevalence (18.43%, 95% CI 11.98–28.36%), while Qinghai and Tibet had the highest rates at 54.19% and 47.50%, respectively, although only two and one study were included for these regions.

Conclusions
The detection rate of depressive symptoms in this study aligns closely with global rates for children and adolescents. High school students exhibit a higher prevalence of depressive symptoms compared to other age groups, highlighting the need for effective interventions targeted at this population. There was no clear temporal trend in the prevalence of depressive symptoms. Additionally, the choice of measurement tool is a critical aspect of epidemiological research; standardizing these measurements is essential for enhancing data comparability across studies.
Trial Registration International Prospective Register of Systematic Reviews: No. CRD42023455604.