bluuebunny/crossref_metadata_2025_split huggingface dataset:
The odds of having obesity in Egyptian children with autism spectrum disorders is higher than stunting compared to healthy developing peers: a national survey
Authors: M. Metwally Ammal , A. Helmy Mona , Aboulghate Ahmed , Abu-Mandil Hassan Naglaa , S. Mahmoud Walaa , S. Ismail Ahmed , M. El Shebini Salwa , H. Ahmed Nihad , B. Mabrok Hoda , H. Mahmoud Maha , A. Elshaarawy Ghada , Elsaied Amal , A. Ashaat Engy , S. ElRifay Amira , Abdelhady Safaa , E. Eldeeb Sherif , M. El-Saied Mostafa , A. El-Masry Sahar , E Hassan Nayera , Y. Badawy Hala , A. Elghareeb Nahed , Abdelrahman Mohamed , M. Alian Khadija 
Published: July 2024

Abstract
Background
The nutritional status and growth of children with Autism spectrum disorders (ASD) is influenced significantly by two factors; food selectivity behaviors due to their consumption of a limited variety of food and the high incidence of gastrointestinal (GIT) disorders.

Aim
This study aimed to assess the nutritional adequacy and growth pattern of ASD children aged three to twelve years compared to their healthy developing peers.

Methods
A national comparative, facility-based cross-sectional study was conducted in eight Egyptian governorates on 285 Egyptian children diagnosed with ASD and 224 children who are their relatives as healthy developing peers. Anthropometric measurements were obtained, including weight, height, head circumference, and mid-upper arm circumference. Body Mass Index (BMI) was calculated and all numbers were plotted on WHO growth charts. Assessment of food preferences, and nutrient intake adequacy of children was done using the Food preference questionnaire, and the Dietary Reference Intakes (DRIs) of Egyptian children.

Results
Calorie-dense food and sugar intake were higher among ASD children than their healthy developing peers. ASD children omit some important protein sources such as dairy (COR = 5.2, 95% CI:2.7–9.9), meat, and poultry (COR = 2.7, 95% CI: 1.6–4.7), and a lower intake of fruits and vegetables than their healthy developing peers. For children with ASD in all age groups, a deficiency in the range of 50–60% was detected for vitamins (C, D, B6, thiamine, riboflavin, niacin) and minerals (iron). A deficiency in the range of 60–70% was detected for folate and calcium. A deficiency of vitamin C calcium and iron was also detected for both children with ASD and their healthy developing relatives aged 6 to 12 years. GIT disorders were common among ASD children compared to healthy developing peers (COR = 2.8 to 10.3). Children with ASD had four-fold higher odds of stunting (COR = 4.1, CI: 1.7–10.1), threefold higher odds of being overweight (COR = 3.3, CI: 1.48–7.32), and nearly eleven-fold higher odds of obesity (COR = 11.4, CI: 4.05–32.17) compared to their healthy developing peers.

Conclusion
ASD children are prone to overweight and protein malnutrition. Their intake of fruits and vegetables is inadequate and hence their intake of vitamins and minerals is insufficient, contributing to stunting.
Assessing urban family physician program challenges in Iran: the insurance organizations’ perspective(2021)
Authors: Shams Lida , Mohammadi Fatemeh 
Published: July 2024

Abstract
Background
The Family Physician Programme is a key health reform in Iran that faces significant challenges in urban areas, particularly in Mazandaran and Fars provinces The study aims to critically evaluate the challenges encountered in the Urban Family Physician Program, with a particular focus on the perspectives of insurance organizations.

Methods
A qualitative approach was adopted, involving semi-structured interviews with 22 experts and managers from basic health insurance funds. Snowball sampling facilitated participant selection, and interviews proceeded until saturation. Data analysis utilized content analysis and Atlas-T software, adhering to COREQ criteria.

Results
Implementation problems of the urban family physician program were categorized into ten Categories and 22 Subcategories, including financing, stewardship, human resources, structure, culture, information system, payment, monitoring and control, the function of insurance organizations, and implementation.

Conclusion
The urban family physician program’s implementation challenges, as viewed by health insurance organizations, underscore the necessity for strategic decision-making in financing, payment models, electronic system integration, structural adjustments, comprehensive monitoring, evaluation, cultural considerations, and appropriate devolution to insurance entities.
Teleworking: does it make workers healthier and productive? A cross-sectional study on a Southern European population
Authors: Perelman Julian , Serranheira Florentino , Castanheira Filipa , Raposo João Filipe , Aguiar Pedro , Neves Pedro , Ramos Sara , Dias Sónia , Maia Teresa , Laires Pedro ,   Twork4Health Group
Published: July 2024

Abstract
Background
Teleworking (TW) has recently shifted from a marginal into a common practice. Yet, concerns have been raised regarding potential work-health negative effects, related to the reduced socialization, and extended working hours with computers at home, possibly offset by reduced commuting time or better individual work-life balance. This paper aims at describing the influence of TW on health, well-being, and productivity perceptions, and how this is shaped by TW conditions.

Methods
We collected data from workers of 25 companies that exert their activity in Portugal. Data were completed with a representative sample of workers who regularly participate in surveys (total N = 1,069). We applied an on-line questionnaire from September the 1st 2022 to December the 1st 2022. We performed a simple descriptive analysis of each variable. Then, we analyzed the relationship between TW conditions and self-reported health, and between TW conditions at home and productivity, using logistic regression models.

Results
We observed a high prevalence of self-perceived health worsening (15.9%), mostly among those with poor TW conditions. Most teleworkers enjoyed favorable TW conditions, despite limited company support. Relevant changes were observed in lifestyle factors, towards more smoking (5.5%), alcohol drinking (4.5%), and worse diet (10.1%). Two thirds reported enhanced productivity. A statistically significant relationship was observed between inadequate TW conditions, health deterioration, and lower productivity. A 6.0% point (pp) increased risk of productivity worsening was observed when employees faced at least one inadequate condition at home (no private working place at home, inadequate heating, artificial light, or absence of well-being at home). The risk of health deterioration increased by 12.9 pp when facing at least one of these inadequate conditions, and by 6.3 under hybrid TW, compared to one or two days of TW.

Conclusions
Most teleworkers highlighted a positive perspective about teleworking. Yet, TW conditions are not favorable for all workers, with consequences on health, well-being, and productivity, suggesting that further support is needed for teleworkers to protect their health at home, and reach its maximum benefit.
Supercharged end-to-side anterior interosseous nerve transfer to restore intrinsic function in high ulnar nerve injury: a prospective cohort study
Authors: Abaskhron Mina , Ezzat Mostafa , Boulis Andrew Gamal , Safoury Yasser El 
Published: July 2024

Abstract
Background
High ulnar nerve injuries is known to have unfavorable motor outcomes compared to other peripheral nerve injuries in the upper extremity. Functional muscle recovery after peripheral nerve injury depends on the time to motor end plate reinnervation and the number of motor axons that successfully reach the target muscle. The purpose of this study is to assess the functional recovery, and complications following performing supercharge end-to-side (SETS) anastomosis for proximal ulnar nerve injuries. Our study focuses on the role of SETS in the recovery process of high ulnar nerve injury.

Patient and methods
This study is a prospective, single-arm, open-label, case series. The original proximal nerve pathology was dealt with according to the cause of injury, then SETS was performed distally. The follow-up period was 18 months. We compared the neurological findings before and after the procedure. A new test was used to show the effect of SETS on recovery by performing a Lidocaine proximal ulnar nerve block test.

Results
Recovery of the motor function of the ulnar nerve was evident in 33 (86.8%) patients. The mean time to intrinsic muscle recovery was 6.85 months ± 1.3, only 11.14% of patients restored protective sensation to the palm and finger and 86.8% showed sensory level at the wrist level at the end of the follow-up period. Lidocaine block test was performed on 35 recovered patients and showed no change in intrinsic hand function in 31 patients.

Conclusion
SETS exhibit a remarkable role in the treatment of high ulnar nerve damage. SETS transfer can act as a nerve transfer that can supply intrinsic muscles by its fibers and allows for proximal nerve regeneration. We believe that this technique improves recovery of hand motor function and allows recovery of sensory fibers when combined with treating the proximal lesion.

Trial registration
Approved by Research Ethics Committee of Faculty of Medicine- Cairo University on 01/09/2021 with code number: MD-215–2021.
The effect of antimicrobial peptide-added adhesive resins on shear bond strength and the adhesive remnant index of orthodontic brackets
Authors: Kurt Demirsoy Kevser , Buyuk Suleyman Kutalmış , Kaplan Melek Hilal , Kokbas Umut , Abay Feridun , Ozen Ceyda , Akkaya Alper 
Published: July 2024

Abstract
Objectives
The aim of this study was to evaluate the effect of in-vivo produced Nisin which is an antimicrobial peptide (AMP) added to adhesive resin on shear bond strength (SBS) and the adhesive remnant index (ARI) of orthodontic brackets.

Methods
Bacterial AMP was produced by fermentation and the ideal AMP/Bond concentration and antimicrobial efficacy of the mixture were tested. To evaluate the SBS and ARI scores of AMP-added adhesive resins, 80 maxillary premolar teeth extracted for orthodontic purposes were used and randomly assigned into 2 groups (n = 40). Group 1: Control Group (teeth bonded with standard adhesive resin); Group 2: Experimental Group (teeth bonded with AMP-added adhesive resin). Statistical analysis was performed using the SPSS package program and applying the Mann-Whitney U and Fisher’s exact tests. P < 0.05 was considered as statistically significant.

Results
Nisin synthesized in-vivo from Lactococcus lactis (L. lactis) (ATCC 7962) bacteria was provided to form a homogenous solution at an ideal concentration To find the minimum AMP/Bond mixture ratio that showed maximum antimicrobial activity, AMP and Bond mixtures were tested at various concentration levels between 1/160 and 1/2 (AMP/Bond). As a result, the optimum ratio was determined as 1/40. The antimicrobial efficacy of Nisin-added adhesive resin was tested against Streptococcus mutans (S. mutans) (ATCC 35,688) and Lactobacillus strains (cariogenic microorganisms). AMP formed a 2.7 cm diameter zone alone, while 1/40 AMP-bond mixture formed a 1.2 cm diameter zone. SBS values of the teeth bonded with Nisin added adhesive (17.49 ± 5.31) were significantly higher than the control group (14.54 ± 4.96) (P = 0.004). According to the four point scale, Nisin added adhesive provided a higher ARI score in favour of the adhesive and tooth compared to the control group (ARI = 3, n = 20).

Conclusions
Nisin produced from L. lactis (ATCC 7962) had greater antimicrobial effects after mixing with adhesive bond against cariogenic microorganisms S. mutans (ATCC 35,688) and Lactobacillus strains. Nisin added adhesive increased shear bond strength (SBS) of orthodontic brackets and ARI scores in favor of adhesive & teeth.

Clinical relevance
Clinicians should take into account that using Nisin-added adhesive resin in orthodontic treatments can provide prophylaxis against tooth decay, especially in patients with poor oral hygiene.
Effect of force direction and impaction angulation during dilaceration impacted central incisor traction: a finite element analysis
Authors: Yang Qian , Yang Liu , Li Ning , Sun Kai , Li Liang , Wang Yulan , Han Xiaohang , Wang Tiejun 
Published: July 2024

Abstract
Background
The effects of traction forces at different angles on impacted central incisors(ICI)with varying inverted angles (IA) may be different. The objective of this study was to analyze the biomechanical effects of different force directions (FD) on developmentally inverted ICI with multi-angle variations and to offer insights and guidance for the treatment of inverted ICI.

Methods
Three-dimensional finite element method was employed to simulate clinical scenarios of inverted ICI traction. As such, 0.2 N of force (direction: antero-superior angles of 90°, 100°, 110°, 120°, and 130° relative to the long axis of the inverted ICI crown) was applied to the inverted ICI with inverse angles (IA) of 40°, 30°, 20°, 10° and 0°. Inverted ICI apical displacement and Von Mises stress on periodontal ligament (PDL) and alveolar bone were compared.

Results
IA and FD showed minimal influence on the stress distribution in the PDL, as higher stresses were concentrated in the apical region. The higher stresses in the alveolar bone are focused on the cervical and apical regions of the tooth. In particular, IA exerts a more significant impact on stress distribution in the alveolar bone than FD. The influence of IA on the apical displacement of inverted ICI is larger than that of FD.

Conclusions
To promote the health of the root and periodontal tissues, it is recommended to use an angle of 100°-110° relative to the long axis of the ICI crown when dealing with a large IA (> 20°) developmentally inverted ICI. Conversely, an angle of 110°-120° can be used.
The regulatory effect of TiO2 nanotubes loaded with graphene oxide on macrophage polarization in an inflammatory environment
Authors: Cao Xu , Luo Bin , Mu Yanting , Wang Caiyun , Lu Ran , Yao Yao , Chen Su 
Published: July 2024

Abstract
Background
Excessive inflammation is a major cause of implant failure. The surface morphology, hydrophilicity, and loading of biomaterials are major properties modulating anti-inflammatory macrophage activation. This paper investigates the regulatory effects of modifying the surface of Titanium dioxide nanotubes (TNTs) with graphene oxide (GO) on the polarization of mouse monocyte macrophages (RAW264.7).

Methods
TNT was produced by the anodic oxidation of titanium. GO was subsequently electrodeposited on the TNT to obtain a TNT–GO composite. The samples were characterised through scanning electron microscopy (SEM), Raman spectroscopy, and X-ray diffraction. RAW264.7 cells were separately seeded onto the surface of three groups of samples: pure Ti, TNT, and TNT–GO. Under the condition of lipopolysaccharide stimulation, the influence of the sample surfaces on the gene expression profiles was investigated through RNA sequence analysis. In addition, cell spreading was observed through SEM, cell adhesion and proliferation were analysed using the CCK8 assay, and the expression of inflammation-related factors was investigated by ELISA and cellular immunofluorescence staining. The production of reactive oxygen species (ROS) in the RAW264.7 cells on the surface of the three groups was detected via immunofluorescence staining.

Results
The CCK8 results indicated that the adhesion and proliferation of the RAW264.7 cells were reduced on the TNT and TNT–GO surfaces. ELISA results revealed significant differences in the pro-inflammatory factors tumour necrosis factor-α and interleukin-6 secretion among the three groups at 24 h (p < 0.05). The secretion of pro-inflammatory factors significantly reduced and the expression of anti-inflammatory factor IL-10 increased on the TNT and TNT–GO surfaces. The RNA sequencing, ELISA, and cell immunofluorescence staining test results suggested that the inflammatory response of M1 polarization was reduced and the M2 polarization of macrophages was induced on the TNT–GO surface, which may be attributed to the reduction in ROS production.

Conclusions
Under lipopolysaccharide stimulation, the inflammatory response of the RAW264.7 cells was reduced and the M2 polarization of macrophages was promoted on the TNT–GO surface, which may be caused by the reduced ROS production. Consequently, the designed TNT–GO material is promising for implants owing to its excellent inflammation regulation ability.
A nationwide neurosurgical inter-disciplinary service for cancer-related refractory pain
Authors: khashan Morsi , Strauss Ido , Hochberg Yehonathan , Brill Silviu , Tellem Rotem , Sharon Haggai , Hochberg Uri 
Published: July 2024

Abstract
Purpose
Neurosurgical ablative procedures, such as cordotomy and cingulotomy, are often considered irreversible and destructive but can provide an effective and individualized solution for cancer-related refractory pain, when all other approaches have been unsuccessful. This paper provides an in-depth exploration of a novel approach to managing refractory cancer pain. It involves an interdisciplinary team led by a neurosurgeon at a renowned national referral center.

Methods
a retrospective analysis of the medical records of all sequential patients who underwent their initial evaluation at our interdisciplinary refractory cancer pain clinic from February 2017 to January 2023.

Results
A total of 207 patients were examined in the clinic for a first visit during the study period. All patients were referred to the clinic due to severe pain that was deemed refractory by the referring physician. The mean age was 61 ± 12.3 years, with no significant sex difference (P = 0.58). The mean ECOG Performance Status score was 2.35. Conservative measures had not yet been exhausted in 28 patients (14%) and 9 patients were well controlled (4%). Neurosurgical ablative procedures were recommended for 151 (73%) of the patients. Sixty-six patients (32%) eventually underwent the procedure. 91 patients (44%) received a negative recommendation for surgery. Thirty-five patients (17%) were referred for further invasive procedures at the pain clinic.

Conclusion
An Interdisciplinary cooperation between palliative care specialists, pain specialists, and neurosurgeons ensures optimal patient selection and provides safe and effective neurosurgery for the treatment of refractory cancer-related pain.
Mitigating risks in central line-associated bloodstream infection: a comprehensive insight into critical care nurses’ knowledge, attitudes, barriers, and compliance
Authors: Alqalah Talal Ali Hussein 
Published: July 2024

Abstract
Background
Central venous catheter-related bloodstream infections (CLABSIs) are a significant concern in intensive care units (ICUs) as they lead to increased morbidity, mortality, and healthcare costs. Fortunately, these infections are largely preventable through strict adherence to CLABSI prevention guidelines. Nurses play a critical role in preventing CLABSIs.

Aim
This study aimed to investigate factors affecting critical care nurses' knowledge, attitudes, and perceived barriers related to implementing CLABSI prevention guidelines, and to predict factors influencing compliance with these guidelines.

Methods
This cross-sectional study was conducted from April to May 30, 2023, with a convenience sample of 470 critical care nurses from ICUs across eight hospitals in Sana’a, Yemen. Data were collected using an observational checklist and self-administered questionnaire. Descriptive statistics, Independent Student’s t-test, one-way ANOVA, Pearson’s correlation coefficient, multiple linear regression, and multilayer perceptron neural networks were performed.

Results
Critical care nurses exhibited low knowledge of CLABSI prevention guidelines, with compliance reaching an acceptable level. Despite the higher perceived barriers, the nurses demonstrated a positive attitude. Nurses with greater knowledge and positive attitudes displayed higher compliance levels. However, perceived barriers were negatively associated with knowledge and compliance. Notably, multilayer neural network analysis identified knowledge and perceived barriers as the strongest predictors of nurses' compliance.

Conclusion
The current findings emphasize the need for multifaceted strategies to implement the CLABSI prevention guidelines. These strategies should address knowledge gaps, support positive attitudes, and address practical barriers faced by nurses to ensure successful implementation of CLABSI prevention.
Studying microbial triglyceride production from corn stover saccharides unveils insights into the galactose metabolism of Ustilago maydis
Authors: Richter Paul , Panchalingam Jathurshan , Miebach Katharina , Schipper Kerstin , Feldbrügge Michael , Mann Marcel 
Published: July 2024

AbstractThe global demand for plant oil has reached unprecedented levels and is relevant in all industrial sectors. Driven by the growing awareness for environmental issues of traditional plant oils and the need for eco-friendly alternatives, microbial oil emerges as a promising product with significant potential. Harnessing the capabilities of oleaginous microorganisms is an innovative approach for achieving sustainable oil production. To increase economic feasibility, it is crucial to explore feedstocks such as agricultural waste streams as renewable resource for microbial bioprocesses. The fungal model Ustilago maydis is one promising organism in the field of microbial triglyceride production. It has the ability to metabolize a wide variety of carbon sources for cell growth and accumulates high amounts of triglycerides intracellularly. In this study we asked whether this large variety of usable carbon sources can also be utilized for triglyceride production, using corn stover saccharides as a showcase.Our experiments revealed metabolization of the major saccharide building blocks present in corn stover, demonstrating the remarkable potential of U. maydis. The microorganism exhibited the capacity to synthesize triglycerides using the saccharides glucose, fructose, sucrose, xylose, arabinose, and galactose as carbon source. Notably, while galactose has been formerly considered as toxic to U. maydis, we found that the fungus can metabolize this saccharide, albeit with an extended lag phase of around 100 hours. We identified two distinct methods to significantly reduce or even prevent this lag phase, challenging previous assumptions and expanding the understanding of U. maydis metabolism.Our findings suggest that the two tested methods can prevent long lag phases on feedstocks with high galactose content and that U. maydis can produce microbial triglycerides very efficiently on many different carbon sources. Looking forward, exploring the metabolic capabilities of U. maydis on additional polymeric components of corn stover and beyond holds promise for innovative applications, marking a significant step toward environmentally sustainable bioprocessing technologies.