bluuebunny/crossref_metadata_2025_split huggingface dataset:
A conservative approach to localize loose implant screw through cemented crown: an in vitro experimental study
Authors: Saeed Kale Masoud Mohammad , Al-Zahawi Abdulsalam Rasheed 
Published: May 2024

Abstract
Background
Retrieval of cement-retained implant-supported restorations is intriguing in cases of screw loosening. Detecting the estimated size of the screw access hole (SAH) could decrease destruction to the prosthesis and preserve the crown.

Objectives
To precisely localize loose implant screws through cemented crowns to reduce crown damage after screw loosening.

Materials and methods
In this in vitro study, 60 cement-retained implants supported 30 zirconia-based, and 30 ceramics fused to metal (CFM) lower molar crowns were invented, and each was subdivided into three subgroups (10 each). In group I (AI/BI) (control), SAH was created with the aid of orthopantomography (OPG). In contrast, in group II (zirconia-crown), SAH was created with the aid of CBCT + 3D printed surgical guide with a 2 mm metal sleeve in subgroups IIA/IIIA and CBCT + MAR was used to develop SAH in subgroups IIB/IIIB. SEM and Micro-CT scanned the SAH openings to determine the diameter of the hole, cracking, chipping, and chipping volume.

Results
Regarding the effect of plane CBCT and CBCT + MAR on prepared crowns, a highly significant association between group I with group II (p = 0.001) and group III (p = 0.002) was detected. Regarding the cracking of SAH, significant differences between the zirconium crown and CFM restoration (p = 0.009) were found, while for the chipping, no significant association was seen between groups (p = 0.19).

Conclusions
CBCT, either as a plane CBCT or with MAR, significantly improved the accuracy of drilling the screw channel and decreased injury to the existing restoration and abutment, aiding in better localization of SAH in loosened implant abutment screws.
Analysis of dentin wear and biological properties promoted by experimental inoffice desensitizing materials
Authors: Silva Ramos Fernanda de Souza , de Castro Oliveira Laryssa , Albertinazzi Larissa , Bezerra Sávio José Cardoso , dos Santos Vanessa Rodrigues , Scaramucci Tais , Duque Cristiane , Ganss Bernhard , Souza Marina Trevelin , Pessan Juliano Pelim , Fagundes Ticiane Cestari 
Published: May 2024

Abstract
Background
This study aimed to evaluate dentin wear and biological performance of desensitizing materials.

Methods
Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn’s, One-way ANOVA and Tukey tests (p ≤ 0.05).

Results
No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments.

Conclusions
Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.
18F-FDG PET/CT findings in nevoid basal cell carcinoma syndrome: a systematic review and a new case report
Authors: Zhang Jing , Zhang Yonghong , Jiang Yumeng , Xu Aodi , Wang Yanli 
Published: May 2024

Abstract
Background
To demonstrate and analyze the 18F-FDG positron emission tomography/computed tomography (PET/CT) findings in this rare nevoid basal cell carcinoma syndrome (NBCCS).

Case presentation
A 71-year-old woman with the left invasive breast cancer was treated with hormone therapy for six months and underwent the 18F-FDG PET/CT examination for efficacy evaluation. 18F-FDG PET/CT revealed the improvement after treatment and other unexpected findings, including multiple nodules on the skin with 18F-FDG uptake, bone expansion of cystic lesions in the bilateral ribs, ectopic calcifications and dilated right ureter. She had no known family history. Then, the patient underwent surgical excision of the all skin nodules and the postoperative pathology were multiple basal cell carcinomas. Finally, the comprehensive diagnosis of NBCCS was made. The patient was still in follow-up. Additionally, we have summarized the reported cases (n = 3) with 18F-FDG PET/CT from the literature.

Conclusions
It is important to recognize this syndrome on 18F-FDG PET/CT because of different diagnoses and therapeutic consequences.
Phytochemical and biological assessment of secondary metabolites isolated from a rhizosphere strain, Sphingomonas sanguinis DM of Datura metel
Authors: Awad Mohamed A. , Hammad Sherif F. , El-Mashtoly Samir F. , El-Deeb Bahig , Soliman Hesham S. M. 
Published: May 2024

AbstractBackgroundThe plant roots excrete a large number of organic compounds into the soil. The rhizosphere, a thin soil zone around the roots, is a hotspot for microbial activity, making it a crucial component of the soil ecosystem. Secondary metabolites produced by rhizosphericSphingomonas sanguinisDM have sparked significant curiosity in investigating their possible biological impacts.MethodsA bacterial strain has been isolated from the rhizosphere ofDatura metel. The bacterium’s identification, fermentation, and working up have been outlined. The ethyl acetate fraction of the propagated culture media ofSphingomonas sanguinisDM was fractioned and purified using various chromatographic techniques. The characterization of the isolated compounds was accomplished through the utilization of various spectroscopic techniques, such as UV, MS, 1D, and 2D-NMR. Furthermore, the evaluation of their antimicrobial activity was conducted using the agar well diffusion method, while cytotoxicity was assessed using the MTT test.ResultsThe extract fromSphingomonas sanguinisDM provided two distinct compounds: n-dibutyl phthalic acid (1) and Bis (2-methyl heptyl) phthalate (2) within its ethyl acetate fraction. Furthermore, the 16S rRNA gene sequence ofSphingomonas sanguinisDM has been registered under the NCBI GenBank database with the accession number PP422198. The bacterial extract exhibited its effect against gram-positive bacteria, inhibitingStreptococcus mutans(12.6 ± 0.6 mm) andStaphylococcus aureus(10.6 ± 0.6 mm) compared to standard antibiotics. Conversely, compound1showed a considerable effect against phytopathogenic fungi such asAlternaria alternate(56.3 ± 10.6 mm) andFusarium oxysporum(21.3 ± 1.5 mm) with a MIC value of 17.5 µg/mL. However, it was slightly active againstKlebsiella pneumonia(11.0 ± 1.0 mm). Furthermore, compound2was the most active metabolite, having a significant antimicrobial efficacy againstRhizoctonia solani(63.6 ± 1.1 mm),Pseudomonas aeruginosa(16.7 ± 0.6 mm), andAlternaria alternate(20.3 ± 0.6 mm) with MIC value at 15 µg/mL. In addition, compound2exhibited the most potency against hepatocellular (HepG-2) and skin (A-431) carcinoma cell lines with IC50values of 107.16 µg/mL and 111.36 µg/mL, respectively.ConclusionSphingomonas sanguinisDM, a rhizosphere bacterium ofDatura metel, was studied for its phytochemical and biological characteristics, resulting in the identification of two compounds with moderate antimicrobial and cytotoxic activities.
Process evaluation of the implementation of the ABC method, an intervention for nurses dealing with challenging behaviour of patients with brain injury
Authors: Pouwels Climmy , Spauwen Peggy , Verbeek Hilde , Winkens Ieke , Ponds Rudolf 
Published: May 2024

Abstract
Background
Introducing new working methods is common in healthcare organisations. However, implementation of a new method is often suboptimal. This reduces the effectiveness of the innovation and has several other negative effects, for example on staff turnover. The aim of the current study was to implement the ABC method in residential departments for brain injured patients and to assess the quality of the implementation process. The ABC method is a simplified form of behavioural modification based on the concept that behaviour operates on the environment and is maintained by its consequences.

Methods
Four residential departments for brain injured patients introduced the ABC method sequentially as healthcare innovation using a stepped-wedge design. A systematic process evaluation of the implementation was carried out using the framework of Saunders et al. Descriptive statistics were used to analyse the quantitative data; open questions were clustered.

Results
The training of the ABC method was well executed and the nursing staff was enthusiastic and sufficiently involved. Important aspects for successful implementation had been addressed (like a detailed implementation plan and implementation meetings). However, facilitators and barriers that were noted were not addressed in a timely manner. This negatively influenced the extent to which the ABC method could be properly learned, implemented, and applied in the short and long term.

Conclusions
The most challenging part of the introduction of this new trained and introduced method in health care was clearly the implementation. To have a successful implementation serious attention is needed to tailor-made evidence-based implementation strategies based on facilitators and barriers that are identified during the implementation process. Bottlenecks in working with the ABC method have to be addressed as soon as possible. This likely requires ‘champions’ who are trained for the job, next to an organisation’s management that facilitates the multidisciplinary teams and provides clarity about policy and agreements regarding the training and implementation of the new method. The current process evaluation and the recommendations may serve as an example for the implementation of new methods in other healthcare organisations.
Epidemic preparedness and innovations in digital healthcare: enhancing post-pandemic speech-language pathology services for child and adolescent mental health in Qatar
Authors: Amro Abdullah , Kotkot Hanan Abdallah , Albobali Yahia , Chandra Prem , Khan Yasser Saeed 
Published: May 2024

Abstract
Background
This paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS).

Method
This retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic.

Results
The results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful.

Conclusions
The study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access.
Universal health coverage and equal access in Sweden: a century-long perspective on macro-level policy
Authors: Fredriksson Mio 
Published: May 2024

Abstract
Background
When today’s efforts to achieve universal health coverage are mainly directed towards low-income settings, it is perhaps easy to forget that countries considered to have universal, comprehensive and high-performing health systems have also undergone this journey. In this article, the aim is to provide a century-long perspective to illustrate Sweden’s long and ongoing journey towards universal health coverage and equal access to healthcare.

Methods
The focus is on macro-level policy. A document analysis is divided into three broad eras (1919–1955; 1955–1989; 1989–) and synthesises seven points in time when policies relevant to overarching goals and regulation of universal health coverage and equal access were proposed and/or implemented. The development is analysed and concluded in relation to two egalitarian goals in the context of health: equality of access and equal treatment for equal need.

Results
Over the past century, macro-level policy evolved from the concept of creating access for the neediest and those reliant on wages for their survival to a mandatory insurance with equal right to healthcare for all. However, universal health coverage was not achieved until 1955, and individuals had to rely on their personal financial resources to cover the cost at the time of care utilization until the 1970s. It was not until 1983 that legislation explicitly stated that access to healthcare should be equal for the entire population (horizontal equity), while a vertical equity-principle was not added until 1997. Subsequently, ideas of free choice and privatization have gained significance. For instance, they aim to increase service access, addressing the Swedish health system’s Achilles’ heel in this regard. However, the principle of equal access for all is now being challenged by the emergence of private health insurance, which offers quicker access to services.

Conclusions: brief summary and potential implications
It can be concluded that there is no perpetual Swedish healthcare model and various dimensions of access have been the focus of policy discussion. The discussion on access barriers has shifted from financial to personal and organizational ones. Today, Sweden still ranks high in terms of affordability and equity in international comparisons: although not as well as a decade ago. Whether this marks the beginning of a new trend intertwined with a decline in Sweden’s welfare ‘exceptionalism’, or is a temporary decline remains to be assessed in the future.
Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials
Authors: Amin Ahmed Mazen , Ghaly Ramy , Abuelazm Mohamed T. , Ibrahim Ahmed A. , Tanashat Mohammad , Arnaout Moumen , Altobaishat Obieda , Elshahat Ahmed , Abdelazeem Basel , Balla Sudarshan 
Published: May 2024

Abstract
Background
Clinical decision support systems (CDSS) have been utilized as a low-cost intervention to improve healthcare process measures. Thus, we aim to estimate CDSS efficacy to optimize adherence to oral anticoagulant guidelines in eligible patients with atrial fibrillation (AF).

Methods
A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471806.

Results
We included nine RCTs with a total of 25,573 patients. There was no significant difference, with the use of CDSS compared to routine care, in the number of patients prescribed anticoagulants (RR: 1.06, 95% CI [0.98, 1.14], P = 0.16), the number of patients prescribed antiplatelets (RR: 1.01 with 95% CI [0.97, 1.06], P = 0.59), all-cause mortality (RR: 1.19, 95% CI [0.31, 4.50], P = 0.80), major bleeding (RR: 0.84, 95% CI [0.21, 3.45], P = 0.81), and clinically relevant non-major bleeding (RR: 1.05, 95% CI [0.52, 2.16], P = 0.88). However, CDSS was significantly associated with reduced incidence of myocardial infarction (RR: 0.18, 95% CI [0.06, 0.54], P = 0.002) and cerebral or systemic embolic event (RR: 0.11, 95% CI [0.01, 0.83], P = 0.03).

Conclusion
We report no significant difference with the use of CDSS compared to routine care in anticoagulant or antiplatelet prescription in eligible patients with AF. CDSS was associated with a reduced incidence of myocardial infarction and cerebral or systemic embolic events.
The impact of bolus on clinical outcomes for post-mastectomy breast cancer patients treated with IMRT: data from China
Authors: Jiang Tao , Tian Jiao , Lei Peijie , Meng Chunliu , Fu Jialei , Cao Lianjing , Cheng Jingjing , Zhou Fei , Zhang Hongjun , Song Hao , Lu Haijun , Wei Xiaojuan 
Published: May 2024

Abstract
Purpose
This study aims to investigate the effects of chest wall bolus in intensity-modulated radiotherapy (IMRT) technology on clinical outcomes for post-mastectomy breast cancer patients.

Materials and methods
This retrospective study included patients with invasive carcinoma ((y)pT0-4, (y)pN0-3) who received photon IMRT after mastectomy at the Affiliated Hospital of Qingdao University from 2014 to 2019. The patients were divided into two groups based on whether they received daily bolus application or not, and the baseline characteristics were matched using propensity score matching (PSM). Cumulative incidence (CI) of local recurrence (LR), locoregional recurrence (LRR), overall survival (OS) and disease-free survival (DFS) were evaluated with a log-rank test. Acute skin toxicity and late radiation pneumonia was analyzed using chi-square test.

Results
A total of 529 patients were included in this study, among whom 254 (48%) patients received bolus application. The median follow-up time was 60 months. After matching, 175 well-paired patients were selected. The adjusted 5-year outcomes (95% confidence interval) in patients treated with and without bolus were, respectively: CI of LR 2.42% (0.04–4.74) versus 2.38% (0.05–4.65), CI of LRR 2.42% (0.04–4.74) versus 3.59% (0.73–6.37), DFS 88.12% (83.35–93.18) versus 84.69% (79.42–90.30), OS 94.21% (90.79–97.76) versus 95.86% (92.91–98.91). No correlation between bolus application and skin toxicity (P = 0.555) and late pneumonia (P = 0.333) was observed.

Conclusions
The study revealed a low recurrence rate using IMRT technology. The daily used 5 mm chest wall bolus was not associated with improved clinical outcomes.
The effectiveness of relugolix compared with leuprorelin for preoperative therapy before laparoscopic myomectomy in premenopausal women, diagnosed with uterine fibroids: protocol for a randomized controlled study (MyLacR study)
Authors: Kitade Mari , Kumakiri Jun , Kobori Hiroyuki , Murakami Keisuke 
Published: May 2024

Abstract
Background
The oral gonadotropin-releasing hormone antagonist relugolix, which temporarily stops menstruation, is used to treat heavy menstrual bleeding, pelvic pressure, and low back pain in women with uterine fibroids. Treatment can also help women recover from low hemoglobin levels and possibly shrink the fibroids. However, evidence of preoperative use of relugolix before laparoscopic myomectomy is limited. Nevertheless, the treatment could reduce interoperative blood loss, decrease the risk of developing postoperative anemia, and shorten the operative time. Thus, we aim to test whether 12-week preoperative treatment with relugolix (40 mg orally, once daily) is similar to or not worse than leuprorelin (one injection every 4 weeks) to reduce intraoperative blood loss.

Methods
Efficacy and safety of preoperative administration of drugs will be studied in a multi-center, randomized, open-label, parallel-group, noninferiority trial enrolling premenopausal women ≥ 20 years of age, diagnosed with uterine fibroids and scheduled for laparoscopic myomectomy. Participants (n = 80) will be recruited in the clinical setting of participating institutions. The minimization method (predefined factors: presence or absence of fibroids ≥ 9 cm and the International Federation of Gynecology and Obstetrics [FIGO] type 1–5 fibroids) with randomization is used in a 1:1 allocation. Relugolix is a 40-mg oral tablet taken once a day before a meal, for 12 weeks, up to the day before surgery. Leuprorelin is a 1.88 mg, or 3.75 mg subcutaneous injection, given in three 4-week intervals during patient visits before the surgery. For the primary outcome measure of intraoperative bleeding, the blood flow is collected from the body cavity, surgical sponges, and collection bag and measured in milliliters. Secondary outcome measures are hemoglobin levels, myoma size, other surgical outcomes, and quality-of-life questionnaire responses (Kupperman Konenki Shogai Index and Uterine Fibroid Symptoms—Quality of Life).

Discussion
Real-world evidence will be collected in a clinical setting to use pre-treatment with an oral gonadotropin-releasing hormone antagonist to reduce intraoperative bleeding in women who undergo laparoscopic myomectomy.

Trial registration
jRCTs031210564 was registered on 19 January 2022 in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp).
A three-term conjugate gradient descent method with some applications
Authors: Alhawarat Ahmad , Salleh Zabidin , Alolaiyan Hanan , El Hor Hamid , Ismail Shahrina 
Published: May 2024

AbstractThe stationary point of optimization problems can be obtained via conjugate gradient (CG) methods without the second derivative. Many researchers have used this method to solve applications in various fields, such as neural networks and image restoration. In this study, we construct a three-term CG method that fulfills convergence analysis and a descent property. Next, in the second term, we employ a Hestenses-Stiefel CG formula with some restrictions to be positive. The third term includes a negative gradient used as a search direction multiplied by an accelerating expression. We also provide some numerical results collected using a strong Wolfe line search with different sigma values over 166 optimization functions from the CUTEr library. The result shows the proposed approach is far more efficient than alternative prevalent CG methods regarding central processing unit (CPU) time, number of iterations, number of function evaluations, and gradient evaluations. Moreover, we present some applications for the proposed three-term search direction in image restoration, and we compare the results with well-known CG methods with respect to the number of iterations, CPU time, as well as root-mean-square error (RMSE). Finally, we present three applications in regression analysis, image restoration, and electrical engineering.