bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge on Management of Traumatic Dental Injury and Related Predictors in Taif, Saudi Arabia: A Cross‐Sectional Study
Authors: Shukr Bandar S. , Alshamrani Haifaa M. , Alzubaidi Mohammed A. , Alqarni Ali A. , Alzahrani Muaath H. , Altalhi Faisal K. , Alrizqi Abdulrahman A. 
Published: February 2025

Objectives: This study was undertaken to investigate the knowledge and attitudes toward pediatric traumatic dental injury (TDI) among the population of Taif, as well as predictors of emergency management and intentions for future education, with an additional focus on the subpopulation of parents.Methods: Data were collected from 345 participants using an anonymous questionnaire that was distributed online and contained four sections: demographics, questions regarding TDI knowledge and previous experiences, questions about the management of two clinical cases, and questions about the self‐reported capability to manage future TDIs and the motivation for future education/training. Adjusted linear and logistic regressions were utilized to assess the effect of the different predictors on the total knowledge score, self‐reported management capabilities, TDI learning importance, and future education/training interests.Results: The findings revealed poor overall knowledge regarding TDI management, especially in avulsion incidents, with slightly better knowledge in the subpopulation of parents. In the total population, working in a governmental job (p‐value = 0.047) or as a freelancer (p‐value = 0.006) was associated with higher knowledge, while obtaining any previous TDI information was associated with sufficient management capabilities (p‐value = 0.001). Regarding the parent subpopulation, attending a previous TDI educational course was associated with higher knowledge (p‐value = 0.043). Similar to the total population, obtaining any previous TDI information was associated with sufficient management capabilities (p‐value = 0.001). However, receiving such information from professional resources was associated with lower management capabilities (p‐value = 0.033). No significant associations were observed regarding the outcomes of TDI learning importance and future education/training interests.Conclusion: This study highlights significant gaps in the knowledge, awareness, and skills related to pediatric dental injuries and their management among the population of the Taif region. Targeted educational interventions are needed to increase public awareness and bridge the current gaps in knowledge and skills.
Anlotinib versus placebo as adjuvant therapy for localized high-grade soft tissue sarcomas: a phase 2, double-blinded, randomized controlled trial
Authors: Wang Chunmeng , Hu Xianglin , Yang Lingge , Xu Yu , Zheng Biqiang , Yang Jilong , Liao Zhichao , Sun Zhengwang , Zhang Shengjian , Yu Lin , Yan Yan , Chen Yong , Fujiwara Tomohiro , Zhang Jianrong , Buhtoiarov Ilia N. , Sun Yangbai , Yan Wangjun 
Published: February 2025

Abstract
Purpose: We aimed to investigate the efficacy and safety of anlotinib as adjuvant targeted therapy for completely resected localized high-grade soft tissue sarcomas (STS). Patients and Methods: Patients with localized high-grade STS after complete resection were randomly assigned in a 1:1 ratio to receive either oral 12 mg anlotinib or placebo once daily on days 1-14 every 21 days as a cycle, with up to 6 cycles until disease relapse, unmanageable toxicity or death. The efficacy and safety were analyzed. This trial was the first trial exploring adjuvant targeted therapy for STS (NCT03951571). Results: Between June 2019 and November 2023, 88 patients were randomly assigned to receive anlotinib (n=44) or placebo (n=44). With a median follow-up of 30.95 months, the 1-year and 2-year disease-free survival (DFS) rates were 88% and 77% in the anlotinib group, compared to 64% and 58% in the placebo group. Compared to patients treated with surgery alone, patients receiving adjuvant anlotinib combined with surgery had a reduced risk of disease recurrence (HR 0.47 [95% CI 0.22~1.00, P=0.0445]). Based on the tumor histology, the reduced risk of disease recurrence with anlotinib versus placebo was observed in patients with myxofibrosarcoma (HR 0.54 [95% CI 0.17~1.65], P=0.2698) and undifferentiated pleomorphic sarcoma (HR 0.58 [95% CI 0.12~2.87], P=0.4971). Four patients discontinued anlotinib, including two for proteinuria/hematuria (2/44, 5%) and two for poor healing of surgical wound (2/44, 5%). Conclusions: Compared to surgery alone, adjuvant anlotinib following surgery reduces the incidence of disease relapse in localized high-grade STS, with acceptable toxicity.
RNF6 Inhibits Lung Adenocarcinoma Cell Proliferation by Promoting Cyclin D2 Degradation
Authors: Sun Yuening , Jiang Liyang , Zhang Zubin , Zhu Rongrong , Liang Jingpei , Liu Ziyang , He Yuanming , Huang Zhenqian , Ling Chunhua , Zhou Xiumin , Mao Xinliang 
Published: February 2025

Abstract
The E3 ubiquitin ligase RING finger protein 6 (RNF6) has been widely recognized for its role in promoting tumorigenesis in multiple cancers. However, we found that it is downregulated in lung adenocarcinoma (LUAD), and the molecular rationale for this discrepancy remains unclear. In the present study, we find that RNF6, but not its ΔRING inactive form, inhibits LUAD cell proliferation and migration and sensitizes LUAD to chemotherapy. To understand the molecular mechanism, we utilize affinity purification/tandem mass spectrometry (MS-MS) to analyze RNF6-interacting proteins and find that cyclin D2 (CCND2), a key regulator of the G1–S transition in the cell cycle. RNF6 physically binds to CCND2 and mediates its K48-linked polyubiquitination and subsequent degradation. However, ΔRING RNF6 fails to mediate CCND2 for ubiquitination and degradation. Moreover, Thr280 is critically important for CCND2 stability. When Thr280 is mutated, CCND2 becomes more stable and less ubiquitinated by RNF6. Furthermore, RNF6 arrests LUAD cell cycle at the G1 phase by inhibiting the CCND2/phospho-Rb signaling pathway, which is consistent with decreased cell proliferation. Lastly, RNF6 curtails the growth of LUAD xenografts in vivo, associated with decreased CCND2 expression. Therefore, RNF6 is a novel E3 ligase of CCND2 and suppresses LUAD cell proliferation.
Implications: This study reveals a novel regulation on cell-cycle transition in LUAD and suggests the RNF6/CCND2 axis may represent an alternative therapeutic target for the treatment of LUAD.
Aspirin does not confer protection against major ischemic vascular events in patients diagnosed with rheumatoid arthritis
Authors: Gao Chao , Hou Qiqi , Cao Hongxia , Li Cangtuo , Peng Xu , Han Quanle , Wu Shouling , Li Kangbo 
Published: February 2025

Objective Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. Patients with RA are at increased risk of developing cardiovascular diseases. This retrospective cohort study aimed to determine whether acetylsalicylic acid (aspirin [ASA]) protects against major ischemic vascular events in patients diagnosed with RA. Methods Patients with RA were recruited from a population of 118, 500 participants who were enrolled into the Kailuan Cohort Study between 2014 and 2016. Information regarding demographic characteristics, anthropometric measures, and medical histories were documented. Patients with RA who underwent ASA therapy were propensity score matched at a ratio of 1:4 with patients with RA who did not receive ASA. The risk of ischemic vascular events (myocardial infarction and ischemic stroke) was examined. The relationship between ASA therapy and major ischemic vascular events was analyzed by Cox proportional hazards regression. Results A total of 939 patients with RA were included (189 who received ASA and 750 who did not). During the 3.3-year follow-up, six and 35 major ischemic vascular events occurred in the ASA and non-ASA groups, respectively, with no significant between-group difference in the cumulative incidence of such events. Cox proportional hazards regression analysis showed that ASA therapy was not associated with major vascular ischemic events and its subtypes. Conclusions ASA did not confer protection against major ischemic vascular events in patients diagnosed with RA.
A Process Evaluation Revealed That Flexibility Was Key to Delivering Nutrition Education to Vulnerable Tribal Groups in India
Authors: Mockshell Jonathan , Ritter Thea , Garrett James 
Published: February 2025

Background This study is a process evaluation of a nutrition education intervention that is part of a large-scale development program targeting vulnerable tribal groups in Odisha, India. Objective The objectives are to examine whether the intervention is operating as planned (implementation fidelity), investigate potential pathways to achieve greater impact, and provide recommendations on how to design nutrition education interventions in similar contexts. Methods A program impact pathway forms the basis of this process evaluation, tracing inputs, processes, outputs, outcomes, and impacts. The study's mixed-methods approach includes semistructured interviews, focus group discussions, and Process Net-Mapping. Narrative analysis was applied to examine the transcripts. Data were analyzed in the context of the program impact pathway. Results The intervention was not delivered as intended (low implementation fidelity). Flexibility was key in providing nutrition education to beneficiaries despite challenges, such as the inability to utilize behavior change communication, inadequate funding, and language and cultural barriers. Despite low fidelity, the qualitative results show that the intervention improved awareness of nutrition and health among beneficiaries. Conclusions Providing adequate resources for training frontline workers and beneficiaries is required for nutrition education programs to achieve their desired effectiveness and impact. Utilizing existing organizations, integration into production-based interventions, and incorporating easy-to-understand nutrition models, practical demonstrations, and videos would increase frontline worker and beneficiary engagement and understanding, leading to improved maternal and child nutritional and health outcomes.
Modern contraceptive discontinuation and associated factors among adolescent girls and young women in Tanzania: An analysis of a nationally representative data
Authors: Solomon Victoria J , Kibona Shadrack E , Mukyanuzi Elevatus N , Mbotwa Christopher H 
Published: February 2025

Background: Contraceptive use is vital in reducing the risk of unintended pregnancies and early motherhood. Despite the well-established benefits, the uptake of modern contraceptive methods among adolescent girls and young women (AGYW) is sub-optimal in sub-Saharan Africa. Furthermore, the discontinuation rate of modern contraceptive use poses a significant challenge to its effectiveness. Objective: We aimed to determine a 12-month modern contraceptive discontinuation rate, reasons for discontinuation, and associated factors among AGYW in Tanzania. Design: Retrospective nested within the cross-sectional utilizing quantitative approach. Methods: We retrospectively analysed calendar data on contraceptive use collected in the 2022 Tanzania Demographic and Health Survey (2022 TDHS). The 2022 TDHS data collection was implemented between February and July 2022. The study population comprised AGYW aged 15–24 years. The unit of analysis was the contraceptive episode of use, defined as the period between the start of use and the termination of the method. Our analysis was mainly based on the discontinuation due to dissatisfaction with the method. We used a life-table method to estimate the contraceptive discontinuation rates. A frailty model was employed to assess the factors associated with the discontinuation rate. Results: A total of 668 AGYW with a mean (±standard deviation) age of 21.5 ± 2.1 years were included in the analysis. The overall prevalence of 12-month discontinuation rate due to dissatisfaction with the method was 32.3%. Higher discontinuation rates were observed among injectable and pills. The main reasons for discontinuation were side effects (13.7%) and change in menstrual cycle (8%). Factors associated with higher discontinuation rates included higher age (adjusted hazard ratio (aHR) 1.64, 95% confidence interval (CI) 1.06–2.51 for the 20–24 age group), residing in households headed by a female (aHR 1.40, 95% CI 1.05–1.85), and residing in the western zone (aHR 1.87, 95% CI 1.21–2.90). Conclusion: This study revealed a high prevalence rate of modern contraceptive discontinuation among AGYW in Tanzania. The management of side effects needs to be incorporated into programs aimed at promoting the sustained use of modern contraceptive methods.
Impact of dexmedetomidine during hypothermia on initiation of enteral feeding in newborns with hypoxic-ischemic encephalopathy
Authors: Marsh Kimberly R , Peeples Eric S 
Published: February 2025

Background After early studies suggested safety and potential for benefit of dexmedetomidine use in neonatal hypoxic-ischemic encephalopathy (HIE), our neonatal intensive care unit (NICU) decided to transition from morphine to dexmedetomidine as our standard sedative during therapeutic hypothermia (TH). The primary aim was to monitor the possible side effects of transitioning from morphine to dexmedetomidine with a primary goal of reducing the days to initiation of enteral feeds to less than 3 days, with the hypothesis that the gastrointestinal motility effects of morphine may have been hindering feeding progress during TH. The secondary aim was to determine rates of hemodynamically significant bradycardia. Methods This was a prospective quality improvement study using a retrospective comparison group to determine the comfort, hemodynamic, and early feeding effects of a clinical change in sedation management from morphine to dexmedetomidine. We included infants born at ≥35 weeks of gestation receiving hypothermia for hypoxic-ischemic encephalopathy (HIE) from 2017 to 2023. Results Data were collected from 107 infants: 48 morphine, 35 dexmedetomidine, and 24 neither. Heart rate was lower in the morphine and dexmedetomidine groups compared to no sedation. Blood pressures, pain scores, and blanket temperatures were not different between groups. Infants receiving dexmedetomidine initiated enteral feeds earlier than either of the other groups and reached full enteral feeds earlier than the no treatment group but not the morphine group. Conclusions This study supports a growing body of literature suggesting dexmedetomidine is a well-tolerated alternative to opioids during hypothermia for HIE.
A nomogram for predicting mortality risk in geriatric patients with hip fractures complicated by pneumonia: A multicenter study
Authors: Zhang Kaiming , Li Xiangwei , Xiao Yujia , Zhou Cheng , Liu Yu , Zhen Fan , Zhang Hao , Nie Mao 
Published: February 2025

Objectives: Pneumonia is a common perioperative complication in geriatric patients with hip fractures. This study aimed to analyze demographic characteristics, mortality rates, postoperative outcomes, and perioperative comorbidities, identify risk factors for mortality, and develop a nomogram for predicting the prognosis of these patients. Methods: Data on patients hospitalized for arthroplasty for hip fractures from 2020 to 2023 at three hospitals were retrospectively analyzed. Patients were divided into the P group (patients with hip fractures complicated with pneumonia) and the C group (patients with hip fractures without pneumonia) and demographic characteristics, mortality, postoperative outcomes, and perioperative comorbidities of the patients were analyzed. Multiple logistic regression was then used to identify independent risk factors for inpatient mortality in the P group and a nomogram was constructed to predict inpatient mortality. The predictive performance of the nomogram was assessed using receiver operating characteristic curves, decision curve analysis, and calibration curves. Results: A total of 311 patients participated in the study. Patients in the P group had longer hospitalization ( p = 0.001), higher inpatient mortality ( p < 0.001), higher mortality (30 days) ( p < 0.001), and a poorer recovery of hip function ( p < 0.001). Multiple logistic regression showed that age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were independent risk factors for inpatient mortality in the P group; these factors were incorporated in the nomogram. The C-index of the nomogram was 0.868 (95% CI: 0.802–0.933), and the C-index of internal bootstrapping validation was 0.851 (95% CI: 0.793–0.908), indicating the effectiveness of the nomogram in predicting patient prognosis. Conclusions: Coinfection with pneumonia adversely affected both recovery of hip function and survival in geriatric patients with hip fractures. Age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were found to be independent risk factors for mortality in this patient population.
Longitudinal Associations Between Academic and Social Adjustment Among Chinese College Freshmen: The Mediating Role of Depressive Symptoms
Authors: Ti Yonghe , Yi Cong , Wei Jun , Shi Guangyuan 
Published: February 2025

This study investigated the longitudinal associations between academic and social adjustment and the mediating role of depressive symptoms among Chinese college freshmen using a three-wave longitudinal design. A total of 1183 freshmen (467 males; Mean age = 18.61 years at Wave 1) from eight Chinese universities participated in this study. Using cross-lagged panel analysis, the results showed that academic adjustment predicted increases in social adjustment over time, but not vice versa. Academic adjustment, but not social adjustment, predicted decreases in depressive symptoms over time. Depressive symptoms predicted worsened academic and social adjustment over time. Longitudinal mediation analysis showed that depressive symptoms mediated the effect of academic adjustment on social adjustment over time among Chinese college freshmen. These findings highlight the contributions of academic adjustment to social adjustment for Chinese freshmen and emphasize the need for Chinese colleges to promote freshmen’s academic adjustment at the beginning of college life.
Impact of cigarette smoking and gender on EGFR mutation status in Iraqi lung cancer patients
Authors: Kareem Taghreed Abdulrahman , Mohammed Reyadh Salim , Nasir Ban Abbas 
Published: February 2025

Background and aim Lung cancer, particularly NSCLC, is the foremost reason behind deaths associated with cancer globally and the second most prevalent malignancy among males in Iraq. Mutations in the EGFR gene are significant druggable targets in NSCLC, linked to sensitivity to tyrosine kinase inhibitors. This study aims to analyse the incidence and kinds of EGFR mutations in Iraqi NSCLC patients and their correlation with gender and smoking status, despite global data indicating that EGFR mutations are more prevalent in females and non-smokers. Materials and methods A retrospective analysis was conducted on 214 FFPET samples. Information regarding the patients’ gender and smoking history was documented. DNA was extracted use the NucleoSpin tissue kit, and EGFR mutations were identified employing the Cobas z 480 analyser. The prevalence and types of mutations were associated with gender and smoking status; a p-value below 0.05 was regarded as statistically significant. Results Among 214 NSCLC cases, 51 (23.8%) exhibited EGFR mutations, with 58.8% being male and 41.2% female. The exon 19 deletion, Exdel19, represented the highest prevalence in both males and females, constituting 70% and 71.4%, respectively. The smoking status exhibited a significant correlation with Exdel19 mutation status ( p = 0.048), indicating a considerably greater mutation rate among nonsmokers. Conclusion The results of this study demonstrated the influence of smoking on the occurrence of EGFR mutations, particularly Exdel19, in Iraqi lung cancer patients. Systematic evaluation of EGFR mutations, in conjunction with smoking reduction initiatives, will enhance results with targeted therapy and diminish the burden of lung cancer both locally and globally.
Developing Presurgical Conversion Formulas to Predict Miniaci Angle for Personalized Realignment Targets in Opening-Wedge High Tibial Osteotomies
Authors: Chen Hongyu , Chen Liang , Zhang Yuan , Wu Qiang , Yan Mengning , Jiang Xu , Wang Liao 
Published: February 2025

Background: The correlation between the Miniaci angle and presurgical hip-knee-ankle (HKA) angle, weightbearing line (WBL) percentage, and changes in the HKA angle (ΔHKA angle) and WBL percentage (ΔWBL percentage) is significant in opening-wedge high tibial osteotomy (OWHTO). The conversion formulas that interrelate the Miniaci angle with pre-HKA angle (formula 1), pre-WBL percentage (formula 2), ΔHKA angle (formula 3), and ΔWBL percentage (formula 4) have been derived through the linear regression analysis. However, the accuracy of conversion formulas has not been validated. Purpose: To validate the precision of conversion formulas targeting various surgical objectives for OWHTO planning in the varus knee patient population. Study design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective study of 155 lower limbs of 112 patients with medial unicompartmental knee osteoarthritis was conducted. A computer simulation of OWHTO was performed to calculate the Miniaci angle by delivering the WBL to the Fujisawa point (group 1), at 65% WBL percentage (group 2), and 4.5° of valgus (group 3). Spearman correlation and Bland-Altman analyses were conducted between the computer simulation and formula calculation. Results: Upon evaluating the widely accepted Fujisawa point as a postoperative target, all formula results demonstrated a strong correlation with computer simulation outcomes ( r = 0.962-0.999). Compared with the simulated Miniaci angle, the mean bias of the calculated angles derived from formulas 1 to 4 was 0.098° (formula 1), –0.268° (formula 2), 0.065° (formula 3), and −0.246° (formula 4). Notably, the formula based on the ΔHKA angle exhibited an ideal correlation with the simulated Miniaci angle ( r = 0.998-0.999). In the 3 groups with varying postoperative targets, the mean bias of this formula in predicting the Miniaci angle was 0.065° (group 1), 0.070° (group 2), and 0.080° (group 3). Conclusion: Formulas based on the presurgical HKA angle and WBL percentage showed perfect accuracy for measuring the Miniaci angle targeting the Fujisawa point. The formula based on ΔHKA angle achieved the best accuracy and may be a valuable tool for measuring the Miniaci angle in broader surgical targets.