bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-consequence analysis of continuous denosumab therapy for osteoporosis treatment in South Korea
Authors: Cha Seungju , Sohn Minjeong , Yang Hyowon , Yeh Eric J. , Baek Ki-Hyun , Ha Jeonghoon , Ku Hyemin 
Published: January 2024

Abstract
Background
Insurance reimbursement provisions in South Korea limit osteoporosis medication availability for patients with T-scores exceeding − 2.5. This study aimed to evaluate the financial impact and fracture prevention of continuous denosumab therapy until a T-score>-2.0 (Dmab-C strategy), versus discontinuation of denosumab after reaching T-score>-2.5 (Dmab-D strategy) in osteoporosis patients.

Methods
A cost-consequence analysis from a Korean healthcare system perspective was performed using a newly developed Markov model. The incidence of vertebral and non-vertebral fracture, fracture-related deaths, drug costs, and fracture-treatment costs were estimated and compared between Dmab-C and Dmab-D strategy over a lifetime in eligible patients aged 55 years.

Results
Base-case analysis revealed that Dmab-C prevented 32.21 vertebral fracture (VF) and 12.43 non-VF events per 100 patients over a lifetime, while reducing 1.29 fracture-related deaths. Lifetime direct healthcare cost saving per patient was KRW 1,354,655 if Dmab-C replaces Dmab-D. When productivity losses were considered, Dmab-C saved KRW 29,025,949 per patient compared to Dmab-D. The additional treatment costs of Dmab-C could be offset by the higher subsequent treatment costs and fracture treatment costs of Dmab-D. The sensitivity analysis showed consistent patterns with results of the base-case analysis.

Conclusion
Continuous treatment using denosumab until osteoporosis patients achieve and maintain a T-score of -2.0 would provide greater clinical and economic benefits in terms of fracture prevention and reduced mortality risks compared to outcomes from discontinuing treatment at a T-score of -2.5 or above. This new treatment strategy would effectively lower the risk of fractures and fracture-related mortality, ultimately leading to lower medical expenses.
Powered single hip joint exoskeletons for gait rehabilitation: a systematic review and Meta-analysis
Authors: Daliri Mahla , Ghorbani Mohammad , Akbarzadeh Alireza , Negahban Hossein , Ebrahimzadeh Mohammad H , Rahmanipour Elham , Moradi Ali 
Published: January 2024

Abstract
Background
Gait disorders and as a consequence, robotic rehabilitation techniques are becoming increasingly prevalent as the population ages. In the area of rehabilitation robotics, using lightweight single hip joint exoskeletons are of significance. Considering no prior systematic review article on clinical outcomes, we aim to systematically review powered hip exoskeletons in terms of gait parameters and metabolic expenditure effects.

Methods
Three databases of PubMed, Scopus, and Web of science were searched for clinical articles comparing outcomes of gait rehabilitation using hip motorized exoskeleton with conventional methods, on patients with gait disorder or healthy individuals. Of total number of 37 reviewed articles, 14 trials were quantitatively analyzed. Analyses performed in terms of gait spatiotemporal parameters like speed (self-speed and maximum speed), step length, stride length, cadence, and oxygen consumption.

Results
Improved clinical outcomes of gait spatiotemporal parameters with hip joint exoskeletons are what our review’s findings show. In terms of gait values, meta-analysis indicates that rehabilitation with single hip joint exoskeleton enhanced parameters of maximum speed by 0.13 m/s (0.10–0.17) and step length by 0.06 m (0.05–0.07). For the remaining investigated gait parameters, no statistically significant difference was observed. Regarding metabolic parameters, oxygen consumption was lower in individuals treated with hip exoskeleton (− 1.23 ml/min/kg; range − 2.13 to − 0.32).

Conclusion
Although the analysis demonstrated improvement with just specific gait measures utilizing powered hip exoskeletons, the lack of improvement in all parameters is likely caused by the high patient condition heterogeneity among the evaluated articles. We also noted in patients who rehabilitated with the hip exoskeleton, the oxygen cost was lower. More randomized controlled trials are needed to verify both the short- and long-term clinical outcomes, including patient-reported measures.

Level of evidence
Level I (systematic review and meta-analysis).
The impact of primary total hip and knee replacement on frailty: an observational prospective analysis
Authors: Kappenschneider Tobias , Bammert Philip , Maderbacher Günther , Greimel Felix , Parik Lukas , Holzapfel Dominik Emanuel , Schraag Amadeus Dominik , Götz Julia , Michalk Katrin , Grifka Joachim , Meyer Matthias 
Published: January 2024

Abstract
Background
Osteoarthritis is a prevalent condition in frail older adults that requires hip or knee replacement in many patients. The aim of the study was to determine the impact of hip and knee arthroplasty on frailty.

Methods
In this prospective short-term study, we used data from 101 participants of the ongoing Special Orthopaedic Geriatrics (SOG) trial, funded by the German Federal Joint Committee (GBA). Frailty, measured by Fried’s Physical Frailty Phenotype (PFP), was assessed preoperatively, 7 days postoperatively, 4–6 weeks and 3 months after hip and knee arthroplasty. ANOVA with repeated measures and post-hoc tests for the subgroups were used for the statistical analysis.

Results
Of the 101 participants, 50 were pre-frail (1–2 PFP criteria) and 51 were frail (≥ 3 PFP criteria) preoperatively. In the pre-frail group, the PFP score decreased from 1.56 ± 0.50 (median 2) preoperatively to 0.53 ± 0.73 (median 0) 3 months after surgery (p < 0.001). The PFP score in the frail cohort decreased from 3.39 ± 1.45 (median 3) preoperatively to 1.27 ± 1.14 (median 1) 3 months postoperatively (p < 0.001). While the PFP score of the pre-frail participants increased 7 days after surgery, the PFP score of the frail group decreased significantly.

Conclusion
Pre-frail individuals often regain robustness and patients with frailty are no longer assessed as frail after surgery. Joint replacement is an effective intervention to improve frailty in hip and knee osteoarthritis.

Trial registration
This study is part of the Special Orthopaedic Geriatrics (SOG) trial, German Clinical Trials Register DRKS00024102. Registered on 19 January 2021.
Vitamin intake and periodontal disease: a meta-analysis of observational studies
Authors: Mi Nannan , Zhang Miaomiao , Ying Zheng , Lin Xiaoping , Jin Ying 
Published: January 2024

Abstract
Objective
A meta-analysis was performed to assess the epidemiological correlation between dietary intake of various types of vitamin intake and the risk of periodontal disease.

Methods
A comprehensive computerized search was conducted in eight databases, namely PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine Disc, CNKI, VIP, and WanFang Database, and a random effect model was applied to combine pooled odds ratio (ORs) with corresponding 95% confidence intervals (CIs) of the included studies, and the sensitivity analysis was performed to explore the impact of a single study on the comprehensive results.

Results
We finally included 45 effect groups from 23 observational studies, with a total number of study participants of 74,488. The results showed that higher levels of vitamin A (OR: 0.788, 95% CI: 0.640–0.971), vitamin B complex (OR: 0.884, 95% CI: 0.824–0.948), vitamin C (OR: 0.875, 95% CI: 0.775–0.988), vitamin D (OR: 0.964, 95% CI: 0.948–0.981), and vitamin E (OR: 0.868, 95% CI: 0.776–0.971) intake all were negatively correlated with periodontal disease. After removing each study, leave-one-out sensitivity analysis indicated no significant change in the overall results of any of the five meta-analyses.

Conclusions
The results from this meta-analysis demonstrated a negative association between high-dose vitamin A, vitamin B complex, vitamin C, vitamin D, and vitamin E consumption and the likelihood of developing periodontal disease, revealing the significant role of vitamins in preventing periodontal disease.
The effect of increasing the gaps between the front teeth on torque and intrusion control of the incisors for anterior retraction with clear aligners: a prospective study
Authors: Li Ni , Lei Xiao , Cao Yuan , Liu Lu , Zhang Yanqi , Ning Qiang , Gui Linyuan , Jin Fang 
Published: January 2024

Abstract
Objective
To investigate the effect of sequential distalization on increasing gaps in the maxillary anterior teeth, focusing on the control of torque and three-dimensional teeth movement during anterior retraction with clear aligners in extraction cases.

Methods
We recruited 24 patients who were undergoing extraction bilateral maxillary first premolars with clear aligners. According to a predetermined increment in the spaces between the maxillary anterior teeth, the patients were divided into three groups: those with no gap (9 cases), a 0.5 mm gap (6 cases) and a 1.0 mm gap (9 cases). In each group, a 2.0 mm en-mass retraction was applied on the anterior teeth. Plaster casts of the upper full dentition were obtained both before and after a 2 mm retraction. The palatal folds were used to overlap each pair of models. The three-dimensional movement of the teeth and the change of torque for the anterior teeth were subsequently analyzed using Geomagic Studio 2014 software.

Results
The change in torque in the groups with added gaps was significantly smaller than that in the group with no gaps (P < 0.05). There was no significant difference in this respect when comparing the group with a 0.5 mm gap added to the group with a 1.0 mm gap was added (P > 0.05). In the labial-lingual and vertical directions, the displacements of the central and lateral incisors were smaller in the groups with additional gaps compared to those in the groups without gaps (P < 0.05). However, there was no significant difference observed when comparing the group with a 0.5 mm added gap to the group with a 1.0 mm added gap (P > 0.05). Then, a comparison was made between the displacement of the second premolar to the second molar in the mesial-distal direction across all groups. The study revealed that the anchorage molars in the group without gaps demonstrated significantly smaller displacement compared to those in the group with additional gaps (P < 0.05).

Conclusion
Advantages were observed in controlling the torque of the anterior teeth and achieving a desired pattern closer to normal bodily movement by sequentially distalizing the maxillary anterior teeth gaps. Increasing the gaps between the maxillary anterior teeth also resulted in improved control of the vertical direction of the anterior teeth. However, this retraction strategy necessitates substantial protection of the anchorage molars.
Translation and validation into Spanish of the oral health self-efficacy scale in Chilean older adults
Authors: Muñoz-Sepúlveda Fernanda , Acevedo Claudia , Mariño Rodrigo , Sanzana-Luengo Cristina , Navarro Pablo , Beltrán Víctor 
Published: January 2024

Abstract
Background
Population ageing poses a challenge to improving the well-being of older adults, particularly in terms of oral health. Promoting self-efficacy in oral health behaviours is crucial for maintaining this population’s health and quality of life. The Oral Health Self-Efficacy Scale (OHSES) has been widely used to assess dental self-efficacy and is considered comprehensive and reliable. However, there is a need to validate OHSES for Spanish-speaking older adults. This study aimed to assess the reliability and validity of the translated questionnaire for use in the older Chilean population.

Methods
A sample of 188 older adults, aged 60 years and above residing independently in the community, were recruited by accessing databases from the National Senior Citizen Service and various community organisations within the region of La Araucanía. The participants underwent comprehensive oral examinations and oral health interviews, focusing on variables such as OHSES, Oral health-related quality of life (OHIP-14Sp), assessment of remaining teeth, knowledge and attitudes toward oral health, and sociodemographic characteristics. The validity of the translated questionnaire was assessed through translation and cross-cultural adaptation, cognitive debriefing, and face and content validation. The psychometric properties of the questionnaire were evaluated through measures of internal consistency (Cronbach’s alpha), content validity (Content validity index), construct validity (factor analysis and Pearson correlation analysis), and test-retest reliability (intraclass correlation).

Results
The Spanish version of OHSES demonstrated adequate face and content validity. The confirmatory factor analysis confirmed a two-factor scale with 7 items for a better fit. The scale demonstrated high internal consistency (Cronbach’s alpha = 0.821) and acceptable test–retest reliability (ICC = 0.411). Correlations were found between the OHSES score, the number of remaining teeth, knowledge and attitudes towards oral health, and the OHIP-14Sp (p < 0.01).

Conclusions
This study confirms the validity of the Spanish version of the Oral Health Self-Efficacy Scale for older adults in Chile. The scale is expected to be helpful in assessing self-efficacy in dental interventions and collecting data for international comparisons. This research opens new dimensions in patient-reported assessment of oral health.
Evaluation of the genotoxicity, cytotoxicity, and bioactivity of calcium silicate-based cements
Authors: Esen Merve , Guven Yeliz , Seyhan Mehmet Fatih , Ersev Handan , Tuna-Ince Elif Bahar 
Published: January 2024

Abstract
Background
As calcium silicate-based cements (CSCs) have found success in various vital pulp therapy applications, several new CSC products have emerged. This study aimed to assess the genotoxicity, cytotoxicity, and bioactivity of four CSCs by comparing the newly introduced materials Bio MTA+ and MTA Cem with previously studied materials, Biodentine and NeoMTA.

Methods
Genotoxicity was evaluated using the micronucleus (MN) assay in human peripheral blood lymphocyte cells, measuring MN frequency and nuclear division index (NDI). Cytotoxicity was assessed in human dental pulp stem cells through the Water-Soluble Tetrazolium Salt-1 (WST-1) colorimetric assay. Bioactivity was determined by ELISA, measuring the levels of angiogenic and odontogenic markers (BMP-2, FGF-2, VEGF, and ALP). Statistical analyses included ANOVA, Dunnet and Sidak tests, and Wald chi-square test. (p < .05).

Results
The MN frequency in the groups was significantly lower than that in the positive control group (tetraconazole) (p < .05). NDI values decreased with increasing concentration (p < .05). Bio MTA+ and NeoMTA showed decreased cell viability at all concentrations in 7-day cultures (p < .01). All materials increased BMP-2, FGF-2, and VEGF levels, with Biodentine and NeoMTA showing the highest levels of BMP-2 and FGF-2 on day 7. Biodentine displayed the highest VEGF levels on day 7. Biodentine and NeoMTA groups exhibited significantly higher ALP activity than the Bio MTA+ and MTA Cem groups by day 7.

Conclusion
Bio MTA+ and MTA Cem demonstrated no genotoxic or cytotoxic effects. Moreover, this study revealed bioactive potentials of Bio MTA+ and MTA Cem by enhancing the expression of angiogenic and osteogenic growth factors.
The effects of rhythmic auditory stimulation on functional ambulation after stroke: a systematic review
Authors: Gonzalez-Hoelling Samira , Reig-García Gloria , Bertran-Noguer Carme , Suñer-Soler Rosa 
Published: January 2024

Abstract
Background
Several studies have reported the effect of rhythmic auditory stimulation (RAS) on functional ambulation in stroke patients, yet no systematic overview has yet been published. This study aims to synthesize the available evidence describing changes in stroke patients after RAS intervention for functional ambulation and the use of walking assistive devices, and to find out if the effect of RAS and music-based RAS differs depending on the lesioned area.

Methods
The PubMed, PEDro, Cochrane Central Register of Controlled Trials, Web of Science, Scopus and CINAHL electronic databases were searched for reports evaluating the effect of RAS on walking in stroke patients, applying the PICOS criteria for the inclusion of studies.

Results
Twenty one articles were included (948 stroke survivors). Most studies were of good methodological quality according to the PEDro scale, but they had a high risk of bias. The most consistent finding was that RAS improves walking and balance parameters in stroke patients in all phases compared to baseline and versus control groups with conventional treatment. Functional ambulation and the use of walking assistive devices were inconsistently reported. Several studies also suggest that RAS may be as good as other complementary therapies (horse-riding and visual cueing).

Conclusions
Despite the beneficial effects of RAS, the question remains as to whether it is better than other complementary therapies. Given the heterogeneity of the interventions, the interventions in control groups, the varied durations, and the different outcome measures, we suggest that care should be taken in interpreting and generalizing findings.

PROSPERO Registration
CRD42021277940.
Mechanisms predictive of Tibetan Medicine Sophora moorcroftiana alkaloids for treatment of lung cancer based on the network pharmacology and molecular docking
Authors: Ji Peng , Zhao Nian-Shou , Wu Fan-Lin , Wei Yan-Ming , Laba Ci-Dan , Wujin Cuo-Mu , Hua Yong-Li , Yuan Zi-Wen , Yao Wan-Ling 
Published: January 2024

Abstract
Background
Leguminous Sophora moorcroftiana (SM) is a genuine medicinal material in Tibet. Many research results have reveal the Sophora moorcroftiana alkaloids (SMA), as the main active substance, have a wide range of effects, such as antibacterial, antitumor and antiparasitic effects. However, there are few reports on the inhibition of lung cancer (LC) and its inhibitory mechanism, and the pharmacological mechanism of SMA is still unclear, Therefore, exploring its mechanism of action is of great significance.

Methods
The SMA active components were obtained from the literature database. Whereas the corresponding targets were screened from the PubChem and PharmMapper database, UniProt database were conducted the correction and transformation of UniProt ID on the obtained targets. The GeneCards and OMIM databases identified targets associated with LC. Venny tools obtained the intersection targets of SMA and LC. R language and Cytoscape software constructed the visual of SMA - intersection targets – LC disease network. The intersection targets protein-protein interaction (PPI) network were built by the STRING database. The functions and pathways of the common targets of SMA and LC were enriched by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Subsequently, molecular docking And A549 cells vitro experiment were performed to further validate our finding.

Results
We obtained six kinds of alkaloids in SM, 635 potential targets for these compounds, and 1,303 genes related to LC. SMA and LC intersection targets was 33, including ALB, CCND1, ESR1, NOTCH1 and AR. GO enrichment indicated that biological process of SMA was mainly involved in the positive regulation of transcription and nitric oxide biosynthetic process, and DNA-templated, etc. Biological functions were mainly involved in transcription factor binding and enzyme binding, etc. Cell components were mainly involved in protein complexes, extracellular exosome, cytoplasm and nuclear chromatin, etc., Which may be associated with its anti-LC effects. KEGG enrichment analysis showed that main pathways involved in the anti-LC effects of SMA, including pathway in cancer, non small-cell lung cancer, p53, PI3K-Akt and FOXO signaling pathways. Molecular docking analyses revealed that the six active compounds had a good binding activity with the main therapeutic targets 2W96, 2CCH and 1O96. Experiments in vitro proved that SMA inhibited the proliferation of LC A549 cells.

Conclusions
Results of the present study, we have successfully revealed the SMA compounds had a multi-target and multi-channel regulatory mechanism in treatment LC, These findings provided a solid theoretical reference of SMA in the clinical treatment of LC.
Baicalin enhances proliferation and reduces inflammatory-oxidative stress effect in H2O2-induced granulosa cells apoptosis via USP48 protein regulation
Authors: Chen Jun , Lin Chuhua , Huang Xiurong , Bian Wei 
Published: January 2024

Abstract
Background
Oxidative stress and inflammation can lead to apoptosis of ovarian granulosa cells (GCs), resulting in ovulation disorders and infertility. Baicalin (BAI) promotes cell proliferation and reduces inflammation and oxidative stress. However, the mechanisms by which BAI treatment affects oxidative stress and inflammation in GCs remain incompletely understood.

Methods
KGN cells were treated with hydrogen peroxide (H2O2) to analyze the effect of oxidative stress on GCs in vitro. Subsequently, H2O2-stimulated KGN cells were treated with BAI. The levels of GSH-Px, CAT, and SOD were measured using an activity assay kit. The levels of MDA, IL-1β, IL-6, IL-8, and TNF-α were measured by ELISA. Proliferation, apoptosis, and mRNA and protein levels were measured using the CCK8, flow cytometry, qRT-PCR, and western blotting.

Results
H2O2 treatment inhibited KGN cell proliferation and promoted apoptosis, accompanied by increased oxidative stress and inflammation. BAI promoted proliferation, inhibited apoptosis, and reduced oxidative stress and inflammation in H2O2-stimulated KGN cells. BAI treatment promoted USP48 protein expression, and USP48 knockdown abrogated the protective effects of BAI, indicating that USP48 is a downstream mediator of BAI.

Conclusion
BAI treatment enhanced cell proliferation and ameliorated oxidative stress and inflammation by enhancing USP48 protein expression. BAI, which is used clinically and as a dietary supplement, may alleviate oxidative stress-induced GC injury and ovarian disorders.