bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of oral health-related quality of life on total mortality: a prospective cohort study
Authors: Arimoto Nishiki , Nishimura Rumi , Kobayashi Teruo , Asaeda Mayuka , Naito Toru , Kojima Masaaki , Umemura Osami , Yokota Makoto , Hanada Nobuhiro , Kawamura Takashi , Wakai Kenji , Naito Mariko 
Published: October 2023

Abstract
Background
The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists.

Methods
In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7–56.7, Q3 = 56.8–59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12–60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model.

Results
We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 − 3.48) for Q1, 1.69 (95% CI, 0.90 − 3.17) for Q2, and 0.65 (95% CI, 0.29 − 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15–2.46) for Q1, 1.53 (95% CI, 1.04–2.27) for Q2, and 1.09 (95% CI, 0.71–1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79).

Conclusions
A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy.

Trial registration
Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632–3, 8–21, and E2019-1603).
Outpatient education, a momentous in clinical education: a qualitative study of medical students’, faculty members’, and residents’ perspectives
Authors: Barzegar Marziyeh , Faghihi Seyed Aliakbar , Amini Mitra , Zarifsanaiey Nahid , Boushehri Elham 
Published: October 2023

AbstractBackgroundEven though a lot of scholars have been looking at outpatient education lately because it has become more popular and they want to know about its successes, failures, and problems, we have not been able to find a complete study. Therefore, our study aims to gain a deeper understanding of the various aspects of outpatient education based on the actual experiences of medical students, faculty, and residents.MethodsFace-to-face and semi-structured interviews were used to collect data for this qualitative study. Until data saturation was reached, the interviews continued. A total of 21 participants from Shiraz University of Medical Sciences, including medical students, residents, and teachers, were enrolled. The Guba and Lincoln-first written standards for scientific accuracy in qualitative research were used to figure out how reliable the data were.ResultsFourteen categories were extracted from four main themes. The results show that four categories: “physical space and equipment,” “prerequisites related to the curriculum,” “teaching skills development,” and “near-peer teachers” should be considered for outpatient education preparation. Theme 2, “implementation requirements,” included “student dimension,” “faculty’s commitment to planning,” and “program supervision.” Theme 3, “challenges of outpatient education,” was described by five related categories, including “curriculum implementation challenges,” “student challenges,” “faculty challenges,” “system-related challenges,” and “patient-related challenges.” Finally, two categories emerged about facilitators of outpatient education: internal and external facilitators.ConclusionOutpatient clinics represent a crucial aspect of medical practice. To effectively leverage this resource, preliminary planning, considering all the prerequisites, paying attention to the implementation requirements, getting to know the challenges, and trying to solve them, especially with incentives, are essential.
Including audience response systems in debriefing. A mixed study during nursing simulation-based learning
Authors: Molina-Rodríguez Alonso , Suárez-Cortés María , Leal-Costa César , Ruzafa-Martínez María , Díaz-Agea José Luis , Ramos-Morcillo Antonio Jesús , Jiménez-Ruiz Ismael 
Published: October 2023

Abstract
Background
The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation.

Methods
A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed “ad hoc”, on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale.

Results
(1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was “Motivation”, with a mean of 4.7 (SD = 0.480), followed by the dimension “Participation”, with a mean of 4.66 (SD = 0.461), and lastly, the dimension “Attention”, with a mean of 4.64 (SD = 0.418).

Conclusions
The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.
Zoonotic diseases: understanding the risks and mitigating the threats
Authors: Elsohaby Ibrahim , Villa Luca 
Published: October 2023

AbstractZoonotic diseases are like a sneaky game of “tag” between animals and humans, where the stakes are high and the consequences can be deadly. From the bubonic plague to COVID-19, zoonotic diseases have affected humanity for centuries, reminding us of our interconnectedness with the animal kingdom and the importance of taking proactive measures to prevent their spread. Whether it is avoiding contact with animals or practicing good hygiene, staying safe from zoonotic diseases is a game we all need to play.
Causal effects of gut microbiome on autoimmune liver disease: a two-sample Mendelian randomization study
Authors: Fu Yugang , Li Jiacheng , Zhu Yingying , Chen Chong , Liu Jing , Gu Simin , Zheng Yiyuan , Li Yong 
Published: October 2023

Abstract
Background
Epidemiological studies have indicated a potential link between the gut microbiome and autoimmune liver disease (AILD) such as autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). The relationship between the gut microbiome and autoimmune liver disease is still uncertain due to confounding variables. In our study, we aim to shed light on this relationship by employing a two-sample Mendelian randomization approach.

Methods
We conducted a two-sample Mendelian randomization (MR) study using the R package "TwoSampleMR". The exposure data consisted of genetic variants associated with 194 bacterial traits obtained from the MiBioGen consortium. Summary statistics for AILD were obtained from the GWAS Catalog website. Furthermore, a series of sensitivity analyses were performed to validate the initial MR results.

Results
There were two, four and three bacteria traits associated with an increased risk of AIH. PBC, and PSC respectively. In contrast, there were five, two and five bacteria traits associated with a decreased risk for AIH, PBC and PSC. Notably, the genus_Clostridium_innocuum_group showed a negative association with AIH (OR = 0.67, 95% CI: 0.49–0.93), and the genus_Actinomyces was found to be genetically associated with a decreased risk of PSC (OR = 0.62, 95% CI: 0.42–0.90).

Conclusions
Our study identified the causal impact of specific bacterial features on the risk of AILD subtypes. Particularly, the genus_Clostridium_innocuum_group and the genus_Actinomyces demonstrated significant protective effects against AIH and PSC respectively. These findings provide further support for the potential use of targeted probiotics in the management of AILD.
HK3 stimulates immune cell infiltration to promote glioma deterioration
Authors: Li Shupeng , Li Ziwei , Wang Xinyu , Zhong Junzhe , Yu Daohan , Chen Hao , Ma Wenbin , Liu Lingling , Ye Minghuang , Shen Ruofei , Jiang Chuanlu , Meng Xiangqi , Cai Jinquan 
Published: October 2023

Abstract
Background
Glioma is the most common and lethal type of brain tumor, and it is characterized by unfavorable prognosis and high recurrence rates. The reprogramming of energy metabolism and an immunosuppressive tumor microenvironment (TME) are two hallmarks of tumors. Complex and dynamic interactions between neoplastic cells and the surrounding microenvironment can generate an immunosuppressive TME, which can accelerate the malignant progression of glioma. Therefore, it is crucial to explore associations between energy metabolism and the immunosuppressive TME and to identify new biomarkers for glioma prognosis.

Methods
In our work, we analyzed the co-expression relationship between glycolytic genes and immune checkpoints based on the transcriptomic data from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) and found the correlation between HK3 expression and glioma tumor immune status. To investigate the biological role of HK3 in glioma, we performed bioinformatics analysis and established a mouse glioblastoma (GBM) xenograft model.

Results
Our study showed that HK3 significantly stimulated immune cell infiltration into the glioma TME. Tissue samples with higher HK3 expressive level showed increasing levels of immune cells infiltration, including M2 macrophages, neutrophils, and various subtypes of activated memory CD4+ T cells. Furthermore, HK3 expression was significantly increasing along with the elevated tumor grade, had a higher level in the mesenchymal subtype compared with those in other subtypes of GBM and could independently predict poor outcomes of GBM patients.

Conclusion
The present work mainly concentrated on the biological role of HK3 in glioma and offered a novel insight of HK3 regulating the activation of immune cells in the glioma microenvironment. These findings could provide a new theoretical evidence for understanding the metabolic molecular within the glioma microenvironment and identifying new therapeutic targets.
Profiling small RNAs in fecal immunochemical tests: is it possible?
Authors: Birkeland Einar , Ferrero Giulio , Pardini Barbara , Umu Sinan U. , Tarallo Sonia , Bulfamante Sara , Hoff Geir , Senore Carlo , Rounge Trine B , Naccarati Alessio 
Published: October 2023

AbstractFecal microRNAs represent promising molecules with potential clinical interest as non-invasive diagnostic and prognostic biomarkers. Colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) is an effective tool for prevention of cancer development. However, due to the poor sensitivity of FIT especially for premalignant lesions, there is a need for implementation of complementary tests. Improving the identification of individuals who would benefit from further investigation with colonoscopy using molecular analysis, such as miRNA profiling of FIT samples, would be ideal due to their widespread use. In the present study, we assessed the feasibility of applying small RNA sequencing to measure human miRNAs in FIT leftover buffer in samples from two European screening populations. We showed robust detection of miRNAs with profiles similar to those obtained from specimens sampled using the established protocol of RNA stabilizing buffers, or in long-term archived samples. Detected miRNAs exhibited differential abundances for CRC, advanced adenoma, and control samples that were consistent for FIT and RNA-stabilizing buffers. Interestingly, the sequencing data also allowed for concomitant evaluation of small RNA-based microbial profiles. We demonstrated that it is possible to explore the human miRNome in FIT leftover samples across populations and envision that the analysis of small RNA biomarkers can complement the FIT in large scale screening settings.
The gut microbiome tango in the progression of chronic kidney disease and potential therapeutic strategies
Authors: Tang Zijing , Yu Shiyan , Pan Yu 
Published: October 2023

AbstractChronic kidney disease (CKD) affects more than 10% population worldwide and becomes a huge burden to the world. Recent studies have revealed multifold interactions between CKD and gut microbiome and their pathophysiological implications. The gut microbiome disturbed by CKD results in the imbalanced composition and quantity of gut microbiota and subsequent changes in its metabolites and functions. Studies have shown that both the dysbiotic gut microbiota and its metabolites have negative impacts on the immune system and aggravate diseases in different ways. Herein, we give an overview of the currently known mechanisms of CKD progression and the alterations of the immune system. Particularly, we summarize the effects of uremic toxins on the immune system and review the roles of gut microbiota in promoting the development of different kidney diseases. Finally, we discuss the current sequencing technologies and novel therapies targeting the gut microbiome.
Drivers, barriers, and response to care of Australian pregnant women seeking chiropractic care for low back and pelvic girdle pain: a qualitative case study
Authors: Bernard-Giglio Maria , French Simon D , Myburgh Corrie , de Luca Katie 
Published: October 2023

Abstract
Background
Pregnancy-related low back and/or pelvic girdle pain is common, with a prevalence rate of up to 86% in pregnant women. Although 19.5% of Australian pregnant women visit a chiropractor for pelvic girdle pain, little is known about the experience of pregnant women who seek this care. The aim of this study was to describe and explore the experiences of Australian pregnant women who seek chiropractic care for their current pregnancy-related low back and/or pelvic girdle pain.

Methods
A qualitative case study approach with purposive sampling from 27 chiropractic practices was used. A grounded theory approach was informed by a constructivist and interpretivist stance, which provided understanding and meaning to the pregnant women’s experiences. Online unstructured interviews were recorded, transcribed, and anonymised. A thematic analysis was subsequently conducted on the primary data. Codes and major themes were developed with the use of critical self- reflection (memos), survey finding triangulation and respondent validation.

Results
Sixteen potential respondents expressed interest in participating. After eligibility screening and data saturation, nine interviews were undertaken. Four key themes were identified: “Care drivers: what drives care seeking?”, “Care barriers: what barriers are encountered?”, “Chiropractic treatment: what does treatment consist of?” and “Response to care: what response was there to care?”.

Conclusion
Four key themes: care drivers, care barriers, chiropractic treatment, and response to care support an emergent substantive-level theory in women’s care seeking experiences for pregnancy-related back pain and chiropractic care. This theory is that chiropractic care for pregnant women experiencing low back pain and pelvic girdle pain may improve pain and function, while reducing pregnancy-related biopsychosocial concerns. The findings may inform antenatal health providers and the chiropractic profession about pregnant women’s experience seeking chiropractic care as well as directing future research.
Overcoming distance: an exploration of current practices of government and charity-funded critical care transport and retrieval organizations
Authors: Greene Adam , Dion Pierre-Marc , Nolan Brodie , Trachter Rob , Vu Erik , Trojanowski Jan 
Published: October 2023

Abstract
Background
For critically ill and injured patients, timely access to definitive care is associated with a reduction in avoidable mortality. Access to definitive care is significantly affected by geographic remoteness. To overcome this disparity, a robust critical care transport (CCT) or retrieval system is essential to support the equity of care and overcome the tyranny of distance. While critical care transport or retrieval systems have evolved over the years, there is no universally accepted system or standard, which has led to considerable variation in practices. The objective of this mixed-methods study was to identify and explore the current clinical, operational, and educational practices of government and charity-funded critical care transport and retrieval organizations operating across access- and weather- challenged geography.

Methods
This study utilized a mixed-methods approach comprising a rapid review of the literature and semi-structured interviews with identified subject matter experts (SME).

Results
A total of 44 articles and 14 interviews with SMEs from six different countries, 12 different services/systems, and seven operational roles, including clinicians (physician, paramedic, and nurse), educator, quality improvement, clinical governance, clinical informatics and research, operations manager, and medical director were included in the narrative analysis. The study identified several themes including deployment, crew composition, selection and education, clinical governance, quality assurance and quality improvement and research.

Conclusion
This mixed-methods study underscores the paucity of literature describing current clinical, operational, and educational practices of government or charity-funded CCT or retrieval programs operating across access- and weather- challenged geography. While many common themes were identified including clearly defined mission profiles, use of dedicated or specialized transport teams, central coordination, rigorous selection processes, service-sponsored graduate education, and strong clinical governance, there is little consensus and considerable variation in current practices. Further research is needed to identify and harmonize best practices within the CCT and retrieval environments.
Escherichia coli displays a conserved membrane proteomic response to a range of alcohols
Authors: Sen Oishi , Hinks Jamie , Lin Qifeng , Lin Qingsong , Kjelleberg Staffan , Rice Scott A. , Seviour Thomas 
Published: October 2023

Abstract
Background
Alcohol is a good and environment-friendly fuel that can be microbially produced, capable of eliminating many of the limitations of the present-day fossil fuels. However, the inherent toxic nature of alcohols to the microbial cells leads to end-product inhibition that limits large-scale alcohol production by fermentation. Fundamental knowledge about the stress responses of microorganisms to alcohols would greatly facilitate to improve the microbial alcohol tolerance. The current study elucidates and compares the changes in the membrane proteome of Escherichia coli in response to a range of alcohols.

Results
Although alcohol toxicity increased exponentially with alcohol chain length (2–6 carbon), similar stress responses were observed in the inner and outer membrane proteome of E. coli in the presence of 2-, 4- and 6-carbon alcohols at the MIC50. This pertains to: (1) increased levels of inner membrane transporters for uptake of energy-producing metabolites, (2) reduced levels of non-essential proteins, associated with anaerobic, carbon starvation and osmotic stress, for energy conservation, (3) increased levels of murein degrading enzymes (MltA, EmtA, MliC and DigH) promoting cell elongation and 4) reduced levels of most outer membrane β-barrel proteins (LptD, FadL, LamB, TolC and BamA). Major outer membrane β-barrel protein OmpC, which is known to contribute to ethanol tolerance and membrane integrity, was notably reduced by alcohol stress. While LPS is important for OmpC trimerisation, LPS release by EDTA did not lower OmpC levels. This suggests that LPS release, which is reported under alcohol stress, does not contribute to the reduced levels of OmpC in the presence of alcohol.

Conclusions
Since alcohol primarily targets the integrity of the membrane, maintenance of outer membrane OmpC levels in the presence of alcohol might help in the survival of E. coli to higher alcohol concentrations. The study provides important information about the membrane protein responses of E. coli to a range of alcohols, which can be used to develop targeted strategies for increased microbial alcohol tolerance and hence bioalcohol production.