bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary potassium liberalization with fruit and vegetables versus potassium restriction in people with chronic kidney disease (DK-Lib CKD): a clinical trial protocol
Authors: Iman Yasmin , Balshaw Robert , Alexiuk Mackenzie , Hingwala Jay , Cahill Leah , Mollard Rebecca , Tangri Navdeep , Mackay Dylan 
Published: October 2023

Abstract
Background
Potassium regulation in the body is primarily done in the kidney. In addition to this, hyperkalemia, occurs in approximately 10% of individuals with chronic kidney disease (CKD) and is associated with elevated all-cause mortality. Individuals with CKD are often told to restrict dietary potassium (K), however, this recommendation is based on low quality evidence. Reduced quality of life, limited dietary choices and nutritional deficiencies are all potential negative outcomes that may occur when restricting dietary K in CKD patients. There is a need for randomized controlled trials investigating the impact of dietary K modification on serum K concentrations in people with CKD.

Methods
A randomized 2-period crossover design comparing a liberalized K fruit and vegetable diet where participants will be required to consume ~ 3500 mg of dietary K daily, to a standard K restricted diet where participants will be required to consume < 2000 mg of dietary K daily. All participants will begin on a liberalized K run-in period for 2 weeks where they will receive fruit and vegetables home deliveries and for safety will have clinical chemistry, including serum potassium measurements taken after 1 week. Participants will then be randomized into either liberalized K or standard K diet for six weeks and then crossover to the other intervention for another 6 weeks after a 2-week washout period.

Discussion
30 male and female CKD outpatients, ≥ 18 years of age, who have an estimated glomerular filtration rate (eGFR) between 15 and 45 ml/min/1.73m2 and serum K between 4.5 and 5.5 mEq/L. This design would have greater than 80% power to detect a difference of 0.35 mEq/L serum K between groups. Anthropometric measurements, clinical chemistry, dietary recalls, physical function assessments, as well as a quality of life assessments will also be measured in this trial. These findings will provide high quality evidence for, or against, recommendations for dietary K restriction in individuals living with CKD. The removal of K restriction could provide individuals living with CKD more dietary choice leading to improved dietary status and quality of life.

Trial Registration
This trial has received approval from the University of Manitoba Research Ethics board (HS25191 (B2021:104)).
Zimmermann-Laband syndrome and infantile systemic hyalinosis: an enigma with two separate terms with overlapping features: a case report
Authors: Owlia Fatemeh , Navabazam Alireza , akhavan-karbasi Mohammad-Hasan , Derakhshan Barjoei Mohammad Moein 
Published: October 2023

AbstractBackgroundZimmermann-Laband Syndrome (ZLS) and infantile systemic hyalinosis (ISH) are rare genetic disorders. They are characterized by various spectrum manifestations. In spite of other case reports, this case with features of both syndromes was reported by oral medicine specialists and oral and maxillofacial surgeons.Case presentationIn this study, we reported an 18-months old female patient with gingival overgrowth. This phenomenon completely embedded all the erupted teeth. In this case, the presence of multiple papulonodular cutaneous lesions is a newly observed aspect that has rarely been reported in the existing literature. Gingival overgrowth was excised under general anesthesia. At six months of follow-up after surgery, mastication and breathing problems were improved. Aesthetic aspects were ameliorated in terms of gingival appearance.ConclusionsTo date, due to the ambiguous presentations, both syndromes remain an enigma for specialists. A timely diagnosis could be crucial for prognosis and preventing severe further surcharge. Dentists could play an important role in the diagnosis of rare disorders.
Psychosis secondary to thyrotoxicosis that persisted post-thyroidectomy: a case report
Authors: Kothari Shiva , Townsend William , Chaudhry Zuhaib , Kalin Seth , Freeman Kevin 
Published: October 2023

Abstract
Background
This case report is of a patient with psychosis secondary to thyrotoxicosis that persisted and reemerged after definitive treatment of thyroidectomy, which is a unique occurrence in the literature.

Case presentation
This patient is a male between 30 and 35 years of age with a history of Graves Disease and no past psychiatric history who was admitted to the hospital due to psychosis secondary to thyrotoxicosis. The thyrotoxicosis was treated with surgical removal, but the psychotic symptoms persisted after surgery and normalization of standard thyroid functional measures. The symptoms were of sufficient significance for inpatient psychiatric hospitalization, a rare occurrence. Ultimately after an extended stay in the psychiatric unit, the patient’s symptoms stabilized with a second-generation antipsychotic, and the patient was discharged from the psychiatric unit.

Conclusion
This case is evidence that the link between psychosis and hyperthyroidism is still poorly understood due to the patient’s psychotic symptoms persisting after the definitive treatment of thyroidectomy and the fact that it required anti-psychotic medications for normalization.
Identification of the causal relationship between sleep quality, insomnia, and oral ulcers
Authors: Liu Qianxi , Wang Jiongke , Liu Tiannan , Zeng Xin , Zhang Xuefeng 
Published: October 2023

Abstract
Background
Multiple epidemiological studies have posited a potential association between sleep quality and the risk of oral diseases, yet the resulting conclusions have remained contentious, and the presence of a causal link remains equivocal. In this study, we aimed to investigate the causal relationship between sleep duration, insomnia, and common oral diseases.

Methods
We utilized genetic correlation and two-sample Mendelian randomization analyses based on summary statistics from genome-wide association studies of sleep duration (N = 460,099), insomnia (N = 462,341), mouth ulcer (N = 385,026), oral cavity cancer (N = 4,151), and periodontal disease (N = 527,652).

Results
Our results revealed a negative genetic correlation between sleep duration and mouth ulcer (genetic correlation: -0.09, P = 0.007), while a positive genetic correlation between insomnia and mouth ulcer was observed (genetic correlation: 0.18, P = 2.51E-06). Furthermore, we demonstrated that longer sleep duration is significantly associated with a reduced risk of mouth ulcers (OR: 0.67, 95% CI: 0.54–0.83, P = 2.84E-04), whereas insomnia is nominally associated with an increased risk of mouth ulcers (OR: 1.40, 95% CI: 1.01–1.95, P = 0.044). In contrast, no significant association was detected between sleep quality and periodontal disease or oral cavity cancer.

Conclusions
This work provides robust evidence to support the notion that enhanced sleep quality may confer a decreased risk of oral ulcers, thereby bearing considerable clinical relevance.
Sense of coherence in a general adult population in Northern Norway and its associations with oral health
Authors: Mathisen Kine Margrethe , Holde Gro Eirin , Torp Steffen , Jönsson Birgitta 
Published: October 2023

Abstract
Background
Sense of coherence (SOC) is a global orientation to life that may affect a person’s way of acting and living within his or her life context, which can have an impact on general and oral health. The aims of this study were (i) to describe the distribution of SOC in a general adult population; (ii) to explore whether sociodemographic characteristics, oral health-related behaviours, self-reported oral health, and clinical oral status were associated with SOC; and (iii) to explore whether SOC was associated with self-reported oral health, controlling for sociodemographic characteristics, oral health-related behaviours, and oral clinical status.

Methods
This study was based on data from the cross-sectional population-based study Oral Health in Northern Norway (N = 1819 individuals, 923 women, mean age 47.1 ± 15.2 years). Data were collected between October 2013 and November 2014 in Troms County. Participants answered a questionnaire that included items on SOC, sociodemographic characteristics, oral health-related behaviours, and self-reported oral health. Clinical oral status (number of teeth, dental caries, and periodontal status) was determined through oral and radiographic examination. Linear regression analysis was used to examine factors associated with SOC. Logistic regression analysis was used to examine SOC and its association with self-reported oral health adjusted for sociodemographic characteristics, behaviours, and clinical oral status.

Results
The mean SOC score was 68.5 (standard deviation 10.5). The younger age groups (20–29 and 30–39 years) had mean SOC scores of 64.0 (95% CI: 62.7,65.3) and 67.2 (95% CI: 66.0,68.5), respectively, and the older age groups (40–79 years) had mean SOC scores between 69.8 and 70.1 (95% CI: 68.2,71.3). A higher mean SOC score was associated with older age, higher education level, higher income (all p < 0.001), being married/cohabiting (p = 0.005), and toothbrushing ≥ 2 times/day (p = 0.008). Approximately 49% of participants reported good oral health. SOC was positively associated with self-reported good oral health in the adjusted model (odds ratio:1.03 [95% CI: 1.02,1.05] p < 0.001).

Conclusions
SOC was associated with sociodemographic characteristics and toothbrushing habits. There was no significant association between SOC and clinical oral status; however, SOC was positively associated with self-reported good oral health. This indicates that a person’s SOC might have an impact on how an individual perceives their oral health, independent of sociodemographic characteristics and the presence of oral diseases.
A systematic review on removal of osseointegrated implants: un update
Authors: Tafuri Giuseppe , Santilli Manlio , Manciocchi Eugenio , Rexhepi Imena , D’Addazio Gianmaria , Caputi Sergio , Sinjari Bruna 
Published: October 2023

Abstract
Background
Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be biological or mechanical complications during the therapy, which lead to the loss of the implant. This systematic review aims to evaluate the current state of the art in the literature on techniques used for the removal of dental implants. Various aspects will be analyzed, such as the success of the technique, any complications, and the advantages and disadvantages of their use.

Methods
Two reviewers conducted a literature analysis (PubMed, Embase, Web of Science) of the last 20 years (2003–2023). The main criterion analyzed was the success of the technique, while secondary outcomes such as complications and risks of the technique were also analyzed. 258 articles were identified in the various search databases. 42 eligible articles were subsequently identified after an article screening. Only 18 full texts were subsequently included in the review.

Results
A total of 18 articles were selected and 1142 implants and 595 patients were included. The main techniques used were the Counter-Torque Ratchet Technique (CTRT), Piezoelectric bone surgery (PBS), trephine drills, carbide burs, Erbium, Chromium, Yttrium, Scandium, Gallium, Garnett (Er:Cr:YSGG) laser and carbon dioxide (CO2) laser. Combined uses of techniques have been identified such as: PBS and trephine burs or carbide burs, trephine burs with the use of a 3d-printed guide, CTRT and trephine burs. The technique with the highest success rate, less morbidity for the patient, and less removal of bone appears to be the CTRT.

Conclusions
The use of conservative techniques, especially CTRT, in bone removal is useful to allow for immediate implant placement in the removal area. However, further studies with a high sample size are needed to be performed on all techniques, particularly new randomized controlled trials (RCTs) that allow for the analysis of the success of alternative techniques such as Laser and Piezosurgery, which appear to be very promising.
Negation recognition in clinical natural language processing using a combination of the NegEx algorithm and a convolutional neural network
Authors: Argüello-González Guillermo , Aquino-Esperanza José , Salvador Daniel , Bretón-Romero Rosa , Del Río-Bermudez Carlos , Tello Jorge , Menke Sebastian 
Published: October 2023

Abstract
Background
Important clinical information of patients is present in unstructured free-text fields of Electronic Health Records (EHRs). While this information can be extracted using clinical Natural Language Processing (cNLP), the recognition of negation modifiers represents an important challenge. A wide range of cNLP applications have been developed to detect the negation of medical entities in clinical free-text, however, effective solutions for languages other than English are scarce. This study aimed at developing a solution for negation recognition in Spanish EHRs based on a combination of a customized rule-based NegEx layer and a convolutional neural network (CNN).

Methods
Based on our previous experience in real world evidence (RWE) studies using information embedded in EHRs, negation recognition was simplified into a binary problem (‘affirmative’ vs. ‘non-affirmative’ class). For the NegEx layer, negation rules were obtained from a publicly available Spanish corpus and enriched with custom ones, whereby the CNN binary classifier was trained on EHRs annotated for clinical named entities (cNEs) and negation markers by medical doctors.

Results
The proposed negation recognition pipeline obtained precision, recall, and F1-score of 0.93, 0.94, and 0.94 for the ‘affirmative’ class, and 0.86, 0.84, and 0.85 for the ‘non-affirmative’ class, respectively. To validate the generalization capabilities of our methodology, we applied the negation recognition pipeline on EHRs (6,710 cNEs) from a different data source distribution than the training corpus and obtained consistent performance metrics for the ‘affirmative’ and ‘non-affirmative’ class (0.95, 0.97, and 0.96; and 0.90, 0.83, and 0.86 for precision, recall, and F1-score, respectively). Lastly, we evaluated the pipeline against two publicly available Spanish negation corpora, the IULA and NUBes, obtaining state-of-the-art metrics (1.00, 0.99, and 0.99; and 1.00, 0.93, and 0.96 for precision, recall, and F1-score, respectively).

Conclusion
Negation recognition is a source of low precision in the retrieval of cNEs from EHRs’ free-text. Combining a customized rule-based NegEx layer with a CNN binary classifier outperformed many other current approaches. RWE studies highly benefit from the correct recognition of negation as it reduces false positive detections of cNE which otherwise would undoubtedly reduce the credibility of cNLP systems.
Characterization of essential eggshell proteins from Aedes aegypti mosquitoes
Authors: Isoe Jun , Simington Carter J. , Oscherwitz Max E. , Peterson Alyssa J. , Rascón Alberto A. , Massani Brooke B. , Miesfeld Roger L. , Riehle Michael A. 
Published: October 2023

Abstract
Background
Up to 40% of the world population live in areas where mosquitoes capable of transmitting the dengue virus, including Aedes aegypti, coexist with humans. Understanding how mosquito egg development and oviposition are regulated at the molecular level may provide new insights into novel mosquito control strategies. Previously, we identified a protein named eggshell organizing factor 1 (EOF1) that when knocked down with RNA interference (RNAi) resulted in non-melanized and fragile eggs that did not contain viable embryos.

Results
In this current study, we performed a comprehensive RNAi screen of putative A. aegypti eggshell proteins to identify additional proteins that interact with intracellular EOF1. We identified several proteins essential for eggshell formation in A. aegypti and characterized their phenotypes through a combination of molecular and biochemical approaches. We found that Nasrat, Closca, and Polehole structural proteins, together with the Nudel serine protease, are indispensable for eggshell melanization and egg viability. While all four proteins are predominantly expressed in ovaries of adult females, Nudel messenger RNA (mRNA) expression is highly upregulated in response to blood feeding. Furthermore, we identified four additional secreted eggshell enzymes that regulated mosquito eggshell formation and melanization. These enzymes included three dopachrome-converting enzymes (DCEs) and one cysteine protease. All eight of these eggshell proteins were essential for proper eggshell formation. Interestingly, their eggshell surface topologies in response to RNAi did not phenocopy the effect of RNAi-EOF1, suggesting that additional mechanisms may influence how EOF1 regulates eggshell formation and melanization.

Conclusions
While our studies did not identify a definitive regulator of EOF1, we did identify eight additional proteins involved in mosquito eggshell formation that may be leveraged for future control strategies.
Phenylalanyl-tRNA synthetase deficiency caused by biallelic variants in FARSA gene and literature review
Authors: Guo Ruolan , Chen Yuanying , Hu Xuyun , Qi Zhan , Guo Jun , Li Yuchuan , Hao Chanjuan 
Published: October 2023

Abstract
Background
Aminoacyl-tRNA synthetases (ARSs) are indispensable enzymes for protein biosynthesis in cells. The phenylalanyl-tRNA synthetase (FARS1) located in cytoplasm which consists of two FARS alpha subunits (FARSA) and two FARS beta subunits (FARSB). Autosomal recessive inheritance of pathogenic variants of FARSA or FARSB can result in defective FARS1 which are characterized by interstitial lung disease, liver disease, brain abnormalities, facial dysmorphism and growth restriction.

Methods
Exome sequencing was used to detect the candidate variants. The in silico prediction and expressional level analysis were performed to evaluate the pathogenicity of the variations. Additionally, we presented the patient’s detailed clinical information and compared the clinical feature with other previously reported patients with FARSA-deficiency.

Results
We identified compound heterozygous rare missense variants (c.1172 T > C/ p.Leu391Pro and c.1211G > A/ p.Arg404His) in FARSA gene in a Chinese male patient. The protein structure prediction and the analysis of levels of FARSA and FARSB subunits indicated both variants pathogenic. Clinical feature review indicated inflammatory symptoms in young infants may be an additional key feature. Thyroid dysfunction should be considered as a phenotype with variable penetrance.

Conclusions
Our results expanded the current phenotypic and genetic spectrum of FARSA-deficiency.
c-Diadem: a constrained dual-input deep learning model to identify novel biomarkers in Alzheimer’s disease
Authors: Jemimah Sherlyn , AlShehhi Aamna ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: October 2023

Abstract
Background
Alzheimer’s disease (AD) is an incurable, debilitating neurodegenerative disorder. Current biomarkers for AD diagnosis require expensive neuroimaging or invasive cerebrospinal fluid sampling, thus precluding early detection. Blood-based biomarker discovery in Alzheimer’s can facilitate less-invasive, routine diagnostic tests to aid early intervention. Therefore, we propose “c-Diadem” (constrained dual-input Alzheimer’s disease model), a novel deep learning classifier which incorporates KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway constraints on the input genotyping data to predict disease, i.e., mild cognitive impairment (MCI)/AD or cognitively normal (CN). SHAP (SHapley Additive exPlanations) was used to explain the model and identify novel, potential blood-based genetic markers of MCI/AD.

Methods
We developed a novel constrained deep learning neural network which utilizes SNPs (single nucleotide polymorphisms) and microarray data from ADNI (Alzheimer’s Disease Neuroimaging Initiative) to predict the disease status of participants, i.e., CN or with disease (MCI/AD), and identify potential blood-based biomarkers for diagnosis and intervention. The dataset contains samples from 626 participants, of which 212 are CN (average age 74.6 ± 5.4 years) and 414 patients have MCI/AD (average age 72.7 ± 7.6 years). KEGG pathway information was used to generate constraints applied to the input tensors, thus enhancing the interpretability of the model. SHAP scores were used to identify genes which could potentially serve as biomarkers for diagnosis and targets for drug development.

Results
Our model’s performance, with accuracy of 69% and AUC of 70% in the test dataset, is superior to previous models. The SHAP scores show that SNPs in PRKCZ, PLCB1 and ITPR2 as well as expression of HLA-DQB1, EIF1AY, HLA-DQA1, and ZFP57 have more impact on model predictions.

Conclusions
In addition to predicting MCI/AD, our model has been interrogated for potential genetic biomarkers using SHAP. From our analysis, we have identified blood-based genetic markers related to Ca2+ ion release in affected regions of the brain, as well as depression. The findings from our study provides insights into disease mechanisms, and can facilitate innovation in less-invasive, cost-effective diagnostics. To the best of our knowledge, our model is the first to use pathway constraints in a multimodal neural network to identify potential genetic markers for AD.
Data from network meta-analyses can inform clinical practice guidelines and decision-making in diabetes management: perspectives of the taskforce of the guideline workshop
Authors: Ceriello Antonio , Rodbard Helena W. , Battelino Tadej , Brosius Frank , Cosentino Francesco , Green Jennifer , Ji Linong , Kellerer Monika , Koob Susan , Kosiborod Mikhail , Lalic Nebojsa , Marx Nikolaus , Nedungadi T. Prashant , Parkin Christopher G. , Rydén Lars , Sheu Wayne Huey-Herng , Standl Eberhard , Vandvik Per Olav , Schnell Oliver ,   for the Taskforce of the Guideline Workshop
Published: October 2023

AbstractIn recent years, several novel agents have become available to treat individuals with type 2 diabetes (T2D), such as sodium-glucose cotransporter-2 inhibitors (SGLT-2i), tirzepatide, which is a dual glucose-dependent insulinotropic polypeptide receptor agonist (GIP RA)/glucagon-like peptide-1 receptor agonist (GLP-1 RA), and finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA) that confers significant renal and cardiovascular benefits in individuals with (CKD). New medications have the potential to improve the lives of individuals with diabetes. However, clinicians are challenged to understand the benefits and potential risks associated with these new and emerging treatment options. In this article, we discuss how use of network meta-analyses (NMA) can fill this need.