bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress testing of an objective structured clinical examination during undergraduate clinical clerkship: a mixed-methods pilot study
Authors: Shimizu Ikuo , Mori Junichiro , Yamauchi Aiga , Kato Sawako , Masuda Yuichi , Nakazawa Yuichi , Kanno Hiroyuki 
Published: December 2023

Abstract
Background
Progress testing is an assessment method in which an examination reflecting competencies at graduation is regularly administered to students over multiple years, thereby facilitating self-directed learning. However, the significance of the objective structured clinical examination as a progress test in undergraduate education, needs to be determined. This study provides evidence of the role of the objective structured clinical examination for progress testing and optimal scoring methods for assessing students in different academic years.

Methods
We conducted a sequential explanatory mixed-methods pilot study. Participants were assessed using the Item Rating Scale, the year-adjusted Global Rating Scale, and the Training Level Rating Scale. The characteristics of each scale were compared quantitatively. In addition, the influence of the objective structured clinical examination as a progress test on learning attitudes was examined. Qualitative data from a post-examination questionnaire were analyzed, using content analysis to explore influences on self-directed learning.

Results
Sixth and fifth year clinical students (n = 235) took the objective structured clinical examination progress test. The total Item Rating Scales were recorded (%) as 59.03 ± 5.27 and 52.64 ± 5.08 (p < 0.01); Training Level Rating Scale was 3.94 ± 0.39 vs 3.22 ± 0.42 (p < 0.01); and the year-adjusted Global Rating Scale was 4.25 ± 0.44 vs 4.32 ± 0.52 (no significant difference), for the sixth and fifth year students, respectively. The correlations across stations and the reliability of each station were satisfactory. Four categories were identified in the qualitative analysis: “motivation to learn during the clinical clerkship was promoted,” “dissatisfied with being asked about things they had not experienced,” “confusion about being unable to use conventional test-taking strategies,” and “insufficient understanding of competencies at graduation.” The scores indicated significant differences in performance according to training year.

Conclusions
This study provides evidence that the objective structured clinical examination can be used as a progress testing tool for undergraduate clinical clerkships. Further enhancement of training opportunities and dissemination of performance competency goals in clerkship curricula are required if we intend to promote self-directed learning through progress testing.
Management of edoxaban therapy and clinical outcomes in patients undergoing major or nonmajor surgery: a subanalysis of the EMIT-AF/VTE study
Authors: von Heymann Christian , Unverdorben Martin , Colonna Paolo , Santamaria Amparo , Saxena Manish , Vanassche Thomas , Köhler Sabine , Borrow Amanda P. , Jin James , Chen Cathy 
Published: December 2023

Abstract
Background
Optimising periprocedural management of direct oral anticoagulation in patients with atrial fibrillation on chronic treatment undergoing major surgeries is an important aspect of balancing the risk of surgery-related bleeding with the risk of thromboembolic events, which may vary by surgery type.

Methods
This subanalysis of the prospective EMIT-AF/VTE programme assessed periprocedural-edoxaban management, according to physicians’ decisions, and bleeding and thromboembolic event rates in patients who underwent major vs. nonmajor surgeries. Edoxaban interruption and clinical outcomes were compared between major vs. nonmajor surgeries and between renal function subgroups (creatinine clearance [CrCL] ≤ 50 mL/min vs. > 50 mL/min).

Results
We included 276 major and 512 nonmajor surgeries. The median pre- and postprocedural duration of edoxaban interruption in major vs. nonmajor surgeries was 4 vs. 1 days, whereas median duration of interruption for those with preprocedural-only and postprocedural-only interruption was 2 vs. 1 days and 2 vs. 0 days, respectively (P < 0.0001). Rates of all bleeding and clinically relevant nonmajor bleeding were numerically higher in major vs. nonmajor surgeries. Event rates (number of events per 100 surgeries) were low overall (< 6 events per 100 surgeries), independent of renal function subgroups.

Conclusion
In this subanalysis of the EMIT-AF/VTE programme, periprocedural-edoxaban interruption was significantly longer in patients undergoing major vs. nonmajor surgery. This clinician-driven approach was associated with low rates of bleeding and thromboembolic events following both major and nonmajor surgeries.

Trial registration
NCT02950168, registered October 31, 2016; NCT02951039, registered November 1, 2016.
Assisted reproductive technology induces different secondary sex ratio: parental and embryonic impacts
Authors: Zhao Jiansen , Shen Haoran , Zhu Qijiong , Liu Jiong , Han Jianhua , Yi Ruiting , Li Junxing , Lin Yanshan , Liu Tao , Zhong Xinqi 
Published: December 2023

Abstract
Background
Assisted reproduction technology (ART) has advanced significantly, raising concerns regarding its impact on the secondary sex ratio (SSR), which is the sex ratio at birth in offspring. This study aimed to explore factors affecting SSR in singletons, singletons from twin gestation, and twins from twin gestation within the context of ART.

Methods
A retrospective analysis was conducted on data from 8335 births involving 6,223 couples undergoing ART. Binary logistic regression assessed relationships between parental and embryonic factors and SSR in singletons and singletons from twin gestation. Multinomial logistic regression models were utilized to identify factors influencing SSR in twins from twin gestation.

Results
Secondary infertility (OR = 1.164, 95% CI: 1.009–1.342), advanced paternal age (OR = 1.261, 95% CI: 1.038–1.534), and blastocyst embryo transfer (OR = 1.339, 95% CI: 1.030–1.742) were associated with an increased SSR, while frozen embryo transfer (FET) showed a negative association with SSR (OR = 0.738, 95% CI: 0.597–0.912) in singletons. A longer duration of gonadotropin (Gn) usage reduced SSR in singletons (OR = 0.961, 95% CI: 0.932–0.990) and singletons from twin gestation (OR = 0.906, 95% CI: 0.838–0.980). In singletons from twin gestation, male-induced infertility (OR = 2.208, 95% CI: 1.120–4.348) and higher Gn dosage (OR = 1.250, 95% CI: 1.010–1.548) were significantly associated with an increased SSR. Women aged > 35 years and intracytoplasmic sperm injection (ICSI) were associated with lower SSR (OR = 0.539, 95% CI: 0.293–0.990 and OR = 0.331, 95% CI: 0.158–0.690, respectively). In twins from twin gestation, paternal age exceeded maternal age (OR = 0.682, 95% CI: 0.492–0.945) and higher Gn dosage (OR = 0.837, 95% CI: 0.715–0.980) were associated with a higher proportion of male twins. Cleavage stage transfer (OR = 1.754, 95% CI: 1.133–2.716) resulted in a higher percentage of boy-girl twins compared to blastocyst transfer.

Conclusion
This study demonstrates the complex interplay of various factors in determining the SSR in ART, highlighting the importance of considering infertility type, paternal age, fertilization method, embryo transfer stage, and Gn use duration when assessing SSR. Nevertheless, further research with a large sample size is necessary to confirm and expand upon the findings of this study.
Three-dimensional quantification of mandibular asymmetries in Caucasian adult patients with different sagittal and vertical skeletal patterns. A cone beam study using 3D segmentation and mirroring procedures
Authors: España-Pamplona Pilar , Zamora-Martinez Natalia , Tarazona-Álvarez Beatriz , Pangrazio-Kulbersh Valmy , Paredes-Gallardo Vanessa 
Published: December 2023

Abstract
Introduction
An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level.

Methods
The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software’s. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels.

Results
There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036–0.222; p < 0.001). Although the subjects under study did not present significant differences between mandibular asymmetries and their sagittal or vertical skeletal pattern (p = 0.809 and p = 0.453, respectively), a statistically significant difference has been found depending on the anatomical region (p < 0.001; CI95%=1.020–1.021), being higher in the condyle, followed by the ramus and the corpus.

Conclusions
Although mandibular asymmetries cannot be correlated with vertical and sagittal skeletal patterns in symmetric patients, knowledge about 3D segmentation procedures and color maps can provide valuable information to identify mandibular asymmetries.
Comparative analysis of surgical interventions for osteonecrosis of the femoral head: a network meta-analysis of randomized controlled trials
Authors: Hu Liyou , Deng Xiaolei , Wei Bo , Wang Jian , Hou Decai 
Published: December 2023

Abstract
Background
Despite several surgical options, there remains no consensus regarding the optimal approach for osteonecrosis of the femoral head (ONFH), a prevalent and refractory disease. To determine the most suitable treatment modality, we compared randomized controlled trials (RCTs) that evaluated multiple surgical treatments for ONFH using a Bayesian network meta-analysis (NMA).

Methods
The outcomes of 11 different surgical treatments were assessed using NMA comparisons of the rate of progression of femoral head necrosis, the rate of conversion to total hip arthroplasty, and improvement of the Harris hip score (HHS). A random effects model was used to analyze the odds ratio (OR) or mean difference, and risk of bias was assessed using the Cochrane risk of bias assessment tool for randomized trials. The confidence of the results was assessed using the confidence in network meta-analysis tool.

Results
A total of 18 RCTs were included in the meta-analysis. Compared with core decompression (CD), the forest plot showed that autologous bone grafting (ABG), free fibula grafting (FFG), vascularized bone grafting (VBG), autologous bone grafting combined with bone marrow aspirate concentrate (ABG + BMAC), and biomaterial grafting combined with vascularized bone grafting (BMG + VBG) delayed ONFH progression. Among them, ABG + BMAC showed the most promising results (OR 0.019; 95% confidence interval [CI] 0.0012–0.25). However, upon comparing CD with different surgical modalities, no significant differences were found in preventing total hip arthroplasty. Furthermore, we cannot draw conclusions regarding the HHS due to attribution and high heterogeneity across the studies.

Conclusion
Overall, ABG, VBG, FFG, ABG + BMAC, and BMG + VBG showed significant results in preventing ONFH progression compared with that shown by CD. Based on the surface under the cumulative ranking, ABG + BMAC was the most effective. Moreover, all treatments involving bone grafting were found to be effective, possibly indicating the necessity of its use in the treatment of ONFH.
Metabolic GWAS-based dissection of genetic basis underlying nutrient quality variation and domestication of cassava storage root
Authors: Ding Zehong , Fu Lili , Wang Bin , Ye Jianqiu , Ou Wenjun , Yan Yan , Li Meiying , Zeng Liwang , Dong Xuekui , Tie Weiwei , Ye Xiaoxue , Yang Jinghao , Xie Zhengnan , Wang Yu , Guo Jianchun , Chen Songbi , Xiao Xinhui , Wan Zhongqing , An Feifei , Zhang Jiaming , Peng Ming , Luo Jie , Li Kaimian , Hu Wei 
Published: December 2023

AbstractBackgroundMetabolites play critical roles in regulating nutritional qualities of plants, thereby influencing their consumption and human health. However, the genetic basis underlying the metabolite-based nutrient quality and domestication of root and tuber crops remain largely unknown.ResultsWe report a comprehensive study combining metabolic and phenotypic genome-wide association studies to dissect the genetic basis of metabolites in the storage root (SR) of cassava. We quantify 2,980 metabolic features in 299 cultivated cassava accessions. We detect 18,218 significant marker-metabolite associations via metabolic genome-wide association mapping and identify 12 candidate genes responsible for the levels of metabolites that are of potential nutritional importance.Me3GT,MeMYB4, andUGT85K4/UGT85K5, which are involved in flavone, anthocyanin, and cyanogenic glucoside metabolism, respectively, are functionally validated through in vitro enzyme assays and in vivo gene silencing analyses. We identify a cluster of cyanogenic glucoside biosynthesis genes, among whichCYP79D1,CYP71E7b, andUGT85K5are highly co-expressed and their allelic combination contributes to low linamarin content. We findMeMYB4is responsible for variations in cyanidin 3-O-glucoside and delphinidin 3-O-rutinoside contents, thus controlling SR endothelium color. We find human selection affects quercetin 3-O-glucoside content and SR weight per plant. The candidate geneMeFLS1is subject to selection during cassava domestication, leading to decreased quercetin 3-O-glucoside content and thus increased SR weight per plant.ConclusionsThese findings reveal the genetic basis of cassava SR metabolome variation, establish a linkage between metabolites and agronomic traits, and offer useful resources for genetically improving the nutrition of cassava and other root crops.
Bladder capacity in an elimination communication infant: a case report
Authors: Kraut Roni 
Published: December 2023

Abstract
Background
Bladder capacity is essential in assessing children with voiding dysfunction, yet it is currently unclear how best to determine a benchmark bladder capacity; various formulas have been proposed.

Case presentation
This report details the unique case of an elimination communication Caucasian infant (< 2 years old) who achieved nighttime and daytime dryness by 6 months of age. His first morning voids were measured from 8 to 20 months of age and compared with three formulas: (1) the Koff formula, a widely used formula based on fill volumes in anesthetized infants; (2) the Kaefer formula, a formula based on fill volume in nonanesthetized infants; and (3) the Holmdahl formula, a formula based on frequency–volume charts in normal infants.

Conclusion
This infant’s first morning void was found to be most consistent with Kaefer's formula. Further research is required to determine if formulas based on fill volume in nonanesthetized infants provide the more accurate benchmark bladder capacity in infants.
Primary cystic echinococcosis of the peritoneum: a case report
Authors: Kardoun Nizar , Fendri Sami , Rejab Haitham , Youssef Mejdoub , Tlili Ahmed , Triki Meriam , Toumi Nozha , Trigui Ayman , Boujelbene Salah 
Published: December 2023

Abstract
Background
Peritoneal cystic echinococcosis happens usually after traumatic rupture or after surgical treatment. Primary peritoneal cystic echinococcosis is a very rare case that constitutes a diagnostic and therapeutic challenge.

Case report
A 30-year-old Tunisian man was admitted for hypogastric pain since 4 months. He has a 10 cm hypogastric mass. Biological-tests were normal. A computed tomography Scan showed a cystic mass on the pelvis measuring 13 × 17 cm without echinococcosis cyst in the liver.
The patient was operated and we found a cystic mass of 17 cm located on the Douglas cul-de-sac that suggest a pelvic hydatid cyst. We have performed an aspiration of the cyst confirms the diagnosis followed by injection of hypertonic solution, extarction of the germinal layer and a maximal reduction of the pericyst. The postoperative course was uneventful.

Conclusion
Trough our case, we try to focus on the diagnosis and therapeutic options of this rare entity that we should think of in front of a patient with isolated peritoneal cyst especially in endemic country.
Shotgun metagenomics reveals interkingdom association between intestinal bacteria and fungi involving competition for nutrients
Authors: Xie Zixuan , Canalda-Baltrons Aleix , d’Enfert Christophe , Manichanh Chaysavanh 
Published: December 2023

Abstract
Background
The accuracy of internal-transcribed-spacer (ITS) and shotgun metagenomics has not been robustly evaluated, and the effect of diet on the composition and function of the bacterial and fungal gut microbiome in a longitudinal setting has been poorly investigated. Here we compared two approaches to study the fungal community (ITS and shotgun metagenomics), proposed an enrichment protocol to perform a reliable mycobiome analysis using a comprehensive in-house fungal database, and correlated dietary data with both bacterial and fungal communities.

Results
We found that shotgun DNA sequencing after a new enrichment protocol combined with the most comprehensive and novel fungal databases provided a cost-effective approach to perform gut mycobiome profiling at the species level and to integrate bacterial and fungal community analyses in fecal samples. The mycobiome was significantly more variable than the bacterial community at the compositional and functional levels. Notably, we showed that microbial diversity, composition, and functions were associated with habitual diet composition instead of driven by global dietary changes. Our study indicates a potential competitive inter-kingdom interaction between bacteria and fungi for food foraging.

Conclusion
Together, our present work proposes an efficient workflow to study the human gut microbiome integrating robustly fungal, bacterial, and dietary data. These findings will further advance our knowledge of the interaction between gut bacteria and fungi and pave the way for future investigations in human mycobiome.
Unidirectional freeze casting of compressible metallic aerogel composed of freeze-dried cellulose nanofibers and silver nanowires
Authors: Lee Donghyun , Choi Jungwook 
Published: December 2023

AbstractMetallic aerogels have attracted tremendous interest because of their superior properties, such as low density, high electrical conductivity, and large specific surface area. However, extremely brittle connections in their 3D networks remain a challenge. In this study, compressible aerogels with microporous fiber-like structure consisting of freeze-dried cellulose nanofibers (CNFs) and silver nanowires (AgNWs) were fabricated by unidirectional freeze-casting process. To improve the robustness, elasticity, and deformability of the aerogel, freeze-dried microfiber-structured CNFs assembled with AgNWs were used. The freeze-dried CNF/AgNW-based aerogels exhibited a low density (8.51–13.5 mg/cm3) and high porosity (up to 98.2%). Furthermore, these aerogels demonstrated impressive mechanical properties with high compressive strength (up to 4.85 kPa at 70% strain), elastic modulus (up to 16.3 kPa), and yield strength (up to 2 kPa). Additionally, the aerogels exhibited reversible deformability up to a 10% strain and maintained their durability over 200 cycles of compressive strain at 10%. The fabricated aerogels also showed a low electrical resistivity (< 8.65 mΩ·m) in addition to robust and compressible mechanical properties. These aerogels are expected to be useful in a wide range of applications that require characteristics such as light weight, high compressive strength, high elasticity, and low electrical resistivity.
Racial and ethnic differences in the effects of state firearm laws: a systematic review subgroup analysis
Authors: Smart Rosanna , Barnes-Proby Dionne , Holmes Pierrce , Schell Terry L. , Morral Andrew R. 
Published: December 2023

AbstractBackgroundDespite growing evidence about how state-level firearm regulations affect overall rates of injury and death, little is known about whether potential harms or benefits of firearm laws are evenly distributed across demographic subgroups. In this systematic review, we synthesized available evidence on the extent to which firearm policies produce differential effects by race and ethnicity on injury, recreational or defensive gun use, and gun ownership or purchasing behaviors.Main bodyWe searched 13 databases for English-language studies published between 1995 and February 28, 2023 that estimated a relationship between firearm policy in the USA and one of eight outcomes, included a comparison group, evaluated time series data, and provided estimated policy effects differentiated by race or ethnicity. We used pre-specified criteria to evaluate the quality of inference and causal effect identification. By policy and outcome, we compared policy effects across studies and across racial/ethnic groups using two different ways to express effect sizes: incidence rate ratios (IRRs) and rate differences. Of 182 studies that used quasi-experimental methods to evaluate firearm policy effects, only 15 estimated policy effects differentiated by race or ethnicity. These 15 eligible studies provided 57 separate policy effect comparisons across race/ethnicity, 51 of which evaluated interpersonal violence. In IRR terms, there was little consistent evidence that policies produced significantly different effects for different racial/ethnic groups. However, because of different baseline homicide rates, similar relative effects for some policies (e.g., universal background checks) translated into significantly greater absolute differences in homicide rates among Black compared to white victims.ConclusionsThe current literature does not support strong conclusions about whether state firearm policies differentially benefit or harm particular racial/ethnic groups. This largely reflects limited attention to these questions in the literature and challenges with detecting such effects given existing data availability and statistical power. Findings also emphasize the need for additional rigorous research that adopts a more explicit focus on testing for racial differences in firearm policy effects and that assesses the quality of race/ethnicity information in firearm injury and crime datasets.