bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of oral health status: an ecological study in Iran
Authors: Tahani Bahareh , Baghban Alireza Akbarzadeh , Kazemian Ali 
Published: November 2023

Abstract
Objectives
The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level.

Materials and methods
The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05).

Results
Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01–0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07–0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2–0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 − 0.48) were positively in associated with FT.

Conclusions
The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.
MDP-salts as an adhesion promoter with MDP-primers and self-adhesive resin cement for zirconia cementation
Authors: Abdou Ahmed , Hussein Nasser , Abd El-Sattar Nour E. A. , Takagaki Tomohiro , Kusumasari Citra , Rizk Amr , Abo-Alazm Emad A. 
Published: November 2023

Abstract
Purpose
To evaluate the effect of zirconia priming with MDP-Salt before MDP containing primers and self-adhesive cement on the shear bond strength.

Materials and methods
Fully sintered high translucent zirconia specimens (n = 120) were assigned into 2 groups (n = 60 each): Control (No Pretreatment) and Methacryloyloxydecyl dihydrogen phosphate salt (MDP-Salt) pretreated. Each group was divided into 3 subgroups (n = 20) according to cementation protocol: 1) MDP + Silane primer and conventional resin cement, 2) MDP+ Bisphenyl dimethacrylate (BPDM) primer and conventional resin cement, and 3) MDP containing self-adhesive resin cement. Shear bond strength (SBS) was measured after 10,000 thermocycling. Contact angle was measured for tested groups. Surface topography was assessed using a 3D confocal laser scanning microscope (CLSM). Weibull analysis was performed for SBS and one-way ANOVA for contact angle and surface topography measurements (α = 0.05).

Results
The use of MDP-Salt significantly improved the SBS (p < .05) for all tested subgroups. Self-adhesive cement showed an insignificant difference with MDP + Silane group for both groups (p > .05). MDP + BPDM showed a significantly lower characteristic strength compared to self-adhesive resin cement when both were pretreated with MDP-Salt. No difference between all tested groups in the surface topographic measurements while MDP-Salt showed the highest contact angle.

Conclusion
MDP-Salt pretreatment can improve bonding performance between zirconia and MDP containing products.
Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey
Authors: St-Pierre Frederique , Petrosyan Romela , Gupta Arjun , Hughes Stephen , Trickett John , Read Susan , Van Doren Vanessa , Zeveney Andrew , Shoushtari Christiana 
Published: November 2023

Abstract
Background
Internal medicine (IM) residency is a notoriously challenging time generally characterized by long work hours and adjustment to new roles and responsibilities. The COVID-19 pandemic has led to multiple emergent adjustments in training schedules to accommodate increasing needs in patient care. The physician training period, in itself, has been consistently shown to be associated with vulnerability with respect to mental well-being. The impact of the COVID-19 pandemic on the experience of IM trainees is not well established.

Objective
Characterize the impact of the COVID-19 pandemic on trainee clinical education, finances, and well-being.

Methods
We developed a survey composed of 25 multiple choice questions, 6 of which had an optional short-answer component. The survey was distributed by the American College of Physicians (ACP) to 23,289 IM residents and subspecialty fellows. We received 1,128 complete surveys and an additional 269 partially completed surveys.

Results
The majority of respondents reported a disruption in their clinical schedule (76%) and a decrease in both didactic conferences (71%) and protected time for education (56%). A majority of respondents (81%) reported an impact on their well-being with an increase in their level of burnout and 41% of respondents reported a decrease in level of direct supervision. Despite these changes, the majority of trainee respondents (78%) felt well prepared for clinical practice after graduation.

Conclusions
These results outline the vulnerable position of internal medicine physicians in training. Preserving educational experiences, adequate supervision, and humane work hours are essential in protecting trainees from mental illness and burnout during global emergencies.
Longitudinal evolution of sleep disturbances in early multiple system atrophy: a 2‐year prospective cohort study
Authors: Zhang Lingyu , Hou Yanbing , Li Chunyu , Wei Qianqian , Ou Ruwei , Liu Kuncheng , Lin Junyu , Yang Tianmi , Xiao Yi , Jiang Qirui , Zhao Bi , Shang Huifang 
Published: November 2023

Abstract
Background
The progression of sleep disturbances remains unclear in patients with early multiple system atrophy (MSA). We aimed to explore the frequency, severity, and coexistence of 2-year longitudinal changes of sleep disturbances including REM sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), and Parkinson’s disease-related sleep problems (PD-SP) in early MSA.

Methods
MSA patients with a disease duration < 3 years were enrolled to complete a 2-year follow-up visit. Sleep disturbances including RBD, EDS, and PD-SP were assessed using the RBD Screening Questionnaire, Epworth sleepiness scale, and PD sleep scale-2, respectively.

Results
A total of 220 patients with MSA enrolled in the study and 90 patients completed the 2-year follow-up visit. The score of all three sleep disturbances significantly increased over the 2-year follow-up in MSA and MSA with the predominant parkinsonism group (all p < 0.05). The frequency of PD-SP (from 14.5 to 26.7%) and EDS (from 17.7 to 37.8%) was progressively increased (all p < 0.05) except for RBD (from 51.8 to 65.6%, p = 0.152) over the 2-year follow-up in MSA. The frequency of coexistence of two or three sleep disturbances also increased over time. The most common sleep disturbance was RBD, followed by EDS and PD-SP over the 2-year follow-up.

Conclusions
The present study demonstrated that the frequency of different types of sleep disturbances progressively increased except for RBD and the coexistence of two or three sleep disturbances became more common over time in early MSA. Our study suggested that the assessment and management of sleep disturbances should begin early in MSA.
Tumor-to-tumor spread: a case report and literature review of renal cell carcinoma metastasis into thyroid cancer
Authors: Gawlik Cassidy , Lane Jason , Horattas Mark 
Published: November 2023

AbstractTumor-to-tumor metastasis is a rare, yet important entity. Patients with a history of renal cell carcinoma (RCC) may have tumor deposits to the thyroid gland preceding or following their initial cancer diagnosis for many years. The diagnosis can be challenging, and clinicians must remain suspicious of a newly found thyroid nodule in a patient with a history of RCC. In this review, we report a case of a patient with RCC who was incidentally found to have a thyroid nodule on surveillance imaging found to be consistent with tumor-to-tumor metastasis from RCC into papillary thyroid carcinoma. It is imperative to consider this diagnosis as the thyroid is the most common site of spread, and treatment with partial or total thyroidectomy has led to improved survival.
Histologic tumor type as a determinant of survival in hormone receptor-positive, HER2-negative, pT1-3 invasive ductal and lobular breast cancer
Authors: Göker Menekse , Denys Hannelore , Hendrix An , De Wever Olivier , Van de Vijver Koen , Braems Geert 
Published: November 2023

Abstract
Purpose
The aim of the study was to compare the difference in survival between invasive ductal (IDC) and lobular carcinoma (ILC).

Methods
Data of patients (n = 1843) with a hormone receptor-positive, HER2-negative, pT1-3 IDC or ILC cancer without distant metastasis, treated at the Ghent University Hospital over the time period 2001–2015, were analyzed.

Results
ILC represented 13.9% of the tumors, had a higher percentage of pT3 and pN3 stages than IDC, lymphovascular space invasion (LVSI) was less present and Ki-67 was mostly low. 73.9% of ILCs were grade 2, whereas IDC had more grade 1 and grade 3 tumors. Kaplan–Meier curves and log-rank testing showed a significant worse DFS for ILC with pN ≥ 1 than for their IDC counterpart. In a multivariable Cox regression analysis the histologic tumor type, ductal or lobular, was a determinant of DFS over 120 months (IDC as reference; hazard ratio for ILC 1.77, 95% CI 1.08–2.90) just as the ER Allred score (hazard ratio 0.84, 95% CI 0.78–0.91), LVSI (hazard ratio 1.75, 95% CI 1.12–2.74) and pN3 (hazard ratio 2.29, 95% CI 1.03–5.09). Determinants of OS over ten years were age (hazard ratio 1.05, 95% CI 1.02–1.07), LVSI (hazard ratio 3.62, 95% CI 1.92–6.82) and the ER Allred score (hazard ratio 0.80, 95% CI 0.73–0.89).

Conclusion
The histologic tumor type, ductal or lobular, determines DFS in hormone receptor-positive, HER2-negative, pT1-3 breast cancer besides the ER Allred score, LVSI and pN3.
Irisin suppresses pancreatic β cell pyroptosis in T2DM by inhibiting the NLRP3-GSDMD pathway and activating the Nrf2-TrX/TXNIP signaling axis
Authors: Li Tianrong , Yang Jingjing , Tan Anjun , Chen Hewen 
Published: November 2023

Abstract
Background
Irisin plays a key role in metabolic diseases, including type 2 diabetes mellitus (T2DM). However, the mechanism underlying the link between irisin and the development of T2DM, particularly in pancreatic islet β-cells, remains unknown.

Methods
In vitro, Min6 cells were treated with high glucose (HG) to generate T2DM cell models. GSDMD-N staining, Western blotting assays, and ELISA were performed to measure the expression levels of GSDMD, caspase 1, IL-1β, and IL-18. Next, the NLRP3 stimulator, ATP, was used to assess the effect of irisin on NLRP3 inflammasome. To evaluate the function of the Nrf2-TrX/TXNIP signaling axis, the Nrf2 inhibitor ML385 was used. For in vivo assessment, we first established T2DM model mice. Then, hematoxylin and eosin (H&E) staining was performed to observe the islet morphology, and the immunofluorescence technique was used to examine the mass of α and β cells. To confirm the role of the Nrf2-TrX/TXNIP signaling axis, ML385 was injected into the mice. Immunofluorescence of Nrf2, caspase 1, and GSDMD was detected in the islet cells of the model mice to verify the results.

Results
We found that irisin treatment significantly decreased the expression of GSDMD-N (P31) and cleaved caspase-1 (p20), decreased caspase1 activity, and inhibited the secretion of IL-1β and IL-18 in HG-treated Min6 cells. We also found that irisin inhibited oxidative stress and NLRP3 expression by activating the Nrf2-TrX/TXNIP signaling axis. Additionally, in the T2DM model mice, irisin enhanced the function of islet cells, decreased insulin resistance, and preserved the morphology of pancreatic islets.

Conclusion
We showed in this study that irisin can be used for treating pyroptosis in HG-induced islet β-cells and T2DM model mice. We also found that irisin inhibits pyroptosis and oxidative stress by inhibiting the NLRP3-GSDMD pathway and activating the Nrf2-TrX/TXNIP signaling axis.
Toll-like receptor 7 and RIG-I-like receptors expression in peripheral blood mononuclear cells of naïve patients with hepatitis C
Authors: Gilanipour Atena , Teimoori Ali , Arabzadeh Seyed Alimohammad , Mollaie Hamid Reza , Mousavi Elham 
Published: November 2023

Abstract
Background
The proper function of Pattern Recognition Receptors (PRRs) as a part of the host immune system can eliminate numerous pathogens from the body. However, some viruses can manipulate PRRs to escape the innate immune system. As there is controversy in the activation of PRRs in patients infected with HCV, we decided to evaluate the gene expression changes of PRRs in HCV cases compared to the healthy control.

Methods
In this study, the relative expression of Toll-like receptor 7, RIG-I, and MAD-5 in peripheral mononuclear blood cells of twenty HCV patients and twenty healthy controls of the same gender and age were analyzed by quantitative Real-time PCR.

Results
Our results showed that the expression of RIG-I and MAD-5 significantly increased in HCV-infected samples compared to the controls (P value:0.01; P value:0.05), while the expression of TLR7 was similar between the case and the control group (P value:0.1).

Conclusion
It seems in suppressing HCV, RIG-I and MAD-5 receptors are likely to be more activated than TRL7 in HCV patients. The lack of TLR7 gene expression might reflect the defect of the host in the stimulation of the innate immune system through the TLR7 pathway.
Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Oliveira Henrique Ceretta , Hayashi Daisuke , Carvalho Samantha Dalbosco Lins , Barros Rita de Cássia Lopes de , Neves Mayza Luzia dos Santos , Andrechuk Carla Renata Silva , Alexandre Neusa Maria Costa , Ribeiro Paula Aver Bretanha , Rodrigues Roberta Cunha Matheus 
Published: November 2023

Abstract
Background
Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. Selecting the best patient-reported outcome measure (PROM) among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to assess medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus.

Methods
This review followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature).

Results
A total of 110 records encompassing 27 different PROMs were included in the review. The included records were published between 1986 and 2023, most of which reported studies conducted in the United States and were published in English. None of the PROMs were classified in the category “a”, thus being recommended for use due to the quality of its measurement properties. The PROMs that should not be recommended for use (category “c”) are the MTA, GMAS, DMAS-7, MALMAS, ARMS-D, and 5-item questionnaire. The remaining PROMs, e.g., MMAS-8, SMAQ, MEDS, MNPS, ARMS-12, MGT, MTA-OA, MTA-Insulin, LMAS-14, MARS-5, A-14, ARMS-10, IADMAS, MAQ, MMAS-5, ProMAS, ARMS‐7, 3-item questionnaire, AS, 12-item questionnaire, and Mascard were considered as having the potential to be recommended for use (category “b”).

Conclusion
None of the included PROMs met the criteria for being classified as trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, 21 PROMs have the potential to be recommended for use, but further studies are needed to ensure their quality based on the COSMIN guideline for systematic reviews of PROMs.

Systematic review registration
PROSPERO CRD42019129109
Severe-Enduring Anorexia Nervosa (SE-AN): a case series
Authors: Marcolini Federica , Ravaglia Alessandro , Tempia Valenta Silvia , Bosco Giovanna , Marconi Giorgia , Sanna Federica , Zilli Giulia , Magrini Enrico , Picone Flavia , De Ronchi Diana , Atti Anna Rita 
Published: November 2023

Abstract
Background
Anorexia Nervosa (AN) poses significant therapeutic challenges, especially in cases meeting the criteria for Severe and Enduring Anorexia Nervosa (SE-AN). This subset of AN is associated with severe medical complications, frequent use of services, and the highest mortality rate among psychiatric disorders.

Case presentation
In the present case series, 14 patients were selected from those currently or previously taken care of at the Eating Disorders Outpatients Unit of the Maggiore Hospital in Bologna between January 2012 and May 2023. This case series focuses on the effects of the disease, the treatment compliance, and the description of those variables that could help understand the great complexity of the disorder.

Conclusion
This case series highlights the relevant issue of resistance to treatment, as well as medical and psychological complications that mark the life course of SE-AN patients. The chronicity of these disorders is determined by the overlapping of the disorder's ego-syntonic nature, the health system's difficulty in recognizing the problem in its early stages, and the presence of occupational and social impairment.
Definitions and consequences of current alignment techniques and phenotypes in total knee arthroplasty (TKA) – there is no winner yet
Authors: Karasavvidis Theofilos , Pagan Moldenhauer Cale A. , Lustig Sébastien , Vigdorchik Jonathan M. , Hirschmann Michael T. 
Published: November 2023

AbstractDissatisfaction following total knee arthroplasty (TKA) has been extensively documented and it was attributed to numerous factors. In recent years, significant focus has been directed towards implant alignment and stability as potential causes and solutions to this issue. Surgeons are now exploring a more personalized approach to TKA, recognizing the importance of thoroughly understanding each individual patient’s anatomy and functional morphology. A more comprehensive preoperative analysis of alignment and knee morphology is essential to address the unresolved questions in knee arthroplasty effectively. The crucial task of determining the most appropriate alignment strategy for each patient arises, given the substantial variability in bone resection resulting from the interplay of phenotype and the alignment strategy chosen. This review aims to comprehensively present the definitions of different alignment techniques in all planes and discuss the consequences dependent on knee phenotypes.Level of evidence V.
Global health collaborative research: beyond mandatory collaboration to mandatory authorship
Authors: Nyangulu Wongani John 
Published: November 2023

AbstractCollaborative research between the global north and global south is common and growing in number. Due to inability of local governments to fund research, global north actors provide the bulk of research funding. While providing mutual benefits, global collaborative research projects are far from ideal. In this paper, we review the authorship discrepancies in global collaborative research, discuss preventive measures in place and their shortfalls, and recommend an intervention to address the problem. Malawi research guidelines recommend collaboration between foreign and local researchers in locally conducted research. However, there is no provision requiring joint authorship in final published papers. Journal recommendations on authorship criteria exist, but they can disadvantage low- and middle-income country researchers in collaborative projects because of exclusionary interpretations of guidelines. For example, the requirement for authors to make substantial contributions to conception or design of the work may favor research grant holders, often from the global north. Systematic and holistic changes proposed to address power asymmetries at the core of the problem have been proposed. However, these proposals may take a long time to produce change. Ad interim, local institutions can take more direct action to address inequalities by establishing offices of research integrity to enforce mandates to increase opportunities for authorship in collaborative research.
A narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19
Authors: Allahveisi Azra , Afradiasbagharani Parivash , Bazrafkan Mahshid , Kafaeinezhad Raheleh , Hosseini Elham 
Published: November 2023

Abstract
Background
Although COVID-19 infection has dropped across the world and SARS-CoV-2 vaccines have been developed, global concerns remain about the disease’s long-term health consequences. The purpose of this research was to review the consequences of SARS-CoV-2 on male health, particularly the reproductive system and the pathogenic mechanisms affecting male infertility. Improving knowledge on these issues may help in considering to which extent some of the remaining concerns should be addressed.

Results
The primary target of this disease is the pulmonary system, but reproductive organs may be targeted by the virus. To enter host cells, the virus utilizes both ACE2 and TMPRSS2, which are differentially expressed in the spermatogonial stem, Leydig, and Sertoli cells, thereby providing possible testicular vulnerability. COVID-19-related stress and psychological distress may also affect aspects of male reproductive health.

Conclusions
Since some pathological effects of COVID-19 infection and dysregulations are linked to infertility, more attention is needed to determine whether such dysregulations regress following infection decline.