bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer
Authors: Hanyu Takaaki , Ichikawa Hiroshi , Kano Yosuke , Ishikawa Takashi , Muneoka Yusuke , Hirose Yuki , Miura Kohei , Tajima Yosuke , Shimada Yoshifumi , Sakata Jun , Wakai Toshifumi 
Published: January 2024

Abstract
Background
Recent advances in treatment are expected to bring a cure to more patients with gastric cancer (GC). Focusing on the risk of death from other diseases (DOD) has become a crucial issue in patients cured of GC. The aim of this study was to elucidate the risk factors for DOD in patients who underwent curative gastrectomy with lymph node dissection for GC.

Methods
We enrolled 810 patients who underwent curative gastrectomy with lymph node dissection for GC from January 1990 to December 2014 and had no recurrence or death of GC until December 2019. We investigated the risk factors for DOD defined as death excluding death from a malignant neoplasm, accident, or suicide after gastrectomy, focusing on the perioperative characteristics at gastrectomy.

Results
Among 315 deaths from any cause, 210 died from diseases other than malignancy, accidents and suicide. The leading cause of DOD was pneumonia in 54 patients (25.7%). The actual survival period in 167 patients (79.5%) with DOD was shorter than their estimated life expectancy at gastrectomy. Multivariate analysis revealed that a high Charlson Comorbidity Index score (score 1–2: hazard ratio [HR] 2.192, 95% confidence interval [CI] 1.713–2.804, P < 0.001 and score ≥ 3: HR 4.813, 95% CI 3.022–7.668, P < 0.001), total gastrectomy (HR 1.620, 95% CI 1.195–2.197, P = 0.002) and the presence of postoperative complications (HR 1.402, 95% CI 1.024–1.919, P = 0.035) were significant independent risk factors for DOD after gastrectomy for GC, in addition to age of 70 years or higher, performance status of one or higher and body mass index less than 22.0 at gastrectomy.

Conclusions
Pneumonia is a leading cause of DOD after curative gastrectomy and lymph node dissection for GC. Paying attention to comorbidities, minimizing the choice of total gastrectomy and avoiding postoperative complications are essential to maintain the long-term prognosis after gastrectomy.
Biomimetic approach to strengthen the incisal fracture composite build-up: an in vitro study
Authors: Jadhav Ganesh R. , Mittal Priya , Shinde Siddharth , Al-Qarni Mohammed A. , Al-Obaid Mohammed , Abullais Shahabe Saquib , Cicciù Marco , Minervini Giuseppe 
Published: January 2024

Abstract
Objective
Incisal composite build-up shows a high failure susceptibility. The incorporation of fiber-reinforced composite (FRC) during composite restoration could improve its strength. Hence the study was planned to compare the effect of various positions of FRC on the strength of composite resin incisal build-ups.

Methods
In maxillary incisors (n = 90), 3 mm of the incisal edge was cut and teeth were categorized into three groups based on the location and number of fibers used during incisal composite build-up - Group I: composite resin; Group II: composite resin and a single fiber palatally and Group III: composite resin along with two fibers palatally.

Results
The data showed that group II had the maximum load-bearing values followed by group I and group III.

Conclusion
Within the confines of our study, it can be concluded that the addition of FRC to the conventional incisal composite build-up increased the overall strength restoration. Such composite restoration reinforced with a single fiber on the palatal side showed the highest load-bearing capacity compared to two fibers reinforced and unreinforced composites. The common mode of failure in group I was in composite resin, in two fibers reinforced at fibers-composite junction, and in one fiber reinforced composite was in the remaining part of the tooth.
Is there a common pattern of dental specialties in the world? Orthodontics, the constant element
Authors: Garcia-Espona Ignacio , Garcia-Espona Cristina , Alarcón José Antonio , Garcia-Espona Eugenia , Fernández-Serrano Javier 
Published: January 2024

Abstract
Background
There is a lack of studies comparing the status of dental specialties worldwide. Therefore, this study aimed to analyze the differences and similarities between the number and types of dental specialties in 31 countries, including every continent, in the world.

Materials and methods
Available official documents and webpages from regulatory bodies, official colleges and councils, and dental institutions were collected from 31 countries and analyzed to obtain reliable data on dental specialties. Differences were analyzed using the Lorentz curve and Gini test. Additionally, a cluster analysis was performed to obtain groups of countries with similar patterns in the number and types of dental specialties.

Results
A total of 32 different specialties were officially recognized among all the analyzed countries. Orthodontics and oral surgery (100% and 93.1%, respectively) were the two most frequently officially recognized dental specialties worldwide. The total global degree of inequality in the 31 analyzed countries was 42.4%. The Anglo-Saxon countries showed the greatest similarity, approximately 15-fold higher than the European countries. Cluster analysis differentiated six main groups of countries according to the number and types of dental specialties. European countries formed one of the two largest clusters, and the other cluster was of Anglo-Saxon, Asian, African, and several Eastern European countries with a high number of specialties.

Conclusions
Officially recognized dental specialties in the different continents and countries show an asymmetric organization. The number, names, and skills of officially recognized dental specialties exhibited significant differences, showing inequalities in their organization. The Anglo-Saxon pattern of dental specialties showed greater equality than the European pattern. Orthodontics was the only constant element among the different patterns.
Three-dimensional evaluation of condylar morphology after orthodontic treatment in adult patients with Class II malocclusion by cone-beam computed tomography
Authors: Shi Qiutao , Gu Zhiyuan , Lai Danping , Dai Qi , Yu Fengyang 
Published: January 2024

Abstract
Background
The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT).

Methods
Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment.

Results
Height of condylar head increase significant (P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head (P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably (P < .05). No significant difference was detected in other values ((P > .05).

Conclusion
Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.
Chronic restraint stress promotes oral squamous cell carcinoma development by inhibiting ALDH3A1 via stress response hormone
Authors: Luo Shihong , Long Huiqing , Lou Fangzhi , Liu Yiyun , Wang Haiyang , Pu Juncai , Ji Ping , Jin Xin 
Published: January 2024

Abstract
Background
Chronic restraint stress (CRS) has iteratively been reported to be possibly implicated in the development of numerous cancer types. However, its role in oral squamous cell carcinoma (OSCC) has not been well elucidated. Here we intended to evaluate the role and mechanism.

Methods
The effects of CRS were investigated in xenograft models of OSCC by using transcriptome sequencing, LC–MS, ELISA and RT-PCR. Moreover, the role of CRS and ALDH3A1 on OSCC cells was researched by using Trans-well, flow cytometry, western blotting, immunofluorescence, ATP activity and OCR assay. Furthermore, immunohistochemical staining was employed to observe the cell proliferation and invasion of OSCC in xenotransplantation models.

Results
CRS promoted the progression of OSCC in xenograft models, stimulated the secretion of norepinephrine and the expression of ADRB2, but decreased the expression of ALDH3A1. Moreover, CRS changed energy metabolism and increased mitochondrial metabolism markers. However, ALDH3A1 overexpression suppressed proliferation, EMT and mitochondrial metabolism of OSCC cells.

Conclusion
Inhibition of ALDH3A1 expression plays a pivotal role in CRS promoting tumorigenic potential of OSCC cells, and the regulatory of ALDH3A1 on mitochondrial metabolism may be involved in this process.
Dental care professionals’ awareness of oral dryness and its clinical management: a questionnaire-based study
Authors: Fisic Amela , Aras Hulya Cevik , Almhöjd Ulrica , Almståhl Annica 
Published: January 2024

Abstract
Background
Despite the high prevalence of oral dryness and awareness of its complications, there is limited research on the clinical management of patients with oral dryness in general dental care.

Purpose
To (1) describe and compare awareness among dental care professionals regarding saliva functions, potential causes and complications of oral dryness, and patient management (2) Investigate if the length of professional experience influences these aspects.

Methods
A digital self-administrated survey was sent to 2668 dental care professionals working in the general dental care, Public Dental Service, in Sweden. Twelve dental care professionals reviewed the questionnaire prior to its distribution. The questionnaire comprised 32 questions about patient management, awareness of saliva functions, causes and complications of oral dryness, and self-assessment queries.

Results
The response rate was 18.6% (241 dentists and 257 dental hygienists). Older adults (65+) were asked more often about dry mouth (93.0%) compared to those aged 18–23 years (50.0%) and those under 18 years (24.9%). Dental hygienists encountered individuals with oral dryness more frequently (61.1%) than dentists (48.5%) (p < 0.01), and more often asked individuals in the age groups 18–23 years (p = 0.003), 24–40 years (p = 0.045), and 41–65 years (p = 0.031) about dry mouth. A higher proportion of dental hygienists (88.3%) than dentists (51.0%) had measured salivary secretion rate, (p < 0.001) and more often suggested preventive dental care 3–4 times a year, (42.5% vs. 30.5%) (p < 0.007). Dentists had a higher awareness of saliva functions, while dental hygienists had a higher awareness about causes and complications of oral dryness. Higher proportions of dentists and dental hygienists with over 10 years of professional experience had measured salivary secretion rate (69.1% vs. 95.7%) compared to their counterparts with less than 10 years of professional experience (35.9% vs. 79.5%) (p < 0.001 for both).

Conclusion
Compared to dentists, dental hygienists were more attentive to patients with oral dryness as they encountered these individuals more often, asked more age-groups, suggested frequent preventive measures, and had higher awareness of the causes and complications of oral dryness. Length of professional experience could improve both the management of patients with oral dryness and awareness of its causes, particularly for dental hygienists.
Study on the status and problems of teaching system of “medical advanced mathematics”: data based on a research of 11 universities in China
Authors: Sun Jiangjie , Liu Tong , Li Hui 
Published: January 2024

Abstract
Background and aim
Driven by Innovation 2.0 (the information age, the innovation form of the knowledge society), the form evolved by the Internet development, giving rise to economic and social development (“Internet +”). With this background, a novel approach is presented for fostering excellence in physicians, aligning with the contemporary demands of our era.

Methods
Self-administered questionnaire was used to facilitate the collection of data on medical advanced mathematics course offerings, distribution of teaching hours of each major and the perception of the course teaching system in 11 medical universities in China. The distribution of course offerings in each major was analyzed, and one-sample t-test was conducted on the perspectives of course offerings, content settings (theoretical & practical), educational objectives, teaching reforms, and Synthetical Sensation (SS) of the curriculum system and educational model.

Results
The study included various specialties such as clinical medicine, pharmacy, public health, health management, and life sciences, all of which offered advanced mathematics course. The content of medical mathematics textbooks was designed to meet the practical needs of relevant professions, and encompass online laboratory classes and social practice. However, a noticeable misalignment was observed between the content of medical mathematics courses and the realistic requirements of professions (t = -3.614~-3.018, P < 0.05). The perceived difference in the completeness of curriculum systems was not significantly apparent. There was a difference in the perception of the effectiveness of teaching reforms (t = -4.485, P < 0.05), and there was a difference in the perception of the synthesis of the educational model in all cases (t = -5.067, P < 0.05).

Conclusion
There are localized differences in curricula, and the number of course hours is basically reasonable; course content needs to be updated; the implementation of course objectives is not in place; the curriculum system can meet the needs of talent training; the innovation of the education model needs to be put into practice; and there are obvious differences in the comprehensive cognition of the teaching system and the education model. Based on the analysis of the problems, we build a new STC teaching mode with smart classroom based on “professional needs, practical needs and requirements for cultivating excellent physician talents”.
Awareness and level of digital literacy among students receiving health-based education
Authors: Aydınlar Alp , Mavi Arda , Kütükçü Ece , Kırımlı Elçim Elgün , Alış Deniz , Akın Ata , Altıntaş Levent 
Published: January 2024

Abstract
Background
Being digitally literate allows health-based science students to access reliable, up-to-date information efficiently and expands the capacity for continuous learning. Digital literacy facilitates effective communication and collaboration among other healthcare providers. It helps to navigate the ethical implications of using digital technologies and aids the use of digital tools in managing healthcare processes. Our aim in this study is to determine the digital literacy level and awareness of our students receiving health-based education in our university and to pave the way for supporting the current curriculum with courses on digital literacy when necessary.

Method
Students from Acibadem University who were registered undergraduate education for at least four years of health-based education, School of Medicine, Nutrition and Dietetics, Nursing, Physiotherapy and Rehabilitation, Psychology, Biomedical Engineering, Molecular Biology, and Genetics were included. The questionnaire consisted of 24 queries evaluating digital literacy in 7 fields: software and multimedia, hardware and technical problem solving, network and communication/collaboration, ethics, security, artificial intelligence (A.I.), and interest/knowledge. Two student groups representing all departments were invited for interviews according to the Delphi method.

Results
The survey was completed by 476 students. Female students had less computer knowledge and previous coding education. Spearman correlation test showed that there were weak positive correlations between the years and the “software and multimedia,” “ethics,” “interest and knowledge” domains, and the average score. The students from Nursing scored lowest in the query after those from the Nutrition and Dietetics department. The highest scores were obtained by Biomedical Engineering students, followed by the School of Medicine. Participants scored the highest in “network” and “A.I.” and lowest in “interest-knowledge” domains.

Conclusion
It is necessary to define the level of computer skills who start health-based education and shape the curriculum by determining which domains are weak. Creating an educational environment that fosters females’ digital knowledge is recommended. Elective courses across faculties may be offered to enable students to progress and discuss various digital literacy topics. The extent to which students benefit from the digital literacy-supported curriculum may be evaluated. Thus, health-based university students are encouraged to acquire the computer skills required by today’s clinical settings.

Registration
This study was approved by Acıbadem University and Acıbadem Healthcare Institutions Medical Research Ethics Committee (ATADEK) (11 November 2022, ATADEK registration: 2022-17-138) All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from the participants.
TMPRSS2 isoform 1 downregulation by G-quadruplex stabilization induces SARS-CoV-2 replication arrest
Authors: De Magis Alessio , Schult Philipp , Schönleber Antonia , Linke Rebecca , Ludwig Kerstin U. , Kümmerer Beate M. , Paeschke Katrin 
Published: January 2024

Abstract
Background
SARS-CoV-2 infection depends on the host cell factors angiotensin-converting enzyme 2, ACE2, and the transmembrane serinprotease 2, TMPRSS2. Potential inhibitors of these proteins would be ideal targets against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Our data opens the possibility that changes within TMPRSS2 can modulate the outcome during a SARS-CoV-2 infection.

Results
We reveal that TMPRSS2 acts not only during viral entry but has also an important role during viral replication. In addition to previous functions for TMPRSS2 during viral entry, we determined by specific downregulation of distinct isoforms that only isoform 1 controls and supports viral replication. G-quadruplex (G4) stabilization by chemical compounds impacts TMPRSS2 gene expression. Here we extend and in-depth characterize these observations and identify that a specific G4 in the first exon of the TMPRSS2 isoform 1 is particular targeted by the G4 ligand and affects viral replication. Analysis of potential single nucleotide polymorphisms (SNPs) reveals that a reported SNP at this G4 in isoform 1 destroys the G4 motif and makes TMPRSS2 ineffective towards G4 treatment.

Conclusion
These findings uncover a novel mechanism in which G4 stabilization impacts SARS-CoV-2 replication by changing TMPRSS2 isoform 1 gene expression.
Evolution in key indicators of maternal and child health across the wealth gradient in 41 sub-Saharan African countries, 1986–2019
Authors: Lee Yeeun , Bolongaita Sarah , Sato Ryoko , Bump Jesse B. , Verguet Stéphane 
Published: January 2024

Abstract
Background
Aggregate trends can be useful for summarizing large amounts of information, but this can obscure important distributional aspects. Some population subgroups can be worse off even as averages climb, for example. Distributional information can identify health inequalities, which is essential to understanding their drivers and possible remedies.

Methods
Using publicly available Demographic and Health Survey (DHS) data from 41 sub-Saharan African countries from 1986 to 2019, we analyzed changes in coverage for eight key maternal and child health indicators: first dose of measles vaccine (MCV1); Diphtheria-Pertussis-Tetanus (DPT) first dose (DPT1); DPT third dose (DPT3); care-seeking for diarrhea, acute respiratory infections (ARI), or fever; skilled birth attendance (SBA); and having four antenatal care (ANC) visits. To evaluate whether coverage diverged or converged over time across the wealth gradient, we computed several dispersion metrics including the coefficient of variation across wealth quintiles. Slopes and 5-year moving averages were computed to identify overall long-term trends.

Results
Average coverage increased for all quintiles and indicators, although the range and the speed at which they increased varied widely. There were small changes in the wealth-related gap for SBA, ANC, and fever. The wealth-related gap of vaccination-related indicators (DPT1, DPT3, MCV1) decreased over time. Compared to 2017, the wealth-gap between richest and poorest quintiles in 1995 was 7 percentage points larger for ANC and 17 percentage points larger for measles vaccination.

Conclusions
Maternal and child health indicators show progress, but the distributional effects show differential evolutions in inequalities. Several reasons may explain why countries had smaller wealth-related gap trends in vaccination-related indicators compared to others. In addition to service delivery differences, we hypothesize that the allocation of development assistance for health, the prioritization of vaccine-preventable diseases on the global agenda, and indirect effects of structural adjustment programs on health system-related indicators might have played a role.
Exploring older people’s understanding of the QOL-ACC, a new preference-based quality-of-life measure, for quality assessment and economic evaluation in aged care: the impact of cognitive impairment and dementia
Authors: Lay Kiri , Crocker Matthew , Engel Lidia , Ratcliffe Julie , Milte Rachel , Hutchinson Claire 
Published: January 2024

Abstract
Background
Quality-of-life is an essential outcome for quality assessment and economic evaluation in health and social care. The-Quality-of-Life – Aged Care Consumers (QOL-ACC) is a new preference-based quality-of-life measure, psychometrically validated with older people in aged care. More evidence is needed to inform the self-report reliability of the QOL-ACC in older people with varying levels of cognitive impairment and dementia.

Methods
A think-aloud protocol was developed and applied with older residents. The Mini Mental State Examination (MMSE) was applied to assign participants to no cognitive impairment (NCI - MMSE score ≥ 27) and cognitive impairment (MMCI - MMSE score < 27) subgroups. Three independent raters utilised a Tourangeau survey response model-based framework to identify response issues. Data were compared across cognition subgroups and synthesized using a ‘traffic light’ grading to classify frequency and type of response issues. Gradings were utilised to assess self-report reliability according to different levels of cognitive impairment.

Results
Qualitative data from 44 participants (NCI = 20, MMCI = 24) were included for analysis. Response issues were more evident in the cognitive impairment subgroup than the no cognitive impairment subgroup. All participants who received a ‘red’ grade had an MMSE score of < 20 and 66% of ‘amber’ grades occurred in the cognitive impairment subgroup.

Conclusions
The QOL-ACC is able to be completed reliably by older residents with an MMSE score > 17. Future research is needed to assess the generalisability of these findings to other preference-based quality of life instruments and for older people in other care settings including health systems.