bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conservative management of double teeth in molar teeth with pulp or periapical disease: a report of five cases and literature review
Authors: Chen Mengxi , Bai Xinna , Wang Xiangzhu , Xie Xiaoli , Chen Minmin 
Published: October 2023

Abstract
Background
Double teeth are usually the result of an abnormality in the developing tooth germ. Double teeth can occur in either the primary or permanent dentition, with the majority of cases concerning permanent teeth reported in the anterior teeth and less frequently in the molar teeth.

Case presentation
This report illustrates five cases of double teeth in molars with pulp and periapical disease, including one case of geminated teeth and four cases of fused teeth. Radiographic findings revealed the presence of extra teeth on the buccal aspect of the molar in five cases, with or without communication between the two root canal systems. Root canal treatment was performed by using CBCT and a dental operating microscope. The treatment outcome was good in all five cases.

Conclusion
The diagnosis and treatment of double teeth requires special attention. The root canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Proper anatomical structure analysis prior to treatment facilitates the development of an appropriate treatment plan, thereby increasing the likelihood of successful treatment both aesthetically and functionally.
Practice of non-institutional delivery and its associated factors among women who gave birth in Southern Ethiopia, 2022
Authors: Geta Temesgen , Sugebo Fekire , Anjulo Fekadu 
Published: October 2023

Abstract
Background
Non-institutional delivery is one of the major reasons that results in high mortality rates for a mother and her neonate. The World Health Organization estimates that only 43% of mothers have access to skilled delivery services. A recent Ethiopian Mini Demographic Survey indicated that more than half of Ethiopian women have given birth non-institutionally. This shows that maternal health remains a major public health challenge in Ethiopia, irrespective of the government’s measures for institutional delivery. So, the aim of this study was to assess the practice of non-institutional delivery and its associated factors among women who gave birth in the study area.

Methods
A community-based cross-sectional study was carried out on 260 study participants from June 1 to July 1, 2022, in Boloso Bombe Woreda. Data collection was done using a structured questionnaire, and systematic sampling techniques were used to select the study subjects. The data was entered into the EPI data version 3.1 and analyzed using SPSS version 25. The adjusted odds ratio, along with 95% confidence intervals, was used, and the level of statistical significance was declared at a P-value of 0.05.

Result
Out of 260 women interviewed, 252 (97%) pregnant women participated in the interview. The prevalence of non-institutional delivery among study participants was 68.7% (95% CI: 63.1–72.9). Mothers who were a daily laborer [AOR = 6.6;95%CI(3.6(1.2–11.2), last pregnancy planned [AOR = 0.4; 95%CI (0.4(0.2–0.8)), an absence of antenatal care contacting history [AOR = 3.3; 95%CI (1.3–8.6)], respondents’ knowledge on the labor complication [AOR = 3; (95%CI); 3.5(2.2–6.1)], and place of first delivery [AOR = 8.7 95%CI(3.2–23)] were factors that significantly associated with practice of non-institutional delivery.

Conclusion
This study indicated that the majority of study participants practiced non-institutional delivery in this study area. Thus, we strongly recommend that all responsible bodies take immediate action, such as community health education on pregnancy-related complications, encouraging ANC visits, and raising awareness of the advantages of preventing non-institutional delivery in order to reduce non-institutional pregnancy practices and improve the factors identified.
Online education isn’t the best choice: evidence-based medical education in the post-epidemic era—a cross-sectional study
Authors: Zhang Yi , Liu Jiarui , Liang Jun , Lang Jie , Zhang Lijia , Tang Mingwen , Chen Xinyu , Xie Yan , Zhang Jianlin , Su Liyu , Wang Xin 
Published: October 2023

Abstract
Background
The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.

Methods
We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students’ preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.

Results
The blended group’s exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness”, the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was ‘flexible in time and space’ (99%), followed by ‘can be viewed repeatedly, facilitating a better understanding of knowledge points’ (98%). Their foremost reason for liking offline teaching was ‘helps to create a good learning atmosphere’ (97%), followed by ‘teachers can control students’ learning status in real time’ (89%).

Conclusions
This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students’ learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students’ understanding of the course content.
Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study
Authors: Coleman Deidra Carroll , Frederick Anitra , Cron Stanley , Markham Christine , Guilamo-Ramos Vincent , Santa Maria Diane 
Published: October 2023

Abstract
Background
Nurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students’ attitudes and intentions about sexual health education and parent communication counseling.

Methods
Using an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a community/public health nursing clinical course. Independent t-tests, chi-squared tests, and the Mann-Whitney U test were used to compare intervention and control groups at baseline. Multiple linear regression was used to compare the groups for pre-post changes. Qualitative content analysis was used to analyze exit interview transcripts.

Results
We found statistically significant differences in nursing students’ confidence to teach sexual health (p = < 0.001), satisfaction with skills as a sexual health educator (p = < 0.001), beliefs about the efficacy of parent-adolescent communication for reducing negative sexual outcomes among adolescents (p = < 0.001), and intentions to counsel parents on sexual health (p = < 0.001), with greater improvements in the intervention group than in the control group. Furthermore, we found statistically significant differences in nursing students’ intentions to counsel parents about the HPV vaccine (p = < 0.01) and to endorse the HPV vaccine (p = < 0.05), with greater improvements in the intervention group than in the control group. Across all survey categories, qualitative findings confirmed improvements seen on the pre-post survey.

Conclusion
Providing evidence-based adolescent sexual health training, including sexual health education content and discussion strategies, can prepare nursing students to strongly endorse sexual health communication and HPV vaccination uptake and to counsel parents on initiating and navigating these conversations with their youth. Our project exemplifies how a nursing program could organize an immersive experience, or elective within a specialty area, that aligns with the competency-based approach endorsed by the American Association of Colleges of Nursing.

Trial registration
This study was registered with ClinicalTrials.gov (NCT02600884) on 09/01/2015; the first participant was recruited on 09/29/2015.
TMT-based quantitative proteomics reveals the targets of andrographolide on LPS-induced liver injury
Authors: Ge Shihao , Lian Wenqi , Bai Yongjiang , Wang Linzheng , Zhao Fuwei , Li Houmei , Wang Dongliang , Pang Quanhai 
Published: October 2023

AbstractBackgroundAndrographolide (Andro) is a diterpenoid derived from Andrographis paniculate, which has anti-inflammatory, antibacterial, antiviral and hepatoprotective activities. Gram-negative bacterial infections can cause varying degrees of liver injury in chickens, although Andro has been shown to have a protective effect on the liver, its underlying mechanism of action and effects on liver proteins are not known.MethodsThe toxicity of Andro on the viability of leghorn male hepatoma (LMH) cells at different concentrations and times was analyzed by CCK-8 assays. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in the culture supernatants were measured using an automatic biochemical analyzer to evaluate the protective effect of androscopolide on LPS-induced injury of LMH cells. Subsequently, TMT proteomics analysis were performed on the negative control group (NC group), LPS, and LPS-Andro groups, and bioinformatics analysis was performed on the differentially expressed proteins (DEPs).ResultsIt was found that Andro reduced ALT and AST levels in the cell supernatant and alleviated LPS-induced injury in LMH cells. Proteomic analysis identified 50 and 166 differentially expressed proteins in the LPS vs. NC group and LPS-Andro vs. LPS group, respectively. Andro may be involved in steroid metabolic processes, negative regulation of MAPK cascade, oxidative stress, and other processes to protect against LPS-induced liver injury.ConclusionsAndro protects against LPS-induced liver injury, HMGCS1, HMGCR, FDPS, PBK, CAV1, PRDX1, PRDX4, and PRDX6, which were identified by differential proteomics, may be the targets of Andro. Our study may provide new theoretical support for Andro protection against liver injury.
Microbiological diagnosis of pulmonary invasive aspergillosis in critically ill patients with severe SARS-CoV-2 pneumonia: a bronchoalveolar study
Authors: Estella Ángel , Martín-Loeches Ignacio , Núñez María Recuerda , García Clara González , Pesaresi Liliana Marcela , Escors Alvaro Antón , Prieto Maria Dolores López , Calvo Juan Manuel Sánchez 
Published: October 2023

Abstract
Background
Diagnosing COVID-19-associated pulmonary aspergillosis (CAPA) can be challenging since radiological and clinical criteria in the critically ill patient are nonspecific. Microbiological diagnostic support is therefore crucial. The aim of this study was to document the incidence of aspergillosis using bronchoalveolar lavage (BAL) as the diagnostic method and to determine the performance of the current mycological diagnostic tests most widely used for the diagnosis of CAPA, together with evaluation of the Asp lateral flow device (LFD).

Methods
Prospective cohort study conducted between March 2020 and June 2022. Inclusion criteria were critically ill patients admitted to the ICU with SARS-CoV-2 pneumonia requiring invasive mechanical ventilation. Diagnostic bronchoscopy and BAL were performed at the beginning of invasive mechanical ventilation. The sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR + and LR-) of BAL culture, direct examination with calcofluor white stain, ELISA (Platelia) and LFD (AspLFD) for detection of galactomannan (GM) were evaluated. Aspergillus-qPCR was applied when discrepancies between diagnostic tests arose.

Results
Of the 244 critically ill patients with SARS-CoV-2 pneumonia admitted to the ICU, the majority (n = 200, 82%) required invasive mechanical ventilation. Diagnostic bronchoscopic procedures were performed in 160 patients (80%), who were enrolled in this study. The incidence of CAPA was 18.7% (n = 30). LFD-GM demonstrated a sensitivity of 84%, specificity of 99%, PPV 94%, NPV 97%, LR(+) of 84, and LR(-) of 0.16. At GM-ELISA indices of ≥ 0.5 and ≥ 1.0, sensitivity was 92% and 79%, specificity was 95% and 99%, PPV 76% and 91%, NPV 99% and 96%, LR(+) 18 and 79, and LR(-) 0.08 and 0.21, respectively. The optimal cut-off index from the ROC curve was 0.48, with sensitivity of 95% and specificity of 95%.

Conclusions
Using a diagnostic strategy based on bronchoscopy and BAL, we documented a high incidence of pulmonary aspergillosis in patients with severe SARS-CoV-2 pneumonia. Asp-LFD showed moderate sensitivity and excellent specificity, with a high PPV, and could be used for rapid diagnosis of patients with suspected CAPA.
Analysis of clinical efficacy and safety of hand-sewn anastomosis for the digestive tract with Da Vinci robot in rectal cancer surgery
Authors: Feng Zhen , Sun Zhiwei , Zhang Qianshi , Ren Shuangyi 
Published: October 2023

Abstract
Purpose
The study aimed to analyze the clinical efficacy and safety of hand-sewn anastomosis for the digestive tract with Da Vinci robot in rectal cancer surgery.

Methods
A retrospective study was conducted to collect the clinical data from 27 patients who underwent Da Vinci robotic rectal cancer radical surgery in the department of gastrointestinal surgery at the Second Affiliated Hospital of Dalian Medical University from August 2019 to February 2022. All patients received a manual suture for digestive tract reconstruction. After the posterior wall was sutured, the anterior wall was sutured continuously. Finally, a prilling thread was used to sew the junction of the front and rear walls. Perioperative indexes and complications were recorded.

Results
All 27 patients successfully underwent the operation. Neither conversion to laparotomy nor perioperative death occurred. The operation time and intraoperative blood loss were 183.6 ± 44.8 min and 54.8 ± 34.4 ml, respectively. A total of 15.3 ± 7.8 lymph nodes were harvested. The pain score 24 h after operation was 1.3 ± 1.3. The time out of bed, the time to exhaust, and the time to eat were 15.6 ± 2.9 h, 2.2 ± 0.8 days, and 2.1 ± 0.6 days, respectively. A total of 4 patients (14.8%) developed complications after the operation. Grade B anastomotic leakage gradually resolved after drainage and antibiotic therapy in 1 case. A patient with grade C anastomotic leakage received a second operation for ileostomy. One patient with postoperative pneumonia recovered after anti-infective treatment. Another patient with intraperitoneal hemorrhage improved after symptomatic treatment with blood transfusion and hemostasis. The postoperative hospitalization time and total hospitalization costs were 8.9 ± 4.4 days and 89,236.1 ± 13,527.9 yuan, respectively.

Conclusions
Manual suture with Da Vinci robotic surgery system is safe and feasible for reconstructing the digestive tract in rectal cancer surgery.
Human iPSC-derived glia models for the study of neuroinflammation
Authors: Stöberl Nina , Maguire Emily , Salis Elisa , Shaw Bethany , Hall-Roberts Hazel 
Published: October 2023

AbstractNeuroinflammation is a complex biological process that plays a significant role in various brain disorders. Microglia and astrocytes are the key cell types involved in inflammatory responses in the central nervous system. Neuroinflammation results in increased levels of secreted inflammatory factors, such as cytokines, chemokines, and reactive oxygen species. To model neuroinflammation in vitro, various human induced pluripotent stem cell (iPSC)-based models have been utilized, including monocultures, transfer of conditioned media between cell types, co-culturing multiple cell types, neural organoids, and xenotransplantation of cells into the mouse brain. To induce neuroinflammatory responses in vitro, several stimuli have been established that can induce responses in either microglia, astrocytes, or both. Here, we describe and critically evaluate the different types of iPSC models that can be used to study neuroinflammation and highlight how neuroinflammation has been induced and measured in these cultures.
Quantitative analysis of acetylation in peste des petits ruminants virus-infected Vero cells
Authors: Meng Xuelian , Wang Xiangwei , Zhu Xueliang , Zhang Rui , Zhang Zhidong , Sun Yuefeng 
Published: October 2023

Abstract
Background
Peste des petits ruminants virus (PPRV) is a highly contagious pathogen that strongly influences the productivity of small ruminants worldwide. Acetylation is an important post-translational modification involved in regulation of multiple biological functions. However, the extent and function of acetylation in host cells during PPRV infection remains unknown.

Methods
Dimethylation-labeling-based quantitative proteomic analysis of the acetylome of PPRV-infected Vero cells was performed.

Results
In total, 1068 proteins with 2641 modification sites were detected in response to PPRV infection, of which 304 differentially acetylated proteins (DAcPs) with 410 acetylated sites were identified (fold change < 0.83 or > 1.2 and P < 0.05), including 109 up-regulated and 195 down-regulated proteins. Gene Ontology (GO) classification indicated that DAcPs were mostly located in the cytoplasm (43%) and participated in cellular and metabolic processes related to binding and catalytic activity. Functional enrichment indicated that the DAcPs were involved in the minichromosome maintenance complex, unfolded protein binding, helicase activity. Only protein processing in endoplasmic reticulum pathway was enriched. A protein-protein interaction (PPI) network of the identified proteins further indicated that a various chaperone and ribosome processes were modulated by acetylation.

Conclusions
To the best of our knowledge, this is the first study on acetylome in PPRV-infected host cell. Our findings establish an important baseline for future study on the roles of acetylation in the host response to PPRV replication and provide novel insights for understanding the molecular pathological mechanism of PPRV infection.
Global priority for the care of orphans and other vulnerable children: transcending problem definition challenges
Authors: Shawar Yusra Ribhi , Shiffman Jeremy 
Published: October 2023

Abstract
Background
Tens of millions of children lack adequate care, many having been separated from or lost one or both parents. Despite the problem’s severity and its impact on a child’s lifelong health and wellbeing, the care of vulnerable children—which includes strengthening the care of children within families, preventing unnecessary family separation, and ensuring quality care alternatives when reunification with the biological parents is not possible or appropriate—is a low global priority. This analysis investigates factors shaping the inadequate global prioritization of the care of vulnerable children. Specifically, the analysis focuses on factors internal to the global policy community addressing children’s care, including how they understand, govern, and communicate the problem.

Methods
Drawing on agenda setting scholarship, we triangulated among several sources of data, including 32 interviews with experts, as well as documents including peer-reviewed literature and organizational reports. We undertook a thematic analysis of the data, using these to create a historical narrative on efforts to address children’s care, and specifically childcare reform.

Results
Divisive disagreements on the definition and legitimacy of deinstitutionalization—a care reform strategy that replaces institution-based care with family-based care—may be hindering priority for children’s care. Multiple factors have shaped these disagreements: a contradictory evidence base on the scope of the problem and solutions, divergent experiences between former Soviet bloc and other countries, socio-cultural and legal challenges in introducing formal alternative care arrangements, commercial interests that perpetuate support for residential facilities, as well as the sometimes conflicting views of impacted children, families, and the disability community. These disagreements have led to considerable governance and positioning difficulties, which have complicated efforts to coordinate initiatives, precluded the emergence of leadership that proponents universally trust, hampered the engagement of potential allies, and challenged efforts to secure funding and convince policymakers to act.

Conclusion
In order to potentially become a more potent force for advancing global priority, children’s care proponents within international organizations, donor agencies, and non-governmental agencies working across countries will need to better manage their disagreements around deinstitutionalization as a care reform strategy.