bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the impact of acidic medications and fluoride-containing mouthwash on the enamel surface using quantitative light-induced fluorescence, microhardness, and scanning electron microscopy: an in vitro study
Authors: Bhasin Saanya , Singh Simran , Thomas Manuel Sebastian , Mahabala Karuna Yarmunja , Shenoy Ramya 
Published: January 2025

Abstract

Background
Due to their acidic nature, certain medications can have deleterious effects on tooth enamel. Fluoride is a popular method for reversing these effects. Therefore, this study aimed to assess the impact of acidic medications, specifically anti-asthmatic drugs and vitamin C tablets, on enamel surfaces and to investigate the effects of fluoride following drug exposure.

Methods
An in vitro experimental study was conducted on ninety-six healthy human posterior teeth. Forty-eight samples were tested for surface demineralization via quantitative laser fluorescence (QLF), and the other forty-eight samples were tested for enamel microhardness via a Vickers hardness tester. The samples were divided into six groups: (i) Group DW_NF- samples immersed in distilled water with no fluoride exposure; (ii) Group DW_F- samples immersed in distilled water with intermittent fluoride exposure; (iii) Group VC_NF- samples treated with vitamin C only; (iv) Group VC_F- samples treated with vitamin C and fluoride mouthwash; (v) Group SB_NF- samples exposed to salbutamol inhaler with no fluoride exposure; (vi) Group SB_NF- samples exposed to salbutamol inhaler followed by fluoride exposure. For the evaluation of surface morphology by scanning electron microscopy (SEM), two random samples used for QLF from each group were taken. The Wilcoxon signed-rank test, Kruskal‒Wallis test, and post hoc test were applied as appropriate. The p value was set at 0.05.

Results
Following exposure to medication, significantly higher QLF values were observed in Group VC_F and Group SB_F than in Group DW-NF (control group) (p = 0.15 and 0.004, respectively). The difference in the QLF values was significantly greater in Group VC_NF than in the control group DW-NF, indicating greater demineralization with acidic medications (p = 0.034). Significant changes in surface microhardness were detected in Group VC_F compared with the control group (p = 0.024). Qualitative analysis of SEM images revealed erosion at the enamel surface in all groups except the control group, with the most prominent erosion in the vitamin C- and fluoride-treated groups (VC_F group).

Conclusion
This study demonstrated the erosive potential of vitamin C tablets on enamel surfaces. Furthermore, the use of acidic fluoride mouthwash immediately after exposure to acidic medication exacerbates enamel demineralization.
Nursing professionalism and associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Abebe Moges Tadesse , Zeleke Agerie Mengistie , Ferede Yeshiwas Ayale , Gonete Yosef Aragaw , Tassew Worku Chekol 
Published: January 2025

Abstract

Background
A higher level of nursing professionalism improves autonomy among nurses, the quality of nursing care, and patient outcomes. However, inconsistent findings on the prevalence of nursing professionalism and associated factors have been reported among studies conducted in Ethiopia, and a meta-analysis of pooled results have not been performed. Therefore, the aim of this systematic review and meta-analysis was to determine the pooled prevalence of higher levels of nursing professionalism and factors associated with it.

Methods
PubMed, Science Direct, HINARI, African Journals Online, Google Scholar, and university online institutional repositories in Ethiopia were accessed from 15/10/2024–30/10/2024. The items were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed via the Newcastle–Ottawa Scale. Cross-sectional studies were included without time period limits. Data extraction was conducted via Microsoft Excel and analyzed with STATA 17. The Galbraith plot, I2 statistic and meta-regression were used to determine heterogeneity. We used a random effects model in the presence of heterogeneity. Publication bias was assessed via funnel plots and Egger’s based regression. We also computed a sensitivity analysis and subgroup analysis by sample size and study period.

Results
Twelve primary studies involving 3710 nurses were included in this systematic review and meta-analysis. The pooled prevalence of higher levels of nursing professionalism was 43%. Bachelor's degree and above educational status (POR: 1.80, CI: 1.38, 2.33), learning from government colleges (POR: 2.14, CI: 1.34, 3.42), better payment (POR: 1.85, CI: 1.16, 2.98), long years of work experience (POR: 2.15, CI: 1.73, 2.68), positive self-image (POR: 3.85, CI: 2.17, 6.84), job satisfaction (POR: 2.42, CI: 1.49, 3.95) and training opportunities (POR: 2.88, CI: 1.14, 7.32) were factors that determined higher levels of nursing professionalism in Ethiopia.

Conclusion
The pooled prevalence of higher levels of nursing professionalism in Ethiopia was low. Educational status, and attending college, payment, work experience, self-image, job satisfaction, and training were factors that determined the level of professionalism. These factors can be modified to increase the level of nursing professionalism in Ethiopia.
Evaluating the impact, implementation experience and political economy of primary care networks in Kenya: protocol for a mixed methods study
Authors: Amboko Beatrice , Nzinga Jacinta , Tsofa Benjamin , Mugo Peter , Musiega Anita , Maritim Beryl , Wong Ethan , Mazzilli Caitlin , Ng’ang’a Wangari , Hagedorn Brittany , Turner Gillian , Musuva Anne , Murira Felix , Ravishankar Nirmala , Hussein Salim , Barasa Edwine 
Published: January 2025

Abstract

Background
Primary care networks (PCNs) are increasingly being adopted in low- and middle-income countries (LMICs) to improve the delivery of primary health care (PHC). Kenya has identified PCNs as a key reform to strengthen PHC delivery and has passed a law to guide its implementation. PCNs were piloted in two counties in Kenya in 2020 and implemented nationally in October 2023. This protocol outlines methods for a study that examines the impact, implementation experience and political economy of the PCN reform in Kenya.

Methods
We will adopt the parallel databases variant of convergent mixed methods study design to concurrently but separately collect quantitative and qualitative data. The two strands will be mixed during data collection to refine questions, with findings triangulated during analysis and interpretation to provide a comprehensive understanding of PCN implementation. The quantitative study will use a controlled before and after study design and collect data using health facility and client exit surveys. The primary outcome measure will be the service delivery readiness of PHC facilities. We will use a random sample of 228 health facilities and 2560 clients in four currently implementing PCNs, four planning to implement and four control counties at baseline and post-implementation. We shall undertake a preliminary cross-sectional analysis of the data at baseline from October to December 2023, followed by a difference-in-difference analysis at the endline from October to December 2024 to compare the outcome differences between the intervention and control counties over a 12-month period. The qualitative study will include a cross-sectional process evaluation and political economy analysis (PEA) using document reviews and approximately 80 in-depth interviews with national and sub-national stakeholders. The process evaluation will assess the emergence of PCN reforms, the implementation experience, the mechanism of impact and how the context affects implementation and outcomes. The PEA will examine the interaction of structural factors, institutions and actors/stakeholders’ interests and power relations in implementing PCNs. We will also examine the gendered effects of the PCNs, including power relations and norms, and their implications on PHC from the supply and demand sides. We shall undertake a thematic analysis of the qualitative data.

Discussion
This evaluation will contribute robust evidence on the impact, implementation experience, political economy and gendered implications of PCNs in a LMIC setting, as well as guide the refining of PCN implementation in Kenya and other LMICs implementing or planning to implement PCNs to enhance their effectiveness.
External validation of a multivariable prediction model for positive resection margins in breast-conserving surgery
Authors: Manhoobi Irina Palimaru , Ellbrant Julia , Bendahl Pär-Ola , Redsted Søren , Bodilsen Anne , Tramm Trine , Christiansen Peer , Rydén Lisa 
Published: January 2025

Abstract

Objectives
Positive resection margins after breast-conserving surgery (BCS) most often demands a repeat surgery. To preoperatively identify patients at risk of positive margins, a multivariable model has been developed that predicts positive margins after BCS with a high accuracy. This study aimed to externally validate this prediction model to explore its generalizability and assess if additional preoperatively available variables can further improve its predictive accuracy. The validation cohort included 225 patients with invasive breast cancer who underwent BCS at Aarhus University Hospital, Aarhus, Denmark during 2020–2022. Receiver operating characteristic (ROC) and calibration analysis were used to validate the prediction model. Univariable logistic regression was used to evaluate if additional variables available in the validation cohort were associated with positive margins and backward elimination to explore if these variables could further improve the model´s predictive accuracy.

Results
The AUC of the model was 0.60 (95% CI: 0.50–0.70) indicating a lower discriminative capacity in the external cohort. We found weak evidence for an association between increased preoperative breast density on mammography and positive resection margins after BCS (p = 0.027), but the AUC of the model did not improve, when mammographic breast density was included as an additional variable in the model.
Chemotherapy in synergy with innate immune agonists enhances T cell priming for checkpoint inhibitor treatment in pancreatic cancer
Authors: Niu Nan , Li Keyu , Wang Junke , Funes Vanessa , Espinoza Birginia , Li Pan , Wang Jianxin , Lyman Melissa , He Mengni , Herbst Brian , Wichroski Michael , Novosiadly Ruslan , Shoucair Sami , Mou Yiping , Zheng Lei 
Published: January 2025

Abstract

Background
The combination of conventional chemotherapy and immune checkpoint inhibitors (ICIs) has been unsuccessful for pancreatic ductal adenocarcinoma (PDAC). Administration of maximum tolerated dose of chemotherapy drugs may have immunosuppressive effects.

Methods
We thus tested, by using the preclinical model of PDACs including the genetically engineered mouse KPC spontaneous pancreatic tumor model and the pancreatic KPC tumor orthotopic implant model, the combinations of synthetic innate immune agonists including STING and NLRP3 agonist, respectively, and ICIs with or without chemotherapy.

Results
We found that innate agonists potentiate the role of chemotherapy in inducing effector T cells and subsequently to prime the tumor microenvironment (TME) better for ICI treatments. Triple combination of chemotherapy, innate agonists, and ICIs is superior to single modalities or double modalities in antitumor efficacies. Adding chemotherapy to innate agonists enhances the infiltration of overall CD8+ T cells and the memory cytotoxic subtype. NLRP3 agonist has a less effect than STING agonist on driving the T cell exhaustion. Adding chemotherapy to innate agonists enhances the infiltration of dendritic cells (DCs) in the tumors and CD86+ mature DCs in tumor draining lymph nodes. RNA sequencing analysis of the pancreatic tumors demonstrates the role of the combination of STING/NLRP3 agonist and chemotherapy, but not either treatment modality alone, in upregulating the T cell activation signaling. The NLRP3 agonist-mediated T cell activation is likely through regulating the nitrogen metabolism pathways.

Conclusion
This study supports the clinical testing of both STING and NLRP3 agonists, respectively, in combination with chemotherapy to sensitize PDAC patients for ICI treatments.
Appropriateness of learning environments in preprimary educational institutions: the case of preschools in Bahir Dar city, Ethiopia
Authors: Worku Mulugeta Yayeh 
Published: January 2025

Abstract
This study aimed to examine the appropriateness of learning environments in preprimary institutions, specifically focusing on preschools in Bahir Dar city, Ethiopia. To achieve this, a mixed-methods research approach was employed, guided by an adapted framework for assessing learning environments. Participants included preschool teachers and leaders who were selected through a comprehensive sampling technique. Data were collected using questionnaires and observations, and analyzed both quantitatively (using means, standard deviations, one-sample t-tests, and independent samples t-tests) and qualitatively through a thematic analysis approach. The findings revealed several challenges related to the physical environments, facilities, and classroom conditions within the preschools. The study concludes that, despite some positive efforts, preschools in Bahir Dar city were struggling to provide preprimary education in environments that are unsuitable for children. Finally, the article offers recommendations aimed at improving the learning environments of these institutions.
Greenhouse gas emissions (GHGE), water footprint and nitrogen loss associated with food consumption among adults: findings from the updated LEBANese natiONal food consumption survey (LEBANON-FCS)
Authors: Hoteit Maha , Khattar Maroun , Antar Esraa , Malli Dana ,   The Adults-Lebanon-FCS Group, Fadlallah Zahraa , Khadra Razan , Chahine Mohamad , Poh Omasyarifa Binti Jamal , Tzenios Nikolaos , Al Manasfi Elham , Chahine Abdulrahman 
Published: January 2025

Abstract

Background
Lebanon is grappling with numerous environmental challenges, including water scarcity, landfill waste, deforestation, and rising air pollution. Food choices significantly influence global greenhouse gas emissions and environmental impacts, making it crucial to evaluate the environmental footprints (EFPs) of Lebanon’s current dietary habits. This study aimed to assess food consumption patterns and their EFPs among a nationally representative sample of Lebanese adults.

Methods
A cross-sectional survey was conducted from May to September 2022, involving 444 Lebanese adults aged 18 to 64 years. The sample was representative, and participants were distributed across the eight Lebanese governorates. Sociodemographic and medical data were collected via a questionnaire, food consumption was assessed through a validated Food Frequency Questionnaire (FFQ) and two non-consecutive 24-hour recalls, and anthropometric measurements were also taken. EFPs were derived from databases and repositories.

Results
The typical EFPs of an average Lebanese adult included water usage of 2,862.39 ± 1,617.88 L/day, greenhouse gas emissions of 4.43 ± 2.29 kg CO2-eq/day, and nitrogen use of 12.72 ± 6.76 g/day. Animal products were the primary contributors to greenhouse gas emissions, while vegetable products had the highest water footprint and nitrogen loss impact on the environment. Grains and cereals, the most consumed food category, significantly influenced the water footprint and nitrogen loss. Additionally, meat consumption notably drove greenhouse gas emissions.

Conclusion
Lebanon must address its environmental challenges and the impact of dietary choices on greenhouse gas emissions and EFPs. By evaluating and understanding the environmental consequences of current dietary patterns, Lebanon can take proactive steps towards promoting sustainable food practices and mitigating environmental degradation.
RNA binding protein ILF3 increases CEP55 mRNA stability to enhance malignant potential of breast cancer cells and suppress ferroptosis
Authors: Chen Sheng , Luo Yangyong , Ruan Simin , Su Guosen , Huang Guoxing 
Published: January 2025

Abstract

Background
Ferroptosis has emerged as a promising therapeutic target in cancer treatment. CEP55, a key regulator of cell mitosis, plays a significant role in the tumorigenesis of many malignancies. In this study, we elucidated the function of CEP55 in the ferroptosis of breast cancer (BC).

Methods
The protein levels of CEP55 and ILF3 were detected by immunoblotting or immunohistochemistry, and their mRNA levels were assessed by quantitative PCR. Cell invasion and migration were evaluated by transwell assay. Cell apoptosis and colony formation were tested by flow cytometry and colony formation assays, respectively. RNA immunoprecipitation (RIP) experiment and CEP55 mRNA stability assay were used to validate the relationship between ILF3 and CEP55 mRNA. Subcutaneous xenograft studies were performed to analyze the role of ILF3 depletion in tumor growth.

Results
CEP55 and ILF3 were upregulated in most of human BC samples and MDA-MB-231 and MCF-7 BC cells. The depletion of CEP55 or ILF3 impaired the growth, invasion, and migration of MDA-MB-231 and MCF-7 cells, while promoted their ferroptosis and apoptosis. Mechanistically, ILF3 stabilized CEP55 mRNA to regulate CEP55 expression in BC cells. CEP55 restoration partially rescued the malignant potential defects of ILF3-depleted BC cells and attenuates their ferroptosis. Moreover, ILF3 depletion enhanced the anti-tumor growth activity of the ferroptosis inducer erastin in MDA-MB-231 subcutaneous xenograft tumors.

Conclusion
Our observations indicate that the depletion of ILF3 impairs the malignant potential of BC cells and promotes their ferroptosis by downregulating CEP55 expression. Silencing ILF3 or CEP55 could represent a potential therapeutic strategy for BC treatment.

Graphical abstract
HSP90 inhibitors promote cell death by degrading Met and BCR::ABL1 in both imatinib-resistant and -sensitive chronic myeloid leukemia cells
Authors: Tsubaki Masanobu , Matsuo Taira , Komori Rie , Nagai Noriaki , Yamamoto Tetsushi , Nishida Shozo 
Published: January 2025

Abstract

Background
Chronic myeloid leukemia is associated with a more favorable prognosis following treatment with BCR::ABL1 tyrosine kinase inhibitors (TKIs). Nonetheless, about 40% of affected individuals with CML display resistance or intolerance towards BCR::ABL1 TKIs. Heat shock protein 90 (HSP90) functions as a molecular chaperone and is known for its overexpression in various types of cancer, thereby HSP90 is a potential candidate for the treatment of BCR::ABL1 TKI-resistant and -sensitive CML. In present study, we aimed to investigate whether HSP90 inhibitors promote cell death in imatinib-resistant and -sensitive CML cells.

Results
KW-2478 and NVP-AUY922, which are HSP90 inhibitors, promoted cell death in both imatinib-resistant and -sensitive CML cells. Imatinib-resistant cells showed greater sensitivity to HSP90 inhibitors in comparison to imatinib-sensitive cells. KW-2478 inhibited the activation of Akt, extracellular regulated protein kinase 1/2, and c-Jun N-terminal kinase 1/2 in imatinib-resistant and -sensitive CML cells by promoting Met and BCR::ABL1 degradation.

Conclusion
These findings indicate inhibition of HSP90 such as KW-2478 and NVP-AUY922 as potential candidates for CML therapy.
Exploring the relationship between dissociative experiences and recovery in psychosis: cross-sectional study
Authors: Calciu Claudia , Macpherson Rob , Rees Kerry J. , Chen Sui Yung , Ruxton Sarah , White Rhiannon , Almaskati Mazen , Hill Francesca , Vasilis-Peter Anca , Desando Sebastian , Pennell Oliver , Nasubuga Carolyn , Webb Jackie , Walker Mark , Soponaru Camelia 
Published: January 2025

Aims and method
This study explored the association among dissociative experiences, recovery from psychosis and a range of factors relevant to psychosis and analysed whether dissociative experiences (compartmentalisation, detachment and absorption) could be used to predict specific stages of recovery. A cross-sectional design was used, and 75 individuals with psychosis were recruited from the recovery services of the Gloucestershire Health and Care NHS Foundation Trust. Five questionnaires were used – the Dissociative Experiences Scale – II (DES), Detachment and Compartmentalisation Inventory (DCI), Questionnaire about the Process of Recovery, Stages of Recovery Instrument (STORI), and Positive and Negative Syndrome Scale – and a proforma was used to collect demographic data.

Results
Our findings indicated that compartmentalisation, detachment and absorption, as measured by DES and DCI, do not predict stages of recovery as measured by the STORI.

Clinical implications
The results of this study suggest that there is no simple relationship between dissociative and psychotic symptoms. They also suggest a need to assess these symptoms separately in practice and indicate that special approaches to treatment of psychosis may be needed in cases where such symptoms have a significant role.
The association between experiences of racism and mental health on children and young people in the UK: rapid scoping review
Authors: Ghezae Fiyory Tzeggai , Zungu Zonke , John Ann , Abdinasir Kadra , Bhui Kamaldeep , Adebiyi Adenike , Creswell Cathy 
Published: January 2025

Background
Racism is increasingly recognised as a key contributor to poor mental health. However, the existing literature primarily focuses on its effects on adults.

Aim
To identify literature on the association between experiences of racism and mental health in children and young people in the UK.

Method
Inclusion criteria were: (a) peer-reviewed publications containing original data; (b) UK-based research; (c) included examination of associations between mental health and experiences of direct or indirect racism (quantitative or qualitative); (d) inclusion of an assessment of mental health outcomes; (e) participant ages up to and including 18 years of age or (if the range went beyond 18) with a mean age of 17 years or less. Six databases were searched between 2000 and 2022; an initial 11 522 studies were identified with only eight meeting the inclusion criteria.

Results
Five of the identified studies provided quantitative data and three provided qualitative data. The majority of studies (7/8) focused on children and young people aged 10 years and over; only one focused on children under the age of 10 years. Measurements of racism varied among the studies providing quantitative data. Only four studies directly focused on the effects of racism on the mental health of children and young people.

Conclusion
Although the included studies highlighted potential negative impacts of experiences of racism on children and young people in the UK, this review shows the lack of available literature to inform policy and practice. No studies examined the impact of internalised racism, systemic and institutional racism, or intersectionality.