bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990–2017
Authors: Shoaee Shervan , Ghasemi Erfan , Sofi-Mahmudi Ahmad , Shamsoddin Erfan , Tovani-Palone Marcos Roberto , Roshani Shahin , Heydari Mohammad-Hossein , Yoosefi Moein , Masinaei Masoud , Azadnaejafabadi Sina , Mohammadi Esmaeil , Rezaei Negar , Larijani Bagher , Fakhrzadeh Hossein , Farzadfar Farshad 
Published: January 2024

Abstract
Background
Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide.

Methods
We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders.

Results
Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values.

Conclusion
The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders.
A bivariate Poisson regression to analyse impact of outlier women on correlation between female schooling and fertility in Malawi
Authors: Kaombe Tsirizani Mwalimu 
Published: January 2024

Abstract
Background
Women’s levels of education and fertility are commonly associated. In Sub-Saharan Africa, the pace of decreasing fertility rates varies greatly, and this is linked to women’s levels of education. However, this association may be influenced by unusual females who have uncommon measurements on both variables. Despite this, most studies that researched this association have only analysed the data descriptively, without taking into account the effect of potential outliers. This study aimed to examine the presence and impact of outlier women on the relationship between female education and fertility in Malawi, using regression methods.

Methods
To analyse the correlation between women’s schooling and fertility and evaluate the effect of outliers on this relationship, a bivariate Poisson model was applied to three recent demographic and health surveys in Malawi. The R software version 4.3.0 was used for model fitting, outlier computations, and correlation analysis. The STATA version 12.0 was used for data cleaning.

Results
The findings revealed a correlation of -0.68 to -0.61 between schooling and fertility over 15 years in Malawi. A few outlier women were identified, most of whom had either attended 0 or at least 9 years of schooling and had born either 0 or at least 5 children. The majority of the outliers were non-users of modern contraceptive methods and worked as domestic workers or were unemployed. Removing the outliers from the analysis led to marked changes in the fixed effects sizes and slight shifts in correlation, but not in the direction and significance of the estimates. The woman’s marital status, occupation, household wealth, age at first sex, and usage of modern contraceptives exhibited significant effects on education and fertility outcomes.

Conclusion
There is a high negative correlation between female schooling and fertility in Malawi. Some outlier women were identified, they had either attended zero or at least nine years of schooling and had either born zero or at least five children. Most of them were non-users of modern contraceptives and domestic workers. Their impact on regression estimates was substantial, but minimal on correlation. Their identification highlights the need for policymakers to reconsider implementation strategies for modern contraceptive methods to make them more effective.
The effect of acupuncture on exercise capacity in patients with COPD is mediated by improvements of dyspnea and leg fatigue: a causal mediation analysis using data from a randomized controlled trial
Authors: Kayo Takumi , Suzuki Masao , Mitsuma Tadamichi , Fukuda Fumihiko 
Published: January 2024

Abstract
Background
Acupuncture is known to improve exercise capacity in patients with chronic obstructive pulmonary disease (COPD), but its mechanism remains unknown. Whether acupuncture improves exercise capacity in patients with COPD through alleviation of leg fatigue and dyspnea is examined by applying causal mediation analysis to previous trial data.

Methods
Sixty-two patients with COPD completed treatments with either real or placebo acupuncture once a week for 12 weeks. Walk distance measured using the 6-minute walk test and intensities of leg fatigue and dyspnea in the modified Borg scale were evaluated at baseline and after treatment. The intervention effect of acupuncture against the placebo acupuncture on two mediators, changes in leg fatigue and dyspnea, and whether they mediated improvements in walk distance, were analyzed.

Results
Linear regression analysis showed that the unstandardized regression coefficients [95% confidence interval (CI)] for the intervention effect by acupuncture were -4.9 (-5.8–-4.0) in leg fatigue and -3.6 (-4.3–-2.9) in dyspnea. Mediation analysis showed that when changes in leg fatigue were considered as a mediator, direct effect, indirect effect and proportion mediated were 47.1 m (95% CI, 4.6–85.1), 34.3 m (-2.1–82.1), and 42.1%, respectively, and when changes in dyspnea were considered as a mediator, they were 9.8 m (-32.9–49.9), 72.5 m (31.3–121.0), and 88.1%, respectively, and the effects of joint mediator were -5.8 m (-55.4–43.9), 88.9 m (32.7–148.5), and 107.0%, respectively.

Conclusion
The improvement in exercise capacity by acupuncture is explained by changes in both leg fatigue and dyspnea.
Dietary lysozyme and avilamycin modulate gut health, immunity, and growth rate in broilers
Authors: Abdel-Latif Mervat A. , El-Hamid Hatem S. Abd , Emam Mohamed , Noreldin Ahmed. E. , Helmy Yosra A. , El-Far Ali H. , Elbestawy Ahmed R. 
Published: January 2024

Abstract
Background
Attempts to use dietary lysozyme (LYZ) as an alternative to antibiotics in broilers have been successful, but further research is needed for effective use. Here, we compared the differences between LYZ and avilamycin (AVI) feed additives for growth performance, gut health and immunity of broilers. One-day old, one hundred and twenty broiler chicks (Ross 308) were randomly allocated into three groups consisting forty birds in each group. Standard diet without supplementation was applied as the control group (I), while the chicks of the other groups were supplemented with 100 mg of AVI per kg diet (AVI, group II), and 90 mg LYZ per kg diet (LYZ, group III) for five consecutive weeks.

Results
Body weight, feed conversion ratio, body weight gain, and European production efficiency factor were markedly (p < 0.05) increased in both AVI and LYZ groups in relation to CON group, but the feed intake and protein efficiency ratio were not affected. Both AVI and LYZ significantly (p < 0.001) upregulated the mRNA expression of ileal interleukin-18 (IL-18), interferon-gamma (IFN-γ), and interleukin-10 (IL-10), interleukin-2 (IL-2), and glutathione peroxidase (GSH-PX) genes compared to CON group. However, IL-2, IL-10, IL-18, and GSH-PX genes were markedly (p < 0.01) upregulated in LYZ compared to the AVI group. LYZ treated group had a significant increase (p < 0.05) in the serological haemagglutination inhibition titers of H5N1 vaccination and a significant decrease (p < 0.0001) in coliform counts compared to control and AVI groups, but all growth parameters were nearly similar between AVI and LYZ groups. The VH and VH/CD were markedly higher in LYZ than AVI and control groups.

Conclusion
Exogenous dietary lysozyme supplementation by a dose of 90 mg/kg broilers’ diet induced better effects on intestinal integrity, fecal bacterial counts, immune response, and growth performance which were comparable to avilamycin. Therefore, dietary lysozyme could safely replace avilamycin in the broiler chickens’ diet. However, further experimental studies regarding the use of lysozyme in commercial broilers, both in vitro and in vivo, targeting more communities of intestinal microbiome and explaining more details about its beneficial effects need to be conducted.
Chitinous material bioconversion by three new chitinases from the yeast Mestchnikowia pulcherrima
Authors: Minguet-Lobato Marina , Cervantes Fadia V. , Míguez Noa , Plou Francisco J. , Fernández-Lobato María 
Published: January 2024

Abstract
Background
Chitinases are widely distributed enzymes that perform the biotransformation of chitin, one of the most abundant polysaccharides on the biosphere, into useful value-added chitooligosaccharides (COS) with a wide variety of biotechnological applications in food, health, and agricultural fields. One of the most important group of enzymes involved in the degradation of chitin comprises the glycoside hydrolase family 18 (GH18), which harbours endo- and exo-enzymes that act synergistically to depolymerize chitin. The secretion of a chitinase activity from the ubiquitous yeast Mestchnikowia pulcherrima and their involvement in the post-harvest biological control of fungal pathogens was previously reported.

Results
Three new chitinases from M. pulcherrima, MpChit35, MpChit38 and MpChit41, were molecularly characterized and extracellularly expressed in Pichia pastoris to about 91, 90 and 71 mU ml− 1, respectively. The three enzymes hydrolysed colloidal chitin with optimal activity at 45 ºC and pH 4.0-4.5, increased 2-times their activities using 1 mM of Mn2+ and hydrolysed different types of commercial chitosan. The partial separation and characterization of the complex COS mixtures produced from the hydrolysis of chitin and chitosan were achieved by a new anionic chromatography HPAEC-PAD method and mass spectrometry assays. An overview of the predicted structures of these proteins and their catalytic modes of action were also presented. Depicted their high sequence and structural homology, MpChit35 acted as an exo-chitinase producing di-acetyl-chitobiose from chitin while MpChit38 and MpChit41 both acted as endo-chitinases producing tri-acetyl-chitotriose as main final product.

Conclusions
Three new chitinases from the yeast M. pulcherrima were molecularly characterized and their enzymatic and structural characteristics analysed. These enzymes transformed chitinous materials to fully and partially acetylated COS through different modes of splitting, which make them interesting biocatalysts for deeper structural-function studies on the challenging enzymatic conversion of chitin.
Socioeconomic inequalities in the use of medical consultation services in Peru, 2019
Authors: Díaz-Ruiz Renato , Vargas-Fernández Rodrigo , Rojas-Roque Carlos , Hernández-Vásquez Akram 
Published: January 2024

Abstract
Background
Socioeconomic inequalities in the population influence access to health services and constitute a challenge for health systems, especially in low- and middle-income countries. In Peru, an increase in the use of medical services has been estimated; however, the study of inequalities in the use of medical services is limited. Therefore, the objective of this research was to analyze and decompose socioeconomic inequalities in the use of medical consultation services in Peru.

Methods
A cross-sectional analytical study was conducted using data from the National Household Survey 2019. The outcome variable was the use of a consultation attended by a physician in the last 4 weeks in persons who presented symptom or discomfort, illness, relapse of chronic disease and/or accident. Concentration curves and Erreygers concentration indices were used to determine socioeconomic inequalities, and a generalized linear regression model was used for the decomposition analysis of inequalities.

Results
A total of 52,715 persons were included in the study. The frequency of medical consultation was 25.4% (95% confidence interval: 24.8 − 26.1%). In the inequality analysis, it was found that the use of medical consultations was concentrated among the wealthiest individuals. The main contributing factors were having another type of health insurance (social health insurance [EsSalud], private health insurance, health provider, the Armed Forces, and the Police), residing in an urban area, belonging to the richest wealth quintile, having a chronic disease, and residing in the highlands of Peru.

Conclusions
Based on our findings, government institutions seeking to achieve equitable access to health services should consider the main factors contributing to this inequality in the formulation of strategies to lessen the negative impact of inadequate disease control in the population.
Identification of HSP90B1 in pan-cancer hallmarks to aid development of a potential therapeutic target
Authors: Huang Xiaoliang , Zhang Weiming , Yang Na , Zhang Yujie , Qin Tianyu , Ruan Hanyi , Zhang Yan , Tian Chao , Mo Xianwei , Tang Weizhong , Liu Jungang , Zhang Beibei 
Published: January 2024

AbstractHeat shock proteins play crucial roles in various biochemical processes, encompassing protein folding and translocation. HSP90B1, a conserved member of the heat shock protein family, growing evidences have demonstrated that it might be closely associated with cancer development. In the present study, we employed multi-omics analyses and cohort validations to explore the dynamic expression of HSP90B1 in pan-cancer and comprehensively evaluate HSP90B1 as a novel biomarker that hold promise for precision cancer diagnostics and therapeutics. The results suggest HSP90B1 was highly expressed in various kinds of tumors, often correlating with a poor prognosis. Notably, methylation of HSP90B1 emerged as a protective factor in several cancer types. In immune infiltration analysis, the expression of HSP90B1 in most tumors showed a negative association with CD8 + T cells. HSP90B1 expression was positively correlated with microsatellite instability and tumor mutational burden. HSP90B1 expression was also discovered to be positively correlated with tumor metabolism, cell cycle-related pathways and the expression of immune checkpoint genes. The expression of HSP90B1 was mainly negatively correlated with immunostimulatory genes and positively correlated with immunosuppressive genes, as well as strongly correlated with chemokines and their receptor genes. In addition, the HSP90B1 inhibitor PU-WS13 demonstrated significant efficacy in suppressing cancer cell proliferation in both leukemic and solid tumor cells, and remarkably reduced the expression of the cancer cell surface immune checkpoint PD-L1. The single-cell RNA sequencing analysis further highlighted that HSP90B1 was significantly higher in tumor cells compared to surrounding cells, revealing a potential target therapeutic window. Taken together, HSP90B1 emerges as a promising avenue for breakthroughs in cancer diagnosis, prognosis and therapy. This study provides a rationale for HSP90B1 targeted cancer diagnosis and therapy in future.
Substance use care innovations during COVID-19: barriers and facilitators to the provision of safer supply at a toronto COVID-19 isolation and recovery site
Authors: Kolla Gillian , Tarannum Chowdhury Nishwara , Fajber Kaitlin , Worku Fiqir , Norris Kris , Long Cathy , Fagundes Raphaela , Rucchetto Anne , Hannan Eileen , Kikot Richard , Klaiman Michelle , Firestone Michelle , Bayoumi Ahmed , Laurence Gab , Hayman Kate 
Published: January 2024

Abstract
Background
Early in the COVID-19 pandemic, there was an urgent need to establish isolation spaces for people experiencing homelessness who were exposed to or had COVID-19. In response, community agencies and the City of Toronto opened COVID-19 isolation and recovery sites (CIRS) in March 2020. We sought to examine the provision of comprehensive substance use services offered to clients on-site to facilitate isolation, particularly the uptake of safer supply prescribing (prescription of pharmaceutical opioids and/or stimulants) as part of a spectrum of comprehensive harm reduction and addiction treatment interventions.

Methods
We conducted in-depth, semi-structured interviews with 25 clients and 25 staff (including peer, harm reduction, nursing and medical team members) from the CIRS in April–July 2021. Iterative and thematic analytic methods were used to identify key themes that emerged in the interview discussions.

Results
At the time of implementation of the CIRS, the provision of a safer supply of opioids and stimulants was a novel and somewhat controversial practice. Prescribed safer supply was integrated to address the high risk of overdose among clients needing to isolate due to COVID-19. The impact of responding to on-site overdoses and presence of harm reduction and peer teams helped clinical staff overcome hesitation to prescribing safer supply. Site-specific clinical guidance and substance use specialist consults were crucial tools in building capacity to provide safer supply. Staff members had varied perspectives on what constitutes ‘evidence-based’ practice in a rapidly changing, crisis situation.

Conclusion
The urgency involved in intervening during a crisis enabled the adoption of prescribed safer supply, meeting the needs of people who use substances and assisting them to complete isolation periods, while also expanding what constitutes acceptable goals in the care of people who use drugs to include harm reduction approaches.
Immunogram defines four cancer-immunity cycle phenotypes with distinct clonal selection patterns across solid tumors
Authors: Hu Ying , Sun Huaibo , Shi Wei , Chen Chen , Wu Xueying , Jiang Yu , Zhang Guoying , Li Na , Song Jin , Zhang Hao , Shen Baiyong , Zeng Hui , Zhang Henghui 
Published: January 2024

Abstract
Background
The cancer-immunity cycle (CI cycle) provides a theoretical framework to illustrate the process of the anticancer immune response. Recently, the update of the CI cycle theory emphasizes the importance of tumor’s immunological phenotype. However, there is lack of immunological phenotype of pan-cancer based on CI cycle theory.

Methods
Here, we applied a visualizing method termed ‘cancer immunogram’ to visualize the state of CI cycle of 8460 solid tumors from TCGA cohort. Unsupervised clustering of the cancer immunogram was performed using the nonnegative matrix factorization (NMF) analysis. We applied an evolutionary genomics approach (dN/dS ratio) to evaluate the clonal selection patterns of tumors with distinct immunogram subtypes.

Results
We defined four major CI cycle patterns across 32 cancer types using a cancer immunogram approach. Immunogram-I was characterized by ‘hot’ and ‘exhausted’ features, indicating a favorable prognosis. Strikingly, immunogram-II, immunogram-III, and immunogram-IV represented distinct immunosuppressive patterns of ‘cold’ tumor. Immunogram-II was characterized by ‘cold’ and ‘radical’ features, which represented increased expression of immune inhibitor molecules and high levels of positive selection, indicating the worst prognosis. Immunogram-III was characterized by ‘cold’ and ‘recognizable’ features and upregulated expression of MHC I molecules. Immunogram-IV was characterized by ‘cold’ and ‘inert’ features, which represented overall immunosuppression, lower levels of immunoediting and positive selection, and accumulation of more tumor neoantigens. In particular, favorable overall survival was observed in metastatic urothelial cancer patients with immunogram-I and immunogram-IV after immune checkpoint inhibitor (ICI) therapy. Meanwhile, a higher response rate to ICI therapy was observed in metastatic gastric cancer patients with immunogram-I phenotype.

Conclusions
Our findings provide new insight into the interaction between immunity and cancer evolution, which may contribute to optimizing immunotherapy strategies.
Evaluating the long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne diseases in China: an interrupted time series analysis
Authors: Wang Yongbin , Qing Siyu , Lan Xianxiang , Li Lun , Zhou Peiping , Xi Yue , Liang Ziyue , Zhang Chenguang , Xu Chunjie 
Published: January 2024

Abstract
Background
The long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne infectious diseases (ZVBs) remains uncertain. This study sought to examine the changes in ZVBs in China during the COVID-19 pandemic and predict their future trends.

Methods
Monthly incidents of seven ZVBs (Hemorrhagic fever with renal syndrome [HFRS], Rabies, Dengue fever [DF], Human brucellosis [HB], Leptospirosis, Malaria, and Schistosomiasis) were gathered from January 2004 to July 2023. An autoregressive fractionally integrated moving average (ARFIMA) by incorporating the COVID-19-associated public health intervention variables was developed to evaluate the long-term effectiveness of interventions and forecast ZVBs epidemics from August 2023 to December 2025.

Results
Over the study period, there were 1,599,647 ZVBs incidents. HFRS and rabies exhibited declining trends, HB showed an upward trajectory, while the others remained relatively stable. The ARFIMA, incorporating a pulse pattern, estimated the average monthly number of changes of − 83 (95% confidence interval [CI] − 353–189) cases, − 3 (95% CI − 33–29) cases, − 468 (95% CI − 1531–597) cases, 2191 (95% CI 1056–3326) cases, 7 (95% CI − 24–38) cases, − 84 (95% CI – 222–55) cases, and − 214 (95% CI − 1036–608) cases for HFRS, rabies, DF, HB, leptospirosis, malaria, and schistosomiasis, respectively, although these changes were not statistically significant besides HB. ARFIMA predicted a decrease in HB cases between August 2023 and December 2025, while indicating a relative plateau for the others.

Conclusions
China's dynamic zero COVID-19 strategy may have exerted a lasting influence on HFRS, rabies, DF, malaria, and schistosomiasis, beyond immediate consequences, but not affect HB and leptospirosis. ARFIMA emerges as a potent tool for intervention analysis, providing valuable insights into the sustained effectiveness of interventions. Consequently, the application of ARFIMA contributes to informed decision-making, the design of effective interventions, and advancements across various fields.