bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring dental students' knowledge on oral cancer prevention: a cross-sectional study in Moldova, Armenia, and Belarus
Authors: Golburean Olga , Uncuta Diana , Manrikyan Gayane , Shakavets Natalia , Vardanyan Izabella , Markaryan Marina , Özkaya Ferda , Costea Daniela-Elena , Osman Tarig Al-Hadi 
Published: January 2025

Abstract

Background
Survival rate of patients with oral cancer (OC) remains to be very low despite advancements in therapy and surgical techniques. This is attributed to the fact that most OC cases are discovered at a late stage. Dentists play a vital role in early detection of OC through oral mucosal examination, and in informing the patients about avoidable risk factors of the disease, such as tobacco and excessive alcohol use. This study aimed at evaluating knowledge about OC among dental students in Moldova, Armenia and Belarus; three former soviet countries with high rates of tobacco use.

Methods
This was a cross-sectional, multi-country study based on self-administered questionnaire. Dental students in their clinical years at three dental faculties in Moldova, Armenia and Belarus were invited to participate in the study. Data collection took place during the period May to September 2019. Association between different categorical variables was investigated using Chi-squared test. A knowledge score ranging from 0–14 was constructed from the obtained data. Differences in the knowledge score between different groups of students was investigated using either student`s t-test whenever comparing two groups, or One-way ANOVA with Bonferroni`s correction for three or more groups. The level of significance was set to 0.05 for all statistical tests.

Results
A total of 642 dental students participated in the study. The mean knowledge score was found to be 6.62 ± 2.61, with 45% of the students scoring below the mean. Students from Belarus had the highest score (7.3 ± 2.14) in comparison to Armenia (6.66 ± 2.64) and Moldova (5.66 ± 2.81), as revealed by ANOVA test. However, we observed a significant increase (p-value < 0.001, ANOVA) in the students` knowledge score as they proceed through study years from third (6.07 ± 2.61) to fifth year (7.49 ± 2.48). In addition, we found that Students with current or previous cigarette smoking habits had significantly (p-value < 0.001, student`s t-test) lower mean knowledge score (5.96 ± 2.82) when compared to students who have never been smokers (6.98 ± 2.42).

Conclusions
The present study reveals notable gaps in OC knowledge and concerning tobacco use behaviors among dental students in Moldova, Belarus, and Armenia. By providing comprehensive education on risk factors and addressing personal habits, dental schools can better prepare future professionals to play a critical role in OC prevention and management.
Self-directed learning versus traditional didactic learning in undergraduate medical education: a systemic review and meta-analysis
Authors: Aulakh Jasmine , Wahab Hana , Richards Christine , Bidaisee Satesh , Ramdass Prakash V. A. K 
Published: January 2025

Abstract

Background
Self-Directed Learning (SDL) is a theory of andragogy in which adult learners take their own initiative to identify and tailor their individual learning process and outcomes. In undergraduate medical education, SDL aims to develop medical students into lifelong learners. This study aims to estimate the overall effectiveness of self-directed learning compared to traditional didactic learning (TDL).

Methods
We performed a systematic review and meta-analysis according to the PRISMA statement. A systematic search was used across PubMed, Scopus, Embase and Google Scholar to identify peer-reviewed articles spanning from January 1, 2014, to May 30, 2024. Key words used were “self-directed learning” AND “undergraduate medical education.” Forest plots were generated with the Open Meta-analyst Software, comparing SDL and TDL.

Results
A total of 2,955 titles and abstracts were screened for eligibility, of which 95 articles met the eligibility criteria for full-text review. Following a more detailed screening, 19 articles met the criteria for inclusion in the systematic review and 14 articles met the criteria for inclusion in the meta-analysis. The systematic review included 2,098 students while the meta-analysis included 1,792 students. The overall mean difference for all studies was 2.399, 95% CI [0.121–4.678], and I2 = 98.56%.

Conclusion
Self-directed learning compared to traditional didactic learning is an effective learning strategy in medical undergraduate education and has the potential to aid in students’ learning and improve their cognitive performance. Moreover, SDL nurtures qualities such as autonomy, curiosity, and self-regulation, which are essential for success in the ever-evolving field of medicine.
Turning nursing students’ mistakes into resources for learning in simulation-based training: facilitators’ assumptions about providing feedback in debriefing
Authors: Lervik Wenche , Solberg Mads , Wiig Astrid Camilla , Berg Helen 
Published: January 2025

Abstract

Background
The aim of this study was to investigate how facilitators approach and use nursing students’ mistakes in simulation-based training as learning resources in the simulation debriefing phase. Facilitators are responsible for raising students’ awareness of their performances during the debriefing and facilitating reflections on their performances, including satisfactory behaviours and performance gaps. Research on facilitators’ work during debriefing has highlighted various challenges, such as providing a safe and constructive climate among novice students while simultaneously teaching them the correct procedures, methods, and knowledge of caring practices to become professional nurses. There is a lack of research on how facilitators approach, handle, and use students’ mistakes as a learning resource. Thus, this study investigated facilitators’ assumptions about providing feedback to nursing students when they made mistakes during simulation-based training

Method
Individual semi-structured interviews were conducted with nine experienced facilitators from three universities in Norway. Data were analyzed following the principles of thematic analysis (TA).

Results
Facilitators made varying assumptions about the simulations and debriefings as learning processes. These differences were evident in their accounts of how feedback was provided to students when they made mistakes during the simulation-based training.

Conclusion
Facilitators’ statements about their practices reflect assumptions about how they make simulation activities a resource for meaningful learning, including how to use students’ mistakes as learning opportunities during debriefing discussions. Consequently, these assumptions regarding learning provide valuable insights into the ambiguous and complex praxis of using simulation-based training as a professional educational tool.
Discrete choice modelling of hypertension patients’ preferences for attributes of a public medical facility in Ibadan, Nigeria
Authors: Otekunrin Oluwaseun Aramide , Adebisi Tekiyat Abiola , Adeniran-Babatunde Sururoh , Otekunrin Olutosin Ademola 
Published: January 2025

Abstract

Background
Not much is known about hypertension patients’ preferences for attributes of public medical facilities in Nigeria and how these preferences influence their choices of medical facilities for treatment. An understanding of what these patients want especially in terms of service delivery could contribute to improved hypertension control.

Objective
This study aimed to determine hypertension patients’ preferences for attributes of a public medical facility in Ibadan, Nigeria.

Methods
A Discrete Choice Experiment (DCE) that utilized three hypothetical medical facilities was used for the study. A simple random sample (SRS) of 150 eligible hypertension patients was selected from a secondary medical facility in Ibadan, Nigeria. An efficient D-optimal choice design was adopted and used in generating nine hypothetical choice sets for the experiment. Each patient was expected to study the nine sets carefully and choose an option from each of the sets. The first choice set was repeated as the tenth set to examine respondents’ consistency. The DCE questionnaires were administered using a one-to-one interview method. A mixed logit regression modeling technique was used to obtain parameter and Willingness to Pay (WTP) estimates.

Results
The patients preferred medical facilities with waiting time before consultation with medical doctors to be between thirty minutes and one hour. The attribute level ‘‘a lot of information’’ was the most preferred. The patients were unwilling to pay for the “little or no drugs and diagnostic equipment” attribute level. A negative and significant coefficient for cost indicated that higher out-of-pocket costs negatively affected hypertension patients’ choice of a public medical facility.

Conclusion
Hypertension patients attending a public medical facility in Ibadan, Nigeria preferred a facility with access to comprehensive information about their health in addition to reasonable waiting times, availability of a lot of drugs and diagnostic equipment, and reduced out-of-pocket costs. Provision of healthcare services that align with these preferences could enhance patient satisfaction thus contributing to improved hypertension control.
Identification and characterization of tumor and stromal derived liquid biopsy analytes in pancreatic ductal adenocarcinoma
Authors: Götze Julian , Meißner Kira , Pereira-Veiga Thais , Belloum Yassine , Schneegans Svenja , Kropidlowski Jolanthe , Gorgulho Joao , Busch Alina , Honselmann Kim Christin , Schönrock Martin , Putscher Arne , Peine Sven , Nitschke Christine , Simon Ronald , Spindler Volker , Izbicki Jakob Robert , Hackert Thilo , Bokemeyer Carsten , Pantel Klaus , Uzunoglu Faik Güntaç , Sinn Marianne , Harriet Wikman  
Published: January 2025

Abstract

Background
The lack of predictive biomarkers contributes notably to the poor outcomes of patients with pancreatic ductal adenocarcinoma (PDAC). Cancer-associated fibroblasts (CAFs) are the key components of the prominent PDAC stroma. Data on clinical relevance of CAFs entering the bloodstream, known as circulating CAFs (cCAFs) are scarce. Here, we developed a combined liquid biopsy assay to detect cCAFs and circulating tumor cells (CTCs) in metastatic PDAC (mPDAC) and other metastatic gastrointestinal malignancies (mGI). In addition, we evaluated plasma hyaluronan (HA) levels as a complementary surrogate biomarker of the stromal extent in patients with PDAC.

Methods
A sequential liquid biopsy assay based on a two step-enrichment, combining marker dependent and independent cell enrichment, was established for cCAF and CTC detection and validated in mPDAC and mGI patients. The enriched cells were identified by multiplex immunofluorescence. HA measurement was performed by ELISA on blood samples from healthy blood donors (HD), localized and late-stage PDAC patients.

Results
cCAFs (≥ 1cCAFs/7.5 mL blood) were detected in 95.4% of mPDAC and in 78.2% of mGI patients, with significantly higher numbers in mPDAC compared to mGI patients (mean number 22.7 vs. 11.0; P = 0.0318). mPDAC patients with ≥ 15 cCAFs/7.5 mL blood had a significant shorter median overall survival (mOS 3.2 months (95% confidence interval (CI) 0.801–5.855) vs. 14.2 months (95% CI 6.055–22.332); P = 0.013), whereby CTC levels were not associated with mOS. In mGI neither cCAFs nor CTCs had a significant impact on OS. HA plasma levels in mPDAC patients were significantly higher compared to HD (mean 123.0 ng/mL vs. 74.45 ng/mL, P = 0.015). High HA in localized and late-stage PDAC were associated with a significantly shorter mOS (mOSlocalized PDAC: 12.6 months vs. 23.5 months (P = 0.008); mOSmPDAC: 1.8 months vs. 5.3 months (P = 0.004)).

Conclusions
Our liquid biopsy assay provides robust detection of cCAFs in mPDAC and mGI patients. The measurement of both circulatory stromal parameters, cCAFs and HA, adds valuable clinical information as they are associated with an unfavorable outcome in PDAC. These results highlight that stromal characteristics unique to PDAC could be leveraged to fill the current gap in discovering predictive biomarkers.
SNORA37/CMTR1/ELAVL1 feedback loop drives gastric cancer progression via facilitating CD44 alternative splicing
Authors: Bao Banghe , Tian Minxiu , Wang Xiaojing , Yang Chunhui , Qu Jiaying , Zhou Shunchen , Cheng Yang , Tong Qiangsong , Zheng Liduan 
Published: January 2025

Abstract

Background
Emerging evidence shows that small nucleolar RNA (snoRNA), a type of highly conserved non-coding RNA, is involved in tumorigenesis and aggressiveness. However, the roles of snoRNAs in regulating alternative splicing crucial for cancer progression remain elusive.

Methods
High-throughput RNA sequencing and comprehensive analysis were performed to identify crucial snoRNAs and downstream alternative splicing events. Biotin-labeled RNA pull-down, mass spectrometry, cross-linking RNA immunoprecipitation, and in vitro binding assays were applied to explore interaction of snoRNAs with protein partners. Alternative splicing and gene expression was observed by real-time quantitative RT-PCR and western blot assays. In vitro and in vivo studies were performed to investigate biological effects of snoRNAs and their protein partners in gastric cancer. Survival analysis was undertaken by using Kaplan-Meier method and log-rank test.

Results

SNORA37 was identified as an up-regulated snoRNA essential for tumorigenesis and aggressiveness of gastric cancer. Gain- and loss-of-function studies indicated that SNORA37 promoted the growth, invasion, and metastasis of gastric cancer cells in vitro and in vivo. Mechanistically, as an ELAV like RNA binding protein 1 (ELAVL1)-generated snoRNA, SNORA37 directly bound to cap methyltransferase 1 (CMTR1) to facilitate its interaction with ELAVL1, resulting in nuclear retention and activity of ELAVL1 in regulating alternative splicing of CD44. Rescue studies revealed that SNORA37 exerted oncogenic roles in gastric cancer progression via facilitating CMTR1-ELAVL1 interaction. In clinical gastric cancer cases, high levels of SNORA37, CMTR1, ELAVL1, or CD44 were associated with shorter survival and poor outcomes of patients.

Conclusions
These results indicated that SNORA37/CMTR1/ELAVL1 feedback loop drives gastric cancer progression via facilitating CD44 alternative splicing.
Experimental infection of wild boars (Sus scrofa) with Rickettsia rickettsii and evaluation of the transmission potential to Amblyomma sculptum ticks
Authors: Neves Lucianne Cardoso , de Campos Binder Lina , de Freitas Paula Warley Vieira , de Lima Nicolas Jalowitzki , Cardoso Ennya Rafaella Neves , Santos Rayane Almeida , Bittencourt Raphaela Bueno Mendes , Pádua Gracielle Teles , dos Santos Gabriel Cândido , Tavares Mariana Avelar , de Azevedo Serpa Maria Carolina , Pinter Adriano , de Almeida Felicio Artur Luiz , Labruna Marcelo B. , da Silva Krawczak Felipe 
Published: January 2025

Abstract

Background
Brazilian spotted fever is a tick-borne disease caused by the bacterium Rickettsia rickettsii, whose main vector in Brazil is the tick Amblyomma sculptum. Amplifying hosts are essential for the perpetuation of this bacterium in the tick population as they can be sources of infection during bacteremic periods. Recent studies demonstrated the ability of suids (Sus scrofa) to sustain populations of A. sculptum, one of the main tick species found parasitizing wild boars in the midwestern and southeastern regions of Brazil. In this study, wild boars were experimentally infected with R. rickettsii by tick infestation and were evaluated for their ability to transmit the infection to A. sculptum ticks, under laboratory conditions.

Methods
Four wild boars were infected with R. rickettsii through infestation with R. rickettsii-infected A. sculptum adults (infected group); a fifth wild boar was infested with uninfected A. sculptum adults (control group). Simultaneously, the animals were infested with uninfected larvae and nymphs of A. sculptum. The wild boars were monitored for 28 days by clinical examination and hematological tests, real-time quantitative PCR (qPCR) of blood for the detection of Rickettsia and inoculation of blood in guinea pigs. IgG antibody titers were followed until the end of the experiment. Unfed nymphs and adults, molted from engorged larvae and nymphs that fed on wild boars, were used to infest susceptible guinea pigs and rabbits; some of these unfed ticks were tested by qPCR for rickettsial detection.

Results
The wild boars showed no clinical or hematological alterations, and bacteremia was not detected by qPCR or inoculation of wild boar blood into guinea pigs. Furthermore, wild boars showed a moderate humoral response, with anti-R. rickettsii endpoint titers up to 256 or 512. Rickettsial DNA was not detected in molted ticks after acquisition feeding on wild boars. Moreover, no disease or seroconversion was observed in guinea pigs and rabbits that were infested with ticks originated from wild boar acquisition feeding.

Conclusions
Wild boars seroconverted to Rickettsia spp. after being infested with R. rickettsii-infected A. sculptum; however, they did not develop bacteremia and did not act as competent amplifying hosts of R. rickettsii for A. sculptum ticks.

Graphical Abstract
Age- and sex-specific differences in myocardial sympathetic tone and left ventricular remodeling following myocardial injury
Authors: Haider Achi , Bengs Susan , Portmann Angela , Fröhlich Sandro , Etter Dominik , Maredziak Monika , Warnock Geoffrey I. , Akhmedov Alexander , Kozerke Sebastian , Keller Claudia , Montecucco Fabrizio , Weber Bruno , Mu Linjing , Buechel Ronny R. , Regitz-Zagrosek Vera , Kaufmann Philipp A. , Camici Giovanni G. , Ametamey Simon M. , Gebhard Catherine 
Published: January 2025

Abstract

Background
Presentations and outcomes of acute myocardial infarction (MI) differ between women and men, with the worst outcomes being reported in younger women. Mental stress induced ischemia and sympathetic activation have been suggested to play a prominent role in the pathogenesis of MI in younger women, however, the impact of sex hormones on these parameters remains unknown.

Methods
The effect of sex hormones and age on myocardial infarct size and myocardial sympathetic activity (MSA) was assessed in male and female, as well as young (4–6 months) and aged (20–22 months) FVB/N mice (n = 106, 60 gonadectomized and 46 sham-operated animals) who underwent in vivo [11C]meta-hydroxyephedrine ([11C]mHED) positron emission tomography (PET) and cardiac magnetic resonance (CMR) imaging 24 h after a 30 min myocardial ischemic injury.

Results
MSA and catecholamine levels following myocardial injury were highest in young males (p = 0.008 and p = 0.043 vs. young females, respectively) and were reduced by orchiectomy. Accordingly, testosterone serum levels correlated positively with MSA (r = 0.66, p < 0.001). Males had a larger average infarct size and lower left ventricular contractility following myocardial injury than females (p < 0.05 vs. females). These sex differences were no longer evident in gonadectomized animals (p = NS vs. females). In female animals, estrogen depletion did not affect MSA (ovariectomy effect, p = 0.892). Female animals showed an age-dependent increase in MSA (p = 0.011), which was absent in males.

Conclusion
Testosterone associates with an increase in sympathetic tone, contributing to adverse cardiac remodeling following MI. Conversely, females maintain sympathetic integrity, independent of sex hormones. Our results suggest a biological advantage of female sex in post MI recovery. Further research is warranted to confirm these findings in humans.
Peripheral proteinopathy in neurodegenerative diseases
Authors: Xu Bin , Lei Xia , Yang Ying , Yu Jiayi , Chen Jun , Xu Zhi , Ye Keqiang , Zhang Jing 
Published: January 2025

Abstract
Proteinopathies in neurology typically refer to pathological changes in proteins associated with neurological diseases, such as the aggregation of amyloid β and Tau in Alzheimer’s disease, α-synuclein in Parkinson’s disease and multiple system atrophy, and TAR DNA-binding protein 43 in amyotrophic lateral sclerosis and frontotemporal dementia. Interestingly, these proteins are also commonly found in peripheral tissues, raising important questions about their roles in neurological disorders. Multiple studies have shown that peripherally derived pathological proteins not only travel to the brain through various routes, aggravating brain pathology, but also contribute significantly to peripheral dysfunction, highlighting their crucial impact on neurological diseases. Investigating how these peripherally derived proteins influence the progression of neurological disorders could open new horizons for achieving early diagnosis and treatment. This review summarizes the distribution, transportation pathways, and pathogenic mechanisms of several neurodegenerative disease-related pathological proteins in the periphery, proposing that targeting these peripheral pathological proteins could be a promising strategy for preventing and managing neurological diseases.
A longitudinal analysis of physical exercise in shaping language learners’ emotional well-being: a comparative analysis between L1 and L2 students
Authors: Akram Huma , Oteir Ibrahim Naser 
Published: January 2025

Abstract

Background
Students’ psychological wellness is one of the key elements that improve their well-being and shape their academic progress in the realm of language learning. Among various strategies, physical exercise emerges as an effective approach, allowing learners to manage their emotions considerably.

Methods
Employing a quasi-experimental research design, this study examines the impact of a three-month physical running exercise intervention on emotional regulation behaviors among L1 (Arabic language) and L2 (English as a foreign language learning) students. Data was collected at three (pre-test, mid-test, and post-test) intervals, focusing cognitive reappraisal (CR) and expressive suppression (ES) the key constructs of emotional regulation.

Findings
The results showed that the emotional regulation abilities of both groups were considerably impacted by the physical running exertion and differed significantly, with students’ CR skills significantly improving and their ES decreasing over time. However, no significant interaction effect between time and (L1 and L2) groups’ CR was observed, suggesting that physical exercise universally benefits cognitive reappraisal regardless of the language learning context. Conversely, a significant interaction effect was observed in students’ ES, with L2 students experiencing more reduction compared to their L1 counterparts, highlighting the unique emotional challenges faced by L2 learners and the effectiveness of physical activity in mitigating these challenges.

Conclusion
The results highlight the importance of physical exercise in enhancing emotional regulation abilities among students, particularly in a second language learning context. Given this, regular physical activity programs should be incorporated into educational curricula to support students’ emotional well-being and academic success. It further offers insightful recommendations for teachers, students, administrators, and policymakers to optimize physical exercise integration in higher education.