bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: A systematic review and meta-analysis
Authors: Dodds Michael , Haddou Mohamed Ben , Day Jon 
Published: December 2022

Abstract
Background
Xerostomia negatively affects quality of life. Symptoms include oral dryness; thirst; difficulty speaking, chewing, and swallowing food; oral discomfort; mouth soft tissue soreness and infections; and rampant tooth decay. The objective of this systematic review and meta-analysis was to investigate if gum chewing is an intervention that results in objective improvements in salivary flow rates and subjective relief from xerostomia.
Methods
We searched electronic databases including Medline, Scopus, Cochrane, Google Scholar and the citations of review papers (last searched 15/11/22). The study populations were elderly people with xerostomia (> 60 years old, any gender, and any severity of xerostomia), and medically compromised people with xerostomia. The intervention of interest was gum chewing. Comparisons included gum chewing vs. no gum chewing. The outcomes included salivary flow rate, self-reported xerostomia, and thirst. All settings and study designs were in scope. We conducted a meta-analysis on studies where measurements of unstimulated whole salivary flow rate for both a gum chewing, and no gum chewing intervention (daily chewing of gum for two weeks or longer) were reported. We assessed risk of bias using Cochrane’s Risk of Bias tool (version 1).
Results
Five thousand and sixty-two studies were screened and 0.44% (n = 24) met the inclusion criteria for the systematic review. Eight of the 24 papers had a high overall risk of bias. Of the 24 papers selected for the systematic review, 23.08% (n = 6) met the criteria to be included in the meta-analysis which confirmed a significant overall effect of gum on saliva flow outcomes compared to control (SMD = 0.44, 95% CI: 0.22–0.66; p = 0.00008; I2 = 46.53%).
Conclusions
Chewing gum can increase unstimulated salivary flow rate in elderly and medically compromised people with xerostomia. Increasing the number of days over which gum is chewed increases the improvement in the rate of salivation. Gum chewing is linked with improvements in self-reported levels of xerostomia (although it is noted that in five of the studies reviewed, no effects were detected). Future studies should eliminate sources of bias, standardise methods to measure salivary flow rate, and use a common instrument to measure subjective relief from xerostomia.
Study registration:
PROSPERO CRD42021254485.
Oral Health Status and Hygiene Practices Among Visually Impaired Adolescents From a School in Kenya
Authors: Macharia Maureen , Masiga Mary , Psiwa Nathan , Bermudez Janella , Seminario Ana Lucia , Kemoli Arthur 
Published: December 2022

Abstract
Background
Visual impairment afflicts a significant population globally. The aim of this study was to determine the oral health status and oral hygiene practices among visually impaired adolescents from a school in Kenya.
Methods
A descriptive cross-sectional study was carried out among 159 adolescents aged 10–19 years attending the largest public primary boarding school for the blind in Kenya. A questionnaire was used to record participants’ social demographic variables and oral hygiene practices. Clinical examination was undertaken to assess oral health status which consisted of oral hygiene, gingival health, and dental caries.
Results
There were 69 (43.4%) and 90 (56.6%) participants in Category I and II visual impairment respectively, 85 (53.5%) were male and 74 (46.5%) were female. Study participants were divided into three age categories: 10–12 years (30.2%), 13–15 years (42.1%), and 16–19 years (27.7%), with an overall mean age of 13.9 ± 2.3. There was a statistically significant difference between visual impairment and age (p = 0.04). All participants brushed their teeth, majority (67.3%) brushed two or more times daily. Only 41.5% of the participants replaced their toothbrushes at 3 months. Sex and age influenced frequency of toothbrush replacement (p = 0.04). The average plaque score and gingival score index was 0.95 ± 0.45 and 0.28 ± 0.25 respectively, with gingivitis prevalence of 88.1%. Plaque score index had a statistically significant association with the gingival score index (p = 0.01). Overall dental caries prevalence was 44.7%, [42.1%)] permanent dentition and [8.2%] deciduous dentition. Mean DMFT was 0.44 ± 0.60 with a statistically significant association with age (p = 0.03), sex (p = 0.05) and visual impairment (p = 0.04). Mean dmft was 0.12 ± 0.32 with a statistically significant association with plaque score index (p = 0.04). Oral hygiene practices did not influence oral hygiene and dental caries status. However, a statistically significant association was reported between frequency of toothbrush replacement and gingival score index (p = 0.00).
Conclusions
The study reported general good oral hygiene, prevalent gingivitis (88.1%), and almost half of the study population affected by dental caries (44.7%). Most participants were unaware of using fluoridated toothpaste and of needing to change toothbrushes within 3 months. Frequency of toothbrush replacement was reported to influence gingival score index.
Enhancement of water hyacinth juice treatment in an anaerobic sequential batch reactor with coffee husk–derived biochar
Authors: Maruyama Daiki , Akizuki Shinichi , Sekine Mutsumi , Fujita Akinori , Habtu Nigus Gabbiye , Sato Shinjiro , Toda Tatsuki 
Published: December 2022

Abstract
Anaerobic digestion of compressed water hyacinth juice (WHJ) is one of the appropriate ways to enhance excessively grown water hyacinths. The addition of biofilm carriers is effective in enhancing digestibility as they can retain microorganisms at a high density in the digester. This study evaluated the anaerobic digestion performance in a sequential batch reactor in the presence of a natural carrier, biochar from coffee husks which are representative agricultural waste in areas where water hyacinths are thriving, compared to those with a commonly used carrier (polyurethane sponge) and without a carrier. In the biochar-filled condition, the CH4 production was 471 mL g-VS− 1 and the total organic carbon (TOC) removal efficiency was 88.6%. In contrast, in the no-carrier condition, the CH4 production decreased and the TOC removal efficiency dropped to 54.5%. The porosity of the biochar promoted microbial attachment and biofilm formation. Candidatus Diapherotrites archaeon ADurb.Bin253, which belongs to the symbiotic archaeon Nanoarchaeaeota, was detected in all reactors, suggesting that it contributed to the organic decomposition. The performance of the biochar was comparable to that of the sponge carrier, indicating that the coffee husk–derived biochar can be considered a sustainable and useful carrier for enhancing the anaerobic digestion of WHJ.
Deep-learning-based Blood Pressure Estimation using Multi channel Photoplethysmogram and Finger Pressure with Attention Mechanism
Authors: Kyung Jehyun , Yang Joon-Young , Choi Jeong-Hwan , Chang Joon-Hyuk , Bae Sangkon , Choi Jinwoo , Kim Younho 
Published: December 2022

Abstract
Recently, several studies have proposed methods for measuring cuffless blood pressure (BP) using finger photoplethysmogram (PPG) signals. This study presents a new BP estimation system that measures PPG signals under progressive finger pressure, making the system relatively robust to errors caused by finger position when using the cuffless oscillometric method. To reduce errors caused by finger position, we developed a sensor that can simultaneously measure multi-channel PPG and force signals in a wide field of view (FOV). We propose a deep-learning-based algorithm that can learn to focus on the optimal PPG channel from multi channel PPG using an attention mechanism. The errors (ME±STD) of the proposed multi channel system were 0.43±9.35 mmHg and 0.21±7.72 mmHg for SBP and DBP, respectively. Through extensive experiments, we found a significant performance difference depending on the location of the PPG measurement in the BP estimation system using finger pressure.
Employees’ preferences on organisational aspects of psychotherapeutic consultation at work by occupational area, company size, requirement levels and supervisor function – a cross-sectional study in Germany
Authors: Kohl Fiona , Angerer Peter , Weber Jeannette 
Published: December 2022

Abstract
Background
Common mental disorders affect a significant proportion of the population worldwide at any given time. Psychotherapeutic consultation at work offers employees with mental distress short-term and low-threshold access to psychotherapeutic treatment. However, this offer is only accepted by one to two perfect of the employees to whom it is offered. Taking into account employees‘ preferences regarding organisational aspects might increase the use of psychotherapeutic consultation at work. This study therefore aimed to identify preferences on organisational aspects of psychotherapeutic consultation at work among employees of diverse occupational areas, company sizes, supervisor functions and job requirement levels.
Methods
A total of 755 employees were recruited via advertisements on social media (Instagram, Facebook and LinkedIn). Participants rated on a 5-point Likert scale their agreement to different implementation options of psychotherapeutic consultation at work: type (in-person/video/telephone), location (on/outside company premises), time (within/outside working hours), scope (diagnostic/diagnostic + treatment) and purpose (private/occupational). Additionally, the maximum accepted distance to the location of consultation was assessed. Various analyses of variances (ANOVA) were conducted to determine differences in agreement to implementation options within each organisational aspect and to analyse differences between occupational areas, company sizes, requirement levels and between employees with and without supervisor function.
Results
Participants indicated a preference for in-person psychotherapeutic consultation that takes places outside company premises and outside working hours. Furthermore, they preferred offers including diagnostic and treatment sessions compared to offers including diagnostic sessions only. Even though participants agreed that consultation should be offered for all purposes, agreement for occupational issues was stronger than for private issues. For some implementation options, the level of agreement varied according to occupational field, company size, supervisor function and level of requirement. However, these differences did not affect the key findings mentioned above.
Conclusion
Those findings give practical indications on the organisational design of psychotherapeutic consultation at work. The results suggest that in-person consultation outside company premises and working hours combining diagnostic and treatment sessions will be accepted by employees regardless of their occupational area, company size, supervisor function and requirement level.
Breast cancer remotely imposes a myeloid bias on hematopoietic stem cells by reprogramming the bone marrow niche.
Authors: Gerber-Ferder Yohan , Cosgrove Jason , Duperay-Susini Aléria , Missolo-Koussou Yoann , Dubois Marine , Sedlik Christine , Lameiras Sonia , Baulande Sylvain , Guermonprez Pierre , Passaro Diana , Perié Leila , Piaggio Eliane , Helft Julie 
Published: December 2022

Abstract
Increased number of circulating myeloid cells is a hallmark of most cancers, however it remains unclear how primary tumors impact on myelopoiesis. Here we show that non-metastatic breast tumors remotely instruct the fate of long-term hematopoietic stem cell (HSCLT) in the bone marrow. We found that HSCLT from tumor bearing mice acquire a myeloid bias persisting upon primary and secondary HSCLT transfer in lethally-irradiated tumor-free animals. By imaging the bone marrow HSC niche, we found that the tumor-bearing status is associated with increased physical interactions between mesenchymal stem/stromal cells (MSC) and HSCLT. Moreover, ex vivo co-culture experiments demonstrate that MSC isolated from tumor-bearing mice increase myeloid differentiation of HSCLT isolated from tumor free mice. In summary, our data reveal that breast cancer remotely promotes myelopoiesis at the earliest stages of hematopoietic differentiation in the BM mesenchymal niche.
No Causal Association Between C-Reactive Protein and the Risk of Type 1 Diabetes: A Bidirectional Mendelian Randomization Study
Authors: Tian Fengyuan , Huang Shuo , Xu Wangda , Feng Xiaohong , Chen Jie , Wang Xi , Huang Qi 
Published: December 2022

Abstract
Background
Accumulating evidence from observational studies has shown that circulating C-reactive protein (CRP) levels are correlated with Type 1 diabetes (T1D) appearing a potential predictive marker of intervention, yet are of unknown causality. To clarify, we introduce a bidirectional two-sample Mendelian randomization (MR) framework to investigate the causality between circulating CRP levels and T1D.
Methods
Based on aggregated statistics from large-scale genome-wide association studies (GWAS), we evaluated the pooled impact of CRP on the risk of developing T1D. We obtained 6 single nucleotide polymorphisms (SNPs) for CRP selected as instrumental variables from a recent GWAS (n = 204,402). The T1D related SNPs were from a large-scale T1D GWAS (n = 6,808 T1D cases; n = 12,173 controls). Subsequent inverse-variance weighted (IVW) method, simple median method, weighted median method were conducted to acquire the genetic correlation between CRP levels and T1D. In sensitivity analyses, MR-Egger, MR-PRESSO, and leave-one-out analysis were applied to exclude the potentially pleiotropic variants in this study.
Results
The results of IVW provided no causal evidence that genetically predicted circulating CRP levels on the risk of T1D, with OR of 0.922 (95% CI: 0.662–1.285, P = 0.631). Furthermore, we denoted 14 T1D-related SNPs as an instrumental variable in MR analyses and yielded no significant associations of T1D on CRP levels according to the IVW result (OR: 1.000, 95% CI: 0.990–1.010, P = 0.930). MR-Egger, MR-PRESSO, and leave-one-out analysis indicated no indication for potential directional pleiotropy effects.
Conclusion
Our findings failed to provide evidence to support the causal relationship between CRP levels and T1D.
How does the COVID-19-related work-life balance impact stress on primary healthcare workers?
Authors: Putri Nuzulul , Melania Miftahul Karomah Nastiti , Cheng Lim Yin 
Published: December 2022

Abstract
Background:
Most studies in advanced care settings reported that the increasing workload increases the work-life imbalance and harms the mental health of health workers. The COVID-19 pandemic's tracing, testing, treatment, and mass vaccination also have multiplied the primary healthcare workers' workload. Nevertheless, studies on primary care workers are scarce. This study aimed to investigate how the COVID-19-related work-life balance impact stress on primary healthcare workers in the third years of the pandemic.
Methods:
The study was a cross-sectional, web-based survey conducted on primary healthcare workers in Kediri Regency, Indonesia, with the highest Omicron case surge worldwide. It was conducted right after the surge between July and August 2022, the third year of the COVID-19 pandemic hit Indonesia. Under coordination with the local government health officials, primary healthcare workers were invited to participate in an online survey. The respondents were asked to evaluate their socioeconomic demography, work conditions, personal life, and perceived stress (using the Perceived Stress Scale by Cohen et al.) during the pandemic. Their work-life balance was evaluated using the Work/Nonwork Interference and Enhancement Scale. We used several hierarchical linear regression models to determine what variables contribute to working stress among primary healthcare workers.
Results:
Socioeconomic demography variables, including gender, age, marital status, years of professional experience, and educational level, were not significantly associated with stress levels among our respondents. Separately, work conditions and personal life variables did not associate with stress levels. However, work-life balance dimensions as a predictor of primary health workers' stress were significantly associated with primary health workers' stress.
Conclusion:
The work and personal lives interferences related to COVID-19 handling created a work-life imbalance, increasing the propensity for higher stress among primary health workers. At the same time, enhancement between work and personal lives decreased the stress level. Social support from the work environment and family protects health workers against stress during the pandemic.
Organization of the demand for primary oral health care in the Brazilian Unified Health System
Authors: Sasaki Katia Miyuki , Neres Talitha Giovanna Silva , Silva Erica Tatiane , Zeredo Jorge Luis Lopes 
Published: December 2022

Abstract
Organizing the demand for oral healthcare is a big challenge for the oral health teams, because it needs careful planning and requires time and communication with other professionals. The present study aims to describe the organization of the demand for oral health treatment in primary care units in Brazil. In this descriptive and qualitative study, the workflow processes during the demand organization were mapped out according to the information from semi-structured, in-depth interviews with open-ended question; and described using a business process management modelling tool. The care routine was at first described as the “AS IS” model, which was evaluated by the oral team professionals, rearranged, and further described as the “TO BE” model. The model describing the “AS IS” situation was used for a global view of the process to optimize the resources, redistributed tasks and reduced waste and repetitions based on the resulting workflow obtained with the study. It was also taken in consideration the fact that the unit faced a significant increase in the demand of patients due to restrictions offered by the dental service in addition to non-urgent treatments being avoided by patients during COVID-19 pandemic. In the present study, structuring the work processes in a visual way using modelling tools was useful to picture the entire treatment process and adjust when needed. The use of the modelling tool was useful to understand and reorganize the workflow of the demand organization and ultimately improve the efficiency of the resources. The use of such managerial tools helped the oral health professionals to efficiently rearrange their tasks and set priorities to meet their needs. With the use of management tools, each unit can readjust its structures and ways of working, aiming to improve the quality of public health care services provided to patients.
Electroacupuncture regulates the cross-talk between Islets and Peripancreatic Adipose tissue to combat obesity combined with insulin resistance
Authors: Liu Yun , Xu Tiancheng , Wang Xuan , Lu Mengjiang , Yuan Mingqian , Gong Meirong , Li Qian , Xia Youbing , Yu Zhi , Xu Bin 
Published: December 2022

AbstractElectroacupuncture plays a positive role in regulating glucolipid metabolism and is related to the coordination of sensory nerves. As a complex functional unit, the pancreas is crucial for the regulation of glucolipid metabolism throughout the body. In particular, the expandability of peripancreatic adipose tissue promotes the progression of obesity into type 2 diabetes mellitus. However, the changes in the response and interaction of pancreatic components to electroacupuncture remain to be determined. Here, We studied certain characteristics of obesity combined with insulin resistance using high-fat diet fed rats, and verified the functional changes and neuroplasticity changes in pancreatic components after electroacupuncture. We further compared the effects of different acupoints to optimize the scheme. Electroacupuncture (2 mA, 2/15 Hz) treatment was performed for 2 weeks after 4 weeks of high-fat diet feeding. In order to explore the hypoglycemic mechanism of Electroacupuncture and the specific pathway mediating the interaction between peripancreatic adipose tissue and pancreatic islets, we detected the expressions of transient receptor potential vanilloid 1 (TRPV1), calcitonin gene–related peptide (CGRP), insulin and other proteins in the pancreas and peripancreatic adipose tissue. The increased body weight, triglycerides, total cholesterol, serum glucose, and insulin levels in the model rats suggested the presence of obesity and insulin resistance. Electroacupuncture at ST25, LI11, or ST37 acupoints ameliorated the aforementioned symptoms to varying degrees, with electroacupuncture at ST25 being the most effective. Electroacupuncture resulted in increased activity of the TRPV1-CGRP-islet beta cell pathway, which led to reduced insulin secretion by pancreatic beta cells, and alleviation of metabolic stress in peripheral insulin-sensitive tissues. After chemically silencing TRPV1 sensory afferents, the observed effect disappeared, verifying that TRPV1 sensory afferents play a vital role in mediating electroacupuncture-mediated regulation of islet and peripancreatic adipose tissue function. Moreover, in TRPV1 knockout mice, the level of peripancreatic adipose tissue inflammation decreased, paralleling the recovery of islet beta cell function. Our study determined the interaction of electroacupuncture-mediated TRPV1 sensory afferents on peripancreatic adipose tissue and pancreatic islets, ultimately improving glucolipid metabolism, and the combined effect of electroacupuncture at ST25 was the most successful.