bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of vitamin K, fibre intake and progression of periodontal attachment loss in American adults
Authors: Chuai Yuanyuan , Dai Bichong , Liu Xiaoyun , Hu Menglin , Wang Yuanyin , Zhang Hengguo 
Published: May 2023

Abstract
Background
Periodontitis-related attachment loss is accompanied by mucosal bleeding and inflammatory lesions. Dietary vitamin K and fibre intake are known to be correlation factors of haemostasis and anti-inflammation, respectively.

Objective
To explore the association between severe periodontal attachment loss and vitamin K or fibre intake in American adults.

Methods
A cross-sectional analysis was conducted including 2747 males and 2218 females in the National Health and Nutrition Examination Surveys (NHANES) from 2009 to 2014. The number of teeth with severe periodontal attachment loss (above 5 mm attachment loss) was used as the dependent variable. The main independent variables included the intake of vitamin K and dietary fibre. The association among variables was examined using multivariable linear regression models, hierarchical regression, fitted smoothing curves, and generalized additive models.

Results
Based on the indicators of 4965 subjects, we found that severe attachment loss tended to occur in elderly individuals or males and was accompanied by less intake of vitamin K or dietary fibre, as well as lower educational qualification. Vitamin K intake was stably negatively associated with attachment loss progression in each multivariable linear regression model. In subgroup analyses, a negative association between fibre intake and attachment loss progression was identified in all races except blacks (β = 0.0005, 95% CI: -0.0005 to 0.0016). The relationship between fibre intake and attachment loss progression was a broad U-shaped curve (inflection point: 753.4 mg), which especially manifested in males (inflection point: 967.5 mg).

Conclusion
There was an inverse association between vitamin K intake and the progression of periodontal attachment loss in American adults, while dietary fibre should be moderate in intake (below 753.4 mg), especially in males (below 967.5 mg).
Sella turcica variations in patients with transverse skeletal discrepancies versus patients with normal transverse relationships. a cross- sectional study
Authors: Seifeldin Nouran , Eltimamy Ahmed , Abbady Nora Al 
Published: May 2023

Abstract
Background
The sella turcica (ST) is a crucial landmark in orthodontics. It is utilized as a reliable predictor of future growth of the skeletal pattern, assisting in early diagnosis and promoting better treatment planning options. The goal of this research was to compare the morphology and bridging of the sella turcica in transverse maxillary deficient malocclusions and malocclusions with normal transverse relationships.

Methods
A total of 52 cone beam computed tomographic (CBCT) images were selected with an age range of 18–30 years. Group I comprised 26 patients previously diagnosed with transverse maxillary deficiency, while group II comprised 26 patients with normal transverse skeletal relationships. The length, depth and diameter of the ST were measured by two observers, the shape was evaluated as round, oval or flat and sellar bridging was calculated in each case. An Independent t-test was used to compare between the sellar dimensions in both groups. For assessment of bridging percentage Chi square test was used.

Results
The mean values of the length, depth and diameter of the sella in group I was 11.09 mm, 8.56 and 12.81 mm respectively and 10.34 mm, 8.24 and 12.38 mm in group II respectively (P ≤ 0.05). No significant differences were found between both groups in any of the sellar dimensions. The rounded ST shape was the most prevalent among both groups (59.6%). Partial ST bridging was found in only 7.7% of group I (p < 0.0001*). Complete ST bridging wasn’t detected in either of the groups.

Conclusions
There was no correlation found between transverse maxillary deficiency and the morphology and bridging of the sella turcica.
Comparing the clinical efficacy of three surgical methods for cesarean scar pregnancy
Authors: Zeng Shaoying , Wang Yang , Ye Ping , Xu Ling , Han WenLing , Li Feng , Tang Chen , Zhou Jieli , Xie Xiaoying 
Published: May 2023

Abstract
Background
We aimed to compare the clinical efficacy of three surgical methods in the treatment of various types of cesarean scar pregnancy (CSP).

Methods
Herein, 314 cases of CSP were treated in the department of Obstetrics and Gynecology of the First Affiliated Hospital of Gannan Medical University between June 2017 and June 2020. The patients were divided into three groups based on the treatment received: group A (n = 146; curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery), group B [n = 90; curettage after methotrexate (MTX) injection into the local gestational sac], and group C (n = 78; laparoscopic, transvaginal, and transabdominal cesarean scar resection). These groups were divided into three subgroups (type I, type II, and type III) according to the CSP type of the patients.

Results
The intraoperative blood loss, length of hospital stay, hospitalization cost, menstrual recovery time, and serum β-HCG normalization time were lower in groups A than in groups B or C with type I, II and III CSP (P < 0.05). Operative efficiency and Successful second pregnancy rate were higher in groups A than in groups B or C with type I and II CSP (P < 0.05). But in type III CSP, the complications were more serious in group A than group C.

Conclusions
Curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery is an effective and relatively safe treatment for patients with type I and II CSP. Laparoscopic surgery is more suitable for type III CSP.
Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication – a longitudinal cohort study
Authors: Striberger Rebecka , Zarrouk Moncef , Kumlien Christine , Axelsson Malin 
Published: May 2023

Abstract
Background
Patients with intermittent claudication need lifelong treatment with secondary prevention to prevent cardiovascular events and progression of atherosclerotic disease. Illness perception, health literacy, self-efficacy, adherence to medication treatment, and quality of life are factors influencing patients’ self-management. Knowledge of these factors could be important when planning for secondary prevention in patients with intermittent claudication.

Aim
to compare illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life in in patients with intermittent claudication.

Methods
A longitudinal cohort study was conducted with 128 participants recruited from vascular units in southern Sweden. Data were collected through medical records and questionnaires regarding illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life.

Results
In the subscales in illness perception, patients with sufficient health literacy reported less consequences and lower emotional representations of the intermittent claudication. They also reported higher self-efficacy and higher quality of life than patients with insufficient health literacy. In comparison between men and women in illness perception, women reported higher illness coherence and emotional representations associated with intermittent claudication compared to men. A multiple regression showed that both consequences and adherence were negative predictors of quality of life. When examining changes over time, a significant increase in quality of life was seen between baseline and 12 months, but there were no significant differences in self-efficacy..

Conclusion
Illness perception differs in relation to level of health literacy and between men and women. Further, the level of health literacy seems to be of importance for patients’ self-efficacy and quality of life. This illuminates the need for new strategies for improving health literacy, illness perception, and self-efficacy over time. For example, more tailored information regarding secondary prevention could be provided to strengthen self-management to further improve quality of life in patients with intermittent claudication.
Revealing platelet-related subtypes and prognostic signature in pancreatic adenocarcinoma
Authors: Zhao Jian-Gang , Li Yu-Jie , Wu Yong , Zhang Ke , Peng Lin-Jia , Chen Hao 
Published: May 2023

Abstract
Background
Pancreatic adenocarcinoma (PDAC) is a malignant tumor with high heterogeneity and poor prognosis. In this study, we sought to identify the value of platelet-related genes in prognosis and heterogeneity of PDAC through multiple transcriptomic methods.

Methods
Based on datasets from Gene Expression Omnibus and The Cancer Genome Atlas (TCGA), platelet-related genes were screened out, and the TCGA cohort (n = 171) was identified into two subtypes by unsupervised clustering. The platelet-related risk score model (PLRScore) was constructed by univariate Cox and LASSO regression, and the predictive ability was evaluated by Kaplan-Meier test and time-dependent receiver operating characteristic (ROC) curves. The results were validated in two other external validation sets, ICGC-CA (n = 140) and GSE62452 (n = 66). Furthermore, predictive nomogram containing clinical characteristics and PLRScore was established. In addition, we determined the possible correlation between PLRScore and immune infiltration and response of immunotherapy. Finally, we analyzed the heterogeneity of our signature in various types of cells using single-cell analysis.

Results
Platelet-related subtypes that have significant difference of overall survival and immune states (p < 0.05) were identified. PLRScore model based on four-gene signature (CEP55, LAMA3, CA12, SCN8A) was constructed to predict patient prognosis. The AUCs of training cohort were 0.697, 0.687 and 0.675 for 1-, 3-and 5-year, respectively. Further evaluation of the validation cohorts yielded similar results. In addition, PLRScore was associated with immune cell infiltration and immune checkpoint expression, and had promising ability to predict response to immunotherapy of PDAC.

Conclusions
In this study, the platelet-related subtypes were identified and the four-gene signature was constructed and validated. It may provide new insights into the therapeutic decision-making and molecular targets of PDAC.
Community perspectives on family planning service quality among users and non-users: a qualitative study from two cities in Burkina Faso
Authors: Bazie Fiacre , Speizer Ilene S. , Castle Sarah , Boukary Kindo , Maytan-Joneydi Amelia , Calhoun Lisa M. , Onadja Yentema , Guiella Georges 
Published: May 2023

Abstract
Background
Most studies that focus on quality of family planning (FP) services collect data from facilities. These studies miss the perspectives of quality from women who do not visit a facility and for whom perceived quality may be a barrier to service utilization.

Methods
This qualitative study from two cities in Burkina Faso examines perceived quality of FP services from women who were recruited at the community level to avoid potential biases based on recruiting women at facilities. Twenty focus group discussions were undertaken with varying groups of women of different ages (15–19; 20–24; 25+), marital statuses (unmarried; married), and current modern contraceptive use experiences (current non-users; current users). All focus group discussions were undertaken in the local language and transcribed and translated into French for coding and analysis.

Results
Women discuss FP service quality in a variety of locations, depending on their age group. Perspectives on service quality for younger women are often informed by others’ experiences whereas for the older women, they are formed by their own and others’ experiences. Two important aspects of service delivery emerge from the discussions including interactions with providers and selected system-level aspects of service provision. Important components of provider interactions relate to (a) the initial reception from the provider, (b) the quality of counseling received, (c) stigma and bias from providers, and d) privacy and confidentiality. At the health system level, discussions revolved around (a) wait time; (b) stockouts of methods; (c) costs of services/methods; (d) the expectation for tests as part of service provision; and (e) difficulties with method removal.

Conclusions
To increase contraceptive use among women, it is crucial to address the components of service quality they identify as related to higher quality services. This means supporting providers to offer services in a more friendly and respectful manner. In addition, it is important to ensure that full information is provided to clients on what to expect during a visit to avoid false expectations that lead to poor perceived quality. These types of client-focused activities can improve perceptions of service quality and ideally support use of FP to meet women’s needs.
The effects of an e-health brisk walking intervention in increasing moderate-to-vigorous physical activity in physically inactive older people with cognitive frailty: study protocol for a randomized controlled trial
Authors: Kwan Rick Yiu Cho , Liu Justina Yat Wa , Lee Paul Hong , Sin Olive Suk Kan , Wong Julia Sze Wing , Fu Mei Rosemary , Suen Lorna Kwai Ping 
Published: May 2023

Abstract
Background
Cognitive frailty is a risk for many adverse health outcomes that are commonly observed in older people. Physical activity is known to be effective to reserve cognitive frailty but the prevalence of physical inactivity is still high in older people. E-health enhances behavioural change effects through an innovative way to deliver behavioural change methods that can enhance the behavioural change effects. However, its effects on older people with cognitive frailty, its effects compared with conventional behavioural change methods, and the sustainability of the effects are unclear.

Methods
This study employs a single-blinded, two-parallel-group, non-inferiority, randomized controlled trial design with a 1:1 group allocation ratio. Eligible participants are aged 60 years or above, have cognitive frailty and physical inactivity, and possess a smartphone for more than six months. The study will be conducted in community settings. In the intervention group, participants will receive a 2-week brisk-walking training followed by a 12-week e-health intervention. In the control group, participants will receive a 2-week brisk-walking training followed by a 12-week conventional behavioural change intervention. The primary outcome is minutes of moderate-to-vigorous physical activity (MVPA). This study aims to recruit a total of 184 participants. Generalized estimating equations (GEE) will be used to examine the effects of the intervention.

Ethics and dissemination
The trial has been registered at ClinicalTrials.gov (Identifier: NCT05758740) on 7th March 2023, https://clinicaltrials.gov/ct2/show/NCT05758740, and all items come from the World Health Organization Trial Registration Data Set. It has been approved by the Research Ethics Committee of Tung Wah College, Hong Kong (reference number: REC2022136). The findings will be disseminated in peer-reviewed journals and presented at international conferences relevant to the subject fields.

Trial registration
The trial has been registered at ClinicalTrials.gov (Identifier: NCT05758740) and all items come from the World Health Organization Trial Registration Data Set. The latest version of the protocol was published online on 7th March 2023.
The effectiveness of the serious game “Broodles” for siblings of children with intellectual disabilities and/or visual impairment: study protocol for a randomized controlled trial
Authors: Veerman Linda K. M. , Willemen Agnes M. , Derks Suzanne D. M. , Brouwer-van Dijken Anjet A. J. , Sterkenburg Paula S. 
Published: May 2023

Abstract
Background
Siblings of children with disabilities also need support. However, there are only a few evidence-based interventions for these siblings. The current study aims to assess the effectiveness of a newly developed serious game for young siblings of children with intellectual disability (ID) and/or visual impairment (VI). This serious game is hypothesized to improve sibling’s quality of life, adjustment to their brother’s or sister’s disability, and multiple aspects of psychosocial well-being.

Methods
The intervention consists of a serious game called “Broodles” (in Dutch: “Broedels”) that helps children to recognize and deal with thoughts, feelings, and difficult situations. The game consists of eight 20-minute levels that all have the same structure with eight game elements. Each level addresses a domain of sibling quality of life and combines animations, mini-documentaries, fun mini-games, and multiple-choice questions. In addition to the game, siblings make a worksheet after playing each level. In order to support the child, the parents or caregivers receive a short brochure with information and tips. The effectiveness of the intervention will be investigated among a sample of 154 children aged 6–9 years and their parents or caregivers, using a two-arm parallel RCT design. The experimental group will play the serious game “Broodles” over a period of 4 weeks, whereas the control group will be placed on a waiting list. Assessments will take place at three time points: pre-test (week 1), post-test (week 5), and follow-up (weeks 12–14). At each timepoint, children and parents will complete several questionnaires on quality of life and different aspects of psychosocial well-being. In addition, children will make drawings to assess the sibling relationship. Next to that, parents and children will answer closed and open-ended questions about the sibling adjustment to their brother or sister’s disability. Finally, parents and children will evaluate the serious game through closed and open-ended questions.

Discussion
This study contributes to the knowledge about sibling interventions and serious games. Additionally, if the serious game is proven to be effective, it will be a readily available, easily accessible, and free of charge intervention for siblings.

Trial registration
ClinicalTrials.gov, NCT05376007, registered prospectively on April 21, 2022.
[99mTc]-labelled anti-Programmed Death-Ligand 1 single-domain antibody SPECT/CT: a novel imaging biomarker for myocardial PD-L1 expression
Authors: Nazir Muhummad Sohaib , Hughes Daniel Johnathan , Chand Gitasha , Adamson Kathryn , Johnson Jessica , Bailey Damion , Gibson Victoria , Ting Hong Hoi , Lyon Alexander R. , Cook Gary J. R. ,   PECan study group, Edmonds Scott , Georgiou Alexandros , Karapanagiotou Eleni , Josephs Debra , McLean Emma , Spicer James , Goh Vicky 
Published: May 2023

Abstract
Background
Myocardial programmed death-ligand 1 (PD-L1) expression is implicated in immune checkpoint inhibitor (ICI)-associated myocarditis. Measurement of myocardial PD-L1 expression may have potential use as a mechanistic and predictive biomarker. The aim of this study was to determine non-invasive assessment of myocardial PD-L1 expression using [99mTc]-labelled anti-PD-L1 single-domain antibody (NM-01) SPECT/CT.

Methods
Thoracic [99mTc]NM-01 SPECT/CT was performed in lung cancer patients (n = 10) at baseline and 9-weeks following anti-programmed cell death protein 1 (PD-1) therapy. Baseline and 9-week left ventricular and right ventricular to blood pool ratios (LVmax:BP) and (RVmax:BP) were measured. LVmax was compared to background skeletal muscle (musclemax). Intra-rater reliability was determined by intraclass correlation coefficient (ICC) and Bland–Altman analysis.

Results
Mean LVmax:BP values were 2.76 ± 0.67 at baseline vs 2.55 ± 0.77 at 9 weeks (p = 0.42). Mean RVmax:BP was 1.82 ± 0.32 at baseline vs 1.76 ± 0.45 at 9 weeks (p = 0.67). Myocardial PD-L1 expression was at least threefold greater than skeletal muscle at baseline for the LV (LVmax to musclemax 3.71 ± 0.77 vs 0.98 ± 0.20 (p < 0.001)) and at least twofold for the RV (LVmax to musclemax 2.49 ± 0.63 vs 0.98 ± 0.20 (p < 0.001)). There was excellent intra-rater reliability for LVmax:BP with ICC 0.99 (95% confidence interval 0.94–0.99, p < 0.001), mean bias -0.05 ± 0.14 (95% limits of agreement -0.32 to 0.21). There were no major adverse cardiovascular events or myocarditis during follow-up.

Conclusion
This study is the first to report PD-L1 expression of the heart that can be quantified non-invasively without invasive myocardial biopsy, with high reliability and specificity. This technique can be applied to investigate myocardial PD-L1 expression in ICI-associated myocarditis and cardiomyopathies.
Clinical trial registration PD-L1 Expression in Cancer (PECan) study (NCT04436406). https://clinicaltrials.gov/ct2/show/NCT04436406 June 18th, 2020.
Current status of contemporary diagnostic radiotracers in the management of breast cancer: first steps toward theranostic applications
Authors: Altena Renske , Tzortzakakis Antonios , Af Burén Siri , Tran Thuy A. , Frejd Fredrik Y. , Bergh Jonas , Axelsson Rimma 
Published: May 2023

Abstract
Background
Expanding therapeutic possibilities have improved disease-related prospects for breast cancer patients. Pathological analysis on a tumor biopsy is the current reference standard biomarker used to select for treatment with targeted anticancer drugs. This method has, however, several limitations, related to intra- and intertumoral as well as spatial heterogeneity in receptor expression as well as the need to perform invasive procedures that are not always technically feasible.

Main body
In this narrative review, we focus on the current role of molecular imaging with contemporary radiotracers for positron emission tomography (PET) in breast cancer. We provide an overview of diagnostic radiotracers that represent treatment targets, such as programmed death ligand 1, human epidermal growth factor receptor 2, polyadenosine diphosphate-ribose polymerase and estrogen receptor, and discuss developments in therapeutic radionuclides for breast cancer management.

Conclusion
Imaging of treatment targets with PET tracers may provide a more reliable precision medicine tool to find the right treatment for the right patient at the right time. In addition to visualization of the target of treatment, theranostic trials with alpha- or beta-emitting isotopes provide a future treatment option for patients with metastatic breast cancer.
Metagenomic analysis reveals specific BTEX degrading microorganisms of a bacterial consortium
Authors: Wu Hui-jun , Du Xian-yuan , Wu Wen-jing , Zheng Jin , Song Jia-yu , Xie Jia-cai 
Published: May 2023

AbstractPetroleum hydrocarbon contamination is of environmental and public health concerns due to its toxic components. Bioremediation utilizes microbial organisms to metabolism and remove these contaminants. The aim of this study was to enrich a microbial community and examine its potential to degrade petroleum hydrocarbon. Through successive enrichment, we obtained a bacterial consortium using crude oil as sole carbon source. The 16 S rRNA gene analysis illustrated the structural characteristics of this community. Metagenomic analysis revealed the specific microbial organisms involved in the degradation of cyclohexane and all the six BTEX components, with a demonstration of the versatile metabolic pathways involved in these reactions. Results showed that our consortium contained the full range of CDSs that could potentially degrade cyclohexane, benzene, toluene, and (o-, m-, p-) xylene completely. Interestingly, a single taxon that possessed all the genes involved in either the activation or the central intermediates degrading pathway was not detected, except for the Novosphingobium which contained all the genes involved in the upper degradation pathway of benzene, indicating the synergistic interactions between different bacterial genera during the hydrocarbon degradation.