bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-resolution CBCT assessing a maxillary central incisor with root bifurcation: A case report
Authors: Carneiro Ana Luiza Esteves , Spin-Neto Rubens , Salgado Daniela Miranda Richarte de Andrade , Meneses Núbia Rafaelle Oliveira de , López Edna Alejandra Gallardo , Fonseca Alice Souza Villar Cassimiro , Costa Claudio 
Published: August 2023

Cone beam computed tomography (CBCT) is an imaging modality widely used in endodontics, since it provides three-dimensional images without superposition of structures. The maxillary central incisor usually presents a single root and one root canal, but anatomical variations can happen. The aim of the present paper is to report a high-resolution CBCT evaluation of an upper central incisor with root bifurcation. This paper shows a descriptive and qualitative assessment of high-resolution CBCT images for endodontic purposes. A 39-year-old male patient was referred to a radiologic clinic to acquire CBCT images of the right upper central incisor, as the referring clinician noticed an anatomical difference between the two upper central incisors on a panoramic radiograph and suspected of dens invaginatus. CBCT images were acquired in high resolution (voxel size of 0.08 mm) and a restricted field-of-view (4x4 cm). CBCT volume displayed an anatomical variation of the central incisor, which presented root bifurcation and two root canals, with a normal clinical crown. The present case report shows a rare diagnosis of a maxillary central incisor presenting bifurcated root with two root canals, and to the best of the authors’ knowledge, this is the first case report to present high-resolution CBCT images with disclosed acquisition protocols to diagnose a bifurcated central incisor. The documentation of unusual cases has great didact value and contributes to information propagation. In the present case, high-resolution CBCT allowed a detailed evaluation of both roots and root canals, facilitating the clinician’s diagnostic task.
Parent's Stigma Towards Childhood Tuberculosis: A Multicenter Survey from Eastern Bandung Regency
Authors: Melati Azalia , Rohmatin Titin , Putri Karina Grashiva , Asri Tika , Apriani Desi , Rakhmawati Windy 
Published: August 2023

Aims: Tuberculosis-related stigma negatively influences tuberculosis prevention programs such as delayed diagnoses, poor treatment adherence, and decreased quality of life of patients. This descriptive quantitative study aimed to describe the stigma towards tuberculosis among parents.
Method: A total of 30 samples taken through accidental sampling were parents who had children (0-14 years) with tuberculosis who had been treated at the public health centers. A questionnaire adapted from Van Rie TB Stigma Scale (VTSS) was used and analyzed using descriptive analysis.
Result: Most parents (76.6%) had lower levels of stigma, while the others scored higher levels. Lower stigma levels can be caused by a mature mindset, good knowledge of TB information, and indicates higher hopes from parents to increase their care level for children’s development, health-seeking behavior, and support for children’s TB treatment until it is completed. Accordingly, higher stigma levels from parents might be a result of several external factors that can increase the lack of motivation for health-seeking behavior in their children’s TB treatment.
Conclusion: The role of health workers is very important in reducing stigma. Health education about prevention and treatment of childhood tuberculosis is still needed because it is a source of fear and high stigma against childhood tuberculosis in society.
The Implementation of Hands and Feet Exercise Towards Pain Management Among DM Type II Patients with Peripheral Neuropathy in Indonesia
Authors: Sartika Mila , Suryana Ilham , Azam Rohman , Jumaiyah Wati 
Published: August 2023

Aims: The prevalence of diabetes mellitus (DM) worldwide increased significantly every year, including Indonesia. The most common complication among patients with Type II DM was DPN (Diabetic Peripheral Neuropathy) with the severe symptom being pan. However, only limited studies discussed related topics about intervention to reduce pain. Aim. This research objective was to measure the effectiveness of hand and foot exercises toward pain among patients with Type II DM.
Method: A quasi-experiment of pre-post test design with a control and intervention group was applied in this study. To obtain respondents, this research used convenience sampling. This study is located in the inpatient ward of two hospitals in Indonesia located in suburban areas. Two questionnaires used in this study are Michigan Neuropathy Screening Instrument (MNSI) and Visual Analog Score (VAS). The Visual Analog Score (VAS).
Results: A total of 38 respondents were divided into the same number of intervention and control groups with each of them 19 respondents. The average pain scale in the 1st to 8th week of measurement has decreased gradually in both group. Based on the results of the Friedman Test there was an effect of applying hand and foot exercises in reducing patient pain and diabetic peripheral neuropathy among the intervention group (p< 0.00) but no statistically significant decreased in the control group (p> 0.000). These results are in line with the reference journal in the assessment of pain response in both groups. These exercise increase blood vessel circulation and muscle strength.
Conclusion: This intervention can be implemented among patients with Type II DM as one of the pain management in clinical settings. The standard operational procedures with structured training must be done to implement this intervention.
Influence of Educational Videos on Knowledge and Attitude on Reproduktive Health in Adolescent
Authors: Nopyanti Eti , Sri Futriani Elfira , Suliati Suliati , Murtiani Farida , Dinar Widiantari Aninda 
Published: August 2023

Aims: Reproductive health education is essential to improve knowledge and attitude to grow up and live healthily. Audiovisual media as teaching method is considered as effective way to deliver message and material for health topic in teenager. It was reported that 10-14 years-old adolescent in Jakarta has reached 874,865 people in 2020. High populated of adolescent increased higher-risk sexual behavior. Sexual and reproductive education aims to increase knowledge about the anatomy and physiology of the organs and also improve attitude to avoid high-risk sex behavior.
Objective: We aim to observe the effect of educational videos on the knowledge and attitudes of adolescents about reproductive health.
Method: Quasi-experimental research with pre and post-test without control group. Research sample was 100 students of 231 Junior School Jakarta using systematic random sampling. Intervention was educational videos about healthy sex behavior.
Result: We found significantly increased average knowledge (15,91 vs 23,24, p= 0,0001) and attitude (34,12 vs 43,26, p= 0,0001) score after the intervention.
Conclusion: There was an significant diffrence of adolescents' knowledge and attitudes about reproductive health after educational video interventions. School and teacher play an active role in reproductive health counseling activities for adolescents with the right media.
The caecal microbiota promotes the acute inflammatory response and the loss of the intestinal barrier integrity during severe Eimeria tenella infection
Authors: Tomal Florian , Sadrin Guillaume , Gaboriaud Pauline , Guitton Edouard , Sedano Laura , Lallier Nathalie , Rossignol Christelle , Larcher Thibaut , Rouille Elodie , Ledevin Mireille , Guabiraba Rodrigo , Silvestre Anne , Lacroix-Lamandé Sonia , Schouler Catherine , Laurent Fabrice , Bussière Françoise I. 
Published: August 2023

IntroductionCoccidiosis, a disease caused by intestinal apicomplexan parasites Eimeria, is a threat to poultry production. Eimeria tenella is one of the most pathogenic species, frequently causing a high prevalence of opportunistic infections.ObjectiveThe objective of this study is to investigate the role of the microbiota in the pathogenesis of severe Eimeria tenella infection.MethodsWe have previously shown that microbiota can promote parasite development. To study the effect of the microbiota on the pathogenesis of this infection, we used an experimental condition (inoculum of 10 000 oocysts E. tenella INRAE) in which the parasite load is similar between germ-free and conventional broilers at 7 days post-infection (pi). Thirteen conventional and 24 germ-free chickens were infected. Among this latter group, 12 remained germ-free and 12 received a microbiota from conventional healthy chickens at 4 days pi. Caeca and spleens were collected at 7 days pi.ResultsOur results demonstrated caecal lesions and epithelium damage in conventional chickens at 7 days pi but not in germ-free infected chickens. Administration of conventional microbiota to germ-free chickens partially restored these deleterious effects. At day 7 pi, both infected conventional and germ-free chickens exhibited increased gene expression of inflammatory mediators, including IL15, IFNγ, TNFα and the anti-inflammatory mediator SOCS1, whereas the inflammatory mediators CXCLi2, CCL20, IL18, CSF1, NOS2, PTGS2, IL1β, IL6, the receptor CCR2, and the anti-inflammatory mediators TGFβ1 and IL10 were upregulated only in infected conventional chickens. Notably, the IL18, PTGS2 gene expression was significantly higher in the infected conventional group. Overall, the inflammatory response enhanced by the microbiota might be in part responsible for higher lesion scores. Epithelial tight junction protein gene expression analysis revealed a significant upregulation of CLDN1 with the infection and microbiota, indicating a potential loss of the intestinal barrier integrity.ConclusionThese observations imply that, during E. tenella infection, the caecal microbiota could trigger an acute inflammatory response, resulting in a loss of intestinal integrity. Increase in bacterial translocation can then lead to the likelihood of opportunistic infections. Hence, modulating the microbiota may offer a promising strategy for improving poultry gut health and limiting caecal coccidiosis.
Higher docosahexaenoic acid levels lower the protective impact of eicosapentaenoic acid on long-term major cardiovascular events
Authors: Le Viet T. , Knight Stacey , Watrous Jeramie D. , Najhawan Mahan , Dao Khoi , McCubrey Raymond O. , Bair Tami L. , Horne Benjamin D. , May Heidi T. , Muhlestein Joseph B. , Nelson John R. , Carlquist John F. , Knowlton Kirk U. , Jain Mohit , Anderson Jeffrey L. 
Published: August 2023

IntroductionLong-chain omega-3 polyunsaturated fatty acids (OM3 PUFA) are commonly used for cardiovascular disease prevention. High-dose eicosapentaenoic acid (EPA) is reported to reduce major adverse cardiovascular events (MACE); however, a combined EPA and docosahexaenoic acid (DHA) supplementation has not been proven to do so. This study aimed to evaluate the potential interaction between EPA and DHA levels on long-term MACE.MethodsWe studied a cohort of 987 randomly selected subjects enrolled in the INSPIRE biobank registry who underwent coronary angiography. We used rapid throughput liquid chromatography-mass spectrometry to quantify the EPA and DHA plasma levels and examined their impact unadjusted, adjusted for one another, and fully adjusted for comorbidities, EPA + DHA, and the EPA/DHA ratio on long-term (10-year) MACE (all-cause death, myocardial infarction, stroke, heart failure hospitalization).ResultsThe average subject age was 61.5 ± 12.2 years, 57% were male, 41% were obese, 42% had severe coronary artery disease (CAD), and 311 (31.5%) had a MACE. The 10-year MACE unadjusted hazard ratio (HR) for the highest (fourth) vs. lowest (first) quartile (Q) of EPA was HR = 0.48 (95% CI: 0.35, 0.67). The adjustment for DHA changed the HR to 0.30 (CI: 0.19, 0.49), and an additional adjustment for baseline differences changed the HR to 0.36 (CI: 0.22, 0.58). Conversely, unadjusted DHA did not significantly predict MACE, but adjustment for EPA resulted in a 1.81-fold higher risk of MACE (CI: 1.14, 2.90) for Q4 vs. Q1. However, after the adjustment for baseline differences, the risk of MACE was not significant for DHA (HR = 1.37; CI: 0.85, 2.20). An EPA/DHA ratio ≥1 resulted in a lower rate of 10-year MACE outcomes (27% vs. 37%, adjusted p-value = 0.013).ConclusionsHigher levels of EPA, but not DHA, are associated with a lower risk of MACE. When combined with EPA, higher DHA blunts the benefit of EPA and is associated with a higher risk of MACE in the presence of low EPA. These findings can help explain the discrepant results of EPA-only and EPA/DHA mixed clinical supplementation trials.
Multimodality imaging in diagnosing lipomatous atrial septal hypertrophy with atrial septal defect: a case report
Authors: Yu Yi , Ding Ming , Chen Jin-Lan , Wang Ting , Chen Yu-Han , Yang Xiao-Min , Chen Su-Yun , Wang Yue-Peng , Li Yi-Gang 
Published: August 2023

BackgroundLipomatous atrial septal hypertrophy (LASH) with atrial septal defect (ASD) is a rare congenital anomaly. Although LASH is a histologically benign cardiac lesion characterized by excessive fat deposition in the interatrial septum that spares the fossa ovale, it has been associated with supraventricular arrhythmias or sick sinus syndrome. Application of multimodal imaging is crucial for accurate diagnosis, appropriate treatment of LASH with ASD, and follow-up.Case summaryA 68-year-old female patient presented with recurrent chest tightness and palpitation. Multimodal imaging revealed the characterizations of LASH and ASD. Two-dimensional transesophageal echocardiography showed a “dumbbell”-shaped involvement of the cephalad and caudal regions with sparing of a single secundum ASD. The septum with a brightness feature is an uncommon condition characterized by the deposition of unencapsulated fat cells in the atrial septum. Real-time four-dimensional transesophageal echocardiography reflected the lipomatous hypertrophy of the atrial septum and an oval-shaped ASD. Cardiac computer tomography angiography later confirmed this finding. The patient achieved a good clinical response with an ASD percutaneous occlusion guided by intracardiac echocardiography (ICE).ConclusionThis case demonstrates a LASH combined with ASD. Multimodality imaging can provide an accurate diagnosis and may guide the procedure for precise occlusion.
The diagnostic value of morphological features of fat deposition of sacroiliac joint steatosis in axial spondyloarthritis
Authors: Zhao Jiaoshi , Lin Churong , Liu Dong , Liu Budian , Chen Qilong , Gu Jieruo 
Published: August 2023

BackgroundFindings of fatty lesions in the context of other imaging manifestations, especially bone marrow edema and erosions can effectively assist in the diagnosis of axSpA. Chemical shift-encoded MRI is a sequence which allows for the quantification of fat signal and has been applied in the imaging evaluation of the SIJ in axSpA. The objective of this study was to investigate the diagnostic performance of morphological features of fatty lesions visualized by CSE-MRI in the imaging evaluation of SIJ in axSpA.MethodsFatty lesions with morphological features (subchondral, homogeneity and distinct border) were assessed and recorded as a binary variable in each quadrant of the SIJ. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for different morphological features as well as the anatomical distribution in patients with nr-axSpA and r-axSpA. T1-weighted images and CSE-MRI fat fraction maps were directly compared in the recognition of different morphological features.ResultsEighty-two patients [non-SpA (n = 21), nr-axSpA (n = 23), r-axSpA (n = 38)] with lower back pain (LBP) were enrolled. Presence of the three morphological features of fatty lesions had a specificity of 90.48% in axSpA. The sensitivities of being subchondral, homogeneity and distinct border were 52.17, 39.13 and 39.13% in nr-axSpA on T1-weighted images. For patients with r-axSpA, the sensitivities reached 86.84, 76.32 and 57.89%. No significant difference was found in the distribution of fatty lesions between T1-weighted images and CSE-MRI. However, CSE-MRI fat fraction maps could detect significantly more fatty lesions with homogeneity (p = 0.0412) and distinct border (p = 0.0159) than T1-weighted images in the sacroiliac joint, but not subchondral lesions (p = 0.6831).ConclusionThe homogeneity and distinct border are more relevant for the diagnosis of axSpA. Moreover, CSE-MRI could detect more typical morphological features of fatty lesions than T1-weighted images in showing these two features. The presence of all three features was more likely to be indicative of axSpA.
An immunogenic cell death-related classification predicts prognosis and response to immunotherapy in kidney renal clear cell carcinoma
Authors: Wang Licheng , Zhu Yaru , Ren Zhen , Sun Wenhuizi , Wang Zhijing , Zi Tong , Li Haopeng , Zhao Yan , Qin Xin , Gao Dacheng , Zhang Libo , He Ziyang , Le Wei , Wu Qiang , Wu Gang 
Published: August 2023

IntroductionImmunogenic cell death (ICD) is a form of regulated cell death that activates an adaptive immune response in an immunocompetent host and is particularly sensitive to antigens from tumor cells. Kidney clear cell carcinoma (KIRC) is an immunogenic tumor with extensive tumor heterogeneity. However, no reliable predictive biomarkers have been identified to reflect the immune microenvironment and therapeutic response of KIRC.MethodsTherefore, we used the CIBERSORT and ESTIMATE algorithms to define three ICD clusters based on the expression of ICD-related genes in 661 KIRC patients. Subsequently, we identified three different ICD gene clusters based on the overlap of differentially expressed genes (DEGs) within the ICD clusters. In addition, principal component analysis (PCA) was performed to calculate the ICD scores.ResultsThe results showed that patients with reduced ICD scores had a poorer prognosis and reduced transcript levels of immune checkpoint genes regulated with T cell differentiation. Furthermore, the ICD score was negatively correlated with the tumor mutation burden (TMB) value of KICD. patients with higher ICD scores showed clinical benefits and advantages of immunotherapy, indicating that the ICD score is an accurate and valid predictor to assess the effect of immunotherapy.DiscussionOverall, our study presents a comprehensive KICD immune-related ICD landscape that can provide guidance for current immunotherapy and predict patient prognosis to help physicians make judgments about the patient’s disease and treatment modalities, and can guide current research on immunotherapy strategies for KICD.
Cancer data quality and harmonization in Europe: the experience of the BENCHISTA Project – international benchmarking of childhood cancer survival by stage
Authors: Lopez-Cortes Angela , Didonè Fabio , Botta Laura , Hjalgrim Lisa L. , Jakab Zsuzsanna , Cañete Nieto Adela , Stiller Charles , Zeller Bernward , Gatta Gemma , Pritchard-Jones Kathy ,   The BENCHISTA Project Working Group
Published: August 2023

IntroductionVariation in stage at diagnosis of childhood cancers (CC) may explain differences in survival rates observed across geographical regions. The BENCHISTA project aims to understand these differences and to encourage the application of the Toronto Staging Guidelines (TG) by Population-Based Cancer Registries (PBCRs) to the most common solid paediatric cancers.MethodsPBCRs within and outside Europe were invited to participate and identify all cases of Neuroblastoma, Wilms Tumour, Medulloblastoma, Ewing Sarcoma, Rhabdomyosarcoma and Osteosarcoma diagnosed in a consecutive three-year period (2014-2017) and apply TG at diagnosis. Other non-stage prognostic factors, treatment, progression/recurrence, and cause of death information were collected as optional variables. A minimum of three-year follow-up was required. To standardise TG application by PBCRs, on-line workshops led by six tumour-specific clinical experts were held. To understand the role of data availability and quality, a survey focused on data collection/sharing processes and a quality assurance exercise were generated. To support data harmonization and query resolution a dedicated email and a question-and-answers bank were created.Results67 PBCRs from 28 countries participated and provided a maximally de-personalized, patient-level dataset. For 26 PBCRs, data format and ethical approval obtained by the two sponsoring institutions (UCL and INT) was sufficient for data sharing. 41 participating PBCRs required a Data Transfer Agreement (DTA) to comply with data protection regulations. Due to heterogeneity found in legal aspects, 18 months were spent on finalizing the DTA. The data collection survey was answered by 68 respondents from 63 PBCRs; 44% of them confirmed the ability to re-consult a clinician in cases where stage ascertainment was difficult/uncertain. Of the total participating PBCRs, 75% completed the staging quality assurance exercise, with a median correct answer proportion of 92% [range: 70% (rhabdomyosarcoma) to 100% (Wilms tumour)].ConclusionDifferences in interpretation and processes required to harmonize general data protection regulations across countries were encountered causing delays in data transfer. Despite challenges, the BENCHISTA Project has established a large collaboration between PBCRs and clinicians to collect detailed and standardised TG at a population-level enhancing the understanding of the reasons for variation in overall survival rates for CC, stimulate research and improve national/regional child health plans.
Factors influencing nurses’ post-traumatic growth during the COVID-19 pandemic: Bayesian network analysis
Authors: Yao Xi , Wang Junyi , Yang Yingrui , Zhang Hongmei 
Published: August 2023

ObjectiveDuring the COVID-19 pandemic, nurses, especially if females and working in intensive care units or emergencies unit, were much more at risk than other health-workers categories to develop malaise and acute stress symptoms. This study aimed to examine the nurses’ post-traumatic growth and associated influencing factors during the COVID-19 pandemic.MethodsA cross-sectional study using an online survey was conducted at Henan Provincial People’s Hospital to gather data from nurses. A set of questionnaires was used to measure the participants’ professional identity, organizational support, psychological resilience and post-traumatic growth. Univariate, correlation, and multiple linear regression analyses were used to determine significant factors influencing post-traumatic growth. A theoretical framework based on the Bayesian network was constructed to understand post-traumatic growth and its associated factors comprehensively.ResultsIn total, 1,512 nurses participated in the study, and a moderate-to-high level of post-traumatic growth was reported. After screening, the identified variables, including psychological counseling, average daily working hours, average daily sleep duration, professional identity, organizational support, and psychological resilience, were selected to build a Bayesian network model. The results of Bayesian network showed that professional identity and psychological resilience positively affected post-traumatic growth directly, which was particularly pronounced in low- and high-scoring groups. While organizational support positively affected post-traumatic growth indirectly.ConclusionAlthough this study identified a moderate-to-high level of nurses’ post-traumatic growth, proactive measures to improve psychological resilience fostered by professional identity and organizational support should be prioritized by hospitals and nursing managers.