bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care between the Netherlands and Germany
Authors: Wijnen Annet , Seeber Gesine H. , Dietz Günter , Dijkstra Baukje , Dekker Johan S. , Vermeulen Karin M. , Slager Geranda E. C. , Hessel Aike , Lazovic Djordje , Bulstra Sjoerd K. , Stevens Martin 
Published: June 2023

Abstract
Background
Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA.

Methods
A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective.

Results
124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%.

Conclusions
German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries.

Trial registration
The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).
Reconstruction using the colon or jejunum in patients with synchronous advanced esophageal and gastric cancers: a retrospective study from a single institutional database
Authors: Jiang Rongrong , Wang Youbo , Xu Juefeng , Chen Zhiming , Pang Liewen 
Published: June 2023

Abstract
Purpose
The aim of this study was to evaluate the feasibility and efficacy of simultaneous resection of synchronous advanced esophageal and gastric cancers.

Methods
We retrospectively analyzed the clinical data of 16 patients who underwent resection of synchronous advanced esophageal squamous cell carcinoma (ESCC) and gastric adenocarcinoma from January 2009 to Dec 2021. Subtotal esophagectomy and total gastrectomy were performed using the Ivor-Lewis or McKeown approach. Reconstruction was performed using a pedicled jejunal graft or colon interposition. Perioperative and postoperative data of all patients were analyzed.

Results
There were no in-hospital mortalities following surgery, but 9 patients (56.3%) suffered major perioperative complications. Comparison of the groups that received reconstruction using the jejunum and the colon indicated similar incidences of perioperative complications, overall survival, and disease-free survival. Cox regression analysis indicated that lymph node metastasis of both cancers was independent risk factor for overall survival.

Conclusion
The existence of synchronous tumors of the esophagus and stomach is not unusual, the radical surgical treatment could be carried out whenever possible.
Investigating the factors influencing students’ academic enthusiasm for a shift of paradigm among education managers shaping academic pedagogy
Authors: Moghadasi Javad , Keikavoosi-Arani Leila 
Published: June 2023

AbstractBackgroundEducation managers are among the most important determinants of a university’s academic pedagogy and plans to improve the quality of education. To improve the quality of education and academic enthusiasm of students in a medical university, it might be necessary to improve the university’s pedagogy paradigm through people who shape this pedagogy. This study aimed to investigate the factors that influence the academic enthusiasm of students in a medical university with the purpose of improving the university’s pedagogy paradigm.MethodsThis cross-sectional descriptive-correlational study was conducted on the students of Alborz University of Medical Sciences in the academic year 2021–2022 (3180 students). The sample size was calculated to be 343 using Cochran’s formula. The participants were recruited by stratified random sampling with respect to the proportion of students in different faculties, disciplines, and education levels. The data collection tool was a researcher-made questionnaire. Data were analyzed by one-sample t-test and confirmatory factor analysis using SMART-PLS and SPSS26.ResultsThe developed model consisted of 3 dimensions (academic, individual and social), 10 components (teaching-learning environment, culture, extracurricular activities, facilities and equipment, attitude, knowledge, skill, classmate, family, relatives and friends) and 64 indicators.ConclusionThe developed model can help medical universities take a step towards improving the academic productivity and performance of their students and gain a competitive advantage in this respect.
Factors associated with caretakers’ knowledge, attitude, and practices in the management of pneumonia for children aged five years and below in rural Uganda
Authors: Kajungu Dan , Nabukeera Betty , Muhoozi Michael , Ndyomugyenyi Donald Bruce , Akello Mercy Consolate , Gyezaho Collins , Waako James , Kasirye Ronnie 
Published: June 2023

Abstract
Background
Efforts aimed at reducing morbidity and mortality associated with pneumonia in children aged five years and below largely depend on caretakers. This study aimed to assess the factors associated with knowledge, attitudes, and practices of caretakers regarding pneumonia.

Methods
This was a cross-sectional study carried out within Iganga and Mayuge health and demographic surveillance site (IMHDSS) cohort in Eastern Uganda. Caretakers of children under the age of five years were assessed for knowledge, attitudes, and practices using a set of indicators. The caretaker characteristics as determinants for knowledge, attitude, and practices in relation to pneumonia management were assessed for association. Logistic regression was used to assess the factors associated with caretaker knowledge, attitudes and practices.

Results
A total of 649 caretakers of children five years and below of age were interviewed. Caretakers knew pneumonia as one of the childhood diseases, but were less knowledgeable about its transmission, signs and symptoms, risk factors and treatment. Overall, 28% had good knowledge, 36% had moderate knowledge and 35% had poor knowledge. The caretaker attitude was good for more than a half of the respondents (57%), while majority reported good practices (74.1%). Older age (OR = 1.63, 95% CI (1.05–2.51)), Tertiary education (OR = 4.92, 95% CI (2.5–9.65)), being married (OR = 1.82, 95% CI (1.05–3.15)) were associated with having good knowledge. Age above 35 years (aOR = 1.48, 95% CI (1.03–2.11)), and main source of livelihood were associated with good attitude and lastly being female (OR = 2.3, 95% CI (1.23–4.37)), being a Muslim (aOR = 0.5, 95% CI (0.35–0.75)), and being a farmer (OR = 0.5, 95% CI (0.33–0.85)) were associated with being a good caretaker practice.

Conclusions
The caretakers of children five years and below, have relatively adequate knowledge about the signs and symptoms of pneumonia, risk factors and treatment measures. Higher education, being married, and being a salary earner were associated with better knowledge about pneumonia, while being female, being a Muslim, and being a peasant farmer were associated with good practice. Targeted interventions to equip caretakers with relevant and adequate skills and knowledge for lower-income and less educated caretakers, considering cultural and religious beliefs about childhood pneumonia identification and management are required.
Cost-effectiveness of the combination of immunotherapy and chemotherapy for extensive-stage small-cell lung cancer: a systematic review
Authors: Wang Tao , Li Yilin , Zheng Xiaoqiang 
Published: June 2023

Abstract
Background
The combination of immunotherapy and chemotherapy for extensive-stage small-cell lung cancer (ES-SCLC) was primarily carried out with a combination of immune checkpoint inhibitors (ICIs) and platinum-etoposide (EP). It is likely to be more effective in treating ES-SCLC than EP alone, but could result in high healthcare costs. The study aimed to investigate the cost-effectiveness of this combination therapy for ES-SCLC.

Methods
We searched literature from the following databases: PubMed, Embase, Cochrane Library, and Web of Science for studies on cost-effectiveness of immunotherapy combined with chemotherapy for ES-SCLC. The literature search period was up to April 20, 2023. The quality of the studies was evaluated using the Cochrane Collaboration's tool and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Results
A total of 16 eligible studies were included in the review. All studies met CHEERS recommendations, and all randomized controlled trials (RCTs) in these studies were rated as having low risk of bias using the Cochrane Collaboration's tool. The treatment regimens compared were ICIs plus EP or EP alone. All studies mainly used incremental quality-adjusted life year and incremental cost-effectiveness ratio as outcomes. Most ICIs plus EP treatment regimens were not cost-effective based on corresponding willingness-to-pay thresholds.

Conclusions
Adebrelimab plus EP and serplulimab plus EP were probably cost-effective for ES-SCLC in China, and serplulimab plus EP was probably cost-effective for ES-SCLC in the U.S. Lowering the price of ICIs and selecting ES-SCLC patients who were sensitive to ICIs could improve the cost-effectiveness of the ICIs-combined treatment.
Characterization of 17β-estradiol-degrading enzyme from Microbacterium sp. MZT7 and its function on E2 biodegradation in wastewater
Authors: Hao Peng , Pan Hanyu , Lv Zongshuo , Zhang Jingyi , Wang Lixia , Zhu Yanbin , Basang Wangdui , Gao Yunhang 
Published: June 2023

Abstract
Background
17β-estradiol (E2) residues exhibit harmful effects both for human and animals and have got global attention of the scientific community. Microbial enzymes are considered as one of the effective strategies having great potential for removal E2 residues from the environment. However, limited literature is available on the removal of E2 from wastewater using short-chain dehydrogenase.

Results
In this study, 17β-estradiol degrading enzyme (17β-HSD-0095) was expressed and purified from Microbacterium sp. MZT7. The optimal pH and temperature for reaction was 7 and 40 °C, respectively. Molecular docking studies have shown that the ARG215 residue form a hydrogen bond with oxygen atom of the substrate E2. Likewise, the point mutation results have revealed that the ARG215 residue play an important role in the E2 degradation by 17β-HSD-0095. In addition, 17β-HSD-0095 could remediate E2 contamination in synthetic livestock wastewater.

Conclusions
These findings offer some fresh perspectives on the molecular process of E2 degradation and the creation of enzyme preparations that can degrade E2.

Graphical Abstract
Nano hydrogel-based oxygen-releasing stem cell transplantation system for treating diabetic foot
Authors: Chen Liangmiao , Zheng Bingru , Xu Yizhou , Sun Changzheng , Wu Wanrui , Xie Xiangpang , Zhu Yu , Cai Wei , Lin Suifang , Luo Ya , Shi Changsheng 
Published: June 2023

AbstractThe employment of stem cells and hydrogel is widespread in contemporary clinical approaches to treating diabetic foot ulcers. However, the hypoxic conditions in the surrounding lesion tissue lead to a low stem cell survival rate following transplantation. This research introduces a novel hydrogel with superior oxygen permeability and biocompatibility, serving as a vehicle for developing a stem cell transplantation system incorporating oxygen-releasing microspheres and cardiosphere-derived stem cells (CDCs). By optimizing the peroxidase fixation quantity on the microsphere surface and the oxygen-releasing microsphere content within the transplantation system, intracellular oxygen levels were assessed using electron paramagnetic resonance (EPR) under simulated low-oxygen conditions in vitro. The expression of vascularization and repair-related indexes were evaluated via RT-PCR and ELISA. The microspheres were found to continuously release oxygen for three weeks within the transplantation system, promoting growth factor expression to maintain intracellular oxygen levels and support the survival and proliferation of CDCs. Moreover, the effect of this stem cell transplantation system on wound healing in a diabetic foot mice model was examined through an in vivo animal experiment. The oxygen-releasing microspheres within the transplantation system preserved the intracellular oxygen levels of CDCs in the hypoxic environment of injured tissues. By inhibiting the expression of inflammatory factors and stimulating the upregulation of pertinent growth factors, it improved the vascularization of ulcer tissue on the mice’s back and expedited the healing of the wound site. Overall, the stem cell transplantation system in this study, based on hydrogels containing CDCs and oxygen-releasing microspheres, offers a promising strategy for the clinical implementation of localized stem cell delivery to improve diabetic foot wound healing.
Age- and sex-related differences of periodontal bone resorption, cognitive function, and immune state in APP/PS1 murine model of Alzheimer’s disease
Authors: Chen Huiwen , Liao Yue , Zhang Xu , Shen Hui , Shang Dihua , He Zhiyan , Zhou Wei , Song Zhongchen 
Published: June 2023

Abstract
Background
The existence of an interconnected mechanism between cognitive disorders and periodontitis has been confirmed by mounting evidence. However, the role of age or sex differences in this mechanism has been less studied. This study aims to investigate sex and age differences in the characterization of periodontal bone tissue, immune state and cognitive function in amyloid precursor protein/presenilin 1(APP/PS1) murine model of Alzheimer’s disease (AD).

Methods
Three- and twelve-month-old male and female APP/PS1 transgenic mice and wild-type (WT) littermates were used in this study. The Morris water maze (MWM) was used to assess cognitive function. The bone microarchitecture of the posterior maxillary alveolar bone was evaluated by microcomputed tomography (micro-CT). Pathological changes in periodontal bone tissue were observed by histological chemistry. The proportions of helper T cells1 (Th1), Th2, Th17 and regulatory T cells (Tregs) in the peripheral blood mononuclear cells (PBMCs) and brain samples were assessed by flow cytometry.

Results
The learning ability and spatial memory of 12-month-old APP/PS1 mice was severely damaged. The changes in cognitive function were only correlated with age and genotype, regardless of sex. The 12-month-old APP/PS1 female mice exhibited markedly periodontal bone degeneration, evidenced by the decreased bone volume/total volume (BV/TV), trabecular thickness (Tb.Th), and bone mineral density (BMD), and the increased trabecular separation (Tb.Sp). The altered periodontal bone microarchitecture was associated with genotype, age and females. The flow cytometry data showed the increased Th1 and Th17 cells and the decreased Th2 cells in the brain and PBMC samples of 12-month-old APP/PS1 mice, compared to age- and sex-matched WT mice. However, there was no statistical correlation between age or sex and this immune state.

Conclusions
Our data emphasize that age and sex are important variables to consider in evaluating periodontal bone tissue of APP/PS1 mice, and the cognitive impairment is more related to age. In addition, immune dysregulation (Th1, Th2, and Th17 cells) was found in the brain tissue and PBMCs of APP/PS1 mice, but this alteration of immune state was not statistically correlated with sex or age.
Associations between vertebral bone marrow fat and sagittal spine alignment as assessed by chemical shift-encoding-based water–fat MRI
Authors: Chen Fangsi , Huang Yingying , Guo Anna , Ye Peipei , He Jiawei , Chen Shaoqing 
Published: June 2023

Abstract
Background
The relationship between sagittal spine alignment and vertebral bone marrow fat is unknown. We aimed to assess the relationship between vertebral bone marrow fat and sagittal spine alignment using chemical shift-encoding-based water–fat magnetic resonance imaging (MRI).

Methods
A total of 181 asymptomatic volunteers were recruited for whole spine X-ray and lumbar MRI. Spine typing was performed according to the Roussouly classification and measurement of vertebral fat fraction based on the chemical shift-encoding-based water–fat MRI. One-way analysis of variance (ANOVA) was used to analyze the differences in vertebral fat fraction between spine types. The post hoc least significant difference (LSD) test was utilized for subgroup comparison after ANOVA.

Results
Overall, the vertebral fat fraction increased from L1 to L5 and was the same for each spine type. The vertebral fat fraction was the highest in type 1 and lowest in type 4 at all levels. ANOVA revealed statistically significant differences in fat fraction among different spine types at L4 and L5 (P < .05). The post hoc LSD test showed that the fat fraction of L4 was significantly different (P < .05) between type 1 and type 4 as well as between type 2 and type 4. The fat fraction of L5 was significantly different between type 1 and type 3, between type 1 and type 4, and between type 2 and type 4 (P < .05).

Conclusion
Our study found that vertebral bone marrow fat is associated with sagittal spine alignment, which may serve as a new additional explanation for the association of sagittal alignment with spinal degeneration.
The interactions of Candida albicans with gut bacteria: a new strategy to prevent and treat invasive intestinal candidiasis
Authors: Wang Fei , Wang Zetian , Tang Jianguo 
Published: June 2023

Abstract
Background
The gut microbiota plays an important role in human health, as it can affect host immunity and susceptibility to infectious diseases. Invasive intestinal candidiasis is strongly associated with gut microbiota homeostasis. However, the nature of the interaction between Candida albicans and gut bacteria remains unclear.

Objective
This review aimed to determine the nature of interaction and the effects of gut bacteria on C. albicans so as to comprehend an approach to reducing intestinal invasive infection by C. albicans.

Methods
This review examined 11 common gut bacteria’s interactions with C. albicans, including Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus faecalis, Staphylococcus aureus, Salmonella spp., Helicobacter pylori, Lactobacillus spp., Bacteroides spp., Clostridium difficile, and Streptococcus spp.

Results
Most of the studied bacteria demonstrated both synergistic and antagonistic effects with C. albicans, and just a few bacteria such as P. aeruginosa, Salmonella spp., and Lactobacillus spp. demonstrated only antagonism against C. albicans.

Conclusions
Based on the nature of interactions reported so far by the literature between gut bacteria and C. albicans, it is expected to provide new ideas for the prevention and treatment of invasive intestinal candidiasis.
Epigenome-wide association study identifies novel genes associated with ischemic stroke
Authors: Peng Hao , Palma-Gudiel Helena , Soriano-Tarraga Carolina , Jimenez-Conde Jordi , Zhang Mingzhi , Zhang Yonghong , Zhao Jinying 
Published: June 2023

Abstract
Background
DNA methylation has previously been associated with ischemic stroke, but the specific genes and their functional roles in ischemic stroke remain to be determined. Here we aimed to identify differentially methylated genes that play a functional role in ischemic stroke in a Chinese population.

Results
Genome-wide DNA methylation assessed with the Illumina Methylation EPIC Array in a discovery sample including 80 Chinese adults (40 cases vs. 40 controls) found that patients with ischemic stroke were characterized by increased DNA methylation at six CpG loci (individually located at TRIM6, FLRT2, SOX1, SOX17, AGBL4, and FAM84A, respectively) and decreased DNA methylation at one additional locus (located at TLN2). Targeted bisulfite sequencing confirmed six of these differentially methylated probes in an independent Chinese population (853 cases vs. 918 controls), and one probe (located at TRIM6) was further verified in an external European cohort (207 cases vs. 83 controls). Experimental manipulation of DNA methylation in engineered human umbilical vein endothelial cells indicated that the identified differentially methylated probes located at TRIM6, TLN2, and FLRT2 genes may play a role in endothelial cell adhesion and atherosclerosis.

Conclusions
Altered DNA methylation of the TRIM6, TLN2, and FLRT2 genes may play a functional role in ischemic stroke in Chinese populations.
Working Paper 42: From sanctions to confiscation while upholding the rule of law
Authors: Dornbierer Andrew 
Published: June 2023

Written in the light of Russia's war of aggression in Ukraine, the Working Paper explores whether it is justifiable to confiscate assets frozen under financial sanctions in order to redirect them to the victims of state aggression.
The paper first explores the concept of sanctions and financial sanctions (asset freezes) and what they mean in practice.
Using the example of Canada, which has introduced a legislative mechanism for this purpose, the paper analyses whether states should be able to confiscate sanctioned assets purely on the basis that they have been sanctioned.
It then looks at more established measures that states could adopt and apply to target sanctioned assets, including:

Traditional conviction based confiscation measures, including 'extended confiscation' mechanisms
Non-conviction based confiscation (forfeiture) measures
Unexplained wealth laws

The paper recommends ways to maximise the effectiveness of these alternative avenues for recovering assets, which are much less controversial and can arguably be applied without infringing on legal rights.
Opting for mechanisms that abide by established legal rights will not only significantly increase the chance of recovering assets without subsequent legal challenges. It will also ensure that the very reason for targeting the assets in the first place – namely to seek justice and compensation for acts of aggression – is not undermined through the erosion of the rule of law.
Working Paper 45: Strategic anti-corruption communications
Authors: Baez Camargo Claudia , Schönberg Johanna 
Published: June 2023

This Working Paper is intended to guide practitioners who are seeking to complement conventional anti-corruption measures by adopting a behavioural communications approach.
It aims to connect a typology of anti-corruption messages with behavioural change theories, and discuss their impact.
Subsequently, it suggests practical implications for designing anti-corruption communication as part of behaviour change interventions. This includes outlining how to develop a robust Theory of Change as a means to enhance the success of such efforts.
The guidance is based on a review of seven key topically pertinent studies that have been recently published.
This publication is prepared as guidance for the USAID Indonesia Integrity Initiative (USAID INTEGRITAS).