bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early satisfactory results of percutaneous repair in neglected achilles tendon rupture
Authors: Hammad Mostafa Elsebai , Fayed Aly Maher , Ayoub Mostafa Ahmed , Emran Ali Mahmoud 
Published: June 2023

Abstract
Purpose
This investigation aimed to study the outcome of percutaneous repair of Achilles tendon ruptures regarding patient-reported and objective outcomes.

Methods
This is a retrospective review of a cohort of patients (n = 24) who underwent percutaneous repair of neglected Achilles rupture in the period between 2013 and 2019. Included patients were adults with closed injuries, presented 4–10 weeks after rupture, with intact deep sensation. All underwent clinical examination, X-rays to exclude bony injury and MRI for diagnosis confirmation. All underwent percutaneous repair by the same surgeon, using the same technique and rehabilitation protocol. The postoperative assessment was done subjectively using ATRS and AOFAS score and objectively using a percentage of heel rise comparison to the normal side and calf circumference difference.

Results
The mean follow-up period was 14.85 months ± 3 months. Average AOFAS scores at 6,12 months were 91 and 96, respectively, showing statistically significant improvement from pre-op level (P < 0.001). Percentage of heel rise on the affected side and calf circumference showed statistically significant improvement over the 12 month follow up period (P < 0.001). Superficial infection was reported in two patients (8.3%), and two cases reported transient sural nerve neuritis.

Conclusion
Percutaneous repair of neglected Achilles rupture using the index technique proved a satisfactory patient-reported and objective measurement at a one-year follow-up. With only minor transient complications.
Prevalence, clinical characteristics, and 3-dimensional radiographic analysis of supernumerary teeth in Guangzhou, China: a retrospective study
Authors: He Lidan , Que Guoying , Yang Xiaoxia , Yan Siqi , Luo Song 
Published: June 2023

Abstract
Objective
The aim was to investigate the prevalence and clinical and 3-dimensional (3D) radiographic characteristics of supernumerary teeth (ST) in a paediatric dental population. The factors associated with ST eruption potential were analysed, and the optimal extraction time for nonerupted ST was discussed.

Methods
A retrospective study was performed in a 13,336-participant baseline population aged 3–12 years for whom panoramic radiographs had been obtained in the hospital from 2019 to 2021. The medical records and radiographic data were reviewed to identify patients with ST. Both the demographic variables and ST characteristics were recorded and analysed .

Results
In total, 890 patients with 1,180 ST were screened from the 13,336 baseline population. The ratio of males (679) to females (211) was approximately 3.2:1. Generally, ST occurred singularly and were frequently found in the maxilla (98.1%). A total of 40.8% of ST were erupted, and the 6-year-old age group presented the highest eruption rate (57.8%). The eruption rate of ST was highly negatively correlated with age. A total of 598 patients additionally underwent cone- beam computed tomography (CBCT). According to the CBCT images, the majority of ST were conical, normally oriented, palatally situated, nonerupted and symptomatic. The most common ST-associated complication was failed eruption of adjacent teeth. In addition, symptomatic ST were more common in the 7- to 8- and 9- to 10-year-old age groups. The eruption rate of ST was 25.3% among the patients who had undergone CBCT. A normal orientation and the labial position were significant protective factors for ST eruption, with odds ratios (ORs) of 0.004 (0.000-0.046) and 0.086 (0.007–1.002), respectively. Age and the palatal position were significant risk factors, with ORs of 1.193 (1.065–1.337) and 2.352 (1.377–4.02), respectively.

Conclusions
This study provides a detailed analysis of ST characteristics in 3–12 year old children. Age as well as the position and orientation of ST were reliable predictors of the ST eruption. An age of 6 years old may be the optimal time for extraction of nonerupted ST to maximize the utilization of eruption potential and reduce the incidence of ST-associated complications.
Remote online open book examinations: through the lenses of faculty and students in health professions programmes
Authors: Er Hui Meng , Wong Pei Se , Nadarajah Vishna Devi 
Published: June 2023

Abstract
Background
Open book examinations have been used to assess students’ higher order cognitive skills. These examinations can be conducted online remotely with the advancement of technology. However, there are concerns regarding its validity and reliability particularly if the examinations are not proctored. The objective of this study was to explore the perceptions of faculty and students in health professions programmes about remote online open book examinations (ROOBE).

Methods
Semi-structured interviews were conducted among 22 faculty staff who were involved in ROOBE in health professions programmes. All interviews were audio recorded, transcribed verbatim and analysed using a thematic analysis approach. The perceptions of 249 medical students were obtained using an online questionnaire after they completed ROOBE.

Results
The faculty agreed that open book examinations could promote students’ higher order cognitive skills and reduce students’ stress. However, they were concerned about students’ academic integrity during non-invigilated ROOBE which could affect recognition by accreditation and professional bodies. The shift from traditional practice of closed-book examinations to ROOBE required change management with the support of guidelines and faculty training.
Majority of the students claimed that the examinations were challenging
as they assessed their ability to apply knowledge in real world problems. Nevertheless, they preferred ROOBE due to less anxiety and memorisation, and
more emphasis on problem solving skills. The shortcomings were insufficient time for information searching during
examinations and uncertainty in preparedness for future practice as they
focused less on memorisation of factual knowledge during examination
preparation. Cheating among peers and
internet instability during non-invigilated ROOBE were the concerns highlighted
by some students.

Conclusions
Faculty and students expressed favourable views about ROOBE in promoting
higher order cognitive skills. Adequate
technological support was essential during ROOBE. While there was a need to
address issues related to academic integrity, ROOBE could be included as an
authentic assessment within the systems of assessment.
Multimodal teaching methods for students in dentistry: a replacement for traditional teaching or a valuable addition? A three-year prospective cohort study
Authors: Gatt Gabriella , Attard Nikolai J. 
Published: June 2023

Abstract
Background
This student-centred prospective cohort study evaluated the impact of multimodal teaching methods on student performance in the theoretical domain of dental studies.

Methods
Dental students answered anonymous questionnaires indicating their preferences and opinions three times over three consecutive academic years. Data collected included gender, course, year of study and most frequent and preferred learning modality. Survey responses from Google Forms were analysed with SPSS 20.0 software (IBM Company, Chicago, IL, USA). Scale responses were tested with the Mann-Whitney U test against gender, program and year of study. Grades obtained from structured examinations held in the third academic year were analysed using the Wilcoxon Signed Rank Test according to the teaching method employed. The level of statistical significance was set at p < 0.05.

Results
The response rate was high (> 80%) throughout the study. Acceptance of online modalities increased over time (Kruskal-Wallis test, p < 0.001) and 75% of students requested that online teaching modalities be maintained. Significant differences in gender, program of study, year of study and discipline taught were observed (Mann-Whitney test, p < 0.05). Females differed from males by favouring online modalities and face-to-face lectures, respectively, and clinical year students opted to retain pre-recorded online lectures. Recorded lectures resulted better for teaching core knowledge (Wilcoxon Signed Rank Test, p = 0.034), while face-to-face lectures were better for teaching applied knowledge (Wilcoxon Signed Rank Test, p = 0.043). Student responses to open-ended questions identified the need for a blended approach with in-person lecturing as an opportunity to socialise and avoid mental health issues. Although preferences varied, students showed a willingness to influence their learning and changes in curriculum, a predilection for self-directed learning and the need for freedom in engaging with resources and content.

Conclusions
In the context of this study, online teaching modalities resulted in comparable examination performance and improved student satisfaction. This highlights the need for a blended approach to teaching.
“Discrimination is always intersectional” – understanding structural racism and teaching intersectionality in medical education in Germany
Authors: Weßel Merle , Gerhards Simon Matteo 
Published: June 2023

Abstract
Background
Racism in medicine represents a global problem. It takes place on the individual, institutional and structural level. Especially structural racism can have serious effects on the health of individual people. Furthermore, racist discrimination is not always based on race solemnly but frequently intersects with other social categories such as gender, class or religion. To describe this multidimensional form of discrimination the term intersectionality has been coined. However, the understanding of structural intersectional racism in medicine is still fragmented, especially in the German context. Yet, medical students need to be trained in understanding structural and intersectional racism to see the impact of racist structures on the patient’s health.

Method
We conducted a qualitative study to explore the knowledge, awareness and perception of racism in medicine and health care of medical students in Germany. Our research questions are how do medical student understand structural racism and its effects on health in Germany? Do students see interrelations with other forms of discrimination and in this context to what extent are they familiar with the concept of intersectionality? Which categories intersect from their point of views with race in context of medicine and health care? We conducted focus groups with medical students (n = 32) in Germany.

Results
Our results demonstrate that students have a wide spectrum of knowledge, awareness and perceptions about racism from being rather elaborate to very little knowledge about it. The students have particular problems to understand and situate structural racism in Germany. Some raised doubts about the relevance. Yet, other students are aware of the concept of intersectionality and are convinced that racism must be looked at from an intersectional perspective.

Conclusions
The diverse knowledge, awareness and perceptions of medical students about structural racism and intersectionality hints to a lack of systematic education of medical students about these issues in Germany. Yet, in context of diversifying societies an understanding about racism and its impact on health is imminent for future medical doctors to provide good care for their patients. Therefore, this knowledge gap must be systematically filled by the medical education.
Curriculum satisfaction of graduates of medical residency in ophthalmology
Authors: Guimarães A.B.C. , Amaral E. , Carvalho K.M. 
Published: June 2023

Abstract
Background
The number of ophthalmologists trained in Brazil has increased, but their satisfaction with the medical residency curriculum is unclear.
The purpose of this study is to evaluate the satisfaction and self-confidence of graduates of a reference ophthalmology residency program in Brazil and to analyze whether there is a difference in these parameters among those who graduated in different decades.

Methods
This is a cross-sectional web-based study conducted in 2022 with 379 ophthalmologists who graduated from the Faculty of Medical Sciences of the State University of Campinas (UNICAMP), Brazil. We aim to obtain data on satisfaction and self-confidence in clinical and surgical practices.

Results
In total, 158 questionnaires were completed (41.68% response rate); 104 respondents completed their medical residency between 2010 and 2022, 34 between 2000 and 2009, and only 20 before 2000. Most respondents were satisfied or very satisfied with their programs (98.7%). Respondents reported insufficient exposure to low vision rehabilitation (62.7%), toric intraocular implants (60.8%), refractive surgery (55.7%), and orbital trauma surgery (84.8%), particularly among graduates before 2010. They also reported insufficient training in certain non-clinical areas, such as office management (61.4%), health insurance management (88.6%), and personnel and administration skills (74.1%). We found that respondents who graduated a long time ago had higher confidence in clinical and surgical practices.

Conclusions
Brazilian ophthalmology residents and UNICAMP graduates expressed high levels of satisfaction with their residency training programs. Those who completed the program a long time ago appear to have more confidence in clinical and surgical practices. There were clinical and non-clinical areas with insufficient training identified for improvement.
Next-generation sequencing in the diagnosis of neurobrucellosis: a case series of eight consecutive patients
Authors: Yu Lili , Zhang Zhenyuan , Zou Yueli , Qi Xuejiao , Zhang Yu , Bai Kaixuan , Han Xiaochen , Bu Hui 
Published: June 2023

Abstract
Background
Neurobrucellosis (NB) presents a challenge for rapid and specific diagnosis. Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) has showed power in detection of causative pathogens, even some infrequent and unexpected pathogens. In this study, we presented 8 cases of NB diagnosed by the NGS of CSF.

Methods
Between August 1, 2018 and September 30, 2020, NGS was used to detect causative pathogens in clinically suspected central nervous system (CNS) infections. Data on demographics, clinical features, and laboratory tests, imaging results and NGS results were collected and reviewed.

Results
Among the presented 8 patients, Brucella was rapidly detected using NGS of CSF within 1–4 days, despite those eight patients had variable medical history, disease course, clinical manifestations, laboratory tests and imaging findings. NGS showed the sequence reads corresponded to Brucella species were 8 to 448, with genomic coverage of 0.02 to 0.87%. The relative abundance was 0.13% to 82.40% and sequencing depth was 1.06 to 1.24. Consequently, patients were administered with 3 to 6 months of doxycycline, ceftriaxone and rifampicin, double or triple combination, supplemented with symptomatic therapy and were fully recovered except for case 1.

Conclusion
NGS of CSF provides a powerful tool in detection of Brucella in a prompt and specific manner, and can be considered for first-line diagnostic use in practice.
Granzyme B + CD8 + T cells with terminal differentiated effector signature determine multiple sclerosis progression
Authors: Shi Ziyan , Wang Xiaofei , Wang Jiancheng , Chen Hongxi , Du Qin , Lang Yanlin , Kong Lingyao , Luo Wenqin , Qiu Yuhan , Zhang Ying , Li Chen , Wen Dingke , Yao Jie , Cheng Xia , Cai Linjun , Lin Xue , Wang Rui , Mou Zichao , Li Shuangjie , Liu Duanya , Zhou Hong , Zhou Hongyu , Yang Mu 
Published: June 2023

Abstract
Background
Multiple sclerosis (MS) leads to demyelination and neurodegeneration with autoimmune responses in central nervous system. Patients begin with a relapsing–remitting (RR) course, and more than 80% of them may advance to secondary progressive MS (SPMS), which is characteristic for the gradual decline of neurological functions without demonstrated treating method to prevent. This study aims to investigate the contribution of peripheral CD8 + T cells during the conversion from RRMS to SPMS, as well as reveal potential diagnostic signature in distinguishing SPMS.

Methods
Single-cell RNA sequencing was employed to reveal the heterogeneity of CD8 + T cells between SPMS and RRMS. In addition, flow cytometry was used to further characterized CD8 + T cell dynamic changes in patients. T cell receptor sequencing was performed to detect the clonal expansion of MS. Using Tbx21 siRNA, T-bet was confirmed to manipulate GzmB expression. The correlation between GzmB + CD8 + T cell subsets and clinical characteristics of MS and their potential diagnostic value for SPMS were evaluated by generalized linear regression models and receiver operating characteristic (ROC) curve respectively.

Results
Other than diminished naïve CD8 + T cell, elevating of activated CD8 + T cell subsets were observed in SPMS patients. Meanwhile, this aberrant amplified peripheral CD8 + T cells not only exhibited terminal differentiated effector (EMRA) phenotype with GzmB expression, but also possessed distinct trajectory from clonal expansion. In addition, T-bet acted as a key transcriptional factor that elicited GzmB expression in CD8 + TEMRA cells of patients with SPMS. Finally, the expression of GzmB in CD8 + T cells was positively correlated with disability and progression of MS, and could effectively distinguish SPMS from RRMS with a high accuracy.

Conclusions
Our study mapped peripheral immune cells of RRMS and SPMS patients and provided an evidence for the involvement of GzmB + CD8 + TEMRA cells in the progression of MS, which could be used as a diagnostic biomarker for distinguishing SPMS from RRMS.
A complex network of transcription factors and epigenetic regulators involved in bovine leukemia virus transcriptional regulation
Authors: Plant Estelle , Bellefroid Maxime , Van Lint Carine 
Published: June 2023

AbstractBovine Leukemia Virus (BLV) is the etiological agent of enzootic bovine leukosis, a disease characterized by the neoplastic proliferation of B cells in cattle. While most European countries have introduced efficient eradication programs, BLV is still present worldwide and no treatment is available. A major feature of BLV infection is the viral latency, which enables the escape from the host immune system, the maintenance of a persistent infection and ultimately the tumoral development. BLV latency is a multifactorial phenomenon resulting in the silencing of viral genes due to genetic and epigenetic repressions of the viral promoter located in the 5ʹ Long Terminal Repeat (5ʹLTR). However, viral miRNAs and antisense transcripts are expressed from two different proviral regions, respectively the miRNA cluster and the 3ʹLTR. These latter transcripts are expressed despite the viral latency affecting the 5ʹLTR and are increasingly considered to take part in tumoral development. In the present review, we provide a summary of the experimental evidence that has enabled to characterize the molecular mechanisms regulating each of the three BLV transcriptional units, either through cis-regulatory elements or through epigenetic modifications. Additionally, we describe the recently identified BLV miRNAs and antisense transcripts and their implications in BLV-induced tumorigenesis. Finally, we discuss the relevance of BLV as an experimental model for the closely related human T-lymphotropic virus HTLV-1.
Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis
Authors: Zhang Yu , Ju Jidong , Wu Jinchun 
Published: June 2023

Abstract
Background
Currently, self-locking stand-alone cages (SSC) are commonly applied in anterior cervical discectomy and fusion (ACDF), as are cage-plate constructs (CPC). However, it remains controversial concerning the long-term effectiveness of both apparatuses. Our purpose is to compare long-term effectiveness of SSC with CPC in monosegmental ACDF.

Methods
Four electronic databases were queried to identify studies comparing SSC versus CPC in monosegmental ACDF. The meta-analysis was carried out with the use of the Stata MP 17.0 software package.

Results
Ten trials with 979 patients were included. Compared to CPC, SSC significantly reduced operative time, intraoperative blood loss, duration of hospitalisation, cervical Cobb angle at final follow-up, 1-month postoperative dysphagia rate, and incidence of adjacent segment degeneration (ASD) at final follow-up. No significant difference was found regarding 1-month postoperative cervical Cobb angle, JOA scores, NDI scores, fusion rate and cage subsidence rate at final follow-up.

Conclusion
Both devices achieved similar long-term effectiveness in monosegmental ACDF regarding JOA scores, NDI scores, fusion rate and cage subsidence rate. SSC had significant advantages over CPC in reducing surgical duration, intraoperative bleeding, duration of hospitalisation, as well as rates of dysphagia and ASD after surgery. Therefore, SSC is a better option than CPC in monosegmental ACDF. However, SSC is inferior to CPC in maintaining cervical curvature at long-term follow-up. Whether radiological changes affect clinical symptoms needs confirmation in trials with longer follow-up.