bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of an online program including mindfulness, exercise therapy and patient education compared to online exercise therapy and patient education for people with Patellofemoral Pain: protocol for a randomized clinical trial
Authors: Priore Liliam Barbuglio Del , Perez Vitoria Ozores , Briani Ronaldo Valdir , Farinelli Lucca Andre Liporoni Bego , da Silva Júlia de Cássia Pinto , Martins Odisséia Marli Gimenes , Lopes Fábio Arruda , Amorim Anita Barros , Pappas Evangelos , de Azevedo Fábio Mícolis 
Published: May 2023

AbstractBackgroundPatellofemoral pain (PFP) is a common knee disorder that causes persistent pain, lower self-reported function and quality of life. People with PFP also present with altered psychological factors, which are associated with higher levels of pain and dysfunction. Mindfulness-based interventions (MBI) generally consist of meditative practices developed to provide a holistic approach to chronic conditions. However, the effects of MBI on clinical and psychological outcomes for people with PFP remains understudied.MethodsThis assessor-blinded, parallel, two-arm randomized clinical trial aims to investigate the effects of adding an 8-week online MBI program to exercise therapy and patient education on clinical and psychological factors for people with PFP. We also aim to investigate whether psychological factors mediate changes in pain and function. Sixty-two participants with PFP will be recruited and randomized into one of two treatment groups (Mindfulness or Control group). Both groups will receive an 8-week intervention involving exercise therapy and education delivered through an online platform. The Mindfulness group will additionally receive a MBI component including formal and informal practices. Outcomes will be assessed online at baseline, intervention endpoint (follow-up 1) and 12 months after intervention completion (follow-up 2). Comparisons between groups will be performed at all time points with linear mixed models. A mediation analysis will be performed using a 3-variable framework.DiscussionExercise therapy and patient education are considered the “best management” options for PFP. However, unsatisfactory long-term prognosis remains an issue. It is known that people with PFP present with altered psychological factors, which should be considered during the evaluation and treatment of people with PFP. Adding a MBI to the current best treatment for PFP may improve short and long-term effects by addressing the underlying psychological factors.Trial registrationRegistro Brasileiro de Ensaios Clínicos(ReBEC) RBR-4yhbqwk, registered in April 6, 2021.
Comparison between radical surgery and chemoradiotherapy in patients with cervical esophageal cancer: a propensity score matched analysis
Authors: Qi Kang , Lin Gang , Liu Haibo , Zhang Xining , Chen Zhimao , Li Jian 
Published: May 2023

AbstractBackgroundThe prognostic value of radical surgery (RS) and chemoradiotherapy (CRT) for cervical esophageal cancer (CEC) was estimated using the Surveillance, Epidemiology and End Results (SEER) database after 1:1 propensity score matching (PSM).MethodsThis retrospective study used SEER data of CEC patients between 2004 and 2015. The prognostic effects on cancer-specific survival (CSS) were evaluated using multivariate cox regression analysis following radical surgery or CRT before and after PSM. The subgroup analysis of CSS is carried out according to T stages.ResultsA total of 440 patients met the eligibility criteria. Three hundred and fifty-six(80.9%)patients underwent chemoradiotherapy, and eighty-four (19.1%) patients underwent radical surgery. There were significant differences between patients of radical surgery and CRT groups with regard to the tumor grade, histology and N stage. After PSM, 80 matched pairs (A total of 160 patients) were selected. Multivariable cox regression analysis revealed no difference in the CSS of patients that underwent either radical surgery or CRT before [hazard ratio (HR): 0.955, 95% CI: 0.704–1.295, P = 0.766] and after PSM (HR: 0.767, 95% CI: 0.512–1.149, P = 0.198). Subgroup analysis revealed no significant difference in CSS between patients with radical surgery and CRT groups for all T stages (T 1–4, all P > 0.05).ConclusionsThis analysis revealed that the prognostic outcomes in patients with cervical esophageal cancer were comparable between radical surgery and CRT.
Salivary proteins offer insights into keratinocyte death during aphthous stomatitis. A case-crossover study
Authors: Cofré-Leiva Camila , Camargo-Ayala Paola Andrea , Vergara-Pérez Angela , Hernández-Olivos Romina , Sanhueza Sergio , Nova-Lamperti Estefanía , Zúñiga-Hernández Jessica , Rivera César 
Published: May 2023

Abstract
Background
The death of oral keratinocytes is a crucial step in the emergence of recurrent aphthous stomatitis (RAS, also known as aphthae or aphthous ulcers). Since there are no experimental models available to research aphthous ulcers, little is understood about this process. We hypothesize that saliva can be a data bank of information that offers insights on epithelial damage.

Methods
In this case-crossover study, we assessed the salivary proteome of patients with RAS (n = 36) in the presence and absence of ulcers using discovery proteomics and bioinformatics. Additionally, we contrasted these patterns with those of healthy individuals (n = 31) who had no prior aphthous ulceration.

Results
Salivary proteome showed that during the ulcerative phase, controlled cell death was downregulated. Due to its ability to distinguish between individuals with and without ulcers, the ATF6B protein raises the possibility that endoplasmic reticulum (ER) stress is responsible for the damage that leads to the death of oral keratinocytes. The high abundance of TRAP1 and ERN1 matches with this biological discovery. The type of death is immunogenic, according to the functional data found in a cell death database.

Conclusion
We identified a cellular process that can lead to the death of oral keratinocytes in the etiopathogenesis process of RAS. Future studies should be conducted to identify what is responsible for the increase in ER stress signaling that would lead to an anti-cell death response.
Research efficacy of gaseous ozone therapy as an adjuvant to periodontal treatment on oxidative stress mediators in patients with type 2 diabetes: a randomized clinical trial
Authors: Rapone Biagio , Ferrara Elisabetta , Qorri Erda , Inchingolo Francesco , Isola Gaetano , Dongiovanni Paola , Tartaglia Gianluca Martino , Scarano Antonio 
Published: May 2023

Abstract
Background
Chronic inflammation and cumulative oxidative stress have been theorized as two common pathways of the interconnection between periodontitis and diabetes. Improvement in oxidizing status has been demonstrated in periodontal patients with diabetes treated with proper non-surgical periodontal treatment. In addition to periodontal treatment, Gaseous ozone therapy has been reported to possess anti-inflammatory properties and the ability to stimulate the endogenous antioxidant defence mechanism. To date, the antioxidant effect of gaseous ozone, in addition with periodontal treatment in diabetic patients, has been examined in only one study. The aim of this study was to determine the efficacy of gaseous ozone therapy as an alternative approach to supporting non-surgical periodontal therapy (NSPT), aimed at improving antioxidant machinery and interfering with ROS production on plasma levels in diabetic individuals diagnosed with moderate or severe periodontitis.

Methods
One hundred and eighty patients with periodontitis and type 2 diabetes mellitus were randomly assigned to receive non-surgical periodontal treatment (NSPT) plus gaseous ozone therapy (A) NSPT alone (B). Clinical and periodontal parameters -Bleeding on probing (BOP), Periodontal pocket depth (PPD), and Clinical attachment Level (CAL)- and plasma levels of oxidant-antioxidant (TOS- TAOS) levels, glutathione (GSH), and malondialdehyde (MDA) were recorded at baseline and at 3- (T1) and at 6-months (T2) after treatment.

Results
Both treatments were efficacious in reducing clinical parameters. However, there were no significant differences regarding oxidative stress parameters in group A compared to group B.

Conclusions
In the present study, gaseous ozone therapy did not enhance the effect of periodontal treatment in reducing oxidative stress in plasma levels of periodontitis patients with type II diabetes.

Trial registration
The study was registered with ISRCTN1728169 (23/07/2022).
Influence of a new abutment design concept on the biomechanics of peri-implant bone, implant components, and microgap formation: a finite element analysis
Authors: Nie Huimin , Tang Yantai , Yang Yan , Wu Weijie , Zhou Wenjuan , Liu Zhonghao 
Published: May 2023

AbstractBackgroundA new two-piece abutment design consisting of an upper prosthetic component and tissue-level base has been introduced; however, the biomechanical behavior of such a design has not been documented. This study aimed to investigate the effect of a two-piece abutment design on the stress in the implant components and surrounding bone, as well as its influence on microgap formation.MethodsTo simulate the implant models in the mandibular left first molar area, we established nine experimental groups that included three bone qualities (type II, III, and IV) and three implant–abutment designs (internal bone level, tissue level, and a two-piece design). After the screw was preloaded, the maximum occlusal (600 N) and masticatory (225 N) forces were established. Finite element analysis was performed to analyze the maximum and minimum principal stresses on the peri-implant bone; the von Mises stresses in the implants, abutments, bases, and screws, and the microgaps at the implant–abutment, implant–base, and base–abutment interfaces.ResultsFor all three loading methods, the two-piece abutment design and bone-level connection exhibited similarities in the maximum and minimum principal stresses in the peri-implant bone. The von Mises stresses in both screws and bases were greater for the two-piece design than for the other connection types. The smallest microgap was detected in the tissue-level connection; the largest was observed at the implant–base interface in the two-piece design.ConclusionsThe present study found no evidence that the abutment design exerts a significant effect on peri-implant bone stress. However, the mechanical effects associated with the base and screws should be noted when using a two-piece abutment design. The two-piece abutment design also had no advantage in eliminating the microgap.
The lasting impact of COVID-19 on surgical training from the perspective of surgical residents and consultants in Saudi Arabia: a nationwide cross-sectional study
Authors: Qedair Jumanah T. , Alnahdi Wejdan A. , Mortada Hatan , Alnamlah Abdulrahman A. , Almadani Raghad Z. , Hakami Alqassem Y. 
Published: May 2023

Abstract
Background
Since the start of the COVID-19 pandemic, many precautionary measures have been set to curb the transmission of the virus. That has led to changes, most notably in surgical education, like lack of surgical exposure and clinical activities. However, the question aiming at the impact of changes made by the COVID-19 pandemic on surgical education and its extent remains unanswered.

Materials & methods
An electronic survey was distributed among surgical residents and consultants from all over Saudi Arabia, starting from the 6th till the 21st of July, 2021. Descriptive statistics were presented using counts and proportions (%). Study subjects were compared with the different perspectives during the COVID-19 pandemic by using Chi-square test. A p-value cut-off point of 0.05 at 95% CI was used to determine statistical significance.

Results
A total of 243 out of 500 surgical residents and consultants responded to the survey, giving a response rate of 48.6%. The majority were general surgeons (50.5%) and cardiothoracic surgeons (21.8%). Nearly 66% of surgeons, both residents and consultants, strongly agreed on the importance of training for infectious disease outbreaks. 44.7% of the consultants and 48% of the residents showed their willingness to respond to the pandemic regardless of its severity. Over 70% of surgeons agreed that developing clinical skills was compromised by the COVID-19 pandemic, and 40% expected a negative impact of the COVID-19 on their operative skills. Simulation was ranked best for disaster medicine training by over 77% of the respondents. The most common concern among surgeons during the COVID-19 pandemic was their family’s health and safety. Regarding virtual curriculum components, online practice questions and surgical videos were preferred by the surgical consultant and resident, respectively.

Conclusions
Although the COVID-19 pandemic has impacted surgical education, it has highlighted the alarming need for adopting new components. For surgical training programs, we recommend improving the virtual curriculum, incorporating disaster medicine training, providing psychological services, and prioritizing immunization and treatment access for surgeons’ families.
Trends in the distribution of socioeconomic inequalities in smoking and cessation: evidence among adults aged 18 ~ 59 from China Family Panel Studies data
Authors: Huang Ming Zhao , Liu Tai Yi , Zhang Zhong Min , Song Fujian , Chen Ting 
Published: May 2023

Abstract
Introduction
Cigarette smoking is usually more prevalent among those with a lower socioeconomic status (SES), which can be driven by inequalities in the initiation and cessation of smoking, giving rise to SES disparities in health. This study aimed to gauge the SES inequalities in smoking related behaviours and their evolving trends based on a nationally representative database.

Method
Data were extracted from repeated cross-sectional China Family Panel Studies (CFPS) of adults aged ≥18 and <60 years in 2012, 2014, 2016 and 2018. SES was constructed by principal component analysis based on income, education and occupation. Regression-based odds ratios and coefficients as the relative effect index of inequality were applied to quantify the degree of socioeconomic inequality in smoking related behaviours and to adjust for possible confounding factors. Multivariable regressions were utilized to explore the temporal trends in smoking inequalities.

Results
The smoking prevalence among men decreased from 61.16% to 2012 to 57.88% in 2018, cigarette consumption among current smokers declined from 16.71 to 15.49 cigs/per day, and the cessation rate increased from 17.55% to 24.08%. Cigarette consumption for women decreased from 13.39 in 2012 to 11.01 cigs/per day in 2018. Smoking prevalence showed significant SES inequalities among men and women from 2012 to 2018 (men: OR2012 (95%CI)= 0.72 (0.63, 0.83), OR2014 = 0.60 (0.52, 0.69), OR2016 = 0.58 (0.50, 0.67), OR2018 = 0.56 (0.48, 0.66); women: OR2012 = 0.63 (0.41, 0.97), OR2014 = 0.50 (0.32, 0.79), OR2016 = 0.44 (0.26,  0.73), OR2018 = 0.50 (0.30,  0.85)). Cigarette consumption showed significant SES inequalities among men from 2012 to 2018 (β2012=-1.39 (-2.22, -0.57), β2014=-2.37 (-3.23, -1.50), β2016=-2.35 (-3.25, -1.44), β2018=-2.91 (-3.86, -1.97)). In 2018, inequality emerged in smoking cessation rates among men and smoking intensity among women. However, all tests for trends in changes over time were not statistically significant (P varied from 0.072 to 0.602).

Conclusion
The smoking prevalence declined between 2012 and 2018 in China. However, SES inequalities in smoking persist, while socioeconomic inequalities in smoking were not alleviated among adults aged 18 ~ 59 in China. Tobacco control measures should be implemented by giving more attention to people with lower SES who are more vulnerable to tobacco use.
Gut microbiome combined with metabolomics reveals biomarkers and pathways in central precocious puberty
Authors: Huang Xiaoyan , Chen Jixiong , Zou Haozhe , Huang Peng , Luo Hailing , Li Haidan , Cai Yuhua , Liu Li , Li Yongsheng , He Xiaojie , Xiang Wei 
Published: May 2023

Abstract
Background
Central precocious puberty (CPP) is a common disease in prepubertal children and results mainly from disorders in the endocrine system. Emerging evidence has highlighted the involvement of gut microbes in hormone secretion, but their roles and downstream metabolic pathways in CPP remain unknown.

Methods
To explore the gut microbes and metabolism alterations in CPP, we performed the 16S rRNA sequencing and untargeted metabolomics profiling for 91 CPP patients and 59 healthy controls. Bioinformatics and statistical analyses, including the comparisons of alpha and beta diversity, abundances of microbes, were undertaken on the 16S rRNA gene sequences and metabolism profiling. Classifiers were constructed based on the microorganisms and metabolites. Functional and pathway enrichment analyses were performed for identification of the altered microorganisms and metabolites in CPP.

Results
We integrated a multi-omics approach to investigate the alterations and functional characteristics of gut microbes and metabolites in CPP patients. The fecal microbiome profiles and fecal and blood metabolite profiles for 91 CPP patients and 59 healthy controls were generated and compared. We identified the altered microorganisms and metabolites during the development of CPP and constructed a machine learning-based classifier for distinguishing CPP. The Area Under Curves (AUCs) of the classifies were ranged from 0.832 to 1.00. In addition, functional analysis of the gut microbiota revealed that the nitric oxide synthesis was closely associated with the progression of CPP. Finally, we investigated the metabolic potential of gut microbes and discovered the genus Streptococcus could be a candidate molecular marker for CPP treatment.

Conclusions
Overall, we utilized multi-omics data from microorganisms and metabolites to build a classifier for discriminating CPP patients from the common populations and recognized potential therapeutic molecular markers for CPP through comprehensive analyses.
Polyetheretherketone (PEEK) rods versus titanium rods for posterior lumbar fusion surgery: a systematic review and meta-analysis
Authors: Li Wenhao , Zhao He , Li Chuanhong , Liu Tao , Guan Jianbin , Yang Yongdong , Yu Xing 
Published: May 2023

Abstract
Background
Rigid fixation, represented by titanium rods, is a widely used fixation technique for lumbar fusion. However, this technique carries the risk of degeneration of adjacent segments. In recent years, the semi-rigid fixation technique represented by PEEK rods has gradually matured, and its effectiveness has been verified by numerous studies. The aim of this study was to systematically evaluate the effectiveness of these two fixation modalities in posterior lumbar fusion surgery.

Methods
Studies meeting the inclusion criteria were searched in PubMed, Cochrane Library, ScienceDirect, Embase, CNKI, and Wanfang databases. After data extraction and quality assessment of included studies, meta-analysis was performed using STATA 15.1 software. The protocol for this systematic review was registered on INPLASY (2021110049) and is available in full on the inplasy.com (https://inplasy.com/inplasy-2021-11-0049/).

Results
Fifteen relevant studies were finally included, including eight prospective studies and seven retrospective studies. The results of meta-analysis showed that in ODI (P = 0.000), JOA score (P = 0.017), VAS score for lower limb pain (P = 0.027), fusion rate of bone graft at week 12 (P = 0.001), fusion rate of bone graft at last follow-up (P = 0.028), there was a statistical difference between the two groups. The PEEK rod group was superior to the titanium rod group in the above aspects. While in VAS score for LBP (P = 0.396), there was no statistical difference between the two groups.

Conclusion
Both PEEK rods and titanium rods are effective fixation materials in lumbar fusion surgery. PEEK rods may be superior to titanium rods in improving postoperative function and improving bone graft fusion rates. However, given the limitations of this study, whether these conclusions are applicable needs further research.
Recurrent embolic strokes due to antiphospholipid syndrome and non-bacterial thrombotic endocarditis in a patient with basal cell carcinoma
Authors: Svantner Julianna , Lavanchy Luc , Labouchère Ania 
Published: May 2023

Abstract
Background
Non-Bacterial Thrombotic Endocarditis (NBTE) is a common form of aseptic thrombotic endocarditis that primarily affects mitral valves and less frequently aortic valves. NBTE is caused by systemic inflammatory reactions. This condition induces valve thickening or attached sterile mobile vegetation. NBTE is mostly asymptomatic; however, major clinical manifestations result from systemic emboli rather than valve dysfunction. When significant damage occurs, valvular insufficiency or stenosis can appear and promote heart failure occasionally requiring valve replacement surgery. NBTE is associated with hypercoagulable states, systemic lupus erythematous (SLE), antiphospholipid syndrome, or malignancies.

Case presentation
We report successful biological aortic valve replacement surgery including cardiopulmonary bypass for a 78-year-old man with NBTE and voluminous vegetation on the aortic valve inducing moderate aortic insufficiency and acute heart failure. The histopathological analysis of the valve sample showed myxoid degeneration, fibrous remodeling, and partial necrosis without any bacteria, thus indicating marantic endocarditis. Initially, the patient presented to the emergency department with an acute stroke. He was already using Apixaban treatment for a history of atrial fibrillation and cardioembolic stroke. Because of the recurrence of stroke and appearance of aortic vegetation, the investigations were extended. The antiphospholipid antibodies were positive without any indication of bacterial endocarditis. The malignancy screening was positive for basal cell carcinoma (BCC). The surgery and postoperative course were uneventful, and the patient was discharged with vitamin K antagonists (VKA). To our knowledge, NBTE with such a volume is rare and its apparent association with BCC has not been previously reported.

Conclusion
Outside of SLE and antiphospholipid syndrome, NBTE is a rare and underdiagnosed disease associated with thromboembolic events. Adequate anticoagulation is a cornerstone of its treatment. Anticoagulation management during perioperative care and valve surgery deserves specific attention and helps to protect the patient from embolic complications. In the case of stroke and thromboembolic events of unclear cause or suspected NBTE, echocardiography and thrombophilia assessments including an immunological workup are recommended.
Pulmonary artery sarcoma: an unexpected settler in the right ventricular outflow tract
Authors: Hu Hui-min , Li Yi-dan , Wei Chang-wei , liu Yan , lv Xiu-zhang , Yang Yuan-hua 
Published: May 2023

AbstractPulmonary artery sarcoma (PAS) is a sporadic malignant tumor that mainly originates from the pulmonary arteries. However, PAS may also involve the right ventricular outflow tract (RVOT) and lead to obstruction, syncope, or sudden death. Early diagnosis and complete surgical resection are essential to prolong survival and improve the quality of life of patients with PAS. Herein, we report a case of a young female patient admitted for pulmonary malignancy and acute pulmonary embolism. The patient had a mass in the RVOT, which was detected by transthoracic echocardiography. Computed tomography and magnetic resonance imaging revealed the invasion depth and extent of the lesions. Surgical resection improved hemodynamics, while pathological and immunohistochemical tests confirmed the diagnosis of a pulmonary artery sarcoma. Local recurrence was detected in the adjacent tissues about two months after the surgery. Given the potential risk of reoperation, the patient was suggested to undergo conservative treatment.