bluuebunny/crossref_metadata_2025_split huggingface dataset:
New-onset stroke on the risk of hip fracture: the Kailuan cohort study in China
Authors: Zhang Nan , Guo Lu , Yu Yaohui , Chen Shuohua , Gao Lishu , Hou Xiaoli , Tian Faming , Wu Shouling 
Published: May 2023

Abstract
Purpose
Stroke is a documented risk factor for hip fracture(HF). However, no data is currently available on this issue in mainland China, we therefore assessed the risk of hip fracture after new-onset stroke using a cohort study.

Methods
This study included 165,670 participants without a history of stroke at baseline from the Kailuan study. All participants were followed biennially until December 31, 2021. During follow-up, a total of 8,496 new-onset stroke cases were identified. For each case subject, four control subjects was randomly selected, matched for age (± 1 years) and sex. The final analysis comprised 42,455 pair-matched cases and controls. A multivariate Cox proportional hazard regression model was used to estimate the effect of new-onset stroke on the risk of hip fracture.

Results
During an average follow-up of 8.87 (3.94) years, a total of 231 hip fracture cases occurred, 78 cases in the stroke group and 153 cases in the control group, with incidence rates of 1.12 and 0.50 per 1000 person-years, respectively. The cumulative incidence of the stroke group was higher than that of the controls (P < 0.01). The adjusted hazard ratio (95% confidence interval) of hip fractures in the stroke group was 2.35 (1.77 to 3.12) (P < 0.001) to controls. After stratifying by gender, age, and body mass index, the higher risk was revealed in female (HR 3.10, 95 CI: 2.18 to 6.14, P < 0.001), age < 60 years old (HR 4.12, 95% CI: 2.18 to 7.78, P < 0.001), and non-obesity (BMI<28 kg/m2) (HR 1.74, 95% CI:1.31 to 2.31, P < 0.001) subgroup.

Conclusions
Stroke significantly increases the risk of hip fracture, strategy for protecting stroke patients from falls and hip fractures should be emphasized in poststroke long-term management, particularly the female, age < 60 years old, and non-obese patients.
Biomechanical effect of endplate defects on the intermediate vertebral bone in consecutive two-level anterior cervical discectomy and fusion: a finite element analysis
Authors: Zhang Jiarui , Chen Wenzhao , Weng Rui , Liang De , Jiang Xiaobing , Lin Hongheng 
Published: May 2023

Abstract
Background
Intermediate vertebral collapse is a newly discovered complication of consecutive two-level anterior cervical discectomy and fusion (ACDF). There have been no analytical studies related to the effects of endplate defects on the biomechanics of the intermediate vertebral bone after ACDF. This study aimed to compare the effects of endplate defects on the intermediate vertebral bone biomechanics in the zero-profile (ZP) and cage-and-plate (CP) methods of consecutive 2-level ACDF and to determine whether collapse of the intermediate vertebra is more likely to occur using ZP.

Methods
A three-dimensional finite element (FE) model of the intact cervical spine (C2–T1) was constructed and validated. The intact FE model was then modified to build ACDF models and imitate the situation of endplate injury, establishing two groups of models (ZP, IM-ZP and CP, IM-ZP). We simulated cervical motion, such as flexion, extension, lateral bending and axial rotation, and compared the range of motion (ROM), upper and lower endplate stress, fusion fixation device stress, C5 vertebral body stress, intervertebral disc internal pressure (intradiscal pressure, or IDP) and the ROM of adjacent segments in the models.

Results
There was no significant difference between the IM-CP model and the CP model in the ROM of the surgical segment, upper and lower endplate stress, fusion fixation device stress, C5 vertebral body stress, IDP, or ROM of the adjacent segments. Compared with the CP model, the endplate stress of the ZP model is significantly higher in the flexion, extension, lateral bending and axial rotation conditions. Compared with the ZP model, endplate stress, screw stress, C5 vertebral stress and IDP in IM-ZP were significantly increased under flexion, extension, lateral bending and axial rotation conditions.

Conclusions
Compared to consecutive 2-level ACDF using CP, collapse of the intermediate vertebra is more likely to occur using ZP due to its mechanical characteristics. Intraoperative endplate defects of the anterior lower margin of the middle vertebra are a risk factor leading to collapse of the middle vertebra after consecutive 2-level ACDF using ZP.
Computerized dynamic occlusal analysis and its correlation with static characters in post-orthodontic patients using the T-Scan system and the ABO objective grading system
Authors: Wang Menglin , Liu Le , Ma Xihua , Jin Xiang , Zhang Zhenbao , Jia Xiangmin , Fan Jiadong , Tang Haoning , Li Yanfeng 
Published: May 2023

Abstract
Objectives
This study was conducted to detect the overall performance of both static and dynamic occlusion in post-orthodontic patients using quantified methods, and to ascertain the correlation between the two states of occlusion.

Materials and methods
A total of 112 consecutive patients evaluated by ABO-OGS were included in this study. Based on the pre-treatment Angle’s classification of the malocclusion, samples were divided into four groups. After removing orthodontic appliances, each patients underwent the American Board of Orthodontic objective grading system (ABO-OGS) and T-Scan evaluations. All the scores were compared within these groups. Statistical evaluation included reliability tests, multivariate ANOVA, and correlation analyses (p < 0.05 was considered significant).

Results
The mean ABO-OGS score was satisfactory and did not differ by Angle classifications. The indices making substantial contributions to ABO-OGS were occlusal contacts, occlusal relationships, overjet, and alignment. Disocclusion time in post-orthodontic patients was longer than normal. Occlusion time, disocclusion time, and force distribution during dynamic motions were considerably influenced by static ABO-OGS measurements, especially occlusal contacts, buccolingual inclination, and alignment.

Conclusion
Post-orthodontic cases that passed the static evaluation of clinicians and ABO-OGS may nevertheless be left with dental casts interference in dynamic motions. Both static and dynamic occlusion should be extensively evaluated before ending orthodontic treatment. Further research is needed on dynamic occlusal guidelines and standards.
Survival analysis of implants after surgical treatment of peri-implantitis based on bone loss severity and surgical technique: a retrospective study
Authors: Hwang Sooshin , Lee Hee-min , Yun Pil-Young , Kim Young-Kyun 
Published: May 2023

AbstractBackgroundFew trials have compared the results of surgical treatment for peri-implantitis based on severity of peri-implantitis and surgical method. This study investigated the survival rate of implants based on type of surgical method used and initial severity of peri-implantitis. Classification of severity was determined based on bone loss rate relative to fixture length.MethodsMedical records of patients who underwent peri-implantitis surgery from July 2003 to April 2021 were identified. Classification of peri-implantitis was divided into 3 groups (stage 1: bone loss < 25% (of fixture length), stage 2: 25% < bone loss < 50%, stage 3: bone loss > 50%) and performance of resective or regenerative surgery was investigated. Kaplan-Meier survival curves and Cox hazards proportional models were used to analyze the cumulative survival rate of implants. Median survival time, predicted mean survival time, hazard ratio (HR), and 95% confidence interval (CI) were calculated.ResultsBased on Kaplan-Meier analysis, 89 patients and 227 implants were included, and total median postoperative survival duration was 8.96 years. Cumulative survival rates for stage 1, 2, and 3 were 70.7%, 48.9%, and 21.3%, respectively. The mean survival time for implants in stage 1, 2, and 3 was 9.95 years, 7.96 years, and 5.67 years, respectively, with statistically significant difference (log-rank p-value < 0.001). HRs for stage 2 and stage 3 were 2.25 and 4.59, respectively, with stage 1 as reference. Significant difference was not found in survival time between resective and regenerative surgery groups in any peri-implantitis stage.ConclusionsThe initial bone loss rate relative to the fixture length significantly correlated with the outcome after peri-implantitis surgery, demonstrating a notable difference in the long-term survival rate. Difference was not found between resective surgery and regenerative surgery in implant survival time. Bone loss rate could be utilized as a reliable diagnostic tool for evaluating prognosis after surgical treatment, regardless of surgical method used.Trial registrationRetrospectively registered. (KCT0008225)
Pre-dental treatment screening in Indonesia during the COVID-19 pandemic: a questionnaire survey of dental practitioners
Authors: Widyarman Armelia Sari , Roeslan Moehamad Orliando , Dewanto Iwan 
Published: May 2023

Abstract
Background
Dental practitioners have a high risk of contracting COVID-19 during the treatment of patients because of exposure to airborne droplets. However, the application of pre-procedure treatment screening in dental practices in Indonesia varied during the pandemic. The purpose of this study was to investigate the use of updated pre-procedure dental treatment protocols and procedures among dental practitioners in Indonesia.

Methods
This study consisted of dentists registered as members of the Indonesian Dental Association who attended the Indonesian Dental Association webinar series in 2021. All the participants completed a questionnaire survey. The participants, who were from various regions in Indonesia, were granted password-protected access to a URL hosting the questionnaire. The questionnaire collected demographic information and contained questions on adherence to updated protocols and patient screening procedures, to which the respondents answered “Yes” or “No”. For the analysis, the participants were divided into three groups based on the type of facility where they were employed: public (government) hospitals, private hospitals, or university hospitals (dental schools). A chi-square test was used to investigate the association between professional background and the implementation of updated protocols, including pre-procedure dental treatment screening. A value of P < 0.05 was considered statistically significant.

Results
The age range of the participants was 20 − 60 years. The participants worked in facilities in 32 provinces in Indonesia. In total, there were 5,323 participants (males: n = 829; females: n = 4,494). In terms of professional backgrounds, 2,171, 2,867, and 285 participants were employed in government hospitals, private hospitals, and dental faculties, respectively. Among 5,232 participants who implemented updated COVID-19 prevention protocols, 5,053 (98%) participants performed pre-surgery procedures Among 151 participants who did not implement updated COVID-19 prevention protocols, 133 (88%) individuals carried out pre-rinse procedures.

Conclusions
Almost all the dental practitioners employed in government hospitals, private hospitals, and dental faculties in Indonesia performed pre-surgery patient screening procedures. There was an agreement between the dental professionals in all three settings on the need for COVID-19 pre-treatment screening procedures in dental practices during the COVID-19 pandemic.
Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis
Authors: Werawatganon Duangporn , Vivatvakin Sarocha , Somanawat Kanjana , Tumwasorn Somying , Klaikeaw Naruemon , Siriviriyakul Prasong , Chayanupatkul Maneerat 
Published: May 2023

Abstract
Background
Severe acute pancreatitis is a potentially life-threatening disease. Despite being a common disorder, acute pancreatitis lacks a specific treatment. The present study aimed to examine the effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis.

Methods
Male ICR mice were randomly divided into 4 groups (n = 6 per group). The control group received two intraperitoneal (i.p.) injections of normal saline as a vehicle control. The acute pancreatitis (AP) group received two i.p. injections of L-arginine 450 mg/100 g body weight. AP plus probiotics groups received L-arginine to induce acute pancreatitis as above. In the single-strain and mixed-strain groups, mice received 1 mL of Lactobacillus plantarum B7 1 × 108 CFU/mL and 1 mL of Lactobacillus rhamnosus L34 1 × 108 CFU/mL and Lactobacillus paracasei B13 1 × 108 CFU/mL by oral gavage, respectively for 6 days starting 3 days prior to the AP induction. All mice were sacrificed 72 h after L-arginine injection. Pancreatic tissue was obtained for histological evaluation and immunohistochemical studies for myeloperoxidase, whereas ileal tissue was used for immunohistochemical studies for occludin, and claudin-1. Blood samples were collected for amylase analysis.

Results
Serum amylase levels and pancreatic myeloperoxidase levels in the AP group were significantly higher than in controls and significantly decreased in probiotic groups compared with the AP group. Ileal occludin and claudin-1 levels were significantly lower in the AP group than in controls. Ileal occludin levels significantly increased, whereas ileal claudin-1 levels did not significantly change in both probiotic groups as compared with the AP group. The pancreatic histopathology showed significantly higher degree of inflammation, edema, and fat necrosis in the AP group, and these changes improved in mixed-strained probiotic groups.

Conclusions
Probiotics, particularly the mixed-strain ones, attenuated AP via the reduction of inflammation and the maintenance of intestinal integrity.
The effects of developmental model of peer observation on the virtual teaching quality of basic medical sciences faculty
Authors: Doroh Mohammad Habibi , Farajpour Arezou , Amirmajdi Elham Mokhtari 
Published: May 2023

Abstract
Background
After the Corona pandemic, medical education has shifted to virtual education, but there has been limited time and possibilities for empowering faculty for this purpose. Therefore, it seems necessary to evaluate the quality of the provided training and provide feedback to the faculty in order to improve the quality of training. The purpose of this study was to investigate the effect of teacher formative evaluation by peer observation method on the quality of virtual teaching of basic medical sciences faculty.

Methods
In this study, seven trained faculty members observed and based on a checklist evaluated the quality of 2 virtual sessions taught by each faculty of basic medical sciences, and provided them feedback; after at least 2 weeks, their Virtual teachings were again observed and evaluated. The results before and after providing feedback were compared through SPSS software.

Results
After intervention, significant improvements were observed in the average scores of “overall virtual performance”, “virtual classroom management” and “content quality”. Specifically, there was a significant increase in the average score of “overall virtual performance” and “virtual class management” among female faculty, and the average score of “overall virtual performance” among permanently employed faculty members with more than 5 years of teaching experience, before and after intervention (p < 0.05).

Conclusion
Virtual and online education can be a suitable platform for the implementation of formative and developmental model of peer observation of faculty; and should be considered as an opportunity to empower and improve the quality of the faculty’ performance in virtual education.
The impact of pandemic disruptions on clinical skills learning for pre-clinical medical students: implications for future educational designs
Authors: Saad Shannon , Richmond Cassandra , King Dane , Jones Caelyn , Malau-Aduli Bunmi 
Published: May 2023

AbstractBackgroundPandemic disruptions to medical education worldwide resulted in rapid adaptations to clinical skills learning. These adaptations included moving most teaching to the online environment, decreasing the accepted “hands-on” methods of teaching and learning. While studies have shown significant impacts on student confidence in skills acquisition, there is a paucity of assessment outcome studies which would contribute a valuable perspective on whether measurable deficits were incurred. Here, a preclinical (Year 2) cohort was investigated for clinical skills learning impacts that could influence their transition to hospital-based placements.MethodsA sequential mixed methods approach was used on the Year 2 Medicine cohort, including: focus group discussions with thematic analysis; a survey derived from the themes observed; and a cohort comparison of the clinical skills examination results of the disrupted Year 2 cohort, compared to pre-pandemic cohorts.ResultsStudents reported experiencing benefits and disadvantages of the shift to online learning, including a decrease in confidence in their skills acquisition. End of year summative clinical assessments showed non-inferior outcomes when compared to previous cohorts for the majority of clinical skills. However, for procedural skills (venepuncture) the disrupted cohort had significantly lower scores compared to a pre-pandemic cohort.ConclusionsRapid innovation during the COVID-19 pandemic provided the opportunity to compare online asynchronous hybrid clinical skills learning with the usual practice of face-to-face synchronous experiential learning. In this study, students’ reported perceptions and assessment performance data indicate that careful selection of skills suitable for online teaching, supported by timetabled “hands-on” sessions and ample practice opportunities, is likely to provide non-inferior outcomes for clinical skills learning in students about to transition to clinical placements. The findings can be used to inform clinical skills curriculum designs that incorporate the virtual environment, and assist with future-proofing skills teaching in the case of further catastrophic disruptions.
Medical school origins of award-winning surgeons; analysis of a complete national dataset
Authors: Steele S. , Andrade G. , Sambandan N. 
Published: May 2023

Abstract
Background
Britain attracts doctors from all over the world to work in the National Health Service. Elucidating the educational backgrounds of award-winning doctors working in the country is potentially an important medical education issue and merit award audit. Using the British clinical merit award schemes as outcome measures, we identify medical school origins of award-winning doctors who have been identified as having achieved national or international prominence.

Methods
The Clinical Excellence Awards/Distinction Awards schemes select doctors in Britain who are classified as high achievers, with categories for national prominence and above. We used this outcome measure in a quantitative observational analysis of the 2019 dataset of all 901 award-winning doctors. Pearson's Chi-Square test was used where appropriate.

Results
Seven medical schools (London university medical schools, Glasgow, Edinburgh, Aberdeen, Oxford, Cambridge and Manchester) accounted for 52.7% of the surgical award-winning doctors in the 2019 round, despite the dataset representing 85 medical schools. Surgeons with the lower grade national awards came from a more diverse educational background of 43 medical schools. International medical graduates accounted for 16.1% of the award-winning surgeons and 9.8% of the award-winning non-surgeons. 87.1% of the surgical award-winners were from European medical schools, whereas 93.2% of the non-surgical award-winners were from European medical schools.

Conclusions
The majority of the award-winning surgeons originated from only seven, overrepresented, medical schools. A greater diversity of medical school origin existed for the lowest grade national merit awards. These comprised 43 medical schools and indicated greater globalization effects in this category. International medical graduates contributed substantially to these award holders; surgical award-winners were more likely to be international medical graduates (16.1%) than non-surgical award-winners (9.8%). This study not only indicates educational centres associated with the production of award-winners but also provides students with a roadmap for rational decision making when selecting medical schools.
Extracellular arginine availability modulates eIF2α O-GlcNAcylation and heme oxygenase 1 translation for cellular homeostasis
Authors: Hung Yu-Wen , Ouyang Ching , Ping Xiaoli , Qi Yue , Wang Yi-Chang , Kung Hsing-Jien , Ann David K. 
Published: May 2023

Abstract
Background
Nutrient limitations often lead to metabolic stress during cancer initiation and progression. To combat this stress, the enzyme heme oxygenase 1 (HMOX1, commonly known as HO-1) is thought to play a key role as an antioxidant. However, there is a discrepancy between the level of HO-1 mRNA and its protein, particularly in cells under stress. O-linked β-N-acetylglucosamine (O-GlcNAc) modification of proteins (O-GlcNAcylation) is a recently discovered cellular signaling mechanism that rivals phosphorylation in many proteins, including eukaryote translation initiation factors (eIFs). The mechanism by which eIF2α O-GlcNAcylation regulates translation of HO-1 during extracellular arginine shortage (ArgS) remains unclear.

Methods
We used mass spectrometry to study the relationship between O-GlcNAcylation and Arg availability in breast cancer BT-549 cells. We validated eIF2α O-GlcNAcylation through site-specific mutagenesis and azido sugar N-azidoacetylglucosamine-tetraacylated labeling. We then evaluated the effect of eIF2α O-GlcNAcylation on cell recovery, migration, accumulation of reactive oxygen species (ROS), and metabolic labeling during protein synthesis under different Arg conditions.

Results
Our research identified eIF2α, eIF2β, and eIF2γ, as key O-GlcNAcylation targets in the absence of Arg. We found that O-GlcNAcylation of eIF2α plays a crucial role in regulating antioxidant defense by suppressing the translation of the enzyme HO-1 during Arg limitation. Our study showed that O-GlcNAcylation of eIF2α at specific sites suppresses HO-1 translation despite high levels of HMOX1 transcription. We also found that eliminating eIF2α O-GlcNAcylation through site-specific mutagenesis improves cell recovery, migration, and reduces ROS accumulation by restoring HO-1 translation. However, the level of the metabolic stress effector ATF4 is not affected by eIF2α O-GlcNAcylation under these conditions.

Conclusions
Overall, this study provides new insights into how ArgS fine-tunes the control of translation initiation and antioxidant defense through eIF2α O-GlcNAcylation, which has potential biological and clinical implications.