bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual inspection of root patterns and radiographic estimation of its canal configurations by confirmation using sectioning method. An ex vivo study on maxillary first premolar teeth
Authors: Faraj Bestoon Mohammed , Abdulrahman Mewan Salahaldeen , Faris Tavga Mustafa 
Published: May 2022

Abstract
Background
A thorough understanding of the original root and canal anatomy is a critical technical prerequisite for performing cleaning and shaping treatments. Therefore, this research aimed to characterize maxillary first premolar teeth' root morphology and canal architecture.

Methods
One hundred forty-two extracted human adult maxillary first premolar teeth have been retrieved. The extracted teeth were thoroughly cleaned and irrigated to eliminate any remaining debris or blood. They were then preserved in formalin solution until they were eligible for screening. To begin, a visual examination was employed to ascertain the number of roots and their geometry in each sample. Then, utilizing digital radiography in two plains, mesiodistal and distomesial, to further determine those parameters. Finally, a sectioning technique had been used to have the samples cut mesiodistally into slices to validate the internal root canal architecture and identify the number of root canals and their varieties in accordance with Vertucci's categorization system. The canal layout, the pulp chamber, and the root canals were all highlighted (marked) using a fine tip marker in a permanent orange hue to make the canal features more accessible and accurate to visualize. All of the processes were conducted by two highly qualified dentists. The sample size was estimated statistically using the Sealed Envelope program, and the percentage of each configuration was derived in proportion to the overall sample size in order to establish the percentage of each type in each configuration.

Results
From the 142 teeth examined, 42 (29.57%) had one root, 97 (68.31%) had two roots, and only three premolars (2.12%) had three roots. Concerning canal configurations, 100 teeth (70.43%) had type (IV) canal configuration, followed by 37 teeth (26.05%) had types (V), three teeth (2.12%) had type (VIII), and one tooth (0.70%) for each of type (I) and type (II).

Conclusions
The anatomical pattern of inspected maxillary first premolars are mainly two rooted and predominantly have a type (IV) canal morphology.
Factors affecting academic burnout of nursing students according to clinical practice experience
Authors: Hwang Eunhee , Kim Jeonghyun 
Published: May 2022

Abstract
Background
Academic burnout has a negative effect on learning outcomes of nursing students. Factors affecting academic burnout may differ depending on whether or not they have experience in clinical practice and identifying these differences would be necessary to seek for strategies to lower academic burnout of nursing students. This study aimed to determine the effects of stress, depression, and anxiety on academic burnout according to the clinical practice experience of nursing students.

Methods
Data were collected from 171 female nursing students in South Korea. Self-report questionnaires from 83 participants without clinical practice experience and 88 with clinical practice experience were analyzed using descriptive statistics, χ2-tests, analysis of variance, t-test, Spearman correlation coefficient, and stepwise multiple regression.

Results
Academic burnout was positively correlated to stress (r = .52, p < .001), anxiety (r = .50, p < .001) and depression (r = .44, p < .001). In those students with no clinical practice experience, anxiety and depression explained for academic burnout by 44%, and those students with clinical practice experience, stress and major satisfaction explained for 33% of academic burnout.

Conclusions
Universities and clinical institutions should establish a cooperative system to reduce stress, depression and anxiety and increase major satisfaction.
Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: a worked example from a study of cervical screening attendance in older women
Authors: Bravington Alison , Chen Hong , Dyson Judith , Jones Lesley , Dalgliesh Christopher , Bryan Amée , Patnick Julietta , Macleod Una 
Published: May 2022

Abstract
Background
Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners.

Methods
Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery.

Results
Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners).

Conclusion
The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content.
Respiratory support strategy in adults with acute hypoxemic respiratory failure: a systematic review and network meta-analysis
Authors: Okano Hiromu , Sakuraya Masaaki , Masuyama Tomoyuki , Kimata Shunsuke , Hokari Satoshi 
Published: May 2022

Abstract
Introduction
Network meta-analyses (NMAs) of respiratory management strategies for acute hypoxemic respiratory failure (AHRF) have been reported, but no previous study has compared noninvasive ventilation (NIV), high-flow nasal oxygen (HFNO), standard oxygenation therapy (SOT), and invasive mechanical ventilation (IMV) for de novo AHRF. Therefore, we conducted an NMA to assess the effectiveness of these four respiratory strategies in patients with de novo AHRF.

Methods
The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Ichushi databases were searched. Studies including adults aged ≥18 years with AHRF and RCTs that compared two different oxygenation techniques (SOT, NIV, HFNO, or IMV) were selected. A frequentist-based approach with multivariate random-effects meta-analysis was used. The outcomes were mortality and intubation rates.

Results
Among the 14,263 records initially identified, 25 studies (3302 patients) were included. In the analysis of mortality, compared to SOT, NIV (risk ratio [RR], 0.76; 95% confidence interval [CI], 0.61–0.95) reduced mortality; however, IMV (RR, 1.01; 95% CI, 0.57–1.78) and HFNO (RR, 0.89; 95% CI, 0.66–1.20) did not. For assessments of the intubation incidence, compared to SOT, NIV use (RR, 0.63; 95% CI, 0.51–0.79) was associated with a reduction in intubation, but HFNO (RR, 0.82; 95% CI, 0.61–1.11) was not significant.

Conclusions
Our NMA demonstrated that only NIV showed clinical benefits compared with SOT as an initial respiratory strategy for de novo AHRF. Further investigation, especially comparison with HFNO, is warranted.

Trial registration
PROSPERO (registration number: CRD42020213948, 11/11/2020).
The efficacy of chemical topping in field-grown cotton is mediated by drip irrigation amount in irrigated agricultural area
Authors: TIAN Yu , LIAO Baopeng , HAN Huanyong , WANG Fangyong , DU Mingwei , TIAN Xiaoli , LI Zhaohu 
Published: May 2022

Abstract
Background
Cotton production in China is challenged by high labor input including manual topping (MT). Recently, to replace MT in the Xinjiang cotton region of China, mepiquat chloride (MC) was applied once more than the traditional multiple-application; this was designated as chemical topping (CT), but it is unclear whether the amount of irrigation needs to be adjusted to accommodate CT.

Results
The main plots were assigned to three drip irrigation amounts [300 (I1), 480 (I2), and 660 (I3) mm], and the subplots were assigned to the CT treatments [450 (MC1), 750 (MC2), and 1 050 (MC3) mL·hm−2 25% MC] with MT as a control that was performed after early bloom. The optimum drip irrigation amount for CT was explored based on leaf photosynthesis, chlorophyll fluorescence, biomass accumulation, and yield. There were significant influences of drip irrigation, topping treatments and their interaction on chlorophyll fluorescence characteristics, gas exchange parameters and biomass accumulation characteristics as well as yield. The combination of I2 and MC2 (I2MC2) performed best. Compared with I2MT, the net photosynthetic rate (Pn), stomatal conductance (Gs), transpiration rate (Tr), and photochemical quenching coefficient (qP) of I2MC2 significantly increased by 4.0%∼7.2%, 6.8%∼17.1%, 5.2%∼17.6%, and 4.8%∼9.6%, respectively, from the peak flowering to boll opening stages. Moreover, I2MC2 showed fast reproductive organ biomass accumulation and the highest seed cotton yield; the latter was 6.6%∼12.8% higher than that of I2MT. Further analysis revealed that a 25% MC emulsion in water (MCEW) application resulted in yield improvement by increasing Pn, φPSII, and qP to promote biomass accumulation and transport to reproductive organs.

Conclusion
The results showed that the 480 mm drip irrigation combined with 750 mL·hm−2 MC increased the rate of dry matter accumulation in reproductive organs by increasing Pn, φPSII, and qP to improve photosynthetic performance, thus achieving higher yield.
Deciphering the genome of Simplicillium aogashimaense to understand its mechanisms against the wheat powdery mildew fungus Blumeria graminis f. sp. tritici
Authors: Zhu Mo , Duan Xiao , Cai Pengkun , Li Yong-fang , Qiu Zongbo 
Published: May 2022

AbstractSimplicillium spp. are mycoparasites that exert growth-inhibitory effects on phytopathogenic fungi. However, limited studies have examined the effects of Simplicillium spp. on powdery mildews. In this study, morphological and molecular analyses revealed that S. aogashimaense is a mycoparasite of the wheat powdery mildew fungus, Blumeria graminis f. sp. tritici (Bgt), under field conditions. The inoculation of Bgt colonies with S. aogashimaense significantly impaired Bgt colony formation and conidial distribution and markedly decreased the biomass of Bgt. To examine the interaction between Simplicillium and Bgt, an S. aogashimaense strain that constitutively expresses green fluorescent protein (GFP) was constructed using the Agrobacterium tumefaciens-mediated transformation (ATMT) method. The hyphae of GFP-expressing S. aogashimaense directly penetrated the B. graminis structures. These findings indicate that ATMT can be employed to reveal the biocontrol activities of physiologically and phylogenetically diverse Simplicillium spp. In vitro, S. aogashimaense exudates compromised Bgt conidial germination and appressorial formation. Thus, S. aogashimaense functions as a potential biological control agent by impeding the development of Bgt and can be a viable alternative for controlling the wheat powdery mildew. To gain further insights into the mechanism underlying this mycoparasitism, the genome of S. aogashimaense was sequenced and assembled. S. aogashimaense harbored seven chromosomes comprising 8963 protein-coding genes. Additionally, two putative effector-coding genes (Sao008714 and Sao006491) were identified. The expression levels of Sao008714 and Sao006491 in S. aogashimaense were dramatically upregulated during the mycoparasitic interaction. In addition, 41 gene clusters putatively involved in the production of secondary metabolites, which exhibit insecticidal, antifungal and antibacterial activities, were identified using genome-wide identification, annotation and analysis of secondary metabolite biosynthesis gene clusters. These results suggest that S. aogashimaense parasitizes Bgt and hence, can be considered for phytopathogen management.
Why care about integrated care? Part 3. Weighing sunlight: delivering integration in practice and measuring success
Authors: Tracy Derek K. , Hanson Kara , Underwood Benjamin R. , Shergill Sukhwinder S. 
Published: May 2022

SUMMARYThe first two articles in this series have shown the direction of travel for health and social care in England, and how the status quo in already stressed systems is not viable. It is difficult to disagree with the principles of ‘integrated care’, yet we currently lack evidenced models on which we might build. There is a need for experiential learning and sharing of experiences. This third article describes in more granularity the experiences, positive and negative, of an early-adopting integrating service in south-east London that incorporated aspects of the local authority and secondary care physical and mental health services. It provides structured guidance on which types of integration one might aim for, managing internal and external relationships, and discussion on evaluating progress.
Timing of Puberty, Pubertal Growth, and Adult Height in Short Children Born Small for Gestational Age Treated With Growth Hormone
Authors: Upners Emmie N , Raket Lars Lau , Petersen Jørgen H , Thankamony Ajay , Roche Edna , Shaikh Guftar , Kirk Jeremy , Hoey Hilary , Ivarsson Sten-A , Söder Olle , Juul Anders , Jensen Rikke Beck 
Published: May 2022

Abstract

Context
Growth hormone (GH) is used to treat short children born small for gestational age (SGA); however, the effects of treatment on pubertal timing and adult height are rarely studied.

Objective
To evaluate adult height and peak height velocity in short GH-treated SGA children.

Methods
Prospective longitudinal multicenter study. Participants were short children born SGA treated with GH therapy (n = 102). Adult height was reported in 47 children. A reference cohort of Danish children was used. Main outcome measures were adult height, peak height velocity, age at peak height, and pubertal onset. Pubertal onset was converted to SD score (SDS) using Danish reference data.

Results
Gain in height SDS from start of treatment until adult height was significant in both girls (0.94 [0.75; 1.53] SDS, P = .02) and boys (1.57 [1.13; 2.15] SDS, P &lt; .001). No difference in adult height between GH dosage groups was observed. Peak height velocity was lower than a reference cohort for girls (6.5 [5.9; 7.6] cm/year vs 7.9 [7.4; 8.5] cm/year, P &lt; .001) and boys (9.5 [8.4; 10.7] cm/year vs 10.1 [9.7; 10.7] cm/year, P = .002), but no difference in age at peak height velocity was seen. Puberty onset was earlier in SGA boys than a reference cohort (1.06 [–0.03; 1.96] SDS vs 0 SDS, P = .002) but not in girls (0.38 [–0.19; 1.05] SDS vs 0 SDS, P = .18).

Conclusion
GH treatment improved adult height. Peak height velocity was reduced, but age at peak height velocity did not differ compared with the reference cohort. SGA boys had an earlier pubertal onset compared with the reference cohort.
Remnant Cholesterol Predicts Long-term Mortality of Patients With Metabolic Dysfunction–associated Fatty Liver Disease
Authors: Huang Hangkai , Guo Yanjun , Liu Zhening , Zeng Yan , Chen Yishu , Xu Chengfu 
Published: May 2022

Abstract

Context
Elevated serum remnant cholesterol independently predicts risks of cardiovascular diseases. However, the association between remnant cholesterol and metabolic dysfunction–associated fatty liver disease (MAFLD) remains unclear.

Objective
This study aimed to explore the association of remnant cholesterol with MAFLD and its long-term mortality.

Methods
We extracted data from the NHANES III, 1988 to1994 and the linked mortality data until December 31, 2015. The association between remnant cholesterol and MAFLD was analyzed by multivariable logistic regression. Cox proportional hazards regression was performed to assess whether elevated remnant cholesterol increased all-cause and cause-specific mortalities in MAFLD patients.

Results
At baseline, 28.6% (1474/5156) of participants had MAFLD. In multivariable logistic regression, the fourth quartile of remnant cholesterol was associated with an increased risk of MAFLD compared with the first quartile (odds ratio [OR]: 1.714; 95% CI, 1.586-1.971; P &lt; .001). In participants with normal levels of triglycerides, low-density lipoprotein and high-density lipoprotein cholesterol, the relationship between remnant cholesterol and MAFLD risk remained significant (OR: 1.346; 95% CI, 1.248-1.761; P &lt; .001). During a median follow-up of 307 months, MAFLD patients with serum remnant cholesterol in the fourth quartile were associated with a higher risk of all-cause mortality (hazard ratio [HR]: 2.183; 95% CI, 1.825-2.407; P &lt; .001), as well as a higher risk of cardiovascular mortality (HR: 2.346; 95% CI, 2.046-2.885; P &lt; .001) and cancer-related mortality (HR: 2.366; 95% CI, 1.864-2.932; P &lt; .001) compared with MAFLD patients in the first quartile.

Conclusion
Remnant cholesterol was independently associated with the risk of MAFLD and predicted all-cause, cardiovascular, and cancer-related mortalities in MAFLD patients.
The Mount Sinai Clinical Pathway for the Diagnosis and Management of Hypercortisolism due to Ectopic ACTH Syndrome
Authors: Alba Eva L , Japp Emily A , Fernandez-Ranvier Gustavo , Badani Ketan , Wilck Eric , Ghesani Munir , Wolf Andrea , Wolin Edward M , Corbett Virginia , Steinmetz David , Skamagas Maria , Levine Alice C 
Published: May 2022

Abstract
Neoplasms that secrete ectopic adrenocorticotropin (ACTH) may cause severe, life-threatening hypercortisolism. These tumors are often difficult to localize and treat, requiring a comprehensive and systematic management plan orchestrated by a multidisciplinary team. The Mount Sinai Adrenal Center hosted an interdisciplinary retreat of experts in adrenal disorders and neuroendocrine tumors (NETs) with the aim of developing a clinical pathway for the management of Cushing syndrome due to ectopic ACTH production. The result was institutional recommendations for the diagnosis, localization, surgical approaches to intrathoracic tumors and bilateral adrenalectomy, and perioperative and postoperative medical management of hypercortisolism and its sequelae. Specific recommendations were made regarding the timing and selection of therapies based on the considerations of our team as well as a review of the current literature. Our clinical pathway can be applied by other institutions directly or serve as a guide for institution-specific management.
A Novel Method for Adult Height Prediction in Children With Idiopathic Short Stature Derived From a German-Dutch Cohort
Authors: Blum Werner F , Ranke Michael B , Keller Eberhard , Keller Alexandra , Barth Sandra , de Bruin Christiaan , Wudy Stefan A , Wit Jan M 
Published: May 2022

Abstract

Context
Prediction of adult height (AH) is important in clinical management of short children. The conventional methods of Bayley-Pinneau (BP) or Roche-Wainer-Thissen (RWT) have limitations.

Objective
We aimed to develop a set of algorithms for AH prediction in patients with idiopathic short stature (ISS) which are specific for combinations of predicting variables.

Methods
Demographic and auxologic data were collected in childhood (1980s) and at AH (1990s). Data were collected by Dutch and German referral centers for pediatric endocrinology. A total of 292 subjects with ISS (219 male, 73 female) were enrolled. The population was randomly split into modeling (n = 235) and validation (n = 57) cohorts. Linear multi-regression analysis was performed with predicted AH (PAH) as response variable and combinations of chronological age (CA), baseline height, parental heights, relative bone age (BA/CA), birth weight, and sex as exploratory variables.

Results
Ten models including different exploratory variables were selected with adjusted R² ranging from 0.84 to 0.78 and prediction errors from 3.16 to 3.68 cm. Applied to the validation cohort, mean residuals (PAH minus observed AH) ranged from −0.29 to −0.82 cm, while the conventional methods showed some overprediction (BP: +0.53 cm; RWT: +1.33 cm; projected AH: +3.81 cm). There was no significant trend of residuals with PAH or any exploratory variables, in contrast to BP and projected AH.

Conclusion
This set of 10 multi-regression algorithms, developed specifically for children with ISS, provides a flexible tool for AH prediction with better accuracy than the conventional methods.