bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital versus radiographic accuracy evaluation of guided implant surgery: an in vitro study
Authors: Yi Chun , Li Sha , Wen Aonan , Wang Yong , Zhao Yijiao , Zhang Yu 
Published: November 2022

Abstract
Background
Cone-beam computed tomography (CBCT) is the most widely used method for postsurgical evaluation of the accuracy of guided implant surgery. However, the disadvantages of CBCT include radiation exposure, artifacts caused by metal implants, and high cost. Few studies have introduced a digital registration method to replace CBCT for evaluating the accuracy of guided surgery. The purpose of this study was to compare digital registration to conventional CBCT in terms of the capacity to evaluate the implant positioning accuracy of guided surgery.

Materials and methods
This in vitro study included 40 acrylic resin models with posterior single mandibular tooth loss. Guided surgery software was used to determine the optimal implant position; 40 tooth-supported fully guided drilling templates were designed and milled accordingly. After the guided surgery, the accuracies of the surgical templates were evaluated by conventional CBCT and digital registration. For evaluation by conventional CBCT, postsurgical CBCT scans of the resin models were performed. The CBCT data were reconstructed and superimposed on the implant planning data. For digital registration, we constructed a virtual registration unit that consisted of an implant replica and a scan body. Next, we obtained postsurgical optical scans of resin models with the scan body. The postsurgical implant position was identified by superimposition of the registration unit and optical scan data. The implant planning data and postsurgical implant position data were superimposed; deviations were reported in terms of distance for implant entry/apex point and in terms of angle for the implant axis. Interclass correlation coefficients (ICCs) and Bland–Altman plots were used to analyze the agreement between the two evaluation methods.

Results
The ICCs between the two methods were 0.986, 0.993, and 0.968 for the entry point, apex point, and angle, respectively; all were significantly greater than 0.75 (p < 0.001). Bland–Altman plots showed that the 95% limits of agreement of the differences were − 0.144 to + 0.081 mm, − 0.135 to + 0.147 mm, and − 0.451° to + 0.729° for the entry point, apex point, and angle, respectively; all values were within the maximum tolerated difference.

Conclusion
Conventional CBCT and digital registration showed good agreement in terms of evaluating the accuracy of implant positioning using tooth-supported surgical templates.
Research attitudes, practice and literacy among Kenyan palliative care healthcare professionals: an observational, cross-sectional online survey
Authors: RA Powell , Z Ali , Gikaara N , Qanungo S , ES Melikam , KB Cartmell 
Published: November 2022

Abstract
Background:
While research is needed to advocate for implementation of global agendas to strengthen palliative care, healthcare professionals’ research literacy must improve to bridge the gap between evidence and practice. A resurgent focus on North-South power disparities, means attention should also focus on understanding low- and middle-income countries’ local agency to implement palliative care research agendas.

Methods:
An observational, cross-sectional online survey among Kenyan palliative healthcare professionals currently working at any of the palliative and hospice care organizations operational during January – December 2019, using descriptive statistics.

Results:
Among the 93 survey respondents, participants were mainly nurses (50.54%; n = 47). Regarding research attitudes: all agreed/strongly agreed research was important for their professional work. Over nine-tenths (91.21%; n = 83) reported having the skills to conduct research, and 91.30% (n = 84) wanted to conduct research in their clinical work. 90% (90.21%; n = 83) reported supervisory support to conduct research. A comparable proportion (90.22%; n = 83) would undertake research if they could find funding. Regarding research practice: over two-thirds (70.65%; n = 65) reported ever having had a mentor who encouraged them to do research, while approximately half (50.59%; n = 43) reported reading evidence-based journal articles about once per month and attending monthly in-house meetings on palliative care (56.79%; n = 46). Regarding research literacy: while over two-fifths of respondents described their current research literacy level as ‘none’ or ‘beginner’ (44.56%; n = 41), a comparable proportion described it as ‘intermediate’ (45.65%; n = 42), with 9 (9.78%) stating it was ‘advanced’.

Conclusion:
The majority of palliative healthcare professionals report having interest, skills and support at work to conduct palliative care research, with a low-to-medium level of research literacy. The current study explored palliative care staff attitudes to, experience in, and literacy with the research process, which is necessary to creating a dialogue on implementing research findings. This study also adds to the global empowerment agenda, addressing inequities in research opportunities and local capacity to own and undertake palliative care research.
Knowledge of obstetric fistula and its associated factors among women of reproductive age in Northwestern Ethiopia: a community-based cross-sectional study
Authors: Tsega Dejen Meskerem , Assebe Yadeta Tesfaye , Gedefaw Azeze Getnet , Demis Bizuneh Asmamaw , Tiruye Getahun , Semahegn Agumasie 
Published: November 2022

Abstract
Background
Obstetric fistula has been a major maternal health challenges in low and middle-income countries, especially in Ethiopia, due to high child marriage and poor access to healthcare. Obstetric fistula is common among teenage mothers that results in a vast social, economic and cultural sequel. In Ethiopia, there is a paucity of research evidence on women’s knowledge about obstetric fistula. Therefore, this study aimed to assess women’s knowledge about obstetric fistula and its associated factors at Banja District, Northwestern Ethiopia.

Methods
A community-based cross-sectional study design was conducted from 1st -21th July 2021. Systematic sampling method was used to recruit 784 women in the reproductive age from six rural and one urban sub-districts. Two days of training was given to research assistants regarding the objective of the study, inclusion and exclusion criteria, checking completeness and ways of protecting confidentiality. Data were collected using face-to-face interview method. Collected data were entered into EpiData and exported into SPSS version 24 for cleaning and analysis. Descriptive statistics, binary and multivariable logistic regression analysis were performed to identify associated factors. Adjusted odds ratio (AOR) at 95% CI with p < 0.05 was used to declare significant association with women’s knowledge of obstetric fistula.

Results
A total of 773 women gave a complete response with response rate of 98.6% (773/784). One-third (36.4%; 95%CI: 32.9-39.7%) had good knowledge about obstetric fistula. Women who had completed primary education (AOR:3.47, 95%CI:2.01–5.98), secondary and above (AOR:3.30, 95%CI:1.88–5.80), being a student (AOR: 6.78, 95%CI:3.88–11.86), get counseling about obstetric fistula (AOR:6.22, 95%CI: 3.78–10.24), participated in pregnant women’s discussion forum (AOR:3.36, 95%CI: 1.99–5.66), had antenatal care follow-up (AOR: 2.40, 95% CI: 1.39–4.13), being an urban resident (AOR: 3.19, 95% CI: 1.33–7.66), and having access to Television/Radio (AOR:1.68, 95%CI:1.10–2.60) were significantly associated with women’s good knowledge about obstetric fistula.

Conclusion
Women’s knowledge about obstetric fistula is unacceptably low. Therefore, concerned stakeholders should enhance awareness creation programs, strengthen antenatal care, counselling and women’s discussion forum that could substantially optimize women’s knowledge about obstetric fistula and its risk factors of obstetric fistula.
Practical training using immersive roleplay and an intensive course on clinical ethics consultation in Japan
Authors: Udagawa Makoto , Takimoto Yoshiyuki 
Published: November 2022

AbstractBackgroundClinical ethics consultation (CEC) is not sufficiently widespread in Japan. A possible reason is that a practical training system for CEC has not been established. Hence, we have developed “immersive role-play (IR)” as a practical training program that applies a new theatrical technique, immersive theater, to role-play learning. Its characteristics include high fidelity in the use of a studio and actors and dynamic realism in the progression of the scenario to immerse learners in role-play learning.MethodsWe offered an intensive course on CEC for healthcare professionals from 2016 to 2019, with IR as part of the course curriculum. A questionnaire survey was administered to the participants regarding the educational effectiveness of IR. The questionnaire was anonymous, and participants responded on a 4-point Likert scale regarding their satisfaction with IR and their perception of its learning effects. An open-ended section at the end of the questionnaire asked about the effectiveness and areas for improvement of IR.ResultsThe questionnaire survey showed good results in all categories: usefulness, satisfaction, understanding, and interest. In the questions that compared the learning to traditional role-play learning, the participants gave significantly high ratings, specifically for “realism,“ “seriousness,“ “understanding the importance of communication skills,“ and “understanding the diversity of the narratives.“ In the free-text responses, the most frequent response was that they learned a lot about the practical procedures for participation.ConclusionIR is sufficiently effective as a practical educational program, but not for everyone. It is suitable for those who are or will soon work as consultants. Conversely, beginners and intermediates who have not fully mastered the CEC theory and skills will need a stage-specific educational program separate from the IR.
Drivers, uncertainties, and future scenarios of the Iranian health system
Authors: Emami Mozhgan , Haghdoost Ali Akbar , Yazdi-Feyzabadi Vahid , Mehrolhassani Mohammad Hossein 
Published: November 2022

Abstract
Background
Health promotion is an essential dimension of sustainable development in any country. It has a high degree of complexity, with numerous components interacting both inside and outside of the system, so having a systemic and forward-looking approach is essential to planning for the future.

Methods
The research has been designed based on scenario-based planning in three main stages. The data gathering was qualitative by working group meetings and compiling an importance-uncertainty questionnaire to complete the cross-impact analysis matrix. The MicMac and scenario Wizard has been used for data analysis.

Results
The scoping review and upstream document evaluation lead to 54 key variables for analyzing the Iranian health system (HS). The MicMac analysis ends by determining seven key variables: power, politics, and communication network; lifestyle and behavioral factors; quality of human resources training and education; environmental and occupational risk factors, payment and tariff system, and allocation pattern; support society / individuals health; and services effectiveness, especially para-clinical and outpatient ones. Finally, six main scenario spaces are depicted using Scenario Wizard. collective equity was the priority of the HS vision in the desirable scenario, consisting of the most favorable state of the uncertainties. The second, third, and fourth scenarios are also considered desirable. In the disaster scenario, which is the most pessimistic type of consistent scenario in this study, health and equity are not significant either in the social or individual dimensions. In the sixth scenario, the individual dimension of health and equity is the most critical perspective of the HS.

Conclusions
Due to the unsustainability and high complexity of the Iran’s HS, the development and excellence of the HS governance based on the Iran context and health advocacy improvement (applying good governance); creating sustainable financial resources and rational consumption; and human resources training and education are three main principles leading the HS to the images of the desired scenarios.
Visible light-regulated cationic polymer coupled with photodynamic inactivation as an effective tool for pathogen and biofilm elimination
Authors: Wang Qian , Shi Qingshan , Li Yulian , Lu Shunying , Xie Xiaobao 
Published: November 2022

Abstract
Background
Pathogenic microorganism pollution has been a challenging public safety issue, attracting considerable scientific interest. A more problematic aspect of this phenomenon is that planktonic bacteria exacerbate biofilm formation. There is an overwhelming demand for developing ultra-efficient, anti-drug resistance, and biocompatibility alternatives to eliminate stubborn pathogenic strains and biofilms.

Results
The present work aims to construct a visible light-induced anti-pathogen agents to ablate biofilms using the complementary merits of ROS and cationic polymers. The photosensitizer chlorin e6-loaded polyethyleneimine-based micelle (Ce6-TPP-PEI) was constructed by an amphiphilic dendritic polymer (TPP-PEI) and physically loaded with photosensitizer chlorin e6. Cationic polymers can promote the interaction between photosensitizer and Gram-negative bacteria, resulting in enhanced targeting of PS and lethality of photodynamic therapy, and remain active for a longer duration to prevent bacterial re-growth when the light is turned off. As expected, an eminent antibacterial effect was observed on the Gram-negative Escherichia coli, which is usually insensitive to photosensitizers. Surprisingly, the cationic polymer and photodynamic combination also exert significant inhibitory and ablative effects on fungi and biofilms. Subsequently, cell hemolysis assessments suggested its good biocompatibility.

Conclusions
Given the above results, the platform developed in this work is an efficient and safe tool for public healthcare and environmental remediation.
A modular and self-adjuvanted multivalent vaccine platform based on porcine circovirus virus-like nanoparticles
Authors: Liu Ze-Hui , Deng Zhuo-Fan , Lu Ying , Fang Wei-Huan , He Fang 
Published: November 2022

Abstract
Background
Virus-like particles (VLPs) are supramolecular structures composed of multiple protein subunits and resemble natural virus particles in structure and size, making them highly immunogenic materials for the development of next-generation subunit vaccines. The orderly and repetitive display of antigenic epitopes on particle surface allows efficient recognition and cross-link by B cell receptors (BCRs), thereby inducing higher levels of neutralizing antibodies and cellular immune responses than regular subunit vaccines. Here, we present a novel multiple antigen delivery system using SpyCatcher/Spytag strategy and self-assembled VLPs formed by porcine circovirus type 2 (PCV2) Cap, a widely used swine vaccine in solo.

Results
Cap-SC, recombinant Cap with a truncated SpyCatcher polypeptide at its C-terminal, self-assembled into 26-nm VLPs. Based on isopeptide bonds formed between SpyCatcher and SpyTag, classical swine fever virus (CSFV) E2, the antigen of interest, was linked to SpyTag and readily surface-displayed on SpyCatcher decorated Cap-SC via in vitro covalent conjugation. E2-conjugated Cap VLPs (Cap-E2 NPs) could be preferentially captured by antigen presenting cells (APCs) and effectively stimulate APC maturation and cytokine production. In vivo studies confirmed that Cap-E2 NPs elicited an enhanced E2 specific IgG response, which was significantly higher than soluble E2, or the admixture of Cap VLPs and E2. Moreover, E2 displayed on the surface did not mask the immunodominant epitopes of Cap-SC VLPs, and Cap-E2 NPs induced Cap-specific antibody levels and neutralizing antibody levels comparable to native Cap VLPs.

Conclusion
These results demonstrate that this modularly assembled Cap-E2 NPs retains the immune potential of Cap VLP backbone, while the surface-displayed antigen significantly elevated E2-induced immune potency. This immune strategy provides distinctly improved efficacy than conventional vaccine combination. It can be further applied to the development of dual or multiple nanoparticle vaccines to prevent co-infection of PCV2 and other swine pathogens.
Cellular nanomechanics derived from pattern-dependent focal adhesion and cytoskeleton to balance gene transfection of malignant osteosarcoma
Authors: Wang Yongtao , Wang Nana , Yang Yingjun , Chen Yazhou , Zhang Zhengguo 
Published: November 2022

AbstractGene transfection was supposed to be the most promising technology to overcome the vast majority of diseases and it has been popularly reported in clinical applications of gene therapy. In spite of the rapid development of novel transfection materials and methods, the influence of morphology-dependent nanomechanics of malignant osteosarcoma on gene transfection is still unsettled. In this study, cell spreading and adhesion area was adjusted by the prepared micropatterns to regulate focal adhesion (FA) formation and cytoskeletal organization in osteosarcoma cells. The micropattern-dependent FA and cytoskeleton could induce different cellular nanomechanics to affect cell functions. Our results indicated that transfection efficiency was improved with enlarging FA area and cell nanomechanics in micropatterned osteosarcoma. The difference of gene transfection in micropatterned cells was vigorously supported by cellular internalization capacity, Ki67 proliferation ability and YAP mechanotranduction through the regulation of focal adhesion and cytoskeletal mechanics. This study is an attempt to disclose the relationship of cell nanomechanics and gene transfection for efficient gene delivery and develop multifunctional nanomedicine biomaterials for accurate gene therapy in osteosarcoma cells.
The bone–muscle connection in breast cancer: implications and therapeutic strategies to preserve musculoskeletal health
Authors: Ballinger Tarah J. , Thompson William R. , Guise Theresa A. 
Published: November 2022

AbstractBreast cancer and its therapies frequently result in significant musculoskeletal morbidity. Skeletal complications include bone metastases, pain, bone loss, osteoporosis, and fracture. In addition, muscle loss or weakness occurring in both the metastatic and curative setting is becoming increasingly recognized as systemic complications of disease and treatment, impacting quality of life, responsiveness to therapy, and survival. While the anatomical relationship between bone and muscle is well established, emerging research has led to new insights into the biochemical and molecular crosstalk between the skeletal and muscular systems. Here, we review the importance of both skeletal and muscular health in breast cancer, the significance of crosstalk between bone and muscle, and the influence of mechanical signals on this relationship. Therapeutic exploitation of signaling between bone and muscle has great potential to prevent the full spectrum of musculoskeletal complications across the continuum of breast cancer.
Cooling down with Entresto. Can sacubitril/valsartan combination enhance browning more than coldness?
Authors: Nikolic Marina , Novakovic Jovana , Ramenskaya Galina , Kokorekin Vladimir , Jeremic Nevena , Jakovljevic Vladimir 
Published: November 2022

Abstract
Background
It is a growing importance to induce a new treatment approach to encourage weight loss but also to improve maintenance of lost weight. It has been shown that promotion of brown adipose tissue (BAT) function or acquisition of BAT characteristics in white adipose tissue (terms referred as “browning”) can be protective against obesity.

Main text
Amongst numerous established environmental influences on BAT activity, cold exposure is the best interested technique due to its not only effects on of BAT depots in proliferation process but also de novo differentiation of precursor cells via β-adrenergic receptor activation. A novel combination drug, sacubitril/valsartan, has been shown to be more efficient in reducing cardiovascular events and heart failure readmission compared to conventional therapy. Also, this combination of drugs increases the postprandial lipid oxidation contributing to energy expenditure, promotes lipolysis in adipocytes and reduces body weight. To date, there is no research examining potential of combined sacubitril/valsartan use to promote browning or mechanisms in the basis of this thermogenic process.

Conclusion
Due to the pronounced effects of cold and sacubitril/valsartan treatment on function and metabolism of BAT, the primary goal of further research should focused on investigation of the synergistic effects of the sacubitril/valsartan treatment at low temperature environmental conditions.
Computed tomography-measured body composition and survival in rectal cancer patients: a Swedish cohort study
Authors: Kotti Angeliki , Holmqvist Annica , Woisetschläger Mischa , Sun Xiao-Feng 
Published: November 2022

Abstract
Background
The association between body composition and survival in rectal cancer patients is still unclear. Therefore, we aimed to evaluate the impact of computed tomography (CT)-measured body composition on survival in rectal cancer patients, stratifying our analyses by sex, tumour location, tumour stage and radiotherapy.

Methods
This retrospective cohort study included 173 patients with rectal adenocarcinoma. CT colonography scans at the time of diagnosis were used to assess the skeletal muscle index (SMI) and the visceral adipose tissue area (VAT). The patients were divided into a low or high SMI group and a low or high VAT group according to previously defined cutoff values. Endpoints included cancer-specific survival (CSS) and overall survival (OS).

Results
In all patients, low SMI was associated with worse CSS (HR, 2.63; 95% CI, 1.35–5.12; P = 0.004) and OS (HR, 3.57; 95% CI, 2.01–6.34; P < 0.001) compared to high SMI. The differences remained significant after adjusting for potential confounders (CSS: adjusted HR, 2.28; 95% CI, 1.13–4.58; P = 0.021; OS: adjusted HR, 3.17; 95% CI, 1.73–5.82; P < 0.001). Low SMI was still related to a poor prognosis after stratifying by sex, tumour location, stage and radiotherapy (P < 0.05). High VAT was associated with better CSS (HR, 0.31; 95% CI, 0.11–0.84; P = 0.022) and OS (HR, 0.40; 95% CI, 0.17–0.97; P = 0.044) compared to low VAT among men with rectal cancer ≤ 10 cm from the anal verge. High VAT was associated with worse CSS (HR, 4.15; 95% CI, 1.10–15.66; P = 0.036) in women with rectal cancer ≤ 10 cm from the anal verge.

Conclusions
Low SMI was associated with worse survival. High VAT predicted better survival in men but worse survival in women. The results suggest that CT-measured body composition is a useful tool for evaluating the prognosis of rectal cancer patients and demonstrate the need to include the sex and the tumour location in the analyses.