bluuebunny/crossref_metadata_2025 huggingface dataset:
Induction of labor or expectant management? Birth outcomes for nulliparous individuals choosing midwifery care
Authors: Erickson Elise N. , Bailey Joanne M. , Colo Shanti D. , Carlson Nicole S. , Tilden Ellen L.
Published: May 2021

Background

Induction of labor (IOL) has been studied as a strategy to reduce rates of cesarean birth (CB). Midwifery care models are also associated with lower CB rates, even considering that midwives perform fewer IOLs. In this study, we examined childbirth outcomes among individuals undergoing IOL in certified nurse‐midwifery (CNM) care as compared to two categories of expectant management (EM).

Methods

Data were from two CNM practices in the United States (2007‐2018). The sample was limited to term nulliparous, nondiabetic, singleton, vertex pregnancies. Individuals having an IOL in each week of gestation (37th, 38th, etc) were compared with those having EM. Two methods for defining EM were considered as each method when used alone limits interpretation. Inclusive EM included all births starting in the same week as IOL. The exclusive EM group was comprised of all births occurring in the next gestational age week relative to the IOL cases (ie, 39th week IOL versus all births occurring at 40 weeks or later). Adjusted regression models were used to examine differences in CB by IOL versus EM (inclusive or exclusive) at each week of gestation.

Results

Among 4057 CNM‐attended pregnancies, the overall rate of IOL was 28.9% (95% CI 27.5%‐30.3%) and CB was 19.4% (95% CI 18.1%‐20.6%). Most IOLs involved obstetric indications. CB rates did not differ by IOL versus inclusive EM when performed between 37 and 40 weeks, though post hoc power calculations indicate these comparisons were low‐powered. In multivarable models, IOL in the 40th week was associated with lower odds for CB versus exclusive EM definition (ie, births occurring at 41 0/7 weeks or later, OR (95% CI) = 0.57 (0.36‐0.90)). This finding is explained by the large increase in CB rates after IOL during the 41st week (34.3%, up from 21.9% in the 40th week). Furthermore, the adjusted odds for CB in the 41st week were 55% higher relative to inclusive EM (all labors 41st week and later), OR (95% CI) = 1.55(1.11‐2.15). Neonatal outcomes (aside from macrosomia) did not differ by IOL/EM at any gestational age.

Discussion

Outcomes for nulliparous individuals having IOL or EM in the context of a midwifery model of care include low overall use of CB and low frequency of IOL before 41 weeks. In this model, IOL in the 40th week may lower CB odds, especially in comparison to those who do not have spontaneous labor and later undergo an IOL in the 41st week.
What tactical repertoire to use in strikes and when to use it? Strategies of workers and their mobilization power in Chile (2010–2018)
Authors: Velásquez Orellana Diego , Pérez Domingo , Link Sebastián
Published: May 2021

This research analyses workers’ mobilization power in Chile through the joint‐cost model, suggesting that wider tactical repertoires, and especially transgressive ones, tend to result in shorter strikes, as a proxy of relative success against the employers. Using the Labor Strike Observatory's original dataset, we study this relation in the Chilean case, where neoliberalism has weakened unions and constrained the occurrence of strikes at the workplace level. We advanced two quantitative methods of analysis. First, using latent class analysis, we identify the tactical repertoires used by strikers. Second, following an event history methodology, we estimate the contribution of each repertoire to the risk of ending the strike. This paper analyses the strategies and milestones of strikers’ actions, shows the greater power of violent tactics compared to peaceful ones at the beginning of the conflict and finally discusses some limitations of the joint‐cost model in the capital–labour relation.
Surgical outcomes and proposal for a treatment algorithm for urethral strictures in transgender men
Authors: de Rooij Freek P. W. , Peters Femke R. M. , Ronkes Brechje L. , van der Sluis Wouter B. , Al‐Tamimi Muhammed , van Moorselaar R. Jeroen A. , Bouman Mark‐Bram , Pigot Garry L. S.
Published: May 2021

Objectives

To assess our results of surgical treatment for urethral strictures in transgender men, and to provide a surgical treatment algorithm.

Patients and methods

A single centre, retrospective cohort study was conducted of transgender men who underwent surgical correction of their urethral stricture(s) between January 2013 and March 2020. The medical charts of 72 transgender men with 147 urethral strictures were reviewed. The primary outcomes were the success and recurrence rates after surgical treatment for urethral strictures.

Results

The median (interquartile range [IQR]) follow‐up was 61 (25–202) months. At last follow‐up, 50/72 (69%) were able to void while standing (after one [60%], two [20%], three [6%], four [8%], five [4%], or seven [2%] procedures), 10/72 (14%) await further treatment, two of the 72 (3%) sat to void despite good urodynamic function, and 10/72 (14%) had a definitive urethrostomy. Of 104 surgical treatments included in separate success rate analysis, 65 (63%) were successful (43/75 [57%] after phalloplasty, 22/29 [76%] after metoidioplasty). The highest success rates in short urethral strictures were seen after a Heineke‐Mikulicz procedure (six of seven cases), and in longer or more complicated urethral strictures after two‐stage with graft (four of six), two‐stage without graft (10/12), pedicled flap (11/15, 73%), and single‐stage graft (seven of seven) urethroplasties. Grafts used were buccal mucosa or full‐thickness skin grafts. Success rates improved over time, with success rates of 38% and 36% in 2013 and 2014, to 71% and 73% in 2018 and 2019, respectively. We concluded with a surgical treatment algorithm based on previous literature, stricture characteristics, and our surgical outcomes.

Conclusion

The highest success rates were seen after a Heineke‐Mikulicz procedure in short urethral strictures; and after graft, pedicled flap, or two‐stage urethroplasties in longer or more complicated urethral strictures. Finally, most of the transgender men were able to void while standing, although in some multiple surgical procedures were necessary to accomplish this.
Alleviating carbohydrate counting with a FiASP‐plus‐pramlintide closed‐loop delivery system (artificial pancreas): Feasibility and pilot studies
Authors: Tsoukas Michael A. , Cohen Elisa , Legault Laurent , von Oettingen Julia E. , Yale Jean‐François , Vallis Michael , Odabassian Madison , El Fathi Anas , Rutkowski Joanna , Jafar Adnan , Ghanbari Milad , Gouchie‐Provencher Nikita , René Jennifer , Palisaitis Emilie , Haidar Ahmad
Published: May 2021

Aim

To assess whether a FiASP‐and‐pramlintide closed‐loop system has the potential to replace carbohydrate counting with a simple meal announcement (SMA) strategy (meal priming bolus without carbohydrate counting) without degrading glycaemic control compared with a FiASP closed‐loop system.

Materials and Methods

We conducted a 24‐hour feasibility study comparing a FiASP system with full carbohydrate counting (FCC) with a FiASP‐and‐pramlintide system with SMA. We conducted a subsequent 12‐day outpatient pilot study comparing a FiASP‐and‐placebo system with FCC, a FiASP‐and‐pramlintide system with SMA, and a FiASP‐and‐placebo system with SMA. Basal‐bolus FiASP‐and‐pramlintide were delivered at a fixed ratio (1 U:10 μg). Glycaemic outcomes were measured, surveys evaluated gastrointestinal symptoms and diabetes distress, and participant interviews helped establish a preliminary coding framework to assess user experience.

Results

Seven participants were included in the feasibility analysis. Time spent in 3.9‐10 mmol/L was similar between both interventions (81%‐84%). Four participants were included in the pilot analysis. Time spent in 3.9‐10 mmol/L was similar between the FiASP‐and‐placebo with FCC and FiASP‐and‐pramlintide with SMA interventions (70%), but was lower in the FiASP‐and‐placebo with SMA intervention (60%). Time less than 3.9 mmol/L and gastrointestinal symptoms were similar across all interventions. Emotional distress was moderate at baseline, after the FiASP‐and‐placebo with FCC and SMA interventions, and fell after the FiASP‐and‐pramlintide with SMA intervention. SMA reportedly afforded participants flexibility and reduced mealtime concerns.

Conclusions

The FiASP‐and‐pramlintide system has the potential to substitute carbohydrate counting with SMA without degrading glucose control.
Comparative efficacy of glucose‐lowering medications on body weight and blood pressure in patients with type 2 diabetes: A systematic review and network meta‐analysis
Authors: Tsapas Apostolos , Karagiannis Thomas , Kakotrichi Panagiota , Avgerinos Ioannis , Mantsiou Chrysanthi , Tousinas Georgios , Manolopoulos Apostolos , Liakos Aris , Malandris Konstantinos , Matthews David R. , Bekiari Eleni
Published: May 2021

Aim

To compare the effects of glucose‐lowering drugs on body weight and blood pressure in adults with type 2 diabetes.

Methods

We searched Medline, Embase, the Cochrane Library, and grey literature sources until 29 September 2020 for randomized controlled trials of at least 24 weeks' duration assessing the effects of glucose‐lowering drugs on body weight and blood pressure in adults with type 2 diabetes. We performed frequentist network meta‐analyses and calculated weighted mean differences and 95% confidence intervals combining trial arms of different approved doses of a given intervention into a single group. We evaluated the confidence in pooled estimates using the CINeMA (Confidence In Network Meta‐Analysis) framework.

Results

In total, 424 trials (276 336 patients) assessing 21 antidiabetic medications from nine drug classes were included. Subcutaneous semaglutide was the most efficacious in reducing body weight followed by oral semaglutide, exenatide twice‐daily, liraglutide, and the sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. The same agents also conferred the greatest reductions in systolic blood pressure. Metformin had a modest effect in reducing body weight and systolic blood pressure. Diastolic blood pressure was reduced with the SGLT‐2 inhibitors pioglitazone, exenatide twice‐daily and semaglutide. In subgroup analyses of trials with over 52 weeks' duration, semaglutide and SGLT‐2 inhibitors reduced both body weight and systolic blood pressure.

Conclusions

Semaglutide and SGLT‐2 inhibitors conferred reductions both in body weight and blood pressure that were sustainable for over 1 year of treatment. These agents may be preferable treatment options for patients with type 2 diabetes who are overweight/obese and/or hypertensive.
Deep learning‐based scheme to diagnose Parkinson's disease
Authors: Vyas Tarjni , Yadav Raj , Solanki Chitra , Darji Rutvi , Desai Shivani , Tanwar Sudeep
Published: May 2021

Parkinson's disease (PD) is a neurological disorder of the central nervous system that causes difficulty in movement, often including tremors and rigidity. Early detection of PD can prevent symptoms up to a certain age and increase life expectancy. For this purpose, we have used brain images from magnetic resonance imaging (MRI) technique. A deeper level of feature detection in MRI can identify biomarkers that can be used to know how the disease spreads, leading to a cure in the future. With these motives, we have presented two novel approaches using deep learning (DL) techniques. 2D and 3D convolution neural networks (CNN) are used, which are trained on MRI scans in the axial plane. The dataset was constructed using images from Parkinson's progression markers initiative (PPMI). The four pre‐processing techniques used in this article are bias field correction, histogram matching, Z‐score normalization, and image resizing. Pre‐processing techniques were essential inaccurate training models. Every class prediction done by the model would have taken multiple features into account across multiple layers of the brain and not relied on a single or few important features, making DL a powerful concept. A total of 318 MRI scans were used to train and test a 2D CNN and a 3D CNN model. We have compared the models' results using different evaluation parameters such as accuracy, loss, confusion matrix, receiver operating characteristic (ROC) curve, and precision‐recall (PR) curve. The 3D model learned key features from the data and was able to classify the test data with 88.9% accuracy with 0.86 area under curve (AUC). In contrast, the 2D model achieved a mediocre accuracy of 72.22% with 0.50 AUC. This shows that the 3D model is more accurate and reliable than the 2D model.
The effect of a toothpaste containing oleanolic acid in reducing plaque and gingivitis: a proof‐of‐concept randomized trial
Authors: Ramírez Gloria M. , Villar Cristina Cunha , Saraiva Luciana , Benítez Carlos G. , Rubio Carlos M. , Malheiros Zilson Magalhães , Stewart Bernal , Kilpatrick LaTonya , Romito Giuseppe A.
Published: May 2021

Objectives

To assess the safety and efficacy of an oleanolic acid (OA)‐containing toothpaste in reducing gingival inflammation and plaque in patients with gingivitis.

Methods

This proof‐of‐concept parallel, double‐blind, randomized controlled clinical trial included 99 patients. Following a 1‐week washout, patients were randomized into three groups: OA group (fluoride toothpaste containing 0.1% OA and placebo mouthwash); negative control (fluoride toothpaste and placebo mouthwash); and CHX group (fluoride toothpaste and 0.12% chlorhexidine mouthwash). Patients were clinically assessed at inclusion, pre‐washout visit, baseline and after 4 days, 1 week and 2 weeks of twice‐daily use of the products. Patients received a diary for documentation of bleeding on brushing and provided unstimulated saliva samples.

Results

After two weeks, all groups showed significant reductions in all clinical parameters. The CHX group exhibited significantly greater reductions in gingival index and interproximal gingival index scores at week 2, as compared to patients in the negative control (p = 0.04). In contrast, reductions in gingival index scores did not differ between CHX and OA groups and between OA and negative control groups at week 2. The CHX group had significantly greater reductions in plaque index scores at day‐4, 1‐week and 2‐week evaluations, as compared to the negative control and OA groups. The frequency of adverse events was similar among the groups. None of the groups reduced salivary transferrin levels. Finally, the OA group had the lowest percentage of self‐reported bleeding events.

Conclusion

OA toothpaste failed to provide antiplaque and antigingivitis effects superior to those of a fluoride toothpaste after 2 weeks of use.
Dosimetry of pulsed magnetic field towards attaining bacteriostatic effect on Enterococcus faecalis: Implications for endodontic therapy
Authors: Naskar Sharmistha , Chandan  , Baskaran Divya , Roy Choudhury Aditya N. , Chatterjee Subhomoy , Karunakaran Subbaraj , Murthy B.V. Sreenivasa , Basu Bikramjit
Published: May 2021

Aim

To examine in a laboratory setting the efficacy of moderate to high strength magnetic fields, as a potential bacteriostatic stimulus, against Enterococcus faecalis, one of the causative agents for infection during root canal treatments.

Methodology

Four different strengths (1, 2, 3 and 4 T) of the pulsed magnetic field (PMF) were applied in thirty repetitions to bacterial suspension. A pickup coil setup was used to measure the electromotive force induced inside the bacterial suspensions. The optical density (OD) was monitored over time (for 16 h 40 min) during the post‐treatment period to assess bacterial growth. Along with the change in OD values, live/dead assay, membrane depolarization study, atomic force microscopy (AFM), scanning electron microscopy (SEM) and reactive oxygen species (ROS) assay on selected samples were studied to evaluate the effect of PMFs. All results were analysed using one‐way ANOVA followed by post hoc Tukey test and considered significant at p < .05. Regression analysis (at a confidence of 95%, α = 0.05) was performed on the bacterial growth and membrane depolarization studies to determine progressive changes of the outcomes.

Results

The peak value of the induced electromotive force was recorded as 0.25 V, for the 4 T magnetic field pulse with a pulse width of 16 ms. There was a significant arrest of bacterial cell growth after an exposure to PMFs of 1 T, 3 T and 4 T (ANOVA score: F (4, 495) =395.180 at p = .05). The image‐based qualitative results of the live/dead assay using fluorescence microscopy techniques indicated that an exposure to higher PMFs (3 T/ 4 T) induced a bacteriostatic effect in a longer post‐exposure timescale. Evidence of altered membrane potential within the 2 h of exposure to 4 T PMF was supported by the incidence of elevated ROS. For the ROS assay, a significant difference occurred for 4 T exposed samples (ANOVA score: calculated F (1, 3) =20.2749 at p = .05). SEM and AFM observations corroborated with the outcomes, by portraying significant membrane damage.

Conclusion

In a laboratory setting, PMFs with higher magnitudes (3 T and 4 T) were capable of inducing bacteriostatic effects on E. faecalis.
Prevalence and antimicrobial resistance profile of Staphylococcus aureus in inherited epidermolysis bullosa: a cross‐sectional multicenter study in Brazil
Authors: Santin Juliana T. , Mariath Luiza M. , Rossato Adriana M. , Schuler‐Faccini Lavínia , Kiszewski Ana E.
Published: May 2021

Background

Infection is an important complication of epidermolysis bullosa (EB), and Staphylococcus aureus has been pointed out as the most common pathogen among this population. The objective of this study was to investigate the prevalence and antimicrobial resistance profile of S. aureus colonizing EB patients in Brazil.

Methods

This cross‐sectional multicenter study was conducted between December 2015 and December 2017. We included a total of 89 individuals with EB from medical centers across Brazil. Data were obtained through clinical and bacteriological investigation. S. aureus were identified by biochemical tests. The nuc and mecA genes were confirmed by PCR assay. Antimicrobial susceptibility was investigated by disk diffusion method.

Results

The overall prevalence of S. aureus was 51.7% (46/89). Methicillin‐resistant S. aureus (MRSA) was detected in 24.7% (19/77) of all S. aureus isolates, colonizing 15.7% (14/89) of all patients. Community‐associated (CA)‐MRSA strains were resistant against sulfamethoxazole/trimethoprim and levofloxacin (P < 0.05%). S. aureus colonization of the nares and belly button represented a 3.4 times higher risk of simultaneous skin lesion colonization (P < 0.05%).

Conclusions

The high frequency of MRSA colonizing patients with EB is alarming considering its association with life‐threatening complications and poorer outcomes. EB patients are at increased risk of colonization and infection by Staphylococcus aureus and CA‐MRSA. Getting to know S. aureus carriage sites and its antimicrobial susceptibility profile is key when planning new individualized and more effective prophylactic and therapeutic measures.
Demographics, clinical characteristics and outcomes among 197 patients with COVID‐19 in the Gold Coast area
Authors: Je David , O'Brolchain Aongus , Ulett Kimberly B. , Zainudheen Amith , Gerrard John , Alcorn Kylie , Memon Salim
Published: May 2021

Background

Clinical characteristics and outcomes of coronavirus disease 2019 (COVID‐19) patients have been varied internationally but have not been studied in an Australian cohort.

Aim

To describe characteristics and outcomes of approximately the first 200 documented COVID‐19 cases during the first outbreak in the Gold Coast.

Methods

Retrospective observational cohort study of COVID‐19 patients managed by Gold Coast Hospital and Health Service (GCHHS). Demographics, clinical characteristics and outcomes data were collected.

Results

One hundred and ninety‐seven patients were included (mean age 45 years); 52.3% were female and 9.1% were healthcare workers. Most were overseas travellers (53.8%), contacts of a local confirmed case (25.4%) or cruise ship passengers (17.3%). The commonest comorbidities were hypertension (14.2%) and asthma (11.2%). The commonest symptoms were cough (74.1%), fever (58.9%), sore throat (48.7%), headache (48.7%) and rhinorrhoea (46.2%). Sixty‐three patients were hospitalised and the rest admitted to a ‘virtual ward’. Of 63 hospitalised patients, 5 (7.9%) required intensive care unit (ICU) admission and 3 (4.8%) required intubation. No patients died. Due to low numbers of accurate exposure dates, the incubation period could not be reliably calculated for a significant proportion of the cohort. Average duration of symptoms was 14 days, time from first symptom to hospitalisation was 5.3 days and time from first symptom to ICU admission was 11.6 days. The majority (88%) experienced mild disease and achieved complete symptom resolution (97%). Nasopharyngeal swab polymerase chain reaction was the main diagnostic method (99%). Twenty‐four patients received anti‐viral pharmacotherapy, with 87.5% getting hydroxychloroquine.

Conclusions

The present study provides characteristics and outcomes of the first 197 patients with COVID‐19 in the Gold Coast.
Nurses’ perceptions on and experiences in conflict situations when caring for adolescents with anorexia nervosa: A qualitative study
Authors: Wu Wan‐Ling , Chen Shu‐Ling
Published: May 2021

Anorexia nervosa (AN), which primarily affects adolescent girls and young women, is characterized by excessive dieting, leading to severe weight loss and a pathological fear of becoming overweight, or unhealthy behaviours that hinder weight gain. Caring for patients who have AN is particularly challenging for nursing staff, who are on the front line and have the closest contact with patients. However, little is known about how nursing staff care for adolescent patients with AN in Taiwan. This study aimed to explore nurses’ perceptions on and experiences in conflict situations in caring for adolescents with AN. A qualitative study approach was conducted. Through semi‐structured interviews, ten nursing staff from the paediatric ward at a university‐affiliated medical centre in central Taiwan shared their experiences. Recorded interviews were transcribed and analysed by content analysis. This analysis identified three themes with eight subthemes: (i) struggling to develop therapeutic relationships, (ii) selective focusing, and (iii) difficulty changing minds. The findings of this study indicated a need for ongoing support for nursing staff, the development of therapeutic relationships with adolescent patients with AN, extensive nursing staff preparation, and the development of in‐service training programs to enable nursing staff to care for these patients with greater understanding.
Intensified job demands in healthcare and their consequences for employee well‐being and patient satisfaction: A multilevel approach
Authors: Huhtala Mari , Geurts Sabine , Mauno Saija , Feldt Taru
Published: May 2021

Aims

Intensified job demands (IJDs) and their effects on employee burnout, work engagement and patient satisfaction were investigated across different work units and occupational groups in a healthcare setting.

Design

A multilevel study.

Methods

One thousand twenty‐four healthcare employees responded to a survey in 2019 and rated their experiences of IJDs, burnout and work engagement. Nine hundred fifty‐one patients rated their satisfaction with care received from healthcare staff.

Results

Work units and occupational groups who shared more experiences of increased time pressure and multitasking reported higher exhaustion. Shared perceptions of increased planning and performing one's work autonomously correlated with higher exhaustion and lower patient satisfaction at the work‐unit level. Moreover, work intensification was found to be highest in emergency care and among nurses, while job‐related planning demands were highest in leadership services.

Conclusion

IJDs are a shared risk to employee well‐being among heterogeneous healthcare staff and relate negatively to customer‐rated patient satisfaction. We found that high time‐pressure demands increase the shared risk of burnout—especially among nurses and healthcare staff working in emergency care. Furthermore, increased independence and self‐determination in planning and executing work tasks also increase the shared risk of burnout especially among those in leadership services. This can lead to lower customer/care satisfaction among patients.

Impact

With the accelerating pace of socio‐economic change, the pace of work is also getting faster. Our findings help understand how IJDs are experienced among heterogeneous healthcare staff. Because different occupational groups and work units had different demands, this research shows that attempts to mitigate the negative effects of IJDs need to be planned and implemented in a context‐specific way. It seems crucial to pay more attention especially to adequate nurse staffing so that the adverse effects of IJDs could be mitigated among them.
Description of control programmes for Salmonella in pigs in Europe. Progress to date?
Authors: Correia‐Gomes Carla , Leonard Finola , Graham David
Published: May 2021

Salmonella spp. are one of the main causes of foodborne disease in Europe and have been associated with consumption of pig meat. However, Salmonella monitoring programmes in pigs and pig meat are not harmonized between those European countries where they exist. In general, current control programmes in Europe can be split into those aiming for: (a) elimination of infection and (b) control and reduction. Elimination programmes for Salmonella were introduced by Sweden, Norway, and Finland several decades ago. They have several elements in common including: prevalence at farm level at the start of the programmes was low, the programmes focus on the entire food chain and use bacteriology as the main detection method. If Salmonella contamination is detected stringent measures are applied. These programmes have achieved their target of a very low level of positive carcase swabs. Other European countries (e.g., Denmark, Germany, Netherlands, Belgium, UK, Ireland) have aimed for control and reduction of Salmonella in pigs rather than elimination. The main component that these programmes have in common is that their monitoring system is based on serology and farms are assigned to risk categories based on their serological profile, with control measures being targeted to high seroprevalence farms. The degree of success of each programme has varied but overall, the programmes described here have not achieved a consistent reduction of farm‐level prevalence. This review describes these programmes in detail and discusses reasons for the failure to achieve the desired outcome of reducing Salmonella prevalence at farm level.
Demographics and Monetary Policy Shocks
Authors: BERG KIMBERLY A. , CURTIS CHADWICK C. , LUGAUER STEVEN , MARK NELSON C.
Published: May 2021

We show that consumption expenditures for older households are more responsive to monetary policy shocks than for young‐ or middle‐aged households. A one‐standard‐deviation expansionary monetary policy shock induces a statistically significant and quantitatively large (1.7%) increase in aggregate consumption for old households over the ensuing 3 years. The responses for young‐ and middle‐aged households are smaller and not statistically significant. We also present evidence, suggesting that life‐cycle wealth effects play a role in driving the responses. We then build the wealth mechanism into a partial equilibrium life‐cycle model, which can qualitatively match the empirical patterns.
The Trueness of Obturator Prosthesis Base Manufactured by Conventional and 3D Printing Techniques
Authors: Alfaraj Amal , Yang Chao‐Chieh , Levon John A. , Chu Tien‐Min G. , Morton Dean , Lin Wei‐Shao
Published: May 2021

Purpose

To compare the intaglio surface trueness of obturator prosthesis bases manufactured by traditional compression molding, injection molding, and 3D printing techniques.

Materials and Methods

A complete edentulous master cast with Aramany Class I maxillary defect was selected for this in vitro study. Four study groups (n = 10/group) were included in this study, Group A: Compression Molding, Group B: Injection Molding, and Group C: Cara Print 3D DLP Printer, and Group D: Carbon 3D DLS Printer. All obturator prostheses' intaglio surfaces were scanned with a laboratory scanner (E4; 3Shape Inc, New Providence, NJ) and the dimensional differences between study samples and their corresponding casts were calculated as the root mean square (measured in mm, absolute value) using a surface matching software (Geomagic design X; 3D Systems, Rock Hill, SC). One‐way Analysis of variance (ANOVA) and Fisher's least significant difference (LSD) test were used to compare groups differences in RMS (α = 0.05).

Results

There was a significant effect of manufacturing technique on the RMS values for the 4 conditions [F(3,36) = 5.743, p = 0.003]. Injection Molding (0.070 mm) and Compression Molding groups (0.076 mm) had a lower interquartile range, and the Cara Print 3D‐Printer group (0.427 mm) and Carbon 3D‐Printer (0.149 mm) groups had a higher interquartile range. The Injection Molding group showed the best and uniform surface matching with the most area in green in the color maps. The Injection Molding group (0.139 ± 0.049 mm) had significantly lower RMS than all other groups (p < 0.001 for all comparisons). Compression Molding (0.269 ± 0.057 mm), Cara Print 3D‐Printer (0.409 ± 0.270 mm), and Carbon 3D‐Printer (0.291 ± 0.082 mm) groups were not significantly different from each other (Compression Molding versus Carbon 3D‐Printer, p = 0.59; Compression Molding versus Cara Print 3D‐Printer, p = 0.25; Cara Print 3D‐Printer versus Carbon 3D‐Printer, p = 0.40).

Conclusion

Obturator prosthesis bases manufactured with injection molding technique showed better intaglio surface trueness than ones made by the compression molding technique and 3D printers. Although obturator prosthesis bases manufactured from different 3D printers showed similar trueness, a DLP 3D printer produced less consistent outcome than a DLS 3D printer.
The Milwaukee youth engagement pilot: Evidence of reciprocal legal socialization in Juvenile Court
Authors: Buss Emily
Published: May 2021

This paper describes a pilot project implemented in Milwaukee's Juvenile Court, which was designed as a preliminary feasibility study to assess whether a change in court procedures could alter young offenders’ engagement in the court process and enhance their relationship with the juvenile court judge. Participants in the pilot engaged in regular monthly conversations with the juvenile judge and other legal actors in an informal context focused on collaborative planning and problem solving. The procedural justice and legal socialization literature suggests that these changes in interactions and relationships might facilitate the development of a “consensus” orientation to legal authority associated with a shared trust in the law and a voluntary acceptance of its legitimacy. This paper offers an evaluation of the pilot project using a quasi‐ethnographic approach based on observational data and interviews with participants. Although the original focus of the pilot was on the relationship between the young offenders and the judge and on the impact of that relationship on the youths’ attitudes, it became evident, over the course of the study, that the impact of the engagement was felt on both sides of the relationship, and that it was not limited to the judge and the youth. The paper explores the potential value of “reciprocal socialization”—socialization of legal authorities by the subjects with whom they interact—to the successful achievement of the juvenile justice system's aims.
Injecting network structure determines the most efficient strategy to achieve Hepatitis C elimination in people who inject drugs
Authors: Brown Chloe , Siegele Martin , Wright Mark , Cook Charlotte , Parkes Julie , I Khakoo Salim , Sacks‐Davis Rachel , Buchanan Ryan M
Published: May 2021

Transmission of Hepatitis C (HCV) continues via sharing of injection equipment between people who inject drugs (PWID). Network‐based modelling studies have produced conflicting results about whether random treatment is preferable to targeting treatment at PWID with multiple partners. We hypothesise that differences in the modelled injecting network structure produce this heterogeneity. The study aimed to test how changing network structure affects HCV transmission and treatment effects. We created three dynamic injecting network structures connecting 689 PWID (UK‐net, AUS‐net and USA‐net) based on published empirical data. We modelled HCV in the networks and at 5 years compared prevalence of HCV 1) with no treatment, 2) with randomly targeted treatment and 3) with treatment targeted at PWID with the most injecting partnerships (degree‐based treatment). HCV prevalence at 5 years without treatment differed significantly between the three networks (UK‐net (42.8%) vs. AUS‐net (38.2%),p< 0.0001 and vs. USA‐net (54.0%),p< 0.0001). In the treatment scenarios UK‐net and AUS‐net showed a benefit of degree‐based treatment with a 5‐year prevalence of 1.0% vs. 9.6%p< 0.0001 and 0.15% vs. 0.44%,p< 0.0001. USA‐net showed no significant difference (29.3% vs. 29.2%,p= 0.0681). Degree‐based treatment was optimised with low prevalence, moderate treatment coverage conditions whereas random treatment was optimised in low treatment coverage, high prevalence conditions. In conclusion, injecting network structure determines the transmission rate of HCV and the most efficient treatment strategy. In real‐world injecting network structures, the benefit of targeting HCV treatment at individuals with multiple injecting partnerships may have been underestimated.
Consistent investment of sophisticated rank‐dependent utility agents in continuous time
Authors: Hu Ying , Jin Hanqing , Zhou Xun Yu
Published: May 2021

We study portfolio selection in a complete continuous‐time market where the preference is dictated by the rank‐dependent utility. As such a model is inherently time inconsistent due to the underlying probability weighting, we study the investment behavior of a sophisticated consistent planners who seek (subgame perfect) intra‐personal equilibrium strategies. We provide sufficient conditions under which an equilibrium strategy is a replicating portfolio of a final wealth. We derive this final wealth profile explicitly, which turns out to be in the same form as in the classical Merton model with the market price of risk process properly scaled by a deterministic function in time. We present this scaling function explicitly through the solution to a highly nonlinear and singular ordinary differential equation, whose existence of solutions is established. Finally, we give a necessary and sufficient condition for the scaling function to be smaller than one corresponding to an effective reduction in risk premium due to probability weighting.
Environmental association modelling with loci under divergent selection predicts the distribution range of a lizard
Authors: Llanos‐Garrido Alejandro , Briega‐Álvarez Andrea , Pérez‐Tris Javier , Díaz José A.
Published: May 2021

During the historical building of a species range, individual colonizers have to confront different ecological challenges, and the capacity of the species to broaden its range may depend on the total amount of adaptive genetic variation supplied by evolution. We set out to increase our understanding of what defines a range and the role of underlying genetics by trying to predict an entire species’ range from the geographical distribution of its genetic diversity under selection. We sampled five populations of the western Mediterranean lizard Psammodromus algirus that inhabit a noticeable environmental gradient of temperature and precipitation. We correlated the genotypes of 95 individuals (18–20 individuals per population) for 21 SNPs putatively under selection with environmental scores on a bioclimatic gradient, using 1 × 1 km2 grid cells as sampling units. By extrapolating the resulting model to all possible combinations of alleles, we inferred all the geographic cells that were theoretically suitable for a given amount of genetic variance under selection. The inferred distribution range overlapped to a large extent with the realized range of the species (77.46% of overlap), including an accurate prediction of internal gaps and range borders. Our results suggest an adaptability threshold determined by the amount of genetic variation available that would be required to warrant adaptation beyond a certain limit of environmental variation. These results support the idea that the expansion of a species’ range can be ultimately linked to the arising of new variants under selection (either newly selected variants from standing genetic variation or innovative mutations under selection).
Proposal of New Radiological Classification and Treatment Strategy for Transverse Fractures of the C2 Axis Body
Authors: Kim Sung‐Kyu , Ko Jong‐Hyun , Park Jong‐Beom , Seo Hyoung‐Yeon , Chang Dong‐Gune , Chang Kibong
Published: May 2021

Objective

To investigate the characteristics of transverse fractures of the C2 axis body diagnosed on sagittal computed tomography (CT) and to propose new classification and appropriate treatment strategies.

Methods

A retrospective study was performed by enrolling 49 patients (26 men and 23 women) with transverse fractures of the C2 axis body who were treated at four national trauma centers of tertiary university hospitals from January 2000 to December 2017. The mean age of the patients was 60.8 years (ranging from 21 to 90 years). We classified 49 transverse fractures of the C2 body into three types based on fracture trajectories involving superior articular facet (SAF) and lateral cortex (LC) of the C2 body on coronal CT as follows: Type 1, involvement of C2 SAF on both sides; Type 2, unilateral involvement of C2 SAF on one side and LC on the other side; Type 3, involvement of LC on both sides. The characteristics, treatment methods, and results of 49 transverse fractures of the C2 body were analyzed. Mean follow‐up was 12.6 months (ranging from 12 to 26 months).

Results

Twenty‐six (53.1%) patients were Type 1, 21 (42.9%) were Type 2, and 2 (4.0%) were Type 3. Correlation coefficients for intra‐observer and inter‐observer reliabilities of classification were 0.723 and 0.598 (both, P < 0.001), respectively. About 40.8% (7 Type 1 and 13 Type 2) of the patients had fracture displacement >3 mm; Incidence of fracture displacement >3 mm was higher in Type 2 than Type 1 (61.9% vs 26.9%, P < 0.05). About 79.6% (20 Type 1, 17 Type 2 and 2 Type 3) of the patients were treated conservatively, and 20.4% (6 Type 1 and 4 Type 2) underwent surgery. At last follow‐up, 47 out of 49 patients achieved fusion; overall fusion rate was 95.9%. All conservatively treated Type 1 and Type 3 patients achieved fusion. Out of 17 conservatively treated Type 2 patients, 15 achieved fusion but two developed nonunion; however, two nonunion patients opted not to undergo surgery. Subgroup analysis showed that Philadelphia brace caused nonunion significantly in fracture displacement >3 mm compared to Minerva brace/Halovest (100% vs 0%, P < 0.05). All surgically treated Type 1 and 2 patients achieved fusion. In terms of clinical outcomes, neck pain visual analog scale and neck disability index were significantly improved (both, P < 0.01). According to Odom's criteria, 93.9% (46/49) of the patients achieved satisfactory outcomes. No major complications occurred.

Conclusions

The majority of transverse fractures of C2 body can be treated conservatively. However, surgery or rigid Minerva brace/Halovest should be considered for Type 2 transverse fractures of the C2 body with fracture displacement >3 mm.
Alterations of the pigmentation system in the aging process
Authors: Kang Hee Young , Lee Jin Wook , Papaccio Federica , Bellei Barbara , Picardo Mauro
Published: May 2021

Human skin aging is a natural phenomenon that results from continuous exposure to intrinsic (time, genetic factors, hormones) as well as extrinsic factors (UV exposure, pollution, tobacco). In areas that are frequently exposed to the sun, photoaging blends with the process of intrinsic aging, resulting in an increased senescent cells number and consequently accelerating the aging process. The severity of photodamage depends on constitutional factors, including skin phototype (skin color, tanning capacity), intensity, and duration of sunlight/UV exposure. Aging affects nearly every aspect of cutaneous biology, including pigmentation. Clinically, the phenotype of age pigmented skin has a mottled, uneven color, primarily due to age spots, with or without hypopigmentation. Uneven pigmentation might be attributed to the hyperactivation of melanocytes, altered distribution of pigment, and turnover. In addition to direct damage to pigment‐producing cells, photodamage alters the physiological crosstalk between keratinocytes, fibroblasts, endothelial cells, and melanocytes responsible for natural pigmentation homeostasis. Interestingly, age‐independent diffuse expression of senescence‐associated markers in the dermal and epidermal compartment is also associated with vitiligo, suggesting that premature senescence plays an important role in the pathology.
Wild Legalities: Animals and Settler Colonialism in Palestine/Israel
Authors: Braverman Irus
Published: May 2021

This article examines the underlying biopolitical premises of wildlife management in Palestine/Israel that make, remake, and unmake this region's settler colonial landscape. Drawing on interviews with Israeli nature officials and observations of their work, the article tells several animal stories that illuminate the hierarchies and slippages between wild and domestic, nature and culture, native and settler, and human and nonhuman life in Palestine/Israel. Animal bodies are especially apt technologies of settler colonialism, I show here. They naturalize and normalize settler modes of existence, while criminalizing native livelihoods and relations. Utilizing the terra nullius doctrine, creating biblical landscapes by reintroducing extirpated wild animals, controlling the movement of Palestinians and their animals while letting Jewish settlers and their animals roam unhindered, criminalizing the Palestinians’ more‐than‐human relations, and introducing restrictions on native engagement with animals are all an inherent part of nature administration in Palestine/Israel. But while they serve as tools for advancing colonial practices, nonhuman animals are also subject to the same violence that afflicts humans. Understanding the more‐than‐human dimensions of the settler colonial order is instrumental for thinking about how to subvert this order and redirect its violence toward decolonized, or “wild,” legalities. [animal studies, settler colonialism, biopolitics, nature conservation, Palestine/Israel]
Commensal bacteria‐immunity crosstalk shapes mucosal homeostasis in teleost fish
Authors: Yu Yong‐Yao , Ding Li‐Guo , Huang Zhen‐Yu , Xu Hao‐Yue , Xu Zhen
Published: May 2021

Fish harbour complex and dynamic microbiota in their mucosal surfaces. Due to the vital role of commensal microbiota in many biological functions including growth enhancement, nutrition, development, metabolism and immune response, many scholars have begun to refer to the microbiome as an ‘extended self’. Several studies have indicated that a normal microbiota contributes to fish health, and disturbances in microbial communities may lead to secondary infections and disease. Under evolutionary selective forces, fish have developed excellent innate immune mechanisms and an adaptive immune system composed of B cells and T cells to discriminate between beneficial and opportunistic bacteria for microbiome homeostasis. Many functional studies have demonstrated the involvement of immune cells, cytokines and Igs in maintaining microbiome homeostasis, and many beneficial microbes contribute to improving the immune barrier against external threats. Additionally, many host‐derived probiotics have been empirically used in the aquaculture sector and have been demonstrated to provide effective protection against fish diseases. Although little is known about the interactions between microbiota and the mucosal immune system in fish compared to mammals, managing aquaculture system microbiota may represent a promising alternative to antibiotics for disease prevention and control. This review thus provides an updated and comprehensive summary of currently characterized microbe compositions in fish mucosal tissues. Thereafter, the current knowledge on the crosstalk between microbiota and the mucosal immune system and probiotics in application is also discussed herein, thereby providing a theoretical basis for the development of microbe‐based disease control technologies in aquaculture.
Where to start? A new citizen science, remote sensing approach to map recreational disturbance and other degraded areas for restoration planning
Authors: Rowe Helen I. , Gruber Daniel , Fastiggi Mary
Published: May 2021

This UN Decade on Ecosystem Restoration highlights the capacity of restoration to mitigate trends in biodiversity loss and land degradation. However, many managers lack the tools they need to systematically and comprehensively identify degraded sites to prioritize restoration efforts given limited resources. We developed a novel, inexpensive, low‐tech approach for training and engaging citizen scientists to identify recreational impacts and other degraded areas within a defined unforested area. The mapping process follows four phases: (1) Landscape scans by citizen scientists using Google Earth Pro imagery; (2) A second scan of all marked sites based on high resolution aerial photography; (3) Compilation of basic information about the degraded sites; (4) Addition of associated soil type and plant communities. In the 12,375 ha McDowell Sonoran Preserve (Scottsdale, Arizona), we detected 67 new sites not previously identified by land managers, using an estimated 305 citizen scientist hours and only 30 staff hours. Each site has accompanying information including distance from nearest access point, cause of degradation, and plant and soils detail. After completion, we conducted independent field visits of 33% of the detected sites and verified degradation in all cases. We found that the remotely sensed approach provided better perspective to accurately measure the scale and original source of degradation compared with field visits. The approach can be conducted over a short period of time using citizen scientists, allows managers to undertake landscape level restoration prioritization and planning, and, if repeated, can be used to monitor changes in degradation and restoration over time.
Cavitary pulmonary disease in a patient on dialysis
Authors: Lamech Tanuj M. , Nithya Govindasamy , Aiswarya Dhanapalan , Sastry Bhagavatula V. R. H. , Arumugam Venkatesh , Gopalakrishnan Natarajan
Published: May 2021

A 24‐year‐old man on maintenance hemodialysis presented with bilateral cavitary consolidations and methicillin‐sensitiveStaphylococcus aureus(MSSA) bacteremia following ulceration of the skin over his arteriovenous (AV) fistula cannulation site. A diagnosis of septic pulmonary embolism was made, which presumptively originated from a localized MSSA infection of his AV access. He had an excellent response to a 28‐day course of cloxacillin, with the resolution of the pulmonary lesions.