bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomineralization of Dental Tissues Treated with Silver Diamine Fluoride
Authors: Sulyanto R.M. , Kang M. , Srirangapatanam S. , Berger M. , Candamo F. , Wang Y. , Dickson J.R. , Ng M.W. , Ho S.P.
Published: July 2021

Silver diamine fluoride (SDF) is a dental biomaterial used to arrest dental caries. To better understand SDF’s mechanism of action, we examined the localization of silver within the tissues of SDF-treated teeth. Carious primary teeth fixed within 2 min of SDF application (SDF-minutes, n = 3), at 3 wk after SDF application in vivo (SDF-weeks, n = 4), and at 2 y after multiple SDF applications in vivo (SDF-multiple, n = 1) were investigated in this study. Carious primary teeth without SDF application (no-SDF, n = 3) served as controls. Mineral density and structural analyses were performed via micro–X-ray computed tomography and scanning electron microscopy. Elemental analyses were performed through X-ray fluorescence microprobe and energy-dispersive X-ray spectroscopic techniques. SDF-treated teeth revealed higher X-ray–attenuated surface and subsurface regions within carious lesions, and similar regions were not present in no-SDF teeth. Regions of higher mineral density correlated with regions of silver abundance in SDF-treated teeth. The SDF penetration depth was approximated to 0.5 ± 0.02 mm and 0.6 ± 0.05 mm (mean ± SD) for SDF-minutes and SDF-weeks specimens, respectively. A higher percentage of dentin tubular occlusion by silver or calcium phosphate particles was observed in primary teeth treated with SDF-weeks as compared with SDF-minutes. Elemental analysis also revealed zinc abundance in carious lesions and around the pulp chamber. SDF-weeks teeth had significantly increased tertiary dentin than SDF-minutes and no-SDF teeth. These results suggest that SDF treatment on primary teeth affected by caries promotes pathologic biomineralization by altering their physicochemical properties, occluding dentin tubules, and increasing tertiary dentin volume. These seemingly serendipitous effects collectively contribute to the cariostatic activity of SDF.
Determining County-Level Counterfactuals for Evaluation of Population Health Interventions: A Novel Application of K-Means Cluster Analysis
Authors: Strutz Kelly L. , Luo Zhehui , Raffo Jennifer E. , Meghea Cristian I. , Vander Meulen Peggy , Roman Lee Anne
Published: July 2021

Objectives

Evaluating population health initiatives at the community level necessitates valid counterfactual communities, which includes having similar population composition, health care access, and health determinants. Estimating appropriate county counterfactuals is challenging in states with large intercounty variation. We describe an application of K-means cluster analysis for determining county-level counterfactuals in an evaluation of an intervention, a county perinatal system of care for Medicaid-insured pregnant women.

Methods

We described counties by using indicators from the American Community Survey, Area Health Resources Files, University of Wisconsin Population Health Institute County Health Rankings, and vital records for Michigan Medicaid-insured births for 2009, the year the intervention began (or the closest available year). We ran analyses of 1000 iterations with random starting cluster values for each of a range of number of clusters from 3 to 10 with commonly used variability and reliability measures to identify the optimal number of clusters.

Results

The use of unstandardized features resulted in the grouping of 1 county with the intervention county in all solutions for all iterations and the frequent grouping of 2 additional counties with the intervention county. Standardized features led to no solution, and other distance measures gave mixed results. However, no county was ideal for all subpopulation analyses.

Practice Implications

Although the K-means method was successful at identifying comparison counties, differences between the intervention county and comparison counties remained. This limitation may be specific to the intervention county and the constraints of a within-state study. This method could be more useful when applied to other counties in and outside Michigan.
Remembering the river: Flood, memory and infrastructural ecologies of stormwater drainage in Mumbai
Authors: Chitra V.
Published: July 2021

Mumbai’s storm water drainage system is rapidly transforming as incidences of heavy rainfall rise. Its transformation is built on the idea of conserving the city’s ‘rivers’ that were lost to urban development. While this move to recuperate a heritage of rivers seems like a step in the right direction, Mumbai’s drainage system was largely cobbled together over time through piecemeal interventions in an estuarine landscape. This article shows how by engineering a history of rivers, the city’s planning authorities set in motion an agenda to train the expansive estuarine and improvisational systems into governable riverine channels contained within the state’s developmental visions. It focuses on one major channel, the Mithi, to show how the rationality of disaster preparedness, the emergent calculus of carrying capacities, as well as infrastructure are braided into constructed ecological histories to inscribe a new hydrological order on the city. For Mumbai’s engineers, these changes introduce new scalar logics and alter the nature of the drainage assemblage. Mithi’s transformation is emblematic of how articulations of nature, technology and urban development are emerging from the anxieties of climate change.
The effect of film production studios on housing prices in Atlanta, the Hollywood of the South
Authors: Zahirovic-Herbert Velma , Gibler Karen M
Published: July 2021

Governments compete to attract film productions to their communities, expecting them to provide economic benefits directly through local purchases and employment and indirectly through publicity and image building. Atlanta, Georgia, has become a large film production hub, partially because of a state tax credit programme. As a result, permanent production facilities have been established that may influence surrounding real estate prices. Convenience and a desire to live among other creatives may encourage actors, technical workers and support staff to live nearby, and the film industry cachet may attract additional residents, increasing house prices. However, if the facilities are perceived to be similar to other industrial operations, they may negatively affect surrounding house prices. We investigate film production studios’ effect on residential property values using housing sales data and information on film production studios’ location, size and year established. To mitigate bias from the potential endogeneity of studios’ location choices, we augment the standard hedonic pricing framework to incorporate proximity to a film production studio and construct treatment and comparison groups. Using a spatial difference-in-difference framework, we find that while houses located closest to film production studios tend to sell for lower prices than houses further away, the discount is not attributable to the studios. Instead, the establishment of a new studio, especially a large one, is a positive event in the housing market. These findings have important policy implications for local governments in making decisions about film industry incentives and facilities’ site selection as possible drivers of redevelopment.
Rare complications of chicken pox in immunocompetent children: Acute respiratory distress syndrome
Authors: Mahto Subodh Kumar , Gupta Kritika , Pasricha Nitasha , Agarwal Nagina , Sheoran Ankita
Published: July 2021

Chickenpox is a highly contagious disease caused by varicella zoster virus. Fever and papulovesicular rash are hallmarks of this disease. These manifestations are self-liming and complete recovery is seen in most cases. We report two cases of chickenpox infection where the rare and atypical manifestations of acute respiratory distress syndrome with pleural effusion were seen.
Expressions of Doubt in Online News Discussions
Authors: Evans Anthony M. , Stavrova Olga , Rosenbusch Hannes , Brandt Mark J.
Published: July 2021

Online discussions about politics and current events play a growing role in public life, and they can foster positive outcomes (e.g., civic engagement and political participation) and negative outcomes (e.g., hostility and polarization). The present research examines how the use of doubtful (vs. confident) language influences behavior in online discussions of current events. We examine the effects of doubtful language on comment popularity (i.e., recommendations from other users) and the use of emotional language in subsequent replies. We examine data from 1.9 million user comments from the New York Times website. Comments containing doubtful language were less popular, receiving fewer user recommendations. Additionally, replies to doubtful comments were less emotional (containing fewer positive emotions and fewer negative emotions). These results suggest that although doubtful authors are less likely to be recommended by other users, they may play an important role in helping to foster civility in online discussions.
The Dad Bod: An Impossible Body?
Authors: Clay Simon , Brickell Chris
Published: July 2021

The term “Dad Bod” first emerged in a 2015 article by college student Pearson and initially described a young male physique that balances fat and muscle and also connotes a relaxed lifestyle involving ample amounts of beer and pizza. The term has since gained in popularity and entered the household lexicon, often in relation to early-middle-aged men. Using Scott’s theory of “performative regulation” and digital articles from men’s health and fitness magazines, blogs, and other popular media outlets, this article examines connections between the Dad Bod and female sexual desire, health, well-being, men’s body positivity, and masculinity. The Dad Bod speaks to profound tensions in neoliberal society which men navigate in a range of ways by ignoring, resisting, and/or embodying this identity.
A Barthian Critique of Schleiermacher’s Doctrine of God: Questioning the Schleiermacher Renaissance
Authors: Michelson Jared
Published: July 2021

Schleiermacher is an increasingly important resource for contemporary systematic theology, particularly as Barth’s criticisms of Schleiermacher, which were thought to have undermined his dogmatic relevance, are subject to severe criticism. With reference to the doctrine of God, Barth argues that Schleiermacher’s theology generates a “God behind God” and is problematized by Feuerbach. I offer a detailed reading of Schleiermacher’s mature account of the divine being and attributes and suggest in view of this interpretation that a slightly nuanced version of Barth’s critique rightly applies to Schleiermacher’s doctrine of God. I make this argument in dialogue with the many contemporary voices arguing in Schleiermacher’s defense and raise some critical questions for those seeking to retrieve Schleiermacher’s doctrine of God.
Modification of Nicholson–Bailey model under refuge effects with stability, bifurcation, and chaos control
Authors: Din Qamar , Ishaque Waqas , Iqbal Muhammad Asad , Saeed Umer
Published: July 2021

In this article, a modification is proposed for the classical Nicholson–Bailey model. It is assumed that the modified model follows all axioms of Nicholson–Bailey model except that in every generation a fraction of the hosts have a safe refuge from attack of parasitoids. It is investigated that under this assumption the modified model has stable coexistence. Furthermore, Neimark–Sacker bifurcation is interrogated at positive steady-state of modified model by implementing the normal forms theory of bifurcation. Chaos control methods based on perturbation of parameter and state feedback strategy are implemented to escape the trajectories from bifurcating and chaotic behavior. Furthermore, numerical simulations are carried out for illustration of theoretical discussion. Finally, all theoretical discussion is illustrated by taking into account real observed field data of host–parasitoid interaction.
The Impact of the COVID-19 Pandemic on Lifestyle: How Young people have Adapted Their Leisure and Routine during Lockdown in Italy
Authors: Panarese Paola , Azzarita Vittoria
Published: July 2021

The COVID-19 pandemic is an unprecedented global event. Physical distancing and other restrictions imposed by national and local governments all over the world to contain the spread of the virus almost certainly have had a significant impact on young people, who are more sensitive to peer interaction and social stimuli than adults.

This article sets out to investigate the lifestyles of young Italians during the first lockdown, with the aim of exploring how leisure becomes the object of a negotiation between social needs, regulatory requirements, and a situation of crisis. To investigate these aspects, we present the results of a quantitative study conducted on a large group of individuals in Italy, focusing on young Italians’ lifestyles and leisure activities, together with an overview of prevailing moods. Our findings indicate that young people activated various adaptation strategies in response to the crisis with possible significant effects on lifestyles and well-being.
Nineteen Eighty-Four, totalitarian lived skepticism, and unlearning how to love
Authors: Löfgren Ingeborg
Published: July 2021

This article explores what we can learn about truth and meaning from fiction, through a reading of George Orwell’s (Eric Blair’s) dystopic novel Nineteen Eighty-Four (1949) in the light of philosopher Stanley Cavell’s notion of lived skepticism. The article suggests that we can conceive of the novel as portraying lived skepticism of a totalitarian variety. This lived skepticism is a condition of uncertainty and doubt forced upon the members of the novel’s totalitarian society through indoctrination and physical and psychological torture. The article argues that the novel imagines three areas of totalitarian lived skepticism: lived skepticism with regard to the external world, with regard to language, and with regard to other minds. Among these three, the article centers on totalitarian lived meaning and other-minds skepticism. In particular, it asks who could be considered to be the main character’s “best case” of knowing another mind. It furthermore asks what relationship between intimacy, privacy, love, cruelty, and knowledge the novel imagines to obtain within its fictional universe. The article argues that Orwell’s novel gives us a nightmarish vision of the annihilation of the possibilities of love, by showing us The Party’s perverted pedagogy of unlearning. Through the dystopic world of Nineteen Eighty-Four, the reader is offered a potent object of comparison by which she can trace her own moral and sense-making boundaries: what does it mean at the end of the novel that the main character “loves” Big Brother? Can we understand imaginatively what it would be to love Big Brother? Or is the word “love” here merely carrying the illusion of sense—an illusion served to the reader as a pedagogical tool with which she may better learn how to tell sense from nonsense?
Sensitivity to Moral Principles Predicts Both Deontological and Utilitarian Response Tendencies in Sacrificial Dilemmas
Authors: Bostyn Dries H. , Roets A. , Conway P.
Published: July 2021

When facing sacrificial dilemmas in which harm maximizes outcomes, people appear sensitive to three moral principles: They are more averse to actively causing harm than passively allowing it ( action principle), causing harm directly than indirectly ( contact principle), and causing harm as a means than as a by-product of helping others ( intention principle). Across five studies and a meta-analysis ( N = 1,218), we examined whether individual differences in people’s sensitivity to these principles were related to participants’ moral preferences on sacrificial dilemmas. Interestingly, sensitivity to each of these principles was related to both elevated harm-rejection (i.e., deontological) as well as elevated outcome-maximization (i.e., utilitarian) response tendencies. Rather than increasing responses consistent with only one philosophical position, people sensitive to moral principles balanced moral concerns about causing harm and maximizing outcomes similar to people high in other measures of moral concern.
Albanian National Action Plan for Roma Inclusion 2016–2020: A Study on the Program Achievements at the Halfway Mark
Authors: Qejvanaj Gentian
Published: July 2021

Roma segregation in Albania has been causing growing concern since the fall of the communist regime. In this study, we analyze the effectiveness of the Albanian national action plan for Roma inclusion 2016–2020, in 2018, halfway in its implementation period. We gathered data on education and employment from the pre-implementation period (2015) and compared it with the latest available data in 2018. Interviews with local experts and surveys by the Balkan Barometer will provide background information to assess the current state of Roma integration in Albania. Moreover, descriptive statistics from national and international institutions and structured interviews will draw an independent narrative of Roma affairs. In our conclusion, we suggest moving beyond the “us and them” approach with programs run on inertia; our findings highlight that although encouraging achievements have been reached under the 2016–2020 action plan, real inclusion is still far, as statistical achievements do not say much about the quality of the education or job training provided under the 2016–2020 action plan.
Associations Between Workplace Violence, Mental Health, and Physical Health among Korean Workers: The Fifth Korean Working Conditions Survey
Authors: Kim Hae Ran
Published: July 2021

Background:

Workplace violence (WPV) is a global public health problem and a threat to the health of Korean workers. This study assessed the prevalence and risk factors of WPV and its association with mental and physical health among Korean workers.

Methods:

Data obtained for 50,205 respondents to the Fifth Korean Working Conditions Survey were utilized for this study. Verbal abuse, threats, physical violence, and sexual harassment were assessed individually and as a composite for “any WPV.” Workers were characterized by education, income, shift work status, access to a health and safety education program, work sector and overall health. Descriptive analyses and multiple logistic regression analyses were used to estimate the prevalence of WPV and its association with mental and physical health.

Findings:

Overall, 5.6% of workers reported experiencing one of four forms of WPV. The prevalence of verbal abuse, threats, physical violence, and sexual harassment were 4.9%, 0.7%, 0.2%, and 1.1%, respectively. Most perpetrators were customers. Prevalence of WPV was associated with lower education level, poor health status, long working hours, shift work, and no experience of health and safety education; 9.0% of service workers experienced violence. Workers who had experienced WPV were more likely to experience anxiety, sleep-related problems, depressive symptoms, back pain, headache/eye strain, and overall fatigue.

Conclusions/Applications to Practice:

Workplace violence is a serious occupational and public health concern in Korea. These results suggest managing WPV may improve workers’ well-being and that violence-prevention strategies, policies, and regulations should be implemented across most industries.
Two Crises Separated by a Decade: Political Economy of Trade Strategy and Reserves Accumulation in East Asia
Authors: Nag Biswajit , Ray Partha
Published: July 2021

This article seeks to explore the relationship between the global financial crisis (2007–2009) and the East Asian crisis (1997–1999) via the contribution of select East Asian countries, which led to the formation of the ‘global imbalance’, that is, experience of substantial and consistent current account surplus. Taking a cue from Bernanke’s ‘savings glut’ hypothesis, which has held ‘global imbalance’ to be a factor behind the global financial crisis, specifically, the article argues that in these countries, the nature of current account balance has undergone a sea change since the end of the 1990s. They also accumulated a substantial amount of foreign exchange reserves since then along with a major shift of trade regime and consequent trade surplus in all these countries. The article conjectures that the mishandling of the rescue package by International Monetary Fund could have induced them to go aggressively for accumulation of forex reserves. Thus, the two crises separated by a decade and in different continents are, indeed, linked through providing an incentive for brewing up of global imbalance via an activist trade policy in select East Asian countries. Seen in this context and from this standpoint, the two crises, indeed, appear to be close siblings!

JEL Codes: F41, F62, O53
Simulation of near-fault ground motions for randomized directivity parameters
Authors: Daoud Yara , Dabaghi Mayssa , Der Kiureghian Armen
Published: July 2021

The Dabaghi and Der Kiureghian stochastic near-fault ground motion model requires information about the source, site, and source-to-site geometry, including directivity parameters. Directivity parameters entail often unavailable knowledge of the rupture geometry and hypocenter location. This article presents methods to randomize the directivity parameters required to simulate near-fault ground motions. A first procedure is proposed where only the contributing fault, earthquake magnitude, and site location are known. Possible rupture directivity conditions are accounted for by randomizing the rupture geometry and hypocenter location. For this purpose, new predictive models of the rupture geometry parameters are developed for shallow crustal earthquakes with magnitudes between 5.2 and 7.9. To allow validation of synthetic motions with NGA-West2 models, a second procedure randomizes the rupture geometry and both hypocenter and site locations. Results show a general agreement between the two methods.
Transcatheter arterial chemoembolization combined with Hippo/YAP inhibition significantly improve the survival of rats with transplanted hepatocellular carcinoma
Authors: Quan Yi , Li Zhi , Zhu Kangshun , Liang Jundi
Published: July 2021

Background

This study aimed to explore the effect of inhibiting the Hippo/Yes-associated protein (YAP) signaling pathway on the outcomes of transcatheter arterial chemoembolization (TACE) in treating transplanted hepatocellular carcinoma (HCC).

Methods

A transplanted HCC rat model was established. Then, rats were randomly divided into four groups: Sham, TACE, verteporfin (inhibitor of Hippo/YAP), and TACE+verteporfin. Lent-OE-YAP was transfected into rats to overexpress YAP in vivo. After treatments, morphological changes, tumor weight, and the overall survival of rats in different groups were analyzed. Real-time PCR, immunohistochemistry staining, and Western blotting were used to determine the expression of factors related to the Hippo/YAP signaling pathway.

Results

Tumor weight and tissue lesions in the TACE and verteporfin groups were significantly reduced compared with the Sham group. Verteporfin significantly decreased tumor weight after TACE treatment. In addition, verteporfin significantly improved the overall survival of rats with transplanted HCC after TACE treatment. Compared with the Sham group, both TACE and verteporfin groups exhibited significantly decreased expression of macrophage-stimulating (MST)1, MST2, long-acting thyroid stimulator 1, transcriptional co-activator with PDZ-binding motif (TAZ), Yes-associated protein (YAP), TEA domain transcription factor (TEAD)1, TEAD2, TEAD3, and TEAD4. TACE plus verteporfin significantly enhanced the downregulation of effectors in the Hippo/YAP signaling pathway and decreased tumor size, while the overexpression of YAP exerted opposite effects.

Conclusion

The inhibition of the Hippo/YAP signaling pathway via verteporfin significantly improved the outcomes of TACE in treating transplanted HCC.
High-density Lipoprotein Cholesterol Is Negatively Correlated with Bone Mineral Density and Has Potential Predictive Value for Bone Loss
Authors: Tang Yuchen , Wang Shenghong , Yi Qiong , Xia Yayi , Geng Bin
Published: July 2021

Background

Many studies have shown that lipids play important roles in bone metabolism. However, the association between high-density lipoprotein cholesterol (HDL-C) and bone mineral density (BMD) is unclear. Therefore, this study aimed to investigate the linear or nonlinear relation between HDL-C levels and BMD and addressed whether the HDL-C levels had the potential values for predicting the risk of osteoporosis or osteopenia.

Methods

Two researchers independently extracted all information from the National Health and Nutrition Examination Survey (NHANES) database. Participants over 20 years of age with available HDL-C and BMD data were enrolled in the final analysis. The linear relationship between HDL-C levels and BMD was assessed using multivariate linear regression models. Moreover, the nonlinear relationship was also characterized by fitted smoothing curves and generalized additive models. In addition, the odds ratio (OR) for osteopenia and osteoporosis was evaluated with multiple logistic regression models.

Results

The weighted multivariable linear regression models demonstrated that HDL-C levels displayed an inverse association with BMD, especially among females and subjects aged 30 to 39 or 50 to 59. Moreover, the nonlinear relationship characterized by smooth curve fittings and generalized additive models suggested that (i) HDL-C levels displayed an inverted U-shaped relationship with BMD among women 30 to 39 or over 60 years of age; (ii) HDL-C levels exhibited a U-shaped association with BMD among women 20 to 29 or 50 to 59 years of age. In addition, females with high HDL levels (62-139 mg/dL) had an increased risk of osteopenia or osteoporosis.

Conclusion

This study demonstrated that HDL-C levels exhibit an inverse correlation with BMD. Especially in females, clinicians need to be alert to patients with high HDL-C levels, which may indicate an increased risk of osteoporosis or osteopenia. For these patients, close monitoring of BMD and early intervention may be necessary.
Progranulin deficiency in Iba-1+ myeloid cells exacerbates choroidal neovascularization by perturbation of lysosomal function and abnormal inflammation
Authors: Takahashi Kei , Nakamura Shinsuke , Otsu Wataru , Shimazawa Masamitsu , Hara Hideaki
Published: July 2021

Background

Age-related macular degeneration (AMD) is the principal cause of permanent blindness among elderly individuals worldwide. Chronic inflammation in the subretinal space is associated with a progression of exudative AMD. Progranulin (PGRN) is a growth factor secreted from myeloid cells and plays an important role in controlling the lysosomal function. A deficiency in PGRN leads to inflammation of the neurons in the central nervous system. The purpose of this study was to investigate the role played by PGRN in the size of the choroidal neovascularization (CNV) in laser-induced CNV mice.

Methods

CNVs were induced in C57BL/6J mice by laser photocoagulation of the retina. The expression of PGRN and the accumulation of Iba-1+cells around the sites of the CNVs were determined.Grn−/−,Grn+/−, andGrn+/+mice with laser-induced CNVs were also studied. To evaluate the effect of macrophages on the inflammation, we used a macrophage cell line (RAW264.7) in which the expression of PGRN was knocked down by RNA interference and peritoneal macrophages derived fromGrn−/−andGrn+/+mice. These cells were incubated under hypoxic conditions (1% O2).

Results

Iba-1+myeloid cells migrated and accumulated in the photocoagulation-induced CNV areas, and the CNV lesions secreted high levels of PGRN inGrn+/+mice. The size of the CNVs was larger inGrn−/−mice than inGrn+/−andGrn+/+mice. InGrn−/−mice, the number of ocular-infiltrating Iba-1+cells around the CNV was higher, and these cells produced more VEGF-A than the cells in theGrn+/+mice. PGRN-silencing of RAW264.7 cells led to abnormal activation of the cells. In addition, hypoxic conditions promoted the production of proangiogenic and proinflammatory cytokines from PGRN-deficient macrophages. Interestingly, the expression level of lysosome-associated proteins and the number of activated lysosomes increased in PGRN-deficient macrophages.

Conclusions

These findings indicate that PGRN deficiency in Iba-1+cells activates the lysosomal function that then leads to abnormal inflammation. The aberrant activation of Iba-1+myeloid cells might contribute to the progression of the CNV and the regulation of these cells might be a novel therapeutic target for exudative AMD.
Drug interaction between a selective serotonin reuptake inhibitor and a triptan leading to serotonin toxicity: a case report and review of the literature
Authors: Jin Gilbert , Stokes Philip
Published: July 2021

Background

Serotonin toxicity is a known side effect of selective serotonin reuptake inhibitors and has previously also been described as a possible side effect of 5-hydroxytryptamine receptor agonist (triptan) medications. However, the literature is conflicted about the risk of developing serotonin toxicity as a result of drug interaction between selective serotonin reuptake inhibitors and triptans.

Case presentation

A 30-year-old Caucasian woman with a history of depression on regular fluvoxamine presented to the emergency department with right-sided facial and lower limb twitching. The patient had recently been prescribed sumatriptan for migraines and had taken her first ever dose shortly prior to the onset of symptoms. She was tachycardic, diaphoretic, and hypertonic on initial assessment with bilateral lower limb and ocular clonus. Electrocardiogram showed sinus tachycardia with QT interval under the treatment interval, and pathology and imaging findings were unremarkable. Her symptoms improved with supportive management and cyproheptadine.

Conclusions

This patient’s presentation fulfilled both Sternbach and Hunter criteria for serotonin toxicity, illustrating a potential case of serotonin toxicity as a result of drug interaction between a selective serotonin reuptake inhibitor and a triptan.
Subdiaphragmatic abscess due to penetration of a duodenal ulcer successfully treated with endoscopic transgastric drainage: a case report
Authors: Takami Tomoya , Takihara Hiroshi , Yasuda Koji , Kasyu Nozomi , Yoshitake Hiroyuki , Shintani Hiroshi , Kataoka Naoki , Yamaguchi Tomoyuki , Makimoto Shinichiro
Published: July 2021

Background

Subdiaphragmatic abscesses are sometimes caused by intraabdominal infections. We report a case of endoscopic ultrasound-guided transgastric drainage.

Case presentation

A 75-year-old Asian man was referred to our hospital for treatment for upper gastrointestinal bleeding. On admission, blood tests showed a marked inflammatory response, and abdominal computed tomography showed free air in the abdominal cavity and a left subdiaphragmatic abscess. Therefore, the patient was diagnosed with an intraabdominal abscess associated with a perforated duodenal ulcer. Because he did not have generalized peritonitis, fasting and antibiotic treatment were the first therapies. However, because of the strong pressure on the stomach associated with the abscess and difficulty eating, we performed endoscopic ultrasound-guided transgastric drainage. After treatment, the inflammatory response resolved, and food intake was possible. The patient’s condition remains stable.

Conclusions

Drainage is the basic treatment for subdiaphragmatic abscesses; however, percutaneous drainage is often anatomically difficult, and surgical drainage is common. We suggest that our success with endoscopic ultrasound-guided transgastric drainage in this patient indicates that this approach can be considered in similar cases and that it can be selected as a minimally invasive treatment method.
Learning without loss
Authors: Elser Veit
Published: July 2021

We explore a new approach for training neural networks where all loss functions are replaced by hard constraints. The same approach is very successful in phase retrieval, where signals are reconstructed from magnitude constraints and general characteristics (sparsity, support, etc.). Instead of taking gradient steps, the optimizer in the constraint based approach, called relaxed–reflect–reflect (RRR), derives its steps from projections to local constraints. In neural networks one such projection makes the minimal modification to the inputs x, the associated weights w, and the pre-activation value y at each neuron, to satisfy the equation $x\cdot w=y$
x
⋅
w
=
y
. These projections, along with a host of other local projections (constraining pre- and post-activations, etc.) can be partitioned into two sets such that all the projections in each set can be applied concurrently—across the network and across all data in the training batch. This partitioning into two sets is analogous to the situation in phase retrieval and the setting for which the general purpose RRR optimizer was designed. Owing to the novelty of the method, this paper also serves as a self-contained tutorial. Starting with a single-layer network that performs nonnegative matrix factorization, and concluding with a generative model comprising an autoencoder and classifier, all applications and their implementations by projections are described in complete detail. Although the new approach has the potential to extend the scope of neural networks (e.g. by defining activation not through functions but constraint sets), most of the featured models are standard to allow comparison with stochastic gradient descent.
Emergency Laparotomy Follow-Up Study (ELFUS): prospective feasibility investigation into postoperative complications and quality of life using patient-reported outcome measures up to a year after emergency laparotomy
Authors: Saunders D. I. , Sinclair R. C. F. , Griffiths B. , Pugh E. , Harji D. , Salas B. , Reed H. , Scott C.
Published: July 2021

Background

Emergency laparotomy carries a significant risk profile around the time of surgery. This research aimed to establish the feasibility of recruitment to a study using validated scoring tools to assess complications after surgery; and patient-reported outcome measures (PROMs) to assess quality of life and quality of recovery up to a year following emergency laparotomy (EL).

Methods

We used our local National Emergency Laparotomy Audit (NELA) register to identify potential participants at a single NHS centre in England. Complications were assessed at 5, 10 and 30 days after EL. Patient-reported outcome measures were collected at 1, 3, 6 and 12 months after surgery using EQ5D and WHODAS 2.0 questionnaires.

Results

Seventy of 129 consecutive patients (54%) agreed to take part in the study. Post-operative morbidity survey data was recorded from 63 and 37 patients at postoperative day 5 and day 10. Accordion Complication Severity Grading data was obtained from 70 patients. Patient-reported outcome measures were obtained from patients at baseline and 1, 3, 6 and 12 months after surgery from 70, 59, 51, 48, to 42 patients (100%, 87%, 77%, 75% and 69% of survivors), respectively.

Conclusions

This study affirms the feasibility of collecting PROMs and morbidity data successfully at various time points following emergency laparotomy, and is the first longitudinal study to describe quality of life up to a year after surgery. This finding is important in the design of a larger observational study into quality of life and recovery after EL.
Limits of data anonymity: lack of public awareness risks trust in health system activities
Authors: Gille Felix , Brall Caroline
Published: July 2021

Public trust is paramount for the well functioning of data driven healthcare activities such as digital health interventions, contact tracing or the build-up of electronic health records. As the use of personal data is the common denominator for these healthcare activities, healthcare actors have an interest to ensure privacy and anonymity of the personal data they depend on. Maintaining privacy and anonymity of personal data contribute to the trustworthiness of these healthcare activities and are associated with the public willingness to trust these activities with their personal data. An analysis of online news readership comments about the failed care.data programme in England revealed that parts of the public have a false understanding of anonymity in the context of privacy protection of personal data as used for healthcare management and medical research. Some of those commenting demanded complete anonymity of their data to be willing to trust the process of data collection and analysis. As this demand is impossible to fulfil and trust is built on a false understanding of anonymity, the inability to meet this demand risks undermining public trust. Since public concerns about anonymity and privacy of personal data appear to be increasing, a large-scale information campaign about the limits and possibilities of anonymity with respect to the various uses of personal health data is urgently needed to help the public to make better informed choices about providing personal data.
The role of inhibition of osteocyte apoptosis in mediating orthodontic tooth movement and periodontal remodeling: a pilot study
Authors: Kaplan Michele , Kalajzic Zana , Choi Thomas , Maleeh Imad , Ricupero Christopher L. , Skelton Michelle N. , Daily Madeleine L. , Chen Jing , Wadhwa Sunil
Published: July 2021

Background

Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts.

Material and methods

Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining.

Results

We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement.

Conclusion

Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.
Barriers to recruitment, retention and intervention delivery in a randomized trial among patients with firearm injuries
Authors: Floyd Anthony S. , Lyons Vivian H. , Whiteside Lauren K. , Haggerty Kevin P. , Rivara Frederick P. , Rowhani-Rahbar Ali
Published: July 2021

Background

We discuss barriers to recruitment, retention, and intervention delivery in a randomized controlled trial (RCT) of patients presenting with firearm injuries to a Level 1 trauma center. The intervention was adapted from the Critical Time Intervention and included a six-month period of support in the community after hospital discharge to address recovery goals. This study was one of the first RCTs of a hospital- and community-based intervention provided solely among patients with firearm injuries.

Main text

Barriers to recruitment included limited staffing, coupled with wide variability in length of stay and admission times, which made it difficult to predict the best time to recruit. At the same time, more acutely affected patients needed more time to stabilize in order to determine whether eligibility criteria were met. Barriers to retention included insufficient patient resources for stable housing, communication and transportation, as well as limited time for patients to meet with study staff to respond to follow-up surveys. These barriers similarly affected intervention delivery as patients who were recruited, but had fewer resources to help with recovery, had lower intervention engagement. These barriers fall within the broader context of system avoidance (e.g., avoiding institutions that keep formal records). Since the patient sample was racially diverse with the majority of patients having prior criminal justice system involvement, this may have precluded active participation from some patients, especially those from communities that have been subject to long and sustained history of trauma and racism. We discuss approaches to overcoming these barriers and the importance of such efforts to further implement and evaluate hospital-based violence intervention programs in the future.

Conclusion

Developing strategies to overcome barriers to data collection and ongoing participant contact are essential to gathering robust information to understand how well violence prevention programs work and providing the best care possible for people recovering from injuries.

Trial registration

ClinicalTrials.govNCT02630225. Registered 12/15/2015.
Effect of positive end-expiratory pressure on additional passive ventilation generated by CPR compressions in a porcine model
Authors: Levenbrown Yosef , Hossain Md Jobayer , Keith James P. , Burr Katlyn , Hesek Anne , Shaffer Thomas H.
Published: July 2021

Background

Compressions given during cardiopulmonary resuscitation generate small, ineffective passive ventilations through oscillating waves. Positive end-expiratory pressure increases the volume of these passive ventilations; however, its effect on passive ventilation is unknown. Our objective was to determine if increasing positive end-expiratory pressure during cardiopulmonary resuscitation increases passive ventilation generated by compressions to a clinically significant point. This study was conducted on 13 Landrace-Yorkshire pigs. After inducing cardiac arrest with bupivacaine, cardiopulmonary resuscitation was performed with a LUCAS 3.1. During cardiopulmonary resuscitation, pigs were ventilated at a positive end-expiratory pressure of 0, 5, 10, 15, 20 cmH2O (randomly determined) for 9 min. Using the NM3 respiratory monitoring device, expired minute ventilation and volumetric capnography were measured. Arterial blood gas was obtained for each positive end-expiratory pressure level to compare the effects of positive end-expiratory pressure on carbon dioxide.

Results

Increasing positive end-expiratory pressure from 0 to 20 cmH2O increased the mean (SEM) expired minute ventilation from 6.33 (0.04) to 7.33 (0.04) mL/min. With the 5-cmH2O incremental increases in positive end-expiratory pressure from 0 to 20 cmH2O, volumetric capnography increased from a mean (SEM) of 94.19 (0.78) to 115.18 (0.8) mL/min, except for 15 cmH2O, which showed greater carbon dioxide exhalation with volumetric capnography compared with 20 cmH2O. PCO2 declined significantly as positive end-expiratory pressure was increased from 0 to 20 cmH2O.

Conclusions

When increasing positive end-expiratory pressure from 0 to 20, the contribution to overall ventilation from gas oscillations generated by the compressions became more significant, and may even lead to hypocapnia, especially when using positive end-expiratory pressures between 15 and 20.
Risk assessment of labial bone perforation in the anterior mandibular region: a virtual immediate implant placement study
Authors: Tsai Yi-Wen Cathy , Huang Ren-Yeong , Cheng Chia-Dan , Cheng Wan-Chien , Cochran David L. , Nguyen Thomas T. , Shieh Yi-Shing , Lin Fu-Gong , Sung Cheng-En
Published: July 2021

Background

This study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure.

Methods

Series qualified CBCT images of 149 participants (894 teeth) were selected to analyze the assigned anatomical parameters, including concavity depth, concavity angle, torque, and deep bone thickness. Four classes of crestal and radicular dentoalveolar bone phenotypes (CRDAPs) of mandibular anterior teeth were categorized according to the thickness of dentoalveolar bone at both crestal and radicular zones. Data were adjusted for categorical (gender and CRDAP) and continuous (age, cavity angle, cavity depth, and deep bone thickness) variables using a multivariable logistic regression analysis with generalized estimating equation method.

Results

The overall probability of LBP after virtual implant placement was 21.6%. There is statistically significant higher prevalence of LBP at canine (28.5%) and CRDAP class II (29.2%) regions (p < 0.001). After adjusting confounding variables, CRDAP class II and class IV regions are more likely to have LBP when compared with CRDAP class I (control) regions (p < 0.01). The risk of LBP at canine site is 6.31 times more likely than at the central incisor (control) (p < 0.01).

Conclusions

Using a virtual immediate implant placement technique, the prevalence of LBP is significantly higher at the mandibular canine site and thin radicular dentoalveolar phenotype in the anterior mandibular region.
Toxicological screening and evaluation of anti-allergic and anti-hyperglycemic potential of Sonneratia caseolaris (L.) Engl. fruits
Authors: Dev Shrabanti , Acharyya Rabindra Nath , Akter Sheuly , Al Bari Md. Abdullah , Asma Kaniz , Hossain Hemayet , Sarkar Kishore Kumar , Biswas Nripendra Nath , Das Asish Kumar
Published: July 2021

Background

Sonneratia caseolaris (L.) Engl. (S. caseolaris) belonging to the Sonneratiaceae family is commonly known as Ora. It is traditionally used as an astringent, antiseptic, to treat sprains, swellings, cough and in arresting hemorrhage. The ethanolic extract of S. caseolaris (L.) Engl. fruits was investigated in the present study for its toxicity as well as anti-allergic and anti-hyperglycemic potentials.

Methods

Major phenolic compounds were identified and quantified by HPLC. Behavioral change, body weight, mortality and different blood parameters were measured to assess the toxicological effect of the extract. Anti-allergic activity was evaluated using TDI-induced allergic model mice. Oral glucose tolerance test (OGTT) and STZ-induced diabetic mice were used to evaluate the anti-hyperglycemic activity.

Results

Crude extract contained ellagic acid, vanillic acid and myrecitin (27.41, 3.06 and 7.93 mg per 100 g dry extract respectively). No major toxicity was observed in both acute and sub-acute toxicity study. Oral administration of the extract significantly ameliorated TDI-induced allergic symptoms like sneezing, scratching, swelling, redness and watery rhinorrhoea in the experimental mice. The extracts also reduced the total and differential count of leukocytes in the blood. The extract treated mice showed significant reduction in blood glucose, SGOT, SGPT, cholesterol, triglycerides, urea, creatinine and bilirubin level.

Conclusions

S. caseolaris contains bioactive phytoconstituents which may be the possible precursors to isolate and characterize the novel compounds targeting the diseases like allergy and diabetes.