bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosomes: A Novel Therapeutic Agent for Cartilage and Bone Tissue Regeneration
Authors: Liu Yanxin , Ma Yifan , Zhang Jingjing , Yuan Yuan , Wang Jinqiao
Published: December 2019

Despite traditionally treating autologous and allogeneic transplantation and emerging tissue engineering (TE)-based therapies, which have commonly performed in clinic for skeletal diseases, as the “gold standard” for care, undesirably low efficacy and other complications remain. Therefore, exploring new strategies with better therapeutic outcomes and lower incidences of unfavorable side effect is imperative. Recently, exosomes, secreted microvesicles of endocytic origin, have caught researcher’s eyes in tissue regeneration fields, especially in cartilage and bone-related regeneration. Multiple researchers have demonstrated the crucial roles of exosomes throughout every developing stage of cartilage and bone tissue regeneration, indicating that there may be a potential therapeutic application of exosomes in future clinical use. Herein, we summarize the function of exosomes derived from the primary cells functioning in skeletal diseases and their restoration processes, therapeutic exosomes used to promote cartilage and bone repairing in recent research, and applications of exosomes within the setting of the TE matrix.
Nonlinear modeling of the arm dynamics for the manipulators with reverse sensory validation
Authors: Bozek Pavol
Published: December 2019

The article deals with design issues of a system for regulating and controlling of the pendulum amplitude using an inertial system and a stepper motor. Basis of the solution is the pendulum theory and its mathematical model, respectively mathematical modeling of the pendulum trajectory. The aim is to derive the mathematical equation of the pendulum, calculate its oscillation period, and plot the oscillation of the pendulum model with damping or actuating in real time on a case study, as proposed by the authors. Following is the description of the inertial system, which is represented by an accelerometer and an angle sensor. Information about the velocity, acceleration, and position of the pendulum are acquired by mathematical derivations. The proposed hardware model and amplitude control algorithm for the microcontroller together with a brief description of the concluded experiments, which were focused on the accuracy of measurement and evaluation of all acquired data, is described next. The obtained results can be applied in the field of robotics, mainly due to its accuracy of trajectory calculation and plotting but also by reverse validation control of the movement of the monitored robot effectors.
The precision calculating method of robots moving by the plane trajectories
Authors: Božek Pavol , Lozhkin Alexander
Published: December 2019

Robots with complex motion paths are very rarely designed. The main obstacle is the lack of the necessary mathematical apparatus, despite the fact that the theory was proposed by Newton. We managed to formulate a new method for obtaining linear transformation parameters. It can be used for ellipse, hyperbola, as well as for other complex flat differentiable curves. A theorem for receiving the values of a transformed curve is formulated in the general case. The theoretical algorithm and the results of experimental studies using the geometric modeling method are presented. The proposed method works for all test curves, but this does not mean that it can always be used. Separation of the characteristic equation imposes additional complexity. Additional research is necessary, but it can be applied to many mechatronic frameworks now.
Neural network adaptive command filtered control of robotic manipulators with input saturation
Authors: Wang Lin , Yang Chunzhi
Published: December 2019

This paper investigates finite-time control of uncertain robotic manipulators with external disturbances by means of neural network control and backstepping technique. To solve the “explosion of terms” in traditional backstepping control, a second-order command filter is designed, and the virtual input and its first-order derivative can be obtained accurately in a finite time. The parameters of the neural network are updated by using the tracking error signals. The proposed controller can guarantee that the tracking error converges to a small region of the origin in some finite time. Finally, we give a simulation study to show the effectiveness of the proposed method.
An evaluation of positive behavioural support implemented within an intensive community support service for people with learning disabilities who present with behaviours that challenge
Authors: Lewis Nicola , Reynolds Emma , Vale Melanie , Keenan Emma , Hartland Amanda , Haines Maisy , Davies Bronwen E
Published: December 2019

This article evaluates the effectiveness of a multidisciplinary intensive community support service, using positive behavioural support (PBS) as a core intervention model to reduce behaviours of concern and to improve the quality of life and occupational involvement of individuals with a learning disability who present with behaviours that challenge. The service used outcome measures to evaluate the effectiveness of the PBS model. The study looks at pre- and post-outcome measures which showed a significant improvement in behaviour, quality of life and occupational outcomes for individuals with a learning disability presenting with complex behaviours of concern. This study contributes to the growing evidence base for PBS being delivered by specialist community learning disability teams.
Budesonide for Protein Losing Enteropathy in Patients with Fontan Circulation: A Systematic Review and Meta-Analysis
Authors: Kewcharoen Jakrin , Mekraksakit Poemlarp , Limpruttidham Nath , Kanitsoraphan Chanavuth , Charoenpoonsiri Nattawat , Poonsombudlert Kittika , Pattison Robert J. , Rattanawong Pattara
Published: December 2019

Background:

Recent studies have shown that oral budesonide can be used to improve albumin level in patients with protein-losing enteropathy (PLE) following Fontan procedure. However, there has never been a systematic review and meta-analysis to confirm this finding. We performed a systematic review and meta-analysis to explore the therapeutic effect of budesonide in patients with PLE post-Fontan procedure.

Methods:

We searched the databases of MEDLINE and EMBASE from inception to January 2019. Included studies were published studies that evaluate albumin level before and after budesonide therapy in patients with PLE following Fontan procedure. Data from each study were combined using the random-effects model.

Results:

Five studies with 36 post-Fontan operation patients with PLE were included. In random-effects model, there was a statistically significant difference in albumin level between before and after budesonide treatment (weighted mean difference = 1.28, 95% confidence interval: 0.76-1.79). No publication bias was observed on a funnel plot and Egger test with a P value of .676.

Conclusions:

The results of this systematic review and meta-analysis show that budesonide can be used to increase albumin level in patients with PLE following Fontan operation. Further studies may focus on the impact of outcome of budesonide in this population.
The Congenital Cardiac Anesthesia Society—Society of Thoracic Surgeons Cardiac Anesthesia Database Collaboration
Authors: Vener David F. , Abbasi Rania K. , Brown Morgan , Greene Nathaniel , Guzzetta Nina A. , Jacobs Jeffrey P. , Latham Gregory , Mossad Emad , Nicolson Susan C. , Twite Mark , Zhang Shuaqi , Wise-Faberowski Lisa
Published: December 2019

Multi-institutional databases and registries have proliferated over the last decade in all specialties of medicine. They may be especially helpful in low-frequency/high-acuity fields such as pediatric and congenital heart diseases. The Society of Thoracic Surgeon’s Congenital Heart Surgery Database (STSCHSD) is the largest single data set for the congenital heart disease population and includes contemporaneous data from over 120 programs in the United States (and several outside of the United States), capturing greater than 98% of the congenital cardiac surgical procedures in the United States. In 2010, the Congenital Cardiac Anesthesia Society partnered with the STSCHSD to incorporate anesthesia-related elements into the data set. Voluntary site participation in the anesthesia data has grown steadily. Currently, over 60 sites performing more than 60% of cardiac bypass procedures in the STSCHSD are submitting anesthesia data annually into the STSCHSD. Anesthesia data include perioperative medication usage, modalities for hemodynamic and neurologic monitoring, blood product, antifibrinolytic and procoagulant use, and anesthesia-related adverse events. This special article provides a descriptive summary of relevant findings to date, reflecting the wide variety in anesthesia practice patterns present among institutions and illustrates the functionality of a multisite registry in pediatric cardiac anesthesia which can be utilized both locally and nationally.
Atrioventricular Valve Repair in Single Ventricle Physiology: Timing Matters
Authors: Miana Leonardo A. , Manuel Valdano , Turquetto Aida Luísa , Issa Hugo Neder , Guerreiro Gustavo Pampolha , Caneo Luiz Fernando , Jatene Fábio Biscegli , Jatene Marcelo Biscegli
Published: December 2019

Objectives:

Atrioventricular valve (AVV) regurgitation in patients with single ventricle (SV) physiology severely impacts prognosis; the appropriate timing for surgical treatment is unknown. We sought to study the results of surgical treatment of AVV regurgitation in SV patients and evaluate risk factors for mortality.

Methods:

Medical records of 81 consecutive patients with moderate or severe AAV regurgitation who were submitted to AVV repair or replacement during any stage of univentricular palliation between January 2013 and May 2017 were examined. We studied demographic data and perioperative factors looking for predictors that might have influenced the results. Binary logistic regression was used to assess the impact on postoperative ventricular dysfunction and mortality.

Results:

Median age and weight were seven months (interquartile range [IQR]: 3-24) and 5.2 kg (IQR: 3.7-11.2), respectively. Seventy (86.4%) patients underwent AVV repair, and 11 (13.6%) patients underwent AVV replacement. There was an association between AVV repair effectiveness and timing of intervention ( P = .004). Atrioventricular valve intervention at the time of initial surgical palliation was associated with more ineffective repairs ( P = .001), while AVV replacement was more common between Glenn and Fontan procedures ( P = .004). Overall 30-day mortality was 30.5% (25 patients). In-hospital mortality was 49.4%, and it was higher when AVV repair was performed concomitant with initial (stage 1) palliation (64.1% vs 35.7%; P = .01) and when an effective repair was not achieved (75% vs 41%; P = .008). Multivariable analysis identified timing concomitant with stage 1 palliation as an independent risk factor for mortality ( P = .01); meanwhile, an effective repair was a protective factor against in-hospital mortality ( P = .05).

Conclusion:

Univentricular physiology with AVV regurgitation is a high-risk group of patients. Surgery for AVV regurgitation at stage 1 palliation was associated with less effective repair and higher mortality in this initial experience. On the other hand, effective repair determined better outcomes, highlighting the importance of experience and the learning curve in the management of such patients.
Intraoperative Flow Study Predicted the Postoperative Pulmonary Artery Pressure in the Bidirectional Glenn Operation
Authors: Korun Oktay , Yücel İlker Kemal , Çiçek Murat , Altın Hüsnü Fırat , Yurdakök Okan , Kılıç Yiğit , Selçuk Arif , Yurtseven Nurgül , Şaşmazel Ahmet , Aydemir Numan Ali
Published: December 2019

Background:

The aim of this study was to evaluate the predictability of postoperative pulmonary artery pressure (PAP) using intraoperative flow study in patients undergoing bidirectional Glenn operation.

Methods:

Patients who underwent Glenn operation under cardiopulmonary bypass (CPB) were included in the study. During the operation, after the completion of additional procedures under CPB, an intraoperative flow study was performed prior to Glenn anastomosis. After the completion of bidirectional Glenn, the patient was separated from the CPB and PAP was measured. The relationship between this pressure and flow study measurement was analyzed.

Results:

Nine patients who underwent bidirectional Glenn operation with additional procedures under CPB between July 2018 and January 2019 were included in the study. The median PAP was 9 mm Hg (interquartile range [IQR]: 7-10 mm Hg) in the flow study and 10 mm Hg (IQR: 8-11 mm Hg) after CPB, and the median difference between these pressures was 1 mm Hg (IQR: 1-3 mm Hg). There was a strong correlation between these two measurements ( r = 0.732; P = .025).

Conclusion:

The results of this study show that PAP after the Glenn procedure can be estimated using an intraoperative flow study. We believe that this method may be useful in intraoperative decision-making for Glenn operation in single ventricular patients who require extensive pulmonary artery (PA) reconstruction due to limited PA development, branch PA stenosis, or nonconfluent PAs. Also, this method can be used as a sort of intraoperative pulmonary resistance reversibility study in patients with high preoperative pulmonary vascular resistance due to surgically correctable pulmonary venous hypertension.
Asymptomatic Balanced Double Aortic Arch Associated With Tetralogy of Fallot
Authors: Haranal Maruti , Abdul Latiff Haifa Binti , Sivalingam Sivakumar
Published: December 2019

Coexistence of asymptomatic balanced double aortic arch with tetralogy of Fallot (TOF) is extremely rare and represents a surgical dilemma in decision-making due to the lack of consensus on the management of this subset of patients. We report a case of asymptomatic balanced double aortic arch coexistent with TOF in a two-year-old girl.
Outcomes of Multistage Palliation of Infants With Single Ventricle and Atrioventricular Septal Defect
Authors: Alsoufi Bahaaldin , McCracken Courtney , Kanter Kirk , Shashidharan Subhadra , Border William , Kogon Brian
Published: December 2019

Background:

Published palliation outcomes of infants with functional single ventricle (SV) and common atrioventricular septal defect (AVSD) are poor due to associated cardiac and extracardiac anomalies and development of atrioventricular valve (AVV) regurgitation. We report current palliation results.

Methods:

From 2002 to 2012, 80 infants with functional SV with AVSD underwent multistage palliation. Competing-risks analyses modeled events after first-stage surgery and Glenn (death/transplantation vs next palliation surgery) and examined factors associated with survival and AVV intervention.

Results:

Sixty-eight (80%) patients received neonatal palliation: modified Blalock-Taussig shunt (n = 33, 41%), Norwood (n = 20, 25%), and pulmonary artery band (n = 15, 19%), whereas 12 (15%) received primary Glenn. On competing-risks analysis, one-year following first-stage surgery, 29% of patients had died or received transplantation and 62% had undergone Glenn. Five years following Glenn, 9% of patients had died or received transplantation and 68% had undergone Fontan. Overall eight-year survival was 64% and was lower in patients with genetic syndromes (53% vs 82%), patients requiring concomitant total anomalous pulmonary venous connection repair (53% vs 69%), and those requiring neonatal palliation (48% vs 100%). Factors associated with mortality were unplanned reoperation (hazard ratio [HR]: 3.7 [1.7-8.0], P = .001) and extracorporeal membrane oxygenation use (HR: 7.1 [3.0-16.6], P < .001). Initial AVV regurgitation ≥ moderate was associated with AVV intervention (HR: 6.2 [2.4-16.1], P = .002) with eight-year freedom from death or AVV intervention of 25% in those patients.

Conclusions:

Patients with SV with AVSD are a distinct group and commonly have associated cardiac and extracardiac malformations that complicate care and affect survival. The development of AVV regurgitation requiring intervention is common but does not affect survival.
Transfusing Platelets During Bypass Rewarming in Neonates Improves Postoperative Outcomes: A Randomized Controlled Trial
Authors: Gautam Nischal K. , Pierre James , Edmonds Kayla , Pawelek Olga , Griffin Evelyn , Xu Zhang , Dodge-Khatami Ali , Salazar Jorge
Published: December 2019

Background:

In neonates, transfusion of platelets after hemodilution from cardiopulmonary bypass (CPB) has been standard. We hypothesize that platelet administration during the rewarming phase before termination of CPB would reduce coagulopathy, enhance hemostasis, reduce transfusion, and improve postoperative outcomes after neonatal cardiac surgery.

Methods:

A prospective, randomized trial was performed in 46 neonates. Controls received platelets only at the end of bypass with other blood products to assist in hemostasis. The treatment group received 10 mL/kg of platelets during the rewarming phase of bypass after cross-clamp release. After protamine, transfusion and perioperative management protocols were identical and constant among groups.

Results:

Two neonates in each group were excluded secondary to postoperative need for extracorporeal support. Controls (n = 21) and treatment patients (n = 21) were similar in age, weight, case complexity, associated syndromes, single ventricle status, and CPB times. Compared to controls, the treatment group required 40% less postbypass blood products (58 ± 29 vs 103 ± 80 mL/kg, P = .04), and case completion time after protamine administration was 28 minutes faster ( P = .016). The treatment group required fewer postoperative mediastinal explorations for bleeding ( P = .045) and had a lower fluid balance ( P = .04). The treatment group had shorter mechanical ventilation ( P = .016) and length of intensive care unit times ( P = .033). There were no 30-day mortalities in either group.

Conclusion:

Platelet transfusion during the rewarming phase of neonatal cardiac surgery was associated with reduced bleeding and improved postoperative outcomes, compared to platelets given after coming off bypass. Further studies are necessary to understand mechanisms and benefits of this strategy.
Supraclavicular Translocation of Aberrant Left Subclavian Artery for Vascular Ring Division and Resection of Kommerell’s Diverticulum
Authors: Turbendian Harma K. , Mesher Andrew , Mitchell Max B.
Published: December 2019

Intrathoracic left subclavian to common carotid artery translocation is advocated for patients undergoing vascular ring division in the setting of an enlarged Kommerell’s diverticulum and aberrant left subclavian artery. This approach poses technical challenges in larger patients and patients with unfavorable body habitus. Supraclavicular left subclavian artery to common carotid translocation greatly simplifies this procedure in select patients.
Protein Losing Enteropathy After Fontan Operation: Glimpses of Clarity Through the Lifting Fog
Authors: Rychik Jack , Dodds Kathryn M. , Goldberg David , Glatz Andrew C. , Fogel Mark , Rossano Joseph , Chen Jonathan , Pinto Erin , Ravishankar Chitra , Rand Elizabeth , Rome Jonathan J. , Dori Yoav
Published: December 2019

Fontan-associated protein losing enteropathy is a challenge to treat and is a major contributor to morbidity and mortality in patients with palliated single ventricle. Numerous strategies for management have been proposed, with confusion as to how best to stratify and implement care among the many treatments available. Medical management can be helpful in some, while novel lymphatic interventions hold potential for remission with good results. We review our institutional approach to protein losing enteropathy after Fontan operation and provide a suggested algorithm and pathway for effective care.
A novel autologous-made matrix using hyaline cartilage chips and platelet-rich growth factors for the treatment of full-thickness cartilage or osteochondral defects: Preliminary results
Authors: Cugat Ramón , Alentorn-Geli Eduard , Navarro Jordi , Cuscó Xavier , Steinbacher Gilbert , Seijas Roberto , Álvarez-Díaz Pedro , Barastegui David , Laiz Patricia , Samitier Gonzalo , García-Balletbó Montserrat
Published: December 2019

Purpose:

To report the clinical, functional, and magnetic resonance imaging (MRI)-based outcomes of a novel autologous-made matrix consisting of hyaline cartilage chips combined with mixed plasma poor rich in platelets clot and plasma rich in growth factors (PRGF) for the treatment of knee full-thickness cartilage or osteochondral defects.

Methods:

Between July 2015 and January 2018, all patients with full-thickness cartilage or osteochondral defects undergoing this novel cartilage restoration surgical technique were approached for eligibility. Indications for this procedure included traumatic or atraumatic full-thickness knee cartilage defects or osteochondritis dissecans. Patients were included if they had no concomitant use of stem cells, previous ipsilateral cartilage repair procedure, or follow-up was less than 10 months. The outcomes included data on current symptoms, physical exam, patient-reported, and functional outcomes (visual analogue scale (VAS) for pain, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) subjective form, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Lequesne index, and short form-12 (SF-12)) and the magnetic resonance observation of cartilage repair tissue (MOCART) score. These outcomes were compared to preoperative values, except for the MOCART score.

Results:

Fifteen patients were included in this preliminary study: mean (standard deviation (SD), range) follow-up 15.9 months (7.2, 10–32), age 26.8 years (12.1, 16–58), and body mass index 23.2 (2.1, 19.3–26.9). There were 14 men (93%) and 1 woman (7%). There was a statistically significant improvement between pre- and postoperative periods for VAS for pain ( p = 0.003), Lysholm score ( p = 0.002), IKDC subjective form ( p = 0.003), WOMAC for pain ( p = 0.005), WOMAC for stiffness ( p = 0.01), WOMAC for function ( p = 0.002), Lequesne Index ( p = 0.002), and SF-12 physical component summary ( p = 0.007). The postoperative mean (SD; range) MOCART score was 70 (12.4; 40–85).

Conclusions:

The use of this novel cartilage restoration surgical technique provides excellent clinical, functional, and MRI-based outcomes in young, active individuals with full-thickness cartilage or osteochondral defects.

Level of evidence:

Level IV—Therapeutic case series.
Tranexamic acid in hip fracture surgery: A systematic review and meta-analysis
Authors: Haj-Younes Bashar , Sivakumar Brahman S , Wang Michael , An Vincent VG , Lorentzos Peter , Adie Sam
Published: December 2019

Aims:

The primary objective of this review was to determine whether tranexamic acid (TXA) reduces transfusion rates in patients undergoing surgery for hip fractures. The secondary objective was to assess the effects of TXA on mortality and thromboembolic events in the same cohort.

Methods:

A systematic review of electronic databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included randomized controlled trials comparing perioperative TXA in patients treated surgically for hip/proximal femoral fractures against placebo. The primary outcome was the proportion of patients requiring blood transfusion. Secondary outcomes were blood loss, mortality, and complications. Meta-analysis was performed using inverse variance and random effects model.

Results:

The pooled data from 10 studies involving 842 patients showed that the proportion of patients requiring blood transfusion was significantly less in the TXA group (risk ratio (RR) 0.72, 95% confidence interval (CI) 0.59–0.88). There was no difference between TXA and control groups when comparing mortality (RR 1.17, 95% CI 0.65–2.10), deep venous thrombosis (RR 1.14, 95% CI 0.43–3.06), pulmonary embolism (RR 0.53, CI 0.09–3.02), acute coronary syndrome (RR 1.52, CI 0.18–12.98), cerebrovascular events (RR 0.78, CI 0.16–3.68), or wound complications (RR 1.61, CI 0.51–5.13).

Conclusion:

There is evidence that TXA reduces the proportion of patients requiring blood transfusions when undergoing hip fracture surgery. However, the small sample size and low event rates for adverse effects preclude any definitive conclusions from being established regarding adverse effects. Future trials should be powered to further assess potential complications and determine the ideal dosage and regime.
New Contexts for Professional Learning: Analyzing High School Science Teachers’ Engagement on Twitter
Authors: Fischer Christian , Fishman Barry , Schoenebeck Sarita Yardi
Published: December 2019

This mixed-methods observational study analyzes Advanced Placement (AP) Biology teachers’ engagement in microblogging for professional learning. Data from three hashtag-based Twitter communities—#apbiochat, #apbioleaderacad, and #apbioleaderacademy (121 users; 2,253 tweets)—are analyzed using educational data mining, qualitative two-cycle content analysis, social network analysis, linear and logistic regression analyses, and hierarchical linear modeling. Results indicate that teachers’ use of Twitter reflects aspects of high-quality professional development. Notably, Twitter’s nonhierarchical organization affords shared content creation and distribution. Additionally, Twitter allows for different temporal participation patterns and supports the personalization of learning experiences aligned to teachers’ needs and preferences. Furthermore, teachers frame their interactions on Twitter positively—thus, creating a supportive environment for professional learning that might reduce perceived professional isolation. Based on this analysis, policymakers and school leaders should feel comfortable encouraging teachers to use microblogging as part of their professional learning activities.
Correlates of Health Literacy Among Polish Immigrants With Chronic Health Conditions: Preliminary Results
Authors: Leszko Magdalena , Timoszyk-Tomczak Celina
Published: December 2019

The rapid increase in immigration to the United States in the past decades has resulted in an influx of individuals who have to familiarize themselves with a completely new health care system and practices, often in a new language. The purpose of this study was to assess health literacy and investigate its correlates among older U.S. Polish immigrants living in the Greater Chicago area. We conducted a cross-sectional study on 60 older adults (24 men, 36 women; mean age = 71.1 years) who completed the Short Test of Functional Health Literacy (S-TOFHLA) and a demographic survey. Scores on S-TOFHLA were lower among older and less-educated immigrants. Undocumented immigrants reported using health care services less frequently than those with legal status. These results confirm the findings of previous studies that older age and fewer years of education are associated with inadequate health literacy. Being familiar with at least the basic information about one’s condition will help patients to better understand a diagnosis, manage their symptoms, and improve any preventive treatment. The findings emphasize the importance of health education among older Polish immigrants. More research employing diverse groups of immigrants is needed to better understand the factors associated with health literacy.
What Child Oral Health–Related Behaviors Can First-time Mothers Actualize? A Pragmatic Prospective Study
Authors: Alvey J. , Divaris K. , Lytle L. , Vann W.F. , Lee J.Y.
Published: December 2019

Introduction:

First-time pregnant women are considered to be receptive to health information, rendering the prenatal period an opportune time to provide helpful information on the importance of child-related oral health. However, little is known about pregnant women’s knowledge of child oral health–related behaviors (COHBs) during pregnancy and their implementation after birth. We sought to address this knowledge gap by a prospective investigation of intended and actualized oral health behaviors among first-time pregnant women.

Methods:

We examined relationships between intended and actualized COHBs and their correlations with changes in oral health knowledge, health literacy, general self-efficacy, and dental neglect in a cohort of first-time pregnant clients at Women, Infants, and Children sites in North Carolina—participants of a large community-based study. The COHBs were related to diet (i.e., frequency of fruit juice and sweet snacks consumption and nighttime bottle-feeding) and oral hygiene practices (e.g., performance of daily oral hygiene and use of fluoridated toothpaste). Analyses relied on descriptive statistics and bivariate tests (Student’s t and McNemar’s). Data were collected from 48 participants (White, 44%; African American, 40%; Native American, 17%) at baseline and again at least 12 months after the birth of their first child.

Results:

On average, most mothers actualized 3 of 5 COHBs (range, 1 to 4). Significant differences between before and after birth were noted for frequency of sweet snacks consumption and putting the baby in bed with a bottle. No correlation was found between knowledge, literacy, self-efficacy, neglect, and sociodemographic characteristics and COHB actualization.

Conclusion:

Our findings suggest that first-time mothers in the studied population are likely to implement some but not all positive intended COHBs during pregnancy. Interventions are needed to assist women in implementing these practices. We support that, for prenatal interventional efforts to reap positive benefits, messaging should be personalized and include specific guidance on how to implement these recommendations.

Knowledge Transfer Statement:

A knowledge gap exists in our understanding of the relationship between first-time mothers’ intended and actualized child oral health behaviors, with implications in the optimal timing of infant and early childhood oral health messaging. Our findings suggest that first-time mothers are likely to implement some but not all positive behaviors that they intended to adopt during pregnancy. Interventions are needed to assist women in implementing these practices.
Roles of Ego Social Networks for Community Development in Southern Ethiopia: The Case of Tullo Community
Authors: Abebe Aleminew , Kebede Wassie , Alemie Ajanaw
Published: December 2019

This article explores the roles of Ego social networks for community development in the Tullo community of southern Ethiopia. By employing qualitative research methods, data were collected through semi-structured in-depth interviews and participatory mapping. The analysis revealed that social networks contribute to community development as communication channels and forums of information sharing. Networks also provide economic and social support to the members and beyond. Individuals known as Egos loom large in social networks and play a pivotal role in leading the functions of Ego networks for community development. The study draws important lessons about functions of the Ego networks to sustain the peaceful and meaningful life of the studied community.
Functional assessments of foot strength: a comparative and repeatability study
Authors: Bruening Dustin A. , Ridge Sarah T. , Jacobs Julia L. , Olsen Mark T. , Griffin Dallin W. , Ferguson Drew H. , Bassett Kirk E. , Johnson A. Wayne
Published: December 2019

Background

Evaluating the strength of the small muscles of the foot may be useful in a variety of clinical applications but is challenging from a methodology standpoint. Previous efforts have focused primarily on the functional movement of toe flexion, but clear methodology guidelines are lacking. A novel foot doming test has also been proposed, but not fully evaluated. The purposes of the present study were to assess the repeatability and comparability of several functional foot strength assessment techniques.

Methods

Forty healthy volunteers were evaluated across two testing days, with a two-week doming motion practice period between them. Seven different measurements were taken using a custom toe flexion dynamometer (seated), custom doming dynamometer (standing), and a pressure mat (standing). Measurements from the doming dynamometer were evaluated for reliability (ICCs) and a learning effect (paired t-tests), while measurements from the toe flexion dynamometer and pressure mat were evaluated for reliability and comparability (correlations). Electromyography was also used to descriptively assess the extent of muscle isolation in all measurements.

Results

Doming showed excellent within-session reliability (ICCs > 0.944), but a clear learning effect was present, with strength (p < 0.001) and muscle activity increasing between sessions. Both intrinsic and extrinsic muscles were engaged during this test. All toe flexion tests also showed excellent reliability (ICCs > 0.945). Seated toe flexion tests using the dynamometer were moderately correlated to standing toe flexion tests on a pressure mat (r > 0.54); however, there were some differences in muscle activity. The former may better isolate the toe flexors, while the latter appeared to be more functional for many pathologies. On the pressure mat, reciprocal motion appeared to display slightly greater forces and reliability than isolated toe flexion.

Conclusions

This study further refines potential methodology for foot strength testing. These devices and protocols can be duplicated in the clinic to evaluate and monitor rehabilitation progress in clinical populations associated with foot muscle weakness.
Biometric handwriting analysis to support Parkinson’s Disease assessment and grading
Authors: Cascarano Giacomo Donato , Loconsole Claudio , Brunetti Antonio , Lattarulo Antonio , Buongiorno Domenico , Losavio Giacomo , Sciascio Eugenio Di , Bevilacqua Vitoantonio
Published: December 2019

Background

Handwriting represents one of the major symptom in Parkinson’s Disease (PD) patients. The computer-aided analysis of the handwriting allows for the identification of promising patterns that might be useful in PD detection and rating. In this study, we propose an innovative set of features extracted by geometrical, dynamical and muscle activation signals acquired during handwriting tasks, and evaluate the contribution of such features in detecting and rating PD by means of artificial neural networks.

Methods

Eleven healthy subjects and twenty-one PD patients were enrolled in this study. Each involved subject was asked to write three different patterns on a graphic tablet while wearing the Myo Armband used to collect the muscle activation signals of the main forearm muscles. We have then extracted several features related to the written pattern, the movement of the pen and the pressure exerted with the pen and the muscle activations. The computed features have been used to classify healthy subjects versus PD patients and to discriminate mild PD patients from moderate PD patients by using an artificial neural network (ANN).

Results

After the training and evaluation of different ANN topologies, the obtained results showed that the proposed features have high relevance in PD detection and rating. In particular, we found that our approach both detect and rate (mild and moderate PD) with a classification accuracy higher than 90%.

Conclusions

In this paper we have investigated the representativeness of a set of proposed features related to handwriting tasks in PD detection and rating. In particular, we used an ANN to classify healthy subjects and PD patients (PD detection), and to classify mild and moderate PD patients (PD rating). The implemented and tested methods showed promising results proven by the high level of accuracy, sensitivity and specificity. Such results suggest the usability of the proposed setup in clinical settings to support the medical decision about Parkinson’s Disease.
Antimicrobial efficacy of 0.8% Hyaluronic Acid and 0.2% Chlorhexidine against Porphyromonas gingivalis strains: An in-vitro study
Authors: Binshabaib Munerah , Aabed Kawther , Alotaibi Fitoon , Alwaqid Milaf , Alfraidy Aljohara , Alharthi Shatha
Published: December 2019

Objective: The aim of the present in-vitro study was to assess antimicrobial efficacy of 0.8% hyaluronic acid (HA) and 0.2% Chlorhexidine gluconate (CHX) against Porphyromonas gingivalis (P. gingivalis).

Methods: The study was performed between December 2018 and March 2019 at the College of Dentistry at the Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. The P. gingivalis biofilms were formed and grown for 72 hours at 37°C under anaerobic conditions on glass slides coated with human saliva. The slides were individually positioned and exposed to 0.8% HA or 0.2% CHX. Therapeutically, the biofilms were divided into 3 groups as follows: (a) negative group; (b) 0.8% HA group and (c) 0.2% CHX group. P-values less than 0.05 were considered statistically significant.

Results: In the 0.8% HA group, P. gingivalis CFUs/ml were significantly higher at baseline than at 24- (P<0.05), 48 (P<0.05) and 72 hours (P<0.05) intervals. In the 0.2% CHX group, P. gingivalis CFUs/ml were significantly higher at baseline than at 72 hours interval (P<0.05). In the CHX group, there was no difference in P. gingivalis CFUs/ml between baseline, 24- and 48-hours intervals. At 48- and 72-hours intervals, the P. gingivalis CFUs/ml were significantly higher in the 0.2% CHX group compared with the 0.8% HA group.

Conclusion: In-vitro, 0.8% HA is more effective in reducing the P. gingivalis CFUs/ml compared with 0.2% CHX.

doi: https://doi.org/10.12669/pjms.36.2.1456

How to cite this:Binshabaib M, Aabed K, Alotaibi F, Alwaqid M, Alfraidy A, Alharthi S. Antimicrobial efficacy of 0.8% Hyaluronic Acid and 0.2% Chlorhexidine against Porphyromonas gingivalis strains: An in-vitro study. Pak J Med Sci. 2020;36(2):111-114.   doi: https://doi.org/10.12669/pjms.36.2.1456

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Post parotidectomy facial nerve palsy: A retrospective analysis
Authors: Hafeez Siddiqui Dr. Atif , Shakil Saad , Rahim Danish ur , Shaikh Irfan Ahmed
Published: December 2019

Background & Objectives: Transient paralysis of facial nerve is seen to vary from 15 % to 66 % in post-parotid surgery. The objective of this study was to find out the complications in post-parotidectomy with regards to facial nerve dysfunction since it is a vital structure encountered in parotid surgeries.

Methods: This was a retrospective study through non probability convenient sampling technique carried from September 2010 to January 2019 in the Department of Otorhinolaryngology, Dow University of Health Sciences, Dr. Ruth K.M.Pfau Civil Hospital, Karachi. Clinical data were recorded from 75 patients and out of them 70 patients had undergone surgery with parotid gland tumours and were reported on the morphology, age, sex, surgical procedure and complications, particularly facial nerve dysfunctions. In most cases ante-grade technique was performed to identify the facial nerve, whereas retrograde technique was used in recurring tumours, and in difficult cases. The stimulator of the nerve has not been used. The nature or severity of Facial nerve dysfunction was assessed in terms of either it is, permanent or temporary, total or incomplete in respect to its branches.

Results: Among total 75 patients; the mean age was 38.75 ± 9.26 years with male to female ratio of 1:1. Majority of the patients were diagnosed as pleomorphic adenoma, i.e. 78.6% after which 12% were diagnosed as mucoepidermoid carcinoma. 88.6% of patients had superficial parotidectomy and 11.4% of patients had total parotidectomy. About 75% of patients had no complications. 5(7.1%) patients had complete facial nerve palsy. Damage to the mandibular, buccal and temporozygomatic branch was observed in 10(14%), 2(3%) and 1(1.4%) patients respectively.

Conclusion: The most prevalent benign parotid tumour in this study was pleomorphic adenoma. After performing parotid surgery, it was predicted that the rate of complications related to the facial nerve injury was reduced as compared to the previous studies.

doi: https://doi.org/10.12669/pjms.36.2.1706

How to cite this:Siddiqui AH, Shakil S, Danish-ur-Rahim, Shaikh IA. Post parotidectomy facial nerve palsy: A retrospective analysis. Pak J Med Sci. 2020;36(2):126-130. doi: https://doi.org/10.12669/pjms.36.2.1706

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Postoperative pain management for circumcision; Comparison of frequently used methods
Authors: Münevveroglu Caglar , Gunduz Mehmet
Published: December 2019

Objective: To determine the ideal method for postoperative pain management after circumcision by comparing the most frequently used different methods like; dorsal penile block, caudal epidural block, subcutaneous ring block, intravenous paracetamol and intravenous tramadol HCl.

Methods: Between May 1st 2015 to May 1st 2016, 500 children between 2-10 year old were circumcised at the department of pediatric surgery of Istanbul Medipol University Health Care Practice & Research Center Sefakoy Hospital. Five groups were formed according to postoperative analgesia methods which were planned to be compared; Group-I. penile block, Group-II. Caudal epidural block, Group-III. subcutaneous ring block, Group-IV as intravenous paracetamol and Group-V as intravenous tramadol HCl. In order to evaluate the postoperative pain levels of children, Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) was filled at 30, 60, 120, 180 minutes after circumcision by a researcher who does not know which method was applied.

Results: No significant difference is found between the groups (p>0.05). In the statistical analysis, no significant difference was found in the effect of analgesia methods on CHEOPS scores between 30, 60, 120 and 180 minutes (p>0.05). In parallel with this result, no significant difference was found in the effect of heart beat rates and respiration rate averages between 30, 60, 120 and 180 minutes (p>0.05).

Conclusion: It has been shown that none of the five method has any superiority in reducing pain after circumcision and that all five methods can be used. However, we think that side effects of regional anesthesia and systemic analgesic applications should not be ignored.

doi: https://doi.org/10.12669/pjms.36.2.505

How to cite this:Munevveroglu C, Gunduz M. Postoperative pain management for circumcision; Comparison of frequently used methods. Pak J Med Sci. 2020;36(2):91-95. doi: https://doi.org/10.12669/pjms.36.2.505

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Biomedical foundations of security
Authors: Lobanov Aleksey
Published: December 2019

The textbook discusses the threats and risks to life and health of people in post-industrial society. The role and place of medical and biological technologies in the system of ensuring the safety of the population of the Russian Federation are shown from the standpoint of an interdisciplinary approach.
Briefly, but quite informative, the structure of the human body and the principles of its functioning are described. The specificity and mechanism of toxic effects on humans of harmful substances, energy effects and combined action of the main damaging factors of sources of emergency situations of peace and war are shown.
The medical and biological aspects of ensuring the safety of human life in adverse environmental conditions, including in regions with hot and cold climates (Arctic) are considered. Means and methods of first aid to victims are shown. The questions of organization and carrying out of measures of medical support of the population in zones of emergency situations and the centers of defeat are covered.
Designed for students, students and cadets of educational institutions of higher education, studying under the bachelor's program. It can also be useful for teachers, researchers and a wide range of professionals engaged in practical work on the planning and organization of biomedical protection of the population.
Conceptual Approach to Creating a Complex System of Radiation Protection in the Conditions of Influence of High-Dose Fields of Ionizing Radiation
Authors: Solov'ev V. , Bushmanov Andrey , Zorin V. , Grachev M.
Published: December 2019

The general approaches and criteria for substantiating the complex system of radiation protection (RP) of a human operator in the conditions of work in high-dose fields of ionizing radiation are considered. When planning work in such conditions, it is advisable to consider a set of measures of an organizational, technical and medical nature. Each activity has its measures own limits to reduce the dose load on the human operator or the development of adverse effects of radiation, and in some cases only a combination of them can give a certain protective effect, allowing to carry out the necessary activities in such conditions. If an operator works in mobile technical facilities (for example, a bulldozer, a caterpillar all-terrain vehicle, a helicopter, etc.) an important place is occupied by the issue of strengthening the technical component of the RP, primarily by engineering the design of additional shield elements. The biomedical rationale for the optimality of such protection is givenensuring maximum protection of vital organs, in the first place, red bone marrow, a significant volume of which is concentrated in the bones in the lumbar vertebrae, sacrum and pelvis. Several examples of the performance of professional activity of operator in the conditions of high-dose ionizing radiation fields and an expert evaluation of the limiting capabilities of the technical and medical component of the integrated RP are considered.