bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized Clinical Trial comparing clinical adjustment times of CAD/CAM screw‐retained posterior crowns on ti‐base abutments created with digital or conventional impressions. One‐year follow‐up
Authors: Derksen Wiebe , Tahmaseb Ali , Wismeijer Daniel
Published: June 2021

Objectives

The purpose of this randomized clinical trial was to compare the required time of potential clinical adjustments of posterior screw‐retained monolithic zirconia implant retained crowns based on intraoral optical scanning (IOS) or conventional impressions.

Materials and methods

Patients with posterior tissue level implants (Straumann RN) replacing solitary teeth were recruited. Of all patients, impressions were taken with both an IOS (3M™ TDS) and a conventional (polyether) pick‐up impression. Randomization was performed after impression taking and patients were to receive either a crown based on the digital or the conventional impression. The time required for adjustments at placement was recorded. Additionally, restoration survival and mechanical complications with a follow‐up of one year were documented.

Results

Thirty two patients with 45 implants were included: 23 restorations in the test (IOS) and 22 in the control (conventional) group. The average adjustment time was 3.35 min (SD ± 3.38, range: 0–11 min) for the digital versus 6.09 min (SD ± 4.63, range: 0–18 min) for the conventional impressions (p = .039). A proper fit (no adjustments required) was achieved 39,1% in the digital and 18,2% conventional group respectively. All 45 restorations could be placed within the two planned appointments and only two minor mechanical complications occurred during the first year of function.

Conclusions

The use of IOS resulted in shorter adjustment times at try‐in than conventional impressions for solitary CAD/CAM implant restorations. Screw‐retained solitary monolithic zirconia restorations on ti‐base abutments show low complication‐ and survival rates in the short term.
Classification of functional abilities of children and adolescents with cerebral palsy
Authors: Palisano Robert J
Published: June 2021

This commentary is on the systematic review by Piscitelli et al. on pages 1251–1261 of this issue.
Assessment of the cytotoxic effects and chemical composition of the insoluble precipitate formed from sodium hypochlorite and chlorhexidine gluconate
Authors: Jeong Ji Wook , Sarmast Nima D. , Terlier Tanguy , van der Hoeven Ransome , Holland Julian N. , Parikh Neha
Published: June 2021

Aim

To investigate (1) the cytotoxic potential of the brown precipitate (BP) formed with sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX), using both a small animal model of Caenorhabditis elegans (C. elegans) and cultured human gingival fibroblasts; and (2) the chemical composition of BP using Time‐of‐Flight Secondary Ion Mass Spectrometry (ToF‐SIMS).

Methodology

Brown precipitate was obtained by mixing equal volumes of 6% NaOCl and 2% CHX and separating the BP from clear supernatant by centrifugation. The brown precipitate was weighed and solubilized in dimethyl sulfoxide for cytotoxicity experiments. The cytotoxic effect of BP was assessed using C. elegans larvae and primary immortalized human gingival fibroblasts‐hTERT (hTERT‐hNOF) cells. Various dilutions of BP (25 ng/µL–150 ng/µL), supernatant (0.15% v/v), NaOCl (1:100–1:1000 dilutions of 6% NaOCl) or CHX (1:500–1:1000 dilutions of 2% CHX) along with vehicle control (0.5% v/v ethanol and 0.15% v/v DMSO) or untreated control (growth medium) were tested on C. elegans larvae and hTERT‐hNOF cells. Viability was assessed in C. elegans larvae using stereomicroscopy and in hTERT‐hNOF cells using dehydrogenase‐based colorimetric assay. ToF‐SIMS was used to assess the chemical composition of BP in comparison with CHX and para‐chloroaniline (PCA). The C. elegans and cell line data were analysed using Log‐Rank test and Student's t‐test, respectively (p < .05).

Results

BP‐75 ng/µL and BP‐150 ng/µL were significantly more toxic to C. elegans larvae than the untreated, vehicle, supernatant or CHX treatment groups (p < .0001). Similarly, in hTERT‐hNOF cells, BP‐50 ng/µL, BP‐75 ng/µL and BP‐150 ng/µL induced significant cytotoxicity within 2 h compared with untreated, vehicle, supernatant and CHX treatments (p < .05). ToF‐SIMS analysis of BP revealed ion composition characteristic of both CHX and the carcinogen PCA.

Conclusions

Brown precipitate was toxic in both C. elegans larvae and hTERT‐hNOF cells. The ToF‐SIMS analysis of BP revealed ions characteristic of CHX and PCA that could account for the toxicities observed in C. elegans larvae and human gingival fibroblasts. Because of the insoluble and toxic nature of BP, consecutive use of CHX and NaOCl irrigants should be avoided in root canal treatment.
A multicentric survey to evaluate preclinical education in Endodontology in German‐speaking countries
Authors: Sacha Sabine Rosa , Sonntag David , Burmeister Ulrike , Rüttermann Stefan , Gerhardt‐Szép Susanne
Published: June 2021

Aim

To evaluate preclinical education in Endodontology at Austrian, German and Swiss dental schools using an online survey.

Methodology

An online survey divided into nine categories was sent using SurveyMonkey software to 37 dental schools, before the spread of the COVID‐19 pandemic. The questionnaire included 50 questions to evaluate preclinical endodontic education, such as faculty‐to‐student ratios, topics taught and materials used, in preclinical phantom head courses. Seven and 14 days after the first e‐mail contact, dental schools received a reminder e‐mail. After four and six weeks, the dental schools were contacted by telephone and asked to participate in the online survey. The processing time was eight weeks in total.

Results

The response rate was 89%. Preclinical endodontic education at the participating dental schools differs considerably. Theory classes ranged from 1 to 70 h (15 h mean), and practical classes ranged from 3 to 78 h (39 h mean). The faculty‐to‐student ratio varied between 1:4 and 1:38 (1:15 mean). Forty‐five per cent of the dental schools had a specialist in endodontics teaching theory. Several dental microscopes were available for preclinical teaching purposes at 82% of the dental schools. The majority (82%) taught root canal preparation with rotary or reciprocating NiTi instruments. Overall, 85% of the dental schools taught lateral compaction, amongst other methods, for canal filling.

Conclusion

A substantial divergence amongst the dental schools regarding the time dedicated to theory and practical instruction in Endodontology was reported. However, convergence in the use of root canal treatment techniques and materials was reported.
THE ECONOMICS OF SAVINGS GROUPS
Authors: Burlando Alfredo , Canidio Andrea , Selby Rebekah
Published: June 2021

Millions of households worldwide rely on savings groups (SGs) to satisfy their financial needs, yet important gaps remain in our understanding of this novel financial institution. We show theoretically that, within an SG, the supply of funds could fall short or be in excess of its demand. Then, we use week‐by‐week records from 46 Ugandan SGs to show that most groups do not generate sufficient loanable funds. We conclude by proposing three interventions that, in light of our model, should ease credit rationing and improve the welfare of SG members: requiring SG members to publicly state their savings and borrowing goals, encouraging early savings, and linking SGs with formal financial institutions.
Cosmopolitanism and expatriate’s preference for host country food: The conditional effects of experiential capital and retail development
Authors: Miocevic Dario , Kvasina Antonija , Crnjak‐Karanovic Biljana
Published: June 2021

In this paper we explore the insufficiently addressed domain of expatriates’ preference for local (host country) food. Extant literature on this segment of consumers shows that tensions created by moving abroad are also reflected in their varying preference for host country foods. By drawing on social identity theory, we investigate how a cosmopolitan identity drives a preference for host country food under the contingent effects of an expatriate's experiential capital and host country's retail development. Based on a unique dataset of 293 expatriates living in six countries of the Greater Middle East, the findings from binary logistic regression model show that cosmopolitanism significantly explains expatriate's preference for host country food. We also show that the dimensions of experiential capital have countervailing moderating effects on this relationship whereas in countries with lower levels of retail development, the relationship between cosmopolitanism and expatriates’ preference for host country food becomes stronger. The findings of this study imply that cosmopolitan expatriates should not be considered a uniform segment as previous studies have advocated. Eventually, this study offers valuable contributions to literature that investigates the influence of socio‐cultural identities in food consumption as well as to literature dealing with expatriate consumer behaviour.
Relation of cardiac function to insulin resistance as evaluated by hyperinsulinemic‐euglycemic clamp analysis in individuals with type 2 diabetes
Authors: Otowa‐Suematsu Natsu , Sakaguchi Kazuhiko , Kaneko Akihiro , Ito Jun , Morita Yasuko , Miura Hiroshi , Yamada Tomoko , So Anna , Komada Hisako , Okada Yuko , Hirota Yushi , Tamori Yoshikazu , Ogawa Wataru
Published: June 2021

Aims

Whereas homeostasis model assessment of insulin resistance (HOMA‐IR), an easily measured but limited index of insulin resistance, has been shown to correlate with impairment of cardiac function in individuals without diabetes, the pathological relevance of insulin resistance to the development of cardiac dysfunction in individuals with type 2 diabetes has remained unclear. Here we investigated the relation between left ventricular (LV) function as assessed by echocardiography and insulin resistance as evaluated by hyperinsulinemic‐euglycemic clamp analysis, the gold standard for measurement of this parameter, in individuals with type 2 diabetes.

Methods

This retrospective study included 34 individuals with type 2 diabetes who underwent both hyperinsulinemic‐euglycemic clamp analysis and echocardiography. Both the insulin sensitivity index (ISI) as determined by glucose clamp analysis as well as HOMA‐IR were determined as measures of insulin resistance. The ratio of the peak early‐ to late‐diastolic mitral inflow velocities (E/A) and the LV ejection fraction (LVEF) were determined as measures of diastolic and systolic function, respectively.

Results

The ISI was significantly correlated with both the E/A ratio and LVEF (correlation coefficients of 0.480 and 0.360, respectively), whereas HOMA‐IR was not correlated with either cardiac parameter. Multivariate analysis revealed that ISI was an independent predictor for both a high log [E/A] (P = 0.031) and a high LVEF (P = 0.045).

Conclusions

Insulin resistance as evaluated by hyperinsulinemic‐euglycemic clamp analysis may be causally related to LV diastolic and systolic dysfunction in individuals with type 2 diabetes.
Gut microbiome and amyotrophic lateral sclerosis: A systematic review of current evidence
Authors: Sun Jiangwei , Huang Tingting , Debelius Justine W. , Fang Fang
Published: June 2021

Amyotrophic lateral sclerosis (ALS), characterized by a loss of motor neurons in the brain and spinal cord, is a relatively rare but currently incurable neurodegenerative disease. The global incidence of ALS is estimated as 1.75 per 100,000 person‐years and the global prevalence is estimated as 4.1–8.4 per 100,000 individuals. Contributions from outside the central nervous system to the etiology of ALS have been increasingly recognized. Gut microbiome is one of the most quickly growing fields of research for ALS. In this article, we performed a comprehensive review of the results from existing animal and human studies, to provide an up‐to‐date summary of the current research on gut microbiome and ALS. In brief, we found relatively consistent results from animal studies, suggesting an altered gut microbiome composition in experimental ALS. Publication bias might however be a concern. Findings from human studies are largely inconclusive. A few animal and human studies demonstrated the usefulness of intervention with microbial‐derived metabolites in modulating the disease progression of ALS. We discussed potential methodological concerns in these studies, including study design, statistical power, handling process of biospecimens and sequencing data, as well as statistical methods and interpretation of results. Finally, we made a few proposals for continued microbiome research in ALS, with the aim to provide valid, reproducible, and translatable findings.
First evidence of deviation from Mendelian proportions in a conservation programme
Authors: Grueber Catherine E. , Farquharson Katherine A. , Wright Belinda R. , Wallis Graham P. , Hogg Carolyn J. , Belov Katherine
Published: June 2021

Classic Mendelian inheritance is the bedrock of population genetics and underpins pedigree‐based management of animal populations. However, assumptions of Mendelian inheritance might not be upheld in conservation breeding programmes if early viability selection occurs, even when efforts are made to equalise genetic contributions of breeders. To test this possibility, we investigated deviations from Mendelian proportions in a captive metapopulation of the endangered Tasmanian devil. This marsupial population is ideal for addressing evolutionary questions in conservation due to its large size, range of enclosure types (varying in environmental conditions), good genomic resources (which aid interpretation), and the species’ biology. Devil mothers give birth to more offspring than they can nurse in the pouch, providing the potential for intense viability selection amongst embryos. We used data from 140 known sire‐dam‐offspring triads to isolate within‐family selection from population‐level mechanisms (such as mate choice or inbreeding), and compared observed offspring genotypes at 123 targeted SNPs to neutral (i.e., Mendelian) expectations. We found lower offspring heterozygosity than expected, and subtle patterns that varied across a gradient of management intensity from zoo‐like enclosures to semi‐wild environments for some loci. Meiotic drive or maternal‐foetal incompatibilities are consistent with our results, although we cannot statistically confirm these mechanisms. We found some evidence that maternal genotype affects annual litter size, suggesting that family‐level patterns are driven by differential offspring mortality before birth or during early development. Our results show that deviations from Mendelian inheritance can occur in conservation programmes, despite best‐practice management to prevent selection.
Recent advances in autonomic neurology: An overview
Authors: Nakane Shunya
Published: June 2021

The importance of autonomic neurology has grown exponentially since the development of neuroscience, genetics, and immunology. Advances in this field have made it possible to elucidate the pathomechanism of dysautonomia and autonomic nervous system interactions in both health and disease. In the special issue “Recent Advances in Autonomic Neurology,” four articles covering a wide range of topics in clinical neuroscience, including degenerative diseases, genetic disorders, immune‐mediated neuropathy, and autoimmune encephalitis, were published. This review focused on presenting the recent progress in the clinical approaches for dysautonomia in autoimmune diseases, Ehlers‐Danlos syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, and coronavirus disease 2019 (COVID‐19). Of particular current concern, is Long COVID, defined as the persistence of symptoms after 3 weeks from being infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), may involve autonomic dysfunction. The research and clinical practice for autonomic dysfunction in neurology is constantly evolving, which is exemplified by the current clinical research on Long COVID.
The impact of anatomical variables on haemodialysis tunnelled catheter replacement without fluoroscopy
Authors: Maggiani‐Aguilera Pablo , Chávez‐Iñiguez Jonathan S. , Navarro‐Gallardo Joana G. , Navarro‐Blackaller Guillermo , Flores‐Llamas Alondra M. , Pelayo‐Retano Tania , Arellano‐Delgado Erendira A. , González‐Montes Violeta E. , Yanowsky‐Ortega Ekatherina , Raimann Jochen G. , Garcia‐Garcia Guillermo
Published: June 2021

Aim

Tunnelled haemodialysis (HD) catheters can be used instantly, but there are several anatomical variables that could impact it survival. This study aimed to examine the impact of different novel anatomic variables, with catheter replacement.

Methods

In a single‐centre a prospective cohort in chronic kidney disease G5 patients were conducted. The primary outcome was to determine the factors associated with catheter replacement during the first 6‐month of follow‐up. All procedures were performed without fluoroscopy. Three anatomic regions for catheter tip position were established: considered as superior vena cava (SVC), cavo‐atrial junction (CAJ) and mid‐to deep atrium (MDA). Many other anatomical variables were measured. Catheter‐related bloodstream infection was also included.

Results

Between January 2019 and January 2020 a total of 75 patients with tunnelled catheter insertion were analysed. Catheter replacement at 6‐month occur in 10 (13.3%) patients. By multivariate analysis, the incorrect catheter tip position (SVC) (OR 1.23, 95% CI 1.07–1.42, p <.004), the presence of extrasystoles during the procedure (OR 0.88, 95% CI 0.78–0.98, p = .03), incorrect catheter tug (OR 1.31, 95% CI 1.10–1.55, p = .003), incorrect catheter top position (kinking; OR 1.40, 95% CI 1.04–1.88, p = .02) and catheter‐related bloodstream infection (OR 2.60, 95% CI 2.09–3.25, p <.001) were the only variables associated with catheter replacement at 6‐month follow‐up.

Conclusion

The risk of catheter replacement at 6‐month follow‐up could be attenuated by avoiding incorrect catheter tug and top position, and by placing the vascular catheter tip in the CAJ and MDA.
Brady‐arrhythmias in patients with atrial fibrillation and heart failure of reduced ejection fraction: is his‐bundle pacing superior to biventricular pacing？
Authors: Ma Pei‐pei , Yang Yi‐heng , Dai Bai‐ling , Zhang Rong‐feng , Wang Nan , Li Dan‐na , Yin Xiao‐meng , Gao Lian‐jun , Xia Yun‐long , Yang Yan‐zong , Dong Ying‐xue
Published: June 2021

Objective

To investigate the efficacy and safety of His‐bundle pacing (HBP) compared with the traditional biventricular pacing (BVP) on patients with brady‐arrhythmias, who suffer from permanent atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF).

Methods

All patients with brady‐arrhythmias, permanent AF and HFrEF were continuously enrolled from January 2017 to July 2019 and followed up for at least 12 months. The differences in QRS duration (QRSd), New York Heart Association (NYHA) classification, left ventricular ejection fraction (LVEF), tricuspid regurgitation grade, mitral regurgitation grade, left ventricular end‐diastolic diameter (LVEDD), and left atrial size were compared.

Results

A total of 52 patients were enrolled: 37 patients were with HBP and 15 patients with BVP. There was no electrode dislodged, perforation, infection or thrombosis during the follow‐up of 18.12 ± 4.45 months. The success rate for HBP implantation was 88.10%. The capture threshold of his‐bundle and the threshold of the left ventricular lead remained stable during follow‐up. LVEF increased to higher than 50% in 11 patients with HBP (29.73%). The NYHA classification (both p < .001), LVEF (both p < .001) and LVEDD improved significantly during the follow‐up in both groups. NYHA (p = .030), LVEF (p = .013), and LVEDD (p = .003) improved in patients with HBP compared with BVP.

Conclusion

HBP was safe and more effective in improving the cardiac function and remodeling in patients with brady‐arrhythmias, permanent AF and HFrEF compared with BVP.
Empiric slow‐pathway ablation results for presumed atrioventricular nodal reentrant tachycardia in pediatric patients
Authors: Duman Derya , Ertuğrul İlker , Yıldırım Baştuhan Işıl , Aykan Hayrettin Hakan , Karagöz Tevfik
Published: June 2021

Background

In pediatric patients with documented narrow QRS tachycardia that is suggestive of atrioventricular nodal reentrant tachycardia (AVNRT) and not inducible in electrophysiological study (EPS), empiric slowpathway ablation (ESPA) may be considered. There is limited data in children about this topic.

Methods

Seventy‐nine patients who underwent cryoablation and/or radiofrequency ablation (RFA) for presumed AVNRT between January 2010 and January 2020, with no inducible tachycardia and no other tachycardia mechanisms during EPS, were included in this study.

Results

The age was between 6 and 18 years. All patients had no structural heart disease. Preablation exhibited sustained SP conduction for all patients. In all cases, the ablation end points were prolongation in wenckebach cycle length (WBCL) with loss of cross and/or jump, and/or echo beat. The end points were not achieved in two patients. Overall, the mean basal WBCL increased to 351 ms (240‐500 ms) from 301.3 ms (180‐420 ms), evident in the non‐recurrence group. Nine patients had a transient AV block that improved. We followed the patients without medication for about 46.9 months (8 months to 10 years). Palpitations occurred again in 9 of 77 patients (clinical recurrence rate 9/79 – 11.3%). The documented ECG recurrence rate was 1.2% (1/79). In the non‐recurrence group, WBCL prolongation was higher and mean age was lower than in the recurrence group (13.075 vs. 15.33 years).

Conclusion

In cases with presumed AVNRT, ESPA seems to be a reasonable and safe way. In our study, we found our procedural success rate as 97.4% and follow‐up recurrence rate as 12.6% (9+1/79).
Wearable electronic devices for chronic pain intensity assessment: A systematic review
Authors: Avila Francisco R. , McLeod Christopher J. , Huayllani Maria T. , Boczar Daniel , Giardi Davide , Bruce Charles J. , Carter Rickey E. , Forte Antonio J.
Published: June 2021

Wearable electronic devices are a convenient solution to pain intensity assessment as they can provide continuous monitoring for more precise medication adjustments. However, there is little evidence regarding the use of wearable electronic devices for chronic pain intensity assessment. Our primary objective was to examine the physiologic parameters used by wearable electronic devices for chronic pain intensity assessment. We initially inquired PubMed, CINAHL, and Embase for studies evaluating the use of wearable electronic devices for chronic pain intensity assessment. We updated our inquiry by searching on PubMed, Embase, Scopus, and Google Scholar. English peer‐reviewed studies were included, with no exclusions based on time frame or publication status. Of 348 articles that were identified on the first inquiry, 8 fulfilled the eligibility criteria. Of 179 articles that were identified on the last inquiry, only 1 fulfilled the eligibility criteria. We found articles evaluating wristbands, smartwatches, and belts. Parameters evaluated were psychomotor and sleep patterns, space and time mobility, heart rate variability, and skeletal muscle electrical activity. Most of the studies found significant positive associations between physiological parameters measured by wearable electronic devices and self‐reporting pain scales. Wearable electronic devices reliably reflect physiologic or biometric parameters, providing a physiological correlation for pain. Early stage investigation suggests that the degree of pain intensity can be discerned, which ideally will reduce the bias inherent to existing numeric/verbal scales. Further research on the use of these devices is vital.
Absorption Spectra for Firefly Bioluminescence Substrate Analog: TokeOni in Various pH Solutions
Authors: Ogawa Haruhisa , Ono Ryohei , Noguchi Yoshifumi , Kitada Nobuo , Saito‐Moriya Ryohei , Maki Shojiro A. , Akiyama Hidefumi , Itabashi Hideyuki , Hiyama Miyabi
Published: June 2021

AkaLumine hydrochloride, named TokeOni, is one of the firefly luciferin analogs, and its reaction with firefly luciferase produces near‐infrared (NIR) bioluminescence. Prior to studying the bioluminescence mechanism, basic knowledge about the chemical structures, electronic states, and absorption properties of TokeOni at various pH values of solution has to be acquired. In this paper, the absorption spectra for TokeOni and AkaLumine at pH 2–10 were measured. Density functional theory (DFT) calculations, time‐dependent DFT calculations, and the vibrational analyses were carried out. The absorption spectra indicate that the chemical forms of TokeOni in solutions are same as those of AkaLumine. The peaks at pH 7–10 in the absorption spectra correspond to the excitation from the ground state of a carboxylate anion of AkaLumine, the peak at pH 2 corresponds to the excitation from the ground state of a carboxylate anion with an N‐protonated thiazoline ring and N‐protonated dimethylamino group of AkaLumine, and the peak at pH 4 corresponds to the excitation from the ground state of a carboxylate anion with an N‐protonated thiazoline ring of AkaLumine.
Analysis of immediate use of sunscreen after microneedling
Authors: Meyer Patrícia Froes , Silva Rodrigo Marcel Valentim da , Carreiro Eneida de Morais , Borges Fábio dos Santos , Silva Francy Richarles da Cruz , Vieira Bruno Haysllan de Araújo , Maia Rafaella Rêgo , Queiroga Farias Stephany Luanna , Soares Ciro Dantas , Rodrigues Joyce , Pasqual Gustavo Felipe
Published: June 2021

Introduction

Microneedling promotes skin microlesions that lead to an inflammatory process, increasing cell proliferation, cell metabolism, and synthesis of collagen and elastin, therefore restoring skin integrity.

Objective

This study aims to investigate the differences between the physical and the physical‐chemical sunscreen application after microneedling, assessed through histological analysis.

Method

This was a two‐phase study. The first phase investigated the physical and physical‐chemical sunscreen penetration mixed with India ink through histological analysis. The sunscreens were applied after the microleakage in vivo on the skin of a volunteer who underwent abdominoplasty 24 hours after the procedure. Histological analyses were carried out using optical and electron microscopy. The second phase analysed the skin reactions with the use of physical sunscreen after different microneedling treatments. The sample consisted of 30 volunteers distributed into three groups: G1 received the "Roller" microneedling, G2 received pen micropuncture treatment, and G3 received the fractional radiofrequency treatment.

Results

The histological analyses of the first phase indicated that the physical‐chemical protection sunscreen penetrated more deeply, and pigment was found among the collagen fibres and the dermal fibroblast cytoplasm in comparison to the physical protection sunscreen, which had the pigment confined exclusively in the superficial epidermis layer. The second phase results demonstrated that the use of the physical protection sunscreen after the different microneedling techniques showed no adverse reactions such as itching, pain or soreness, and the hyperaemia.

Conclusion

The proposed intervention showed that the use of physical protection sunscreen after different microneedling procedures is safe.
Severe gag reflex during dental treatment associated with hiatus hernia: A case report
Authors: Tanaka Yuto , Ohshita Naohiro , Okamura Tomohiko , Momota Yoshihiro , Ono Yoshiaki
Published: June 2021

Aims

This report presents a case wherein severe gagging during dental treatment was linked to hiatus hernia.

Methods and results

A 22‐year‐old man with a severe gagging problem presented with a chief complaint of pain localized to the lower molars. Oral examination revealed inadequate plaque control, demineralization of the enamel surface on buccal–gingival margins of all teeth, and inflamed gingival tissue surrounding the coronal portion of both mandibular third molars; panoramic radiography revealed that they were horizontally impacted. As the patient reported experiencing vomiting and heartburn for the past two months, he was referred to the internal medicine department before scheduling surgical tooth extraction. Hiatus hernia and reflux esophagitis were diagnosed, and the severity of gagging was significantly reduced by modifying the patient's eating behavior and administering a proton pump inhibitor. Although intravenous sedation was still required for surgical extraction of the impacted third molars, preventive treatments, such as tooth cleaning and fluoride application, could be performed without the need for pharmacological intervention.

Conclusion

While gagging is often attributed to conditioning responses and iatrogenic factors, interdisciplinary consultation for successful management may facilitate the elucidation of local anatomical and systemic causes.
Change‐point analysis through integer‐valued autoregressive process with application to some COVID‐19 data
Authors: Chattopadhyay Subhankar , Maiti Raju , Das Samarjit , Biswas Atanu
Published: June 2021

In this article, we consider the problem of change‐point analysis for the count time series data through an integer‐valued autoregressive process of order 1 (INAR(1)) with time‐varying covariates. These types of features we observe in many real‐life scenarios especially in the COVID‐19 data sets, where the number of active cases over time starts falling and then again increases. In order to capture those features, we use Poisson INAR(1) process with a time‐varying smoothing covariate. By using such model, we can model both the components in the active cases at time‐point t namely, (i) number of nonrecovery cases from the previous time‐point and (ii) number of new cases at time‐point t. We study some theoretical properties of the proposed model along with forecasting. Some simulation studies are performed to study the effectiveness of the proposed method. Finally, we analyze two COVID‐19 data sets and compare our proposed model with another PINAR(1) process which has time‐varying covariate but no change‐point, to demonstrate the overall performance of our proposed model.
Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients
Authors: Kutzler Heather L. , Kuzaro Hillary A. , Serrano Oscar K. , Feingold Andrew , Morgan Glyn , Cheema Faiqa
Published: June 2021

The widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) continues to propagate the coronavirus disease 2019 (COVID‐19) pandemic with solid organ transplant (SOT) recipients being an exceptionally vulnerable population for poor outcomes. Treatments for COVID‐19 are limited; however, monoclonal antibodies are emerging as a potential therapeutic option to change the trajectory of high‐risk patients. This retrospective single center cohort study evaluated the outcomes of SOT recipients with mild to moderate COVID‐19 who received bamlanivimab monotherapy. Eighteen SOT recipients (15 kidney, 2 liver, and 1 heart) received the medication between November 9, 2020 and February 10, 2021 with no reported infusion reactions. One patient experienced headache and fatigue following the infusion that resolved within 3 days. Fourteen patients continued their recovery as an outpatient with no further escalation in care. Three patients required hospitalization: two for suspected bacterial pneumonia 9 and 32 days postinfusion, respectively, and one for acute kidney injury 7 days postinfusion. One patient had an emergency room visit for gastrointestinal symptoms 24 days postinfusion. In this small cohort of SOT recipients, bamlanivimab monotherapy appeared to be a well‐tolerated option for treatment of mild to moderate COVID‐19, but it was not completely effective in preventing hospitalization. One month following the end of this cohort, COVID‐19 treatment guidance changed due to the rising prevalence of resistant variants. For this reason, bamlanivimab is now recommended to be used only in combination with etesevimab. Further studies are needed to fully elucidate the role of this therapy in SOT recipients.
Model of care, Noma Children’s Hospital, northwest Nigeria
Authors: Isah Shafi'u , Amirtharajah Mohana , Farley Elise , Semiyu Adetunji Adeniyi , Samuel Joseph , Oluyide Bukola , Bil Karla , Shoaib Muhammad , Abubakar Nura , de Jong Annette , Pereboom Monique , Lenglet Annick , Sherlock Mark
Published: June 2021

The Nigerian Ministry of Health has been offering care for noma patients for many years at the Noma Children’s Hospital (NCH) in Sokoto, northwest Nigeria, and Médecins Sans Frontières has supported these initiatives since 2014. The comprehensive model of care consists of four main components: acute care, care for noma sequelae, integrated hospital‐based services and community‐based services. The model of care is based on the limited evidence available for prevention and treatment of noma and follows WHO’s protocols for acute patients and best practice guidelines for the surgical treatment of noma survivors. The model is updated continually as new evidence becomes available, including evidence generated through the operational research studies performed at NCH. By describing the model of care, we wish to share the lessons learned with other actors working in the noma and neglected tropical disease sphere in the hope of guiding programme development.
Diagnosis and surgical management of a retrobulbar abscess causing unilateral exophthalmos in a Boer goat
Authors: Fuchs Allison A. , Walker Kelsey E. , Adkins Pamela R.F. , Donnelly Kevin S. , Giuliano Elizabeth A.
Published: June 2021

A 10‐year‐old Boer goat wether presented for unilateral exophthalmos of 2‐ to 3‐week duration. Ocular ultrasonography and computed tomography (CT) were utilized in the diagnosis of the patient's orbital disease and surgical planning. Exenteration was performed under the same general anesthetic event as CT. Cytology, culture, and histopathology were performed after exenteration. Cytology was consistent with a mixed bacterial infection. Culture confirmed the presence ofStreptococcusovis. Histopathology on the enucleated globe and mass revealed no evidence of tumor and confirmed intraocular extension of retrobulbar inflammation. Histopathologic diagnosis was consistent with severe chronic orbital pyogranuloma and fibrinosuppurative endophthalmitis confined to the subretinal space. The abscess recurred in the orbital space 2 weeks postoperatively; the orbit was explored. Repeat culture was consistent withS. ovis,Staphylococcusschleigerisubspeciescoagulans, andFusobacteriumnecrophorum. Complete resolution was obtained after drainage and lavage of the orbit. Abscess is cited as a cause of exophthalmos in small ruminants, but no individual case reports exist. Advanced imaging allowed presumptive diagnosis and surgical planning. Histopathology confirmed intraocular extension of retrobulbar disease.
A randomized study of a best practice alert for platelet transfusions
Authors: Murphy Colin , Mou Eric , Pang Emily , Shieh Lisa , Hom Jason , Shah Neil
Published: June 2021

Background and Objectives

Inappropriate platelet transfusions represent an opportunity for improvements in patient care. Use of a best practice alert (BPA) as clinical decision support (CDS) for red cell transfusions has successfully reduced unnecessary red blood cell (RBC) transfusions in prior studies. We studied the impact of a platelet transfusion BPA with visibility randomized by patient chart.

Materials and Methods

A BPA was built to introduce CDS at the time of platelet ordering in the electronic health record. Alert visibility was randomized at the patient encounter level. BPA eligible platelet transfusions for patients with both visible and non‐visible alerts were recorded along with reasons given for override of the BPA. Focused interviews were performed with providers who interacted with the BPA to assess its impact on their decision making.

Results

Over a 9‐month study period, 446 patient charts were randomized. The visible alert group used 25.3% fewer BPA eligible platelets. Mean monthly usage of platelets eligible for BPA display was 65.7 for the control group and 49.1 for the visible alert group (p = 0.07). BPA‐eligible platelets used per inpatient day at risk per month were not significantly different between groups (2.4 vs. 2.1, p = 0.53).

Conclusion

It is feasible to study CDS via chart‐based randomization. A platelet BPA reduced total platelets used over the study period and may have resulted in $151,069 in yearly savings, although there were no differences when adjusted for inpatient days at risk. During interviews, providers offered additional workflow insights allowing further improvement of CDS for platelet transfusions.
A story of fibers and stress: Matrix‐embedded signals for fibroblast activation in the skin
Authors: Sawant Mugdha , Hinz Boris , Schönborn Katrin , Zeinert Isabel , Eckes Beate , Krieg Thomas , Schuster Ronen
Published: June 2021

Our skin is continuously exposed to mechanical challenge, including shear, stretch, and compression. The extracellular matrix of the dermis is perfectly suited to resist these challenges and maintain integrity of normal skin even upon large strains. Fibroblasts are the key cells that interpret mechanical and chemical cues in their environment to turnover matrix and maintain homeostasis in the skin of healthy adults. Upon tissue injury, fibroblasts and an exclusive selection of other cells become activated into myofibroblasts with the task to restore skin integrity by forming structurally imperfect but mechanically stable scar tissue. Failure of myofibroblasts to terminate their actions after successful repair or upon chronic inflammation results in dysregulated myofibroblast activities which can lead to hypertrophic scarring and/or skin fibrosis. After providing an overview on the major fibrillar matrix components in normal skin, we will interrogate the various origins of fibroblasts and myofibroblasts in the skin. We then examine the role of the matrix as signaling hub and how fibroblasts respond to mechanical matrix cues to restore order in the confusing environment of a healing wound.
Experiences with industrial application of wave-based architectural acoustics simulations
Authors: Pedersen Jesper , Pind Finnur
Published: June 2021

Current state-of-the-art tools for simulation of acoustics in the built environment largely utilize geometrical acoustics technology, such as ray-tracing. Wave-based methods are known to be much more accurate than thatof geometrical acoustics methods with the accurate inclusion of wave-effects such as resonant behavior, diffraction, focusing, and interference, but the computational burden has been the roadblock preventing the practical commercial application. However, recent advancements in both numerical methodology and cloud computing are now enabling the industry to explore the benefits of this technology. In this talk, we will present the findings from multiple case-studies of practical application of a cloud-based wave-based acoustics simulation tool. The case-studies include several real-world industrial projects, but a study of the scenes provided in “GRAS—Ground truth for room acoustical simulation” is also presented. The results are compared to traditional modelling approaches and measurement where available. It is found that there are significant accuracy improvements to be gained from shifting towards the use of wave-based acoustical simulation tools, and with the lower levels of uncertainty, it is assessed that the new methods can enable more efficient and robust design processes in building design.
Building fish sound libraries, measuring aquatic soundscapes and quantifying the effects of noise
Authors: Juanes Francis
Published: June 2021

Sound is a fundamental component of the sensory environment of many aquatic animals. Despite its importance, the effects of noise on aquatic organisms, particularly fishes, is not well studied nor is underwater noise regulated by most legislation. As the world has got noisier, the range and intensity of underwater anthropogenic noise continues to increase. Intense short-term noise can permanently alter auditory thresholds and lead to mortality for some organisms, while long-term chronic noise such as that produced by vessels, can lead to physiological and behavioural changes. Noise pollution can also mask environmental cues, vocalizations, or dampen the ability to hear conspecifics, prey or predators. Here, I will summarize our work developing quantitative descriptions of marine soundscapes and use our results to better understand the effects of noise on sound production and behaviour of fishes. Specifically, we are quantifying the known soniferous fish species to better understand taxonomic and geographic distribution patterns; developing inexpensive, novel, long-term, field-based methodological and statistical tools to localize and automatically detect vocalizing species; and quantifying and modeling the effects of noise on fish ecology in natural systems.
Tom and Thode’s excellent adventure: Practical guidance on surviving seedy bars, preparing for a DJ career, dismantling the U.S. Panama Canal zone, and other useful tips when working with towed acoustic arrays in the Eastern Tropical Pacific
Authors: Thode Aaron M.
Published: June 2021

Tom Norris used many acoustic tools in his research career, but it is safe to say that towed passive acoustic arrays were one of his specialties. In 1998 the National Marine Fisheries Service conducted the Stenella Population and Abundance Monitoring (SPAM) cruise. The NOAA ship Endeavor was to survey enormous dolphin populations in the Eastern Tropical Pacific (ETP), starting from Lima, Peru, and ending in Panama City, Panama. Jay Barlow, one of my PhD thesis committee members, permitted me to participate in the cruise as a member of his towed array passive acoustic monitoring team. The first time I ever met Tom, the acoustics team leader, was when he was carrying a surfboard into his cabin, and I wondered how in the world he had managed to ship a surfboard into Peru. It was the first of many times I have enjoyed both working with and wondering about Tom, and our first trip together taught me practical things they forgot to teach in graduate school. Here, I will review Tom’s tips on Mackie mixer boards, buying drinks in dangerous bars, tracking dolphin whistles, not antagonizing visual observers, and liberating furniture from the U.S. Panama canal zone.
A robotic ultrasound system for multi-modality widefield preclinical imaging
Authors: Czernuszewicz Tomek , Rojas Juan , Dayton Paul , Papadopoulou Virginie
Published: June 2021

We will give an overview of the technology, and present results showing the robotic ultrasound system's use in a variety of use cases, including dual-imaging aligned with bioluminescence data for oncology studies, therapeutic ultrasound delivery, and multi-modality ultrasound imaging for liver disease.
Consequences of power law scattering from soft tissues
Authors: Parker Kevin
Published: June 2021

A recent series of theoretical and experimental results support the hypothesis that ultrasound speckle statistics and backscatter are deeply rooted in power law behaviors. The implications for the tissue characterization are direct and lead to Burr distributions for speckle analysis and the H-scan analysis for the tissue characterization.
Boundary element methods based nearfield acoustic holography for fluids with constant flow
Authors: Valdivia Nicolas P.
Published: June 2021

In this work, we present integral formulations to recover an arbitrarily shaped structure's vibrations from nearfield pressure measurements when the medium contains constant flow. This problem is central to the application of the Nearfield Acoustic Holography (NAH) technique. The classical application of the NAH for arbitrarily shaped geometries utilizes an integral formulation that not includes flow information. In many instances, we can argue that the classical application of NAH will be appropriate for a small subsonic flow instead of the more complicated integral formulations that contain the flow information. The main question that we should ask is how large the flow should be to impact the classical NAH reconstruction. Similarly, we want to quantify the advantage of using the integral formulations with flow information for these conditions. We intend to address these questions using numerically simulated data from point sources. [This work has been supported by the Office of Naval Research.]
The electromomentum coupling in generalized Willis media
Authors: Shmuel Gal , Pernas-Salomón René , Muhafra Alan , Kosta Majd , Torrent Daniel , Haberman Michael R. , Norris Andrew N.
Published: June 2021

By developing and applying a homogenization scheme for elastodynamics, Willis discovered that the momentum of composite materials is macroscopically coupled with their strain through a constitutive tensor. This now-termed Willis tensor not only enlarges the design space of metamaterials, but is also necessary for obtaining a meaningful effective description that respects basic physical laws. In this talk, I will show how additional tensors of Willis type emerge by generalizing the homogenization theory of Willis to thermoelastic-, piezomagnetic- or piezoelectric media. I will provide examples for the latter case that exhibit an electromomentum coupling. I will show that this coupling is necessary for describing the effective properties of asymmetric piezoelectric media using a homogenized description that respects reciprocity and energy conservation. Finally, I will demonstrate how this coupling can be used to realize a device that actively control the phase of elastic waves.
Engineering acoustic reflections with programmable metasurfaces
Authors: Popa Bogdan-Ioan
Published: June 2021

Acoustic anomalous reflectors have recently drawn intense attention due to their ability to reflect impinging waves in non-specular directions. However, virtually all previously analyzed anomalous reflectors are passive structures with high spatial and/or temporal dispersion. Therefore, they are typically narrowband and unidirectional, namely they operate in the desired manner for only one direction of incidence. We discuss here a method to design quasi-omnidirectional and broadband anomalous metasurface reflectors composed of programmable non-resonant scatterers capable to manipulate the in-plane wave vector component in prescribed ways. We illustrate the method in 3D experiments in which the incident waves undergo negative reflections and show that the desired effect does not depend on the direction of incidence and has a bandwidth an order of magnitude larger than passive designs. Furthermore, we show experimentally that anomalous reflectors of various geometries can be realized by simply rearranging the active scatterers to fill-in the desired geometries as long as the periodicity of the scatterer lattice remains subwavelength. This is direct evidence that the presented metasurfaces behave like continuous materials rather than gratings or phonic crystal. The implications of this finding on the design of future sound manipulation devices will be discussed.