bluuebunny/crossref_metadata_2025 huggingface dataset:
Proposal for a Conceptual Framework for the Development of Geriatric Dentistry
Authors: León S. , Giacaman R.A.
Published: September 2021

Demographic changes with an increasingly higher proportion of older adults worldwide and an epidemiologic transition resulting in more teeth retained and higher demand and expectations set up new scenarios for the oral health of the older population. Thus, geriatric dentistry must be reconfigured, transitioning from the traditional focus on prosthesis to a more holistic discipline, actively incorporating geriatric and gerontologic aspects. We describe some situations that provide the rationale for a new conceptual framework for the advancement of geriatric dentistry as a clinical specialty. On the basis of scientific evidence and our academic experience, we propose 4 concepts that should steer the discipline during the following years and become its structural pillars: minimal intervention dentistry, oral functionality, patient-centered care, and interdisciplinary teamwork. Since data and evidence are limited, a special focus on poor and developing countries is incorporated. Adjusting clinical guidelines and public health policies around these concepts will increase access to oral care for older people, including those with physical or social barriers, and will ensure better oral health–related quality of life and well-being. These concepts have deep consequences in the education and training of new dentists and specialists, at the public and private levels.
“The lungs of a ship”: Ventilation, acclimatization, and labor in the maritime environment, 1740–1800
Authors: Sampson Paul E
Published: September 2021

This article examines the connection between projects for shipboard ventilation and the shifting medical discourse about acclimatization in the British Empire during the eighteenth century. I argue that the design, use, and disuse of a class of shipboard “ventilators” proposed by natural philosopher Stephen Hales helps us to trace changing ideas about the ability of European bodies to acclimate, or “season,” to tropical environments. These ventilating machines appealed to British administrators because they represented an embodiment of providential and enlightened ideas that validated the expansion of overseas empire. In addition, they promised to increase labor efficiency by reducing the mortality and misery experienced by the sailors and enslaved people during long sea voyages. As skepticism about acclimatization grew in response to stubbornly high mortality rates in the West Indies, Hales’ ventilators fell out of favor – a development underscored by their dismissal as a potential solution for the appalling conditions found in the transatlantic slave trade. By examining ventilators’ nearly fifty-year career in naval and slave ships, this article will show the role of technology and the shipboard environment in the transition from enlightened optimism about acclimatization toward later attitudes of racial and environmental essentialism.
Appearance Reveals Music Preferences
Authors: Tian Laura , Alaei Ravin , Rule Nicholas O.
Published: September 2021

Disclosing idiosyncratic preferences can help to broker new social interactions. For instance, strangers exchange music preferences to signal their identities, values, and preferences. Recognizing that people’s physical appearances guide their decisions about social engagement, we examined whether cues to people’s music preferences in their physical appearance and expressive poses help to guide social interaction. We found that perceivers could detect targets’ music preferences from photos of their bodies, heads, faces, eyes, and mouths (but not hair) and that the targets’ apparent traits (e.g., submissiveness, neatness) undergirded these judgments. Perceivers also desired to meet individuals who appeared to match their music preferences versus those who did not. Music preferences therefore seem to manifest in appearance, regulating interest in others and suggesting that one’s identity redundantly emerges across different types of cues. People may thus infer others’ music preferences to identify candidates for social bonding.
TOP-PRO study: A randomized double-blind controlled trial of topiramate versus propranolol for prevention of chronic migraine
Authors: Chowdhury Debashish , Bansal Luv , Duggal Ashish , Datta Debabrata , Mundra Ankit , Krishnan Anand , Koul Arun , Gupta Anu
Published: September 2021

Objective

The aim of the TOP-PRO-study, a double-blind randomized controlled trial, was to assess the efficacy (non-inferiority) and tolerability of propranolol compared to topiramate for the prevention of chronic migraine.

Background

Except for topiramate, oral preventive treatment for chronic migraine lacks credible evidence.

Methods

Chronic migraine patients aged above 18 years and less than 65 years of age, not on any preventive treatment were randomly allocated to receive topiramate (100 mg/day) or propranolol (160 mg/day). The primary efficacy outcome was the mean change in migraine days per 28 days at the end of 24 weeks from baseline. A mean difference of 1.5 days per four weeks was chosen as the cut-off delta value. Multiple secondary efficacy outcomes and treatment emergent adverse events were also assessed.

Results

As against the planned sample size of 244, only 175 patients could be enrolled before the spread of the corona virus disease-2019 pandemic and enforcement of lockdown in India. Of the 175 randomized patients, 95 (topiramate 46 and propranolol 49) completed the trial. The mean change in migraine days was −5.3 ± 1.2 vs −7.3 ± 1.1 days (p = 0.226) for topiramate and propranolol groups respectively. Propranolol was found to be non-inferior and not superior to topiramate (point estimate of −1.99 with a 95% confidence interval of −5.23 to 1.25 days). Multiple secondary outcomes also did not differ between the two groups. Intention to treat analysis of 175 patients and per-protocol analysis of 95 patients yielded concordant results. There was no significant difference in the incidence of adverse events between the two groups.

Conclusion

Propranolol (160mg/day) was non-inferior, non-superior to topiramate (100mg/day) for the preventive treatment of chronic migraine and had a comparable tolerability profile. Trial Registration: Clinical Trials Registry-India CTRI/2019/05/018997)
Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis
Authors: Hasami Nesar Ahmad , Smeeing Diederik Pieter Johan , Pull ter Gunne Albert Frederik , Edwards Michael John Richard , Nelen Stijn Diederik
Published: September 2021

Background:

The exact benefit of locking plates over nonlocking plates in patients with lateral malleolus fractures remains unclear. The primary aim of this study was to compare the functional outcome of locking plates vs nonlocking plates in patients with a lateral malleolus fracture. The secondary aims were to compare the number of complications and hardware removals and to compare whether results differed for older patients and for patients treated with anatomical locking plates.

Methods:

The PubMed/MEDLINE, Embase, Cochrane, and CINAHL databases were searched for studies comparing locking plates with nonlocking plates in patients with fixated lateral malleolus fractures. All included studies were assessed on their methodologic quality using the MINORS. Subgroup analyses were performed on older patients and patients treated with anatomical locking plates.

Results:

A total of 11 studies were included. The meta-analysis showed that functional outcome did not differ between patients treated with locking plates and nonlocking plates (MD 2.38, 95% CI −2.71 to 7.46). No difference in both complication rate (OR 1.10, 95% CI 0.74-1.63) and the amount of hardware removals (OR 0.77, 95% CI 0.52-1.14) was found. Even after analyzing older patients and patients treated with anatomical locking plates, no benefit was shown.

Conclusion:

This meta-analysis demonstrates no clear benefit in selecting locking plates over nonlocking plates in the treatment of lateral malleolus fractures.

Clinical Relevance:

Locking plates are increasingly being used in the treatment of lateral malleolus fractures. Biomechanical studies have shown an increased stability with use of locking vs nonlocking plates. This clinical review does not support a benefit of use of locking plates for these fractures.
Minimally invasive harvesting fascia lata (FL) in ophthalmic plastic surgery
Authors: Kadir Syeed Mehbub Ul , Hasanuzzaman Md. , Santiago-Gatmaitan Yvette Marie , Mansurali Vanessa Naseem , Mitra Mukti Rani , Roy Soma Rani , Haider Md. Golam
Published: September 2021

Purpose:

To describe a minimally invasive technique of harvesting fascia lata, and also to analyze the clinical uses and the outcome of fascia lata in Ophthalmic Plastic and Reconstructive surgery.

Methods:

This interventional study was done in three tertiary care eye hospitals in Bangladesh from July 2014 to June 2020. We obtained autologous fascia lata for the correction of congenital ptosis with poor levator function (⩽4 mm), covering the ciliary staphyloma, repair of the extruded implant following anophthalmic socket surgery, and was also used to wrap the orbital implant after enucleation. Preserved FL was used only for children before 6 years of age for the treatment of congenital ptosis.

Results:

Out of 60 subjects, 38 (63.3%) were male and 22 (36.7%) were female. Autogenous fascia lata was used for frontalis brow suspension (FBS) in 25 (41.67%) patients of congenital ptosis with poor levator function, as patch graft in ciliary staphyloma (11 cases, 18.3%), to wrap orbital implant following enucleation in intraocular malignancies (nine cases, 15%), to repair of implant extrusion following evisceration (five cases, 8.3%), and as fascial sling to correct recurrent paralytic ectropion (one case, 1.67%). Allogeneic or preserved fascia lata was used to correct congenital ptosis in patients less than 6 years of age (nine cases, 15%). Mean follow-up time was 5.32 months.

Conclusion:

Fascia lata (autogenous and allogeneic preserved) has varied uses in ophthalmic plastic surgery. Harvesting fascia lata (FL) using with minimally invasive method was successful with the least scar on the thigh to correct congenital ptosis, ciliary staphyloma, repair of extruded implant, and in wrapping implant after enucleation to get better cosmesis and motility.
Predictive and retrospective modelling of airborne infection risk using monitored carbon dioxide
Authors: Burridge Henry C. , Fan Shiwei , Jones Roderic L. , Noakes Catherine J. , Linden P. F.
Published: September 2021

The risk of long range, herein ‘airborne', infection needs to be better understood and is especially urgent during the COVID-19 pandemic. We present a method to determine the relative risk of airborne transmission that can be readily deployed with either modelled or monitored CO2 data and occupancy levels within an indoor space. For spaces regularly, or consistently, occupied by the same group of people, e.g. an open-plan office or a school classroom, we establish protocols to assess the absolute risk of airborne infection of this regular attendance at work or school. We present a methodology to easily calculate the expected number of secondary infections arising from a regular attendee becoming infectious and remaining pre/asymptomatic within these spaces. We demonstrate our model by calculating risks for both a modelled open-plan office and by using monitored data recorded within a small naturally ventilated office. In addition, by inferring ventilation rates from monitored CO2, we show that estimates of airborne infection can be accurately reconstructed, thereby offering scope for more informed retrospective modelling should outbreaks occur in spaces where CO2 is monitored. Well-ventilated spaces appear unlikely to contribute significantly to airborne infection. However, even moderate changes to the conditions within the office, or new variants of the disease, typically result in more troubling predictions.
Modus operandi of persons convicted of a sexual offense from victims’ perspectives in a Turkish sample
Authors: Gonultas (Gönültaş) Burak M. , Zeyrek-Rios Emek Yüce , Lester David
Published: September 2021

Child sexual abuse is typically studied using reports from the offender and in Western countries. The aim of the present study was to investigate pre- and post-abuse strategies of persons convicted of a sexual offense to children in Turkey using the statements made by the child victims and to frame the results using rational choice theory. A qualitative study was made for the themes in the police statements from 46 children who were victims of child sexual abuse. The content analysis revealed that persons convicted of a sexual offense to children differ in terms of their methods to approach children and in their pre- and post-abuse behaviors depending on their relationship with the victim. A total of 85% of the offenses were extra-familial and 15% within the family. Only 21% of the extra-familial offenses were opportunist; most involved bribes and introductions through friends or intermediaries. Two tactics unique to Turkey were promises of marriage and the use of children as intermediaries. The use of force and blackmail was more common in the intra-familial offenses. The results of the qualitative analysis were, on the whole, consistent with results from persons convicted of a sexual offense to children’s statements, but some of the tactics used by offenders in Turkey were unique to Turkish culture.
Ethical Considerations for Qualitative Research Methods During the COVID-19 Pandemic and Other Emergency Situations: Navigating the Virtual Field
Authors: Newman Peter A. , Guta Adrian , Black Tara
Published: September 2021

Qualitative research is integral to the pandemic response. Qualitative methods are ideally suited to generating evidence to inform tailored, culturally appropriate approaches to COVID-19, and to meaningfully engaging diverse individuals and communities in response to the pandemic. In this paper, we discuss core ethical and methodological considerations in the design and implementation of qualitative research in the COVID-19 era, and in pivoting to virtual methods—online interviews and focus groups; internet-based archival research and netnography, including social media; participatory video methods, including photo elicitation and digital storytelling; collaborative autoethnography; and community-based participatory research. We identify, describe, and critically evaluate measures to address core ethical challenges around informed consent, privacy and confidentiality, compensation, online access to research participation, and access to resources during a pandemic. Online methods need not be considered unilaterally riskier than in-person data collection; however, they are clearly not the same as in-person engagement and require thoughtful, reflexive, and deliberative approaches in order to identify and mitigate potential and dynamically evolving risks. Ensuring the ethical conduct of research with marginalized and vulnerable populations is foundational to building evidence and developing culturally competent and structurally informed approaches to promote equity, health, and well-being during and after the pandemic. Our analysis offers methodological, ethical, and practical guidance in the COVID-19 pandemic and considerations for research conducted amid future pandemics and emergency situations.
Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review
Authors: Salerno Alexander , Strambo Davide , Nannoni Stefania , Dunet Vincent , Michel Patrik
Published: September 2021

Background

Posterior circulation and anterior circulation strokes share many clinical, pathogenetic and radiological features, although some clinical signs are highly specific to posterior circulation strokes. Arterial stenosis and occlusions occur in significant numbers in both acute posterior circulation and anterior circulation strokes, making them good candidates for endovascular treatment. Among posterior circulation strokes, basilar artery occlusions stand out because of the diagnostic and acute treatment challenges.

Methods

We reviewed the literature on clinical stroke syndromes and neuroimaging findings and systematically describe for each anatomical site of stroke the detailed clinical and radiological information (anatomical representation, diffusion weighted imaging and angiographic sequences). The principles of neuroimaging of posterior circulation strokes and the prognosis for each stroke localization are also discussed.

Review summary

Stroke syndromes in the territories of the vertebral, basilar, cerebellar, and posterior cerebral arteries are presented. Features typical of posterior circulation strokes are highlighted, including patterns of basilar artery occlusions. Clinical severity and prognosis of posterior circulation strokes are highly variable, and given that they are more difficult to detect on CT-based neuroimaging, magnetic resonance imaging is the technique of choice in suspected posterior circulation strokes. Rapid identification of arterial occlusion patterns may provide prognostic information and support acute revascularization decisions.

Conclusions

Posterior circulation stroke syndromes tightly reflect lesion localization and arterial occlusion patterns. Although many clinical and pathogenetic features are similar to anterior circulation strokes, notable differences exist in terms of clinical presentation, stroke mechanism, prognosis, and response to acute recanalization.
Hypofractionated radiation in secretory breast cancer: A case report
Authors: Tatebe Ken , Perez Claudia , Usha Lydia , Ghai Ritu , Wang Dian , Barry Parul
Published: September 2021

Secretory carcinoma is a rare and indolent breast cancer with a lack of established treatment paradigms. We describe a case of a woman who underwent breast conservative therapy in the modern era. A 48 year old woman with a screen-detected left breast cancer was found to have early-stage secretory carcinoma after definitive breast conservation surgery. Further management with adjuvant radiation was recommended. After definitive breast conservative surgery, final pathology was notable for secretory breast carcinoma due to the immunohistologic characteristics of the tumor, ETV6-NTRK3 gene fusion, and histologic findings. After multi-disciplinary discussion, it was recommended that the patient proceed with adjuvant radiation. She was treated using a modestly hypofractionated regimen of 4256 cGy in 16 fractions. She tolerated the treatment well, developing only grade 1 radiation dermatitis. At 1 year follow-up she was clinically and radiographically free of disease. With a shift in management toward breast conservative therapy, defining the role of adjuvant radiation for secretory carcinomas in the modern era is of increasing importance. Modestly hypofractionated radiation is well-tolerated. Oncologic outcomes will be assessed with continued long-term follow-up.
Controversing the datafied smart city: Conceptualising a ‘making-controversial’ approach to civic engagement
Authors: Baibarac-Duignan Corelia , de Lange Michiel
Published: September 2021

In this paper, we propose the concept of controversing as an approach for engaging citizens in debates around the datafied city and in shaping responsible smart cities that incorporate diverse public values. Controversing addresses the engagement of citizens in discussions about the datafication of urban life by productively deploying controversies around data. Attempts to engage citizens in the smart city frequently involve ‘neutral’ data visualisations aimed at making abstract sociotechnical issues more tangible. In addition, citizens are meant to gather around issues already defined externally by others. Instead, we focus on how people might become engaged and develop the capacity to shape alternative urban futures. We suggest that making controversial apparently less contentious issues in the smart city allows people to identify their own issues, come together temporarily as a public, imagine alternative possibilities and thus develop capacities for action. In this context, controversies can act as agents of change and open up new spaces for participation and action. We develop the notion of controversing as a deliberate strategy of making datafication controversial, and operationalise the term along the dimensions of recontextualisation, meaning-making and agency. We then look at two cases from the mid-sized city of Amersfoort in the Netherlands, first to test the conceptual potential of controversing to expose how frictions shape citizen engagement, and second to analyse how controversing may frame design-oriented methods aimed at involving diverse participants in discussing datafication and defining public values in the datafied smart city.
Interventions Targeting the Wellbeing of Migrant Youths: A Systematic Review of the Literature
Authors: Heyeres Marion , Perera Nirukshi , Udah Hyacinth , Attakey Akpene , Whiteside Mary , Tsey Komla
Published: September 2021

Migration can affect the physical, mental, emotional, and social wellbeing of individuals and families. This study provides an overview of interventions aimed at improving the wellbeing of young migrants. It identifies knowledge gaps and provides direction for future research. The review process comprises a systematic search of six academic databases, and websites for relevant peer-reviewed and gray literature on the topic. A total of 2,911 records were identified, of which 28 studies met our eligibility criteria for inclusion. Thematic analysis comprised of the description of study characteristics and outcome themes. EPHPP and CASP tools were utilized to assess the methodological quality of studies. The review findings indicate a number of approaches with varying effectivity, however, arts, music, and sports programs showed good results for youth across all migrant groups. Our findings call for further and more high-quality evaluation research, with longitudinal designs that ideally include stakeholder collaboration.
Land Allocation Choice in Both Contract and Non-Contract Farming: A Study of Potato Growers in West Bengal, India
Authors: Sinha Ashish Aman , Behera Hari Charan , Behura Ajit Kumar , Swain Braja Bandhu
Published: September 2021

This paper analyses how farmers to take decision to allocate and use their lands for potato production when both contract and non-contract farming options are available in West Bengal. We used a primary data collected from 327 potato producing households in Bankura and Bardhaman districts of West Bengal. We used generalized least squares fixed effect model in the empirical analysis. We observed that imposed restriction of seed supply limits the choice of both potato farming and non-potato farming. The benefits from contract farming are not accrued by the farmers who are mainly small and marginal landholders. They are also in a moment of ambiguity to choice their land use under non-potato cultivation. The choice of the farmers, therefore, remains constrained. This uncertainty can be overcome only through effective land use planning and institutional intervention.
Effect of Phase Change Material Cooling Vests on Body Thermoregulation and Thermal Comfort of Patients With Paraplegia: A Human Subject Experimental Study
Authors: Moussalem Charbel K. , Mneimneh Farah , Sarieddine Rana , Bsat Shadi , El Houshiemy Mohamad N. , Minassian Georges B. , Ghaddar Nesreen , Ghali Kamel , Omeis Ibrahim
Published: September 2021

Study design

Randomized experimental study.

Objective

Compared to able-bodied people, patients with paraplegia due to thoracic spinal cord injury (SCI) are at an increased risk of heat illnesses during exercise due to impaired thermoregulatory responses. To overcome this limitation, we investigated the performance of three phase change material (PCM) cooling vests of different melting temperatures (Eijsvogels, #49) and coverage area of the trunk.

Methods

Sixteen participants were divided into three groups according to their injury level. All were tested for V20 full vest (20°C Tm, 75% coverage). Mid-thoracic and high-thoracic groups were tested for V14 vest (14°C Tm, 75% coverage). The mid-thoracic group was tested for V20 half vest (20°C Tm, 50% coverage). The participants performed a 30-min arm-crank exercise followed by a recovery period inside a controlled hot climatic chamber. The heart rate, segmental skin (Tskin), and core temperature (Tcore) values were recorded, and subjective questionnaires were taken.

Results

Compared to no vest (NV) test, all the vests showed an effective decrease in Tskin values of the trunk. However, the decrease in Tskin was not enough to induce a significant decrease in Tcore in all three groups. Mid-thoracic and low-thoracic groups showed a reduction in the increasing Tcore by the end of the exercise and recovery period. Finally, the level of thermal comfort was enhanced for the three groups.

Conclusion

The effectiveness of cooling vests for persons with paraplegia is dependent on injury level and thus the ratio of sensate to insensate skin. Future studies necessitate the investigation of the cooling effects of PCM vests at a lower Tm with a larger sample size.
A Systematic Review of the Impacts of Entrepreneurial Support Programs in Science, Technology, Engineering, and Math Fields
Authors: Zappe Sarah E. , Cutler Stephanie L. , Gase Lauren
Published: September 2021

Programs dedicated to entrepreneurship education in the Science, Technology, Engineering, and Math (STEM) fields have expanded tremendously. However, much remains unknown about the current state of research and practice of these programs. This article presents results from a systematic review designed to explore how Entrepreneurial Support Programs serving science and technology innovators conceptualize and measure individual-level impacts. Results suggest that the intended impacts of programs are often ill-defined. While many programs focus on improving entrepreneurial mindset, the term is frequently not well defined, operationalized, or clearly measured. Likewise, results suggest that understanding the impact of programs is challenging due to the quality of the research or evaluation procedures employed. Finally, results suggest that there is a strong lack of diversity awareness or acknowledgment in the field; the vast majority of the papers did not mention gender, race, or other demographic characteristics. Moving forward, researchers and practitioners have an opportunity to strengthen data-driven work to assess the impact of entrepreneurship support programs through the use of clear definitions, well-documented methods, and assessment instruments with sufficient validity evidence.
Understanding and mathematical modelling of cellular resource allocation in microorganisms: a comparative synthesis
Authors: Zeng Hong , Rohani Reza , Huang Wei E. , Yang Aidong
Published: September 2021

Background

The rising consensus that the cell can dynamically allocate its resources provides an interesting angle for discovering the governing principles of cell growth and metabolism. Extensive efforts have been made in the past decade to elucidate the relationship between resource allocation and phenotypic patterns of microorganisms. Despite these exciting developments, there is still a lack of explicit comparison between potentially competing propositions and a lack of synthesis of inter-related proposals and findings.

Results

In this work, we have reviewed resource allocation-derived principles, hypotheses and mathematical models to recapitulate important achievements in this area. In particular, the emergence of resource allocation phenomena is deciphered by the putative tug of war between the cellular objectives, demands and the supply capability. Competing hypotheses for explaining the most-studied phenomenon arising from resource allocation, i.e. the overflow metabolism, have been re-examined towards uncovering the potential physiological root cause. The possible link between proteome fractions and the partition of the ribosomal machinery has been analysed through mathematical derivations. Finally, open questions are highlighted and an outlook on the practical applications is provided. It is the authors’ intention that this review contributes to a clearer understanding of the role of resource allocation in resolving bacterial growth strategies, one of the central questions in microbiology.

Conclusions

We have shown the importance of resource allocation in understanding various aspects of cellular systems. Several important questions such as the physiological root cause of overflow metabolism and the correct interpretation of ‘protein costs’ are shown to remain open. As the understanding of the mechanisms and utility of resource application in cellular systems further develops, we anticipate that mathematical modelling tools incorporating resource allocation will facilitate the circuit-host design in synthetic biology.
rKOMICS: an R package for processing mitochondrial minicircle assemblies in population-scale genome projects
Authors: Geerts Manon , Schnaufer Achim , Van den Broeck Frederik
Published: September 2021

Background

The advent of population-scale genome projects has revolutionized our biological understanding of parasitic protozoa. However, while hundreds to thousands of nuclear genomes of parasitic protozoa have been generated and analyzed, information about the diversity, structure and evolution of their mitochondrial genomes remains fragmentary, mainly because of their extraordinary complexity. Indeed, unicellular flagellates of the order Kinetoplastida contain structurally the most complex mitochondrial genome of all eukaryotes, organized as a giant network of homogeneous maxicircles and heterogeneous minicircles. We recently developed KOMICS, an analysis toolkit that automates the assembly and circularization of the mitochondrial genomes of Kinetoplastid parasites. While this tool overcomes the limitation of extracting mitochondrial assemblies from Next-Generation Sequencing datasets, interpreting and visualizing the genetic (dis)similarity within and between samples remains a time-consuming process.

Results

Here, we present a new analysis toolkit—rKOMICS—to streamline the analyses of minicircle sequence diversity in population-scale genome projects. rKOMICS is a user-friendly R package that has simple installation requirements and that is applicable to all 27 trypanosomatid genera. Once minicircle sequence alignments are generated, rKOMICS allows to examine, summarize and visualize minicircle sequence diversity within and between samples through the analyses of minicircle sequence clusters. We showcase the functionalities of the (r)KOMICS tool suite using a whole-genome sequencing dataset from a recently published study on the history of diversification of the Leishmania braziliensis species complex in Peru. Analyses of population diversity and structure highlighted differences in minicircle sequence richness and composition between Leishmania subspecies, and between subpopulations within subspecies.

Conclusion

The rKOMICS package establishes a critical framework to manipulate, explore and extract biologically relevant information from mitochondrial minicircle assemblies in tens to hundreds of samples simultaneously and efficiently. This should facilitate research that aims to develop new molecular markers for identifying species-specific minicircles, or to study the ancestry of parasites for complementary insights into their evolutionary history.
Magnitude and associated factors of anemia among AZT based HAART experienced adult HIV patients at University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia, 2019: a retrospective cohort study
Authors: Getaneh Zegeye , Wale Worku , Chanie Belete , Temesgen Etetetu , Abebe Metadele , Walie Melesse , Lemma Mulualem
Published: September 2021

Background

Anemia is the most common hematologic abnormalities in AIDS patients usually associated with disease progression and poor clinical outcomes. Zidovudine (AZT), which is one of the nucleoside reverse transcriptase inhibitor drug families of the first line antiretroviral therapy regimen for HIV/AIDS patients, causes anemia due to early long-term of higher-dose therapy. This study was aimed to assess the magnitude and associated factors of anemia among AZT containing HAART experienced adult HIV/ADIS patients at University of Gondar Comprehensive Specialized Referral Hospital, northwest, Ethiopia, 2019.

Methods

A retrospective cohort study was conducted among a total of 320 adult AZT based HAART experienced HIV/AIDS patients from January 2016 to December 2018. Systematic random sampling technique was used to select the patients’ charts. All required data for this study were extracted from patients’ medical charts. Data were coded, cleared and entered into Epi Info version 3.5.3, and transformed to SPSS version 20 for analysis. Descriptive statistics, bivariable and multivariable logistic regression models were fitted to identify associated factors of anemia and P-value < 0.05 was considered as statistically significance.

Results

A total of 320 adult AZT based HAART experienced HIV/AIDS patients’ charts were assessed. Of the total patients, 198 (61.9%) were females and 133 (41.6%) were within the age range of 35–45 years. More than half, 237(76.9%) of the patients were from the urban area and 186 (58.1%) were on WHO clinical stage III at the baseline. The prevalence of anemia was 50% (95% CI 44.7–55.0%), 44.1% (95% CI 38.4–50.0%), 35.6% (95% CI 30.3–40.6%), 40% (95% CI 34.4–45.6%), 40.6% (95% CI 35.0–46.3) and 39.1% (95% CI 33.4–44.1%) at baseline, 6 months, 12 months, 18 months, 24 months and 30 months of follow-up period, respectively. The overall prevalence of anemia was 41.6%. Anemia had significant association with WHO clinical stage and base line Hgb values.

Conclusions

A significant number of participants were anemic in this study. WHO clinical stage and baseline Hgb value were the contributing factors for anemia among these patients. Therefore, anemia needs an immediate intervention on associated factor to improve the anemic status and living condition of HIV patient.
Root canals shaped by nickel-titanium instrumentation with automated computerized numerical control systems
Authors: Wang Liming , Li Wenxiang , Yoo Yeon-Jee , Chung Shin Hye , Oh Soram , Perinpanayagam Hiran , Kum Kee-Yeon , Gu Yu
Published: September 2021

Background

To investigate the efficacy of a nickel-titanium (NiTi) file with an automated computerized numerical control (CNC) system for root canal shaping.

Methods

The movement of the automated device and the insertion angle were investigated. In Experiment 1, simulated resin root canals were randomly divided into four groups (n = 20): manual downward movement using a handpiece (Group 1), vertical downward movement by CNC (Group 2), reciprocating up and down movement by CNC (Group 3), and spiral up and down movement by CNC (Group 4). In Experiment 2, five different insertion angles of the NiTi file were evaluated (n = 20). Four parameters were used to evaluate the shaping ability: change in the working length, central axis offset, curvature variation, and preparation time. Groups were compared using one-way analysis of variance (ANOVA) with significance was set at P < 0.05.

Results

The change in central axis position in the curved part of the root canal was found to be smaller in Group 4 than in other groups (P < 0.05). The curvature changes and preparation time of Groups 1 and 4 were significantly reduced compared with Groups 2 and 3 (P < 0.05). The variation in working length and curvature in the 5° insertion angle group was significantly smaller than in the other groups (P < 0.05).

Conclusions

A spiral up and down movement, controlled by the CNC machine, and 5° insertion angle, maintained original root canal shape more precisely than other methods.
Serum GGT/ALT ratio predicts vascular invasion in HBV-related HCC
Authors: Zhao Zhifeng , Zhu Yiming , Ni Xiaochun , Lin Jiayun , Li Hongjie , Zheng Lei , Zhang Chihao , Qi Xiaoliang , Huo Haizhong , Lou Xiaolou , Fan Qiang , Bao Yongyang , Luo Meng
Published: September 2021

Background

The gamma-glutamyl transferase (GGT) to alanine aminotransferase (ALT) ratio has been reported as an effective predictor of the severity of hepatitis and HCC. The purpose of this study was to determine the role of the GGT/ALT ratio in the prediction of vascular invasion and survival outcomes in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Methods

The risk factors for vascular invasion were determined by univariate/multivariate logistic analysis. The cut-off value of GGT/ALT in predicting vascular invasion was calculated using the receiver operating characteristic (ROC) curve. The prognostic value of GGT/ALT was examined by Cox analysis and Kaplan–Meier curves. Sensitivity analysis, such as subgroup analysis and propensity score matching (PSM), was performed to reduce potential confounding bias.

Results

A high GGT/ALT ratio was identified as an independent risk factor for vascular invasion (P = 0.03). The correlation analysis suggested that higher GGT/ALT was associated with more severe tumour burdens, including vascular invasion (P < 0.001), tumour volume > 5 cm (P < 0.001), poor pathological differentiation (P = 0.042), more severe BCLC (P < 0.001) and ALBI grade (P = 0.007). In the survival analysis, a high GGT/ALT ratio was associated with poor overall survival (OS) (HR: 1.38; 95% CI 1.03, 1.87; P < 0.0001) and disease-free survival (DFS) (HR: 1.32; 95% CI 1.03, 1.87; P < 0.0001). In the subgroup analysis, similar results were consistently observed across most subgroups. In PSM analysis, GGT/ALT remained independently associated with vascular invasion (OR, 186; 95% CI 1.23, 3.33).

Conclusion

The GGT/ALT ratio was a potential effective factor in the prediction of vascular invasion and prognosis in patients with HBV-related HCC.
Performance evaluation of RDT, light microscopy, and PET-PCR for detecting Plasmodium falciparum malaria infections in the 2018 Zambia National Malaria Indicator Survey
Authors: Mwenda Mulenga C. , Fola Abebe A. , Ciubotariu Ilinca I. , Mulube Conceptor , Mambwe Brenda , Kasaro Rachael , Hawela Moonga B. , Hamainza Busiku , Miller John M. , Carpi Giovanna , Bridges Daniel J.
Published: September 2021

Background

Zambia continues to advance on the path to elimination with significant reductions in malaria morbidity and mortality. Crucial components that have contributed to progress thus far and are necessary for achieving the national malaria elimination goals include properly identifying and treating all malaria cases through accurate diagnosis. This study sought to compare and assess the diagnostic performance of Rapid Diagnostic Tests (RDT) and Light Microscopy (LM) with photo-induced electron transfer polymerase chain reaction (PET-PCR) as the gold standard using 2018 Malaria Indicator Survey (MIS) data across Zambia to better understand diagnostic accuracy metrics and how these vary across a transmission gradient.

Methods

Cross-sectional samples collected in a nationally representative survey from 7 provinces in Zambia were tested for the presence of malaria parasites by light microscopy (LM), rapid diagnostic test (RDT) and the gold standard PET-PCR. Diagnostic performance was assessed including sensitivity, specificity, negative- and positive-predictive values across a wide malaria transmission spectrum. Diagnostic accuracy metrics were measured, and statistically significant differences were calculated between test methods for different outcome variables.

Results

From the individuals included in the MIS, the overall prevalence ofPlasmodium falciparummalaria was 32.9% by RDT, 19.4% by LM, and 23.2% by PET-PCR. Herein, RDT and LM diagnostic performance was compared against gold standard PET-PCR with LM displaying a higher diagnostic accuracy than RDTs (91.3% vs. 84.6% respectively) across the transmission spectrum in Zambia. However, the performance of both diagnostics was significantly reduced in low parasitaemia samples. Consistent with previous studies, RDT diagnostic accuracy was predominantly affected by a high rate of false positives.

Conclusions

RDTs and LM both perform well across a range of transmission intensities within their respective target applications, i.e., in the community, for the former, where ease of use and speed of result is critical, and at the health facility, for the latter, where accuracy is prioritized. However, the performance of both diagnostic methods is adversely affected by low parasitaemia infections. As Zambia moves towards elimination more sensitive tools may be required to identify the last cases.
Effect of guidewire insertion in fractional flow reserve procedure for real geometry using computational fluid dynamics
Authors: Abuouf Yasser , AlBadawi Muhamed , Ookawara Shinichi , Ahmed Mahmoud
Published: September 2021

Background

Coronary artery disease is an abnormal contraction of the heart supply blood vessel. It limits the oxygenated blood flow to the heart. Thus, diagnosing its severity helps physicians to select the appropriate treatment plan. Fractional flow reserve (FFR) is the most accurate method to pinpoint the stenosis severity. However, inserting the guidewire across stenosis may cause a false overestimation of severity.

Methods

To estimate the errors due to guidewire insertion, reconstructed three-dimensional coronary artery geometry from a patient-specific scan is used. A comprehensive three-dimensional blood flow model is developed. Blood is considered non-Newtonian and the flow is pulsatile. The model is numerically simulated using realistic boundary conditions.

Results

The FFR value is calculated and compared with the actual flow ratio. Additionally, the ratio between pressure drop and distal dynamic pressure (CDP) is studied. The obtained results for each case are compared and analyzed with the case without a guidewire. It was found that placing the guidewire leads to overestimating the severity of moderate stenosis. It reduces the FFR value from 0.43 to 0.33 with a 23.26% error compared to 0.44 actual flow ratio and the CDP increases from 5.31 to 7.2 with a 35.6% error. FFR value in mild stenosis does not have a significant change due to placing the guidewire. The FFR value decreases from 0.83 to 0.82 compared to the 0.83 actual flow ratio.

Conclusion

Consequently, physicians should consider these errors while deciding the treatment plan.
Patent challenges and factors associated with successful patent challengers under the patent linkage system: recent evidence from South Korea after the Korea United States free trade agreement
Authors: Son Kyung-Bok , Choi Nahye , Lee Boram , Byun Joonsoo , Yang Dong-Wook , Lee Tae-Jin
Published: September 2021

Objectives

The patent linkage system upgraded patent challenges to an important factor in granting timely market approval for generic drugs. We aim to understand patent challenges and identify the factors that are associated with successful patent challengers under the patent linkage system in South Korea.

Methods

We constructed a novel dataset that combined information on manufacturers with detailed data about their patent challenges after introduction of the patent linkage system. Based on the number of successful patent challenges, manufacturers were categorized into non-challengers, passive challengers, and aggressive challengers. Then, two types of logistic models were applied to identify the factors associated with successful and aggressive challengers.

Findings

Only 39 active ingredients were challenged by 77 manufacturers from March 2015 to December 2019. Of 171 manufacturers, 94 (55 %) were non-challengers, 58 (34 %) were passive challengers who had succeeded in fewer than 4 patent challenges, and 19 (11 %) were aggressive challengers who had succeeded in 4 or more patent challenges. Higher sales, more employees, and a greater number of reimbursed drugs were associated with being a patent challenger, while a greater number of reimbursed drugs was associated with being an aggressive challenger.

Conclusion

Some manufacturers utilize patent challenges to strengthen their product portfolios in the market. However, under the patent linkage system, the frequency of patent challenges is limited in South Korea compared to the United States. In particular, patent challenges against drugs in injection form and biologics are very rare.
The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: a systematic review and meta-analysis
Authors: Areia Carlos , Biggs Christopher , Santos Mauro , Thurley Neal , Gerry Stephen , Tarassenko Lionel , Watkinson Peter , Vollam Sarah
Published: September 2021

Background

Timely recognition of the deteriorating inpatient remains challenging. Wearable monitoring systems (WMS) may augment current monitoring practices. However, there are many barriers to implementation in the hospital environment, and evidence describing the clinical impact of WMS on deterioration detection and patient outcome remains unclear.

Objective

To assess the impact of vital-sign monitoring on detection of deterioration and related clinical outcomes in hospitalised patients using WMS, in comparison with standard care.

Methods

A systematic search was conducted in August 2020 using MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, CENTRAL, Health Technology Assessment databases and grey literature. Studies comparing the use of WMS against standard care for deterioration detection and related clinical outcomes in hospitalised patients were included. Deterioration related outcomes (primary) included unplanned intensive care admissions, rapid response team or cardiac arrest activation, total and major complications rate. Other clinical outcomes (secondary) included in-hospital mortality and hospital length of stay. Exploratory outcomes included alerting system parameters and clinical trial registry information.

Results

Of 8706 citations, 10 studies with different designs met the inclusion criteria, of which 7 were included in the meta-analyses. Overall study quality was moderate. The meta-analysis indicated that the WMS, when compared with standard care, was not associated with significant reductions in intensive care transfers (risk ratio, RR 0.87; 95% confidence interval, CI 0.66–1.15), rapid response or cardiac arrest team activation (RR 0.84; 95% CI 0.69–1.01), total (RR 0.77; 95% CI 0.44–1.32) and major (RR 0.55; 95% CI 0.24–1.30) complications prevalence. There was also no statistically significant association with reduced mortality (RR 0.48; 95% CI 0.18–1.29) and hospital length of stay (mean difference, MD − 0.09; 95% CI − 0.43 to 0.44).

Conclusion

This systematic review indicates that there is no current evidence that implementation of WMS impacts early deterioration detection and associated clinical outcomes, as differing design/quality of available studies and diversity of outcome measures make it difficult to reach a definite conclusion. Our narrative findings suggested that alarms should be adjusted to minimise false alarms and promote rapid clinical action in response to deterioration.

PROSPERO Registration number:CRD42020188633.