bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the penetration of intracoronal bleaching agents into the cervical region using different intraorifice barriers
Authors: Sakalli Bugce , Basmaci Fatma , Dalmizrak Ozlem
Published: June 2022

Background

The present study aimed to make a comparison between the effects of 35% hydrogen peroxide gel (HP) and sodium perborate with distilled water (SP) bleaching agents on the sealing characteristics of glass ionomer cement (GIC), TheraBase, ProRoot MTA and Biodentine intraorifice barriers.

Methods

One hundred and twelve single-rooted mandibular human premolar teeth extracted from young patients (14–25 years) were chosen. Root cement and cementoenamel junction (CEJ) of teeth were examined under a stereomicroscope at 10 × magnification to ensure there was no cement defect or dentin gap in CEJ. After the endodontic access cavities were opened on the occlusal surfaces of the teeth, the working length was determined. Instrumentation of each root canal was performed with a ProTaper Gold rotary system in the determined working length and filled with gutta-percha + AH Plus with a single cone technique using. Root fillings were removed 3 mm short of the CEJ and sealed with one of the following intraorifice barrier materials (n = 30/group): 1. GIC; 2. TheraBase; 3. ProProot-MTA; 4. Biodentine. In each of the sub-groups, either HP or SP was used to perform intracoronal bleaching on days 1, 4, and 7. All outer surfaces of the specimens except the 3 mm cervical region were covered with nail polish and modeling wax layers. Specimens were immersed in a 5 ml Eppendorf tube that contained 2 mL of distilled water. The penetration of peroxide release was measured using the colorimetric ferric thiocyanate method. Statistical analysis of the data was performed with Three-way ANOVA and Tukey’s test (P = 0.05).

Results

In the HP groups, GIC showed the greatest peroxide release when compared with other tested groups on day 1 (P < 0.05). Biodentine and ProRoot MTA displayed a significantly lower peroxide leakage when compared to GIC and TheraBase on days 1 and 4 (P < 0.05). While GIC and TheraBase were used, HP observed higher peroxide penetration when compared with SP on days 1 and 4 (P < 0.05).

Conclusions

Peroxide diffusion was significantly influenced by the kind of intracoronal bleaching agents and intraorifice barrier materials used.
Ethical issues in oncology practice: a qualitative study of stakeholders’ experiences and expectations
Authors: Crico Chiara , Sanchini Virginia , Casali Paolo G. , Pravettoni Gabriella
Published: June 2022

Background

Clinical Ethics Support Services (CESS) have been established to support healthcare professionals in addressing ethically sensitive issues in clinical practice and, in many countries, they are under development. In the context of growing CESS, exploring how healthcare professionals experience and address clinical ethics issues in their daily practice represents a fundamental step to understand their potential needs. This is even more relevant in the context of extremely sensitive diseases, such as cancer. On this basis, we carried out a qualitative study conducting in-depth semi-structured interviews with stakeholders of a major comprehensive cancer centre in Italy, with the twofold aim of investigating what ethical issues arise in the context of clinical oncology and how they are addressed, as well as stakeholders’ expectations about a potential CESS to be implemented within the Institution.

Methods

The study was conducted within the theoretical framework of Grounded Theory. Participants were healthcare professionals and other key stakeholders working within the cancer centre. The semi-structured interview aimed at exploring common ethical aspects of oncology, investigating stakeholders’ professional experience in dealing with clinical ethics issues, their expectations and requests regarding ethics support services. Transcripts of the interviews were coded and analysed according to the principles of Grounded Theory.

Results

Twenty-one stakeholders were interviewed. Our analysis showed a wide consensus on the identification of ethically relevant issues, above all those concerning communication, end-of-life, and resource allocation. The absence of institutional tools or strategies to address and manage ethical issues at the patient bedside emerged, and this is reflected in the widespread request for their development in the future. The ideal support service should be fast and flexible in order to adapt to different needs and clinical cases.

Conclusions

The interviewees showed a limited degree of ‘ethical awareness’: despite having reported many issues in clinical practice, they could hardly identify and describe the ethical aspects, while  complaining about a lack of ethical resources in their management. To build a truly effective support service, it therefore seems appropriate to take such context into consideration and address the emerged needs. Ethical sensitivity seems to be key and it becomes even more relevant in critical clinical areas, such as the therapeutic pathways of terminally ill patients.
Incorporation of complementary and traditional medicine in ICD-11
Authors: Reddy Bill , Fan Arthur Yin
Published: June 2022

Traditional medicine (TM) is practiced in various forms in over 180 countries. Despite this, health information systems on TM are limited. Consistent with this, the World Health Organization’s (WHO) international classification for diseases (ICD) has not to date included TM concepts. This is now changing, as the WHO has endorsed the reflection of TM paradigms in the new 11th Revision of ICD (ICD-11). Although some countries have had national Traditional Medicine classification systems for many years, information from such systems has not been standardized nor been made available globally. By including TM within the ICD, international standardization will be possible allowing for measuring, counting, comparing, formulating questions and monitoring over time. ICD-11 is a classification system for the twenty-first century, and it now provides an opportunity for interested users to integrate the coding of diagnostic concepts from both TM and Western Medicine. This paper describes the new TM classification in ICD and demonstrates through coding examples how to code TM concepts alongside Western Medicine concepts.
Organisational culture and ethnic diversity in nursing homes: a qualitative study of healthcare workers’ and ward nurses’ experiences
Authors: Debesay Jonas , Arora Sanjana , Fougner Marit
Published: June 2022

Background

The increase in care needs that comes with an ageing population, in combination with a shortage of healthcare workers, has made ethnic diversity among healthcare workers (HCW) an evident reality across many countries. This article aims to explore how a multicultural workplace is experienced, through the accounts of HCWs and leaders in nursing homes.

Methods

This article reports on the findings from qualitative interviews with 16 HCWs and managers from nursing homes in Oslo. The interviews were conducted from August to September 2021. We analysed the data using a reflective thematic analysis informed by a hermeneutic-phenomenological approach.

Results

Six themes emerged from the interview data: (1) understanding diversity through shared norms and multicultural experiences, (2) greater flexibility in a multicultural workforce, (3) challenging traditional norms in a multicultural workforce, (4) language proficiency and exclusionary practices at work, (5) perceptions of the role of the ward nurse, and (6) prejudices among and harassment from patients.

Conclusions

To ensure the effective organisation and wellbeing of HCWs in a multicultural workforce, managers must develop an inclusive organisational culture. They must be able to engage with difficult topics and conflicts that may arise in the working environment.
Revisiting the seven pillars of RDoC
Authors: Morris Sarah E. , Sanislow Charles A. , Pacheco Jenni , Vaidyanathan Uma , Gordon Joshua A. , Cuthbert Bruce N.
Published: June 2022

Background

In 2013, a few years after the launch of the National Institute of Mental Health’s Research Domain Criteria (RDoC) initiative, Cuthbert and Insel published a paper titled “Toward the future of psychiatric diagnosis: the seven pillars of RDoC.” The RDoC project is a translational research effort to encourage new ways of studying psychopathology through a focus on disruptions in normal functions (such as reward learning or attention) that are defined jointly by observable behavior and neurobiological measures. The paper outlined the principles of the RDoC research framework, including emphases on research that acquires data from multiple measurement classes to foster integrative analyses, adopts dimensional approaches, and employs novel methods for ascertaining participants and identifying valid subgroups.

Discussion

To mark the first decade of the RDoC initiative, we revisit the seven pillars and highlight new research findings and updates to the framework that are related to each. This reappraisal emphasizes the flexible nature of the RDoC framework and its application in diverse areas of research, new findings related to the importance of developmental trajectories within and across neurobehavioral domains, and the value of computational approaches for clarifying complex multivariate relations among behavioral and neurobiological systems.

Conclusion

The seven pillars of RDoC have provided a foundation that has helped to guide a surge of new studies that have examined neurobehavioral domains related to mental disorders, in the service of informing future psychiatric nosology. Building on this footing, future areas of emphasis for the RDoC project will include studying central-peripheral interactions, developing novel approaches to phenotyping for genomic studies, and identifying new targets for clinical trial research to facilitate progress in precision psychiatry.
Real-time feedback control of split-belt ratio to induce targeted step length asymmetry
Authors: Carr Sean , Rasouli Fatemeh , Kim Seok Hun , Reed Kyle B.
Published: June 2022

Introduction

Split-belt treadmill training has been used to assist with gait rehabilitation following stroke. This method modifies a patient’s step length asymmetry by adjusting left and right tread speeds individually during training. However, current split-belt training approaches pay little attention to the individuality of patients by applying set tread speed ratios (e.g., 2:1 or 3:1). This generalization results in unpredictable step length adjustments between the legs. To customize the training, this study explores the capabilities of a live feedback system that modulates split-belt tread speeds based on real-time step length asymmetry.

Materials and methods

Fourteen healthy individuals participated in two 1.5-h gait training sessions scheduled 1 week apart. They were asked to walk on the Computer Assisted Rehabilitation Environment (CAREN) split-belt treadmill system with a boot on one foot to impose asymmetrical gait patterns. Each training session consisted of a 3-min baseline, 10-min baseline with boot, 10-min feedback with boot (6% asymmetry exaggeration in the first session and personalized in the second), 5-min post feedback with boot, and 3-min post feedback without boot. A proportional-integral (PI) controller was used to maintain a specified step-length asymmetry by changing the tread speed ratios during the 10-min feedback period. After the first session, a linear model between baseline asymmetry exaggeration and post-intervention asymmetry improvement was utilized to develop a relationship between target exaggeration and target post-intervention asymmetry. In the second session, this model predicted a necessary target asymmetry exaggeration to replace the original 6%. This prediction was intended to result in a highly symmetric post-intervention step length.

Results and discussion

Eleven out of 14 participants (78.6%) developed a successful relationship between asymmetry exaggeration and decreased asymmetry in the post-intervention period of the first session. Seven out of the 11 participants (63.6%) in this successful correlation group had second session post-intervention asymmetries of < 3.5%.

Conclusions

The use of a PI controller to modulate split-belt tread speeds demonstrated itself to be a viable method for individualizing split-belt treadmill training.
Does one size fit all? A qualitative study about the need for individualized information transfer for orthognathic patients
Authors: Graf Isabelle , Enders Anna , Karbach Ute , Mihailovic Tatjana , Kruse Teresa , Pollklas Melanie , Höfer Karolin , Zöller Joachim , Braumann Bert
Published: June 2022

Aims

For any orthodontic-orthognathic treatment, it is crucial that patients are provided with enough and proper information in order to make evidence-based decisions- not only prior to treatment start, but also throughout the course of therapy. Thus, the objectives of this qualitative study were to identify information needs of patients undergoing combined orthodontic-orthognathic treatment. Additionally, professionals’ perspectives were evaluated.

Methods

A qualitative research approach was chosen in order to determine crucial aspects of information needs before and throughout treatment. With respect to a purposive sampling strategy and thematic saturation, we conducted ten semi-structured interviews with patients who had finished their orthodontic-orthognathic surgery treatments (five women, five men; being 21 to 34 years old). The indications for the combination treatment were severe skeletal Class IIs to Class IIIs with various vertical and transverse discrepancies. In addition, a multidisciplinary focus-group with six professionals from the maxillofacial surgery and orthodontic department (three women, three men; being 30 to 38 years old) helped to reflect about the experts’ point of views.

After transcription, data was categorized and analyzed by Mayring’s content analysis.

Results

We identified three key themes. During this analysis, we focused on theme (1) ‘information transfer’ with its corresponding categories ‘information needs’ – depending on different treatment stages –, ‘source of information’ and ‘doctor-patient-communication’. The affected patients ranked individualized patient information and empathetic doctor-patient-communication high.

This was mostly in line with the professionals’ point of view. Verbal communication was seen as being the best way to communicate throughout treatment. The role of the internet as a source of information was seen diversely.

Conclusion

This qualitative study highlights the need for individualized patient information and reveals both met and unmet information needs by patients. Although evidence-based written information is highly necessary for orthognathic patients and their families alike, it cannot replace an empathetic way of direct verbal doctor-patient-communication. It seems crucial to give specific individualized information at different treatment stages, starting at a thoroughly interdisciplinary screening at the very beginning.
Infection susceptibility and vector competence of Rhodnius robustus Larrousse, 1927 and R. pictipes Stal, 1872 (Hemiptera, Reduviidae, Triatominae) for strains of Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) I, II and IV
Authors: de Abreu Ana Paula , Lucas da Silva Hevillyn Fernanda , Sarto Marcella Paula Mansano , Iunklaus Giullia Ferreira , Trovo João Vitor , de Souza Fernandes Nilma , Teston Ana Paula Margioto , Toledo Max Jean de Ornelas
Published: June 2022

Background

Rhodnius robustus and Rhodnius pictipes are vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease (CD), that are found in the Brazilian Amazon region. Susceptibility to infection and vector competence depend on the parasite-vector relationship. Our objective was to evaluate the interaction between T. cruzi and these two triatomine vectors in pure and mixed experimental infections of T. cruzi strains from the same or different geographic regions.

Methods

Fifth-instar nymphs of R. robustus and R. pictipes were fed on mice infected with four T. cruzi strains, namely genotypes TcIAM, TcIMG, TcIIPR, and TcIVAM, respectively, from the Brazilian states of Amazonas, Minas Gerais and Paraná. Over a period of 120 days, excreta were examined every 20 days to assess vector competence, and intestinal contents (IC) were examined every 30 days to determine susceptibility to infection.

Results

The highest positive rate in the fresh examination (%+FE, 30.0%), the highest number of parasitic forms (PF, n = 1969) and the highest metacyclogenesis rate (%MC, 53.8%) in the excreta were recorded for R. robustus/TcIVAM. Examination of the IC of R. pictipes revealed a higher number of PF in infections with TcIAM (22,680 PF) and TcIIPR (19,845 PF) alone or in association (17,145 PF), as well as a %+FE of 75.0% with TcII, in comparison with the other genotypes. The highest %MC (100%) was recorded for the mixed infections of TcIAM with TcIIPR or TcIVAM in the IC of R. pictipes.

Conclusions

Overall, both species were found to be susceptible to the T. cruzi strains studied. Rhodnius robustus showed vector competence for genotypes TcIVAM and TcIAM+TcIVAM and R. pictipes for TcIAM+TcIVAM and TcIAM+TcIIPR; there was elimination of infective forms as early as at 20 days. Our results suggest that both the genetics of the parasite and its geographic origin influence the susceptibility to infection and vector competence, alone or in association.

Graphical Abstract
Diagnostic validity of Autism Diagnostic Observation Schedule, second edition (K-ADOS-2) in the Korean population
Authors: Kim So Yoon , Oh Miae , Bong Guiyoung , Song Da-Yea , Yoon Nan-He , Kim Joo Hyun , Yoo Hee Jeong
Published: June 2022

Background

Although the Korean version of the Autism Diagnostic Observation Schedule-2 (K-ADOS‐2) is widely being used to diagnose autism spectrum disorder (ASD) in South Korea, no previous study has examined the validity and reliability of all modules of K-ADOS-2 across a wide age range, particularly older children, adolescents, and adults.

Method

Data from 2,158 participants were included (mean age = 79.7 months; 73.6% male): 1473 participants with ASD and 685 participants without ASD (Toddler Module, n = 289; Module 1, n = 642; Module 2 n = 574; Module 3 n = 411; Module 4, n = 242). Participants completed a battery of tests, including the K-ADOS or K-ADOS-2 and other existing diagnostic instruments. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, positive predictive value (PPV), negative predictive value (NPV), Cohen’s kappa (k), and agreement with existing diagnostic instruments were computed. Cronbach’s α values were also calculated.

Results

All developmental cells of the K-ADOS-2 showed sufficient ranges of sensitivity 85.4–100.0%; specificity, 80.4–96.8%; area under the ROC curve, .90-.97; PPV, 77.8–99.3%; NPV, 80.6–100.0%; and k values, .83–.92. The kappa agreements of developmental cells with existing diagnostic instruments ranged from .20 to .90. Cronbach’s α values ranged from .82 to .91 across all developmental cells.

Limitation

The best-estimate clinical diagnoses made in this study were not independent of the K-ADOS-2 scores. Some modules did not include balanced numbers of participants in terms of gender and diagnostic status.

Conclusion

The K-ADOS-2 is a valid and reliable instrument in diagnosing ASD in South Korea. Future studies exploring the effectiveness of the K-ADOS-2 in capturing restricted, repetitive behaviors and differentiating ASD from other developmental disabilities are needed.
An infantile case of hereditary folate malabsorption with sudden development of pulmonary hemorrhage: a case report
Authors: Sakurai Yukari , Toriumi Naohisa , Sarashina Takeo , Ishioka Toru , Nagata Marino , Kobayashi Hiroya , Azuma Hiroshi
Published: June 2022

Background

Hereditary folate malabsorption—a rare disorder caused by impairment of the folate transporter—can develop into severe folate deficiency manifesting as megaloblastic anemia and occasionally thrombocytopenia. Reportedly, megaloblastic anemia can manifest with hemorrhagic episodes, possibly due to ineffective platelet production and platelet dysfunction. However, life-threatening hemorrhage events in hereditary folate malabsorption have not been well investigated.

Case presentation

A 3-month-old Japanese boy was transferred to our hospital due to thrombocytopenia and severe megaloblastic anemia. During a thorough examination of hematopoietic abnormalities, the patient suddenly went into cardiac arrest due to pulmonary hemorrhage. Although intravenous folate supplementation was started soon after the identification of folate deficiency, the patient died of circulatory defect and multiple organ failure. The cause of pulmonary hemorrhage, such as respiratory infection, could not be confirmed. Genetic investigation revealed a mutation in the SLC46A1 gene to be the cause of the hereditary folate malabsorption.

Conclusion

We report an infantile case of hereditary folate malabsorption that progressed to lethal pulmonary hemorrhage before folate deficiency was identified. Clinicians should consider that megaloblastic anemia could lead to severe bleeding without warning, and that nutrient supplementation should be initiated as soon as possible.
The effect of performance-based financing interventions on out-of-pocket expenses intended to improve access to and utilization of maternal health services in sub-Saharan Africa: protocol for a systematic review and meta-analysis
Authors: Nkangu Miriam , Little Julian , Omonaiye Olumuyiwa , Yaya Sanni
Published: June 2022

Background

Out-of-pocket expenses have been reported as a major barrier to accessing antenatal care and skilled birth delivery in most of sub-Saharan Africa. Performance-based financing (PBF) is one of several strategies introduced in lower- and middle-income countries to strengthen a weak health system. This review aims to synthesize evidence on the effectiveness of PBF interventions implemented with the objective of reducing out-of-pocket expenses and improving access to and utilization of ANC and skilled birth delivery and family planning in sub-Saharan Africa. It will consider evidence across health sectors and identify gaps in the evidence.

Methods and analysis

This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline. The systematic review will apply a three-step strategy to search five databases (CINAHL, PubMed, Ovid Medline, EMBASE, Cochrane.) and grey literature with the help of a librarian. Two independent reviewers will conduct screening to determine eligibility and critical appraisal of selected studies using the risk of bias criteria developed by the Cochrane EPOC Group and the New Castle Ottawa Scale for observational studies. The certainty of evidence for the outcomes will be assessed using “Grades of Recommendation, Assessment, Development, and Evaluation” (GRADE) approach. This review will consider experimental and quasi-experimental study designs and observational studies. Studies published in English and French language(s) will be included. Studies published since the introduction of PBF in sub-Saharan Africa will be included. Data will be collected on each item that contributes to out-of-pocket expenses. This review will adopt the Multiple Dimensions of Access Framework to organize the findings.

Discussion

This systematic review will support evidence-informed data for the performance-based financing community and government by identifying, describing, and assessing the impact of performance-based financing interventions on out-of-pocket expenses in promoting access and utilization of ANC, skilled birth delivery, and family planning across health sectors.

Systematic review registration

This review has been registered with PROSPERO, Registration number CRD42020222893.
Uses of mathematical modeling to estimate the impact of mass drug administration of antibiotics on antimicrobial resistance within and between communities
Authors: Olesen Scott W.
Published: June 2022

Background

Antibiotics are a key part of modern healthcare, but their use has downsides, including selecting for antibiotic resistance, both in the individuals treated with antibiotics and in the community at large. When evaluating the benefits and costs of mass administration of azithromycin to reduce childhood mortality, effects of antibiotic use on antibiotic resistance are important but difficult to measure, especially when evaluating resistance that “spills over” from antibiotic-treated individuals to other members of their community. The aim of this scoping review was to identify how the existing literature on antibiotic resistance modeling could be better leveraged to understand the effect of mass drug administration (MDA) on antibiotic resistance.

Main text

Mathematical models of antibiotic use and resistance may be useful for estimating the expected effects of different MDA implementations on different populations, as well as aiding interpretation of existing data and guiding future experimental design. Here, strengths and limitations of models of antibiotic resistance are reviewed, and possible applications of those models in the context of mass drug administration with azithromycin are discussed.

Conclusions

Statistical models of antibiotic use and resistance may provide robust and relevant estimates of the possible effects of MDA on resistance. Mechanistic models of resistance, while able to more precisely estimate the effects of different implementations of MDA on resistance, may require more data from MDA trials to be accurately parameterized.

Graphical Abstract
Mass drug administration of antibacterials: weighing the evidence regarding benefits and risks
Authors: Rolfe Robert J. , Shaikh Hassaan , Tillekeratne L. Gayani
Published: June 2022

Background

Mass drug administration (MDA) is a strategy to improve health at the population level through widespread delivery of medicine in a community. We surveyed the literature to summarize the benefits and potential risks associated with MDA of antibacterials, focusing predominantly on azithromycin as it has the greatest evidence base.

Main body

High-quality evidence from randomized controlled trials (RCTs) indicate that MDA-azithromycin is effective in reducing the prevalence of infection due to yaws and trachoma. In addition, RCTs suggest that MDA-azithromycin reduces under-five mortality in certain low-resource settings that have high childhood mortality rates at baseline. This reduction in mortality appears to be sustained over time with twice-yearly MDA-azithromycin, with the greatest effect observed in children < 1 year of age. In addition, observational data suggest that infections such as skin and soft tissue infections, rheumatic heart disease, acute respiratory illness, diarrheal illness, and malaria may all be treated by azithromycin and thus incidentally impacted by MDA-azithromycin. However, the mechanism by which MDA-azithromycin reduces childhood mortality remains unclear. Verbal autopsies performed in MDA-azithromycin childhood mortality studies have produced conflicting data and are underpowered to answer this question. In addition to benefits, there are several important risks associated with MDA-azithromycin. Direct adverse effects potentially resulting from MDA-azithromycin include gastrointestinal side effects, idiopathic hypertrophic pyloric stenosis, cardiovascular side effects, and increase in chronic diseases such as asthma and obesity. Antibacterial resistance is also a risk associated with MDA-azithromycin and has been reported for both gram-positive and enteric organisms. Further, there is the risk for cross-resistance with other antibacterial agents, especially clindamycin.

Conclusions

Evidence shows that MDA-azithromycin programs may be beneficial for reducing trachoma, yaws, and mortality in children < 5 years of age in certain under-resourced settings. However, there are significant potential risks that need to be considered when deciding how, when, and where to implement these programs. Robust systems to monitor benefits as well as adverse effects and antibacterial resistance are warranted in communities where MDA-azithromycin programs are implemented.

Graphical Abstract
Are pigs overestimated as a source of zoonotic influenza viruses?
Authors: Hennig Christin , Graaf Annika , Petric Philipp P. , Graf Laura , Schwemmle Martin , Beer Martin , Harder Timm
Published: June 2022

Background

Swine influenza caused by influenza A viruses (IAV) directly affects respiratory health and indirectly impairs reproduction rates in pigs causing production losses. In Europe, and elsewhere, production systems have intensified featuring fewer holdings but, in turn, increased breeding herd and litter sizes. This seems to foster swine IAV (swIAV) infections with respect to the entrenchment within and spread between holdings. Disease management of swine influenza is difficult and relies on biosecurity and vaccination measures. Recently discovered and widely proliferating forms of self-sustaining modes of swIAV infections in large swine holdings challenge these preventive concepts by generating vaccine-escape mutants in rolling circles of infection.

Main body

The most recent human IAV pandemic of 2009 rooted at least partly in IAV of porcine origin highlighting the zoonotic potential of swIAV. Pigs constitute a mixing vessel of IAV from different species including avian and human hosts. However, other host species such as turkey and quail but also humans themselves may also act in this way; thus, pigs are not essentially required for the generation of IAV reassortants with a multispecies origin. Since 1918, all human pandemic influenza viruses except the H2N2 virus of 1958 have been transmitted in a reverse zoonotic mode from human into swine populations. Swine populations act as long-term reservoirs of these viruses. Human-derived IAV constitute a major driver of swIAV epidemiology in pigs. Swine-to-human IAV transmissions occurred rarely and mainly sporadically as compared to avian-to-human spill-over events of avian IAV. Yet, new swIAV variants that harbor zoonotic components continue to be detected. This increases the risk that such components might eventually reassort into viruses with pandemic potential.

Conclusions

Domestic pig populations should not be globally stigmatized as the only or most important reservoir of potentially zoonotic IAV. The likely emergence from swine of the most recent human IAV pandemic in 2009, however, emphasized the principal risks of swine populations in which IAV circulate unimpededly. Implementation of regular and close-meshed IAV surveillance of domestic swine populations to follow the dynamics of swIAV evolution is clearly demanded. Improved algorithms for directly inferring zoonotic potential from whole IAV genome sequences as well as improved vaccines are still being sought.
Characterization, distribution, and virulence of protistan entomopathogen, Mattesia dispora (Sporozoa, Gregarina) in the Indian meal moth, Plodia interpunctella (Lepidoptera: Pyralidae) populations in Turkey
Authors: Yaman Mustafa , Sağlam Tuğba , Ertürk Ömer
Published: June 2022

Background

Indian meal moth, Plodia interpunctella (Hübner) (Lepidoptera: Pyralidae) is the dominant pest on the stored products throughout the world. As an alternative to chemical insecticides, entomopathogens can be natural suppressors for pest populations. For this reason, the study of entomopathogens existing in the natural population of a pest contributes to the decision-making process of controlling that pest. In the present study, characterization, distribution, and virulence of protistan entomopathogen, the Turkish strain of Mattesia dispora in the Indian meal moth, Plodia interpunctella populations were presented.

Results

During the microscopic observations, a protistan entomopathogen was found in the populations of P. interpunctella in Turkey. It was identified as the Turkish strain of Mattesia dispora, a neogregarine pathogen. Typical fresh navicular oocysts of the pathogen were 13.28 ± 0.41 (13.1–14.41) μm in length and 7.72 ± 0.51 (6.6–8.54) μm in width (n = 50). Oocysts stained with Giemsa measured 12.32 ± 0.78 (10.88–13.24) μm in length and 7.01 ± 0.26 (6.5–7.43) μm in width. Polar plugs were recognizable clearly by light and electron microscopy, measuring 900 to 1100 nm. The oocyst wall was quite thick, measuring 600 to 800 nm. Each oocyst contained 8 sporozoites. 2.047 dead and 413 living larvae, 932 adults, and 40 pupae, collected from 14 different locations from 2019 to 2021 were examined for the presence of the protistan entomopathogen. In total, 225 of 3.432 P. interpunctella adult and larvae were found to be infected with this pathogen. Total infection occurred as 5.2 for M. dispora. Infection rates by M. dispora were 4.8% for dead larvae, 14.8% for living larvae, and 2.1% for adults. On the other hand, M. dispora infections reached 33% in some populations. M. dispora infections were observed in the seven (50%) of the examined populations. Furthermore, the Turkish strain of M. dispora had a high pathogenic effect against the second/third instar larvae of P. interpunctella. The average mortality rate was 98.33%.

Conclusions

Little is known about neogregarine infections as a natural suppressing factor in pest populations. The Turkish strain of M. dispora is very common and widespread in the populations of P. interpunctella. Furthermore, it has very high virulence on the P. interpunctella larvae. Such a widespread infection and very high virulence are desirable properties for a biological control agent. The results indicate that M. dispora can be an important natural suppressing protistan entomopathogen in P. interpunctella populations.
Effect of acute depression associated with COVID-19 infection on health-seeking behaviour: a psychiatrist's personal account and case report
Authors: Müller Monika , Broadhead Jeremy , Simpson Thomas , Abas Melanie A.
Published: June 2022

Background

Despite the abundant research on COVID-19-related mental health problems, little attention has been paid to acute depression occurring concurrently with the infection as a neuropsychiatric manifestation. This is important because depression is known to adversely affect help-seeking. Decreased help-seeking is likely to be aggravated by the isolation measures demanded as part of fighting the pandemic, given the disruption of social support networks.

Aims

To study the effects of acute depression associated with COVID-19 infection on help-seeking behaviour.

Method

We present a case report and personal account of a patient psychiatrist who developed a first onset of acute depression as part of COVID-19 infection.

Results

Despite being a mental health expert the patient lacked insight into his mood change and its negative effect on help-seeking behaviour, resulting in reliance on a family caregiver to raise the alarm.

Conclusions

For those experiencing this complex interaction between COVID-19 infection and the brain, social support will be needed to ensure timely presentation to the healthcare system. Greater attention to behavioural change as part of COVID-19 infection is needed to optimise treatment outcome.
The Smear: Vibrational Flesh and the Calculus of Black Queer Becoming in Barry Jenkins’s Moonlight
Authors: Harris Dionte
Published: June 2022

This essay examines the game played in the first act of Barry Jenkins’s 2016 film Moonlight. “Smear the queer” is a game most resembling tackle football. The author examines how the “rules” of the game manifest as a type of power, one whose function is to set the terms of relation. Smear the queer engenders a calculus of violence, as the game represents a mode of policing, and the film highlights the ways race, gender, and sexuality are marshaled to regulate queer Black people’s embodied expression. Focusing on those who touch protagonist Chiron’s life, the author considers smear the queer as it comes into play off the field, arguing that the smear—a framework for relation and a politic of touch—seeks to exploit queer vulnerability in order to make violence intimate and permanent in day-to-day interactions so that it no longer figures as spectacular. Such a tactic seeks to foreclose the otherwise world-making possibilities of being and becoming, living and creating “with.”
Relationship Between Baseline Rectal Tumor Length and Magnetic Resonance Tumor Regression Grade Response to Chemoradiotherapy: A Subanalysis of the TRIGGER Feasibility Study
Authors: Hodges Nicola , Battersby Nicholas , Rao Sheela , Brown Gina ,   the TRIGGER Study Group, Anandappa Gayathri , Cunningham David , Tait Diana , Tekkis Paris , Chong Irene , Aitken Katharine , Chau Ian , Rasheed Shahnawaz , Balyasnikova Svetlana , Moran Brendan , Falk Stephen , Sizer Bruce , Branagan Graham , O’Toole Lorcan , Adusumalli Madhavi , Nagtegaal Iris , Von Loga Katharina , Thrower Andrew , Jackson Andrew , Roach Huw , Hassan Hussein , Carss Michael , Bateman Andrew , Wills Mark , Martin Caroline , Evans Ceri , Robinson Emily , Zenasni Zohra , Frost Michelle , Thomas Karen , Di Fabio Francesco , Rawlani Rayesh , Cousins Hayley , Thomas Rachel , Jenkins Jessica , Strawson-Smith Thomas , Walther Axel , Spencer Timothy , Robinson Tim , Gower Elysia , Wong Newton , Short Sharon , Collins Jennifer , Driscoll Celine , Mabelin Louies , Bozas Georgios , Heeney Elaine , Hegab Mohammad , Mattocks Lehentha , West Nick , Quirke Phil , Lee Kil Yeon , Rodrigues Tania , Hiranyakai Art , Lynch Rodney , Gamage Bawantha
Published: June 2022

Background

It is widely believed that small rectal tumors are more likely to have a good response to neoadjuvant treatment, which may influence the selection of patients for a ‘watch and wait’ strategy.

Objective

The aim of this study was to investigate whether there is a relationship between baseline tumor length on magnetic resonance imaging (MRI) and response to chemoradiotherapy.

Method

The 96 patients with locally advanced rectal cancer randomised (2:1–intervention:control) in the TRIGGER feasibility study where eligible. Baseline tumor length was defined as the maximal cranio-caudal length on baseline MRI (mm) and was recorded prospectively at study registration. Magnetic resonance tumor regression grade (mrTRG) assessment was performed on the post-chemoradiotherapy (CRT) MRI 4–6 weeks (no later than 10 weeks) post completion of CRT. This was routinely reported for patients in the intervention (mrTRG-directed management) arm and reported for the purposes of this study by the central radiologist in the control arm patients. Those with an mrTRG I/II response were defined as ‘good responders’ and those with an mrTRG III–V response were defined as ‘poor responders’.

Results

Overall, 94 patients had a post-CRT MRI performed and were included. Forty-three (46%) patients had a good response (mrTRG I/II) and 51 (54%) patients had a poor response (mrTRG III/IV). The median tumor length of good responders was 43 mm versus 50 mm (p < 0.001), with considerable overlap in tumor lengths between groups.

Conclusion

Baseline tumor length on MRI is not a clinically useful biomarker to predict mrTRG tumor response to CRT and therefore patient suitability for a deferral of surgery trial.
Occupational Matching and Cities
Authors: Papageorgiou Theodore
Published: June 2022

In this paper, I document that workers in larger cities have significantly more occupational options than workers in smaller ones. They are able to form better occupational matches and earn higher wages. I also note differences in occupation reallocation patterns across cities. I develop a dynamic model of occupation choice that microfounds agglomeration economies and captures the empirical patterns. The calibration of the model suggests that better occupational match quality accounts for approximately 35 percent of the observed wage premium and one-third of the greater inequality in larger cities. (JEL J24, J31, J41, J63, R23)
Dynamic Capital Tax Competition under the Source Principle
Authors: Gross Till , Klein Paul , Makris Miltiadis
Published: June 2022

We explore the short- and long-run implications of tax competition between jurisdictions, where governments can only tax capital at source. We do this in the context of a neoclassical growth model under commitment and capital mobility. We provide a new theoretical perspective on the dynamic capital tax externalities that emerge in this model. Numerically, we show that the net capital tax externality is positive in the short run but converges to zero in the long run. We also find that noncooperative source-based capital taxes are initially positive and slowly decline toward zero. (JEL D62, H25, H71, H73, H87)
Dynamics of Markups, Concentration, and Product Span
Authors: Helpman Elhanan , Niswonger Benjamin
Published: June 2022

We develop a model with a finite number of multiproduct firms together with a continuum of single-product firms and study the dynamics that arise from product innovation. Consistent with the available evidence, the model predicts rising markups and concentration and a declining labor share. Our dynamics predict the possibility of an inverted-U relationship between labor productivity and product span, for which we provide suggestive evidence. In the optimal allocation, product span and labor productivity are strictly positively related. We also characterize optimal policies for these types of sectors. (JEL D21, D33, D43, J24, O31)
APLICAÇÃO DE REDES NEURAIS RECORRENTES NA PREVISÃO DE SÉRIES TEMPORAIS: UM ESTUDO DE PREÇOS DE AÇÕES DA BOLSA DE VALORES
Authors: Furtuoso Gabriel Dilly Vieira , Santos Marcos Dos , Quintal Renato Santiago
Published: June 2022

A predição de eventos futuros de modo assertivo tem sido o objeto de análise de diversos pesquisadores, sobretudo na área financeira. Nesse contexto, são inúmeras as possibilidades do emprego desse ferramental no processo decisório de gestores e analistas de investimentos. O objetivo deste artigo é propor um modelo de rede neural recorrente com base no estudo de séries temporais, orientado à predição e estimação do preço de ações da Bolsa de Valores brasileira. Nesse contexto, o presente estudo viabiliza a caracterização de direções de tendências financeiras e a predição dos preços por meio do treinamento da rede neural, empregando dados reais da Bolsa de Valores brasileira a partir do ano de 2010. No que concerne à metodologia, a presente pesquisa pode ser classificada como aplicada, explicativa, quanto a seus objetivos, e quantitativa quanto à forma de abordagem. Os resultados obtidos neste estudo revelam a capacidade de aprendizado de problemas complexos e, consequentemente, a possibilidade de aplicação em outras áreas.
Total or Near-total Thyroidectomy in treatment of Thyroid Cancer
Authors: Li Gang , Wu Lihong
Published: June 2022

Objectives: To observe the clinical efficacy on total or near-total thyroidectomy in the treatment of thyroid cancer.

Methods: Ninety-four patients with thyroid cancer treated in Meiris Branch of the First Affiliated Hospital of Qiqihar Medical College from June 2018 to June 2020 were selected as subjects. According to different surgical methods, they were divided into observation group and control group, with 47 patients in each group. The control group was treated with total thyroidectomy, while the observation group received near-total thyroidectomy. The two groups were both followed up for one year. The therapeutic effect, surgery-related indexes (surgical duration, intraoperative bleeding volume, postoperative analgesia time and postoperative 24-h VAS score), the incidence of complications three months after surgery, and the serum levels of relevant indexes [parathyroid hormone (PTH), calcium ion (Ca2+) and signal transducer and activator of transcription 3 (STAT3)] before and 14 d after surgery were compared between the two groups. The difference in quality of life [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] between the two groups one year after surgery was observed.

Results: During the one year follow-up, there was no death in both groups. The total efficacy of the observation group was higher than that of the control group (0.05). The surgical duration, postoperative analgesia time and postoperative 24-h VAS score of the observation group were higher than those of the control group (p<0.05). However, no statistically significant difference was found in intraoperative bleeding volume between the two groups (p> 0.05). Three months after surgery, the total incidence of postoperative complications in the observation group was higher than that in the control group (p< 0.05). Fourteen days after surgery, the levels of PTH, Ca2+ and STAT3 in the two groups were lower than those before surgery, and the levels in the observation group were lower than those in the control group (p< 0.05). One year after surgery, cognitive, emotional, role, social and physical scores in the observation group were all lower than those in the control group, without statistically significant differences (p> 0.05).

Conclusion: Total thyroidectomy is effective in the treatment of thyroid cancer, but has many postoperative complications. Clinicians need to choose the appropriate surgical method according to the actual condition of patients.

doi: https://doi.org/10.12669/pjms.38.6.5765

How to cite this:Li G, Wu L. Total or Near-total Thyroidectomy in treatment of Thyroid Cancer. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5765

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Igbo Understanding of the Human Being: A Philosophical Approach
Authors: Ugwu Anayochukwu Kingsley
Published: June 2022

The conception of the human being remains a philosophical controversial discourse among scholars to include Igbo extraction. The discourse has taken many dimensions describable as social, ontological, theologico-anthropological and even normative. Questions now follow: is the human being entirely a spiritual or physical being, or socio-political being, or even anhropological being? What differentiates his existence from the existence of other realities – be it physical or spiritual? It is in addressing these questions that this paper presents a socio-ontological conception of the human being held by Umuoka People which holds that the human being is Maadjvuru which interprets ‘Sustained-Survived/Surviving-Spirit.’ Doing this, the paper shall employ hermeneutical and phenomenological approaches to critically evaluate and undertake the discourse. The paper is expected to present more insights into the discourse by showing that the human being is a manifestation of the spirit, a concretized-spirit with complex physical and spiritual components whose existential experiences underpin his complex nature.
Coherent microwave emission as an indicator of non-thermal energy release at a coronal X-ray point
Authors: Altyntsev Alexander , Meshalkina Nataliya , Myshyakov Ivan
Published: June 2022

A response has been found in a narrow band 5–7 GHz of microwave emission to the appearance of a coronal X-ray point. The emission source is a short X-ray loop located in the tail part of an active region and occurring when magnetic fields are reconnected near the footpoints of high and low loops rooted in nearby magnetic pores of the opposite polarity. The power of energy release is low and no response of the hot plasma component was observed in hard X-rays. Analysis of images in soft X-ray and extreme UV radiation shows that microwave emission has a coherent nature and is generated at a frequency of about twice the plasma frequency by electrons with energies above several tens of keV. The result indicates a high diagnostic potential of microwave observations to detect acceleration processes in weak transitory events and can be useful for observation planning with new generation radioheliographs currently under development.