bluuebunny/crossref_metadata_2025 huggingface dataset:
Practical and Multidisciplinary Review on Wilson Disease: The Portuguese Perspective
Authors: Calinas Filipe , Cardoso Hélder , Carvalhana Sofia , Ferreira José , Gonçalves Cristina , Magalhães Marina , Pessegueiro Miranda Helena , Presa José , Rolanda Carla , Santos Arsénio , Santos Rui M.
Published: November 2024

Wilson disease (WD) is a genetic disorder of copper metabolism caused by mutations in the ATP7B gene resulting in toxic copper accumulation in several organs. WD can manifest as liver disease, a progressive neurological disorder, a psychiatric illness, or a combination of these. Other clinical manifestations can also occur. Diagnosis is challenging and typically requires a range of biochemical tests, imaging, genetic testing for ATP7B, and/or liver biopsy. WD is treatable with chelating agents, such as d-penicillamine and trientine, and/or zinc salts alongside with dietary copper restriction. Liver transplantation may be indicated in WD patients with severe hepatic disease, and cautiously considered in patients with neurological WD. Treatment success highly depends on patient adherence and treatment persistence. Therefore, effective interventions for improving patient adherence and close monitoring are key for preventing WD progression. In Portugal, there are no reference centers for WD, and patients are dispersed across numerous medical specialists. This review aimed to summarize the most recent and relevant information for the diagnosis, treatment, and monitoring of WD in Portugal, as well as possible interventions for stimulating adherence to treatment.
Utility of First-Morning-Voided Urinary Total Luteinizing Hormone in Detecting the Onset of Central Puberty
Authors: Demir And , Hero Matti , Main Katharina M. , Juul Anders
Published: November 2024

Introduction: Early morning basal serum luteinizing hormone (S-LH) ≥0.3 IU/L is a specific marker for the onset of central puberty. In this study, we aimed to investigate the sensitivity and specificity of the first-morning-voided (FMV) total urinary LH (U-LH) to replace this marker. Methods: We re-analyzed our previously published data set of 297 children (145 boys and 152 girls, aged 5–15 years, across Tanner stages 1 through 5) using receiver operating characteristic (ROC) analysis and determined cutoff values for FMV total U-LH in predicting early morning S-LH concentration at or above 0.3 IU/L. We also determined S-LH and serum follicle-stimulating hormone (S-FSH) concentrations in girls at different stages of sexual maturation. Results: ROC analysis showed that FMV total U-LH levels of 0.60 and 0.63 IU/L in girls and boys, respectively, predicted early morning S-LH levels of 0.3 IU/L or higher with 97.4% sensitivity and 90.6% specificity. Higher cutoff levels for U-LH (0.78 IU/L for boys and 0.79 IU/L for girls) yielded 94.7% specificity at the expense of a relatively lower level of sensitivity (94.1%). The areas under the curve were 0.98 in boys and 0.99 in girls, respectively. Additionally, the increase in FMV total U-LH (or S-LH) levels identified the activation of central pubertal development at the mean age of 10.3 (10.3) in boys and 10.5 (10.6) in girls. The S-FSH concentrations of the six biochemically prepubertal girls with thelarche, ranging between 2.3 and 2.7 IU/L, were significantly higher than those measured in biochemically and clinically prepubertal girls of the same 10–12-year-old age group and significantly lower than those measured in both biochemically and clinically pubertal girls (p = 0.039 and p = 0.018, respectively). Conclusions: A FMV total U-LH concentration of 0.6 IU/L or above reliably reflects pubertal morning S-LH levels and is effective in detecting the onset of central puberty, which occurs at similar ages in both sexes. Concurrent S-FSH or noninvasive FMV U-FSH determinations may be useful in the differential diagnosis of isolated thelarche.
Cerebral Cortical Vasodilation via Nicotinic Receptors by Heated Tobacco Product Aerosol Extract in Rats
Authors: Uchida Sae , Moriya Jura , Morihara Daichi , Shimura Mayura , Kagitani Fusako
Published: November 2024

Introduction: Smoking increases the risk of lung cancer due to a number of components of smoke. The use of novel heated tobacco products (HTPs), alternative to conventional combustion cigarettes, has increased in recent years. However, the in vivo biological effects of HTPs are poorly understood. This study aimed to clarify the acute effects of injecting aerosol extract prepared from an HTP on regional cerebral blood flow (rCBF) in rat cortex by comparing them to the effects of injecting smoke extract prepared from conventional combustible cigarettes. Methods: In urethane anesthetized rats, rCBF was measured using laser speckle contrast imaging simultaneously with arterial pressure. Results: Both cigarette smoke extract and HTP aerosol extract, at a dose equivalent to 30 μg nicotine/kg, injected intravenously, increased cortical rCBF without changing arterial pressure. The magnitude and time course of the increased rCBF response to both extracts were similar throughout the cortical area, and the rCBF increases were all abolished by dihydro-β-erythroidine, an α4β2-preferring nicotinic acetylcholine receptor (nAChR) antagonist. Conclusion: In conclusion, our study demonstrated that the effect of injecting aerosol extract prepared from an HTP, an acute increase in cortical rCBF, is mediated via activation of α4β2-like neuronal nAChRs in the brain.
The Protective Effect of Esculentoside A on MPL/lpr Mice by Upregulating the Expression of CD19+IL-35+Breg Cells and Interleukin-35
Authors: Wang Xing , Tang Jieyin , Zhang Xianggui , Zeng Huilin
Published: November 2024

Introduction: Esculentoside A (EsA) is one of the main components of the traditional Chinese medicine Phytolacca esculenta. The possible mechanism of action of EsA in the treatment of lupus nephritis (LN) was explored by observing the effects of EsA on CD19+ IL-35+regulatory B (IL-35+Breg) cells. Methods: Twenty-four MRL/lpr mice were randomly divided into control, EsA, and EsA+IL-12p35 antibody groups. Mice were administered the respective treatments intraperitoneally once a day for 4 weeks. The urine protein/creatinine ratio (UPCR) and blood creatinine (Cr) and IL-35, IL-10, and IL-17 expression levels were measured. Body and spleen weight were measured to calculate the splenic index (SI). Flow cytometry was performed to determine the proportion of CD19+ IL-35+ Breg cells in the spleen. Hematoxylin-eosin and PASM-Masson staining of renal tissues were performed, and the “Austin” acute index (AI) system for LN was determined. Results: The most severe conditions were seen in mice in the control group, with the highest UPCR, Cr, and IL-17 levels and SI and AI scores; the most severe renal histopathology, and the lowest proportion of CD19+ IL-35+ Breg cells and IL-35 and IL-10 levels. This was followed by the EsA+IL-12p35 antibody group. The EsA group had the lowest UPCR, Cr, and IL-17 levels and SI and AI scores; the mildest renal lesions; and the highest proportion CD19+ IL-35+ Breg cells and IL-35 and IL-10 levels. Conclusion: EsA delayed the progression of LN by promoting the proliferation of CD19+ IL-35+ Breg cells, upregulating the expression of IL-35, and decreasing the secretion of IL-17.
Bilateral Pterygium in a Paediatric Cancer Patient Taking Vemurafenib: A Case Report
Authors: Choi David , Meyer Jay J.
Published: November 2024

Introduction: Anticancer drugs with reactive oxygen species-inducing mechanisms, such as vemurafenib, have been shown to be effective against various types of cancer. However, the adverse effects of increased oxidative stress have the potential to damage not only cancer cells, but also normal cells, potentially leading to ocular diseases such as pterygium and cataract. Case Presentations: A 9-year-old patient presented with bilateral nasal pterygia and early bilateral cortical cataracts, which are uncommon for his age group. The patient has a background of v-raf murine sarcoma viral oncogene homologue B1 (BRAF) V600E-positive pilocytic astrocytoma with anaplastic features, diagnosed at age 2.5 years old. Vemurafenib was commenced at the time of diagnosis. Conclusion: We suspect that these ophthalmic findings are associated with his prolonged treatment with vemurafenib which may be of pathophysiological significance.
África “pré-colonial” e “colonial”: choques religiosos e suas influências nos trajes desses períodos
Authors:   Universidade de São Paulo. Escola de Comunicações e Artes, Viana Fausto
Published: November 2024

O trabalho é um ensaio expandido e, até onde se sabe, inédito em língua portuguesa ao acessar um tema bastante raro que elucida como o modo de vestir e a filosofia do islamismo - e suas regras, por vezes rígidas - alteraram o vestir no continente africano, notadamente nas regiões sob sua influência.
“Pipocando na hora do Fervo”: a matripotência no Breaking
Authors: Oliveira Louise Lucena de , Paixão Maria de Lurdes Barros da
Published: November 2024

Women in Breaking occupy a place of constant struggle to sublimate the erasure, invisibility and silencing of their history in this culture. In light of this, the article aims to reflect on black and Afro-Brazilian women in the socio-historical and cultural construction of Brazilian Breaking, as a reflexive-critical and Afro-referenced exercise, to guide to the south the paths taken by these women through the intersections between social, political and cultural issues related to race, gender and sexuality, based on an autobiographical account and analysis of an interview conducted with the Bsbgirls crew, in 2012, by UnBTV. Through the work it is possible to see that even with changes in the scene there are still multiple issues to be problematized and reflected upon.
Ensino remoto emergencial e saúde mental: desafios enfrentados por docentes universitários durante a Pandemia de Covid-19
Authors: Poli Wellyngton Ribamar Silva , Ribeiro Lucineia Lopes Bahia
Published: November 2024

This article aimed to investigate the impacts of emergency remote teaching on the mental health of university teachers in the context of the Covid-19 pandemic. An exploratory research was carried out through individual interviews guided by a script. Based on Bardin's content analysis, we sought to investigate the impacts of emergency remote teaching on mental health related to teaching practice, work and social context. In the discussions, we found that the following impacts were generated: the feeling of not being able to teach, difficulties in technological adaptation and little interaction with students, work overload, social isolation. And as consequences of these impacts, symptoms such as insecurity, fear, abandonment, lack of passion for work, demotivation, fear of the unknown, feeling of isolation, frustration and anguish, stress, feeling of anger, panic attack, depression, contamination of leisure time through the loss of the distinction between working hours and leisure time, decrease in physical activity, increase in alcohol consumption and also increase in family conflicts. The findings are in line with other studies and contribute to the discussion of the importance of considering psychosocial impacts in the processes of implementing new forms of teaching.
Integralidade na formação de Terapeutas Ocupacionais: análise das percepções e estrutura curricular da Graduação
Authors: Lucena Thaís Carolyne Nink , Pereira Amanda Polin
Published: November 2024

Introduction: Integrative and Complementary Health Practices (PICS) in the area of ​​Occupational Therapy (OT) require training and discussion in the graduation process to guarantee access and care within the integral reasoning of the body, mind, emotions and connections. Objectives: To verify the training, perceptions and experiences with PICS of OT undergraduates at the Faculty of Medicine of Ribeirão Preto at the University of São Paulo. Methods: Cross-sectional, exploratory, descriptive and quantitative study using an online questionnaire developed in research with undergraduates in the last semester and analysis of the curricular structure and teaching plans. Results and discussion: Of the total of 17 undergraduates, 12 reported knowledge about PICS (100%), 92% used them for personal purposes, and 17% stated doubts about their effectiveness and uncertainty about their credibility in the Brazilian Unified Health System (SUS) as a therapeutic resource in the profession. There was minimal training offered on PICS, of the 69 subjects in the undergraduate course, 3 dealt with the topic in a theoretical and experimental way, with a low workload and insufficient content for logic and professional use. Final considerations: There is a need for curricular changes to incorporate these practices as a therapeutic resource within the profession in order to guarantee access and quality care to the population.
Tutoria na Pandemia: os desafios de sempre, os novos e as lições permanentes
Authors: Amaral Fernando Sampaio do , Ueno Helene Mariko
Published: November 2024

University life is full of challenges that add up and the pandemic has shaken social and educational systems, reaffirming existing vulnerabilities and creating new ones. This work, developed on the Mentoring Program of the School of Arts, Sciences and Humanities of the University of São Paulo, set out to think about these challenges, ways to improve tutoring and learning in this context. Among the challenges, we find: lack of institutional support; tutors’ response capabilities; availability of tutors; and adherence to program activities. However, there are many potentialities that extend to both professional and academic as well as personal spheres. So, suggestions for the program were listed, including a calendar of activities, participation in the organization of events and involvement in scientific activities. Permanent lessons include: 1. the virus was not the protagonist in deaths during the pandemic; 2. our risk society demands that we be prepared for anything and everything; 3. human values help us face adversity.
Trade Elasticities in General Equilibrium: Demand, Supply, and Aggregation
Authors: Farrokhi Farid , Soderbery Anson
Published: November 2024

We develop a general equilibrium model of international trade that incorporates imperfect factor mobility, product entry, and external returns to scale into a unified framework. The effects from these microeconomic channels can be summarized by two composite elasticities that govern supply and aggregation. We structurally derive export supply and import demand curves, develop a heteroskedastic estimator, and estimate supply, aggregation, and demand elasticities across international product markets. Employing our estimated model, we evaluate the impact of recent US protectionist policies and highlight the importance of our estimates and general equilibrium effects for tariff passthrough rates and cross-industry employment reallocations.
Machine Learning Can Predict Shooting Victimization Well Enough to Help Prevent It
Authors: Heller Sara B. , Jakubowski Benjamin , Jelveh Zubin , Kapustin Max
Published: November 2024

Using Chicago police data, we train a machine learning model to predict the risk of being shot in the next 18 months. Out-of-sample accuracy is strikingly high. A central concern with using police data is “baking in” bias, or overestimating risk for groups likelier to interact with police conditional on behavior. Our predictions, however, accurately recover risk across demographic groups. Legal, ethical, and practical barriers should prevent using victimization predictions to target law enforcement. But using them to target social services could increase both the potential for interventions to reduce shootings and the available statistical power to detect those reductions.
Underlying Inflation and Asymmetric Risks
Authors: Le Bihan Hervé , Leiva-León Danilo , Pacce Matías
Published: November 2024

We propose a new measure of underlying inflation that informs, in real time, about asymmetric risks on the outlook of inflationary pressures. The asymmetries are generated through nonlinearities induced by economic activity. The new indicator is based on a multivariate regime-switching framework jointly estimated on disaggregated sub-components of the euro area HICP and has several additional advantages. First, it is able to swiftly infer abrupt changes in underlying inflation. Second, it helps to timely track turning points in underlying inflation. Third, the proposed indicator also has a satisfactory performance with respect to various criteria relevant for inflation monitoring.
The Long-Run Effects of Individual Debt Relief
Authors: Bruze Gustaf , Hilsløv Alexander Kjær , Maibom Jonas
Published: November 2024

Individuals with extensive debt may be granted debt relief in court. We provide a comprehensive evaluation of the Danish debt relief program with data from court records linked to nationwide register data. Using event-study methods and quasi-random assignment of applicants to court trustees with varying admission rates, we show that debt relief leads to a large increase in earned income, employment, assets, real estate, secured debt, home ownership, and wealth that persists for more than 25 years after a court ruling. The net transition of workers into employment accounts for two thirds of the increase in earned income.
Time Varying Extremes
Authors: Müller Ulrich K. , Watson Mark W.
Published: November 2024

Standard extreme value theory implies that the distribution of the largest observations of a large cross section is well approximated by a parametric model, governed by a location, scale and shape parameter. The extremes of a panel of independent cross sections are all governed by the same parameters as long as the underlying distribution as well as the size of the cross sections are time invariant. We derive inference about these parameters, and tests of the null hypothesis of time invariance, under asymptotics that do not require the number of extremes or the number of time periods to increase. We further apply Hamiltonian Monte Carlo techniques to estimate the path of time-varying parameters. We illustrate the approach in four examples of U.S. data: damages from weather-related disasters, financial returns, city sizes and firm sizes.
Revisiting the taxonomy of Pseudotiphia villosa (Fabricius, 1793) and notes on another Pseudotiphia Ashmead, 1903 species (Hymenoptera: Tiphiidae: Tiphiinae)
Authors: BARTALUCCI M. BONI
Published: November 2024

The splitting between Pseudotiphia villosa (Fabricius, 1793) and Pseudotiphia olcesei (Tournier, 1889) is examined with the resulting restoration of the latter as a good species. The synonymy of Tiphia beckeri Tournier, 1889 with Tiphia villosa is proposed together with the new combination of the name Tiphia arenicola Kohl, 1889 under Pseudotiphia and its synonymy with Pseudotiphia caspica Boni Bartalucci, 2010.
Applying Fractal Theory: Solving the Geometric Challenge of Price Change and Scaling in Economics
Authors: Abimbola Latifat , Adegoke Taiwo , Oladoja Oladapo
Published: November 2024

Background: Price changes in economics present significant geometric challenges due to sharp discontinuities, which cannot be efficiently described by continuous processes like Brownian motion. Traditional models often rely on linear assumptions, yet financial data frequently exhibit irregular, complex patterns. Fractal theory, a mathematical framework, offers a more accurate way to describe these fluctuations by revealing the underlying self-similar structures in price changes and scaling phenomena. This study explores the use of fractal geometry to gain deeper insights into market behavior. Objective: The objective is to demonstrate that an alternative model, constructed based on geometric scaling assumptions, offers a more accurate description of price changes in competitive markets. Method: The study combined the scaling principle from fractal geometry with a stable Levy model to formulate an integrated model. The logarithmic transformation of the model was applied over successive price changes to observe the behavior of market prices. Result: The scaling principle asserts that no specific time interval (such as a day or a week) holds inherent significance in competitive markets. Instead, these time features are compensated or arbitrated away, supporting the idea that market behavior is self-similar across different time scales. Conclusion: The scaling principle provides a more reliable framework for modeling price changes and is recommended for consideration in economic analyses.
Breeding of new kiwifruit (Actinidia chinensis) cultivars with yellow (golden) fleshed and superior characteristics
Authors: Asadi Mojdeh , Ghasemnezhad Mahmood , Bakhshipour Adel , Olfati Jamalali , Atak Arif
Published: November 2024

The most widely cultivated species globally is Actinidia deliciosa cv. ‘Hayward’. However, in recent years, consumers have shown greater demand for new varieties with novel flesh colour, flavour and appearance in international markets. To meet these expectations, one breeding study was started in 2016 at the University of Guilan in Iran to develop new kiwifruit cultivars with superior characteristics. In this breeding program, 201 female and 534 male hybrid genotypes were obtained from combinations of six different parents using the controlled cross-breeding technique. The evaluations were carried out over three consecutive stages. In the first stage, 201 female hybrid genotypes and control (‘Golden’) were evaluated based on 25 phenological and pomological traits. In the second stage, hybrids passed the desired threshold values in 7 key attributes were selected. Sensory testing in the next stage evaluated these selected hybrid genotypes more. As a result of the first stage, 30 hybrid genotypes with fruit weight (90 ≥ g) were selected. Then, in the second stage, 21 hybrids that showed acceptable dry matter, hue angle, flesh firmness, soluble solid content, acidity, and ascorbic acid were selected. Finally, 13 hybrid genotypes received high scores in sensory testing, and just two hybrid genotypes represented a 100% of novelty with positive texture. These genotypes were selected as potential cultivar candidates. In future studies, fruit yield, disease/pest resistance, and post-harvest performance trials of the 13 selected candidates will be evaluated at different sites. Thus, the ones that give the best results will be introduced to kiwifruit growers.
Patterns and factors associated with electrolyte abnormalities among patients with heart failure in Uganda
Authors: Abdi Awil Abdulkadir , Louis Nyende , Hirsi Abshir M. , Nur Ibrahim Ahmed , Mohamud Muktar Hassan , Ali Wardat Rashid , Imtiaz Naqeeb Kara
Published: November 2024

Background

Electrolyte abnormalities (EAs) worsen the clinical course of patients with heart failure (HF). The patterns of EAs vary among patients with HF. This study investigated patterns and factors associated with EAs among patients with HF admitted to Hoima Regional Referral Hospital (HRRH) in western Uganda.

Methods

This hospital-based cross-sectional study used quantitative data of 384 HF patients admitted at HRRH between 21st February and 15th May 2023. Data on sociodemographic, lifestyle, and medical characteristics were collected and presented as descriptive statistics. EAs were considered electrolyte values below or above the reference normal ranges. Bivariate and multiple logistic regression analyses were conducted to establish associations. An association with a p < 0.05 is considered statistically significant.

Results

Of 384 HF patients, 342 (89.1%) had EAs. Hypocalcemia was the most common EA, 165 (43.0%). Among the patients, 69 (18.0%) were on diuretics, 185 (48.2%) were on angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), and 105 (27.3%) were on calcium channel blockers (CCBs). Additionally, 264 (68.8%) had a history of hypertension, and 20 (5.2%) demonstrated good drug adherence. Patients with good drug adherence had lower odds of EAs (Adjusted Prevalence Odds Ratio [Adjusted POR] = 0.2, 95% CI: 0.1–0.7, p = 0.009). Those on diuretics had higher odds of EAs compared to those on ACEIs/ARBs and CCBs, with an Adjusted POR of 5.7 (95% CI: 1.3–15.0, p = 0.019). A history of hypertension also increased the odds of EAs (Adjusted POR = 4.0, 95% CI: 1.9–8.4, p < 0.001).

Conclusions

The prevalence of EAs in patients with HF at HRRH was high, with hypocalcemia being the most common. Patients with good drug adherence had lower odds of EAs. On the other hand, diuretic use and a history of hypertension were associated with increased odds of EAs.
Motivations for enrollment in a COVID-19 ring-based post-exposure prophylaxis trial: qualitative examination of participant experiences
Authors: Brisson Julien , Balasa Rebecca , Bowra Andrea , Hill David C. , Doshi Aarti S. , Tan Darrell H. S. , Perez-Brumer Amaya
Published: November 2024

Background

Ring-based studies are a novel research design commonly used for research involving infectious diseases: contacts of newly infected individuals form a ring that is targeted for interventions (e.g., vaccine, post-exposure prophylaxis). Given the novelty of the research design, it is critical to obtain feedback from participants on their experiences with ring-based studies to help with the development of future trials.

Methods

In 2021, we conducted 26 semi-structured interviews with adult participants of a COVID-19 ring-based post-exposure prophylaxis trial based in Canada. We applied a purposive sampling approach and electronically recruited participants who tested positive for COVID-19 (Index Cases) and either agreed or declined for the study team to contact their potentially exposed contacts. We also included individuals who participated in the trial after being potentially exposed to an Index Case (known as Ring Members), and those who declined to participate after potential exposure. The methodological design of semi-structured interviews allowed participants to share their opinions and experiences in the trial (e.g., elements they enjoyed and disliked regarding their participation in the study).

Results

The majority of participants in our study were women (62%) and the average age was 37.3 years (SD = 13.2). Overall, participants reported being highly satisfied with partaking in the ring-based trial. Notably, no substantial complaints were voiced about the trial’s design involving contact after exposure. The most common reason of satisfaction was the knowledge of potentially helping others by advancing knowledge for a greater cause (e.g., development of potential treatment to prevent SARS-CoV-2 infection). Other reasons were curiosity about participating in a trial, and an activity to fill free time during the pandemic. A central element of dislike was confusion about instructions with the trial (e.g., independent at home SARS-CoV-2 testing). Additionally, maintaining confidentiality was a crucial concern for participants, who sought assurance that their data would not be shared beyond the scope of the study.

Conclusions

Our results have the potential to inform future research, including clinical trials such as ring-based studies, by incorporating insights from participants’ experiences into the development of study protocols. Despite some protocol-related challenges, participants expressed high satisfaction, driven by the desire to advance science and potentially aid others.
Comprehensive evaluation of the antibacterial and antibiofilm activities of NiTi orthodontic wires coated with silver nanoparticles and nanocomposites: an in vitro study
Authors: Abdallah Omnia M. , Sedky Youssef , Shebl Heba R.
Published: November 2024

Background

Fixed orthodontic appliances act as a niche for microbial growth and colonization. Coating orthodontic wires with antimicrobial silver nanoparticles (AgNPs) and nanocomposite was adopted in this study to augment the biological activity of these wires by increasing their antibacterial and antibiofilm properties and inhibiting bacterial infections that cause white spot lesions and lead to periodontal disease.

Methods

Three concentrations of biologically synthesized AgNPs were used for coating NiTi wires. The shape, size, and charge of the AgNPs were determined. Six groups of 0.016 × 0.022-inch NiTi orthodontic wires, each with six wires, were used; and coated with AgNPs and nanocomposites. The antimicrobial and antibiofilm activities of these coated wires were tested against normal flora and multidrug-resistant bacteria (Gram-positive and Gram-negative bacterial isolates). The surface topography, roughness, elemental percentile, and ion release were characterized.

Results

AgNPs and nanocomposite coated NiTi wires showed significant antimicrobial and antibiofilm activities. The chitosan-silver nanocomposite (CS-Ag) coated wires had the greatest bacterial growth inhibition against both Gram-positive and Gram-negative bacteria. The surface roughness of the coated wires was significantly reduced, impacting the surface topography and with recorded low Ni and Ag ion release rates.

Conclusions

NiTi orthodontic wires coated with AgNPs, and nanocomposites have shown increased antimicrobial and antibiofilm activities, with decreased surface roughness, friction resistance and limited- metal ion release.
Protocol for leading health services innovation: a hybrid type 2 mixed method implementation trial for developing and assessing a codesigned graduate certificate program in health innovation
Authors: Kosiol Jennifer , Avery Mark , Silvester Tracey , Smyth Michaela , Sanger Georgina , Purdy Jonathan , Alford Stewart , Byrnes Joshua , Bialocerkowski Andrea
Published: November 2024

Background

A significant issue with innovative problem-solving in healthcare is an existing deficiency in continuing education for many healthcare professionals, which hinders the successful implementation of inventive solutions and progress in the field. Educators play a crucial role in guiding students to cultivate the knowledge and skills necessary to confront these challenges, including problem solving, collaboration, and the use of rapidly advancing technologies. It is vital to design educational programs that empower and motivate students to develop the proficiency and knowledge they need to be effective problem solvers, collaborators, and cultivators of innovative solutions. This project aims to assess the implementation and effectiveness of a codesigned postgraduate university program for a multidisciplinary health workforce.

Methods

The Leading Health Services Innovation Project is a hybrid type 2 mixed method implementation trial of a codesigned Graduate Certificate in Health Services Innovation. In collaboration with a large tertiary and quaternary health service, we developed a codesign process to guide the project, with time quarantined to create space for two-way learning between health sector partners and healthcare academics. Qualitative interviews and quantitative surveys for primary users will evaluate the implementation strategies. The reach, effectiveness, adoption implementation, and maintenance (RE-AIM) framework will guide the evaluation and maintenance of the program.

Results

Integrating a codesign strategy complemented by a well-structured implementation and evaluation protocol that is a combination of implementation science theoretical frameworks (Knowledge to Action, Evidence-Based Co-design, RE-AIM) may lead to translational competence as a potential outcome.

Anticipated outcomes

The application, resourcing and commitment to codesigned tertiary-level learning and qualification will demonstrate the achievement of a contemporary and comprehensive postgraduate university degree program in health innovation management.
Knowledge, attitude, practices, and perceived barriers to using point-of-care ultrasound by Asian primary care physicians – a mixed method study
Authors: Ng Amy Pui Pui , Liu Kiki Sze Nga , Wong Zoey Cho Ting , Tang Zoe Ho Wai , Wan Eric Yuk Fai , Yu Esther Yee Tak , Dao Man Chi , Wu Chun Yu , Lam Tai Pong
Published: November 2024

Background

Although research shows that point-of-care ultrasound is helpful in primary care, there is little research on point-of-care ultrasound use and the barriers to its use in Asia. This study estimated the prevalence of primary care physicians using point-of-care ultrasound in Hong Kong and assessed their perceived knowledge, attitude, practices, and barriers to using point-of-care ultrasound.

Study design

This was a mixed-method study: cross-sectional survey, followed by semi-structured interviews. Primary care physicians who were members of the Hong Kong College of Family Physicians and/or were clinical teachers affiliated with the Department of Family Medicine and Primary Care at the University of Hong Kong were invited to participate.

Results

A total of 330 and 14 completed the survey and interviews, respectively. The prevalence of respondents using point-of-care ultrasound was 22.5%. Perceived knowledge was fair (mean score: 1.9 out of 4; SD: 0.6). The attitudes were mostly positive (mean score: 3.0 out of 4; SD: 0.5). Majority stated that barriers to using point-of-care ultrasound were related to training (90.9%), the competence of point-of-care ultrasound skills (90.2%), and clinical support (89.5%). Qualitative data identified that most participants found point-of-care ultrasound useful; however, participants felt that its use was limited by their competence of point-of-care ultrasound and by factors related to their clinical practice.

Conclusions

Almost a quarter of respondents are using point-of-care ultrasound with a majority having positive attitudes. They lack confidence in their skills as knowledge is poor but simultaneously find training and clinic support limited.
Efficacy and diabetes risk of moderate-intensity statin plus ezetimibe versus high-intensity statin after percutaneous coronary intervention
Authors: Choo Eun Ho , Moon Donggyu , Choi Ik Jun , Lim Sungmin , Lee Jungkuk , Kang Dongwoo , Hwang Byung-Hee , Kim Chan Joon , Lee Jong-Min , Yoo Ki-Dong , Jeon Doo Soo , Chang Kiyuk
Published: November 2024

Backgrounds

High-intensity statin is recommended for patients undergoing percutaneous coronary intervention (PCI), and ezetimibe is recommended to be added in patients not achieving low-density lipoprotein cholesterol (LDL-C) targets. Moderate-intensity statin plus ezetimibe can reduce LDL-C levels similar to high-intensity statin. The aim of this study is to examine the long-term efficacy and safety of moderate-intensity statin plus ezetimibe as the first-line strategy compared to high-intensity statin in patients undergoing PCI.

Method

Data was obtained from the Health Insurance Review and Assessment Service database of South Korea. Patients who underwent PCI from 2012 to 2017 were included. The primary efficacy endpoint was major adverse cardiac cerebrovascular events (MACCEs), a composite of all-cause death, revascularization, or ischemic stroke. The safety endpoint was new-onset diabetes mellitus (DM).

Results

A total of 45,501 patients received high-intensity statin (n = 38,340) or moderate-intensity statin plus ezetimibe (n = 7,161). Among propensity-score-matched 7,161 pairs, MACCEs occurred in 1,460 patients with high-intensity statin and 1,406 patients with moderate-intensity statin plus ezetimibe (33.8% vs. 31.9%, hazard ratio 0.96, 95% confidence interval 0.89–1.03, P = 0.27) at a median follow-up of 2.7 years. DM was newly diagnosed in 398 patients with high-intensity statin and 342 patients with moderate-intensity statin plus ezetimibe (12.5% vs. 10.7%; hazard ratio 0.84, 95% confidence interval 0.73–0.97, P = 0.02).

Conclusion

In patients undergoing PCI, moderate-intensity statin plus ezetimibe demonstrated a similar risk of MACCEs but a lower risk of new-onset DM than high-intensity statin. Early combination treatment of moderate-intensity statin and ezetimibe may be a useful and safe lipid-lowering strategy after PCI.

Graphical abstract

Cumulative incidence according to the first-line lipid-lowering strategy in patients undergoing percutaneous coronary intervention. Abbreviation: MACCE, major adverse cardiac cerebrovascular events; PCI, percutaneous coronary intervention.
Oral function status of older patients seeking dental implant treatment
Authors: Taue Risako , Osawa Tokiko , Uchida Yoshiki , Hayashi Myu , Kitakabu Kentaro , Sato Yuji , Furuya Junichi
Published: November 2024

Purpose

In recent years, dental implant treatment has become an option for prosthetic treatment for missing teeth and is often performed in older patients. However, the complex oral functional decline in old age presents challenges in terms of frailty prevention, making oral function management after prosthetic treatment crucial. Nonetheless, the actual status of oral function in older patients seeking dental implant treatment remains unclear. In this study, we aimed to assess the oral function status of older patients seeking dental implant treatment.

Methods

Among patients receiving prosthetic treatment for missing teeth, 227 older patients (111 in the pre-dental implant group and 116 in the pre-bridge/denture group) who underwent a thorough examination of their oral function were included in this study. Age, sex, comorbidities, smoking status, number of functional teeth, and occlusal support status were obtained from the medical records. Statistical analyses were performed using the t-test, chi-square test, and logistic regression (p < 0.05).

Results

Compared with the pre-bridge/denture group, the pre-dental implant group had significantly better oral hygiene, occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function and a significantly lower prevalence of oral hypofunction. Older age and decreased occlusal support were associated with the diagnosis of oral hypofunction, even after adjusting for confounding factors including prosthetic treatment.

Conclusions

Although older patients seeking dental implant treatment have a higher oral function than those seeking general prosthetic treatment, older age and a lower number of occlusal supports suggest that appropriate oral function management is needed.
Early behavioral indicators of aberrant feces in newly-weaned piglets
Authors: Witjes Vivian L. , Veldkamp Fleur , Velkers Francisca C. , de Jong Ingrid C. , Meijer Ellen , Rebel Johanna M. J. , Stegeman Jan A. , Tobias Tijs J.
Published: November 2024

Background

Post-weaning diarrhea (PWD) is a frequently occurring health and welfare issue in weaned piglets. Behavioral changes indicating impaired health may be detectable before the onset of signs and could be useful to detect the development of PWD early, enabling targeted and timely interventions. Current algorithms enable automated behavioral classification on the group level, while PWD may not affect all piglets in one pen and individual level analysis may be required. Therefore, this study aimed to assess whether changes in pen activity or individual piglet behavior can be early indicators of the occurrence of PWD. During 3 replicated rounds, 72 piglets (Sus scrofa domestica, Landrace x Large White) weaned at 27 days of age, were housed in 4 pens with 6 piglets each. Individual fecal color and consistency were scored (0–5; ≥ 3 considered as aberrant feces) six times during the first two weeks post-weaning using rectal swabs. Additionally, using a similar scoring scale, feces on the pen floor were assessed daily. Two methods were applied for behavioral scoring. Individual behaviors (eating, drinking, standing, walking; n = 48) were scored manually and instantaneously with a five-minute interval from videos of the first two rounds, while pen activity (eating, drinking, moving; n = 12) was analyzed automatically and continuously using a commercially available algorithm from videos of all three rounds.

Results

Piglets showing a relatively higher proportion of standing behavior one day before fecal scoring had increased odds of an aberrant fecal color score (odds ratio (OR): 4.8; 95% confidence interval (CI): 1.5–15.3). Furthermore, odds of aberrant colored feces increased in pens where piglets showed more moving activity two days before (OR: 6.14; 1.26 < 95%CI < 29.84), which was also found for fecal consistency (OR: 4.77; 95%CI: 1.1–21.6).

Conclusions

Our results indicate that increased standing in individual piglets and an increased moving activity on the pen level may be important behavioral indicators of PWD before the onset of diarrhea. Further development of current algorithms that can identify behavioral abnormalities in groups, from the pen to the individual level, may therefore be a promising avenue for improved and targeted health and welfare monitoring.
Stepwise to clarify differentiation between pleomorphic xanthoastrocytoma and giant cell glioblastoma using p53, CD34 and KI67; clinicopathological hospital based study
Authors: Essa Abdelhakeem A. , Abd Elhakeem Ahmed Abd Esattar , Tayel Amr M. , Ismail Ahmad Abdalla
Published: November 2024

Background

Giant cell glioblastoma (GCGB) and pleomorphic xanthoastrocytoma (PXA) are rare astrocytic neoplasms. Although they share certain histopathological and histochemical findings, they are characterized by different clinical behaviour and prognosis. Nevertheless, few cases remain uncertain, as their histopathological features and immunophenotypes do not correspond to the typical pattern either of GCGB or PXA and require additional immunohistochemical diagnostic measures for appropriate diagnosis.

Specific aims

We carried out this study to address the clinicopathological features of these neoplasms and to examine the expression profile of GFAP, synaptophysin, p53, CD34, and Ki67 proteins.

Results

The mean age of the patients was high in GCGB (mean ± SD:49 ± 16.9 years) as compared to PXA (mean ± SD: 29 ± 10.6 years) and APXA (mean ± SD:31 ± 11.5 years). GCGB was more common in women, whereas both PXA and APXA were more common in men. The preferential localization of these tumours was the parietal (GCGB and APXA), and temporal (PXA) lobes. Statistically significant different expressions of P53 (P value = 0.024) and CD34 (P value = 0.001) between PXA and GCGB aid in discrimination between these entities. Interestingly, the similar expression patterns of p53 and CD34 proteins in both GCGB and APXA suggest the presence of possible common molecular mechanisms in both of them.

Conclusions

Our work demonstrated that CD34 immunohistochemical expression is more pronounced in PXA, in contrast to p53 which is frequently expressed in GCGB, and APXA. The altered expression of p53, CD34 among GCGB, PXA, and APXA suggests possible roles of these proteins in the development of these neoplasms.
An Algorithm for the Microsurgical Resection of Cerebellar Cavernomas
Authors: Früh Anton , Mertens Robert , Nissimov Nitzan , Fekonja Lucius , Truckenmueller Peter , Hallek Laura , Schröder Nils , Kullick Maggy , Zdunczyk Anna , Wessels Lars , Vajkoczy Peter
Published: November 2024

BACKGROUND AND OBJECTIVES:

Cavernous malformations (CMs) account for 8% to 15% of all cerebrovascular anomalies and pose clinical significance due to their potential to cause symptomatic hemorrhage, seizures, and focal neurological deficits. While the majority of CMs are located supratentorial, the less common posterior fossa, particularly cerebellar CMs (cCMs), pose a unique treatment challenge. This study aims to contribute to the understanding and management of cerebellar CMs, thereby assisting in the decision-making process for clinical interventions in this patient population.

METHODS:

We conducted a retrospective analysis of all patients who were treated for CMs from 2010 to 2023 at our tertiary healthcare facility. Patients with cCMs were further analyzed concerning their treatment strategy and functional outcome based on the modified Rankin Scale.

RESULTS:

Nine hundred fourteen patients with CMs were treated between 2013 and 2023 at our center. Among these subjects, 6.5% (n = 59) presented with cerebellar lesions. The median age was 54 [37-64] years, and 15 (25.4%) patients showed associated developmental venous anomalies. Nearly half of these patients (49.0%) were surgically treated. Surgical approaches were tailored and individualized to the specific CM location based on a treatment algorithm and encompassed supracerebellar-infratentorial, telovelar, suboccipital transcortical, retrosigmoid transcortical, and retrosigmoidal transhorizontal fissure approaches. Univariate analysis revealed no risk factors concerning postoperative morbidity. The surgically treated patients showed a significant improvement between preoperative and follow-up functional outcomes.

CONCLUSION:

cCMs are rare but frequently necessitate surgical intervention. This study enhances the current understanding of cCMs, underscoring the intricate challenges associated with their management. Differentiated algorithms with tailored approaches ensure the optimization of outcomes in the treatment of these challenging lesions.
Self-Reported Use of Prohibited Substances and Methods Among Athletes of the Brazilian Delegations
Authors: Waclawovsky Aline Josiane , Ramis Thiago Rozales , Lima Frederico Diniz , Schuch Felipe Barreto , Royes Luiz Fernando Freire
Published: November 2024

Use of prohibited substances and methods (doping) by elite athletes is a complex and multifactorial behavior. Understanding the factors associated with doping behavior is crucial to identifying potential intervention targets to reduce doping among this group. However, there are limited data on the prevalence and correlations of self-reported prohibited substance use among Brazilian Olympic athletes. We present data from a cross-sectional, self-reported online survey. Participants were elite Brazilian athletes who participated in the 2020 Olympic and Paralympic Games. A total of 209 athletes (52.6% females) from both Brazilian delegations were surveyed. The self-reported doping use of prohibited substances or methods was found to be 7.2%. Receiving a recommendation from a medical doctor, even knowing that the substance is prohibited, was associated with an increased risk of self-reported doping use (OR = 17.474; 95% CI = 4.664–65.470, P < 0.001). Nearly 1 in 10 athletes reported use in their careers. Medical recommendation to use substances was the only factor associated with an increased risk of doping among elite athletes.
Perspectivas de graduandos de Odontologia de uma universidade pública baiana quanto à inserção no mercado de trabalho
Authors: Arruda Pereira Jaila , Silva de Carvalho Fábio , Alves Paz de Carvalho Cristiane
Published: November 2024

Objetivos: identificar as perspectivas de estudantes de Odontologia de uma universidade pública baiana sobre a inserção no mercado de trabalho. Métodos: realizou-se um estudo transversal, com discentes do sétimo ao décimo período da graduação, que responderam, presencialmente, durante o mês de março de 2023, a um questionário elaborado pelas pesquisadoras. Posteriormente, os dados foram analisados de forma descritiva. Resultados: participaram do estudo 75 graduandos (95,0%), com idade média de 25,1 anos, sendo a maioria mulheres (68,0%). Observou-se que 46,7% deles consideraram o mercado de trabalho bom, mas que depende da qualificação do profissional. Acerca do conhecimento sobre empreendedorismo, os graduandos relataram não ter (52,0%) ou ser insuficiente (45,3%). A maioria deles não se considera preparado para administrar seu consultório (92,0%). Conclusão: os graduandos de Odontologia deste estudo revelaram uma perspectiva positiva em relação ao mercado de trabalho. Todavia, demonstraram insegurança e despreparo quanto à administração e ao gerenciamento do consultório odontológico.