bluuebunny/crossref_metadata_2025 huggingface dataset:
Photographic Assessment of Intermittent Exotropia Using a Translucent Cover
Authors: Chung Seung Ah , Rhiu Soolienah , Park Aram , Yu Jaeeun
Published: September 2021

Purpose:

To evaluate the validity of the photographic assessment with a translucent cover that is clinically available for the evaluation of intermittent exotropia.

Methods:

Photographs of 270 patients who cooperated for the prism and alternate cover test (PACT) were reviewed. Full-face images were obtained with a digital camera while a translucent cover was placed in front of either eye. The change in distance from the medial canthus to the nasal limbus with occlusion was measured and the photographic angle was estimated by three independent ophthalmologists based on representative photographs. These two measurements were correlated with the angle measured using the PACT, and clinical features related to the discrepancy between the photographic angle and the angle measured with the PACT were determined.

Results:

Patients with intermittent exotropia of 27.0 ± 6.1 prism diopters (PD) showed a 4.5 ± 3.3 mm exodrift and an estimated angle of 29.0 ± 4.3 PD on the photographs with occlusion. The exodrift distance and photographic angle were positively correlated with the angle of PACT (
r
= 0.256,
P
< .001 and
r
= 0.546,
P
< .001, respectively). Of the 47 patients with a discrepancy of greater than 8 PD, 38 patients (80.9%) were regarded as having a photographic angle that was larger than the angle of PACT, which was more common in older patients, in those with a small distance angle, and when taking off the spectacles.

Conclusions:

Photographs with a translucent cover can reveal the latent components of intermittent exotropia. However, the photographic angle might differ from the real angle, particularly in older patients with a small angle and with the spectacles off.

[
J Pediatr Ophthalmol Strabismus
. 2021;58(5):331–338.]
Vernal Keratoconjunctivitis: Beyond the Classic Treatment
Authors: Bernales Andrea , Berger Osvaldo , Hamada Samer
Published: September 2021

Vernal keratoconjunctivitis is a chronic allergic conjunctivitis with corneal involvement that affects children and adolescents. Its pathogenic mechanisms are not entirely clear, but IgE and other inflammatory mediators are involved. An 8-year-old boy with vernal keratoconjunctivitis not responding to conventional treatment started immunotherapy with good results, decreasing the topical steroid dependence. Conventional vernal keratoconjunctivitis treatment involves topical antihistamines and steroids. These are not always effective and steroids can be associated with severe ocular complications in the long term. The authors suggest searching for possible allergens and starting immunotherapy associated with conventional topical treatment earlier, in addition to measuring the health-related quality of life by applying the Quality of Life in Children with Vernal Keratoconjunctivitis questionnaire and adjusting the treatment according to the impact on patients' quality of life.

[
J Pediatr Ophthalmol Strabismus.
2021;58(5):e36–e39.]
Investigating Adverse Childhood Experiences and Nutrition and Physical Activity Behaviors Using the Omaha System
Authors: Secginli Selda , Yas Merve Altiner , Ilhan Nesrin , Olsen Jeanette M.
Published: September 2021

The aim of the current study was to examine the relationship between adverse childhood experiences (ACEs) and nutrition and physical activity behaviors using the Omaha System. A descriptive cross-sectional design was used with 227 women recruited from three vocational institutes. Measures included Omaha System Knowledge, Behavior, and Status ratings for nutrition and physical activity; sociodemographic information; and the ACE Questionnaire. Results demonstrated that more than one half of participants had a history of at least one ACE (
n
= 132; 58.1%), and 33 (14.5%) had four or more. ACEs score was significantly associated with nutrition, but not physical activity behavior. Understanding the links between ACEs and health behaviors and including a brief screening for ACEs in primary care practice settings may help nurses holistically customize health promotion interventions and lead to better health outcomes. The Omaha System can efficiently measure health-related behaviors; examine their relationship to risk factors, such as ACEs; and capture individual and population-level changes. [
Journal of Psychosocial Nursing and Mental Health Services, 60
(3), 23–30.]
Geriatric oral health competency among dental providers
Authors: Tabrizi Maryam ,   Department of General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States, Lee Wei-Chen ,   Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, United States
Published: September 2021

Background

Geriatrics as an educational topic has been a high priority in current health care. The innovative Age-Friendly health system with the 4Ms structure (what Matters most, Medication, Mentation, Mobility) needs to be integrated into oral health and dental services training. The purpose of this study is to respond to one question: are the graduating general dentists trained and prepared to treat medically vulnerable elderly in communities?

Methods

All pre-doctorate dental students from first year to fourth year were invited to voluntarily respond to an online survey provided on Qualtrics. The survey provided examples of two broken molar teeth that need extraction. First, students were asked how comfortable they felt extracting the two molars based on the x-rays. Then, the question was repeated to evaluate if they felt comfortable with extracting the teeth in a patient with one chronic condition and related medication(s). Finally, the students were again questioned whether they feel comfortable to provide the same service to medically vulnerable patients with multiple health conditions and polypharmacy.

Results

The majority of students who participated in this study said they were comfortable with extracting the teeth of patients without any chronic condition. However, many more chose to refer medically vulnerable patients with multiple chronic conditions and polypharmacy to a specialist.

Conclusions

Dental education in many U.S. dental schools may provide adequate education and create competent general dentists. Yet, the competency and confidence required for dentists to be able to treat older adults with multiple health conditions and using prescribed or over-the-counter medication is insufficient.
Reduced-form setting under model uncertainty with non-linear affine intensities
Authors: Biagini Francesca , Oberpriller Katharina
Published: September 2021

In this paper we extend the reduced-form setting under model uncertainty introduced in [5] to include intensities following an affine process under parameter uncertainty, as defined in [15]. This framework allows us to introduce a longevity bond under model uncertainty in a way consistent with the classical case under one prior and to compute its valuation numerically. Moreover, we price a contingent claim with the sublinear conditional operator such that the extended market is still arbitrage-free in the sense of “no arbitrage of the first kind” as in [6].
Measuring the Burden of Disease in Korea, 2008-2018
Authors: Jung Yoon-Sun , Kim Young-Eun , Park Hyesook , Oh In-Hwan , Jo Min-Woo , Ock Minsu , Go Dun-Sol , Yoon Seok-Jun
Published: September 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.
El fortín romano tardo-republicano del Tossal de la Cala (Benidorm, Alicante). Autopsia y reinterpretación de un yacimiento histórico
Authors: Bayo Fuentes Sonia , Moratalla Jávega Jesús , Morillo Cerdán Ángel , Sala Sellés Feliciana
Published: September 2021

En este trabajo presentamos cómo se ha ido recuperando la información de las excavaciones antiguas en el Tossal de la Cala e interpretado a la luz de los datos obtenidos en nuestras excavaciones (2013-2020), realizadas mediante convenio de colaboración con el Ayuntamiento de Benidorm. El final del proceso ha sido, primero, la recuperación de un yacimiento que se creía arrasado y, seguidamente, la caracterización fundamentada de un tipo de fortificación tardo-republicana de pequeña extensión inédito en la Hispania de la conquista.
Um passado mal-acabado:políticas de rebaixamento étnico-racial da população cigana
Authors: Gonçales Nathalia Ferreira
Published: September 2021

Este artigo busca traçar uma série de operações e pensamentos que atravessam o tempo e persistem em atualizar políticas de rebaixamento étnico-racial da população cigana em contexto europeu. Neste sentido, articula o evento histórico do Samudaripen, o extermínio do povo cigano pelas mãos do regime nazista e seus colaboradores na Segunda Guerra Mundial, com a composição de um imaginário coletivo a respeito do bairro de Font de la Pólvora, comunidade da Catalunha, marcado desde sua constituição por narrativas de marginalização e abandono, e de sua população residente, majoritariamente de etnia cigana. Evocações estigmatizadas de uma etnicidade associada a processos simbólicos e materiais de inferiorização estruturam sistematicamente os mecanismos de produção de precariedade que marcam o cotidiano da vida no bairro.
Dá tamaquaré pra ele! Humanos e animais entre poder e humilhação na Amazônia Paraense
Authors: Domingues Bruno Rodrigo Carvalho
Published: September 2021

Neste artigo, analiso o que chamei de cosmoerotismo amazônico, uma forma particular de acesso ao cosmos para a interferência na vida afetivo-sexual dos seres humanos na Amazônia Paraense, especialmente na cidade de Abaetetuba, por meio do uso de “patuás” para o amor e para o sexo, confeccionados a partir da interação entre humanos, animais, plantas e caboclos. O uso dos patuás acarreta algumas consequências, dentre as quais a humilhação, aqui analisada à luz de teóricos que acionam essa emoção hostil, ancorados nas relações de poder. Os resultados apontam para a formação de complexos emocionais desenvolvidos a partir da relação entre humanos e não humanos.
A monstruosidade da humilhação: uma etnografia entre mulheres agredidas com agentes químicos
Authors: Díaz-Benítez María Elvira
Published: September 2021

A partir de dados etnográficos levantados na Colômbia entre mulheres que tiveram seus corpos agredidos com agentes químicos, procuro argumentar que esse ato marca e amputa especialmente rostos como uma forma de deixar o sujeito atacado vivo, mas sub-humanizado, envergonhado e afastado do convívio social. Pretendo analisar os efeitos iniciais desse ato como desfazimento, isto é, como aquele que acomete e altera as relações e a própria percepção que o sujeito tem de si, como uma humilhação que procura ser perene e se esticar no tempo como uma cicatriz visível, como um instrumento de fazer monstros. Analiso também movimentos coletivos e subjetivos de recusa da humilhação.
Do abjeto ao não-enlutável: o problema da inteligibilidade na filosofia de Butler
Authors: Rodrigues Carla , Gruman Paula
Published: September 2021

Neste trabalho, o conceito de abjeto, tal como pensado por Judith Butler a partir da obra de Julia Kristeva, é analisado e aproximado da ideia butleriana de uma distinção existente entre vidas passíveis de enlutamento e vidas não-enlutáveis. Propomos uma compreensão do conceito de abjeto na obra dessas autoras, além de estabelecer uma relação entre a noção de abjeto e a ideia de impureza da antropóloga Mary Douglas. Entendemos que, na obra de Butler, existem aproximações possíveis entre as divisões entre sujeito e abjeto e entre enlutável e não enlutável. Sugerimos que a categoria da inteligibilidade é o operador teórico que atravessa esses dois momentos da obra de Butler. Compreendemos que, por mais que a ênfase da filósofa mude do gênero para a violência contra as vidas, seu interesse principal mantém-se em realizar uma crítica da norma que categoriza algumas vidas e corpos como válidos, enquanto outros pertencem a uma zona de ininteligibilidade, abjetos, cujas vidas não contam.
Les écrits de la discorde. Le procès de Belle-Île et la fabrique du cartulaire de Quimperlé (vers 1110-1130)
Authors: Queney Lucile
Published: September 2021

Composé à la fin des années 1120, le cartulaire de l’abbaye de Quimperlé est fortement marqué par le procès relatif à la possession de Belle-Île-en-Mer, gagné par l’abbaye cornouaillaise contre celle de Redon, une dizaine d’années plus tôt. La violence exprimée par le rédacteur quimperlois dans son « Opuscule » est révélatrice d’un souvenir toujours vif qui est à l’origine de ce cartulaire composite, rassemblant tant l’histoire du monastère que les diverses chartes attestant de ses possessions. Revendiqué comme une protection juridique, le manuscrit répond aussi, dans ses choix d’organisation et de sélection, à des enjeux mémoriels et de gestion des biens de l’abbaye. Le conflit pour Belle-Île est central dans cette affaire et il atteste de la mobilisation des réseaux de soutien des deux abbayes pour appuyer leur légitimité. Cette concurrence s’inscrit dans les mutations sociales et ecclésiales de ce début de xiie siècle, ce qui explique l’implication, dans ce conflit très local, du pape et du duc de Bretagne.
Un tabellionage princier : les tabellions du comté de Dunois au xve siècle
Authors: Mouftiez Vincent
Published: September 2021

Seigneurie princière, le comté de Dunois (créé en 1439 au profit de Jean, bâtard du duc d’Orléans) fut le siège d’un tabellionage dont une centaine de registres ont été conservés. Leur étude permet d’étudier le travail quotidien des tabellions, ces notaires du nord de la France, qui ont été l’objet d’un renouveau historiographique au cours des dernières années. Ils témoignent de l’uniformité des pratiques du tabellionage dans le Nord du royaume au xve siècle et nous permettent de connaître les méthodes de travail (les jours, les lieux), les origines, les activités économiques et l’intégration dans la société des tabellions. L’étude d’un cas particulier montre le parcours professionnel d’un homme, à partir de l’échelon le plus bas (clerc du bailliage) jusqu’au poste de tabellion. L’étude de son patrimoine foncier et de ses alliances matrimoniales illustre son ascension sociale : il devient membre de l’élite dunoise et intègre la noblesse locale.
Analyses of the gut bacteriomes of four important Drosophila pests
Authors: Lin Qingcai , Zhai Yifan , Chen Hao , Qin Dongyun , Zheng Li , Gao Huanhuan
Published: September 2021

Several Drosophila species (Diptera: Drosophilidae) have become serious economic pests of berry and soft-skinned stone fruits around the world. Prominent examples are Drosophila suzukii (Matsumura), D. melanogaster (Meigen), D. hydei (Sturtevant), and D. immigrans (Sturtevant). Information on the biology and ecology of Drosophila is important for a better understanding of these important fruit pests and, ultimately, for fruit protection. In this study, the gut bacteriomes of these four Drosophila species were surveyed and the differences among bacterial communities were characterised. The 16S rRNA genes of gut microbes were sequenced by Illumina MiSeq technology (Illumina, San Diego, California, United States of America), followed by α-diversity and β-diversity analyses. The results show that bacteria of the family Enterobacteriaceae (Kluyvera and Providencia; phylum Proteobacteria) dominated all four Drosophila species. Specific dominant gut bacterial communities were found in each Drosophila species. The dominant families in D. melanogaster and D. suzukii were Enterobacteriaceae, Comamonadaceae, and Acetobacteraceae. In the intestine of D. hydei, Enterobacteriaceae had a proportion of 56.99%, followed by Acetobacteraceae, Spiroplasmataceae, and Bacillales Incertae Sedis XII. In D. immigrans, besides Enterobacteriaceae, Alcaligenaceae, Flavobacteriaceae, Xanthomonadaceae, Comamonadaceae, and Sphingobacteriaceae also had high relative abundance. These data expand current knowledge about the putative function related to gut microbes – for example, the metabolism of carbohydrates, amino acids, inorganic ions, lipids, and secondary metabolites. This knowledge provides a basis for further metatranscriptomic and metaproteomic investigations.
Psychometric properties of an instrument 3: convergent, discriminant, known-groups, and criterion validity
Authors: Lee Eun-Hyun
Published: September 2021

Before evaluating convergent, discriminant, and known-groups validity, it is suggested to design an instrument that reflects hypothetical relationships or differences with other comparator instruments or groups. For criterion validity, a gold-standard instrument measuring the same construct should be carefully selected.
Does a nurse-led postpartum self-care program for first-time mothers in Bangladesh improve postpartum fatigue, depressive mood, and maternal functioning?: a non-synchronized quasi-experimental study
Authors: Khatun Fahima , Lee Tae Wha , Lee Hye Jung , Park Jeongok , Song Ju Eun , Kim Sue
Published: September 2021

Purpose: This study aimed to test the efficacy of a nurse-led postpartum self-care (NL-PPSC) intervention at reducing postpartum fatigue (PPF) and depressive mood and promoting maternal functioning among first-time mothers in Bangladesh.Methods: A non-synchronized quasi-experimental design was used. First-time mothers were recruited during postpartum (PP) and assigned to the experimental or control group (34 each). The experimental group attended the NL-PPSC—a 1-day intervention that focused on increasing self-efficacy—at a hospital in person. The control group received usual care. Data on PPF, depressive mood, maternal functioning, self-care behaviors, PP self-efficacy, and self-care knowledge were collected at 2 weeks PP (attrition 23.5%) and 6 weeks PP (attrition 16.1%). Data were analyzed using descriptive statistics, bivariate statistics, and linear mixed model analysis.Results: One-third (33.3%) of new mothers experienced depressive mood (Edinburgh Postnatal Depression Scale scores of ≥13 points). The NL-PPSC intervention statistically significantly decreased PPF (β=–6.17, SE=1.81, t=–3.39, p<.01) and increased maternal functioning at 6 weeks PP in the experimental group (β=13.72, t=3.73, p<.01) as opposed to the control group. Knowledge was also statistically significant for increased maternal functioning over time (β=.37, SE=.18, t=2.03, p<.05). However, no statistically significant differences in PP depressive mood were observed over time.Conclusion: The NL-PPSC intervention was feasible and effective at improving fatigue and maternal functioning in Bangladeshi mothers at 6 weeks PP. PP care knowledge was effective at improving maternal functioning; this finding supports the implementation of the NL-PPSC intervention for new mothers after childbirth.
Comparative analysis of different hydrogels for the bioprinting of 3D in vitro skeletal muscle models
Authors: Aliberti Flaminia , Rinvenuto Lorenza , Loi Giada , Benedetti Laura , Scocozza Franca , Ronzoni Flavio Lorenzo , Sampaolesi Maurilio , Cusella Gabriella , Conti Michele , Ceccarelli Gabriele
Published: September 2021

In this study we demonstrated an application of 3D Bioprinting using different commercially available hydrogels (CELLINK AB, Sweden) with the aim to identify the most suitable biomaterial for the proliferation and differentiation of murine muscle cells (C2C12).
An in vitro lung biomimetic model
Authors: Licciardello Michela , Ciardelli Gianluca , Tonda-Turo Chiara
Published: September 2021

The design and fabrication of a system to both mimic the multicellular composition of the lung and its vascular network, as well as the composition and structure of extracellular matrix (ECM) was developed.
Development of a multiscale testing method for the reduction of soft biological tissues waste during mechanical characterization
Authors: Lugas Andrea T. , Serino Gianpaolo , Terzini Mara , Bignardi Cristina , Audenino Alberto L.
Published: September 2021

Two biaxial mechanical test methods were devised to compare their suitability for the mechanical characterization of soft biological tissues with the least possible tissue waste. Nanoindentation was used to explore the microscopic properties of the tissue and to overcome the macroscopic test limitations.
Elucidating molecular connetion between IAHSP onset and Alsin protein by means of Homology Modelling and Molecular Dynamics
Authors: Miceli Marcello , Exertier Cecile , Vallone Beatrice , Cavaglià Marco , Deriu Marco A.
Published: September 2021

The Infantile-onset Ascending Hereditary Spastic Paralysis (IAHSP) is an incurable rare neurodegerative disease related to a mutation-driven aberrant behaviour of the Alsin protein. The lack of information on Alsin atomic structure limits a complete understanding on pathology mechanisms. In this work, molecular modelling techniques have been applied to shed lights on Alsin folding dynamics and misfunction induced by aberrant mutations.
3D in vitro model of the pancreatic acino-ductal unit through additive manufacturing technology
Authors: Sgarminato Viola , Tonda-Turo Chiara , Ciardelli Gianluca
Published: September 2021

This project aims at reproducing the morphology and the composition of the pancreatic acino-ductal unit. More specifically, this work involves the use of additive manufacturing technologies to fabricate a 3D exocrine glandular tissue model that mimics in vitro the physiological structure experienced by cells in vivo.
Electrostimulation of a 3D in vitro skin model to activate wound healing
Authors: Villata Simona , Napione Lucia , Baruffaldi Désirée , Nardini Christine , Frascella Francesca , Pirri Fabrizio
Published: September 2021

The aim of the work is to propose a methodology for the stimulation of a 3D in vitro skin model to activate wound healing. The presented work is in the frame of the national research project, CronXCov, “Checking the CHRONIC to prevent COVID-19”, devoted to understand how physiologic and inflamed skin on chip 3D models evolve upon a range of physical (e.g., electrical, mechanical, optical) stimulations, over time. Thanks to the 3D modelling, using Next Generation Sequencing and the network medicine frame of analysis to process the data, we will systematically characterize the effects of the applied stimuli, offering new insight for the exploitation of wound healing.
How to measure monitoring and evaluation system effectiveness?
Authors: Ba Abdourahmane
Published: September 2021

Background: Although the roadblocks to development achievement in Africa emerge noticeably from resource scarcity, lack of security and good governance, or poor economic approaches, they also surface from ineffective development management practices. The monitoring and evaluation (ME) systems effectiveness assessment by the World Bank in 2007 revealed little effectiveness, mainly on cases studied in Africa.Objective: This research investigates the framework for monitoring and evaluation system effectiveness as a development management tool and shapes its measurements. It creates a framework that will help understand better the success factors of an effective ME System and how they contribute to improved development management.Methods: A trifold approach was used, which comprises three iterations — Literature review, Case Studies, and Survey. The first revisited the most relevant literature on development management and performance monitoring systems, while the second used a qualitative study of three cases in the West Africa region. The third is a survey of a sample of practitioners and managers in West Africa, where data was analysed using correlations and regressions.Results: There are significant linkages between ‘ME-System Quality’, ‘ME-Information Quality’, and ‘ME-Service Quality’. The results highlighted that the ‘Results-Based Management Practice’ of organisations, the effective ‘Knowledge and Information Management Culture’, including learning, and the ‘Evidence-Based Decision-Making Practice’ are directly influenced by effective ME System.Conclusions: Effective ME System contributes greatly to expand ‘Improved Policy and Program Design’, ‘Improved Operational Decisions’, ‘Improved Tactical and Strategic Decisions’, and ‘Improved Capability to Advance Development Objectives’.
The National Chest Pain Centers Program: Monitoring and Improving Quality of Care for Patients with Acute Chest Pain in China
Authors: Xiang Ding-Cheng , Jin Yin-Zi , Fang Wei-Yi , Su Xi , Yu Bo , Wang Yan , Wang Wei-Min , Wang Le-Feng , Yan Hong-Bing , Fu Xiang-Hua , Zheng Zhi-Jie , Labresh Kenneth A. , Huo Yong , Ge Jun-Bo
Published: September 2021

Abstract

Background:

The National Chest Pain Centers Program (NCPCP) is the largest nationwide, hospital-based, multifaceted, continuous quality improvement initiative, which aims to monitor and improve the quality of care for patients with acute chest pain. The accreditation of the standardized chest pain center is central to the project. The purpose of establishing chest pain centers is to develop a mechanism for “sending acute chest pain patients to a hospital with capabilities for the best treatment in the shortest time possible.”

Objectives:

This study aims to evaluate the effectiveness and implementation of the chest pain center accreditation and to identify factors that may influence its implementation in local settings.

Study Design and Methods:

Hospitals that have been accredited between January 2016 and September 2020 will be recruited in this study. We will conduct a self-controlled retrospective cohort study by comparing the care performance before, during, and after the accreditation. Measures for care performance will be selected based on the American College of Cardiology/American Heart Association clinical practice guidelines, which will be divided into prehospital processes, in-hospital processes, and in-hospital outcomes. For the implementation of the chest pain center accreditation, we will use a modified reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework to investigate the implementation process, and the consolidated framework for implementation research will be used to identify factors that emerge within the local context and influence the implementation fidelity and feasibility.

Progress to Date:

As of September 2020, there were 4,621 hospitals that registered the NCPCP, of which 1,507 hospitals were accredited. A total of 5,228,973 patients with a primary diagnosis on admission were enrolled from the registered hospitals, among which 34.6% were acute coronary syndromes.

Conclusions:

In this study, we proposed recommendations for improving the implementation of chest pain center accreditation, which will improve the quality of care for patients with acute chest pain and promote the sustainable development of chest pain center.

Trial Registration:

ClinicalTrials.gov, NCT04014972, registered July 10, 2019
Evaluation of two conservative different treatment protocols for symptomatic proximal deep caries management in molar teeth; an 18-month clinical report
Authors: Sherwood I. Anand , Divyameena B. , Ramyadharshini T. , Subashri V. , Banerjee Avijit
Published: September 2021

Aim:

The primary aim of this clinical trial was to observe the clinical success in conservative management of symptomatic deep proximal caries in permanent molar teeth with two treatment pulpotomy with Biodentine and indirect pulp capping with calcium hydroxide.

Materials and Methods:

A total of 71 patients who reported to department for the management of symptomatic proximal deep carious lesions in molar teeth participated in the trial. Posttreatment clinical success at 18 months was defined as asymptomatic teeth positively responding to cold pulp sensibility test (only in indirect pulp capping) and absence of periapical infection. Chi-squared test and Kaplan–Meier survival analysis were done.

Results:

Chi-squared test revealed no significant association between pulp status and posttreatment follow-up in both the treatment groups. Kaplan–Meier survival analysis showed mean survival of pulpotomy procedure for moderate and ambiguous pulp as 66.16 and 67.77 weeks, respectively, with no significant difference for two different pulp statuses. In indirect pulp capping procedure, there was significant difference (P = 0.038) (Log-rank Mantel-Cox) between the two pulp status category with moderate pulpitis having mean survival period of 69.27 weeks and ambiguous pulp with 42.83 weeks.

Conclusion:

Pulpotomy with Biodentine yielded better results than compared to indirect pulp capping.
Comparative evaluation of pull-out bond strength of fiber post using different luting cements in endodontically treated teeth
Authors: Singh Neha , Garg Ashima , Mittal Rakesh
Published: September 2021

Aim:

This study was aimed to evaluate and compare the pull-out bond strength of fiber post using glass ionomer cement (GIC), resin-modified glass ionomer cements (RMGIC), self-etch adhesive resin cement, and self-adhesive resin cement in endodontically treated teeth.

Materials and Methods:

Forty single-rooted teeth with single canal were decoronated, endodontically treated, post space were prepared and divided into four groups (n = 10) based on the cement used for luting the fiber post. Group 1: GIC, Group 2: RMGIC, Group 3: Self etch adhesive resin cement, Group 4: Self-adhesive resin cement. Pull-out test was evaluated for the prepared samples. Statistical analysis was performed using analysis of variance and Tukey's test (P = 0.05).

Results:

The mean pull-out bond strength of Group 4 was statistically higher than Group 1,2 and 3. Group 1 showed the least bond strength among all the groups.

Conclusion:

Within the limitation of this study, self-adhesive resin cements provide better bond strength of fiber post to root canal compared to self-etch adhesive resin cement and glass ionomer based cements.
Comparative evaluation of sealing ability of three bioactive obturation materials
Authors: Singla Meenu G , Panghal Sakshi
Published: September 2021

Aim:

The aim of this study was to evaluate and compare the sealing ability of three obturating materials used with single-cone technique: C Point/Endosequence BC sealer, gutta-percha/Endoseal MTA and gutta-percha/GuttaFlow bioseal using bacterial leakage model with Enterococcus faecalis.

Materials and Methods:

Seventy-six extracted human single-rooted mandibular premolars with straight canals prepared using Hyflex CM up to 45/04 and assigned to 3 experimental groups according to the root canal filling material as Group A - C Point/Endosequence BC sealer; Group B - guttapercha/Endoseal MTA; Group C - guttapercha/GuttaFlow bioseal. Split-chamber bacterial leakage model was prepared and microleakage analysis was made every 24 h for up to 9 weeks. The presence of E. faecalis was confirmed by light microscopy and Gram staining.

Results:

A survival analysis was performed using Kaplan–Meier plots and a log-rank test and it was found that Group A showed the best apical seal followed by Group C and then Group B at the end of the observational period. The difference in bacterial leakage among Group A and C versus Group B was statistically significant (P < 0.05), but there was no significant difference between Group A and Group C.

Conclusion:

C Point/Endosequence BC sealer and GP/Guttaflow bioseal sealer has shown better apical seal with single-cone technique as compared to GP/Endoseal MTA.
Comparison of fracture resistance of endodontically treated mandibular first molars restored with different reinforcing materials with and without cusp capping
Authors: Singh Vaishnavi J , Mantri Shivkumar P , Paul Bonny , Dube Kavita A , Gupta Nishikumari , Ghosh Sayantani
Published: September 2021

Aim:

This study aims to estimate and compare the fracture resistance of endodontically treated mandibular first molar restored with reinforced composite resin or cusp capping.

Materials and Methods:

Seventy-five freshly extracted intact mandibular molars were randomly divided into five groups. The teeth were embedded vertically into the self-cure acrylic lined with elastomeric impression material to a level 1 mm apical to the cement-enamel junction. Group 1 included intact teeth. After access preparation in Groups 2–5, canals were negotiated with 10 K file, cleaned shaped using K3XF NiTi rotary files, 17% Ethylenediaminetetraacetic acid, and 3% sodium hypochlorite. After drying, the canals were obturated with gutta-percha and Sealapex sealer. Group 2 teeth were restored using Cavit. In Groups 3–5, the access cavity floor was lined by resin-modified glass-ionomer cement. After etching, rinsing, and bonding, teeth were restored. Group 3 teeth with everX posterior as a base and 1.5 mm of occlusal nanohybrid composite. Group 4 teeth were restored with nanohybrid composite after bonding Interlig fiber circumferentially in the access cavity. In Group 5, after 2 mm cusp reduction, etching, and bonding, teeth were restored by cusp capping using nanohybrid composite. All specimens were subjected to a fracture test. The peak-load fracture value in Newton was recorded.

Results:

One-way analysis of variance test for intergroup comparison revealed a statistically significant difference between the groups (P = 0.011). Post hoc Tukey's test showed a significant difference (P = 0.005) between everX posterior and Cavit specimens. The Chi-square test results revealed that there is a significant difference (P = 0.0276) in the fracture pattern between the groups.

Conclusion:

It is concluded that restoration using short fiber-reinforced composite improved the fracture resistance of endodontically treated mandibular molars. Cusp-capped teeth exhibited more favorable fractures. The combined use of fiber-reinforced composite and capping the cusps using nanohybrid composite could be a viable option to restore molar favorably.
Evaluation of 18FDG PET-CT-positive mediastinal-hilar lymph nodes in extrathoracic malignancies by EBUS-TBNA; correlation of SUVmax, and short-axis diameter with the final diagnosis
Authors: Luthra Kunal , Singh Jyoti
Published: September 2021

Introduction:

Intrathoracic lymph node metastasis from extrathoracic neoplasms are rare. Primary malignancies that metastasize to mediastinal-hilar lymph nodes are head and neck , carcinoma breast ,and genitourinary. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)/endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently the preferred modality for mediastinal lymph node sampling.

Methods:

Fifty seven patients with extrathoracic malignancies with maximum standardized uptake value (SUVmax) of mediastinal-hilar lymph nodes greater than or equal to 2.5 were taken up for EBUS-TBNA. The histo-cytopathological results obtained from EBUS-TBNA were compared with SUVmax value and short-axis diameter of a lymph node as noted on EBUS.

Results:

Out of 74 sampled nodes, 49 (66.2%) were benign and 25 (33.8%) were malignant. The SUVmax range of benign nodes was 2.8–13 as compared to 3–18 of malignant nodes. The size range of malignant and benign nodes were 8–35 mm and 8–30 mm, respectively. The mean size of abnormal nodes (metastatic + granulomatous) was 17.5 (8–35 mm) and the mean SUVmax was 9.1 (3.4–18), and it was a statistically significant difference when compared to reactive (normal) nodes. At SUVmax cut-off 7.5, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 78.5%, 81.2%, 84.6%, and 74.2%, respectively for detecting abnormal nodes. At 13 mm size cut-off, sensitivity, specificity, PPV, NPV were 75.5%, 65%, 75%, and 72%, respectively, for detecting abnormal nodes.

Conclusion:

The majority of mediastinal-hilar nodes with increased metabolic activity are benign in nature. Size and SUVmax are poor predictors of metastasis in tuberculosis endemic region. There should be a restrictive attitude toward invasive diagnostic testing for mediastinal-hilar nodes in extrathoracic malignancies.
Tacrolimus Therapeutic Drug Monitoring and Correlation with Clinical Events – A Single-Center Prospective Study
Authors: Prabhu Mayoor V. , Karopadi Akash Nayak , Subhramanyam Sreepada V. , Pai B. H. , Nayak K. S.
Published: September 2021

Background:

Tacrolimus exposure is estimated by trough levels (C0). Recent studies suggest that C0 may not accurately reflect the area under the curve (AUC) and may not correlate with clinical events like acute rejection (AR) and nephrotoxicity.

Materials and Methods:

In an open, prospective, single-center study, 29 consecutive recipients of renal transplantation underwent C0 along with 2-h (C2), 4-h (C4), and 6-h (C6) estimation of blood tacrolimus levels by enzyme-linked immunosorbent assay, 72 h after initiation with tacrolimus or after a change in its dosage. AUC was estimated by trapezoidal method. C0, C2, C4, and C6 levels were correlated with the AUC.

Results:

Thirty-six AUC estimations were made over a 2-year period. The best correlate was C6. Correlation coefficients were C0 – 0.868, C2 – 0.788, C4 – 0.839, and C6 – 0.904. C6 values accounted for 79% of the variability of the AUC. Six patients experienced AR, with 5 having C0 within the target range. C6 values correlated best with AUC in these patients (C0 – 0.970, C2 – 0.833, C4 – 0.942, and C6 – 0.970). This was statistically significant. Three patients developed tacrolimus toxicity. In these patients, the correlation coefficients were C0 – 0.551, C2 – 0.556, C4 – 0.77, and C6 – 0.941. By regression analysis, we developed predictive equations. The equation AUC = 12.126 + 2.81 × C0 + 2.92 × C6 best predicted the AUC.

Conclusions:

Overall C6 levels were more predictive of the AUC, accurately predicting AR and nephrotoxicity. Incorporating C6 may improve tacrolimus therapeutic drug monitoring.
Unusual Presentation of Posttransplant Renal Artery Stenosis - A Case Report
Authors: Annavarajula Sashi Kiran , Suryaprakash B. , Kashinatham D. , Poddar Pawan
Published: September 2021

Transplant renal artery stenosis (TRAS) is a well-recognized and potentially treatable cause of early graft dysfunction. Recognition of TRAS can sometimes be difficult, and the presentation may mimic acute allograft rejection. A high index of suspicion along with arteriography is crucial in early recognition and management.
Varying Presentations of Pulmonary Nocardiosis in Kidney Transplant Recipients - Case Series
Authors: Shabeen Kumar , Sreedharan Sandeep , Polachirakkal Zachariah Paul , Shashindran Nandita , Mathew Anil , Kumar V. Ani , Kurian George , Nair Rajesh R.
Published: September 2021

Infections continue to be a significant cause of morbidity and mortality after solid organ transplantation. Early identification of the pathogenic organism is extremely important as the disease process might progress rapidly resulting in fatality. In this case series, we describe varying presentations of pulmonary nocardiosis, an uncommon opportunistic bacterial infection that often complicates the diagnosis of pneumonia, especially in immunocompromised patients. Although cough, fever, expectoration and breathlessness are the most common symptoms of pulmonary nocardiosis, they can also manifest as night sweats, weight loss and malaise. Some are incidentally diagnosed while being evaluated for other causes. Radiological features are also non-specific, usual findings being irregular nodules, cavitation, reticulo nodular diffuse pneumonia and pleural effusions. Bronchoalveolar lavage has the best diagnostic yield, but may have to be repeated several times to confirm a diagnosis, if the index of suspicion is high. Initial therapy with high dose trimethoprim- sulfamethoxazole is found to be effective in most of the cases. Duration of treatment should be a minimum of 6 months, and at least 12 months if central nervous system is affected. Other agents used for treatment include imipenem, minocycline, third generation cephalosporins, linezolid and amikacin. A high index of suspicion, with aggressive evaluation in an immunosuppressed individual will enable an early diagnosis, leading to prompt treatment and limit dissemination of disease thus preventing fatality.
Our Renal Transplant Protocols During COVID-19 Times – A Prospective Study from High-Volume Tertiary Center of North India
Authors: Sadasukhi Nripesh , Patel Ketul , Sadasukhi T. C. , Gupta Manish , Gupta H. L. , Sharma Ashish , Malik Sandeep
Published: September 2021

Introduction:

There is a strong temporal association between the increase in coronavirus disease-2019 (COVID-19) infections and a striking reduction in overall solid-organ transplantation procedure. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health-care systems in the backdrop of a virulent pandemic. Our current communication shares a protocol for donor and transplant recipient selection during the COVID-19 pandemic to continue lifesaving kidney transplantation. This protocol was created utilizing the guidelines of various organizations and from the clinical experience of the authors and will continue to evolve as more is understood about severe acute respiratory syndrome coronavirus 2 and how it affects organ donors and transplant recipients.

Objectives:

In this study, we aimed to review the published literature and compare it with our kidney transplantation is done in 115 patients in our hospital from July 2020 to February 2021 in the time of COVID-19 and what protocols we follow before transplant to reduce the risk of COVID-19 infection. This article also contains currently available immunosuppressive strategies.

Methods:

A prospective study was done in Mahatma Gandhi Hospital Jaipur for the transplant done from July 2020 to February 2021. A total of 115 patients from 20th July to 28th February were considered for the study.

Results:

All 115 patients who were COVID negative on reverse transcriptase–polymerase chain reaction assay and high-resolution computed tomography were considered for the transplant. COVID status on discharge for all 115 recipients was negative. During workup, two donors were found COVID-19 positive and were shifted to COVID center for treatment and their transplant postpone. Out of 115 renal transplant patients, only 1 patient became COVID-19 positive after 5 days of operation.

Conclusions:

Every transplant center should put its local policy about transplantation depending on the state of the epidemic in the country. Nowadays, transplantation programs should be limited to urgent cases. We suggest lowering the threshold for diagnosis of COVID-19 among renal transplant recipients.
Correlation of Three-Dimensional Computerized Tomographic Renal Parenchymal Volumetry with DTPA Split Renal Function in Prospective Donors - A Retrospective Study
Authors: Kale Pavankumar G. , Choudary G. P. Venkat , Sandeep P. , Lakshmi Amancharla Y. , Kumar V. Seva , Mantri Ranadheer
Published: September 2021

Introduction:

Split renal function (SRF) in prospective renal donors is traditionally measured by means of scintigraphy. Recent studies have reported the utility of three-dimensional computerized tomographic renal volumetry as an alternative to scintigraphy in estimating SRF. As computed tomography (CT) angio is done routinely for donors use of the same CT for estimating renal functions can eliminate the radiation from scintigraphy.

Methods:

In our study, renal volume was estimated on computerized tomographic renal angiography images using Siemens volumetry software by drawing contours manually on images, wherein we found the mean total renal volume to be 212.7 ± 38 CC and mean split renal volume to be 49.76 CC ± 2.86 and 50.23CC ± 2.86 on the right and left side, respectively.

Results:

This split renal volume was corrected to body mass index and surface area wherein we found significant correlation between renal volume and function when both were corrected to body surface area (P < 0.0001).

Conclusion:

From our results, it appears that computerized tomographic renal angiography not only depicts anatomy but also can give information about renal function which needs further confirmation.
Sequential Organ Failure Assessment Score for Predicting Outcome of Severely Ill Obstetric Patients Admitted to Intensive Care Unit
Authors: Srivastava Uma , Dwivedi Yogita , Verma Shiva , Kannaujia Ashish K. , Ambasta Suruchi , Lalramthara Israel
Published: September 2021

Background and Aim:

Severe maternal illness is a life-threatening condition for pregnant women and often requires admission into the ICU. The aim was to evaluate the performance of maximum sequential organ failure assessment (SOFA) score to predict the outcome of patients admitted to ICU.

Material and Methods:

This prospective study was done on 121 consecutive women with severe obstetric illness admitted to the ICU during one year. Basic demographic, obstetrical data, indication of admission to ICU and interventions done were noted. SOFA score was evaluated according to the worst score for each of its six components every 24 hr till discharge or death in ICU. The receiver-operator characteristic (ROC) curve was constructed to predict the outcome of ICU. For analysis, patients were categorized as survivors and non-survivors.

Results:

Out of 121 patients admitted, 65 survived and 56 died with mortality rate of 45.9%. There were no differences among survivor and non-survivor patients regarding demographic data, obstetrical data and interventions done, but anaemia and inadequate ante natal care was more common in non survivors. ICU utilisation rate of obstetric patients was 1.9%. Most patients were admitted due to obstetric causes (87.6%), mainly for hypertensive disorders (46%) and were post caesarean (84.29%). Total maximum SOFA scores were higher in non-survivors than in survivors (14.09 ± 5.53 vs 7.47 ± 4.58, P < 0.001). Area under curve (AUC) for SOFA score was 0.859, standard error 0.035, P < 0.001, showing good discriminatory power for predicting mortality in ICU.

Conclusion:

SOFA score is an effective tool to predict outcome of severely ill obstetric patients admitted to ICU.