bluuebunny/crossref_metadata_2025 huggingface dataset:
The specificities of risk identification and express estimation of investment projects in modern conditions
Authors: Chechenova Liana , Volykhina Natalya , Egorov Yuriy
Published: May 2019

Objective: When assessing the risks of an investment project, it is necessary to take into account the uniqueness of each project, which requires the search for completely new solutions, the application and combination of various tools and assessment methods for the effective implementation of the project. The objective is to develop and test an algorithm for express risk assessment of an investment project using an integral risk factor. In order to achieve this the following issues are considered: the development of the risk theory and the main stages of its development, the modern concept of risk and risk classification in the context of investment projects, modern methods for assessing the risks of investment projects and their problems. Next, the concept of an integral risk factor is introduced and an express assessment of risks of a local investment project is carried out using an integral risk factor. Methods: The classical methods of identifying and assessing project risks (the method of expert estimates, the Monte-Carlo simulation method), the comparative method, analysis, and synthesis are used in the study. Results: The basic characteristics of the concept of “risk” inherent in the modern understanding were formulated. A new concept of the integral risk factor and the method of its calculation were proposed. Alternative scenarios for the implementation of the investment project using the integral risk factor were developed. An algorithm for complex risk express assessment of an investment project on a multi-brand dealer auto center construction was developed by means of an integral risk factor and Monte-Carlo simulation method. Practical importance: The developed algorithm can be used by managers to identify and evaluate or carry out an express assessment of complex risks of investment projects in the process of operating real projects, as well as to provide background for developing new and more advanced methods of project risks assessment.
Differential Role of TGF-β in Extracellular Matrix Regulation during Trypanosoma cruzi—Host Cell Interaction
Authors: Silva Tatiana Araujo , Ferreira Luis Felipe de Carvalho , Pereira Mirian Claudia de Souza , Calvet Claudia Magalhaes
Published: May 2019

Transforming growth factor beta (TGF-β) is a determinant for inflammation and fibrosis in cardiac and skeletal muscle in Chagas disease. To determine its regulatory mechanisms, we investigated the response of T. cruzi-infected cardiomyocytes (CM), cardiac fibroblasts (CF) and L6E9 skeletal myoblasts to TGF-β. Cultures of CM, CF and L6E9 were infected with T. cruzi (Y strain) and treated with TGF-β (1–10 ng/mL, 1h or 48 h). Fibronectin (FN) distribution was analyzed by immunofluorescence and Western blot (WB). Phosphorylated SMAD2 (PS2), phospho-p38 (p-p38), and phospho-c-Jun (p-c-Jun) signaling were evaluated by WB. CF and L6E9 showed an increase in FN from 1 ng/mL of TGF-β, while CM displayed FN modulation only after 10 ng/mL treatment. CF and L6E9 showed higher PS2 levels than CM, while p38 is less stimulated in CF than CM and L6E9. After T. cruzi infection, localized FN disorganization was observed in infected CF and L6E9. T. cruzi induced an increase in FN in CF cultures, mainly in uninfected cells. Infected CF cultures treated with TGF-β showed a reduction in PS2 and an increase in p-p38 and p-c-Jun levels. Our data suggest that p38 and c-Jun pathways may be participating in the fibrosis regulatory process mediated by TGF-β after T. cruzi infection.
Rediscovering the Ethical Priority of the Most Actionable System of Biomolecules—The Metabolome
Authors: Lewis Cecil M. , McCall Laura-Isobel , Sharp Richard , Spicer Paul G.
Published: May 2019

A remarkable feature of US federal investments in human genetics has been the availability of parallel funding for studies examining ethical, legal and social implications (ELSI). This funding has allowed ELSI researchers to develop new strategies to understand genetics, evaluate the benefits of genetic testing, and propose health policy that maximize the promise while minimizing harms. Despite successes, a consequence of this investment is the preoccupation with what is arguably the least actionable system of biomolecules, human DNA. In contrast, the most actionable system of biomolecules, the metabolome, is grossly understudied, despite its often more alarming ELSI.
Electrocautery Damage Can Reduce Implant Fatigue Strength
Authors: Sonntag Robert , Gibmeier Jens , Pulvermacher Samuel , Mueller Ulrike , Eckert Johannes , Braun Steffen , Reichkendler Markus , Kretzer J. Philippe
Published: May 2019

Background:

The risk of femoral stem fracture after total hip replacement is low and can often be associated with a specific implant system or other factors that may reduce the fatigue strength. Additionally, damage to a metal component during revision surgery by an electrocautery device may further affect the fatigue behavior.

Methods:

Two clinical cases of stem failure after revision of fractured ceramic components are presented; the retrieved components were analyzed for the cause of failure. In vitro cyclic load-to-failure testing of titanium alloy femoral stems after electrocautery application at 2 different locations (at the base and about midway on the femoral neck) was performed using a stepwise increase in load until implant fracture occurred. In addition, a detailed characterization of the local material structure around the electrocautery marks was performed.

Results:

Superficial discoloration and melting marks were found on the retrieved components, including at the location of crack initiation in the anterolateral region, which may have reduced the fatigue strength of the material. In addition, elemental analysis indicated material transfer from the electrocautery tip. Damage to the surface by the electrocautery device significantly reduced the in vitro load to failure by up to 47% compared with that of undamaged femoral neck specimens. Material analysis revealed a relevant modification in microstructure, with an extension of approximately 2.7 mm and a depth of 550 µm, which could be divided in 3 structural zones.

Conclusions:

Intraoperative electrocautery device contact with the implant during surgical revision of a total hip replacement cannot always be avoided. However, on the basis of our findings, the risk of implant failure is increased due to a change in microstructure and a potential reduction of the implant’s fatigue strength. Surgeons and manufacturers of electrocautery devices should be aware of this concern.

Clinical Relevance:

During revision surgery, contact between an electrocautery device and the femoral component should be avoided to reduce the chance of subsequent femoral neck fracture.
Risk Factors for Delayed Presentation Among Patients with Musculoskeletal Injuries in Malawi
Authors: Agarwal-Harding Kiran J. , Chokotho Linda C. , Mkandawire Nyengo C. , Martin Claude , Losina Elena , Katz Jeffrey N.
Published: May 2019

Background:

The burden of injuries is high in low-income and middle-income countries such as Malawi, where access to musculoskeletal trauma care is limited. Delayed treatment can worsen trauma-related disability. Understanding risk factors for delayed hospital presentation will assist in guiding trauma system development.

Methods:

We examined the records of 1,380 pediatric and adult patients with fractures who presented to the orthopaedic clinics of 2 urban referral hospitals and 2 rural district hospitals in Malawi. We used multivariate Poisson regression to evaluate the association between presentation to a hospital ≥2 days after the injury (delayed presentation) and 11 covariates: age, sex, education level, occupation, season of injury, day of injury, injury mechanism, injury type or extremity of injury, referral status, hospital of presentation, and estimated travel time.

Results:

Twenty-eight percent of pediatric patients and 34% of adult patients presented late. In the pediatric cohort, fall (relative risk [RR], 1.40 [95% confidence interval (CI), 1.02 to 1.93]), sports injuries (RR, 1.65 [95% CI, 1.09 to 2.49]), tibial or fibular injuries (RR, 1.36 [95% CI, 1.05 to 1.77]), injury over the weekend (RR, 2.30 [95% CI, 1.88 to 2.80]), estimated travel time of ≥20 minutes (RR, 1.45 [95% CI, 1.16 to 1.81]), referral from another facility (RR, 1.46 [95% CI, 1.05 to 2.02]), and presentation to Kamuzu Central Hospital, Mangochi District Hospital, or Nkhata Bay District Hospital (RR, 1.34 [95% CI, 1.07 to 1.69]) independently increased the risk of delayed presentation. In the adult cohort, fall (RR, 1.85 [95% CI, 1.38 to 2.46]), injury over the weekend (RR, 1.80 [95% CI, 1.38 to 2.36]), estimated travel time ≥20 minutes (RR, 1.36 [95% CI, 1.03 to 1.80]), and presentation to Kamuzu Central Hospital (RR, 1.74 [95% CI, 1.30 to 2.33]) independently increased the risk of delayed presentation.

Conclusions:

Delayed presentation to the hospital after a musculoskeletal injury is common in Malawi. Interventions are needed to improve access to musculoskeletal trauma care, especially for pediatric patients with tibial or fibular injuries, all patients after falls, patients injured over the weekend, and patients living far from health facilities.
International Expert Consensus on a Cell Therapy Communication Tool: DOSES
Authors: Murray Iain R. , Chahla Jorge , Safran Marc R. , Krych Aaron J. , Saris Daniel B.F. , Caplan Arnold I. , LaPrade Robert F. ,   on behalf of the Cell Therapies Communication Expert Group
Published: May 2019

Background:

The lack of a standardized system for describing cell therapies acts as a barrier to advancement in clinical and basic research and practice. The aim of this study was to establish an international expert consensus on strategies to improve standardization and transparency when describing cell therapies. The secondary aim was to develop a consensus among experts on the contents of a standardized tool for describing cell therapies.

Methods:

The need for expert consensus on strategies to improve cell therapy communication was confirmed at the American Academy of Orthopaedic Surgeons/National Institutes of Health Optimizing Clinical Use of Biologics Symposium in 2018. A working group of 6 experts convened an international consensus process involving clinicians and basic scientists using validated Delphi methodology. This iterative process was used to define statements on communication of cell therapies and develop a standardized tool for describing cell therapies.

Results:

Thirty-four experts completed 3 rounds survey with use of the Delphi process. After 3 rounds, 27 statements relating to existing nomenclature, solutions to improve communication, ideal characteristics of a framework, mandatory elements of a new framework, and future work to facilitate application reached consensus with >80% agreement and <5% disagreement. Consensus was reached on the contents of a tool for improving standardization and transparency when describing cell therapies. This tool, dubbed “DOSES,” is based on the reporting of 5 core items: donor (i.e., autologous, allogeneic, xenogeneic), origin of tissue, separation from other cell types/preparation method, exhibited cell characteristics associated with behavior, and the site of delivery.

Conclusions:

This study has established expert consensus on the communication of cell therapies. The DOSES tool has been developed to improve standardization and transparency in describing cell therapies.

Clinical Relevance:

The DOSES tool for describing cell therapies can be utilized by researchers, clinicians, regulators, and industry professionals to improve standardization and transparency when describing cell therapies. The use of this tool may allow clinicians and patients to better understand the characteristics of current and future cell preparations.
An Effort to Improve Students’ Activeness at Structure Class Using Slido App
Authors: Muthmainnah Nur
Published: May 2019

This research was conducted to improve students’ activeness at structure class by sharing their idea, comment, questions and structure mastery. This research applied slido.com application as the media to teach. It was a classroom action research which had been conducted in two cycles. The subjects of this research were the third semester students of English Education Department of IAIN Salatiga. The writer took one of 3 classes as the sample of the research randomly. The researcher observed the improvement of students’ activeness at structure class by collecting the data through observation and measurement technique. The data were in the form of observation checklist and field notes, documentation, and students’ task. The data which were collected were analyzed to know the description of the class activity and the learning progress.  After the cycles conducted, it resulted that there ware improvement in students’ activeness in delivering questions, giving comments, and doing simple task. The description of result was also proven with the students’ mean score improved from 51 in their pre-test into 67 in the second cycle. It can be drawn a conclusion that there is an improvement in students’ activeness in the structure class taught using slido application.
Keberlanjutan Komoditas Kakao Sebagai Produk Unggulan Agroindustri dalam Meningkatkan Kesejahteraan Petani
Authors: Nurhadi Eko , Hidayat Syarif Imam , Indah Pawana Nur , Widayanti Sri , Harya Gyska Indah
Published: May 2019

Tidak sedikit petani menjual hasil panen pertanian berupa produk primer. Pengolahan hasil untuk memberikan nilai tambah sebagai alternatif meningkatkan pendapatan dan kesejahteraan belum membudaya. Beberapa kendala teknis, ekonomis, sosial, dan manajerial dihadapi petani. Penelitian ini bertujuan (1) melakukan monitoring dan evaluasi terhadap kesejahteraan petani kakao rakyat dan advokasi pengembangan agroindustri mamin kakao, dan (2) Memberikan pendampingan petani dalam pemasaran produk kakao, penataan kelembagaan dan pengendalian mutu. Analisis data menggunakan statistika deskriptif dan analisis Partial Least Square (PLS). Sebagai produsen pemula agroindustri mamin kakao, petani rentan gagal dalam mengembangkan bisnis. Keberlanjutan usaha dan kesejahteraan petani memerlukan pendampingan intensif dari semua pihak.
Reducing provider workload while preserving patient safety via a 2-way texting intervention in Zimbabwe’s voluntary medical male circumcision program: study protocol for an un-blinded, prospective, non-inferiority, randomized controlled trial
Authors: Feldacker Caryl , Murenje Vernon , Barnhart Scott , Xaba Sinokuthemba , Makunike-Chikwinya Batsirai , Holeman Isaac , Tshimanga Mufuta
Published: May 2019

Background: Surgical male circumcision (MC) safely reduces risk of female-to-male HIV-1 transmission by up to 60%. The average rate of global moderate and severe adverse events (AEs) is 0.8%: 99% of men heal from MC without incident. To reach the 2016 global MC target of 20 million, productivity must double in countries plagued by severe healthcare worker shortages like Zimbabwe. The ZAZIC consortium partners with the Zimbabwe Ministry of Health and Child Care and performed over 120,000 MCs. MC care in Zimbabwe requires in-person, follow-up visits at post-operative days 2,7, and 42. ZAZIC program adverse event rate is 0.4%; therefore, overstretched clinic staff conducted more than 200,000 unnecessary reviews for MC clients without complications.
Methods: Through an un-blinded, prospective, randomized, control trial in two high-volume MC facilities, we will compare two groups of adult MC clients with cell phones randomized 1:1 into two groups: 1) routine care (control group N=361) and 2) clients who receive and respond to a daily text with in-person follow-up only if desired or if a complication is suspected (intervention N=361). If an intervention client responds affirmatively to any automated daily text with a suspected AE, an MC nurse will exchange manual, modifiable, scripted texts with the client to determine symptoms and severity, requesting an in-person visit if desired or warranted. Both arms will complete a study-specific, Day 14, in-person, follow-up review for verification of self-reports (intervention) and comparison (control). Data collection includes extraction of routine client MC records, study-specific database reports, and participant usability surveys. Intent-to-treat (ITT) analysis will explore differences between groups to determine if two-way texting (2wT) can safely reduce MC follow-up visits; estimate the cost savings associated with 2wT over routine MC follow-up; and assess the acceptability and feasibility of 2wT for scale-up.
Discussion: It is expected that this mobile health intervention will be as safe as routine care while providing distinct advantages in efficiency, costs, and reduced healthcare worker burden. The success of this intervention could lead to adaptation and adoption of this intervention at the national level, increasing efficiency of MC scale up, reducing burdens on providers and patients.

Clinical Trial Registration Number

NCT03119337
A large number of cerebral microbleeds in CADASIL patients presenting with recurrent seizures: A case report
Authors: Anamnart Chumpol , Songsaeng Dittapong , Chanprasert Sirisak
Published: May 2019

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy associated with the NOTCH3 gene. Clinical manifestations include strokes, transient ischaemic events, psychiatric disturbances, dementia, and migraines. We report a case of a Thai man with a severe CADASIL phenotype who presented with recurrent seizures and acute ischaemic stroke and classic vascular risk factors.
Case presentation: A 50-year-old man with a history of mood disorder and progressive cognitive decline for 20 years as well as well-controlled diabetes mellitus and hypertension presented with recurrent generalized seizures and acute right-sided weakness. An MRI of the brain showed acute infarction of the left pons, a large number of cerebral microbleeds throughout the brain and white matter abnormalities without classic anterior temporal lobe lesions. Molecular genetic testing identified a homozygous pathologic variant, c.1672C>T (p. Arg558Cys), in the NOTCH3 gene. The diagnosis of CADASIL was confirmed. His clinical symptoms deteriorated, and he died of tracheobronchitis with secretion obstruction.
Conclusion: This case raises awareness of an uncommon cause of acute ischaemic stroke in patients with classic vascular risk factors and emphasizes the need for a complete evaluation in cases with unexpected clinical presentation or unexpected diagnostic study results.
Food‐Grade Maize Composition, Evaluation, and Genetics for Masa‐Based Products
Authors: Holmes Mark , Renk Jonathan S. , Coaldrake Peter , Kalambur Sathya , Schmitz Chuck , Anderson Nickolas , Gusmini Gabe , Annor George , Hirsch Candice N.
Published: May 2019

Maize (Zea mays L.) masa (dough or flour that is soaked and cooked in an alkaline solution in the nixtamlization process) based products have been consumed by humans worldwide for thousands of years. Still, there is not a comprehensive understanding of the chemical and physical properties of maize that contribute to masa quality. Starches and proteins affect the alkaline processing of maize but are seldom discussed in a holistic way to understand their individual and combined effects on masa production, particularly in the context of the entire food system from breeding to evaluation to product development and production. In this review, the food‐grade maize production chain is described including current breeding efforts and grain evaluation methods. The compositions of starches and prolamin proteins are also discussed relative to their effect on masa properties. Understanding the interactions of grain endosperm components and final product quality of maize masa‐based products will allow for more efficient breeding and food processing operations in the future.
Home and overseas experience in developing turquoise organization
Authors: Butov A. V.
Published: May 2019

Transformation of organizations is a regular and continuous process proving the development of all spheres of economy and society. The article deals with the theory and practice of establishing organizations of the new type, which can reveal the potential of every employee. The author investigated the evolution of organization development for the last 100 years, showed the foundations of the theory of turquoise organizations by F. Lalu and described three discoveries of this theory and the essential characteristics of the turquoise organizations, which could crucially change the current system of management and provide a real breakthrough in raising its efficiency. Special attention is paid to specificity of introducing the model of turquoise organization in Russian and overseas companies. Key elements of the organizational model of well-known foreign turquoise companies, such as Buurtzorg, Sun Hydraulics, FAVI, working in different fields, were given in the article. Competitive advantages of these companies working by turquoise principles of management and showing fast growth in key lines of activity were demonstrated. The author studied the experience of establishing turquoise organizations in Russia (the VkusVill company, the Saving bank, the Modulbank and the internet-bank Tochka) and identified the basic turquoise principles introduced in management of these organizations, their results and prospects of development and analyzed problems connected with limited use of the turquoise model. The article provides concrete recommendations aimed at introduction of turquoise principles in practice of Russian companies’ work.
Certain mechanisms of establishing economy of sustainable industrial growth in Russia and problems of their implementation
Authors: Poletaeva V. M. , Smulov A. M.
Published: May 2019

The development of Russian economy at the present stage is connected with a number of difficulties hindering its shift from the ineffective raw material export model to the model of sustainable industrial growth. The essential drawback of the raw material export model aimed at extraction and export of mineral resources and import of industrial and consumer goods is a low resistance of economic growth to the impact of different factors, such as the situation on global commodity and finance markets, geo-political and economic circumstances in other countries. In contrast to the raw material export model the foundation of the model of sustainable industrial growth is formed by technologically developed manufacturing industry, the so-called locomotive industries characterized by high labour productivity, which provides a rise in putting out products showing competitiveness both on home and overseas markets. Due to this fact such products will be able to meet a considerable proportion of demand on the part of enterprises and population of the country for industrial goods and consumer goods and at the same time to make up a serious share in the export structure. The article deals with two key groups of mechanisms providing the shift of Russian economy from the ineffective raw material export model to the model of sustainable industrial growth, i.e. finance and non-finance ones. The authors analyzed principle difficulties hindering these mechanisms’ implementation in Russia: inability of non-finance mechanisms to guarantee the rise in quality and competitivenessof home-made goods; disparity of resources’ volume to needs of the national economic system in investment; obvious disproportion in districting funds by types of economic activity; the use of enterprises’ own resources for investment, etc.
Temporal Variation in Antibiotic Resistance of Acinetobacter baumannii in a Teaching Hospital in Tunisia: Correlation with Antimicrobial Consumption
Authors: Nadia Jaidane , Wejdene Mansour , Remy A. Bonnin , Meriam Ghardallou , Cherifa Chaouch , Rachida Golli , Nesrine Kalboussi , Noureddine Boujaafar , Olfa Bouallegue , Thierry Naas
Published: May 2019

Background:

To investigate the potential correlation between the rates of antimicrobial drug consumption and the prevalence of antimicrobial resistance among clinical Acinetobacter baumannii recovered in a tertiary care hospital in Tunisia.

Methods:

The microbiological and epidemiological profiles of A. baumannii infections at the Hospital Sahloul, Sousse, were investigated between 2001 to 2004 and 2012 to 2015 along with the consumption record of broad-spectrum antibiotics.

Results:

Our data showed that extensively drug-resistant A. baumannii (XDRAb) isolates increased from 11.2% to 30.5% between 2012 and 2015 and disseminated endemically for a long time. Furthermore, we evidenced a drastic increase of carbapenem-resistant A. baumannii isolates from 29.5% in 2001 up to 88.6% in 2015 (612/691). This rise could be paralleled with a significant increase in antibiotic consumption over the last 15 years, especially with the sharp increase in the annual consumption of imipenem (r = 0.816 and p <103). A noteworthy correlation between carbapenem use and resistance rate (r = 0.778, p<0.001) was evidenced.

Conclusion:

Feedback of these data to clinicians and decision-makers in the local setting was crucial to promote the rational use of antimicrobials and to raise awareness to strictly implement hygiene measures to limit the spread of these XDRAb isolates, to prevent colonization and subsequent infection.
Baseline Characteristics of Patients with Ankylosing Spondylitis and Psoriatic Arthritis Treated with Secukinumab in the Real-World Setting: AQUILA, a Non-Interventional Study
Authors: Kiltz Uta , Legeler Carolin , Maier-Peuschel Monika , Mann Christian , Tony Hans-Peter
Published: May 2019

Objective:

AQUILA is an ongoing, multicenter, prospective, Non-Interventional Study (NIS) with secukinumab, designed to evaluate real-world evidence for different aspects of treatment in patients with Ankylosing Spondylitis (AS) and psoriatic arthritis (PsA) in Germany. Here we report the study design and baseline characteristics including comorbidities and prior medication of patients as well as insights into medical care in Germany.

Methods:

Patients (age ≥18 years) with active AS or PsA, who were under secukinumab treatment or just about initiating secukinumab therapy based on medical therapeutic need,
are
enrolled. Each patient
is
observed for 52 weeks.

Results:

A total of 572 patients (AS, n = 187; PsA, n = 385) have been recruited in this ongoing study. Mean age, weight, and BMI were similar between the subgroups. About 66.4% of patients had previously received biologics other than secukinumab. Depression was the most common comorbidity (AS, 9.1%; PsA, 15.6%). Plaque psoriasis was also frequently reported (AS, 9.6%; PsA, 62.3%).

Conclusion:

The Non-Interventional Study (NIS) baseline characteristics indicate that the demographics were similar to populations of previous secukinumab trials of AS and PsA patients except
to
comorbidities and exposure to biologics. A majority of the patients who received secukinumab in this setting had previously received biologics. Comorbidities relating to obesity and cardiovascular disease were particularly evident in PsA patients whereas the elevated depression prevalence was equally distributed.
Diagnostic and Therapeutic Challenges of a Slipped Capital Femoral Epiphysis in a Low and Middle Income Country: A Case Report and Literature Review
Authors: Mbonda Aimé , Tchuenkam Landry W , Tochie Joel Noutakdie , Abogo Serges , Essomba René
Published: May 2019

Background:

Slipped Capital Femoral Epiphysis (SCFE) is an incapacitating orthopedic disease, particularly affecting older children and adolescents and caused by the sliding of the proximal femoral epiphysis on the metaphysis. SCFE has a clinical polymorphism, compounded with a certain diagnostic variability among health practitioners and the relatively high cost of its surgical management contribute to the diagnostic delay observed in most developed countries as well as developing ones. Herein, we report the case of SCFE in an adolescent Cameroonian, with emphasis on its diagnostic and therapeutic challenges in Low and Middle-Income Countries (LMICs), in a bit to improve on timely recognition and management by clinicians in these settings.

Case Presentation:

A 10-year-old girl has presented with unilateral right thigh pain of more than one year duration associated with a limping gait and no fever. Before the referral to our health facility, she consulted several general practitioners in rural areas and pediatricians in the city with no definite diagnosis. On the basis of the clinical and the imaging studies, the diagnosis of stable right SCFE with moderate displacement was made. Under general anesthesia, the patient underwent open reduction and internal fixation with three pins under c-arm fluoroscopy. Clinical and radiological follow-up till one year after surgical intervention were satisfactory. The pins were removed after one year of fixation confirming a good bone fusion in plain x-ray. Her clinical examination and radiological follow-up three years after removal of the pins were satisfactory.

Conclusion:

The case report illustrates that SCFE often a missed diagnosis in LMICs. This is worrisome because delayed diagnosis may lead to long-term complications such as avascular necrosis and early degenerative joint disease. Although the above case was missed by several clinicians and finally diagnose late, the present case highlights the need for a high index of clinical suspicion in order to timely diagnose and timely manage SCFE to avert potential long-term physical disabilities and psychological trauma in children.
Same-Site Deep Sclerectomy Re-Operation with Subconjunctival and Subscleral Collagen Matrix (Ologen™) and Minimal use of Mitomycin C
Authors: Díaz-Aljaro Pablo , Loscos-Arenas Jordi , Romera-Romero Pau , Romanic-Bubalo Nevena , Grixolli-Mazzon Stefano , X Valldeperas
Published: May 2019

Purpose:

This study aimed to evaluate the safety and efficacy of same-site Deep Sclerectomy (DS) re-operation with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C in cases of late failure blebs.

Methods:

A prospective evaluation of consecutive patients on which same-site DS was performed with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C; all performed at a single university institution. Intraocular pressure (IOP), number of glaucoma medications, postoperative interventions, postoperative complications and surgical success were registered at 24 hours, 1, 6 and 12 months after the surgery.

Results:

Twenty-five eyes of 25 patients were included in this study. Time from first DS was 55.08 ± 28.16 months. Mean preoperative IOP was 20.88 ± 6.06 mmHg and it was reduced to 16.64 ± 4.02 mmHg, at 12 months after re-operation (p 0,007). At this final visit, requirements for topical medications dropped from a mean of 2.2 ± 1.0 to 0.72 ± 1.0 per patient and no medications were required in 60% of patients. Success was 36 % in criteria A (IOP ≤15mmHg), 72% in criteria B (IOP ≤18 mmHg) and 80 % in criteria C (IOP ≤15 mmHg), 12 months after the second surgery.

Conclusion:

The same-site DS re-operation with subconjunctival and subscleral collagen matrix (Ologen®) and minimal use of mitomycin C is a safe and adequate technique for the reduction of IOP, especially when targeted IOP is not lower than 15mmHg.
Preemptive Alveolar Recruitment Maneuver Followed by PEEP in Obese Patients Undergoing Laparoscopic Gastric Banding. Does it make a Difference? A Randomized Controlled Clinical Study
Authors: Elokda Sherif A. , Farag Hanan M.
Published: May 2019

Background:

Impaired respiratory functions during general anesthesia are commonly caused by lung atelectasis more in morbidly obese patients. This occurs more frequently with laparoscopic surgery due to trendelenburg position and pneumoperitoneum. Preemptive recruitment maneuver + PEEP results in the prevention of these changes.

Aim:

To quantitate the effects of RM and PEEP on intraoperative hypoxemia and respiratory mechanics during laparoscopic gastric banding in obese patients.

Study Design:

A randomized, double-blinded, controlled study.

Method and Materials:

Fifty adults ASA I-II, BMI (40-50 kg/m2) for elective laparoscopic gastric banding were randomized into, groups C, and RM, 25 patients each. Group C patients received standard ventilation, VT 6 ml/kg, I: E ratio 1: 2 PEEP 5 cm H2O, and respiratory rate 10-12 breaths/ min. RM patients received standard ventilation with one alveolar recruitment maneuver after mechanical ventilation with PEEP of 15 cm H2O till the end of the surgery. Heart rate, mean blood pressure, respiratory mechanical parameters: peak airway pressure, plateau pressure and end-expiratory lung volume, PaO2, PaO2/FiO2 and (SpO2) were assessed.

Results:

PaO2 and PaO2/FiO2 ratio increased significantly in the RM group after RM from T2 (before pneumoperitoneum) to T6 (end of surgery) compared with group C (P < 0.001). Peak and plateau airway pressures increased significantly in group C from T2 till T5 (60 min after pneumoperitoneum) compared with the RM group (P < 0.001). End-expiratory lung volume increased significantly in the RM group after RM compared with group C (P<0.001).

Conclusion:

Preemptive RM with PEEP of 15 cm H2O was effective in preventing pneumoperitoneum-induced intraoperative hypoxemia and respiratory mechanics changes.
Predictive Validity of a Caries Risk Assessment Model at a Dental School
Authors: Brons‐Piche Emily , Eckert George J. , Fontana Margherita
Published: May 2019

Caries risk assessment (CRA) is an essential component informing clinical decision making for personalized caries management. The aim of this study was to assess the predictive validity of the CRA model used at the University of Michigan School of Dentistry. Data from patients treated in the school's adult integrated clinics between 2011 and 2014 who had a CRA documented were accessed from the electronic health record. Data extracted included caries risk category, date of reassessments, presence of caries risk indicators/factors, and treatments completed. Out of 2,449 patients who had a CRA completed in 2011, 447 had one or more reassessments at least 180 days after the initial CRA. Caries risk status was significantly associated (p<0.0001) with the number of new caries‐related treatments during follow‐up, with significant increases (p<0.01) in these needs for each caries risk level. For the 11,152 patients with a completed CRA in 2011‐14, the prediction model (area under the curve=0.82) included the following risk factors significantly (p<0.001) associated with increased caries experience/needs over time: stagnant plaque (OR 2.6, 95% CI 2.4, 2.9), presence of salivary risk factors (OR 2.6, 95% CI 2.2, 2.9), presence of dietary risk factors (OR 3.2, 95% CI 2.9, 3.6), lack of adequate protective factors (OR 2.1, 95% CI 1.8, 2.4), presence of conditions that affect compliance (OR 2.4, 95% CI 1.9, 3.1), and past/current caries experience (OR 23.7, 95% CI 21.1, 26.7). High risk patients were significantly more likely (p<0.0001) to have restorative, extraction, or endodontic treatments completed due to caries and less likely (p<0.0001) to have diagnostic procedures than low or moderate risk patients. These results suggest that the CRA model used at the dental school can help predict adult patients' future caries experience/needs.
Increasing Dental Students' Understanding of Population Surveillance Through Data Mining
Authors: Rai Nayanjot K. , Carey Clifton , Brunson Diane , Tiwari Tamanna
Published: May 2019

An understanding of population surveillance is important for predoctoral dental students, so they will comprehend the health needs of the population in order to provide needed care and promote overall health. The aim of this study was to teach data mining and surveillance methodologies to dental students and to assess the association between systemic health factors and tooth loss in patients visiting the University of Colorado School of Dental Medicine clinics. The students were calibrated to using the data mining methodologies from the Electronic Health Record (EHR) using a rubric and presentation by a faculty member. The EHR was reviewed for age, gender, race/ethnicity, number of natural teeth present, systemic diseases reported including cardiovascular disease and diabetes, and history of any form of tobacco use. A total of 1,338 patients who visited the clinics in spring 2017 were included in the study; of those, 354 (27%) had <20 teeth. The results showed greater odds of having <20 teeth for those who reported cardiovascular disease (OR=2.1, 95% CI 1.6, 2.7), diabetes (OR=1.7, 95% CI 1.2, 2.3), tobacco use (OR=1.4, 95% CI 1.0, 1.9), and being Hispanic (OR=1.4, 95% CI 1.0, 1.9). After adjusting for age, gender, and ethnicity, the odds of having <20 teeth for patients with tobacco use were found to be twice that of patients with no tobacco use (OR=2.1, 95% CI 1.5, 3.0). Understanding population surveillance could be beneficial in designing evidence‐based interventions at the dental school and community levels.
Comparison of Effectiveness of Two Teaching Methods on Acquisition of Skills in Preclinical Fixed Prosthodontics
Authors: Sadid‐Zadeh Ramtin , Sannito Nicole M. , DeLuca Joseph T.
Published: May 2019

The aim of this study was to evaluate the effects of dental faculty‐student interactions, virtual assessment software, and associated rubrics on student performance by assessing tooth preparations generated during the students' final practical exam. The study, conducted in 2017 and 2018, compared teeth prepared for preclinical fixed prosthodontics competency exams by two subsequent classes of second‐year dental students trained using different methods. Class A was trained for nine months prior to the exam using feedback via student‐faculty interactions and conventional rubrics. Class B was trained for five and half months prior to the exam via contemporary rubrics that incorporated feedback from both faculty and virtual assessment software. Two blinded, independent, and calibrated faculty members randomly evaluated the tooth preparations and graded them as excellent, standard, or standard not met for occlusal reduction, axial/lingual reduction, contour/long axis/axial wall height, finish line location, finish line quality, and finish of the preparation. The interrater agreement was slight to fair (0.01 < Kappa < 0.4) for evaluation of preparations. The teaching method did not have a significant impact (p>0.05) on student performance for the assessed criteria. These results suggest that, with the use of virtual assessment software, a course director may be able to shorten a course and obtain the same results as a nine‐month course.
Defining Endodontic Residents' Clinical Experiences: A National Survey
Authors: Blacher Jonathan D. , Safavi Kamran E. , Aseltine Robert H. , Kaufman Blythe M.
Published: May 2019

Endodontic residency programs across the U.S. vary in the exposure they provide to residents in procedures, protocols, and equipment. Having information on the range of clinical experiences provided in programs would be useful for program directors and for applicants who are seeking the best fit for their residency. The aim of this study was to collect information from residents in U.S. endodontic residency programs about the procedures and equipment they experienced in their programs. In January 2018, a 14‐question survey was emailed to all 437 endodontic residents with an email address in the 2016‐17 American Association of Endodontists Membership Directory. Survey items asked about the number of endodontic procedures, techniques employed, and products used in residents' programs. A total of 133 endodontic residents responded to all or part of the survey, for a 30% response rate. The majority reported completing 151‐250 nonsurgical root canals, 26‐50 nonsurgical retreatments, 0‐10 surgical retreatments, and 0‐10 regenerative endodontic procedures during their residencies. All respondents said they used a surgical operating microscope (SOM), and 82% reported using a multi‐file rotary system for nonsurgical procedures. Respondents reported that the main instruments they used were Dentsply Sirona file systems, and the most commonly used obturation technique was warm vertical compaction/condensation, reported by 92% of respondents. These endodontic residents reported being exposed to a variety of procedures, products, and protocols during their residency. Based on information they provided, prospective endodontic residency applicants can expect to use the SOM for treatment, to gain extensive experience in primary nonsurgical endodontic treatment, and to not perform endodontic surgery during their first year of postgraduate training.
Where Do Pediatric Dental Residents Intend to Practice? Exploring the Influence of Loan Repayment Programs and Other Factors
Authors: Alrayyes Sahar M. , Garrett Alan M. , LeHew Charles W. , Compton Anne Ashley
Published: May 2019

The high cost of dental education and consequent loan burdens contribute to the shortage of pediatric dental providers in rural areas (RAs). Economic incentives are meant to recruit practitioners to RAs. The aim of this study was to assess the ability of government subsidized loan repayment programs (GSLRPs) to recruit pediatric specialists to practice in RAs. A 26‐item questionnaire was emailed to all 921 pediatric dental residents across the U.S. in 2015 for a cross‐sectional study of factors influencing their choice of practice location. The instrument included information about GSLRPs, enabling the study to serve as a quasi‐experiment on the level of funding needed to make GSLRPs effective. A total of 169 residents responded, for an 18% response rate; 74% of respondents were women and 86% had student loan debt. Among the respondents, 40.6% said they would like to practice in RAs, but only 4.1% actually intended to do so. Over one‐third initially reported interest in GSLRPs for practicing in RAs. However, after being informed that the average GSLRP is $30,000 annually, one‐third of those lost interest. Although 14.2% said no amount would convince them to consider practice in an RA, over half (53.3%) indicated willingness to consider it if the GSLRP were $40,000‐$60,000. These results suggest that current GSLRP levels are insufficient to induce pediatric dentists to practice in RAs.
Motivation as a Predictor of Dental Students' Affective and Behavioral Outcomes: Does the Quality of Motivation Matter?
Authors: Orsini Cesar A. , Binnie Vivian I. , Jerez Oscar M.
Published: May 2019

Since the motivation to study and engage in academic activities plays a key role in students' learning experience and well‐being, gaining a better understanding of dental students' motivations can help educators implement interventions to support students' optimal motivations. The aim of this study, grounded in self‐determination theory, was to determine the predictive role of different types of motivation (autonomous motivation, controlled motivation, and amotivation) in the affective and behavioral outcomes of dental students. Amotivation is the absence of drive to pursue an activity due to a failure to establish relationships between activity and behavior; controlled motivation involves behaving under external pressure or demands; and autonomous motivation is an internalized behavior with a full sense of volition, interest, choice, and self‐determination. A cross‐sectional correlational study was conducted in 2016, in which 924 students (90.2% response rate) from years one to six agreed to participate, granting permission to access their current GPAs and completing four self‐reported questionnaires on academic motivation, study strategies, vitality, and self‐esteem. The results showed that self‐determined motivation (i.e., autonomous over controlled motivation) was positively associated with vitality, self‐esteem, and deep study strategies and negatively associated with surface study strategies. The contrary results were found for amotivation. In the motivational model, deep study strategies showed a positive association with students' academic performance. Contrary results were found for surface study strategies. This study extends understanding of the differentiation of motivation based on its quality types and suggests that being motivated does not necessarily lead to positive educational outcomes. Autonomous motivation, in contrast to controlled motivation and amotivation, should be supported to benefit students with regard to their approaches to learning and well‐being since it can promote students' vitality, self‐esteem, deep over surface study strategies, and enhanced academic performance.
Agreement Between Faculty and %Comparison for Preparation Depth Assessment in a Dental Technique Skills Course
Authors: Sadid‐Zadeh Ramtin , Lawson Brian , Hua Jia , Arany Hema
Published: May 2019

The aim of this retrospective study was to assess agreement between faculty and virtual assessment software in depth evaluation of rounded rectangular preparations in non‐anatomical teeth prepared by second‐year dental students. A total of 184 non‐anatomical ivorine mandibular first molars prepared by second‐year students were retrospectively evaluated in 2018. Each tooth was prepared to a depth of 1.5 mm within a laser‐marked outline using a 330 bur, as detailed in the technique skills course syllabus. Preparations were recorded using an intraoral scanner. Then, virtual assessment software was used to superimpose a three‐dimensional (3D) image of each preparation on a 3D image of a standard preparation produced by a faculty member. The software was used to calculate percentage comparison (%Comparison) values at 200 μm tolerance. Values of %Comparison ≥72% were considered satisfactory. In addition, each preparation depth was evaluated by two calibrated faculty members using a periodontal probe and a 330 bur. The preparation depth was considered satisfactory when more than 50% of the tooth preparation had a depth of 1.5 mm. The results showed almost perfect agreement (0.81 < kappa < 0.99) between faculty assessment and %Comparison value. The findings suggest that %Comparison values may be used to assess the tooth preparation depth of rounded rectangular preparations in non‐anatomical teeth when prepared in a laser‐marked outline.