bluuebunny/crossref_metadata_2025 huggingface dataset:
Endodontic surgery with simultaneous root canal filling: case report
Authors: Fernando Accorsi Orosco  , Lúcia Coelho Garcia Pereira  , Monica Misaé Endo  , Ralph Angeli Rangel  , Alexandre Silva Bramante  , Clóvis Monteiro Bramante
Published: June 2022

Endodontic surgery is an excellent alternative for solving problems unsolved by conventional treatments and/or root canal retreatment. Objective: This study aims to report a clinical case of an endodontic surgery with simultaneous root canal filling. Case report: The left mandibular lateral incisor (#32) showed constant exudation even after root canal instrumentation and many changes of calcium hydroxide paste as intracanal medication. So, the treatment´s option was the endodontic surgery with simultaneous root canal filling for removing the periapical lesion. After the root canal filling, the curettage and apical plasty were made and the bone cavity was filled with calcium sulfate. Histopathological examination pointed out a periapical cyst. Conclusion: Endodontic surgery with simultaneous root canal filling of the tooth #32 was successful, once the patient did not exhibited any clinical symptoms, the exudate disappeared, and radiographically, it can be observed the formation of bone repair. The time of follow-up was of four months.
Developmental anomalies affecting the morphology of teeth – a review
Authors: Ashish Shrestha  , Vinay Marla  , Sushmita Shrestha  , Iccha K Maharjan
Published: June 2022

The development of tooth is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. The role of genes in determining the shape and form of a specific tooth has already been defined, the alterations in which can lead to a variety of anomalies in regards to number, size, form, shape, structure, etc. Objective: To review the literature on the developmental anomalies of teeth. Literature review: The developmental anomalies affecting the morphology exists in both deciduous & permanent dentition and shows various forms such as gemination, fusion, concrescence, dilacerations, dens evaginatus, dens invaginatus, enamel pearls, taurodontism or peg laterals. These anomalies have clinical significance concerning esthetics, malocclusion and more importantly predisposing the development of dental caries and periodontal diseases. Conclusion: Knowledge of various diagnostic criteria for identification of these developmental anomalies is significant for early diagnosis and pertinent treatment.
Whitening gel and light source influence on pulp chamber temperature
Authors: Lígia Maria Lima Andreatta  , Ana Flávia Soares  , Juliana Fraga Soares Bombonatti  , Adilson Yoshio Furuse  , Rafael Francisco Lia Mondelli
Published: June 2022

The chemical injury caused to the pulp by the penetration of the whitening gel is already known, but another possible cause may be the heat generated by the irradiation of the whitening gel with light sources to accelerate the whitening reaction. Objective: To evaluate in vitro the temperature increasing in the pulp chamber during in-office bleaching with different gel concentrations and light sources. Material and methods: A maxillary human central incisor was used in the 6 groups evaluated. The specimen was sectioned 3 mm apical to the cementoenamel junction. The root canal and pulp chamber were cleaned and widened with a diamond bur to receive the sensor of a thermocouple thermometer. The following hydrogen peroxide gel concentrations were evaluated: 35%, 25%, 15%, and 10%; and the following light sources were applied: blue hybrid LED/laser and violet hybrid LED/laser. The specimen bleaching was repeated 6 times per group. As a control, the temperature was measured with the application of light, without applying any gel. Results were evaluated with one-way ANOVA and Tukey’s test (α = 5%). Results: Significant differences between groups were observed (p < 0.05). The blue LED without the gel induced the smallest heat (37.5 ± 0.2) and the blue LED with 15% gel caused the highest heat (38.2 ± 0.3). The combination of violet LED with the 10% gel caused no significant increase in temperature compared to the control in which light was used without gel (p> 0.05). Conclusion: No increase in pulp chamber temperature was higher than 2°C.
Clinical and radiographic assessment of root canal treatments performed by dental students
Authors: Andressa Benvenutti  , Micheli Scalvi  , Sinval Adalberto Rodrigues Junior  , Carla Battiston
Published: June 2022

Retrospective assessment of procedures performed in dental school clinics is a valuable tool to critically assess the teaching/ learning process. Objective: This retrospective study assessed the success rate of root canal treatments executed by dental students during a two-year time span. Material and methods: Patients who had undergone root canal treatments at the clinics of the School of Dentistry of Unochapecó during 2011-2013 were recalled for assessment of the quality of the procedure and the associated coronal restoration. The quality of the root canal treatments was assessed clinically and radiographically, while the coronal restorations were assessed clinically by a trained dental student. Data were analyzed by descriptive statistics and chi-square test (α=0.05). Results: Thirtytwo patients returned for evaluation of 38 root canal treatments and coronal restorations. The success of root canal treatments was 89.5%, while 78.5% of the coronal restorations were considered successful. A significant association was observed between the success of the root canal treatments and the quality of the coronal restoration (p<0.005) and the apical length of the root canal filling (p><0.011). The presence of flaws within the filling material was not significantly associated to the success/failure of the root canal treatment (p=0.459). Conclusion: A high success rate of root canal treatment performed by dental students at an average 13-month evaluation period was observed. An adequate coronal restoration and a good apical sealing is required for a good prognosis of teeth undergoing root canal treatment. ><0.005) and the apical length of the root canal filling (p<0.011). The presence of flaws within the filling material was not significantly associated to the success/failure of the root canal treatment (p=0.459). Conclusion: A high success rate of root canal treatment performed by dental students at an average 13-month evaluation period was observed. An adequate coronal restoration and a good apical sealing is required for a good prognosis of teeth undergoing root canal treatment.
Measurement of Spee curve in individuals with temporomandibular disorders: a cross-sectional study
Authors: Glaucia Marques Dias  , Letícia Ladeira Bonato  , Patrícia Rocha Coelho  , Josemar Parreira Guimarães  , Rafaela Ladeira Bonato
Published: June 2022

Several factors are cited as capable to influence the development of Temporomandibular Disorders (TMD), among them, the psychological, systemic, genetic, and occlusal factors. The curve of Spee is the factor directly related to the TMJ. However, the combination of variations in amplitude, and the presence of signs and symptoms of TMD have not been investigated. Objective: The aim of this study was to measure the curve of Spee in patients with TMD, through the use of study models, comparing these values with the different clinical and symptomatic presentations of such individuals. We evaluated 198 models of patients treated at the care service for patients with TMD at UFJF. The maximum depth of the curve was determined by the sum of the distances between the lowest part of the buccal cusp of the posterior teeth of each hemiarch to a reference plane, using a caliper to measure. The following factors were considered: gender, presence of myalgia (temporal, masseter, medial pterygoid, lateral and sternocleidomastoid muscles) and TMJ arthralgia, and the presence of occlusal interferences and parafunctional habit of bruxism. For statistical analysis, we used T-test and ANOVA test with a significance level of 5%. Conclusion: There was a statistically significant association between the presence of occlusal interferences and changes in the curve (p = 0.01). There was no association between the following factors: the presence of myalgia and/or arthralgia, gender, achievement of bruxism, and the type of TMD presented with changes in the Spee curve.
Bilateral maxillary osteoplasty with esthetic purpose in patient with secondary hyperparathyroidism-related brown tumor: case report
Authors: Bruna da Fonseca Wastner  , Vitor Hugo Candido Ferreira  , Juliana Lucena Schussel  , Roberta Targa Stramandinoli-Zanicotti  , Laurindo Moacir Sassi
Published: June 2022

To report a case of a patient with secondary hyperparathyroidism that developed brown tumour in bilateral maxilla surgically managed with bilateral osteoplasty for aesthetic reasons. Case report: A 46 years-old woman patient with chronic kidney disease with complain of a painless bilateral growth on the maxilla, beginning 10 years before that ceased after surgical removal of the parathyroid eight years before. A CT scan showed a diffuse and heterogeneous bone lesion, with lytic areas and increased multilobulated volume on the maxilla, bilaterally. The surgery was an osteoplasty of the maxilla bone and performed under general anaesthesia. At 16-month follow-up, no recurrence was observed and the patient is satisfied with aesthetic and functional results. Conclusion: Secondary hyperparathyroidism related with oral brown tumour is a rare condition that affects function and aesthetic. The case reported in this paper was appropriately managed, achieving patient expectation and improving her life quality.
A simplified restorative technique of fractured maxillary anterior teeth
Authors: Adilson Yoshio Furuse  , Fabio Antonio Piola Rizzante  , Rafael Francisco Lia Mondelli  , Juliana Fraga Soares Bombonatti
Published: June 2022

Fractures of the anterior teeth consists of a clinical condition that generates not only aesthetic and psychological problems, but may also cause dental pain. Thus, the affected teeth should be treated as urgencies in dental offices and their resolution whenever possible should be in a single session. Direct resin composite restorations should wherever possible be preferred due to the speed and possibility of obtaining good results. Objective: The objective of this case report is to describe the clinical sequence for restoration of a maxillary central incisor that presented a crown fracture using an immediate insert technique for resin composite (a "free hand" technique) with a modification to obtain dentin layer. Case report: A patient sought treatment after she fractured tooth #21. The restoration was performed with resin composite using the immediate technique. To facilitate the layering technique, the immediate insertion technique was changed for making the dentin lobes with the aid of a Teflon tape and the support with the index finger. Conclusion: The restoration of fractured anterior teeth can be performed quickly with the use of resin composites of different opacities and the use of the technique of immediate insertion proposed in this case report.
A Comprehensive Computational Perspective in Drug Discovery for
Alzheimer's Disease
Authors: Selvaraj Manikandan , Sadasivam Karthik , Jothimani Muralidharan , Muthusamy Karthikeyan
Published: June 2022

Alzheimer's Disease (AD), the most common and major disability issue in our society,
has a substantial economic impact. Despite substantial advances in aetiology, diagnosis, and therapy,
the fundamental causes of the disease remain unknown, accurate biomarkers are not well characterized,
and current pharmaceutical medications are not cost-effective. Effective care for Alzheimer's
disease and other types of dementia is crucial for patients' long-term health. Pathogenesis advances
have aroused the scientific community's interest in the creation of new pharmacological
treatments that target recognized disease targets throughout the previous two decades. Pharmacological
therapy has recently been assigned 10 - 20% of the direct costs of AD. Less than 20% of Alzheimer's
patients respond somewhat to standard medicines with questionable cost-effectiveness
(donepezil, galantamine, memantine and rivastigmine). Therefore, currently known treatment approaches
address the condition indirectly, as acetyl cholinesterase related inhibitors and the Nmethyl
d-aspartate as receptor and antagonists have little effect on the sickness. Novel targets and
specific small molecules must also be found in order to be useful in the therapy of AD. This chapter
examines a wide spectrum of Alzheimer's disease targets as well as contemporary progress in the
discovery of disease inhibitors. In addition, brief in-silico investigations were highlighted and provided
to understand how the theoretical lead in AD treatment development is attainable.
Apolipoprotein A1 Inhibits Adipogenesis Progression of Human
Adipose-Derived Mesenchymal Stem Cells
Authors: Su Xin , Wang Bin , Lai Min , Peng Hua , Song Jingjin , Huang Huaibin , Chen Xiang , Cheng Ye
Published: June 2022

Background:

According to the reports, the most vital characteristic of obesity
is an aberrant accumulation of triglycerides (TG) in the adipocyte. On the other hand,
circulating concentrations of apolipoprotein A1 (apoA1) have been demonstrated to be
strongly correlated with the prevalence and the pathological development of obesity.
Nevertheless, the underlying mechanisms whereby apoA1 modulates the pathogenesis
of obesity is still not fully elucidated.

Methods:

Adipose-derived mesenchymal stem cells (AMSCs, isolated from the
hospitalized patients were combined with 15 μg/ml recombined human apoA1 protein.
The effects of apoA1 on modulating the intracellular levels of TG and the expression
contents of adipogenic related cytokines were also analyzed. Furthermore, whether
apoA1 modulated the adipogenesis progression via sortilin was also explored in the
current research.

Results:

During the adipogenesis progression, apoA1 could significantly lower the
quantity of intracellular lipid droplets (LDs). Meanwhile, apoA1 could decrease the
intracellular levels of TG and down-regulate the expression contents of several vital
adipogenic related cytokines, such as CCAAT enhancer-binding proteins α/β
(C/EBPα/β), fatty acid synthetase (FAS), and fatty acid-binding protein 4 (FABP4).
Moreover, the inhibitory effect of apoA1 was further verified to be induced through upregulating
the SORT1 gene expression which subsequently increased sortilin protein.
Consistent with these findings, silencing the SORT1 gene expression could induce the
loss-of-function (LOF) of apoA1 in modulating the adipogenesis progression of AMSCs.

Conclusions:

In conclusion, apoA1 could suppress the adipogenesis progression of
human AMSCs through, at least partly, up-regulating the SORT1 gene expression which
subsequently increases the sortilin protein content. Thereby, the present research sheds
light on a novel pathogenic mechanism by which apoA1 regulates adipogenesis
progression and proposes that apoA1 embraces the function to treat obesity in clinical
practice.
Value of Rox Index to Predict Intubation and Intensive Care Unit
Outcome In Patients With Respiratory Failure
Authors: Mammadova Ayshan , Eriş Esra , Solmaz Zeynep Sena , Kara Ayşe Taşçı , Atasoy Aydın , Gürsel Gül
Published: June 2022

Background:

Recent literature suggests that the respiratory rate oxygenation (ROX) index
may be useful in predicting intubation indication in hypoxemic patients.

Objective:

In this study, we evaluated the accuracy of the ROX index in predicting intubation, length
of stay in the ICU, and mortality in ICU patients with hypoxemic respiratory failure with and without
hypercapnia.

Methods:

A single-centre retrospective cohort study of 290 patients with a preliminary diagnosis of
respiratory failure were treated with low-flow oxygen systems. Demographics, medical history,
clinical, laboratory, treatment, and prognostic data were obtained from the hospital's electronic
records. The ROX index was calculated at the time of ICU admission.

Results:

Thirty-seven percent of non-hypercapnic and 69% of hypercapnic patients were intubated
(p: 0.005). In hypercapnic patients, ROX: 6.9 had highest sensitivity (81%) and specificity (65%)
values for intubation (p: 0.005). In non-hypercapnic patients, ROX: 6.2 had the highest sensitivity
(81%) and specificity (40%) values. While 11% of hypercapnic patients and 30% of non-hypercapnic
patients died (p: 0.05), 22% of hypercapnic patients and 33% of non-hypercapnic patients stayed in
the ICU longer than 14 days (p: 0.044). The highest sensitivity and specificity values were found for
mortality in hypercapnic patients; for ROX value of 5.94 (sensitivity: 86%, specificity: 61%) and
ICU stay longer than 14 days; for ROX value of 7.4 (sensitivity:71%, specificity:68%).

Conclusion:

Results of our study suggest that the ROX index calculated during ICU admission can
help predict intubation indication and length of ICU stay in patients with respiratory failure and
hypercapnia may influence the cutoff values.
Phytochemicals and Nanoparticles in the Modulation of PI3K/Akt/mTOR
Kinases and its Implications in the Development and Progression of Gastrointestinal
Cancers: A Review of Preclinical and Clinical Evidence
Authors: Narayanankutty Arunaksharan , Nambiattil Sreelakshmi , Mannarakkal Sreeshna
Published: June 2022

Background:

Gastrointestinal cancer are the major form of cancer in developing countries,
which comprises gastric cancer (GC), hepatic cancer (HCC), colorectal cancers (CRC), etc.;
they account for a large number of cancer-related deaths globally. Gastrointestinal cancers generally
have a multifactorial origin, where both genetic and dietary factors play prominent roles. PI3K/Akt
signaling is the prime signaling pathway associated with the Phosphoinositide-3 kinase/protein kinase
B signaling pathway.

Objectives:

The present review aims to summarize the role of the PI3K/Akt signaling pathway on
the different events of gastrointestinal cancers, such as proliferation, survival, metastasis, angiogenesis,
drug resistance and stem cell properties.

Methods:

Literature collection has been done using the appropriate keywords from Pub-
Med/Medline, Scopus, Web of science, or Eurekaselect. The details of individual types of cancers
were selected by giving respective keywords.

Results:

PI3K signaling pathway is important in various gastrointestinal carcinogenesis and progression
events; the pathway is involved in proliferation, survival, metastasis, and drug resistance.
Several natural phytochemicals and their derivatives have been shown to inhibit PI3K signaling and
its downstream regulatory elements, subsequently resulting in anticancer and anti-metastatic activity.
Although numerous preclinical evidences are available, conclusive clinical reports are lacking on
the anticancer aspects of PI3K inhibitors in gastric cancer.

Conclusion:

Phytochemicals are promising drug candidates for targeting the PI3K/mTOR pathway
in various gastrointestinal cancer treatments. However, there is a need for extensive clinical studies
to ascertain the commercial value of anticancer therapeutic compounds against cancers of the stomach,
liver, and intestine.
Carbon-based Nanomaterials for Delivery of Small RNA Molecules:
A Focus on Potential Cancer Treatment Applications
Authors: Habib Saffiya , Singh Moganavelli
Published: June 2022

Background:

Nucleic acid-mediated therapy holds immense potential in treating recalcitrant
human diseases such as cancer. This is underscored by advances in understanding the mechanisms
of gene regulation. In particular, the endogenous protective mechanism of gene silencing known
as RNA interference (RNAi) has been extensively exploited.

Methods:

We review the developments from 2011 to 2021 using nano-graphene oxide, carbon nanotubes,
fullerenes, carbon nanohorns, carbon nanodots and nanodiamonds for the delivery of therapeutic
small RNA molecules.

Results:

Appropriately designed effector molecules such as small interfering RNA (siRNA) can, in
theory, silence the expression of any disease-causing gene. Alternatively, siRNA can be generated in
vivo by introducing plasmid-based short hairpin RNA (shRNA) expression vectors. Other small
RNAs, such as micro RNA (miRNA), also function in post-transcriptional gene regulation and are
aberrantly expressed under disease conditions. The miRNA-based therapy involves either restoration
of miRNA function through the introduction of miRNA mimics; or the inhibition of miRNA function
by delivering anti-miRNA oligomers. However, the large size, hydrophilicity, negative charge and
nuclease-sensitivity of nucleic acids necessitate an appropriate carrier for their introduction as medicine
into cells.

Conclusion:

While numerous organic and inorganic materials have been investigated for this purpose,
the perfect carrier agent remains elusive. Carbon-based nanomaterials have received widespread attention
in biotechnology recently due to their tunable surface characteristics and mechanical, electrical,
optical and chemical properties.
Exploration and Evaluation of In-vitro Antioxidant Activity of ABANA: A
Polyherbal Formulation
Authors: Bharati Deepak , Puri Abhijeet
Published: June 2022

Objective:

The purpose of this study was to determine the antioxidant capacity of Abana® (a poly-ingredient formulation with natural constituents).

Methods:

Extensive ethanol extraction of polyherbal formulations was followed by fractionation into petroleum ether, chloroform, and ethyl acetate extracts. Various fractions were further analyzed using this conventional method for phytochemical composition and concentration dependent antioxidant activity. Due to the presence of phenolic compounds in the formulation, extracts were analyzed for total phenolic content, flavonoid content, and in- vitro antioxidant activity. Antioxidant capacity was determined using total reducing potential, 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2-azinobis-ethyl-benzothiozoline-sulphonic acid diammonium salt (ABTS) and nitric oxide inhibition assays.

Results:

Primitive phytochemical screening revealed the presence of steroids, saponins, flavonoids, alkaloids and tannins which were confirmed using thin-layer chromatography. The antioxidant activity of Abana tablet extracts decreased in the order ethyl acetate > ethanolic > chloroform > petroleum ether comparable to that of ascorbic acid and butylated hydroxytoluene.

Conclusion:

The current investigation suggests that the ethanolic extract and fractions of Abana polyherbal formulations exhibit significant antioxidant activity. Our results strongly imply that polyherbal compounds are a potential source of antioxidants capable of scavenging free radicals. The strong positive connection between antiradical scavenging activity and overall polyphenolic concentration in polyherbal drugs demonstrates that polyphenols are significant components capable of scavenging free radicals. Additional research is required to isolate and characterize the active moiety responsible for biological activity and treat it under various stress conditions.
FAMILIA PHYLLONOMACEAE
Authors:   Instituto de Ecología, A.C. Centro Regional del Bajío, Pérez-Calix Emmanuel
Published: June 2022

La familia está formada por un sólo género distribuido principalmente en bosques húmedos, desde el norte de México (Durango) hasta Sudamérica (Bolivia y Perú).
FAMILIA NYMPHAEACEAE
Authors:   Instituto de Biología Universidad Nacional Autónoma de México, Novelo Alejandro , Bonilla-Barbosa Jaime ,   Centro de Investigaciones Biológicas Universidad Autónoma del Estado de Morelos
Published: June 2022

Familia con seis géneros y cerca de 66 especies dulceacuícolas, de amplia distribución mundial. Una gran cantidad de representantes incluyendo híbridos, particularmente del género Nymphaea, se utilizan con fines ornamentales. En la región de esta Flora se han encontrado cuatro especies nativas pertenecientes al género Nymphaea
BoLA - DRB3 Gene Polymorphism and its Association with Lactation Yield and Milk Constituents in Crossbred Cattle
Authors: Tayeng Kauvery , Tomar Satyendra Singh , Nanavati Sandeep , Aich Ranjit , Ignetious Shely , Nagoriya Sunil Kumar
Published: June 2022

The present study was undertaken to explore polymorphism at exon 2 of BoLA-DRB3 gene locus and its association with milk yield, fat % and protein % in a total of 40 Holstein-Friesian crosssbred cows using PCR-RFLP method. PCR-RFLP using Hae III restriction enzyme revealed presence of 7 genotypes with frequencies 0.475 (AA), 0.225 (AB), 0.050 (AE), 0.100 (BB), 0.050 (DD), 0.050 (EE) and 0.050 (II), respectively and PCR-RFLP using Bst YI yielded 3 genotypes with frequencies 0.050 (AA), 0.625 (AB) and 0.325 (BB), respectively. To study the association of BoLA-DRB3.2 genotypes with milk yield, fat and protein %, the data was subjected to analysis of variance employing general linear model using SPSS software package. Effect of farm (p less than 0.01) and parity (p less than 0.05) was significant on lactation yield; while the effect of season of calving, Hae III genotypes and Bst YI genotypes were non-significant. For fat % the effect of parity and season of calving was significant (p less than 0.05), while the effect of farm and genotype was non-significant. Milk protein % was significantly (p less than 0.05) influenced only by Bst YI genotype. Genotype AB recorded significantly higher protein % as compared to genotype BB.
Effect of Season and Year of Birth on Pubertal Age, Body Weight and Scrotal Circumference of Kankrej Bulls at First Semen Collection
Authors: Dangar Nikhil S , Brahmkshtri Balkrishna P , Modi Lalit C , Ramani Umed V , Kharadi Vishnu B , Khasatiya Chandubhai T , Pandya Gaurav M , Deshmukh Niteen
Published: June 2022

Data on 26 bulls of Kankrej cattle (birth date from 2006 to 2017) inducted at a semen station from 2010 to 2020 were analyzed to study the effects of season and year of birth on age, body weight and scrotal circumference of bull at first semen collection. The overall least-squares means for age, body weight, and scrotal circumference of bulls at first semen collection were 1122.36 ± 86.9 days, 537.69 ± 10.51 kg and 30.86 ± 1.60 cm. Non-genetic factors like season and year of birth did not contribute significantly (p>0.05) to these parameters’ variations. Results of the study revealed well adaptation of Kankrej cattle breed to seasonal changes and farm management took care of yearly variation in such a way that age, body weight and scrotal circumference of Kankrej bulls at first semen collection did not vary significantly.
Aspectos generales del cultivo de papa en Cundinamarca
Authors: Santos Díaz Adriana Marcela , Gómez Arias Linda Yhiset , Pedraza Rute Rafael Antonio , Gómez Latorre Douglas Andrés , Bohórquez Caballero Gilma Lorena , Ureña Sosa Diego Fernando , Gómez Rodríguez Katherine , Villagrán Munar Edwin Andrés , Numa Vergel Stephanie Johana , Gómez Vargas Yolanda
Published: June 2022

Esta publicación le brinda al productor, en un lenguaje natural de fácil entendimiento, algunos aspectos clave para el cultivo de papa. Está enfocado en temáticas como el clima, el uso de suelo, las plagas y las enfermedades, con conocimientos actualizados con el fin de mejorar las prácticas en su actividad productiva.
Investigating the Potential for Clinical Decision Support in Sub-Saharan Africa With AFYA (Artificial Intelligence-Based Assessment of Health Symptoms in Tanzania): Protocol for a Prospective, Observational Pilot Study (Preprint)
Authors: Schmude Marcel , Salim Nahya , Azadzoy Hila , Bane Mustafa , Millen Elizabeth , O’Donnell Lisa , Bode Philipp , Türk Ewelina , Vaidya Ria , Gilbert Stephen
Published: June 2022

BACKGROUND

Low- and middle-income countries face difficulties in providing adequate health care. One of the reasons is a shortage of qualified health workers. Diagnostic decision support systems are designed to aid clinicians in their work and have the potential to mitigate pressure on health care systems.

OBJECTIVE

The Artificial Intelligence–Based Assessment of Health Symptoms in Tanzania (AFYA) study will evaluate the potential of an English-language artificial intelligence–based prototype diagnostic decision support system for mid-level health care practitioners in a low- or middle-income setting.

METHODS

This is an observational, prospective clinical study conducted in a busy Tanzanian district hospital. In addition to usual care visits, study participants will consult a mid-level health care practitioner, who will use a prototype diagnostic decision support system, and a study physician. The accuracy and comprehensiveness of the differential diagnosis provided by the diagnostic decision support system will be evaluated against a gold-standard differential diagnosis provided by an expert panel.

RESULTS

Patient recruitment started in October 2021. Participants were recruited directly in the waiting room of the outpatient clinic at the hospital. Data collection will conclude in May 2022. Data analysis is planned to be finished by the end of June 2022. The results will be published in a peer-reviewed journal.

CONCLUSIONS

Most diagnostic decision support systems have been developed and evaluated in high-income countries, but there is great potential for these systems to improve the delivery of health care in low- and middle-income countries. The findings of this real-patient study will provide insights based on the performance and usability of a prototype diagnostic decision support system in low- or middle-income countries.

CLINICALTRIAL

ClinicalTrials.gov NCT04958577; http://clinicaltrials.gov/ct2/show/NCT04958577

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/34298
The CCP, the State and the Cadres in China
Authors: Li Suizhou
Published: June 2022

This paper, on the basis of documentary analysis, examines the CCP's monopoly of cadre management. The basic question to be answered is what the relationships among the Party, the state and the cadres are through an analysis of how the Party manages the cadres. Constitutionally, both the legislature (the people's congress in Chinese lexicon) and the government have extensive authority in cadre management. In reality, there is no state autonomy in personnel, and the state exercises its cadre management functions and duties through the party branches dispatched by the CCP committees. This study shows that the cadre management system is still highly centralized, a heritage with which all the reformists have to deal. This is the background to understand the evolution of the system reforms both at present and in the future. This paper is descriptive, but creatively descriptive in that it depicts a picture of how the Party manages its cadres.
Productivity Changes in the Chinese Provincial Governments
Authors: Yang Guanqiong
Published: June 2022

This paper applies a Data Envelope Analysis (DEA) method to the measurements and evaluations of Chinese provincial governmental productivity. It defines operationally the inputs and outputs of the government and governmental productivity in terms of eight indicators, and calculates the changes in governmental productivity with the DEA method for the period of 1985 to 2003. It decomposes the total factor productivity (TFP) into efficient changes and technical changes, and illustrates the characteristics of the changes in governmental productivity from periods to periods, and analyzes theoretically the characteristic patterns. It compares the differences in changes of governmental productivity among the different regions. In the processes of analysis, we emphasize the effects of administrative and economic reforms on governmental productivity, and the relationship between governmental productivity and administrative and economic reforms.
Treatment Decision Making for Older Kidney Patients during COVID-19
Authors: Porteny Thalia , Gonzales Kristina M. , Aufort Kate E. , Levine Sarah , Wong John B. , Isakova Tamara , Rifkin Dena E. , Gordon Elisa J. , Rossi Ana , Di Perna Gary , Koch-Weser Susan , Weiner Daniel E. , Ladin Keren ,   Stakeholder Advisory Board
Published: June 2022

Background and objectives

Coronavirus disease 2019 (COVID-19) disrupted medical care across health care settings for older patients with advanced CKD. Understanding how shared decision making for kidney treatment decisions was influenced by the uncertainty of an evolving pandemic can provide insights for supporting shared decision making through the current and future public health crises.

Design, setting, participants, & measurements

We performed thematic and narrative analyses of semistructured interviews with patients (CKD stages 4 and 5, age 70+), care partners, and clinicians from Boston, Portland (Maine), San Diego, and Chicago from August to December 2020.

Results

We interviewed 76 participants (39 patients, 17 care partners, and 20 clinicians). Among patient participants, 13 (33%) patients identified as Black, and seven (18%) had initiated dialysis. Four themes with corresponding subthemes emerged related to treatment decision making and the COVID-19 pandemic: (1) adapting to changed educational and patient engagement practices (patient barriers to care and new opportunities for telemedicine); (2) reconceptualizing vulnerability (clinician awareness of illness severity increased and limited discussions of patient COVID-19 vulnerability); (3) embracing home-based dialysis but not conservative management (openness to home-based modalities and limited discussion of conservative management and advanced care planning); and (4) satisfaction and safety with treatment decisions despite conditions of uncertainty.

Conclusions

Although clinicians perceived greater vulnerability among older patients CKD and more readily encouraged home-based modalities during the COVID-19 pandemic, their discussions of vulnerability, advance care planning, and conservative management remained limited, suggesting areas for improvement. Clinicians reported burnout caused by the pandemic, increased time demands, and workforce limitations, whereas patients remained satisfied with their treatment choices despite uncertainty.

Clinical Trial registry name and registration number:

Decision Aid for Renal Therapy (DART), NCT03522740
DRUG UTILIZATION STUDY IN TRAUMA INTENSIVE CARE UNIT
Authors: HIVALE NITIN SUKADEV , KULKARNI MADHURI D , B LAHAMATE SHRIKANT
Published: June 2022

Objective: Trauma is defined as major public health problem worldwide and associated with significant morbidity and mortality both in developed and developing countries and to study prescription pattern in TICU among head trauma patients.
Methods: The study was conducted in Trauma Intensive Care Unit of Department of Surgery in a Tertiary Care Hospital. This was a prospective, observational study done at a Tertiary Care Teaching Hospital. A total of 637 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patient’s data recorded in case report form and analyzed to study the prescription pattern.
Results: A total of 637 cases were enrolled in this study. Trauma was more common in 499 (78.34%) male followed by 138 (21.66%) female. The average duration of stay in TICU was 3.62±1.38 days. In this study, mortality rate in study was 17.27 %. In the current study, the total numbers of drugs prescribed per prescription in TICU are most commonly between 5 and 8 (55.26%) drugs followed by between 9 and 12 drugs were 37.83%. The present study states that the most common prescribed drugs used were ranitidine (100%) followed by ondansetron (89.64%). Among antimicrobials cephalosporins were most commonly used ceftriaxone (31.08%) and cefotaxime (27.63%).
Conclusions: The aim of study is monitoring and evaluation of the prescribers as well as recommends necessary modifications to achieve rational medical care. Study outcomes suggesting that admission to TICU is more in middle age group with mean age of 40.2 years. Average numbers of drugs prescribed were 8.76 drugs per patients which shows the trends of polypharmacy in the prescriptions.
EXTRACTION AND CHARACTERIZATION OF FICUS GLOMERATA FOR ANTIOXIDANT ACTIVITY
Authors: PRAKASH ANIL , SARANGDEVOT YUVRAJ SINGH , VYAS BHUPENDRA , ROY SONALI
Published: June 2022

Objective: This study is focused on the evaluation of phytochemical constituents and antioxidant properties contained in Ficus glomerata. Various phytochemical constituents such as alkaloid, glycoside, total phenolic content, flavonoid, and carbohydrate constituent content were evaluated.
Methods: Extraction of plant F. glomerata was obtained using methanol as solvent using soxhlation. Antioxidant properties in F. glomerata extract were evaluated using free radical scavenging activity using 2, 2-diphenyl-1-picrylhydrazyl method. Antioxidant activity of the extract of F. glomerata was expressed as gallic acid equivalent.
Results: The result obtained from the study was in support of the use of F. glomerata as a natural antioxidant against free radicals that are formed in the pathogenesis of many metabolic disorders.
Conclusion: The results obtained from the research found to conclude that antioxidant properties derived from natural extracts may be a promising alternative to synthetic oxidants and may aid in avoiding the side effects associated with the use of synthetic antioxidants. Other than the antioxidant properties, a correlation was observed between the total phenolic content and the antioxidant properties.
READINESS TO TAKE RE-TEST - FIRST YEAR MBBS STUDENT VIEW
Authors: GARA RAMADEVI , RAO RAPETIRAMANA
Published: June 2022

Objectives: During COVID-19 pandemic, there were many changes adopted in medical education, most of the syllabus (theory and practical) was taught in online. During this online classes, 1st year MBBS students were the most affected, because they are new to curriculum, difficult to adopt the transition from intermediate to under graduation course, this created lot of pressure in the students. Once the students are back for offline classes, we have conducted internal assessment test after a month of offline classes and the test results were poor. Main objective of this study is to see the relationship between conducting retest and improving the academic performance and to record the student view on retest.
Methods: Sample size for the 1st test (n-149) and 2nd test (n-141). We have given Google form with ten questions, out which responses were recorded based on Likert 4 point scale.
Results: The repeat exam provided immediate reward for using the initial exam as a study guide. When we compared the results of test and retest, there was great improvement in score.
Conclusion: Retest helped to reduce test anxiety and to encourage the learning of course material. It helped the faculty to fill the lacunae to improve the further outcome.
HISTOGENESIS OF HUMAN FETAL STOMACH AT VARIOUS GESTATIONAL AGES – AN OBSERVATIONAL STUDY
Authors: RAO RAPETI RAMANA , GARA RAMADEVI , RAO B NARASINGA
Published: June 2022

Objective: Knowledge on timelines of structural and histological development of fetal stomach helps in the diagnosis of abnormalities (duplication cyst of the pylorus, heterotopic pancreatic tissue, etc.,) and weighing interventions as an option. The present study was undertaken to establish the timelines of the developmental process of stomach (e.g., appearance of curvatures, gastric pit, gastric glands, and various cell types) correlating with the gestational age.
Methods: Fifty normal, aborted and unclaimed fetuses were obtained from local private and government hospitals observing all formalities. The tissues of 3–5 mm thickness were taken and preserved in 10% formalin for 72 h, followed by tissue processing and staining with hematoxylin eosin and periodic acid Schiff and observations were made under microscope.
Results: Lesser and greater curvatures appeared in the first trimester. All the four layers and gastric pits were observed at 16th week, cuboidal epithelium turns columnar and nidus of gastric glands, circular muscular layer submucuosa noted by 18th week, longitudinal layer of muscle appeared at 20th week, parietal, zymogenand mucus neck cells observed by 24th week in fundus, and body oblique muscle was evident by 28th week and near adult pattern seen by 32nd week of gestation.
Conclusion: From the available literature, very few studies have reported regarding histogenesis of human fetal stomach in India. The present study is one such to supplement the known data and knowledge regarding histogenesis of human fetal stomach and help in diagnosis and treatment of related congenital anomalies.
ATENOLOL IN EPISODIC MIGRAINE PROPHYLAXIS: A REVIEW
Authors: DAHIYA VIKASH , ROHILLA ANKUR , JAIN SAROJ , ROHILLA SEEMA
Published: June 2022

Atenolol seems to reduce blood vessel dilation, which is known to contribute to migraine. It reduces electrical activity of nervous system and reduces it excitability. Atenolol is a β1-cardioselective beta-blocker that influences the heart circulation through veins and arteries. Primarily, it is used to treat high blood pressure and heart-related chest pain. It is also used as a supplement subsequent to a heart attack to lower the risk of death. Atenolol has shown efficacy in prevention of migraines and to treat certain irregularities in heartbeats. It can be taken orally or parentally. It reduces the heart rate and workload of cardiac muscles by blocking β1-adrenergic receptors in heart. It restricted blood flow in the brain by reducing blood vessel dilation and helpful in the treatment of migraine. It reduced the electrical activity of nervous system and made it less excitable. It also repressed the waves of electric currents that proved beneficial in the treatment of migraine aura.
IMPACT OF AUDIT AND POLICY IMPLEMENTATION ON ELECTIVE CASE CANCELLATION RATE: A RETROSPECTIVE STUDY
Authors: PAWAR SWATI JAYANTH , P RANI , VR HEMANTHKUMAR
Published: June 2022

Objectives: Cancellation of elective posted case on the day of surgery is the most distressing news for the patient and their wards and also leads to wastage of hospital resources. Cancellation of elective surgical case is a preventable situation, if the involved team members take necessary steps suitable for successful conduct of surgery. This study was done to assess whether audit of case cancellation and policies implemented have reduced the rate of case cancellation.
Methods: This audit was conducted for the past 3 years (2016–2018) in tertiary care hospital with 1500 beds and 12 functional elective operating rooms distributed among eleven specialties. Case cancellation done after the case was posted in the list was considered for the audit. With the consensus of both the surgeon and anesthesiologist, cancelled cases were entered in the cancellation form with the reasons specified. The forms were collected at the end of the day. Cancellations were discussed in operation theater (OT) committee meeting and new policies were made and remedial measures were taken.
Results: Total numbers of elective posted cases were 6094, 5623, and 5353 and case cancellation rate was 8%, 5.6%, and 5.7% in 2016, 2017, 2018, respectively. Patient-related factors were 4.45%, 2.86%, and 3.51%, surgery-related were 2.3%, 1.5%, and 1.21%, anesthesia-related were 0.07%, 0.21%, and 0.3% and infrastructure-related cancellation rate was 1.3%, 1.07%, and 0.69%, respectively. The cancellation rates have been decreased with statistical significance of p<0.00001.
Conclusion: Regular audit of OT utilization and policy implementation will significantly reduce the avoidable causes of case cancellation.
ANTI-DIABETIC EFFECT OF GREEN SYNTHESISED SILVER NANOPARTICLES OF PIPER BETLE
Authors: N MEENAKSHI , R ANGAYARKANNI , A ARCHANA
Published: June 2022

Objective: The objective of the current study is toward the green synthesis of silver nanoparticles from the aqueous leaf extracts of Piper betle (BL) and to evaluate its anti-diabetic efficacy. Methods: Silver nanoparticles were prepared with the aqueous leaf extract of Piper betle. Characterization of silver nanoparticles prepared from extracts of Piper betle was done by UV-Visible spectrophotometer absorbance spectrum; Scanning Electron Microscope; and Fourier transform infrared spectrophotometer. The anti-diabetic efficacy was ascertained by inhibition assay of α-amylase activity and glucose diffusion inhibitory study with aqueous leaf extract of Piper betle and silver nanoparticles of Piper betle (BLNP). Results: Based on the findings of spectrophotometer studies, it was confirmed that the silver nanoparticles were generated. High-density silver nanoparticles were synthesized by Piper betle was depicted by scanning electron microscope. The plant extracts (BLE) and its nanoformulation (BLNP) showed a constructive impact on controlling the glucose level by the inhibition of α-amylase activity and glucose diffusion. Conclusion: It was concluded that the Piper betle can be employed as alternative medicine in the efficient management of Diabetes Mellitus.
Public Civil Action: Advances and Setbacks in its Evolution Legislative
Authors: Mattar Daniela Costa Soares , Vaz Flávio Marcos de Oliveira , França Mhardoqueu Geraldo Lima , Lonchiat Fabrizia Angelica Bonatto
Published: June 2022

The objective of this investigation is to propose a scientific analysis about the advances and setbacks of the public civil action legislation as an instrument of collective protection of rights. Thus, it makes healthy to understand the institute of Law n. 7.347/85 and make a comparison between the main points of the bill n. 5,139/09 and the new collective action law (PL n. 4,778/20) proposed by the representatives of the National Council of Justice and delivered to the president of the Chamber of Deputies on September 1, 2020, in order to verify that the new draft of collective actions innovative proposals something in relation to bill n. 5,139/09; as well as a brief analysis of the bills n. 1.641/21, a new proposal from the Brazilian Institute of Procedural Law with the aim of contributing to the advancement of the Brazilian collective process. It is important that the critical approach to the proposed investigation object took place through the research bibliographical, documentary and jurisprudential in addition to comparative, interpretative and systematic analyses.
El Hombre y el Arte
Authors: Menéndez Díaz Azucena
Published: June 2022

Azucena Menéndez Díaz

Como parte de la celebración del día internacional de la acuarela la pintora Azucena Menéndez Díaz nos recibe en el Museo Nacional de la acuarela “Alfredo Guati Rojo” de la ciudad de México, sitio de reunión donde se comparten sentimientos, manera de ser y pensar a través del arte como testigo de la historia del hombre hasta lo que hoy se conoce como bellas artes, como representación pictórica de los sucesos y costumbres sucedidos sucesivamente el arte acompañó el crecimiento europeo en pueblos como los Latinos, los Etruscos y los Romanos, expresiones como la pintura, la escultura y la arquitectura que nos permiten conocer la cultura de estos pueblos.
Día Nacional del Urbanista Mexicano
Authors: Kaye López Juan Lázaro , Rincón Gallardo Eduardo
Published: June 2022

Juan Lázaro Kaye López y Eduardo Rincón Gallardo

El 8 de octubre se celebra en México el Día Nacional del Urbanista y en la celebración del 2021, Juan L. Kaye, presidente de la AMU (Asociación Mexicana de Urbanistas) y el arquitecto Eduardo Rincón Gallardo, presidente de la Comisión de Honor de la AMU, hicieron entrega de la medalla “Carlos Lazo Barreiro” al Premio Nacional al Mérito Urbanístico.

En su discurso, Juan L. Kaye habla sobre la tarea del urbanista desde la integridad de la ciudad, su valor para dirigir el camino de la planeación, asegurar condiciones de bienestar, el impulso a la ciudadanía y reducir la brecha de desigualdad.

A su vez, Eduardo Rincón Gallardo define conceptos que permean el conocimiento urbanista y su teorización: civilización, poblamiento, migración, el cambio climático, la diversidad real de la sociedad, enseñar y aprender. Son las pautas que menciona en su discurso, las cuales invitan a los asistentes a reflexionar sobre la acción urbana actual. 