bluuebunny/crossref_metadata_2025 huggingface dataset:
Automatic Quantitative Assessment of Lens Opacities Using Two Anterior Segment Imaging Techniques: Correlation with Functional and Surgical Metrics
Authors: Mackenbrock Lars H. B. , Łabuz Grzegorz , Yildirim Timur M. , Auffarth Gerd U. , Khoramnia Ramin
Published: October 2022

The purpose of this study is to quantitatively assess lens opacity, using a swept-source optical coherence tomography (SS-OCT) device for anterior segment assessment, and establish the correlation with Scheimpflug imaging, corrected distance visual acuity (CDVA) and cumulative dissipated energy (CDE). This prospective cross-sectional single-center study enrolled 51 patients (51 eyes) with crystalline lens opacity. Patients with previous ocular surgery, pathologies or general disorders affecting vision were excluded. Eyes were scanned with an SS-OCT device, and lens densitometry was automatically analyzed using a custom MATLAB script which examined lens density, nuclear density and linear density. The same analyses were performed on Scheimpflug images. Preoperative CDVA and CDE during phacoemulsification were recorded. Spearman’s (ρ) and Pearson’s (r) correlation coefficients were assessed according to data normality. Statistically significant correlations were established between SS-OCT and Scheimpflug imaging using lens analysis (ρ = 0.47, p < 0.001), nuclear analysis (ρ = 0.73, p < 0.001) and linear analysis (r = 0.44, p < 0.001). A significant correlation with CDE was found with all the SS-OCT methods (r = 0.57, p < 0.001). Only the nuclear analysis of the SS-OCT scans (Tb = −0.33, p < 0.01) and Pentacam Nucleus Staging (Tb = −0.26, p < 0.05) showed a statistically significant correlation with CDVA. Good inter-device agreement in lens densitometry was found. However, SS-OCT yielded improved lens imaging compared with the Scheimpflug device and a higher correlation with clinical parameters. Thus, high-resolution SS-OCT has the potential to become a preferable option for automatic cataract grading and preoperative planning.
The Effect of Submaximal Exercise on Jugular Venous Pulse Assessed by a Wearable Cervical Plethysmography System
Authors: Menegatti Erica , Proto Antonino , Paternò Gianfranco , Gadda Giacomo , Gianesini Sergio , Raisi Andrea , Pagani Anselmo , Piva Tommaso , Zerbini Valentina , Mazzoni Gianni , Grazzi Giovanni , Taibi Angelo , Zamboni Paolo , Mandini Simona
Published: October 2022

The jugular venous pulse (JVP) is a one of the crucial parameters of efficient cardiovascular function. Nowadays, limited data are available regarding the response of JVP to exercise because of its complex and/or invasive assessment procedure. The aim of the present work is to test the feasibility of a non-invasive JVP plethysmography system to monitor different submaximal exercise condition. Twenty (20) healthy subjects (13M/7F mean age 25 ± 3, BMI 21 ± 2) underwent cervical strain-gauge plethysmography, acquired synchronously with the electrocardiogram, while they were carrying out different activities: stand supine, upright, and during the execution of aerobic exercise (2 km walking test) and leg-press machine exercise (submaximal 6 RM test). Peaks a and x of the JVP waveform were investigated since they reflect the volume of cardiac filling. To this aim, the Δax parameter was introduced, representing the amplitude differences between a and x peaks. Significant differences in the values of a, x, and Δax were found between static and exercise conditions (p < 0.0001, p < 0.0001, p < 0.0001), respectively. Particularly, the Δax value for the leg press was approximately three times higher than the supine, and during walking was even nine times higher. The exercise monitoring by means of the novel JVP plethysmography system is feasible during submaximal exercise, and it provides additional parameters on cardiac filling and cerebral venous drainage to the widely used heartbeat rate value.
A Host-Directed Approach to the Detection of Infection in Hard-to-Heal Wounds
Authors: Burnet Michael , Metcalf Daniel G. , Milo Scarlet , Gamerith Clemens , Heinzle Andrea , Sigl Eva , Eitel Kornelia , Haalboom Marieke , Bowler Philip G.
Published: October 2022

Wound infection is traditionally defined primarily by visual clinical signs, and secondarily by microbiological analysis of wound samples. However, these approaches have serious limitations in determining wound infection status, particularly in early phases or complex, chronic, hard-to-heal wounds. Early or predictive patient-derived biomarkers of wound infection would enable more timely and appropriate intervention. The observation that immune activation is one of the earliest responses to pathogen activity suggests that immune markers may indicate wound infection earlier and more reliably than by investigating potential pathogens themselves. One of the earliest immune responses is that of the innate immune cells (neutrophils) that are recruited to sites of infection by signals associated with cell damage. During acute infection, the neutrophils produce oxygen radicals and enzymes that either directly or indirectly destroy invading pathogens. These granular enzymes vary with cell type but include elastase, myeloperoxidase, lysozyme, and cathepsin G. Various clinical studies have demonstrated that collectively, these enzymes, are sensitive and reliable markers of both early-onset phases and established infections. The detection of innate immune cell enzymes in hard-to-heal wounds at point of care offers a new, simple, and effective approach to determining wound infection status and may offer significant advantages over uncertainties associated with clinical judgement, and the questionable value of wound microbiology. Additionally, by facilitating the detection of early wound infection, prompt, local wound hygiene interventions will likely enhance infection resolution and wound healing, reduce the requirement for systemic antibiotic therapy, and support antimicrobial stewardship initiatives in wound care.
Metacognitive Scales: Assessing Metacognitive Knowledge in Older Adults Using Everyday Life Scenarios
Authors: Bampa Grigoria , Kouroglou Despina , Metallidou Panagiota , Tsolaki Magdalini , Kougioumtzis Georgios , Papantoniou Georgia , Sofologi Maria , Moraitou Despina
Published: October 2022

The multidimensional effect of aging on cognition and its interference with daily functioning is well reported by many studies. Therefore, the ability to detect age-related cognitive changes is of great importance for older adults to help compensate for cognitive decline. For that, metacognition and its course of change across the lifespan of a person have attracted considerable scientific interest. The aim of the present study is to present three new self-report questionnaires, developed to measure older adults’ metacognitive knowledge for everyday memory (MKEM), metacognitive knowledge for everyday attention (MKEA), and metacognitive knowledge for everyday executive functions (MKEEFs). The questionnaires were tested for structural validity and reliability. A sample size of 171 community-dwelling adults of advancing age (97 females and 74 males) voluntarily participated in this study and their ages ranged from 50 to 82 years (mean = 59.32, SD = 7.39). Exploratory factor analysis using principal component analysis with varimax rotation was applied to examine structural validity. The results revealed a one-factor structure for the MKEM with high internal consistency (α = 0.88), a two-factor structure for the MKEA, that reflected “divided and shifted attention” (α = 0.74) and “concentration” (α = 0.75), and a two-factor structure for the MKEEFs that reflected “planning” (α = 0.70) and “inhibition” (α = 0.65). The variables created for each factor respectively showed significant positive correlations between each other.
Capillary Blood Gas in Children Hospitalized Due to Influenza Predicts the Risk of Lower Respiratory Tract Infection
Authors: Wrotek August , Jackowska Teresa
Published: October 2022

Background: Influenza may impair respiratory exchange in the case of lower respiratory tract infections (LRTIs). Capillary blood gas (CBG) reflects arterial blood values but is a less invasive method than arterial blood sampling. We aimed to retrospectively verify the usefulness of CBG in pediatric influenza. Material and methods: CBG parameters (pH, pCO2, pO2, SatO2) in laboratory confirmed influenza cases hospitalized in 2013–2020 were verified in terms of LRTI, chest X-ray (CXR) performance, radiologically confirmed pneumonia (CXR + Pneumonia), prolonged hospitalization, and intensive care transfer. A theoretical CBG-based model for CXR performance was created and the odds ratios were compared to the factual CXR performance. Results: Among 409 children (aged 13 days–17 years 3/12, median 31 months), the usefulness of CBG decreased with the age. The SatO2 predicted the LRTI with AUC = 0.74 (95%CI: 0.62–0.86), AUC = 0.71 (0.61–0.82), and AUC = 0.602 (0.502–0.702) in children aged <6 months old (mo), 6–23 mo, 24–59 mo, respectively, while pO2 revealed AUC = 0.73 (0.6–0.85), AUC = 0.67 (0.56–0.78), and AUC = 0.601 (0.501–0.702), respectively. The pCO2 predicted the LRTI most precisely in children <6 months with AUC = 0.75 (0.63–0.87), yet not in older children. A high negative predictive value for CXR + Pneumonia was seen for SatO2 < 6 mo (96.7%), SatO2 6–23 mo (89.6%), pO2 < 6 mo (94.3%), pO2 6–23 mo (88.9%). The use of a CBG-driven CXR protocol (based on SatO2 and pO2) would decrease the odds of an unnecessary CXR in children <2 years old (yo) by 84.15% (74.5–90.14%) and 86.15% (66.46–94.28%), respectively. SatO2 and pO2 also predicted a prolonged hospitalization <6 mo AUC = 0.71 (0.59–0.83) and AUC = 0.73 (0.61–0.84), respectively, and in 6–23 mo AUC = 0.66 (0.54–0.78) and AUC = 0.63 (0.52–0.75), respectively. Conclusions: The CBG is useful mainly in children under two years, predicts the risk of LRTI, and can help exclude the risk of CXR + pneumonia. Children under six months of age represent the group that would benefit the most from CBG. A CBG-based protocol for the performance of CXR could significantly decrease the number of unnecessary CXRs.
Intravitreal Fluocinolone Acetonide for Diabetic Macular Edema: Long-Term Effect and Structure/Function Correlation
Authors: Minnella Angelo Maria , Maceroni Martina , Zagami Claudia , Quarato Elena , Rizzo Stanislao , Giarletti Matteo , Placidi Giorgio , Falsini Benedetto
Published: October 2022

The long-term effect of intravitreal Fluocinolone acetonide (FAc) on retinal morphology and function in diabetic macular edema (DME) was investigated. Seventeen eyes of twelve consecutive DME patients, treated by intravitreal FAc, were retrospectively evaluated. Retinal morphology was assessed with central macular thickness (CMT). Retinal function was assessed by best-corrected visual acuity (BCVA) and cone b-wave and photopic negative response (PhNR). The main outcome was a mean change in CMT at month 24. The secondary outcomes were changes in cone b-wave and PhNR at month 24. The incidence of adverse events was also recorded. Mean CMT decreased from 406.52 µm (±138.74) at baseline to 310 µm (±130.39) at 24 months (p = 0.008). No significant changes in the other parameters were found. At baseline, BCVA and PhNR amplitude were negatively correlated (r = −0.55) with CMT. At the end of follow-up, the change in CMT was negatively correlated with baseline CMT (r = −0.53, p = 0.03) and positively correlated with baseline PhNR amplitude (r = 0.58, p < 0.01). A significant, long-term reduction in CMT was observed in DME patients after FAc implant. The anti-edema effect tended to be stronger in patients with the poorest baseline retinal morphology (CMT) and function (PhNR). Structure/function correlations might help to characterize the patients who may benefit from this treatment.
Ureaplasma parvum Septic Arthritis, a Clinic Challenge
Authors: Suárez-Cuervo Carlos , Nicolás Concepción , Fernández-Suárez Jonathan , Morilla Ana , Fernández Javier , Caminal-Montero Luis
Published: October 2022

Ureaplasma parvum is usually part of the normal genital microbiota. Rarely, it can cause invasive infections such as septic arthritis or meningitis. A case of a 74-year-old woman with follicular lymphoma who developed cellulitis followed by elbow arthritis with negative routine bacterial cultures is described. U. parvum was identified in the synovial fluid using a broad-range 16S ribosomal RNA gene polymerase chain reaction (PCR) and also in vaginal fluid by a targeted PCR (Anyplex™ II STI-7). Multilocus Sequence Typing (MLST) revealed that isolates from both sources belonged to ST4, a worldwide distributed clone. Treatment consisted of surgery and targeted antibiotic therapy with doxycycline and azithromycin. Evolution showed initial clinical improvement in arthritis despite functional sequelae. Ureaplasma arthritis should be considered as a rare cause of arthritis in negative culture, especially in immunosuppressed patients. In these cases, the treatment is not well established, but according to this and previous works, patients could improve with doxycycline, azithromycin or fluoroquinolone therapy on a prolonged basis.
The Assessment of Subregions in the Frontal Lobe May Be Feasible in the Differential Diagnosis of Progressive Supranuclear Palsy—Parkinsonism Predominant (PSP-P) and Multiple System Atrophy (MSA)
Authors: Alster Piotr , Madetko-Alster Natalia , Migda Bartosz , Nieciecki Michał , Koziorowski Dariusz , Królicki Leszek
Published: October 2022

Progressive Supranuclear Palsy—Parkinsonism Predominant (PSP-P) is associated with moderate responsiveness to levodopa treatment and a possible lack of typical PSP milestones. The clinical manifestation of PSP-P poses difficulties in neurological examination. In the early stages it is often misdiagnosed as Parkinson’s Disease, and in the more advanced stages PSP-P shows more symptoms in common with Multiple System Atrophy—Parkinsonian type (MSA-P). The small number of tools enabling differential diagnosis of PSP-P and MSA leads to the necessity of searching for parameters facilitating in vivo diagnosis. In this study, 14 patients with PSP-P and 21 patients with MSA-P were evaluated using Single Photon Emission Computed Tomography. Considering the fact that PSP is linked with frontal deficits, regions of the frontal lobe were assessed in the context of hypoperfusion and their possible usefulness in the differential diagnosis with MSA-P. The outcome of the work revealed that the right middle frontal gyrus was the region most significantly affected in PSP-P.
Reflex of the Gracilis in Brain Death
Authors: Ryu Han Uk , Kim Sang Yeon , Kang Hyun Goo
Published: October 2022

In patients with brain death, reflex movements originating from spinal reflexes are observed intermittently. Generally, they can occur under hypoxic stimuli such as when the ventilator is removed, under physical stimuli such as bending the neck, or under hypotension. Finger- and toe-jerk responses are commonly observed reflex movements that can occur in patients with brain death. In addition, the Lazarus sign, known as the most dramatic reflex movement, appears mainly in the upper extremities (e.g., the hands and arms) and in the distal lower extremities (e.g., the soles and toes). This case showed a reflex movement that was triggered by the contraction of the gracilis, a proximal muscle in the lower extremities, with only a gentle stimulus on the sole.
Salmonella Typhi Vaccination Response as a Tool for the Stratification of Risk in Patients with Predominantly Antibody Deficiencies
Authors: Alonso-Larruga Ana , Barrios Yvelise , Franco Andrés , Suárez-Toste Isabel , Rodríguez-Salazar María José , Matheu Víctor
Published: October 2022

Predominantly antibody deficiencies are the most frequent type of primary immunodeficiency (PID). Diagnosis requires evaluation of the immune function by distinguishing the presence or absence of a response against polysaccharide antigens. Salmonella enterica serovar Typhi-based vaccines have proved to be a suitable tool. We studied a group of patients with suspicion of primary immunodeficiency and classified them by final diagnosis. We analyzed the vaccination response to S. Typhi and other immune biomarkers and clinical data. The aim of this study was to classify patients regarding the intensity of their immune response measured as the difference between specific immunoglobulin G levels before and after vaccination and antibody levels in the post-vaccination sample in order to improve clinical decisions regarding follow up and treatment of immunodeficiency patients. We established four groups of response: Non responders (NR), Low responders (LR), Intermediate responders (IR), and High responders (HR), where we found differences in IgG, IgG1, IgG2, IgG4, IgA, IgA1, IgA2, and IgM, and where the finally achieved diagnosis was also different and corresponding to the level of vaccination response.
Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer
Authors: Kim Ka Eun , Ko Eun Young , Han Boo-Kyung , Ko Eun Sook , Choi Ji Soo , Kim Haejung , Lee Jeong Eon , Lee Hyunwoo
Published: October 2022

This study aimed to investigate the differences in ultrasound (US) visibility for the localization of clipped metastatic lymph nodes after neoadjuvant chemotherapy (NAC), according to tissue marker type. This single-center retrospective study included 59 consecutive patients with breast cancer who underwent tissue marker insertion for histologically proven metastatic axillary lymph nodes before NAC, between March 2020 and August 2021. Two breast tissue markers were used: UltraClip™ (n = 29) and UltraCor™ Twirl™ (n = 30). The US visibility of tissue markers after NAC and the successful excision rate of the clipped lymph nodes were compared between the two types of tissue markers. UltraCor™ Twirl™ showed better overall US visibility than UltraClip™ after NAC (86.7% vs. 72.4%), but the difference was statistically insignificant. In the absence of residual metastatic lymph nodes on US after NAC (n = 32), UltraCor™ Twirl™ showed significantly better US visibility (83.3%, 15/18) than UltraClip™ (42.9%, 6/14; p = 0.027). The marker type was not associated with the successful excision of the clipped lymph node. UltraCor™ Twirl™ showed better US visibility than UltraClip™ in the metastatic axillary lymph nodes after NAC in the absence of residual suspicious lymph nodes on US.
Differential Diagnosis of Alzheimer Disease vs. Mild Cognitive Impairment Based on Left Temporal Lateral Lobe Hypomethabolism on 18F-FDG PET/CT and Automated Classifiers
Authors: Nuvoli Susanna , Bianconi Francesco , Rondini Maria , Lazzarato Achille , Marongiu Andrea , Fravolini Mario Luca , Cascianelli Silvia , Amici Serena , Filippi Luca , Spanu Angela , Palumbo Barbara
Published: October 2022

Purpose: We evaluate the ability of Artificial Intelligence with automatic classification methods applied to semi-quantitative data from brain 18F-FDG PET/CT to improve the differential diagnosis between Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI). Procedures: We retrospectively analyzed a total of 150 consecutive patients who underwent diagnostic evaluation for suspected AD (n = 67) or MCI (n = 83). All patients received brain 18F-FDG PET/CT according to the international guidelines, and images were analyzed both Qualitatively (QL) and Quantitatively (QN), the latter by a fully automated post-processing software that produced a z score metabolic map of 25 anatomically different cortical regions. A subset of n = 122 cases with a confirmed diagnosis of AD (n = 53) or MDI (n = 69) by 18–24-month clinical follow-up was finally included in the study. Univariate analysis and three automated classification models (classification tree –ClT-, ridge classifier –RC- and linear Support Vector Machine –lSVM-) were considered to estimate the ability of the z scores to discriminate between AD and MCI cases in. Results: The univariate analysis returned 14 areas where the z scores were significantly different between AD and MCI groups, and the classification accuracy ranged between 74.59% and 76.23%, with ClT and RC providing the best results. The best classification strategy consisted of one single split with a cut-off value of ≈ −2.0 on the z score from temporal lateral left area: cases below this threshold were classified as AD and those above the threshold as MCI. Conclusions: Our findings confirm the usefulness of brain 18F-FDG PET/CT QL and QN analyses in differentiating AD from MCI. Moreover, the combined use of automated classifications models can improve the diagnostic process since its use allows identification of a specific hypometabolic area involved in AD cases in respect to MCI. This data improves the traditional 18F-FDG PET/CT image interpretation and the diagnostic assessment of cognitive disorders.
A Study of Biomarkers Associated with Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes
Authors: Efrem Ion Cristian , Moța Maria , Vladu Ionela Mihaela , Mitrea Adina , Clenciu Diana , Timofticiuc Diana Cristina Protasiewicz , Diaconu Ileana-Diana , Turcu Adina , Crișan Anda Elena , Geormăneanu Cristiana , Glodeanu Adina Dorina , Mahler Beatrice , Tudor Marinela Sînziana , Amzolini Anca Maria , Micu Simona Elena , Barău Abu Alhija Anca , Mită Adrian , Filip Maria Monalisa , Forțofoiu Maria
Published: October 2022

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term that no longer excludes patients that consume alcohol or present other liver diseases, unlike nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the role of different biomarkers as predictors of MAFLD in patients with type 2 diabetes mellitus (T2DM). In this regard, a cross-sectional, non-interventional study was conducted over a period of 8 months in patients with T2DM. Liver steatosis displayed by abdominal ultrasound certified the MAFLD diagnosis. A percentage of 49.5% of the studied patients presented MAFLD. Through logistic regression adjusted for gender, age, T2DM duration, lipid-lowering therapy, smoking status, nutritional status, we demonstrated that elevated triglycerides (TG) levels, high non-high-density-lipoprotein (HDL)-cholesterol-to-HDL-cholesterol (non-HDL/HDL) ratio, high atherogenic index of plasma (AIP), and increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) had predictive value for MAFLD in patients with T2DM. Furthermore, we calculated the optimal cut-off values for these biomarkers (184 mg/dL for TG, 0.615 for AIP, 3.9 for the non-HDL/HDL ratio, and 2.01 for HOMA-IR) which can predict the presence of MAFLD in patients with T2DM. To our knowledge, this is the first study to assess the predictive value of the non-HDL/HDL ratio for MAFLD in patients with T2DM.
Systematic Review and Meta-Analysis on the Sensitivity and Specificity of 13C/14C-Urea Breath Tests in the Diagnosis of Helicobacter pylori Infection
Authors: Jambi Layal K.
Published: October 2022

Helicobacter pylori (H. pylori) continues to be a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer. The aim of the present systematic review and meta-analysis was to determine the sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection. A PRISMA systematic search appraisal and meta-analysis were conducted. A systematic literature search of PubMed, Web of Science, EMBASE, Scopus, and Google Scholar was conducted up to August 2022. Generic, methodological and statistical data were extracted from the eligible studies, which reported the sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection. A random effect meta-analysis was conducted on crude sensitivity and specificity of 13C/14C-urea breath test rates. Heterogeneity was assessed by Cochran’s Q and I2 tests. The literature search yielded a total of 5267 studies. Of them, 41 articles were included in the final analysis, with a sample size ranging from 50 to 21857. The sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection ranged between 64–100% and 60.5–100%, respectively. The current meta-analysis showed that the sensitivity points of estimate were 92.5% and 87.6%, according to the fixed and random models, respectively. In addition, the specificity points of estimate were 89.9% and 84.8%, according to the fixed and random models, respectively. There was high heterogeneity among the studies (I2 = 98.128 and 98.516 for the sensitivity and specificity, respectively, p-value < 0.001). The 13C/14C-urea breath tests are highly sensitive and specific for the diagnosis of H. pylori infection.
Comment on Kehrer et al. Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons. Diagnostics 2022, 12, 1650
Authors: Nduka Charles , Kannan Ruben Yap , Volk Gerd Fabian , Guntinas-Lichius Orlando
Published: October 2022

In “Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis—Machine Settings and Technical Aspects for Facial Surgeons”, Andreas Kehrer et al. present ultrasound (US) device settings for facial muscle examination to be used by facial surgeons to improve their workflow and enhance their image quality [...]
Managerial Practices for the Digital Transformation of Manufacturers
Authors: Budde Lukas , Benninghaus Christoph , Hänggi Roman , Friedli Thomas
Published: October 2022

The digital transformation is a complex and multi-faceted phenomenon, which companies hamper to manage effectively. One particular facet of this phenomenon is the role of managers, which is still underrepresented in research. This study aims to identify and explain why and what managerial practices and competencies are particularly needed to effectively govern through this transformation. We choose the case study methodology as the research design with eight manufacturing companies in Western Europe, where we applied within- and cross-case analyses. Specific barriers for digital transformation and four aggregated managerial practices, such as strategy/organization, collaboration, cross-functionality and data-driven use cases, were identified. These were supported by 13 competencies to facilitate digitalization. We explicate these practices based on the change management theory and provide a model describing the impact of these practices on profitability. This study contributes to the emergent change theory by analyzing practices and competencies that managers should be equipped with to foster digitalization.
Describing the Function, Disability, and Health of Adults and Older Adults during the Early Coronavirus Restrictions in 2019: An Online Survey
Authors: Derakhshan Pegah , Miller William C. , Borisoff Jaimie , Esfandiari Elham , Forwell Sue , Jarus Tal , Mohammadi Somayyeh , Rash Isabelle , Sakakibara Brodie , Schmidt Julia , Tao Gordon , Tregobov Noah , Mortenson William Ben
Published: October 2022

The restrictions in 2019 due to Coronavirus impacted Canadians’ daily living, especially those at higher risk of compromised health conditions. This study aimed to describe the physical, psychological, and social well-being of adults with disabilities, and older adults from May to June 2020. Participants from the group of community-dwelling adults (≥19 years of age), who communicated in English, lived in British Columbia, and had Internet access via a computer, tablet, or smartphone with special focus on populations who had stroke, spinal cord injury and other disabilities were included. For measurement outcomes, an online survey was used to administer standardized measures of level of participation, mobility, anxiety and depression, boredom, resilience, technology readiness, social support, and social networks. Seventy-two participants were recruited, with a mean age (SD) of 61.2 (13.8). This study was comprised of two groups: the adult group consisted of individuals with disabilities under the age of 65 (48.6%) and the older adult group consisted of individuals over the age of 65 with and without self-identified disability (51.4%). There was no significant difference in the proportion of participation restriction between adult (83%) and older adult’ (81%) groups (p = 0.69). In the study population, 27.8% and 16.7% of participants exceeded the anxiety and depression cut-off scores, respectively. Boredom was experienced by 76.4% of participants. Participants’ mean (SD) resilience and life space scores were 72.4 (14.0) and 51.9 (24.0), respectively. The older adults (≥65 years) showed significantly lower depression (p = 0.012) and better resilience (p = 0.038), social support (p = 0.043), and social network (p = 0.021) than the younger adults. Issues with anxiety, boredom, participation, and life space activity were identified in both study groups. This information may provide supporting evidence when creating policies to mitigate existent health and social inequities.
Marcel Tanner, Global Health Specialist “Extraordinaire” Incl Supplementary Materials with Personal Contributions from Renowned Experts
Authors: Bergquist Robert , Meier Lukas
Published: October 2022

Marcel Tanner, President of the Swiss Academy of the Sciences, Director emeritus of the Swiss Tropical and Public Health Institute (Swiss TPH), and Professor of Epidemiology and Medical Parasitology at the University of Basel, Switzerland, is indeed extraordinary, especially when considering the broad set of global health issues covered by his research [...]
MALDI-TOF MS for Rapid Analysis of Bacterial Pathogens Causing Urinary Tract Infections in the Riyadh Region
Authors: Anwer Razique , Darami Hassan , Almarri Firas K. , Albogami Mazen A. , Alahaydib Faisal
Published: October 2022

The successful treatment of bacterial disease is relied on selecting a suitable drug based on the type of bacteria and antimicrobial susceptibility testing. The study’s objective was to identify bacterial isolates from urine samples of patients from the community, followed by antimicrobial susceptibility testing of the isolated bacteria. A total of seventy urine samples were received in the clinical microbiology laboratory; out of which 18 culture-positive cultures and by direct identification using MALDI-TOF MS (Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry) were identified. Of 18 identified bacteria, 17 (94%) were pathogenic. The culture demonstrated that the major species detected in urine samples were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Aeromonas caviae. E. coli (72.2%) was the most common bacterium retrieved from urine samples followed by K. pneumoniae (16.6%). Interestingly, all the isolates, except Enterococcus faecalis, were resistant to erythromycin. The isolates 8 of 13 (61.5%) were resistant to both of the cotrimoxazole and tetracycline. We performed MLST (Multi-locus Sequence Typing) typing of 13 E. coli isolates to study their genetic relatedness and diversity. MLST typing of E. coli showed a total of nine different STs (Sequence Types), which showed the diversity among them. ST 129 was the most common ST found in three E. coli isolates. In our study, two isolates with ST 1126 and ST 1432 represented the global clonal complex 155. MALDI-TOF MS provided dependable results for identifying the bacteria up to species level from urine samples by indirect culture methods. Such local surveillances are highly recommended for empirical therapy awareness and determining isolates’ level of resistance.
Bacterial Contamination of Surgical Instruments Used at the Surgery Department of a Major Teaching Hospital in a Resource-Limited Country: An Observational Study
Authors: Owusu Enid , Asane Francis W. , Bediako-Bowan Antoinette A. , Afutu Emmanuel
Published: October 2022

Surgical instruments, be they disposable or reusable, are essential in any surgical procedure. Reusable surgical instruments should be properly sterilized or disinfected before use. However, the protocols are not always followed accordingly. This results in sterilization and disinfection failures, leading to a possible increase in the incidence of surgical site infections. This observational study report on bacterial contaminants identified instruments used for surgical procedures in a major teaching hospital in a resource-limited country. In total, 207 pre-sterilized surgical instruments and instrument parts used at three units—the general surgical theater, and the gastrointestinal (GI) endoscopy and urology endoscopy (uro-endoscopy) units—within the surgical department were randomly sampled and examined for bacterial contamination. Bacteria isolates were identified, and their antimicrobial susceptibility patterns were determined. Bacteria isolates that were identified included Citrobacter spp., Citrobacter freundii, Bacillus cereus, Staphylococcus hominis, and Staphylococcus aureus. Bacillus cereus was the most predominant bacteria isolated (30/61, 49.1%), and Staphylococcus hominis the least (1/61, 1.6%). In terms of the number of isolates from the three units examined, the uro-endoscopy unit recorded the highest followed by the general surgical theater and the GI endoscopy. However, there was no association between the various units and bacteria isolated, and no significant difference between the number of isolates among the various units (p = 0.9467, χ2 = 0.1095). In this study, even though CFU per device or device part counted was less than 20, bacteria isolated from the instruments used for a surgical procedure is of great concern considering that the setting of the study is a major teaching hospital. Multi-drug resistance was observed in almost all the isolated bacteria. Sterilization processes should be strictly adhered to, taking into consideration the length and temperature in order to reduce the risk of using contaminated instruments in these environments. It is therefore recommended that similar studies should be carried out in surgical departments at different levels of hospitals to ascertain the extent of this problem.
Evaluation of Xpert MTB/RIF Assay, MTB Culture and Line Probe Assay for the Detection of MDR Tuberculosis in AFB Smear Negative Specimens
Authors: Lama Chandri , Adhikari Sanjib , Sapkota Sanjeep , Regmi Ramesh Sharma , Ghimire Gokarna Raj , Banjara Megha Raj , Ghimire Prakash , Rijal Komal Raj
Published: October 2022

The global burden of tuberculosis (TB), particularly with multidrug resistance (MDR), is escalating and has become a major health challenge. It is well known that acid-fast bacilli (AFB) smear-negative TB patients are the major source of spreading TB to healthy individuals when left untreated. Early diagnosis of TB and rapid detection of drug resistance are important for the proper management of drug-resistant TB (DR-TB). Therefore, a laboratory based cross-sectional study was conducted from July to December 2019 at the National Tuberculosis Centre, Thimi, Nepal, with the objective of evaluating the diagnostic performance of Xpert MTB/RIF assay, Mycobacterium tuberculosis (MTB) culture and line probe assay (LPA) for the detection of MDR-TB in AFB smear-negative sputum samples. We evaluated a total of 222 AFB smear-negative sputum specimens, of which 21.6% (n = 48) showed MTB positive with Xpert MTB/RIF assay and, while culturing on Lowenstein–Jensen (LJ) media, 21.2% (n = 47) were MTB culture positive. The sensitivity, specificity, PPV and NPV at 95% confidence interval of Xpert MTB/RIF assay on diagnosing M. tuberculosis from smear-negative specimens were 73% (57–84), 92% (87–96), 71% (59–81) and 93% (89–95), respectively. In addition, the sensitivity of Xpert MTB/RIF assay and LPA in detecting rifampicin resistance was 75% (42–94, 95% CI) and 91.67% (62–99, 95% CI), respectively. The current study also assessed a significant association between the occurrence of pulmonary tuberculosis with different age group, TB history and alcohol consumption. These findings indicate that Xpert MTB/RIF assay and LPA are appropriate methods for early detection and accurate diagnosis of TB and RIF mono-resistant cases.
Oral Microbiome and Dental Caries Development
Authors: Zhang Josie Shizhen , Chu Chun-Hung , Yu Ollie Yiru
Published: October 2022

Dental caries remains the most prevalent oral disease worldwide. The development of dental caries is highly associated with the microbiota in the oral cavity. Microbiological research of dental caries has been conducted for over a century, with conventional culture-based methods and targeted molecular methods being used in order to identify the microorganisms related to dental caries. These methods’ major limitation is that they can identify only part of the culturable microorganisms in the oral cavity. Introducing sequencing-based technology and bioinformatics analysis has boosted oral microbiome research and greatly expanded the understanding of complex oral microbiology. With the continuing revolution of molecular technologies and the accumulated sequence data of the oral microbiome, researchers have realized that microbial composition alone may be insufficient to uncover the relationship between caries and the microbiome. Most updated evidence has coupled metagenomics with transcriptomics and metabolomics techniques in order to comprehensively understand the microbial contribution to dental caries. Therefore, the objective of this article is to give an overview of the research of the oral microbiome and the development of dental caries. This article reviews the classical concepts of the microbiological aspect of dental caries and updates the knowledge of caries microbiology with the results of current studies on the oral microbiome. This paper also provides an update on the caries etiological theory, the microorganisms related to caries development, and the shifts in the microbiome in dental caries development.
Caries Experience and Treatment Needs in Urban and Rural Environments in School-Age Children from Three Provinces of Ecuador: A Cross-Sectional Study
Authors: Vélez-León Eleonor María , Albaladejo-Martínez Alberto , Cuenca-León Katherine , Encalada-Verdugo Liliana , Armas-Vega Ana , Melo María
Published: October 2022

In Ecuador, national epidemiological surveys have not been updated; however, some regional studies in the northern areas of the country still report a high prevalence of dental caries. The aim of this study was to determine the experience, severity, and need for treatment of dental caries in school children aged 6 to 12 years in urban and rural settings in three provinces of southern Ecuador. This cross-sectional, relational study examined 1938 schoolchildren in the provinces of Azuay, Cañar, and Morona Santiago. The survey instruments were based mainly on the WHO manual Methods of Oral Health Surveys (dmft) for primary and permanent dentition (DMFT), as well as the prevalence, severity, and Significant Caries Index (SCI). The parametric Student’s t-test was used to compare two groups, and the Spearman’s Rho and Tau-c Kendall correlation coefficients were used to associate the categorical variables. Results: The prevalence of caries in the primary dentition was 78% and 89.2% in the permanent dentition. The dmft (M = 4.12, SD = 2.86) and DMFT (M = 3.62: SD = 3.07) placed the general group in a moderate caries index. The need for treatment was 90.68% in the primary dentition, while it was 87.99% in the permanent dentition. Caries severity in both dentitions was high (M = 7.74; SD = 3.42). Conclusions. Alarming indicators of caries experience and the need for treatment were observed in the population studied.
Evaluation of the Efficacy of CPP-ACP Remineralizing Mousse in MIH White and Yellow Opacities—In Vitro Vickers Microhardness Analysis
Authors: Cardoso-Martins Inês , Arantes-Oliveira Sofia , Coelho Ana , Pessanha Sofia , F. Marques Paula
Published: October 2022

Remineralization of tooth enamel can be partially achieved by the application of a casein phosphopeptides and amorphous phosphate (CPP-ACP) complex. However, evidence to support its effectiveness in Molar-incisor-hypomineralization (MIH)-affected teeth is scarce. The study’s aim is to evaluate the efficacy of CPP-ACP mousse in remineralizing MIH-affected enamel using a Vickers microhardness test. Two groups of enamel opacities of hypomineralized permanent teeth, white (group A) and yellow (group B) lesions (n = 14), went through a 28-day treatment protocol with GC Tooth Mousse. Before and after treatment, microhardness was measured in three different areas of each tooth (hypomineralized, transition, and outside the hypomineralized area). Data were analyzed using parametric and non-parametric tests with a significance of p < 0.05. The mean microhardness values increased in the hypomineralized and transition areas in both groups after the treatment protocol (in group A, 105.38 ± 11.70 to 158.26 ± 37.34; 123.04 ± 22.84 to 156.33 ± 35.70; in group B, 108.63 ± 14.66 to 143.06 ± 22.81; 132.55 ± 20.66 to 146.00 ± 12.88) and the differences pre/post-treatment were statistically significant within each group (p < 0.001 for both groups). Between groups, there was a statistically significant difference in the same areas (hypomineralized: p = 0.003; transition: p = 0.008) with a higher improvement in enamel hardness in group A. Topical application of CPP-ACP showed an increase in the physical strength of the hypomineralized and transition areas of MIH-affected enamel, likely due to an increase in mineral content.
Learning Curve and Comparison of Dynamic Implant Placement Accuracy Using a Navigation System in Young Professionals
Authors: Spille Johannes , Helmstetter Eva , Kübel Paul , Weitkamp Jan-Tobias , Wagner Juliane , Wieker Henning , Naujokat Hendrik , Flörke Christian , Wiltfang Jörg , Gülses Aydin
Published: October 2022

The aim of the current study was to evaluate the learning curve and accuracy of implant placement by young professionals using a dynamic computer-assisted surgical system for dental implant placement. Ten students tried to place eight implants with a dynamic surgical system in predefined positions on two consecutive weekends, resulting in 160 implant placements in total. Postoperatively, the positions of the implants were scanned with an intraoral scanner and compared for deviations at the entry point, the apex, as well as angular deviations to the master model. The mean values of all measurements improved; statistical significance was found for the changes in the angle as well as for the position of the implants to the apex (p < 0.001). Furthermore, the young professionals indicated subjective improvement in handling the dynamic surgery system. Navigated surgical dental implant placement can be learned quickly and can support young professionals in everyday clinical practice, especially in difficult anatomic situations.
Challenges and Opportunities for Dental Education from COVID-19
Authors: Li Bolei , Cheng Lei , Wang Haohao
Published: October 2022

With the ongoing COVID-19 pandemic, dental education has been profoundly affected by this crisis. First of all, COVID-19 brought physical and psychological health problems to dental students and educators. In addition, both non-clinical teaching and clinical-based training experienced challenges, ranging from fully online educational content to limited dental training, students’ research was delayed in achieving project milestones and there was hesitancy in respect of the COVID-19 vaccine. On the other hand, the COVID-19 pandemic has increased the demand for teledentistry and dental emergency treatment, and brought awareness of the advantages and high-speed development of distance education. This review aims to present these challenges and opportunities for dental education, and suggest how dental institutions should prepare for the future demand for dental education.
Size- and Stereochemistry-Dependent Transcriptional Bypass of DNA Alkyl Phosphotriester Adducts in Mammalian Cells
Authors: Tan Ying , Wu Jiabin , Clabaugh Garrit , Li Lin , Du Hua , Wang Yinsheng
Published: October 2022

Environmental, endogenous and therapeutic alkylating agents can react with internucleotide phosphate groups in DNA to yield alkyl phosphotriester (PTE) adducts. Alkyl-PTEs are induced at relatively high frequencies and are persistent in mammalian tissues; however, their biological consequences in mammalian cells have not been examined. Herein, we assessed how alkyl-PTEs with different alkyl group sizes and stereochemical configurations (SP and RP diastereomers of Me and nPr) affect the efficiency and fidelity of transcription in mammalian cells. We found that, while the RP diastereomer of Me- and nPr-PTEs constituted moderate and strong blockages to transcription, respectively, the SP diastereomer of the two lesions did not appreciably perturb transcription efficiency. In addition, none of the four alkyl-PTEs induced mutant transcripts. Furthermore, polymerase η assumed an important role in promoting transcription across the SP-Me-PTE, but not any of other three lesions. Loss of other translesion synthesis (TLS) polymerases tested, including Pol κ, Pol ι, Pol ξ and REV1, did not alter the transcription bypass efficiency or mutation frequency for any of the alkyl-PTE lesions. Together, our study provided important new knowledge about the impact of alkyl-PTE lesions on transcription and expanded the substrate pool of Pol η in transcriptional bypass.
DEDG: Cluster-Based Delay and Energy-Aware Data Gathering in 3D-UWSN with Optimal Movement of Multi-AUV
Authors: Alkanhel Reem , Chaaf Amir , Samee Nagwan Abdel , Alohali Manal Abdullah , Muthanna Mohammed Saleh Ali , Poluektov Dmitry , Muthanna Ammar
Published: October 2022

The monitoring of underwater aquatic habitats and pipeline leakages and disaster prevention are assisted by the construction of an underwater wireless sensor network (UWSN). The deployment of underwater sensors consumes energy and causes delay when transferring the gathered sensed data via multiple hops. The consumption of energy and delays are minimized by means of an autonomous unmanned vehicle (AUV). This work addresses the idea of reducing energy and delay by incorporating an AUVs-assisted, three-dimensional UWSN (3D-UWSN) called DEDG 3D-UWSN. Energy in the sensor nodes is saved by clustering and scheduling; on the other hand, the delay is minimized by the movement of the AUV and inter-cluster routing. In clustering, multi-objective spotted hyena optimization (MO-SHO) is applied for the selection of the best sensor for the cluster head, which is responsible for assigning sleep schedules for members. According to the total number of members, an equal half of the members is provided with sleep slots based on the energy and hop counts. The redundancy in the gathered data is eliminated by measuring the Hassanat distance. Then, the moving AUV is able to predict its movement by the di-factor actor–critic path prediction method. The mid-point among the four heads is determined so that the AUV can collect data from four heads at a time. In cases where the waiting time of the CH is exceeded, three-step, inter-cluster routing is executed. The three steps are the discovery of possible routes, ignoring the longest paths and validating the filtered path with a fuzzy–LeNet method. In this 3D-UWSN, the sensed data are not always normal, and, hence, a weighted method is presented to transfer emergency events by selecting forwarders. This work is implemented on Network Simulator version 3.26 to test the results. It achieves better efficiency in terms of data collection delay, end-to-end delay, AUV tour length, network lifetime, number of alive nodes and energy consumption.