bluuebunny/crossref_metadata_2025 huggingface dataset:
Axial Spondyloarthritis Treatment Recommendations and Disease Activity Monitoring in Clinical Practice: Results of an Online Survey
Authors: Sinnappan Stephanie , Forte Alexandra , Ermann Joerg
Published: January 2024

Objective

Clinical practice guidelines are not always followed consistently. To better understand potential barriers to the implementation of treatment recommendations in axial spondyloarthritis and ankylosing spondylitis (axSpA/AS), an online survey was conducted.

Methods

Email invitations were sent to US rheumatology care providers in January 2023. The questionnaire included 20 questions, with an estimated completion time of 5-7 minutes.

Results

One hundred four of 441 (24%) invitees participated, including 80/104 (77%) board-certified rheumatologists and 20/104 (19%) fellows. Survey participants identified UpToDate (85%), treatment guidelines (74%), and colleagues (54%) as relevant sources of knowledge for managing axSpA/AS. Of the participants, 64% and 53% considered themselves to be at least moderately familiar with the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network (ACR/SAA/SPARTAN) and Assessment of Spondyloarthritis international Society/European Alliance of Associations for Rheumatology (ASAS/EULAR) treatment recommendations for axSpA/AS, respectively. Whereas 69% of participants agreed or strongly agreed that disease activity scores are useful for making treatment decisions in axSpA/AS, only 37% measure patient-reported outcomes (PROs) frequently (≥ 50% of clinic visits) while 82% do so for C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). PROs are typically recorded during clinic encounters (65%) and CRP/ESR are obtained after the visit (86%). Of the participants, 57% and 47% considered the Bath Ankylosing Spondylitis Disease Activity Index and Ankylosing Spondylitis Disease Activity Score to be at least moderately useful for measuring disease activity in axSpA/AS, respectively; 41% and 37% thought the same about the ASAS 20% improvement criteria and Clinical Disease Activity Index, respectively.

Conclusion

Treatment guidelines are an important resource for rheumatologists who manage patients with axSpA/AS. Although there is general agreement that disease activity monitoring is important, the implementation of the respective recommendations is lacking. Reasons may include lack of familiarity and an underdeveloped infrastructure to efficiently collect PROs.
Preliminary Development of a Novel Tool to Document Vessel Wall Involvement in Patients With Large-Vessel Vasculitis
Authors: Kwok Timothy S.H. , Zhou Alan L. , Nguyen Emily Lan-Vy , Kwan Andrew , Al-Yaarubi Razan A. , Tofighi Taraneh , Gakhal Natasha K. , Lake Shirley , Soowamber Medha
Published: January 2024

Vascular imaging plays an important role in baseline assessment and monitoring disease progression in large-vessel vasculitis (LVV).1However, interpretation and documentation of vessel wall involvement can be challenging due to a lack of standardized radiology reporting frameworks and unfamiliarity with vascular anatomy among rheumatologists.2,3
Multiplicity of nontrivial solutions for a class of fractional Kirchhoff equations
Authors: Shao Liuyang , Chen Haibo , Pang Yicheng , Wang Yingmin
Published: January 2024

In this article, we study a class of fractional Kirchhoff with a superlinear nonlinearity:

   \begin{document}$ \begin{equation} \begin{cases} M(\int_{\mathbb{R}^{N}}|(-\triangle)^{\frac{\alpha}{2}}u|^{2}dx)(-\triangle)^{\alpha}u+\lambda V(x)u = f(x, u)\; \; \mbox{in}\; \; \mathbb{R}^{N}, \\ u\in H^{\alpha}(\mathbb{R}^{N}), \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; \; N\geq1, \; \; \; \; \; \; \; \; (1.1)\notag \end{cases} \end{equation} $\end{document}

where $ \lambda > 0 $ is a parameter, $ a $ and $ b $ are positive numbers satisfying $ M(t) = am(t)+b $, $ m:\mathbb{R}^{+}\rightarrow \mathbb{R}^{+} $ is continuous. $ V: \mathbb{R}^{N}\times\mathbb{R}\rightarrow \mathbb{R} $ is continuous. $ f $ satisfies $ \lim\limits_{|t|\rightarrow \infty}f(x, t)/|t|^{k-1} = Q(x) $ uniformly in $ x\in\mathbb{R}^{N} $ for each $ 2 < k < 2_{\alpha}^{\ast}, (2_{\alpha}^{\ast} = \frac{2N}{N-2\alpha}) $. We investigated the effects of functions $ m $ and $ Q $ on the solution. By applying the variational method, we obtain the existence of multiple solutions. Furthermore, it is worth mentioning that the ground state solution has also been obtained.
BILSTM-SimAM: An improved algorithm for short-term electric load forecasting based on multi-feature
Authors: Chen Mingju , Qiu Fuhong , Xiong Xingzhong , Chang Zhengwei , Wei Yang , Wu Jie
Published: January 2024

With the growing number of user-side resources connected to the distribution system, an occasional imbalance between the distribution side and the user side arises, making short-term power load forecasting technology crucial for addressing this issue. To strengthen the capability of load multi-feature extraction and improve the accuracy of electric load forecasting, we have constructed a novel BILSTM-SimAM network model. First, the entirely non-recursive Variational Mode Decomposition (VMD) signal processing technique is applied to decompose the raw data into Intrinsic Mode Functions (IMF) with significant regularity. This effectively reduces noise in the load sequence and preserves high-frequency data features, making the data more suitable for subsequent feature extraction. Second, a convolutional neural network (CNN) mode incorporates Dropout function to prevent model overfitting, this improves recognition accuracy and accelerates convergence. Finally, the model combines a Bidirectional Long Short-Term Memory (BILSTM) network with a simple parameter-free attention mechanism (SimAM). This combination allows for the extraction of multi-feature from the load data while emphasizing the feature information of key historical time points, further enhancing the model's prediction accuracy. The results indicate that the R2 of the BILSTM-SimAM algorithm model reaches 97.8%, surpassing mainstream models such as Transformer, MLP, and Prophet by 2.0%, 2.7%, and 3.6%, respectively. Additionally, the remaining error metrics also show a reduction, confirming the validity and feasibility of the method proposed.
Comparing Innovative ‘Chosen Training’ with ‘Standard Training’ in Czechia: How Did the New Program Help?
Authors: Hora Ondřej , Suchanec Miroslav , Horáková Markéta
Published: January 2024

This paper evaluates the active labour market policy instrument called ‘chosen training’ (in Czech zvolené rekvalifikace), introduced to the Czech labour market policy in 2012. This new instrument allows the registered unemployed much more freedom to choose their supposed future career path by selecting the preferred profession for training and preferred training provider than traditional standard training programs. The added value of this paper is in the intentional linking of the provision of new measures with the assessment of impacts. The methodology of this text is based on quantitative program assessment. We used PES administrative data OK Práce for programmes implemented in 2016 and tracked the outcomes for 2016-2020. We compare a new instrument with more traditional training programs that continue to be provided alongside the new tool. We concluded that chosen training provided better results than standard training, and we addressed some of the reasons behind the perceived difference. Key words: training, active labour market policy, evaluation, targeting
The Influence of Labor Market Determinants on Economic Inequality Measured by Gini Coefficient in Montenegro
Authors: Popović Nemanja , Radović Milivoje , Đurašković Jovan
Published: January 2024

In this paper an analysis is conducted with the aim of a better understanding how the labour market and income inequality in society are connected, examining the relationships between the variables that describe economic inequality and the labour market in Montenegro. The analysis involves the use of econometric techniques and VAR models, which, with the use of impulse response functions and variance decomposition, best reflect the impact of selected labour market variables on economic inequality. The results of the analysis show that the variables of the labour market, namely the unemployment rate and the long-term unemployment rate, proved to be significant in explaining economic inequality, measured by the Gini coefficient. The results of the research can be useful to various researchers dealing with the issue of economic inequality in Montenegro, providing an additional mechanism for analyzing flows and predicting the future values of the determinants of economic inequality. The results also enable a different approach in the analysis of the labour market and the economic inequality in Montenegrin society, which can serve as a basis for many future analyses. Key words Gini coefficient; labour market; VAR models; inequality
La fortaleza de Tíscar: la organización del espacio de hábitat, agrícola y ganadero en un asentamiento de montaña en época andalusí
Authors: Villar-Mañas Sonia
Published: January 2024

Tíscar se configura en época andalusí en un lugar de montaña que determina en buena medida la organización de los espacios productivos, defensivos y habitacionales. Estos espacios, aunque modificados, perviven en el paisaje. Nuestro objetivo ha sido identificarlos y entender las relaciones que se dan entre ellos. Para esta tarea se ha recurrido al reconocimiento superficial del terreno, al análisis de las fuentes escritas, islámicas y cristianas, y a la revisión de la bibliografía sobre la zona. También se han analizado los datos procedentes de las intervenciones arqueológicas previas. Posteriormente, toda la evidencia recogida se ha procesado en un SIG. El análisis del conjunto de datos se ha volcado sobre un modelo digital del terreno que nos ha permitido comprender la gestión de los recursos naturales por parte de las comunidades campesinas de Tíscar a lo largo del periodo andalusí e identificar los lugares destinados para la explotación de los mismos. Esto nos ha permitido también comprender las relaciones que se dieron entre ellos y el papel que tuvo la fortaleza de Tíscar en la organización y gestión de los diferentes espacios en un lugar de montaña.
Las traducciones árabe y latina del De simplicium medicamentorum facultatibus VI: el caso del grano de ben
Authors: Díaz-Marcos Marina , Solá-Portillo Sara
Published: January 2024

El grano de ben es un fruto que ha sido utilizado con fines terapéuticos desde la Antigüedad. Su descripción está incluida en el libro VI del De simplicium medicamentorum facultatibus de Galeno (s. II), una de las obras farmacológicas más importantes de la historia de la medicina. En este artículo compararemos desde una perspectiva filológica la entrada que Galeno dedicó a este simple en dos de sus traducciones medievales: la árabe de Ḥunayn ibn Isḥāq (s. IX) y la latina de Gerardo de Cremona (s. XII). Nuestro análisis ayudará a profundizar en el estudio de estas dos traducciones y en la técnica de Gerardo de Cremona, el traductor más prolífico de obras de medicina griega y árabe al latín en la Edad Media.
El reino de Castilla en la historiografía árabe: Pedro I y sus sucesores
Authors: Penelas Mayte
Published: January 2024

Este artículo estudia cómo historiadores árabes tan influyentes y renombrados como Ibn Ḫaldūn (m. 808/1406) y al-Maqrīzī (m. 845/1442) describen los reinados de los reyes cristianos de Iberia que fueron contemporáneos suyos, y, especialmente, cómo describen el reinado de Pedro I de Castilla (g. 1350-1366 y 1367-1369). El artículo ofrece un análisis en profundidad de los fragmentos dedicados a Pedro I, al que Ibn Ḫaldūn conoció personalmente, y muestra que su muerte a manos de su medio hermano Enrique II (g. 1366-1367 y 1369-1379) recibió gran atención en Kitāb al-ʿIbar de Ibn Ḫaldūn y Durar al-ʿuqūd al-farīda de al-Maqrīzī. Pone de relieve asimismo que la información sobre el reino de Castilla que proporcionan ambos autores, aunque alterada, guarda relación con fuentes castellanas contemporáneas, y que parte de esa información relativa a la dār al-ḥarb en el otro extremo del Mediterráneo llegó de alguna manera al Egipto mameluco, donde Ibn Ḫaldūn y al-Maqrīzī (y su coetáneo al-Qalqašandī a través de Ibn Ḫaldūn) la incorporaron a sus respectivas obras.
La revanche de la billetterie
Authors: Quidu Pascal
Published: January 2024

Cet article étudie les effets du développement de ce que nous appelons une « billetterie intelligente » au sein du spectacle vivant subventionné. A partir d’une vingtaine d’entretiens, d’une enquête par questionnaire et d’observations de terrain, il montre qu’elle occupe désormais une place centrale au sein des structures culturelles, en particulier parce qu’elle produit des données sur l’activité des lieux de spectacle et sur les comportements des spectateurs. La mise en forme de ces données suscite des attentes considérables, en particulier du fait des difficultés que traverse le secteur (baisse de fréquentation, difficultés à diversifier les publics). À défaut de pouvoir les surmonter, cette focalisation sur la production et l’exploitation de datas sert d’opérateur de compromis entre des acteurs qui ne partagent pas la même conception de leur mission culturelle.
Émergence et évolution de la fonction de communication au sein des universités publiques marocaines
Authors: Jmoula Lamyae
Published: January 2024

Cet article examine l’avènement et l’évolution de la fonction communication dans les universités publiques marocaines. Il s’agit, entre autres, d’examiner les pratiques et les dispositifs mis en œuvre afin d’analyser la manière dont les universités marocaines conçoivent et perçoivent la communication. Nous concluons de nos observations de terrain que la fonction de communication dans l’université marocaine cherche encore ses marques. De plus, la volonté de développer une communication de proximité par l’entremise des réseaux socio-numériques se heurte à des habitudes traditionnelles de communication unidirectionnelle et descendante.
Modelling and Control of Reflected Heat from Light Shelves in Tropical Climates
Authors: Ambadi Archana P. , Raphael Benny
Published: January 2024

While light shelves enhance daylight inside buildings in tropical climates, there is a concern that the heat reflected from them will increase the cooling load inside a building. In this study, experiments are conducted under controlled conditions to understand the heat transmission characteristics of light shelves. The total heat reflected by a prototype of a light shelf is compared to the case of a similar setup with a no light shelf. Different materials were tested to evaluate the heat and light transmission. A mirror glass light shelf gave the highest illuminance, whereas an aluminium light shelf transmitted maximum heat. To explain the experimental results, a simulation model was created using the heat balance equation for the light shelf. The Mean square error between the simulation and experimental data is computed to predict the heat transmitted by the light shelf. The simulation model could reasonably replicate the trends obtained in the experimental data. The simulation model helps in controlling the heat transferred by light shelves in tropical climates.
Multiple Immune and Genetic Mechanisms Contribute to Cmv5s-Driven Susceptibility and Tissue Damage during Acute Murine Cytomegalovirus Infection
Authors: Annis Jessica L , Duncan John Benjamin W , Billcheck Helen O , Kuzma Anna G , Crittenden Rowena B , Brown Michael G
Published: January 2024

The MHC class I molecule H-2Dk conveys resistance to acute murine CMV infection in both C57L (H-2Dk transgenic) and MA/My mice. M.H2k/b mice are on an MA/My background aside from a C57L-derived region spanning the MHC (Cmv5s), which diminishes this resistance and causes significant spleen histopathology. To hone in on the effector elements within the Cmv5s interval, we generated several Cmv5-recombinant congenic mouse strains and screened them in vivo, allowing us to narrow the phenotype-associated interval >6-fold and segment the genetic mechanism to at least two independent loci within the MHC region. In addition, we sought to further characterize the Cmv5s-associated phenotypes in their temporal appearance and potential direct relationship to viral load. To this end, we found that Cmv5s histopathology and NK cell activation could not be fully mirrored in the MA/My mice with increased viral dose, and that marginal zone destruction was the first apparent Cmv5s phenotype, being reliably quantified as early as 2 d postinfection in the M.H2k/b mice, prior to divergence in viral load, weight loss, or NK cell phenotype. Finally, we further dissect NK cell involvement, finding no intrinsic differences in NK cell function, despite increased upregulation of activation markers and checkpoint receptors. In conclusion, these data dissect the genetic and immunologic underpinnings of Cmv5 and reveal a model in which polymorphism within the MHC region of the genome leads to the development of tissue damage and corrupts protective NK cell immunity during acute viral infection.
Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms
Authors: Martino Gabriella , Viola Anna , Vicario Carmelo Mario , Bellone Federica , Silvestro Orlando , Squadrito Giovanni , Schwarz Peter , Lo Coco Gianluca , Fries Walter , Catalano Antonino
Published: January 2024

A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.
Incorporating Artificial Intelligence Into Athletic Training Education: Developing Case-Based Scenarios Using ChatGPT
Authors: Schneider Kyle , Tomchuk David , Snyder Ben , Bisch Tarrah , Koch Gina
Published: January 2024

Context

ChatGPT is an AI-based large language model platform capable of mimicking human language patterns by responding to user queries. Although concerns over AI-generated content exist in health care and higher education, the ChatGPT platform can assist athletic training educators in creating academic content to alleviate aspects of their academic workload and responsibilities.

Objective

To provide a brief historical overview of ChatGPT, accepted positives and negatives, and examples of how athletic training educators can use ChatGPT for case-based scenario contention creation.

Background

The initial development of ChatGPT began in 2018, with its public launch in November 2022. ChatGPT uses machine and in-context learning to replicate human language expression. Since its public launch, students, researchers, educators, clinicians, governments, and companies have sought to determine how to incorporate ChatGPT into their workflow operations.

Data Synthesis

Athletic training educators can incorporate ChatGPT into their academic content creation methodology. With the capability of ChatGPT, athletic training educators have the potential to facilitate athletic training student learning more efficiently.

Results

ChatGPT can ease the academic workload of athletic training educators while being a beneficial clinical tool that athletic training students may use in their future workplace settings.

Recommendation(s)

Athletic training educators should consider using ChatGPT or a similar AI-based large language model platform when developing education content and simulation scenarios.

Conclusions

ChatGPT can lessen athletic training educator workload and potentially facilitate athletic training student learning.
Screening of Chronic Kidney Disease in Adults: A 10 years' Experience in North Indian City on World Kidney Day
Authors: Rai Pradeep Kumar , Rai Punam , Bedi Sonam , Bansal Anubhav , Rai Yashwin
Published: January 2024

Chronic kidney disease (CKD) is a complex disease that is asymptomatic in its early stages. Its delayed recognition may predispose patients to adverse outcomes. Early detection and management of kidney disease through screening programs is widely recommended. In the present study, we conducted a screening program at a hospital set up on World Kidney Day for 10 years to detect patients with CKD. The current study constituted 1324 apparently healthy adults, aged >18 years. Information on age, sex, height, weight, history of diabetes mellitus (DM) and hypertension (HTN), and familial history of kidney disease was recorded. Systolic and diastolic blood pressure, random blood sugar; urinalysis, and serum creatinine (Cr) levels were measured. The study outcome was the presence of CKD. Binary logistic regression analysis was applied to find the predictors of CKD. The median age of the study subjects was 40 years. CKD was found in 35.6% of subjects. Age, DM, HTN, and abnormal Cr levels were associated with increasing risk of CKD. The main objective of the present study was to identify the extent of risk relative to the co-factors of CKD and thereby target those who are potentially modifiable, like DM, to intervene at the earliest possible stage to treat the current disease condition and prevent the future health impairment.
Clinico-biochemical Profile of Biopsy-proven Minimal Change Disease in Adults from a Tertiary Care Center in South India
Authors: Udupa Karteek R. N. , Eshwarappa Mahesh , Gurudev K. C. , Gireesh M. S. , Reddy Rajshekar , Yousuff Mohammed
Published: January 2024

Minimal change disease (MCD) is the most common cause of nephrotic syndrome (NS) in children, and in adults, it contributes to 10%–25% of NS. MCD in adults follows a slightly different course associated with increased incidence of steroid resistance, hematuria, and HTN. This is a prospective-record analysis study aimed to analyze the profile of MCD in adults, response to treatment, and relapse rates. A retrospective observational study was carried out and data were collected retrospectively from all biopsy-proven MCD patients between 2012 and 2018. A total of 86 adults were diagnosed to have biopsy-proven MCD. Of these, 32 were excluded due to insufficient data/lost for follow-up. The IBM SPSS Statistics version 22.0 was used for the statistical analysis. Descriptive analysis includes expression of all the explanatory and outcome variables in terms of frequency and proportions for categorical variables whereas in terms of mean ± standard deviation for continuous variables. Chi-square test was used to compare the age, gender, remission, renal failure and response of different drugs, treatment durations, comorbidity conditions, relapse episodes, and different types of infections based on the degree of proteinuria among study patients. A total of 54 biopsy-proven adult MCD patients were analyzed. The mean age of the patients studied was 36.67 years, with the oldest patient being 76 years. In the study group, 37 (68.5%) patients were male and 14 (31.5%) were female. In the study population, 20 (37%) were hypertensive, 3 (5.6%) were diabetic, and 10 (18.5%) had renal failure at presentation. On treatment, 52 out of 54 patients received steroids, of which 41 (75.9%) were steroid responsive, 6 (11.1%) steroid dependent, and 7 (13%) steroid resistant. The mean time for remission in steroidsensitive patients was 8.8 weeks. Among the steroid-dependent and steroid-resistant patients, 11 patients received calcineurin inhibitors (CNIs), of which 3 were CNI resistant. In the study Group 1 patient received cyclophosphamide and two received rituximab. In the study population, two patients failed to achieve remission and one patient was initiated on hemodialysis and later lost for follow-up. Minimal change NS is a type of NS which is highly responsive to steroids with good prognosis in children. Adult MCD patients require a higher and prolonged course of steroid when compared to children. CNIs and rituximab form a promising second-line drug in patients who are steroid resistant/dependent. However, CNI dependency or relapse after stopping steroids is a concern.
CYP3A5 Polymorphisms Leading to Tacrolimus Toxicity Following an Adult Renal Transplant
Authors: Alotaibi Nouf
Published: January 2024

Tacrolimus is one of the calcineurin inhibitors used for maintaining immuno-suppression in thoracic and abdominal transplantations including heart, lung, liver, intestine, pancreas, and renal transplants. It has a narrow therapeutic window requiring therapeutic drug monitoring (TDM). Genetic polymorphism in the expression of cytochrome P3A5 enzyme plays a significant role in the bioavailability of tacrolimus in patients, leading to toxicity or rejection. In this case, we studied a renal transplant patient who received a standard dose of tacrolimus and experienced toxicity related to the poor expression of cytochrome P450 3A5 (CYP3A5), which required the withholding of tacrolimus and cutting the dose for several days with more frequent TDM. Similar cases have been reported before, yet there is no consensus on the appropriate dosage. The projected cost of additional TDM and hospitalization significantly exceeds the one-time cost of genetic CYP3A5 testing. In high-risk renal transplant recipients, pharmacogenetic testing must be considered to cut the time to limit TDM, prevent extended hospitalization, and reduce the total cost of transplantation.
Collapsing Glomerulopathy in a Patient with a TRPC6 Mutation Presenting as Rapidly Progressive Glomerulonephritis: A Case Report and Review of the Literature
Authors: Gokce Ibrahim , Kaya Mehtap , Cicek Neslihan , Guven Sercin , Ercetin Yigit , Yildiz Nurdan , Kaya Handan , Alpay Harika
Published: January 2024

Collapsing glomerulopathy (CG) is a proliferative disease characterized by segmental or global wrinkling of the glomerular basement membrane and the formation of pseudocrescents, whereas focal segmental glomerulosclerosis (FSGS) is characterized by podocytopenia, and focal and segmental sclerosis of the glomeruli. Mutations in NPHS1, NPHS2, WT1, PLCE1, CD2AP, ACTN4, and TRPC6 have been reported in steroid-resistant FSGS patients. The mutations p.R895C and p.R895L in Exon 13 are the only ones in TRPC6 causing CG reported to date. Here, we present the case of a 17-year-old male patient with a collapsing variant of familial FSGS caused by a mutation in TRPC6 (p.R895C) who presented with rapidly progressive (crescentic) and proliferative glomerulonephritis.
A Nine-year-old Boy with Renovascular Hypertension: Knowing Where to Look
Authors: Ozlu Sare Gulfem , Ece İbrahim , Koca Serhat , Ozbulbul Nilgun Isiksalan
Published: January 2024

Renal artery entrapment (RAE) by hypertrophic diaphragmatic crura is an extremely rare cause of renovascular hypertension (RVH). Here, we report the case of a 9-year-old boy diagnosed with RVH caused by right RAE by a hypertrophic diaphragmatic crus and successfully managed with close medical monitoring. Diagnosis of this entity is easily overlooked if the optimal views are not obtained during imaging, which depends on a high index of suspicion. We would like to remind clinicians to keep this rare condition in mind when evaluating children with RVH.
A paradigm shift from calcium hydroxide to bioceramics in direct pulp capping: A narrative review
Authors: Al–Saudi Khaled Wagih
Published: January 2024

For many years, calcium hydroxide (CH) was the preferred material for direct pulp capping (DPC), occupying an elevated position. The collapse of this paradigm is due to the emergence of bioceramics with less pulpal inflammation and superior mineralization abilities than CH. The goal of the current article was directed to: (1) review the history of DPC “the idea of an exposed pulp as a hopeless organ has given way to one of healing and optimism,” (2) classify the bioceramics in dentistry, and (3) explain and compare the mechanism by which dentin barriers for CH and bioceramics are formed. A comprehensive literature search of the database was conducted using PubMed, Google Scholar, and Scopus utilizing the following terms: Biodentine, calcium hydroxide, calcium aluminate, calcium phosphate, calcium silicate, direct pulp capping, NeoMTA Plus, Quick-Set2, and TotalFill. Reference mining of the selected publications was utilized to discover other studies and strengthen the results. Only works written in English were taken into consideration, and there were no restrictions on the year of publication. Bioceramic materials might be used as an intriguing substitute for CH. Compared to CH, they induced more positive pulpal reactions.
In vitro comparative evaluation of antioxidative effect of selenium alone and in combination with green tea and alpha-tocopherol on the shear bond strength of universal composite resin to enamel after in-office bleaching
Authors: Halkai Rahul S. , Halkai Kiran R. , Aneesha Y. Ayshathul , Naaz Sameena
Published: January 2024

Background:

Antioxidant application soon after bleaching process increases the shear bond strength (SBS) of composite resin to enamel.

Aims:

The aim of the study was to evaluate the antioxidant effects of selenium alone and in combination with alpha-tocopherol (αT) and green tea (GT) on SBS of composite resin to enamel following in-office bleaching with 38% hydrogen peroxide (HP).

Methods:

Sixty extracted human single -rooted premolar teeth were cleaned and embedded in acrylic resin blocks at the level of cementoenamel junction(CEJ) followed by bleaching with 38% hydrogen peroxide (HP) and arbitrarily divided into seven groups (n=10) for antioxidant application: Group I (negative control): intact teeth, Group II (positive control): only bleaching, Group III: 10% selenium (Se), Group IV: 10% alpha tocopherol (αT), Group V: 10% αT +10% Se, Group VI: 10% Green tea (GT), Group VII: 10%GT+10% Se. In all groups, self-etch adhesive was applied and composite restoration was done, and specimens were stored in distilled water for 24h followed by SBS evaluation.

Statistical Analysis:

One-way analysis of variance and post hoc Tukey’s tests were used (P < 0.05).

Results:

The highest SBS was found in negative control Group I (intact teeth) and least in positive control Group II (bleached teeth), whereas in experimental groups, Group VII (GT + Se) showed highest followed by Groups V (αT + Se), III (Se), and VI (GT) and least in Group IV (αT).

Conclusion:

Combination of selenium with green tea and alpha tocopherol enhanced the SBS of composite resin following in-office bleaching.
Assessment of the impact of XP-Endo Finisher file on push-out bond strength of various endodontic sealers
Authors: Mohite Pramod , Gupta Divya , Gupta Ruchika , Kamat Sharad , Shaw Amar Kumar
Published: January 2024

Background:

An endodontic treatment is considered a success after thorough chemomechanical debridement coupled with obturating root canals in a concrete way thereby providing hermetic seal. Gutta-percha being nonadherent necessitates use of a sealer to achieve hermetic seal. Adequate adhesion of root canal sealer with gutta-percha core and radicular dentin ensures lack of apical leakage.

Materials and Methods:

Sixty extracted mandibular premolars with single root canal decoronated at cementoenamel junction were selected and randomly allocated to two groups (n = 30). Samples in Group 1 were prepared with BT Race file, while Group 2 samples were prepared with BT Race alongwith XP Endo file. Absorbent paper points were used for canal drying and samples were randomly divided into six subgroups. In Subgroup I, obturation was done with bio-ceramic (BC) sealer (Endosequence BC) and BC gutta-percha. In Subgroup II, resin-based (AH plus) sealer and gutta-percha were used. In Subgroup III, calcium hydroxide-based (Sealapex) sealer and gutta-percha were used. Sectioning of root samples was done perpendicularly into coronal, middle, and apical segments of 3 mm each. A universal testing machine was used for sample testing, in which push-out bond strength corresponded to the highest value obtained. Stereomicroscopic (×20) study of the samples determined the failure mode at dentin/sealer/main cone interface.

Statistical Analysis:

Analysis of variance and post hoc Tukey’s tests were used for data analysis.

Results:

Endosequence BC with XP-Endo files showed the highest mean push-out bond strength (16.31 MPa), whereas Sealapex without XP-Endo file had the lowest values (12.76 MPa). Mixed failure of adhesive and cohesive mode was observed for most samples.

Conclusion:

Adjunctive irrigation agitation technique utilizing XP-Endo Finisher facilitates biofilm eradication from difficult niches in root canals, thereby improving adhesion of sealer and subsequently the sealer bond strength.
Effect of prewarming and continuous warming on tissue dissolving ability of Triton™ versus Twin Kleen™: An in vitro study
Authors: Deepa Velagala Lakshmi , Vanga Himasai Reddy , Kadali Naveena , Divve Sravyasai , Sravya Vemana , Kapa Roopa Sravya
Published: January 2024

Context:

TwinKleen™ and Triton™ are newer all-in-one irrigants that have simultaneous action on both organic and inorganic contents. Studies comparing their tissue dissolving ability (TDA) either at room temperature (RT) or on prewarming (PW) and continuous warming (CW) are not yet reported.

Aims:

To evaluate and compare the effect of 3% sodium hypochlorite (NaOCl), Twin Kleen™, and Triton™, on the bovine TDA.

Materials and Methods:

One hundred and twenty tissue specimens (size 4 mm × 4 mm × 2 mm and weight 37 ± 3 mg) were divided into Group 1, normal saline (negative control); Group 2, 3% NaOCl (positive control); Group 3, Twin Kleen™; and Group 4, Triton™ (n = 30) Each group is further divided into three subgroups with ten samples each as sub group a – at room temperature (RT), sub group b – on pre warming (PW) and sub group c– on continuous warming (CW), Tissue specimens were immersed in test tubes with 5 ml of respective irrigants replenished thrice every 15 min. The percentage difference in tissue weights was calculated after 5, 10, and 15 min.

Statistical Analysis Used:

Multiple intergroup comparisons were done using Tukey’s multiple-comparison test, using SPSS software version 23.0.

Results:

Both Triton™ and 3% NaOCl showed significantly higher dissolution than normal saline and Twin Kleen™ on CW followed by PW than at RT. Twin Kleen™ showed significantly less dissolution at all the tested temperatures.

Conclusions:

Heating enhances the TDA of Triton™ and 3% NaOCl but not Twin Kleen™. CW showed significantly higher dissolution than PW.
Analysis of cyclic fatigue resistance of different endodontic nickel–titanium rotary instruments: An in vitro study
Authors: Langaliya Akshayraj , Patel Neeta , Pallipurath Athulya , Parmar Girish , Kothari Anjali , Jhala Kairavi
Published: January 2024

Aims:

The aim of this in vitro study was to compare the cyclic fatigue resistance of three different endodontic nickel–titanium rotary instruments using a dynamic testing device.

Materials and Methods:

Ten files each of ProTaper Gold (PG), Hyflex Electro-discharge Machining (HEDM), and TruNatomy (TN) were tested in a custom-fabricated dynamic cyclic fatigue testing device at 60° curvature having a radius of curvature of 5 mm. The number of cycles to the fracture (NCF) of each instrument was calculated and three continuous groups were compared by the Kruskal–Wallis test and Dunn post hoc test was used for pairwise comparison.

Results:

Cyclic fatigue resistance of HEDM was the highest, followed by TN. PG had the lowest among the three.

Conclusion:

Within the limitations of the present in vitro results, it can be concluded that HEDM files appeared to be suitable for shaping complex canals with the greater number of cycles before it fractures.
Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study
Authors: Awati Aishwarya Sanjay , Dhaded Neha S. , Mokal Siddhesh , Doddwad Preeti Kore
Published: January 2024

Objective:

The objective of the study was to compare and evaluate the depth of penetration of an epoxy resin-based sealer following a final rinse of 17% ethylenediaminetetraacetic acid (EDTA) and 18% 1-hydroxyethylidene 1, 1-diphosphonate (HEDP), with diode laser and passive ultrasonic activation (PUI): an in vitro confocal laser scanning microscopy study.

Materials and Methods:

Fifty-two extracted human mandibular premolar teeth with single root and single canal were selected. They were disinfected in 0.1% thymol solution, cleaned of calculus and soft tissues, and stored in 0.1% thymol solution till use. All teeth were radiographed and selected as per the inclusion and exclusion criteria. The teeth were decoronated using a diamond disk under copious water spray to acquire a standardized root length of 14 mm. Working length was established by inserting a size 10-K file into each root canal until it is visible at the apical foramen and by subtracting 1 mm from the recorded length. Instrumentation of the root canal was done till master apical file size of F3 using ProTaper universal, rotary instruments. The canals were irrigated with 2 mL of 3% sodium hypochlorite between successive files. Teeth were randomly divided into four subgroups n = 12 according to the intervention. Passive ultrasonic irrigation and diode laser were used to activate the irrigants. Final irrigation was performed with distilled water. These specimens were examined using confocal laser scanning microscope (OLYMPUS FLUOVIEW FV 3000) for dentinal tubule penetration of the sealer. Two-way ANOVA test and Tukey’s multiple post hoc test were used for statistical analysis.

Results:

Highly significant difference was seen between the groups with EDTA and HEDP, with HEDP demonstrating the highest penetration. Among the activation techniques used in this study, PUI showed the highest penetration of the sealer. The least penetration was seen with diode laser activation and EDTA.

Conclusions:

The irrigation activation techniques significantly influence the penetration of sealer into root dentinal tubules. When penetration of sealer with different irrigation techniques and irrigants was evaluated, significant greater level of sealer penetration was attained with PUI activation of HEDP.
Comparative evaluation of stress distribution against the root canal wall at three different levels using novel NiTi rotary files – A finite element analysis
Authors: Singh Rimjhim , Dubey Sandeep , Singh Palak , Samant Praveen Singh , Saha Suparna Ganguly
Published: January 2024

Background:

Recent innovations in the physical and mechanical features of endodontic file systems have diminished the prospect of stress generation and fracture risk in novel endodontic files.

Aim:

The purpose of this research was to comparatively evaluate the stress distribution of recently introduced endodontic rotary files with distinct features and metallurgy at three different levels of the root canal wall by finite element analysis.

Materials and Methods:

Forty endodontic files were used in this experiment after being inspected through a scanning electron microscope for any surface deformities. Based on their metallurgy and design, the scanned files were divided into four groups, each with 10 samples: Group A-2Shape files, Group B-F360, Group C-One Curve, and Group D-TruNatomy. To assess the mechanical behavior of these files, the stress produced by computer-aided models of these instruments on the dentinal wall of a simulated root canal was numerically analyzed using ANSYS® 15 Workbench finite element software.

Results:

A one-way ANOVA was used to assess all the raw data with post hoc Tukey analysis, the Shapiro–Wilk test, and Levene’s test. F360 files exerted the maximum stress on the dentinal wall, while TruNatomy files exerted the least stress at all the distinct levels of dentinal walls.

Conclusions:

There was no statistically significant variation in the stress generated between the four groups. Therefore, it can be concluded that improvements in rotary file design and metallurgy have the potential to reduce the stress during canal shaping and the risk of instrument breakage during clinical use.
Double trouble in an ectopic pregnancy
Authors: Singh Shalini , Kamatham Vandana , Vijayan Sharmila , Joshi Prashant
Published: January 2024

Gestational trophoblastic diseases are histologically different types of tumors originating from the placenta with an incidence of 0.2–5.8/1000 pregnancies. Ectopic pregnancy is the implantation of the fertilized ovum outside the uterine cavity, and a 0.64% incidence is reported. Ectopic cornual pregnancy and molar pregnancy are rare cases, and a combination of these two rare entities occurring simultaneously is even rare and very few cases have been reported in the literature. A cornual pregnancy refers to the implantation and development of a gestational sac in one of the upper and lateral portions of the uterus, whereas an interstitial pregnancy is a gestational sac that implants within the proximal, intramural portion of the fallopian tube that is enveloped by the myometrium. We present one of the rare combinations of molar pregnancy and cornual/interstitial ectopic pregnancy in a 30-year-old G3P1 who presented with a triad of amenorrhea, vaginal bleeding, and abdominal pain. Laparotomy was done in view of an ultrasound which was suggestive of a well-defined complex thick-walled lesion of size 3.2 × 3.3 with a gestational sac and no cardiac activity in the right fallopian tube/adnexa suggesting tubal ectopic pregnancy. Beta-human chorionic gonadotropin (β-hCG) levels were done and noted to be as high as 9998 mIU/mL. Intraoperatively, a cornual ectopic pregnancy was found with no hemoperitoneum which was excised. Histopathology showed chorionic villi with variable size and hydropic change, myxoid stromal changes, and cistern formation with polar trophoblastic proliferation, based on which a diagnosis of molar pregnancy was made. Although ultrasonography and higher than usual serum β-hCG levels are diagnostic of uterine molar pregnancy, they do not yield a proper diagnosis in ectopic molar pregnancy, hence, making it difficult to distinguish between an early ectopic molar pregnancy from a nontrophoblastic tubal pregnancy. The final diagnosis is usually made only after histopathology. A high degree of clinical suspicion of cornual pregnancy followed by histopathological examination of the products of conception is the standard for arriving at an appropriate diagnosis. Serial serum β-hCG level follow-up is recommended to rule out its malignant potential.
Gestational trophoblastic neoplasia coexisting with cervical carcinoma: A case report
Authors: Soriano-Estrella Agnes L. , Bolastig-Canson Julie Ann B , Rendaje Ginessa Grace G. , Galingan May Delight G.
Published: January 2024

Gestational trophoblastic neoplasia (GTN) with a concurrent cervical malignancy is very rare, making the case both a diagnostic dilemma and a therapeutic challenge. Currently, there has only been one reported case worldwide. We present a case of GTN Stage I:11 with non-keratinizing squamous cell carcinoma of the cervix Stage II-B. Initial treatment, in the form of chemotherapy, was directed toward the GTN, as this appeared to be the more aggressive disease. Surgery was not feasible during diagnosis due to the cervical carcinoma. However, the GTN proved resistant to chemotherapy due to the increasing beta human chorionic gonadotropin titers. An attempt to decrease the size of the cervix for surgery to be possible through chemoradiation was instituted, but due to complications and tumor progression to the lungs, she succumbed to the malignancy.
International Endometrial Tumor Analysis (IETA) terminology for the evaluation of endometrial color flow and vascular pattern in women with abnormal uterine bleeding – a reproducibility study among ob-gyn ultrasound subspecialists in a tertiary training hospital
Authors: Yu Nina Rojana Lim , Panlilio-Vitriolo Regina Rosario
Published: January 2024

BACKGROUND:

The International Endometrial Tumor Analysis (IETA) group developed a catalog of standardized terms to describe findings that may be associated with uterine pathology. However, there is a lack of reliability studies for these descriptors in the literature.

OBJECTIVE:

The objective of this study was to estimate interobserver and intraobserver reliability with regard to the IETA group descriptors for endometrial vascular characteristics in women with abnormal uterine bleeding.

MATERIALS AND METHODS:

Five nonexpert and five expert raters assessed stored still images of transvaginal ultrasound examinations obtained from 68 women with abnormal uterine bleeding and endometrial thickening. Endometrial vascularity was evaluated using the IETA group descriptors for color flow and vascular pattern. Interobserver agreement was estimated by comparing the assessments of the nonexpert and expert raters. Intraobserver agreement was estimated by repeating the raters’ assessment after 4 weeks. Interrater agreement to the subjective assessment of an expert investigator was also computed.

RESULTS AND CONCLUSION:

The reproducibility of assigning IETA color score is good regardless of the degree of expertise of the rater, although the experts displayed better interobserver reliability (κ = 0.74 vs. 0.57) and intraobserver reliability (κ = 0.84 vs. 0.63). However, the reproducibility of describing IETA vascular patterns is significantly worse for both expert and nonexpert raters in both interobserver reliability (experts κ = 0.49 vs. 0.34) and intraobserver reliability (experts κ = 0.65 vs. 0.42). Both expert and nonexpert raters exhibited acceptable agreement with the reference standard, with experts performing better for both color score (κ = 0.79 vs. 0.70) and vascular pattern (κ = 0.63 vs. 0.44).