bluuebunny/crossref_metadata_2025 huggingface dataset:
PP187 Robotic Surgery, Any Updates?
Authors: Andellini Martina , Di Mauro Roxana , Faggiano Francesco , Derrico Pietro , Ritrovato Matteo
Published: December 2019

Introduction

This work aims to update the previous robotic surgery health technology assessment (HTA) study conducted in 2013 in Bambino Gesù Children's Hospital. The study, focused on the evaluation of the newest evidence that have emerged over the last three years, aims to identify if there are new perspectives and advantages of introducing this technology in the hospital.

Methods

Decision-oriented HTA (DoHTA) method was applied to conduct the assessment. It involved the integration of the European Network for HTA Core Model® (version 3.0) and the analytic hierarchy process providing the definition and the numerical evaluation of assessment parameters through which it is possible to evaluate the performance of the technologies compared. Three years after the first technology's evaluation, an updated literature review was conducted, using the same 2013 key words, to identify changes in the indicators’ performance score. The performance values have been updated through a quantitative and qualitative evaluation of data gathered from the literature review, expert opinion and context analysis. The global weights’ system, developed in 2013, has not been updated because the relative importance of each domain remained unchanged. The performance values of safety, efficacy, costs, and social aspects have been estimated, identifying the differences in terms of percentage values in comparison with the previous study.

Results

Results showed a slight improvement on safety and organizational aspects in robotic surgery; however, clinical effectiveness and economic, social and legal aspects remained unvaried. More specifically, it has been registered a 3 percent reduction of the difference of the distance between robotic and laparoscopic performance values (2013: 14, 15 percent; 2017: 11, 29 percent).

Conclusions

Results highlighted a slight improvement in robotic surgery performances even if it confirmed the previous results for which the laparoscopic system outperformed the others and currently is keeping the best performance techniques. Finally, sensitivity analysis and a Monte Carlo simulation were carried out proving the stability and reliability of the solution.
PP193 How Does HTA Address Social Expectations Now? An International Survey.
Authors: Gagnon Hubert , Bellemare Christian , Legault Georges-Auguste , Bédard Suzanne K. , Béland Jean-Pierre , Bernier Louise , Dagenais Pierre , Daniel Charles-Etienne , Tapin Danielle , Parent Monelle , Patenaude Johane
Published: December 2019

Introduction

After surveying its members on ethical issues (2003), the International Network of Agencies for Health Technology Assessment (INAHTA) mandated its Ethics Working Group (2005) to reflect on the role of health technology assessment (HTA) organizations in meeting social expectations. Some aspects of these have since been clarified by two studies addressing either the official position of INAHTA's members or the publication authors. An international survey was carried out on the perception of HTA professionals’ expectations when producing HTA reports: how to fulfil HTA's social role, which value judgments should be made explicit and what should be the status of ethical analysis.

Methods

A twenty-two question, web-based, anonymous survey was devised from our recent systematic review on the integration of ethics into HTA and carried from April to July 2018. The information on 328 HTA agencies/contact persons from seventy-five countries was collected from the website of INAHTA, Health Technology Assessment International (HTAi), the European Network for Health Technology Assessment (EUnetHTA), EuroScan International Network, the HTA Network of the Americas (RedETSA) and the HTA Network of Asia (HTAsiaLink), a 2015 World Health Organization survey, HTAi members, and our local HTA network (Québec, Canada).

Results

Eighty-nine participants completed and submitted a finalized survey for a 27 percent participation rate representing thirty-three countries. Regarding how the HTA reports should fulfil their social role, our results showed that over 84 percent of the respondents agreed upon the necessity to address it to decision makers, patients and citizens. At a lower and more variable level, the same result was found about the necessity to make value judgements explicit in different sections of the report, including ethical analysis. This contrasts with the variability of responses obtained on the status of ethical analysis although an agreement on the expertise required was observed. Variability in the usefulness of patient, public or stakeholder participation was observed.

Conclusions

At the dawn of this decade, this study reveals high expectations on context-dependent decisions in HTA: the necessity to integrate the ‘explicitation’ of value judgements and systematic ethical analysis to fulfil HTA's social role.
PP194 Intersectoral Costs And Benefits In The Societal Perspective
Authors: Drost Ruben , van der Putten Inge , Ruwaard Dirk , Evers Silvia , Paulus Aggie
Published: December 2019

Introduction

Many health care interventions have costs and benefits that spill over to sectors outside the healthcare sector. Little is known about these inter-sectoral costs and benefits (ICBs). However, to achieve an efficient allocation of scarce resources, insights on ICBs are indispensable. The main objective of this study was to identify the ICBs related to health care and provide a sector-specific classification scheme for these ICBs. For this sector-specific classification scheme mental disorders were taken as an example, as we expect that this is the sector with the most ICBs.

Methods

Using PubMed, a literature search was conducted for ICBs of mental disorders and related (psycho)social effects. A policy perspective was used to build the scheme's structure, which was adapted to the outcomes of the literature search. In order to validate the scheme's international applicability inside and outside the mental health domain, semi-structured interviews were conducted with (inter)national experts in the broad fields of health care.

Results

The searched-for items appeared in a total of fifty-two studies. The ICBs found were classified in one of four sectors: “Education”, “Labor and Social Security”, “Household and Leisure” or “Criminal Justice System”. Psycho(social) effects were placed in a separate section under “Individual and Family”. Based on interviews, the scheme remained unadjusted, apart from adding a population-based dimension.

Conclusions

This is the first study which offers a sector-specific classification of ICBs. Given the explorative nature of the study, no guidelines on sector-specific classification of ICBs were available. Nevertheless, the classification scheme was acknowledged by an international audience and could therefore provide added value to researchers and policymakers in the field of health technology assessment. The identification and classification of ICBs offers decision makers supporting information on how to optimally allocate scarce resources. By exploring a new area of research, which has remained largely unexplored until now, the current study has an added value as it may form the basis for the development of a tool which can be used to calculate the ICBs of health care interventions.
VP14 Cost Analysis For HD And Peritoneal Dialysis For ESRD In South Africa
Authors: Makhele Letlhogonolo , Matlala Moliehi , Sibanda Mncengeli , Martin Antony , Godman Brian
Published: December 2019

Introduction

Hemodialysis (HD) and peritoneal dialysis (PD) are commonly used to treat patients with end-stage renal disease (ESRD). However, their costs have grown considerably in recent years as the rates of non-communicable diseases including diabetes and hypertension have grown. This will adversely impact on national health budgets especially in low- and middle-income countries (LMICs). Currently, there is limited knowledge about the costs of ESRD and the different components within the public healthcare system in South Africa. Consequently, our objective was to examine the direct medical costs of both approaches from a public provider perspective to provide future guidance.

Methods

A prospective observational study undertaken at a leading public hospital in South Africa based principally on patients’ notes and costs from nationally procured lists. A micro-costing approach was used to estimate health care costs among adult patients with ESRD who had received either HD and PD for at least 3 months.

Results

The majority of patients (35 percent) were aged 40 to 50 years. Patients aged 29-39 years were mostly on HD (28 percent) while those between 51-59 years mostly on PD (29 percent), with HD typically managed in the private sector with limited facilities in the public sector. The average age of patients on HD and PD was 41 and 42 years respectively. Variable costs (USD 20, 488.79) were the highest cost component for PD patients with fixed costs the highest component for HD patients ((USD 16,231.45). The annual cost of HD (USD 31,993.12) was higher than PD (USD 25,282 per patient) but not statistically significant (p = 0.816). The overall burden if appreciably more patients with ESRD are managed appropriately within the public system (covering 80 percent of the population) would be considerable and become unaffordable.

Conclusions

HD costs more than PD. These cost estimates are useful for carrying out future health economic analyses and for allocating greater resources to prevent progress to ESRD.
VP27 Countrywide Screening Of Cardiovascular Diseases Through Telemedicine
Authors: Galvan Pedro , Ortellado Jose , Rivas Ronald , Portillo Juan , Mazzoleni Julio , Hilario Enrique
Published: December 2019

Introduction

Through telemedicine, advantageous telediagnostic systems can be developed to improve the health care of populations that do not have access to specialists. However, evidence on how such innovation technology can enhance the countrywide electrocardiographic (EKG) screening to support a prevention program for cardiovascular diseases is limited. The usability of telemedicine to improve the countrywide detection of heart diseases according to the national cardiovascular disease prevention program in Paraguay was investigated.

Methods

This cross-sectional survey included adults (≥19 and ≤ 80 years) and children (≥1 and ≤ 18 years) with medical prescription. The study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute (IICS-UNA) to evaluate the utility of a telediagnostic net for detection and prevention program of cardiovascular disease in public health. For this purpose, the results obtained by the EKG telediagnosis net implemented in sixty countrywide public hospitals were analyzed and verified the adherence to the cardiovascular prevention program.

Results

A total of 246,217 remote EKG diagnoses were performed between January 2014 and August 2018. Of the total, 80.6 percent (198,494) corresponded to adults and 19.4 percent (47,723) to children. The adult diagnoses were mainly normal (66.3 percent), sinus bradycardia (11.2 percent), right bundle branch block (4.8 percent), left ventricular hypertrophy (4.7 percent), ventricles repolarization disorder (4.4 percent), sinus tachycardia (4,4 percent), ischemia (1.7 percent), atrial fibrillation (1.1 percent), left bundle branch block (0.7 percent), and unspecified arrhythmias (0.6 percent). The children's diagnoses were mainly normal (79.4 percent), sinus bradycardia (10.6 percent), sinus tachycardia (3,2 percent), unspecified arrhythmias (2.8 percent), right bundle branch block (1.9 percent), left ventricular hypertrophy (1.0 percent), left bundle branch block (0.4 percent), ventricles repolarization disorder (0.3 percent), and atrial fibrillation (0.2 percent). The mean adherence rate to the prevention program was 2.3 between 2014 and 2018 for each thousand diagnosis performed.

Conclusions

The results show that the telemedicine can enhance significantly the EKG screening to support a prevention program for cardiovascular diseases and health programs. However, before carrying out its systematic implementation, a contextualization with the regional epidemiological profile must be performed.
VP28 Building A Virtual Diagnosis Network Through A Telemedicine Platform
Authors: Galvan Pedro , Rivas Ronald , Grossling Benicio , Portillo Juan , Mazzoleni Julio , Hilario Enrique
Published: December 2019

Introduction

Advances in information and communication technology (ICT) and health technology have enhanced healthcare for many countries around the world. The challenge for low income setting countries is to build a telemedicine platform to enhance the community hospital diagnosis response capacity. Populations living in remote areas did not have access to specialist care and quality diagnostic services and thus depended on the low response capacity of their local health system. There were subsequent equity issues between urban and rural populations. In this context the virtual telediagnosis network should be directed towards developing better equity in the provision of services in remote locations without access to specialists. The usability of a telemedicine platform to enhance the virtual diagnosis network of community hospitals in rural areas of Paraguay was investigated.

Methods

This descriptive study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute (IICS-UNA) and the University of the Basque Country (UPV / EHU) to evaluate the utility of a telemedicine platform to enhance the virtual diagnosis network of community hospitals. For this purpose, the results obtained by the virtual telediagnosis network implemented in sixty public countryside community hospitals were analyzed.

Results

A total of 427,026 remote diagnoses were performed between January 2014 and October 2018 in sixty community hospitals. Of the total, 35.76 percent (152,703) corresponded to tomography studies, 62.55 percent (267,100) to electrocardiography (EKG), 1.68 percent (7,204) to electroencephalography (EEG) and 0.01 percent (19) to ultrasound. There were no significant differences between the remote and the face-to-face diagnosis. With the remote diagnosis a reduction of the cost was obtained, that supposes an important benefit for each citizen of the sixty communities.

Conclusions

The results show that the virtual diagnosis network based on a telemedicine platform can enhance significantly the community hospital diagnostic services, maximizing professional time and productivity, increasing access and equity, and reducing costs. However, before carrying out its countrywide implementation, a contextualization with the regional epidemiological profile must be performed.
VP75 Improving Access To Ultra-Orphan Medicines In NHS Scotland
Authors: Downes Noreen , Jones Jan , Lee Anne , Brown Ailsa , McGuire Pauline , Wright Helen
Published: December 2019

Introduction

Medicines for very rare conditions present challenges for healthcare globally due to uncertain evidence and often extremely high costs. In 2014, SMC introduced an ultra-orphan framework placing less emphasis on the cost per quality adjusted life year (QALY). Despite this, many medicines continued to be not recommended. A new pathway aimed at improved patient access based on further evidence collection is now being implemented.

Methods

The development of the new pathway has involved collaboration with key stakeholders including patient groups, the pharmaceutical industry, and clinicians. Medicines that meet a new definition (based on four criteria including the prevalence of the condition treated) will be appraised by the SMC committee and a data collection plan will then be agreed with the pharmaceutical company.

Results

From April 2019, medicines validated as ultra-orphans will initially be appraised using the broader decision-making framework and the SMC committee will outline key uncertainties in the clinical effectiveness. The medicine will then be available for a period of at least three years while further data are gathered, potentially comprising ongoing clinical trials, registry data, and patient reported outcome measures. SMC will then re-assess the clinical and economic evidence to inform a final decision on routine use of the medicine in NHS Scotland.

Conclusions

The new pathway for ultra-orphan medicines will allow further evidence on their longer-term clinical benefits to be collected before a final decision on routine use. This approach reflects the current direction of travel in medicines regulation, by making medicines that address an unmet need available to patients at an earlier stage of development.
VP90 Which Matching Adjusted Indirect Comparison Method Is Best?
Authors: Alsop Jonathan , Pont Lawrence , Scott Martin
Published: December 2019

Introduction

Matching adjusted indirect comparison (MAIC) methods are extremely useful when conducting ITCs, as they reduce baseline imbalances between studies, particularly upon patient characteristics that are confounded with treatment. The standard approach when conducting MAIC is that proposed by Signorovitch et al. (2010). However, there are newer, and potentially better, methods available.

Methods

Three different MAIC methods (Signorovitch, Entropy Balancing, Polynomial Weighting) were compared using multiple phase 3 RCTs conducted in Diabetic Retinal Edema. The matching ability of each method was assessed, alongside its ability to avoid large weights (i.e. avoiding high leverage), and maximise effective same size (ESS). Each method's overall ease of use and impact upon estimates of treatment effectiveness were also evaluated.

Results

All methods were able to precisely match the aggregate level data. However, the Entropy Balancing and Polynomial Weighting both outperformed the Signorovitch method in terms of having the lowest maximum weights. The Polynomial Weighting provided the highest ESS. The Entropy Balancing method was arguably the most challenging to implement, whilst the Signorovitch method the least. The Polynomial Weighting method appears to provide the greatest flexibility to the user.

Conclusions

Whilst the Signorovitch method has become almost synonymous with MAIC, the Entropy Balancing and Polynomial Weighting methods offer potentially superior performance. In the absence of head-to-head trial data, these new MAIC approaches should provide less biased and more precise estimates of comparative effectiveness – ultimately leading to better decision making by regulators and payers.
VP92 Portable Robotic Exoskeleton Stride Management Assist (SMA®)
Authors: Sánchez-Gómez Luis María , Hijas-Gómez Ana Isabel , Polo-DeSantos Mar , Luengo-Matos Setefilla
Published: December 2019

Introduction

The Stride Management Assist (SMA®) device consist in a portable robotic exoskeleton designed for gait rehabilitation and training by repetition of walking patterns with automated regular gait cycles. Used for adult population with gait disorders of neurological or musculoskeletal origin that require rehabilitation. The objective of this work is to assess its efficacy and safety.

Methods

This technology was identified by the early Awareness and Alert System, “SINTESIS-new technologies” of AETS-ISCIII. An early assessment of the technology was conducted. The searched databases were: Pubmed, Embase, WOS, Tripdatabase, ClinicalTrials.org and Cochrane Library. Clinical studies using the device published in any language until 10 October 2018 were reviewed.

Results

We found 3 abstracts to congresses and 6 clinical trials that evaluated the use of the device. Outcomes measures among studies included spatiotemporal gait parameters, energy expenditure, muscular activity and functional performance. Five studies consisted in proof-of-concept analysis; 3 studies evaluated the effect of gait training with SMA® compared with conventional therapy alone in individuals after stroke (2 studies) and Parkinson disease (1 study); and 1 before-and-after study assessed the effect of gait training with SMA® in elderly adults. During its use, improvements in spatiotemporal gait parameters were described in 4/5 studies, and 2/5 studies showed less energy expenditure versus 2/5 studies that found no differences. After gait training, 3/4 studies described greater improvements in gait parameters when associated its use. Only one clinical trial collected safety data reporting no adverse events.

Conclusions

The SMA® device allows to increase the efficiency and parameters of the march during its use. The assistance in the stride might have an impact on health by facilitating the recovery of the gait; however, further research is needed to determine the feasibility in the latter case since comparative studies with conventional therapy are limited.
June–September 2019
Authors: Cranmer Frank
Published: December 2019

On 9 September, the European Union (Withdrawal) (No 2) Act 2019 received Royal Assent and Parliament was prorogued until 14 October. The prorogation was challenged in the courts both in England and Wales and in Scotland, and a strong Divisional Court of Queen's Bench and the Inner House of the Court of Session came to opposite conclusions as to its legality. The judgments were appealed to the Supreme Court, and on 24 September an eleven-judge bench handed down a unanimous judgment in the conjoined cases of Miller and Cherry.
General Synod of the Church of England
Authors: Cranmer Frank
Published: December 2019

This report covers the groups of sessions held in February 2019 and July 2019. After the spate of legislation in 2018, when nine Measures were enacted – the highest number in a single year since the Church was empowered by the Church of England Assembly (Powers) Act 1919 to make Measures having the force and effect of statute – 2019 saw the enactment of just a single Measure.
Governing Body of the Church in Wales
Authors: Chinery Matthew
Published: December 2019

The April meeting was held while the Anglican Consultative Council was meeting in Hong Kong, and the Governing Body received a video message from Dr Heather Payne and the Ven Mary Stallard, its two representatives. In his presidential address to the September meeting, the Archbishop of Wales spoke of the challenges facing the Church and said that those who challenged the Church, asking sometimes uncomfortable questions, deserved to be taken seriously. He also highlighted some of the initiatives that the Church in Wales was undertaking as part of the acknowledgement that the status quo for ministry in Wales was unlikely to meet the needs of the province in the decades ahead.
General Synod of the Anglican Church of Canada
Authors: Perry Alan T
Published: December 2019

The General Synod normally meets every three years for a session lasting several days. It held its 42nd session from 10 to 16 July 2019 in Vancouver. There were three items of business that particularly attracted the attention of the media, though a number of other important issues were also addressed during the session.
Poststorm Thermospheric NO Overcooling?
Authors: Mikhailov Andrey V. , Perrone Loredana
Published: December 2019

A mechanism of the neutral gas density decrease at middle latitudes during the recovery storm phase is discussed. The recently proposed method to retrieve thermospheric parameters from ionospheric observations is used for the analysis of equinoctial, summer, and winter severe magnetic storms. CHAllenging Minisatellite Payload and Swarm neutral gas density observations are used for a comparison. It is shown that storm‐induced atomic oxygen variation is the controlling process. Well‐known F2‐layer storm morphology and the poststorm decrease of neutral gas density reflect the same storm‐induced variations of atomic oxygen abundance in the upper atmosphere. There is no need to attract a new “poststorm NO overcooling” concept to explain the decrease of neutral gas density.
Intraoperative assessment of skull base tumors using stimulated Raman scattering microscopy
Authors: Shin Kseniya S. , Francis Andrew T. , Hill Andrew H. , Laohajaratsang Mint , Cimino Patrick J. , Latimer Caitlin S. , Gonzalez-Cuyar Luis F. , Sekhar Laligam N. , Juric-Sekhar Gordana , Fu Dan
Published: December 2019

Intraoperative consultations, used to guide tumor resection, can present histopathological findings that are challenging to interpret due to artefacts from tissue cryosectioning and conventional staining. Stimulated Raman histology (SRH), a label-free imaging technique for unprocessed biospecimens, has demonstrated promise in a limited subset of tumors. Here, we target unexplored skull base tumors using a fast simultaneous two-channel stimulated Raman scattering (SRS) imaging technique and a new pseudo-hematoxylin and eosin (H&E) recoloring methodology. To quantitatively evaluate the efficacy of our approach, we use modularized assessment of diagnostic accuracy beyond cancer/non-cancer determination and neuropathologist confidence for SRH images contrasted to H&E-stained frozen and formalin-fixed paraffin-embedded (FFPE) tissue sections. Our results reveal that SRH is effective for establishing a diagnosis using fresh tissue in most cases with 87% accuracy relative to H&E-stained FFPE sections. Further analysis of discrepant case interpretation suggests that pseudo-H&E recoloring underutilizes the rich chemical information offered by SRS imaging, and an improved diagnosis can be achieved if full SRS information is used. In summary, our findings show that pseudo-H&E recolored SRS images in combination with lipid and protein chemical information can maximize the use of SRS during intraoperative pathologic consultation with implications for tissue preservation and augmented diagnostic utility.
An inhibitor of apoptosis protein (EsIAP1) from Chinese mitten crab Eriocheir sinensis regulates apoptosis through inhibiting the activity of EsCaspase-3/7-1
Authors: Qu Chen , Sun Jiejie , Xu Qingsong , Lv Xiaojing , Yang Wen , Wang Feifei , Wang Ying , Yi Qilin , Jia Zhihao , Wang Lingling , Song Linsheng
Published: December 2019

Inhibitor of apoptosis proteins (IAPs) maintain the balance between cell proliferation and cell death by inhibiting caspase activities and mediating immune responses. In the present study, a homolog of IAP (designated as EsIAP1) was identified from Chinese mitten crab Eriocheir sinensis. EsIAP1 consisted of 451 amino acids containing two baculoviral IAP repeat (BIR) domains with the conserved Cx2 Cx6 Wx3 Dx5 Hx6 C motifs. EsIAP1 mRNA was expressed in various tissues and its expression level in hemocytes increased significantly (p < 0.01) at 12–48 h after lipopolysaccharide stimulation. In the hemocytes, EsIAP1 protein was mainly distributed in the cytoplasm. The hydrolytic activity of recombinant EsCaspase-3/7-1 against the substrate Ac-DEVD-pNA decreased after incubation with rEsIAP1. Moreover, rEsIAP1 could directly combine with rEsCaspase-3/7-1 in vitro. After EsIAP1 was interfered by dsRNA, the mRNA expression and the hydrolytic activity of EsCaspase-3/7-1 increased significantly, which was 2.26-fold (p < 0.05) and 1.71-fold (p < 0.05) compared to that in the dsGFP group, respectively. These results collectively demonstrated that EsIAP1 might play an important role in apoptosis pathway by regulating the activity of EsCaspase-3/7-1 in E. sinensis.
Diverse dechlorinators and dechlorination genes enriched through amendment of chlorinated natural organic matter fractions
Authors: Temme Hanna R. , Novak Paige J.
Published: December 2019

Chlorinated natural organic matter (Cl-NOM) can act as an electron acceptor for organohalide-respiring bacteria, stimulating contaminant dechlorination.
Metal–organic framework templated Pd/CeO2@N-doped carbon for low-temperature CO oxidation
Authors: Fan Weidong , Liu Dongyuan , Wang Xia , Liu Xiuping , Cao Dongwei , Fan Lili , Huang Zhaodi , Guo Wenyue , Sun Daofeng
Published: December 2019

A new Pd/Ce based metal–organic framework is designed and synthesized as a self-sacrificial template for fabrication of an efficient catalyst for CO oxidation.
Aggregation-induced emission characteristics and solvent triggered hierarchical self-assembled chiral superstructures of naphthalenediimide amphiphiles
Authors: Shejul Dipak A. , Wagalgave Sopan M. , Jadhav Ratan W. , Kobaisi Mohammad Al , La Duong Duc , Jones Lathe A. , Bhosale Rajesh S. , Bhosale Sidhanath V. , Bhosale Sheshanath V.
Published: December 2019

Herein, we report the design, synthesis and self-assembly of two naphthalene diimide amphiphiles NDI-TA1 and NDI-TA2 bearing acylated and deacylated hydroxyl groups of tartaric acid, respectively.
Dawn of a New Age Fissure Sealant? A Study Evaluating the Clinical Performance of Embrace WetBond and ART Sealants: Results from a Randomized Controlled Clinical Trial
Authors: Haricharan Praveen Bhoopathi , Barad Naveen , Patil Chetan R. , Voruganti Sreenivas , Mudrakola Durga Prasad , Turagam Neeraja
Published: December 2019

Objectives The main purpose of this article is to evaluate the clinical performance of atraumatic restorative treatment (ART) sealant versus Embrace WetBond sealant in terms of retention and fissure caries prevention among a section of school children in the southern Indian state of Karnataka (ClinicalTrials.gov NCT02716558).

Materials and Methods After obtaining consent from the parents and screening the children against the inclusion cum exclusion criteria, 90 school children whose mandibular first molars were caries free and with a well-defined pit and fissure system were recruited for this spilt mouth trial. The respective molars were allocated either to the ART sealant or the embrace group after the randomization process. The sealants were applied according to the manufacturer’s instructions and followed up at the end of 3rd, 6th, and 12th month, respectively. The outcome measures assessed were the retention and the caries preventive effects of the materials.

Results At the end of the 6th month, about one-fourth of the sealants in either group remained totally intact, without evidence of caries. No significant differences were seen between the sealants either in terms of retention or caries preventive benefits at the end of 12 months.

Statistical Analysis The chi-squared test was used to check differences in proportions. The significance value was set at <0.05. Kappa test was performed to assess the intraexaminer reproducibility with respect to retention and caries status.

Conclusion The moisture-tolerant resin sealant could not replicate the physical properties usually associated with conventional resin sealants. The usage of ART sealants was deemed to be less cumbersome in an outreach setting as observed in this trial.
Treatment of Severe Ulnar Instability of the MCP Joint Improves Function in LRTI Arthroplasty for Osteoarthritis of the Thumb CMC Joint
Authors: Wirth Johanna , Baur Eva-Maria
Published: December 2019

Background Comorbidity in the metacarpophalangeal joint (MCPj) of the thumb, i.e., hyperextension or ulnar collateral instability, could affect the outcome of arthroplasty in the thumb carpometacarpal joint (CMCj).

Objective In a retrospective study, we evaluated the effect of arthrodesis of the MCPj for thumbs with unstable MCPj and simultaneous ligament reconstruction tendon interposition (LRTI) arthroplasty for the CMCj in terms of strength, function, and patient satisfaction.

Patients and Methods A total of 69 thumbs treated with a LRTI arthroplasty of the CMCj were included. In 14 of those cases, an arthrodesis of the MCPj was performed as well. In 12 thumbs, both procedures were done simultaneously; in one case MCPj arthrodesis followed LRTI arthroplasty, whereas one patient already had MCPj arthrodesis at time of LRTI arthroplasty. Those 14 thumbs were compared with the control group of 55 thumbs who had only undergone LRTI. At a mean follow-up of 4 to 5 years (mean 54 [10–124] months) postoperative assessments included range of motion (ROM) of the CMC, MCP, and interphalangeal (IP) joint of the thumb, as well as any instability of the MCPj. Pinch and grip strength were examined, also the visual analogue scale (VAS), patient satisfaction, QuickDASH, PRWE-Thumb, and the Kapandji's Opposition Score. Radiologically, proximalization of the first metacarpal bone was measured. Student's t-test was used to determine significance, p < 0.05 was considered significant.

Results Additional arthrodesis of the MCPj provided no significant difference of function in thumbs that only had a hyperextension-instability. However, in thumbs with marked ulnar instability, stronger pinch-grip was obtained with arthrodesis, compared with only LRTI.

Conclusion In patients with advanced painful thumb CMCj osteoarthritis, we recommend (simultaneous) arthrodesis of the MCPj, to allow a stable thumb grip if there is additional marked ulnar collateral ligament instability.

Level of Evidence This is a Level III, retrospective comparative study.
A Cross-Sectional Study to Understand 3D Facial Differences in a Population of African Americans and Caucasians
Authors: Kau Chung H. , Wang Jue , Davis Matthew
Published: December 2019

Objective The purpose of this cross-sectional retrospective study was to use three-dimensional surface imaging to determine gender dimorphism and facial morphological changes from adolescence to adulthood in African American and Caucasian populations.

Materials and Methods Three-dimensional images were captured and the total sample size included 371 subjects. Images were combined using Rapidform 2006 Plus Pack 2 software to produce a male and female facial average for each population. Comparisons were conducted within the following categories: (1) gender comparison within each race, (2) adult and adolescent comparison within each race, and (3) adult and adolescent comparison between the races.

Results Adolescent gender comparisons within each race showed high percentages of similarity. However, adult females in both races showed more prominent periorbital, malar, and nasolabial regions and less prominent lower forehead, nose, and lower face compared with adult males of the same race. African American adult females showed increase in length and width of the face, increased nasal tip projection, and decreased periorbital regions compared with African American adolescent females. Welsh adult females had an increase in the nose and chin projection compared with Welsh adolescent females. Adult males of both races had increase in nose and chin projection, increase in length and width of the face, and decreased periorbital, malar, and nasolabial regions compared with adolescent males of the same race. African American adolescents had a wider alar base, more protrusive lips, and periorbital regions, and less prominent nose and chin compared with the Welsh adolescents. African American adults also had a wider alar base; more protrusive lips and periorbital regions; a broader face; and more retrusive chin, nose, nasolabial region; and lower forehead compared with Welsh adults.

Conclusions Few differences were noted between genders within the same racial groups during adolescence. However, changes became more distinct in adulthood. From adolescence to adulthood, facial morphologies were similarly matched within the gender for females; however, there were significant changes for males. Lastly, facial morphology patterns tend to be established early in life.
Evaluation of Marginal Adaptation and Microleakage of Three Glass Ionomer-Based Class V Restorations: In Vitro Study
Authors: Ebaya Maha M. , Ali Ashraf I. , Mahmoud Salah H.
Published: December 2019

Objective The aim of this study was to evaluate and compare the marginal adaptation and microleakage of class V cavities restored with conventional glass ionomer cement (GIC), resin-modified glass ionomer (RMGI), and bioactive ionic resin (BIR) restorative materials after 6 months of water storage.

Materials and Methods One hundred twenty standardized class V cavities (2 mm deep, 4 mm in width, and 3 mm in height) were prepared in sound extracted human molar teeth, where the coronal margins were in enamel while the cervical margins were in dentin. Three glass ionomer-based restorations were tested (n = 40): GIC (Equia Fil), RMGI (Fuji II LC), and BIR (ACTIVA Bioactive Restorative). Half of the teeth from each group (n = 20) were evaluated for their marginal adaptation with scanning electron microscopy and the other half submitted to dye penetration test to examine microleakage. Further division for each subgroup (n = 10) occurred to be tested immediately, while the remaining teeth were examined after keeping for 6 months and thermocycling.

Statistical analysis The outcomes were analyzed by Kruskal–Wallis and Mann–Whitney U tests.

Results No statistically significant differences were observed among the three studied restorative materials. However, the differences were statistically significant in microleakage test between enamel and dentin and after water aging.

Conclusion All tested restorative materials exhibited the same marginal adaptation and microleakage. Dentin substrate revealed greater microleakage than enamel, especially with BIR restorative material. Water aging had a negative effect on RMGI with respect to microleakage.
Glial Fibrillary Acid Protein and Cerebral Oxygenation in Neonates Undergoing Cardiac Surgery
Authors: Hansen Jan Hinnerk , Kissner Lydia , Chitadze Guranda , Logoteta Jana , Jung Olaf , Dütschke Peter , Attmann Tim , Scheewe Jens , Kramer Hans-Heiner
Published: December 2019

Background Neonates undergoing surgery for complex congenital heart disease are at risk of developmental impairment. Hypoxic–ischemic brain injury might be a contributing factor. We aimed to investigate the perioperative release of the astrocyte cytoskeleton component glial fibrillary acid protein and its relation to cerebral oxygenation.

Methods Serum glial fibrillary acid protein levels were measured before and 0, 12, 24, and 48 hours after surgery. Reference values were based on preoperative samples; concentrations above the 95th percentile were defined as elevated. Cerebral oxygenation was derived by near-infrared spectroscopy.

Results Thirty-six neonates undergoing 38 surgeries utilizing cardiopulmonary bypass were enrolled (complete data available for 35 procedures). Glial fibrillary acid protein was elevated after 18 surgeries (arterial switch: 7/12; Norwood: 5/15; others: 6/8; p = 0.144). Age at surgery was higher in cases with elevated serum levels (6 [4–7] vs. 4 [2–5] days, p = 0.009) and intraoperative cerebral oxygen saturation was lower (70 ± 10% vs. 77 ± 7%, p = 0.029). In cases with elevated postoperative glial fibrillary acid protein, preoperative cerebral oxygen saturation was lower for neonates undergoing the arterial switch operation (55 ± 9% vs. 64 ± 4%, p = 0.048) and age at surgery was higher for neonates with a Norwood procedure (7 [6–8] vs. 5 [4–6] days, p = 0.028).

Conclusions Glial fibrillary acid protein was elevated after ∼50% of neonatal cardiac surgeries and was related to cerebral oxygenation and older age at surgery. The potential value as a biomarker for cerebral injury after neonatal cardiac surgery warrants further investigation; in particular, the association with neurodevelopmental outcome needs to be determined.
Cross Sections for Electron Collisions with NO, N2O, and NO2
Authors: Song Mi-Young , Yoon Jung-Sik , Cho Hyuck , Karwasz Grzegorz P. , Kokoouline Viatcheslav , Nakamura Yoshiharu , Tennyson Jonathan
Published: December 2019

Cross section data are compiled from the literature for electron collisions with oxides of nitrogen (NxOy) molecules: the species nitric oxide (NO), nitrous oxide (N2O), and nitrogen dioxide (NO2) are explicitly considered. Cross sections are collected and reviewed for total scattering, elastic scattering, momentum transfer, excitations of rotational, vibrational, and electronic states, dissociation, ionization, and dissociative attachment. For each of these processes, the recommended values of the cross sections are presented. The literature has been surveyed up to the end of 2017. These results are supplemented by a reanalysis of the swarm measurements for NO and newly calculated cross sections for rotational excitation of N2O and for rotational excitation and electronic excitation of NO2.
Stimulated echo and diffusion processes in 3He adsorbed by MCM-41 nanostructured material
Authors: Birchenko A. P. , Mikhin N. P. , Rudavsky E. Ya. , Sopelnyk Ya. Yu.
Published: December 2019

The diffusion processes in 3He adsorbed by MCM-41 nanostructured material with a channel diameter of 2.5 nm were studied using pulsed nuclear magnetic resonance. The measurements were carried out using the stimulated spin echo method with a three-pulse spin system excitation regime. The measured dependences of the stimulated spin echo amplitude on the square of the magnetic field gradient showed the presence of two different slopes along the curve, which means the presence of two different diffusion processes in the adsorbed helium. These processes correspond to two different layered phases that are formed during the gas adsorption in a narrow channel, due to the van der Waals interaction with the walls. These phases were identified according to the measured values of the diffusion coefficient. It turned out that one of the layered phases corresponds to gaseous helium, and the other phase is close to liquid helium. The utilized methods did not allow for the detection of the solid phase, which is usually formed in a narrow parietal layer.
The melting of two-dimensional electron crystals in narrow channels
Authors: Syvokon V. E. , Sharapova I. V.
Published: December 2019

The molecular dynamics method was used to study 2D electron systems located in narrow channels with various ratios of the channel width to the average distance between electrons. The spatial structures formed in the channels at low temperatures are determined as a function of the channel width, and features of the structural transitions are analyzed. The effect of temperature on the structural transitions is investigated. The temperatures at which the spatial order is broken in the electron system are determined as a function of channel width, including in the region of structural transitions.
Concentration dependences of electrical conductivity and the Hall effect of the CexSn1–xSe single crystals
Authors: Abbasov I. I. , Ismailov Sh. S. , Huseynov J. I. , Abdurahmanova V. A.
Published: December 2019

The concentration dependences of the Hall coefficient, electrical conductivity, and charge carrier mobility in CexSn1–xSe (х ≤ 0.02) are studied over a temperature range of 77–400 K. In the considered samples, impurities are compensated with intrinsic defects. As the cerium concentration increases (x = 0.01; 0.015), the concentration of donor impurities grows, and a change in the type of conductivity is observed.
Structural transformations in N2–Kr alloys
Authors: Solodovnik A. A. , Mysko-Krutik N. S.
Published: December 2019

The structural characteristics of N2–Kr alloys were studied using electron diffraction over the entire range of mutual concentrations. The samples were prepared in situ by condensing a gaseous mixture on aluminum and carbon substrates at temperatures of 5 and 20 K. The structure and solubility regions of the solutions were determined. The maximum solubility values of the components were: less than 20 mol.% for krypton in a nitrogen crystal, and less than 11 mol.%. for nitrogen in solid krypton. Phase separation of the solid solution was observed in a concentration range of 20–89 mol.% Kr. The effect of diluting the molecular matrix with krypton on the orientational ordering of N2 molecules in the solutions was investigated. An experimental dependence of the orientation order parameter on the solution composition was determined for N2-based solutions.
Performance of sheep systems grazing perennial pastures. 1. Pasture persistence and enterprise productivity
Authors: Robertson Susan M. , Broster John C. , Friend Michael A.
Published: December 2019

Sheep production can be optimised by matching the pasture supply curve to feed demand. This study evaluated the production from four management systems with Merino ewes during 2006–2010 in southern New South Wales by using different combinations of lambing time (winter, split, spring), ram breed (Merino, terminal), and percentage of summer-active pasture species (40% or 20% lucerne, Medicago sativa). All systems were stocked at a similar midwinter rate (dry-sheep equivalents per hectare of 8, 10.2, 13, 11.2 and 11.2 in the successive seasons 2006–2010), and there were three replicates of each system. Groundcover and pasture persistence were not adversely impacted by sheep system because sheep were removed at predetermined biomass triggers. Wool production per hectare was up to 178% or 12 kg/ha higher (P < 0.001) in systems where a later month of lambing allowed an increase in number of ewes per hectare at the same midwinter stocking rate. The quantity of lamb sold was not consistently higher in any one system, or in systems producing both crossbred and Merino lambs vs only Merino lambs, owing to variation in the weight and age of lambs at sale, but was increased (P < 0.001) by 175 kg/ha with use of 40% compared with 20% lucerne in a high-rainfall year. The risk of requiring high levels of supplementary feeding was higher in systems with later lambing because of below-average rainfall between 2006 and 2009. Large increases in production can be achieved from the same pasture base through choice of management system with different lambing time, stocking rate or ram breed, but flexibility is needed to optimise production in varying seasonal conditions.
Variable functional connectivity architecture of the preterm human brain: Impact of developmental cortical expansion and maturation
Authors: Stoecklein Sophia , Hilgendorff Anne , Li Meiling , Förster Kai , Flemmer Andreas W. , Galiè Franziska , Wunderlich Stephan , Wang Danhong , Stein Sophie , Ehrhardt Harald , Dietrich Olaf , Zou Qihong , Zhou Shuqin , Ertl-Wagner Birgit , Liu Hesheng
Published: December 2019

Significance

Even though preterm brains are immature and will undergo a myriad of developmental processes, they already display great interindividual differences in their functional connectivity (FC) architecture. Interestingly, functionally less variable brain regions are morphologically more mature around term birth than functionally more complex and variable brain regions. Despite the overall resemblance of variability patterns in preterm infants and adults, some brain regions, especially in higher cognitive networks, show a developmental shift toward greater FC variability in adults, related to postnatal cortical expansion. Our result of robust variability distribution in the preterm brain indicates the need to develop individualized FC measures that may lead to predictors of nervous function in this high-risk population.
Sadness, but not all negative emotions, heightens addictive substance use
Authors: Dorison Charles A. , Wang Ke , Rees Vaughan W. , Kawachi Ichiro , Ericson Keith M. M. , Lerner Jennifer S.
Published: December 2019

Significance

The epidemic of deaths attributable to addictive substances, including tobacco, highlights the need to better understand ways in which emotions drive substance craving and consumption. In a test of alternative theories of emotion and decision making, we found that sadness, specifically, rather than negative mood, generally, increased addictive substance use. In a nationally representative, longitudinal sample, sadness—but not other negative emotions—reliably predicted current smoking and relapse 20 y later. In laboratory experiments with real smokers, sadness increased both impatience for cigarette puffs and actual volume of puffs taken. Results provide not only theoretical implications but also policy implications for the design of antismoking public service announcements, which could unintentionally increase cigarette cravings among smokers if they trigger sadness.