bluuebunny/crossref_metadata_2025 huggingface dataset:
Linguistic Validation, Adaptation, and Reliability of the Liverpool Elbow Score’s Patient-Answered Questionnaire in Bulgarian the Bulgarian Les-Paq Questionnaire
Authors: Tsenkov Ts. , Slavchev S. , Dimitrov N.
Published: December 2023

Background

There is a lack of upper-limb organ specific patient-reported questionnaires that are linguistically validated and culturally adapted for the Bulgarian population. The Liverpool Elbow Score (LES) is a mixed elbow-specific score with excellent psychometric properties of the patient-answered questionnaire (PAQ). There is no Bulgarian version. The aim of this study was to perform a linguistic validation and cultural adaptation of the LES−PAQ in Bulgarian, and to test the validity and reliability of the Bulgarian version.

Materials and Methods

The study was conducted in a single institution. Participant selection criteria were defined – included were mentally healthy adult patients with a diagnosis of osteochondritis dissecans of the radiocapitellar joint, elbow arthritis, lateral epicondylitis and elbow contracture. Excluded were patients with coexisting upper limb conditions, illiterate and non-native Bulgarian speakers. The Bulgarian LES−PAQ was created. The process consisted of forward translation, reconciliation and backward translation. An expert committee agreed upon a pre-final Bulgarian version. A final version was decided after cultural adaptation. The psychometric properties and reliability of the Bulgarian LES−PAQ was tested.

Results

101 patients were included in this study. We did not observe a ceiling or floor effect. Cronbach’s α coefficient was 0.858. Intraclass correlation coefficient was 0.864 (95% CI 0.77 to 0.92; p < 0.05). A moderate negative correlation was revealed between the LES-PAQ and the DASH (r = -0.591, p < 0.05), and a high positive correlation with SF-12 (r = 0.867, p < 0.001).

Conclusion

The Bulgarian LES−PAQ is a reliable and valid instrument for assessing elbow conditions such as osteochondritis dissecans of the radiocapitellar joint, elbow arthritis, lateral epicondylitis and elbow contracture. It may assist Bulgarian healthcare professionals in both research and daily work.
Attitude of Athletes Towards Dietary Supplements
Authors: Miteva I. , Kundurdzhiev T. , Valchev V.
Published: December 2023

At the beginning of 2023 we carried out a survey among active athletes asking about their attitude towards dietary supplements.

Aim

The aim of the study was to evaluate the attitude of athletes towards dietary supplements using a survey method. The objective of the study was to determine whether active athletes use dietary supplements.

Materials and methods

The participants in the study were asked to anonymously complete a survey consisting of 16 questions. In January 2023, we surveyed 50 active athletes from the „Vasil Levski” National Sports Academy (35 men and 15 women). Forty-six of the participants were between 18 and 22 years old and 4 were between 23 and 27 years old.

Results

The majority (94%) of the surveyed athletes trusted the advertisement of a particular dietary supplement. Ninety per cent had complete trust in the pharmacists’ advice. Pharmacists played a significant role in the choice of dietary supplements. A high percentage (60%) of the respondents who used dietary supplements had not sought medical advice prior to their use. Ninety per cent of the respondents used dietary supplements for weight loss in order to fit in a particular category; 78% indicated that they used dietary supplements for improvement of their sports achievements; 72% used supplements to increase their stamina and 46% – to shorten their time for recovery. A campaign should be initiated to encourage the use of dietary supplements only when they are prescribed by physicians.
Comparison of Ultrasonography and Cone-Beam Computed Tomography Accuracy in Measuring the Soft Tissue Thickness of Maxillary and Mandibular Gingiva in a Sheep Model
Authors: Latifi S. , Moudi E. , Abesi F. , Minouei A. , Hozouri M. , Bijani A.
Published: December 2023

Background

To date, few studies have compared the accuracy of cone-beam computed tomography (CBCT) and ultrasonography in measuring the soft tissue thickness of the maxillary and mandibular gingiva.

Aims

To compare the accuracy of ultrasonography and CBCT in measuring the soft tissue thickness of the maxillary and mandibular gingiva in a sheep model.

Materials and Methods

In this study, 38 different landmarks (26 points from the upper jaw and 12 points from the lower jaw) were evaluated. The gingival soft tissue thickness was measured using a digital caliper, ultrasonography, and standard and high-resolution CBCTs. The measurements were finally compared with each other.

Results

Regarding the thicknesses < 2 mm, no significant difference was seen between the measurements of the digital caliper and ultrasonography (mean difference < 0.1 mm, p = 0.140). Conversely, data analysis indicated significant differences between CBCTs measurements and digital caliper and ultrasonography measurements. Regarding thicknesses > 2 mm, digital caliper measurement was not significantly different from ultrasonography and high-resolution CBCT measurements (mean differences < 0.1 mm) but differed from the standard CBCT measurement. Also, a significant difference was observed between ultrasonography and standard CBCT measurements but not between ultrasonography and high-resolution CBCT (mean differences < 0.1 mm). Finally, mean differences between standard and high-resolution CBCT measurements were statistically significant.

Conclusion

According to the results, ultrasonography can be a reliable option for measuring gingival soft tissues regardless of their thickness, while CBCT may be more suitable for thicker gingival tissues. Clinicians should carefully consider the measurement accuracy of different imaging methods when planning dental procedures.
A Rare Case of Adult Precursor B-Cell Lymphoblastic Lymphoma/Leukemia Presenting with Multiple Osteolytic Bone Lesions as Sole Manifestation
Authors: Micheva I. , Dimitrova S.
Published: December 2023

Primary precursor B-lymphoblastic lymphoma/leukemia (B-LBLL) of bone is uncommon neoplasm that accounts for less than 1% of primary bone tumors. It has been commonly reported in pediatric population but is rare in adults. We present a case of a 20-year-old man with multiple osteolytic lesions as sole presentation of acute lymphoblastic leukemia, whose diagnosis was established by bone biopsy. A peripheral blood smear and the bone marrow aspirate showed no blast cells. The patient received treatment according to BFM 99 protocol and achieved complete response confirmed by F-FDG-PET/CT.
Current Therapeutic Options in Active Moderate-to-Severe Thyroid-Associated Ophthalmopathy
Authors: Stoynova M. , Shinkov A. , Kovatcheva R.
Published: December 2023

Active moderate-to-severe TAO is a disease, the treatment of which requires a multidisciplinary team, an individualized approach and strict follow-up, yet it is often suboptimal. Recent knowledge about the pathogenesis of the disease and the randomized controlled trials conducted in recent years made it possible to use new therapeutic combinations and biological agents. The currently recommended first-line therapy for active moderate-to-severe TAO is the combination of intravenous glucocorticoids (GCs) in moderate doses and mycophenolate or, in more severe cases, a high-dose GC treatment alone. There are several options for second-choice therapy, if needed: a new course with GCs, combination of orbital radiotherapy and GCs (preferably intravenous), cyclosporine and oral GCs, azathioprine and oral GCs, rituximab, tocilizumab or teprotumumab. The clinical manifestations of TAO should also be considered when choosing second-line treatment. Thus, for example, teprotumumab best affects diplopia, orbital radiotherapy – visual disturbances and diplopia, while intravenous GCs, mycophenolate, cyclosporine, rituximab and tocilizumab – the inflammatory manifestations of TAO. However, the question of the availability of the new drugs in routine clinical practice remains unsolved.
The Death of Sperm Cells
Authors: Kavaldzhieva K. K. , Dimitrova-Dikanarova D. K. , Mladenova K. S. , Lazarov V. V. , Mladenov N. Y.
Published: December 2023

A major factor affecting male fertility is excessive death of germ cells, both immature germ cells and mature spermatozoa. It can be due to various factors causing testicular and/or post-testicular damage, such as infections, obstructive conditions, toxins, oxidative stress, hormonal imbalance, hyperthermia, and anti-sperm antibodies. Massive death of spermatozoa leads to a high proportion of dead sperm cells in the ejaculate (necrozoospermia or necrospermia) while death of immature germ cells can lead to low sperm count (oligozoospermia or oligospermia). Cell death can occur both by necrosis and by apoptosis; in recent decades, it has been found that apoptosis of mature spermatozoa is not only possible but quite common, and can contribute to infertility. Treatment approaches are primarily directed to the underlying condition, i.e. removing the cause(s) of sperm cell death whenever possible, but include also attempts to bypass the cell death event by intracytoplasmic sperm injection with testicular spermatozoa.
Decentralized Clinical Trials – Current Environment, Potential Barriers and Facilitators for Implementation and Risk Mitigation: A Review of the Literature
Authors: Dimitrova M. , Hristov R. , Djemadan A. , Gaytandzieva I.
Published: December 2023

Introduction

Decentralized clinical trials are a new approach in health technology research and development that take advantage of innovative digital technologies in data collection for clinical trial purposes. Decentralized clinical trials achieve shorter participant recruitment periods, better adherence to assigned therapy, lower drop-out rates and shorter trial duration overall. Participants reported greater convenience compared to traditional clinical trials due to the studies being conducted at home and the removal of transport and time barriers.

Materials and methods

A literature review was conducted using the Scoping Review methodology defined by Arskey and O’Malley in 2005 and further updated in 2010 and 2014. PubMed, Scopus, and Google Scholar scientific databases were searched using predefined inclusion and exclusion criteria and keywords: virtual clinical trials, and/or decentralized clinical trials and barriers and challenges.

Results

The literature review found 40 articles that met the specified inclusion and exclusion criteria. The results of the different studies in this area show that decentralized clinical trials achieve shorter recruitment periods, better adherence to assigned therapy, lower dropout rates from trials, and shorter trial duration overall. Participants reported greater convenience compared to traditional clinical trials due to the studies being conducted at home and the removal of transport and time barriers. Major challenges with this type of trial is the difficulty in conducting physical examinations, invasive therapies by the investigators, and privacy protection.

Conclusion

The adoption of a regulatory framework for digital healthcare, education of medical professionals and patients about innovative technologies are necessary, especially in countries from Central and Eastern Europe.
Research on forecasting model of corporate financial crisis based on pattern recognition and artificial intelligence
Authors: Li Dongyun
Published: December 2023

In today’s rapid development of the economic environment, the company’s financial crisis can significantly reflect the enterprise crisis, and it has a significant impact on the development of the enterprise. Therefore, the prediction of the company’s financial crisis and the establishment of an early warning system have important practical significance. Based on the method of pattern recognition and artificial intelligence, this paper establishes a new forecasting model of corporate financial crisis, predicts its financial index data and realises the dynamic financial crisis warning. The model developed in this paper employs pattern recognition and artificial intelligence, and is thus endowed with high classification accuracy, good anti-noise ability and the ability to be sorted according to the importance of its index features.
Effectiveness and duration of two-arch fixed appliance treatment
Authors: Chew Ming Tak , Sandham Andrew
Published: December 2023

The aims of this study were to determine the effectiveness and duration of single-phase two-arch fixed appliance treatment and to evaluate factors that may influence these two variables. Data were collected from 177 consecutively completed cases at the Orthodontic Department, Government Dental Clinic, Singapore, during a three-month period. Pre-treatment and post-treatment models were assessed using the Peer Assessment Rating (PAR) index. The result showed that two-arch fixed appliance treatment reduced the malocclusions on average by 77.80 per cent over a period of 25 months. Multiple regression techniques revealed that 22 per cent of the variability in treatment effectiveness could be explained by the pre-treatment PAR score, the age at the start of treatment, the frequency of office visits and whether or not the treatment involved extractions. The variation in treatment duration was due to the frequency of office visits, the pre-treatment PAR score and whether or not the treatment involved extractions or headgear.
Treatment of an “ankylosed” upper central incisor in the mixed dentition
Authors: Cerny Robert
Published: December 2023

A ten-year-old boy presented with an unerupted upper right central incisor (UR1). An OPG radiograph showed a super-numerary tooth lying over its crown, preventing its eruption. Standard orthodontic treatment involving removal of the super-numerary tooth, attaching a gold chain to the UR1 and treatment with fixed orthodontic appliances failed to bring the tooth down, until it was found that tough fibrous gingival tissue entwined in the gold chain had “ankylosed” the tooth. Once this tissue had been removed and the wound packed open, the tooth was brought down successfully into occlusion.
A comparison of retention rates of brackets with thermally-cured and light-cured custom bases in indirect bonding procedures
Authors: Miles Peter G.
Published: December 2023

This study compared the retention rates of thermally-cured (TC) and light-cured (LC) custom bases attached to metal mini-diamond brackets and clear Spirit MB brackets, when used in indirect bonding procedures. The custom base comprised either the light-cured or thermally-cured material attached to the bracket base and prepared in the laboratory, the whole unit later being bonded to the natural teeth. Thirty consecutively treated patients had fixed appliances fitted in both arches, with Spirit MB brackets on the maxillary anterior teeth, and metal brackets on the maxillary posterior and all mandibular teeth. All brackets were bonded using either the LC or TC method. All procedures and treatment was by the same operator, using identical techniques. Observation was for six months. All bonding failures were recorded. The results indicated no significant differences in the retention rates of either of the custom-base materials when used with metal brackets. However, the Spirit MB brackets exhibited a significantly higher bonding failure rate when a TC custom base was used. It was therefore concluded that either material could be used in the indirect bonding of metal brackets, and that LC custom bases should be used in the indirect bonding of Spirit MB brackets.
A new bracket system: Control 21™Part I
Authors: Goldschmied Felix
Published: December 2023

The Control 21™ system is a new low energy orthodontic bracket system that provides prescriptive variable torque and angulation together with active, dimensionally-changing slot geometry.
Facial aesthetics in Orthodontics
Authors: Jay Bowman S.
Published: December 2023

Current trends in orthodontic care emphasise alternatives to the extraction of premolars, despite a lack of support from the refereed literature for many of the non-extraction treatments. Anecdotal reports published in non peer-reviewed journals have called into question the aesthetic effects of extraction treatment. As calls for evidence-based treatments increase throughout dentistry, reports on the effects—both positive and negative— of different orthodontic options have appeared in growing numbers. Given the results of a variety of reports in the peer-reviewed literature, it may be concluded that orthodontic treatment involving extractions can produce improved aesthetics for many patients who have some combination of crowding and protrusion. However, careful diagnosis followed by evidence-based treatment decisions should be the accepted clinical norm as the specialty of Orthodontics embarks on its second century.
Bonding to previously bleached teeth
Authors: Homewood Christopher (Kip) , Tyas Martin , Woods Michael
Published: December 2023

Some authors have reported a decrease in the bond strength of restorative composite resin to previously bleached enamel. Since there has been an increase in the number of adult patients seeking orthodontic treatment, this study was undertaken to determine whether the act of bleaching would somehow affect the bonding of orthodontic brackets to enamel surfaces. Sixty extracted premolar teeth were divided into 6 groups of 10, for comparison of the shear/peel bond strength of orthodontic brackets to enamel using light-cured composite resin cement and a resin-modified glass-ionomer cement. For each material, one group of teeth was used for bonding to unbleached enamel, and the other two for bonding to enamel at 24 hours and 14 days after bleaching. The experimental method simulated clinical procedures as closely as possible. No significant difference in the shear/peel bond strength was found between the bleached and the unbleached groups. It was concluded, therefore, that at-home bleaching with Nite Lite does not affect the shear/peel bond strength of light-cured composite resin and resin-modified glass-ionomer cements used for bracket bonding.
Non-extraction Tip-Edge appliance management of a moderate Angle Class II division 1 malocclusion commenced in the late mixed dentition
Authors: Kift Russell J.
Published: December 2023

This case presentation concerns the correction of a moderate Angle Class II division 1 malocclusion of a patient whose treatment began during the late mixed dentition. Owing to the need to preserve and improve the existing facial aesthetics, treatment was started with a non-extraction approach and, in order to exploit favourable dentofacial growth changes and to avoid the possibility of extraction of teeth, was timed to coincide with the patient’s expected adolescent growth spurt. Fixed appliances only were used. Special consideration had to be made for the patient’s fractured upper central incisor teeth. An aesthetically pleasing treatment outcome was achieved within the expected time frame for correction. The case shows the successful combination of typical Begg mechanotherapy used during the early stages of treatment and Tip-Edge rectangular archwire mechanotherapy as used for the later and finishing stages.
Finishing occlusion in Class II or Class III molar relation: Therapeutic Class II and III
Authors: Nangia Annu , Ali Darendeliler M.
Published: December 2023

The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalise the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.
Varying treatments of Class II malocclusions: Two case reports
Authors: Malek Sameh , Rapaport Morris , Ali Darendeliler M.
Published: December 2023

Two female patients, JH aged 13 years 5 months and CN, aged 13 years 10 months, presented at the Sydney University Orthodontic Clinic, Australia. Patient JH complained that her lower teeth were “too far back behind her top teeth”. She was treated using the Speed Appliance. Patient CN complained that her teeth were “crooked”. The main point of interest of her case is the mechanics used following the extraction of her four first molar teeth. Both patients were keen to improve their appearance.
Syndecan-1 expression during postnatal tooth and oral mucosa development in rats aged from two days to six weeks
Authors: De Angelis Daniel D. , Sampson Wayne J. , Wiebkin Ole W. , Wilson David F.
Published: December 2023

Syndecans are a family of heparan sulphate proteoglycans that regulate cell-matrix interactions that influence cell growth, proliferation and morphology. The aim of this study was to observe changes in the expression of Syndecan-1 in the developing epithelium of the rat oral mucosa and in the epithelial cell rests of Malassez in the developing periodontium of normal rat molars, from late crown development through to early eruption. Immuno-histo-chemistry (Syndecan-1 N–18) and histochemistry (Alcec Blue) were used to observe changes in the expression of Syndecan-1 in rats aged two to 42 days. Results indicated that during normal tooth development in the rat, labelling or staining of variable intensity for Syndecan-1 was demonstrated in the stratified oral epithelium above the stratum basale in the rat tongue and palate, and in ameloblasts of the developing molar in rats aged two to 14 days. Histochemical staining of the predentine and dentine layers was consistent in all specimens. Labelling or staining for Syndecan-1 was negative in the rat periodontal ligament, which may suggest that either Syndecan-1 was not expressed during normal molar root development or that continued work is required for identification of a suitable label in rats.
Pulp-test responses in orthodontic patients
Authors: Cave S. G. , Freer T. J. , Podlich H. M.
Published: December 2023

The diagnosis of orofacial pain is complicated in the orthodontic patient as treatment-induced alterations to pulpal physiology may result in altered responses to pulp-test stimuli. Thirty-three subjects commencing fixed orthodontic treatment and another 15 subjects not undergoing orthodontic treatment were used in this study. Cold and electrical stimuli were applied to the maxillary incisor teeth prior to treatment, after the placement of fixed appliances and at regular intervals for both groups for up to 252 days. At baseline, response thresholds to electric testing were typically higher for orthodontic subjects, particularly for the lateral incisors. For the non-orthodontic group, the response threshold over the 252 days was relatively constant. For the orthodontic group, application of force immediately increased the response threshold to electric pulp testing, which peaked after two months. By day 252, response means for lateral incisors still remained elevated. Responses to thermal testing were more consistent and reliable. The results of this study indicate that dental practitioners should interpret responses to electric pulp testing cautiously in orthodontic patients and that thermal testing with carbon dioxide snow may be more reliable.
Uprighting of impacted lower third molars using brass ligature wire
Authors: Moro Naohiro , Murakami Teruo , Tanaka Takemasa , Ohto Chie
Published: December 2023

As the orthodontic stage at the time of the eruption of the third molar is usually the retention period, it is desirable for both the patient and the clinician that impacted or inclined third molars be uprighted without an appliance. Impacted lower third molars can be successfully uprighted using only brass ligature wire. This paper suggests that brass ligature-wire therapy can be used to upright impacted molars that show considerable inclination.
Incomplete unilateral cleft of the primary palate: delayed secondary bone grafting combined with orthodontic treatment
Authors: Lertnimulchai Supachai
Published: December 2023

The presence of a fissural lateral incisor in an alveolar cleft is not a common occurrence and, if one is present, must in most instances be removed because of microdontia or because it may compromise a bone graft. This case report presents an example of bone grafting carried out late in the secondary stage of the patient’s dentition, in conjunction with retention of the fissural lateral incisor as requested by the patient, and shows an acceptable outcome from the points of view of both aesthetics and dento-alveolar health.
A comparison of splinted and banded Herbst appliances: treatment changes and complications
Authors: Hägg Urban , Tse Edmond L.K. , Rabie A. Bakr M. , Robinson W.
Published: December 2023

The aims of this study were to compare the frequency of clinical problems, such as fracture and dislodgment, and the dentofacial changes in 28 13-year-old Chinese children with Class II, division 1 malocclusions treated with either cast-metal splinted Herbst appliances or banded Herbst appliances.

The first fourteen children were treated with a maximum anchorage type of banded Herbst appliance for six months, and the remainder were treated with cast-silver splinted Herbst appliances for seven months. The dentofacial form and the treatment changes were assessed with the aid of pre- and post-treatment lateral cephalometric radiographs. The number of visits and the number of fractured and dislodged appliances were recorded. Both appliances had similar effects on the dentofacial structures. There were no statistically significant dentofacial differences between the groups at the conclusion of treatment. During treatment relatively few banded appliances were dislodged and few splinted appliances fractured. However, a large number of banded appliances fractured, and a similar number of splinted Herbst appliances were dislodged. The latter required less clinical and laboratory time to service and/or replace. It was concluded that splinted Herbst appliances are preferable to banded Herbst appliances because of the savings in clinical and laboratory time. Aust Orthod J 2002; 18:
Maxillonasal dysplasia (Binder syndrome): a lateral cephalometric assessment
Authors: Carach Barbara , Woods Michael , Scott Peter
Published: December 2023

Binder syndrome or maxillonasal dysplasia was first described by Binder in 1962, and is a disorder characterised by nasomaxillary hypoplasia. The records of 33 patients who had been diagnosed clinically with Binder syndrome at the Royal Children’s Hospital of Melbourne were examined. Of these 33 patients, 14 were selected because they met the inclusion criteria: that they had not had prior surgical and/or orthodontic treatment, and that high-quality lateral cephalometric radiographs were available. The craniofacial morphology of these patients was determined on lateral cephalometric radiographs and compared with published age- and sex-matched norms. In agreement with published studies, the anteroposterior lengths of the anterior cranial base and maxilla were reduced, and the majority of patients had a Class III skeletal relationship. Although the lower incisors tended to be prominent, both overjet and overbite fell within the ranges for the normal population. Despite the fact that the orthodontic and surgical treatment for patients with Binder syndrome is normally carried out within specialised units, clinicians should be aware of the variety of ways in which this condition may present.
Distortions in panoramic radiographs
Authors: Yeo D.K.L. , Freer T.J. , Brockhurst P.J.
Published: December 2023

This study was designed to investigate the factors affecting linear distortion in orthopantomography. A test model was constructed with metallic rods positioned to simulate maxillary teeth from the first permanent molar to the lateral incisor. In addition to examining the effects of varying the tilts of the test rods in a mesio-distal or bucco-palatal direction, spatial position changes (sagittal displacement, transverse displacement and horizontal rotation) of the test model were evaluated by determining the magnification changes in the width and length of the test rods. Results showed that significant errors occurred with all variations in magnification when test rods were inclined buccopalatally (p < 0.001) at or exceeding 5 degrees relative to the true perpendicular, and for spatial positioning errors (p < 0.05) at or exceeding ±5 degrees and ±5 mm. Bucco-palatally inclined objects in the lateral incisor-canine region were particularly susceptible to large changes in horizontal magnification. Linear measurements and clinical assessments from panoramic radiographs should therefore be undertaken cautiously. To minimise errors in orthopantomography, it is important to position the patient in the focal trough precisely according to the manufacturer’s specification.
Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?
Authors: Grave Keith , Townsend Grant
Published: December 2023

Background: Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians.

Methods: Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. Results: For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt.

Conclusion: Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.
A longitudinal index study of orthodontic stability and relapse
Authors: Olive Richard J. , Basford Kaye E.
Published: December 2023

Background: Previous studies of stability and relapse after orthodontic treatment report short-term stability is generally followed by slow relapse to the original condition. What these studies do not report is whether this relapse is continuous or interspersed with periods of improvement or stability.

Methods: A subjective 0–10 index of malocclusion was used to record post-treatment stability and relapse over 10 to 12 years following fixed appliance orthodontic treatment of 24 patients. The severity scores were plotted on timelines.

Results: Episodes of change, both favourable and unfavourable, were interspersed with episodes of stability.

Conclusions: Changes in the first 3 and 12 months post-treatment are indicative of the 10 to 12 years post-treatment outcomes. This index may provide a useful instrument to analyze patients and/or their study models longitudinally.
Distribution of the epithelial rests of Malassez and their relationship to blood vessels of the periodontal ligament during rat tooth development
Authors: Kat Petrina S.P. , Sampson Wayne J. , Wilson David F. , Wiebkin Ole W.
Published: December 2023

Background: There is some evidence that the epithelial cell rests of Malassez partition the root surface from the periodontal ligament blood vessels, and may protect the root from resorption.

Objective: The aim of the present study was to determine the distributions of the epithelial rests of Malassez (ERM) and blood vessels in the periodontal ligament (PDL) of the developing rat first molar before, during and after emergence.

Methods: Four Sprague-Dawley rats were sacrificed at two days, one week, two weeks, three weeks, four weeks and six weeks of age. After processing, the maxillae were embedded in paraffin, and sectioned longitudinally and transversely. The sections were stained with a double immuno-histochemical technique which utilised a keratin antibody AE1–AE3 (1:2,000) and an endothelial antibody Factor VIII (1:10,000) to enable simultaneous labelling of ERM and blood vessels. ERM and blood vessel counts were obtained from the mesio-buccal roots of three week, four week and six week-old rats, whilst qualitative observations were made for the earlier developmental stages.

Results: ERM cells and cell clusters were found in the tooth third of the PDL width at the three, four and six week stages. Cells and cell clusters increased in number with age, especially in the upper third of the mesio-buccal root. The largest numbers of cells and clusters were found on the distal surfaces of the roots in all age groups. Cells and clusters in all root surfaces increased from three to four weeks, but decreased from four to six weeks. The greatest number of blood vessels was found in the bone-side third of the PDL. The distal surface had the highest proportion of blood vessels, and the palatal surface the least proportion. The number of blood vessels in all surface quadrants did not vary much from three to four weeks of age, but increased from four to six weeks of age, possibly as a reaction to tooth emergence and occlusal function. Physiological root resorption was only observed after tooth emergence, and appeared to be related to loss of continuity of the ERM network and the incursion of blood vessels.

Conclusions: Orthodontic root resorption can be regarded as an exaggerated response to loss of PDL homeostatic control, possibly mediated by the epithelial rests of Malassez.
The genetic contribution to orthodontic root resorption: a retrospective twin study
Authors: Ngan Daniel C. S. , Kharbanda Om P. , Byloff Friedrich K. , Ali Darendeliler M.
Published: December 2023

Background: One of the difficulties in assessing the causes of root resorption is to separate the contribution made by genetic factors from those due to environmental factors, such as treatment.

Objective: The aim of this study was to investigate the genetic contribution to orthodontic root resorption.

Methods: The subjects of this investigation were 16 monozygotic (MZ) and 10 dizygotic (DZ) twins. All twins had zygosity diagnosed using microsatellite analysis. Each twin-pair had same type of malocclusion, were treated with the same type of appliance, and by the same clinician. The lengths of the maxillary incisors, mandibular incisors, and mandibular molars were assessed both qualitatively and quantitatively, on pre- and post-treatment panoramic films. The genetic contribution to external apical root resorption was assessed using concordance and heritability estimates.

Results: Concordance estimates from the qualitatively and quantitatively measured external apical root resorption were 44.9 per cent and 49.2 per cent respectively for the MZ twins, and 24.7 per cent and 28.3 per cent respectively for DZ twins. An overall heritability estimate of 0.34 was obtained.

Conclusions: External apical root resorption was not dependent on the pretreatment root length. Qualitatively and quantitatively determined estimates of concordance indicate a genetic component to root resorption. A larger sample is needed before models of heritability can be used to determine the components contributing to the variance.
Opuntia humifusa (Raf.) Raf. (Cactaceae) in the Bulgarian flora
Authors: Zahariev Dimcho
Published: December 2023

Opuntia humifusa (Raf.) Raf. is included in the List of Top 10 of the worst invasive alien plant species in Bulgaria. This is the fastest spreading species of the four species of the Opuntia genus found so far in natural habitats in Bulgaria. In the period 2010-2023, 3 new localities of the species were established in 3 new floristic regions of Bulgaria: Black Sea Coast (North), Stara Planina (East) and Strandzha Mountain. They describe the northernmost and easternmost distribution limits of the species in Bulgaria. The described localities are different in area: from 0.08 ha to 21.11 ha. The characteristics of the abiotic environment are presented such as: slope, exposure, elevation, bedrock, soil, climatic region and subregion. The habitats in which individuals of the species are found are indicated. Accompanying plant species were studied. The spatial structure of O. humifusa populations was studied. The reasons for the appearance and spread of this invasive alien plant species in territories that have not been inhabited by it until now have been examined, considering that these reasons are not natural, but have an anthropogenic character. Our findings support the opinions of other researchers about the key role of nature lovers in the spread of this invasive species. Factors favoring the increase in population size in established localities are indicated. Methods have been proposed to control the spread of the species.
Natural tourist resources in the Stara planina tourist region (Bulgaria)
Authors: Kabakchieva Dora , Vasileva Vanya
Published: December 2023

The Stara planina tourist region is one of the most attractive regions for tourism in Bulgaria and one of the few that have almost year-round tourist activities. The outline of the area includes the mountain of the same name, but also the Pre-Balkan. This fact predetermines the exceptional richness and diversity of natural tourist resources. Here are some of the largest broad-leaved forests in the country, waterfalls, bizarre rock formations, etc. The relatively well-preserved natural environment is a prerequisite for the presence of exceptional biodiversity, as well as a significant number of protected areas. The region is specialized mainly in mountain tourism, including recreation, mountain trekking, rural and ecotourism. Due to the scarce tourist infrastructure, ski tourism still lags behind in its development compared to other mountain regions in the country. Very often, the Stara planina Region is primarily identified with its cultural and historical heritage, while its natural features remain in the background. Regardless of this, and as a result of the more intense tourist load, the problem of protecting natural tourist resources from the growing anthropogenic pressure is gaining special relevance. There is also an urgent need to identify and evaluate the prospects for sustainable development of the tourism industry in the region.

The purpose of the present study is to valorize the natural tourist resources of the Stara planina tourist region and to provide guidelines for their sustainable use.
The ability to form environmental competence throughout Waste management
Authors: Doychinova Klaida
Published: December 2023

Environmental competence is a category related to environmental awareness, environmental culture, environmental ethics and environmental behaviour and is a key competence. An efficient way to build a public awareness of environmental responsibility is to separate waste, a concept that is now widespread across Europe. Project work is an integrative strategy that provides opportunities for cooperation and interaction between students in the team organization of cognitive activity, realizing the connection between theoretical knowledge and practical activity of students, for conducting active training of students and effective socialization of the training, thus increasing the practical focus of the acquired knowledge and competences.

The article presents results following the application of the project method as an opportunity to increase the environmental competence of junior high school students, with regards to sustainable waste management at school and in their households.
Impact of credit use on profitability among cassava smallholder farmers in Southwest, Nigeria
Authors: Adeosun Damilola Richard , Adegbite Dorcas Adetokunbo , Sanusi Rahman Akintayo , Ayansina Simeon Olusola , Oke Folashade Olukemi
Published: December 2023

Nigeria has large economic potential with high profitability but profitability is not increasing, and agricultural production is poor. This is hinged on the understanding of the impact of credit use on profitability, however, the influence of credit use on cassava production remains poorly understood, consequently affecting the profitability of cassava farmers. Thus, this study assessed the impact of credit use on the profitability of cassava farmers among smallholders in southwest Nigeria. Multi-stage sampling procedure was used to select 210 smallholder cassava farmers for the study. A structured questionnaire was used to collect data on the socio-economic characteristics and profitability of cassava farmers. Data were analysed with descriptive statistics, budgetary analysis, ordinary least squares (OLS), and t-test statistics. Results show that 60.0% of the farmers were male, 81.0% were married, 33.3% had secondary education, 70.5% had no contact with extension agents, 71.9% were members of a cooperative society, 61.9% had savings and 49.5% had access to credit. Furthermore, the mean age, farming experience, farm size, and household size of the sampled cassava farmers were 43 years, 19 years, 3.1 hectares, and 6 persons, respectively.

Budgetary analysis shows that mean revenue per hectare from cassava production was ₦131,917.8 ($369.4)/ha for credit users with gross margin of ₦85,138.7 ($238.4)/ha and return on investment of 1.54, whereas ₦117,602.5 ($329.3)/ha for non-users with gross margin of ₦71,923.4 ($201.4)/ha and return on investment of 1.31, implicating that cassava production is a profitable and viable enterprise and that credit users are more profitable than non-users. Farm size (p < 0.01), membership in cooperative society (p < 0.10), and credit (p < 0.01) significantly influenced the profitability of the cassava farmers. The test of the mean difference in revenue and net farm income was significant at 1%. The study concluded that credit had a positive significant influence on cassava farmers’ profitability. Hence, credits should be made available by relevant stakeholders like government and non-governmental organisations, to cassava farmers in the study area.
Evaluation of parenteral injection skills of medical undergraduates on mannequins in a tertiary care teaching hospital in South India – A cross-sectional study
Authors: James Jerin , Porkodi A , Rani Jamuna , Varadarajan Sathyanarayanan
Published: December 2023

Appropriate knowledge and expertise of parenteral injection is vital in the medical field. Hence we impart training on mannequins before the students practice on patients. This study was conducted to evaluate the skill exhibited by the students in parenteral injection skills, namely intravenous, intramuscular, intradermal and subcutaneous injections. The students were assessed for step based on the pre-validated check list created for Objective Structured Practical Examination. In this study, 16 % of the students failed to check the prescription order before starting the procedure. The name and the expiry date of the drug was not checked by 22 % of the students. Hundred percent of the students sterilized their hands. Loading of drug was done properly by 80 % of the students and 88 % of the students checked for air bubbles in the syringe and removed them properly. The site for injection was not sterilized by 26 percent of the students. Tourniquet was not applied by 19 percent of the students and 28 % of the students did not hold the bevel up during insertion for intravenous route. The steps where frequent faltering happened needs to be emphasized for them to perform better in a more efficient manner during the summative assessment as well as for future practice.
Humoral response after breakthrough SARS-CoV-2 infection in type 2 diabetes mellitus patients
Authors: Michalski Aleksander , Goralczyk Magdalena , Brzozowski Michal , Dworzanski Jakub , Drop Bartlomiej , Stepien Ewa , Polz-Dacewicz Malgorzata
Published: December 2023

Type 2 diabetes mellitus (T2DM) remains an important public health problem in both developing and developed countries. In addition, the recent COVID-19 pandemic has revealed furthel risks for diabetes patients in terms of symptoms and disease progression. Higher mortality and morbidity are related to the complexity of the pathology of this chronic underlying disease, which negatively affects the immune response to the SARSCoV-2 virus. The humoral response plays an important role in the eradication of the virus; thus, it was analyzed in vaccinated diabetics who underwent COVID-19, as well as in the control group. The aim of this study was to assess the prevalence and level of IgG antibodies raised against the nucleocapsid protein (NCP), S1 subunit receptor binding domain (RBD) and subunit Spike 2 (S2) subunit of the virus’s S protein using the Microblot Array test. The results demonstrated significantly lower prevalence and titers of anti-SARS antibodies in diabetic patients compared to the control group. In addition, antibody titers were negatively related to the duration of this chronic disease, body mass index (BMI), comorbidities and HbA1c concentration. Further research is needed to develop the best strategy for specific prevention of SARS-CoV-2 infection in diabetic patients.
Bats of the Ostrava city and their synantropization
Authors: Gajdošík Martin
Published: December 2023

Based on the published findings (Koštejnová 2013, Slezáková 2014, Gajdošík 2020), unpublished data from museum specimens (2005 – 2013), and data from field surveys (2005 – 2023), a total of 13 bat species were recorded in the urban area of Ostrava in North Moravia. Common species in the area included Pipistrellus pipistrellus, Nyctalus noctula, Eptesicus serotinus, Myotis daubentonii, and Vespertilio murinus. P. pipistrellus was eudominant species (D = 74.41), followed by N. noctula (D = 11.41). E. serotinus was a subdominant species (D = 4.59), followed by M. daubentonii (D = 3.77) and V. murinus (D = 2.45). The occurrence of M. mystacinus/brandtii was recendent (D = 1.33), and the occurrence of M. nattereri (D = 0.51), E. nilssonii (D = 0.51), P. pygmaeus (D = 0.31), Plecotus auritus/austriacus (D = 0.31), Pipistrellus nathusii (D = 0.20), N. leisleri (D = 0.10), M. myotis (D = 0.10) and M. brandtii (D = 0.10) were subrecendent. In the summer season, eudominant species were P. pipistrellus (D = 76.84), followed by the N. noctula (D = 10.63), subdominant E. serotinus (D = 4.74), and M. daubentonii (D = 3.89), with M. mystacinus/brandtii being recendent (D = 1.37). In the winter season, eudominant species were V. murinus (D = 62.50), followed by the N. noctula (D = 34.38) and subdominant P. nathusii (D = 3.13). However, the species composition inside and outside buildings differed significantly. In the summer season, eudominant species inside buildings was P. pipistrellus (D = 99.57), followed by the subrecendent species V. murinus (D = 0.29) and M. daubentonii (D = 0.14). Outside buildings, N. noctula (D = 40.16) were eudominant, followed by E. serotinus (D = 17.72), P. pipistrellus (D = 14.17), and M. daubentonii (D = 14.17), with M. mystacinus/brandtii (D = 5.12) was dominant, and M. nattereri (D = 1.97), E. nilssonii (D = 1.97), P. pygmaeus (D = 1.18), and P. auritus/austriacus (D = 1.18) were recendent species. In the winter season, eudominant species inside buildings were V. murinus (D = 68.75), followed by N. noctula (D = 25.00), and the situation was very similar outside the buildings during this period, with eudominant V. murinus (D = 56.25) and N. noctula (D = 43.75). Two roosts of the maternity colonies P. pipistrellus were recorded in city buildings: in Výškovice, Lumírova 10, in a expansion joint near the balcony on the top floor of a panel residential building; and in Zábřeh, Plzeňská 2617/4 and Plzeňská 2617/6, in expansion joints on the top floors of an old panel building used as a hostel and apartment building.