bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of an individually tailored oral hygiene intervention in improving gingival health among community‐dwelling adults with physical disabilities in Thailand
Authors: Sermsuti‐Anuwat Nithimar , Pongpanich Sathirakorn 
Published: December 2020

AbstractAimsPersons with physical disabilities require specific methods for sustaining good oral health. This study aimed to evaluate an individually tailored oral hygiene intervention program (IT‐OHI) for improving gingival health among adults with disabilities.Methods and resultsA single group, quasi‐experimental design with pre‐ and post‐tests, conducted at a community club for disabled people in Thailand. This study included 145 adults with disabilities, aged 18‐74 years. Trained caregivers provided IT‐OHI program to all participants. Calibrated dentists assessed the gingival bleeding and dental plaque at baseline/pre‐intervention (T0) and at 6 (T1) and 12 (T2) weeks post‐intervention. The outcomes were analyzed using the Friedman test, Cochran's Q test, and Binary logistic regression. There were significant decreases in bleeding on probing scores (P < .001) and plaque control record scores (P < .001) throughout the study. However, considering the individual periods, values between T1 and T2 did not improve. Additionally, the IT‐OHI program's protective effect was more substantial among the male participants at 12 weeks post‐intervention (odds ratio = 0.094, P = .027) than among the females.ConclusionThe IT‐OHI program had partial effectiveness in improving gingival health and reducing dental plaque accumulation in a group of Thai people with physical disabilities; however, the long‐term impact remains unclear.
“The Debt of Gratitude”: Mobilizing “Motherhood” in Times of Unrest in the United Arab Emirates
Authors: Sabban Rima 
Published: December 2020

ObjectiveThe objective of this study is to examine the framework of "motherhood" and gender identity politics in the context of growing nationalist state projects rooted in the UAE national service discourse. While the Western scholarship has extensively examined the concept of motherhood, little empirical studies have focused on the complex linkages between motherhood, state, and national service, particularly in non‐Western contexts such as the UAE.MethodsThe method was an in‐depth field interviews with national mothers. National mothers have increasingly emerged as the new ideological “objects” of the state‐led nationalist campaign to promote national military service in the UAE. The study further dissects the spatial boundaries of, and the complex relationships between motherhood and state, while simultaneously highlighting vignette of gendered narratives of various local UAE national mothers, and how they micro‐view, sacrifice, cope, and respond to the ongoing state project.ResultsThe results show how UAE national service has shaped the daily lives and sense of belonging of UAE national mothers, their acceptance of the changes National service has brought to their families. A “debt of gratitude” is a catalyst of their attitude to a state which represents their interpretation and understanding of what they foresee as the UAE state's act of “disciplining and governmentality” in times of ongoing unrest in the broader Middle East region.ConclusionIn conclusion, UAE mothers aligned their adaptation to a new disrupted change and family relationships.
Rh disease prevention: the European Perspective
Authors: Toly‐Ndour Cécile , Huguet‐Jacquot Stéphanie , Mailloux Agnès , Delaby Hélène , Canellini Giorgia , Olsson Martin L. , Wikman Agneta , Koelewijn Joke M. , Minon Jean‐Marc , Legler Tobias J. , Clausen Frederik B. , Lambert Mark , Ryan Helen , Bricl Irena , Hasslund Sys , Orzinska Agnieszka , Guz Katarzyna , Uhrynowska Malgorzata , Matteocci Antonella , Nogues Nuria , Muniz‐Diaz Eduardo , Sainio Susanna , De Haas Masja , Van der Schoot C. Ellen 
Published: December 2020

Background and ObjectivesIn Europe, postnatal and subsequently antenatal administration of anti‐RH1 (D) immunoglobulins (Ig) has reduced the number of maternal anti‐RH1 immunizations and the incidence of haemolytic disease of the foetus and newborn since the 1960s. Non‐invasive foetal RHD genotyping now enables antenatal prophylaxis to be targeted only to women carrying RHD‐positive foetus. We aimed at describing how Rh disease prevention is currently managed in different European countries.Materials and MethodsWe prepared an online survey on guidelines and biological tests performed for Rh disease prevention. The link was sent to 15 expert laboratories among Europe, selected by their publications in the field.ResultsExperts from thirteen countries responded. Guidelines on anti‐RH1 prophylaxis are similar regarding the major aspects of RH disease prevention, including indication and timing of anti‐RH1 Ig administration, as well as indication of foetal RHD genotyping. Different anti‐RH1 Ig preparations are used, and the dosing may differ depending on gestational age. Other controversial issues include (1) timing for foetal RHD genotyping, (2) indication of tests performed to quantitate feto‐maternal haemorrhage prior to anti‐RH1 Ig administration, (3) if there is a remaining indication for newborn RH1 phenotyping. Procedures for monitoring the prophylaxis efficiency and evaluating the national prevention programme also differ among countries.ConclusionDespite some differences among countries, the Rh disease prevention policies are very efficient in Europe, but HDFN cases due to maternal anti‐RH1 immunization have not completely disappeared. It therefore remains important to share best practices for continuous improvement in reducing anti‐RH1 alloimmunization.
Experimental approach to nasal septal cartilage regeneration with adipose tissue‐derived stem cells and decellularized porcine septal cartilage
Authors: Kuhlmann Constanze , Schenck Thilo Ludwig , Tluczynski Katharina , Aszodi Attila , Metzger Philipp , Giunta Riccardo , Wiggenhauser Paul Severin 
Published: December 2020

AbstractBackgroundCartilage shortage is a major problem in facial reconstructive surgery. Prior studies have shown that decellularized porcine nasal septal cartilage (DPNC) seeded with primary human nasal chondrocytes enabled cartilage regeneration and showed potential as a replacement material for nasal cartilage. Since adipose tissue‐derived stem cells (ASCs) are easily accessible and almost abundantly available, they appear to be a promising alternative to limited chondrocytes making the combination of DPNC and ASCs a feasible approach towards clinical translation. Thus, this study was intended to investigate the interactions between ASCs and DPNC in an in vitro model.MethodsDPNCs were seeded and 3D‐cultured with primary human ASCs that were priorly characterized with trilineage differentiation and flow cytometry. Cell vitality and proliferation were evaluated by Live‐Dead, alamarBlue, and PicoGreen assays. Chondrogenic differentiation was examined by DMMB assay and cryosectioning‐based histology. Cell invasion within DPNC was visualized and quantified by fluorescent histology (DAPI, Phalloidin).ResultsASCs showed good adherence to DPNC and Live‐Dead assay proved their viability over 2 weeks. AlamarBlueassay showed an increase in metabolic activity compared to 2D cultures, and PicoGreen assay demonstrated an increase of cell number within DPNC over time. Biochemical assays and histology added evidence of chondrogenic differentiation of 3D‐cultured ASCs under the influence of chondrogenic induction medium. Fluorescent image analysis showed a significant increase of cell‐occupied areas of scaffolds over time (P < .05).ConclusionsDPNC scaffolds provided a suitable environment for ASCs that allowed good cell vitality, high proliferation, and chondrogenic differentiation. Thus, the use of ASCs and DPNC yields a promising alternative to the use of primary human chondrocytes. For facial cartilage tissue engineering, we regard ASCs as an attractive alternative to human nasal chondrocytes due to their better accessibility and availability. Further research will be necessary to determine long‐term effects and in vivo outcomes of ASCs and DPNC in cartilage regeneration of the face.
Respiratory alkalinization and posterior cerebral artery dilatation predict acute mountain sickness severity during 10 h normobaric hypoxia
Authors: Barclay Holly , Mukerji Saptarshi , Kayser Bengt , O'Donnell Terrence , Tzeng Yu‐Chieh , Hill Stephen , Knapp Katie , Legg Stephen , Frei Dan , Fan Jui‐Lin 
Published: December 2020

New Findings
What is the central question of this study?
The pathophysiology of acute mountain sickness (AMS), involving the respiratory, renal and cerebrovascular systems, remains poorly understood. How do the early adaptations in these systems during a simulated altitude of 5000 m relate to AMS risk?
What is the main finding and its importance?
The rate of blood alkalosis and cerebral artery dilatation predict AMS severity during the first 10 h of exposure to a simulated altitude of 5000 m. Slow metabolic compensation by the kidneys of respiratory alkalosis attributable to a brisk breathing response together with excessive brain blood vessel dilatation might be involved in early development of AMS.
AbstractThe complex pathophysiology of acute mountain sickness (AMS) remains poorly understood and is likely to involve maladaptive responses of the respiratory, renal and cerebrovascular systems to hypoxia. Using stepwise linear regression, we tested the hypothesis that exacerbated respiratory alkalosis, as a result of a brisk ventilatory response, sluggish renal compensation in acute hypoxia and dysregulation of cerebral perfusion predict AMS severity. We assessed the Lake Louise score (LLS, an index of AMS severity), fluid balance, ventilation, venous pH, bicarbonate, sodium and creatinine concentrations, body weight, urinary pH and cerebral blood flow [internal carotid artery (ICA) and vertebral artery (VA) blood flow and diameter], in 27 healthy individuals (13 women) throughout 10 h exposures to normobaric normoxia (fraction of inspired O2 = 0.21) and normobaric hypoxia (fraction of inspired O2 = 0.117, simulated 5000 m) in a randomized, single‐blinded manner. In comparison to normoxia, hypoxia increased the LLS, ventilation, venous and urinary pH, and blood flow and diameter in the ICA and VA, while venous concentrations of both bicarbonate and creatinine were decreased (P < 0.001 for all). There were significant correlations between AMS severity and the rates of change in blood pH, sodium concentration and VA diameter and more positive fluid balance (P < 0.05). Stepwise regression found increased blood pH [beta coefficient (β) = 0.589, P < 0.001] and VA diameter (β = 0.418, P = 0.008) to be significant predictors of AMS severity in our cohort [F(2, 20) = 16.1, R2 = 0.617, P < 0.001, n = 24], accounting for 62% of the variance in peak LLS. Using classic regression variable selection, our data implicate the degree of respiratory alkalosis and cerebrovascular dilatation in the early stages of AMS development.
Deformation Modeling of a Flexible Instrument Using a Bézier Curve
Authors: Rajesh Gudala , Khatait Jitendra P. 
Published: December 2020

Abstract
Flexible instruments are extensively used in medical applications. Manipulation of these instruments is challenging and troublesome. To study the behavior of these instruments, different modeling approaches like finite element, Cosserat rod, and differential geometry have been used. In this paper, an alternate modeling approach using Bézier curve is proposed to understand large deformation in a flexible instrument. The shape is represented by a Bézier curve. The deformation includes extension, flexure, and torsion in the instrument. Strain energy and geometric constraints are formulated using Bézier control points. The shape of the deformed instrument under the given constraints is obtained by minimizing the total strain energy. Nonlinear constrained optimization is used for the minimization to find the deformed shape. The proposed method is applied for large elastic deformation in three-dimensional space. Loop formation is observed and validated with the experimental results. The proposed method will help in understanding the mechanics of a flexible instrument. Looping is a common problem during colonoscopy. The developed model will help in developing strategies for the safe introduction of these instruments inside the body for performing diagnostic and surgical interventions.
Enhancement in Film Cooling Effectiveness Using Delta Winglet Pair
Authors: Halder Nirmal , Saha Arun K. , Panigrahi P. K. 
Published: December 2020

Abstract
A simulation study has been carried out to investigate the influence of delta winglet pair (DWP) for improving the film cooling effectiveness of a gas turbine blade. Incompressible continuity, momentum, energy, and two equations k − ω SST model have been used for investigating the nature of flow field, temperature field, and turbulent statistics. The Reynolds number based on the jet velocity and the diameter of the film cooling hole is set at a constant value equal to 4232. The jet to the crossflow blowing ratio has been varied as 0.5, 1.0, and 1.5. The corresponding Reynolds numbers based on the crossflow inlet velocity and film hole diameter are equal to 6462, 4229, and 3231, respectively. It is observed that common-flow-down (CFD) DWP configuration augments the film cooling effectiveness due to generation of secondary longitudinal vortices, which annihilates the counter-rotating vortex structures present in the baseline flow. The generation of hairpin vortices and the growth of shear layer vortices are modified due to the implementation of DWP. The overall turbulence intensity and vorticity get reduced due to the presence of DWP. A maximum of 97.46% and a minimum of 61.50% enhancement in film cooling effectiveness have been observed at blowing ratio of M = 1.5 and M = 0.5, respectively. The wake region of the film cooling jet is modified due to DWP leading to formation of stagnation region and lower mixing resulting in higher film cooling effectiveness. The strength of horseshoe vortices is reduced due to the presence of DWP, resulting in lower mixing between the jet with the cross flows and stable film formation. Lower thermal boundary layer thickness is observed in DWP configuration compared to that of the baseline case confirming lower mixing due to the implementation of DWP. Overall, the present study explains the effectiveness of DWP configuration for enhancement of film cooling effectiveness of a DWP.
Corneal confocal microscopy compared with quantitative sensory testing and nerve conduction for diagnosing and stratifying the severity of diabetic peripheral neuropathy
Authors: Ferdousi Maryam , Kalteniece Alise , Azmi Shazli , Petropoulos Ioannis N , Worthington Anne , D'Onofrio Luca , Dhage Shaishav , Ponirakis Georgios , Alam Uazman , Marshall Andrew , Faber Catharina G , Lauria Giuseppe , Soran Handrean , Malik Rayaz A 
Published: December 2020

IntroductionDiabetic neuropathy can be diagnosed and assessed using a number of techniques including corneal confocal microscopy (CCM).Research design and methodsWe have undertaken quantitative sensory testing, nerve conduction studies and CCM in 143 patients with type 1 and type 2 diabetes without neuropathy (n=51), mild neuropathy (n=47) and moderate to severe neuropathy (n=45) and age-matched controls (n=30).ResultsVibration perception threshold (p<0.0001), warm perception threshold (WPT) (p<0.001), sural nerve conduction velocity (SNCV) (p<0.001), corneal nerve fiber density (CNFD) (p<0.0001), corneal nerve branch density (CNBD) (p<0.0001), corneal nerve fiber length (CNFL) (p=0.002), inferior whorl length (IWL) (p=0.0001) and average nerve fiber length (ANFL) (p=0.0001) showed a progressive abnormality with increasing severity of diabetic neuropathy. Receiver operating characteristic curve analysis for the diagnosis of diabetic neuropathy showed comparable performance in relation to the area under the curve (AUC) but differing sensitivities and specificities for vibration perception threshold (AUC 0.79, sensitivity 55%, specificity 90%), WPT (AUC 0.67, sensitivity 50%, specificity 76%), cold perception threshold (AUC 0.64, sensitivity 80%, specificity 47%), SNCV (AUC 0.70, sensitivity 76%, specificity 54%), CNFD (AUC 0.71, sensitivity 58%, specificity 83%), CNBD (AUC 0.70, sensitivity 69%, specificity 65%), CNFL (AUC 0.68, sensitivity 64%, specificity 67%), IWL (AUC 0.72, sensitivity 70%, specificity 65%) and ANFL (AUC 0.72, sensitivity 71%, specificity 66%).ConclusionThis study shows that CCM identifies early and progressive corneal nerve loss at the inferior whorl and central cornea and has comparable utility with quantitative sensory testing and nerve conduction in the diagnosis of diabetic neuropathy.
Effective prevention of intimate partner violence through couples training: a randomised controlled trial ofIndashyikirwain Rwanda
Authors: Dunkle Kristin , Stern Erin , Chatterji Sangeeta , Heise Lori 
Published: December 2020

BackgroundBetween 2015 and 2018, three civil society organisations in Rwanda implementedIndashyikirwa, a four-part intervention designed to reduce intimate partner violence (IPV) among couples and within communities. We assessed the impact of the programme’s gender transformative curriculum for couples.MethodsSectors (n=28) were purposively selected based on density of village savings and loan association (VLSA) groups and randomised (with stratification by district) to either the full community-levelIndashyikirwaprogramme (n=14) or VSLA-only control (n=14). Within each sector, 60 couples recruited from VSLAs received either a 21-session curriculum or VSLA as usual. No blinding was attempted. Primary outcomes were perpetration (for men) or experience (for women) of past-year physical/sexual IPV at 24 months post-baseline, hypothesised to be reduced in intervention versus control (ClinicalTrials.gov:NCT03477877).ResultsWe enrolled 828 women and 821 men in the intervention sectors and 832 women and 830 men in the control sectors; at endline, 815 women (98.4%) and 763 men (92.9%) in the intervention and 802 women (96.4%) and 773 men (93.1%) were available for intention-to-treat analysis. Women in the intervention compared with control were less likely to report physical and/or sexual IPV at 24 months (adjusted relative risk (aRR)=0.44, 95% CI 0.34 to 0.59). Men in the intervention compared with control were also significantly less likely to report perpetration of physical and/or sexual IPV at 24 months (aRR=0.54, 95% CI 0.38 to 0.75). Additional intervention benefits included reductions in acceptability of wife beating, conflict with partner, depression, and corporal punishment against children and improved conflict management, communication, trust, self-efficacy, self-rated health, household earnings, food security and actions to prevent IPV. There were no study-related harms.ConclusionsTheIndashyikirwacouples’ training curriculum was highly effective in reducing IPV among male/female couples in rural Rwanda. Scale-up and adaptation to similar settings should be considered.
Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia
Authors: Donato Katherine , McConnell Margaret , Han Dan , Gunaratna Nilupa S , Tessema Masresha , De Groote Hugo , Cohen Jessica 
Published: December 2020

IntroductionBiofortified crops have tremendous potential to improve child nutrition. We tested whether complementing the distribution of quality protein maize (QPM) with a package of interventions informed by behavioural insights could support greater consumption of QPM by young children and translate into improved growth.MethodsWe conducted a cluster-randomised trial in Oromia, Ethiopia. Clusters of households with a child between 6 and 35 months were randomised into an arm receiving QPM seed only (320 households, 203 clusters) or an arm receiving QPM seed and a child consumption targeting intervention (290 households, 183 clusters). The intervention package included tools to help caregivers keep QPM separate from conventional maize and to earmark QPM specifically for child consumption, as well as encouragement regarding cooking QPM specifically for young children. We analysed the impact of the intervention on food storage, cooking and consumption behaviours and on anthropometric measures (weight-for-age, height-for-age z scores).ResultsThe consumption targeting intervention increased the probability of child consumption of QPM in the past week by 17.3 percentage points (pp) (95% CI 9.4 pp to 25.1 pp; p<0.01), increased the probability that QPM flour was stored separately from conventional maize by 46.5 pp (95% CI 38.3 pp to 54.7 pp; p<0.01) and increased the probability that caregivers cooked QPM specifically for young children in the past week by 14.4 pp (95% CI 7.9 pp to 20.9 pp; p<0.01). These effects persisted, but were attenuated, 10 months postintervention. No significant effects on anthropometric outcomes were found.ConclusionsEnhancing the distribution of new, biofortified crop varieties with a consumption targeting campaign can change storage, cooking and consumption behaviours. However, these improved behaviours did not translate into increased growth in this setting.Trial registration numberNCT02710760and AEARCTR0000786.
Country performance against COVID-19: rankings for 35 countries
Authors: Jamison Dean T , Lau Lawrence J , Wu Kin Bing , Xiong Yanyan 
Published: December 2020

ObjectiveTo generate rankings of 35 countries from all continents (except Africa) on performance against COVID-19.DesignInternational time series, cross-sectional analysis.Selected countriesCountries having 5500 or more cases (collectively including 85% of the world’s cases) as of 16 April 2020 and that had reached 135 days into their pandemic by 30 July.Main outcome measuresTheinitial severityandlate-pandemicperformance of countries can reasonably be ranked by COVID-19 cases or deaths per million population. For guiding policy and informing public accountability during the pandemic, we proposemid-pandemicperformance rankings based on doubling time in days of the total number of cases and deaths in a country. Rank orderings then follow.ResultsAt day 25 into a country’s pandemic, cross-country performance variation was modest: in most countries, cumulative deaths doubled in fewer than 5 days. By day 65, and even more so by day 135, great cross-country variation emerged. By day 135, 9 of the 10 top-performing countries on deaths were European, although they were initially hard hit by the pandemic. Thus, rankings change rapidly enough to point to the value of a dynamic indicator. Five countries—Brazil, Mexico, India, Indonesia and Israel—were among the seven poorest performers at day 135 on both cases and deaths. Doubling times for cases and for deaths are positively correlated, but differ sufficiently to point to the value of both indicators.ConclusionsReadily available data support transparently generated rankings of countries’ performance against COVID-19 based on doubling times of cases and deaths. It is premature to judge the value of these rankings in practice, but the potential and early experience suggest they might help facilitate identification of good policies and inform judgements on national leadership.