bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of mild Class II malocclusion in growing patients with clear aligners versus fixed multibracket therapy: A retrospective study
Authors: Dianiskova Simona , Rongo Roberto , Buono Raffaele , Franchi Lorenzo , Michelotti Ambra , D’Antò Vincenzo 
Published: May 2021

AbstractObjectiveTo compare the dental and skeletal effects of intermaxillary elastics on the correction of mild Angle's Class II division 1 malocclusion with clear aligner treatment (CA) versus fixed multibracket (FMB) in growing patients.Settings and sample populationThe study sample consisted of 49 consecutively patients (mean age ± SD 12.9 ± 1.7 years), 32 females and 17 males referred from the School of Orthodontics of the University of Bratislava Comenius (Slovakia). All patients were treated with a non‐extraction orthodontic treatment, 25 with FMB and 24 with CA.MethodsThe cephalometric analysis was performed at the beginning (T0) and the end of the treatment (T1). The t test for unpaired data was carried out to compare cephalometric values at T0 and changes at T1‐T0 between the two groups. The level of significance was set as P < .0035.ResultsThe two groups showed no statistically significant differences (ANPg = −0.1°; P = .762) in the correction of the sagittal intermaxillary relation. The analysis of vertical skeletal changes showed no statistically significant effects on mandibular inclination (SN/MP = 0.1°; P = .840). The two treatments had a statistically significant and clinically relevant difference in controlling the inclination of the lower incisors (L1/GoGn = 4.8°, CAG = −0.5°± 3.9°; FMB = 4.3°± 5.8°; P < .001).ConclusionsClass II elastics combined with CA and FMB produce a similar correction on sagittal discrepancies in growing patients. CA presented a better control in the proclination of the lower incisors. CA and elastics might be a good alternative in the correction of mild Class II malocclusion in cases where a proclination of lower incisors is unwanted.
Association between maternal ritodrine hydrochloride administration during pregnancy and childhood wheezing up to three years of age: The Japan environment and children's study
Authors: Murata Tsuyoshi , Kyozuka Hyo , Yasuda Shun , Fukuda Toma , Yamaguchi Akiko , Maeda Hajime , Sato Akiko , Ogata Yuka , Shinoki Kosei , Hosoya Mitsuaki , Yasumura Seiji , Hashimoto Koichi , Nishigori Hidekazu , Fujimori Keiya ,   The Japan Environment, Children’s Study (JECS) Group
Published: May 2021

AbstractBackgroundThe effects of maternal ritodrine hydrochloride administration (MRA) during pregnancy on fetuses and offspring are not entirely clear. The present study aimed to evaluate the association between MRA and childhood wheezing using data from a nationwide Japanese birth cohort study.MethodsThis study analyzed the data of the participants enrolled in the Japan Environment and Children's Study, a nationwide prospective birth cohort study, between 2011 and 2014. Data of women with singleton live births after 22 weeks of gestation were analyzed. The participants were divided according to MRA status. Considering childhood factors affecting the incidence of wheezing, including smoking environment and childhood viral infections, a logistic regression model was used to calculate odds ratios for “wheezing ever,” diagnosis of asthma in the last 12 months, and “asthma ever” in women with MRA, with women who did not receive MRA as the reference. Additionally, participants were stratified by term births, and odds ratios for outcomes were calculated using a logistic regression model.ResultsA total of 68,123 participants were analyzed. The adjusted odds ratio for wheezing was 1.17 (95% confidence interval, 1.12–1.22). The adjusted odds ratios for the other outcomes did not significantly increase after adjusting for childhood factors. The same tendency was confirmed after excluding women with preterm births.ConclusionMRA was associated with a slightly increased incidence of childhood wheezing up to three years, irrespective of term or preterm birth status. It is important that perinatal physicians consider the potential effects of MRA on the offspring's childhood health.
Clinicopathological and molecular characteristics of endometrial neuroendocrine carcinomas reveal preexisting endometrial carcinoma origin
Authors: Ono Kyoko , Kasajima Rika , Katayama Kayoko , Miyagi Yohei , Yokose Tomoyuki 
Published: May 2021

AbstractEndometrial neuroendocrine carcinoma is a rare disease with unknown clinicopathological and molecular characteristics. Therefore, we conducted the present study to elucidate the clinicopathological and molecular characteristics of endometrial neuroendocrine carcinoma, as compared to conventional endometrial carcinoma, and to determine the origin of the former. We analyzed 22 endometrial neuroendocrine carcinomas and 22 conventional endometrial neoplasia cases with respect to clinical, histological and genetic features. Of these, 21/22 neuroendocrine carcinoma cases were admixed carcinomas, with 15 admixed with endometrioid adenocarcinoma. Genetic analysis of hotspot mutations in 50 cancer‐related genes revealed that the neuroendocrine carcinoma group carried mutations in PIK3CA (12/22 cases; 54%) and PTEN (8/22 cases; 36%), commonly encountered in endometrioid adenocarcinoma. Comparative statistical analysis of neuroendocrine carcinoma and conventional endometrial neoplasia cases showed a significant trend only in PIK3CA mutation. Moreover, in six mixed‐type neuroendocrine carcinoma cases, macrodissection was used to separate the neuroendocrine carcinoma and endometrioid adenocarcinoma components for next‐generation sequencing, which revealed several mutations common among the two. These findings suggest that endometrial neuroendocrine carcinoma could originate from conventional endometrial neoplasia, especially endometrioid adenocarcinoma.
The Effect of Reframing the Goals of Family Planning Programs from Limiting Fertility to Birth Spacing: Evidence from Pakistan
Authors: Naz Saman , Acharya Yubraj 
Published: May 2021

AbstractContraceptive prevalence in Pakistan has plateaued near 34 percent for over a decade, suggesting that fertility levels are likely to stay high unless effective interventions are designed. We evaluate the Family Advancement for Life and Health 2007–2012 (FALAH), a family planning project implemented in 31 districts of Pakistan. Deviating from previous programs, FALAH emphasized birth spacing—as opposed to limiting family size—as the primary purpose of contraceptive use. We use Pakistan Demographic and Health Survey to evaluate FALAH's impact on continuous and binary measures of birth intervals. To estimate the causal effects of the project, we compare the outcomes for multiple children born to the same mother before and after the project. We find that FALAH increased interbirth intervals by 2.4 months on average and reduced the proportion of short birth intervals by approximately 7.1 percentage points. This finding suggests that birth spacing as a goal of contraceptive use may resonate better with Pakistani couples than limiting family size. The project's effects were more pronounced for women with high education, in rural areas, and in the middle of the wealth distribution.
Internet Memes as Protest Media in Populist Hungary
Authors: Lukács Gabriella 
Published: May 2021

ABSTRACTScholars propose that memes are efficient tools of political mobilization as they stimulate large masses to take up a cause. Focusing on what is called O1G activism in Hungary, I demonstrate that the role of memes in political activism is conditioned by the particular sociopolitical contexts in which they are produced. In Hungary, activists used social media to assemble databases of O1G memes, but this strategy was not conducive to building narrative capacity. These databases, however, galvanized other prominent developments. They helped make the domain of politics more inclusive by reconfiguring the affective tone of engagement from confrontation to conversation.
THE AUTHOR OF THE EPIC: TOLKIEN, EVOLUTION, AND GOD'S STORY
Authors: Freeman Austin M. 
Published: May 2021

AbstractI argue that, because God is the author of history and has a purpose for his creation, evolution has a plot and can be analyzed with tools drawn from literary criticism. This necessitates engagement with the “epic of evolution” genre of scientific literature. I survey several prominent versions of the epic and distinguish between a purely naturalistic epic of evolution and a goal‐oriented Christian epic of evolution (CEE). In dealing with CEE, I use the thought of J. R. R. Tolkien, along with Kevin Vanhoozer and Dorothy Sayers, to discuss the ways in which we can theologically legitimate speaking of God as the “author” of evolutionary history.
Design and Computational Fluid Dynamics Analysis of a Novel Compact Mixing Chamber in Blast Furnace Ironmaking
Authors: Dutta Tanmay 
Published: May 2021

Abstract
Homogeneous mixing of hot air from the hot blast stove with suitable quantity of cold air in a mixing chamber is very essential to maintain uniform temperature of hot air at all tuyers of a blast furnace. Proper design of the mixing chamber is very important for stable and efficient operation of blast furnace, lower energy consumption, and lower carbon dioxide emission. Comprehensive understanding of the physics of the mixing process is very essential for efficient design of the mixing chamber. In this paper, computational fluid dynamics (CFD) simulations are conducted to analyze the mixing of hot and cold air in a tangential cold gas inlet type and in a radial cold gas inlet type mixing chambers, which are commonly used in the industry. Results show that both types of mixing chamber produce very non-homogeneous mixture of cold and hot air despite having large mixing length in the long hot blast main. Also, design of a novel compact mixing chamber is presented and CFD analysis of this mixing chamber is conducted. The new mixing chamber is found to produce almost homogeneously mixed air stream within a very short length due to very high turbulence of the intensely swirling air flow. Also, the new mixing chamber is found to save large amount of high-quality thermal energy, which is wasted in the other two designs through the wall of the long hot blast main.
Chapter 8: Collective Action for Learning, Improvement, and Redesign
Authors: Lawson Hal A. , Jones Emily , Beddoes Zac , Estes Steven , Morris Stephanie A. , Mitchell Murray F. , van der Mars Hans , Ward Phillip 
Published: May 2021

The pandemic, imperatives for human and civil rights, growing economic challenges, new accountability requirements, and distance-delivered learning technologies are reminders of novel 21st-century needs, problems, challenges, and opportunities. All demand a sense of urgency. Building on selected traditions and achievements, today’s futuristic planning offers timely opportunities to make history. Founded on the idea of aphysical education system—with roles and responsibilities for every stakeholder (e.g., teacher, teacher educator)—this new agenda transcends what individuals can accomplish. It requires collective action. Collective action necessitates special formations, such as professional learning communities; social networks; and partnerships among schools, communities, universities, and professional associations, both state and national. In turn, these formations require organizers and facilitators. Examples illustrate collective action’s potential, also indicating why it must be a shared priority for professional education, professional development, and professional associations.
Associations between low HDL, sex and cardiovascular risk markers are substantially different in sub-Saharan Africa and the UK: analysis of four population studies
Authors: Greiner Rosamund , Nyirenda Moffat , Rodgers Lauren , Asiki Gershim , Banda Louis , Shields Beverley , Hattersley Andrew , Crampin Amelia , Newton Robert , Jones Angus 
Published: May 2021

IntroductionLow high-density lipoprotein (HDL) is widely used as a marker of cardiovascular disease risk, although this relationship is not causal and is likely mediated through associations with other risk factors. Low HDL is extremely common in sub-Saharan African populations, and this has often been interpreted to indicate that these populations will have increased cardiovascular risk. We aimed to determine whether the association between HDL and other cardiovascular risk factors differed between populations in sub-Saharan Africa and the UK.MethodsWe compared data from adults living in Uganda and Malawi (n=26 216) and in the UK (n=8747). We examined unadjusted and adjusted levels of HDL and applied the WHO recommended cut-offs for prevalence estimates. We used spline and linear regression to assess the relationship between HDL and other cardiovascular risk factors.ResultsHDL was substantially lower in the African than in the European studies (geometric mean 0.9–1.2 mmol/L vs 1.3–1.8 mmol/L), with African prevalence of low HDL as high as 77%. Total cholesterol was also substantially lower (geometric mean 3.3–3.9 mmol/L vs 4.6–5.4 mmol/L). In comparison with European studies the relationship between HDL and adiposity (body mass index, waist to hip ratio) was greatly attenuated in African studies and the relationship with non-HDL cholesterol reversed: in African studies low HDL was associated with lower non-HDL cholesterol. The association between sex and HDL was also different; using the WHO sex-specific definitions, low HDL was substantially more common among women (69%–77%) than men (41%–59%) in Uganda/Malawi.ConclusionThe relationship between HDL and sex, adiposity and non-HDL cholesterol in sub-Saharan Africa is different from European populations. In sub-Saharan Africans low HDL is a marker of low overall cholesterol and sex differences are markedly attenuated. Therefore low HDL in isolation is unlikely to indicate raised cardiovascular risk and the WHO sex-based cut-offs are inappropriate.
Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyefficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services
Authors: Goel Hena , Wemyss Thomas Alan , Harris Tanya , Steinbach Ingeborg , Stancliffe Rachel , Cassels-Brown Andrew , Thomas Peter Benjamin Michael , Thiel Cassandra L 
Published: May 2021

ObjectiveThough one of the most common surgeries, there is limited information on variability of practices in cataract surgeries. ‘Eyefficiency’ is a cataract surgical services auditing tool to help global units improve their surgical productivity and reduce their costs, waste generation and carbon footprint. The aim of the present research is to identify variability and efficiency opportunities in cataract surgical practices globally.Methods and Analysis9 global cataract surgical facilities used the Eyefficiency tool to collect facility-level data (staffing, pathway steps, costs of supplies and energy use), and live time-and-motion data. A point person from each site gathered and reported data on 1 week or 30 consecutive cataract surgeries. Environmental life cycle assessment and descriptive statistics were used to quantify productivity, costs and carbon footprint. The main outcomes were estimates of productivity, costs, greenhouse gas emissions, and solid waste generation per-case at each site.ResultsNine participating sites recorded 475 cataract extractions (a mix of phacoemulsification and manual small incision). Cases per hour ranged from 1.7 to 4.48 at single-bed sites and 1.47 to 4.25 at dual-bed sites. Average per-case expenditures ranged between £31.55 and £399.34, with a majority of costs attributable to medical equipment and supplies. Average solid waste ranged between 0.19 kg and 4.27 kg per phacoemulsification, and greenhouse gases ranged from 41 kg carbon dioxide equivalents (CO2e) to 130 kg CO2e per phacoemulsification.ConclusionResults demonstrate the global diversity of cataract surgical services and non-clinical metrics. Eyefficiency supports local decision-making for resource efficiency and could help identify regional or global best practices for optimising productivity, costs and environmental impact of cataract surgery.
Viability of preloaded Descemet membrane endothelial keratoplasty grafts with 96-hour shipment
Authors: Chen Conan , Solar Steven Jared , Lohmeier John , Terrin Staci , Baliga Satya , Wiener Batya Gold , Lewis Daniel Schouten , Chiang Eric , Barnes Kali Alexandra , Chaurasia Akash , Eghrari Allen O 
Published: May 2021

ObjectiveTo assess feasibility and compare the effects of 96-hour shipment of Descemet membrane endothelial keratoplasty (DMEK) grafts as a scroll or a tri-fold on cell viability.Methods and analysisDMEK grafts were prepared at the Rocky Mountain Lions Eye Bank. Twenty pre-stripped DMEK grafts, paired from 10 donors, were either tri-folded in an endothelium-in configuration using microforceps and loaded into a plastic Treyetech cartridge, or suctioned in a scrolled endothelium-out configuration into a modified Jones Tube. Grafts were shipped via FedEx to a secondary location and back for 48 hours each way, resulting in a total shipping time of 96 hours. After shipping, grafts were removed from inserters onto glass slides and unfolded using viscoelastic with endothelium facing upwards. Calcein-AM stained grafts were imaged with a fluorescent microscope and endothelial cell loss (ECL) was measured using trainable segmentation in Fiji by a masked grader.ResultsA total of 20 grafts were shipped for 96 hours, split between preloaded tri-folded (n=10) and preloaded scrolled (n=10) tissues. No significant difference in ECL was observed across groups after prolonged shipping (14.8% vs 13.7% ECL respectively, p=0.68).ConclusionFor preloaded DMEK after 96 hours, both scrolled and tri-folded tissue demonstrated clinically acceptable levels of ECL. The data suggest a wider window of time for endothelial cell viability and is promising for the prospect of international shipment of preloaded grafts.
Treatment for acute bronchiolitis before and after implementation of new national guidelines: a retrospective observational study from primary and secondary care in Oslo, Norway
Authors: Klem Nicolai , Skjerven Håvard Ove , Nilsen Beate , Brekke Mette , Vallersnes Odd Martin 
Published: May 2021

BackgroundAcute bronchiolitis treatment guidelines changed in Norway in 2013, no longer recommending the use of nebulised epinephrine. We aimed to assess whether these changes were successfully implemented in both primary and secondary care. Secondary aims were to compare the difference in management of acute bronchiolitis patients in primary and secondary care between 2009 and 2017.MethodsWe retrospectively registered data on demographics, clinical features and management from electronic medical records of all infants (<12 months of age) diagnosed with acute bronchiolitis at a primary care centre (Oslo Accident and Emergency Outpatient Clinic) and a secondary care centre (Oslo University Hospital) in Norway in 2009, 2014 and 2017. All patient records were individually reviewed to ensure data accuracy.ResultsWe included 680 (36.3%) patients from primary care and 1195 (63.7%) from secondary care. There was a reduction in the use of nebulised epinephrine from 2009 to 2017 from 66.9% to 16.1% of cases (p<0.001) in primary care and from 59.1% to 4.9% (p<0.001) in secondary care. In parallel, there was an increase in the use of nebulised saline treatment, from 0.8% to 53.8% (p<0.001) in primary care and from 39.3% to 65.3% (p<0.001) in secondary care. The decrease in the use of nebulised racemic epinephrine occurred earlier in secondary care than in primary care; 13.4% vs 56.1%, respectively, in 2014.ConclusionsImplementation of the new guidelines on the treatment of acute bronchiolitis was successfully implemented in both primary and secondary care.
Ectopic growth of the Chaetothyriales fungal symbiont on Ipomoea carnea
Authors: Noor Aziza Ibrahim , Nava Amy , Neyaz Marwa , Cooke Peter , Creamer Rebecca , Cook Daniel 
Published: May 2021

Swainsonine, an indolizidine alkaloid, is an α-mannosidase and mannosidase II inhibitor that alters glycoprotein processing and causes lysosomal storage disease. Swainsonine is the toxic principle in several plant species worldwide and causes severe toxicosis in livestock grazing these plants. All swainsonine-containing plant taxa investigated to date are associated with fungal symbionts that produce swainsonine. Among the swainsonine-containing convolvulaceous species, Ipomoea carnea Jacq. is associated with a seed-transmitted symbiont belonging to the fungal order Chaetothyriales. The nature of this association was unclear; therefore, this association was investigated further using microscopy. Macroscopic and microscopic data reported here demonstrate that the Chaetothyriales symbiont associated with I. carnea grows ectopically on the adaxial (upper) surface of leaves as lacy mycelia in plants that contain swainsonine and was not present on plants lacking swainsonine that were derived from fungicide-treated seeds. Hyphae were not observed on the surface of any other tissues including the abaxial (lower) leaf surface, petiole, and stem. Mycelia were not visible in internal tissues below the epidermis, and there did not appear to be any hyphal extensions within the fibrovascular bundles or stomata. Longitudinal and (or) cross sections of the stems or petioles did not show evidence of hyphae growing between cells. These results suggest an epibiotic growth habit of the Chaetothyriales symbiont in association with I. carnea.
National Trends in the Burden of Atrial Fibrillation During Hospital Admissions for Heart Failure
Authors: Reinhardt Samuel W. , Chouairi Fouad , Miller P. Elliott , Clark Katherine A. A. , Kay Bradley , Fuery Michael , Guha Avirup , Freeman James V. , Ahmad Tariq , Desai Nihar R. , Friedman Daniel J. 
Published: May 2021

Background
Heart failure (HF) and atrial fibrillation (AF) frequently coexist and may be associated with worse HF outcomes, but there is limited contemporary evidence describing their combined prevalence. We examined current trends in AF among hospitalizations for HF with preserved (HFpEF) ejection fraction or HF with reduced ejection fraction (HFrEF) in the United States, including outcomes and costs.

Methods and Results

Using the National Inpatient Sample, we identified 10 392 189 hospitalizations for HF between 2008 and 2017, including 4 250 698 with comorbid AF (40.9%). HF hospitalizations with AF involved patients who were older (average age, 76.9 versus 68.8 years) and more likely White individuals (77.8% versus 59.1%;
P
<0.001 for both). HF with preserved ejection fraction hospitalizations had more comorbid AF than HF with reduced ejection fraction (44.9% versus 40.8%). Over time, the proportion of comorbid AF increased from 35.4% in 2008 to 45.4% in 2017, and patients were younger, more commonly men, and Black or Hispanic individuals. Comorbid hypertension, diabetes mellitus, and vascular disease all increased over time. HF hospitalizations with AF had higher in‐hospital mortality than those without AF (3.6% versus 2.6%); mortality decreased over time for all HF (from 3.6% to 3.4%) but increased for HF with reduced ejection fraction (from 3.0% to 3.7%;
P
<0.001 for all). Median hospital charges were higher for HF admissions with AF and increased 40% over time (from $22 204 to $31 145;
P
<0.001).

Conclusions
AF is increasingly common among hospitalizations for HF and is associated with higher costs and in‐hospital mortality. Over time, patients with HF and AF were younger, less likely to be White individuals, and had more comorbidities; in‐hospital mortality decreased. Future research will need to address unique aspects of changing patient demographics and rising costs.