bluuebunny/crossref_metadata_2025_split huggingface dataset:
PDK1 Is Required for Maintenance of CD4+ Foxp3+ Regulatory T Cell Function
Authors: Oh Hyunju , Zhao Jingyao , Grinberg-Bleyer Yenkel , Postler Thomas S. , Wang Pingzhang , Park Sung-Gyoo , Rabadan Raul , Hayden Matthew S. , Ghosh Sankar 
Published: March 2021

Abstract
Regulatory T (Treg) cells have an essential role in maintaining immune homeostasis, in part by suppressing effector T cell functions. Phosphoinositide-dependent kinase 1 (PDK1) is a pleiotropic kinase that acts as a key effector downstream of PI3K in many cell types. In T cells, PDK1 has been shown to be critical for activation of NF-κB and AKT signaling upon TCR ligation and is therefore essential for effector T cell activation, proliferation, and cytokine production. Using Treg cell–specific conditional deletion, we now demonstrate that PDK1 is also essential for Treg cell suppressive activity in vivo. Ablation of Pdk1 specifically in Treg cells led to systemic, lethal, scurfy-like inflammation in mice. Genome-wide analysis confirmed that PDK1 is essential for the regulation of key Treg cell signature gene expression and, further, suggested that PDK1 acts primarily to control Treg cell gene expression through regulation of the canonical NF-κB pathway. Consistent with these results, the scurfy-like phenotype of mice lacking PDK1 in Treg cells was rescued by enforced activation of NF-κB downstream of PDK1. Therefore, PDK1-mediated activation of the NF-κB signaling pathway is essential for regulation of Treg cell signature gene expression and suppressor function.
Inclusion of an Optimized Plasmodium falciparum Merozoite Surface Protein 2–Based Antigen in a Trivalent, Multistage Malaria Vaccine
Authors: Eacret Jacqueline S. , Parzych Elizabeth M. , Gonzales Donna M. , Burns James M. 
Published: March 2021

Abstract
Plasmodium falciparum merozoite surface protein (PfMSP)2 is a target of parasite-neutralizing Abs. Inclusion of recombinant PfMSP2 (rPfMSP2) as a component of a multivalent malaria vaccine is of interest, but presents challenges. Previously, we used the highly immunogenic PfMSP8 as a carrier to enhance production and/or immunogenicity of malaria vaccine targets. In this study, we exploited the benefits of rPfMSP8 as a carrier to optimize a rPfMSP2-based subunit vaccine. rPfMSP2 and chimeric rPfMSP2/8 vaccines produced in Escherichia coli were evaluated in comparative immunogenicity studies in inbred (CB6F1/J) and outbred (CD1) mice, varying the dose and adjuvant. Immunization of mice with both rPfMSP2-based vaccines elicited high-titer anti-PfMSP2 Abs that recognized the major allelic variants of PfMSP2. Vaccine-induced T cells recognized epitopes present in both PfMSP2 and the PfMSP8 carrier. Competition assays revealed differences in Ab specificities induced by the two rPfMSP2-based vaccines, with evidence of epitope masking by rPfMSP2-associated fibrils. In contrast to aluminum hydroxide (Alum) as adjuvant, formulation of rPfMSP2 vaccines with glucopyranosyl lipid adjuvant–stable emulsion, a synthetic TLR4 agonist, elicited Th1-associated cytokines, shifting production of Abs to cytophilic IgG subclasses. The rPfMSP2/8 + glucopyranosyl lipid adjuvant–stable emulsion formulation induced significantly higher Ab titers with superior durability and capacity to opsonize P. falciparum merozoites for phagocytosis. Immunization with a trivalent vaccine including PfMSP2/8, PfMSP1/8, and the P. falciparum 25 kDa sexual stage antigen fused to PfMSP8 (Pfs25/8) induced high levels of Abs specific for epitopes in each targeted domain, with no evidence of antigenic competition. These results are highly encouraging for the addition of rPfMSP2/8 as a component of an efficacious, multivalent, multistage malaria vaccine.
Collegiate Athletic Trainers' Experiences With Work-Family Conflict and Work-Family Guilt Based Upon Organizational Factors
Authors: Rynkiewicz Kelsey M. , Eason Christianne M. , Singe Stephanie M. 
Published: March 2021

Context
The collegiate athletic setting has been described as having high workloads and working demands. The extensive time commitment required of athletic trainers working in this setting has been identified as a precursor to work-family conflict (WFC) and work-family guilt (WFG). Although individualized, experiences in the work-life interface can largely be affected by organizational factors (ie, elements specific to the workplace). Staff size and patient load may influence the athletic trainer's feelings of WFC and WFG, yet these factors have not been directly studied.

Objective
To examine organizational factors and experiences of WFC and WFG among collegiate athletic trainers.

Design
Cross-sectional study.

Setting
Collegiate setting.

Patients or Other Participant(s)
A total of 615 (females = 391, gender variant or nonconforming = 1, males = 222, preferred not to answer = 1) athletic trainers responded to an online survey. The average age of participants was 33 ± 9 years, and they were Board of Certification certified for 10 ± 8 years. A total of 352 participants (57.2%) worked in National Collegiate Athletic Association Division I, 99 in Division II (16.1%), and 164 in Division III (26.7%).

Main Outcome Measure(s)
Participants responded to demographic and workplace characteristic questions (organizational infrastructure, staff size, and number of varsity-level athletic teams). They completed WFC and WFG scales that have been previously validated and used in the athletic trainer population.

Results
Work-family conflict and WFG were universally experienced among our participants, with WFC scores predicting WFG scores. Participants reported more time-based conflict than strain- or behavior-based conflict. No differences in WFC and WFG scores were found among organizational infrastructures. Weak positive correlations were present between staff size and WFC scores and WFG scores. The number of athletic teams was not associated with WFC or WFG scores.

Conclusions
Organizational factors are an important component of the work-life interface. From an organizational perspective, focusing on improving work-life balance for the athletic trainer can help mitigate experiences with WFC and WFG.
Caries Prevalence and Associated Risk Factors in School Children at Kannur in Kerala, India
Authors: Nithya K , Peedikayil Faizal C. , Chandru T.P , Kottayi Soni , Ismail Shabnam , Aparna T.P 
Published: March 2021

Background:
Caries is the most prevalent affliction of children and is dependent on various factors such as social, economic, demographic and nutritional factors.

Aim:
This study was conducted to determine the prevalence of dental caries in school going children and its association with risk factors.

Materials and Methods:
A cross-sectional study was conducted during the period from August 2019 to December 2019. Study subjects were 1947 school children. The examination was done by a single examiner and the data was entered by trained assistants. A semi-structured questionnaire was used to record the risk factors for dental caries in children. The components of Decayed, missing, filled (DMF) and Decayed, extracted, filled (def) were recorded as per the criteria of WHO (1997) for diagnosing caries. Using SPSS version 22 (IBM Corporation Chicago, USA) data were analyzed. Chi-square test were done to find the relationship of prevalence with the risk factors.P< 0.05 is considered as statistically significant.

Results:
Total Caries prevalence was found to be 49.1%. The highest rate of caries occurrence, 55.4% was observed in children who belonged to the age group of 6–8 years. The def was shown to be more in the 9–11 age group and DMF in 12–15 age groups with 3.34 ± 3.74 and 2.18 ± 2.65 respectively. Statistically significant increase in caries is found in children whose both the parents were working (P < 0.001) and also in children who take sweets twice a day or more (P < 0.001).

Conclusion:
The prevalence of caries in 6–15 year old school children at Kannur is 49.1%. Working parents and high sugar consumption were found to be risk factors for caries in school going children.
Assessment of Tobacco Prevalence Among Employees Working in a Shopping Mall in Panvel, Navi Mumbai, Maharashtra, India
Authors: Dodeja Heena Lachhman , Dhameliya Vibhuti Bhupat , Ram Sabita M. , Thakkar Vaibhav Pravin 
Published: March 2021

Background:
India is one of the countries in the world where prevalence of smoking and smokeless tobacco use is high. There is a need of cessation programs in various settings, and workplace with high prevalence can be targeted for the same. There are no studies conducted on prevalence of tobacco consumption among employees working at a shopping mall in this part of the country.

Aim:
This study estimates the prevalence of tobacco use among employees working in a shopping mall in Panvel.

Materials and Methods:
A descriptive cross-sectional study was conducted among the selected study population of 250 employees using the questionnaire adopted from the Global Adult Tobacco Survey (GATS). Informed consent was taken from every participant. The data were collected by means of a structured questionnaire adopted from GATS. Data collected were entered and statistically analyzed using the Statistical Package for the Social Sciences version 24.0 software (IBM, Armonk, NY, USA). Descriptive and inferential statistical analyses were carried out in the present study.P< 0.05 was considered statistically significant.

Results:
73.2% (183) of the employees were nontobacco users and 26.8% (67) consumed tobacco. The prevalence of smoking was 12% (30), and for smokeless, it was 11.6% (29), and 3.2% (8) consumed both forms. It was found that 12% (30) were willing to take help from the counselor to quit the habit and 13.2% (33) were not willing to take help.

Conclusions:
The present study reflects high prevalence rates of tobacco use among the employees. De-addiction programs and counseling sessions can be conducted for the employees willing to quit tobacco. New policies and tactics on tobacco use need to be explored to ensure the initiation of new tobacco control activities and monitor the existing tobacco control policies.
Knowledge, Attitude, and Behavior Related to Secondhand Smoke Exposure Among Pregnant Women With Smoking Spouses in Davangere City
Authors: Yavagal Puja Chandrashekar , Velangi Chandrabhaga S. , Desai Jagruthi Mutalik , Gupta Himani , Sheik Farheen S. , Kaushal Manika 
Published: March 2021

Background:
Exposure to secondhand smoke among pregnant women is highly prevalent in India. Secondhand smoke exposure is linked with various serious deleterious health problems.

Aim:
The aim of this study was to assess knowledge, attitude, and behavior related to secondhand smoke exposure among pregnant women with smoking husbands in Davangere city.

Materials and Methods:
A descriptive cross-sectional questionnaire survey was conducted among 245 nonsmoking pregnant women with smoking husbands attending two antenatal clinics in Davanagere city using pretested, validated, investigator-administered closed-ended 18 item questionnaire. Responses to items were placed on a 3-point Likert scale. Statistical significance was set atP< 0.05. IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, N.Y., USA) was used for statistical analysis. Descriptive statistics were generated in terms of percentages.

Results:
The mean age of study participants was 26.22 ± 4.11 years. Majority of pregnant women were unaware of secondhand smoke exposure (>60%). They were unaware of its systemic complications such as cardiac problems, respiratory problems, and cancer. They were unaware of the harmful effects of secondhand tobacco smoke (SHS) on fetus/child (>60%) which indicated poor knowledge of participants toward harmful effects of secondhand smoke exposure majority of participants showed favorable attitude (>50%) and felt the need to get educated regarding SHS. Majority reported positive behavior by refraining themselves from secondhand smoke (>50%).

Conclusions:
Knowledge regarding secondhand smoke exposure among pregnant women with smoking husbands was poor. Inspite of having favorable attitude and behavior toward avoidance of smoke exposure, majority of women felt helpless in refraining their husbands from smoking.
An 8-Year Retrospective Analysis of Oral Submucous Fibrosis in Patients Visiting Dental College, Secunderabad
Authors: Prathima Vedati , Koneru Mrunalini , Sunil V. V. N. , Jois Harshavardhan , Reddy Madhusudhan 
Published: March 2021

Background:
Oral submucous fibrosis (OSMF) is a chronic, progressive, scarring precancerous condition of the oral cavity seen predominantly in the Indian subcontinent and South East Asia. In India, the prevalence of OSMF has been increased over the past four decades from 0.03% to 6.42%.

Aim:
The study aims to provide an 8-year retrospective analysis of OSMF in patients visiting dental college, Secunderabad.

Materials and Methods:
A retrospective analysis was conducted from 2008 to 2016 in dental college, Secunderabad. Data were collected from patient's outpatient records from the department of oral medicine and radiology, year wise in the perspective of demographic details, history of nutritional deficiency, adverse habits, symptoms, clinical features, site involved, and mouth opening. There were no inclusion or exclusion criteria. All the cases which were provisionally diagnosed to be OSMF were included. The data were analyzed with SPSS package version 24. Chi-square test has been applied to check the association of different parameters such as gender, nutritional deficiency, adverse habits, area, palpable fibrous bands, and mouth opening with age.P< 0.05 was considered statistically significant.

Results:
The total patients were found to be 107. The mean age of the patients was 38 ± 12. Among the total patients, 86% were males and 14% were females. Among them, 3.7% were unskilled workers. Almost all of them (99%) reported no nutritional deficiency. Majority (51.4%) were having betel nut chewing habit, followed by tobacco chewing, intake of spicy food, smoking, and alcohol. Nearly 43% had limited mouth opening, followed by burning sensation and other symptoms. Palpable fibrous bands were present in 4.1% of the patients. Nearly 83.2% have been affected with OSMF in the buccal mucosa site. Grade 1 (>20 mm) mouth opening was present in 12.1% of the patients, 7.5% were having Grade 2 (11–19 mm), and 3.7% had Grade 3 (<10 mm) mouth opening. A significant association was found between age and adverse habits (P = 0.023). There was no significant association between age and sex (P = 0.924), nutritional deficiency (P = 0.766), area (P = 0.567), palpable fibrous bands (P = 0.221), and mouth opening (P = 0.155).

Conclusion:
Majority of the patients with OSMF were males who were < 30 years, having betel nut chewing habit and Grade 1 mouth opening.
Assessment of Self-Perception and Need for Orthodontic Treatment Using the Index of Orthodontic Treatment Need in Visually Impaired Students of Northern Karnataka, India
Authors: Singh Sanjeev B. , Jatti Roopa , Deshpande Sumedh R. 
Published: March 2021

Background:
In recent years, the perception of an individual with a disability like visual impairment has been slowly evolving from the “forgotten” person to one who is recognized as needing treatment.

Aim:
The aim is to assess the self-perception and orthodontic treatment need in visually impaired (VI) students and to compare these with the control group (CG), and also to create awareness about malocclusion and orthodontic treatment in both groups.

Materials and Methods:
The present cross-sectional study was conducted in the special schools for the VI in the North Karnataka region. The CG was from the local schools in the same region. A total of 125 VI, 162 control students aged 11–19 years were included in the study. Determination of Esthetic Component (AC) and dental health component (DHC) in VI and control students were done. Chi-square test and Kappa statistics were used to compare between the study and the CG and to find out the agreement between the subjects and the orthodontist respectively. APvalue of <0.05 was considered to be statistically significant.

Results:
About 24% of VI and 6.1% of the control perceived to be in need of orthodontic treatment according to the AC. However, 24% of VI and 20.9% of control showed “definite need” of treatment based upon the DHC. The AC when compared between study and CG by Chi-square test, was found to be highly significant statistically with aP< 0.001.

Conclusions:
High percentage of VI students perceived a “definite need” as compared to control students based on AC. The data of the present study suggest that the VI students are more concerned about their malocclusion and perceive that they need orthodontic treatment.
Radiographic evaluation of third molar impaction
Authors: Khan Soban Qadir , Khabeer Abdul , Alyousef Nujood Ibrahim , Benrashed Mashael Abdullah , AlMaimouni Yara , Al-Thobity Ahmad , Gad Mohammed M. , Akhtar Sarfaraz 
Published: March 2021

Background:
The impaction of third molar can compromise adjacent teeth by increasing the risk of developing dentoalveolar lesions.

Aims:
The aim of this study was to evaluate the prevalence of impacted third molar in association to patients' demographics and its angulation among patients who visited dental clinics at the College of Dentistry, Imam Abdulrahman Bin Faisal University.

Settings and Design:
Retrospective radiographic study of patients visiting Dental Hospital.

Subjects and Methods:
Data were obtained from the dental records and digital orthopantomogram (OPG) of included study sample.

Statistical Analysis:
The Chi-square test was used to determine the association of impacted third molars with sex and nationality, whereas another two methods, analysis of variance, and Tukey post hoc test were applied, respectively, to establish the association of impacted third molars with the age of the patients.

Results:
A total of 1286 OPGs were collected and analyzed for the suitability of the study. Of these 1068 patients fulfilled the criteria for inclusion in the study, among them, 206 (19.3%) had at least one impacted third molar. Female population had a significantly high prevalence of third molars compared to male (P = 0.02). Similarly, the age of the patients was found to be significantly associated with impacted teeth (P < 0.001); also, the vertical and mesioangular impactions were found in 46.5% and 32.2% of the patients, respectively.

Conclusion:
The study found a low female predilection for the prevalence of third molar impaction with highest inclination at the young age that decreases with the growing age. Vertical impaction had the highest prevalence followed by mesioangular angulation.
Association of serum osteopontin with first hospitalization and all-cause mortality after kidney transplantation
Authors: Yang Hsiao-Hui , Hsu Bang-Gee , Ho Ching-Chun , Lee Ming-Che 
Published: March 2021

Objective:
Osteopontin (OPN) is involved in vascular calcification and atherosclerosis. We evaluated the association between serum OPN levels and the first postoperative hospitalization and all-cause mortality in patients who received kidney transplantation (KT).

Materials and Methods:
Seventy KT recipients were enrolled in this study from January to April 2012. The primary end point was first postoperative hospitalization or death. All patients were monitored in the outpatient clinics until June 30, 2017. Serum OPN level was measured by enzyme-linked immunosorbent assay.

Results:
During follow-up (median length, 65 months), 47 first postoperative hospitalizations and 8 deaths occurred. In comparison with serum median OPN levels, serum OPN level was positively associated with KT duration (P = 0.048), serum blood urea nitrogen (BUN; P = 0.043), and serum creatinine levels (P = 0.045) but negatively associated with estimated glomerular filtration rate (eGFR; P = 0.049). Hospitalized KT recipients had a higher prevalence of diabetes mellitus (DM) (P = 0.032), BUN (P = 0.002), and serum OPN level (P = 0.001) but lower eGFR (P = 0.030) than did patients not hospitalized. KT recipients who died had higher serum level of creatinine (P = 0.009) and OPN (P = 0.001) but lower eGFR (P = 0.036) than did surviving patients. Multivariate Cox analysis adjusted for age, gender, DM, hypertension, eGFR, KT duration, and steroid used showed that serum OPN level was associated with both first postoperative hospitalization (P = 0.049) and all-cause mortality (P = 0.017).

Conclusions:
Serum OPN level is a potential biomarker for first postoperative hospitalization and all-cause mortality in KT recipients.
Extreme horseshoe and circumanal anal fistulas-challenges in diagnosis and management
Authors: Garg Pankaj , Kaur Baljit , Yagnik Vipul D. , Menon Geetha R. 
Published: March 2021

Objectives:
Extreme horseshoe anal fistulas are rare, and there are little data on the diagnosis and management of these fistulas.

Materials and Methods:
Patients with horseshoe anal fistula, in which the fistula tract encircled more than 75% of the anal circumference were included in the study. All patients were assessed by a preoperative magnetic resonance imaging (MRI). The patients were managed by a sphincter-sparing procedure. The continence was evaluated by an objective continence scoring system (Vaizey's scores).

Results:
1059 anal fistula patients were operated on over 7-years with a median follow-up of 36 months (range: 5–79 months). There were 47/1059 (4.4%) patients with extreme horseshoe anal fistulas. In 4/47 patients, the fistulas were complete circumanal (encircling anal canal completely). The mean age was 39.5 ± 10.9 years, M/F-41/6. The fistula was supralevator in 12/47 (25.5%), had an associated abscess in 28/47 (59.6%), and was recurrent in 33/47 (70.2%) patients. The tracts were intersphincteric in 27/47, transsphincteric in 2/47, and both (intersphincteric and transsphincteric) in 18/47 patients. All patients (n = 47) were managed by a sphincter-sparing procedure. Four patients were lost to follow-up. The fistula healed completely in 34/43 (79%) patients. There was no significant difference between preoperative and postoperative Vaizey's continence scores 0.031 ± 0.17 and 0.033 ± 0.18 respectively (P=0.90, Mann–Whitney U-test).

Conclusion:
Extreme horseshoe fistulas are rare, with an incidence of about 4% (in a referral practice). The missed diagnosis of circumferential tracts could lead to a recurrence. MRI was pivotal to confirm the diagnosis. Proper identification and management of internal opening and adequate drainage of all tracts were crucial for successfully treating extreme horseshoe fistulas.