bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral candidiasis in HIV-uninfected pediatric population in areas with limited fungal diagnosis: A case study from a tertiary hospital, Tanzania
Authors: Mushi Martha F. , Loi Neema , Mshana Stephen E. 
Published: May 2021

Background: Oral candidiasis (OC) is an indirect indicator of cell-mediated immunodeficiency with a high predictive value of disseminated candidiasis. Here, we report the prevalence and factors associated with laboratory-confirmed OC in human immunodeficiency virus (HIV)-uninfected children with clinical OC attending the outpatient clinic or admitted in pediatric wards of the Bugando Medical Center (BMC). Methods: A cross-sectional study was conducted between January and June 2017. Social demographic and clinical data were collected using a pre-tested data collection tool. Oral swabs were collected using a sterile cotton swab and mycological culture was done to detect Candida spp. followed by susceptibility testing as per European Committee on Antimicrobial Testing (EUCAST) guidelines. Data were analyzed using STATA version 13 following study objectives. Results: A total of 325 non-repetitive oral swabs from HIV-uninfected children aged between 2 and 156 months were collected. Candida spp. were detected in 123 (37.8%) children. One (1.8%) C. albicans isolate was resistant to fluconazole, voriconazole, and posaconazole with minimum inhibitory concentrations (MIC) of 256 μg/ml, 32 μg/ml, and 0.31 μg/ml, respectively. Upon multivariate logistic regression analysis, being a male child (OR 2, 95% CI 1.2–3.2, p = 0.008) and having a history of antibiotic use (OR 1.8, 95% CI 1.1–2.8, p = 0.017) independently predicted laboratory-confirmed OC among HIV-uninfected children. Conclusion: Only a third of children with clinical OC were laboratory confirmed, and this was more likely in male children with a history of antibiotic use. Most of the isolates were highly susceptible to commonly used antifungal agents like fluconazole. Treatment of children at risk should be prioritized to reduce associated morbidity.
Determining the Cutoff Points of the 5C Scale for Assessment of COVID-19 Vaccines Psychological Antecedents among the Arab Population: A Multinational Study
Authors: Ghazy Ramy Mohamed , Abd ElHafeez Samar , Shaaban Ramy , Elbarazi Iffat , Abdou Marwa Shawky , Ramadan Ahmed , Kheirallah Khalid A. 
Published: May 2021

Background One of the newly faced challenges during the COVID-19 is vaccine hesitancy (VH). The validated 5C scale, that assesses 5 psychological antecedents of vaccination, could be effective in exploring COVID-19 VH. This study aimed to determine a statistically valid cutoff points for the 5C sub-scales among the Arab population. Methods A cross-sectional study was conducted among 446 subjects from 3 Arab countries (Egypt, United Arab Emirates (UAE), and Jordan). Information regarding sociodemographics, clinical history, COVID-19 infection and vaccination history, and 5C scale were collected online. The 5C scores were analyzed to define the cutoff points using the receiver operating characteristic curve (ROC) and to verify the capability of the questionnaire to differentiate whether responders are hesitant or non-hesitant to accept vaccination. ROC curve analysis was conducted for previous vaccine administration as a response, with the predictors being the main 5 domains of the 5C questionnaire. The mean score of each sub-scale was compared with COVID-19 vaccine intake. Results The mean age of the studied population was 37 ± 11, 42.9% were males, 44.8% from Egypt, 21.1% from Jordan, and 33.6% from the UAE. Statistically significant differences between vaccinated and unvaccinated participants, respectively, were detected in the median score of confidence [6.0(1.3) versus 4.7(2.0)], complacency [(2.7(2.0) versus 3.0(2.0)], constraints [1.7(1.7) versus 3.7(2.3)], and collective responsibility [6.7(1.7) versus 5.7(1.7)]. The area under the curve of the 5 scales was 0.72, 0.60, 0.76, 0.66, 0.66 for confidence, complacency, constraints, calculation, and collective responsibility at cutoff values of 5.7, 4.7, 6.0, 6.3, and 6.2, respectively. Conclusion The Arabic validated version of the 5C scale has a good discriminatory power to predict COVID-19 vaccines antecedent.
Antimicrobial Effectiveness of Photodynamic Therapy, 5% Sodium Hypochlorite and 2% Chlorhexidine Gluconate in Root Canal Treated Teeth: A Clinical Study
Authors: Bharti Ramesh , Tikku Aseem Prakash , Chandra Anil , Gupta Prashant 
Published: May 2021

Aim: To evaluate the effectiveness of photodynamic therapy (PDT), sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHO) in the endodontic re-treatment in the removing of microorganisms from previously filled infected root canals. Materials and Methods: The study samples consist of 54 root canal treated anterior teeth with apical periodontitis were randomly divided into three groups according to the disinfection protocol. Microbiological samples from the root canals were collected after removing the gutta-percha (S1) and following the endodontic re-treatment (S2) with either 5% NaOCl, 2% CHO or PDT procedure for 1 minute. Microbiological samples were cultivated on selective plates to assess the presence or absence of microbial growth and determine the average reduction of viable microorganisms. Results: Significant reduction in the total bacterial count in all the groups at post treatment ( P < .001). PDT provided statistically higher (99.74%) elimination of Enterococcus faecalis in comparison to NaOCl (95%) and CHO (88%). Conclusions: The use of PDT in endodontic re-treatment led to the significant reduction of the remaining bacterial species. So, PDT can be used for routine endodontic disinfection in failed root canal cases.
Opioid Prescribing Habits for Common Arthroscopic Procedures in Opioid Naïve Patients
Authors: Thompson Matthew M. , Popp Lucas , Foster Michael J. , Malik Hassan , Henn R. Frank 
Published: May 2021

Background: With the opioid epidemic and the increasing number of opioid-related deaths, there is growing awareness in the medical community regarding the dangers of opioid overprescription. As a result, there is a willingness among physicians to abandon old norms and adopt new data-driven prescribing practices. Purpose: To demonstrate patient-reported consumption data of opioid medications after anterior cruciate ligament (ACL) reconstructions (ACLRs), knee arthroscopies, and rotator cuff repairs to provide data-driven guidelines for prescribing opioids after these procedures. Study Design: Case series; Level of evidence, 4. Methods: Included in the study were 168 patients who underwent an ACLR, knee arthroscopy, or arthroscopic rotator cuff repair over a 17-month period. Patients were excluded if they had an opioid allergy, had preexisting opioid use, had an acute postoperative complication requiring further surgery, required hospitalization, exhibited drug-seeking behaviors, or were lost to follow-up. Medical records were reviewed to determine the number of opioid pills prescribed and the number of pills taken postoperatively. Prescribing was standardized in that 15 hydrocodone/acetaminophen pills (5/325 mg) were prescribed for all knee arthroscopy procedures and 40 hydrocodone/acetaminophen pills were prescribed for all ACL and rotator cuff procedures. The mean number of pills consumed and percentage of prescribed pills taken were analyzed in association with specific procedures and patient demographics. Results: Overall, the mean (±SD) reported opioid consumption overall was 13.5 ± 13.0 pills, with a utilization rate of 45.6% of the prescription. The mean reported opioid consumption for ACLRs, knee arthroscopies, and rotator cuff repairs was 19.1 ± 15.4, 7.2 ± 5.4, and 17.2 ± 14.3 pills, respectively ( P < .001). This represented a utilization rate of 48%, 47%, and 41%, respectively. Conclusion: This study provides important information regarding opioid utilization after common arthroscopic procedures. For ACLRs, knee arthroscopies, and rotator cuff repairs, by respectively prescribing 20, 10, and 20 pills postoperatively, the amount of unused medications would decrease by 60%, 47%, and 64%, respectively. We recommend prescribing no more than 20, 10, and 20 hydrocodone/acetaminophen pills (5/325 mg) for ACLRs, knee arthroscopies, and arthroscopic rotator cuff repairs, respectively.
Investigating strategic responses of SMEs during COVID-19 pandemic: A cognitive appraisal perspective
Authors: Miocevic Dario 
Published: May 2021

In this study, we investigate the response intentions of small- and medium-sized enterprises (SMEs) during the recent economic crisis initiated by the COVID-19 pandemic. We draw on the cognitive appraisal theory and investigate how an SME’s level of proactivity triggers top managers’ emotional reactions, which in the end shapes an SME’s response strategies (investment vs divestment). To test our assumptions, we use survey data from 155 top managers of Croatian SMEs operating in business-to-business industries. We find that an SME’s proactivity positively (negatively) influences the emergence of positive (negative) emotions. Also, we find that top managers charged with positive (negative) emotions are more prone to engage in investment (divestment) as a response to economic crisis. Furthermore, through the broaden-and-build perspective we reveal the mediating effect of emotions on the relationship between proactivity and response intentions as well as the mediating effect of performance expectations on the link between emotions and response intentions. JEL CLASSIFICATION M10; M19
Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology
Authors: Arries-Kleyenstüber Ebin J. 
Published: May 2021

Introduction Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology. Objective This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics. Methods A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc–testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables. Results Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study. Conclusion Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.
Comparison of Transabdominal and Transvaginal Sonograms in Evaluation of Cervical Length During Pregnancy
Authors: Fitzpatrick Anna , DiGiacinto Dora 
Published: May 2021

Objective: A short cervix during pregnancy indicates a higher risk of preterm delivery. Transvaginal sonography is widely used for the detection of a short cervix. The literature indicates that 21–24 weeks is the most sensitive gestational age to assess transvaginal cervical length (TV CL) of ≤2.5 cm for potential preterm delivery. Pregnancies between 18 and 20 weeks’ gestation are generally performed transabdominally; thus, it could be beneficial to have a recognized correlation between the transabdominal cervical length (TA CL) measurement and the TV CL measurement at this earlier time period. Materials and Methods: An online database search produced 13 research articles to be reviewed. Inclusion criteria consisted of TA CL and TV CL assessment of singleton pregnancies with intact membranes. Results: Findings indicate high diagnostic yield when a TA CL of <2.9 cm or TV CL of <2.5 cm is used for defining a shortened cervix when measured between 18 and 20 weeks’ gestation. Conclusion: This review of the literature indicates a correlation between average TA CL and average TV CL measurements, although the relationship widens as CLs become shorter.
Feasibility of comprehensive genotyping specimens from radial endobronchial ultrasonography and electromagnetic navigation bronchoscopy
Authors: Robin Maxime , Mhanna Laurent , Chaltiel Leonor , Plat Gavin , Héluain Valentin , Basset Céline , Meilleroux Julie , Filleron Thomas , Mazières Julien , Hermant Christophe , Guibert Nicolas 
Published: May 2021

IntroductionMini-invasive bronchoscopic techniques (such as radial endobronchial ultrasonography (rEBUS) and electromagnetic navigation (EMN)) have been developed to reach the peripheral lung but result in small samples. The feasibility of an adequate molecular testing from these specimens has been very little studied.MethodsWe retrospectively reviewed EMN and rEBUS procedures performed in patients diagnosed with lung cancer in our institution in 2017 and 2018. We analysed the sensitivity for rEBUS and EMN and each sampling method, and the feasibility of a comprehensive molecular testing.ResultsIn total, 317 rEBUS and 14 EMN were performed. Median sizes of tumours were 16 and 32 mm for EMN and rEBUS, respectively. Overall sensitivity for rEBUS and EMN was 84.3%. Cytology was found to be complementary with biopsies, with 13.3% of cancer diagnosed on cytology while biopsies were negative. Complication rate was 2.4% (pneumothorax 1.5%, mild haemoptysis 0.9%). Genotyping (immunohistochemistry forROS1andALKfollowed by fluorescencein situhybridisation if positive and hybrid capture next-generation sequencing covering 48 genes), when ordered (n=188), was feasible in 69.1% (EGFR17.7%,KRAS31.7%,BRAF4.8%,ALK1.2%,MET3.1%,HER20.8%). PD-L1 (programmed death-ligand 1) expression, when ordered (n=232), could be analysed in 94% of cases. Overall, 56.9% (33 out of 58) of patients for whom genotyping was not feasible underwent a second sampling (12 pretreatment, 21 at progression), allowing for the detection of six actionable genotypes (fiveEGFR, oneMET).ConclusionrEBUS and EMN are sensitive and safe procedures that result in limited samples, often not suitable for genotyping, highlighting the importance of integrating liquid biopsy in routine testing.
Comparison of hamstring and quadriceps tendon autografts in anterior cruciate ligament reconstruction with gait analysis and surface electromyography
Authors: Schagemann J. , Koebrich T. , Wendlandt R. , Schulz A. P. , Gille J. , Oheim R. 
Published: May 2021

Abstract
Background
Anterior cruciate ligament (ACL) tear is the most frequent ligamentous injury of the knee joint. Autografts of hamstring (HS) or quadriceps tendons (QT) are used for primary ACL reconstruction. In this study, we planned to examine whether harvesting an HS graft is related to a deficit in dynamic knee stabilisation and strength revealed by dynamic valgus as compared with QT graft or the uninjured leg. Furthermore, if this deficit exists, is it compensated by higher neuromuscular activity of the quadriceps muscle?

Materials and methods
Adult patients who had undergone ACL reconstruction with QT or HS autografts were included in this two-armed cohort study. Clinical outcome was assessed by clinical data analysis, physical examination and the Lysholm Score and Knee Injury and Osteoarthritis Score (KOOS). In addition, gait analysis and non-invasive surface electromyography were performed.

Results
A complete data set of 25 patients (QT: N = 8, HS: N = 17) was analysed. There was no significant demographic difference between the groups. Time between surgery and follow-up was significantly longer for the QT group. Significant differences regarding clinical outcome were not found between the treated and untreated leg or between the two groups, with excellent scores at the time of follow-up. Gait analysis revealed no significant differences of varus–valgus angles. Significant differences in surface electromyography were only found in the QT group with increased vastus medialis obliquus activity of the treated legs (p < 0.01).

Conclusions
Our results suggest that harvesting of HS grafts for primary ACL reconstruction will not lead to a medial collapse and consequently impaired medial stabilisation of the knee when compared with QT grafts.

Level of evidence
IV.
Low rate of early periprosthetic fractures in cementless short-stem total hip arthroplasty using a minimally invasive anterolateral approach
Authors: Luger Matthias , Hipmair Günter , Schopper Clemens , Schauer Bernhard , Hochgatterer Rainer , Allerstorfer Jakob , Gotterbarm Tobias , Klasan Antonio 
Published: May 2021

Abstract
Purpose
Minimally invasive (MIS) approaches in combination with short stems have gained popularity in recent years in total hip arthroplasty (THA). A decreased risk for periprosthetic femoral fractures (PFFs) is reported for cementless short-stem THA, but in contrast to other approaches, the risk factors for PFFs for short-stem THA using MIS anterolateral approach in supine position are not described in literature.

Methods
A single-center consecutive series of 1052 hips in 982 patients, performed between 2014 and 2019 with a short curved stem and a press fit using an MIS anterolateral approach in supine position, was retrospectively screened for inclusion. Fourteen patients were lost to follow-up. Therefore, 1038 THAs in 968 patients were included. Risk factors for intra- and postoperative PFFs within 90 days were analyzed. We investigated for sex, age, body mass index (BMI), diagnosis, and laterality.

Results
In total, 18 PFFs (1.7%) occurred. Intraoperative fracture occurred in ten cases ( 0.9%), with another eight cases (0.8%) occurring postoperatively. Increased American Society of Anesthesiologists (ASA) Score was a significant risk factor for PFF (p = 0.026), whereas sex (p = 0.155), age (p = 0.161), BMI (p = 0.996), and laterality (p = 1.000) were not. Seven PFFs (0.7%) required revision arthroplasty.

Conclusion
Cementless short-stem THA using the MIS anterolateral approach is a procedure with a low number of PFFs within 90 days from index surgery. Fracture rates are comparable to other MIS approaches, and comparable femoral short stems are used. Age, sex, and BMI were not identified as risk factors of PFF, while risk for PFF increased with ASA Score.

Level of Evidence
Level IV
Overexpression of the receptor for advanced glycation end-products in the auditory cortex of rats with noise-induced hearing loss
Authors: Lee Chang Ho , Kim Kyung Woon , Lee Da-hye , Lee So Min , Kim So Young 
Published: May 2021

AbstractBackgroundThe receptor for advanced glycation end-products (RAGE) is involved in neuroinflammation. This study investigated the changes in RAGE expression following noise-induced hearing loss.MethodsThree-week-old female Sprague–Dawley rats were exposed to 115 dB SPL white noise for 4 h daily for 3 d (noise group, n = 16). In parallel, age and sex-matched control rats were raised under standard conditions without noise exposure (control group, n = 16). After 2 h (noise immediate, n = 8) and 4 wk (noise 4-week, n = 8) of noise exposure, the auditory cortex was harvested and cytoplasmic and nuclear fractions were isolated. The gene expression levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL6), interleukin 1 beta (IL1β), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and RAGE were evaluated using real-time reverse transcription polymerase chain reaction. The protein expression levels of nuclear RAGE and cytosolic RAGE were evaluated using western blotting. Additionally, matrix metalloproteinase 9 (MMP9) was pharmacologically inhibited in the noise immediate group, and then nuclear and cytosolic RAGE expression levels were evaluated.ResultsThe noise immediate and noise 4-week groups exhibited increased auditory thresholds at 4, 8, 16, and 32 kHz frequencies. The genes encoding the pro-inflammatory cytokines TNF-α, IL6, IL1β, and NF- κB were increased 3.74, 1.63, 6.42, and 6.23-fold in the noise immediate group, respectively (P = 0.047, 0.043, 0.044, and 0.041). RAGE mRNA expression was elevated 1.42-fold in the noise 4-week group (P = 0.032). Cytosolic RAGE expression was increased 1.76 and 6.99-fold in the noise immediate and noise 4-week groups, respectively (P = 0.04 and 0.03). Nuclear RAGE expression was comparable between the noise and control groups. matrix metalloproteinase 9 (MMP9) inhibition reduced cytosolic RAGE expression in the noise immediate group (P = 0.004).ConclusionsNoise exposure increased the expression of cytosolic RAGE in the auditory cortex and upregulated pro-inflammatory genes, but this response could be alleviated by MMP9 inhibition.
Ethylene enhances root water transport and aquaporin expression in trembling aspen (Populus tremuloides) exposed to root hypoxia
Authors: Tan Xiangfeng , Liu Mengmeng , Du Ning , Zwiazek Janusz J. 
Published: May 2021

Abstract
Background
Root hypoxia has detrimental effects on physiological processes and growth in most plants. The effects of hypoxia can be partly alleviated by ethylene. However, the tolerance mechanisms contributing to the ethylene-mediated hypoxia tolerance in plants remain poorly understood.

Results
In this study, we examined the effects of root hypoxia and exogenous ethylene treatments on leaf gas exchange, root hydraulic conductance, and the expression levels of several aquaporins of the plasma membrane intrinsic protein group (PIP) in trembling aspen (Populus tremuloides) seedlings. Ethylene enhanced net photosynthetic rates, transpiration rates, and root hydraulic conductance in hypoxic plants. Of the two subgroups of PIPs (PIP1 and PIP2), the protein abundance of PIP2s and the transcript abundance of PIP2;4 and PIP2;5 were higher in ethylene-treated trembling aspen roots compared with non-treated roots under hypoxia. The increases in the expression levels of these aquaporins could potentially facilitate root water transport. The enhanced root water transport by ethylene was likely responsible for the increase in leaf gas exchange of the hypoxic plants.

Conclusions
Exogenous ethylene enhanced root water transport and the expression levels of PIP2;4 and PIP2;5 in hypoxic roots of trembling aspen. The results suggest that ethylene facilitates the aquaporin-mediated water transport in plants exposed to root hypoxia.