bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Presentation and Factors Leading to Complications of Deep Neck Spaces Infections at CHUK
Authors: Ncogoza Isaie , Eric Eric , Mvukiyehe Jean Paul , Shaye David 
Published: April 2021

Background
Deep neck space infection (DNSI) mostly arise from the local extension of dental, tonsils and parotid gland infections. Early diagnosis and management is the key to avoid associated complications.
Objective
Our study aimed at evaluating the clinical presentation and factors related to complications of DNSIs at the University Teaching Hospital of Kigali.
Methods
This cross-sectional study was conducted at the University teaching hospital of Kigali from September 2017 to November 2018. It enrolled 66 participants. Patient information was recorded using a questionnaire and analyzed using Epidata 3.1 software. The data were processed using SPSS 16.0. Comparison of categorical variables were performed using the chi-square test. Associations with p-values=0.05 were considered statistically significant.
Results
Males accounted for 35 (53%) of DNSIs. The majority (97%) presented with neck pain and 21% with a history of tooth extraction. The submandibular space was the most involved in 33 (50%) cases. The average duration of symptoms at presentation was 11 days. Delayed consultation and advanced age (>40years) were associated with complications and hospital stay with (p value=0.022) and (p=0.015) respectively.
Conclusion
Neck pain on background of tooth extraction is the most common presentation of patients with DNSIs. Delayed presentation and advanced age are central factors for complications and longer hospital stay.
Rwanda J Med Health Sci 2021;4(1):8-19
Evaluation of Marginal Adaptation of Composite Restorations Reinforced with Novel Enamel Inserts (Biofillers) in Class V Cavities
Authors: Hegde Reshma S , Biradar Nandini , Patil Basanagouda S , Moogi Prashant , Allappanavar Keerti S , Shetty Nithin K 
Published: April 2021

ABSTRACTAim and objectiveTo evaluate the marginal adaptation at the tooth-restoration interface at enamel and cementum margins using composite restoration reinforced with novel enamel inserts/biofillers.Materials and methodsStandardized class V box-shaped cavities were prepared in 40 extracted maxillary first premolar teeth which were divided randomly into four experimental groups consisting of 10 samples each. Group I: Bulk placement. Groups II: Horizontal incremental technique. Group III: Restoration with precured composite balls (megafillers). Group IV: Restoration with biofillers. All the cavities were restored with visible light-activated direct restorative nanocomposite. The specimens were thermocycled for 24 hours. After thermocycling, the samples were immersed in a 1% methylene blue for 4 hours and subsequently evaluated for microleakage. Microleakage scores (0–4) were obtained from gingival margins of class V restorations and analyzed by statistical analysis. Evaluation of the data was performed by Kruskal–Wallis one-way analysis of variance (ANOVA), and Mann–WhitneyUtests.ResultsMicroleakage scores have indicated restorations with biofillers showed best results followed by megafillers, incremental horizontal build-up, and bulk filling.ConclusionBiofillers provide a novel approach in improving microleakage and marginal adaptability of composite resin restorations.Clinical significanceIncorporation of inserts, which are capable of adequate bonding to resin and tooth, may provide improved marginal adaptability and reduce microleakage around restorative margins.How to cite this articleBiradar N, Allappanavar KS, Shetty NK,et al.Evaluation of Marginal Adaptation of Composite Restorations Reinforced with Novel Enamel Inserts (Biofillers) in Class V Cavities. J Contemp Dent Pract 2020;21(12):1368–1373.
Different Post Placement Strategies for the Restoration of Endodontically Treated Maxillary Premolars with Two Roots: Single Post vs Double Post
Authors: Grandini Simone , Ferrari Marco , Spicciarelli Valentina , Marruganti Crystal , Martignoni Marco , Andreatti Ludovica , Doldo Tiziana 
Published: April 2021

ABSTRACT

Aim and objective
The present study compared the fracture strength and failure pattern of endodontically treated, bi-rooted, maxillary premolars with different number of coronal walls and postendodontic restoration (one vs double post).

Materials and methods
105 premolars were divided into 3 groups according to the number of residual walls: control group (intact teeth; n = 15), group 1 (3 residual walls; n = 45), group 2 (2 residual walls; n = 45). Each test group was then divided into 3 subgroups (n = 15 each) according to postendodontic restoration: no post (A), 1 post (B) or 2 posts (C). A load was applied parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and Tukey's tests were used to detect fracture strength differences among groups, while Chi-square test was used to check differences in fracture pattern.

Results
No significant differences were observed between control group (intact teeth) and groups A1 (p = 0.999), B1 (p = 0.997) and C1 (p = 1.000); statistically significant differences were detected between control group and groups A2 (p < 0.001), B2 (p < 0.001) and C2 (p < 0.05). Different post placement techniques were non-significantly associated with fracture pattern in both groups 1 (p = 0.666) and 2 (p = 0.143) while, irrespective of the number of posts, the presence of the post was significantly associated with the fracture pattern in teeth with two residual walls. The double-post technique did not further improve the fracture resistance of hardly damaged endodontically treated maxillary bi-rooted premolars compared to single-post technique. Therefore, the insertion of a single post in the palatal canal could be a safer and more conservative choice.

Clinical significance
The double-post technique did not further improve the fracture resistance of severely structurally compromised endodontically treated maxillary premolars with two roots compared to the single-post technique. Therefore, the safer and less invasive treatment is the placement of a single post in the palatal canal.
How to cite this article
Spicciarelli V, Marruganti C, Martignoni M, et al. Different Post Placement Strategies for the Restoration of Endodontically Treated Maxillary Premolars with Two Roots: Single Post vs Double Post. J Contemp Dent Pract 2020;21(12):1374–1378.
Emotional Dynamics of Action and Core Involvement: A new theoretical perspective for designing development strategies in schools
Authors: Upadhayaya Venus 
Published: April 2021

Emotional Dynamics of Action and Core Involvement are theortical perspectives that define an individual's life long scope of learning and progress. An individualâ€™s life long Emotional Dynamics of Action (EDA) and his/her Core Involvement in what he/she aspires to do, in what he/she takes up, in whatever he/she achieves get immensely impacted in school. EDA and CI are not isolated patterns of emotional construct; they get constantly evolved and devolved, constantly learned and unlearned. An individual's EDA and CI constantly impact those around and also constantly get impacted by those around. Thus school becomes a space that defines the life-long capacity of an individual. Schools greatly make up a society and its behavioural and attitudinal construct. The aim of this paper is to on a fresh construct define how schools play a pivotal role in determining a childâ€™s consciousness. The psychological patterns determining communication between a childâ€™s internal and external settings and his level of self-awareness get shaped in school. And these psychological patterns define the EDA and CI of the individual. Researcher defines how positive EDA and CI can be cultivated and practised and how schools can become a major strageic point for development.
The Use of Bedside Ultrasound for Gallstone Disease Care within a Community-based Emergency Department: A Confirmation Bias
Authors: Gunther Karin H , Smith Joshua , Boura Judith , Sherman Andrew , Siegel David 
Published: April 2021

INTRODUCTION Traditional evaluation for suspicion of gallstone or gallbladder-related disease includes evaluation with a formal technician-performed ultrasound. However, the use of point-of-care bedside ultrasounds (Bedside US) has been shown to be a viable alternative for the diagnosis of gallstones and gallbladder-related diseases. Purpose Statement: The purpose of this study was to evaluate the impact of Bedside US use in gallbladder evaluation on key patient care outcomes within our community-based emergency department setting. METHODS This retrospective study compared the use of no ultrasound (No US), a formal technician performed ultrasound (Tech US) and Bedside US for gallstone and gallbladder related diseases within a community hospital emergency department between January 1, 2015 and January 1, 2018. Initial vitals, lab work, patient socio-demographics, medical history, emergency department length of stay in hours and disposition were reviewed. RESULTS Of a total N = 449 patients included, patients who received a Bedside US had the fewest computerized tomography scans (No US 62% vs. Tech US 29% vs. Bedside US 16%; p < 0.0001), the shortest median emergency department length of stay (No US 4.5 days vs. Tech US 5.0 days vs. Bedside US 3.0 days; p < 0.0001), and were more likely to be discharged home (No US 41% vs. Tech US 55% vs. Bedside US 81%; p = 0.0006) compared to those that received no ultrasound or a formal ultrasound. Patients who received a Bedside US also had the statistically significant highest incidence of prior cholelithiasis (No US 29.4% vs Tech US 14.3% vs. Bedside US 31.3%; p = 0.001) and lowest total median bilirubin levels (No US 0.5 vs. Tech US 0.5 vs. Bedside US 0.3; p = 0.016) when compared to the other two groups. CONCLUSIONS Although there was a confirmation bias, these study results indicate that point-of-care bedside ultrasound could be a viable alternative for gallstones and gallbladder-related diseases with benefits of use in a community hospital setting.
Using Quantitative D-Dimer to Determine the Need for Pulmonary CT Angiography in COVID-19 Patients
Authors: Mikhjian Gary , Elghoroury Ahmad , Cronovich Keith , Brody Kevin , Jarski Robert 
Published: April 2021

INTRODUCTION: COVID-19 has been frequently cited as a condition causing a pro-inflammatory state leading to hypercoagulopathy and increased risk for venous thromboembolism. This condition has thus prompted prior studies and screening models that utilize D-dimer for pulmonary embolism (PE) into question. The limited research to date has failed to provide tools or guidance regarding what COVID-19 positive patients should receive pulmonary CT angiography screening. This knowledge gap has led to missed diagnoses, CT overutilization, and increased morbidity and mortality. OBJECTIVE: The purpose of this study was to examine the utility of the quantitative D-dimer lab marker in a convenience sample of 426 COVID-19 positive patients to assist providers in determining the utility of pulmonary CT angiography. METHODS: The authors conducted a retrospective analysis on all COVID-19 positive patients within the Henry Ford Medical System between March 1st, 2020 through April 30th, 2020 who received pulmonary CT angiography and had a quantitative D-dimer lab drawn within 24 hours of CT imaging. RESULTS: Our sampling criteria yielded a total of n = 426 patients, of whom 347 (81.5%) were negative for PE and 79 (18.5%) were positive for PE. The average D-dimer in the negative PE group was 2.95 μg./mL. (SD 4.26), significantly different than the 9.15 μg./mL. (SD 6.80) positive PE group (P < 0.05; 95% CI -7.8, -4.6). Theoretically, applying the traditional ≤ 0.5 μg./mL. D-dimer cut-off to our data would yield a sensitivity of 100% and specificity of 7.49% for exclusion of PE. Based on these results, the authors would be able to increase the D-dimer threshold to < 0.89 μg./mL. to maintain their sensitivity to 100% and raise the specificity to 27.95%. Observing a D-dimer cut-off value of ≤ 1.28 μg./mL. would reduce sensitivity to 97.47% but increase the specificity to 57.93%. CONCLUSIONS: These study results support the utilization of alternative D-dimer thresholds to exclude PE in COVID-19 patients. Based on these findings, providers may be able to observe increased D-dimer cut-off values to reduce unnecessary pulmonary CT angiography scans.
Common Problematic Scholarly Activity Project Planning Expectations of Project Novices
Authors: Wisniewski Samuel J. , Corser William D. 
Published: April 2021

INTRODUCTION Scholarly Activity (SA) projects, whether using methods more traditionally associated with research and or “quality improvement” projects, have been shown to confer value to resident physicians and other project novices in multiple ways. The inclusion of community and university-based residents and faculty in spearheading SA projects has led to improved understanding of medical literature and enhanced clinical practices, arguably producing more “well-rounded” physicians. PURPOSE OF PAPER The primary purpose of this paper is to provide a summary of problematic expectations frequently assumed by project novices when developing and conducting SA projects. RESULTS The authors will discuss a total of 26 problematic project-related novice expectations during five typical project phase categories. CONCLUSIONS Learning to navigate the complexities of training to become a practicing physician, while also planning high quality SA project designs has been and will continue to be a complex challenge. The authors hope that this article can be used by supervising faculty and other graduate medical education mentors to assist the SA project novice (SAPN) plan SA projects. By establishing realistic expectations during project planning phases, the SAPN can avoid potential missteps that typically impede SA project completion.
A Closer Look into the Association between the Sacroiliac Joint and Low Back Pain
Authors: Wieczorek Ashley , Campau Erin , Pionk Elizabeth , Gabriel-Champine Molly E. , Ríos-Bedoya Carlos F. 
Published: April 2021

INTRODUCTION Low back pain is the most common type of global disability and annually costs the United States over two billion dollars. Opioids have been used to reduce low back pain, although current evidence concerning efficacy is lacking. Sacroiliac joint dysfunction (SIJD) is estimated to be a primary pain source of low back pain in between 10 and 25% of affected patients. The primary objective of this study was to evaluate the rate of SIJD identified through osteopathic techniques in a convenience sample of patients seeking low back pain treatment. The secondary objective was to assess prevalence of low back pain and SIJD among different age groups, and genders. METHODS Retrospective chart reviews were completed the adult patients who had received osteopathic manipulative treatment for low back pain at Family Health and Wellness Center in Essexville, MI from January 2018 through June 2019. The prevalence of patients with SIJD was identified during reviews of osteopathic procedural documentation for patients seeking low back pain treatment. Data regarding patients’ age, sex, and treatment modalities were also extracted. Descriptive statistics consisting of frequencies and percentages were calculated. RESULTS A total of 84 patient records were reviewed. A total of 51 (60.7%) patients seeking low back pain treatment were diagnosed with SIJD identified by osteopathic providers. This included patients with both lumbar and sacral diagnoses simultaneously. SIJD alone accounted for 26 (31%) of patients seeking treatment. Female patients were more likely to have SIJD involvement than males. Forty one (48.8%) treated patients were between 45-64 years old. Muscle Energy Technique was documented to be the most used for 68 (81%) patients. In addition, techniques tended to move from direct to indirect for older patients. DISCUSSION Our study demonstrated that SIJD appeared to contribute to low back pain in 51 (60.7%) of low back pain cases identified using osteopathic techniques. This is much greater than the previously reported percentages of 10 to 25%. One possible confounding influence included varied resident screening and reporting of sacral dysfunction. Since multiple areas of the body can be treated at one time, our current procedure notes did not allow for distinguishing between which types of modalities were used on each region or capture residents’ preferred treatments. CONCLUSIONS Although further studies are needed, our results suggest that knowledge of SIJD’s impact on low back pain could lead to improved patient outcomes such as decreased medical costs and opioid use.
A Longitudinal Observation of the Influence of Michigan Sports Concussion Law on Parents’ Knowledge and Perception of Sport-Related Concussion
Authors: LaBond Virginia , Liebsch Karyn , West Brian , Caputo Dane , Barber Kimberly 
Published: April 2021

INTRODUCTION In 2013, Michigan enacted legislation requiring parents and athletes to receive educational material concerning sport-related concussion (SRC). The aim of this study was to examine trends in concussion knowledge of parents from one community following implementation of Michigan’s Sports Concussion Laws (MSCL). METHODS A convenience sample of parents of students from a suburban school district were surveyed via district email at one year and five years post MSCL implementation. Results were compared to an equivalent 33-item survey obtained prior to the law. Individual questions were compared between the three surveys using Chi-square analysis with statistical significance observed at p < 0.05. RESULTS A total of 381 responses were obtained from the one-year post-MSCL (1yMSCL) and 178 in the five-year post-MSCL (5yMSCL) survey. Awareness of district policy regarding concussion was significantly higher after implementation of the MSCL (i.e., 77% at 1yMSCL and 71% at 5yMSCL) compared to prior 18% pre-MSCL (p < 0.0001). Respondents to the 5yMSCL survey were also significantly more aware of medical guidelines surrounding “return to play” after SRC compared to 1yMSCL (84.8% v 78.7%, p = 0.01). At 5yMSCL, significantly more respondents agreed that head injuries could cause more brain damage to children than adults (86.5% v 78.7% at 1yMSCL, p = 0.03). Finally, most parents at both survey periods rated the concussion educational material as the most helpful information source regarding SRC. CONCLUSIONS Based on these results, parental knowledge awareness appears to have increased concerning awareness of medical guidelines for SRC and potential brain damage risks to children after enactment of the MSCL.
Introducing electronic circuits and hydrological models to postsecondary physical geography and environmental science students: systems science, circuit theory, construction, and calibration
Authors: Kinar Nicholas J. 
Published: April 2021

Abstract. A classroom activity involving the construction, calibration, and
testing of electronic circuits was introduced to an advanced hydrology class
at the postsecondary level. Two circuits were constructed by students: (1) a
water detection circuit and (2) a hybrid relative humidity (RH)/air
temperature sensor and pyranometer. The circuits motivated concepts of
systems science, modelling in hydrology, and model calibration. Students
used the circuits to collect data useful for providing inputs to
mathematical models of hydrological processes. Each student was given the
opportunity to create a custom hydrological model within the context of the
class. This is an example of constructivist teaching where students engage
in the creation of meaningful knowledge, and the instructor serves as a
facilitator to assist students in the achievement of a goal. Analysis of
student-provided feedback showed that the circuit activity motivated,
engaged, and facilitated learning. Students also found the activity to be a
novel and enjoyable experience. The theory of circuit operation and
calibration is provided along with a complete bill of materials (BOM) and
design files for replication of this activity in other postsecondary
classrooms. Student suggestions for improvement of the circuit activity are
presented along with additional applications.
Exchange interaction in short-lived flavine adenine dinucleotide biradical in aqueous solution revisited by CIDNP (chemically induced dynamic nuclear polarization) and nuclear magnetic relaxation dispersion
Authors: Zhukov Ivan V. , Kiryutin Alexey S. , Panov Mikhail S. , Fishman Natalya N. , Morozova Olga B. , Lukzen Nikita N. , Ivanov Konstantin L. , Vieth Hans-Martin , Sagdeev Renad Z. , Yurkovskaya Alexandra V. 
Published: April 2021

Abstract. Flavin adenine dinucleotide (FAD) is an important
cofactor in many light-sensitive enzymes. The role of the adenine moiety of
FAD in light-induced electron transfer was obscured, because it involves an
adenine radical, which is short-lived with a weak chromophore. However, an
intramolecular electron transfer from adenine to flavin was revealed several
years ago by Robert Kaptein by using chemically induced dynamic nuclear
polarization (CIDNP). The question of whether one or two types of biradicals of
FAD in aqueous solution are formed stays unresolved so far. In the present
work, we revisited the CIDNP study of FAD using a robust mechanical sample
shuttling setup covering a wide magnetic field range with sample
illumination by a light-emitting diode. Also, a cost efficient fast field
cycling apparatus with high spectral resolution detection up to 16.4 T for
nuclear magnetic relaxation dispersion studies was built based on a 700 MHz
NMR spectrometer. Site-specific proton relaxation dispersion data for FAD
show a strong restriction of the relative motion of its isoalloxazine and
adenine rings with coincident correlation times for adenine, flavin, and
their ribityl phosphate linker. This finding is consistent with the
assumption that the molecular structure of FAD is rigid and compact. The
structure with close proximity of the isoalloxazine and purine moieties is
favorable for reversible light-induced intramolecular electron transfer from
adenine to triplet excited flavin with formation of a transient
spin-correlated triplet biradical F⚫−-A⚫+. Spin-selective recombination of the biradical leads to the formation of CIDNP
with a common emissive maximum at 4.0 mT detected for adenine and flavin
protons. Careful correction of the CIDNP data for relaxation losses during
sample shuttling shows that only a single maximum of CIDNP is formed in the
magnetic field range from 0.1 mT to 9 T; thus, only one type of FAD
biradical is detectable. Modeling of the CIDNP field dependence provides
good agreement with the experimental data for a normal distance distribution
between the two radical centers around 0.89 nm and an effective electron
exchange interaction of −2.0 mT.