bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hybrid implants in the dental rehabilitation of posterior maxilla
Authors: Krishnaprabhu Rajkumar , Shadamarshan R Arunkumar , Roy Chowdhury Sanjay Kumar 
Published: December 2021

Context:
Implant-retained prosthodontic rehabilitation of the posterior maxilla poses a unique challenge due to deficiency in bony characteristics in many cases, thereby requiring elaborate adjunctive surgical procedures to aid in implant placement.

Aims:
We aimed to evaluate the efficacy of hybrid implants in the prosthodontic rehabilitation of edentulous posterior maxilla.

Subjects and Methods:
Prospective clinical evaluation of 27 patients (30 implants) rehabilitated using hybrid implants at 1 and 4 weeks after implant placement and 3, 6, and 12 months after functional loading was conducted.

Statistical Analysis Used:
Descriptive statistics were used for statistical analysis.

Results:
The average pain score on the Visual Analog Scale was 4.53 and 0.76 at the end of 1st week and 4 weeks. Four implants (13.33%) were found unstable by 4 weeks. Two implants (6.67%) had exposure by 12 months. Less than 1 mm of mobility was seen in one implant (3.33%) by 3 months, four implants (13.33%) by 6 months, and five implants (16.67%) by 12 months. One implant (3.33%) developed mobility up to 2 mm by 12 months. Seven implants (23.33%) showed a probing depth of ≥5 mm but none more than 6 mm. Gingival recession of 2 and 3 mm was seen in two implants (6.67%) and one implant (3.33%), respectively, at the end of 12 months. The average bone loss was 0.17, 0.31, and 0.46 mm by 3, 6, and 12 months. The average rate of bone loss was 0.02 mm per month.

Conclusions:
Hybrid implant is an excellent alternative in patients with inadequate bone in the posterior maxilla precluding the requirement of maxillary sinus lift and grafting.
Resistance to dynamic and static loading of the implant mounts on its respective implant
Authors: Blanco-Gonzalez Daniela , Villalobos-Ramirez Francisco , Fernández-López Ottón , Chavarría-Bolaños Daniel , Vargas-Koudriavtsev Tatiana 
Published: December 2021

Introduction:
Implant restorations should endure a variable range of forces over a long period of time. Some commercial brands offer the implant together with an accessory called “implant mount” or “implant holder,” which might be used as a temporary abutment. However, scientific literature in the use of implant holders as abutments for restorations is scarce.

Objectives:
The purpose of this in vitro study was to compare the load at which implant holders of Implant Direct® and Zimmer® fail under static compression after being subjected to fatigue, and to compare the gap produced between the implant–holder complexes after dynamic loading.

Materials and Methods:
The test protocol was based on the recommendation of ISO 14801. Five implant–implant holder assemblies of each brand were subjected to dynamic loading. A load of 250 N was applied at 5 × 106 cycles and at 15 Hz stress frequency (Eden Prairie, MN, USA). The gap (μm) at the interface was measured postfatigue using scanning electron microscopy (S-3700N, HITACHI, Japan), and afterward, static loading was applied and the maximum load (N) after the point of failure was established. Implant–definitive abutment complexes were used as controls. Data were analyzed by means of a central tendency measurement test Mann–Whitney U-test (nonparametric).

Results:
There was no difference between both the implant holder groups (P ≤ 0.05); however, a slight trend of greater resistance was observed for the Zimmer® group. The gap in the interface was greater for Implant Direct® implants, but the difference was not statistically significant.

Conclusion:
No significant differences were found in terms of the maximum load under compression or the interface gap after the dynamic loading in the two experimental groups.
Clinical and Angiographic Profile of Patients with Severe Left Ventricular Systolic Dysfunction without Established Coronary Artery Disease
Authors: Khandelwal Lokesh , Trehan Vijay Kumar , Girish M P , Gupta Mohit Dayal , Safal Safal 
Published: December 2021

Objective:
Coronary artery disease (CAD) is the most common etiology of heart failure with reduced ejection fraction (EF). Coronary angiography is usually not done in patients with severe left ventricular systolic dysfunction (LVSD) without a history of acute coronary syndrome or angina, due to fear of increased risk. Hence, the prevalence of CAD in such cases remains unknown. This study aimed at analyzing the clinical and angiographic profile of the patients with severe LVSD (EF ≤35%) without established CAD.

Methods:
This was a prospective, observational study conducted from January 2018 to July 2019. One hundred consecutive patients (≥18 years) with severe LVSD (EF ≤35%) without established CAD were assessed for underlying CAD by coronary angiography. Patients were divided into those with no CAD and CAD. Patients having CAD were further classified into those with significant CAD and severe CAD based on angiographic lesion severity. The risk factors contributing to significant CAD were analyzed.

Results:
Sixty-four patients had no CAD and 36 patients had CAD, of which 34 and 26 patients had significant CAD and severe CAD, respectively. 41.7% patients had double-vessel disease followed by 33.3% and 25% patients having triple-vessel disease and single-vessel disease, respectively. The risk factors for significant CAD were male >55 years/female >65 years, male gender, diabetes mellitus, smoking, and dyslipidemia. Multivariate logistic regression analysis showed diabetes and dyslipidemia to be the independent risk predictors for significant CAD.

Conclusion:
Occult CAD is present in high proportions in patients with severe LVSD without established CAD specially in presence of risk factors such as diabetes, male >55 years/female >65 years and dyslipidemia. Hence, coronary angiography should be considered strongly in such patients having one or more of these risk factors.
Evaluation of Some Biomarkers in Diagnosis of Bacterial Bloodstream Infection in Children
Authors: Abood Rana Mohammed , Ashoor Zainab Fadhel , Al Saadi Yasir Ibrahim 
Published: December 2021

Background:
Bloodstream infection (BSI) is a life-threatening condition caused by the presence of microorganisms, generally caused by a range of bacteria in the blood.

Objectives:
The aim of this study was to evaluate the possible role of procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers of pediatric BSI.

Methodology:
The study was conducted on 150 blood samples collected from the patient who admitted to Children Welfare Teaching Hospital, Medical City, Baghdad. During the period from November 2020 to March 2021, ninety blood samples from them were positive culture and 60 blood samples were negative culture (control group). The isolates were identified depending on the morphological, microscopic examination, and biochemical tests. Moreover, serum was obtained from all participants for the determination of the screening level of human PCT measured by enzyme-linked immunosorbent assay and CRP by slide agglutination test.

Results:
The results in this study revealed that the mean levels of serum PCT and CRP in Gram-negative group and Gram-positive group were significantly difference from the control group.

Conclusions:
The adoption of these biomarkers as routine diagnostic tests for sepsis may help in the early diagnosis of pediatric sepsis.
In vitro Assessment of Antimicrobial Susceptibility Patterns in Positive Blood Cultures of 22 Neonates with Neonatal Sepsis in a Children's Hospital in Baghdad
Authors: Nashtar Saad Badai , Abdullah Razzaq Kaream , Al-Rubaye Waad Edan Louis 
Published: December 2021

Introduction:
neonatal sepsis (NS) is a serious disease in neonatology responsible for the higher percentage of neonatal deaths. It is a microbial disease caused by various types of bacterial and nonbacterial pathogens.

Objectives:
The objective is to determine the causative bacterial pathogens of NS for the specified period and their susceptibility toward the available antimicrobial drugs.

Patients and Methods:
Blood cultures of 67 neonates with clinical picture of NS were assessed for antimicrobial sensitivity.

Results:
Forty three cultures (64.2%) were negative, 4 cultures (5.9%) revealed Candida spp. and 20 (29.9%) cultures were positive. Gram-negative bacteria Klebsiella was the predominant pathogen causing NS (45.45%) followed be Gram-positive Staphylococcus aureus (18.2%). Vancomycin, ciprofloxacin, and amikacin were the most effective antimicrobials against Gram-positive isolates while imipenem was the most effective against Gram-negative bacteria.

Discussion:

klebsiella was the predominant microbe in NS in many studies, other pathogens were variable between countries. Vancomycin and imipenem approved their excellent effects reported in many others studies while penicillin approved high bacterial resistance recorded previously.

Conclusion:
Gram-negative bacteria were predominant and more resistant to the tested antimicrobials. Imipenem, vancomycin, ciprofloxacin were the best effective according to the isolated microbes.
Assessment of the anterior and caudal extent of inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of submandibular fossa using computed tomography
Authors: Kumar Deepak , Brar Ramandeep , Ahmad Tahir , Narad Chintan , Sodhi S. P. S. , Kaur Amandeep 
Published: December 2021

Background:
A well-versed knowledge of the precise location of various anatomical landmarks is necessary to avoid complications during surgery. The study was conducted for the assessment of the anterior and caudal extent of the inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of the submandibular fossa using computed tomography (CT).

Materials and Methods:
One hundred CT scans were randomly selected for this study accounting for 200 hemimandibles. Both axial and coronal images were obtained and evaluated concurrently. Results were subjected to statistical analysis for correct inferences.

Results:
A total of 200 hemimandibles (n = 200) from 100 patients with a mean age was 23.89 ± 1.75 years ranging from 21 to 33 years were evaluated. The mean length of the anterior loop was 0.95 mm for all of the observation combined and measurement range from 0 to 5.1 mm. The total frequency of type I, type II, and type III of mental nerve was found as 71%, 4.5%, and 24.5%, respectively. At the level of the first molar, the mean distance from the center of the inferior alveolar canal to the external surface of the buccal cortex (Q) was 5.44 ± 1.38 mm ranging from 2.4 to 10.4 mm. Furthermore, there was no statistically significant difference in MF-IMB (mental foramen to the inferior border of mandible) between the right and left sides of the mandible. (P = 0.87).

Conclusion:
Our study demonstrates that analyzing CT scans using the methods described in this study can be a useful tool in avoiding the iatrogenic injuries to inferior alveolar nerve and arteries during various maxillofacial surgical procedures.
Nasal changes in different age groups
Authors: Shastri Dipti , Tandon Pradeep , Singh Ankita 
Published: December 2021

Objective:
The objective of this study was to evaluate nasal changes in different age groups and to detect gender difference in nasal dimensions.

Materials and Methods:
Clinical measurement and profile photographic records of 279 randomly selected subjects were obtained for the evaluation of nasal changes. Thirty-nine subjects were excluded, and the final sample consisted of 240 subjects. The subjects were divided into four groups by age: Group 1 (16–20 years), Group 2 (21–30 years), Group 3 (31–40 years), and Group 4 (41–50 years). Each group was further subdivided on the basis of gender. Data were collected and analyzed by two-way multivariate analysis of variance with Duncan's multiple range post hoc test.

Results:
In both males and females, nasal height and breadth increased with except nasal index and nasolabial angle. More nasal changes were seen in males as compared to females of the same age group.

Conclusions:
Nonconsistent age-related changes were found for nasal index and nasolabial angle. The rest of the nasal parameters increased with age and differ between the genders. Larger nasal changes were seen in males as compared to females of the same age group.
Augmentation rhinoplasty using olecranon bone graft
Authors: Mehta Jitendra S. , Zade Manish P. , Nakade Dhananjay V. , Gupta Shitiz , Akhila C. V. 
Published: December 2021

Background:
Correction of saddle nose deformity is one of the most frequently sought surgeries by patients seeking rhinoplasty in Asian countries. Nasal dorsal augmentation always requires graft material to achieve the desired result. Various autologous grafts and alloplastic materials have been described in the literature with their advantages and disadvantages. We report our study on the use of olecranon bone graft for augmentation rhinoplasty in severe saddle nose deformity and discuss our experience with it.

Materials and Methods:
In this observational study, 12 patients who underwent dorsal nasal augmentation using olecranon bone graft from August 2011 to December 2020 were studied. All ten patients with congenital deformity underwent graft insertion through a closed rhinoplasty approach, whereas two patients with posttraumatic deformity were operated through old scars over the nasal dorsum. The graft was fixed with screws at nasion in both posttraumatic cases. All the patients were evaluated postoperatively at regular intervals for graft resorption by clinical photographs and X-ray nasal bone.

Results:
The age ranged from 20 years to 48 years. No immediate complications related to graft placement were noted. One patient had a hairline fracture of the ulna at the donor site on the 3rd postoperative day which was managed conservatively with a cast. The mean follow-up period was 2 years. No nasal dorsum projection loss or signs of bone resorption were observed for up to 5 years after surgery. One patient with posttraumatic deformity required removal of fixation screw which got exposed after 2 years of surgery.

Conclusion:
Olecranon bone graft is a suitable material for nasal dorsal augmentation in severe saddle nose deformity because of ease of harvest and minimal donor area morbidity. The appropriate thickness of the cortex of the olecranon process allows custom molding and provides resistance to resorption in long term, thereby giving a desirable outcome.
Indian Subset Analysis of a Phase IIIb Open-Label Study of Afatinib in Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor-Naïve Patients with Epidermal Growth Factor Receptor Mutation Positive Non-small Cell Lung Cancer
Authors: Rajappa Senthil J. , Srinivasa B. J. , Bondarde Shailesh A. , Gokhale Partha Mohan , Sonone Pankaj , Dahiya Arun Kumar 
Published: December 2021

Aims:
The study aimed to evaluate the safety and efficacy of afatinib in locally advanced or metastatic nonsmall cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations, in Indian subset of a Phase IIIB open-label study.

Methods:
A multicenter, open-label, Phase IIIB study was conducted to evaluate afatinib in EGFR tyrosine kinase inhibitor-naïve patients with locally advanced/metastatic EGFRm + NSCLC across five countries (34 sites; China, Hong Kong, India, Singapore, and Taiwan). A total 541 patients were recruited, out of which 50 patients were from India. In this article, we have evaluated the safety and tolerability of afatinib in Indian subset of patients (n = 50). Treatment with afatinib was continued until lack of clinical benefit as determined by the investigator. Primary endpoint was safety in terms of patients with serious adverse events (SAEs). Secondary endpoints included number of patients with drug-related AEs, time to symptomatic progression (TTSP), and progression-free survival (PFS).

Results:
Forty-six out of 50 patients experienced at least one AE. As in the overall study, diarrhea was the most common drug-related AE in Indian patients. In majority (85%) of cases, severity of diarrhea was of grade 1 or 2. No new safety concern was identified in the study. Median TTSP and PFS were 13.43 months (95% confidence interval [CI]: 8.51, 18.33) and 10.08 months (95% CI: 7.32, 14.75), respectively, in Indian subset.

Conclusions:
Safety and tolerability of afatinib were consistent with overall study and previously reported data. Most of the AEs were manageable without any need of treatment discontinuation.
Effect of turbidity on ultraviolet disinfection of domestic wastewater for agricultural reuse
Authors: Garay Diego Fernando Atoche , Voltolini Lisiana Crivelenti , Bastos Reinaldo Gaspar , Souza Claudinei Fonseca 
Published: December 2021

Water treatment and reuse are fundamental because of the increasing demand for freshwater, especially in agriculture. Accordingly, this study evaluated the effects of turbidity of wastewater processed at the Effluent Treatment Station (ETE) of the UFSCar/Araras and of UV dose on microbial inactivation. The ETE treats up to 2000 L of wastewater daily from toilets and a university restaurant and has five components (grease box, septic tank, microalgae tank, upflow anaerobic filter, and wetlands). Pretreated effluents were used in the experiments, and sampling sites consisted of inspection boxes located after the wetlands. Sample collection, inspection, preservation, and analyses were performed according to standard methods. Sample turbidity was adjusted to 5, 50, 100, 200, and 300 nephelometric turbidity units (NTU), and UV doses of 7.2–28.8 mWs cm-2 were used. A 5 x 5 factorial design (five turbidity levels and five radiation doses) was used, totaling 25 treatments. Each treatment was performed in triplicate. The data were submitted to analysis of variance and Tukey’s test. The results showed that the increase in turbidity significantly decreased disinfection efficiency in samples with turbidity levels higher than 50 NTU. The microbial inactivation coefficients obtained here can be extrapolated to disinfection of wastewater with turbidity up to 300 NTU to eliminate thermotolerant coliforms. The UV sterilizer is feasible for wastewater treatment and its reuse in agriculture.
Keywords: domestic effluent, sustainability, ultraviolet radiation, water reuse.
Mission-Based Filters in the Electronic Residency Application Service: Saving Time and Promoting Diversity
Authors: Swails Jennifer L. , Adams Sasha , Hormann Mark , Omoruyi Emma , Aibana Omowunmi 
Published: December 2021

ABSTRACT

Background
Holistic review promotes diversity, but widespread implementation remains limited.

Objective
We aimed to develop a practical approach to incorporate holistic review principles in screening applicants in the Electronic Residency Application Service (ERAS) and to assess the impact on diversity.

Methods
Three residency programs (internal medicine [IM], pediatrics, and surgery) at McGovern Medical School developed filters to identify applicants with experiences/attributes aligned with the institutional mission. These filters were retroactively applied to each program's 2019–2020 applicant pool using built-in ERAS capabilities to group applicants by user-defined features. We compared the demographics of applicants reviewed during the cycle with those identified retrospectively through experiences/attributes filters.

Results
The IM, pediatrics, and surgery programs received 3527, 1341, and 1313 applications, respectively, in 2019–2020. Retrospective use of experiences/attributes filters, without scores, narrowed the IM applicant pool for review to 1301 compared to 1323 applicants reviewed during actual recruitment, while the pediatrics filters identified 514 applicants compared to 384 at baseline. The surgery filters resulted in 582 applicants, but data were missing for baseline comparison. Compared to the baseline screening approach utilizing scores, mission-based filters increased the proportions of underrepresented in medicine applicants selected for review in IM (54.8% [95% CI 52.1–57.5] vs 22.7% [20.4–24.9], P &lt; .0001) and pediatrics (63.2% [95% CI 59.1–67.4] vs 25.3% [20.9–29.6], P &lt; .0001).

Conclusions
Program directors can leverage existing ERAS features to conduct application screening in alignment with holistic review principles. Widespread implementation could have important repercussions for enhancing physician workforce diversity.
Antibiotic prophylaxis with amoxicillin to prevent infective endocarditis in periodontitis patients reconsidered: a narrative review
Authors: Hatz Christian R. , Cremona Mario ,  Liu Chun Ching , Schmidlin Patrick R. , Conen Anna 
Published: December 2021

OBJECTIVES: To discuss first, the adequacy of the antibiotic prophylaxis regimen currently recommended for the prevention of infective endocarditis in periodontitis patients, and second, preventive measures to decrease the rate of bacteraemia after periodontal treatment.
MATERIALS AND METHODS: A bibliographic literature search identifying clinical trials between January 1990 and January 2021, focusing on microorganisms in bacteraemia after periodontal treatment and bacteria in infective endocarditis, was performed. Two reviewers independently identified and screened the literature by systematically searching in Medline/Premedline, EMBASE and Cochrane Library.
RESULTS: Two hundred and seventy articles were identified, of which twenty-three met the inclusion criteria. Bacteraemia rates after periodontal treatment ranged from 10–94% in the investigated patients. Mainly oral pathogens related to infective endocarditis, such as viridans group streptococci (up to 70%) and HACEK group pathogens (e.g., Aggregatibacter actinomycetemcomitans), were detected. But typical oral and periodontopathogenic species, such as Porphyromonas spp. (P.s gingivalis) (up to 50%), Actinomyces spp. (up to 30%) and Fusobacterium spp. (up to 30%), which do not usually cause infective endocarditis, were also found. Infective endocarditis episodes that might have been in association with a dental treatment were mainly caused by viridans group streptococci. Prophylactic measures like rinse application of chlorhexidine, povidone-iodine or essential oils, diode laser or systemic antibiotic prescription were described as decreasing the bacteraemia rate after periodontal interventions to 5–70%.
CONCLUSION: The currently recommended systemic antibiotic prophylaxis with amoxicillin before periodontal treatment in high-risk cardiovascular patients still covers the most common oral bacteria causing infective endocarditis, namely viridans group streptococci, and therefore seems adequate in this context. Since bacteraemia, not infective endocarditis, is the endpoint in most studies, the causality between bacteraemia after periodontal treatments and infective endocarditis remains difficult to elucidate. Until more evidence is available regarding this, adherence to current guidelines for antibiotic prophylaxis in patients at high risk for infective endocarditis undergoing periodontal treatment remains recommended.