bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Evaluation of the Bonding Efficacy of Multimode Adhesive, Two-Step Self-Etch Adhesive, and a Total-Etch System to Pulpal Floor Dentin – An In vitro Study
Authors: Valsan Dhanya , Bhaskaran Sajeev , Mathew Joy , Hari Krishnan , Joy Joseph 
Published: February 2023

Abstract

Background:
Postendodontic restoration with composite resins has gained popularity due to the development of more reliable adhesives with simplified bonding procedures and less technique sensitivity. Pulpal floor dentin is a complex biological structure and a more challenging bonding substrate. Hence, appropriate selection of the bonding agent for these regions of the tooth is important.

Aims:
To compare the shear bond strength of a new generation of dental adhesives referred to as multimode adhesives, two-step self-etch adhesive, and a total-etch system to pulpal floor dentin.

Materials and Methods:
Sixty human mandibular molars were sectioned with a slow speed diamond disc to expose the pulp chamber and divided into four groups of 15 teeth each, based on the bonding agent used. Group A: Single bond universal (self-etch); Group B: Single Bond Universal (etch-and-rinse), Group C: Clearfil SE Bond, Group D: Adper Single Bond 2. Using a split Teflon mold, composite cylinders were built on the prepared dentinal surfaces. The shear bond strength was then evaluated with the universal testing machine.

Results:
Two step self-etch adhesives recorded higher shear bond strength than total-etch and multimode/universal adhesives applied in both self-etch and etch-and-rinse techniques.

Conclusion:
The self-etching/priming system bonded more strongly to the pulpal floor dentin than multimode adhesive and total-etch system.
Transformation of ophthalmology education during the Coronavirus Disease 2019 pandemic by E-learning in India
Authors: Pathania Meenakshi , Chaudhary Rajat , Attri Jyotsana 
Published: February 2023

Purpose:
The purpose of this study was to assess the impact of the coronavirus disease 2019 pandemic imposed social distancing measures on the learning of ophthalmology in the institutions involved in the training of the ophthalmologists and the use of alternate E-learning methods to maintain the standard of education.

Materials and Methods:
This study was conducted among the postgraduate residents and faculty involved in ophthalmology-related education from October 15, 2020, to September 15, 2021. The study was based on a questionnaire performed based on a Google Form that was sent to the participants.

Results:
A total of 345 participants completed the survey. Most of the participants were using conventional learning methods such as lectures, ward rounds, clinical meets, and journal clubs. E-learning techniques showed a statistically significant increase during the pandemic (P < 0.001). Theoretical studies continued but the surgical training of the residents and fellows was significantly reduced.

Conclusion:
During the pandemic due to the imposed challenges in ophthalmology learning, even though surgical learning suffered, there was a significant increase in the utilization of E-learning alternatives, opening a new arena of learning opportunities.
Effect of TENS and stabilization exercises on pelvic pain in pelvic cancer survivors following multimodal treatment
Authors: Mathias Oshin Diana , Pattanshetty Renu B 
Published: February 2023

Background:
Pelvic floor muscle (PFM) dysfunction and pain are common complications seen in pelvic cancers including the gynecological and genitourinary systems before and after treatments such as chemotherapy, radiotherapy, and surgeries and may contribute to significant morbidity as the survival rates increase in these patients.

Objective:
The objective of the clinical trial was to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) and stabilization exercises on pelvic pain in pelvic cancer survivors following multimodal treatment.

Materials and Methods:
Thirty-one patients including both male and female adults treated for pelvic cancers were recruited in the study. Outcome measures in terms of pain were assessed at baseline and at the end of the study by the visual analog scale and genitourinary pain index (GUPI) scale, abdominal muscle strength by pressure biofeedback unit for transverse abdominal (TrA) muscle, and quality of life (QOL) by functional assessment of cancer therapy general questionnaire. Pelvic stabilization exercises and TENS were administered once daily approximately 30 min during the acute hospitalization.

Results:
Pelvic stabilization exercises and TENS demonstrated to be effective in ameliorating pelvic pain (P < 0.001) and improving in the GUPI scores of pain, incontinence, increasing strength of TrA musculature (P < 0.001), and improving overall QOL (P < 0.005).

Conclusion:
The trial suggests that a combination of pelvic stabilization exercises and conventional TENS may be used as a strategic tool to reduce pain and improve PFM strength after multimodal treatments in pelvic cancer survivors in the clinical setup of an Indian Scenario.
Validation of a simple technique for accurate treatment delivery for bilateral breast irradiation using the electronic portal imaging device
Authors: Dhar Debojoyti , Mallik Suman , Goswami Jyotirup 
Published: February 2023

Background and Aims:
While bilateral breast cancer is rare, the challenge for the radiation oncologist is to limit the dose to multiple important organs-at-risk and reducing the chance of overlapping tangential fields to limit hotspots. In this study, we present a simple technique to verify the setup accuracy of breast tangential fields using the electronic portal imaging device (EPID) for bilateral breast cancer.

Patients and Methods:
A 74-year-old female, with bilateral breast cancers, right staged as T1N0M0 and the left T2N1M0, received postoperative radiotherapy following bilateral breast conservative surgery. Standard CT-based simulation and target delineation were done, followed by treatment planning using classical field arrangements with two separate isocenters, one for each breast (keeping identical anteroposterior and superior-inferior coordinates). The planned doses were 45 Gy/25 # for whole breasts, plus tumor bed boost of 15 Gy/6 # and 50 Gy/25 # to left supraclavicular fossa. After setting up the patient, two small lead wires were placed at the medial borders of medial tangents (as seen on light fields) of each breast (longer one for left), followed by EPID imaging (dual exposure: One lateral tangent field image and other larger to include lead wires) of respective contralateral lateral tangential fields to verify that there was no actual overlapping with the opposite medial tangential field, as indicated by the lead wires.

Conclusion:
The study has validated a simple EPID-based technique for routine use in the field matching for radiotherapy of bilateral breast cancer.
Experimental study on the induction of cytotoxic T lymphocyte killing effects and dendritic-cell-based tumor vaccine prepared by high-intensity focused ultrasound
Authors: Li Zhichao , Xue Guoliang , Wei Zhigang , Ye Xin 
Published: February 2023

Aims:
This study was conducted to explore the high-intensity focused ultrasound (HIFU) prepared antigen-sensitized dendritic cells (DC) and the induction of cytotoxic T lymphocyte (CTL) killing effects by DC and to observe their anti-tumor immunity effects on BALB/c mice.

Methods and Material:
GM-CSF and IL-4 were used to culture the mouse bone marrow-derived DC. HIFU was used to prepare CT-26 tumor cell antigen-sensitive DC vaccines. The capability of T cell proliferation was detected by 3H-TdR, and the CTL cytotoxicity was detected using standard 4h51Cr release assay. The DC-based tumor vaccine prepared using HIFU irradiation was given to normal BALB/c mice. The mice were injected with CT-26 cancer cells subcutaneously seven days later. Further, the occurrence time of the tumor, its weight and volume on the 20th day was observed, and the allergic DC group challenged using repeated-freezing-thawing method alone with the normal saline control group (negative control group) were used to compare group differences.

Results:
DC in the HIFU group, tumor cell freeze-thawing group, tumor supernatant group, and phosphate buffer solution (PBS) group could induce T cell proliferation in vitro. However, the ability to induce T cell proliferation of DC in the HIFU group and tumor cell freeze-thawing group was significantly higher than those in the tumor supernatant and PBS groups (P < 0. 05). CTL induced in vitro by DC in the HIFU group, and the tumor cell freeze-thawing group had significant cytotoxicity to colon cancer, being significantly different from those in the tumor supernatant and PBS groups (P < 0.05). There was no significant difference between the cytotoxicity of CTL induced in vitro in the HIFU group and the tumor cell freeze-thawing group (P > 0.05). Additionally, significant differences in the occurrence time of the tumor, its weight and volume on the 20th day, and the median survival time of mice among the HIFU group, the repeated-freezing-thawing group, and the negative control group were observed (P < 0.01 or P < 0.05). There was a significant difference between the HIFU and the repeated-freezing-thawing group (P < 0.05).

Conclusions:
HIFU prepared antigen-sensitized DC could cause substantial proliferation of T cells and CTL with strong anti-tumor effects. The DC-based tumor vaccine prepared using HIFU irradiation affected active immunization on the tumor occurrence in vitro and was better than the DC-based tumor vaccine prepared using the repeated-freezing-thawing method.
The role of metabolic tumor parameters predicting cervical lymph node metastasis in patients with head and neck squamous cell carcinoma
Authors: Goksel Sibel , Erdivanli Ozlem C. , Bulbul Ogun , Dursun Engin 
Published: February 2023

Purpose:
This study aimed to investigate the contribution of metabolic positron emission tomography/computed tomography (PET/CT) parameters of the primary tumor in predicting regional lymph node metastasis (LNM) at initial staging in patients with head and neck squamous cell carcinoma (HNSCC).

Methods:
A total of 114 patients diagnosed with HNSCC and who underwent PET/CT scanning for staging were included in the study between May 2014 and December 2020. Predictive values of maximum standardized uptake value (SUVmax), maximum standardized uptake ratio (SURmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor in the prediction of cervical LNM were evaluated with logistic regression.

Results:
The patients were diagnosed with cancer of the larynx (46.5%), oropharynx (9.6%), nasopharynx (22.8%), hypopharynx (4.4%), and oral cavity (16.7%). All metabolic parameters of the primary tumor were significantly different between patients with positive and negative LNM (all P < 0.001). MTV (P = 0.022) and TLG (P = 0.007) were significantly higher in patients with contralateral LNM. MTV value of the primary tumor was found as the single significant predictor of regional LNM in patients with HNSCC (OR = 23.17, P < 0.001 vs. OR = 31.1, P < 0.001, respectively) in univariate and multivariate logistic regression analyses. The sensitivity, specificity, and accuracy of MTV were 89%, 80%, and 86%, respectively.

Conclusion:
MTV of the primary tumor can predict regional LNM and guide the selection of the treatment modalities and clinical decisions in patients with HNSCC at initial staging.
360° open-ended and navigated magnetic resonance–guided microwave ablation for hepatic tumors in risk areas
Authors: Cui Dan , Ding Min , Wang Zhi , Shi Yaoping , Wang Tao , Shi Donghua , Hu Hao , Chi Jiachang , Zhai Bo 
Published: February 2023

Context:
Image-guided local ablation has becoming a promising treatment option for patients unsuitable for surgical resection. Currently, magnetic resonance (MR) imaging has been used as guidance for ablation due to its good soft-tissue contrast, high image quality and absence of ionizing radiation. However, the limited operating space and interrupted and delayed imaging of the conventional MR equipment increased the difficulty of puncture during operation. Therefore, we utilized an easy-to-use optical navigation system with a 0.4 T 360° open MR system to perform MR-guided microwave ablation (MWA) to treat liver tumor patients in risk areas.

Aim:
To evaluate the safety and efficacy of MR-guided MWA in treating liver tumors using a 0.4 T open and navigated MR system.

Materials and Methods:
A retrospective analysis was performed on 19 liver tumor patients who underwent MR-guided MWA between August 2014 and August 2017. The complications, complete ablation, and long-term outcomes were analyzed and evaluated.

Results:
It was found that navigated MRI guidance allowed for precise needle placement in the targeted tumor, and ablation was successfully performed in all patients without serious intraoperative complications and death. Additionally, complete ablation was reached at 94.74% (18/19), with only one patient discovered with residual tumor, and therefore received another MWA session within three months.

Conclusion:
360° open MR system combined with navigation systems conveniently enhanced the operation of MR-guided ablation, producing effective outcomes. Therefore, this option may be a safe and effective therapy for liver tumors in patients, especially for those situated in risk areas and those not visible to identify by ultrasound or computerized tomography.
Comparison of analgesic effect in celiac plexus neurolysis
Authors: Kong Fan-Lei , Bie Zhi-Xin , Li Bin , Guo Run-Qi , Xu Sheng , Li Xiao-Guang 
Published: February 2023

Context:
Currently, short-term recurrence of pain is the biggest clinical challenge of celiac plexus neurolysis for patients with refractory abdominal cancer pain.

Aim:
To evaluate the analgesic effect and safety of celiac plexus neurolysis using ethanol injection combined with iodine-125 (125I) radioactive seed implantation for refractory abdominal cancer pain.

Settings and Design:
The study was a randomized controlled trial.

Methods and Materials:
About 10 patients with severe refractory abdominal cancer pain were enrolled in this study. The patients were randomly divided into group A (ethanol injection combined with 125I radioactive seed implantation, n = 5) and group B (ethanol injection alone, n = 5). The primary end point was pain relief measured by means of numerical rating scale (NRS). And the secondary end point was mean administration of analgesic drugs and the safety of the procedure.

Statistical Analysis Used:
Repeated measures of analysis of variance were used for statistical analysis.

Results:
The NRS scores were significantly reduced by 24 h postprocedure in both groups (group A: P = 0.001 and group B: P = 0.001). Group A did not show significant recurrence based on NRS scores during the follow-up period. In contrast, the NRS scores recurred significantly in group B by 1 month postprocedure (P = 0.026). The intake of analgesic drugs was significantly reduced in both the groups postprocedure (group A: P = 0.013 and group B: P = 0.013). Overall, it was significantly lower in group A than in group B (P = 0.041). No treatment-related deaths or major complications were observed.

Conclusions:
Celiac plexus neurolysis using ethanol injection in combination with 125I radioactive seed implantation has a longer analgesic duration than using ethanol injection alone. It could be a safe and long-lasting analgesic approach for managing refractory abdominal cancer pain.
Delayed biopsy following completion of transarterial chemoembolization in patients with hepatocellular carcinoma
Authors: Zhi Weihua , Hou Jie , Fan Shupeng , Han Yue 
Published: February 2023

Background:
Hepatocellular carcinoma (HCC) is one of the most common malignant cancers worldwide. Less than 30% of patients are suitable candidates for surgery. Transarterial chemoembolization (TACE) is considered as a first-line treatment for patients with unresectable advanced liver cancer. In the routine diagnosis and treatment pathway for unresectable HCC, a biopsy is usually performed firstly, followed by hepatic artery angiography and TACE. However, hepatic artery angiography data reveals that the risk of arteriovenous shunt (AVS) is significantly increased following biopsy, which negatively affects the outcomes of TACE.

Aim:
To investigate the feasibility of delayed biopsy following TACE in patients with HCC.

Methods:
Data from 112 patients with a definitive diagnosis of HCC were retrospectively analyzed. Patients who underwent biopsy immediately after TACE formed the experimental group (n = 55) and those who underwent biopsy before TACE formed the control group (n = 57). Positive pathological diagnosis rate, incidence of AVS, and rates of TACE-related complications were compared between the two groups. In addition, factors affecting the occurrence of AVS were assessed.

Results:
There was no significant difference in positive pathological diagnosis rate between the experimental and control groups (81.8% vs. 77.2%, respectively; P = 0.545). The incidence of AVS in the experimental group was lower than that in the control group (3.6% vs. 22.8%, respectively; P = 0.003), and embolization results were better in the experimental group. There was no difference in the incidence of TACE-related complications between the two groups. Late tumor stage (P = 0.04) and pre-TACE biopsy puncture (P = 0.003) are associated with the occurrence of AVS.

Conclusion:
In patients with HCC, delayed biopsy following completion of TACE did not affect pathological diagnosis results and yielded better embolization outcomes. Therefore, delayed biopsy following completion of TACE in patients with HCC is worth popularizing for clinical use. However, with the development of precision medicine, the diagnosis and treatment of tumor will certainly advance to the molecular level, whether the ischemic and oxygen-deficient tumor microenvironment caused by TACE treatment will have an impact on tumor tissue at molecular level remains unknown.
An In Vitro Study to Determine the Physicochemical, Mechanical, and Antibacterial Properties of a Novel Spirulina Containing Controlled Release Intrapocket Drug Delivery System
Authors: Mishra Supriya , Johnson Lynn , Sangha Kuldip Singh , Gupta Vineeta , Agarwal Sangita , Rajput Shikha 
Published: February 2023

Context:
Periodontitis is primarily an inflammatory condition caused by an array of microorganisms present in dental plaque. Elimination or adequate suppression of periodontal pathogens in the subgingival microflora is essential for adequate periodontal healing to take place. The development of subgingivally placed controlled delivery systems has provided the possibility of effective intrapocket concentration levels of antibacterial agents for an extended period of time, resulting in an altered subgingival flora and enhanced healing of the attachment apparatus. Although a number of synthetic antimicrobial agents are being used as local drug delivery, currently, pharmaceutical technology development has focused on the ingredients derived from nature. Natural phytochemicals have proven to be worthy substitutes of their synthetic and chemical-laden counterparts owing to their extensive natural activity, advanced safety margins, and inferior costs so that they can be of huge benefits, especially to the lower socioeconomic population around the world and spirulina platensis (SP) is one such emerging remedy.

Aims:
The aim of the study was to develop three controlled release drug delivery systems containing different concentrations of SP to be used inside the periodontal pockets. The study also aimed to determine the antimicrobial activity of all the three concentrations of SP drug delivery system against major periodontopathic microorganisms and to test the physicochemical properties of the delivery system that exhibited maximum antimicrobial efficacy so that the suitability of its use inside the periodontal pocket could be determined.

Settings and Design:
The study was an in vitro experimental design.

Subjects and Methods:
Three different controlled release SP hydrogels (4%, 6%, and 12%) to be used inside the periodontal pockets were developed and antibacterial properties against periodontal pathogens were assessed. The hydrogel exhibiting maximum antimicrobial efficacy was then tested of physicochemical and mechanical properties to determine its suitability of its use inside the periodontal pocket.

Statistical Analysis Used:
Data were analyzed using one-way analysis of variance. Post hoc Tukey honestly significant difference test was used for comparison within the group and between the different groups.

Results:
12% SP hydrogel was found to have maximum antimicrobial efficacy against major periodontal pathogens, and its physicochemical and mechanical properties were also optimum to be used inside the periodontal pocket.

Conclusions:
12% SP hydrogel can act as a promising adjunct to periodontal mechanical therapy and may also reduce the chances of more invasive periodontal surgical procedures.
Drug Information Services in Low-Resource Setting
Authors: Patil Amol N. , Kumar M. Praveen , Yadav Rohitash , Kosey Sourabh , Behl Tapan , Kumaravel J. 
Published: February 2023

Objective:
The objective of this study was to assess the pharmacy professionals’ understanding and viewpoints on drug information center (DIC) services and differences, if any, with pharmacologist's survey conducted earlier.

Materials and Methods:
An electronic cross-sectional knowledge, practice, and attitude survey was carried out. A questionnaire in the form of the hyperlink was sent to pharmacy professionals through e-mail, Facebook messenger, and WhatsApp. Factors linked to pharmacy professionals’ vision in expanding countrywide DIC services were studied with logistic regression in R.

Results:
A total of 125 pharmacy professionals responded. The participant believing in the published literature as a standard reference for establishing and running the DIC services; participants identifying more challenges in the day-to-day DIC functioning; and participants believing in the ability of DIC in reducing morbidity, mortality, and cost of care had 4.76 (95% confidence interval [CI] = 0.97–6.44), 4.24 (95% CI = 0.97–6.44), and 2.43 (95% CI = 0.97–6.44) times association with good knowledge score. Good attitude scores were discovered of participants working in fully and partially functional DIC (odds ratio [OR] = 9.66, CI = 0.97–6.44 and OR = 9.49, CI = 0.97–6.44) to participants not involved in DIC duties. The participant who understood DIC services’ real purpose had 2.83 (95% CI = 0.97–6.44) times association with good practice scores. Overall, pharmacy professionals carried better attitude scores, but lesser knowledge, and practice scores than pharmacology professionals.

Conclusion:
Lower knowledge and practice score of pharmacy professionals asks for training in critical appraisal of published literature and due modifications in graduate and postgraduate curricula. A collaborative approach between pharmacists and pharmacologists is needed to improve the quality of drug information services and evidence-based medicine practice in low-resource countries like India.