bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective, Randomized Comparison of the Classical Altemir’s Method With the Newer Seldinger’s Technique of Submental Intubation
Authors: S P S Aswin Ram , Bhatia Nidhi , Jain Kajal , Gupta Tarush , Hazarika Amarjyoti 
Published: April 2023

BACKGROUND:
Submental intubation performed using the classical Altemir’s technique is a well-accepted, safe technique for providing optimal operating field to the maxillofacial surgeon, in cases where either nasotracheal or orotracheal intubation is impossible. We propose a new, percutaneous Seldinger’s technique of submental intubation as an interesting alternative to the classical Altemir’s technique, wherein a percutaneous dilatational tracheostomy kit is used to dilate the submental tract, instead of bluntly dissecting it. We hypothesized that Seldinger’s technique would be associated with reduced procedure time and minimal scar formation in patients with maxillofacial fractures.

METHODS:
We enrolled 60 patients scheduled to undergo maxillofacial injury fixation under general anesthesia. After consent, the cohort was randomly allocated to undergo submental intubation by either the classical Altemir’s technique or Seldinger’s technique. As our primary objective, we noted the time taken to complete the procedure of submental intubation. Our secondary objectives were the components of primary outcome, such as disconnection/apnea time, bleeding, and technical difficulties during the procedure. We also observed for complications such as presence of salivary fistula/infection at hospital discharge and scar characteristics at 1- and 3-month follow-up.

RESULTS:
The median time for performing submental intubation in the Seldinger group was significantly lower than that in the Altemir group (170.5 [136.5–256.0] seconds vs 220.0 [205.5–289.0] seconds; P value, .040). The median disconnection time was also significantly lower in the Seldinger group (12.0 [10.8–20.0] seconds vs 19.0 [15.0–23.0] seconds; P value, .036). Furthermore, significant bleeding was absent in nearly 53.8% of the study participants in the Seldinger group as compared to 25.9% in the Altemir group. At follow-up, there was no evidence of differences in scar characteristics between the 2 groups.

CONCLUSIONS:
Seldinger’s technique is associated with shorter procedure time and reduced apnea time due to easier and better tract formation, thus minimizing the effort required to exteriorize the endotracheal tube. Furthermore, as dilation reduces tissue damage, Seldinger’s technique is associated with significantly less procedural bleeding. Thus, Seldinger’s technique can be safe, easy, and faster to perform compared with the classical Altemir’s technique of submental intubation in patients with maxillofacial trauma.
Prediction of Acute Myocardial Injury in Noncardiac Surgery in Patients at Risk for Major Adverse Cardiovascular and Cerebrovascular Events: A Multivariable Risk Model
Authors: Mases Anna , Beltrán de Heredia Sandra , Gallart Lluís , Román Lorena , Bosch Laia , Núñez Maria , Rueda Mireia , Recasens Lluís , Sabaté Sergi 
Published: April 2023

BACKGROUND:
The best use of perioperative cardiac biomarkers assessment is still under discussion. Massive postoperative troponin surveillance can result in untenably high workloads and costs for health care systems and potentially harmful interventions for patients. In a cohort of patients at risk for major adverse cardiovascular and cerebrovascular events (MACCEs), we aimed to (1) determine whether preoperative biomarkers can identify patients at major risk for acute myocardial injury in noncardiac surgery, (2) develop a risk model for acute myocardial injury prediction, and (3) propose an algorithm to optimize postoperative troponin surveillance.

METHODS:
Prospective, single-center cohort study enrolling consecutive adult patients (≥45 years) at risk for MACCE scheduled for intermediate-to-high-risk noncardiac surgery. Baseline high-sensitivity troponin T (hsTnT) and N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP), as well as hsTnT on the first 3 postoperative days were obtained. The main outcome was the occurrence of acute myocardial injury. Candidate predictors of acute myocardial injury were baseline concentrations of hsTnT ≥14 ng/L and NT-proBNP ≥300 pg/mL and preoperative and intraoperative variables. A multivariable risk model and a decision curve were constructed.

RESULTS:
Of 732 patients, 42.1% had elevated hsTnT and 37.3% had elevated NT-proBNP levels at baseline. Acute myocardial injury occurred in 161 patients (22%). Elevated baseline hsTnT, found in 84% of patients with acute myocardial injury, was strongly associated with this outcome: odds ratio (OR), 12.08 (95% confidence interval [CI], 7.78–19.42). Logistic regression identified 6 other independent predictors for acute myocardial injury: age, sex, estimated glomerular filtration rate (eGFR) <45 mL·min−1·1.73 m−2, functional capacity <4 METs or unknown, NT-proBNP ≥300 pg/mL, and estimated intraoperative blood loss. The c-statistic for the risk model was 77% (95% CI, 0.73–0.81). The net benefit of the model began at a risk threshold of 7%.

CONCLUSIONS:
Baseline determination of cardiac biomarkers in patients at risk for MACCE shortly before intermediate- or high-risk noncardiac surgery helps identify those with the highest risk for acute myocardial injury. A baseline hsTnT ≥14 ng/L indicates the need for postoperative troponin surveillance. In patients with baseline hsTnT <14 ng/L, our 6-predictor model will identify additional patients at risk for acute myocardial injury who may also benefit from postoperative surveillance.
Analytic Narratives in Political Economy
Authors: Skarbek David , Skarbek Emily 
Published: April 2023

Abstract
Analytic narratives combine rational choice theory—often extensive-form, game-theoretic models—and qualitative evidence to understand historical and institutional questions in political economy. This article begins by characterizing the features of analytic narratives that distinguish this method from others in economics and political science. Analytic narratives gained prominence in the 1990s as the result of several factors, including the development of game theory, a turn away from general equilibrium theorizing, and the increasing interest in institutions and economic history. Based on the initial responses and subsequent methodological debates, four criticisms of analytic narratives are discussed: those based on claims to originality, the value of rational choice theory, case studies and external validity, and the merits of qualitative evidence. As the article argues, differing disciplinary approaches and perspectives generated many of these criticisms. Nevertheless, from a methodological perspective, analytic narratives remain an effective and distinctive method for analyzing the political economy of institutions.
A Smithian Reading of Chilean Free Banking
Authors: Paganelli Maria Pia 
Published: April 2023

Abstract
In the second half of the nineteenth century, the Chilean free banking system worked similarly to how Adam Smith describes the eighteenth-century free banking system in Scotland. The characteristics of free banking that Smith identifies as conductive of successful outcomes—free entry, unlimited liability, and convertibility on demand—are present in both Scotland and Chile. And the Chilean system failed for similar reasons to the worries Smith had about the Scottish system: inconvertibility, legal tender, involvement with government borrowing, and lobbying. The Chilean experience of free banking appears to follow Smith's account of free banking.
Perturbing the muscle work loop paradigm to unravel the neuromechanics of unsteady locomotion
Authors: Sponberg Simon , Abbott Emily , Sawicki Gregory S. 
Published: April 2023

ABSTRACTMuscle function during movement is more than a simple, linear transformation of neural activity into force. The classic work loop technique has pioneered our understanding of muscle, but typically only characterizes function during unperturbed movement cycles, such as those experienced during steady walking, running, swimming and flying. Yet perturbations away from steady movement often place greater demands on muscle structure and function and offer a unique window into muscle's broader capacity. Recently, studies in diverse organisms from cockroaches to humans have started to grapple with muscle function in unsteady (perturbed, transient and fluctuating) conditions, but the vast range of possible parameters and the challenge of connecting in vitro to in vivo experiments are daunting. Here, we review and organize these studies into two broad approaches that extend the classic work loop paradigm. First, in the top-down approach, researchers record length and activation patterns of natural locomotion under perturbed conditions, replay these conditions in isolated muscle work loop experiments to reveal the mechanism by which muscle mediates a change in body dynamics and, finally, generalize across conditions and scale. Second, in the bottom-up approach, researchers start with an isolated muscle work loop and then add structural complexity, simulated loads and neural feedback to ultimately emulate the muscle's neuromechanical context during perturbed movement. In isolation, each of these approaches has several limitations, but new models and experimental methods coupled with the formal language of control theory give several avenues for synthesizing an understanding of muscle function under unsteady conditions.
A2TEA: Identifying trait-specific evolutionary adaptations
Authors: Stöcker Tyll , Uebermuth-Feldhaus Carolin , Boecker Florian , Schoof Heiko 
Published: April 2023

Background: Plants differ in their ability to cope with external stresses (e.g., drought tolerance). Genome duplications are an important mechanism to enable plant adaptation. This leads to characteristic footprints in the genome, such as protein family expansion. We explore genetic diversity and uncover evolutionary adaptation to stresses by exploiting genome comparisons between stress tolerant and sensitive species and RNA-Seq data sets from stress experiments. Expanded gene families that are stress-responsive based on differential expression analysis could hint at species or clade-specific adaptation, making these gene families exciting candidates for follow-up tolerance studies and crop improvement. Software: Integration of such cross-species omics data is a challenging task, requiring various steps of transformation and filtering. Ultimately, visualization is crucial for quality control and interpretation. To address this, we developed A2TEA: Automated Assessment of Trait-specific Evolutionary Adaptations, a Snakemake workflow for detecting adaptation footprints in silico. It functions as a one-stop processing pipeline, integrating protein family, phylogeny, expression, and protein function analyses. The pipeline is accompanied by an R Shiny web application that allows exploring, highlighting, and exporting the results interactively. This allows the user to formulate hypotheses regarding the genomic adaptations of one or a subset of the investigated species to a given stress. Conclusions: While our research focus is on crops, the pipeline is entirely independent of the underlying species and can be used with any set of species. We demonstrate pipeline efficiency on real-world datasets and discuss the implementation and limits of our analysis workflow as well as planned extensions to its current state. The A2TEA workflow and web application are publicly available at: https://github.com/tgstoecker/A2TEA.Workflow and https://github.com/tgstoecker/A2TEA.WebApp, respectively.
Sugar content and erosive potential of commonly prescribed Orodispersible tablets- An in vitro study.
Authors: Anand Lahari , Pentapati Kalyana , Shenoy Revathi , Yelleti Geethika , Kumar Saurabh 
Published: April 2023

Background: Dental caries is a major non-communicable disease of public health concern caused due to freely available dietary sugars. We aimed to compare the sugar content and erosive potential with duration of use and drug classes of orodispersible tablets (ODTs). Methods: We conducted an in vitro evaluation of the total sugar content (TSC), Potential of Hydrogen (pH), solubility, and Titratable Acidity (TA) of commonly prescribed 62 ODTs. TA was measured by titrating the samples with known amount of. 0.1N sodium hydroxide (NaOH) with phenolphthalein indicator and pH was determined by digital pH meter. TSC was evaluated by phenol sulphuric acid. Solubility was assessed by filtration. Results: Out of the 62 ODTs, majority were Antimicrobials (n=30). One-quarter of the ODTs (26%) had a mean pH below ≤5.5. No significant difference was seen in the mean pH with respect to different drug classes (p=0.082) and duration of use of ODTs. A significant difference was seen in the mean percentage solubility with respect to drug classes (p<0.001). Antimicrobials had the least percentage of solubility as compared to other drug classes. Antiemetics and proton pump inhibitors (24.33 ± 17.34) had significantly higher mean percentage sugar content than Antimicrobials (23.25 ± 17.16). No significant difference was seen in the mean TSC with respect to various drug classes (p=0.718) and between the duration of use of drugs (P=0.568) respectively. No significant difference was seen in the mean percentage TA with respect to drug class (p=0.123) and duration of use of drugs (p=0.424). Conclusion: Overall, we can conclude that one in four ODT formulations had a pH below 5.5 (critical pH). Only one ODT formulation did not have a sugar content. No difference was seen in the mean pH, sugar content, and TA with respect to duration of use of drugs and drug classes.
Assessment of the antibacterial effect of Barium Titanate nanoparticles against Staphylococcus epidermidis adhesion after addition to maxillofacial silicone
Authors: Kareem Yasir Mohammed , Hamad Thekra Ismael 
Published: April 2023

Background: Maxillofacial silicones are the most popular and acceptable material for making maxillofacial prostheses, but they are not perfect in every sense. To enhance their effectiveness, more improvements to their properties are required, such as their antimicrobial efficiency. This study assess the antibacterial effect of barium titanate nanoparticles in various percentages against staphylococcus epidermidis biofilm adhesion after addition to maxillofacial silicone. Methods: Barium titanate nanoparticles were added into VST-50 platinum silicone elastomer in four weight percentages (0.25wt%, 0.5wt%, 0.75wt% and 1wt%). 50 specimens were prepared and categorized into five groups; one control group and four experimental groups. All conducted data was statistically analyzed using (one-way ANOVA) analysis of variance, and Games-Howell multiple comparison test (significant level at p < 0.05). Shapiro-Wilk and Levene’s tests were used, respectively, to evaluate the normal distribution and homogeneity of the data. Result: One-way ANOVA test revealed a highly significant difference between all groups, and Games-Howell test revealed a highly significant difference between the control group and the four experimental groups. The 0.25wt% and 0.5wt% groups revealed a highly significant difference between them and with the (0.75%wt and 0.1%wt) groups. While the 0.75wt% group revealed a significant difference with 1wt% group. Conclusions: The addition of barium titanate to VST-50 maxillofacial silicone enhanced the antibacterial activity of silicon against Staphylococcus epidermidis, and this activity seems to be concentration dependent. FTIR analysis demonstrated no chemical interaction between the Barium Titanate and the VST-50 maxillofacial silicone elastomer. SEM pictures show that the barium titanate nanopowder was effectively dispersed inside the maxillofacial silicone matrix.
Remote consultations in orthodontics: factors to consider for success
Authors: Seager Leonie , Deeming Guy 
Published: April 2023

Remote consultations in orthodontics were quickly thrust to the forefront of the orthodontic profession during the COVID-19 pandemic of 2020. With the UK public now accepting telephone consultations and various video applications as a convenient and secure method of communication, it seems likely that, even after the ramifications of the COVID-19 pandemic have dissipated, increased use of remote consultations will continue to be seen as desirable. It is therefore important that orthodontists, and any other orthodontic staff who have been delegated the task of being involved in teleorthodontics ensure they are aware of the limitations as well as the benefits of teleorthodontics. They should also be able to demonstrate competence in how to effectively and appropriately carry out teleorthodontic appointments remotely with patients. CPD/Clinical Relevance: It is likely that patient expectations surrounding traditional face-to-face consultations will change as a result of the COVID-19 pandemic and the opportunity to investigate and explore new ways of working should be embraced. Working through the considerations that must be taken at each stage of the remote consultation as well as the use of appropriate checklists will ensure that the risk of human error is reduced, while undertaking remote consultations in orthodontics.
Double burden of malnutrition and associated factors among adolescent in Ethiopia: A systematic review and meta-analysis
Authors: Gezaw Aragaw , Melese Wolde , Getachew Bekalu , Belachew Tefera 
Published: April 2023

BackgroundAs adolescence is a transition period from childhood to adulthood malnutrition occurring at this age resonates through generations. Although there were many individual studies in Ethiopia about different form of malnutrition among adolescent, their results are inconclusive indicating the need for generating a pooled estimate of adolescent nutritional status and associated factors. This review and meta-analyses aimed at estimating the pooled prevalence of different forms of malnutrition and associated factors among adolescents in Ethiopia.Method and materialsWe searched data bases from Pub Med, Cochrane Library, Health Inter Network Access to Research Initiative (HINARI), Science Direct and search engines; Google and Google Scholar and other sources; Reference of References and expert contact which were used to select the studies. Joanna Briggs Institute (JBI) quality appraisal tool was applied to identify eligible studies. STATA/SE V.14 was used to analyze the data. Effect size with 95% Confidence Interval (CI) and heterogeneity were estimated. Heterogeneity of studies was quantified with I2statistic >50% used as an indicator of heterogeneity. Potential publication bias was assessed using Funnel plots and Egger’s regression test. Trim and fill analysis was also performed. The presences of a statistical association between independent and dependent variables were declared at P <0.05. The PROSPERO registration number for the review is CRD42020159734.ResultsThe pooled prevalence of overweight/obesity, stunting and thinness were 10.63% (95% CI: 8.86, 12.40), 20.06% (95% CI: 15.61, 24.51) and 21.68% (95% CI: 9.56, 33.81), respectively. Being female (OR: 2.02, CI: 1.22–3.34), low dietary diversity score (OR: 2.26 CI: 1.28–3.99) and high physical activity (OR: 0.36, 95%CI: 0.14–0.88) were significantly associated with adolescent overweight/obesity. Urban residence (OR: 0.82, 95%CI: 0.68–0.99), protected drinking water source (OR: 0.50, CI: 0.27–0.90) and having family size<5 people (OR: 0.54, CI: 0.44–0.66) were independent predictors of adolescent stunting. Early adolescent age (10–14 years) (OR: 2.38, CI: 1.70–3.34), protected water source for drinking (OR: 0.36, CI: 0.21–0.61), low wealth index (OR: 1.80, CI: 1.01–3.19) and family size <5 people (OR: 0.50, CI: 0.28–0.89) were significantly (P < 0.05) associated with adolescent thinness.ConclusionThe prevalence of overweight/obesity, stunting and thinness are high in Ethiopian adolescents indicating the upcoming challenge of double burden of malnutrition. The results imply the presence of double burden of malnutrition among adolescents which heralds the need for programmatic and policy response in terms of addressing modifiable risk factors including: dietary practices, physical activity, water source and economic status of these adolescents.
Use of machine learning to identify risk factors for insomnia
Authors: Huang Alexander A. , Huang Samuel Y. 
Published: April 2023

ImportanceSleep is critical to a person’s physical and mental health, but there are few studies systematically assessing risk factors for sleep disorders.ObjectiveThe objective of this study was to identify risk factors for a sleep disorder through machine-learning and assess this methodology.Design, setting, and participantsA retrospective, cross-sectional cohort study using the publicly available National Health and Nutrition Examination Survey (NHANES) was conducted in patients who completed the demographic, dietary, exercise, and mental health questionnaire and had laboratory and physical exam data.MethodsA physician diagnosis of insomnia was the outcome of this study. Univariate logistic models, with insomnia as the outcome, were used to identify covariates that were associated with insomnia. Covariates that had a p<0.0001 on univariate analysis were included within the final machine-learning model. The machine learning model XGBoost was used due to its prevalence within the literature as well as its increased predictive accuracy in healthcare prediction. Model covariates were ranked according to the cover statistic to identify risk factors for insomnia. Shapely Additive Explanations (SHAP) were utilized to visualize the relationship between these potential risk factors and insomnia.ResultsOf the 7,929 patients that met the inclusion criteria in this study, 4,055 (51% were female, 3,874 (49%) were male. The mean age was 49.2 (SD = 18.4), with 2,885 (36%) White patients, 2,144 (27%) Black patients, 1,639 (21%) Hispanic patients, and 1,261 (16%) patients of another race. The machine learning model had 64 out of a total of 684 features that were found to be significant on univariate analysis (P<0.0001 used). These were fitted into the XGBoost model and an AUROC = 0.87, Sensitivity = 0.77, Specificity = 0.77 were observed. The top four highest ranked features by cover, a measure of the percentage contribution of the covariate to the overall model prediction, were the Patient Health Questionnaire depression survey (PHQ-9) (Cover = 31.1%), age (Cover = 7.54%), physician recommendation of exercise (Cover = 3.86%), weight (Cover = 2.99%), and waist circumference (Cover = 2.70%).ConclusionMachine learning models can effectively predict risk for a sleep disorder using demographic, laboratory, physical exam, and lifestyle covariates and identify key risk factors.