bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of A Fluoride Toothpaste Containing Enzymes and Salivary Proteins on Periodontal Pathogens in Subjects with Black Stain: A Pilot Study
Authors: Carelli Maria , Zatochna Iuliia , Sandri Angela , Burlacchini Gloria , Rosa Angelica , Baccini Francesca , Signoretto Caterina 
Published: March 2023

Abstract
Objective Black stain (BS) is an extrinsic dental discoloration particularly difficult to treat. Although its etiology is not fully clear yet, chromogenic bacteria inside the oral cavity seem to be involved. In this pilot study, we evaluated whether a toothpaste containing enzymes and salivary proteins could improve oral health and reduce the presence of periodontal pathogens in subjects predisposed to BS discoloration.
Materials and Methods Twenty-six subjects were enrolled in the study: 10 subjects without BS; 16 subjects with BS, randomly assigned in two groups: test (n = 8) and control (n = 8). The test group used a toothpaste containing sodium fluoride, enzymes, and salivary proteins. The control group used a toothpaste with amine fluoride. At enrollment and after 14 weeks, participants were subjected to professional oral hygiene, evaluation of BS (through Shourie index) and oral health status, collection of saliva and dental plaque samples. The presence of periodontal pathogens in plaque and saliva of all subjects was investigated by molecular analysis (PCR).
Statistical Analysis The prevalence of investigated microbial species in patients with/without BS was performed by Chi-squared test. The variation in the prevalence of the investigated species after treatment in test and control group was analyzed by t-test.
Results Clinical evaluation showed that 86% of participants with BS had a reduction in the Shourie index, independently from the toothpaste used. In particular, a greater reduction in the Shourie index was observed in subjects using an electric toothbrush. We did not observe an effect of the fluoride toothpaste containing enzymes and salivary proteins on the composition of the oral microbiota of the test subjects in comparison with controls. When comparing all subjects with BS (n = 16) and without BS (n = 10), P. gingivalis detection was significantly higher in saliva samples collected from subjects with BS (p = 0.0129).
Conclusion We verified that the use of an enzyme-containing toothpaste alone is not sufficient to prevent the formation of BS dental pigmentation in subjects predisposed to this discoloration. Mechanical cleaning, especially using electrical toothbrushes, seems to be useful to counteract BS formation. Moreover, our results suggest a possible association between BS and the presence of P. gingivalis at the salivary level.
Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
Authors: Kumar Rahul , Mishra Arpan , Damde Harikrishna , Yadav Prasant , Yadav Sanjay Kumar 
Published: March 2023

Abstract
Introduction This study analyzes barriers to the adoption of emergency laparoscopy (EL), safety, and accessibility in a low-resource setting of a low- and middle-income country (LMIC).
Methods In this prospective observational study, patients with blunt trauma abdomen (BTA) who required exploration were included and divided into two groups—open exploration (open surgery [OSx]) and laparoscopic exploration (laparoscopic surgery [LSx]). Data were compiled and analyzed.
Results Out of 94 BTA patients, 66 required exploration, and the rest were managed conservatively. Out of 66 patients, 42 were in OSx and 24 were in LSx, reason for not selecting LSx was the surgeon's preference for OSx in 26 patients and the lack of availability of operation theater (OT) slots in 16 patients. LSx even after indication was less likely if patients had preoperative evidence of perforation peritonitis.
Conclusion Lack of resources (OT availability and trained personnel) are barriers to the adoption of emergency LSx in low-resource settings.
Single- and Bicolumn Limited Intercarpal Fusion: A Solution for the SLAC or SNAC Wrist
Authors: Solgård Lars , Gvozdenovic Robert 
Published: March 2023

Abstract
Background Single- or bicolumn limited intercarpal fusion, also called one- or two-column fusion, has been introduced as an alternative to four-corner fusion. The rationale behind this is obtaining less need for bone grafting and consequently improving the chances of the union.
Method From August 2014 to October 2020, 45 consecutive patients (15 women), with a mean age of 58.4 years (range: 35–79), have been treated for scapholunate advanced collapse or scaphoid nonunion advanced collapse wrist. In 33 cases, the surgery was performed as two-column fusion, and in 12 cases as one-column fusion. The union was determined by a computed tomography (CT) scan or X-ray follow-up studies. The pain assessments (visual analog score: 0–100), range of motion (ROM), grip strength, and Quick Disabilities of the Arm, Shoulder, and Hand score were prospectively included.
Results Of 45 patients, 43 were available for the follow-up, at a mean of 35 months (range: 12–68). All patients but two achieved union at a mean of 9.5 weeks (range: 5–25 weeks). Pain diminished from 60.3 (mean) preoperatively to 16.7 (mean) postoperatively (p = 0.0001). Grip strength slightly increased from 28.2 KgF (mean) to 29 KgF (mean) (not significantly, p = 0.86). Quick Disability of the Arm, Shoulder, and Hand score improved from 39.5 (median) before the surgery to 11 (median) after the surgery (p = 0.0004). The postoperative ROM of 62/37 degrees (mean) were recorded for total dorsovolar/radioulnar flexions, respectively. Three patients were converted to total wrist fusion and one to total wrist arthroplasty. One had a rearthrodesis to two-column fusion, which united.
Conclusion One- and two-column fusion showed significant improvement in pain and function, with minimal impairment of the grip strength on the short- to mid-term follow-up. A union rate of 95% and an acceptable complication rate were achieved, without fusing all carpals.
Level of Evidence Prospective, cohort study, level III.
An Unusual Case of Xanthoma of Bilateral Achilles Tendon with Gouty Infiltration: A Rare Case Report
Authors: Khatoon Heena M. , Srirambhatla Annapurna , Sharma Abhimanyu , Sankepally Poojitha , Arora Abhishek J. 
Published: March 2023

AbstractAchilles tendon xanthoma is a benign and rare disease with a high incidence in patients having familial hypercholesterolemia. Patients present with or without pain and thickened tendons. Gout is seen in patients with hyperuricemia. Coexistence of xanthoma and gout is extremely rare. We searched the PubMed literature with ‘Xanthoma’ and ‘Gout’ as keywords and could find only one case report. Imaging modalities such as radiography and ultrasonography, play a vital role in diagnosing this condition early, hence helping the patient to commence the use of potentially lifesaving lipid-lowering therapeutic agents. Magnetic resonance imaging is helpful in delineating the morphological changes, exact measurements, and eventually in treatment planning. It helps to rule out early involvement of other tendons by the same pathology. We present a case of a 25-year-old male patient who presented to our institute with bilateral large symmetrical swelling in the posterior aspects of ankles for 4 years, with normal serum and blood parameters. Bilaterality, enormous size and normal blood and serum parameters make this case unique.
Fetal Epicardial Fat Thickness: Its Role as Marker for Gestational Diabetic Mellitus
Authors: Singh Amandeep , Josan Amitojveer S. , Gupta Kamlesh , Pahwa Sangeeta 
Published: March 2023

AbstractBackground There are very few studies on the association between fetal epicardial fat thickness (EFT) and gestational diabetes mellitus (GDM).Aims To evaluate the role of fetal epicardial fat thickness as a marker and use it in pregnancies to screen for GDM.Settings and Design A cross-sectional analytical study was conducted in the Department of Radiodiagnosis and Imaging at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, after the due clearance from the institutional research and ethics committee.Materials and Methods The study included pregnant patients at 24 + 0/6 to 28 + 0/6 weeks of gestation scheduled for a 75 g oral glucose tolerance test from December 1, 2020 to March 30, 2022. Antenatal ultrasound was performed on Voluson E8 Expert BT12 (Wipro GE) ultrasound machine. Out of 180 patients, 60 patients were selected, that is, 30 patients with raised 75 g OGTT results (cases of GDM) and 30 patients with normal 75 g OGTT results.Statistical Analysis The collected data were transformed into variables, coded, and entered into Microsoft Excel. Data were analyzed using the Shapiro–Wilk normality test, student's t-test or Mann–Whiney U test, chi-square test, or Fisher's exact test and statistically evaluated using the SPSS-PC-25 version.Results Fetal EFT was found to be significantly more in the GDM group in comparison to controls without GDM, and the increased fetal EFT was positively associated with 2-hour OGTT serum glucose values.The mean fetal epicardial fat thickness (EFT) in mothers with GDM was significantly larger, i.e., 0.17 ± 0.02 cm than in mothers without GDM, i.e., 0.12 ± 0.01 cm (p < 0.001). The receiver operating characteristic (ROC) curve plotted from values calculated from our results shows high sensitivity (i.e., 96.67%) and specificity (i.e., 90%) of fetal EFT as a predictor for GDM with an AUROC value of 0.96 and 95% confidence interval of 0.92 to 1.0.Conclusions EFT was significantly higher in fetuses of diabetic versus nondiabetic mothers. The mean difference in EFT of GDM cases and controls was relatively small but was statistically significant. The study concluded that measuring the epicardial fat thickness in fetuses can serve as a novel marker in GDM.
Thyroxine Replacement Therapy during Ramadan Fasting: Physicians' and Patients' Perceptions and Practices
Authors: Beshyah Salem A. , Khalil Aly B. , Beshyah Anas S. , Benbarka Mahmoud M. , Sherif Ibrahim H. 
Published: March 2023

Abstract
Objective Thyroxine (T4) therapy is taken on an empty stomach and no food is taken for a short period. During Ramadan fasting (RF), Muslim patients may face difficulties taking levothyroxine as recommended.
Materials and Methods We performed a mixed methods study of an online survey of 218 physicians to explore their perceptions and practices. Also, we interviewed a sample of 172 hypothyroid patients to establish their practices and source of information. Their median age was 46 (17–90) years; they had hypothyroidism for a median of 5 years and took a median thyroxine dose of 100 µg daily. Furthermore, we attempted to explore the effects of RF on available thyroid function tests.
Results Consultants were 58.4%, and the most represented specialty was endocrinology, 46.1%. Regarding the impact of RF on T4 therapy, 52.3% thought the RF was not clinically relevant in most patients on T4 replacement. However, 27.5% thought RF affects T4 replacement therapy in a clinically relevant manner. About 77.1% of respondents reported giving advice routinely to all patients on T4 replacement during RF. One hundred sixty-four respondents were split between recommending taking the medications with Iftar, Suhour, or other times. Most respondents (73.9%) do not repeat measurements of thyroid hormone levels after Ramadan unless needed during their scheduled clinic visit. On the other hand, 50.3% of the patients confirmed that their physician advised them to take their thyroxine during Ramadan, whereas 40.4% could not recall receiving any advice. About 59.9% of the patients took thyroxine with Iftar, 23.8% with Suhour, and 16.3% at different times. In those patients where thyroid function tests were available before and after RF, serum thyroid-stimulating hormone and serum-free T4 did not show a specific pattern in the group as a whole and with subgroups.
Conclusion There is variation in the advice that hypothyroid patients receive on taking thyroxine during Ramadan and in their practices. Further studies are needed to determine the best timing for thyroxine replacement.
Bronchial Artery Embolization in Management of Hemoptysis in a Developing Country: An Initial Experience
Authors: Garg Puneet , Khandelwal Ayush , Bhardwaj Krishna , Ish Pranav , Khurana Rajat , Malik Amita 
Published: March 2023

Abstract
Objectives This article evaluates the immediate success, recurrence rate, complications, and the culprit vessel of bronchial artery embolization (BAE) in patients presenting with hemoptysis.
Materials and Methods All patients who underwent BAE from July 1, 2018 to August 31, 2021 were included. BAE was done for moderate to severe hemoptysis or for mild hemoptysis which was recurrent and not controlled by medical management. Patients referred for surgical intervention and hemoptysis controlled on medical management were excluded.
Results One hundred and thirty patients underwent BAE in the study period. Mean age was 41.5 years and majority (73.1%) was male. Forty-three (33.1%) patients had mild, 46 (35.4%) had moderate, and 41 (31.5%) with the duration of symptoms ranging from 3 days to 25 years. Most common culprit vessel was posterior intercostal artery closely followed by the intercostobronchial artery. Hypervascularity was the most common angiographic abnormality encountered. On an average, 2.75 vessels were embolized per BAE with a wide range of 1 to 8 vessels. Hemoptysis control was seen in 96.1% patients immediately, 90.7 % at 1 month, 82.3 % at 3 months, and 66.9 % at 6 months. Overall recurrence was seen in 43 patients (33.1%). Chest pain was the most common minor side effect occurring in 77.1% cases.
Conclusion BAE is a safe and effective procedure that can be performed routinely in patients presenting with moderate to massive hemoptysis or with mild hemoptysis refractory to medical management.
Expanding the Spectrum of NUBPL-Related Leukodystrophy
Authors: van der Knaap Marjo S. , Fumagalli Francesca , Tonduti Davide , Zambon Alberto A. , Ghezzi Daniele , Lamantea Eleonora , Izzo Rossella , Parazzini Cecilia , Baldoli Cristina 
Published: March 2023

AbstractMitochondrial leukodystrophies constitute a group of different conditions presenting with a wide range of clinical presentation but with some shared neuroradiological features. Genetic defects in NUBPL have been recognized as cause of a pediatric onset mitochondrial leukodystrophy characterized by onset at the end of the first year of life with motor delay or regression and cerebellar signs, followed by progressive spasticity. Early magnetic resonance imagings (MRIs) show white matter abnormalities with predominant involvement of frontoparietal regions and corpus callosum. A striking cerebellar involvement is usually observed. Later MRIs show spontaneous improvement of white matter abnormalities but worsening of the cerebellar involvement evolving to global atrophy and progressive involvement of brainstem. After the 7 cases initially described, 11 more subjects were reported. Some of them were similar to patients from the original series while few others broadened the phenotypic spectrum. We performed a literature review and report on a new patient who further expand the spectrum of NUBPL-related leukodystrophy. With our study we confirm that the association of cerebral white matter and cerebellar cortex abnormalities is a feature commonly observed in early stages of the disease but beside the original and so far prevalent presentation, there are also uncommon phenotypes: clinical onset can be earlier and more severe than previously thought and signs of extraneurological involvement can be observed. Brain white matter can be diffusely abnormal without anteroposterior gradient, can progressively worsen, and cystic degeneration can be present. Thalami can be involved. Basal ganglia can also become involved during disease evolution.
A Case of Giant Cutaneous Lopez Type III Meningioma of the Scalp
Authors: Cheng Man Fung , Cheung Ling Kit , Dodoo Ernest Addy , Po Yin Chung 
Published: March 2023

AbstractMeningiomas are the most common central nervous system (CNS) tumors. Extracranial meningiomas are rare, constituting 2% of all meningiomas. We describe a case of Lopez type III meningioma of the scalp in a 72-year-old gentleman who had a long-standing giant scalp mass and presented with recent mild left-sided limb weakness and numbness. Magnetic resonance imaging (MRI) of the skull demonstrated a right frontoparietal tumor extending through the skull into the scalp. Tumor excision revealed World Health Organization (WHO) grade 1 meningioma. Clinicians should correlate a cutaneous skull mass and new onset of neurological symptoms. Cutaneous meningioma is an important differential diagnosis.
A Nod for Meckel: A Novel Surgical Position Utilizing Meckel's Cave Anatomy for Percutaneous Glycerol Rhizotomy in Trigeminal Neuralgia
Authors: Piper Keaton Francis , Flores-Milan Gabriel , Cruz Alejandro Matos , Kumar Jay I. , Loveren Harry van 
Published: March 2023

Abstract
Objective We aim to describe a novel positioning technique using a specific surgical table to achieve the optimal angle during percutaneous glycerol rhizotomy (PGR) for trigeminal neuralgia (TN).
Design This is a descriptive and photographic analysis of successful cases for future implementation.
Setting This study was conducted at a single-institution, academic center.
Participants The participants were adult patients with TN who underwent PGR and provided consent for publication.
Main Outcome Measures Primary outcomes of this study were TN symptomatic relief and surgical complications.
Results The use of a beach chair sliding headboard surgical table for PGR is plausible and ensures precise and immobile head flexion for 1 hour postglycerol injection. There were no intraoperative or postoperative complications. All patients achieved successful reduction of TN symptoms.
Conclusions Utilizing this new method of intraoperative navigation with a unique surgical table in the upright position, surgeons may achieve precise head adjustments post-PGR. Head flexion has been postulated as a means of ensuring glycerol containment in Meckel's cave. This method can help standardize this procedure for future systematic studies on the importance of head positioning post-PGR.
The role of public versus private social safety nets in mitigating the impact of shocks in rural Pakistan
Authors: Naveed Samina , Malik Ayesha Imran , Adil Iftikhar Hussain 
Published: March 2023

AbstractThis study compares the protective effectiveness of Social Safety Nets (SSNs) provided by government and NGOs in rural Pakistan, using quasi-experimental methodology on PRPHS (2011–12) data. The treatment group was the households receiving SSNs assistance. The counterfactual (control group) was determined using propensity score matching. Outcome indicators were shock-coping strategies from which households are theoretically protected from by SSNs: reducing food consumption, switching to cheaper food, and distress asset sales. The impact of both types of SSNs was calculated by average treatment effect on the treatment group. The results showed insignificantly lesser treatment units used shock-coping strategies than the matched control unit, implying that receiving either type of SSN did not protect the household from resorting to coping strategies. However, households with public SSNs tended not to resort to switching to cheaper food as a coping strategy. This suggests that public SSNs have more protective effectiveness than private SSNs. JEL classification H31, H53, H55, H76.
Reformulating computational social science with citizen social science: the case of a community-based mental health care research
Authors: Bonhoure Isabelle , Cigarini Anna , Vicens Julián , Mitats Bàrbara , Perelló Josep 
Published: March 2023

AbstractComputational social science is being scrutinised and some concerns have been expressed with regards to the lack of transparency and inclusivity in some of the researches. However, how computational social science can be reformulated to adopt participatory and inclusive practices? And, furthermore, which aspects shall be carefully considered to make possible this reformulation? We present a practical case that addresses the challenge of collectively studying social interactions within community-based mental health care. This study is done by revisiting and revising social science methods such as social dilemmas and game theory and by incorporating the use of digital interfaces to run experiments in-the-field. The research can be framed within the emergent citizen social science or social citizen science where shared practices are still lacking. We have identified five key steps of the research process to be considered to introduce participatory and inclusive practices: research framing, research design, experimental spaces, data sources, and actionable knowledge. Social dilemmas and game theory methods and protocols need to be reconsidered as an experiential activity that enables participants to self-reflect. Co-design dynamics and the building of a working group outside the academia are important to initiate socially robust knowledge co-production. Research results should support evidence-based policies and collective actions put forward by the civil society. The inclusion of underserved groups is discussed as a way forward to new avenues of computational social science jointly with intricate ethical aspects. Finally, the paper also provides some reflections to explore the particularities of a further enhancement of social dimensions in citizen science.
Leverage zones in Responsible AI: towards a systems thinking conceptualization
Authors: Nabavi Ehsan , Browne Chris 
Published: March 2023

AbstractThere is a growing debate amongst academics and practitioners on whether interventions made, thus far, towards Responsible AI have been enough to engage with the root causes of AI problems. Failure to effect meaningful changes in this system could see these initiatives not reach their potential and lead to the concept becoming another buzzword for companies to use in their marketing campaigns. Systems thinking is often touted as a methodology to manage and effect change; however, there is little practical advice available for decision-makers to include systems thinking insights to work towards Responsible AI. Using the notion of ‘leverage zones’ adapted from the systems thinking literature, we suggest a novel approach to plan for and experiment with potential initiatives and interventions. This paper presents a conceptual framework called the Five Ps to help practitioners construct and identify holistic interventions that may work towards Responsible AI, from lower-order interventions such as short-term fixes, tweaking algorithms and updating parameters, through to higher-order interventions such as redefining the system’s foundational structures that govern those parameters, or challenging the underlying purpose upon which those structures are built and developed in the first place. Finally, we reflect on the framework as a scaffold for transdisciplinary question-asking to improve outcomes towards Responsible AI.