bluuebunny/crossref_metadata_2025_split huggingface dataset:
Where are race-based oral health inequities bound? Protocol for a systematic review on interventions to tackle racial injustice in dental outcomes
Authors: Bastos João L. , Constante Helena M. , Schuch Helena S. , Haag Dandara G. , Nath Sonia , Celeste Roger K. , Guarnizo-Herreño Carol C. , McCallum Mary J. , Jamieson Lisa M. 
Published: March 2022

Abstract
Background
Only three literature reviews have assessed the impact of interventions on the reduction of racial inequities in general health to date; none has drawn from attempts at promoting racial oral health equity. This protocol aims to increase transparency and reduce the potential for bias of an ongoing systematic review conceived to answer the following questions: Are there any interventions to mitigate racial oral health inequities or improve the oral health of racially marginalized groups? If so, how successful have they been at promoting racial oral health equity? How do conclusions of previous reviews change by taking the findings of oral health interventions into account?

Methods
Reviewed studies must deploy interventions to reduce racial gaps or promote the oral health of groups oppressed along ancestral and/or cultural lines. We will analyze randomized clinical trials, natural experiments, pre-post studies, and observational investigations that emulate controlled experiments by assessing interactions between race and potentially health-enhancing interventions. Either clinically assessed or self-reported oral health outcomes will be considered by searching for original studies in MEDLINE, LILACS, PsycInfo, SciELO, Web of Science, Scopus, and Embase from their earliest records to March 2022. Upon examining abstracts of conference proceedings, trial registries, reports of related stakeholder organizations, as well as contacting researchers for unpublished data, we will identify studies in the grey literature. If possible, we will carry out a meta-analysis with subgroup and sensitivity analysis, including formal meta-regression, to address potential heterogeneity and inconsistency among selected studies.

Discussion
Conducting a systematic review of interventions to mitigate racial oral health inequities is crucial for determining which initiatives work best and under which conditions they succeed. Such knowledge will help consolidate an evidence base that may be used to inform policy and practice against persistent and pervasive racial inequities in general and oral health.

Systematic review registration
This protocol has been registered at the International Prospective Register of Systematic Reviews, under the identification number CRD42021261450.
Some new results and inequalities for subsequences of Nörlund logarithmic means of Walsh–Fourier series
Authors: Baramidze David , Persson Lars-Erik , Singh Harpal , Tephnadze George 
Published: March 2022

AbstractWe prove that there exists a martingale $f\in H_{p} $
f
∈

H
p

such that the subsequence $\{L_{2^{n}}f \}$
{

L

2
n

f
}
of Nörlund logarithmic means with respect to the Walsh system are not bounded from the martingale Hardy spaces $H_{p}$

H
p

to the space $weak-L_{p} $
w
e
a
k
−

L
p

for $0< p<1 $
0
<
p
<
1
. We also prove that for any $f\in L_{p}$
f
∈

L
p

, $p\geq 1 $
p
≥
1
, $L_{2^{n}}f$

L

2
n

f
converge to f at any Lebesgue point x. Moreover, some new related inequalities are derived.
Antimicrobial resistance (AMR) in COVID-19 patients: a systematic review and meta-analysis (November 2019–June 2021)
Authors: Kariyawasam Ruwandi M. , Julien Danielle A. , Jelinski Dana C. , Larose Samantha L. , Rennert-May Elissa , Conly John M. , Dingle Tanis C. , Chen Justin Z. , Tyrrell Gregory J. , Ronksley Paul E. , Barkema Herman W. 
Published: March 2022

Abstract
Background
Pneumonia from SARS-CoV-2 is difficult to distinguish from other viral and bacterial etiologies. Broad-spectrum antimicrobials are frequently prescribed to patients hospitalized with COVID-19 which potentially acts as a catalyst for the development of antimicrobial resistance (AMR).

Objectives
We conducted a systematic review and meta-analysis during the first 18 months of the pandemic to quantify the prevalence and types of resistant co-infecting organisms in patients with COVID-19 and explore differences across hospital and geographic settings.

Methods
We searched MEDLINE, Embase, Web of Science (BioSIS), and Scopus from November 1, 2019 to May 28, 2021 to identify relevant articles pertaining to resistant co-infections in patients with laboratory confirmed SARS-CoV-2. Patient- and study-level analyses were conducted. We calculated pooled prevalence estimates of co-infection with resistant bacterial or fungal organisms using random effects models. Stratified meta-analysis by hospital and geographic setting was also performed to elucidate any differences.

Results
Of 1331 articles identified, 38 met inclusion criteria. A total of 1959 unique isolates were identified with 29% (569) resistant organisms identified. Co-infection with resistant bacterial or fungal organisms ranged from 0.2 to 100% among included studies. Pooled prevalence of co-infection with resistant bacterial and fungal organisms was 24% (95% CI 8–40%; n = 25 studies: I2 = 99%) and 0.3% (95% CI 0.1–0.6%; n = 8 studies: I2 = 78%), respectively. Among multi-drug resistant organisms, methicillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and multi-drug resistant Candida auris were most commonly reported. Stratified analyses found higher proportions of AMR outside of Europe and in ICU settings, though these results were not statistically significant. Patient-level analysis demonstrated > 50% (n = 58) mortality, whereby all but 6 patients were infected with a resistant organism.

Conclusions
During the first 18 months of the pandemic, AMR prevalence was high in COVID-19 patients and varied by hospital and geography although there was substantial heterogeneity. Given the variation in patient populations within these studies, clinical settings, practice patterns, and definitions of AMR, further research is warranted to quantify AMR in COVID-19 patients to improve surveillance programs, infection prevention and control practices and antimicrobial stewardship programs globally.
Emergency caesarean section in a patient with pygomelia: a curious tale of a misidentified “tail”—a case report
Authors: Reena  , Singh Rahul , Vikram Ashutosh 
Published: March 2022

Abstract
Background
Polymelia or congenital duplication of the lower limb is a rare occurrence. This congenital duplication when occurring in the region of the buttocks is known as pygomelia. Its appearance can even mimic a human tail or pseudotail.

Case presentation
A 22-year-old primigravida posted for emergency caesarean section was found to have a tail-like structure attached to her lower back. Pre-operative imaging of that appendage to rule out spinal dysraphism was not done due to the need of emergency surgery and pregnant status of the patient. The patient received general anaesthesia for surgery, and in the follow-up, X-ray imaging was done which showed a hemipelvis and a femur bone in that appendage confirming the diagnosis of pygomelia.

Conclusions
In a rare occurrence of pygomelia, the exact nature can be identified by various imaging modalities. General anaesthesia was a safe choice in such a patient presenting for emergency caesarean section.
Parameter estimation and sensitivity analysis for a model of tumor–immune interaction in the presence of immunotherapy and chemotherapy
Authors: Elkaranshawy Hesham A. , Makhlouf Ahmed M. 
Published: March 2022

AbstractA mathematical model has been utilized to examine the interaction between tumor cells and immune cells. In this model, the immune cells include natural killer cells, circulating lymphocytes, CD8+T cells, CD4+T cells, and cytokines. The model not only represents the traditional role of CD4+T cells in activating CD8+T cells but also illustrates its role in killing the tumor via the secretion of cytokines. Besides, treatments with both chemotherapy and immunotherapy are considered. However, since this model was not fitted to experimental data before, parameter estimation is performed to fit the model with experimental data, first. The estimation is validated to verify the correctness of the model using the experimental data for the tumor growth. Second, numerical experiments are performed using a set of human data. Results show the mutual relations between tumor cells, and body immune cells in the absence and in the presence of therapy. Results also show that CD4+T cells could play a crucial role in immunotherapy. Third, sensitivity analysis is performed by calculating the normalized sensitivity coefficients to identify the relative influence of body parameters on the tumor cell population. The obtained results provide a tool to identify which parameters should be increased or decreased before treatment to get the optimal immune response.
Phase I Study of Safety, Tolerability, and Efficacy of Tebentafusp Using a Step-Up Dosing Regimen and Expansion in Patients With Metastatic Uveal Melanoma
Authors: Carvajal Richard D. , Nathan Paul , Sacco Joseph J. , Orloff Marlana , Hernandez-Aya Leonel F. , Yang Jessica , Luke Jason J. , Butler Marcus O. , Stanhope Sarah , Collins Laura , McAlpine Cheryl , Holland Chris , Abdullah Shaad E. , Sato Takami 
Published: March 2022

PURPOSEThis phase I study aimed to define the recommended phase II dose (RP2D) of tebentafusp, a first-in-class T-cell receptor/anti-CD3 bispecific protein, using a three-week step-up dosing regimen, and to assess its safety, pharmacokinetics, pharmacodynamics, and preliminary clinical activity in patients with metastatic uveal melanoma (mUM).METHODSIn this open-label, international, phase I/II study, HLA-A*02 or HLA-A*02:01+ patients with mUM received tebentafusp 20 μg once in week 1 and 30 μg once in week 2. Dose escalation (starting at 54 μg) began at week 3 in a standard 3 + 3 design to define RP2D. Expansion-phase patients were treated at the RP2D (20-30-68 μg). Blood and tumor samples were collected for pharmacokinetics/pharmacodynamics assessment, and treatment efficacy was evaluated for all patients with baseline efficacy data as of December 2017.RESULTSBetween March 2016 and December 2017, 42 eligible patients who failed a median of two previous treatments were enrolled: 19 in the dose escalation cohort and 23 in an initial dose expansion cohort. Of the dose levels investigated, 68 μg was identified as the RP2D. Most frequent treatment-emergent adverse events regardless of attribution were pyrexia (91%), rash (83%), pruritus (83%), nausea (74%), fatigue (71%), and chills (69%). Toxicity attenuated following the first three doses. The overall response rate was 11.9% (95% CI, 4.0 to 25.6). With a median follow-up of 32.4 months, median overall survival was 25.5 months (range, 0.89-31.1 months) and 1-year overall survival rate was 67%. Treatment was associated with increased tumor T-cell infiltration and transient increases in serum inflammatory mediators.CONCLUSIONUsing a step-up dosing regimen of tebentafusp allowed a 36% increase in the RP2D compared with weekly fixed dosing, with a manageable side-effect profile and a signal of efficacy in mUM.
Inhibin Inactivation in Female Mice Leads to Elevated FSH Levels, Ovarian Overstimulation, and Pregnancy Loss
Authors: Walton Kelly L , Goney Monica P , Peppas Zoe , Stringer Jessica M , Winship Amy , Hutt Karla , Goodchild Georgia , Maskey Shreya , Chan Karen L , Brûlé Emilie , Bernard Daniel J , Stocker William A , Harrison Craig A 
Published: March 2022

AbstractInhibins are members of the transforming growth factor-β family, composed of a common α-subunit disulfide-linked to 1 of 2 β-subunits (βA in inhibin A or βB in inhibin B). Gonadal-derived inhibin A and B act in an endocrine manner to suppress the synthesis of follicle-stimulating hormone (FSH) by pituitary gonadotrope cells. Roles for inhibins beyond the pituitary, however, have proven difficult to delineate because deletion of the inhibin α-subunit gene (Inha) results in unconstrained expression of activin A and activin B (homodimers of inhibin β-subunits), which contribute to gonadal tumorigenesis and lethal cachectic wasting. Here, we generated mice with a single point mutation (Arg233Ala) in Inha that prevents proteolytic processing and the formation of bioactive inhibin. In vitro, this mutation blocked inhibin maturation and bioactivity, without perturbing activin production. Serum FSH levels were elevated 2- to 3-fold in InhaR233A/R233A mice due to the loss of negative feedback from inhibins, but no pathological increase in circulating activins was observed. While inactivation of inhibin A and B had no discernible effect on male reproduction, female InhaR233A/R233A mice had increased FSH-dependent follicle development and enhanced natural ovulation rates. Nevertheless, inhibin inactivation resulted in significant embryo-fetal resorptions and severe subfertility and was associated with disrupted maternal ovarian function. Intriguingly, heterozygous Inha+/R233A females had significantly enhanced fecundity, relative to wild-type littermates. These studies have revealed novel effects of inhibins in the establishment and maintenance of pregnancy and demonstrated that partial inactivation of inhibin A/B is an attractive approach for enhancing female fertility.
British Travelers to the Mines of Rio de la Plata and Chile in the Aftermath of the Financial Crisis of 1825–26: Political Economy and Questions of Observation
Authors: Cooper Brian P. 
Published: March 2022

Abstract
This article focuses on work published by British travelers to Chile and Rio de la Plata who inspected mining association holdings in the region in the wake of the financial crisis of 1825–26. The travelers sought to determine whether it proved prudent to continue to direct British men, money, know-how, and equipment to the mines. They drew on the work of political economists to help establish the credibility of their observations and accounts, particularly with respect to the relationship between the lack of the division of labor and population in La Plata and Chile and prospects for future speculative investments in the mines. However, while political economists blamed the financial crisis on the uncertainty generated by the actions of the Bank of England and private banks, the commercial travelers focused on other sources of observational and representational error: principal-agent problems in the joint-stock mining associations, and the travelers' ignorance and prejudices about the region.
Two Types of Travelers in the History of the Transmission of Western Economic Knowledge in Late Qing and Early Republican China
Authors: Chao Hsiang-Ke 
Published: March 2022

AbstractThe history of the transmission of Western knowledge to China—Western Learning or Xixue—usually revolves around travelers. What is unmentioned, however, is that the identity of the two types of Chinese travelers of economic knowledge evolved throughout the Western Learning Movement. One-way travelers introduced political economy as a means to improve institutions and statecraft. First-generation Chinese students overseas continued to promote economics as a science capable of enriching a nation's wealth but focused on the theoretical aspect. The second-generation students became economics professionals, who were primarily concerned with practical economic problems and created a scene of practical pluralism of economics during the interwar period. Not all travelers were of the same quality. To judge between the good and bad traveler, further criteria are required. It can be said that good travelers may have a correct understanding of Western theory, and that their translations are faithful, yielding the knowledge they transmitted with integrity. But travelers confronted the problems of trading off faithful and significant knowledge transmissions. Such conundrums can be explained by distinguishing between their distinct conceptions of economics—economics as statecraft, as science, and as a discipline characterized by its practical pluralism—concerning travelers' ideas of solving China's practical economic problems in different periods.
Wolf Ladejinsky: Field Trips for a Democratic Countryside
Authors: D'Onofrio Federico , Tyler Hannah 
Published: March 2022

AbstractBy looking at the life, travels, and work of Wolf Ladejinsky, one of the leading American experts and advisers on agrarian reforms in Asia during the postwar era, this article sheds light on the practices of development experts. Ladejinsky's work shows how the postwar period saw the emergence of a new kind of traveling economist whose task was to engineer and assess the implementation of modernization programs. In particular, the article analyzes the role of field trips in the career of Ladejinsky across Asia. The task of traveling experts was complicated. Ladejinsky's agenda was clear and his goals predetermined but they had to be adapted to different national and international frameworks. Adaptation had two sides: on the one hand, it meant fixing certain elements of the land reform plan, such as the maximum size of landowners' estates, according to local agricultural conditions; on the other, adaptation consisted of a form of institutional engineering, to harness political will, popular support, and bureaucratic structures for land reform. He developed, therefore, an array of methodological suggestions to collect relevant information during short visits.
Evolution of plasticity: metabolic compensation for fluctuating energy demands at the origin of life
Authors: Seebacher Frank , Beaman Julian 
Published: March 2022

ABSTRACT
Phenotypic plasticity of physiological functions enables rapid responses to changing environments and may thereby increase the resilience of organisms to environmental change. Here, we argue that the principal hallmarks of life itself, self-replication and maintenance, are contingent on the plasticity of metabolic processes (‘metabolic plasticity’). It is likely that the Last Universal Common Ancestor (LUCA), 4 billion years ago, already possessed energy-sensing molecules that could adjust energy (ATP) production to meet demand. The earliest manifestation of metabolic plasticity, switching cells from growth and storage (anabolism) to breakdown and ATP production (catabolism), coincides with the advent of Darwinian evolution. Darwinian evolution depends on reliable translation of information from information-carrying molecules, and on cell genealogy where information is accurately passed between cell generations. Both of these processes create fluctuating energy demands that necessitate metabolic plasticity to facilitate replication of genetic material and (proto)cell division. We propose that LUCA possessed rudimentary forms of these capabilities. Since LUCA, metabolic networks have increased in complexity. Generalist founder enzymes formed the basis of many derived networks, and complexity arose partly by recruiting novel pathways from the untapped pool of reactions that are present in cells but do not have current physiological functions (the so-called ‘underground metabolism’). Complexity may thereby be specific to environmental contexts and phylogenetic lineages. We suggest that a Boolean network analysis could be useful to model the transition of metabolic networks over evolutionary time. Network analyses can be effective in modelling phenotypic plasticity in metabolic functions for different phylogenetic groups because they incorporate actual biochemical regulators that can be updated as new empirical insights are gained.
Clinicians as Leaders: Impact and Challenges
Authors: Khan Rehan Nasir , Aziz Ayesha , Siddiqui Nadeem Ahmed 
Published: March 2022

Healthcare has always been a complex system phenomenon which needs accountability from the leading clinical and management roles. Adequate and competent leadership is recognized as a driving point for a successful healthcare division. Medical professionals taking charge for quality improvement are well placed yet the style to deliver their leadership qualities bears a massive significance. While exceptional clinical prowess is of tremendous importance, harmonious teamwork, inefficiency reduction and patient communication and safety lead to noteworthy health management outcomes. Explores not explains the importance of leadership, qualities and styles of a leader, various leadership theories, the impact of leadership in medical education and the current issues related to medical leadership.
doi: https://doi.org/10.12669/pjms.38.4.4918
How to cite this:Khan RN, Aziz A, Siddiqui NA. Clinicians as Leaders: Impact and Challenges. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4918
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
In-air Hand Gesture Signature Recognition: An iHGS Database Acquisition Protocol
Authors: Khoh Wee How , Pang Ying Han , Yap Hui Yen 
Published: March 2022

Background With the advances in current technology, hand gesture recognition has gained considerable attention. It has been extended to recognize more distinctive movements, such as a signature, in human-computer interaction (HCI) which enables the computer to identify a person in a non-contact acquisition environment. This application is known as in-air hand gesture signature recognition. To our knowledge, there are no publicly accessible databases and no detailed descriptions of the acquisitional protocol in this domain. Methods This paper aims to demonstrate the procedure for collecting the in-air hand gesture signature’s database. This database is disseminated as a reference database in the relevant field for evaluation purposes. The database is constructed from the signatures of 100 volunteer participants, who contributed their signatures in two different sessions. Each session provided 10 genuine samples enrolled using a Microsoft Kinect sensor camera to generate a genuine dataset. In addition, a forgery dataset was also collected by imitating the genuine samples. For evaluation, each sample was preprocessed with hand localization and predictive hand segmentation algorithms to extract the hand region. Then, several vector-based features were extracted. Results In this work, classification performance analysis and system robustness analysis were carried out. In the classification analysis, a multiclass Support Vector Machine (SVM) was employed to classify the samples and 97.43% accuracy was achieved; while the system robustness analysis demonstrated low error rates of 2.41% and 5.07% in random forgery and skilled forgery attacks, respectively. Conclusions These findings indicate that hand gesture signature is not only feasible for human classification, but its properties are also robust against forgery attacks.
The human conscience between witnessing and discernment: Heidegger, Ricoeur and beyond
Authors: Grzywacz Robert 
Published: March 2022

The paper deals with the problem of human conscience as an attentional mode of being that effectuates an original capacity for discernment. Such an undertaking, after the necessary terminological and phenomenological clarifications, requires one to cope with its specific background, especially the critique of the moral worldview and the postmetaphysical setting of contemporary thinking. Taking into consideration the Heideggerian view of the matter, I reflect on the doubts Ricoeur addressed to the former, and take advantage of Ricoeur’s early philosophy to reinterpret and develop his own stance as expounded in Oneself as Another. His later work on ideology and utopia may contribute to helping to establish some criteria for the functioning of the conscience.