Search Results (11,324)

Candida albicans (C. albicans) adhering to denture-based resins (DBRs) is a known cause of denture stomatitis. A new approach to prevent denture stomatitis is to include antimicrobial substances within DBRs. Here, we examined the mechanical performance and antifungal properties of DBRs containing benzyldimethyldodecyl ammonium chloride (C₁₂BDMA-Cl) as an antimicrobial compound. C₁₂BDMA-Cl is a quaternary ammonium compound, and its antifungal properties have never been investigated when combined with dental acrylic resin. Therefore, we modified a commercially available heat-polymerized acrylic DBR to contain 3 and 5 wt.% of C₁₂BDMA-Cl. Unmodified DBR was used as a control group. Specimens were prepared using the conventional heat processing method. The specimen’s flexural strength, elastic modulus, microhardness, and surface roughness were evaluated. C. albicans biofilm was grown on the specimens and assessed via colony-forming units (CFUs) and scanning electron microscopy (SEM). In silico molecular docking was applied to predict the potential C₁₂BDMA-Cl inhibition activity as an antifungal drug. The 3% C₁₂BDMA-Cl DBR demonstrated antifungal activities without a deterioration effect on the mechanical performance. SEM images indicated fewer colonies in DBR containing C₁₂BDMA-Cl, which can be a potential approach to managing denture stomatitis. In conclusion, C₁₂BDMA-Cl is a promising antifungal agent for preventing and treating denture stomatitis. Full article

Background: Patient safety is an important component of healthcare service quality, and there are numerous instruments in the literature that measure patient safety. This scoping reviewaims to map the instruments/scales for assessing patient safety in healthcare services. Method: This scoping review follows the JBI methodology. The protocol was registered on the Open Science Framework. Eligibility criteria were defined based on studies that include instruments or scales for assessing patient safety in healthcare services, in any language, and without temporal restrictions. It adhered to all scoping review checklist items [PRISMA-ScR], with searches in the Embase, Lilacs, MedLine, and Scopus databases, as well as the repository of the Brazilian Digital Library of Theses and Dissertations. Two independent reviewers performed selection and data extraction in July 2023. Results: Of the 4019 potential titles, 63 studies reported on a total of 47 instruments/scales and 71 dimensions for patient safety assessment. The most-described dimensions were teamwork, professional satisfaction, safety climate, communication, and working conditions. Conclusion: The diversity of instruments and dimensions for patient safety assessment characterizes the multidimensionality and scope of patient safety. However, it hinders benchmarking between institutions and healthcare units. Full article

This systematic literature review aims to evaluate and synthesize the effectiveness of various embedding techniques—word embeddings, contextual word embeddings, and context-aware embeddings—in addressing Meaning Conflation Deficiency (MCD). Using the PRISMA framework, this study assesses the current state of research and provides insights into the impact of these techniques on resolving meaning conflation issues. After a thorough literature search, 403 articles on the subject were found. A thorough screening and selection process resulted in the inclusion of 25 studies in the meta-analysis. The evaluation adhered to the PRISMA principles, guaranteeing a methodical and lucid process. To estimate effect sizes and evaluate heterogeneity and publication bias among the chosen papers, meta-analytic approaches were utilized such as the tau-squared (τ²) which represents a statistical parameter used in random-effects, H-squared (H²) is a statistic used to measure heterogeneity, and I-squared (I²) quantify the degree of heterogeneity. The meta-analysis demonstrated a high degree of variation in effect sizes among the studies, with a τ² value of 8.8724. The significant degree of heterogeneity was further emphasized by the H² score of 8.10 and the I² value of 87.65%. A trim and fill analysis with a beta value of 5.95, a standard error of 4.767, a Z-value (or Z-score) of 1.25 which is a statistical term used to express the number of standard deviations a data point deviates from the established mean, and a p-value (probability value) of 0.2 was performed to account for publication bias which is one statistical tool that can be used to assess the importance of hypothesis test results. The results point to a sizable impact size, but the estimates are highly unclear, as evidenced by the huge standard error and non-significant p-value. The review concludes that although contextually aware embeddings have promise in treating Meaning Conflation Deficiency, there is a great deal of variability and uncertainty in the available data. The varied findings among studies are highlighted by the large τ², I², and H² values, and the trim and fill analysis show that changes in publication bias do not alter the impact size’s non-significance. To generate more trustworthy insights, future research should concentrate on enhancing methodological consistency, investigating other embedding strategies, and extending analysis across various languages and contexts. Even though the results demonstrate a significant impact size in addressing MCD through sophisticated word embedding techniques, like context-aware embeddings, there is still a great deal of variability and uncertainty because of various factors, including the different languages studied, the sizes of the corpuses, and the embedding techniques used. These differences show how future research methods must be standardized to guarantee that study results can be compared to one another. The results emphasize how crucial it is to extend the linguistic scope to more morphologically rich and low-resource languages, where MCD is especially difficult. The creation of language-specific models for low-resource languages is one way to increase performance and consistency across Natural Language Processing (NLP) applications in a practical sense. By taking these actions, we can advance our understanding of MCD more thoroughly, which will ultimately improve the performance of NLP systems in a variety of language circumstances. Full article

This study sought to evaluate the genetic variations of the ovocalyxin-32 gene and its association with egg quality traits in indigenous chicken populations, focusing on exons 1 and 6. Genotype frequencies of SNPs (G/T and A/G) within these exons were assessed for their conformity to the Hardy–Weinberg equilibrium (HWE) across several strains. While most strains exhibited close adherence to HWE expectations, some like light-brown and gray strains indicated substantial discrepancies, particularly for the TT genotype, which points towards the possible effects of genetic drift as well as selection pressures. This study also analyzed the influence of such SNPs on egg quality parameters. A thinner eggshell, reduced shell weight, and decreased breaking strength were associated with the G/T SNP in exon 1, suggesting a likely negative effect on egg quality in T allele carriers. Conversely, the AG genotype displayed better performance in shell thickness, weight and egg weight in the A/G SNP in exon 1, whilst yolk height was best improved by the AA genotype compared to breaking strength. For instance, in exon 6, the A/G SNP enhanced the shell and yolk quality among AG genotypes, while the CC genotype resulted in better eggshell characteristics with enlarged yolks because the C/T SNP was linked. Nonetheless, there were no significant deviations from the HWE despite these associations, which suggested that most breeds had a stable genetic background. Further, considering SNPs’ additive and dominant effects in this research, it was indicated that additive effects account for phenotypic expressions given by the G/T SNP located at exon 1. In contrast, significant additive and dominant effects were observed under the A/G SNP situated at the exon. Generally, it therefore could be concluded from this study that specific SNPs within the ovocalyxin-32 gene may act as good markers for marker-assisted selection (MAS) that can improve desired characteristics—such as those of egg quality—in indigenous chicken breeds. This study demonstrated that both additive and dominance effects must be taken into account when performing genetic analyses, thereby emphasizing the complexity of phenotypic variation caused by genetic mechanisms in native chicken races. Full article

This paper elucidates the prerequisites for maximum likelihood estimation (MLE) of parameters within the exponential and scale parameter families. Estimation of these parameters is predicated on data derived from censored samples and seeks to adhere to stochastic ordering principles. The study establishes that for two independent normal distributions and a two-parameter exponential distribution discernible by the distinct parameter sets, the MLEs of the parameters evince a stochastically ordered relationship when evaluated using full datasets. Furthermore, this research is extended to corroborate the persistence of stochastic ordering in the MLEs of such parameters under conditions of fixed censoring of samples. Full article

Background: Recent studies have associated total neoadjuvant therapy (TNT) with better treatment adherence, decreased toxicity, improved complete clinical response and anal sphincter preservation rates in patients with locally advanced rectal cancer (LARC). However, real-world experience with TNT in the management of LARC remains limited. Aim: This study aimed to evaluate the efficacy and safety outcomes of TNT for LARC in Western Australia. Methods: Patients with LARC (cT2-4 and/or cN1-2) who underwent induction chemotherapy followed by neoadjuvant chemoradiotherapy or neoadjuvant chemoradiotherapy followed by consolidation chemotherapy, followed by surgery were recruited from two hospitals in Western Australia. Efficacy outcomes assessed included clinical response (complete, partial, no response), and pathologic complete response (pCR) rate, R0 resection rate, and R1 resection rate were evaluated. Those patients who achieved clinical complete response following TNT were given the option of active surveillance. The safety and tolerability of TNT were assessed. Results: 32 patients with LARC were treated with TNT. In total, 17 patients (53%) received chemoradiotherapy followed by consolidation chemotherapy and 15 patients (47%) received induction chemotherapy followed by chemoradiotherapy. Nine (28%) of the patients with LARC treated with TNT had a complete clinical response, twenty-one (66%) patients had a partial clinical response, and two (6%) patients had no response to TNT. Of the 32 patients, 27 (84%) underwent surgery. There was a 100% R0 resection rate. The pCR rate was 15%. pCR, clinical response, and the R0 resection rate were similar between the two TNT regimens. TNT was well tolerated, with the majority of patients (88%) completing the chemotherapy course with grade 1 and 2 adverse effects. Conclusions: In conclusion, TNT emerges as a promising approach for the management of LARC. However, further research is warranted to refine the optimal TNT protocols, determine its long-term outcomes, and identify patient populations who would benefit the most from this innovative therapeutic strategy. Full article

Introduction: Poor outcomes following IVF treatments are speculated to be due to the transfer of aneuploid embryos that cannot be identified based on morphological evaluation alone. This leads to patients requiring numerous embryo transfers and, consequently, a prolonged time interval before live birth. Embryo selection following preimplantation genetic testing for aneuploidy (PGT-A) with next-generation sequencing (NGS) has been suggested as an intervention to shorten time to pregnancy in women undergoing in vitro fertilisation (IVF). Past studies assessing the clinical efficacy of PGT-A in improving clinical outcomes have been conflicting and the associated clinical pregnancy rates and live birth rates following the transfer of a mosaic embryos have yet to be determined. None of the existing studies solely included women of advanced reproductive age (ARA). The pilot study and proposed RCT will determine if, compared to morphological evaluation alone, the use of PGT-A through NGS is a more clinically effective, safer, and more cost-effective way to provide IVF treatment in women of advanced reproductive age. Method and Analysis: The proposed pilot study will aim to randomise 100 patients within a single-centre study to evaluate recruitment, randomisation, and adherence to study protocol and allocated trail arms by participating patients. The results of the pilot study will enable us to determine the sample size for a larger study to establish the effectiveness of PGT-A in ARA women. Ethics and Dissemination: The study (Integrated Research Application System Number 236067) received approval from the Health Research Authority and Health and Care Research Wales (HCRW) and the East Midlands—Leicester South Research Ethics Committee (20/EM/0290). The results will be made available to patients, the funders, the Reproductive Medicine societies, and other researchers. Trial registration: ClinicalTrials.gov Identifier: NCT05009745, n. Full article

Background: Today, single-inhaler ICS/LAMA/LABA (SITT) COPD therapies are available. It is unclear whether they are more effective than multiple-device triple therapies (MITT) in improving COPD outcomes. Methods: We retrospectively considered patients on SITT/MITT in 2019/2020 who were prescribed >7 packages of ICS/LABA/LAMA or ICS/LAMA (+LAMA). The two treatments were compared concerning systemic corticosteroids, antibiotics, salbutamol, antifungal prescriptions, and number of emergency room visits/hospitalizations (ERV/Hs). We studied 292 MITT patients (Group A) during 2019, switching to SITT in 2020, and 366 subjects (Group B) who took SITT during 2019, and 206 MITT individuals (Group C) in 2020. Results: ICS/LABA + LAMA (MITT) package use was 8.2 ± 4.2 and 7.85 ± 4 in 2019, switching to 11.2 ± 3.2 when patients shifted to SITT in 2020 (p = 0.0001). Group A MITT package use was lower than in SITT patients in 2019 (9.31 ± 2.71, p = 0.0001; Group B). Throughout 2020, Group C (10.3 ± 6.1 packs) adherence to ICS/LABA was similar to SITT adherence in Group A (p = 0.270), whereas LAMA package use (9.1 ± 5) was lower (p = 0.0038). Patients using systemic corticosteroids/antibiotics were fewer in SITT in 2020, compared to the MITT results in 2019. Subjects with fewer ERV/Hs were observed with SITT rather than with MITT. Particularly, 13.8% of patients needed ≥2 ERV/Hs when treated with SITT, whereas 19.2% needed ≥2 ERV/Hs with MITT in 2019 (p = 0.08). Multivariate analysis, adjusted for all confounding factors including treatment adherence, showed that MITT (vs. SITT) can have an increased risk of at least one ERV/H (subjects receiving MITT during 2019 passing to SITT in 2020, OR: 1.718 [1.010–2.924], p = 0.046; Group A/MITT/2019 vs. Group B/SITT/2019, OR: 1.650 [0.973–3.153], p = 0.056; Group C/MITT/2020 vs. Group B/SITT/2019, OR: 1.908 [1.018–3.577], p = 0.044). Conclusions: SITT therapy may promote treatment adherence more effectively, therefore, reducing COPD exacerbations better than MITT. A possible synergistic effect of ICS/LABA/LAMA intake with a single device might be another cause of SITT’s greater efficacy. Full article

This article describes the presence of a subliminal thesis—with conspiratorial and apocalyptic content—in the discourse of the Seventh-day Adventist tradition based on a documentary analysis of Adventist publications from the 1900s to the 1990s. The history of the development of this thesis is classified into three periods: (1) Proto-Adventist Subliminal Thesis, from 1900s to 1940s, with a discourse of anti-spiritualist emphasis; (2) Adventist Subliminal Thesis’ First Wave, from 1950s to 1960s, with a discourse of anti-media emphasis in the context of James Vicary’s experiments in the 1950s; and (3) Adventist Subliminal Thesis’ Second Wave, from 1970s to 1990s, with a discourse of conspiratorial emphasis in the context of the satanic panic of the 1980s and 1990s. The Adventist subliminal thesis is configured in a way of thinking that considers (1) the human being as a “mass-man” and culture as “mass culture”; (2) the media as having the power of manipulation and mental control; (3) adherence to moral panic phenomena as reactions to media threats to traditional values; and (4) the cosmic narrative of the Great Controversy as a worldview for understanding media messages and products as part of a satanic conspiracy. Full article

Background: Patients’ compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated. Objective: To assess if “extended” tattoos can predict long-term compliance to regular therapy of adolescents with mild-to-moderate asthma. Methods: A 12-month retrospective observational investigation was conducted on non-smoker asthmatic adolescents of both genders. Patients assuming <70% of prescribed vilanterol/fluticasone furoate o.d. were defined as “non-compliant”. Tattoo surfaces were defined as “mild” or “extended” if they were < or ≥400 cm², respectively. The relationship between tattoos and compliance on the evolution of resources consumption at 6 and 12 months was assessed by generalized estimating equation (GEE) models at the first and second semester of the treatment period. Results: It was found that 13.2% of compliant adolescents had mild tattoos, while 47.2% of non-compliant adolescents had mild-to-extended tattoos (odds ratio (OR) 6.91, 95% CI 2.49 to 19.17, p < 0.001). The mean annual adherence to treatment was 57.8% ± 10.1 SD expected doses in non-compliant subjects with “mild tattoos” (54.8 cm² ± 36.9 SD), but 38.6% ± 11.4 SD expected doses in those with “extended tattoos” (568.4 cm² ± 111.6 SD, p < 0.001). Total cost proved to be a linear trend from the lowest values of compliant patients with no/mild tattoos (EUR 65.22 at 6 months and EUR 33.63 at 12 months) to the highest values of non-compliant adolescents with extended tattoos (EUR 330.75 at 6 months and EUR 297.34 at 12 months). Conclusions: Tattoo extension might be used as a reliable predictor of poor compliance and higher health care costs in adolescents with mild-to-moderate asthma. Patients characterized by poor compliance to a long-term therapeutic strategy and tattooing attitude likely share some aspects of their personality profile. Full article

Background and Objective: The complexity of antiretroviral therapy (ART) regimens in people living with HIV (PLHIV) poses significant challenges for medication management, impacting adherence and overall health outcomes. The Medication Regimen Complexity Index (MRCI) is a tool that quantifies regimen complexity, yet its correlation with hospitalization rates and adverse drug reactions (ADRs) in PLHIV remains underexplored. Materials and Methods: This prospective study, which was conducted at a government-funded antiretroviral treatment center, investigated the relationships among MRCI scores, hospitalization due to ADRs, and the ADR rates in 285 PLHIV participants over 18 months. Results: The study revealed a significant association between higher baseline MRCI scores and hospitalization due to ADRs, with a threshold MRCI score of 8 indicating increased risk. There was no significant association between average MRCI scores and overall ADR rates or non-ADR-related hospitalizations. Conclusions: These findings emphasize the importance of monitoring medication regimen complexity in PLHIV, particularly in the context of preventing hospitalizations related to ADRs. Further research is needed to understand the multifactorial influences on ADR occurrence and to optimize ART regimens for better patient outcomes. Full article

Anaemia in pregnancy is a global problem of significance in all settings. The most common cause is iron deficiency. Large numbers of women are affected, ranging up to 25–30% antenatally and 20–40% postnatally. It is associated with serious adverse outcomes for both the mother and her baby. The risk of low birth weight, preterm birth, postpartum haemorrhage, stillbirth, and neonatal death are all increased in the presence of anaemia. For the infants of affected pregnancies, complications may include neurocognitive impairment. Making an accurate diagnosis during pregnancy has its challenges, which include the choice of thresholds of haemoglobin below which a diagnosis of anaemia in each trimester of pregnancy can be made and, aligned with this question, which are the most appropriate biomarkers to use to define iron deficiency. Treatment with oral iron supplements increases the haemoglobin concentration and corrects iron deficiency. But high numbers of women fail to respond, probably due to poor adherence to medication, resulting from side effects. This has resulted in an increased use of more expensive intravenous iron. Doubts remain about the optimal regimen to of oral iron for use (daily, alternate days, or some other frequency) and the cost-effectiveness of intravenous iron. There is interest in strategies for prevention but these have yet to be proven clinically safe and effective. Full article

Recognizing pediatric eye health issues at an early stage, along with ensuring that parents are well informed, is crucial. This study measures parents’ knowledge and perspectives on pediatric ophthalmic disease. The study utilized a cross-sectional design, and participants included Saudi parents of children residing in Saudi Arabia. Data were collected using a pre-validated self-administered questionnaire with a scoring system. Sociodemographic characteristics and factors associated with knowledge/attitude were collected and analyzed. Initially, 425 respondents participated in this study. Excluding the participants whose work was related to healthcare and those with incomplete data yielded 370 responses on which the subsequent analyses were performed. The analysis revealed that only half of the parents recognized the need for annual eye examinations for children. Most of them showed gaps in knowledge regarding the frequency of routine eye exams and indicators of visual problems. Notably, parents with good/excellent knowledge were more proactive in their eye care practices, such as adherence to recommended eye examination schedules and accepting corrective measures like glasses for common conditions such as refractive errors and amblyopia. However, parental willingness to permit surgical interventions did not correlate significantly with their level of knowledge, signaling the influence of other factors. In conclusion, this study underscores the need for enhanced public health education to improve parental awareness of pediatric eye diseases in Saudi Arabia. Given the link between knowledge and proactive eye health practices, targeted interventions should distribute comprehensive, culturally sensitive information accessible to all demographics. Full article

The integration of machine learning (ML) in marine engineering has been increasingly subjected to stringent regulatory scrutiny. While environmental regulations aim to reduce harmful emissions and energy consumption, there is also a growing demand for the interpretability of ML models to ensure their reliability and adherence to safety standards. This research highlights the need to develop models that are both transparent and comprehensible to domain experts and regulatory bodies. This paper underscores the importance of transparency in machine learning through a use case involving a VLGC ship two-stroke propulsion engine. By adhering to the CRISP-DM standard, we fostered close collaboration between marine engineers and machine learning experts to circumvent the common pitfalls of automated ML. The methodology included comprehensive data exploration, cleaning, and verification, followed by feature selection and training of linear regression and decision tree models that are not only transparent but also highly interpretable. The linear model achieved an RMSE of 23.16 and an MRAE of 14.7%, while the accuracy of decision trees ranged between 96.4% and 97.69%. This study demonstrates that machine learning models for predicting propulsion engine fuel consumption can be interpretable, adhering to regulatory requirements, while still achieving adequate predictive performance. Full article

Background: The Madin–Darby canine kidney (MDCK) cell line constitutes a key component of influenza vaccine production, but its dependence on adherent growth limits cell culture density and hinders vaccine yield. There is evidence that the use of gene editing techniques to inhibit cell adhesion and establish an easily suspended cell line can improve vaccine yield; however, the mechanisms underlying MDCK cell adhesion are unclear. Methods: In this study, we used transcriptomics to analyse differentially expressed mRNAs and miRNAs in adherent and suspension cultures of MDCK cells. Results: We found that claudin-1 (CLDN1) expression was downregulated in the suspension MDCK cells and that CLDN1 promotes MDCK cell–extracellular matrix adhesion. Additionally, microRNA (miR)-175 expression was upregulated in the suspension MDCK cells. Importantly, we demonstrated that miR-175 inhibits MDCK cell adhesion by targeting the CLDN1 3′-untranslated region (UTR). These findings contribute to a more comprehensive understanding of the regulatory mechanisms modulating cell adhesion and provide a basis for establishing suspension-adapted, genetically engineered cell lines. Our work could also facilitate the identification of targets for tumour therapy. Full article