Active versus expectant management for premature rupture of membranes at term: A randomized, controlled study.

OBJECTIVE: To compare the effects on feto-maternal outcomes of expectant versus active management for premature rupture of membranes (PROM) at term. METHODS: This was a prospective randomized (1:1) controlled study involving 86 pregnant-women who received either expectant management (n = 43) or active management with misoprostol (n = 43) for PROM at term. Primary outcome was route of delivery. Secondary outcomes were: PROM to presentation interval; latency period; PROM to delivery interval; recruitment to delivery interval; labour and delivery complications. RESULTS: Baseline-characteristics were similar between groups. There was no significant difference between active and expectant groups in mean PROM to presentation/admission, or PROM to delivery. However, mean latency period (11.1 ± 7.3 hours vs 8.8 ± 5.5 hours) and mean recruitment to delivery intervals after PROM (14.7 ± 5.2 hours vs 11.8 ± 5.0 hours) were significantly shorter for the active group compared with the expectant group. Although the rate of caesarean section was less in expectant management group (21%) compared with the active management group (30%), the difference was not statistically significant. There were no significant differences between groups in delivery or perinatal complications. CONCLUSION: Active and expectant management for PROM at term gave comparable outcomes in terms of methods of delivery and complications. However, active management significantly shortened the latency period and induction to delivery intervals compared with expectant management.Trial-Registration: Pan-African-trial-registry-(PACTR)-approval-number PACTR202206797734088.

Laser induced plant leaf extract mediated synthesis of CuO nanoparticles and its photocatalytic activity.

Metal nanoparticles furnished by the green synthesis approach have exhibited fascinating attributes owing to their biocompatibility with biomolecules, and their rapid environmentally friendly synthesis. On copper oxide (CuO) nanoparticles, a laser induced bio reduction work has been accomplish using Centella asiatica aqueous extract at room temperature is the pioneer in the field. This synthesis technique is easy, fruitful, eco-friendly, and counterfeit for the size-tunable synthesis of diverse shapes of stable copper nanoparticles. UV-visible spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), Fourier Transform Infrared Spectroscopy (FTIR), Energy - Dispersive X-ray Spectroscopy (EDX), X-ray diffraction (XRD) and photodegradation study have astounding properties of regulating the formation, crystalline nature, and morphology of an integrated specimen. Moreover, the obtained copper oxide nanoparticle has the tendency to decrease the absorbance maximum value of methylene blue because of the catalytic activity posed by these nanoparticles on the reduction of methylene blue by Centella asiatica. It has been studied and confirmed by UV-visible spectrophotometer, and it has been recognised as an electron relay effect.

Fischer Linear Discrimination and Quadratic Discrimination Analysis-Based Data Mining Technique for Internet of Things Framework for Healthcare.

The internet of reality or augmented reality has been considered a breakthrough and an outstanding critical mutation with an emphasis on data mining leading to dismantling of some of its assumptions among several of its stakeholders. In this work, we study the pillars of these technologies connected to web usage as the Internet of things (IoT) system's healthcare infrastructure. We used several data mining techniques to evaluate the online advertisement data set, which can be categorized as high dimensional with 1,553 attributes, and the imbalanced data set, which automatically simulates an IoT discrimination problem. The proposed methodology applies Fischer linear discrimination analysis (FLDA) and quadratic discrimination analysis (QDA) within random projection (RP) filters to compare our runtime and accuracy with support vector machine (SVM), K-nearest neighbor (KNN), and Multilayer perceptron (MLP) in IoT-based systems. Finally, the impact on number of projections was practically experimented, and the sensitivity of both FLDA and QDA with regard to precision and runtime was found to be challenging. The modeling results show not only improved accuracy, but also runtime improvements. When compared with SVM, KNN, and MLP in QDA and FLDA, runtime shortens by 20 times in our chosen data set simulated for a healthcare framework. The RP filtering in the preprocessing stage of the attribute selection, fulfilling the model's runtime, is a standpoint in the IoT industry. Index Terms: Data Mining, Random Projection, Fischer Linear Discriminant Analysis, Online Advertisement Dataset, Quadratic Discriminant Analysis, Feature Selection, Internet of Things.

Polyaza functionalized graphene oxide nanomaterial based sensor for Escherichia coli detection in water matrices.

Water quality is widely discussed owing to its significance in public health due to the inability to access clean water. Waterborne diseases account for the presence of pathogens like Escherichia coli (E. coli) in drinking water in the environmental community. Owing to the rapid increase of such bacterial microorganisms, a cost-effective sensor setup has been developed. Herein, we demonstrate the amine-functionalized graphene oxide (fGO) based 2D nanomaterial used to graft E. coli on its surface. The comparative analysis of the deposition of nanosheets on the glass substrate and PDMS was executed. The impedance variations of GO-based nanosensor at various concentrations of E. coli were performed and their potential difference was recorded. It was observed that the impedance changes inversely with the bacterial concentrations and was fed to the Arduino microcontroller. The experimental setup was standardized for the range of 0.01 Hz to 100 kHz. The obtained analog data was programmed with a microcontroller and the bacterial concentration in colony-forming units was displayed. The real-time analysis showsthe low-level detection of E. coli in aquatic environments. Experiments were conducted using the developed nanosensor to test the efficiency in complex water matrices and whose behavior changes with various physical, chemical, and environmental factors.

A systematic review of droplet and aerosol generation in dentistry.

OBJECTIVES: This review aimed to identify which dental procedures generate droplets and aerosols with subsequent contamination, and for these, characterise their pattern, spread and settle. DATA RESOURCES: Medline(OVID), Embase(OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS databases were searched for eligible studies from each database's inception to May 2020 (search updated 11/08/20). Studies investigating clinical dental activities that generate aerosol using duplicate independent screening. Data extraction by one reviewer and verified by another. Risk of bias assessed through contamination measurement tool sensitivity assessment. STUDY SELECTION: A total eighty-three studies met the inclusion criteria and covered: ultrasonic scaling (USS, n = 44), highspeed air-rotor (HSAR, n = 31); oral surgery (n = 11), slow-speed handpiece (n = 4); air-water (triple) syringe (n = 4), air-polishing (n = 4), prophylaxis (n = 2) and hand-scaling (n = 2). Although no studies investigated respiratory viruses, those on bacteria, blood-splatter and aerosol showed activities using powered devices produced greatest contamination. Contamination was found for all activities, and at the furthest points studied. The operator's torso, operator's arm and patient's body were especially affected. Heterogeneity precluded inter-study comparisons but intra-study comparisons allowed construction of a proposed hierarchy of procedure contamination risk: higher (USS, HSAR, air-water syringe, air polishing, extractions using motorised handpieces); moderate (slow-speed handpieces, prophylaxis, extractions) and lower (air-water syringe [water only] and hand scaling). CONCLUSION: Gaps in evidence, low sensitivity of measures and variable quality limit conclusions around contamination for procedures. A hierarchy of contamination from procedures is proposed for challenge/verification by future research which should consider standardised methodologies to facilitate research synthesis. CLINICAL SIGNIFICANCE: This manuscript addresses uncertainty around aerosol generating procedures (AGPs) in dentistry. Findings indicate a continuum of procedure-related aerosol generation rather than the common binary AGP or non-AGP perspective. The findings inform discussion around AGPs and direct future research to support knowledge and decision making around COVID-19 and dental procedures.

Hippocampal formation volume, its subregions, and its specific contributions to visuospatial memory tasks.

Visuospatial memory (VSM) is the ability to represent and manipulate visual and spatial information. This cognitive function depends on the functioning of the hippocampal formation (HF), located in the medial portion of the temporal cortex. The present study aimed to investigate whether there is an association between the volume of the HF and performance in VSM tests. High-resolution structural images (T1) and neuropsychological tests evaluating VSM were performed on 31 healthy individuals. A VSM index was created by grouping 5 variables from 5 tasks (4 from the CANTAB battery and 1 from the Rey-Osterrieth Complex Figure test). Multiple linear regression models using the volumes of HF subregions as independent variables and the VSM index as the dependent variable were conducted to test the hypothesis that memory performance could be predicted by HF volumes. We also conducted analyses to explore the role of covariates that may mediate this relationship, specifically age and intelligence quotient (IQ). We found significant associations between the hippocampal subregions of the left hemisphere and the VSM index (F(7,22)=2.758, P=0.032, R2a=0.298). When IQ was accounted for as a covariate, we also found significant results for the right hemisphere (F(8,21)=2.804, P=0.028, R2a=0.517). We concluded that the bilateral hippocampal formations contributed to performance on VSM tasks. Also, VSM processing is essential for a diverse set of daily activities and may be influenced by demographic variables in healthy subjects.

Hippocampal formation volume, its subregions, and its specific contributions to visuospatial memory tasks

Visuospatial memory (VSM) is the ability to represent and manipulate visual and spatial information. This cognitive function depends on the functioning of the hippocampal formation (HF), located in the medial portion of the temporal cortex. The present study aimed to investigate whether there is an association between the volume of the HF and performance in VSM tests. High-resolution structural images (T1) and neuropsychological tests evaluating VSM were performed on 31 healthy individuals. A VSM index was created by grouping 5 variables from 5 tasks (4 from the CANTAB battery and 1 from the Rey-Osterrieth Complex Figure test). Multiple linear regression models using the volumes of HF subregions as independent variables and the VSM index as the dependent variable were conducted to test the hypothesis that memory performance could be predicted by HF volumes. We also conducted analyses to explore the role of covariates that may mediate this relationship, specifically age and intelligence quotient (IQ). We found significant associations between the hippocampal subregions of the left hemisphere and the VSM index (F(7,22)=2.758, P=0.032, R2a=0.298). When IQ was accounted for as a covariate, we also found significant results for the right hemisphere (F(8,21)=2.804, P=0.028, R2a=0.517). We concluded that the bilateral hippocampal formations contributed to performance on VSM tasks. Also, VSM processing is essential for a diverse set of daily activities and may be influenced by demographic variables in healthy subjects.

A novel use of intratympanic dexamethasone for intractable posterior canal benign paroxysmal positional vertigo: report of two cases.

BACKGROUND: Benign paroxysmal positional vertigo is a common inner-ear pathology, characterised by episodic vertigo lasting for a few seconds that is associated with sudden change in the head position. Benign paroxysmal positional vertigo is treated with canalolith repositioning manoeuvres. Intractable vertigo describes a small group of patients who either do not improve with canalolith repositioning manoeuvres (persistent cases) or who relapse after improvement of initial symptoms (recurrent cases). These cases are difficult to treat and may have to be treated surgically.Case reportsThis paper reports two cases of intractable posterior canal benign paroxysmal positional vertigo that were treated with intratympanic dexamethasone injections on an interval basis. RESULTS: Both patients showed good control of their vertiginous symptoms, with negative Dix-Hallpike test findings following the intervention. CONCLUSION: The findings support an underlying inflammatory pathology in intractable benign paroxysmal positional vertigo; intratympanic steroids should be considered as an intermediate option before proceeding to a definitive surgical intervention.

Dietary carbohydrates: a review of international recommendations and the methods used to derive them.

BACKGROUND/OBJECTIVES: Renewed dietary recommendations for carbohydrates have recently been published by various international health authorities. The present work (1) reviews the methods and processes (systematic approach/review, inclusion of public consultation) used to identify, select and grade the evidence underpinning the recommendations, particularly for total carbohydrate (CHO), fibre and sugar consumption, and (2) examines the extent to which variation in the methods and processes applied relates to any differences in the final recommendations. SUBJECTS/METHODS: A search of WHO, US, Canada, Australia and European sources identified 19 documents from 13 authorities with the desired detailed information. Processes and methods applied to derive recommendations were compiled and compared. RESULTS: (1) A relatively high total CHO and fibre intake and limited intake of (added or free) sugars are generally recommended. (2) Even where recommendations are similar, the specific justifications for quantitative/qualitative recommendations differ across authorities. (3) Differences in recommendations mainly arise from differences in the underlying definitions of CHO exposure and classifications, the degree to which specific CHO-providing foods and food components were considered, and the choice and number of health outcomes selected. (4) Differences in the selection of source material, time frames or data aggregation and grading methods appeared to have minor influence. CONCLUSIONS: Despite general consistency, apparent differences among the recommendations of different authorities would likely be minimized by: (1) More explicit quantitative justifications for numerical recommendations and communication of uncertainty, and (2) greater international harmonization, particularly in the underlying definitions of exposures and range of relevant nutrition-related outcomes.

Effect of early embryonic deletion of huntingtin from pyramidal neurons on the development and long-term survival of neurons in cerebral cortex and striatum.

We evaluated the impact of early embryonic deletion of huntingtin (htt) from pyramidal neurons on cortical development, cortical neuron survival and motor behavior, using a cre-loxP strategy to inactivate the mouse htt gene (Hdh) in emx1-expressing cell lineages. Western blot confirmed substantial htt reduction in cerebral cortex of these Emx-httKO mice, with residual cortical htt in all likelihood restricted to cortical interneurons of the subpallial lineage and/or vascular endothelial cells. Despite the loss of htt early in development, cortical lamination was normal, as revealed by layer-specific markers. Cortical volume and neuron abundance were, however, significantly less than normal, and cortical neurons showed reduced brain-derived neurotrophic factor (BDNF) expression and reduced activation of BDNF signaling pathways. Nonetheless, cortical volume and neuron abundance did not show progressive age-related decline in Emx-httKO mice out to 24months. Although striatal neurochemistry was normal, reductions in striatal volume and neuron abundance were seen in Emx-httKO mice, which were again not progressive. Weight maintenance was normal in Emx-httKO mice, but a slight rotarod deficit and persistent hyperactivity were observed throughout the lifespan. Our results show that embryonic deletion of htt from developing pallium does not substantially alter migration of cortical neurons to their correct laminar destinations, but does yield reduced cortical and striatal size and neuron numbers. The Emx-httKO mice were persistently hyperactive, possibly due to defects in corticostriatal development. Importantly, deletion of htt from cortical pyramidal neurons did not yield age-related progressive cortical or striatal pathology.

The challenges of implementing an integrated One Health surveillance system in Australia.

As 75 per cent of emerging infectious diseases are of animal origin, a One Health approach that integrates the health of humans, animals and the environment could provide an earlier opportunity for zoonotic disease detection and prevention. In Australia, human, animal and ecological health are managed by separate sectors with limited communication. This study aims to explore how professionals in these fields perceive a One Health approach to zoonotic disease surveillance, aiming to identify the challenges to the implementation of an integrated system in Australia. Using a qualitative research method, ten semistructured interviews were conducted with academic experts to gain insight into the possibility of developing an integrated surveillance system in Australia. A thematic analysis of the data was undertaken. Findings showed the absence of a clear definition and subsequent vision for the future of One Health act as a barrier to interdisciplinary collaboration, and that siloed approaches by different sectors restrict the ability for professionals to work collaboratively across disciplines. An understanding of disease transmission was considered by participants to be a necessary requirement for a successful One Health approach. Finally, participants considered political will an essential requirement for the integration of surveillance systems. This study demonstrates that for a One Health approach to be implemented in an Australian setting, those working in the fields of human, animal and ecological health must agree on several aspects. The establishment of a formal governance body with representatives from each sector could assist in overcoming long-standing barriers of privacy and distrust. Further, developing interdisciplinary training in One Health concepts for medical, environmental and veterinary students may encourage cross-disciplinary collaboration. Finally, demonstrating to policymakers the economic benefit of improved and timely detection of zoonoses may help in facilitating a structured One Health approach to disease surveillance in Australia.

Measuring oral health impact among care home residents in Wales.

OBJECTIVE: To explore inequalities in oral health impact among care home residents using OHIP-14 and ADHS criteria. BASIC RESEARCH DESIGN: Cross-sectional survey with structured interview and clinical examination using 2009 ADHS criteria including OHIP-14. Comparisons were made between groups of residents and with findings from the ADHS 2009. PARTICIPANTS: Care homes and residents were randomly selected. Those without capacity and non-English/Welsh speakers were excluded. 447 residents answered all OHIP-14 questions and had full oral examination. MAIN OUTCOME MEASURE: OHIP-14. RESULTS: Reporting of OHIP problems was more common among care home residents compared with older people examined in the ADHS 2009 (50% vs 40%). There was no difference in the mean number of impacts between residents who were: dentate/edentate; denture wearing/non-denture wearing; with/without caries. Residents reporting 'problems and pain in your mouth at the moment', or 'occasional or more frequent dry mouth', more often experienced OHIP-14 impacts. CONCLUSION: Compared with peers living in the community, both dentate and edentate care home residents are more likely to live with one or more impacts. Two simple questions related to 'Any problems and pain in your mouth?' and 'Do you have frequent dry mouth?' may help to target care home residents more likely to experience oral health impacts.

A direct electron detector for time-resolved MeV electron microscopy.

The introduction of direct electron detectors enabled the structural biology revolution of cryogenic electron microscopy. Direct electron detectors are now expected to have a similarly dramatic impact on time-resolved MeV electron microscopy, particularly by enabling both spatial and temporal jitter correction. Here we report on the commissioning of a direct electron detector for time-resolved MeV electron microscopy. The direct electron detector demonstrated MeV single electron sensitivity and is capable of recording megapixel images at 180 Hz. The detector has a 15-bit dynamic range, better than 30-µm spatial resolution and less than 20 analogue-to-digital converter count RMS pixel noise. The unique capabilities of the direct electron detector and the data analysis required to take advantage of these capabilities are presented. The technical challenges associated with generating and processing large amounts of data are also discussed.

Implementing peer review of teaching: a guide for dental educators.

Peer review of teaching (PRT) is well established and valued within higher education. Increasingly, dental educators involved in undergraduate or postgraduate teaching are required to undertake PRT as part of their teaching development. Despite this, there is a paucity of literature relating to PRT within dental education, and none that considers the implementation of PRT within large dental teaching establishments. This article describes in detail a staged process for the planning and implementation of PRT within a UK dental school. It uses relevant educational literature to supplement the authors' experiences and recommendations. By highlighting aspects of the process which are key to successful implementation, it is a useful guide for all dental educator teams who wish to successfully introduce, restructure or refresh a PRT scheme.

Social media use, attitudes, behaviours and perceptions of online professionalism amongst dental students.

Use of social media has increased amongst health professionals. This has benefits for patient care but also introduces risks for confidentiality and professional fitness to practise. This study aimed to examine dental student attitudes towards professional behaviour on social media. The secondary aim was to establish the extent and nature of social media use and exposure to potentially unprofessional behaviours. A cross-sectional study was carried out in one dental school. Data were collected using questionnaires to examine social media use, perceptions and attitudes towards social media and professional behaviours online. Students who responded (N = 155) all used social media at least once per week; most used more than one platform. Students were aware of the relationship between social media use and professional practice. Posting drunken photographs and interacting with staff and patients online were widely considered as unprofessional. Security settings affected behaviour and most had seen inappropriate behaviours online. The study found that students use social media extensively.. Students are aware of the risks but there is a greater sense of safety in closed groups and many students are exposed to potentially inappropriate content online. This suggests that training should be implemented to help students manage these risks.

Towards High Capacity Li-ion Batteries Based on Silicon-Graphene Composite Anodes and Sub-micron V-doped LiFePO4 Cathodes.

Lithium iron phosphate, LiFePO4 (LFP) has demonstrated promising performance as a cathode material in lithium ion batteries (LIBs), by overcoming the rate performance issues from limited electronic conductivity. Nano-sized vanadium-doped LFP (V-LFP) was synthesized using a continuous hydrothermal process using supercritical water as a reagent. The atomic % of dopant determined the particle shape. 5 at. % gave mixed plate and rod-like morphology, showing optimal electrochemical performance and good rate properties vs. Li. Specific capacities of >160 mAh g-1 were achieved. In order to increase the capacity of a full cell, V-LFP was cycled against an inexpensive micron-sized metallurgical grade Si-containing anode. This electrode was capable of reversible capacities of approximately 2000 mAh g-1 for over 150 cycles vs. Li, with improved performance resulting from the incorporation of few layer graphene (FLG) to enhance conductivity, tensile behaviour and thus, the composite stability. The cathode material synthesis and electrode formulation are scalable, inexpensive and are suitable for the fabrication of larger format cells suited to grid and transport applications.

Oral cancer: exploring the stories in United Kingdom newspaper articles.

Objective Reports suggest that patients with oral cancer delay seeking help because they are unaware of the symptoms. The majority of adults (95%) engage with news reports and 40% read newspapers. Newspaper oral cancer stories may influence awareness and health-seeking behaviour. The aim of this study was to explore how oral cancer is portrayed in UK newspaper print media.Design Qualitative content analysis of articles from ten newspapers with the widest UK print circulation. All articles using the terms 'mouth cancer' and 'oral cancer' over a three year period were retrieved. Duplicates, non-cancer and non-human articles were excluded.Results 239 articles were analysed. Common topics included 'recent research', 'survivor stories', 'health information' and 'celebrity linkage'. Articles were often emotive, featuring smoking, alcohol, sex and celebrity. Articles lacked a proper evidence base and often failed to provide accurate information about signs and symptoms, information about prevention and signposting to treatment.Conclusions Opportunities to save lives are being missed. Further work to improve social responsibility in the media and develop guidance to enhance the quality of information, health reporting and signposting to help are indicated.

Dental students' experiences of treating orthodontic emergencies - a qualitative assessment of student reflections.

INTRODUCTION: Professional regulatory bodies in the UK and Europe state that dental graduates should be able to manage orthodontic emergency patients. Therefore, the aim of this study was to explore dental student experiences of treating orthodontic emergencies within a teaching institution. MATERIALS AND METHOD: This study was designed as a single-centre evaluation of teaching based in a UK university orthodontic department. The participants were fourth-year dental students who treated orthodontic emergency patients under clinical supervision as part of the undergraduate curriculum. Student logbook entries for one academic year detailing the types of emergencies treated and structured, reflective commentaries for each procedure were analysed using thematic analysis methods. The total numbers and types of orthodontic emergencies treated by students were presented. Overall, self-reported student confidence in managing orthodontic emergencies was calculated. Themes, which represented student reflections, were identified. RESULTS: Seventy-two students participated in the study. Overall, 69% of students stated they were confident in managing orthodontic emergencies. Students treated a range of emergencies, of which the most frequent was debonded brackets (38%). Reflections from student commentaries were housed under a primary theme of building procedural confidence. Three subthemes were identified: (i) theory-practice integration; (ii) expanding clinical experience; and (iii) importance of a supportive clinical learning environment. CONCLUSION: The majority of dental students were confident in managing orthodontic emergencies. Theoretical knowledge supplemented by exposure to a range of clinical problems within a supported learning environment made students feel more confident.

A model of milk production in lactating dairy cows in relation to energy and nitrogen dynamics.

A generic daily time-step model of a dairy cow, designed to be included in whole-system pasture simulation models, is described that includes growth, milk production, and lactation in relation to energy and nitrogen dynamics. It is a development of a previously described animal growth and metabolism model that describes animal body composition in terms of protein, water, and fat, and energy dynamics in relation to growth requirements, resynthesis of degraded protein, and animal activity. This is further developed to include lactation and fetal growth. Intake is calculated in relation to stage of lactation, pasture availability, supplementary feed, and feed quality. Energy costs associated with urine N excretion and methane fermentation are accounted for. Milk production and fetal growth are then calculated in relation to the overall energy and nitrogen dynamics. The general behavior of the model is consistent with expected characteristics. Simulations using the model as part of a whole-system pasture simulation model (DairyMod) are compared with experimental data where good agreement between pasture, concentrate and forage intake, as well as milk production over 3 consecutive lactation cycles, is observed. The model is shown to be well suited for inclusion in large-scale system simulation models.