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Abstract Background Regular HIV testing among people who inject drugs is an essential component of HIV prevention and treatment efforts. We explored HIV testing behaviour among a community-recruited sample of injection drug users (IDU) in Bangkok, Thailand. Methods Data collected through the Mitsampan Community Research Project were used to examine correlates of HIV testing behaviour among IDU and to explore reasons for not being tested. Multivariate logistic regression was used to examine factors associated with willingness to access HIV testing at the drug-user-run Mitsampan Harm Reduction Centre (MSHRC). Results Among the 244 IDU who participated in this study, 186 (76.2%) reported receiving HIV testing in the previous six months. Enrolment in voluntary drug treatment (odds ratio [OR] = 2.34; 95% confidence interval [CI]: 1.18 - 4.63) and the tenofovir trial (OR = 44.81; 95%CI: 13.44 - 149.45) were positively associated with having been tested, whereas MSHRC use (OR = 1.78; 95%CI: 0.96 - 3.29) was marginally associated with having been tested. 56.9% of those who had not been tested reported in engaging in HIV risk behaviour in the past six months. 181 (74.2%) participants were willing to be tested at the MSHRC if testing were offered there. In multivariate analyses, willingness to get HIV testing at the MSHRC was positively associated with ever having been to the MSHRC (adjusted odds ratio [AOR] = 2.42; 95%CI: 1.21 - 4.85) and, among females, being enrolled in voluntary drug treatment services (AOR = 9.38; 95%CI: 1.14 - 76.98). Conclusions More than three-quarters of IDU received HIV testing in the previous six months. However, HIV risk behaviour was common among those who had not been tested. Additionally, 74.2% of participants were willing to receive HIV testing at the MSHRC. These findings provide evidence for ongoing HIV prevention education, as well potential benefits of incorporating HIV testing for IDU within peer-led harm reduction programs.

Abstract Background Malunion is the most common complication of distal radius fracture. It has previously been demonstrated that there is a correlation between the quality of anatomical correction and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Computer assisted surgical planning, combined with patient-specific surgical guides, has the potential to improve pre-operative understanding of patient anatomy as well as intra-operative accuracy. For patients with malunion of the distal radius fracture, this technology could significantly improve clinical outcomes that largely depend on the quality of restoration of normal anatomy. Therefore, the objective of this study is to compare patient outcomes after corrective osteotomy for distal radius malunion with and without preoperative computer-assisted planning and peri-operative patient-specific surgical guides. Methods/Design This study is a multi-center randomized controlled trial of conventional planning versus computer-assisted planning for surgical correction of distal radius malunion. Adult patients with extra-articular malunion of the distal radius will be invited to enroll in our study. After providing informed consent, subjects will be randomized to two groups: one group will receive corrective surgery with conventional preoperative planning, while the other will receive corrective surgery with computer-assisted pre-operative planning and peri-operative patient specific surgical guides. In the computer-assisted planning group, a CT scan of the affected forearm as well as the normal, contralateral forearm will be obtained. The images will be used to construct a 3D anatomical model of the defect and patient-specific surgical guides will be manufactured. Outcome will be measured by DASH and PRWE scores, grip strength, radiographic measurements, and patient satisfaction at 3, 6, and 12 months postoperatively. Discussion Computer-assisted surgical planning, combined with patient-specific surgical guides, is a powerful new technology that has the potential to improve the accuracy and consistency of orthopaedic surgery. To date, the role of this technology in upper extremity surgery has not been adequately investigated, and it is unclear whether its use provides any significant clinical benefit over traditional preoperative imaging protocols. Our study will represent the first randomized controlled trial investigating the use of computer assisted surgery in corrective osteotomy for distal radius malunions. Trial registration NCT01193010

A study on the development of luminescent Ge nanocrystals embedded in oxide matrices using various techniques was conducted to examine the photoluminescent properties of the Ge/porous Si structures using the 514.5 nm line of Ar+ laser as excitation source. A new orange-green photoluminescent band centered at 2.25 eV was observed with a maximal intensity comparable to that of the host porous Si. Spectral analysis indicates that it primarily originates form Ge-related defects in the interface between the host porous Si and Ge nanocrystals embedded in the pores.

Purpose: The purpose of this study was to evaluate the clinical and radiographic effectiveness of Biodentine® as a pulpotomy medicament for use in primary molars. Methods: A retrospective chart review was conducted on children who had received fuli-mouth dental rehabilitation under general anesthesia between January 1, 2013, and May 1, 2018. Three clinical outcomes (pain, pathologic mobility, and soft tissue pathology) and two radiographic outcomes (pathologic radiolucency and pathologic root resorption) defined a composite outcome of pulp therapy failure. Results: The final study sample consisted of 208 children with a mean age of 4.9 years. The total number of primary molars that received a Biodentine® pulpotomy over the 30-month posttreatment period was 608. Survival analyses determined that the cumulative probability of clinical survival at 30 months was 93.7 percent (95 percent confidence interval [95% Cl] equals 83.7 percent to 99.2 percent) and radiographic survival probability was 85.6 percent (95% Cl equals 76.3 percent to 93.7 percent). The majority (n equals 14 out of 20; 70 percent) of failed Biodentine, e pulpotomies occurred before 18 months. Conclusions: Primary molar pulpotomies utilizing Biodentine# as the pulpal medicament had favorable clinical and radiographic results after 30 months. Biodentine ' can be considered an alternative to other commonly used primary tooth pulpotomy medicaments. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this pilot study was to determine whether an audiovisual intervention was more effective than verbal instructions at reducing preoperative anxiety levels for parents whose children were having their first experience of dental treatment with the use of oral sedation. Methods: A prospective clinical trial was conducted. Parents were systematically assigned to either view an animated video (intervention group) or receive standardized verbal instructions (control group). Questionnaires modified from the Amsterdam Preoperative Anxiety and Information Scale were distributed to parents at the assessment appointment before the preoperative information was given (T0) and again at the subsequent sedation appointment (T1). The change in parental anxiety levels between T0 and T1 was measured (Δ equals T0-T1). Results: A total of 40 subjects comprised of 20 individuals each in the control and intervention group were included in the final analytical data set. There were no significant differences in the effectiveness of reducing preoperative parental anxiety between the audiovisual intervention and the verbal instructions. Conclusions: The audiovisual intervention was effective at reducing preoperative parental anxiety, but the reduction was not significantly different from using verbal instructions. Dentists may wish to incorporate audiovisual aids to supplement verbal instructions during the sedation preoperative consultation. [ABSTRACT FROM AUTHOR]

Background and Purpose: Quantitative T1 and diffusion tensor imaging (DTI) may provide information about pathological changes underlying disability and progression in diseases like multiple sclerosis (MS). Imaging the corpus callosum (CC), a primary site of damage in MS with a critical role in interhemispheric connectivity, may be useful for assessing overall brain health, prognosis, and therapy efficacy. We assessed the feasibility of multisite clinical trials using advanced MRI by examining the intra and intersite reproducibility of T1 and DTI measurements in the CC and segmented white matter (WM).Methods: Five healthy volunteers were scanned twice within 24 hours at six 3T sites. Coefficients of variation (COVs) and intraclass correlation coefficients (ICCs) for CC and WM T1 , fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Dax ), and radial diffusivity (Drad ) assessed intrasite and intersite reliability.Results: CC and WM T1 showed excellent intrasite reproducibility with low COVs (mean = .90% and .89%, respectively) and good ICCs (CC = .78, WM = .90). T1 also demonstrated intersite reliability (low COVs: CC = 2.4%, WM = 1.8%; moderate ICCs: CC = .43, WM = .69). DTI had low intrasite COVs (CC: FA = 1.3%, MD = 1.5%, Dax = 1.4%, Drad = 2.2%; WM: FA = .9%, MD = .9%, Dax = .7%, Drad = 1.2%) and high intrasite ICCs (CC: FA = .95, MD = .97, Dax = .94, Drad = .97; CC: FA = .9, MD = .66, Dax = .88, Drad = .63), indicating excellent intrasite reproducibility. DTI also showed excellent intersite reliability with low COVs (CC: FA = 2.1%, MD = 4.1%, Dax = 3.4%, Drad = 5.3%, WM: FA = 1.3%, MD = 1.9%, Dax = 1.8%, Drad = 2.1%,) and good ICCs (CC: FA = .90, MD = .84, Dax = .72, Drad = .90; WM: FA = .83, MD = .34, Dax = .62, Drad = .41).Conclusions: T1 and DTI measures are reproducible using equivalent MRI scanners and sequence protocols. Using a similar MR system, it is feasible to carry out multicenter studies using T1 and DTI to evaluate changes within the CC and WM. [ABSTRACT FROM AUTHOR]

Purpose To assess the reproducibility of myelin water fraction (MWF) and geometric mean T2 (GMT2), which are in vivo markers of pathological changes underlying disability and progression in diseases such as multiple sclerosis. Materials and Methods Five healthy volunteers were scanned twice within 24 hours at six different sites using the same manufacturer's 3T magnetic resonance (MR) system. T2 distributions were produced by fitting multiecho 3D T2 data using non-negative least squares, with stimulated echo correction. MWF, the fraction of signal with T2 between 15 and 40 msec to the entire signal, and GMT2, the mean T2 on a logarithmic scale from T2 between 40 and 200 msec, were examined in white matter. Results Intrasite coefficients of variation (COVs) were low (mean 3.99% for MWF and 0.51% for GMT2), as were intersite COVs (mean 4.68% for MWF, 0.31% for GMT2). Scan-rescan intraclass correlation coefficients (ICCs) (0.76 for MWF and 0.93 for GMT2) and Bland-Altman plots indicated good agreement between single site scans. Intersite ICCs were relatively high (0.69 for MWF and 0.92 for GMT2), revealing good intersite reliability. Conclusion MWF and GMT2 measures are reproducible between scans and across sites with an equivalent MR scanner and sequence protocol. Multicenter clinical trials using quantitative T2 relaxation are feasible. J. Magn. Reson. Imaging 2013;38:1445-1453. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Malunion is the most common complication of distal radius fracture. It has previously been demonstrated that there is a correlation between the quality of anatomical correction and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Computer assisted surgical planning, combined with patient-specific surgical guides, has the potential to improve pre-operative understanding of patient anatomy as well as intra-operative accuracy. For patients with malunion of the distal radius fracture, this technology could significantly improve clinical outcomes that largely depend on the quality of restoration of normal anatomy. Therefore, the objective of this study is to compare patient outcomes after corrective osteotomy for distal radius malunion with and without preoperative computer-assisted planning and peri-operative patient-specific surgical guides. Methods/Design: This study is a multi-center randomized controlled trial of conventional planning versus computer-assisted planning for surgical correction of distal radius malunion. Adult patients with extra-articular malunion of the distal radius will be invited to enroll in our study. After providing informed consent, subjects will be randomized to two groups: one group will receive corrective surgery with conventional preoperative planning, while the other will receive corrective surgery with computer-assisted pre-operative planning and peri-operative patient specific surgical guides. In the computer-assisted planning group, a CT scan of the affected forearm as well as the normal, contralateral forearm will be obtained. The images will be used to construct a 3D anatomical model of the defect and patient-specific surgical guides will be manufactured. Outcome will be measured by DASH and PRWE scores, grip strength, radiographic measurements, and patient satisfaction at 3, 6, and 12 months postoperatively. Discussion: Computer-assisted surgical planning, combined with patient-specific surgical guides, is a powerful new technology that has the potential to improve the accuracy and consistency of orthopaedic surgery. To date, the role of this technology in upper extremity surgery has not been adequately investigated, and it is unclear whether its use provides any significant clinical benefit over traditional preoperative imaging protocols. Our study will represent the first randomized controlled trial investigating the use of computer assisted surgery in corrective osteotomy for distal radius malunions. Trial registration: NCT01193010. [ABSTRACT FROM AUTHOR]

Purpose: Previous in vivo and in vitro studies of forearm supination–pronation suggest that distal radioulnar joint kinematics may be affected by elbow flexion. The primary hypotheses tested by this study were that, in vivo, ulnar variance changes with elbow flexion and forearm rotation, and the arc of forearm rotation changes in relationship to elbow flexion. Methods: Changes in radioulnar kinematics during forearm supination–pronation and elbow flexion (0° to 90°) were studied in 5 uninjured subjects using computed tomography, dual-orthogonal fluoroscopy, and 3-dimensional modeling. Analysis of variance and post-hoc testing was performed. Results: Proximal translation of the radius was greatest with the elbow flexed to 90° with the arm in midpronation. With the arm in midpronation, the translation of the radius was significantly greater at 0° versus 45° of elbow flexion (0.82 ± 0.59 mm vs 0.65 ± 0.80 mm, F: 4.49, post hoc: 0.055; p = .05) and significantly smaller at 45° versus 90° of elbow flexion (0.65 ± 0.80 mm vs 0.97 ± 0.35 mm, F: 4.49, post hoc: 0.048; p = .05). Proximal translation of the radius in midpronation was significantly greater than when the forearm was in a supinated position when the elbow was at 0° or 90° flexion (F: 14.90, post hoc: <0.01; p < .01, F: 19.11, post hoc: <0.01, p < .01). The arc of forearm rotation was significantly decreased at 0° compared with 90° of elbow flexion (129.3° ± 22.2° vs 152.8° ± 14.4°, F: 3.29, post hoc: 0.79; p = .09). The center of rotation shifted volarly and ulnarly with increasing elbow extension. Conclusions: Elbow position affects the kinematics of the distal radioulnar joint. The kinematics of the distal radioulnar joint are primarily affected by forearm rotation and secondarily by elbow flexion. These findings have clinical relevance to our understanding of ulnar impaction, and how elbow position affects the proximal–distal translation of the radius. These findings have implications for the treatment of ulna impaction, radiographic evaluation of the distal ulna, and future biomechanical studies. [Copyright &y& Elsevier]

Sickle cell disease is a growing health burden afflicting millions around the world. Clinical observation and laboratory studies have shown that the severity of sickle cell disease is ameliorated in individuals who have elevated levels of fetal hemoglobin. Additional pharmacologic agents to induce sufficient fetal hemoglobin to diminish clinical severity is an unmet medical need. We recently found that up-regulation of peroxisome proliferator-activated receptor coactivator-1a (PGC-1a) can induce fetal hemoglobin synthesis in human primary erythroblasts. Here, we report that a small molecule, SR-18292, increases PGC-1a leading to enhanced fetal hemoglobin expression in human erythroid cells, ß-globin yeast artificial chromosome mice, and sickle cell disease mice. In SR-18292-treated sickle mice, sickled red blood cells are significantly reduced, and disease complications are alleviated. SR-18292, or agents in its class, could be a promising additional therapeutic for sickle cell disease. [ABSTRACT FROM AUTHOR]

Introduction: Clinical trials that involve participants from multiple sites necessitate standardized and reliable quantitative MRI outcomes to detect significant group differences over time. Metabolite concentrations measured by proton MRS (1H‐MRS) provide valuable information about in vivo metabolism of the central nervous system, but can vary based on the acquisition and quantitation methods used by different MR sites. Therefore, we investigated the intra‐ and inter‐site reproducibility of metabolite concentrations measured by 1H‐MRS on MRI scanners from a single manufacturer across six sites. Methods: Five healthy controls were scanned twice within 24 h at six participating 3 T MR sites with large single‐voxel PRESS (TE/TR/NSA = 36 ms/4000 ms/56) and anatomical images for voxel positioning and correction of partial volume relaxation. Absolute metabolite concentrations were calculated relative to the T1 and T2 relaxation corrected signal from water. Intra‐ and inter‐site reproducibility was assessed using Bland–Altman plots and intra‐ and inter‐site coefficient of variation (CoV) as well as intra‐ and inter‐site intra‐class correlation coefficient. Results: The median intra‐site CoVs for the five major metabolite concentrations ([NAA], [tCr], [Glu], [tCho] and [Ins]) were between 2.5 and 5.3%. Inter‐site CoVs were also low, with the median CoVs for all metabolites between 3.7 and 6.4%. Metabolite concentrations were robust to small inconsistencies in voxel placement and site was not the driving factor in the variance of the measurement of any metabolite concentration. Between‐subject differences accounted for the majority of the concentration variability for creatine, choline and myo‐inositol (42–65% of the variance). Conclusion: A large single‐voxel 1H‐MRS acquisition from a single manufacturer's MRI scanner is highly reproducible and reliable for multi‐site clinical trials. [ABSTRACT FROM AUTHOR]

Since its Fast-Track approval by the Federal Drug Administration, the human papillomavirus (HPV) vaccine has been marked by controversies. Unconfirmed reports of adverse events in both Japan and Denmark led to suspensions of national vaccination programs, which setback the fight against cervical cancer and associated mortality and morbidity. Despite follow-up studies of vaccine adverse reports, additional randomized control trials, and review reports from both the World Health Organization and the European Commission, there is still a great deal of hesitancy around the vaccine. While all three version of the HPV vaccine have been shown to be efficacious and safe, additional ethical dilemmas deserve to be considered as well., (© 2024 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, The Korean Society for AIDS, and Korean Society of Pediatric Infectious Diseases.)

Sickle cell disease is a growing health burden afflicting millions around the world. Clinical observation and laboratory studies have shown that the severity of sickle cell disease is ameliorated in individuals who have elevated levels of fetal hemoglobin. Additional pharmacologic agents to induce sufficient fetal hemoglobin to diminish clinical severity is an unmet medical need. We recently found that up-regulation of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) can induce fetal hemoglobin synthesis in human primary erythroblasts. Here, we report that a small molecule, SR-18292, increases PGC-1α leading to enhanced fetal hemoglobin expression in human erythroid cells, β-globin yeast artificial chromosome mice, and sickle cell disease mice. In SR-18292-treated sickle mice, sickled red blood cells are significantly reduced, and disease complications are alleviated. SR-18292, or agents in its class, could be a promising additional therapeutic for sickle cell disease.

Purpose: The purpose of this study was to evaluate the clinical and radiographic effectiveness of Biodentine ® as a pulpotomy medicament for use in primary molars. Methods: A retrospective chart review was conducted on children who had received full-mouth dental rehabilitation under general anesthesia between January 1, 2013, and May 1, 2018. Three clinical outcomes (pain, pathologic mobility, and soft tissue pathology) and two radiographic outcomes (pathologic radiolucency and pathologic root resorption) defined a composite outcome of pulp therapy failure. Results: The final study sample consisted of 208 children with a mean age of 4.9 years. The total number of primary molars that received a Biodentine ® pulpotomy over the 30-month posttreatment period was 608. Survival analyses determined that the cumulative probability of clinical survival at 30 months was 93.7 percent (95 percent confidence interval [95% CI] equals 83.7 percent to 99.2 percent) and radiographic survival probability was 85.6 percent (95% CI equals 76.3 percent to 93.7 percent). The majority ( n equals 14 out of 20; 70 percent) of failed Biodentine ® pulpotomies occurred before 18 months. Conclusions: Primary molar pulpotomies utilizing Biodentine ® as the pulpal medicament had favorable clinical and radiographic results after 30 months. Biodentine ® can be considered an alternative to other commonly used primary tooth pulpotomy medicaments.

Purpose: Despite being the most common pediatric solid tumors, incidence and outcome of CNS tumors in Chinese children have not been systematically reported. We addressed this knowledge gap by comparing the epidemiology of pediatric CNS tumors in Hong Kong and the United States., Patients and Methods: Data between 1999 and 2016 from a population-based cancer registry in Hong Kong, China, on patients < 18 years old with CNS tumors (Hong Kong cohort) and from the US SEER Program (Asian/Pacific Islander and all ethnicities) were compared. Incidence and overall survival (OS) by histology were evaluated., Results: During the study period, 526 children were newly diagnosed with CNS tumors in Hong Kong (crude incidence rate, 2.47 per 100,000; 95% CI, 2.26 to 2.69). Adjusted incidences were significantly lower in the Hong Kong (2.51; 95% CI, 2.30 to 2.74) than in the SEER (Asian/Pacific Islander: 3.26; 95% CI, 2.97 to 3.57; P < .001; all ethnicities: 4.10 per 100,000; 95% CI, 3.99 to 4.22; P < .001) cohorts. Incidences of germ cell tumors (0.57 v 0.24; P < .001) were significantly higher, but those of glial and neuronal tumors (0.94 v 2.61; P < .001), ependymomas (0.18 v 0.31; P = .005), and choroid plexus tumors (0.08 v 0.16; P = .045) were significantly lower in Hong Kong compared with SEER (all ethnicities) cohorts. Compared with the SEER (Asian/Pacific Islander) cohort, histology-specific incidences were similar except for a lower incidence of glial and neuronal tumors in Hong Kong (0.94 v 1.74; P < .001). Among cohorts, OS differed only for patients with glial and neuronal tumors (5-year OS: Hong Kong, 52.5%; SEER [Asian/Pacific Islander], 73.6%; SEER [all ethnicities], 79.9%; P < .001)., Conclusion: We identified important ethnic differences in the epidemiology of CNS tumors in Chinese children. These results will inform the development of pediatric neuro-oncology services in China and aid further etiologic studies.

Background and Purpose: Quantitative T 1 and diffusion tensor imaging (DTI) may provide information about pathological changes underlying disability and progression in diseases like multiple sclerosis (MS). Imaging the corpus callosum (CC), a primary site of damage in MS with a critical role in interhemispheric connectivity, may be useful for assessing overall brain health, prognosis, and therapy efficacy. We assessed the feasibility of multisite clinical trials using advanced MRI by examining the intra and intersite reproducibility of T 1 and DTI measurements in the CC and segmented white matter (WM)., Methods: Five healthy volunteers were scanned twice within 24 hours at six 3T sites. Coefficients of variation (COVs) and intraclass correlation coefficients (ICCs) for CC and WM T 1 , fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (D ax ), and radial diffusivity (D rad ) assessed intrasite and intersite reliability., Results: CC and WM T 1 showed excellent intrasite reproducibility with low COVs (mean = .90% and .89%, respectively) and good ICCs (CC = .78, WM = .90). T 1 also demonstrated intersite reliability (low COVs: CC = 2.4%, WM = 1.8%; moderate ICCs: CC = .43, WM = .69). DTI had low intrasite COVs (CC: FA = 1.3%, MD = 1.5%, D ax = 1.4%, D rad = 2.2%; WM: FA = .9%, MD = .9%, D ax = .7%, D rad = 1.2%) and high intrasite ICCs (CC: FA = .95, MD = .97, D ax = .94, D rad = .97; CC: FA = .9, MD = .66, D ax = .88, D rad = .63), indicating excellent intrasite reproducibility. DTI also showed excellent intersite reliability with low COVs (CC: FA = 2.1%, MD = 4.1%, D ax = 3.4%, D rad = 5.3%, WM: FA = 1.3%, MD = 1.9%, D ax = 1.8%, D rad = 2.1%,) and good ICCs (CC: FA = .90, MD = .84, D ax = .72, D rad = .90; WM: FA = .83, MD = .34, D ax = .62, D rad = .41)., Conclusions: T 1 and DTI measures are reproducible using equivalent MRI scanners and sequence protocols. Using a similar MR system, it is feasible to carry out multicenter studies using T 1 and DTI to evaluate changes within the CC and WM., (© 2018 by the American Society of Neuroimaging.)