Nevin Manimala Statistics

Evaluation of candida albicans adherence to CAD-CAM milled, 3D-printed, and heat-cured PMMA resin and efficacy of different disinfection techniques: an in-vitro study

J Prosthodont. 2022 Aug 8. doi: 10.1111/jopr.13583. Online ahead of print.


PURPOSE: Candida albicans has been regarded as the most predominant oral fungal pathogen and the main cause of denture stomatitis. This study aimed to investigate C. albicans adherence to three types of denture base polymers: heat-cured polymethylmethacrylate (PMMA), CAD-CAM milled and 3D-printed. The efficacy of four common disinfection techniques, glutaraldehyde, brushing, microwave irradiation, and Polident overnight tablets, were also examined.

MATERIAL AND METHODS: Sixty blocks of pink acrylic specimens were fabricated from each polymer group. To investigate the C. albicans adherence, as well as the efficacy of different disinfection techniques on removing the yeast from the different materials, specimens were cultured within the fungal culture overnight followed by disinfection. The adhered C. albicans on the materials were then obtained by vortexing in phosphate buffered saline (PBS), and the numbers of the yeast in the suspensions were evaluated by measuring the optical density and/or colony-forming units on agar plates. Data were expressed as mean ± SEM (standard error of the mean). Statistical differences were evaluated by one-way analysis of variance (ANOVA) followed by the post-hoc Tukey HSD tests.

RESULTS: Significant differences in C. albicans adherence to the three polymers were noted. CAD-CAM milled and heat-cured PMMA showed significantly less C. albicans adherence compared with 3D printed PMMA. No significant difference was noted between milled and heat-cured PMMA. In the disinfection test, microwave irradiation, mechanical brushing, and Polident tablets were found to be effective in removing fungal attachment on the different denture materials, while glutaraldehyde was found to be the least effective.

CONCLUSION: C. albicans adherence to the polymers varies greatly based on the types of PMMA. 3D-printed had the highest fungal biofilm attachment. Microwave irradiation, mechanical brushing, and Polident overnight tablets had comparable results in removing C. albicans from all types of PMMA, while glutaraldehyde was not as effective. This article is protected by copyright. All rights reserved.

PMID:35941701 | DOI:10.1111/jopr.13583

Nevin Manimala Statistics

Encounters and management of oral conditions at general medical practices in Australia

BMC Health Serv Res. 2022 Aug 8;22(1):1013. doi: 10.1186/s12913-022-08299-2.


BACKGROUND: Poor oral health has been widely recognised as an ongoing public health issue. Patients with oral conditions may visit either a general practitioner (GP) or a dental practitioner for management. The aims of this study are to report (i) the GP management rate of oral health conditions by patient and GP demographics, (ii) what specific oral conditions were managed, and (iii) how GPs managed oral conditions.

METHODS: Data from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. Descriptive statistics with 95% confidence intervals around point estimates were used to summarise data. Multivariate logistic regression was performed to determine the independent effect of patient and GP characteristics.

RESULTS: A total of 972,100 GP encounters were included in the dataset, with oral condition-related encounters managed at a rate of 1.19 oral conditions per 100 GP encounters. Patients who were aged 54 years or younger, resided in a socioeconomically disadvantaged area, came from a non-English speaking background or Indigenous background were more likely to have oral conditions managed by GPs. The most commonly reported oral conditions were dental and oral mucosa-related. Over 60% of oral conditions were managed by GPs through prescribed medications.

CONCLUSIONS: This study provided an overview of management of oral conditions by GPs in Australia. Patients from certain vulnerable demographic groups were more likely to attend a GP for management of oral conditions. Common oral conditions and management approaches were identified. The findings of this study contribute to public health and health policy discussions around optimising primary care provision in oral health.

PMID:35941685 | DOI:10.1186/s12913-022-08299-2

Nevin Manimala Statistics

Patient’s satisfaction in physiotherapy outpatient departments of Amhara regional comprehensive specialized hospitals, Ethiopia

BMC Health Serv Res. 2022 Aug 8;22(1):1011. doi: 10.1186/s12913-022-08338-y.


BACKGROUND: Satisfaction is basically the state of being gratified and act of fulfilling one’s need or desires. Nowadays, evidence-based practice concept is prevailing and there has been a growing interest in the measurement of patient satisfaction in healthcare research. Patient satisfaction surveys provide several benefits for healthcare professionals. Assessing patient’s satisfaction with physiotherapy service could generate knowledge that can utilized for improving or maintaining quality service. Although a wide coverage and high emphasis givens to patient satisfaction studies in developed counties, there are few research’s done in Africa. This study aimed to assess satisfaction in physiotherapy service and identify predictors that affect satisfaction among patient treated in physiotherapy outpatient department.

OBJECTIVES: To assess satisfaction in physiotherapy service and identify associated factors among patients in physiotherapy outpatient department in Amhara regional state comprehensive specialized hospitals.

METHOD: Institution based cross-sectional study was conducted among physiotherapy outpatients from April to June 2021, at three selected Comprehensive specialized hospitals. Data were collected by interviewing participants using semi-structured questionnaire. Patient satisfaction was determined by using Medrisk tool. Data were analyzed by using descriptive statistics and bivariate and multivariable logistic regression method were used to identify predictor factors.

RESULT: A total of 409 participants with a response rate of 95% were included in this study. The overall satisfaction among physiotherapy outpatient attendee was 50.1% with 95% CI (46.2-55.7). Pain level (AOR = 5.59 95%CI (2.58-12.1), longitudinal continuity of care (AOR = 3.02 95%CI (1.46-6.62) and self-rated health improvement (AOR = 3.76, 95% CI (1.78-7.94) were significantly associated factors.

CONCLUSION: The overall satisfaction in this study were found to be low in Amhara regional state comprehensive specialized hospitals. pain level, self-rated health improvement and longitudinal continuity of care were significantly associated factors.

PMID:35941683 | DOI:10.1186/s12913-022-08338-y

Nevin Manimala Statistics

Oncologic and functional outcomes of different reconstruction modalities after resection of chondrosarcoma of the scapula: a medium- to long-term follow-up study

BMC Musculoskelet Disord. 2022 Aug 8;23(1):758. doi: 10.1186/s12891-022-05661-7.


OBJECTIVES: To evaluate the oncologic and functional results of scapular reconstruction after partial or total scapulectomy for chondrosarcoma.

MATERIALS AND METHODS: Twenty-one patients with chondrosarcoma who underwent partial or total scapulectomy between January 2005 and July 2019 were reviewed retrospectively.

RESULTS: At a mean follow-up of 62.6 months (range, 13-123 months), four patients developed local recurrence, and three developed distant metastases, one of which developed both recurrence and metastasis. The overall survival rate of patients at 5 years was 84.6%, the disease-free survival rate was 69.3%, and the complication rate was 19% (4/21). The 1993 American Musculoskeletal Tumor Society (MSTS93) scores of patients in the partial scapulectomy group, total scapulectomy + humeral suspension group and prosthetic reconstruction group were 26.50 ± 1.38, 19.00 ± 2.58, and 21.38 ± 2.62, respectively. There was a statistically significant difference between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group ( P = 0.006 and 0.0336, respectively). The range of motion of the shoulder joint for forward flexion was 80.83° ± 11.14°, 51.25° ± 21.36°, and 52.50° ± 11.02°, respectively. The p-values for the comparison between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group were 0.0493 and 0.0174, respectively. And the range of motion of abduction was 75.00° ± 10.49°, 32.50° ± 11.90°, 41.88° ± 11.63°, respectively. Patients in the partial scapulectomy group had significantly better postoperative shoulder abduction function than the total scapulectomy + humeral suspension or prosthetic reconstruction group (P = 0.0035 and 0.0304, respectively). There was no significant difference in MSTS93 scores and flexion and abduction function of the shoulder joint in the upper extremity after total scapulectomy with humeral suspension or prosthetic reconstruction (P > 0.05).

CONCLUSIONS: Surgical treatment of chondrosarcoma of the scapula can achieve a satisfactory prognosis and shoulder function. Total scapulectomy followed by prosthetic reconstruction or humeral suspension are both feasible treatments.

PMID:35941682 | DOI:10.1186/s12891-022-05661-7

Nevin Manimala Statistics

Determining host factors contributing to the reactivation of JC virus in kidney transplant recipients

Virol J. 2022 Aug 8;19(1):131. doi: 10.1186/s12985-022-01843-w.


BACKGROUND AND AIMS: The John Cunningham virus (JCV) is the established etiological agent of the polyomavirus-associated nephropathy among renal transplant recipients. In the present study, we aimed to determine the probable predictive factors leading to JCV replication in renal transplant patients.

MATERIAL AND METHODS: Urine and plasma samples were collected from a total of 120 consecutive renal-transplanted patients without preliminary screening from Jan 2018 to Mar 2019. After DNA extraction, the simultaneous detection and quantification of JCV and BK polyomavirus (BKV) were conducted using a Real-time quantitative PCR method. Moreover, statistical analyses were performed using the statistical software packages, SPSS version 21.

RESULTS: The prevalence of JCV viruria and viremia among renal transplant recipients were 26 (21.67%) and 20 (16.67%), respectively. A significant association was observed between the JCV and two risk factors, diabetes mellitus (P = 0.002) and renal stones (P = 0.015). The prevalence of JCV viremia among recipients who were grafted near time to sampling was significantly higher (P = 0.02). There was a statistically significant coexistence between BK and JC viruses among our patients (P = 0.029). The frequency of JCV viruria in males was reported almost three times more than in females (P = 0.005). The JCV shedding in urine was significantly associated with the tropical steroids like prednisolone acetate, which have been the standard regimen (P = 0.039). Multivariable analysis revealed duration of post-transplantation (OR, 0.89; P = 0.038), diabetes mellitus (OR, 1.85; P = 0.034), and renal stone (OR 1.10; P = 0.04) as independent risk factors associated with JCV viremia post-renal transplantation.

CONCLUSION: It seems that the discovery of potential risk factors, including immunological and non-immunological elements, may offer a possible preventive or therapeutic approach in the JCV disease episodes. The results of this study may also help clarify the probable clinical risk factors involving in progressive multifocal leukoencephalopathy development.

PMID:35941650 | DOI:10.1186/s12985-022-01843-w

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Seroconversion following the first, second, and third dose of SARS-CoV-2 vaccines in immunocompromised population: a systematic review and meta-analysis

Virol J. 2022 Aug 8;19(1):132. doi: 10.1186/s12985-022-01858-3.


BACKGROUND: Immunocompromised (IC) patients are at higher risk of more severe COVID-19 infections than the general population. Special considerations should be dedicated to such patients. We aimed to investigate the efficacy of COVID-19 vaccines based on the vaccine type and etiology as well as the necessity of booster dose in this high-risk population.

MATERIALS AND METHODS: We searched PubMed, Web of Science, and Scopus databases for observational studies published between June 1st, 2020, and September 1st, 2021, which investigated the seroconversion after COVID-19 vaccine administration in adult patients with IC conditions. For investigation of sources of heterogeneity, subgroup analysis and sensitivity analysis were conducted. Statistical analysis was performed using R software.

RESULTS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 81 articles in the meta-analysis. The overall crude prevalence of seroconversion after the first (n: 7460), second (n: 13,181), and third (n: 909, all population were transplant patients with mRNA vaccine administration) dose administration was 26.17% (95% CI 19.01%, 33.99%, I2 = 97.1%), 57.11% (95% CI: 49.22%, 64.83%, I2 = 98.4%), and 48.65% (95% CI: 34.63%, 62.79%, I2 = 94.4%). Despite the relatively same immunogenicity of mRNA and vector-based vaccines after the first dose, the mRNA vaccines induced higher immunity after the second dose. Regarding the etiologic factor, transplant patients were less likely to develop immunity after both first and second dose rather than patients with malignancy (17.0% vs 37.0% after first dose, P = 0.02; 38.3% vs 72.1% after second dose, P < 0.001) or autoimmune disease (17.0% vs 36.4%, P = 0.04; 38.3% vs 80.2%, P < 0.001). To evaluate the efficacy of the third dose, we observed an increasing trend in transplant patients after the first (17.0%), second (38.3%), and third (48.6%) dose.

CONCLUSION: The rising pattern of seroconversion after boosting tends to be promising. In this case, more attention should be devoted to transplant patients who possess the lowest response rate.

PMID:35941646 | DOI:10.1186/s12985-022-01858-3

Nevin Manimala Statistics

Examining the adoption and implementation of behavioral electronic health records by healthcare professionals based on the clinical adoption framework

BMC Med Inform Decis Mak. 2022 Aug 8;22(1):210. doi: 10.1186/s12911-022-01959-7.


BACKGROUND: While various quantitative studies based on the Unified Theory of Acceptance and Use of Technology (UTAUT) and Technology Acceptance Models (TAM) exist in the general medical sectors, just a few have been conducted in the behavioral sector; they have all been qualitative interview-based studies.

OBJECTIVE: The purpose of this study is to assess the adoption dimensions of a behavioral electronic health record (EHR) system for behavioral clinical professionals using a modified clinical adoption (CA) research model that incorporates a variety of micro, meso, and macro level factors.

METHODS: A questionnaire survey with quantitative analysis approach was used via purposive sampling method. We modified the existing CA framework to be suitable for evaluating the adoption of an EHR system by behavioral clinical professionals. We designed and verified questionnaires that fit into the dimensions of the CA framework. The survey was performed in five US behavioral hospitals, and the adoption factors were analyzed using a structural equation analysis.

RESULTS: We derived a total of seven dimensions, omitting those determined to be unsuitable for behavioral clinical specialists to respond to. We polled 409 behavioral clinical experts from five hospitals. As a result, the ease of use and organizational support had a substantial impact on the use of the behavioral EHR system. Although the findings were not statistically significant, information and service quality did appear to have an effect on the system’s ease of use. The primary reported benefit of behavioral EHR system adoption was the capacity to swiftly locate information, work efficiently, and access patient information via a mobile app, which resulted in more time for better care. The primary downside, on the other hand, was an unhealthy reliance on the EHR system.

CONCLUSIONS: We demonstrated in this study that the CA framework can be a useful tool for evaluating organizational and social elements in addition to the EHR system’s system features. Not only the EHR system’s simplicity of use, but also organizational support, should be considered for the effective implementation of the behavioral EHR system.

TRIAL REGISTRATION: The study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB No.: B-1904-534-301).

PMID:35941636 | DOI:10.1186/s12911-022-01959-7

Nevin Manimala Statistics

Perceptions and knowledge regarding the COVID-19 pandemic between U.S. and China: a mixed methods study

Global Health. 2022 Aug 8;18(1):76. doi: 10.1186/s12992-022-00864-y.


BACKGROUND: SARS-CoV-2, a new coronavirus first reported by China on December 31st, 2019, has led to a global health crisis that continues to challenge governments and public health organizations. Understanding COVID-19 knowledge, attitudes, and practices (KAP) is key for informing messaging strategies to contain the pandemic. Cross-national studies (e.g.: comparing China to the U.S.) are needed to better understand how trans-cultural differences may drive differences in pandemic response and behaviors. The goal of the study is to compare knowledge and perceptions of COVID-19 between adults in China and the U.S. These data will provide insight into challenges these nations may face in coordinating pandemic response.

METHODS: This is a convergent mixed methods study comparing responses from China and the U.S. to a multinational COVID-19 KAP online survey. The survey included five quantitative constructs and five open-ended questions. Chinese respondents (n = 56) were matched for gender, age, education, perceived social standing, and time of survey completion with a U.S. cohort (n = 57) drawn from 10,620 U.S.

RESPONDENTS: Quantitative responses were compared using T-test & Fisher-Exact tests. Inductive thematic analysis was applied to open-ended questions.

RESULTS: Both U.S. and Chinese samples had relatively high intention to follow preventive behaviors overall. Differences in intended compliance with a specific recommendation appear to be driven by the different cultural norms in U.S. and China. Both groups expressed trepidation about the speed of COVID-19 vaccine development, driven by concern for safety among Chinese respondents, and concern for efficacy among U.S.

RESPONDENTS: The Chinese cohort expressed worries about other countries’ passive handling of the pandemic while the U.S. cohort focused on domestic responses from individuals and government. U.S. participants appeared more knowledgeable on some aspects of COVID-19. Different perspectives regarding COVID-19 origins were identified among the two groups. Participants from both samples reported high trust in health professionals and international health organizations.

CONCLUSIONS: Mixed methods data from this cross-national analysis suggests sociocultural differences likely influence perceptions and knowledge of COVID-19 and its related public health policies. Discovering and addressing these culturally-based differences and perceptions are essential to coordinate a global pandemic response.

PMID:35941625 | DOI:10.1186/s12992-022-00864-y

Nevin Manimala Statistics

Comparison of amphotericin B deoxycholate in combination with either flucytosine or fluconazole, and voriconazole plus flucytosine for the treatment of HIV-associated cryptococcal meningitis: a prospective multicenter study in China

BMC Infect Dis. 2022 Aug 8;22(1):677. doi: 10.1186/s12879-022-07665-z.


BACKGROUND: The most appropriate alternative to induction therapy for HIV-associated cryptococcal meningitis (CM) remains unclear when standard treatment is unavailable, inaccessible, intolerable, or ineffective.

METHODS: A prospective, multi-centre cohort study was conducted to analyze the data of 156 HIV-infected patients with CM who were treated with amphotericin B deoxycholate (AmB-D) + flucytosine (5FC), voriconazole (VCZ) + 5FC, or AmB-D + Fluconazole (Flu) as induction regimens. Clinical efficacy, cumulative mortality, and adverse effects were compared among the three treatment groups.

RESULTS: Fewer deaths occurred by week 4 and week 10 among patients receiving AmB-D + 5FC than among those receiving AmB-D + Flu [4 (5.1%) vs. 8 (16.0%) deaths by week 4; hazard ratio, 1.8; 95% confidence interval [CI], 1.0 to 3.3; p = 0.039; and 8 (10.3%) vs. 14 (28.0%) deaths by week 10; hazard ratio, 1.8; 95% CI, 1.1 to 2.7; p = 0.008, respectively]. AmB-D plus 5FC was found to result in significantly higher rates of cerebrospinal fluid (CSF) culture sterility (57.6% vs. 34% by week 2; 87.9% vs. 70% by week 10; p < 0.05 for both comparisons). However, the differences in CSF culture sterility and mortality between the VCZ + 5FC group and the AmB-D + 5FC group were not statistically significant. VCZ plus 5FC had a significantly advantageous effect on the incidence of new AIDS-defining illness and length of hospital stay, compared with AmB-D plus 5FC. Laboratory adverse events (grade 3 or 4), such as severe anemia, were less frequent with VCZ + 5FC use than with AmB-D combined with 5FC or Flu use.

CONCLUSION: Our results suggest that AmB-D combined with 5FC remains the more efficacious induction regimen compared to AmB-D plus Flu, and that VCZ + 5FC might be a potential alternative when the standard regimen is not readily available, accessible, tolerated, or effective.

CLINICAL TRIALS: Registration number, ChiCTR1900021195. Registered 1 February 2019, .

PMID:35941618 | DOI:10.1186/s12879-022-07665-z

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Individual and community-level factors of abortion in East Africa: a multilevel analysis

Arch Public Health. 2022 Aug 9;80(1):184. doi: 10.1186/s13690-022-00938-8.


BACKGROUND: Abortion is one of the top five causes of maternal mortality in low and middle-income countries. It is associated with a complication related to pregnancy and childbirth. Despite this, there was limited evidence on the prevalence and associated factors of abortion in East African countries. Therefore, this study aimed to investigate the prevalence and associated factors of abortion among reproductive-aged women in East African countries.

METHODS: The Demographic and Health Surveys (DHS) data of 12 East African countries was used. A total weighted sample of 431,518 reproductive-age women was included in the analysis. Due to the hierarchical nature of the DHS data, a multilevel binary logistic regression model was applied. Both crude and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was calculated for potential associated factors of abortion in East Africa. In the final model, variables with a p value < 0.05 were declared as statistically significant factors of abortion.

RESULTS: Around 5.96% (95%CI: 4.69, 7.22) of reproductive-aged women in East Africa had a history of abortion. Alcohol use, tobacco or cigarette smoking, being single, poorer wealth index, currently working, traditional family planning methods, and media exposure were associated with a higher risk of abortion. However, higher parity, having optimum birth intervals, and modern contraceptive uses were associated with lower odds of abortion.

CONCLUSIONS: The prevalence of abortion among reproductive-aged women in East Africa was high. Abortion was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during the intervention to prevent the burdens associated with abortion.

PMID:35941615 | DOI:10.1186/s13690-022-00938-8