Category: Nevin Manimala

BMC Oral Health. 2024 Dec 2;24(1):1459. doi: 10.1186/s12903-024-05132-6.

ABSTRACT

BACKGROUND: To establish the occlusal plane, the conventional methods for facial analysis to gain accurate alignment of the occlusal plane are inadequate, while 3D technologies are an ideal diagnostic tool. The aims of this research are to compare the difference accuracy of anatomic landmarks on the occlusal plane and ala-tragus line between the conventional clinical method and 3D image method in both non-orthodontic and orthodontic treatment volunteers.

METHODS: A total of 44 volunteers (22 non-orthodontic and 22 orthodontic treatment volunteers) with normal occlusion were selected. All volunteers received 2 operative methods for occlusal plane determination. In conventional method, the occlusal plane was defined by the fox plane line. The ala-tragus line was defined by the radio-opaque markers. In the 3D image method, the volunteers were recorded intraoral images, 3D facial images and CBCT images. A 3D virtual picture was created using EXOCAD® software. The occlusal plane was generated by the incisal and occlusal surfaces of the teeth. Both methods, the angles and distances between the occlusal plane and ala-tragus line were measured and compared statistically on both sides of each volunteer.

RESULTS: Both volunteers’ group, the mean angles and distances between the occlusal plane-ala tragus line in the conventional method were reported to be significantly greater than the 3D method (P < 0.05). The percentage difference of angles in conventional method were reported to be significantly higher by 13.61-21.58% (p < 0.05) compared to the 3D method. The percentage difference of distances in the conventional method were reported to be significantly greater than the 3D method by 4.73-7.51% (p < 0.05).

CONCLUSIONS: Within the limitation of the study, it can be concluded that both conventional and digital methods for establishing the occlusal plane are not parallel to the occlusal plane. The occlusal plane and ala-tragus line in the conventional method and the 3D method were significantly different in terms of angles and distances in both non-orthodontic and orthodontic treatment volunteers. However, the deviation angle of both methods is approximately 13-20 degrees, which is clinically acceptable for occlusal plane establishment. The accuracy of both methods is still within the using in clinical implementation.

PMID:39623366 | DOI:10.1186/s12903-024-05132-6

BMC Infect Dis. 2024 Dec 2;24(1):1374. doi: 10.1186/s12879-024-10248-9.

ABSTRACT

INTRODUCTION: Malaria, a widespread tropical disease, remains a significant global health issue, resulting in numerous deaths each year. In Ghana, malaria is a leading cause of illness, contributing to a large proportion of hospital outpatient visits. The study assessed the pattern of malaria and vector IgG antibody levels among suspected malaria patients seeking healthcare at selected health facilities across Ghana.

METHODS: Samples from a total of 823 participants aged 1 to 85 years with clinical malaria from the ten regions of Ghana were recruited into the study. Archived plasma obtained from each participant was used to assess antibody responses against MSP1 (19 k), MSP2 (FC27 & 3D7), MSP3, gSG6-P1, and GLURP-RO using ELISA. The data were categorized according to study site, age group, gender, and diagnostic tests. Data were analyzed using Kruskal-Wallis’s statistics. The statistical significance was assessed at 0.05.

RESULTS: The mean ± standard error of the mean (S.E) of MSP3 IgG concentration for the different age groups were 16, 847 ± 3, 031 ng/mL for 0-4 years, 18, 973 ± 4,357 ng/mL for 5-10 years, 25,961 ± 5,436 ng/mL for 11-15 years and 76, 244 ± 8, 209 ng/mL for ≥ 16 years. A significant (Kruskal-Wallis statistic = 122.6, p < 0.0001) increase in P. falciparum MSP 3 (p < 0.0001) and gSG6-P1(p < 0.0001) IgG concentration was observed with increasing age categories. There were significant differences in antibody responses against MSP2 (FC27) IgG (Kruskal-Wallis statistic = 29.63, p = 0.0005), MSP3 IgG (Kruskal-Wallis statistic = 32.53, p = 0.0002), GLURP-RO IgG (Kruskal-Wallis statistic = 52.8, p < 0.0001) and gSG6-P1 IgG (Kruskal-Wallis statistic = 152.8, p < 0.0001) across the study regions.

CONCLUSION: The study reveals that IgG against merozoite surface proteins MSP3, GLURP-RO, and gSG6-P1 but not MSP1 and MSP2 antibodies increase with age. The mean IgG antibody concentrations varied in the selected regions of Ghana. A longitudinal study where confounding factors are controlled for is recommended to provide insights into the development of immunity and antibody efficacy, and to enhance the effectiveness of malaria prevention efforts in Ghana. This will help improve the overall understanding of malaria transmission.

PMID:39623362 | DOI:10.1186/s12879-024-10248-9

BMC Vet Res. 2024 Dec 2;20(1):544. doi: 10.1186/s12917-024-04395-z.

ABSTRACT

BACKGROUND: Infectious diseases, particularly the Goatpox virus (GTPV) from the Poxviridae family, significantly impact livestock health and agricultural economies, especially in developing regions. Recent GTPV outbreaks in previously eradicated areas underscore the need for effective control measures, with vaccination being the most reliable strategy. This study investigates the effects of administering standard and double doses of live attenuated goatpox vaccine in pregnant Murcia-Granada goats, a non-native breed in Iran, to determine optimal vaccination protocols.

RESULTS: In 2018, 400 healthy and pregnant Murcia Granada goats imported from Spain were divided into groups of 200 and vaccinated with either a standard dose (0.5 ml) or a double dose (single 0.9 ml injection) of live attenuated goatpox vaccine. Post-vaccination, the goats were monitored daily for clinical signs of infection, with samples collected for PCR analysis to detect the presence of GTPV strains. In group A, which received the standard vaccine dose, no abortions or vaccine-related side effects were observed, and body temperatures remained normal. In group B, administered a double dose, 37% of the goats experienced abortions, displaying signs of GTPV infection, such as skin lesions (pox lesions) and increased body temperatures. Molecular analysis confirmed the vaccine strain of GTPV as the infection source, ruling out external contamination. Statistical analysis showed no significant differences in abortion rates concerning gestational age or t he age of the pregnant goats.

CONCLUSION: The study highlights the importance of adhering to standard vaccine dosages in pregnant Murcia Granada goats to prevent adverse outcomes like abortions. This study emphasizes the necessity to review and revise vaccination protocols tailored to specific breeds and varying maintenance conditions, including pregnancy and outbreak scenarios. These findings stress the necessity for cautious and tailored vaccination strategies to ensure the safety and efficacy of vaccines in different goat breeds.

PMID:39623355 | DOI:10.1186/s12917-024-04395-z

BMC Womens Health. 2024 Dec 2;24(1):633. doi: 10.1186/s12905-024-03434-z.

ABSTRACT

BACKGROUND: Latinas constitute nearly 20% of midlife women in the United States (U.S.), but remain underrepresented in menopause research. Many midlife Latinas are disadvantaged by limited English proficiency, less formal education, living below the federal poverty level, lack of health insurance, and social isolation and discrimination – factors that negatively affect menopause-related symptoms and health outcomes. This study aimed to understand knowledge, attitudes, and experiences of the menopause transition among midlife Latinas.

METHODS: We conducted a qualitative descriptive study using five focus groups with 29 Hispanic/Latina midlife women. An emergent content analysis was performed by four bilingual coders. Data on socio-demographics, menopausal symptoms, menopause knowledge, and attitudes toward menopause and hormone therapy were collected over the phone. Descriptive statistics were performed to characterize study participants.

RESULTS: Participants were aged 50.3 ± 6.3 years, 45% postmenopausal, 79% viewed menopause positively, and 55% reported having “little knowledge” about menopause. Seven themes emerged: 1) menopause is a stage of life (una etapa de vida); 2) not wanting to become an old lady (no quererme hacer viejita); 3) in our culture, we do not ask [about menopause]; 4) family dynamics; 5) each body is different (todo cuerpo es diferente); 6) menopause self-management and treatment options; 7) information is power (información es poder).

CONCLUSIONS: Although Latinas reported having a positive view of menopause, we found a need for culturally-tailored comprehensive menopause education. The importance of involving family members in menopause education was also revealed. Our next steps are to determine the best menopause messaging strategies and educational formats for midlife Latinas.

PMID:39623354 | DOI:10.1186/s12905-024-03434-z

Comput Biol Med. 2024 Dec 1;184:109484. doi: 10.1016/j.compbiomed.2024.109484. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep spindles may be implicated in sensing and regulation of peripheral glucose. Whether spindle density in patients with type 2 diabetes mellitus (T2DM) differs from that of healthy subjects is unknown.

METHODS: Our retrospective analysis of polysomnography (PSG) studies identified 952 patients with T2DM and 952 sex-, age- and BMI-matched control subjects. We extracted spindles from PSG electroencephalograms and used rank-based statistical methods to test for differences between subjects with and without diabetes. We also explored potential modifiers of spindle density differences. We replicated our analysis on independent data from the Sleep Heart Health Study.

RESULTS: We found that patients with T2DM exhibited about half the spindle density during sleep as matched controls (P < 0.0001). The replication dataset showed similar trends. The patient-minus-control paired difference in spindle density for pairs where the patient had major complications were larger than corresponding paired differences in pairs where the patient lacked major complications, despite both patient groups having significantly lower spindle density compared to their respective control subjects. Patients with a prescription for a glucagon-like peptide 1 receptor agonist had significantly higher spindle density than those without one (P ≤ 0.03). Spindle density in patients with T2DM monotonically decreased as their highest recorded HbA1C level increased (P ≤ 0.003).

CONCLUSIONS: T2DM patients had significantly lower spindle density than control subjects; the size of that difference was correlated with markers of disease severity (complications and glycemic control). These findings expand our understanding of the relationships between sleep and glucose regulation.

PMID:39622099 | DOI:10.1016/j.compbiomed.2024.109484

Burns. 2024 Nov 9;51(1):107311. doi: 10.1016/j.burns.2024.107311. Online ahead of print.

ABSTRACT

INTRODUCTION: Burn-related fatalities pose a significant global public health challenge, with a substantial impact on the elderly population. This study examines two decades of burn-related mortality data in the United States, aiming to understand the trends, disparities, and contributing factors among adults aged 65 and older.

OBJECTIVES: The primary objectives of this study are to (1) analyze the trends in burn-related mortality rates among older adults, (2) investigate disparities based on gender, race and geographic regions, and (3) identify comorbidities and complications associated with burn-related deaths in this demographic.

METHODS: Data were obtained from the Centers for Disease Control and Prevention (CDC) using the National Center for Health Statistics database. The study cohort consists of individuals aged 65 and older who experienced burn-related deaths between 1999 and 2020. Various demographic variables, including age, sex, race/ethnicity, and location of death, were considered. The study also examined urban-rural classifications and regional differences. Mortality rates were calculated and adjusted for age. Joinpoint regression analysis was employed to assess trends in age-adjusted mortality rates over time. Modes of death and common comorbidities and complications were analyzed.

RESULTS: Between 1999 and 2020, a total of 96,498 older adults succumbed to burn injuries in the United States. Analysis revealed a concerning increase in burn-related mortality rates from 2012 onwards. Demographic disparities were evident, with older men consistently exhibiting higher mortality rates compared to women. Racial disparities were observed, with Black individuals experiencing the highest mortality burden. Geographic analysis indicated elevated mortality rates in Western states and rural areas. Accidents emerged as the leading cause of death, with ischemic heart disease and hypertensive diseases being prevalent comorbidities. Complications, with septicemia being the most common, contribute significantly to mortality.

CONCLUSION: Our analysis of 20 years of burn-related mortality data from the CDC reveals alarming trends in the United States. Unlike global trends, mortality rates have stagnated from 1999 to 2020, indicating a persistent public health challenge. Black individuals aged over 65 bear the brunt of burn-related mortality, facing the highest age-adjusted rates among all racial groups. Regional disparities are stark, with states in the top 90 % exhibiting significantly higher age-adjusted mortality rates compared to those in the bottom 10 %. Moreover, rural areas consistently report higher mortality rates than urban areas. Ischemic heart disease, hypertensive diseases, and other heart-related conditions emerge as prevalent comorbidities. To effectively reduce burn-related injuries and fatalities, targeted public health policies are imperative. These interventions must prioritize high-risk populations and adopt culturally sensitive approaches to promote safety. Additionally, enhancing access to healthcare and fire safety education is vital for mitigating the burden of burn-related mortality among the elderly population.

PMID:39622090 | DOI:10.1016/j.burns.2024.107311

Ann Intern Med. 2024 Dec 3. doi: 10.7326/M23-3166. Online ahead of print.

ABSTRACT

BACKGROUND: Accounting for race and ethnicity in estimating disease risk may improve the accuracy of predictions but may also encourage a racialized view of medicine.

OBJECTIVE: To present a decision analytic framework for considering the potential benefits of race-aware over race-unaware risk predictions, using cardiovascular disease, breast cancer, and lung cancer as case studies.

DESIGN: Cross-sectional study.

SETTING: NHANES (National Health and Nutrition Examination Survey), 2011 to 2018, and NLST (National Lung Screening Trial), 2002 to 2004.

PATIENTS: U.S. adults.

MEASUREMENTS: Starting with risk predictions from clinically recommended race-aware models, the researchers generated race-unaware predictions via statistical marginalization. They then estimated the utility gains of the race-aware over the race-unaware models, based on a simple utility function that assumes constant costs of screening and constant benefits of disease detection.

RESULTS: The race-unaware predictions were substantially miscalibrated across racial and ethnic groups compared with the race-aware predictions as the benchmark. However, the clinical net benefit at the population level of race-aware predictions over race-unaware predictions was smaller than expected. This result stems from 2 empirical patterns: First, across all 3 diseases, 95% or more of individuals would receive the same decision regardless of whether race and ethnicity are included in risk models; second, for those who receive different decisions, the net benefit of screening or treatment is relatively small because these patients have disease risks close to the decision threshold (that is, the theoretical “point of indifference”). When used to inform rationing, race-aware models may have a more substantial net benefit.

LIMITATIONS: For illustrative purposes, the race-aware models were assumed to yield accurate estimates of risk given the input variables. The researchers used a simplified approach to generate race-unaware risk predictions from the race-aware models and a simple utility function to compare models.

CONCLUSION: The analysis highlights the importance of foregrounding changes in decisions and utility when evaluating the potential benefit of using race and ethnicity to estimate disease risk.

PRIMARY FUNDING SOURCE: The Greenwall Foundation.

PMID:39622056 | DOI:10.7326/M23-3166

J Med Internet Res. 2024 Dec 2;26:e54127. doi: 10.2196/54127.

ABSTRACT

BACKGROUND: The project of scaling up noncommunicable disease (NCD) interventions in Southeast Asia aimed to strengthen the prevention and control of hypertension and diabetes, focusing on primary health care and community levels. In Vietnam, health volunteers who were members of the Intergenerational Self-Help Clubs (ISHCs) implemented community-based NCD screening and health promotion activities in communities. The ISHC health volunteers used an app based on District Health Information Software, version 2 (DHIS2) tracker (Society for Health Information Systems Programmes, India) to record details of participants during screening and other health activities.

OBJECTIVE: This study aimed to assess the strengths, barriers, and limitations of the NCD screening app used by the ISHC health volunteers on tablets and to provide recommendations for further scaling up.

METHODS: A mixed methods observational study with a convergent parallel design was performed. For the quantitative data analysis, 2 rounds of screening data collected from all 59 ISHCs were analyzed on completeness and quality. For the qualitative analysis, 2 rounds of evaluation of the screening app were completed. Focus group discussions with ISHC health volunteers and club management boards and in-depth interviews with members of the Association of the Elderly and Commune Health Station staff were performed.

RESULTS: In the quantitative analysis, data completeness of all 6704 screenings (n=3485 individuals) was very high. For anthropomorphic measurements, such as blood pressure, body weight, and abdominal circumference, less than 1% errors were found. The data on NCD risk factors were not adequately recorded in 1908 (29.5%) of the screenings. From the qualitative analysis, the NCD screening app was appreciated by ISHC health volunteers and supervisors, as an easier and more efficient way to report to higher levels, secure data, and strengthen relationships with relevant stakeholders, using tablets to connect to the internet and internet-based platforms to access information for self-learning and sharing to promote a healthy lifestyle as the strengths. The barriers and limitations reported by the respondents were a non-age-friendly app, incomplete translation of parts of the app into Vietnamese, some issues with the tablet’s display, lack of sharing of responsibilities among the health volunteers, and suboptimal involvement of the health sector; limited digital literacy among ISHC health volunteers. Recommendations are continuous capacity building, improving app issues, improving tablet issues, and involving relevant stakeholders or younger members in technology adoption to support older people.

CONCLUSIONS: The implementation of the NCD screening app by ISHC volunteers can be an effective way to improve community-led NCD screening and increase the uptake of NCD prevention and management services at the primary health care level. However, our study has shown that some barriers need to be addressed to maximize the efficient use of the app by ISHC health volunteers to record, report, and manage the screening data.

PMID:39622043 | DOI:10.2196/54127

J Med Internet Res. 2024 Dec 2;26:e54015. doi: 10.2196/54015.

ABSTRACT

BACKGROUND: There is a pressing need to understand the implications of the rapid adoption of virtual primary care for people with opioid use disorder. Potential impacts, including disruptions to opiate agonist therapies, and the prospect of improved service accessibility remain underexplored.

OBJECTIVE: This scoping review synthesized current literature on virtual primary care for people with opioid use disorder with a specific focus on benefits, challenges, and strategies.

METHODS: We followed the Joanna Briggs Institute methodological approach for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting our findings. We conducted searches in MEDLINE, Web of Science, CINAHL Complete, and Embase using our developed search strategy with no date restrictions. We incorporated all study types that included the 3 concepts (ie, virtual care, primary care, and people with opioid use disorder). We excluded research on minors, asynchronous virtual modalities, and care not provided in a primary care setting. We used Covidence to screen and extract data, pulling information on study characteristics, health system features, patient outcomes, and challenges and benefits of virtual primary care. We conducted inductive content analysis and calculated descriptive statistics. We appraised the quality of the studies using the Quality Assessment With Diverse Studies tool and categorized the findings using the Consolidated Framework for Implementation Research.

RESULTS: Our search identified 1474 studies. We removed 36.36% (536/1474) of these as duplicates, leaving 938 studies for title and abstract screening. After a double review process, we retained 3% (28/938) of the studies for extraction. Only 14% (4/28) of the studies were conducted before the COVID-19 pandemic, and most (15/28, 54%) used quantitative methodologies. We summarized objectives and results, finding that most studies (18/28, 64%) described virtual primary care delivered via phone rather than video and that many studies (16/28, 57%) reported changes in appointment modality. Through content analysis, we identified that policies and regulations could either facilitate (11/28, 39%) or impede (7/28, 25%) the provision of care virtually. In addition, clinicians’ perceptions of patient stability (5/28, 18%) and the heightened risks associated with virtual care (10/28, 36%) can serve as a barrier to offering virtual services. For people with opioid use disorder, increased health care accessibility was a noteworthy benefit (13/28, 46%) to the adoption of virtual visits, whereas issues regarding access to technology and digital literacy stood out as the most prominent challenge (12/28, 43%).

CONCLUSIONS: The available studies highlight the potential for enhancing accessibility and continuous access to care for people with opioid use disorder using virtual modalities. Future research and policies must focus on bridging gaps to ensure that virtual primary care does not exacerbate or entrench health inequities.

PMID:39622042 | DOI:10.2196/54015

Nurs Adm Q. 2025 Jan-Mar 01;49(1):35-43. doi: 10.1097/NAQ.0000000000000661. Epub 2024 Dec 3.

ABSTRACT

This systematic review aims to evaluate the effectiveness of simulation in enhancing the knowledge and skills required for preventing, managing, and treating pressure injuries (PIs) among nursing students. A systematic review of English articles published between January 1, 2014, and March 31, 2024, was conducted to determine the effectiveness of simulation in PI education. PubMed, Cochrane Library, Medline (OVID), Scopus, Web of Science, CINAHL, and Science Direct databases were searched using the keywords “simulation”, “pressure ulcer”, “pressure injury”, “nursing”, and “nursing education”. The study data were analyzed using the content analysis method. Of the 101 articles retrieved from the databases, 5 met the eligibility criteria. The study found that simulation in PI prevention and management education increased students’ knowledge and skill levels, enhanced their satisfaction and communication skills, and was more effective than traditional didactic education. This systematic review supports the use of simulation as an educational tool for nursing students in preventing, implementing protective interventions, and managing PI. Furthermore, it encourages further research to explore the role and effectiveness of different formats of simulation, particularly high-fidelity simulation, in PI management education and their impact on student achievement and clinical practice.

PMID:39622032 | DOI:10.1097/NAQ.0000000000000661