Category: Nevin Manimala

J Neuroimaging. 2024 Apr 26. doi: 10.1111/jon.13204. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Differentiating idiopathic normal pressure hydrocephalus (iNPH) from neurodegenerative disorders such as progressive supranuclear palsy (PSP), Multiple System Atrophy-parkinsonian type (MSA-P), and vascular dementia (VaD) is challenging due to overlapping clinical and neuroimaging findings. This study assesses if quantitative brain stem and cerebellum metrics can aid in this differentiation.

METHODS: We retrospectively compared the sagittal midbrain area, midbrain to pons ratio, MR parkinsonism index (MRPI), and cerebellar atrophy in 30 PSP patients, 31 iNPH patients, 27 MSA-P patients, 32 VaD patients, and 25 healthy controls. Statistical analyses determined group differences, sensitivity, specificity, and the area under the receiver operating characteristic curves.

RESULTS: There was an overlap in midbrain morphology between PSP and iNPH, as assessed with MRPI, midbrain to pons ratio, and midbrain area. A cutoff value of MRPI > 13 exhibited 84% specificity in distinguishing PSP from iNPH and 100% in discriminating PSP from all other conditions. A cutoff value of midbrain to pons ratio at <0.15 yielded 95% specificity for differentiating PSP from iNPH and 100% from all other conditions. A cutoff value of midbrain area at <87 mm² exhibited 97% specificity for differentiating PSP from iNPH and 100% from all other conditions. All measures showed low sensitivity. Cerebellar atrophy did not differ significantly among groups.

CONCLUSION: Our study questions MRPI’s diagnostic performance in distinguishing PSP from iNPH. Simpler indices such as midbrain to pons ratio and midbrain area showed similar or better accuracy. However, all these indices displayed low sensitivity despite significant differences among PSP, MSA-P, and VaD.

PMID:38676300 | DOI:10.1111/jon.13204

Int J Paediatr Dent. 2024 Apr 26. doi: 10.1111/ipd.13195. Online ahead of print.

ABSTRACT

BACKGROUND: International data suggest that parents may have reservations about the use of silver diamine fluoride (SDF).

AIM: The aims of this study were to: (1) examine the acceptance of parents/carers towards the use of SDF for the management of caries in children’s primary teeth in secondary care dental settings in the UK and the United States and (2) determine which factors may affect the acceptance of the use of SDF.

DESIGN: This was a cross-sectional questionnaire of SDF acceptability, completed by parents of young children. It was validated and adapted to local populations. Data were analysed with descriptive and inferential statistics.

RESULTS: Of the 113 Sheffield parents, 73% reported that they would accept SDF treatment of children’s posterior teeth, with 58% reporting this for anterior teeth. Parents having less concern about posterior aesthetics had a statistically significant effect on reported acceptance of SDF (p = .013). In the Colorado sample (n = 104), 72% reported that they would accept SDF on posterior teeth, and 58% reported that they would accept SDF on anterior teeth. Concerns about aesthetics had an effect on decreasing SDF acceptance overall (p = .0065) in anterior (p = .023) and posterior teeth (p = .108).

CONCLUSION: The majority of parents in the two study populations accepted the treatment using SDF. However, concern about aesthetics had an influence on acceptability.

PMID:38676286 | DOI:10.1111/ipd.13195

Int J Paediatr Dent. 2024 Apr 26. doi: 10.1111/ipd.13198. Online ahead of print.

ABSTRACT

BACKGROUND: The conicity of the root canals of primary teeth is an important measure for endodontic therapies. However, determining this conicity depends on the methods employed, which requires further investigation.

AIM: The aim of this study was to determine the conicity of the root canals of the upper and lower primary second molars using nanotomography (nCT).

DESIGN: An in vitro study was performed using nine primary second molars, both upper and lower, subjected to nCT. Comparisons between the diameters of root canals were performed between the thirds (cervical-D0, middle-D5, and apical-D7). The conicity (%) was determined for each root canal from cervical to apical. Data were statistically analyzed with a significance level of 5%.

RESULTS: The conicity ranged from 2% to 8% for the upper primary second molars. Significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in the mesio- and distobuccal roots (p < .05), but not in the palatal roots (p > .05). For the lower primary second molars, the conicity ranged from 2% to 17%, as well as significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in all roots (distal, mesiobuccal, and mesiolingual; p < .05).

CONCLUSION: The conicity of the upper primary second molars was different from that of the lower ones, which showed a greater variability.

PMID:38676283 | DOI:10.1111/ipd.13198

Biol Res Nurs. 2024 Apr 26:10998004241249938. doi: 10.1177/10998004241249938. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to determine the effects of caffeine consumption and sleep on post-spinal headache after spinal anesthesia.

BACKGROUND: Post-spinal headache is among the most well-known and common complications of spinal anesthesia. Although caffeine consumption is recommended to prevent headache after spinal anesthesia, caffeine does not prevent headache and causes sleep-related problems. No study in the literature found a correlation between sleep and caffeine consumption after spinal anesthesia and post-spinal headache.

METHODS: The research is a descriptive and cross-sectional study. The study sample comprised 425 patients who underwent elective surgery in a research hospital. The research data were collected by face-to-face interviews between April 2021 and December 2023. The “Sociodemographic and Clinical Characteristics Form,” “Richard-Campbell Sleep Scale,” “Insomnia Severity Index,” and “Visual Analog Scale” were used in data collection. Factors affecting post-spinal headache were determined using binary logistic regression analysis.

RESULTS: According to the binary logistic regression, the insomnia severity score (OR = 1.234; p < .001), sleep quality score (OR = .992; p < .01), postoperative sleep duration (OR = .619; p < .05), and not consuming coffee (OR = .035; p < .001) are statistically significant predictors of post-spinal headache and explain 57.7% of the variance. A one-unit increase in patients’ insomnia severity increased the probability of experiencing a post-spinal headache by 23.4%. With a one-unit increase in sleep quality, there was an 8% decrease in the probability of experiencing spinal headache, and a 3.81% decrease in the probability of experiencing post-spinal headache with an increase in sleep duration after surgery. The probability of experiencing post-spinal headache was 0.35 times higher in individuals who did not consume caffeine after surgery than in those who consumed it.

CONCLUSION: The present study demonstrated that insomnia severity and sleep quality were more effective than caffeine consumption in preventing post-spinal headache. Insomnia and decreased sleep quality may cause a significant burden in developing post-spinal headache in patients and may cause post-spinal headache to be observed more frequently. Therefore, the use of caffeine in preventing or reducing post-spinal headache may adversely affect the duration and quality of sleep and increase the severity of insomnia.

PMID:38676282 | DOI:10.1177/10998004241249938

Sensors (Basel). 2024 Apr 21;24(8):2648. doi: 10.3390/s24082648.

ABSTRACT

A systematic study of the nonlinear response of Silicon Photomultipliers (SiPMs) was conducted through Monte Carlo (MC) simulations. The MC code was validated against experimental data for two different SiPMs. Nonlinearity mainly depends on the balance between the photon rate and the pixel recovery time. Additionally, nonlinearity has been found to depend on the light pulse shape, the correlated noise, the overvoltage dependence of the photon detection efficiency, and the impedance of the readout circuit. Correlated noise has been shown to have a minor impact on nonlinearity, but it can significantly affect the shape of the SiPM output current. Considering these dependencies and a previous statistical analysis of the nonlinear response of SiPMs, two phenomenological fitting models were proposed for exponential-like and finite light pulses, explaining the roles of their various terms and parameters. These models provide an accurate description of the nonlinear responses of SiPMs at the level of a few percentages for a wide range of situations.

PMID:38676265 | DOI:10.3390/s24082648

Sensors (Basel). 2024 Apr 20;24(8):2643. doi: 10.3390/s24082643.

ABSTRACT

The study presents a promising approach to enzymatic kinetics using Electrochemical Impedance Spectroscopy (EIS) to assess fundamental parameters of modified enteropeptidases. Traditional methods for determining these parameters, while effective, often lack versatility and convenience, especially under varying environmental conditions. The use of EIS provides a novel approach that overcomes these limitations. The enteropeptidase underwent genetic modification through the introduction of single amino acid modifications to assess their effect on enzyme kinetics. However, according to the one-sample t-test results, the difference between the engineered enzymes and hEKL was not statistically significant by conventional criteria. The kinetic parameters were analyzed using fluorescence spectroscopy and EIS, which was found to be an effective tool for the real-time measurement of enzyme kinetics. The results obtained through EIS were not significantly different from those obtained through traditional fluorescence spectroscopy methods (p value >> 0.05). The study validates the use of EIS for measuring enzyme kinetics and provides insight into the effects of specific amino acid changes on enteropeptidase function. These findings have potential applications in biotechnology and biochemical research, suggesting a new method for rapidly assessing enzymatic activity.

PMID:38676260 | DOI:10.3390/s24082643

Arch Oral Biol. 2024 Apr 24;163:105981. doi: 10.1016/j.archoralbio.2024.105981. Online ahead of print.

ABSTRACT

OBJECTIVES: An ex-vivo study was aimed at (i) programming clinically validated robot three-year random toothbrushing, (ii) evaluating cervical macro- and microwear patterns on all tooth groups of different functional age, (iii) documenting and codificating wear related morphological features at the cemento-enamel junction in young teeth and on roots in older teeth.

DESIGN: Following ethical approval random toothbrushing (44 strokes per tooth horizontally, rotating, vertically; 2x/d) with manual toothbrushes and low-abrasive dentifrice was performed in an artificial oral cavity with brushing-force 3.5 N on 14 extracted human teeth. Morphological features were examined by SEM at baseline and after simulated 3 years using the replication technique. 3D-SEM analyses were carried out with a four-quadrant back scattered electron detector. Wilcoxon-Mann-Whitney-test was used for statistical analyses.

RESULTS: 3-year random toothbrushing with horizontal, rotating and vertical brushing movements revealed morphological features classified as four enamel patterns, one dentin pattern and three cervical patterns. Negative impacts were enamel, cementum and dentin loss. Positive impact on oral health was removing dental calculus and straightening cervical traumatic and iatrogenic damages. The volume loss varied from x̅=34.25nl to x̅=87.75nl. Wear extended apically from 100 to 1500 micrometres.

CONCLUSION: Robot simulated toothbrushing in an artificial oral cavity, with subsequent SEM and 3D-SEM assessment, elucidated both negative and oral health-contributing micromorphology patterns of cervical wear after simulated 3-year random toothbrushing. Cervical macro- and microwear of cementum revealed, for the first time, what we describe as overhanging enamel peninsulas and enamel islands on roots in young teeth, but no enamel islands on roots from older teeth after root cementum loss. In contrast, many older teeth exhibited enamel peninsulas.

PMID:38669743 | DOI:10.1016/j.archoralbio.2024.105981

Lung Cancer. 2024 Apr 23;191:107798. doi: 10.1016/j.lungcan.2024.107798. Online ahead of print.

ABSTRACT

OBJECTIVES: In this study, we explored the clinical outcomes of non-small cell lung cancer (NSCLC) patients with EGFR Exon20 in-frame insertions (Exon20ins), and the impact of the location of Exon20ins on these clinical outcomes.

MATERIALS AND METHODS: The efficacies of current systemic therapies in NSCLC patients harboring Exon20ins were investigated using a large-scale clinico-genomic database of LC-SCRUM-Asia, and compared with that of amivantamab in the CHRYSALIS trial.

RESULTS: Of the 11,397 patients enrolled in LC-SCRUM-Asia, Exon20ins were detected in 189 patients (1.7 %). Treatment with classical EGFR tyrosine-kinase inhibitors (classical TKIs) was associated with a significantly shorter progression-free survival (PFS) in NSCLC patients with Exon20ins as compared with Exon19 deletions and L858R. Post platinum-based chemotherapy, classical TKIs and immune checkpoint inhibitors (ICIs) were associated with a shorter PFS than with docetaxel in patients with Exon20ins (HR [95 % CI]; TKIs vs docetaxel, 2.16 [1.35-3.46]; ICIs vs docetaxel, 1.49 [1.21-1.84]). Patients treated with amivantamab in the CHRYSALIS trial showed a risk reduction in PFS and overall survival as compared with LC-SCRUM-Asia patients treated with docetaxel, classical TKIs, or ICIs. Among the 189 patients, Exon20ins were classified as near-loop or far-loop insertions in 115 (61 %) and 56 (30 %) patients, respectively. Treatment with osimertinib was associated with a longer PFS in patients with Exon20ins in near-loop as compared with far-loop (median, 5.6 vs. 2.0 months; HR [95 % CI], 0.22 [0.07-0.64]).

CONCLUSIONS: After platinum-based chemotherapy, classical TKIs and ICIs are less effective in NSCLC patients with Exon20ins, and amivantamab may be a promising targeted therapy. There is a possibility that the location of Exon20ins has an impact on the efficacy of TKIs.

PMID:38669727 | DOI:10.1016/j.lungcan.2024.107798

Environ Int. 2024 Apr 23;187:108686. doi: 10.1016/j.envint.2024.108686. Online ahead of print.

ABSTRACT

The blood levels of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) have been thoroughly investigated in Greek children from the Rhea birth cohort study. This investigation aimed to assess exposure levels, explore their possible relationship with children’s age and sex, and indicate potential sources of exposure. Exposure patterns and common sources of PCBs and OCPs were analyzed using bivariate and multivariate statistics. A total of 947 blood samples from study participants were analyzed for OCP and PCB exposure, with 375 samples collected at 4 years old, 239 at 6.5 years old, and 333 at 11 years old. Elevated levels of DDE were observed in 6.5-year-old children compared to corresponding levels in other European countries. Higher levels of DDE were found in 4-year-old children, with the lowest concentrations in the 11-year-old group. The DDT/DDE ratio was consistently less than 1 among all the examined subjects. These results indicate exposure to DDT and DDE both in utero and through breastfeeding and dietary intake. For the entire cohort population, the highest concentration was determined for PCB 28, followed by PCBs 138, 153, and 180. The sum of the six indicator PCBs implied low exposure levels for the majority of the cohort population. Spearman correlations revealed strong associations between PCBs and OCPs, while principal component analysis identified two different groupings of exposure. DDE exhibited a correlation with a series of PCBs (153, 156, 163, 180), indicating a combined OCP-PCB source, and an anticorrelation with others (52, 28, 101), implying a separate and competing source.

PMID:38669722 | DOI:10.1016/j.envint.2024.108686

J Neurosurg. 2024 Apr 26:1-7. doi: 10.3171/2024.1.JNS232342. Online ahead of print.

ABSTRACT

OBJECTIVE: Intraoperative MRI (iMRI) is the gold-standard technique for intraoperative evaluation of the extent of resection in brain tumor surgery. Unfortunately, it is currently available at only a few neurosurgical centers. A commercially available software, Virtual iMRI Cranial, provides an elastic fusion between preoperative MRI and intraoperative CT (iCT). The aim of this study was to evaluate the accuracy of this software in determining the presence of residual tumor.

METHODS: Virtual iMRI was performed in patients who underwent iCT after intracranial tumor resection. The results of the software in terms of presence or absence of tumor residual were then compared with postoperative MRI performed within 48 hours after surgery to evaluate the diagnostic accuracy of virtual iMRI.

RESULTS: Sixty-six patients were included in the present study. The virtual iMRI findings were concordant with the postoperative MRI data in 35 cases (53%) in the detection of tumor residual (p = 0.006). No false-negative findings (i.e., presence of residual on postoperative MRI and absence of residual on virtual iMRI) were encountered. Virtual iMRI had a sensitivity of 1 (95% CI 0.86-1), specificity of 0.26 (95% CI 0.14-0.42), positive predictive value of 0.44 (95% CI 0.3-0.58), and negative predictive value of 1 (95% CI 0.72-1). Subgroup analysis revealed that the virtual iMRI findings were concordant with postoperative MRI findings in all cases (n = 9) of lower-grade glioma (LGG) with a sensitivity of 1 (95% CI 0.59-1) and a specificity of 1 (95% CI 0.16-1) (p = 0.003); a statistically significant association was also found for grade 4 gliomas with a sensitivity of 1 (95% CI 0.69-1) and a specificity of 0.33 (95% CI 0.08-0.7) (p = 0.046) (19 patients). No significant association was found when considering meningiomas or metastases.

CONCLUSIONS: The commercially available virtual iMRI can predict the presence or absence of tumor residual with high sensitivity. The diagnostic accuracy of this method was higher in LGGs and much lower for meningiomas or metastases; these findings must be evaluated in prospective studies in a larger population.

PMID:38669708 | DOI:10.3171/2024.1.JNS232342