Category: Nevin Manimala

BMC Oral Health. 2024 Aug 7;24(1):909. doi: 10.1186/s12903-024-04586-y.

ABSTRACT

BACKGROUND: Bad breath (halitosis) is a common problem affecting psycho-social wellbeing of young people. We aimed to explore the extent of self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh.

METHODS: A cross-sectional study was conducted among university students from November 2021 to April 2022. Six private and two public universities were approached. A total of 318 participants were conveniently selected for the study. A self-administered questionnaire was used for data collection. Students unwilling to participate were excluded. Multivariable logistic regression analysis was used to examine factors associated with halitosis. Statistical analysis was conducted using Stata Version 17.

RESULTS: A total of 55.97% of students had self-perceived halitosis, with females (74.53%) having a significantly higher proportion than males (36.94%) (p < 0.001). A significantly higher proportion of halitosis was found among participants who were overweight ( 61%), had obesity (60.77%), smoked cigarette (46.79%), consumed alcohol (71.43%), lacked exercise (66.29%), were on unhealthy diet (57.35%), consumed coffee/tea (61.35%), breathed through mouth (64.60%), brushed tooth infrequently (85.71%), changed toothbrush after 6 months (77.42%), did not use toothpaste (94.74%), did not use/ sometimes used fluoride toothpaste (75.76%), lacked dental floss use (60.85%), did not use toothpick (62.87%), did chew or sometimes chewed sugar-free chewing gum (75.82%), did not clear / cleaned tongue sometimes (76.14%), did use mouth freshener regularly or occasionally (64.97%), did not use or used mouthwash sometimes (58.87%) were also associated with higher self-perceived halitosis (p < 0.05 for all). Students with gum bleeding, swollen gums, dry mouth, dental caries, food accumulation, and tooth sensitivity had a significantly (p < 0.05 for all) higher proportion of self-perceived halitosis (76.85%, 81.82%, 72.50%, 67.78%, 64.13% and 67.40%, respectively) compared to those without this problem. Being female (OR = 5.04; 95% CI: 2.01-12.62; p < 0.001), alcohol consumers (OR 7.35; 95% CI: 1.77-30.50; p = 0.006); not using sugar free chewing gum (OR = 0.25; 95% CI: 0.10-0.58; p = 0.001), lack of tongue cleaning (OR 4.62; 95% CI: 2.16-9.84; p < 0.001), and gum bleeding (OR = 7.43; 95% CI: 3.00-18.35; p < 0.001) were independently associated with halitosis on multivariable regression.

CONCLUSION: This study reveals a high proportion of self-perceived halitosis and relevant factors. There should be more public education on the causes of halitosis and potential management approaches.

PMID:39113016 | DOI:10.1186/s12903-024-04586-y

BMC Health Serv Res. 2024 Aug 8;24(1):911. doi: 10.1186/s12913-024-11391-4.

ABSTRACT

BACKGROUND: Equitable geographical distribution of health resources, such as hospital beds, is fundamental in ensuring public accessibility to healthcare services. This study examines the distribution of hospital beds across Saudi Arabia’s 20 health regions.

METHODS: A secondary data analysis was conducted using the 2022 Saudi Ministry of Health Statistical Yearbook. The study focused on calculating the hospital beds-per-1,000-people ratio across Saudi Arabia’s 20 health regions. The analysis involved comparing regional bed distributions using the Gini index and Lorenz curve to assess the distribution of hospital beds.

RESULTS: The national average beds-per-1,000-people ratio was 2.43, serving a population of approximately 32.2 million. The calculated mean Gini index for bed distribution was 0.15, which indicates a relatively equitable distribution. Further analysis revealed some regional disparities, with health regions like Makkah and Jeddah displaying critically low bed-to-population ratios. In contrast, others like Al-Jouf and the Northern region reported higher ratios. The study also identified the need for an additional 17,062 beds to meet international standards of 2.9 beds per 1,000 people.

CONCLUSIONS: The findings revealed a national average beds-per-1,000-people ratio of 2.43, with some regional disparities. The study highlights the critical need for targeted healthcare planning and policy interventions to address the uneven distribution of hospital beds across Saudi Arabia.

TRIAL REGISTRATION: Not applicable.

PMID:39113012 | DOI:10.1186/s12913-024-11391-4

BMC Nurs. 2024 Aug 7;23(1):537. doi: 10.1186/s12912-024-02209-z.

ABSTRACT

BACKGROUND: This study investigated the mediating effects of self-efficacy and social support on the relationship between stress and burnout among infection control nurses (ICNs) during an emerging infectious disease pandemic.

METHODS: The study participants encompassed 210 ICNs with at least six months’ experience in an infection control unit at a general hospital in South Korea during the COVID-19 pandemic. Data were analyzed using independent t-tests or one-way analysis of variance (ANOVA), while descriptive statistics were performed using SPSS/WIN 26.0 software. Hayes’s PROCESS macro 4.2 software was used to verify the significance of the indirect effects of the mediators.

RESULTS: Stress had a significant positive effect on burnout (β = 0.80, p < .001), accounting for 73% of the variance. Self-efficacy (β = – 0.26, p < .001) and social support (β = – 0.11, p = .034) had a significant negative effect on burnout, accounting for 78% of the variance. Stress was lower when self-efficacy and social support were entered into the model (β = 0.80 → 0.59), indicating that self-efficacy and social support mediated the relationship between stress and burnout.

CONCLUSION: This study is significant in that it confirms the effects of self-efficacy and social support on the relationship between stress and burnout among ICNs. The results highlight the importance of establishing organizational support systems and developing and implementing programs for enhancing self-efficacy in order to reduce burnout among ICNs.

PMID:39113008 | DOI:10.1186/s12912-024-02209-z

BMC Oral Health. 2024 Aug 7;24(1):908. doi: 10.1186/s12903-024-04639-2.

ABSTRACT

BACKGROUND: Effect of aging on tissue adaptability and retention of digital obturator is still under investigation.

METHODS: A maxillary Armany (class I) epoxy reference model was scanned to fabricate digital obturator fabricated from milled Co-Cr framework and 3D printed bulb. A color map of the scanned reference and digital obturator was made using Geomagic software to evaluate the accuracy of fit before and after cyclic loading using ROBOTA chewing simulator at 37,500, 75,000 and 150,000 cycles to simulate clinically 3-, 6- and 12-months chewing condition. Insertion-removal condition simulating the placement and removal of the obturator was done using repeated 360, 720 and 1440 cycles and retention was evaluated before and after the repeated cycles. Data were collected, tabulated and statistically analyzed using Statistical Package for Social Sciences (IBM SPSS Statistics 26). Student t-test and multi variable ANOVA test were used to detect significance. P-value < 0.05 was considered significant difference.

RESULTS: For retention test: There was a significant difference between baseline and 3, 6 and12 months. For the tissue surface adaptation test: There was significant difference at all measured areas (P-value < 0.05) before and after application of load.

CONCLUSION: digitally designed and fabricated obturator was highly retentive and has excellent tissue surface adaptation upon fabrication, After application of load; reduction of retention and lack of tissue adaptation were resulted. THE CLINICAL IMPLICATION: of this manuscript is that digital obturator can be used successfully with the shortcomings of loosening retention and adaptation afterwhile. So, clinical trials should investigate the clinical acceptance of these shortcomings.

PMID:39113006 | DOI:10.1186/s12903-024-04639-2

BMC Surg. 2024 Aug 7;24(1):225. doi: 10.1186/s12893-024-02520-1.

ABSTRACT

BACKGROUND: Pediatric patients undergoing liver transplantation are particularly susceptible to complications arising from intraoperative fluid management strategies. Conventional liberal fluid administration has been challenged due to its association with increased perioperative morbidity. This study aimed to assess the impact of intraoperative high-volume fluid therapy on pediatric patients who are undergoing living donor liver transplantation (LDLT).

METHODS: Conducted at the Children’s Hospital of Chongqing Medical University from March 2018 to April 2021, this retrospective study involved 90 pediatric patients divided into high-volume and non-high-volume fluid administration groups based on the 80th percentile of fluid administered. We collected the perioperative parameters and postoperative information of two groups. Multivariable logistic regression was utilized to assess the association between estimated blood loss (EBL) and high-volume FA. Kaplan-Meier survival analysis was used to compare patient survival after pediatric LDLT.

RESULTS: Patients in the high-volume FA group received a higher EBL and longer length of stay than that in the non-high-volume FA group. Multivariate logistic regression analysis indicated that hours of maintenance fluids and fresh frozen plasma were significantly associated risk factors for the occurrence of EBL during pediatric LDLT. In addition, survival analysis showed no significant differences in one-year mortality between the groups.

CONCLUSIONS: High-volume fluid administration during LDLT is linked with poorer intraoperative and postoperative outcomes among pediatric patients. These findings underscore the need for more conservative fluid management strategies in pediatric liver transplantations to enhance recovery and reduce complications.

PMID:39113003 | DOI:10.1186/s12893-024-02520-1

Respir Res. 2024 Aug 7;25(1):303. doi: 10.1186/s12931-024-02908-w.

ABSTRACT

BACKGROUND: Acute lung injury (ALI) following pneumonia involves uncontrolled inflammation and tissue injury, leading to high mortality. We previously confirmed the significantly increased cargo content and extracellular vesicle (EV) production in thrombin-preconditioned human mesenchymal stromal cells (thMSCs) compared to those in naïve and other preconditioning methods. This study aimed to investigate the therapeutic efficacy of EVs derived from thMSCs in protecting against inflammation and tissue injury in an Escherichia coli (E. coli)-induced ALI mouse model.

METHODS: In vitro, RAW 264.7 cells were stimulated with 0.1 µg/mL liposaccharides (LPS) for 1 h, then were treated with either PBS (LPS Ctrl) or 5 × 10⁷ particles of thMSC-EVs (LPS + thMSC-EVs) for 24 h. Cells and media were harvested for flow cytometry and ELISA. In vivo, ICR mice were anesthetized, intubated, administered 2 × 10⁷ CFU/100 µl of E. coli. 50 min after, mice were then either administered 50 µL saline (ECS) or 1 × 10⁹ particles/50 µL of thMSC-EVs (EME). Three days later, the therapeutic efficacy of thMSC-EVs was assessed using extracted lung tissue, bronchoalveolar lavage fluid (BALF), and in vivo computed tomography scans. One-way analysis of variance with post-hoc TUKEY test was used to compare the experimental groups statistically.

RESULTS: In vitro, IL-1β, CCL-2, and MMP-9 levels were significantly lower in the LPS + thMSC-EVs group than in the LPS Ctrl group. The percentages of M1 macrophages in the normal control, LPS Ctrl, and LPS + thMSC-EV groups were 12.5, 98.4, and 65.9%, respectively. In vivo, the EME group exhibited significantly lower histological scores for alveolar congestion, hemorrhage, wall thickening, and leukocyte infiltration than the ECS group. The wet-dry ratio for the lungs was significantly lower in the EME group than in the ECS group. The BALF levels of CCL2, TNF-a, and IL-6 were significantly lower in the EME group than in the ECS group. In vivo CT analysis revealed a significantly lower percentage of damaged lungs in the EME group than in the ECS group.

CONCLUSION: Intratracheal thMSC-EVs administration significantly reduced E. coli-induced inflammation and lung tissue damage. Overall, these results suggest therapeutically enhanced thMSC-EVs as a novel promising therapeutic option for ARDS/ALI.

PMID:39112999 | DOI:10.1186/s12931-024-02908-w

BMC Oral Health. 2024 Aug 7;24(1):905. doi: 10.1186/s12903-024-04694-9.

ABSTRACT

BACKGROUND: Warfarin patients who need dental extraction face the problem of bleeding and no sufficient hemostasis results in dry socket and postoperative pain. This study aimed to evaluate and compare the efficacy of the topical application of tranexamic acid-soaked absorbable Gelfoam (TXA-Gel) and saline-soaked absorbable Gelfoam (saline-Gel) in relieving postoperative pain following bilateral simple extraction of permanent mandibular molars in warfarin patients.

METHODS: This was a randomized, triple-blinded, split-mouth, active-controlled clinical trial. It was performed at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, between November 2021 and October 2023. 60 bilateral permanent mandibular molars, which were indicated for simple extraction in 30 warfarin patients randomly assigned into two groups according to the topical hemostatic agents after extraction used: Group 1: control group, saline-Gel (n = 30). Group 2: TXA-Gel (n = 30). A simple randomization method was performed by flipping a coin. The primary outcome measure was the visual analogue scale (VAS). The intensity of pain was evaluated at the baseline (t₀), and on the 1st (t₁), 2nd (t₂), 3rd (t₃), 4th (t₄), 5th (t₅), 6th (t₆), and 7th (t₇) days following extraction. The Kolmogorov-Smirnov test and the Mann-Whitney U test were performed. The level of significance was set at 0.05 (p < 0.05).

RESULTS: The mean vas scores was 4.17 ± 1.76 at t1 and decreased to 0.73 ± 0.78 at t7 in the TXA-Gel group. However, in the Gelfoam group, the mean vas scores was 4.83 ± 2.18 at t1 and decreased to 1.80 ± 1.00 at t7. The results of the Mann-Whitney U test showed that there was no statistically significant difference between the two groups at t1 (p = 0.236) and t2 (p = 0.155). However, there was a statistically significance difference at the rest time points (p < 0.05).

CONCLUSIONS: TXA-Gel played a prominent role in alleviating post-extraction pain in warfarin patients.

TRIAL REGISTRATION: The trail was retrospectively registered at the ISRCTN registry (ISRCTN71901901).

PMID:39112998 | DOI:10.1186/s12903-024-04694-9

J Environ Manage. 2024 Aug 6;367:122018. doi: 10.1016/j.jenvman.2024.122018. Online ahead of print.

ABSTRACT

Climate change has a significant impact on dissolved oxygen (DO) concentrations, particularly in coastal inlets where numerous human activities occur. Due to the various water quality (WQ), hydrological, and climatic parameters that influence this phenomenon, predicting and modeling DO variation is a challenging process. Accordingly, this study introduces an innovative Deep Learning Neural Network (DLNN) methodology to model and predict DO concentrations for the Egyptian Rashid coastal inlet, leveraging field-recorded WQ and hydroclimatic datasets. Initially, statistical and exploratory data analyses are performed to provide a thorough understanding of the relationship between DO fluctuations and associated WQ and hydroclimatic stressors. As an initial step towards developing an effective DO predictive model, conventional Machine Learning (ML) approaches such as Gaussian Process Regression (GPR), Support Vector Regression (SVR), and Decision Tree Regressor (DTR) are employed. Subsequently, a DLNN approach is utilized to validate the prediction capabilities of the investigated conventional ML approaches. Finally, a sensitivity analysis is conducted to evaluate the impact of WQ and hydroclimatic parameters on predicted DO. The outcomes demonstrate that DLNN significantly improves DO prediction accuracy by 4% compared to the best-performing ML approach, achieving a Correlation Coefficient of 0.95 with a root mean square error (RMSE) of 0.42 mg/l. Solar radiation (SR), pH, water levels (WL), and atmospheric pressure (P) emerge as the most significant hydroclimatic parameters influencing DO fluctuations. Ultimately, the developed models could serve as effective indicators for coastal authorities to monitor DO changes resulting from accelerated climate change along the Egyptian coast.

PMID:39111007 | DOI:10.1016/j.jenvman.2024.122018

J Environ Manage. 2024 Aug 6;367:122080. doi: 10.1016/j.jenvman.2024.122080. Online ahead of print.

ABSTRACT

The rapid advancement of artificial intelligence (AI) in the 21st century is driving profound societal changes and playing a crucial role in optimizing energy systems to achieve carbon neutrality. Most G20 nations have developed national AI strategies and are advancing AI applications in energy, manufacturing, and agriculture sectors to meet this goal. However, disparities exist among these nations, creating an “AI divide” that needs to be addressed for regulatory consistency and fair distribution of AI benefits. Here, we look at the linear effects of AI and the Paris Agreement (AI), as well as their potential interaction on carbon neutrality. We also investigate whether geopolitical risk (GPR) can hinder or enhance efforts to attain carbon neutrality through energy transition (ET). To measure carbon neutrality of G20 countries, we employed a robust parametric Malmquist index combined with the fixed-effect panel stochastic frontier model to account for heterogeneity. Results indicate that from 1990 to 2022, carbon neutrality has improved primarily due to technological advancements. Developed G20 countries led in technological progress, while developing countries showed modest gains in carbon efficiency. Using the Driscoll-Kraay robust standard error method, we found that AI has a positive but insignificant linear effect on carbon neutrality. However, the interaction between PA and AI was positive and statistically significant, suggesting that PA augments AI’s potential in accelerating carbon neutrality. Energy transition accelerates carbon neutrality in both developed and developing G20 countries. However, the role of energy transition in achieving carbon neutrality becomes negative when the interaction term between energy transition and geopolitical risk (ET × GRP) is incorporated. Regarding control variables, green innovation positively impacts carbon neutrality, whereas financial development has an insignificant effect. Industrial structure and foreign direct investment both negatively affect carbon neutrality, thereby supporting the pollution haven hypothesis. It is recommended that strategies to bridge the “AI divide” and uphold geopolitical stability are crucial to achieve carbon neutrality.

PMID:39111003 | DOI:10.1016/j.jenvman.2024.122080

Appl Physiol Nutr Metab. 2024 Aug 7. doi: 10.1139/apnm-2023-0619. Online ahead of print.

ABSTRACT

A competitive sport season represents a multidimensional stressor where physical and psychological stress may render an athlete susceptible to energy deficiency (ED). Downstream effects of ED can include a reduction in measured-to-predicted resting metabolic rate (RMRratio), indicating metabolic compensation. A pathway linking stress, eating attitudes, metabolic compensation has not been explored. To test if sport-specific stress is associated with eating attitudes and metabolism in endurance athletes (18-22yr) at different phases of a competitive season, we assessed two groups of athletes; 26 swimmers (15 female, 11 male) during peak season (PEAK), and 26 runners (female); across pre- (PRE) and off-season (OFF). Stress (RESTQ-52), eating attitudes (cognitive restraint (CR), drive for muscularity (DM), and body dissatisfaction (BD)), and metabolism (RMRratio) were assessed. In PRE, sport-specific stress and CR were negatively correlated with RMRratio (R=-.58; p<.05, R=-.55; p<.05, respectively). In PEAK, sport-specific stress and DM were negatively correlated with RMRratio (R=-.64; p<.05; R=-.40; p<.05, respectively). DM was positively related to sport-specific stress (R=.55; p<.05). During OFF, there was no relation between RMRratio and sport-specific stress. In runners, there was a change in stress from PRE-to-OFF with highest reported stress during PRE (p<.05) versus OFF. Regression analyses revealed that sport-specific stress and CR were significant predictors of RMRratio during PRE and PEAK (p<.05), but not OFF (p>.05). Associations between stress, eating attitudes, and metabolic compensation in endurance athletes during PRE and PEAK season suggest that during heavier training, metabolic compensation may be linked to upstream eating attitudes associated with sport-stressors.

PMID:39110996 | DOI:10.1139/apnm-2023-0619