Category: Nevin Manimala

Int J Speech Lang Pathol. 2024 Mar 13:1-11. doi: 10.1080/17549507.2024.2311931. Online ahead of print.

ABSTRACT

PURPOSE: Early intervention based on principles of cross-situational statistical learning (CSSL) for late-talking children has shown promise. This study explored whether parents could be trained to deliver this intervention protocol with fidelity and if they found the intervention to be acceptable.

METHOD: Mothers of four English-speaking children aged 18-30 months who scored <10th centile for expressive vocabulary were recruited to an 8-week group training program. Parents were taught principles of CSSL and asked to perform 16 home treatment sessions (30 minutes each) in total, providing auditory bombardment of target words in full sentences at high dose number and syntactic variability, using a range of physical exemplars. Home diaries and two videotaped sessions measured treatment fidelity. Pre- and post-treatment questionnaires measured acceptability.

RESULT: One parent discontinued the study after the second group training session. Three parents completed 15/16 group training sessions and reported completing 87% of home sessions. Two parents demonstrated implementing the intervention as per the target dose number by the first fidelity session (Weeks 2/3), and the third parent was very close to meeting target dose number by the second fidelity session (Weeks 7/8).

CONCLUSION: Parents can be trained to deliver an intervention based on cross-situational statistical learning principles.

PMID:38477891 | DOI:10.1080/17549507.2024.2311931

JAMA Psychiatry. 2024 Mar 13. doi: 10.1001/jamapsychiatry.2024.0047. Online ahead of print.

ABSTRACT

IMPORTANCE: While psychedelic-assisted therapy has shown promise in the treatment of certain psychiatric disorders, little is known about the potential risk of psychotic or manic symptoms following naturalistic psychedelic use, especially among adolescents.

OBJECTIVE: To investigate associations between naturalistic psychedelic use and self-reported psychotic or manic symptoms in adolescents using a genetically informative design.

DESIGN, SETTING, AND PARTICIPANTS: This study included a large sample of adolescent twins (assessed at age 15, 18, and 24 years) born between July 1992 and December 2005 from the Swedish Twin Registry and cross-sectionally evaluated the associations between past psychedelic use and psychotic or manic symptoms at age 15 years. Individuals were included if they answered questions related to past use of psychedelics. Data were analyzed from October 2022 to November 2023.

MAIN OUTCOMES AND MEASURES: Primary outcome measures were self-reported psychotic and manic symptoms at age 15 years. Lifetime use of psychedelics and other drugs was also assessed at the same time point.

RESULTS: Among the 16 255 participants included in the analyses, 8889 were female and 7366 were male. Among them, 541 participants reported past use of psychedelics, most of whom (535 of 541 [99%]) also reported past use of other drugs (ie, cannabis, stimulants, sedatives, opioids, inhalants, or performance enhancers). When adjusting for substance-specific and substance-aggregated drug use, psychedelic use was associated with reduced psychotic symptoms in both linear regression analyses (β, -0.79; 95% CI, -1.18 to -0.41 and β, -0.39; 95% CI, -0.50 to -0.27, respectively) and co-twin control analyses (β, -0.89; 95% CI, -1.61 to -0.16 and β, -0.24; 95% CI, -0.48 to -0.01, respectively). In relation to manic symptoms, likewise adjusting for substance-specific and substance-aggregated drug use, statistically significant interactions were found between psychedelic use and genetic vulnerability to schizophrenia (β, 0.17; 95% CI, 0.01 to 0.32 and β, 0.17; 95% CI, 0.02 to 0.32, respectively) or bipolar I disorder (β, 0.20; 95% CI, 0.04 to 0.36 and β, 0.17; 95% CI, 0.01 to 0.33, respectively).

CONCLUSIONS AND RELEVANCE: The findings in this study suggest that, after adjusting for other drug use, naturalistic use of psychedelic may be associated with lower rates of psychotic symptoms among adolescents. At the same time, the association between psychedelic use and manic symptoms seems to be associated with genetic vulnerability to schizophrenia or bipolar I disorder. These findings should be considered in light of the study’s limitations and should therefore be interpreted with caution.

PMID:38477889 | DOI:10.1001/jamapsychiatry.2024.0047

Eur J Gastroenterol Hepatol. 2024 Mar 4. doi: 10.1097/MEG.0000000000002736. Online ahead of print.

ABSTRACT

OBJECTIVE: Liver cancer is the third most common cause of cancer-related deaths worldwide. Hepatitis B and C infections are the main factors affecting mortality. During recent years, Montenegro conducted activities on eradication of viral hepatitis according to the global strategy for the primary prevention of liver cancer mortality. The objective of this study was to assess the liver cancer mortality trend in Montenegro for the period of 1990-2018 using regression techniques.

METHODS: liver cancer mortality data in Montenegro from 1990 to 2018 were collected. Mortality rates were age standardized to the World Standard Population. The joinpoint, linear and Poisson regressions were used to assess liver cancer mortality trends both overall and gender specific.

RESULTS: The mortality trend was constant, with no significant increase or decrease in mortality rates both at the overall level and by gender. The number of cases, however, increases significantly at the overall level by an average of 1.4% per year [average annual percentage change (AAPC) (95% confidence interval, CI): 1.4 (0.5-2.3); P = 0.004] and in women by 1.9% per year [AAPC (95% CI): 1.9 (0.8-3.1); P = 0.002]. In men, there was no change in the number of cases. The three age groups most burdened by mortality from liver cancer were 65-74 (34.9%), 75-84 (26.6%) and 55-64 (25.8%).

CONCLUSION: The consistent implementation of prevention measures and hepatitis virus infection treatment has played a role in partially favorable liver cancer mortality trends in Montenegro. It is crucial to closely monitor guidelines for this cancer and give particular attention to the elderly population as the most affected.

PMID:38477857 | DOI:10.1097/MEG.0000000000002736

Int J Prosthodont. 2024 Mar 13;0(0):1-21. doi: 10.11607/ijp.8816. Online ahead of print.

ABSTRACT

PURPOSE: To compare the fracture load of two framework materials, zirconia and a new fiber-reinforced composite (FRC), for full-arch implant-supported rehabilitations using various cross- sections.

MATERIAL AND METHODS: A cobalt-chromium metal model simulating the all-on-four concept and including 2 anterior straight and 2 posterior 45- degree angled multi-unit digital implant analogs was manufactured. 4 straight multi-unit abutments were screwed onto the implant analogs. The metallic model was scanned, and 18 frameworks were fabricated, consisting of 9 made of zirconia and 9 made of fiber-reinforced composite (FRC). The frameworks were then divided into 6 groups, with each group consisting of 3 frameworks (n=3). Group division was based on material type (Zirconia or FRC Trilor) and framework cross-section: 3.5 x 6 mm2, 5.5 x 6 mm2, or 7.5 x 6 mm2. All specimens underwent thermocycling in 2 baths (5 ͦ c- 55 ͦ c for 2350 cycles). Subsequently, the frameworks were cemented to the abutments of the metal model and subjected to a load-to-failure bending test at 3 different points using a universal testing machine (crosshead speed: 1 mm/min) until complete fracture occurred (according to ISO/TS 11405:2015). Descriptive statistics were used to present quantitative variables as means ± standard deviations. To compare two means, Student’s t-test or Mann-Whitney test was utilized, and for three means, ANOVA test was used.

RESULTS: The FRC group with a 7.5 x 6 mm2 cross-section exhibited the highest load-to-failure values (ranging from 1020 N to 2994N) , while the zirconia group with a 3.5 x 6 mm2 cross-section recorded the lowest values (ranging from 212 N to 1287 N). The material type and framework cross-section significantly affected the mean load-to-fracture values (p< 0.05). Regardless of the framework cross-section, the FRC group exhibited higher fracture loads than the zirconia group. In both materials, fracture load values were increased with larger framework cross-sectional areas, with the highest values observed at the inter-implant midpoint.

CONCLUSION: The FRC Trilor demonstrated a fracture load that make it a suitable alternative to zirconia for all-on-four implant prosthetic frameworks.

PMID:38477846 | DOI:10.11607/ijp.8816

Int J Prosthodont. 2024 Mar 13;0(0):1-19. doi: 10.11607/ijp.8906. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the influence of restoration bonding and type of preparation on load bearing capacity of a tooth restored with indirect glass ceramic or hybrid ceramic occlusal veneer restoration.

MATERIALS AND METHODS: Occlusal surfaces of extracted human molar teeth were prepared for indirect occlusal veneers with or without circumferential chamfer. The occlusal veneers were milled either from CAD/CAM hybrid ceramic (HC) Cerasmart (GC), or lithium-disilicate glass ceramic (LDGC) IPS e.max CAD (Ivoclar Vivadent) blocks. Finalized veneers were bonded to teeth following manufacturers’ instructions or according to the technique for the intended deteriorated bonding using n-hexane wax solution preconditioning on restorations (n=8/group). The ultimate fracture load was recorded, and fracture types were analyzed and classified visually. Statistical analysis was performed using one-way ANOVA.

RESULTS: The highest fracture load was recorded in teeth with bonded LDGC veneer (p≤0.0007). The bonded HC veneers had only marginally higher fracture load compared to non-bonded veneers. In all groups with deteriorated bonding, veneers loosened without tooth fracture whereas in the bonded veneer groups tooth fractures were observed, especially in teeth restored with LDGC material.

CONCLUSIONS: Bonded LDGC occlusal veneers have high load bearing capacity which exceeds the fracture resistance of tooth structure. Circumferential chamfer preparation for an occlusal veneer has no influence on fracture load of a restored tooth.

PMID:38477845 | DOI:10.11607/ijp.8906

Int J Prosthodont. 2024 Mar 13;0(0):1-27. doi: 10.11607/ijp.8953. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine and compare color differences of pressed lithium disilicate ceramic specimens after repeated firing cycles. An additional objective was to determine and evaluate correlation of CIEDE2000 values analyzed by X-Rite Color i5 Spectrophotometer, VITA EasyShade Advance 4.0 and Adobe Photoshop.

MATERIAL AND METHODS: Tile specimens (N=36) with 8 x 10 x 1.5mm dimensions were prepared by IPS e.max Press lithium disilicate MT Monochromatic ingots and IPS e.max Multi Press lithium disilicate Multichromatic ingots. Specimens were exposed to 7 repeated firing cycles. Color analysis was performed after the 1st, 2nd, 3rd, 5th, and 7th firing cycles. CIE L*a*b* values were measured by X-Rite Color i5 Spectrophotometer, VITA EasyShade Advance 4.0 and Adobe Photoshop. CIE DE*2000 (ΔE*00) was calculated to estimate color differences.

RESULTS: Linear regression and multiple comparison analysis (Tukey’s HSD test) showed a statistically significant (p<.001) color difference ΔE*00 after multiple firing cycles. Statistically significant differences (p<.05) were also noted in different shade groups and between different instruments used for shade evaluation. Moreover, significant differences (p<.05) were found in interactive effects between different shades tested by different instrument, different shades tested after multiple firing cycles and different instruments after multiple firing cycles.

CONCLUSIONS: Lithium disilicate material shows significant color differences after repeated firing cycles tested by three color analysis instruments. Measuring instruments used to evaluate CIE L*a*b* color values showed significant differences in color values analysis, which may lead to altered level of interpretation, particularly to determine perceptibility and clinical acceptability thresholds.

PMID:38477844 | DOI:10.11607/ijp.8953

Int Nurs Rev. 2024 Mar 13. doi: 10.1111/inr.12957. Online ahead of print.

ABSTRACT

AIM: To evaluate the mediating roles of occupational resilience and the moderationg role of perceived organizational support in the relationship between career calling and nurse burnout.

BACKGROUND: Burnout is a frequent and serious problem in the field of nursing, and it poses a serious threat to both nurses’ health and patient safety. Although many studies have described the links between burnout, career calling, and occupational resilience, little is known about the actual mechanisms between career calling and nurse burnout.

METHODS: A cross-sectional study of 615 nurses in China was conducted using a convenience sampling method. The data were analyzed using descriptive statistics and Pearson correlation analysis. Hypotheses were tested using structural equation models and bootstrapping methods. STROBE guidelines were followed.

RESULTS: Career calling was found to be negatively associated with nurse burnout, and occupational resilience mediated the relationship between career calling and burnout. Additionally, perceived organizational support was found to play a moderating role in the relationship between occupational resilience and burnout.

CONCLUSION: Career calling can reduce burnout by increasing nurses’ levels of occupational resilience, and perceived organizational support moderates this mechanism. Hence, policies focused on encouraging and sustaining career calling should be provided by nurse managers in order to enhance stress resistance and reduce burnout.

PMID:38477788 | DOI:10.1111/inr.12957

Arq Bras Cardiol. 2024 Mar 8;121(1):e20230242. doi: 10.36660/abc.20230242. eCollection 2024.

ABSTRACT

BACKGROUND: The European Society of Cardiology guidelines recommend an LDL-cholesterol (LDL-C) < 55 mg/dL for patients with established cardiovascular disease. While the Friedewald equation to estimate LDL-C is still widely used, the newer Martin-Hopkins equation has shown greater accuracy.

OBJECTIVES: We aimed to assess: A) the proportion of patients reaching LDL-C goal and the therapies used in a tertiary center; B) the impact of using the Martin-Hopkins method instead of Friedewald’s on the proportion of controlled patients.

METHODS: A single-center cross-sectional study including consecutive post-myocardial infarction patients followed by 20 cardiologists in a tertiary hospital. Data was collected retrospectively from clinical appointments that took place after April 2022. For each patient, the LDL-C levels and attainment of goals were estimated from an ambulatory lipid profile using both Friedewald and Martin-Hopkins equations. A two-tailed p-value of < 0.05 was considered statistically significant for all tests.

RESULTS: Overall, 400 patients were included (aged 67 ± 13 years, 77% male). Using Friedewald’s equation, the median LDL-C under therapy was 64 (50-81) mg/dL, and 31% had LDL-C within goals. High-intensity statins were used in 64% of patients, 37% were on ezetimibe, and 0.5% were under PCSK9 inhibitors. Combination therapy of high-intensity statin + ezetimibe was used in 102 patients (26%). Applying the Martin-Hopkins method would reclassify a total of 31 patients (7.8%). Among those deemed controlled by Friedewald’s equation, 27 (21.6%) would have a Martin-Hopkins’ LDL-C above goals.

CONCLUSIONS: Less than one-third of post-myocardial infarction patients had LDL-C within the goal. Applying the Martin-Hopkins equation would reclassify one-fifth of presumably controlled patients into the non-controlled group.

PMID:38477763 | DOI:10.36660/abc.20230242

Codas. 2024 Mar 11;36(2):e20220273. doi: 10.1590/2317-1782/20232022273pt. eCollection 2024.

ABSTRACT

PURPOSE: To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates.

METHODS: This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant’s medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%.

RESULTS: On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with “pass” and “fail” results on the NHS test in both groups.

CONCLUSION: Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the “fail” result on the NHS tests in term and preterm neonates.

PMID:38477758 | DOI:10.1590/2317-1782/20232022273pt

J Bone Miner Res. 2024 Mar 3:zjae033. doi: 10.1093/jbmr/zjae033. Online ahead of print.

ABSTRACT

Fracture risk increases with lower areal BMD (aBMD); however, aBMD-related estimate of risk may decrease with age. This may depend on technical limitations of 2-dimensional (2D) DXA which are reduced with 3D high-resolution peripheral quantitative computed tomography (HR-pQCT). Our aim was to examine whether the predictive utility of HR-pQCT measures with fracture varies with age. We analyzed associations of HR-pQCT measures at the distal radius and distal tibia with two outcomes: incident fractures and major osteoporotic fractures. We censored follow-up time at first fracture, death, last contact or 8 years after baseline. We estimated hazard ratios (HR) and 95%CI for the association between bone traits and fracture incidence across age quintiles. Among 6835 men and women (ages 40-96) with at least one valid baseline HR-pQCT scan who were followed prospectively for a median of 48.3 months, 681 sustained fractures. After adjustment for confounders, bone parameters at both the radius and tibia were associated with higher fracture risk. The estimated HRs for fracture did not vary significantly across age quintiles for any HR-pQCT parameter measured at either the radius or tibia. In this large cohort, the homogeneity of the associations between the HR-pQCT measures and fracture risk across age groups persisted for all fractures and for major osteoporotic fractures. The patterns were similar regardless of the HR-pQCT measure, the type of fracture, or the statistical models. The stability of the associations between HR-pQCT measures and fracture over a broad age range shows that bone deficits or low volumetric density remain major determinants of fracture risk regardless of age group. The lower risk for fractures across measures of aBMD in older adults in other studies may be related to factors which interfere with DXA but not with HR-pQCT measures.

PMID:38477737 | DOI:10.1093/jbmr/zjae033