Category: Nevin Manimala

Community Dent Oral Epidemiol. 2023 Feb 9. doi: 10.1111/cdoe.12821. Online ahead of print.

ABSTRACT

The aim of this introductory paper is to provide an overview of key methodological developments in social and behavioural research in oral health. In the first section, we provide a brief historical perspective on research in the field. In the second section, we outline key methodological issues and introduce the seven papers in the theme. Conceptual models can contextualize research findings and address the ‘why’ and ‘how’ instead of ‘what’ and ‘how many’. Many models exist, albeit they need to be evaluated (and adapted) for use in oral health research and in specific settings. The increasing availability of big data can facilitate this with data linkage. Through data linkage, it is possible to explore and understand in a broader capacity the array of factors that influence oral health outcomes and how oral health can influences other factors. With advances in statistical approaches, it is feasible to consider casual inferences and to quantify these effects. There is a need for not only individual efforts to embrace causal inference research but also systematic and structural changes in the field to yield substantial results. The value of qualitative research in co-producing knowledge with and from human participants in addressing ‘the how’ and ‘the why’ factors is also key. There have been calls to employ more sophisticated qualitative methods together with mixed methods approaches as ways of helping to address the complex or Wicked Problems in population oral health. In the final section, we outline possible future methodological directions in social and behavioural oral health research including participatory approaches and the development of core outcome sets. Our overriding goal in the paper is to facilitate a critical debate in relation to methodological issues which can be used to improve understanding and generate knowledge in population oral health and that this, in turn, will help inform oral health policy and practices.

PMID:36756884 | DOI:10.1111/cdoe.12821

Clin Cardiol. 2023 Feb 9. doi: 10.1002/clc.23987. Online ahead of print.

ABSTRACT

The efficacy of anteriolateral versus anterior-posterior electrode positions in the success of atrial fibrillation’s (AF) electrical cardioversion is unclear. Our aim is to perform a meta-analysis to compare the success rate of both electrode positions. PUBMED, WOS, OVID, and SCOPUS were searched. Inclusion criteria were clinical trials that compared anterior-lateral with anterior-posterior electrodes in external cardioversion of AF. After the full-text screening, 11 trials were included in the analysis. The total number of patients included in the study is 1845. The pooled analysis showed a statistically significant association between anterior-lateral electrode and increased cardioversion rate of AF (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.02-1.92, p = .04). Subgroup analysis revealed a statistically significant association between the anterior-lateral electrode and increased cardioversion rate of AF in subgroups of less than five shocks, patients with 60 years old or more and patients with left atrial (LA) diameter >45 mm (OR = 1.72, 95% CI = 1.17-2.54, p = .006), (OR = 1.73, 95% CI = 1.18-2.54, p = .005), and (OR = 1.86, 95% CI = 1.04-3.34, p = .04), respectively. Anteriolateral electrode is more effective than anterior-posterior electrode in external cardioversion of AF, particularly in patients who have received less than 5 shocks, are 60 years old or older and have a LA diameter greater than 45 mm.

PMID:36756856 | DOI:10.1002/clc.23987

J Crohns Colitis. 2023 Feb 9:jjad017. doi: 10.1093/ecco-jcc/jjad017. Online ahead of print.

ABSTRACT

BACKGROUND: The Lémann Index (LI), and the recently updated LI are tools for measuring structural bowel damage in adults with Crohn’s disease (CD) but have not been evaluated in children. We aimed to validate the updated LI in the prospective multicenter ImageKids study of pediatric CD.

METHODS: We included children with CD undergoing magnetic resonance enterography (MRE), pelvic magnetic resonance imaging (MRI) and ileocolonoscopy. Half were followed for 18 months, when MRE was repeated. Serum was collected for fibrosis-related proteomic markers. The LI was calculated by central readers from the MRE, ileocolonoscopy, physical examination and surgical data. Reliability and construct validity were assessed at baseline, while responsiveness and test-retest reliability were explored longitudinally.

RESULTS: Two hundred forty children were included (mean age, 14.2±2.5 years; median disease duration, 2.2 years [IQR 0.25-4.42]; median baseline LI, 4.23 [IQR 2.0-8.8]). The updated LI had excellent inter-observer reliability (interclass correlation coefficient [ICC]=0.94, 95% CI 0.92-0.95) but poor, although statistically significant, correlation with radiologist and gastroenterologist global assessments of damage and with serum proteomic levels of fibrotic markers (r=0.15-0.30, most p<0.05). The updated LI had low discriminative validity for detecting damage (area under the receiver operating characteristic curve [AUC-ROC] 0.69, 95%CI 0.62-0.75). In 116 repeated MREs, responsiveness was suboptimal for differentiating improved from unchanged disease (AUC-ROC 0.58, 95%CI, 0.45-0.71). Test-retest reliability was high among stable patients (ICC=0.84, 0.72-0.91).

CONCLUSION: Overall, the updated LI had insufficient psychometric performance for recommending its use in children. An age-specific index may be needed for children with shorter disease duration than typical adult cohorts.

PMID:36756849 | DOI:10.1093/ecco-jcc/jjad017

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Feb;37(2):133-135;140. doi: 10.13201/j.issn.2096-7993.2023.02.011.

ABSTRACT

Objective:To investigate the positive imaging rate of otitis media in children aged 1-12 years by analyzing the positive rate of otitis media suggested by cranial magnetic resonance imaging（MRI） images in children. Methods:By collecting the brain MRI images of children aged 1-12 in Department of Otolaryngology, Jinan children’s Hospital from January 2014 to December 2020, the overall incidence of otitis media and mastoiditis was firstly determined, and then it was divided into 12 age groups according to age, each age group was split into boy and girl groups according to gender, each group was divided into left, right and bilateral groups, with the changes of otitis media and mastoiditis in the scanning field as the positive standard statistical analysis of the results. Results:Among 12 439 children in the study, 1321 cases were diagnosed with tympanitis, with a positive rate of 10.62%. Among them, 892 patients were male, with a positive rate of 67.52%, and 429 cases were female, with a positive rate of 32.48%. The positive rate of the male was higher than that of female children, 1.84 times higher than that of female children. The positive momentum in male and female children was negatively correlated with age （P<0.01）. The favorable rates of male children in the left ear, right ear, and both ears were higher than those in female children of the same age（P<0.05）. There was no difference in the positive rate of the left and right ear in children with tympanitis （P=0.76）. Conclusion:Craniocerebral MRI examination in children with tympanitis can clarify the inflammation of the middle ear cavity and the effusion in the mastoid air chamber. The positive rate of children at two years old showed a steep decline, which may be due to the acceleration of mastoid gasification, the change of tympanic environment, the increase of air chamber in the tympanic room, the evolution of air pressure could offset the negative pressure caused by poor Eustachian tube function, to reduce the incidence of tympanitis.

PMID:36756829 | DOI:10.13201/j.issn.2096-7993.2023.02.011

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Feb;37(2):92-96. doi: 10.13201/j.issn.2096-7993.2023.02.003.

ABSTRACT

Objective:To summarize the clinical characteristics of elderly patients with chronic suppurative otitis media who underwent type Ⅰ tympanoplasty, and to analyze for the first time the efficacy of type Ⅰtympanoplasty in elderly patients from multiple perspectives of medical data and patient evaluation, so as to provide reference for doctors and patients to make rational decisions on treatment methods. Methods:Forty-four elderly patients（45 ears） who underwent type Ⅰtympanoplasty from May 2016 to February 2022 were retrospectively analyzed, and were followed up for 6 months to 3 years. To analyze the clinical characteristics of patients, summarize the success rate of graft, and compare the hearing level of patients before and after surgery. The patients’ quality of life before and after operation was evaluated by Chronic Ear Survey, and the scores obtained were statistically analyzed. Results:Of the 44 patients（45 ears）, 22.22%（10/45） of the ears had predisposing factors. The percentage of hearing loss, ear pus and tinnitus were 91.11%（41/45）, 88.89%（40/45） and 42.22%（19/45）, respectively. Mixed deafness accounted for 55.56%（25/45）. 66.67%（30/45） patients were diagnosed as tympanosclerosis by operation. The graft success rate was 97.78%. There was no significant difference in bone conduction hearing threshold before and after surgery, but there was significant difference in air conduction hearing threshold and air bone conduction difference. The scores of “activity restriction”, “symptom”, “medical resource utilization” and their total scores of the preoperative and postoperative were statistically different. Hypertension or diabetes had no significant effect on the efficacy of type Ⅰ tympanoplasty in elderly patients. Conclusion:Type Ⅰtympanoplasty is safe and effective in elderly patients, and the quality of life of patients after surgery is significantly improved. It is necessary to increase the awareness of elderly patients to seek medical advice and use surgical methods reasonably to treat chronic suppurative otitis media.

PMID:36756821 | DOI:10.13201/j.issn.2096-7993.2023.02.003

Cardiovasc Res. 2023 Feb 9:cvad031. doi: 10.1093/cvr/cvad031. Online ahead of print.

ABSTRACT

AIMS: Publicized adverse events after vaccination agianst SARS-CoV-2 raised concern among patients with coronary atherosclerosis disease (CAD). We sought to study the association between SARS-CoV-2 vaccines and long-term clinical outcomes including ischemic and bleeding events among patients with CAD.

METHODS AND RESULTS: Inpatients diagnosed with CAD by coronary angiography, without a history of SARS-CoV-2 infection and vaccination were included between January 1 and April 30, 2021, and underwent follow-up until January 31, 2022. Two doses of inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac, BBIBPCorV or WIBP-CorV) were available after discharge, and the group was stratified by vaccination. The primary composite outcomes were cardiovascular death, nonfatal myocardial infarction, stent thrombosis, unplanned revascularization, ischemic stroke, venous thromboembolism or peripheral arterial thrombosis. The bleeding outcomes were Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. Cox regression models with vaccination status as time-dependent covariate were used to calculate the hazard ratio (HR) for the outcomes. Propensity score matching method was used to reduce confounding biases. This prospective cohort study included 2078 individuals with CAD, 1021 (49.1%) were vaccinated. During a median follow-up of 9.1 months, 45 (4.3%) primary composite outcomes occurred in the unvaccinated group, and 33 (3.2%) in the vaccinated group. In Cox regression, the adjusted HR was 1.13 [95% CI 0.65-1.93]. The adjusted HR for the bleeding outcomes associated with vaccination was 0.81 [95% CI 0.35-1.19]. After matching, the adjusted HR for the primary composite outcomes associated with vaccination was 1.06 [95% CI 0.57-1.99] and for the bleeding outcomes was 0.91 [95% CI 0.35-2.38]. Similar results were found in the seven prespecified subgroups. No grade 3 adverse reactions after vaccination were recorded.

CONCLUSIONS: Our results indicated no evidence of an increased ischemic or bleeding risk after vaccination with inactivated SARS-CoV-2 vaccine among Chinese patients with CAD, with limited statistical power.

PMID:36756815 | DOI:10.1093/cvr/cvad031

Physiol Rep. 2023 Feb;11(3):e15558. doi: 10.14814/phy2.15558.

ABSTRACT

Mandibular advancement devices (MADs) are frequently prescribed for obstructive sleep apnea (OSA) patients, but approximately one third of patients experience no therapeutic benefit. Understanding the mechanisms by which MADs prevent pharyngeal collapse may help optimize MAD therapy. This study quantified the relative contributions of changes in airspace cross-sectional area (CSA) versus changes in velopharyngeal compliance in determining MAD efficacy. Sixteen patients with moderate to severe OSA (mean apnea-hypopnea index of 32 ± 15 events/h) underwent measurements of the velopharyngeal closing pressure (P_CLOSE ) during drug induced sedated endoscopy (DISE) via stepwise reductions in nasal mask pressure and recording of the intraluminal pressure with a catheter. Airspace CSA was estimated from video endoscopy. Pharyngeal compliance was defined as the slope of the area-pressure relationship of the velopharyngeal airspace. MAD therapy reduced P_CLOSE from a median of 0.5 cmH₂ O pre-advancement to a median of -2.6 cmH₂ O post-advancement (p = 0.0009), increased the minimal CSA at the velopharynx by approximately 20 mm² (p = 0.0067), but did not have a statistically significant effect on velopharyngeal compliance (p = 0.23). P_CLOSE had a strong correlation with CSA but did not correlate with velopharyngeal compliance. Our results suggest that MADs reduce velopharyngeal collapsibility by increasing airway size as opposed to affecting velopharyngeal compliance. This contradicts the speculation of previous literature that the effectiveness of MADs is partially due to a reduction in velopharyngeal compliance resulting from stretching of the soft palate. These findings suggest that quantification of velopharyngeal CSA pre- and post-MAD advancement has potential as a biomarker to predict the success of MAD therapy.

PMID:36756800 | DOI:10.14814/phy2.15558

Int Wound J. 2023 Feb 9. doi: 10.1111/iwj.14077. Online ahead of print.

ABSTRACT

This study aimed to identify some risk factors for post-burn scarring in children aged 0-18 years. One hundred and eighty two participants were involved in this cohort study. Under the age of 18 who were admitted to the Department of Burn Reconstructive Surgery with a diagnosis of upper and lower extremity burns were followed for 6 months. A total of 182 participants (62.1% male, and 37.9% female participants) enrolled in this study. Age ranged from 1 to 17 and the average age was 3.95 ± 3.35. The degree of burn and the anatomical location of the burn had a statistically significant effect on the development of hypertrophic scars. The length of the patient’s hospitalisation days and the area of ​​the burn were statistically correlated with wound healing (P = 000, P = .074). For example, the average length of hospitalisation days was 8 ± 5 days in the hypertrophic scars group of patients, and in the group with normal scars, average bed days were 6 ± 3 days (P = .000). Grade IIIb burns increased the risk of hypertrophic scar development by 4.9 times and grade IV burns increased it by 2.5 times. In addition, when the area of burns was 11% or more, the risk of hypertrophic scar development was increased by 58.8%. In the case of wound swab infection, the risk of hypertrophic scar development was 12.4% higher (B = 1.124, 95 EI = 0.55; 2.28, P = .748). Participants’ age, burn area and degree of burn are statistically significant risk factors for post-burn scarring in children aged 0-18 years.

PMID:36756785 | DOI:10.1111/iwj.14077

Ecology. 2023 Feb 9:e3990. doi: 10.1002/ecy.3990. Online ahead of print.

ABSTRACT

The center-periphery hypothesis predicts a decline in population performance toward the periphery of a species’ range, reflecting an alteration of environmental conditions at range periphery. However, the rare demographic tests of this hypothesis failed to disentangle the role of geography from that of ecological niche and are biased toward temperate regions. We hypothesized that because species are expected to experience optimal abiotic conditions at their climatic niche center, (i) central populations will have better demographic growth, survival, and fertility than peripheral populations. As a result, (ii) central populations are expected to have higher growth rates than peripheral populations. Peripheral populations are expected to decline, thus limiting species range expansion beyond these boundaries. Because peripheral populations are expected to be in harsh environmental conditions, (iii) population growth rate will be more sensitive to perturbation of survival-growth rather than fertility in peripheral populations. Finally, we hypothesized that (iv) soils properties will drive the variations in population growth rates for narrowly distributed species for which small scale ecological factors could outweigh landscape level drivers. To test these hypotheses, we studied the demography of Thunbergia atacorensis (Acanthaceae), a range-limited herb in West Africa. We collected three years of demographic data to parametrize an integral projection model and estimated population level demographic statistics. Demographic vital rates and population growth rates did not change significantly with distance from geographic or climatic center, contrary to predictions. However, populations at the center of the geographic range were demographically more resilient to perturbation than those at the periphery. Soil nitrogen was the main driver of population growth rate variation. The relative influence of survival-growth on population growth rates exceeded that of fertility at the geographic range center while we observed the opposite pattern for climatic niche. Our study highlights the importance of local scale processes in shaping the dynamics and distribution of range-limited species. Our findings also suggest that the distinction between geographic distribution and climatic niche is important for a robust demographic test of the center-periphery hypothesis. This article is protected by copyright. All rights reserved.

PMID:36756774 | DOI:10.1002/ecy.3990

Scand J Med Sci Sports. 2023 Feb 9. doi: 10.1111/sms.14325. Online ahead of print.

ABSTRACT

The altitude differential of the specific mechanical energy, diff (e_mech ), is used to evaluate skiing performance. It is defined as the negative differential between the skier’s total specific mechanical energy (e_mech ) and the altitude of the skier’s centre of mass (COM). Till now, e_mech was obtained upon a mass-point (MP) model of the skier’s COM, which neither considered the segmental energies of their relative movements to the COM, nor their rotational kinetic energies. The aims of the study were therefore: a) to examine the deviations in diff (e_mech ) between the MP and a more complex linked segment (LS) skier model consisting of 15 rigid bodies, which encountered the aforementioned defectiveness, b) to compare the energy fluctuations of the two skier models, and c) to investigate the influence of the gate setup on a) and b) in giant slalom. Three-dimensional whole-body kinematics of nine skiers was measured using a global navigation satellite system and an inertial motion capture system while skiing on a predefined course divided into a turny and open gate setup. Mechanical energies including their altitude differentials were calculated for the LS and MP models. There were no significant differences in e_mech and diff (e_mech ) ski turn averages, as in individual data points, between both skier models for both analysed gate setups. The energies additionally considered by the LS model presented a negligible part regardless of the gate setup. In conclusion, the MP skier model is sufficiently accurate for the evaluation of the skiing performance with diff (e_mech ).

PMID:36756770 | DOI:10.1111/sms.14325