Category: Nevin Manimala

Oral Health Prev Dent. 2023 Mar 15;21(1):83-92. doi: 10.3290/j.ohpd.b3957085.

ABSTRACT

PURPOSE: To assess the levels of oral health-related quality of life (OHRQoL) in orthodontic patients both during the suspension of dental services caused by COVID-19 and after a year of dental service reinstatement, and to evaluate the associated factors for OHRQoL in those patients during the suspension period.

MATERIALS AND METHODS: A cross-sectional online study was conducted both during the suspension of dental service due to COVID-19 (T1) and after a year of dental service reinstatement (T2). The questionnaire – consisting of personal information, subjective complaints, OHIP-14 and oral health conditions – was completed by the participants at T1 and T2. Data were evaluated by the Χ2 test, the Wilcoxon rank-sum test, and multivariate logistic regression analysis.

RESULTS: 324 participants were ultimately included in the study sample. The participants reported higher OHIP-14 total scores at T1 than T2 (p < 0.001). Statistically significant differences were detected in the domains psychological discomfort, psychological disability, social disability and handicap (p < 0.001). The multivariate logistic regression analysis showed that wearing fixed appliances, being over 18 years old, having delayed orthodontic treatment and poor oral hygiene habits were statistically significantly associated with higher OHIP-14 total scores at T1 (p < 0.05).

CONCLUSION: The OHRQoL in orthodontic patients was negatively impacted by the suspension of dental services during COVID-19, which was reflected in all the psychosocial domains. Types of appliances, ages, delays in follow-up visits and oral hygiene habits seemed to be the factors associated with OHRQoL in orthodontic patients during the suspension.

PMID:36920256 | DOI:10.3290/j.ohpd.b3957085

J Adhes Dent. 2023 Mar 15;25(1):63-70. doi: 10.3290/j.jad.b3956401.

ABSTRACT

PURPOSE: This study investigated the effect of different surface treatments and the effect of silane heat treatment with laser on the shear bond strength (SBS) of a nanoceramic composite to repaired hybrid CAD/CAM blocks.

MATERIALS AND METHODS: 60 hybrid CAD/CAM specimens (Cerasmart, GC) were prepared and randomly divided into six groups according to the different surface treatments (n = 10): group ER: Er:YAG laser+silane (Monobond Plus, Ivoclar Vivadent); group ER+SHT: Er:YAG laser+silane heat treatment; group B: bur+silane; group B+SHT: bur+silane heat treatment; group HF: hydrofluoric acid+silane; group HF+SHT: hydrofluoric acid+silane heat treatment. Afterwards, a universal adhesive (Universal Bond Quick, Kuraray) was applied, and nanoceramic resin composite (Zenit, President) cylinders were bonded to the Cerasmart specimens. They were thermocycled for 10,000 cycles (5-55°C) and subjected to SBS testing using a universal testing machine. Failure modes were examined with a stereomicroscope (15X). Scanning electron microscopy (SEM) was used to evaluate the surface topography (n = 2). The data were statistically analyzed using the Mann-Whitney U-test and the Kruskal-Wallis test (p < 0.05).

RESULTS: Regarding the surface treatments, group ER showed significantly lower SBS than groups B and HF (p < 0.05). Regarding the presence of silane heat treatment by laser, groups ER+SHT and B+SHT showed significantly lower SBS than group HF+SHT(p < 0.05). In addition, group B+SHT showed significantly lower SBS than did group B (p < 0.05).

CONCLUSION: Er:YAG laser treatment for repairing hybrid CAD/CAM blocks was not as effective as bur roughening or hydrofluoric acid etching. Silane heated by Er:YAG laser was incapable of significantly increasing the bond strength to repaired hybrid CAD/CAM blocks.

PMID:36920254 | DOI:10.3290/j.jad.b3956401

J Diabetes Sci Technol. 2023 Mar 15:19322968231161317. doi: 10.1177/19322968231161317. Online ahead of print.

ABSTRACT

Gestational diabetes mellitus (GDM) is a common metabolic disease of pregnancy that threatens the health of several million women and their offspring. The highest prevalence of GDM is seen in women of low socioeconomic status. Women with GDM are at increased risk of adverse maternal outcomes, including increased rates of Cesarean section delivery, preeclampsia, perineal tears, and postpartum hemorrhage. However, of even greater concern is the increased risk to the fetus and long-term health of the child due to elevated glycemia during pregnancy. Although the use of continuous glucose monitoring (CGM) has been shown to reduce the incidence of maternal and fetal complications in pregnant women with type 1 diabetes and type 2 diabetes, most state Medicaid programs do not cover CGM for women with GDM. This article reviews current statistics relevant to the incidence and costs of GDM among Medicaid beneficiaries, summarizes key findings from pregnancy studies using CGM, and presents a rationale for expanding and standardizing CGM coverage for GDM within state Medicaid populations.

PMID:36919680 | DOI:10.1177/19322968231161317

Hum Brain Mapp. 2023 Mar 15. doi: 10.1002/hbm.26273. Online ahead of print.

ABSTRACT

The validity and reliability of diagnoses in psychiatry is a challenging topic in mental health. The current mental health categorization is based primarily on symptoms and clinical course and is not biologically validated. Among multiple ongoing efforts, neurological observations alongside clinical evaluations are considered to be potential solutions to address diagnostic problems. The Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) has published multiple papers attempting to reclassify psychotic illnesses based on biological rather than symptomatic measures. However, the effort to investigate the relationship between this new categorization approach and other neuroimaging techniques, including resting-state fMRI data, is still limited. This study focused on investigating the relationship between different psychotic disorders categorization methods and resting-state fMRI-based measures called dynamic functional network connectivity (dFNC) using state-of-the-art artificial intelligence (AI) approaches. We applied our method to 613 subjects, including individuals with psychosis and healthy controls, which were classified using both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the B-SNIP biomarker-based (Biotype) approach. Statistical group differences and cross-validated classifiers were performed within each framework to assess how different categories. Results highlight interesting differences in occupancy in both DSM-IV and Biotype categorizations compared to healthy individuals, which are distributed across specific transient connectivity states. Biotypes tended to show less distinctiveness in occupancy level and included fewer cellwise differences. Classification accuracy obtained by DSM-IV and Biotype categories were both well above chance. Results provided new insights and highlighted the benefits of both DSM-IV and biology-based categories while also emphasizing the importance of future work in this direction, including employing further data types.

PMID:36919656 | DOI:10.1002/hbm.26273

J Hum Nutr Diet. 2023 Mar 15. doi: 10.1111/jhn.13162. Online ahead of print.

ABSTRACT

BACKGROUND: Hypovitamin B1 occurs frequently during critical illness but is challenging to predict or rapidly diagnose. The objective of this study were to evaluate whether plasma phosphate concentrations predict hypovitamin B1, enteral nutrition prevents hypovitamin B1 and intravenous thiamine supplementation achieves supraphysiological concentrations in critically ill patients.

METHOD: Thirty-two enterally-fed critically ill patients, with a plasma phosphate concentration ≤ 0.65 mmol/L, formed a nested cohort within a larger randomised clinical trial. Patients were assigned to receive intravenous thiamine (200 mg) twice daily or no intravenous thiamine (control). Thiamine pyrophosphate concentrations were measured at 4 time points (pre- and post-infusion, and 4- and 6-hours post-infusion) on days 1 and 3 in those allocated to thiamine and once in the control group.

RESULTS: Baseline thiamine pyrophosphate concentrations were similar (intervention 88 [67, 93] vs. control 89 [62, 110] nmol/L, P=0.49). Eight (25%) patients had hypovitamin B1 (intervention 3 vs. control 5), with two patients in the control group remaining insufficient at day 3. There was no association between baseline phosphate and thiamine pyrophosphate concentrations. Intravenous thiamine achieved supraphysiological concentrations 6 hours post first infusion with concentrations increasing to day 3. In the control group, thiamine pyrophosphate concentrations were not statistically different between baseline and day 3 (mean change 8.6 (-6.0, 23.1) nmol/L, P=0.25).

CONCLUSIONS: Phosphate concentrations did not predict hypovitamin B1, which was observed in 25% of the participants. Enteral nutrition alone prevented the development of new hypovitamin B1. Administration of a single 200 mg dose of intravenous thiamine achieved supraphysiological concentrations of thiamine pyrophosphate with repeated dosing sustaining this effect. This article is protected by copyright. All rights reserved.

PMID:36919646 | DOI:10.1111/jhn.13162

Circulation. 2023 Mar 15. doi: 10.1161/CIRCULATIONAHA.122.060002. Online ahead of print.

ABSTRACT

BACKGROUND: Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare, fatal, premature aging disease caused by a toxic protein called progerin. Circulating progerin has not been previously detected, precluding research using readily available biological samples. This study aimed to develop a plasma progerin assay to evaluate progerin’s quantity, response to progerin-targeted therapy, and relationship to patient survival.

METHODS: Biological samples were collected by The Progeria Research Foundation Cell and Tissue Bank from a non-HGPS cohort cross-sectionally and a HGPS cohort longitudinally. HGPS donations occurred at baseline and intermittently while treated with farnesylation inhibitors lonafarnib±pravastatin and zoledronate, within 3 sequential open-label clinical trials at Boston Children’s Hospital totaling >10 years of treatment. An ultrasensitive single-molecule counting progerin immunoassay was developed with prespecified performance parameters. Intra- and interpatient group statistics were descriptive. The relationship between progerin and survival was assessed by using joint modeling with time-dependent slopes parameterization.

RESULTS: The assay’s dynamic detection range was 59 to 30 000 pg/mL (R²=0.9987). There was no lamin A cross-reactivity. Mean plasma progerin in non-HGPS participants (n=69; 39 male, 30 female; age, 0.2-71.3 years) was 351±251 pg/mL, and in drug-naive participants with HGPS (n=74; 37 female, 37 male; age, 2.1-17.5 years) was 33 261±12 346 pg/mL, reflecting a 95-fold increase in affected children (P<0.0001). Progerin levels did not differ by sex (P=0.99). Lonafarnib treatment resulted in an average per-visit progerin decrease from baseline of between 35% to 62% (all P<0.005); effects were not augmented by adding pravastatin and zoledronate. Progerin levels fell within 4 months of therapy and remained lower for up to 10 years. The magnitude of progerin decrease positively associated with patient survival (P<0.0001; ie, 15 000 pg/mL decrease yields a 63.9% decreased risk of death). For any given decrease in progerin, life expectancy incrementally increased with longer treatment duration.

CONCLUSIONS: A sensitive, quantitative immunoassay for progerin was developed and used to demonstrate high progerin levels in HGPS plasma that decreased with lonafarnib therapy. The extent of improved survival was associated with both the magnitude of progerin decrease and duration at lower levels. Thus, plasma progerin is a biomarker for HGPS whose reduction enables short- and long-term assessment of progerin-targeted treatment efficacy.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov. Unique identifiers: NCT00879034 and NCT00916747.

PMID:36919608 | DOI:10.1161/CIRCULATIONAHA.122.060002

Circ Res. 2023 Mar 15. doi: 10.1161/CIRCRESAHA.122.321693. Online ahead of print.

ABSTRACT

BACKGROUND: Extracellular renal interstitial cGMP inhibits renal proximal tubule (RPT) sodium (Na⁺) reabsorption via Src (Src family kinase) activation. Through which target extracellular cGMP acts to induce natriuresis is unknown. We hypothesized that cGMP binds to the extracellular α1-subunit of NKA (sodium-potassium ATPase) on RPT basolateral membranes to inhibit Na⁺ transport similar to ouabain-a cardiotonic steroid.

METHODS AND RESULTS: Urine Na⁺ excretion was measured in uninephrectomized 12-week-old female Sprague-Dawley rats that received renal interstitial infusions of vehicle (5% dextrose in water), cGMP (18, 36, and 72 μg/kg per minute; 30 minutes each), or cGMP+rostafuroxin (12 ng/kg per minute) or were subjected to pressure-natriuresis±rostafuroxin infusion. Rostafuroxin is a digitoxigenin derivative that displaces ouabain from NKA. Renal interstitial cGMP and raised renal perfusion pressure induced natriuresis and increased phosphorylated Src^Tyr416 and Erk 1/2 (extracellular signal-regulated protein kinase 1/2)^{Thr202/Tyr204}; these responses were abolished with rostafuroxin coinfusion. To assess cGMP binding to NKA, we performed competitive binding studies with isolated rat RPTs using bodipy-ouabain (2 μM)+cGMP (10 µM) or rostafuroxin (10 µM) and 8-biotin-11-cGMP (2 μM)+ouabain (10 μM) or rostafuroxin (10 µM). cGMP or rostafuroxin reduced bodipy-ouabain fluorescence intensity, and ouabain or rostafuroxin reduced 8-biotin-11-cGMP staining. We cross-linked isolated rat RPTs with 4-N₃-PET-8-biotin-11-cGMP (2 μM); 8-N₃-6-biotin-10-cAMP served as negative control. Precipitation with streptavidin beads followed by immunoblot analysis showed that RPTs after cross-linking with 4-N₃-PET-8-biotin-11-cGMP exhibited a significantly stronger signal for NKA than non-cross-linked samples and cross-linked or non-cross-linked 8-N₃-6-biotin-10-cAMP RPTs. Ouabain (10 μM) reduced NKA in cross-linked 4-N₃-PET-8-biotin-11-cGMP RPTs confirming fluorescence staining. 4-N₃-PET-8-biotin-11-cGMP cross-linked samples were separated by SDS gel electrophoresis and slices corresponding to NKA molecular weight excised and processed for mass spectrometry. NKA was the second most abundant protein with 50 unique NKA peptides covering 47% of amino acids in NKA. Molecular modeling demonstrated a potential cGMP docking site in the ouabain-binding pocket of NKA.

CONCLUSIONS: cGMP can bind to NKA and thereby mediate natriuresis.

PMID:36919600 | DOI:10.1161/CIRCRESAHA.122.321693

Ann Med. 2023 Dec;55(1):926-945. doi: 10.1080/07853890.2023.2185808.

ABSTRACT

BACKGROUND: Pregnant women participated in multifaceted case management (MCM) to prevent Fetal Alcohol Spectrum Disorders (FASD).

METHODS: Women recruited from antenatal clinics for a longitudinal child development study were screened for alcohol use. Forty-four pregnant women were defined as high-risk drinkers on the Alcohol Use Disorder Identification Test (AUDIT) by an AUDIT score ≥8 and participated in 18 months of MCM to facilitate reduction or cessation of alcohol consumption. Forty-one women completed MCM. Fifty-five equally high-risk women who received standard antenatal care comprised the comparison/control group. Development in offspring was evaluated by a blinded interdisciplinary team of examiners through 5 years of age.

RESULTS: At five years of age, more children (34%) of MCM participating women did not meet the criteria for FASD vs. non-MCM offspring (22%). Furthermore, a statistically significant (p = .01) lower proportion of MCM offspring (24%) was diagnosed with fetal alcohol syndrome (FAS) compared to controls (49%). Children of MCM participants had significantly (p < .05) better physical outcomes: lower total dysmorphology scores, larger head circumferences, longer palpebral fissures, and higher midfacial measurements. Neurodevelopment results showed mixed outcomes. While Bayley developmental scores indicated that MCM offspring were performing significantly worse on most domains through 18 months, group scores equalized and were not significantly different on Kaufman Assessment Battery neurobehavioral measures by five years. Regression analyses indicated that offspring of women who received standard antenatal care were associated with significantly more negative outcomes than MCM offspring: a diagnosis of FAS (OR = 3.2; 95% CI: 1.093-9.081), microcephaly (OR = 5.3; 95% CI: 2.1-13.5), head circumference ≤10th centile (OR = 4.3; 95%CI: 1.8-10.4), and short palpebral fissures (OR = 2.5; 95% CI: 1.0-5.8).

CONCLUSION: At age five, proportionally fewer children of MCM participants qualified for a diagnosis of FAS, and proportionally more had physical outcomes indicating better prenatal brain development. Neurobehavioral indicators were not significantly different from controls by age five.KEY MESSAGESMultifaceted Case Management (MCM) was designed and employed for 18 months during the prenatal and immediate postpartum period to successfully meet multiple needs of women who had proven to be very high risk for birthing children with fetal alcohol spectrum disorders (FASD).Offspring of the women who participated in MCM were followed up through age five years and were found to have significantly better physical outcomes on multiple variables associated with fetal alcohol syndrome (FAS) and FASD, such as larger head circumferences and fewer minor anomalies, than those children born to equally at-risk women not receiving MCM.Fewer children of women receiving MCM were diagnosed with FASD than the offspring of equally-at-risk controls, and significantly (p = .01) fewer MCM offspring had FAS, the most severe FASD diagnosis.

PMID:36919586 | DOI:10.1080/07853890.2023.2185808

J Sports Sci. 2022 Oct;40(20):2217-2224. doi: 10.1080/02640414.2022.2139881.

ABSTRACT

We aimed to clarify the differences in soccer instep kicking dynamics between sex groups. The instep kicking of seven female (height: 160.3 ± 6.1 cm; mass: 54.3 ± 5.2 kg) and seven male (height: 173.0 ± 5.9 cm; mass: 70.0 ± 9.0 kg) players were recorded by a motion capture system (500 Hz). Joint moments of the kicking leg were computed and normalized by the body mass and height. Statistical parametric mapping was used to compare the entire kicking motion between the two groups. Significantly slower resultant ball velocity seen in female players was most likely explained by their significantly slower run-up velocity, shorter leg length and lower foot-ball velocity ratio. Female players exhibited significantly smaller knee joint moment in the latter part (80-86%) of kicking. Also, significantly smaller positive work done by knee extension moment and the ratio of work (knee extension/hip flexion) were found in female players. These results suggested that the suppressed knee extension moment action was identified as a key kinetic characteristic in the instep kicking of female players, and to compensate for this action, they more rely on the work due to hip flexion moment to execute the instep kicking.

PMID:36919566 | DOI:10.1080/02640414.2022.2139881

Expert Rev Med Devices. 2023 Mar 15:1-8. doi: 10.1080/17434440.2023.2190019. Online ahead of print.

ABSTRACT

BACKGROUND: Powered intraosseous (IO) systems are valuable devices for emergent situations, with limited data on user preferences. A simulation/survey-based study was conducted among emergency medical service (EMS) providers to evaluate attitudes toward general powered IO system features to measure preferences/satisfaction for the most-commonly used and a novel powered IO system (with a passive safety needle, battery life indicator, and snap-securement/dressing).

RESEARCH DESIGN AND METHODS: Forty-two EMS providers completed a simulated activity using both powered IO systems and a 30-item questionnaire, including multiple choice, free-text, ranking, and Likert-like questions. Ranking scores were reported using a scale of 0 (least important/satisfactory) to 100 (most important/satisfactory). Statistical significances were evaluated via Wilcoxon signed-rank sum test.

RESULTS: Providers indicated driver performance (mean score ± SD; 77.8 ± 27.5) and IO needle safety mechanism (63.1 ± 27.9) as the most important features. Participants reported significantly higher (p < 0.001) satisfaction with the novel IO system overall, and its needle safety, battery life indicator, securement/dressing, and ease-of-use. Powered driver performance satisfaction was similar and favorable for the novel (88.1 ± 18.2) and traditional (87.1 ± 15.3) systems.

CONCLUSIONS: These findings highlight the value of clinician/user input and demonstrate EMS providers are more satisfied with a powered IO system featuring design elements intended to enhance safety and ease-of-use.

PMID:36919560 | DOI:10.1080/17434440.2023.2190019