Category: Nevin Manimala

J Oral Rehabil. 2023 Feb 16. doi: 10.1111/joor.13435. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to compare the trabecular internal structure of different regions of the mandible according to the grades of appositional classification in the mandible angle region in probable bruxist individuals and non-bruxist G0(Convex course of the basal cortex, no directional change, no bone apposition) individuals by measuring Fractal Dimension (FD) on panoramic radiographs.

METHODS: 200 sample jaws, bilaterally, of 80 probable bruxists and 20 non-bruxist G0 individuals were included in the study. According to the classification in the literature, each mandible angle apposition severity was classified as G0-G1-G2-G3. FD was calculated by selecting the region of interest (ROI) area of 7 regions from each sample. Gender differences in changes between ROIs in radiographs and independent samples t-test were evaluated. Relation between categorical variables was determined by chi square test(p<0.05).

RESULTS: In the comparison of the probable bruxist and non-bruxist G0 groups, FD was found to be statistically significantly higher in the mandible angle(p=0.013) and cortical bone(p=0.000) regions in the probable bruxist group than in the non-bruxist G0 group. There is a statistically significant difference between probable bruxist G0 and non-bruxist G0 grades in terms of FD averages in cortical bone (p<0.001). A statistically significant difference was found in the relationship of ROIs with gender in canine apex(p=0.021) and canine distal(p=0.041) regions.

CONCLUSION: FD was found to be higher in the mandibular angle region and cortical bone in probable bruxist individuals than in non-bruxist G0 individuals. Morphological changes seen in the mandible angulus region may be a finding that may raise suspicion for bruxism for clinicians.

PMID:36794633 | DOI:10.1111/joor.13435

Acta Ophthalmol. 2023 Mar;101(2):e185-e196. doi: 10.1111/aos.15230. Epub 2022 Aug 5.

ABSTRACT

PURPOSE: The purpose of this study is to assess the effect of various fluence levels on prophylactic corneal cross-linking (CXL) combined with femtosecond laser in situ keratomileusis (FS-LASIK-Xtra) or transepithelial photorefractive keratectomy (TransPRK-Xtra) on biomechanics, demarcation line (DL), and stromal haze.

METHODS: Prospective analysis where two prophylactic CXL protocols (lower/higher fluence [LF/HF]: 30 mw/cm² , 60/80 s, 1.8/2.4 J/cm² ) were performed as part of either an FS-LASIK-Xtra or TransPRK-Xtra procedure. Data were collected preoperatively and at 1 week and 1, 3, and 6 months postoperatively. Main outcome measures were (1) dynamic corneal response parameters and the stress-strain index (SSI) from Corvis, (2) actual DL depth (ADL), and (3) stromal haze on OCT images analysed by a machine learning algorithm.

RESULTS: Eighty-six eyes from 86 patients underwent FS-LASIK-Xtra-HF (21 eyes), FS-LASIK-Xtra-LF (21 eyes), TransPRK-Xtra-HF (23 eyes), and TransPRK-Xtra-LF (21 eyes). SSI increased similarly by around 15% in all groups 6 months postoperatively (p = 0.155). All other corneal biomechanical parameters were statistically significant worsening postoperatively, but the change was similar in all groups. At 1 month postoperatively, there was no statistical difference in mean ADL among four groups (p = 0.613), mean stromal haze was similar between the two FS-LASIK-Xtra groups, but higher in the TransPRK-Xtra-HF group compared with the TransPRK-Xtra-LF group.

CONCLUSIONS: FS-LASIK-Xtra and TransPRK-Xtra lead to a similar ADL and improve SSI equally. Lower fluence prophylactic CXL might be recommended as it achieves similar mean ADL with potentially less induced stromal haze, especially in TransPRK. The clinical relevance and applicability of such protocols remains to be assessed.

PMID:36794626 | DOI:10.1111/aos.15230

J Oral Rehabil. 2023 Feb 16. doi: 10.1111/joor.13432. Online ahead of print.

ABSTRACT

BACKGROUND: Gag reflex may occur in patients of all ages and often considered having a multifactorial etiology.

OBJECTIVE: The aim of the study was to evaluate the prevalence and influencing factors of gag reflex in Turkish children aged 7-14 years in the dental setting.

METHODS: This cross-sectional study was carried out among 320 children aged between 7-14 years. First, an anamnesis form which include sosyodemographic status, monthly level of income, children past medical, and dental experiences was filled by mothers. Children’s fear levels were evaluated using the Dental Subscale of Children’s Fear Survey Schedule(CFSS-DS) while mother’s anxiety levels using the Modified Dental Anxiety Scale(MDAS). The revised dentist section of gagging problem assessment questionnaire (GPA-R-de) were used for both children and mothers. Statistical analysis were done with SPSS program.

RESULTS: The prevalence of gag reflex among children was 34.1%, among mothers was 20.3%. The association between child and mother gagging was found statistically significant (χ2=53.121, p<0.001). When the mother of the child gagged, the risk of child gagging increases 6.83 times (p<0.001). Higher CFSS-DS scores of children increase risk of gagging (OR=1.052, p=0.023). Children who were previously treated mostly in public hospitals significantly more likely to gag compared with private dental clinics (OR=10.990, p<0.001).

CONCLUSION: It was concluded that negative past dental experiences, previous dental treatments with local anesthesia, history of hospital admission, number and place of previous dental visits, dental fear level of children, and low education level and gagging of mother have an influence on the gagging of children.

PMID:36794577 | DOI:10.1111/joor.13432

Pharm Stat. 2023 Feb 16. doi: 10.1002/pst.2294. Online ahead of print.

ABSTRACT

The breakthrough propensity score methodology was formulated by Rosenbaum and Rubin in the 1980s for the mitigation of confounding bias in non-randomized comparative studies to facilitate causal inference for treatment effects. The methodology had been used mainly in epidemiological and social science studies that may often be exploratory, until it was adopted by FDA/CDRH in 2002 and applied in the evaluation of medical device pre-market confirmatory studies, including those with a control group extracted from a well-designed and executed registry database or historical clinical studies. Around 2013, following the Rubin outcome-free study design principle, the two-stage propensity score design framework was developed for medical device studies to safeguard study integrity and objectivity, thereby strengthening the interpretability of study results. Since 2018, the scope of the propensity score methodology has been broadened so that it can be used for the purpose of leveraging external data to augment a single-arm or randomized traditional clinical study. All these statistical approaches, collectively referred to as propensity score-based methods in this article, have been considered in the design of medical device regulatory studies and stimulated related research, as evidenced by the latest trends in journal publications. We will provide a tutorial on the propensity score-based methods from the basic idea to their implementation in regulatory settings for causal inference and external data leveraging, along with step-by-step descriptions of the procedures of the two-stage outcome-free design through examples, which can be used as templates for real study proposals.

PMID:36794571 | DOI:10.1002/pst.2294

J Int Med Res. 2023 Feb;51(2):3000605231154657. doi: 10.1177/03000605231154657.

ABSTRACT

Hepatic epithelioid angiomyolipoma (HEAML) is a rare tumour of mesenchymal tissue with a malignant tendency. Occurring most frequently in women, the relative incidence in men and women, according to incomplete statistics, is approximately 1:5. In rare cases, disease occurrence and development is hidden. Lesions are generally discovered as chance findings by patients; abdominal pain is the first symptom, and imaging has no specificity in diagnosing the disease. Therefore, great difficulties exist in the diagnosis and treatment of HEAML. Here, the case of a 51-year-old female patient with a history of hepatitis B, and abdominal pain over 8 months as the initial symptom, is described. The patient was found to have multiple intrahepatic angiomyolipoma. Due to the small and scattered foci, complete resection was impossible, and because of her history of hepatitis B, conservative treatment was undertaken, with the patient undergoing regular follow-up. When hepatic cell carcinoma could not be excluded, the patient was treated with transcatheter arterial chemoembolization. No tumour neogenesis or metastasis was detected at the 1-year follow-up.

PMID:36794565 | DOI:10.1177/03000605231154657

J Telemed Telecare. 2023 Feb 16:1357633X231151788. doi: 10.1177/1357633X231151788. Online ahead of print.

ABSTRACT

INTRODUCTION: In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults.

METHODS: We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen’s d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire – Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively.

RESULTS: Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: -0.63; 95% CI: -0.99 to -0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: -0.74; 95% CI: -1.24 to -0.25).

DISCUSSION: Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.

PMID:36794548 | DOI:10.1177/1357633X231151788

CNS Neurosci Ther. 2023 Feb 16. doi: 10.1111/cns.14108. Online ahead of print.

ABSTRACT

BACKGROUND: Serum albumin to globulin ratio (A/G) has been widely used as a representative biomarker for assessing inflammation and nutrition status. However, in patients with acute ischemic stroke (AIS), the predictive value of serum A/G has rarely been reported. We aimed to evaluate whether serum A/G is associated with prognosis in stroke.

METHODS: We analyzed data from the Third China National Stroke Registry. The patients were categorized into quartile groups according to the serum A/G at admission. Clinical outcomes included poor functional outcomes (modified Rankin Scale [mRS] score of 3-6 or 2-6) and all-cause mortality at 3 months and1 year. Multivariable logistic regressions and Cox proportional hazards regressions were used to evaluate the association of serum A/G with the risk of poor functional outcomes and all-cause mortality.

RESULTS: A total of 11, 298 patients were included in this study. After adjustment for confounding factors, patients in the highest serum A/G quartile had a lower proportion of mRS score 2-6 (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.76-1.00) and mRS score 3-6 (OR, 0.87; 95% CI, 0.73-1.03) at 3 months follow-up. At 1 year follow-up, there was a significant association between higher serum A/G and mRS score 3-6 (OR, 0.68; 95% CI, 0.57-0.81). We also found that the highest serum A/G was related to decreased risk of all-cause mortality (hazard ratio [HR], 0.58; 95% CI, 0.36-0.94) at 3 months follow-up. Similar results were found at 1-year follow-up.

CONCLUSIONS: Lower serum A/G levels were associated with poor functional outcomes and all-cause mortality at 3 months and 1-year follow-up in patients with acute ischemic stroke.

PMID:36794538 | DOI:10.1111/cns.14108

J Appl Gerontol. 2023 Feb 16:7334648231158482. doi: 10.1177/07334648231158482. Online ahead of print.

ABSTRACT

Using the 2021 Occupational Employment and Wage Statistics (OEWS) dataset, we calculate the ratio of direct care workers relative to the population of older adults (ages 65+) across rural and urban areas in the US. We find that there are, on average, 32.9 home health aides per 1000 older adults (age 65+) in rural areas and 50.4 home health aides per 1000 older adults in urban areas. There are, on average, 20.9 nursing assistants per 1000 older adults in rural areas and 25.3 nursing assistants per 1000 older adults in urban areas. There is substantial regional variation. Greater investment needs to be made in improving wages and job quality for direct care workers to attract workers to these critical occupations, especially in rural areas where the need for direct care is greater.

PMID:36794536 | DOI:10.1177/07334648231158482

Clin Rehabil. 2023 Feb 16:2692155231152417. doi: 10.1177/02692155231152417. Online ahead of print.

ABSTRACT

OBJECTIVES: To critically appraise the psychometric properties of light touch-pressure somatosensory assessments to provide guidance for tool selection for research or clinical purposes.

DATA SOURCES: MEDLINE, CINAHL, and PsycInfo were searched for research indexed from January 1990-November 2022. English language and human subject filters were applied. “Somatosensation”, “psychometric property”, and “nervous system-based health condition” search terms were combined. Grey literature and manual searches were conducted to ensure thoroughness.

REVIEW METHODS: The reliability, construct validity, and/or measurement error of light touch-pressure assessments was reviewed in adult populations with neurological disorders. Reviewers individually extracted and managed data including patient demographics, assessment characteristics, statistical methods, and psychometric properties. Methodological quality of results was evaluated using an adapted version of the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

RESULTS: Thirty-three of 1938 articles were included for review. Fifteen light touch-pressure assessments demonstrated good or excellent reliability. Further, five of those 15 assessments achieved adequate validity and one of the 15 assessments achieved adequate measurement error. Over 80% of the summarized study ratings were determined to be of low or very low quality.

CONCLUSION: We recommend using electrical perceptual tests, the Semmes-Weinstein Monofilaments, the Graded and Redefined Assessment of Strength, Sensibility, and Prehension, and the Moving Touch Pressure Test given that they demonstrated good to excellent results in three psychometric properties. No other assessment achieved adequate ratings in more than two psychometric properties. This review highlights a fundamental need to develop sensory assessments that are reliable, valid, and sensitive to change.

PMID:36794517 | DOI:10.1177/02692155231152417

Expert Opin Drug Saf. 2023 Feb 16. doi: 10.1080/14740338.2023.2181341. Online ahead of print.

ABSTRACT

BACKGROUND: Safety issues for fluoroquinolones have been provided by regulatory agencies. This study was conducted to identify signals of fluoroquinolones reported in the Korea Adverse Event Reporting System (KAERS) using tree-based machine learning (ML) methods.

RESEARCH DESIGN AND METHODS: All adverse events (AEs) associated with the target drugs reported in the KAERS from 2013 to 2017 were matched with drug label information. A dataset containing label-positive and -negative AEs was arbitrarily divided into training and test sets. Decision tree, random forest (RF), bagging, and gradient boosting machine (GBM) were fitted on the training set with hyperparameters tuned using five-fold cross-validation and applied to the test set. The ML method with the highest area under the curve (AUC) scores was selected as the final ML model.

RESULTS: Bagging was selected as the final ML model for gemifloxacin (AUC score: 1) and levofloxacin (AUC: 0.9987). RF was selected in ciprofloxacin, moxifloxacin, and ofloxacin (AUC scores: 0.9859, 0.9974, and 0.9999 respectively). We found the final ML methods detected additional signals that were not detected using the disproportionality analysis (DPA) methods.

CONCLUSIONS: The bagging-or-RF-based ML methods performed better than DPA and detected novel AE signals previously unidentified using the DPA methods.

PMID:36794497 | DOI:10.1080/14740338.2023.2181341