Category: Nevin Manimala

Microsc Res Tech. 2021 Jul 2. doi: 10.1002/jemt.23857. Online ahead of print.

ABSTRACT

The aim of this study was to investigate human dental enamel surfaces using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), Raman spectroscopy, and small angle X-ray scattering (SAXS) techniques concerning differences between the demineralized enamel surface and remineralized enamel surface by casein phosphopeptide amorphous calcium phosphate, Tooth mousse® (CPP-ACP) and remineralizing oral care systems (ROCS®) agents within the same tooth. For this purpose, 20 freshly extracted human maxillary central incisors without caries and defects were used. Labial surfaces of each of the teeth were divided into four sections, which were marked as follows: Group 1, normal enamel; Group 2, demineralized enamel with demineralization solution; Group 3, demineralized enamel + remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth); and Group 4, remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth). To describe the changes in tooth enamel, the phosphate group concentration within enamel was used as an indicator of the degree of mineralization. The phosphate and carbonate bands in the FTIR and Raman spectra were used to investigate the structural changes in the demineralized and remineralized enamel. Spectroscopic data were statistically analyzed in terms of CPP-ACP and ROCS using one-way analysis of variance. The carbonate content of demineralized enamel was higher than the carbonate content in the other groups (p < .03). The apatite carbonate-phosphate balance in the samples with only remineralizing agent-especially ROCS applied-changed significantly (p < .05) compared to the normal group. The average FTIR spectra of the groups were subjected to multivariate hierarchical cluster analysis (HCA) conducted with the use of the OPUS 5.5 software. Nanosized surface morphologies of the samples were compared using pair distance distributions obtained through SAXS analyses. According to the SAXS analyses, applications of CCP + ACP and ROCS agents were effective on nanostructures for all groups.

PMID:34213062 | DOI:10.1002/jemt.23857

HIV Med. 2021 Jul 1. doi: 10.1111/hiv.13126. Online ahead of print.

ABSTRACT

OBJECTIVES: South Africa has made remarkable progress in increasing the coverage of antiretroviral therapy (ART) among pregnant women; however, viral suppression among pregnant women receiving ART is reported to be low. Access to routine viral load testing is crucial to identify women with unsuppressed viral load early in pregnancy and to provide timely intervention to improve viral suppression. This study aimed to determine the coverage of maternal viral load monitoring nationally, focusing on viral load testing, documentation of viral load test results, and viral suppression (viral load < 50 copies/mL). At the time of this study, the first-line regimen for women initiating ART during pregnancy was non-nucleoside reverse transcriptase (NNRTI)-based regimen.

METHODS: Between 1 October and 15 November 2019, a cross-sectional survey was conducted among 15- to 49-year-old pregnant women attending antenatal care in 1589 nationally representative public health facilities. Data on ART status, viral load testing and viral load test results were extracted from medical records. Logistic regression was used to examine factors associated with coverage of viral load testing.

RESULTS: Of 8112 participants eligible for viral load testing, 81.7% received viral load testing, and 94.1% of the viral load test results were documented in the medical records. Of those who had viral load test results documented, 74.1% were virally suppressed. Women initiated on ART during pregnancy and who received ART for three months had lower coverage of viral load testing (73%) and viral suppression (56.8%) compared with women initiated on ART before pregnancy (82.8% and 76.1%, respectively). Initiating ART during pregnancy rather than before pregnancy was associated with a lower likelihood of receiving a viral load test during pregnancy (adjusted odds ratio = 1.6, 95% confidence interval: 1.4-1.8).

CONCLUSIONS: Viral load result documentation was high; viral load testing could be improved especially among women initiating ART during pregnancy. The low viral suppression among women who initiated ART during pregnancy despite receiving ART for three months highlights the importance of enhanced adherence counselling during pregnancy. Our finding supports the WHO recommendation that a Dolutegravir-containing regimen be the preferred regimen for women who are newly initiating ART during pregnancy for more rapid viral suppression.

PMID:34213065 | DOI:10.1111/hiv.13126

Vet Ophthalmol. 2021 Jul 2. doi: 10.1111/vop.12915. Online ahead of print.

ABSTRACT

OBJECTIVE: Identify ocular findings associated with blunt ocular trauma to aid in differentiation from other equine ocular diseases.

STUDY DESIGN: Retrospective case-control study.

METHODS: Medical records of horses at the Equine Clinic Munich-Riem, Munich, Germany and Auburn University, College of Veterinary Medicine were reviewed. Age, sex, breed, laterality, and clinical findings on ophthalmic examination, as well as an observed (confirmed) or unobserved (suspected) history of trauma, were recorded. Statistical analysis was performed to identify any correlation between clinical signs and blunt ocular trauma. Fifty-nine clinical signs were evaluated, and their association with blunt ocular trauma and non-traumatic uveitis was determined. The frequency of clinical signs associated with non-traumatic uveitis was also reported.

RESULTS: Fifty-five eyes affected with blunt trauma were included. The comparison group consisted of 233 eyes (168 horses) diagnosed with non-traumatic uveitis. The most frequent ocular findings after BOT included cataract (36/55, 65.5%), corneal edema (26/55, 47.2%), decreased intraocular pressure (23/55, 41.8%), aqueous flare (19/55, 34.5%), lens subluxation, luxation, or lens loss (18/55, 32.7%), fibrin in the anterior chamber (18/55, 32.7%), hyphema (16/55, 29.1%), peripapillary depigmentation (“butterfly lesion”) (16/55, 29.1%), conjunctival hyperemia (16/55, 29.1%), corneal fibrosis (15/55, 27.3%), corpora nigra avulsion (14/55, 25.5%), blepharospasm (13/55, 23.6%), and iridodialysis (11/55, 20.0%).

CONCLUSIONS: The characteristic pattern of ocular signs associated with blunt ocular trauma may assist in differentiation from other types of uveitis and may improve interpretation of ocular lesions identified during pre-purchase examinations. This study also represents the first peer-reviewed documented and photographed cases of iridodialysis in the horse.

PMID:34213057 | DOI:10.1111/vop.12915

Chemphyschem. 2021 Jul 2. doi: 10.1002/cphc.202100431. Online ahead of print.

ABSTRACT

In many experimental investigations of thermodynamic equilibrium or kinetic properties of series of similar reactions it is found that the enthalpies and entropies derived from van ‘t Hoff or Arrhenius plots exhibit a strong linear correlation. The origin of this Enthalpy-Entropy compensation, which is strongly related to the coalescence tendency of van ‘t Hoff or Arrhenius plots, is not necessarily due to a physical/chemical/biological process. It can also be a merely statistical artefact. A new method, called Combined K-CQF makes it possible both to quantify the degree of coalescence of experimental Van ‘t Hoff lines and to verify whether or not the Enthalpy-Entropy Compensation is of a statistical origin at a desired confidence level. The method is universal and can handle data sets with any degree of coalescence of Van ‘t Hoff (or Arrhenius) plots. The new method requires only a standard least square fit of the enthalpy ΔH versus entropy ΔS plot to determine the two essential dimensionless parameters K and CQF . The parameter K indicates the position (in inverse temperature) of the coalescence region of Van ‘t Hoff plots and CQF is a quantitative measure of the smallest spread of the Van ‘t Hoff plots. The position of the ( K, CQF) couple with respect to universal confidence contours determined from a large number of simulations of random Van ‘t Hoff plots indicates straightforwardly whether or not the ΔH-ΔS compensation is a statistical artefact.

PMID:34213060 | DOI:10.1002/cphc.202100431

Stat Med. 2021 Jul 2. doi: 10.1002/sim.9030. Online ahead of print.

ABSTRACT

Healthcare researchers are showing renewed interest in the utilization of N-of-1 clinical trials for the individualization of pharmacological treatments. Here, we propose a frequentist approach to conducting treatment individualization in N-of-1 trials that we call “partial empirical Bayes.” We infer the most beneficial treatment for the patient from combining the information provided by a previously conducted population crossover trial with individual patient data. We propose a method for estimating an optimal number of treatment cycles and investigate the statistical conditions under which N-of-1 trials are more beneficial than traditional clinical approaches. We represent the patient population with a random-coefficients linear model and calculate estimators of posttreatment individual disease severities. We show the estimators’ consistency under the most common N-of-1 designs and examine their prediction errors and performance with small numbers of patient’s responses. We demonstrate by simulating new patients that our approach is equivalent or superior to both the common clinical practice of recommending the on-average best treatment for all patients and the common individualization method that simply compares average responses to the tested treatments. We conclude that some situations exist in which individualization with N-of-1 trials is highly beneficial while other situations exist in which individualization may be unfruitful.

PMID:34213011 | DOI:10.1002/sim.9030

J Intellect Disabil Res. 2021 Jul 2. doi: 10.1111/jir.12865. Online ahead of print.

ABSTRACT

BACKGROUND: Deficits in executive functioning (EF) have been measured in individuals with developmental disabilities, such as autism spectrum disorder and attention-deficit/hyperactivity disorder, through the use of behaviour rating scales and performance-based assessment. Associations between EF and variables such as challenging and adaptive behaviour have been observed; however, limited research exists on EF profiles in children with heterogeneous developmental delay or with intellectual disability (ID) or the impact of EF on adaptive and challenging behaviour with this population.

METHODS: The present study sought to examine the EF profile of 93 children (75 male and 18 female) previously identified with developmental delay in early childhood. EF was assessed using the Behaviour Rating Inventory of Executive Function, Second Edition (BRIEF-2). Children were categorised into an ID group (n = 14) or no ID group (n = 79) based on scores from cognitive and adaptive behaviour assessments. EF profiles were investigated and compared by group. In addition, the impact of EF on both adaptive behaviour and challenging behaviour was measured using hierarchical linear regressions.

RESULTS: Statistically significant differences in caregiver-reported EF were not observed between groups; however, both the ID and the no ID group scores were elevated as reported by their caregivers. For the overall sample, caregiver-EF accounted for significant variance in both adaptive (22%) and challenging (68%) behaviour after accounting for child age and sex.

CONCLUSIONS: Results indicated deficits in EF for children with and without ID. The significance of EF was accounted for in both adaptive and challenging behaviour for all children in the sample. Future research could elucidate the role of adaptive and challenging behaviour in understanding EF variability among children with histories of developmental delay.

PMID:34213015 | DOI:10.1111/jir.12865

Microsurgery. 2021 Jul 2. doi: 10.1002/micr.30783. Online ahead of print.

ABSTRACT

INTRODUCTION: In flap transfer with perforator to perforator anastomosis (FTPPA), encountering poor pulsation and blood flow in a recipient perforator intraoperatively often makes FTPPA impossible. This study sought to identify color and spectral Doppler ultrasonography (CSDUS) parameters that can aid reliable preoperative selection of a recipient perforator artery.

PATIENTS AND METHODS: The study enrolled 38 patients with lower extremity lymphedema who underwent vascularized lymphatic tissue transfer with perforator to perforator anastomosis for physiological lymphatic flow reconstruction. In all cases, three candidate recipient perforators were searched in each lower extremities, and vessel diameter and peak systolic flow velocity (PSFV) were measured. The inclusion criteria for candidates were a vessel diameter of >0.5 mm and a PSFV of >10 cm/s. These measures were compared with intraoperative findings, diameters and if there was pulsation and visible spurting evident.

RESULTS: A total of 114 candidates were selected, and 52 of the candidates were dissected until suitable perforators were found. PSFV (cm/s) on CSDUS was ≥20.0 in 32 perforators (84.2%) and was 15.0-19.9 in 6 perforators (15.8%) in the group with pulsation and visible spurting evident, and 15.0-19.9 in one perforator (7.1%) and ≤ 14.9 in 13 perforators (92.9%) in the group without pulsation and visible spurting evident. There was a statistically significant correlation between preoperative PSFV and intraoperative pulsation and visible spurting evident after dissection (P = 0.021 × 10^-3 ). The flap survival rate was 92.1%.

CONCLUSION: PSFV is an important preoperative determinant of the suitability of a recipient perforator artery for FTPPA.

PMID:34213025 | DOI:10.1002/micr.30783

Biometrics. 2021 Jul 2. doi: 10.1111/biom.13526. Online ahead of print.

ABSTRACT

Multiple types of molecular (genetic, genomic, epigenetic, etc.) measurements, environmental risk factors, and their interactions have been found to contribute to the outcomes and phenotypes of complex diseases. In each of the previous studies, only the interactions between one type of molecular measurement and environmental risk factors have been analyzed. In recent biomedical studies, multidimensional profiling, in which data from multiple types of molecular measurements are collected from the same subjects, is becoming popular. A myriad of recent studies have shown that collectively analyzing multiple types of molecular measurements is not only biologically sensible but also leads to improved estimation and prediction. In this study, we conduct an M-E interaction analysis, with M standing for multidimensional molecular measurements and E standing for environmental risk factors. This can accommodate multiple types of molecular measurements and sufficiently account for their overlapping as well as independent information. Extensive simulation shows that it outperforms several closely related alternatives. In the analysis of TCGA (The Cancer Genome Atlas) data on lung adenocarcinoma and cutaneous melanoma, we make some stable biological findings and achieve stable prediction. This article is protected by copyright. All rights reserved.

PMID:34213006 | DOI:10.1111/biom.13526

Biometrics. 2021 Jul 2. doi: 10.1111/biom.13524. Online ahead of print.

ABSTRACT

Mendelian randomization (MR) has been a popular method in genetic epidemiology to estimate the effect of an exposure on an outcome using genetic variants as instrumental variables (IV), with two-sample summary-data MR being the most popular. Unfortunately, instruments in MR studies are often weakly associated with the exposure, which can bias effect estimates and inflate Type I errors. In this work, we propose test statistics that are robust under weak instrument asymptotics by extending the Anderson-Rubin, Kleibergen, and the conditional likelihood ratio test in econometrics to two-sample summary-data MR. We also use the proposed Anderson-Rubin test to develop a point estimator and to detect invalid instruments. We conclude with a simulation and an empirical study and show that the proposed tests control size and have better power than existing methods with weak instruments. This article is protected by copyright. All rights reserved.

PMID:34213007 | DOI:10.1111/biom.13524

Ulus Travma Acil Cerrahi Derg. 2021 Jul;27(4):449-456. doi: 10.14744/tjtes.2020.49196.

ABSTRACT

BACKGROUND: The optimal timing of intervention for aneurysmatic subarachnoid hemorrhage is one of the historically controversial issues in neurosurgery. Although numerous studies investigated the subject, they had many limitations due to the nature of the disease. Early and ultra-early interventions have gained more and more supporters in recent decades. Nevertheless, the effects of the early and ultra-early intervention on the outcome of the disease are far from clarity.

METHODS: A single-center retrospective cohort study was carried out at Trakya University Medical Faculty Training and Practice Hospital. The study includes data on all patients admitted with an aneurysmal subarachnoid hemorrhage between January 1, 2001, and December 31, 2005. Patients were divided into two groups according to their WFNS grade status: Good (I-III) or poor (IV-V) grades. Patients are also classified according to their Glasgow Outcome Scale score: Unfavorable (1-2) or favorable (3-5) outcomes. Data were analyzed statistically, and the effects of the early and ultra-early intervention on the outcome were assessed.

RESULTS: A total of 580 patients were admitted in the study period. Among them, 494 were eligible for the study. The median age (interquartile range) was 55 (18) years. While 244 (49.4%) patients were women, 250 (50.6%) patients were men. Three hundred and fourteen (63.6%) patients were operated, and 25 patients (5.1%) were undergone endovascular treatment. The ultra-early intervention was achieved in 60 (12.1%) patients and 142 patients (28.7%, including the previous ultra-early intervention group) early intervention was achieved. A meaningful outcome difference was present between the poor-grade ultra-early treatment group and the rest (p=0.007). Analogously, a meaningful outcome difference was present between the poor-grade early treatment group and the rest (p<0.001).

CONCLUSION: This study supports the growing trend toward early or ultra-early intervention in aneurysmatic subarachnoid hemorrhage. Our findings showed that both early and ultra-early interventions have positive effects on the outcome in poor-grade aneurysmatic subarachnoid hemorrhage patients. Future studies with more homogenized and larger samples should be realized to clarify the optimal timing of intervention for aneurysmatic subarachnoid hemorrhage.

PMID:34212997 | DOI:10.14744/tjtes.2020.49196