Category: Nevin Manimala

Dent Med Probl. 2021 Dec 28. doi: 10.17219/dmp/136359. Online ahead of print.

ABSTRACT

Peri-implant mucositis is a common inflammatory lesion of the soft tissues surrounding endosseous implants, with no loss of the supporting bone. Its prevention or early diagnosis are vital for dental implant success.The aim of this review was to investigate knowledge strengths and gaps in clinicians’ perceptions of periimplant mucositis prevalence and evidence for successful treatment.A literature search for articles published until 2020, reporting on the prevalence of peri-implant mucositis and its treatment was performed in standard online databases. The inclusion criteria were as follows: studies in English; studies with an available abstract; studies on humans with at least 1 dental implant; and studies reporting on the prevalence and/or treatment of peri-implant mucositis. Sixty-five studies fulfilled the inclusion criteria. The included papers were analyzed to identify data on the prevalence and treatment of peri-implant mucositis. The prevalence statistics for peri-implant mucositis had wide ranges in both the patient-based (PB) analysis and the implant-based (IB) analysis; the possible reasons for these wide ranges are discussed. Treatment methods for peri-implant mucositis were analyzed individually and compared to the management of gingivitis.It was determined that the currently available information on the prevalence rates and the standardized therapeutic protocols for peri-implant mucositis are insufficient. Since the mean gingivitis and peri-implant mucositis prevalence rates in the PB analysis were similar, it is possible that peri-implant mucositis is underestimated due to variables related to implant rehabilitation itself.

PMID:34962364 | DOI:10.17219/dmp/136359

J Child Adolesc Psychiatr Nurs. 2021 Dec 28. doi: 10.1111/jcap.12362. Online ahead of print.

ABSTRACT

INTRODUCTION: This study examined what affects parents’ thoughts about vaccinating their children. We explored whether parents’ attitudes towards the coronavirus disease 2019 (COVID-19) vaccine and their perception of control of COVID-19 were related to their thoughts about vaccinating their children.

METHODS: The sample of this descriptive study consisted of parents (n = 274) with children between the ages of 0-12. To collect data on parents’ thoughts and opinions participants completed the Attitudes Towards COVID-19 Vaccine Scale and the Perception of Control of COVID-19 Scale.

RESULTS: Parents’ thoughts about having their children vaccinated were related to a number of children, gender, education status, employment status, death of a relative due to COVID-19, and fear of taking their child to a hospital due to fear of COVID-19. There was a statistically significant relationship between the parents’ thought of vaccinating their children against COVID-19 and the mean scores of the Attitudes Toward the COVID-19 Vaccine Scale and the Perception of Control of COVID-19 Scale.

CONCLUSION: It was surprising that parents with a high education level and working parents had negative thoughts about getting their children vaccinated against COVID-19. In addition, parents’ attitudes towards COVID-19 vaccine and their perceptions of COVID-19 control were related to parents’ thoughts on getting their children vaccinated.

PMID:34962336 | DOI:10.1111/jcap.12362

Health Econ. 2021 Dec 27. doi: 10.1002/hec.4464. Online ahead of print.

ABSTRACT

Using a new survey of Italian households, we study the effect of fear of COVID-19 contagion and income risk on consumption. The survey elicits individual-level indicators of fear of contagion, distinguishing between worries while working, shopping, traveling, eating out and meeting relatives or friends. We find that the probabilities of consumption drops and increased saving after the pandemics are positively associated to fear of contagion, particularly while shopping. Income uncertainty also contributes to savings increase and consumption drop. Our findings suggest that fear of contagion and income risk limits the effectiveness of policies aimed at stimulating consumption during the pandemic.

PMID:34962332 | DOI:10.1002/hec.4464

Neurogastroenterol Motil. 2021 Dec 27:e14308. doi: 10.1111/nmo.14308. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative ileus (POI) involves an intestinal inflammatory response that is modulated by afferent and efferent vagal activation. We aimed to identify the potential influence of the vagus nerve on POI by tracking central vagal activation and its role for peripheral inflammatory changes during the early hours after surgery.

METHODS: C57BL6 mice were vagotomized (V) 3-4 days prior to experiments, while control animals received sham vagotomy (SV). Subgroups underwent either laparotomy (sham operation; S-POI) or laparotomy followed by standardized small bowel manipulation to induce postoperative ileus (POI). Three hours and 9 h later, respectively, a jejunal segment was harvested and infiltration of inflammatory cells in intestinal muscularis was evaluated by fluorescein isothiocyanate (FITC) avidin and myeloperoxidase (MPO) staining. Moreover, the brain stem was harvested, and central nervous activation was investigated by Fos immunochemistry in both the nucleus of the solitary tract (NTS) and the area postrema (AP). Data are presented as mean ± SEM, and a p < 0.05 was considered statistically significant.

KEY RESULTS: Three hour experiments revealed no significant differences between all experimental groups, except MPO staining: 3 h after abdominal surgery, there were significantly more MPO-positive cells in vagotomized S-POI animals compared to sham-vagotomized S-POI animals (26.7 ± 7.1 vs. 5.1 ± 2.4, p < 0.01). Nine hour postoperatively intramuscular mast cells (IMMC) were significantly decreased in the intestinal muscularis of V/POI animals compared to SV/POI animals (1.5 ± 0.3 vs. 5.9 ± 0.2, p < 0.05), while MPO-positive cells were increased in V/POI animals compared to SV/POI animals (713.2 ± 99.4 vs. 46.9 ± 5.8, p < 0.05). There were less Fos-positive cells in the NTS of V/POI animals compared to SV/POI animals (64.7 ± 7.8 vs. 132.8 ± 23.9, p < 0.05) and more Fos-positive cells in the AP of V/POI animals compared to SV/POI animals 9 h postoperatively (38.0 ± 2.0 vs. 13.7 ± 0.9, p < 0.001).

CONCLUSIONS AND INTERFERENCES: Afferent nerve signaling to the central nervous system during the development of early POI seems to be mediated mainly via the vagus nerve and to a lesser degree via systemic circulation. During the early hours of POI, the intestinal immune response may be attenuated by vagal modulation, suggesting interactions between the central nervous system and the intestine.

PMID:34962331 | DOI:10.1111/nmo.14308

J Ultrasound Med. 2021 Dec 28. doi: 10.1002/jum.15934. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to show the relationship between gluten-free diet (GFD) compliance in Celiac Disease (CD) and early atherosclerotic findings in pediatric patients and to test the effectiveness of carotid-intima-media-thickness (cIMT) to possibly predict long-term compliance to the GFD.

METHODS: Patients from 6 to 18 years of age with a diagnosis of CD confirmed by endoscopic duodenal biopsy who were followed at our hospital’s pediatric gastroenterology outpatient clinic between November 2020 and May 2021 were evaluated in this single-center, prospective study. The study patients were divided into two groups according to GFD compliance. Serologic and biochemical tests were conducted routinely during the follow-up period. cIMT was measured using ultrasound for both groups.

RESULTS: A total of 80 patients (GFD-non-compliant: n = 35, GFD-compliant: n = 45) were evaluated. No significant differences were observed between the groups in terms of demographic data and pathology results. The mean cIMT value was 0.44 ± 0.028 mm for the GFD-compliant group and 0.54 ± 0.036 mm for the GFD-non-compliant group, with a statistically significant between-group difference (P < .001). The receiver operating characteristic curve analysis showed an area under the curve of 0.992 (95% confidence interval [CI]: 0.978-1, P < .001) for discrimination of the groups. In addition, a cutoff value of 0.486 mm for cIMT showed 96% (95% CI: 0.83-0.99) sensitivity and 94% (95% CI: 0.79-0.99) specificity for distinguishing GFD-compliant patients from non-GFD-compliant patients.

CONCLUSION: In this study, the relationship between long-term GFD compliance and cIMT was demonstrated in CD. Currently used by some authors for the assessment of preclinical atherosclerosis, cIMT can also be used as a long-term indicator of dietary compliance as well as cardiovascular risk.

PMID:34962314 | DOI:10.1002/jum.15934

J Clin Nurs. 2021 Dec 28. doi: 10.1111/jocn.16174. Online ahead of print.

ABSTRACT

OBJECTIVES: This cross-sectional study aimed to identify whether five factors of the health belief model were related to continuous positive airway pressure adherence in Thai people with obstructive sleep apnoea.

BACKGROUND: Obstructive sleep apnoea is a disorder impacting health, social wellbeing and the economy. Continuous positive airway pressure is a gold standard of treatment; however, poor adherence to treatment is an important issue that is related to a multiplicity of psychological and behavioural factors.

METHODS: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was used to report the study. Purposive sampling was used to recruit 94 patients newly diagnosed with sleep apnoea and using CPAP devices from a sleep clinic. Participants completed a demographic record, the Thai versions of the Functional Outcomes of Sleep Questionnaire, the Perceived Barriers Questionnaire and the Self-Efficacy Measure for Sleep Apnea. CPAP adherence was measured by using information downloaded from the smart card of the devices. Data were analysed using descriptive statistics and logistic regression.

RESULTS: Only 54.3% of participants adhered to CPAP treatment using standard protocols. Perceived seriousness of their condition was significantly associated with CPAP adherence, whereas perceived susceptibility, benefits, barriers and self-efficacy were not.

CONCLUSIONS: We found a low rate of CPAP adherence among participants. The only factor related to CPAP adherence was perceived seriousness.

RELEVANCE FOR THE CLINICAL PRACTICE: With a low rate of CPAP adherence, healthcare professionals, especially nurses, should encourage patients to use CPAP regularly by providing them with support and education regarding the severity of the disease if untreated and the benefits of CPAP treatment on the disease. Healthcare professionals should be aware of psychological factors impacting patients’ perception of sleep apnoea and CPAP treatment. Interventions dealing with these factors should be developed and implemented in practice.

PMID:34962327 | DOI:10.1111/jocn.16174

Scand J Caring Sci. 2021 Dec 28. doi: 10.1111/scs.13061. Online ahead of print.

ABSTRACT

BACKGROUND: In coming decades, the number of people affected by illnesses who need palliative care will rise worldwide. Registered Nurses are in a central position in providing this care, and education is one of the necessary components for meeting coming requirements. However, there is a lack of knowledge about palliative care in undergraduate nursing education curricula, including the extent of the education provided and the related pedagogical methods.

AIM: The aim was to investigate the extent, content and pedagogical methods used and to explore lecturers’ experiences of being responsible for teaching and learning about palliative care for undergraduate nursing students on nursing programmes at Swedish universities.

SETTING: All 24 universities responsible for providing undergraduate nursing education in Sweden participated.

PARTICIPANTS: One lecturer with in-depth knowledge about palliative care or end-of-life care education participated in the quantitative (n = 24) and qualitative (n = 22) parts of the study.

METHOD: A mixed-method research study with an explorative design was used. Descriptive statistics were used to analyse quantitative data, and content analysis for qualitative, with both also analysed integratively.

RESULTS: Few undergraduate nursing programmes included a specific course about palliative care in their curricula, however, all universities incorporated education about palliative care in some way. Most of the palliative care education was theoretical, and lecturers used a variety of pedagogical strategies and their own professional and personal experience to support students to understand the palliative care approach. Topics such as life and death were difficult to both learn and teach about.

CONCLUSIONS: There is a need for substantial education about palliative care. Lecturers strive on their own to develop students’ understanding and increase the extent of palliative care education with innovative teaching strategies, but must compete with other topics. Palliative care teaching must be prioritised, not only by the universities, but also by the national authority.

PMID:34962307 | DOI:10.1111/scs.13061

J Morphol. 2021 Dec 28. doi: 10.1002/jmor.21441. Online ahead of print.

ABSTRACT

Vertebral morphology has profound biomechanical implications and plays an important role in adaptation to different habitats and foraging strategies for cetaceans. Extant porpoise species (Phocoenidae) display analogous evolutionary patterns in both hemispheres associated with convergent evolution to coastal versus oceanic environments. We employed 3D geometric morphometrics to study vertebral morphology in five porpoise species with contrasting habitats: the coastal Indo-Pacific finless porpoise (Neophocaena phocaenoides); the mostly coastal harbor porpoise (Phocoena phocoena) and Burmeister’s porpoise (Phocoena spinipinnis); and the oceanic spectacled porpoise (Phocoena dioptrica) and Dall’s porpoise (Phocoenoides dalli). We evaluated the radiation of vertebral morphology, both in size and shape, using multivariate statistics. We supplemented data with samples of an early-radiating delphinoid species, the narwhal (Monodon monoceros); and an early-radiating delphinid species, the white-beaked dolphin (Lagenorhynchus albirostris). Principal component analyses were used to map shape variation onto phylogenies, and phylogenetic constraints were investigated through permutation tests. We established links between vertebral morphology and movement patterns through biomechanical inferences from morphological presentations. We evidenced divergence in size between species with contrasting habitats, with coastal species tending to decrease in size from their estimated ancestral state, and oceanic species tending to increase in size. Regarding vertebral shape, coastal species had longer centra and shorter neural processes, but longer transverse processes, whilst oceanic species tended to have disk-shaped vertebrae with longer neural processes. Within Phocoenidae, the absence of phylogenetic constraints in vertebral morphology suggests a high level of evolutionary lability. Overall, our results are in accordance with the hypothesis of speciation within the family from a coastal ancestor, through adaptation to particular habitats. Variation in vertebral morphology in this group of small odontocetes highlights the importance of environmental complexity and particular selective pressures for the speciation process through the development of adaptations that minimize energetic costs during locomotion and prey capture. This article is protected by copyright. All rights reserved.

PMID:34962309 | DOI:10.1002/jmor.21441

Biostatistics. 2021 Dec 28:kxab047. doi: 10.1093/biostatistics/kxab047. Online ahead of print.

ABSTRACT

Strategic preparedness reduces the adverse health impacts of hurricanes and tropical storms, referred to collectively as tropical cyclones (TCs), but its protective impact could be enhanced by a more comprehensive and rigorous characterization of TC epidemiology. To generate the insights and tools necessary for high-precision TC preparedness, we introduce a machine learning approach that standardizes estimation of historic TC health impacts, discovers common patterns and sources of heterogeneity in those health impacts, and enables identification of communities at highest health risk for future TCs. The model integrates (i) a causal inference component to quantify the immediate health impacts of recent historic TCs at high spatial resolution and (ii) a predictive component that captures how TC meteorological features and socioeconomic/demographic characteristics of impacted communities are associated with health impacts. We apply it to a rich data platform containing detailed historic TC exposure information and records of all-cause mortality and cardiovascular- and respiratory-related hospitalization among Medicare recipients. We report a high degree of heterogeneity in the acute health impacts of historic TCs, both within and across TCs, and, on average, substantial TC-attributable increases in respiratory hospitalizations. TC-sustained windspeeds are found to be the primary driver of mortality and respiratory risks.

PMID:34962265 | DOI:10.1093/biostatistics/kxab047

Brief Bioinform. 2021 Dec 27:bbab541. doi: 10.1093/bib/bbab541. Online ahead of print.

ABSTRACT

The study of genetic minority variants is fundamental to the understanding of complex processes such as evolution, fitness, transmission, virulence, heteroresistance and drug tolerance in Mycobacterium tuberculosis (Mtb). We evaluated the performance of the variant calling tool LoFreq to detect de novo as well as drug resistance conferring minor variants in both in silico and clinical Mtb next generation sequencing (NGS) data. The in silico simulations demonstrated that LoFreq is a conservative variant caller with very high precision (≥96.7%) over the entire range of depth of coverage tested (30x to1000x), independent of the type and frequency of the minor variant. Sensitivity increased with increasing depth of coverage and increasing frequency of the variant, and was higher for calling insertion and deletion (indel) variants than for single nucleotide polymorphisms (SNP). The variant frequency limit of detection was 0.5% and 3% for indel and SNP minor variants, respectively. For serial isolates from a patient with DR-TB; LoFreq successfully identified all minor Mtb variants in the Rv0678 gene (allele frequency as low as 3.22% according to targeted deep sequencing) in whole genome sequencing data (median coverage of 62X). In conclusion, LoFreq can successfully detect minor variant populations in Mtb NGS data, thus limiting the need for filtering of possible false positive variants due to sequencing error. The observed performance statistics can be used to determine the limit of detection in existing whole genome sequencing Mtb data and guide the required depth of future studies that aim to investigate the presence of minor variants.

PMID:34962257 | DOI:10.1093/bib/bbab541