Category: Nevin Manimala

BMC Public Health. 2022 Apr 30;22(1):865. doi: 10.1186/s12889-022-13296-5.

ABSTRACT

BACKGROUND: Screen media use in early childhood has largely increased in recent years, even more so during the COVID-19 epidemic, and there is much discussion regarding its influence on neurodevelopment, including Autism Spectrum Disorder (ASD).

METHODS: We examined the relationship between use of TV, computer, tablet and smartphone at age 2 years and risk of ASD assessed in telephone-based questionnaires among 12,950 children participating in the nationally representative ELFE (‘Etude Longitudinale Française sur les Enfants’) birth cohort study in France.

RESULTS: In inverse-probability weighted (IPW) multinomial regression analyses, children’s weekly or daily screen media use was associated with an increased likelihood of an intermediate risk of ASD (IPW-controlled OR for weekly use:1.07, 95% CI 1.02-1.12; IPW-controlled OR for daily use:1.05, 95% CI 1.02-1.08) but inversely associated with a high risk (IPW-controlled OR for weekly use: 0.60, 95% CI 0.50-0.73; IPW-controlled OR for daily use: 0.75, 95% CI 0.62-0.91), as ascertained by the M-CHAT. This was confirmed when studying TV as well as computer/tablet exposure separately.

CONCLUSIONS: Overall, our nationally-representative study conducted among a large sample of 2-year-old children, indicates a complex relationship between screen exposure and ASD risk.

PMID:35490214 | DOI:10.1186/s12889-022-13296-5

BMC Pregnancy Childbirth. 2022 Apr 30;22(1):374. doi: 10.1186/s12884-022-04688-x.

ABSTRACT

BACKGROUND: To compare specific dietary and behavioral recommendations for hemorrhoids prevention during pregnancy.

METHODS: This was a randomized, single-blind, multicenter trial conducted in three different clinical centers. Patients were randomly allocated into two groups in a ratio of 1:1. Intervention consisted of specific dietary and behavioral counseling. The primary outcome of this study was the rate of hemorrhoids at the time of discharge from the obstetrics unit. Categorical variables were compared by the Chi-Squared or Fisher exact tests, as appropriate. Continuous variables were compared using either the Student’s t-test or the Mann-Whitney U test. Binary logistic regression model was used to identify independent predictors of hemorrhoids after delivery. This analysis was performed on factors with a p-value < 0.10 in univariate analysis. Statistical analysis was performed using IBM SPSS 23.0 and GraphPad Prism 9 software. A P-value of less than 0.05 was considered significant for all tests.

RESULTS: We observed a significantly lower hemorrhoids rate in the intervention group at the time of discharge from the obstetrics unit after delivery (intention-to-treat (ITT) (the relative risk (RR) 0.38; 95% the confidence interval (CI) 0.24-0.59; p < 0.001) per-protocol (PP) (RR 0.42; 95% CI 0.27-0.64; p < 0.001). There was no significant difference in spontaneous miscarriage rate between the groups for both ITT and PP analysis. Additional binary logistic regression analysis revealed that the intervention applied in this study was the only protective factor. Both, the history of hemorrhoids before pregnancy and the increase of newborn height was associated with a higher risk of hemorrhoids.

CONCLUSIONS: Our suggested intervention, aimed to modify dietary and behavioral habits, significantly reduces the rate of hemorrhoids after pregnancy and can be safely recommended to pregnant women.

TRIAL REGISTRATION: Date of registration: 2016-05-09; Date of initial patient enrollment: 2016-06-02; Trial registration number: 158200-16-843-357; Trial registration site URL: https://www.mf.vu.lt/mokslas/vilniaus-regioninis-biomedicininiu-39tyrimu-etikos-komitetas#isduoti40vrbtek-leidimai .

PMID:35490229 | DOI:10.1186/s12884-022-04688-x

BMC Health Serv Res. 2022 Apr 30;22(1):582. doi: 10.1186/s12913-022-07991-7.

ABSTRACT

BACKGROUND: In Russia, remote retail trade of over-the-counter (OTC) medicines was legalised. According to statistics as of April 2020, consumer demand in the categories of “online pharmacies” increased by 803%.

METHODS: The study was conducted in two stages by cross-sectional method using a structured questionnaire in the central region of Russia: 1st stage – July-August 2020; 2nd stage – February-March 2021. The results of the study were obtained using qualitative (method of discussions in focus groups) and quantitative methods (survey) of sociological research, logical and statistical analysis. The representativeness of the data was ensured by a sufficient sample size including 1194 consumers (with confidence probability = 0.95 and confidence interval ≤ 0.05).

RESULTS: The number of respondents fully supporting the legalisation of online trade in medicines increased. Consumer attitudes towards online commerce depend on the age group of the respondents. 1.5 times more respondents over 46 years (12.1%) are strongly against distance selling of medicines compared to survey participants aged 18 to 25 years (7.8%). Six months after the first survey, no respondent strongly opposed the sale of prescription medicines through the internet, whereas in the first survey half of consumers held this view. The percentage of respondents who considered pharmaceutical counselling when purchasing medicines online as extremely important decreased by a factor of 4 over time (10.9%) M (08.2020) = 3.66 (0.992); M (03. 2021) = 3.17 (0.981) t = 7.66 (p < 0.05). Consumers consider accessibility for people with disabilities (80.3%) to be the most significant advantage of distance selling medicines.

CONCLUSION: Consumer demand for the purchase of medicines online will grow as this type of sale has undeniable advantages. However, some risks remain when buying medicines online.

PMID:35490211 | DOI:10.1186/s12913-022-07991-7

Sci Rep. 2022 Apr 30;12(1):7086. doi: 10.1038/s41598-022-11179-8.

ABSTRACT

Deep endometriosis (DE) occurs in 15-30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25-49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien-Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.50% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI 1.90-11.30; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Adenomyosis is an independent preoperative risk factor for surgical complications in DE surgery after adjustment for known demographic, clinical and surgical risk factors.

PMID:35490172 | DOI:10.1038/s41598-022-11179-8

J Craniomaxillofac Surg. 2021 Sep 30:S1010-5182(21)00216-X. doi: 10.1016/j.jcms.2021.09.012. Online ahead of print.

ABSTRACT

The aim of the study was to evaluate the efficacy and preliminary outcomes of using a postauricular-groove approach without endoscopic assistance for the excision of parotid tumors. Patients who underwent parotidectomy using a postauricular-groove incision were selected for this study. For patients in which parotidectomy was difficult, namely, for tumors located in the deep lobe area, the parotid gland sternocleidomastoid space was fully utilized, and the tumor was resected from the posterior plane. A total of fifty-eight patients with parotid tumor were enrolled and divided into superior lobe group (n = 46) and deep lobe group (n = 12). The difference in operation time (94 vs 119 min) and postoperative drainage (20.18 vs 45.33 mL) was statistically significant between the tumors in the superficial and deep lobes. However, postoperative cosmetic VAS score was 10 (extremely satisfied) for all patients. The incidence of transient facial nerve paralysis was comparable (8.7% vs 16.7%), and all of them resolved spontaneously within 3 months. No recurrence of tumors was found in either group in the median follow-up interval of 26.45 months (range 22.2-35.3 months), which was comparable to the result using the conventional “S” approach. After making full use of the parotid gland sternocleidomastoid space, the postauricular-groove approach demonstrated satisfactory facial nerve protection, as well as easy maneuverability without the risk of surgical complications for tumors located in the deep lobe area. Importantly, the postauricular-groove approach showed excellent cosmetic outcomes for all patients and should be considered an alternative approach for parotidectomy of selected cases.

PMID:35490146 | DOI:10.1016/j.jcms.2021.09.012

Sci Rep. 2022 Apr 30;12(1):7089. doi: 10.1038/s41598-022-11193-w.

ABSTRACT

The functional safety assessment is one of the primary tasks both at the design stage and at the stage of operation of critical infrastructure at all levels. The article’s main contribution is the information technology of calculating the author’s metrics of functional safety for estimating the instance of the model of the cyber-physical system operation. The calculation of metric criteria analytically summarizes the results of expert evaluation of the system in VPR-metrics and the results of statistical processing of information on the system’s operation presented in the parametric space Markov model of this process. The advantages of the proposed approach are the following: the need to process orders of magnitude less empirical data to obtain objective estimates of the investigated system; taking into account the configuration scheme and architecture of the security subsystem of the investigated system when calculating the metric; completeness, compactness, and simplicity of interpretation of evaluation results; the ability to assess the achievability of the limit values of the metric criteria based on the model of operation of the investigated system. The paper demonstrates the application of the proposed technology to assess the functional safety of the model of a real cyber-physical system.

PMID:35490168 | DOI:10.1038/s41598-022-11193-w

Endocrinol Diabetes Metab. 2022 Apr 30:e340. doi: 10.1002/edm2.340. Online ahead of print.

ABSTRACT

OBJECTIVE: To delineate the prevalence and associated risk factors of low BMD, osteoporosis/bone fragility and fracture in transfusion-dependent thalassemia (TDT) in the Chinese population in Hong Kong.

DESIGN, PATIENTS AND MEASUREMENTS: A retrospective cohort study design was employed. Patients of TDT who had serial Hologic dual-energy X-ray absorptiometry (DXA) from 2010 to 2016 and received regular transfusion for at least 5 years were recruited. Clinical and biochemical data, from 5 years before the first DXA scan, were retrieved from the electronic record system of the Hospital Authority, till 30 June 2020. Low bone mineral density and osteoporosis/bone fragility are defined by the ISCD 2019 position guidelines.

RESULTS: Seventy-seven patients were included in the analysis. The fracture prevalence of TDT among the Chinese population in Hong Kong was 15.58%. Up to 55.84% of patients had low bone mineral density, and 5.19% patients had osteoporosis/bone fragility state. The median age at first fracture was 31.73 years (range 24.06-44.18 years). In the regression analysis, a higher log(10) transformation of average ferritin levels over 5 years before the first DXA scan was significantly associated with fracture occurrence regardless of bisphosphonate treatment (OR 310.73, 95% CI 3.99-24183.89, p = .010). Mean average ferritin level over 5 years was 6695.5 ± 2365.7 pmol/L (fracture group) versus 4350.7 ± 3103.2 pmol/L (non-fracture group), p = .016. Hip and spine BMD Z-score did not have statistically significant association with fracture occurrence.

CONCLUSION: Iron overloading plays an important role in adverse bone health in TDT. Dual X-ray densitometry is insufficient in predicting fracture risk.

PMID:35490138 | DOI:10.1002/edm2.340

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Mar 3:S2212-4403(22)00848-3. doi: 10.1016/j.oooo.2022.02.013. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the effects of nonsurgical rapid maxillary expansion (RME) and surgically assisted RME (SARME) on palatal morphology and upper arch dimensions using three-dimensional (3D) models in skeletally mature patients.

STUDY DESIGN: Thirty-eight skeletally mature patients with a maxillary transverse deficiency were divided into RME and SARME groups. Nineteen patients in the RME group (mean age, 19.16 ± 2.25 years) were treated using a full-coverage bonded acrylic splint expander; 19 patients in the SARME group (mean age, 20.38 ± 3.36) were treated using the banded palatal expansion appliance with hyrax screws. The 3D models were obtained before and after expansion. The maxillary dental arch widths, maxillary first molar angulation, palatal area, and palatal volume were calculated on the 3D models.

RESULTS: All variables showed statistically significant changes after the retention period (P < .001). The maxillary arch width between first premolars (P < .05), the palatal area (P < .01), and the palatal volume (P < .05) significantly increased in the SARME group compared to the RME group. The maxillary first molar tipping in the RME group was significantly higher than that in the SARME group (P < .01).

CONCLUSIONS: Although SARME has more positive effects in skeletally mature patients, nonsurgical RME can be considered as an alternative by evaluating surgical risks, periodontal status, and the need for skeletal expansion.

PMID:35490136 | DOI:10.1016/j.oooo.2022.02.013

Acad Radiol. 2022 Mar 30:S1076-6332(22)00202-1. doi: 10.1016/j.acra.2022.03.025. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Hard data labels for automated algorithm training are binary and cannot incorporate uncertainty between labels. We proposed and evaluated a soft labeling methodology to quantify opacification and percent well-aerated lung (%WAL) on chest CT, that considers uncertainty in segmenting pulmonary opacifications and reduces labeling burden.

MATERIALS AND METHODS: We retrospectively sourced 760 COVID-19 chest CT scans from five international centers between January and June 2020. We created pixel-wise labels for >27,000 axial slices that classify three pulmonary opacification patterns: pure ground-glass, crazy-paving, consolidation. We also quantified %WAL as the total area of lung without opacifications. Inter-user hard label variability was quantified using Shannon entropy (range=0-1.39, low-high entropy/variability). We incorporated a soft labeling and modeling cycle following an initial model with hard labels and compared performance using point-wise accuracy and intersection-over-union of opacity labels with ground-truth, and correlation with ground-truth %WAL.

RESULTS: Hard labels annotated by 12 radiologists demonstrated large inter-user variability (3.37% of pixels achieved complete agreement). Our soft labeling approach increased point-wise accuracy from 60.0% to 84.3% (p=0.01) compared to hard labeling at predicting opacification type and area involvement. The soft label model accurately predicted %WAL (R=0.900) compared to the hard label model (R=0.856), but the improvement was not statistically significant (p=0.349).

CONCLUSION: Our soft labeling approach increased accuracy for automated quantification and classification of pulmonary opacification on chest CT. Although we developed the model on COVID-19, our intent is broad application for pulmonary opacification contexts and to provide a foundation for future development using soft labeling methods.

PMID:35490114 | DOI:10.1016/j.acra.2022.03.025

Rev Esp Cir Ortop Traumatol. 2022 Apr 27:S1888-4415(22)00011-X. doi: 10.1016/j.recot.2022.01.005. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVE: Dual modularity stems seek to more precisely restore anatomy by allowing intraoperative adjustments thanks to modular necks. Our aim is to compare the radiographic length correction with the H MAX-M® Stem versus its monoblock counterpart H MAX-S®.

MATERIAL AND METHODS: A prospective cohort study was carried out through consecutive sampling on patients who underwent primary total hip arthroplasty with coxarthrosis diagnosis between 2011 and 2015. One arm of the cohort included patients who were operated with a modular stem and the other with a monobloc stem. Length was measured on the anteroposterior pelvic-bearing radiograph at six months. The mean of the measurements obtained for each arm of the cohort were compared with each other.

RESULTS: No statistically significant differences were observed in the correction of asymmetry between both groups, determined as the difference in length between the operated hip and the contralateral hip (P=.106). Nor were differences observed in postoperative length values (P=.053). It should be noted that for both the modular stem and the monobloc stem, the majority group is the one with restored length (84.1% and 80.4%, respectively; P=.001).

CONCLUSION: Despite the theoretical advantage of modularity and that having interchangeable parts could be of great interest, in our study, we have not been able to demonstrate a superiority of modular designs compared to monoblock for control of postoperative leg length discrepancy.

PMID:35490100 | DOI:10.1016/j.recot.2022.01.005