Category: Nevin Manimala

Codas. 2021 May 14;33(2):e20190219. doi: 10.1590/2317-1782/20202019219. eCollection 2021.

ABSTRACT

PURPOSE: Adapt and validate the content and appearance of the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) for nursing infants aged 6 to 24 months.

METHODS: This is a validation study. The parameters were based on the literature on orofacial motor development, the authors’ experience, and on a committee of ten members. Data analysis was performed using descriptive statistics, content validity index, and agreement among experts.

RESULTS: The protocol was organized into functional blocks after maintenance, exclusion, modification, and addition of items, and was adapted according to the age group. A high level of agreement between experts was obtained for 90% of the items. The final version of the protocol includes new items such as history of feeding, orofacial parafunctional habits, facial mobility, dentition, oral breathing mode, swallowing of pasty food, and details specific for the age group. An operational manual and a table for recording the scores were also included.

CONCLUSIONS: The OMES-E Infants protocol was validated for its content and appearance, and may contribute to orofacial myofunctional diagnosis in the 6 to 24-month age group.

PMID:34008774 | DOI:10.1590/2317-1782/20202019219

Rev Saude Publica. 2021 May 17;55:21. doi: 10.11606/s1518-8787.2021055002134. eCollection 2021.

ABSTRACT

OBJECTIVE: To characterize breastfeeding patterns in the first six months of life and factors associated with early weaning in a birth-cohort in Rio Branco, state of Acre.

METHODS: This is a prospective study with all babies born between April and June 2015. The mothers were interviewed soon after birth and between 6 and 15 months postpartum. At hospital discharge, breastfeeding was defined as exclusively (EBF), and breastfeeding (BF). In the follow-up, breastfeeding patterns were exclusive breastfeeding (EBF), predominant breastfeeding (PBF), and breastfeeding (BF). The interruption of breastfeeding in the first six months was classified as early weaning. The Kaplan Meier method (log-rank: 95%) was used to estimate the conditional probability of change in breastfeeding pattern, and early weaning risk. Crude and adjusted proportional Cox regression models, and their respective 95% confidence intervals (95%CI), were used to analyze the factors associated with early weaning.

RESULTS: The study included 833 infants in EBF (95.4%) and BF (4.6%) at hospital discharge. During the first six months of life, the infant likely discharged in EBF remaining in EBF, becoming PBF, and BF, were respectively 16.4%, 32.3%, and 56.5%. The weaning likely at six months was statistically higher for infants discharged in BF (47.4%) when compared with those discharged in EBF (26%). Factors associated with early weaning were BF at hospital discharge (HR = 1.82; 95%CI 1.06-3.11), no mother cross-breastfeeding (HR = 2.50; 95%CI 1.59-3.94), pacifier use (HR = 6.23; 95%CI 4.52-8.60), less than six months of breastfeeding intention (HR = 1.93; 95%CI 1.25-2.98), lack of breastfeeding in the first hour of life (HR = 1.45; 95%CI 1.10-1.92), and pregnancy alcohol consumption (HR = 1.88; 95%CI 1.34-2.90).

CONCLUSION: Compared to infants in EBF, those in BF at hospital discharge were more likely to wean. Public health efforts should prioritize EBF at hospital discharge, promote breastfeeding in the first hour of life, and prevent alcohol consumption risks during pregnancy, cross-breastfeeding and pacifier use.

PMID:34008778 | DOI:10.11606/s1518-8787.2021055002134

Braz J Med Biol Res. 2021 May 17;54(7):e10687. doi: 10.1590/1414-431X2020e10687. eCollection 2021.

ABSTRACT

Helicobacter pylori (H. pylori) induces an intense inflammatory response, mediated by proinflammatory cytokines, including interleukin (IL)-6 and its membrane receptor (IL-6R), which activates important signaling pathways in the development of gastric disease and cancer. We investigated the gene and protein expression of IL-6 and IL-6R and the influence of polymorphisms rs1800795, rs1800796, and rs1800797 on its gene expression together with H. pylori infection. Furthermore, an in-silico analysis was performed to support our results. Gastric biopsies were obtained from patients with gastric symptoms and patients with gastric cancer (GC) and were divided into groups (Control, Gastritis, and Cancer). H. pylori was detected by PCR. Real-time-qPCR was employed to determine gene expression, and western blot assay was used to analyze protein expression levels. PCR-RFLP was used to characterize IL-6 polymorphisms. Bioinformatics analyses were performed using the Gene Expression Omnibus (GEO) database and GEO2R to screen out differentially expressed genes (DEGs). H. pylori was detected in 43.3% of the samples. Statistically significant differences were found for IL-6 (P=0.0001) and IL-6R (P=0.0005) genes among the three groups, regardless of the presence of H. pylori. Among patients with H. pylori infection, the IL-6 and IL-6R gene and protein expressions were significantly increased, highlighting IL-6 gene overexpression in patients with GC. No statistically significant differences were found for the rs1800795, rs1800796, and rs1800797 polymorphisms compared to IL-6 gene expression. The results indicated that the IL-6 polymorphisms do not influence its expression, but IL-6 and IL-6R expression seems to be altered by the presence of H. pylori.

PMID:34008757 | DOI:10.1590/1414-431X2020e10687

An Acad Bras Cienc. 2021 May 17;93(suppl 1):e20200883. doi: 10.1590/0001-3765202120200883. eCollection 2021.

ABSTRACT

Gamma-ray bursts (GRBs) are the most energetic and mysterious events in the Universe, which are observed in all ranges of electromagnetic spectrum. Most valuable results about physics of GRB are obtained by optical observations. GRBs are initially detected in gamma-rays with poor localization accuracy, and an optical counterpart should be found. The faster the counterpart is found, the more it can give to physics. This first phase, as a rule, corresponds to an early afterglow. The next phases of the observations are multicolor photometry, polarimetry, spectroscopy, and few days later the search for a supernova or kilonova associated with the GRB, and finally, observations of the host galaxy. To manage the problem of fast optical observations, telescopes with a small aperture are suitable. They can have a large field of view, which is necessary to cover initial localizations of GRBs. The sensitivity of the telescope+detector may be sufficient to record statistically significant light curve with fine time resolution. We describe one of the networks of telescopes with a small aperture IKI-GRB FuN, and present the results of early optical observation of GRB sources, and discuss the design requirements of the optical observations for effective GRB research in the next decade.

PMID:34008766 | DOI:10.1590/0001-3765202120200883

Z Orthop Unfall. 2021 May 18. doi: 10.1055/a-1471-8622. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare posterolateral fusion with transforaminal lumbar interbody fusion (PLF + TLIF) and PLF only in terms of revision surgery rates and complications, as well as functional and radiological outcomes in lumbar spinal stenosis (LSS) patients.

METHODS: Seventy-one patients (37 patients in the PLF + TLIF group and 34 patients in the PLF only group) who underwent surgery due to LSS between January 2013 and December 2016 were retrospectively investigated. Functional evaluation was performed by using the McGill-Melzack Pain Questionnaire (MPQ), Roland Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI) scales pre-and postoperatively. Radiological evaluation was made by examining adjacent vertebrae, posterior ligamentous complex (PLC) morphology, and sagittal balance on magnetic resonance imaging (MRI).

RESULTS: Postoperative MPQ, RMDQ, and ODI scores were significantly better in the PLF + TLIF group (p < 0.001, p < 0.001, and p = 0.001, respectively). The complication rate was significantly higher in the PLF only group (p = 0.026). In the PLF + TLIF group, postoperative functional scores showed significant improvement in terms of the instrumented segment and level of interbody fusion. Postoperative functional scores showed significant improvement in PLF + TLIF patients with no complications, no revision surgery, no postoperative MRI findings, and neutral sagittal balance compared to the preoperative functional scores (p < 0.001).

CONCLUSION: PLF + TLIF is significantly superior in terms of functional scores and complications, despite the statistical similarity in terms of postoperative MRI findings and sagittal balance between the groups. Surgeons should prefer PLF + TLIF for the surgical treatment of LSS for better results.

PMID:34005826 | DOI:10.1055/a-1471-8622

Singapore Med J. 2021 May 19. doi: 10.11622/smedj.2021052. Online ahead of print.

ABSTRACT

INTRODUCTION: Neurofibromatosis type 1 (NF 1) is an autosomal dominant neurocutaneous disease characterised by multisystemic involvement, including bone tissue. Deformities and reduced bone mass are the main bone manifestations in NF1. Quantitative computed tomography (QCT) provides true volumetric bone mineral density (BMD) measurement. This study aimed to evaluate bone metabolism parameters and BMD in children with NF1 using QCT.

METHODS: The data of 52 paediatric NF1 patients (23 female, 29 male) was evaluated retrospectively. We investigated anthropometric measurements, biochemical parameters like total calcium, phosphate, magnesium, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), parathyroid hormone, calcitonin, urinary calcium/creatinine ratio, and QCT parameters like lumbar trabecular and cortical BMD, trabecular area and cortical thickness. Comparisons of gender and puberty status were performed.

RESULTS: 25% of patients had skeletal deformities and 42.3% had 25OHD inadequacy (< 20 ng/mL). The frequency of 25OHD inadequacy was significantly higher in pubertal/postpubertal patients than prepubertal patients (61.9% vs. 29.0%, p = 0.019). Trabecular BMD Z-score was < -2.0 in 11.5% of patients; all with low BMD were at the pubertal/postpubertal stage. There was a significant negative correlation between age and trabecular Z-score (r = -0.41, p = 0.003). Mean cortical BMD was statistically similar between the genders and puberty groups. Puberty status, anthropometric Z-scores, and biochemical and QCT parameters were statistically similar between the genders (p > 0.05).

CONCLUSION: Paediatric NF1 patients may present with low BMD and 25OHD inadequacy, especially at puberty. QCT may be a useful tool to evaluate trabecular and cortical bone separately in NF1 patients.

PMID:34005845 | DOI:10.11622/smedj.2021052

Am J Clin Nutr. 2021 May 18:nqab109. doi: 10.1093/ajcn/nqab109. Online ahead of print.

ABSTRACT

BACKGROUND: Diet, in particular the Mediterranean diet, has been associated with better cognitive function and less cognitive decline in older populations.

OBJECTIVES: To quantify associations of a healthy diet, defined by adherence to either the Mediterranean diet, the WHO guidelines, or Dutch Health Council dietary guidelines, with cognitive function and cognitive decline from middle age into old age.

METHODS: From the Doetinchem Cohort Study, a large population-based longitudinal study, 3644 participants (51% females) aged 45-75 y at baseline, were included. Global cognitive function, memory, processing speed, and cognitive flexibility were assessed at 5-y time intervals up to 20-y follow-up. Adherence to the Mediterranean diet was measured with the modified Mediterranean Diet Score (mMDS), adherence to the WHO dietary guidelines with the Healthy Diet Indicator (HDI), and adherence to the Dutch Health Council dietary guidelines 2015 with the modified Dutch Healthy Diet 2015 index (mDHD15-index). The scores on the dietary indices were classified in tertiles (low, medium, high adherence). Linear mixed models were used to model level and change in cognitive function by adherence to healthy diets.

RESULTS: The highest tertiles of the mMDS, HDI, and mDHD15-index were associated with better cognitive function compared with the lowest tertiles (P values <0.01), for instance at age 65 y equal to being 2 y cognitively younger in global cognition. In addition, compared with the lowest tertiles, the highest tertiles of the mMDS, HDI, and mDHD15-index were statistically significantly associated with 6-7% slower global cognitive decline from age 55 to 75 y, but also slower decline in processing speed (for mMDS: 10%; 95% CI: 2, 18%; for mDHD15: 12%; 95% CI: 6, 21%) and cognitive flexibility (for mDHD15: 10%; 95% CI: 4, 18%).

CONCLUSIONS: Healthier dietary habits, determined by higher adherence to dietary guidelines, are associated with better cognitive function and slower cognitive decline with aging from middle age onwards.

PMID:34004676 | DOI:10.1093/ajcn/nqab109

Cerebrovasc Dis. 2021 May 18:1-8. doi: 10.1159/000516116. Online ahead of print.

ABSTRACT

BACKGROUND: The Los Angeles Motor Scale (LAMS) is a 3-item, 0-to-5-point motor stroke-deficit scale derived from the Los Angeles Prehospital Stroke Screen. We assessed the predictive validity (for interventions performed and discharge disposition) of the LAMS performed in the field by paramedics in a geographic region of over 5,200 km2, covering both rural and urban areas.

METHODS: We analyzed data gathered from Phase I of the LIT-PASS study (Large Vessel Occlusion Identification Through Prehospital Administration of Stroke Scales) which included all patients with suspected acute cerebrovascular disease, as assessed by the Balance, Eyes, Face, Arm, Speech, Terrible Headache/Time to Call 911 (BE-FAST) test.

RESULTS: Among 1,906 patients with median age 72 years (interquartile range [IQR] 60-81), 53% were female with a median on-scene time of 15 min (IQR 12-19). C statistics for the interventions of mechanical thrombectomy, alteplase administration, computed tomography angiography, and perfusion imaging were 0.681, 0.643, and 0.680, respectively. The cut point for predicting these 3 interventions was confirmed to be LAMS ≥ 4. LAMS ≥ 4 had sensitivity 0.730 (0.661-0.790) and specificity 0.570 (0.539-0.601) for mechanical intervention (endovascular thrombectomy, coiling, or clipping) and relative risk of 2.98 (2.19-4.07) for in-hospital death.

CONCLUSIONS: This real-world field study validates the LAMS as an effective tool for prehospital assessment of suspected strokes in determining transport decisions, with predictive validity for interventions performed.

PMID:34004604 | DOI:10.1159/000516116

Orthop Nurs. 2021 May-Jun 01;40(3):182-188. doi: 10.1097/NOR.0000000000000758.

ABSTRACT

General anesthesia, prolonged immobilization, and pain may adversely affect pulmonary function in patients undergoing prosthetic surgery. The aim of this study was to evaluate the effect of balloon-blowing exercises on pulmonary functions in patients undergoing total hip arthroplasty. The patients in the experimental group performed three sets of balloon-blowing exercises in the morning, at noon, and in the evening on the first to third days postoperatively. The increase in forced vital capacity (FVC) values between the control and experimental groups in the postoperative period was statistically significant (p < .001), in favor of the experimental group. The increase in forced expiratory volume during the first second (FEV1)/FVC ratio was found to be significantly higher in the experimental group than in the control group (p < .001). Patients who performed balloon-blowing exercises increased their FVC and FEV1/FVC ratio.

PMID:34004618 | DOI:10.1097/NOR.0000000000000758

Forensic Sci Int. 2021 May 7;324:110823. doi: 10.1016/j.forsciint.2021.110823. Online ahead of print.

ABSTRACT

Calls for blind proficiency testing in forensic science disciplines intensified following the 2009 National Academy of Sciences report and were echoed in the 2016 report by the President’s Council of Advisors on Science and Technology. Both practitioners and scholars have noted that “open” proficiency tests, in which analysts know they are being tested, allow for test-taking behavior that is not representative of behavior in routine casework. This study reports the outcomes of one laboratory’s blind quality control (BQC) program. Specifically, we describe results from approximately 2.5 years of blind cases in the latent print section (N = 376 latent prints submitted as part of 144 cases). We also used a widely available quality metrics software (LQMetrics) to explore relationships between objective print quality and case outcomes. Results revealed that nearly all BQC prints (92.0%) were of sufficient quality to enter into AFIS. When prints had a source present in AFIS, 41.7% of print searches resulted in a candidate list containing the true source. Examiners committed no false positive errors but other types of errors were more common. Average print quality was in the midpoint of the range (53.4 on a 0-to-100 scale), though prints were evenly distributed across the Good, Bad, and Ugly categories. Quality metrics were significantly associated with sufficiency determinations, examiner conclusions, and examiner accuracy. Implications for blind testing and the use of quality metrics in routine casework as well as proficiency testing are discussed.

PMID:34004529 | DOI:10.1016/j.forsciint.2021.110823