Nevin Manimala

J Prosthet Dent. 2024 Mar 12:S0022-3913(24)00128-8. doi: 10.1016/j.prosdent.2024.02.012. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: A trial restoration is an important diagnostic tool that can be fabricated through analog or digital pathways. Digital workflows may have improved accuracy, but this is yet to be demonstrated conclusively.

PURPOSE: The purpose of this in vitro study was to compare the dimensional accuracy of trial restorations produced by different analog (molded) and digital (milled and 3D printed) methods. Parameters studied included fabrication methods, Shore-A hardness of silicone putty indices, length of span, and labial tooth levels.

MATERIAL AND METHODS: Digital additive trial restorations were designed on a single virtual cast from maxillary right to left lateral incisor teeth (4 teeth) and from maxillary right to left first premolar teeth (8 teeth). Both designs were identical on the 4 anterior teeth. Each digital trial restoration was 3-dimensionally (3D) printed to produce reference casts. The original cast was 3D printed to produce 44 replica casts. There were 8 experimental groups (4 analog and 4 digital) with 10 specimens each. For the analog groups, 20 silicone indices per reference cast were made: 10 from standard silicone putty (63 to 70 Shore-A hardness) and 10 from hard silicone putty (90 Shore-A hardness). The analog trial restorations were molded on replica casts with silicone indices and bis-acryl resin. The digital trial restorations were either milled or 3D printed and adapted onto replica casts. Each trial restoration was scanned and digitally superimposed onto respective scanned reference casts. Measurements were recorded at 3 levels: cervical, middle, and incisal. The independent samples Kruskal-Wallis, 2-sample Mann-Whitney, and Bonferroni tests were used to compare the distribution of accuracy among all groups (α=.05).

RESULTS: The dimensional accuracy of the different trial restoration fabrication methods was comparable in terms of median values of trueness (how close the readings were to the reference), and no statistically significant difference was found among them (P>.05). When the dimensional accuracy in terms of precision (how close the readings were to each other) were analyzed, the hard putty groups demonstrated a statistically significant better outcome, whereas standard putty consistently showed the poorest result. The incisal level displayed the most significant deviation (P=.005) when all groups were compared. The incisal discrepancy values of the short-span standard putty trial restoration varied by as much as 0.84 mm in some specimens.

CONCLUSIONS: Milled and 3D printed trial restoration fabrication techniques showed dimensional accuracy comparable with that of the analog groups. However, the choice of silicone putty was shown to affect the dimensional accuracy of an analog molded trial restoration. A high Shore-A hardness silicone putty produced the best precision and should be used when fabricating an analog molded trial restoration.

PMID:38480017 | DOI:10.1016/j.prosdent.2024.02.012

J Prosthet Dent. 2024 Mar 12:S0022-3913(24)00143-4. doi: 10.1016/j.prosdent.2024.02.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Precise data are a prerequisite for accurately fitting restorations. Therefore, intraoral scanners have to be reliable. Data on differences between the same model of intraoral scanning systems are lacking.

PURPOSE: This in vitro study evaluated differences in the scanning accuracy of a partially edentulous maxilla between combinations of new intraoral scanners of a single model from the same manufacturer (Primescan; Dentsply Sirona) and several calibration aids.

MATERIAL AND METHODS: The in vitro reference model simulated a maxilla with 6 prepared teeth for a complete arch fixed partial denture. Five precision ceramic balls were used to detect dimensional deviation between the reference model and the scan. Distances were divided into 4 categories, from short distances between 2 neighboring precision balls to the cross-arch distance with the scan path comprising all 5 balls. For each combination of 4 new intraoral scanners and their respective calibration aids, 12 model registrations were generated. The data were statistically analyzed using ANOVA (α=.05).

RESULTS: Distance deviations increased with increasing scan path length and were significantly affected by the covariates “scanner” (P≤.023) and, for 3 of 4 distance categories, the “calibration aid” (short, medium, and long distances: P≤.013). For short and medium distances, acceptable scanning results were achieved for all test groups. The largest deviation was 539 µm for the cross-arch distance.

CONCLUSIONS: Scanning accuracy depends on the scanner and the calibration aid used, in particular, for spans exceeding a single quadrant.

PMID:38480016 | DOI:10.1016/j.prosdent.2024.02.019

Clin Nutr ESPEN. 2024 Apr;60:362-372. doi: 10.1016/j.clnesp.2024.02.025. Epub 2024 Feb 29.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disease characterized by abdominal pain, distension, and altered bowel habits. Probiotics may alleviate IBS symptoms, but clinical trials remain conflicting.

AIMS: To conduct a systematic review and meta-analysis of clinical trials to evaluate the efficacy and safety of probiotics for IBS patients.

METHODS: We searched relevant trials in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar from 2000 to June 2023. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. A risk ratio (RR) and a 95% CI were calculated for dichotomous outcomes.

RESULTS: A total of 20 studies involving 3011 patients were obtained. The results demonstrated that probiotics are more effective than placebo in reducing global IBS symptoms improvement rate (RR = 1.401, 95% CI 1.182-1.662, P < 0.001) and quality of life scores (SMD = 0.286, 95% CI = 0.154-0.418, P < 0.001). Subgroup analyses showed that a shorter treatment time (less than eight weeks) could reduce distension scores (SMD = 0.197, 95% CI = 0.038-0.356, P = 0.015). High doses (daily dose of probiotics ≥ 10ˆ10) or multiple strains of probiotics exhibit beneficial effects on abdominal pain (SMD = 0.412, 95% CI = 0.112-0.711, P = 0.007; SMD = 0.590, 95% CI = 0.050-1.129, P = 0.032; respectively). However, there was no significant benefit on global symptom scores (SMD = 0.387, 95% CI 0.122 to 0.653, P = 0.004) with statistically high inter-study heterogeneity (I2 = 91.9%, P < 0.001). Furthermore, there was no significant inter-group difference in terms of adverse events frequency (RR = 0.997, 95% CI 0.845-1.177, P = 0.973).

CONCLUSION: Probiotics are effective and safe for IBS patients. High doses or multiple probiotic strains seem preferable, but definite conclusions are challenging due to the high heterogeneity. Large-scale, well-designed, and rigorous trials are needed to confirm their effectiveness.

PMID:38479936 | DOI:10.1016/j.clnesp.2024.02.025

Clin Nutr ESPEN. 2024 Apr;60:348-355. doi: 10.1016/j.clnesp.2024.02.021. Epub 2024 Feb 27.

ABSTRACT

BACKGROUND & AIMS: Patients receiving oncological esophagectomy or gastrectomy are known to be at high risk for vitamin and micronutrient deficiency before, during and after surgery. However, there are no clear guidelines for these cancer patients regarding postoperative vitamin supplementation.

METHODS: We conducted a metanalysis consisting of 10 studies regarding vitamin and micronutrient deficiencies after oncological gastric or esophageal resection. 5 databases were searched.

RESULTS: Data was sufficient regarding Vitamins B12 and 25-OH D3 as well as calcium. We were able to show deficiencies in 25-OH Vitamin D3 levels (p < 0.001) and lower levels of Vitamin B12 and calcium (bit p < 0.001) when compared to the healthy population.

CONCLUSIONS: Patients from these groups are at risk for vitamin deficiencies. A guideline on postoperative supplementation is needed.

PMID:38479934 | DOI:10.1016/j.clnesp.2024.02.021

Clin Nutr ESPEN. 2024 Apr;60:298-302. doi: 10.1016/j.clnesp.2024.02.020. Epub 2024 Feb 21.

ABSTRACT

BACKGROUND & AIMS: Disruptions in the home parenteral nutrition (HPN) process may lead to failure to achieve the intended treatment purposes. This study aimed to evaluate the mid-term clinical outcome in a group of patients with short bowel syndrome (SBS) after a sudden change in the type of home parenteral nutrition programs from customized to commercially premixed admixtures.

METHODS: The study conducted in 2020 identified 51 patients with SBS: 27 (53%) women and 24 (47%) men. The SBS were classified as SBS with end jejunostomy 23 (45%) patients, with jejuno-colon anastomosis 23 (45%) patients, with jejuno-ileo anastomosis and total colon in continuity 5 (10%) patients. The following therapeutic program-related data were analysed: changes in nutritional status, body mass index (BMI), Controlling Nutritional Status (CONUT) score, and biochemical assessment. For statistical analysis, the Wilcoxon rank-sum and signed-rank paired tests with continuity corrections were used to compare the results. A p-value of <0.001 was considered statistically significant.

RESULTS: There was no statistically significant difference between the analysed groups in total energy, amino acid concentrations, and intravenous volume supplementation. BMI and CONUT assessments of nutritional status and selected biochemical parameters were stable during the study period.

CONCLUSIONS: The study demonstrated that a sudden change in the HPN therapy program from parenteral admixtures, tailored to meet individual patients’ needs, to commercially premixed admixtures had no significant impact on the mid-term clinical condition of patients with SBS.

PMID:38479925 | DOI:10.1016/j.clnesp.2024.02.020

Clin Nutr ESPEN. 2024 Apr;60:187-194. doi: 10.1016/j.clnesp.2024.01.021. Epub 2024 Jan 30.

ABSTRACT

INTRODUCTION: Among the many micronutrients, Vitamin D deficiency has been associated with the severity of Severe Acute Respiratory Syndrome Coronavirus 2 patients.

DESIGN AND METHODS: A retrospective observational study was conducted on Severe acute respiratory syndrome coronavirus 2 patients admitted to a tertiary care hospital between April 5, 2021, and May 5, 2021.

RESULTS: Among 285 patients,77.2 % of the patients who stayed for more than 14 days were either Vitamin D insufficient or deficient [P value < 0.05]. In our study, the mean oxygen saturation at admission was 85.7 % in the Vitamin D deficiency group compared to 95.6 % in Vitamin D sufficiency patients [P value < 0.05]. Mean serum ferritin was 398 ng/ml in the Vitamin D deficiency group compared to 393 ng/ml in Vitamin D sufficiency patients [P value > 0.05]. The mean C-reactive protein was 107.6 mg/ml in the Vitamin D deficiency group compared to 21.8 ng/ml in Vitamin D sufficiency patients [P value < 0.05]. The mean D-Dimer was 2268 ng/ml in the Vitamin D deficiency group compared to 781 ng/ml in Vitamin D sufficiency patients [P value < 0.05]. In the non-survivor group,97.4 % were Vitamin D deficient and insufficient. Only 2 % of the patients who survived were Vitamin D deficient [P value < 0.05].

CONCLUSION: We observed that low 25-hydroxy Vitamin D levels were associated with lower oxygen saturation and higher acute physiology and chronic health evaluation II scores, requiring a more extended stay in the hospital. C-reactive protein and D-dimers were significantly higher in Vitamin D deficient patients, suggesting severe disease. We did not find statistically significant findings in the case of the correlation of serum ferritin levels with Vitamin D status.

PMID:38479909 | DOI:10.1016/j.clnesp.2024.01.021

Clin Nutr ESPEN. 2024 Apr;60:179-186. doi: 10.1016/j.clnesp.2024.01.022. Epub 2024 Jan 24.

ABSTRACT

BACKGROUND AND AIMS: The circadian pattern of eating behaviors has garnered increasing interest as a strategy for obesity prevention and weight loss. It is believed that the benefits stem from aligning food intake with the body’s natural daily rhythms. However, the existing body of evidence is limited in scale and scope and there has been insufficient evaluation of temporal eating behaviors, such as the specific time of day in which the highest calorie consumption occurs, meal frequency, and distribution. This research aims to explore the association between the timing of the largest meal of the day and eating frequency with Body Mass Index (BMI) and obesity.

METHODS: Participants (n = 2050, 18-65y) were part of an exploratory cross-sectional and population-based research, with data collection in a virtual environment. Linear regression analyses and restricted cubic splines evaluated differences in BMI associated with independent eating variables [timing of the largest meal, number of meals/day (as continuous and categorical: ≤3 or >3/day), and each largest meal of the day (breakfast/lunch/dinner)]. Logistic regression models were fitted to assess Odds Ratios (OR) and 95 % Confidence Intervals (CI) of obesity associated with the same independent variables.

RESULTS: Our main findings were that the timing of the largest meal and reporting dinner as the largest meal were associated with higher values of BMI (respectively, 0.07 kg/m² and 0.85 kg/m²) and increased odds of obesity [respectively OR(95%CI):1.04(1.01,1.08), and OR(95%CI):1.67(1.18,2.38)]. Those who realized more than 3 meals/day presented lower values of BMI (-0.14 kg/m²) and 32 % lower odds of having obesity [OR(95%CI):0.68(0.52,0.89)]. Reporting lunch as the largest meal also protected against obesity [OR(95%CI):0.71(0.54,0.93)]. These associations were statistically significant and independent of sex, age, marital status, education level, diet quality, sleep duration, and weekly frequency of physical exercise.

CONCLUSION: Having the largest meal earlier in the day, concentrating the majority of caloric intake during lunch, and consuming more than three meals a day, may present a promising intervention for preventing and treating obesity/overweight.

PMID:38479908 | DOI:10.1016/j.clnesp.2024.01.022

J Neurophysiol. 2024 Mar 13. doi: 10.1152/jn.00285.2023. Online ahead of print.

ABSTRACT

Neurons in sensory and motor cortices tend to aggregate in clusters with similar functional properties. Within the primate dorsal (‘where’) pathway, an important interface between three-dimensional (3D) visual processing and motor-related functions consists of two hierarchically organized areas: V3A and the caudal intraparietal (CIP) area. In these areas, 3D visual information, choice-related activity, and saccade-related activity converge, often at the single neuron level. Characterizing the clustering of functional properties in areas with mixed selectivity, such as these, may help reveal organizational principles that support sensorimotor transformations. Here we quantified the clustering of visual feature selectivity, choice-related activity, and saccade-related activity by performing correlational and parametric comparisons of the responses of well-isolated, simultaneously recorded neurons in macaque monkeys. Each functional domain showed statistically significant clustering in both areas. However, there were also domain-specific differences in the strength of clustering across the areas. Visual feature selectivity and saccade-related activity were more strongly clustered in V3A than CIP. In contrast, choice-related activity was more strongly clustered in CIP than V3A. These differences in clustering may reflect the areas’ roles in sensorimotor processing. Stronger clustering of visual and saccade-related activity in V3A may reflect a greater role in within-domain processing, as opposed to cross-domain synthesis. In contrast, stronger clustering of choice-related activity in CIP may reflect a greater role in synthesizing information across functional domains to bridge perception and action.

PMID:38478896 | DOI:10.1152/jn.00285.2023

Neurology. 2024 Apr 9;102(7):e209224. doi: 10.1212/WNL.0000000000209224. Epub 2024 Mar 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: Few anecdotal cases and 1 small retrospective study during short-duration space missions suggest that headache may occur early in flight, as part of the space motion syndrome. Whether headaches may also occur at later stages of space flights is unknown. We aimed to prospectively characterize the incidence, timing, clinical features, and management of space headaches during long-duration flights.

METHODS: We prospectively evaluated the occurrence, characteristics, and evolution of space headaches and the effects of treatment and countermeasures during long-haul flights with onboard questionnaires and correlated them with prevailing temperature, pressure, and ambient O₂ and CO₂ levels, measured within the International Space Station. In addition, we analyzed retrospective headache data from a different astronaut cohort. Headache data were reported using descriptive statistics and correlation data with intraindividual logistic regression models. Astronauts were included through (inter)national aerospace organizations.

RESULTS: In the prospective study, 22/24 (91.7%) astronauts (mean ± SD age: 46.6 ± 6.5 years, 95.8% male) experienced ≥1 episode of headache during a total of 3,596 space days. A total of 378 episodes were reported (median 9; range 1-128) with detailed information on 189. Phenotypically, 170/189 (89.9%) episodes were tension-type headache (TTH) and 19/189 (10.1%) were migraine. Episodes in the first week differed from those in later periods in terms of phenotype (migraine 12/51 [23.5%] vs 7/138 [5.1%]; TTH 39/51 [86.5%] vs 131/138 [94.9%]; overall p = 0.0002) and accompanying symptoms: nausea: 17.6% vs 6.9%, p = 0.05; vomiting: 9.8% vs 0.7%, p = 0.005; nasal congestion: 52.9% vs 29.7%, p = 0.004; facial edema: 41.2% vs 1.4%, p < 0.001; and duration (p = 0.001). Severity and treatments were similar: acute antiheadache medication: 55.6%; other medication: 22.4%; and alternative treatments: 41.1%. Headache occurrence was not associated with temperature or ambient pressure/levels of O₂ and CO₂ (all p > 0.05). In the retrospective study, 23/42 (54.8%) astronauts (43.5 ± 7.2 years, 90.5% male) reported experiencing ≥1 headache episode during mission. Nasal congestion was the most common (8/33; 24.2%) accompanying symptom. Seventeen of 42 astronauts have been previously described.

DISCUSSION: Astronauts during space flights frequently experience headaches. These most often have characteristics of TTHs but sometimes have migrainous features, particularly during the first week of flight in astronauts without a history of recurrent headaches before or after the space flight.

PMID:38478846 | DOI:10.1212/WNL.0000000000209224

J Phys Ther Educ. 2023 Mar 1;37(1):38-42. doi: 10.1097/JTE.0000000000000265. Epub 2023 Jan 18.

ABSTRACT

INTRODUCTION: Since the lockdown in March 2020, the COVID-19 pandemic has inevitably affected all individuals across the world. The purpose of this study was to determine the perceived impacts of the pandemic on doctor of physical therapy (DPT) students and if there were any statistically significant differences based on minority status, gender, or class standing.

REVIEW OF LITERATURE: Literature suggested that DPT students experienced negative impacts of the pandemic on academic success and mental health. However, there is a lack of comprehensive understanding of the perceived physical, mental, financial, and academic impacts of the COVID-19 pandemic by physical therapist students nationally.

SUBJECTS: Convenience sampling was used to recruit all students enrolled in physical therapist programs in the United States.

METHODS: The research design was a cross-sectional survey administered electronically using the Alchemer survey platform with 12 Likert scale items compiled in the physical, mental, financial, and academic domains. All items were designed to evaluate the perceived impacts of the pandemic on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree).

RESULTS: A total of 1,230 completed responses were received. The mean responses were 3.45 (SD 1.12), 3.48 (SD 0.92), 2.74 (SD 1.03), and 3.33 (SD 0.93) for the physical, mental, financial, and academic domains, respectively. No significant difference was found based on minority status. A statistically significant difference was found in the mental domain, with female students perceiving a more negative impact by the pandemic. First-year students reported a significantly higher negative impact in the physical domain compared with second-year students. The perceived impact in the academic domain was significantly higher for both first- and second-year students than third-year students.

CONCLUSIONS: Developing and promoting access to campus and community resources to address the challenges caused by the COVID-19 pandemic is critical to facilitating student success during and after the pandemic.

PMID:38478841 | DOI:10.1097/JTE.0000000000000265