Nevin Manimala

Urology. 2024 Jul 21:S0090-4295(24)00594-6. doi: 10.1016/j.urology.2024.07.028. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of a modified technique of posterior reconstruction by iliopectineal ligament suspension during robot-assisted radical prostatectomy (RARP) on recovery of early continence.

METHODS: A prospective, single surgeon, single center, randomized controlled trial was performed from August 2018 to March 2020 with 171 patients (92 control vs. 79 experimental). The posterior reconstruction was done using a standard technique in the control group and was modified for the experimental group by incorporating not only the “Rocco” stitch between Denonvilliers’ fascia and the rhabdosphincter but also the iliopectineal ligaments bilaterally to further improve posterior support with this suspensory ‘hammock’. Both groups of patients were followed for a year with questionnaires and 24-hour pad tests.

RESULTS: Both groups were comparable in terms of baseline demographic, clinical and pathological characteristics. With regards to recovery of urinary continence, no statistically significant differences were found for socially continent (0-1 pads per day) or fully continent (0 pads per day) rates at all time points examined (1, 3, 6, 12 months). Moreover, there was no statistically significant differences between the groups for presence of urinary symptoms, bowel symptoms, sexual function, and hormonal symptoms.

CONCLUSIONS: The modified technique of posterior reconstruction by iliopectineal ligament suspension is not associated with improved early continence as compared to the standard posterior reconstruction technique during RARP. Future studies may want to explore other variations of suspensory sutures that could strengthen posterior urethral support to achieve earlier recovery of continence.

PMID:39043340 | DOI:10.1016/j.urology.2024.07.028

J Dent. 2024 Jul 21:105257. doi: 10.1016/j.jdent.2024.105257. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the impact of a “fast” crystallization and simultaneous-glazing on the physicochemical properties of lithium-disilicate CAD/CAM-ceramic.

METHODS: Lithium-disilicate bars and crowns (IPS e.max CAD, Ivoclar-Vivadent) were divided into four groups (n=30): WG/F (WG=with glaze/F=fast crystallization), NG/F (NG=no glaze), WG/C (C=conventional crystallization), and NG/C. A liquid/powder glaze system was used (IPS Ivocolor®, Ivoclar-Vivadent). Specimens were crystallized (Programat P310, Ivoclar-Vivadent) using the P161 program for C (approx. 20-25min), and P165 for F (approx. 14-16min). Bars (n=30) underwent three-point bending tests (flexural strength-FS in MPa and modulus of elasticity-E in GPa) using a universal testing machine. Crowns were analyzed via scanning electron microscopy (SEM) after selective etching, and to Raman, FTIR-ATR, and X-ray diffraction (XRD) spectroscopies to assess chemical composition.

RESULTS: For FS, both factors/interaction were statistically significant. C (427.48±42.41MPa) showed significantly higher values than F (409.82±38.82MPa). WG (398.32±29.80MPa) exhibited significantly lower FS than NG (438.21±41.77MPa). For E data, both factors/interaction were significant. NG (90.28±14.71GPa) displayed higher E than WG (83.07±5.69GPa), while C (90.08±12.98GPa) exhibited higher E than F (83.46±9.40GPa). NG/C showed the best results for both variables. F groups showed (SEM) porous surfaces and crack-like marks on crystals. FTIR, Raman and XRD spectra confirmed the typical composition of a lithium-disilicate glass ceramic, and some attenuated signals and structural variations (XRD) in WG.

CONCLUSIONS: “Fast” crystallization and simultaneous-glazing produced weaker/less-rigid structures with irregular crystals and glassy phases. Simultaneous glazing may have hindered proper thermal distribution during crystallization.

SIGNIFICANCE: “Fast” crystallization and simultaneous glazing with non-recommended systems, can adversely affect the final properties of lithium disilicate restorations.

PMID:39043330 | DOI:10.1016/j.jdent.2024.105257

J Dent. 2024 Jul 21:105231. doi: 10.1016/j.jdent.2024.105231. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the seating accuracy of resin composite CAD/CAM overlay restorations, employing various preparation designs and luting materials (pre-heated composite (HC) or resin cement (RC)).

METHODS: A human molar’s STL file was utilized to create 100 3D-printed resin tooth replicas, randomly distributed into 5 groups (n=20) based on finishing line preparation designs: 1) Rounded shoulder above the dental equator – DE (SA); 2) Chamfer above the DE (CA); 3) Butt joint above the DE (BJ); 4) Rounded shoulder below the DE (SB); 5) Chamfer below the DE (CB). Digital impressions were acquired for all replicas, and restorations milled using Tetric CAD (Ivoclar Vivadent). The restorations were luted with HC (Tetric Prime, Ivoclar Vivadent) or RC (RelyX Universal, 3M). Seating accuracy was evaluated through digital scans during try-in without any luting agent and post-cementation using a 3D analysis software (Geomagic wrap, 3D Systems). Data were statistically analyzed using Two-Way ANOVA (p<0.05).

RESULTS: The type of luting material (RC vs HC), preparation design, and their interactions significantly impacted 3D seating of the restorations (p<0.001). HC exhibited higer volumetric increase than RC. BJ and CA designs consistently demonstrated superior seating accuracy, irrespective of the luting material used.

CONCLUSIONS: The utilization of pre-heated composite resin could negatively influence the seating of overlay restorations, probably due to its higher viscosity when compared to the resin cement. However, when HC is selected as luting agent, preparation designs lacking internal angles are recommended for enhancing the precision of overlays seating.

PMID:39043328 | DOI:10.1016/j.jdent.2024.105231

J Affect Disord. 2024 Jul 21:S0165-0327(24)01174-1. doi: 10.1016/j.jad.2024.07.114. Online ahead of print.

ABSTRACT

BACKGROUND: Early life environments can have long-lasting impacts on future health and wellbeing. Maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life. Anxiety disorders are one of the most prevalent mental health conditions, affecting approximately 7 % of children and adolescents globally, with a lifetime prevalence of 15-20 %. Identifying prenatal risk factors can support future and current public health interventions and maternity care.

METHODS: Data were obtained from the Growing Up in New Zealand longitudinal study of child development. Prenatally, mothers provided sociodemographic information as well as data on their mental health, potential teratogens, and lifestyle factors such as supplement intake and exercise levels. At 8-years old, 4922 children self-completed the PROMIS-SF anxiety measure. Bivariate analyses and backward stepwise regression were used to determine the best multivariable model.

RESULTS: Significant prenatal predictors of anxiety symptoms at 8-years old included elevated maternal depression symptoms, body mass index in the overweight/obese range, exercise patterns, and paracetamol, anti-inflammatory and alcohol intake.

LIMITATIONS: Sample attrition from baseline to 8-year may have affected statistical power. To further untangle the effect of timing and duration of the exposures reported in this study, larger sample sizes would be required.

CONCLUSIONS: Prenatal mental health and wellbeing was significantly associated with child anxiety symptoms at 8-years of age. This study highlights the importance of supporting expectant mothers’ health and wellbeing during pregnancy to ensure children have the best opportunity to have good mental health.

PMID:39043309 | DOI:10.1016/j.jad.2024.07.114

J ISAKOS. 2024 Jul 21:S2059-7754(24)00131-7. doi: 10.1016/j.jisako.2024.07.003. Online ahead of print.

ABSTRACT

INTRODUCTION: Previous studies on rotator cuff tears have examined both clinical and radiographic parameters which may influence post-operative clinical outcomes. While rotator cuff tears are frequently classified by size or depth, there is currently no literature available examining the thickness of the remnant tendon, and its impact on post-operative outcomes. We hypothesize that decreased pre-operative transverse tendon thickness will result in poorer post-operative clinical outcomes.

METHODS: We prospectively recruited patients who underwent arthroscopic repair of small to medium full-thickness rotator cuff tears. These patients were followed up for a minimum of 2 years post-operatively. Basic biodata, as well as Visual Analog Scale (VAS) for pain, Constant-Murley Score (CMS), UCLA Shoulder Score (USS), and Oxford Shoulder Score (OSS) at 3 different time points (pre-operatively, 1 year post-operatively, and 2 year post-operatively) were collected. Transverse tendon thickness was measured by independent blinded radiologists on pre-operative ultrasonographic images. Wilcoxon signed-rank test was used to compare outcome scores and multivariable robust linear model was fitted to assess the effect of transverse tendon thickness on post-operative scores.

RESULTS: A total of 63 patients were enrolled in this study, predominantly female (65%) and had a median age of 72 years. Pre-operatively, the median transverse cuff thickness was 5.0 mm and median tear size was 1.4 cm. The median VAS at preoperative was 7, which reduced to 0 at 2 year post-operative, indicating statistically significant improvement in pain levels (p<0.001). Statistically significant improvement in shoulder function measured by CMS, UCLA score and OSS were also seen over time (p<0.001). Robust regression analysis revealed that transverse cuff thickness had no statistically significant effect on VAS (p=0.99), CMS (p=0.84), UCLA score (p=0.22), and OSS scores (p=0.73) at 2 year postoperatively.

DISCUSSION: Pre-operative transverse tendon thickness of small- to mid-sized supraspinatus tears do not influence clinical outcomes after arthroscopic repair. Differences in transverse tendon thickness may have an association with tendon healing but does not translate to an association with post-operative outcomes in terms of pain, function, and patient reported outcome measures. Level of evidenceIV.

PMID:39043294 | DOI:10.1016/j.jisako.2024.07.003

Chemosphere. 2024 Jul 21:142918. doi: 10.1016/j.chemosphere.2024.142918. Online ahead of print.

ABSTRACT

Coastal wetlands possess significant carbon storage capabilities. However, in coastal soil-plant systems augmented with biochar and microorganisms, the mechanisms of these amendments and carbon participation remain unclear. This study utilized pot experiments to explore how Enteromorpha prolifera biochar and Arbuscular mycorrhizal fungi (AMF) affect soil organic carbon (SOC), carbon-related microbes, photosynthetic and osmotic system of Suaeda salsa. The results showed biochar reduced exchangeable sodium percentage by 6.9% through adsorption and ion exchange, and increased SOC content by 34.4%. The abundance of carbon-related microorganisms (Bacteroidota and Chloroflexi) was increased and carbon metabolizing enzyme (cellulase and sucrase) activity in the soil was enhanced. AMF significantly improved plant growth compared with CK, as evidenced by the enhanced dry weight by 2.34 times. A partial least squares pathway model (PLS-PM) and correlation analysis suggested that the combined effect of biochar and AMF could be outlined as two pathways: soil and plant. Biochar increased SOC, improved the growth of soil carbon metabolizing microorganisms, and further promoted the activity of carbon-related enzymes. Additionally, AMF facilitated nutrient absorption by plants through root symbiosis, with biochar further enhancing this process by acting as a nutrient adsorber. These combined effects of biochar and AMF at soil and plant level enhanced the photosynthetic process of Suaeda salsa. The transport of photosynthetic products to the roots can increase the carbon storage in the soil. This study provides quantitative evidence supporting the increase of carbon storage in coastal wetland soil-plant systems through a combined application of biochar and AMF.

PMID:39043273 | DOI:10.1016/j.chemosphere.2024.142918

J Obstet Gynecol Neonatal Nurs. 2024 Jul 20:S0884-2175(24)00248-X. doi: 10.1016/j.jogn.2024.06.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify factors associated with the receipt, completion, and goals of palliative care birth plans during the prenatal period.

DESIGN: Retrospective observational study of medical record data.

SETTING: Midwestern U.S. quaternary pediatric hospital.

PARTICIPANTS: Maternal-fetal dyads who received maternal-fetal medicine and palliative care from July 2016 through June 2021 (N = 128).

METHODS: Using demographic and clinical predictors, we performed descriptive statistics, group comparisons (chi-square or Fisher exact test and Wilcoxon rank sum test or Student t test), and logistic regression for three outcomes: birth plan offered, birth plan completed, and goals of care (comfort-focused vs. other).

RESULTS: Of 128 dyads, 60% (n = 77) received birth plans, 30% (n = 23) completed them, and 31% (n = 40) expressed comfort-focused goals. Participants with comfort-focused goals compared to other goals were more likely to receive birth plans, odds ratio (OR) = 7.20, 95% confidence interval (CI) [1.73, 29.9], p = .01. Participants of non-Black minority races had lower odds of being offered birth plans when compared to White participants, OR = 0.11, 95% CI [0.02, 0.68], p = .02. Odds of being offered (OR = 11.54, 95% CI [2.12, 62.81], p = .005) and completing (OR = 4.37, 95% CI [1.71, 11.17], p < .001) the birth plan increased with each prenatal palliative care visit. Compared to those without, those with neurological (OR = 9.32, 95% CI [2.60, 33.38], p < .001) and genetic (OR = 4.21, 95% CI [1.04, 17.06], p = .04) diagnoses had increased odds of comfort-focused goals.

CONCLUSION: Quality improvement efforts should address variation in the frequency at which birth plans are offered. Increasing palliative care follow-up may improve completion of the birth plan.

PMID:39043263 | DOI:10.1016/j.jogn.2024.06.004

Can J Ophthalmol. 2024 Jul 20:S0008-4182(24)00172-8. doi: 10.1016/j.jcjo.2024.05.030. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) compared with conventional phacoemulsification cataract surgery (CPCS).

METHODS: Randomized controlled trials (RCTs) were systematically searched in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, and Wanfang. Main outcomes were visual acuity, capsulotomy parameters, effective lens position, and complications. Secondary outcomes included refractive outcomes, intraoperative parameters, and corneal parameters.

RESULTS: In total, 41 RCTs involving 9310 eyes were included. There was a statistically significant difference in favour of FLACS over CPCS for uncorrected distance visual acuity at 12 months (mean difference [MD] -0.03; 95% CI -0.05 to -0.01); corrected distance visual acuity at 1 week (MD -0.05; 95% CI -0.07 to -0.02) and 12 months (MD -0.02; 95% CI -0.04 to -0.00); area of capsulotomy at 1 month (MD 4.04 mm²; 95% CI 3.45-4.64) and 6 months (MD 5.02 mm²; 95% CI 3.28-6.77); and intraocular lens centroid-pupil centroid distance at 1 week (MD -0.06 mm; 95% CI -0.08 to -0.05), 1 month (MD -0.07 mm; 95% CI -0.09 to -0.06), and 6 months (MD -0.06 mm; 95% CI -0.07 to -0.04). With regard to surgical complications, FLACS was less than CPCS for the incidence of decentred IOL (odds ratio 0.06; 95% CI 0.01-0.24). However, FLACS did not increase the incidence of other intraoperative or postoperative complications except subconjunctival hemorrhage.

CONCLUSIONS: Both FLACS and CPCS are effective and safe. FLACS achieves better visual outcomes in the early postoperative period and long-term follow-up, accompanied by more accurate capsulotomy and more optimized effective lens position than CPCS. However, no difference of visual outcomes was found after middle-term follow-up.

PMID:39043258 | DOI:10.1016/j.jcjo.2024.05.030

Proc Biol Sci. 2024 Aug;291(2027):20240788. doi: 10.1098/rspb.2024.0788. Epub 2024 Jul 24.

ABSTRACT

Cyanobacteria can form complex interactions with heterotrophic microorganisms, but this relationship is susceptible to nutrient concentrations. Disentangling the cyanobacteria-bacteria interactions in relation to nutrient supply is essential to understanding their roles in geochemical cycles under global change. We hypothesize that enhanced nutrient supply in oligotrophic oceans can promote interactions among cyanobacteria and bacteria. Therefore, we investigated the planktonic bacteria and their interactions with cyanobacteria in relation to elevated nutrients caused by enhanced upwelling around a shallow and a deep seamount in the tropical western Pacific Ocean. We found obviously higher complexity of network occurred with significantly more cyanobacteria in the deep chlorophyll maximum layer of the shallow seamount when compared with that of the deep seamount. Cyanobacteria can shape bacterial interaction and community evenness in response to relatively high nutrient concentrations. The effects of the nutrients on cyanobacteria-related networks were further estimated based on the Tara Oceans data. Statistical analyses further showed a facilitative effect of nitrate concentrations on cyanobacteria-bacteria mutualistic interactions in the global oligotrophic ocean. By analysing the Tara Ocean macrogenomic data, we detected functional genes related to cyanobacteria-bacteria interactions in all samples, indicating the existence of a mutualistic relationship. Our results reveal cyanobacteria-bacteria interaction in response to nutrient elevation in oligotrophic ocean and highlight the potentially negative effects of global change on the bacterial community from the view of the bio-interaction.

PMID:39043236 | DOI:10.1098/rspb.2024.0788

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241261076. doi: 10.1177/10760296241261076.

ABSTRACT

Pulmonary embolism (PE) is a heterogenous condition with variable clinical presentations. Thrombin generation potential (TGP) and biomarkers, and blood cellular indices can reflect the underlying pathophysiology and risk stratification of PE. This case-control study analyzed TGP in 209 PE patients from Loyola University, Pulmonary Embolism Response Team program compared to normal human plasma (NHP) controls. The present study evaluates TGP and biomarkers, and cellular indices in relation to PE severity, according to the European Society of Cardiology (ESC) guidelines. Statistical analysis including median with interquartile range (IQR), 2-tailed Wilcoxon Mann-Whitney test, Chi-square test, and Spearman Correlational analysis were performed. There were 209 patients with PE, with an almost equal distribution between sex, and a median age of 63 years. Significant downregulation in peak thrombin and endogenous thrombin potential (ETP), as well as upregulation in lag time, were observed in PE patients versus controls. Biomarker analysis revealed pronounced elevations, with D-dimer demonstrating the most significant increase. Blood cellular indices also rose in PE patients, correlating with disease severity. PE severity was associated with higher TGP and biomarker levels. Mortality rates differed significantly across risk categories and were highest in patients with elevated cellular indices. TGP and biomarkers are intricately linked to PE severity and can aid in risk stratification. Elevated cellular indices are associated with increased mortality, highlighting their potential as prognostic markers. These findings could enhance the precision of PE management strategies.

PMID:39043231 | DOI:10.1177/10760296241261076