Nevin Manimala

J Clin Periodontol. 2023 Dec 20. doi: 10.1111/jcpe.13936. Online ahead of print.

ABSTRACT

AIM: To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study.

MATERIALS AND METHODS: We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation.

RESULTS: Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs.

CONCLUSIONS: Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.

PMID:38116705 | DOI:10.1111/jcpe.13936

Epilepsia. 2023 Dec 20. doi: 10.1111/epi.17871. Online ahead of print.

ABSTRACT

OBJECTIVE: Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe in the healthy brain. This leads to the hypothesis that statistical learning may be impaired in patients with epilepsy (PWE) involving the temporal lobe, and that this impairment could contribute to their varied memory deficits. In turn, studies done in collaboration with PWE, that evaluate the necessity of medial temporal lobe circuitry through disease and causal perturbations, provide an opportunity to advance basic understanding of statistical learning.

METHODS: We implemented behavioral testing, volumetric analysis of the medial temporal lobe substructures, and direct electrical brain stimulation to examine statistical learning across a cohort of 61 PWE and 28 healthy controls.

RESULTS: We found that behavioral performance in a statistical learning task was negatively associated with seizure frequency irrespective of seizure origin. The volume of hippocampal subfields CA1 and CA2/3 correlated with statistical learning performance, suggesting a more specific role of the hippocampus. Indeed, transient direct electrical stimulation of the hippocampus disrupted statistical learning. Furthermore, the relationship between statistical learning and seizure frequency was selective as behavioral performance in an episodic memory task was not impacted by seizure frequency.

SIGNIFICANCE: Overall, these results suggest that statistical learning may be hippocampally dependent and that the statistical learning task could serve as a clinically useful behavioral assay of seizure frequency that may complement existing approaches such as seizure diaries. Simple and short statistical learning tasks may thus provide patient-centered endpoints for evaluating the efficacy of novel treatments in epilepsy.

PMID:38116686 | DOI:10.1111/epi.17871

Scand J Urol. 2023 Dec 20;58:133-140. doi: 10.2340/sju.v58.14730.

ABSTRACT

In comparable men with non-metastatic prostate cancer, radical prostatectomy (RP), radiotherapy (RAD) and active surveillance (AS) are treatment options with similar survival rates, but different side-effects. Healthcare professionals consider pretreatment shared decision making (SDM) to be an essential part of medical care, though the patients’ view about SDM is less known. In this article, we explore prostate cancer (PCa) patients’ SDM wish (SDMwish), and experiences (SDMexp). Material and methods: This is a registry-based survey performed by the Cancer Registry of Norway (2017-2019). One year after diagnosis, 5,063 curatively treated PCa patients responded to questions about their pre-treatment wish and experience regarding SDM. Multivariable analyses identified factors associated with SDM. Statistical significance level: p < 0.05. Results: Overall, 78% of the patients wished to be involved in SDM and 83% of these had experienced SDM. SDMwish and SDMexp was significantly associated with decreasing age, increasing education, and living with a partner. Compared with the RP group, the probability of SDMwish and SDMexp was reduced by about 40% in the RAD and the AS groups. Conclusion: Three of four curatively treated PCa wanted to participate in SDM, and this wish was met in four of five men. Younger PCa patients with higher education in a relationship, and opting for RP, wanted an active role in SDM, and experienced being involved. Effective SDM requires the responsible physicians’ attention to the individual patients’ characteristics and needs.

PMID:38116675 | DOI:10.2340/sju.v58.14730

Asia Pac J Public Health. 2023 Nov 21:10105395231211997. doi: 10.1177/10105395231211997. Online ahead of print.

ABSTRACT

The World Health Organization (WHO) recommends the use of color-coded cardiovascular disease (CVD) risk charts for CVD management. This study evaluated the agreement between the laboratory and non-laboratory 10-year CVD risks based on 2019 WHO CVD risk-prediction charts. The agreement of CVD risk scores among 40- to 69-year-old Bhutanese population stratified by gender and age groups (<60 and ≥60 years) was determined via weighted kappa statistics. In the general population, there was substantial agreement between the two CVD risk score charts for all ages and <60 years but a moderate agreement for participants aged ≥60 years. In males, substantial agreement was observed in all ages and in <60 years and moderate agreement in ≥60 years. In females, both the predictions showed substantial agreement in all ages and <60, but a moderate agreement for ≥60 years. The non-laboratory-based risk charts can be used interchangeably with laboratory-based charts for predicting 10-year CVD risk in resource-constrained countries like Bhutan.

PMID:38116599 | DOI:10.1177/10105395231211997

Iran J Pharm Res. 2023 Mar 23;22(1):e134772. doi: 10.5812/ijpr-134772. eCollection 2023 Jan-Dec.

ABSTRACT

BACKGROUND: Amphotericin B (AmB) is the first-line drug to treat invasive fungal infections. However, its delivery to the body and clinical use faces many challenges because of its poor solubility, poor pharmacokinetics, and severe nephrotoxicity.

OBJECTIVES: Due to the necessity for designing safer and more effective nanocarriers for AmB and the importance of preclinical pharmacokinetic studies in evaluating these novel drug delivery systems, the present study was framed to explore the influence of rat strain on the pharmacokinetic profile of this drug.

METHODS: Twenty-four Wistar and Sprague-Dawley (SD) rats were intravenously injected with 1 mg/kg AmB as Fungizone or AmBisome, which are the two most commonly marketed formulations of the drug. Blood samples were collected before and at regular intervals up to 24 h after administration. Drug concentration was analyzed by a validated HPLC method, and pharmacokinetic parameters were determined by the non-compartmental method.

RESULTS: Irrespective of the type of formulation, the AUC_0-t and AUC_0-∞ values were significantly higher (P < 0.001), and Cl as an important PK parameter was markedly lower (P < 0.001) in SD rats compared to the Wistar strain. For Fungizone, the mean Cl values in SD and Wistar rats were 206.90 and 462.95 mL/h/kg (P < 0.001), respectively. The apparent volume of distribution (V_ss) was also lower in SD rats compared to Wistar; however, for AmBisome, the difference in V_ss was not statistically significant. Our further investigation suggested that the higher amount of total protein in the SD strain may justify the higher plasma concentrations and lower Cl and V_ss of amphotericin B in this strain compared to the Wistar strain.

CONCLUSIONS: Overall, following intravenous administration of AmB, there were significant differences in the pharmacokinetic parameters of the drug between two rat strains for both formulations. The obtained data is important for correctly interpreting experimental data from different research groups.

PMID:38116555 | PMC:PMC10728861 | DOI:10.5812/ijpr-134772

Iran J Pharm Res. 2023 Apr 17;22(1):e132736. doi: 10.5812/ijpr-132736. eCollection 2023 Jan-Dec.

ABSTRACT

BACKGROUND: Community pharmacists play an important role in improving outcome by providing advice and counselling services to patients.

OBJECTIVES: The aim of this study was to measure the willingness to pay (WTP) for pharmacist counselling services in community pharmacies and identify determinant factors on consumers’ WTP.

METHODS: A self-administered questionnaire-based survey was conducted in community pharmacies in Tehran (capital of Iran) from January 1, 2020 to February 20, 2021. Contingent valuation method was applied to evaluate respondents’ maximum WTP using three hypothetical scenarios illustrating different levels of counselling services. Logistic regression was used to analyze the association between different variables and WTP for pharmacy services.

RESULTS: Total number of participants who completed the questionnaire were 332 and 60% of the participants were male. In the first scenario 70.2% of participants were willing to pay for oral counselling pharmacy services. In the second and third scenario, percentage of people willing to pay increased to 79.5%. and 86.1%, respectively. In the first scenario, monthly income (OR = 0.041, P value = 0.04), the duration of underlying illness (OR = 0.04, P value = 0.04) and the using internet (OR = 2.59, P value = 2.59) had a statistically significant relationship with willingness to pay. In the third scenario, the willingness to pay increased as the age decreased. The possibility of using the internet (OR = 3.32, P value = 0.00) and the need for a community pharmacist (OR = 2.19, P value = 0.03) increased the chance of willingness to pay.

CONCLUSIONS: More consumers are willing to pay for more pharmacist counselling services. Therefore, improving the quality of counselling services could have positive economic effects on community pharmacies.

PMID:38116550 | PMC:PMC10728831 | DOI:10.5812/ijpr-132736

Front Cardiovasc Med. 2023 Dec 5;10:1250404. doi: 10.3389/fcvm.2023.1250404. eCollection 2023.

ABSTRACT

BACKGROUND: To assess the relationship of genetically predicted sexual behavior (age at first sex (AFS) and the number of sexual partners (NSP)) on cardiovascular diseases (CVDs).

METHODS AND RESULTS: We performed two-sample Mendelian randomization (MR) with publicly available datasets from the UK Biobank and FinnGen Study, and analyzed genome-wide association results for sexual behaviors and twelve types of CVDs. The univariable MR method provided a total effect of AFS and NSP on CVDs, and showed evidence that early AFS rather than NSP was associated with CVDs, including angina pectoris (AP), atrial fibrillation and flutter (AFF), coronary atherosclerosis (CAS), deep vein thrombosis of the lower extremity (DVT-LE), heart failure (HF), hypertension (HTN), ischaemic stroke (IS), and myocardial infarction (MI). Given sex as a social determinant of CVD risk, we used gender-stratified SNPs to investigate gender differences in the development of CVDs. These results showed a stronger causal relationship of AFS on CVDs in females than in males. Further multivariable MR analyses indicated a direct effect after accounting for insomnia, number of days of vigorous physical activity 10 + minutes (VPA 10 + min), and time spent watching television (TV). Two-step MR demonstrated these three risk factors act as a mediator in AFS associated AP/HTN/HF.

CONCLUSIONS: We provide evidence that early AFS increased the risk of CVDs. These associations may be partly caused by VPA 10 + min, insomnia, and the time spent on TV. The causality of AFS on CVDs in females was stronger than in males. Conversely, genetically predicted NSP was not associated with CVDs.

PMID:38116537 | PMC:PMC10728475 | DOI:10.3389/fcvm.2023.1250404

Front Vet Sci. 2023 Dec 5;10:1274786. doi: 10.3389/fvets.2023.1274786. eCollection 2023.

ABSTRACT

Developing and evaluating novel diagnostic assays are crucial components of contemporary diagnostic research. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) are frequently used to evaluate diagnostic assays’ performance. The variation in AUC estimation can be quantified nonparametrically using resampling methods, such as bootstrapping, and then used to construct interval estimation for the AUC. When multiple observations are observed from the same subject, which is very common in veterinary diagnostic tests evaluation experiments, a traditional bootstrap-based method can fail to provide valid interval estimations of AUC. In particular, the traditional method does not account for the correlation among data observations and could result in interval estimation that fails to cover the true AUC adequately at the desired confidence level. In this paper, we proposed two novel methods to calculate the confidence interval of the AUC for correlated diagnostic test data based on cluster bootstrapping and hierarchical bootstrapping, respectively. Our simulation studies showed that both proposed methods had adequate coverage probabilities which were higher than the existing traditional method when there were intra-subject correlations. We also discussed applying the proposed methods to evaluate a novel whole-virus ELISA (wv-ELISA) diagnostic assay in detecting porcine parainfluenza virus type-1 antibodies in swine serum.

PMID:38116513 | PMC:PMC10728486 | DOI:10.3389/fvets.2023.1274786

Adv Med Educ Pract. 2023 Dec 15;14:1425-1431. doi: 10.2147/AMEP.S426199. eCollection 2023.

ABSTRACT

BACKGROUND: Learning fine motor skill is central to preclinical dental education. Dental students are introduced to anatomical tooth carving to facilitate the development of their fine motor skill and manual dexterity. Various carving technique exists, such as wax build-up, and geometric (block carving technique). Since substantial laboratory Time and instructors’ effort are required to teach students the desired techniques, blended learning approach via pre-recorded demonstration may improve the teaching and learning efficiency of anatomical tooth carving. For years, we used the Geometric method to teach preclinical dental students to carve down tooth sculptures after performing live demonstrations for them. Multiple practical laboratory demonstrations are necessary to deepen the student’s comprehensive understanding of dental anatomical features and teach them correct instrumentation; this is time-consuming and challenging due to limited laboratory hours and limited view field. Accordingly, in 2016 the teaching staff created videos for tooth drawing, carving, and identification, and uploaded them to the students’ university platform. Years later, we decided to perform this retrospective study.

OBJECTIVE: To assess the enhancement in students’ tooth carving skills after implementing blended learning with video demonstrations.

METHODS: The student’s total grades were used for comparative purposes. The students’ total grades between 2010 and 2019 were collected and categorized into two groups: Group 1 (n=858), which learned tooth carving by the Geometric method after live demonstrations, and Group 2 (972), which benefited from blended learning with video demonstrations in learning. The two groups’ mean, median, mode, Percentile 75, and Percentile 90 were compared.

RESULTS: Group 2 showed higher grades than group 1, and the differences between the two groups’ mean and median were statistically significant p<0.001. Moreover, the mode, P75 and P90 favored group 2.

CONCLUSION: Results show that blended learning with video demonstrations enhanced the achievements of dental students in tooth carving.

PMID:38116478 | PMC:PMC10729676 | DOI:10.2147/AMEP.S426199

BMJ Neurol Open. 2023 Dec 9;5(2):e000527. doi: 10.1136/bmjno-2023-000527. eCollection 2023.

ABSTRACT

BACKGROUND: Idiopathic intracranial hypertension (IIH) is a neurometabolic condition severely impacting the quality of life of people living with IIH (PwIIH). Most PwIIH are overweight or live with obesity, and weight loss is recommended by healthcare professionals (HCPs) as it is central to disease management. There is currently no research evaluating patient-clinician interactions when discussing weight management in IIH. The aim of this study was to evaluate the patient experience of communication with HCPs regarding weight management from the perspective of PwIIH.

METHODS: A cross-sectional online survey was developed and distributed by the IIH UK charity via their mailing list and social media network. Eligible participants were adults with IIH who have been recommended to lose weight by their HCP. Descriptive statistics were used to summarise quantitative responses and content analysis was used to inductively draw out themes from open-ended free-text responses.

RESULTS: There were 625 respondents. One-fifth of PwIIH (n=127/603, 21%) felt that HCPs were supportive and empathetic about weight management. Five themes were identified on how experiences regarding weight management for IIH can be improved, with PwIIH recommending for HCPs to: (1) detail the relationship between IIH and weight, (2) individualise care, (3) give advice, (4) provide support and (5) adapt communication.

CONCLUSION: The majority of PwIIH recalled a poor experience and negative emotions when engaged in discussions regarding weight management with their HCPs. Further research should explore the HCPs perspective and evaluate interventions aiming to improve the quality of patient-HCPs communication in IIH.

PMID:38116470 | PMC:PMC10729070 | DOI:10.1136/bmjno-2023-000527