Nevin Manimala

Lasers Med Sci. 2024 Apr 28;39(1):117. doi: 10.1007/s10103-024-04065-4.

ABSTRACT

The skin contraction phenomenon occurs due to the energy emitted by the surgical CO₂ LASER affecting the collagen architecture and intracellular water content in tissues. The study aimed to assess how gender, age, breed, body-weight, CO₂ LASER emission mode, and potency influence skin contraction following the incision. The study involved 80 dogs (N = 80) of both genders, multiple breeds, undergoing major surgery with CO₂ LASER. Subjects were grouped based on LASER potency (12 or 15 Watts) and emission mode (Superpulse-SP or Continuous-CT): GSP12, GSP15, GCT12, and GCT15. A 10 mm incision was performed using the surgical CO₂ LASER beam, consistently employing a focal point of 0.4 mm, positioned at a distance of 1 mm from the skin surface, and always maintained perpendicular to it, and resulting lengths measured with a digital caliper. Results were considered significant for p-value < 0.05. GSP12 showed minimal contraction, while GCT15 exhibited the most significant. Male subjects in GCT12, GCT15, and GSP12 experienced less contraction than females. Purebred dogs had greater contraction than mixed breeds. GSP12 individuals showed age-related contraction decrease (p < 0.01), with skin contracting by 0.09 mm per year. Weight and skin contraction trended towards significance (p = 0.06), with a 0.02 mm increase per unit weight. For a constant power of 12 W, the analysis of the relationship between the emission mode of the LASER beam and the final skin contraction (GSP12 vs. GCT12) revealed statistically significant differences (p < 0.01). This study suggests that the use of the Continuous mode of LASER emission, regardless of the power used, is associated with a higher level of final skin contraction. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION FOR PROSPECTIVELY REGISTERED TRIALS: Project approval registration number by the Research and Teaching Ethics Committee (CEIE),Faculty of Veterinary Medicine-University of Lisbon (FMV_ULisboa), Lisboa-Portugal, N/Refª 015/2022.

PMID:38678503 | DOI:10.1007/s10103-024-04065-4

J Psycholinguist Res. 2024 Apr 28;53(3):41. doi: 10.1007/s10936-024-10081-w.

ABSTRACT

The outbreak of Covid-19 has led to the need for institutions to provide online learning to their students. In this context, it is important to understand the views of both students and teachers regarding online classes. This study aims to explore the opinions of English teachers and students in vocational colleges in China about online English learning. A convenience sampling technique was used in the study. Data was collected using a questionnaire survey from the respondents. Data were analyzed using SPSS statistical software. Focused on the perceptions of English teachers and students in vocational colleges about online English learning. The results of the study revealed negative perceptions of both students and teachers about vocational English education in an online learning environment. This study highlights the importance of addressing both teachers’ and students’ negative feelings about online learning. The findings of this study are useful for educators and academic departments in improving the online learning experience for vocational students. It also emphasizes the need for effective implementation of ICT modules to improve the quality of online education. The study suggested that ICT modules should be implemented in various media platforms and applications to improve the quality of online learning by academic departments. Overall, this study emphasizes the importance of understanding stakeholder perceptions in online learning environments and provides insights for improving the quality of online education.

PMID:38678498 | DOI:10.1007/s10936-024-10081-w

Psychometrika. 2024 Apr 28. doi: 10.1007/s11336-024-09971-8. Online ahead of print.

ABSTRACT

Modern assessment demands, resulting from educational reform efforts, call for strengthening diagnostic testing capabilities to identify not only the understanding of expected learning goals but also related intermediate understandings that are steppingstones on pathways to learning goals. An accurate and nuanced way of interpreting assessment results will allow subsequent instructional actions to be targeted. An appropriate psychometric model is indispensable in this regard. In this study, we developed a new psychometric model, namely, the diagnostic facet status model (DFSM), which belongs to the general class of cognitive diagnostic models (CDM), but with two notable features: (1) it simultaneously models students’ target understanding (i.e., goal facet) and intermediate understanding (i.e., intermediate facet); and (2) it models every response option, rather than merely right or wrong responses, so that each incorrect response uniquely contributes to discovering students’ facet status. Given that some combination of goal and intermediate facets may be impossible due to facet hierarchical relationships, a regularized expectation-maximization algorithm (REM) was developed for model estimation. A log-penalty was imposed on the mixing proportions to encourage sparsity. As a result, those impermissible latent classes had estimated mixing proportions equal to 0. A heuristic algorithm was proposed to infer a facet map from the estimated permissible classes. A simulation study was conducted to evaluate the performance of REM to recover facet model parameters and to identify permissible latent classes. A real data analysis was provided to show the feasibility of the model.

PMID:38678490 | DOI:10.1007/s11336-024-09971-8

Abdom Radiol (NY). 2024 Apr 28. doi: 10.1007/s00261-024-04308-6. Online ahead of print.

ABSTRACT

PURPOSE: Atezolizumab/bevacizumab (atezo-bev) is the first-line chemotherapy for patients with unresectable hepatocellular carcinoma (HCC). However, hepatic artery infusion chemotherapy (HAIC) can be used as an alternative. Our aim was to compare the prognosis of HAIC treatment between newly diagnosed patients and patients treated after failure of atezo-bev.

METHODS: We retrospectively assessed 73 patients with HCC treated with HAIC between January 2022 and September 2023. Fifty-seven patients were treated with HAIC at initial diagnosis, while 16 were treated with HAIC after first-line atezo-bev combination chemotherapy. We evaluated tumor responses, such as overall survival (OS), progression-free survival (PFS), and objective response rate (ORR).

RESULTS: No significant difference was observed in either OS or PFS between patients with HCC treated with HAIC at the initial diagnosis and those treated after atezo-bev treatment failure. However, the ORR of the initial HAIC group was 19.6% and that of the HAIC group after atezo-bev therapy failure was 43.6%, which was a statistically significantly difference.

CONCLUSION: Although no significant difference was observed for OS and PFS, the ORR of patients in the HAIC group after the failure of atezo-bev therapy was superior to that of newly diagnosed patients. HAIC may prolong survival in patients with HCC after atezo-bev treatment failure.

PMID:38678485 | DOI:10.1007/s00261-024-04308-6

J Perianesth Nurs. 2024 Apr 27:S1089-9472(24)00007-8. doi: 10.1016/j.jopan.2024.01.002. Online ahead of print.

ABSTRACT

PURPOSE: To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery.

DESIGN: Delphi method inquiry to 15 clinical and nursing experts.

METHODS: On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established.

FINDINGS: The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal’s W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (P < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery.

CONCLUSIONS: The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.

PMID:38678461 | DOI:10.1016/j.jopan.2024.01.002

J Nutr Educ Behav. 2024 Apr 25:S1499-4046(24)00052-6. doi: 10.1016/j.jneb.2024.03.007. Online ahead of print.

ABSTRACT

OBJECTIVE: Describe the adaptation, implementation, and perceptions of Kids SIPsmartER’s classroom component during the coronavirus disease-impacted 2020-2021 school year.

DESIGN: Mixed methods process evaluation.

SETTING: Seven rural Appalachian middle schools (US).

PARTICIPANTS: Middle-school teachers (n = 14) and principals (n = 6).

INTERVENTION: Kids SIPsmartER was a multilevel, school-based intervention designed to decrease sugar-sweetened beverage intake. The 12-lesson classroom component was supported by an implementation protocol.

MEASURES: Implementation protocol adaptations, program perceptions, and the school context were assessed using teacher and principal interviews, teacher-completed fidelity checklists, and researcher-maintained field notes. Adaptations were mapped to the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).

ANALYSIS: Qualitative data were content coded. Quantitative data were summarized using descriptive statistics.

RESULTS: All schools maintained Kids SIPsmartER and delivered 100% of lessons. Ten adaptations were made to the implementation protocol. Schools used adapted delivery approaches to meet individual needs. Teachers and principals identified more benefits than barriers to implementing the program.

CONCLUSIONS AND IMPLICATIONS: Using a strategically adapted implementation protocol that was flexible to schools’ individual needs allowed all middle schools to deliver Kids SIPsmartER during the 2020-2021 school year. Findings identify adaptation considerations that other school-based evidence-based interventions could incorporate to facilitate delivery during high-stress times.

PMID:38678457 | DOI:10.1016/j.jneb.2024.03.007

Am J Orthod Dentofacial Orthop. 2024 Apr 26:S0889-5406(24)00112-4. doi: 10.1016/j.ajodo.2024.02.013. Online ahead of print.

ABSTRACT

INTRODUCTION: The extraction of second premolars and associated changes in the volume of the airway have not been previously explored. This retrospective study aimed to compare the volumetric changes of the airway preorthodontic and postorthodontic treatment in relevant extraction and control samples and to identify variables that may influence the outcome.

METHODS: Cone-beam computed radiography scans of 54 patients with second premolar extraction and 59 nonextraction patients treated in a private orthodontic practice were matched for crowding. The average age for both samples was 15 years. The images were individually landmarked and measured by applying volumetric, linear, and angular parameters. The results were analyzed using repeated measures, such as variance analysis, correlation testing, and regression statistical analyses.

RESULTS: There was a statistically significant increase in the airway volume for both groups (P <0.05). The difference in increase between the groups was not statistically significant. Seven variables demonstrated a collectively significant effect on changes to airway volume (F[7,112] = 38.48; P <0.001; r² = 0.701), with 70% of the variation predicted by the variables. Multiple regression analyses indicated that changes to the area of minimum constriction (B = 32.45; t = 11.95; P <0.001) and changes to airway length (B = 94.75; t = 7.79; P <0.001) had a statistically significant effect on airway volume.

CONCLUSIONS: The volume of the airway increased in both the extraction and nonextraction samples. The biggest contributors to the increase were an increase in airway length and an increase in the area of minimum constriction, which likely occurred as a result of natural growth.

PMID:38678455 | DOI:10.1016/j.ajodo.2024.02.013

Am J Orthod Dentofacial Orthop. 2024 Apr 26:S0889-5406(24)00137-9. doi: 10.1016/j.ajodo.2024.03.014. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study was to examine the use of orthodontic 3-dimensional (3D) printing technology in North America and to understand why orthodontists are, or are not, incorporating 3D printing technology in their practices.

METHODS: A survey questionnaire was delivered on a secure online platform, RedCap (Case Western Reserve University Clinical and Translational Science Award; no. UL1TR002548). The survey consisted of 14-34 items with branching logic. The association between participant demographics and in-house 3D printing was assessed using a chi-square test of independence.

RESULTS: A total of 518 responses were recorded. The highest number of responses came from respondents in the 36-45-year age group. Most of the respondents were practice owners; 46.9% had 3D printers in their office. Chi-square tests of independence were performed on the data to see which associations existed. The strongest statistical associations with using an in-house 3D printer are seen with patient load, practice type, years since residency, and orthodontist’s position.

CONCLUSIONS: Approximately 75% of orthodontists use 3D printing technology in some capacity in North America. Major factors that influenced orthodontists to incorporate 3D printing technology into their office were self-interest and research. Major factors that have prevented orthodontists from not incorporating 3D printing technology into their office were space for equipment/ventilation and digital workflow training deficit. Orthodontists use their 3D printers mostly to make plastic retainers from printed models. The strongest associations with using in-house 3D printers are seen in patient load, practice type, years since residency, and orthodontist position. Increasing patient load and being in private practice increases the likelihood of having a 3D printer.

PMID:38678454 | DOI:10.1016/j.ajodo.2024.03.014

Med Educ Online. 2024 Dec 31;29(1):2345444. doi: 10.1080/10872981.2024.2345444. Epub 2024 Apr 28.

ABSTRACT

Accelerated medical school curricula, such as three-year programs, have gained attention in recent years but studies evaluating their impact are still scarce. This study examines the Fully Integrated Readiness for Service Training (FIRST) program, a three-year accelerated pathway, to assess its impact on students’ academic performance preparedness for residency. In this observational study, we compared the academic outcomes of FIRST program students to traditional four-year curriculum students from 2018 to 2023. We analyzed multiple metrics, including exam performance (United States Medical Licensing Examination Step scores, shelf exam scores, and pre-clinical course scores) and clinical performance scores during the application and individualization phases. Analysis of Variance was used to examine the effect of accelerated pathway program experience relative to traditional 4-year medical school curriculum on the learning outcomes. FIRST program students were on average 1.5 years younger upon graduation than their traditional peers. While FIRST program students scored slightly lower on Step 2 Clinical Knowledge (CK), they exhibited no significant differences in other exam scores or clinical performance relative to the traditional students. Notably, FIRST students achieved equivalent clinical performance ratings during critical clerkships and rotations. Our findings suggest that a three-year medical school curriculum can effectively prepare students for residency and produce graduates with comparable medical knowledge and clinical skills, offering potential benefits in terms of financial relief and personal well-being for medical students.

PMID:38678447 | DOI:10.1080/10872981.2024.2345444

Clin Physiol Funct Imaging. 2024 Apr 28. doi: 10.1111/cpf.12884. Online ahead of print.

ABSTRACT

It is controversial whether people with vasovagal syncope (VVS) have abnormal autonomic responses at baseline and whether specific diagnostic manoeuvres have a diagnostic value. We investigated whether the pupillary light reflex and cardiac autonomic tests can be used to identify autonomic dysfunction in volunteers with a medical history of VVS. The study groups included 128 healthy volunteers, of whom 31 reported a history of typical VVS. The right pupil was evaluated using an automated, commercial infra-red pupillometer under strict conditions. In addition to miosis and mydriasis kinetics, pupil diameters were measured. Heart rate variability at rest and heart rate changes to standing were quantified with high-resolution electrocardiography and designated software. The demographic and clinical characteristics of both groups were statistically similar. Average constriction velocity (ACV) was significantly higher in VVS patients following a univariate analysis (3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s, p = 0.042) and after correcting for potential confounders (p = 0.049). All other pupillometric and heart rate indices were comparable between groups. Patients with a history of VVS depict pupillary parasympathetic overactivity in response to light stimuli, manifested as increased ACV. The prognostic implications of this finding and the significance of using this simple clinical tool to identify patients who are at risk for developing frequent episodes of VVS or physical injuries following a syncope merits further study.

PMID:38678442 | DOI:10.1111/cpf.12884