Nevin Manimala

Int J Prosthodont. 2024 Feb 26;0(0):1-32. doi: 10.11607/ijp.8602. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the surface characteristics, accuracy (trueness and precision), and dimensional stability of tooth preparation dies fabricated using conventional gypsum and direct light processing (DLP), stereolithography (SLA), and polymer jetting printing (PJP) techniques.

MATERIALS AND METHODS: Gypsum preparation dies were replicated according to the reference data and imported into DLP, SLA, and PJP printers, and the test data were obtained by scanning after 0, 1, 3, 7, 14, 28, and 42 days. After analyzing the surface characteristics, a best-fit algorithm between the test and the reference data was used to evaluate the accuracy and dimensional stability of the preparation dies. The data were analyzed by one-way analysis of variance and Tukey test or Kruskal-Wallis H test (α = .05).

RESULTS: Compared with the gypsum group (3.61 ± 0.59 μm), the root mean square error (RMSE) values of the SLA group (5.33 ± 0.48 μm) was rougher (P < .05), the PJP group (2.43 ± 0.37 μm) was smoother (P < .05), and the DLP group (2.92 ± 0.91 μm) had no significant difference (P > .05). For trueness, the RMSE was greater in the PJP (34.90 ± 4.91 μm) and SLA (19.01 ± 0.95 μm) groups than in the gypsum (16.47 ± 0.47 μm) group (P < .05), and no significant difference was found between the DLP (17.10 Å} 1.77 μm) and gypsum groups. Regarding precision, the RMSE ranking was gypsum = DLP = SLA < PJP group. The RMSE ranges in the gypsum, DLP, PJP, and SLA groups at different times were 6.79 to 8.86 μm, 5.44 to 10.17 μm, 10.16 to 11.28 μm, and 10.94 to 32.74 μm, respectively.

CONCLUSION: Although gypsum and printed preparation dies showed statistically significant differences in surface characteristics, accuracy, and dimensional stability, all tooth preparation dies were clinically tolerated and used to produce fixed restorations.

PMID:38408132 | DOI:10.11607/ijp.8602

Plant Biotechnol J. 2024 Feb 26. doi: 10.1111/pbi.14323. Online ahead of print.

ABSTRACT

Although forward-genetics-metabolomics methods such as mGWAS and mQTL have proven effective in providing myriad loci affecting metabolite contents, they are somehow constrained by their respective constitutional flaws such as the hidden population structure for GWAS and insufficient recombinant rate for QTL. Here, the combination of mGWAS and mQTL was performed, conveying an improved statistical power to investigate the flavonoid pathways in common wheat. A total of 941 and 289 loci were, respectively, generated from mGWAS and mQTL, within which 13 of them were co-mapped using both approaches. Subsequently, the mGWAS or mQTL outputs alone and their combination were, respectively, utilized to delineate the metabolic routes. Using this approach, we identified two MYB transcription factor encoding genes and five structural genes, and the flavonoid pathway in wheat was accordingly updated. Moreover, we have discovered some rare-activity-exhibiting flavonoid glycosyl- and methyl-transferases, which may possess unique biological significance, and harnessing these novel catalytic capabilities provides potentially new breeding directions. Collectively, we propose our survey illustrates that the forward-genetics-metabolomics approaches including multiple populations with high density markers could be more frequently applied for delineating metabolic pathways in common wheat, which will ultimately contribute to metabolomics-assisted wheat crop improvement.

PMID:38408119 | DOI:10.1111/pbi.14323

PLoS Negl Trop Dis. 2024 Feb 26;18(2):e0012004. doi: 10.1371/journal.pntd.0012004. Online ahead of print.

ABSTRACT

BACKGROUND: Pythiosis is a rare disease with high mortality, with over 94% of cases reported from Thailand and India. Prompt diagnosis and surgery improves patient outcomes. Therefore, continuing professional development (CPD) is essential for early recognition. However, a needs assessment related to a pythiosis CPD program has not been performed.

OBJECTIVES: We conducted a needs assessment to develop a pythiosis CPD program.

PATIENTS/METHODS: We conducted a survey study with 267 King Chulalongkorn Memorial Hospital residents (141 internal medicine (IM) residents and 126 surgery residents). A 30-item survey consisting of a knowledge assessment, demographic section, and an attitudes portion was distributed both electronically and via paper. The data was analyzed with descriptive and inferential statistics.

RESULTS: Sixty-seven percent completed the survey (110/141 IM residents, 70/126 surgery residents). The mean score [95% confidence interval] on the knowledge assessment was 41.67% [39.64%-43.69%] across all objectives. The three domains with the highest scores were pythiosis risk factors (67.22% correct), microbiologic characteristics (50.83%), and radiographic interpretation (50.56%). The three domains with the lowest scores were laboratory investigation (15.00%), epidemiology (29.17%), and symptomatology (30.83%). Most participants noted that the program should be online with both synchronous and asynchronous sessions, with a preferred length of 60-90 minutes per session.

CONCLUSION: The pythiosis CPD program should emphasize education regarding symptomatology, laboratory investigation, and epidemiology, all of which are critical for the early detection of pythiosis to decrease mortality from this devastating disease. Most respondents felt this program was necessary and should be implemented in a virtual blended format.

PMID:38408109 | DOI:10.1371/journal.pntd.0012004

JMIR Public Health Surveill. 2024 Feb 26;10:e49381. doi: 10.2196/49381.

ABSTRACT

BACKGROUND: Public health surveillance data are critical to understanding the current state of the HIV and AIDS epidemics. Surveillance data provide significant insight into patterns within and progress toward achieving targets for each of the steps in the HIV care continuum. Such targets include those outlined in the National HIV/AIDS Strategy (NHAS) goals. If these data are disseminated, they can be used to prioritize certain steps in the continuum, geographic locations, and groups of people.

OBJECTIVE: We sought to develop and report indicators of progress toward the NHAS goals for US cities and to characterize progress toward those goals with categorical metrics.

METHODS: Health departments used standardized SAS code to calculate care continuum indicators from their HIV surveillance data to ensure comparability across jurisdictions. We report 2018 descriptive statistics for continuum steps (timely diagnosis, linkage to medical care, receipt of medical care, and HIV viral load suppression) for 36 US cities and their progress toward 2020 NHAS goals as of 2018. Indicators are reported categorically as met or surpassed the goal, within 25% of attaining the goal, or further than 25% from achieving the goal.

RESULTS: Cities were closest to meeting NHAS goals for timely diagnosis compared to the goals for linkage to care, receipt of care, and viral load suppression, with all cities (n=36, 100%) within 25% of meeting the goal for timely diagnosis. Only 8% (n=3) of cities were >25% from achieving the goal for receipt of care, but 69% (n=25) of cities were >25% from achieving the goal for viral suppression.

CONCLUSIONS: Display of progress with graphical indicators enables communication of progress to stakeholders. AIDSVu analyses of HIV surveillance data facilitate cities’ ability to benchmark their progress against that of other cities with similar characteristics. By identifying peer cities (eg, cities with analogous populations or similar NHAS goal concerns), the public display of indicators can promote dialogue between cities with comparable challenges and opportunities.

PMID:38407961 | DOI:10.2196/49381

JMIR Perioper Med. 2024 Feb 26;7:e45126. doi: 10.2196/45126.

ABSTRACT

BACKGROUND: Osteoarthritis is a significant cause of disability, resulting in increased joint replacement surgeries and health care costs. Establishing benchmarks that more accurately predict surgical duration could help to decrease costs, maximize efficiency, and improve patient experience. We compared the anesthesia-controlled time (ACT) and surgery-controlled time (SCT) of primary total knee (TKA) and total hip arthroplasties (THA) between an academic medical center (AMC) and a community hospital (CH) for 2 orthopedic surgeons.

OBJECTIVE: This study aims to validate and compare benchmarking times for ACT and SCT in a single patient population at both an AMC and a CH.

METHODS: This retrospective 2-center observational cohort study was conducted at the University of Colorado Hospital (AMC) and UCHealth Broomfield Hospital (CH). Cases with current procedural terminology codes for THA and TKA between January 1, 2019, and December 31, 2020, were assessed. Cases with missing data were excluded. The primary outcomes were ACT and SCT. Primary outcomes were tested for association with covariates of interest. The primary covariate of interest was the location of the procedure (CH vs AMC); secondary covariates of interest included the American Society of Anesthesiologists (ASA) classification and anesthetic type. Linear regression models were used to assess the relationships.

RESULTS: Two surgeons performed 1256 cases at the AMC and CH. A total of 10 THA cases and 12 TKA cases were excluded due to missing data. After controlling for surgeon, the ACT was greater at the AMC for THA by 3.77 minutes and for TKA by 3.58 minutes (P<.001). SCT was greater at the AMC for THA by 11.14 minutes and for TKA by 14.04 minutes (P<.001). ASA III/IV classification increased ACT for THA by 3.76 minutes (P<.001) and increased SCT for THA by 6.33 minutes after controlling for surgeon and location (P=.008). General anesthesia use was higher at the AMC for both THA (29.2% vs 7.3%) and TKA (23.8% vs 4.2%). No statistically significant association was observed between either ACT or SCT and anesthetic type (neuraxial or general) after adjusting for surgeon and location (all P>.05).

CONCLUSIONS: We observed lower ACT and SCT at the CH for both TKA and THA after controlling for the surgeon of record and ASA classification. These findings underscore the efficiency advantages of performing primary joint replacements at the CH, showcasing an average reduction of 16 minutes in SCT and 4 minutes in ACT per case. Overall, establishing more accurate benchmarks to improve the prediction of surgical duration for THA and TKA in different perioperative environments can increase the reliability of surgical duration predictions and optimize scheduling. Future studies with study populations at multiple community hospitals and academic medical centers are needed before extrapolating these findings.

PMID:38407957 | DOI:10.2196/45126

JMIR Serious Games. 2024 Feb 26;12:e45546. doi: 10.2196/45546.

ABSTRACT

BACKGROUND: Health rumors arbitrarily spread in mainstream social media on the internet. Health rumors emerged in China during the outbreak of COVID-19 in early 2020. Many midelders/elders (age over 40 years) who lived in Wuhan believed these rumors.

OBJECTIVE: This study focused on designing a serious game as an experimental program to prevent and control health rumors. The focus of the study was explicitly on the context of the social networking service for midelders/elders.

METHODS: This research involved 2 major parts: adopting the Transmission Control Protocol model for games and then, based on the model, designing a game named “Fight With Virus” as an experimental platform and developing a cognitive questionnaire with a 5-point Likert scale. The relevant variables for this experimental study were defined, and 10 hypotheses were proposed and tested with an empirical study. In total, 200 participants were selected for the experiments. By collecting relevant data in the experiments, we conducted statistical observations and comparative analysis to test whether the experimental hypotheses could be proved.

RESULTS: We noted that compared to traditional media, serious games are more capable of inspiring interest in research participants toward their understanding of the knowledge and learning of health commonsense. In judging and recognizing the COVID-19 health rumor, the test group that used game education had a stronger ability regarding identification of the rumor and a higher accuracy rate of identification. Results showed that the more educated midelders/elders are, the more effective they are at using serious games.

CONCLUSIONS: Compared to traditional media, serious games can effectively improve midelders’/elders’ cognitive abilities while they face a health rumor. The gameplay effect is related to the individual’s age and educational background, while income and gender have no impact.

PMID:38407954 | DOI:10.2196/45546

Xenotransplantation. 2024 Jan-Feb;31(1):e12843. doi: 10.1111/xen.12843.

ABSTRACT

BACKGROUND: In recent years, the implementation of the first case of pig-to-human heart xenotransplantation and the report of three cases of pig-to-brain-dead human recipient kidney transplantation indicate that xenotransplantation is getting closer to clinical application. In the near future, China may also launch clinical trials of kidney xenotransplantation. Therefore, it is necessary to investigate the level of knowledge and acceptance of xenotransplantation among kidney transplant recipients and candidates in China. This study aims to investigate the level of comprehension and acceptance of kidney xenotransplantation in kidney transplant recipients and explore related factors, providing a reference for promoting the application and clinical trials of xenotransplantation in the near future.

METHODS: A questionnaire was completed by 211 kidney transplant recipients and 21 candidates. Answers to the questionnaires were self-administered by the respondents. Scores were compared using nonparametric tests, as well as using Chi-square test or Fisher’s exact test to compare differences in answers.

RESULTS: Respondents demonstrated a high score of 75 (out of 100) on knowledge and acceptance of kidney xenotransplantation. The sector “Knowledge and Attitude” received the overall highest score from respondents (85.0 out of 100), while “Risks and Concerns” received the lowest score (50 out of 100). Interestingly, respondents paid more attention to infection risks but showed less concern about rejection or unknown risks. Furthermore, 191 respondents (82.3%) expected that pig kidney xenografts could function for at least 5 years or more. The scores were statistically significant in terms of age, gender, level of education, level of knowledge on the case of xenotransplantation clinical trial, and willingness to donate organs. cognition CONCLUSIONS: The awareness rates of xenotransplantation are high among kidney transplant recipients and candidates, for which the majority showed a generally favorable attitude towards this procedure. Respondents did not have a comprehensive understanding of the specific knowledge of xenotransplantation and expressed more concern about the risk of infection compared to the risk of rejection and other unknown risks, while also expecting long-term survival similar to allograft transplantation for pig kidney xenografts.

PMID:38407927 | DOI:10.1111/xen.12843

Xenotransplantation. 2024 Jan-Feb;31(1):e12844. doi: 10.1111/xen.12844.

ABSTRACT

BACKGROUND: Xenotransplantation (XTx) is an alternative treatment for organ scarcity. Investigating the acceptance of XTx among patients from diverse cultural and religious backgrounds is essential. This study aimed to evaluate the knowledge, attitudes, and awareness of XTx among patients undergoing liver transplant (LT).

METHODS: This descriptive study was conducted between November 2022 and August 2023. The study population comprised LT patients aged ≥18 years who were admitted to the hepatology clinic of a university hospital in Turkey. Of the 360 patients (n = 360) interviewed, 351 were deemed eligible for inclusion. A questionnaire was used to collect data. The Kolmogorov-Smirnov test, median, standard deviation, minimum-maximum, number, percentage, and Pearson’s chi-square test were used for statistical analysis.

RESULTS: Of the patients, 78.3% were religious and adhered to religious requirements, and 87.2% considered their religious beliefs when making important decisions. In all, 41.3% of the participants believed that organ or tissue transplantation from animals to humans is ethical, while 70.1% of the participants believed that organ and tissue transplantation from non-halal animals to humans was impossible. Specifically, 56.7% would not allow organ or tissue transplantation from a non-halal animal to themselves or a relative. Knowledge and attitude towards XTx were not affected by transplantation type (p > .05), but were affected by sex and educational level (p < .05).

CONCLUSION: This study found that LT patients generally oppose XTx. To enhance knowledge and awareness, religious leaders and healthcare professionals should organize comprehensive and effective seminars on this topic.

PMID:38407925 | DOI:10.1111/xen.12844

JAMA Netw Open. 2024 Feb 5;7(2):e2356425. doi: 10.1001/jamanetworkopen.2023.56425.

ABSTRACT

IMPORTANCE: Use of valproate and certain other antiseizure medications (ASMs) in pregnancy is associated with abnormal fetal brain development with potential long-term implications for the child.

OBJECTIVE: To examine whether use of valproate and other ASMs in pregnancy among mothers with epilepsy is associated with epilepsy risk in their children.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, population-based register cohort study included singletons born to mothers with epilepsy in Denmark, Finland, Iceland, Norway, and Sweden from January 1, 1996, to December 31, 2017. Data analysis was performed from October 2022 to December 2023.

EXPOSURE: Redeemed prescription for an ASM from 30 days before pregnancy until birth.

MAIN OUTCOMES AND MEASURES: The main outcome was epilepsy in children, assessed using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses from hospital care. Adjusted hazard ratios (AHRs) and 95% CIs were estimated using Cox proportional hazards regression. Secondary analyses included dose-response analyses, analyses using children of mothers who discontinued ASM prior to pregnancy as the reference, and sibling analyses.

RESULTS: This cohort study included 38 663 children of mothers with epilepsy (19 854 [51.4%] boys). Children were followed up from birth; the mean length of follow-up was 7.2 years (range 0-22 years). Compared with 22 207 children of mothers not using an ASM in pregnancy, increased risks of epilepsy in children of mothers who used valproate in pregnancy (monotherapy: AHR, 2.18; 95% CI, 1.70-2.79; polytherapy: AHR, 2.10; 95% CI, 1.49-2.96) were observed. However, there was no dose-dependent association, and there was a similar risk of epilepsy in siblings who were exposed and unexposed to valproate (AHR, 0.95; 95% CI, 0.50-1.82). Prenatal exposure to topiramate monotherapy was associated with increased risk of epilepsy (AHR, 2.32; 95% CI, 1.30-4.16), and the risk was greater for higher doses, but the risk attenuated in comparisons with children of mothers who discontinued topiramate before pregnancy (AHR, 1.19; 95% CI, 0.26-5.44). Prenatal exposure to clonazepam monotherapy was also associated with increased epilepsy risk (AHR, 1.90; 95% CI, 1.16-3.12), but limited follow-up and low numbers precluded further analyses. No associations were observed for prenatal exposure to lamotrigine (AHR, 1.18; 95% CI, 0.95-1.47), levetiracetam (AHR, 1.28; 95% CI, 0.77-2.14), carbamazepine (AHR, 1.13; 95% CI, 0.85-1.50), or oxcarbazepine (AHR, 0.68; 95% CI, 0.44-1.05).

CONCLUSIONS AND RELEVANCE: In this cohort study of children born to mothers with epilepsy, the associations found between prenatal exposure to certain ASMs and the child’s risk of epilepsy did not persist in sensitivity analyses, suggesting that maternal ASM use in pregnancy may not increase epilepsy risk in children beyond that associated with the maternal epilepsy itself. These findings are reassuring for women in need of treatment with ASM in pregnancy.

PMID:38407908 | DOI:10.1001/jamanetworkopen.2023.56425

JAMA Netw Open. 2024 Feb 5;7(2):e2356466. doi: 10.1001/jamanetworkopen.2023.56466.

ABSTRACT

IMPORTANCE: Wildfires, intensified by climate change, have known effects on physical health but their effects on mental health are less well characterized. It has been hypothesized that the residential proximity to a large wildfire can exacerbate underlying mental health conditions as evidenced by increased prescriptions of psychotropic medications.

OBJECTIVE: To evaluate the association between the occurrence of large wildfires and the prescription rates of psychotropic medications immediately following the start of the fire.

DESIGN, SETTING, AND PARTICIPANTS: This cohortstudy used an interrupted time-series analysis to compare psychotropic medication prescriptions in the 6 weeks before and after each of 25 wildfires. The setting was California counties within metropolitan statistical areas (MSAs) experiencing large wildfires from 2011 through 2018. Participants included individuals residing in California MSAs with prescriptions of psychotropic medications recorded in the Merative MarketScan Research Database (MarketScan) during the study period. Statistical analysis was performed for these 25 large wildfires occurring between September 2011 and November 2018.

EXPOSURE: Residential proximity to large wildfires that burned more than 25 000 acres occurring in a California county within an MSA.

MAIN OUTCOMES AND MEASURES: Prescriptions of psychotropic medications, including antidepressants, antipsychotics, anxiolytics, hypnotics, and mood-stabilizers, with statins as a negative control outcome.

RESULTS: For the study period, prescription data and patient-level attributes were extracted for 7 115 690 unique individuals (annual mean [range]: 889 461 [455 705-1 426 928] individuals) enrolled in MarketScan and residing in fire-affected MSAs. This study found a statistically significant increase in prescriptions of antidepressants (rate ratio [RR], 1.04 [95% CI, 1.01-1.07]), anxiolytics (RR, 1.05 [95% CI, 1.02-1.09]), and mood-stabilizing medications (RR, 1.06 [95% CI, 1.01-1.13]) in the fire period compared with the prefire baseline. However, the prescriptions of antipsychotics, hypnotics, and the negative control outcome, statins, showed no significant association.

CONCLUSIONS AND RELEVANCE: In this cohort study of large California wildfires, the occurrence of wildfire was associated with increased mental health burden as reflected in increased prescription rates of certain psychotropic medications. The findings underscore the need for further scientific examination into the mental health effects of wildfires and the allocation of mental health resources in disaster responses. California experienced a substantial burden of wildfires from 2011 to 2018, and as wildfires become more intense and frequent in the context of anthropogenic climate change, it is increasingly important to understand and address their mental health effects.

PMID:38407907 | DOI:10.1001/jamanetworkopen.2023.56466