Nevin Manimala

J Nat Prod. 2023 Sep 18. doi: 10.1021/acs.jnatprod.3c00566. Online ahead of print.

ABSTRACT

DP4+ is one of the most popular methods for the structure elucidation of natural products using NMR calculations. While the method is simple and easy to implement, it requires a series of procedures that can be tedious, coupled with the fact that its computational demand can be high in certain cases. In this work, we made a substantial improvement to these limitations. First, we deeply explored the effect of molecular mechanics architecture on the DP4+ formalism (MM-DP4+). In addition, a Python applet (DP4+App) was developed to automate the entire process, requiring only the Gaussian NMR output files and a spreadsheet containing the experimental NMR data and labels. The script is designed to use the statistical parameters from the original 24 levels of theory (employing B3LYP/6-31G* geometries) and the new 36 levels explored in this work (over MMFF geometries). Furthermore, it enables the development of customizable methods using any desired level of theory, allowing for a free choice of test molecules.

PMID:37721602 | DOI:10.1021/acs.jnatprod.3c00566

Surg Endosc. 2023 Sep 18. doi: 10.1007/s00464-023-10379-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Reinforcement of crural closure with synthetic resorbable mesh has been proposed to decrease recurrence rates after hiatal hernia repair, but continues to be controversial. This systematic review aims to evaluate the safety, efficacy, and intermediate-term results of using biosynthetic mesh to augment the hiatus.

METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed throughout this systematic review. The Risk of Bias in Non-Randomized Studies of Interventions and Risk of Bias in Randomized Trials tools were used to perform qualitative assessment of all studies included in this review. Recommendations were then summarized for the following pre-defined key items: protocol, research question, search strategy, study eligibility, data extraction, study design, risk of bias, publication bias, and statistical analysis.

RESULTS: The systematic literature search found 520 articles, 101 of which were duplicates and 355 articles were determined to be unrelated to our study and excluded. The full text of the remaining 64 articles was thoroughly assessed. A total of 18 articles (1846 patients) were ultimately included for this review, describing hiatal hernia repair using three different biosynthetic meshes-BIO-A, Phasix ST, and polyglactin mesh. Mean operative time varied from 127 to 223 min. Mean follow up varied from 12 to 54 months. There were no mesh erosions or explants. One mesh-related complication of stenosis requiring reoperation was reported with BIO-A. Studies showed significant improvement in symptom and quality-of-life scores, as well as satisfaction with surgery. Recurrence was reported as radiologic or clinical recurrence. Overall, recurrence rate varied from 0.9 to 25%.

CONCLUSION: The use of biosynthetic mesh is safe and effective for hiatal hernia repair with low complications rates and high symptom resolution. The reported recurrence rates are highly variable due to significant heterogeneity in defining and evaluating recurrences. Further randomized controlled trials with larger samples and long-term follow-up should be performed to better analyze outcomes and recurrence rates.

PMID:37721592 | DOI:10.1007/s00464-023-10379-1

Surg Endosc. 2023 Sep 18. doi: 10.1007/s00464-023-10399-x. Online ahead of print.

ABSTRACT

BACKGROUND: Robotics has been used safely and successfully in a variety of adult surgeries and is gradually gaining ground in pediatrics. While the benefits of robotic-assisted surgery in disease treatment are well recognized, its high cost has led to questions. To investigate whether robotic-assisted laparoscopic surgery (RALS) is cost-effective compared to conventional laparoscopic surgery (LS) in pediatric surgery, we attempted to construct a model to perform an analysis of these two surgical approaches using Python statistical analysis software.

METHODS: We selected four common complex pediatric surgical conditions (choledochal cyst, Hirschsprung’s disease, vesicoureteral reflux, and congenital hydronephrosis) from three systems (pediatric hepatobiliary, gastroenterology, and urology). Models were constructed using Python statistical software to compare hospital costs and surgical outcomes for RALS and LS. In addition, we performed a preferred strategy analysis for both surgical modalities while assessing model uncertainty using one-way sensitivity analysis.

RESULTS: For the four diseases, the operative time decreased sequentially. The total inpatient costs of RALS were 10,816.72, 9145.44, 8414.29, 7973.58 dollars, respectively, yielding 1.789, 1.712, 1.749, 1.792 quality adjustment life years (QALYs) over two years post-operatively. The incremental cost of RALS relative to LS for each disease was 3523.44, 3200.20, 3049.79, 3043.66 dollars, respectively, with an incremental utility of 0.060, 0.054, 0.051, 0.050 QALYs. The incremental cost-effectiveness ratios (ICERs) for RALS for each of the four diseases were 58,724.01, 59,262.95, 59,799.79, 60,873.20 dollars/QALY, all less than 100,000 dollars/QALY. The cost of robot consumables was the main incremental cost of RALS and had the most significant impact on the model.

CONCLUSION: For the four pediatric surgical conditions described above, RALS has higher inpatient costs than LS, but it has better postoperative outcomes, and all four RALS treatments are cost-effective. Children with complex diseases and long operative times appear to benefit more from RALS.

PMID:37721590 | DOI:10.1007/s00464-023-10399-x

Eur Phys J E Soft Matter. 2023 Sep 18;46(9):84. doi: 10.1140/epje/s10189-023-00343-1.

ABSTRACT

Granular convergence is a property of a granular pack as it is repeatedly sheared in a cyclic, quasistatic fashion, as the packing configuration changes via discrete events. Under suitable conditions the set of microscopic configurations encountered converges to a periodic sequence after sufficient shear cycles. Prior work modeled this evolution as the iteration of a pre-determined, random map from a set of discrete configurations into itself. Iterating such a map from a random starting point leads to similar periodic repetition. This work explores the effect of restricting the randomness of such maps in order to account for the local nature of the discrete events. The number of cycles needed for convergence shows similar statistical behavior to that of numerical granular experiments. The number of cycles in a repeating period behaves only qualitatively like these granular studies.

PMID:37721576 | DOI:10.1140/epje/s10189-023-00343-1

Odontology. 2023 Sep 18. doi: 10.1007/s10266-023-00852-7. Online ahead of print.

ABSTRACT

Even without diseases that cause dysphagia, physiological swallowing function declines with age, increasing the risk of aspiration. This study analyzed age-related changes in laryngeal movement in older adults. The study population consisted of 10 volunteers in their 80s and six in their 20s. A videofluoroscopic study of 3 and 10 mL barium swallows was performed laterally using a digital fluorographic. The recorded images were retrieved to a personal computer and analyzed frame-by-frame using video analysis software. The movement of the larynx during swallowing, barium’s pharyngeal transit time (PTT), and laryngeal elevation delay time (LEDT) were analyzed. Results were compared between the 20s and 80s age groups using statistical analyses. The PTT was shorter in the 20s than in the 80s age group. The PTT was significantly longer in the 80s group than in the 20s for both 3 and 10 mL barium swallows. LEDT in the 80s was statistically significantly longer than that in the 20s for the 10 ml barium. No statistically significant differences were found; however, there was a tendency for the 80s group to have more types of laryngeal movement velocity peaks. In this study, LEDT was prolonged in the 80s with 10 ml barium swallowing than in the 20s. Two peak patterns of laryngeal elevation during swallowing were observed. The velocity peaks showed a two-peak pattern when the patients were in their 80s and when the barium volume was tested at 10 mL. Our results suggest that aging’s effect on swallowing relates to laryngeal elevation.

PMID:37721560 | DOI:10.1007/s10266-023-00852-7

Eur J Prosthodont Restor Dent. 2023 Sep 14. doi: 10.1922/EJPRD_2542Cambiaghi09. Online ahead of print.

ABSTRACT

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs).

METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05).

RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses.

CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

PMID:37721553 | DOI:10.1922/EJPRD_2542Cambiaghi09

Community Dent Health. 2023 Sep 14. doi: 10.1922/CDH_00015Ghanati09. Online ahead of print.

ABSTRACT

OBJECTIVE: Prognostic risk prediction models estimate the probability of developing head and neck cancer (HNC), providing valuable information for managing the disease. While different prognostic HNC risk prediction models have been developed worldwide, a comprehensive evaluation of their methods is lacking. We conducted a scoping review with a critical assessment aiming to identify the methodological strengths and limitations of HNC risk prediction models.

METHOD: We searched Medline, Embase, Scopus, Web of Science, and CAB Abstracts databases and included full-text-available peer-reviewed published papers on developing or validating a prognostic HNC risk prediction model. Study quality was appraised using the PROBAST tool.

RESULTS: Nine papers were included. Although all had a high risk of bias, mainly in the analysis domain, only two studies had high concerns about clinical applicability.

CONCLUSION: Currently published studies provide insufficient information on methods, making it difficult to judge the models’ quality and applicability. Future investigations should follow the guidelines in reporting the prediction modelling studies.

PMID:37721548 | DOI:10.1922/CDH_00015Ghanati09

Eur J Prosthodont Restor Dent. 2023 Sep 18. doi: 10.1922/EJPRD_2586AbuBaker08. Online ahead of print.

ABSTRACT

INTRODUCTION: This in-vitro study investigated limitations of intra-oral scanners (IOS) in capturing palatal defects at decreased mouth openings. The trueness and precision of composite 3D-printed models from Cone-Beam Computed Tomography (CBCT) and IOS were measured.

METHODS: A partially dentate palatal defect model was scanned with IOS (3M™TrueDefinition) at various simulated mouth openings. Five silicone impressions were poured in gypsum. Scans were taken using 3M™TrueDefinition; Planmeca Planscan®, n=5 each. Model was scanned on two CBCT (PlanmecaProFace®; Accuitomo170®CBCT, n=5 each). Geomagic®Control2014™ was used to create composite-models merging CBCT with IOS. Thirty composite-models were 3D-printed. Trueness and precision were measured. Pearson Correlation Coefficients measured correlation between mouth opening and data capture. Data analysed using Kruskal-Wallis, Wilcoxon rank-sum, and ANOVA. Statistical significance inferred when p⟨0.05.

RESULTS: Mouth openings ⟨20mm, IOS didn’t capture information of soft tissue. Increased mouth opening positively correlated with increased data capture(r=0.93, p=0.001). AccuitomoCBCT and TrueDefinition IOS composite-models had the highest (trueness) and [precision](median (IQR) 0.172 mm(0.062-0.426)); [mean [SD] 0.080 mm [0.008]]. Casts had the lowest results (median (IQR) 0.289 mm(0.119-1.565));[mean [SD] 0.338 mm [0.089]](p⟨0.001).

CONCLUSION: Mouth opening ⟨20mm resulted in insufficient data capture by IOS for clinical applications. Composite digital models showed promising trueness and precision results.

PMID:37721541 | DOI:10.1922/EJPRD_2586AbuBaker08

Oper Dent. 2023 Sep 1;48(5):564-574. doi: 10.2341/23-010-L.

ABSTRACT

OBJECTIVES: This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office bleaching gels immediately and after 1 week of mixing.

METHODS AND MATERIALS: We randomly divided 49 premolars into seven groups: control (no bleaching) and the following in-office bleaching (Opalescence Boost 40%, Total Blanc One Step 35%, and Whiteness HP Blue 35%) applied at two storage times: immediately and after 1 week. We evaluated the BE using a digital spectrophotometer and the HPP through UV-Vis spectroscopy. We measured the initial concentration, pH, and viscosity using titration, a Digital pH meter and Rheometer, respectively. For statistical analysis, we used a twoway analysis of variance and Tukey and Dunnet tests (α=0.05).

RESULTS: We observed higher BE and HPP for Opalescence Boost and Total Blanc One Step after 1 week of mixing than for Whiteness HP Blue (p<0.001). We observed a significantly lower initial concentration for Whiteness HP Blue 1 week after mixing compared to immediately (p=0.00001). All bleaching gels showed a decrease in pH after 1 week of mixing (p=0.00003). However, Total Blanc One Step had a lower pH at both evaluation times (p<0.001). Only Opalescence Boost maintained viscosity 1 week after mixing.

CONCLUSIONS: Opalescence Boost was the only bleaching gel able to keep bleaching efficacy, with the same characteristics of permeability and physical- chemical properties after 1 week of mixing.

PMID:37721110 | DOI:10.2341/23-010-L

Monaldi Arch Chest Dis. 2023 Sep 15. doi: 10.4081/monaldi.2023.2736. Online ahead of print.

ABSTRACT

Leprosy is a neglected disease sporadically reported in high-income countries. Skin lesion and peripheral nerve involvement represent most common manifestations. Mediastinal lymphadenopathy in the absence of superficial lymph nodes involvement is very rare. Atypical or rare clinical presentations of disease may delay diagnosis and therapy and cause potential life-threatening manifestations and disabilities. We describe the case of a 49-year-old Sinhalese man who was admitted to our hospital with a one-month history of peripheral neurological symptoms and skin lesions on lower limbs. CT scan showed the presence of mediastinal lymphadenopathies without lung parenchymal and superficial lymph nodes involvement. Endobronchial ultrasound-guided transbronchial needle aspiration showed the presence of granulomas while skin biopsy revealed dermo-hypodermic granulomas with perineural lymphohistiocytic inflammatory reaction. Fite-Faraco staining demonstrated the presence of acid-fast bacilli in both lymph nodal and skin biopsy and polymerase chain reaction was positive for Mycobacterium leprae. Multibacillary leprosy was then diagnosed.

PMID:37721088 | DOI:10.4081/monaldi.2023.2736