Nevin Manimala

Influenza Other Respir Viruses. 2021 Dec 17. doi: 10.1111/irv.12940. Online ahead of print.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza-like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10 million inhabitants) from 2014-2015 to 2020-2021 winter seasons.

MATERIAL AND METHODS: Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet).

RESULTS: RSV accounted for nearly 19% of pediatric ILI with a risk of infection nearly two-fold greater than that of individuals ≥15 years. RSV positivity rate increased to 28% considering 0-5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly two-fold higher than the risk of RSV infection, the age group 4-6 months and 7-12 months showed a five-fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with pre-existing underlying health conditions had a nearly five-fold greater risk of getting RSV infection than otherwise healthy 0-5 years old children. RSV was identified in ILI cases <15 years of age in all considered winter seasons except in the 2020-2021 season.

DISCUSSION: Sentinel surveillance of ILI allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing, and intensity of the RSV and influenza community circulation. This surveillance approach can be implemented to assess the RSV circulation and impact in a real-time manner.

PMID:34921508 | DOI:10.1111/irv.12940

J Vet Intern Med. 2021 Dec 17. doi: 10.1111/jvim.16298. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic profiling identifies seasonal variance of serum metabolites in humans. Despite the presence of seasonal disease patterns, no studies have assessed whether serum metabolites vary seasonally in dogs.

HYPOTHESIS: There is seasonal variation in the serum metabolite profiles of healthy dogs.

ANIMALS: Eighteen healthy, client-owned dogs.

METHODS: A prospective cohort study. Serum metabolomic profiles were assessed monthly in 18 healthy dogs over a 12-month period. Metabolic profiling was conducted using a canine-specific proton nuclear magnetic resonance spectroscopy platform, and the effects of seasonality were studied for 98 metabolites using a cosinor model. Seasonal component was calculated, which describes the seasonal variation of each metabolite.

RESULTS: We found no evidence of seasonal variation in 93 of 98 metabolites. Six metabolites had statistically significant seasonal variance, including cholesterol (mean 249 mg/dL [6.47 mmol/L] with a seasonal component amplitude of 9 mg/dL [0.23 mmol/L]; 95% confidence interval [CI] 6-13 mg/dL [0.14-0.33 mmol/L], P < .008), with a peak concentration of 264 mg/dL (6.83 mmol/L) in June and trough concentration of 236 mg/dL (6.12 mmol/L) in December. In contrast, there was a significantly lower concentration of lactate (mean 20 mg/dL [2.27 mmol/L] with a seasonal component amplitude of 4 mg/dL [0.42 mmol/L]; 95% CI 2-6 mg/dL [0.22-0.62 mmol/L], P < .001) during the summer months compared to the winter months, with a peak concentration of 26 mg/dL (2.9 mmol/L) in February and trough concentration of 14 mg/dL (1.57 mmol/L) in July.

CONCLUSIONS AND CLINICAL IMPORTANCE: We found no clear evidence that seasonal reference ranges need to be established for serum metabolites of dogs.

PMID:34921444 | DOI:10.1111/jvim.16298

J Oral Rehabil. 2021 Dec 17. doi: 10.1111/joor.13298. Online ahead of print.

ABSTRACT

BACKGROUND: Orthodontic treatment is a common clinical method of malocclusion. Studies have found that neurons in the sensorimotor cortex of the brain undergo adaptive remodeling in response to changes in oral behavior or occlusion.

OBJECTIVE: To explore whether orthodontic treatment could be sufficient to cause neuroplastic changes in the corticomotor excitability of the masseter muscle.

METHODS: Fifteen Angle Class II malocclusion patients who were receiving the orthodontic treatment participated in the study. Cortical excitability was assessed by electromyographic activity changes evoked by transcranial magnetic stimulation. Four orthodontic time points were recorded, including baseline, day 1, day 7, and day 30. Motor evoked potentials (MEPs) were recorded in the masseter muscle and the first dorsal interosseous muscle (FDI) serving as a control. The data were analyzed by stimulus-response curves and corticomotor mapping. Statistical analyses involved repeated measures analysis of variance, two-way ANOVA and post-hoc Tukey tests.

RESULTS: Motor evoked potentials (MEPs) of the masseter muscle were significantly decreased during orthodontic treatment compared with baseline (P<0.001). MEPs of masseter muscle were dependent on session and stimulus intensity (P<0.001), whereas MEPs of FDI were only dependent on stimulus intensity (P=0.091). Finally, Post hoc Tukey tests demonstrated that MEPs of masseter muscle on days 1 and 7, with 70% to 90% stimulus intensities, were higher compared with baseline values. (P<0.001) CONCLUSIONS: The present study suggested that orthodontic treatment can lead to neuroplastic changes in the corticomotor control of the masseter muscle, which may add to our understanding of the adaptive response of subjects to changes of oral environment during the orthodontic treatment.

PMID:34921434 | DOI:10.1111/joor.13298

Perspect Psychiatr Care. 2021 Dec 18. doi: 10.1111/ppc.13001. Online ahead of print.

ABSTRACT

PURPOSE: This study was aimed at comparing the conscientious intelligence levels of nursing students and determining the factors affecting their conscientious intelligence.

DESIGN AND METHODS: Two hundred and forty nursing students were involved in the study.

FINDINGS: There were no statistically significant differences between the first and fourth-year students in terms of the mean scores they obtained from the compassion, responsibility toward the creator, conscious awareness, and social sensitivity sub-dimensions. Of the students, those who chose the profession willingly, those who were women and those who did not perceive nursing as a profession just to earn money obtained higher mean scores in the Conscientious Intelligence Scale.

PRACTICE IMPLICATIONS: The results of the study revealed that Nurse Academics should make more attempts to improve students’ conscientious intelligence.

PMID:34921416 | DOI:10.1111/ppc.13001

Br J Psychol. 2021 Dec 17. doi: 10.1111/bjop.12547. Online ahead of print.

ABSTRACT

Previous studies on perceptual grouping found that people can use spatiotemporal and featural information to group spatially separated rigid objects into a unit while tracking moving objects. However, few studies have tested the role of objects’ self-motion information in perceptual grouping, although it is of great significance to the motion perception in the three-dimensional space. In natural environments, objects always move in translation and rotation at the same time. The self-rotation of the objects seriously destroys objects’ rigidity and topology, creates conflicting movement signals and results in crowding effects. Thus, this study sought to examine the specific role played by self-rotation information on grouping spatially separated non-rigid objects through a modified multiple object tracking (MOT) paradigm with self-rotating objects. Experiment 1 found that people could use self-rotation information to group spatially separated non-rigid objects, even though this information was deleterious for attentive tracking and irrelevant to the task requirements, and people seemed to use it strategically rather than automatically. Experiment 2 provided stronger evidence that this grouping advantage did come from the self-rotation per se rather than surface-level cues arising from self-rotation (e.g. similar 2D motion signals and common shapes). Experiment 3 changed the stimuli to more natural 3D cubes to strengthen the impression of self-rotation and again found that self-rotation improved grouping. Finally, Experiment 4 demonstrated that grouping by self-rotation and grouping by changing shape were statistically comparable but additive, suggesting that they were two different sources of the object information. Thus, grouping by self-rotation mainly benefited from the perceptual differences in motion flow fields rather than in deformation. Overall, this study is the first attempt to identify self-motion as a new feature that people can use to group objects in dynamic scenes and shed light on debates about what entities/units we group and what kinds of information about a target we process while tracking objects.

PMID:34921401 | DOI:10.1111/bjop.12547

Aust N Z J Obstet Gynaecol. 2021 Dec 17. doi: 10.1111/ajo.13469. Online ahead of print.

ABSTRACT

BACKGROUND: Queensland introduced a colour-coded cardiotocograph (CTG) classification system (green, blue, yellow and red) to complement the Royal Australian and New Zealand College of Obstetricians and Gynaecologists prose-based classification system of ‘low, unlikely, maybe or likely’ fetal compromise.

AIMS: The aim of the study was to determine the clinical impact of the introduction of the colour-coded CTG classification system compared to the prose-based system. We hypothesised there would be no change in the rate of operative delivery for intrapartum fetal compromise (OD-IFC).

MATERIALS AND METHODS: This retrospective non-inferiority study from November 2014 to May 2018 used routinely collected data from the Mater Mother’s Hospital. Non-insured women with a singleton, non-anomalous, cephalic fetus at term, attempting a vaginal birth with continuous intrapartum CTG were included. The primary outcome was OD-IFC. Secondary outcomes included various obstetric and perinatal outcomes. Non-inferiority analysis was performed with a pre-specified non-inferiority margin of 2% risk difference.

RESULTS: Eleven thousand seven hundred and twenty-seven participants were included. The OD-IFC rate was similar across the study groups (prose-based 15.1% vs colour-coded 15.3%, adjusted odds ratio (aOR) 1.02, 95% CI 0.93-1.13) with the adjusted risk difference of 0.29% (95% CI -0.98 to 1.56), which did not exceed the inferiority margin. There were more spontaneous (aOR 1.11, 95% CI 1.04-1.19) and fewer instrumental (aOR 0.87, 95% CI 0.80-0.95) vaginal births in the colour-coded cohort. There were no differences in neonatal outcomes.

CONCLUSIONS: Reassuringly, the colour-coded CTG classification system was non-inferior to the prose-based system, did not influence OD-IFC but was associated with more spontaneous vaginal deliveries.

PMID:34921390 | DOI:10.1111/ajo.13469

Eur J Dent. 2021 Dec 17. doi: 10.1055/s-0041-1735908. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the shear bond strength (SBS) of lithium disilicate glass-ceramic (LDGC) and resin cement (RC) using different surface treatments.

MATERIALS AND METHODS: LDGC blocks (Vintage LD Press) were prepared, etched with 4.5% hydrofluoric acid, and randomly divided into seven groups (n = 10), depending on the surface treatments. The groups were divided as follows: 1) no surface treatment (control), 2) Silane Primer (KS), 3) Signum Ceramic Bond I (SGI), 4) Signum Ceramic Bond I/Signum Ceramic Bond II (SGI/SGII), 5) experimental silane (EXP), 6) experimental silane/Signum Ceramic Bond II (EXP/SGII), and 7) Experimental/Adper Scotchbond Multi-purpose Adhesive (EXP/ADP). The specimens were cemented to resin composite blocks with resin cement and stored in water at 37 °C for 24 hours. The specimens underwent 5,000 thermal cycles and were subjected to the SBS test. Mode of failure was evaluated under the stereo microscope.

STATISTICAL ANALYSIS: Data were analyzed with Welch ANOVA and Games-Howell post hoc tests (α = 0.05).

RESULTS: The highest mean SBS showed in group EXP/ADP (45.49 ± 3.37 MPa); however, this was not significantly different from group EXP/SGII (41.38 ± 2.17 MPa) (p ≥ 0.05). The lowest SBS was shown in the control group (18.36 ± 0.69 MPa). This was not significantly different from group KS (20.17 ± 1.10 MPa) (p ≥ 0.05).

CONCLUSIONS: The different surface treatments significantly affected the SBS value between LDGC and RC. The application of pure silane coupling agent with or without the application of an adhesive improved the SBS value and bond quality.

PMID:34921384 | DOI:10.1055/s-0041-1735908

J Knee Surg. 2021 Dec 17. doi: 10.1055/s-0041-1740384. Online ahead of print.

ABSTRACT

There has been no consensus about how to determine the individual posterior tibial slope (PTS) intraoperatively. The purpose of this study was to investigate whether the tibial plateau could be used as a reference for reproducing individual PTS during medial unicompartmental knee arthroplasty (UKA). Preoperative computed tomography (CT) data from 48 lower limbs for medial UKA were imported into a three-dimensional planning software. Digitally reconstructed radiographs were created from the CT data as the lateral knee plain radiographs and the radiographic PTS angle was measured. Then, the PTS angles on the medial one-quarter and the center of the MTP (¼ and ½ MTP, respectively), and that on the medial tibial eminence (TE) were measured on the sagittal multiplanar reconstruction image. Finally, 20 lateral knee radiographs with an arthroscopic probe placed on the ¼ and the ½ MTP were obtained intraoperatively, and the angle between the axis of the probe and the tangent line of the plateau was measured. The mean radiographic PTS angle was 7.9 ± 3.0 degrees (range: 1.7-13.6 degrees). The mean PTS angles on the ¼ MTP, the ½ MTP, and the TE were 8.1 ± 3.0 degrees (1.2-13.4 degrees), 9.1 ± 3.0 degrees (1.4-14.7 degrees), and 9.9 ± 3.1 degrees (3.1-15.7 degrees), respectively. The PTS angles on the ¼ MTP and the ½ MTP were strongly correlated with the radiographic PTS angle (r =0.87 and 0.80, respectively, p < 0.001). A statistically significant difference was observed between the mean angle of the radiographic PTS and the PTS on the TE (p < 0.01). The mean angle between the axis of the probe and the tangent line of the tibial plateau was -0.4 ± 0.9 degrees (-2.3-1.3 degrees) on the ¼ MTP and -0.1 ± 0.7 degrees (-1.5-1.2 degrees) on the ½ MTP, respectively. An area from the medial one-quarter to the center of the MTP could be used as an anatomical reference for the individual PTS.

PMID:34921377 | DOI:10.1055/s-0041-1740384

J Reconstr Microsurg. 2021 Dec 17. doi: 10.1055/s-0041-1740123. Online ahead of print.

ABSTRACT

BACKGROUND: Postmastectomy radiation therapy (PMRT) is an important component in the treatment of locally advanced breast cancer. Optimal timing of therapy in relation to autologous breast reconstruction (ABR) remains clinically debated. Herein, we comparatively analyze short- and long-term outcomes between immediate ABR (I-ABR) and delayed-immediate ABR (DI-ABR) in the setting of PMRT.

METHODS: Adult patients undergoing ABR with PMRT were separated into cohorts based on reconstructive timeline: I-ABR or DI-ABR. The groups were propensity matched 1:1 by age, body mass index, and comorbidities. Surgical site events and long-term clinical outcomes (readmissions, reoperations, and revision procedures) were collected. Univariate analyses were completed using Pearson’s chi-squared tests and Fisher’s exact tests, and statistical significance was set at p < 0.05.

RESULTS: One hundred and thirty-two flaps (66 in each cohort) were identified for inclusion. Patients with I-ABR were more likely to experience fat necrosis (p = 0.034) and skin necrosis (p < 0.001), require additional office visits (p < 0.001) and outpatient surgeries (p = 0.015) to manage complications, and undergo revision surgery after reconstruction (p < 0.001). DI-ABR patients, however, had a 42.4% incidence of complications following tissue expander placement prior to reconstruction, with 16.7% of patients requiring reoperation during this time. Only one patient (I-ABR) experienced flap loss due to a vascular complication.

CONCLUSION: The complications encountered in both of these groups were not prohibitive to offering either treatment. Patients should be made aware of the specific and unique risks of these reconstruction timelines and involved throughout the entire decision-making process. Plastic surgeons should continue to strive to elucidate innovative approaches that facilitate enhanced quality of life without compromising oncologic therapy.

PMID:34921369 | DOI:10.1055/s-0041-1740123

J Reconstr Microsurg. 2021 Dec 17. doi: 10.1055/s-0041-1740925. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps.

METHODS: The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure.

RESULTS: One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher’s exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006).

CONCLUSION: This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.

PMID:34921368 | DOI:10.1055/s-0041-1740925