Nevin Manimala

Dent Mater J. 2023 Mar 18. doi: 10.4012/dmj.2022-184. Online ahead of print.

ABSTRACT

This study evaluated the effect of luting system with acidic primers on the durability of bonds with Ti-15Mo-5Zr-3Al titanium alloy (Ti-15Mo-5Zr-3Al) and its component metals. Adherend metals were Ti-15Mo-5Zr-3Al, Ti, Mo, Zr, and Al. Four primers were evaluated as adhesion promoters: Alloy Primer (ALP), Estenia Opaque Primer (EOP), M. L. Primer (MLP), and Super Bond liquid (SBL). An acrylic resin was used as the luting material. Pre- and post-thermocycling shear bond strength was determined to evaluate the bonding durability, and the results were compared using non-parametric statistical analyses (n=11/group). The post-thermocycling bond strength in MPa (median) associated with ALP, EOP, MLP, and SBL were 18.8, 19.8, 4.1, and 0.8, respectively, for Ti-15Mo-5Zr-3Al. The results showed that two primers containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) were effective for the durability of bonding of Ti-15Mo-5Zr-3Al to the resin. MDP enhanced the bonding durability of the resin bonded to either Ti, Zr, or Al.

PMID:36935125 | DOI:10.4012/dmj.2022-184

Toxicol Ind Health. 2023 Mar 19:7482337231162762. doi: 10.1177/07482337231162762. Online ahead of print.

ABSTRACT

Occupational exposure to dimethylacetamide (DMAc) has been reported to cause toxic hepatitis. Sixty spandex workers were included in this study to research the clinical manifestations and expression of cytokines and lymphocytes in DMAc-induced toxic hepatitis. Chinese drugs (reduced glutathione and Hugan tablets) were used to treat them. The manifestations including jaundice, asthenia, appetite, nausea, emesis, abdominal distension, yellow urine, and dizziness were scored. The percentages of patients rated as 0-3, 4-6, 7-9, and 10-12 points were 33.3%, 43.3%, 21.7%, and 1.7%, respectively, before treatment, and all patients showed 0-3 points after the treatment. The ultrasonic and CT imaging revealed diffuse intrahepatic hypodensity, intrahepatic calcification, signs of liver injury, and splenomegaly, which improved after therapy. Blood analysis showed that ALT, AST, TBIL, IL-6, IL-10, TNF-α, IFN-γ, CD3⁺%, and CD4⁺/CD8⁺ statistically decreased after drug treatment. Correlation analysis demonstrated positive linear correlations between ALT and TBIL, AST and TBIL, IL-10 and ATL, IL-10 and AST, IL-10 and TBIL, IFN-γ and IL-6, IFN-γ and TNF-α, and CD3⁺% and ALT. Pro-inflammatory cytokines and lymphocytes in DMAc-induced toxic hepatitis reflected an active immune state that decreased after treatment. IL-10 may inhibit the immune response in this disease, as a protective mechanism.

PMID:36935113 | DOI:10.1177/07482337231162762

Am J Epidemiol. 2023 Mar 17:kwad065. doi: 10.1093/aje/kwad065. Online ahead of print.

ABSTRACT

The aim of this study was to quantify waning rates from seroprevalence data collected in a study of population with a high vaccination coverage and fixed vaccination schedule. Data were collected during the national Immunologic Survey in the Slovak Republic in 2018. The average waning rate after the first dose (age 1.5 – 10 years) is 9.7% per year from the geometric mean titre (GMT) value 2634 mUI/ml. The average waning rate after the second dose (age 10 – 33 years) is significantly lower, 4.8% per year from the lower GMT value 1331 mUI/ml. This decline in antibody levels suggests that vaccine-induced protection may be compromised and results in the increase in the proportion of seronegative/borderline individuals. These outcomes may provide a valuable source for critical assessment of direct and indirect effects of vaccination.

PMID:36935110 | DOI:10.1093/aje/kwad065

J Clin Epidemiol. 2023 Mar 17:S0895-4356(23)00055-0. doi: 10.1016/j.jclinepi.2023.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: In biomedical research, spin is the overinterpretation of findings, and it is a growing concern. To date, the presence of spin has not been evaluated in prognostic model research in oncology, including studies developing and validating models for individualised risk prediction.

STUDY DESIGN AND SETTING: We conducted a systematic review, searching MEDLINE and EMBASE for oncology-related studies that developed and validated a prognostic model using machine learning published between 01/01/2019 and 05/09/2019. We used existing spin frameworks and described areas of highly suggestive spin practices.

RESULTS: We included 62 publications (including 152 developed models; 37 validated models). Reporting was inconsistent between methods and the results in 27% of studies due to additional analysis and selective reporting. Thirty-two studies (out of 36 applicable studies) reported comparisons between developed models in their discussion and predominantly used discrimination measures to support their claims (78%). Thirty-five studies (56%) used an overly strong or leading word in their title, abstract, results, discussion or conclusion.

CONCLUSION: The potential for spin needs to be considered when reading, interpreting, and using studies that developed and validated prognostic models in oncology. Researchers should carefully report their prognostic model research using words that reflect their actual results and strength of evidence.

PMID:36935090 | DOI:10.1016/j.jclinepi.2023.03.012

J Shoulder Elbow Surg. 2023 Mar 17:S1058-2746(23)00260-4. doi: 10.1016/j.jse.2023.02.126. Online ahead of print.

ABSTRACT

BACKGROUND: Over the last few decades, several databases and clinical registries have been used to generate studies for orthopedic surgery research including shoulder arthroplasty. Observational database studies present data that is best used to provide information regarding associations between variables but is unable to prove causation. Yet, there remains a tendency for authors to use causal language and conclusive statements in published shoulder arthroplasty literature utilizing such databases.

METHODS: We systematically identified administrative database and registry studies on shoulder arthroplasty in five orthopedic journals from January 2020 to December 2021. Papers were independently graded by two reviewers for the presence, absence, or inconsistent use of causal language throughout the publication. Chi-squared analyses were conducted to determine the relationship between causality language and article characteristics including the journal of publication.

RESULTS: There were 65 eligible articles. 67.7% of titles and abstracts were considered either consistently causal or inconsistently causal in language and inference. When reviewing the full text, 69.2% contained some degree of causal language (38.5% consistently causal, 30.8% inconsistently causal). There were no statistically significant associations between the journal and title and abstract final grading (p = 0.863) or the journal and full text grading (p = 0.726).

CONCLUSION: The use of causal language remains highly prevalent in observational database studies related to shoulder arthroplasty. Understanding the limitations of observational database studies is paramount for accurate interpretation of these publications.

PMID:36935077 | DOI:10.1016/j.jse.2023.02.126

Am J Kidney Dis. 2023 Mar 17:S0272-6386(23)00574-7. doi: 10.1053/j.ajkd.2023.01.442. Online ahead of print.

ABSTRACT

RATIONALE & OBJECTIVE: The heart-kidney crosstalk is recognized as the cardiorenal syndrome. We examined the association of cardiac function and structure with the risk of kidney failure with replacement therapy (KFRT) in a chronic kidney disease (CKD) population.

STUDY DESIGN: Prospective observational cohort study.

SETTING & PARTICIPANTS: 3,027 participants from the Chronic Renal Insufficiency Cohort Study.

EXPOSURES: Five pre-selected variables that assess different aspects of cardiac structure and function: left ventricular mass index (LVMI), LV volume, left atrial (LA) area, peak tricuspid regurgitation (TR) velocity, and left ventricular ejection fraction (EF) as assessed by echocardiography.

OUTCOMES: Incident KFRT (primary outcome), and annual eGFR slope (secondary outcome).

ANALYTICAL APPROACH: Multivariable Cox models and mixed-effects models.

RESULTS: Mean age was 59 (SD 11) years, 54% were men, and mean eGFR was 43 (17) ml/min/1.73m². Between 2003 and 2018 (median follow-up, 9.9 years), 883 participants developed KFRT. Higher LVMI, LV volume, LA area, peak TR velocity, and lower EF were each statistically significantly associated with an increased risk of KFRT, with corresponding HRs for the highest vs. lowest quartiles (lowest vs. highest for EF) of 1.70 (95%CI, 1.27 to 2.26), 1.50 (1.19 to 1.90), 1.43 (1.11 to 1.84), 1.45 (1.06 to 1.96), and 1.26 (1.03 to 1.56), respectively. For secondary outcome, participants in the highest vs. lowest quartiles (lowest vs. highest for EF) had a statistically significantly faster eGFR decline, except for LA area (ΔeGFR slope per year, -0.57 [95%CI, -0.68 to -0.46] mL/min/1.73m² for LVMI, -0.25 [-0.35 to -0.15] mL/min/1.73m² for LV volume, -0.01 [-0.12 to -0.01] mL/min/1.73m² for LA area, -0.42 [-0.56 to -0.28] mL/min/1.73m² for peak TR velocity, and -0.11 [-0.20 to -0.01] mL/min/1.73m² for EF, respectively).

LIMITATIONS: The possibility of residual confounding.

CONCLUSIONS: Multiple aspects of cardiac structure and function were statistically significantly associated with the risk of KFRT. These findings suggest that cardiac abnormalities and incidence of KFRT are potentially on the same causal pathway related to the interaction between hypertension, heart failure, and coronary artery diseases.

PMID:36935072 | DOI:10.1053/j.ajkd.2023.01.442

Brain Behav. 2023 Mar 19:e2947. doi: 10.1002/brb3.2947. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Randomized controlled trials and observational studies of nabiximols oromucosal spray in patients with multiple sclerosis (MS) spasticity have shown improvement in a range of associated symptoms (pain, spasms, fatigue, bladder dysfunction, and sleep disturbances). This study evaluated the effectiveness and tolerability of add-on nabiximols in the routine management of patients with MS spasticity in Austria, with a focus on spasticity-associated symptoms.

METHODS: This was an open, prospective, multicenter, observational, non-interventional study of patients with MS spasticity receiving add-on treatment with nabiximols oromucosal spray. Main endpoints were patient-reported changes from baseline in the frequency (counts) or severity (mean Numerical Rating Scale [NRS] scores) of spasticity-associated symptoms, and patient-reported changes from baseline in impairment of daily activities due to spasticity, after 1 and 3 months of nabiximols treatment. No analyses were conducted for statistical significance.

RESULTS: There were 55 patients in the effectiveness population, and 62 in the safety population. Patients reported clinically relevant reductions from baseline to month 3 in the average number of spasms/day (-68.2%) and number of urinary incontinence episodes (-69.3%) in the week prior to the clinic visit, and reductions in mean 0-10 NRS scores for sleep impairment (-47.2%), fatigue (-26.4%), pain (40.4%), and spasticity severity (39.0%). There was no change from baseline in daily activity impairment due to spasticity. The majority of patients were at least partly satisfied with add-on nabiximols for spasticity-associated symptoms. There were 31 adverse events (27 treatment related) reported in 19 patients, with no new safety signals.

CONCLUSIONS: Add-on nabiximols improved the severity of MS spasticity and a range of spasticity-associated symptoms during real-world use in Austria. Nabiximols is an option for patients with MS spasticity who fail first-line oral antispasticity treatment.

PMID:36934456 | DOI:10.1002/brb3.2947

Clin Exp Dent Res. 2023 Mar 19. doi: 10.1002/cre2.719. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose was to conduct a comprehensive study of malocclusions and oral dysfunctions on 11-year-old children and to study the risk factors associated with malocclusions.

MATERIAL AND METHODS: A cross-sectional descriptive epidemiological survey was conducted among 359 children in France. A clinical examination was conducted, and orthodontic and oral functional data were collected. In addition, the need for orthodontic treatment was evaluated using the criteria defined by of the French National Authority for Health (HAS). Finally, a univariate and multivariate analysis was performed to assess the risks associated with malocclusions.

RESULTS: Most children (88%) exhibited a malocclusion, regardless of gender (p = .912). The examination of oral functions identified a large number of swallowing (87%) and respiration (42.7%) disorders. The presence of malocclusion was statistically linked to the low position of the tongue at rest (p < .001), abnormal swallowing (p = .03), and improper mouth breathing (p = .001). After a multivariate analysis, the type of respiration (odds ratio [OR] = 3.2 [1.4-7.3]) and the position of tongue at rest (OR = 3.43 [1.7-7.1]) were the two most prominent factors in the prediction of emerging malocclusion.

CONCLUSION: This epidemiological survey reveals a high prevalence of dental malocclusions and functional disorders. Oral respiration and the low position of the tongue at rest are the most important factors in the prediction of a malocclusion.

PMID:36934443 | DOI:10.1002/cre2.719

Cancer Med. 2023 Mar 19. doi: 10.1002/cam4.5801. Online ahead of print.

ABSTRACT

Salivary gland malignancies are rare and are often acompanied by poor prognoses. So, identifying the populations with risk factors and timely intervention to avoid disease progression is significant. This study provides an effective prediction model to screen the target patients and is helpful to construct a cost-effective follow-up strategy. We enrolled 249 patients diagnosed with salivary gland tumors and analyzed prognostic risk factors using Cox proportional hazard univariable and multivariable regression models. The patients’ data were split into training and validation sets on a 7:3 ratio, and the random survival forest (RSF) model was established using the training sets and validated using the validation sets. The maximally selected rank statistics method was used to determine a cut point value corresponding to the most significant relation with survival. Univariable Cox regression suggested age, smoking, alcohol consumption, untreated, neural invasion, capsular invasion, skin invasion, tumors larger than 4 cm, advanced T and N stage, distant metastasis, and non-mucous cell carcinoma were risk factors for poor prognosis, and multivariable analysis suggested that female, aging, smoking, untreated, and non-mucous cell carcinoma were risk factors. The time-dependent ROC curve showed the AUC of the RSF prediction model on 1-, 2-, and 3-year survival were 0.696, 0.779, and 0.765 respectively in the validation sets. Log-rank tests suggested that the cut point 7.42 risk score calculated from the RSF was most effective in dividing patients with significantly different prognoses. The prediction model based on the RSF could effectively screen patients with poor prognoses.

PMID:36934429 | DOI:10.1002/cam4.5801

Ann Intensive Care. 2023 Mar 19;13(1):20. doi: 10.1186/s13613-023-01111-2.

NO ABSTRACT

PMID:36934400 | DOI:10.1186/s13613-023-01111-2