Nevin Manimala

Rapid Commun Mass Spectrom. 2021 Dec 13:e9238. doi: 10.1002/rcm.9238. Online ahead of print.

ABSTRACT

RATIONALE: The Sm₂ O₃ -ZrO₂ -HfO₂ system is a promising base for development of a wide spectrum of new refractory materials. Reliable data on thermodynamic properties in this system are of significant importance for planning the preparation and application of the high temperature ceramics. Especially, they can be useful for calculation of the unknown phase equilibria in this system.

METHODS: Thermodynamic properties of the Sm₂ O₃ -ZrO₂ -HfO₂ system were studied by the high temperature mass spectrometric method. The samples in the system under consideration synthesized by the solid-state method were vaporized from a tungsten twin effusion cell using a MS-1301 magnetic sector mass spectrometer. Ionization of the vapor species effusing from the cell was carried out by electrons at an energy of 25 eV.

RESULTS: It was shown that, at temperatures below 2500 K, the main vapor species over the ceramics based on the Sm₂ O₃ -ZrO₂ -HfO₂ system were SmO, Sm, and O corresponding to vapor composition over pure Sm₂ O₃ . The SmO, Sm, and O partial vapor pressures over the samples and the Sm₂ O₃ activities were obtained in the temperature range 2319-2530 K. This allowed the excess Gibbs energy values to be determined. For comparison, the excess Gibbs energies in the Sm₂ O₃ -ZrO₂ -HfO₂ system were also calculated by the semi-empirical Kohler, Toop, Redlich-Kister, and Wilson methods and optimized by the statistical thermodynamic Generalized Lattice Theory of Associated Solutions.

CONCLUSIONS: The thermodynamic data calculated by the semi-empirical approaches at 2423 K were shown to be lower than the experimental values. However, the Toop and Wilson methods were found to be useful for evaluation of the excess Gibbs energy values at the Sm₂ O₃ mole fraction less and higher than 0.32, respectively. The self-consistent thermodynamic description of the Sm₂ O₃ -ZrO₂ -HfO₂ system was derived at high temperatures by optimization of the experimental results using the Generalized Lattice Theory of Associated Solutions.

PMID:34902877 | DOI:10.1002/rcm.9238

Eur J Dent. 2021 Dec 13. doi: 10.1055/s-0041-1736331. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined the effectiveness of different functional monomers in universal adhesives on zirconia/resin composite bond strength both before and after thermocycling. Four universal adhesives (G-premio bond universal, GPU; Clearfil Tri-S bond universal, CTB; Optibond Universal, OBU; Tetric N-bond universal; TNU), one adhesive (single bond 2; SB2), and one ceramic primer (Clearfil ceramic primer plus, CCP) were used in this study.

MATERIALS AND METHODS: Zirconia discs were prepared and embedded in acrylic. Specimens were polished and sandblasted with alumina. The specimens were randomly divided into two groups (24 hours and the thermocycled), and each group was divided into six subgroups (n = 10), according to zirconia surfaces treatments: no Tx, CCP + SB2, GPU, CTB, OBU, TNU. An Ultradent mold was located on top of the treated zirconia surface. The resin composite was filled into the mold and then light-cured. A universal testing device was used to determine the shear bond strength.

STATISTICAL ANALYSIS: The data were statistically analyzed using one-way ANOVA and Tukey’s test.

RESULTS: After water storage for 24 hours, the shear bond strengths were GPU > CCP + SB2 = CTB = OBU = TNU > no Tx (p < 0.05). After thermocycling, the shear bond strengths were CCP + SB2 = GPU = CTB = TNU > OBU > no Tx (p < 0.05).

CONCLUSION: The universal adhesives containing 10-MDP exhibited the best performance in the shear bond strength of the zirconia/resin composite interface both before and after thermocycling.

PMID:34902875 | DOI:10.1055/s-0041-1736331

Eur J Dent. 2021 Dec 13. doi: 10.1055/s-0041-1736388. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was developed to evaluate the influence of voxel size on bone measurements for implant planning.

MATERIALS AND METHODS: The research was performed by using edentulous synthetic human mandibles with different levels of bone resorption. For each mandible, height and bone thickness were measured with a digital caliper. The PaX-i3d device was used to acquire the volumes of the five mandibles, with 50kVp, 4 mA, and a voxel size of 0.08 mm. After the acquisition, the images were reconstructed in the software CS three-dimensional Imaging, with four different sizes of voxels: 0.1, 0.2, 0.3, and 0.4 mm. All volumes were analyzed by a single evaluator who performed measurements to obtain bone height and thickness, using the reference points that were considered in obtaining the gold standard. The data were analyzed by ANOVA with a significance level of 5%.

RESULTS: There was no significant difference in the measurements obtained with different voxel sizes, both for bone height measurements and bone thickness. There was no statistically significant difference in measurements in thickness in comparison to the gold standard.

CONCLUSION: When necessary, to measure height and bone thickness, it is possible to recommend voxel images of larger size (0.40 mm) without compromising the quality of the patient’s clinical planning.

PMID:34902874 | DOI:10.1055/s-0041-1736388

Am J Perinatol. 2021 Dec 13. doi: 10.1055/s-0041-1740193. Online ahead of print.

ABSTRACT

OBJECTIVE: Inflammatory bowel disease (IBD) reproductive health counseling is associated with higher knowledge, lower voluntary childlessness, greater medication adherence during pregnancy, and improved outcomes of pregnancy. Our aims were to assess counseling and knowledge about IBD and reproductive health in a tertiary care IBD patient population.

STUDY DESIGN: We anonymously surveyed women and men ages 18 to 45 cared for at the Stanford IBD clinic about reproductive health and administered the CCPKnow questionnaire. STATA was used to summarize descriptive statistics and compare categorical variables using Fisher’s exact test.

RESULTS: Of the 100 patients (54% women) who completed the survey, only 33% reported prior reproductive health counseling. Both men and women considered not having a child due to IBD (31% women, 15% men) and most (83%) had no prior counseling. A minority of patients had an adequate (>8/17) CCPKnow score (45% women, 17% men). The majority of women with prior pregnancy had pre-existing IBD (67%), yet many did not seek gastrointestinal (GI) care (38% preconception, 25% during pregnancy) and 33% stopped/changed medications, with 40% not discussing this with a physician. Prior counseling was significantly associated with education level (p = 0.013), biologic use (p = 0.003), and an adequate CCPKnow score (p = 0.01). Overall, 67% of people wanted more information on IBD and reproductive health.

CONCLUSION: In an educated tertiary care cohort, the majority of patients had low CCPKnow scores and rates of IBD reproductive health counseling. Many patients with IBD prior to pregnancy reported no GI care preconception or during pregnancy and stopped/changed medications without consulting a physician. There is an urgent need for proactive counseling by gastroenterologists and obstetricians on IBD and reproductive health.

KEY POINTS: · There is inadequate reproductive health counseling in IBD.. · Many IBD patients do not seek prenatal/perinatal GI care.. · Patients change medications without consultation.. · GIs and OBs should proactively counsel IBD patients..

PMID:34902866 | DOI:10.1055/s-0041-1740193

J Athl Train. 2021 Dec 13. doi: 10.4085/1062-6050-733-20. Online ahead of print.

ABSTRACT

CONTEXT: Research has demonstrated individuals with chronic ankle instability (CAI) present with alterations in the compositional structure of the talar articular cartilage. These alterations likely influence how the talar cartilage responds to loading associated with activities of daily living, such as walking. Ultrasonography has emerged as an alternative imaging modality to assess the amount of cartilage deformation in response to loading because it can be clinically accessible and cost-effective for routine measurements.

OBJECTIVE: To compare talar cartilage deformation in response to a standardized exercise protocol between those with and without chronic ankle instability. Secondly, to examine the association between spatiotemporal walking gait parameters and cartilage deformation.

DESIGN: Case-control.

SETTING: Research Laboratory.

PATIENTS OR OTHER PARTICIPANTS: A volunteer sample of 24 participants with self-reported CAI (age = 23.2 ± 3.9 years; BMI = 25.1 ± 3.7 kg/m2) and 24 un-injured controls (age = 24.3 ± 2.9 years; BMI = 22.9 ± 2.8 kg/m2).

MAIN OUTCOME MEASURE(S): Spatiotemporal walking gait was first assessed from five self-selected trials using an electronic walkway with data sampled at 120Hz. An 8-to-13MHz linear-array ultrasound transducer placed transversely in line with the medial and lateral malleoli captured three images before and after a standardized loading protocol consisting of 30 single and double-limb squats, 2-minute single-limb balance and 10 single-leg drops from a 40cm height box.

RESULTS: After controlling for body mass index, participants with chronic ankle instability had greater deformation compared to the un-injured controls (p=0.034). No other significant between group differences were observed (p>0.05). No significant partial correlations were observed between talar cartilage deformation and spatiotemporal gait parameters when controlling for body mass index (p>0.05).

CONCLUSIONS: Individuals with CAI had greater talar cartilage deformation in response to a standardized exercise protocol than controls. The amount of talar cartilage deformation was not associated with spatiotemporal walking gait.

PMID:34902859 | DOI:10.4085/1062-6050-733-20

Am J Trop Med Hyg. 2021 Dec 13:tpmd210261. doi: 10.4269/ajtmh.21-0261. Online ahead of print.

ABSTRACT

Cystic echinococcosis (CE) is a zoonosis with a cosmopolitan distribution caused by Echinococcus granulosus sensu lato tapeworms. Although Uzbekistan and other countries in Central Asia are considered endemic, estimates of disease burden are lacking. We present data regarding surgically managed cases of CE obtained from Uzbekistan’s national disease surveillance registry. These data are from medical centers in Uzbekistan authorized to treat the disease and reported to the Uzbek Center for Sanitation and Epidemiology from the period 2011 to 2018. Information included data regarding the patient age class (children 14 years or younger), but no data regarding the cyst location. Incidence rates were calculated using data from the national population registry, and the Cuzick nonparametric test for trends was used to test for differences in the incidence over time at the country level and regional levels. A total of 7,309 CE cases were reported. Of these, 857 (11.73%) involved pediatric patients. The mean incidence rates were 4.4 per 100,000 population in 2011 and 2.3 per 100,000 population in 2018 (P = 0.016). One region (Republic of Karalpakistan) showed a nonstatistically significant increase (P = 0.824). All other regions except three showed a statistically significant decrease. We present the decrease in the incidence of surgically treated CE in Uzbekistan from 2011 to 2018. However, the presence of cases involving children suggest ongoing parasite transmission. The absence of clinical information (starting with cyst stage and localization) needs to be addressed to improve the national surveillance system. Field studies are also needed to further explore the epidemiology of CE in the country.

PMID:34902836 | DOI:10.4269/ajtmh.21-0261

Sleep Med Rev. 2021 Nov 26;61:101573. doi: 10.1016/j.smrv.2021.101573. Online ahead of print.

ABSTRACT

The efficacy and safety of dual orexin receptor antagonists (DORAs) for primary insomnia have been well verified in several large randomized controlled trials (RCTs) over the past several decades. However, there have been few systematic comparisons of different DORAs, and the best DORA for insomniacs has remained unclear. Here, Medline, Embase, Cochrane library, and clinicaltrials.gov were searched for RCTs (through December 31, 2020) to evaluate different DORAs versus a placebo. We pooled data from 13 RCTs. DORAs were superior to the placebo in all efficacy outcomes except the subjective number of awakenings (P = 0.90), but also showed higher risks of somnolence, abnormal dreams, fatigue, and dry mouth (somnolence: P < 0.00001; abnormal dreams: P = 0.03; fatigue: P = 0.001; dry mouth: P = 0.007). No statistical differences were found between any two of the DORAs in terms of primary efficacy outcomes. However, lemborexant yielded the three-highest surfaces under the curve ranking area (SUCRA) values (78.25%, 96.25% and 89.13%). Taken together, we conclude that DORAs are superior to the placebo in terms of efficacy and safety measures.

PMID:34902823 | DOI:10.1016/j.smrv.2021.101573

Sleep Med Rev. 2021 Nov 11;61:101569. doi: 10.1016/j.smrv.2021.101569. Online ahead of print.

ABSTRACT

Insomnia (ID) is the most common sleep disorder; however pathogenetic mechanisms underlying ID symptoms are not fully understood. Adopting a multifactorial view and considering ID a condition that involves interregional neuronal coordination would be useful to understand the ID pathophysiology. Functional connectivity (FC) may help to shed light on functional processes and neural correlates underlying ID symptoms. Despite a growing number of studies assessing FC anomalies, insight into ID pathophysiology is still fragmentary. This systematic review aims to search empirical evidence regarding FC changes in ID during resting-state. Thirty-one studies involving 1052 ID participants met the inclusion criteria for this review. Results suggested several associations between ID symptoms and impaired intra- and inter-hemispheric interactions of principal resting-state networks. Overall, evidence supported the hypothesis that a disrupted organization of the brain functional connectome characterizes ID, resulting in a decline in sleep, cognition, emotion, and memory. However, the wide methodological heterogeneity between reviewed studies and limitations in terms of study protocols and statistical approaches raised from this systematic review, makes it difficult to provide a univocal framework of ID pathophysiology. Future researches in this field should lead towards shared and rigorous search designs to ensure solid research evidence in the ID pathophysiology.

PMID:34902821 | DOI:10.1016/j.smrv.2021.101569

Value Health Reg Issues. 2021 Dec 10;29:93-99. doi: 10.1016/j.vhri.2021.10.001. Online ahead of print.

ABSTRACT

OBJECTIVES: Reducing healthcare costs is a constant endeavor of all healthcare organizations, governments, policy makers, and individuals. A comparative study of available healthcare policies from the patient’s perspective is not available. Furthermore, an analysis of how the various components of these policies affect the healthcare cost of a patient is required.

METHODS: Data were collected from 150 hospitalized patients in India regarding their views on 7 healthcare cost categories covering 22 cost components. These are statistically analyzed under 4 commonly used health insurance policies (2 government insurance schemes: ex-servicemen contributory health scheme and employee state insurance; private insurance schemes; and self-financing-ie, no insurance) to assess which healthcare cost component is more important under which policy option.

RESULTS: Under 7 healthcare cost categories, 22 cost components were studied, and out of these 22, 16 were found statistically significant. Results revealed that the treatment of all 16 significant cost components under the 4 health insurance policy options was statistically different.

CONCLUSIONS: Patients covered under government sector health insurance policies were found to be less concerned about healthcare costs, whereas those covered under private health insurance policies were found to be more cost-conscious. Access to healthcare or transportation costs to the healthcare facility is a key concern area for self-financed patients.

PMID:34902812 | DOI:10.1016/j.vhri.2021.10.001

Heart Lung. 2021 Dec 10;52:71-75. doi: 10.1016/j.hrtlng.2021.11.013. Online ahead of print.

ABSTRACT

BACKGROUND: Sarcopenia, or skeletal muscle depletion, was common in the elderly and often led to a poor prognosis of diseases. The area of the psoas muscle in abdominal computed tomography (CT) is the most common used for diagnosing sarcopenia. However, patients with pneumonia routinely only undergo chest CT.

OBJECTIVES: This study aimed to determine whether paraspinal muscle area (PMA) obtained by chest CT can predict death for community-acquired pneumonia (SCAP) patients entering intensive care unit (ICU).

METHODS: This study enrolled 208 SCAP patients admitted to ICU after undergoing chest CT. PMA, paraspinal muscle radiodensity (PMD), and lean paraspinal muscle area (LPMA) were calculated on chest CT images. The main outcome was mortality during hospitalization. Logistic regression, receiver operating characteristic (ROC) curve, and Kaplan-Meier curves were used to evaluate forecasting effectiveness.

RESULTS: The primary outcome occurred in 76 (36.53%) patients. In multivariate logistic regression, PMA, lactic dehydrogenase (LDH), invasive mechanical ventilation (IMV), red blood cell (RBC) and age≥ 65 years were independent risk factors predicting death during hospitalization (adjusted Odds Ratio [OR]: 0.886, 1.002, 3.178, 0.612 and 2.003, respectively). The area under curve (AUC) of PMA to predict death was 0.720 (P< 0.001). During hospitalization, the median survival time of high-PMA (51.00 days) and low-PMA groups (20.00 days) was statistically significant (P< 0.001).

CONCLUSION: Lower PMA was associated with an increased risk of death for SCAP patients admitted to the ICU. In other words, PMA may help early identify adverse prognosis of SCAP patients admitted to ICU.

PMID:34902778 | DOI:10.1016/j.hrtlng.2021.11.013