Nevin Manimala

Curr Cardiol Rev. 2022;18(6):e280422204203. doi: 10.2174/1573403X18666220428115520.

ABSTRACT

INTRODUCTION: Coronary bifurcation lesions (CBL) are one fifth of all coronary lesions and they do not have an optimal strategy for stenting yet. Bioresorbable scaffolds (BRS) are novel inventions proposed to be the optimal solution. The aim of this systematic review was to assess the role of BRS in treating CBL by comparing it to dedicated bifurcation stents (DBS).

METHODS: A systematic review was conducted following the PRISMA guidelines, searching databases such as ScienceDirect, EMBASE, MEDLINE, NIH, TRIP, PUBMED, and ClinicalTrials. gov. The risk of bias was assessed by MINORS and modified Cowley’s criteria. Q statistic was used for heterogeneity testing and a meta-analysis was conducted using the “meta” package in the R software application.

RESULTS: Fourteen studies were included with an average follow-up period of twelve months. Almost 80% of the participants were male (p-value= 0.148) and around two-thirds were smokers. Meta-analysis was performed for myocardial infarction (MI), target lesion revascularisation (TLR), major adverse cardiac events (MACE), and stent thrombosis (ST). These showed statistically nonsignificant differences, with a slight trend favouring BRS except with stent thrombosis.

CONCLUSION: There is a lack of randomised trials on the topic, which may be an area for further research. But the results showed favourable yet statistically insignificant outcomes for BRS except for ST, an issue that can be addressed with technological advancement.

PMID:36415952 | DOI:10.2174/1573403X18666220428115520

J Adolesc. 2022 Nov 22. doi: 10.1002/jad.12123. Online ahead of print.

ABSTRACT

INTRODUCTION: Expressive flexibility, or the ability to both up- and down-regulate emotional expressions in social interactions, is thought as an indicator and a consequence of healthy interpersonal relationships. The present longitudinal study examined bidirectional associations between expressive flexibility and friendship quality in early adolescence. Since prior research found inconsistent results regarding the adaptiveness of expressive flexibility, which indicated the necessity to consider individual variability in the process, we further tested the potential moderating effect of social anxiety in the links from expressive flexibility to friendship quality.

METHODS: Participants from two junior high schools in eastern China (N = 274; 50.4% female; M_age = 13.56) were surveyed at three time points with 6-month intervals. Expressive flexibility, friendship quality, and social anxiety were all assessed via self-reported scales.

RESULTS: According to the cross-lagged model results, friendship quality significantly predicted increased expressive flexibility over time. Conversely, the longitudinal association from expressive flexibility to friendship quality was not significant, but the interaction between expressive flexibility and social anxiety significantly predicted later friendship quality. Further analyses via the Johnson-Neyman technique revealed that expressive flexibility only positively predicted friendship quality for adolescents with lower levels of social anxiety.

CONCLUSION: Our results suggest that expressive flexibility is not always socially adaptive, so practical interventions that aim to improve youths’ social adjustment via expressive flexibility training might need to consider the role of individual characteristics.

PMID:36415946 | DOI:10.1002/jad.12123

Prostate. 2022 Nov 22. doi: 10.1002/pros.24463. Online ahead of print.

ABSTRACT

INTRODUCTIONS: The American Society of Anesthesiologists Physical Status Classification System (ASA) is a validated risk stratification method for patients undergoing surgery. There is an increased prevalence of benign prostatic hyperplasia and comorbidities in our aging population. The role of ASA related to postoperative complications in patients undergoing holmium laser enucleation of the prostate (HoLEP) has not been described.

METHODS: A review of our database was performed for patients who underwent HoLEP from July 2018 to December 2020. Patients were stratified based on ASA score. Preoperative, perioperative, and complication data were analyzed using SAS analytics software.

RESULTS: Of 472 patients undergoing HoLEP, 320 (67.8%) were ASA 3-4 patients. There was a statistically significant difference found in age (72.3 ± 9.8 vs. 69.1 ± 9.0 years, p < 0.001), body mass index (BMI) (29.0 ± 5.9 vs. 27.3 ± 4.2, p = 0.004), and use of antiplatelet/anticoagulant medications (14.6% vs. 2.6%, p < 0.001) in the ASA 3-4 group. There was no significant difference between prostate volume (p = 0.158) or catheter-dependent urinary retention (p = 0.376). No difference was found in enucleation time (52.76 ± 24.8 vs. 54.16 ± 23.7 min, p = 0.587), OR specimen weight (70.24 ± 58.5 vs. 81.53 ± 65.9, p = 0.094). or intraoperative complications (2.8% vs. 1.3%, p = 0.330). There were higher postoperative complications in the ASA 3-4 group (12.8% vs. 7.9%, p = 0.03), but no difference in Clavien ≥3 complications (p = 0.068). ASA 3-4 patients had similar postoperative international prostate symptom score (p = 0.159).

CONCLUSION: HoLEP is feasible and effective in patients who are ASA 3-4. The high-risk cohort had an increased rate of low-grade complications. Patients with an ASA score of 3-4 should be counseled regarding a higher rate of low-grade complications.

PMID:36415930 | DOI:10.1002/pros.24463

J Esthet Restor Dent. 2022 Dec;34(8):1238-1246. doi: 10.1111/jerd.12954. Epub 2022 Aug 17.

ABSTRACT

OBJECTIVE: To compare in vitro the accuracy of fit of a reference prosthesis seated on three-dimensional (3D) printed casts generated from digital implant scans vs stone casts made by conventional implant impressions.

MATERIAL AND METHODS: A partially edentulous maxillary master cast with two internal connection implants was generated, while a reference implant-supported prosthesis was fabricated. Conventional splinted open-tray impressions were taken to create stone casts (n = 10) (control group). A digital scan was taken of the master cast using a white light intraoral optical scanner (IOS) (TRIOS, 3Shape), and a Standard Tessellation Language (STL) file was obtained. Four 3D printers were used to print the casts (n = 10 from each 3D printer): Straumann® P30+, Varseo S, Form 3b+and M2 Carbon. Accuracy of fit of the reference prosthesis on all control and test casts was assessed using the screw resistance test and radiographic test. Additionally, all casts were digitized using the same IOS, and the STL files were superimposed to the master cast STL file (reference) to evaluate the 3D accuracy with inspection Geomagic Control software using the root-mean-square (RMS) error.

RESULTS: The reference prosthesis presented with clinically acceptable fit on all casts. The highest median RMS error was found in the stone cast group (94.6 μm) while the lowest median was in the M2 Carbon group (46.9 μm). The Kruskal-Wallis test revealed a statistically significant difference between the groups (p < 0.001). For post hoc comparisons, Dunn’s test with the Holm-Bonferroni correction resulted in a statistically significant difference in four tests, with M2 Carbon exhibiting lower RMS error than the stone cast (p < 0.001) and P30+ (p < 0.001) groups, Form 3b exhibiting lower RMS error than the stone cast (p < 0.001) group, and Varseo S exhibiting lower RMS error than the stone cast (p = 0.006) group.

CONCLUSION: Using the screw-resistance test and radiographic assessment, the reference prosthesis fit presented with clinically acceptable accuracy of fit on all casts. Printed casts from 3 different printers demonstrated statistically significant lower 3D deviations than stone casts generated using a conventional implant impression for the present partially edentulous scenario with two implants, but this did not affect prosthesis fit.

CLINICAL SIGNIFICANCE: Even though there were 3D deviations between the master cast and all control and test casts generated from conventional impressions and digital scans respectively, the reference prosthesis presented with accurate fit on all casts. This indicates that there is a threshold for clinically acceptable accuracy of fit and that 3D-printed casts may be used as definitive master casts to fabricate implant-supported fixed dental prostheses for the partially edentulous anterior maxilla.

PMID:36415927 | DOI:10.1111/jerd.12954

Acta Orthop. 2022 Nov 22;93:849-853. doi: 10.2340/17453674.2022.5255.

ABSTRACT

BACKGROUND AND PURPOSE: The incidence of primary and revision total hip arthroplasty (THA) has increased over the last decades. Previous forecasts from different healthcare systems have predicted a continuous increase. We present a forecast of both primary and revision surgery from 2020 to 2050 based on 25 years data from the healthcare system in Denmark.

PATIENTS AND METHODS: We retrieved data from the Danish Hip Arthroplasty Register on 198,835 primary and 29,456 revision surgeries. Historical censuses and population forecasts were retrieved from Statistics Denmark. Logistic and Gompertz regression analysis was used to forecast incidence rates (IR) and total numbers in the next 30 years.

RESULTS: Our forecast predicts an increase in IR of 3-9% and an increase in total numbers of primary THA of between 12% and 19% in 2050. For revision THA the IRs have reached a plateau but total numbers are predicted to increase by 19% in 2050.

CONCLUSION: Our forecast shows that both primary and revision THA will increase in total numbers in the next decades, but the IR for primary THA is near its plateau and for revision THA the plateau has already been reached. The forecast may aid in healthcare resource planning for the decades to come.

PMID:36415903 | DOI:10.2340/17453674.2022.5255

J Biol Rhythms. 2022 Nov 22:7487304221134330. doi: 10.1177/07487304221134330. Online ahead of print.

ABSTRACT

Late sleep timing is prevalent in early childhood and a risk factor for poor behavioral and health outcomes. Sleep timing is influenced by the phase of the circadian clock, with later circadian timing linked to delayed sleep onset in young children. Light is the strongest zeitgeber of circadian timing and, in adults, evening light produces circadian phase delay in an intensity-dependent manner. The intensity-dependent circadian phase-shifting response to evening light in children, however, is currently unknown. In the present study, 33 healthy, good-sleeping children aged 3.0 to 4.9 years (M = 4.14 years, 39% male) completed a 10-day between-subjects protocol. Following 7 days of a stable sleep schedule, an in-home dim-light circadian assessment was performed. Children remained in dim-light across 3 days (55 h), with salivary melatonin collected in regular intervals throughout each evening. Phase-shifting effects of light exposure were determined via changes in the timing of the dim-light melatonin onset (DLMO) prior to (Day 8) and following (Day 10) a light exposure stimulus. On Day 9, children were exposed to a 1 h light stimulus in the hour before their habitual bedtime. Each child was randomly assigned to one intensity between 5 and 5000 lux (4.5-3276 melanopic EDI). Across light intensities, children showed significant circadian phase delays, with an average phase delay of 56.1 min (SD = 33.6 min), and large inter-individual variability. No relationship between light intensity and magnitude of the phase shift was observed. However, a greater percentage of melatonin suppression during the light exposure was associated with a greater phase delay (r = -0.73, p < 0.01). These findings demonstrate that some young children may be highly sensitive to light exposure in the hour before bedtime and suggest that the home lighting environment and its impact on circadian timing should be considered a possible contributor to behavioral sleep difficulties.

PMID:36415902 | DOI:10.1177/07487304221134330

Arthritis Rheumatol. 2022 Nov 22. doi: 10.1002/art.42381. Online ahead of print.

ABSTRACT

OBJECTIVES: Few data are available on whether changes in metabolic syndrome (MetS) affect incident gout. We investigated associations among MetS changes and incident gout in a young male cohort.

METHODS: This nationwide population-based cohort study included 20-39-year-old men who participated in serial health check-ups. The outcome, incident gout, was defined by the claims database diagnostic code for gout. Associations among MetS changes and incident gout were analyzed with Cox proportional hazard models.

RESULTS: Among 1,293,166 subjects, 18,473 were diagnosed with gout (incidence rate 3.36/1,000 person-years). Subjects who were MetS-chronic (MetS at all three health check-ups) had nearly four-fold higher risk of incident gout than subjects who were MetS-free (no MetS at all three health check-ups; aHR [95% CI] 3.82 [3.67-3.98]). Development of MetS more than doubled the risk of incident gout (aHR 2.31 [2.20-2.43]). Conversely, recovery from MetS reduced incident gout risk by nearly half (aHR 0.52 [0.49-0.56]). Among MetS components, changes in elevated triglycerides (development, aHR 1.74 [1.66-1.81]; recovery, aHR 0.56 [0.54-0.59]) and abdominal obesity (development, aHR 1.94 [1.85-2.03]; recovery, aHR 0.69 [0.64-0.74]) showed the greatest association with altered risk of incident gout. Associations among MetS changes and incident gout were more pronounced in subjects in their 20s than subjects in their 30s and in subjects who were under- or normal weight.

CONCLUSIONS: Changes in MetS status were associated with altered risk of incident gout. These results suggest that MetS is a modifiable risk factor for gout.

PMID:36415898 | DOI:10.1002/art.42381

Ecol Evol. 2022 Nov 18;12(11):e9499. doi: 10.1002/ece3.9499. eCollection 2022 Nov.

ABSTRACT

Fishes have repeatedly evolved characteristic body shapes depending on how close they live to the substrate. Pelagic fishes live in open water and typically have narrow, streamlined body shapes; benthic and demersal fishes live close to the substrate; and demersal fishes often have deeper bodies. These shape differences are often associated with behavioral differences: pelagic fishes swim nearly constantly, demersal fishes tend to maneuver near the substrate, and benthic fishes often lie in wait on the substrate. We hypothesized that these morphological and behavioral differences would be reflected in the mechanical properties of the body, and specifically in vertebral column stiffness, because it is an attachment point for the locomotor musculature and a central axis for body bending. The vertebrae of bony fishes are composed of two cones connected by a foramen, which is filled by the notochord. Since the notochord is more flexible than bony vertebral centra, we predicted that pelagic fishes would have narrower foramina or shallower cones, leading to less notochordal material and a stiffer vertebral column which might support continuous swimming. In contrast, we predicted that benthic and demersal fishes would have more notochordal material, making the vertebral column more flexible for diverse behaviors in these species. We therefore examined vertebral morphology in 79 species using micro-computed tomography scans. Six vertebral features were measured including notochordal foramen diameter, centrum body length, and the cone angles and diameters for the anterior and posterior vertebral cones, along with body fineness. Using phylogenetic generalized least squares analyses, we found that benthic and pelagic species differed significantly, with larger foramina, shorter centra, and larger cones in benthic species. Thus, morphological differences in the internal shape of the vertebrae of fishes are consistent with a stiffer vertebral column in pelagic fishes and with a more flexible vertebral column in benthic species.

PMID:36415873 | PMC:PMC9674476 | DOI:10.1002/ece3.9499

J Matern Fetal Neonatal Med. 2022 Nov 22:1-9. doi: 10.1080/14767058.2022.2150073. Online ahead of print.

ABSTRACT

PURPOSE: Adiponectin may be an important indicator in the regulation of fetal and neonatal growth due to its metabolism, energy balance, and insulin-sensitizing action. The current study’s goal was to determine if there is a link between adiponectin +276 G/T gene polymorphism and serum adiponectin level in newborns classified as appropriate for gestational age (AGA), small for gestational age (SGA), or large for gestational age (LGA).

METHODS: The study included newborns classified as AGA (n = 65), SGA (n = 65), or LGA (n = 65) according to their gestational age or birth weight. To determine the presence of adiponectin +276 G/T gene polymorphism, genotyping was done using polymerase chain reaction-restriction fragment length polymorphism. Enzyme-linked immunosorbent assay was used to determine the level of adiponectin in the blood.

RESULTS: The SGA newborns had significantly lower levels of serum adiponectin than the AGA and LGA newborns. There were statistically significant differences between the genotype frequencies (GG, GT, TT) of the SGA newborns (29.9%, 45.1%, 13.9%), the AGA newborns (41.6%, 20.7%, 44.4%), and the LGA newborns (28.6%, 34.1%, 41.7%) (chi-square = 15.8; degree of freedom = 4; p = .003). The newborns carrying the GT genotype had an increased risk of being SGA compared to those carrying the GG and TT genotypes (odds ratio [OR] = 3.07; confidence interval [CI] = 95% (1.38-6.64); p = .005 and OR = 6.96; CI = 95% (2.19-22.1); p < .001, respectively). The newborns carrying the GG and TT genotypes had better protection against being SGA than those carrying the GT genotype (OR = 0.33; CI = 95% (0.15-0.72); p = .005 and OR = 0.14; CI = 95% (0.05-0.46); p < .001, respectively). The newborns carrying the GT genotype had lower birth weights, head circumferences, and ponderal indices than those carrying the TT genotype (p < .001). The serum adiponectin levels between adiponectin +276 G/T genotypes did not differ significantly (p = .429). In addition, serum adiponectin level showed a significant positive correlation with birth weight, birth length, head circumference, and ponderal index in all newborns.

CONCLUSION: The results of the current study suggest that the adiponectin +276 G/T gene polymorphism was associated with an increased chance of being born SGA or LGA. The effect of this polymorphism on newborn birth size was independently associated with serum adiponectin levels. Adiponectin may play a role in fetal growth.

PMID:36415042 | DOI:10.1080/14767058.2022.2150073

Ecology. 2022 Nov 22:e3926. doi: 10.1002/ecy.3926. Online ahead of print.

ABSTRACT

Alterations in global climate via extreme precipitation will have broadscale implications on ecosystem functioning. The increased frequency for drought coupled with heavy, episodic rainfall will likely generate impacts to biotic and abiotic processes across aquatic and terrestrial ecosystems. Despite demonstrated shifts in global precipitation, less is known about how extreme precipitation interacts with biophysical factors at controlling future demographic processes, especially those sensitive to climate extremes such as organismal recruitment and survival. We utilized a field-based precipitation manipulation experiment in 0.1 ha forest canopy openings to test future climate scenarios characterized by extreme precipitation on temperate tree seedling survival. The effect of planting seedbed (undisturbed leaf litter/organic material versus scarified, exposed mineral soils), seedling ontogeny, species, and functional traits were examined against four statistically defined precipitation scenarios. Results indicate seedlings grown within precipitation treatments characterized by heavy, episodic rainfall preceded by prolonged drying responding similarly to drought treatments lacking episodic inputs. Moreover, among all treatment conditions tested, scarified seedbeds most strongly affected seedling survivorship (odds ratio 6.9). Compared to any precipitation treatment, the effect size (predicted probabilities) of seedbed was over twice as important at controlling seedling survivorship. Yet, the interaction between precipitation and seedbed resulted in a 27.9% improvement in survivorship for moisture sensitive species. Seedling sensitivity to moisture was variable among species, most closely linked to functional traits like seed mass. For instance, under dry moisture regimes, survivorship increased linearly with seed mass (log transformed; adjusted R² = 0.72, p < 0.001), although no relationship was apparent under wet moisture regimes. Although precipitation influenced survival, extreme rainfall events were not enough to offset moisture deficits nor provide a rescue effect under droughty conditions. The relationships reported here highlight the importance of plant seedbed and species (e.g., functional traits) as edaphic and biotic controls that modify the influence of extreme future precipitation on seedling survival in temperate forests. Ultimately, we demonstrate the biophysical factors most influential to early forest development that may override the negative effects of increasingly variable precipitation. This work contributes to refinements of species distribution models and can inform reforestation strategies intended to maintain biodiversity and ecosystem function under increasing climate extremes.

PMID:36415040 | DOI:10.1002/ecy.3926