Nevin Manimala

J Health Econ. 2022 Mar 10;83:102612. doi: 10.1016/j.jhealeco.2022.102612. Online ahead of print.

ABSTRACT

We investigate the effects of incentivizing early prenatal care utilization on infant health by exploiting a reform that required expectant mothers to initiate prenatal care during the first ten weeks of gestation to obtain a one-time monetary transfer paid after childbirth. Applying a difference-in-differences design to individual-level data on the population of births and fetal deaths, we identify modest but statistically significant positive effects of the policy on neonatal health. We further provide suggestive evidence that improved maternal health-related knowledge and behaviors during pregnancy are plausible channels through which the reform might have affected fetal health.

PMID:35421668 | DOI:10.1016/j.jhealeco.2022.102612

Food Chem. 2022 Apr 9;387:132932. doi: 10.1016/j.foodchem.2022.132932. Online ahead of print.

ABSTRACT

A rapid, simple, and efficient analysis methodology for screening specific quantitative peptides of beef was established based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) coupled with orthogonal partial least squares-discriminant analysis (OPLS-DA). The OPLS-DA model was built to select species-specific peptides that make a significant contribution to classification. Peptides with statistical significance were selected based on the variable importance in the projection (VIP) values and univariate P values. After the workflow of the statistical process, three specific quantitative peptides were identified by using homemade products with different beef contents. A quantification method for selected specific quantitative peptides was established by using LC-MS/MS. The quantitative results were applied to commercialized beef products. The developed method has high sensitivity, specificity, and repeatability. The results of this study proved that the integration of LC-MS/MS coupled with OPLS-DA is an efficient method for screening specific quantitative peptides and identification of the authenticity of meat products.

PMID:35421655 | DOI:10.1016/j.foodchem.2022.132932

Curr Probl Cancer. 2022 Mar 29;46(3):100861. doi: 10.1016/j.currproblcancer.2022.100861. Online ahead of print.

ABSTRACT

In clinical practice, a large number of patients have failed to receive chemotherapy or combination therapy because of drug resistance, recurrence and metastasis of specific sites. Therefore, how to choose the initial chemotherapy individually and reduce the occurrence of drug resistance is the key to cure high-risk GTN. This study investigated the efficacy of chemotherapy based on 5-fluorouracil (5-FU) regimen and EMA/CO regimen as the initial chemotherapy regimen in the treatment of high-risk gestational trophoblastic neoplasms (high-risk GTN). The treatment status of high-risk GTN patients who received primary chemotherapy using 5-Fu regimens (FAV and FA regimens) or EMA/CO regimens at Cancer Hospital of China Medical University from 2002 to 2019 was retrospective analyzed. Regular follow-up was conducted to evaluate its efficacy and to analyze prognostic factors. There were a total of 87 high-risk patients, 75 in the 5-FU-based group and 12 in the EMA/CO group. The clinical characteristics of patients in both groups were not statistically significant (P > 0.05). The overall survival rate of all patients was 87.4%, the rate of serological complete remission (SCR) was 87.4%, the SCR rate of initial treatment was 75.9%, the recurrence rate was 7.9%, and the mortality rate was 12.6%. There were no statistical differences in overall survival rate, SCR rate, SCR rate of initial treatment, drug resistance rate, recurrence rate and mortality in the 5-FU group and the EMA/CO group (P > 0.05). The median follow-up was 106 months. Kaplan-Meier analysis showed that the 1-year survival rate, 5-year survival rate and 10-year survival rate in the 5-FU group were 91.9%, 84.3% and 84.3% respectively. The 1-year survival rate, 5-year survival rate and 10-year survival rate of the EMA/CO group were all 91.7%, and there was no statistical difference in the overall survival time between the 2 groups (P > 0.05). COX proportional stepwise regression analysis showed that only clinical staging was an independent risk factor of the prognosis of high-risk GTN (P = 0.003). Conclusion Both 5-FU regimen and EMA / CO regimen can be used as the first-line treatment for high-risk GTN patients, and their effects are similar. For high-risk GTN patients with drug resistance, EMA / CO, FAEV and PEB can be used as second-line salvage chemotherapy.

PMID:35421635 | DOI:10.1016/j.currproblcancer.2022.100861

J Exp Child Psychol. 2022 Apr 11;220:105430. doi: 10.1016/j.jecp.2022.105430. Online ahead of print.

ABSTRACT

Children’s everyday learning environment is semantically structured. For example, semantically related things (e.g., fork and spoon) usually co-occur in the same contexts. The current study examines the effects of semantically structured contexts on preschool-age children’s (N = 65, 33 girls, age range: 52-68 months) use of statistical information to learn novel word-object mappings. Children were assigned into one of two conditions, in which objects from the same semantic category repeatedly co-occurred in the same trials (Same-category condition) or objects from different categories repeatedly co-occurred in the same trials (Different-categories condition). Children’s word learning performance in the two conditions were comparable. However, their errors at test suggested that information extracted by children in the two conditions differed. Importantly, children in the Same-category condition extracted both statistical and semantic relationships from the stimuli.

PMID:35421627 | DOI:10.1016/j.jecp.2022.105430

J Acad Nutr Diet. 2022 Apr 11:S2212-2672(22)00199-X. doi: 10.1016/j.jand.2022.04.003. Online ahead of print.

ABSTRACT

BACKGROUND: Food marketing influences consumers’ preferences for and selection of marketed products. Although a substantial body of research has described food marketing practices in brick-and-mortar stores, no research has examined food marketing in online grocery retail despite its growing importance as a source of food-at-home purchases.

OBJECTIVE: To develop and apply a coding instrument to describe food marketing and the nutritional quality of marketed products in online grocery stores.

DESIGN: Quantitative content analysis and review of product Nutrition Facts labels and ingredients lists to calculate nutrient density and level of processing using the NOVA classification system.

PARTICIPANTS: /setting: Foods and beverages (n=3,473) marketed in the top revenue-generating online grocery retailers and those participating in the United States Department of Agriculture Supplemental Nutrition Assistance Program Online Purchasing Pilot (n=21) in 2019-2020.

MAIN OUTCOME MEASURES: Use of marketing mix strategies (i.e., product, placement, promotion, and pricing) across retailers and nutritional quality of marketed products. Products were considered of poor nutritional quality if they were ultra-processed (NOVA category 4) and excessive in sodium, saturated fat, free sugars, and/or other sweeteners. Products were also classified into 13 mutually exclusive food groups.

STATISTICAL TESTS PERFORMED: The proportion of retailers using each marketing strategy, proportion of products of poor nutritional quality, and proportion of products in each food group were calculated.

RESULTS: Retailers commonly used product recommendations, search result ordering, branded website content, user-generated content, and social media engagement to market products online. Candy, sweets, and snacks made up the largest percentage of marketed products (17.3%), followed by fruit, vegetables, and legumes (16.7%). Most (62%) marketed products were of poor nutritional quality. Staple food categories such as fruits, vegetables, and grains were frequently marketed, particularly through price reductions and product recommendations.

CONCLUSIONS: Online grocery retailers use a variety of customizable food marketing strategies on their websites. Although most marketed products are of poor nutritional quality, there is potential for marketing of staple food categories online that is not feasible in the brick-and-mortar store.

PMID:35421615 | DOI:10.1016/j.jand.2022.04.003

J Biomed Inform. 2022 Apr 11:104072. doi: 10.1016/j.jbi.2022.104072. Online ahead of print.

ABSTRACT

BACKGROUND: Medical decision-making impacts both individual and public health. Clinical scores are commonly used among various decision-making models to determine the degree of disease deterioration at the bedside. AutoScore was proposed as a useful clinical score generator based on machine learning and a generalized linear model. However, its current framework still leaves room for improvement when addressing unbalanced data of rare events.

METHODS: Using machine intelligence approaches, we developed AutoScore-Imbalance, which comprises three components: training dataset optimization, sample weight optimization, and adjusted AutoScore. Baseline techniques for performance comparison included the original AutoScore, full logistic regression, stepwise logistic regression, least absolute shrinkage and selection operator (LASSO), full random forest, and random forest with a reduced number of variables. These models were evaluated based on their area under the curve (AUC) in the receiver operating characteristic analysis and balanced accuracy (i.e., mean value of sensitivity and specificity). By utilizing a publicly accessible dataset from Beth Israel Deaconess Medical Center, we assessed the proposed model and baseline approaches to predict inpatient mortality.

RESULTS: AutoScore-Imbalance outperformed baselines in terms of AUC and balanced accuracy. The nine-variable AutoScore-Imbalance sub-model achieved the highest AUC of 0.786 (0.732-0.839), while the eleven-variable original AutoScore obtained an AUC of 0.723 (0.663-0.783), and the logistic regression with 21 variables obtained an AUC of 0.743 (0.685-0.800). The AutoScore-Imbalance sub-model (using a down-sampling algorithm) yielded an AUC of 0.771 (0.718-0.823) with only five variables, demonstrating a good balance between performance and variable sparsity. Furthermore, AutoScore-Imbalance obtained the highest balanced accuracy of 0.757 (0.702-0.805), compared to 0.698 (0.643-0.753) by the original AutoScore and the maximum of 0.720 (0.664-0.769) by other baseline models.

CONCLUSIONS: We have developed an interpretable tool to handle clinical data imbalance, presented its structure, and demonstrated its superiority over baselines. The AutoScore-Imbalance tool can be applied to highly unbalanced datasets to gain further insight into rare medical events and facilitate real-world clinical decision-making.

PMID:35421602 | DOI:10.1016/j.jbi.2022.104072

J Esthet Restor Dent. 2022 Apr 14. doi: 10.1111/jerd.12909. Online ahead of print.

ABSTRACT

OBJECTIVES: To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome).

MATERIAL AND METHODS: Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons.

RESULTS: The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387).

CONCLUSIONS: Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients’ satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow.

CLINICAL SIGNIFICANCE: PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients’ perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow.

PMID:35421283 | DOI:10.1111/jerd.12909

Microsc Res Tech. 2022 Apr 14. doi: 10.1002/jemt.24109. Online ahead of print.

ABSTRACT

The purpose of this study was to introduce antibacterial property to pits and fissure sealant (PFS) in order to mitigate the major clinical problems associated with PFS, such as microleakage and secondary caries. We prepared a pH reliant cobalt oxide nanoparticle incorporated with minocycline (MNC@CO) and characterized to investigate its antibacterial potential against Streptococcus sobrinus. The physiochemical, morphological, and drug release kinetics at different pH (7.4, 5.0, and 3.5) from nanoparticles were investigated. The MNC@CO were added at 2.5% and 5.0% into experimental PFS and characterized for their antibiofilm capacity, biocompatibility, and mechanical properties including compressive and flexural strength. The groups 2.5% and 5.0% has shown statistically significant antimicrobial capacity against S. sobrinus compared to control (p < .05). The highest percentage of MNC release at different pH (especially at pH 5.0 and 3.5) was observed from 5.0% MNC@CO doped PFS. The PFS doped with 2.5% MNC@CO showed a highest compressive strength (110 MPa) over a period of 70 days as compared to 5.0% MNC@CO (75 MPa) and control (80 MPa). The flexural strength of both experimental groups was lower for both time points (24 h and 30 days) than control. In conclusion, the present study found that 2.5% MNC@CO doped PFS showed considerable anti-biofilm potential without compromising mechanical properties.

PMID:35421274 | DOI:10.1002/jemt.24109

Fam Med. 2022 Apr;54(4):298-303. doi: 10.22454/FamMed.2022.652106.

ABSTRACT

BACKGROUND AND OBJECTIVES: Teaching medical trainees evidence-based medicine (EBM) is required by the Accreditation Council for Graduate Medical Education. Most published graduate EBM curricula focus on critical appraisal over point-of-care information mastery. Faculty at the University of Rochester Family Medicine Residency implemented a clinically integrated, cyclical EBM curriculum juxtaposing information mastery with expert-level skills such as critical appraisal. We administered the Evidence-Based Medicine Environment Survey (EBMES) to learners before and after the yearlong curriculum.

METHODS: Two cohorts of participating third-year residents completed the EBMES before and after an EBM curriculum.

RESULTS: Over 2 years, 21 residents completed pre- and postevaluations. Resident perception of the EBM educational and practice environment was high at baseline and improved for 15 of 36 survey items (P&lt;.05).

CONCLUSIONS: Resident perception of the EBM learning environment improved after participation in a yearlong curriculum. Nearly all of the content covered in the “Science of Family Medicine” curriculum and measured by EBMES improved in a statistically significant manner. We propose that EBM curricula should combine traditional literature search and critical appraisal skills with information mastery to maximize effectiveness. Our curriculum can be modified to fit other graduate family medicine contexts.

PMID:35421246 | DOI:10.22454/FamMed.2022.652106