Nevin Manimala

Acta Orthop Belg. 2022 Jun;88(2):285-291. doi: 10.52628/88.2.7727.

ABSTRACT

The aim of this retrospective study is to evaluate and compare the clinical and radiological results of the use of Zero-P implant and the integrated cage-plate implant in surgical treatment of single level cervical disc disease. It includes 54 consecutive patients who underwent single level anterior cervical discectomy and fusion. The patients were divided into 2 groups. Group (A) including 28 patients operated with zero- profile implant and group (B) including 26 patients operated with integrated cage-plate implant. Mean operative time, blood loss, incidence of dysphagia and any other complications related to the procedure were recorded and compared. Patients were assessed radiologically by measuring cervical lordosis using the Cobb angle and the segmental angle. Patients were assessed clinically by the Japanese orthopedic association score and the neck disability index. These values were also compared. The mean age of the patients in group (A) was 49.5±11 years, and in group (B) it was 49.8±11.6 years. Mean blood loss and operative time in group (A) were 77.3±9.4 ml and 72.1±7.9 minutes, while in group B, they were 80.7±9.5 ml and 74.8±8.4 minutes with no statistically significant difference between both groups. There were also no statistically significant difference between both groups as regards incidence of dysphagia, clinical scores nor radiological parameters. In conclusion, both zero-profile implant and integrated cage-plate implant have comparable satisfactory clinical and radiological results in treatment of single level cervical disc diseases with little complications.

PMID:36001834 | DOI:10.52628/88.2.7727

Acta Orthop Belg. 2022 Jun;88(2):217-221. doi: 10.52628/88.2.8784.

ABSTRACT

The aim of the study is to find the correlation between vitamin D level and the severity of slippage and bilateral development in slipped capital femoral epiphysis (SCFE) cases if any. Thirty-nine patients with moderate-severe stable SCFE were evaluated regarding their vitamin D level and to which extent the severity of vitamin D deficiency, if present, can be correlated with the severity and bilaterality of the slip. Vitamin D serum level was assessed pre- operatively for all patients. In case of deficiency, the patient underwent in situ pinning unless performed before his/her presentation. Alongside, he/she received a vitamin D course until correction prior to the definitive surgery (Imhäuser osteotomy with osteochondroplasty) 6-12 weeks after. Thereafter, osteotomy healing and physis closure were monitored radiologically. Results show that all patients but one had vitamin D deficiency, with an average of 14.39 ng/mL, necessitating vitamin D therapy before proceeding to the definitive surgery. No correlation existed between vitamin D level and Southwick angle severity with a p-value of 0.85. A negative correlation existed between vitamin D level and bilaterality, but not statistically significant (p-value 0.192). Patients’ osteotomy healing was uneventful, and physeal closure was achieved in all the cases that had in situ pinning. We conclude that the severity of Vitamin D deficiency could be linked to the bilateral development of SCFE but not the severity of slippage. Treatment of Vitamin D deficiency facilitates physeal closure.

PMID:36001825 | DOI:10.52628/88.2.8784

Am J Audiol. 2022 Aug 24:1-6. doi: 10.1044/2022_AJA-21-00241. Online ahead of print.

ABSTRACT

PURPOSE: Military service personnel are at increased risk for developing tinnitus due to heightened exposure to acoustic trauma. The auditory disorder is the leading service-connected disability among veterans and is highly comorbidly diagnosed with posttraumatic stress disorder (PTSD). The biopsychosocial model illustrates that chronic health conditions are exacerbated or maintained by psychiatric distress. Therefore, alleviation of such psychiatric distress can have beneficial impacts on health conditions, such as tinnitus. The aim of this study was to determine whether individuals with both disorders who receive evidence-based therapy for PTSD will experience decreases in both PTSD and tinnitus-related distress.

METHOD: Veterans with comorbid bothersome tinnitus and PTSD received cognitive processing therapy and were assessed for PTSD, tinnitus-related distress, and depression at baseline and 1 month posttreatment follow-up.

RESULTS: At posttreatment follow-up, participants demonstrated significant decreases in PTSD symptoms compared to their baseline scores. Participants also demonstrated decreased tinnitus-related distress and depression, with high effect sizes.

CONCLUSIONS: This pilot study demonstrated that clinical management addressing psychiatric distress, as associated with PTSD, may simultaneously provide benefit for patients with bothersome tinnitus. Although not statistically significant due to the small sample size, large effect sizes indicate that tinnitus-related distress decreased as a function of receiving evidence-based therapy for PTSD. Future clinical trials should increase sample sizes and compare effects to control conditions.

PMID:36001823 | DOI:10.1044/2022_AJA-21-00241

J Speech Lang Hear Res. 2022 Aug 24:1-22. doi: 10.1044/2022_JSLHR-21-00607. Online ahead of print.

ABSTRACT

PURPOSE: Systematic review and meta-analysis are regarded as standard and valuable tools for providing an objective and reproducible synthesis of research findings in the literature. Their increasing popularity has led to heightened expectations for comprehensiveness and rigor in conducting scientific reviews and analyses. The purpose of this tutorial is to provide an overview and guidance on how to address the key elements for conducting a high-quality systematic review with meta-analysis.

METHOD: This tutorial describes practical guidelines to conduct systematic review and meta-analysis for researchers who are interested in learning and applying the method. Drawing on previous meta-analytic reviews of second-language learning as illustrative examples, it discusses the methodological choices and judgment calls in each step of the review and analysis process. As a hands-on tutorial, it uses a published data set concerning the role of talker variability in speech training studies as a running example to elucidate the statistical process and interpret the results of meta-analysis with freely available R software.

RESULTS/CONCLUSIONS: This tutorial provides a walk-through of the methodological choices, controversial issues, and common practices in conducting systematic reviews and meta-analyses. The data set and R codes are offered as publicly accessible supplementary materials (https://osf.io/e9bkf/) for replication and practice, which we hope will motivate more applications in the speech, language, and hearing sciences field as well as behavioral and social sciences research in general.

PMID:36001816 | DOI:10.1044/2022_JSLHR-21-00607

Am J Speech Lang Pathol. 2022 Aug 24:1-9. doi: 10.1044/2022_AJSLP-21-00310. Online ahead of print.

ABSTRACT

PURPOSE: Patients undergoing cardiac surgery are reported to be at higher risk for oropharyngeal dysphagia and aspiration, which may predispose them to respiratory complications such as pneumonia. Speech-language pathology consultation facilitates early identification of swallowing difficulties providing appropriate and timely interventions during the postoperative period. This study explores the association between pneumonia and timing of speech-language pathology order entry and evaluation following cardiac surgery.

METHOD: A retrospective study was performed on adults who underwent cardiac surgery in a tertiary care center, from July 2016 through December 2019. Patients with preexisting tracheostomy upon admission for cardiac surgery were excluded. The medical records of patients who had speech-language pathology consultation orders for swallowing concerns were analyzed in order to compare the timing of speech-language pathology order entry, completion of speech-language pathology evaluation, and incidence of pneumonia during hospitalization following cardiac surgery.

RESULTS: During the study period, 3,168 patients underwent cardiac surgery, of which 2,864 patients met the inclusion criteria. Speech-language pathology was ordered for 473 cases (16.5%), and clinical swallow evaluation (CSE) was completed by speech-language pathology in 419 patients (88.6%), of which 309 patients were suspected to have dysphagia (73.7%). Among the 2,391 patients without speech-language pathology consultation, pneumonia was reported in 34 patients (1.42%). Pneumonia was reported in 53 patients in the speech-language pathology cohort, of which 43 patients (13.9%) were suspected to have dysphagia. Patients with pneumonia had significantly longer median time (20.0 hr, range: 4.9-26.7) from speech-language pathology orders to completion of CSE, compared to those without pneumonia (13.2 hr, range: 3.2-22.4, p = .025). There was no significant difference in the median time from extubation to speech-language pathology consultation order time in patients with pneumonia versus those without pneumonia. Patients with pneumonia were observed to have prolonged, although not statistically significant, median time from extubation to CSE (70.4 hr, range: 21.2-215) compared to those without pneumonia (42.2 hr, range: 19.5-105.8, p = .066).

CONCLUSIONS: Patients without pneumonia in the postoperative period were observed to have shorter median time from extubation to speech-language pathology evaluation. Future studies are needed to further understand the impact of early speech-language pathology consultation and incidence of pneumonia in this population.

PMID:36001815 | DOI:10.1044/2022_AJSLP-21-00310

Oper Dent. 2022 Jul 1;47(4):382-391. doi: 10.2341/21-016-C.

ABSTRACT

OBJECTIVE: The aim of this in vivo study was to evaluate the clinical one-year follow-up of a silica- and flouroapatite-reinforced glass carbomer filling material as compared to a resin composite restorative material.

METHODS AND MATERIALS: In this study, a total of 100 restorations were performed. Caries were removed conventionally with diamond burs. Half of the restorations were restored with nanocomposite resin (TEP) (Tokuyama Estelite, Tokuyama Dental, Japan) and the other half were restored with glass carbomer (GC) material (GCP Dental, The Netherlands). Each restorative material was applied according to the manufacturer’s instructions. Restorations were evaluated with modified USPHS criteria at the end of the first week, 6 months, and 12 months. Data were analyzed using Fisher’s Exact Chi-Square test, Fisher Freeman Halton Test, and Continuity (Yates) Correction. The Wilcoxon sign test was used for intra-group comparisons of the parameters.

RESULTS: When the filling materials were compared with one another, a statistically significant difference was observed in the 12th month on the marginal discoloration. A statistically significant difference was observed between the two materials in the 6th month on the marginal adaptation (p<0.05).

CONCLUSIONS: In view of these results, there is a need to improve the physical properties of the GC filling material in further in vivo studies.

PMID:36001813 | DOI:10.2341/21-016-C

JMIR Form Res. 2022 Apr 27. doi: 10.2196/35114. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic represents the most unprecedented global challenge in recent times. As the global community attempts to manage the pandemic long-term, it is pivotal to understand what factors drive prevalence rates, and to predict the future trajectory of the virus.

OBJECTIVE: This study has two objectives. Firstly, it tests the statistical relationship between socioeconomic status and COVID-19 prevalence. Secondly, it utilises machine learning techniques to predict cumulative COVID-19 cases in a multi-country sample of 182 countries. Taken together, these objectives will shed light upon socioeconomic status as a global risk factor of the COVID-19 pandemic.

METHODS: This research utilised exploratory data analysis and supervised machine learning methods. Exploratory analysis included variable distribution, variable correlations and outlier detection. Following this, three supervised regression techniques were applied: linear regression, random forest, and adaptive boosting. Results were evaluated using k-fold cross validation and subsequently compared to analyse algorithmic suitability. The analysis involved two models. Firstly, the algorithms were trained to predict 2021 COVID-19 prevalence using only 2020 reported case data. Following this, socioeconomic indicators were added as features and the algorithms were trained again. The Human Development Index metrics of life expectancy, mean years of schooling, expected years of schooling, and Gross National Income were used to approximate socioeconomic status.

RESULTS: All variables correlated positively with 2021 COVID-19 prevalence, with R2 values ranging from 0.55-0.85. Using socioeconomic indicators, COVID-19 prevalence was predicted with a reasonable degree of accuracy. Using 2020 reported case rates as a lone predictor to predict 2021 prevalence rates, the average predictive accuracy of the algorithms was low (R2=0.543). When the socioeconomic indicators were added alongside 2020 prevalence rates as features, average predictive performance improved considerably (R2=0.721) and all error statistics decreased. This suggested that adding socioeconomic indicators alongside 2020 reported case data optimised prediction of COVID-19 prevalence to a considerable degree. Linear regression was the strongest learner with R2=0.693 on the first model and R2=0.763 on the second model, followed by random forest (0.481 and 0.722) and AdaBoost (0.454 and 0.679). Following this, the second model was retrained using a selection of additional COVID-19 risk factors (population density, median age, and vaccination uptake) instead of the HDI metrics. Average accuracy dropped to 0.649 however, which highlights the value of socioeconomic status as a predictor of COVID-19 cases in the chosen sample.

CONCLUSIONS: Results show that socioeconomic status should be an important variable to consider in future epidemiological modelling, and highlights the reality of the COVID-19 pandemic as a social phenomenon as well as a healthcare phenomenon. This paper also puts forward new considerations about the application of statistical and machine learning techniques to understand and combat the COVID-19 pandemic.

PMID:36001798 | DOI:10.2196/35114

Intern Med J. 2022 Aug 24. doi: 10.1111/imj.15918. Online ahead of print.

ABSTRACT

BACKGROUND: Administrative coding of out-of-hospital cardiac arrest (OHCA) is heterogeneous, with the prevalence of non-informative diagnoses uncertain.

METHODS: Hospital discharge diagnoses provided to a state-wide OHCA registry were characterized as either ‘informative’ or ‘non-informative’. ‘Informative’ diagnoses stated an OHCA had occurred or defined OHCA as occurring due to coronary artery disease, cardiomyopathy, channelopathy, definite non-cardiac cause, or no known cause. Non-informative diagnoses were blank, stated presenting cardiac rhythm only, provided irrelevant information or presented a complication of the OHCA as the main diagnosis. Characteristics of patients receiving informative versus non-informative diagnoses were compared.

RESULTS: Of 1,479 OHCA patients aged 1-50 years, 290 patients were admitted to 15 hospitals. 90 diagnoses (31.0%) were non-informative (arrest rhythm = 50, blank = 21, complication = 10, irrelevant = 9). 200 diagnoses (69.0%) were informative (cardiac arrest = 84, coronary artery disease = 54, non-cardiac diagnosis = 48, cardiomyopathy = 8, arrhythmia disorder = 4, unascertained = 2). Only ten diagnoses (3.5%) included both the fact of OHCA and an underlying cause. Patients receiving a non-informative diagnosis were more likely to have survived OHCA or been referred for forensic assessment (p=0.011) and had longer median length of stay (9 vs 5 days, p=0.0019).

CONCLUSION: Almost one-third of diagnoses for young patients discharged after an OHCA included neither the fact of OHCA nor any underlying cause. Under-estimating the burden of OHCA impacts ongoing patient and at-risk family care, data sampling strategies, international statistics and research funding. This article is protected by copyright. All rights reserved.

PMID:36001398 | DOI:10.1111/imj.15918

Crit Rev Anal Chem. 2022 Aug 24:1-22. doi: 10.1080/10408347.2022.2113359. Online ahead of print.

ABSTRACT

Endocrine disruptive compounds are natural or anthropogenic environmental micropollutants that alter the function of the endocrine system ultimately damaging the metabolism. Bisphenol A (BPA) is the most common of these pollutants and it is often used in epoxy coatings and polycarbonates as a plasticizer. Therefore, monitoring BPA levels in different environments is very important and challenging. In recent years, an increasing number of BPA detection methods have been proposed. This article presents a critical review of aptamer-based electrochemical, fluorescence-based, colorimetric, and several other BPA detection platforms published in the last decade. Furthermore, a statistical evaluation has been made using principle component analysis showing analytical performance parameters do not create very different clusters. Comparisons to other BPA detection methods are also presented so that the reader has an overall literature overview.

PMID:36001397 | DOI:10.1080/10408347.2022.2113359

Perm J. 2022 Aug 24:1-7. doi: 10.7812/TPP/21.131. Online ahead of print.

ABSTRACT

Introduction The objective of this study was to compare the antibiotic initiation rate and duration, hospital length of stay, emergency department (ED) admission rate and chest radiography usage in a pediatric inpatient unit before and after the decentralization of rapid respiratory pathogen panel (RRPP) processing. Methods This retrospective cohort study examined antibiotic initiation rates and durations, hospital lengths of stay, ED admission rates, and chest radiography usage from 2 respiratory virus seasons. For the 2014 cohort, RRPPs were processed at a centralized laboratory, and result times averaged 26 hours, whereas for the 2015 cohort, RRPPs were processed on-site with result times averaging 2 hours. Demographic data were collected and demonstrated similar populations. Chi-square testing was used to detect the change of antibiotic initiation rates, ED admission rates, and chest radiography usage after on-site RRPP processing was introduced. Antibiotic duration and hospital length of stay were determined by Wilcoxon rank sum. Results The study population included 94 patients from the 2014 respiratory virus season and 108 patients from the 2015 respiratory virus season. There were no statistically significant differences in gender, ethnicity, or age between the 2 cohorts. Antimicrobial initiation rates during hospital stay decreased from 46% to 27% (p = 0.005). The rate of admission from the ED decreased from 75% to 30% (p < 0.001). There were no statistically significant differences in antibiotic duration, hospital length of stay, or chest radiography usage. Conclusion Rapid respiratory pathogen testing is a useful tool that can decrease unnecessary antibiotic initiation and hospital admissions in the pediatric population.

PMID:36001386 | DOI:10.7812/TPP/21.131