Nevin Manimala

J Neurosurg Spine. 2022 Jan 28:1-12. doi: 10.3171/2021.11.SPINE211098. Online ahead of print.

ABSTRACT

OBJECTIVE: Noninvasive electrical stimulation represents a distinct group of devices used to augment fusion rates. However, data regarding outcomes of noninvasive electrical stimulation have come from a small number of studies. The goal of this systematic review and meta-analysis was to determine outcomes of noninvasive electrical stimulation used as an adjunct to fusion procedures to improve rates of successful fusion.

METHODS: PubMed, Embase, and the Cochrane Clinical Trials database were searched according to search strategy and PRISMA guidelines. Random-effects meta-analyses of fusion rates with the three main modalities of noninvasive electrical stimulation, capacitively coupled stimulation (CCS), pulsed electromagnetic fields (PEMFs), and combined magnetic fields (CMFs), were conducted using R version 4.1.0 (The R Foundation for Statistical Computing). Both retrospective studies and clinical trials were included. Animal studies were excluded. Risk-of-bias analysis was performed with the Risk of Bias 2 (RoB 2) and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tools.

RESULTS: Searches of PubMed, Embase, and the Cochrane Clinical Trials database identified 8 articles with 1216 participants meeting criteria from 213 initial results. There was a high overall risk of bias identified for the majority of randomized studies. No meta-analysis could be performed for CCS as only 1 study was identified. Meta-analysis of 6 studies of fusion rates in PEMF did not find any difference between treatment and control groups (OR 1.89, 95% CI 0.36-9.80, p = 0.449). Meta-analysis of 2 studies of CMF found no difference in fusion rates between control and treatment groups (OR 0.90, 95% CI 0.07-11.93, p = 0.939). Subgroup analysis of PEMF was limited given the small number of studies and patients, although significantly increased fusion rates were seen in some subgroups.

CONCLUSIONS: This meta-analysis of clinical outcomes and fusion rates in noninvasive electrical stimulation compared to no stimulation did not identify any increases in fusion rates for any modality. A high degree of heterogeneity between studies was noted. Although subgroup analysis identified significant differences in fusion rates in certain groups, these findings were based on a small number of studies and further research is needed. This analysis does not support routine use of these devices to augment fusion rates, although the data are limited by a high risk of bias and a small number of available studies.

PMID:35090134 | DOI:10.3171/2021.11.SPINE211098

Int J Dent Hyg. 2022 Jan 28. doi: 10.1111/idh.12582. Online ahead of print.

ABSTRACT

AIM: The null hypothesis is that there is no difference in the post-operative anti-inflammatory efficacy of chlorhexidine (CHX), 2% saline rinses (SR) and a herbal mouthwash (MW) after non-surgical mechanical debridement (MD) for treatment of peri-implant mucositis (PiM). The aim was to compare the post-operative anti-inflammatory efficacy of CHX, 2% SR and a herbal oral rinse after non-surgical MD of PiM.

MATERIALS AND METHODS: The present randomized controlled trial had a single-blinded parallel arm design. Patients diagnosed with PiM were enrolled. Demographic information were recorded. All patients underwent MD and were randomly divided into 4 groups: CHX-group: 0.12% non-alcoholic CHX; Sodium chloride (NaCl) group: 2% NaCl rinses; Herbal MW group: Herbal-based MW; and H₂ O group: distilled water with peppermint flavor. After MD, all participants were advised to rinse twice daily (every 12 hrs) for 2-weeks with their respective MWs. In all groups, peri-implant modified plaque index (mPI), modified gingival index (mGI), and probing depth (PD) were measured at baseline and at 12-weeks of follow-up. Sample-size was estimated using data from a pilot investigation; and group-comparisons were performed. Statistical significance was confirmed when P-values were below 0.01.

RESULTS: Sixty individuals (15 patients/group) were included. At baseline, mPI, mGI, and PD were comparable in all groups. At baseline, there was no significant difference in peri-implant mPI, mGI and PD in all groups. At 12-weeks’ follow-up, there was a statistically significant reduction in peri-implant mPI (P< 0.01), mGI (P< 0.01) and PD (P< 0.01) in CHX, NaCl and herbal MW groups compared with H₂ O group. There was no significant relation between implant location, duration for which, implants were functional, gender and peri-implant clinical parameters in all groups.

CONCLUSION: After non-surgical MD, post-operative use of CHX and herbal and NaCl MWs is useful for the management of PiM in the short-term.

PMID:35090087 | DOI:10.1111/idh.12582

J Magn Reson Imaging. 2022 Jan 28. doi: 10.1002/jmri.28068. Online ahead of print.

ABSTRACT

BACKGROUND: Lymph node (LN) staging plays an important role in treatment decision-making. Current problem is that preoperative detection of LN involvement is always highly challenging for radiologists.

PURPOSE: To explore the value of the nomogram model combining intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and radiomics features from the primary lesion of rectal adenocarcinoma in assessing the non-enlarged lymph node metastasis (N-LNM) preoperatively.

STUDY TYPE: Retrospective.

POPULATION: A total of 126 patients (43% female) comprising a training group (n = 87) and a validation group (n = 39) with pathologically confirmed rectal adenocarcinoma.

FIELD STRENGTH/SEQUENCE: A 3.0 Tesla (T); T₂ -weighted imaging (T₂ WI) with fast spin-echo (FSE) sequence; IVIM-DWI spin-echo echo-planar imaging sequence.

ASSESSMENT: Based on pathological analysis of the surgical specimen, patients were classified into negative LN (LN-) and positive LN (LN+) groups. Apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D*) and microvascular volume fraction (f) values of primary lesion of rectal adenocarcinoma were measured. Three-dimensional (3D) radiomics features were measured on T₂ WI and IVIM-DWI. A nomogram model including IVIM-DWI and radiomics features was developed.

STATISTICAL TESTS: General_univariate_analysis and multivariate logistic regression were used for radiomics features selection. The performance of the nomogram was assessed by the receiver operating characteristic (ROC) curve, calibration, and decision curve analysis (DCA).

RESULTS: The LN+ group had a significantly lower D* value ([13.20 ± 13.66 vs. 23.25 ± 18.71] × 10^-3 mm² /sec) and a higher f value (0.43 ± 0.12 vs. 0.34 ± 0.10) than the LN- group in the training cohort. The nomogram model combined D*, f, and radiomics features had a better evaluated performance (AUC = 0.864) than any other model in the training cohort.

DATE CONCLUSION: The nomogram model including IVIM-DWI and MRI radiomics features in the primary lesion of rectal adenocarcinoma was associated with the N-LNM.

EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 2.

PMID:35090079 | DOI:10.1002/jmri.28068

Clin Pharmacol Ther. 2022 Jan 28. doi: 10.1002/cpt.2534. Online ahead of print.

ABSTRACT

The Covid-19 pandemic has a major impact not only on public health and daily living, but also on clinical trials worldwide. To investigate the potential impact of the Covid-19 pandemic on the initiation of clinical trials, we have descriptively analysed the longitudinal change in phase II and III interventional clinical trials initiated in Europe and in the United States. Based on the public clinical trial register EU Clinical Trials Register and clinicaltrials.gov, we conducted (a) a yearly comparison of the number of initiated trials from 2010 to 2020 and (b) a monthly comparison from January 2020 to February 2021 of the number of initiated trials. The analyses indicate that the Covid-19 pandemic affected both the initiation of clinical trials overall and the initiation of non-Covid-19 trials. An increase in the overall numbers of clinical trials could be observed both in Europe and the US in 2020 as compared to 2019. However, the number of non-Covid-19 trials initiated is reduced as compared to the previous decade, with a slightly larger relative decrease in the US as compared to Europe. Additionally, the monthly trend for the initiation of non-Covid-19 trials differs between regions. In the US, after a sharp decrease in April 2020, trial numbers reached the levels of 2019 from June 2020 onwards. In Europe, the decrease was less pronounced, but trial numbers mainly remained below the 2019 average until February 2021.

PMID:35090044 | DOI:10.1002/cpt.2534

J Gerontol B Psychol Sci Soc Sci. 2022 Jan 28:gbac014. doi: 10.1093/geronb/gbac014. Online ahead of print.

ABSTRACT

OBJECTIVES: In previous research on retirement, what individuals value in life is often assumed to remain stable after the transition into retirement. However, retirement exposes individuals to new social settings and might thus prompt them to re-evaluate their life orientations. Quantitative empirical knowledge about this process is limited, though. This study examines the impact of retirement on changes in the perceived importance of self-development, social status, societal contribution, and generativity in older adults’ lives. We draw on the life-course framework to develop hypotheses about which life orientations are more likely to change after retirement and how.

METHODS: We analyzed data collected in 2015 and 2018 among 5,034 Dutch individuals aged 60-65 and employed at baseline. Around half had fully retired at follow-up (either voluntarily or involuntarily), and ten percent worked after retirement.

RESULTS: Conditional change models reveal that voluntary full retirement was linked to statistically significant – but (very) small – decreases in the importance of self-development, social status, societal contribution, and generativity compared to continuous career work. Differences in changes of life orientations between retirement processes (i.e., post-retirement work, involuntary full retirement) were also small.

DISCUSSION: The findings point to relatively high levels of continuity during the transition from career employment to retirement, given the small effect sizes observed. The notion that after retirement, individuals will re-evaluate what they value in life – as expected in light of the exposure-based mechanism from the life-course literature – seems to be less pronounced than initially expected.

PMID:35090023 | DOI:10.1093/geronb/gbac014

J Athl Train. 2022 Jan 28. doi: 10.4085/1062-6050-0399.21. Online ahead of print.

ABSTRACT

CONTEXT: Individuals with chronic ankle instability (CAI) exhibit impaired lower limb biomechanics during unilateral drop jump landing on a flat surface. However, lower limb biomechanical adaptations during unilateral drop jump landing on more challenging surfaces such as unstable or inclined are yet to be described.

OBJECTIVE: Determine how unilateral drop jump landing surfaces (flat, unstable and inclined) influence lower limb EMG, kinematics and kinetics in individuals with CAI.

DESIGN: Descriptive laboratory study.

SETTING: Biomechanics laboratory.

PATIENTS OR OTHER PARTICIPANTS: Twenty-two young adults with CAI.

INTERVENTIONS: Participants completed five trials of unilateral drop jump landing from a 46 cm height platform on flat (DROP), unstable (FOAM) and laterally inclined (WEDGE) surfaces.

MAIN OUTCOME MEASURE(S): EMG of gluteus medius, vastus lateralis, gastrocnemius medialis, peroneus longus and tibialis anterior muscles were recorded. Knee and ankle angles and moments were calculated using a three-dimensional motion analysis system and a force plate. Biomechanical variables were compared between tasks using one-dimensional statistical nonparametric mapping.

RESULTS: During DROP, greater ankle dorsiflexion angles, knee extension moments and vastus lateralis muscle activity (FOAM only) were observed compared to FOAM and WEDGE. Greater ankle inversion angles were observed during FOAM and WEDGE compared to DROP. Peroneus longus muscle activity was greater during DROP compared to FOAM. During FOAM, greater ankle inversion and knee extension angles, ankle inversion and internal rotation moments as well as smaller peroneus longus muscle activity were observed compared to WEDGE.

CONCLUSIONS: The greater ankle inversion and plantarflexion angles as well as the lack of increase in peroneus longus muscle activation during FOAM and WEDGE could increase the risk of recurrent LAS in individuals with CAI. The results of this study improve our understanding of lower limb biomechanics changes when landing on more challenging surfaces and will help clinicians better targeting deficits associated with CAI during rehabilitation.

PMID:35090022 | DOI:10.4085/1062-6050-0399.21

PLoS One. 2022 Jan 28;17(1):e0263301. doi: 10.1371/journal.pone.0263301. eCollection 2022.

ABSTRACT

BACKGROUND: In the context of the COVID-19 pandemic, many individuals have been found to endorse conspiracy beliefs. Socio-demographic variables, personality functioning, anxiety, and loneliness could be risk factors for this endorsement.

METHODS: In a representative sample of the German population (N = 2,503) measures of conspiracy mentality, conspiracy-related beliefs toward COVID-19, personality functioning (OPD-SQS), anxiety (HADS), and loneliness (UCLA) were assessed. Pearson product-moment correlations and multiple linear regression analyses were conducted.

RESULTS: Conspiracy mentality and conspiracy-related beliefs toward COVID-19 were strongly correlated. Regression analyses found younger age, male gender, lower education, and lower income to be associated with conspiracy mentality. The subscales relationship model and self-perception of the OPD-SQS were positively related to conspiracy mentality whereas interpersonal contact was negatively associated. Higher levels of anxiety were statistically predictive for conspiracy mentality.

CONCLUSION: Our findings indicate a contribution of personality functioning to the understanding of conspiracy mentality and thus to the advancement of interventions during the pandemic.

PMID:35089987 | DOI:10.1371/journal.pone.0263301

PLoS One. 2022 Jan 28;17(1):e0262799. doi: 10.1371/journal.pone.0262799. eCollection 2022.

ABSTRACT

OBJECTIVE: Sleep disturbances are common in pregnancy. Blocking blue light has been shown to improve sleep and may be a suitable intervention for sleep problems during pregnancy. The present study investigated the effects of blue light blocking in the evening and during nocturnal awakenings among pregnant women on primary sleep outcomes in terms of total sleep time, sleep efficiency and mid-point of sleep.

METHODS: In a double-blind randomized controlled trial, 60 healthy nulliparous pregnant women in the beginning of the third trimester were included. They were randomized, using a random number generator, either to a blue-blocking glass intervention (n = 30) or to a control glass condition constituting partial blue-blocking effect (n = 30). Baseline data were recorded for one week and outcomes were recorded in the last of two intervention/control weeks. Sleep was measured by actigraphy, sleep diaries, the Bergen Insomnia Scale, the Karolinska Sleepiness Scale and the Pre-Sleep Arousal Scale.

RESULTS: The results on the primary outcomes showed no significant mean difference between the groups at posttreatment, neither when assessed with sleep diary; total sleep time (difference = .78[min], 95%CI = -19.7, 21.3), midpoint of sleep (difference = -8.9[min], 95%CI = -23.7, 5.9), sleep efficiency (difference = -.06[%], 95%CI = -1.9, 1.8) and daytime functioning (difference = -.05[score points], 95%CI = -.33, .22), nor by actigraphy; total sleep time (difference = 13.0[min], 95%CI = -9.5, 35.5), midpoint of sleep (difference = 2.1[min], 95%CI = -11.6, 15.8) and sleep efficiency (difference = 1.7[%], 95%CI = -.4, 3.7). On the secondary outcomes, the Bergen Insomnia Scale, the Karolinska Sleepiness Scale and the Pre-Sleep Arousal Scale the blue-blocking glasses no statistically significant difference between the groups were found. Transient side-effects were reported in both groups (n = 3).

CONCLUSIONS: The use of blue-blocking glasses compared to partially blue-blocking glasses in a group of healthy pregnant participants did not show statistically significant effects on sleep outcomes. Research on the effects of blue-blocking glasses for pregnant women with sleep-problems or circadian disturbances is warranted.

TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov (NCT03114072).

PMID:35089982 | DOI:10.1371/journal.pone.0262799

PLoS One. 2022 Jan 28;17(1):e0262708. doi: 10.1371/journal.pone.0262708. eCollection 2022.

ABSTRACT

The COVID-19 pandemic continues to have major impact to health and medical infrastructure, economy, and agriculture. Prominent computational and mathematical models have been unreliable due to the complexity of the spread of infections. Moreover, lack of data collection and reporting makes modelling attempts difficult and unreliable. Hence, we need to re-look at the situation with reliable data sources and innovative forecasting models. Deep learning models such as recurrent neural networks are well suited for modelling spatiotemporal sequences. In this paper, we apply recurrent neural networks such as long short term memory (LSTM), bidirectional LSTM, and encoder-decoder LSTM models for multi-step (short-term) COVID-19 infection forecasting. We select Indian states with COVID-19 hotpots and capture the first (2020) and second (2021) wave of infections and provide two months ahead forecast. Our model predicts that the likelihood of another wave of infections in October and November 2021 is low; however, the authorities need to be vigilant given emerging variants of the virus. The accuracy of the predictions motivate the application of the method in other countries and regions. Nevertheless, the challenges in modelling remain due to the reliability of data and difficulties in capturing factors such as population density, logistics, and social aspects such as culture and lifestyle.

PMID:35089976 | DOI:10.1371/journal.pone.0262708

PLoS One. 2022 Jan 28;17(1):e0263337. doi: 10.1371/journal.pone.0263337. eCollection 2022.

ABSTRACT

Implementations of construction projects in Indonesia, especially in Aceh Province, are often delayed. Time, quality, and cost are three important components of planning a construction project. The benchmark for a successful construction project is the project completion time being in accordance with the time period specified in the contract. In project implementation, there is often a risk of delays in completing construction projects that can cause losses and fines; therefore, it is necessary to know the risk factors potentially causing project delays. The purpose of this study was to identify the risk factors causing delays greatly affecting construction projects in Aceh Province. The data used in this study were questionnaire data distributed to 68 respondents. The data processing methods included validity tests, reliability tests, and the construction of descriptive statistics. Ultimately, 60 delay factors were obtained; of these, 30 risk indicators were included in the very influential category with a mode value of (= 5), 29 delay risk indicators were in the high influence category with a mode value of (= 4), and one indicator was included in the category of medium influence (= 3).

PMID:35089971 | DOI:10.1371/journal.pone.0263337