Nevin Manimala

J Adhes Dent. 2021 Apr 7;23(2):113-119. doi: 10.3290/j.jad.b1079547.

ABSTRACT

PURPOSE: To evaluate the influence of different surface treatments of two CAD/CAM glass ceramics on surface topography, shear bond strength of composite cement, flexural strength, and elastic modulus.

MATERIALS AND METHODS: Two ceramics were evaluated: lithium-disilicate (LDS) and zirconia-reinforced lithium silicate (ZLS) glass ceramics. Glass ceramics were sintered and the surfaces were sandblasted (SBL) or etched with 9% hydrofluoric acid for 10 s (HF10), 20 s (HF20) or 30 s (HF30). The treated surfaces were analyzed using scanning electron microscopy (n = 3) to evaluate the etching pattern. For bond strength testing, ceramic samples were silanized after treatments and an adhesive was applied to the surface. Afterwards, a silicone mold was used to build composite-cement cylinders, which were tested after 24 h or one year of water storage (n = 10). Flexural strength and modulus were assessed using a 3-point bending test (n = 15). The data were subjected to statistical analysis at a pre-set α = 0.05.

RESULTS: SBL and HF resulted in different surface topographies. Increased HF etching time influenced the surface dissolution level and exposition of crystals for LDS, while no effect of etching time was observed for ZLS. After one year, the bond strength to LDS significantly decreased, regardless of treatments. For ZLS, HF10 and HF20 showed stable bond strengths over time. SBL yielded the lowest bond strength for both ceramics and statistically significantly reduced the flexural strength of ZLS. The flexural strength and elastic modulus of ceramics were not affected by different etching times.

CONCLUSION: Bonding stability depended on the glass ceramic and the pretreatment method employed. HF etching did not change the mechanical properties of the ceramics and is indicated as a ceramic treatment for bonding.

PMID:33825425 | DOI:10.3290/j.jad.b1079547

Zhongguo Yi Liao Qi Xie Za Zhi. 2021 Apr 8;45(2):194-199. doi: 10.3969/j.issn.1671-7104.2021.02.015.

ABSTRACT

OBJECTIVE: To understand the current situation of artificial intelligence production enterprise quality management system, so as to provide reference basis for the research and standardization of Artificial Intelligence Medical Device (AIMD) product quality management.

METHODS: Based on YY/T 0287-2017 Medical Device Quality Management System for Regulatory Requirements, Medical Equipment Production and the Quality Control Standard for Independent Software Appendix and Xavier GMLP report, the relevant factors were screened and the questionnaire was designed by combining expert consultation and literature review. Then, a total of 32 representative AIMD enterprises were invited to fill in the questionnaire. Descriptive statistical analysis was performed on the data results using Excel 2016.

RESULTS: Through in-depth analysis of the four themes in product planning and design, result output, product quality control and product change, it was found that it was necessary for enterprises participating in the survey to improve the quality management system of AIMD products to different degrees.

CONCLUSIONS: This study is the first time to systematically investigate the status quo of quality management of AIMD enterprises. The result will be useful for the establishment and continuous improvement of product quality management system. It will also provide a reference for the research of AIMD product quality management and the establishment of the standard.

PMID:33825381 | DOI:10.3969/j.issn.1671-7104.2021.02.015

J Gynecol Oncol. 2021 May;32(3):e45. doi: 10.3802/jgo.2021.32.e45.

ABSTRACT

OBJECTIVE: The aim of this study is to analyze and draw the potential differences between the robotic-assisted surgery (RS) and the laparoscopy (LPS) in endometrial cancer staging.

METHODS: In this single-institution retrospective study we enrolled 1,221 consecutive clinical stage I-III endometrial cancer patients undergone minimally invasive surgical staging. We compared patients treated by LPS and by RS, on the basis of perioperative and oncological outcomes (disease-free survival [DFS] and overall survival [OS]). A sub-analysis of the high-risk endometrial cancer population was performed in the 2 cohorts.

RESULTS: The 2 cohorts (766 treated by LPS and 455 by RS) were homogeneous in terms of perioperative and pathological data. We recorded differences in number of relapse/progression (11.7% in LPS vs. 7% in RS, p=0.008) and in number of deaths (9.8% in LPS vs. 4.8% in RS, p=0.002). Whereas, univariate and multivariate analyses according to DFS and OS confirmed that the surgical approach did not influence the DFS or the OS. In the multivariable analysis the association of the age and grading was significant for DFS and OS. In the sub-analysis of the 426 high risk EC patients (280 in LPS and 146 in RS) the univariate and the multivariate confirmed the influence of the age in DFS and OS, independently of the minimally invasive approach.

CONCLUSIONS: In our large retrospective analysis, we confirmed that the RS and LPS have similar efficacy and safety for endometrial cancer staging also for the high-risk endometrial cancer patients.

PMID:33825360 | DOI:10.3802/jgo.2021.32.e45

Neuropsychopharmacol Rep. 2021 Apr 6. doi: 10.1002/npr2.12179. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to investigate the prevalence and severity of corona-associated anxiety and mental health disorder among Iranian dentists during the COVID-19 pandemic.

METHODS: A study was conducted using online survey from May 2nd to 14th, 2020. The questionnaire consisted of three sections: demographic information, anxiety (18 questions), and general health (GH) (GHQ-28). Scoring system was based on Likert scale. The questionnaire was registered at Porsline website. Data were analyzed using t test and Pearson’s correlation coefficient statistical tests.

RESULTS: A total of 320 dentists from all over the country fully completed questionnaires. 42.5% of dentist had corona-associated anxiety and 32.5% out of them had mild severity and no severe anxiety was observed. 62.5% of dentists were nonpsychiatric according to GHQ-28, 35% had mild disorders in GH, and no one had severe GH disorders. There were significant relationships between gender, marital status, and family history of psychiatric disorders with GH status. There was a significant relationship between history of physical illness with corona-associated anxiety. There was a significant relationship between history of psychiatric disorders with corona-associated anxiety and GH status.

CONCLUSION: The prevalence of corona-associated anxiety and mental disorders in dentists was moderate; by holding psychological workshops to maintain and strengthen the morale of dentists during the corona pandemic, along with teaching them the correct way to use personal protective equipment, while maintaining the mental health of dentists, we will help them return to work and provide dental services.

PMID:33825340 | DOI:10.1002/npr2.12179

Clin Respir J. 2021 Apr 7. doi: 10.1111/crj.13372. Online ahead of print.

ABSTRACT

OBJECTIVES: No large sample studies have been designed to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP1RAs) in the primary and secondary prevention of respiratory disorders. We aimed at evaluating the relationship between use of GLP1RAs and occurrence of 12 kinds of respiratory disorders.

METHODS: Large randomized placebo-controlled trials of GLP1RAs were included. We conducted meta-analysis using random-effects model and measured heterogeneity using I² . Treatment effect was presented as risk ratio (RR) and 95% confidence interval (CI).

RESULTS: Seven trials including 55922 participants were included in meta-analysis. The occurrence rates of various respiratory disorders were low, with the minimum of 0.02% (pulmonary fibrosis) and the maximum of 2.31% (pneumonia). Although not reaching statistical significance, GLP1RAs versus placebo showed the reduced trends in the risks of 9 kinds of respiratory disorders including pneumonia (RR 0.89, 95% CI 0.78-1.01), squamous cell carcinoma of lung (SCCL; RR 0.55, 95% CI 0.25-1.21), asthma (RR 0.82, 95% CI 0.51-1.32), and chronic obstructive pulmonary disease (COPD; RR 0.89, 95% CI 0.73-1.10), but the increased trend in interstitial lung disease (ILD; RR 1.89, 95% CI 0.87-4.08). GLP1RAs had neutral effects on two other respiratory disorders. Heterogeneity in any meta-analysis was absent or low.

CONCLUSION: GLP1RAs show the reduced trends in the risks of 9 kinds of respiratory disorders (e.g., pneumonia, SCCL, asthma, and COPD), but the increased trend in the risk of ILD. However, these findings need to be validated by further studies due to the low incidence rates of all the respiratory disorders.

PMID:33825329 | DOI:10.1111/crj.13372

J Med Syst. 2021 Apr 6;45(5):58. doi: 10.1007/s10916-021-01732-9.

ABSTRACT

To evaluate an academic institution’s implementation of a gynecologic electronic consultation (eConsult) service, including the most common queries, turnaround time, need for conversion to in-person visits, and to demonstrate how eConsults can improve access and convenience for patients and providers. This is a descriptive and retrospective electronic chart review. We obtained data from the UCSF eConsult and Smart Referral program manager. The medical system provided institution-wide statistics. Three authors reviewed and categorized gynecologic eConsults for the last fiscal year. The senior author resolved conflicts in coding. The eConsult program manager provided billing information and provider reimbursement. A total of 548 eConsults were submitted to the gynecology service between July 2017 and June 2020 (4.5% of institutional eConsult volume). Ninety-five percent of the eConsults were completed by a senior specialist within our department. Abnormal pap smear management, abnormal uterine bleeding, and contraception questions were the most common queries. Over half (59.3%) of all inquiries were answered on the same day as they were received, with an average of 9% declined. Gynecology was the 10th largest eConsult provider at our institution in 2020. The present investigation describes one large university-based experience with eConsults in gynecology. Results demonstrate that eConsults permit appropriate, efficient triaging of time-sensitive conditions affecting patients especially in the time of the COVID-19 pandemic. eConsult services provide the potential to improve access, interdisciplinary communication, and patient and provider satisfaction.

PMID:33825075 | DOI:10.1007/s10916-021-01732-9

J Genet Eng Biotechnol. 2021 Apr 6;19(1):54. doi: 10.1186/s43141-021-00154-x.

ABSTRACT

BACKGROUND: Diagnosis of breast cancer is more complicated due to lack of minimal invasive biomarker with sufficient precision. DNA methylation is a promising marker for cancer diagnosis. In this study, authors evaluated methylation patterns for PTEN and SMAD4 in blood samples using EpiTect Methyl II QPCR assay quantitative PCR technology.

RESULTS: Methylation status for PTEN and SMAD4 were statistically significant as breast cancer patients reported hypermethylation compared to benign and control groups (77.1 ± 17.9 vs. 24.9 ± 4.5 and 15.1 ± 1.4 and 70.1 ± 14.4 vs. 28.2 ± 0.61 and 29.5 ± 3.6, respectively). ROC curve analysis revealed that both PTEN (AUC = 0.992) and SMAD4 (AUC = 0.853) had good discriminative power for differentiating BC from all non-cancer individuals (benign and healthy combined) compared to routine tumor markers CEA (AUC = 0.538) and CA15.3 (AUC = 0.686). High PTEN methylation degree was associated with late stages (84.2 ± 17.4), positive lymph node (84.2 ± 18.5), positive ER (81.3 ± 19.7), positive PgR (79.5 ± 19.1), and positive HER2 (80.7 ± 19.0) vs. 67.4 ± 13.8, 70.6 ± 14.8, 72.8 ± 14.9, 72.5 ± 14.7, and 70.2 ± 13.5 in early stages, negative lymph node, negative ER, negative PgR, and negative HER2, respectively. Similar results were obtained regarding SMAD4 methylation. Sensitivity, specificity, positive and negative predictive values, and accuracy for methylated PTEN were 100%, 95%, 99.1%, 100%, and 95%, respectively when differentiated BC from all-non cancer controls. Interestingly, PTEN could distinguish early BC stages with good sensitivity 84.4%, 51.4%, 69.1%, 72%, and 70%, respectively.

CONCLUSION: Methylation status of PTEN and SMAD4 is a promising blood marker for early detection of breast cancer. Future studies are needed for their role as prognostic markers.

PMID:33825073 | DOI:10.1186/s43141-021-00154-x

Cardiovasc Intervent Radiol. 2021 Apr 6. doi: 10.1007/s00270-021-02824-2. Online ahead of print.

ABSTRACT

PURPOSE: To determine 30-day-mortality rates and identify predictors for survival in patients undergoing endovascular revascularization for acute mesenteric ischemia (AMI) due to occlusion of the celiac (CA) or superior mesenteric artery (SMA) from arterial thrombosis in the setting of atherosclerosis at the vessel origin.

MATERIALS AND METHODS: A retrospective analysis on patients who underwent acute endovascular revascularization to treat AMI caused by thrombotic occlusion of the CA and/or SMA between January 2011 and December 2019 was conducted. 30-day-mortality rates were calculated. Univariate binomial logistic regression analyses (p < 0.05) were performed to assess whether the following factors were associated with 30-day mortality: sex, age, history of smoking, history of abdominal angina, signs of bowel necrosis on pre-interventional CT, one- vs. two-vessel disease, patency of the inferior mesenteric artery, outpatient or inpatient occurrence of ischemia, onset of AMI during ITU stay, elevated pre-interventional serum lactate levels, total leukocyte count, platelet/lymphocyte ratio and neutrophil/lymphocyte ratio.

RESULTS: 40 patients were included in this analysis. 30-day-mortality rate was 25/40 (62.5%). Median overall survival of patients who survived the first 30 days was 36 ± 18 months. None of the analyzed factors was statistically significantly associated with 30-day mortality.

CONCLUSION: Although mortality of patients with AMI due to acute arterial thrombosis remains high, almost 40% of patient who underwent emergent endovascular revascularization survived longer than one month. Since no predictors for the outcome in these patients were identified, all patients with AMI should be offered an immediate revascularization effort.

PMID:33825061 | DOI:10.1007/s00270-021-02824-2

Cogn Res Princ Implic. 2021 Apr 6;6(1):27. doi: 10.1186/s41235-021-00290-5.

ABSTRACT

Camouflage-breaking is a special case of visual search where an object of interest, or target, can be hard to distinguish from the background even when in plain view. We have previously shown that naive, non-professional subjects can be trained using a deep learning paradigm to accurately perform a camouflage-breaking task in which they report whether or not a given camouflage scene contains a target. But it remains unclear whether such expert subjects can actually detect the target in this task, or just vaguely sense that the two classes of images are somehow different, without being able to find the target per se. Here, we show that when subjects break camouflage, they can also localize the camouflaged target accurately, even though they had received no specific training in localizing the target. The localization was significantly accurate when the subjects viewed the scene as briefly as 50 ms, but more so when the subjects were able to freely view the scenes. The accuracy and precision of target localization by expert subjects in the camouflage-breaking task were statistically indistinguishable from the accuracy and precision of target localization by naive subjects during a conventional visual search where the target ‘pops out’, i.e., is readily visible to the untrained eye. Together, these results indicate that when expert camouflage-breakers detect a camouflaged target, they can also localize it accurately.

PMID:33825054 | DOI:10.1186/s41235-021-00290-5

Brain Struct Funct. 2021 Apr 7. doi: 10.1007/s00429-020-02200-9. Online ahead of print.

ABSTRACT

While previous structural-covariance studies have an advanced understanding of brain alterations in Parkinson’s disease (PD), brain-behavior relationships have not been examined at the individual level. This study investigated the topological organization of grey matter (GM) networks, their relation to disease severity, and their potential imaging diagnostic value in PD. Fifty-four early-stage PD patients and 54 healthy controls (HC) underwent structural T1-weighted magnetic resonance imaging. GM networks were constructed by estimating interregional similarity in the distributions of regional GM volume using the Kullback-Leibler divergence measure. Results were analyzed using graph theory and network-based statistics (NBS), and the relationship to disease severity was assessed. Exploratory support vector machine analyses were conducted to discriminate PD patients from HC and different motor subtypes. Compared with HC, GM networks in PD showed a higher clustering coefficient (P = 0.014) and local efficiency (P = 0.014). Locally, nodal centralities in PD were lower in postcentral gyrus and temporal-occipital regions, and higher in right superior frontal gyrus and left putamen. NBS analysis revealed decreased morphological connections in the sensorimotor and default mode networks and increased connections in the salience and frontoparietal networks in PD. Connection matrices and graph-based metrics allowed single-subject classification of PD and HC with significant accuracy of 73.1 and 72.7%, respectively, while graph-based metrics allowed single-subject classification of tremor-dominant and akinetic-rigid motor subtypes with significant accuracy of 67.0%. The topological organization of GM networks was disrupted in early-stage PD in a way that suggests greater segregation of information processing. There is potential for application to early imaging diagnosis.

PMID:33825053 | DOI:10.1007/s00429-020-02200-9