Nevin Manimala

Trop Med Int Health. 2021 Oct 3. doi: 10.1111/tmi.13684. Online ahead of print.

ABSTRACT

BACKGROUND: To estimate the prevalence of macrosomia and contributing factors among pregnant women with diabetes in Ethiopia.

METHODS: The Cochrane, PubMed, Google Scholar, SCOPUS, Web of Science electronic databases and gray literature found in online university repositories were searched for primary studies reporting the prevalence of macrosomia (birth weight ≥4 kg, irrespective of gestational age) and/or at least one determinant factor using WHO diabetes diagnosis criteria were involved. Variations across the studies were checked using the I² statistic; funnel plot and Egger’s test were used to assess publication bias. A weighted inverse random effect model was used to estimate the overall prevalence of macrosomia.

RESULTS: The overall prevalence of macrosomic newborns among pregnant women with diabetes [15.1% (95% CI; 9.0%, 21.2%)] was higher than the prevalence among non-diabetic mothers (3.9%). Maternal blood glucose level >100 mg/dl [AOR=10.5: 95% CI; 5.9, 15.1] and >120 mg/dl [AOR=8.8: 95% CI; 4.5, 13.0], lack of Antenatal Care (ANC) visit [AOR=10.8: 95% CI; 6.0, 15.0], previous adverse birth outcomes and advanced maternal age [AOR=3.5: 95% CI; 1.0, 5.9] were significantly associated with the prevalence of macrosomia at 95 % CI.

CONCLUSION: The pooled prevalence of macrosomia among pregnant women with diabetes was higher than the prevalence among non-diabetic pregnant women (3.9%). Advanced maternal age, previous adverse birth outcomes, lack of ANC and uncontrolled maternal plasma glucose level were independent predictors of macrosomia.

PMID:34601758 | DOI:10.1111/tmi.13684

Int Endod J. 2021 Oct 3. doi: 10.1111/iej.13642. Online ahead of print.

ABSTRACT

AIM: To evaluate the influence of traditional and conservative access cavity preparations on the remaining dentine thickness in the coronal third of mesial canals of extracted mandibular molars prepared with reciprocating instruments, using micro-computed tomography as the analytical tool.

METHODOLOGY: Seventy extracted mandibular molars were scanned at a pixel size of 19 μm. From this initial sample, twenty teeth were selected, pair-matched, and distributed into 2 groups (n=10) according to the access cavity preparation: traditional (TradAC) or conservative (ConsAC). The root canals were sequentially enlarged with Reciproc Blue R25 (size 25, 0.08v taper) and R40 (size 40, 0.06v taper) instruments. A new scan was performed and the postoperative stacks were co-registered with their respective preoperative datasets. A colour-coded cross-sections of the roots were created and used to identify and measure the smallest dentine thickness related to both MB and ML canals at 1.0-mm intervals from the furcation level up to 5 mm in the apical direction, in both mesial and distal aspects of the roots, before and after preparation. The statistical analyses were performed with paired-samples t-test, independent-samples Student T, and Chi-Square test with a significance level of 5%.

RESULTS: In all levels of both groups, dentine thickness before preparation was greater than after preparation (p < 0.05). No difference in the percentage of dentine reduction were observed between TradAC and ConsAC groups (p > 0.05), but a significantly greater reduction was observed to the distal aspect of the roots (p < 0.05). After root canal preparation, dentine thickness thinner than 0.5 mm was observed mostly at the distal aspect of the root (10% to 15%) of the MB and ML canals, with no influence of the access cavity type on its incidence to either mesial (X² =1.66; p=0.2) or distal (X² =0.40; p=0.5) directions. In the TradAC group, dentine thickness in most slices was greater than 1.0 mm after preparation (n=124) while, in the ConsAC, it ranged from 0.5 to 1.0 mm (n=136).

CONCLUSION: Traditional or conservative access cavity preparation in extracted mandibular molars did not influence the remaining dentine thickness in the coronal third of mesial canals enlarged with thermomechanically-treated nickel-titanium reciprocating instruments.

PMID:34601728 | DOI:10.1111/iej.13642

Headache. 2021 Oct 3. doi: 10.1111/head.14225. Online ahead of print.

ABSTRACT

OBJECTIVE: This internet survey aimed to analyze the activity of midolordecabeza.org, a specialized website for headache stakeholders.

BACKGROUND: eHealth tools, such as websites, can be educational for stakeholders of a specific disease, such as patients. This is particularly helpful in chronic disorders such as migraine. eHealth also enhances patient-centered outcome research. The website midolordecabeza.org has the stated aim of organizing key information on headache making it accessible and useful for all stakeholders, and, eventually promoting patient participation.

METHODS: We analyzed Google Analytics (GA) data to study the web’s activity, traffic source, geographical distribution of access, registered-user behavior, electronic device performance, and temporary references with greater web activity.

RESULTS: From January 2015 until December 2020, the website registered 1,121,585 visitors, 1,775,953 sessions, and a total of 3,833,144 views with an average time per session of nearly 2 min. Higher data traffic has been registered in Spanish-speaking countries such as Spain (33.3%; 591,256/1,775,953), where Spain’s regions with higher views were statistically significantly correlated with the nationwide migraine prevalence (ρ = 0.505; p = 0.039). In regard to social behavior, returning users were statistically significantly associated with being a woman (84.0%; 5696/6781), and they predominantly acceded from organic searches (50.6%; 3434/6781). When answering available open surveys, 72.5% (1827/2520) described their migraine as a disabling disease with high impact on their daily tasks and 64.4% (14,016/21,764) were unaware of what their headache diagnosis is.

CONCLUSIONS: Spanish-speaking patients with migraine around the world increasingly visited the headache-specialized website midolordecabeza.org using different electronic devices, showing great interest in their disease. This website allowed them to get updated information on their disease, share clinical data with physicians, and finally express their concerns.

PMID:34601726 | DOI:10.1111/head.14225

J Gastrointest Cancer. 2021 Oct 3. doi: 10.1007/s12029-021-00723-w. Online ahead of print.

ABSTRACT

PURPOSE: Mortality from pancreatic cancer has risen fast in the past two decades in East Africa, including Kenya. However, there was a paucity of conclusive data about the survival of pancreatic cancer patients in the study setting. Hence, this study aimed to assess the survival outcomes of pancreatic cancer patients at Kenyatta National Hospital.

METHODS: A hospital-based retrospective cohort analysis was used to evaluate the survival outcomes among pancreatic cancer patients treated in the study setting from 1 January 2015 to 31 December 2019. A total of 64 eligible pancreatic cancer patients were included in the study. In the pre-designed data abstraction tool, the data were collected by reviewing the medical records of the patients. The data were analyzed using the Statistical Package for the Social Sciences version 22 software. The mean survival time was estimated using Kaplan-Meier survival analysis. Cox regression analysis was employed to estimate the predictors of mortality among pancreatic cancer patients.

RESULTS: The mean age of the study participants was 60.38 ± 12.61 years. Most of the patients had adenocarcinoma (96.9%) and were diagnosed at an advanced stage of the disease. The overall mean and median survival estimate for pancreatic cancer was 48.7 ± 9.7 and 39.0 ± 23.9 months, respectively. The present study showed that the overall survival rate of pancreatic cancer patients was 79.7%.

CONCLUSION: The mortality rate of pancreatic cancer in the present study was 20%. The overall mean survival estimate for pancreatic cancer was 48.7 ± 9.7 months, and the majority had disease progression in the last follow-up period.

PMID:34601708 | DOI:10.1007/s12029-021-00723-w

Ir J Med Sci. 2021 Oct 3. doi: 10.1007/s11845-021-02788-9. Online ahead of print.

ABSTRACT

BACKGROUND: International evidence indicates that about 10% of people with alcohol dependence will seek and commence treatment each year. Based upon Irish estimates of prevalence of dependence, a target of 690.0 treated cases per 100,000 population per annum is expected.

AIMS: This study analyses routine national surveillance data on alcohol treatment to measure how treatment need is being met.

METHODS: National treatment surveillance data on problem alcohol use collected by the National Drug Treatment Reporting System (NDTRS) were analysed. The study included cases resident in Ireland, aged 18-64 years entering treatment for alcohol use disorder (AUD) between 2015 and 2019 (n = 44,079). Treatment rates were calculated per 100,000 of the population. Descriptive and exploratory statistics were used to describe characteristics of cases treated.

RESULTS: National rate of treated AUD was 270 cases per 100,000 annually, with a rate of treated alcohol dependence of 165/100,000. There was a fivefold difference between the lowest and highest rates (119 cases per 100,000 in Meath versus 633 in Waterford). Drinking patterns indicate high levels of alcohol consumption and prolonged use prior to treatment. The use of other drugs alongside alcohol was common.

CONCLUSIONS: Despite high rates of alcohol consumption and dependence, the rate of treatment entry nationally is sub-optimal, although there are wide geographic variations. There is a need to better understand the reasons for low treatment entry rates in Ireland for people with alcohol dependence. Monitoring and surveillance play a key role in measuring the successful efforts to reduce the harm of alcohol.

PMID:34601707 | DOI:10.1007/s11845-021-02788-9

Int Urol Nephrol. 2021 Oct 3. doi: 10.1007/s11255-021-02999-0. Online ahead of print.

ABSTRACT

PURPOSE: It is a prospective randomized controlled trial comparing the efficacy of percutaneous tibial nerve stimulation versus sham for a shortened 6-week protocol of treatment in management of refractory OAB in non-neurogenic adult patients.

METHODS: A total of 50 adults with refractory non-neurogenic overactive bladder symptoms were randomized 1:1 to 6 weeks of treatment with weekly percutaneous tibial nerve stimulation or sham therapy. Overactive bladder symptom score as well as 3-day voiding diaries were completed at baseline and at 7th week, 3rd and 6th month.

RESULTS: The 7th week, 3rd and 6th month symptom score assessment for overall bladder symptoms demonstrated that percutaneous tibial nerve stimulation patients achieved statistically significant improvement in bladder symptoms with 52% reporting moderately improved responses compared to non-response of sham patients from baseline (P = 0.001). Voiding diary parameters after 6 weeks of therapy showed that PTNS patients had statistically significant improvements in frequency, voided volume and urgency urinary incontinence episodes compared to sham. No serious device-related adverse events or malfunctions were reported.

CONCLUSION: A shortened 6-week treatment protocol with PTNS appears to be successful and more effective than sham in the treatment of refractory OAB. PTNS therapy is safe and effective in treating OAB symptoms with 52% success rate following a shortened 6-week protocol. The duration of treatment with PTNS can be halved compared to the conventional 12 weeks, which would make it more acceptable and cost effective for patients.

PMID:34601705 | DOI:10.1007/s11255-021-02999-0

Neurol Sci. 2021 Oct 2. doi: 10.1007/s10072-021-05636-x. Online ahead of print.

ABSTRACT

BACKGROUND: Up to 50% of motor neuron disease (MND) patients show neuropsychological deficits which negatively affect prognosis and care. However, disability-related logistical issues and uneven geographical coverage of healthcare services may prevent MND patients from accessing neuropsychological evaluations. This study thus aimed to standardize for the Italian population the ALS Cognitive Behavioral Screen-Phone Version (ALS-CBS™-PhV), an MND-specific, telephone-based screening for frontotemporal dysfunction.

METHODS: The cognitive section of the ALS-CBS™-PhV, the Italian telephone-based Mini-Mental State Examination (Itel-MMSE), and the Telephone Interview for Cognitive Status (TICS) was administered to 359 healthy individuals (143 males, 216 females; age, 52.7 ± 15.8; education, 13.1 ± 4.4). Norms were derived through equivalent scores. Validity, factorial structure, reliability, diagnostic accuracy, and item difficulty and discrimination were examined. Statistical equivalence between the telephone-based and in-person versions was tested.

RESULTS: ALS-CBS™-PhV measures were predicted by age and education. The ALS-CBS™-PhV reflected a mono-component structure, converged with Itel-MMSE and TICS scores (r_s = .23-.51) and was equivalent to its in-person format (t = .37; p = .72). Good internal (Cronbach’s α = .61), test-retest (ICC = .69), and inter-rater (ICC = .96) reliability was detected. High accuracy was found when tested against both the Itel-MMSE and the TICS (AUC = .82-89). Backward digit span items were the most discriminative.

DISCUSSION: The ALS-CBS™-PhV is a statistically solid screening test for frontotemporal disorders featuring MND. Its standardization allows for (1) improvements in tele-healthcare for MND patients, (2) epidemiological applications, and (3) effective assessments in decentralized clinical trials. The ALS-CBS™-PhV can be also suitable for assessing bedridden and visually impaired patients with motor disorders.

PMID:34601697 | DOI:10.1007/s10072-021-05636-x

Environ Sci Pollut Res Int. 2021 Oct 3. doi: 10.1007/s11356-021-16562-y. Online ahead of print.

ABSTRACT

The circular economy (CE) is a proposal for a new, more sustainable, and durable economy model. As a consequence, this pro-environmental economic model induces visible changes in the labor market which are Green Jobs (GJs). This paper is focused on the creation of Green Jobs in the CE. The GJs are most visible in the environmental goods and services sector (EGSS). This study aims to investigate EGSS among 28 European Union countries in the years 2009-2019. The adopted method was literature research complemented by the statistical analysis of secondary data from Eurostat in the linear regression method. Then, some Sustainable Development Goals (SDGs) and their measure were used as main indicators reflecting changes in the labor market. Results are presented as a model indicating which of the SDGs can support CE and enhance a number of the Green Jobs. Presented results contribute to the science because combine factors influencing GJs creation in EGSS, in a CE perspective. This study underlines a lack of uniform methods for measuring and forecasting the effects of Green Jobs creation and indicates future research directions.

PMID:34601690 | DOI:10.1007/s11356-021-16562-y

J Comput Neurosci. 2021 Oct 3. doi: 10.1007/s10827-021-00797-2. Online ahead of print.

ABSTRACT

Recurrent neural networks of spiking neurons can exhibit long lasting and even persistent activity. Such networks are often not robust and exhibit spike and firing rate statistics that are inconsistent with experimental observations. In order to overcome this problem most previous models had to assume that recurrent connections are dominated by slower NMDA type excitatory receptors. Usually, the single neurons within these networks are very simple leaky integrate and fire neurons or other low dimensional model neurons. However real neurons are much more complex, and exhibit a plethora of active conductances which are recruited both at the sub and supra threshold regimes. Here we show that by including a small number of additional active conductances we can produce recurrent networks that are both more robust and exhibit firing-rate statistics that are more consistent with experimental results. We show that this holds both for bi-stable recurrent networks, which are thought to underlie working memory and for slowly decaying networks which might underlie the estimation of interval timing. We also show that by including these conductances, such networks can be trained to using a simple learning rule to predict temporal intervals that are an order of magnitude larger than those that can be trained in networks of leaky integrate and fire neurons.

PMID:34601665 | DOI:10.1007/s10827-021-00797-2

Clin Rheumatol. 2021 Oct 3. doi: 10.1007/s10067-021-05947-6. Online ahead of print.

ABSTRACT

Instagram allows for graphical and visual information exchange. This paper aims to explore the current landscape of rheumatology on Instagram and analyse the accounts available based on their objectives and level of engagement. The search term “#rheumatology” reveals 62 results, leaving 55 after careful exclusion. On grouping into “educational”, “broadcasting”, “support”, and a combination of all three, an analysis is carried out using the total number of posts, follower counts, number of caption characters (last 10 posts), likes per post (last 10 posts), archived stories, reels, IgTV (Instagram Television) videos, hashtags, and links in bio. The analysis reveals that 29 accounts (52.7%) disseminate educational content, 36 (65.4%) are run by organisations, and 22 (40.0%) are of an institute or clinic. Character counts (rho 0.44, p = 0.0006) and videos (likes for ten posts 149 vs. 54, p = 0.006) positively correlate with the number of likes, while hashtag use and post count have no statistical significance with likes. Reels and IgTV videos are infrequently used (18.18%, 3.6%). The rheumatology social media landscape is in its nascency and currently split into educational and broadcasting accounts with a significant overlap between the two. The positive correlation of character counts and videos and the negative correlation of hashtag use and post count with likes lay the case for quality content to improve engagement. Social media editors may ensure quality content for rheumatology education using Instagram. Key Points • The current landscape of Instagram use in rheumatology is limited and largely orientated towards educative content. • Likes on Instagram are positively correlated with caption character counts and videos. • Using currently underutilised tools like videos, engaging captions, and infographics may enhance the utility of Instagram in rheumatology education.

PMID:34601652 | DOI:10.1007/s10067-021-05947-6