Nevin Manimala

J Dent. 2021 Mar 20:103640. doi: 10.1016/j.jdent.2021.103640. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the influence of neutral color backgrounds on the perception of color differences in dentistry.

METHODS: A software was developed for this study that calculated the perceptibility (PT) and acceptability (AT) thresholds of color differences between a pair of computer-simulated incisor samples (n = 60 pairs) over three neutral color (white, gray and black) backgrounds. CIELAB and CIEDE2000 color difference formulas were used. Five groups of volunteer observers (N = 100) participated in the psychophysical experiment (n = 20): Dentists; Dental students; Dental auxiliaries; Dental technicians; and Laypersons. The psychophysical experiment was performed in a dark environment on a calibrated high-resolution screen. To determine PT and AT values, the 60 pairs of samples were randomly presented to each observer over the different backgrounds. The data were adjusted (TSK Fuzzy) and analyzed statistically using Student t-test and ANOVA (α = 0.05).

RESULTS: Regardless of the metric and the background used, the PT values showed no difference among different observers (p > 0.05). Dentists showed the lowest PT values. Dental technicians showed the lowest AT (p ≤ 0.05) and similar values for the three backgrounds (p > 0.05), regardless of the metric used. The other groups of observers showed the lowest and the highest AT values when using black and white backgrounds, respectively (p ≤ 0.05).

CONCLUSIONS: The lowest AT values using a black background indicates that the use of this background allows for the evaluation of slight color differences, and should be used for challenging color differences in esthetic dentistry. This study showed the influence of the observer experience on color evaluation in dentistry.

CLINICAL SIGNIFICANCE: There was no influence of the background color on the perceptibility threshold. However, dentists and dental technicians showed greater ability to perceive slight color differences compared to other groups of observers.

PMID:33757865 | DOI:10.1016/j.jdent.2021.103640

J Dent. 2021 Mar 20:103641. doi: 10.1016/j.jdent.2021.103641. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate, by means of microtensile bond strength test (µTBS), nanoleakage expression analysis (NL), gelatin zymography and in situ zymography, the effects of an experimental metal salt-based zirconium oxynitrate etchant [ZrO(NO3)2,] – ZON with two simplified adhesives on long-term bond strength and endogenous enzymatic activities.

METHODS: Middle/deep coronal dentin surfaces (N = 32) were conditioned either with a traditional 37% H3PO4 etchant (TE) or with ZON. Further, a single-component etch-and-rinse adhesive (EF) or a universal adhesive (AU) were applied and µTBS and NL tests were performed. Additional freshly extracted teeth were processed for gelatin zymography and in situ zymography evaluation. The tests were performed at baseline and (T0) and after 1-year-aging (T12). Bond strength and in situ zymography results were analyzed using analysis of variance (ANOVA) (three-way and one-way, respectively), while Chi-squared test was used for the NL results. Statistical significance was preset at α = 0.05.

RESULTS: All the investigated factors (adhesive system, dentin conditioner and aging) significantly influenced µTBS, with the AU and ZON performing better compared to EF and TE, respectively, and with lower bond strength values after aging (p < 0.05). Incremented silver nitrate deposits were observed at the adhesive interfaces after aging, especially for the TE groups (p < 0.05). Further, the experimental groups treated with ZON had significantly lower levels of enzymatic activity compared to TE, as shown by gelatin and in situ zymography (p < 0.05).

CONCLUSIONS: The experimental etchant demonstrated promising results in hybrid-layer preservation over time when used with simplified bonding systems, and could therefore be recommended in the clinical practice.

PMID:33757864 | DOI:10.1016/j.jdent.2021.103641

Arch Phys Med Rehabil. 2021 Mar 21:S0003-9993(21)00237-9. doi: 10.1016/j.apmr.2021.02.024. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine differences in participation problems between diagnostic groups and to examine diagnosis as a determinant of participation with and without statistically accounting for confounders.

DESIGN: Secondary analyses of data from eight studies (total 1,735 participants).

SETTING: Community, the Netherlands PARTICIPANTS: Diagnostic-groups included: stroke (n=534), subarachnoid hemorrhage (n=104), other acquired brain injury (n=163), progressive neurological diseases (n=112), acute coronary syndrome (n=536) and spinal cord injury (n=286).

MAIN OUTCOME MEASURE: Participation was measured with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation). This measure has three scales: Restrictions, Satisfaction and Frequency. Scores were also computed for three domains across these scales: Productivity, Leisure and Social in this study. The range of all scores is from 0 (worst) up to 100 (best). Possible confounders were age, sex, level of education, marital status and time since onset of the condition.

RESULTS: Significant differences in levels of participation between diagnostic-groups were found. People with acute coronary syndrome showed better participation scores in all scales and domains compared to most or all other diagnostic groups, except for the Social domain. People with progressive neurological diseases showed the lowest (worst) Restriction- and Satisfaction scores, whereas people with stroke showed the lowest Frequency scores. After correcting for confounders, diagnosis explained significant proportions of the variance of participation (Frequency 6.4%; Restrictions 15.1%; Satisfaction 5.1%, Productivity 13.2%; Leisure 13.8%; Social: 6.9%).

CONCLUSIONS: Participation problems occurred in all six diagnostic groups within this study. Differences in participation between diagnostic-groups were found, thereby showing diagnosis-specific participation profiles, also after correcting for confounders.

PMID:33757804 | DOI:10.1016/j.apmr.2021.02.024

Am J Cardiol. 2021 Mar 20:S0002-9149(21)00267-8. doi: 10.1016/j.amjcard.2021.03.024. Online ahead of print.

ABSTRACT

Prevalence of atrial fibrillation (AF) increases with age, along with comorbidities and, thus, polypharmacy. Non-adherence is associated with polypharmacy. This study aimed to identify patients at risk for cardiovascular events according to their pharmacological treatment intensity and adherence. Patients (n=18,113) with a mean age of 71.5±8.7 years, at high cardiovascular risk were followed between December 2005 until December 2007 for a median time of 2 years. The association between polypharmacy and adherence and their impact on cardiovascular and bleeding events were explored. Adherence was defined as a study drug intake of ≥80%. Patients with more co-medications had a higher body mass index, higher prevalence of hypertension, coronary heart disease, heart failure, and diabetes mellitus (all p<0.0001) compared to ≤4 or 5-8 co-medications, but no differences in history of stroke (p=0.68) or transient ischemic attack (p=0.065). Across all treatments, the adjusted hazard ratios (HRs) increased in patients with more co-medications (>=9 vs <=4) for all-cause death (HR 1.30; 1.06-1.59), major bleeding (HR 1.65; 1.33-2.05), and all bleeding events (HR 1.44; 1.31-1.59). Yearly event rates were higher in non-adherent than adherent patients for stroke and systemic embolism (SSE) (3.14 vs 1.00), all-cause death (7.76 vs. 2.66), major bleeding (6.21 vs. 2.65), and all bleeding (28.71 vs. 19.05; all p<0.0001). After an event the patients were more likely to become non-adherent (adherence after SSE 30.3%, after major bleeding 33.4%, after all bleeding 66.7%; all p<0.0001). The treatment effects were consistent to the overall group in the different polypharmacy groups. In conclusion, polypharmacy and non-adherence are risk indicators for increased adverse cardiovascular and bleeding events. Dabigatran is safe to use across the full spectrum of AF patients, independent of the number of co-medications and adherence. Patients with co-medications and comorbidities require special attention and encouragement to adhere to oral anticoagulation.

PMID:33757788 | DOI:10.1016/j.amjcard.2021.03.024

Adv Clin Exp Med. 2021 Mar 23. doi: 10.17219/acem/130592. Online ahead of print.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia, the most common cause of supraventricular tachycardia in the global population and the most common arrhythmia requiring treatment in an emergency department.

OBJECTIVES: To systematically review recent literature and quantify the correlation between the choice of pharmacological cardioversion (PCV) drug and the national or international guidelines.

MATERIAL AND METHODS: A systematic review was performed in accordance with the PRISMA statement methodology. The PubMed search engine was used to search for articles regardless of type or language and published in the last 6 years (May 2014-May 2020). In addition, we searched for AF guidelines and recommendations published online by cardiology and emergency medicine societies.

RESULTS: The search strategy returned a total of 2615 abstracts. A total of 2598 full texts were screened; 2540 full texts were excluded with reasons and 58 articles from 32 countries were included in the analysis. In 17 of the 58 articles (29%), we noted discrepancies with the AF guidelines, specifically regarding the PCV drug used, the patients’ comorbidities and the contraindications associated with the PCV drug. The most common clinical situation for the use of a contraindicated drug was when ibutilide was administered to patients with heart failure. The analysis did not reveal any statistically significant correlations, although the correlation between the sample size and guideline adherence was close to statistical significance (p < 0.06).

CONCLUSION: Our systematic analysis revealed substantial non-adherence to AF treatment guidelines.

PMID:33757165 | DOI:10.17219/acem/130592

Ginekol Pol. 2021 Mar 23. doi: 10.5603/GP.a2021.0024. Online ahead of print.

ABSTRACT

OBJECTIVES: Incomplete healing of the uterine scar after cesarean section may result in formation of a niche. The aim of this study is to identify the potential risk factors for the improper uterine healing after cesarean section in women with single layer, full thickness uterine closure with the use of two- and three-dimensional transvaginal ultrasonography.

MATERIAL AND METHODS: 204 women with a history of at least one low transverse cesarean section (CS) with a single layer uterine closure participated in the study. Residual myometrial thickness (RMT), adjacent myometrial thickness (AMT), width (W), depth (D) and volume of the niche, RMT/AMT, RMT/D, RMT/W ratio and clinical characteristics were analyzed.

RESULTS: A niche after cesarean section was found in 153 cases. However only five patients had a RMT < 2.2 mm, and 35 had an RMT/AMT ratio ≤ 0.5. The RMT and RMT/AMT ratio among women who had undergone more than one cesarean section was lower than among women who underwent the first cesarean section. No statistically significant relationship was found between the incidence of niche, its parameters and cervical dilation, uterine contractions, cesarean section in the second stage of labor, type of uterus incision expansion and flexion, operator’s experience.

CONCLUSIONS: Healing of the uterine cesarean section scar in women with single-layer continuous suture covering the entire thickness of the myometrium, excluding the decidua is not affected by the mode of caesarean section, type of uterine incision expansion and flexion, operator’s experience, stage of labor at the time of caesarean section.

PMID:33757154 | DOI:10.5603/GP.a2021.0024

Ginekol Pol. 2021 Mar 23. doi: 10.5603/GP.a2020.0168. Online ahead of print.

ABSTRACT

OBJECTIVES: Vulvodynia diagnosis is based on medical history and physical examination. The study is aimed to evaluate the clinical usefulness of a pelvic floor physical examination (VAMP protocol) for vulvodynia diagnosis, applied during gynecological examination, proposed as educational and diagnostic tool.

MATERIAL AND METHODS: Pelvic physical examinations were performed for 650 non-pregnant female patients. A study group of 449 cases met the vulvodynia diagnostic criteria (120 with provoked, 104 with spontaneous, and 121 with mixed subtype) and were compared with those of 201 healthy individuals. Four anatomical regions were examined: the vulva (V) and anus (A) with a cotton swab, the internal pelvic muscles (M) with a digital examination of the levator ani, and the paraurethral (P) area with digital pressure. Only the maximum pain score for a given area was recorded, using a Numerical Rating Scale. The four anatomical regions were recorded under the VAMP acronym.

RESULTS: Differences in mean scores VAMP protocol were statistically between vulvodynia and comparison group for V = 6.48 vs 0.98; M = 6.29 vs 1.05; and P = 6.89 vs 1.33, with exception of A = 0.03 vs 0.08. Patient age, weight, way of delivery, other concomitant diseases (e.g., dysuria, anal and bowel symptoms), vulvodynia subtype, and pain duration did not influence VAMP scores in patients with vulvodynia and comparison group.

CONCLUSIONS: Pelvic examination according to VAPM protocol can be applied in vulvar pain patients for diagnostic purposes. Besides of vulvodynia symptoms any other analyzed variables did not influence on scores of VAMP protocols. We found that cut-off score ≥ 3 even in one of V, M or P component of VAMP protocol can be considered as diagnostic criterium for vulvodynia. Component A (anus area) was not useful for vulvodynia diagnosis.

PMID:33757151 | DOI:10.5603/GP.a2020.0168

Am J Perinatol. 2021 Mar 23. doi: 10.1055/s-0041-1726125. Online ahead of print.

ABSTRACT

OBJECTIVE: Electrolyte, hemoglobin, and bilirubin values are routinely reported with point-of-care (POC) testing for blood gases. Results are rapidly available and require a small blood volume. Yet, these results are underutilized due to noted discrepancies between central laboratory (CL) and POC testing. The study aimed to determine the correlation between POC and CL measurement of electrolytes, hemoglobin, and bilirubin in neonates.

STUDY DESIGN: Electrolyte, hemoglobin, and bilirubin results obtained from capillary blood over a 4-month period were analyzed. Each CL value was matched with a POC value from the same sample or another sample less than 1-hour apart. Agreement was determined by measuring the mean difference (MD) between paired samples with 95% limits of agreement (LOA) and Lin’s concordance correlation (LCC).

RESULTS: There were 355-paired sodium/potassium, 139 paired hemoglobin, and 197 paired bilirubin values analyzed. POC sodium values were lower (133.5 ± 5.8 mmol/L) than CL (140.2 ± 5.8 mmol/L), p <0.00001 with poor agreement (LCC = 0.49; MD = 6.7; 95% LOA: -13.6 to 0.14). POC potassium values were lower (4.6 ± 0.98 mmol/L) than CL (4.98 ± 1.24mEq/L), p < 0.0001, but with better concordance and agreement. (LCC = 0.6; MD = 0.4; 95% LOA: -2.3 to 1.4). There were no differences in hemoglobin between POC (14.3 ± 3.2 g/dL) and CL (14.4 ± 3.1 g/dL), p = 0.2 with good LCC (0.93) and in bilirubin values between POC (6.0 ± 3.2 mg/dL) and CL (5.8 ± 3.0 mg/dL), MD = 0.18, and p = 0.07.

CONCLUSION: POC Sodium values are lower than CL. POC potassium levels are also lower, but the differences may not be clinically important while hemoglobin and bilirubin levels are similar between POC and CL. As POC potassium, hemoglobin, and bilirubin levels closely reflect CL values, these results can be relied upon to make clinical judgments in neonates.

KEY POINTS: · Electrolyte, hemoglobin, and bilirubin are available as POC.. · POC sodium and potassium values are lower than CL results.. · Hemoglobin and bilirubin values are similar between POC and CL..

PMID:33757138 | DOI:10.1055/s-0041-1726125

Ultraschall Med. 2021 Mar 23. doi: 10.1055/a-1408-2292. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting cervical infiltration by endometrial carcinoma using meta-analysis assessment.

METHODS: An extensive search of papers comparing TVS and MRI for assessing cervical infiltration in endometrial cancer in the same set of patients was performed in Medline (Pubmed), Web of Science, and the Cochrane Database. Quality was assessed using QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies-2). Quantitative meta-analysis was performed.

RESULTS: Our extended search identified 12 articles that used both techniques in the same set of patients and were included in the meta-analysis. The risk of bias for most studies was high for patient selection and index tests in QUADAS-2. Overall, the pooled estimated sensitivity and specificity for diagnosing cervical infiltration in women with endometrial cancer were identical for both techniques [69 % (95 % CI, 51 %-82 %) and 93 % (95 % CI, 90 %-95 %) for TVS, and 69 % (95 % CI, 57 %-79 %) and 91 % (95 % CI, 90 %-95 %) for MRI, respectively]. No statistical differences were found when comparing both methods. Heterogeneity was high for sensitivity and moderate for specificity when analyzing TVS and moderate for both sensitivity and specificity in the case of MRI.

CONCLUSION: TVS and MRI showed very similar diagnostic performance for diagnosing cervical involvement in women with endometrial cancer.

PMID:33757136 | DOI:10.1055/a-1408-2292

Zootaxa. 2020 Dec 23;4896(4):zootaxa.4896.4.5. doi: 10.11646/zootaxa.4896.4.5.

ABSTRACT

A new species, Gammarus baengnyeongensis sp. nov., belonging to the family Gammaridae Leach, 1814 was collected from the Baengnyeongdo and Daecheongdo islands in South Korea. This new species is characterized by the flagellum of antenna 2 with calceoli, and the length ratio of outer ramus to inner ramus of uropod 3. Descriptions of diagnostic characteristics of the species are provided in the text. We performed statistical analysis to confirm the significance of morphological differences of interspecies. Additionally, we compare the new species to related species by the partial sequence of the mitochondrial cytochrome c oxidase subunit 1 (CO1) gene. Genetic distances between the new species and closely related species rated from 29.1-40.8%, which highly supports Gammarus baengnyeongensis sp. nov. as a valid species. In this study, we add one new Gammarus species in Korean waters.

PMID:33756848 | DOI:10.11646/zootaxa.4896.4.5