Nevin Manimala

Orthod Craniofac Res. 2022 Mar 18. doi: 10.1111/ocr.12569. Online ahead of print.

ABSTRACT

OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the effectiveness of using maxillary protraction during different stages of the dentition by assessing changes in the jaws and inclination of incisors.

MATERIALS AND METHODS: MEDLINE (PubMed), Embase, Cochrane, Web Of Science, China National Knowledge Infrastructure, and Wanfang Databases were searched without time limitations up to the 15th January 2022. Google Scholar was used to search grey literature. We included cohort studies that compared the effect of maxillary protraction by analyzing primary outcomes and were grouped in age-related conditions. Mean differences and 95% confidence intervals were used for statistical analysis, followed by Grading of Recommendations Assessment, Development and Evaluation analysis.

RESULTS: Six studies were finally included. The heterogeneity test showed P≥0.1 and I² ≤50%, and a fixed-effect model was applied. Patients in the early treatment group (ETG) were mainly in the early-mixed dentition stage, while patients in the late-treatment group (LTG) were in the late-mixed and early-permanent dentition stage. Meta-analysis showed that there were no statistical differences (P>0.05) between the ETG and LTG groups in terms of SNA (the angle composed by point Sella-Nasion-Subspinale), SNB (the angle composed by point Sella-Nasion-Supramentale), ANB (the angle composed by point Subspinale-Nasion-Supramentale), Wits, U1/SN (the angle composed by the axis of upper incisors and Sella-Nasion plane), and L1/MP (the angle composed by the axis of lower incisors and the mandibular plane).

CONCLUSION: Our analysis showed that maxillary protraction applied in the late-mixed or early-permanent dentition stage did not cause different effects on the maxillary growth, the correction of the intermaxillary relationship, the inhibition of mandibular growth, and dental tipping of skeletal class III patients when compared with that in the early-mixed dentition stage. Collectively, these data provide a theoretical basis for widening the applicable age period of maxillary protraction and choosing the best treatment opportunity for children patients after a comprehensive assessment.

PMID:35303382 | DOI:10.1111/ocr.12569

J Sci Food Agric. 2022 Mar 18. doi: 10.1002/jsfa.11881. Online ahead of print.

ABSTRACT

BACKGROUND: Probiotics and prebiotics are widely used as natural feed additives in the nutrition of farm animals, including poultry. The using of this type of preparations has a positive effect on animal welfare, human health and the environment. High potential is attributed to preparations combining probiotics and prebiotics, called synbiotics. The aim of the research was to confirm the beneficial effects of synbiotics on turkey’s performance and the number of dominant intestinal microbiota. In addition, we also investigated the concentration of organic acids (lactic acid, fatty acids: short chain – SCFA and branched chain – BCFA) in the excreta of turkeys.

RESULTS: The synbiotic supplementation of turkey’s caused statistically significant (P < 0.05) differences in body weight of animals and European Production Efficiency Factor (EPEF) compared to control group after 15 weeks of rearing. The administration of the synbiotics resulted in a significant (P < 0.05) reduction in the count of potential pathogens (Clostridium spp., Clostridium coccoides and Escherichia coli), while a significant (P < 0.05) increase in the count of beneficial microorganisms (lactobacilli and Bifidobacterium spp.) in the excreta of turkeys. Result of the synbiotic supplementation, the SCFAs and lactic acid concentration were significantly (P < 0.05) increased, while the BCFAs concentration were decreased.

CONLUSION: The results showed a beneficial influence of the synbiotics on the animal’s performance, the dominant intestinal microbiota, and the fatty acids profile in the excreta of turkeys. The developed synbiotics can be effectively used in turkey’s nutrition. This article is protected by copyright. All rights reserved.

PMID:35303378 | DOI:10.1002/jsfa.11881

Am J Hematol. 2022 Mar 18. doi: 10.1002/ajh.26540. Online ahead of print.

NO ABSTRACT

PMID:35303371 | DOI:10.1002/ajh.26540

Vet Rec. 2022 Mar;190(6):e1384. doi: 10.1002/vetr.1384.

ABSTRACT

BACKGROUND: Since 2013, badger culling has been part of the UK Government’s strategy for controlling bovine tuberculosis (bTB) within a high-risk area (HRA) in England. Government surveillance data now enables an examination of bTB herd incidence and prevalence, its headline indicators, within and outside cull areas over the period 2009-2020.

METHODS: Analysis compared herd incidence and prevalence data from within and outside badger culling areas. A range of models (GLMs, GLMMs, GAMs and GAMMs) were used to analyse incidence and prevalence in culled and unculled areas using frequentist and Bayesian approaches. Change in incidence across ten county areas within the HRA for the period 2010-2020 was also compared.

RESULTS: Analyses based on Defra published data using a variety of statistical methodologies did not suggest that badger culling affected herd bTB incidence or prevalence over the study period. In 9 of 10 counties, bTB incidence peaked and began to fall before badger culling commenced.

LIMITATIONS: There are limitations around the data available on culling location, temporal information and other confounding factors. As such, further analysis of any future datasets that may be released on bTB levels in areas where badger culling has been implemented is warranted.

CONCLUSION: This examination of government data obtained over a wide area and a long time period failed to identify a meaningful effect of badger culling on bTB in English cattle herds. These findings may have implications for the use of badger culling in current and future bTB control policy.

PMID:35303326 | DOI:10.1002/vetr.1384

Fam Med. 2022 Mar;54(3):221-225. doi: 10.22454/FamMed.2022.864395.

ABSTRACT

BACKGROUND AND OBJECTIVES: Family physicians play a crucial role in addressing the opioid epidemic. We studied a novel peer-review opioid prescribing educational intervention for family medicine residents that incorporates guided instruction from an interdisciplinary care team.

METHODS: We used a mixed-methods study design in the setting of a family medicine residency program in the Midwestern United States. Residents participated in small group, peer-to-peer discussions of patients chronically prescribed opioids with guidance and input from faculty, a pharmacist, and pharmacy students. Discussions followed a structured approach to evaluation based on guidelines, and written recommendations were given to the patients’ resident primary care physician (PCP). For each patient, we reviewed electronic medical records to assess whether PCPs implemented the written recommendations. We used one-way analyses of variance to determine the statistical significance of changes made. The principal investigator interviewed seven participating residents to survey their satisfaction with the curriculum and collated suggestions for improvement.

RESULTS: Over a 3-year period, we reviewed 59 patients as part of the intervention; of these, 53 had complete records reviewed for this study. Patients’ morphine milligram equivalent dosage (MME) declined modestly (P=.035). The number and proportion of recommendations implemented was correlated with the decline in MME (P=.004 and P=.013, respectively). Interviewed residents unanimously evaluated the curriculum positively, citing that the structured approach helped align their practices with guidelines.

CONCLUSIONS: The guided peer-review intervention effectively decreased chronic opioid use among patients, and residents positively evaluated the curriculum.

PMID:35303305 | DOI:10.22454/FamMed.2022.864395

Fam Med. 2022 Mar;54(3):216-220. doi: 10.22454/FamMed.2022.698419.

ABSTRACT

BACKGROUND AND OBJECTIVES: HIV preexposure prophylaxis (PrEP) has been purposefully incorporated into our family medicine resident training within existing didactic lectures, readings, and routine office visit precepting. This mixed-methods evaluation assesses training strategies for PrEP use via survey and drug use evaluation (DUE).

METHODS: We surveyed 80 current and former family medicine residents (2014-2018) about their exposure to training components, self-reported confidence and competency in PrEP use, and practice behaviors reflecting CDC guidelines for patient eligibility and testing. In addition, we conducted a DUE of patients receiving PrEP from 2012-2018 for adherence to CDC guidelines. We report results with descriptive statistics, with χ2 analysis for group comparisons.

RESULTS: Survey response rate was 56.3%. Among respondents, 46.7% have prescribed PrEP and 55.5% self-assessed as competent to prescribe PrEP, with the majority (84%) rating precepting as most effective for building competence. Those self-assessed as competent were more likely to endorse practice behaviors reflecting CDC guidelines for monitoring PrEP (P&lt;.05). DUE identified 68 patients; 98.5% men who have sex with men. No women with recent sexually transmitted infections, nor persons who inject drugs (PWID) received PrEP. Initial testing completion ranged from 79.4% (HIV) to 54.4% (hepatitis B). Follow-up testing completion ranged from 41.5% (HIV) to 26.4% (syphilis).

CONCLUSIONS: Residents rated precepting as the most effective training. However, DUE demonstrated that PrEP underuse, as well as suboptimal testing, limited experiential training on CDC guidelines. Curricular updates should further emphasize appropriate patient selection for PrEP, including women, minorities, and PWID, as well as robust testing, to continue expanding PrEP access.

PMID:35303304 | DOI:10.22454/FamMed.2022.698419

Curr Nutr Rep. 2022 Mar 18. doi: 10.1007/s13668-022-00405-4. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Drug-resistant epilepsy represents around one-quarter of epilepsies worldwide. Although ketogenic diets (KD) have been used for refractory epilepsy since 1921, the past 15 years have witnessed an explosion of KD use in the management of epilepsy. We aimed to review evidence from randomized controlled trials (RCTs) regarding the efficacy and safety of KD in drug-resistant epilepsy in children and adolescents.

RECENT FINDINGS: A literature search was performed in the Pubmed, Cohrane, Scopus, ClinicalTrials.gov, and Google Scholar databases. Predefined criteria were implemented regarding data extraction and study quality. Data were extracted from 14 RCTs in 1114 children and adolescents aged from 6 months to 18 years. Primary outcome was seizure reduction after the intervention. In 6 out of the 14 studies, there was a statistical significant seizure reduction by > 50% in the KD-treated group compared with the control group over a follow-up of 3-4 months. Secondary outcomes were adverse events, seizure severity, quality of life, and behavior. Gastrointestinal symptoms were the most frequent adverse events. Serious adverse events were rare. We conclude that the KD is an effective treatment for drug-resistant epilepsy in children and adolescents. Accordingly, RCTs investigating long-term impact, cognitive and behavioral effects, and cost-effectiveness are much anticipated.

PMID:35303283 | DOI:10.1007/s13668-022-00405-4

Neurosurg Rev. 2022 Mar 18. doi: 10.1007/s10143-022-01771-x. Online ahead of print.

ABSTRACT

This study aimed to investigate the value of apparent diffusion coefficient (ADC) histogram analysis in differentiating intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (ATM). Retrospective analyzed the clinical, magnetic resonance imaging, and pathological data of 20 and 25 patients with SFT/HPC and ATM, respectively. Histogram analysis was performed on the axial ADC images using MaZda software, and nine histogram parameters were obtained, including mean, variance, skewness, kurtosis, and the 1^st (ADC1), 10^th (ADC10), 50^th (ADC50), 90^th (ADC90), and 99^th (ADC99) percentile ADC. Differences in ADC histogram parameters between SFT/HPC and ATM were compared by an independent t test or Mann-Whitney U test, while the statistically significant histogram parameters were further analyzed by drawing receiver operating characteristic (ROC) curves to evaluate the differential diagnostic performance. Among the nine ADC histogram parameters we extracted, the mean, ADC1, ADC10, ADC50, and ADC90 in the SFT/HPC group were greater than those of ATM, and significant differences were observed (all P < 0.05). ROC analysis showed that the ADC1 generated the highest area under the curve (AUC) value of 0.920 in distinguishing the two tumors, when using 91.00 as the optimal threshold. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in distinguishing between SFT/HPC and ATM were 84.00%, 85.00%, 84.44%, 87.50%, and 81.00%, respectively. ADC histogram analysis can be a reliable tool to differentiate between SFT/HPC and ATM, with the ADC1 being the most promising potential parameter.

PMID:35303202 | DOI:10.1007/s10143-022-01771-x

Eur J Health Econ. 2022 Mar 18. doi: 10.1007/s10198-022-01443-z. Online ahead of print.

ABSTRACT

The skilled labour shortage in nursing is an issue not unique to Germany. Unattractive characteristics of nursing jobs are one reason for the low supply in nursing personnel. In our study, we analyse the influence of job characteristics on the attractiveness of nursing jobs. We address this issue via factorial survey analysis, an experimental method particularly suited to assessing personal opinions and less prone to social desirability bias than standard interview methods. Around 1300 (current and former) nurses in a distinct region in Germany were asked to rate a set of synthetic job postings, each of which contained information on 9 systematically varied job characteristics. We find that, first, attractiveness of care jobs is most strongly affected by rather “soft” characteristics such as atmosphere within the team and time for patients. “Hard” factors play a considerably smaller role. Second, one hard factor, contract duration, is estimated to be among the most important job factors, however. This is a remarkable finding given that nursing occupations suffer from severe skill shortages. Third, though wage has a statistically significant influence on attractiveness, enormous wage raises would be needed to yield higher attractiveness gains than the top-rated soft factors, or to compensate for less pleasant job characteristics with respect to those factors. Last, even after controlling for other job characteristics, hospital nursing is still rated as more attractive than geriatric nursing.

PMID:35303192 | DOI:10.1007/s10198-022-01443-z

J Orthop Traumatol. 2022 Mar 18;23(1):15. doi: 10.1186/s10195-022-00633-y.

ABSTRACT

STUDY DESIGN: Monocentric, prospective, observational study.

OBJECTIVE: The clinical relevance of bacterial colonization of intervertebral discs is controversial. This study aimed to determine a possible relationship between bacterial and viral colonization and low-grade infection of the discs.

METHODS: We investigated 447 disc samples from 392 patients. Microbiological culture was used to examine the samples for bacterial growth, polymerase chain reaction (PCR) was used for detection of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and Cytomegalovirus (CMV), and histopathological analysis was used to detect signs of inflammation. The results were compared between subgroups organized according to gender, age, location of the samples, surgical approach, preoperative C-reactive protein (CRP), preoperative and 6 months postoperative Oswestry Disability Index (ODI) and Neck Disability Index (NDI), and Modic changes (MC) of the corresponding endplates. Also, we assessed the occurrence of postoperative infections within 6 months.

RESULTS: Microbiological culture was positive in 38.78% of the analyzed intervertebral discs. Altogether, 180 bacteria were isolated. Coagulase-negative staphylococci (CONS) (23.41%) and Cutibacterium acnes (18.05%) were the most frequently detected microorganisms. None of HSV-1, HSV-2, or CMV were detected. Male patients (p = 0.00036) and cervical segments (p = 0.00001) showed higher rates of positive culture results. Ventral surgical approaches ( p < 0.001) and Type 2 MC (p = 0.0127) were significantly associated with a positive microbiological result ( p< 0.001). Neither pre- nor postoperative ODI and NDI are associated with positive culture results. In 4 (1.02%) patients, postoperative spondylodiscitis occurred.

CONCLUSIONS: With 447 segments from 392 patients, we present one of the largest studies to date. While disc degeneration caused by HSV-1, HSV-2, and CMV seems unlikely, we found positive microbiological culture results in 38.78% of all discs. The role of local skin flora and sample contamination should be the focus of further investigations.

LEVEL OF EVIDENCE: III.

TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (ID: NCT04712487, https://www.

CLINICALTRIALS: gov/ct2/show/study/NCT04712487 ).

PMID:35303173 | DOI:10.1186/s10195-022-00633-y