Nevin Manimala

Oral Maxillofac Surg. 2022 Mar 29. doi: 10.1007/s10006-022-01057-y. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to identify whether dental implants placed using a flapless technique have a higher early failure rate, defined as failure within 6 months of placement, compared to implants placed with flap elevation when a surgical guide is not used.

METHODS: A retrospective cohort study was conducted to evaluate implants placed with either flapless (FL) or mucoperiosteal flap (MF) surgery between 2006 and 2012 at the Philadelphia VA Medical Center (PVAMC). Implant status after FL or MF surgery was assessed using dental encounter and radiographs at subsequent follow-up appointments to assess for early implant failures within 6 months of implant placement.

RESULTS: The FL technique was used to place 89 implants in 38 subjects, while the MF technique was used to place 381 implants in 139 subjects. Early failure occurred in 37 implants, of which 13 occurred in the FL group and 24 occurred in the MF group. FL surgery was found to be associated with a 265% increase in early implant failure (OR 2.653; 95% CL 1.287-5.469) and was statistically significant (p = 0.0064). Residents were over 200% more likely to have an early implant failure when using the FL technique (OR 2.314; 95% CL 1.112-4.816), CONCLUSIONS: Analysis revealed flapless implant placement was associated with higher early implant failure rates. In addition, early failures were more likely to occur when residents placed an implant using the flapless technique. While FL surgery can result in long-term success, it is a more technique-sensitive approach that requires greater clinical skill and stricter case selection to perform.

PMID:35348935 | DOI:10.1007/s10006-022-01057-y

Cogn Res Princ Implic. 2022 Mar 26;7(1):26. doi: 10.1186/s41235-022-00372-y.

ABSTRACT

Considerable research has examined the prevalence and apparent consequences of task-unrelated thoughts (TUTs) in both laboratory and authentic educational settings. Few studies, however, have explored methods to reduce TUTs during learning; those few studies tested small samples or used unvalidated TUT assessments. The present experimental study attempted to conceptually replicate or extend previous findings of interpolated testing and pretesting effects on TUT and learning. In a study of 195 U.S. undergraduates, we investigated whether interpolated testing (compared to interpolated restudy) and pretesting on lecture-relevant materials (compared to pretesting on conceptually related but lecture-irrelevant materials) would reduce TUTs during a video lecture on introductory statistics. Subjects completed either a content-matched or content-mismatched pretest on statistics concepts and then watched a narrated lecture slideshow. During the lecture, half of the sample completed interpolated tests on the lecture material and half completed interpolated restudy of that material. All subjects responded to unpredictably presented thought probes during the video to assess their immediately preceding thoughts, including TUTs. Following the lecture, students reported on their situational interest elicited by the lecture and then completed a posttest. Interpolated testing significantly reduced TUT rates during the lecture compared to restudying, conceptually replicating previous findings-but with a small effect size and no supporting Bayes-factor evidence. We found statistical evidence for neither an interpolated testing effect on learning, nor an effect of matched-content pretesting on TUT rates or learning. Interpolated testing might have limited utility to support students’ attention, but varying effect sizes across studies warrants further work.

PMID:35348931 | DOI:10.1186/s41235-022-00372-y

Neurosurg Rev. 2022 Mar 28. doi: 10.1007/s10143-022-01775-7. Online ahead of print.

ABSTRACT

Neuropathic pain presents a burdening and impairing condition which may occasionally occur after spinal tumor surgery. While it has been described in peripheral nerve sheath tumors, data on other intradural tumor patients is sparse. We hereby present a large cohort population undergoing different intradural spinal tumor surgery with assessment of early postoperative and follow-up outcomes, focusing on the occurrence of neuropathic pain. We performed a retrospective monocentric study including all patients treated for intradural spinal tumors between 2009 and 2020. We extracted surgical aspects as well as pre- and postoperative clinical courses from the records. Statistical analysis of potential contributing prognostic factors was performed including matched pair analysis. In total, 360 patients were included for analysis. At a median follow-up of 2 years, 26/360 patients complained of a neuropathic pain syndrome (7.2%) requiring continuous medication. Of these patients only 50% complained preoperatively of pain. Tumor entity did not significantly influence the incidence of postoperative neuropathic pain (p = 0.91). Sacrifice of the tumor carrying nerve root and tumor recurrence also did not increase the risk for this condition. Persistent neuropathic pain requiring continuous treatment occurred in 7.2% of patients undergoing intradural spinal surgery in our cohort. This frequently underestimated postoperative adverse event represents a disabling condition leading to a substantial impairment in the quality of life among the affected patients.

PMID:35348919 | DOI:10.1007/s10143-022-01775-7

Anim Cogn. 2022 Mar 28. doi: 10.1007/s10071-022-01612-w. Online ahead of print.

ABSTRACT

Communication between parents and dependent offspring is critical not only during provisioning, but also in antipredator contexts. In altricial birds, a top cause of reproductive failure is nest predation, and alarm calls both by parents and chicks can serve to alert others and increase the likelihood of offspring escaping predation. Understanding the factors that determine the strength of parental antipredator responses to different nestling alarm calls can provide insight into parent-offspring recognition. The prothonotary warbler (Protonotaria citrea), a host of the obligate brood parasite, the brown-headed cowbird (Molothrus ater), never rejects cowbird young and raises the parasite together with its own offspring. To determine whether warbler parents learn cowbird nestling alarm calls, we presented experimentally parasitized or non-parasitized parents with playbacks of conspecific warbler, parasitic cowbird, and a harmless heterospecific control, eastern bluebird (Sialis sialis), nestling alarm calls. We recorded the latency to respond and the number of chips given by members of the resident warbler pair. We found that parents were most likely to respond to warbler nestling alarm calls, least likely to respond to bluebird calls, with a statistically intermediate likelihood of responding to cowbird calls. Critically, current and past parasitism status did not affect the likelihood of response to any playback or the number of chips given, however, currently parasitized parents had greater response latencies to playbacks than non-parasitized parents. These results suggest that warbler parents do not learn cowbird alarm calls from breeding experiences and, in turn, that cowbirds may employ a generalized, bet-hedging alarm call.

PMID:35348917 | DOI:10.1007/s10071-022-01612-w

Pediatr Nephrol. 2022 Mar 28. doi: 10.1007/s00467-021-05417-w. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm kidney is exposed to various exogenous factors that may impact its function such as nephrotoxic drugs or nephrocalcinosis. We investigated prevalence and risk factors of nephrocalcinosis (NC) in recently born very low birth weight (VLBW) infants submitted to improved biological monitoring.

METHODS: Retrospective, case-control study in very preterm infants (< 32 + 6 weeks, ≤ 1500 g) admitted to a tertiary care unit during a 6-year period. Each case (ultrasound-diagnosed NC) was matched with two controls (no NC). Data were collected at days 15 and 30 of life and 35 weeks corrected age, with follow-up at 18 months and 3 years.

RESULTS: Of 525 eligible infants, overall prevalence of NC was 17.1% at 35 weeks corrected age. Prevalence was halved between 2012 (26.1%) and 2017 (11.8%). We included 265 infants, more than half being born before 28 weeks. Cases presented with more severe morbidity than controls, but reached statistical significance only in infants born < 28 weeks (88.2% vs. 68.3%, P = 0.01). Protein, energy, calcium, phosphorus, and vitamin D intakes were similar in the two groups and did not change significantly over the study period. Weight gain was similar in the two groups. Exposure to furosemide (OR [IC95%]: 1.26 [1.02; 1.57]) and postnatal growth (1.65 [1.04; 2.67]) were independent risk factors of NC. NC resolved 12-18 months after diagnosis in 61% of infants.

CONCLUSION: Prevalence of NC is significant but can be reduced. Furosemide should be cautiously prescribed in VLBW infants, and nutritional support must be well monitored to support postnatal growth and limit risk of nephrocalcinosis.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT 04,860,583. A higher resolution version of the Graphical abstract is available as Supplementary information.

PMID:35348900 | DOI:10.1007/s00467-021-05417-w

Acta Neurochir (Wien). 2022 Mar 28. doi: 10.1007/s00701-022-05164-3. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic and the need for social distancing created challenges for accessing and providing health services. Telemedicine enables prompt evaluation of patients with traumatic brachial plexus injury, even at a distance, without prejudice to the prognosis. The present study aimed to verify the validity of range of motion, muscle strength, sensitivity, and Tinel sign tele-assessment in adults with traumatic brachial plexus injury (TBPI).

METHODS: A cross-sectional study of twenty-one men and women with TBPI admitted for treatment at a Rehabilitation Hospital Network was conducted. The participants were assessed for range of motion, muscle strength, sensitivity, and Tinel sign at two moments: in-person assessment (IPA) and tele-assessment (TA).

RESULTS: The TA muscle strength tests presented significant and excellent correlations with the IPA (the intra-rater intraclass correlation coefficient, ICC ranged between 0.79 and 1.00 depending on the muscle tested). The agreement between the TA and IPA range of motion tests ranged from substantial to moderate (weighted kappa coefficient of 0.47-0.76 (p < 0.05) depending on the joint), and the kappa coefficient did not indicate a statistically significant agreement in the range of motion tests of supination, wrist flexors, shoulder flexors, and shoulder external rotators. The agreement between the IPA andTA sensitivity tests of all innervations ranged from substantial to almost perfect (weighted kappa coefficient 0.61-0.83, p < 0.05) except for the C5 innervation, where the kappa coefficient did not indicate a statistically significant agreement. The IPA versus TA Tinel sign test showed a moderate agreement (weighted kappa coefficient of 0.57, p < 0.05).

CONCLUSIONS: The present study demonstrated that muscle strength tele-assessment is valid in adults with TBPI and presented a strong agreement for many components of TA range of motion, sensitivity, and Tinel sign tests.

PMID:35348897 | DOI:10.1007/s00701-022-05164-3

Clin Oral Investig. 2022 Mar 29. doi: 10.1007/s00784-022-04439-4. Online ahead of print.

ABSTRACT

OBJECTIVES: Periodontitis is a local inflammatory disease of high prevalence worldwide. Increasing evidence has shown its association with cardiovascular diseases. While high-density lipoprotein is an important protective factor in preventing cardiovascular diseases, this study aims to examine whether high-density lipoprotein cholesterol (HDL-C) level is associated with different status of periodontitis.

MATERIALS AND METHODS: A total of 874 Chinese retirees (≥ 60 years of age) with different statuses of periodontitis were enrolled. Periodontal clinical data were collected to define periodontal disease severity (no, mild-moderate, severe). Peripheral blood was collected for serum lipid profile analysis. Linear and logistic regression analysis with adjustment for potential confounders (gender, age, BMI, alcohol intake, exercise frequency, smoking habits) were used to determine the association of periodontitis with HDL-C.

RESULTS: After adjustments for confounders, linear regression analyses revealed a significant relationship between the decreased HDL-C and periodontitis severity (p < 0.05). Although the multivariable-adjusted ORs of decreased HDL-C were not statistically significant, logistic regression analyses showed Chinese elderly with severe periodontitis had higher odds of exhibiting clinically abnormal HDL-C levels than those without periodontitis.

CONCLUSIONS: The elderly population with periodontitis showed HDL-C levels significantly lower than those without periodontitis. The severity of periodontitis was positively correlated with serum HDL-C levels.

CLINICAL RELEVANCE: Periodontitis reduces HDL-C level in the elderly population, indicating that oral health should be paid attention to in the prevention and treatment of dyslipidemia.

PMID:35348881 | DOI:10.1007/s00784-022-04439-4

Surg Endosc. 2022 Mar 29. doi: 10.1007/s00464-022-09192-z. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic-assisted thermal ablation has been used successfully to treat early hepatocellular carcinoma (HCC) tumors, defined as < 3 cm in diameter. This approach allows for ablation of tumors located in areas of the liver that are otherwise inaccessible for a percutaneous approach. Thermal ablation of exophytic tumors remains controversial due to a reported increased risk of tumor seeding of the abdominal cavity and incomplete ablation.

METHODS: This cohort study consisted of 663 HCC tumors treated with thermal ablation at a single, quaternary academic medical center between 2/2001 and 1/2021. Post treatment, patients were followed at a defined interval schedule beginning at one month post treatment, then every 3 months for 2 years, every 6 months in year 3, followed by yearly studies. Patients’ medical records were reviewed for three years post ablation for evidence of complete ablation and intra-abdominal dissemination of disease.

RESULTS: 326 patient records met the inclusion criteria. Comparing the exophytic and non-exophytic groups, there were statistically significant differences in etiology of liver disease (p = 0.048) and TNM stage (p = 0.03), as well as a higher rate of incomplete ablation in the non-exophytic group (10.2% vs 3.3%; p = 0.045). Otherwise, there were no statistically significant differences in baseline characteristics, tumor characteristics, or use of thermal ablation technology. Rates of intra-abdominal dissemination of HCC were low in both groups: 1.1% (n = 1) in the exophytic group and 1.7% (n = 4) in the non-exophytic group. There was no significant difference in intra-abdominal dissemination of HCC between the groups (p > 0.99, RR = 0.66; 95% CI 0.07-5.79). Additionally, no differences were seen in dissemination between microwave ablation and radiofrequency ablation (p > 0.99).

CONCLUSION: This study demonstrates that laparoscopic-assisted thermal ablation of small, exophytic tumors is safe and does not increase the risk for disseminated intra-abdominal HCC disease.

PMID:35348874 | DOI:10.1007/s00464-022-09192-z

Arch Orthop Trauma Surg. 2022 Mar 29. doi: 10.1007/s00402-022-04426-0. Online ahead of print.

ABSTRACT

INTRODUCTION: While higher institutional case volume is associated with better postoperative outcomes in various types of surgery, institutional case volume has been rarely included in risk prediction models for surgical patients. This study aimed to develop and validate the predictive models incorporating institutional case volume for predicting in-hospital mortality and 1-year mortality after hip fracture surgery in the elderly.

MATERIALS AND METHODS: Data for all patients (≥ 60 years) who underwent surgery for femur neck fracture, pertrochanteric fracture, or subtrochanteric fracture between January 2008 and December 2016 were extracted from the Korean National Health Insurance Service database. Patients were randomly assigned into the derivation cohort or the validation cohort in a 1:1 ratio. Risk prediction models for in-hospital mortality and 1-year mortality were developed in the derivation cohort using the logistic regression model. Covariates included age, sex, type of fracture, type of anaesthesia, transfusion, and comorbidities such as hypertension, diabetes, coronary artery disease, chronic kidney disease, cerebrovascular disease, and dementia. Two separate models, one with and the other without institutional case volume as a covariate, were constructed, evaluated, and compared using the likelihood ratio test. Based on the models, scoring systems for predicting in-hospital mortality and 1-year mortality were developed.

RESULTS: Analysis of 196,842 patients showed 3.6% in-hospital mortality (7084/196,842) and 15.42% 1-year mortality (30,345/196,842). The model for predicting in-hospital mortality incorporating the institutional case volume demonstrated better discrimination (c-statistics 0.692) compared to the model without the institutional case volume (c-statistics 0.688; likelihood ratio test p value < 0.001). The performance of the model for predicting 1-year mortality was also better when incorporating institutional case volume (c-statistics 0.675 vs. 0.674; likelihood ratio test p value < 0.001).

CONCLUSIONS: The new institutional case volume incorporated scoring system may help to predict in-hospital mortality and 1-year mortality after hip fracture surgery in the elderly population.

PMID:35348872 | DOI:10.1007/s00402-022-04426-0

Eur Radiol. 2022 Mar 29. doi: 10.1007/s00330-022-08692-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop a deep learning algorithm to automatically evaluate and diagnose scoliosis on full spinal X-ray images.

METHODS: This retrospective study collected full spinal X-ray images (anteroposterior) from four hospital databases from January 1, 2018, to March 31, 2021. The data were divided into training and validation sets. Full spinal X-ray images for external validation were independently collected at one hospital from April 1, 2021, to June 30, 2021. Model effectiveness was validated with a public dataset. Statistical software R was used to analyze the accuracy and sensitivity of the model curvature and anatomical balance parameters and assess interrater consistency.

RESULTS: This study included 788 and 185 training and test datasets, respectively. The accuracy and recall of the algorithm model for the Cobb angle, apical vertebrae (AV), upper vertebrae, and lower vertebrae were 89.36%, 85.71%, 77.2%, and 80.24% and 97.35%, 93.38%, 84.11%, and 87.42%, respectively. The symmetric mean absolute percentage error at the Cobb angle was 5.99%, and the automatic measurement time was 1.7 s. The mean absolute error values of the Cobb angle and the distances between the center sacral vertical line and AV and C7 plumb line were 1.07° and 1.12 and 1.38 mm, respectively. Statistical analysis confirmed that the Cobb angle results were in good agreement with the gold standard (interclass coefficients of 0.996, 0.978, and 0.825; p < 0.001).

CONCLUSION: Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency.

KEY POINTS: • Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency. • Multi-center validation data were used in this study to guarantee the reliability of the research. • Algorithmic model measures 200 times faster than radiologists.

PMID:35348867 | DOI:10.1007/s00330-022-08692-9