Nevin Manimala

Dev Med Child Neurol. 2021 Feb 26. doi: 10.1111/dmcn.14844. Online ahead of print.

ABSTRACT

AIM: To examine interrater agreement and validity of the Functional Communication Classification System (FCCS) for young children with cerebral palsy (CP) aged 2 or 3 years.

METHOD: Speech-language pathologist (SLP) and parent FCCS ratings for 31 children with CP (aged 2y, n=16; aged 3y, n=15; 18 males, 13 females) were examined for interrater agreement using a weighted Cohen’s kappa statistic. Relationships between FCCS (SLP) ratings and: (1) concurrent validity with the Language Use Inventory, a standardized pragmatic assessment for children aged 18 to 47 months, (2) gross motor and fine motor function, (3) associated impairments (visual and intellectual), and (4) primary expressive communication mode were examined using Spearman’s correlation coefficients.

RESULTS: Almost perfect interrater agreement between SLP and parent FCCS ratings were found (k_w =0.94). Correlations with FCCS (SLP) were excellent for pragmatic function (r_s =-0.83, p<0.001), intellectual function (r_s =0.89, p<0.001), and primary expressive communication mode (r_s =0.92, p<0.001). Correlations were good for gross motor function (r_s =0.72, p<0.001) and visual impairment (r_s =0.70, p<0.001) and fair for fine motor function (r_s =0.53, p<0.002). Analysis was unwarranted for epilepsy (n=1 out of 31) and hearing-associated impairments (n=0 out of 31).

INTERPRETATION: The FCCS has excellent interrater agreement and validity for communication classification of children with CP aged 2 or 3 years and is highly suitable for surveillance and research purposes.

PMID:33638178 | DOI:10.1111/dmcn.14844

J Environ Qual. 2021 Feb 26. doi: 10.1002/jeq2.20209. Online ahead of print.

ABSTRACT

In August 2015, 11.3 million L of heavy metal contaminated water spilled into the Animas River from the Gold King Mine (GKM). National attention focused on water quality and agricultural production in areas affected by the spill. In response to local concerns, surface soil elemental concentrations were analyzed in three New Mexico, USA agricultural fields to determine potential threats to agronomic production. Irrigated fields in the Animas Watershed were scanned using portable X-ray fluorescence (PXRF) spectrometry to monitor the spatiotemporal variability of Pb, As, Cu, and Cr. Total of 175 locations were scanned using PXRF before and after the growing season for three years. Geostatistical model with the lowest Root Mean Square Error (RMSE) was chosen as the optimal model. The lowest RMSE for the elements ranged from to 0.10 to 0.44 meters (m) for As, 0.50 to 0.98 m for Cr, 0.15 to 0.91 m for Cu and 0.14 to 0.44 m for Pb across the models selected. The spatial dependence between the measured values exhibited strong to moderate autocorrelation for all metals except for As, it was strong to weak. Some areas in each field exceeded the New Mexico Environment Department soil screening limit of 7.07 mg As kg^-1 . All sampling locations were below the screening limit at last sampling time in 2019. Mixed models used for temporal analysis showed significant decrease only in As below the screening value at the end of the study. Results indicate that the agricultural soils were below the soil screening guideline values. This article is protected by copyright. All rights reserved.

PMID:33638153 | DOI:10.1002/jeq2.20209

J Clin Psychol. 2021 Feb 26. doi: 10.1002/jclp.23125. Online ahead of print.

ABSTRACT

OBJECTIVE: One strategy for improving the clinical utility of mental health diagnostic systems is to better align them with how clinicians conceptualize psychopathology in practice. This approach was used in International Classification of Diseases 11th Revision (ICD-11) development, but its underlying assumption-a link between taxonomic “fit” and clinical utility-remains untested.

METHODS: Using data from global mental health clinician samples (combined N = 5404), we investigated the association between taxonomic fit and clinical utility in mental disorder categories.

RESULTS: The overall association between fit and utility was positive (r = 0.19) but statistically not different from zero (95% confidence interval [CI]: -0.06, 0.43) in this small sample (N = 39 ICD/DSM categories). However, a positive association became clear after correcting for outliers (r = 0.34 [0.05, 0.58] or higher). Further insights were apparent for specific diagnoses given their locations in the scatterplot.

CONCLUSIONS: Results suggest a positive link between taxonomic fit and clinical utility in mental disorder diagnoses, highlighting future research directions.

PMID:33638149 | DOI:10.1002/jclp.23125

Sleep Breath. 2021 Feb 26. doi: 10.1007/s11325-020-02279-8. Online ahead of print.

ABSTRACT

PURPOSE: Evaluate the impact of counterclockwise rotation of the occlusal plane (CCWROP) on pharynx morphology and polysomnography in maxillomandibular advancement (MMA) surgery to treat obstructive sleep apnea (OSA) patients.

METHODS: Prospective clinical trial of patients with OSA treated by MMA. Computed tomography and polysomnography were performed pre- and postoperatively and the parameters were compared. The surgery classified the patients into two groups: with (R) and without (NR) CCWROP.

RESULTS: The study sample comprised 38 individuals: R (n = 19) and NR (n = 19). An anterior mandible advancement of 0.71 mm was identified for each degree of CCWROP (p < 0.001). As for polysomnography, the apnea-hypopnea index was reduced by 80% and 62% in R and NR, showing final values of 6.8 and 13.0, respectively. The apnea index changed equally in both groups. Reduction of 68 and 26% in the hypopnea index was observed for R and NR, respectively, with no statistically significant difference. Total volume increased by 45% in R and 30% in NR. Retropalatal and retrolingual volumes increased by 49% and 4% in R and 43% and 15% in NR, respectively. The minimum axial area increased by 92% in the retropalatal region and 97% in the retrolingual region in R, whereas these increases were of 76% and 31% in NR, respectively.

CONCLUSION: Anterior mandibular advancement of 0.71 mm for each degree of CCWROP is of great importance for surgical planning. As a result of this resource, individuals in R presented better results than those in NR in all parameters assessed, especially regarding the retrolingual region.

PMID:33638129 | DOI:10.1007/s11325-020-02279-8

J Immigr Minor Health. 2021 Feb 26. doi: 10.1007/s10903-021-01169-9. Online ahead of print.

ABSTRACT

Very few studies have investigated frailty among older immigrants in Europe. The aim of the current study was to investigate inequalities in frailty in young-olds related to gender, educational level and country of origin, as well as intersections between these characteristics. Cross-sectional data were used from older Turkish and Moroccan immigrants (n = 466) and native Dutch (n = 1,020), all aged 55-65 years and participating in the Longitudinal Aging Study Amsterdam. Frailty was assessed with a 30-item frailty index, based on the deficit accumulation approach. Frailty was higher among women, lower educated, and people with a migration background. Of all groups considered, frailty levels were the highest among Turkish immigrants. No statistically significant interaction effects between gender, educational level and country of origin were found. When targeting frailty interventions, special attention should be devoted to older immigrants, as they are the most vulnerable group with the highest frailty levels.

PMID:33638120 | DOI:10.1007/s10903-021-01169-9

Environ Sci Pollut Res Int. 2021 Feb 26. doi: 10.1007/s11356-021-12735-x. Online ahead of print.

ABSTRACT

Northern Italy was the most affected by CoViD-19 compared to other Italian areas and comprises zones where air pollutants concentration was higher than in the rest of Italy. The aim of the research is to determine if particulate matter (PM) has been the primary cause of the high CoViD-19 spread rapidity in some areas of Northern Italy. Data of PM for all the 41 studied cities were collected from the local environmental protection agencies. To compare air quality data with epidemiological data, a statistical analysis was conducted identifying the correlation matrices of Pearson and Spearman, considering also the possible incubation period of the disease. Moreover, a model for the evaluation of the epidemic risk, already proposed in literature, was used to evaluate a possible influence of PM on CoViD-19 spread rapidity. The results exclude that PM alone was the primary cause of the high CoVid-19 spread rapidity in some areas of Northern Italy. Further developments are necessary for a better comprehension of the influence of atmospheric pollution parameters on the rapidity of spread of the virus SARS-CoV-2, since a synergistic action with other factors (such as meteorological, socio-economic and cultural factors) could not be excluded by the present study.

PMID:33638072 | DOI:10.1007/s11356-021-12735-x

Pharmacoecon Open. 2021 Feb 26. doi: 10.1007/s41669-021-00260-z. Online ahead of print.

ABSTRACT

Novel cancer therapies are associated with survival patterns that differ from established therapies, which may include survival curves that plateau after a certain follow-up time point. A fraction of the patient population is then considered statistically cured and subject to the same mortality experience as the cancer-free general population. Mixture cure models have been developed to account for this characteristic. As compared to standard survival analysis, mixture cure models can often lead to profoundly different estimates of long-term survival, required for health economic evaluations. This tutorial is designed as a practical introduction to mixture cure models. Step-by-step instructions are provided for the entire implementation workflow, i.e., from gathering and combining data from different sources to fitting models using maximum likelihood estimation and model results interpretation. Two mixture cure models were developed to illustrate (1) an “uninformed” approach where the cure fraction is estimated from trial data and (2) an “informed” approach where the cure fraction is obtained from an external source (e.g., real-world data) used as an input to the model. These models were implemented in the statistical software R, with the freely available code on GitHub. The cure fraction can be estimated as an output from (“uninformed” approach) or used as an input to (“informed” approach) a mixture cure model. Mixture cure models suggest presumed estimates of long-term survival proportions, especially in instances where some fraction of patients is expected to be statistically cured. While this type of model may initially seem complex, it is straightforward to use and interpret. Mixture cure models have the potential to improve the accuracy of survival estimates for treatments associated with statistical cure, and the present tutorial outlines the interpretation and implementation of mixture cure models in R. This type of model will likely become more widely used in health economic analyses as novel cancer therapies enter the market.

PMID:33638063 | DOI:10.1007/s41669-021-00260-z

J Clin Monit Comput. 2021 Feb 27. doi: 10.1007/s10877-021-00677-1. Online ahead of print.

ABSTRACT

Strain echocardiography enables the automatic quantification of the global longitudinal strain (GLS), which is a direct measure of ventricular shortening during systole. In the current context of overwhelmed ICUs and clinician shortage, GLS has the advantage to be quick and easy to measure by non-experts. However, little is known regarding its value to assess bi-ventricular systolic function in critically ill COVID-19 patients. Therefore, we designed a study to compare right and left ventricular GLS with classic echo-Doppler indices of systolic function, namely the ejection fraction for the left ventricle (LVEF) and the fractional area change (FAC), the tricuspid annular plane systolic excursion (TAPSE), and the tissue Doppler velocity of the basal free lateral wall (S’) for the right ventricle. Eighty transthoracic echocardiographic evaluations done in 30 ICU patients with COVID-19 were analyzed. We observed a fair relationship (r = 0.73, p < 0.01) between LVEF and left ventricular GLS. The GLS cut-off value of – 22% identified a LVEF < 50% with a sensitivity of 63% and a specificity of 80%. All patients with a GLS > – 17% had a LVEF < 50%. Although statistically significant, relationships between FAC (r = 0.41, p < 0.01), TAPSE (r = 0.26, p < 0.05) and right ventricular GLS were weak. S’ was not correlated with right ventricular GLS. In conclusion, left ventricular GLS was useful to assess left ventricular systolic function. However, right ventricular GLS was poorly correlated with FAC, TAPSE and S’. Further studies are needed to clarify what is the best method to assess right ventricular systolic function in ICU patients with COVID-19.

PMID:33638061 | DOI:10.1007/s10877-021-00677-1

J Med Ultrason (2001). 2021 Feb 26. doi: 10.1007/s10396-021-01081-7. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of our study was to determine the usability of lung ultrasonography (LUS) in the diagnosis of COVID-19, and to match the morphological features of lesions detected on computed tomography (CT) with the findings observed on LUS.

METHODS: Sixty patients with COVID-19 were included in this prospective study. Patients were examined by radiology and anesthesia clinic specialists for a visual CT score. A LUS 12-zone ultrasonography protocol was applied by the investigator blinded to the CT and PCR test results. The characteristics of abnormal findings and the relationship of lesions to the pleura and the distance to the pleura were investigated.

RESULTS: Forty-five males and 25 females evaluated within the scope of the study had an average age of 61.2 ± 15.3 years. The total CT score was calculated as 14.3 ± 5.3, and the LUS score was found to be 19.9 ± 7.6. There was a statistically significant positive correlation between the measured LUS and CT scores (r = 0.857, p < 0.001). The mean distance of these lesions to the pleura was 5.2 ± 1.76 cm. LUS findings in 51 areas corresponded to non-pleural lesions on CT. There was a negative correlation between the measured distance to the pleura and the LUS scores (p < 0.001, r = – 0.708).

CONCLUSION: The results of this study showed that the correlation between CT and LUS findings may be used in the diagnosis of COVID-19 pneumonia, although there are some limitations. ClinicalTrials.gov identifier: NCT04719234.

PMID:33638057 | DOI:10.1007/s10396-021-01081-7

Clin Oral Investig. 2021 Feb 27. doi: 10.1007/s00784-021-03811-0. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the present study was to evaluate the in vitro biocompatibility of Theracal PT, Theracal LC, and MTA Angelus, considered as bioactive materials used for vital pulp treatment, on human dental pulp stem cells (hDPSCs).

MATERIALS AND METHODS: Human dental pulp stem cells (hDPSCs) were isolated from third molars, and material eluates were prepared (undiluted, 1:2, and 1:4 ratios). The hDPSC cytotoxicity, adhesion, morphology, viability, and cell migration were assessed. The mineralization nodule formation was determined by Alizarin red S staining (ARS). The odonto/osteogenic differentiation potential was assessed by osteo/odontogenic marker expression real-time qPCR. The chemical composition and ion release of the vital pulp materials were determined by energy dispersive X-ray (EDX) and inductively coupled plasma-mass spectrometry (ICP-MS), respectively. Statistical differences were assessed by ANOVA and Tukey’s test (p < 0.05).

RESULTS: The three vital pulp materials showed variable levels of calcium, tungsten, silicon, and zirconium release and in their chemical composition. Cytocompatibility assays revealed higher hDPSC viability and migration rates when treated with Theracal PT than with Theracal LC. The lowest cell adhesion and spreading were observed in all Theracal LC-treated groups, whereas the highest were observed when treated with MTA. Theracal PT and MTA promoted the upregulation of DSPP and RUNX2 gene expression (p < 0.05). After 21 days, both MTA Angelus and Theracal PT-treated cells exhibited a significantly higher mineralized nodule formation than the negative control (p < 0.05).

CONCLUSIONS: This study demonstrates the favorable in vitro cytocompatibility and bioactive properties of the recently introduced Theracal PT and the well-established MTA Angelus on hDPSCs, as opposed to Theracal LC. More studies, including in vivo animal testing are suggested before these new formulations might be used in the clinical setting.

CLINICAL RELEVANCE: Theracal PT is a new material that could be clinically suitable for vital pulp therapy. Further studies considering its biocompatibility and bioactivity are necessary.

PMID:33638052 | DOI:10.1007/s00784-021-03811-0