Nevin Manimala

Sleep Med. 2021 Aug 13;86:19-24. doi: 10.1016/j.sleep.2021.08.008. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the influence of loneliness on sleep behavior and sleep quality based on propensity score-matched samples in Southwest China.

METHODS: Individual-level data were obtained from a Southwest China cohort study. Participants who felt lonely were matched with those who did not with propensity scores on the basis of age, gender, socioeconomic factors, physical exercise and social connection level. Sleep behavior (onset and offset timing), sleep quality (sleep latency, nocturnal awakenings and subjective sleep quality), and daytime function (daytime sleepiness and fatigue) were assessed with the Pittsburgh Sleep Index Scale (PSQI) and compared between the two groups. The data were collected between May 2019 and December 2019, and data analyses were completed in April 2021.

RESULTS: A total of 11,696 participants were included, and 824 out of 839 participants who felt loneliness were statistically matched with 824 participants who did not. Analyses of the matched samples showed that sleep onset and offset timing were similar between those who felt lonely and those who did not (p = 0.110 and p = 0.751, respectively). Sleep latency was longer in those who felt lonely (26.84 [0.9] vs. 35.52 [1.2] min, p < 0.001) than in those who did not. Furthermore, participants who felt lonely tended to have poor subjective sleep, a higher frequency of nocturnal awakenings, daytime sleepiness and fatigue (all p < 0.001).

CONCLUSIONS: Loneliness was associated with extended sleep latency, increased nocturnal awakenings, and reduced subjective sleep quality and daytime function but was not associated with sleep behavior, including sleep onset and offset timings.

PMID:34454179 | DOI:10.1016/j.sleep.2021.08.008

Hand Surg Rehabil. 2021 Aug 25:S2468-1229(21)00247-4. doi: 10.1016/j.hansur.2021.08.009. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the effect of hand deformity on upper-limb function and health-related quality of life (HRQOL) in children with hemiplegic cerebral palsy (CP). The study included 44 children with hemiplegic CP between the ages of 6 and 14 years (mean age, 10.04 years; SD, 3.1; 23 males, 21 females). The Manual Ability Classification System (MACS) and Gross Motor Function Classification System (GMFCS) were used, with the Zancolli classification to characterize hand deformities on the more affected side. Upper-limb function was assessed in terms of unilateral capacity (Quality of Upper Extremity Skills Test: QUEST) and bimanual performance (Children’s Hand-use Experience Questionnaire: CHEQ), while HRQOL was evaluated on the KIDSCREEN-27 questionnaire. Comparison of bimanual performance and unilateral capacity in children with Zancolli level I and II hemiplegic CP found statistically significant differences (p < 0.01). There was also a significant difference on the HRQOL ‘physical activities and health’ subdomain, in favor of Zancolli level I deformity (P = 0.003), but not on the other HRQOL domains (p > 0.05). Upper-limb function and the HRQOL physical health domain were poorer with greater hand deformity in children with hemiplegic CP.

PMID:34454162 | DOI:10.1016/j.hansur.2021.08.009

Am J Obstet Gynecol MFM. 2021 Aug 25:100472. doi: 10.1016/j.ajogmf.2021.100472. Online ahead of print.

ABSTRACT

BACKGROUND: Women who undergo cesarean delivery report that they are less satisfied with their child birthing experience and have later skin-to-skin contact. As cesarean deliveries account for nearly one-fifth of all births globally, improving the child birthing experience is imperative. One delivery technique that may improve the child birthing experience, termed the family-centered cesarean, allows the mother to view the birth of her baby and to have the baby immediately placed on her chest following delivery.

OBJECTIVE(S): Our primary outcome was to compare satisfaction with birthing experiences between women who underwent either a family-centered or traditional cesarean delivery. Our secondary outcomes compared timing of skin-to-skin contact, and maternal and neonatal outcomes between the two methods of cesarean delivery.

STUDY DESIGN: Pregnant women aged ≥ 18 years who had been admitted to Labor and Delivery with a planned cesarean delivery at one of two delivery units were prospectively enrolled. Women were randomized 1:1, but not blinded, to either the family-centered cesarean (Method 1; N=68) or traditional cesarean (Method 2; N=61). Time to skin-to-skin interactions and newborn vitals were recorded by a nurse at time of delivery. A self-administered questionnaire was provided to participants in the hospital on postpartum to obtain satisfaction with the birthing experience using a modified Likert scale, ranging from 1 (lowest) to 5 (highest). Baseline characteristics and all other variables of interest were abstracted from the electronic medical record. Baseline characteristics, maternal satisfaction, and maternal/neonatal outcomes between methods of delivery were compared using t tests and Pearson’s chi-squared (or Fisher’s exact), as appropriate.

RESULTS: Between June 2016-July 2018, women who were randomized to either Method 1 or Method 2 did not significantly differ by baseline characteristics. This study was unable to detect a difference in satisfaction (4.6 Method 1 vs. 4.4 Method 2; p=0.27). However, mean time to skin-to-skin contact was significantly different. Patients in Method 1 established skin-to-skin contact on average 11.2 minutes earlier than those in Method 2 (5.1 vs 16.3; p<0.01). No other differences in maternal and neonatal outcomes were identified.

CONCLUSION(S): While our study did not find statistical differences in maternal/newborn outcomes, including maternal satisfaction, the family-centered cesarean was significantly associated with earlier skin-to-skin contact. Given known benefits of earlier skin-to-skin contact without associated harm, women should be allowed to choose either method of cesarean delivery based on their personal preference.

PMID:34454161 | DOI:10.1016/j.ajogmf.2021.100472

Sci Total Environ. 2021 Aug 21;802:149721. doi: 10.1016/j.scitotenv.2021.149721. Online ahead of print.

ABSTRACT

The natural flow regime (i.e. magnitude, frequency, duration, timing and rate of change of flow events) is crucial for maintaining freshwater biodiversity and ecosystem services. Protecting instream flow from anthropogenic alterations first requires an understanding of the relationship between aquatic organisms and the flow regime. In this study, we used a unique framework based on random forest modeling to quantify effects of natural flow regime metrics on fish and macroinvertebrate assemblages across ecoregions and flow regime types in the state of South Carolina, USA. We found that all components of the natural flow regime affected both fish and benthic macroinvertebrate assemblages, suggesting that maintaining natural aspects of all flow regime components is critical for protecting freshwater diversity. We identified hydrologic metrics and flow regime components such as magnitude, frequency, and duration of flow events, that were associated with the greatest ecological responses for individual stream classes to help managers prioritize hydrologic and biological metrics of interest during environmental flow standard development. The response of aquatic organisms to hydrologic metrics varied across stream classifications and ecoregions, highlighting the importance of accounting for differences in flow regime and ecoregion when designing environmental flow standards. We provide a flexible framework based on statistical flow-ecology relationships that can be used to inform instream flow management and assess effects of flow alteration on riverine assemblages.

PMID:34454154 | DOI:10.1016/j.scitotenv.2021.149721

J Appl Clin Med Phys. 2021 Aug 28. doi: 10.1002/acm2.13405. Online ahead of print.

ABSTRACT

PURPOSE: This paper proposes a model for the angular dependency of MatriXX response and investigates whether MatriXX, with the angular-model-based approach can be applied to true composite dose verification for IMRT plans.

METHOD: This model attributes the angular dependence of MatriXX response to dynamical translation of its effective measurement plane (EMP) due to the change of beam angle. Considering this mechanism, true composite dose verifications for IMRT plans specified in AAPM TG 119 report using both MatriXX and Gafchromic EBT3 films were undertook and compared to validate the applicability of MatriXX for patient specific QA of composite beam IMRT plans. Dose verifications using MatriXX with and without angular-model-based approach were performed.

RESULTS: MatriXX with angular-model-based approach achieved gamma passing rates with 3%/3 mm and 3%/2 mm criteria better than 98.3% and 98.1% respectively for true composite dose verification of plans in AAPM TG 119 report. The 3%/3 mm and 3%/2 mm gamma passing rates using MatriXX without angular-model-based approach ranged from 85.8% to 98.2% and from 81.3% to 96.5%, respectively. The p-values from the single sided paired t-test indicated no statistical difference between the passing rates from MatriXX with angular-model-based approach and from films, and significant difference between the passing rates from uncorrected MatriXX and from films.

CONCLUSION: The proposed model for angular dependent MatriXX response is necessary and effective. Dose verification using MatriXX with angular-model-based approach is acceptable for true composite beam IMRT plans with required accuracy to simplify patient specific QA.

PMID:34453876 | DOI:10.1002/acm2.13405

J Esthet Restor Dent. 2021 Aug 28. doi: 10.1111/jerd.12814. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare at-home systems with reduced daily time of use (10% hydrogen peroxide [HP] gel with prefilled (PT) or customized trays (CT), and 10% carbamide peroxide [CP] gel), with the conventional nightguard vital bleaching (10% CP). Bleaching efficacy, adverse effects, and patient’s satisfaction were evaluated.

METHODS: Sixty participants were randomly divided into treatments (14 days): Opalescence GO (OGO)-10%HP PT-30 min, White Class-10%HP CT-30 min, Opalescence PF-10%CP CT-2 h, and Opalescence PF-10%CP CT-8 h. Color difference (visual and spectrophotometer), tooth sensitivity (visual analogue scale), gingival condition (Löe index), enamel mineralization (laser fluorescence), and patients’ satisfaction (questionnaire) were assessed. Statistical tests were applied (5%).

RESULTS: After 1 year, color difference was similar for the groups (p > 0.05). All groups showed similar sensitivity risk (p > 0.05). The intensity of sensitivity and gingival irritation was mild for all gels, but higher for OGO. Fluorescence after bleaching remained similar to those of sound enamel. All participants were satisfied with treatments.

CONCLUSIONS: All systems produced similar bleaching efficacy, which was maintained after 1 year. Patients were satisfied with bleaching outcomes. Tooth sensitivity occurred in all groups, but with overall mild intensity. No relevant gingival irritation and enamel demineralization was observed.

CLINICAL SIGNIFICANCE: Bleaching with 10% HP gels in prefilled and CTs represent efficacious alternative for tooth color change, with patients’ acceptance similar to conventional 10% CP. Patients must be warned about the mild sensitivity and gingival irritation potential, mainly with PTs.

PMID:34453873 | DOI:10.1111/jerd.12814

Electrophoresis. 2021 Aug 28. doi: 10.1002/elps.202100211. Online ahead of print.

ABSTRACT

Proteomic characterization of alveolar bones in oral surgery represents an analytical challenge due to their insoluble character. The implementation of a straightforward technique could lead to the routine use of proteomics in this field. We have thus developed a simple technique for the characterization of bone tissue for human maxillary and mandibular bones. It is based on the direct in-bone tryptic digestion of proteins in both healthy and pathological human maxillary and mandibular bone samples. The released peptides were then identified by the LC-MS/MS. Using this approach, a total of 1120 proteins were identified in the maxillary bone and 1151 proteins in the mandibular bone. The subsequent partial least squares – discrimination analysis of protein data made it possible to reach 100% discrimination between the samples of healthy alveolar bones and those of the bone tissue surrounding the inflammatory focus. These results indicate that the in-bone protein digestion followed by the LC-MS/MS and subsequent statistical analysis can provide a deeper insight into the field of oral surgery at the molecular level. Furthermore, it could also have a diagnostic potential in the differentiation between the proteomic patterns of healthy and pathological alveolar bone tissue. Data are available via ProteomeXchange with the identifier PXD026775. This article is protected by copyright. All rights reserved.

PMID:34453862 | DOI:10.1002/elps.202100211

Pediatr Allergy Immunol. 2021 Aug 28. doi: 10.1111/pai.13656. Online ahead of print.

ABSTRACT

BACKGROUND: The Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non-infective rhinitis and conjunctivitis (“rhinoconjunctivitis”) which is reported here.

METHODS: Prevalence and severity of rhinoconjunctivitis were assessed by questionnaire among schoolchildren in GAN Phase I and ISAAC Phases I and III surveys 15-23 years apart. Absolute rates of change in prevalence were estimated for each centre and modelled by multi-level linear regression to compare trends by age group, time period and per-capita national income.

RESULTS: 27 GAN centres in 14 countries surveyed 74,361 13-14-year-olds (“adolescents”) and 45,434 6-7-year-olds (“children”), with average response proportions of 90% and 79% respectively. Many centres showed highly significant (p<0.001) changes in prevalence of rhinoconjunctivitis in the past year (“current rhinoconjunctivitis”), compared to ISAAC. The direction and magnitude of centre-level trends varied significantly (p<0.001) both within and between countries. Overall, current rhinoconjunctivitis prevalence decreased slightly from ISAAC Phase III to GAN: -1.32% per 10 years, 95%CI [-2.93%, +0.30%] among adolescents; -0.44% [-1.29%, +0.42%] among children. Together, these differed significantly (p<0.001) from the upward trend within ISAAC. Among adolescents, centre-level trends in current rhinoconjunctivitis were highly correlated with those for eczema symptoms (rho=0.72, p<0.0001) but not with centre-level trends in asthma symptoms (rho=0.15, p=0.48). Among children, these correlations were positive but not significant.

CONCLUSION: Symptoms of non-infective rhinoconjunctivitis among schoolchildren may no longer be on the increase globally, although trends vary substantially within and between countries.

PMID:34453861 | DOI:10.1111/pai.13656

Aliment Pharmacol Ther. 2021 Aug 28. doi: 10.1111/apt.16580. Online ahead of print.

ABSTRACT

BACKGROUND: Increase in lipid levels associated with the treatment of inflammatory bowel disease (IBD) has previously been reported. However, it is unknown if this effect is similar for all IBD drug classes.

AIM: To precisely assess the effect of different IBD drug classes on lipid profiles METHODS: We performed a systematic literature search of randomised controlled trials and observational cohort studies that assessed lipid levels before and after induction (≤10 weeks) and maintenance (>10 weeks) of IBD treatment. Data of 11 studies (1663 patients) were pooled using random effects models. The influence of patient and disease characteristics on treatment effects on total cholesterol levels was analysed in 6 studies (1211 patients) for which individual data were available, using linear mixed models.

RESULTS: A statistically significant increase in total cholesterol was observed after induction treatment with corticosteroids (+1.19 mmol/L, 95% confidence interval [CI₉₅ ] +0.52 to +2.59), and tofacitinib (+0.66 mmol/L, CI₉₅ +0.42 to +0.79), but not after anti-TNFα treatment (-0.11 mmol/L, CI₉₅ -0.26 to +0.36 mmol/L). Similar differences were observed after maintenance treatment. Treatment effects were significantly related to age, but not with other factors. Lipid changes were inversely correlated with but not modified by CRP changes.

CONCLUSIONS: Increase in total cholesterol levels was strongest for corticosteroids followed by tofacitinib but was not observed for anti-TNFα agents. Whether total cholesterol change associated with IBD treatment has an effect on cardiovascular risk requires further study.

PMID:34453860 | DOI:10.1111/apt.16580

Eur Heart J Acute Cardiovasc Care. 2021 Aug 28:zuab072. doi: 10.1093/ehjacc/zuab072. Online ahead of print.

ABSTRACT

Risk stratification dates to the dawn of the cardiac intensive care unit (CICU). As the CICU has evolved from a dedicated unit caring for patients with acute myocardial infarction to a complex healthcare environment encompassing a broad array of acute and chronic cardiovascular pathology, an expanding array of risk scores are available that can be applied to CICU patients. Most of these scores were designed for use either in patients with a specific acute cardiovascular diagnosis or unselected critically ill patients, and risk scores developed in other populations often underperform in the CICU. More recently, risk scores have been developed specific to the CICU population, demonstrating improved performance. All existing risk scores have relevant limitations, both in terms of performance and applicability to patient care. Risk scores have been predominantly developed to predict short-term mortality, either by quantifying severity of illness or by incorporating other risk factors for mortality. It is essential to distinguish mortality risk attributable to severity of illness, which may be modifiable through intervention, from mortality risk attributable to non-modifiable risk factors. This review discusses established risk scores applicable to the CICU population, details how risk score performance is characterized, describes how new risk scores can be developed, explains how the information provided by risk scores can be used in clinical practice, and highlights how novel risk stratification approaches can be developed.

PMID:34453848 | DOI:10.1093/ehjacc/zuab072