Tag: nevin manimala

Biomol Biomed. 2024 Apr 13. doi: 10.17305/bb.2024.10449. Online ahead of print.

ABSTRACT

Vitamin D is commonly used to prevent and treat osteoporosis, with studies indicating its potential to reduce fractures, falls, and mortality. However, meta-analyses present inconsistent findings regarding its efficacy, particularly reflecting significant variability in data and outcomes related to various dosing regimens. In this meta-analysis, we assessed the impact of high-dose intermittent oral administration of vitamin D3 on serum 25(OH)D levels, fractures, falls, and mortality among elderly individuals. We included 14 randomized controlled trials (RCTs) and employed Review Manager 5.4 for statistical analysis. Our findings indicate that intermittent monthly administration of vitamin D3 (over 800 IU per day) significantly raised serum 25(OH)D levels at all timepoints after six months, maintaining levels above 75 nmol/L throughout the year. This regimen showed no increase in all-cause mortality, with a risk ratio (95% CI) of 0.95 (0.87-1.04). Likewise, it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively. Although one-year intermittent administration significantly increased the concentration of 25(OH)D in serum, further research is needed to determine if this method would increase the incidence of falls. Therefore, it is not recommended at this stage due to the lack of demonstrated safety in additional relevant RCTs. This study had been registered on PROSPERO (CRD42022363229).

PMID:38615341 | DOI:10.17305/bb.2024.10449

J Nurs Scholarsh. 2024 Apr 14. doi: 10.1111/jnu.12971. Online ahead of print.

ABSTRACT

BACKGROUND: Compared to other providers, nurses spend more time with patients, but the exact quantity and nature of those interactions remain largely unknown. The purpose of this study was to characterize the interactions of nurses at the bedside using continuous surveillance over a year long period.

METHODS: Nurses’ time and activity at the bedside were characterized using a device that integrates the use of obfuscated computer vision in combination with a Bluetooth beacon on the nurses’ identification badge to track nurses’ activities at the bedside. The surveillance device (AUGi) was installed over 37 patient beds in two medical/surgical units in a major urban hospital. Forty-nine nurse users were tracked using the beacon. Data were collected 4/15/19-3/15/20. Statistics were performed to describe nurses’ time and activity at the bedside.

RESULTS: A total of n = 408,588 interactions were analyzed over 670 shifts, with >1.5 times more interactions during day shifts (n = 247,273) compared to night shifts (n = 161,315); the mean interaction time was 3.34 s longer during nights than days (p < 0.0001). Each nurse had an average of 7.86 (standard deviation [SD] = 10.13) interactions per bed each shift and a mean total interaction time per bed of 9.39 min (SD = 14.16). On average, nurses covered 7.43 beds (SD = 4.03) per shift (day: mean = 7.80 beds/nurse/shift, SD = 3.87; night: mean = 7.07/nurse/shift, SD = 4.17). The mean time per hourly rounding (HR) was 69.5 s (SD = 98.07) and 50.1 s (SD = 56.58) for bedside shift report.

DISCUSSION: As far as we are aware, this is the first study to provide continuous surveillance of nurse activities at the bedside over a year long period, 24 h/day, 7 days/week. We detected that nurses spend less than 1 min giving report at the bedside, and this is only completed 20.7% of the time. Additionally, hourly rounding was completed only 52.9% of the time and nurses spent only 9 min total with each patient per shift. Further study is needed to detect whether there is an optimal timing or duration of interactions to improve patient outcomes.

CLINICAL RELEVANCE: Nursing time with the patient has been shown to improve patient outcomes but precise information about how much time nurses spend with patients has been heretofore unknown. By understanding minute-by-minute activities at the bedside over a full year, we provide a full picture of nursing activity; this can be used in the future to determine how these activities affect patient outcomes.

PMID:38615340 | DOI:10.1111/jnu.12971

Med Educ Online. 2024 Dec 31;29(1):2339569. doi: 10.1080/10872981.2024.2339569. Epub 2024 Apr 14.

ABSTRACT

BACKGROUND: eLearning can be an effective tool to achieve learning objectives. It facilitates asynchronous distance learning, increasing flexibility for learners and instructors. In this context, the high educational value of videos provides an invaluable primary component for longitudinal digital curricula, especially for maintaining knowledge on otherwise rarely taught subjects. Although literature concerning eLearning evaluation exists, research comprehensively describing how to design effective educational videos is lacking. In particular, studies on the requirements and design goals of educational videos need to be complemented by qualitative research using grounded theory methodology.

METHODS: Due to the paucity of randomized controlled trials in this area, there is an urgent need to generate recommendations based on a broader fundament than a literature search alone. Thus, the authors have employed grounded theory as a guiding framework, augmented by Mayring’s qualitative content analysis and commonly used standards. An adaptive approach was conducted based on a literature search and qualitative semi-structured interviews. Drawing on these results, the authors elaborated a guide for creating effective educational videos.

RESULTS: The authors identified 40 effective or presumedly effective factors fostering the success of video-based eLearning in teaching evidence-based medicine, providing a ready-to-use checklist. The information collected via the interviews supported and enriched much of the advice found in the literature.

DISCUSSION: To the authors’ knowledge, this type of comprehensive guide for video-based eLearning needs has not previously been published. The interviews considerably contributed to the results. Due to the grounded theory-based approach, in particular, consensus was achieved without the presence of a formal expert panel. Although the guide was created with a focus on teaching evidence-based medicine, due to the general study selection process and research approach, the recommendations are applicable to a wide range of subjects in medical education where the teaching aim is to impart conceptual knowledge.

PMID:38615337 | DOI:10.1080/10872981.2024.2339569

J Math Biol. 2024 Apr 14;88(6):62. doi: 10.1007/s00285-024-02083-y.

ABSTRACT

The design of optimized non-pharmaceutical interventions (NPIs) is critical to the effective control of emergent outbreaks of infectious diseases such as SARS, A/H1N1 and COVID-19 and to ensure that numbers of hospitalized cases do not exceed the carrying capacity of medical resources. To address this issue, we formulated a classic SIR model to include a close contact tracing strategy and structured prevention and control interruptions (SPCIs). The impact of the timing of SPCIs on the maximum number of non-isolated infected individuals and on the duration of an infectious disease outside quarantined areas (i.e. implementing a dynamic zero-case policy) were analyzed numerically and theoretically. These analyses revealed that to minimize the maximum number of non-isolated infected individuals, the optimal time to initiate SPCIs is when they can control the peak value of a second rebound of the epidemic to be equal to the first peak value. More individuals may be infected at the peak of the second wave with a stronger intervention during SPCIs. The longer the duration of the intervention and the stronger the contact tracing intensity during SPCIs, the more effective they are in shortening the duration of an infectious disease outside quarantined areas. The dynamic evolution of the number of isolated and non-isolated individuals, including two peaks and long tail patterns, have been confirmed by various real data sets of multiple-wave COVID-19 epidemics in China. Our results provide important theoretical support for the adjustment of NPI strategies in relation to a given carrying capacity of medical resources.

PMID:38615293 | DOI:10.1007/s00285-024-02083-y

Cancer Causes Control. 2024 Apr 14. doi: 10.1007/s10552-024-01873-5. Online ahead of print.

ABSTRACT

PURPOSE: Breast cancer (BC) characteristics are known to influence patients survival. Social differences have been reported by previous studies for those characteristics but questions persist because of inconsistent conclusions. We aimed to investigate the impact of education on BC stage, grade, and hormone receptor (HR) status, while adjusting for potential confounders including a broad set of health behaviors, anthropometric measures, and reproductive factors.

METHODS: In the French E3N cohort, 5236 women developed a primary invasive BC for which there was available information on stage, grade, and HR status. No multivariate analyses was performed for BC stage based on the lack of association in bivariate analyses. Odds ratios and confidence intervals were estimated using multinomial logistic regression models for BC grade or binomial logistic regression models for HR status of BC.

RESULTS: Women with a lower education were diagnosed with higher grade BC compared to women with a higher education (1.32 [1.12; 1.57]). This association was slightly attenuated after adjustment for covariates independently and more strongly affected in the fully adjusted model (1.20 [0.99; 1.45]). A significant association was observed between lower education and HR- status of BC (1.20 [1.02; 1.42]) attenuated after adjustment for age at first childbirth (1.12 [0.95; 1.33]).

CONCLUSION: In this cohort, education was associated with BC grade and HR status but not stage at diagnosis. The link between education and BC grade was not entirely explained by the different adjustments. A specific mechanism could be at play and deserves further investigations.

PMID:38615276 | DOI:10.1007/s10552-024-01873-5

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:26495. doi: 10.4317/medoral.26495. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the surgical accuracy of a new universal disposable stop system for implant drills (FCA Universal Drill Stop).

MATERIAL AND METHODS: A total of 60 bovine ribs were included in this in vitro study. The ribs were randomized into three study groups (n=20 ribs per group). In each study group (Group1: drills without stop or control group, Group 2: prefabricated drills with stop or gold standard group, and Group 3: drills with FCA Universal Drill Stop) a total of 100 osteotomies were performed with implant drills in each group, following the drilling sequence for the placement of a dental implant of 10 mm length and 4 mm diameter. The accuracy of the depth of the osteotomies was quantified clinically (with periodontal probe) and radiologically, using ImageJ version 1.48v software.

RESULTS: The order of highest to lowest accuracy (clinical and radiological) in the depth of osteotomies was: FCA Universal Drill Stop> prefabricated drills with a stop>drills without stop, with statistically significant differences being observed between both systems with stop with respect to the control group, although not between them.

CONCLUSIONS: The new universal disposable stop system for implant drills, offers similar accuracy to prefabricated drills with stop, with both systems being much more accurate than implant drills without stop. Although this experimental evaluation showed favourable results, further clinical studies are necessary.

PMID:38615258 | DOI:10.4317/medoral.26495

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:25658. doi: 10.4317/medoral.25658. Online ahead of print.

ABSTRACT

BACKGROUND: The role of Platelet-rich Plasma injections as a complementary therapy, together with other minimally invasive procedures, has been analyzed previously, however, there are no articles that evaluate the effects of intra-articular infiltration in the Temporomandibular Joint by itself. The aim of this article is to evaluate the effectiveness of intra-articular infiltration with Platelet-rich Plasma, as a single procedure, to both reduce pain and improve clinical parameters in painful joint disorders.

MATERIAL AND METHODS: A systematic search was performed using the terms “Temporomandibular Joint Disorders” and “Platelet-rich plasma” in May 2021. Only the Clinical Trials found in the Pubmed/Medline, Embase, Cochrane Library/Cochrane CENTRAL, Google Scholar, and LILACS databases were selected.

RESULTS: Only four articles were selected for full-text review. Statistically significant differences were found in pain reduction Platelet-rich Plasma-based interventions with respect to preoperative measurements up to six months. Only two studies found significant intergroup differences favoring Platelet-rich Plasma over other interventions. In relation to maximum mouth opening, three studies reported an increase compared to the preoperative measurements.

CONCLUSIONS: Platelet-rich Plasma might potentially be effective in reducing pain levels and improving clinical parameters such as interincisal distance. However, studies with better methodological quality, larger sample sizes, and lower risk of bias are required to assess the real value of this intervention in the management of painful joint disorders.

PMID:38615254 | DOI:10.4317/medoral.25658

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:26493. doi: 10.4317/medoral.26493. Online ahead of print.

ABSTRACT

BACKGROUND: The initiation of odontogenic tumorigenesis often involves the activation of the MAP-kinase pathway, with a pivotal role played by the BRAF V600E mutation. This study aimed to investigate the frequency of BRAF V600E immunoexpresion in ameloblastomas diagnosed in four Latin American centers and correlate this finding with the histological types and subtypes of the analyzed cases.

MATERIAL AND METHODS: A total of 86 samples of ameloblastomas were examined for immunohistochemistry using anti-BRAF V600E antibody. The histopathological features of each case were analyzed.

RESULTS: Positivity for anti-BRAF V600E antibody was detected in 65/86 cases (75.6%). BRAF V600E was positive in 38/56 cases (67.9%) of conventional ameloblastomas and in 27/30 cases (90.0%) of unicystic ameloblastomas. A statistically significant difference in BRAF V600E positivity was observed when comparing unicystic ameloblastomas to conventional ameloblastomas (p=0.03). No statistically significant difference in BRAF V600E positivity was observed when comparing histological variants, both for conventional ameloblastomas and unicystic ameloblastomas.

CONCLUSIONS: This study highlights a high frequency of BRAF V600E immunoreactivity in ameloblastomas among Latin American cases. The prevalence of the BRAF V600E immunoexpresion may suggest the feasibility of utilizing BRAF-targeted therapy for ameloblastomas with this mutation.

PMID:38615253 | DOI:10.4317/medoral.26493

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:26559. doi: 10.4317/medoral.26559. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to retrospectively measure the incidence of missed orbital blowout fracture diagnosis in primary examinations of patients with surgically treated fractures, to identify the causes of the diagnostic oversight, and to describe the clinical manifestations of the fractures.

MATERIAL AND METHODS: A retrospective cohort of all patients with unilateral orbital blowout fractures who underwent subsequent surgical fracture reduction at the Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, from January 2011 to July 2021, was gathered. Demographics, fracture type, associated injuries, clinical manifestations, reconstruction indication, diagnostic delay, and causes of fractures were analysed. For statistical analysis, Fisher’s exact test, unpaired t-test, and the Wilcoxon Rank Sum were used. Significance was set at P˂0.05.

RESULTS: Fracture diagnosis was missed in 26 (13%) of 207 patients: in 40% of patients aged under 18 years and in 10% of patients aged 18 years or over (P=0.005). Suboptimal eye examination was found in 62% of patients with missed fracture and in 13% of those with timely diagnosis (P<0.001). Adjusted odds ratios for missed diagnosis in patients aged under 18 years versus patients aged 18 years and over was 9.3 (95% CI 2.4-35) and in patients with suboptimal versus sufficient eye examination 13.6 (95% CI 5.1-37). More common clinical manifestations in patients aged under 18 years were diplopia or restricted eye movements (P=0.005), pain in eye movements (P=0.010), nausea and/or vomiting (P<0.001), and bradycardia (P=0.014); periorbital haematoma was rarer (P<0.001). Suboptimal eye examination was involved in 62% and misinterpretation of computed tomography images in 50% of missed fractures, together explaining 85% of cases.

CONCLUSIONS: Orbital blowout fractures are often missed in primary examination, especially in children and adolescents, who also present with subtler clinical manifestations. While the diagnosis can be difficult, appropriate clinical and radiological examination will reveal most cases.

PMID:38615251 | DOI:10.4317/medoral.26559

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:26456. doi: 10.4317/medoral.26456. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to describe the perception of dentists from the North macroregion of Minas Gerais, Brazil, users of telediagnosis in Oral Medicine, during the COVID-19 pandemic.

MATERIAL AND METHODS: This is a cross-sectional and descriptive study. Data collection was carried out online, between May and October 2022. The information was transferred to the Statistical Package for the Social Sciences for Windows (SPPS)® version 24.

RESULTS: The sample consisted of 255 dentists, predominantly female. Regarding perception, a significant percentage (47.8%) of respondents agreed that they would like to use telediagnosis frequently, more than half (60.6%) agreed that the technology is easy to use, only a small percentage (8.8%) needed technical support to use it and almost half (48.2%) mentioned the desire to continue using it after the pandemic. When asked if patients felt confident and comfortable when passing on information, more than half disagreed or remained neutral (58.4%), a similar result was found in relation to confidence in the application of the instrument by professionals.

CONCLUSIONS: It is concluded that, during the pandemic, telediagnosis in Oral Medicine was an easy and adequate tool. However, professionals must be trained and prepared to be comfortable and ready for use.

PMID:38615250 | DOI:10.4317/medoral.26456