Tag: nevin manimala

J Am Vet Med Assoc. 2023 Sep 12:1-8. doi: 10.2460/javma.23.07.0379. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the use of a locking 3.5/4.0-mm jumbo tibial plateau leveling osteotomy (TPLO) plate in maintaining the postoperative tibial plateau angle (TPA) in giant-breed dogs weighing > 50 kg and to report the associated complications.

ANIMALS: Canine patients weighing > 50 kg that underwent TPLO stabilized with a locking 3.5/4.0-mm jumbo TPLO plate between January 2017 and May 2022.

METHODS: Retrospective case series retrieving postoperative outcomes from the medical records. Healing scores and TPAs were calculated using postoperative and recheck radiographs. Owner-perceived outcomes were obtained via questionnaire.

RESULTS: 24 stifles in 22 dogs were included. Postoperative complications were recorded in 11 of 24 cases (45.8%) inclusive of 1 minor, 1 catastrophic, and 9 major complications. A statistically significant increase in TPA over the convalescent period was found. Grade 4 healing was present in 18 of 24 (75%) stifles, while the remainder were scored as grade 3.

CLINICAL RELEVANCE: The use of a locking 3.5/4.0-mm jumbo TPLO plate did not prevent a statistically significant increase in TPA through convalescence. This procedure displayed an unacceptably high complication rate when compared with contemporary literature of TPLO. Despite a high complication rate in this patient population, most complications were successfully managed with medical and/or surgical treatment, and high mean and median healing scores were achieved at the radiographic recheck. Additionally, owner-perceived long-term outcomes were excellent.

PMID:37699545 | DOI:10.2460/javma.23.07.0379

Pediatr Neurol. 2023 Aug 22;148:101-107. doi: 10.1016/j.pediatrneurol.2023.08.017. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the long-term functional and neurodevelopmental outcomes in pediatric patients who underwent neurosurgical intervention following suspected abusive head trauma (AHT).

METHODS: We performed a single-center retrospective review (January 1, 2007, to December 31, 2019) of patients aged less than three years who had intracranial injury suspicious for AHT and received a neurosurgical procedure. Long-term functional outcome was measured using the Pediatric Cerebral Performance Category (PCPC), Pediatric Overall Performance Category (POPC), and the Mullen Scales of Early Learning (MSEL).

RESULTS: Seventy-seven patients were identified; 53 survived to discharge and had at least one-year follow-up. To examine long-term functional outcome, PCPC at the last available visit was examined and found to be 1 or 2 (normal to mild disability) for 64% of patients and 3 or 4 (moderate to severe disability) for 36%. The last available MSEL composite score for neurodevelopmental assessment also demonstrated that 13% of patients scored in the “average” range, 17% in the “below average” range, and 70% in the “very low” range. There was no statistical difference in the last available PCPC or POPC score or the last available MSEL score for patients who received a craniotomy when compared with those who received an intracranial shunt.

CONCLUSIONS: For patients with AHT who survived to discharge, functional improvements over time were noted in both patients who received craniotomy or who simply required shunt placement. These results suggest that, for patients who survive to discharge, operative management of AHT can lead to reasonable long-term functional outcomes.

PMID:37699270 | DOI:10.1016/j.pediatrneurol.2023.08.017

Dermatitis. 2023 Sep 12. doi: 10.1089/derm.2023.0148. Online ahead of print.

ABSTRACT

Background: Convolutional neural networks (CNNs) have the potential to assist allergists and dermatologists in the analysis of patch tests. Such models can help reduce interprovider variability and improve consistency of patch test interpretations. Objective: Our aim is to evaluate the performance of a CNN model as a proof of concept in discriminating between patch tests with reactions and patch tests without reactions. Methods: We performed a retrospective analysis of patch test images from March 2020 to March 2021. The CNN model was trained as a binary classifier to discriminate between reaction and nonreaction patches. Performance of the model was determined using summary statistics and receiver operator characteristics (ROC) curves. Results: In total, 13,622 images from 125 patients were recorded for analysis. The majority of patients in the cohort were female (81.6%) with Fitzpatrick skin types I-II (88.0%). The area under curve was 0.940, indicating a high discriminative performance of the model for this data set. This resulted in a total accuracy of 90.1%, sensitivity of 86.0%, and specificity of 90.2%. Conclusions: CNNs have the capacity to determine the presence of delayed-type reactions in patch tests. Future prospective studies are required to assess the generalizability of such models.

PMID:37699249 | DOI:10.1089/derm.2023.0148

Games Health J. 2023 Sep 12. doi: 10.1089/g4h.2023.0054. Online ahead of print.

ABSTRACT

Objective: Wordbot, a chatbot designed for gamified education, transforms the process of memorizing complex medical terminology into an engaging and enjoyable activity for medical students. Taking inspiration from the “guessing words” game, Wordbot aims to improve medical students’ learning outcomes by making the vocabulary memorization process more memorable. Materials and Methods: Wordbot, which can be implemented on the LINE platform, was created for this research, specifically to improve medical terminology learning. Wordbot incorporated mobile devices and personal computer-compatible flashcard games with features such as user ranking and personalization to enhance motivation and optimize learning outcomes. In the experimental research setting, half of a total of 48 nursing students were randomly assigned to use Wordbot for 4 months, and the other half were assigned to a control group relying on self-study without the help of Wordbot. Both groups received pretest and post-test to assess their respective learning of medical terminology. In this study, a statistical t-test was used to analyze the results between the two groups. In addition, user usability testing was conducted to evaluate the usability of Wordbot and gather feedback on user experience. Results: The results of this study have demonstrated that Wordbot is effective in facilitating students learning of medical terminology. Students experienced a significant improvement in their knowledge of medical terminology. An average user usability test score of 83.25 indicated that users’ satisfaction with Wordbot is high. Conclusion: Incorporating gamification and personalization elements in Wordbot can significantly improve the overall enjoyment of the learning process. By participating in diverse interactive activities, users can effectively enhance their proficiency in spelling, recognition, and speaking. Wordbot utilizes sophisticated algorithms to generate customized questions based on identified mistakes, which facilitate error identification and correction. The robust findings of this study overwhelmingly support Wordbot’s role as a convenient and easily accessible tool for learning medical terminology. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Chang Gung Medical Foundation (Protocol code: 202201586B0, date of approval: 8 November 2022). We obtained informed consent from all of our study participants regarding their willingness to participate in this study.

PMID:37699207 | DOI:10.1089/g4h.2023.0054

Int J Prosthodont. 2023 Sep 12;36(4):501-507. doi: 10.11607/ijp.7947.

ABSTRACT

PURPOSE: To compare the accuracy of occlusal stabilization appliances fabricated by digital workflows to those fabricated by conventional workflows.

MATERIALS AND METHODS: In total, 10 volunteers were recruited in this single-blinded crossover study. All volunteers received two types of occlusal stabilization appliances: a digital additively manufactured stabilization splint (DS) and a conventionally fabricated splint (CS). The accuracy was assessed using a 4-point rating scale addressing two aspects of the occlusal appliances: occlusal contact and basic performance. In addition, silicone impression materials were used to assess the gap between the appliance and the maxillary arch to ensure an accurate fit. Differences were quantitatively assessed with Mann-Whitney U test and independent-sample t test.

RESULTS: The occlusal contact rating of DS (15.90 ± 1.73) was significantly higher than that of CS (14.10 ± 1.10, P < .05). The basic performance rating of DS (8.70 ± 0.48) was also significantly higher than that of CS (7.20 ± 0.92. P < .05). Quantitative evaluation of fit accuracy revealed a statistically significant difference (P < .05), with DS (636.29 ± 268.51 μm) being superior to CS (704.2 ± 306.05 μm).

CONCLUSION: The stabilization splints fabricated with a digital workflow showed better accuracy than the conventionally fabricated splints in terms of occlusal contact, basic performance, and fit accuracy. Because this is a pilot study, formal trials with a completely digital fabrication workflow will be conducted in the future.

PMID:37699192 | DOI:10.11607/ijp.7947

Int J Prosthodont. 2023 Sep 12;36(4):498-500. doi: 10.11607/ijp.8317.

ABSTRACT

PURPOSE: To assess the marginal and internal fit of monolithic zirconia fixed dental prostheses (FDPs) comparing two different intraoral scanners (IOSs) and assessment methods.

MATERIALS AND METHODS: A maxillary typodont with three prepared teeth allowed fabrication of five-unit high-translucency monolithic zirconia FDPs. The typodont was scanned with two IOSs: Cerec Omnicam and 3Shape TRIOS 3. In total, 30 FDPs were milled from presintered high-translucency zirconia blocks. Dual-scan and silicone replica assessments were used to determine marginal and internal gaps.

RESULTS: A statistical significance was observed for marginal gaps (3Shape [74.27 ± 10.4 μm] and Cerec [86.45 ± 14.3 μm]) and for internal gaps (3Shape [126.12 ± 12.7 μm] and Cerec [112.38 ± 17.2 μm]).

CONCLUSIONS: The outcomes of this study showed that the 3Shape TRIOS 3 produced a better overall marginal fit, while the Cerec Omnicam created a better internal fit. Additionally, a greater overall marginal and internal gap was noted with the silicone replica method over the dual-scan method.

PMID:37699191 | DOI:10.11607/ijp.8317

Thyroid. 2023 Sep 12. doi: 10.1089/thy.2023.0317. Online ahead of print.

ABSTRACT

BACKGROUND: Hypothyroidism is common, and in iodine-sufficient areas is primarily caused by autoimmune destruction of the thyroid gland. Observational studies have consistently shown an inverse association between serum 25-hydroxyvitamin D concentration and autoimmune diseases; however, there is a lack of evidence from randomized controlled trials to support a benefit of vitamin D supplementation, particularly for autoimmune thyroid diseases. We therefore aimed to assess the effect of vitamin D supplementation on the incidence of hypothyroidism.

METHODS: We analyzed data from the D-Health Trial (N=21,315), a randomized, double-blind, placebo-controlled trial of 60,000 international units per month of supplemental vitamin D3 among Australians aged 60 years and over. Hypothyroidism, a tertiary outcome of the D-Health Trial, was defined by treatment with levothyroxine, ascertained via linkage with the Australian Pharmaceutical Benefits Scheme. The outcome was time to first prescription of levothyroxine. We began follow-up at 12 months after randomization; people who had died or who had been dispensed levothyroxine during the first year were excluded. Flexible parametric survival models were used to assess the effect of vitamin D supplementation on hypothyroidism, overall and within strata defined by age, sex, body mass index, and predicted baseline vitamin D status.

RESULTS: We included 17,851 participants in the main analysis (vitamin D=8939; placebo=8912). During a median follow up of 4.1 years (IQR 4.1-4.1) 293 participants developed hypothyroidism (vitamin D=138 [1.5%]; placebo=155 [1.7%]). Vitamin D supplementation did not significantly reduce the incidence of hypothyroidism (overall hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.71-1.12). There was some suggestion of an effect in females (overall HR 0.78; 95% CI 0.58-1.06) but not in males (overall HR 1.06; 95% CI 0.74-1.50; p interaction 0.20).

CONCLUSIONS: Vitamin D supplementation did not reduce the incidence of hypothyroidism overall; however, the possible beneficial effect observed in females warrants further investigation.

CLINICAL TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12613000743763.

PMID:37698908 | DOI:10.1089/thy.2023.0317

Int Endod J. 2023 Sep 12. doi: 10.1111/iej.13975. Online ahead of print.

ABSTRACT

AIM: Fat mass and obesity-associated (FTO) protein, the first discovered N6-methyladenine (m6A) demethylase, played positive roles in bone formation. In this study, the aim was to investigate the function and potential mechanism of Fto in dentine formation.

METHODOLOGY: In vivo model, postnatal 12-day (PN12), 4-week-old (4 wk), 6-week-old (6 wk) healthy male C57BL/6J were randomly divided into Fto knockout (Fto^-/- ) mice and wild-type (WT) littermates according to their genotypes, with 3-5 mice in each group. The mandibles of Fto^-/- mice and WT control littermates were isolated for analysis by micro-computed tomography (micro-CT), 3-dimensional reconstruction and Haematoxylin-eosin (HE) staining. In vitro, mouse dental papilla cells (mDPCs) and human dental stem pulp cells (hDPSCs) were cultured with odontogenetic medium to evaluate differentiation capacity; expression levels of odontoblastic related genes were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR). The inclusion levels of Runt-related transcription factor 2 (RUNX2) exon 5 in mDPCs and hDPSCs were detected by semiquantitative real-time polymerase chain reaction (RT-PCR). The RNA binding motif protein 4 (RBM4) m6A site was verified through m6A methylated RNA immunoprecipitation (MeRIP) and the stability of RBM4 mRNA influenced by FTO knockdown was measured by mRNA stability assay. Differences with p values < .05 were regarded as statistically significant.

RESULTS: We discovered that Fto^-/- mice showed significant dentine formation defects characterized by widened pulp cavity, enlarged pulp-tooth volume ratio, thinned dentine and pre-dentine layer of root (p < .05). Fto^-/- mDPCs and FTO-silencing hDPSCs not only exhibited insufficient mineralization ability and decreased expression levels of odontoblastic mineralization related genes (p < .05), but showed significantly reduced Runx2 exon 5 inclusion level (p < .05). FTO knockdown increased the m6A level of RBM4 and destabilized the mRNA of RBM4, thus contributing to the reduced RBM4 expression level. Moreover, Rbm4 overexpression in Fto^-/- mDPCs can partly restore Runx2 exon 5 inclusion level and the differentiation ability disrupted by Fto knockout.

CONCLUSION: Thus, within the limitations of this study, the data suggest that FTO promotes odontoblastic differentiation during dentine formation by stabilizing RBM4 mRNA to promote RUNX2 exon 5 inclusion.

PMID:37698901 | DOI:10.1111/iej.13975

JMIR Serious Games. 2023 Sep 12;11:e42067. doi: 10.2196/42067.

ABSTRACT

BACKGROUND: Many studies have started integrating virtual reality (VR) into neurorehabilitation for children with cerebral palsy (CP). The results of the effects of VR on motor skill learning, including the short- to long-term results of relevant studies, must be pooled in a generic framework.

OBJECTIVE: This systematic review and meta-analysis aimed to investigate the short- to long-term effects of therapies including VR on motor skill learning in children with CP.

METHODS: Two examiners followed the inclusion and exclusion criteria of the “Participant, Intervention, Control, and Outcome” framework. Randomized controlled trials (RCTs) and non-RCTs were considered if they compared VR-included interventions with control groups on motor functions and daily life activities in children with CP. PubMed, ScienceDirect, Embase, and IEEE Xplore databases were searched. The modified Downs and Black assessment was used to assess the methodological quality of the included studies. Meta-analyses and subgroup analyses for RCTs were conducted whenever possible.

RESULTS: A total of 7 RCTs, 2 non-RCTs, and 258 children with CP were included. The priority focus of 78% (7/9) of the studies was upper limb functions. There was a significant short-term effect of adding VR to conventional therapies on upper limb functions when compared with conventional therapies (P=.04; standardized mean difference [SMD]=0.39, 95% CI 0.01-0.76). The overall medium- to long-term effects showed a trend toward favoring the VR group, although the difference was not statistically significant (P=.06; SMD=0.37, 95% CI -0.02 to 0.77). For balance (P=.06; SMD=1.04, 95% CI -0.04 to 2.12), gross motor functions (P=.30; SMD=2.85, 95% CI -2.57 to 8.28), and daily life activities outcomes (P=.21; SMD=0.29, 95% CI -0.16 to 0.74), the overall effect in the short term also showed a trend toward favoring the VR group, but these results were not statistically significant.

CONCLUSIONS: VR seems to have additional benefits for motor skill learning in children with CP. Studies with follow-up outcomes of VR training focusing on balance and gross motor functions in patients with CP were quite limited. Future research on balance and gross motor function outcomes should target particularly long-term results of therapies including VR on motor skill learning.

TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021227734; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227734.

PMID:37698895 | DOI:10.2196/42067

JAMA Netw Open. 2023 Sep 5;6(9):e2333360. doi: 10.1001/jamanetworkopen.2023.33360.

NO ABSTRACT

PMID:37698865 | DOI:10.1001/jamanetworkopen.2023.33360