Tag: nevin manimala

Odontology. 2023 Aug 1. doi: 10.1007/s10266-023-00839-4. Online ahead of print.

ABSTRACT

Trace- and macro-chemical elements are crucial for cellular physiological functioning, and their alterations in biological fluids might be associated with an underlying pathological state. Hence, this study aimed to examine and summarize the published literature concerning the application of salivary ionomics for caries diagnosis. An extensive search of studies was conducted using PubMed, EMBASE, Web of Science, and Scopus, without any language and year restriction for answering the following PECO question: “In subjects (i.e., children, adolescents, or adults) with good systematic health, are there any variations in the salivary concentrations of trace- or macro-elements between caries-free (CF) individuals and caries-active (CA) subjects?” A modified version of the QUADOMICS tool was used to assess the quality of the included studies. The Review Manager Version 5.4.1. was used for data analyses. The analysis of salivary chemical elements that significantly differed between CF and CA subjects was also performed. Thirty-four studies were included, involving 2299 CA and 1669 CF subjects, having an age range from 3 to 64 years in over 16 countries. The meta-analysis revealed a statistically significant difference (p < 0.05) in the salivary levels of calcium, phosphorus, chloride, magnesium, potassium, sodium, and zinc between CA and CF subjects, suggesting higher levels of calcium, phosphorus, potassium, and sodium in CF subjects while higher levels of chloride, magnesium, and zinc in CA patients. Half of the included studies (17/34) were considered high quality, while the remaining half were considered medium quality. Only zinc and chloride ions were found to be higher significantly and consistent in CF and CA subjects, respectively. Conflicting outcomes were observed for all other salivary chemical elements including aluminum, bromine, calcium, copper, fluoride, iron, potassium, magnesium, manganese, sodium, ammonia, nitrite, nitrate, phosphorus, lead, selenium, and sulfate ions.

PMID:37526792 | DOI:10.1007/s10266-023-00839-4

Lasers Med Sci. 2023 Aug 1;38(1):172. doi: 10.1007/s10103-023-03837-8.

ABSTRACT

This study aimed to evaluate the efficacy of fluoride-free remineralizing agents in initial enamel caries, with and without combined Er,Cr:YSGG laser application. The remineralization effect of various agents and their combinations on artificial initial caries was investigated using 10 experimental groups (n = 7): NC, negative control; PC, positive control; TM, calcium-phosphate compounds (CPP-ACP); TD, theobromine-containing toothpaste; RG, ROCS® remineralizing gel; L, Er,Cr:YSGG laser (2780 nm; 0.25 W; repetition rate, 20 Hz; pulse duration, 140 μs; tip diameter, 600 μm; without air/water cooling); L + fluoride toothpaste; L + TM; L + TD; and L + RG. The demineralized bovine enamel specimens were subjected to an 8-day pH cycle by daily application of the remineralizing agents and laser therapy once prior to the pH cycle and paste application. The enamel samples underwent the Vickers surface microhardness test, and one sample per group was analyzed with scanning electron microscopy. The Kruskal Wallis test was used to compare the microhardness recovery percentage (SMHR%) for each group, and multiple comparisons were made with the Dunn test. Groups L (p = 0.003), RG (p = 0.019), L + TM (p < 0.001), L + fluoride toothpaste (p = 0.001),and L + RG (p = 0.036) exhibited significant increase in SMHR%. The tested remineralizing agents exhibited no statistically significant difference in effect when used alone and in combination with Er,Cr:YSGG laser. Combined application of Er,Cr:YSGG laser and ROCS® remineralization gel effectively promoted enamel remineralization, while use of CPP-ACP and fluoride toothpaste alone was ineffective. Theobromine-containing toothpaste exhibited the least SMHR%. Long-term evaluation of these agents is recommended.

PMID:37526766 | DOI:10.1007/s10103-023-03837-8

Lasers Med Sci. 2023 Aug 1;38(1):171. doi: 10.1007/s10103-023-03774-6.

ABSTRACT

The effects of low-level laser on the wound healing and burn injuries have been previously examined to demonstrate some satisfactory results. Despite there are a few articles available to study photobiomodulation (PBM) effects on the pain relief of cesarean sectioned wound, however no systematic examination has been carried out so far regarding its healing. Here, the aim of this clinical study was to evaluate PBM effect on the cesarean-sectioned wound healing. PBM effects of semiconductor lasers are investigated at 658 and 660 nm with 100, 150 and 350 mW output powers on 40 patients. Due to the global increasing number of cesarean sections, we have decided to investigate the effect of laser as a reliable technique to recover the wounds fast. We considered women as the target group who had their first delivery giving the birth of their children by cesarean section. We selected patients are who treated by laser therapy using indium gallium aluminum phosphide (InGaAlP) semiconductor linear scanning type with beam cross section of 12 cm² and the output power of 100 mW at 658 nm exposing a therapeutic dose of 2 J/cm². The purpose is to accelerate the healing process of the wounds after delivery as an intervention group against the people who chose the conventional methods (using ointments, pills, etc.) to heal their cesarean sectioned wounds as the control group. Regarding the wounds of these two groups, the questionnaires were filled by patients to assess the severity of pain from visual analogue scale (VAS) based on the healing of wounds from redness, edema, ecchymosis, discharge, and distance between the two edges of the wound (REEDA) scale in the early hours after surgery and the post-treatment follow-up on the third, seventh, and the tenth days. The data collected by these questionnaires were analyzed using statistical package for social science)SPSS( as a statistical software to give out the comparative histograms. This study reports a clinical examination of PBM under intervention group of 40 patients ranging 18-40 years old with body mass index (BMI) of 29-36, during post-cesarean surgery to elucidate successful healing of the wounds and scars against conventional methods which considered as control group. Comparison of mean REEDA scores on the third day (p = 0.035), seventh day (p = 0.03), and tenth day (p = 0.02) after delivery exhibits that the two groups benefit a statistically significant difference with each other. For instance, the mean wound healing score in the intervention group was almost half of the mean wound healing score on the tenth day in the control group (1.09 ± 0.586 vs. 2.25 ± 0.422). The post-cesarean follow-up indicates that the patients treated by the laser therapy (intervention group) encounter better recovery than the control group.

PMID:37526765 | DOI:10.1007/s10103-023-03774-6

Int J Biometeorol. 2023 Aug 1. doi: 10.1007/s00484-023-02510-7. Online ahead of print.

ABSTRACT

Many studies have reported that the impact of high temperatures affects physiology, welfare, health, and productivity of farm animals, and among these, the dairy cattle farming is one of the livestock sectors that suffers the greatest effects. The temperature-humidity index (THI) represents the state of the art in the evaluation of heat stress conditions in dairy cattle but often its measurement is not carried out in sheds. For this reason, the aim of this study was the monitoring of the THI in three dairy cattle farms in Mugello (Tuscany) to understand its influence on dairy cows. THI values were calculated using meteorological data from direct observation in sheds and outdoor environments. Data relating to the animal’s behavior were collected using radio collars. The Pearson test and Mann-Kendall test were used for statistical analysis. The results highlighted a significant (P < 0.001) upward trend in THImax during the last 30 years both in Low Mugello (+ 1.1 every 10 years) and in High Mugello (+ 0.9 every 10 years). In Low Mugello sheds, during the period 2020-2022, more than 70% of daytime hours during the summer period were characterized by heat risk conditions (THI > 72) for livestock. On average the animals showed a significant (P < 0.001) decrease in time spent to feeding and rumination, both during the day and the night, with a significant (P < 0.001) increase in inactivity. This study fits into the growing demand for knowledge of the micro-climatic conditions within farms in order to support resilience actions for protecting both animal welfare and farm productivity from the effects of climate change. This could also be carried out thanks to estimation models which, based on the meteorological conditions forecast, could implement the thermal stress indicator (THI) directly from the high-resolution meteorological model, allowing to get a prediction of the farm’s potential productivity loss based on the expected THI.

PMID:37526764 | DOI:10.1007/s00484-023-02510-7

Acta Diabetol. 2023 Aug 1. doi: 10.1007/s00592-023-02155-3. Online ahead of print.

ABSTRACT

AIMS: The target of metabolic control (HbA1c < 7% or 53 mmol/mol) recommended by the ADA and ISPAD is attained by 30% of children with Type 1 Diabetes (T1D). Advances in technologies for T1D aim to improve metabolic outcomes and reduce complications. This observational study assesses the long-term outcomes of advanced technologies for treatment of T1D compared to conventional approach started at onset in a group of very young children with T1D.

METHODS: 54 patients with less 4 years old at onset of T1D were enrolled and followed for up to 9 years after diagnosis. 24 subjects started continuous subcutaneous insulin (CSII) treatment and 30 subjects received MDI therapy from onset. Auxological data, HbA1c and total daily insulin dose (TDD/kg) have been collected at admission and every 4 months. HbA1cAUC>6%, rates of acute complications, glycemic variability indices and glucometrics were also recorded.

RESULTS: Patients with CSII therapy had significantly lower mean HbA1c values compared to subjects receiving MDI treatment. CSII approach also recorded lower mean HbA1cAUC>6% and TDD/kg than MDI therapy. At the last download data, the time in range (TIR) was higher in patients with CSII and hyperglycemia events were lower. Better glycemic variability indices have been described during CSII therapy, including mean glycemia, standard deviation, coefficient of variation (CV), glycemia risk index (GRI) and high blood glucose index (HBGI). There was no statistically significant difference between frequency of severe hypoglycemia and ketoacidosis episodes between groups.

CONCLUSIONS: Early initiation of diabetes technologies is safe and able to determine a better long term glycemic control in young children with T1D. It also allows to flatten the trajectory of HbA1c, probably reducing microvascular, macrovascular and neurological complications of diabetes in this very peculiar age group.

PMID:37526745 | DOI:10.1007/s00592-023-02155-3

J Math Biol. 2023 Aug 1;87(2):35. doi: 10.1007/s00285-023-01958-w.

ABSTRACT

Renewal equations are a popular approach used in modelling the number of new infections, i.e., incidence, in an outbreak. We develop a stochastic model of an outbreak based on a time-varying variant of the Crump-Mode-Jagers branching process. This model accommodates a time-varying reproduction number and a time-varying distribution for the generation interval. We then derive renewal-like integral equations for incidence, cumulative incidence and prevalence under this model. We show that the equations for incidence and prevalence are consistent with the so-called back-calculation relationship. We analyse two particular cases of these integral equations, one that arises from a Bellman-Harris process and one that arises from an inhomogeneous Poisson process model of transmission. We also show that the incidence integral equations that arise from both of these specific models agree with the renewal equation used ubiquitously in infectious disease modelling. We present a numerical discretisation scheme to solve these equations, and use this scheme to estimate rates of transmission from serological prevalence of SARS-CoV-2 in the UK and historical incidence data on Influenza, Measles, SARS and Smallpox.

PMID:37526739 | DOI:10.1007/s00285-023-01958-w

Arch Orthop Trauma Surg. 2023 Aug 1. doi: 10.1007/s00402-023-05003-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Scaphoid is the most fractured carpal bone, with a 5-10% nonunion rate. Treatment challenges include choosing the implant and graft that best corrects humpback deformity and carpal malalignment with higher chances of bony healing.

OBJECTIVE: Compare cortico-cancellous and cancellous grafts between two groups of patients treating scaphoid nonunion with locking plates using autologous bone graft and evaluate bone healing rates and radiographic, tomographic, and functional parameters before and after surgery.

METHODS: Non-randomized prospective study including 20 cases of scaphoid nonunion. Groups were divided into Group A (ten patients treated with cortico-cancellous iliac graft) and Group B (ten patients treated with cancellous iliac graft). Patients underwent pre- and postoperative radiographs, computed tomography, and functional evaluation.

RESULTS: In postoperative analysis, Group A showed a statistically significant difference in intrascaphoid angle (p = 0.002) and scapholunate angle (p = 0.011) correction when comparing the pre- and postoperative periods. Group B showed a statistically significant difference in intrascaphoid angle (p = 0.002) and scapholunate angle correction (p = 0.0018), grip strength (p = 0.002), and tip pinch strength (p = 0.001) when comparing the pre- and postoperative periods. By comparing both groups, Group B showed a statistically significant difference in intrascaphoid angle correction (p = 0.002), grip strength (p = 0.002), tip pinch strength (p = 0.002), and radial deviation (p = 0.0003). There was no statistical difference when comparing bony healing between groups.

CONCLUSION: Scaphoid nonunion treatment with a locking plate was effective, showing a high bony healing rate and improved carpal alignment in imaging tests for both graft types. However, results for intrascaphoid angle correction, grip strength, tip pinch strength, and radial deviation were better in Group B.

LEVEL OF EVIDENCE: IV, case series.

PMID:37526738 | DOI:10.1007/s00402-023-05003-9

Int J Legal Med. 2023 Aug 1. doi: 10.1007/s00414-023-03072-4. Online ahead of print.

ABSTRACT

Sex estimation from skeletal remains is one of the crucial issues in forensic anthropology. Long bones can be a valid alternative to skeletal remains for sex estimation when more dimorphic bones are absent or degraded, preventing any estimation from the first intention methods. The purpose of this study was to generate and compare classification models for sex estimation based on combined measurement of long bones using machine learning classifiers. Eighteen measurements from four long bones (radius, humerus, femur, and tibia) were taken from a total of 2141 individuals. Five machine learning methods were employed to predict the sex: a linear discriminant analysis (LDA), penalized logistic regression (PLR), random forest (RF), support vector machine (SVM), and artificial neural network (ANN). The different classification algorithms using all bones generated highly accuracy models with cross-validation, ranging from 90 to 92% on the validation sample. The classification with isolated bones ranked between 83.3 and 90.3% on the validation sample. In both cases, random forest stands out with the highest accuracy and seems to be the best model for our investigation. This study upholds the value of combined long bones for sex estimation and provides models that can be applied with high accuracy to different populations.

PMID:37526736 | DOI:10.1007/s00414-023-03072-4

JAMA. 2023 Aug 1;330(5):460-466. doi: 10.1001/jama.2023.9864.

ABSTRACT

IMPORTANCE: Neural tube defects are among the most common birth defects in the US.

OBJECTIVE: To review new evidence on the benefits and harms of folic acid supplementation for the prevention of neural tube defects to inform the US Preventive Services Task Force.

EVIDENCE REVIEW: Sources included PubMed, Cochrane Library, Embase, and trial registries from July 1, 2015, through July 2, 2021; references; and experts, with surveillance through February 10, 2023. Two investigators independently reviewed English-language randomized studies and nonrandomized cohort studies in very highly developed countries that focused on the use of folic acid supplementation for the prevention of neural tube defect-affected pregnancies; methodological quality was dually and independently assessed.

FINDINGS: Twelve observational studies (reported in 13 publications) were eligible for this limited update (N = 1 244 072). Of these, 3 studies (n = 990 372) reported on the effect of folic acid supplementation on neural tube defects. For harms, 9 studies were eligible: 1 randomized clinical trial (n = 431) reported on variations in twin delivery, 7 observational studies (n = 761 125) reported on the incidence of autism spectrum disorder, and 1 observational study (n = 429 004) reported on maternal cancer. Two cohort studies and 1 case-control study newly identified in this update reported on the association between folic acid supplementation and neural tube defects (n = 990 372). One cohort study reported a statistically significant reduced risk of neural tube defects associated with folic acid supplementation taken before pregnancy (adjusted relative risk [aRR], 0.54 [95% CI, 0.31-0.91]), during pregnancy (aRR, 0.62 [95% CI, 0.39-0.97]), and before and during pregnancy (aRR, 0.49 [95% CI, 0.29-0.83]), but this association occurred for only the later of 2 periods studied (2006-2013 and not 1999-2005). No other statistically significant benefits were reported overall. No study reported statistically significant harms (multiple gestation, autism, and maternal cancer) associated with pregnancy-related folic acid exposure.

CONCLUSIONS AND RELEVANCE: New evidence from observational studies provided additional evidence of the benefit of folic acid supplementation for preventing neural tube defects and no evidence of harms related to multiple gestation, autism, or maternal cancer. The new evidence was consistent with previously reviewed evidence on benefits and harms.

PMID:37526714 | DOI:10.1001/jama.2023.9864

Eur J Trauma Emerg Surg. 2023 Aug 1. doi: 10.1007/s00068-023-02339-0. Online ahead of print.

ABSTRACT

PURPOSE: Conflicting evidence exists on the choice of surgical or non-surgical treatment of flail chest injuries. We aimed to perform a meta-analysis comparing outcomes in patients presenting flail chest undergoing surgical or non-surgical treatment.

METHODS: Embase, PubMed, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing surgery to no surgery in patients with acute unstable chest wall injuries. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Random effects meta-analyses were performed. Heterogeneity was assessed using I² statistics.

RESULTS: Six RCTs (544 patients) were included, and surgical treatment was used in 269 (49.4%). Compared to no surgery, surgery reduced mechanical ventilation days (WMD – 4.34, 95% CI – 6.98, – 1.69; p < 0.01; I² = 87%; GRADE: very low; PI – 13.51, 4.84); length of intensive care unit stay (WMD – 4.62, 95% CI – 7.19, – 2.05; p < 0.01; I² = 78%; GRADE: low; PI – 12.86, 3.61) and the incidence of pneumonia (RR 0.50, 95% CI 0.31, 0.81; p = 0.005; I² = 54%; GRADE: moderate; PI 0.13, 1.91). No difference in mortality (RR 0.56, 95% CI 0.19, 1.65; p = 0.27; I² = 23%; GRADE: moderate; PI 0.04, 7.25), length of hospital stay (WMD – 5.39, 95% CI – 11.38, – 0.60; p = 0.08; I² = 89%; GRADE: very low; PI – 11.38, 0.60), or need for tracheostomy (RR 0.59, 95% CI 0.34, 1.03; p = 0.06; I² = 54%; GRADE: moderate; PI 0.11, 3.24) was found.

CONCLUSIONS: Our results suggest that surgical treatment is advantageous compared to non-surgical treatment for patients with flail chest secondary to rib fractures.

PMID:37526708 | DOI:10.1007/s00068-023-02339-0