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Nevin Manimala Statistics

Geometric Reliability of Super-Resolution Reconstructed Images from Clinical Fetal MRI in the Second Trimester

Neuroinformatics. 2023 Jun 7. doi: 10.1007/s12021-023-09635-5. Online ahead of print.

ABSTRACT

Fetal Magnetic Resonance Imaging (MRI) is an important noninvasive diagnostic tool to characterize the central nervous system (CNS) development, significantly contributing to pregnancy management. In clinical practice, fetal MRI of the brain includes the acquisition of fast anatomical sequences over different planes on which several biometric measurements are manually extracted. Recently, modern toolkits use the acquired two-dimensional (2D) images to reconstruct a Super-Resolution (SR) isotropic volume of the brain, enabling three-dimensional (3D) analysis of the fetal CNS.We analyzed 17 fetal MR exams performed in the second trimester, including orthogonal T2-weighted (T2w) Turbo Spin Echo (TSE) and balanced Fast Field Echo (b-FFE) sequences. For each subject and type of sequence, three distinct high-resolution volumes were reconstructed via NiftyMIC, MIALSRTK, and SVRTK toolkits. Fifteen biometric measurements were assessed both on the acquired 2D images and SR reconstructed volumes, and compared using Passing-Bablok regression, Bland-Altman plot analysis, and statistical tests.Results indicate that NiftyMIC and MIALSRTK provide reliable SR reconstructed volumes, suitable for biometric assessments. NiftyMIC also improves the operator intraclass correlation coefficient on the quantitative biometric measures with respect to the acquired 2D images. In addition, TSE sequences lead to more robust fetal brain reconstructions against intensity artifacts compared to b-FFE sequences, despite the latter exhibiting more defined anatomical details.Our findings strengthen the adoption of automatic toolkits for fetal brain reconstructions to perform biometry evaluations of fetal brain development over common clinical MR at an early pregnancy stage.

PMID:37284977 | DOI:10.1007/s12021-023-09635-5

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Nevin Manimala Statistics

The causal effects of inflammatory bowel disease on primary biliary cholangitis: A bidirectional two-sample Mendelian randomization study

Liver Int. 2023 Jun 7. doi: 10.1111/liv.15616. Online ahead of print.

ABSTRACT

BACKGROUND: Observational studies have indicated that the incidence of primary biliary cholangitis (PBC) is higher in inflammatory bowel disease (IBD) patients than that in healthy people. However, whether the correlation is causal remains unclear.

METHODS: The genetic associations with IBD were obtained from publicly available genome-wide association studies (GWAS) of European ancestry with 31 665 cases and 33 977 controls, consisting of 17 897 Crohn’s disease (CD) and 13 768 ulcerative colitis (UC) cases. The genetic associations with PBC were obtained from a European GWAS with 2764 cases and 10 475 controls. A bidirectional two-sample Mendelian randomization (MR) design was implemented to determine the causal relationship between IBD and PBC. In the forward MR, the IBD was treated as the exposure while the PBC was the exposure in the reverse MR. The inverse-variance-weighted (IVW) method was utilized as the main statistic method, and a series of sensitivity analyses were performed to detect heterogeneity and horizontal pleiotropy.

RESULTS: A total of 99 valid instrumental variables (IVs) were selected for IBD and the number of IVs for PBC was 18. The forward MR analysis indicated that genetically predicted IBD (UC and CD) was significantly associated with an increased risk of PBC (IVW OR = 1.343; 95% CI: 1.220-1.466). Similar casual associations were observed in UC (IVW OR = 1.244; 95% CI: 1.057-1.430) and CD (IVW OR = 1.269; 95% CI: 1.159-1.379). Such results were still consistent in multiple MR methods. The reverse MR analysis implicated that genetic susceptibility to PBC might not alter the risk of IBD (IVW OR = 1.070; 95% CI: 0.984-1.164).

CONCLUSION: Our study found that genetically predicted IBD can increase the risk of PBC while not vice versa in the European population, which may enlighten the aetiology of PBC, together with the IBD patient management.

PMID:37283182 | DOI:10.1111/liv.15616

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Nevin Manimala Statistics

Fat distribution measurements by chemical shift-encoded transition region extraction predict the risk of hyperglycaemia, dyslipidaemia and metabolic syndrome in mice

NMR Biomed. 2023 Jun 7:e4985. doi: 10.1002/nbm.4985. Online ahead of print.

ABSTRACT

Metabolically healthy or unhealthy obesity is closely related to metabolic syndrome (MetS). To validate a more accurate diagnostic method for obesity that reflects the risk of metabolic disorders in a pre-clinical mouse model, C57BL/6J mice were fed high-sucrose-high-fat and chow diets for 12 weeks to induce obesity. MRI was performed and analysed by chemical shift-encoded fat-water separation based on the transition region extraction method. Abdominal fat was divided into upper and lower abdominal regions at the horizontal lower border of the liver. Blood samples were collected, and the glucose level, lipid profile, liver function, HbA1c and insulin were tested. k-means clustering and stepwise logistic regression were applied to validate the diagnosis of hyperglycaemia, dyslipidaemia and MetS, and to ascertain the predictive effect of MRI-derived parameters to the metabolic disorders. Pearson or Spearman correlation was used to assess the relationship between MRI-derived parameters and metabolic traits. The receiver-operating characteristic curve was used to evaluate the diagnostic effect of each logistic regression model. A two-sided p value less than 0.05 was considered to indicate statistical significance for all tests. We made the precise diagnosis of obesity, dyslipidaemia, hyperglycaemia and MetS in mice. In all, 14 mice could be diagnosed as having MetS, and the levels of body weight, HbA1c, triglyceride, total cholesterol and low-density lipoprotein cholesterol were significantly higher than in the normal group. Upper abdominal fat better predicted dyslipidaemia (odds ratio, OR = 2.673; area under the receiver-operating characteristic curve, AUCROC = 0.9153) and hyperglycaemia (OR = 2.456; AUCROC = 0.9454), and the abdominal visceral adipose tissue (VAT) was better for predicting MetS risk (OR = 1.187; AUCROC = 0.9619). We identified the predictive effect of fat volume and distribution in dyslipidaemia, hyperglycaemia and MetS. The upper abdominal fat played a better predictive role for the risk of dyslipidaemia and hyperglycaemia, and the abdominal VAT played a better predictive role for the risk of MetS.

PMID:37283179 | DOI:10.1002/nbm.4985

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Nevin Manimala Statistics

Understanding the impact of the COVID‑19 pandemic on healthcare services for adults during three waves of COVID‑19 infections: A South African private sector experience

S Afr Med J. 2023 Mar 8;113(4):e16505. doi: 10.7196/SAMJ.2023.v113i4.16505.

ABSTRACT

BACKGROUND: Since the onset of the COVID‑19 pandemic, healthcare resources have been repurposed to focus on COVID‑19. Resource reallocation and restrictions to movement that affected general access to care may have inadvertently resulted in undue disruptions in the continuum of care for patients requiring non-COVID‑19 healthcare services.

OBJECTIVES: To describe the change in pattern of health service use in the South African (SA) private sector.

METHODS: We conducted a retrospective study of a nationwide cohort of privately insured individuals. An analysis of claims data was performed for non-COVID‑19 related healthcare services provided from April 2020 to December 2020 (year 1 of COVID‑19) and April 2021 to December 2021 (year 2 of COVID‑19) relative to the same period in 2019 prior to the COVID‑19 pandemic in SA. Over and above plotting the monthly trends, we tested for statistical significance of the changes using a Wilcoxon test given the non-normality of all the outcomes.

RESULTS: Between April and December 2020, relative to the same period in 2021, and also relative to the same period in 2019, we found a 31.9% (p<0.01) and a 16.6% (p<0.01) reduction in emergency room visits, respectively; a 35.9% (p<0.01) and 20.5% (p<0.01) reduction in medical hospital admissions; a 27.4% (p=0.01) and 13.0% (p=0.03) reduction in surgical hospital admissions; a 14.5% (p<0.01) and 4.1% (p=0.16) reduction in face-to-face general practitioner consultations for chronic members; a 24.9% (p=0.06) and 5.2% (p=0.54) reduction in mammography for female members; a 23.4% (p=0.03) and 10.8% (p=0.09) reduction in Pap smear screenings for female members; a 16.5% (p=0.08) and 12.1% (p=0.27) reduction in colorectal cancer registrations and an 18.2% (p=0.08) and 8.9% (p=0.07) decrease in all oncology diagnoses. Uptake of telehealth services throughout the healthcare delivery system increased by 5 708% in 2020 compared with 2019, and 36.1% for 2021 compared with 2020.

CONCLUSION: A significant reduction in emergency room visits, hospital admissions and utilisation of primary care services was observed since the start of the pandemic. Further research is required to understand if there are long-term consequences of delayed care. An increase in the use of digital consultations was observed. Research on their acceptability and effectiveness may open new modalities of care, which may have cost- and time-saving benefits.

PMID:37283155 | DOI:10.7196/SAMJ.2023.v113i4.16505

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Investigating the relationship between breast and gynecological cancers and infertility and its treatments: a case-control study

Eur J Cancer Prev. 2023 May 22. doi: 10.1097/CEJ.0000000000000815. Online ahead of print.

ABSTRACT

OBJECTIVE: Due to the high prevalence of breast and gynecological cancers among women, it is crucial to identify the risk factors of these cancers. Thus, the present study aimed to evaluate the relationship between breast and gynecological cancers and infertility and its treatments in women suffering from these cancers.

METHODS: This case-control study was conducted with the participation of 400 people (200 women with breast and gynecological cancers and 200 healthy women without a history of cancer) in hospitals and health centers in Tabriz, Iran, in 2022. Data were collected using a four-part researcher-made questionnaire including sociodemographic characteristics, obstetric characteristics, information related to cancer, and information related to infertility and its treatments.

RESULT: s Based on the multivariable logistic regression model and by controlling sociodemographic and obstetric characteristics as possible confounding variables, women with cancer had an infertility history almost four times more than women who did not have a history of cancer (OR = 3.56; 95% CI: 1.36-9.33; P = 0.010). Women with breast cancer had an infertility history five times more than women without a history of breast cancer (OR = 5.11; 95% CI: 1.68-15.50; P = 0.004). The infertility history of women with gynecological cancer was more than three times that of the control group. However, there was no statistically significant difference between the two groups (OR = 3.36; 95% CI: 0.99-11.47; P = 0.053).

CONCLUSION: Infertility and its treatments may be involved in increasing the risk of breast and gynecological cancers.

PMID:37283054 | DOI:10.1097/CEJ.0000000000000815

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Nevin Manimala Statistics

Assessment of the Dentinal Surface Adaptation Efficacy of Different Obturation Systems with Bioceramic Sealer: A Scanning Electron Microscope Study

J Contemp Dent Pract. 2022 Aug 1;23(8):834-838. doi: 10.5005/jp-journals-10024-3345.

ABSTRACT

AIM: Aim of this study was to evaluate the dentinal surface adaptation effectiveness of different obturation methods with bioceramic sealer.

MATERIALS AND METHODS: Sixty recently removed human permanent premolars of the mandible having a solitary, straight as well as completely produced root were chosen on the basis of clinical/radiographic evaluation. The coronal parts of the premolars were subjected to sectioning at the cementoenamel junction (CEJ) with the aid of a water-cooled diamond disk. The regular access opening was done, following which the working length was visually estimated by deducting 1 mm from the length of a 10 size K-file (Dentsply, OK, USA) at the apex. Subsequent to preparing the radicular canal, the premolar specimens were randomly allocated to one of the following three groups. Group I: Lateral compaction (LC) technique; group II: Warm vertical compaction (WVC) technique; and group III: Thermafil obturation technique. Following obturation, the samples were subjected to sectioning in the horizontal direction at three dissimilar points as follows: First at the cervical third, then at the middle, and at the apical third employing a minitom under water irrigation to put off overheating. Internal spaces amid the radicular dentin as well as the obturating agents were appraised with the use of a scanning electron microscope (SEM).

RESULTS: Intragroup analysis showed that higher gaps were noted at the coronal level (2.30 ± 0.04), in pursuit by middle part (1.12 ± 0.02) and apical third (0.70 ± 0.02) for the LC method. With the WVC procedure, higher gaps were situated in the coronal level (1.96 ± 0.07), again in pursuit by middle part (1.02 ± 0.02) and apical third (0.86 ± 0.04). Even with the Thermafil obturation method, higher gaps were noted at the coronal level (0.92 ± 0.10), in pursuit by middle part (0.67 ± 0.05) and apical third (0.57 ± 0.01). No statistically significant difference was noted within the group. Upon intergroup comparative assessment of dentinal surface adaptation with dissimilar obturation systems at coronal, middle and apical thirds, there was a statistically noteworthy disparity amid the groups (p <0.001).

CONCLUSION: This research arrived at a conclusion that the most superior dentinal adaptation of bioceramic sealer was procured when the Thermafil obturation method was employed for obturating the root canals compared to the WVC technique as well as the LC technique.

CLINICAL SIGNIFICANCE: Numerous endodontic substances have been promoted for obturating the root canal areas. Majority of the methods use a core substance, in addition to a sealer. Despite the type of core agent, a sealer indispensable to each technique offers a fluid-tight sealing. The oral physicians’ comprehension of the characteristics of the endodontic sealer plus method used, enhances the therapeutic effect.

PMID:37283019 | DOI:10.5005/jp-journals-10024-3345

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Quantitative Analysis of Publication Trends in the Journal of Indian Prosthodontic Society between 2011 and 2020

J Contemp Dent Pract. 2022 Aug 1;23(8):828-833. doi: 10.5005/jp-journals-10024-3390.

ABSTRACT

AIM: To analyze quantitatively the trends in publication and compare the scientific content published during 2011-2015 and 2016-2020.

MATERIALS AND METHODS: An online search for all the different manuscripts published from 2011 to 2020 was performed electronically on the website of the Journal of Indian Prosthodontic Society (JIPS). The manuscripts were grouped into the following broader categories: Author, article grouping, original article subtype, prosthetic division, and statistical analysis.

RESULTS: The authors from private institutions showed higher publication trends than the authors from government institutions. The period 2016-2020 showed a higher number of publications with four or more authors. There was more original research published, followed by case reports. There was an increasing trend in a systematic review during 2016-2020 as compared to the period 2011-2015. There were a greater number of in vitro experimental studies published with a comparison of the means in the statistical analysis. There was more publication on materials and technology, followed by implants in the prosthetic division of articles.

CONCLUSION: The analysis shows the overall progress of the journal explains the characteristics of the authors involved in the research, highlights the types of research done, statistical methods used, and important areas of research and trends in research in prosthodontics at a national level.

CLINICAL SIGNIFICANCE: The publication trends will focus on the research thrust areas and the type of research done in the specialty, pointing out the gaps in the research and identifying the future course of action for authors and journals. It also helps for comparison with international publication trends in prosthodontics and provides information to prospective authors to focus research on the priority areas of the concerned journal for better acceptance.

PMID:37283018 | DOI:10.5005/jp-journals-10024-3390

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Nevin Manimala Statistics

Impact of Three Different Surgical Drilling Protocols on Early Loaded Single Implant in Posterior Maxilla: A 3-year Follow-up

J Contemp Dent Pract. 2022 Aug 1;23(8):819-827. doi: 10.5005/jp-journals-10024-3391.

ABSTRACT

AIM: This study aims to compare three different drilling techniques for implant site preparation to enhance the primary stability of the early loaded single implant in the posterior maxilla.

MATERIALS AND METHODS: A total of 36 dental implants were used in this study for the replacement of a missing single tooth or more in the maxillary posterior region with an early loaded dental implant. The patients were randomly divided into three groups. In group I, the drilling was performed using an undersized drilling technique, in group II, the drilling was performed using bone expanders, and in group III, the drilling was performed using the osseodensification (OD) technique. Patients were evaluated clinically and radiographically at regular time intervals immediately, 4 weeks, 6 months, 1 year, 2 years, and 3 years after surgery. All clinical and radiographic parameters were subjected to statistical analysis.

RESULTS: All implants in group I were stable and successful, while 11 from 12 implants survived in both groups II and III. There was no significant difference in peri-implant soft tissue health and marginal bone loss (MBL) throughout the whole study period between the three groups, while there was a significant difference in implant stability and insertion torque between groups I, II, and III at the time of implant placement.

CONCLUSION: Preparing the implant bed using the undersized drilling technique with drills with similar geometry to the implant being inserted provides high implant primary stability without the need for additional instruments or cost.

CLINICAL SIGNIFICANCE: Dental implants can be early loaded in the posterior maxilla by using an undersized drilling technique, as it improves primary stability.

PMID:37283017 | DOI:10.5005/jp-journals-10024-3391

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Nevin Manimala Statistics

Quantitative Microbial Leakage Evaluation of Restorative Materials with/without Antibacterial Primer as an Intracoronal Barrier: An Ex Vivo Study

J Contemp Dent Pract. 2022 Aug 1;23(8):813-818. doi: 10.5005/jp-journals-10024-3357.

ABSTRACT

AIM: Aim of this research was to assess the microbial leakage of restorative materials with/without antibacterial primer as an intracoronal barrier.

MATERIALS AND METHODS: Fifty-five extracted single-rooted teeth were included in this study. The canals were cleaned, shaped, and obturated with gutta-percha and AH plus sealer at the established working length. After removing 2 mm of coronal gutta-percha, the teeth were incubated for 24 hours. The teeth were divided into groups according to the materials used as intracoronary orifice barriers as follows: • Group I: Clearfil Protect Bond/Clearfil AP-X • Group II: Xeno IV/Clearfil AP-X • Group III: Chemflex (glass ionomer) • Group IV: Positive control (no barrier) • Group V: Negative control (no barrier and inoculated with sterile broth) Sterile 2 chambers bacterial technique was used to assess the microleakage and Enterococcus faecalis was considered as a microbial marker. The percentage of samples leaked, the time taken for leakage, and the number of colony-forming units (CFUs) in the leaked samples were calculated and analyzed statistically.

RESULTS: There was no statistically significant difference found in bacterial penetration among the three investigated materials after 120 days of use as an intracoronal orifice barrier. This study can also infer that the leaked sample from the Clearfil Protect Bond showed the least mean number of CFUs (43 CFUs) followed by Xeno IV (61 CFUs) and glass ionomer cement (GIC) (63 CFUs).

CONCLUSION: This study concluded that all three experimental antibacterial primers performed better as intracoronal barrier. However, Clearfil Protect Bond with an antibacterial primer showed promising results as an intracoronal orifice barrier in reducing the number of bacterial leakages.

CLINICAL SIGNIFICANCE: The significance of intracoronal orifice barriers in the success of endodontic treatment depends on the ability of the materials to prevent microleakage. This helps clinicians to provide successful antibacterial therapy against endodontic anaerobes.

PMID:37283016 | DOI:10.5005/jp-journals-10024-3357

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Influence of Thermocycling and Surface Treatments on the Flexural Strength of Denture Base Resin: An In Vitro Study

J Contemp Dent Pract. 2022 Aug 1;23(8):788-792. doi: 10.5005/jp-journals-10024-3387.

ABSTRACT

AIM: The purpose of this study was to evaluate the flexural strength of heat polymerized denture base resin after thermocycling and different surface treatments done prior to repair or relining.

MATERIALS AND METHODS: In this in vitro study, 80 specimens were made with heat-polymerized denture base resin and thermocycled (500 cycles between 5 and 55 °C). The specimens were divided in four groups based on different types of surface treatment: group I (control group: without surface treatment), group II (chloroform for 30 seconds), group III [methyl methacrylate (MMA) for 180 seconds], and group IV (dichloromethane for 15 seconds). The flexural strength was assessed using a Universal testing machine with three-point bending test. The obtained data were subjected to statistical analysis using one-way ANOVA and post-hoc tests.

RESULTS: The values of average flexural strength of denture base resin measured were as follows: group I: 111.1 MPa, group II: 86.9 MPa, group III: 73.1 MPa, and group IV: 78.8 MPa. Groups II and IV possessed superior flexural strength than group III. The maximum values were observed with the control group.

CONCLUSION: The flexural strength of heat-polymerized denture base resin gets affected by different surface treatments done prior to relining procedures. Lowest flexural strength was obtained when treated with MMA monomer for 180 seconds as compared to the other etchants used.

CLINICAL SIGNIFICANCE: Prior to denture repair procedures, operators must choose the chemical surface treatment judiciously. It should not affect the mechanical properties such as flexural strength of denture base resins. Reduction in flexural strength of polymethyl methacrylate (PMMA) denture base can predispose the prosthesis to deteriorated performance when in function.

PMID:37283012 | DOI:10.5005/jp-journals-10024-3387