Tag: nevin manimala

Psychol Med. 2023 May 25:1-11. doi: 10.1017/S0033291723001186. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital-based biobanks are being increasingly considered as a resource for translating polygenic risk scores (PRS) into clinical practice. However, since these biobanks originate from patient populations, there is a possibility of bias in polygenic risk estimation due to overrepresentation of patients with higher frequency of healthcare interactions.

METHODS: PRS for schizophrenia, bipolar disorder, and depression were calculated using summary statistics from the largest available genomic studies for a sample of 24 153 European ancestry participants in the Mass General Brigham (MGB) Biobank. To correct for selection bias, we fitted logistic regression models with inverse probability (IP) weights, which were estimated using 1839 sociodemographic, clinical, and healthcare utilization features extracted from electronic health records of 1 546 440 non-Hispanic White patients eligible to participate in the Biobank study at their first visit to the MGB-affiliated hospitals.

RESULTS: Case prevalence of bipolar disorder among participants in the top decile of bipolar disorder PRS was 10.0% (95% CI 8.8-11.2%) in the unweighted analysis but only 6.2% (5.0-7.5%) when selection bias was accounted for using IP weights. Similarly, case prevalence of depression among those in the top decile of depression PRS was reduced from 33.5% (31.7-35.4%) to 28.9% (25.8-31.9%) after IP weighting.

CONCLUSIONS: Non-random selection of participants into volunteer biobanks may induce clinically relevant selection bias that could impact implementation of PRS in research and clinical settings. As efforts to integrate PRS in medical practice expand, recognition and mitigation of these biases should be considered and may need to be optimized in a context-specific manner.

PMID:37226828 | DOI:10.1017/S0033291723001186

Autism. 2023 May 25:13623613231171980. doi: 10.1177/13623613231171980. Online ahead of print.

ABSTRACT

A vast majority of individuals with autism spectrum disorder experience impairments in motor skills. Those are often labelled as additional developmental coordination disorder despite the lack of studies comparing both disorders. Consequently, motor skills rehabilitation programmes in autism are often not specific but rather consist in standard programmes for developmental coordination disorder. Here, we compared motor performance in three groups of children: a control group, an autism spectrum disorder group and a developmental coordination disorder group. Despite similar level of motor skills evaluated by the standard movement assessment battery for children, in a Reach-to-Displace Task, children with autism spectrum disorder and developmental coordination disorder showed specific motor control deficits. Children with autism spectrum disorder failed to anticipate the object properties, but could correct their movement as well as typically developing children. In contrast, children with developmental coordination disorder were atypically slow, but showed a spared anticipation. Our study has important clinical implications as motor skills rehabilitations are crucial to both populations. Specifically, our findings suggest that individuals with autism spectrum disorder would benefit from therapies aiming at improving their anticipation, maybe through the support of their preserved representations and use of sensory information. Conversely, individuals with developmental coordination disorder would benefit from a focus on the use of sensory information in a timely fashion.

PMID:37226824 | DOI:10.1177/13623613231171980

J Diabetes Sci Technol. 2023 May 25:19322968231176531. doi: 10.1177/19322968231176531. Online ahead of print.

ABSTRACT

BACKGROUND: When launched, FreeStyle Libre (FSL; a flash glucose monitor) onboarding was mainly conducted face-to-face. The COVID-19 pandemic accelerated a change to online starts with patients directed to online videos such as Diabetes Technology Network UK for education. We conducted an audit to evaluate glycemic outcomes in people who were onboarded face-to-face versus those who were onboarded remotely and to determine the impact of ethnicity and deprivation on those outcomes.

METHODS: People living with diabetes who started using FSL between January 2019 and April 2022, had their mode of onboarding recorded and had at least 90 days of data in LibreView with >70% data completion were included in the audit. Glucose metrics (percent time in ranges) and engagement statistics (previous 90-day averages) were obtained from LibreView. Differences between glucose variables and onboarding methods were compared using linear models, adjusting for ethnicity, deprivation, sex, age, percent active (where appropriate), and duration of FSL use.

RESULTS: In total, 935 participants (face-to-face 44% [n = 413]; online 56% [n = 522]) were included. There were no significant differences in glycemic or engagement indices between onboarding methods and ethnicities, but the most deprived quintile had significantly lower percent active time (b = -9.20, P = .002) than the least deprived quintile.

CONCLUSIONS: Online videos as an onboarding method can be used without significant differences in glucose and engagement metrics. The most deprived group within the audit population had lower engagement metrics, but this did not translate into differences in glucose metrics.

PMID:37226777 | DOI:10.1177/19322968231176531

Stroke. 2023 May 25. doi: 10.1161/STROKEAHA.122.040247. Online ahead of print.

ABSTRACT

BACKGROUND: White matter hyperintensities of presumed vascular origin (WMH) are the most prominent imaging feature of cerebral small vessel disease (cSVD). Previous studies suggest a link between cSVD burden and intracerebral hemorrhage and worse functional outcome after thrombolysis in acute ischemic stroke. We aimed to determine the impact of WMH burden on efficacy and safety of thrombolysis in the MRI-based randomized controlled WAKE-UP trial of intravenous alteplase in unknown onset stroke.

METHODS: The design of this post hoc study was an observational cohort design of a secondary analysis of a randomized trial. WMH volume was quantified on baseline fluid-attenuated inversion recovery images of patients randomized to either alteplase or placebo in the WAKE-UP trial. Excellent outcome was defined as score of 0-1 on the modified Rankin Scale after 90 days. Hemorrhagic transformation was assessed on follow-up imaging 24-36 hours after randomization. Treatment effect and safety were analyzed by fitting multivariable logistic regression models.

RESULTS: Quality of scans was sufficient in 441 of 503 randomized patients to delineate WMH. Median age was 68 years, 151 patients were female, and 222 patients were assigned to receive alteplase. Median WMH volume was 11.4 mL. Independent from treatment, WMH burden was statistically significantly associated with worse functional outcome (odds ratio, 0.72 [95% CI, 0.57-0.92]), but not with higher chances of any hemorrhagic transformation (odds ratio, 0.78 [95% CI, 0.60-1.01]). There was no interaction of WMH burden and treatment group for the likelihood of excellent outcome (P=0.443) or any hemorrhagic transformation (P=0.151). In a subgroup of 166 patients with severe WMH, intravenous thrombolysis was associated with higher odds of excellent outcome (odds ratio, 2.40 [95% CI, 1.19-4.84]) with no significant increase in the rate of hemorrhagic transformation (odds ratio, 1.96 [95% CI, 0.80-4.81]).

CONCLUSIONS: Although WMH burden is associated with worse functional outcome, there is no association with treatment effect or safety of intravenous thrombolysis in patients with ischemic stroke of unknown onset.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT01525290.

PMID:37226772 | DOI:10.1161/STROKEAHA.122.040247

Ann Otol Rhinol Laryngol. 2023 May 25:34894231173483. doi: 10.1177/00034894231173483. Online ahead of print.

ABSTRACT

BACKGROUND: Sphenoid and frontal sinuses have narrow ostia and are prone to stenosis. However, their relative rates of patency are not well established, and descriptive rates of sphenoid stenosis have never been reported. The objective is to measure the patency of the sphenoid and frontal sinus ostia postoperatively.

METHODS: A prospective multi-institutional cohort study was performed. Ostial patency was measured at surgery and 3 and 6 months postoperatively. Pertinent clinical history such as the presence of nasal polyps and prior history of ESS as well as the use of steroid eluting stents were recorded. Overall stenosis rates were calculated for both the sphenoid and frontal sinuses, and Wilcoxon-Signed Rank Test was used to compare intraoperative and postoperative ostial areas. Factorial Analysis of Variance (ANOVA) was performed to determine effects of 5 clinical factors.

RESULTS: Fifty patients were included. The mean sphenoid sinus ostial area decreased 42.2% in size from baseline to 3 months postoperatively (T0 55.2 ± 28.7 mm vs T3 m 31.8 ± 25.5 mm, P < .001). The mean frontal sinus ostial area decreased 39.8% in size from baseline to 3 months postoperatively (T0 33.7 ± 17.2 mm vs T3 m 19.9 ± 15.1 mm, P < .001). Neither the sphenoid nor the frontal sinus ostial patency demonstrated statistically significant change from 3 to 6 months postoperatively.

CONCLUSION: Both sphenoid and frontal sinus ostia routinely narrow postoperatively, predominately from baseline to 3 months. These findings can serve as a reference for both clinical outcomes and future studies of these surgeries.

PMID:37226723 | DOI:10.1177/00034894231173483

Oper Dent. 2023 May 23. doi: 10.2341/22-039-L. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable and wear-resistant alternative.

OBJECTIVE: To evaluate and compare the volumetric wear (mm3) of bulk-fill composite resins to a conventional composite resin and enamel after thermo-mechanical loading.

METHODS AND MATERIALS: Five composite resins (n=10) were evaluated: four bulk-fill composite resins (Filtek One Bulk Fill [3M Oral Care], Tetric EvoCeram Bulk Fill [Ivoclar Vivadent], Tetric PowerFill [Ivoclar Vivadent], SonicFill 3 [Kerr Corp]); and one conventional composite resin (Filtek Supreme Ultra [3M Oral Care]). Enamel from recently extracted human teeth was used as a control. Specimens were subjected to a 2-body volumetric wear evaluation using a chewing simulator (CS-4.8, Mechatronik). Disc-shaped specimens (10 mm in diameter × 3 mm in thickness) received 500,000 load cycles against steatite antagonists while simultaneously thermocycled (5000 cycles, 5-55°C). Volumetric wear (mm3) was measured using the Geomagic Control X software (3D Systems) based on digital scans of the specimens obtained before and after thermo-mechanical loading, with a Trios 3 (3Shape) digital scanner. Scanning electron microscopy analysis of wear facets and composite resin filler shape and size was performed. Volumetric wear was statistically analyzed using the one-way ANOVA and Tukey’s post-hoc test (α=0.05).

RESULTS: All tested composite resins wore at rates significantly higher than enamel (p<0.05). The mean volumetric wear of the composite resins ranged from 1.01 mm3 to 1.48 mm3, while enamel had a mean volumetric wear of 0.25 mm3. Bulk-fill composite resins showed higher wear resistance than the conventional composite resin (p<0.05).

CONCLUSIONS: Bulk-fill composite resins showed higher wear resistance than the conventional composite resin, and both types of composite resin were not as wear-resistant as enamel.

PMID:37226712 | DOI:10.2341/22-039-L

Oper Dent. 2023 May 23. doi: 10.2341/21-132-C. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the clinical performance of mildly acidic universal adhesives Scotchbond Universal (SU, 3M Oral Care, St Paul, MN, USA) and Prime & Bond Elect (PBE, Dentsply Sirona, Charlotte, NC, USA) in the restoration of noncarious cervical lesions (NCCLs).

METHODS AND MATERIALS: A total of 63 patients in need of 203 NCCL restorations participated in this randomized controlled clinical trial. Notch-shaped lesions were restored with Kalore (GC Corporation, Tokyo, Japan) after application of either SU or PBE, following the etch-and-rinse (ER) or self-etch (SE) techniques. Subjects were followed up for 60 months. The focus of the statistical analyses was on the change of outcome over time as assessed by the Modified USPHS rating system (ie, Alfa vs Bravo + Charlie outcomes). Logistic regression was performed for each outcome separately with compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS 9.4 (SAS, Cary, NC, USA).

RESULTS: One-hundred twenty-nine teeth in 35 subjects were assessed at the 60-month follow-up. In addition, three restorations that failed prior to the 60-month evaluation, two of which were in subjects who did not present for the 60-month follow-up, were included in the statistical analysis. In total, two restorations in the SU_ER group and three restorations in the PBE_SE group failed the retention category. Statistically significant differences were obtained for the comparison of restorations in the PBE_SE and PBE_ER groups, where the former was 58% less likely to maintain a score of Alfa for marginal discoloration than the latter.

CONCLUSIONS: SU and PBE demonstrated acceptable clinical performance at 60 months with regard to restoration retention. Phosphoric-acid etching of the NCCLs prior to adhesive application significantly improved the performance of PBE in regard to marginal discoloration.

PMID:37226698 | DOI:10.2341/21-132-C

J Adv Nurs. 2023 May 24. doi: 10.1111/jan.15719. Online ahead of print.

ABSTRACT

AIM: The purpose of this study was to explore the relationship between nurses’ well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship.

DESIGN: This was a quantitative cross-sectional study.

METHODS: This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses’ Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman’s rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses’ well-being was completed by AMOS 23.0 statistical software.

RESULTS: The scores of nurses’ well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman’s analysis showed that nurses’ well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses’ well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)].

CONCLUSION: Nurses’ well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses’ well-being.

IMPACT: This suggests that nursing managers need to pay attention to clinical nurses’ well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses’ daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.

PMID:37226654 | DOI:10.1111/jan.15719

J Oral Rehabil. 2023 May 24. doi: 10.1111/joor.13517. Online ahead of print.

ABSTRACT

BACKGROUND: Disc displacement with reduction (DDwR) therapy should be performed only when pain or discomfort is presented. Data on treatment options for painful DDwR are very limited.

OBJECTIVE: The aim was to investigate whether an isometric training of the lateral pterygoid muscle (LPM) is equivalent to stabilization appliance therapy with regard to treatment of painful DDwR. The training program is based on the science of Janda.

METHODS: This was a prospective, randomized study with a comparative treatment group. Sixty patients (≥18 years) with DDwR and pain were randomly assigned to two groups: (1) muscle training, (2) stabilization appliance. The following variables were recorded at baseline examination and after 2, 4 and 6 months: changes in orofacial pain, clicking sounds of the temporomandibular joint (TMJ), force degrees for the lateral movement of the mandible and interincisal opening distance. P values of < 0.05 were considered statistically significant but 95% confidence intervals were also presented.

RESULTS: A decrease in orofacial pain intensity was seen in both groups (P < 0.0001). Registered TMJ clicking disappeared after 6 months of treatment in 37% (n=11) of the patients in the training group and in 27% (n=8) of the appliance group (P = 0.0009 and P = 0.0047). Muscle training showed 27 improvements in Janda force degrees at the end of the study (P < 0.0001).

CONCLUSION: Muscle training and appliance therapy improved mouth opening and reduced pain intensity in both patient groups. Muscle training might be a promising option in treatment of patients suffering from painful DDwR.

PMID:37226632 | DOI:10.1111/joor.13517

Wiad Lek. 2023;76(4):831-837. doi: 10.36740/WLek202304120.

ABSTRACT

OBJECTIVE: The aim: Нygienic assessment of labour conditions and risks for the Ukrainian agricultural personnel treating berries and melon crops with fungicides, herbicides and insecticides for justification of their safe use regulations.

PATIENTS AND METHODS: Materials and methods: Natural studies of labour conditions and risk correspond to the acting laws of Ukraine. The results were statistically treated using IBM SPSS StatisticsBase v.22.

RESULTS: Results: The natural studies of fungicides, insecticides, used for treatment of berries and melon crops, show that labour air environment corresponds to hygienic standards. The authors have established that the hazard index of complex fungicides effect on spray fueling attendants and tractor drivers is 0.110}0.046 and 0.155}0.071, that of herbicides – 0.34}0.025 and 0.380}0.257, that of insecticides – 0.221}0.111 and 0.222}0.110, respectively; hazard index of combined effect of several acting substances makes up- 0.239}0.088 and 0.336}0.140 for spray fueling attendants and tractor drivers, respectively. The statistical analysis shows that the hazard coefficients of inhalation and percutaneous penetration do not differ statistically between spray fueling attendants and tractor drivers (р>0.05). The percutaneous risk (%) of various pesticide groups for spray fueling attendants ranges 65.74-97.58 %, for tractor drivers – 50.72-95.23 %.

CONCLUSION: Conclusions: The analysis has shown that the professional risk of fungicides, herbicides, insecticides, during agricultural treatment of the berries and melon crops does not exceed standards.

PMID:37226623 | DOI:10.36740/WLek202304120