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Nevin Manimala Statistics

Prevention of Dental Erosion Caused by Fermented Milk: An In-vitro Study

Oral Health Prev Dent. 2022 Nov 8;20(1):401-412. doi: 10.3290/j.ohpd.b3556031.

ABSTRACT

PURPOSE: This study aimed to assess the efficacy of three techniques for preventing dental erosion and thereby identify effective methods. The three techniques were: 1) adding calcium to fermented milk (2% Ca and 0.5% Ca); 2) topical application of fluoride to the teeth before exposure to fermented milk (acidulated phosphate fluoride [APF] gel and 0.05% NaF); and 3) a combination of the two techniques (APF gel + 0.5% Ca, 0.05% NaF + 0.5% Ca).

MATERIALS AND METHODS: pH cycling was performed on bovine-tooth specimens alternately immersed in experimental solutions and artificial saliva. After treatment, the microhardness and roughness of the enamel surfaces were measured, and changes in the surface morphology were observed using atomic force microscope images.

RESULTS: Microhardness did not differ statistically significantly between the 2% Ca and mineral water (negative control) groups (2% Ca: 295.34 ± 11.50; mineral water group: 294.76 ± 10.67; p > 0.05). Surface roughness did not differ statistically significantly between the 2% Ca, 0.05% NaF + 0.5% Ca, and mineral water groups (2% Ca: 16.81 ± 7.23; 0.05% NaF + 0.5% Ca: 15.77 ± 2.86; mineral water group: 13.35 ± 5.53; p > 0.05). The surface morphology did not change in the mineral water and 2% Ca groups.

CONCLUSION: Considering that 2% calcium is a high concentration, adding a low concentration of calcium to fermented milk and applying a low concentration of fluoride daily decreased the reduction of surface microhardness and reduced the increase in surface roughness without causing marked changes in surface morphology. This confirms that combining the two techniques is an effective strategy to prevent dental erosion in-vitro.

PMID:36346335 | DOI:10.3290/j.ohpd.b3556031

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Nevin Manimala Statistics

Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Arch Argent Pediatr. 2022 Nov 10:e202202672. doi: 10.5546/aap.2022-02672.eng. Online ahead of print.

ABSTRACT

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMIfor-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource.

PMID:36346326 | DOI:10.5546/aap.2022-02672.eng

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Quantitative Brain Morphometry of Portable Low-Field-Strength MRI Using Super-Resolution Machine Learning

Radiology. 2022 Nov 8:220522. doi: 10.1148/radiol.220522. Online ahead of print.

ABSTRACT

Background Portable, low-field-strength (0.064-T) MRI has the potential to transform neuroimaging but is limited by low spatial resolution and low signal-to-noise ratio. Purpose To implement a machine learning super-resolution algorithm that synthesizes higher spatial resolution images (1-mm isotropic) from lower resolution T1-weighted and T2-weighted portable brain MRI scans, making them amenable to automated quantitative morphometry. Materials and Methods An external high-field-strength MRI data set (1-mm isotropic scans from the Open Access Series of Imaging Studies data set) and segmentations for 39 regions of interest (ROIs) in the brain were used to train a super-resolution convolutional neural network (CNN). Secondary analysis of an internal test set of 24 paired low- and high-field-strength clinical MRI scans in participants with neurologic symptoms was performed. These were part of a prospective observational study (August 2020 to December 2021) at Massachusetts General Hospital (exclusion criteria: inability to lay flat, body habitus preventing low-field-strength MRI, presence of MRI contraindications). Three well-established automated segmentation tools were applied to three sets of scans: high-field-strength (1.5-3 T, reference standard), low-field-strength (0.064 T), and synthetic high-field-strength images generated from the low-field-strength data with the CNN. Statistical significance of correlations was assessed with Student t tests. Correlation coefficients were compared with Steiger Z tests. Results Eleven participants (mean age, 50 years ± 14; seven men) had full cerebrum coverage in the images without motion artifacts or large stroke lesion with distortion from mass effect. Direct segmentation of low-field-strength MRI yielded nonsignificant correlations with volumetric measurements from high field strength for most ROIs (P > .05). Correlations largely improved when segmenting the synthetic images: P values were less than .05 for all ROIs (eg, for the hippocampus [r = 0.85; P < .001], thalamus [r = 0.84; P = .001], and whole cerebrum [r = 0.92; P < .001]). Deviations from the model (z score maps) visually correlated with pathologic abnormalities. Conclusion This work demonstrated proof-of-principle augmentation of portable MRI with a machine learning super-resolution algorithm, which yielded highly correlated brain morphometric measurements to real higher resolution images. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Ertl-Wagner amd Wagner in this issue.

PMID:36346311 | DOI:10.1148/radiol.220522

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Nevin Manimala Statistics

Disentangling Rates, Risk, and Drivers of Suicide in the Construction Industry

Crisis. 2022 Nov 8. doi: 10.1027/0227-5910/a000885. Online ahead of print.

ABSTRACT

Background: Research suggests construction industry workers (CIWs) face increased suicide vulnerability. Aims: The current study synthesizes international evidence examining rates, risk, and drivers of CIW suicide. Method: Comprehensive searches of MEDLINE, PsycInfo, Embase, Emcare, Web of Science, Scopus, and gray literature were undertaken, identifying studies that discussed, theorized about, or demonstrated risks and/or rates and/or drivers of CIW suicide, without inclusion of other industries. Results: A number of included studies statistically analyzed suicide outcomes in a variety of CIW populations, with the majority reporting increased rate and/or risk, however significant heterogeneity limited comparisons. Twenty-five potential drivers were identified and classified as personal- or industry-related. Disentanglement highlighted the relevance of previously understood personal drivers, need for future focus on industry drivers, and potential interplay between drivers. Limitations: Exclusion of non-English articles as well as inability to extend analysis to fully understand rates and/or risk of CIW suicide and tenuous links between suggested drivers and suicide outcomes. Conclusion: Despite limitations, this paper aids understanding in relation to the suggestion that CIWs are at increased suicide vulnerability. Disentanglement of potential drivers demonstrates the importance of future research focused on industry drivers to assist in prevention strategies.

PMID:36345928 | DOI:10.1027/0227-5910/a000885

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Analysis of ghrelin, leptin, and interleukin-6 salivary concentration among children aged 7-10 years and its relationship with nutritional status and some anthropometric data

Pediatr Endocrinol Diabetes Metab. 2022 Nov 8:47885. doi: 10.5114/pedm.2022.119782. Online ahead of print.

ABSTRACT

INTRODUCTION: Obesity is a complex condition with multifactorial aetiopathogenesis. Adipose tissue is reservoir of many adipokines which play a great role in proinflammatory response in obesity. Aim of the study: Comparative assessment of ghrelin, leptin, and interleukin-6 (IL-6) salivary concentration among children having proper and excess of body mass. Analysis of the interrelationship between the obtained concentrations of substances and selected anthropometric parameters and blood pressure values in the studied children.

MATERIAL AND METHODS: The study group comprised 102 children aged 7-10 years. The nutritional status of children was assessed by the use of the BMI index. The control group (n = 74) comprised children with proper body mass, and the study group (n = 28) contained children having overweight/obesity. Saliva samples were taken from all children at school. Subsequently, some anthropometric parameters and blood pressure values of the children were measured. The laboratory assessment of substances was made by ELISA method. Next, statistical analysis of all obtained results was performed using professional software.

RESULTS: Salivary ghrelin, leptin, and IL-6 concentrations were statistically significantly higher in the study group than in the control group (p = 0.001). The study revealed a positive correlation between salivary ghrelin concentration and BMI in the whole study population (p = 0.001), and between ghrelin concentration and body weight, waist circumference, hip circumference, and waist-to-hip ratio in all subjects. In the study group, the BMI value was positively correlated only with IL-6 saliva concentration (p = 0.005).

CONCLUSIONS: The study revealed significant differences between saliva ghrelin, leptin, and IL-6 concentration between the control group and the study group. The above findings can be a good predictor with which to detect co-existing metabolic alternations in obese patients.

PMID:36345925 | DOI:10.5114/pedm.2022.119782

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The effect of an integrated electronic medical record system on malaria out-patient case management in a Ugandan health facility

Health Informatics J. 2022 Oct-Dec;28(4):14604582221137446. doi: 10.1177/14604582221137446.

ABSTRACT

BACKGROUND: Malaria contributes 20% of outpatient cases in health facilities in Uganda. Data also show that there is a severe shortage of skilled health care personnel in sub-Saharan Africa. Electronic Medical Record (EMR) systems have been shown to provide benefits to health care providers and patients alike, making them important for low resourced settings.

METHODS: A comparative study was performed from March 2018 to March 2019 in which an integrated EMR system was implemented with treatment guidelines for malaria, and its effect was evaluated on malaria outpatient case management in one Ugandan health facility. Another health facility was used as a control site.

RESULTS: Malaria outpatient visits were 1.3 h shorter in the EMR group (p < .0001), and 80% more participants in the EMR group had age and weight information available to clinicians at the point of prescribing (p < .0001). Fewer participants in the EMR group had recurring malaria with no statistical significance (p = .097). Malaria surveillance reporting was significantly more accurate at the EMR intervention site (p < .05).

CONCLUSION: The EMR system probably improved malaria outpatient case management by reducing outpatient visit durations, improving the availability of patient age and weight information to inform prescribing and improving the accuracy of malaria surveillance reporting.

PMID:36345921 | DOI:10.1177/14604582221137446

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The efficacy and safety of the combination of photobiomodulation therapy and pulsed electromagnetic field therapy on androgenetic alopecia

J Cosmet Dermatol. 2022 Nov 8. doi: 10.1111/jocd.15490. Online ahead of print.

ABSTRACT

BACKGROUND: Photobiomodulation therapy (PBMT) appears to be safe and effective for hair loss. Pulsed electromagnetic field therapy (PEMF) also has a positive biological effect on hair re-growth.

OBJECTIVES: We evaluated the efficacy and safety of both PBMT and PEMF for the treatment of androgenetic alopecia (AGA).

MATERIALS AND METHODS: This study was a 24-week, randomized, double-blind, sham device-controlled trial. We recruited 80 subjects with androgenetic alopecia. The subjects got treatment every week for the 1st 12 weeks, every other week for the next 8 weeks. PBMT entails 15-min therapy, and PEMF was carried out for 10 min.

RESULTS: The baseline hair density was 114.57 (±28.75)/cm2 and 113.31 (±30.07)/cm2 in both treatment and control groups. After 24 weeks of treatment, the mean hair density increased to 139.37 (±31.4)/cm2 in the treatment group but only to 119.78 (±31.92)/cm2 in the control group. The difference between two groups was statistically significant (p < 0.05). Based on the global assessment of independent experts, the score was 0.41 (±0.62) in the treatment group and 0.07 (±0.45) in the control group. Only very mild erythema or irritation was reported, and no serious adverse reactions were reported.

CONCLUSIONS: A combination of PBMT and PEMF is a valid and safe treatment option for AGA.

PMID:36345917 | DOI:10.1111/jocd.15490

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Late-onset fetal growth restriction management: a national survey

Minerva Obstet Gynecol. 2022 Nov 7. doi: 10.23736/S2724-606X.22.05217-4. Online ahead of print.

ABSTRACT

BACKGROUND: Fetal growth restriction (FGR) is an obstetric condition that increases the risk of adverse neonatal outcomes. FGR antenatal care aims to decrease fetal morbidity and mortality through optimal fetal monitoring. However, no univocal strategies for late-onset FGR outpatient management are available, and this survey investigated gynaecologists’ attitudes concerning outpatient frequency tests.

METHODS: We mailed a survey to 429 Italian gynaecologists. The primary purpose was the ambulatory care of late-onset FGR without doppler alterations evaluation. The queries estimated the self-reported medical practice regarding cardiotocography (CTG) and obstetric ultrasound exams before hospitalization. Statistical analysis was performed with Stata 14.1 (Stata corp., College Station, TX, USA) for symmetrically distributed continuous variables, and the mean differences were analyzed using the t-test. Where appropriate, the proportions between the groups were evaluated using Fisher’s exact or Chi-square test. P values <0.05 were considered statistically significant.

RESULTS: 128 responses (29.8%) from the 429 SCCAL members were available for the survey. 39.9% of respondents had a late FGR standardized protocol. Regarding non-severe FGR with normal fetal doppler, 70.8% suggested a fetal doppler study after one week (92/128), 13.8% (18/128) and 6.9% (9/128) proposed the exam, respectively, two and three times for a week. 0.8% (1/128) of respondents had a daily doppler exam, 7.7% (10/128) did not answer, and 3.1% (4/128) repeated the ultrasound exam to time for a week. The antenatal CTG was offered: 70.8% (92/128) of gynaecologists recommended one weekly CTG, whereas 13.8% (18/128) suggested two. 6.9% (9/128) recommended three weekly tests and 0.8% a daily test. 7.7% (10/128) of gynaecologists did not respond. At least, we investigated the gynaecologist’s recommendations for outpatient EFW evaluation: 59.4% (76/128) repeated EFW after two weeks, 31.3% (40/128) after one week. 3.9% (4/128) and 3.1 (4/128) recommended EFW after three weeks and twice a week.

CONCLUSIONS: Gynaecologists recommend unnecessary cardiotocography and ultrasound Doppler exams for non-severe late-onset FGR with normal doppler. However, additional studies and comprehensive surveys are needed to support a standardized protocol and assess the feto-maternal outcomes impact.

PMID:36345906 | DOI:10.23736/S2724-606X.22.05217-4

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The association between gestational age and maternal adverse outcomes in patients undergoing trial of labor after cesarean

Minerva Obstet Gynecol. 2022 Nov 7. doi: 10.23736/S2724-606X.22.05174-0. Online ahead of print.

ABSTRACT

BACKGROUND: Although successful trial of labor after cesarean (TOLAC) resulting in vaginal birth after cesarean (VBAC) can lead to improved maternal and neonatal outcomes, an unsuccessful TOLAC is associated with increased risk of uterine rupture, higher blood loss, and increased risk of infection. Data remain limited in terms of whether differences in gestational age of patients who attempt TOLAC affect maternal morbidity. Out objective was to examine the association between gestational age and maternal adverse outcomes in women undergoing trial of labor after cesarean.

METHODS: This population-based cross-sectional study used birth data from the U.S. National Vital Statistics from 2014 to 2018. Women with liveborn singleton gestation who underwent TOLAC at 23 – 41 weeks’ gestation were included in the analytic population. The primary outcome was a composite of maternal adverse outcomes: admission to the intensive care unit, blood transfusion, uterine rupture, or unplanned hysterectomy. Secondary outcomes were individual measures within the primary composite outcome. Outcomes were compared between patients who underwent TOLAC at term (37-41 weeks gestational age) and those who underwent TOLAC at preterm (23-36 weeks gestational age). Multivariable analyses adjusted for demographic and obstetric differences between the two groups.

RESULTS: 455,284 patients met inclusion criteria for the study; 39,589 (8.7%) were at a preterm gestational age (GA) and 415,695 (91.3%) were at a term GA. The overall composite maternal adverse outcome was significantly higher for patients undergoing TOLAC at preterm GA (12.0 per 1,000 live births) compared to term GA (8.0 per 1,000 live births; aRR1.42; 95% CI 1.29-1.56). Among individual conditions within the primary composite outcome, preterm gestational age was associated with increased risk of admission to the intensive care unit, blood transfusion, and unplanned hysterectomy.

CONCLUSIONS: In patients who underwent TOLAC, preterm gestational age was associated with increased risk of adverse maternal outcomes.

PMID:36345903 | DOI:10.23736/S2724-606X.22.05174-0

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Pre-donation water and salty snacks to prevent vasovagal reactions among blood donors

Transfusion. 2022 Nov 8. doi: 10.1111/trf.17173. Online ahead of print.

ABSTRACT

BACKGROUND: Minimizing the risk of vasovagal reactions (VVRs) can prevent donor harms and improve donor return. We report the results of a program to reduce VVR rates.

STUDY DESIGN AND METHODS: The program was implemented on June 11, 2017 and consisted in drinking water and eating a salty snack before donating blood, plasma, or platelets. All donations made during the “pre-program period” (October 11, 2015-June 10, 2017) and “post-program period” (June 11, 2017-May 11, 2019) were included. Study outcomes comprised VVRs (any severity) and syncopal VVRs, whether employee- or donor-reported. An interrupted time series (ITS) analysis proxied causality based on the “pre-program trend,” the “immediate trend” (i.e., immediately before versus after the program), and the “post-program trend”. The relative risk (RR) of VVR (along with confidence intervals [CIs]) was reported, overall and stratified by subgroups based on age, sex, donor type (i.e., first-time versus repeat), and donation type (i.e., whole blood versus apheresis).

RESULTS: The monthly VVR rate (any severity) dropped from 4.6% in the pre-program period to 4.3% in the post-program period, and never reached its pre-program level. The ITS analysis revealed a statistically significant and increasing pre-program trend (RR [95% CI] = 1.011 [1.002-1.020]), a statistically significant and decreasing immediate trend (RR [95% CI] = 0.848 [0.743-0.969]), and a non-statistically-significant and stable post-program trend (RR [95% CI] = 0.999 [0.993-1.006]). Similar trends were observed for nearly all high- and low-risk subgroups. No statistically significant trend was observed for syncopal VVRs.

DISCUSSION: These results suggest that the herein-described program durably reduced the incidence of VVRs (any severity) by ~15%.

PMID:36345887 | DOI:10.1111/trf.17173