Tag: nevin manimala

Disabil Rehabil. 2022 Nov 2:1-15. doi: 10.1080/09638288.2022.2140844. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of mobile health applications (mHealth apps) containing a physical training component on physical function and physical activity in stroke rehabilitation.

MATERIALS AND METHODS: A systematic literature search was conducted in three databases for studies published from inception to 12 July 2022. Clinical trials including mHealth apps with a physical training component were included using outcomes of physical function and physical activity. Quality of life was extracted as a secondary outcome.

RESULTS: Five RCTs, two non-RCTs, and four uncontrolled clinical trials were included with a total of 264 stroke survivors. Eleven apps were identified with a physical training component using features of gamification (six apps), exercise prescription (three apps), and physical activity (two apps). Six out of seven studies reported statistically significant improvements in physical function in favor of the experimental group, with the most robust findings for upper extremity function. For physical activity, statistically significant improvements were seen in the experimental groups. Only one study showed significant improvement in quality of life. Overall study quality was fair.

CONCLUSIONS: mHealth apps containing a physical training component are promising for physical function and physical activity in stroke rehabilitation. Further research is warranted to confirm these conclusions.Implications for rehabilitationDesign content of mobile apps with a physical training component were focused on gamification, exercise prescription, and physical activityUsing mobile app-delivered therapy seem promising for improving upper extremity function in stroke rehabilitationUsing mobile apps also supported an increase of physical activity in people with strokeStudies using mobile apps should report more specifically the dosage of physical training and adherenceUsing mobile apps seems promising as an additional tool for clinical work, however, more studies are required to understand their effectiveness in stroke rehabilitation.

PMID:36325613 | DOI:10.1080/09638288.2022.2140844

J Korean Med Sci. 2022 Oct 31;37(42):e304. doi: 10.3346/jkms.2022.37.e304.

ABSTRACT

BACKGROUND: In Korea, the birth rate is declining at an alarming pace. This study aimed to investigate the changes and trends in the population count, number of births, and birth rate in Korea, in the past and future.

METHODS: Data regarding the total number of births, crude birth rate, and total fertility rate were collected from the “Statistics Korea Census” of the national statistical portal, census report, and Statistics Korea’s “2020 Population Trend Survey for 1981-2020, provisional results of birth and death statistics.” We used the Organisation for Economic Co-operation and Development 2019 Family Database for the TFR. To develop a better understanding of the data in this study, we classified it according to the modern history of Korea.

RESULTS: The changes and trends in the number of births and fertility rate in Korea, after liberation, were due to the birth control policy that restricted births. In Korea’s low fertility society, which began in the mid-2000s, the fertility rate dropped to below 0.84 in 2020, despite policies to improve the quality of the population. The death toll has reached 300,000, entering an era of population decline.

CONCLUSION: As we enter the era of population decline, we are in a direction that will cause various socioeconomic problems, from demographic problems to future population decline.

PMID:36325608 | DOI:10.3346/jkms.2022.37.e304

J Esthet Restor Dent. 2022 Nov 2. doi: 10.1111/jerd.12979. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of rubber dam isolation on shear bond strength of two different adhesive systems to enamel.

MATERIALS AND METHODS: The mesial, distal, lingual, and vestibular enamel surfaces of thirty human third molars were prepared (total n = 120). A custom splint was made to fit a volunteer’s maxilla, holding the specimens in place in the oral cavity. Four composite resin cylinders were bonded to each tooth with one of two bonding agents (OptiBond FL and Prime&Bond active) with or without rubber dam isolation. Shear bond strength was tested in a universal testing machine and failure modes were assessed. Significance level for statistical analyses was set at 5%.

RESULTS: All pairwise comparisons revealed statistical differences (p < 0.05). The highest mean shear bond strength values were obtained in rubber dam experimental groups, regardless of the adhesive system. Group OptiBond FL with rubber dam presented the highest mean bond strength values. Fracture modes for specimens bonded without rubber dam isolation were adhesive and cohesive within enamel, while rubber dam experimental groups revealed only cohesive fractures.

CONCLUSIONS: Absolute isolation with rubber dam increases bond strength to enamel, independent of the adhesive system. The three-step total-etch system OptiBond FL provided significantly higher bond strength values than Prime&Bond active under both experimental conditions.

CLINICAL SIGNIFICANCE: Rubber dam isolation has a significant effect on bond strengths to enamel, independent of the adhesive system. Its application is, therefore, advised whenever adhesive procedures are performed. A filled three-step etch-and-rinse adhesive performed superiorly, with or without rubber dam isolation, when bonding to enamel compared to an isopropanol-based universal adhesive.

PMID:36325593 | DOI:10.1111/jerd.12979

Pediatr Transplant. 2022 Nov 2:e14425. doi: 10.1111/petr.14425. Online ahead of print.

ABSTRACT

BACKGROUND: Caregivers play an important role in maintaining a functioning graft after pediatric liver transplantation. Therefore, the psychosocial factors of both patients and caregivers can have a critical impact on transplant outcomes. Appropriate assessment and recognition of these factors pre-transplantation may allow transplant teams to better define the needs of pediatric organ recipients and develop specific countermeasures, which may then contribute toward improving transplant outcomes.

METHODS: We studied 136 pediatric LT recipients followed at Texas Children’s Hospital. Licensed social workers conducted comprehensive pre-transplant assessments on each patient, consisting of 22 psychosocial variables that were thought to impact adherence, which were reviewed during our study period. Non-adherence was determined using the MLVI for up to 4 years after transplantation. Biopsy-confirmed rejection episodes were assessed in the first 3 years after liver transplantation.

RESULTS: Factors significantly associated with non-adherence (defined as MLVI >2) included parental age and parental education level at assessment, type of insurance, and household income. The number of ACR episodes trended higher in patients with non-adherence, and these patients had a higher number of moderate to severe rejection episodes but this trend was not statistically significant.

CONCLUSIONS: Psychosocial characteristics such as parental age, education level, insurance, and household income may contribute significantly to suboptimal adherence to medications after transplantation. Identification of these psychosocial factors and early intervention is essential to the success and equitable care of our pediatric LT recipients.

PMID:36325588 | DOI:10.1111/petr.14425

Nurs Open. 2022 Nov 2. doi: 10.1002/nop2.1453. Online ahead of print.

ABSTRACT

AIM: The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency.

DESIGN: A cross-sectional design.

METHODS: Healthcare Professional Core Competency Instrument, consisting of 11 sub-scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t-test, ANOVA and linear regression were used for data analysis.

RESULTS: Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence-based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts.

PMID:36323624 | DOI:10.1002/nop2.1453

Cognition. 2022 Oct 30:105310. doi: 10.1016/j.cognition.2022.105310. Online ahead of print.

NO ABSTRACT

PMID:36323619 | DOI:10.1016/j.cognition.2022.105310

Acad Radiol. 2022 Oct 30:S1076-6332(22)00516-5. doi: 10.1016/j.acra.2022.10.002. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: To evaluate the effectiveness of an artificial intelligence (AI) in radiology literacy course on participants from nine radiology residency programs in the Southeast and Mid-Atlantic United States.

MATERIALS AND METHODS: A week-long AI in radiology course was developed and included participants from nine radiology residency programs in the Southeast and Mid-Atlantic United States. Ten 30 minutes lectures utilizing a remote learning format covered basic AI terms and methods, clinical applications of AI in radiology by four different subspecialties, and special topics lectures on the economics of AI, ethics of AI, algorithm bias, and medicolegal implications of AI in medicine. A proctored hands-on clinical AI session allowed participants to directly use an FDA cleared AI-assisted viewer and reporting system for advanced cancer. Pre- and post-course electronic surveys were distributed to assess participants’ knowledge of AI terminology and applications and interest in AI education.

RESULTS: There were an average of 75 participants each day of the course (range: 50-120). Nearly all participants reported a lack of sufficient exposure to AI in their radiology training (96.7%, 90/93). Mean participant score on the pre-course AI knowledge evaluation was 8.3/15, with a statistically significant increase to 10.1/15 on the post-course evaluation (p= 0.04). A majority of participants reported an interest in continued AI in radiology education in the future (78.6%, 22/28).

CONCLUSION: A multi-institutional AI in radiology literacy course successfully improved AI education of participants, with the majority of participants reporting a continued interest in AI in radiology education in the future.

PMID:36323613 | DOI:10.1016/j.acra.2022.10.002

Clin Lymphoma Myeloma Leuk. 2022 Sep 8:S2152-2650(22)00623-1. doi: 10.1016/j.clml.2022.08.014. Online ahead of print.

ABSTRACT

INTRODUCTION: Patients with relapsed/refractory acute myeloid leukemia (r/r AML) are characterized as having a poor prognosis. The only viable option of treatment for these patients is allogenic stem cell transplantation (allo-HSCT). Therefore, we have attempted to analyse factors related to both the disease itself and the transplantation procedure that could have an influence on the improvement of outcomes in this group of patients.

PATIENTS AND METHODS: Sixty-four patients with r/r AML underwent allo-HSCT at our center in 2012 to 2021. Fifty-two had active disease at the beginning of theallo-HSCT procedure, with amedian number of blasts in bone marrow (BM) of 18, and 12 had therapeutic aplasia after the last reinduction (blasts < 5% in BM).

RESULTS: The probability of overall survival (OS) at 2 years was 25%. The median follow-up for survivors was 21.5 months. Progression-free survival (PFS) estimates were above 46%. The main cause of death was disease progression (49%). A statistically significant effect on premature death was reported for the diagnosis of secondary AML (sAML) and cytomelovirus (CMV) reactivation post allo-HSCT. On the other hand, chronic graft versus host disease (cGVHD) decreased the risk of disease progression. sAML and CMV reactivation were found to have opposite effects.

PMID:36323603 | DOI:10.1016/j.clml.2022.08.014

J Perianesth Nurs. 2022 Oct 30:S1089-9472(22)00240-4. doi: 10.1016/j.jopan.2022.05.081. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated the effect of oral melatonin as a premedication before cataract surgery on pain score, anxiety, surgical conditions, and intraocular pressure (IOP) during cataract surgery with phacoemulsification under topical anesthesia.

DESIGN: This randomized, double-blind prospective study was conducted among 120 patients aged 50 to 80.

METHODS: Patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety and pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of surgical conditions were recorded. The results were analyzed using SPSS 23 software, and statistical analysis consisted of χ² test and t-test, and a P value less than .05 was considered significant.

FINDINGS: There was a significant difference between the two groups regarding pain after the surgery before being discharged from the recovery room. The mean pain score in the melatonin group was lower than the placebo group in T4 (in the postoperative ward) (P < .05). The anxiety score of patients was lower in the melatonin group in T3 and T4 (during surgery and in the postoperative ward, respectively) (P < .05). IOP was significantly lower in the case group at the end of the surgery after receiving premedication (P = .021).

CONCLUSIONS: This study showed that 3 mg Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced patients’ anxiety scores, pain score, and IOP.

PMID:36323602 | DOI:10.1016/j.jopan.2022.05.081

Zhonghua Wai Ke Za Zhi. 2022 Nov 1;60(11):1004-1010. doi: 10.3760/cma.j.cn112139-20220530-00244.

ABSTRACT

Objective: To investigate the changes of imaging parameters of patellofemoral joint after kinematic alignment total knee arthroplasty (KA-TKA) and mechanical alignment total knee arthroplasty (MA-TKA) and the effects on clinical outcomes. Methods: A retrospective analysis was performed on 227 patients diagnosed with knee osteoarthritis, 105 males and 122 females, with the age of (68.6±7.2) years (range: 52 to 86 years). The patients underwent unilateral TKA at the Department of Orthopaedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, from January 2020 to July 2021. The patients were divided into the KA-TKA group (n=102) and the MA-TKA group (n=125) according to the alignment method. The Blackburne-Peel index, lateral patellofemoral angle, patellofemoral tilt angle and patellofemoral index of the two groups were recorded before and 6 months after operation. The frequency of lateral patellar retinaculum release, preoperative and postoperative knee range of motion (ROM), and Oxford knee score(OKS) were also recorded. The differences between preoperative and postoperative measurement data of each group were calculated. If the difference was in line with normal distribution, the independent sample t-test or t‘-test was used for comparison between the two groups. If it did not conform to normal distribution, Mann-Whitney U test was used. Paired sample t-test was used for comparison before and after treatment. Chi-square test was used for comparation of categorical data between the two groups. Results: After 6 months of operation, the patellar tilt angles of the KA-TKA group and the MA-TKA group were (14.22±3.26)° and (13.35±2.27)°, and the lateral patellar angles were (9.73±4.86)° and (11.91±3.89)°, respectively. The change of lateral patellofemoral angle in the KA-TKA group was significantly less than that in the MA-TKA group ((1.68±4.86)° vs. (4.15±4.88)°, t=3.805, P<0.01). OKS and ROM were improved in the both groups at 6 months after operation (all P<0.05), but there were no statistic significance in preoperative and postoperative difference between the two groups (all P>0.05). The intraoperative lateral patellar retinacular release rate was 14.4% (18/125) in the MA-TKA group and 6.9% (7/102) in the KA-TKA group, with no statistical difference (χ²=3.256,P=0.071). Conclusions: There are greater patella lateral tilt at 6 months postoperatively in the KA-TKA group compared with the MA-TKA group, but this radiographic difference could not show differences of clinical outcomes and postoperative ROM, the frequency of intraoperative lateral patellar retinacular release wouldn’t increase. Therefore, KA-TKA does not increase the difficulty of postoperative patellofemoral joint complications and intraoperative lateral patellar release.

PMID:36323583 | DOI:10.3760/cma.j.cn112139-20220530-00244