Tag: nevin manimala

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0042-1743151. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess hepatitis B surface antibody (anti-HBs) persistence among dental students two decades after infant vaccination and immune response after revaccination or booster dose in nonimmune groups.

MATERIALS AND METHODS: A cross-sectional study was performed using laboratory reports for anti-HBs performed to dental students at the Umm al-Qura University from 2016 to 2020. Reports were classified according to baseline antibody titer into group I (titer <10 mIU/mL), group II (titer 10 to <100 mIU/mL), and group III (titer ≥100 mIU/mL). The basal antibody titer of each group was correlated to student’s gender and birth year and compared with postrevaccination or booster dose titer in groups I and II.

STATISTICAL ANALYSIS: Data of baseline and postrevaccination anti-HBs antibody titers were analyzed using Statistical Package for Social Science (SPSS). One-way ANOVA was used to compare between different means for antibody titers of students as well as baseline and postrevaccination antibody levels for nonimmune students with nonprotective antibody titers. Pairwise multiple comparison of the difference between baseline and postrevaccination anti-HBs antibody titers were done by post hoc Tukey’s honestly significant difference (HSD) test. Chi-squared test was used for comparing between the frequencies. A p-Value of ≤0.05 was considered significant and p < 0.01 was considered highly significant.

RESULTS: A significant percentage (73.6%) of students had antibody titer <10 mIU/mL, while only 4.8% had antibody titer ≥100 mIU/mL with nonsignificant difference between both genders (χ ² =3.784, p = 0.151). A statistically nonsignificant difference was also found between the three categories of anti-HBs antibody titers among students with different birth dates (χ ² = 13.817, p = 0.182). After revaccination of nonimmune students, 100% of them showed strongly protective antibody titers with mean of 842.88 to 844.58 mIU/mL. A highly significant difference was observed between the mean baseline and postrevaccination antibody titers in both genders, with a higher mean of post revaccination (p = 0.000).

CONCLUSION: Two decades after infant immunization, a significant percentage of dental students failed to maintain the anti-HBs seroprotective titer. So titer measurement should be made compulsory before they begin their clinical training and revaccination or booster dose should be given to nonimmune students to maintain a high protection level.

PMID:35436788 | DOI:10.1055/s-0042-1743151

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0042-1743154. Online ahead of print.

ABSTRACT

OBJECTIVES: The malondialdehyde (MDA) level and TA count represent the progression of oral potentially malignant disorders (OPMD) to malignancy and thus may be used as an indicator of oral epithelial dysplasia (OED). This study aimed to determine the MDA level and tissue apoptosis (TA) count in oropharyngeal tissue of Wistar rats exposed to sidestream cigarette smoke.

MATERIALS AND METHODS: Wistar rats were divided into three groups: T4 group (4-week cigarette smoke exposure), T8 group (8-week cigarette smoke exposure), and control group, which was not exposed to cigarette smoke. The oropharyngeal tissue of the rats from each group was examined histopathologically to count the number of apoptotic cells, and then the blood serum was made to measure the MDA level.

STATISTICAL ANALYSIS: Bonferroni test was performed to see the differences in each group for MDA level. While the data from tissue apoptosis were analyzed using Mann-Whitney U test for the significance. All data were considered significant if p < 0.05.

RESULTS: The MDA level and TA count increased as the duration of cigarette smoke exposure increased. In the T8 group, the MDA level and TA count were significantly higher compared with the T4 and control groups with a p-value < 0.05.

CONCLUSIONS: Exposure to sidestream cigarette smoke increased the TA count and MDA level in the oropharyngeal tissue of Wistar rats. The TA count and MDA level may be used as markers of OPMD.

PMID:35436787 | DOI:10.1055/s-0042-1743154

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0042-1743155. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated the effect of learning by observation on the development of fine motor skills related to endodontic manual instrumentation. We evaluated if learning by observation with guidance had any influence upon operator performance under tense or taxing conditions.

MATERIALS AND METHODS: Dental students prepared standardized simulated root canals of varying morphology. Learning involved silent video with hand guidance (n = 23), audiovisual combined with oral instructions (n = 23), or silent video (n = 13). Undergraduates who previously completed conventional preclinical endodontics provided comparative data as a control group (n = 16). During investigations, a root canal of a lower molar plastic tooth was shaped, beginning with a primary task, and followed by multitasking conditions. The performance of the students was assessed by evaluating the accuracy of dental canal shaping and time taken to complete the task.

STATISTICAL ANALYSIS: Differences were analyzed using ANOVA (p < 0.05).

RESULTS: Performance was similar during learning between the three experimental groups. Accuracy of the performance did not differ within each group for the two tests nor between the groups at each test (p > 0.05).

CONCLUSIONS: These findings demonstrated that performance subsequent to learning by observation without instructions was comparable to learning with instructed observation. The results also identified that the performance of the experimental group (1.5- to 2-hour practice) was comparable with the conventional control group (15- to 20-hour practice). Alternative approaches to learning dexterity skills in dentistry may provide improved outcomes, especially in demanding situations.

PMID:35436786 | DOI:10.1055/s-0042-1743155

Pediatr Emerg Care. 2022 Apr 19. doi: 10.1097/PEC.0000000000002712. Online ahead of print.

ABSTRACT

OBJECTIVE: Children with medical complexity (CMC) compose 1% of the pediatric population but account for 20% of pediatric emergency department (ED) visits. Previous descriptions of challenges and interventions to ensure quality of care are limited. Our objective was to elicit pediatric emergency medicine (PEM) physicians’ perspectives on challenges and opportunities for improvement of emergency care of CMC, with a focus on emergency information forms (EIFs).

METHODS: We conducted a web-based survey of PEM physicians participating the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. The survey was designed using an expert panel, and subsequently piloted and revised to an 18-item survey. Data were analyzed with descriptive statistics.

RESULTS: One hundred fifty-one of 495 respondents (30%) completed the survey. Most respondents (62.9%) reported caring for >10 CMC per month. Whereas overall medical fragility and time constraints were major contributors to the challenges of caring for CMC in the ED, communication with known providers and shared care plans were identified as particularly helpful. Most respondents did not report routine use of EIFs. Anticipated emergencies/action plan was deemed the most important component of EIFs.

CONCLUSIONS: Most PEM physicians view the care for CMC in the ED as challenging despite practicing in high-resource environments. Further research is needed to develop and implement strategies to improve care of CMC in the ED. Understanding experiences of providers in general ED settings is also an important next step given that 80% of CMC present for emergency care outside of major children’s hospitals.

PMID:35436769 | DOI:10.1097/PEC.0000000000002712

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0041-1741375. Online ahead of print.

ABSTRACT

OBJECTIVE: Airborne particles are one of the most important factors in the spread of infectious pathogens and must be monitored in healthcare facilities. Viable particles are living microorganisms, whereas non-viable particles do not contain microorganisms but act as transport for viable particles. The effectiveness of ozone in reducing these particles in a non-controlled room and a controlled cleanroom using high-efficiency particles air (HEPA) filter was analyzed in this study.

MATERIALS AND METHODS: Viable particles and non-viable particles sized 0.5 and 5 μm were quantified before and after ozonation in two different health environments: non-controlled (group 1) and controlled area, which was associated with a HEPA filtering system (group 2). Active air sampling using a MAS 100 was used to count the number of viable particles, while the number of non-viable particles/m³ was obtained following the manufacturer’s recommendations of the Lasair III 310C system.

RESULTS: Our results of the viable particles counting were not quantifiable and analyzed using statistical tests. Both groups showed a slight tendency to reduce the number of viable particles after ozonation of the environmental air. A statistically significant reduction of non-viable 5 μm particles after ozonation was observed in both groups (G1: p = 0,009; G2: p = 0,002). Reduction in the non-viable 0.5 μm particles after ozonation was observed only in group 2, associated with the HEPA filter. In group 1, after ozonation, a significant increase in 0.5 μm particles was observed, probably due to the breaking of 5 μm particles by ozone gas. Our results suggest that ozone gas can break 5 μm particles and, when associated with a HEPA filter, increases its effectiveness in removing 0.5 μm particles.

CONCLUSION: Considering that 5 μm particles are important in the air transport of microorganisms, their reduction in the environment can be a relevant parameter in controlling the dissemination of infections.

PMID:35436785 | DOI:10.1055/s-0041-1741375

Pediatr Emerg Care. 2022 Apr 19. doi: 10.1097/PEC.0000000000002728. Online ahead of print.

ABSTRACT

BACKGROUND: Sledding is not a risk-free winter sport. According to the US Consumer Product Safety Commission, there were an estimated 13,954 sledding accidents requiring medical care in 2010. However, specific information concerning pediatric injuries related to sledding is not well defined.

OBJECTIVES: This study aimed to identify the most common types of injuries associated with sledding accidents and demographic factors related to risk of injury in pediatric patients, and to compare injuries associated with 2 different age groups and sexes.

METHODS: This is a retrospective descriptive study of pediatric patients (<18 years of age) presenting to a regional level I pediatric trauma center secondary to a sledding injury between 2006 and 2016. Demographic information including sex, age, mechanism of injury, and injury severity score was captured and analyzed using descriptive statistics.

RESULTS: There were 209 patients identified for 10 years. There were no mortalities. There were 85 patients with primary head injury, of which 82 (96.5%) were hospitalized and 33 (38.8%) required an intensive care unit (ICU) stay. Seventy-five patients primarily suffered from extremity injuries, of which 56 (74.6%) had lower extremity fractures requiring operative intervention. There was no difference in ICU or length of stay between younger children (0-11 years) and adolescents (12-18 years) or between male and female patients.

CONCLUSIONS: Childhood sledding can result in a variety of significant injuries requiring surgical intervention and hospitalization. Children pulled on sleds behind motorized vehicles are at higher risk for more severe injuries resulting in a higher rate of ICU admission.

PMID:35436765 | DOI:10.1097/PEC.0000000000002728

J Biomech. 2022 Apr 12;137:111093. doi: 10.1016/j.jbiomech.2022.111093. Online ahead of print.

ABSTRACT

Chiari malformation is characterised by the herniation of the cerebellar tonsils through the foramen magnum. However, tonsillar herniation and other 2D morphometric measurements of the posterior cranial fossa (PCF) have a weak association with patients’ symptoms and clinical outcomes. This study aimed to contrast current 2D metrics with a novel 3D shape analysis of the PCF and the hindbrain, to determine if 3D measurements provides further insight into the pathophysiology of Chiari. The cranium of 12 controls and 21 Chiari malformation patients with (N = 9) and without (N = 12) a syrinx were scanned. The morphology of the PCF was quantified with typical 2D measurements. Additionally, a correspondence-based shape model that normalised the PCF volume, was used to find 3D differences in the shape of the PCF, and the distance of the hindbrain from the inner surfaces of the PCF. Shape analysis showed that, compared to controls, the caudal (p = 0.007; 2.3 mm, IQR: 1.6-3.3 mm) and anterior (p = 0.027; 1.3 mm,IQR: 1.1-1.6 mm) surfaces of the hindbrain were closer to the PCF in patients with and without a syrinx, respectively. However, there were negligible differences in the shape of the PCF between patient groups (p > 0.39). Current morphometric measures should be normalised for variation in PCF volume, so that shape measures are not biased. The reduced CSF space between the hindbrain and PCF will alter CSF dynamics, which may compress cerebellar vasculature and contribute to patient symptomatology.

PMID:35436754 | DOI:10.1016/j.jbiomech.2022.111093

EBioMedicine. 2022 Apr 15;79:104007. doi: 10.1016/j.ebiom.2022.104007. Online ahead of print.

ABSTRACT

BACKGROUND: Virtually few accurate and robust prediction models of lower-grade gliomas (LGG) survival exist that may aid physicians in making clinical decisions. We aimed to develop a prognostic prediction model of LGG by incorporating demographic, clinical and transcriptional biomarkers with either main effects or gene-gene interactions.

METHODS: Based on gene expression profiles of 1,420 LGG patients from six independent cohorts comprising both European and Asian populations, we proposed a 3-D analysis strategy to develop and validate an Accurate Prediction mOdel of Lower-grade gLiomas Overall survival (APOLLO). We further conducted decision curve analysis to assess the net benefit (NB) of identifying true positives and the net reduction (NR) of unnecessary interventions. Finally, we compared the performance of APOLLO and the existing prediction models by the first systematic review.

FINDINGS: APOLLO possessed an excellent discriminative ability to identify patients at high mortality risk. Compared to those with less than the 20^th percentile of APOLLO risk score, patients with more than the 90^th percentile of APOLLO risk score had significantly worse overall survival (HR=54·18, 95% CI: 34·73-84·52, P=2·66 × 10^-69). Further, APOLLO can accurately predict both 36- and 60-month survival in six independent cohorts with a pooled AUC_36-month=0·901 (95% CI: 0·879-0·923), AUC_60-month=0·843 (95% CI: 0·815-0·871) and C-index=0·818 (95% CI: 0·800-0·835). Moreover, APOLLO offered an effective screening strategy for detecting LGG patients susceptible to death (NB_36-month=0·166, NR_36-month=40·1% and NB_60-month=0·258, NR_60-month=19·2%). The systematic comparisons revealed APOLLO outperformed the existing models in accuracy and robustness.

INTERPRETATION: APOLLO has the demonstrated feasibility and utility of predicting LGG survival (http://bigdata.njmu.edu.cn/APOLLO).

FUNDING: National Key Research and Development Program of China (2016YFE0204900); Natural Science Foundation of Jiangsu Province (BK20191354); National Natural Science Foundation of China (81973142 and 82103946); China Postdoctoral Science Foundation (2020M681671); National Institutes of Health (CA209414, CA249096, CA092824 and ES000002).

PMID:35436725 | DOI:10.1016/j.ebiom.2022.104007

Leg Med (Tokyo). 2022 Apr 6;57:102061. doi: 10.1016/j.legalmed.2022.102061. Online ahead of print.

ABSTRACT

BACKGROUND: Recently, Olze et al. came up with a staging system based on the radiological changes in the root pulp of the third molar.

AIMS & OBJECTIVES: The current study seeks to ascertain the utility of visibility of the root pulp of the third molar as a system of forensic age estimation in the Indian population, as suggested by Olze. et al. and to assess the accuracy of cut-off stages for 18, 21, and 25 years of age.

MATERIAL AND METHODS: Radio-visiogram of 220 Patients (116 males and 104 females) of age 15 to 30 years were examined and staged as per Olze. et al. stage-based system. The statistical methods included descriptive analysis, chi-square test, and Rank-order correlation [rho] test of Spearman. EasyROC web tool was used for ROC analyses and calculating ROC curves (AUCs), likelihood ratio, predictive values, and screening tests for accuracy. Youden’s index was used to decide the cut-off stage for the different age groups.

RESULTS: Specificity close to 100% was observed among both the Sex for cut-off levels 1, 2, and 3 among 18, 21, and 25 years of age correspondingly with minimal Type II error. Inter andIntraobservations with a kappa value of 0.66 and 0.65, respectively, indicate good agreement.

CONCLUSION: Olze’s third molar root pulp 1, 2, and 3 stages can be used as an optimal cut-off for the 18, 21, and 25-year-old thresholds correspondingly with high specificity for both the sexes for age estimation among the Indian population.

PMID:35436735 | DOI:10.1016/j.legalmed.2022.102061

J Environ Radioact. 2022 Apr 15;248:106885. doi: 10.1016/j.jenvrad.2022.106885. Online ahead of print.

ABSTRACT

With several databases available, including two sets of in situ measurements of the ambient gamma dose rate and an airborne survey of K, Th, U in soil, Belgium is a favourable case for exploring the mapping methodology for terrestrial radiation. The first step is the harmonization of the different data sets, taking in situ measurements with an ion chamber as the reference. Corrections are necessary, based on the data themselves (a) to the measurements of permanent monitoring stations, (b) to the data calculated from airborne measurements of the soil activity, due in particular to the attenuation by the forest cover, and (c) to the other data calculated from the soil activity, due to the lower activity of the upper layer. After subtracting the cosmic contribution, a harmonized database of the terrestrial gamma dose rate (TGDR) based on 379 in situ measurements was built, together with a harmonized data set of 30134 TGDR values calculated from the concentrations of K, Th, U in soil deduced from the airborne survey. The two data sets are in good agreement with each other for all statistical characteristics that were examined like basic statistics, qq-plots, analysis of variance (ANOVA) or variograms, which validates the airborne-based data set by the link with in situ ion chamber measurements. ANOVA reveals the strong relation between TGDR and the soil class, which justifies the use of a soil map as the framework for developing the TGDR map. The variograms show the absence of residual spatial correlations within soil classes. The two harmonized TGDR data sets were mapped at the nodes of a kilometric grid by the moving average method within soil groups. There is a rather good agreement between the maps, confirming the equivalence between the two data sets and the validation of the airborne based one, which can obviously give more detail. After reducing the maps to a 10 km × 10 km grid, the two data sets were used to check the accuracy of the Belgian part of the European TGDR contained in the European Atlas of Natural Radiation.

PMID:35436723 | DOI:10.1016/j.jenvrad.2022.106885