Tag: nevin manimala

J Dent Educ. 2022 Feb 18. doi: 10.1002/jdd.12892. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVES: The objective of this retrospective study was twofold: it aimed to investigate dental students’ communication and physical exam self-assessment skills by comparing students’ self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students’ communication skills.

METHODS: At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar’s test (p < 0.05).

RESULTS: Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045).

CONCLUSIONS: While there was disagreement between students and faculty versus SPs, they weren’t meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student’s self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.

PMID:35181888 | DOI:10.1002/jdd.12892

J Knee Surg. 2022 Feb 18. doi: 10.1055/s-0042-1743232. Online ahead of print.

ABSTRACT

Robotic-assisted total knee arthroplasty (RA-TKA) has demonstrated improved alignment and outcome scores when compared with manual total knee arthroplasty (M-TKA); however, few studies compare differences in the same patient. This study is a retrospective review that assesses clinical outcomes of 36 patients who underwent a primary RA-TKA and had undergone a prior contralateral M-TKA. All surgeries were performed by a single surgeon at the same institution. Patients were assessed for differences in hospital length of stay, improvement in pre- versus postoperative range of motion, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. Student’s t-test and Fisher’s exact test were utilized to detect significant differences. Patient demographics showed a mean age of 64.5, 24 females (67%), and mean body mass index of 35.1 ± 5.7. The average follow-up time was 2.9 years for M-TKA and 1.3 years for RA-TKA. Hospital length of stay was decreased by 5.5 hours for RA-TKA (p = 0.03). Total postoperative WOMAC score was not statistically different between RA-TKA and M-TKA (p = 0.061); however, pain and stiffness components were statistically improved in RA-TKA (p = 0.041 and p = 0.007), respectively. KOOS was higher in RA-TKA, which approached statistical significance (p = 0.005). Pre- versus postoperative knee flexion improved significantly in both cohorts. There was a significant difference in pre- versus postoperative range of motion at 3, 6, and 12 months follow-up after RA-TKA in comparison to M-TKA (p < 0.05). There were no postoperative complications. Patients who underwent RA-TKA demonstrated early improvement at 1-year follow-up in pain, stiffness, and knee flexion when compared with their prior contralateral M-TKA. There was a significant decrease in postoperative length of stay by 5.5 hours in the RA-TKA group. Limitations include a small sample size and differences in follow-up times between RA-TKA and M-TKA.

PMID:35181873 | DOI:10.1055/s-0042-1743232

Z Geburtshilfe Neonatol. 2022 Feb 18. doi: 10.1055/a-1741-6172. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm birth (PTB) is an important cause of neonatal mortality and morbidity. Spontaneous PTB (sPTB) is the most common cause of PTB. In patients with a singleton pregnancy, progesterone treatment appears to reduce the rate of spontaneous preterm birth in those with a previous history of spontaneous preterm labor and/or cervical shortening in the current pregnancy. Progesterone therapies used for the prevention of sPTB may increase the risk of gestational diabetes mellitus (GDM) towards the end of pregnancy owing to their effects on carbohydrate metabolism.

AIM: We aimed to show the effects of vaginal progesterone use, starting time, and duration of treatment on GDM.

METHODS: A retrospective cohort study was carried out in pregnant women 18 to 39 years old who came to our hospital between January 1, 2021, and August 31, 2021, and who had a 2-hour 75-g oral glucose tolerance test (OGTT) at 24 to 28 weeks of gestation. In a total of 540 patients, 68 were diagnosed with GDM based on at least one abnormal plasma glucose value at screening. The remaining 472 patients with normal plasma glucose levels were considered as the control group. The groups were compared in terms of age, parity, pre-pregnancy body mass index (BMI), smoking, gestational age, and vaginal progesterone use. Patients using vaginal progesterone with and without GDM were then compared again in terms of indications for vaginal progesterone use, initiation time of progesterone therapy, duration of progesterone use, and cervical length.

RESULTS: The incidence of GDM in our study group was 12.5%. Despite the use of vaginal progesterone at a higher rate in the GDM group than in the control group (23.5 vs. 13.9%; p=0.07), it was not statistically significant. When we examined patients using progesterone as a subgroup analysis, the mean time to start vaginal progesterone treatment was 19.8±2.6 (14-24), and it was significantly earlier in the GDM group (18.1±2.0 vs. 20.2±2.6; p=0.007). Initiation of vaginal progesterone before 20 weeks of gestation was statistically significantly more frequent in the GDM group than the control group (68.8 vs. 39.4%; p=0.050 OR :3.3, 95%CI: 1.0-10.8). The mean duration of vaginal progesterone use was 50.0±15.6 days (28-90) and it was longer in the GDM group (57.8±13.4 vs. 48.1±15.6; p=0.027).

CONCLUSION: Since the duration of vaginal progesterone use will be prolonged, there may be a risk of GDM, especially in patients who started vaginal progesterone before the 20th week of pregnancy. Even if the OGTT test performed between 24-28 weeks is normal, it should be kept in mind that these patients may have GDM in the later weeks of pregnancy, and repeating the OGTT test should be considered if necessary.

PMID:35181880 | DOI:10.1055/a-1741-6172

Eur J Dent. 2022 Feb 18. doi: 10.1055/s-0041-1740221. Online ahead of print.

ABSTRACT

OBJECTIVES: This study evaluated the surface microhardness of composite, affected by surface coating with different dental adhesive systems.

MATERIALS AND METHODS: A total of 100 composite discs were divided into five groups. Group 1 was uncoated (control group C), and groups 2 to 5 were coated with different adhesive systems (OptiBond FL: FL, OptiBond SOLO Plus: SOLO, OptiBond XTR: XTR, and OptiBond All in one: AIO, respectively). The Vickers microhardness (VHN) was measured without and with 500 thermocycles.

STATISTICAL ANALYSIS: The data were analyzed using two-way ANOVA and Tukey’s posthoc test at the 95% confidence level.

RESULTS: At 24 hours, the VHN of C (59.96 ± 3.68) and FL (59.83 ± 4.54) were significantly higher than SOLO (51.73 ± 4.63) and AIO (51.45 ± 4.11). The VHN of XTR (54.96 ± 3.68) was not significant compared with that of C and all other groups. After thermocycling, VHN were significantly decreased in all groups. However, there were no significant differences among all groups.

CONCLUSIONS: At 24 hours, composite coated with different adhesive systems have different effects to VHN. Thermocycling all adhesive resin systems coated on composite surface significantly decreased the VHN.

PMID:35181872 | DOI:10.1055/s-0041-1740221

Eur J Dent. 2022 Feb 18. doi: 10.1055/s-0041-1740226. Online ahead of print.

ABSTRACT

OBJECTIVE: Topical application of ambonese banana (Musa paradisiaca var. sapientum (L.) kuntze) stem sap gel (GEGPA) on the socket wound area showed an increase in the expression of platelet-derived growth factor-BB, while decrease in the expression of matrix metalloproteinase-2 and 9. The aim of this study is to achieve standard formulation of GEGPA through stability, viscosity, distribution area, and drugs release for oral gel wound healing.

MATERIALS AND METHODS: This is an in vitro and in vivo study with the randomized posttest only control group design. The gel was formulated according to the composition of each group by adding hydroxypropyl methylcellulose (HPMC), Lexgard, propylene glycol, and cold water to obtain 100 g of gel. Observations were made through the following tests: stability, viscosity, distribution area, drug release, and histopathological analysis of tooth extraction wound healing.

STATISTICAL ANALYSIS: Data were analyzed using a one-way analysis of variance (α = 0.05) with GraphPad Prism-8 statistical software.

RESULTS: The study showed that the GEGPA formulation was stable against changes in consistency, color, smell, homogeneity, and pH value. There is a significant difference between groups with respect to viscosity (p = 0.0001), adhesion (p = 0.004), dispersion (p = 0.000), and fibroblast cell numbers on days 3 and 5 (p = 0.007 and p = 0.001). There is no interaction between the active ingredients and the gel base of all formulations. Formulation 3 had better properties in terms of viscosity, broad distribution, and drug release compared with other groups. Application of GEGPA to tooth extraction wounds showed a significant proliferation of fibroblast cells on days 3 and 5.

CONCLUSIONS: The formulation of M. paradisiaca var. sapientum (L.) kuntze extract with HPMC and propylene glycol obtained a gel preparation, GEGPA, that was organoleptically stable and met the topical gel standard for wounds in the oral cavity.

PMID:35181871 | DOI:10.1055/s-0041-1740226

Eur J Dent. 2022 Feb 18. doi: 10.1055/s-0041-1735933. Online ahead of print.

ABSTRACT

OBJECTIVES: Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OA_m) is being recommended treatment for patients who refuse or do not tolerate continuous positive airway pressure. The mode of action of OA_m is to promote the advancement of the mandible or tongue with a subsequent increase in the tone of the pharyngeal muscles and the permeability of the upper airway, but most OA_m use conventional models as reference, analogic, or digital, dissociating dental arches of the skull structures.

MATERIALS AND METHODS: A retrospective longitudinal study of 33 OSA patient treated with a different OA_m, that use Camper plane as reference with skull structures for dental arches disocclusion, where polysomnographic, cephalometric measures, and subjective data from questionnaires pre- and post-treatment were assessed and correlated. Descriptive analysis, correlated Chi-square tests, and basic statistics were used. Generalized linear mixed model for repeated measure and post hoc Tukey-Kramer test compares the variables pre- and post-treatment. Shapiro-Wilk test and Pearson’s correlation coefficients were used. All statistical tests were set in 5% level of significance.

RESULTS: Regarding polysomnography data, there was a significant association between apnea hypopnea index (AHI) with oxygen saturation, arousal index (AI) and the maximum heartbeats, and sleep improvement and health risk reduction. Additionally, from cephalometric data, it was found a significant association between the tongue posture with the soft palate, hioyd-C3 and, lower and posterior airway. When both parameters are correlated, there are a significant dependent association with hyoid bone position with AHI and AI. The limitation of this study was the two-dimensional image used without provide volumetric measurements, but this limitation was reduced with the follow-up polysomnography parameters.

CONCLUSION: In this pilot study, DIORS OA_m as an uniquely designed device using Camper plane as a reference for disocclusion was effective in the control of OSA.

PMID:35181870 | DOI:10.1055/s-0041-1735933

Environ Sci Pollut Res Int. 2022 Feb 18. doi: 10.1007/s11356-022-18559-7. Online ahead of print.

ABSTRACT

Dam safety assessment is important to implement the appropriate measures to avoid a dam break disaster as part of the water reservoirs management process. Prediction-based approaches are valuable to compare the actual measurements with the simulated values to proactively detect anomalies. However, the application of the conventional hydrostatic seasonal time (HST) has some limitations related to an instantaneous response of the dam to environmental factors, which can lead to inaccurate prediction and interpretation, especially for daily measurements. Besides, the generalization ability (GA) of these models is not analyzed enough despite its crucial importance in selecting the appropriate models. In this study, the multiple linear regression (MLR), artificial neural network (ANN), support vector regression (SVR), and adaptive boosting (AdaBoost) models with nonlinear autoregressive exogenous (NARX) inputs are proposed to incorporate the response delay of the dam to the hydraulic load. Thus, these models were evaluated and compared with the HST model for predicting the daily pore water pressure in an embankment dam. Moreover, we proposed a classification method of the models into four categories, namely perfect, excellent, good, and poor according to the GA. Results show that, except for the AdaBoost, the other ML models outperformed the traditional statistical approach (HST) in terms of prediction accuracy as well as the GA. Overall, the study results provide new insights in enhancing the monitoring processes and dam safeties by detecting the anomalies early through the comparison of the measurements and simulated results produced by the best-fitted models from the confidence interval (CI) perspective.

PMID:35181857 | DOI:10.1007/s11356-022-18559-7

J Gerontol A Biol Sci Med Sci. 2022 Feb 18:glac046. doi: 10.1093/gerona/glac046. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary function (PF) progressively declines with aging. Forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) are predictors of morbidity of pulmonary and cardiovascular diseases and all-cause mortality. In addition, reduced PF is associated with elevated chronic low-grade systemic inflammation, glucose metabolism, body fatness, and low muscle strength. It may suggest pleiotropic genetic effects between PF with these age-related factors.

METHODS: We evaluated whether FEV1 and FVC share common pleiotropic genetic effects factors with interleukin-6, high-sensitivity C-reactive protein, body mass index, muscle (grip) strength, plasma glucose, and glycosylated hemoglobin in 3,888 individuals (age range: 26-106). We employed sex-combined and sex-specific correlated meta-analyses to test whether combining genome-wide association p-values from two or more traits enhances the ability to detect variants sharing effects on these correlated traits.

RESULTS: We identified 32 loci for PF, including 29 novel pleiotropic loci associated with pulmonary function and (i) body fatness (CYP2U1/SGMS2), (ii) glucose metabolism (CBWD1/DOCK8 and MMUT/CENPQ), (iii) inflammatory markers (GLRA3/HPGD, TRIM9, CALN1, CTNNB1/ZNF621, GATA5/SLCO4A1/NTSR1, and NPVF/C7orf31/CYCS), and (iv) muscle strength (MAL2, AC008825.1/LINC02103, AL136418.1).

CONCLUSIONS: The identified genes/loci for PF and age-related traits suggest their underlying shared genetic effects, which can explain part of their phenotypic correlations. Integration of gene expression and genomic annotation data shows enrichment of our genetic variants in lung, blood, adipose, pancreas, and muscles, among others. Our findings highlight the critical roles of identified gene/locus in systemic inflammation, glucose metabolism, strength performance, PF, and pulmonary disease, which are involved in accelerated biological aging.

PMID:35180297 | DOI:10.1093/gerona/glac046

PLoS One. 2022 Feb 18;17(2):e0264213. doi: 10.1371/journal.pone.0264213. eCollection 2022.

ABSTRACT

Few large-scale studies have been conducted to show the joint effects of mortality associated with physical activity and sedentarism. Therefore, we examined the relationship between all-cause mortality and behavioral patterns among adults in the United States. Data of 17,730 non-institutionalized US civilians aged ≥20 years were extracted from the 2007-2014 National Health and Nutrition Examination Survey. We set the criteria for metabolic equivalents as 600 according to the WHO guideline, and sedentary time as 300 min/day according to the median. The Cox proportional hazards model was adjusted for demographic and lifestyle characteristics. During the 58.54±28.18 months follow-up, all-cause mortality rate was 4% and heart-related and cancer mortality rate was 1%. Participants in the high metabolic equivalents and low sedentary time group had a lower risk of all-cause (hazard ratio = 0.41, 95% confidence interval = 0.34-0.50), cardiovascular (hazard ratio = 0.36; 95% confidence interval = 0.23-0.55), and cancer (hazard ratio = 0.55; 95% confidence interval = 0.37-0.83) mortality, compared to those in the low metabolic equivalents and high sedentary time group. Sufficient physical activity and less sedentary behavior reduce all-cause and cause-specific mortality in adults in the United States, especially cardiovascular mortality among the elderly. Additional nationwide policies to improve behavioral patterns among adults need to be implemented in the United States.

PMID:35180280 | DOI:10.1371/journal.pone.0264213

PLoS One. 2022 Feb 18;17(2):e0264199. doi: 10.1371/journal.pone.0264199. eCollection 2022.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) and its treatment impact patients’ physical health as well as emotional and social wellbeing. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients with T2DM at a tertiary care hospital in Ethiopia.

METHODS: A face-to-face cross-sectional survey was conducted among patients with T2DM at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. We collected data using a validated Amharic version of the 5-level EuroQoL-5 dimensions (EQ-5D-5L) questionnaire. Descriptive statistics were used to present patient characteristics. Kruskal-Wallis and Mann-Whitney U tests were performed to explore differences in the median scores of EQ-5D-5L utility and visual analog scale (EQ-VAS). Multivariable Tobit regression models were used to identify predictors of HRQoL. Utility scores were calculated using disutility weights of the Ethiopian general population. Statistical significance was determined at p < 0.05.

RESULTS: A total of 360 patients with T2DM participated. Mean (SD) age was 64.43(10.61) years. Reported health problems were mostly in the pain/discomfort (67.3%) dimension followed by mobility (60.5%), whereas the usual activities domain (34.1%) was the least health problem being reported. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.95 (0.88-0.96) and 80 (75.0-85.0), respectively. In multivariable Tobit regression models older age, having poor glycemic control, longer duration of diabetes, insulin usage, obesity, and having diabetes-related complications were significant negative predictors of HRQoL.

CONCLUSIONS: Overall, patients with T2DM had lower HRQoL than the general population, which was attributed to being older age, longer duration of diabetes, insulin use, obesity, inadequate glycemic control, and diabetes-related complications. The utility index we generated can be used in future economic evaluations to inform decisions about alternative interventions and resource allocation.

PMID:35180266 | DOI:10.1371/journal.pone.0264199