Tag: nevin manimala

Front Med (Lausanne). 2021 Feb 16;8:608941. doi: 10.3389/fmed.2021.608941. eCollection 2021.

ABSTRACT

Background: Lower serum lipid metabolism might be associated with the decline of activity of daily living in the extreme longevity group. However, studies on models and possible paths of this correlation between total cholesterol (TC) and disability in centenarians are scarce. The aim of this study was to verify this correlation and explore the mediating effect of BMI and blood pressure on this relationship in Hainan centenarians. Methods: We conducted a cross-sectional analysis of 1002 centenarians from the China Hainan Centenarians Cohort Study (CHCCS). Data on demographics, anthropometry data, lifestyle, and TC levels were collected through interviews, physical examinations, and laboratory tests. The Barthel index and Lawton index, measuring the disability status, were used to estimate the activity of daily living (ADL) and instrumental activity of daily living (IADL). A multivariable logistic regression model was used to explore the correlation between disability and TC levels. Mediation analyses were used to explore the both direct and indirect effects of TC level on disability. Results: After adjusting for covariates, with 1 mmol/L increment in TC, the adjusted odds ratios (ORs) of ADL severe disability and ADL moderate & severe disability were 0.789(95%CI: 0.650-0.959) and 0.822(95%CI: 0. 0.699-0.966), respectively. There was a significant declining trend in the prevalence of different types of disability with increment in TC. The correlation was more pronounced among Hainan female centenarians. In the analysis of mediating effect among the female population, BMI significantly mediated the effect of TC levels on different types of disability. BMI and SBP, as chain mediators, multiply and chain mediated the effect of TC levels on IADL. Conclusion: Low TC levels might be correlated with a higher frequency of disability in female centenarians, and this correlation might be mediated by BMI and blood pressure.

PMID:33665198 | PMC:PMC7921456 | DOI:10.3389/fmed.2021.608941

Integr Med Res. 2021 Sep;10(3):100715. doi: 10.1016/j.imr.2021.100715. Epub 2021 Jan 9.

ABSTRACT

BACKGROUND: Danggwijagyaksan (DJS) has been one of the most widely used herbal medicines for gynecological disorders in traditional East Asian medicine. Several clinical studies about DJS have shown improvement in menopausal symptoms. This pilot study aimed to evaluate the efficacy, safety and feasibility of DJS for treating climacteric syndrome with a blood-deficiency-dominant pattern.

METHODS: This was a randomized, double-blind, placebo-controlled pilot trial. A group of 45-to 60-year-old women with climacteric syndrome were registered for the trial. The participants received treatment over a 4-week period and were then followed for 4 weeks. The primary outcome measure was the mean change in the Menopause Rating Scale (MRS). Secondary outcome measures included the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Blood-Deficiency Scoring System (BDSS), lean body mass, and serum hormone levels, including follicle-stimulating hormone (FSH) and estradiol (E₂) levels.

RESULTS: The MRS and BDSS scores decreased significantly in both groups, but the differences between two groups were not significant. The WHOQOL-BREF scores increased in the control group. No statistically meaningful differences in serum hormone levels or lean body mass were observed in both groups. There were no serious adverse events, and the laboratory tests were within the normal range. The recruitment rate, completion rate and medication adherence rate were over 90% in both groups, indicating high feasibility.

CONCLUSIONS: DJS showed clinical effectiveness in the treatment of climacteric syndrome with a blood-deficiency-dominant pattern. Additionally, DJS was shown to be safe and feasible for a large-scale study to confirm the efficacy of the treatment. Trial registration: Clinical Research Information Service (CRIS, https://cris.nih.go.kr): KCT0002387.

PMID:33665100 | PMC:PMC7903340 | DOI:10.1016/j.imr.2021.100715

Ann Glob Health. 2021 Feb 25;87(1):22. doi: 10.5334/aogh.3045.

ABSTRACT

BACKGROUND: Hepatitis B virus (HBV) infection disproportionally affects populations in sub-Saharan Africa. Lack of HBV awareness perpetuates disease burden in Africa.

OBJECTIVE: To promote HBV awareness in Tanzania using a systematic, measurable, and expandable approach to educating health care workers (HCW).

METHODS: We designed and implemented an HBV knowledge and teaching skills session in southern Tanzania to empower HCWs in leading education to promote disease awareness in their communities. Training was divided into two sessions: didactic and practical. A five-question anonymous survey was distributed in person immediately before and after the practical portion of the training to evaluate HBV knowledge as well as specific skills for teaching. Differences between responses before and after the sessions were evaluated by Chi-Square analysis. A sub-group of questions were further analyzed for differences based on HCW self-report of HBV serostatus awareness.

FINDINGS: 130 HCWs participated in the didactic lecture and 30 HCWs participated in both portions. A pre-post training five-question survey showed an increase in correct answers for all questions, with two showing statistical significance: HBV is silent (7% pre vs. 87% post; p < 0.0001), and repetition as key to promote awareness (63% pre vs. 100% post; p = 0.0002).

CONCLUSIONS: Our low-cost intervention is applicable to increase HBV awareness in low resource settings across Africa.

PMID:33665144 | PMC:PMC7908926 | DOI:10.5334/aogh.3045

Front Oncol. 2021 Feb 16;10:581347. doi: 10.3389/fonc.2020.581347. eCollection 2020.

ABSTRACT

BACKGROUND: This study aims to construct and validate a model based on convolutional neural networks (CNNs), which can fulfil the automatic segmentation of clinical target volumes (CTVs) of breast cancer for radiotherapy.

METHODS: In this work, computed tomography (CT) scans of 110 patients who underwent modified radical mastectomies were collected. The CTV contours were confirmed by two experienced oncologists. A novel CNN was constructed to automatically delineate the CTV. Quantitative evaluation metrics were calculated, and a clinical evaluation was conducted to evaluate the performance of our model.

RESULTS: The mean Dice similarity coefficient (DSC) of the proposed model was 0.90, and the 95th percentile Hausdorff distance (95HD) was 5.65 mm. The evaluation results of the two clinicians showed that 99.3% of the chest wall CTV slices could be accepted by clinician A, and this number was 98.9% for clinician B. In addition, 9/10 of patients had all slices accepted by clinician A, while 7/10 could be accepted by clinician B. The score differences between the AI (artificial intelligence) group and the GT (ground truth) group showed no statistically significant difference for either clinician. However, the score differences in the AI group were significantly different between the two clinicians. The Kappa consistency index was 0.259. It took 3.45 s to delineate the chest wall CTV using the model.

CONCLUSION: Our model could automatically generate the CTVs for breast cancer. AI-generated structures of the proposed model showed a trend that was comparable, or was even better, than those of human-generated structures. Additional multicentre evaluations should be performed for adequate validation before the model can be completely applied in clinical practice.

PMID:33665160 | PMC:PMC7921705 | DOI:10.3389/fonc.2020.581347

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):237-244. doi: 10.1016/j.jobcr.2021.02.004. Epub 2021 Feb 12.

ABSTRACT

OBJECTIVE: To address the clinical question whether microsurgery hold an advantage in terms of clinical and patient oriented outcome over conventional macrosurgical procedures in the treatment of gingival recession.

MATERIAL AND METHODS: A Literature search on MEDLINE, SCOPUS, EMBASE (Excerpta Medica Database) via Ovid and Cochrane library was conducted in order to investigate clinical studies on efficacy of microsurgery in the treatment of localized or multiple gingival recession as compared to conventional macrosurgical procedures. Publications before May 2020 and grey literature was searched without any language restrictions. Primary outcome considered was change in recession depth and mean root coverage. Whereas, change in clinical attachment level, Change in keratinized tissue, patient oriented outcome like esthetics, pain and discomfort were the secondary outcome. Based on inclusion criteria ten studies were included in systematic review. Data was extracted and analyzed.

RESULTS AND CONCLUSION: All the included studies showed improvement in the mean percentage of root coverage or mean root coverage (primary outcome) when microsurgical approach was used. Predictability of complete root coverage is better with microsurgical instrumentation but results are not statistically significant. As far as patient centered outcome is concerned, there is no evidence for recommendation of microsurgery.

PMID:33665073 | PMC:PMC7903135 | DOI:10.1016/j.jobcr.2021.02.004

Integr Med Res. 2021 Sep;10(3):100685. doi: 10.1016/j.imr.2020.100685. Epub 2020 Oct 29.

ABSTRACT

BACKGROUND: Traditional medicine (TM) is widely used in South Korea and Taiwan, and both societies have similar systems for the management of TM. This study aimed to compare the TM systems in South Korea and Taiwan.

METHODS: We searched for studies on the TM systems and collected statistical data from the websites of relevant government agencies in both countries. Interviews were conducted with experts on TM and officials from government agencies. The two TM systems were described and examined in terms of policies, resources, utilization, licensing, and educational systems.

RESULTS: Both South Korea and Taiwan have a dual system that separates the administration, licensing and educational systems between TM and Western Medicine (WM), and the TM systems are well established and highly standardized. Comparing with South Korea, however, Taiwan has a more flexible dual medical system in which education courses for producing dual licensure are provided. Additionally, in the system in Taiwan, dual license holders can use both TM and WM methods without limitations and WM doctors can apply acupuncture under some circumstances. Because of the strict dual medical system in South Korea, TM and WM conflict with each other on most health issues.

CONCLUSION: Both South Korea and Taiwan have the advantages of preserving TM, as TM and WM are systemically independent and together provide a more holistic approach. The institutionalization of TM in South Korea and Taiwan may be a good reference for countries considering modernization of their TM.

PMID:33665088 | PMC:PMC7903058 | DOI:10.1016/j.imr.2020.100685

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):204-208. doi: 10.1016/j.jobcr.2021.01.013. Epub 2021 Jan 29.

ABSTRACT

INTRODUCTION: The present study evaluated a national social marketing campaign (SMC) conducted in 2008, with the ultimate aim of improving control of oral cancer in Sri Lanka. The approach was based on our published Risk Factor Model (RFM).

METHODS: Social marketing tools were developed to educate the public on the major risk factors for oral cancer. A cross-sectional community-based cluster survey was carried out in 2013 by interviewing 491 citizens >25 years of age to assess any improvements to the level of disease awareness in the community. Changes in the number of case presentations were obtained from registrations at Government Hospital Dental Clinics (GHDC) from the year 2008-2015.

RESULTS: A random sample of 491 members of the public was interviewed in 2013. Most (93%) were aware of oral cancer; but only 45.4% of oral potentially malignant disorders (OPMD). Statistically significant improvements were observed on awareness of oral cancer and OPMD and of the risk factors for oral cancer. A marked increase in the detection of oral leukoplakia and of oral cancer occurred in the GHDC surveillance system in the years 2012 and 2013, at the time the SMC campaign was implemented.

CONCLUSION: The improvement in public awareness of oral cancer and of its major risk factors, and the changed public behavior seen in the increased attendance at healthcare facilities for mouth examination, may be attributed, at least in part, to our SMC. Such Risk Factor-based approaches to social marketing are proposed for control of oral cancer.

PMID:33665068 | PMC:PMC7898001 | DOI:10.1016/j.jobcr.2021.01.013

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):215-218. doi: 10.1016/j.jobcr.2021.02.002. Epub 2021 Feb 9.

ABSTRACT

BACKGROUND AND AIM: The impact of oral health related disease and treatment on the patient’s overall well-being and functioning is a topic of growing interest in clinical research and practice. Research shows that there is a significant reduction in the quality of life for the patients throughout the treatment of head and neck cancer. Therefore, the aim of the study is to assess the quality of life among treated head and neck cancer patients.

MATERIALS AND METHOD: The cross sectional study was conducted among 225 head and neck cancer patients. The European Organization for Research and Treatment of Cancer (EORTC QLQ C-30), Quality Of Life Head and Neck35″ (QLQ-HN35) instruments were used to assess their quality of life. The study population was divided into three groups based on the treatment done: Group I (Surgery), Group II (Surgery and Radiotherapy) and Group III (Surgery, Radiotherapy and Chemotherapy). Independent t-test and one way ANOVA test were done to analyze the data.

RESULTS: Trouble with opening mouth (34.66 ​± ​30.58) was one of the highest rated symptoms among the study population. Salivary dysfunction leading to dry mouth (33.33 ​± ​34.06), sticky saliva (33.33 ​± ​26.72) were also found to be severe. Among the three groups, the Global Health Status, Symptom Scale mean scores were more high in Group I, Functional Scale and H&N35 symptoms mean scores was high in Group III however no statistical significance was observed (p ​> ​0.05).

CONCLUSION: Head and neck cancer has severe effects on the quality of life. As observed from the findings of the current study, Global Health Status indicated a healthy level of living among patients who have undergone surgery alone; head and neck symptoms were more severe and problematic among patients who had surgery and radiotherapy. Therefore, assessing health related quality of life can be a factor that is weighed against treatment burden, toxicity, survival benefit. It can be more integral to treatment planning, refining treatment protocols and a better post-operative care and support.

PMID:33665070 | PMC:PMC7900579 | DOI:10.1016/j.jobcr.2021.02.002

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):225-233. doi: 10.1016/j.jobcr.2021.01.016. Epub 2021 Feb 3.

ABSTRACT

OBJECTIVE: To compare the clinical and radiographic effectiveness of A PRF Plus as an adjuctive material to osseous bone graft in socket preservation and ridge augmentation.

METHODS: Twenty patients with need to preserve extraction socket in non-molar sites planning for further prosthetic rehabilitation were divided into two groups. Test Group (Group A) was treated with A PRF Plus membrane and Sybograf plus ™ (70% HA and 30 %β TCP) bone graft. The Control Group (Group B) was treated with Sybograf plus ™ (70% HA and 30% βTCP) bone graft. Both groups had same socket preservation surgical technique.

RESULTS: Both Group A and Group B showed significant improvement in clinical and radiographic parameters. Mean socket length, Vertical Resorption reduction in Group A was 1.48 whereas in Group B was 1.67 which is statistically significant. (p ​≤ ​0.05). Changes in Horizontal width reduction at 1,3, and 5 ​mm depth of the socket for both groups were not statistically significant. The Gain in socket fill for Group A and B 6 months postoperatively was 1185.30HU ± 473.21 and 966.60 HU ± 273.27 respectively. But intergroup comparison was not statistically significant. (p ​= ​0.17). There were no significant statistical differences in postoperative pain in Group A and Group B as subjects experienced moderate amount of pain. The assessment of post-operative swelling showed that only 30% subjects in Group A reported with swelling. Whereas 80% subjects in Group B complained of post-operative swelling.

CONCLUSION: The results of the present study proved utilisation of A PRF Plus as a promising adjunct to conventional regenerative therapy for socket preservation.

PMID:33665072 | PMC:PMC7900600 | DOI:10.1016/j.jobcr.2021.01.016

PeerJ. 2021 Feb 22;9:e10839. doi: 10.7717/peerj.10839. eCollection 2021.

ABSTRACT

BACKGROUND: Studies that focus on the relationships of problematic Internet use (PIU), sleep disorders, and behavioral/emotional problems were limited. This study aimed to explore (1) the relationship between PIU and behavioral/emotional problems among Chinese adolescents and (2) whether sleep disorders mediate the relationship between PIU and behavioral/emotional problems.

METHODS: A total of 1,976 adolescents were recruited by cluster sampling from ten secondary schools in Guangzhou between January and April 2019, and 1,956 of them provided valid information (response rate: 98.9% ). Among them, 50.8% were males and the mean age was 13.6±1.5 years, ranging from 11 to 18 years. Data on behavioral/emotional problems, sleep disorders, and PIU were collected using a self-reported questionnaire. Linear regression models and mediation analyses were performed.

RESULTS: Of the participants, 14.5% (284/1,956) reported moderate to severe PIU, and their average score for total difficulties was significantly higher than the score for average users (14.9±5.5 Vs 9.8±4.7). After adjusting for controlled variables, PIU was further proven to be positively related to elevated levels of behavioral/emotional problems (unstandardized β = 0.16, p < 0.05). In addition, sleep disorders partially mediated the forgoing associations.

CONCLUSIONS: Adolescents with problematic Internet habits were at higher risk of developing behavioral and emotional problems than their normal-use peers, and sleep disorders partially mediated the effect. Close attention and effective guidance for adolescents with PIU and behavioral/emotional problems were recommended for parents and schools.

PMID:33665021 | PMC:PMC7906038 | DOI:10.7717/peerj.10839