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Nevin Manimala Statistics

Equine-Assisted Therapies for Children With Cerebral Palsy: A Meta-analysis

Pediatrics. 2022 Jun 3:e2021055229. doi: 10.1542/peds.2021-055229. Online ahead of print.

ABSTRACT

CONTEXT: Equine-assisted therapy in different facets aims to improve the clinical condition of children with cerebral palsy. A more comprehensive overview on the overall effects and on the differences between different treatment modalities seems desirable.

OBJECTIVE: We compared the effectiveness of various equine-assisted treatments on motor capabilities and quality of life of children with cerebral palsy.

DATA SOURCES: We conducted systematic searches of PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials.

STUDY SELECTION: Randomized and nonrandomized controlled parallel-group or crossover studies on equine-assisted therapies in comparison with standard of care were included.

DATA EXTRACTION: Data on motor function assessed by different instruments were considered as the primary outcome. Secondary outcomes included global, social, physical, and emotional scores of quality of life.

RESULTS: Strong evidence for a positive effect of equine-assisted therapies, particularly hippotherapy, on global gross motor function and motor capabilities during walking in children with cerebral palsy was identified (SMD 0.24, 95% CI 0.05 to 0.43, P = .01, t2 = 0.00, I2 = 15%; SMD 2.68, 95% CI 1.02 to 4.34, P = .002, t2 = 0.0, I2 = 0%). No evidence for the improvement in quality of life could be shown in the global assessment, nor in any subscore.

CONCLUSIONS: Equine-assisted therapy, particularly hippotherapy, can be a therapeutic tool for children who are learning to walk.

LIMITATION: The heterogeneity of tools used in different studies and the low number of studies addressing quality of life issues limited the number of studies available for distinct analyses.

PMID:35656779 | DOI:10.1542/peds.2021-055229

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Nevin Manimala Statistics

Mechanical properties and metallurgical features of two similar endodontic rotary instruments with different heat treatments (FireWire™ and Gold)

Sci Prog. 2022 Apr-Jun;105(2):368504221103763. doi: 10.1177/00368504221103763.

ABSTRACT

The aim of this study was to explain the mechanical differences between EdgeTaper Platinum (ETP) and ProTaper Gold (PTG) determining the transition temperatures and the composition of the alloy of ETP, since no data are present in literature. A total of 130 instruments were selected: 65 ETP F2 and 65 PTG F2. 20 instruments per type were submitted to each mechanical tests. The cyclic fatigue and torsional tests were performed at a pre-set temperature of 35 °C ± 1 °C. During the cyclic fatigue test, Time to fracture, number of cycles to fracture (NCF) and the fragment length (FL) were recorded. During the static torsional, Torque to Fracture (TtF) and FL were recorded. The fracture surface of 5 randomly selected fragments from each test was examined through a Scanning Electron Microscopy (SEM) and an EDX analysis was performed. 20 instruments per type were submitted to a bending test The force generated (grams) to bend each was recorded. Recorded data of mechanical and metallurgical tests were statistically analyzed using a one-way analysis of variance (ANOVA) test with significance set to a 95% confidence level. ETP F2 showed a higher cyclic fatigue resistance and bending ability than PTG F2, with a statistically significant difference (p < 0.05). PTG showed a higher torsional resistance with a statistically significant difference (p < 0.05). DSC analysis of 5 samples for each instrument type pointed out that the austenite finish temperature of PTG was higher than the ETP, respectively of 49.99 ± 3.31 (°C) and 38.92 ± 1.75 (°C). EDX analysis confirmed the near-equiatomic composition of the Ni-Ti alloys, with a presence of a third component recognized as rubidium in the ETP samples. ETP showed higher flexibility in comparison with PTG, despite the latter is characterized by a more martensitic characterization. since its Af temperature is higher than the ETP.

PMID:35656775 | DOI:10.1177/00368504221103763

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Nevin Manimala Statistics

Identifying Migraine Phenotype Post Traumatic Headache (MPTH) to Guide Overall Recovery From Traumatic Brain Injury

J Child Neurol. 2022 Jun 3:8830738221100327. doi: 10.1177/08830738221100327. Online ahead of print.

ABSTRACT

Objective: The primary aim of this study is to develop an easy way to identify migraine phenotype posttraumatic headache (MPTH) in children with traumatic brain injury, to treat headache in traumatic brain injury effectively, and to promote faster recovery from traumatic brain injury symptoms overall. Methods: We evaluated youth aged 7-20 years in a pediatric neurology traumatic brain injury (TBI) clinic, assigning a migraine phenotype for post-traumatic headache (MPTH) at the initial visit with the 3-item ID Migraine Screener. We stratified the sample by early (≤6 weeks) and late (>6 weeks) presenters, using days to recovery from concussion symptoms as the primary outcome variable. Results: 397 youth were assessed; 54% were female. Median age was 15.1 years (range 7.0-20.4 years), and 34% of the sample had sports-related injuries. Migraine phenotype for posttraumatic headache (MPTH) was assigned to 56.1% of those seen within 6 weeks of traumatic brain injury and 50.7% of those seen after the 6-week mark. Irrespective of whether they were early or late presenters to our clinic, patients with migraine phenotype (MPTH) took longer to recover from traumatic brain injury than those with posttraumatic headache (PTH) alone. Log rank test indicated that the survival (ie, recovery) distributions between those with migraine phenotype posttraumatic headache (MPTH) and those with posttraumatic headache (PTH) were statistically different, χ2(3) = 50.186 (P < .001). Conclusions: Early identification of migraine phenotype posttraumatic headache (MPTH) following concussion can help guide more effective treatment of headache in traumatic brain injury and provide a road map for the trajectory of recovery from traumatic brain injury symptoms. It will also help us understand better the mechanisms that underlie conversion to persistent posttraumatic headache and chronic migraine after traumatic brain injury.

PMID:35656769 | DOI:10.1177/08830738221100327

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Nevin Manimala Statistics

Effectiveness of telehealth interventions among traumatic brain injury survivors: A systematic review and meta-analysis

J Telemed Telecare. 2022 Jun 3:1357633X221102264. doi: 10.1177/1357633X221102264. Online ahead of print.

ABSTRACT

INTRODUCTION: Traumatic brain injury (TBI) represents a major cause of death and disability worldwide. Brain damage is associated with physical and psychological difficulties among TBI survivors. Diverse face-to-face and telehealth programs exist to help survivors cope with these burdens. However, the effectiveness of telehealth interventions among TBI survivors remains inconclusive.

METHODS: A systematic review and meta-analysis of randomized control trials were conducted. Relevant full-text articles were retrieved from seven databases, from database inception to January 2022, including Academic Search Complete, CINAHL, EMBASE, Cochrane, MEDLINE, PubMed, and Web of Science. Bias was assessed with the revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis was performed using a random-effects model to calculate the pooled effect size of telehealth interventions for TBI survivors. STATA 16.0 was used for statistical analysis.

RESULTS: In total, 17 studies (N = 3158) applying telehealth interventions among TBI survivors were included in the analysis. Telehealth interventions decreased neurobehavioural symptom (standardized mean difference: -0.13; 95% confidence interval [CI]: -0.36 to 0.10), reduce depression (standardized mean difference: -0.32; 95% CI: -0.79 to 0.14), and increase symptom management self-efficacy (standardized mean difference: 0.22; 95% CI: 0.02-0.42).

DISCUSSION: Telehealth interventions are promising avenues for healthcare delivery due to advances in technology and information. Telehealth programs may represent windows of opportunity, combining traditional treatment with rehabilitation to increase symptom management self-efficacy among TBI patients during recovery. Future telehealth programs can focus on developing the contents of telehealth modules based on evidence from this study.

PMID:35656767 | DOI:10.1177/1357633X221102264

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Nevin Manimala Statistics

Parents’ and Therapists’ Satisfaction with Four Early Childhood Power Mobility Devices

Can J Occup Ther. 2022 Jun 3:84174221098879. doi: 10.1177/00084174221098879. Online ahead of print.

ABSTRACT

Background. Little is known about satisfaction with power mobility devices used by young children. Purpose. Parents’ and therapists’ satisfaction with four early childhood power mobility devices were examined. Method. A two-phased study, comprising Trial Phase cross-sectional design and Loan Phase one-group pretest-posttest design. Parents and therapists of children 9 months to 6 years with mobility limitations completed the Quebec User Evaluation of Satisfaction of Assistive Technology 2.0 Device Subscale (QUEST8) plus an additional device Aesthetics rating. Findings. Seventy-four parents and 42 therapists from 18 child development and rehabilitation centres participated. Parent and therapist median QUEST8 and Aesthetics scores varied across devices when trialled and over the six-month loan. Favourable median ratings had no statistically significant differences between parents and therapists. Parent ratings decreased statistically over loan period although therapists’ ratings did not. Device dimensions, safety, and aesthetics were highly rated. Implications. Similarities and differences exist among parent and therapist ratings.

PMID:35656731 | DOI:10.1177/00084174221098879

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Quality of life after extra corporeal life support therapy

Perfusion. 2022 Jun 3:2676591221106148. doi: 10.1177/02676591221106148. Online ahead of print.

ABSTRACT

BACKGROUND: Extra Corporeal Life Support (ECLS) may be a life-saving treatment for patients with reversible cardiac and/or respiratory failure. ECLS is associated with a high risk of complications and mortality. Because only a small number of studies have been conducted into the long-term effects of ECLS, we investigated the difference in quality of life, anxiety and depressive complaints and PTSD 3 months after ICU discharge.

METHOD: It is a retrospective case-control study covering the period January 2012 to December 2017. The ECLS patient group was compared to a matched similar patient group in the Intensive Care (IC) that did not have ECLS therapy. Quality of life was measured with the Short-Form-36 (SF-36) questionnaire, anxiety and depression was measured with the Hospital Anxiety and Depression Scale (HADS) questionnaire and for PTSD the Impact of Events Scale (IES) questionnaire was used, comparing sum scores and cut-off points of scores from both groups.

RESULTS: Included were 19 patients in the ECLS group and 38 in the control group. The mean sum scores on the sub scales of the SF36 questionnaire were the same for both groups. Only the mean score of 66.2 (scale 0-100) on the domain ‘general health experience’ was statistically significantly different in the ECLS group than in the control group (56.8, p = .02). There was no significant difference between the sum scores of both groups on anxiety and depressive complaints. In the ECLS group 32% of the patients may have a depressive disorder versus 18% from the control group (p = .32). And 26% of the patients from the ECLS group may have an anxiety disorder versus 7% from the control group (p = .51). The incidence of PTSD was 42% in the ECLS group and 24% in the control group (p = .22).

CONCLUSION: We found no statistically significant difference in quality of life, anxiety and depressive symptoms and PTSD symptoms between ECLS patients and the matched control group – 3 months after the ICU discharge. The incidence of anxiety and depressive symptoms and PTSD in the ECLS group is higher than in the control group, however, this difference is not significant.

PMID:35656759 | DOI:10.1177/02676591221106148

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Nevin Manimala Statistics

Substitution voicing index: towards improved speech assessment in patients who have undergone laryngeal oncosurgery

Clin Linguist Phon. 2022 Jun 3:1-16. doi: 10.1080/02699206.2022.2059398. Online ahead of print.

ABSTRACT

This study aimed to develop a multidimensional model for the evaluation of substitution voicing (SV) after laryngeal oncosurgery. The study group consisted of 121 adult male individuals: 59 patients with SV after laryngeal oncosurgery (endolaryngeal cordectomy, partial laryngectomy, total laryngectomy with tracheoesophageal prosthesis) and 62 healthy controls. A multidimensional protocol for the assessment of SV included, 1) self-reported speech evaluation with a short version of the Speech Handicap Index, 2) auditory-perceptual assessment, and 3) acoustic speech analysis using AMPEX® (Auditory Model Based Pitch Extractor) software. Moderate correlations were observed between parameters from self-reported auditory-perceptual and acoustic speech analysis domains. The multidimensional Substitution Voicing Index (SVI), including markers from these domains, was elaborated by using linear stepwise regression to determine the optimal set of parameters for categorising SV patients. The lowest mean SVI score was revealed in the control subgroup corresponding to the normal speech, followed by cordectomy subgroup and partial laryngectomy subgroup. The highest mean SVI score was revealed in the total laryngectomy subgroup, reflecting the most severely deteriorated quality of SV. One-way analysis of variance identified statistically significant differences between the mean SVI scores in separate subgroups. The results demonstrated the potential benefits of the SVI for a multidimensional evaluation of SV in patients after laryngeal oncosurgery.

PMID:35656723 | DOI:10.1080/02699206.2022.2059398

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Clustered Mendelian randomization analyses identify distinct and opposing pathways in the association between genetically influenced insulin-like growth factor-1 and type 2 diabetes mellitus

Int J Epidemiol. 2022 Jun 3:dyac119. doi: 10.1093/ije/dyac119. Online ahead of print.

ABSTRACT

BACKGROUND: There is inconsistent evidence for the causal role of serum insulin-like growth factor-1 (IGF-1) concentration in the pathogenesis of human age-related diseases such as type 2 diabetes (T2D). Here, we investigated the association between IGF-1 and T2D using (clustered) Mendelian randomization (MR) analyses in the UK Biobank.

METHODS: We conducted Cox proportional hazard analyses in 451 232 European-ancestry individuals of the UK Biobank (55.3% women, mean age at recruitment 56.6 years), among which 13 247 individuals developed type 2 diabetes during up to 12 years of follow-up. In addition, we conducted two-sample MR analyses based on independent single nucleotide polymorphisms (SNPs) associated with IGF-1. Given the heterogeneity between the MR effect estimates of individual instruments (P-value for Q statistic = 4.03e-145), we also conducted clustered MR analyses. Biological pathway analyses of the identified clusters were performed by over-representation analyses.

RESULTS: In the Cox proportional hazard models, with IGF-1 concentrations stratified in quintiles, we observed that participants in the lowest quintile had the highest relative risk of type 2 diabetes [hazard ratio (HR): 1.31; 95% CI: 1.23-1.39). In contrast, in the two-sample MR analyses, higher genetically influenced IGF-1 was associated with a higher risk of type 2 diabetes. Based on the heterogeneous distribution of MR effect estimates of individual instruments, six clusters of genetically determined IGF-1 associated either with a lower or a higher risk of type 2 diabetes were identified. The main clusters in which a higher IGF-1 was associated with a lower risk of type 2 diabetes consisted of instruments mapping to genes in the growth hormone signalling pathway, whereas the main clusters in which a higher IGF-1 was associated with a higher risk of type 2 diabetes consisted of instruments mapping to genes in pathways related to amino acid metabolism and genomic integrity.

CONCLUSIONS: The IGF-1-associated SNPs used as genetic instruments in MR analyses showed a heterogeneous distribution of MR effect estimates on the risk of type 2 diabetes. This was likely explained by differences in the underlying molecular pathways that increase IGF-1 concentration and differentially mediate the effects of IGF-1 on type 2 diabetes.

PMID:35656699 | DOI:10.1093/ije/dyac119

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Nevin Manimala Statistics

Effect of Glide Path and Coronal Flaring on the Centering Ability and Transportation of Root Canals: Micro-CT In Vitro Study

J Contemp Dent Pract. 2021 Dec 1;22(12):1471-1476.

ABSTRACT

AIM: To compare the effect of glide path and coronal flaring on the centering ability and transportation in curved canals prepared by different NiTi instruments using micro-CT.

MATERIALS AND METHODS: The mesiobuccal canal of 48 extracted mandibular molars was selected and divided into two groups of 24 each according to the type of instrument used, either Race Evo or EdgeSequel. Each group was further divided into three subgroups: Group I: without glide path and coronal flaring (control); Group II: with glide path and without coronal flaring; Group III: with glide path and coronal flaring. Following access opening and working length determination, coronal flaring and glide path were done in the required groups. The canals were then prepared according to the assigned instruments and assessed using micro-CT at 3, 5, and 7 mm of the root canal. Data of pre- and postoperative measurements were statistically analyzed using SPSS.

RESULTS: The mean value of centering ability was 0.39 (SD 0.36) while the mean value of transportation ability was 0.002 (SD 0.153). Transportation and centering ability did not vary significantly among the tested groups of rotary instruments. Comparison of centering and transportation among root canal instrumentation groups at 3, 5, and 7 mm showed no statistical significance (p >0.05).

CONCLUSION: No significant difference was found among the tested groups regarding transportation and centering ability.

CLINICAL SIGNIFICANCE: This study provided data on the effect of glide path and coronal flaring on the centering ability and transportation on curved canals prepared by Race Evo and EdgeSequel. Coronal flaring and glide path did not affect the centering ability and transportation.

PMID:35656689

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Nevin Manimala Statistics

Clinical Performance and Parental Satisfaction with Composite Strip Crown and Prefabricated Zirconia Crown for Primary Anterior Teeth: A Randomized Clinical Trial

J Contemp Dent Pract. 2021 Dec 1;22(12):1462-1470.

ABSTRACT

AIM: To compare clinical performance and parental satisfaction with composite strip crown and prefabricated zirconia crown for primary anterior teeth.

MATERIALS AND METHODS: The study compares clinical evaluation and parental satisfaction of two different crowns for primary anterior teeth. A total of 102 teeth in each group selected between ages 3 and 6 years, who met the inclusion criteria, were randomly allocated into two groups for further evaluation. Group A for strip crowns (55 teeth) and group B for zirconia crowns (47 teeth). The crowns were evaluated clinically with various criteria like-color match, crown retention, gingival health, crown contour, opposing tooth wear, marginal integrity, and recurrent caries. The samples were also evaluated for parental satisfaction based on 5-point Likert scale and child liking was also recorded with Smiley face Likert scale at baseline, 3 and 9 months. Statistical analysis was done using Chi-square test (p <0.05).

RESULTS: Zirconia crowns showed better color match, crown retention, crown contour, and gingival health. Strip crowns showed more discoloration and chipping of material over a period of time. None of the samples showed opposing tooth wear, open margins, and recurrent caries in strip and zirconia crown group. Parents and children both were highly satisfied with zirconia crowns.

CONCLUSION: Clinically zirconia crowns showed higher success rate as compared to strip crowns and parental overall satisfaction was higher for zirconia crowns.

CLINICAL SIGNIFICANCE: Zirconia crowns exhibited a higher clinical performance and parental satisfaction; hence, if affordability is out weighted, zirconia crown stands better with esthetics of the child.

PMID:35656688