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Nevin Manimala Statistics

Comparison of mechanical and optical properties of a newly marketed universal composite resin with contemporary universal composite resins: An in vitro study

Microsc Res Tech. 2021 Nov 12. doi: 10.1002/jemt.23985. Online ahead of print.

ABSTRACT

The purpose of this study was to evaluate the surface roughness, microhardness, color change, and translucency of a newly marketed universal nanohybrid composite resin (CR) (G-aenial A’CHORD) comparing with four contemporary universal CRs including two nanofilled (Filtek and Estelite Asteria) and two nanohybrid CRs (Charisma Dimond and Neo Spectra ST HV in vitro). Sixty-five specimens (8.0 mm × 2.0 mm) were fabricated (n = 13, per group). After finishing and polishing, specimens were subjected to surface roughness and microhardness tests. Color and translucency of the specimens were evaluated at baseline and after darkening with coffee solution at day 1 and day 7. A representative specimen from each group was investigated under scanning electron microscopy (SEM). Data was analyzed statistically (p < .05). There were significant differences among the groups in terms of surface roughness, microhardness, color, and translucency. The surface roughness was recorded as: Charisma Diamond > Neo Spectra ST HV, Filtek > Estelite Asteria, G-aenial A’CHORD, whereas Vickers Hardness number was as: Filtek, Charisma Diamond > Neo Spectra ST HV > G-aenial A’CHORD, Estelite Asteria. Color change was as: Charisma Diamond > Neo Spectra ST HV, Filtek, G-aenial A’CHORD > Estelite Asteria and the translucency was as: Neo Spectra ST HV > G-aenial A’CHORD, Filtek > Estelite Asteria, Charisma Diamond. SEM examinations revealed smooth surfaces for G-aenial A’CHORD, Neo Spectra ST HV and Estelite Asteria. Mechanical and optical properties of universal composite resins with different compositions show variations.

PMID:34766666 | DOI:10.1002/jemt.23985

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SARS-CoV-2 AY.4.2 variant circulating in Italy: genomic preliminary insight

J Med Virol. 2021 Nov 12. doi: 10.1002/jmv.27451. Online ahead of print.

ABSTRACT

The appearance of emerging variants of SARS-CoV-2 carrying mutations into the spike protein has recently raised concern with respect to tracking their transmission and mitigating the impact in the evolving pandemic across countries. AY.4.2, a recently detected Delta variant sub-lineage, is considered a new variant under investigation (VUI) since it carries specific genetic signatures present in the spike protein, called Y145H and A222V. Here using genomic epidemiology we provide the first preliminary insight regarding the circulation of this emerging VUI in Italy. This article is protected by copyright. All rights reserved.

PMID:34766651 | DOI:10.1002/jmv.27451

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Re-Analysis of the STEADY-PD II Trial-Evidence for Slowing the Progression of Parkinson’s Disease

Mov Disord. 2021 Nov 12. doi: 10.1002/mds.28850. Online ahead of print.

ABSTRACT

BACKGROUND: Recent examination of the STEADY-PD III isradipine clinical trial data concluded that early-stage Parkinson’s disease (PD) participants who had longer exposure to isradipine had a significant delay in their need for symptomatic medication, as well as a lower medication burden at the end of the trial. These findings suggest that greater exposure to isradipine might slow disease progression.

OBJECTIVES: To test this hypothesis, the data from the STEADY-PD II isradipine clinical trial, in which an extended-release (ER) formulation of the drug was used, was re-examined.

METHODS: The re-analysis of the STEADY-PD II data was restricted to participants assigned placebo or tolerable isradipine treatment (10 mg isradipine/day or less). The effect of isradipine treatment was assessed by Unified Parkinson’s Disease Rating Scale (UPDRS) at the end of the 52-week trial, rather than by last observation carried forward at the beginning of symptomatic therapy.

RESULTS: Participant cohorts were well-matched for baseline disability, initial disease progression, and time to initiation of symptomatic therapy. Participants given 10 mg/day ER isradipine had significantly smaller total and part 3 UPDRS scores at the end of the trial than did the placebo cohort. Post hoc adjustment for symptomatic therapy diminished the statistical significance of these differences. In those participants not taking a monoamine oxidase B inhibitor, the progression in UPDRS scores also was significantly reduced.

CONCLUSIONS: These results are consistent with the recent secondary analysis of the STEADY-PD III clinical trial-suggesting that clinically attainable brain exposure to isradipine may slow early-stage PD progression. © 2021 International Parkinson and Movement Disorder Society.

PMID:34766657 | DOI:10.1002/mds.28850

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The efficacy of 5 rehabilitation treatments after anterior cruciate ligament reconstruction: A network meta-analysis

Medicine (Baltimore). 2021 Nov 12;100(45):e27835. doi: 10.1097/MD.0000000000027835.

ABSTRACT

BACKGROUND: The efficacy of traditional rehabilitation, proprioceptive training, and neuromuscular training after anterior cruciate ligament (ACL) reconstruction is also controversial. In order to help medical staff better choose the rehabilitation treatment plan after ACL reconstruction, we conducted this network meta-analysis.

METHODS: Chinese and English databases such as Wanfang, Weipu, China Zhiwang, and PubMed, Cochrane Library, Embase were retrieved. We collected clinical controlled trial papers on traditional rehabilitation therapy, proprioceptive training and neuromuscular training after ACL reconstruction for meta-analysis.

RESULTS: In this meta-analysis, 12 studies were included, including 486 patients who received rehabilitation treatment after ACL reconstruction. Based on network meta-analysis, it was found that 4 groups of direct comparison and 6 groups of indirect comparison were formed for 5 rehabilitation treatment schemes after ACL reconstruction. The curative effect of traditional rehabilitation training combined with proprioception training is better than that of traditional rehabilitation training (mean difference value of traditional rehabilitation training combined with proprioception training vs traditional rehabilitation training was 8.00, 95% confidence interval: 2.61,13.39). The efficacy of proprioceptive training is better than that of traditional rehabilitation training (mean difference value of proprioceptive training vs traditional rehabilitation training is 11.01, 95% confidence interval: 0.62,21.39). There was no statistical significance between the other rehabilitation trainings. According to the surface under cumulative ranking curve, the therapeutic effects of the 5 rehabilitation treatment programs after ACL reconstruction were ranked as follows: proprioceptive training (72%) > traditional rehabilitation training combined with neuromuscular training (70.8%) > traditional rehabilitation training combined with proprioception training (57.1%) > neuromuscular training (45.5%) > traditional rehabilitation training (4.6%). No publication bias was found in the funnel plot.

CONCLUSION: Combined with the results of meta-analysis and surface under cumulative ranking efficacy sequence diagram, it can be seen that traditional rehabilitation training combined with proprioceptive training and traditional rehabilitation training combined with neuromuscular training have significant efficacy. Due to the limitations of this study, the conclusions of this network meta-analysis still need to be further confirmed by a large sample size and well-designed randomized controlled trials.

PMID:34766600 | DOI:10.1097/MD.0000000000027835

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Analysis of long-term antibody response in COVID-19 patients by symptoms grade, gender, age, BMI, and medication

J Med Virol. 2021 Nov 12. doi: 10.1002/jmv.27452. Online ahead of print.

ABSTRACT

The first aim of the study was to analyze the change in antibody titer at 15-day intervals until 60 days post symptom onset (PSO) The second aim was to analyze relationship between antibody titer and symptom grade, gender, age, BMI, medications, vitamin supplements, and herbal therapies. Blood samples were collected from 43 patients (5 mild, 21 moderate, 17 severe diseases), 18 women (41.9 %), and 25 men (58.1 %), on 15, 30, 45, and 60 days PSO after COVID-19 infection. The serum antibody titers were determined by measuring the COVID-19 IgG antibodies by ELISA. Associations between the duration of symptoms, demographic and clinical parameters, medications and vitamins used, and herbal therapies were evaluated by interviewing the participants. Within the first 15 days of illness, 81.4% of the patients were positive. From day 45 PSO, seropositivity was 89.5%. The anti-SARS-CoV-2 antibody titers were statistically higher in men than women at all-time (p<0.01). Antibody titer was higher in older participants compared to younger participants (p<0.02). Plaquenil or Favipiravir use did not effect antibody response (p>0.05). Men had higher fever (p=0.006), shortness of breath (p=0.004), and chest pain (p=0.03) than women. We found powerful antibody response by sixty days PSO, as well as higher antibody response and severity of symptoms in men gender. Data also showed that SARS-CoV-2 antibodies are higher in individuals with older age, whereas BMI, concomitant chronic disease, and medications had no effect on antibody titers. This article is protected by copyright. All rights reserved.

PMID:34766646 | DOI:10.1002/jmv.27452

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In vivo effectiveness of visual inspection and laser fluorescence in the diagnosis of early pit-and-fissure carious lesions: A cross-sectional study in a group of Romanian children

Medicine (Baltimore). 2021 Nov 12;100(45):e27811. doi: 10.1097/MD.0000000000027811.

ABSTRACT

General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. The evaluation of 237 occlusal surfaces and caries risk assessment were performed in 96 children aged 7 to 15 years. The presence of pit-and-fissure noncavitated lesions was recorded using ICDAS-II scoring system and laser fluorescence. Statistical analysis was performed using McNemar test, with a level of significance of P < .05. The caries risk was measured for all participants. In 109 occlusal surfaces both methods identified enamel changes (46%) and in 62 cases both methods excluded the carious lesion (26.2%). The statistical analysis showed a significant moderate agreement between ICDAS-II code and DiagnoDent pen measurements (McNemar chi-squared statistic 9.5, P = .002 and Cohen kappa coefficient = 0.427). The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.

PMID:34766591 | DOI:10.1097/MD.0000000000027811

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Pooled analysis of the efficacy and safety of tibial nerve stimulation versus antimuscarinic agents in the management of overactive bladder syndrome

Medicine (Baltimore). 2021 Nov 12;100(45):e27745. doi: 10.1097/MD.0000000000027745.

ABSTRACT

OBJECTIVES: The purpose of this meta-analysis was to evaluate the efficacy and safety of tibial nerve stimulation (TNS) versus antimuscarinic agents in the management of overactive bladder (OAB) syndrome.

METHODS: The databases MEDLINE, EMBASE, the Cochrane Controlled Trial Register of Controlled Trials from 2000 to May 2021 were searched to identify randomized controlled trials that referred to the use of TNS and antimuscarinic agents for the treatment of OAB syndrome. A systematic review and meta-analysis was conducted.

RESULTS: Eight publications involving 420 patients were included in the meta-analysis. In the analysis, we found TNS had a comparable effect with antimuscarinic agents on micturition per day, nocturia, urge incontinence, and voided volume (P = .9; .4; .78; .44, respectively). Scores measured by questionnaires Overactive Bladder Symptom Score and Overactive Bladder questionnaire Short Form items also indicated no statistical difference between 2 groups. TNS group had a significantly less discontinuation rate and adverse events (P = .003; .0001).

CONCLUSIONS: TNS is as effective as antimuscarinic agents for the treatment of OAB. Moreover, TNS appears to be more tolerable and safer than antimuscarinic agents.

PMID:34766587 | DOI:10.1097/MD.0000000000027745

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Comparison of rehabilitation outcomes for transcatheter versus surgical aortic valve replacement as redo procedure in patients with previous cardiac surgery: Evidence based on 11 observational studies

Medicine (Baltimore). 2021 Nov 12;100(45):e27657. doi: 10.1097/MD.0000000000027657.

ABSTRACT

BACKGROUND: Currently, the number of severe aortic stenosis (AS) patients with a history of prior cardiac surgery (PCS) has increased. Both transcatheter aortic valve replacement (TAVR) and traditional surgical aortic valve replacement (sAVR) are effective therapy for AS. However, PCS increases the risk of adverse outcomes in patients undergoing aortic valve replacement. Thus, this meta-analysis was designed to comparatively evaluate the impact of PCS on clinical outcomes between TAVR and sAVR.

METHODS: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science up to February 1, 2021 was conducted for relevant studies that comparing TAVR and sAVR for severe AS patients with a history of PCS. The primary outcome was the non-inferiority of TAVR and sAVR in mortality. The secondary outcomes were the other clinical outcomes. Two reviewers assessed trial quality and extracted the data independently. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2.

RESULTS: A total of 11 studies including 8852 patients were identified. The pooled results indicated that there was no difference in 30-day, and 1-year all-cause mortality between TAVR and sAVR. No significant difference was also observed in total follow-up and cardiovascular mortality between TAVR and sAVR. However, subgroup analysis revealed significantly higher 1-year all-cause mortality (OR 1.92; 95% CI 1.05-3.52; P = .04) and total follow-up mortality (OR 2.28; 95% CI 1.09-4.77; P = .03) in TAVR than sAVR for patients with a history of coronary artery bypass graft, aortic valve replacement, and mitral valve reconstruction. In addition, TAVR experienced higher pacemaker implantation than sAVR. However, compared with sAVR, TAVR experienced shorter length of stay (MD -3.18 days; 95% CI -4.78 to -1.57 days) and procedural time (MD -172.01 minutes; 95% CI -251.15 to -92.88) respectively. TAVR also lead to much less bleeding than sAVR.

CONCLUSIONS: Our analysis shows that TAVR as a redo procedure was equal to sAVR in mortality for severe AS patients with PCS, especially coronary artery bypass graft. We agree the advantage of TAVR as a redo procedure for patients with a history of PCS. Patients receiving TAVR experienced rapid recovery, shorter operation time and less bleeding, without increasing short and long term mortality.

PMID:34766568 | DOI:10.1097/MD.0000000000027657

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East Asian herbal medicine for cancer pain: A protocol for systematic review and meta-analysis with using association rule analysis to identify core herb pattern

Medicine (Baltimore). 2021 Nov 12;100(45):e27699. doi: 10.1097/MD.0000000000027699.

ABSTRACT

BACKGROUND: Cancer pain is an important factor in cancer management that affects a patient’s quality of life and survival-related outcomes. The aim of this review is to systematically evaluate the efficacy and safety of oral administration East Asian herbal medicine (EAHM) for primary cancer pain, and to explore core herb patterns based on collected data.

METHODS: A comprehensive literature search will be conducted in 10 electronic databases including PubMed, Cochrane Library, Cumulative Index to Nursing & Allied Health Literature, EMBASE, Korean Studies Information Service System, Research Information Service System Oriental Medicine Advanced Searching Integrated System, Korea Citation Index, Chinese National Knowledge Infrastructure Database (CNKI), CiNii for randomized controlled trials from their inception until August 19, 2021. Statistical analysis will be performed in the software R version 4.1.1. and R studio program using the default settings of the ‘meta’ package. When heterogeneity in studies is detected, the cause will be identified through meta regression and subgroup analysis. Methodological quality will be assessed independently using the revised tool for risk of bias in randomized trials (Rob 2.0).

RESULTS: This study will provide more comprehensive and specific evidence of EAHM for cancer pain management.

CONCLUSIONS: Based on the results of this review, it is expected that the efficacy and safety of East Asian herbal medicine for cancer pain may be confirmed. In addition, it will be possible to derivation of a core herb pattern related to this research topic through additional association rule mining analysis.

PMID:34766572 | DOI:10.1097/MD.0000000000027699

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Prevalence and health outcomes in community-dwelling older adults with comorbid cancer and dementia: a longitudinal analysis

Aging Ment Health. 2021 Nov 12:1-9. doi: 10.1080/13607863.2021.2003298. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine health outcomes in community-dwelling older adults with: dementia only, cancer only, and comorbid cancer and dementia.

METHODS: Longitudinal analysis was conducted using data from 2010 to 2016 waves of the Health and Retirement Study. Health outcomes included mortality, limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), nursing home utilization, hospital stay, homecare use, self-rated health, and out-of-pocket medical expenditure. Panel regression was used for statistical analysis.

RESULTS: The prevalence of comorbid cancer and dementia ranged from 2.56% to 2.97%. Individuals with comorbid cancer and dementia demonstrated a higher likelihood of nursing home utilization and poorer self-rated health but a lower likelihood of hospital stay, homecare use, and out-of-pocket expenditures, compared to the cancer only or dementia only groups. The differences in mortality and ADL and IADL limitations were not statistically significant.

CONCLUSION: Comorbid cancer and dementia predicted longer nursing home utilization and poorer self-rated health. The results help guide care planning for individuals with comorbid cancer and dementia.

PMID:34766530 | DOI:10.1080/13607863.2021.2003298