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Nevin Manimala Statistics

Surface characteristics and adhesion of veneering composite resin to PAEK based substructure restorative materials

J Prosthodont. 2022 Mar 27. doi: 10.1111/jopr.13511. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ) and nickel-chromium alloy (NiCr) substructure restorative materials.

MATERIALS AND METHODS: Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness (VHN) was evaluated before preparing the surface for bonding by shot-blasting using 110 μm Al2 O3 particles. The surface roughness (Ra) of each sample was determined using a non-contact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following de-bonding were assessed. The data were statistically analysed using ANOVA and Tukey’s post-hoc comparison test (p < 0.05). RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13μm) and NiCr (1.87 ±0.07 μm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01).

CONCLUSIONS: PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness. This article is protected by copyright. All rights reserved.

PMID:35340086 | DOI:10.1111/jopr.13511

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Nevin Manimala Statistics

Are there disparities in access to robot-assisted laparoscopic surgery among pediatric urology patients? US institutional experience

Int J Urol. 2022 Mar 26. doi: 10.1111/iju.14866. Online ahead of print.

ABSTRACT

OBJECTIVE: Literature suggests access to robotic surgery varies by race and payer status. We seek to investigate whether disparities exist in robot-assisted laparoscopic surgery among the pediatric urology population at our tertiary academic medical center and, if so, to find plausible reasons why.

METHODS: Retrospective analysis identified patients who underwent open or robot-assisted laparoscopic surgery by a single surgeon at a tertiary care center between 2008 and 2019. Univariate and multivariate analyses determined the relationship of patient demographic and socioeconomic factors to procedure approach.

RESULTS: Among 356 patients, race, age, American Society of Anesthesiologists status, and year of surgery were significant by univariate analysis. Insurance status was not significant (P = 0.066). Multivariate analysis indicated that age, American Society of Anesthesiologists status, and year of surgery were statistically significant (P < 0.001, P = 0.005, P < 0.001). By multivariate logistic regression, Black and Hispanic patient race were not significant with an odds ratio of 0.60 (0.35-1.02) (P = 0.061). In 60.2% of open cases, open approach selection was attributable to complex pathology, limitations of robotic approach, and surgeon’s robot-assisted laparoscopic learning curve.

CONCLUSIONS: Optimal procedure approach was determined by case complexity and surgeon’s robot-assisted laparoscopic learning curve and was independent of patient race and payer status. This study did not find racial or socioeconomic disparities in robotic surgery within pediatric urology at our tertiary medical center, inconsistent with previous literature.

PMID:35340066 | DOI:10.1111/iju.14866

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Nevin Manimala Statistics

DNA image cytometry parameters to identify high-grade cervical lesions

Cytopathology. 2022 Mar 27. doi: 10.1111/cyt.13121. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the performance of different DNA image cytometry (DNA-ICM) ploidy parameters to categorize a DNA-ICM result, and consequently identify high-grade cervical intraepithelial neoplasia or worse (≥CIN2).

METHODS: Cervical samples from 232 women were collected for DNA-ICM analysis and biopsy confirmation. Five DNA parameters were used to define DNA aneuploidy: number of cells with exceeding events (EE) over 2.5cEE, 4cEE, 5cEE, 9cEE, and aneuploid stemlines. DNA-ICM results were categorized as normal, suspicious, and abnormal.

RESULTS: For individual DNA ploidy parameters, sensitivity for 50 cells with 2.5cEE, 45 cells with 4cEE, 1 cell with 9cEE and aneuploid stemline were 72.95%. 54.1%, 69.67% and 54.1%, while specificity were 80.0%, 90.0%, 89.09% and 95.45%, respectively. For 5cEE parameter, sensitivity for 1, 2, 3, 4 and 5 cells were 93.44%, 85.25%, 81.97%, 77.87% and 75.41%, while specificity were 46.36%, 63.64%, 74.55%, 76.36% and 80.91%, respectively. For categorized DNA-ICM results, a suspicious result revealed superior sensitivity to an abnormal result (87.70% vs 82.79%, P = 0.031), but inferior specificity (54.55% vs 75.45%, P <0.001). Both DNA-ICM results were statistically different from a normal result (P <0.05).

CONCLUSION: For prognostic purposes 1 cell with 9cEE, 45 cells with 4cEE and aneuploid stemline are the best parameters to categorize an abnormal DNA-ICM result, followed by 50 cells with 2.5cEE and 4 cells with 5cEE. For screening purposes, 10 cells with 2.5cEE, 10 cells with 4cEE, and 2 cells with 5cEE are suitable parameters to categorize a suspicious DNA-ICM result.

PMID:35340056 | DOI:10.1111/cyt.13121

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Nevin Manimala Statistics

Association between efficiency and quality of care of public healthcare facilities: Evidence from Pakistan

Int J Health Plann Manage. 2022 Mar 26. doi: 10.1002/hpm.3465. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal and child health is an important component of the Sustainable Development Goals. Pakistan has one of the worst maternal and neonatal health outcomes in the world. This is despite significant health system investments across the country.

AIMS: The objectives of this study are twofold. First, the study estimates the technical efficiency of the public healthcare facilities in Pakistan, defined as the number of obstetric deliveries compared to the number of medical specialists, nurses, and other health and non-health staff members. Second, the study evaluates the relationship between efficiency and quality of care; the latter is measured in terms of maternal and neonatal mortality.

MATERIALS & METHODS: The data were taken from the Pakistan Health Facility Assessment Survey. Efficiency score was calculated for 843 public healthcare facilities, using Stochastic Frontier Analysis. We then used two-stage residual inclusion approach with bootstrapping to evaluate the relationship between efficiency and quality.

RESULTS AND DISCUSSION: The average efficiency score was 0.48 (range: 0-1) and none of the public healthcare facilities were on the frontier, implying that efficiency gains can be made across the board. The relationship between efficiency and quality is found to be positive and statistically significant, that is, more efficient healthcare facilities also had lower rates of maternal and neonatal mortality.

CONCLUSION: We conclude that more efficient public healthcare facilities also had lower mortality rates, probably due to better infrastructure and health system financing.

PMID:35340046 | DOI:10.1002/hpm.3465

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Nevin Manimala Statistics

Topical steroid withdrawal through the lens of social media

Clin Exp Dermatol. 2022 Mar 26. doi: 10.1111/ced.15194. Online ahead of print.

ABSTRACT

BACKGROUND: The term topical steroid withdrawal (TSW) describes an adverse effect that generally occurs with inappropriate prolonged use of high-potency topical corticosteroids (TCS). The presence of user-generated content relating to TSW on social media has not been well-defined to date.

OBJECTIVE: We aimed to explore content relating to topical steroid withdrawal on social media.

METHODS: Using a data analytics platform, we retrospectively analysed the hashtag #topicalsteroidwithdrawal on social media over a 5 year period, from the 8th of February 2016 until the 8th of February 2021. We assessed: interactions, performance, shares, likes, mentions, language and country of origin using descriptive statistics.

RESULTS: Across all social media platforms there was a 274% increase in mentions of the hashtag #topicalsteroidwithdrawal in the year 2020(7992) compared with the year 2016(2138). Top associated hashtags included #TSW, #eczema, and #topicalsteroidaddiction. On Instagram, we found a 288% increase in number of mentions and a 592% increase in performance of #topicalsteroidwithdrawal in 2020(618,354) when compared to 2016(89,390).

CONCLUSION: Our results confirm an increase in the presence of user-generated content relating to TSW on social media and also highlight its extent. Large numbers of patients are exposed to this content which could influence their engagement with TCS.

PMID:35340034 | DOI:10.1111/ced.15194

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Nevin Manimala Statistics

Analytical results for directional and quadratic selection gradients for log-linear models of fitness functions

Evolution. 2022 Mar 27. doi: 10.1111/evo.14486. Online ahead of print.

ABSTRACT

Log-linear models are widely used for assessing determinants of fitness in empirical studies, for example, in determining how reproductive output depends on trait values or environmental conditions. Similarly, theoretical works of fitness and natural selection employ log-linear models, often with a negative quadratic term, generating Gaussian fitness functions. However, in the specific application of regression-based analysis of natural selection, such models are rarely employed. Rather, OLS regression is the predominant means of assessing the form of natural selection. OLS regressions allow specific evolutionary quantitative parameters, selection gradients, to be estimated, and benefit from the fact that the associated statistical models are easily applied. We examine whether selection gradients can be directly expressed in terms of the coefficients of models using exponential fitness functions with linear or quadratic arguments. Such models can be easily fitted with generalised linear models (GLMs). The expressions we obtain coincide with those for Gaussian functions, but relax the major constraint that the (log) fitness function is concave (downwardly curved). Additionally these results lead to univariate and multivariate analyses of both linear and quadratic selection that potentially incorporate pragmatic and interpretable models of fitness functions, where the parameters can be related analytically to selection gradients, and that can be operationalised using widely-available statistical tools. This article is protected by copyright. All rights reserved.

PMID:35340021 | DOI:10.1111/evo.14486

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Nevin Manimala Statistics

Discriminating features of ground reaction forces in overweight old and young adults during walking using functional principal component analysis

Gait Posture. 2022 Mar 21;94:166-172. doi: 10.1016/j.gaitpost.2022.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: Limited attention has been paid to age- or body size-related changes in the ground reaction forces (GRF) during walking despite their strong associations with lower limb injuries and pathology.

RESEARCH QUESTION: Do the features of GRF during walking associate with age or body size?

METHODS: Fifty-four participants were subdivided into four groups according to their age and body size: overweight old (n = 12), non-overweight old (n = 13), overweight young (n = 13), and non-overweight young (n = 16). Participants were asked to walk at their self-selected speeds on level ground with force plates embedded in the center of walkway. Functional principal component analysis (FPCA) was performed to extract major modes of variation and functional principal component scores (FPCs) in three-dimensional GRFs. Analysis of variance models were employed to investigate the effect of age, body size, or their interactions on the FPCs of each component of the GRF, with the adjustment to gait speed.

RESULTS: Significant age and body size effects were observed in FPC1 across all three-dimensional GRF. Both overweight and older groups showed greater braking force after heel-strike and greater propulsive forces during pre-swing when compared to the non-overweight and younger groups, respectively. The overweight old group displayed greater medial forces during mid-stance and the overweight young group showed prominently larger medial forces during pre-swing, while non-overweight old showed a tendency of flatter medial-lateral GRF waveforms during the entire stance phase. FPC2 revealed that only body size had an effect on three-dimensional GRF with the highest FPC2 scores in the overweight old group.

SIGNIFICANCE: Three-dimensional GRF during walking could be altered by the body size and age, which were more pronounced in the overweight and older group. The more dynamic GRF pattern with greater and/or lower peaks could be contributing factors to the increased joint load and injury rates observed in overweight aged individuals.

PMID:35339964 | DOI:10.1016/j.gaitpost.2022.03.012

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Nevin Manimala Statistics

Automatic scan range for dose-reduced multiphase CT imaging of the liver utilizing CNNs and Gaussian models

Med Image Anal. 2022 Mar 17;78:102422. doi: 10.1016/j.media.2022.102422. Online ahead of print.

ABSTRACT

Multiphase CT scanning of the liver is performed for several clinical applications; however, radiation exposure from CT scanning poses a nontrivial cancer risk to the patients. The radiation dose may be reduced by determining the scan range of the subsequent scans by the location of the target of interest in the first scan phase. The purpose of this study is to present and assess an automatic method for determining the scan range for multiphase CT scans. Our strategy is to first apply a CNN-based method for detecting the liver in 2D slices, and to use a liver range search algorithm for detecting the liver range in the scout volume. The target liver scan range for subsequent scans can be obtained by adding safety margins achieved from Gaussian liver motion models to the scan range determined from the scout. Experiments were performed on 657 multiphase CT volumes obtained from multiple hospitals. The experiment shows that the proposed liver detection method can detect the liver in 223 out of a total of 224 3D volumes on average within one second, with mean intersection of union, wall distance and centroid distance of 85.5%, 5.7 mm and 9.7 mm, respectively. In addition, the performance of the proposed liver detection method is comparable to the best of the state-of-the-art 3D liver detectors in the liver detection accuracy while it requires less processing time. Furthermore, we apply the liver scan range generation method on the liver CT images acquired from radiofrequency ablation and Y-90 transarterial radioembolization (selective internal radiation therapy) interventions of 46 patients from two hospitals. The result shows that the automatic scan range generation can significantly reduce the effective radiation dose by an average of 14.5% (2.56 mSv) compared to manual performance by the radiographer from Y-90 transarterial radioembolization, while no statistically significant difference in performance was found with the CT images from intra RFA intervention (p = 0.81). Finally, three radiologists assess both the original and the range-reduced images for evaluating the effect of the range reduction method on their clinical decisions. We conclude that the automatic liver scan range generation method is able to reduce excess radiation compared to the manual performance with a high accuracy and without penalizing the clinical decision.

PMID:35339951 | DOI:10.1016/j.media.2022.102422

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Nevin Manimala Statistics

Urbanization and systolic/diastolic blood pressure from a gender perspective: Separating longitudinal from cross-sectional association

Health Place. 2022 Mar 24;75:102778. doi: 10.1016/j.healthplace.2022.102778. Online ahead of print.

ABSTRACT

There has been a generally negative view of the impact of urbanization on a rising burden of non-communicable diseases including cardiovascular disease. However, the evidence on the relationship between urbanization and cardiovascular health has remained inconclusive. A comprehensive picture of the relationship is lacking, given an implicit assumption that the longitudinal association between changes in cardiovascular health and an increasingly urbanized environment is similar between less and more urbanized communities, men and women. We used the longitudinal data on adults (18-64 years) from the China Health and Nutrition Survey (1991-2015) and employed within-between random-effects models to disaggregates the longitudinal and cross-sectional associations between urbanization and systolic/diastolic blood pressure (SBP/DBP) and examined heterogeneities in the longitudinal association by average urbanization level and gender. We found that the positive longitudinal association of urbanization with SBP/DBP was stronger in less urbanized than more urbanized communities. The cross-sectional association between urbanization and SBP was negative and significant, although the cross-sectional association between urbanization and DBP was of no statistical significance. Moreover, the positive longitudinal association between urbanization and DBP was stronger among men than women, although the gender heterogeneity in the longitudinal association of urbanization with SBP was not significant.

PMID:35339955 | DOI:10.1016/j.healthplace.2022.102778

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Nevin Manimala Statistics

An in vitro evaluation of the sensitivity and responses of Dermanyssus gallinae to selected acaricides

Poult Sci. 2022 Feb 22;101(5):101798. doi: 10.1016/j.psj.2022.101798. Online ahead of print.

ABSTRACT

Dermanyssus gallinae is an obligatory ectoparasite of birds which feeds on blood and significantly compromise the well-being of commercially raised laying hens. In this study, the mortality rates and responses of D. gallinae to 2 acaricides with a physical mode of action (Dergall and Mite Max) and 2 acaricides with a chemical mode of action (Milben Ex and Bio PK) were evaluated in tree dilutions (S1-3) and compared at 8-time intervals after application. The evaluation involved a novel method that simulates real-world conditions in a commercial poultry farm. Tested products have shown high efficacy (84.3-100%) against D. gallinae in the producer recommended solution (S1). Acaricides with a physical mechanism of action were as effective as chemical agents in eradicating poultry red mites. The compared preparations differed only in the onset of action which was longer in acaricides with a physical mode of action (1-6 h for chemical 24 h for physical in S1). An increase in the concentration of the active ingredient did not significantly speed up the onset of action of the evaluated preparations. However, the efficacy of Dergall and Bio PK decreased when the applied dose was halved, to 12% and 0% respectively. A decrease in the dose Mite Max led to a somewhat smaller, but not statistically significant decrease in mite mortality rates (74%). The proposed method for evaluating acaricide efficacy can be helpful in selecting the most effective preparations and the optimal concentration of the working solution to be applied in commercial layer farms, thus reducing the costs associated with the eradication of D. gallinae. The developed method enables a reliable evaluation of acaricides with both a physical and chemical mode of action, and it supports observations of the parasites’ responses to the applied treatment.

PMID:35339937 | DOI:10.1016/j.psj.2022.101798