Tag: nevin manimala

J Oral Implantol. 2021 Dec 22. doi: 10.1563/aaid-joi-D-21-00055. Online ahead of print.

ABSTRACT

The aims of this study were to evaluate the effect of (i) the different surgical guide designs and (ii) implant placement location on the accuracy of fully guided implant placement in single edentulous sites using an in vitro study model. Forty-five partially edentulous models were scanned and divided into three groups: group 1, tooth-supported full-arch surgical guide; group 2, three different tooth-supported shortened surgical guides (SSGs); and group 3, tooth-supported full-arch surgical guide with a crossbar. All surgical guides were printed and used for fully guided implant placement. A total of 180 implants (60 per group) were placed, and scanbodies were positioned on all models, and postoperative surface scan files (STL) files were obtained. Superimposition of preoperative and postoperative STL files was performed, and the accuracy of implant position was evaluated. The interaction between group and implant location was statistically significant for angle, 3D offset at the base, and at the tip (p<0.001). The post-hoc tests showed a statistically significantly higher deviation for group 2 compared to group 3 for all outcomes for implants #4 (p<0.05) and #7 (p<0.05). There was also a statistically significant difference in all outcomes between groups 1 and 3 for implant #7 (p<0.05). All surgical guide designs presented satisfactory performance with clinically acceptable levels of deviation. However, SSGs presented higher accuracy for guided implant placement in a single-edentulous site, whereas a full-arch surgical guide with a crossbar presented superior outcomes when two or more guided implants were placed simultaneously.

PMID:34937081 | DOI:10.1563/aaid-joi-D-21-00055

PLoS One. 2021 Dec 22;16(12):e0261176. doi: 10.1371/journal.pone.0261176. eCollection 2021.

ABSTRACT

BACKGROUND: Bilateral internal thoracic arteries (BITA) are uncommonly used in the every-day practice due to safety concerns and technical challenges with Y-grafts. We hypothesized that in-situ BITA use during coronary artery by-pass grafting (CABG) for two vessel disease is equally safe to standard strategy with left internal thoracic artery-left anterior descending artery revascularization and venous graft to other target vessels.

METHODS: A propensity score matched analysis was used to compare elective on-pump CABG patients who received in-situ BITA (BITA-group), versus left internal thoracic artery graft to the left anterior descending artery plus vein (SITA-group). Primary end points were 30-days all-cause-mortality, major adverse cardiac events and incidents and deep sternal wound infections.

RESULTS: A total of 50 matched pairs (c-statistics 0.769) were selected from patients operated on between January 2015 and April 2020 using BITA (n = 50) and SITA (n = 2170). There were no inter-group differences in demographics and basic clinical characteristics. The total operation time was longer in the BITA-group (4.0 vs 3.6 hours; p = 0.004). The rate of complete revascularization was similar, as was median aortic cross-clamp time, median extracorporeal circulation time, rate of re-explorations for bleeding, deep sternal wound infections or length of stay. One patient died in BITA group, 3 days after surgery, from a non-cardiac cause. After 36 months, the survival rate was 98% for BITA-group and 96% for controls (log-rank, p = 0.577).

CONCLUSIONS: In-situ use of BITA during coronary revascularization for two-vessel disease is as safe and effective, as use of single ITA and vein graft. In-situ strategy abolishes allows to avoid the technically demanding composite graft configuration.

PMID:34937067 | DOI:10.1371/journal.pone.0261176

PLoS One. 2021 Dec 22;16(12):e0261494. doi: 10.1371/journal.pone.0261494. eCollection 2021.

ABSTRACT

PURPOSE: Patients undergo dilatation and evacuation for abortion or miscarriage. However, bleeding is sometimes problematic. Despite reports on the association between volatile anesthetics and increased bleeding during the procedure, firm evidence is lacking. Therefore, we conducted a systematic review and meta-analysis to compare the effects of volatile anesthetics and propofol on the amount of bleeding in patients undergoing dilatation and evacuation.

METHODS: We conducted a systematic search of four databases, namely PubMed, Embase, Cochrane Central Register of Controlled Trials databases, and Web of Science (Clarivate Analytics), from their respective inception to April 2021. Moreover, we searched two trial registration sites. The inclusion criterion was randomized controlled trials of patients who underwent dilatation and evacuation under general anesthesia using volatile anesthetics or propofol. The primary outcome was the amount of perioperative bleeding. The mean difference of the bleeding was combined using a random-effects model. The I2 statistic was used to assess heterogeneity. We assessed risk of bias with Cochrane domains. We controlled type I and II errors due to sparse data and repetitive testing with Trial Sequential Analysis. We assessed the quality of evidence with GRADE.

RESULTS: Five studies were included in the systematic review. The amount of bleeding was compared in four studies and was higher in the volatile anesthetic group, with a mean difference of 164.7 ml (95% confidence interval, 43.6 to 285.7; p = 0.04). Heterogeneity was considerable, with an I2 value of 97%. Two studies evaluated the incidence of significant bleeding, which was significantly higher in the volatile anesthetic group (RR, 2.42; 95% confidence interval, 1.04-5.63; p = 0.04).

CONCLUSION: Choosing propofol over volatile anesthetics during dilatation and evacuation might reduce bleeding and the incidence of excessive bleeding. However, the quality of the evidence was very low. This necessitates further trials with a low risk of bias.

TRIAL REGISTRATION: PROSPERO (CRD42019120873).

PMID:34937059 | DOI:10.1371/journal.pone.0261494

PLoS One. 2021 Dec 22;16(12):e0260042. doi: 10.1371/journal.pone.0260042. eCollection 2021.

ABSTRACT

This study was concerned with how accurate people are in their knowledge of population norms and statistics concerning such things as the economic, health and religious status of a nation and how those estimates are related to their own demography (e.g age, sex), ideology (political and religious beliefs) and intelligence. Just over 600 adults were asked to make 25 population estimates for Great Britain, including religious (church/mosque attendance) and economic (income, state benefits, car/house ownership) factors as well as estimates like the number of gay people, immigrants, smokers etc. They were reasonably accurate for things like car ownership, criminal record, vegetarianism and voting but seriously overestimated numbers related to minorities such as the prevalence of gay people, muslims and people not born in the UK. Conversely there was a significant underestimation of people receiving state benefits, having a criminal record or a private health insurance. Correlations between select variables and magnitude and absolute accuracy showed religiousness and IQ most significant correlates. Religious people were less, and intelligent people more, accurate in their estimates. A factor analysis of the estimates revealed five interpretable factors. Regressions were calculated onto these factors and showed how these individual differences accounted for as much as 14% of the variance. Implications and limitations are acknowledged.

PMID:34937066 | DOI:10.1371/journal.pone.0260042

Phys Med Biol. 2021 Dec 22. doi: 10.1088/1361-6560/ac459d. Online ahead of print.

ABSTRACT

Multi-energy spectral CT has a broader range of applications with the recent development of photon-counting detectors. However, the photons counted in each energy bin decrease when the number of energy bins increases, which causes a higher statistical noise level of the CT image. In this work, we propose a novel iterative dynamic dual-energy CT algorithm to reduce the statistical noise. In the proposed algorithm, the multi-energy projections are estimated from the dynamic dual-energy CT data during the iterative process. The proposed algorithm is verified on sufficient numerical simulations and a laboratory two-energy-threshold PCD system. By applying the same reconstruction algorithm, the dynamic dual-energy CT’s final reconstruction results have a much lower statistical noise level than the conventional multi-energy CT. Moreover, based on the analysis of the simulation results, we explain why the dynamic dual-energy CT has a lower statistical noise level than the conventional multi-energy CT. The reason is that: the statistical noise level of multi-energy projection estimated with the proposed algorithm is much lower than that of the conventional multi-energy CT, which leads to less statistical noise of the dynamic dual-energy CT imaging.

PMID:34937002 | DOI:10.1088/1361-6560/ac459d

J Neural Eng. 2021 Dec 22. doi: 10.1088/1741-2552/ac4595. Online ahead of print.

ABSTRACT

OBJECTIVE: Electroencephalography microstates (EEG-ms), which reflect a large topographical representation of coherent electrophysiological brain activity, are widely adopted to study cognitive processes mechanisms and aberrant alterations in brain disorders. EEG-ms topographies are quasi-stable lasting between 60-120 milliseconds. Some evidence suggests that EEG-ms are the electrophysiological signature of resting-state networks (RSNs). However, the spatial and functional interpretation of EEG-ms and their association with functional MRI (fMRI) remains unclear.

APPROACH: In a large cohort of healthy subjects (n = 52), we conducted several statistical and machine learning approaches analyses on the association among EEG-ms spatio-temporal dynamics and the blood-oxygenation-level dependent (BOLD) simultaneous EEG-fMRI data using statistical and machine learning approaches.

MAIN RESULTS: Our results using a generalized linear model unraveled that EEG-ms transitions were largely and negatively associated with blood-oxygenation-level dependent (BOLD) signals in the somatomotor, visual, dorsal attention, and ventral attention fMRI networks with limited association within the default mode network. Additionally, a novel recurrent neural network (RNN) confirmed the association between EEG-ms transitioning and fMRI signal while revealing that EEG-ms dynamics can predict BOLD signals and vice versa.

SIGNIFICANCE: Results suggest that EEG-ms transitions may represent the deactivation of fMRI RSNs and provide evidence that both modalities can measure common aspects of undergoing brain neuronal activities. Moreover, our results may help to better understand the electrophysiological interpretation of EEG-ms and solve several contradicting findings in the literature.

PMID:34937003 | DOI:10.1088/1741-2552/ac4595

Int J Sports Physiol Perform. 2021 Dec 21:1-6. doi: 10.1123/ijspp.2020-0836. Online ahead of print.

ABSTRACT

PURPOSE: Modern pentathlon is a multidisciplinary sport that involves exhaustive training which can cause tissue damage and metabolic changes. However, few studies have evaluated the metabolic changes that occur in pentathletes. Accordingly, we aimed to evaluate the metabolomic profile of pentathletes during a 3-week training period before competition using nuclear magnetic resonance.

METHODS: Blood samples from 6 members of a Brazilian modern pentathlon team were collected at the beginning (Pre1, Pre2, and Pre3) and end (Post1, Post2, and Post3) of each week. Low molecular-weight metabolite profiles were analyzed by nuclear magnetic resonance spectroscopy, and biochemical markers were assessed using enzyme-linked immunosorbent assays. Data were assessed using partial least-squares discriminant analysis and univariate statistical model.

RESULTS: Metabolic changes were observed between pre- and postdata of each week and over the 3 weeks before the competition in the partial least-squares discriminant analysis. Creatine kinase concentration increased in the first 2 weeks (P = .045 and P = .039), but there was no difference in the last week (P > .05). Lactate levels increased significantly after training in each week (P < .001). Cortisol levels at Post3 were different from all other time points (P < .05) and the concentrations of peroxides increased over the weeks (P < .05). Among all metabolites, sarcosine showed the greatest differences (P = .004) in the pretraining and posttraining periods of the 3 weeks.

CONCLUSION: Serum analysis of athletes using nuclear magnetic resonance showed metabolic changes depending on the intensity of the training performed each week.

PMID:34936983 | DOI:10.1123/ijspp.2020-0836

Altern Ther Health Med. 2021 Dec 22:AT6920. Online ahead of print.

ABSTRACT

CONTEXT: Health literacy is defined as the capacity of an individual to acquire, interpret, and understand basic health information and services to improve their health. Cancer patients often turn to complementary and alternative medicine (CAM) to cope with diagnosis and treatment processes.

OBJECTIVES: The study aimed to determine the effects of health-literacy levels on oncology patients’ use of CAM.

DESIGN: The research team conducted a descriptive cross-sectional study. Using a 95% confidence interval and a 0.95 power ratio, with the analysis performed in the G Power statistical analysis program, version 3.1, the study sample was calculated to be a minimum 120 people.

SETTING: The study took place in Turkey in the outpatient chemotherapy and oncology unit at Ondokuz Mayis University’s Health Application and Research Center between February 2019 and January 2020.

PARTICIPANTS: Participants were 200 oncology patients treated in the unit.

OUTCOME MEASURES: The data were collected using an introductory information form, the Health Literacy Scale (HLS), and the Holistic Complementary and Alternative Health Questionnaire (HCAMQ). Results were analyzed using percentages, means, and the Spearman correlation analysis, Mann Whitney U, and Kruskal Walls tests.

RESULTS: Of the 200 participants, 54% were women; 38.0% were between the ages of 57 and 69; 53.5% were primary school graduates; and 36% were Stage-4 cancer patients. The most common side effect of chemotherapy was fatigue and weakness, with 80.5% experiencing those symptoms. Concerning CAM use, 42.5% used at least one CAM method, and 44.7% of those individuals stated that they resorted to those methods to reduce the treatment’s negative effects.

CONCLUSION: The participants’ health literacy levels were high, and they had moderately positive attitudes toward CAM. No significant relationship existed between health-literacy levels and attitudes toward CAM (P = .219). However, strengthening health literacy can be a preventive practice for the correct and reliable use of CAM.

PMID:34936994

Immunobiology. 2021 Dec 17;227(1):152166. doi: 10.1016/j.imbio.2021.152166. Online ahead of print.

ABSTRACT

Soluble TNF receptors (sTNFR1 and sTNFR2) are natural endogenous inhibitors of TNF and are elevated in inflammatory, autoimmune, and chronic degenerative diseases. In Chagas disease, pleiotropic cytokine TNF is considered key in immunopathology. Thus, we aimed to evaluate the levels of TNF, sTNFR1, and sTNFR2 in the serum of patients with chronic Chagas disease. TNF and its soluble receptors were quantified using Cytometric Bead Array in the serum of 132 patients, of which 51 had the indeterminate form (IND), 39 the mild cardiac form (CARD 1), 42 the severe cardiac form (CARD 2), and 20 non-infected individuals (NI). The results indicate that the soluble receptors may regulate TNF in Chagas disease, as their leves were higher in T. cruzi-infected individuals when compared to non-infected individuals. We found a moderate negative correlation between sTNFR1 and TNF in individuals with the IND form, suggesting a relationship with non-progression to more severe forms, such as heart disease. sTNFR1 and sTNFR2 were increased in all clinical forms, but with a moderate positive correlation in more severe patients (r = 0.50 and p = 0.0005). TNF levels showed no statistical differences in the groups of patients. These findings suggest the importance of the endogenous balance of the levels of soluble TNF receptors in the protection and balance in patients with chronic Chagas disease, besides revealing the immunological complexity in chronic T. cruzi-infected individuals.

PMID:34936965 | DOI:10.1016/j.imbio.2021.152166

Transplant Cell Ther. 2021 Dec 19:S2666-6367(21)01443-3. doi: 10.1016/j.jtct.2021.12.008. Online ahead of print.

ABSTRACT

BACKGROUND: The utility of weekly rectal swab surveillance cultures (RSSC) as a resource to identify gut colonisation with Extended Spectrum Beta-Lactamase (ESBL)-producing E Coli or Klebsiella pneumoniae carbapenemase (KPC) producing organisms, to guide empirical antibiotic therapy in HSCT patients continues to be a subject of interest. There is urgency to assess and justify modifications to empirical antibiotics based upon regional epidemiology and patient groups.

OBJECTIVE: To study the utility of weekly rectal swab surveillance cultures (RSSC) to guide empirical antibiotics therapy and the impact of gut colonisation on transplant outcomes.

STUDY DESIGN: This is a retrospective analysis of 317 successive first transplants done in three pediatric bone marrow transplant centres in Indian sub-continent, mainly for hemoglobinopathies, between April 2016 and April 2021. Transplantation, infection control and febrile neutropenia management protocols are identical among the three centres. First line antibiotics were chosen based on RCCS reports i.e. meropenem and high dose meropenem with colistin for ESBL and carbapenemase resistant colonisation respectively for first half of the study and no adjustment was made in the second half. Clinical response to antibiotics, long term outcomes, antibiotic-resistant bacteraemia and acute GVHD were analysed. Log-rank test, Chi-squared test and Wilcoxon test were used to compare data using R Statistical software.

RESULTS: Of all 871 weekly RSSC done, 162 were positive for ESBL- or KPC-resistant organism. RCCS were ESBL-positive in 106 patients (33%) and KPC-positive in 10 patients (3%). Within 97 ESBL-positive patients for whom antimicrobial susceptibility testing (AST) report was available, only 22 (25%) demonstrated clinical resistance of Pip-Taz. Within the 10 KPC-positive patients’ clinical resistance was observed only in 4 (40%) to Pip-Taz and 3 (30%) to meropenem. For ESBL-positive RSSC where 1st line empirical antibiotics were used, 66% of the patients responded clinically. Even within the 15 who were resistant to 1st line empirical antibiotics (Pip-Taz) on RSSC reports, 67% responded to Pip-Taz clinically. Within these patients 27 (56%) never needed any carbapenems. Using Pip-Taz empirically in ESBL-positive patients did not prolong meropenem use within 100 days of transplantation (p=0.18). For KPC-positive RSSC where 1st line empirical antibiotics were used, all patients clinically responded, including 4 who were resistant to Pip-Taz and 3 patients who were meropenem resistant on RCCS. Comparing patients who were ESBL-positive, KPC-positive and neither, no statistically significant difference was seen in overall survival (p=0.95), disease free survival (p=0.45), transplant related mortality (p=0.97), rejection (p=0.68) and rate of acute GVHD grade II-IV (p=0.78). Comparing the ESBL-positive patients who did and did not get higher-level empirical antibiotics, no statistical difference was seen in overall survival (p=0.32), disease free survival (p=0.64), transplant related mortality (p=0.65), rejection (p=0.46), acute GVHD grade II-IV (p=0.26) or antibiotic resistant bacteraemia (p=0.3).

CONCLUSIONS: In context of transplantation for non-malignant HSCTs, empiric antibiotic choice based on rectal swab surveillance cultures is not justified, even in regions with a high prevalence of antimicrobial resistance. Antimicrobial susceptibility testing (AST) reports in surveillance cultures did not correlate with in-vivo clinical response. Colonisation reported on weekly surveillance rectal swab cultures showed no correlation with clinical outcomes.

PMID:34936930 | DOI:10.1016/j.jtct.2021.12.008