Tag: nevin manimala

Epilepsy Behav. 2022 Jan 17;127:108538. doi: 10.1016/j.yebeh.2021.108538. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate the potential impact of cannabidiol (CBD) on healthcare resource utilization and determine the effect of CBD on seizure-related emergency departments (ED) and hospital admissions in patients with epilepsy.

METHODS: This single-center, retrospective longitudinal cohort study included patients ≥1 year on CBD, excluding participants in CBD clinical trials or on <6 months of CBD therapy. Demographics, antiseizure medications (ASM), ED and hospital admissions were collected from the electronic medical record. Co-primary outcomes included change in seizure-related ED and hospital admissions. Secondary outcomes included change in ASMs and total ED or hospital admissions. Co-primary outcomes were assessed using generalized linear modeling. Descriptive statistics were used to analyze all other variables.

RESULTS: In the one-hundred total patients, there was no difference in either seizure-related ED visits (0.012 vs 0.011, p = 0.85) or hospital admissions per month (0.019 vs 0.021, p = 0.7). However, given the low percentage of the total cohort (n = 100) with either a seizure-related ED visits and hospital admissions (9% and 18%, respectively), a subgroup analysis was conducted. Those with seizure-related hospital admissions prior to CBD (n = 18) had significantly less seizure-related hospital admissions after initiation of CBD (23 admissions [0.104 per month] vs 15 admissions [0.055 per month], p = 0.007).

CONCLUSION: Despite the lack of statistically significant difference in primary outcomes for the total cohort, CBD may have a potential for a clinically beneficial impact in real-world settings on those patients with prior seizure-related admissions, who are the highest utilizers of healthcare resources.

PMID:35051868 | DOI:10.1016/j.yebeh.2021.108538

Biosens Bioelectron. 2022 Jan 2;202:113955. doi: 10.1016/j.bios.2021.113955. Online ahead of print.

ABSTRACT

Proteins secreted by cells play significant roles in mediating many physiological, developmental, and pathological processes due to their functions in intra/intercellular communication and signaling. Conventional end-point methods are insufficient for understanding the temporal response in cell secretion process, which is often highly dynamic. Furthermore, cellular heterogeneity makes it essential to analyze secretory proteins from single cells. To uncover individual cellular activities and the underlying kinetics, new technologies are needed for real-time analysis of the secretomes of many cells at single-cell resolution. This study reports a high-throughput biosensing microarray platform, which is capable of label-free and real-time secretome monitoring from a large number of living single cells using a biochip integrating ultrasensitive nanoplasmonic substrate and microwell compartments having volumes of ∼0.4 nL. Precise synchronization of image acquisition and microscope stage movement of the developed optical platform enables spectroscopic analysis with high temporal and spectral resolution. In addition, our system allows simultaneous optical imaging of cells to track morphology changes for a comprehensive understanding of cellular behavior. We demonstrated the platform performance by detecting interleukin-2 secretion from hundreds of single lymphoma cells in real-time over many hours. Significantly, the analysis of the secretion kinetics allows us to study cellular response to the stimulations in a statistical way. The new platform is a promising tool for the characterization of single-cell functionalities given its versatility, throughput and label-free configuration.

PMID:35051850 | DOI:10.1016/j.bios.2021.113955

J Commun Disord. 2022 Jan 17;95:106181. doi: 10.1016/j.jcomdis.2021.106181. Online ahead of print.

ABSTRACT

INTRODUCTION: A feasibility study of The Fluency Trust Residential Course (FTRC) for adolescents who stutter was conducted. The study aimed to measure key areas of a feasibility trial, for example, recruitment and retention, outcome measure completion, outcome measure reliability, and acceptability of the intervention to inform future research into the FTRC.

METHODS: Quantitative and qualitative methods were used. Participants were 23 adolescents (12-17 years), 23 parents and 2 Speech-Language Pathologists (SLPs) from the FTRC. Data collection included: outcome measure collection via a pre-test post-test quasi-experimental design (including two baseline measures), intervention fidelity checklists, semi-structured interviews with adolescents to explore acceptability of the intervention and semi-structured interviews with SLPs to explore their experiences of research participation and views on a future trial.

RESULTS: Recruitment, retention and outcome measure completion levels were all 100%. Intervention fidelity was 95% and there were no adverse events. Outcome measures showed good test- re-test reliability: Progress Questionnaire Child Intraclass Correlation Coefficient (ICC) = 0.87 (95% CI = 0.69-0.94 sig< 0.001) and Progress Questionnaire Parent ICC = 0.88 (95% CI = 0.70-0.95 sig< 0.001). Descriptive statistics showed that group medians and means of all outcome measures shifted in a positive direction between pre and post-tests (9 weeks follow-up). Twenty-five percent of young people showed changes on the Progress Questionnaire Child that were above the minimal important difference. Seventy-five percent of parents showed changes on the Progress Questionnaire Parent that were above the minimal important difference. Acceptability of the intervention by adolescents was high. SLPs reported participation was manageable and they were pleased to be part of the research.

CONCLUSION: Quantitative and qualitative data suggest that a future definitive trial of the FTRC is indicated after additional development work and feasibility testing. Recommendations for further research are included.

PMID:35051833 | DOI:10.1016/j.jcomdis.2021.106181

Comput Methods Programs Biomed. 2022 Jan 10;215:106624. doi: 10.1016/j.cmpb.2022.106624. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Lyme disease which is one of the most common infectious vector-borne diseases manifests itself in most cases with erythema migrans (EM) skin lesions. Recent studies show that convolutional neural networks (CNNs) perform well to identify skin lesions from images. Lightweight CNN based pre-scanner applications for resource-constrained mobile devices can help users with early diagnosis of Lyme disease and prevent the transition to a severe late form thanks to appropriate antibiotic therapy. Also, resource-intensive CNN based robust computer applications can assist non-expert practitioners with an accurate diagnosis. The main objective of this study is to extensively analyze the effectiveness of CNNs for diagnosing Lyme disease from images and to find out the best CNN architectures considering resource constraints.

METHODS: First, we created an EM dataset with the help of expert dermatologists from Clermont-Ferrand University Hospital Center of France. Second, we benchmarked this dataset for twenty-three CNN architectures customized from VGG, ResNet, DenseNet, MobileNet, Xception, NASNet, and EfficientNet architectures in terms of predictive performance, computational complexity, and statistical significance. Third, to improve the performance of the CNNs, we used custom transfer learning from ImageNet pre-trained models as well as pre-trained the CNNs with the skin lesion dataset HAM10000. Fourth, for model explainability, we utilized Gradient-weighted Class Activation Mapping to visualize the regions of input that are significant to the CNNs for making predictions. Fifth, we provided guidelines for model selection based on predictive performance and computational complexity.

RESULTS: Customized ResNet50 architecture gave the best classification accuracy of 84.42% ±1.36, AUC of 0.9189±0.0115, precision of 83.1%±2.49, sensitivity of 87.93%±1.47, and specificity of 80.65%±3.59. A lightweight model customized from EfficientNetB0 also performed well with an accuracy of 83.13%±1.2, AUC of 0.9094±0.0129, precision of 82.83%±1.75, sensitivity of 85.21% ±3.91, and specificity of 80.89%±2.95. All the trained models are publicly available at https://dappem.limos.fr/download.html, which can be used by others for transfer learning and building pre-scanners for Lyme disease.

CONCLUSION: Our study confirmed the effectiveness of even some lightweight CNNs for building Lyme disease pre-scanner mobile applications to assist people with an initial self-assessment and referring them to expert dermatologist for further diagnosis.

PMID:35051835 | DOI:10.1016/j.cmpb.2022.106624

Am J Dent. 2021 Dec;34(6):338-344.

ABSTRACT

PURPOSE: To compare the plaque removal efficacy of a new children’s powered toothbrush to a children’s manual toothbrush.

METHODS: 55 subjects aged 5-8 years old, who met entry criteria, participated in this single-center, two-cell, examiner-blind, randomized, crossover, single use clinical study. Subjects brushed at home with their first assigned toothbrush and fluoride toothpaste, under supervision of a parent or legal guardian, at least once daily for 2 minutes during a 1-week acclimation period. After refraining from oral hygiene for 12-16 hours, and from eating and drinking for 4 hours, subjects returned to the clinical site where they were assessed for plaque using the Rustogi Modified Navy Plaque Index (RMNPI). Subjects then brushed their teeth with their assigned toothbrush and toothpaste for 2 minutes and plaque levels were reassessed. Subjects were then given their second assigned toothbrush and the acclimation period and clinical site visit were repeated. Safety-in-use was also assessed during each clinic visit. Differences between pre-and post-brushing scores were analyzed for each toothbrush and between toothbrush groups for whole mouth plaque and 12 subset sites using baseline adjusted ANCOVA.

RESULTS: Both toothbrushes significantly (P< 0.0001) reduced whole mouth and 12 subset site plaque scores from the pre-brushing baseline. Between treatment comparisons showed that use of the powered toothbrush resulted in statistically significant reductions in whole mouth plaque (55%, P< 0.0001) and in 12 subset site scores (40-208%) compared to the manual brush. This clinical study showed that brushing with a new children’s powered toothbrush was safe and significantly more effective than brushing with a manual toothbrush in reducing whole mouth plaque scores, as well as plaque scores at a range of subset sites in the mouth.

CLINICAL SIGNIFICANCE: This new powered toothbrush may enable children to safely achieve significant and meaningful improvements in oral hygiene compared to brushing with a manual toothbrush.

PMID:35051323

Am J Dent. 2021 Dec;34(6):307-312.

ABSTRACT

PURPOSE: To investigate the tooth-whitening effects of mouthrinses containing different sizes of hydroxyapatite (HAP) particles after prolonged application time and compare them with a commercial whitening mouthrinse.

METHODS: 50 bovine incisors were stained and randomly distributed into five groups: the HAP groups with 3 µm, 200 nm and 50 nm particle size, the commercial whitening mouthrinse group and the distilled water group. The teeth underwent prolonged mouthrinse applications that were equivalent to simulated 3- and 6-month mouthrinsing. Tooth color was measured and calculated before and after mouthrinsing. The group and application time effects were analyzed with a nonparametric analysis of longitudinal data using the nparLD package in R and ANOVA-type statistic was reported. Pairwise Wilcoxon rank-sum tests with BH correction were performed to compare the tooth color changes of individual groups. The mouthrinse-treated enamel was observed by SEM.

RESULTS: The whitening effect of HAP mouthrinses after the prolonged application time was confirmed. The HAP mouthrinses exhibited similar whitening effects to the commercial mouthrinses. The particle size and application time could significantly affect the whitening performance of HAP mouthrinses. The 50 nm HAP group exhibited significantly higher ΔE values than the 3 µm group after the 6-month-equivalent application (P= 0.024). A longer period of application increased significantly the ΔE and ΔL values (P< 0.05). The HAP-treated enamel surfaces were entirely covered with HAP after the 6-month-equivalent application.

CLINICAL SIGNIFICANCE: The HAP nanoparticles showed better tooth-whitening performance after a longer period of mouthrinsing than the microsized HAP particles. This should be taken into consideration by dental manufacturers for optimizing the particle size for their HAP-containing products. To achieve a better outcome in tooth-whitening, the patients should apply the mouthrinse regularly for an extended period of time.

PMID:35051317

Am J Dent. 2021 Dec;34(6):327-332.

ABSTRACT

PURPOSE: To evaluate the marginal sealing ability of different restorative materials used in deep margin elevation (DME) on zirconia-reinforced lithium silicate CAD-CAM ceramic restorations.

METHODS: A total of 30 Class II cavities were prepared in freshly extracted human molars with the proximal margin located 1 mm below the cemento-enamel junction (CEJ). All specimens were randomly assigned to one of three groups (n=10): control group, resin composite group (Filtek Z350 XT), and resin-modified glass-ionomer group (RMGI) (Vitremer Tricure). In Group 1, control group, no DME was performed. The inlay margin of the control group was placed directly on the dentin. In Groups 2 and 3, DME was used to elevate the margin to 1 mm above the CEJ with resin composite and RMGI, respectively. Zirconia-reinforced lithium silicate CAD-CAM ceramic restorations were manufactured and bonded on all specimens with universal bonding and resin luting cement. All specimens were aged by water storage for 6 months. Marginal sealing ability at different interfaces was evaluated with a stereomicroscope at 40x magnification by scoring the depth of silver nitrate penetrating along the adhesive surfaces. Statistical differences between groups were analyzed using the Kruskal-Wallis and Mann-Whitney U tests.

RESULTS: At the dentin interface, there was no significant difference in microleakage scores in the control group and resin composite group (P= 0.577); however, the RMGI group had significantly higher microleakage compared to the control group (P= 0.004) and resin composite group (P= 0.007).

CLINICAL SIGNIFICANCE: Deep margin elevation can be achieved with resin composite. Resin-modified glass-ionomer must be used with caution due to the high microleakage scores.

PMID:35051321

Eur J Dent Educ. 2022 Jan 20. doi: 10.1111/eje.12773. Online ahead of print.

ABSTRACT

INTRODUCTION: The aims of this study are to evaluate the situations that cause anxiety in clinical training and to discuss the precautions that can be taken to reduce clinical anxiety in dental education.

MATERIALS AND METHODS: This multi-centered survey based study was created through Google Docs and 3rd, 4th and 5th grade dental students were included. The students were asked to rate their reactions on a 4-point Likert scale “not anxious” to “very anxious” for 27 questions related to academics, communication and interaction, diagnosis, dental treatments, deficiencies and mistakes in the treatments.

RESULTS: 1332 students were reached, and 1320 students completed the questionnaire. While extracting wrong tooth (3.53 ± 0.83), getting infected by patient (3.39 ± 0.85), getting diagnosis wrong (3.31 ± 0.83) were identified as the 3 most anxiety-provoking situations; taking panoramic radiograph (1.48 ± 0.71), communication with patients and dental assistants /nurses (1.76 ± 0.87; 1.64 ± 0.76) were identified as 3 situations that cause the least anxiety. Female students reported higher anxiety levels than male students in most of the questions (p<0.05). A statistically significant difference was observed between the grades of the students (p <0.05). 3^rd grade students showed statistically higher anxiety levels than higher grades in 16 out of 27 questions. No statistical significance was observed according to the status of the university (p>0.05).

CONCLUSION: Questions related to diagnosis, delivery of the dental treatments, deficiencies and mistakes in the treatments caused higher anxiety levels among dentistry students. As experience and time in the clinical training increase, the anxiety level of the students decreases. Orientation programs and establishing an effective communication between grades are recommended. Also, gender-based solutions must be taken into consideration.

PMID:35051299 | DOI:10.1111/eje.12773

Am J Dent. 2021 Dec;34(6):300-306.

ABSTRACT

PURPOSE: To evaluate the color, surface roughness and microhardness of human dental enamel subjected to brushing with whitening dentifrices.

METHODS: The enamel samples (4 x 4 x 2 mm) were darkened using 0.2% chlorhexidine and black tea, and were randomly divided into seven groups (n= 15) for brushing cycles with only water; control; conventional dentifrice (Colgate Maximum Anticaries Protection); dentifrice containing 2% hydrogen peroxide (Colgate Luminous White Advanced); dentifrice containing sodium tripolyphosphate (Sensodyne True White); dentifrice containing activated charcoal (Black is White); and dentifrice containing blue covarine (Close Up White Now). The samples were submitted to 1,000 and 30,000 brushing cycles. The color values (CIE L*a*b*), surface roughness (Ra) and microhardness (Knoop) were recorded at four time points: baseline, after staining, after 1,000 and after 30,000 brushing cycles. The data were submitted to statistical analyses using paired t-test, ANOVA and Tukey.

RESULTS: The color analysis, roughness and microhardness results showed interaction between the effect of the dentifrices and the time point (P< 0.001). The bleaching dentifrices brought about color changes (ΔE) significantly greater than those obtained with conventional dentifrices and the control; however, there were no significant color changes among the bleaching dentifrices. When the color coordinates were evaluated individually, the L* values increased and the a* and b* values decreased throughout the experiment. The conventional toothpaste and the toothpastes containing blue covarine, activated charcoal or hydrogen peroxide promoted a statistically significant increase in the surface roughness of the samples after the last brushing cycle. The sodium tripolyphosphate dentifrice caused a progressive reduction in roughness. The microhardness increased statistically after 30,000 cycles for the conventional toothpaste, blue covarine and hydrogen peroxide. It was concluded that the whitening dentifrices lightened the samples, which evidenced greater luminosity and reduction in reddish and yellow tones. Moreover, they did not have deleterious effects on microhardness, and caused acceptable changes in surface roughness.

CLINICAL SIGNIFICANCE: Dentifrices with different whitening strategies changed the color of the samples, resulting in samples with greater luminosity and reduced reddish and yellowish tones. They also caused changes in surface roughness within the acceptable clinical limit and did not have a deleterious effect on the microhardness of dental enamel.

PMID:35051316

J Nutr. 2021 Nov 23:nxab398. doi: 10.1093/jn/nxab398. Online ahead of print.

ABSTRACT

BACKGROUND: Although the role of diet is increasingly acknowledged in psychiatry, data are still scarce regarding its early impact on the most significant behavioral disorders of childhood (i.e., hyperactivity-inattention and conduct problems).

OBJECTIVES: The objective of this study was to explore the relation between children’s dietary patterns at 2 years and developmental trajectories of hyperactivity-inattention and conduct problems between 3 and 8 years.

METHODS: We recruited 1432 mother-child dyads from the French EDEN (etude sur les déterminants pré- et postnatals du développement et de la santé de l’enfant) mother-child cohort to conduct the analyses. Three dietary patterns, labeled guidelines, processed and fast foods, and baby foods, were identified using an FFQ in children aged 2 years in a previous study. The Strengths and Difficulties Questionnaire was used to assess hyperactivity-inattention and conduct problems at 3, 5, and 8 years of age and build related trajectories from 3 to 8 years. The relation between children’s dietary patterns at 2 years and the worst developmental trajectories of hyperactivity-inattention and conduct problems were determined with multivariable logistic regressions adjusted for potential socioeconomic, maternal, and child confounders.

RESULTS: The score on the guidelines dietary pattern was negatively associated with the risk of hyperactivity-inattention problems (OR: 0.75; 95% CI: 0.60-0.94), contrary to adherence to the baby foods dietary pattern (OR: 1.41; 95% CI: 1.16-1.71).

CONCLUSIONS: Distinct patterns of children’s diet at 2 years were predictive of developmental trajectories of hyperactivity-inattention problems between 3 and 8 years. These results highlight the relevance of conducting further studies to clarify the mechanisms involved.

PMID:35051294 | DOI:10.1093/jn/nxab398