Tag: nevin manimala

Oral Health Prev Dent. 2021 Jan 7;19(1):587-594. doi: 10.3290/j.ohpd.b2259087.

ABSTRACT

PURPOSE: This in-situ-study investigated if rinsing the oral cavity with a calcium containing solution or a fluoride containing mouthwash immediately before an erosive attack leads to reduced enamel softening.

MATERIALS AND METHODS: Bovine enamel samples (n = 240) with measured baseline surface microhardness (KHN) were assigned to five series (S1-5). Twelve participants carried out each series as follows: Four enamel samples of the associated test series were placed in an intraoral appliance and carried in each participants’ mouth. After 30 min, the participants either rinsed the oral cavity for 60 s with 30 ml of a solution prepared from a 1,000 mg calcium effervescent tablet dissolved in 100 ml water (S2), an 800 mg calcium containing mineral supplement powder (5 g) dissolved in 200 ml water (S3), a fluoride (500 ppm) mouthwash (S4), a fluoride (500 ppm) and stannous chloride (800 ppm) containing mouthwash (S5), or did not rinse with any test solution before the erosive attack (S1, negative control). The participants subsequently rinsed the oral cavity with 100 ml of a soft drink (Sprite Zero) for 60 s to simulate the erosive attack and immediately afterwards with water to stop the erosive process. As final step, surface microhardness was measured a second time and hardness loss (∆KHN) calculated. Differences of ∆KHN between the series were investigated by fitting a mixed effect model to the data set.

RESULTS: The highest loss of microhardness and thus softening of enamel (mean of ∆KHN; lower/upper confidence level) was observed in the negative control (S1: 60.2; 67.6/52.8). While no statistically significant difference (P > 0.05) compared to S1 could be found in S2 (50.0; 57.4/42.5) and S3 (54.6; 62.1/47.2), statistically significantly less softening of enamel (P < 0.001) was discovered in S5 (33.8; 41.2/26.4) and S4 (41.8.2; 49.3/34.4). S5 showed the overall lowest values for ∆KHN and thus best protection from enamel softening.

CONCLUSION: Rinsing with a fluoride mouthwash or a fluoride and stannous chloride containing mouthwash immediately before an erosive attack reduces the softening of enamel. None of the investigated calcium-containing solutions was able to reduce erosion induced softening of enamel.

PMID:34734518 | DOI:10.3290/j.ohpd.b2259087

Int J Health Plann Manage. 2021 Nov 3. doi: 10.1002/hpm.3360. Online ahead of print.

ABSTRACT

BACKGROUND: Supplier-induced demand (SID) refers to the concept that healthcare providers may deliver services that are not medically necessary to patients. An estimation of the extent to which this event has occurred can be insightful for policymaking and guiding health and insurance systems. This study aimed to investigate the extent of SID when performing a diagnostic ultrasonography for primary breast cancer patients and its relationship with socioeconomic factors in Iran.

METHODS: Data were obtained using questionnaires from 334 patients referred to the Cancer Research Center. To identify the patients who were candidates for undergoing a necessary diagnostic US, we employed the international clinical guidelines with confirmation of our expert panelists. With their assistance, a comprehensive index was created to screen those ‘most probably affected by SID’.

RESULTS: 55.9% had undergone an unnecessary diagnostic ultrasonography, and thus were most probably affected by SID. A significant association between socioeconomic factors (education, occupation, and supplemental health insurance) and SID was confirmed (p value ≤ 0.001, 0.002, and 0.039, respectively).

CONCLUSION: This study supports the SID hypothesis and the unnecessary demand for diagnostic ultrasonography in primary breast cancer. Also, our evidence indicates imposing excessive costs that can positively influence the policymakers’ decision-making in the healthcare systems.

PMID:34734427 | DOI:10.1002/hpm.3360

Low Urin Tract Symptoms. 2021 Nov 3. doi: 10.1111/luts.12415. Online ahead of print.

ABSTRACT

OBJECTIVES: The International Prostate Symptom Score (IPSS) approaches its 30th anniversary. This ubiquitous clinical assessment tool is a standard in the assessment and research of lower urinary tract symptoms in men. The authors explore its history, development, and subsequent dissemination through validated translations across the world. An estimated global coverage is calculated and mapped according to language population.

METHODS: Embase and Medline literature searches were performed, with further hand searches of grey literature and online resources. Twenty-two abstracts and journal articles validating language translations of the IPSS were reviewed in full and tabulated. Language population data were gathered from an official database and mapped.

RESULTS: The IPSS is available in 53 languages. Twenty-seven languages have statistically or clinically validated translations for use in male patients. This corresponds to a conservative estimate of global population coverage of approximately 2.3 billion men, or 60% of the worldwide male population. Translation methodology involves forward and back translation. Statistical validation is performed with control patients. Cronbach’s alpha is used for internal consistency, and Spearman’s coefficient (p) or Pearson’s coefficient (r) for test-retest reliability. Issues such as the emergence of altered versions deviating from original validated translations and translation difficulties due to cultural differences are observed. Further translational work is needed to validate versions of the IPSS in languages of the developing world.

CONCLUSIONS: The IPSS is the most prevalent patient-administered questionnaire used in urology across the world. There is no other clinical tool seen to have similar coverage. This paper aims to provide a roadmap for future clinical tools to acquire a similar level of translation and dissemination.

PMID:34734477 | DOI:10.1111/luts.12415

Sci Rep. 2021 Nov 3;11(1):21619. doi: 10.1038/s41598-021-00781-x.

ABSTRACT

High-throughput third-generation nanopore sequencing devices have enormous potential for simultaneously observing epigenetic modifications in human cells over large regions of the genome. However, signals generated by these devices are subject to considerable noise that can lead to unsatisfactory detection performance and hamper downstream analysis. Here we develop a statistical method, CpelNano, for the quantification and analysis of 5mC methylation landscapes using nanopore data. CpelNano takes into account nanopore noise by means of a hidden Markov model (HMM) in which the true but unknown (“hidden”) methylation state is modeled through an Ising probability distribution that is consistent with methylation means and pairwise correlations, whereas nanopore current signals constitute the observed state. It then estimates the associated methylation potential energy function by employing the expectation-maximization (EM) algorithm and performs differential methylation analysis via permutation-based hypothesis testing. Using simulations and analysis of published data obtained from three human cell lines (GM12878, MCF-10A, and MDA-MB-231), we show that CpelNano can faithfully estimate DNA methylation potential energy landscapes, substantially improving current methods and leading to a powerful tool for the modeling and analysis of epigenetic landscapes using nanopore sequencing data.

PMID:34732768 | DOI:10.1038/s41598-021-00781-x

Sci Rep. 2021 Nov 3;11(1):21587. doi: 10.1038/s41598-021-00531-z.

ABSTRACT

Phenotype-based assortative mating is well established in humans, with the potential for further convergence through a shared environment. To assess the correlation within infertile couples of physical, social, and behavioural characteristics and 155 circulating metabolic measures. Cross sectional study at a tertiary medical center of 326 couples undertaking IVF. Serum lipids, lipoprotein subclasses, and low-molecular weight metabolites as quantified by NMR spectroscopy (155 metabolic measures). Multivariable and quantile regression correlations within couples of metabolite profiles. Couples exhibited statistical correlations of varying strength for most physical, social, and behavioural characteristics including age, height, alcohol consumption, education, smoking status, physical activity, family history and ethnicity, with correlation coefficients ranging from 0.22 to 0.73. There was no evidence of within couple associations for BMI and weight, where the correlation coefficients were – 0.03 (95% CI – 0.14, 0.08) and 0.01 (95% CI – 0.10, 0.12), respectively. Within spousal associations of the metabolite measurements were all positive but with weak to modest magnitudes, with the median correlation coefficient across all 155 measures being 0.12 (range 0.01-0.37 and interquartile range 0.10-0.18). With just four having associations stronger than 0.3: docosahexaenoic acid (0.37, 95% CI 0.22, 0.52), omega-3 fatty acids (0.32, 95% CI 0.20, 0.43) histidine (0.32, 95% CI 0.23, 0.41) and pyruvate (0.32, 95% CI 0.22, 0.43). Infertile couples exhibit spousal similarities for a range of demographic and serum metabolite measures, supporting initial assortative mating, with diet-derived metabolites suggesting possible subsequent convergence of their individual metabolic profile.

PMID:34732718 | DOI:10.1038/s41598-021-00531-z

Nat Commun. 2021 Nov 3;12(1):6330. doi: 10.1038/s41467-021-26692-z.

ABSTRACT

Flash drought is characterized by a period of rapid drought intensification with impacts on agriculture, water resources, ecosystems, and the human environment. Addressing these challenges requires a fundamental understanding of flash drought occurrence. This study identifies global hotspots for flash drought from 1980-2015 via anomalies in evaporative stress and the standardized evaporative stress ratio. Flash drought hotspots exist over Brazil, the Sahel, the Great Rift Valley, and India, with notable local hotspots over the central United States, southwestern Russia, and northeastern China. Six of the fifteen study regions experienced a statistically significant increase in flash drought during 1980-2015. In contrast, three study regions witnessed a significant decline in flash drought frequency. Finally, the results illustrate that multiple pathways of research are needed to further our understanding of the regional drivers of flash drought and the complex interactions between flash drought and socioeconomic impacts.

PMID:34732727 | DOI:10.1038/s41467-021-26692-z

Cancer Nurs. 2021 Nov 1. doi: 10.1097/NCC.0000000000001032. Online ahead of print.

ABSTRACT

BACKGROUND: Because of their cancer and treatment adverse effects, most pediatric oncology patients will experience 1 or more symptoms at one time that can seriously affect their quality of life. Because these children are attached to parents, their symptom burden directly influences the parental stress level and parental interpretations of their children’s quality of life.

OBJECTIVE: The aim of this study was to examine the association between child-reported symptom burden and the pediatric quality of life reported by children with cancer and their parents, and whether parental perceived stress mediates these relationships.

METHODS: In a cross-sectional design, convenience sampling was used to recruit 80 parent-child dyads. Advanced statistical methods were adopted to analyze the mediating effects of parental stress between children’s symptom burden and their quality of life.

RESULTS: The results revealed that parental stress was the mediator in the relationship between child-reported symptom burden and children’s quality of life reported by parents. The results also showed that parental stress was not a mediator in the relationship between child-reported symptom burden and their quality of life. This underscored the differences in interpretations of quality of life reported by children and their parents.

CONCLUSION: Children’s symptom burden is an important factor in predicting parental stress level and the quality of life reported by the children. Children’s voice should be incorporated whenever possible.

IMPLICATIONS FOR PRACTICE: The knowledge gained from this study will facilitate intervention development to enhance parents’ abilities in stress management and symptom management for their children with the support of the nursing profession.

PMID:34732679 | DOI:10.1097/NCC.0000000000001032

Med Sci Monit. 2021 Nov 4;27:e933444. doi: 10.12659/MSM.933444.

ABSTRACT

BACKGROUND The Gab1 gene has an important role in cell proliferation in meningioma via various signaling pathways. However, the relationship between polymorphisms of the Gab1 gene and meningioma remains unknown. In this study, we aimed to investigate the plausible association of single-nucleotide polymorphisms (SNPs) of the Gab1 gene and meningioma risk in a northern Chinese Han population. MATERIAL AND METHODS This case-control study included 205 patients with meningioma and 297 healthy controls. Four loci of the Gab1 gene were genotyped using the multiplex snapshot technique. The odds ratio (OR) and 95% confidence interval (CI) were calculated by chi-squared and logistic regression analysis. The distributions of Gab1 SNP genotypes and allele frequencies were compared between patients with meningioma and healthy controls and among patients stratified by clinical phenotypes. RESULTS The allelic frequency distributions of G at rs3805236 and C at rs1397529 were significantly higher in patients with meningioma than in healthy controls. The frequency of the rs3805236-GG and rs1397529-AC genotypes were significantly higher in patients with meningioma than in controls. Furthermore, there was a statistically significant difference between the genotypes of patients versus healthy individuals at rs1397529, according to stratification by dural invasion. The allelic frequency distributions of alleles or genotypes at rs3805246 and rs3828512 were not different in patients with meningioma and healthy controls. CONCLUSIONS The Gab1 gene rs3805236A>G and rs1397529A>C SNPs increased the risk of meningioma in the northern Chinese Han population. Furthermore, rs1397529A>C may be related to enhanced dural invasion in patients with meningioma.

PMID:34732686 | DOI:10.12659/MSM.933444

Neurol Med Chir (Tokyo). 2021 Nov 3. doi: 10.2176/nmc.st.2021-0254. Online ahead of print.

ABSTRACT

Each year, the Japan Neurosurgical Society (JNS) reports up-to-date statistics from the Japan Neurosurgical Database regarding case volume, patient demographics, and in-hospital outcomes of the overall cohort and neurosurgical subgroup according to the major classifications of main diagnosis. We hereby report patient demographics, in-hospital mortality, length of hospital stay, purpose of admission, number of medical management, direct surgery, endovascular treatment, and radiosurgery of the patients based on the major classifications and/or main diagnosis registered in 2018 and 2019 in the overall cohort (523283 and 571143 patients, respectively) and neurosurgical subgroup (177184 and 191595 patients, respectively). The patient demographics, disease severity, proportion of purpose of admission (e.g., operation, 33.9-33.5%) and emergent admission (68.4-67.8%), and in-hospital mortality (e.g., cerebrovascular diseases, 6.3-6.5%; brain tumor, 3.1-3%; and neurotrauma, 4.3%) in the overall cohort were comparable between 2018 and 2019. In total, 207783 and 225217 neurosurgical procedures were performed in the neurosurgical subgroup in 2018 and 2019, respectively, of which endovascular treatment comprised 19.1% and 20.3%, respectively. Neurosurgical management of chronic subdural hematoma (19.4-18.9%) and cerebral aneurysm (15.4-14.8%) was most common. Notably, the proportion of management of ischemic stroke/transient ischemic attack, including recombinant tissue plasminogen activator infusion and endovascular acute reperfusion therapy, increased from 7.5% in 2018 to 8.8% in 2019. The JNS statistical update represents a critical resource for the lay public, policy makers, media professionals, neurosurgeons, healthcare administrators, researchers, health advocates, and others seeking the best available data on neurosurgical practice.

PMID:34732592 | DOI:10.2176/nmc.st.2021-0254

J Craniofac Surg. 2021 Nov 2. doi: 10.1097/SCS.0000000000008353. Online ahead of print.

ABSTRACT

OBJECTIVE: Suboptimal pain management after primary palatoplasty (PP) may lead to complications such as hypoxemia, and increased hospital length of stay. Opioids are the first option for postoperative acute pain control after PP; however, adverse effects include excessive sedation, respiratory depression, and death, among others. Thus, optimizing postoperative pain control using opioid-sparing techniques is critically important. This paper aims to analyze efficacy and safety of combined intravenous (IV), dexmedetomidine, and IV acetaminophen during PP.

METHODS: Review of a cohort of patients who underwent PP from April 2009 to July 2018 at a large free-standing children’s hospital was performed, comparing patients who received combined IV dexmedetomidine and acetaminophen with those who did not receive either of the 2 medications. Efficacy was measured through opioid and nonopioid analgesic dose and timing, pain scores, duration to oral intake, and length of stay. Safety was measured by 30-day complication rates including readmission for bleeding and need for supplementary oxygen.

RESULTS: Total postoperative acetaminophen (P = 0.01) and recovery room fentanyl (P < 0.001) requirements were significantly lower in the study group compared with the control group. Length of stay, oral intake duration, pain scores, total postoperative opioid requirements, and complications rates trended favorably in the study group, though differences did not reach statistical significance.

CONCLUSIONS: Intraoperative IV dexmedetomidine and acetaminophen during PP provides safe and effective perioperative pain control, resulting in statistically significant decreased need for postoperative acetaminophen and fentanyl. Larger studies are necessary to determine if other trends identified in this study may be significant.

PMID:34732670 | DOI:10.1097/SCS.0000000000008353