Tag: pubmed

Quintessence Int. 2024 Nov 1;0(0):0. doi: 10.3290/j.qi.b5809024. Online ahead of print.

ABSTRACT

OBJECTIVE: This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment.

MATERIALS AND METHODS: forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.

RESULTS: Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups.

CONCLUSION: Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months.

CLINICAL SIGNIFICANCE: laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

PMID:39485147 | DOI:10.3290/j.qi.b5809024

Chaos. 2024 Nov 1;34(11):111102. doi: 10.1063/5.0235846.

ABSTRACT

We propose a mutual information statistic to quantify the information encoded by a partition of the state space of a dynamical system. We measure the mutual information between each point’s symbolic trajectory history under a coarse partition (one with few unique symbols) and its partition assignment under a fine partition (one with many unique symbols). When applied to a set of test cases, this statistic demonstrates predictable and consistent behavior. Empirical results and the statistic’s formulation suggest that partitions based on trajectory history, such as the ordinal partition, perform best. As an application, we introduce the weighted ordinal partition, an extension of the popular ordinal partition with parameters that can be optimized using the mutual information statistic, and demonstrate improvements over the ordinal partition in time series analysis. We also demonstrate the weighted ordinal partition’s applicability to real experimental datasets.

PMID:39485135 | DOI:10.1063/5.0235846

Chaos. 2024 Nov 1;34(11):113108. doi: 10.1063/5.0228472.

ABSTRACT

This article is concerned with the existence and spectral stability of pulses in singularly perturbed two-component reaction-diffusion systems with slowly mixed nonlinearity. In this paper, the slow nonlinearity is referred to be “mixed” in the sense that it is generated by a trigonometric function multiplied by a power function. We demonstrate via geometric singular perturbation theory that this model can support both the single-pulse and the double-hump solutions. The presence of the slowly mixed nonlinearity complicates the stability analysis on pulses, since the conditions that govern their stability can no longer be explicitly computed. We remove this difficulty by introducing the hypergeometric functions followed by a comparison theorem. By doing so, the “slow-fast” eigenvalues can be determined via the nonlocal eigenvalue problem method. We prove that the double-hump solution is always unstable, while the single-pulse solution can be stable under certain parameter conditions.

PMID:39485130 | DOI:10.1063/5.0228472

Acad Med. 2024 Oct 31. doi: 10.1097/ACM.0000000000005908. Online ahead of print.

ABSTRACT

PURPOSE: Virtual patients (VPs) are increasingly used in health care professions education to support clinical reasoning (CR) development. However, the extent to which feedback is given across CR components is unknown, and guidance is lacking on how VPs can optimize CR development. This systematic review sought to identify how VPs provide feedback on CR.

METHOD: Seven databases (MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, and ProQuest Dissertations) were searched in March 2023 using terms (e.g., medical education, virtual patient, case-based learning, computer simulation) adapted from a previous systematic review. All studies that described VP use for developing CR in medical professionals and provided feedback on at least 1 CR component were retrieved. Screening, data extraction, and quality assessment were performed. Narrative synthesis was performed to describe the approaches used to measure and provide feedback on CR.

RESULTS: A total of 6,526 results were identified from searches, of which 72 met criteria, but only 35 full-text articles were analyzed because the reporting of interventions in abstracts (n = 37) was insufficient. The most common CR components developed by VPs were leading diagnosis (23 [65.7%]), management or treatment plan (23 [65.7%]), and information gathering (21 [60%]). The CR components were explored by various approaches, from redefined questions to free text and concept maps.

CONCLUSIONS: Studies describing VP use for giving CR feedback have mainly focused on easy-to-assess CR components, whereas few studies have described VPs designed for assessing CR components, such as problem representation, hypothesis generation, and diagnostic justification. Despite feedback being essential for learning, few VPs provided information on the learner’s use of self-regulated learning processes. Educators designing or selecting VPs for CR use must consider the needs of learner groups and how different CR components can be explored and should make the instructional design of VPs explicit in published work.

PMID:39485118 | DOI:10.1097/ACM.0000000000005908

J Magn Reson Imaging. 2024 Nov 1. doi: 10.1002/jmri.29648. Online ahead of print.

ABSTRACT

BACKGROUND: Although improvement of cognitive function after liver transplantation has been demonstrated in several neuropsychological studies, there is limited research on longitudinal changes in the cirrhotic patients’ brain structure before and after transplantation.

PURPOSE: To investigate longitudinal changes of brain microstructure in cirrhotic patients using diffusion kurtosis imaging (DKI).

STUDY TYPE: Prospective.

SUBJECTS: A total of 153 cirrhosis patients, comprising 60 hepatic encephalopathy (HE) patients (16 females/44 males) and 93 no-HE patients (35 females/58 males), along with 93 healthy controls (HCs) (53 females/40 males) were enrolled. Subsequently, 58 recipients completed 1-month postoperative follow-up, 29 patients completed 1-, 3-months, and 17 patients completed 1-, 3-, 6-month follow-up.

SEQUENCE: Spin-echo single-shot echo-planar sequence using a 3.0 T scanner.

ASSESSMENT: Diffusion kurtosis estimator software was used to estimate the DKI parameter maps by a MR imaging physicist (Y.-Y.C. with 12 years of experience).

STATISTICAL TESTS: The diffusion metrics (eg, radial kurtosis [RK], mean kurtosis, fractional anisotropy, mean diffusivity) of the patients before transplantation were compared with those of the HCs using voxel-wise analysis of variance (ANOVA), along with t tests for post hoc analysis. Linear mixed-effects models were applied to the longitudinal data. We imposed a cluster level Family Wise Error (FWE) correction rate of P_FWE = 0.05 with voxel-wise cutoff of P = 0.001 together with a cluster-size cutoff of N ≥ 56, and generated smoothness estimates from the preprocessed data using the mixed-model autocorrelation function.

RESULTS: The RK metrics of the patients decreased significantly in the anterior cingulate cortex (HE/no-HE < HC, ANOVA-F = 21.91). After transplantation, the RK of the pallidum showed a continuous upward trend (time effect T = 11.26); whereas the RK of the right postcentral gyrus showed a continuous downward trend (time effect T = -9.56). In addition, the RK in superior longitudinal fasciculus showed new-onset decrease after transplantation.

DATA CONCLUSION: Longitudinal changes in DKI metrics reveal the course of brain microstructural changes before and after transplantation in cirrhotic patients, potentially associated with cognitive alterations after surgery.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 4.

PMID:39485115 | DOI:10.1002/jmri.29648

J Gastroenterol Hepatol. 2024 Nov 1. doi: 10.1111/jgh.16794. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The simulation-based mastery learning (SBML) method holds promise for improving the efficiency and effectiveness of endoscopy training. However, further study is required to establish its advantages over the traditional method. We aim to prospectively compare outcomes between gastrointestinal endoscopy trainees taught using SBML and those trained using conventional apprenticeship methods for upper endoscopy.

METHODS: We performed a blinded, stepwise, comparative study with SBML participants deliberately practicing deconstructed steps of upper endoscopy and apprenticeship participants observing procedures. Three blinded trainers assessed trainees’ skills using a validated esophagogastroduodenoscopy (EGD) tool pre-and post-training. The minimum pass standard (MPS) was set at a score > 2. We compared MPS of the groups using standard statistics and paired t-test.

RESULTS: Six trainees were enrolled in the SBML group, and six in the conventional group. All trainees in the SBML group passed the minimum standard compared with the conventional group (P = 0.06). All trainees in the SBML group obtained significantly higher scores in overall basic GI endoscopic skills, esophageal, stomach, and duodenal observation skills than those of the conventional apprenticeship group (P < 0.05). The SBML curriculum led to three times more learning (Cohen’s d = 6.5) than the conventional method (Cohen’s d = 1.8).

CONCLUSION: This prospective study supports SBML for upper endoscopy training compared with the traditional apprentice-based method. SBML resulted in a steeper learning curve, as trainees learned three times more during the same period. Furthermore, trainees developed a uniform competency level at the end of training.

PMID:39484698 | DOI:10.1111/jgh.16794

Euro Surveill. 2024 Oct;29(44). doi: 10.2807/1560-7917.ES.2024.29.44.2400680.

ABSTRACT

COVID-19 vaccination recommendations include healthcare workers (HCWs). We measured COVID-19 vaccine effectiveness (CVE) of the autumn 2023 dose against laboratory-confirmed SARS-CoV-2 infection in a prospective cohort study of 1,305 HCWs from 13 European hospitals. Overall CVE was 22% (95% CI: -17 to 48), 49% (95% CI: -8 to 76) before and -11% (95% CI: -84 to 34) after the start of BA.2.86/JN.1 predominant circulation. Autumn 2023 COVID-19 vaccination led to a moderate-to-low reduction in SARS-CoV-2 infection incidence in HCWs. Monitoring of CVE is crucial for COVID-19 prevention.

PMID:39484687 | DOI:10.2807/1560-7917.ES.2024.29.44.2400680

J Hosp Med. 2024 Nov 1. doi: 10.1002/jhm.13542. Online ahead of print.

ABSTRACT

BACKGROUND: High-quality trial evidence supports the use of one dose of dexamethasone in the outpatient management of croup; however, there are no inpatient trials, and the optimal treatment regimen for the inpatient management of croup remains uncertain. Significant practice variability exists in the corticosteroid treatment of children hospitalized for croup.

OBJECTIVE: To evaluate the association of dexamethasone treatment regimen (1 vs. >1 dose) with hospital length of stay (LOS) and 30-day return to emergency department (ED) visits among children hospitalized for croup.

METHODS: A cohort study of children hospitalized for croup at a children’s hospital between 2010 and 2022. Children less than 10 years old, without known airway anomalies and who received dexamethasone for croup treatment were included. Children who received 1 dose versus >1 dose of dexamethasone were compared. Propensity score analyses, using inverse probability of treatment weighting, were conducted to estimate the treatment effects of dexamethasone regimen on hospital LOS and all-cause 30-day return to ED visit.

RESULTS: Of 471 children hospitalized for croup, 229 (49%) received 1 dose of dexamethasone; 242 (51%) received >1 dose. In the propensity-weighted analyses, children receiving >1 dose of dexamethasone had a longer mean LOS by 59.6 h (95% CI 44.8-74.5, p < .001) compared with those receiving >1 dose. There was no statistically significant difference in the odds of all-cause 30-day return to ED visit; OR 1.30, (95% CI 0.76-2.22, p = .33).

CONCLUSIONS: Among children hospitalized for croup, children who received >1 dose of dexamethasone had a longer LOS compared with children who received 1 dose of dexamethasone; however, there was no statistically significant difference in the 30-day return to ED visits. Randomized clinical trials are needed to determine the optimal dexamethasone treatment regimen for children hospitalized with croup.

PMID:39484678 | DOI:10.1002/jhm.13542

NeuroSci. 2022 Jan 14;3(1):52-62. doi: 10.3390/neurosci3010004. eCollection 2022 Mar.

ABSTRACT

PURPOSE: The main purpose of this retrospective study was to identify auditory dysfunctions related to traumatic brain injury (TBI) in individuals evaluated in an Audiology clinic.

METHOD: Peripheral and central auditory evaluations were performed from March 2014 to June 2018 in 26 patients (14 males) with TBI. The age of the participants ranged from 9 to 59 years old (34.24 ± 15.21). Six participants had blast-related TBI and 20 had blunt force TBI. Sixteen experienced a single TBI event whereas ten experienced several. Correlation analyses were performed to verify the relationship, if any, between the number of auditory tests failed and the number, type, and severity of TBIs.

RESULT: All participants failed at least one auditory test. Nearly 60% had abnormal results on degraded speech tests (compressed and echoed, filtered or in background noise) and 25% had a high frequency hearing loss. There was no statistically significant correlation between the number of auditory tests failed and the number, type, and severity of TBIs.

CONCLUSION: Results indicated negative and heterogenous effects of TBI on peripheral and central auditory function and highlighted the need for a more extensive auditory assessment in individuals with TBI.

PMID:39484668 | PMC:PMC11523697 | DOI:10.3390/neurosci3010004

Digit Health. 2024 Oct 7;10:20552076241288430. doi: 10.1177/20552076241288430. eCollection 2024 Jan-Dec.

ABSTRACT

BACKGROUND: Coronary artery disease (CAD) is a global health concern. Conventional single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is a noninvasive method for assessing the severity of CAD. However, it relies on manual classification by clinicians, which can lead to visual fatigue and potential errors. Deep learning techniques have displayed promising results in CAD diagnosis and prediction, providing efficient and accurate analysis of medical images.

METHODS: In this study, we explore the application of deep learning methods for assessing the severity of CAD and identifying cases of multivessel disease (MVD). We utilized the EfficientNet-V2 model in combination with DeepSMOTE to evaluate CAD severity using SPECT MPI images.

RESULTS: Utilizing a dataset consisting of 254 patients (176 with MVD and 78 with single-vessel disease [SVD]), our model achieved an accuracy rate of 84.31% and area under the receiver operating characteristic curve (AUC) value of 0.8714 in predicting cases of MVD. These results underline the promising potential of our approach in MVD prediction, offering valuable diagnostic insights and the prospect of reducing medical costs.

CONCLUSION: This study emphasizes the feasibility of employing deep learning techniques for predicting MVD based on SPECT MPI images. The integration of Efficient-Net-V2 and DeepSMOTE methods effectively evaluates CAD severity and distinguishes MVD from SVD. Our research presents a practical approach to the early prediction and diagnosis of MVD, ultimately leading to enhanced patient outcomes and reduced healthcare costs.

PMID:39484655 | PMC:PMC11526402 | DOI:10.1177/20552076241288430