Tag: pubmed

Cardiovasc J Afr. 2024 Apr 5;34:1-9. doi: 10.5830/CVJA-2024-005. Online ahead of print.

ABSTRACT

Cardiovascular risk is a health concern in people living with HIV/AIDS (PLWH). This longitudinal study (baseline vs 36 months) aimed to investigate the relationship between body composition and markers of cardiovascular risk in a South African study population [HIV free, n = 22 vs HIV positive on antiretroviral therapy (HIV+ART), n = 73)]. Health questionnaires, anthropometric measurements, biochemical analyses and flow-mediated dilation were performed. Linear mixed-model statistical analyses were applied. The HIV+ART vs the HIV-free groups were independently associated with body mass index (BMI) [-4.92 (-7.99 to -1.84), p = 0.002] and waist circumference [-10.5 (-17.2 to -3.77), p = 0.003]. ART duration was associated with BMI [2.60 (0.57-4.62), p = 0.013], waist circumference [3.83 (0.03-7.63), p = 0.048] and high-density lipoprotein cholesterol [20.18 (2.37-41.09), p = 0.025]. The data showed that intricate relationships existed in this study population between HIV, ART, body composition and cardiometabolic variables. There is a need for more research investigating cardiovascular risk in PLWH, particularly in the context of changes in body composition measures.

PMID:38787609 | DOI:10.5830/CVJA-2024-005

JMIR Public Health Surveill. 2024 May 24;10:e39297. doi: 10.2196/39297.

ABSTRACT

BACKGROUND: Innovation in seasonal influenza vaccine development has resulted in a wider range of formulations becoming available. Understanding vaccine coverage across populations including the timing of administration is important when evaluating vaccine benefits and risks.

OBJECTIVE: This study aims to report the representativeness, uptake of influenza vaccines, different formulations of influenza vaccines, and timing of administration within the English Primary Care Sentinel Cohort (PCSC).

METHODS: We used the PCSC of the Oxford-Royal College of General Practitioners Research and Surveillance Centre. We included patients of all ages registered with PCSC member general practices, reporting influenza vaccine coverage between September 1, 2019, and January 29, 2020. We identified influenza vaccination recipients and characterized them by age, clinical risk groups, and vaccine type. We reported the date of influenza vaccination within the PCSC by International Standard Organization (ISO) week. The representativeness of the PCSC population was compared with population data provided by the Office for National Statistics. PCSC influenza vaccine coverage was compared with published UK Health Security Agency’s national data. We used paired t tests to compare populations, reported with 95% CI.

RESULTS: The PCSC comprised 7,010,627 people from 693 general practices. The study population included a greater proportion of people aged 18-49 years (2,982,390/7,010,627, 42.5%; 95% CI 42.5%-42.6%) compared with the Office for National Statistics 2019 midyear population estimates (23,219,730/56,286,961, 41.3%; 95% CI 4.12%-41.3%; P<.001). People who are more deprived were underrepresented and those in the least deprived quintile were overrepresented. Within the study population, 24.7% (1,731,062/7,010,627; 95% CI 24.7%-24.7%) of people of all ages received an influenza vaccine compared with 24.2% (14,468,665/59,764,928; 95% CI 24.2%-24.2%; P<.001) in national data. The highest coverage was in people aged ≥65 years (913,695/1,264,700, 72.3%; 95% CI 72.2%-72.3%). The proportion of people in risk groups who received an influenza vaccine was also higher; for example, 69.8% (284,280/407,228; 95% CI 69.7%-70%) of people with diabetes in the PCSC received an influenza vaccine compared with 61.2% (983,727/1,607,996; 95% CI 61.1%-61.3%; P<.001) in national data. In the PCSC, vaccine type and brand information were available for 71.8% (358,365/498,923; 95% CI 71.7%-72%) of people aged 16-64 years and 81.9% (748,312/913,695; 95% CI 81.8%-82%) of people aged ≥65 years, compared with 23.6% (696,880/2,900,000) and 17.8% (1,385,888/7,700,000), respectively, of the same age groups in national data. Vaccination commenced during ISO week 35, continued until ISO week 3, and peaked during ISO week 41. The in-week peak in vaccination administration was on Saturdays.

CONCLUSIONS: The PCSC’s sociodemographic profile was similar to the national population and captured more data about risk groups, vaccine brands, and batches. This may reflect higher data quality. Its capabilities included reporting precise dates of administration. The PCSC is suitable for undertaking studies of influenza vaccine coverage.

PMID:38787605 | DOI:10.2196/39297

Int J Prosthodont. 2024 Feb 21;37(7):221-226. doi: 10.11607/prd.8928.

ABSTRACT

PURPOSE: To evaluate fracture load values of five types of interim CAD/CAM crowns with and without thermocycling.

MATERIALS AND METHODS: A complete coverage crown was designed on a mandibular first molar with a uniform 1.5-mm axial and occlusal reduction, and the STL file was exported to manufacture 100 crowns using five materials (20 crowns per material): ZCAD Temp Esthetic (SM-ZCAD; Harvest Dental); Telio CAD (SM-TCAD); P pro Crown and Bridge (AM-PPRO); E-Dent 400 C&B MHF (AM-EDENT); and DENTCA Crown & Bridge (AM-DENTCA). Each group was then divided into two subgroups: before and after thermocycling (10 cornws per subgroup). The STL file of the mandibular first molar die was used to manufacture 100 resin dies. Each die was assigned to one interim crown. Interim crowns were then luted to their assigned die using a temporary luting agent. The fracture strength of crowns was then assessed using a universal testing machine at a crosshead speed of 2 mm/minute. Two-way ANOVA followed by Tukey multiple comparations post-hoc tests were used to assess the effect of material choice and thermocycling process on the fracture strength of interim crowns (α = .05).

RESULTS: Material choice and the thermocycling process exerted a significant (P < .001) impact on the fracture strength of interim crowns. However, the interaction between these two factors did not yield a statistically significant effect (P = .176).

CONCLUSIONS: Within the limitations of this study, the type of interim materials and thermocycling process have a significant impact on the fracture strength of interim crowns.

PMID:38787587 | DOI:10.11607/prd.8928

Int J Prosthodont. 2024 Feb 21;37(7):195-202.

ABSTRACT

PURPOSE: To evaluate the fracture resistance of permanent resin crowns for primary teeth produced using two different 3D-printing technologies (digital light processing [DLP] and stereolithography [SLA]) and cemented with various luting cements (glass ionomer, resin-modified glass ionomer, and self-adhesive resin cement), whether thermally aged or not.

MATERIALS AND METHODS: A typodont primary mandibular second molar tooth was prepared and scanned, and a restoration design was created with web-based artificial intelligence (AI) dental software. A total of 96 crowns were prepared, and 12 experimental groups were generated according to the cement type, 3Dprinting technology (DLP or SLA), and thermal aging. Fracture resistance values and failure types of the specimens were noted. The results were statistically analyzed with three-way ANOVA and Tukey HSD tests (α = .05).

RESULTS: The results of the three-way ANOVA showed that there was an interaction among the factors (3D-printing technology, cement type, and thermal aging) (P = .003). Thermal aging significantly decreased the fracture resistance values in all experimental groups. DLP-printed crowns showed higher fracture resistance values than SLA-printed crowns. Cement type also affected the fracture resistance, with glass ionomer cement showing the lowest values after aging. Resin-modified glass ionomer and resin cements were more preferable for 3D-printed crowns.

CONCLUSIONS: The type of cement and the 3D-printing technology significantly influenced the fracture resistance of 3D-printed permanent resin crowns for primary teeth, and it was decided that these crowns would be able to withstand masticatory forces in children.

PMID:38787584

Int J Prosthodont. 2024 Feb 21;37(7):187-193. doi: 10.11607/ijp.8905.

ABSTRACT

PURPOSE: To characterize material changes that may occur in virgin cobalt-chromium (Co-Cr) alloy powder when it is blended with alloy powders that have been reused multiple times.

MATERIALS AND METHODS: Initially, 20 kg of virgin Co-Cr powder was loaded into a laser-sintering device. The tensile test specimens were fabricated in the first (Group 1), fourth (Group 2), seventh (Group 3), tenth (Group 4), and thirteenth (Group 5) production cycles (N = 15). Prior to fabricating the specimens, powder alloy samples were collected from the powder bed for analysis. The tensile strength, elastic modulus, and percent elongation were calculated with tensile testing. Scanning electron microscopy and energy dispersive x-ray spectroscopy (SEM/EDS) and laser particle size distribution (LPSD) were used to analyze the alloy powder samples. The fracture surface of one tensile test specimen from each group was examined via SEM/EDS. One-way ANOVA followed by Dunnett T3 test was used for statistical analysis (α = .05).

RESULTS: No difference was observed between groups in terms of tensile strength. A statistically significant difference was observed between Groups 1 and 2 in terms of percent elongation. Groups 2 and 4 were statistically significantly different in terms of both elastic modulus and percent elongation (P ≤ .05). SEM images of the powder alloy showed noticeable differences with increasing numbers of cycles. SEM images and the EDS analysis of the fractured specimens were in accordance with the strength data.

CONCLUSIONS: Reusing Co-Cr alloy powder increased the particle size distribution. However, there was no correlation between increased cycle number and the mechanical properties of the powder.

PMID:38787583 | DOI:10.11607/ijp.8905

Health Phys. 2024 May 24. doi: 10.1097/HP.0000000000001830. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the effects of tube current and tube voltage choices on patient dose in adult and pediatric CT protocols by qualitative analysis using Principal Component Analysis (PCA), cluster analysis, and statistical analysis.Dose length product (DLP), Effective mAs (Eff. mAs), and volume-weighted CT dose index (CTDIvol) dose descriptors were obtained from 16 adult and pediatric head phantom CT examinations. Different tube voltage and tube current values were selected in both pediatric head and adult head CT imaging protocols, and PCA and cluster analysis were applied to the data obtained for qualitative analysis of the relationship between CTDIvol, Eff. mAs and Total DLP values. The two principial components (PC) with the highest values among those obtained as a result of the PCA method were used. PC1 was 70.97%, and PC2 was 28.03%. In the cluster analysis, it was observed that the values obtained from pediatric and adult phantom CT scans were classified into two different clusters. The correlation coefficient for adult patients was r = 0.998, and for pediatric patients, the correlation coefficient was r = 0.947. When the obtained clusters were examined, the degree of closeness or distance of the variables could be observed. In the study, as a result of the analysis of CTDIvol, Eff. mAs and Total DLP data based on manufacturer data at different kV and mA values with PCA and cluster analysis, it was shown that pediatric patients could be exposed to more radiation than the adult patients.

PMID:38787573 | DOI:10.1097/HP.0000000000001830

J Vis. 2024 May 1;24(5):12. doi: 10.1167/jov.24.5.12.

ABSTRACT

Materials exhibit an extraordinary range of visual appearances. Characterizing and quantifying appearance is important not only for basic research on perceptual mechanisms but also for computer graphics and a wide range of industrial applications. Although methods exist for capturing and representing the optical properties of materials and how they vary across surfaces (Haindl & Filip, 2013), the representations are typically very high-dimensional, and how these representations relate to subjective perceptual impressions of material appearance remains poorly understood. Here, we used a data-driven approach to characterizing the perceived appearance characteristics of 30 samples of wood veneer using a “visual fingerprint” that describes each sample as a multidimensional feature vector, with each dimension capturing a different aspect of the appearance. Fifty-six crowd-sourced participants viewed triplets of movies depicting different wood samples as the sample rotated. Their task was to report which of the two match samples was subjectively most similar to the test sample. In another online experiment, 45 participants rated 10 wood-related appearance characteristics for each of the samples. The results reveal a consistent embedding of the samples across both experiments and a set of nine perceptual dimensions capturing aspects including the roughness, directionality, and spatial scale of the surface patterns. We also showed that a weighted linear combination of 11 image statistics, inspired by the rating characteristics, predicts perceptual dimensions well.

PMID:38787569 | DOI:10.1167/jov.24.5.12

JAMA Netw Open. 2024 May 1;7(5):e2410994. doi: 10.1001/jamanetworkopen.2024.10994.

ABSTRACT

IMPORTANCE: The health care workforce continues to experience high rates of depression and anxiety. Finding ways to effectively support the mental health and well-being of health care workers is challenging.

OBJECTIVE: To test the effectiveness of remote, pushed digital assessments and engagement to improve depression and anxiety among health care workers compared with usual care.

DESIGN, SETTING, AND PARTICIPANTS: This was a 9-month randomized clinical trial with a 6-month intervention period. Participants were health care workers with self-reported daily access to a smartphone and at least 4 clinical hours per week. Participants were randomized to usual care or the intervention between January 2022 and March 2023. Data analyses were conducted between May and July 2023.

INTERVENTIONS: All participants completed baseline, 6-month, and 9-month mental health, well-being, and burnout assessments. The control group had open access to a web-based mental health platform. Participants in the intervention group received monthly text messaging about mental health, mental health assessments, and linkages to care.

MAIN OUTCOMES AND MEASURES: The primary outcomes were mean change in depression and anxiety scores at 6 months from baseline. Secondary outcomes include mean change in well-being, burnout, and self-reported workplace productivity.

RESULTS: In this study, 1275 participants were randomized (642 [50.4%] to the intervention group and 633 [49.6%] to control group). Participants had a mean (SD) age of 38.6 (10.9) years, 1063 participants (83.4%) were female, 320 (25.1%) self-identified as Black, and 793 (62.2%) self-identified as White. Across the groups, the mean difference in depression score was significantly different at 6 months (-0.96 [95% CI, -1.52 to -0.40]) and at 9 months (-1.14 [95% CI, -1.69 to -0.58]). The mean difference in anxiety score from baseline to 6 months was statistically significantly larger for those in the intervention group vs usual care (-0.71 [95% CI, -1.25 to -0.17]) and held true at 9 months (-1.06 [95% CI, -1.59 to -0.52]).

CONCLUSIONS AND RELEVANCE: In a trial of health care workers, a proactive digital engagement strategy, including pushed text messaging, mobile mental health assessments, and connection to care, improved depression and anxiety over a 6-month period compared with simply making the same resources available for individuals to find and use.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05028075.

PMID:38787562 | DOI:10.1001/jamanetworkopen.2024.10994

JAMA Netw Open. 2024 May 1;7(5):e2411717. doi: 10.1001/jamanetworkopen.2024.11717.

ABSTRACT

IMPORTANCE: For patients with nonspine bone metastases, short-course radiotherapy (RT) can reduce patient burden without sacrificing clinical benefit. However, there is great variation in uptake of short-course RT across practice settings.

OBJECTIVE: To evaluate whether a set of 3 implementation strategies facilitates increased adoption of a consensus recommendation to treat nonspine bone metastases with short-course RT (ie, ≤5 fractions).

DESIGN, SETTING, AND PARTICIPANTS: This prospective, stepped-wedge, cluster randomized quality improvement study was conducted at 3 community-based cancer centers within an existing academic-community partnership. Rollout was initiated in 3-month increments between October 2021 and May 2022. Participants included treating physicians and patients receiving RT for nonspine bone metastases. Data analysis was performed from October 2022 to May 2023.

EXPOSURES: Three implementation strategies-(1) dissemination of published consensus guidelines, (2) personalized audit-and-feedback reports, and (3) an email-based electronic consultation platform (eConsult)-were rolled out to physicians.

MAIN OUTCOMES AND MEASURES: The primary outcome was adherence to the consensus recommendation of short-course RT for nonspine bone metastases. Mixed-effects logistic regression at the bone metastasis level was used to model associations between the exposure of physicians to the set of strategies (preimplementation vs postimplementation) and short-course RT, while accounting for patient and physician characteristics and calendar time, with a random effect for physician. Physician surveys were administered before implementation and after implementation to assess feasibility, acceptability, and appropriateness of each strategy.

RESULTS: Forty-five physicians treated 714 patients (median [IQR] age at treatment start, 67 [59-75] years; 343 women [48%]) with 838 unique nonspine bone metastases during the study period. Implementing the set of strategies was not associated with use of short-course RT (odds ratio, 0.78; 95% CI, 0.45-1.34; P = .40), with unadjusted adherence rates of 53% (444 lesions) preimplementation vs 56% (469 lesions) postimplementation; however, the adjusted odds of adherence increased with calendar time (odds ratio, 1.68; 95% CI, 1.20-2.36; P = .003). All 3 implementation strategies were perceived as being feasible, acceptable, and appropriate; only the perception of audit-and-feedback appropriateness changed before vs after implementation (19 of 29 physicians [66%] vs 27 of 30 physicians [90%]; P = .03, Fisher exact test), with 20 physicians (67%) preferring reports quarterly.

CONCLUSIONS AND RELEVANCE: In this quality improvement study, a multicomponent set of implementation strategies was not associated with increased use of short-course RT within an academic-community partnership. However, practice improved with time, perhaps owing to secular trends or physician awareness of the study. Audit-and-feedback was more appropriate than anticipated. Findings support the need to investigate optimal approaches for promoting evidence-based radiation practice across settings.

PMID:38787561 | DOI:10.1001/jamanetworkopen.2024.11717

JAMA Netw Open. 2024 May 1;7(5):e2412055. doi: 10.1001/jamanetworkopen.2024.12055.

ABSTRACT

IMPORTANCE: Heat waves are increasing in frequency, intensity, and duration and may be acutely associated with pregnancy outcomes.

OBJECTIVE: To examine changes in daily rates of preterm and early-term birth after heat waves in a 25-year nationwide study.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study of singleton births used birth records from 1993 to 2017 from the 50 most populous US metropolitan statistical areas (MSAs). The study included 53 million births, covering 52.8% of US births over the period. Data were analyzed between October 2022 and March 2023 at the National Center for Health Statistics.

EXPOSURES: Daily temperature data from Daymet at 1-km2 resolution were averaged over each MSA using population weighting. Heat waves were defined in the 4 days (lag, 0-3 days) or 7 days (lag, 0-6 days) preceding birth.

MAIN OUTCOMES AND MEASURES: Daily counts of preterm birth (28 to <37 weeks), early-term birth (37 to <39 weeks), and ongoing pregnancies in each gestational week on each day were enumerated in each MSA. Rate ratios for heat wave metrics were obtained from time-series models restricted to the warm season (May to September) adjusting for MSA, year, day of season, and day of week, and offset by pregnancies at risk.

RESULTS: There were 53 154 816 eligible births in the 50 MSAs from 1993 to 2017; 2 153 609 preterm births and 5 795 313 early-term births occurring in the warm season were analyzed. A total of 30.0% of mothers were younger than 25 years, 53.8% were 25 to 34 years, and 16.3% were 35 years or older. Heat waves were positively associated with daily rates of preterm and early-term births, showing a dose-response association with heat wave duration and temperatures and stronger associations in the more acute 4-day window. After 4 consecutive days of mean temperatures exceeding the local 97.5th percentile, the rate ratio for preterm birth was 1.02 (95% CI, 1.00-1.03), and the rate ratio for early-term birth was 1.01 (95% CI, 1.01-1.02). For the same exposure, among those who were 29 years of age or younger, had a high school education or less, and belonged to a racial or ethnic minority group, the rate ratios were 1.04 (95% CI, 1.02-1.06) for preterm birth and 1.03 (95% CI, 1.02-1.05) for early-term birth. Results were robust to alternative heat wave definitions, excluding medically induced deliveries, and alternative statistical model specifications.

CONCLUSIONS AND RELEVANCE: In this cohort study, preterm and early-term birth rates increased after heat waves, particularly among socioeconomically disadvantaged subgroups. Extreme heat events have implications for perinatal health.

PMID:38787560 | DOI:10.1001/jamanetworkopen.2024.12055