Tag: pubmed

BMC Oral Health. 2023 Oct 11;23(1):745. doi: 10.1186/s12903-023-03486-x.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effect of secondhand smoke on dental caries and gingival health among schoolchildren in Damascus, Syria.

MATERIALS AND METHODS: This was a cross-sectional study. It was carried out at government schools in Damascus, Syria. This study included healthy children aged 10 to 13 years old. Schoolchildren were interviewed to answer the researcher-administered questionnaire to obtain answers regarding demographic information and family smoking behavior. A dental examination was performed by a dentist, and the number of decayed (D), missing (M), and filled (F) permanent teeth (DMFT) was scored based on the World Health Organization (WHO) 1997. A gingival examination was performed using the modified gingival index (MGI) and Silness-Leo plaque index (PI) to assess gingival inflammation and plaque accumulation, respectively.

RESULTS: A total of 284 schoolchildren participated. More than half (61.26%) of them were exposed to secondhand smoke (SHS), and about half of them (52.11%) resided in a house with at least one cigarette smoked in a day. About one-third of the passive smokers (33.30%) had poor plaque control, with a statistically significant difference from non-passive smokers (p < 0.05). The multivariate regression model showed that the number of smokers at home was significantly associated with the DMFT score, dental plaque accumulation, and gingival inflammation (p < 0.1). However, the number of cigarettes smoked at home in a day was not a predictor for dental caries and gingival status (p = 1.000).

CONCLUSIONS: Within the limitations of this study, the number of smokers at home appears to have more adverse effects on children’s oral health compared to the quantity of smoke inhaled. In addition, SHSe was associated with more dental plaque accumulation among schoolchildren.

PMID:37821880 | DOI:10.1186/s12903-023-03486-x

Nurs Outlook. 2023 Oct 9;71(6):102054. doi: 10.1016/j.outlook.2023.102054. Online ahead of print.

ABSTRACT

BACKGROUND: Nursing Doctor of Philosophy program enrollment has declined. Undergraduate nursing student (UGS) research engagement is associated with future graduate education, an essential element for building the nursing faculty pipeline.

PURPOSE: (a) To describe the infrastructure and culture-enhancing resources and strategies associated with building UGS research engagement and (b) to evaluate UGS research engagement.

METHODS: Guided by a socioecological systems model university and college documents, databases, and college of nursing survey results were used to identify approaches to, and outcomes of, engaging UGS in research. Descriptive statistics were calculated to illustrate 5-year UGS research engagement trends.

FINDINGS: Resources and strategies included grant funding, research assistant funding, student research showcases, and faculty mentorship. UGS research 5-year engagement trends included (a) a 75% increase in the number of students mentored, (b) a 30% rise in funded research proposals, and (c) a 54% increase in paid research assistantships.

DISCUSSION: Purposefully using existing resources, growing the college of nursing infrastructure, and cultivating a culture recognizing faculty contributions were approaches associated with increased UGS research engagement.

PMID:37820409 | DOI:10.1016/j.outlook.2023.102054

Appl Physiol Nutr Metab. 2023 Oct 11. doi: 10.1139/apnm-2023-0184. Online ahead of print.

ABSTRACT

Females demonstrate greater fatigue resistance during a range of exercise modalities; however, this may be confounded by the lower mechanical work completed. Accordingly, this study examined the sex-specific peripheral and central fatigue mechanisms during repeated all-out cycling and whether they are affected by total mechanical work performed. 26 healthy young adults (12 females) performed 10 × 10 s all-out cycling interspersed by 30 s passive recovery. Metabolic responses, peripheral and central fatigue was quantified via changes in pre- to post-exercise blood lactate, potentiated quadriceps twitch force (and contractile properties) evoked via supramaximal electrical stimulation of the femoral nerve, and voluntary activation of the knee extensors, respectively. During exercise, mechanical work, vastus lateralis muscle activation (via surface electromyography, EMG) and deoxygenation (via near-infrared spectroscopy) were recorded. Sex comparison analyses were performed before and after statistically controlling for total mechanical work (via ANCOVA). Mechanical work and muscle activation plateaued at similar sprint repetition (sprint 5) and voluntary activation change (pre vs. post) was similar between the sexes. Females, however, showed lower percent work decrement (i.e., fatigability; P = 0.037) and peripheral responses as evident by lower reductions in quadriceps twitch force (P < 0.001), and muscle deoxygenation (P = 0.001). Adjusting for total mechanical work did not change these sex comparison results. We show that females’ greater fatigue resistance during repeated all-out cycling may not be attributed to the greater total mechanical work performed but could be mediated by lower peripheral fatigue in the knee extensor muscles.

PMID:37820383 | DOI:10.1139/apnm-2023-0184

Pediatr Emerg Care. 2023 Oct 12. doi: 10.1097/PEC.0000000000003066. Online ahead of print.

ABSTRACT

OBJECTIVE: Ophthalmia neonatorum (ON) is a conjunctivitis occurring in neonates and can be caused by multiple bacterial pathogens. The risk of invasive bacterial infection (IBI) in neonates with ON is poorly known. Our objectives were to document the association of ON with IBI in term neonates and to investigate practice variation.

METHODS: This was a retrospective observational study of all neonates who presented to a single emergency department (ED) between January 2018 and December 2019. Participants were all children with a final diagnosis of ON according to the treating physician as registered in the ED computerized database. Newborns with craniofacial malformations and premature infants were excluded. The primary outcome was IBI as defined by growth of any bacterial pathogen in the blood or cerebrospinal fluid. Perinatal risk factors, ED visit details (symptoms on presentation, management, and treatment plan) as well as complications (ocular morbidity, death, and unscheduled return visits) were collected. Data were analyzed using descriptive statistics.

RESULTS: Fifty-two term neonates were included. There were no cases of IBI associated with ON (0%; 95% confidence interval [CI], 0%-6.9%). Six ocular bacterial infections were identified, one of which was Chlamydia trachomatis. Although there were no IBIs, ocular complications, deaths, or unscheduled return visits to the ED, there was a wide variation in physician’s management of ON. Physicians ordered investigations in 49% (95% CI, 34%-62%) of neonates, prescribed antibiotics to 87% (95% CI, 74%-94%), and involved specialists in 39% (95% CI, 27%-52%) of cases.

CONCLUSIONS: Emergency department presentations of term neonates with ON are associated with a low risk of IBI. A better understanding of the current practice variation is needed to inform clinical guidelines for the management of neonates with ON presenting to the ED.

PMID:37820378 | DOI:10.1097/PEC.0000000000003066

J Med Internet Res. 2023 Oct 10. doi: 10.2196/47112. Online ahead of print.

ABSTRACT

BACKGROUND: Recent studies have linked a low Heart Rate Variability (HRV) with COVID-19 infection, indicating that this parameter can be a marker of the onset of the disease, its severity, and predictor of mortality in infected people. Given the large offer of wearable devices that capture physiological signals of the human body easily and non-invasive, several studies used this equipment to measure the HRV of individuals and related these measures to the infection by COVID-19.

OBJECTIVE: The objective of this study was to assess the utility of HRV measurements obtained from wearable devices as predictive indicators for COVID-19 infection, as well as the onset and worsening of symptoms in affected individuals.

METHODS: A systematic review was conducted, searching the following databases up to the end of January 2023: Embase, PubMed, Web of Science, Scopus, and IEEE. Studies had to include (I) measures of HRV in patients with COVID-19 and (II) measurements involving the use of wearable devices. We also conducted a meta-analysis of these measures to reduce the possible biases and increase the statistical power of the primary research.

RESULTS: The main result was the association between low HRV and the onset and worsening of COVID-19 symptoms. In some cases, it was possible to predict the onset of COVID-19 before a positive clinical test. The meta-analysis of studies reported shows that a reduction in HRV parameters is associated with COVID-19 infection. Individuals with COVID-19 presented a reduction in the SDNN and RMSSD indices compared to healthy individuals. The decrease in the SDNN index (Standard Deviation of the Normal-to-Normal interbeat interval) was 3.25 ms (95% CI -5.34 to -1.16), and the decrease in the RMSSD index (Root Mean Square Successive Difference) was 1.24 ms (95% CI -3.71 to 1.23).

CONCLUSIONS: Wearable devices that measure changes in HRV, such as smart watches, rings, and bracelets, provide information that allows identifying the COVID-19 infection during the presymptomatic period as well as its worsening, through an indirect and non-invasive self-diagnosis.

CLINICALTRIAL: International Prospective Register of Systematic Reviews (PROSPERO; CRD42023399705).

PMID:37820372 | DOI:10.2196/47112

J Chem Inf Model. 2023 Oct 11. doi: 10.1021/acs.jcim.3c00761. Online ahead of print.

ABSTRACT

Raman spectra are examples of high dimensional data that can often be limited in the number of samples. This is a primary concern when Deep Learning frameworks are developed for tasks such as chemical species identification, quantification, and diagnostics. Open-source data are difficult to obtain and often sparse; furthermore, the collecting and curating of new spectra require expertise and resources. Deep generative modeling utilizes Deep Learning architectures to approximate high dimensional distributions and aims to generate realistic synthetic data. The evaluation of the data and the performance of the deep models is usually conducted on a per-task basis and provides no indication of an increase to robustness, or generalization, on a wider scale. In this study, we compare the benefits and limitations of a standard statistical approach to data synthesis (weighted blending) with a popular deep generative model, the Variational Autoencoder. Two binary data sets are divided into 3-fold to simulate small, limited samples. Synthetic data distributions are created per fold using the two methods and then augmented into the training of two Deep Learning algorithms, a Convolutional Neural Network and a Fully-Connected Neural Network. The goal of this study is to observe the trends in learning as synthetic data are continually augmented to the training data in increasing batches. To determine the impact of each synthetic method, Principal Component Analysis and the discrete Fréchet distance are implemented to visualize and measure the distance between the source and synthetic distributions along with the Machine Learning metric balanced accuracy for evaluating performance on imbalanced data.

PMID:37820361 | DOI:10.1021/acs.jcim.3c00761

Am J Respir Crit Care Med. 2023 Oct 11. doi: 10.1164/rccm.202305-0854OC. Online ahead of print.

ABSTRACT

RATIONALE: Assessing the early use of video-assisted thoracoscopic surgery (VATS) or intrapleural enzyme therapy (IET) in pleural infection requires a phase III randomized controlled trial (RCT).

OBJECTIVES: To establish the feasibility of randomization in a surgery versus non-surgery trial as well as the key outcome measures which are important to identify relevant patient-centered outcomes in a RCT.

METHODS: MIST-3 was a prospective multicenter RCT. All-comers with a confirmed diagnosis of pleural infection were enrolled and those with ongoing pleural sepsis after up to 24-hours of standard care were randomized to one of 3 arms; continued standard care, IET, or surgical opinion for VATS. The analysis was by intention to treat, despite some participants in the VATS arm not being fit enough to undergo surgical intervention.

MAIN RESULTS: Of 97 eligible patients, 60 (62%) participants were randomized. Despite a difference in time-to-intervention, length of stay was similar in both arms. There were no significant inter-group differences in 2-month readmission and further intervention. Compared to VATS, IET demonstrated a greater improvement in mean EQ-5D-5L health utility index at 2 months from baseline.

CONCLUSION: This is the first multicenter RCT of early IET vs early surgery in pleural infection. Despite logistical challenges posed by the COVID-19 pandemic, the study met its predefined feasibility criteria. Potential shortening of LOS with early surgery, and signals toward earlier resolution of pain and shortened recovery with IET were demonstrated. The study findings suggest that a definitive study is feasible and required to assess optimal initial management. Clinical trial registration available at www.isrctn.com, ID: ISRCTN18192121.

PMID:37820359 | DOI:10.1164/rccm.202305-0854OC

J Dev Behav Pediatr. 2023 Oct 11. doi: 10.1097/DBP.0000000000001221. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to understand health care experiences among a sample of caregivers of children with TDs to inform future directions for improving the health care system.

METHODS: We conducted a survey of caregivers of youth with TDs and used descriptive statistics and quantitative analyses to characterize the health care utilization practices of the sample.

RESULTS: The majority (70%) of families first consulted their pediatrician/primary care provider, and caregivers reported receiving care in line with current best practice guidelines. However, caregivers in the current sample perceived a lack of knowledgeability on the part of their first providers, which significantly predicted more providers seen and also reported difficulty finding specialty providers (63% of the sample reported difficulty finding a treatment provider who understood tics).

CONCLUSION: Results suggest that improving caregiver satisfaction with early health care experiences for their child’s TD may help to relieve the burden on families and the health care system more broadly, along with continued efforts to increase the number of specialty providers available.

PMID:37820348 | DOI:10.1097/DBP.0000000000001221

Pediatr Infect Dis J. 2023 Oct 9. doi: 10.1097/INF.0000000000004082. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify the difference in clinical characteristics between viral pneumonia and Mycoplasma pneumoniae, providing cues on their differential diagnosis for primary hospitals with the insufficient pathogen detection capacity.

METHODS: We retrospectively reviewed the medical records of hospitalized children with acute respiratory tract infections, and pathogenic microbes test results were analyzed. Clinical characteristics, routine blood parameters and hospitalization duration and fee were compared between M. pneumoniae and viral pneumonia. We used in the multivariable logistic regression to predict the probability of children with M. pneumoniae and graphically represented by a dynamic nomogram. The discrimination and clinical utility of the model were confirmed by receiver operating characteristic and decision curve analysis curves.

RESULT: A total of 375 children with community-acquired pneumonia were included. Mycoplasma infection accounted for the largest proportion (22.13%). The incidence of both hypothermia and vomiting was lower in M. pneumoniae compared to viral pneumonia (hypothermia: 10.50% vs. 0.00%; vomiting: 7.90% vs. 0.00%). The prevalence of hyperthermia was higher in M. pneumoniae (hyperthermia: 89.5% vs. 100%). Procalcitonin, peripheral blood white blood cell count and lymphocyte levels were higher in the viral pneumonia group, and eosinophil levels were conversely lower. As for the duration of illness, the mean length of stay was 5.20 ± 2.12 (viral pneumonia) and 6.27 ± 2.48 days (M. pneumoniae). Children with M. pneumoniae had higher overall hospital costs and required more medical treatment. The above were all statistically significant with a P < 0.05. The scoring system was established based on the above results. Receiver operating characteristic curves showed good model-discrimination ability with 0.844 of the area under the curve in the training set and 0.778 in the test set. Decision curve analysis curves demonstrated the discriminative superiority of this model. The web-based dynamic nomogram calculator is accessible at https://zhxylxy0160128.shinyapps.io/Nomogram/.

CONCLUSION: Nomograms have satisfactory discrimination, and clinical utility may benefit in predicting the probability of developing M. pneumoniae in children. Children with M. pneumoniae have a higher burden than those with viral pneumonia and may require more intensive in-hospital monitoring.

PMID:37820276 | DOI:10.1097/INF.0000000000004082

Pediatr Infect Dis J. 2023 Oct 5. doi: 10.1097/INF.0000000000004128. Online ahead of print.

ABSTRACT

BACKGROUND: Doxycycline is considered the first-line treatment of Lyme disease in adolescents and adults, but largely disproven concerns of permanent tooth staining prevented its use and evaluation in children <8 years old. We sought to describe short-term adverse effects and treatment failures among young children receiving oral doxycycline for Lyme disease.

METHODS: We completed a 2-pronged evaluation of children with Lyme disease treated with doxycycline. We performed a retrospective case series of patients <8 years old who were diagnosed with Lyme disease and treated with doxycycline. We then performed a telephone follow-up survey study of the patients’ parents to gather additional details regarding clinical outcomes and adverse reactions to doxycycline. Descriptive statistics were calculated.

RESULTS: A total of 32 patients were identified through the retrospective case series and 18 participated in the follow-up survey. The most common clinical diagnosis (22/32; 69%) was single erythema migrans. Seven (22%) had neurological Lyme disease. Three patients (9%) stopped doxycycline treatment prematurely due to adverse effects. During telephone follow-up, 2 children were reported to have dental staining. No patients were identified with treatment failure during the retrospective case series. On telephone follow-up, 3 patients had residual symptoms after treatment, though none were convincing of treatment failure.

CONCLUSIONS: Our study suggests that doxycycline is generally well-tolerated and an effective treatment of Lyme disease in young children. Prospective, observational studies with long-term assessment of dental staining and clinical outcomes are needed. Alternative antibiotics, principally amoxicillin, remain the preferred treatment of non-neurological Lyme disease manifestations in young children, but doxycycline is likely a safe and effective alternative when needed.

PMID:37820258 | DOI:10.1097/INF.0000000000004128