Tag: pubmed

Clin Psychol Psychother. 2023 Sep 12. doi: 10.1002/cpp.2907. Online ahead of print.

ABSTRACT

Studies of anger treatment have often reported on reappraisal and relaxation techniques delivered in person to forensic and psychiatric samples. The present study evaluated an integrative programme of cognitive-behavioural affective therapy (CBAT) delivered remotely to chronic pain sufferers with comorbid anger. Volunteers (N = 54) were randomly assigned to either CBAT or an Emotional Education (EE) group, both receiving hour-long videorecorded sessions twice a week for 4 weeks plus weekly calls by telephone. At 1-month post-treatment, follow-up was conducted. Outcomes were measured using the Anger Parameters Scale (APS) and its five subscales (frequency, duration, intensity, latency and threshold) as well as daily self-monitored anger logs. As hypothesized, pre- to post-treatment decline in APS total scores was significant for CBAT, Hedges’ g = 0.65, 95% CI [0.14, 1.16] but nonsignificant and small for EE, g = 0.17, CI [-0.41, 0.75]. At the primary endpoint (post-treatment), APS total scores were significantly lower for CBAT than for EE. Treatment gains were maintained till follow-up. On all five APS subscales, pre-post effect sizes were medium-sized for CBAT and generally small for EE. This picture was mirrored in the self-monitored frequency, duration and intensity of anger. Findings support the efficacy of CBAT over time, its comparative efficacy over EE and its ecological generalizability. Future research could expand sample size, reduce sample imbalance, extend follow-up and strengthen treatment potency with more sessions. The present study renews enthusiasm for teletherapy and is the first to demonstrate CBAT efficacy in treating maladaptive anger in the chronic pain population.

PMID:37699599 | DOI:10.1002/cpp.2907

J Parasitol. 2023 Oct 1;109(5):450-463. doi: 10.1645/23-4.

ABSTRACT

Recent studies of louse ectoparasites from mummies have developed robust data sets that allow a true epidemiological approach to the prehistory of louse parasitism. One epidemiological principle is that the binomial of overdispersion is normally negative, meaning that in a host population, parasites are aggregated in a few individuals. We demonstrate the overdispersion of lice in 3 different prehistoric communities that differ along 3 axes or variables: environmental setting, socioeconomic status, and cultural affiliation. Distinct cultural practices could have been involved in different patterns of louse infestation. Prevalence, intensity, and abundance of infestations exhibit statistically significant differences between the communities. We also find differences in prevalence between subadults and adults that contrasted by cultural affiliation and suggest conditions different from those seen today. We show that overall prevalence was affected primarily by ecological setting, not socioeconomic status nor cultural affiliation. These findings demonstrate that statistical analysis of archaeological data can reveal the states of infestation in past populations with lifestyles not seen in modern people. Our approach paves the way for future comparisons of subpopulations within archaeological communities.

PMID:37699596 | DOI:10.1645/23-4

J Sport Rehabil. 2023 Sep 12:1-10. doi: 10.1123/jsr.2022-0343. Online ahead of print.

ABSTRACT

CONTEXT: The long duration and high cost of anterior cruciate ligament reconstruction (ACLR) rehabilitation can pose barriers to completing rehabilitation, the latter stages of which progress to demanding sport-specific exercises critical for a safe return to sport. A staged approach shifting in-person physiotherapy sessions to later months of recovery may ensure patients undergo the sport-specific portion of ACLR rehabilitation. Design/Objective: To compare postoperative outcomes of knee function in patients participating in a staged ACLR physiotherapy program to patients participating in usual care physiotherapy through a randomized controlled trial.

METHODS: One hundred sixty-two patients were randomized to participate in staged (n = 80) or usual care physiotherapy (n = 82) following ACLR and assessed preoperatively and postoperatively at 2 weeks, 6 weeks, 3 months, and 6 months. The staged group completed the ACLR rehabilitation protocol at home for the first 3 months, followed by usual care in-person sessions. The usual care group completed in-person sessions for their entire rehabilitation. Outcome measures included the Lower Extremity Functional Scale, International Knee Documentation Committee Questionnaire, pain, range of motion, strength, and hop testing.

RESULTS: There were no statistically significant between-group differences in measures of knee function at 6 months postoperative. Patients in the usual care group reported significantly higher International Knee Documentation Committee scores at 3 months postoperative (mean difference = 5.8; 95% confidence interval, 1.3 to 10.4; P = .01).

CONCLUSION: A staged approach to ACLR rehabilitation does not appear to impede knee function at 6 months postoperative but may result in worse patient reported outcomes at early follow-ups.

PMID:37699588 | DOI:10.1123/jsr.2022-0343

Clin Psychol Psychother. 2023 Sep 12. doi: 10.1002/cpp.2908. Online ahead of print.

ABSTRACT

Cognitive behavioural therapy (CBT) including exposure and response prevention is the first-line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in-person delivery, few studies have assessed the role of therapist-guided, manual-based CBT for OCD delivered in real-time via videoconferencing methods. The present study sought to fill this gap by comparing in-person and online delivery of group-based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group-based CBT that was provided in-person (pre-COVID-19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID-19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2-h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in-person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post-treatment. Videoconferenced, clinician-led CBT may be a promising alternative to in-person delivery for those with moderate to severe OCD symptoms.

PMID:37699581 | DOI:10.1002/cpp.2908

J Am Vet Med Assoc. 2023 Sep 12:1-8. doi: 10.2460/javma.23.07.0379. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the use of a locking 3.5/4.0-mm jumbo tibial plateau leveling osteotomy (TPLO) plate in maintaining the postoperative tibial plateau angle (TPA) in giant-breed dogs weighing > 50 kg and to report the associated complications.

ANIMALS: Canine patients weighing > 50 kg that underwent TPLO stabilized with a locking 3.5/4.0-mm jumbo TPLO plate between January 2017 and May 2022.

METHODS: Retrospective case series retrieving postoperative outcomes from the medical records. Healing scores and TPAs were calculated using postoperative and recheck radiographs. Owner-perceived outcomes were obtained via questionnaire.

RESULTS: 24 stifles in 22 dogs were included. Postoperative complications were recorded in 11 of 24 cases (45.8%) inclusive of 1 minor, 1 catastrophic, and 9 major complications. A statistically significant increase in TPA over the convalescent period was found. Grade 4 healing was present in 18 of 24 (75%) stifles, while the remainder were scored as grade 3.

CLINICAL RELEVANCE: The use of a locking 3.5/4.0-mm jumbo TPLO plate did not prevent a statistically significant increase in TPA through convalescence. This procedure displayed an unacceptably high complication rate when compared with contemporary literature of TPLO. Despite a high complication rate in this patient population, most complications were successfully managed with medical and/or surgical treatment, and high mean and median healing scores were achieved at the radiographic recheck. Additionally, owner-perceived long-term outcomes were excellent.

PMID:37699545 | DOI:10.2460/javma.23.07.0379

Pediatr Neurol. 2023 Aug 22;148:101-107. doi: 10.1016/j.pediatrneurol.2023.08.017. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the long-term functional and neurodevelopmental outcomes in pediatric patients who underwent neurosurgical intervention following suspected abusive head trauma (AHT).

METHODS: We performed a single-center retrospective review (January 1, 2007, to December 31, 2019) of patients aged less than three years who had intracranial injury suspicious for AHT and received a neurosurgical procedure. Long-term functional outcome was measured using the Pediatric Cerebral Performance Category (PCPC), Pediatric Overall Performance Category (POPC), and the Mullen Scales of Early Learning (MSEL).

RESULTS: Seventy-seven patients were identified; 53 survived to discharge and had at least one-year follow-up. To examine long-term functional outcome, PCPC at the last available visit was examined and found to be 1 or 2 (normal to mild disability) for 64% of patients and 3 or 4 (moderate to severe disability) for 36%. The last available MSEL composite score for neurodevelopmental assessment also demonstrated that 13% of patients scored in the “average” range, 17% in the “below average” range, and 70% in the “very low” range. There was no statistical difference in the last available PCPC or POPC score or the last available MSEL score for patients who received a craniotomy when compared with those who received an intracranial shunt.

CONCLUSIONS: For patients with AHT who survived to discharge, functional improvements over time were noted in both patients who received craniotomy or who simply required shunt placement. These results suggest that, for patients who survive to discharge, operative management of AHT can lead to reasonable long-term functional outcomes.

PMID:37699270 | DOI:10.1016/j.pediatrneurol.2023.08.017

Dermatitis. 2023 Sep 12. doi: 10.1089/derm.2023.0148. Online ahead of print.

ABSTRACT

Background: Convolutional neural networks (CNNs) have the potential to assist allergists and dermatologists in the analysis of patch tests. Such models can help reduce interprovider variability and improve consistency of patch test interpretations. Objective: Our aim is to evaluate the performance of a CNN model as a proof of concept in discriminating between patch tests with reactions and patch tests without reactions. Methods: We performed a retrospective analysis of patch test images from March 2020 to March 2021. The CNN model was trained as a binary classifier to discriminate between reaction and nonreaction patches. Performance of the model was determined using summary statistics and receiver operator characteristics (ROC) curves. Results: In total, 13,622 images from 125 patients were recorded for analysis. The majority of patients in the cohort were female (81.6%) with Fitzpatrick skin types I-II (88.0%). The area under curve was 0.940, indicating a high discriminative performance of the model for this data set. This resulted in a total accuracy of 90.1%, sensitivity of 86.0%, and specificity of 90.2%. Conclusions: CNNs have the capacity to determine the presence of delayed-type reactions in patch tests. Future prospective studies are required to assess the generalizability of such models.

PMID:37699249 | DOI:10.1089/derm.2023.0148

Games Health J. 2023 Sep 12. doi: 10.1089/g4h.2023.0054. Online ahead of print.

ABSTRACT

Objective: Wordbot, a chatbot designed for gamified education, transforms the process of memorizing complex medical terminology into an engaging and enjoyable activity for medical students. Taking inspiration from the “guessing words” game, Wordbot aims to improve medical students’ learning outcomes by making the vocabulary memorization process more memorable. Materials and Methods: Wordbot, which can be implemented on the LINE platform, was created for this research, specifically to improve medical terminology learning. Wordbot incorporated mobile devices and personal computer-compatible flashcard games with features such as user ranking and personalization to enhance motivation and optimize learning outcomes. In the experimental research setting, half of a total of 48 nursing students were randomly assigned to use Wordbot for 4 months, and the other half were assigned to a control group relying on self-study without the help of Wordbot. Both groups received pretest and post-test to assess their respective learning of medical terminology. In this study, a statistical t-test was used to analyze the results between the two groups. In addition, user usability testing was conducted to evaluate the usability of Wordbot and gather feedback on user experience. Results: The results of this study have demonstrated that Wordbot is effective in facilitating students learning of medical terminology. Students experienced a significant improvement in their knowledge of medical terminology. An average user usability test score of 83.25 indicated that users’ satisfaction with Wordbot is high. Conclusion: Incorporating gamification and personalization elements in Wordbot can significantly improve the overall enjoyment of the learning process. By participating in diverse interactive activities, users can effectively enhance their proficiency in spelling, recognition, and speaking. Wordbot utilizes sophisticated algorithms to generate customized questions based on identified mistakes, which facilitate error identification and correction. The robust findings of this study overwhelmingly support Wordbot’s role as a convenient and easily accessible tool for learning medical terminology. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Chang Gung Medical Foundation (Protocol code: 202201586B0, date of approval: 8 November 2022). We obtained informed consent from all of our study participants regarding their willingness to participate in this study.

PMID:37699207 | DOI:10.1089/g4h.2023.0054

Int J Prosthodont. 2023 Sep 12;36(4):501-507. doi: 10.11607/ijp.7947.

ABSTRACT

PURPOSE: To compare the accuracy of occlusal stabilization appliances fabricated by digital workflows to those fabricated by conventional workflows.

MATERIALS AND METHODS: In total, 10 volunteers were recruited in this single-blinded crossover study. All volunteers received two types of occlusal stabilization appliances: a digital additively manufactured stabilization splint (DS) and a conventionally fabricated splint (CS). The accuracy was assessed using a 4-point rating scale addressing two aspects of the occlusal appliances: occlusal contact and basic performance. In addition, silicone impression materials were used to assess the gap between the appliance and the maxillary arch to ensure an accurate fit. Differences were quantitatively assessed with Mann-Whitney U test and independent-sample t test.

RESULTS: The occlusal contact rating of DS (15.90 ± 1.73) was significantly higher than that of CS (14.10 ± 1.10, P < .05). The basic performance rating of DS (8.70 ± 0.48) was also significantly higher than that of CS (7.20 ± 0.92. P < .05). Quantitative evaluation of fit accuracy revealed a statistically significant difference (P < .05), with DS (636.29 ± 268.51 μm) being superior to CS (704.2 ± 306.05 μm).

CONCLUSION: The stabilization splints fabricated with a digital workflow showed better accuracy than the conventionally fabricated splints in terms of occlusal contact, basic performance, and fit accuracy. Because this is a pilot study, formal trials with a completely digital fabrication workflow will be conducted in the future.

PMID:37699192 | DOI:10.11607/ijp.7947

Int J Prosthodont. 2023 Sep 12;36(4):498-500. doi: 10.11607/ijp.8317.

ABSTRACT

PURPOSE: To assess the marginal and internal fit of monolithic zirconia fixed dental prostheses (FDPs) comparing two different intraoral scanners (IOSs) and assessment methods.

MATERIALS AND METHODS: A maxillary typodont with three prepared teeth allowed fabrication of five-unit high-translucency monolithic zirconia FDPs. The typodont was scanned with two IOSs: Cerec Omnicam and 3Shape TRIOS 3. In total, 30 FDPs were milled from presintered high-translucency zirconia blocks. Dual-scan and silicone replica assessments were used to determine marginal and internal gaps.

RESULTS: A statistical significance was observed for marginal gaps (3Shape [74.27 ± 10.4 μm] and Cerec [86.45 ± 14.3 μm]) and for internal gaps (3Shape [126.12 ± 12.7 μm] and Cerec [112.38 ± 17.2 μm]).

CONCLUSIONS: The outcomes of this study showed that the 3Shape TRIOS 3 produced a better overall marginal fit, while the Cerec Omnicam created a better internal fit. Additionally, a greater overall marginal and internal gap was noted with the silicone replica method over the dual-scan method.

PMID:37699191 | DOI:10.11607/ijp.8317