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Effects of White Chicken Eggshell Powder on Compressive Strength, Water Solubility, and Setting Time of Calcium-Enriched Mixture

Iran Endod J. 2023;18(3):152-158. doi: 10.22037/iej.v18i3.39798.

ABSTRACT

INTRODUCTION: The present study aimed to evaluate the effects of adding chicken eggshell powder (CESP) to calcium-enriched mixture (CEM) cement on its compressive strength (CS), solubility, and setting time.

MATERIALS AND METHODS: In this study, CESP was added at weight percentages of 3% and 5% to the powder component of the CEM cement. To measure the CS, a total of 36 samples (height, 6 mm; diameter, 4 mm) were tested in a universal testing machine. The setting time was assessed for 18 disk-shaped samples (diameter, 10 mm; height, 1 mm). Additionally, solubility test was performed on 18 samples (diameter, 8 mm; height, 1 mm) after 24 hours, 72 hours, seven days, and 14 days under dehydration conditions by calculating the weight changes; the results were then subjected to a normality test. Next, for the comparison of different test groups, parametric ANOVA test and post-hoc Tukey’s multiple comparison test were performed at a significance level of 0.05.

RESULTS: The addition of 5% CESP to the CEM cement significantly reduced its setting time and water solubility (P=0.02 and P=0.01, respectively). Moreover, it significantly increased the CS over a 21-day period (P<0.001). Additionally, the addition of 3% CESP also resulted in a significant increase in CS (P<0.001). While 3% CESP reduced setting time and water solubility, the difference was not statistically significant.

CONCLUSION: The findings suggest that the addition of 5% CESP to CEM cement has the potential to improve its sealing ability, durability, and ability to withstand chewing forces in endodontic treatments. These results highlight the relevance of CESP as an additive for cement modifications and indicate its potential clinical implications.

PMID:37431529 | PMC:PMC10329759 | DOI:10.22037/iej.v18i3.39798

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Effect of Silver Nanoparticles of Herbal Origin on the Compressive and Push-out Bond Strengths of Mineral Trioxide Aggregate

Iran Endod J. 2023;18(3):159-164. doi: 10.22037/iej.v18i3.31364.

ABSTRACT

INTRODUCTION: The purpose of this in vitro study was to investigate the effect of incorporating silver nanoparticles (AgNPs) of herbal origin into mineral trioxide aggregate (MTA) on the push-out bond strength (PBS) and compressive strength (CS) in simulated furcal area perforations.

MATERIALS AND METHODS: In this in vitro study, simulated furcal area perforations (1.3 mm in diameter and 2 mm in depth) were created in 40 extracted human lower molar teeth, which were divided into two groups (n=20): MTA alone and MTA combined with AgNPs (2% wt). Using a universal testing machine, PBS was evaluated by performing push-out tests, while CS was assessed using cylindrical specimens. The normal distribution of data was checked using the Kolmogorov-Smirnov test, and statistical analysis was performed using two-way ANOVA.

RESULTS: The CS results showed no significant difference between the MTA group at 4 and 21 days (P=0.297), but a significant difference was observed in the nanosilver/MTA group (P=0.013). However, there was no significant difference in the push-out bond strength among the study groups (P>0.05).

CONCLUSION: The incorporation of herbal origin silver nanoparticles did not significantly affect the PBS or CS of MTA.

PMID:37431522 | PMC:PMC10329756 | DOI:10.22037/iej.v18i3.31364

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Factors Associated with Self-Management of Peritoneal Dialysis Patients in Urumqi of Xinjiang of China: A Cross-Sectional Survey

Patient Prefer Adherence. 2023 Jul 5;17:1573-1589. doi: 10.2147/PPA.S415593. eCollection 2023.

ABSTRACT

PURPOSE: To explore the factors associated with self-management of Peritoneal Dialysis (PD) patients and methods of acquiring PD knowledge.

DESIGN: Cross-sectional survey design.

SETTING: Urumqi, Xinjiang, China.

PATIENTS: 131 Chinese maintenance Peritoneal Dialysis (PD) patients.

METHODS: This cross-sectional study was conducted from October 2019 to March 2020 in the First Affiliated Hospital of Xinjiang Medical University of China. 131 PD patients were recruited. Data were collected, including demographic characteristics, clinical dialysis data, self-management ability scale, and methods to obtain PD knowledge. A self-management questionnaire was used for the evaluation of self-management ability.

RESULTS: The score of the self-management ability of PD patients in Xinjiang, China, was (57.6±13.7) points, which was at the middle level in China. There was no statistically significant difference in the self-management ability scores of patients with different ages, sex, ethnicity, marital status, pre-dialysis status, PD time, PD procedures, self-care ability, PD satisfaction, and 24-hour average urine output (P>0.05). There were significant differences in the self-management ability scores of patients with different education levels, occupations, and medical insurance forms (P<0.05). The self-management ability of PD patients was positively correlated with the disease course of uremia and attending lectures on PD knowledge (P<0.05). The main factor affecting self-management ability was education level. There 73.28% of patients considered that it was necessary to establish a WeChat group for PD patients, and 65.7% believed that establishing a WeChat group for PD patients could facilitate communication between patients and enhance treatment confidence.

CONCLUSION: The study surveyed PD patients who have certain self-management ability. For patients with different education levels, different health education methods should be adopted to promote the improvement of patients’ self-management ability. Furthermore, WeChat is essential for Chinese PD patients to obtain disease-related information.

PMID:37431511 | PMC:PMC10329827 | DOI:10.2147/PPA.S415593

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Time to Viral Re-suppression and Its Predictors among Adults on Second-Line Antiretroviral Therapy in South Wollo Zone Public Hospitals: Stratified Cox Model

HIV AIDS (Auckl). 2023 Jul 5;15:411-421. doi: 10.2147/HIV.S406372. eCollection 2023.

ABSTRACT

BACKGROUND: Even though there are many patients on second-line antiretroviral therapy (ART) in Ethiopia, there is a paucity of evidence on the rate of viral resuppression and its predictors. Therefore, this study aimed to determine a time to viral resuppression and identify predictors among adults on second-line ART in South Wollo public hospitals, northeast Ethiopia.

METHODS: A retrospective-cohort study design was employed using patients enrolled in second-line ART from August 28, 2016 to April 10, 2021. Data were collected using a structured data-extraction checklist with a sample size of 364 second-line ART patients from February 16 to March 30, 2021. EpiData 4.6 was used for data entry and Stata 14.2 was used for analysis. The Kaplan-Meier method was used for estimating time to viral resuppression. The Shönfield test was used to check the proportional-hazard assumption, and the “no interaction” stratified Cox assumption was checked using the likelihood-ratio test. A stratified Cox model was applied to identify predictors of viral resuppression.

RESULTS: Median time to viral re-suppression in patients on a second-line regimen was 10 (IQR 7-12) months. BeingFemale (AHR 1.31, 95% CI 1.01-1.69), low viral load count at switch (AHR 1.98, 95% CI 1.26-3.11), normal-range BMI at switch (AHR 1.42, 95% CI 1.03-1.95), and lopinavir-based second-line regimen (AHR 1.72, 95% CI 1.15-2.57) were significant predictors of early time to viral resuppression after stratification by WHO stage and adherence level.

CONCLUSION: Median time to viral re-suppression after switching to second-line ART was 10 months. In the stratified Cox model, female sex, baseline viral copies, second-line regimen type, and BMI at switch were statistically significant predictors of time to viral resuppression. Different stakeholders working on the HIV program should maintain viral resuppression by addressing significant predictors, and ART clinicians should consider ritonavir-boosted lopinavir based second-line ART for newly switched patients.

PMID:37431501 | PMC:PMC10329832 | DOI:10.2147/HIV.S406372

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Sex/gender differences in individual and joint trajectories of common mental health symptoms in early to middle adolescence

JCPP Adv. 2021 Dec 11;2(1):e12057. doi: 10.1002/jcv2.12057. eCollection 2022 Mar.

ABSTRACT

BACKGROUND: Early to middle adolescence is a critical period of development for mental health issues. Illuminating sex/gender differences in mental health trajectories in this period is important for targeting screening and preventive interventions; however, evidence to date on the extent and nature of sex/gender differences in common mental health issue trajectories in this period has produced mixed findings. There is a particular gap in our knowledge of sex/gender differences in the joint trajectories of commonly co-occurring mental health issues in adolescence, given the strong tendency for mental health issues to co-occur.

METHOD: We applied sex/gender-stratified latent class growth analysis to an age-heterogeneous cohort (age 10-15) derived from the population-representative UK Household Longitudinal Study. We explored sex/gender differences in attention deficit hyperactivity disorder (ADHD) symptoms, internalizing problems, and conduct problems individually and jointly.

RESULTS: We found indications of sex/gender differences in a number of areas. There were fewer classes in the optimal model to describe the heterogeneity in internalizing problems and conduct problems trajectories in males and females respectively. Further, for ADHD, affected males were more likely to enter adolescence with already elevated symptoms whereas affected female trajectories were characterized by an escalation of symptoms during adolescence.

CONCLUSIONS: There are sex/gender differences in the levels and trajectories of specific mental health symptoms in early to middle adolescence; however, in both males and females there is a strong tendency for multiple issues to co-occur.

PMID:37431498 | PMC:PMC10242831 | DOI:10.1002/jcv2.12057

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Modeling MOG Antibody-Associated Disorder and Neuromyelitis Optica Spectrum Disorder in Animal Models: Visual System Manifestations

Neurol Neuroimmunol Neuroinflamm. 2023 Jul 10;10(5):e200141. doi: 10.1212/NXI.0000000000200141. Print 2023 Sep.

ABSTRACT

BACKGROUND AND OBJECTIVES: Mechanisms of visual impairment in aquaporin 4 antibody (AQP4-IgG) seropositive neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disorder (MOGAD) are incompletely understood. The respective impact of optic nerve demyelination and primary and secondary retinal neurodegeneration are yet to be investigated in animal models.

METHODS: Active MOG35-55 experimental autoimmune encephalomyelitis (EAE) was induced in C57BL/6Jrj mice, and monoclonal MOG-IgG (8-18C5, murine), recombinant AQP4-IgG (rAb-53, human), or isotype-matched control IgG (Iso-IgG, human) was administered 10 days postimmunization. Mobility impairment was scored daily. Visual acuity by optomotor reflex and ganglion cell complex thickness (GCC, 3 innermost retinal layers) by optical coherence tomography (OCT) were longitudinally assessed. Histopathology of optic nerve and retina was investigated during presymptomatic, acute, and chronic disease phases for immune cells, demyelination, complement deposition, natural killer (NK) cell, AQP4, and astrocyte involvement, retinal ganglion cells (RGCs), and Müller cell activation. Groups were compared by nonparametric tests with a p value <0.05 indicating statistical significance.

RESULTS: Visual acuity decreased from baseline to chronic phase in MOG-IgG (mean ± standard error of the mean: 0.54 ± 0.01 to 0.46 ± 0.02 cycles/degree, p < 0.05) and AQP4-IgG EAE (0.54 ± 0.01 to 0.43 ± 0.02, cycles/degree, p < 0.05). Immune cell infiltration of optic nerves started in presymptomatic AQP4-IgG, but not in MOG-IgG EAE (5.85 ± 2.26 vs 0.13 ± 0.10 macrophages/region of interest [ROI] and 1.88 ± 0.63 vs 0.15 ± 0.06 T cells/ROI, both p < 0.05). Few NK cells, no complement deposition, and stable glial fibrillary acid protein and AQP4 fluorescence intensity characterized all EAE optic nerves. Lower GCC thickness (Spearman correlation coefficient r = -0.44, p < 0.05) and RGC counts (r = -0.47, p < 0.05) correlated with higher mobility impairment. RGCs decreased from presymptomatic to chronic disease phase in MOG-IgG (1,705 ± 51 vs 1,412 ± 45, p < 0.05) and AQP4-IgG EAE (1,758 ± 14 vs 1,526 ± 48, p < 0.01). Müller cell activation was not observed in either model.

DISCUSSION: In a multimodal longitudinal characterization of visual outcome in animal models of MOGAD and NMOSD, differential retinal injury and optic nerve involvement were not conclusively clarified. Yet optic nerve inflammation was earlier in AQP4-IgG-associated pathophysiology. Retinal atrophy determined by GCC thickness (OCT) and RGC counts correlating with mobility impairment in the chronic phase of MOG-IgG and AQP4-IgG EAE may serve as a generalizable marker of neurodegeneration.

PMID:37429715 | DOI:10.1212/NXI.0000000000200141

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The New Big Is Small: Leveraging Knowledge from Small Trials for Rare Disease Drug Development – Blarcamesine for Rett Syndrome

Br J Clin Pharmacol. 2023 Jul 10. doi: 10.1111/bcp.15843. Online ahead of print.

ABSTRACT

Big data in drug development may not satisfactorily address the demands of precision medicine in a rare disease population, making the use of smaller clinical trials necessary. Consequently, the use of innovative design and analysis of these clinical trials using model-informed approaches have become indispensable. This requires informative exposure-outcome analysis, together with formal statistical analysis, which should include the strength of evidence for a study outcome. We demonstrate how knowledge can be gained, with supporting strength of evidence, from a small (data) clinical trial with a low dose of blarcamesine in the treatment of Rett syndrome (RTT). Based on a small data paradigm, pharmacometrics item response theory modeling and Bayes factor analysis were used to show that blarcamesine is efficacious in RTT.

PMID:37429704 | DOI:10.1111/bcp.15843

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Kinesiophobia and its associated factors in patients with coronary heart disease: a cross-sectional study based on latent feature analysis

BMJ Open. 2023 Jul 10;13(7):e072170. doi: 10.1136/bmjopen-2023-072170.

ABSTRACT

OBJECTIVES: The aim of this study was to explore the current situation of kinesiophobia in patients with coronary heart disease, classify it based on potential profile analysis and explore the relevant factors of kinesiophobia in different categories of patients with coronary heart disease.

DESIGN: Cross-sectional study.

SETTING: Patients with coronary heart disease in China.

PARTICIPANTS: Adult (aged >18 years) patients with coronary heart disease in China; 252 participants in this study answered the questionnaire.

PRIMARY AND SECONDARY OUTCOME MEASURES: The study investigated the scores of Tampa Scale for Kinesiophobia Heart, and collected information on the patient’s age, gender, monthly household income, education level, place of residence, marital status, occupational status, hypertension, diabetes, heart failure and body mass index (BMI).

RESULTS: Kinesiophobia in patients with coronary heart disease can be divided into low fear type (C1), intermediate fear type (C2) and high fear type (C3). Elderly patients were classified as type C3. Women and patients with a normal BMI were classified as type C1; patients with a normal BMI and patients with an overweight BMI were classified as type C2.

CONCLUSION: Kinesiophobia of patients with coronary heart disease can be divided into three categories, and intervention measures are implemented according to their different demographic characteristics to reduce kinesiophobia of patients and promote the participation of patients in exercise rehabilitation.

PMID:37429691 | DOI:10.1136/bmjopen-2023-072170

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What are the prognostic factors for the development of incontinence-associated dermatitis (IAD): a protocol for a systematic review and meta-analysis

BMJ Open. 2023 Jul 10;13(7):e073115. doi: 10.1136/bmjopen-2023-073115.

ABSTRACT

INTRODUCTION: Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research.

METHODS AND ANALYSIS: This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance.

ETHICS AND DISSEMINATION: No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.

PMID:37429690 | DOI:10.1136/bmjopen-2023-073115

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Determinants of early initiation of breast feeding during COVID-19 pandemic among urban-dwelling mothers from Tigray, Northern Ethiopia: a community-based cross-sectional study

BMJ Open. 2023 Jul 10;13(7):e070518. doi: 10.1136/bmjopen-2022-070518.

ABSTRACT

OBJECTIVES: The objective of this study was to assess the practice of early initiation of breast feeding (EIBF) and its determinant factors among urban-dwelling mothers from Tigray during the COVID-19 pandemic.

DESIGN: A community-based cross-sectional study was conducted from April to June 2021. Data were analysed using StataSE Version 16 software. To identify determinant factors of the dependent variable, multivariate logistic regression analyses was used at a statistical significance of p<0.05. The strength of the association was measured by OR and 95% CI.

SETTING AND PARTICIPANTS: The study was conducted among 633 lactating mothers of infants under the age of 6 months living in Mekelle city, Tigray, Northern Ethiopia from April to June 2021. A three-stage cluster sampling was used to select study participants.

MAIN OUTCOME MEASURE: EIBF or no EIBF.

RESULTS: Three hundred and sixty eight (59.6%) mothers/caregivers practised EIBF. Maternal education (adjusted OR, AOR 2.45, 95 % CI 1.01 to 5.88), parity (AOR 1.20, 95 % CI 1.03 to 2.20), caesarean section delivery (AOR 0.47, 95 % CI 0.32 to 0.69) and breastfeeding information and support postdelivery (AOR 1.59, 95% CI 1.10 to 2.31) were found to be significant determinants of EIBF.

CONCLUSIONS: EIBF is defined as initiation of breastfeeding within 1 hour after delivery. EIBF practice was far from optimal. During the COVID-19 pandemic, maternal education, parity, type of delivery and the provision of up-to-date breastfeeding information and support right after delivery determined the time of breastfeeding initiation.

PMID:37429688 | DOI:10.1136/bmjopen-2022-070518