Tag: pubmed

Int Endod J. 2023 Jul 15. doi: 10.1111/iej.13955. Online ahead of print.

ABSTRACT

AIM: To assess the clinical and radiographic outcome of partial pulpotomy by comparing MTA Angelus and Total Fill BC, as pulpotomy agents, in mature teeth with deep caries and symptoms indicative of irreversible pulpitis.

METHODOLOGY: The study was designed as parallel-two arm, double blind, randomized superiority clinical trial (RCT) registered at www.

CLINICALTRIALS: gov (NCT04870398). Symptomatic mature permanent teeth with deep caries fulfilling the inclusion criteria were randomly treated using either MTA Angelus or Total Fill BC. Partial pulpotomy was performed and following complete haemostasis, the capping material was placed over the remaining pulp tissue and a postoperative periapical radiograph was taken. Clinical and radiographic follow-up evaluation was performed for a median time of 2 years whereas levels of pain intensity were evaluated preoperatively and for 7 days after intervention using Visual Analogue Scale (VAS). For the primary outcome, (failure/success of treatment), Kaplan-Meier survival curves for the capping materials were plotted and a log-rank test for equality of survivor functions was applied. A multivariable random effects Cox Regression model was also applied. For the secondary outcome, (post-operatively reported pain), a multivariable mixed effects ordinal logistic regression was structured.

RESULTS: One hundred and thirty-seven teeth in 123 patients underwent partial pulpotomy using randomly either MTA Angelus (N=74), or Total Fill BC (n=63). The percentage failure for MTA Angelus and Total Fill BC was 10.8% (8/74) and 17.5% (11/63) respectively, but the difference was not statistically significant (adjusted HR: 1.83; 95%CI: 0.68, 4.91; p= 0.23). Weak evidence was found that secondary caries involvement may impose 3.54 times greater hazard for treatment failure (adjusted HR: 3.54; 95%CI: 1.00, 12.51; p= 0.05). For each passing minute of procedural bleeding control, there was also 57% higher hazard for treatment failure (adjusted HR: 1.57; 95%CI: 0.99, 2.48; p=0.05). The odds for higher post-operative pain were 4.73 times greater for the Total Fill BC compared to MTA Angelus (adjusted OR: 4.73; 95%CI: 2.31, 9.66; p<0.001).

CONCLUSIONS: Both materials exhibited similar and favorable outcome rates after partial pulpotomy in teeth with deep caries and symptoms of irreversible pulpitis. Total Fill BC was associated with higher level of postoperative pain intensities.

PMID:37452640 | DOI:10.1111/iej.13955

Br J Educ Psychol. 2023 Jul 15:e12625. doi: 10.1111/bjep.12625. Online ahead of print.

ABSTRACT

BACKGROUND: Home mathematics environment (HME) research has focused on parent-child interactions surrounding numerical activities as measured by the frequency of engaging in such activities. However, HME survey questions have been developed from limited perspectives (e.g., Early Childhood Research Quarterly, 27, 2012, 231; Journal of Social Issues, 64, 2008, 95; Early childhood mathematics education research: Learning trajectories for young children, Routledge, New York, 2009), by researchers from a small subset of countries (15; Psychological Bulletin, 147, 2020, 565), which may skew our interpretations.

AIMS AND SAMPLE: This study broadened international representation by leveraging secondary data from the 2019 TIMSS to examine the variation of the frequency and reliability of the HME scale and its relation to children’s mathematical achievement. Across 54 countries, 231,138 parents and children (M_age = 10.22 years; 51% male) participated in the larger study.

METHODS: Parents completed a retrospective home environment survey and children were assessed on mathematics skills. Basic frequency descriptive statistics, Cronbach’s alpha reliability coefficients, and Pearson’s r correlation coefficients were used to assess variability across countries.

RESULTS: Findings suggested that families in certain countries engaged in home mathematics activities more frequently than families in other countries; however, the HME scale demonstrated acceptable internal consistency across families in all countries (M α = .79; range = [.73, .89]). Further, the average relation between HME and mathematical achievement was r = .15 with a range between r = .02 to r = .41.

CONCLUSION: Our results indicate substantial variation across countries in the HME-mathematical achievement association. These findings underscore the importance of international representation in advancing research on the diversity of a child’s home environment.

PMID:37452611 | DOI:10.1111/bjep.12625

Int J Rheum Dis. 2023 Jul 15. doi: 10.1111/1756-185X.14828. Online ahead of print.

ABSTRACT

AIM: To investigate nurses’ opinions and practices regarding psychological support and patient-centered care (PCC) for patients with rheumatoid arthritis.

METHOD: Registered nurses engaged in rheumatic care in Japan were asked to complete the questionnaire regarding nurses’ perceived necessity, understanding, and implementation of psychological support, and six patient supports related to PCC, using a seven-point Likert scale. Correlation on practice between psychological support and PCC was evaluated.

RESULTS: A total of 53 nurses participated. Nurses indicated high necessity of providing psychological support, whereas implementation was statistically significantly lower than necessity and motivation. Nurses’ answers showed significantly lower implementation compared with understanding regarding basic concepts of psychological support: listening, empathy, acceptance, open questions, and closed questions. Most nurses (54.7%) sometimes provided psychological support, followed by often (34.0%), always (5.7%), and not at all (5.6%). Perceived necessity of PCC was rated high. However, its implementation was significantly lower than necessity for all evaluated cares, such as patients’ need-based support and support to patients’ families, related to PCC. Positive correlations were observed between the implementation of psychological support and PCC. Nurses stressed the importance of psychological support for patient education and shared decision-making.

CONCLUSION: This preliminary study indicated that most nurses considered psychological support and PCC necessary, but their implementation was relatively low. As psychological support is also crucial to shared decision-making, in addition to PCC, barriers to its implementation should be addressed to improve patients’ outcomes and quality of life.

PMID:37452602 | DOI:10.1111/1756-185X.14828

J Magn Reson Imaging. 2023 Jul 15. doi: 10.1002/jmri.28915. Online ahead of print.

ABSTRACT

BACKGROUND: Increased afterload in aortic stenosis (AS) induces left ventricle (LV) remodeling to preserve a normal ejection fraction. This compensatory response can become maladaptive and manifest with motion abnormality. It is a clinical challenge to identify contractile and relaxation dysfunction during early subclinical stage to prevent irreversible deterioration.

PURPOSE: To evaluate the changes of regional wall dynamics in 3D + time domain as remodeling progresses in AS.

STUDY TYPE: Retrospective.

POPULATION: A total of 31 AS patients with reduced and preserved ejection fraction (14 AS_rEF: 7 male, 66.5 [7.8] years old; 17 AS_pEF: 12 male, 67.0 [6.0] years old) and 15 healthy (6 male, 61.0 [7.0] years old).

FIELD STRENGTH/SEQUENCE: 1.5 T Magnetic resonance imaging/steady state free precession and late-gadolinium enhancement sequences.

ASSESSMENT: Individual LV models were reconstructed in 3D + time domain and motion metrics including wall thickening (TI), dyssynchrony index (DI), contraction rate (CR), and relaxation rate (RR) were automatically extracted and associated with the presence of scarring and remodeling.

STATISTICAL TESTS: Shapiro-Wilk: data normality; Kruskal-Wallis: significant difference (P < 0.05); ICC and CV: variability; Mann-Whitney: effect size.

RESULTS: AS_rEF group shows distinct deterioration of cardiac motions compared to AS_pEF and healthy groups (TI_{AS_rEF} : 0.92 [0.85] mm, TI_{AS_pEF} : 5.13 [1.99] mm, TI_healthy : 3.61 [1.09] mm, ES: 0.48-0.83; DI_{AS_rEF} : 17.11 [7.89]%, DI_{AS_pEF} : 6.39 [4.04]%, DI_healthy : 5.71 [1.87]%, ES: 0.32-0.85; CR_{AS_rEF} : 8.69 [6.11] mm/second, CR_{AS_pEF} : 16.48 [6.70] mm/second, CR_healthy : 10.82 [4.57] mm/second, ES: 0.29-0.60; RR_{AS_rEF} : 8.45 [4.84] mm/second; RR_{AS_pEF} : 13.49 [8.56] mm/second, RR_healthy : 9.31 [2.48] mm/second, ES: 0.14-0.43). The difference in the motion metrics between healthy and AS_pEF groups were insignificant (P-value = 0.16-0.72). AS_rEF group was dominated by eccentric hypertrophy (47.1%) with concomitant scarring. Conversely, AS_pEF group was dominated by concentric remodeling and hypertrophy (71.4%), which could demonstrate hyperkinesia with slight wall dyssynchrony than healthy. Dysfunction of LV mechanics corresponded to the presence of myocardial scarring (54.9% in AS), which reverted the compensatory mechanisms initiated and performed by LV remodeling.

DATA CONCLUSION: The proposed 3D + time modeling technique may distinguish regional motion abnormalities between AS_pEF, AS_rEF, and healthy cohorts, aiding clinical diagnosis and monitoring of AS progression. Subclinical myocardial dysfunction is evident in early AS despite of normal EF.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 1.

PMID:37452574 | DOI:10.1002/jmri.28915

Transfusion. 2023 Jul 14. doi: 10.1111/trf.17484. Online ahead of print.

ABSTRACT

BACKGROUND: The identification of blood donors at risk of developing low hemoglobin (Hb) and subsequent intervention is expected to reduce donation-induced iron deficiency and low Hb among blood donors. This study explores the effects of ferritin-guided iron supplementation for female first-time donors implemented in four of five administrative regions in Denmark.

STUDY DESIGN AND METHODS: We included 45,919 female first-time donors in this study. Hb values were determined in donations of included donors during a 2-year follow-up period. For each region, an intervention group (after implementation) and a control group (before implementation) were defined. The primary outcome was Hb below the donation threshold (7.8 mmol/L ~ 12.5 g/dL) at the time of donation, in the control group, and the intervention group, using logistic regression. The secondary outcome was the number of donations per donor given during the follow-up period.

RESULTS: We observed a statistically significant decrease in the risk of female first-time donors experiencing a donation with low Hb after ferritin-guided iron supplementation was introduced: Odds ratio, 0.82; 95% confidence interval (CI), 0.71-0.95. We found a statistically significant increase in the number of donations per donor during the follow-up period after intervention; rate ratio: 1.05, 95% CI: 1.02-1.08.

DISCUSSION: Ferritin-guided iron supplementation led to a significant reduction in the occurrence of low hemoglobin (Hb) levels among Danish female first-time blood donors. The intervention was additionally associated with an increase in the number of donations per donor.

PMID:37452554 | DOI:10.1111/trf.17484

J Anim Physiol Anim Nutr (Berl). 2023 Jul 14. doi: 10.1111/jpn.13861. Online ahead of print.

ABSTRACT

The application of hay feeding devices, such as the use of hay nets or slow feeders, can help with the management of weight in ponies; however, there is still a lack of knowledge regarding their effect on equine posture. Therefore, the aim of the study was to assess the effect of different feeding devices on the posture of ponies using morphometric analysis. Two different breed types, Shetland type (SH, n = 5) versus Welsh Cob type (WC, n = 4), were fed the same forage in four different ways: on the ground (G), using a fully filled haynet (HF), using a partially filled haynet (HL) and using a slow-feeder hay box (HB). Video recordings were obtained and then geometric morphometric analysis was applied. Breed morphology was confirmed by body morphometric measurements. Data were analysed statistically using one-way ANOVA, canonical variate analysis (CVA), principal component analysis (PCA), partial least-squares (PLS) analysis and multivariate analysis of variance (MANOVA). Moreover, a mixed model was performed to study differences in mandibular angle. SH and WC ponies were shown to have significantly different body morphometric measurements. The geometric morphometric analysis results showed that ponies arch their back and modify their neck shape differently according to the feeding method and their morphological group. For the neck, the SH and WC ponies adapted similarly to the use of small-holed hay nets, but their posture varied when feeding from the ground or hay box. The back postures consistently differed according to the breed type and feeding method. The mandibular angle for both breed types was reduced with all the feeding devices compared to feeding from the ground. Further studies are needed to evaluate the long-term effects of slow-feeding devices on posture and mandibular angle, taking into consideration animals with different morphologies.

PMID:37452526 | DOI:10.1111/jpn.13861

Clin Anat. 2023 Jul 14. doi: 10.1002/ca.24049. Online ahead of print.

ABSTRACT

The dorsal scapular nerve (DSN) entrapment neuropathy has recently been recognized as a common cause of circumscapular pain and cases of winged scapula. Course of the nerve is important because the middle scalene muscle is frequently accessed for surgical treatments. Studies in the literature have not focused on the morphometric relationship of the DSN with the scalene muscles and its relationship with the long thoracic nerve (LTN). The neck regions of 13 adult cadavers were dissected bilaterally. The relationship of DSN with scalene muscles and LTN was evaluated. Cervical spinal nerves involved in the formation of the DSN were identified. Three types of DSN were observed based on the cervical spinal nerves from which it originates, five types of DSN from its relationship with the scalene muscles, and two types of DSN from its relationship with the LTN. The distance from where the nerve pierces the scalene muscle to the mastoid process was found to be greater in DSNs originating from C4 and C5 (93.85 ± 4.11 mm, p = 0.033). In DSNs not connected with LTN, the distance from where the nerve pierces the scalene muscle to the superior trunk/C5 (12.74 ± 7.73 mm, p = 0.008) and the length of the nerve within the scalene muscle (14.94 ± 5.5 mm, p = 0.029) were found to be statistically significantly greater. The topographic and morphometric anatomy of the proximal part of the DSN is important, especially for scalene muscles-focused surgical treatments and interscalene nerve blocks. We believe our results may guide clinical approaches and surgery.

PMID:37452523 | DOI:10.1002/ca.24049

Med Sci Monit. 2023 Jul 15;29:e940511. doi: 10.12659/MSM.940511.

ABSTRACT

BACKGROUND Stroke is a leading cause of long-term disability, often resulting in impaired mobility and gait abnormalities, necessitating effective rehabilitation approaches. Robotic-assisted gait training (RAGT) offers precise control and intensive, task-specific training. The EksoNR exoskeleton shows potential in facilitating gait recovery. This study assesses the efficacy and tolerability of RAGT using EksoNR in the rehabilitation of 19 stroke patients. MATERIAL AND METHODS A prospective nonrandomized, observational study design was employed with a single group convenience sample. The study included 19 individuals post-stroke, who underwent a 4-week rehabilitation program. Baseline and post-rehabilitation assessments were conducted using selected International Classification of Functioning, Disability and Health (ICF) codes, gait exoskeleton parameters (number of steps, walking time, time of verticalization) obtained during the exoskeleton sessions, and the Timed Up and Go Test (TUG). RESULTS The study revealed statistically significant improvements in all analyzed ICF categories, except for D530 Toileting, indicating enhanced functioning. The most notable improvements in activity and participation were observed in the categories of D410 Changing basic body position (-0.84±0.60) and D450 Walking (-0.84±0.60). Additionally, gait analysis demonstrated significant enhancements in the number of steps (difference of 506.79±252.49), walking time (13.02±7.91), and time of verticalization (11.82±9.21) (p>0.001). The TUG test also showed a statistically significant improvement in mobility (p=0.005). CONCLUSIONS This study supports previous findings, demonstrating that RAGT using the EksoNR lower extremity exoskeleton improves gait and functional status in stroke patients, while being well tolerated. The results highlight the potential of this approach for improved rehabilitation outcomes.

PMID:37452491 | DOI:10.12659/MSM.940511

Scand J Gastroenterol. 2023 Jul 14:1-8. doi: 10.1080/00365521.2023.2233038. Online ahead of print.

ABSTRACT

OBJECIVES: At present, no sensitive or specific screening test exists for primary sclerosing cholangitis (PSC). PSC screening is mainly based on elevated alkaline phosphatase (ALP) in patients with inflammatory bowel disease (IBD). We aimed to produce a screening score based on laboratory tests to predict the likelihood of PSC. Moreover, we evaluated the additional roles of liver histology and magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of PSC.

MATERIALS AND METHODS: The data of 385 patients who came for their first endoscopic retrograde cholangiography (ERC) to confirm PSC diagnosis were retrieved from the PSC registry of the Helsinki University Hospital. Overall, 69 patients referred for ERC with suspected PSC, in whom PSC was excluded by ERC or liver biopsy and MRCP, served as controls. We included patients’ demographics and 13 laboratory test results in the analysis. Variables with significant odds ratios were selected for multivariate logistic regression, which was used to create a novel scoring system for PSC. The presence of IBD, serum perinuclear anti-neutrophil cytoplasmic antibodies, and ALP levels demonstrated the highest predictive value for PSC. A score was assigned for each statistically significant predictor.

RESULTS: The optimal cut-off point for the score was ≥3, with an AUC of 0.83 (95%CI: 0.78-0.88). The addition of liver histology or MRCP findings to the score did not add a predictive value.

CONCUSIONS: In conclusion, we created a novel, simple scoring system to screen the probability of PSC. The HelPSCreen-score may help to assess the disease prevalence and to target further investigations in patients suspected of PSC.

PMID:37452487 | DOI:10.1080/00365521.2023.2233038

New Phytol. 2023 Jul 14. doi: 10.1111/nph.19117. Online ahead of print.

ABSTRACT

Predicting the fate of coastal marshes requires understanding how plants respond to rapid environmental change. Environmental change can elicit shifts in trait variation attributable to phenotypic plasticity and act as selective agents to shift trait means, resulting in rapid evolution. Comparably, less is known about the potential for responses to reflect the evolution of trait plasticity. Here, we assessed the relative magnitude of eco-evolutionary responses to interacting global change factors using a multifactorial experiment. We exposed replicates of 32 Schoenoplectus americanus genotypes ‘resurrected’ from century-long, soil-stored seed banks to ambient or elevated CO₂ , varying levels of inundation, and the presence of a competing marsh grass, across two sites with different salinities. Comparisons of responses to global change factors among age cohorts and across provenances indicated that plasticity has evolved in five of the seven traits measured. Accounting for evolutionary factors (i.e. evolution and sources of heritable variation) in statistical models explained an additional 9-31% of trait variation. Our findings indicate that evolutionary factors mediate ecological responses to environmental change. The magnitude of evolutionary change in plant traits over the last century suggests that evolution could play a role in pacing future ecosystem response to environmental change.

PMID:37452486 | DOI:10.1111/nph.19117