Tag: pubmed

Int J Oral Maxillofac Implants. 2023 Jan-Feb;38(1):71-76. doi: 10.11607/jomi.9829.

ABSTRACT

Purpose: To investigate the effect of incisive papilla on esthetic ratings and lip support for patients who are treated with implant-supported fixed prostheses on edentulous maxillae. Materials and Methods: A study population of 118 patients with maxillomandibular edentulism was identified. A self-administered questionnaire was used to evaluate treatment outcomes through a patient perspective. Also, clinical factors such as smile line, maxillary resorption, incisive papilla position, and lip support were evaluated. Results: Lip support has a significant effect on the facial esthetic scores of patients, while smile line and incisive papilla localization have not had a proven statistically significant effect on esthetic and facial esthestic scores of patients treated with implant-supported fixed prostheses on maxillae. Conclusion: Although the patients were diagnosed with disadvantageous clinical factors such as crestally localized incisive papilla, they still noted higher esthetic scores with their fixed prostheses. Factors that affect the esthetic perception of patients or their priorities should be investigated more to understand the reasons for patient satisfaction with prostheses.

PMID:37099573 | DOI:10.11607/jomi.9829

Int J Oral Maxillofac Implants. 2023 Jan-Feb;38(1):77-83. doi: 10.11607/jomi.9555.

ABSTRACT

Purpose: To compare the effects of regular implant drills to osseodensifying drills used in clockwise and counterclockwise motions on bone dimension change and primary implant stability. Materials and Methods: A total of 40 bone models were made (20 × 15 × 4 mm) from porcine tibia to represent implants placed in soft bone. Implant osteotomies were prepared in the bone models using one of the following techniques: (1) regular implant drills in a clockwise direction (group A), (2) regular implant drills in a counterclockwise direction (group B), (3) osseodensifying drills in a clockwise direction (group C), and (4) osseodensifying drills in a counterclockwise direction (group D). Bone-level tapered titanium alloy implants (4.1 × 10 mm) were placed following osteotomy creation. The implant stability quotient (ISQ) was measured after implant placement. Each bone model was scanned with an optical scanner to convert to Standard Tessellation Language (STL) files before and after the osteotomy creation. Presurgical and postsurgical STL files were superimposed, and the dimensional changes were measured at 1, 3, and 7 mm from the crestal bone. Histomorphometric analysis was done, and bone-to-implant contact percentage (BIC%) was calculated. Results: There were no significant differences in ISQ values (P = .239) between any of the groups. Histomorphometric analysis showed implants in group D had significantly higher BIC% than groups A (P = .020) and B (P = .009). The amount of bone expansion decreased with distance from the crest (P < .001). Groups B (P = .039) and D (P = .001) showed significant expansions at all levels compared with group A. No other statistically significant differences in dimensional change were found between groups. Conclusion: Both regular and osseodensification burs used in a counterclockwise motion contribute to expansion of bone dimension compared to conventional drilling methods.

PMID:37099572 | DOI:10.11607/jomi.9555

Int J Oral Maxillofac Implants. 2023 Jan-Feb;38(1):157-168. doi: 10.11607/jomi.9796.

ABSTRACT

Purpose: To assess the accuracy of totally guided implant placement with static surgical splints in relation to the different types of supporting tissues (tooth, mucosa, or bone). Materials and Methods: This review was carried out following the PRISMA guidelines. An electronic search was done of the MEDLINE (PubMed), Embase, and Cochrane Library databases, without publication year or language restrictions. Results: The literature search yielded a total of 877 articles; 18 were included in the qualitative synthesis, and 16 of these articles were included in the quantitative analysis. The included studies presented a high risk of bias, except for one randomized clinical trial. The strength of the recommendations is therefore weak. In the angular deviation treatment, statistically significant differences were observed in the accuracy of the implants with tooth vs bone support: Bone support yielded 1.31 degrees greater deviation vs tooth support (SD = 0.43; 95% CI: 0.47, 2.15, P = .002). No significant differences were observed in the linear deviations. Conclusion: Tooth support proved to be significantly more precise than bone support splints. There were no differences referring to horizontal coronal deviation, horizontal apical deviation, or vertical deviation according to the type of splint support used.

PMID:37099571 | DOI:10.11607/jomi.9796

PLoS One. 2023 Apr 26;18(4):e0284852. doi: 10.1371/journal.pone.0284852. eCollection 2023.

ABSTRACT

AIM: In a retrospective and exploratory case-control study, we examined the genetic association of two common polymorphisms in the 3′ untranslated region (UTR) of DICER1 (rs3742330) and DROSHA (rs10719) genes in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and its related clinical phenotypes in a Saudi cohort.

METHODS: DNA genotyping was performed using TaqMan real-time PCR assays in 500 participants, including 152 POAG, 102 PACG, and 246 non-glaucomatous controls. Statistical analyses were performed to examine the association(s).

RESULTS: Allele and genotype frequency of rs3742330 and rs10719 did not vary significantly in POAG and PACG compared to controls. No significant deviation was observed from Hardy-Weinberg Equilibrium (p > 0.05). Gender stratification revealed no significant allelic/genotype association with glaucoma types. Also, these polymorphisms showed no significant genotype effect on clinical markers such as intraocular pressure, cup/disc ratio, and the number of antiglaucoma medications. Logistic regression showed no effect of age, sex, rs3742330, and rs10719 genotypes on the risk of disease outcome. We also examined a combined allelic effect of rs3742330 (A>G) and rs10719 (A>G). However, none of the allelic combinations significantly affected POAG and PACG.

CONCLUSIONS: The 3′ UTR polymorphisms rs3742330 and rs10719 of DICER1 and DROSHA genes are not associated with POAG and PACG or its related glaucoma indices in this Middle-Eastern cohort of Saudi Arab ethnicity. However, there is a need to validate the results on a broader population and other ethnicities.

PMID:37099569 | DOI:10.1371/journal.pone.0284852

Fam Med. 2023 Apr 18. doi: 10.22454/FamMed.149721. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The rapid increase in the older adult population necessitates an increase in physicians who are adept at caring for the various medical comorbidities that accompany aging. To fill the gap in geriatric medical education and overcome barriers to medical student interest in geriatrics, we developed a friendly caller program that links medical students to older adults through multiple weekly phone calls. This study examines the impact of this program on geriatric care competency, a foundational skill for primary care physicians, in first-year medical students.

METHODS: We used a mixed-methods design to measure how medical students’ self-assessed geriatric knowledge was impacted by their longitudinal interactions with seniors. We compared pre- and postsurvey data using a Mann-Whitney test. We used deductive qualitative analysis to examine themes that emerged from narrative feedback.

RESULTS: Our results demonstrated that students (n=29) showed a statistically significant increase in components of their self-assessed geriatric care competency. Qualitative analysis of student responses revealed five common themes: transformation of preconceived notions regarding older adults, relationship building, greater understanding of older adults, communication skills, and self-compassion.

CONCLUSIONS: Given the shortage of physicians competent in geriatric care amid a rapidly growing older adult population, this study highlights a novel, older adult service-learning program that positively impacts geriatric knowledge in medical students.

PMID:37099388 | DOI:10.22454/FamMed.149721

JMIR Res Protoc. 2023 Apr 26;12:e45176. doi: 10.2196/45176.

ABSTRACT

BACKGROUND: A hallmark of gastrointestinal cancer, especially pancreatic cancer, is the dense stromal tumor microenvironment in which cancer-associated fibroblasts (CAFs) represent the major stromal cell type. Preclinical studies have demonstrated that depletion of fibroblast activation protein (FAP)-positive CAFs results in increased survival.

OBJECTIVE: We present the protocol for a systematic review and meta-analysis that aim to assess the currently available evidence on the effect of FAP expression on survival and clinical characteristics in gastrointestinal cancers.

METHODS: The literature search and data analysis will be conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. The databases PubMed/MEDLINE, Web of Science Core Collection, Cochrane Library, and ClinicalTrials.gov will be searched via their respective online search engines. A meta-analysis comparing patients with and without FAP overexpression with the following outcomes will be performed: postoperative survival (overall and median survival; 1-, 2-, 3-, and 5-year survival rates), histological differentiation (grading), local tumor invasion, lymph node metastases, and distant metastases. Odds ratios will be calculated for binary data, and weighted mean differences and relative SD differences will be determined for continuous data. The 95% CI, heterogeneity measures, and statistical significance will be reported for each outcome. The chi-square and Kruskal-Wallis tests will be used to evaluate statistical significance. A P value of <.05 will be considered statistically significant.

RESULTS: Database searches will commence in April 2023. The meta-analysis will be completed by December 2023.

CONCLUSIONS: In recent years, several publications on FAP overexpression in gastrointestinal tumors have been published. The only published meta-analysis on this topic dates to 2015. It included 15 studies on various solid tumors and only 8 studies focusing exclusively on gastrointestinal tumors. The expected results of the present analysis will provide new evidence on the prognostic value of FAP in gastrointestinal tumors and thereby support health care professionals and patients in their decision-making.

TRIAL REGISTRATION: PROSPERO CRD42022372194; https://tinyurl.com/352ae8b8.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/45176.

PMID:37099374 | DOI:10.2196/45176

JMIR Cardio. 2023 Apr 26;7:e45299. doi: 10.2196/45299.

ABSTRACT

BACKGROUND: An accurate quantitative analysis of coronary artery stenotic lesions is essential to make optimal clinical decisions. Recent advances in computer vision and machine learning technology have enabled the automated analysis of coronary angiography.

OBJECTIVE: The aim of this paper is to validate the performance of artificial intelligence-based quantitative coronary angiography (AI-QCA) in comparison with that of intravascular ultrasound (IVUS).

METHODS: This retrospective study included patients who underwent IVUS-guided coronary intervention at a single tertiary center in Korea. Proximal and distal reference areas, minimal luminal area, percent plaque burden, and lesion length were measured by AI-QCA and human experts using IVUS. First, fully automated QCA analysis was compared with IVUS analysis. Next, we adjusted the proximal and distal margins of AI-QCA to avoid geographic mismatch. Scatter plots, Pearson correlation coefficients, and Bland-Altman were used to analyze the data.

RESULTS: A total of 54 significant lesions were analyzed in 47 patients. The proximal and distal reference areas, as well as the minimal luminal area, showed moderate to strong correlation between the 2 modalities (correlation coefficients of 0.57, 0.80, and 0.52, respectively; P<.001). The correlation was weaker for percent area stenosis and lesion length, although statistically significant (correlation coefficients of 0.29 and 0.33, respectively). AI-QCA tended to measure reference vessel areas smaller and lesion lengths shorter than IVUS did. Systemic proportional bias was not observed in Bland-Altman plots. The biggest cause of bias originated from the geographic mismatch of AI-QCA with IVUS. Discrepancies in the proximal or distal lesion margins were observed between the 2 modalities, which were more frequent at the distal margins. After the adjustment of proximal or distal margins, there was a stronger correlation of proximal and distal reference areas between AI-QCA and IVUS (correlation coefficients of 0.70 and 0.83, respectively).

CONCLUSIONS: AI-QCA showed a moderate to strong correlation compared with IVUS in analyzing coronary lesions with significant stenosis. The main discrepancy was in the perception of the distal margins by AI-QCA, and the correction of margins improved the correlation coefficients. We believe that this novel tool could provide confidence to treating physicians and help in making optimal clinical decisions.

PMID:37099368 | DOI:10.2196/45299

J Med Internet Res. 2023 Apr 26;25:e40176. doi: 10.2196/40176.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) in China are disproportionately affected by the HIV epidemic, and medication adherence to antiretroviral treatment in this vulnerable population is suboptimal. To address this issue, we developed an app-based case management service with multiple components, informed by the Information Motivation Behavioral skills model.

OBJECTIVE: We aimed to conduct a process evaluation for the implementation of an innovative app-based intervention guided by the Linnan and Steckler framework.

METHODS: Process evaluation was performed alongside a randomized controlled trial in the largest HIV clinic in Guangzhou, China. Eligible participants were HIV-positive MSM aged ≥18 years planning to initiate treatment on the day of recruitment. The app-based intervention had 4 components: web-based communication with case managers, educational articles, supportive service information (eg, information on mental health care and rehabilitation service), and hospital visit reminders. Process evaluation indicators of the intervention include dose delivered, dose received, fidelity, and satisfaction. The behavioral outcome was adherence to antiretroviral treatment at month 1, and Information Motivation Behavioral skills model scores were the intermediate outcome. Logistic and linear regression was used to investigate the association between intervention uptake and outcomes, controlling for potential confounders.

RESULTS: A total of 344 MSM were recruited from March 19, 2019, to January 13, 2020, and 172 were randomized to the intervention group. At month 1 follow-up, there was no significant difference in the proportion of adherent participants between the intervention and control groups (66/144, 45.8% vs 57/134, 42.5%; P=.28). In the intervention group, 120 participants engaged in web-based communication with case managers and 158 accessed at least 1 of the delivered articles. The primary concern captured in the web-based conversation was the side effects of the medication (114/374, 30.5%), which was also one of the most popular educational articles topics. The majority (124/144, 86.1%) of participants that completed the month 1 survey rated the intervention as “very helpful” or “helpful.” The number of educational articles accessed was associated with adequate adherence in the intervention group (odds ratio 1.08, 95% CI 1.02-1.15; P=.009). The intervention also improved the motivation score after adjusting for baseline values (β=2.34, 95% CI 0.77-3.91; P=.004). However, the number of web-based conversations, regardless of conversation features, was associated with lower motivation scores in the intervention group.

CONCLUSIONS: The intervention was well-received. Delivering educational resources of interest may enhance medication adherence. The uptake of the web-based communication component could serve as an indicator of real-life difficulties and could be used by case managers to identify potential inadequate adherence.

TRIAL REGISTRATION: Clinicaltrial.gov NCT03860116; https://clinicaltrials.gov/ct2/show/NCT03860116.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-020-8171-5.

PMID:37099367 | DOI:10.2196/40176

JMIR Serious Games. 2023 Apr 26;11:e40284. doi: 10.2196/40284.

ABSTRACT

BACKGROUND: Currently, many central auditory processing disorder screening tests are available for children, and serious games (SGs) are frequently used as a tool for the diagnosis of different neural deficits and disorders in health care. However, it has not been possible to find a proposal that unifies both ideas. In addition, the validation and improvement of SGs, in general, does not take into account the player-game interaction, thus omitting valuable information about the playability and usability of the game.

OBJECTIVE: This study presented Amalia’s Planet, a game conceived for use in school environments, which allows a first assessment of a child through their performance of the proposed tasks related to different aspects of auditory performance. In addition, the game defines a series of events in relation to the execution of the tasks, which were evaluated for the subsequent optimization of its performance and the improvement of its usability.

METHODS: Using screening tools based on the use of SG technologies, a total of 87 school-age children were evaluated to test the various hypotheses proposed in this study. By grouping users according to whether they had personal history of hearing pathologies, the discriminant power, playability, and usability of the final solution were examined using traditional statistical techniques and process mining (PM) algorithms.

RESULTS: With a confidence level of 80% for test 2 (P=.19), there was no statistical evidence to reject the null hypothesis that a player’s performance is affected by whether the player had a previous auditory pathology. Furthermore, the tool allowed the screening of 2 players initially categorized as healthy because of their low level of performance in the tests and the similarity of their behavior with that of the group of children with a previous pathology. With regard to the validation of the proposed solution, the use of PM techniques made it possible to detect the existence of events that lasted too long, which can lead to player frustration, and to discover small structural flaws in the game.

CONCLUSIONS: SGs seem to be an appropriate tool for the screening of children at risk of central auditory processing disorder. Moreover, the set of PM techniques provides a reliable source of information regarding the playability and usability of the solution to the development team, allowing its continuous optimization.

PMID:37099359 | DOI:10.2196/40284

Clin Infect Dis. 2023 Apr 26:ciad238. doi: 10.1093/cid/ciad238. Online ahead of print.

ABSTRACT

BACKGROUND: Tuberculosis case-finding interventions are critical to meeting World Health Organization End TB strategy goals. We investigated the impact of community-wide tuberculosis active case-finding (ACF) alongside scale-up of HIV testing and care on trends in adult tuberculosis case notification rates (CNRs) in Blantyre, Malawi.

METHODS: Five rounds of ACF for tuberculosis (1-2 weeks of leafleting, door-to-door enquiry for cough and sputum microscopy) were delivered to neighbourhoods (“ACF areas”) in North-West Blantyre between April 2011 and August 2014. Many of these neighborhoods also had concurrent HIV testing interventions. The remaining neighbourhoods in Blantyre City (“non-ACF areas”) provided a non-randomised comparator. We analyzed TB CNRs from January 2009 until December 2018. We used interrupted time series analysis to compare tuberculosis CNRs before ACF and after ACF, and between ACF and non-ACF areas.

FINDINGS: Tuberculosis CNRs increased in Blantyre concurrently with start of ACF for tuberculosis in both ACF and non-ACF areas, with a larger magnitude in ACF areas. Compared to a counterfactual where pre-ACF CNR trends continued during ACF period, we estimated there were an additional 101 (95% confidence interval [CI] 42 to 160) microbiologically confirmed (Bac+) tuberculosis diagnoses per 100,000 person-years in the ACF areas in three and a half years of ACF. Compared to a counterfactual where trends in ACF area were the same as trends in non-ACF areas, we estimated an additional 63 (95% CI 38 to 90) Bac+ diagnoses per 100,000 person-years in the same period.

INTERPRETATION: Tuberculosis ACF was associated with a rapid increase in people diagnosed with tuberculosis in Blantyre.

PMID:37099318 | DOI:10.1093/cid/ciad238