Tag: pubmed

Acta Odontol Scand. 2022 May 26:1-17. doi: 10.1080/00016357.2022.2077980. Online ahead of print.

ABSTRACT

OBJECTIVE: The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement.

MATERIAL AND METHODS: An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted.

RESULTS: The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading (p = .00045, .00005, .00055, and .00005, respectively), and no statistically significant results in the other two studies (p = .225, .371, respectively.) However, the results of the favoured intervention were not statistically significant (p = .104, .166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly (p = .013, .001, .05, respectively).

CONCLUSIONS: The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone.

PMID:35617455 | DOI:10.1080/00016357.2022.2077980

PLoS Med. 2022 May 26;19(5):e1004015. doi: 10.1371/journal.pmed.1004015. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs.

METHODS AND FINDINGS: We conducted a cross-sectional analysis using data from the baseline questionnaire of the United Kingdom Research study into Ethnicity and Coronavirus Disease 2019 (COVID-19) Outcomes in Healthcare workers (UK-REACH) cohort study, administered between December 2020 and March 2021. We used logistic regression to examine associations of demographic, household, and occupational risk factors with SARS-CoV-2 infection (defined by polymerase chain reaction (PCR), serology, or suspected COVID-19) in a diverse group of HCWs. The primary exposure of interest was self-reported ethnicity. Among 10,772 HCWs who worked during the first UK national lockdown in March 2020, the median age was 45 (interquartile range [IQR] 35 to 54), 75.1% were female and 29.6% were from ethnic minority groups. A total of 2,496 (23.2%) reported previous SARS-CoV-2 infection. The fully adjusted model contained the following dependent variables: demographic factors (age, sex, ethnicity, migration status, deprivation, religiosity), household factors (living with key workers, shared spaces in accommodation, number of people in household), health factors (presence/absence of diabetes or immunosuppression, smoking history, shielding status, SARS-CoV-2 vaccination status), the extent of social mixing outside of the household, and occupational factors (job role, the area in which a participant worked, use of public transport to work, exposure to confirmed suspected COVID-19 patients, personal protective equipment [PPE] access, aerosol generating procedure exposure, night shift pattern, and the UK region of workplace). After adjustment, demographic and household factors associated with increased odds of infection included younger age, living with other key workers, and higher religiosity. Important occupational risk factors associated with increased odds of infection included attending to a higher number of COVID-19 positive patients (aOR 2.59, 95% CI 2.11 to 3.18 for ≥21 patients per week versus none), working in a nursing or midwifery role (1.30, 1.11 to 1.53, compared to doctors), reporting a lack of access to PPE (1.29, 1.17 to 1.43), and working in an ambulance (2.00, 1.56 to 2.58) or hospital inpatient setting (1.55, 1.38 to 1.75). Those who worked in intensive care units were less likely to have been infected (0.76, 0.64 to 0.92) than those who did not. Black HCWs were more likely to have been infected than their White colleagues, an effect which attenuated after adjustment for other known risk factors. This study is limited by self-selection bias and the cross sectional nature of the study means we cannot infer the direction of causality.

CONCLUSIONS: We identified key sociodemographic and occupational risk factors associated with SARS-CoV-2 infection among UK HCWs, and have determined factors that might contribute to a disproportionate odds of infection in HCWs from Black ethnic groups. These findings demonstrate the importance of social and occupational factors in driving ethnic disparities in COVID-19 outcomes, and should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting HCWs in future waves of the COVID-19 pandemic.

TRIAL REGISTRATION: The study was prospectively registered at ISRCTN (reference number: ISRCTN11811602).

PMID:35617423 | DOI:10.1371/journal.pmed.1004015

PLoS Pathog. 2022 May 26;18(5):e1010359. doi: 10.1371/journal.ppat.1010359. Online ahead of print.

ABSTRACT

As of January 2022, at least 60 million individuals are estimated to develop post-acute sequelae of SARS-CoV-2 (PASC) after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While elevated levels of SARS-CoV-2-specific T cells have been observed in non-specific PASC, little is known about their impact on pulmonary function which is compromised in the majority of these individuals. This study compares frequencies of SARS-CoV-2-specific T cells and inflammatory markers with lung function in participants with pulmonary PASC and resolved COVID-19 (RC). Compared to RC, participants with respiratory PASC had between 6- and 105-fold higher frequencies of IFN-γ- and TNF-α-producing SARS-CoV-2-specific CD4+ and CD8+ T cells in peripheral blood, and elevated levels of plasma CRP and IL-6. Importantly, in PASC participants the frequency of TNF-α-producing SARS-CoV-2-specific CD4+ and CD8+ T cells, which exhibited the highest levels of Ki67 indicating they were activity dividing, correlated positively with plasma IL-6 and negatively with measures of lung function, including forced expiratory volume in one second (FEV1), while increased frequencies of IFN-γ-producing SARS-CoV-2-specific T cells associated with prolonged dyspnea. Statistical analyses stratified by age, number of comorbidities and hospitalization status demonstrated that none of these factors affect differences in the frequency of SARS-CoV-2 T cells and plasma IL-6 levels measured between PASC and RC cohorts. Taken together, these findings demonstrate elevated frequencies of SARS-CoV-2-specific T cells in individuals with pulmonary PASC are associated with increased systemic inflammation and decreased lung function, suggesting that SARS-CoV-2-specific T cells contribute to lingering pulmonary symptoms. These findings also provide mechanistic insight on the pathophysiology of PASC that can inform development of potential treatments to reduce symptom burden.

PMID:35617421 | DOI:10.1371/journal.ppat.1010359

PLoS Comput Biol. 2022 May 26;18(5):e1010080. doi: 10.1371/journal.pcbi.1010080. Online ahead of print.

ABSTRACT

Finding the right amount of deliberation, between insufficient and excessive, is a hard decision making problem that depends on the value we place on our time. Average-reward, putatively encoded by tonic dopamine, serves in existing reinforcement learning theory as the opportunity cost of time, including deliberation time. Importantly, this cost can itself vary with the environmental context and is not trivial to estimate. Here, we propose how the opportunity cost of deliberation can be estimated adaptively on multiple timescales to account for non-stationary contextual factors. We use it in a simple decision-making heuristic based on average-reward reinforcement learning (AR-RL) that we call Performance-Gated Deliberation (PGD). We propose PGD as a strategy used by animals wherein deliberation cost is implemented directly as urgency, a previously characterized neural signal effectively controlling the speed of the decision-making process. We show PGD outperforms AR-RL solutions in explaining behaviour and urgency of non-human primates in a context-varying random walk prediction task and is consistent with relative performance and urgency in a context-varying random dot motion task. We make readily testable predictions for both neural activity and behaviour.

PMID:35617370 | DOI:10.1371/journal.pcbi.1010080

PLoS One. 2022 May 26;17(5):e0268648. doi: 10.1371/journal.pone.0268648. eCollection 2022.

ABSTRACT

BACKGROUND: Neonatal mortality remains a public health problem in the developing world. Globally, around 2.5 million neonatal deaths are reported annually with the highest mortality concentrated in sub-Saharan Africa and South Asia. In comparison with countries demonstrating the lowest neonatal mortality, the risk of mortality is over 30 times higher in sub-Saharan Africa. Ethiopia is among the countries with a high neonatal mortality rate, and the burden of this mortality remains unreported in many pastoralist areas such as Somali Regional State, Eastern Ethiopia. We aimed to investigate factors associated with neonatal mortality in public Hospitals of the Somali Regional State in Eastern Ethiopia.

METHODS: A facility-based cross-sectional study was conducted from May 1st to 30th, 2020 in three public Hospitals of Somali Regional State in Eastern Ethiopia. A total of 510 neonates admitted to neonatal intensive care units from January 2018 to December 2019 were enrolled in the study. The charts of neonates were randomly selected and retrieved. Data were collected using a pretested and validated structured questionnaire. The collected were entered into Epidata version 3.1 and exported to SPSS version 22 (IBM SPSS Statistics, 2013) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using adjusted odds ratio (AOR) with 95% Confidence Interval (CI). Statistical significance was considered at a p-value <0.05.

RESULTS: Overall, the neonatal mortality was 18.6% [95%CI (15.31, 22.30)], equating to a rate of 186 per 1000 live births. The most common causes of mortality were prematurity (44.6%), low birth weight (33.5%), and birth asphyxia (27.6%). In the final model of multivariable analysis, predictors such as: lack of antenatal care follow-up[AOR = 3.71, 95%CI (2.13, 6.44)], neonatal sepsis [AOR = 1.84, 95%CI (1.07, 3.19], preterm birth [AOR = 2.20, 95%CI (1.02, 4.29], and birth asphyxia [AOR = 2.40, 95%CI(1.26,4.43)], and birth weight of less than 2500gms[AOR = 3.40, 95%CI(1.92, 6.01)] were statistically associated with neonatal mortality.

CONCLUSION: In this study, the neonatal mortality rate was high compared to national and global targets because one in five neonates dies due to preventable causes. Modifiable and non-modifiable risk factors were identified as predictors. This result calls for all stakeholders to provide due attention to low birth weight and premature babies. Early identification and management of birth asphyxia and neonatal sepsis are also very crucial to reduce the risks of neonatal deaths.

PMID:35617349 | DOI:10.1371/journal.pone.0268648

PLoS One. 2022 May 26;17(5):e0268967. doi: 10.1371/journal.pone.0268967. eCollection 2022.

ABSTRACT

Integrated bioinformatics and statistical approaches are now playing the vital role in identifying potential molecular biomarkers more accurately in presence of huge number of alternatives for disease diagnosis, prognosis and therapies by reducing time and cost compared to the wet-lab based experimental procedures. Breast cancer (BC) is one of the leading causes of cancer related deaths for women worldwide. Several dry-lab and wet-lab based studies have identified different sets of molecular biomarkers for BC. But they did not compare their results to each other so much either computationally or experimentally. In this study, an attempt was made to propose a set of molecular biomarkers that might be more effective for BC diagnosis, prognosis and therapies, by using the integrated bioinformatics and statistical approaches. At first, we identified 190 differentially expressed genes (DEGs) between BC and control samples by using the statistical LIMMA approach. Then we identified 13 DEGs (AKR1C1, IRF9, OAS1, OAS3, SLCO2A1, NT5E, NQO1, ANGPT1, FN1, ATF6B, HPGD, BCL11A, and TP53INP1) as the key genes (KGs) by protein-protein interaction (PPI) network analysis. Then we investigated the pathogenetic processes of DEGs highlighting KGs by GO terms and KEGG pathway enrichment analysis. Moreover, we disclosed the transcriptional and post-transcriptional regulatory factors of KGs by their interaction network analysis with the transcription factors (TFs) and micro-RNAs. Both supervised and unsupervised learning’s including multivariate survival analysis results confirmed the strong prognostic power of the proposed KGs. Finally, we suggested KGs-guided computationally more effective seven candidate drugs (NVP-BHG712, Nilotinib, GSK2126458, YM201636, TG-02, CX-5461, AP-24534) compared to other published drugs by cross-validation with the state-of-the-art alternatives top-ranked independent receptor proteins. Thus, our findings might be played a vital role in breast cancer diagnosis, prognosis and therapies.

PMID:35617355 | DOI:10.1371/journal.pone.0268967

Glob Chang Biol. 2022 May 26. doi: 10.1111/gcb.16226. Online ahead of print.

ABSTRACT

The carbon use efficiency (CUE) of soil microorganisms is a critical parameter for the first step of organic carbon (C) transformation by and incorporation into microbial biomass and shapes C cycling in terrestrial ecosystems. As C and nitrogen (N) cycles interact closely and N availability affects microbial metabolism, N addition to soil may shift the microbial CUE. We conducted a meta-analysis (100 data pairs) to generalize information about the microbial CUE response to N addition in soil based on the two most common CUE estimation approaches: (i) ¹³ C-labelled substrate addition (¹³ C-substrate) and (ii) ¹⁸ O-labelled water addition (¹⁸ O-H₂ O). The mean microbial CUE in soils across all biomes and approaches was 0.37. The effects of N addition on CUE, however, were depended on the approach: CUE decreased by 12% if measured by the ¹³ C-substrate approach, while CUE increased by 11% if measured by the ¹⁸ O-H₂ O approach. These differences in the microbial CUE response depending on the estimation approach are explained by the divergent reactions of microbial growth to N addition: N addition decreases the ¹³ C incorporation into microbial biomass (this parameter is in the numerator by CUE calculation based on the ¹³ C-substrate approach). In contrast, N addition slightly increases (although statistically insignificant) the microbial growth rate (in the numerator of the CUE calculation when assessed by the ¹⁸ O-H₂ O approach), significantly raising the CUE. We explained these N addition effects based on CUE regulation mechanisms at the metabolic, cell, community, and ecosystem levels. Consequently, the differences in the microbial responses (microbial growth, respiration, C incorporation, community composition, and dormant or active states) between the ¹³ C-substrate and ¹⁸ O-H₂ O approaches need to be considered. Thus, these two CUE estimation approaches should be compared to understand microbially mediated C and nutrient dynamics under increasing anthropogenic N input and other global change effects.

PMID:35617026 | DOI:10.1111/gcb.16226

Environ Health Perspect. 2022 May;130(5):57702. doi: 10.1289/EHP11281. Epub 2022 May 26.

NO ABSTRACT

PMID:35617000 | DOI:10.1289/EHP11281

Wound Manag Prev. 2022 May;68(5):28-36.

ABSTRACT

BACKGROUND: Multiple factors affect the sleep quality of individuals with intestinal stomas.

PURPOSE: This study sought to determine sleep quality and factors affecting sleep in individuals with intestinal ostomies.

METHODS: A descriptive cross-sectional design was used. This study followed 68 individuals with intestinal stomas at the stoma therapy unit of a university hospital. A form was used to gather information about patient demographic and stoma-related data (age, sex, work status, stoma duration, cause and type of stoma, stoma care provider, sleep status during the day, daily coffee consumption, and stoma-related factors affecting sleep), and the Pittsburgh Sleep Quality Index was used to score patient sleep patterns. Descriptive statistics, t-test, chi-square test, Fisher’s exact test, and logistic regression analysis were used for statistical analysis.

RESULTS: The patients’ mean age was 53.7 ± 13.8 years; 51.5% were male, and 66.2% were married. Of the 68 patients, 41.2% had a diagnosis of rectal cancer, and 55.9% had ileostomies. Mean stoma duration was 24.1 ± 5.8 months, and 57.4% of participants performed their own stoma care. On a scale of 0 to 21, the participants’ mean sleep score was 9.08 ± 5.03, and 66.2% of patients were found to have poor sleep quality. High sleep quality was significantly positively associated with colostomy (odds ratio, 1.78; 95% confidence interval [CI], 1.18-2.69; P = .006) and self-performed stoma care (odds ratio, 1.54; 95% confidence interval, 1.03-2.30; P = .036).

CONCLUSION: The results of the current study can provide reference data for future studies and highlight the importance of assessing sleep quality in persons with intestinal stomas.

PMID:35617011

JAMA Oncol. 2022 May 26. doi: 10.1001/jamaoncol.2022.1479. Online ahead of print.

ABSTRACT

IMPORTANCE: Women with large breast size treated with adjuvant breast radiotherapy (RT) have a high rate of acute toxic effects of the skin. Breast RT in the prone position is one strategy that may decrease these toxic effects.

OBJECTIVE: To determine if breast RT in the prone position reduces acute toxic effects of the skin when compared with treatment in the supine position.

DESIGN, SETTING, AND PARTICIPANTS: This phase 3, multicenter, single-blind randomized clinical trial accrued patients from 5 centers across Canada from April 2013 to March 2018 to compare acute toxic effects of breast RT for women with large breast size (bra band ≥40 in and/or ≥D cup) in the prone vs supine positions. A total of 378 patients were referred for adjuvant RT and underwent randomization. Seven patients randomized to supine position were excluded (5 declined treatment and 2 withdrew consent), and 14 patients randomized to prone position were excluded (4 declined treatment, 3 had unacceptable cardiac dose, and 7 were unable to tolerate being prone). Data were analyzed from April 2019 through September 2020.

INTERVENTIONS: Patients were randomized to RT in the supine or prone position. From April 2013 until June 2016, all patients (n = 167) received 50 Gy in 25 fractions (extended fractionation) with or without boost (range, 10-16 Gy). After trial amendment in June 2016, the majority of patients (177 of 190 [93.2%]) received the hypofractionation regimen of 42.5 Gy in 16 fractions.

MAIN OUTCOMES AND MEASURES: Main outcome was moist desquamation (desquamation).

RESULTS: Of the 357 women (mean [SD] age, 61 [9.9] years) included in the analysis, 182 (51.0%) were treated in the supine position and 175 (49.0%) in prone. There was statistically significantly more desquamation in patients treated in the supine position compared with prone (72 of 182 [39.6%] patients vs 47 of 175 [26.9%] patients; OR, 1.78; 95% CI, 1.24-2.56; P = .002), which was confirmed on multivariable analysis (OR, 1.99; 95% CI, 1.48-2.66; P < .001), along with other independent factors: use of boost (OR, 2.71; 95% CI, 1.95-3.77; P < .001), extended fractionation (OR, 2.85; 95% CI, 1.41-5.79; P = .004), and bra size (OR, 2.56; 95% CI, 1.50-4.37; P < .001).

CONCLUSIONS AND RELEVANCE: This randomized clinical trial confirms that treatment in the prone position decreases desquamation in women with large breast size receiving adjuvant RT. It also shows increased toxic effects using an RT boost and conventional fractionation.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01815476.

PMID:35616948 | DOI:10.1001/jamaoncol.2022.1479