Tag: pubmed

J Am Osteopath Assoc. 2021 Mar 1;121(3):255-263. doi: 10.1515/jom-2020-0020.

ABSTRACT

CONTEXT: With the advent of increasingly accessible three-dimensional (3D) printing, the possibility to efficiently design and generate prototype innovations is also increasing. This type of manufacturing can potentially enhance medical education by allowing design of models specific to osteopathic manipulative medicine (OMM).

OBJECTIVES: To determine the viability of a 3D-printed mechanically moveable rib cage in enhancing the teaching of rib osteopathic principles.

METHODS: A single-blind, qualitative study was conducted to evaluate the use of educating students with this novel 3D-printed, movable rib model vs. a traditional static rib model. A total of 237 first-year medical students participated in the study and received the same standardized lecture on the rib dysfunction. Students were also assigned at random to either a comparison group, which would utilize the 3D printed rib model, or the control group, which would utilize the traditional static model. Students would also complete an entrance and exit surveys assessing subjective scores of overall student satisfaction and objective scores for knowledge of OMM rib dysfunction and treatment. An independent samples t-test was applied to assess potential differences between select student evaluation scores (those with continuous variables) of the rib model in the comparison and experiment groups. Chi-square goodness of fit test was conducted to determine if there were any significant differences in entry and exit survey responses between the two groups. Descriptive statistics of the mean and standard deviation were also reported.

RESULTS: For both comparison and control groups, the mean score on an 11-point scale for the evaluation question, “Please rank on a scale of 0-10 how helpful you thought the rib models were to your education,” was 9.08 (SD, 1.397). Independent t-test results showed that the comparison group had higher scores than the control group when queried about whether they felt the model accurately depicted the material presented (comparison group mean, 9.55 [SD, 978] vs. control group mean, 9.06 [SD, 1.33; t(235) = 3.253; p=0.01). Chi-square test of goodness-of-fit showed that the differences between the number of correct answers chosen by participants for Item 3 (a case-based question asking students which rib they would treat for a patient presenting to an OMT clinic) was statistically significantly higher for the comparison group (51.9% correct in comparison group vs. 48.1% in control group), even though both groups scored similarly on this item during the entry survey.

CONCLUSIONS: The results of this study suggest that utilizing 3D printing to demonstrate somatic dysfunctions of the rib cage may improve understanding and student satisfaction for diagnosis and treatment.

PMID:33635955 | DOI:10.1515/jom-2020-0020

J Am Osteopath Assoc. 2021 Mar 1;121(3):281-286. doi: 10.1515/jom-2020-0202.

ABSTRACT

CONTEXT: There has been a steady increase in the number of osteopathic (DO) medical students in the United States without a corresponding increase in DO representation in competitive specialties.

OBJECTIVES: To investigate the trends and impact of the Accreditation Council for Graduate Medical Education (ACGME) single accreditation system on DO match rates into dermatology and other competitive specialty programs.

METHODS: Information was collected through public databases (Electronic Residency Application Service [ERAS]; National Resident Matching Program [NRMP]; Association of American Medical Colleges [AAMC]; National Match Service, Inc. [NMS]; and the ACGME) to evaluate the match statistics of competitive specialties, including dermatology, otolaryngology, orthopedic surgery, neurosurgery, and plastic surgery. Residency program and medical school websites and residency communications were used to confirm whether the match placements were to programs that had traditionally been ACGME-accredited or former American Osteopathic Association (AOA) programs.

RESULTS: From 2012 to 2016 (pre-unification), osteopathic graduates comprised only 0.5% of the matches the specific specialties studied here and only 0.9% of ACGME dermatology positions. Post-unification (2017-2019), DOs comprised 2.0% of the matches into these specialties and 4.4% of the total ACGME dermatology positions. This apparent increase is misleading, as it is solely due to the transition of formerly AOA programs to ACGME status. The true post-unification DO match rate to traditionally ACGME programs is actually 0.6% for all competitive specialties and 0.4% for dermatology. Post-unification, 27.6% of formerly AOA positions in these competitive specialties were filled by allopathic (MD) applicants.

CONCLUSIONS: DO match rates into dermatology and other competitive specialties were poor prior to GME unification and continue to remain low. This situation, when coupled with the closing of many AOA programs and MDs matching into former AOA positions, threatens the future of osteopathic physicians in competitive specialties. Osteopathic recognition is one way to potentially help preserve osteopathic representation and philosophy in the single accreditation system era. Programs should not be hesitant to consider osteopathic applicants for competitive specialties.

PMID:33635959 | DOI:10.1515/jom-2020-0202

PLoS Genet. 2021 Feb 26;17(2):e1009373. doi: 10.1371/journal.pgen.1009373. Online ahead of print.

ABSTRACT

Whether hard sweeps or soft sweeps dominate adaptation has been a matter of much debate. Recently, we developed haplotype homozygosity statistics that (i) can detect both hard and soft sweeps with similar power and (ii) can classify the detected sweeps as hard or soft. The application of our method to population genomic data from a natural population of Drosophila melanogaster (DGRP) allowed us to rediscover three known cases of adaptation at the loci Ace, Cyp6g1, and CHKov1 known to be driven by soft sweeps, and detected additional candidate loci for recent and strong sweeps. Surprisingly, all of the top 50 candidates showed patterns much more consistent with soft rather than hard sweeps. Recently, Harris et al. 2018 criticized this work, suggesting that all the candidate loci detected by our haplotype statistics, including the positive controls, are unlikely to be sweeps at all and that instead these haplotype patterns can be more easily explained by complex neutral demographic models. They also claim that these neutral non-sweeps are likely to be hard instead of soft sweeps. Here, we reanalyze the DGRP data using a range of complex admixture demographic models and reconfirm our original published results suggesting that the majority of recent and strong sweeps in D. melanogaster are first likely to be true sweeps, and second, that they do appear to be soft. Furthermore, we discuss ways to take this work forward given that most demographic models employed in such analyses are necessarily too simple to capture the full demographic complexity, while more realistic models are unlikely to be inferred correctly because they require a large number of free parameters.

PMID:33635910 | DOI:10.1371/journal.pgen.1009373

PLoS One. 2021 Feb 26;16(2):e0247415. doi: 10.1371/journal.pone.0247415. eCollection 2021.

ABSTRACT

In 2015, the World Health Organization substantially revised its guidance for vaccination coverage cluster surveys (revisions were finalized in 2018) and has since developed a set of accompanying resources, including definitions for standardized coverage indicators and software (named the Vaccination Coverage Quality Indicators-VCQI) to calculate them.-The current WHO vaccination coverage survey manual was used to design and conduct two nationally representative vaccination coverage surveys in Nigeria-one to assess routine immunization and one to measure post-measles campaign coverage. The primary analysis for both surveys was conducted using VCQI. In this paper, we describe those surveys and highlight some of the analyses that are facilitated by the new resources. In addition to calculating coverage of each vaccine-dose by age group, VCQI analyses provide insight into several indicators of program quality such as crude coverage versus valid doses, vaccination timeliness, missed opportunities for simultaneous vaccination, and, where relevant, vaccination campaign coverage stratified by several parameters, including the number of previous doses received. The VCQI software furnishes several helpful ways to visualize survey results. We show that routine coverage of all vaccines is far below targets in Nigeria and especially low in northeast and northwest zones, which also have highest rates of dropout and missed opportunities for vaccination. Coverage in the 2017 measles campaign was higher and showed less geospatial variation than routine coverage. Nonetheless, substantial improvement in both routine program performance and campaign implementation will be needed to achieve disease control goals.

PMID:33635913 | DOI:10.1371/journal.pone.0247415

Pediatr Obes. 2021 Feb 25:e12778. doi: 10.1111/ijpo.12778. Online ahead of print.

ABSTRACT

BACKGROUND: Weight loss in children and adolescents with type 2 diabetes (T2D) is associated with improved glycaemic control.

OBJECTIVES: To assess the effects of liraglutide vs placebo on body mass index (BMI) and weight parameters in children and adolescents with T2D using data from the ellipse trial (NCT01541215).

METHODS: The ellipse trial randomized participants (10-<17 years old, BMI >85th percentile, T2D, glycated haemoglobin [HbA_1c ] 7.0%-11.0% [if diet- and exercise-treated] or 6.5% to 11.0% [if treated with metformin, basal insulin or both]) to liraglutide or placebo. This post-hoc analysis evaluated changes from baseline to weeks 26 and 52 in absolute BMI, percent change in BMI and other weight-related parameters. Changes were assessed by liraglutide overall (all doses) and liraglutide by dose (0.6, 1.2 and 1.8 mg/day) vs placebo using a pattern mixture model of observed data, with missing observations imputed from each treatment group.

RESULTS: In total, 134 participants were included. There were statistically significant differences between groups in certain parameters, including absolute BMI (estimated treatment difference [ETD] -0.89 kg/m² ; 95% confidence interval [CI] -1.71,-0.06) and percent change in BMI (ETD -2.73%; 95% CI -5.15,-0.30) at week 52, but none at week 26. Dose-dependent effects were not observed for liraglutide vs placebo for all BMI/weight parameters.

CONCLUSIONS: Compared with placebo, liraglutide was associated with statistically significant reductions in BMI/weight parameters at week 52, but not week 26, in children and adolescents with T2D.

PMID:33634589 | DOI:10.1111/ijpo.12778

Jpn J Nurs Sci. 2021 Feb 26:e12410. doi: 10.1111/jjns.12410. Online ahead of print.

ABSTRACT

AIM: For successful simulation-based learning (SBL), a structured interactive and bidirectional debriefing should be a prerequisite. The purpose of this study is to identify the effects of instructor-led hot debriefing (debriefing immediately after simulation) and cold debriefing (debriefing occurring after a certain period following simulation) in simulation with case-based learning (CBL).

METHOD: This study used a nonequivalent control group pretest-posttest design. A sample of 59 fourth-year nursing students in South Korea were invited and randomly divided into two groups, a post-simulation hot debriefing (PSHD, male = 4, female = 26), and cold debriefing (PSCD, male = 3, female = 26). We used clinical performance competency, satisfaction with CBL and SBL, and debriefing tools. The study period was from October to December of 2019. We analyzed the data with SPSS 23.0 software, using descriptive statistics and the t test.

RESULTS: Clinical performance competency means that the scores of both groups were significantly improved in the posttest (PSHD = 33.13 ± 5.11, PSCD = 34.10 ± 4.15) as compared to those in the pretest (t = -7.010, p < .001). The knowledge (t = -12.689, p < .001) and skill (t = -5.338, p = .001) scores of clinical performance competency in the PSCD were higher than those in the PSHD. The mean satisfaction scores of the PSHD group with CBL (4.53 ± 0.60) and debriefing (4.66 ± 0.55) was higher than for those in the PSCD group.

CONCLUSION: As a result of this study, PSHD and PSCD led by an instructor improved student clinical performance competency. The PSHD method, in particular, might be a positive influence on learner satisfaction with CBL, SBL, and debriefing.

PMID:33634592 | DOI:10.1111/jjns.12410

Phytochem Anal. 2021 Feb 25. doi: 10.1002/pca.3041. Online ahead of print.

ABSTRACT

INTRODUCTION: The chemical diversity of plants plays an essential role in the development of new drugs. However, new bioactive compound identification and isolation are challenging due to the complexity and time-consuming nature of the traditional process. Recently, alternative strategies have become popular, such as the statistical approach to correlate compounds with biological activities, overcoming bottlenecks in bioactive natural product research.

OBJECTIVE: We aimed to determine bioactive compounds against resistant human melanoma cells from leaves of Aspidosperma subincanum, Copaifera langsdorffii, Coussarea hydrangeifolia, Guarea guidonea and Tapirira guianensis, using a metabolomics approach.

MATERIAL AND METHODS: The extracts and fractions were obtained by accelerated solvent extraction (ASE) and tested against resistant melanoma cells SK-MEL-28 and SK-MEL-103. Chemical analysis was performed by high-performance diode array detector tandem mass spectrometry (HPLC-DAD-MS/MS). Chemical and biological data were analysed through univariate and multivariate analysis.

RESULTS: The species present high chemical diversity, including indole alkaloids, glycosylated flavonoids, galloylquinic acid derivatives, cinnamic acid derivatives, and terpenes. The ASE fractionation separated the compounds according to the physicochemical properties; only C. langsdorffii and T. guianensis extracts were active. Both results from the chemical profile and the biological assay were treated using a metabolomics approach to identify the contribution of different classes of secondary metabolites in the viability of human melanoma cells. The analyses showed the metabolites from C. langsdorffii and T. guianensis, such as polyphenols and terpenes, were the main compounds correlated with the biological response.

CONCLUSION: These findings afford alternative pathways that are trustworthy and less time-consuming to identify new bioactive compounds against multidrug-resistant human melanoma cells.

PMID:33634541 | DOI:10.1002/pca.3041

J Obstet Gynaecol Res. 2021 Feb 25. doi: 10.1111/jog.14721. Online ahead of print.

ABSTRACT

AIM: To evaluate the theme trends and knowledge structure of multifetal pregnancy reduction (MPR)-related literature by using bibliometric analysis.

METHODS: Published scientific papers regarding MPR were retrieved from the PubMed database. Data extraction and statistics were conducted using Bibliographic Item Co-Occurrence Matrix Builder (BICOMB). Furthermore, gCLUTO software was used in the study for bi-clustering analysis and strategic diagram analysis.

RESULTS: According to the search strategy, 906 total papers were included. Among all the extracted MeSH terms, 41 high frequency ones were identified and hotspots were clustered into four categories. In the strategic diagram, research on intrauterine treatment of MPR was most well developed. In contrast, statistical data on the sequelae of fetal reduction surgery and applications of MPR in assisted reproductive technologies were relatively immature.

CONCLUSION: The analysis of common terms among the high-frequency network terms in multiparous pregnancy reduction can help researchers and clinicians understand the hotspots, key topics, and issues to be discovered on MPR. Research on intrauterine treatment of MPR was most well developed.

PMID:33634542 | DOI:10.1111/jog.14721

J Public Health Dent. 2021 Feb 25. doi: 10.1111/jphd.12448. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the prevalence of dental fluorosis, and factors associated with its occurrence in two cohorts of children exposed to different fluoride concentrations in the Malaysian water supply.

METHODS: A cross-sectional study was conducted among lifelong residents (n = 1,155) aged 9 and 12 years old living in fluoridated and nonfluoridated areas. Malaysian children aged 12 years were born when the level of fluoride in the public water supply was 0.7 ppm while those aged 9 years were born after the level was reduced to 0.5 ppm. Fluorosis was blind scored using standardized photographs of maxillary central incisors using Dean’s criteria. Fluoride exposures and other factors were assessed by parental questionnaire. Data were analyzed using descriptive statistics, Chi-squared analyses, and logistic regression.

RESULTS: Fluorosis prevalence was lower (31.9 percent) among the younger children born after the reduction of fluoride concentration in the water, compared to a prevalence of 38.4 percent in the older cohort. Early tooth brushing practices and fluoridated toothpaste were not statistically associated with fluorosis status. However, the prevalence of fluorosis was significantly associated with parents’ education level, parents’ income, fluoridated water, type of infant feeding method, age breast feeding ceased, use of formula milk, duration of formula milk intake, and type of water used to reconstitute formula milk via simple logistic regression. Fluoridated water remained a significant risk factor for fluorosis in multiple logistic regression.

CONCLUSIONS: Fluorosis was lower among children born after the adjustment of fluoride concentration in the water. Fluoridated water remained as a strong risk factor for fluorosis after downward adjustment of its fluoride concentration.

PMID:33634490 | DOI:10.1111/jphd.12448

Biom J. 2021 Feb 26. doi: 10.1002/bimj.202000159. Online ahead of print.

ABSTRACT

This article proposes four new principles for logical biomarker cut-point selection methods to adhere to: subgroup sensibility, sensitivity, specificity, and target monotonicity. At every cut-point value, our method gives confidence intervals not only for the efficacy at that cut-point value, but also efficacies in the marker-positive and marker-negative subgroups defined by that cut-point. These confidence intervals are given simultaneously for all possible cut-point values. Using Alzheimer’s disease (AD) and type 2 diabetes (T2DM) as examples, we show our method achieves the four principles. Our method strongly controls familywise type I error rate (FWER) across both levels of multiplicity: the multiplicity of having marker-positive and marker-negative subgroups at each cut-point, and the multiplicity of searching through infinitely many cut-points. This is in contrast to other available methods. The confidence level of our simultaneous confidence intervals is in fact exact (not conservative). An application (app) is available, which implements the method we propose.

PMID:33634510 | DOI:10.1002/bimj.202000159