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Nevin Manimala Statistics

Evaluation of wear behaviour of various occlusal splint materials and manufacturing processes

J Mech Behav Biomed Mater. 2022 Jan 1;126:105053. doi: 10.1016/j.jmbbm.2021.105053. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the volumetric and vertical loss of occlusal splints manufactured by conventional (heat-cure), subtractive (CAD/CAM) and additive (3D-printing) methods.

METHODS: Six occlusal splint materials were investigated (n = 126), using three manufacturing methods: heat-cured, CAD/CAM and 3D-printed built-in three different printing angles (0°,45°and 90°). Block-on-ring wear testing was performed with extracted human molars as the antagonist. All samples were tested with an applied force of 49N at 1 Hz and 60RPM in artificial saliva at 37 °C for six and 12 months. Scanning electron microscopy images were analysed to evaluate the wear on the tooth enamel and in the splint material. Volumetric and vertical wear loss were statistically analysed.

RESULTS: The lowest volumetric and vertical loss was observed in CAD-CAM materials (6.44 ± 1.77 mm3 and 48.3 ± 7.14 μm) with no statistical significance to the heat-cured material (17.22 ± 9.23 mm3 and 148 ± 121.1 μm) after 12 months (p < 0.172). The mean volumetric loss of 3D printed materials ranged from 0.25 ± 0.15 mm3 to 0.29 ± 0.1 4mm3 with no statistical difference, whereas, the differences in vertical loss from 131.63 ± 44.1 μm to 493 ± 79.19 μm were statistically significant (p < 0.001). The highest vertical loss was observed in the KeySplint Soft 3D printed at 90° (385.35 ± 82.37 μm), whereas FreePrint Splint 2.0 with a build angle of 0° had the highest volumetric loss (204.59 ± 25.67 mm3).

CONCLUSION: CAD-CAM material had the highest wear resistance followed by heat-cured material.KeySplint Soft and FreePrint Splint 2.0 3D printed materials would be preferred for patients that do not have severe bruxing episodes. No significant wear of human enamel after six and 12 months was observed under SEM for any tested materials.

PMID:34998068 | DOI:10.1016/j.jmbbm.2021.105053

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Nevin Manimala Statistics

Psychopathological networks: Theory, methods and practice

Behav Res Ther. 2021 Dec 1;149:104011. doi: 10.1016/j.brat.2021.104011. Online ahead of print.

ABSTRACT

In recent years, network approaches to psychopathology have sparked much debate and have had a significant impact on how mental disorders are perceived in the field of clinical psychology. However, there are many important challenges in moving from theory to empirical research and clinical practice and vice versa. Therefore, in this article, we bring together different points of view on psychological networks by methodologists and clinicians to give a critical overview on these challenges, and to present an agenda for addressing these challenges. In contrast to previous reviews, we especially focus on methodological issues related to temporal networks. This includes topics such as selecting and assessing the quality of the nodes in the network, distinguishing between- and within-person effects in networks, relating items that are measured at different time scales, and dealing with changes in network structures. These issues are not only important for researchers using network models on empirical data, but also for clinicians, who are increasingly likely to encounter (person-specific) networks in the consulting room.

PMID:34998034 | DOI:10.1016/j.brat.2021.104011

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Impact of meningococcal C conjugate vaccine on incidence of invasive meningococcal disease in an 18-year time-series in Brazil and in distinct Brazilian regions

Trop Med Int Health. 2022 Jan 8. doi: 10.1111/tmi.13718. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of meningococcal C conjugate (MCC) vaccine in Brazil.

METHODS: Ecological study assessing all invasive meningococcal disease (IMD) and meningococcal C disease (MenC) cases reported in all age groups, from 2001 to 2019. MCC was implemented in 2010. Data were collected on the DATASUS platform. Joinpoint regression was performed to assess the Annual Percent Change (APC) of the incidence rate.

RESULTS: IMD incidence decreased in all Brazilian regions from 2001 onwards, without apparent additional reduction attributable to MCC vaccine in the North, Northeast and South. The higher and statistically significant APC reduction in all age groups, in the North and South, and in children <5 years, in the Northeast, occurred between 2001-2011 (-15.4%), 2004-2012 (-14.4%), and 2001-2013 (-10.3%), respectively, before MCC vaccine implementation. Annual incidence of MenC in under 5 years significantly fell in the North (-6.8%; 2011-2018), Southeast (-40.6%; 2010-2015) and Midwest (-48.6%; 2010-2014), which may be attributable to MCC implementation.

CONCLUSION: IMD and MenC behaved differently after MCC vaccine implementation in Brazil during this 18-year time-series analysis. This suggests that the control of IMD should be based on multiple public health care measures and considered on a regional basis.

PMID:34997999 | DOI:10.1111/tmi.13718

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Characteristics of equilibrium function and the sensory organization of postural balance in women 85-95 years old.

Adv Gerontol. 2021;34(5):775-782.

ABSTRACT

The purpose of this work is to establish the age-related indicators’ characteristics of the effectiveness of the balance function and the postural balance sensory organization in women 85-95 years old. We examined 68 women aged 85-95 years [mean age (M±SD) 89,3±3 years]. The first age group included 37 women whose calendar age ranged from 85 to 89 years (mean age 86,9±1,6 years). The second age group included 31 women of 90-95 years (mean age: 92,1±1,4). To assess the components of the postural balance, a computer-based dynamic posturographic complex «Smart Equitest Balance Manager» was used. The Sensory Organization Test (SOT) was performed. Comparative assessment of the Equilibrium Score indicators in all SOT functional tests, including the Composite of all equilibrium scores, did not reveal statistically significant differences between the examined groups of women. The sensory analysis did not reveal age-related changes in somatosensory, visual and vestibular information in the control over balance, either. At the same time, the indicator of sensory preference (Ratio for sensory analysis-patient Preference) was higher in women 90-95 years old (p=0,007). In women after 89 years of age, there are no age-related changes in the sensory organization of postural control or the effectiveness of maintaining static and static-dynamic balance. No decrease in overall balance performance, as well as the adaptive capabilities of their balance function, was noticed. At the same time, long-lived women retain the effectiveness of the sensory integration process to maintain postural balance and a sense of spatial orientation, which can be considered a predictor of active longevity. In addition, centenarians retain the ability of spatial and temporal organization of postural equilibrium control, as well as the degree and order of the muscles involved to reduce the imbalance recruitment. The results obtained made it possible to designate SOT parameters that can be taken into account when predicting postural changes and life expectancy in women in old age.

PMID:34998018

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Impact of lockdown during Covid-19 pandemic on physical activity and arrhythmia burden in heart failure patients

Pacing Clin Electrophysiol. 2022 Jan 8. doi: 10.1111/pace.14443. Online ahead of print.

ABSTRACT

BACKGROUND: Restricted outdoor activity during COVID-19 related lockdown may accelerate heart failure (HF) progression and thereby increase cardiac arrhythmias. We analyzed the impact of March/April 2020 lockdown on physical activity and arrhythmia burden in HF patients treated with cardiac resynchronization therapy (CRT) devices with daily, automatic remote monitoring (RM) function.

METHODS: The study cohort included 405 HF patients enrolled in BIO|STREAM.HF registry in 16 countries, who had left ventricular ejection fraction (LVEF) ≤40% (mean 28.2±6.6%) and NYHA class II/III/IV (47.9%/49.6%/2.5%) before CRT pacemaker/defibrillator implantation. The analyzed RM data comprised physical activity detected by accelerometer, mean heart rate and nocturnal rate, PP variability, percentage of biventricular pacing, atrial high rate episode (AHRE) burden, ventricular extrasystoles and tachyarrhythmias, defibrillator shocks, and number of implant interrogations (i.e., follow-ups). Intraindividual differences in RM parameters before (4-week period) vs. during (4-week period) lockdown were tested for statistical significance and independent predictors were identified.

RESULTS: There was a significant relative change in activity (mean -6.5%, p<0.001), AHRE burden (+17%, p = 0.013), and follow-up rate (-75%, p<0.001) during lockdown, with no significant changes in other RM parameters. Activity decreased by ≥8 min/day in 46.5% of patients; predictors were higher LVEF, lower NYHA class, no defibrillator indication, and more activity before lockdown. AHRE burden increased by ≥17 min/day in 4.7% of patients; predictors were history of atrial fibrillation, higher LVEF, higher body mass index, and activity decrease during lockdown.

CONCLUSION: Unfavorable changes in physical activity, AHRE burden, and follow-up rate were observed during lockdown, but not in ventricular arrhythmia. This article is protected by copyright. All rights reserved.

PMID:34997979 | DOI:10.1111/pace.14443

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External validation of prognostic models for chronic kidney disease among type 2 diabetes

J Nephrol. 2022 Jan 8. doi: 10.1007/s40620-021-01220-w. Online ahead of print.

ABSTRACT

BACKGROUND: Various prognostic models have been derived to predict chronic kidney disease (CKD) development in type 2 diabetes (T2D). However, their generalisability and predictive performance in different populations remain largely unvalidated. This study aimed to externally validate several prognostic models of CKD in a T2D Thai cohort.

METHODS: A nationwide survey was linked with hospital databases to create a prospective cohort of patients with diabetes (n = 3416). We undertook a systematic review to identify prognostic models and traditional metrics (i.e., discrimination and calibration) to compare model performance for CKD prediction. We updated prognostic models by including additional clinical parameters to optimise model performance in the Thai setting.

RESULTS: Six relevant previously published models were identified. At baseline, C-statistics ranged from 0.585 (0.565-0.605) to 0.786 (0.765-0.806) for CKD and 0.657 (0.610-0.703) to 0.760 (0.705-0.816) for end-stage renal disease (ESRD). All original CKD models showed fair calibration with Observed/Expected (O/E) ratios ranging from 0.999 (0.975-1.024) to 1.009 (0.929-1.090). Hosmer-Lemeshow tests indicated a good fit for all models. The addition of routine clinical factors (i.e., glucose level and oral diabetes medications) enhanced model prediction by improved C-statistics of Low’s of 0.114 for CKD and Elley’s of 0.025 for ESRD.

CONCLUSIONS: All models showed moderate discrimination and fair calibration. Updating models to include routine clinical factors substantially enhanced their accuracy. Low’s (developed in Singapore) and Elley’s model (developed in New Zealand), outperformed the other models evaluated. These models can assist clinicians to improve the risk-stratification of diabetic patients for CKD and/or ESRD in the regions settings are similar to Thailand.

PMID:34997924 | DOI:10.1007/s40620-021-01220-w

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Implant treatment after traumatic tooth loss: A systematic review

Dent Traumatol. 2022 Jan 8. doi: 10.1111/edt.12730. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Treatment after traumatic tooth loss is challenging and is currently guided by expert opinion and the individual patient situation. The aim of this study was to provide an overview on the outcome of dental implant treatment in the anterior maxilla after traumatic tooth loss, based on a systematic review of the existing evidence.

MATERIALS AND METHODS: A systematic search of the literature was performed on PubMed, Cochran Library and Web of Science following the PRISMA guidelines based on a structured research question (PICO). All clinical studies of five patients or more with follow-up of at least 1 year after implant loading were included. Patients were at least 18 years of age. Cohen’s Kappa-coefficient was calculated. The Newcastle-Ottawa Scale was applied to assess the quality of the included studies. Descriptive statistical methods were applied.

RESULTS: Nine hundred and ninety-nine articles were identified through the systematic search. Finally, six articles were eligible for inclusion. The studies comprised prospective and retrospective cohort studies and case series. From these, 96 patients with 120 implants were included. The age ranged from 18 to 59 years. The survival rates of implants and superstructures were 97% and 95%, respectively, after a mean follow-up of 3.5 years. Mean marginal bone resorption was 0.56 mm (range 0.21-1.30 mm). Complication rates were 7% and 11% on implant and superstructure level, respectively. Patient-reported outcome measures and objective evaluations showed a high level of satisfaction with the aesthetic outcome. Bone augmentation was performed in 60 implant sites. Three patients underwent pre-surgical orthodontic treatment. The maxillary central incisor was the most frequently replaced tooth (70%).

CONCLUSIONS: This systematic review revealed a low level of evidence on the outcome of dental implant treatment after traumatic tooth loss. Systematic reporting of treatment outcomes of tooth replacements after dental trauma is highly encouraged to further guide dentists for the benefit of these challenging patients.

PMID:34997947 | DOI:10.1111/edt.12730

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Colorectal Cancer Survivors’ Receptivity toward Genomic Testing and Targeted Use of Non-Steroidal Anti-Inflammatory Drugs to Prevent Cancer Recurrence

J Community Genet. 2022 Jan 8. doi: 10.1007/s12687-021-00574-9. Online ahead of print.

ABSTRACT

Genomic testing and targeted use of non-steroidal anti-inflammatory drugs (NSAIDs) may mitigate cancer recurrence risks. This study examines colorectal cancer (CRC) survivors’ interest and receptivity to these strategies. Patients diagnosed with stage I-III CRC in 2004-2012 were recruited through the New Mexico Cancer Registry to complete a cancer survivorship experiences survey. We assessed interest in genomic testing, daily aspirin (ASA) and NSAID use, and receptivity to future daily ASA/NSAIDs. Descriptive statistics and multivariable logistic regression models estimated factors associated with genomic testing interest. Receptivity to future ASA/NSAIDs use was estimated for non-users of ASA/NSAIDs. Among CRC survivors (n = 273), 83% endorsed interest in genomic testing, 25% were ASA users and 47% ASA/NSAIDs users. In our final model, genomic testing interest was associated with being uncoupled [OR = 4.11; 95% CI = 1.49-11.35], low income [OR = 0.35, 95% CI: 0.14-0.88], smoking history [OR = 0.35, 95% CI: 0.14-0.90], low [OR: 0.33, 95% CI: 0.07-1.43] and moderate [OR: 0.26, 95% CI: 0.11-0.61] health literacy, and personal CRC risk worry [OR: 2.86, 95% CI: 1.63-5.02, p = 0.0002]. In our final model, ASA use was associated with age [OR: 1.05, 95% CI: 1.01-1.10] and cardiovascular disease history [OR: 2.42, 95% CI: 1.23-4.73, p = 0.010]. Among non-users ASA/NSAIDs, 83% reported receptivity to ASA/NSAIDs to reduce cancer risks, and no significant correlates were identified. The majority of survivors’ expressed genomic testing interest and endorsed receptivity toward ASA/NSAIDs use for cancer risk management. Further research to optimize ASA/NSAIDs use guided by genomic testing is warranted.

PMID:34997901 | DOI:10.1007/s12687-021-00574-9

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Arthroscopic remplissage is safe and effective: clinical and magnetic resonance results at a minimum 3 years of follow-up

J Orthop Traumatol. 2022 Jan 8;23(1):5. doi: 10.1186/s10195-021-00624-5.

ABSTRACT

BACKGROUND: Large Hill-Sachs lesions are considered a risk factor for recurrence of instability after arthroscopic Bankart repair alone. The aim of this study was to demonstrate that remplissage is a safe procedure that effectively reduces the risk of recurrent dislocations without causing fatty degeneration of the infraspinatus at medium-term follow-up.

METHODS: Patients who underwent arthroscopic Bankart repair and remplissage with a minimum 3 years of follow-up were included. Constant-Murley (CMS), American Shoulder and Elbow Surgeons (ASES), and Walch-Duplay scores were evaluated. Magnetic resonance imaging (MRI) was performed to detect the appearance of fatty infiltration inside the infraspinatus muscle, the percentage of the Hill-Sachs lesion filled by the tendon and its integration, and the onset of rotator cuff tears.

RESULTS: Thirteen patients (14 shoulders) with a mean follow-up of 55.93 (± 18.16) months were enrolled. The Walch-Duplay score was 95.00 [87.25-100.00], with a return to sport rate of 100%. Both the CMS and the ASES indicated excellent results. The affected shoulders showed a statistically significant reduction in active external rotation both with the arm at the side (ER1) and with the arm at 90° of abduction (ER2) (p = 0.0005 and p = 0.0010, respectively). A reduction in infraspinatus isometric strength was found for both ER1 and ER2, but this reduction was only statistically relevant in ER2 (p = 0.0342). There was a traumatic recurrence of instability in two cases (14.28%). MRI evaluation demonstrated an absence of adipose infiltration in 50% of cases and only a minimal amount in the remaining 50%. In 12 cases (85.72%), the capsulotenodesis completely filled the lesion and good tendon-bone integration was observed.

CONCLUSION: Arthroscopic remplissage provided successful clinical outcomes without fatty infiltration of the infraspinatus and with good healing of the tissues. The low risk of recurrence was associated with an objective limitation on active external rotation, but this did not influence the patients’ daily or sports activities.

LEVEL OF EVIDENCE: Cohort study, level of evidence 3.

PMID:34997890 | DOI:10.1186/s10195-021-00624-5

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Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial

Pharmacoecon Open. 2022 Jan 8. doi: 10.1007/s41669-021-00319-x. Online ahead of print.

ABSTRACT

BACKGROUND: Health anxiety is a prevalent and debilitating disorder associated with extensive use of healthcare services and reduced quality of life (QoL). Regional variability in specialised clinics or specialist healthcare providers limits access to evidence-based treatment, which may be overcome by internet-delivered Acceptance and Commitment Therapy (iACT).

OBJECTIVE: This study investigated the cost effectiveness of iACT for severe health anxiety in adults.

METHODS: Based on a Danish randomised controlled trial (March 2016-March 2017), the economic evaluation compared costs and effects between iACT and an active control condition (iFORUM). Effectiveness was measured using self-report questionnaires. The cost analysis applied a societal perspective. Resource use and healthcare costs were extracted from the Danish National Registries. Linear regression analysis was applied using change in costs/effectiveness outcomes as the dependant variable. Time, group, and interaction between time and group were independent variables. The primary outcome was the proportion of clinically significant improvements, defined as a ≥ 25% reduction in two measures of health anxiety. The probability of cost effectiveness was presented in a cost-effectiveness acceptability curve for a range of threshold values for willingness to pay.

RESULTS: No significant differences were detected in healthcare costs between groups; however, the iACT group significantly improved in all effectiveness outcomes. The economic analysis showed that, from the healthcare perspective, iACT was associated with an incremental cost-effectiveness ratio of €33 per additional case of clinically significant improvement compared with iFORUM and that, from the societal perspective, iACT dominated iFORUM because it was more effective and less expensive.

CONCLUSIONS: We found no statistically significant differences in costs between groups; however, iACT for severe health anxiety may be cost effective, as evidenced by significant differences in effect.

TRIAL REGISTRY NUMBER: Clinicaltrials.gov, no. NCT02735434.

PMID:34997899 | DOI:10.1007/s41669-021-00319-x