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Nevin Manimala Statistics

Changes in Eyelid Parameters after Orbital Decompression According to the Surgical Approach in Thyroid Eye Disease

Korean J Ophthalmol. 2021 Sep 6. doi: 10.3341/kjo.2021.0035. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the changes in eyelid parameters after the endonasal approach compared with transcaruncular medial wall decompression combined with the transconjunctival inferior wall decompression approach with inferomedial strut preservation.

METHODS: In total, 71 patients with thyroid eye disease who underwent orbital decompression were retrospectively evaluated. The data collected included Hertel exophthalmometry, marginal reflex distance 1, marginal reflex distance 2, interpalpebral fissure, levator function test measures, and complications related to surgery.

RESULTS: Proptosis reduction produced a statistically significant improvement across all decompression groups. Lower eyelid retraction produced a statistically significant improvement in the two-wall decompression groups but not in the one-wall decompression groups. No statistical difference was observed in the upper eyelid retraction and levator function after surgery across all decompression groups. In the post-hoc analysis, statistical improvement was not observed in the lower eyelid retraction between the endonasal and transcaruncular approach in the one-wall and two-wall decompression groups, although statistically significant exophthalmos reduction and improvement in the lower eyelid retraction was noted in the two-wall decompression subgroups compared with one-wall decompression subgroups.

CONCLUSIONS: Our study showed no differences in eyelid parameters between the endonasal and transcaruncular decompression approaches in one-wall and two-wall decompression. In the two-wall decompression group, proptosis reduction was greater with the endonasal approach than with the transcaruncular approach when the strut was preserved; however, it does not lead to a significant difference in the improvement of lower eyelid retraction.

PMID:34488259 | DOI:10.3341/kjo.2021.0035

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Nevin Manimala Statistics

Influence of surface treatment of resin composite substrate on the load-bearing capacity under fatigue of lithium disilicate monolithic simplified restorations

J Mech Behav Biomed Mater. 2021 Aug 24;124:104792. doi: 10.1016/j.jmbbm.2021.104792. Online ahead of print.

ABSTRACT

This study evaluated the influence of surface treatments of resin composite substrate on the fatigue behavior of adhesively cemented lithium disilicate glass-ceramic simplified restorations. CAD/CAM lithium disilicate ceramic blocks were shaped into discs (N = 60, Ø = 10 mm; thickness = 1.0 mm). Resin composite discs (N = 60, Ø = 10 mm, thickness = 2 mm) were allocated into four groups considering the “surface treatment” factor: Ctrl – no surface treatment; Bur – grinding with coarse diamond bur (#3101G, KG Sorensen); PA – etching with 37% phosphoric acid (15 s); AA – air abrasion with alumina particles (45 μm, 10 mm distance, 2.8 bars, 10 s). The surface topography, the roughness, the fractal dimension (estimated by the box-counting method) and the contact angle analyses were performed after the surface treatments. The lithium disilicate discs were etched (5% hydrofluoric acid, 20 s), silanized and adhesively cemented (Multilink N, Ivoclar Vivadent) on the resin composite discs. The samples (bonded restoration set) were subjected to a step-stress fatigue test at 20 Hz, 10,000 cycles/step with a step-size of 100 N applied on the ceramic surface, having ceramic up and resin composite down. Fractographic analysis was performed. The fatigue data (Fatigue Failure Load – FFL; and Cycles for Failure – CFF) were analyzed by Kaplan Meier with Mantel-Cox log-rank post-hoc tests (α = 0.05). No statistical difference for fatigue performance could be found among the groups (FFL means: 820-867 N; CFF means: 53,195-61,090 cycles). The bur group showed higher surface roughness and contact angle values. The PA group has the highest average fractal dimension. Therefore, the resin composite surface treatment induces topographical changes, however, it has no effect on the fatigue behavior of lithium disilicate restorations.

PMID:34488172 | DOI:10.1016/j.jmbbm.2021.104792

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Nevin Manimala Statistics

Redistribution of mineral phases of incineration bottom ash by size and magnetic separation and its effects on the leaching behaviors

Environ Pollut. 2021 Aug 24;290:118015. doi: 10.1016/j.envpol.2021.118015. Online ahead of print.

ABSTRACT

Size and magnetic separation of incineration bottom ash (IBA) are common for ferrous metals recovery, however, their influences on the mineral phase and the element redistribution, and subsequently the induced variation of metal leaching potential herein remain limited understanding. The lack of research in this field may misunderstand IBA performances, cause confused results for comparison among various studies, and potentially lead to biased conclusions. We herein quantitatively investigate the effects of size and magnetic separation on the IBA based on element distribution, leaching behavior, morphology, and mineralogy with statistical analysis. For preparation, sieving was performed with the original IBA (to obtain 7 size-fractions termed as OR1-7, respectively), followed by magnetic separation of each, to further yield magnetic fractions (MF1-7) to discriminate nonmagnetic fractions (NF1-7). In this study, we show that size and magnetic separation may pose significant yet different impacts on different fractions, which would affect their leaching potential concerning their respective downstream applications.

PMID:34488162 | DOI:10.1016/j.envpol.2021.118015

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Nevin Manimala Statistics

Sleep apnea syndrome and subthalamic stimulation in Parkinson’s disease

Sleep Med. 2021 Jul 24;86:106-112. doi: 10.1016/j.sleep.2021.07.031. Online ahead of print.

ABSTRACT

OBJECTIVES: Τhe association between Parkinson’s disease (PD) and sleep apnea syndrome (SAS) is not fully elucidated and very few studies reported on SAS outcome after deep brain stimulation (DBS). Here, we compare the clinical profile of PD patients with and without SAS and assess, for the first time, the value of pre-DBS SAS as predictor of post-DBS outcome in PD.

METHODS: Fifty patients were grouped into PD with SAS (PD-SAS+,n = 22) and without (PD-SAS-,n = 28), based on the Apnea-Hypopnea-Index (AHI≥5) in polysomnography. We used novel multivariate statistical models to compare pre-DBS profiles and assess post-DBS motor, non-motor and quality of life (QoL) changes in both groups.

RESULTS: In the entire cohort, 44% of patients had at least mild SAS (AHI≥5), while 22% had at least moderate (AHI≥15). Mean AHI was 11/h (NREM-AHI = 10.2/h and REM-AHI = 13.5/h). The two groups had equal demographics and PD characteristics, and did not differ in respect to unified Parkinson’s disease rating scale (UPDRS)-IIOFF, Body-Mass-Index, polysomnographic features, RBD, depression, sleepiness and QoL scores. The PD-SAS+ group had significantly higher scores in UPDRS-IIIOFF (41.1 ± 17.7 vs. 30.9 ± 11.7,p < 0.05) compared to PD-SAS- group. The groups did not differ in respect to post-DBS change in UPDRS-II, UPDRS-III, Epworth sleepiness scale, Hamilton depression rating scale and PDQ39 scores. Positive airway pressure therapy had no impact on post-DBS outcome.

CONCLUSIONS: In patients with PD and candidates for DBS, the presence of SAS is associated with increased motor signs, but not with a specific non-motor, QoL or sleep-wake profile. The presence of SAS prior to STN-DBS is not associated with worse outcome after surgery.

PMID:34488169 | DOI:10.1016/j.sleep.2021.07.031

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Nevin Manimala Statistics

The Prison and Transition Health (PATH) cohort study: Prevalence of health, social, and crime characteristics after release from prison for men reporting a history of injecting drug use in Victoria, Australia

Drug Alcohol Depend. 2021 Aug 28;227:108970. doi: 10.1016/j.drugalcdep.2021.108970. Online ahead of print.

ABSTRACT

BACKGROUND: People who inject drugs are overrepresented in prison and have diverse and complex health needs. However, outcomes after release from prison are poorly understood, limiting effective interventions supporting community reintegration. We describe the prevalence of socio-demographics, physical and mental health, alcohol and other drug use, and crime characteristics of men with histories of injecting drug use after their release from prison in Victoria, Australia.

METHODS: Data come from the Prison and Transition Health (PATH) prospective cohort study. Interviews were undertaken approximately three, 12, and 24 months after release from their index prison episode and were completed in the community, or in prison for those reimprisoned during the study. We present cross-sectional descriptive statistics for each follow-up wave of the PATH study.

RESULTS: Among 400 men recruited into PATH, 85 % (n = 336) completed at least one follow-up interview; 162 (42 %) completed all three interviews. Participants reported social disadvantage and health inequity, including high rates of unemployment, homelessness, and physical and mental health morbidities at each follow-up time point. Rapid return to illicit substance use was common, as was overdose (ranging 9 %-13 %), receptive syringe sharing (ranging 20 %-29 %), involvement in crime-related activities (ranging 49 %-58 %), and reimprisonment (ranging 22 %-50 %) over the duration of follow-up.

CONCLUSION: Men in this study experienced substantial health and social challenges across a 24-month prospective follow-up period. Improved understanding of characteristics and experiences of this group after release from prison can inform more coordinated and continued care between prison and the community.

PMID:34488074 | DOI:10.1016/j.drugalcdep.2021.108970

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Nevin Manimala Statistics

Pre-screening Ability of the Functional-Belief-Based Alcohol Use Questionnaire (FBAQ) among Chiang Mai University Undergraduates: An External Validation Study

Drug Alcohol Depend. 2021 Aug 28;227:109002. doi: 10.1016/j.drugalcdep.2021.109002. Online ahead of print.

ABSTRACT

BACKGROUND: High-risk drinking behavior is common in university students, which often leads to negative consequences. Several standard screening tools to identify high-risk drinkers have been validated in this domain. However, most tools rely on drinking frequency and require standard drink calculations. The Functional-Belief-Based Alcohol use Questionnaire (FBAQ) was recently proposed as a pre-screening tool for high-risk drinkers in the young adult population. We aimed to validate the pre-screening accuracy of the FBAQ when applied to external data of university undergraduates.

METHODS: Data from two prospective cross-sectional surveys of Chiang Mai University undergraduates were used for validation of the FBAQ. A high-risk drinker was defined as a person with the 12-month AUDIT score ≥ 8. Pre-screening performance and accuracy indices were presented separately for dataset I, dataset II, and the combined dataset. The pooled area under the receiver operating characteristic curve (AuROC), sensitivity, and specificity were estimated using individual patient data meta-analysis methods.

RESULTS: From the two datasets, 1641 students were included, 811 students in 2019 and 830 students in 2020. Of these, 387 (23.6 %) students were classified as high-risk drinkers. The combined AuROC of the FBAQ score was 0.83 (95 %CI 0.75-0.92) in discriminating high-risk drinkers. The pooled sensitivity and specificity at the FBAQ score cutoff ≥ 6 were 92.8 % (95 %CI 88.0-95.7 %) and 51.6 % (95 %CI 41.1-62.0 %).

CONCLUSIONS: In this external validation, the FBAQ shows excellent discriminative ability and is proven to be highly sensitive in detecting high-risk drinkers among Chiang Mai University undergraduates. Therefore, incorporating the FBAQ as a pre-screening tool to the AUDIT could make the initiation of the screening process easier and reduce extensive AUDIT evaluations in students with low risk.

PMID:34488075 | DOI:10.1016/j.drugalcdep.2021.109002

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Nevin Manimala Statistics

Analysis of genetic and clinical factors associated with buprenorphine response

Drug Alcohol Depend. 2021 Aug 28;227:109013. doi: 10.1016/j.drugalcdep.2021.109013. Online ahead of print.

ABSTRACT

BACKGROUND: Buprenorphine, approved for treating opioid use disorder (OUD), is not equally efficacious for all patients. Candidate gene studies have shown limited success in identifying genetic moderators of buprenorphine treatment response.

METHODS: We studied 1616 European-ancestry individuals enrolled in the Million Veteran Program, of whom 1609 had an ICD-9/10 code consistent with OUD, a 180-day buprenorphine treatment exposure, and genome-wide genotype data. We conducted a genome-wide association study (GWAS) of buprenorphine treatment response [defined as having no opioid-positive urine drug screens (UDS) following the first prescription]. We also examined correlates of buprenorphine treatment response in multivariable analyses.

RESULTS: Although no variants reached genome-wide significance, 6 loci were nominally significant (p < 1 × 10-5), four of which were located near previously characterized genes: rs756770 (ADAMTSL2), rs11782370 (SLC25A37), rs7205113 (CRISPLD2), and rs13169373 (LINC01947). A higher maximum daily buprenorphine dosage (aOR = 0.98; 95 %CI: 0.97, 0.995), greater number of UDS (aOR = 0.97; 95 %CI: 0.96, 0.99), and history of hepatitis C (HCV) infection (aOR = 0.71; 95 %CI: 0.57, 0.88) were associated with a reduced odds of buprenorphine response. Older age (aOR: 1.01; 95 %CI: 1.000, 1.02) was associated with increased odds of buprenorphine response.

CONCLUSIONS: This study had limited statistical power to detect genetic variants associated with a complex human phenotype like buprenorphine treatment response. Meta-analysis of multiple data sets is needed to ensure adequate statistical power for a GWAS of buprenorphine treatment response. The most robust phenotypic predictor of buprenorphine treatment response was intravenous drug use, a proxy for which was HCV infection.

PMID:34488071 | DOI:10.1016/j.drugalcdep.2021.109013

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Nevin Manimala Statistics

Vaping and psychotic experiences among college students in the United States

Drug Alcohol Depend. 2021 Sep 1;227:108987. doi: 10.1016/j.drugalcdep.2021.108987. Online ahead of print.

ABSTRACT

AIM: While cigarette and marijuana use has been linked to psychotic experiences, few empirical studies have examined the relation between vaping and psychotic experiences.

METHODS: We analyzed data from the Healthy Minds Survey (September 2020 – December 2020; N = 29,232 students from 36 universities), and used multiple logistic regression models to examine the associations between vaping over the past 30 days and psychotic experiences over the past 12 months, adjusting for age, gender, and race/ethnicity. We then additionally adjusted for cigarette and marijuana use, as well as depression and anxiety.

RESULTS: Roughly 14 % of students in the sample reported psychotic experiences over the past year, and around 14-15 % of students reported vaping over the past month. In multiple logistic regression models, vaping was significantly associated with psychotic experiences (aOR 1.88; 95 % CI: 1.63-2.18). This association attenuated but remained statistically significant even after adjusting for any cigarette use and marijuana use, and after adjusting for depression and anxiety.

CONCLUSIONS: Among college students, vaping was significantly associated with psychotic experiences, even after accounting for simple measures of cigarette and marijuana use, and mental health problems, calling for more prospective studies to examine the association.

PMID:34488073 | DOI:10.1016/j.drugalcdep.2021.108987

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Nevin Manimala Statistics

Evaluation of movement and brain activity

Clin Neurophysiol. 2021 Aug 19;132(10):2608-2638. doi: 10.1016/j.clinph.2021.04.023. Online ahead of print.

ABSTRACT

Clinical neurophysiology studies can contribute important information about the physiology of human movement and the pathophysiology and diagnosis of different movement disorders. Some techniques can be accomplished in a routine clinical neurophysiology laboratory and others require some special equipment. This review, initiating a series of articles on this topic, focuses on the methods and techniques. The methods reviewed include EMG, EEG, MEG, evoked potentials, coherence, accelerometry, posturography (balance), gait, and sleep studies. Functional MRI (fMRI) is also reviewed as a physiological method that can be used independently or together with other methods. A few applications to patients with movement disorders are discussed as examples, but the detailed applications will be the subject of other articles.

PMID:34488012 | DOI:10.1016/j.clinph.2021.04.023

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Nevin Manimala Statistics

Prescription appropriateness in elderly patients with polypharmacy in primary care: Cluster-randomized controlled trial PHARM-PC

Aten Primaria. 2021 Sep 3;53(10):102124. doi: 10.1016/j.aprim.2021.102124. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the effectiveness of a pharmacist-led systematic review of medications on: potentially inappropriate medications (PIM), health outcomes and costs.

DESIGN: Prospective, open, controlled and cluster-randomized clinical trial.

SETTING: Six primary care clinics from Balearic Islands.

PARTICIPANTS: Forty-two clusters (21 per group), and 549 patients aged ≥65 years and ≥5 chronic medications were included; of which 277 were allocated to Intervention Group (IG) and 272 to Control Group (CG). Patients were excluded if they were: institutionalized, temporarily displaced, routinely monitored under private healthcare, or home care.

INTERVENTION: PIM detection by the pharmacist using a combination of explicit and implicit methods; and communication of the most appropriate therapeutic strategies to the physician.

MEASUREMENTS: Proportion of patients with PIM and mean number of PIM/patient (main outcomes); and morbidity, mortality, and costs (secondary outcomes) were assessed.

STATISTICAL PLAN: Following an intention-to-treat approach, quantitative and qualitative outcomes variables were compared by T-Student and Chi-square tests, respectively. Results were providing as difference in proportions for qualitative outcomes and difference in means for quantitative outcomes with respective 95% confidence intervals (95% CI).

RESULTS: After intervention, proportion of patients with PIM decreased by 13.7% (95% CI: 9.3; 18.2) more in IG than CG. Mean number of PIM/patient and mean cost of PIM/patient decreased by 0.43 (95% CI: 0.32; 0.54) and 72.11€ (95% CI: 26.15; 118.06) more in IG than CG, respectively. However, no statistically significant differences were observed in morbidity, mortality or costs of healthcare resources.

CONCLUSIONS: PIM detection and recommendations provided by pharmacist could contribute to reduce significantly PIM and drug expenditure; but without reaching statistically significant differences in morbidity, mortality, and healthcare resources costs.

PMID:34488034 | DOI:10.1016/j.aprim.2021.102124