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Novozhilova N, Babina K, Polyakova M, Sokhova I, Sherstneva V, Zaytsev A, Makeeva I, Mikheikina A. The Effect of Different Compositions and Concentrations of Etidronate-Containing Irrigants on the Antibacterial Activity of Sodium Hypochlorite against Enterococcus faecalis and Candida albicans. Dent J (Basel) 2024; 12:46. [PMID: 38534270 DOI: 10.3390/dj12030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. The disc diffusion method was used to compare the antibacterial effect of pure SH and SH mixed with 9%, 15%, and 18% etidronate of two manufactures (dual rinse (DR); IsraDent (ID)) and EDTA. The pH and temperature of the solutions were measured immediately after mixing and within 40 min. The ANOVA revealed a significant influence of the type of irrigating solution on the C. albicans and E. faecalis inhibition zone diameters that ranged from 6.6 to 51.6 mm and from 6.4 to 12.4 mm, respectively. SH with DR 9% exhibited the highest effect against C. albicans. The antifungal activity of the other irrigants was SH = SH + DR15% = SH + DR18% = SH + ID9% > SH + EDTA > SH + ID15% > SH + ID18%. No significant differences in the anti-E. faecalis effect were revealed between the tested solutions except for the mixtures of SH and 15% and 18% ID, which exhibited no antiseptic effect. There was a strong positive correlation between antiseptic activity against both microorganisms and the pH values of the tested solutions. In conclusion, most etidronate formulations did not significantly hamper sodium hypochlorite activity against C. albicans and E. faecalis. The effect was concentration- and manufacturer-dependent.
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Affiliation(s)
- Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Valeria Sherstneva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Babina K, Salikhova D, Doroshina V, Makeeva I, Zaytsev A, Uvarichev M, Polyakova M, Novozhilova N. Antigingivitis and Antiplaque Effects of Oral Probiotic Containing the Streptococcus salivarius M18 Strain: A Randomized Clinical Trial. Nutrients 2023; 15:3882. [PMID: 37764667 PMCID: PMC10535351 DOI: 10.3390/nu15183882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
We aimed to assess the effect of oral probiotic containing the Streptococcus salivarius M18 strain on gingival inflammation, bleeding on probing, and oral biofilm. Sixty-one consenting participants aged between 18 and 25 with gingivitis were recruited in this double-blind, parallel-group study and randomly divided into the probiotic group (n = 31) and the placebo group (n = 30). Fifty-seven participants completed the entire study protocol, 27 in the probiotic group and 30 in the placebo group. The outcomes were assessed after 4 weeks of intervention and 4 weeks of follow-up. There was a significant decrease in the Gingival Index, with the effect size of 0.58 [95%CI 0.05-1.10], and Turesky modification of the Quigley and Hein Plaque Index, with the effect size of 0.55 [95%CI: 0.02-1.07], in the probiotic group after the intervention. However, after a 4-week follow-up, the only significant treatment outcome was improved gingival condition according to the Gingival Index. The Gingival Bleeding Index also decreased significantly in the probiotic group after the intervention period; after the follow-up, this parameter did not differ significantly in both groups from the baseline values. In the placebo group, there were no significant improvements in the assessed parameters throughout this study. No serious side effects were registered. Within the limitations of this study, we conclude that the use of oral probiotic containing the Streptococcus salivarius M18 strain resulted in a significant improvement in gingival condition and oral hygiene level in young adults with gingivitis. Trial registration NCT05727436. Funding: none.
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Dilara Salikhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Matvey Uvarichev
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (D.S.); (V.D.); (I.M.); (M.U.); (M.P.); (N.N.)
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Mikheikina A, Novozhilova N, Polyakova M, Sokhova I, Mun A, Zaytsev A, Babina K, Makeeva I. Knowledge, Attitude, and Practice towards Chelating Agents in Endodontic Treatment among Dental Practitioners. Dent J (Basel) 2023; 11:156. [PMID: 37504222 PMCID: PMC10378705 DOI: 10.3390/dj11070156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
The use of chelating agents (CAs) in the endodontic irrigation protocol is required to dissolve the inorganic components of the smear layer. We aimed to assess the knowledge, attitude, and practice of dental professionals regarding the use of CAs during root canal treatment. A cross-sectional anonymous online survey was conducted among specialized endodontists and general dentists who routinely perform endodontic treatment and work in government-funded or private clinics in Moscow. The 8 min survey consisted of four parts: basic demographic data, knowledge (five items), attitude (four items), and practice (five items). We collected 376 completed questionnaires; a majority of the respondents were general dentists (87.5%) and worked in private clinics (77.4%). Most respondents (83.5%) showed a fair knowledge of the CAs used in endodontics, while 16.5% showed a poor knowledge of the topic. Small yet significant differences were found between endodontists and general practitioners and between dentists employed by private and government-funded clinics. A majority of dental practitioners (83%) demonstrated a positive attitude towards the use of CAs in endodontic treatment, and there were no differences among the study subgroups. Almost a third of the respondents always used chelating solutions during endodontic treatment, while 17% of the respondents did not use them at all. There were significant differences in this parameter between dentists working in private and government-funded clinics. Practice significantly correlated with attitude towards chelating agents and with knowledge of the topic. In conclusion, dental practitioners demonstrated a fair knowledge of CAs. Despite a positive attitude, 71% of the respondents did not use CAs for all endodontic patients.
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Affiliation(s)
- Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anastasia Mun
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Babina K, Salikhova D, Polyakova M, Zaytsev A, Egiazaryan A, Novozhilova N. Knowledge and Attitude towards Probiotics among Dental Students and Teachers: A Cross-Sectional Survey. Dent J (Basel) 2023; 11:dj11050119. [PMID: 37232770 DOI: 10.3390/dj11050119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
This cross-sectional survey assessed the knowledge of and the attitude towards probiotics of dental students and academics at Sechenov University, Moscow, Russia. Our questionnaire consisted of 15 questions divided into 3 sections: respondents' sociodemographic data, knowledge on probiotics, and attitude towards probiotics. The data were analyzed using the Mann-Whitney U test, Fisher's exact test, and Spearman's rank correlation coefficient. Out of the 658 questionnaires distributed, a total of 239 questionnaires were completed by the undergraduates, yielding a response rate of 39.6%, and 54 by the teaching staff (response rate = 100%). Most students (53.6%) and teachers (55.5%) had a fair knowledge of probiotics (p = 0.3135). A vast majority of dental students (97.9%) and all teachers had a positive attitude towards probiotics, with higher mean scores among academics (p < 0.001). A positive weak correlation was found between knowledge and attitude (Spearman r = 0.17, p = 0.0027). The results obtained reveal the need for more evidence-based educational trainings for university teachers and a course on probiotics to be included in the curriculum for dental students.
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Dilara Salikhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Egiazaryan
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Novozhilova N, Andreeva E, Polyakova M, Makeeva I, Sokhova I, Doroshina V, Zaytsev A, Babina K. Antigingivitis, Desensitizing, and Antiplaque Effects of Alkaline Toothpastes: A Randomized Clinical Trial. Dent J (Basel) 2023; 11:96. [PMID: 37185474 PMCID: PMC10136796 DOI: 10.3390/dj11040096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
Gingivitis is a widespread disease commonly associated with dentin hypersensitivity, that, in turn, may complicate routine dental care, leading to plaque accumulation. We aimed to assess the antigingivitis, desensitizing, and antiplaque effects of a fluoride-containing (TWF) alkaline toothpaste and a fluoride-free (TW) alkaline toothpaste. Eighty-four consenting patients aged 20-25 years with diagnosed gingivitis and dentin hypersensitivity (DH) were recruited in this double-blind, parallel-group study and randomly divided into two groups (each n = 42). Eighty-two patients completed the entire study protocol. The outcomes were assessed after 4 weeks of intervention. A significant improvement in gingival condition was found according to the modified gingival index, with effect sizes of 0.99 [CI95%: 0.52-1.46] and 1.71 [CI95%: 1.18-2.24], and the gingival bleeding index, with effect sizes of 3.17 [CI95%: 2.39-3.94] and 2.64 [CI95%: 1.96-3.32] in the TW and TWF groups, respectively. DH also decreased in both groups, with a significantly greater reduction in the TWF group (effect sizes of 3.28 [CI95%: 2.51-4.04] and 3.10 [CI95%: 2.40-3.80] according to the visual analog scale and Schiff scale, respectively). No side effects were registered. In conclusion, the use of alkaline toothpaste provided a significant reduction in gingival inflammation and bleeding, DH, and oral hygiene after 4 weeks of daily use in young adults. Trial Registration: NCT0562376. Funding: none.
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Affiliation(s)
- Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Elena Andreeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Abstract
IMPORTANCE Family income is known to be associated with children's health; the association may be particularly pronounced among lower-income children in the US, who tend to have more limited access to health resources than their higher-income peers. OBJECTIVE To investigate the association of family income with claims-based measures of morbidity and mortality among children and adolescents in lower-income families in the US enrolled in Medicaid or the Children's Health Insurance Program. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis included 795 000 participants aged 5 to 17 years enrolled in Medicaid (Medicaid Analytic eXtract claims, 2011-2012) living in families with income below 200% of the federal poverty threshold (American Community Survey, 2008-2013). Follow-up ended in December 2021. EXPOSURES Family income relative to the federal poverty threshold. MAIN OUTCOMES AND MEASURES Record of International Classification of Diseases, Ninth Revision codes for an infection, mental health disorder, injury, asthma, anemia, or substance use disorder and death record within 10 years of observation (Social Security Administration death records through 2021). RESULTS Among 795 000 individuals in the sample (all statistics weighted: mean [SD] income-to-poverty ratio, 90% [53%]; mean [SD] age, 10.6 [3.9] years; 56% aged 10 to 17 years), 33% had a diagnosed infection, 13% had a mental health disorder, 6% had an injury, 5% had asthma, 2% had anemia, 1% had a substance use disorder, and 0.6% died between 2011 and 2021, with the mean (SD) age at death of 19.8 (4.2) years. For those aged 5 to 9 years, higher family income was associated with lower adjusted prevalence of all outcomes, except mortality: children in families with an additional 100% income relative to the federal poverty threshold had 2.3 (95% CI, 1.8-2.9) percentage points fewer infections, 1.9 (95% CI, 1.5-2.2) percentage points fewer mental health diagnoses, 0.7 (95% CI, 0.5-0.8) percentage points fewer injuries, 0.3 (95% CI, 0.09-0.5) percentage points less asthma, 0.2 (95% CI, 0.08-0.3) percentage points less anemia, and 0.06 (95% CI, 0.03-0.09) percentage points fewer substance use disorder diagnoses. Except for injury and anemia, the associations were more pronounced among those aged 10 to 17 years than those 5 to 9 years (P for interaction <.05). For those aged 10 to 17 years, an additional 100% income relative to the federal poverty threshold was associated with a lower 10-year mortality rate by 0.18 (95% CI, 0.12-0.25) percentage points. CONCLUSIONS AND RELEVANCE Among children and adolescents in the US aged 5 to 17 years with family income under 200% of the federal poverty threshold who accessed health care through Medicaid or the Children's Health Insurance Program, higher family income was significantly associated with a lower prevalence of diagnosed infections, mental health disorders, injury, asthma, anemia, and substance use disorders and lower 10-year mortality. Further research is needed to understand whether these associations are causal.
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Affiliation(s)
| | - Vinayak Bhatia
- Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Maria Polyakova
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California
- National Bureau of Economic Research (NBER), Cambridge, Massachusetts
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Babina K, Polyakova M, Sokhova I, Doroshina V, Zaytsev A, Nikonova EE, Budylin GS, Shirshin EA, Tantardini C, Novozhilova N. Translucency and Color Stability of a Simplified Shade Nanohybrid Composite after Ultrasonic Scaling and Air-Powder Polishing. Nanomaterials (Basel) 2022; 12:4465. [PMID: 36558318 PMCID: PMC9782865 DOI: 10.3390/nano12244465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
We aimed to assess the influence of professional dental prophylaxis on the translucency and color stability of a novel simplified shade nanohybrid composite material. Sixty composite disks (5 mm in diameter and 2 mm thick) of light (n = 30) and dark (n = 30) shades were prepared. The specimens were randomly divided into the following three groups (n = 10) according to the prophylaxis procedure used: ultrasonic scaling, air-powder polishing with sodium bicarbonate, and controls. The specimens were submitted to translucency and color analysis based on the CIELab system. Two measurements were performed before and after 48-h storage in coffee. Translucency values of untreated light and dark specimens were 9.15 ± 0.38 and 5.28 ± 1.10, respectively. Air-powder polishing decreased the translucency of the light composite specimens. Storage in coffee resulted in color changes (∆E) ranging between 2.69 and 12.05 and a mean translucency decrease ranging between -0.88 and -6.91. The samples in the light group tended to exhibit greater staining; the treatment method had no effect on ∆E. It can be concluded that light-shade composite restorations are more prone to translucency and color changes resulting from air-powder polishing and contact with staining media. However, further research using other composites and powders is required.
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Elena E. Nikonova
- Laboratory of Clinical Biophotonics, Biomedical Science and Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Faculty of Physics, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Gleb S. Budylin
- Laboratory of Clinical Biophotonics, Biomedical Science and Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Institute of Spectroscopy of the Russian Academy of Sciences, 108840 Moscow, Russia
| | - Evgeny A. Shirshin
- Faculty of Physics, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Christian Tantardini
- Hylleraas Center, Department of Chemistry, UiT The Arctic University of Norway, 9037 Tromso, Norway
- Institute of Solid State Chemistry and Mechanochemistry SB RAS, 630128 Novosibirsk, Russia
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Novozhilova N. The effect of toothpastes containing hydroxyapatite, fluoroapatite, and Zn-Mg-hydroxyapatite nanocrystals on dentin hypersensitivity: A randomized clinical trial. J Int Soc Prev Community Dent 2022; 12:252-259. [PMID: 35462739 PMCID: PMC9022388 DOI: 10.4103/jispcd.jispcd_333_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 11/04/2022] Open
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Bobkov V, Voronchikhin V, Polyakova M, Meleshin A, Voronchikhina I. Assessment of the collection of sweet potato varieties ( IPOMOEA BATATAS L.) in terms of suitability for cultivation and breeding in CRNZ. BIO Web Conf 2022. [DOI: 10.1051/bioconf/20224701004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The article presents the results of a reconnaissance study of the suitability of sweet potato varieties collection for cultivation and breeding process in the conditions of the Central region of the Non-Chernozem zone. Sweet potato cuttings with 4-5 nodes were planted according to the scheme 70 x 40 cm with subsequent watering. During the growing season, sweet potato was watered as necessary. Each variant was tested in 4-fold repetition, 10 plants per plot. The varieties had a high variability of all economically useful traits within the repetitions. For most varieties, the sum of effective temperatures was not enough to accumulate a sufficient amount of plastic substances in the root tubers. As a result of our research, it was found that sweet potato varieties Vinnitskiy rozoviy and Manchzhurskiy are most suitable for cultivation in the CRNZ. They are characterized by a relatively high yield of commercial root tubers. The remaining varieties (Americanskiy begevy, Boregard, Yaponskiy, Germanskiy belyi and O'Henry) are not suitable for cultivation in this zone. Nevertheless, they are characterized by a high potential for the formation of root bulges, which can be used in sweet potato breeding. The possibility of breeding work with sweet potato in the conditions of the CRNZ is shown. Nevertheless, for successful work in this direction, it is necessary to use a greenhouse.
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Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Zaytsev A, Novozhilova N. The Effect of Ultrasonic Scaling and Air-Powder Polishing on the Roughness of the Enamel, Three Different Nanocomposites, and Composite/Enamel and Composite/Cementum Interfaces. Nanomaterials (Basel) 2021; 11:3072. [PMID: 34835835 PMCID: PMC8623571 DOI: 10.3390/nano11113072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/06/2021] [Accepted: 11/13/2021] [Indexed: 11/20/2022]
Abstract
We aimed to assess the effects of ultrasonic scaling and air-powder polishing on the roughness of enamel, three nanocomposites (Premise, Herculite Ultra, Harmonize), and composite/enamel and composite/cementum interfaces. Class V cavities were restored in 99 extracted third molars with one of the three nanocomposites and treated with ultrasonic scaler or air-powder polishing device (calcium carbonate or sodium bicarbonate powders). The roughness (Ra) of the investigated surfaces was measured with contact profilometer before and after treatment. The data were analyzed using repeated measures ANOVA. Specimens' Ra values before instrumentation were near the clinically acceptable 0.2 μm threshold. All techniques increased the roughness of the tested surfaces; however, the enamel was slightly affected. The mean Ra values after prophylaxis for composite, composite/cementum and composite/enamel surfaces were 0.32-0.55, 1.33-1.73, and 1.25-1.36, respectively. The extent of composite surface damage was material dependent. Premise surface was not altered by ultrasonic scaling significantly. Air-powder polishing with both powders produced a greater increase in surface roughness of composite resin and restorations margins than ultrasonic scaling. The Ra values after both types of air polishing for Herculite Ultra and Harmonize were approximately 1.5 and 2 times higher, respectively, than those after ultrasonic scaling (p < 0.05).
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Marianna Arakelyan
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
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Polyakova M, Bhatia V, Bundorf MK. Analysis of Publicly Funded Reinsurance-Government Spending and Insurer Risk Exposure. JAMA Health Forum 2021; 2:e211992. [PMID: 35977191 PMCID: PMC8796983 DOI: 10.1001/jamahealthforum.2021.1992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/11/2021] [Indexed: 11/14/2022] Open
Abstract
This analysis compares the design of section 1332 reinsurance policies across states based on their potential for reducing insurer risk exposure and likely level of government spending.
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Affiliation(s)
- Maria Polyakova
- School of Medicine, Stanford University, Stanford, California.,National Bureau of Economic Research, Cambridge, Massachusetts
| | | | - M Kate Bundorf
- National Bureau of Economic Research, Cambridge, Massachusetts.,Sanford School of Public Policy, Duke University, Durham, North Carolina
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Polyakova M, Udalova V, Kocks G, Genadek K, Finlay K, Finkelstein AN. Racial Disparities In Excess All-Cause Mortality During The Early COVID-19 Pandemic Varied Substantially Across States. Health Aff (Millwood) 2021; 40:307-316. [PMID: 33523748 DOI: 10.1377/hlthaff.2020.02142] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The impact of the coronavirus disease 2019 (COVID-19) pandemic has been starkly unequal across race and ethnicity. We examined the geographic variation in excess all-cause mortality by race and ethnicity to better understand the impact of the pandemic. We used individual-level administrative data on the US population between January 2011 and April 2020 to estimate the geographic variation in excess all-cause mortality by race and Hispanic origin. All-cause mortality allows a better understanding of the overall impact of the pandemic than mortality attributable to COVID-19 directly. Nationwide, adjusted excess all-cause mortality during that period was 6.8 per 10,000 for Black people, 4.3 for Hispanic people, 2.7 for Asian people, and 1.5 for White people. Nationwide averages mask substantial geographic variation. For example, despite similar excess White mortality, Michigan and Louisiana had markedly different excess Black mortality, as did Pennsylvania compared with Rhode Island. Wisconsin experienced no significant White excess mortality but had significant Black excess mortality. Further work understanding the causes of geographic variation in racial and ethnic disparities-the relevant roles of social and environmental factors relative to comorbidities and of the direct and indirect health effects of the pandemic-is crucial for effective policy making.
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Affiliation(s)
- Maria Polyakova
- Maria Polyakova is an assistant professor of medicine at Stanford University, in Stanford, California
| | - Victoria Udalova
- Victoria Udalova is a research economist at the Census Bureau, in Washington, D.C
| | - Geoffrey Kocks
- Geoffrey Kocks is a graduate student in economics at the Massachusetts Institute of Technology, in Cambridge, Massachusetts
| | - Katie Genadek
- Katie Genadek is a research economist at the Census Bureau
| | - Keith Finlay
- Keith Finlay is a research economist at the Census Bureau
| | - Amy N Finkelstein
- Amy N. Finkelstein is the John & Jennie S. McDonald Professor of Economics at the Massachusetts Institute of Technology
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Abstract
OBJECTIVE To examine occupational heritability in medicine and changes in heritability over time, with Swedish population wide administrative data that allowed mapping family trees of physicians spanning up to three generations. DESIGN Retrospective observational study. SETTING Individual level administrative registry data from Sweden. PARTICIPANTS Physicians born in 1950-90 and living in Sweden at some time during 2001-16 (n=47 400). MAIN OUTCOME MEASURES The proportion of individuals with a completed medical degree with at least one parent who also trained in medicine, and the change in this proportion across birth cohorts. Additional analyses were conducted among other relatives (grandparents, aunts and uncles, and siblings) and for individuals with a law degree. RESULTS For 27 788 physicians, where the educational background for both parents was known, 14% had a parent who was also a physician and 2% had two parents who were physicians. The proportion of physicians with at least one physician parent increased significantly over time, from 6% for physicians born in 1950-59 to 20% for physicians born in 1980-90 (P<0.001). The same pattern of increasing occupational heritability was not seen for individuals with law degrees. CONCLUSIONS In recent cohorts of physicians in Sweden, one in five had a parent who was also a physician, more than triple the proportion seen for physicians born three decades earlier. A similar pattern was not seen in lawyers, suggesting that increasing occupational heritability in medicine does not reflect intergenerational persistence of high paying degrees alone. Rather, for physicians in Sweden, medicine might increasingly run in families.
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Affiliation(s)
- Maria Polyakova
- Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Petra Persson
- National Bureau of Economic Research, Cambridge, MA, USA
- Department of Economics, Stanford University, Stanford, CA, USA
- Research Institute of Industrial Economics, Stockholm, Sweden
| | - Katja Hofmann
- Department of Economics, Stanford University, Stanford, CA, USA
| | - Anupam B Jena
- National Bureau of Economic Research, Cambridge, MA, USA
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
- Massachusetts General Hospital, Boston, MA, USA
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Affiliation(s)
- Maria Polyakova
- Ruhr University Bochum Faculty of Mechanical Engineering Laboratory of Fluid Separations Universitätsstrasse 150 44801 Bochum Germany
| | - Anna‐Lena Diekmann
- Ruhr University Bochum Faculty of Mechanical Engineering Laboratory of Fluid Separations Universitätsstrasse 150 44801 Bochum Germany
| | - Marcus Grünewald
- Ruhr University Bochum Faculty of Mechanical Engineering Laboratory of Fluid Separations Universitätsstrasse 150 44801 Bochum Germany
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Harding D, Bramsiepe C, Stenger F, Polyakova M, Diekmann AL, Grünewald M. Methode zur Auswahl und Konfiguration von modularen Prozesseinheiten an einem industriellen Beispielprozess. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- D. Harding
- Evonik Operations GmbH Paul-Baumann-Str. 1 45772 Marl Deutschland
| | - C. Bramsiepe
- Evonik Operations GmbH Paul-Baumann-Str. 1 45772 Marl Deutschland
| | - F. Stenger
- Evonik Operations GmbH Rodenbacher Chaussee 4 63457 Hanau-Wolfgang Deutschland
| | - M. Polyakova
- Ruhr-Universität Bochum Universitätsstr. 150 44801 Bochum Deutschland
| | - A.-L. Diekmann
- Ruhr-Universität Bochum Universitätsstr. 150 44801 Bochum Deutschland
| | - M. Grünewald
- Ruhr-Universität Bochum Universitätsstr. 150 44801 Bochum Deutschland
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Weinhold H, Schindel AL, Polyakova M, Harding D, Wekenborg K, Grünewald M. Entwicklung einer Prozesssynthesemethodik für Spezialchemikalien: Herausforderungen und Ergebnisse. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- H. Weinhold
- Merck KGaA Soderstr. 102 64287 Darmstadt Deutschland
| | - A.-L. Schindel
- Ruhr Universität Bochum Lehrstuhl Fluidverfahrenstechnik Universitätsstr. 150 44801 Bochum Deutschland
| | - M. Polyakova
- Ruhr Universität Bochum Lehrstuhl Fluidverfahrenstechnik Universitätsstr. 150 44801 Bochum Deutschland
| | - D. Harding
- Evonik Technology & Infrastructure GmbH Paul-Baumann-Str. 1 45772 Marl Deutschland
| | - K. Wekenborg
- Merck KGaA Soderstr. 102 64287 Darmstadt Deutschland
| | - M. Grünewald
- Ruhr Universität Bochum Lehrstuhl Fluidverfahrenstechnik Universitätsstr. 150 44801 Bochum Deutschland
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Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Novozhilova N. The Effect of Finishing and Polishing Sequences on The Surface Roughness of Three Different Nanocomposites and Composite/Enamel and Composite/Cementum Interfaces. Nanomaterials (Basel) 2020; 10:nano10071339. [PMID: 32659992 PMCID: PMC7407209 DOI: 10.3390/nano10071339] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate the effect of final surface treatment and dental composite type on the roughness of the composite surface, composite/enamel interface, and composite/cementum interface, as well as on the polishing time. Class V cavities prepared in extracted teeth (n = 126) were restored using one of the three nanohybrid composites with different filler sizes. The specimens were randomly assigned to three different finishing and polishing sequences. The roughness (Ra) of the investigated surfaces was measured using the contact profilometer. The time required to achieve visible gloss was documented. The data were analyzed using ANOVA with Tukey's post hoc test (p < 0.05). There was no significant influence of the composite type on the restoration surface roughness (p = 0.088), while the polishing method had a significant impact (p < 0.001). The Ra of the composites ranged between 0.08 µm and 0.29 µm, with the lowest values (0.09 µm ± 0.05 µm) found in the aluminum oxide disc group (p < 0.001). The time to achieve a visible composite gloss was influenced by the polishing method, composite type, and interactions between these factors (p < 0.001). The interface roughness was significantly greater than that of the composite surface (p < 0.001), and depended on the composite type and polishing system employed.
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Decarolis F, Polyakova M, Ryan SP. Subsidy Design in Privately Provided Social Insurance: Lessons from Medicare Part D. J Polit Econ 2020; 128:1712-1752. [PMID: 32431365 PMCID: PMC7236560 DOI: 10.1086/705550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The efficiency of publicly-subsidized, privately-provisioned social insurance programs depends on the interaction between strategic insurers and the subsidy mechanism. We study this interaction in the context of Medicare's prescription drug coverage program. We find that the observed mechanism is successful in keeping "raise-the-subsidy" incentives relatively low, acts much like a flat voucher, and obtains a level of welfare close to the optimal voucher. Across a range of counterfactuals, we find that more efficient subsidy mechanisms share three features: they retain the marginal elasticity of demand, limit the exercise of market power, and preserve the link between prices and marginal costs.
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Abstract
Background Recent studies have reported that low-income adults living in more affluent areas of the United States have longer life expectancies. Less is known about the relationship between the affluence of a geographic area and morbidity of the low-income population. Objective To evaluate the association between the prevalence of chronic conditions among low-income, older adults and the economic affluence of a local area. Design Cross-sectional association study. Setting Medicare in 2015. Participants 6 363 097 Medicare beneficiaries aged 66 to 100 years with a history of low-income support under Medicare Part D. Measurements Adjusted prevalence of 48 chronic conditions was computed for 736 commuting zones (CZs). Factor analysis was used to assess spatial covariation of condition prevalence and to construct a composite condition prevalence index for each CZ. The association between morbidity and area affluence was measured by comparing the average of condition prevalence index across deciles of median CZ house values. Results The mean age of study participants was 77.7 years (SD, 8.2); 67% were women, and 61% were white. The crude prevalence of 48 chronic conditions ranged from 72.5 per 100 for hypertension to 0.6 per 100 for posttraumatic stress disorder. The prevalence of these 48 chronic conditions was highly spatially correlated. Composite condition prevalence was on average substantially lower in more affluent CZs. Limitation Low-income status measured on the basis of receipt of Medicare Part D low-income subsidies and not capturing persons not enrolled in Medicare Part D. Conclusion Low-income, older adults living in more affluent areas of the country are healthier, and areas with poor health in the low-income, older adult population tend to have a high prevalence of most chronic conditions. Primary Funding Source National Institute on Aging.
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Affiliation(s)
- Maria Polyakova
- Maria Polyakova is an assistant professor of health research and policy at Stanford University School of Medicine, Stanford, CA and a faculty research fellow at the National Bureau of Economic Research, Cambridge, MA
| | - Lynn M. Hua
- Lynn M. Hua is a doctoral student in the Department of Health Care Management at the University of Pennsylvania, Philadelphia, PA
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Bundorf MK, Polyakova M, Stults C, Meehan A, Klimke R, Pun T, Chan AS, Tai-Seale M. Machine-Based Expert Recommendations And Insurance Choices Among Medicare Part D Enrollees. Health Aff (Millwood) 2019; 38:482-490. [PMID: 30830808 DOI: 10.1377/hlthaff.2018.05017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Choosing a health insurance plan is difficult for many people, and patient-centered decision support may help consumers make these choices. We tested whether providing a patient-centered decision-support tool-with or without machine-based, personalized expert recommendations-influenced decision outcomes for Medicare Part D enrollees. We found that providing an online patient-centered decision-support tool increased older adults' satisfaction with the process of choosing a prescription drug plan and the amount of time they spent choosing a plan. Providing personalized expert recommendations as well increased rates of plan switching. Many people who could have accessed the tool chose not to, and the characteristics of people who used the tool differed from those who did not. We conclude that a patient-centered decision-support tool providing personalized expert recommendations can help people choose a plan, but different approaches may be necessary to encourage more people to periodically reevaluate their options.
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Affiliation(s)
- M Kate Bundorf
- M. Kate Bundorf ( ) is an associate professor of health research and policy at the Stanford University School of Medicine, in California
| | - Maria Polyakova
- Maria Polyakova is an assistant professor of health research and policy at the Stanford University School of Medicine
| | - Cheryl Stults
- Cheryl Stults is a research sociologist at the Palo Alto Medical Foundation Research Institute, in California
| | - Amy Meehan
- Amy Meehan is a research associate at the Palo Alto Medical Foundation Research Institute
| | - Roman Klimke
- Roman Klimke is a graduate student at the John F. Kennedy School of Government, Harvard University, in Cambridge, Massachusetts
| | - Ting Pun
- Ting Pun is an independent consultant in Mountain View, California
| | - Albert Solomon Chan
- Albert Solomon Chan is chief of digital patient experience and an investigator at Sutter Health, in Palo Alto, and an adjunct professor at the Stanford Center for Biomedical Informatics Research, Stanford School of Medicine
| | - Ming Tai-Seale
- Ming Tai-Seale is a professor in the Department of Family Medicine and Public Health, University of California San Diego, director of outcomes analysis and scholarship at UC San Diego Health, and director of research at UCSD Health Sciences International, in La Jolla
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Affiliation(s)
- C. Bramsiepe
- Evonik Technology & Infrastructure GmbH; Process Technology & Engineering; Paul-Baumann-Straße 1 45772 Marl Deutschland
| | - M. Polyakova
- Ruhr-Universität Bochum; Lehrstuhl für Fluidverfahrenstechnik; Universitätsstraße 150 44801 Bochum Deutschland
| | - F. Stenger
- Evonik Technology & Infrastructure GmbH; Process Technology & Engineering; Rodenbacher Chaussee 4 63457 Hanau Deutschland
| | - M. Grünewald
- Ruhr-Universität Bochum; Lehrstuhl für Fluidverfahrenstechnik; Universitätsstraße 150 44801 Bochum Deutschland
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Einav L, Finkelstein A, Polyakova M. Private provision of social insurance: drug-specific price elasticities and cost sharing in Medicare Part D. Am Econ J Econ Policy 2018; 10:122-153. [PMID: 30233766 PMCID: PMC6141206 DOI: 10.1257/pol.20160355] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We explore how private drug plans set cost-sharing in the context of Medicare Part D. While publicly-provided drug coverage typically involves uniform cost-sharing across drugs, we document substantial heterogeneity in the cost-sharing for different drugs within privately-provided plans. We also document that private plans systematically set higher consumer cost sharing for drugs or classes associated with more elastic demand; to do so we estimate price elasticities of demand across more than 150 drugs and across more than 100 therapeutic classes. We conclude by discussing the various channels that likely affect private plans' cost-sharing decisions.
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Affiliation(s)
- Liran Einav
- Department of Economics, Stanford University, and NBER, 579 Serra Mall, Stanford, CA 94305- 6072
| | - Amy Finkelstein
- Department of Economics, Massachusetts Institute of Technology, and NBER, 77 Massachusetts Avenue, Building E52, Room 442, Cambridge MA 02139
| | - Maria Polyakova
- Department of Health Research and Policy, Stanford University, and NBER, Redwood Building T111, 150 Governor's Lane, Stanford, CA 94305
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Polyakova M, Bundorf MK, Kessler DP, Baker LC. ACA Marketplace premiums and competition among hospitals and physician practices. Am J Manag Care 2018; 24:85-90. [PMID: 29461855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine the association between annual premiums for health plans available in Federally Facilitated Marketplaces (FFMs) and the extent of competition and integration among physicians and hospitals, as well as the number of insurers. STUDY DESIGN We used observational data from the Center for Consumer Information and Insurance Oversight on the annual premiums and other characteristics of plans, matched to measures of physician, hospital, and insurer market competitiveness and other characteristics of 411 rating areas in the 37 FFMs. METHODS We estimated multivariate models of the relationship between annual premiums and Herfindahl-Hirschman indices of hospitals and physician practices, controlling for the number of insurers, the extent of physician-hospital integration, and other plan and rating area characteristics. RESULTS Premiums for Marketplace plans were higher in rating areas in which physician, hospital, and insurance markets were less competitive. An increase from the 10th to the 90th percentile of physician concentration and hospital concentration was associated with increases of $393 and $189, respectively, in annual premiums for the Silver plan with the second lowest cost. A similar increase in the number of insurers was associated with a $421 decrease in premiums. Physician-hospital integration was not significantly associated with premiums. CONCLUSIONS Premiums for FFM plans were higher in markets with greater concentrations of hospitals and physicians but fewer insurers. Higher premiums make health insurance less affordable for people purchasing unsubsidized coverage and raise the cost of Marketplace premium tax credits to the government.
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Affiliation(s)
- Maria Polyakova
- Stanford University, Redwood Bldg, Rm T111, 150 Governor's Ln, Stanford, CA 94305.
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Polyakova M. Corrigendum to "Risk selection and heterogeneous preferences in health insurance markets with a public option" [J. Health Econ. 49 (2016) 153-168]. J Health Econ 2018; 57:89. [PMID: 29182937 DOI: 10.1016/j.jhealeco.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Maria Polyakova
- Department of Health Research and Policy, Stanford University, Stanford, CA, USA.
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Polyakova M, Hua LM, Bundorf MK. Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrollees. Health Aff (Millwood) 2017; 36:2078-2084. [DOI: 10.1377/hlthaff.2017.0660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Maria Polyakova
- Maria Polyakova is an assistant professor of health research and policy at the Stanford University School of Medicine, in California, and a faculty research fellow at the National Bureau of Economic Research, in Cambridge, Massachusetts
| | - Lynn Mei Hua
- Lynn Mei Hua is a research associate in the Department of Health Research and Policy at the Stanford University School of Medicine
| | - M. Kate Bundorf
- M. Kate Bundorf is an associate professor of health research and policy and chief of the Division of Health Services Research at the Stanford University School of Medicine and a research associate at the National Bureau of Economic Research
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Schümberg K, Polyakova M, Steiner J, Schroeter M. P 154 Serum S100B is related to illness duration and clinical symptoms in Schizophrenia – a meta-regression analysis. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.06.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Polyakova M. Risk selection and heterogeneous preferences in health insurance markets with a public option. J Health Econ 2016; 49:153-168. [PMID: 27454199 DOI: 10.1016/j.jhealeco.2016.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 06/18/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Abstract
Conventional wisdom suggests that if private health insurance plans compete alongside a public option, they may endanger the latter's financial stability by cream-skimming good risks. This paper argues that two factors may contribute to the extent of cream-skimming: (i) degree of horizontal differentiation between public and private options when preferences are heterogeneous; (ii) whether contract design encourages choice of private insurance before information about risk is revealed. I explore the role of these factors empirically within the unique institutional setting of the German health insurance system. Using a fuzzy regression discontinuity design to disentangle adverse selection and moral hazard, I find no compelling support for extensive cream-skimming of public option by private insurers despite their ability to fully underwrite risk. A model of demand for private insurance supports the idea that heterogeneity in non-pecuniary preferences and long-term structure of private insurance contracts may be muting cream-skimming in this setting.
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Affiliation(s)
- Maria Polyakova
- Department of Health Research and Policy, Stanford University, Stanford, CA, USA; NBER.
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Polyakova M, Sander C, Arelin K, Lampe L, Luck T, Kratzsch J, Hoffman K, Riedel-Heller S, Villringer A, Schoenknecht P, Schroeter M. First Evidence For Glial Pathology In Late Life Minor Depression: s100b Is Increased In Males With Minor Depression. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Minor depression is diagnosed when a patient suffers from two to four depressive symptoms for at least two weeks. Though minor depression is a widespread phenomenon, its pathophysiology has hardly been studied. To get a first insight into the pathophysiological mechanisms underlying this disorder we assessed serum levels of biomarkers for plasticity, glial and neuronal function: brain-derived neurotrophic factor (BDNF), S100B and neuron specific enolase (NSE). Twenty-seven subjects with minor depressive episode and 82 healthy subjects over 60 years of age were selected from the database of the Leipzig population-based study of civilization diseases (LIFE). Serum levels of BDNF, S100B and NSE were compared between groups, and correlated with age, body-mass index, and degree of white matter hyperintensities (score on Fazekas scale). S100B was significantly increased in males with minor depression in comparison to healthy males, whereas other biomarkers did not differ between groups (P = 0.10–0.66). NSE correlated with Fazekas score in patients with minor depression (rs = 0.436, P = 0.048) and in the whole sample (rs = 0.252, P = 0.019). S100B correlated with body mass index (rs = 0.246, P = 0.031) and with age in healthy subjects (rs = 0.345, P = 0.002). Increased S100B in males with minor depression, without alterations in BDNF and NSE, supports the glial hypothesis of depression. Correlation between white matter hyperintensities and NSE underscores the vascular hypothesis of late life depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Polyakova M, Schroeter ML, Elzinga BM, Holiga S, Schoenknecht P, de Kloet ER, Molendijk ML. Brain-Derived Neurotrophic Factor and Antidepressive Effect of Electroconvulsive Therapy: Systematic Review and Meta-Analyses of the Preclinical and Clinical Literature. PLoS One 2015; 10:e0141564. [PMID: 26529101 PMCID: PMC4631320 DOI: 10.1371/journal.pone.0141564] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 10/10/2015] [Indexed: 12/21/2022] Open
Abstract
Emerging data suggest that Electro-Convulsive Treatment (ECT) may reduce depressive symptoms by increasing the expression of Brain-Derived Neurotrophic Factor (BDNF). Yet, conflicting findings have been reported. For this reason we performed a systematic review and meta-analysis of the preclinical and clinical literature on the association between ECT treatment (ECS in animals) and changes in BDNF concentrations and their effect on behavior. In addition, regional brain expression of BDNF in mouse and human brains were compared using Allen Brain Atlas. ECS, over sham, increased BDNF mRNA and protein in animal brain (effect size [Hedge’s g]: 0.38―0.54; 258 effect-size estimates, N = 4,284) but not in serum (g = 0.06, 95% CI = -0.05―0.17). In humans, plasma but not serum BDNF increased following ECT (g = 0.72 vs. g = 0.14; 23 effect sizes, n = 281). The gradient of the BDNF increment in animal brains corresponded to the gradient of the BDNF gene expression according to the Allen brain atlas. Effect-size estimates were larger following more ECT sessions in animals (r = 0.37, P < .0001) and in humans (r = 0.55; P = 0.05). There were some indications that the increase in BDNF expression was associated with behavioral changes in rodents, but not in humans. We conclude that ECS in rodents and ECT in humans increase BDNF concentrations but this is not consistently associated with changes in behavior.
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Affiliation(s)
- M. Polyakova
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital, Leipzig, Germany
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Leipzig, Germany
- * E-mail: (MP);
| | - M. L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital, Leipzig, Germany
| | - B. M. Elzinga
- Institute of Psychology, Leiden University and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - S. Holiga
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital, Leipzig, Germany
| | - P. Schoenknecht
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Leipzig, Germany
| | - E. R. de Kloet
- Division of Medical Pharmacology, Division of Endocrinology, and Leiden Academic Center for Drug Research, Leiden University Medical Center, Leiden, The Netherlands
| | - M. L. Molendijk
- Institute of Psychology, Leiden University and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail: (MP);
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Polyakova M, Sonnabend N, Sander C, Mergl R, Schroeter ML, Schroeder J, Schönknecht P. Prevalence of minor depression in elderly persons with and without mild cognitive impairment: a systematic review. J Affect Disord 2014; 152-154:28-38. [PMID: 24103852 DOI: 10.1016/j.jad.2013.09.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/08/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Minor depression (MinD) and mild cognitive impairment (MCI) are common disorders in late life that often coexist. The aim of the present review is to demonstrate prevalence rates of minor depression in older patients with and without MCI. METHODS Electronic database searches were performed through Medline, ISI Web of Knowledge, Psycinfo, and Cochrane library. Two independent reviewers extracted the original studies based on inclusion criteria: representative study population aged 55 and older, diagnostics of MinD according to DSM. Data on prevalence rates, risk factors, comorbidity and health care usage were analyzed. RESULTS Point prevalence for MinD is higher in medical settings (median 14.4%) than in the community-based settings (median 10.4%) and primary care patients (median 7.7%). Although minor depression is rarely investigated in elderly persons with MCI, nearly 20% of patients with MCI seem to suffer from MinD. No data was found on the prevalence of MCI in patients with MinD. Risk factors associated with MinD include female gender, history of cerebrovascular diseases, generalized anxiety disorder, loneliness, and long-term institutional care. LIMITATIONS Methodological differences of included studies resulted in a broad range of prevalence rates. No data is shown regarding the prevalence of MCI in MinD group due to insufficient evidence. CONCLUSIONS Our review indicates that MinD is frequent in elderly population. MCI among those subjects has not been sufficiently investigated. Future studies based on clinical structured interviews should be performed in longitudinal design in order to differentiate late-life depression from progressive MCI or early manifestation of Alzheimer's disease.
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Affiliation(s)
- M Polyakova
- Department of Psychiatry, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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