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The need for acute assessments in home healthcare - Swedish registered nurses' experiences
Westerholm J, Gustafsson LK and Söderman M
The study aims to describe Swedish RNs' experiences of acute assessments at home. More patients with complex nursing needs are cared for at home due to an ageing population. Registered nurses (RNs) who work with home healthcare need a broad medical competence and clinical experience alongside adapted decision support systems for maintaining patient safety in acute assessments within home healthcare.
Maturation of germinal center B cells after influenza virus vaccination in humans
McIntire KM, Meng H, Lin TH, Kim W, Moore NE, Han J, McMahon M, Wang M, Malladi SK, Mohammed BM, Zhou JQ, Schmitz AJ, Hoehn KB, Carreño JM, Yellin T, Suessen T, Middleton WD, Teefey SA, Presti RM, Krammer F, Turner JS, Ward AB, Wilson IA, Kleinstein SH and Ellebedy AH
Germinal centers (GC) are microanatomical lymphoid structures where affinity-matured memory B cells and long-lived bone marrow plasma cells are primarily generated. It is unclear how the maturation of B cells within the GC impacts the breadth and durability of B cell responses to influenza vaccination in humans. We used fine needle aspiration of draining lymph nodes to longitudinally track antigen-specific GC B cell responses to seasonal influenza vaccination. Antigen-specific GC B cells persisted for at least 13 wk after vaccination in two out of seven individuals. Monoclonal antibodies (mAbs) derived from persisting GC B cell clones exhibit enhanced binding affinity and breadth to influenza hemagglutinin (HA) antigens compared with related GC clonotypes isolated earlier in the response. Structural studies of early and late GC-derived mAbs from one clonal lineage in complex with H1 and H5 HAs revealed an altered binding footprint. Our study shows that inducing sustained GC reactions after influenza vaccination in humans supports the maturation of responding B cells.
Neurologic comorbidity in psychiatric inpatients: evidence from neurologic consultations in a Spanish center
Peña-Salazar C, Kazah N, Carrillo B, Díaz C, Callén A, Serrano-Blanco A and Aznar-Lou I
The presence of psychiatric comorbidity in some neurological disorders is common. A bi-directional influence between some psychiatric and neurological disorders has been discussed, but not widely studied. There is an absence of literature on the typology and rates of neurology consultations in different types of psychiatric inpatients.
High Levels of Triggering Receptor Expressed in Myeloid Cells-Like Transcript-1 Positive, but Not Glycoprotein 1b+, Microparticles Are Associated With Poor Outcomes in Acute Respiratory Distress Syndrome
Gibson AD, Bayrón-Marrero Z, Nieves-Lopez B, Maldonado-Martínez G and Washington AV
To identify triggering receptor expressed in myeloid cells-like transcript-1 positive (TLT-1+) microparticles (MPs) and evaluate if their presence is associated with clinical outcomes and/or disease severity in acute respiratory distress syndrome (ARDS).
Glycemic variability after mechanical thrombectomy for anterior circulation acute ischemic stroke
Cabral A, Carvalho A, Barros P, Ribeiro M, Castro S, Calvão-Pires P, Rodrigues M, Costa H, Battistella V, Gregório T, Paredes L, Veloso M and Rocha M
Morbidity remains high among patients who undergo successful mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO). Stress hyperglycemia worsens the prognosis after acute ischemic stroke (AIS), but aggressively treating hyperglycemia does not improve the outcome. There is no consensus on how to best manage glycemia after AIS. Glycemic variability (GV) reflects glycemic fluctuations over time and could be the culprit. We aimed to elucidate how GV impacts outcome of AIS patients treated with MT.
Attention-Deficit/Hyperactivity Disorder Diagnoses in Finland During the COVID-19 Pandemic
Auro K, Holopainen I, Perola M, Havulinna AS and Raevuori A
Several reports suggest an increase in attention-deficit/hyperactivity disorder (ADHD) symptoms during the COVID-19 pandemic. This nationwide study assessed new ADHD diagnoses and ADHD prevalence before and during the pandemic.
Prospective prediction of treatment outcomes in adolescents: A head-to-head comparison of alternative model for personality disorder versus borderline personality disorder
Sharp C, Kulesz P and Kerr S
Despite substantial evidence in support of the alternative model for personality disorder (AMPD) that has accumulated over the last decade, a gap remains in terms of head-to-head comparisons of the predictive power of Section II categorical diagnoses versus Section III AMPD diagnoses for clinical outcomes. The current study uses archival data from a naturalistic treatment outcome study in an adolescent psychiatric inpatient sample to compare the predictive power of the Section III AMPD (combined Criterion A and B assessment) versus Section II borderline personality disorder (BPD) in predicting treatment outcomes from admission to discharge. Outcomes in general psychiatric severity and emotion dysregulation were assessed in a sample of 59 adolescents (76.3% female, = 15.27, = 1.17) at admission and at discharge on average about a month later. Results showed that, on average, predictive power of both AMPD measures and BPD were relatively modest. However, the AMPD, operationalized through combined measures of identity diffusion and maladaptive traits, was a stronger predictor of reduction in general psychiatric severity than a measure of BPD. The findings of the study add to a growing body of literature pointing to the advantages of Section III AMPD over Section II categorical diagnosis for clinical utility in predicting treatment response. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Bowel function, urinary tract function, and health-related quality of life in males with anorectal malformations
Gertler J, Granström AL, Oddsberg J, Gunnarsdóttir A, Svenningsson A, Wester T and Örtqvist L
There is a knowledge gap regarding long-term outcomes for males undergoing surgery for an anorectal malformation (ARM). The purpose of this study was to investigate bowel function, bladder function, and health-related quality of life (HRQoL) in male patients with an anorectal malformation.
Personalized Cognitive Health in Psychiatry: Current State and the Promise of Computational Methods
Chen CS and Vinogradov S
Decades of research have firmly established that cognitive health and cognitive treatment services are a key need for people living with psychosis. However, many current clinical programs do not address this need, despite the essential role that an individual's cognitive and social cognitive capacities play in determining their real-world functioning. Preliminary practice-based research in the Early Psychosis Intervention Network early psychosis intervention network shows that it is possible to develop and implement tools that delineate an individuals' cognitive health profile and that help engage the client and the clinician in shared decision-making and treatment planning that includes cognitive treatments. These findings signify a promising shift toward personalized cognitive health.
Morally injurious events and posttraumatic embitterment disorder in U.K. health and social care professionals during COVID-19: A longitudinal web survey
Brennan CJ, McKay MT and Cole JC
To longitudinally estimate the prevalence and predictors of potentially morally injurious events (PMIEs) and posttraumatic embitterment disorder (PTED) and in U.K. health and social care workers (HSCWs) during the COVID-19 pandemic. Additionally, to investigate the mechanism by which PMIEs increase embitterment by lowering personal belief in procedural justice, that is, the belief that they experience fair processes.
Alzheimer Disease Cerebrospinal Fluid Biomarkers in a Tertiary Neurology Practice
Li W, Petersen RC, Algeciras-Schimnich A, Cogswell PM, Bornhorst JA, Kremers WK, Boeve BF, Jones DT, Botha H, Ramanan VK, Knopman DS, Savica R, Josephs KA, Cliatt-Brown C, Andersen E, Day GS, Graff-Radford NR, Ertekin-Taner N, Lachner C, Wicklund M, van Harten A, Woodruff BK, Caselli RJ and Graff-Radford J
To evaluate the performance of Alzheimer disease (AD) cerebrospinal fluid (CSF) biomarkers in a tertiary neurology clinic setting with high frequency of non-AD cases, including normal pressure hydrocephalus (NPH).
Comparison of initial dental treatment decisions between in-person and asynchronous teledentistry examinations for people with special health care needs
Kandala K, Archer HR, Moss KL, White B, Thomas BR, Wu D, Milner BE and Weintraub JA
People with special health care needs in long-term care settings have difficulty accessing a traditional dental office. The goal of the authors was to assess initial treatment decision concordance between dentists conducting traditional in-person examinations using mobile equipment and additional dentists conducting examinations using asynchronous teledentistry technology.
Incidence of Sexually Transmitted Infections in Youth with HIV During Pre-COVID and COVID Era
Khan F, Loerinc LB, Scheel A, Gillespie SE and Camacho-Gonzalez AF
Adolescents and young adults (AYAs) living with HIV have high rates of co-sexually transmitted infections (STIs). During the coronavirus disease (COVID) pandemic, STI prevention strategies, including access to testing/treatment facilities, availability of health care workers, and condom availability, may have decreased. This study aimed to determine if differences in STI incidence for first infection and reinfection existed between the pre-COVID and COVID eras in a cohort of AYAs living with HIV in Atlanta, GA. Retrospective chart review was conducted for all patients between ages 13 and 24 at the Grady Ponce Clinic. Two eras were identified: a pre-COVID era (January 1, 2009-December31, 2019) and a COVID era (January 1, 2020-June 30, 2021). STIs recorded included gonorrhea, chlamydia, human papillomavirus, syphilis, trichomonas, herpes simplex virus, lymphogranuloma venereum, hepatitis C, bacterial vaginosis, and chancroid. First and recurrent incidence rates for any STIs were reported. Our sample included 766 sexually active AYAs with HIV. A total of 721 patients were included in the pre-COVID era and 583 (80.9%) had at least one STI. A total of 337 patients were included in the COVID era, and 158 had at least one STI (46.9%). The overall first STI incidence rate increased from 42.47 to 58.67 per 100 person-years (PY) and the recurrent STI incidence rate increased from 121.50 to 169.85 per 100 PY from the pre-COVID to the COVID era ( < 0.001). Our study demonstrated significantly higher incidence rates of first and recurrent STIs in AYAs living with HIV in the COVID era. We urge continuation of existing STI prevention programs to avoid secondary clinical and economic adverse effects of increased infections.
Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life
Morinaga D, Nagai S, Kaku T, Itoh T, Soejima Y, Takeshita F, Horikawa T, Abe N, Iijima T, Soejima D, Hara T, Sato R, Murakami M, Sawase T and Nishimura M
This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL).
Herpetic lymphadenitis mimicking Richter transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma
Bidot S and Feldman AL
Axi-cel outcomes among non-Hispanic Black patients
Wesson W and Ahmed N
Trends in Empiric Broad-Spectrum Antibiotic Use for Suspected Community-Onset Sepsis in US Hospitals
Rhee C, Chen T, Kadri SS, Lawandi A, Yek C, Walker M, Warner S, Fram D, Chen HC, Shappell CN, DelloStritto L, Klompas M and
Little is known about the degree to which suspected sepsis drives broad-spectrum antibiotic use in hospitals, what proportion of antibiotic courses are unnecessarily broad in retrospect, and whether these patterns are changing over time.
Suicide Mortality During the Perinatal Period
Zivin K, Zhong C, Rodríguez-Putnam A, Spring E, Cai Q, Miller A, Johns L, Kalesnikava VA, Courant A and Mezuk B
The US has the highest maternal mortality rate among developed countries. The Centers for Disease Control and Prevention deems nearly all of these deaths preventable, especially those attributable to mental health conditions. Coordination between US health care and social service systems could help further characterize circumstances and risks associated with perinatal suicide mortality.
Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis
Shi W, Chen Z, Shi L, Jiang S, Zhou J, Gu X, Lei X, Xiao T, Zhu Y, Qian A, Zhou W, Lee SK, Du L, Yang J, Ma X, Hu L and
The overutilization of antibiotics in very preterm infants (VPIs) at low risk of early-onset sepsis (EOS) is associated with increased mortality and morbidities. Nevertheless, the association of early antibiotic exposure with bronchopulmonary dysplasia (BPD) remains equivocal.
Insights Derived From Text-Based Digital Media, in Relation to Mental Health and Suicide Prevention, Using Data Analysis and Machine Learning: Systematic Review
Sweeney C, Ennis E, Mulvenna MD, Bond R and O'Neill S
Text-based digital media platforms have revolutionized communication and information sharing, providing valuable access to knowledge and understanding in the fields of mental health and suicide prevention.
Beyond the First Trimester: Social Determinants of Delayed Prenatal Care at a Community Health Center Using the PRAPARE Tool
Page A, McCann R, Maness S, Merriweather M and Dobbs PD
Social determinants of health have been used to explore associations with pregnancy outcomes and the birth weight of infants; however, research employing individually based social risk measures has not examined associations among underserved populations, including pregnant persons at community health centers. Data were collected from a sample (n = 345) of pregnant persons who sought care at a community health center between January 2019 and December 2020. Social risks of pregnant patients were measured using the PRAPARE tool. First, associations between patients' social risks and trimester in which they initiated care were assessed using ANOVAs, grouping social risk by PRAPARE social determinant domains (persona characteristics, family and home, money and resources, and social and emotional health). ANOVAs were stratified by ethnicity. Next, a multivariate logistic regression examined associations between social measures and seeking care after the first trimester. Patients who sought care in the first trimester reported more financial needs than those who sought care in the second (p = .02) or the third (p = .049). Hispanic patients who sought care in the first trimester reported more monetary needs than those who sought care in the second trimester (p = .048), and non-Hispanic patients who sought care in the first trimester reported greater family and home needs than those who sought care in the second trimester (p = .47). Those who experienced stress were 3.07 times as likely to seek care after the first trimester as those who reported no stress. CHC may reduce social risk among poor and underserved communities by reducing barriers to access to care.
Alteration of Gene Expression in Pathological Keratinization of the Ocular Surface
Yoshioka H, Ueta M, Fukuoka H, Yokoi N, Mizushima K, Naito Y, Kinoshita S and Sotozono C
To investigate the molecular mechanism of pathological keratinization in the chronic phase of ocular surface (OS) diseases.
Refractory pure red cell aplasia associated with T-cell large granular lymphocyte leukemia treated by ruxolitinib
Gong Y, Li Y, Chen X, Yang H, Zhang Y, He G and Fan L
Acquired pure red cell aplasia (PRCA) is a rare syndrome characterized by normocytic normochromic anemia with severe reticulocytopenia and absence of erythroid precursors in the bone marrow. For refractory PRCA patients, the low response rate and high toxicity of alternative therapies pose a great challenge. T-cell large granular lymphocyte (T-LGL) leukemia is one of the most common conditions in secondary PRCA and also the most difficult form to manage with an inferior treatment response to other secondary PRCA forms. T-LGL leukemia exhibits sustained activation of the intracellular JAK-STAT signaling pathway. We herein report a case of PRCA associated with T-LGL leukemia that had been refractory to multiple lines of therapies and was successfully treated by ruxolitinib. The patient achieved complete remission and tolerated ruxolitinib well without occurrence of neutropenia or thrombocytopenia. This preliminary finding favors ruxolitinib as a potential salvage therapy for refractory PRCA associated with T-LGL leukemia.
Adjudication of Low-Flow, Low-Gradient Aortic Stenosis Severity: Dobutamine Stress Echocardiography and MSCT Are Complementary, Not Competitive
Clavel MA and Pibarot P
Comparison of intraocular pressure measurements with the tono-pen, goldmann applanation tonometer, and noncontact tonometer in nonglaucomatous pseudophakic children
Oskan Yalcın S and Kaplan AT
To evaluate the agreement between the Goldman applanation tonometer (GAT), Tono-Pen, and noncontact tonometer (NCT) in the measurement of intraocular pressure (IOP) in pseudophakic children.
Intraindividual Comparison of Dose Reduction and Coronary Calcium Scoring Accuracy Using Kilovolt-independent and Tin Filtration CT Protocols
Zook S, Tayal B, Kragholm K, Abdelkarim O, Tran D, Cocker M, Ramirez-Giraldo JC, Hallam K, Sexton C, Johnson S and Chang SM
Purpose To investigate the ability of kilovolt-independent (hereafter, kV-independent) and tin filter spectral shaping to accurately quantify the coronary artery calcium score (CACS) and radiation dose reductions compared with the standard 120-kV CT protocol. Materials and Methods This prospective, blinded reader study included 201 participants (mean age, 60 years ± 9.8 [SD]; 119 female, 82 male) who underwent standard 120-kV CT and additional kV-independent and tin filter research CT scans from October 2020 to July 2021. Scans were reconstructed using a Qr36f kernel for standard scans and an Sa36f kernel for research scans simulating artificial 120-kV images. CACS, risk categorization, and radiation doses were compared by analyzing data with analysis of variance, Kruskal-Wallis test, Mann-Whitney test, Bland-Altman analysis, Pearson correlations, and κ analysis for agreement. Results There was no evidence of differences in CACS across standard 120-kV, kV-independent, and tin filter scans, with median CACS values of 1 (IQR, 0-48), 0.6 (IQR, 0-58), and 0 (IQR, 0-51), respectively ( = .85). Compared with standard 120-kV scans, kV-independent and tin filter scans showed excellent correlation in CACS values ( = 0.993 and = 0.999, respectively), with high agreement in CACS risk categorization (κ = 0.95 and κ = 0.93, respectively). Standard 120-kV scans had a mean radiation dose of 2.09 mSv ± 0.84, while kV-independent and tin filter scans reduced it to 1.21 mSv ± 0.85 and 0.26 mSv ± 0.11, cutting doses by 42% and 87%, respectively ( < .001). Conclusion The kV-independent and tin filter research CT acquisition techniques showed excellent agreement and high accuracy in CACS estimation compared with standard 120-kV scans, with large reductions in radiation dose. CT, Cardiac, Coronary Arteries, Radiation Safety, Coronary Artery Calcium Score, Radiation Dose Reduction, Low-Dose CT Scan, Tin Filter, kV-Independent © RSNA, 2024.
Association of NID2 SNPs with Glioma Risk and Prognosis in the Chinese Population
Hao J, Huang C, Zhao W, Zhao L, Hu X, Zhang W, Guo L, Dou X, Jin T and Hu M
Glioma is the most common primary intracranial tumor with high mortality and poor prognosis. The purpose of this study was to investigate how single-nucleotide polymorphisms (SNPs) of the NID2 gene affect glioma risk and prognosis. Four candidate SNPs of NID2 in 529 glioma patients and 478 healthy controls were successfully genotyped by Agena MassARRAY mass spectrometer. Logistic regression was utilized to assess the associations between NID2 SNPs and glioma risk under different genetic models. Furthermore, the relationship between risk-related SNPs in NID2 and the prognosis of glioma patients was explored through Kaplan-Meier (KM) survival curve and Cox proportional hazard regression analysis. The results showed that rs11846847 (OR 1.24, p = 0.017) and rs1874569 (OR 1.22, p = 0.026) were significantly associated with an increased risk of glioma, and rs11846847 also had a risk-increasing effect on glioma in participants ≤ 40 years old. The interaction model of rs11846847 and rs1874569 could be more suitable for forecasting glioma risk. We also discovered a significant association between rs1874569 and poor prognosis in glioma patients (HR 1.32, p = 0.039) and especially CC genotype was relevant to shorter overall survival (OS) and progression-free survival (PFS) in patients with high-grade glioma. Additionally, the study demonstrated that gross total resection or chemotherapy improve glioma prognosis in the Chinese Han population. This study is the first to provide evidence for the association of NID2 SNPs with glioma risk and prognosis, suggesting that NID2 variants might be potential factors for glioma.
Remote Monitoring App for Endocrine Therapy Adherence Among Patients With Early-Stage Breast Cancer: A Randomized Clinical Trial
Graetz I, Hu X, Kocak M, Krukowski RA, Anderson JN, Waters TM, Curry AN, Robles A, Paladino A, Stepanski E, Vidal GA and Schwartzberg LS
Adjuvant endocrine therapy (AET) use among women with early-stage, hormone receptor-positive breast cancer reduces the risk of cancer recurrence, but its adverse symptoms contribute to lower adherence.
The limitations of evidence-based medicine compel the practice of personalized medicine
Einav S and O'Connor M
Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer
Abboretti F, Mantziari S, Didisheim L, Schäfer M and Teixeira Farinha H
Perioperative chemotherapy combined with surgical resection represent the gold standard in the treatment of locally advanced gastric cancer. The Mandard tumor regression score (TRG) is widely used to evaluate pathological response to neoadjuvant treatment. The aim of this study was to assess the prognostic value of TRG in terms of overall survival (OS) and disease-free (DFS).
The relation of recurrent laryngeal nerve to inferior thyroid artery and extralaryngeal nerve branching may increase the risk of vocal cord paralysis in thyroidectomy
Aygun N, Unlu MT, Caliskan O, Kostek M, Isgor A and Uludag M
The anatomical variations of the recurrent laryngeal nerve (RLN) are common during thyroidectomy. We aimed to evaluate the risk of RLN paralysis in case of its anatomical variations, retrospectively.
Effects of parenteral nutrition + best supportive nutritional care vs. best supportive nutritional care alone on quality of life in patients with pancreatic cancer-a secondary analysis of PANUSCO
Emanuel A, Rosenberger F, Krampitz J, Decker-Baumann C, Märten A, Jäger D and Rötzer I
Parenteral nutrition (PN) can be an effective treatment to improve the nutritional status of patients with pancreatic cancer, but the effects of PN on quality of life (QoL) are still understudied. Therefore, we aimed at investigating whether the best supportive nutritional care (BSNC) in combination with PN at home compared to BSNC alone changed QoL in patients with advanced pancreatic cancer undergoing chemotherapy over a period of 7 weeks.
Biogenic metallic nanoparticles: from green synthesis to clinical translation
Shah DD, Chorawala MR, Mansuri MKA, Parekh PS, Singh S and Prajapati BG
Biogenic metallic nanoparticles (NPs) have garnered significant attention in recent years due to their unique properties and various applications in different fields. NPs, including gold, silver, zinc oxide, copper, titanium, and magnesium oxide NPs, have attracted considerable interest. Green synthesis approaches, utilizing natural products, offer advantages such as sustainability and environmental friendliness. The theranostics applications of these NPs hold immense significance in the fields of medicine and diagnostics. The review explores intricate cellular uptake pathways, internalization dynamics, reactive oxygen species generation, and ensuing inflammatory responses, shedding light on the intricate mechanisms governing their behaviour at a molecular level. Intriguingly, biogenic metallic NPs exhibit a wide array of applications in medicine, including but not limited to anti-inflammatory, anticancer, anti-diabetic, anti-plasmodial, antiviral properties and radical scavenging efficacy. Their potential in personalized medicine stands out, with a focus on tailoring treatments to individual patients based on these NPs' unique attributes and targeted delivery capabilities. The article culminates in emphasizing the role of biogenic metallic NPs in shaping the landscape of personalized medicine. Harnessing their unique properties for tailored therapeutics, diagnostics and targeted interventions, these NPs pave the way for a paradigm shift in healthcare, promising enhanced efficacy and reduced adverse effects.
Effect of Lead Exposure and Lifestyle Factors on Methylation Index Markers Among Pb-Exposed Workers
Adepu VK, Kumar HSS, Ravibabu K and Nagaraju R
S-Adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) and the ratio of SAM and SAH in Pb-exposed workers need to be assessed. In this study, we investigated the effects of Pb exposure on SAM, SAH, and methylation index (MI) in Pb-exposed workers with contemplation of lifestyle factors. Blood lead levels (BLLs), SAM, SAH, MI, and lifestyle factors were assessed in 338 male Pb-exposed workers. BLLs are estimated by ICP-OES method. SAM and SAH levels in serum were determined by ELISA method. The MI was calculated using SAM and SAH individual values. The lifestyle factors were collected using standard questionnaire. Levels of SAM and MI were significantly decreased with increased age, experience > 5 years, habits of tobacco chewing, smoking, alcohol consumption, and BLLs 10-30, 30-50, and > 50 µg/dL. Levels of SAH were significantly increased with increased age, habits of tobacco chewing and smoking, and BLLs 10-30, 30-50, and > 50 µg/dL. The association between BLLs and methylation index markers (SAM and MI) was reported as negative and significant. The association between BLLs and SAH was noted positive and significant. The influence of BLLs and lifestyle factors on SAM was noted at 12%, SAH at 35%, and MI at 27%, respectively. The highest percentage of influence was noted in SAH, followed by MI and SAM. In the workers exposed to Pb, lifestyle factors resulted in decreased SAM and MI and increased SAH levels. Adaptation of healthy lifestyle factors, personal hygiene practices, and use of PPE were suggested to minimize the reduction of methylation index markers.
Varenicline and Nicotine Replacement Therapy for Smokers Admitted to Hospitals: A Randomized Clinical Trial
Weeks GR, Gobarani RK, Abramson MJ, Bonevski B, Webb A, Thomas D, Paul E, Sarwar MR, Smith BJ, Perinpanathan S, Kirsa S, Parkinson J, Meanger D, Coward L, Rofe O, Lee P, van den Bosch D and George J
Varenicline is the most effective sole pharmacotherapy for smoking cessation. If used in combination with nicotine replacement therapy (NRT), cessation rates may be further improved, but the efficacy and safety of the combination need to be evaluated.
Paternal intelligence affects school grades in children with and without ADHD - a register-based study
Markkula A, Igelström K, Zhang H and Capusan AJ
ADHD profoundly impacts educational attainment, quality of life, and health in young adults. However, certain subgroups of ADHD patients seem to do quite well, potentially due to differences in intelligence and socioeconomic status. Here we used paternal intelligence from the Swedish Defence Conscription and Assessment register, to investigate the role of genetic propensity for intelligence, on school performance in a large cohort of ADHD patients and matched controls. Patients treated for ADHD in Linköping, Sweden between 1995 and 2020 (n = 3262), sex- and age-matched controls (n = 9591) as well as their parents and siblings were identified using regional and national registers. Socioeconomic and demographic data, ADHD diagnosis and treatment and school grades at age 16 for the study population were extracted from Swedish National registers. We explored the associations between paternal intelligence and child school performance using linear mixed models and mediation analyses, taking a wide range of potential covariates into account. Results indicate that paternal intelligence was positively associated with standardized school grades in their offspring (Z=0.09, 95%CI 0.07, 0.10). This effect was present in both ADHD patients and controls, but ADHD patients had significantly lower standardized grades (Z=-1.03, 95%CI -1.08, -0.98). Child ADHD did not serve as a mediator for how paternal intelligence affected school grades. Our findings indicate that ADHD prevents children from reaching their academic potential at all levels of paternal intelligence. Increased understanding of the contributions of ADHD, intelligence, and SES to functional outcomes can help clinicians to better personalize interventions to the unique preconditions in each patient.
Risk factors for corneal graft rejection after penetrating keratoplasty for keratoconus
Alsubaie H, Alrubaian A, Ahmad K and Ahad MA
To evaluate the association between donor-related factors and the risk of rejection in patients undergoing penetrating keratoplasty (PKP) for keratoconus.
The association between immune cells and breast cancer: insights from mendelian randomization and meta-analysis
Xu W, Zhang T, Zhu Z and Yang Y
Breast cancer (BC) is the most common cancer among women worldwide, with 2.3 million new cases and 685,000 deaths annually. It has the highest incidence in North America, Europe, and Australia and lower rates in parts of Asia and Africa. Risk factors include age, family history, hormone replacement therapy, obesity, alcohol consumption, and lack of physical activity. BRCA1 and BRCA2 gene mutations significantly increase the risk. The five-year survival rate is over 90% in developed countries but lower in developing ones. Early screening and diagnosis, using mammography and MRI, are crucial for reducing mortality. In recent years, significant progress has been made in studying BC immunophenotyping, particularly in multicolor flow cytometry, molecular imaging techniques, and tumor microenvironment analysis. These technologies improve diagnosis, classification, and detection of minimal residual disease. Novel immunotherapies targeting the tumor microenvironment, like CAR-T cell therapy, show high efficiency and fewer side effects. High levels of tumor-infiltrating lymphocytes (TILs) correlate with better prognosis, while immune checkpoint molecules (PD-1, PD-L1) help cancer cells evade the immune system. Tumor-associated macrophages (TAMs) promote invasion and metastasis. Blocking molecules like CTLA-4, LAG-3, and TIM-3 enhance anti-tumor responses, and cytokines like IL-10 and TGF-β aid tumor growth and immune evasion. Mendelian randomization (MR) studies use genetic variants to reduce confounding bias and avoid reverse causation, providing robust causal inferences about immune cell phenotypes and BC. This approach supports the development of precision medicine and personalized treatment strategies for BC.
Advanced Energy Harvesters and Energy Storage for Powering Wearable and Implantable Medical Devices
Gao Z, Zhou Y, Zhang J, Foroughi J, Peng S, Baughman RH, Wang ZL and Wang CH
Wearable and Implantable Active Medical Devices (WIMDs) are transformative solutions for improving healthcare, offering continuous health monitoring, early disease detection, targeted treatments, personalized medicine, and connected health capabilities. Commercialized WIMDs use primary or rechargeable batteries to power their sensing, actuation, stimulation, and communication functions, and periodic battery replacements of implanted active medical devices pose major risks of surgical infections or inconvenience to users. Addressing the energy source challenge is critical for meeting the growing demand of the WIMD market that is reaching valuations in the tens of billions of dollars. This review presents a critical assessment of recent advances in energy harvesting and storage technologies that can potentially eliminate the need for battery replacements. With a key focus on advanced materials that can close the gaps between WIMDs' energy needs and the energy that can harnessed by energy harvesters, this review examines the crucial roles of advanced materials in improving the efficiencies of energy harvesters, wireless charging, and energy storage devices. This review concludes by highlighting the key challenges and opportunities in advanced materials necessary to achieve the vision of wearable and implantable active medical devices that are self-powered, eliminating the risks associated with surgical battery replacement and the inconvenience of frequent manual recharging. This article is protected by copyright. All rights reserved.
Forecasting Myopic Maculopathy Risk Over a Decade: Development and Validation of an Interpretable Machine Learning Algorithm
Chen Y, Yang S, Liu R, Xiong R, Wang Y, Li C, Zheng Y, He M and Wang W
The purpose of this study was to develop and validate prediction model for myopic macular degeneration (MMD) progression in patients with high myopia.
Weight change patterns across adulthood are associated with the risk of osteoarthritis: a population-based study
Cui A, Zhang J, Deng H, Wei X, Zhuang Y and Wang H
Body weight has been recognized as a driving factor of osteoarthritis. Few studies had investigated the association between weight status across adulthood and risk of osteoarthritis (OA). This study investigates the association of weight change patterns across adulthood (lasting at least 25 years) with the risk of OA from the National Health and Nutrition Examination Survey (NHANES) 2013-2018.
Unveiling Statins and Genetics in Age-Related Macular Degeneration: The Coimbra Eye Study-Report 9
Barreto P, Farinha C, Coimbra R, Cachulo ML, Melo JB, Lechanteur Y, Hoyng CB, Cunha-Vaz J and Silva R
To assess the association of age-related macular degeneration (AMD) progression and statins, connected with AMD genetic risk, and if there is an interplay between statins and genetics.
Radiomics and artificial intelligence applications in pediatric brain tumors
Pacchiano F, Tortora M, Doneda C, Izzo G, Arrigoni F, Ugga L, Cuocolo R, Parazzini C, Righini A and Brunetti A
The study of central nervous system (CNS) tumors is particularly relevant in the pediatric population because of their relatively high frequency in this demographic and the significant impact on disease- and treatment-related morbidity and mortality. While both morphological and non-morphological magnetic resonance imaging techniques can give important information concerning tumor characterization, grading, and patient prognosis, increasing evidence in recent years has highlighted the need for personalized treatment and the development of quantitative imaging parameters that can predict the nature of the lesion and its possible evolution. For this purpose, radiomics and the use of artificial intelligence software, aimed at obtaining valuable data from images beyond mere visual observation, are gaining increasing importance. This brief review illustrates the current state of the art of this new imaging approach and its contributions to understanding CNS tumors in children.
Enhancing the Preanesthesia Evaluation: Consensus Development of the Cannabis Use and Behaviors Assessment Tool (CUBAT)
Sladkey N, King DD and Reede LJ
This project aimed to develop an evidence-based preanesthesia cannabis use assessment tool to acquire complete and accurate patient history and develop a best-informed, individualized anesthesia and analgesia care plan.
The social factors behind the mask: contextual effects on trait impressions from faces wearing a face mask
Tumino M, Carraro L and Castelli L
The presence of face masks can significantly impact processes related to trait impressions from faces. In the present research, we focused on trait impressions from faces either wearing a mask or not by addressing how contextual factors may shape such inferences. In Study 1, we compared trait impressions from faces in a phase of the COVID-19 pandemic in which wearing masks was a normative behavior (T1) with those assessed one year later when wearing masks was far less common (T2). Results at T2 showed a reduced positivity in the trait impressions elicited by faces covered by a mask. In Study 2, it was found that trait impressions from faces were modulated by the background visual context in which the target face was embedded so that faces wearing a mask elicited more positive traits when superimposed on an indoor rather than outdoor visual context. Overall, the present studies indicate that wearing face masks may affect trait impressions from faces, but also that such impressions are highly flexible and can significantly fluctuate across time and space.
Long-Term Changes in Atrial Arrhythmia Burden After Renal Denervation Combined With Pulmonary Vein Isolation: SYMPLICITY-AF
Chinitz L, Böhm M, Evonich R, Saba S, Sangriogoli R, Augostini R, O'Neill PG, Fellows C, Kim MY, Hettrick DA, Viktorova E and Ukena C
The autonomic nervous system plays an important role in atrial fibrillation (AF) and hypertension. Renal denervation (RDN) lowers blood pressure (BP), but its role in AF is poorly understood.
Pure Apocrine Intraductal Carcinoma of Salivary Glands: Reassessment of Molecular Underpinnings and Behavior
Delfin L, Doff JJ, Gagan J, Flack A, Krane JF, Jo VY, Torell AG, Palsgrove D and Bishop JA
Intraductal carcinoma (IDC) of the salivary glands is a confounding entity, our understanding of which continues to evolve. At least four forms have been elucidated based on histomorphology, immunophenotype, and molecular profile: (1) intercalated duct-like, S100/SOX10+ with frequent NCOA4::RET fusions; (2) oncocytic, S100/SOX10+ with TRIM33::RET, NCOA4::RET, and BRAF V600E; (3) apocrine, AR+ with PI3 kinase pathway mutations; and (4) mixed/hybrid intercalated duct-like/apocrine, with S100/SOX10+ and AR+ areas and frequent TRIM27::RET. The revelation that myoepithelial cells harbor the same fusion as luminal cells suggested that fusion-positive cases are not in situ carcinomas as previously believed. To this point, purely apocrine IDC with entirely intraductal growth has not been found to harbor fusions, but very few cases have been tested.
2-Year Outcomes of an Atrial Shunt Device in HFpEF/HFmrEF: Results From REDUCE LAP-HF II
Gustafsson F, Petrie MC, Komtebedde J, Swarup V, Winkler S, Hasenfuß G, Borlaug BA, Mohan RC, Flaherty JD, Sverdlov AL, Fail PS, Chung ES, Lurz P, Lilly S, Kaye DM, Cleland JGF, Cikes M, Leon MB, Cutlip DE, van Veldhuisen DJ, Solomon SD and Shah SJ
The REDUCE LAP-HF II (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure II) trial found that, compared with a sham procedure, the Corvia Atrial Shunt did not improve outcomes in heart failure with preserved or mildly reduced ejection fraction. However, after 12-month follow-up, "responders" (peak-exercise pulmonary vascular resistance <1.74 WU and absence of a cardiac rhythm management device) were identified.
Longitudinal prediction of psychosocial functioning outcomes: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section-II personality disorders versus alternative model personality dysfunction and traits
Clark LA, Ro E, Vittengl JR and Jarrett RB
We aimed to determine and compare the longitudinal predictive power of ) two models of personality disorder (PD) for multiple clinically relevant outcomes. A sample of 600 community-dwelling adults-half recruited by calling randomly selected phone numbers and screening-in for high-risk for personality pathology and half in treatment for mental health problems-completed an extensive battery of self-report and interview measures of personality pathology, clinical symptoms, and psychosocial functioning. Of these, 503 returned for retesting on the same measures an average of 8 months later. We used Time 1 interview data to assess personality pathology, both the Section-II PDs and the alternative () model of personality disorder's (AMPD) Criterion A (impairment) and Criterion B (adaptive-to-maladaptive-range trait domains and facets). We used these measures to predict 20 Time 2 functioning outcomes. Both PD models significantly predicted functioning-outcome variance, albeit modestly-averaging 12.6% and 17.9% (Section-II diagnoses and criterion counts, respectively) and 15.2% and 23.2% (AMPD domains and facets, respectively). Each model significantly augmented the other in hierarchical regressions, but the AMPD domains (6.30%) and facets (8.62%) predicted more incremental variance than the Section-II diagnoses (3.74%) and criterion counts (3.31%), respectively. Borderline PD accounted for just over half of Section II's predictive power, whereas the AMPD's predictive power was more evenly distributed across components. We note the predictive advantages of dimensional models and articulate the theoretical and clinical advantages of the AMPD's separation of personality functioning impairment from how this is manifested in personality traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Improving the Acceptability and Implementation of Information and Communication Technology-Based Health Care Platforms for Older People With Dementia or Parkinson Disease: Qualitative Study Results of Key Stakeholders
Ahmed M, Marín M, Gangas P, Bentlage E, Louro C and Brach M
The management of neurodegenerative diseases (NDDs) in older populations is usually demanding and involves care provision by various health care services, resulting in a greater burden on health care systems in terms of costs and resources. The convergence of various health services within integrated health care models, which are enabled and adopted jointly with information and communication technologies (ICTs), has been identified as an effective alternative health care solution. However, its widespread implementation faces formidable challenges. Both the development and implementation of integrated ICTs are linked to the collaboration and acceptance of different groups of stakeholders beyond patients and health care professionals, with reported discrepancies in the needs and preferences among these groups.
Interdependent versus independent inconsistency: Cultural differences in how East Asian and Western people attribute hypocrisy
Seo M, Watanabe S, Kim YH and Laurent SM
Humans worldwide have long deplored hypocrisy, a concept that has been mentioned in texts dating back 100-1,000 years (e.g., the Analects of Confucius, the Tao Te Ching, the Bible, and the Qur'an). However, what influences the extent of hypocrisy attribution or counts as hypocrisy may differ as a function of culture. Previous studies have shown that Westerners attribute greater hypocrisy for within-person attitude-behavior inconsistency than East Asians. Building on this, we predict that East Asians' (vs. Westerners') hypocrisy attribution is more heavily influenced by social relationships. Consistent with past research, this can lead to greater leniency. However, as we show, this can also result in the novel finding we present that attributions of mild-to-moderate hypocrisy are made even when no explicit within-person attitude-behavior inconsistency is present. Across six experiments, we found that Koreans (vs. participants from the United States) attributed more hypocrisy to attitude-contradicting behavior when the person enacting the behavior was not the person who stated the attitude but was someone who shared social bonds with that person (i.e., cross-person, within-relationship attitude-behavior inconsistency; "relational hypocrisy"). Specifically, Koreans attributed more hypocrisy than Americans when a child's behavior contradicted their parent's views (Experiments 1a and 1b) or when attitude-contradicting behavior was enacted by the child of a close friend (Experiment 2). Experiments 3-5 replicated the findings from Experiments 1-2 using additional social contexts (e.g., a spousal relationship). Supplementary analyses showed that differences in hypocrisy attribution between Americans and Koreans were mediated by cultural differences in their perceptions of shared responsibility within relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Robotic surgery versus conventional laparoscopy in sigmoid colectomy for diverticular disease-a comparison of operative trauma and cost-effectiveness: retrospective, single-center analysis
Presl J, Ehgartner M, Schabl L, Singhartinger F, Gantschnigg A, Wallner E, Jäger T, Emmanuel K, Kessler H and Koch OO
Robotic assisted surgery is an alternative, fast evolving technique for performing colorectal surgery. The primary aim of this single center analysis is to compare elective laparoscopic and robotic sigmoid colectomies for diverticular disease on the extent of operative trauma and the costs.
Prevalence of Gender-Affirming Surgical Procedures Among Minors and Adults in the US
Dai D, Charlton BM, Boskey ER, Hughes LD, Hughto JMW, Orav EJ and Figueroa JF
First psychometric evaluation of the Level of Personality Functioning Scale-Brief Form 2.0 in adolescents
Wu J, Allman M, Balzen K, Hutsebaut J and Sharp C
Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology such as the level of personality functioning (LPF) of the alternative model for personality disorders, it is important to have validated measures that can assess LPF in young people. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is the briefest measure of LPF and may be particularly well suited for assessing LPF in youth; however, it has yet to be formally validated in youth. Therefore, the current investigation evaluated the psychometric properties of the LPFS-BF 2.0 in adolescents drawn from a community sample of ethnically diverse North American youth ( = 194, age 12-18; 58% female). Factor structure, gender invariance, reliability, convergent validity, incremental validity, and criterion validity were evaluated. Results demonstrated support for the LPFS-BF 2.0's unidimensional factor structure, as well as high internal consistency. Configural, metric, and scalar measurement invariance was supported across male and female genders, as well as convergent validity. Relative to the Personality Inventory for the DSM-5 Brief Form and Levels of Personality Functioning Questionnaire 12-18, the LPFS-BF 2.0 demonstrated additional variance in predicting borderline personality features, and internalizing and externalizing problems. Study findings support the English version of the LPFS-BF 2.0 as a brief and psychometrically sound instrument for assessing LPF in youth and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Comparison between umbilical and right upper transverse abdominal incisions for pyloromyotomy: a systematic review and meta-analysis
Khandelia H, Krishnan N, Kainth D, Verma A, Anand S and Agarwala S
The aim of this study was to compare the operative parameters and complication rates between the umbilical (UMB) and right upper quadrant (RUQ) skin incisions for Ramstedt's pyloromyotomy for the treatment of infantile hypertrophic pyloric stenosis (IHPS). PubMed, EMBASE, Web of Science and Scopus databases were systematically searched. The studies where any one of the main outcomes of interest, i.e., operative time, wound infection rate, mucosal perforation rate were reported were eligible for inclusion. The statistical analysis was performed using a random-effects model. The methodological quality of the studies was assessed utilizing the Newcastle-Ottawa Scale. Fifteen studies comprising 2964 infants were included. As compared to the UMB group, the RUQ group showed a significantly lower mean operative time (p = 0.0004), wound infection rate (p < 0.0001) and mucosal perforation rate (p = 0.02). Although UMB incision produces an almost undetectable scar, this approach results in significantly more complications. Therefore, the risks and benefits must be weighed and discussed with the caregivers in deciding the surgical approach in patients with IHPS. However, due to a poor methodological quality of nine out of fifteen studies, further studies need to be conducted for an optimal comparison between the two groups.
Personalized therapy in oncology: melanoma as a paradigm for molecular-targeted treatment approaches
Kim KB
In recent decades, the field of systemic cancer treatment has seen remarkable changes due to advancements in the understanding of cancer's biology, immunology, and genetic makeup. As a result, individuals with late-stage cancers are now achieving survival rates that were previously unattainable. The goal of personalized cancer therapy is to enhance clinical outcomes by customizing drug treatments to suit the unique genetic and/or epigenetic profiles of each patient's tumor. This approach aims to reduce the side effects commonly associated with ineffective treatments. Advances in genetic sequencing and molecular cytogenetics have been instrumental in identifying cancer-driving mutations and epigenetic irregularities, leading to the development of specific molecular therapies. This review article highlights the progress and success of targeted molecular therapies in treating malignant melanoma, illustrating the concept of personalized cancer treatment.
A New Method for Low Density Distribution Modeling and Near Threatened Species: The Study Case of Plectrohyla Guatemalensis
Ballesteros M, Díaz-Avalos C, Hernández O and Garro G
We introduce a model that can be used for the description of the distribution of species when there is scarcity of data, based on our previous work (Ballesteros et al. J Math Biol 85(4):31, 2022). We address challenges in modeling species that are seldom observed in nature, for example species included in The International Union for Conservation of Nature's Red List of Threatened Species (IUCN 2023). We introduce a general method and test it using a case study of a near threatened species of amphibians called Plectrohyla Guatemalensis (see IUCN 2023) in a region of the UNESCO natural reserve "Tacaná Volcano", in the border between Mexico and Guatemala. Since threatened species are difficult to find in nature, collected data can be extremely reduced. This produces a mathematical problem in the sense that the usual modeling in terms of Markov random fields representing individuals associated to locations in a grid generates artificial clusters around the observations, which are unreasonable. We propose a different approach in which our random variables describe yearly averages of expectation values of the number of individuals instead of individuals (and they take values on a compact interval). Our approach takes advantage of intuitive insights from environmental properties: in nature individuals are attracted or repulsed by specific features (Ballesteros et al. J Math Biol 85(4):31, 2022). Drawing inspiration from quantum mechanics, we incorporate quantum Hamiltonians into classical statistical mechanics (i.e. Gibbs measures or Markov random fields). The equilibrium between spreading and attractive/repulsive forces governs the behavior of the species, expressed through a global control problem involving an energy operator.
Longitudinal associations between posttraumatic stress disorder, separation anxiety, and rumination among adolescents: Disentangling within-person and between-person associations
Ye Y, Li Y, Wu X and Zhou X
Posttraumatic stress disorder (PTSD) and separation anxiety often show high comorbidity after trauma, which complicates the course of disease and treatment response. However, it is unclear how PTSD and separation anxiety comorbidity occur. According to the cognitive model of PTSD, rumination may be a key cognitive process linking the two constructs. Thus, this study aimed to examine the relation between PTSD and separation anxiety and to assess the mediating role of rumination in this relation among adolescents after trauma.
Treatment of telangiectasias with a 595-nm pulsed dye laser following hemangioma involution: a retrospective analysis
Wu JP, Zhang L and Ge HS
Telangiectasias are the most frequent type of sequelae of infantile hemangiomas after involution. Few studies have reported the treatment of telangiectasias with 595-nm pulsed dye lasers. Therefore, the objective of this study was to assess the efficacy and safety of a 595-nm pulsed dye laser for treating residual telangiectasias following hemangioma involution. This is a retrospective case series that analyzes the medical records and reviews the charts of 22 patients who had undergone 595-nm pulsed dye laser treatment for residual telangiectasias. Pre- and post-treatment digital images were independently assessed, and the changes were scored to ascertain the efficacy of the treatment (0 = no change, 4 = complete improvement). Of the 22 patients, 59.1% experienced complete resolution of telangiectasias following treatment. No serious complications or side effects were reported. The observations indicate that the 595-nm pulsed dye laser is effective and safe for treating residual telangiectasias following hemangioma involution.
"Caught between two worlds": Managing identity in bisexual fatherhood
Matthews M, Bower-Brown S and Imrie S
Bisexuality in fatherhood is largely invisible, with very little known about the experiences of bisexual fathers. Conducted by researchers in the United Kingdom, this study is one of the first to explore the experiences of bisexual fathers, and, using an identify-focused approach, it aims to understand bisexual fathers' experiences of managing their bisexuality and role as a father. Twenty-four bisexual fathers in Europe and North America took part in qualitative, semistructured interviews that focused on their bisexual identity, becoming a parent, experiences of family life, and community involvement. Reflexive thematic analysis was conducted, and four themes were identified: valuing different types of authenticity, seeking safety in the community, reconciling bisexuality with the traditional family, and sharing and learning across age groups. Despite describing their identity as often invisible, fathers indicated that their personal identity had a significant impact on their social interactions as well as their individual parenting and family practices. Findings contrast stage models of LGBTQ+ identity development, as fathers' identity work practices were often more important for their identity development and integration than aspiring for full "outness." Findings expand our scholarly understanding of the role of identity in parenting and highlight the need to improve representation and support for bisexual fathers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Clinicians' Perspectives on the Telehealth Serious Illness Care Program for Older Adults With Myeloid Malignancies: Single-Arm Pilot Study
LoCastro M, Wang Y, Yu T, Mortaz-Hedjri S, Mendler J, Norton S, Bernacki R, Carroll T, Klepin H, Wedow L, Goonan S, Erdos H, Bagnato B, Liesveld J, Huselton E, Kluger B and Loh KP
Serious illness conversations may help patients avoid unwanted treatments. We previously piloted the telehealth Serious Illness Care Program (SICP) for older adults with acute myeloid leukemia and myelodysplastic syndrome.
Tension between continuous and deep sedation and assistance in dying: a national survey of intensive care professionals' perceptions
Auffray L, Mora P, Giabicani M, Engrand N, Audibert G, Perrigault PF, Fazilleau C, Gravier-Dumonceau R and Le Dorze M
The situation in France is unique, having a legal framework for continuous and deep sedation (CDS). However, its use in intensive care units (ICU), combined with the withdrawal of life-sustaining therapies, still raises ethical issues, particularly its potential to hasten death. The legalization of assistance in dying, i.e., assisted suicide or euthanasia at the patient's request, is currently under discussion in France. The objectives of this national survey were first, to assess whether ICU professionals perceive CDS administered to ICU patients as a practice that hastens death, in addition to relieving unbearable suffering, and second, to assess ICU professionals' perceptions of assistance in dying.
Ludwig's Angina During Pregnancy-A Case Report
Balaji VCR and Vani K
Pregnancy is accompanied by several physiological changes such as altered salivary flow rate, mucosal immunity and altered microbial flora. This may predispose pregnant women to oral health problems. This could be accentuated by oral health neglect, polypharmacy and a host of other factors, including dietary modification. However, a very significant percentage of women are not counselled on oral health during pregnancy. Lack of proper oral healthcare and awareness predispose pregnant women to oral and odontogenic infections, which can lead to severe complications. The manuscript aims to present a rare case of Ludwig's angina (LA) in a full-term pregnant woman requiring immediate attention.
Maxillomandibular Fusion Along with Fusion of Dorsal Surface of the Tongue to the Hard Palate-A Case Report
Balaji SM, Munnee K, Balaji P, Chellaraj CJ, Nishanth S and Balaji VCR
This case report presents a rare combination of congenital anomalies in an otherwise healthy male infant born at 36 weeks. The infant was diagnosed with congenital maxillomandibular synechia, ectrodactyly, and ankyloglossia superior syndrome (ASS).
Gout Arthritis of Temporomandibular Joint - A Rare Case Report and Review of Literature
Kumar N, Jyotsana K, Srinivasa Raju M and Bhagawati BT
Gout is a metabolic disorder that leads to elevated serum uric acid levels and deposition of urate crystals in the joints. The disease is usually confined to the joint space and leads to pain and limitation of jaw opening. The case describes a 45-year-old female patient with a chief complaint of 'occasional pain in the left temporal muscle region'. The case disclosed a gout manifestation in the temporomandibular joint (TMJ) after physical and radiographic findings. Gout manifestation in the TMJ is an unusual presentation and a few reports in the English literature address the subject. Gout in the TMJ should be included as a differential diagnosis for joint disorders because of its rarity. A clinician may overlook gout involving the TMJ in the differential diagnosis of facial pain even when the patient has received a diagnosis of gout in other joints.
Management of Broken Screw Inside Implant Screw Channel: A Case Report
Azim SA, Aldrissi HA, Annamma LM and Warreth A
This case report outlines a novel prosthodontic approach for managing a broken screw inside an implant screw channel, emphasising the importance of innovative solutions in implant dentistry.
Autologous Concentrate Growth Factor for the Treatment of Endo-Perio Lesion - A Case Report
Aggarwal P and Singh V
The success of a combined periodontal and endodontic lesion depends on the elimination of both these disease processes. In the case of a combined endo-perio lesion, endodontic therapy results in healing of the endodontic component of involvement, while the prognosis of teeth would finally depend on the healing of the periodontal structure.
Prostate Metastasis in Oral Malignant Melanoma - A Case Report
Muthukumaran V, Warrier SA, Balaji B, Elengkumaran S, Thamizhchelvan H and Divyambika CV
Melanoma is the ninth most prevalent and the second most lethal tumour. The aetiology and pathogenesis remain uncertain. It occurs in elderly people, over the fifth decade, and is predominant in males. Clinically, they present as an asymptomatic macular or nodular growth. The prognosis is impacted by the size of the tumour and distant metastases. Patients with distant metastases have a 5-year survival rate of less than 30%, constituting metastasis as the major cause of melanoma-related fatality. Currently, the mainstay of treatment for metastatic melanoma is immunotherapy due to the inoperable state, radioresistant nature of the tumour and high chances of cytotoxicity in chemotherapy. A senile male patient, who was diagnosed with oral malignant melanoma of the maxillary buccopalatal gingiva with distant metastasis to the liver and the prostate, is reported here. Although metastasis to the liver is common among malignant melanomas, in this case metastasis to the prostate gland highlights the rarity.
Airborne Infection Control Practices in Homes for the Aged in the Context of Tuberculosis Elimination
Nujum ZT, Sindhu S, Rakesh PS, Remya G and Anuja U
National Strategic Plan to End tuberculosis (TB) in India 2020-2025 aims to prevent the emergence of TB in susceptible populations. Airborne infection control (AIC) practices in high-risk settings like homes for the aged (HFA) will be essential to achieve this.
Use of Smartphones for Social and Sexual Networking among Transgender Women in South India: Implications for Developing Smartphone-based Online HIV Prevention Interventions
Shunmugam M, Chakrapani V, Kumar P, Mukherjee D and Madhivanan P
Smartphone use is increasing among transgender women (TGW), including those who engage in sex work. Current government-supported HIV prevention interventions focus on physical venue-based outreach among TGW, missing the opportunity to reach them through smartphone-based interventions.
Effect of Combined Intervention of Yoga and Physiotherapy as Compared to Only Physiotherapy on Lower Limb Muscle Strength, Balance and Range of Motion among Elders with Compromised Stair Climbing in Puducherry - A Parallel Arm Non-Randomized Control Trial
Gupta R, Sahu SK, Barathi A, Kumar N, Naik D and Roy G
The activity of daily living (ADL) related to stair climbing is one of the most compromised ADLs among the elders. It requires good muscle strength, balance, and range of motion (ROM) in the lower limb. We aimed to investigate the effects of Yoga complemented with physiotherapy (Intervention group) compared to only physiotherapy (control group) on lower limb muscle strength, balance, and ROMs among elders with ADL limitation in stair climbing. Sixty-five community-dwelling elders with compromised stair climbing were enrolled. Elders who consented to yoga along with physiotherapy were enrolled in the intervention arm. Data were collected and analyzed following 12 weeks of intervention. Endline assessment showed that the intervention group had more improvement in all test scores and ROMs as compared to the control group, although there were improvements in both arms as compared to baseline. Considering the beneficial effects of both interventions, yoga can be added to gain additional advantages.Trial Registration:Indian Clinical Trials Registry number CTRI/2021/08/035825.
Assessment of Body Frame Size by Elbow Breadth and Frame Index and Its Relation to Body Composition Parameters among Tribal Preschool Children in West Bengal, India
Mahapatra B and Bose K
In children, body frame size estimation is used to interpret body mass and evaluate growth patterns. The present study aims to assess the body frame size by elbow breadth and frame index and its relation to body composition parameters among tribal preschool children (1-5 years of age). In the present study, 848 preschool children (430 boys and 418 girls) were included. The mean elbow breadth showed an increasing trend with increasing age, but inverse results were observed in the case of frame index. Age-wise, statistically significant sex differences were found in mean elbow breadth and frame index (except for 2 years of age). Boys show higher mean elbow breadth and frame index in all age groups, and significant sex differences were found. Elbow breadth and frame index had the strongest significant positive correlations with fat free mass (FFM) (r = 0.590, P < 0.01) and FFM index (r = 0.539, P < 0.01), respectively.
Clinical Profile and Outcome in Snake Envenomation in the Maval Region of Western Maharashtra: A Rural Tertiary Health-care Hospital Experience
Metkar GS, Saraf SP and Nagare MR
A prospective observational study was conducted in a rural tertiary health-care hospital in the Maval region to analyze sociodemographic contributors, clinical profile, and outcomes in snake envenomation. Fifty-eight patients with confirmed snakebites admitted to the hospital from November 2019 to August 2021 were studied. Snakebite was found to be the most common in middle-aged adult male agricultural population while working outdoors in the daytime. Bleeding from the bite site and other areas such as the oral cavity, swelling, and bluish discoloration of the affected limb were the clinical features observed. Complications such as cellulitis and acute kidney injury were detected in 81% of patients. Despite this, there was no mortality or permanent disability in any of the patients. The knowledge of risk factors can help the vulnerable agrarian population to protect themselves from snakebites. Good medical facilities such as intensive care units, laboratory support, and availability of antisnake venom and blood products are important determinants in final patient outcome.
Adverse Drug Reaction Patterns of First-line Anti-tubercular Drugs among Saharia Tuberculosis Patients: An Observational Study in Particularly Vulnerable Tribal Group of Madhya Pradesh, India
Mishra P, Bhat J, Yadav R, Sharma RK and Rao VG
The Saharia tribe of Madhya Pradesh has a very high tuberculosis (TB) burden. However, there is no report of adverse drug reaction (ADR) available in patients receiving anti-TB chemotherapy in the community. Reporting and monitoring of ADRs among TB patients is still rare in marginalized communities. An observational prospective study was performed from November 2019 to June 2020 to assess the patterns of ADRs in 250 Saharia TB patients, who were prescribed Category-I daily DOTS (HRZE) by the physician. Both male and female participants equally experienced ADR during the treatment, but relatively more females (92.6%) than males (88.6%) reported ADR during Phase I. Out of 250 patients, 224 patients (89.6%) experienced one or more ADRs in Phase I. The central nervous system-related (75.6%) ADR was mostly reported followed by any gastrointestinal (74.4%), cardiovascular (49.2%) and any dermatological related (44.4%) ADRs. It is paramount to timely monitor and proactively manages ADRs pertaining to anti-TB drug treatment with minimal alteration in the treatment course.
Intestinal Parasitosis among Pregnant Women Attending Antenatal Clinic at a Tertiary Care Hospital in Sikkim, a Northeastern State of India
Ojha K, Deokota S and Dolma KG
The research paper explores the burden and associated factors of intestinal parasitic infections among pregnant women in Sikkim, India, categorized as neglected tropical diseases affecting 1.5 billion globally, with higher rates in tropical regions. These infections pose significant health risks, causing anemia, poor maternal-perinatal health, and perpetuating generational undernutrition and recurrent infections. A cross-sectional study of 100 pregnant women in Sikkim aimed to determine the burden of intestinal parasitosis and associated sociodemographic factors. It reported a lower prevalence compared to similar studies, with Giardia Lamblia as the dominant parasite. The study found a significant link between intestinal parasitosis and anemia. In conclusion, the paper recommends routine screening and deworming for pregnant women with low hemoglobin levels, emphasizing health education and awareness about intestinal parasitosis during pregnancy, especially in resource-limited settings. Adherence to India's National Guidelines for Deworming during pregnancy is crucial.
Perception of Threat and Efficacy in Contracting COVID-19 Infection among Tobacco Users - A Cross-sectional Analytical Study from Four Indian States
Kar SS, Joseph N, Goel S, Singh RJ, Patro BK, Pala S, Kumar R, Purohit B, Medini SK, Kharbangar ON and Anandraj J
To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at higher risk of COVID-19 infection and should be at higher efficacy to practice preventive measures for the disease as compared to nonusers of tobacco.
Determinants of Good Glycemic Control among Individuals of Type II Diabetes Mellitus Seeking Treatment at a Rural Health-care Facility in Goa - A Cross-sectional Study
Kankonkar NP, Dsouza BD, Kankonker NM and Vadivel D
Good glycemic control is the aim of managing type 2 diabetes mellitus (T2DM) which is crucial for the prevention of long-term complications in individuals with T2DM. The aim of this study was to identify the factors associated with good glycemic control in individuals with T2DM following up at a rural health-care facility (HCF) in Goa. A cross-sectional study was conducted among 120 individuals with T2DM who regularly followed up at a rural HCF in Goa. Participants were selected using simple random sampling. It was found that the participants belonging to the 60-89 years of age group and those on mono/dual oral therapy were more likely to have good glycemic control. Participants' glycated hemoglobin A1c decreased by 0.083% for every year of increase in age and increased by 0.044% for every centimeter increase in abdominal girth.
Prevalence and Association of Digital Eye Strain with the Quality of Sleep and Feeling of Loneliness among Female College Students in Northern India
Rana M, Gupta PC, Grover S, Furr A and Bhargava N
Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with friends. While it is known that the association between screen exposure and psychological well-being is both harmful and stronger among adolescents than younger children, what is less studied are the causal factors that may mediate the relationship.
Application of Health Belief Model to Comprehend Adherence to COVID-19-appropriate Behavior among COVID-19 Vaccinees in Himachal Pradesh
Gupta P, Mahajan A, Chander V and Barwal VK
The augmentation of precautionary behaviors through the application of health belief model (HBM) constructs could help in curbing the current pandemic.
Exploration of Barriers and Possible Solutions for Nonutilization of Facility-based Integrated Counseling and Testing Center Using the Delphi Technique
Mohan R, Surendran P, Rajalakshmi M and Ganapathy K
A major group of the population, especially antenatal checkup (ANC) mothers and their spouses, people admitted for surgery, and people attending STI clinics, are reluctant to pretest counseling.
Nursing Personnel Workload and Staffing Need for Rural Hospitals of Darjeeling District, India: Assessment by Application of Workload Indicators of Staffing Need Tool (World Health Organization)
Mortuja SG, Dasgupta S, Bhattacherjee S and Mukherjee A
The Workload Indicators of Staffing Need (WISN) human resource planning and management tool developed by Shipp (1998) and popularized by the World Health Organization gives health managers a way to analyze and calculate correct staffing levels in health facilities.
Essential Public Health Functions of Public Health Personnel in Subdistrict Health-promoting Hospitals, Thailand
Yodkong W and Wongsawat P
In Thailand, public health service roles have been defined by the Ministry of Public Health, while essential public health functions (EPHFs) were not assigned as necessity health-care service activities responding to the missions of primary care units.
COVID-19 Stigma and Discrimination in a North Indian State: A Concurrent Mixed Method Study
Kaur M, Lakshmi PVM, Sharma A, Purayil VP, Mathur N and Verma V
We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select blocks, subcenters, and urban primary healthcenters from each of the four selected districts. The systematic random sampling was used to select households. A sample of 423 adults was interviewed using a structured questionnaire and 10 in-depth interviews were conducted using an interview guide. Binary logistic regression was performed to find the predictors. Stigma prevalence was mild 18%, moderate 45%, and severe 37%. Logistic regression indicated that stigma was lower in the rural compared to the urban population (P < 0.01). Hospitalized patients faced discrimination more often compared to those who were treated/quarantined at home. People feared police (71%), testing (69%), and contracting the infection (65%). Fear of screening, disclosure of status, and transmission of the virus were the drivers of stigma and discrimination. Co-occurrence of labeling, stereotyping, and cognitive separation was observed.
Feasibility and Efficacy of Telephone Based Follow-up in Patients with Headache - A Longitudinal Cohort Study
Ray S, Tiwari S, Chakravarty K, Mehta S, Baishya J and Lal V
Chronic headache greatly affects the quality of life and also constitutes a significant burden on the health system.
Noncommunicable Diseases and Gender Gap in Out-of-pocket Spending on Inpatient Health Care: An Investigation of Indian Elderly
Chatterjee C and Biswas AK
The present study intends to examine whether there exists any gender gap in out-of-pocket spending on hospitalization between elderly men and elderly women. Data were drawn from the NSS 75th Round Health Care Survey (2017-2018) consisting of a total number of 45,299 elderly. Bivariate analysis and t-test were used to examine the disease burden and gender gap in health spending. The burden of noncommunicable diseases such as bone disease and anemia is considerably higher among elderly women than elderly men. There is a significant, positive gender gap in inpatient health spending, especially in the rural area across various diseases. Lower level of awareness, male dominance in health-related decision-making, and financial dependence are some possible factors for the gender gap. Generating awareness among households and particularly among women regarding health-care system, chronic diseases, and sources of health financing along with formulating disease-specific policy may reduce the gender gap in health spending.
Psychological Distress among Care Recipients Attending Youth Mental Health Promotion Centers across Karnataka, India
Raghuvir S, Arelingaiah M, Loganathan S, Ramamurthy SV, Naik V and Banandur PS
Yuva Spandana (YS) is a unique community-based youth mental health promotion program implemented across Karnataka.
COVID-19-related Fears and Practices among Postnatal Women Availing Services at a Rural Maternity Hospital in South Karnataka
Regy MM, Maria SB, Olasa RT, Kujur E, Johnson AR and Joseph M
The postnatal period is a critical phase indeed, in which, owing to the pandemic, an added apprehension being the safety and well-being of both, mother and child. This study was mainly done to assess the attitude and practices regarding postnatal care during the Covid-19 pandemic among women availing services at Snehalaya hospital, Solur. It was a hospital based cross- sectional study done among post-natal mothers and data were collected using an interview schedule following sections such as- socio-demographic details, questions assessing the attitudes towards postnatal care during the pandemic followed by questions assessing the practices in the same period. It was found that of the total interviewed, nearly half mothers reported to have a fear of getting infected with Covid-19 and few reported to have a fear of deaths due to Covid-19. Fear of dying from Covid-19 was an evident finding seen more among the gainfully employed and those with bad obstetric history. The socioeconomic status did have a bearing on the perceptions towards the pandemic influence on the maternal and child health during the puerperal period.
Association of Common Mental Disorders with Diabetes Mellitus - Evidence from Community-based Matched Case-Control Study in North India
Salve HR, Kamble BD, Krishnan A, Sagar R, Ramakrishnan L, Kant S, Nongkynrih B and Sreenivas V
Diabetes mellitus (DM) and depression are major public health problems globally. Evidence of linkage of common mental disorders (CMDs) including depression and anxiety disorders with DM is sparsely reported from community-based settings.
Comparison of Prevalence of Metabolic Disorders of Urban and Rural Adults of Punjab, India
Bakhetia P, Bains K and Cheema S
A study was conducted to determine the prevalence of metabolic syndrome (MetS) in urban and rural areas of Ludhiana district, Punjab. A total of 1000 subjects aged 25-65 years were selected for screening. The study found that both urban and rural areas had an average body mass index above 23.0 kg/m2, with rural populations having higher waist circumference, hip circumference, and waist-hip ratios. Abdominal obesity was more prevalent in women in both areas. Rural men and women had higher fasting blood glucose and systolic blood pressure/diastolic blood pressure levels. MetS prevalence in urban areas is lower among men (7%) and women (10%) compared to rural areas (34% and 26%). The timely detection of metabolic disorder risk factors and intervention can effectively address MetS in the Indian population, thereby improving the country's health statistics.
Awareness Regarding POCSO Act: A Cross-Sectional Study
Kaur R, Sharma R, Sharma D, Kaur S, Khan S, Pahwa S, Sharma S and Jaswal SS
Child sexual abuse occurs in a variety of settings and the POCSO Act, 2012 came into force with effect from November 14, 2012.
Polycystic Ovarian Syndrome among Young Women of a University in Central Gujarat - A Cross-sectional Study
Shringarpure K, Baxi R, Sheth M, Patel P, Parmar V and Baxi S
Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal PCOS screening appears to be a cost-effective strategy, benefiting earlier diagnosis and intervention.
Gay and Bisexual Men too should not be Left Out/Deprived of Human Papilloma Virus Vaccination in "Cervical Cancer Elimination Programme" in Countries with a High Prevalence of HIV
Aggarwal A, Gupta N, Barua M and Jani KK
Growth and Puberty Attainment of Girls with Human Immunodeficiency Virus
Devi NA, Kaur H, Suri D and Bhalla AK
Pattern of physical growth and pubertal changes among 59 girls, aged 8-15 years, diagnosed as cases of HIV on anti-retroviral therapy was cross-sectionally studied. Besides, measurement of body weight, height, and body mass index, breast development stage, presence or absence of pubic and axillary hair, and age of attainment of menarche were also noted in these subjects in the growth clinic of the department. With the advancement of age, the weight and height of HIV girls increased; however, they were lighter and shorter compared to their normal peers. 15.3% of HIV girls were short-statured and underweight. None of the study participants were found to be overweight or obese. 40.7% of HIV girls had attained menarche (mean age: 12.58 ± 1.349 years). The appearance of pubic (13.45 ± 1.64 years) and axillary hair (13.73 ± 1.41 years) occurred around 1 year later. The delayed physical growth and puberty attainment of HIV girls than their normal counterparts may be due to the influence of the disease.
Prevalence of Depression among Married Women in a Rural Area of North Kerala: A Cross-sectional Study
Lamiya KK, Haveri SP and Mundodan JM
Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female preponderance. A cross-sectional study was designed to assess the burden of depression among married women in a rural setting in North Kerala and identify its sociodemographic risk factors. The sample size was calculated to be 453 (prevalence = 24.9%; error = 20%; design-effect = 1.5). Systematic random sampling was used to select the participants from the eligible couple register. They were interviewed using MINI and Montgomery-Ashberg Depression Rating Scales. Descriptive analysis showed that 24.2% was suffering from current depression, mostly mild and none severe. Two percent reported past depression and 5.4% experienced spousal violence. Poor family support, experience of domestic violence, morbidity, and older spouses were found to be significant risk factors. The provision of mental health services by trained personnel and strict vigilance against the marriage of girls below the legal age and domestic violence are need of the hour.
[Effectiveness of physical rehabilitation methods based on the impact of eccentric load in upper limb injuries]
Khadakhanov IS, Stepanenko DA, Pavlov VI, Kozlova NM, Shishonin AY and Vecher AA
The rehabilitation of patients after upper limb injuries is becoming increasingly relevant in current medical practice considering that this pathology is often occurred in professional athletes, elderly people, people with active lifestyle.
[Opportunities of phototherapy in acute respiratory diseases. Opinion of doctors and patients]
Konyshko NA, Volynets LI and Konyshko GS
To analyze the effects and tolerability of physiotherapeutic methods with optical radiation (phototherapy) in acute respiratory diseases (ARD) on the basis of the modern scientific literature data and the results of doctors and patients survey.
[Method of comprehensive physiotherapy of dental patients after COVID-19]
Kulikova NG, Al-Zamil MK, Zhilokov ZG and Tkachenko AS
Functional gastrointestinal disorders, which had an impact on the dentofacial system (pain, loose teeth and falling out of them) in patients who have had COVID-19, drew the close attention of specialists of different profiles. The pathogenesis of worsening post-COVID edentulism is insufficiently studied, as many issues of adequate therapy remain unsolved, in which the role of non-drug technologies in the treatment of dental patients who have suffered from COVID-19 is extremely high.
[Physical rehabilitation in sarcopenia: modern approaches. (A literature review)]
Samoilova YG, Matveeva MV, Yakimova YL, Samoilov EY, Kudlay DA and Yakimovich IY
The number of middle-aged and elderly population is increasing every year. At the same time, the course of most chronic diseases worsens with age, which can be explained by significant changes in body composition, including redistribution and increase of fat mass and decrease in muscle and skeletal mass. Thus, a decrease in muscle mass becomes intrinsic for the body from the age of 40 and develops on average by 0.5-1.0% per year. The prevalence of patients with sarcopenia is estimated to be between 11 and 50% in different age groups of population: middle, elderly and senile. In addition, the decline in physical activity associated with the urbanization and automation of labor exacerbates the disease at a younger age, which predicts an increase in the number of such patients in the future.
[Hydrogen sulfide balneotherapy in comprehensive sanatorium-resort treatment of post-burn scars in children]
Khodasevich LS, Mironov VI, Rassokha IA, Popov GK and Sharapova SA
Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy is an integral part of rehabilitation measures in such patients.
[Dependence of medical rehabilitation effectiveness of patients with somatic diseases and meteopathology on features of weather-forming factors of the Moscow region]
Uyanaeva AI, Pogonchenkova IV, Tupitsyna YY, Lvova NV, Turova EA, Ksenofontova IV, Maksimova GA and Kharisov NF
Climate change and formation of regional weather features increase both direct (immediate effects of extremal temperature and other weather and climatic anomalies) and indirect (environmental deterioration, etc.) consequences of global climate change. The development of investigations of medical weather assessment, medical and meteorological forecasting system, the use of treatment and preventive measures give the opportunity to prepare for weather biotropic conditions and reduce weather-conditioned exacerbations.
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