Author: Nevin Manimala

Influenza Other Respir Viruses. 2021 Mar 27. doi: 10.1111/irv.12856. Online ahead of print.

ABSTRACT

BACKGROUND: Seasonal influenza vaccination is recommended for patients with chronic respiratory conditions, but uptake is suboptimal. We undertook a comprehensive mixed methods study in order to examine the barriers and enablers to influenza vaccination in patients with chronic respiratory conditions.

METHODS: Mixed methods including a survey (n = 429) which assessed sociodemographics and the psychological factors associated with vaccine uptake (ie confidence, complacency, constraints, calculation and collective responsibility) with binary logistic regression analysis. We also undertook focus groups and interviews (n = 59) to further explore barriers and enablers to uptake using thematic analysis.

RESULTS: The survey analysis identified that older participants were more likely to accept the vaccine, as were those with higher perceptions of collective responsibility around vaccination, lower levels of complacency and lower levels of constraints. Thematic analysis showed that concerns over vaccine side effects, lack of tailored information and knowledge, and a lack of trust and rapport with healthcare professionals were key barriers. In contrast, the importance of feeling protected, acceptance of being part of an at-risk group and feeling a reduced sense of vulnerability after vaccination were seen as key enablers.

CONCLUSIONS: Our findings showed that the decision to accept a vaccine against influenza is influenced by multiple sociodemographic and psychological factors. Future interventions should provide clear and transparent information about side effects and be tailored to patients with chronic respiratory conditions. Interactions between patients and their healthcare providers have a particularly important role to play in helping patients address their concerns and feel confident in vaccination.

PMID:33773079 | DOI:10.1111/irv.12856

J Int AIDS Soc. 2021 Mar;24(3):e25691. doi: 10.1002/jia2.25691.

ABSTRACT

INTRODUCTION: As the leading sexually transmitted infection worldwide, human papillomavirus (HPV) may disproportionately affect transwomen. We aimed to estimate anal HPV prevalence, especially focusing on high-risk (hr)-HPV types and evaluate their associated factors among transwomen living in Rio de Janeiro, Brazil.

METHODS: Transwomen enrolled in a respondent-driven sampling (RDS)-based survey conducted between August 2015 and January 2016 self-collected anal samples, which were promptly stored at minus 80°C. After DNA extraction, HPV detection and genotyping were performed using the PapilloCheck test. We estimated HPV prevalences and evaluated the correlates of anal hr-HPV infection using a regression logistic model.

RESULTS: Out of 345 transwomen, 272 (78.8%) were included in this analysis (122 [44.9%] HIV-positive). No participant had ever received HPV vaccination. Among participants enrolled, 212 (77.9%) were positive for any anal HPV type and 165 (60.7%) for hr-HPV. Most common hr-HPV were as follows: HPV16 (17.6%), HPV68 (14.7%), HPV39 (14.3%), HPV56 (12.5%), HPV51 (11.4%) and HPV52 (11.0%). HIV-positive transwomen had three times the odds of having an hr-HPV compared to HIV-negative transwomen. Participants who had a current rectal Neisseria gonorrhoeae infection had 3.7 times the odds of being coinfected with hr-HPV. Among HIV-positive transwomen, neither antiretroviral therapy use, undetectable viral load, current and nadir CD4 counts were associated with anal hr-HPV infection.

CONCLUSIONS: Brazilian transwomen in our study exhibit some of the highest population-specific rates of HPV and hr-HPV. There is an urgent need to elucidate the burden of HPV infection, prevalence of HPV-related diseases and access to and uptake of HPV vaccination among transwomen, especially from low- and middle-income settings.

PMID:33773075 | DOI:10.1002/jia2.25691

Nurs Open. 2021 Mar 27. doi: 10.1002/nop2.844. Online ahead of print.

ABSTRACT

AIM: This study aimed to determine effectiveness of peanut ball on the duration of the stages of labour and frequency of caesarean section.

DESIGN: A systematic review and meta-analysis.

METHOD: A comprehensive electronic search was carried out with no time limit until December 2020. Collected data were analysed using software RevMan- version 5.3. Heterogeneity was assessed using I² , T² , and ² . GRADE approach was used to assess the certainty of evidence.

RESULTS: The meta-analysis on six clinical trials with 645 participants showed no statistically significant difference between the two groups in caesarean surgery rate (RR = 0.82) and length of the first (MD = -15.64).

CONCLUSIONS: Therefore, further clinical trials with stronger evidence should be carried out to assess the effectiveness of peanut ball on caesarean surgery rate and length of first and second stages of labour.

PMID:33773071 | DOI:10.1002/nop2.844

Anat Rec (Hoboken). 2021 Mar 26. doi: 10.1002/ar.24626. Online ahead of print.

ABSTRACT

The quantification of cranial sexual dimorphism (CSD) among modern humans is relevant in evolutionary studies of morphological variation and in a forensic context. Despite the abundance of quantitative studies of CSD, few have specifically examined intra-sex variability. Here we quantify CSD in a geographically homogeneous sample of adult crania, which includes Italian individuals from the 19^th and 20^th centuries. Cranial morphology is described with 92 3D landmarks analyzed using Procrustean geometric morphometrics (PGMM). Size and shape variables are used to compare morphological variance between sexes in the whole cranium and four individual regions. The same variables, plus Procrustes form, are used to quantify average sex differences and explore classification accuracy. Our results indicate that: i) as predicted by Wainer’s rule, males present overall more variance in size and shape, albeit this is statistically significant only for total cranial size; ii) differences between sexes are dominated by size and to a lesser extent by Procrustes form; iii) shape only accounts for a minor proportion of variance; iv) the cranial base shows almost no dimorphism for shape; and v) facial Procrustes form is the most accurate predictor of skeletal sex. Overall, this study suggests developmental factors underlying differences in CSD among cranial regions; stresses the need for population-specific models that describe craniofacial variation as the basis for models that facilitate the estimation of sex in unidentified skeletal remains; and provides one of the first confirmations of ‘Wainer’s rule’ in relation to sexual dimorphism in mammals specific to the human cranium.

PMID:33773067 | DOI:10.1002/ar.24626

Int J Dent Hyg. 2021 Mar 26. doi: 10.1111/idh.12499. Online ahead of print.

ABSTRACT

OBJECTIVES: The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue-piercing compared with controls. The aim was to assess the influence of tongue-piercing on periodontal and peri-implant health status in adults.

METHODS: Test and control groups comprised of individuals with and without tongue-piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue-ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A P<0.01 was considered statistically significant.

RESULTS: Forty-eight and 49 individuals were included in the test- and control-groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (P<0.01), GI (P<0.01), PD (P<0.01) and mesial (P<0.01) and distal (P<0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control-group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws.

CONCLUSION: Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.

PMID:33773044 | DOI:10.1111/idh.12499

Liver Transpl. 2021 Mar 26. doi: 10.1002/lt.26057. Online ahead of print.

ABSTRACT

Organ shortage continues to limit our ability to provide transplant to all in need of liver transplantation. The current urgency-based system is based on the laboratory MELD-Na score, which efficiently and effectively rank orders patients by their estimated risk for 90-day waitlist mortality, with a c-statistic of 0.88.¹ MELD-Na is agnostic to factors such as age, etiology of liver disease, and co-morbidity, as well as one’s expected post-transplant survival. Transplant centers are entrusted, according to the Final Rule, to ensure that candidates meet a minimal threshold of utility where liver transplant would benefit the patient.

PMID:33773023 | DOI:10.1002/lt.26057

J Appl Clin Med Phys. 2021 Mar 26. doi: 10.1002/acm2.13230. Online ahead of print.

ABSTRACT

The performance of three digital detectors was measured at two exposure index (EI) levels in terms of the effect on features at the borderline of detectability. The null hypothesis was that there would be no statistically significant difference in the CNR of marginally visible features of a baseline- (2.2 µGy) and reduced dose (1.4 µGy) images. The experiment used three digital detectors and a phantom composed of an aluminum contrast-recovery plate, with features of varying diameters and hole depths, which was placed between the detector/grid and 5-20 cm Lucite. Exposures were made using a kVp between 55 and 110 corresponding to the Lucite thickness and a mAs producing an EI of approximately 220 or 140. Images were acquired for all detectors, EI values, and all Lucite thicknesses, then scored by a team of physicists and technologists in terms of feature visibility for each feature size. Contrast-to-noise ratio (CNR) was calculated for each feature using an ROI over the feature and a local background annulus. The uncertainty in the CNR was determined by sampling the background at each feature size, finding residuals from an overall background fit, and then calculating a standard deviation in the noise for each size. The marginal feature pair for each feature size bracketed the reader score. The difference between the CNR values of corresponding marginal features in EI-paired images was significant (P < 0.05) for one detector and not significant (P > 0.05) for marginal features of the other two. Based on both reader scoring and CNR measurements of phantoms, patient doses can be lowered by 30% for those two detectors without a statistically significant difference in lesion perceptibility of the marginally visible feature, while for the other detector there was a statistically significant change in marginal feature detectability and dose reduction was not recommended.

PMID:33773008 | DOI:10.1002/acm2.13230

Microsc Res Tech. 2021 Mar 26. doi: 10.1002/jemt.23761. Online ahead of print.

ABSTRACT

The aim of the study was to evaluate the effects of different polishing systems on the surface roughness of various bulk-fill and nano-filled resin-based composites using different methods. For the study, a total of 192 disc-shaped samples (10-mm wide and 2-mm thick) were prepared from four different bulk-fill composites (Filtek Bulk Fill, X-tra fil, Beautifil-Bulk Restorative and Fill Up) and two nano-filled resin-based composites (Ceram.x SphereTEC and Filtek Z550). The samples in each composite group were divided into four subgroups according to the polishing system to be used (n = 8). Four different polishing systems (Sof-Lex Diamond, Clearfil Twist Dia, HiLuster Plus, OptiDisc) were applied. Then, surface roughness measurements were carried out using a contact-type profilometer. One sample from each group was subjected to atomic force microscopy (AFM) and scanning electron microscope (SEM) examinations. Surface roughness (Ra) values were statistically analyzed in terms of composites and polishing systems using the two-way analysis of variance (ANOVA) and comparisons among groups were performed using the Tukey test (α = .05). Surface roughness values differed significantly in relation to the composite and polishing system used (p < .05). Among all composites, the lowest surface roughness values were obtained in the groups treated with the OptiDisc polishing system (except Beautifil-Bulk Restorative), whereas the highest roughness values were observed in the group polished with Clearfil Twist Dia (except Filtek Z550). X-tra fil showed the highest roughness value with all polishing systems tested. The findings of AFM analyses were consistent with profilometric measurements. The nano-filled resin-based composites showed smoother surface than bulk-fill composites and the type of the polishing systems was found to affect surface roughness.

PMID:33772935 | DOI:10.1002/jemt.23761

J Nurs Manag. 2021 Mar 27. doi: 10.1111/jonm.13316. Online ahead of print.

ABSTRACT

AIM: To determine the effectiveness of information technology interventions on hand hygiene compliance among healthcare professionals.

BACKGROUND: Performing hand hygiene is the optimal approach to prevent the transmission of healthcare-associated infections. However, results regarding the effectiveness of information technology interventions on hand hygiene compliance were inconsistent to date.

EVALUATION: A search for studies published up to May 2020 was undertaken. A meta-analysis was conducted using RevMan 5.3 software.

KEY ISSUES: The most commonly used information technology systems were: automated training, electronic counting devices and remote monitoring, real-time hand hygiene reminders and feedback, and automated monitoring. These four types of technology systems can significantly improve hand hygiene compliance among healthcare professionals (odds ratio = 3.06, p < .001).

CONCLUSION: The four types of information technology can be effectively used to change the hand hygiene behavior. Because the information systems can monitor personnel and conduct statistical analyses automatically, they save labor costs of human monitors, are more time efficient, and eliminate accompanying human error.

IMPLICATIONS FOR NURSING MANAGEMENT: The use of the four types of information technology is convenient and could reduce healthcare-associated infections; thus, they could be widely used in the future as the key to increase hand hygiene compliance rate.

PMID:33772923 | DOI:10.1111/jonm.13316

Fundam Clin Pharmacol. 2021 Mar 26. doi: 10.1111/fcp.12674. Online ahead of print.

ABSTRACT

The nonclinical branch of regulatory pharmacology has traditionally relied on the sensitivity and specificity of regulatorily recommended bioassays. Nonetheless, any predictive testing (e.g., safety pharmacology) with less than 100% sensitivity or 100% specificity is significantly prone to deliver false (negative or positive) results (outcomes discordant to the clinical gold standard). It was recently suggested that the statistics-based and regulatory pertinent “predictive values approach” (PVA) might help to reach a more predictive use of preclinical testing data. To resolve the associated probabilities of carcinogenicity to humans, the PVA was applied to 37 pharmaceuticals (bearing inadequate epidemiological evidence of carcinogenicity but) identifiable as unequivocal mutagens. According to current knowledge, a 98.9% (or more) probability of carcinogenicity to humans was reckoned for those 37 genotoxic drugs. Accordingly, these pharmaceutical drugs might be scientifically and regulatorily regarded as “carcinogenic to humans.” In the USA, European Union, or Canada, the great majority of these 37 pharmaceuticals are currently authorized for medical use in humans. From this appraisal results, the following is suggested 1) for the pharmaceuticals listed in this report, to include significant carcinogenicity warnings in the prescribing information; 2) to conduct pharmacoepidemiology studies or risk-benefit analyses (as warranted), and 3) based on the respective risk-benefit analyses, to re-evaluate the authorization of hydralazine and phenoxybenzamine as antihypertensives, oxcarbazepine as an anticonvulsant, and phenazopyridine as a urinary tract antimicrobial or analgesic. For those four latter drugs (e.g., phenoxybenzamine), a 99.5% probability of carcinogenicity to humans was estimated.

PMID:33772863 | DOI:10.1111/fcp.12674