Category: Nevin Manimala

JAMA Health Forum. 2024 Jul 5;5(7):e241794. doi: 10.1001/jamahealthforum.2024.1794.

ABSTRACT

IMPORTANCE: Understanding mortality disparities among justice system-involved populations is crucial for public health and policy, especially for marginalized racial groups such as American Indian/Alaska Native persons.

OBJECTIVE: To examine racial disparities in mortality within the broader justice system-involved population in South Dakota, focusing on different sentencing dispositions and the role of place.

DESIGN, SETTING, AND PARTICIPANTS: This observational study used administrative criminal records linked to mortality data from January 2000 to December 2016. The statewide data linked data from South Dakota Attorney General’s Office and South Dakota Department of Health. Individuals aged 18 years and older with arrests were analyzed in this population-based sample. Data were analyzed from August 1, 2022, to July 30, 2023.

EXPOSURE: Sentencing dispositions were categorized as arrest only, fine, probation, jail, and prison.

MAIN OUTCOMES AND MEASURES: The main outcomes were mortality rates (both all-cause and cause-specific) calculated using Poisson regression models, adjusted for demographic and county variables.

RESULTS: Of 182 472 individuals with 422 987 arrests, the study sample included 29 690 American Indian/Alaska Native arrestees (17 900 [60%] male; mean [SD] age, 29.4 [11.0] years) and 142 248 White arrestees (103 471 [73%] male; mean [SD] age, 32.6 [12.9] years). American Indian/Alaska Native persons accounted for 16% of arrestees and 26% of arrests, but only 9% of the population in South Dakota. Across dispositions, mortality risk was greater for White individuals sentenced to probation, jail, and prison relative to White individuals who were arrested only. In terms of racial disparities, all-cause mortality risk was 2.37 (95% CI, 1.95-2.88) times higher for American Indian/Alaska Native than White arrestees in the arrest-only disposition. Disparities persisted across all dispositions but narrowed substantially for probation and prison. Results were similar for cause-specific mortality risk, except for cancer risk. In urban areas, mortality risk was 2.70 (95% CI, 1.29-2.44) times greater for American Indian/Alaska Native individuals relative to White individuals among those with arrest-only dispositions.

CONCLUSIONS AND RELEVANCE: In this population-based observational study, mortality risk and associated racial disparities among justice system-involved individuals differed substantially across dispositions and places, underscoring the need for public health interventions tailored to these factors. Further research is needed to understand the mechanisms through which sentencing and place shape these disparities.

PMID:38995634 | DOI:10.1001/jamahealthforum.2024.1794

Pain Ther. 2024 Jul 12. doi: 10.1007/s40122-024-00632-3. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study is to examine the analgesic efficacy of varying doses of hydromorphone hydrochloride in conjunction with absorbable gelatin sponge for postoperative pain management in elderly individuals undergoing lumbar fusion surgery. Additionally, the study aims to assess the sustained release analgesic properties of this combination and to determine the optimal dosage of hydromorphone hydrochloride for effective pain relief.

METHODS: A total of 113 elderly patients (aged ≥ 65 years old) meeting the criteria for 1-2-level posterior lumbar fusion surgery at Ganzhou City People’s Hospital between July 2022 and August 2023 were randomly assigned to four groups: group A (0.2 mg hydromorphone hydrochloride 1 ml), group B (0.3 mg hydromorphone hydrochloride 1.5 ml), group C (0.4 mg hydromorphone hydrochloride 2 ml), and group D (0.9% normal saline 2 ml) for standard anesthesia induction and maintenance. Prior to suturing the incision, gelfoam was utilized to administer epidural analgesia to each group. Following the surgical procedure, an intravenous analgesia pump was utilized for pain management. The baseline infusion rate was set at 0.5 ml/h. Patient-controlled analgesia (PCA) was administered at a dose of 2 ml, with a lockout interval of 20 min, allowing the patient to self-administer as needed. Pain relief was assessed using the visual analogue scale (VAS) prior to surgery, as well as at 1 day and 3 days post-operation. The frequency of PCA requests within the initial 48-h postoperative period, the remedial analgesia with dezocine, postoperative adverse reactions, and duration of hospitalization were documented for analysis.

RESULTS: The VAS scores of groups B and C were found to be significantly lower than those of group D 1 day after the operation. Additionally, VAS scores at 3 days post-operation, remedial rate of dezocine and PCA follow-up times at 48 h in groups A, B, and C were significantly lower compared to group D (P < 0.001). There was no statistically significant difference between group B and group C in VAS scores at 1 day and 3 days post-operation, as well as PCA follow-up times at 48 h post-operation (P < 0.001). Furthermore, the VAS scores of groups B and C were lower than those of group A at 1 day and 3 days post-operation (P < 0.05). The PCA frequency of group C was also lower than that of group A at 48 h post-operation (P < 0.05).

CONCLUSION: The combination of hydromorphone hydrochloride and absorbable gelatin sponge epidural analgesia has been shown to enhance postoperative pain management. A dosage of 0.4 mg of hydromorphone hydrochloride may be considered an appropriate analgesic dose, as it can provide effective pain relief without eliciting adverse reactions.

TRIAL REGISTRATION: ChiCTR.org.cn(ChiCTR2200064863). Registered on October 20, 2022.

PMID:38995609 | DOI:10.1007/s40122-024-00632-3

Methods Mol Biol. 2024;2836:183-215. doi: 10.1007/978-1-0716-4007-4_11.

ABSTRACT

Metaproteomics has become a crucial omics technology for studying microbiomes. In this area, the Unipept ecosystem, accessible at https://unipept.ugent.be , has emerged as a valuable resource for analyzing metaproteomic data. It offers in-depth insights into both taxonomic distributions and functional characteristics of complex ecosystems. This tutorial explains essential concepts like Lowest Common Ancestor (LCA) determination and the handling of peptides with missed cleavages. It also provides a detailed, step-by-step guide on using the Unipept Web application and Unipept Desktop for thorough metaproteomics analyses. By integrating theoretical principles with practical methodologies, this tutorial empowers researchers with the essential knowledge and tools needed to fully utilize metaproteomics in their microbiome studies.

PMID:38995542 | DOI:10.1007/978-1-0716-4007-4_11

Methods Mol Biol. 2024;2836:67-76. doi: 10.1007/978-1-0716-4007-4_5.

ABSTRACT

Recently, HexNAcQuest was developed to help distinguish peptides modified by HexNAc isomers, more specifically O-linked β-N-acetylglucosamine (O-GlcNAc) and O-linked α-N-acetylgalactosamine (O-GalNAc, Tn antigen). To facilitate its usage (particularly for datasets from glycoproteomics studies), herein we present a detailed protocol. It describes example cases and procedures for which users might need to use HexNAcQuest to distinguish these two modifications.

PMID:38995536 | DOI:10.1007/978-1-0716-4007-4_5

Indian J Gastroenterol. 2024 Jul 12. doi: 10.1007/s12664-024-01630-1. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Endoscopic retrograde cholangiopancreatography (ERCP) may help detect cholangiocarcinoma in patients with primary sclerosing cholangitis (PSC), but it may be associated with complications. This study was aimed at determining the prognostic impact of ERCP on patients with PSC without cholangitis.

METHODS: Patients with PSC without cholangitis were divided into two groups: those who underwent ERCP within three years after diagnosis (ERCP-performed group) and those who did not (non-ERCP group). These groups were compared in terms of clinical outcomes (liver-related death or liver transplantation, endoscopic treatment requirement and repeated cholangitis) and the composite outcome.

RESULTS: Of 99 patients with PSC with detailed medical history, 49 were included in the ERCP-performed group and 21 in the non-ERCP group. In Kaplan-Meier analysis, the non-ERCP group was less likely to achieve the three outcomes and the composite outcome, showing statistical significance (endoscopic treatment requirement; p = 0.017 and composite outcome; p = 0.014). A Cox proportional hazards model indicated that ERCP in the asymptomatic state was a significant predictor of endoscopic treatment requirement (hazard ratio [HR]: 4.37, 95% confidence interval [CI]: 1.03-18.59) and the composite outcome (HR: 4.54, 95% CI: 1.07-19.28).

CONCLUSION: ERCP in patients with PSC without cholangitis is likely to require further endoscopic treatment and may be associated with poor prognosis.

PMID:38995523 | DOI:10.1007/s12664-024-01630-1

Behav Res Methods. 2024 Jul 12. doi: 10.3758/s13428-024-02451-y. Online ahead of print.

ABSTRACT

Interpretation biases in the processing of ambiguous affective information are assumed to play an important role in the onset and maintenance of emotional disorders. Reports of low reliability for experimental measures of cognitive biases have called into question previous findings on the association of these measures with markers of mental health and demonstrated the need to systematically evaluate measurement reliability for measures of cognitive biases. We evaluated reliability and correlations with self-report measures of mental health for interpretation bias scores derived from the Ambiguous Cue Task (ACT), an experimental paradigm for the assessment of approach-avoidance behavior towards ambiguous affective stimuli. For a non-clinical sample, the measurement of an interpretation bias with the ACT showed high internal consistency (r_SB = .91 – .96, N = 354) and acceptable 2-week test-retest correlations (r_Pearson = .61 – .65, n = 109). Correlations between the ACT interpretation bias scores and mental health-related self-report measures of personality and well-being were generally small (r ≤ |.11|) and statistically not significant when correcting for multiple comparisons. These findings suggest that in non-clinical populations, individual differences in the interpretation of ambiguous affective information as assessed with the ACT do not show a clear association with self-report markers of mental health. However, in allowing for a highly reliable measurement of interpretation bias, the ACT provides a valuable tool for studies considering potentially small effect sizes in non-clinical populations by studying bigger samples as well as for work on clinical populations, for which potentially greater effects can be expected.

PMID:38995519 | DOI:10.3758/s13428-024-02451-y

Clin Transl Oncol. 2024 Jul 12. doi: 10.1007/s12094-024-03573-7. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Immune checkpoint inhibitors (ICIs) have shown remarkable efficacy against various cancers in clinical practice. However, ICIs can cause immune checkpoint inhibitor-associated pancreatic injury, often leading to drug withdrawal, and then patients must go to specialized treatment. The patients, their primary tumors are sensitive to ICIs therapy, may experience treatment delays due to such adverse reactions. Therefore, there is a need for systematic clinical researches on immune-related pancreatic toxicity to provide a clinical basis for its prevention and treatment.

METHODS: This study involved the collection of data from patients treated with ICIs and addressed pancreatic injury with preemptive treatment before continuing ICIs therapy. Then, we also statistically analyzed the incidence of pancreatic injury in patients with different courses and combined treatment, and the success rate of rechallenge treatment.

RESULTS: The study included 62 patients, with 33.9% (21/62) experiencing varying degrees of pancreatic injury. Patients with pancreatic injury, 10 cases evolved into pancreatitis, representing 47.6% (10/21) in the pancreatic injury subgroup and 16.1% (10/62) of the total patient cohort. Preemptive treatment was administered to 47.6% (10/21) of patients with pancreatitis, the effective rate was 100%. Among these patients, 70% (7/10) underwent successful rechallenge with ICIs. The occurrence of pancreatic injury was positively correlated with the treatment duration (P < 0.05) but showed no significant correlation with combination therapies (P > 0.05).

CONCLUSION: The likelihood of pancreatic injury increased with longer treatment durations with ICIs; no significant association was found between the incidence of ICIs-related pancreatic damage and combination therapies. Preemptive treatment for immune-related pancreatitis is feasible, allowing some patients to successfully undergo rechallenge with ICIs therapy.

PMID:38995514 | DOI:10.1007/s12094-024-03573-7

Ecotoxicology. 2024 Jul 12. doi: 10.1007/s10646-024-02784-6. Online ahead of print.

ABSTRACT

Electronic waste (e-waste) has been identified as an emerging pollutant and is the fastest growing waste stream at the present time. Significant technological development and modernization within the last decade has led to the rapid accumulation of outdated, broken and unwanted electrical and electronic equipment (EEE). Electronic products mainly consist of a range of metal containing components that, when disposed of improperly, could result in metal constituents leached into the environment and posing a health risk to humans and animals alike. Metal exposure can induce oxidative stress in organisms, which could lead to synergistic, antagonistic and additive effects. The metals found highest in abundance in the simulated e-waste leachate, were nickel (Ni), barium (Ba), zinc (Zn), lithium (Li), iron (Fe), aluminium (Al) and copper (Cu). An acute exposure study was conducted over a 96 h period to determine the potential toxicity of e-waste on the test organism Danio rerio. Biomarker analysis results to assess the biochemical and physiological effects induced by e-waste leachate, showed a statistically significant effect induced on acetylcholinesterase activity, superoxide dismutase, catalase activity, reduced glutathione content, glutathione s-transferase, malondialdehyde and glucose energy available. The Integrated Biomarker Response (IBRv2) analysis revealed a greater biomarker response induced as the exposure concentration of e-waste leachate increased.

PMID:38995499 | DOI:10.1007/s10646-024-02784-6

J Patient Rep Outcomes. 2024 Jul 12;8(1):71. doi: 10.1186/s41687-024-00750-8.

ABSTRACT

BACKGROUND: Cancer-associated malnutrition is associated with worse symptom severity, functional status, quality of life, and overall survival. Malnutrition in cancer patients is often under-recognized and undertreated, emphasizing the need for standardized pathways for nutritional management in this population. The objectives of this study were to (1) investigate the relationship between malnutrition risk and self-reported symptom severity scores in an adult oncology outpatient population and (2) to identify whether a secondary screening tool for malnutrition risk (abPG-SGA) should be recommended for patients with a specific ESAS-r cut-off score or group of ESAS-r cut-off scores.

METHODS: A single-institution retrospective cross-sectional study was conducted. Malnutrition risk was measured using the Abridged Patient-Generated Subjective Global Assessment (abPG-SGA). Cancer symptom severity was measured using the Revised Edmonton Symptom Assessment System (ESAS-r). In accordance with standard institutional practice, patients completed both tools at first consult at the cancer centre. Adult patients who completed the ESAS-r and abPG-SGA on the same day between February 2017 and January 2020 were included. Spearman’s correlation, Mann Whitney U tests, receiver operating characteristic curves, and binary logistic regression models were used for statistical analyses.

RESULTS: 2071 oncology outpatients met inclusion criteria (mean age 65.7), of which 33.6% were identified to be at risk for malnutrition. For all ESAS-r parameters (pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and wellbeing), patients at risk for malnutrition had significantly higher scores (P < 0.001). All ESAS-r parameters were positively correlated with abPG-SGA score (P < 0.01). The ESAS-r parameters that best predicted malnutrition risk status were total ESAS-r score, lack of appetite, tiredness, and wellbeing (area under the curve = 0.824, 0.812, 0.764, 0.761 respectively). Lack of appetite score ≥ 1 demonstrated a sensitivity of 77.4% and specificity of 77.0%. Combining lack of appetite score ≥ 1 with total ESAS score > 14 yielded a sensitivity of 87.9% and specificity of 62.8%.

CONCLUSION: Malnutrition risk as measured by the abPG-SGA and symptom severity scores as measured by the ESAS-r are positively and significantly correlated. Given the widespread use of the ESAS-r in cancer care, utilizing specific ESAS-r cut-offs to trigger malnutrition screening could be a viable way to identify cancer patients at risk for malnutrition.

PMID:38995461 | DOI:10.1186/s41687-024-00750-8

AIDS Behav. 2024 Jul 12. doi: 10.1007/s10461-024-04419-7. Online ahead of print.

ABSTRACT

Loss to follow-up (LTFU) in high-resolution anoscopy (HRA) programs jeopardizes the procedure’s potential to help prevent anal cancer. We explored quality improvement factors to understand how to address this LTFU. Using the transtheoretical COM-B Model (Capability, Opportunity, Motivation, and Behavior) and a sequential explanatory mixed-methods design, we surveyed and interviewed 13 patients who remained engaged in HIV care but who delayed their HRA monitoring or treatment visits in the same community clinic, and 6 HRA clinicians and medical assistants. Analyses involved descriptive statistics and rapid qualitative analysis. Patients were racially, ethnically, and economically representative of the LTFU population, and were generally experienced with HRA (Mean HRA visits = 4.6, SD = 2.8, mdn = 3). Providers were experienced clinicians and medical assistants (Mean years providing HRA = 6.0, SD = 2.2). Analyses revealed two primary, related barriers: (A) motivational barriers such as physical pain, discomfort, embarrassment, and anxiety; which were largely borne from (B) opportunity barriers such as difficulties with scheduling, inconsistent after-care (particularly for pain and discomfort), anxiety-inducing exam rooms and equipment, and internalized and anticipated stigma. Capability barriers, such as limited health literacy about HRA, were less common and, like motivational barriers, linked to opportunity barriers. Participants recommended potential facilitators, including easier scheduling, standardization of pain management and after-care services, and examination room modifications to reduce anxiety. To retain HRA patients in community settings, interventions should address social and physical opportunity barriers that strongly determine motivational and capability barriers. Improving convenience, standardizing pain management, and introducing stigma interventions specific to HRA, could alleviate both motivational and capability barriers.

PMID:38995441 | DOI:10.1007/s10461-024-04419-7