Category: Nevin Manimala

Int J Bipolar Disord. 2024 Dec 28;12(1):44. doi: 10.1186/s40345-024-00367-2.

ABSTRACT

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common neuro-developmental disorder that often persists into adulthood. Moreover, it is frequently accompanied by bipolar disorder (BD) as well as borderline personality disorder (BPD). It is unclear whether these disorders share underlying pathomechanisms, given that all three are characterized by alterations in affective states, either long or short-term. BD is characterized by infrequent but intense mood shifts, while ADHD and BPD involve more dynamic emotional fluctuations. It is yet to be determined whether these disorders represent distinct phenomena or different points on a spectrum of affective dysregulation.

METHODS: This study seeks to distinguish the emotional dysregulation of BPD, ADHD, and BD by using digital phenotyping, a measurement burst electronic-diary method with different sampling rates, and accelerometry to measure participants’ activity. Our study will include 480 participants aged 14 to 50 (120 each from BPD, ADHD, BD, and healthy control groups) from five European sites. Participants’ smartphones will provide continuous data on their digital phenotypes, i.e., by indicators of physical activity and communication, for one year, along with daily evening ratings of mood and sleep. Moreover, five intensive measurement periods of five days each, called measurement bursts, will occur throughout the year, with electronic diaries asking participants to report on mood, self-esteem, impulsivity, life events, social interactions, and dysfunctional behaviors ten times a day. Moreover, participants will wear activity sensors during the five measurement bursts. Statistical analysis aims to identify whether affective dysregulation aspects share or differ across disorders. Specifically, data analysis aims to investigate the differences in parameters of affect fluctuation such as attractor strength and variability between disorders and to test the association of genetic risk factors for psychiatric disorders and resilience factors with critical parameters of affect modulation.

DISCUSSION: The results of this study offer the potential to link patients’ external exposures with their affective state, reduce misdiagnosis, and determine the best timing for therapeutic interventions. Potential limitations of the study include insufficient recruitment of patients and drop-outs due to various protocol violations.

TRIAL REGISTRATION: Study code: DRKS00028917, registered 27.07.2022, https://drks.de/search/de/trial/DRKS00028917 .

PMID:39733204 | DOI:10.1186/s40345-024-00367-2

Surg Endosc. 2024 Dec 28. doi: 10.1007/s00464-024-11457-8. Online ahead of print.

ABSTRACT

BACKGROUND: We performed a systematic review and network meta-analysis (NMA) of individualized patient data (IPD) to inform the development of evidence-informed clinical practice recommendations.

METHODS: We searched MEDLINE, Embase, and Cochrane Central in October 2023 to identify RCTs comparing Hartmann’s resection (HR), primary resection and anastomosis (PRA), or laparoscopic peritoneal lavage (LPL) among patients with class Ib-IV Hinchey diverticulitis. Outcomes of interest were prioritized by an international, multidisciplinary panel including two patient partners. Article screening, data extraction for IPD, and risk of bias appraisal were performed by two reviewers. We used a random-effects NMA to synthesize direct and indirect evidence. Heterogeneity was evaluated using the I² statistic. The panel appraised the certainty of the evidence using GRADE and CINeMA.

RESULTS: Fourteen reports of seven RCTs were derived from 4,659 articles. IPD data were available for 595/678 patients (88.8%) across trials. Patients had a mean age ± SD of 64.61 ± 13.64 years and a mean BMI ± SD of 26.12 ± 5.20 kg/m², representing Hinchey classes I (1.2%), II (1.0%) III (76.3%), and IV (12.1%), respectively. Using minimal important difference thresholds, in-hospital/30-day mortality was higher among patients receiving LPL versus HR [42 more per 1000, 95% CI (41 fewer to 331 more), moderate effect; low certainty] as well as PRA [45 more per 1000 patients, 95% CI (33 fewer to 340 more) moderate effect; low certainty] without heterogeneity (I² = 0%). Among 417 patients from four trials, there was a lower stoma rate among patients receiving PRA versus LPL [539 fewer per 1000, 95% CI (647 fewer to 306 fewer), large effect; low certainty].

CONCLUSION: PRA likely confers a lower stoma rate at 1 year compared to HR, while there may be no difference in 30-day/in-hospital mortality. LPL likely confers a higher in-hospital/30-day mortality rate compared to HR and PRA.

PMID:39733170 | DOI:10.1007/s00464-024-11457-8

Sci Rep. 2024 Dec 28;14(1):31451. doi: 10.1038/s41598-024-82983-7.

ABSTRACT

This study investigated the incidence of new-onset cardiovascular disorders up to 3.5 years post SARS-CoV-2 infection for 56,400 individuals with COVID-19 and 1,093,904 contemporary controls without COVID-19 in the Montefiore Health System (03/11/2020 to 07/01/2023). Outcomes were new incidence of major adverse cardiovascular event (MACE), arrhythmias, inflammatory heart disease, thrombosis, cerebrovascular disorders, ischemic heart disease and other cardiac disorders between 30 days and (up to) 3.5 years post index date. Results were also compared with a pre-pandemic cohort over similar observation duration (N = 64,541). Cumulative incidence and hazard ratios adjusted for competitive risks were analyzed. Compared to contemporary controls, hospitalized COVID-19 patients had significantly higher risk of developing MACE (aHR = 2.29, 95% confidence interval [2.27, 2.31], p < 0.001), arrhythmias (aHR = 2.54[2.50, 2.58], p < 0.001), inflammatory heart disease (aHR = 5.34[4.79, 5.96], p < 0.001), cerebrovascular (aHR = 2.05[2.00, 2.11], p < 0.001), other cardiac disorders (aHR = 2.31[2.26, 2.35], p < 0.001), thrombosis (aHR = 4.25[4.15, 4.36], p < 0.001), and ischemic heart disease (aHR = 1.89[1.86, 1.92], p < 0.001). Non-hospitalized COVID-19 patients had slightly higher risk of developing MACE (aHR = 1.04[1.03, 1.06], p < 0.001), arrhythmias (aHR = 1.10[1.08, 1.12], p < 0.001), inflammatory heart disease (aHR = 2.29 [2.03, 2.59], p < 0.001), cerebrovascular (aHR = 1.11[1.07, 1.15], p < 0.001), and ischemic heart disease (aHR = 1.10[1.08, 1.13], p < 0.001). Race and ethnicity were mostly not associated with increased risks (p > 0.05). aHRs with contemporary controls as a reference were similar to those with pre-pandemic cohort as a reference. We concluded that new incident cardiovascular disorders in COVID-19 patients, especially those hospitalized for COVID-19, were higher than those in controls. Identifying risk factors for developing new-onset cardiovascular disorders may draw clinical attention for the need for careful follow-up in at-risk individuals.

PMID:39733164 | DOI:10.1038/s41598-024-82983-7

Sci Rep. 2024 Dec 28;14(1):31398. doi: 10.1038/s41598-024-83009-y.

ABSTRACT

This study assessed the factors militating against the effective implementation of electronic health records (EHR) in Nigeria, the computerization of patients’ health records with a lot of benefits including improved patients’ satisfaction, improved care processes, reduction of patients’ waiting time, and medication errors. Despite these benefits, healthcare organizations are slow to adopt the EHR system. Therefore, the study assessed the factors militating against the effective implementation of the EHR system, the level of awareness of EHR, and the utilization of electronic health records; it also investigated the factors militating against the effective implementation of EHR. This is a descriptive cross-sectional study conducted among members of staff of the University of Medical Sciences Teaching Hospital (UNIMEDTH). Purposive sampling was adopted to select the study participants, and a structured questionnaire was used for data collection. Statistical Product and Service Solutions (SPSS) version 27 was used for data analysis, R and Microsoft Excel were used for data visualization. Findings revealed that the respondents had a high level of awareness of EHR with an average mean of 1.29. The study revealed a low utilization rate for EHR (mean 3.01, SD 0.115) and data storage (mean 3.00, SD 0.231), indicating major problems with EHR implementation. Financial limitations (mean 2.63, SD 0.486) and insufficient ICT resources (mean 2.62, SD 0.516) are the main challenges. The regression analysis revealed that EHR utilization is highly impacted by awareness (F = 4.26, p < 0.008), accounting for 15.1% of the variance. Governmental assistance and financial constraints showed a statistically significant negative correlation (r=-0.04, p < 0.05), while inadequate internet connectivity and epileptic power supply showed a statistically significant positive association (r = 0.1, p < 0.05). The results show that, more government support is needed to alleviate financial constraints, and a stable power supply may enhance internet accessibility. The study concluded that epileptic power supply, poor internet connectivity, financial constraints, and other factors mentioned in the study militate against the effective implementation of electronic health records. It was recommended that the management should implement electronic health records effectively for efficient and effective health care delivery.

PMID:39733158 | DOI:10.1038/s41598-024-83009-y

Sci Rep. 2024 Dec 28;14(1):31362. doi: 10.1038/s41598-024-82819-4.

ABSTRACT

Phthalocyanine derivative nanostructures are highly organized organometallic structures that exhibit two-dimensional polymeric phthalocyanine frameworks. We analyze phthalocyanine using the Zagreb-type indices, which offer important insights into the topological characteristics of the molecular structure. Furthermore, we use Pearson correlation analysis to examine the degree of relationship between various structural features and qualities. The significance of [Formula: see text] in materials research and the value of computational techniques in elucidating the chemical’s properties and possible uses as demonstrated by this multidimensional examination of the material. We use a Pearson correlation heat map to show the relation between indices and entropy.

PMID:39733151 | DOI:10.1038/s41598-024-82819-4

Sci Rep. 2024 Dec 28;14(1):31260. doi: 10.1038/s41598-024-82673-4.

ABSTRACT

Manganese (Mn) is a known toxicant and an essential trace element, and it plays an important role in various mechanisms in relation to cardiovascular health. However, epidemiological studies of the association between blood Mn and cardiovascular diseases (CVD) among U.S. adults are rare. A cross-sectional study of 12,061 participants aged ≥ 20 was conducted using data from the National Health and Nutrition Examination Survey 2011-2018. Logistic regression and restricted cubic spline were used to examine the relationship between blood Mn levels and total CVD risk and specific CVD subtypes. Bayesian kernel-machine regression (BKMR) and weighted quantile sum (WQS) analyses were performed to explore the joint effects of Mn with other metals on CVD. The results showed that individuals with the third quartile group of blood Mn levels had significantly lower risks of CVD, displaying a non-linear U-shaped dose-response relationship. A significant interaction of age on this association was observed. No significant associations were found between Mn levels and specific CVD subtypes. BKMR and WQS analyses showed a positive association between heavy metal mixtures and CVD risks, with no interaction between Mn and other metals. In conclusion, blood Mn levels were significantly associated with CVD risks with a U-shaped relationship in U.S. adults, with possible age-specific differences. Future larger prospective studies are warranted to validate these findings.

PMID:39733137 | DOI:10.1038/s41598-024-82673-4

Rheumatol Int. 2024 Dec 28;45(1):10. doi: 10.1007/s00296-024-05763-6.

ABSTRACT

BACKGROUND: Hematological markers such as the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are reliable indicators of inflammation. This study aims to investigate the potential role of these markers in assessing disease activity and treatment response in biologic-naive Ankylosing Spondylitis (AS) patients following the initiation of biological agents.

MATERIALS AND METHODS: We designed this study as a retrospective cohort study with data obtained from a single center. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and The Bath Ankylosing Spondylitis Functional Index (BASFI) were used to evaluate disease activity and functional status of AS patients. Laboratory results at baseline, 3rd, 6th, and 12th months were documented. We calculated hematologic inflammatory markers for each visit. Mean platelet volume (MPV) and red cell distribution width (RDW) were also noted.

RESULTS: 54 biologic-naive patients with AS were included in this study. These inflammatory markers, except RDW, decreased over time. BASDAI, BASFI, CRP and ESR were significantly lower at 3rd, 6th, and 12th months compared to baseline values (all p < 0.001). Furthermore, NLR, PLR, and MLR showed a statistically significant decrease at 3rd, 6th, and 12th months compared to baseline values (all p < 0.001). However, when comparing the values at the 3rd, 6th, and 12th months, no statistically significant differences were observed. We also found no correlation between hematological inflammatory markers and BASDAI scores, despite observing some correlations between hematological markers and acute phase reactants.

CONCLUSION: These markers could be valuable assessment tools for indicating disease activity and monitoring patients with AS after initiating biological treatment.

PMID:39733134 | DOI:10.1007/s00296-024-05763-6

Sci Rep. 2024 Dec 28;14(1):31493. doi: 10.1038/s41598-024-83076-1.

ABSTRACT

Technological disasters in the Americas have significant public health and environmental implications, but there is limited epidemiological analysis of these events. This study aims to characterize the epidemiological profile of technological disasters in the Americas from 2000 to 2021, focusing on morbidity and mortality trends. A retrospective cross-sectional study was conducted. The ANOVA test was applied in the mean rates calculated for each type of disaster. The Mann-Kendall test assessed the presence or absence of temporal trends, and the Dickey-Fuller augmented test was used to determine if the time series were stationary. Predictions were made up to the year 2030 to mean mortality rate per million inhabitants, mean rate of people affected per million inhabitants, and mean rate of people injured per million inhabitants. A total of 733 technological disasters were recorded in the Americas. Statistically significant differences were found between the mean rates of people affected and the mean mortality rates per million inhabitants for each type of technological disaster. No trends were identified. The highest mean mortality rates occurred because of industrial accidents.

PMID:39733127 | DOI:10.1038/s41598-024-83076-1

Sci Rep. 2024 Dec 28;14(1):31393. doi: 10.1038/s41598-024-82970-y.

ABSTRACT

Although the connection between muscular strength and flatfoot condition is well-established, the impact of corrective exercises on these muscles remains inadequately explored. This study aimed to assess the impact of intrinsic- versus extrinsic-first corrective exercise programs on muscle morphometry and navicular drop in boys with flexible flatfoot. Twenty-five boys aged 10-12 with flexible flatfoot participated, undergoing a 12-week corrective exercise program, with a shift in focus at six weeks. Ultrasound imaging measured muscle thickness and cross-sectional area (CSA), and the navicular drop test assessed flatfoot severity. The results demonstrated a significant interaction between exercise type and sequencing on muscle morphometry. Initiating with intrinsic exercises led to sustained improvement, even after transitioning to extrinsic exercises, while extrinsic-first exercises caused deterioration in intrinsic muscle morphometry, which was recovered after transitioning to intrinsic exercises. Statistical analysis revealed significant improvements in muscle thickness and CSA over time, particularly when initiating intrinsic exercises first. The intrinsic-first group also exhibited a more pronounced reduction in navicular drop. In conclusion, initiating corrective exercises with intrinsic muscles proved more effective in improving foot muscle morphometry and reducing navicular drop in boys with flatfoot. Therefore, commencing correction with intrinsic muscle exercises is recommended before progressing to extrinsic muscle exercises.

PMID:39733109 | DOI:10.1038/s41598-024-82970-y

Sci Rep. 2024 Dec 28;14(1):31345. doi: 10.1038/s41598-024-82821-w.

ABSTRACT

The prevalence of prostate-specific antigen (PSA) testing has consistently fallen for several years. This study explored how the decreasing trend differs by selected variables and reasons for taking the PSA test. Analyses involved men, aged 40 years or older, who completed the Behavior Risk Factor Surveillance System (BRFSS) survey in even number years from 2008 through 2022. Trends in PSA testing rates within the past year declined by 46% from 2008 to 2020 and then increased 21% from 2020 to 2022. The greatest changes corresponded with the years of new USPSTF guidelines. Declining PSA testing rates occurred across the levels of all variables considered but were more pronounced in younger men and men never married, less educated, and without health care coverage. After adjusting for these variables, declining PSA testing rates did not significantly differ between racial/ethnic groups or between income groups. The level of several variables influenced the decline, as a function of perceived risk, accessibility, and desire for the test. Inconsistencies with the USPSTF’s guidelines were seen in higher PSA testing in older and more educated men. The distribution of main reasons for taking the test (part of a routine exam [72%], prostate problem/cancer [12%], family history [6%], and other [10%]) remained constant. PSA testing as part of a routine exam (vs. no PSA test) increased with age and was higher in non-Hispanic Blacks, married (or cohabitating), and in men with higher education, higher income, and health care coverage. PSA testing because of a prostate problem/cancer or family history of prostate cancer according to these variables are also described in this study.

PMID:39733093 | DOI:10.1038/s41598-024-82821-w