Category: Nevin Manimala

Med Sci Monit. 2024 Apr 28;30:e943443. doi: 10.12659/MSM.943443.

ABSTRACT

BACKGROUND Necrotizing enterocolitis (NEC) is a potentially life-threatening disease that affects the intestine of the neonate, causing necrosis and general inflammation. Treatment consists of feeding cessation and antibiotic therapy. In more severe cases, surgical intervention is necessary. Recently, different NEC models have been used to study the development of novel diagnostic and therapeutic methods. This work modified an experimental NEC model in rat pups by a single exposure of animals to NEC-causing factors and testing the impact of mother’s milk on prevalence of the disease. MATERIAL AND METHODS Fifty rat pups were subjected to the NEC protocol, in which they were exposed to 100% nitrogen atmosphere and cold stress for set periods of time and formula feeding with exposure to mother’s milk and artificial milk. Twenty-nine pups were used for control. After a set time of 72 h, bowel fragments were obtained and examined histologically by hematoxylin-eosin staining with a modified 3-grade scale. RESULTS Histological features of NEC were present in most of the samples (10/14) in the group exposed to 1 min of hypoxia (P=0.016), 10 min of cold stress (P=0.4) and formula feeding every 3 h with no mother’s milk (P=0.001). In the group of 11 animals with the same stress conditions but fed mother’s milk right after birth, only 1 sample of NEC was present. CONCLUSIONS The modified experimental NEC model based on formula feeding and single exposure to hypothermia and hypoxia was assessed statistically and histologically. In this model, mother’s milk had a protective effect against necrotizing enterocolitis.

PMID:38678319 | DOI:10.12659/MSM.943443

Radiat Prot Dosimetry. 2024 Apr 27:ncae104. doi: 10.1093/rpd/ncae104. Online ahead of print.

ABSTRACT

The objective of this paper is to compare the differences between volumetric CT dose index (CTDIVOL) and size-specific dose estimate (SSDEWED) based on water equivalent diameter (WED) in radiation dose measurement, and explore a new method for fast calculation of SSDEWED. The imaging data of 1238 cases of head, 1152 cases of chest and 976 cases of abdominopelvic were analyzed retrospectively, and they were divided into five age groups: ≤ 0.5, 0.5 ~ ≤ 1, 1 ~ ≤ 5, 5 ~ ≤ 10 and 10 ~ ≤ 15 years according to age. The area of interest (AR), CT value (CTR), lateral diameter (LAT) and anteroposterior diameter (AP) of the median cross-sectional image of the standard scanning range and the SSDEWED were manually calculated, and a t-test was used to compare the differences between CTDIVOL and SSDEWED in different age groups. Pearson analyzed the correlations between DE and age, DE and WED, f and age, and counted the means of conversion factors in each age group, and analyze the error ratios between SSDE calculated based on the mean age group conversion factors and actual measured SSDE. The CTDIVOL in head was (9.41 ± 1.42) mGy and the SSDEWED was (8.25 ± 0.70) mGy: the difference was statistically significant (t = 55.04, P < 0.001); the CTDIVOL of chest was (2.68 ± 0.91) mGy and the SSDEWED was (5.16 ± 1.16) mGy, with a statistically significant difference (t = -218.78, P < 0.001); the CTDIVOL of abdominopelvic was (3.09 ± 1.58) mGy and the SSDEWED was (5.89 ± 2.19) mGy: the difference was also statistically significant (t = -112.28, P < 0.001). The CTDIVOL was larger than the SSDEWED in the head except for the ≤ 0.5 year subgroup, and CTDIVOL was smaller than SSDEWED within each subgroup in chest and abdominopelvic. There were strong negative correlations between f and age (head: r = -0.81; chest: r = -0.89; abdominopelvic: r = -0.86; P < 0.001). The mean values of f at each examination region were 0.81 ~ 1.01 for head, 1.65 ~ 2.34 for chest and 1.71 ~ 2.35 for abdominopelvic region. The SSDEWED could be accurately estimated using the mean f of each age subgroup. SSDEWED can more accurately measure the radiation dose of children. For children of different ages and examination regions, the SSDEWED conversion factors based on age subgroup can be quickly adjusted and improve the accuracy of radiation dose estimation.

PMID:38678314 | DOI:10.1093/rpd/ncae104

J Sports Sci. 2024 Apr 27:1-8. doi: 10.1080/02640414.2024.2323849. Online ahead of print.

ABSTRACT

This study evaluated learning and recall effects following a feedback-based retraining program. A 6-month follow-up of a quasi-randomized controlled trial was performed with and without recall. Twenty runners were assigned to experimental or control groups and completed a 3-week running program. A body-worn system collected axial tibial acceleration and provided real-time feedback on peak tibial acceleration for six running sessions in an athletic training facility. The experimental group received music-based biofeedback in a faded feedback scheme. The controls received tempo-synchronized music as a placebo for blinding purposes. The peak tibial acceleration and vertical loading rate of the ground reaction force were determined in a lab at baseline and six months following the intervention to assess retention and recall. The impacts of the experimental group substantially decreased at follow-up following a simple verbal recall (i.e., run as at the end of the program): peak tibial acceleration:-32%, p = 0.018; vertical loading rate:-34%, p = 0.006. No statistically significant changes were found regarding the retention of the impact variables. The impact magnitudes did not change over time in the control group. The biofeedback-based intervention did not induce clear learning at follow-up, however, a substantial impact reduction was recallable through simple cueing in the absence of biofeedback.

PMID:38678312 | DOI:10.1080/02640414.2024.2323849

Neurocase. 2024 Apr 27:1-8. doi: 10.1080/13554794.2024.2345404. Online ahead of print.

ABSTRACT

In this study, Event-Related Potential (ERP) analyzes were performed to detect cognitive impairments in PD with Deep Brain Stimulation (DBS). A total of 85 volunteers underwent ERP analysis and neuropsychological testing (NPT) to determine cognitive level. In ERP analyses, prolonged latencies were observed in PD groups. However, patients implanted with DBS showed a decrease in latencies, a decrease in symptoms and statistical improvements in both cognitive and attention skills. Considering all these data, ERP results are promising as a noninvasive method that can be used in both disease status and diagnosis of PD.

PMID:38678307 | DOI:10.1080/13554794.2024.2345404

Trials. 2024 Apr 27;25(1):286. doi: 10.1186/s13063-024-08104-x.

ABSTRACT

BACKGROUND: The fragility index is a statistical measure of the robustness or “stability” of a statistically significant result. It has been adapted to assess the robustness of statistically significant outcomes from randomized controlled trials. By hypothetically switching some non-responders to responders, for instance, this metric measures how many individuals would need to have responded for a statistically significant finding to become non-statistically significant. The purpose of this study is to assess the fragility index of randomized controlled trials evaluating opioid substitution and antagonist therapies for opioid use disorder. This will provide an indication as to the robustness of trials in the field and the confidence that should be placed in the trials’ outcomes, potentially identifying ways to improve clinical research in the field. This is especially important as opioid use disorder has become a global epidemic, and the incidence of opioid related fatalities have climbed 500% in the past two decades.

METHODS: Six databases were searched from inception to September 25, 2021, for randomized controlled trials evaluating opioid substitution and antagonist therapies for opioid use disorder, and meeting the necessary requirements for fragility index calculation. Specifically, we included all parallel arm or two-by-two factorial design RCTs that assessed the effectiveness of any opioid substitution and antagonist therapies using a binary primary outcome and reported a statistically significant result. The fragility index of each study was calculated using methods described by Walsh and colleagues. The risk of bias of included studies was assessed using the Revised Cochrane Risk of Bias tool for randomized trials.

RESULTS: Ten studies with a median sample size of 82.5 (interquartile range (IQR) 58, 179, range 52-226) were eligible for inclusion. Overall risk of bias was deemed to be low in seven studies, have some concerns in two studies, and be high in one study. The median fragility index was 7.5 (IQR 4, 12, range 1-26).

CONCLUSIONS: Our results suggest that approximately eight participants are needed to overturn the conclusions of the majority of trials in opioid use disorder. Future work should focus on maximizing transparency in reporting of study results, by reporting confidence intervals, fragility indexes, and emphasizing the clinical relevance of findings.

TRIAL REGISTRATION: PROSPERO CRD42013006507. Registered on November 25, 2013.

PMID:38678289 | DOI:10.1186/s13063-024-08104-x

BMC Psychol. 2024 Apr 27;12(1):241. doi: 10.1186/s40359-024-01746-1.

ABSTRACT

BACKGROUND: Climate change is seriously affecting human survival and development, and the anxiety caused by it is becoming increasingly prominent. How to alleviate people’s climate change anxiety, improve the ecological environment, and promote the formation of green lifestyles among people, especially young people, is an important topic that deserves to be explored. This study examined the relationship between climate change anxiety and pro-environmental behaviors and the underlying psychological mechanism in the adolescents.

METHODS: This study explored the crucial role of future self-continuity (FSC) between climate change anxiety (CCA) and pro-environmental behaviors (PEB) in adolescents and examined the moderating role of green self-efficacy (GSE). In this study, a total of 1,851 middle and high school students from five schools were selected for questionnaire survey.

RESULTS: The results showed that (1) in both middle and high school grades, there was a significant negative correlation between climate change anxiety and pro-environmental behaviors; future self-continuity was significantly positively correlated with pro-environmental behaviors; green self-efficacy was negatively correlated with climate change anxiety and positively correlated with pro-environmental behaviors; (2) climate change anxiety negatively predicted pro-environmental behaviors, and compared with middle school grades, high school grade adolescents’ climate change anxiety was significantly predicted pro-environmental behaviors. Future self-continuity mediated the relationship between climate change anxiety and pro-environmental behaviors in both grades. (3) green self-efficacy moderated the second half of the pathway of the mediation model only in middle grades. Specifically in middle school, future self-continuity did not significantly predict pro-environmental behaviors at low green self-efficacy level, but positively predicted pro-environmental behaviors at high green self-efficacy level. In high school, future self-continuity did not significantly predict pro-environmental behaviors in either high or low green self-efficacy level.

CONCLUSION: This study suggests that there is a moderated mediation model between adolescents’ climate change anxiety and pro-environmental behaviors, with different mediating and moderating effects among adolescents in various grades. This is of great significance in alleviating climate anxiety among adolescents and cultivating their pro-environmental behaviors.

PMID:38678287 | DOI:10.1186/s40359-024-01746-1

BMC Psychol. 2024 Apr 27;12(1):239. doi: 10.1186/s40359-024-01745-2.

ABSTRACT

The impact of free time management and leisure satisfaction on quality of life is distinct, however, the role of satisfaction in enhancing quality of life through free time management remains uncertain. Hence, the objective of this research is to explore how leisure satisfaction acts as a mediator between free time management and the levels of quality of life among university students. Additionally, this study aims to analyse these concepts in relation to gender, age and the number of days of activity participation. Within this particular framework, a total of 213 university students willingly participated in the survey, which included the administration of the “Free Time Management Scale,” “Leisure Satisfaction Scale,” and “Quality of Life Scale.” The analyses employed the Independent T-Test, Pearson Correlation, and Linear Regression methods. The mediating effect was analysed using Structural Equation Modelling. The study found significant relationships between gender, free time management, and life quality. There was a significant relationship between free time management, leisure satisfaction, and quality of life (p < 0.05). Leisure satisfaction partially mediated the quality of life-free time management relationship. As age and physical activity grow, males have a higher standard of living, and time allocation and quality of life improve. Furthermore, it was found that students who effectively managed their time experienced an enhanced quality of life, as evidenced by their increased satisfaction with leisure activities. Notably, the level of satisfaction with well-managed time was identified as a crucial factor in this association.

PMID:38678286 | DOI:10.1186/s40359-024-01745-2

World J Emerg Surg. 2024 Apr 27;19(1):16. doi: 10.1186/s13017-024-00544-9.

ABSTRACT

OBJECTIVE: For traumatic lower extremity artery injury, it is unclear whether it is better to perform endovascular therapy (ET) or open surgical repair (OSR). This study aimed to compare the clinical outcomes of ET versus OSR for traumatic lower extremity artery injury.

METHODS: The Medline, Embase, and Cochrane Databases were searched for studies. Cohort studies and case series reporting outcomes of ET or OSR were eligible for inclusion. Robins-I tool and an 18-item tool were used to assess the risk of bias. The primary outcome was amputation. The secondary outcomes included fasciotomy or compartment syndrome, mortality, length of stay and lower extremity nerve injury. We used the random effects model to calculate pooled estimates.

RESULTS: A total of 32 studies with low or moderate risk of bias were included in the meta-analysis. The results showed that patients who underwent ET had a significantly decreased risk of major amputation (OR = 0.42, 95% CI 0.21-0.85; I²=34%) and fasciotomy or compartment syndrome (OR = 0.31, 95% CI 0.20-0.50, I² = 14%) than patients who underwent OSR. No significant difference was observed between the two groups regarding all-cause mortality (OR = 1.11, 95% CI 0.75-1.64, I² = 31%). Patients with ET repair had a shorter length of stay than patients with OSR repair (MD=-5.06, 95% CI -6.76 to -3.36, I² = 65%). Intraoperative nerve injury was just reported in OSR patients with a pooled incidence of 15% (95% CI 6%-27%).

CONCLUSION: Endovascular therapy may represent a better choice for patients with traumatic lower extremity arterial injury, because it can provide lower risks of amputation, fasciotomy or compartment syndrome, and nerve injury, as well as shorter length of stay.

PMID:38678282 | DOI:10.1186/s13017-024-00544-9

Malar J. 2024 Apr 27;23(1):123. doi: 10.1186/s12936-024-04957-4.

ABSTRACT

BACKGROUND: Malaria is still a disease of global public health importance and children under-five years of age are the most vulnerable to the disease. Nigeria adopted the “test and treat” strategy in the national malaria guidelines as one of the ways to control malaria transmission. The level of adherence to the guidelines is an important indicator for the success or failure of the country’s roadmap to malaria elimination by 2030. This study aimed to assess the fidelity of implementation of the national guidelines on malaria diagnosis for children under-five years and examine its associated moderating factors in health care facilities in Rivers State, Nigeria.

METHODS: This was a descriptive, cross-sectional study conducted in Port Harcourt metropolis. Data were collected from 147 public, formal private and informal private health care facilities. The study used a questionnaire developed based on Carroll’s Conceptual Framework for Implementation Fidelity. Frequency, mean and median scores for implementation fidelity and its associated factors were calculated. Associations between fidelity and the measured predictors were examined using Mann Whitney U test, Kruskal Wallis test, and multiple linear regression modelling using robust estimation of errors. Regression results are presented in adjusted coefficient (β) and 95% confidence intervals.

RESULTS: The median (IQR) score fidelity score for all participants was 65% (43.3, 85). Informal private facilities (proprietary patent medicine vendors) had the lowest fidelity scores (47%) compared to formal private (69%) and public health facilities (79%). Intervention complexity had a statistically significant inverse relationship to implementation fidelity (β = – 1.89 [- 3.42, – 0.34]). Increase in participant responsiveness (β = 8.57 [4.83, 12.32]) and the type of malaria test offered at the facility (e.g., RDT vs. no test, β = 16.90 [6.78, 27.03]; microscopy vs. no test, β = 21.88 [13.60, 30.16]) were positively associated with fidelity score.

CONCLUSIONS: This study showed that core elements of the “test and treat” strategy, such as testing all suspected cases with approved diagnostic methods before treatment, are still not fully implemented by health facilities. There is a need for strategies to increase fidelity, especially in the informal private health sector, for malaria elimination programme outcomes to be achieved.

PMID:38678279 | DOI:10.1186/s12936-024-04957-4

BMC Health Serv Res. 2024 Apr 27;24(1):541. doi: 10.1186/s12913-024-11036-6.

ABSTRACT

BACKGROUND: Research on health resource allocation trends in ethnic minority and impoverished areas in China is limited since the 2009 Medical Reform. This study aimed to investigate the variations and inequalities in health resource distribution among ethnic minority, poverty-stricken, and non-minority regions in Sichuan Province, a multi-ethnic province in Southwest China, from 2009 to 2019.

METHODS: The numbers of beds, doctors and nurses were retrospectively sourced from the Sichuan Health Statistics Yearbook between 2009 and 2019. All the 181 counties in Sichuan Province were categorized into five groups: Yi, Zang, other ethnic minority, poverty-stricken, and non-minority county. The Theil index, adjusted for population size, was used to evaluate health resource allocation inequalities.

RESULTS: From 2009 to 2019, the number of beds (Bed_p1000), doctors (Doc_p1000), and nurses (Nur_p1000) per 1000 individuals in ethnic minority and poverty-stricken counties consistently remained lower than non-minority counties. The growth rates of Bed_p1000 in Yi (140%) and other ethnic minority counties (127%) were higher than in non-minority counties (121%), while the growth rates of Doc_p1000 in Yi (20%) and Zang (11%) counties were lower than non-minority counties (61%). Doc_p1000 in 33% and 50% of Yi and Zang ethnic counties decreased, respectively. Nur_p1000 in Yi (240%) and other ethnic minority (316%) counties increased faster than non-minority counties (198%). The Theil index for beds and nurses declined, while the index for doctors increased. Key factors driving increases in bed allocation include preferential policies and economic development levels, while health practitioner income, economic development levels and geographical environment significantly influence doctor and nurse allocation.

CONCLUSIONS: Preferential policies have been successful in increasing the number of beds in health facilities, but not healthcare workers, in ethnic minority regions. The ethnic disparities in doctor allocation increased in Sichuan Province. To increase the number of doctors and nurses in ethnic minority and poverty-stricken regions, particularly in Yi counties, more preferential policies and resources should be introduced.

PMID:38678273 | DOI:10.1186/s12913-024-11036-6