Category: Nevin Manimala

Am J Public Health. 2023 Sep;113(9):991-999. doi: 10.2105/AJPH.2023.307337.

ABSTRACT

Objectives. To examine the state-level history of US overdose deaths involving stimulants with and without opioids from 1999 to 2020. Methods. We used death certificate data from the National Center for Health Statistics to categorize deaths into 4 groups of interest: cocaine with and without opioids, and psychostimulants with and without opioids. We used a Bayesian multiple change point model to describe the timing and magnitude of changes in overdose death rates involving stimulants for each state and year. Results. There was little change in the death rates of cocaine without opioids. Death rates involving cocaine and opioids sharply increased around 2015, particularly in the Northeast and Mid-Atlantic. We also observed steady increases in deaths involving psychostimulants without opioids just before 2010, particularly in states in the West and South. Deaths involving psychostimulants with opioids increased around 2015 with largest increases concentrated in Appalachian states. Conclusions. There is significant geographic heterogeneity in the co-involvement of stimulants in the US overdose crisis. Results can inform public health efforts to inform state-level overdose efforts such as naloxone distribution. (Am J Public Health. 2023;113(9):991-999. https://doi.org/10.2105/AJPH.2023.307337).

PMID:37556789 | DOI:10.2105/AJPH.2023.307337

J Clin Oncol. 2023 Aug 9:JCO2300126. doi: 10.1200/JCO.23.00126. Online ahead of print.

ABSTRACT

PURPOSE: BMI affects breast cancer risk and prognosis. In contrast to cytotoxic chemotherapy, CDK4/6 inhibitors are given at a fixed dose, irrespective of BMI or weight. This preplanned analysis of the global randomized PALLAS trial investigates the impact of BMI on the side-effect profile, treatment adherence, and efficacy of palbociclib.

METHODS: Patients were categorized at baseline according to WHO BMI categories. Neutropenia rates were assessed with univariable and multivariable logistic regression. Time to early discontinuation of palbociclib was analyzed with Fine and Gray competing risk models. Unstratified Cox models were used to investigate the association between BMI category and time to invasive disease-free survival (iDFS). 95% CIs were derived.

RESULTS: Of 5,698 patients included in this analysis, 68 (1.2%) were underweight, 2,082 (36.5%) normal weight, 1,818 (31.9%) overweight, and 1,730 (30.4%) obese at baseline. In the palbociclib arm, higher BMI was associated with a significant decrease in neutropenia (unadjusted odds ratio for 1-unit change, 0.93; 95% CI, 0.91 to 0.94; adjusted for age, race ethnicity, region, chemotherapy use, and Eastern Cooperative Oncology Group at baseline, 0.93; 95% CI, 0.92 to 0.95). This translated into a significant decrease in treatment discontinuation rate with higher BMI (adjusted hazard ratio [HR] for 10-unit change, 0.75; 95% CI, 0.67 to 0.83). There was no significant improvement in iDFS with the addition of palbociclib to ET in any weight category (normal weight HR, 0.84; 95% CI, 0.63 to 1.12; overweight HR, 1.10; 95% CI, 0.82 to 1.49; and obese HR, 0.95; 95% CI, 0.69 to 1.30) in this analysis early in follow-up (31 months).

CONCLUSION: This preplanned analysis of the PALLAS trial demonstrates a significant impact of BMI on side effects, dose reductions, early treatment discontinuation, and relative dose intensity. Additional long-term follow-up will further evaluate whether BMI ultimately affects outcome.

PMID:37556775 | DOI:10.1200/JCO.23.00126

J Biophotonics. 2023 Aug 9:e202300235. doi: 10.1002/jbio.202300235. Online ahead of print.

ABSTRACT

Ischemic stroke occurs when a blood vessel supplying the brain is blocked, leading to decreased blood flow. Early diagnosis and treatment are crucial. However, existing clinical imaging methods have limitations, such as safety issues and low time resolution. To address these challenges, we propose using photoacoustic tomography (PAT) with a contrast agent, known for its high resolution and contrast capabilities. Our study involved imaging brain vasculature in three groups: normal, unilateral common carotid artery ligation (UCAL), and middle cerebral artery occlusion (MCAO). On the ischemic stroke side, we observed reduced blood vessel density, and hemodynamic changes were evident after injecting indocyanine green (ICG) for PAT. The photoacoustic intensity was notably lower in the ligated sides of the UCAL and MCAO groups, with statistically significant differences between the three groups. This work highlights PAT’s potential as a powerful tool for early diagnosis and guidance in ischemic stroke cases. This article is protected by copyright. All rights reserved.

PMID:37556758 | DOI:10.1002/jbio.202300235

Arq Gastroenterol. 2023 Apr-Jun;60(2):257-263. doi: 10.1590/S0004-2803.202302023-47.

ABSTRACT

•Women with intestinal endometriosis may have impaired quality of life and altered bowel habits. Intestinal endometriosis can be treated medically or surgically. The bowel function of these women is directly correlated with sexual function and quality of life, regardless of the type of treatment. Background – Women with intestinal endometriosis may have a higher incidence of constipation, which may influence their quality of life. Objective – To correlate bowel function with sexual function and quality of life in women with deep endometriosis according to the type of treatment. Methods – Cross-sectional study carried out with 141 women with bowel endometriosis from May 2020 to April 2021. Women were divided into two groups according to kind of treatment: 51 women with surgery treatment and 90 women with medical treatment. The Endometriosis Health Profile Questionnaire were used to assess quality of life e Female Sexual Function Index were used to assess sexual function. To access bowel function we used the following questionnaires: Gastrointestinal Quality of Life Index and Pelvic Floor Distress Inventory. Results – The mean age of women in the surgical group (37.98±5.91years) was higher than that of the medical group (35.68±5.45years) (P=0.006). There was no statistically significant difference between pain symptoms (P=0.905), water intake (P=0.573) or fiber (P=0.173) and physical activity (P=0.792) in both groups. There was no difference between quality of life and sexual function in both groups. There was a direct correlation of bowel function with quality of life and sexual function in both groups. Conclusion: Bowel function is directly correlated with sexual function and quality of life, regardless of the type of treatment.

PMID:37556752 | DOI:10.1590/S0004-2803.202302023-47

J Phys Chem B. 2023 Aug 9. doi: 10.1021/acs.jpcb.3c03540. Online ahead of print.

ABSTRACT

Mixed quantum-classical molecular dynamics simulations have been important tools for studying the hydrated electron. They generally use a one-electron pseudopotential to describe the interactions of an electron with the water molecules. This approximation shows both the strength and weakness of the approach. On the one hand, it enables extensive statistical sampling and large system sizes that are not possible with more accurate ab initio molecular dynamics methods. On the other hand, there has (justifiably) been much debate about the ability of pseudopotentials to accurately and quantitatively describe the hydrated electron properties. These pseudopotentials have largely been derived by fitting them to ab initio calculations of an electron interacting with a single water molecule. In this paper, we present a proof-of-concept demonstration of an alternative approach in which the pseudopotential parameters are determined by optimizing them to reproduce key experimental properties. Specifically, we develop a new pseudopotential, using the existing TBOpt model as a starting point, which correctly describes the hydrated electron vertical detachment energy and radius of gyration. In addition to these properties, this empirically optimized model displays a significantly modified solvation structure, which improves, for example, the prediction of the partial molar volume.

PMID:37556737 | DOI:10.1021/acs.jpcb.3c03540

Codas. 2023 Aug 4;35(4):e20220007. doi: 10.1590/2317-1782/20232022007pt. eCollection 2023.

ABSTRACT

PURPOSE: To identify the main categories of the Activities and Participation component of the International Classification of Functioning, Disability, and Health and to verify the association with age, gender, education, and speech therapy diagnosis in children who are assisted by an oral language clinic.

METHODS: This is an analytical and cross-sectional observational study, carried out with secondary data from 32 medical records of children with the majority male, mean age of 41.03 months, in early childhood education and language disorder associated with other conditions. The main speech-language pathology manifestations were coded according to the pre-selected categories of the Activities and Participation component, and descriptive and bivariate statistical analyzes were performed, and the Fisher’s Exact test was used with a significance level of 5%.

RESULTS: The descriptive analysis of the pre-selected categories allowed us to verify a high number of “Not informed” answers, with a higher percentage in vocal expression without speech (d331) performance (93.8%), making decisions (d177) ability (90.6%), problem solving (d175) performance (65.6%) and capacity (87.5%), reception of oral messages (d310) performance (65.6%) and eating (d550) capacity (65.6%). Among the 24 categories selected, 12 jointly contemplated the Qualifiers of Performance and Capacity. There was a statistically significant association between the three categories with sociodemographic data and speech therapy diagnoses.

CONCLUSION: Difficulties were identified in several categories of the Activities and Participation component and statistically significant associations between them and sociodemographic data and speech therapy diagnoses, showing the impacts of oral language disorders on the activities and participation of children assisted in an outpatient speech therapy service.

PMID:37556703 | DOI:10.1590/2317-1782/20232022007pt

Codas. 2023 Aug 7;35(4):e20210301. doi: 10.1590/2317-1782/20232021301pt. eCollection 2023.

ABSTRACT

PURPOSE: To analyze the performance of normal-hearing adults with communication complaints in the Dichotic Sentences Test.

METHODS: We selected from the database 15 normal-hearing participants with normal results in the Digits Dichotic Test, aged between 19 and 44 years, right-handed, who reported communicative complaints. The Dichotic Sentences Test was applied using two protocols consisting of four different combinations of lists called sequences 1 and 2, in the following order: training, divided attention step, right and left directed attention steps.

RESULTS: In the first application sequence, the average performance in the divided attention step was 84.7% for the right ear and 60.67% for the left, with statistical difference between ears. The asymmetry between ears varied from -50% to 60%. In the directed attention step, the average performance was 99.33% for the right ear and 98% for the left, with no statistical difference. In the second application sequence, there was a tendency for better results, more pronounced for the left ear, with no statistical significance, with the performance variation and asymmetry between ears remaining high. In the comparison between the sequences, in the divided attention step, it was found that, for the right ear, 40% of the individuals did not vary, 33% performed worse, and 26.7% performed better; for the left ear, 6.6% did not vary, 20% performed worse, and 73.33% performed better. There was result stability in the directed attention step.

CONCLUSION: The normal-hearing adults with communication complaints presented a heterogeneous profile, especially in the divided attention step, with a marked difference between ears and response variability.

PMID:37556702 | DOI:10.1590/2317-1782/20232021301pt

Rev Bras Enferm. 2023 Aug 7;76(3):e20220375. doi: 10.1590/0034-7167-2022-0375. eCollection 2023.

ABSTRACT

OBJECTIVES: to analyze the relationship of general, physical, and psychological violence with depressive symptoms and cognition in the elderly.

METHODS: quantitative, cross-sectional study, carried out with 323 elders from the Brazilian northeast. Data collection used a sociodemographic instrument; the Conflict Tactics Scales Form R; the Geriatric Depression Scale; and the Mini-Mental State Examination. The analysis employed descriptive and inferential statistics.

RESULTS: as violence increases, so do the depressive symptoms; the opposite was true when comparing violence with cognitive involvement. There is a correlation between physical and psychological violence and depressive symptoms; more depressive elders are from 1.96 to 3.00 times more likely to be the victims of psychological and physical violence, respectively.

CONCLUSIONS: general, physical, and psychological violence is associated with depressive symptoms; those with less cognitive alterations are more vulnerable to abuse. Elders with depressive symptoms are more likely to suffer psychological and physically violence.

PMID:37556690 | DOI:10.1590/0034-7167-2022-0375

Codas. 2023 Aug 7;35(5):e20220099. doi: 10.1590/2317-1782/20232022099pt. eCollection 2023.

ABSTRACT

PURPOSE: To correlate the dysphagia quality of life and symptoms of anxiety and depression before and after thyroidectomy.

METHODS: Observational, longitudinal, prospective, and experimental study. Twenty patients participated, with a mean age of 54 years, prevalence of females (n=17; 85%) and partial thyroidectomy (n=14; 70%). All subjects underwent laryngeal visual examination and answered the MD Anderson Dysphagia Questionnaire (MDADI) and the Hospital Anxiety and Depression Scale (HADS) in three different moments: preoperatively, immediately postoperatively (maximum one week) and three months after surgery.

RESULTS: There was a significant difference in dysphagia quality of life for the physical and total domains in the three different moments. Regarding anxiety and depression, a statistically significant difference was observed between the scores in all domains, with a greater difference observed between the preoperative period and after 1 week. Higher values were observed in the preoperative period for mild anxiety traits, being more frequent in relation to depression, with a reduction after 1 week and an increase after three months of surgery. There was no significant correlation between the MDADI and HADS protocols.

CONCLUSION: Patients undergoing thyroidectomy self-report better quality of life in dysphagia and reduced anxiety/depression scores after three months of surgery. There was no correlation between anxiety, depression and quality of life in dysphagia at the moments evaluated.

PMID:37556687 | DOI:10.1590/2317-1782/20232022099pt

Codas. 2023 Aug 7;35(5):e20220005. doi: 10.1590/2317-1782/20232022005. eCollection 2023.

ABSTRACT

PURPOSE: Perspective-based studies have been carried out on health professionals to create clinical implications that will positively impact the healthcare system. There are no such studies exploring the perspectives of Indian speech language pathologists (SLPs) towards handling adolescents with language impairments. Therefore, the current study aims to explore the perspectives of Indian SLPs on the assessment of adolescent language.

METHODS: The study followed a cross-sectional study design following a non-random convenient sampling procedure. A total number of 102 SLPs participated in the study. Phase 1 comprised developing a questionnaire to identify the perspectives of SLPs towards the assessment of adolescents with language impairments. A total of 9 questions were formulated for the same. Phase 2 included the data collection which was conducted through an online survey. Phase 3 focused on the data analysis. Descriptive statistics were to determine the mean and SD for continuous variables, and frequency and percentage for discrete variables.

RESULTS: The current study results indicated significant disparities in the perspectives of SLPs towards adolescent language assessment. An overall level of poor awareness and a superficial understanding of the core area (about adolescence, and the areas and tools for assessment) was evident.

CONCLUSION: Understanding the perspectives of SLPs towards adolescent language assessment is critical in paving the way for future clinical development and research.

PMID:37556685 | DOI:10.1590/2317-1782/20232022005