Category: Nevin Manimala

Nurs Sci Q. 2024 Jan;37(1):48-55. doi: 10.1177/08943184231207372.

ABSTRACT

Caring as a central focus within nursing has evolved into a relational ontology to guide practice and enhance well-being. Caring praxis has the potential to address the complexities of adolescent development and to allow for authentic engagement, breaking down the barriers of resistance to care. It is clear from the alarming statistics related to the prevalence of anxiety and depression in adolescents that teens are in distress. The authors in this article examine the construct of relatedness in adolescence through the lens of the theory of unitary caring and propose a trans-theoretical transdisciplinary model of relatedness that informs adolescent practice.

PMID:38054313 | DOI:10.1177/08943184231207372

Behav Brain Sci. 2023 Dec 6;46:e388. doi: 10.1017/S0140525X23001759.

ABSTRACT

Psychologically faithful deep neural networks (DNNs) could be constructed by training with psychophysics data. Moreover, conventional DNNs are mostly monocular vision based, whereas the human brain relies mainly on binocular vision. DNNs developed as smaller vision agent networks associated with fundamental and less intelligent visual activities, can be combined to simulate more intelligent visual activities done by the biological brain.

PMID:38054301 | DOI:10.1017/S0140525X23001759

Int J Gynecol Cancer. 2023 Dec 2:ijgc-2023-004920. doi: 10.1136/ijgc-2023-004920. Online ahead of print.

ABSTRACT

OBJECTIVE: The management and surveillance of glandular pre-cancerous lesions of the uterine cervix present distinct challenges compared with squamous lesions, primarily attributed to the lower effectiveness of diagnostic methods such as cytology or colposcopy. This study aimed to investigate the long-term safety of fertility-sparing treatment for adenocarcinoma in situ and microinvasive adenocarcinoma of the cervix, while identifying factors associated with recurrence, with a particular emphasis on the role of human papillomavirus (HPV) testing.

METHODS: We retrospectively reviewed data from all patients with histopathologically confirmed adenocarcinoma in situ or microinvasive cervical adenocarcinoma who received treatment at a single center between 2002 and 2023. The study involved the examination of consecutive surgical specimens and the follow-up details. Factors associated with recurrence were assessed in a subgroup of patients with available long-term follow-up data (at least 6 months).

RESULTS: In total, 143 patients (112 with adenocarcinoma in situ and 31 with adenocarcinoma) were included in the analysis. Among the 86 patients who underwent fertility-sparing treatment, the recurrence rate was 9% (12% for adenocarcinoma in situ and 4% for adenocarcinoma) during a median follow-up period of 56.6 months (range 7-179). No patients who were HPV negative experienced recurrence during the follow-up period. In contrast, among patients who were HPV positive, the recurrence rate was 38%. Additionally, HPV 16/18 positivity displayed a notable association with a higher risk of recurrence compared with the other high-risk genotypes, although this difference did not reach statistical significance (83% vs 10%; p=0.083, log-rank).

CONCLUSION: Our retrospective study demonstrated a significant association between the risk of recurrence and HPV status during the follow-up period. Consequently, long-term follow-up utilizing HPV testing and genotyping appears to be a secure alternative to a hysterectomy.

PMID:38054269 | DOI:10.1136/ijgc-2023-004920

Int J Gynecol Cancer. 2023 Dec 2:ijgc-2023-004880. doi: 10.1136/ijgc-2023-004880. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate a wide range of clinical and ultrasound characteristics of different uterine smooth muscle tumors to identify features capable of discriminating between these types.

METHODS: This was a retrospective, multicenter study that included 285 patients diagnosed with uterine smooth muscle tumors (50 leiomyosarcomas, 35 smooth muscle tumors of uncertain malignant potential, and 200 leiomyomas). The patients were divided into three groups based on the histological type of their tumors, and the groups were compared according to the variables collected.

RESULTS: Leiomyosarcomas were more common in older and post-menopausal women. Compared with leiomyomas, smooth muscle tumors of uncertain malignant potential and leiomyosarcomas had similar ultrasound features such as absence of normal myometrium, multilocular appearance, hyper-echogenicity in case of uniform echogenicity, absence of posterior shadows, echogenic areas, and hyperechoic rim. Leiomyosarcomas were larger, had more cystic areas, and were associated with a higher prevalence of pelvic free fluid. Smooth muscle tumors of uncertain malignant potential were characterized by a higher frequency of International Federation of Gynecology and Obstetrics (FIGO) type 6-7, the absence of internal shadows, and, in the case of cystic area, the presence of a regular internal wall. Tumor outline varied among the three histological types. A color score of 1 was typical of leiomyoma, a color score 2 was mainly observed in leiomyomas and smooth muscle tumors of uncertain malignant potential, a color score 3 did not differ among the tumors, while a color of score 4 was related to leiomyosarcomas. When combining color scores 3 and 4, leiomyosarcomas and smooth muscle tumors of uncertain malignant potential showed a high percentage of both circumferential and intra-lesional vascularization. A cooked appearance was not statistically different among the tumors.

CONCLUSIONS: Based on our findings, specific ultrasonographic features as well as age and menopausal status are associated with different uterine smooth muscle tumor types. Integration of these data can help the pre-operative assessment of these lesions for proper management.

PMID:38054268 | DOI:10.1136/ijgc-2023-004880

NMR Biomed. 2023 Dec 6:e5079. doi: 10.1002/nbm.5079. Online ahead of print.

ABSTRACT

A technique for combined time-of-flight (TOF) MR angiography (MRA) and quantitative susceptibility mapping (QSM) was developed with key features of standard three-dimensional (3D) TOF acquisitions, including multiple overlapping thin slab acquisition (MOTSA), ramped RF excitation, and venous saturation. The developed triple-echo 3D TOF-QSM sequence enabled TOF-MRA, susceptibility-weighted imaging (SWI), QSM, and R2* mapping. The effects of ramped RF, resolution, flip angle, venous saturation, and MOTSA were studied on QSM. Six volunteers were scanned at 3 T with the developed sequence, conventional TOF-MRA, and conventional SWI. Quantitative comparison of susceptibility values on QSM and normalized arterial and venous vessel-to-background contrasts on TOF and SWI were performed. The ramped RF excitation created an inherent phase variation in the raw phase. A generic correction factor was computed to remove the phase variation to obtain QSM without artifacts from the TOF-QSM sequence. No statistically significant difference was observed between the developed and standard QSM sequence for susceptibility values. However, maintaining standard TOF features led to compromises in signal-to-noise ratio for QSM and SWI, arising from the use of MOTSA rather than one large 3D slab, higher TOF spatial resolution, increased TOF background suppression due to larger flip angles, and reduced venous signal from venous saturation. In terms of vessel contrast, veins showed higher normalized contrast on SWI derived from TOF-QSM than the standard SWI sequence. While fast flowing arteries had reduced contrast compared with standard TOF-MRA, no statistical difference was observed for slow flowing arteries. Arterial contrast differences largely arise from the longer TR used in TOF-QSM over standard TOF-MRA to accommodate additional later echoes for SWI. In conclusion, although the sequence has a longer TR and slightly lower arterial contrast, provided an adequate correction is made for ramped RF excitation effects on phase, QSM may be performed from a multiecho sequence that includes all key TOF features, thus enabling simultaneous TOF-MRA, SWI, QSM, and R2* map computation.

PMID:38054247 | DOI:10.1002/nbm.5079

Zh Vopr Neirokhir Im N N Burdenko. 2023;87(6):52-58. doi: 10.17116/neiro20238706152.

ABSTRACT

Methylation of the O-6-methylguanine-DNA methyltransferase (MGMT) gene promoter is currently the most important prognostic biomarker in therapy of IDH-wild-type glioblastoma. One can obtain information about this methylation from total DNA methylation profile.

OBJECTIVE: To analyze the DNA methylation signal intensity in the MGMT gene in samples of malignant gliomas and identify the most significant genomic positions for calculating the MGMT gene promoter status for further improvement of diagnostics and prediction of therapeutic options in patients with malignant gliomas.

MATERIAL AND METHODS: The study is based on 43 samples (frozen tissue or paraffin blocks) from patients with malignant gliomas. Tumor DNA samples were prepared using the Illumina Infinium MethylationEPIC BeadChip Kit and the Illumina Next-Seq 550 Sequencing System platform. DNA methylation profiles were analyzed using computational algorithms in the R language, specialized libraries minfi and mgmtstp27, as well as basic statistical functions in the Rstudio environment.

RESULTS: We established the MGMT gene promoter status in 43 samples of malignant gliomas considering total DNA methylation profile. In 24 samples (55%), the MGMT gene promoter was methylated. We compared methylation signal in certain CpG islands in groups with methylated and unmethylated MGMT gene promoters and identified the most significant positions for further improvement of data analysis algorithm.

CONCLUSION: These data demonstrate the possibilities and prospects for further improvement of algorithm for analysis of the MGMT gene promoter status based on total DNA methylation profile in patients with malignant gliomas as an alternative to methyl-specific PCR. Our results are consistent with data of other neuro-oncology researchers. Indeed, computational methods like MGMT-STP27 are quite powerful and can be used in scientific and clinical practice to assess prognosis and make decisions about chemotherapy with alkylating agents.

PMID:38054227 | DOI:10.17116/neiro20238706152

Zh Vopr Neirokhir Im N N Burdenko. 2023;87(6):43-51. doi: 10.17116/neiro20238706143.

ABSTRACT

Glioma cell cultures are used in basic researches of tumor processes, personalized medicine for selecting treatment regimens depending on individual characteristics of patients and pharmacology for assessing the effectiveness of chemotherapy. Suppression of glioma culture growth without reduction of malignancy grade is common. Drug cancellation may be followed by substitution of precursor cells by more malignant clones. Therefore, analysis of culture cell malignancy grade is important. In the future, intraoperative analysis of glioma cell malignancy grade can be used to select individual therapy.

OBJECTIVE: We analyzed the relationship between expression of marker genes TUBB3, CD133, CDK4, CDK6, CIRBP, DR4, DR5, EGFR, FGFR, FSHR, GDNF, GFAP, L1CAM, LEF1, MAP2, MDM2, MELK, NANOG, NOTCH2, OCT4, OLIG2, PDGFRA, PDGFA, PDGFB and SOX2 and glioma cell malignancy grade, as well as created appropriate prognostic model.

MATERIAL AND METHODS: We analyzed expression of 25 marker genes in 22 samples of human glioma cultures using quantitative real-time PCR. Statistical analysis was performed using the IBM SPSS Statistics 26.0 software. We used the Kolmogorov-Smirnov and Shapiro-Wilk tests to assess distribution normality. Nonparametric Jonckheere-Terpstra and Spearman tests were applied.

RESULTS: We obtained a prognostic model for assessing the grade III and IV glioma cell malignancy based on expression of marker genes MDM2, MELK, SOX2, CDK4, DR5 and OCT4. Predictive accuracy was 83% (Akaike information criterion -55.125).

PMID:38054226 | DOI:10.17116/neiro20238706143

JBI Evid Synth. 2023 Dec 6. doi: 10.11124/JBIES-23-00043. Online ahead of print.

ABSTRACT

OBJECTIVE: This review update aimed to determine the best strategies for assisted bathing or showering for older adults with dementia.

INTRODUCTION: Assisted bathing is a high-risk activity, as it can trigger agitated behaviors. Assisted bathing of older adults with dementia can create caregiver challenges and stress.

INCLUSION CRITERIA: This review update considered quantitative, qualitative, and mixed methods studies that investigated, firstly, older adults with dementia who required assistance in bathing and, secondly, their caregivers and family members who provided this assistance. The quantitative component considered randomized controlled trials and quasi-experimental studies testing interventions for reducing agitated behaviors in older adults with dementia during bathing, as well as perceived confidence or satisfaction in caregivers. The qualitative component considered studies that reported on experiences of clients or caregivers during the bathing process.

METHODS: A JBI mixed methods review was conducted following the convergent segregated approach. The review considered studies published between 1990 and March 11, 2022. The databases searched were PubMed, CINAHL, and Embase. Gray literature was also searched. Two independent reviewers screened titles and abstracts. Full texts were retrieved for studies that met the inclusion criteria and were assessed further for eligibility. Two reviewers independently assessed the quality of included studies and extracted data using the standardized JBI tools. Due to methodological and clinical heterogeneity, the results were presented in narratively in the quantitative section. For the qualitative component, meta-synthesis was conducted following the JBI approach of meta-aggregation. Finally, evidence from the 2 components was integrated following the convergent segregated approach.

RESULTS: Ten quantitative and 4 qualitative studies were included. The methodological quality was poor to moderate in the quantitative studies and moderate to high in the qualitative studies. Results from 3 quantitative studies suggested that providing training to caregivers on person-centered bathing reduced agitated behaviors in older adults with dementia. Other interventions did not show conclusive evidence of their effectiveness in any outcomes of interest. Two synthesized findings highlighted i) the importance of working within each person’s reality by having the skills and knowledge required to deliver person-centered assistance and ii) the challenges experienced by caregivers, such as lack of support, time pressure, and safety-related fears. The integrated evidence showed that the quantitative and qualitative components complemented each other to promote the training of caregivers to deliver person-centered bathing.

DISCUSSION: Integrated findings can help inform an evidence-based strategy utilizing a person-centered bathing approach to reduce agitated behaviors in older adults with dementia. Due to the limited number of eligible studies, and the clinical and methodological heterogeneity of included quantitative studies, no statistical pooling was possible. More studies are needed, particularly intervention studies with high methodological quality.

CONCLUSIONS: This review update suggests that providing caregivers with person-centered bathing training should be encouraged prior to bathing older adults with dementia. Caregivers should have knowledge and skills, such as relevant assessment and communication skills, enabling them to provide effective bathing experiences to older adults living with dementia. Organizations should provide caregivers with appropriate resources and training for bathing older adults with dementia.

REVIEW REGISTRATION: PROSPERO CRD42020208048.

SUPPLEMENTAL DIGITAL CONTENT: A Japanese-language version of the abstract of this review is available as Supplemental Digital Content 1, http://links.lww.com/SRX/A37.

PMID:38054221 | DOI:10.11124/JBIES-23-00043

Front Psychol. 2023 Nov 20;14:1272919. doi: 10.3389/fpsyg.2023.1272919. eCollection 2023.

ABSTRACT

OBJECTIVE: The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone.

METHODS: The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions.

RESULTS: Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed.

CONCLUSION: Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.

PMID:38054176 | PMC:PMC10694472 | DOI:10.3389/fpsyg.2023.1272919

Emerg Med Int. 2023 Nov 27;2023:6108057. doi: 10.1155/2023/6108057. eCollection 2023.

ABSTRACT

OBJECTIVE: This study aimed to investigate emergency nurses’ disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses.

METHODS: A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses’ disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses’ Disaster Nursing Ability Assessment Scale were used in the survey.

RESULTS: There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05).

CONCLUSION: The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.

PMID:38054165 | PMC:PMC10695688 | DOI:10.1155/2023/6108057