Category: Nevin Manimala

Gynecol Endocrinol. 2023 Dec;39(1):2264983. doi: 10.1080/09513590.2023.2264983. Epub 2023 Oct 19.

ABSTRACT

OBJECTIVE: This study aimed to collect, organize, and conduct a meta-analysis of the literature on the expression of silent information regulator two homolog 1 (SIRT1) in the placental tissue and plasma of patients with pre-eclampsia.

METHODS: The enrolled patients were divided into two groups: the pre-eclampsia group and the healthy group. This study summarized and analyzed the demographic characteristics of the two groups, including pregnancy age, gestational weeks, parity, gravidity, blood pressure, Body Mass Index, newborn weight, placental weight, and SIRT1 expression in placental tissue and maternal plasma.

RESULTS: Eleven studies were included in this research, with 586 cases in the pre-eclampsia group and 479 cases in the control group. Three research studies are reporting immunohistochemistry tests, among which the pre-eclampsia group had a positivity rate of 30.24% (62/205), while the control group had 58.02% (76/131); the two groups have a significant difference (p < 0.05). Two research studies reported the results of ELISA tests, with 107 cases in the pre-eclampsia group and 125 cases in the control group. A comparison of the SIRT1 test results showed a statistically significant difference between the two groups (p < 0.05). Pre-eclampsia group patients had lower gestational weeks, newborn birth weight, and placental weight compared to the healthy control group (all p < 0.05). However, systolic and diastolic blood pressures were higher in the pre-eclampsia group than in the control group (p < 0.05).

CONCLUSION: SIRT1 expression is downregulated in pre-eclampsia patients’ plasma and placental tissue. Further research is needed to validate this conclusion.

PMID:37857342 | DOI:10.1080/09513590.2023.2264983

Epidemiol Health. 2023 Oct 13:e2023090. doi: 10.4178/epih.e2023090. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the risk of lymphadenopathy following SARS-CoV-2 vaccination.

METHODS: A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1- to 42-day risk interval after COVID-19 vaccination compared to the control period. In addition, subgroup analyses were conducted according to baseline characteristics, time since vaccination, and sensitivity analyses adjusted for the length of the risk interval.

RESULTS: The risk of developing lymphadenopathy in the risk interval (1-42 days) after COVID-19 vaccination compared to the control period was significantly increased, with a relative incidence (RI) of 1.17 (95% CI, 1.17-1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44-1.50). In subgroup analyses by baseline characteristics, a significantly increased risk or trend toward increased risk was observed in most subgroups except for those aged 70 years and older, with a significant increase in risk in younger individuals, those with a Charlson’s comorbidity index <5, and those who received mRNA vaccines (mRNA-1273 > BNT162b2). Within the 1- to 42-day post-dose risk period, the relative risk was highest during the 1- to 7-day post-dose period (1.59; 95% CI, 1.57-1.60) compared to the control period, and then the risk declined. In the sensitivity analysis, we found that the longer the risk window, the smaller the RI.

CONCLUSION: SARS-CoV-2 vaccination is associated with a statistically significant increase in the risk of lymphadenopathy, and this risk was observed only with mRNA vaccines.

PMID:37857339 | DOI:10.4178/epih.e2023090

Eval Health Prof. 2023 Oct 19:1632787231207018. doi: 10.1177/01632787231207018. Online ahead of print.

ABSTRACT

This systematic review aimed to identify and compare instruments measuring nurses’ organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses’ organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts’ similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses’ organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.

PMID:37857313 | DOI:10.1177/01632787231207018

Ann Behav Med. 2023 Oct 19:kaad060. doi: 10.1093/abm/kaad060. Online ahead of print.

ABSTRACT

BACKGROUND: Interventions in food pantry settings have the potential to improve health among clients at risk of diet-related disease.

PURPOSE: This study evaluates whether a cluster-randomized, behavioral intervention in food pantries resulted in improved client outcomes.

METHODS: Sixteen Minnesota food pantries were randomized to an intervention (n = 8) or control condition (n = 8). The intervention offered pantries technical assistance to improve healthy food supply and implement behavioral economics strategies to promote healthy food selection. A convenience sample of adult clients were enrolled (paired sample, 158 intervention, 159 control) and followed for 1 year. Additional clients were enrolled at follow-up to assess food selection (follow-up sample, 85 intervention, 102 control). Analysis was limited to data from 11 pantries (5 intervention, 6 control) due to COVID-19. Outcome measures included Healthy Eating Index-2015 (HEI-2015) total and subcomponent scores for 24-hr dietary recalls and client cart selections, and Life’s Simple 7 (LS7) total and subcomponent scores. Multilevel mixed-effects models tested whether client outcomes differed by intervention condition.

RESULTS: In adjusted models, there were no statistically significant differences by intervention condition in HEI-2015 or LS7 scores. Clients in intervention food pantries had improved Refined Grain subcomponent scores (p = .004); clients in control pantries had worsened Saturated Fat subcomponents scores (p = .019) and improved physical activity scores (p = .007).

CONCLUSIONS: The intervention did not result in improved diet quality or cardiovascular health as measured by HEI-2015 or LS7. Coordinated efforts across settings are needed to address health risks facing this population.

PMID:37857305 | DOI:10.1093/abm/kaad060

Prim Care Companion CNS Disord. 2023 Oct 19;25(5):23m03555. doi: 10.4088/PCC.23m03555.

ABSTRACT

Objective: To assess the efficacy, safety, and tolerability of topiramate for the treatment of posttraumatic stress disorder (PTSD) in civilians.

Methods: This 12-week double-blind, randomized, placebo-controlled study enrolled 72 outpatients (aged 19-64 years) with a DSM-IV-TR diagnosis of non-combat-related PTSD and a score ≥ 50 on the Clinician-Administered PTSD Scale (CAPS). The primary efficacy endpoint, percent change in total CAPS score, and secondary efficacy measures were assessed by analysis of covariance. Safety assessments included monitoring of vital signs, physical examinations, clinical laboratory parameters, electrocardiograms, and adverse events (AEs). The study was conducted from October 2001 to March 2004.

Results: The intent-to-treat (ITT) population (N = 68; mean age = 35 years; 87% women; 74% White) showed greater percent reduction in total CAPS scores with topiramate versus placebo (39.5% vs 29.5%), but the difference was not statistically significant (P = .31). Similarly, higher reductions with topiramate versus placebo were seen in the CAPS subscale scores for symptoms of reexperiencing (43.6% vs 34.8%), avoidance/numbing (38.3% vs 30.6%), and hyperarousal (36.6% vs 21.4%). However, these differences were not statistically significant. Six patients in the topiramate arm had a final CAPS score < 20, whereas only 2 in the placebo arm achieved the result (P = .075). The median final topiramate daily dose was 100 mg/d (range, 25-400 mg/d), and mean ± SD treatment duration was 55 ± 32 days, showing the tolerability of the medication. In topiramate-treated patients, treatment-emergent AEs included paresthesia, headache, fatigue, and insomnia; treatment-limiting AEs included influenza-like symptoms, agitation, cognitive problems not otherwise specified, and somnolence. However, a higher rate of AE-related discontinuation was seen in the placebo group than in the treatment group (26% vs 18%).

Conclusions: In this 12-week civilian PTSD study, topiramate improved the primary and secondary outcome measures at a higher rate than did placebo, but the difference did not reach statistical significance. Further adequately powered studies may be warranted.

Trial Registration: Clinical Trials.gov identifier: NCT00208130.

Prim Care Companion CNS Disord 2023;25(5):23m03555.

Author affiliations are listed at the end of this article.

PMID:37857291 | DOI:10.4088/PCC.23m03555

Oncol Res Treat. 2023 Oct 19. doi: 10.1159/000534674. Online ahead of print.

ABSTRACT

INTRODUCTION: Owing to its low incidence, there no reliable statistics about prognostication derived from large sample sizes have been reported of malignant ovarian germ cell tumors (MOGCTs) and sex cord-stromal tumors (SCSTs). The present study aimed to investigate the clinicopathological prognostic factors and the survival trends of MOGCTs and SCSTs.

MATERIALS AND METHODS: Patients with MOGCTs and SCSTs were recorded in the Surveillance, Epidemiology, and End Results (SEER) database diagnosed between 2000 and 2019. Clinical, demographic, and treatment characteristics were compared between groups of MOGCTs and SCSTs. Cox risk regression analysis and Kaplan-Meier survival curves were used to compare overall survival (OS) and cancer-specific survival (CSS), and to assess the prognostic factors.

RESULTS: Information of 2506 patients with MOGCTs and 1556 patients with SCSTs was extracted from the SEER database, respectively. Aged <40 years and single were more common in patients with MOGCTs than in those with SCSTs. The vast majority of patients with MOGCTs and SCSTs underwent surgery (98.1% vs. 94.5%; P<0.001) and women with MOGCTs were more likely to receive chemotherapy than women with SCSTs (56.1% vs. 32.2%; P<0.001). For both patients before and after propensity-score matching, the 5-year OS rates of patients with SCSTs were lower than that of patients with MOGCTs (P<0.05). In multivariate Cox regression analysis, both age and surgery were independent predictors of OS in patients with MOGCTs and SCSTs. FIGO staging was an independent predictor of CSS in MOGCT patients. Tumor size and chemotherapy were also independent predictors of CSS in patients with SCSTs.

CONCLUSION: Compared to patients with SCSTs, those with MOGCTs tended to be younger and had a higher OS and CSS. Adjuvant chemotherapy after surgery did not prolong OS and CSS in patients with SCSTs.

PMID:37857263 | DOI:10.1159/000534674

Soc Sci Med. 2023 Oct 6;337:116281. doi: 10.1016/j.socscimed.2023.116281. Online ahead of print.

ABSTRACT

The rise of the platform economy during the Covid-19 pandemic has stimulated extensive discussions about whether gig workers can obtain equivalent mental health benefits of regular paid employment. Drawing on nationally representative data in the UK, this study aims to examine (1) whether transitioning from no paid work to gig work during Covid-19 is associated with better or worse mental health compared with those who remained not employed and those who became employed in regular jobs; (2) what mechanisms can explain the mental health differences; (3) how the patterns may differ by gender. The results show that transition into gig work is associated with better mental health compared with those who remained not employed, but this pattern is only for male (rather than female) gig workers and can be largely explained by their better financial situation and lower level of loneliness. For both men and women, the transition into gig work is associated with worse mental health compared with the transition into regular employment, but the mechanisms vary across genders. For male gig workers, both higher levels of financial precarity and loneliness in gig work can explain their mental health disadvantages compared with regular workers, but for female gig workers, none of them is at work. These findings facilitate a better understanding of the health consequences of the gig economy, revealing important gender-differentiated socio-psychological mechanisms through which gig work shapes mental health.

PMID:37857244 | DOI:10.1016/j.socscimed.2023.116281

Soc Sci Med. 2023 Oct 7;337:116298. doi: 10.1016/j.socscimed.2023.116298. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined several factors affecting the perception of Canadian parents about their children’s mental health during COVID-19. The contribution of this research included fresh evidence from examining the demographic and sociological factors influencing children’s well-being during COVID-19 using the Canadian context.

METHODS: We used a cross-sectional dataset from Statistics Canada titled Impacts of COVID-19 on Canadians – Parenting during the Pandemic (2020). We relied on an ordered logit model and computed the respective odds ratios.

RESULTS: Our results showed that parents with a university degree and those working from home are less concerned about their children’s mental health. Nonetheless, having a disabled child, belonging to a minority, having children aged six-to fourteen-years old, and having lost a job or experienced a drop in working hours increased parents’ worry. Additionally, having worries about being connected with family and friends, being concerned about work-life balance, feeling lonely at home, and waiting for the reopening of childcare services all increased the likelihood of parents’ anxiety about their child’s mental health. When running the analysis by province, we saw that being an immigrant and belonging to a minority increased parents’ worry only in Ontario and British Columbia.

CONCLUSIONS: Policymakers are encouraged to foster working-from-home practices as working from home has been linked to less worry about child mental health, mainly among mothers, as indicated in our gender heterogeneity analysis. In addition, it is advised that families with a disabled child, and families belonging to a minority received additional support. Lastly, policymakers are advised to consider the social cost of preventive measures and incorporate this into any future preventative policymaking as the social impact variables were robust across all models.

PMID:37857242 | DOI:10.1016/j.socscimed.2023.116298

Obstet Gynecol. 2023 Nov 1;142(5):1162-1168. doi: 10.1097/AOG.0000000000005315. Epub 2023 Aug 10.

ABSTRACT

OBJECTIVE: To evaluate access to prenatal care for pregnant patients receiving medication for opioid use disorder (MOUD) under Medicaid coverage in Florida.

METHODS: A cross-sectional, secret shopper study was conducted in which calls were made to randomly selected obstetric clinicians’ offices in Florida. Callers posed as a 14-week-pregnant patient with Medicaid insurance who was receiving MOUD from another physician and requested to schedule a first-time prenatal care appointment. Descriptive statistics were used to report our primary outcome, the callers’ success in obtaining appointments from Medicaid-enrolled physicians’ offices. Wait time for appointments and reasons the physician offices refused appointments to callers were collected.

RESULTS: Overall, 2,816 obstetric clinicians are enrolled in Florida Medicaid. Callers made 1,747 attempts to contact 1,023 randomly selected physicians’ offices from June to September 2021. Only 48.9% of medical offices (n=500) were successfully reached by phone, of which 39.4% (n=197) offered a prenatal care appointment to the caller. The median wait time until the first appointment was 15 days (quartile 1: 7; quartile 3: 26), with a range of 0-55 days. However, despite offering an appointment, 8.6% of the medical offices stated that they do not accept Medicaid insurance payment or would accept only self-pay. Among the 60.6% of callers unable to secure an appointment, the most common reasons were that the clinician was not accepting patients taking methadone (34.7%) or was not accepting any new patients with Medicaid insurance (23.8%) and that the pregnancy would be too advanced by the time of the first available appointment (7.3%).

CONCLUSION: This secret shopper study found that the majority of obstetric clinicians’ offices enrolled in Florida Medicaid do not accept pregnant patients with Medicaid insurance who are taking MOUD. Policy changes are needed to ensure access to adequate prenatal care for patients with opioid use disorder.

PMID:37856854 | DOI:10.1097/AOG.0000000000005315

Altern Ther Health Med. 2023 Oct 20:AT9236. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the current status of early enteral nutrition (EN) support among patients diagnosed with acute pancreatitis (AP) and analyze the factors influencing its duration. The findings aimed to provide guidance for the development of tailored EN support protocols for pancreatitis patients.

METHODS: A convenience sampling method was employed, and 51 patients diagnosed with acute pancreatitis (AP) were enrolled from the Gastroenterology Department of Zhoushan Hospital between May 2020 and June 2021. Data analysis included the categorization of patients based on their early enteral nutrition (EN) support duration, followed by thorough statistical analysis, including logistic regression, to identify the factors impacting EN duration.

RESULTS: The mean duration of early EN support among AP patients was (93.57 ± 43.29) hours. A mere 13.73% of patients initiated EN within 48 hours of admission. Upon categorizing patients by the median duration of EN support, multiple logistic regression analysis revealed several significant risk factors influencing the duration of EN in AP patients, including patient age, underlying medical conditions, severity of pancreatitis, nutritional status, and blood lipase levels (P < .05).

CONCLUSION: The study highlights the significant influence of disease severity and patients’ functional status on the duration of early EN support in AP cases. It emphasizes the importance of a comprehensive patient assessment by medical professionals to determine the optimal timing for initiating EN support.

PMID:37856815