Category: Nevin Manimala

Worldviews Evid Based Nurs. 2023 Oct 19. doi: 10.1111/wvn.12684. Online ahead of print.

ABSTRACT

BACKGROUND: Health literacy, empowerment, and self-care activities are likely the crucial concepts affecting the quality of life and glycemic control in people with type 2 diabetes (T2D). However, evidence demonstrating the mechanisms underlying these concepts is scarce.

AIMS: The aim of this study was to test the serial mediation roles of empowerment and self-care activities on the relationships between health literacy and quality of life and between health literacy and hemoglobin A1c (HbA1c) in people with T2D.

METHODS: A cross-sectional study was conducted among 319 people with T2D in Guangzhou, China, from July 2019 to January 2020. Data were collected using the Health Literacy Scale, the Diabetes Empowerment Scale-Short Form, the Summary of Diabetes Self-Care Activities Measure, and the Adjusted Diabetes-Specific Quality of Life Scale. RStudio 4.2.1 was used for serial mediation analysis.

RESULTS: The dimension of communicative health literacy accounted for the most total variance (β = 0.810, p < .001) in the construct of health literacy. The serial multiple mediation of empowerment and self-care activities in the associations between health literacy and quality of life (β = -.046, p = .019) and between health literacy and HbA1c (β = -.045, p = .005) were statistically significant.

LINKING EVIDENCE TO ACTION: This study emphasized the vital role of communicative health literacy when improving health literacy in people with T2D. Diabetes care and education specialists could implement empowerment approaches and flexible self-care strategies to improve the quality of life and glycemic control in people with T2D. Enhancing health literacy was suggested as a favorable strategy for promoting empowerment and self-care activities in people with T2D.

PMID:37855192 | DOI:10.1111/wvn.12684

Catheter Cardiovasc Interv. 2023 Oct 19. doi: 10.1002/ccd.30856. Online ahead of print.

ABSTRACT

AIM: The aim of the current study sought to investigate the angiographic patterns of restenosis after drug-coated balloon (DCB) angioplasty for femoropopliteal (FP) lesions and which repeat endovascular therapy (EVT) for DCB restenosis would provide more freedom from recurrent restenosis.

METHODS: This retrospective multicenter study included 119 limbs (chronic limb-threatening ischemia [CLTI]: 55%, lesion length: 136.9 ± 89.6 mm, chronic total occlusion: 25%) of 95 patients (diabetes mellitus: 70%, hemodialysis: 56%) who were diagnosed with DCB restenosis between January 2018 and December 2019. The cases were classified into three groups based on angiographic patterns of restenosis: Class I: focal lesions ≤50 mm, Class II: diffuse lesions >50 mm, and Class III: totally occluded lesions. The DCB restenosis patterns and frequency and predictors of recurrent restenosis after repeated EVT (re-EVT) were investigated.

RESULTS: The mean follow-up duration was 29.8 ± 9.5 months. Groups I, II, and III comprised of 30 (25.2%), 55 (46.2%), and 34 (29.0%) cases, respectively. The overall rate of 1-year freedom from recurrent restenosis was 58.2%. One-year rate of freedom from recurrent restenosis after repeat DCB was not statistically different from that after scaffolding (71.1% vs. 74.6%, respectively, p = 0.911); however, it was significantly better than that after noncoated balloon angioplasty (repeat DCB vs. noncoated balloon angioplasty: 71.1% vs. 25.7%, respectively, p < 0.001). Multivariate analysis demonstrated that CLTI (hazard ratio [HR]: 5.15, p < 0.001) and re-EVT with noncoated balloon (HR: 3.16, p < 0.001) were significantly associated with recurrent restenosis; however, Class III pattern of DCB restenosis was not associated with recurrent restenosis (HR: 1.04, p = 0.918).

CONCLUSIONS: This study revealed the angiographic patterns of restenosis after DCB therapy for FP lesions and the 1-year rate of recurrent restenosis after repeat revascularization. Repeat DCB therapy demonstrated acceptable 1-year recurrent restenosis rates.

PMID:37855184 | DOI:10.1002/ccd.30856

Clin Oral Implants Res. 2023 Oct 19. doi: 10.1111/clr.14194. Online ahead of print.

ABSTRACT

AIM: A new implant system encompassing implants with a tri-oval cross-sectional design and a simplified site preparation protocol at low speed and no irrigation has been developed. The objective of this study was to assess the safety and efficacy of the new implant system using the minipig intraoral dental implant model.

METHODS: Eight Yucatan minipigs were included. Twelve weeks after extractions, four implants per animal were randomly placed and allowed to heal transmucosal for 13 weeks: two Ø3.5 × 10 mm implants with a back-tapered collar and circular cross-section (control) and two Ø3.5 × 11 mm implants with tri-oval collar and cross-section (test). MicroCT and histological analysis was performed.

RESULTS: Thirty-two implants were placed; one implant for the control group was lost. Histologically, BIC was higher in the test compared with the control group (74.1% vs. 60.9%, p < .001). At the platform level, inflammation was statistically significantly higher albeit mild in the test compared with the control group. No other significant differences were observed between groups. MicroCT analysis showed that bone-to-implant-contact (BIC) and trabecular thickness were statistically significantly higher for the test than the control group. Test group had significantly higher first BIC distance than controls on lingual sites.

CONCLUSIONS: The present study results support the safety and efficacy of the new dental implant system and simplified site preparation protocol; human studies should be carried out to confirm these findings.

PMID:37855174 | DOI:10.1111/clr.14194

Bull Entomol Res. 2023 Oct 19:1-13. doi: 10.1017/S0007485323000470. Online ahead of print.

ABSTRACT

The effect of climate factors (temperature, humidity, precipitation, and frost days) on the population changes, damage, and infestation area of the leopard moth, Zeuzera pyrina L., was studied during 2006-2018 in four parts of Iran including Saman, Arak, Najaf-abad, and Baft. For trend analysis, the Mann-Kendall test was run on time series data of both climate and pest population. According to the results, the annual mean (Kendall’s statistics, T = 0.64 and 0.48), annual minimum (T = 0.60 and 0.42), and January mean (T = 0.64 and 0.61, respectively) temperatures showed increasing trends in Saman and Najaf-abad. Moreover, the annual mean minimum and January temperatures (T = 0.41 and 0.45, respectively) in Arak and the annual mean maximum temperature (T = 0.79) in Baft showed increasing trends. The number of frost days/year (Kendall’s statistics, T = -0.63, -0.53, -0.32 and -0.37) and annual mean relative humidity (T = -0.43, -0.63, -0.64 and -0.42, respectively) showed decreasing trends in Saman, Arak, Baft, and Najaf-abad stations. Trend analysis indicated significant increases in the mean number of moths caught (T = 0.59, 0.76 and 0.90), the percentage of infested branches/tree (T = 0.66, 0.58, and 0.90), the number of active holes/tree (T = 0.79, 0.55, and 0.68) and the infested areas (T = 0.99, 0.73, and 0.98, respectively) in Saman, Arak and Najaf-abad stations. According to stepwise regression, the mean temperatures of January, autumn, and winter were the most effective variables for increasing Z. pyrina damage and population, while relative humidity and the number of frost days played the major role in reducing it.

PMID:37855138 | DOI:10.1017/S0007485323000470

Adv Clin Exp Med. 2023 Oct 19. doi: 10.17219/acem/171537. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a life-threatening organ dysfunction without effective therapeutic options. Lipopolysaccharide (LPS), a bacterial endotoxin, is known to induce sepsis. It is associated with oxidative stress, inflammation and multiple organ failure. Gedunin (GN) is a tetranortriterpenoid isolated from the Meliaceae family. Gedunin possesses numerous pharmacological properties, including antibacterial, anti-inflammatory, antiallergic, and anticancer activities. However, the molecular anti-inflammatory mechanism of GN in sepsis has not been established.

OBJECTIVES: The aim of the study was to explore the antioxidant and anti-inflammatory molecular actions underlying the antiseptic activity of GN in an LPS-induced rat model.

MATERIAL AND METHODS: Rats were randomized into 4 sets: group 1 (control) was given 1 mL of dimethyl sulfoxide (DMSO) by gavage, group 2 rats were treated with LPS (100 μg/kg body weight (BW), intraperitoneally (ip.)), group 3 rats were given LPS (100 μg/kg BW, ip.)+GN (50 mg/kg BW in DMSO), and rats in the group 4 were given GN (50 mg/kg BW in DMSO) alone. We studied hepatic markers, inflammatory cytokines and antioxidants using specific biochemical kits and analyzed their statistical significance. Histopathology of liver, lungs and kidney tissues was also explored. The mRNA levels and conducted protein investigations were performed using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot, respectively.

RESULTS: Our findings revealed that GN significantly (p < 0.05) inhibited oxidative stress, lipid peroxides, toxic markers, pro-inflammatory cytokines, and histological changes, thereby preventing multi-organ impairment. Additionally, GN attenuated the HMGβ1/NLRP3/NF-κB signaling pathway and prevented the degradation of Iκβα.

CONCLUSIONS: Gedunin is a promising natural antiseptic agent for LPS-induced sepsis in rats.

PMID:37855061 | DOI:10.17219/acem/171537

J Med Screen. 2023 Oct 19:9691413231208160. doi: 10.1177/09691413231208160. Online ahead of print.

ABSTRACT

BACKGROUND: The lung cancer screening program at St Elizabeth Healthcare (Kentucky, USA) began in 2013. Over 33,000 low-dose computed tomography lung cancer screens have been performed. From 2015 through 2021, 2595 lung cancers were diagnosed systemwide. A Screening Program with Impactful Results from Early Detection, reviews that experience; 342 (13.2%) were diagnosed by screening and 2253 (86.8%) were non-screened. As a secondary objective, the non-screened cohort was queried to determine how many additional individuals could have been screened, identifying barriers and failures to meet eligibility.

METHODS: Our QlikSense database extracted the lung cancer patients from the Cancer Patient Data and Management System, and identified and categorized them separately as screened or non-screened populations. Stage distribution was compared in screened and non-screened groups. Those meeting age criteria, with any smoking history, were further queried for screening eligibility, accessing the electronic medical record smoking history and audit trail, and determining if enough information was available to substantiate screening eligibility. The same methodology was applied to CMS 2015 and USPSTF 2021 criteria.

RESULTS: The screened and non-screened patients were accounted for in a stage migration chart demonstrating clear shift to early stage among screened lung cancer patients. Additionally, analysis of non-screened individuals is presented.

CONCLUSION: Of the St Elizabeth Healthcare eligible patients attributed to primary care providers, 49.6% were screened in 2021. Despite this level of success, this study highlighted a sizeable pool of additional individuals that could have been screened. We are shifting focus to the non-screened pool of patients that meet eligibility, further enhancing the impact on our community.

PMID:37855047 | DOI:10.1177/09691413231208160

EClinicalMedicine. 2023 Oct 6;65:102250. doi: 10.1016/j.eclinm.2023.102250. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: With the emergence of SARS-CoV-2 variants resistant to monoclonal antibody therapies and limited global access to therapeutics, the evaluation of novel therapeutics to prevent progression to severe COVID-19 remains a critical need.

METHODS: Safety, clinical and antiviral efficacy of inhaled interferon-β1a (SNG001) were evaluated in a phase II randomized controlled trial on the ACTIV-2/A5401 platform (ClinicalTrials.govNCT04518410). Adult outpatients with confirmed SARS-CoV-2 infection within 10 days of symptom onset were randomized and initiated either orally inhaled nebulized SNG001 given once daily for 14 days (n = 110) or blinded pooled placebo (n = 110) between February 10 and August 18, 2021.

FINDINGS: The proportion of participants reporting premature treatment discontinuation was 9% among SNG001 and 13% among placebo participants. There were no differences between participants who received SNG001 or placebo in the primary outcomes of treatment emergent Grade 3 or higher adverse events (3.6% and 8.2%, respectively), time to symptom improvement (median 13 and 9 days, respectively), or proportion with unquantifiable nasopharyngeal SARS-CoV-2 RNA at days 3 (28% [26/93] vs. 39% [37/94], respectively), 7 (65% [60/93] vs. 66% [62/94]) and 14 (91% [86/95] vs. 91% [83/81]). There were fewer hospitalizations with SNG001 (n = 1; 1%) compared with placebo (n = 7; 6%), representing an 86% relative risk reduction (p = 0.07). There were no deaths in either arm.

INTERPRETATION: In this trial, SNG001 was safe and associated with a non-statistically significant decrease in hospitalization for COVID-19 pneumonia.

FUNDING: The ACTIV-2 platform study is funded by the NIH. Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number UM1 AI068634, UM1 AI068636 and UM1 AI106701. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

PMID:37855026 | PMC:PMC10579289 | DOI:10.1016/j.eclinm.2023.102250

Int J Prev Med. 2023 Jun 22;14:80. doi: 10.4103/ijpvm.ijpvm_130_22. eCollection 2023.

ABSTRACT

BACKGROUND: The basis of the overcorrecting minus lens is to induce compliance and consequently prevent constant exotropia. Some previous studies advocated early surgical therapy and others suggested over-minus treatment. Our purpose is to evaluate the success rate of the over-minus lens.

METHODS: This descriptive cross-sectional study was carried out on 106 patients under the age of 7 years with intermittent exotropia (IXT) who attended Amir-Al-Momenin Hospital at Guilan University of Medical Sciences, Iran. The data was gathered by a form including sex, age, level of cycloplegic refraction, the amount of deviation before and after using the over-minus glasses, visual acuity, the amount of the over-minus glasses, duration of treatment, recovery, and follow-up. The success rate was defined as decreasing exotropia to less than ten prism diopters or exophoria.

RESULTS: A total of 106 patients with a mean age of 2.25 ± 0.74 years were enrolled in this study. The mean exotropia before and after treatment was 20.96 ± 8.20 and 12.16 ± 11.04 prism diopters, respectively, and there was a statistically significant difference (P < 0.002). The mean refractive spherical and astigmatic errors (cycloplegic refraction) were +1.34 ± 1.07 and -0.32 ± 0.72 diopters, respectively. At the end of the follow-up, exotropia increased in 5.6% of patients, there was no change in 15% of patients with a mean deviation of 25.0 ± 6.06 prism diopters, and 79.24% of patients were treated successfully.

CONCLUSIONS: According to the results of this study, treatment of IXT by over-correcting lenses can be a safe procedure and effective in preventing exotropia.

PMID:37854980 | PMC:PMC10580209 | DOI:10.4103/ijpvm.ijpvm_130_22

Postepy Kardiol Interwencyjnej. 2023 Sep;19(3):251-256. doi: 10.5114/aic.2023.131478. Epub 2023 Sep 27.

ABSTRACT

INTRODUCTION: Data regarding patients with a previous medical record of immunosuppression treatment who have undergone transcatheter aortic valve implantation (TAVI) are limited and extremely inconclusive. Available studies are mostly short term observations; thus there is a lack of evidence on efficacy and safety of TAVI in this specific group of patients.

AIM: To compare the in-hospital and long-term outcomes between patients with or without a medical history of immunosuppressive treatment undergoing TAVI for aortic valve stenosis (AS).

MATERIAL AND METHODS: We conducted a retrospective registry-based analysis including patients undergoing TAVI for AS at 5 centres between January 2009 and August 2017. The primary endpoint was long-term all-cause mortality. Secondary endpoints comprised major vascular complications, life-threatening or disabling bleeding, stroke and new pacemaker implantation.

RESULTS: Of 1451 consecutive patients who underwent TAVI, two propensity-matched groups including 25 patients with a history of immunosuppression and 75 patients without it were analysed. No differences between groups in all-cause mortality were found in a median follow-up time of 2.7 years following TAVI (p = 0.465; HR = 0.73; 95% CI: 0.30-1.77). The rate of major vascular complications (4.0% vs. 5.3%) was similar in the two groups (p = 1.000). There were no statistically significant differences in the composite endpoint combining life-threatening or disabling bleeding, major vascular complications, stroke and new pacemaker implantation (40.0% vs. 20.0%, p = 0.218).

CONCLUSIONS: Patients who had undergone TAVI for AS had similar long-term mortality regardless of whether they had a previous medical record of immunosuppression. Procedural complication rates were comparable between the groups.

PMID:37854972 | PMC:PMC10580841 | DOI:10.5114/aic.2023.131478

Liver Res. 2023 Sep;7(3):256-262. doi: 10.1016/j.livres.2023.07.003. Epub 2023 Jul 16.

ABSTRACT

BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) is characterized by several clinically important prognostic parameters, including portal vein thrombosis (PVT), tumor multifocality, and serum alpha-fetoprotein (AFP) levels, in addition to maximum tumor diameter (MTD). However, associations among these parameters have not been thoroughly examined. Thus, the study aimed to investigate the correlations among these HCC characteristics in a prospectively collected database.

METHODS: An 8080 HCC patient database derived from our weekly HCC council meeting was examined with respect to the correlations at baseline patient presentation between increases in MTD and changes in the percentage of patients with PVT, multifocality, or AFP levels.

RESULTS: The percentage of patients with PVT and with multifocality (tumor nodule numbers ≥3) significantly increased with enlarging MTD, regardless of the serum AFP level, showing the independence of PVT and multifocality on AFP. The percentage of patients with multifocality increased with enlarging MTD, in the presence or absence of PVT, showing the independence of multifocality from PVT. Therefore, discordance was found between different tumor parameters.

CONCLUSIONS: A statistically significant association was found between PVT and MTD and between multifocality and MTD, all three of which are independent of AFP. PVT and multifocality appeared to be independent of each other. Although PVT and multifocality were independent of AFP, they were also augmented with high serum AFP levels. The results suggest the possibility of multiple pathways of tumor progression in the later stages of HCC development.

PMID:37854945 | PMC:PMC10583763 | DOI:10.1016/j.livres.2023.07.003