Category: Nevin Manimala

JMIR Form Res. 2022 Jul 8;6(7):e30230. doi: 10.2196/30230.

ABSTRACT

BACKGROUND: Digital technology, the internet, and social media are increasingly investigated as promising means for monitoring symptoms and delivering mental health treatment. These apps and interventions have demonstrated preliminary acceptability and feasibility, but previous reports suggest that access to technology may still be limited among individuals with psychotic disorders relative to the general population.

OBJECTIVE: We evaluated and compared access to and use of technology and social media in young adults with psychotic disorders (PD), young adults with clinical risk for psychosis (CR), and psychosis-free youths (PF).

METHODS: Participants were recruited through a coordinated specialty care clinic dedicated toward early psychosis as well as ongoing studies. We surveyed 21 PD, 23 CR, and 15 PF participants regarding access to technology and use of social media, specifically Facebook and Twitter. Statistical analyses were conducted in R. Categorical variables were compared among groups using Fisher exact test, continuous variables were compared using 1-way ANOVA, and multiple linear regressions were used to evaluate for covariates.

RESULTS: Access to technology and social media were similar among PD, CR, and PF participants. Individuals with PD, but not CR, were less likely to post at a weekly or higher frequency compared to PF individuals. We found that decreased active social media posting was unique to psychotic disorders and did not occur with other psychiatric diagnoses or demographic variables. Additionally, variation in age, sex, and White versus non-White race did not affect posting frequency.

CONCLUSIONS: For young people with psychosis spectrum disorders, there appears to be no “technology gap” limiting the implementation of digital and mobile health interventions. Active posting to social media was reduced for individuals with psychosis, which may be related to negative symptoms or impairment in social functioning.

PMID:35802420 | DOI:10.2196/30230

JMIR Form Res. 2022 Jul 8;6(7):e35655. doi: 10.2196/35655.

ABSTRACT

BACKGROUND: There is an ongoing discussion about possible differences between insulin degludec (IDeg-100) and glargine U300 (IGlar-300). There is little data and head-to-head comparison of IDeg-100 and IGlar-300 regarding their simultaneous impact on glycemic variability and oxidative stress in patients with type 2 diabetes mellitus (T2DM).

OBJECTIVE: In our randomized, open-label, crossover study, we compared the impact of IDeg-100 and IGlar-300 on glycemic variability and oxidative stress in insulin-naive patients with T2DM.

METHODS: We recruited a total of 25 adult patients with T2DM (7 females) whose diabetes was uncontrolled (HbA_1c ≥7.5%) on two or more oral glucose-lowering drugs; a total of 22 completed the study. Mean age was 57.3 (SD 6.99) years and duration of diabetes was 9.94 (SD 5.01) years. After the washout period, they were randomized alternately to first receive either IDeg-100 or IGlar-300 along with metformin. Each insulin was administered for 12 weeks and then switched. At the beginning and end of each phase, biochemical and oxidative stress parameters were analyzed. On 3 consecutive days prior to each control point, patients performed a 7-point self-monitoring of blood glucose profile. Oxidative stress was assessed by measuring thiol groups and hydroperoxides (determination of reactive oxygen metabolites test) in serum.

RESULTS: IGlar-300 reduced mean glucose by 0.02-0.13 mmol/L, and IDeg-100 reduced glucose by 0.10-0.16 mmol/L, with no significant difference. The reduction of the coefficient of glucose variation also did not show a statistically significant difference. IGlar-300 increased thiols by 0.08 µmol/L and IDeg-100 increased thiols by 0.15 µmol/L, with no significant difference (P=.07) between them. IGlar-300 reduced hydroperoxides by 0.040 CARR U and IDeg-100 increased hydroperoxides by 0.034 CARR U, but the difference was not significant (P=.12).

CONCLUSIONS: The results of our study do not show a significant difference regarding glycemic variability between patients receiving either insulin IDeg-100 or IGlar-300, although IGlar-300 showed greater dispersion of data. No significant difference in oxidative stress was observed. In a larger study, doses of insulins should be higher to achieve significant impact on glycemic parameters and consequently on glycemic variability and oxidative stress.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT04692415; https://clinicaltrials.gov/ct2/show/NCT04692415.

PMID:35802405 | DOI:10.2196/35655

Cochrane Database Syst Rev. 2022 Jul 8;7:CD008347. doi: 10.1002/14651858.CD008347.pub4.

ABSTRACT

BACKGROUND: Peripheral arterial disease is a major health problem, and in about 1% to 2% of patients, the disease progresses to critical limb ischaemia (CLI), also known as critical limb-threatening ischaemia. In a substantial number of individuals with CLI, no effective treatment options other than amputation are available, with around a quarter of these patients requiring a major amputation during the following year. This is the second update of a review first published in 2011.

OBJECTIVES: To evaluate the benefits and harms of local intramuscular transplantation of autologous adult bone marrow mononuclear cells (BMMNCs) as a treatment for CLI.

SEARCH METHODS: We used standard, extensive Cochrane search methods. The latest search date was 8 November 2021.

SELECTION CRITERIA: We included all randomised controlled trials (RCTs) of CLI in which participants were randomly allocated to intramuscular administration of autologous adult BMMNCs or control (either no intervention, conventional conservative therapy, or placebo).

DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes of interest were all-cause mortality, pain, and amputation. Our secondary outcomes were angiographic analysis, ankle-brachial index (ABI), pain-free walking distance, side effects and complications. We assessed the certainty of the evidence using the GRADE approach.

MAIN RESULTS: We included four RCTs involving a total of 176 participants with a clinical diagnosis of CLI. Participants were randomised to receive either intramuscular cell implantation of BMMNCs or control. The control arms varied between studies, and included conventional therapy, diluted autologous peripheral blood, and saline. There was no clear evidence of an effect on mortality related to the administration of BMMNCs compared to control (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.15 to 6.63; 3 studies, 123 participants; very low-certainty evidence). All trials assessed changes in pain severity, but the trials used different forms of pain assessment tools, so we were unable to pool data. Three studies individually reported that no differences in pain reduction were observed between the BMMNC and control groups. One study reported that reduction in rest pain was greater in the BMMNC group compared to the control group (very low-certainty evidence). All four trials reported the rate of amputation at the end of the study period. We are uncertain if amputations were reduced in the BMMNC group compared to the control group, as a possible small effect (RR 0.52, 95% CI 0.27 to 0.99; 4 studies, 176 participants; very low-certainty evidence) was lost after undertaking sensitivity analysis (RR 0.52, 95% CI 0.19 to 1.39; 2 studies, 89 participants). None of the included studies reported any angiographic analysis. Ankle-brachial index was reported differently by each study, so we were not able to pool the data. Three studies reported no changes between groups, and one study reported greater improvement in ABI (as haemodynamic improvement) in the BMMNC group compared to the control group (very low-certainty evidence). One study reported pain-free walking distance, finding no clear difference between BMMNC and control groups (low-certainty evidence). We pooled the data for side effects reported during the follow-up, and this did not show any clear difference between BMMNC and control groups (RR 2.13, 95% CI 0.50 to 8.97; 4 studies, 176 participants; very low-certainty evidence). We downgraded the certainty of the evidence due to the concerns about risk of bias, imprecision, and inconsistency.

AUTHORS’ CONCLUSIONS: We identified a small number of studies that met our inclusion criteria, and these differed in the controls they used and how they measured important outcomes. Limited data from these trials provide very low- to low-certainty evidence, and we are unable to draw conclusions to support the use of local intramuscular transplantation of BMMNC for improving clinical outcomes in people with CLI. Evidence from larger RCTs is needed in order to provide adequate statistical power to assess the role of this procedure.

PMID:35802393 | DOI:10.1002/14651858.CD008347.pub4

JAMA Netw Open. 2022 Jul 1;5(7):e2220908. doi: 10.1001/jamanetworkopen.2022.20908.

ABSTRACT

IMPORTANCE: Historical structural racism may be associated with racial, ethnic, and geographic disparities in breast cancer outcomes, but few studies have investigated these potential relationships.

OBJECTIVE: To test associations among historical mortgage lending discrimination (using 1930s Home Owners’ Loan Corporation [HOLC] redlining data), race and ethnicity, tumor clinicopathologic features, and survival among women recently diagnosed with breast cancer.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used a population-based, state cancer registry to analyze breast tumor clinicopathology and breast cancer-specific death among women diagnosed from 2008 to 2017 and followed up through 2019. Participants included all primary, histologically confirmed, invasive breast cancer cases diagnosed among women aged at least 20 years and who resided in a HOLC-graded area of New Jersey. Those missing race and ethnicity data (n = 61) were excluded. Data were analyzed between June and December 2021.

EXPOSURES: HOLC risk grades of A (“best”), B (“still desirable”), C (“definitely declining”), and D (“hazardous” [ie, redlined area]).

MAIN OUTCOMES AND MEASURES: Late stage at diagnosis, high tumor grade, triple-negative subtype (lacking estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression), breast cancer-specific death.

RESULTS: Among a total of 14 964 women with breast cancer, 2689 were Latina, 3506 were non-Latina Black, 7686 were non-Latina White, and 1083 were other races and ethnicities (non-Latina Asian/Pacific Islander/Native American/Alaska Native/Hawaiian or not otherwise specified); there were 1755 breast cancer-specific deaths. Median follow-up time was 5.3 years (95% CI, 5.2-5.3 years) and estimated 5-year breast cancer-specific survival was 88.0% (95% CI, 87.4%-88.6%). Estimated associations between HOLC grade and each breast cancer outcome varied by race and ethnicity; compared with residence in HOLC redlined areas, residence in HOLC areas graded “best” was associated with lower odds of late-stage diagnosis (odds ratio [OR], 0.34 [95% CI, 0.22-0.53]), lower odds of high tumor grade (OR, 0.72 [95% CI, 0.57-0.91]), lower odds of triple-negative subtype (OR, 0.67 [95% CI, 0.47-0.95]), and lower hazard of breast cancer-specific death (hazard ratio, 0.48 [95% CI, 0.35-0.65]), but only among non-Latina White women. There was no evidence supporting associations among non-Latina Black or Latina women.

CONCLUSIONS AND RELEVANCE: Compared with redlined areas, current residence in non-redlined areas was associated with more favorable breast cancer outcomes, but only among non-Latina White women. Future studies should examine additional factors to inform how historical structural racism could be associated with beneficial cancer outcomes among privileged racial and ethnic groups.

PMID:35802373 | DOI:10.1001/jamanetworkopen.2022.20908

Nephrol Nurs J. 2022 May-Jun;49(3):241-254.

ABSTRACT

Specialty certification demonstrates knowledge and expertise in an area of nursing practice resulting in significant benefits to nurses, patients, public, and hiring organizations, empowering professional practice, and improving nurse retention and patient outcomes. However, a large majority of nurses working in dialysis have never validated their knowledge and skills through specialty certification. A one-group pre- and post-intervention study was conducted, with a sample group of registered nurses working in dialysis, using an asynchronous peer-to-peer education regarding empowering practice through specialty certification. The effect on psychological empowerment was measured using a 2-tailed t test with a comparison of enrollments in pre-certification courses. Results showed a 25% increase in course enrollments, but no statistical significance in psychological empowerment. Future study is needed on how nephrology nursing certification impacts patient outcomes, empowerment, workplace environment, and staff retention in nephrology.

PMID:35802362

Nephrol Nurs J. 2022 May-Jun;49(3):213-225.

ABSTRACT

The scope of end-of-life communication is not well known among nephrology advanced practice nurses (APNs). Guided by the Theory of Planned Behavior, the study aimed to examine the independent effects of knowledge, attitude, and perceived behavioral control on the engagement of APNs in end-of-life communication and the mediating and moderating effects of attitude and perceived behavioral control on the relationships between knowledge and end-of-life communication. A theoretically derived 17-item survey measuring the concepts was administered to a convenience sample of 127 APNs. Descriptive statistics, Pearson’s correlation, and multiple linear regression were employed. Attitudes and perceived behavioral control on end-of-life communication mediated and moderated the relationship between knowledge of end-of-life communication and engagement in end-of-life communication among nephrology APNs.

PMID:35802360

Genes Genomics. 2022 Jul 8. doi: 10.1007/s13258-022-01277-2. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic syndrome is as a well-known risk factor for cardiovascular disease, which is associated with both genetic and environmental factors. Recently, the microbiome composition has been shown to affect the development of metabolic syndrome. Thus, it is expected that the complex interplay among host genetics, the microbiome, and environmental factors could affect metabolic syndrome.

OBJECTIVE: To evaluate the relative contributions of genetic, microbiome, and environmental factors to metabolic syndrome using statistical approaches.

METHODS: Data from the prospective Korean Association REsource project cohort (N = 8476) were used in this study, including single-nucleotide polymorphisms, phenotypes and lifestyle factors, and the urine-derived microbial composition. The effect of each data source on metabolic phenotypes was evaluated using a heritability estimation approach and a prediction model separately. We further experimented with various types of metagenomic relationship matrices to estimate the phenotypic variance explained by the microbiome.

RESULTS: With the heritability estimation, five of the 11 metabolic phenotypes were significantly associated with metagenome-wide similarity. We found significant heritability for fasting glucose (4.8%), high-density lipoprotein cholesterol (4.9%), waist-hip ratio (7.7%), and waist circumference (5.6%). Microbiome compositions provided more accurate estimations than genetic factors for the same sample size. In the prediction model, the contribution of each source to the prediction accuracy varied for each phenotype.

CONCLUSION: The effects of host genetics, the metagenome, and environmental factors on metabolic syndrome were minimal. Our statistical analysis suffers from a small sample size, and the measurement error is expected to be substantial. Further analysis is necessary to quantify the effects with better accuracy.

PMID:35802345 | DOI:10.1007/s13258-022-01277-2

Eat Weight Disord. 2022 Jul 8. doi: 10.1007/s40519-022-01436-0. Online ahead of print.

ABSTRACT

PURPOSE: In this study, it was aimed to evaluate the relationship of hedonic hunger with food addiction and obesity in university students.

METHODS: The research sample consists of 275 university students between the ages of 19-28 years. Body weight (kg), height (cm), waist and hip circumference (cm) were measured by applying a face-to-face questionnaire including descriptive characteristics of individuals, the Power of Food Scale (PFS), the Palatable Eating Motive Scale (PEMS) and the Modified Yale Food Addiction Scale (mYFAS) 2.0. Statistical analysis of the data was done with SPSS (Statistical Package for Social Sciences) 18.

RESULTS: In individuals, according to the mean PFS score the presence of food power-induced hedonic hunger was detected. While according to the mean PEMS score no motivational hedonic hunger was detected. According to the BMI classification the average scores of PFS (p = 0.002), PEMS (p = 0.009), and mYFAS 2.0 (p < 0.001) showed a gradual increase from underweight to obese. A weak positive correlation was found between BMI and PFS score (r = 0.238; p < 0.05) and PEMS score (r = 0.196; p < 0.05), respectively. The moderate positive correlation (r = 0.439 p < 0.001) was found between mYFAS 2.0 and the PEMS scores.

CONCLUSION: As a result, the presence of food-based hedonic hunger was determined in young individuals. A relationship was determined between food addiction and hedonic hunger caused by the motivation to consume delicious foods. Accordingly, hedonic hunger is related to food addiction and obesity in university students.

LEVEL OF EVIDENCE: V, cross-sectional descriptive study.

PMID:35802338 | DOI:10.1007/s40519-022-01436-0

Environ Sci Pollut Res Int. 2022 Jul 8. doi: 10.1007/s11356-022-21844-0. Online ahead of print.

ABSTRACT

In this study, luminescent bio-adsorbent nitrogen-doped carbon dots (N-CDs) was produced and applied for the removal and detection of Hg (II) from aqueous media. N-CDs were synthesized from oil palm empty fruit bunch carboxymethylcellulose (CMC) and urea. According to several analytical techniques used, the obtained N-CDs display graphitic core with an average size of 4.2 nm, are enriched with active sites, stable over a wide range of pH and have great resistance to photobleaching. The N-CDs have bright blue emission with an improved quantum yield (QY) of up to 35.5%. The effect of the variables including pH, adsorbent mass, initial concentration and incubation time on the removal of Hg (II) was investigated using central composite design. The statistical results confirmed that the adsorption process could reach equilibrium within 30 min. The reduced cubic model (R² = 0.9989) revealed a good correlation between the observed values and predicted data. The optimal variables were pH of 7, dose of 0.1 g, initial concentration of 100 mg/L and duration of 30 min. Under these conditions, adsorption efficiency of 84.6% was obtained. The adsorption kinetic data could be well expressed by pseudo-second-order kinetic and Langmuir isotherm models. The optimal adsorption capacity was 116.3 mg g^-1. Furthermore, the adsorbent has a good selectivity towards Hg (II) with a detection limit of 0.01 μM due to the special interaction between Hg (II) and carboxyl/amino groups on the edge of N-CDs. This work provided an alternative direction for constructing low-cost adsorbents with effective sorption and sensing of Hg (II).

PMID:35802332 | DOI:10.1007/s11356-022-21844-0

Environ Sci Pollut Res Int. 2022 Jul 8. doi: 10.1007/s11356-022-21817-3. Online ahead of print.

ABSTRACT

Bisphenols are endocrine disruptor chemicals that disrupt thyroid hormone homeostasis. However, evidence on the effects of bisphenol mixtures on thyroid hormones are insufficient. Therefore, the present study aimed to explore the effects of bisphenol substitutes and bisphenol mixtures on thyroid hormones during pregnancy. The study was conducted among 446 pregnant women in the Guangxi Zhuang Birth Cohort (GZBC), China. In multiple linear regressions, compared with the low-exposure group, bisphenol S (BPS) concentrations in the middle-exposure group led to a 10.90% (95% CI: – 18.16%, – 2.99%) decrease in triiodothyronine (T3) levels in the first trimester; tetrabromobisphenol A (TBBPA) levels in the middle-exposure group led to an 8.26% (95% CI: – 15.82%, – 0.01%) decrease in T3 levels in the first trimester; bisphenol B (BPB) levels in the middle-exposure group led to higher free thyroxine (FT4) levels (9.84%; 95% CI: 1.73%, 18.60%) in the second trimester; bisphenol F (BPF) in the middle-exposure group led to higher FT4 levels (8.59%, 95% CI: 0.53%, 17.31%) in the second trimester; and TBBPA levels in the high-exposure group led to a 9.39% (95% CI: 1.46%, 17.93%) increase in FT4 levels in the second trimester. The Bayesian kernel machine regression (BKMR) and restricted cubic spline (RCS) models showed a U-shaped dose-response relationship between bisphenol A (BPA) and free triiodothyronine (FT3) (p < 0.01) as well as BPS and FT4 (p < 0.05). Nonlinear relationships were also observed between the bisphenol mixture and FT3. Overall, maternal bisphenol exposure affected thyroid hormone levels during pregnancy. This study provides evidence that BPB, BPF, BPS, and TBBPA are unsafe substitutes for BPA, as well as the overall effect of bisphenols on adverse health in human beings.

PMID:35802331 | DOI:10.1007/s11356-022-21817-3