Category: Nevin Manimala

Int J Pediatr Otorhinolaryngol. 2023 May 9;170:111599. doi: 10.1016/j.ijporl.2023.111599. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to summarize the clinical features of congenital preauricular fistula (CPF) in pediatric patients to improve the levels of diagnosis and treatment, reduce the rates of missed diagnosis and recurrence, and shorten the total diagnosis and treatment time.

METHODS: A total of 353 patients with CPF who were admitted to the Department of Otolaryngology in The Children’s Hospital, Zhejiang University School of Medicine between January 2019 and December 2021 was enrolled in this retrospective observational study. Follow ups for 12-42 months were performed to investigate the classification, surgical methods, and postoperative conditions of CPF and to compare the recurrence rate, complication rate, and total diagnosis and treatment time between the active infection CPF group (AICPFG) and infection-controlled/non-infected CPF group (IC/NICPFG).

RESULTS: In 316 cases (89.5%) out of the 353 patients, the natural fistula orifice was located in front of the crus helicis; in 33 cases (9.4%), the natura fistula orifice was located at the crus helicis; and in 4 cases (1.1%), the natura fistula orifice was located in the external acoustic meatus. The AICPFG had 52 cases (14.7%), including 1 case (0.28%) of recurrence and 2 cases (0.56%) of infection at the incision site. The IC/NICPFG had 301 cases (85.3%), including 4 cases (1.13%) of recurrence, 6 cases (1.7%) of infection at the incision site, and 1 case (0.28%) of scar formation at the incision site. There were no significant differences in the recurrence rates and postoperative complications between the AICPFG and IC/NICPFG (p > 0.05). There was a statistically significant difference in the total diagnosis and treatment time between the AICPFG and IC/NICPFG (p < 0.05).

CONCLUSION: A reasonable classification of CPF, use of appropriate surgical methods, and belonging to the AICPFG do not increase the recurrence and complication rates of children but shorten the total treatment course, relieve patients’ suffering, reduce treatment costs, and achieve a better clinical prognosis.

PMID:37196371 | DOI:10.1016/j.ijporl.2023.111599

Annu Rev Nutr. 2023 May 17. doi: 10.1146/annurev-nutr-011923-020327. Online ahead of print.

ABSTRACT

Precise dietary assessment is critical for accurate exposure classification in nutritional research, typically aimed at understanding how diet relates to health. Dietary supplement (DS) use is widespread and represents a considerable source of nutrients. However, few studies have compared the best methods to measure DSs. Our literature review on the relative validity and reproducibility of DS instruments in the United States [e.g., product inventories, questionnaires, and 24-h dietary recalls (24HR)] identified five studies that examined validity (n = 5) and/or reproducibility (n = 4). No gold standard reference method exists for validating DS use; thus, each study’s investigators chose the reference instrument used to measure validity. Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs. The inventory method captured nutrient amounts more accurately than the other methods. Reproducibility (over 3 months to 2.4 years) of prevalence of use estimates on the questionnaires was acceptable for common DSs. Given the limited body of research on measurement error in DS assessment, only tentative conclusions on these DS instruments can be drawn at present. Further research is critical to advancing knowledge in DS assessment for research and monitoring purposes. Expected final online publication date for the Annual Review of Nutrition, Volume 43 is August 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

PMID:37196365 | DOI:10.1146/annurev-nutr-011923-020327

Cancer Control. 2023 Jan-Dec;30:10732748231177544. doi: 10.1177/10732748231177544.

ABSTRACT

BACKGROUND: Previous studies have confirmed the higher risk of bladder cancer (BC) and rectal cancer (RC) development among prostate cancer (PCa) patients receiving radiotherapy. In this study, we intend to explore the long-term trend in second BC and RC incidence among PCa patients undergoing radiotherapy.

METHOD: We identified first primary PCa patients diagnosed between 1975 and 2014 from the Surveillance, Epidemiology, and End Results (SEER)-9 cancer registries. Standardized incidence ratios (SIRs) were calculated by calendar year of diagnosis among PCa patients receiving radiotherapy and not. P trends were evaluated using Poisson regression. 10-year cumulative incidence of BC and RC was calculated utilizing competing risk regression model.

RESULT: Of PCa patients treated with radiotherapy, SIRs of BC increased from .82 (95% CI: .35- 1.61) in 1980-1984 to 1.58 (95% CI: 1.48-1.68) in 2010-2014 (Ptrend=.003). SIRs of RC increased from 1.01 (95% CI: .27-2.58) in 1980-1984 to 1.54 (95% CI: 1.31-1.81) in 2010-2014 (Ptrend=.025). No statistically significant change in both BC and RC incidence was observed. The 10-year cumulative incidence of BC increased from 1975-1984 (.04%) to 2005-2014 (.15%) among PCa treated with radiotherapy. Simultaneously, the 10-year cumulative incidence of RC was demonstrated to range from 1975-1984 (.02%) to 2005-2014 (.11%).

CONCLUSION: we have observed an increasing trend in second BC and RC incidence in PCa patients receiving radiotherapy. There was no significant change in the incidence of second BC and RC in PCa without radiotherapy. These results reflect the increasing clinical burden of second malignant tumors in PCa patients undergoing radiotherapy.

PMID:37196346 | DOI:10.1177/10732748231177544

JMIR Mhealth Uhealth. 2023 May 17;11:e48961. doi: 10.2196/48961.

ABSTRACT

[This corrects the article DOI: 10.2196/44513.].

PMID:37196344 | DOI:10.2196/48961

Hum Reprod. 2023 May 17:dead096. doi: 10.1093/humrep/dead096. Online ahead of print.

ABSTRACT

STUDY QUESTION: Are patients willing to discuss the possibility of treatment being unsuccessful as part of routine care offered at clinics, and what are the factors associated with this willingness?

SUMMARY ANSWER: Nine in every 10 patients are willing to discuss this possibility as part of routine care, with willingness being associated with higher perceived benefits, lower barriers, and stronger positive attitudes towards it.

WHAT IS KNOWN ALREADY: Fifty-eight percent of patients who complete up to three cycles of IVF/ICSI in the UK do not achieve a live birth. Offering psychosocial care for unsuccessful fertility treatment (PCUFT), defined as assistance and guidance on the implications of treatment being unsuccessful, could reduce the psychosocial distress patients experience when it happens, and promote positive adjustment to this loss. Research shows 56% of patients are willing to plan for an unsuccessful cycle, but little is known about their willingness and preferences towards discussing the possibility of definitive unsuccessful treatment.

STUDY DESIGN, SIZE, DURATION: The study was of cross-sectional design, comprising a theoretically driven and patient-centred bilingual (English, Portuguese) mixed-methods online survey. The survey was disseminated via social media (April 2021-January 2022). Eligibility criteria included being aged 18 or older, waiting to or undergoing an IVF/ICSI cycle, or having completed a cycle within the previous 6 months without achieving a pregnancy. Out of 651 people accessing the survey, 451 (69.3%) consented to participate. From these, 100 did not complete 50% of the survey questions, nine did not report on the primary outcome variable (willingness), and 342 completed the survey (completion rate 75.8%, 338 women).

PARTICIPANTS/MATERIALS, SETTING, METHODS: The survey was informed by the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). Quantitative questions covered sociodemographic characteristics and treatment history. Quantitative and qualitative questions gathered data on past experiences, willingness, and preferences (with whom, what, how and when) to receive PCUFT, as well as theory-informed factors hypothesized to be associated with patients’ willingness to receive it. Descriptive and inferential statistics were used on quantitative data about PCUFT experiences, willingness, and preferences, and thematic analysis was applied to textual data. Two logistic regressions were used to investigate the factors associated with patients’ willingness.

MAIN RESULTS AND THE ROLE OF CHANCE: Participants were, on average, 36 years old and most resided in Portugal (59.9%) and the UK (38.0%). The majority (97.1%) were in a relationship for around 10 years, and 86.3% were childless. Participants were undergoing treatment for, on average, 2 years [SD = 2.11, range: 0-12 years], with most (71.8%) having completed at least one IVF/ICSI cycle in the past, almost all (93.5%) without success. Around one-third (34.9%) reported having received PCUFT. Thematic analysis showed participants received it mainly from their consultant. The main topic discussed was patients’ low prognosis, with the emphasis being put on achieving a positive outcome. Almost all participants (93.3%) would like to receive PCUFT. Reported preferences indicated that 78.6% wanted to receive it from a psychologist/psychiatrist/counsellor, mostly in case of a bad prognosis (79.4%), emotional distress (73.5%), or difficulties in accepting the possibility of treatment being unsuccessful (71.2%). The preferred time to receive PCUFT was before initiating the first cycle (73.3%), while the preferred format was in an individual (mean = 6.37, SD = 1.17; in 1-7 scale) or couple (mean = 6.34, SD = 1.24; in 1-7 scale) session. Thematic analysis showed participants would like PCUFT to provide an overview of treatment and all possible outcomes tailored to each patient’s circumstances and to encompass psychosocial support, mainly focused on coping strategies to process loss and sustain hope towards the future. Willingness to receive PCUFT was associated with higher perceived benefit of building psychosocial resources and coping strategies (odds ratios (ORs) 3.40, 95% CI 1.23-9.38), lower perceived barrier of triggering negative emotions (OR 0.49, 95% CI 0.24-0.98), and stronger positive attitudes about PCUFT being beneficial and useful (OR 3.32, 95% CI 2.12-5.20).

LIMITATIONS, REASONS FOR CAUTION: Self-selected sample, mainly composed of female patients who had not yet achieved their parenthood goals. The small number of participants unwilling to receive PCUFT reduced statistical power. The primary outcome variable was intentions, and research shows a moderate association between intentions and actual behaviour.

WIDER IMPLICATIONS OF THE FINDINGS: Fertility clinics should provide patients with early opportunities to discuss the possibility of their treatment being unsuccessful as part of routine care. PCUFT should focus on minimizing suffering associated with grief and loss by reassuring patients they can cope with any treatment outcome, promoting coping resources, and signposting to additional support.

STUDY FUNDING/COMPETING INTEREST(S): M.S.-L. holds a doctoral fellowship from the Portuguese Foundation for Science and Technology, I.P. [Fundação para a Ciência e a Tecnologia] (FCT; SFRH/BD/144429/2019). R.C. holds a post-doctoral fellowship supported by the European Social Fund (ESF) and FCT (SFRH/BPD/117597/2016). The EPIUnit, ITR and CIPsi (PSI/01662) are also financed by FCT through the Portuguese State Budget, in the scope of the projects UIDB/04750/2020, LA/P/0064/2020 and UIDB/PSI/01662/2020, respectively. Dr Gameiro reports consultancy fees from TMRW Life Sciences and Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter, grants from Merck Serono Ltd, an affiliate of Merck KgaA, Darmstadt, Germany.

TRIAL REGISTRATION NUMBER: N/A.

PMID:37196325 | DOI:10.1093/humrep/dead096

Int J Epidemiol. 2023 May 17:dyad062. doi: 10.1093/ije/dyad062. Online ahead of print.

ABSTRACT

It is well-known that designing a cluster randomized trial (CRT) requires an advance estimate of the intra-cluster correlation coefficient (ICC). In the case of longitudinal CRTs, where outcomes are assessed repeatedly in each cluster over time, estimates for more complex correlation structures are required. Three common types of correlation structures for longitudinal CRTs are exchangeable, nested/block exchangeable and exponential decay correlations-the latter two allow the strength of the correlation to weaken over time. Determining sample sizes under these latter two structures requires advance specification of the within-period ICC and cluster autocorrelation coefficient as well as the intra-individual autocorrelation coefficient in the case of a cohort design. How to estimate these coefficients is a common challenge for investigators. When appropriate estimates from previously published longitudinal CRTs are not available, one possibility is to re-analyse data from an available trial dataset or to access observational data to estimate these parameters in advance of a trial. In this tutorial, we demonstrate how to estimate correlation parameters under these correlation structures for continuous and binary outcomes. We first introduce the correlation structures and their underlying model assumptions under a mixed-effects regression framework. With practical advice for implementation, we then demonstrate how the correlation parameters can be estimated using examples and we provide programming code in R, SAS, and Stata. An Rshiny app is available that allows investigators to upload an existing dataset and obtain the estimated correlation parameters. We conclude by identifying some gaps in the literature.

PMID:37196320 | DOI:10.1093/ije/dyad062

Dermatol Pract Concept. 2023 Apr 1;13(2). doi: 10.5826/dpc.1302a134. Online ahead of print.

ABSTRACT

INTRODUCTION: Psoriasis is an immune-mediated, chronic and inflammatory disease whose pathogenesis is affected by the interactions of several immune cells and cytokines. PD-1 is an inhibitor receptor that is expressed to a large extent in T lymphocytes and responsible for regulating autoimmunity and self-tolerance.

OBJECTIVES: In this study, we aimed to investigate the expression of PD-1/PD-L molecules in the lesioned skins of psoriasis patients.

METHODS: The study included 30 psoriasis patients, and 15 healthy volunteers as the control group. Anti PD-1 and PD-L1 antibodies were applied to the skin biopsy samples that were collected from the patient and control groups. Cytoplasmic and membranous staining of PD-1 and PD-L1 were considered positive. The number of stained immune cells that was examined for each case.

RESULTS: The percentage of the tissues with high PD-1 (+) and PDL-1 (+) immune cell counts were significantly higher in the psoriasis patients compared to healthy controls (P values = 0.004 and 0.002, respectively). A negative and statistically significant correlation was detected between PDL-1(+) immune cell numbers and PASI scores (P = 0.033, r=-0.57).

CONCLUSIONS: In the lesioned skin samples of psoriasis patients, the PD-1 and PD-L1 expressions were significantly higher in immune cells than that in the skin samples of the healthy controls. This study was the first investigation of the expression of PD-1/PD-L molecules in the immune cells in found the lesioned skins of psoriasis patients.

PMID:37196303 | DOI:10.5826/dpc.1302a134

Dermatol Pract Concept. 2023 Apr 1;13(2). doi: 10.5826/dpc.1302a116. Online ahead of print.

ABSTRACT

INTRODUCTION: Psoriasis is an inflammatory disease that can cause cardiovascular comorbidities. Some recent studies have indicated that impaired gut microbiota and metabolites may be associated with inflammatory diseases.

OBJECTIVES: In this study, the relationship between serum trimethylamine n-oxide (TMAO, a gut bacterial metabolite) level and carotid intima-media thickness (CIMT) and disease severity in psoriasis patients was investigated.

METHODS: Age- and gender-matched 73 patients and 72 healthy controls were included in the study. In both groups serum trimethylamine n-oxide(TMAO), oxidized low-density lipoprotein (ox-LDL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, total cholesterol, high-sensitivity C-reactive protein (hs-CRP), creatinine, aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels were recorded and the carotid intima-media thickness (CIMT) was measured by B-mode ultrasonography by a cardiologist.

RESULTS: TMAO, hs-CRP, oxidized-LDL, triglyceride and CIMT levels were statistically higher in the patient group. HDL levels were statistically higher in the control group. There was no significant difference between the two groups in terms of total cholesterol and LDL-C levels. In partial correlation analyzes in the patient group, positive correlations were observed between TMAO and CIMT, LDL-C and total cholesterol levels. Linear regression analysis showed that TMAO levels positively predicted CIMT levels.

CONCLUSIONS: This study confirmed that psoriasis is a risk factor for the development of cardiovascular disease and that elevated serum TMAO levels in these patients indicate the presence of intestinal dysbiosis. Furthermore, TMAO levels were found to be a predictor of the risk of developing cardiovascular disease in psoriasis patients.

PMID:37196276 | DOI:10.5826/dpc.1302a116

Dermatol Pract Concept. 2023 Apr 1;13(2). doi: 10.5826/dpc.1302a120. Online ahead of print.

ABSTRACT

INTRODUCTION: Effective communication is an important issue in patient-doctor interaction which is even more important regarding chronic disorders which need a strong relationship between patient and clinician for better compliance and optimal control disease.

OBJECTIVES: This study was aimed to develop the best cultural adapted Persian version of the 28-item Calgary- Cambridge Observation Guide (CCOG) questionnaire.

METHODS: In this descriptive-analytic study, data collected from 400 patients attending the outpatient dermatology clinics of 3 major hospitals in Tehran using the modified Persian version of CCOG questionnaire, both before and after being visited by dermatologists.

RESULTS: The difference of CCG scores for all of questions, except for questions number 1,16 and 22, was statistically significant. The highest score, both before and after visiting, attained by question regarding being respectful. The lowest scores for necessary behavior and the adequate amount of execution were related to questions number 3 (Introducing self) and 4 (Introducing role), respectively. Age and educational level of patients were significantly correlated with their expectations regarding communication skills of clinician.

CONCLUSIONS: This study showed the acceptable validity of modified Persian version of CCOG-24 item questionnaire. Our findings also demonstrated that there was a significant difference between what patients expected from a dermatologist and the manner they actually were treated regarding physician communication skills.

PMID:37196253 | DOI:10.5826/dpc.1302a120

J Am Chem Soc. 2023 May 17. doi: 10.1021/jacs.3c02041. Online ahead of print.

ABSTRACT

Cation-disordered rock-salt (DRX) materials receive intensive attention as a new class of cathode candidates for high-capacity lithium-ion batteries (LIBs). Unlike traditional layered cathode materials, DRX materials have a three-dimensional (3D) percolation network for Li⁺ transportation. The disordered structure poses a grand challenge to a thorough understanding of the percolation network due to its multiscale complexity. In this work, we introduce the large supercell modeling for DRX material Li_1.16Ti_0.37Ni_0.37Nb_0.10O₂ (LTNNO) via the reverse Monte Carlo (RMC) method combined with neutron total scattering. Through a quantitative statistical analysis of the material’s local atomic environment, we experimentally verified the existence of short-range ordering (SRO) and uncovered an element-dependent behavior of transition metal (TM) site distortion. A displacement from the original octahedral site for Ti⁴⁺ cations is pervasive throughout the DRX lattice. Density functional theory (DFT) calculations revealed that site distortions quantified by the centroid offsets could alter the migration barrier for Li⁺ diffusion through the tetrahedral channels, which can expand the previously proposed theoretical percolating network of Li. The estimated accessible Li content is highly consistent with the observed charging capacity. The newly developed characterization method here uncovers the expandable nature of the Li percolation network in DRX materials, which may provide valuable guidelines for the design of superior DRX materials.

PMID:37196223 | DOI:10.1021/jacs.3c02041