Category: Nevin Manimala

Clin Exp Dermatol. 2022 Nov 23:llac086. doi: 10.1093/ced/llac086. Online ahead of print.

ABSTRACT

BACKGROUND: High-risk mucosal human papillomavirus (HR-HPV) seems to play a role in cutaneous squamous cell carcinoma (cSCC), particularly in nail tumours, where genitodigital transmission has been suggested. The role of HR-HPV in nonungual cSCC of the finger needs to be clarified.

AIM: To evaluate the prevalence, clinicopathological characteristics, surrogates and outcomes of HR-HPV in cSCC of the finger.

METHODS: This was an observational bicentric study including patients with an excised in situ or invasive cSCC located on the finger. Differences in HR-HPV and non-HR-HPV tumours were evaluated.

RESULTS: Forty-five patients (45 tumours) were included. HR-HPV was detected in 33% of cases (22% HPV type 16). The mean age was lower in patients with HR-HPV than in those with non-HR-HPV (62·4 vs. 81·1 years, P = 0·001). HR-HPV tumours were smaller (10 mm vs. 15 mm, P = 0·07) and more frequently intraepidermal (60% vs. 20%, P = 0·004). The absence of elastosis (P = 0·030) and inflammation (P = 0·026) and the presence of basaloid morphology (P = 0·003) were surrogates of HR-HPV detection. Mean p16 positivity was 61% in HR-HPV and 36% in non-HR-HPV tumours (P = 0·061). Recurrence after surgery was more common in HR-HPV tumours (58% vs. 34%), although this was not statistically significant. HR-HPV was detected in 27% of the nonungual tumours.

CONCLUSION: HR-HPV-associated cSCC of the finger appears in younger patients, is smaller and is less infiltrative than non-HR-HPV tumours. The presence of a basaloid morphology and the absence of elastosis and inflammation could be used as markers for HR-HPV detection. The high prevalence of HR-HPV in nonungual cSCC suggests its aetiopathogenic role in these tumours.

PMID:36763739 | DOI:10.1093/ced/llac086

PLoS One. 2023 Feb 10;18(2):e0281739. doi: 10.1371/journal.pone.0281739. eCollection 2023.

ABSTRACT

An important question regards the nature of our spatial memories for the paths that we have walked and, in particular, whether such distortions might violate the topological properties of the shape of the paths (i.e., creating an intersection when two paths did not intersect or vice versa). To investigate whether and how this might occur, we tested humans in situations in which they walked simple paths and idiothetic and visual cues either matched or mismatched, with the mismatching cues creating the greatest potential for topological distortions. Participants walked four-segment paths with 90° turns in immersive virtual reality and pointed to their start location when they arrived at the end of the path. In paths with a crossing, when the intersection was not presented, participants pointed to a novel start location suggesting a topological distortion involving non-crossed paths. In paths without a crossing, when a false intersection was presented, participants pointed to a novel start location suggesting a topological distortion involving crossed paths. In paths without crossings and without false intersections, participants showed reduced pointing errors that typically did not involve topological distortions. Distortions more generally, as indicated by pointing errors to the start location, were significantly reduced for walked paths involving primarily idiothetic cues with limited visual cues; conversely, distortions were significantly increased when idiothetic cues were diminished and navigation relied primarily on visual cues. Our findings suggest that our spatial memories for walked paths sometimes involve topological distortions, particularly when resolving the competition between idiothetic and visual cues.

PMID:36763702 | DOI:10.1371/journal.pone.0281739

Nutr Rev. 2023 Feb 10:nuac105. doi: 10.1093/nutrit/nuac105. Online ahead of print.

ABSTRACT

CONTEXT: To date, the efficacy of nutritional interventions on oral mucositis (OM) in patients with cancer, and the quality of this evidence have not been explored.

OBJECTIVE: The goal of this umbrella review was to provide a comprehensive evaluation of nutritional interventions for patients with cancer with OM, as well as to assess the quality of this evidence.

DATA SOURCES: Meta-analyses were searched for using PubMed, Scopus, and ISI Web of Science databases until December 2021, with no time restrictions.

DATA EXTRACTION: Meta-analyses of randomized control trials that evaluated the effects of nutritional interventions on the incidence of OM in patients with cancer had inclusion criteria for this umbrella review. Data extraction, quality assessment of meta-analyses, and primary studies were done independently by 2 authors. The Grading of Recommendations Assessment, Development, and Evaluation technique was used to grade the certainty of evidence.

DATA ANALYSIS: A total of 26 meta-analyses were included in this umbrella review. The results showed that honey, glutamine, and propolis can reduce the incidence of severe OM, based on moderate evidence quality. In addition, zinc supplementation significantly reduced the incidence of OM, regardless of symptom severity; however, low certainty of the evidence was observed. The effects of vitamin E, curcumin, and probiotics on OM were not statistically significant.

CONCLUSION: This umbrella review shows that honey, glutamine, and propolis can significantly reduce the incidence of severe OM. These findings need to be confirmed with well-designed, longitudinal randomized controlled trials.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022301010.

PMID:36763701 | DOI:10.1093/nutrit/nuac105

PLoS One. 2023 Feb 10;18(2):e0277128. doi: 10.1371/journal.pone.0277128. eCollection 2023.

ABSTRACT

This paper constructs a matching index model to research the matching degree of embodied carbon trade and value-added trade among eight regions and 31 provinces in China in 2012 and 2015. The study finds that (1) At the regional level, a mismatch is shown between embodied carbon trade and value-added trade among regions, for example, in 2015, the northwest region has output embodied carbon to the north coast, while input the value-added trades from the north coast. (2) At the provincial level, a mismatch is displayed between embodied carbon transaction and value-added trade, for example, Beijing had a net shift of embodied carbon from Xinjiang in 2015, but Xinjiang had a net transfer of added value from Beijing. Therefore, the Chinese government needs to establish an ecological compensation mechanism to improve the mismatch between embodied carbon trade and value-added trade among Chinese regions (provinces).

PMID:36763669 | DOI:10.1371/journal.pone.0277128

Kidney360. 2023 Feb 10. doi: 10.34067/KID.0000000000000067. Online ahead of print.

ABSTRACT

Background Patients receiving maintenance hemodialysis (HD) have a high incidence of cardiovascular events, including arrhythmia and sudden death. Spironolactone reduces the risk of cardiovascular events and sudden death in patients with heart failure, but the effects of spironolactone on arrhythmic events in patients treated with maintenance HD are unclear. Methods The Safety and Cardiovascular Efficacy of Spironolactone in Dialysis-Dependent ESRD (SPin-D) trial, was a 36-week randomized, placebo-controlled, double-blind trial comparing 3 different doses of spironolactone with placebo in maintenance HD patients. We performed a post-hoc analysis in a subset (n=57) who underwent extended electrocardiographic monitoring using a wearable device at baseline and follow-up. Generalized estimating equations models were fit to determine the associations of spironolactone (individual doses and combined) versus placebo on the incidence rate of predefined categories of arrhythmic events. Results The average age of participants was 55 ±12 years; 61% were male; and 77% were Black. The overall proportion of patients with at least one arrhythmia event was 43% (15/35) at baseline and 81% (43/53) at the end of follow-up. At the end of follow-up, the rate of bradycardic events or conduction blocks was higher in the combined spironolactone group, compared with placebo, (82.4 versus 38.7 events/100 patient days; P<0.001). Similar findings were noted in adjusted models, but did not meet statistical significance (adjusted rate ratio of 2.04; 95%CI 0.83 – 5.05). Conclusions In a 36-week trial of patients receiving maintenance hemodialysis, a higher frequency of bradycardia and conduction blocks was observed among those treated with spironolactone treatment compared with placebo. Larger studies are required to investigate the longer-term effects of spironolactone on cardiac conduction in patients receiving hemodialysis.

PMID:36763641 | DOI:10.34067/KID.0000000000000067

PLoS One. 2023 Feb 10;18(2):e0280723. doi: 10.1371/journal.pone.0280723. eCollection 2023.

ABSTRACT

BACKGROUND: Internet penetration worldwide has increased rapidly over the recent years. With this growth, modern information and communication technologies (ICT) have become increasingly important. They do not only change daily life but also patient-physician interaction and health related information search, which can be summarized as electronic Health (eHealth). eHealth was already known before the emergence of the coronavirus disease 2019 (COVID-19), but this pandemic substantially challenged health systems, physicians and hospitals so profoundly that new services and methods of patient-physician interaction had to be implemented rapidly. This study investigates the attitude of cancer patients towards eHealth and the potential impact of COVID-19 on its use.

METHODS AND FINDINGS: The study was a multicentered study carried out at the university hospitals Bonn and Aachen. Patients were asked to answer a structured questionnaire in the time span between September 2019 and February 2021. Due to the COVID-19 pandemic, no patients were addressed between March 2020 and July 2020. The questionnaire focused on socio-demographic data, the dissemination of internet-enabled devices, the patients’ attitude towards eHealth and the use of modern ICT in daily life and for health-related information search. In total, 280 patients have filled the questionnaire of which 48% were female and 52% were male. Men have a slightly more positive attitude towards the overall potential of eHealth than women which was shown by a significant influence for receiving medical information via e-mail. Hematological-oncological patients with a higher education level reported a significantly higher willingness to send personal health information to their physician and health insurance. A frequency of medical consultation of more than 5 times during the previous year has a significantly positive impact regarding the use of online communication, online video consultation and treatment quality. Younger patients have more concerns about data security than older patients. The study shows a different attitude towards the influence of eHealth on the patient-physician relationship in different therapy situations. While there were no significant changes in patients’ attitude towards eHealth after the start of the COVID-19 pandemic, there was a trend towards an increasingly embracing attitude in patients, who answered the questionnaire during COVID-19 pandemic situation.

CONCLUSIONS: Overall, cancer patients had a positive attitude towards eHealth and the dissemination of internet-enabled devices was high. The study shows that the potential of eHealth is high among hematological-oncological patients. Further eHealth technologies and especially telemedically supported care processes should be implemented to improve patient-physician interaction and cross-sectoral care. COVID-19 pandemic led to a fast initiation and acceleration of new structures and routines for physicians, hospitals and patients. These new processes should be used to promote digitalization in hematological and oncological telemedicine. To successfully implement new eHealth technologies, future research should focus on patients’ concerns about data privacy and data availability especially in the context of exchange of medical information in cross sectoral and interdisciplinary care processes.

PMID:36763640 | DOI:10.1371/journal.pone.0280723

PLoS One. 2023 Feb 10;18(2):e0281515. doi: 10.1371/journal.pone.0281515. eCollection 2023.

ABSTRACT

OBJECTIVE: This study was conducted to find a more effective education method in a neonatal resuscitation program (NRP) using a high-fidelity simulation that has recently shown positive results in terms of its effectiveness.

STUDY DESIGN: A single-blind prospective cohort study was performed. The high-fidelity simulation model was used in a formal NRP training course for trainees caring for neonatal patients. The trainees were divided into a group that conducted the scenario after the lecture (Group A) and a group that attended the lecture after the scenario (Group B) and they both took the test before, during, and after the training.

RESULTS: The increase in score after theory training was statistically significant in both groups, but the final score did not differ between the two groups. However, when compared by career, in Group A, trainees under 24 months tended to be more effective, and in Group B, trainees over 24 months tended to be more effective.

CONCLUSION: The difference in short-term memory of trainees according to the order of education identified by the test score was not prominent, but it was found that the degree of difference in test scores for the order of education tended to be different according to the career. It is thought that the effectiveness of the training might be increased by changing the education order according to the degree of experience of each trainee. More effective educational methods should be introduced by continuously developing lectures for repeated education of various trainees in the future.

PMID:36763618 | DOI:10.1371/journal.pone.0281515

Breastfeed Med. 2023 Feb 10. doi: 10.1089/bfm.2022.0260. Online ahead of print.

ABSTRACT

Background: The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation. Methods: This randomized controlled experimental research included a total of 90 women in the research sample abiding by the research criteria, with 30 each in the intervention groups (coconut oil or tea tree oil application) and 30 in the control group. Women in the intervention groups applied coconut oil or tea tree oil to the nipples on the 3rd, 7th, and 10th days postpartum, whereas the control group did not have any intervention. Data in the research were collected with the Descriptive Information Form for Mothers, Early Postpartum Period Breast Problem Assessment Form, and Visual Analog Scale (VAS). Analysis of data used the chi-square test, Kruskal-Wallis test, and Friedman’s test. Results: Mean age of women participating in the research was 28.23 ± 5.21 years. The differences between the groups applying coconut oil and tea tree oil on the 3rd, 7th, and 10th days postpartum and the control group were significant in terms of incidence of nipple cracks. In addition, the difference in mean VAS points for nipple pain in the groups using coconut oil and tea tree oil and the control group was found to be statistically significant (p < 0.05). Conclusions: According to the research findings, coconut oil and tea tree oil were determined to reduce nipple crack formation and nipple pain. It is recommended to increase the use of coconut oil and tea tree oil related to breast problems in nursing care during the postpartum period. Clinical Trials Registration Number: NCT05456438.

PMID:36763614 | DOI:10.1089/bfm.2022.0260

JMIR Public Health Surveill. 2023 Feb 10;9:e41450. doi: 10.2196/41450.

ABSTRACT

BACKGROUND: Opioid-related overdose mortality has remained at crisis levels across the United States, increasing 5-fold and worsened during the COVID-19 pandemic. The ability to provide forecasts of opioid-related mortality at granular geographical and temporal scales may help guide preemptive public health responses. Current forecasting models focus on prediction on a large geographical scale, such as states or counties, lacking the spatial granularity that local public health officials desire to guide policy decisions and resource allocation.

OBJECTIVE: The overarching objective of our study was to develop Bayesian spatiotemporal dynamic models to predict opioid-related mortality counts and rates at temporally and geographically granular scales (ie, ZIP Code Tabulation Areas [ZCTAs]) for Massachusetts.

METHODS: We obtained decedent data from the Massachusetts Registry of Vital Records and Statistics for 2005 through 2019. We developed Bayesian spatiotemporal dynamic models to predict opioid-related mortality across Massachusetts’ 537 ZCTAs. We evaluated the prediction performance of our models using the one-year ahead approach. We investigated the potential improvement of prediction accuracy by incorporating ZCTA-level demographic and socioeconomic determinants. We identified ZCTAs with the highest predicted opioid-related mortality in terms of rates and counts and stratified them by rural and urban areas.

RESULTS: Bayesian dynamic models with the full spatial and temporal dependency performed best. Inclusion of the ZCTA-level demographic and socioeconomic variables as predictors improved the prediction accuracy, but only in the model that did not account for the neighborhood-level spatial dependency of the ZCTAs. Predictions were better for urban areas than for rural areas, which were more sparsely populated. Using the best performing model and the Massachusetts opioid-related mortality data from 2005 through 2019, our models suggested a stabilizing pattern in opioid-related overdose mortality in 2020 and 2021 if there were no disruptive changes to the trends observed for 2005-2019.

CONCLUSIONS: Our Bayesian spatiotemporal models focused on opioid-related overdose mortality data facilitated prediction approaches that can inform preemptive public health decision-making and resource allocation. While sparse data from rural and less populated locales typically pose special challenges in small area predictions, our dynamic Bayesian models, which maximized information borrowing across geographic areas and time points, were used to provide more accurate predictions for small areas. Such approaches can be replicated in other jurisdictions and at varying temporal and geographical levels. We encourage the formation of a modeling consortium for fatal opioid-related overdose predictions, where different modeling techniques could be ensembled to inform public health policy.

PMID:36763450 | DOI:10.2196/41450

Phys Rev Lett. 2023 Jan 27;130(4):047001. doi: 10.1103/PhysRevLett.130.047001.

ABSTRACT

Research on spatially inhomogeneous weakly coupled superconductors has recently received a boost of interest because of the experimental observation of a dramatic enhancement of the kinetic inductance with relatively low losses. Here, we study the kinetic inductance and the quality factor of a strongly disordered, weakly coupled superconducting thin film. We employ a gauge-invariant random-phase approximation capable of describing collective excitations and other fluctuations. In line with the experimental findings, we have found that in the range of frequencies of interest, and for sufficiently low temperatures, an exponential increase of the kinetic inductance with disorder coexists with a still large quality factor of ∼10^{4}. More interestingly, on the metallic side of the superconductor-insulator transition, we have identified a range of frequencies and temperatures, T∼0.1T_{c}, where quantum coherence effects induce a broad statistical distribution of the quality factor with an average value that increases with disorder. We expect these findings to further stimulate experimental research on the design and optimization of superinductors for a better performance and miniaturization of quantum devices such as qubit circuits and microwave detectors.

PMID:36763448 | DOI:10.1103/PhysRevLett.130.047001