Category: Nevin Manimala

WMJ. 2023 May;122(2):101-104.

ABSTRACT

INTRODUCTION: Initial reports identified preexisting conditions associated with COVID-19 mortality risk. The Centers for Disease Control and Prevention (CDC) 500 Cities Project provides prevalence rate estimates at the census tract level for these conditions. The frequency of these individual condition prevalence rates may associate with the census tracts with greater risk of COVID-19 deaths.

OBJECTIVE/RESEARCH QUESTION: Can the census tract-level outcome of Milwaukee County COVID-19 death rates correlate with the census tract-level COVID-19 individual mortality risk condition prevalence rates?

METHODS: This study used the 296 Milwaukee County, Wisconsin census tracts’ COVID-19 death rates per 100,000 lives to perform a linear regression with individual COVID-19 mortality risk condition prevalence rates, obtained from the CDC’s 500 Cities Project, and a multiple regression with 7 condition prevalence rates. The Milwaukee County Medical Examiner provided census tract identified deaths from COVID-19 from March 2020 through May 2020. Crude death rates for these 3 months per 100,000 population were analyzed in a multiple linear regression versus prevalence rates for these conditions in each census tract.

RESULTS: There were 295 assessable COVID-19-related deaths in Milwaukee County in early 2020. The model of crude death rates showed statistical significance with the condition prevalence rates in Milwaukee County. A regression analysis of each condition’s prevalence rate showed no association with crude death rates.

CONCLUSIONS: This study supports a correlation between high COVID-19 mortality rate census tracts and prevalence rate estimates of conditions associated with high individual COVID-19 mortality rates. The study is limited by the small COVID-19 death sample and the use of a single location. The ability to focus COVID-19 health promotion may save future lives if mitigation strategies are applied extensively in these neighborhoods.

PMID:37141472

Spine (Phila Pa 1976). 2023 May 1. doi: 10.1097/BRS.0000000000004698. Online ahead of print.

ABSTRACT

STUDY DESIGN: In vitro biomechanical study.

OBJECTIVE: This study aimed to investigate the biomechanical effects of facet joint violation (FV) on mobility and optically tracked intervertebral disc (IVD) surface strains at the upper level adjacent to L4-5 pedicle screw-rod fixation.

SUMMARY OF BACKGROUND DATA: FV is a complication that can occur when placing lumbar pedicle screws; the reported incidence is as high as 50%. However, little is known about how FV affects superior adjacent-level spinal stability, and especially IVD strain, after lumbar fusion.

METHODS: Fourteen cadaveric L3-S1 specimens underwent L4-5 pedicle-rod fixation, 7 in the facet joint preservation (FP) group and 7 in the FV group. Specimens were tested multidirectionally under pure moment loading (7.5 Nm). Colored maps of maximum (ε1) and minimum (ε2) principal surface strain changes on the lateral L3-4 disc were generated with the surface divided into 4 quarters anterior to posterior (Q1, Q2, Q3, and Q4, respectively) for subregional analyses. Range of motion (ROM) and IVD strain were normalized to intact upper adjacent-level and compared between the groups using analysis of variance. Statistical significance was set at P<0.05.

RESULTS: Normalized ROM was significantly greater with FV versus FP in flexion (11% greater; P=0.04), right lateral bending (16% greater; P=0.03), and right axial rotation (23% greater; P=0.04). Normalized L3-4 IVD ε1 during right lateral bending was greater on average for the FV group than the FP group: Q1, 18% greater; Q2, 12% greater; Q3, 40% greater (P<0.001); Q4, 9% greater. Normalized ε2 values during left axial rotation were greater in the FV group, the highest increase being 25% in Q3 (P=0.02).

CONCLUSIONS: Facet joint violation during single-level pedicle screw-rod fixation was associated with increased superior adjacent level mobility and alteration of disc surface strains, with significant increases in selected regions and directions of loading.

PMID:37141463 | DOI:10.1097/BRS.0000000000004698

Ocul Immunol Inflamm. 2023 May 4:1-6. doi: 10.1080/09273948.2023.2203752. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: To determine the clinical features, predisposing factors, and management of infectious keratitis caused by Candida spp.

METHODS: Retrospective chart review.

RESULTS: The medical records of 52 patients (54 eyes) with Candida keratitis were available for statistical analysis. Thinning of the corneal stroma was identified in 34 eyes (63.0%), and corneal perforation occurred in 16 eyes (29.6%). Corneal thinning and perforation were more common in Candida albicans compared with non-albicans (P-val < .001, P = .09, respectively). The most common predisposing factors for Candida keratitis were topical steroid use (21 patients, 40.4%), previous corneal transplantation (17 patients, 32.7%), and preexisting ocular surface disease (15 patients, 28.8%). Fourteen eyes (25.9%) required cyanoacrylate glue application and 10 eyes (18.5%) underwent therapeutic penetrating keratoplasty (TPK).

CONCLUSION: Local immunosuppression and ocular surface disease play an important role in Candida keratitis. C. albicans appears to be more invasive compared with non-albicans spp.

PMID:37141453 | DOI:10.1080/09273948.2023.2203752

Eur J Public Health. 2023 May 3:ckad071. doi: 10.1093/eurpub/ckad071. Online ahead of print.

ABSTRACT

BACKGROUND: Coverage by examinations is a crucial indicator of the future impact on the burden of colorectal cancer (CRC). The study aimed to evaluate coverage by examinations associated with CRC screening and early cancer detection of CRC in the Czech Republic. The burden of CRC was also assessed.

METHODS: The novel nationwide administrative registry with individual data (period 2010-19) was used to evaluate coverage by examinations for screening faecal occult blood test and colonoscopy. In the second step, additional examinations for early CRC detection were included in the coverage calculation (complete coverage). Age-specific trends in CRC incidence (period 1977-2018) were investigated using Joinpoint regression.

RESULTS: Coverage by screening examinations within recommended interval was around 30%. Complete coverage reached >37% and >50% at the 3-year interval. The coverage by examinations for the non-screening population aged 40-49 years was almost 4% and 5% (most of them were colonoscopies) at the 3-year interval. In age groups aged ≥50 years, we observed a significant annual decline, especially in the 50-69 age group, with recent annual decreases reaching up to 5-7%. The change in trend and the recent decline were also observed in the age group 40-49.

CONCLUSIONS: More than half of the target screening population was covered by examinations potentially associated with early detection and subsequent treatment of colorectal neoplasms. The substantial coverage by potentially prophylactic examinations might be an explanation for the considerable decrease in CRC incidence.

PMID:37141451 | DOI:10.1093/eurpub/ckad071

Adv Physiol Educ. 2023 May 4. doi: 10.1152/advan.00211.2022. Online ahead of print.

ABSTRACT

The analysis of spontaneous tail coiling (STC) in zebrafish embryos is a functional parameter that allows the study of motor development, and it has recently gained relevance as a biomarker to assess the neurotoxicity of environmental substances. Its practicability in the laboratory makes it a good pedagogical tool for promoting students’ inquiry skills. However, the time and cost of materials and facilities limit their usage in undergraduate laboratories. This study presents the design of a computer-based educational module called “ZebraSTMe,” which is based on a tail coiling assay and aims to improve science processing skills in undergraduate students by connecting them to relevant and novel content. We evaluate students’ perception of learning, the quality of materials used, and the learning gained. Our results show that students perceived an improvement in their statistical analysis, representation, and discussion of experimental data. An improvement in acquired knowledge confirmed this perception. Additionally, the students evaluated the materials’ quality and ease of use and provided feedback for revision. A thematic analysis of the opinions revealed that the module activities promoted students’ reflection on their professional strengths and weaknesses.

PMID:37141434 | DOI:10.1152/advan.00211.2022

Nurs Ethics. 2023 May 4:9697330231160006. doi: 10.1177/09697330231160006. Online ahead of print.

ABSTRACT

BACKGROUND: There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard “narrow” definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown.

RESEARCH AIMS: To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument.

RESEARCH DESIGN: A mixed methods embedded design included a longitudinal, descriptive investigator-developed electronic survey with open-ended questions sent twice a week for 6 weeks. Analysis included descriptive and comparative statistics and content analysis of narrative data.

PARTICIPANTS: Registered nurses from four hospitals within one large healthcare system in Midwest United States.

ETHICAL CONSIDERATIONS: IRB approval was obtained.

RESULTS: 246 participants completed the baseline survey, 80 participants provided data longitudinally for a minimum of 3 data points. At baseline, moral-conflict distress occurred with the highest frequency, followed by moral-constraint distress and moral-tension distress. By intensity, the most distressing sub-category was moral-tension distress, followed by “other” distress and moral-constraint distress. Longitudinally, when ranked by frequency, nurses experienced moral-conflict distress, moral-constraint distress, and moral-tension distress; by intensity, scores were highest for moral-tension distress, moral-uncertainty distress, and moral-constraint distress. Of available resources, participants spoke with colleagues and senior colleagues more frequently than using consultative services such as ethics consultation.

CONCLUSIONS: Nurses experienced distress related to a number of moral issues extending beyond the traditional understanding of moral distress (as occurring due to a constraint) suggesting that our understanding and measurement of moral distress should be broadened. Nurses frequently used peer support as their primary resource but it was only moderately helpful. Effective peer support for moral distress could be impactful. Future research on moral distress sub-categories is needed.

PMID:37141428 | DOI:10.1177/09697330231160006

JAMA Netw Open. 2023 May 1;6(5):e2311673. doi: 10.1001/jamanetworkopen.2023.11673.

ABSTRACT

IMPORTANCE: The American Institute for Cancer Research and American Cancer Society regularly publish modifiable lifestyle recommendations for cancer prevention. Whether these recommendations have an impact on high-risk breast cancer survival remains unknown.

OBJECTIVE: To investigate whether adherence to cancer prevention recommendations before, during, and 1 and 2 years after breast cancer treatment was associated with disease recurrence or mortality.

DESIGN, SETTING, AND PARTICIPANTS: The Diet, Exercise, Lifestyles, and Cancer Prognosis Study (DELCaP) was a prospective, observational cohort study designed to assess lifestyles before diagnosis, during treatment, and at 1 and 2 years after treatment completion, implemented ancillary to the Southwest Oncology Group (SWOG) S0221 trial, a multicenter trial that compared chemotherapy regimens in breast cancer. Participants were chemotherapy-naive patients with pathologic stage I to III high-risk breast cancer, defined as node-positive disease with hormone receptor-negative tumors larger than 1 cm or any tumor larger than 2 cm. Patients with poor performance status and comorbidities were excluded from S0221. The study was conducted from January 1, 2005, to December 31, 2010; mean (SD) follow-up time for those not experiencing an event was 7.7 (2.1) years through December 31, 2018. The analyses reported herein were performed from March 2022 to January 2023.

EXPOSURE: An aggregated lifestyle index score comprising data from 4 time points and 7 lifestyles, including (1) physical activity, (2) body mass index, (3) fruit and vegetable consumption, (4) red and processed meat intake, (5) sugar-sweetened beverage consumption, (6) alcohol consumption, and (7) smoking. Higher scores indicated healthier lifestyle.

MAIN OUTCOMES AND MEASURES: Disease recurrence and all-cause mortality.

RESULTS: A total of 1340 women (mean [SD] age, 51.3 [9.9] years) completed the baseline questionnaire. Most patients were diagnosed with hormone-receptor positive breast cancer (873 [65.3%]) and completed some education beyond high school (954 [71.2%]). In time-dependent multivariable analyses, patients with highest vs lowest lifestyle index scores experienced a 37.0% reduction in disease recurrence (hazard ratio, 0.63; 95% CI, 0.48-0.82) and a 58.0% reduction in mortality (hazard ratio, 0.42; 95% CI, 0.30-0.59).

CONCLUSIONS AND RELEVANCE: In this observational study of patients with high-risk breast cancer, strongest collective adherence to cancer prevention lifestyle recommendations was associated with significant reductions in disease recurrence and mortality. Education and implementation strategies to help patients adhere to cancer prevention recommendations throughout the cancer care continuum may be warranted in breast cancer.

PMID:37140922 | DOI:10.1001/jamanetworkopen.2023.11673

Environ Sci Pollut Res Int. 2023 May 4. doi: 10.1007/s11356-023-27248-y. Online ahead of print.

ABSTRACT

Spontaneous combustion of coal leading to mine fire is a major problem in most of the coal mining countries in the world. It causes major loss to the Indian economy. The liability of coal to spontaneous combustion varies from place to place and mainly depends on the coal intrinsic properties and other geo-mining factors. Hence, the prediction of spontaneous combustion susceptibility of coal is of utmost importance for preventing the risk of fire in coal mines and utility sectors. Machine learning tools are pivotal in system improvements in relation to the statistical analysis of experimental results. Wet oxidation potential (WOP) of coal determined in the laboratory is one of the most relied indices used for assessing the spontaneous combustion susceptibility of coal. In this study, multiple linear regression (MLR) and five different machine learning (ML) techniques, such as Support Vector Regression (SVR), Artificial Neural Network (ANN), Random Forest (RF), Gradient Boosting (GB) and Extreme Gradient Boost (XGB) algorithms, were used to predict the spontaneous combustion susceptibility (WOP) of coal seams based on the coal intrinsic properties. The results derived from the models were compared with the experimental data. The results indicated excellent prediction accuracy and ease of interpretation of tree-based ensemble algorithms, like Random Forest, Gradient Boosting and Extreme Gradient Boosting. The MLR exhibited the least while XGB demonstrated the highest predictive performance. The developed XGB achieved R² of 0.9879, RMSE of 4.364 and VAF of 84.28%. In addition, the results of sensitivity analysis showed that the volatile matter is most sensitive to the changes in WOP of coal samples considered in the study. Thus, during spontaneous combustion modelling and simulation, volatile matter can be used as the most influential parameter for assessing the fire risk of the coal samples considered in the study. Further, the partial dependence analysis was done to interpret the complex relationships between the WOP and intrinsic properties of coal.

PMID:37140867 | DOI:10.1007/s11356-023-27248-y

Neurol Sci. 2023 May 4. doi: 10.1007/s10072-023-06831-8. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is one of the common causes of disability in the elderly. This study aims to estimate the prevalence of hallucinations in Parkinson’s patients in the world.

METHODS: A systematic review of PubMed/Medline, ISI Web of Knowledge, and Google Scholar was conducted from 2017 to 2022. This study investigated the prevalence of hallucinations in Parkinson’s patients. Point prevalence was analyzed with a 95% confidence interval. The variances of each study were calculated using the binomial distribution formula The researcher used Cochrane Q-test with a significance level of less than 0.1 to check the heterogeneity between studies and the change index assigned to heterogeneity I₂. Due to the heterogeneity between the studies, the random effects model was used to combine the results of the studies. All statistical analyses were performed by STATA version 14 software using meta-analysis commands.

RESULTS: Reports indicated that the prevalence of hallucinations in Parkinson’s patients in 32 studies was 28% (0.22-0.34 = 95%CI). The highest prevalence was 34% and 95% CI = 0.07- 0.61 in developing countries and 27% with CI = 0.33-0.21 in developed countries. Reports showed the prevalence in men was 30% (CI = 0.22-0.38) and in women 23% (95% CI = 0.14-0.31).

CONCLUSIONS: Considering the relatively high prevalence of hallucinations in these patients, checking up for the presence of hallucinations on every visit of Parkinson’s patients is recommended, and providing appropriate treatment for that is necessary.

PMID:37140832 | DOI:10.1007/s10072-023-06831-8

Eur Phys J E Soft Matter. 2023 May 4;46(5):31. doi: 10.1140/epje/s10189-023-00286-7.

ABSTRACT

Inference problems for two-dimensional snapshots of rotating turbulent flows are studied. We perform a systematic quantitative benchmark of point-wise and statistical reconstruction capabilities of the linear Extended Proper Orthogonal Decomposition (EPOD) method, a nonlinear Convolutional Neural Network (CNN) and a Generative Adversarial Network (GAN). We attack the important task of inferring one velocity component out of the measurement of a second one, and two cases are studied: (I) both components lay in the plane orthogonal to the rotation axis and (II) one of the two is parallel to the rotation axis. We show that EPOD method works well only for the former case where both components are strongly correlated, while CNN and GAN always outperform EPOD both concerning point-wise and statistical reconstructions. For case (II), when the input and output data are weakly correlated, all methods fail to reconstruct faithfully the point-wise information. In this case, only GAN is able to reconstruct the field in a statistical sense. The analysis is performed using both standard validation tools based on [Formula: see text] spatial distance between the prediction and the ground truth and more sophisticated multi-scale analysis using wavelet decomposition. Statistical validation is based on standard Jensen-Shannon divergence between the probability density functions, spectral properties and multi-scale flatness.

PMID:37140827 | DOI:10.1140/epje/s10189-023-00286-7