Category: Nevin Manimala

Prev Sci. 2023 Mar 8. doi: 10.1007/s11121-023-01515-3. Online ahead of print.

ABSTRACT

There is increasing interest about the fidelity with which interventions are implemented because it is theorized that better implementation fidelity by facilitators is associated with better participant outcomes. However, in the parenting program literature, there is mixed evidence on the relationship between implementation fidelity and outcomes. This paper provides a synthesis of the evidence on the relationship between facilitator delivery and outcomes in the parenting program literature. Following PRISMA guidelines, this paper synthesizes the results of a systematic review of studies on parenting programs aiming to reduce violence against children and child behavior problems. Specifically, it examines associations between observational measures of facilitator competent adherence and parent and child outcomes. A meta-analysis was not feasible due to study heterogeneity. As a result, Synthesis Without Meta-Analysis guidelines were followed. Searches in electronic databases, reference searching, forward citation tracking, and expert input identified 9653 articles. After screening using pre-specified criteria, 18 articles were included. The review found that most studies (n = 13) reported a statistically significant positive relationship with at least one parent or child outcome. However, eight studies reported inconsistent findings across outcomes, and four studies found no association with outcomes. The results suggest that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualized competent adherence-outcome relationships.

PMID:36884129 | DOI:10.1007/s11121-023-01515-3

J Sports Med Phys Fitness. 2023 Mar 8. doi: 10.23736/S0022-4707.23.14253-8. Online ahead of print.

ABSTRACT

BACKGROUND: Gastrointestinal tract illness (GITill) in rugby players is underreported. The incidence, severity (% time loss illness, days lost per illness) and burden of GITill with/without systemic symptoms and signs in professional South African male rugby players during the Super Rugby tournament (2013-2017) are reported.

METHODS: Team physicians completed daily illness logs of players (N.=537; 1141 player-seasons, 102738 player-days). The incidence (illnesses/1000 player-days, 95% CI), severity (% ≥1-day time-loss; days until return-to-play [DRTP]/single illness [mean: 95% CI]) and illness burden (IB: days lost to illness/1000 player-days) for the subcategories of GITill with/without systemic symptoms and signs (GITill+ss; GITill-ss), and gastroenteritis with/without systemic symptoms and signs (GE+ss; GE-ss) are reported.

RESULTS: The incidence of all GITill was 1.0 (0.8-1.2). Incidence was similar for GITill+ss 0.6 (0.4-0.8) and GITill-ss 0.4 (0.3-0.5; P=0.0603). Incidence of GE+ss 0.6 (0.4-0.7) was higher than GE-ss 0.3 (0.2-0.4; P=0.0045). GITill caused ≥1-day time-loss in 62% of cases (GE+ss 66.7%; GE-ss 53.6%). GITill caused an average of 1.1 DRTP/single GITill, which was similar for subcategories. IB of GITill+ss was higher than GITill-ss (IB Ratio: 2.1 [1.1-3.9; P=0.0253]). IB for GITill+ss is 2 times higher than GITill-ss (IB Ratio: 2.1 [1.1-3.9]; P=0.0253); and GE+ss >3 times higher than GE-ss (IB Ratio: 3.0 [1.6-5.8]; P=0.0007).

CONCLUSIONS: GITill accounted for 21.9% of all illnesses during the Super Rugby tournament, with >60% of GITill resulting in time-loss. The average DRTP/single illness was 1.1. GITill+ss and GE+ss resulted in higher IB. Targeted interventions to reduce the incidence and severity of GITill+ss and GE+ss should be developed.

PMID:36884121 | DOI:10.23736/S0022-4707.23.14253-8

J Cancer Res Clin Oncol. 2023 Mar 8. doi: 10.1007/s00432-023-04649-7. Online ahead of print.

ABSTRACT

PURPOSE: It was reported that individual heterogeneity among malignancies (IHAM) might correlate well to the prognosis of lung cancer; however, seldom radiomic study is on this field. Standard deviation (SD) in statistics could scale average amount of variability of a variable; therefore, we used SD of CT feature (Feature_SD) among primary tumor and malignant lymph nodes (LNs) in an individual to represent IHAM, and its prognostic ability was explored.

METHODS: The enrolled patients who had accepted PET/CT scans were selected from our previous study (ClinicalTrials.gov, NCT03648151). The patients had primary tumor and at least one LN, and standardized uptake value of LN higher than 2.0 and 2.5 were enrolled as the cohort 1 (n = 94) and 2 (n = 88), respectively. Feature_SD from the combined or thin-section CT were calculated among primary tumor and malignant LNs in each patient, and were separately selected by the survival XGBoost method. Finally, their prognostic ability was compared to the significant patient characteristics identified by the Cox regression.

RESULTS: In the univariate and multi-variate Cox analysis, surgery, target therapy, and TNM stage were significantly against OS in the both cohorts. In the survival XGBoost analysis of the thin-section CT dataset, none Feature_SD could be repeatably ranked on the top list of the both cohorts. For the combined CT dataset, only one Feature_SD ranked in the top three of both cohorts, but the three significant factors in the Cox regression were not even on the list. Both in the cohort 1 and 2, C-index of the model composed of the three factors could be improved by integrating the continuous Feature_SD; furthermore, that of each factor was obviously lower than Feature_SD.

CONCLUSION: Standard deviation of CT features among malignant foci within an individual was a powerful prognostic factor in vivo for lung cancer patients.

PMID:36884114 | DOI:10.1007/s00432-023-04649-7

Intern Emerg Med. 2023 Mar 8:1-3. doi: 10.1007/s11739-023-03247-2. Online ahead of print.

NO ABSTRACT

PMID:36884110 | PMC:PMC9993357 | DOI:10.1007/s11739-023-03247-2

Ultrasound J. 2023 Mar 8;15(1):12. doi: 10.1186/s13089-023-00308-7.

ABSTRACT

BACKGROUND: Point-of-care ultrasound (POCUS) plays a prominent role in the timely recognition and management of multiple medical, surgical, and obstetric conditions. A POCUS training program for primary healthcare providers in rural Kenya was developed in 2013. A significant challenge to this program is the acquisition of reasonably priced ultrasound machines with adequate image quality and the ability to transmit images for remote review. The goal of this study is to compare the utility of a smartphone-connected, hand-held ultrasound with a traditional ultrasound device for image acquisition and interpretation by trained healthcare providers in Kenya.

METHODS: This study took place during a routine re-training and testing session for healthcare providers who had already received POCUS training. The testing session involved a locally validated Observed Structured Clinical Exam (OSCE) that assessed trainees’ skills in performing the Extended Focused Assessment with Sonography for Trauma (E-FAST) and focused obstetric exams. Each trainee performed the OSCE twice, once using a smartphone-connected hand-held ultrasound and once using their notebook ultrasound model.

RESULTS: Five trainees obtained a total of 120 images and were scored on image quality and interpretation. Overall E-FAST imaging quality scores were significantly higher for the notebook ultrasound compared to the hand-held ultrasound but there was no significant difference in image interpretation. Overall focused obstetric image quality and image interpretation scores were the same for both ultrasound systems. When separated into individual E-FAST and focused obstetric views, there were no statistically significant differences in the image quality or image interpretation scores between the two ultrasound systems. Images obtained using the hand-held ultrasound were uploaded to the associated cloud storage using a local 3G-cell phone network. Upload times were 2-3 min.

CONCLUSION: Among POCUS trainees in rural Kenya, the hand-held ultrasound was found to be non-inferior to the traditional notebook ultrasound for focused obstetric image quality, focused obstetric image interpretation, and E-FAST image interpretation. However, hand-held ultrasound use was found to be inferior for E-FAST image quality. These differences were not observed when evaluating each E-FAST and focused obstetric views separately. The hand-held ultrasound allowed for rapid image transmission for remote review.

PMID:36884093 | DOI:10.1186/s13089-023-00308-7

Soc Psychiatry Psychiatr Epidemiol. 2023 Mar 8. doi: 10.1007/s00127-023-02446-8. Online ahead of print.

ABSTRACT

PURPOSE: The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians’ mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru.

METHODS: Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure).

RESULTS: We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter).

CONCLUSION: In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.

PMID:36884090 | DOI:10.1007/s00127-023-02446-8

Rev Esp Salud Publica. 2023 Mar 2;97:e202303017.

ABSTRACT

OBJECTIVE: The presence of Aedes albopictus, of high sanitary and social impact, was first reported in Valencia (Eastern Spain) in 2015. Innovative tools for its control include the use of the endosymbiotic bacterium Wolbachia pipientis. The release of mosquito males infected with the wPip strain, has proven very promising for large-scale Incompatible Insect Technique (IIT) applications. Before this strategy can be implemented in Valencia, it is important to know whether the natural local mosquito populations are Wolbachia-infected and, if so, identifying the infecting strains/supergroups, these being the objectives of the present work.

METHODS: Eggs were collected from the 19 districts of the València city between May and October 2019. A total of 50 lab-reared adult Ae. albopictus individuals were processed and analyzed for Wolbachia detection and molecular characterization. These actions took place within the framework of a collaboration established with the Department of Health and Consumer Affairs of the city council of Valencia. Fisher’s exact test was used to detect the statistical significance of the differences between groups.

RESULTS: Our study revealed that 94% of the analyzed samples were naturally infected with Wolbachia. Both wAlbA and wAlbB supergroups were identified, with most samples (72% of the infected ones) carrying co-infections.

CONCLUSIONS: These data provide the first characterization of the Wolbachia presence in natural populations of Ae. albopictus in the Mediterranean area of Spain. This information is relevant to evaluate the potential use of Wolbachia strains in order to achieve the suppression of the Asian tiger mosquito populations through massive release of artificially-infected males.

PMID:36883556

Rev Esp Salud Publica. 2023 Mar 1;97:e202303016.

ABSTRACT

OBJECTIVE: The feminization of migration, the need to provide health care to an increasingly diverse population, seeking optimal health data led to considering this research. The objective was to determine the characteristics (socio-demographic profile, obstetric and gynecological record, and monitoring) of migrated pregnant women with a pregnancy process completed in 2019 in Catalonia compared to native women, in public centers (ASSIR-ICS).

METHODS: This descriptive study was based on computerized clinical records of women in the 28 centers dependent on the ICS. A descriptive analysis of the variables was carried out to compare the origin of the pregnant women. The Pearson Chi-Square test at 5% and the corrected standardized residual was used to compare the groups and an analysis of variance for the comparison of means also at 5%.

RESULTS: 36.315 women were analyzed and the resulting mean age was 31.1 years. The BMI at the beginning of pregnancy was 25.4 on average. Smoking habit was 18.1% among Spanish 17.3% among European. Sexist violence was 4% in Latin American women, being statistically higher than the rest. The risk of preeclampsia was 23.4% in sub-Saharan women. Gestational diabetes was diagnosed mainly among Pakistanis (18.5%). The prevalence of Sexually Transmitted Infections (STIs) was detected in Latin Americans (8.6%), Spanish (5.8%) and Europeans (4.5%). Sub-Saharan women performed insufficient ultrasound control (58.2%) and had the lowest percentage of visits with 49.5%. Pregnancy monitoring was insufficient in 79.9% of all rural pregnant women.

CONCLUSIONS: There are differences derived from the geographical origins of pregnant women that condition access to health services.

PMID:36883555

Vopr Pitan. 2023;92(1):74-84. doi: 10.33029/0042-8833-2023-92-1-74-84. Epub 2022 Dec 1.

ABSTRACT

The low cardiovascular risk group according to SCORE in relation to the clinical and laboratory characteristics of patients is very heterogeneous, which leads to the presence of a residual risk of cardiovascular events. This category may include individuals with a family history of cardiovascular disease at a young age, with abdominal obesity (AO), endothelial dysfunction, and high levels of triglyceride-rich lipoproteins. In this regard, an active search is underway for new metabolic markers within the low cardiovascular risk group. The purpose of the study was to compare the nutrition, the adipose tissue distribution in low cardiovascular risk individuals, depending on the AO. Material and methods. The study included 86 healthy low risk (SCORE<1%) patients (mean age 42.6±2 years), who were divided into 2 groups: with AO [waist circumference (WC) >=94 cm in men and >=80 cm in women] – 44 patients (32% of men) and without AO – 42 patients (38% of men). The body composition was carried out using the bioimpedance analyzer. The distribution of ectopic fat deposits in the liver, pancreas and epicardial region was studied using ultrasound methods. A frequency questionnaire (Diet Risk Score) was used to assess nutrition. Results. In low risk patients with AO, signs of unhealthy diet are statistically significantly more common (in 52 in the main group vs 2% in the control group, p<0.01), ectopic deposition of adipose tissue in the liver (53 vs 9%, p<0.001), pancreas (56% in the main group, absent in the control group, p<0.001), epicardia l region (the epicardial fat thickness median is 4.24 mm in the main group vs 2.15 mm in the control group) compared with a control group. Conclusion. The low cardiovascular risk group is very heterogeneous. One of the markers of heterogeneity is central obesity – a marker of unhealthy diet, subclinical ectopic fat deposition and hypertriglyceridemia. Patients with AO of the low cardiovascular risk group require a more thorough examination with the obligatory determination of waist circumference, ultrasound assessment of the liver and pancreas parenchyma, and determination of the epicardial fat thickness. Using a short nutrition questionnaire allows you to quickly identify signs of unhealthy diet and discuss them with the patient.

PMID:36883542 | DOI:10.33029/0042-8833-2023-92-1-74-84

Vopr Pitan. 2023;92(1):6-15. doi: 10.33029/0042-8833-2023-92-1-6-15. Epub 2022 Dec 1.

ABSTRACT

Restoring the adaptive potential of an athlete is of paramount importance not only for the implementation of his training and competitive activities, but also for maintaining health. One of the leading place in complex recovery programs in sports is given to full-fledged optimal nutrition, which provides for meeting the body’s requirements not only in energy, macro- and micronutrients, but also in minor bioactive compounds. The use of anthocyanin-containing products is a promising strategy for the normalization of metabolic and immune disorders that develop as a result of intense physical and neuro-emotional stress not only in athletes, but also in other groups of people exposed to these factors, including military personnel undergoing training in conditions close to combat. This determines the relevance of this study. The aim of the research was to study the effect of an anthocyanin-enriched diet on hematological profile and cellular immunity in rats after intense physical activity. Material and methods. The experiment was carried out for 4 weeks on 4 groups of male Wistar rats with an initial body weight of ~300 g. The motor activity of the animals of the 1st (control) and 2nd groups was limited by the standard keeping animals in the vivarium, while physically active rats of the 3rd and 4th groups received additional physical activity – training on a treadmill. Before the end of the experiment, the animals of 3rd and 4th groups were given debilitating physical activity on a treadmill (until the rats refused to continue the exercise). Rats of all 4 groups received a standard semi-synthetic diet, water ad libitum. Animals in 2nd and 4th groups were additionally fed blueberry and blackcurrant extract (30% anthocyanins) as part of the diet at a daily dose of 15 mg anthocyanins/kg body weight. Hematological parameters were determined on a Coulter ACT TM 5 diff OV hematological analyzer. Expression of CD45R, CD3, CD4, CD8a, CD161 receptors on rat peripheral blood lymphocytes was determined by direct immunofluorescent staining of whole blood cells using a panel of monoclonal antibodies conjugated with fluorescent dyes: APC, FITC, PE. The measurements were carried out on an FC-500 flow cytometer. Results. Intense physical activity in rats of the 3rd group did not lead to a significant change in erythrocyte parameters compared with the control group. Enrichment of the diet with blueberry and black currant extract (the 2nd and the 4th groups) provided a significant (p<0.05) increase in blood content of hemoglobin (Hb) (150.7±0.9 and 154.4±2.0 vs 145.4±0.9 g/l in control), hematocrit (44.95±0.21 and 46.18±0.64 vs 43.78±0.32%) and the average content of Hb in erythrocytes (18.00±0.20 and 18.03±0.24 vs 17.35±0.24 pg). The absolute content of leukocytes and other cellular elements of the leukocyte formula, as well as leukocyte indices in rats of the experimental groups didn’t significantly differ from those of the control rats, which confirms the absence of an inflammatory process. Intense physical activity and anthocyanin enrichment of the diet didn’t have a significant effect on rat platelet parameters. Enrichment of the diet of rats of the 4th group with blueberry and black currant extract led to the activation of cellular immunity, as evidenced by a significant (p<0.01) increase in the percentage (from the total content of T-lymphocytes) of T-helpers (70.13 ±1.34 vs 63.75±0.99%) and a decrease in the relative content of cytotoxic T-lymphocytes (28.65±1.38 vs 34.71±0.95%) in comparison with those in rats of the 3rd group and at the level of the trend (р<0.1) – from the 1st group indexes (66.87±1.20 and 31.87±1.26%, accordingly). Intense physical activity led to a decrease in immunoregulatory index in rats of the 3rd group (1.86±0.07) compared with the control (2.13±0.12) (p<0.1), and in animals of the 4th group this indicator was significantly higher (2.50±0.14, p<0.05). In animals of the 3rd group a statistically significant (p<0.05) decrease in the relative content of NK cells in peripheral blood was found compared to the control. Enrichment of the diet of physically active rats with blueberry and black currant extract led to a significant (p<0.05) increase in the percentage of NK cells compared to this indicator in rats of the 3rd group (4.87±0.75 vs 2.08±0.18%) and had no significant difference with the indicator in rats of the control group (4.32±0.98%). Conclusion. The enrichment of the rats’ diet with blueberry and blackcurrant extract containing a daily dose of 15 mg of anthocyanins per kg of body weight provides an increase in blood Hb content, hematocrit and the average content Hb in erythrocytes. It has been established that intense physical activity induces the cellular immunity suppression. The activating effect of anthocyanins on adaptive cellular immunity and NK cells, which are lymphocytes of innate immunity, was revealed. The data obtained indicate the effectiveness of the use of bioactive compounds (anthocyanins) to increase the adaptive potential of the organism.

PMID:36883535 | DOI:10.33029/0042-8833-2023-92-1-6-15