Category: Nevin Manimala

J Clin Sleep Med. 2023 Jan 20. doi: 10.5664/jcsm.10406. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Sleep deficiency can adversely affect the performance of resident physicians resulting in greater medical errors. However, the impact of sleep deficiency on surgical outcomes, particularly among attending surgeons is less clear.

METHODS: Sixty attending surgeons from academic and community departments of surgery or obstetrics and gynecology were studied prospectively using direct observation and self-report to explore the effect of sleep deprivation on patient safety, operating room communication, medical errors, and adverse events while operating under two conditions, Post-Call (defined as >2 hours of nighttime clinical duties) and Non-Post-Call.

RESULTS: Each surgeon contributed up to five surgical procedures post-call and non-post-call yielding 362 cases total (150 Post-Call and 210 Non-Post-Call). Most common were caesarian section and herniorrhaphy. Hours of sleep on the night before the operative procedure were significantly less Post-Call (4.98 ± 1.41) vs. Non-Post-Call (6.68 ± 0.88, p<0.01). Errors were infrequent and not related to hours of sleep or post-call status. However, Non-Technical Skills for Surgeons (NOTSS) ratings demonstrated poorer performance while Post-Call for Situational Awareness, Decision Making and Communication/Teamwork. Fewer hours of sleep also was related to lower ratings for Situational Awareness and Decision Making. Decreased self-reported alertness was observed to be associated with increased procedure time.

CONCLUSIONS: Sleep deficiency in attending surgeons was not associated with greater errors during procedures performed during the next day. However, procedure time was increased suggesting that surgeons were able to compensate for sleep loss by working more slowly. Ratings on non-technical surgical skills were adversely affected by sleep deficiency.

PMID:36661100 | DOI:10.5664/jcsm.10406

Clin Pediatr (Phila). 2023 Jan 20:99228221149551. doi: 10.1177/00099228221149551. Online ahead of print.

ABSTRACT

To understand the psychological effects on behavior of girls with idiopathic central precocious puberty (ICPP) and to explore the role of gonadotropin-releasing hormone analog (GnRHa) in the reversal or blocking of the negative psychological effects on behaviors of girls with ICPP. A total of 100 girls with ICPP diagnosed at the Department of Endocrinology of Jiangxi Children’s Hospital were divided into the treatment group and observation group with 50 cases in each group. The control group consisted of 50 healthy girls examined at our hospital during the same period. The Achenbach Child Behavior Check List ([CBCL] for parents) was used to evaluate the psychological effects on behavior of the girls diagnosed with ICPP and the girls in the control group, and the scores of related behavioral factors were calculated. At the same time, the psychological effects on behaviors of the girls with ICPP treated with GnRHa were followed up. (1) There were 100 girls with ICPP and 30 with behavioral problems. There were 50 normal healthy girls (control group) with 3 cases of behavior problems. Of the 50 girls with ICPP, after treatment, 8 had behavioral issues. The rate of abnormal psychological effects on behavior in the group of girls with ICPP before treatment was significantly higher than in the control group (P < .01), and after treatment, the rate was lower than before treatment (P < .05). (2) The scores of depression, social withdrawal, poor communication, and school discipline violation in the ICPP group were higher than those in the control group, with a statistical significance (P < .01). (3) After 24 months of GnRHa treatment for girls in the ICPP group, the scores of 4 factors, including depression, social withdrawal, poor communication, and violation of discipline in the Achenbach CBCL, were significantly different before and after treatment (P < .05). (1) Girls with ICPP have low self-esteem, low self-confidence, high incidences of psychological effects on behavior problems, manifested in depression, withdrawal, poor communication, discipline violations, and other aspects; (2) GnRHa treatment can reverse the low self-esteem and low self-confidence of girls with ICPP to varying degrees.

PMID:36661073 | DOI:10.1177/00099228221149551

Eur J Public Health. 2023 Jan 20:ckad002. doi: 10.1093/eurpub/ckad002. Online ahead of print.

ABSTRACT

BACKGROUND: Interpretive front-of-pack labels (FoPLs) are supported by World Health Organization as an important policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy published in 2020, the European Commission stated that it would propose a single mandatory FoPL. The aim of this study was to analyze Spanish consumers’ preference and objective understanding of Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in the EU.

METHODS: In a representative sample of 1026 Spanish adults (50% women, mean age ± SD = 46 ± 14 years), objective understanding was assessed by asking participants to identify the healthiest food products in three food categories (breakfast products, breakfast cereals and added fats). The preference dimensions were tested by asking participants about the perceived helpfulness of the FoPL in discriminating the nutritional quality of food products (subjective understanding) and their overall assessment of the FoPL’s ease of use, informativeness, trust and liking (perception).

RESULTS: In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers’ ability to identify healthier food products across all food categories compared with NutrInform [OR (odds ratio) = 19.1 [14.2-25.7], P < 0.0001]. On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized principal component analysis dimension, respectively, 0.32 ± 1.58 vs. -0.29 ± 1.66, P < 0.0001 and 0.080 ± 1.18 vs. -0.072 ± 1.17, P = 0.039).

CONCLUSIONS: This study provides new evidence to support Nutri-Score in comparison with NutrInform in Spanish consumers, on both objective understanding and preference aspects.

PMID:36661062 | DOI:10.1093/eurpub/ckad002

Conserv Biol. 2023 Jan 20. doi: 10.1111/cobi.14060. Online ahead of print.

ABSTRACT

The role of nature documentaries in shaping public attitudes and behaviour towards conservation and wildlife issues is unclear. We analysed the emotional content of over two million tweets related to Our Planet, a major nature documentary released on Netflix. We show that S1 tweets were largely negative in sentiment at the time of release of the series. Further analyses revealed that this effect was primarily linked to the highly-skewed distributions of retweets and, in particular, to a single negatively-valenced and massively retweeted tweet (>150,000 retweets). We also compared the sentiment associated with species mentioned in Our Planet and a set of control species, with similar features but not mentioned in the documentary. Species mentioned in Our Planet were associated with more negative sentiment than the control species, and this effect coincided with a short period following the airing of the series. Our results are consistent with a general negativity bias in cultural transmission, and document the difficulty of evoking positive sentiment, on social media and elsewhere, in response to environmental issues. This article is protected by copyright. All rights reserved.

PMID:36661052 | DOI:10.1111/cobi.14060

Biomark Med. 2023 Jan 20. doi: 10.2217/bmm-2022-0216. Online ahead of print.

ABSTRACT

Aim: This meta-analysis aimed to investigate the clinical value of calprotectin in rheumatoid arthritis (RA) patients. Methods: The data regarding blood calprotectin levels in RA patients were retrieved from PubMed, Embase, Web of Science and Cochrane databases. Results: Thirty-one eligible articles were included. Calprotectin was increased in RA patients compared with healthy controls (mean difference [MD] = 1.48, 95% CI: 1.16-1.79). Calprotectin was positively associated with C-reactive protein (correlation coefficient [CC] = 0.58, 95% CI: 0.53-0.63) and disease activity score (CC = 0.48, 95% CI: 0.38-0.58) in RA patients. Interestingly, calprotectin showed an increased trend in RA responders compared with nonresponders, but without statistical significance (MD = 0.38, 95% CI: -0.09-0.85). Conclusion: Blood calprotectin relates to disease risk, inflammation and activity in RA patients.

PMID:36661047 | DOI:10.2217/bmm-2022-0216

Ann Surg. 2023 Jan 20. doi: 10.1097/SLA.0000000000005799. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze risk and patterns of locoregional failure (LRF) in patients of the RAPIDO trial at five years.

SUMMARY BACKGROUND DATA: Multimodality treatment improves local control in rectal cancer. Total neoadjuvant treatment (TNT) aims to improve systemic control while local control is maintained. At three years, LRF rate was comparable between TNT and chemoradiotherapy in the RAPIDO trial.

METHODS: 920 patients were randomized between an experimental (EXP, short-course radiotherapy, chemotherapy, and surgery) and a standard-care group (STD, chemoradiotherapy, surgery, and optional post-operative chemotherapy). LRF, including early LRF (eLRF) (no resection except for organ preservation/R2 resection) and locoregional recurrence (LRR) after an R0/R1 resection, were analyzed.

RESULTS: Totally, 460 EXP and 446 STD patients were eligible. At 5.6 years (median follow-up), LRF was detected in 54/460 (12%) and 36/446 (8%) patients in the EXP and STD groups, respectively (P=0.07), in which EXP patients were more often treated with 3D-CRT (P=0.029). In the EXP group, LRR was detected more often (44/431 (10%) vs. 26/428 (6%); P=0.027), with more often a breached mesorectum (9/44 (21%) vs. 1/26 (4); P=0.048). The EXP treatment, enlarged lateral lymph nodes, positive circumferential resection margin, tumor deposits, and node positivity at pathology were significant predictors for developing LRR. Location of the LRRs was similar between groups. Overall survival after LRF was comparable (HR 0.76 (95%CI 0.46-1.26); P=0.29).

CONCLUSION: The EXP treatment was associated with an increased risk of LRR whereas the reduction in disease-related treatment failure and distant metastases remained after 5 years. Further refinement of the TNT in rectal cancer is mandated.

PMID:36661037 | DOI:10.1097/SLA.0000000000005799

Hum Reprod. 2023 Jan 20:dead005. doi: 10.1093/humrep/dead005. Online ahead of print.

ABSTRACT

STUDY QUESTION: Does sperm cryopreservation influence the reproductive outcomes of normozoospermic patients in oocyte donation cycles?

SUMMARY ANSWER: After controlling for confounders, the use of cryopreserved semen from normozoospermic patients does not affect pregnancy and live birth rates after elective ICSI.

WHAT IS KNOWN ALREADY: Sperm cryopreservation by slow freezing is a common practice in ART. While frozen-thawed semen typically presents reduced motility and vitality, its use for ICSI is generally considered adequate in terms of reproductive outcomes. Nevertheless, most studies comparing reproductive outcomes between fresh and cryopreserved sperm include patients with severe male factor (testicular sperm, oligo-, and/or asthenozoospermia) or women of advanced maternal age, where the altered quality of the gametes can partially mask the full effect of freezing/thawing.

STUDY DESIGN, SIZE, DURATION: The study included a retrospective cohort of 7969 couples undergoing their first oocyte donation cycle between January 2013 and December 2019 in one large clinic, using normozoospermic semen from the male partner. All cycles involved elective ICSI, fresh oocytes, and a fresh embryo transfer, either at cleavage or blastocyst stage. Two study groups were established based on the sperm status: fresh (n = 2865) and cryopreserved (n = 5104).

PARTICIPANTS/MATERIALS, SETTING, METHODS: A slow freezing protocol was used for all sperm cryopreservation. Sperm washing, capacitation, and selection prior to ICSI were performed identically for fresh and frozen-thawed samples, using pellet swim-up. Fertilization rate (FR), pregnancy (biochemical and ongoing), and live birth rates were compared between study groups using univariate and multivariate regression analyses.

MAIN RESULTS AND THE ROLE OF CHANCE: Male and female age, sperm concentration and motility after ejaculation, and number of oocytes inseminated were similar between cycles using fresh or cryopreserved sperm. Analysis by Student’s t-test did not indicate a significant difference in FR between fresh and cryopreserved sperm (P = 0.0591); however, after adjusting for confounders, this difference reached statistical significance: 74.65% FR for fresh (CI 95%: 73.92-75.38) versus 73.66% for cryopreserved sperm (CI 95%: 73.11-74.20), P = 0.0334. The adjusted regression analysis revealed higher odds of biochemical pregnancy when using fresh sperm (odds ratio (OR): 1.143, P = 0.0175), but no significant effects of sperm cryopreservation were observed for ongoing pregnancy (OR: 1.101, P = 0.0983) and live birth (OR: 1.082, P = 0.1805).

LIMITATIONS, REASONS FOR CAUTION: Caution should be exerted when extrapolating these results to different protocols for sperm cryopreservation and selection, or to IVM, advanced maternal age and classical IVF cycles, which were excluded from analysis. Owing to the retrospective nature of the study, some uncontrolled for variables may affect the results.

WIDER IMPLICATIONS OF THE FINDINGS: Sperm cryopreservation does not affect pregnancy and live birth rates in normozoospermic patients, and although it may lower FR s slightly, this would not be clinically relevant. In line with previous studies that included patients with an apparent male or female factor, sperm cryopreservation is a safe and convenient technique.

STUDY FUNDING/COMPETING INTEREST(S): The study received no external funding and all authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER: N/A.

PMID:36661036 | DOI:10.1093/humrep/dead005

J Pak Med Assoc. 2022 Oct;72(10):2086-2089. doi: 10.47391/JPMA.273.

ABSTRACT

The aim of this study was to determine whether there is a decrease or an increase in the volume of different regions of the brain by comparing brain morphometry ofpatients diagnosed with Fibromyalgia Syndrome and healthy control subjects. The study included 23 female patients who were diagnosed with fibromyalgia, and 18 females, age-matched healthy subjects. Structural Mitral Regurgitation data was processed using Surface-Based Morphometry (SBM) on the Freesurfer 6.0 programme (http://surfer.nmr.mgh.harvard.edu). As a result of the surface-based analyses, a statistically significant reduction was determined in the Fibromyalgia Syndrome patient group in some brain region. A statistically signficant increase was determined in the FMS patient group with respect to the left anterior occipital sulcus volume, left inferior temporal gyrus thickness and left anterior occipital sulcus area. The results of this study showed that FMS affected brain morphometry through the brain central pain mechanisms and the normal brain morphology was changed because of atrophy in some areas and hypertrophy in some areas.

PMID:36661003 | DOI:10.47391/JPMA.273

J Pak Med Assoc. 2022 Oct;72(10):1977-1982. doi: 10.47391/JPMA.3848.

ABSTRACT

OBJECTIVE: To assess the changes in children’s oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal.

METHODS: The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry, Istanbul, Turkey.. Children aged 11-14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children’s MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ11?14) prior to their dental treatment and 6 months after the treatment.

RESULTS: Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 ±1.02 years. The overall CPQ score ranged from 3-83 (average 33.27 ± 16.46) at baseline and 0-61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size.

CONCLUSIONS: Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation.

PMID:36660984 | DOI:10.47391/JPMA.3848

J Pak Med Assoc. 2022 Oct;72(10):1942-1946. doi: 10.47391/JPMA.2134.

ABSTRACT

OBJECTIVE: To study the level of physical activity of Pakistani labourers in Saudi Arabia, and to find its relationship with body mass index.

METHODS: The observational study was conducted inside the Pakistan Embassy in Riyadh, Saudi Arabia, from October 2017 to March 2018, and comprised Pakistani males aged 22-60 years doing unskilled and semi-skilled jobs. Body mass index was calculated, and the level of physical activity was assessed using the short form of International Physical Activity Questionnaire. Data was analysed using SPSS 20.

RESULTS: There were 130 subjects with mean age of 33.53±7.9 years. There were 109(83.8%) subjects aged <40 years, and 21(16.2%) were aged >40 years. Mean body mass index of the sample was 26.13±5.29kg/m². Overall, 71(54.6%) participants were insufficiently active having energy expenditure <600 metabolic equivalent of task in minutes per week. No statistically significant result was found when total energy expenditure was considered (p>0.05), but significant result was found for energy expenditure due to ‘walk alone’ (p<0.05). Significant correlation was found between profession and overall energy expenditure and job-related energy expenditure. Significant but weak positive correlation was found between body mass index and walk-related energy expenditure (r=0.279), (p<0.001).

CONCLUSIONS: Mean body mass index of the sample was high compared to South Asian cut-off values, and the level of physical activity was very low, but the findings failed to show an inverse relationship between physical activity level and body mass index.

PMID:36660979 | DOI:10.47391/JPMA.2134