Category: Nevin Manimala

Eur J Health Econ. 2022 Aug 19. doi: 10.1007/s10198-022-01506-1. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has brought many changes into people’s lives. Fear, job insecurity, changes in their financial stability, concerns about their future lives have changed the entire lives of people and have affected the cognitive well-being of individuals. The purpose of the present analysis is to measure how the COVID-19 pandemic, along with financial factors, has affected the perceived level of well-being of individuals. We are also interested whether there are differences between life before COVID-19, life now with COVID-19, and life after the COVID-19 pandemic, in terms of future expectations. To address this objective, we performed an ANOVA approach and a GLM estimate on repeated measures for a large sample (1572 respondents) from 43 worldwide countries, during the period May 2020 and July 2021. Our results show that financial factors reflected by both the size of income and changes in personal or family income affect the levels of happiness. Robustness checks using stress as an alternative estimator for happiness have consolidated our results. Additionally, we find that well-being during COVID-19 compared to the previous period decreased, while in future, people expect to be happier, but not more than in the past when they did not know about the existence of this virus. This is one of the first studies to investigate the relationship between happiness and income before, during, and after COVID-19. These findings are important for policymakers to improve the conditions of living in the areas of health and financial stability.

PMID:35984544 | DOI:10.1007/s10198-022-01506-1

Surg Endosc. 2022 Aug 19. doi: 10.1007/s00464-022-09499-x. Online ahead of print.

ABSTRACT

BACKGROUND: Hysterectomy is one of the most common gynecologic surgeries, with an increasing proportion of hysterectomies performed by a laparoscopic approach. Uterine manipulation is critical for patient safety and surgical efficiency; however, the most junior member of the surgical team assumes the responsibility of uterine manipulation, commonly without preparation. The objective of our study was to determine whether kinesthetic learning using a low-cost simulated pelvic model while learning the uterine manipulation maneuvers of a laparoscopic hysterectomy improves learning efficacy and application efficiency compared to an interactive video module alone.

METHODS: Our randomized control trial at an academic medical center included forty first-year and second-year medical students. Participants were randomized to the intervention group that used a low-cost simulated pelvic model for kinesthetic learning during the video module or the control group who only had the interactive video module to learn the uterine manipulation maneuvers of a laparoscopic hysterectomy.

RESULTS: Participants in the intervention group were less likely to make unnecessary movements with demonstration of both pelvic side walls (right wall: control 78.9%, intervention 42.9%, p < 0.027; left wall: control 94.7%, intervention 66.7%, p < 0.046), and this was more pronounced in novice first-year participants (p < 0.009). Additionally, participants in the intervention group reported higher perceived preparedness (100% versus 71.4% in control group, p < 0.037). However, there was no difference in verbal or physical cues required, time per task, or force used between the groups.

CONCLUSION: Kinesthetic practice may not be required for learning the uterine manipulation maneuvers of a laparoscopic hysterectomy, but it may be beneficial for more novice learners and to increase learners’ perceived preparedness. Our novel interactive video module alone may be sufficient to prepare learners to perform uterine manipulation maneuvers prior to the operating room.

PMID:35984522 | DOI:10.1007/s00464-022-09499-x

Eur J Orthop Surg Traumatol. 2022 Aug 19. doi: 10.1007/s00590-022-03360-6. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim was to analyse the lateral malleolus morphology with a focus on the shape of the distal fibula for IM fixation of the fibula in infra- and transsyndesmotic fracture patterns. The secondary aim was to propose a treatment algorithm according to the lateral malleolar anatomy.

METHODS: 77 healthy, skeletally mature volunteers underwent CT scanning of the ankle. The fibula medullary canal and its cortical thickness were quantitatively analysed at 4 different levels measured from the fibular tip (1.5 cm, 3.0 cm, 4.5 cm, and 6.0 cm). A geometric classification was proposed, and a decision algorithm was developed. Statistical significance was set at a p-value < 0.05.

RESULTS: The smallest diameter of the medullary canal of the fibula was at 6.0 cm from the tip of the fibula, in 98.2% of the ankles. The distal fibula can be classified into triangular and rectangular type, according to the cortical thickness index (p < 0.0001). In 16.7% ankles, the internal diameter of the fibula at 6.0 cm was equal or narrower than 3.5 mm (p < 0.05).

CONCLUSION: The shape of the distal fibula as evaluated by CT-guided analysis allows for IM osteosynthesis of the lateral malleolus in 83% of individuals. In our study, the smallest diameter of the medullary canal of the fibula was located 6.0 cm from the tip of the lateral malleolus. Coronal CT evaluation is advantageous in indicating which type of IM implant should be used safely for infra- and transsyndesmotic fracture patterns, potentially reducing intraoperative risks.

PMID:35984518 | DOI:10.1007/s00590-022-03360-6

Support Care Cancer. 2022 Aug 19. doi: 10.1007/s00520-022-07330-w. Online ahead of print.

ABSTRACT

PURPOSE: Heated humidified high-flow nasal cannula (HFNC) oxygen therapy is one of the most important oxygen therapy methods, which are commonly applied to relieve dyspnea in advanced cancer patients. Our study aims to observe the efficacy and safety of HFNC oxygen therapy on dyspnea patients with advanced cancer and explore the clinical application.

METHODS: Sixty subjects with advanced cancer requiring oxygen therapy from a grade 3, class A hospital in China were recruited and randomized (1:1) to traditional nasal catheter oxygen therapy or HFNC. Primary outcomes were dyspnea, oral dryness, and sleep condition, which were recorded after 72-h treatment. Secondary outcomes were heart rate (HR), respiration rate (RR), S_pO₂, P_aO₂, and P_aCO₂, which were recorded after 2, 6, 24, and 72 h treatment.

RESULTS: Seventy-two hours after treatment, there were significant improvements in all primary outcomes (P < 0.001). P_aO₂ and RR were statistically changed 2 h after HFNC treatment (P < 0.001). P_aCO₂ and HR were statistically changed 24 h after HFNC treatment (P < 0.001).

CONCLUSION: HFNC oxygen therapy has good effect, high safety, and is easy to be accepted by dyspnea patients with advanced cancer. It can be used as the first choice of oxygen therapy for these patients and has broad clinical prospects.

TRIAL REGISTRATION: This work was retrospectively registered in the Chinese Clinical Trials Registry (ChiCTR2100049582) on August 4, 2021.

PMID:35984511 | DOI:10.1007/s00520-022-07330-w

Graefes Arch Clin Exp Ophthalmol. 2022 Aug 19. doi: 10.1007/s00417-022-05807-2. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to examine the possible effects of the postmenopausal period on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography (SS-OCTA).

METHODS: This cross-sectional study included 45 eyes of 45 subjects in menstrual group and 40 eyes of 40 subjects in postmenopausal group. SS-OCTA was used for the assessment of vessel density (VD), foveal avascular zone (FAZ), choroidal thickness (CT), choriocapillaris VD, central macular thickness (CMT), nerve fiber layer thickness (RNFL), and ganglion cell layer (GCL) measurements.

RESULT: The VDs of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) measurements were similar in both group. FAZ area was wider in postmenopausal group (0.305 mm² (range, 0.212-0.498 mm²)) compared to menstrual group (0.271 mm² (range, 0.131-0.464 mm²)) (p = 0.013). Choriocapillaris VD was significantly lower in postmenopausal group (p = 0.049). CT was thicker in the postmenopausal group, but with no statistically significant difference (p = 0.066). Central macular thickness, RNFL, and GCL were similar in both groups.

CONCLUSION: This is the first study in the literature to evaluate the retinochoroidal microcirculation in the menstrual and postmenopausal periods with SS-OCTA. We observed an increase in both superficial and deep FAZ area and a decrease in choroidal blood flow in the postmenopausal period. We think that this enlargement in the FAZ area may be related to the decreased amount of estrogen.

PMID:35984487 | DOI:10.1007/s00417-022-05807-2

Bull Environ Contam Toxicol. 2022 Aug 19. doi: 10.1007/s00128-022-03606-3. Online ahead of print.

ABSTRACT

This study aimed to determine the potentially toxic metal contents in soil and spinach samples in areas irrigated with industrial wastewater and to evaluate the potentially toxic metal accumulation in spinach samples according to pollution indices. Water, soil and spinach samples were analysed using atomic absorption spectrophotometer (Perkin-Elmer AAS-300). In this study, it was determined that the potentially toxic metal values ​​in the spinach samples irrigated with groundwater and sugar industry wastewater varied between 1.59 and 1.84, 0.22-0.68, 0.56-1.14, 1.41-1.56, 1.62-3.23, 0.57-1.02, 0.86-1.33, 0.20-0.32 and 0.35-2.10 mg/kg for Cd, Co, Cr, Cu, Fe, Ni, Pb, Zn and Mn, respectively. It was concluded that the difference between the metal values ​​in the spinach samples according to the irrigation sources was statistically significant, except for Cu and Pb (p > 0.05). According to the results of this study, there is no health risk for Pb, Co and Cr with HRI values ​​below 1.0, while there is a risk for Cd, Cu, Fe, Ni, Mn and Zn. The much higher HRI values ​​of Cd than 1 (196.8 and 169.6) suggested that this metal is likely to cause significant health problems in the region.

PMID:35984458 | DOI:10.1007/s00128-022-03606-3

Acta Otolaryngol. 2022 Aug 19:1-4. doi: 10.1080/00016489.2022.2104923. Online ahead of print.

ABSTRACT

BACKGROUND: With the development of otoendoscopic surgery technology and the update of equipment, more and more otoendoscopic tympanoplasty are carried out.

OBJECTIVES: To investigate application of otoendoscopic tympanoplasty.

METHODS: Seventy-six patients with tympanic membrane perforation were randomly enrolled into otoendoscopic group (OP, n = 38) and microscope group (MP, n = 38). We compared two-group patients using operative time, intraoperative blood loss, healing of postoperative perforations, and degree of postoperative hearing improvement.

RESULTS: Average operation time was statistically significant shorter in the OP than the MP (p < .05); the intraoperative blood loss in the OP was significant less than MP (p < .05); after postoperative follow-up, the healing rate of tympanic membrane perforation was 92.11% in the OP compared to 89.47% in the MP. However, there was no statistically significant difference in the two groups (p > .05). There were no statistically significant differences between the preoperative and postoperative air and bone conduction thresholds in the two groups (p > .05).

CONCLUSIONS: Otoendoscopic tympanoplasty is a minimally invasive operation but with similar effects as compared to microscopic one. But the operation time and intraoperative blood loss in the OP were significantly better than those in the MP, thus it is a safe, effective and easy to be operated in clinical practice.

PMID:35984434 | DOI:10.1080/00016489.2022.2104923

Artif Life. 2022 Aug 19:1-22. doi: 10.1162/artl_a_00381. Online ahead of print.

ABSTRACT

Crowd simulations are used extensively to study the dynamics of human collectives. Such studies are underpinned by specific movement models, which encode rules and assumptions about how people navigate a space and handle interactions with others. These models often give rise to macroscopic simulated crowd behaviours that are statistically valid, but which lack the noisy microscopic behaviours that are the signature of believable real crowds. In this article, we use an existing Turing test for crowds to identify realistic features of real crowds that are generally omitted from simulation models. Our previous study using this test established that untrained individuals have difficulty in classifying movies of crowds as real or simulated, and that such people often have an idealised view of how crowds move. In this follow-up study (with new participants) we perform a second trial, which now includes a training phase (showing participants movies of real crowds). We find that classification performance significantly improves after training, confirming the existence of features that allow participants to identify real crowds. High-performing individuals are able to identify the features of real crowds that should be incorporated into future simulations if they are to be considered realistic.

PMID:35984431 | DOI:10.1162/artl_a_00381

Diabetes Care. 2022 Aug 19:dc220275. doi: 10.2337/dc22-0275. Online ahead of print.

ABSTRACT

OBJECTIVE: To measure the acceptability and diagnostic accuracy of commonly used depression screening measures to determine ideal cutoff scores that sensitively identify depressive disorders in adolescents with type 1 diabetes (T1D).

RESEARCH DESIGN AND METHODS: One hundred adolescents (12-17 years old) completed a reference standard, semistructured diagnostic interview and both long and short versions of five commonly used depression screening measures in the United States. To assess feasibility and acceptability, we used screener completion time and participant ratings, respectively. We used descriptive statistics, area under the receiver operating characteristic (ROC) curve analyses, and paired-sample area differences under the ROC curve to assess each measure’s diagnostic validity against our reference standard and to determine ideal cutoff scores for this sample.

RESULTS: Adolescents had a mean age of 15.0 ± 1.7 years, time since T1D diagnosis of 6.0 ± 4.1 years, and glycated hemoglobin (HbA1c) of 8.9 ± 1.8%. Sixty percent of adolescents were male, 15% endorsed a current depressive disorder, and 15% endorsed lifetime suicidality. Measures demonstrated low sensitivity (0.33-0.67) to detect current depressive disorders using preexisting cutoff scores. However, adjusted cutoff scores increased sensitivity and reduced false negatives. All depression screening measures demonstrated “good” to “excellent” predictive validity, and the Children’s Depression Inventory-2 Short version demonstrated significantly greater diagnostic accuracy than the Patient Health Questionnare-2 item version for adolescents.

CONCLUSIONS: Clinics should consider using screening measures with the greatest diagnostic accuracy as identified in this study and adjusting measure cutoff scores to increase sensitivity and reduce false negatives.

PMID:35984419 | DOI:10.2337/dc22-0275

Aust Occup Ther J. 2022 Aug 19. doi: 10.1111/1440-1630.12837. Online ahead of print.

ABSTRACT

INTRODUCTION: Learning from individuals with lived experience is considered an important element of developing recovery-oriented practice capabilities in mental health contexts. Additionally, service user involvement in the education of occupational therapy students is a requirement in accreditation standards. Despite this, many barriers to meaningful inclusion of Lived Experience Educators have previously been identified.

METHOD: This study evaluated the outcomes achieved by students who were involved in a unit of study that incorporated four recovery-oriented practice workshops that were co-designed and co-delivered by Lived Experience Educators and an occupational therapy academic. Change over time was measured using the Recovery Knowledge Inventory (RKI) and the Capabilities for Recovery Oriented Practice Questionnaire (CROP-Q). Change over time was evaluated using paired t-tests. Students also provided qualitative feedback at the conclusion of the workshops. These comments were analysed using interpretive content analysis.

RESULTS: Students’ scores on the RKI and CROP-Q both demonstrated statistically significant improvements from the beginning of the semester to the end of semester (RKI: 53.6-57.7, t = 6.3, P < 0.001; CROP-Q: 75.6-77.0, t = 2.4, P = 0.019). The most common categories included in the qualitative comments were: “Learning from real experiences”; “Learning about how to be a better clinician”; “See the strength and resilience of the educators, reduce stigma”; “Learning about the negative aspects of the mental health system”; and “More effective than other types of learning”.

CONCLUSION: This study has demonstrated that students who engaged with the co-designed and co-delivered workshops improved their recovery knowledge and recovery-oriented capabilities over the course of the semester. Qualitative feedback also suggests that students’ attitudes and skills for future practice were also influenced in positive ways by engaging with Lived Experience Educators.

PMID:35983836 | DOI:10.1111/1440-1630.12837