Category: Nevin Manimala

Drug Alcohol Depend. 2022 Apr 6;235:109442. doi: 10.1016/j.drugalcdep.2022.109442. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine whether young adult opioid misuse reflects a general tendency toward substance use and is influenced by general substance use risk or whether it is a different phenomenon from other drug use.

METHODS: At ages 23 (2016) and 26 (2019), a panel of young adults (n = 3794 to 3833) in the United States self-reported their past-month substance use (opioid misuse, heavy drinking, cigarettes, cannabis) and substance-specific risk factors (perceptions of harm; approval of use; and use of each substance by friends and romantic partners). Structural equation models examined non-opioid and opioid-specific associations between latent risk and substance use factors.

RESULTS: Opioid misuse and opioid-specific risk factors shared significant variance with latent substance use and latent substance use risk, respectively, which were strongly associated. A statistically significant residual correlation between opioid-specific risk and opioid misuse remained.

CONCLUSION: Young adult opioid misuse reflects a general tendency toward substance use and is strongly predicted by risk for substance use. Opioid-specific risk factors play only a small independent role. Existing evidence-based substance use interventions may be effective in preventing opioid misuse among young adults.

PMID:35461085 | DOI:10.1016/j.drugalcdep.2022.109442

Early Hum Dev. 2022 Apr 13;168:105572. doi: 10.1016/j.earlhumdev.2022.105572. Online ahead of print.

ABSTRACT

INTRODUCTION: Over the past five decades the bulk of research on exposure to maternal mental health disorders and infant neurodevelopment has been generated in high-income countries. The current study included infants, residing in low-income communities in South Africa, born to mothers with a history of psychiatric disorders.

AIM: To assess the motor behavior of 10- to 20-week-old infants exposed to maternal mental health disorders, and a subgroup of infants with prenatal psychotropic medication exposure.

METHODS: The present study is a cross-sectional descriptive study, with a longitudinal subgroup analysis. General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), was used at 10-20 weeks corrected age to assess infant motor behavior.

RESULTS: The study included 112 infants. No significant difference (p = 0.523) was found on the MOS-R between infants exposed to maternal mental health disorders (n = 70) and the comparison group (n = 42). Both the exposed and comparison groups scored within the mildly reduced range on the MOS-R. No significant differences were found in a subgroup of infants with prenatal exposure to multi-class psychotropic medication (n = 17), mono-class psychotropic medication (n = 35) or valproate exposure (n = 10) (p > 0.1).

CONCLUSION: No association was found between exposure to maternal mental health disorders or exposure to psychotropic medication and infant motor behavior at 10-20 weeks post-term age on the MOS-R. Future research should focus on the contribution of exposure to specific classes and types of psychotropic medication on neurodevelopmental outcome of infants in larger cohorts.

PMID:35461052 | DOI:10.1016/j.earlhumdev.2022.105572

Drug Alcohol Depend. 2022 Apr 16;235:109467. doi: 10.1016/j.drugalcdep.2022.109467. Online ahead of print.

ABSTRACT

BACKGROUND: The majority of drug overdose deaths in the United States involve opioids, and synthetic opioid-involved overdose death rates are increasing. Naloxone is a key prevention strategy yet estimates of its administration are limited.

METHODS: We analyzed 2019 data from 37 states and the District of Columbia in CDC’s State Unintentional Drug Overdose Reporting System to estimate the percentage of decedents, by sociodemographic subgroup, who experienced a fatal opioid-involved overdose and had no evidence of naloxone administration.

RESULTS: A total of 77.3% of 33,084 opioid-involved overdose deaths had no evidence of naloxone administration. Statistically significant subgroup differences were observed for all sociodemographic groups examined except housing status. The highest percentages of decedents lacking evidence of naloxone administration were those with highest educational attainment (doctorate or professional degree, 87.0%), oldest (55-64 years, 83.4%; ≥65 years, 87.3%) and youngest ages (<15 years, 87.5%), and single marital status (84.5%). The lowest percentages of no evidence of naloxone administration were observed for non-Hispanic American Indian/Alaskan Native persons (66.2%) and those ages 15-24 years (70.8%).

CONCLUSIONS: More than three-quarters of opioid-involved overdose deaths had no evidence of naloxone administration, underscoring the need to ensure sufficient naloxone access and capacity for utilization. While fatal overdose data cannot fully characterize sociodemographic disparities in naloxone administration, naloxone education and access efforts can be informed by apparent inequities. Public health partners can assist persons who use drugs (PWUD) by maintaining naloxone supply and amplifying messages about the high risk of using drugs alone among PWUD and their social networks.

PMID:35461083 | DOI:10.1016/j.drugalcdep.2022.109467

Gait Posture. 2022 Apr 6;95:76-83. doi: 10.1016/j.gaitpost.2022.04.003. Online ahead of print.

ABSTRACT

BACKGROUND: Lower limb prosthetic alignment is a procedure mostly subjective. A prosthetic misaligned induces gait deviations and long-term joint diseases. The alignment effects for each lower limb and the stump stays uncertain.

RESEARCH OBJECTIVE: To identify the effect of the transfemoral alignment prosthesis on ground reaction forces and thermal images of the residual limb.

METHODS: The effect of misalignment and nominal alignment was evaluated in sixteen transfemoral amputees. The nominal alignment was considered as the optimal alignment for each subject. Misalignment included random variations in the anterior-posterior and medial-lateral translation of the prosthetic foot and the angle of flexion-extension, abduction-adduction, and internal-external rotation of the socket and prosthetic foot. The control group consisted of fifteen non-amputee individuals. The ground reaction force parameters and stump temperature were analyzed for each alignment condition. The statistical analysis included the one-way ANOVA, Kruskal-Wallis, and multiple comparison tests.

RESULTS: The prosthesis did not produce statistically significant changes in the average temperature of residual limbs. However, the temperature distribution on the stump skin was different (P < 0.05). The transfemoral prosthesis misalignment produced an irregular heat diffusion on the anterior, posterior, and lateral sides of the stump contour compared to the nominal alignment (P < 0.05). The sound limb did not show differences between nominal alignments and misalignments for most ground reaction force parameters. For almost all GRF parameters, significant differences were observed for the prosthetic limb between misalignment and nominal alignment (P < 0.001). The symmetry indices of ground reaction force parameters of transfemoral amputees did not show any kind of significant improvements after aligning the prosthesis nominally.

SIGNIFICANCE: The stump’s temperature distribution and the ground reaction force findings for the prosthetic limb provide a better understanding of the alignment procedure of the transfemoral prosthesis and improve the amputees’ compliance to the prosthesis.

PMID:35461047 | DOI:10.1016/j.gaitpost.2022.04.003

Aten Primaria. 2022 Apr 20;54(5):102284. doi: 10.1016/j.aprim.2022.102284. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the experiencie with a health education program in Primary Care in patients with chronic shoulder pain of musculoskeletal origin, on pain and disability and establish the protocol in primary care.

DESIGN: Quasi-experimental longitudinal descriptive observational study.

LOCATION: Arroyo de la Vega Health Center, Alcobendas, Madrid.

PARTICIPANTS: Patients referred by their Primary Care Physician to the Primary Care Physiotherapy Unit for shoulder pain of musculoskeletal origin.

INTERVENTION: 7 group sessions of health education and therapeutic exercise.

MAIN MEASUREMENTS: Pain intensity was assessed through the Visual Analogue Scale (VAS), the disability of the upper limb with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the level of disability and shoulder pain with the Shoulder Pain and Disability Index (SPADI) questionnaire.

RESULTS: Statistically significant differences were found in the reduction of pain and disability (P<.01), in addition, drug use and recurrences were reduced.

CONCLUSIONS: The shoulder physiotherapy protocol with health education was effective in reducing pain and disability in patients with chronic shoulder pain of musculoskeletal origin in Primary Care.

PMID:35461039 | DOI:10.1016/j.aprim.2022.102284

Med Image Anal. 2022 Apr 12;79:102457. doi: 10.1016/j.media.2022.102457. Online ahead of print.

ABSTRACT

Unsupervised domain adaptation (UDA) aims to exploit the knowledge learned from a labeled source dataset to solve similar tasks in a new unlabeled target domain. Existing UDA techniques typically assume that samples from source and target domains are freely accessible during the training. However, it may be impractical to access source images due to privacy concerns, especially in medical imaging scenarios with the patient information. To tackle this issue, we devise a novel source free domain adaptation framework with fourier style mining, where only a well-trained source segmentation model is available for the adaptation to the target domain. Our framework is composed of two stages: a generation stage and an adaptation stage. In the generation stage, we design a Fourier Style Mining (FSM) generator to inverse source-like images through statistic information of the pretrained source model and mutual Fourier Transform. These generated source-like images can provide source data distribution and benefit the domain alignment. In the adaptation stage, we design a Contrastive Domain Distillation (CDD) module to achieve feature-level adaptation, including a domain distillation loss to transfer relation knowledge and a domain contrastive loss to narrow down the domain gap by a self-supervised paradigm. Besides, a Compact-Aware Domain Consistency (CADC) module is proposed to enhance consistency learning by filtering out noisy pseudo labels with shape compactness metric, thus achieving output-level adaptation. Extensive experiments on cross-device and cross-centre datasets are conducted for polyp and prostate segmentation, and our method delivers impressive performance compared with state-of-the-art domain adaptation methods. The source code is available at https://github.com/CityU-AIM-Group/SFDA-FSM.

PMID:35461016 | DOI:10.1016/j.media.2022.102457

ESMO Open. 2022 Apr 20;7(3):100470. doi: 10.1016/j.esmoop.2022.100470. Online ahead of print.

ABSTRACT

BACKGROUND: Resection of liver metastases from colorectal cancer (CRC) in the oligometastatic stage improves survival and is a potentially curative treatment. Thus, predictive scores that reliably identify those patients who especially benefit from surgery are essential.

PATIENTS AND METHODS: In this multicenter analysis, 512 patients had undergone surgery for liver metastases from CRC. We investigated distinct cancer-specific risk factors that are routinely available in clinical practice and developed a predictive preoperative score using a training cohort (TC), which was thereafter tested in a validation cohort (VC).

RESULTS: Inflammatory response to the tumor, a right-sided primary tumor, multiple liver metastases, and node-positive primary tumor were significant adverse variables for overall survival (OS). Patients were stratified in five groups according to the cumulative score given by the presence of these risk factors. Median OS for patients without risk factors was 133.8 months [95% confidence interval (CI) 81.2-not reached (nr)] in the TC and was not reached in the VC. OS decreased significantly for each subsequent group with increasing number of risk factors. Median OS was significantly shorter (P < 0.0001) for patients presenting all four risk factors: 14.3 months (95% CI 10.5 months-nr) in the TC and 16.6 months (95% CI 14.6 months-nr) in the VC.

CONCLUSIONS: Including easily obtainable variables, this preoperative score identifies oligometastatic CRC patients with prolonged survival rates that may be cured, and harbors potential to be implemented in daily clinical practice.

PMID:35461024 | DOI:10.1016/j.esmoop.2022.100470

J Surg Res. 2022 Apr 20;276:394-403. doi: 10.1016/j.jss.2022.02.050. Online ahead of print.

ABSTRACT

INTRODUCTION: The Braden Scale is widely used to assess the risk of pressure injury. However, the vague literal description of the items creates difficulties for bedside nurses and limits its sensitivity. To solve this problem, we developed a cartoon version of the Braden scale (CVBS) to improve the pressure injury risk assessment ability of bedside nurses.

METHODS: The CVBS was constructed by two nurses, and the final version was determined through a two-round Delphi consultation. The scale’s content validity was calculated based on expert ratings. A total of 265 patients were evaluated simultaneously with the CVBS by 119 bedside nurses and 46 wound care specialists; and 114 bedside nurses and the same 46 wound care specialists evaluated 239 patients with the original Braden scale (OBS). The interrater reliability between the two groups was calculated as Kappa value, and then the Kappa values of the two versions were compared.

RESULTS: The content validity for the draft scale was not good enough. After modification, the indices of all the items in the final CVBS reached 1.00. The Kappa value of the OBS was 0.69 (95% CI 0.61-0.76); for each item, it ranged from 0.60 to 0.80. The interrater reliabilities of the CVBS were higher than those of the OBS, with an overall kappa value of 0.87 (95% CI 0.81-0.92) and a range of 0.77 to 0.93 for each item. The differences between the Kappa values of the CVBS and those of the OBS were all statistically significant.

CONCLUSIONS: The CVBS had good validity and showed higher interrater reliability than the OBS, indicating that it may improve bedside nurses’ ability to assess pressure injury risk.

PMID:35461011 | DOI:10.1016/j.jss.2022.02.050

EBioMedicine. 2022 Apr 20;79:104008. doi: 10.1016/j.ebiom.2022.104008. Online ahead of print.

ABSTRACT

BACKGROUND: The increase in SARS-CoV-2 infections in December 2021 was driven primarily by the Omicron variant, which largely displaced the Delta over a three-week span. Outcomes from infection with Omicron remain uncertain. We evaluated whether clinical outcomes and viral loads differed between Delta and Omicron infections during the period when both variants were co-circulating.

METHODS: In this retrospective observational cohort study, remnant clinical specimens, positive for SARS-CoV-2 after standard of care testing at the Johns Hopkins Microbiology Laboratory, between the last week of November and the end of December 2021, were used for whole viral genome sequencing. Cycle threshold values (Ct) for viral RNA, the presence of infectious virus, and levels of respiratory IgG were measured, and clinical outcomes were obtained. Differences in each measure were compared between variants stratified by vaccination status.

FINDINGS: The Omicron variant displaced Delta during the study period and constituted 95% of the circulating lineages by the end of December 2021. Patients with Omicron infections (N = 1,119) were more likely to be vaccinated compared to patients with Delta (N = 908), but were less likely to be admitted (0.33 CI 0.21-0.52), require ICU level care (0.38 CI 0.17-0.87), or succumb to infection (0.26 CI 0.06-1.02) regardless of vaccination status. There was no statistically significant difference in Ct values based on the lineage regardless of the vaccination status. Recovery of infectious virus in cell culture was reduced in boosted patients compared to fully vaccinated without a booster and unvaccinated when infected with the Delta lineage. However, in patients with Omicron infections, recovery of infectious virus was not affected by vaccination.

INTERPRETATION: Compared to Delta, Omicron was more likely to cause breakthrough infections of vaccinated individuals, yet admissions were less frequent. Admitted patients might develop severe disease comparable to Delta. Efforts for reducing Omicron transmission are required as, though the admission risk might be lower, the increased numbers of infections cause large numbers of hospitalizations.

FUNDING: NIH/NIAID Center of Excellence in Influenza Research and Surveillance contract HHS N2772201400007C, Johns Hopkins University, Maryland department of health, Centers for Disease Control and Prevention contract 75D30121C11061, and The Modeling Infectious Diseases in Healthcare Network (MInD) under awards U01CK000589.

PMID:35460989 | DOI:10.1016/j.ebiom.2022.104008

J Environ Manage. 2022 Apr 20;314:115081. doi: 10.1016/j.jenvman.2022.115081. Online ahead of print.

ABSTRACT

Starting in 2013, China’s key polluting firms have been required to install continuous emissions monitoring systems (CEMS) and to publish the data for real-time oversight and public scrutiny. However, the CEMS data has rarely been used in local environmental law enforcement because its quality is still of great concern. A lack of criteria to evaluate data quality is one of the causes. In this paper, we design a comprehensive analytical framework for evaluating the quality of CEMS data, which includes completeness, accuracy, and authenticity. To demonstrate the applicability of the framework, we build a CEMS dataset for key polluting firms in Henan province from 2017 to 2019 by scraping the CEMS data from a public platform. We then conduct a comprehensive evaluation using our proposed framework. Some data quality issues are identified. About one-third of the firms did not meet official guidelines for data completeness. When comparing the CEMS data with onsite measurement results, we observe statistically significant inconsistencies in about one-fifth of the firms. In addition, we find evidence that some firms might manipulate CEMS data by strategically turning down the CEMS when a pollutant’s concentration is expected to exceed the limit. Our framework can be expanded by incorporating more evaluation methods and data. We suggest that government agencies should implement a comprehensive framework to enhance the quality of CEMS data, thereby facilitating its application in law enforcement.

PMID:35460987 | DOI:10.1016/j.jenvman.2022.115081