Category: Nevin Manimala

BMC Nurs. 2022 Aug 1;21(1):207. doi: 10.1186/s12912-022-00997-w.

ABSTRACT

BACKGROUND: Instead of ventilator-associated pneumonia (VAP), the modern definition of ventilator-associated events (VAEs) has been introduced to identify infectious and noninfectious respiratory complications. Some studies revealed that compliance to the ventilator bundle is associated with decreased occurrence of VAP, but little is known about its association with the decrease of VAEs occurrence.

METHODS: A prospective cohort research design was used. Data were collected over eight months from May 2019 to February 2020 in five general intensive care units. The researchers assessed the compliance to ventilator care bundle using the Institute for Healthcare Improvement ventilation bundle checklist. Mechanically ventilated patients were prospectively assessed for the occurrence of VAEs using a pre-validated calculator from the Centers for Disease Control and Prevention. All are non-invasive tools and no intervention was done by the authors.

RESULTS: A total of 141 mechanically ventilated patients completed the study. The odds ratio of having VAEs in patients who received ventilator bundle was -1.19 (95% CI, -2.01 to -0.38), a statistically significant effect, Wald χ2(1) = 8.18, p = 0.004.

CONCLUSION/ IMPLICATIONS FOR PRACTICE: Ventilator bundle compliance was associated with a reduced risk for VAEs occurrence. Nurses should comply with the ventilator bundle because it is associated with decreased VAEs occurrence.

PMID:35915444 | DOI:10.1186/s12912-022-00997-w

Ocul Immunol Inflamm. 2022 Aug 1:1-9. doi: 10.1080/09273948.2022.2093755. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of lotilaner ophthalmic solution, 0.25% eyedrops compared to vehicle for the treatment of Demodex blepharitis.

METHODS: In this randomized, controlled, double-masked clinical trial, 54 participants were randomly assigned in a 1:1 ratio to receive either lotilaner ophthalmic solution, 0.25% (study group) or the vehicle (control group) bilaterally, twice daily for 42 days. Outcome measures were collarette cure (collarette grade 0, upper eyelid), mite eradication (mite density of 0 mites/lash), and composite cure (grade 0 for collarettes and erythema).

RESULTS: The proportion of participants achieving collarette cure (80.0% vs 15.8%; p < .001), mite eradication (73.3% vs 21.1%, p = .003) and composite cure (73.3% vs 10.5%, p < .001) at Day 42 was statistically significantly higher in the study group than the control group.

CONCLUSION: Twice-daily 42-day treatment with novel lotilaner ophthalmic solution, 0.25% is safe and effective for the treatment of Demodex blepharitis compared to the vehicle control. (Registry number: ACTRN12620000320954, dated 09/03/2020).

PMID:35914297 | DOI:10.1080/09273948.2022.2093755

Plant Dis. 2022 Aug 1. doi: 10.1094/PDIS-03-22-0516-RE. Online ahead of print.

ABSTRACT

Phomopsis stem canker reduces yield of sunflower (Helianthus annuus L.) up to or exceeding 40%, however, management recommendations have not been developed for U.S. farmers. Between 2009 and 2020, foliar fungicide trials were conducted in Minnesota, Nebraska, North Dakota, and South Dakota for a total of 49 location-years. Random effects meta-analyses were performed on the disease severity index (DSI) and yield data collected from the foliar fungicide trials to determine the overall and individual effectiveness of the tested fungicides. Effect sizes, Cohen’s f or Hedges’ g, were calculated as the difference in DSI or yield between the fungicide treatment and non-treated control (NTC) divided by the pooled standard deviation. The pooled Cohen’s f for DSI and yield was 0.40 [95% CI= (0.29, 0.42)], indicating a large effect size and that fungicide treatments had a significant effect on DSI and yield (P<0.0001). Among the fungicide groups, Quinone Outside Inhibitor (QoI) [DSI (k=45; g=-0.47) and yield (k=46; g=0.41)] is moderately effective and premixes of DeMethylation inhibitors (DMI), Succinate Dehydrogenase Inhibitors (SDHI) and QoI (DMI+SDHI+QoI) [DSI (k=3; g=-0.79) and yield (k=3; g=0.94)] is largely effective in comparison to NTC. Upon performing prediction analyses, the probability of not recovering the fungicide application cost (ploss) associated with QoI (pyraclostrobin) was <0.35 for a range of sunflower grain prices suggesting a greater probability of return on investment from a single application of fungicide. Overall, our study suggests that the use of QoI fungicides is likely to be profitable in the presence of Phomopsis stem canker (DSI>5%).

PMID:35914292 | DOI:10.1094/PDIS-03-22-0516-RE

Ann Intern Med. 2022 Aug 2. doi: 10.7326/M22-0252. Online ahead of print.

ABSTRACT

DESCRIPTION: The Women’s Preventive Services Initiative (WPSI), a national coalition of women’s health professional organizations and patient advocacy representatives, developed a recommendation for counseling midlife women aged 40 to 60 years with normal or overweight body mass index (BMI; 18.5 to 29.9 kg/m²) to maintain weight or limit weight gain to prevent obesity with the long-term goals of optimizing health, function, and well-being. This recommendation is intended to guide clinical practice and coverage of clinical preventive health services for the Health Resources and Services Administration and other stakeholders. Clinicians providing preventive health care to women in primary care settings are the target audience for this recommendation.

METHODS: The WPSI developed this recommendation after evaluating results of a systematic review of the effectiveness and harms of interventions to prevent weight gain and obesity in women aged 40 to 60 years without obesity. Seven randomized clinical trials including 51 638 participants and using various counseling and behavioral interventions were included. Trials indicated favorable weight changes with interventions that were statistically significantly different from control groups in 4 of 5 trials of counseling, but not in 2 trials of exercise. Few harms were reported.

RECOMMENDATION: The WPSI recommends counseling midlife women aged 40 to 60 years with normal or overweight BMI (18.5 to 29.9 kg/m²) to maintain weight or limit weight gain to prevent obesity. Counseling may include individualized discussion of healthy eating and physical activity.

PMID:35914264 | DOI:10.7326/M22-0252

Ann Intern Med. 2022 Aug 2. doi: 10.7326/M22-0160. Online ahead of print.

ABSTRACT

BACKGROUND: Despite high prevalence rates of obesity in the United States, no clinical guidelines exist for obesity prevention in midlife women who commonly experience weight gain.

PURPOSE: To evaluate evidence on the effectiveness and harms of behavioral interventions to reduce weight gain and improve health outcomes for women aged 40 to 60 years without obesity.

DATA SOURCES: English-language searches of Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (inception to 26 October 2021); ClinicalTrials.gov (October 2021); and reference lists of studies and reviews.

STUDY SELECTION: Randomized controlled trials (RCTs) enrolling predominantly midlife women comparing behavioral interventions to prevent weight gain with control groups and reporting health outcomes and potential harms.

DATA EXTRACTION: Dual extraction and quality assessment of individual studies.

DATA SYNTHESIS: Seven RCTs in 12 publications (n = 51 638) were included. Four RCTs showed statistically significant favorable differences in weight change for counseling interventions versus control groups (mean difference of weight change, -0.87 to -2.5 kg), whereas 1 trial of counseling and 2 trials of exercise showed no differences; 1 of 2 RCTs reported improved quality-of-life measures. Interventions did not increase measures of depression or stress in 1 trial; self-reported falls (37% vs. 29%; P < 0.001) and injuries (19% vs. 14%; P = 0.03) were higher with exercise counseling in 1 trial.

LIMITATION: Trials were generally small, heterogeneous, and lacked data on harms, long-term health outcomes, and specific patient populations.

CONCLUSION: Counseling interventions to prevent weight gain in women during midlife may result in modest differences in weight change without causing important harms. More research is needed to determine optimal content, frequency, length, and number of sessions required and should include additional patient populations.

PRIMARY FUNDING SOURCE: Health Resources and Services Administration.

PMID:35914258 | DOI:10.7326/M22-0160

Cancer Res. 2022 Aug 1:CAN-22-1329. doi: 10.1158/0008-5472.CAN-22-1329. Online ahead of print.

ABSTRACT

Triple-negative breast cancer (TNBC) is persistently refractory to therapy, and methods to improve targeting and evaluation of responses to therapy in this disease are needed. Here, we integrate quantitative magnetic resonance imaging (MRI) data with biologically-based mathematical modeling to accurately predict the response of TNBC to neoadjuvant systemic therapy (NAST) on an individual basis. Specifically, 56 TNBC patients enrolled in the ARTEMIS trial (NCT02276443) underwent standard-of-care doxorubicin/cyclophosphamide (A/C) and then paclitaxel for NAST, where dynamic contrast-enhanced MRI and diffusion-weighted MRI were acquired before treatment and after two and four cycles of A/C. A biologically-based model was established to characterize tumor cell movement, proliferation, and treatment-induced cell death. Two evaluation frameworks were investigated using: 1) images acquired before and after two cycles of A/C for calibration and predicting tumor status after A/C, and 2) images acquired before, after two cycles, and after four cycles of A/C for calibration and predicting response following NAST. For Framework 1, the concordance correlation coefficients between the predicted and measured patient-specific, post-A/C changes in tumor cellularity and volume were 0.95 and 0.94, respectively. For Framework 2, the biologically-based model achieved an area under the receiver operator characteristic curve of 0.89 (sensitivity/specificity = 0.72/0.95) for differentiating pathological complete response (pCR) from non-pCR, which is statistically superior (P < 0.05) to the value of 0.78 (sensitivity/specificity = 0.72/0.79) achieved by tumor volume measured after four cycles of A/C. Overall, this model successfully captured patient-specific, spatiotemporal dynamics of TNBC response to NAST, providing highly accurate predictions of NAST response.

PMID:35914239 | DOI:10.1158/0008-5472.CAN-22-1329

J Chiropr Educ. 2022 Aug 1. doi: 10.7899/JCE-21-1. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the ability of 2nd-year students to identify normal and abnormal findings during cardiac and lung auscultation using high-fidelity manikin simulators and standardized patients. A secondary objective was to assess students’ perceived competence and confidence in their abilities.

METHODS: This was a descriptive pilot study of randomly selected 2nd-year students at 1 chiropractic training program. Participants were asked to perform cardiac and lung auscultation on high-fidelity manikins (2 stations) and standardized human patients (2 stations) with normal and abnormal auscultation sounds. Participants described the auscultated sound as “abnormal” or “normal” and were also asked to score their confidence in describing the sound and competence in performing auscultation on a 100-mm visual analog scale. Descriptive statistics were calculated for all study variables.

RESULTS: Thirty-two students (23 women and 9 men) were included. For lung auscultation, 15.6% were incorrect on the human subject and 6.2% were incorrect on the manikin. For cardiac auscultation, 62.5% were incorrect on the human subject and 40.6% were incorrect on the manikin. Confidence mean scores ranged from 34.8 to 60. Competence mean scores ranged from 34.8 to 50.

CONCLUSION: Results identified that 2nd-year students from 1 institution were correct in identifying an abnormal sound during lung auscultation but reported low levels of perceived competence or confidence in their responses. They performed poorly on cardiac auscultation and reported low perceived confidence and competence in their abilities to perform cardiac auscultation and identify sounds.

PMID:35914216 | DOI:10.7899/JCE-21-1

Health Aff (Millwood). 2022 Aug;41(8):1160-1168. doi: 10.1377/hlthaff.2021.01905.

ABSTRACT

Socioeconomic gaps in life expectancy have widened substantially in the United States since 2000. Yet the contribution of specific causes to these growing disparities remains unknown. We used death records from the National Vital Statistics System and population data from Current Population Surveys to quantify the contribution of alcohol-attributable causes of death to changes in US life expectancy between 2000 and 2018 by sex and socioeconomic status (as measured by educational attainment). During the study period, the gap in life expectancy between people with low (high school diploma or less) compared with high (college degree) levels of education increased by three years among men and five years among women. Between 2000 and 2010 declines in cardiovascular disease mortality among people with high education made major contributions to growing inequalities. In contrast, between 2010 and 2018 deaths from a cause with an alcohol-attributable fraction of 20 percent or more were a dominant driver of socioeconomic divergence. Increased efforts to implement cost-effective alcohol control policies will be essential for reducing health disparities.

PMID:35914205 | DOI:10.1377/hlthaff.2021.01905

Environ Sci Technol. 2022 Aug 1. doi: 10.1021/acs.est.2c01103. Online ahead of print.

ABSTRACT

Hypertensive disorders in pregnancy (HDP) are a leading cause of maternal mortality and adverse birth outcomes. Fine particulate matter (PM_2.5) has been linked to HDP risk; however, limited studies have explored the relationships between specific chemical constituents of PM_2.5 and HDP risk. Based on maternal data from the China Labor and Delivery Survey (CLDS), this study included a total of 67,659 participants from 95 participant hospitals in 25 provinces of China between March 1, 2015, and December 31, 2016. Maternal exposure to total PM_2.5 mass and six main components during pregestation and pregnancy were estimated using the Combined Geoscience-Statistical Method. Multilevel logistic regression models were applied to quantify the associations, controlling for sociodemographic characteristics. We found that an interquartile range (IQR) increase in PM_2.5 exposure during the second trimester was associated with a 14% increase in HDP risk (95% CI: 2%, 29%). We observed that black carbon (BC) and SO₄^2- had larger or comparable estimates of the effect than total PM_2.5 mass. The association estimates were greater in the gestational hypertension group than in the group of pre-eclampsia and eclampsia. Our findings suggest that PM_2.5 exposure and specific chemical components (particularly BC and SO₄^2-) were associated with an increased HDP risk in China.

PMID:35914180 | DOI:10.1021/acs.est.2c01103

J Phys Chem B. 2022 Aug 1. doi: 10.1021/acs.jpcb.2c03686. Online ahead of print.

ABSTRACT

Torsion and Lennard-Jones parameters of the optimized potentials for liquid simulations (OPLS) all-atom force field have been refined for describing thermodynamics and dynamics of a wide range of liquid alkanes. Monte Carlo statistical mechanics (MC) and molecular dynamics (MD) simulations were carried out. For thermodynamics properties, MC simulations with truncated electrostatic interactions performed very closely to MD simulations with a Verlet neighbor list and the particle mesh Ewald algorithm. The average errors in comparison with experimental data for computed properties were improved with the modified force field (OPLS/2020), especially for long-chain alkanes. For liquid densities, heats of vaporization, and free energies of hydration, the average errors are 0.01 g/cm³, 0.2 kcal/mol, and ca. 0.5 kcal/mol, respectively; significant gains were made for relative heats of vaporization of isomeric series. Results for self-diffusion coefficients also reproduce experimental data well for linear alkane liquids up to hexadecane. The new force field is suitable for use in improved modeling of myriad systems of importance in chemistry, biology, and materials science.

PMID:35914179 | DOI:10.1021/acs.jpcb.2c03686