Category: Nevin Manimala

Rev Bras Ginecol Obstet. 2022 Apr 20. doi: 10.1055/s-0042-1744289. Online ahead of print.

ABSTRACT

OBJECTIVE: Construction and validation of the WhatsApp Stress Scale (WASS), a questionnaire designed for physicians that measures how the use of smartphones and related software communication applications affects the quality of life of gynecologists who use this tool to communicate with patients.

METHODS: The present cross-sectional observational study analyzed 60 gynecologists according to weekly WhatsApp usage time for communication with patients and compared the data with the perception of the doctor on the use of this virtual interaction as a stressor. Physicians were equally divided into three groups: < 2 hours, 2 to 5 hours, and > 5 hours. The authors created a questionnaire in Likert scale format. The study proceeded in three phases: development of the questionnaire items, pretesting, constructing, and validity and reliability testing using factor analysis, Cronbach α coefficient, and paired t-test.

RESULTS: A 9-item instrument using a 5-point Likert scale was created and administered to the participants in 3 different times: T0, T1 (15 minutes after the end of T0), and T2 (15 days later). All questionnaire items possessed adequate content validity indices and the internal consistency of the instrument was satisfactory (Cronbach α 0.935; 95% confidence interval [CI]: 0.744-0.989; p = 0.0001). No statistically significant differences were observed in the responses between the rounds of testing, indicating good test-retest reliability. A positive association between the high frequency of WhatsApp usage for communication with patients and the stress perceived by the doctor was shown.

CONCLUSION: The WASS is a valid and reliable instrument for assessing the use of messaging applications to communicate with patients as a stressor perceived by gynecologists.

PMID:35445385 | DOI:10.1055/s-0042-1744289

J Biol Phys. 2022 Apr 20. doi: 10.1007/s10867-022-09602-2. Online ahead of print.

ABSTRACT

Pseudoknotted RNA molecules play important biological roles that depend on their folded structure. To understand the underlying principles that determine their thermodynamics and folding/unfolding mechanisms, we carried out a study on a variant of the mouse mammary tumor virus pseudoknotted RNA (VPK), a widely studied model system for RNA pseudoknots. Our method is based on a coarse-grained discrete-state model and the algorithm of PK3D (pseudoknot structure predictor in three-dimensional space), with RNA loops explicitly constructed and their conformational entropic effects incorporated. Our loop entropy calculations are validated by accurately capturing previously measured melting temperatures of RNA hairpins with varying loop lengths. For each of the hairpins that constitutes the VPK, we identified alternative conformations that are more stable than the hairpin structures at low temperatures and predicted their populations at different temperatures. Our predictions were validated by thermodynamic experiments on these hairpins. We further computed the heat capacity profiles of VPK, which are in excellent agreement with available experimental data. Notably, our model provides detailed information on the unfolding mechanisms of pseudoknotted RNA. Analysis of the distribution of base-pairing probability of VPK reveals a cooperative unfolding mechanism instead of a simple sequential unfolding of first one stem and then the other. Specifically, we find a simultaneous “loosening” of both stems as the temperature is raised, whereby both stems become partially melted and co-exist during the unfolding process.

PMID:35445347 | DOI:10.1007/s10867-022-09602-2

Mol Biol Rep. 2022 Apr 20. doi: 10.1007/s11033-022-07195-6. Online ahead of print.

ABSTRACT

BACKGROUND: Breast Cancer is the most frequent neoplasm diagnosed among women worldwide. Genetic background and lifestyle/environment play a significant role in the disease etiology. According to Genome-wide association studies, some single-nucleotide polymorphisms such as 2q35-rs13387042-(G/A) have been introduced to be associated with breast cancer risk and features. In this study, we aimed to evaluate the association between this variant and the risk of breast cancer in a cohort of Iranian women.

METHODS: Demographics and clinical information were collected by interview and using patients’ medical records, respectively. DNA was extracted from 506 blood samples, including 184 patients and 322 controls, and genotyping was performed using allele specific-PCR. SPSS v16 was used for statistical analysis.

RESULT: Statistically significant association was observed between AA genotype and disease risk in all patients [p_adj = 0.048; OR_adj = 2.13, 95% CI (1.01-4.50)] and also ER-positive breast cancers [p_adj = 0.015; OR_adj = 2.12, 95% CI (1.16-3.88)]. There was no association between rs13387042 and histopathological characteristics of the disease. Furthermore, overall survival was not statistically associated with genotype and allelic models even after adjustment for stage and receptor status (p > 0.05).

CONCLUSION: There is a statistically significant association between 2q35-rs13387042 and breast cancer risk. rs13387042-AA genotype might be a risk-conferring factor for breast cancer development in the Iranian population. However, further consideration is suggested to confirm its role in risk assessment and probable association with other genetic markers.

PMID:35445312 | DOI:10.1007/s11033-022-07195-6

Knee Surg Sports Traumatol Arthrosc. 2022 Apr 20. doi: 10.1007/s00167-022-06930-7. Online ahead of print.

ABSTRACT

PURPOSE: To assess the performance of the quadriceps tendon (QT) autograft in pediatric anterior cruciate ligament reconstruction (ACLR).

METHODS: A systematic search of MEDLINE, PubMed, and EMBASE was conducted on March 1, 2021. Studies of all levels of evidence reporting outcomes and/or complications after QT autograft ACLR in pediatric patients (≤ 18 years old) were eligible for inclusion. Study demographics, patient demographics, reported outcomes, and complications were abstracted. Screening and data abstraction were designed in accordance with PRISMA and R-AMSTAR guidelines. Descriptive statistics were presented when applicable, with data for heterogeneous outcomes presented in narrative summary fashion.

RESULTS: A total of 14 studies examining 596 patients (46.3% female), mean age 15.4 years, were included in this systematic review. Mean postoperative Lysholm scores ranged from 94.0 to 99.5. Mean postoperative IKDC subjective scores ranged from 75.9 to 94.0. Limb symmetry index ranged from 96.8 ± 10.4 to 100.4 ± 7.6% across multiple hop tests. Return to sports (RTS) rates ranged from 88.9 to 91.7%. Eleven studies reported postoperative complications, whereby 16 patients (4.8%) experienced contralateral complications and injuries. Forty-six patients (9.4%) experienced ipsilateral complications, including ten graft failures (2.5%) and two growth disturbances (0.6%).

CONCLUSIONS: QT autograft ACLR in the pediatric population retains the potential of regaining a preinjury level of knee stability, and yields promising postoperative function and rates of RTS, yielding comparable outcomes relative to HT autograft and the reference-standard BPTB ACLR that have previously been described in the literature. Moreover, use of the QT autograft is associated with low rates of postoperative complications, including graft failure and growth disturbances in this active and high-risk patient population in observational studies to date. Therefore, clinical equipoise exists to further appraise the influence of QT autograft on postoperative outcomes compared to aforementioned autograft options in a randomized control trial fashion.

LEVEL OF EVIDENCE: IV.

PMID:35445330 | DOI:10.1007/s00167-022-06930-7

Immunol Res. 2022 Apr 20. doi: 10.1007/s12026-022-09278-9. Online ahead of print.

ABSTRACT

Despite the availability of an effective vaccine and antiviral treatments, hepatitis B is still a global public health problem. Hepatitis B vaccination can prevent the disease. Vaccination induces long-lasting protective immune memory, and the identification of memory cell subsets can indicate the effectiveness of vaccines. Here, we compared the frequency of CD4⁺ memory T cell subsets between responders and nonresponders to HB vaccination. Besides, the frequency of IFN-γ⁺ memory T cells was compared between studied groups. Study participants were grouped according to their anti-HBsAb titer. For restimulation of CD4⁺ memory T cells, peripheral blood mononuclear cells (PBMCs) were cultured in the presence of HBsAg and PHA for 48 h. Besides, PMA, ionomycin, and brefeldin were added during the last 5 h of incubation to induce IFN-γ production. Flow cytometry was used for analysis. There was a statistically significant difference in the frequency of CD4⁺CD95⁺, CD4⁺CD95^Hi, and CD4⁺CD95^low/med T stem cell memory (T_SCM) cells between responder and nonresponder groups. However, the comparison of the frequency of memory T cells producing IFN-γ showed no differences. Our results identified a possible defect of immunological CD4⁺ memory T cell formation in nonresponders due to their lower frequency of CD4⁺ T_SCM cells.

PMID:35445310 | DOI:10.1007/s12026-022-09278-9

Psychon Bull Rev. 2022 Apr 20. doi: 10.3758/s13423-022-02097-x. Online ahead of print.

ABSTRACT

In visual search tasks, salient distractors may capture attention involuntarily, but interference can be reduced when the salient distractor appears more frequently on one out of several possible positions. The reduction was attributed to attentional suppression of the high-probability position. However, all previous studies on this topic compared performance on the high-probability position to the remaining positions, which had a low probability of containing the distractor. Therefore, it is not clear whether the difference resulted from reduced interference on the high-probability position or from increased interference on the low-probability positions. To decide between these alternatives, we compared high-probability and low-probability with equal-probability positions. Consistent with attentional suppression, interference was reduced on the high-probability position compared with equal-probability positions. However, there was also an increase in interference on low-probability positions compared with equal-probability positions. The increase is in line with previous reports of boosted interference when distractors are rare. Our results show that the experimental design used in previous research is insufficient to separate effects of attentional suppression and those of distractor rarity.

PMID:35445289 | DOI:10.3758/s13423-022-02097-x

Pediatrics. 2022 Apr 21:e2021055523. doi: 10.1542/peds.2021-055523. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Establishing peripheral intravenous catheter (PIVC) access in infants and children is a common procedure but can be technically difficult. The primary objective was to determine the effect ultrasound had on first attempt PIVC insertion success rates in the pediatric population. Secondary objectives included overall success rates and subgroups analyses.

METHODS: A systematic review of articles using Medline, Embase, CENTRAL, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. Randomized trials evaluating ultrasound-guided PIVC insertion against the landmark approach in pediatric patients who reported at least 1 outcome of success rate (first attempt or overall) were included. Methodological quality of the literature was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis using a random-effects model was performed.

RESULTS: Nine studies with 1350 patients, from a total of 1033 studies, were included for analysis. Ultrasound showed a statistically significant improvement in PIVC insertion success on first attempt in 5 of 8 studies, with an overall success rate of 78% in the ultrasound group and 66% in the control group. The secondary outcome of overall success was improved by ultrasound in studies that allowed ≥3 attempts (pooled OR 3.57, 95% CI 2.05 to 6.21, P < .001, I2 = 0.0%).

CONCLUSIONS: This systematic review suggested that ultrasound improves pediatric PIVC first pass and overall success rates. Subgroup analysis showed improvement in PIVC success rates for patients with difficult intravenous access and a single operator, dynamic, short-axis ultrasound technique.

PMID:35445257 | DOI:10.1542/peds.2021-055523

BJS Open. 2022 Mar 8;6(2):zrac026. doi: 10.1093/bjsopen/zrac026.

ABSTRACT

BACKGROUND: Diverting ileostomy during resection of rectal cancer is frequently performed in patients at risk of anastomotic failure. Clostridium difficile infection (CDI) is reported to be frequent in patients who receive ileostomy closure with a questionable association to postoperative anastomosis leak. The primary aim of this study was to determine the incidence of CDI following ileostomy closure in patients who underwent rectal cancer surgery; the secondary aim was to assess the rate of postileostomy closure CDI in patients who presented with leakage at the original colorectal anastomosis site.

METHODS: Medical records of patients with rectal cancer who underwent ileostomy closure between January 2015 and December 2019 were retrospectively reviewed. All patients had previously received resection and anastomosis for primary rectal cancer with diverting ileostomy. Data regarding CDI incidence, preoperative status, perioperative management, and clinical outcomes were collected. CDI positivity was determined by direct real-time PCR and enzyme-linked fluorescent assays for detecting toxin A and B.Statistical analyses were computed for CDI risk factors.

RESULTS: A total of 1270 patients were included and 208 patients were tested for CDI owing to colitis-related symptoms. The incidence of CDI was 3.6 per cent (46 patients). Multivariable analysis for CDI risk factors identified adjuvant chemotherapy (hazard ratio (HR) 2.28; P = 0.034) and colorectal anastomosis leakage prior to CDI (HR 3.75; P = 0.008). Finally, patients with CDI showed higher colorectal anastomosis leakage risk in multivariable analysis after ileostomy closure (HR 6.922; P = 0.001).

CONCLUSION: Patients with CDI presented with a significantly higher rate of colorectal anastomosis leakage prior to ileostomy closure.

PMID:35445239 | DOI:10.1093/bjsopen/zrac026

Biomed Res Int. 2022 Apr 11;2022:5143383. doi: 10.1155/2022/5143383. eCollection 2022.

ABSTRACT

BACKGROUND: In this study, we introduced a novel surgical strategy to protect vagal nerve branches during radical thoracoscopic surgery in right lung cancer and explored the effects of vagal nerve branch preservation.

METHODS: We retrospectively studied 53 patients with right-sided lung cancer with clinically staged T1N0M0 between 2019 and 2020. All 53 patients were treated with total thoracoscopic lobectomy and mediastinal lymph node dissection in the same number of lymph node stations. Of these, 22 patients adopted a vagus nerve branch protection strategy during lymph node dissection. Another 31 patients were treated with traditional lymph node dissection as the control group.

RESULTS: The characteristics of the patients were similar between the two groups. The operation time and intraoperative bleeding in the protection group were longer than those in the control group. However, the protection group had a lower average postoperative pain score and average postoperative hospital stay. The above difference was not statistically significant. Three cases of arrhythmia occurred in the protection group, including 1 case of tachycardia and 2 cases of atrial fibrillation. In the control group, 13 cases of arrhythmia occurred after the operation, including 8 cases of tachycardia and 5 cases of atrial fibrillation. We also tracked changes in the patients’ heart rates throughout the treatment process (excluding patients with arrhythmias). An increased heart rate was observed postoperatively in both groups, but the increase of heart rate of the protection group was smaller than that of the control group; however, the difference was not statistically significant.

CONCLUSIONS: A vagus nerve branch preservation-based approach to radical surgery is a safe and feasible strategy for right lung cancer treatment, which could significantly reduce the risk of postoperative arrhythmia in patients and may also have a potential role in reducing the length of hospital stay and maintaining heart rate stability in the postoperative period.

PMID:35445140 | PMC:PMC9015860 | DOI:10.1155/2022/5143383

Eur J Breast Health. 2022 Apr 1;18(2):127-133. doi: 10.4274/ejbh.galenos.2022.2021-12-1. eCollection 2022 Apr.

ABSTRACT

OBJECTIVE: Oncoplastic reconstruction (OR) enables widening of the indications for breast conserving therapy (BCT) and is redefining the limits of breast conservation. We examined the outcome and satisfaction of patients undergoing OR after radical lumpectomy (excision of more than 25% of the breast volume) and compared it to the outcome of women undergoing OR after standard lumpectomy.

MATERIALS AND METHODS: A retrospective, cohort study, including all patients undergoing OR after BCT between 2009 and 2018, was conducted. The ratio of volume of excision to breast volume was calculated using imaging studies. The study group included women that had more than 25% of their breast volume removed. The remainder formed the control group. Demographic characteristics, oncological treatment, and operation properties were collected. We compared post-operative complications, margin status and need for further surgery, as well as patient satisfaction, evaluated using the BREAST-Q Questionnaire.

RESULTS: One hundred and fifty women were included, of whom 24 (16%) comprised the study group with a mean breast volume reduction of 39%, while the remainder (mean volume reduction 8%) served as controls. Patient, tumor characteristics and treatment were comparable. There was a non-significant higher proportion of women in the radical group that underwent a second operation due to complications or positive margins [4/24 (16.7%) vs. 14/126 (11%), p = 0.4). Physical well-being was similar but satisfaction with breasts and with outcome was slightly lower for the study group. These differences did not reach statistical significance.

CONCLUSION: Surgical outcome and patient satisfaction in women undergoing very extensive breast resections with OR are comparable to standard resections.

PMID:35445184 | PMC:PMC8987856 | DOI:10.4274/ejbh.galenos.2022.2021-12-1