Category: Nevin Manimala

J Clin Monit Comput. 2022 Aug 2. doi: 10.1007/s10877-022-00899-x. Online ahead of print.

ABSTRACT

Novel technologies allow continuous wireless monitoring systems (CWMS) to measure vital signs and these systems might be favorable compared to intermittent monitoring regarding improving outcomes. However, device safety needs to be validated because uncertain evidence challenges the clinical implementation of CWMS. This review investigates the frequency of device-related adverse events in patients monitored with CWMS in general hospital wards. Systematic literature searches were conducted in PubMed and Embase. We included trials of adult patients in general hospital wards monitored with CWMS. Our primary outcome was the frequency of unanticipated serious adverse device effects (USADEs). Secondary outcomes were adverse device effects (ADEs) and serious adverse device effects (SADE). Data were extracted from eligible studies and descriptive statistics were applied to analyze the data. Seven studies were eligible for inclusion with a total of 1485 patients monitored by CWMS. Of these patients, 54 patients experienced ADEs (3.6%, 95% CI 2.8-4.7%) and no USADEs or SADEs were reported (0%, 95% CI 0-0.31%). The studies of the SensiumVitals® patch, the iThermonitor, and the ViSi Mobile® device reported 28 (9%), 25 (5%), and 1 (3%) ADEs, respectively. No ADEs were reported using the HealthPatch, WARD 24/7 system, or Coviden Alarm Management. Current evidence suggests that CWMS are safe to use but systematic reporting of all adverse device effects is warranted.

PMID:35917046 | DOI:10.1007/s10877-022-00899-x

High Blood Press Cardiovasc Prev. 2022 Aug 2. doi: 10.1007/s40292-022-00534-5. Online ahead of print.

ABSTRACT

INTRODUCTION: There is compelling evidence of significant country-level disparities where African countries, particularly South Africa, have the highest hypertension rates in the world.

AIM: To develop and validate a simple risk scoring algorithm for hypertension in a large cohort (80,270) of South African men and women.

METHODS: Multivariable logistic regression models were used to build our hypertension risk scoring algorithm and validated externally and internally using the standard statistical techniques. We also compared our risk scores with the results from the Framingham risk prediction model for hypertension.

RESULTS: Six factors were identified as the significant correlates of hypertension: age, education, obesity, smoking, alcohol intake and exercise. A score of ≥ 25 (out of 57) for men and ≥ 35 (out of 75) for women were selected as the optimum cut-points with 82% (43%) and 83% (49%) sensitivity (specificity) for males and females, respectively in the development datasets. We estimated probabilities of developing hypertension using the Framingham risk prediction model, which were higher among those with higher scores for hypertension.

CONCLUSIONS: Identifying, targeting and prioritising individuals at highest risk of hypertension will have significant impact on preventing severe cardiometabolic diseases by scaling up healthy diet and life-style factors. Our six-item risk scoring algorithm may be included as part of hypertension prevention and treatment programs by targeting older individuals with high body fat measurements who are at highest risk of developing hypertension.

PMID:35917033 | DOI:10.1007/s40292-022-00534-5

Child Psychiatry Hum Dev. 2022 Aug 2. doi: 10.1007/s10578-022-01403-x. Online ahead of print.

ABSTRACT

Utilizing multiple informants to assess children’s depressive symptoms increases diagnostic accuracy, reliability, and validity of inferences. However, previous studies have found low to moderate agreement among informants. We applied network statistics to gain insight into children and their mothers’ differential perceptions of depressive symptoms. The sample included children and mother dyads (n = 185) who applied to psychotherapy services at an outpatient university clinic. Mothers filled out the Child Behavior Checklist, which includes a depression subscale, and children filled out the Children’s Depression Inventory. We computed association networks for thirteen depressive symptoms separately for children and mothers using the graphical LASSO. Sadness had the highest strength centrality in the networks of both children and mothers, but the pattern of connectivity and centrality of other symptoms differed. We discussed our findings within the framework of network theory.

PMID:35916982 | DOI:10.1007/s10578-022-01403-x

Cancer Causes Control. 2022 Aug 2. doi: 10.1007/s10552-022-01597-4. Online ahead of print.

ABSTRACT

PURPOSE: Lung cancer incidences tend to be higher among males than females in both China and the United States, yet secular incidence patterns are different due to distinct population and environmental exposures. We examined long-term and future trends of lung cancer incidence, as well as the associations of age, period, and cohort effects with gender disparities.

METHODS: Using data from the Cancer Incidence in Five Continents from 1978 to 2012, we calculated age-standardized, age-specific incidence, and male-to-female incidence rate ratios (IRR), and conducted an age-period-cohort analysis. The average annual percentage change (AAPC) of the trends was obtained by Joinpoint Regression. Bayesian age-period-cohort analysis was also conducted to project incidences to 2032.

RESULTS: In China, age-standardized incidence revealed a decreasing trend among males, but showed increasing trends among the younger age groups (30-54 years) in females. Age-standardized incidence rates of males decreased but remained stable among females from 1972 to 2012 in the United States. Male-to-female incidence rate ratios narrowed in both countries and reversed among younger birth cohorts in the United States. Gender disparities are expected to continue to diminish in both countries, and incidence among females appears to exceed that of males in the United States by around 2023-2027.

CONCLUSION: Gender disparities in lung cancer incidence persist and will continue into the future in both countries, but our findings suggested that smoking may play different roles in gender disparities in lung cancer incidence between the two countries. Further population-based epidemiological studies among females in China are imperative.

PMID:35916964 | DOI:10.1007/s10552-022-01597-4

J Psycholinguist Res. 2022 Aug 2. doi: 10.1007/s10936-022-09905-4. Online ahead of print.

ABSTRACT

The thrust of this study was to investigate the impact of learning styles in general and Field dependence/Independence (FD/I) in particular on the receptive/productive lexical performance of language learners. It aimed to check whether FD/I learners perform differently on receptive and productive vocabulary tests. To achieve this, first, 94 Iranian language learners were given the Group Embedded Figure Test (GEFT) to determine their learning style; and second, they were put into two groups and were asked to take a receptive and a productive vocabulary test. Having collected and analyzed the data, the study revealed that first, with regard to the receptive test, although FI learners outperformed the FD ones, this outperformance was not significant statistically. Second, for the productive test, a significant difference was found between FIs and FDs with FI learners having a better performance. Third, FI learners acted significantly better in the productive test compared with receptive test. Finally, FD learners performed almost similarly in both receptive and productive tests. The pertinent implications are also discussed.

PMID:35916955 | DOI:10.1007/s10936-022-09905-4

Osteoporos Int. 2022 Aug 2. doi: 10.1007/s00198-022-06481-0. Online ahead of print.

ABSTRACT

Between 1998 and 2018, the number of hospitalizations for major osteoporotic fractures increased. After standardization for age, these numerical increases translated into a reduced incidence of hospitalizations for hip fractures and an increased incidence of hospitalizations for spine, proximal humerus, and distal radius fractures in both sexes.

INTRODUCTION: The longterm epidemiological trends of hospitalizations for major osteoporotic fractures (MOF) between 1998 and 2018 in Switzerland are unknown.

METHODS: The absolute number of acute hospitalizations for MOF (hip fractures and fractures of the spine, proximal humerus, and distal radius) and related length of acute hospital stay were extracted from the medical database of the Swiss Federal Office of Statistics. Age-standardized incidence rates were calculated using 1998 as the reference year.

RESULTS: Hospitalizations for MOF increased from 4483 to 7542 (+ 68.2%) in men and from 13,242 to 19,362 (+ 46.2%) in women. The age-standardized incidence of hospitalizations for MOF increased by 5.7% in men (p = 0.002) and by 5.1% in women (p = 0.018). The age-standardized incidence of hip fractures decreased by 15.3% in men (p < 0.001) and by 21.5% in women (p < 0.001). In parallel, the age-standardized incidence of MOF other than hip fractures increased by 31.8% in men (p < 0.001) and by 40.1% in women (p < 0.001). The mean length of acute hospital stays for MOF decreased from 16.3 to 8.5 days in men and from 16.9 to 8.1 days in women.

CONCLUSION: Between 1998 and 2018, the number of hospitalizations for MOF increased significantly by a larger extent than expected based on the ageing of the Swiss population alone. This increase was solely driven by an increased incidence of MOF other than hip fractures as incident hip fractures decreased over time in both sexes, more so in women than in men.

PMID:35916908 | DOI:10.1007/s00198-022-06481-0

World J Urol. 2022 Aug 2. doi: 10.1007/s00345-022-04110-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment advances in metastatic renal cell carcinoma (mRCC) have improved overall survival (OS) in mRCC patients over the last two decades. This single center retrospective analysis assesses if the purported survival benefits are also applicable in elderly mRCC patients.

METHODS: 401 patients with mRCC treated at Hannover Medical School from 01/2003-05/2016 were identified and evaluated by chart review. Treatment periods were defined as 01.01.2003-31.12.2009 (P1) and 01.01.2010-31.05.2016 (P2). Age groups were defined according to WHO classes (≤ 60 years: younger, > 60-75 years: elderly and > 75 years: old). Descriptive statistics, Kaplan-Meier analysis and logistic regression were performed.

RESULTS: Median OS improved from 35.1 months in P1 to 59.1 months in P2. Sub-division into the respective age groups revealed median survival of 38.1 (95%-CI: 28.6-47.6) months in younger patients, 42.9 (95%-CI: 29.5-56.3) months among elderly patients and 27.3 (95%-CI: 12.8-41.8) months among old patients. Risk reduction for death between periods was most evident among old patients (young: HR 0.71 (95%-CI: 0.45-1.13, p = 0.2); elderly: HR 0.62 (95%-CI: 0.40-0.97, p = 0.04); old: HR 0.43 (95%-CI: 0.18-1.05, p = 0.06)). Age ≥ 75 years was an independent risk factor for death in P1 but not in P2.

CONCLUSION: Improved OS in the targeted treatment period was confirmed. Surprisingly elderly and old patients seem to profit the most form expansion of therapeutic armamentarium, within the TKI-dominated observation period.

PMID:35916904 | DOI:10.1007/s00345-022-04110-3

Int Urogynecol J. 2022 Aug 2. doi: 10.1007/s00192-022-05290-7. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Women with missed obstetric anal sphincter injuries (OASIs) are at an increased risk of anal incontinence. Our aim was to assess the accuracy of three-dimensional (3D) transperineal ultrasound (TPUS) compared with clinical examination for detecting OASIs.

METHODS: A cross-sectional study of women undergoing their first vaginal delivery. Perineal trauma was initially assessed by the doctor or midwife performing the delivery (accoucheur) and women were then re-examined by the trained research fellow (KW). A 3D TPUS was performed immediately after delivery before suturing to identify OASIs. The research fellow’s clinical diagnosis was used as the reference standard. A power calculation determined that 216 women would be required for the study.

RESULTS: Two hundred and sixty-four women participated and 226 (86%) delivered vaginally. Twenty-one (9%) sustained OASIs. Six (29%) of these tears were missed by the accoucheur but were identified by the research fellow. TPUS identified 19 of the 21 (90.5%) OASIs. One percent (n = 2) had sonographic appearances of an anal sphincter defect that was not seen clinically. The positive and negative predictive value of TPUS to detect OASIs was 91% and 99% respectively. TPUS identified 91% of OASIs compared with 71% detected by the accoucheur, which was not statistically significant.

CONCLUSIONS: The detection rate of OASIs with TPUS and with the clinical findings of the accoucheur was similar. Given the training and financial implications needed for TPUS, attention needs to be focused on the training of midwives and doctors to identify anal sphincter injuries by clinical examination.

PMID:35916899 | DOI:10.1007/s00192-022-05290-7

J Physician Assist Educ. 2022 Jul 1. doi: 10.1097/JPA.0000000000000436. Online ahead of print.

ABSTRACT

INTRODUCTION: This study’s aim was to examine prerequisite course requirements and compare them to previous studies with a secondary aim to examine potential differences relative to program characteristics.

METHODS: Data were extracted from the websites of 265 entry-level physician assistant (PA) programs from October 2020 until December 2020. Course prerequisites as well as number of courses and semester hours required were described and examined according to program location, phase, Carnegie Classification, association with a medical school, and the public/private status of the sponsoring institution.

RESULTS: Of 264 PA programs, more than 50% of programs required 6 common prerequisites: anatomy, physiology, microbiology, statistics, general chemistry, and psychology. The total number of unique prerequisite courses was 28 for all programs with a reduction in humanities and social sciences semester hours compared to previous studies and a slight increase in credit hours required for the common 6 courses. Total prerequisite hours and courses required were higher for master’s programs; private, not-for-profit programs; newly established programs; and those not associated with a medical school. Newer programs are generally located in private, not-for-profit educational institutions that are not associated with a medical school. Programs in the Mountain Division required a lower number of prerequisites, and the South Region required the greatest number of prerequisite courses and semester hours.

DISCUSSION: The present study demonstrates a difference in prerequisite requirements across the country. This could translate to increased cost and a potential barrier to those considering a career as a PA.

PMID:35916887 | DOI:10.1097/JPA.0000000000000436

J Strength Cond Res. 2022 Jul 1. doi: 10.1519/JSC.0000000000004299. Online ahead of print.

ABSTRACT

Edwards, T, Weakley, J, Woods, CT, Breed, R, Benson, AC, Suchomel, TJ, and Banyard, HG. Comparison of countermovement jump and squat jump performance between 627 state and non-state representative junior Australian football players. J Strength Cond Res XX(X): 000-000, 2022-This cross-sectional study investigated differences in lower-body power of state and nonstate representative junior Australian football (AF) players through countermovement jump (CMJ) and squat jump (SJ) performance. A total of 627 players performed the CMJ and SJ at the end of the preseason phase over a 2-week period, with each player grouped according to their age (under 18 [U18] or under 16 [U16]), and highest competition level played (state representation and nonstate representation). One-way multivariate analysis of variance (MANOVA), follow up ANOVA’s, and Cohen’s d effect sizes were used to identify significant main effects and between-group differences. Statistical significance was set at α < 0.05. Significant small-to-moderate effect size differences were observed between competition level, with state U18 and U16 players recording greater CMJ and SJ height, and peak power (PP), compared with their nonstate representative peers, respectively. Similarly, significant small-to-moderate effect size differences existed between age groups, with nonstate U18 players recording greater CMJ and SJ height and PP than nonstate U16 counterparts. However, state U18 and state U16 only differed in CMJ PP. No differences were found between competition level or age groups for the difference between CMJ and SJ jump height (CMJSJdiff). Together, these findings suggest that state and nonstate representative junior AFs may have a similar ability to use the stretch-shortening cycle, despite state representative players jumping higher in the CMJ and SJ.

PMID:35916875 | DOI:10.1519/JSC.0000000000004299