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Nevin Manimala Statistics

A comparison of fine particulate matter (PM2.5) in vivo exposure studies incorporating chemical analysis

J Toxicol Environ Health B Crit Rev. 2022 Nov 9:1-23. doi: 10.1080/10937404.2022.2142345. Online ahead of print.

ABSTRACT

The complex, variable mixtures present in fine particulate matter (PM2.5) have been well established, and associations between chemical constituents and human health are expanding. In the past decade, there has been an increase in PM2.5 toxicology studies that include chemical analysis of samples. This investigation is a crucial component for identifying the causal constituents for observed adverse health effects following exposure to PM2.5. In this review, investigations of PM2.5 that used both in vivo models were explored and chemical analysis with a focus on respiratory, cardiovascular, central nervous system, reproductive, and developmental toxicity was examined to determine if chemical constituents were considered in the interpretation of the toxicity findings. Comparisons between model systems, PM2.5 characteristics, endpoints, and results were made. A vast majority of studies observed adverse effects in vivo following exposure to PM2.5. While limited, investigations that explored connections between chemical components and measured endpoints noted significant associations between biological measurements and a variety of PM2.5 constituents including elements, ions, and organic/elemental carbon, indicating the need for such analysis. Current limitations in available data, including relatively scarce statistical comparisons between collected toxicity and chemical datasets, are provided. Future progress in this field in combination with epidemiologic research examining chemical composition may support regulatory standards of PM2.5 to protect human health.

PMID:36351256 | DOI:10.1080/10937404.2022.2142345

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Does Hypochlorous Acid Cause Ototoxicity? An Experimental Study

Otol Neurotol. 2022 Dec 1;43(10):e1187-e1193. doi: 10.1097/MAO.0000000000003734.

ABSTRACT

AIM: Hypochlorous acid (HOCl) is a weak acid that ionizes in water. It is an effective antiseptic exhibiting low toxicity on living tissues. We aimed to investigate the ototoxic effects of HOCl on an animal model by using electrophysiological and histological methods.

MATERIALS AND METHODS: The study comprised 32 Sprague-Dawley rats, which were separated into four groups: control group (A), saline solution group (B), 70% isopropyl alcohol + 2% chlorhexidine group (C), and HOCl group (D). After recording the auditory brainstem response (ABR) for basal hearing thresholds (8, 16, 24, and 32 kHz), 0.03 ml of the aforementioned materials was injected intratympanically three times every 2 days in groups B, C, and D. ABR measurements were repeated on the 7th and 21st days. All animals were sacrificed, and temporal bones were prepared for examinations of cochlear histology and vascular endothelial growth factor immunohistochemistry.

RESULTS: Basal hearing levels were normal across all frequencies and groups, with no statistical differentiation. On the 7th and 21st days after the ABR test, all other groups demonstrated a significant deterioration in hearing levels compared with group A. When the results from 7th and 21st days were compared within group D, a partial recovery was observed. In histopathology, groups C and D demonstrated moderate and severe cochlear degeneration, along with decreased immunoreactivity in the organ of Corti, stria vascularis, and spiral ligament.

CONCLUSION: This is the first study to evaluate the safety of using HOCl in otology. Although HOCI is less ototoxic than the disinfectant used, it may have a toxic effect on cochlea.Level of Evidence: Animal Research.

PMID:36351230 | DOI:10.1097/MAO.0000000000003734

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COVID-19 Vaccine-Related Beliefs and Behaviors Among Patients With and Survivors of Hematologic Malignancies

JCO Oncol Pract. 2022 Nov 9:OP2200338. doi: 10.1200/OP.22.00338. Online ahead of print.

ABSTRACT

PURPOSE: Patients with and survivors of hematologic malignancies are particularly vulnerable to COVID-19 disease and complications. This study examined patients’ vaccination attitudes and behaviors and their correlates.

METHODS: A two-wave survey was fielded in December 2020 and June 2021 among hematologic malignancy patients and survivors (N = 2,272). Demographic characteristics, intent to get vaccinated, vaccination status, attitudes toward vaccination, and level of trust in specific sources of information about COVID-19 vaccines were assessed. Descriptive statistics were calculated, and linear probability models were estimated to examine binary outcomes and their correlates.

RESULTS: In December 2020, before COVID-19 vaccines were available, 73% stated they were likely or very likely to get vaccinated if an FDA-approved vaccine became available; however, in June 2021 over 90% reported being vaccinated. Being younger, unmarried, trusting local faith leaders, and not having a bachelor’s degree or more were negatively associated with getting vaccinated. Among those hesitant in December 2020, those who expressed a distrust of vaccines in general were least likely to get vaccinated. Being vaccinated in June 2021 was positively associated with the degree to which respondents trust their oncologist, federal agencies, and pharmaceutical companies. Oncologists and primary care physicians were reported as the most trusted sources for information about vaccines.

DISCUSSION: COVID-19 vaccine hesitancy remains a public policy concern even now, as additional boosters are recommended among vulnerable populations. Our findings suggest that patient trust in their treating physicians can play a critical role in promoting individual patient and public health goals.

PMID:36351207 | DOI:10.1200/OP.22.00338

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Real-Space Charge Density Profiling of Electrode-Electrolyte Interfaces with Angstrom Depth Resolution

ACS Nano. 2022 Nov 9. doi: 10.1021/acsnano.2c10819. Online ahead of print.

ABSTRACT

The accumulation and depletion of charges at electrode-electrolyte interfaces is crucial for all types of electrochemical processes. However, the spatial profile of such interfacial charges remains largely elusive. Here we develop charge profiling three-dimensional (3D) atomic force microscopy (CP-3D-AFM) to experimentally quantify the real-space charge distribution of the electrode surface and electric double layers (EDLs) with angstrom depth resolution. We first measure the 3D force maps at different electrode potentials using our recently developed electrochemical 3D-AFM. Through statistical analysis, peak deconvolution, and electrostatic calculations, we derive the depth profile of the local charge density. We perform such charge profiling for two types of emergent electrolytes, ionic liquids, and highly concentrated aqueous solutions, observe pronounced sub-nanometer charge variations, and find the integrated charge densities to agree with those derived from macroscopic electrochemical measurements.

PMID:36351178 | DOI:10.1021/acsnano.2c10819

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Long-Term Outcome of Severe Metabolic Acidemia in ICU Patients, a BICAR-ICU Trial Post Hoc Analysis

Crit Care Med. 2022 Nov 9. doi: 10.1097/CCM.0000000000005706. Online ahead of print.

ABSTRACT

OBJECTIVES: Long-term prognosis of ICU survivors is a major issue. Severe acidemia upon ICU admission is associated with very high short-term mortality. Since the long-term prognosis of these patients is unknown, we aimed to determine the long-term health-related quality of life and survival of these patients.

DESIGN: Post hoc analysis of a multicenter, randomized, controlled trial.

SETTING: Twenty-six French ICUs.

PATIENTS: Day 28 critically ill survivors admitted with severe acidemia and enrolled in the BICAR-ICU trial.

INTERVENTION: Sodium bicarbonate versus no sodium bicarbonate infusion according to the randomization group.

MEASUREMENTS AND MAIN RESULTS: The primary outcome was health-related quality of life (HRQoL) measured with the 36-item Short Form Health Survey and the EuroQol 5-D questionnaires. Secondary outcomes were mortality, end-stage renal disease treated with renal replacement therapy or renal transplantation, place of residence, professional status, and ICU readmission. HRQoL was reduced with no significant difference between the two groups. HRQoL was reduced particularly in the role-physical health domain (64/100 ± 41 in the control group and 49/100 ± 43 in the bicarbonate group, p = 0.28), but it was conserved in the emotional domains (96/100 ± 19 in the control group and 86/100 ± 34 in the bicarbonate group, p = 0.44). Forty percent of the survivors described moderate to severe problems walking, and half of the survivors described moderate to severe problems dealing with usual activities. Moderate to severe anxiety or depression symptoms were present in one third of the survivors. Compared with the French general population, HRQoL was decreased in the survivors mostly in the physical domains. The 5-year overall survival rate was 30% with no significant difference between groups.

CONCLUSIONS: Long-term HRQoL was decreased in both the control and the sodium bicarbonate groups of the BICAR-ICU trial and was lower than the general population, especially in the physical domains.

PMID:36351174 | DOI:10.1097/CCM.0000000000005706

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Management of overweight and obesity in children and adolescents by nurses: a mixed-method study

Rev Lat Am Enfermagem. 2022 Nov 7;30(spe):e3789. doi: 10.1590/1518-8345.6294.3789. eCollection 2022.

ABSTRACT

OBJECTIVE: to analyze the management of overweight and obesity in children and adolescents by nurses of the Family Health Strategy.

METHOD: this is a study of convergent parallel mixed methods, developed in Health Centers of a municipality in northeastern Brazil. In the quantitative stage, data were collected from a questionnaire applied to 98 nurses and analyzed by descriptive statistics. For the qualitative stage, semi-structured interviews were conducted with seven nurses, interpreted by inductive thematic analysis. The quantitative and qualitative results were integrated and presented by a joint display.

RESULTS: most nurses rarely checked waist circumference (77.6%), dyslipidemia (55.7%), blood glucose (42.3%), and neither evaluated blood pressure (75.3%). In the qualitative results, we identified that there are nurses who did not classify body mass index according to sex and age. As for medical tests, the requests were mainly related to the routine of childcare. Guidance on physical activity and diet were given in a basic way or attributed to other professionals, and referrals to other services or professionals were not followed up.

CONCLUSION: it is imperative to train nurses for the management of overweight and obesity in primary care for children and adolescents, with a view to quality of care for the prevention of comorbidities.

KEYPOINTS: (1) There are weaknesses in the management of obesity in children and adolescents by nurses. (2) A mixed method was adopted, which is new and has understanding and inference in a single study. (3) The study suggests the development of specific protocols for nurses. (4) The research suggests continuing education actions for nurses. (5) With proper management, it will be possible to reduce this morbidity and comorbidities.

PMID:36351092 | DOI:10.1590/1518-8345.6294.3789

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Exclusive breastfeeding abandonment in adolescent mothers: a cohort study within health primary services

Rev Lat Am Enfermagem. 2022 Nov 7;30(spe):e3786. doi: 10.1590/1518-8345.6252.3786. eCollection 2022.

ABSTRACT

OBJECTIVE: to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant’s life.

METHOD: this is a cohort study of 105 adolescent mothers followed at the child’s 2-, 4- and 6-months of age. The epidemiological approach was adopted, supported by the positivism paradigm. Exposure variables were those directly related to breastfeeding and sociodemographic, family, maternal and child conditions. Data were collected by interview and analyzed by bivariate and multivariate statistics. The Hazard Ratio (HR) was calculated with a 95% confidence interval (95%CI). The tests were performed, admitting an error type I of 5%. The confidentiality of data was ensured.

RESULTS: the cumulative incidences of exclusive breastfeeding abandonment were 33.3%, 52.2% and 63.8%, at 2, 4 and 6 months, respectively. The variables that remain in the final multivariate model were maternal perception of milk quality (HR=11.6; 95%CI 3.6-37.5), pacifier use (HR=1.9; 95%CI 1.2-3.3), and time of first breastfeeding session (HR=1.4; 95%CI 0.5-12.9).

CONCLUSION: the highest abandonment rate occurs before the fourth month. A perception of having poor-quality milk by the adolescent mother and pacifier use are factors that favor the abandonment of exclusive breastfeeding. Determining the factors associated with breastfeeding abandonment may allow their timely management, especially in more vulnerable populations.

KEYPOINTS: (1) The highest abandonment rate of exclusive breastfeeding occurs before the fourth month. (2) A perception of having poor-quality milk may increase the abandonment of exclusive breastfeeding. (3) Pacifier use may increase the abandonment of exclusive breastfeeding. (4) Knowing the factors associated with exclusive breastfeeding may allow for timely management of them. (5) Exclusive breastfeeding promotion strategies must be adopted early, before and after birth.

PMID:36351091 | DOI:10.1590/1518-8345.6252.3786

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Prevention of non-suicidal self-injury: construction and validation of educational material

Rev Lat Am Enfermagem. 2022 Nov 7;30(spe):e3735. doi: 10.1590/1518-8345.6265.3735. eCollection 2022.

ABSTRACT

OBJECTIVE: to develop and validate educational material to strengthen adolescent health care on non-suicidal self-injury.

METHOD: methodological research designed in three stages: (1) construction of the material based on a mixed study on needs related to the theme through social networks and an umbrella review on health care related to non-suicidal self-injury; (2) validation with 10 experts in mental health and/or self-inflicted violence selected through the Lattes Platform; (3) evaluation by the target public, with health professionals being invited, without restriction of training. Validation and evaluation data were collected by using a sociodemographic questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults. We used descriptive statistics, content validity index, and Gwet’s AC1 test.

RESULTS: the material obtained good general acceptance and reliability in the validation by the experts (AC1= 0.633; p=0.0000) and in the evaluation by the target public (AC1=0.716; p=0.0000). All professionals pointed out the personal contribution and educational potential of the material.

CONCLUSION: we highlight the construction of science-based educational material to strengthen the health care for adolescents with non-suicidal self-injury.

KEYPOINTS: (1) Scientific data-based construction of educational material for prevention of non-suicidal self-injury (NSSI). (2) General acceptance and reliability in the validation of the material by experts. (3) Acceptance and reliability in the evaluation of the material by health professionals. (4) Dissemination of material for health education initiatives to prevent NSSI.

PMID:36351086 | DOI:10.1590/1518-8345.6265.3735

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Genetic ancestry inference from cancer-derived molecular data across genomic and transcriptomic platforms

Cancer Res. 2022 Nov 9:CAN-22-0682. doi: 10.1158/0008-5472.CAN-22-0682. Online ahead of print.

ABSTRACT

Genetic ancestry-oriented cancer research requires the ability to perform accurate and robust genetic ancestry inference from existing cancer-derived data, including whole exome sequencing, transcriptome sequencing, and targeted gene panels, very often in the absence of matching cancer-free genomic data. Here we examined the feasibility and accuracy of computational inference of genetic ancestry relying exclusively on cancer-derived data. A data synthesis framework was developed to optimize and assess the performance of the ancestry inference for any given input cancer-derived molecular profile. In its core procedure, the ancestral background of the profiled patient is replaced with one of any number of individuals with known ancestry. The data synthesis framework is applicable to multiple profiling platforms, making it possible to assess the performance of inference specifically for a given molecular profile and separately for each continental-level ancestry; this ability extends to all ancestries, including those without statistically sufficient representation in the existing cancer data. The inference procedure was demonstrated to be accurate and robust in a wide range of sequencing depths. Testing of the approach in four representative cancer types and across three molecular profiling modalities showed that continental-level ancestry of patients can be inferred with high accuracy, as quantified by its agreement with the gold standard of deriving ancestry from matching cancer-free molecular data. This study demonstrates that vast amounts of existing cancer-derived molecular data are potentially amenable to ancestry-oriented studies of the disease without requiring matching cancer-free genomes or patient self-reported ancestry.

PMID:36351074 | DOI:10.1158/0008-5472.CAN-22-0682

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Patient safety culture and incidents recorded during nursing shift changes in intensive care units

Rev Bras Ter Intensiva. 2022 Nov 4;34(3):386-392. doi: 10.5935/0103-507X.20220446-pt. eCollection 2022.

ABSTRACT

OBJECTIVE: To analyze the association of patient safety culture perceived by nursing professionals with incidents recorded during nursing shifts in intensive care units.

METHODS: This was a cross-sectional study that investigated patient safety culture measured by the Hospital Survey on Patient Safety Culture instrument. Descriptive statistics, chi-square tests, Student’s t-test and multiple linear regression models were analyzed considering a significance level of 5%.

RESULTS: The study reported a mean of 3.1 (standard deviation of 0.4) for the culture of patient safety in the perception of nursing professionals and 480 incidents with and without damage recorded during the nursing shifts. The variables patient safety culture with a difference between means of 0.543 (95%CI 0.022 – 1.065; p < 0.05) and nursing assistants with a difference between means of -0.133 (95%CI -0.192 – -0.074; p < 0.05) were associated with the incidents recorded during the nursing shifts. Further, nursing assistants had a lower tendency to record incidents than did the nurses.

CONCLUSION: The strengthening of the patient safety culture and the aspects tangential to the nursing professionals represent a possible target for interventions to encourage the recording of incidents during the nursing shift shifts and improve patient safety.

PMID:36351070 | DOI:10.5935/0103-507X.20220446-pt