Category: Nevin Manimala

PLoS One. 2023 Feb 10;18(2):e0281515. doi: 10.1371/journal.pone.0281515. eCollection 2023.

ABSTRACT

OBJECTIVE: This study was conducted to find a more effective education method in a neonatal resuscitation program (NRP) using a high-fidelity simulation that has recently shown positive results in terms of its effectiveness.

STUDY DESIGN: A single-blind prospective cohort study was performed. The high-fidelity simulation model was used in a formal NRP training course for trainees caring for neonatal patients. The trainees were divided into a group that conducted the scenario after the lecture (Group A) and a group that attended the lecture after the scenario (Group B) and they both took the test before, during, and after the training.

RESULTS: The increase in score after theory training was statistically significant in both groups, but the final score did not differ between the two groups. However, when compared by career, in Group A, trainees under 24 months tended to be more effective, and in Group B, trainees over 24 months tended to be more effective.

CONCLUSION: The difference in short-term memory of trainees according to the order of education identified by the test score was not prominent, but it was found that the degree of difference in test scores for the order of education tended to be different according to the career. It is thought that the effectiveness of the training might be increased by changing the education order according to the degree of experience of each trainee. More effective educational methods should be introduced by continuously developing lectures for repeated education of various trainees in the future.

PMID:36763618 | DOI:10.1371/journal.pone.0281515

Breastfeed Med. 2023 Feb 10. doi: 10.1089/bfm.2022.0260. Online ahead of print.

ABSTRACT

Background: The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation. Methods: This randomized controlled experimental research included a total of 90 women in the research sample abiding by the research criteria, with 30 each in the intervention groups (coconut oil or tea tree oil application) and 30 in the control group. Women in the intervention groups applied coconut oil or tea tree oil to the nipples on the 3rd, 7th, and 10th days postpartum, whereas the control group did not have any intervention. Data in the research were collected with the Descriptive Information Form for Mothers, Early Postpartum Period Breast Problem Assessment Form, and Visual Analog Scale (VAS). Analysis of data used the chi-square test, Kruskal-Wallis test, and Friedman’s test. Results: Mean age of women participating in the research was 28.23 ± 5.21 years. The differences between the groups applying coconut oil and tea tree oil on the 3rd, 7th, and 10th days postpartum and the control group were significant in terms of incidence of nipple cracks. In addition, the difference in mean VAS points for nipple pain in the groups using coconut oil and tea tree oil and the control group was found to be statistically significant (p < 0.05). Conclusions: According to the research findings, coconut oil and tea tree oil were determined to reduce nipple crack formation and nipple pain. It is recommended to increase the use of coconut oil and tea tree oil related to breast problems in nursing care during the postpartum period. Clinical Trials Registration Number: NCT05456438.

PMID:36763614 | DOI:10.1089/bfm.2022.0260

JMIR Public Health Surveill. 2023 Feb 10;9:e41450. doi: 10.2196/41450.

ABSTRACT

BACKGROUND: Opioid-related overdose mortality has remained at crisis levels across the United States, increasing 5-fold and worsened during the COVID-19 pandemic. The ability to provide forecasts of opioid-related mortality at granular geographical and temporal scales may help guide preemptive public health responses. Current forecasting models focus on prediction on a large geographical scale, such as states or counties, lacking the spatial granularity that local public health officials desire to guide policy decisions and resource allocation.

OBJECTIVE: The overarching objective of our study was to develop Bayesian spatiotemporal dynamic models to predict opioid-related mortality counts and rates at temporally and geographically granular scales (ie, ZIP Code Tabulation Areas [ZCTAs]) for Massachusetts.

METHODS: We obtained decedent data from the Massachusetts Registry of Vital Records and Statistics for 2005 through 2019. We developed Bayesian spatiotemporal dynamic models to predict opioid-related mortality across Massachusetts’ 537 ZCTAs. We evaluated the prediction performance of our models using the one-year ahead approach. We investigated the potential improvement of prediction accuracy by incorporating ZCTA-level demographic and socioeconomic determinants. We identified ZCTAs with the highest predicted opioid-related mortality in terms of rates and counts and stratified them by rural and urban areas.

RESULTS: Bayesian dynamic models with the full spatial and temporal dependency performed best. Inclusion of the ZCTA-level demographic and socioeconomic variables as predictors improved the prediction accuracy, but only in the model that did not account for the neighborhood-level spatial dependency of the ZCTAs. Predictions were better for urban areas than for rural areas, which were more sparsely populated. Using the best performing model and the Massachusetts opioid-related mortality data from 2005 through 2019, our models suggested a stabilizing pattern in opioid-related overdose mortality in 2020 and 2021 if there were no disruptive changes to the trends observed for 2005-2019.

CONCLUSIONS: Our Bayesian spatiotemporal models focused on opioid-related overdose mortality data facilitated prediction approaches that can inform preemptive public health decision-making and resource allocation. While sparse data from rural and less populated locales typically pose special challenges in small area predictions, our dynamic Bayesian models, which maximized information borrowing across geographic areas and time points, were used to provide more accurate predictions for small areas. Such approaches can be replicated in other jurisdictions and at varying temporal and geographical levels. We encourage the formation of a modeling consortium for fatal opioid-related overdose predictions, where different modeling techniques could be ensembled to inform public health policy.

PMID:36763450 | DOI:10.2196/41450

Phys Rev Lett. 2023 Jan 27;130(4):047001. doi: 10.1103/PhysRevLett.130.047001.

ABSTRACT

Research on spatially inhomogeneous weakly coupled superconductors has recently received a boost of interest because of the experimental observation of a dramatic enhancement of the kinetic inductance with relatively low losses. Here, we study the kinetic inductance and the quality factor of a strongly disordered, weakly coupled superconducting thin film. We employ a gauge-invariant random-phase approximation capable of describing collective excitations and other fluctuations. In line with the experimental findings, we have found that in the range of frequencies of interest, and for sufficiently low temperatures, an exponential increase of the kinetic inductance with disorder coexists with a still large quality factor of ∼10^{4}. More interestingly, on the metallic side of the superconductor-insulator transition, we have identified a range of frequencies and temperatures, T∼0.1T_{c}, where quantum coherence effects induce a broad statistical distribution of the quality factor with an average value that increases with disorder. We expect these findings to further stimulate experimental research on the design and optimization of superinductors for a better performance and miniaturization of quantum devices such as qubit circuits and microwave detectors.

PMID:36763448 | DOI:10.1103/PhysRevLett.130.047001

Phys Rev Lett. 2023 Jan 27;130(4):043802. doi: 10.1103/PhysRevLett.130.043802.

ABSTRACT

Confining photons in cavities enhances the interaction between light and matter. In cavity optomechanics, this enables a wealth of phenomena ranging from optomechanically induced transparency to macroscopic objects cooled to their motional ground state. Previous work in cavity optomechanics employed devices where ubiquitous structural disorder played no role beyond perturbing resonance frequencies and quality factors. More generally, the interplay between disorder, which must be described by statistical physics, and optomechanical effects has thus far been unexplored. Here, we demonstrate how sidewall roughness in air-slot photonic-crystal waveguides can induce sufficiently strong backscattering of slot-guided light to create Anderson-localized modes with quality factors as high as half a million and mode volumes estimated to be below the diffraction limit. We observe how the interaction between these disorder-induced optical modes and in-plane mechanical modes of the slotted membrane is governed by a distribution of coupling rates, which can exceed g_{o}/2π∼200 kHz, leading to mechanical amplification up to self sustained oscillations via optomechanical backaction. Our Letter constitutes the first steps towards understanding optomechanics in the multiple-scattering regime and opens new perspectives for exploring complex systems with a multitude of mutually coupled degrees of freedom.

PMID:36763436 | DOI:10.1103/PhysRevLett.130.043802

Phys Rev Lett. 2023 Jan 27;130(4):048202. doi: 10.1103/PhysRevLett.130.048202.

ABSTRACT

Disordered and amorphous materials often retain memories of perturbations they have experienced since preparation. Studying such memories is a gateway to understanding this challenging class of systems. However, it often requires the ability to measure local structural changes in response to external drives. Here, we show that dissipation is a generic macroscopic indicator of the memory of the largest perturbation. Through experiments in crumpled sheets under cyclic drive, we show that dissipation transiently increases when first surpassing the largest perturbation due to irreversible structural changes with unique statistics. This finding is used to devise novel memory readout protocols based on global observables only. The general applicability of this approach is demonstrated by revealing a similar memory effect in a three-dimensional amorphous solid.

PMID:36763418 | DOI:10.1103/PhysRevLett.130.048202

J Am Assoc Nurse Pract. 2023 Feb 10. doi: 10.1097/JXX.0000000000000834. Online ahead of print.

ABSTRACT

BACKGROUND: Inappropriate antibiotic use contributes to the development of antibiotic resistance. Sinusitis is the fifth most common diagnosis responsible for antibiotic use. Appropriate antibiotic prescribing for acute sinusitis treatment is crucial to mitigate antibiotic resistance threats.

PURPOSE: The purpose of this study was to identify patient and provider characteristics associated with antibiotic prescription and to assess provider adherence to antibiotic prescribing guidelines for acute sinusitis treatment.

METHODOLOGY: Retrospective chart review including acute sinusitis cases diagnosed over 12 months, at two express care clinics in the Southwestern United States. Data extraction identified 371 cases meeting inclusion criteria (age >18 years). Descriptive statistical data analyses included Chi square test.

RESULTS: A majority of cases received antibiotic prescriptions (90.8%, n = 337). Sociodemographic characteristics significantly associated with antibiotic prescription (p < .05) included race, ethnicity, insurance type, and smoking status. Patient-reported nature of symptoms, sinus tenderness, and erythema/edema nasal turbinates were also significantly associated with antibiotic prescription (p < .05). Antibiotic prescription and watchful waiting for acute sinusitis treatment were significantly associated with provider types (p < .05).

CONCLUSIONS: A gap exists between current guidelines and clinical practice for acute sinusitis treatment in outpatient settings. Antibiotic prescription occurred, although not indicated, along with incorrect antibiotic choice, dose, and duration of therapy.

IMPLICATIONS: Outpatient antimicrobial stewardship programs for acute sinusitis treatment with a focus on educational interventions for providers may reduce antibiotic overprescribing for acute sinusitis.

PMID:36763411 | DOI:10.1097/JXX.0000000000000834

Phys Rev Lett. 2023 Jan 20;130(3):031901. doi: 10.1103/PhysRevLett.130.031901.

ABSTRACT

We present the study of B[over ¯]^{0}→Σ_{c}(2455)^{0,++}π^{±}p[over ¯] decays based on 772×10^{6} BB[over ¯] events collected with the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider. The Σ_{c}(2455)^{0,++} candidates are reconstructed via their decay to Λ_{c}^{+}π^{∓} and Λ_{c}^{+} decays to pK^{-}π^{+}, pK_{S}^{0}, and Λπ^{+} final states. The corresponding branching fractions are measured to be B(B[over ¯]^{0}→Σ_{c}(2455)^{0}π^{+}p[over ¯])=(1.09±0.06±0.07)×10^{-4} and B(B[over ¯]^{0}→Σ_{c}(2455)^{++}π^{-}p[over ¯])=(1.84±0.11±0.12)×10^{-4}, which are consistent with the world average values with improved precision. A new structure is found in the M_{Σ_{c}(2455)^{0,++}π^{±}} spectrum with a significance of 4.2σ including systematic uncertainty. The structure is possibly an excited Λ_{c}^{+} and is tentatively named Λ_{c}(2910)^{+}. Its mass and width are measured to be (2913.8±5.6±3.8) MeV/c^{2} and (51.8±20.0±18.8) MeV, respectively. The products of branching fractions for the Λ_{c}(2910)^{+} are measured to be B(B[over ¯]^{0}→Λ_{c}(2910)^{+}p[over ¯])×B(Λ_{c}(2910)^{+}→Σ_{c}(2455)^{0}π^{+})=(9.5±3.6±1.6)×10^{-6} and B(B[over ¯]^{0}→Λ_{c}(2910)^{+}p[over ¯])×B(Λ_{c}(2910)^{+}→Σ_{c}(2455)^{++}π^{-})=(1.24±0.35±0.10)×10^{-5}. Here, the first and second uncertainties are statistical and systematic, respectively.

PMID:36763394 | DOI:10.1103/PhysRevLett.130.031901

Oncologist. 2023 Feb 10:oyac251. doi: 10.1093/oncolo/oyac251. Online ahead of print.

ABSTRACT

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies.

METHODS: Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients.

RESULTS: Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant.

CONCLUSIONS: Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.

PMID:36763374 | DOI:10.1093/oncolo/oyac251

JAMA Netw Open. 2023 Feb 1;6(2):e2255626. doi: 10.1001/jamanetworkopen.2022.55626.

ABSTRACT

IMPORTANCE: Hypertension self-management is recommended for optimal blood pressure (BP) control, but self-identified residential contextual factors that hinder hypertension self-care are understudied.

OBJECTIVE: To quantify perceived neighborhood health and hypertension self-care and assess interactions with the area deprivation index (ADI) and healthy food availability at home.

DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study was conducted in Baltimore, Maryland, including primary care adults enrolled in the Achieving Blood Pressure Control Together trial between September 1, 2013, and June 30, 2014. Participants were Black and had at least 2 BP readings greater than or equal to 140/90 mm Hg in the 6 months before enrollment. Analyses were conducted from August 5, 2021, to January 28, 2022.

EXPOSURES: Participants’ perceived neighborhood health, defined as the mean standardized score across 4 subdomains of aesthetic quality, walkability, safety, and violence, with a higher score signifying better neighborhood health.

MAIN OUTCOMES AND MEASURES: Hypertension self-care behavior and self-efficacy. Multivariable generalized linear models were fit regressing each outcome on perceived neighborhood health (higher scores on each domain signify better perceived neighborhood health), adjusted for confounders, and interaction terms between neighborhood health and potential modifiers (ADI [higher percentiles correspond to more deprivation] and healthy food availability [higher scores indicate greater availability]) of the primary association were included.

RESULTS: Among 159 participants (median [IQR] age, 57 [49-64] years; mean [SD] age, 57 (11) years; 117 women [74%]), median (IQR) hypertension self-care behavior was 50 (45-56) and self-efficacy was 64 (57-72). Better perceived neighborhood health was associated with greater hypertension self-care behavior (β, 2.48; 95% CI, 0.63-4.33) and self-efficacy (β, 4.42; 95% CI, 2.25-6.59); these associations persisted for all neighborhood health subdomains except aesthetic quality. There were no statistically significant interactions between perceived neighborhood health or its subdomains with ADI on self-care behavior (P = .74 for interaction) or self-efficacy (P = .85 for interaction). However, better perceived neighborhood aesthetic quality had associations with greater self-care behavior specifically at higher healthy food availability at home scores: β at -1 SD, -0.29; 95% CI, -2.89 to 2.30 vs β at 1 SD, 2.97; 95% CI, 0.46-5.47; P = .09 for interaction). Likewise, associations of perceived worse neighborhood violence with lower self-care behavior were attenuated at higher healthy food availability at home scores (β for -1 SD, 3.69; 95% CI, 1.31-6.08 vs β for 1 SD, 0.01; 95% CI, -2.53 to 2.54; P = .04 for interaction).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, better perceived neighborhood health was associated with greater hypertension self-care among Black individuals with hypertension, particularly among those with greater in-home food availability. Thus, optimizing hypertension self-management may require multifaceted interventions targeting both the patients’ perceived contextual neighborhood barriers to self-care and availability of healthy food resources in the home.

PMID:36763360 | DOI:10.1001/jamanetworkopen.2022.55626