Category: Nevin Manimala

ACS Appl Mater Interfaces. 2022 Dec 1. doi: 10.1021/acsami.2c17962. Online ahead of print.

ABSTRACT

Since its discovery, atomic force microscopy (AFM) has become widely used for surface characterization, evolving from a tool for probing surface topography to a versatile method for characterizing mechanical, electrical, chemical, magnetic, and electro-optical properties of surfaces at the nanoscale. Developments of several AFM-based techniques have enabled even subsurface imaging, which is routinely being carried out at the qualitative level of feature detection for localized subsurface inhomogeneities. We surmise, however, that a quantitative three-dimensional (3D) subsurface characterization can emerge from the AFM mechanical response of flat buried interfaces, and present here a methodology for determining the depth of a film and its mechanical properties. Using load-dependent contact resonance atomic force microscopy (CR-AFM) and accurate modeling of the contact between the AFM tip and a layered sample, we determine the relationship between the measured resonance frequency of the AFM probe and the contact stiffness. Our subsequent statistical analysis reveals an intrinsic and sample-specific interdependence between the depth and modulus sensitivities of CR-AFM. This interdependence prevents the simultaneous accurate determination of both depth and modulus from measurements on a single-layered sample. If the elastic moduli of the sample components are predetermined from separate investigations of bulk samples (or otherwise known), then this methodology accurately yields the location of the interface between the layers of the sample; as such, it can serve as a nondestructive and robust technique for probing layer thickness, subsurface features, and elastic properties of materials used in semiconductor electronics, additive manufacturing, or biomaterials.

PMID:36455132 | DOI:10.1021/acsami.2c17962

Diabetes Care. 2022 Dec 1;45(12):3091-3100. doi: 10.2337/dc22-0835.

ABSTRACT

BACKGROUND: Optimal length of biliopancreatic (BP) and Roux limb in Roux-en-Y gastric bypass (RYGB) for improved glycemic control are not known.

PURPOSE: To investigate how the lengths of the BP and Roux limbs in RYGB differentially affect postoperative glycemic outcomes in patients with type 2 diabetes.

DATA SOURCES: We conducted a systematic literature search using the PubMed, Embase, and the Cochrane Library databases.

STUDY SELECTION: We included studies that reported glycemic outcomes after RYGB and lengths of the BP and Roux limbs.

DATA EXTRACTION: A total of 28 articles were included for data extraction. Glycemic outcomes after RYGB were assessed on the basis of two definitions: remission and improvement.

DATA SYNTHESIS: We categorized the included studies into four groups according to the BP and Roux limb lengths. The type 2 diabetes remission/improvement rates were as follows: long BP-long Roux group 0.80 (95% CI 0.70-0.90)/0.81 (0.73-0.89), long BP-short Roux group 0.76 (0.66-0.87)/0.82 (0.75-0.89), short BP-long Roux group 0.57 (0.36-0.78)/0.64 (0.53-0.75), and short BP-short Roux group 0.62 (0.43-0.80)/0.53 (0.45-0.61). Meta-regression analysis also showed that a longer BP limb resulted in higher postoperative type 2 diabetes remission and improvement rates, whereas a longer Roux limb did not. There was no significant difference or heterogeneity in baseline characteristics, including diabetes-related variables, among the four groups.

LIMITATIONS: Not all included studies were randomized controlled trials.

CONCLUSIONS: Longer BP limb length led to higher rates of type 2 diabetes remission and improvement by 1 year after RYGB in comparisons with the longer Roux limb length.

PMID:36455123 | DOI:10.2337/dc22-0835

Diabetes Care. 2022 Dec 1;45(12):e188-e189. doi: 10.2337/dci22-0038.

NO ABSTRACT

PMID:36455121 | DOI:10.2337/dci22-0038

Med Probl Perform Art. 2022 Dec;37(4):278-292. doi: 10.21091/mppa.2022.4032.

ABSTRACT

It is widely believed that posture and balance stressors are factors in playing-related pain for musicians using hand-held musical instruments. This purpose of this scoping review was to assess the available literature relative to the effects of posture and balance in musicians with neuromusculoskeletal injuries. A search of Medline, Web of Science, and SportDiscus seeking articles combining posture and balance considerations with pain in performing artists was performed. From 1,403 articles initially identified by the search parameters, the further abstract/title review for relevance and inclusiveness of pain and posture/balance variables in performing artists resulted in the retention of 29 articles for this full-text scoping review. The full-text analysis assessed publication type, study design, participant population, methodology, statistical methods, main results, and whether the study evaluated the relationship between posture/balance and pain in musicians. Overall, most of the studies including musicians were observational or descriptive. Although, in recent years, there has been an increase in the number of interventional studies regarding posture, balance and pain in musicians, there is still minimal evidence about the contribution of posture and balance characteristics to pain in musician performers. To reliably establish a predictable relationship with injury symptomatology experienced by musicians, it is essential to integrate standardized, validated measurements of posture and balance in the evaluation of all musicians who report to a health professional with neuromusculoskeletal pain. This will not only allow researchers to determine the effect of postural righting dysfunction on neuromusculoskeletal injuries in musicians, but also may provide a foundation for clinicians to develop effective interventions.

PMID:36455112 | DOI:10.21091/mppa.2022.4032

Med Probl Perform Art. 2022 Dec;37(4):228-241. doi: 10.21091/mppa.2022.4034.

ABSTRACT

The prevention and control of the spread of COVID-19 has become a major challenge and concern globally. Since the COVID-19 pandemic is still ongoing, sufficient knowledge and practices of people toward COVID-19 is necessary. Thai classical dancers are one of the groups affected by the pandemic. Health literacy in dancers has been shown to be crucial for their health and performance. Hence, this study aimed to assess Thai classical dancers’ knowledge and perception about COVID-19. A cross-sectional 25-item online survey was conducted between March and October 2021. Content validity was performed through the index of Item-Objective Congruence (IOC). Descriptive statistics were applied to represent Thai classical dancer characteristics, knowledge, and perception. The Thai version of the questionnaire had 2 modified items and 2 additional items from the original questionnaire, and the IOC was 1.0. Of the 323 participants who completed the survey, most had adequate knowledge about COVID-19, while 23.84% correctly answered about symptoms of severe COVID-19. Thai classical dancers showed a good perception on COVID-19 prevention and control. Basic understanding about COVID-19 among Thai classical dancers based on their available resources is important. Hence, providing more valid sources of information and health literacy to Thai classical dancers should be considered. More studies on COVID-19 in other dancers should also be explored.

PMID:36455107 | DOI:10.21091/mppa.2022.4034

Clin Orthop Relat Res. 2022 Nov 23. doi: 10.1097/CORR.0000000000002484. Online ahead of print.

ABSTRACT

BACKGROUND: Although economic stability, social context, and healthcare access are well-known social determinants of health associated with more challenging recovery after traumatic injury, little is known about how these factors differ by mechanism of injury. Our team sought to use the results of social determinants of health screenings to better understand the population that engaged with psychosocial support services after traumatic musculoskeletal injury and fill a gap in our understanding of patient-reported social health needs.

QUESTION/PURPOSE: What is the relationship between social determinants of health and traumatic musculoskeletal injury?

METHODS: Trauma recovery services is a psychosocial support program at our institution that offers patients and their family members resources such as professional coaching, peer mentorship, post-traumatic stress disorder screening and treatment, educational resources, and more. This team engages with any patient admitted to, treated at, and released from our institution. Their primary engagement population is individuals with traumatic injury, although not exclusively. Between January 2019 and October 2021, the trauma recovery services team interacted with 6036 patients. Of those who engaged with this service, we considered only patients who experienced a traumatic musculoskeletal injury and had a completed social determinants of health screening tool. During the stated timeframe, 13% (814 of 6036) of patients engaged with trauma recovery services and had a complete social determinants of health screening tool. Of these, 53% (428 of 814) had no physical injury. A further 26% (99 of 386) were excluded because they did not have traumatic musculoskeletal injuries, leaving 4.8% (287) for analysis in this cross-sectional study. The study population included patients who interacted with trauma recovery services at our institution after a traumatic orthopaedic injury that occurred between January 2019 and October 2021. Social determinants of health risk screening questionnaires were self-administered prospectively using a screening tool developed by our institution based on Centers for Medicare and Medicaid Services social determinants of health screening questions. Mechanisms of injury were separated into intentional (physical assault, sexual assault, gunshot wound, or stabbing) and unintentional (fall, motor vehicle collision, or motorcycle crash). During the study period, 287 adult patients interacted with trauma recovery services after a traumatic musculoskeletal injury and had complete social determinant of health screening; 123 injuries were unintentional and 164 were intentional. Patients were primarily women (55% [159 of 287]), single (73% [209 of 287]), and insured by Medicaid or Medicare (78% [225 of 287]). Mechanism category was determined after a thorough medical record review to verify the appropriate category. An initial exploratory univariate analysis was completed for the primary outcome variable using the Pearson chi-squared test for categorical variables and a two-tailed independent t-test for continuous variables. All demographic variables and social determinants of health with p < 0.20 in the univariate analysis were included in a multivariate binary regression analysis to determine independent associations with injury mechanism. All variables with p < 0.05 in the multivariate analysis were considered statistically significant.

RESULTS: After controlling for potential demographic confounders, younger age (odds ratio [OR] 0.93 [95% confidence interval (CI) 0.90 to 0.96]; p < 0.001), Black race (compared with White race, OR 2.71 [95% CI 1.20 to 6.16]; p = 0.02), Hispanic ethnicity (compared with White race, OR 5.32 [95% CI 1.62 to 17.47]; p = 0.006), and at-risk status for food insecurity (OR 4.27 [95% CI 1.18 to 15.39]; p = 0.03) were independently associated with intentional mechanisms of injury.

CONCLUSION: There is a relationship between the mechanism of traumatic orthopaedic injury and social determinants of health risks. Specifically, data showed a correlation between food insecurity and intentional injury. Healthcare systems and providers should be cognizant of this, as well as the additional challenges patients may face in their recovery journey because of social needs. Screening for needs is only the first step in addressing patient’s social health needs. Healthcare systems should also allocate resources for personnel and programs that support patients in meeting their social health needs. Future studies should evaluate the impact of such programming in responding to social needs that impact health outcomes and improve health disparities.

LEVEL OF EVIDENCE: Level IV, prognostic study.

PMID:36455101 | DOI:10.1097/CORR.0000000000002484

J Med Internet Res. 2022 Dec 1;24(12):e41527. doi: 10.2196/41527.

ABSTRACT

BACKGROUND: There is no recognized gold standard method for estimating the number of individuals with substance use disorders (SUDs) seeking help within a given geographical area. This presents a challenge to policy makers in the effective deployment of resources for the treatment of SUDs. Internet search queries related to help seeking for SUDs using Google Trends may represent a low-cost, real-time, and data-driven infoveillance tool to address this shortfall in information.

OBJECTIVE: This paper assesses the feasibility of using search query data related to help seeking for SUDs as an indicator of unmet treatment needs, demand for treatment, and predictor of the health harms related to unmet treatment needs. We explore a continuum of hypotheses to account for different outcomes that might be expected to occur depending on the demand for treatment relative to the system capacity and the timing of help seeking in relation to trajectories of substance use and behavior change.

METHODS: We used negative binomial regression models to examine temporal trends in the annual SUD help-seeking internet search queries from Google Trends by US state for cocaine, methamphetamine, opioids, cannabis, and alcohol from 2010 to 2020. To validate the value of these data for surveillance purposes, we then used negative binomial regression models to investigate the relationship between SUD help-seeking searches and state-level outcomes across the continuum of care (including lack of care). We started by looking at associations with self-reported treatment need using data from the National Survey on Drug Use and Health, a national survey of the US general population. Next, we explored associations with treatment admission rates from the Treatment Episode Data Set, a national data system on SUD treatment facilities. Finally, we studied associations with state-level rates of people experiencing and dying from an opioid overdose, using data from the Agency for Healthcare Research and Quality and the CDC WONDER database.

RESULTS: Statistically significant differences in help-seeking searches were observed over time between 2010 and 2020 (based on P<.05 for the corresponding Wald tests). We were able to identify outlier states for each drug over time (eg, West Virginia for both opioids and methamphetamine), indicating significantly higher help-seeking behaviors compared to national trends. Results from our validation analyses across different outcomes showed positive, statistically significant associations for the models relating to treatment need for alcohol use, treatment admissions for opioid and methamphetamine use, emergency department visits related to opioid use, and opioid overdose mortality data (based on regression coefficients having P≤.05).

CONCLUSIONS: This study demonstrates the clear potential for using internet search queries from Google Trends as an infoveillance tool to predict the demand for substance use treatment spatially and temporally, especially for opioid use disorders.

PMID:36454620 | DOI:10.2196/41527

JAMA Netw Open. 2022 Dec 1;5(12):e2244486. doi: 10.1001/jamanetworkopen.2022.44486.

ABSTRACT

IMPORTANCE: Long-term sequelae after symptomatic SARS-CoV-2 infection may impact well-being, yet existing data primarily focus on discrete symptoms and/or health care use.

OBJECTIVE: To compare patient-reported outcomes of physical, mental, and social well-being among adults with symptomatic illness who received a positive vs negative test result for SARS-CoV-2 infection.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a planned interim analysis of an ongoing multicenter prospective longitudinal registry study (the Innovative Support for Patients With SARS-CoV-2 Infections Registry [INSPIRE]). Participants were enrolled from December 11, 2020, to September 10, 2021, and comprised adults (aged ≥18 years) with acute symptoms suggestive of SARS-CoV-2 infection at the time of receipt of a SARS-CoV-2 test approved by the US Food and Drug Administration. The analysis included the first 1000 participants who completed baseline and 3-month follow-up surveys consisting of questions from the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29; 7 subscales, including physical function, anxiety, depression, fatigue, social participation, sleep disturbance, and pain interference) and the PROMIS Short Form-Cognitive Function 8a scale, for which population-normed T scores were reported.

EXPOSURES: SARS-CoV-2 status (positive or negative test result) at enrollment.

MAIN OUTCOMES AND MEASURES: Mean PROMIS scores for participants with positive COVID-19 tests vs negative COVID-19 tests were compared descriptively and using multivariable regression analysis.

RESULTS: Among 1000 participants, 722 (72.2%) received a positive COVID-19 result and 278 (27.8%) received a negative result; 406 of 998 participants (40.7%) were aged 18 to 34 years, 644 of 972 (66.3%) were female, 833 of 984 (84.7%) were non-Hispanic, and 685 of 974 (70.3%) were White. A total of 282 of 712 participants (39.6%) in the COVID-19-positive group and 147 of 275 participants (53.5%) in the COVID-19-negative group reported persistently poor physical, mental, or social well-being at 3-month follow-up. After adjustment, improvements in well-being were statistically and clinically greater for participants in the COVID-19-positive group vs the COVID-19-negative group only for social participation (β = 3.32; 95% CI, 1.84-4.80; P < .001); changes in other well-being domains were not clinically different between groups. Improvements in well-being in the COVID-19-positive group were concentrated among participants aged 18 to 34 years (eg, social participation: β = 3.90; 95% CI, 1.75-6.05; P < .001) and those who presented for COVID-19 testing in an ambulatory setting (eg, social participation: β = 4.16; 95% CI, 2.12-6.20; P < .001).

CONCLUSIONS AND RELEVANCE: In this study, participants in both the COVID-19-positive and COVID-19-negative groups reported persistently poor physical, mental, or social well-being at 3-month follow-up. Although some individuals had clinically meaningful improvements over time, many reported moderate to severe impairments in well-being 3 months later. These results highlight the importance of including a control group of participants with negative COVID-19 results for comparison when examining the sequelae of COVID-19.

PMID:36454572 | DOI:10.1001/jamanetworkopen.2022.44486

JAMA Netw Open. 2022 Dec 1;5(12):e2244505. doi: 10.1001/jamanetworkopen.2022.44505.

ABSTRACT

IMPORTANCE: SARS-CoV-2, which causes COVID-19, poses considerable morbidity and mortality risks. Studies using data collected during routine clinical practice can supplement randomized clinical trials to provide needed evidence, especially during a global pandemic, and can yield markedly larger sample sizes to assess outcomes for important patient subgroups.

OBJECTIVE: To evaluate the association of remdesivir treatment with inpatient mortality among patients with COVID-19 outside of the clinical trial setting.

DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study in US hospitals using health insurance claims data linked to hospital chargemaster data from December 1, 2018, to May 3, 2021, was conducted among 24 856 adults hospitalized between May 1, 2020, and May 3, 2021, with newly diagnosed COVID-19 who received remdesivir and 24 856 propensity score-matched control patients.

EXPOSURE: Remdesivir treatment.

MAIN OUTCOMES AND MEASURES: All-cause inpatient mortality within 28 days of the start of remdesivir treatment for the remdesivir-exposed group or the matched index date for the control group.

RESULTS: A total of 24 856 remdesivir-exposed patients (12 596 men [50.7%]; mean [SD] age, 66.8 [15.4] years) and 24 856 propensity score-matched control patients (12 621 men [50.8%]; mean [SD] age, 66.8 [15.4] years) were included in the study. Median follow-up was 6 days (IQR, 4-11 days) in the remdesivir group and 5 days (IQR, 2-10 days) in the control group. There were 3557 mortality events (14.3%) in the remdesivir group and 3775 mortality events (15.2%) in the control group. The 28-day mortality rate was 0.5 per person-month in the remdesivir group and 0.6 per person-month in the control group. Remdesivir treatment was associated with a statistically significant 17% reduction in inpatient mortality among patients hospitalized with COVID-19 compared with propensity score-matched control patients (hazard ratio, 0.83 [95% CI, 0.79-0.87]).

CONCLUSIONS AND RELEVANCE: In this retrospective cohort study using health insurance claims and hospital chargemaster data, remdesivir treatment was associated with a significantly reduced inpatient mortality overall among patients hospitalized with COVID-19. Results of this analysis using data collected during routine clinical practice and state-of-the-art methods complement results from randomized clinical trials. Future areas of research include assessing the association of remdesivir treatment with inpatient mortality during the circulation of different variants and relative to time from symptom onset.

PMID:36454570 | DOI:10.1001/jamanetworkopen.2022.44505

Pathology. 2022 Oct 13:S0031-3025(22)00270-7. doi: 10.1016/j.pathol.2022.08.004. Online ahead of print.

ABSTRACT

Primary appendiceal adenocarcinoma (APCA), goblet cell adenocarcinoma (GCA), and low/high-grade appendiceal mucinous neoplasms (LAMN/HAMN) are distinct entities with overlapping clinical presentation and histomorphology, leading to diagnostic challenges. We retrospectively reviewed our archived cases between 2010 and 2018 for diagnosis reappraisal and comparative analysis using updated terminology and modern parameters. A total of 87 cases (22 APCA, 40 GCA, and 25 LAMN pT≥3) were included. The entire cohort had 49 women and 38 men with a median age of 59.9 (range 26-88) years. There were no statistically significant differences in age and sex among the three groups. Clinically, patients with GCA were more likely to present with acute appendicitis (65%) and more likely to have appendectomy as initial surgery (68%). Both APCA and GCA were more likely to involve the proximal appendix while LAMN was more likely to involve the distal appendix (p<0.05). All APCAs were associated with mucosal precursor lesions, most commonly tubular, tubulovillous, or villous adenoma, flat LAMN/HAMN-pTis mucinous epithelium, or mixed, which correlated with distinct histomorphology, tumour differentiation, and stage. Although polypoid precursor lesions were rare in GCA, a significant proportion of GCA showed crypt atypia associated with neoplastic cells. Immunohistochemically, APCA had more frequent β-catenin nuclear positivity and loss of SATB2 expression (p<0.05). KRAS mutation was more common in APCA than in GCA (8/11 vs 1/7, p<0.01). We further validated the three-tiered grading system (G1, G2, G3) in GCA, which correlated well with tumour stage and patient survival. APCA had worse progression-free and disease-specific survivals than GCA and LAMN (pT≥3) with the latter being relatively indolent even when perforated with peritoneal spread. Our study is the first comprehensive comparison between all three appendiceal neoplasms. We also describe a spectrum of previously under-recognised crypt atypia in GCA, which should trigger a diligent search for GCA if present.

PMID:36454563 | DOI:10.1016/j.pathol.2022.08.004