Category: Nevin Manimala

PLoS One. 2022 Apr 18;17(4):e0267088. doi: 10.1371/journal.pone.0267088. eCollection 2022.

ABSTRACT

BACKGROUND: To compare intravitreal aflibercept injection with intravitreal ranibizumab injection for the risk of major arterial thromboembolic events (ATEs) and glaucoma.

METHODS: This retrospective, nationwide cohort study investigated 15 611 and 3867 patients aged >50 years with at least one pharmacy claim for intravitreal ranibizumab injection and aflibercept injection between 2011 and 2016, respectively. The inverse probability of treatment weighting method was performed to adjust the baseline difference between the two groups and the hazard risk of adverse events was estimated using the Cox proportional regression model.

RESULTS: No significant difference was noted between intravitreal ranibizumab and aflibercept injection for arterial thromboembolic risk, including ischemic stroke and acute myocardial infarction, during a 2-year follow-up (adjusted hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.53-1.42; P = .583). Subgroup analyses revealed that patients age >65 years (adjusted HR: 0.64, 95% CI: 0.45-0.92) and those without coronary artery disease (adjusted HR: 0.59, 95% CI: 0.37-0.95) had significantly lower arterial thromboembolic risk in the aflibercept group than in the ranibizumab group. Additionally, the risk of glaucoma development after intravitreal injection did not significantly differ between the two groups (adjusted HR: 0.63, 95% CI: 0.37-1.06; P = .084).

CONCLUSIONS: No significant differences in the risk of major ATEs and glaucoma were found between ranibizumab and aflibercept, and aflibercept might be safe for use in elderly patients.

PMID:35436315 | DOI:10.1371/journal.pone.0267088

PLoS One. 2022 Apr 18;17(4):e0267279. doi: 10.1371/journal.pone.0267279. eCollection 2022.

ABSTRACT

BACKGROUND: The issue of whether to include seasonal influenza vaccinations in school-located vaccination programs (SLIV) has been examined in many countries, mainly in the context of economic effectiveness and morbidity prevention. Yet not enough studies have examined the impact of parental risk perceptions, health literacy and SLIV on parental vaccination uptake.

OBJECTIVES: The most recent statistics in Israel point to a higher rate of seasonal influenza vaccination among Arab children (aged 7-9 years) than among Jewish children in the same age group. The present study attempts to explain this high vaccination uptake among mothers from Arab society by comparing their risk perceptions regarding seasonal influenza vaccination and disease to those of Jewish mothers. The study further examines the impact of SLIV on parental risk perceptions and influenza vaccination uptake.

METHODS: This cross-sectional study included mothers of children in the second and third grades faced with the decision of whether their children should receive the seasonal influenza vaccination at school. The study population included a stratified sample of Jewish mothers (n = 159) and Arab mothers from all the Arab population sub-groups: Muslim, Christian, Druse and Bedouin (n = 534).

RESULTS: A comparison of the Arab and Jewish populations revealed a significant difference in vaccination rates; 61.7% among Arab mothers compared to 33.5% among Jewish mothers (χ2(1) = 39.15, P<0.0001). Moreover, significant differences emerged between the Arab and Jewish populations in health literacy and ability to seek information regarding the seasonal influenza vaccination (t (691) = -5.81, p < 0.0001). While no differences emerged in mothers’ perceptions regarding influenza as a disease (t (691) = 1.20, p = 0.2318), Arab mothers perceived the vaccination to be safer than Jewish mothers (t (691) = 2.74, p = 0.0063) and saw its inclusion in the school-located vaccination program as providing more legitimacy (Z = -6.6719, P < .0001).

CONCLUSION: This study showed that the factors influencing vaccination uptake among both the Arab and the Jewish populations include perceived influenza risk, perceived vaccination risk, inclusion in the school-located vaccination program and health literacy. Moreover, influenza vaccination uptake is higher among those who have positive attitudes toward vaccinations, low risk perceptions regarding the vaccine, and low health literacy that impedes their ability to seek information. The research also points to the need for education and tools to boost health literacy among minority groups so that mothers can make independent and informed decisions about whether or not to vaccinate their children.

PMID:35436312 | DOI:10.1371/journal.pone.0267279

PLoS One. 2022 Apr 18;17(4):e0267270. doi: 10.1371/journal.pone.0267270. eCollection 2022.

ABSTRACT

BACKGROUND: Paracetamol is widely used to manage fever and pain during pregnancy worldwide. However, paracetamol may affect the pregnant woman and fetus, once this drug crosses the placental barrier after therapeutic doses and may impair fetal liver function, affecting fetus growth and development. Thus, this study aimed to investigate the association between paracetamol use during pregnancy and perinatal outcomes as preterm birth, low birth weight, and small for gestational age.

METHODS AND FINDINGS: Data from 760 pregnant women within the NISAMI Cohort between June 2012 and February 2014 were analyzed. Logistic regression was used to estimate the association among paracetamol use during pregnancy and preterm birth, low birth weight, and small for gestational age. Multivariate analyses were adjusted for socioeconomic, maternal, pregnancy, and newborn covariates. Around 14% of women were exposed to paracetamol during pregnancy. A decrease in paracetamol use throughout pregnancy was observed. Lower risk of low birth weight in infants born to women exposed to the drug (OR 0.21; IC 95% 0.01-0.99) was found. Paracetamol use during pregnancy was not statistically associated with preterm birth or small for gestational age.

CONCLUSIONS: The findings of this study do not suggest an increased risk of perinatal outcomes. However, it should not be assumed that paracetamol is a risk-free medication and its use must be rational.

PMID:35436308 | DOI:10.1371/journal.pone.0267270

PLoS One. 2022 Apr 18;17(4):e0267000. doi: 10.1371/journal.pone.0267000. eCollection 2022.

ABSTRACT

BACKGROUND: Despite efforts to contain the spread of COVID-19, Addis Ababa, the country’s COVID-19 epicenter, is experiencing a sharp increase in the number of cases and death rate. While poor public adherence to COVID-19 precautionary practices is evident, factors associated with it are not well studied. We aimed to assess the level of practice of COVID-19 precaution and associated factors.

METHODS: This was a hospital-based cross-sectional study conducted from February 1st to 15th, 2021 at Saint Paul’s Hospital Millennium Medical College, a tertiary teaching hospital in Addis Ababa, Ethiopia. We used a structured questionnaire to conduct a face-to-face exit interview with clients visiting the hospital. Systematic random sampling was employed to recruit study participants. Binary and multivariable logistic regressions were implemented to examine factors associated with precautionary practices. Statistical significance was declared at p-value <0.05. The Crude odds ratio (COR) and Adjusted odds ratio (AOR) were reported with a 95% confidence interval.

RESULTS: We analyzed data obtained from 262 participants. The mean age of participants was 36 (SD+12) years. The majority (207, 79%) of the study participants had a favorable attitude towards prevention and control measures of COVID-19. A little over half (116, 55.7%) of the respondents had a satisfactory level of practice of COVID-19 precautions. Living in an area with strict enforcement of COVID-19 precautionary measures [AOR: 2.25, 95% CI (1.22-4.15)], and having a favorable attitude of COVID-19 prevention [AOR: 4.88, 95% CI (2.08-11.68)] were significantly associated with satisfactory COVID-19 precautionary practices.

CONCLUSIONS: The level of practice of COVID-19 precaution was unsatisfactory. Favorable attitude and stricter enforcement of COVID-19 preventive measures might have contributed more to adherence to precautionary practices. The findings highlight the need for a public health education strategy targeted at improving attitudes of the community on COVID-19 focusing on the effectiveness of preventive measures.

PMID:35436310 | DOI:10.1371/journal.pone.0267000

PLoS One. 2022 Apr 18;17(4):e0263745. doi: 10.1371/journal.pone.0263745. eCollection 2022.

ABSTRACT

This study investigated the influence of tourism on sustainable development while considering institutional quality as a moderating variable. Moreover, exchange rate, urbanization, household consumption, per capita income and renewable energy per capita were also essential factors in determining sustainable development. The sample consists of 64 Belt and Road Initiative (BRI) countries from 2003-2018. The outcomes of the two-step system GMM confirmed the statistically significant and positive dynamic nature of sustainable development and its relationship with tourism and other determinants at a significance level of 1% for BRI countries. Institutional quality enhanced the 4.693% sustainability path to achieve the sustainable development goals (SDGs) agenda with regionally interconnected countries at significance level of 1%. Renewable energy per-capita and income per-capita played a significant and positive role, while the exchange rate, household consumption, and urbanization negatively influenced by hurting thd path of sustainable development. The current research findings have valuable contributions to academics as it offers novel insights about the 0. 351% influence of tourism on sustainable development at significance level of 1%, and it proposes valued suggestions to policymakers concerning tourism development strategies.

PMID:35436304 | DOI:10.1371/journal.pone.0263745

Pol Merkur Lekarski. 2022 Apr 19;50(296):99-101.

ABSTRACT

The respiratory tract disease exacerbated by non-steroidal antiinflammatory drugs (NSAIDs) is characterized by the Widal triad, which includes the presence of bronchial asthma, hypersensitivity to NSAIDs (acetylsalicylic acid) and chronic eosinophilic rhinitis and sinusitis (frequently also coincident with nasal polyps). Idiosyncratic hypersensitivity to NSAIDs in the course of bronchial asthma affects approximately 15% of patients.

AIM: The aim of the study is to assess depressiveness and severity of anxiety in the population of patients with partially and poorly controlled asthma.

MATERIALS AND METHODS: A group of 48 patients with partially and poorly controlled bronchial asthma without hypersensitivity to NSAIDs was selected, as well as 42 patients with partially and poorly controlled bronchial asthma hypersensitive to NSAIDs. All the patients underwent an asthma control test. To assess depression, the Beck Depression Scale – BDI II was used. When assessing anxiety as a trait and anxiety as a state, the Spielberger’s STAI – State and Trait Anxiety Inventory – was used.

RESULTS: The mean age in the group with no hypersensitivity to NSAIDs was 51 +/- 15 years and did not differ with statistical significance from the group of patients hypersensitive to NSAIDs, where it was 50 +/- 14 years. The mean level of depression in the group without hypersensitivity was 15 +/- 9, and in the hypersensitivity group 23 +/- 8 and the difference reached the level of statistical significance p<0.005. Moreover, anxiety as a state was lower in the group without hypersensitivity compared to the group with hypersensitivity (the result expressed in sten scores: 6 +/- 2 versus 7 +/-2, p<0.001). Anxiety as a trait was 5 +/- 2 in both groups and there was no inter-group difference.

CONCLUSIONS: Subjects with partially and poorly controlled bronchial asthma and hypersensitivity to NSAIDs have a higher severity of depression and anxiety compared to those with partially and poorly controlled asthma without hypersensitivity to NSAIDs. In that group, anxiety as a state is also greater than in the group without hypersensitivity to NSAIDs.

PMID:35436271

Pol Merkur Lekarski. 2022 Apr 19;50(296):109-113.

ABSTRACT

AIM: The aim of the research involved determination of catalase and superoxide dismutase content in oral fluid of patients exposed to occupational vibration depending upon their dental status.

MATERIALS AND METHODS: The assessment of dental status (DS) and superoxide dismutase (SOD) and catalase (CAT) content in oral fluid (OF) was performed in three groups of patients: control group (n0=129) included the persons exposed to occupational vibration and whose results of combined medical examination excluded the presence of vibration disease (VD); the second (n1=63 patients with VD stage I) and the third (n1=66 patients with VD stage II) groups consisted of the patients, who underwent treatment at the clinical department of the Research Institute of Occupational Hygiene and Occupational Diseases of Kharkiv National Medical University of the Ministry of Health of Ukraine. DS determination was carried out according to the method of K. M. Kosenko (Patent No. 57512, Ukraine) for in-patients and controls (during medical checkups) using the following indices: PMA, OHI-S, DMFT, with assessment of vacuum-pressory resistance of gingival capillaries (VPRC) (according to V. I. Kulazhenko) and community periodontal index of treatment needs (CPITN). SOD content was determined by the nonenzymatic method; CAT content was revealed spectrophotometrically. Primary data were statistically processed with the determination of accuracy by Student’s test.

RESULTS: SOD content depending upon PMA intensity in VD patients ranged from 14.1±0.2 U/min to 15.7±0.5 U/min , was reliably (p<0.05) lower in patients with VD versus the controls (17.8±0.2 U/min and 14.2±0.2 U/min respectively, when PMA>2.1) and did not differ depending upon VD severity (15.7±0.5 U/min in VD stage I and 15.3±0.3 U/min in VD stage II, respectively). SOD content in OF in patients depending upon their OHI-S ranged from 13.5±0.3 U/min to 16.3±0.2 U/min and was reliably (p<0.05) lower in patients with OHI-S≥1.7 U. A comparative analysis showed that the activity of the enzymatic protection of the periodontal membrane could be also determined by the state of hard tissues, in particular by such DS index as DFTM. The activity of SOD in VD stage II was found to be reliably (p<0.05) reduced in patients with DFTM index exceeding 15 pts. A somewhat different pattern of SOD activity was found in OF in patients with VD stage I: SOD activity in OF was similar in all DFTM indices and it became reduced depending upon an increase of DFTM index. SOD content depending upon VPRC index in patients with VD ranged from 10.7±0.5 U/min to 16.8±0.3 U/min and was reliably (p<0.05) lower in cases with VPRC index ≤40 sec. CAT content depending upon PMA intensity in VD patients ranged from 4.6±0.4 U/min to 11.3±0.3 U/min and was reliably (p<0.05) higher in patients with VD stage I versus the controls and differed according to the severity. CAT content in OF in patients depending upon OHI-S ranged from 5.2±0.2 U/min to 10.1±0.3 U/min, was reliably (p<0.05) lower in cases with OHI-S ≥1.7 U, did not differ from the indices observed in the control group and was also found to be reliably lower in patients with VD stage II versus those with VD stage I (7.3±0.3 U/min and 8.6±0.2 U/min, respectively, when OHI-S ranged within 0.7÷1.6 U). CAT content in OF depending upon VPSC index in patients with VD ranged from 5.8±0.2 U/min to 8.6±0.6 U/min and was reliably (p<0.05) lower in cases with VPSC index ≤40 sec. Thus, CAT activity in OF in patients was reliably (p<0.05) reduced (in VPRC>40 sec it was equal to 7.8±0.2 U/min, and in VPRC≤40 sec it was 8.6±0.1 U/ min) in VD stage I with decreased VPRC.

CONCLUSIONS: A trend (p>0.05) towards an increase in SOD activity in VD stage I versus the controls was revealed, whereas VD stage II demonstrated a reliable (p<0.05) reduction of the above activity. At the same time, an unsatisfactory state of oral hygiene was shown to promote inhibition of the enzymatic protection of their periodontal membrane in patients with VD stage I. A trend (p>0.05) towards an increase of SOD activity in VD stage I versus the controls was revealed, whereas VD stage II demonstrated a reliable (p<0.05) reduction of the above activity. The assessment carried out in cases requiring combined treatment with surgical or non-surgical debridement and also in patients with supraor subgingival dental calculus found out that SOD activity was reliably reduced only in cases with VD stage II. CAT activity assessment in OF in VD patients having different levels of CPITN showed that the above activity in persons requiring combined treatment (including prosthodontic treatment; CPITN≥3.1points) was markedly and reliably reduced. All the above facts determine peculiarities in oral treatment strategies for this group of patients.

PMID:35436273

JMIR Ment Health. 2022 Apr 14;9(4):e33450. doi: 10.2196/33450.

ABSTRACT

BACKGROUND: Technology is ever evolving, with more and more diverse activities becoming possible on screen-based devices. However, participating in a heavy screen-based lifestyle may come at a cost. Our hypothesis was that problematic social media use increased the prevalence of mental health outcomes.

OBJECTIVE: This study seeks to systematically examine problematic social media use in youth and its association with symptoms of depression, anxiety, and stress.

METHODS: A systematic search was conducted to identify studies in adolescents and young adults, using the databases Engineering Village, Psycinfo, Pubmed, and Web of Science. A total of 18 studies were identified, with a total of 9269 participants in our review and included in the meta-analysis.

RESULTS: Our metaregression shows moderate but statistically significant correlations between problematic social media use and depression (r=0.273, P<.001), anxiety (r=0.348, P<.001), and stress (r=0.313, P<.001). We did not find evidence of heterogeneity of these summary correlations by age, gender, or year of publication.

CONCLUSIONS: This study provides further evidence of the association between problematic social media use and negative mental health among adolescents and young adults and supports future research to focus on the underlying mechanisms of problematic use of social media.

TRIAL REGISTRATION: PROSPERO CRD42021222309; https://tinyurl.com/2p9y4bjx.

PMID:35436240 | DOI:10.2196/33450

J Med Internet Res. 2022 Apr 18;24(4):e35058. doi: 10.2196/35058.

ABSTRACT

BACKGROUND: Improving interprofessional communication and collaboration is necessary to facilitate the early identification and treatment of patients with sepsis. Preparing undergraduate medical and nursing students for the knowledge and skills required to assess, escalate, and manage patients with sepsis is crucial for their entry into clinical practice. However, the COVID-19 pandemic and social distancing measures have created the need for interactive distance learning to support collaborative learning.

OBJECTIVE: This study aimed to evaluate the effect of sepsis interprofessional education on medical and nursing students’ sepsis knowledge, team communication skills, and skill use in clinical practice.

METHODS: A mixed methods design using a 1-group pretest-posttest design and focus group discussions was used. This study involved 415 undergraduate medical and nursing students from a university in Singapore. After a baseline evaluation of the participants’ sepsis knowledge and team communication skills, they underwent didactic e-learning followed by virtual telesimulation on early recognition and management of sepsis and team communication strategies. The participants’ sepsis knowledge and team communication skills were evaluated immediately and 2 months after the telesimulation. In total, 4 focus group discussions were conducted using a purposive sample of 18 medical and nursing students to explore their transfer of learning to clinical practice.

RESULTS: Compared with the baseline scores, both the medical and nursing students demonstrated a significant improvement in sepsis knowledge (P<.001) and team communication skills (P<.001) in immediate posttest scores. At the 2-month follow-up, the nursing students continued to have statistically significantly higher sepsis knowledge (P<.001) and communication scores (P<.001) than the pretest scores, whereas the medical students had no significant changes in test scores between the 2-month follow-up and pretest time points (P=.99). A total of three themes emerged from the qualitative findings: greater understanding of each other’s roles, application of mental models in clinical practice, and theory-practice gaps. The sepsis interprofessional education-particularly the use of virtual telesimulation-fostered participants’ understanding and appreciation of each other’s interprofessional roles when caring for patients with sepsis. Despite noting some incongruities with the real-world clinical practice and not encountering many sepsis scenarios in clinical settings, participants shared the application of mental models using interprofessional communication strategies and the patient assessment framework in their daily clinical practice.

CONCLUSIONS: Although the study did not show long-term knowledge retention, the use of virtual telesimulation played a critical role in facilitating the application of mental models for learning transfer and therefore could serve as a promising education modality for sepsis training. For a greater clinical effect, future studies could complement virtual telesimulation with a mannequin-based simulation and provide more evidence on the long-term retention of sepsis knowledge and clinical skills performance.

PMID:35436237 | DOI:10.2196/35058

J Med Internet Res. 2022 Apr 14;24(4):e35614. doi: 10.2196/35614.

ABSTRACT

BACKGROUND: The use of digital interventions can be accurately monitored via log files. However, monitoring engagement with intervention goals or enactment of the actual behaviors targeted by the intervention is more difficult and is usually evaluated based on pre-post measurements in a controlled trial.

OBJECTIVE: The objective of this paper is to evaluate if engaging with 2 digital intervention modules focusing on (1) physical activity goals and action plans and (2) coping with barriers has immediate effects on the actual physical activity behavior.

METHODS: The NoHoW Toolkit (TK), a digital intervention developed to support long-term weight loss maintenance, was evaluated in a 2 x 2 factorial randomized controlled trial. The TK contained various modules based on behavioral self-regulation and motivation theories, as well as contextual emotion regulation approaches, and involved continuous tracking of weight and physical activity through connected commercial devices (Fitbit Aria and Charge 2). Of the 4 trial arms, 2 had access to 2 modules directly targeting physical activity: a module for goal setting and action planning (Goal) and a module for identifying barriers and coping planning (Barriers). Module visits and completion were determined based on TK log files and time spent in the module web page. Seven physical activity metrics (steps; activity; energy expenditure; fairly active, very active and total active minutes; and distance) were compared before and after visiting and completing the modules to examine whether the modules had immediate or sustained effects on physical activity. Immediate effect was determined based on 7-day windows before and after the visit, and sustained effects were evaluated for 1 to 8 weeks after module completion.

RESULTS: Out of the 811 participants, 498 (61.4%) visited the Goal module and 406 (50.1%) visited the Barriers module. The Barriers module had an immediate effect on very active and total active minutes (very active minutes: before median 24.2, IQR 10.4-43.0 vs after median 24.9, IQR 10.0-46.3; P=.047; total active minutes: before median 45.1, IQR 22.9-74.9 vs after median 46.9, IQR 22.4-78.4; P=.03). The differences were larger when only completed Barriers modules were considered. The Barriers module completion was also associated with sustained effects in fairly active and total active minutes for most of the 8 weeks following module completion and for 3 weeks in very active minutes.

CONCLUSIONS: The Barriers module had small, significant, immediate, and sustained effects on active minutes measured by a wrist-worn activity tracker. Future interventions should pay attention to assessing barriers and planning coping mechanisms to overcome them.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328.

PMID:35436232 | DOI:10.2196/35614