Category: Nevin Manimala

AIDS Behav. 2022 Nov 28. doi: 10.1007/s10461-022-03925-w. Online ahead of print.

ABSTRACT

This study used an intersectional approach to explore the association between enacted and internalized drug use and HIV stigma on HIV care outcomes among HIV-positive women who inject drugs in Ukraine. Surveys were conducted in Kyiv in 2019-2020. Among the 306 respondents, 55% were engaged in HIV care. More than half (52%) of participants not engaged in care reported internalized stigma related to both drug use and HIV status (i.e., intersectional stigma), compared to only 35% of those who were engaged in HIV care. Among those engaged in care, 36% reported intersectional enacted stigma compared to 44% of those not engaged in care; however, this difference was not statistically significant in the univariable analysis (p = 0.06). In the univariable analysis, participants who reported intersectional internalized stigma had 62% lower odds of being engaged in HIV care (OR 0.38, 95% CI 0.22, 0.65, p < 0.001). In the adjusted model, reported intersectional internalized stigma (aOR 0.52, 95% CI 0.30, 0.92, p = 0.026), reported intersectional enacted stigma (aOR 0.47, 95% CI 0.23, 0.95, p = 0.036), and knowing their HIV status for more than 5-years (aOR 2.29, 95% CI 1.35, 3.87, p = 0.002) were significant predictors of HIV care engagement. These findings indicate that interventions to improve HIV care engagement must address women’s experiences of both HIV and drug use stigma and the different mechanisms through which stigma operates.

PMID:36441406 | DOI:10.1007/s10461-022-03925-w

Curr Cardiol Rep. 2022 Nov 28. doi: 10.1007/s11886-022-01790-6. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Prior European Society of Cardiology (ESC) guidelines endorsed the SCORE 10-year cardiovascular disease (CVD) risk calculator to inform the total risk approach to CVD prevention, including the use of preventive interventions like lipid lowering therapies. However, SCORE was released in 2003, did not allow for estimation of fatal and non-fatal CVD events, and was limited to adults aged 40 to 70 years. The ESC’s Cardiovascular Risk Collaboration (CRC) was tasked with updating SCORE (SCORE2) and with extending the upper age range of adults eligible for risk estimation (SCORE2-OP). This review summarises these two deliverables.

RECENT FINDINGS: Published in 2021, these updated risk scores allow for estimation of 10 year total (fatal + non-fatal) risks of a first atherosclerotic cardiovascular event in adults (SCORE2) and older persons (SCORE2-OP), calibrated for use in four European risk regions. The models account for competing risk of non-CVD death. These were extensively validated with excellent calibration and C-statistics ranging from 0.67 to 0.81. SCORE2 and SCORE2-OP have informed the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. In addition to endorsing these two updated risk calculators, these guidelines have, for the first time, recommended the use of age-related risk categories. This change was motivated to prevent overreliance on age when making CVD prevention decisions.

PMID:36441402 | DOI:10.1007/s11886-022-01790-6

Child Psychiatry Hum Dev. 2022 Nov 28. doi: 10.1007/s10578-022-01468-8. Online ahead of print.

ABSTRACT

In recent years, in addition to its clinical importance, interest in the social-cognitive aspect of internet gaming disorder (IGD) has increased. This study aimed to investigate autistic traits, executive functions, and self-regulation abilities of patients with IGD. Eighty-seven male patients with IGD and eighty-three male healthy controls (HC) were included in the study. All patients were diagnosed with IGD as per the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders-5. Healthy controls without any comorbid psychiatric diagnosis were recruited from the community. The Brief Rating Inventory of Executive Function (BRIEF) and the Social Responsiveness Scale (SRS) were implemented to evaluate autistic traits, executive functions, and self-regulation skills. The Beck Depression Inventory (BDI), Screen for Child Anxiety and Related Disorders and Internet Gaming Disorder Scale-Short-Form were used to evaluate psychopathology. The effect size of the impairments in executive functions and self-regulation skills was large (Cohen’s d = 1.0-2.0). IGD groups had higher levels of autistic traits compared to healthy controls (d = 1.0-1.4). The differences in BDI and BRIEF scores remained significant in logistic regression analysis. Age at illness-onset, total severity of anxiety, and autistic traits were found as significant correlates of deficits in executive functions among patients with IGD. The results of this study supported the higher autistic traits and poorer executive function skills of patients with IGD. Deficits in executive functions were associated with autistic traits and younger age-onset of the illness.

PMID:36441375 | DOI:10.1007/s10578-022-01468-8

Wien Med Wochenschr. 2022 Nov 28. doi: 10.1007/s10354-022-00984-5. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the existence of internationally consistent guidelines for the management of pain, efficient regional anesthesia techniques, safe pain medications, and organizational structures, e.g., acute pain services, various studies have shown that pain is still common among both surgical and non-surgical in-patients.

OBJECTIVE: The primary objective of this study was to evaluate, on a multi-center basis, the point pain prevalence of surgical and non-surgical in-patients. We further analyzed pain intensities, in-hospital pain triggers, pain-related impairments, pain assessments, patient information about pain, and patient satisfaction with pain therapy. This benchmark information should lead to better implementation of pain management strategies and thus improve health care quality.

METHODS: We surveyed all adult in-patients in three general hospitals in Austria (general hospital Klagenfurt am Wörthersee, general hospital Villach, general hospital Wolfsberg) on the index day with two standardized questionnaires for both surgical and non-surgical patients.

RESULTS: Overall, a pain prevalence of 40.0%, with no statistically significant difference between surgical and non-surgical patients, was shown. Higher pain prevalence in female patients, high pain prevalence in the age group 18-30 years, and highest pain prevalence in the age group over 90 years old was found. Overall pain intensity was relatively low, but unacceptable maximum pain within the preceding 24 h was shown. Different in-hospital pain triggers like patient’s care and mobilization were found. Our survey has shown that pain has an impact on personal hygiene, mobilization, mood, sleep, and appetite. However, patients were very satisfied with their pain therapy.

CONCLUSION: Medical staff and nurses have to be sensitized to the urgent need to improve pain management strategies.

PMID:36441358 | DOI:10.1007/s10354-022-00984-5

Clin Physiol Funct Imaging. 2022 Nov 28. doi: 10.1111/cpf.12802. Online ahead of print.

ABSTRACT

INTRODUCTION: Higher blood pressure levels are associated with vascular dysfunction as early as childhood. Here we aim to compare two blood pressure devices for use in childhood populations within a school setting to screen for elevated blood pressure in children.

METHODS: Systolic and diastolic blood pressure, mean arteriolar pressure (MAP) as well as heart rate (HR) were measured with the validated Oscillomate 9002 and Mindray VS-900 in 82 randomly selected children between 10-12 years taking part in the EXAMIN YOUTH study in 2020. Measurements were performed after five minutes at rest in a sitting position in the school environment.

RESULTS: Both devices showed strong correlations for systolic (r = 0.62, t(80) = 7, p<0.001) and diastolic blood pressure (r = 0.73, t(80) = 9.52, p<0.001), MAP (r = 0.75, t(80) = 10.22, p<0.001) and HR (r = 0.89, t(79) = 17.77, p<0.001). There was no evidence for a statistically significant difference of both devices for systolic (110±9 mmHg vs. 111±9 mmHg, p=0.574), diastolic blood pressure (67±9 mmHg vs. 66±9 mmHg, p=0.301) as well as MAP (81±8 mmHg vs. 80±8 mmHg, p=0.400) and HR (83±12 BPM vs. 83±11 BPM, p=0.994).

DISCUSSION: Both devices, the older Oscillomate 9002 and the current Mindray VS-900 showed good agreement for the measurement of blood pressure in school children. It therefore appears to be feasible to measure childhood blood pressure with either device or replace one device with another in prospective long-term studies or screening programs as long as both are validated for use in children. This article is protected by copyright. All rights reserved.

PMID:36440618 | DOI:10.1111/cpf.12802

Biometrics. 2022 Nov 28. doi: 10.1111/biom.13807. Online ahead of print.

ABSTRACT

Copula is a popular method for modeling the dependence among marginal distributions in multivariate censored data. As many copula models are available, it is essential to check if the chosen copula model fits the data well for analysis. Existing approaches to testing the fitness of copula models are mainly for complete or right-censored data. No formal goodness-of-fit (GOF) test exists for interval-censored or recurrent events data. We develop a general GOF test for copula-based survival models using the information ratio (IR) to address this research gap. It can be applied to any copula family with a parametric form, such as the frequently used Archimedean, Gaussian, and D-vine families. The test statistic is easy to calculate, and the test procedure is straightforward to implement. We establish the asymptotic properties of the test statistic. The simulation results show that the proposed test controls the type-I error well and achieves adequate power when the dependence strength is moderate to high. Finally, we apply our method to test various copula models in analyzing multiple real datasets. Our method consistently separates different copula models for all these datasets in terms of model fitness. This article is protected by copyright. All rights reserved.

PMID:36440608 | DOI:10.1111/biom.13807

Vet Ophthalmol. 2022 Nov 28. doi: 10.1111/vop.13043. Online ahead of print.

ABSTRACT

OBJECTIVE: The objectives of the study were to compare intraocular pressure (IOP) readings across a wide range and obtained via three rebound tonometers in ADAMTS10-mutant Beagle-derived dogs with different stages of open-angle glaucoma (OAG) and normal control dogs and to investigate the effect of central corneal thickness (CCT).

ANIMALS STUDIED: Measurements were performed on 99 eyes from 50 Beagle-derived dogs with variable genetics-16 non-glaucomatous and 34 with ADAMTS10-OAG. Seventeen OAG eyes were measured twice-with and without the use of IOP-lowering medications.

PROCEDURES: IOP was measured in each eye using three tonometers with their “dog” setting-ICare® Tonovet (TV), ICare® Tonovet Plus® (TVP), and the novel Reichert® Tono-Vera® Vet (TVA)-in randomized order. CCT was measured with the Accutome® PachPen. Statistical analyses included one-way ANOVA, Tukey pairwise comparisons, and regression analyses of tonometer readings and pairwise IOP-CCT Pearson correlations (MiniTab®).

RESULTS: A total of 116 IOP measurements were taken with each of the three tonometers. When comparing readings over a range of ~7-77 mmHg, mean IOPs from the TV were significantly lower compared with TVP (-4.6 mmHg, p < .001) and TVA (-3.7 mmHg, p = .001). We found no significant differences between TVA and TVP measurements (p = .695). There was a moderate positive correlation between CCT and IOP for TVA (r = 0.53, p < .001), TVP (r = 0.48, p < .001), and TV (r = 0.47, p < .001).

CONCLUSIONS: Our data demonstrate strong agreement between TVP and TVA, suggesting that the TVA may similarly reflect true IOP values in canines. CCT influenced IOP measurements of all three tonometers.

PMID:36440595 | DOI:10.1111/vop.13043

Rev Esp Quimioter. 2022 Nov 28:suarez28nov2022. doi: 10.37201/req/107.2022. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate whether early vitamin C and thiamine administration was associated with a lower 28-day and in-hospital mortality in surgical critically ill patients with refractory septic shock.

METHODS: We performed a retrospective before-and-after study on patients with refractory septic shock. According to local protocol, hydrocortisone is initiated in case of refractory septic shock. In January 2017, the protocol was changed and vitamin C and thiamine were included. Patients who were admitted in 2015-2016 and 2017-2018 were included in the control and treatment groups, respectively. The primary end point was 28-day and in-hospital mortality. Secondary end points were ICU mortality, ICU and hospital length of stay, duration of vasopressors and mechanical ventilation, use of renal replacement therapy (RRT), and the modification in serum procalcitonin and SOFA score during the first 72 h.

RESULTS: A total of 120 patients were included (58 in the treatment group and 62 in the control group). Log-rank test in Kaplan-Meier curves showed lower 28-day and in-hospital mortality over time in the treatment group (p=0.021 and p=0.035, respectively) but it not reached statistical significance in ICU mortality over time (p=0.100). The need of RRT was less frequent in treatment group (17.2% vs. 37.1%, p=0.024). There were no differences in other secondary outcomes.

CONCLUSIONS: Intravenous vitamin C and thiamine administration in surgical patients with refractory septic shock may be associated with a lower 28-day and in-hospital mortality. Further prospective studies are needed in refractory septic shock.

PMID:36440551 | DOI:10.37201/req/107.2022

Cardiol Young. 2022 Nov 28:1-6. doi: 10.1017/S1047951122003626. Online ahead of print.

ABSTRACT

BACKGROUND: The transition from residency to paediatric cardiology fellowship is challenging due to the new knowledge and technical skills required. Online learning can be an effective didactic modality that can be widely accessed by trainees. We sought to evaluate the effectiveness of a paediatric cardiology Fellowship Online Preparatory Course prior to the start of fellowship.

METHODS: The Online Preparatory Course contained 18 online learning modules covering basic concepts in anatomy, auscultation, echocardiography, catheterisation, cardiovascular intensive care, electrophysiology, pulmonary hypertension, heart failure, and cardiac surgery. Each online learning module included an instructional video with pre-and post-video tests. Participants completed pre- and post-Online Preparatory Course knowledge-based exams and surveys. Pre- and post-Online Preparatory Course survey and knowledge-based examination results were compared via Wilcoxon sign and paired t-tests.

RESULTS: 151 incoming paediatric cardiology fellows from programmes across the USA participated in the 3 months prior to starting fellowship training between 2017 and 2019. There was significant improvement between pre- and post-video test scores for all 18 online learning modules. There was also significant improvement between pre- and post-Online Preparatory Course exam scores (PRE 43.6 ± 11% versus POST 60.3 ± 10%, p < 0.001). Comparing pre- and post-Online Preparatory Course surveys, there was a statistically significant improvement in the participants’ comfort level in 35 of 36 (97%) assessment areas. Nearly all participants (98%) agreed or strongly agreed that the Online Preparatory Course was a valuable learning experience and helped alleviate some anxieties (77% agreed or strongly agreed) related to starting fellowship.

CONCLUSION: An Online Preparatory Course prior to starting fellowship can provide a foundation of knowledge, decrease anxiety, and serve as an effective educational springboard for paediatric cardiology fellows.

PMID:36440543 | DOI:10.1017/S1047951122003626

Clin Physiol Funct Imaging. 2022 Nov 28. doi: 10.1111/cpf.12803. Online ahead of print.

ABSTRACT

BACKGROUND: Reduced field-of-view DWI could be proved to quantitatively identify thyroid papillary carcinoma and there is no literature regarding the use of T1-mapping to distinguish nodular goiter from thyroid papillary carcinoma.

PURPOSE: To compare T1-mapping with reduced field-of-view DWI in differentiating nodular goiter and thyroid papillary carcinoma.

STUDY TYPE: Prospective study.

POPULATIONS: Ninety-five hospitalized patients with thyroid nodules were were included into the research.

SEQUENCE: All subjects underwent T1WI, T2WI, reduced field-of-view DWI and T1-mapping sequences.

ASSESSMENT: ADC and T1 values of each thyroid nodule were measured respectively. According to pathological results, the thyroid nodules were divided into two groups: Group 1 (nodular goiter) and Group 2 (thyroid papillary carcinoma).

STATISTICAL TESTS: An independent sample t test was used to evaluate the differences of ADC and T1 between two groups. ROC curve was used to analyse the diagnostic efficiency of T1, ADC, Thyroid Imaging Reporting and Data System, T1&ADC.

RESULTS: The T1 and ADC values of nodular goiter were both higher than those of thyroid papillary carcinoma (P < 0.05). The AUC values of T1 & ADC were significantly higher than that of T1 or ADC alone (P < 0.05). The AUC value of T1 & ADC was as same as that of TI-RADS.

CONCLUSION: The combination of T1-mapping and reduced field-of-view DWI could effectively differentiate nodular goiter from thyroid papillary carcinoma. And it has at least the same diagnostic value as the ultrasound based TI-RADS classification. This article is protected by copyright. All rights reserved.

PMID:36440541 | DOI:10.1111/cpf.12803