Category: Nevin Manimala

Hum Psychopharmacol. 2022 Nov 24:e2858. doi: 10.1002/hup.2858. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of solriamfetol, a dopamine and norepinephrine reuptake inhibitor, on on-the-road driving performance in participants with narcolepsy.

METHODS: In this randomised, double-blind, placebo-controlled, crossover study, driving performance during a 1 h on-road driving test was assessed at 2 and 6 h post-dose following 7 days of treatment with solriamfetol (150 mg/day for 3 days, followed by 300 mg/day for 4 days) or placebo. The primary endpoint was standard deviation of lateral position (SDLP) at 2 h post-dose.

RESULTS: The study included 24 participants (54% male; mean age, 40 years); 22 had evaluable SDLP data. At 2 h post-dose, median SDLP was significantly lower (improved) with solriamfetol compared with placebo (19.08 vs. 20.46 cm [median difference, -1.9 cm], p = 0.002). Four participants on solriamfetol and 7 on placebo had incomplete driving tests. At 6 h post-dose, median SDLP was not statistically significantly different with solriamfetol compared with placebo (19.59 vs. 19.78 cm [median difference, -1.1 cm], p = 0.125). Three participants on solriamfetol and 10 on placebo had incomplete driving tests. Common adverse events (≥5%) included headache, decreased appetite, and somnolence.

CONCLUSIONS: Solriamfetol 300 mg/day improved on-the-road driving performance, at 2 h post-administration in participants with narcolepsy.

PMID:36420633 | DOI:10.1002/hup.2858

Artif Organs. 2022 Nov 24. doi: 10.1111/aor.14465. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) became an accepted therapy for the treatment of severe acute respiratory distress syndrome and chronic obstructive pulmonary disease. However, ECMO systems are still prone to thrombus formation and decrease of gas exchange over time. Therefore, it is necessary to conduct qualified studies to identify parameters for optimization of ECMO systems, and especially the oxygenator. However, commercially marketed oxygenators are not always appropriate and available for certain research use cases. Therefore, we aimed to design an oxygenator, which is suitable for various test conditions such as blood tests, numerical simulation, and membrane studies, and can be modified in membrane area size and manufactured in laboratory.

METHODS: Main design criteria are a homogeneous blood flow without stagnation zones, low pressure drop, manufacturability in the lab, size variability with one set of housing parts and cost-efficiency. Our newly designed oxygenator was tested comparatively regarding blood cell damage, gas transfer performance and pressure drop to prove the validity of the design in accordance with a commercial device.

RESULTS: No statistically significant difference between the tested oxygenators was detected and our new oxygenator demonstrated sufficient hemocompatibility. Furthermore, our variable oxygenator has proven that it can be easily manufactured in the laboratory, allows to use various membrane fiber configurations and can be reopened easily and non-destructively for analysis after use, and the original geometry is available for numerical simulations.

CONCLUSION: Therefore, we consider this newly developed device as a valuable tool for basic experimental and numerical research on the optimization of oxygenators.

PMID:36420613 | DOI:10.1111/aor.14465

Scand J Med Sci Sports. 2022 Nov 24. doi: 10.1111/sms.14278. Online ahead of print.

ABSTRACT

The purpose was to investigate effect of a school-based physical activity (PA)-intervention among 11-and 12-year-olds (6^th – and 7^th graders) across four years. Seven primary schools in Horten municipality in Norway received 45 minutes daily extra PA as part of the curriculum. The intervention started in 2015 with follow-up in 2016 to 2019. The effect was measured after one to four years of participation, among the same children (6^th – to 7^th -grade) and among new children starting in 6^th grade. Two control schools received no additional PA beyond the regular PA at school. The Self-reported Strength and Difficulties Questionnaire (SDQ-S) focusing on internalizing and externalizing difficulties were administrated. A statistical model for repeated measurements was used and adjusted for parents’ educational level, sex, age, and waist-to-height ratio (WHtR). The significance level was p≤0.01. In total, 1221 children completed the SDQ-S. SDQ-S scores were stable, and difficulties were relatively low. The control group had significantly lower SDQ-S scores than the intervention group at start, indicating fewer difficulties. The adjusted effect within the intervention schools showed a borderline significant increase in total difficulty score between 2018 and 2019 (mean difference: 1.02, 95%CI: (-1.82, -0.23, p 0.01). Educational level showed a weak negative correlation with total difficulty score (r=-0.1). No significant change was reported within the control schools. Few psychosocial health problems among 11- and 12-year-olds were detected. The borderline increase in total difficulty score that that was seen for the intervention schools, is believed to be of limited clinical relevance.

PMID:36420609 | DOI:10.1111/sms.14278

Vet Surg. 2022 Nov 24. doi: 10.1111/vsu.13913. Online ahead of print.

ABSTRACT

OBJECTIVE: To document variations in the application of equine prosthetic laryngoplasty among equine surgeons.

STUDY DESIGN: Cross-sectional survey.

SAMPLE POPULATION: Six hundred and seventy-eight equine surgeons performing prosthetic laryngoplasty.

METHODS: An online questionnaire was sent to equine surgeons, including diplomates of the American College of Veterinary Surgeons and European College of Veterinary Surgeons. Questions focused on participant profile, surgical technique, antimicrobial therapy, and concurrent procedures. Descriptive statistical analysis was performed on the survey output.

RESULTS: Complete responses were received from 128/678 individuals, mostly from experienced surgeons. Most participants used 2 prostheses (106/128, 82.8%) and a single loop was the most common method used to anchor the prosthesis in the cricoid (95/128, 74.2%) and arytenoid (125/128, 97.7%) cartilages. Use of general anesthesia was common, although 46/128 (35.9%) participants now performed most laryngoplasty surgery with standing sedation. The material used as a prosthesis varied among surgeons, although participants typically aimed to achieve grade 2 intraoperative arytenoid abduction. Participants most commonly administered perioperative systemic antimicrobial therapy for 1-3 days (57/128, 44.5%) and 48/128 (37.5%) used local antimicrobial therapy.

CONCLUSION: Most surgeons performed laryngoplasty with 2 prostheses, a single loop construct at the muscular process of the arytenoid cartilage and systemic antimicrobial therapy. There was variation in the preferred method of surgical restraint, prosthesis material selection, and use of local antimicrobial therapy.

CLINICAL SIGNIFICANCE: Long-established techniques remain popular in clinical practice despite evidence that variations offer advantages, particularly in relation to biomechanics. Other factors are also likely to influence technique selection in a clinical context.

PMID:36420588 | DOI:10.1111/vsu.13913

Korean J Intern Med. 2022 Nov 24. doi: 10.3904/kjim.2022.084. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Secondary infection with influenza virus occurs in critically ill patients and is associated with substantial morbidity and mortality; however, there is limited information about it in patients with severe coronavirus disease 2019 (COVID-19). Thus, we investigated the clinical outcomes of and risk factors for secondary infections in patients with severe COVID-19.

METHODS: This study included patients with severe COVID-19 who were admitted to seven hospitals in South Korea between February 2020 to February 2021. Multivariate logistic regression analyses were performed to assess factors associated with the risk of secondary infections.

RESULTS: Of the 348 included patients, 104 (29.9%) had at least one infection. There was no statistically significant difference in the 28-day mortality (17.3% vs. 12.3%, p = 0.214), but in-hospital mortality was higher (29.8% vs. 15.2%, p = 0.002) in the infected group than in the non-infected group. The risk factors for secondary infection were a high frailty scale (odds ratio [OR], 1.314; 95% confidence interval [CI], 1.123 to 1.538; p = 0.001), steroid use (OR, 3.110; 95% CI, 1.164 to 8.309; p = 0.024), and the application of mechanical ventilation (OR, 4.653; 95% CI, 2.533 to 8.547; p < 0.001).

CONCLUSIONS: In-hospital mortality was more than doubled in patients with severe COVID-19 and secondary infections. A high frailty scale, the use of steroids and application of mechanical ventilation were risk factors for secondary infection.

PMID:36420564 | DOI:10.3904/kjim.2022.084

Korean J Intern Med. 2022 Nov 24. doi: 10.3904/kjim.2022.283. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The Korean Diabetes Association (KDA) guidelines recommend adults aged ≥ 40 years and adults aged ≥ 30 years with diabetes risk factors for diabetes screening. This study aimed to determine the age threshold for diabetes screening in Korean adults.

METHODS: This study was based on the analyses of Korean adults aged ≥ 20 years using the Korea National Health and Nutrition Examination Survey (KNHANES) and the National Health Insurance Service-National Sample Cohort (NHIS-NSC). To evaluate screening effectiveness, we calculated the number needed to screen (NNS).

RESULTS: NNS to detect diabetes decreased from 63 to 34 in the KNHANES and from 71 to 42 in the NHIS-NSC between the ages of 30-34 and 35-39. When universal screening was applied to adults aged ≥ 35, the NNS was similar to that of adults aged ≥ 40. Compared to the KDA guidelines, the rate of missed screening positive in adults aged ≥ 20 decreased from 4.0% to 0.2% when the newly suggested screening criteria were applied.

CONCLUSIONS: Universal screening for adults aged ≥ 35 and selective screening for adults aged 20 to 34, considering diabetes risk factors, may be appropriate for detecting prediabetes and diabetes in South Korea.

PMID:36420563 | DOI:10.3904/kjim.2022.283

Int J Biostat. 2022 Nov 24. doi: 10.1515/ijb-2022-0001. Online ahead of print.

ABSTRACT

This paper proposes a new flexible discrete triplet Lindley model that is constructed from the balanced discretization principle of the extended Lindley distribution. This model has several appealing statistical properties in terms of providing exact and closed form moment expressions and handling all forms of dispersion. Due to these, this paper explores further the usage of the discrete triplet Lindley as an innovation distribution in the simple integer-valued autoregressive process (INAR(1)). This subsequently allows for the modeling of count time series observations. In this context, a novel INAR(1) process is developed under mixed Binomial and the Pegram thinning operators. The model parameters of the INAR(1) process are estimated using the conditional maximum likelihood and Yule-Walker approaches. Some Monte Carlo simulation experiments are executed to assess the consistency of the estimators under the two estimation approaches. Interestingly, the proposed INAR(1) process is applied to analyze the COVID-19 cases and death series of different countries where it yields reliable parameter estimates and suitable forecasts via the modified Sieve bootstrap technique. On the other side, the new INAR(1) with discrete triplet Lindley innovations competes comfortably with other established INAR(1)s in the literature.

PMID:36420542 | DOI:10.1515/ijb-2022-0001

Clin Chem Lab Med. 2022 Nov 24. doi: 10.1515/cclm-2022-1126. Online ahead of print.

ABSTRACT

Lot-to-lot verification is an integral component for monitoring the long-term stability of a measurement procedure. The practice is challenged by the resource requirements as well as uncertainty surrounding experimental design and statistical analysis that is optimal for individual laboratories, although guidance is becoming increasingly available. Collaborative verification efforts as well as application of patient-based monitoring are likely to further improve identification of any differences in performance in a relatively timely manner. Appropriate follow up actions of failed lot-to-lot verification is required and must balance potential disruptions to clinical services provided by the laboratory. Manufacturers need to increase transparency surrounding release criteria and work closer with laboratory professionals to ensure acceptable reagent lots are released to end users. A tripartite collaboration between regulatory bodies, manufacturers, and laboratory medicine professional bodies is key to developing a balanced system where regulatory, manufacturing, and clinical requirements of laboratory testing are met, to minimize differences between reagent lots and ensure patient safety. Clinical Chemistry and Laboratory Medicine has served as a fertile platform for advancing the discussion and practice of lot-to-lot verification in the past 60 years and will continue to be an advocate of this important topic for many more years to come.

PMID:36420533 | DOI:10.1515/cclm-2022-1126

J Exerc Rehabil. 2022 Oct 26;18(5):308-317. doi: 10.12965/jer.2244376.188. eCollection 2022 Oct.

ABSTRACT

This study aims to examine the relationship between postural perfor-mance, physical fitness level, and shooting performance in Olympic fe-male goalball players. Eight Olympic-level goalball players (age: 20.63± 4.37 years) were recruited from the Turkish National Women’s Goalball Team. Postural stability, physical fitness, and shooting performance of the players were measured. The postural stability was determined us-ing body sway measurements during parallel and single-leg stances on a force plate. The physical fitness level of the players is evaluated by curl-up, isometric push-up, trunk lift, and grip strength (dominant hand) tests. A goalball-specific shooting accuracy test was used for shooting performance. Independent sample t-test and Pearson correlation were used for statistical processing. No statistical difference was observed in body sway parameters between open eyes and closed eyes condi-tions except for the anteroposterior sway area. Some of the body sway parameters performed under different stances positively correlated with all physical fitness tests (P<0.05). There was a positive correlation between the shooting accuracy and trunk lift score (r=0.767). Right leg sway area anterior-posterior and ellipse area negatively correlated with shooting accuracy (r=-0.629 and r=-0.692 respectively). It is necessary to attach importance to the improvement of the physical fitness level specific to core strength to maintain postural stability for visually im-paired athletes. In our study, some factors affecting shooting accuracy were identified, but it is necessary not to restrict a complex structure such as shooting accuracy within certain concepts.

PMID:36420474 | PMC:PMC9650316 | DOI:10.12965/jer.2244376.188

J Trop Med. 2022 Nov 14;2022:9190333. doi: 10.1155/2022/9190333. eCollection 2022.

ABSTRACT

Although the deworming program has been executed since 2000, the intestinal parasitic infection (IPI) rates among primary schoolchildren (PSC) in the two provinces of the Kingdom of Eswatini investigated in 2010 remained high, reaching 32.2%. In this study, we monitored the IPI status along with the associated risk factors for PSC in two provinces-Manzini and Lubombo. After consent from their parents/guardians, a total of 316 samples collected from PSC with grades 1 to 3 from four primary schools in Manzini and Lubombo were examined by the Merthiolate-Iodine-Formaldehyde (MIF) method. In addition, demographic characteristics and risk factors acquired by questionnaire surveys were included to be statistically analyzed. The overall prevalence was 40.5% (128/316), of which the infection rate in Manzini and Lubombo was 28.8% (19/66) and 58.3% (74/140), respectively. Pathogenic protozoa had the highest infection rate of 20.6% (65/316), including Entamoeba histolytica/dispar (8.5%, 27/316), Giardia duodenalis (14.6%, 46/316), and Blastocystis hominis (9.8%, 31/316). In terms of helminth infection, the infection rate was quite low, 1.6% only, and these five infected cases included four cases of Hymenolepis nana and one case of Enterobius vermicularis infection. Present study showed that 27.8% (88/316) of PSC were infected by more than one pathogenic parasite. Personal hygiene like washing hands before a meal has a significant protection effect (OR = 0.32, 95% CI = 0.14-0.75, p=0.009). Rain or well water and the type of water supply from which they drank also showed a considerable risk factor (OR = 2.44, 95% CI = 1.25-4.79, p=0.04). The IPI rate in PSC seems unlikely changed compared to that of the previous survey conducted in 2010, especially when the pathogenic protozoan infection rate remains high. Treatment of infected PSC with appropriate medication to reduce intestinal pathogenic protozoan infection should be seriously considered by Eswatini Health Authority.

PMID:36420456 | PMC:PMC9678472 | DOI:10.1155/2022/9190333