Category: Nevin Manimala

J Phys Chem A. 2022 Nov 23. doi: 10.1021/acs.jpca.2c06438. Online ahead of print.

ABSTRACT

A full-dimensional global potential energy surface (PES) for the reaction ²³Na⁸⁷Rb + ²³Na⁸⁷Rb → ²³Na₂ + ⁸⁷Rb₂ was constructed based on high-level ab initio calculations. The short-range part was expressed as a permutation invariant polynomial-neural network (PIP-NN) fit of 22 003 ab initio points calculated using a coupled cluster method with the one-electron basis 5s5p5d2f plus effective core potentials and core polarizability potentials, while the long-range part was represented in an asymptotically correct form based on multipole expansion. The formation rate of the ²³Na₂⁸⁷Rb₂ complex calculated using a quantum statistical method is in good agreement with experiment, while the estimated 19.20 μs lifetime of the complex from Rice-Ramsperger-Kassel-Marcus (RRKM) theory is significantly shorter than the measured millisecond decay rate, signaling either the inadequacy of RRKM theory or a yet unresolved loss mechanism.

PMID:36417561 | DOI:10.1021/acs.jpca.2c06438

PLoS One. 2022 Nov 23;17(11):e0278101. doi: 10.1371/journal.pone.0278101. eCollection 2022.

ABSTRACT

BACKGROUND: Life expectancy (LE) is increasing all over the world, and relying on LE alone is no longer sufficient to identify whether a country is having a healthier population. Examining the increase in LE in relation to health – health expectancy estimation – is advised to ascertain the increase (or decrease) in LE without disability over time. This study examines the trends in health expectancy at age 60 in Bangladesh from 1996 to 2016.

METHODS: Mortality information from United Nations and World Health Organization and morbidity information from Bangladesh Bureau of Statistics were combined using the Sullivan method.

RESULTS: With an overall declining trend over the study period and a big drop in disability rates during 2012-2013, the disability rates were observed 1.6-1.7% in 2016. The declining trend in disability may have two-fold implications: (1) among the 98.3% older adults (≥60 years) with no severe/extreme disability, those were in jobs could have continued their work if there was no mandatory retirement at age 59, and (2) the 1.7% (translates into 0.2 million in 2020) older adults with severe/extreme disability require care assistance with their daily activities. The observed gain in disability-free life expectancy, the decrease in life expectancy with disability and its proportion allude to the compression of morbidity and healthier older adults over time.

CONCLUSION: In 2020, Bangladesh had 13.2 million (i.e., 8% of the total population) older adults, which is increasing day by day. The policy makers and government are suggested to prioritize the issues of older adults, particularly disability, care needs, retirement age, and health in the light of the current study’s findings. Utilizing health expectancy research is suggested to understand the combined effect of disability and mortality for considering policy changes.

PMID:36417472 | DOI:10.1371/journal.pone.0278101

PLoS Comput Biol. 2022 Nov 23;18(11):e1010724. doi: 10.1371/journal.pcbi.1010724. Online ahead of print.

ABSTRACT

BACKGROUND: Following rapidly rising COVID-19 case numbers, England entered a national lockdown on 6 January 2021, with staged relaxations of restrictions from 8 March 2021 onwards.

AIM: We characterise how the lockdown and subsequent easing of restrictions affected trends in SARS-CoV-2 infection prevalence.

METHODS: On average, risk of infection is proportional to infection prevalence. The REal-time Assessment of Community Transmission-1 (REACT-1) study is a repeat cross-sectional study of over 98,000 people every round (rounds approximately monthly) that estimates infection prevalence in England. We used Bayesian P-splines to estimate prevalence and the time-varying reproduction number (Rt) nationally, regionally and by age group from round 8 (beginning 6 January 2021) to round 13 (ending 12 July 2021) of REACT-1. As a comparator, a separate segmented-exponential model was used to quantify the impact on Rt of each relaxation of restrictions.

RESULTS: Following an initial plateau of 1.54% until mid-January, infection prevalence decreased until 13 May when it reached a minimum of 0.09%, before increasing until the end of the study to 0.76%. Following the first easing of restrictions, which included schools reopening, the reproduction number Rt increased by 82% (55%, 108%), but then decreased by 61% (82%, 53%) at the second easing of restrictions, which was timed to match the Easter school holidays. Following further relaxations of restrictions, the observed Rt increased steadily, though the increase due to these restrictions being relaxed was offset by the effects of vaccination and also affected by the rapid rise of Delta. There was a high degree of synchrony in the temporal patterns of prevalence between regions and age groups.

CONCLUSION: High-resolution prevalence data fitted to P-splines allowed us to show that the lockdown was effective at reducing risk of infection with school holidays/closures playing a significant part.

PMID:36417468 | DOI:10.1371/journal.pcbi.1010724

PLoS One. 2022 Nov 23;17(11):e0274043. doi: 10.1371/journal.pone.0274043. eCollection 2022.

ABSTRACT

BACKGROUND: Neutralizing monoclonal antibody (mAb) treatment for COVID-19 prevents hospitalization and death but is underused, especially in racial/ethnic minority and rural populations. Reasons for underuse and inequity may include community member lack of awareness or healthcare access barriers, among others. This study assessed mAbs community awareness and opportunities for improving equitable mAb access.

METHODS: A concurrent mixed methods study including surveys and focus groups with adults with high-risk conditions or their proxy decision-makers. Surveys and focus group guides addressed diffusion of innovation theory factors. Descriptive statistics and Fisher’s exact method was used to report and compare survey findings by race and ethnicity. Rapid qualitative methods were used for focus group analysis.

RESULTS: Surveys from 515 individuals (460 English, 54 Spanish, 1 Amharic), and 8 focus groups (6 English, 2 Spanish) with 69 participants, completed June 2021 to January 2022. Most survey respondents (75%) had heard little or nothing about mAbs, but 95% would consider getting mAb treatment. Hispanic/Latino and Non-Hispanic People of Color (POC) reported less awareness, greater concern about intravenous infusions, and less trust in mAb safety and effectiveness than White, Non-Hispanic respondents. Focus group themes included little awareness but high interest in mAb treatment and concerns about cost and access barriers such as lacking established sources of care and travel from rural communities. Focus groups revealed preferences for broad-reaching but tailored messaging strategies using multiple media and trusted community leaders.

CONCLUSIONS: Despite unfamiliarity with mAb treatment, most respondents were open to receiving mAbs or recommending mAbs to others. While mAb messaging should have broad reach “to everyone everywhere,” racial and geographic disparities in awareness and trust about mAbs underscore need for tailored messaging to promote equitable access. Care processes should address patient-level barriers like transportation, insurance, or primary care access. COVID-19 treatment dissemination strategies should promote health equity.

PMID:36417457 | DOI:10.1371/journal.pone.0274043

PLoS One. 2022 Nov 23;17(11):e0277950. doi: 10.1371/journal.pone.0277950. eCollection 2022.

ABSTRACT

Ethical livestock production is currently a major concern for consumers. In parallel, research has shown that transport duration is an important factor affecting animal welfare and has a negative impact on the final product quality and on the production cost. This study applied proteomics methods to the animal stress/welfare problem in pigs muscle-exudate with the aim to identify proteins indicative of molecular processes underpinning transport stress and to better characterise this species as a biomedical model. A broader perspective of the problem was obtained by applying label-free LC-MS to characterise the proteome response to transport stress (short or long road transportation) in pigs within the same genetic line. A total of 1,464 proteins were identified, following statistical analysis 66 proteins clearly separating pigs subject to short road transportation and pigs subject long road transportation. These proteins were mainly involved in cellular and metabolic processes. Catalase and stress-induced phosphoprotein-1 were further confirmed by Western blot as being involved in the process of self-protection of the cells in response to stress. This study provide an insight into the molecular processes that are involved in pig adaptability to transport stress and are a step-forward for the development of an objective evaluation method of stress in order to improve animal care and management in farm animals.

PMID:36417452 | DOI:10.1371/journal.pone.0277950

JMIR Serious Games. 2022 Nov 23;10(4):e36695. doi: 10.2196/36695.

ABSTRACT

BACKGROUND: Extreme labor pain has negative effects; pharmacologic analgesic modalities are effective but are accompanied by adverse effects. Virtual reality (VR) works as a distracting nonpharmacologic intervention for pain and anxiety relief; however, the effects of VR use in laboring women is unknown.

OBJECTIVE: Our study aimed to determine the safety and effectiveness of VR technology during labor and delivery and investigate whether it impacts labor and patient satisfaction.

METHODS: In all, 7 databases (PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, and Wan-Fang Database) were systematically searched for randomized controlled trials of VR use in pregnancy and childbirth from the time of database construction until November 24, 2021. Two researchers extracted data and evaluated study quality using the Cochrane Risk of Bias tool 2.0. Outcome measures were labor pain, anxiety, duration, satisfaction, and adverse events. Meta-analyses were performed where possible.

RESULTS: A total of 12 studies with 1095 participants were included, of which 1 and 11 studies were rated as “Low risk” and “Some concerns” for risk of bias, respectively. Of the 12 studies, 11 reported labor pain, 7 reported labor anxiety, and 4 reported labor duration. Meta-analysis revealed that VR use could relieve pain during labor (mean difference -1.81, 95% CI -2.04 to -1.57; P<.001) and the active period (standardized mean difference [SMD] -0.41, 95% CI -0.68 to -0.14; P=.003); reduce anxiety (SMD -1.39, 95% CI -1.99 to -0.78; P<.001); and improve satisfaction with delivery (relative risk 1.32, 95% CI 1.10-1.59; P=.003). The effects of VR on the duration of the first (SMD -1.12, 95% CI -2.38 to 0.13; P=.08) and second (SMD -0.22, 95% CI -0.67 to 0.24; P=.35) stages of labor were not statistically significant.

CONCLUSIONS: VR is safe and effective in relieving maternal labor pain and anxiety; however, due to the heterogeneity among studies conducted to date, more rigorous, large-scale, and standardized randomized controlled trials are required to provide a higher-quality evidence base for the use of VR technology in maternal labor, with the aim of improving experience and outcomes.

TRIAL REGISTRATION: PROSPERO CRD42021295410; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295410.

PMID:36416881 | DOI:10.2196/36695

JAMA Oncol. 2022 Nov 23. doi: 10.1001/jamaoncol.2022.5486. Online ahead of print.

ABSTRACT

IMPORTANCE: A key issue for the adjuvant treatment of patients with melanoma is the assessment of the effect of treatment on relapse, survival, and quality of life (QOL).

OBJECTIVE: To compare QOL in patients with resected melanoma at high risk for relapse who were treated with adjuvant pembrolizumab vs standard of care with either ipilimumab or high-dose interferon α 2b (HDI).

DESIGN, SETTING, AND PARTICIPANTS: The S1404 phase 3 randomized clinical trial was conducted by the SWOG Cancer Research Network at 211 community/academic sites in the US, Canada, and Ireland. Patients were enrolled from December 2015 to October 2017. Data analysis for this QOL substudy was completed in March 2022. Overall, 832 patients were evaluable for the primary QOL end point.

INTERVENTIONS: Patients were randomized (1:1) to treatment with adjuvant pembrolizumab vs standard of care with ipilimumab/HDI.

MAIN OUTCOMES AND MEASURES: Quality of life was assessed for patients at baseline and cycles 1, 3, 5, 7, and 9 after randomization using the Functional Assessment of Cancer Therapy (FACT) Biological Response Modifiers (FACT-BRM), FACT-General, Functional Assessment of Chronic Illness Therapy-Diarrhea, and European QOL 5-Dimension 3-Level scales. The primary end point was the comparison by arm of cycle 3 FACT-BRM trial outcome index (TOI) scores using linear regression. Linear-mixed models were used to evaluate QOL scores over time. Regression analyses included adjustments for the baseline score, disease stage, and programmed cell death ligand 1 status. A clinically meaningful difference of 5 points was targeted.

RESULTS: Among 1303 eligible patients (median [range] age, 56.7 [18.3-86.0] years; 524 women [40.2%]; 779 men [59.8%]; 10 Asian [0.8%], 7 Black [0.5%], 44 Hispanic [3.4%], and 1243 White [95.4%] individuals), 1188 (91.1%) had baseline FACT-BRM TOI scores, and 832 were evaluable at cycle 3 (ipilimumab/HDI = 267 [32.1%]; pembrolizumab = 565 [67.9%]). Evaluable patients were predominantly younger than 65 years (623 [74.9%]) and male (779 [58.9%]). Estimates of FACT-BRM TOI cycle 3 compliance did not differ by arm (ipilimumab/HDI, 96.0% vs pembrolizumab, 98.3%; P = .25). The adjusted cycle 3 FACT-BRM TOI score was 9.6 points (95% CI, 7.9-11.3; P < .001) higher (better QOL) for pembrolizumab compared with ipilimumab/HDI, exceeding the prespecified clinically meaningful difference. In linear-mixed models, differences by arm exceeded 5 points in favor of pembrolizumab through cycle 7. In post hoc analyses, FACT-BRM TOI scores favored the pembrolizumab arm compared with the subset of patients receiving ipilimumab (difference, 6.0 points; 95% CI, 4.1-7.8; P < .001) or HDI (difference, 17.0 points; 95% CI, 14.6-19.4; P < .001).

CONCLUSIONS AND RELEVANCE: This secondary analysis of a phase 3 randomized clinical trial found that adjuvant pembrolizumab improved QOL vs treatment with adjuvant ipilimumab or HDI in patients with high-risk resected melanoma.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02506153.

PMID:36416836 | DOI:10.1001/jamaoncol.2022.5486

JAMA Surg. 2022 Nov 23. doi: 10.1001/jamasurg.2022.5697. Online ahead of print.

ABSTRACT

IMPORTANCE: Long-term oncologic outcomes of robotic surgery remain a hotly debated topic in surgical oncology, but sparse data have been published thus far.

OBJECTIVE: To analyze short- and long-term outcomes of robotic liver resection (RLR) for hepatocellular carcinoma (HCC) from Western high-volume centers to assess the safety, reproducibility, and oncologic efficacy of this technique.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study evaluated the outcomes of patients receiving RLR vs open liver resection (OLR) for HCC between 2010 and 2020 in 5 high-volume centers. After 1:1 propensity score matching, a group of patients who underwent RLR was compared with a validation cohort of OLR patients from a high-volume center that did not perform RLR.

MAIN OUTCOMES AND MEASURES: A retrospective analysis was performed of prospectively maintained databases at 2 European and 2 US institutions of patients who underwent RLR for HCC between January 1, 2010, and September 30, 2020. The main outcomes were safety and feasibility of RLR for HCC and its oncologic outcomes compared with a European OLR validation cohort. A 2-sided P < .05 was considered significant.

RESULTS: The study included 398 patients (RLR group: 125 men, 33 women, median [IQR] age, 66 [58-71] years; OLR group: 315 men, 83 women; median [IQR] age, 70 [64-74] years), and 106 RLR patients were compared with 106 OLR patients after propensity score matching. The RLR patients had a significantly longer operative time (median [IQR], 295 [190-370] minutes vs 200 [165-255] minutes, including docking; P < .001) but a significantly shorter hospital length of stay (median [IQR], 4 [3-6] days vs 10 [7-13] days; P < .001) and a lower number of admissions to the intensive care unit (7 [6.6%] vs 21 [19.8%]; P = .002). Incidence of posthepatectomy liver failure was significantly lower in the RLR group (8 [7.5%] vs 30 [28.3%]; P = .001), with no cases of grade C failure. The 90-day overall survival rate was comparable between the 2 groups (RLR, 99.1% [95% CI, 93.5%-99.9%]; OLR, 97.1% [95% CI, 91.3%-99.1%]), as was the cumulative incidence of death related to tumor recurrence (RLR, 8.8% [95% CI, 3.1%-18.3%]; OLR, 10.2% [95% CI, 4.9%-17.7%]).

CONCLUSIONS AND RELEVANCE: This study represents the largest Western experience to date of full RLR for HCC. Compared with OLR, RLR performed in tertiary centers represents a safe treatment strategy for patients with HCC and those with compromised liver function while achieving oncologic efficacy.

PMID:36416833 | DOI:10.1001/jamasurg.2022.5697

JAMA Netw Open. 2022 Nov 1;5(11):e2243597. doi: 10.1001/jamanetworkopen.2022.43597.

ABSTRACT

IMPORTANCE: Use of attention-deficit/hyperactivity disorder (ADHD) medications has increased substantially over the past decades, but there are concerns regarding their cardiovascular safety.

OBJECTIVE: To provide an updated synthesis of evidence on whether ADHD medications are associated with the risk of a broad range of cardiovascular diseases (CVDs).

DATA SOURCES: PubMed, Embase, PsycINFO, and Web of Science up to May 1, 2022.

STUDY SELECTION: Observational studies investigating the association between ADHD medications (including stimulants and nonstimulants) and risk of CVD.

DATA EXTRACTION AND SYNTHESIS: Independent reviewers extracted data and assessed study quality using the Good Research for Comparative Effectiveness (GRACE) checklist. Data were pooled using random-effects models. This study is reported according to the Meta-analyses of Observational Studies in Epidemiology guideline.

MAIN OUTCOMES AND MEASURES: The outcome was any type of cardiovascular event, including hypertension, ischemic heart disease, cerebrovascular disease, heart failure, venous thromboembolism, tachyarrhythmias, and cardiac arrest.

RESULTS: Nineteen studies (with 3 931 532 participants including children, adolescents, and adults; 60.9% male), of which 14 were cohort studies, from 6 countries or regions were included in the meta-analysis. Median follow-up time ranged from 0.25 to 9.5 years (median, 1.5 years). Pooled adjusted relative risk (RR) did not show a statistically significant association between ADHD medication use and any CVD among children and adolescents (RR, 1.18; 95% CI, 0.91-1.53), young or middle-aged adults (RR, 1.04; 95% CI, 0.43-2.48), or older adults (RR, 1.59; 95% CI, 0.62-4.05). No significant associations for stimulants (RR, 1.24; 95% CI, 0.84-1.83) or nonstimulants (RR, 1.22; 95% CI, 0.25-5.97) were observed. For specific cardiovascular outcomes, no statistically significant association was found in relation to cardiac arrest or arrhythmias (RR, 1.60; 95% CI, 0.94-2.72), cerebrovascular diseases (RR, 0.91; 95% CI, 0.72-1.15), or myocardial infarction (RR, 1.06; 95% CI, 0.68-1.65). There was no associations with any CVD in female patients (RR, 1.88; 95% CI, 0.43-8.24) and in those with preexisting CVD (RR, 1.31; 95% CI, 0.80-2.16). Heterogeneity between studies was high and significant except for the analysis on cerebrovascular diseases.

CONCLUSIONS AND RELEVANCE: This meta-analysis suggests no statistically significant association between ADHD medications and the risk of CVD across age groups, although a modest risk increase could not be ruled out, especially for the risk of cardiac arrest or tachyarrhythmias. Further investigation is warranted for the cardiovascular risk in female patients and patients with preexisting CVD as well as long-term risks associated with ADHD medication use.

PMID:36416824 | DOI:10.1001/jamanetworkopen.2022.43597

JAMA Netw Open. 2022 Nov 1;5(11):e2243618. doi: 10.1001/jamanetworkopen.2022.43618.

ABSTRACT

IMPORTANCE: Accruing evidence suggests that gestational hypertensive disorders (GHTD) and gestational diabetes (GD) are each associated with an increased risk of cardiovascular disease (CVD). However, the extent to which the co-occurrence of GHTD and GD is associated with the risk of CVD remains largely unknown.

OBJECTIVE: To estimate the individual and joint associations of GHTD and GD with incident CVD.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study used the Ministry of Health and Long-Term Care of Ontario (Canada) health care administrative databases. All women in Ontario with a GHTD and/or GD diagnosis, and a live-birth singleton delivery between July 1, 2007, and March 31, 2018, were considered for inclusion. Women with pregravid diabetes, hypertension, or cardiovascular disease were excluded. Statistical analysis was performed from November 2021 to September 2022.

EXPOSURES: GD and/or GHTD, defined using diagnosis coding.

MAIN OUTCOMES AND MEASURES: Individual and joint associations of GHTD and GD with incident CVD (including a composite of myocardial infarction, acute coronary syndrome, stroke, coronary artery bypass grafting, percutaneous coronary intervention, or carotid endarterectomy), estimated using Cox regression models, adjusting for relevant cardiometabolic risk factors. The follow-up extended from the index pregnancy until March 31, 2020.

RESULTS: Among 886 295 eligible women (mean [SD] age, 30 [5.6] years; 43 861 [4.9%] with isolated GHTD, 54 061 [6.1%] with isolated GD, and 4975 [0.6%] with GHTD and GD), there were 1999 CVD events over 12 years of follow-up. In the early postpartum phase (first 5 years post partum), there was no association of co-occurrence of GTHD and GD (adjusted hazard ratio [aHR], 1.42, 95% CI, 0.78-2.58) or GD alone (aHR, 0.80; 95% CI, 0.60-1.06) with CVD; there was an association between isolated GTHD and incident CVD compared with no GTHD and no GD (aHR, 1.90; 95% CI, 1.51-2.35). In the late postpartum period (after the initial 5 years post partum), compared with no GD and no GHTD, isolated GHTD (aHR, 1.41, 95% CI, 1.12-1.76) and co-occurrence of GHTD and GD (aHR, 2.43, 95% CI, 1.60-3.67) were each associated with a higher risk of incident CVD. There was no association between isolated GD and incident CVD.

CONCLUSIONS AND RELEVANCE: In this cohort study, GHTD was associated with a high risk of CVD post partum, and the co-occurrence of GD and GHTD was associated with a much greater postpartum CVD risk. These findings suggest that CVD preventive care is particularly needed in the aftermath of combined GD and GHTD.

PMID:36416822 | DOI:10.1001/jamanetworkopen.2022.43618