Category: Nevin Manimala

Pflege. 2022 Nov 23. doi: 10.1024/1012-5302/a000918. Online ahead of print.

ABSTRACT

An urban-rural comparison of family stress and early childhood intervention: Data linkage between two cross-sectional studies Abstract. Background: So far, there is insufficient information about where in Germany which families are reached by home-visiting programs and how well. One example is the provision of home-visiting program by health service professionals (LaB) in early childhood intervention. Research questions: Are there urban-rural differences in psychosocial stress among families? What differences exist in terms of expanding support services, receiving a service, and using the offered LaB? Methods: Data from a representative family survey on psychosocial stress characteristics and the use of services, and a nationwide survey of professionals on the development and expansion of early childhood intervention at the community level were linked. Analyses included descriptive statistics and regression models. Results: Most psychosocial stress characteristics were reported with similar rates in rural and urban areas. Although the LaB program is more widespread in urban regions, it was more likely to be used in rural regions when offered. LaB was more likely to be used by families with migration background, with signs of depression or anxiety of parents, and with a child with perinatal adversities, and less likely when there was a need for expansion of this service. Conclusions: The increased use in rural areas could be due to the fact that there are long distances to few centralized services. Therefore, the outreach character of the LaB program is appreciated, especially among less mobile families.

PMID:36416107 | DOI:10.1024/1012-5302/a000918

J Diabetes Sci Technol. 2022 Nov 23:19322968221139873. doi: 10.1177/19322968221139873. Online ahead of print.

ABSTRACT

OBJECTIVE: Real-time continuous glucose monitoring (CGM) is effective for diabetes management in cases of type 1 diabetes and adults with type 2 diabetes (T2D) but has not been assessed in adolescents and young adults (AYAs) with T2D. The objective of this pilot interventional study was to assess the feasibility and acceptability of real-time CGM use in AYAs with T2D.

METHODS: Adolescents and young adults (13-21 years old) with T2D for six months or more and hemoglobin A1c (A1c) greater than 7%, on any Food and Drug Administration-approved treatment regimen, were included. After a blinded run-in period, participants were given access to a real-time CGM system for 12 weeks. The use and acceptability of the real-time CGM were evaluated by sensor usage, surveys, and focus group qualitative data.

RESULTS: Participants’ (n = 9) median age was 19.1 (interquartile range [IQR] 16.8-20.5) years, 78% were female, 100% were people of color, and 67% were publicly insured. Baseline A1c was 11.9% (standard deviation ±2.8%), with median diabetes duration of 2.5 (IQR 1.4-6) years, and 67% were using insulin. Seven participants completed the study and demonstrated statistically significant improvement in diabetes-related quality of life, with the mean Pediatric Quality of Life inventory (PedsQL) diabetes score increasing from 70 to 75 after using CGM (P = .026). Focus group results supported survey results that CGM use among AYAs with T2D is feasible, can improve quality of life, and has the potential to modify behavior.

CONCLUSION: Real-time CGM is feasible and acceptable for AYAs with T2D and may improve the quality of life of patients with diabetes. Larger randomized controlled trials are needed to assess the effects on glycemic control and healthy lifestyle changes.

PMID:36416098 | DOI:10.1177/19322968221139873

Ecology. 2022 Nov 23:e3924. doi: 10.1002/ecy.3924. Online ahead of print.

ABSTRACT

The global biodiversity crisis due to anthropogenic pressures jeopardizes marine ecosystems functioning and services. Community responses to these environmental changes can be assessed through functional diversity, a biodiversity component related to organism-environment interactions, estimated through biological traits related to organism functions (locomotion, feeding mode, reproduction). Fishes play a key role in marine systems functioning and supply proteins for billions of humans worldwide, yet most of the knowledge is limited to several commercial species and little is known about the intraspecific variability of their functional traits. The data provided here consists of 867 records of individuals from 85 species of ray-finned (Actinopterygii) and cartilaginous (Chondrichthyes) fishes sampled in the Bay of Biscay (Atlantic, France) between autumn 2017 and 2019. We provided for each individual the taxonomic classification, 16 ecomorphological measures (5 directly made on fresh individuals and 11 realized using individual pictures), that were converted into 9 ecomorphological traits classically documented in the literature (biomass, protrusion, oral gape shape, surface and position, eye size and position, body transversal shape and surface, pectoral fin position and caudal peduncle throttling) and 8 life history traits obtained from Fishbase (maximum length, average depth, depth range, trophic level, reproduction mode, fertilization mode, parental care, vertical position in the water column). These traits document several functions such as dispersion, feeding mode, habitat use, position in the food web, and reproduction. To improve the development of new traits, we provided a picture of each individual with an ROI file containing the different morpho-anatomical measures made using “ImageJ” software and an R function to extract them. In addition, we provided the metadata from each sampling site (years, dates, stations, sampling hours, strata, gears, latitudes, longitudes, depths) and environmental variables measured in situ (conductivity, salinity, water temperature, water density, air temperature). This data set accounting for the intraspecific variability among 85 fish species is of interest to better understand the effects of environmental forcing in a global change context as in the Bay of Biscay, a highly-fished transition zone harboring mixed assemblages of boreal, temperate, and subtropical fish species that are susceptible to display variability in functional trait to adapt to changing conditions. The data set is freely available without copyright restrictions; users should cite this paper in research products (publications, presentations, reports, etc.) derived from the data set.

PMID:36416055 | DOI:10.1002/ecy.3924

Pediatr Pulmonol. 2022 Nov 23. doi: 10.1002/ppul.26246. Online ahead of print.

ABSTRACT

INtubation- SURfactant-Extubation (InSurE) approach is traditional method of surfactant delivery in preterm neonates with Respiratory Distress Syndrome (RDS). Newer, Less Invasive Surfactant Administration(LISA) techniques lessen the need for mechanical ventilation and its adverse consequences. Evidence on the favourable effects of LISA can’t be extrapolated from developed to developing countries. Aim of Study is to compare the effectiveness of InSurE and LISA.

OBJECTIVES: Primary outcome was to find need of intubation and mechanical ventilation within 72 hrs of birth. Neonates were followed until discharge/death for adverse events and complications.

MATERIAL & METHODS: Open-label RCT was conducted at tertiary neonatal intensive care unit. Preterm neonates with diagnosis of RDS were randomized in two groups (InSurE or LISA) to receive surfactant soon after birth. NIPPV was used as primary mode of respiratory support.

RESULTS: Total of 150 neonates were analysed (75 in each group). Insignificant Statistical difference was seen in the need for intubation and mechanical ventilation within 72 h of birth between the two groups [InSurE, 30 (40%) and LISA, 30(40%), relative risk 1.0, 95% confidence interval 0.68-1.48]. 12% (n=9, LISA group) & 14.6% (n=11 InSurE group) had adverse events during the procedure. Also, we observed insignificant statistical difference in the rates of major complications or duration of respiratory support, hospital stay & mortality.

CONCLUSION: LISA and InSurE are equally effective for surfactant administration in the treatment of RDS, when NIPPV is the primary mode of respiratory support. More RCTs are required to compare the efficacy & long-term outcomes of LISA with InSurE. This article is protected by copyright. All rights reserved.

PMID:36416036 | DOI:10.1002/ppul.26246

Glob Chang Biol. 2022 Nov 23. doi: 10.1111/gcb.16513. Online ahead of print.

ABSTRACT

In the Amazon, deforestation and climate change lead to increased vulnerability to forest degradation, threatening its existing carbon stocks and its capacity as a carbon sink. We use satellite L-Band Vegetation Optical Depth (L-VOD) data that provide an integrated (top-down) estimate of biomass carbon to track changes over 2011-2019. Because the spatial resolution of L-VOD is coarse (0.25°), it allows limited attribution of the observed changes. We therefore combined high-resolution annual maps of forest cover and disturbances with biomass maps to model carbon losses (bottom-up) from deforestation and degradation, and gains from regrowing secondary forests. We show an increase of deforestation and associated degradation losses since 2012 which greatly outweigh secondary forest gains. Degradation accounted for 40% of gross losses. After an increase in 2011, old-growth forests show a net loss of above-ground carbon between 2012 and 2019. The sum of component carbon fluxes in our model is consistent with the total biomass change from L-VOD of 1.3 Pg C over 2012-2019. Across nine Amazon countries, we found that while Brazil contains the majority of biomass stocks (64%), its losses from disturbances were disproportionately high (79% of gross losses). Our multi-source analysis provides a pessimistic assessment of the Amazon carbon balance and highlights the urgent need to stop the recent rise of deforestation and degradation, particularly in the Brazilian Amazon.

PMID:36415966 | DOI:10.1111/gcb.16513

Brain. 2022 Nov 23:awac437. doi: 10.1093/brain/awac437. Online ahead of print.

ABSTRACT

More than half of adults with epilepsy undergoing resective epilepsy surgery achieve long-term seizure freedom and might consider withdrawing antiseizure medications (ASMs). We aimed to identify predictors of seizure recurrence after starting postoperative ASM withdrawal and develop and validate predictive models. We performed an international multicentre observational cohort study in nine tertiary epilepsy referral centres. We included 850 adults who started ASM withdrawal following resective epilepsy surgery and were free of seizures other than focal non-motor aware seizures before starting ASM withdrawal. We developed a model predicting recurrent seizures, other than focal non-motor aware seizures, using Cox proportional hazards regression in a derivation cohort (n = 231). Independent predictors of seizure recurrence, other than focal non-motor aware seizures, following the start of ASM withdrawal were focal non motor-aware seizures after surgery and before withdrawal (adjusted hazards ratio [aHR] 5.5, 95% confidence interval [CI] 2.7-11.1), history of focal to bilateral tonic-clonic seizures before surgery (aHR 1.6, 95% CI 0.9-2.8), time from surgery to the start of ASM withdrawal (aHR 0.9, 95% CI 0.8-0.9), and number of ASMs at time of surgery (aHR 1.2, 95% CI 0.9-1.6). Model discrimination showed a concordance statistic of 0.67 (95% CI 0.63-0.71) in the external validation cohorts (n = 500). A secondary model predicting recurrence of any seizures (including focal non-motor aware seizures) was developed and validated in a subgroup that did not have focal non-motor aware seizures before withdrawal (n = 639), showing a concordance statistic of 0.68 (95% CI 0.64-0.72). Calibration plots indicated high agreement of predicted and observed outcomes for both models. We show that simple algorithms, available as graphical nomograms and online tools (predictepilepsy.github.io), can provide probabilities of seizure outcomes after starting postoperative ASMs withdrawal. These multicentre-validated models may assist clinicians when discussing ASM withdrawal after surgery with their patients.

PMID:36415957 | DOI:10.1093/brain/awac437

Brain. 2022 Nov 23:awac440. doi: 10.1093/brain/awac440. Online ahead of print.

ABSTRACT

Despite experimental studies suggesting a disease-modifying role of oestrogens, results from epidemiological studies on the relation of reproductive characteristics and hormonal exposures with Parkinson disease in women are conflicting. We used the data from the E3N cohort study including 98,068 women aged 40-65y in 1990 followed until 2018. Parkinson disease was ascertained using a validation process based on drug claim databases and medical records. Reproductive characteristics and hormonal exposures were self-reported (11 questionnaires). Associations of exposures with Parkinson disease incidence were investigated using time-varying Cox proportional hazards regression with a 5-year exposure lag and age as the time scale adjusted for confounders. We identified 1165 incident Parkinson disease cases during a mean follow-up of 22.0 years (incidence rate = 54.7 per 100 000 person-years). Parkinson disease incidence was higher in women with early (<12y, hazard ratio [HR] = 1.21, 95% confidence interval [CI] = 1.04-1.40) or late age at menarche (≥14y, HR = 1.18, 95% CI = 1.03-1.35) than in women with menarche at 12-13y. Nulliparity was not associated with Parkinson disease, but Parkinson disease incidence increased with the number of children in parous women (P-trend = 0.009). Women with artificial (surgical, iatrogenic) menopause were at greater risk than women with natural menopause (HR = 1.28, 95% CI = 1.09-1.47), especially when artificial menopause occurred at an early age (≤45.0 years). Postmenopausal hormone therapy tended to mitigate greater risk associated with artificial or early menopause (≤45.0 years). While fertility treatments were not associated with Parkinson disease overall, ever users of clomiphene were at greater Parkinson disease risk than never users (HR = 1.81, 95% CI = 1.14-2.88). Other exposures (breastfeeding, oral contraceptives) were not associated with Parkinson disease. Our findings suggest that early and late age at menarche, higher parity, and artificial menopause, in particular at an early age, are associated with increased Parkinson disease incidence in women. In addition, there was some evidence that use of exogenous hormones may increase (fertility treatments) or decrease (postmenopausal hormone therapy) Parkinson disease incidence. These findings support the hypothesis that hormonal exposures play a role in the susceptibility to neurodegenerative diseases. If confirmed, they could help to identify subgroups at high risk for Parkinson disease.

PMID:36415953 | DOI:10.1093/brain/awac440

Curr Cardiol Rev. 2022;18(6):e280422204203. doi: 10.2174/1573403X18666220428115520.

ABSTRACT

INTRODUCTION: Coronary bifurcation lesions (CBL) are one fifth of all coronary lesions and they do not have an optimal strategy for stenting yet. Bioresorbable scaffolds (BRS) are novel inventions proposed to be the optimal solution. The aim of this systematic review was to assess the role of BRS in treating CBL by comparing it to dedicated bifurcation stents (DBS).

METHODS: A systematic review was conducted following the PRISMA guidelines, searching databases such as ScienceDirect, EMBASE, MEDLINE, NIH, TRIP, PUBMED, and ClinicalTrials. gov. The risk of bias was assessed by MINORS and modified Cowley’s criteria. Q statistic was used for heterogeneity testing and a meta-analysis was conducted using the “meta” package in the R software application.

RESULTS: Fourteen studies were included with an average follow-up period of twelve months. Almost 80% of the participants were male (p-value= 0.148) and around two-thirds were smokers. Meta-analysis was performed for myocardial infarction (MI), target lesion revascularisation (TLR), major adverse cardiac events (MACE), and stent thrombosis (ST). These showed statistically nonsignificant differences, with a slight trend favouring BRS except with stent thrombosis.

CONCLUSION: There is a lack of randomised trials on the topic, which may be an area for further research. But the results showed favourable yet statistically insignificant outcomes for BRS except for ST, an issue that can be addressed with technological advancement.

PMID:36415952 | DOI:10.2174/1573403X18666220428115520

J Adolesc. 2022 Nov 22. doi: 10.1002/jad.12123. Online ahead of print.

ABSTRACT

INTRODUCTION: Expressive flexibility, or the ability to both up- and down-regulate emotional expressions in social interactions, is thought as an indicator and a consequence of healthy interpersonal relationships. The present longitudinal study examined bidirectional associations between expressive flexibility and friendship quality in early adolescence. Since prior research found inconsistent results regarding the adaptiveness of expressive flexibility, which indicated the necessity to consider individual variability in the process, we further tested the potential moderating effect of social anxiety in the links from expressive flexibility to friendship quality.

METHODS: Participants from two junior high schools in eastern China (N = 274; 50.4% female; M_age = 13.56) were surveyed at three time points with 6-month intervals. Expressive flexibility, friendship quality, and social anxiety were all assessed via self-reported scales.

RESULTS: According to the cross-lagged model results, friendship quality significantly predicted increased expressive flexibility over time. Conversely, the longitudinal association from expressive flexibility to friendship quality was not significant, but the interaction between expressive flexibility and social anxiety significantly predicted later friendship quality. Further analyses via the Johnson-Neyman technique revealed that expressive flexibility only positively predicted friendship quality for adolescents with lower levels of social anxiety.

CONCLUSION: Our results suggest that expressive flexibility is not always socially adaptive, so practical interventions that aim to improve youths’ social adjustment via expressive flexibility training might need to consider the role of individual characteristics.

PMID:36415946 | DOI:10.1002/jad.12123

Prostate. 2022 Nov 22. doi: 10.1002/pros.24463. Online ahead of print.

ABSTRACT

INTRODUCTIONS: The American Society of Anesthesiologists Physical Status Classification System (ASA) is a validated risk stratification method for patients undergoing surgery. There is an increased prevalence of benign prostatic hyperplasia and comorbidities in our aging population. The role of ASA related to postoperative complications in patients undergoing holmium laser enucleation of the prostate (HoLEP) has not been described.

METHODS: A review of our database was performed for patients who underwent HoLEP from July 2018 to December 2020. Patients were stratified based on ASA score. Preoperative, perioperative, and complication data were analyzed using SAS analytics software.

RESULTS: Of 472 patients undergoing HoLEP, 320 (67.8%) were ASA 3-4 patients. There was a statistically significant difference found in age (72.3 ± 9.8 vs. 69.1 ± 9.0 years, p < 0.001), body mass index (BMI) (29.0 ± 5.9 vs. 27.3 ± 4.2, p = 0.004), and use of antiplatelet/anticoagulant medications (14.6% vs. 2.6%, p < 0.001) in the ASA 3-4 group. There was no significant difference between prostate volume (p = 0.158) or catheter-dependent urinary retention (p = 0.376). No difference was found in enucleation time (52.76 ± 24.8 vs. 54.16 ± 23.7 min, p = 0.587), OR specimen weight (70.24 ± 58.5 vs. 81.53 ± 65.9, p = 0.094). or intraoperative complications (2.8% vs. 1.3%, p = 0.330). There were higher postoperative complications in the ASA 3-4 group (12.8% vs. 7.9%, p = 0.03), but no difference in Clavien ≥3 complications (p = 0.068). ASA 3-4 patients had similar postoperative international prostate symptom score (p = 0.159).

CONCLUSION: HoLEP is feasible and effective in patients who are ASA 3-4. The high-risk cohort had an increased rate of low-grade complications. Patients with an ASA score of 3-4 should be counseled regarding a higher rate of low-grade complications.

PMID:36415930 | DOI:10.1002/pros.24463