Category: Nevin Manimala

Subst Abus. 2022;43(1):801-808. doi: 10.1080/08897077.2021.2010255.

ABSTRACT

Background: Two Way Prayer Meditation (TWPM) is a spiritual intervention that holds promise for improving the psychospiritual well-being of individuals in recovery from substance use disorders (SUD). This study aimed to identify moderators of TWPM’s treatment effects. Moderators tested included gender, race/ethnicity, age, education, religious/spiritual affiliation, and most often used substance. Methods: This study employed a randomized controlled trial design with pretest and posttest. In total, 134 adults in four residential recovery programs participated in the study and were randomly assigned to the TWPM group or the treatment as usual control group. Linear mixed modeling was used to assess the moderating effect of each hypothesized moderator in the form of interaction tests. Sensitivity analyses were conducted by excluding cases with more than a minimum number of missing items. Results: There were no significant moderators for psychological distress, self-esteem, and most of the spiritual well-being outcomes. Both the primary and sensitivity analyses showed education significantly moderated TWPM’s effect on overall spirituality self-ranking. Specifically, TWPM’s positive effect on overall spirituality self-ranking was greater in the master’s degree subgroup than in the less than high school subgroup. Conclusion: TWPM’s treatment effects on most outcomes were not found to vary by the tested participant characteristics. The only statistically significant finding suggests clinicians may need to adjust TWPM workshop/teaching content, delivery style, or language used to reach clients with lower levels of education. Future better-powered studies are recommended to continue exploring the potential moderating effects of race/ethnicity, education, spiritual/religious affiliation, and most often used substance.

PMID:35129421 | DOI:10.1080/08897077.2021.2010255

Ann Surg. 2021 Nov 11. doi: 10.1097/SLA.0000000000005296. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the long-term and short-term outcomes of minimally invasive esophagectomy (MIE) compared with open esophagectomy (OE) in localized esophageal squamous cell carcinoma (ESCC) patients in real-world settings.

BACKGROUND: MIE is an alternative to OE, despite the limited evidence regarding its effect on long-term survival.

METHODS: We recruited 5822 consecutive patients with resectable ESCC in two typical high-volume centers in southern and northern China, 1453 of whom underwent MIE. Propensity score-based overlap weighted regression adjusted for multifaceted confounding factors was used to compare outcomes in the MIE and OE groups.

RESULTS: Five-year overall survival (OS) was 62.7% in the MIE group and 57.7% in the OE group. The overlap weighted Cox regression showed slightly better OS in the MIE group (HR 0.93, 95% CI: 0.82-1.06). Although duration of surgery was longer and treatment cost higher in the MIE group than in the OE group, the number of lymph nodes harvested was larger, the proportion of intraoperative blood transfusions lower, and postoperative complications less in the MIE group. 30-day (RR 0.77, 0.38-1.55) and 90-day (RR 0.79, 0.46-1.35) mortality were lower in the MIE group versus the OE group, although not statistically significant. These findings were consistent across different analytic approaches and subgroups, notably in the subset of ESCC patients with large tumors.

CONCLUSIONS: MIE can be performed safely with OS comparable to OE for patients with localized ESCC, indicating MIE may be recommended as the primary surgical approach for resectable ESCC in health facilities with requisite technical capacity.

PMID:35129490 | DOI:10.1097/SLA.0000000000005296

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2021 Dec 21;33(6):626-628. doi: 10.16250/j.32.1374.2021044.

ABSTRACT

OBJECTIVE: To investigate the epidemiological characteristics and diagnosis of malaria cases in Nantong City from 2015 to 2020, so as to provide insights into the prevention of re-establishment of imported malaria and consolidation of malaria elimination achievements in the city.

METHODS: The epidemic data of malaria in Nantong City from 2015 to 2020 were captured from the National Notifiable Disease Report System, the Information Management System for Parasitic Disease Control and individual epidemiological survey reports of malaria cases. The malaria parasite species, source of infections, population distribution, temporal distribution, spatial distribution and diagnosis of imported malaria cases were descriptively and statistically analyzed.

RESULTS: A total of 241 malaria cases were reported in Nantong City from 2015 to 2020, and all were overseas imported cases, including 191 cases with Plasmodium falciparum malaria (79.25%), 8 cases with P. vivax malaria (3.32%), 33 cases with P. ovale malaria (13.69%) and 9 cases with P. malaria malaria (3.73%). Overseas imported malaria cases acquired infections from 34 countries in Asia, Africa and Latin America, and 97.93% of the cases were infected in Africa, and 90.04% (217/241) were reported in Chongchuan District, Hai’an City and Haimen District. Imported malaria cases were aged from 20 to 68 years, and a median age of 45 (13) years, and 97.10% were male. The median duration between returning to China and malaria onset was 7 (9) days among all imported malaria cases, and the median duration from initial diagnosis to definitive diagnosis was 2 (2) days. There were 167 cases that were initially diagnosed as malaria, with a correct rate of 69.29%, and 53.53 (129/241) of malaria cases were diagnosed at city-level medical institutions and 41.49% (100/241) at county-level medical institutions. In addition, the proportion of malaria cases reported by city-level medical institutions increased from 39.62% in 2015 to 81.25% in 2020 (χ² = 6.94, P < 0.01).

CONCLUSIONS: The accuracy of initial malaria diagnosis requires to be improved in Nantong City. Malaria control knowledge should be specially given to migrant workers to shorten the duration of seeking medical care, and malaria training requires to be intensified among healthcare professionals to improve the diagnostic capability of imported malaria cases and the cure of severe P. falciparum malaria cases.

PMID:35128894 | DOI:10.16250/j.32.1374.2021044

Zhen Ci Yan Jiu. 2022 Jan 25;47(1):53-8. doi: 10.13702/j.1000-0607.201042.

ABSTRACT

OBJECTIVE: To investigate the short-term effect and safety on female abdominal obesity and defecation function in treatment with acupoint embedding therapy at different abdominal layers under B ultrasound.

METHODS: A total of 102 female patients with abdominal obesity were randomly divided into 3 groups, i.e. a deep embedding group (34 cases, 1 case dropped out), a shallow embedding group (34 cases, 3 cases dropped out) and a sham-embedding group (34 cases, 6 cases dropped out). Finally, 92 cases were included in the three groups. Under B ultrasound, in the deep embedding group, the absor-bable surgical suture were embedded in subcutaneous fat layer and muscle layer. In the shallow embedding group, the absorbable surgical suture was embedded in the fat layer and in the sham-embedding group, no suture was embedded. The acupoints for embedding therapy included Zhongwan (CV12), Guanyuan (CV4), bilateral Guanmen (ST22), bilateral Tianshu (ST25), bilateral Daimai (GB26) and bilateral Shuidao (ST28). The acupoint embedding therapy was exerted once every two weeks, for 4 times totally. Before and after treatment, the changes in abdominal obesity indicators (waist circumference ［WC］, body fat rate ［BFR］, body mass index ［BMI］, abdominal subcutaneous fat thickness ［ASFT］) and defecation function indicators (spontaneous bowel movement times ［SBMs］ and Bristol stool scale ［BSS］) were observed and the safety indicators were assessed.

RESULTS: After treatment, WC, BFR, BMI and ASFT were lower than those before treatment in both the deep embedding group and the shallow embedding group (P<0.05), those values in the deep embedding group were reduced more obviously as compared with the shallow embedding group (P<0.05). SBMs and BSS after treatment were increased as compared with those before treatment in both the deep embedding group and the shallow embedding group (P<0.05) and the increase in the deep embedding group was more obvious than in the shallow embedding group (P<0.05). The abdominal obesity indicators and defecation function indicators after treatment were not different statistically as compared with those before treatment in the sham-embedding group (P>0.05). The pain score of acupuncture in either the deep embedding group or the shallow embedding group was higher than in the sham-embedding group (P<0.05). The acceptance was more than 2 points in all of the three groups and there was no statistical significance among groups (P>0.05).

CONCLUSION: Acupoint embedding therapy in both the deep and the shallow subcutaneous layers under B ultrasound may regulate the indicators of female abdominal obesity safely. The acupoint embedding therapy in the deep layer is more effective on abdominal obesity and defecation improvement as compared with that exerted in the shallow layer.

PMID:35128871 | DOI:10.13702/j.1000-0607.201042

Zhen Ci Yan Jiu. 2022 Jan 25;47(1):33-8. doi: 10.13702/j.1000-0607.20210059.

ABSTRACT

OBJECTIVE: To observe the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on the motor function and the expression of glial fibrillary acidic protein (GFAP) and microtubule associated protein 2 (MAP2) in cerebral ischemic penumbra of rats with middle cerebral artery occlusion (MCAO) and explore the mechanism of taVNS in the improvement of motor function in MCAO rats.

METHODS: A total of 48 male SD rats were randomized into a sham-operation group, a model group, a transcutaneous auricular non-vagus nerve stimulation (tnVNS) group and a taVNS group, with 12 rats in each group. The suture-occluded method was adopted to prepare MCAO rat model. The auricular rim was stimulated in the tnVNS group and the concha stimulated in the taVNS group, 2 mA in intensity, 10 Hz in frequency, 30 min each time, once a day, for 14 days consecutively. The nerve functional assessment was recorded in each group. The expressions of nicotinic acetylcholine receptor (α7nAchR) in the cerebral ischemic penumbra and the spleen were detected by using Western blot. With the immunofluorescence, the expressions of GFAP and MAP2 were detected.

RESULTS: After modeling, compared with the sham-operation group, the nerve functional score was increased in the model group, the tnVNS group and the taVNS group (P<0.01), suggesting the success of modeling. After treatment, the score was increased in the model group (P<0.01) as compared with the sham-operation group. Compared with the model group, the neurological deficit score was reduced in the taVNS group (P<0.01). Compared with the sham-operation group, GFAP expression was increased and MAP2 expression was reduced remarkably in the cerebral ischemic penumbra in the model group (P<0.05). In comparison with the model group, GFAP expression was reduced, while MAP2 expression was increased remarkably in the cerebral ischemic penumbra in the taVNS group (P<0.05). There were no significant differences in the abovementioned indexes between the model group and tnVNS group (P>0.05). The differences in the expression of α7nAchR in the cerebral ischemic penumbra and the spleen had no statistical significance among groups (P>0.05).

CONCLUSION: TaVNS is effective on neuroprotection in MCAO rats, which may be related to its function of inhibition of GFAP expression and promotion of MAP2 expression in the ischemic penumbra.

PMID:35128868 | DOI:10.13702/j.1000-0607.20210059

Zhen Ci Yan Jiu. 2022 Jan 25;47(1):39-45. doi: 10.13702/j.1000-0607.20210738.

ABSTRACT

OBJECTIVE: To observe the effect of electroacupuncture(EA)at “Baihui”(GV20) and “Shenting” (GV24) on the expression of melatonin synthesis rate-limiting enzyme-arylalkylamine N-acetyltransferase(AANAT)in pineal gland of rats with focal cerebral ischemia-reperfusion injury, so as to explore the mechanism of EA underlying improving ischemia-reperfusion injury.

METHODS: Forty-eight SD rats were randomly divided into sham operation, model, EA and non-acupoint groups, with 12 rats in each group. The focal cerebral ischemia-reperfusion injury rat model was established by occlusion of the middle cerebral artery. Rats of the EA group received EA at GV20 and GV24, while those in the non-acupoint group received EA at non-acupoints below the costal margins on both sides for 20 min, once daily for 7 days. The neurological deficit score (0 to 4 points) was given after successful modeling according to Longa’s method. Morris water maze test was used to assess the cognitive function of rat. ELISA was used to detect the plasma melatonin content, and PCR and Western blot were used to detect the mRNA and protein expressions of AANAT in the pineal gland, separately. Immunofluorescence staining was used to detect the activation of astrocytes and neuronal injury in the hippocampus.

RESULTS: After focal cerebral ischemia-reperfusion injury and compared with the sham operation group, the neurological deficit score, the escape latency, and the expression of GFAP were significantly increased (P<0.01)，while the times of platform quadrant crossing, the secretion of melatonin at 24:00，AANAT mRNA and protein expression levels and NeuN protein expression were significantly down-regulated (P<0.01). After EA at GV20 and GV24, the above-mentioned indexes all reversed in the EA group relative to the model group, and there were significant differences between the two groups(P<0.01). Compared with the model group, the changes of the abovementioned indexes in the non-acupoint group were not statistically significant (P>0.05).

CONCLUSION: EA at GV20 and GV24 can alleviate neurological deficit and improve cognitive function in cerebral ischemia-reperfusion rats，which may be related to its effects in up-regulating endogenous melatonin levels, inhibiting the activation of astrocytes and protecting damaged neurons in the hippocampus.

PMID:35128869 | DOI:10.13702/j.1000-0607.20210738

J Gynecol Oncol. 2022 Jan 17. doi: 10.3802/jgo.2022.33.e27. Online ahead of print.

ABSTRACT

OBJECTIVE: The need to perform genetic sequencing to diagnose the polymerase epsilon exonuclease (POLE) subtype of endometrial cancer (EC) hinders the adoption of molecular classification. We investigated clinicopathologic and protein markers that distinguish the POLE from the copy number (CN)-low subtype in EC.

METHODS: Ninety-one samples (15 POLE, 76 CN-low) were selected from The Cancer Genome Atlas EC dataset. Clinicopathologic and normalized reverse phase protein array expression data were analyzed for associations with the subtypes. A logistic model including selected markers was constructed by stepwise selection using area under the curve (AUC) from 5-fold cross-validation (CV). The selected markers were validated using immunohistochemistry (IHC) in a separate cohort.

RESULTS: Body mass index (BMI) and tumor grade were significantly associated with the POLE subtype. With BMI and tumor grade as covariates, 5 proteins were associated with the EC subtypes. The stepwise selection method identified BMI, cyclin B1, caspase 8, and X-box binding protein 1 (XBP1) as markers distinguishing the POLE from the CN-low subtype. The mean of CV AUC, sensitivity, specificity, and balanced accuracy of the selected model were 0.97, 0.91, 0.87, and 0.89, respectively. IHC validation showed that cyclin B1 expression was significantly higher in the POLE than in the CN-low subtype and receiver operating characteristic curve of cyclin B1 expression in IHC revealed AUC of 0.683.

CONCLUSION: BMI and expression of cyclin B1, caspase 8, and XBP1 are candidate markers distinguishing the POLE from the CN-low subtype. Cyclin B1 IHC may replace POLE sequencing in molecular classification of EC.

PMID:35128857 | DOI:10.3802/jgo.2022.33.e27

Pharm Stat. 2022 Feb 6. doi: 10.1002/pst.2196. Online ahead of print.

ABSTRACT

The document ICH E9 (R1) has brought much attention to the concept of estimand in the clinical trials community. ICH stands for International Conference for Harmonization. In this article, we draw attention to one facet of estimand that is not discussed in that document but is crucial in the context of observational studies, namely weighting for covariate balance. How weighting schemes are connected to estimand, or more specifically to one of its five attributes identified in ICH E9 (R1), the attribute of population, is illustrated using the Rubin Causal Model. Three estimands are examined from both theoretical and practical perspectives. Factors that may be considered in choosing among these estimands are discussed.

PMID:35128808 | DOI:10.1002/pst.2196

J Gynecol Oncol. 2022 Jan 17. doi: 10.3802/jgo.2022.33.e22. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the diagnostic accuracies of ultrasound and magnetic resonance imaging (MRI) for deep (≥50%) myometrial invasion (DMI) and cervical stromal invasion (CSI) in women with endometrial cancer.

METHODS: This was a prospective study at a gynecology clinic for women with postmenopausal bleeding. Between October 2015-October 2018, consecutive women with suspected endometrial cancer based on ultrasound subjective pattern recognition were simultaneously assessed for DMI and CSI on ultrasound. Subsequently, they also underwent preoperative MRI. We compared the diagnostic accuracies of ultrasound and MRI in predicting DMI and CSI with the final histology as the gold standard.

RESULTS: We included 51 women. The prevalence of DMI and CSI were 22/51 (43%) and 7/51 (14%), respectively. The majority of malignancies were of endometrioid histological subtype (38/51, 75%) and FIGO stage 1 or 2 (40/51, 78%). Ultrasound diagnosed more cases of DMI compared to MRI (19/22 vs. 17/22), however, the difference was not statistically significant. The sensitivities and specificities of ultrasound and MRI for DMI were 86% vs. 77% and 66% vs. 76%, respectively. For CSI, ultrasound and MRI correctly diagnosed the same number of cases (5/7, 71%); their respective false-positive rates were low, 0/44 (0%) and 1/44 (2%). Ultrasound and MRI had a moderate agreement for DMI (ƙ=0.49; 95% confidence interval [CI]=0.26-0.73), whereas the agreement for CSI was substantial (ƙ=0.69; 95% CI=0.36-1.00).

CONCLUSION: Endometrial cancer can be simultaneously diagnosed and staged at women’s initial ultrasound assessment. The accuracies of ultrasound for DMI and CSI are comparable to MRI.

TRIAL REGISTRATION: ISRCTN Identifier: ISRCTN24363390.

PMID:35128854 | DOI:10.3802/jgo.2022.33.e22

J Esthet Restor Dent. 2022 Feb 6. doi: 10.1111/jerd.12883. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance of a standardized photographic shade analysis (PSA) and visual shade matching (VSM) using two color difference formulas.

MATERIALS AND METHODS: Fifty observers (35 undergraduate and 15 graduate students) evaluated the color of two upper left central incisors (LT-light tooth, and DT-dark tooth). VSM was performed using the VITA 3D Master (3D) shade guide in a controlled clinical environment. For PSA, a cross-polarized filter and a gray card (Whibal) were used to standardize the photographs taken (target teeth and shade tabs from 3D). From the pictures obtained, the CIELAB coordinates, and color differences ( ΔEab* and ΔE₀₀ ) were obtained. The shade tabs selected by two experienced researchers were conducted as part of the pilot study, and finally used as a standard for the analysis. Data were analyzed using descriptive statistics and the chi-square test (p ≤ 0.05).

RESULTS: Shade tabs selections of VSM and PSA agreed only for LT. The best “Match” selected by the researchers agreed with data from PSA using ΔE₀₀ . PSA using ΔE₀₀ showed higher total percentages of “Match” and higher percentage of agreement among observers. A relationship was found for LT performing the PSA (p < 0.05).

CONCLUSIONS: The performance of the PSA was better than the VSM, but only when the CIEDE2000 color difference formula was used. Therefore, the color difference formulas influenced on the performance of PSA. Finally, the PSA improved the precision of the VSM.

CLINICAL SIGNIFICANCE: To use a standardized PSA to improve the VSM and shade communication in clinical esthetic dentistry.

PMID:35128799 | DOI:10.1111/jerd.12883