Category: Nevin Manimala

Anaesthesia. 2021 Jul 13. doi: 10.1111/anae.15537. Online ahead of print.

ABSTRACT

Self-reported postoperative functional recovery is an important patient-centred outcome that is rarely measured or considered in research and decision-making. We conducted a secondary analysis of the measurement of exercise tolerance before surgery (METS) study for associations of peri-operative variables with functional decline after major non-cardiac surgery. Patients who were at least 40 years old, had or were at risk of, coronary artery disease and who were scheduled for non-cardiac surgery were recruited. Primary outcome was a reduction in mobility, self-care or ability to conduct usual activities (EuroQol 5 dimension) from before surgery to 30 days and 1 year after surgery. A decline in at least one function was reported by 523/1309 (40%) participants at 30 days and 320/1309 (24%) participants at 1 year. Participants who reported higher pre-operative Duke Activity Status indices more often reported functional decline 30 days after surgery and less often reported functional decline 1 year after surgery. The odds ratios (95%CI) of functional decline 30 days and 1 year after surgery with moderate or severe postoperative complications were 1.46 (1.02-2.09), p = 0.037 and 1.44 (0.98-2.13), p = 0.066. Discrimination of participants who reported functional decline 30 days and 1 year after surgery were poor (c-statistic 0.61 and 0.63, respectively). In summary, one quarter of participants reported functional decline up to one postoperative year.

PMID:34254670 | DOI:10.1111/anae.15537

J Forensic Sci. 2021 Jul 13. doi: 10.1111/1556-4029.14793. Online ahead of print.

ABSTRACT

This article adds to the growth in data-driven analyses seeking to compare samples of violent extremists with other violent populations of interest. While lone-actor terrorists and public mass murderers are frequently treated as distinct offender types, both engage (or attempt to engage) in largely public and highly publicized acts of violence and often use similar weapons. This article investigates the (dis)similarities between both offender types. We use a series of bivariate and multivariate statistical analyses to compare demographic, psychologic and behavioral variables across 71 lone-actor terrorists and 115 public mass murderers. The results show little distinction in sociodemographic profiles, but significant differences in (a) the degree to which they interact with co-ideologues (b) antecedent event behaviors and (c) the degree to which they leak information before the attack. Overall, our data inform the emerging idea that lone-actor terrorists and public mass shooters are not distinct offender types. There is more that unites them than divides them. Although the over-arching focus of our results are on the few variables that distinguish them, the vast majority (80%+), of the 180+ variables showed no significant difference. We discuss implications for threat assessment and management in the context of these results.

PMID:34254683 | DOI:10.1111/1556-4029.14793

Agri. 2021 Jan;33(1):7-14. doi: 10.14744/agri.2020.77698.

ABSTRACT

OBJECTIVES: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]).

METHODS: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.

RESULTS: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.

CONCLUSION: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.

PMID:34254656 | DOI:10.14744/agri.2020.77698

Med Pr. 2021 Jul 13:136987. doi: 10.13075/mp.5893.01110. Online ahead of print.

ABSTRACT

BACKGROUND: Tuberculosis is a chronic infectious disease caused by acid-fast mycobacteria from the Mycobacterium tuberculosis complex group. The disease spreads when people with pulmonary tuberculosis excrete bacteria when they cough, sneeze, laugh or speak. Prisons are often called reservoirs of patients with tuberculosis, posing a great threat to their staff. Longer working hours in prison and penitentiary facilities aid latent contamination among the prison staff. So far, there have been few works discussing latent tuberculosis infection issues among the prisoners and prison staff.

MATERIAL AND METHODS: A total of 84 employees of penitentiary facilities located in the Lublin Voivodship were examined using the QuantiFERON-TB Gold In-Tube (QFT-GIT) test which was approved for use in 2005 by the U.S. Food and Drug Administration as an aid in the diagnosis of Mycobacterium tuberculosis. The material for the research included blood samples collected using the QFT-GIT.

RESULTS: Positive test results of latent tuberculosis infections were found in 16.6% of officers. The highest percentage with positive results of tuberculosis infections was found among the surveyed single women aged 36-57, working in penitentiary facilities. There have been no statistically significant differences between the position of officers and the risk factors increasing the chance of the latent tuberculosis infection. Work experience and contact with inmates were found to have an impact on tuberculosis infection.

CONCLUSIONS: The obtained results partially confirm other authors’ observations concerning the influence of the risk factors of latent tuberculosis infections in prisons. Work experience and contact with inmates have an impact on tuberculosis infections among the prison staff in the Lublin Voivodeship. Med Pr. 2021;72(4).

PMID:34254590 | DOI:10.13075/mp.5893.01110

Phys Chem Chem Phys. 2021 Jul 13. doi: 10.1039/d1cp02233d. Online ahead of print.

ABSTRACT

Changes in the structural dynamics of double stranded (ds)DNA upon ligand binding have been linked to the mechanism of allostery without conformational change, but direct experimental evidence remains elusive. To address this, a combination of steady state infrared (IR) absorption spectroscopy and ultrafast temperature jump IR absorption measurements has been used to quantify the extent of fast (∼100 ns) fluctuations in (ds)DNA·Hoechst 33258 complexes at a range of temperatures. Exploiting the direct link between vibrational band intensities and base stacking shows that the absolute magnitude of the change in absorbance caused by fast structural fluctuations following the temperature jump is only weakly dependent on the starting temperature of the sample. The observed fast dynamics are some two orders of magnitude faster than strand separation and associated with all points along the 10-base pair duplex d(GCATATATCC). Binding the Hoechst 33258 ligand causes a small but consistent reduction in the extent of these fast fluctuations of base pairs located outside of the ligand binding region. These observations point to a ligand-induced reduction in the flexibility of the dsDNA near the binding site, consistent with an estimated allosteric propagation length of 15 Å, about 5 base pairs, which agrees well with both molecular simulation and coarse-grained statistical mechanics models of allostery leading to cooperative ligand binding.

PMID:34254612 | DOI:10.1039/d1cp02233d

Agri. 2021 Jan;33(1):15-22. doi: 10.14744/agri.2020.54289.

ABSTRACT

OBJECTIVES: This study was performed to investigate the efficiency of local heat and cold application to decrease vaccine-associated pain among infants 2-6 months of age.

METHODS: This was a randomized controlled trial. The study universe comprised infants aged 2-6 months who were brought to 4 family health centers in the Safranbolu district of Karabuk Province, Turkey, for a pneumococcal vaccination June 1-November 30, 2016. A total of 96 infants (heat application: 31, cold application: 32, and control group: 33) were enrolled in the the study. The data were collected using an infant ınformation form and the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale.

RESULTS: The mean FLACC score of the infants was 5.531±1.934 in the cold application group, 8.710±1.346 in the heat application group, and 9.152±1.661 in the control group. The difference between the mean scores of the groups was statistically significant (KW=49.043; p=0.000).

CONCLUSION: Local cold and heat application methods applied to the vaccination area before a pneumoccal vaccine reduced vaccine-associated pain in the infants, and the application of cold was more effective than heat.

PMID:34254654 | DOI:10.14744/agri.2020.54289

Int J Occup Saf Ergon. 2021 Jul 13:1-37. doi: 10.1080/10803548.2021.1953787. Online ahead of print.

ABSTRACT

Purpose: This scientometric study was aimed to investigate research and hot topics on unsafe behavior.Methods and Materials: This study was performed using Scientometric analysis mapping tools, such as CiteSpace, Gephi, MINITAB, and VOSviewer for statistical analysis. Studies published in Web of Sciences were included in our study.Results: The first study was published in 1987. The results of the study showed that the Safety Science journal with 111 studies (10.45%), presented most of published studies in this field. United States and China were the two producing countries, with 289 and 229 published studies, respectively. The results of keywords and hot topics showed that between 1991-2000, Safety climate, Safety performance and Modelling were ranked first to third most frequent words, and during 2001-2010, Safety performance was removed from the list of top ten keywords, while Safety climate and Modelling were ranked respectively ninth and sixth most frequent words. Finally, between 2011-2020, keyword Organizational factors has risen to the first rank, indicating the significance of this keyword in the futures.Conclusions: According to the results of the present study, it can be concluded that future studies on unsafe behavior can be conducted in the field of organizational factors.

PMID:34254568 | DOI:10.1080/10803548.2021.1953787

Disabil Rehabil Assist Technol. 2021 Jul 13:1-9. doi: 10.1080/17483107.2021.1937342. Online ahead of print.

ABSTRACT

PURPOSE OF THE ARTICLE: This study explored the impact of assistive technology on the well-being of legally blind adults.

MATERIALS AND METHODS: In this mixed-method study, a convenience sample of 86 legally blind adults took an electronic survey. The questionnaire was comprised of demographics, use patterns, and an instrument called TENS-Interface that measured the impact of technology on well-being categories of autonomy, competence, and relatedness. Descriptive statistics, reliability, power analysis and bivariate correlations were calculated using SPSS statistical software. Three participants completed follow up semi-structured interviews, which were analysed for themes of technological mediation using NVivo 12 software.

RESULTS: The TENS-Interface was validated for use with a legally blind population. Descriptive statistics showed a higher mean for autonomy than competence or relatedness. Braille was positively correlated to both autonomy and competence, while screen reader proficiency was related to competence. Daily use of social media, email, instant messaging, and video calls were correlated to relatedness. The technological devices used by interview participants were analysed for technological mediation. Training was identified as an additional theme.

CONCLUSIONS: Recommendations for practice include providing training to legally blind adults in screen reader use and braille use to support well-being via competence and autonomy. Training is also recommended for this population in the use of social media, email, and video calls to promote well-being through opportunities for relatedness. Further research is recommended to explore instructional methods that are not only efficient, but also meaningful for older adults in the position of losing their vision.IMPLICATIONS FOR REHABILITATIONProviding access to braille instruction and braille assistive technology equipment can promote legally blind adults’ well-being by supporting their basic needs for both competence and autonomy.Providing training in screen reader use can promote legally blind adults’ well-being by supporting their basic need for competence.Providing training in use of email, social media, video calls, and instant messaging can promote legally blind adults’ well-being by supporting their basic need for relatedness.A consideration of technological mediation can allow practitioners to make recommendations that take into account not only efficient task completion, but issues related to meaning and social context.Instruction for adults losing their vision adventitiously needs to address not only efficient task performance, but also meaning and social context.

PMID:34254571 | DOI:10.1080/17483107.2021.1937342

Womens Health (Lond). 2021 Jan-Dec;17:17455065211009751. doi: 10.1177/17455065211009751.

ABSTRACT

Hypertension is a risk factor for cardiovascular disease. Black women have high rates of hypertension compared to women of other racial or ethnic groups and are disproportionately affected by psychosocial stressors such as racial discrimination, gender discrimination, and caregiving stress. Evidence suggests that stress is associated with incident hypertension and hypertension risk. Stress management is associated with improvements improved blood pressure outcomes. The purpose of this review is to synthesize evidence on effects of stress management interventions on blood pressure in Black women. A comprehensive search of scientific databases was conducted. Inclusion criteria included studies that were: (1) primary research that tested an intervention; (2) in the English language; (3) included African-American women; (4) incorporated stress in the intervention; (5) included blood pressure as an outcome; and (6) were US based. Eighteen studies met inclusion criteria. Ten (56%) studies tested meditation-based interventions, two (11%) tested coping and affirmation interventions, and six (33%) tested lifestyle modification interventions that included stress management content. Thirteen of the studies were randomized controlled trials. Reductions in blood pressure were observed in all of the meditation-based interventions, although the magnitude and statistical significance varied. Comprehensive lifestyle interventions were also efficacious for reducing blood pressure, although the relative contribution of stress management versus behavior modification could not be evaluated. Coping and affirmation interventions did not affect blood pressure. Most of the reviewed studies included small numbers of Black women and did not stratify results by race and gender, so effects remain unclear. This review highlights the urgent need for studies specifically focusing on Black women. Given the extensive disparities in cardiovascular disease morbidity and mortality, whether stress management can lower blood pressure and improve primary and secondary cardiovascular disease prevention among Black women is an important question for future research.

PMID:34254559 | DOI:10.1177/17455065211009751

J Vasc Access. 2021 Jul 13:11297298211031339. doi: 10.1177/11297298211031339. Online ahead of print.

ABSTRACT

To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.

PMID:34254560 | DOI:10.1177/11297298211031339