Nevin Manimala

Patient Educ Couns. 2023 Jun 25;115:107862. doi: 10.1016/j.pec.2023.107862. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore patients’ usage rate and perceived usefulness and benefits of a question prompt list (QPL) when collecting prescribed medication in community pharmacies.

METHODS: Data were collected in Swedish pharmacies using questionnaires and semi-structured interviews with patients. The Technology Acceptance Model (TAM) was used, and the outcomes were usage rate, factors impacting on use, and perceived ease of use, usefulness, and benefits of self-reported question-asking and self-perceived medication knowledge. Descriptive statistics and group comparisons were performed, and qualitative data were analyzed thematically with the TAM.

RESULTS: Out of 145 patients filling out the questionnaire, 72 (50.0%) reported they had used the QPL. Patients with new prescriptions and non-native Swedish speakers used the QPL more often (p = 0.03; p = 0.009, respectively). The QPL was quick to read (86.3%) and easy to understand (91.4%). Forty percent stated that they asked more questions, and self-reported users scored higher on self-perceived medication knowledge. In the interviews (n = 14), the QPL was described as an eye-opener as to what one could ask the pharmacist.

CONCLUSIONS: Patients were willing to use a QPL in community pharmacies.

PRACTICE IMPLICATIONS: A QPL in pharmacies might improve patients’ engagement medication knowledge, as well as showcase the expertise of pharmacists.

PMID:37422951 | DOI:10.1016/j.pec.2023.107862

J Electrocardiol. 2023 Jun 22;80:155-161. doi: 10.1016/j.jelectrocard.2023.06.006. Online ahead of print.

ABSTRACT

INTRODUCTION: Past research based on observations has suggested that the gut microbiome (GM) could play a role in developing arrhythmias and conduction blocks. Nonetheless, the nature of this association remains uncertain due to the potential for reverse causation and confounding factors in observational research. The aim of this investigation is to elucidate the causal relationship between GM and the development of arrhythmias as well as conduction blocks.

METHODS: This study collected summary statistics regarding GM, arrhythmias, and conduction blocks. Two-sample Mendelian randomization (MR) analysis was carried out employing various methods, with inverse variance weighted being the primary approach, followed by weighted median, simple mode, MR-Egger, and MR-PRESSO. Moreover, the MR findings were corroborated through multiple sensitivity analyses.

RESULTS: Among them, for atrial fibrillation and flutter (AF), phylum_Actinobacteria and genus_RuminococcaceaeUCG004 demonstrated a negative correlation, while order_Pasteurellales, family_Pasteurellaceae, and genus_Turicibacter were associated with an increased risk. In the case of paroxysmal tachycardia (PT), genus_Holdemania and genus_Roseburia were found to reduce risk. For atrioventricular block (AVB), order_Bifidobacteriales, family_Bifidobacteriaceae, and genus_Alistipes exhibited a negative correlation, whereas genus_CandidatusSoleaferrea showed a positive correlation. Concerning the left bundle-branch block (LBBB), family_Peptococcaceae appeared to decrease the risk, while genus_Flavonifractor was linked to an increased risk. Lastly, no causative GM was identified in the right bundle-branch block (RBBB) context.

CONCLUSION: We have uncovered potential causal links between some GM, arrhythmias, and conduction blocks. This insight may aid in designing microbiome-based interventions for these conditions and their risk factors in future trials. Additionally, it could facilitate the discovery of novel biomarkers for targeted prevention strategies.

PMID:37422943 | DOI:10.1016/j.jelectrocard.2023.06.006

Epilepsy Behav. 2023 Jul 7;145:109332. doi: 10.1016/j.yebeh.2023.109332. Online ahead of print.

ABSTRACT

PURPOSE: Stereotactic laser amygdalohippocampotomy (SLAH) is a minimally invasive surgical treatment for drug-resistant temporal lobe epilepsy (TLE) that has comparable rates of seizure freedom to traditional open resective TLE surgery. The objective of this study was to determine psychiatric outcome (i.e., depression and anxiety changes, psychosis) after SLAH, to explore possible contributory factors to these changes, and to determine the prevalence of de novo psychopathology.

METHODS: We explored mood and anxiety in 37 adult patients with TLE undergoing SLAH using the Beck psychiatric symptoms scales (i.e., Beck Depression Inventory-II [BDI-II] and Beck Anxiety Inventory [BAI]) preoperatively and 6 months following surgery. Multivariable regression analysis was conducted to identify predictors of worse depression or anxiety symptoms following SLAH. The prevalence of de novo psychopathology following SLAH was also determined.

RESULTS: We found a significant decrease in BDI-II (mean decline from 16.3 to 10.9, p = 0.004) and BAI (mean decline from 13.3 to 9.0, p = 0.045) scores following SLAH at the group level. While the rate of resolution of depression (from 62% to 49%) did not achieve statistical significance (p = 0.13, McNemar’s), the rate of resolution of anxiety (from 57% to 35%) was statistically significant (p = 0.03, McNemar’s). The de novo rate of psychopathology (i.e., new onset depression or anxiety) following SLAH was 1 of 7 (14%). Using a metric of meaningful change rather than complete symptom resolution, 16 of 37 (43%) patients experienced improvement in depression and 6 of 37 (16%) experienced worsening. For anxiety, 14 of 37 (38%) experienced meaningful improvement and 8 of 37 (22%) experienced worsening. Baseline performance on the Beck Scales was the only factor contributing to outcome status.

DISCUSSION: In one of the first studies to evaluate psychiatric outcomes after SLAH, we found promising overall trends toward stability or significant improvement in symptom burden at the group level for both depression and anxiety. There was also a significant improvement in clinical anxiety, though the decrease in clinical depression was not significant, likely owing to the limitations of sample size. SLAH may improve overall psychiatric symptoms, similarly to traditional resective TLE surgery, but de novo psychopathology and postoperative psychiatric morbidity remain significant issues, and larger samples are necessary to determine causal contributory factors.

PMID:37422933 | DOI:10.1016/j.yebeh.2023.109332

ALTEX. 2023 Jun 27. doi: 10.14573/altex.2210171. Online ahead of print.

ABSTRACT

In chemical safety assessment, benchmark concentrations (BMC) and their associated uncertainty are needed for the toxicological evaluation of in vitro data sets. A BMC estimation is derived from concentration-response modelling and results from various statistical decisions, which depend on factors such as experimental design and assay endpoint features. In current data practice, the experimenter is often responsible for the data analysis and therefore relies on statistical software often without being aware of the software default settings and how they can impact the outputs of data analysis. To provide more insight into how statistical decision-making can influence the outcomes of data analysis and interpretation, we have developed an automatic platform that includes statistical methods for BMC estimation, a novel endpoint-specific hazard classification system, and routines that flag data sets that are outside the applicability domain for an automatic data evaluation. We used case studies on a large dataset produced by a developmental neurotoxicity (DNT) in vitro battery (DNT IVB). Here we focused on the BMC and its confidence interval (CI) estimation as well as on final hazard classification. We identified five crucial statistical decisions the experimenter must make during data analysis: choice of replicate averaging, response data normalization, regression modelling, BMC and CI estimation, and choice of benchmark response levels. The insights gained in are intended to raise more awareness among experimenters on the importance of statistical decisions and methods but also to demonstrate how important fit-for-purpose, internationally harmonized and accepted data evaluation and analysis procedures are for objective hazard classification.

PMID:37422925 | DOI:10.14573/altex.2210171

Nicotine Tob Res. 2023 Jul 9:ntad117. doi: 10.1093/ntr/ntad117. Online ahead of print.

ABSTRACT

INTRODUCTION: Tobacco is a well-established risk factor for cancer, but its association with other morbidities needs consideration. The low-income and middle-income countries with unprecedented demographic transformation lack evidence on tobacco use and its impact on cognitive health.

METHODS: Using a propensity score matching approach, we utilized data from the Longitudinal Ageing Study of India. Study employed 1:1 nearest neighbor matching with the replacement methodology. We estimated the odds of poor cognitive score and tobacco use among older adults based on five different models for ever tobacco user, former tobacco user, current tobacco user, current smokers, and current smokeless tobacco users with reference to never tobacco users.

RESULTS: The estimated average treatment effect (ATT) for treated and the untreated group has shown a higher likelihood of cognitive decline among ever (OR -0.26; 95%CI -0.43 to -0.09), current (OR -0.28; 95%CI -0.45 to -0.10) and former (OR -0.53; 95%CI -0.87 to -0.19) tobacco users compared to never tobacco users compared to never tobacco users. Finding further suggests that odds of lower cognitive score among older adults who were smoker (OR -0.53; 95%CI -0.87 to -0.19) and smokeless tobacco user (OR -0.22; 95%CI -0.43 to -0.01).

CONCLUSIONS: Interventions designed to prevent and prolong the incidence of cognitive impairment should focus on limiting the use of tobacco. Strategies under tobacco-free generation initiative should be amplified in order to prevent future generation from productivity loss and to promote healthy ageing and premature deaths.

IMPLICATIONS: Evidence of a definitive association between tobacco consumption and cognition among older adults is sporadic in low-income and middle-income countries (LMICs). Though tobacco is a risk factor for various diseases including cancer, the extent of its impact on cognitive health among older population is limited. This study contributes to existing literature by highlighting poor cognitive outcomes among older adults who smoke tobacco and consume smokeless tobacco as compared to never tobacco users. Our findings emphasize the need to accelerate tobacco-free generation efforts in LMICs to reach a higher quality of life and active ageing in pursuit of achieving the sustainable development goal of ‘good health and well-being’.

PMID:37422916 | DOI:10.1093/ntr/ntad117

J Cancer Res Clin Oncol. 2023 Jul 9. doi: 10.1007/s00432-023-05096-0. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this meta-analysis is to systematically review the diagnostic performance of radiomic techniques in predicting peritoneal metastasis in patients with gastric cancer, and to evaluate the quality of current research.

METHODS: We searched PubMed, Web of Science, EBSCO, Embase, and Cochrane databases for relevant studies up to April 3, 2023. Data extraction and quality evaluation were performed by two independent reviewers. Then we performed statistical analysis, including plotting the forest plot and summary receiver operating characteristic (SROC) curve, and source of heterogeneity analysis, through the MIDAS module in Stata 15. We performed meta-regression and subgroup analyses to analyze the sources of heterogeneity. Using the QUADAS-2 scale and the RQS scale to assess the quality of retrieved studies.

RESULTS: Ten studies with 6199 patients were finally included in our meta-analysis. Pooled sensitivity and specificity were 0.77 (95% confidence interval [CI]: 0.66, 0.86), and 0.88 (95% CI 0.80, 0.93), respectively. The overall AUC was 0.89 (95% CI 0.86, 0.92). The heterogeneity of this meta-analysis was high, with I² = 88% (95% CI 75,100). The result of meta-regression showed that QUADAS-2 results, RQS results and machine learning method led to heterogeneity in sensitivity and specificity (P < 0.05). Furthermore, the image segmentation area and the presence or absence of combined clinical factors were associated with sensitivity heterogeneity and specificity heterogeneity, respectively.

CONCLUSION: Undoubtedly, radiomics has potential value in diagnosing peritoneal metastasis of gastric cancer, but the quality of current research is inconsistent, and more standardized and high-quality research is still needed in the future to achieve the transformation of radiomics results into clinical applications.

PMID:37422882 | DOI:10.1007/s00432-023-05096-0

Transfusion. 2023 Jul 9. doi: 10.1111/trf.17469. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal photopheresis (ECP) treatment, mostly based on apheresis technology, is used for immunomodulation in various diseases such as cutaneous T-cell lymphoma, graft versus host disease and other (auto)immune disorders. The aim of this study was to collect high cell counts and purity in shorter procedure times using an ECP off-line system with an increased collection flow rate of 2 mL/min to a target volume of 200 mL buffy coat.

STUDY DESIGN AND METHODS: In this prospective study, data of routinely performed off-line photopheresis treatments were collected and analyzed at the Central Institute for Blood Transfusion & Department of Immunology (ZIB) of the Tirol Kliniken, to assess absolute cell counts and procedure times and to calculate collection efficiencies (CE2).

RESULTS: A total of 22 patients participated in this study. The processed blood volume was 4312 mL, the collection time 120 min, overall procedure time 157 min and the absolute cell counts of treated white blood cells (WBC) and mononuclear cells (MNC) were 5.0 and 4.3 × 10⁹ respectively (median values). The calculated CE2 for WBC and MNC was 21.1% and 58.5%, the proportion of treated MNCs of the total number of MNCs present was 55.0%.

CONCLUSION: The data presented in this study show high therapeutically effective cell counts collected with a high MNC purity within a shorter overall collection/procedure time due to an increased collection flow rate.

PMID:37422880 | DOI:10.1111/trf.17469

Zhonghua Nan Ke Xue. 2021 Nov;27(11):1017-1024.

ABSTRACT

OBJECTIVE: To analyze the academic thought, medication experience and prescription rules of Academician Wang Qi in the treatment of premature ejaculation (PE) using the TCM inheritance support platform (V2.5).

METHODS: We collected and sorted out the medical records on the treatment of PE from Academician Wang Qi’s Clinic. We established a database of medical records on the TCM inheritance support platform, analyzed the drugs and prescriptions in the database and explored new prescriptions using “statistical reports” and “data analysis” systems on the platform.

RESULTS: A total of 91 effective prescriptions were recorded, involving 148 TCM drugs, with Phellodendron, Amomum Villosum, Polygala Tenuifolia, Tuckahoe, Lodestone, Oyster, Acanthopanax Senticosus, Uncaria, Tribulus, and Keel as the top 10 with the highest frequency of use, which were featured mainly by “warm” and “cold” concerning the four natures, “sweet”, “bitter” and “pungent” relating to the five flavors, and acting on “kidney meridian”, “liver meridian” and “heart meridian” in terms of the meridian tropisms. In addition, 5 new prescriptions were obtained through unsupervised entropy hierarchical clustering.

CONCLUSIONS: In the treatment of PE, Academician Wang Qi employs tranquilizing the mind and consolidating the kidney (An Zhi Gu Shen) as the primary strategy, taking into account the three organs of heart, liver and kidneys, focusing on the phase of calming the mind or regulating the liver or clearing the kidney or controlling fire, and adding or reducing drugs according to different conditions and syndromes, which conforms to his diagnosis and treatment mode of “body differentiation－disease differentiation－syndrome differentiation”. The analysis of the potential new prescriptions also accords with Academician Wang Qi’s rules of medication, which can provide some ideas for the clinical treatment of and scientific researches on premature ejaculation in the future.

PMID:37422875

Zhonghua Nan Ke Xue. 2021 Nov;27(11):995-1000.

ABSTRACT

OBJECTIVE: To evaluate the effects of different filling method-related sperm counting chambers and the structural factors of Leja counting chambers on sperm motility using computer-assisted sperm analysis (CASA).

METHODS: Using drop-filled Makler, capillary-loaded Leja and structurally modified Leja sperm counting chambers, we measured sperm concentration, the percentages of progressively motile sperm (PMS) and non-progressively motile sperm (NPMS), total sperm motility, curvilinear velocity (VCL), average path velocity (VAP), straight line velocity (VSL), beat-cross frequency (BCF), linearity (LIN), wobble (WOB) and straightness (STR) in the semen samples of 76 males by CASA and compared them between different chambers.

RESULTS: The drop-filled Makler sperm counting chamber achieved remarkably higher PMS, NPMS, total sperm motility, VCL and VAP than the Leja chambers (P < 0.05). There were no statistically significant differences in VSL, BCF, LIN, WOB and STR between the Makler and Leja chambers (P > 0.05), or in sperm concentration, PMS, NPMS and total sperm motility between the capillary-loaded and structurally modified Leja counting chambers (P > 0.05). The ground edge and thickness of the coverslip of the Leja counting chamber produced no significant inference on the kinetic sperm parameters (P > 0.05).

CONCLUSIONS: The drop-filled sperm counting chamber achieves significantly higher sperm motility and kinetic parameters than the capillary-loaded Leja chamber. The structural factors such as the ground edge and thickness of the coverslip of the Leja counting chamber do not influence the analysis of sperm parameters.

PMID:37422871

Zhonghua Nan Ke Xue. 2021 Nov;27(11):991-994.

ABSTRACT

OBJECTIVE: To evaluate the influence of sperm from different sources in intrauterine insemination on clinical and neonatal outcomes.

METHODS: We retrospectively analyzed the clinical and follow-up data on 1,071 cases of singleton pregnancy by IUI at the Center of Assisted Reproduction of our hospital from January 2015 to December 2017. According to the sources of sperm, 658 of the pregnancies were achieved by artificial insemination by donor (AID) and the other 413 by artificial insemination by husband (AIH). We compared the clinical parameters between the two groups.

RESULTS: No statistically significant differences were observed between the AID and AIH groups in spontaneous abortion (76 ［11.55%］ vs 60 ［14.53%］, P > 0.05), <37 wk premature delivery (20 ［3.48%］ vs16 ［4.65%］, P > 0.05), mean birth weight (［3.33 ± 0.46］ vs ［3.30 ± 0.48］ kg, P > 0.05), <2.5 kg low birth weight (15 ［2.61%］ vs 13 ［3.78%］, P > 0.05), ≥4.0 kg fetal macrosomia (41 ［7.13%］ vs 31 ［9.01%］, P > 0.05), or fetal defects (6 ［1.04%］ vs 4 ［1.16%］, P > 0.05).

CONCLUSIONS: Artificial insemination by donor does not increase the risk of adverse clinical and neonatal outcomes and therefore is considered as a safe and reliable assisted reproductive technique.

PMID:37422870