Nevin Manimala

NCHS Data Brief. 2024 Nov;(37).

ABSTRACT

OBJECTIVES: This report presents provisional 2023 data on infant mortality rates using the U.S. linked birth/infant death files. Infant mortality rates are shown by infant age at death, maternal race and Hispanic origin, maternal age, gestational age, sex of the newborn, maternal state of residence, and the 10 leading causes of infant death.

METHODS: Data are from the period linked birth/infant death files, which link infant deaths with the corresponding birth certificates. Comparisons are made between provisional 2023 and final 2022 data. The linked birth/infant files are based on 100% of birth certificates and 98%-99% of infant death certificates registered in all states and the District of Columbia. For 2023, 1.2% of infant deaths remained unlinked. Infant deaths in states with less than 100% of infant death records linked to their respective birth records are weighted.

RESULTS: In 2023, the U.S. provisional infant mortality rate was 5.61 infant deaths per 1,000 live births, unchanged from the rate in 2022. From 2022 to 2023, changes in the neonatal mortality rate (from 3.59 to 3.65) and the postneonatal mortality rate (from 2.02 to 1.96) were not statistically significant. Changes in infant mortality rates were not significant by most of the characteristics examined: maternal race and Hispanic origin, maternal age, gestational age, sex, or the 10 leading causes of infant death. By state, infant mortality rates increased in Nevada and Washington and declined in New Mexico and West Virginia.

PMID:39642283

J Cardiovasc Pharmacol. 2024 Dec 1;84(6):565-577. doi: 10.1097/FJC.0000000000001635.

ABSTRACT

In a randomized double-blinded clinical trial of patients with ST segment elevation myocardial infarction (STEMI), goflikicept, an interleukin-1 blocker, significantly reduced systemic inflammation, measured as the area under the curve (AUC) for high-sensitivity C reactive protein at 14 days. We report secondary analyses of biomarkers at 28 days, and cardiac function and clinical end points at 1 year. Patients received a single administration of goflikicept 80 mg (n = 34), goflikicept 160 mg (n = 34), or placebo (n = 34). Both doses of goflikicept significantly reduced the AUC for high-sensitivity C reactive protein at 28 days compared with placebo, without statistically significant differences between the doses. There were no statistically significant differences between groups in the AUC for natriuretic peptides at 28 days. There were no significant differences between placebo, goflikicept 80 mg, and 160 mg groups in deaths (2.9%, 2.9%, and 0%), hospitalization for cardiovascular reasons (9.1%, 5.9%, and 0%), new-onset or progression of heart failure (9.1%, 5.9%, and 5.9%), and new or increased use of loop diuretics (24.2%, 14.7%, and 17.6%), nor in the number of patients with treatment emergent adverse events, with no treatment-related serious adverse events in any group. In conclusion, in patients with STEMI, interleukin-1 blockade with goflikicept 80 mg or 160 mg was well tolerated and associated with significant reduction of systemic inflammation. Further adequately powered studies are warranted to determine whether the reduction in systemic inflammation with goflikicept translates into a clinical benefit in patients with STEMI.

PMID:39642282 | DOI:10.1097/FJC.0000000000001635

J Acquir Immune Defic Syndr. 2025 Jan 1;98(1):12-19. doi: 10.1097/QAI.0000000000003531. Epub 2024 Dec 5.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to the COVID-19 pandemic period among cisgender men who have sex with men (MSM) and transgender women (TGW).

SETTING: HIV and sexually transmitted infection testing, prevention, and treatment referral service in Rio de Janeiro, Brazil.

METHODS: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of a recent infection testing algorithm to identify recent HIV infection cases and estimate annualized HIV incidences in the pre- (March 2018-February 2020) and post-COVID-19 pandemic onset period (March 2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection.

RESULTS: Among 3814 MSM and 776 TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between the COVID-19 periods. Overall annualized HIV incidence rates were 6.0% (95% confidence interval [CI]: 4.2 to 7.7) and 6.6% (95% CI: 4.3 to 9.0) in the pre- and post-COVID-19 periods, respectively. During the post-COVID-19 period, higher incidence rates were observed among TGW (8.4% [95% CI: 2.9 to 13.9]), those aged 18-24 years (7.8% [95% CI: 4.0 to 11.7]), of Black race (7.9% [95% CI: 3.8 to 12.0]), and those with <12 years of schooling (7.8% [95% CI: 4.8 to 10.8]). Compared to the pre-COVID-19 period, incidence rates were significantly higher in the post-COVID-19 period for those aged >30 years and TGW, while being lower for those with more years of schooling.

CONCLUSION: HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the COVID-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.

PMID:39642281 | DOI:10.1097/QAI.0000000000003531

Adv Clin Exp Med. 2024 Dec 6. doi: 10.17219/acem/191597. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary metastasectomy (PM) is an important procedure for the treatment of metastatic nodules in the lung. The choice of surgical approach, whether thoracotomy or video-assisted thoracoscopic surgery (VATS), remains controversial in terms of the impact on patient prognosis.

OBJECTIVES: This study aimed to evaluate the outcomes and impact on survival of patients undergoing PM with VATS compared to thoracotomy.

MATERIAL AND METHODS: A retrospective evaluation of 136 patients who underwent PM between September 2012 and July 2020 was performed. Data on the demographics, primary tumor histopathology, metastatic features, surgical approach, surgical outcomes, and survival status were analyzed. Statistical analyses included descriptive statistics, survival analysis and Cox regression models.

RESULTS: Of the participants, 84 underwent thoracotomy and 52 underwent VATS. The median survival time of thoracotomized patients was 86.6 months, while it was 99.6 months for VATS patients. A gender-specific analysis revealed a significantly longer survival time for female VATS patients compared to thoracotomy. Multivariate analysis showed significant independent effects of specific tumor types and the number of nodes removed on survival. Overall, no significant difference in survival was found between the 2 surgical methods.

CONCLUSIONS: Both VATS and thoracotomy are effective and safe options for PM. Video-assisted thoracoscopic surgery may offer advantages, particularly in certain patient groups and tumor types, potentially prolonging survival. Gender-specific analyses suggest a survival benefit of VATS, particularly in women. Further studies are needed to validate these results and optimize surgical decision-making in PM.

PMID:39642280 | DOI:10.17219/acem/191597

Holist Nurs Pract. 2024 Dec 5. doi: 10.1097/HNP.0000000000000714. Online ahead of print.

ABSTRACT

This study aimed to examine the effect of foot reflexology and knee massage with black cumin seed oil on pain and fatigue symptoms in elderly individuals with knee osteoarthritis and assess which of these 2 applications is more effective. Our randomized controlled trial was conducted with 150 participants. Study data were collected from participants over 65 years who received outpatient treatment in a university hospital’s physical therapy and rehabilitation unit and were determined to have no perception problems based on the Mini-Mental Test. After randomization, the study sample was classified into 5 groups, each including 30 participants: (1) foot reflexology with black cumin seed oil, (2) foot reflexology with a placebo, (3) knee massage with black cumin oil, (4) knee massage with a placebo, and (5) control. Participants were administered a Patient Descriptive Information Form, the Lequesne Knee Osteoarthritis Index, the Pain-Visual Analog Scale, the Fatigue Severity Scale, and the Western Ontario and McMaster Universities Osteoarthritis Index. Control group participants received standard of care, while participants in treatment groups received the studied interventions for 6 weeks. Data were collected by administering questionnaires to the participants in the first and sixth weeks and analyzed using IBM Statistical Package for Social Sciences 22.0 software. The study showed that foot reflexology and knee massage administered using black cumin oil effectively reduced pain and fatigue severity in Osteoarthritis (OA) patients, and overall, foot reflexology administered using black cumin oil was the most effective treatment to reduce pain and fatigue.

PMID:39642267 | DOI:10.1097/HNP.0000000000000714

J Nurs Educ. 2024 Dec;63(12):854-856. doi: 10.3928/01484834-20240627-01. Epub 2024 Dec 1.

ABSTRACT

BACKGROUND: As health care continues to evolve, the electronic medical record (EHR) has emerged as an important decision-making tool. To ensure that nursing students work toward competency with the EHR, this study sought to gather information regarding how students use the EHR.

METHOD: Students in a direct-entry, prelicensure program were observed using the EHR during a simulation-based experience (SBE). Focus groups gathered qualitative student perceptions of EHR use.

RESULTS: Minimal use of the EHR during SBE was identified. Students reported using the EHR for information gathering, validating findings, and nursing tasks.

CONCLUSION: This study highlights the need for more robust EHR development and program integration with SBEs in schools of nursing to better align with the clinical practice environment. More research is needed to evaluate how schools of nursing integrate the EHR and how nursing students use the EHR in health care settings to make patient-related decisions. [J Nurs Educ. 2024;63(12):854-856.].

PMID:39642259 | DOI:10.3928/01484834-20240627-01

J Nurs Educ. 2024 Dec;63(12):844-849. doi: 10.3928/01484834-20240730-01. Epub 2024 Dec 1.

ABSTRACT

BACKGROUND: Diversifying the nursing workforce entails concerted efforts to recruit and retain students from under-represented racial and socioeconomic groups who are especially vulnerable to barriers hindering academic success. This article describes faculty strategies for retaining and supporting students toward program completion and first-time National Council Licensure Examination for Registered Nurses (NCLEXRN) passage at a mission-driven school in rural Appalachia where most of the students have socioeconomically disadvantaged backgrounds.

METHOD: Independent samples t tests were used to compare academic variables between students who passed the NCLEX-RN on their first attempt and students who did not. Qualitative data were elicited from interviews and surveys. Data analysis informed policy change and student support services.

RESULTS: An action plan supported under-represented students’ success in first-time NCLEX-RN passage with an average rate of 96% for the past decade.

CONCLUSION: Focused multimodal support can promote the success of students with socioeconomic challenges who will enrich the nursing workforce with the diversity that the profession seeks. [J Nurs Educ. 2024;63(12):844-849.].

PMID:39642257 | DOI:10.3928/01484834-20240730-01

J Nurs Educ. 2024 Dec;63(12):818-825. doi: 10.3928/01484834-20240725-02. Epub 2024 Dec 1.

ABSTRACT

BACKGROUND: In the United States, English for Speakers of Other Languages (ESOL) health care providers are important to the nursing workforce but often face challenges when taking the NCLEX-RN examination. This study evaluated the effects of removing slang and words with multiple meanings from high-stakes examination questions.

METHOD: This study used a quantitative, experimental posttest-only control group design and included a convenience sample of 169 nursing students from a college in southern Florida.

RESULTS: Nursing students performed significantly better on the experimental (M = 79.9 [7.48]) than on the control examination (M = 75.08 [10.51]), t(151.8) = 2.973, p = .003. Students with low language acculturation scores achieved significantly higher scores on the experimental (M = 81.48 [SD = 6.05]) versus the control examinations (M = 72.21 [10.09]), t(60.9) = 4.975, p = .001.

CONCLUSION: Modifying examination questions linguistically can help ESOL nursing students perform better and aid examination creators to design bias-free tests. [J Nurs Educ. 2024;63(12):818-825.].

PMID:39642255 | DOI:10.3928/01484834-20240725-02

Magn Reson Med. 2024 Dec 6. doi: 10.1002/mrm.30401. Online ahead of print.

ABSTRACT

PURPOSE: To develop a deep learning-based method for robust and rapid estimation of the fatty acid composition (FAC) in mammary adipose tissue.

METHODS: A physics-based unsupervised deep learning network for estimation of fatty acid composition-network (FAC-Net) is proposed to estimate the number of double bonds and number of methylene-interrupted double bonds from multi-echo bipolar gradient-echo data, which are subsequently converted to saturated, mono-unsaturated, and poly-unsaturated fatty acids. The loss function was based on a 10 fat peak signal model. The proposed network was tested with a phantom containing eight oils with different FAC and on post-menopausal women scanned using a whole-body 3T MRI system between February 2022 and January 2024. The post-menopausal women included a control group (n = 8) with average risk for breast cancer and a cancer group (n = 7) with biopsy-proven breast cancer.

RESULTS: The FAC values of eight oils in the phantom showed strong correlations between the measured and reference values (R² > 0.9 except chain length). The FAC values measured from scan and rescan data of the control group showed no significant difference between the two scans. The FAC measurements of the cancer group conducted before contrast and after contrast showed a significant difference in saturated fatty acid and mono-unsaturated fatty acid. The cancer group has higher saturated fatty acid than the control group, although not statistically significant.

CONCLUSION: The results in this study suggest that the proposed FAC-Net can be used to measure the FAC of mammary adipose tissue from gradient-echo MRI data of the breast.

PMID:39641987 | DOI:10.1002/mrm.30401

JAMA Health Forum. 2024 Dec 6;5(12):e244365. doi: 10.1001/jamahealthforum.2024.4365.

ABSTRACT

IMPORTANCE: Medicaid programs have expanded coverage of substance use disorder treatment and undertaken many other initiatives to reduce drug overdoses among beneficiaries. However, to date, no information has been published that tracks overdose deaths among the Medicaid population.

OBJECTIVE: To determine the rate of drug overdose among Medicaid beneficiaries.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, US Centers for Medicare & Medicaid Services data from 2016 to 2020 that linked enrollment and demographic data from all Medicaid beneficiaries in the US with the US Centers for Disease Control and Prevention National Death Index were used to determine the rate of drug overdose death among Medicaid beneficiaries. The Medicaid population rates were compared with those of the total US population, overall and by age and sex.

EXPOSURE: Participation in the Medicaid program.

MAIN OUTCOME: Death of a drug overdose.

RESULTS: In 2020, the drug overdose death rate among Medicaid beneficiaries was 54.6 per 100 000, a rate that was twice as high as the drug overdose rate among all US residents (27.9 per 100 000). In 2020, Medicaid beneficiaries comprised 25.0% of the US population but 48% of all overdose deaths (44 277 of 91 783). For each age and sex group older than 15 years, overdose deaths were higher for the Medicaid population than for the US population, with the greatest difference occurring among adults ages 45 to 64 years. From 2016 to 2020, Medicaid overdose deaths increased by 54%.

CONCLUSIONS AND RELEVANCE: The results of this study suggest that more research is needed to understand why Medicaid beneficiaries have higher rates of drug overdoses than all US residents. Additionally, research is needed to understand how best to prevent overdoses among Medicaid beneficiaries. The federal government should support these efforts by routinely linking Medicaid claims and enrollment data to death records.

PMID:39641942 | DOI:10.1001/jamahealthforum.2024.4365