Nevin Manimala

Acta Psychol (Amst). 2023 Sep 30;240:104042. doi: 10.1016/j.actpsy.2023.104042. Online ahead of print.

ABSTRACT

Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.

PMID:37783184 | DOI:10.1016/j.actpsy.2023.104042

Intensive Crit Care Nurs. 2023 Sep 30;80:103551. doi: 10.1016/j.iccn.2023.103551. Online ahead of print.

ABSTRACT

OBJECTIVE: This meta-analysis aimed to assess the predictive value of the rapid shallow breathing index for extubation outcomes.

METHODOLOGY: We conducted a systematic review of literature (inception to March 2023) and a meta-analysis. Statistical analysis was performed using Meta-Disc 1.4 software, RevMan 5.4 software and Stata 14.0 software to evaluate the predictive value of RSBI for extubation outcomes.

RESULTS: A total of 1,987 studies were retrieved, and after applying the inclusion criteria, 79 studies were included in the final analysis, involving 13,170 patients undergoing mechanical ventilation. The random-effects model was employed for statistical analysis. The summary receiver operating characteristic curves (SROC) area under the curve (AUC) was 0.8144. The pooled sensitivity was 0.60 (95% CI: 0.59, 0.61), the pooled specificity was 0.68 (95% CI: 0.66, 0.70).

CONCLUSIONS: The Rapid Shallow Breathing Index demonstrated moderate accuracy, poor pooled sensitivity and specificity in predicting successful extubation, however the study does not present adequate data to support or reject the use of this tool as a single parameter that predicts extubation outcome. Future studies should explore the combination of The Rapid Shallow Breathing Index with other indicators and clinical experience to improve the success rate of extubation and reduce the risk of extubation failure.

IMPLICATIONS FOR CLINICAL PRACTICE: Premature and delayed extubation in mechanically ventilated patients can have a negative impact on prognosis and prolong hospital stay. The Rapid Shallow Breathing Index is a simple, cost-effective, and easily monitored objective evaluation index, which can be used to predict the outcome of extubation, especially in primary hospitals. Our study comprehensively evaluated the value of this tool in predicting extubation outcomes, which can help clinicians combine subjective experience with objective indicators to improve the accuracy of extubation time decisions.

PMID:37783181 | DOI:10.1016/j.iccn.2023.103551

Clinics (Sao Paulo). 2023 Sep 30;78:100283. doi: 10.1016/j.clinsp.2023.100283. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL.

METHODS: Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05).

RESULTS: There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024).

CONCLUSIONS: The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.

PMID:37783169 | DOI:10.1016/j.clinsp.2023.100283

Accid Anal Prev. 2023 Sep 30;193:107331. doi: 10.1016/j.aap.2023.107331. Online ahead of print.

ABSTRACT

Interaction effects constitute crucial crash attributes that can be classified into two distinct categories: spatiotemporal interactions and factor interactions. These interactions are rarely addressed systematically in modeling the severity of single-vehicle (SV) crashes. This study focuses on uncovering these crash attributes by designing a full Bayesian spatiotemporal interaction multilevel logit (STIML-logit) approach with heterogeneity in means and variances (HMV). Meanwhile, a nested Gaussian conditional autoregressive (CAR) structure is proposed to fit the spatiotemporal interaction component and its effectiveness is verified by calibrating four different interaction patterns. A standard multilevel logit (with and without HMV), a multilevel logit with HMV, and a spatiotemporal multilevel logit with HMV are constructed for comparison. Risk factors are decomposed into traffic environment factors (group level) and individual crash factors (case level) to construct a multilevel structure and to capture possible interactions between risk factors from different levels (cross-level factor interactions). We perform regression modeling utilizing SV crash cases covering 96 major urban roads in Shandong, China. The modeling results underscore several significant findings: (1) the STIML-logit with HMV demonstrates the best regression performance, suggesting that systematically dealing with the interaction effects and the HMV is a trustworthy modeling perspective; (2) crash models with the nested CAR outperform those with the traditional CAR and the result is supported by all the spatiotemporal statistical functions, highlighting the potential advantages of the nested structure; (3) all the environment factors maintain significant interactions with the case factors, highlighting that the contribution of the environment factors to crash injuries is not constant but is rather influenced by the specific case-related crash factors. The study introduces a promising regression architecture for modeling crash injuries and revealing subtle crash attributes.

PMID:37783161 | DOI:10.1016/j.aap.2023.107331

Accid Anal Prev. 2023 Sep 30;193:107307. doi: 10.1016/j.aap.2023.107307. Online ahead of print.

ABSTRACT

Identifying critical safety management drivers with high driver-level risks is essential for traffic safety improvement. Previous studies commonly evaluated driver-level risks based upon aggregated statistical characteristics (e.g., driving exposure and driving behavior), which were obtained from long-period driving monitoring data. However, given the great advancements of the connected vehicle and in-vehicle data instrumentation technologies, there has been a notable increase in the collection of short-period driving data, which has emerged as a prominent data source for analysis. In this data environment, traditionally employed aggregated behavior characteristics are unstable due to the time-varying feature of driving behavior coupled with insufficient data sampling periods. Thus, traditional modeling methods based upon aggregated statistical characteristics are no longer feasible. Instead of utilizing such unreliable statistical information to represent driver-level risks, this study employed temporal variation characteristics of driving behavior to identify critical safety management drivers in the short-period driving data environment. Specifically, the relationships between driving behavior temporal variation characteristics and individual crash occurrence probability were developed. To eliminate the impacts of drivers’ driving behavior heterogeneity on model performance, “traffic entropy” index that could quantify the abnormal degrees of driving behavior was proposed. Deep learning models including convolutional neural network (CNN) and long short-term memory (LSTM) were employed to conduct the temporal variation feature mining. Empirical analyses were conducted using data obtained from online ride-hailing services. Experiment results showed that temporal variation characteristics based models outperformed traditional aggregated statistical characteristics based models. The area under the curve (AUC) index was improved by 4.1%. And the proposed traffic entropy index further enhanced the model performance by 5.3%. The best model achieved an AUC of 0.754, comparable to existing approaches utilizing long-period driving data. Finally, applications of the proposed method in driver management program development and its further investigations have been discussed.

PMID:37783160 | DOI:10.1016/j.aap.2023.107307

Ann Diagn Pathol. 2023 Sep 28;67:152214. doi: 10.1016/j.anndiagpath.2023.152214. Online ahead of print.

ABSTRACT

There are immunohistochemistry (IHC) and immunofluorescence (IF) panels described in the literature and established by personal and institutional experiences that are in common use by pathologists in their daily practice. Stewardship is a difficult discussion because IHC utilization is influenced by many factors including the pathologist’s experience, background, practice setting, personal bias, and medicolegal culture. We developed the methodology to audit the IHC/IF utilization in our academic subspecialty practice. We aim to share this methodology and to provide our data that can be used for consideration by other subspecialized academic practices. This analysis included a total of 63,157 specimens that were accessioned during 2022, representing 38,612 cases. The likelihood of ordering IHC/IF ranged from 1 % (in genitourinary pathology) to 59 % (in renal pathology). The average percentage of specimens with IHC/IF was 21 % for the entire practice. In cases where IHC/IF was ordered, the number of stained slides averaged 4.9 per specimen for the entire practice. The number of IHC/IF slides per specimen ranged from 1.9 (in gastrointestinal pathology) to 12.2 (in renal pathology). The highest number of antibodies ordered for a single specimen by subspecialty ranged from 11 (in cardiac pathology) to 63 (in dermatopathology). Renal pathology was the only subspecialty that had an average number of IHC/IF slides that was statistically significantly different from all other subspecialties. We described the various patterns of utilization by subspecialty and rationalized their subtle differences. We also analyzed the types of cases that exceeded the reimbursement limits set by the Centers for Medicare and Medicaid Services (CMS).

PMID:37783147 | DOI:10.1016/j.anndiagpath.2023.152214

Eur J Radiol. 2023 Sep 27;168:111112. doi: 10.1016/j.ejrad.2023.111112. Online ahead of print.

ABSTRACT

PURPOSE: To assess hepatocellular carcinoma (HCC) risk after sustained virologic response (SVR) through clinical data analyses, including evaluation of liver fibrosis using the extracellular volume fraction (ECV) obtained from dual-energy computed tomography (DECT).

METHODS: Ninety-two patients (52 men and 40 women; mean age, 69.9 years) with hepatitis C virus infection after SVR underwent DECT of the liver (3-minute equilibrium-phase images) between January 2020 and March 2022. The ECV was calculated by measuring iodine density; fibrous markers, including ECV, fibrosis-4 index, aspartate aminotransferase to platelet ratio index, and platelet count, were statistically analyzed (p < 0.05). The risk factors associated with HCC were analyzed using univariate and multivariate logistic regression analyses.

RESULTS: The ECV (26.1 ± 4.6 %) in patients with HCC (n,21) was significantly larger than the ECV (20.7 ± 3.3 %) in patients without HCC (n = 71) (p < 0.001). The cutoff value for the ECV was 24.3 %. The area under the operating characteristic curve of the ECV was 0.857, which was higher than that of the serum fibrosis markers. Older age, SVR achieved with interferon, alpha-fetoprotein level (>5 ng/mL), advanced fibrosis before treatment (>F3), and ECV were associated with HCC according to the univariate analysis. Multivariate analyses showed that ECV was the only factor independently associated with HCC (odds ratio 0.619, 95 % confidence interval 0.482-0.795, p < 0.001).

CONCLUSION: Liver fibrosis estimated using ECV can be a predictive marker in patients with HCC after SVR.

PMID:37783146 | DOI:10.1016/j.ejrad.2023.111112

J Stroke Cerebrovasc Dis. 2023 Sep 30;32(11):107348. doi: 10.1016/j.jstrokecerebrovasdis.2023.107348. Online ahead of print.

ABSTRACT

BACKGROUND: Air pollutant concentrations in South Korea vary greatly by region and time. To assess temporal and spatial associations of stroke subtypes with long-term air pollution effects on stroke mortality, we studied ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).

METHODS: This was an observational study conducted in South Korea from 2001-2018. Concentrations of carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and particulate matter ≤10 µm in diameter (PM₁₀) were determined from 332 stations. Average air pollutant concentrations in each district were determined by distance-weighted linear interpolation. The nationwide stroke mortality rates in 249 districts were obtained from the Korean Statistical Information Service. Time intervals were divided into three consecutive 6-year periods: 2001-2006, 2007-2012, and 2013-2018.

RESULTS: The concentrations of air pollutants gradually decreased from 2001-2018, along with decreases in IS and ICH mortality rates. However, mortality rates associated with SAH remained constant. From 2001-2006, NO₂ (adjusted odds ratio [aOR]:1.13, 95% confidence interval: 1.08-1.19), SO₂ (aOR: 1.10, 1.07-1.13), and PM₁₀ (aOR: 1.12, 1.06-1.18) concentrations were associated with IS mortality, and SO₂ (aOR: 1.07, 1.02-1.13) and PM₁₀ (aOR:1.11,1.06-1.22) concentrations were associated with SAH-associated mortality. Air pollution was no longer associated with stroke mortality from 2007 onward, as the air pollution concentration continued to decline. Throughout the entire 18-year period, ICH-associated mortality was not associated with air pollution.

CONCLUSIONS: Considering temporal and spatial trends, high concentrations of air pollutants were most likely to be associated with IS mortality. Our results strengthen the existing evidence of the deleterious effects of air pollution on IS mortality.

PMID:37783139 | DOI:10.1016/j.jstrokecerebrovasdis.2023.107348

Environ Int. 2023 Sep 28;180:108238. doi: 10.1016/j.envint.2023.108238. Online ahead of print.

ABSTRACT

BACKGROUND: Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to low birth weight but higher childhood weight and obesity. However, little is known regarding the associations between PFAS exposure and dynamic body mass index (BMI) trajectories, particularly from birth through preadolescence.

OBJECTIVE: To evaluate the associations of cord serum PFAS concentrations with BMI trajectories from birth to age 10 years and longitudinal BMI in different periods.

METHODS: Based on 887 mother-child pairs in the longitudinal prospective birth cohort, we measured 12 PFAS congeners in cord serum and calculated BMI with anthropometric indicators at 9 follow-up time points from birth to age 10 years. The BMI trajectories were identified using group-based trajectory model (GBTM). To estimate the associations of cord serum PFAS levels with BMI trajectories and longitudinal changes in BMI, logistic regression models, linear mixed models, Bayesian kernel machine regression, and quantile-based g-computation models (QGC) were used.

RESULTS: The median concentrations of 10 PFAS congeners included in statistical analysis ranged from 0.047 to 3.623 μg/L. Two BMI trajectory classes were identified by GBTM, characterized by high group and low group. In logistic regression models, five PFAS congeners (PFBA, PFHpA, PFHxS, PFHpS, and PFDoDA) were associated with the higher probability of being in high BMI trajectory group (odds ratio, OR: 1.21 to 1.74, p < 0.05). Meanwhile, higher PFAS mixture were related to elevated odds for the high group in both BKMR models and QGC models, with PFHpA and PFHpS being the two most important drivers jointly. In the sex-stratified analysis, the positive associations remained significant exclusively among males. In the longitudinal analysis, PFUnDA and PFDoDA were associated with increased BMI from birth to age 10 years. Furthermore, PFBS and PFHpA were negatively related to BMI throughout infancy and toddlerhood (from birth to age 3 years), whereas PFDoDA confirmed a positive association with mid-childhood (from age 6 to 10 years) BMI.

CONCLUSIONS: Prenatal PFAS exposure was positively associated with BMI trajectories from birth to preadolescence and longitudinal BMI in various periods. Future research could use better trajectory modeling strategies to shape more complete growth trajectories and explore the relationship between BMI trajectories and adulthood health.

PMID:37783122 | DOI:10.1016/j.envint.2023.108238

Psychiatry Res. 2023 Sep 22;329:115483. doi: 10.1016/j.psychres.2023.115483. Online ahead of print.

ABSTRACT

Evidence on the impact of the COVID-19 pandemic on psychotic disorders is so far scarce. We conducted an incidence study to ascertain rates of first-episode psychosis (FEP) before and during the COVID-19 pandemic in South London. We screened clinical records of individuals living in the London boroughs of Southwark and Lambeth who were referred to the early intervention services before (from 1/3/2019 to 28/2/2020) and during (from 1/3/2020 to 28/2/2021) the COVID-19 pandemic. We used the Office for National Statistics to determine the population at risk. We computed crude and sex-age standardised FEP incidence per 100,000 person-years. We used Poisson regression to calculate the incidence rate ratio (IRR) across the COVID-19 pandemic. A total of 321 incident cases of FEP were identified during the COVID-19 pandemic, accounting for a crude rate of 69.8 (95% CI 62.1-77.4) per 100,000 person-years. The crude rate for the year before was 47.5 (95% CI 41.2-53.8). The incidence variation between the two years accounted for an adjusted IRR of 1.45 (95% CI 1.22-1.72). The pandemic was accompanied by a 45% spike in the rates of first-episode psychosis. This finding should inform public health research and demonstrate the need for adequate resources for secondary care.

PMID:37783096 | DOI:10.1016/j.psychres.2023.115483