Nevin Manimala

J Am Acad Psychiatry Law. 2023 Oct 3:JAAPL.230074-23. doi: 10.29158/JAAPL.230074-23. Online ahead of print.

ABSTRACT

As racial influences on forensic outcomes are identified in every aspect of practice, scholars are exploring methods to disentangle race from its historical, economic, and attitudinal antecedents. Because jurisdictions vary in these influences, definitions and data may differ among them, creating inconsistencies in analysis and policy. This retrospective database review compared differences in racial outcomes among 200 pretrial defendants, 160 Black and 40 White, exploring a wide range of socioeconomic, clinical, and forensic influences before, during, and after hospitalization. Because of the tight relationship of socioeconomic factors and race, investigators hypothesized that it would be difficult to distinguish racial influences alone. Using a confirmatory approach to data collection and a statistical analysis based in logistic regression, only differences in referral for psychological testing were identified. Application of this method based on local demographics and culture may prove useful for institutions interested in evaluating racial influences on forensic outcomes.

PMID:37788863 | DOI:10.29158/JAAPL.230074-23

J Nurs Meas. 2023 Sep 1;31(3):378-388. doi: 10.1891/JNM-2021-0072.

ABSTRACT

Background and Purpose: Cancer patients experience physical and psychological ailments resulting from cancer illness, a difficult and long treatment process and fear of death. Nurse-patient interaction seems to play an important role when responding to the psychological needs of patients with cancer. The aim of this study is to adapt and examine the psychometric properties of the Nurse-Patient Interaction Scale (NPIS) among Turkish cancer patients. Design and Method: In a cross-sectional design, patients receiving cancer treatment at Farabi hospital in Turkey responded to the Personal Information Form and the NPIS. Descriptive statistics, principal component analysis (PCA), and confirmatory factor analysis (CFA) were applied. Findings: The NPIS was found to be suitable for a single factor structure, including 11 out of the original 14 items. The 11-items uni-dimensional model showed an acceptable/good fit with the data: χ² = 154.369, (df = 44), χ²/df = 3.51, p = .0001, RMSEA = 0.100, p-value for test of close fit = 0.0001, CFI = 0.98, TLI = 0.97 and SRMR = 0.012.

PMID:37788857 | DOI:10.1891/JNM-2021-0072

Funct Plant Biol. 2023 Oct 4. doi: 10.1071/FP22225. Online ahead of print.

ABSTRACT

Water stress can affect plant ecological distribution, crop growth and carbohydrate distribution, impacting berry quality. However, previous studies mainly focused on short-term water stress or osmotic stress and few studies paid attention to the responses of grape to long-term water stresses. Grapevines were subjected to no water stress (CK), mild water stress (T1) and moderate water stress (T2). Hundred-berry weight and malic acid content were reduced under T1 and T2; however, glucose and fructose content showed the opposite trend. Endogenous hormones and polyamines (PAs) can regulate plant growth and development as well as physiological metabolic processes. T1 and T2 could increase abscisic acid content, however, indole-3-acetic acid, jasmonate, gibberellins 3 and 4, cytokinin and trans-zeatin contents were slightly decreased. Three species of PAs (putrescine, spermidine and spermine) were detected, presenting obvious tissue specificity. Furthermore, there was a statistically positive correlation relating spermidine content in the pulp with glucose and fructose contents of grape berries; and a negative correlation with organic acid. In summary, water stress had a profound influence on hormonally-driven changes in physiology and berry quality, indicating that endogenous hormones and the PAs play a critical role in the development and ripening of grape berries under water stress.

PMID:37788830 | DOI:10.1071/FP22225

South Med J. 2023 Oct;116(10):806-811. doi: 10.14423/SMJ.0000000000001612.

ABSTRACT

OBJECTIVE: The ability to competently suture is an expected skill for graduating medical students, but many graduates report feeling unprepared to perform this skill. This study aimed to improve student confidence and clinical readiness for third-year clerkships by implementing a novel, mandatory 7.5-hour longitudinal suturing skills curriculum across the first 3 years of medical school.

METHODS: The required suturing skills curriculum was implemented for all medical students throughout the first 3 years of medical school at a large academic health center in the mid-South United States. Precurriculum (n = 167) and postcourse (n = 148) surveys were administered to first-year students in the first year of the curriculum (2017-2018), and a parallel follow-up survey was administered to this cohort in 2020 after students completed their clinical clerkship year (n = 82). Aggregate changes in students’ survey responses were analyzed for proper instrument position, simple interrupted sutures, and instrument ties using independent groups Mann-Whitney U tests and Rosenthal correlation coefficients for effect sizes.

RESULTS: Statistically significant improvement from pre to post was observed in student comfort in performing three basic skills: proper instrument position (P < 0.001), simple interrupted suture (P < 0.001), and instrument ties (P < 0.001). These pre-post gains were sustained at 2-year follow-up (P < 0.001). Also, the majority of students (66%) reported they were very or completely prepared to suture wounds during their clerkships. Most (83%) also reported they had successfully sutured patient wounds during third-year clerkships without needing significant direction or guidance.

CONCLUSIONS: We found that a longitudinal suture curriculum with dedicated faculty involvement can improve student confidence in suturing and overall preparedness for third-year clerkships. Although the study is limited to ratings of student comfort and self-reported performance as well as some attrition of responses at postcourse survey and postclerkship survey, the findings highlight the importance of a focused curriculum dedicated to teaching basic suturing skills. Our findings also contribute to the limited body of work examining longitudinal surgical skills development for medical students.

PMID:37788814 | DOI:10.14423/SMJ.0000000000001612

South Med J. 2023 Oct;116(10):783-789. doi: 10.14423/SMJ.0000000000001610.

ABSTRACT

OBJECTIVES: Coronary heart disease (CHD) is the leading cause of morbidity and mortality among US women. Minority women have higher rates of CHD and are more likely to experience adverse outcomes. Because of racial disparities in CHD outcomes, the purpose of this study was to assess CHD knowledge and awareness in African American and Hispanic women.

METHODS: Using a survey research design, a convenience sample of African American and Hispanic women was surveyed in their local communities. CHD knowledge, awareness, and demographic data were collected using an online survey. The survey was administered in English and Spanish using an iPad. CHD knowledge was assessed using a 7-item survey based on the American Heart Association’s Life’s Simple 7 brochure. CHD awareness was assessed using a 7-item survey adapted from the American Heart Association’s Survey of Women’s Cardiovascular Disease Awareness. CHD knowledge was scored on a scale of 0 to 7, and awareness was assessed based on responses to each question. The data analysis consisted of cross-tabulations and multivariable repeated measures analysis. We assessed differences in CHD knowledge and awareness based on race/ethnicity. We hypothesized that there would be statistically significant differences in CHD knowledge and awareness based on specific demographic factors (eg, age, income, education, health literacy).

RESULTS: A total of 100 African American (n=50) and Hispanic (n = 50) women participated in the study. Results revealed that CHD knowledge and awareness were limited for both groups. Seventy-three percent of participants (African American 66%; Hispanic 80%) did not know that CHD is the leading cause of death in women and 75% (African American 60%; Hispanic 90%) were moderately or not at all informed about CHD.

CONCLUSIONS: These findings support the need for more research on innovative strategies to improve CHD knowledge and awareness, particularly in African American and Hispanic women who are at highest risk, thereby addressing racial/ethnic and gender disparities in CHD morbidity and mortality.

PMID:37788811 | DOI:10.14423/SMJ.0000000000001610

J Oral Maxillofac Surg. 2023 Sep 15:S0278-2391(23)01120-5. doi: 10.1016/j.joms.2023.09.009. Online ahead of print.

ABSTRACT

BACKGROUND: Sport injuries can negatively impact physical and psychological aspects of athletes. There is a gap in the literature regarding facial trauma present in basketball.

PURPOSE: The purpose of this study is to identify and describe facial trauma present in the National Basketball Association (NBA).

STUDY DESIGN, SETTING, SAMPLE: This is a retrospective cohort study in which the sample (n = 206) consists of players that suffered facial injuries in the NBA, the data were collected from a public access online resource.

INDEPENDENT VARIABLE: The predictor variables were player position (center, point guard, shooting guard, small forward, and power forward), team conference (Eastern/Western), and if played games occurred in playoff season.

MAIN OUTCOME VARIABLES: The primary outcome variable was the injury location (upper, middle, and lower facial third), and the secondary outcome was type of injury (soft tissue/bone fracture).

COVARIATES: Player’s age, height, weight, and body mass index were collected.

ANALYSES: χ² and logistic regression were calculated to determine associations between predictor and outcome variables. Logistic regression was used to determine if variables were predictive for injury. Odds ratio was also computed for significant results. P value less than .05 (95% confidence interval) was considered statistically significant.

RESULTS: A total of 206 players suffered facial injuries, and a total of 212 injuries were quantified. The mean age of the injured players was 27.24 ± 4.06 years, mean height (centimeters) was 201 ± 59.31 cm, mean weight (kilograms) was 99.48 ± 12.41 kg, and body mass index was 24.52 ± 1.75 kg/m². Of the 212 injuries, none of them occurred in the first facial third, 158 (75%) were in the middle third, and 54 (25%) were in the lower third; 151 of them were fractures (61%) and 61 were soft tissue injuries (29%). Most injuries were concentrated in centers (23%) and power forwards (23%). The most common fracture occurred in the nasal bones (39.2%), and most soft tissue injuries occurred in the eye globes (25%). Almost all injuries occurred during regular season games (97%), and the Eastern conference was slightly predominant (52%).

CONCLUSION AND RELEVANCE: Facial trauma in the NBA has risen in recent years. The player’s position, height and weight games were the primary factors associated to facial trauma in the NBA.

PMID:37788800 | DOI:10.1016/j.joms.2023.09.009

Sci Total Environ. 2023 Oct 1:167506. doi: 10.1016/j.scitotenv.2023.167506. Online ahead of print.

ABSTRACT

Metabolic syndrome (MetS) prevalence has increased dramatically worldwide and has become a public health issue. Polycyclic aromatic hydrocarbons (PAHs) were identified as risk factors of MetS, while essential metals are integral parts of metalloenzymes catalyzing metabolic processes. However, effects of co-exposure to PAHs and essential metals have not been investigated yet. We aimed to assess whether essential metals could modify the hazard effects of PAHs on MetS, and underlying mediation effects of microRNA (miRNAs) were further explored. A cross-sectional study of 1451 males including 278 MetS cases was conducted. Internal exposure levels of 5 classes of PAH metabolites, 7 essential metals, as well as expressions of PAHs-associated 8 plasma miRNAs were assessed. Multiple exposure models, Bayesian kernel machine regression (BKMR), and quantile g-computation (QGcomp) were used simultaneously to identify MetS-related critical chemicals. Mutual effect modification between chemicals and mediation effects of miRNAs on chemical-MetS association was testified. In this study, hydroxyphenanthrene (OHPhe) and selenium (Se) were consistently identified as MetS-related key chemicals in three statistical methods. OHPhe was positively associated with MetS [OR (95%CI) = 1.79 (1.21, 2.65), P = 0.004], while Se had a negative relationship with MetS [OR (95%CI) = 0.61 (0.43, 0.87), P = 0.007]. Effect modification analysis observed the association between OHPhe and MetS was weakened with increased Se exposure. Only the expression of miR-24-3p was negatively associated with MetS [OR (95%CI) =0.81 (0.66, 0.95), P = 0.048] and could mediate 16.1 % of OHPhe-MetS association in subjects with low Se exposure (≤0.87 μg/mmol creatinine) (P = 0.019). We found a mutual effect modification between OHPhe and Se on MetS, and the positive OHPhe-MetS association was attenuated with increased Se exposure. Mediation effects of miR-24-3p on OHPhe-MetS association were dependent on Se dose. Our findings may provide new insight into the prevention and intervention of MetS.

PMID:37788778 | DOI:10.1016/j.scitotenv.2023.167506

Sci Total Environ. 2023 Oct 1:167505. doi: 10.1016/j.scitotenv.2023.167505. Online ahead of print.

ABSTRACT

Environmental lead exposure is a well-known and significant public health concern. In areas with low lead exposure, comprehensive and detailed research and validation are needed to eliminate the adverse effects of environmental lead exposure. This study aims to understand the possible food pathways of environmental lead exposure by exploring the contribution of food to blood lead and the mediating effect of blood lead in the occurrence of diseases. Similarly, as lead is a heavy metal pollutant with good research foundation, fine analysis of lead in this period can also be a reference for other unknown pollutants. In this cross-sectional study of 1162 peoples, the data are taken from National Health and Nutrition Examination Survey (NANHES) 2015-2016, we grouped the population according to the median blood lead level (0.038 μmol/L) to screen the variables adjusted by the model. we grouped foods by code and used a generalized additive mixed model (GAMM) to study their relationship with blood lead levels, a correlation has been found between egg mixtures (p = 0.007) and legumes (p = 0.041) consumption and blood lead levels. We analyzed how metabolic status, exercise, and macronutrient intake modulate the impact of certain foods on blood lead levels to infer its possible process. To verify whether adverse effects are caused by lead, we explored the mediating effect of blood lead on the relationship between food intake and disease [cardiovascular diseases (CVD), respiratory diseases, cancer], however, no statistically significant mediating effect was found. Overall, environmental lead exposure through food still affects blood lead levels, but it has not led to adverse outcomes in blood, respiratory system, or cancers Under conditions where lead exposure levels were equivalent to those in the study (blood lead levels， mean = 0.052 μmol/L, standard deviation = 0.048 μmol/L, median = 0.038 μmol/L, min = 0.002 μmol/L, max = 0.904 μmol/L, skewness = 6.543, kurtosis = 89.391).

PMID:37788771 | DOI:10.1016/j.scitotenv.2023.167505

J Vasc Surg Venous Lymphat Disord. 2023 Oct 1:S2213-333X(23)00390-6. doi: 10.1016/j.jvsv.2023.09.003. Online ahead of print.

ABSTRACT

OBJECTIVE: There is no study in the literature evaluating the dynamic thiol/disulfide homeostasis in patients with chronic venous insufficiency. Thus, we designed this study to evaluate the dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress in patients with chronic venous insufficiency.

METHODS: This was a prospective case-control study performed at the department of cardiovascular surgery of a tertiary referral hospital in Turkey. A total of 80 (CEAP C3 – C6) patients with lower extremity chronic venous insufficiency (as the study group) and 80 healthy subjects (as the control group) were enrolled to the study. The participants’ basic demographic and clinical characteristics as well as serum levels of some laboratory parameters including albumin, ferroxidase, myeloperoxidase, native thiol, total thiol, disulphide, native thiol/total thiol, disulphide/native thiol and disulphide/total thiol were determined, and then compared between the groups.

RESULTS: In terms of basic demographic and clinical characteristics, both groups were statistically similar and there were no significant differences between the groups. When the laboratory parameters were considered, serum ferroxidase and myeloperoxidase levels were detected to be significantly higher while albumin, native thiol, total thiol and disulphide levels were detected to be significantly lower in study group than in control group.

CONCLUSIONS: Dynamic thiol/disulphide homeostasis could be considered as an indicator reflecting the oxidative stress status in patients with chronic venous insufficiency.

PMID:37788743 | DOI:10.1016/j.jvsv.2023.09.003

Int J Infect Dis. 2023 Oct 1:S1201-9712(23)00733-6. doi: 10.1016/j.ijid.2023.09.019. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to identify factors deterring secondary household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from SARS-CoV-2-positive cohabitants.

METHODS: A case-control study was conducted with 272 healthcare workers in close contacts with SARS-CoV-2-positive cohabitants. Logistic regression modeling was employed to determine the factors independently associated with secondary household transmission.

RESULTS: A SARS-CoV-2 infection within the past 6 months was the most protective factor against secondary household transmission (adjusted odds ratio = 0.07, 95% confidence interval: 0.01-0.61, P < 0.05). Home isolation and older age of primary index case (7-12, ≥18 years) were also associated with a reduced risk. Both monovalent and bivalent messenger ribonucleic acid booster vaccinations exhibited potential protective tendencies, but were not statistically significant. Additionally, bivalent vaccines did not demonstrate a clear advantage over monovalent vaccines.

CONCLUSION: A recent history of SARS-CoV-2 infection, home isolation of positive cohabitants, and older age of primary index cases were positively associated with a reduced risk of secondary household transmission. Regarding booster vaccinations, data from a single center with a limited sample size may not capture all statistically significant differences, necessitating broader studies.

PMID:37788740 | DOI:10.1016/j.ijid.2023.09.019