Nevin Manimala

Cien Saude Colet. 2023 Sep;28(9):2677-2688. doi: 10.1590/1413-81232023289.15672022. Epub 2023 Jan 27.

ABSTRACT

The objective of this article is to identify the prevalence and evaluate the factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil. Cross-sectional study with 2,439 adolescents from Sample 2 (2015) of the National School-based Health Survey. Extreme weight loss behaviors, such as self-induced vomiting, laxative use and use of medicines or formulas (outcome) and independent variables were evaluated using a self-administered electronic questionnaire. The statistical analysis was performed following a hierarchical conceptual model. The prevalence of extreme weight loss behaviors in the sample was 12.1%. Among the factors that showed significant association with the outcome, we emphasize the administration model of the private school (PR = 0.62; CI = 0.46-0.84), bullying related to body appearance and for other reasons (PR = 1.62; CI = 1.19-2.20), forced sexual intercourse (PR = 2.65; CI = 1.90-3.69), insomnia (PR = 1.84; CI = 1.43-2.37), and be perceived as fat or very fat (PR = 1.90; CI = 1.50-2.42). Moderate prevalence of extreme weight loss behaviors was identified among adolescents. Socioeconomic factors, exposure to violence, mental health, and body image were associated with the adoption of these behaviors.

PMID:37672456 | DOI:10.1590/1413-81232023289.15672022

Braz J Biol. 2023 Sep 4;83:e274719. doi: 10.1590/1519-6984.274719. eCollection 2023.

ABSTRACT

This article presents the results of the culling of cows of the Simmental and Holstein breeds in the Republic of Kazakhstan. The purpose of the research was to study the actual number of culled cows of dairy productivity in the farms of the Republic of Kazakhstan to determine its norm. The object of research were cows of Simmental (18,462 heads) and Holstein (17,862 heads) breeds in various regions of the republic. The research was carried out according to generally accepted zootechnical methods using statistical data processing using RStudio. The results of the studies showed that the percentage of culling increases in cows of the Simmental and Holstein breeds and amounts to 19.7 and 22.9%, respectively. The analysis of the retirement of full-aged cows of the Simmental breed showed that the main causes are hoof diseases (up to 26%), low reproductive function (up to 21%), low productivity (up to 18%). Holstein cows had an increase in disposals in all categories except for disposals for various reasons, for problems with reproduction, the disposal is up to 21%. The determination of the relationship between productivity and retirement in the Simmental breed cows showed that with age and increased lactation, the proportion of retired cows also increases, in the Holstein breed, with increased productivity, the percentage of culled animals also increases.

PMID:37672436 | DOI:10.1590/1519-6984.274719

Braz Oral Res. 2023 Sep 4;37:e088. doi: 10.1590/1807-3107bor-2023.vol37.0088. eCollection 2023.

ABSTRACT

This study evaluated physicochemical properties of experimental infiltrants after addition of hydroxyapatite nanoparticles (HAp) or 58S bioactive glass (BAG) and diphenyliodonium hexafluorophosphate (DPI). The resin matrix was composed of TEGDMA/Bis-EMA (3:1), 0.5 mol% CQ, and 1 mol% EDAB. The blends received or not 0.5 mol% DPI and 10% wt BAG or HAp. Icon was used as commercial control. The groups were characterized by XRD, FT-IR spectrometry, and SEM before and after simulated body fluid (SBF) immersion for up to 7 days. Polymerization kinetics (n =3 ), water sorption and solubility (n=10), and viscosity (n = 3) were surveyed. For polymerization kinetics, the samples were polymerized for 5 min and the data were obtained from 40 s and 5 min. Statistical analysis was made using ANOVA and Tukey’s test (a = 0.05). After 7 days of SBF immersion, XRD and FT-IR showed that the HAp crystalline phase was present only in the HAp groups. A lower degree of conversion (DC) and polymerization rate were observed for the Icon and BAG groups, whereas HAp showed higher values. For the BAG group, DPI increased polymerization rate and DC in 40 s. After 5 min, all groups presented DC above 80%. In groups with particles, the HAp groups exhibited higher viscosity, whereas DPI groups showed a decrease in viscosity. Icon had the highest water sorption. To conclude, BAG neither improved the physicochemical properties studied, nor did it show bioactive properties. The addition of DPI reduced viscosity caused by particle addition and also attenuated the DC decrease caused by BAG addition. The addition of bioactive particles to infiltrants should be seen with caution because they increase viscosity and may not bring major clinical improvements that justify their use. DPI might be indicated only if any component is added to the infiltrant to act as a compensation mechanism.

PMID:37672421 | DOI:10.1590/1807-3107bor-2023.vol37.0088

JMIR Med Inform. 2023 Sep 6;11:e48693. doi: 10.2196/48693.

ABSTRACT

BACKGROUND: Recent advances in natural language processing (NLP) have heightened the interest of the medical community in its application to health care in general, in particular to stroke, a medical emergency of great impact. In this rapidly evolving context, it is necessary to learn and understand the experience already accumulated by the medical and scientific community.

OBJECTIVE: The aim of this scoping review was to explore the studies conducted in the last 10 years using NLP to assist the management of stroke emergencies so as to gain insight on the state of the art, its main contexts of application, and the software tools that are used.

METHODS: Data were extracted from Scopus and Medline through PubMed, using the keywords “natural language processing” and “stroke.” Primary research questions were related to the phases, contexts, and types of textual data used in the studies. Secondary research questions were related to the numerical and statistical methods and the software used to process the data. The extracted data were structured in tables and their relative frequencies were calculated. The relationships between categories were analyzed through multiple correspondence analysis.

RESULTS: Twenty-nine papers were included in the review, with the majority being cohort studies of ischemic stroke published in the last 2 years. The majority of papers focused on the use of NLP to assist in the diagnostic phase, followed by the outcome prognosis, using text data from diagnostic reports and in many cases annotations on medical images. The most frequent approach was based on general machine learning techniques applied to the results of relatively simple NLP methods with the support of ontologies and standard vocabularies. Although smaller in number, there has been an increasing body of studies using deep learning techniques on numerical and vectorized representations of the texts obtained with more sophisticated NLP tools.

CONCLUSIONS: Studies focused on NLP applied to stroke show specific trends that can be compared to the more general application of artificial intelligence to stroke. The purpose of using NLP is often to improve processes in a clinical context rather than to assist in the rehabilitation process. The state of the art in NLP is represented by deep learning architectures, among which Bidirectional Encoder Representations from Transformers has been found to be especially widely used in the medical field in general, and for stroke in particular, with an increasing focus on the processing of annotations on medical images.

PMID:37672328 | DOI:10.2196/48693

J Phys Chem B. 2023 Sep 6. doi: 10.1021/acs.jpcb.3c05212. Online ahead of print.

ABSTRACT

We develop an analytical statistical-mechanical model to study the dynamic properties of liquid water. In this two-dimensional model, neighboring waters can interact through a hydrogen bond, a van der Waals contact, or an ice-like cage structure or have no interaction. We calculate the diffusion coefficient, viscosity, and thermal conductivity versus temperature and pressure. The trends follow those seen in the water experiments. The model explains that in warm water, heating drives faster diffusion but less interaction, so the viscosity and conductivity decrease. Cooling cold water causes poorer energy exchange because water’s ice-like cages are big and immobile and collide infrequently. The main antagonism in water dynamics is not between vdW and H bonds, but it is an interplay between both those pair interactions, multibody cages, and no interaction. The value of this simple model is that it is analytical, so calculations are immediate, and it gives interpretations based on molecular physics.

PMID:37672327 | DOI:10.1021/acs.jpcb.3c05212

JMIR Public Health Surveill. 2023 Sep 6;9:e45664. doi: 10.2196/45664.

ABSTRACT

BACKGROUND: The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strategies. However, having a closer look is still necessary to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff.

OBJECTIVE: This study aimed to obtain quantitative information on job-related stressors of physicians and nurses and the coping strategies of HCPs and nonmedical staff at 2 periods of the COVID-19 pandemic. By further analyzing qualitative comments, we wanted to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff on different levels of experience.

METHODS: A cross-sectional survey was conducted at 2 time points during the COVID-19 pandemic in several European countries. The first study period (T1) lasted between April 1 and June 20, 2020, and the second study period (T2) lasted between November 25, 2021, and February 28, 2022. On a quantitative level, we used a questionnaire on stressors for physicians and nurses and a questionnaire on coping strategies for HCPs and nonmedical staff. Quantitative data were descriptively analyzed for mean values and differences in stressors and coping strategies. Qualitative data of free-text boxes of HCPs and nonmedical staff were analyzed via thematic analysis to explore the experiences of the individuals.

RESULTS: T1 comprised 609 participants, and T2 comprised 1398 participants. Overall, 296 participants made 438 qualitative comments. The uncertainty about when the pandemic would be controlled (T1: mean 2.28, SD 0.85; T2: mean 2.08, SD 0.90) and the fear of infecting the family (T1: mean 2.26, SD 0.98; T2: mean 2.02, SD 1.02) were the most severe stressors identified by physicians and nurses in both periods. Overall, the use of protective measures (T1: mean 2.66, SD 0.60; T2: mean 2.66, SD 0.60) and acquiring information about COVID-19 (T1: mean 2.29, SD 0.82; T2: mean 1.99, SD 0.89) were identified as the most common coping strategies for the entire study population. Using thematic analysis, we identified 8 themes of personal experiences on the micro, meso, and macro levels. Measures, working conditions, feelings and emotions, and social climate were frequently mentioned topics of the participants. In T1, feelings of isolation and uncertainty were prominent. In T2, feelings of exhaustion were expressed and vaccination was frequently discussed. Moreover, unmet psychosocial needs were identified.

CONCLUSIONS: There is a need for improvement in pandemic preparedness. Targeted vocational education measures and setting up of web-based mental health support could be useful to bridge gaps in psychosocial support needs in future crises.

PMID:37672320 | DOI:10.2196/45664

JMIR Public Health Surveill. 2023 Sep 6;9:e43199. doi: 10.2196/43199.

ABSTRACT

BACKGROUND: A clear understanding of the anthropometric and sociodemographic risk factors related to BMI and hypertension categories is essential for more effective disease prevention, particularly in India. There is a paucity of nationally representative data on the dynamics of these risk factors, which have not been assessed among healthy reproductive-age Indian women.

OBJECTIVE: This cross-sectional polycystic ovary syndrome (PCOS) task force study aimed to assess the anthropometric and sociodemographic characteristics of healthy reproductive-age Indian women and explore the association of these characteristics with various noncommunicable diseases.

METHODS: We conducted a nationwide cross-sectional survey from 2018 to 2022 as part of the Indian Council of Medical Research-PCOS National Task Force study, with the primary aim of estimating the national prevalence of PCOS and regional phenotypic variations among women with PCOS. A multistage random sampling technique was adopted, and 7107 healthy women (aged 18-40 years) from 6 representative geographical zones of India were included in the study. The anthropometric indices and sociodemographic characteristics of these women were analyzed. Statistical analysis was performed to assess the association between exposure and outcome variables.

RESULTS: Of the 7107 study participants, 3585 (50.44%) were from rural areas and 3522 (49.56%) were from urban areas. The prevalence of obesity increased from 8.1% using World Health Organization criteria to 40% using the revised consensus guidelines for Asian Indian populations. Women from urban areas showed higher proportions of overweight (524/1908, 27.46%), obesity (775/1908, 40.62%), and prehypertension (1008/1908, 52.83%) categories. A rising trend of obesity was observed with an increase in age. Women aged 18 to 23 years were healthy (314/724, 43.4%) and overweight (140/724, 19.3%) compared with women aged 36 to 40 years with obesity (448/911, 49.2%) and overweight (216/911, 23.7%). The proportion of obesity was high among South Indian women, with 49.53% (531/1072) and 66.14% (709/1072), using both World Health Organization criteria and the revised Indian guidelines for BMI, respectively. BMI with waist circumference and waist-to-height ratio had a statistically significant linear relationship (r=0.417; P<.001 and r=0.422; P<.001, respectively). However, the magnitude, or strength, of the association was relatively weak (0.3<|r|<0.5). Statistical analysis showed that the strongest predictors of being overweight or obese were older age, level of education, wealth quintile, and area of residence.

CONCLUSIONS: Anthropometric and sociodemographic characteristics are useful predictors of overweight- and obesity-related syndromes, including prehypertension, among healthy Indian women. Increased attention to the health of Indian women from public health experts and policy makers is warranted. The findings of this study can be leveraged to offer valuable insights, informing health decision-making and targeted interventions that mitigate risk factors of overweight, obesity, and hypertension.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/23437.

PMID:37672315 | DOI:10.2196/43199

JAMA Netw Open. 2023 Sep 5;6(9):e2332413. doi: 10.1001/jamanetworkopen.2023.32413.

ABSTRACT

IMPORTANCE: The Apgar score is used worldwide as an assessment tool to estimate the vitality of newborns in their first minutes of life. Its applicability to estimate neurodevelopmental outcomes in infants born extremely preterm (EPT; <28 weeks’ gestation) is not well established.

OBJECTIVE: To investigate the association between the Apgar score and neurodevelopmental outcomes in infants born EPT.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted using data from the Effective Perinatal Intensive Care in Europe-Screening to Improve Health in Very Preterm Infants in Europe (EPICE-SHIPS) study, a population-based cohort in 19 regions of 11 European countries in 2011 to 2012. Clinical assessments of cognition and motor function at age 5 years were performed in infants born EPT and analyzed in January to July 2023.

EXPOSURES: Apgar score at 5 minutes of life categorized into 4 groups (0-3, 4-6, 7-8, and 9-10 points).

MAIN OUTCOMES AND MEASURES: Cognitive and motor outcomes were assessed using the Wechsler Preschool and Primary Scale of Intelligence test of IQ derived from locally normed versions by country and the Movement Assessment Battery for Children-Second Edition. Parents additionally provided information on communication and problem-solving skills using the Ages and Stages Questionnaire, third edition (ASQ-3). All outcomes were measured as continuous variables.

RESULTS: From the total cohort of 4395 infants born EPT, 2522 infants were live born, 1654 infants survived to age 5 years, and 996 infants (478 females [48.0%]) followed up had at least 1 of 3 outcome measures. After adjusting for sociodemographic variables, perinatal factors, and severe neonatal morbidities, there was no association of Apgar score with IQ, even for scores of 3 or less (β = -3.3; 95% CI, -10.5 to 3.8) compared with the score 9 to 10 category. Similarly, no association was found for ASQ-3 (β = -2.1; 95% CI, -24.6 to 20.4). Congruent results for Apgar scores of 3 or less were obtained for motor function scores for all children (β = -4.0; 95% CI, -20.1 to 12.1) and excluding children with a diagnosis of cerebral palsy (β = 0.8, 95% CI -11.7 to 13.3).

CONCLUSIONS AND RELEVANCE: This study found that low Apgar scores were not associated with longer-term outcomes in infants born EPT. This finding may be associated with high interobserver variability in Apgar scoring, reduced vitality signs and poorer responses to resuscitation after birth among infants born EPT, and the association of more deleterious exposures in the neonatal intensive care unit or of socioeconomic factors with greater changes in outcomes during the first 5 years of life.

PMID:37672271 | DOI:10.1001/jamanetworkopen.2023.32413

JAMA Cardiol. 2023 Sep 6. doi: 10.1001/jamacardio.2023.2808. Online ahead of print.

ABSTRACT

IMPORTANCE: Valsartan has shown promise in attenuating cardiac remodeling in patients with early-stage sarcomeric hypertrophic cardiomyopathy (HCM). Genetic testing can identify individuals at risk of HCM in a subclinical stage who could benefit from therapies that prevent disease progression.

OBJECTIVE: To explore the potential for valsartan to modify disease development, and to characterize short-term phenotypic progression in subclinical HCM.

DESIGN, SETTING, AND PARTICIPANTS: The multicenter, double-blind, placebo-controlled Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) randomized clinical trial was conducted from April 2014 to July 2019 at 17 sites in 4 countries (Brazil, Canada, Denmark, and the US), with 2 years of follow-up. The prespecified exploratory VANISH cohort studied here included sarcomere variant carriers with subclinical HCM and early phenotypic manifestations (reduced E’ velocity, electrocardiographic abnormalities, or an increased left ventricular [LV] wall thickness [LVWT] to cavity diameter ratio) but no LV hypertrophy (LVH). Data were analyzed between March and December 2022.

INTERVENTIONS: Treatment with placebo or valsartan (80 mg/d for children weighing <35 kg, 160 mg/d for children weighing ≥35 kg, or 320 mg/d for adults aged ≥18 years).

MAIN OUTCOMES AND MEASURES: The primary outcome was a composite z score incorporating changes in 9 parameters of cardiac remodeling (LV cavity volume, LVWT, and LV mass; left atrial [LA] volume; E’ velocity and S’ velocity; and serum troponin and N-terminal prohormone of brain natriuretic peptide levels).

RESULTS: This study included 34 participants, with a mean (SD) age of 16 (5) years (all were White). A total of 18 participants (8 female [44%] and 10 male [56%]) were randomized to valsartan and 16 (9 female [56%] and 7 male [44%]) were randomized to placebo. No statistically significant effects of valsartan on cardiac remodeling were detected (mean change in composite z score compared with placebo: -0.01 [95% CI, -0.29 to 0.26]; P = .92). Overall, 2-year phenotypic progression was modest, with only a mild increase in LA volume detected (increased by 3.5 mL/m2 [95% CI, 1.4-6.0 mL/m2]; P = .002). Nine participants (26%) had increased LVWT, including 6 (18%) who developed clinically overt HCM. Baseline LA volume index (LAVI; 35 vs 28 mL/m2; P = .01) and average interventricular septum thickness (8.5 vs 7.0 mm; P = .009) were higher in participants who developed HCM.

CONCLUSIONS AND RELEVANCE: In this exploratory cohort, valsartan was not proven to slow progression of subclinical HCM. Minimal changes in markers of cardiac remodeling were observed, although nearly one-fifth of patients developed clinically overt HCM. Transition to disease was associated with greater baseline interventricular septum thickness and LAVI. These findings highlight the importance of following sarcomere variant carriers longitudinally and the critical need to improve understanding of factors that drive disease penetrance and progression.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01912534.

PMID:37672268 | DOI:10.1001/jamacardio.2023.2808

Crit Rev Anal Chem. 2023 Sep 6:1-39. doi: 10.1080/10408347.2023.2253473. Online ahead of print.

ABSTRACT

Soil is one type of Earth material demonstrating a wide range of physical, chemical, and biological properties. As the compositional profile of soil is a product of interaction between numerous abiotic and biotic components, it tends to be unique by its geographic origin. Hence, soil is paramount for predicting source or origin in forensic provenance and intelligence, food provenance, biosecurity, and archaeology. In the context of forensic investigation, source tracing of soil could be executed by a comparison or provenance analysis. Soil compositional fingerprints acquired using analytical methods must be carefully interpreted via suitable mathematical and statistical tools since multiple sources can contribute to the variability of soil other than its provenance. This article reviews recent trends in soil sampling and data interpretation strategies proposed for source tracing of soil evidence. Performances of soil provenance indicators are also described. Then, perspectives on possible research directions guiding forensic soil provenance are proposed. This timely critical review reveals the essential idea and gap in forensic soil provenance for stimulating the development of more efficient and effective provenance strategies.

PMID:37672265 | DOI:10.1080/10408347.2023.2253473