Nevin Manimala

Appl Neuropsychol Adult. 2024 Mar 11:1-10. doi: 10.1080/23279095.2024.2326935. Online ahead of print.

ABSTRACT

Theory of mind (ToM) has been addressed in relation to functional alterations of certain brain regions and their connections. The objective is to evaluate ToM in imprisoned criminal offenders and to analyze their relationship with the functions linked to the prefrontal cortex according to their expression in neuropsychological tests. The sample was composed of 52 subjects. 27 committed instrumental homicides and 25 crimes of sale and/or possession of narcotics. A control group was taken, 19 healthy subjects at liberty. The Faux-Pas (FP) and the Reading the Mind in the Eyes tests were used. A neuropsychological battery of executive functions and functions related to the frontal lobes and Hare’s Psychopathy Checklist-Revised (PCL-R) was also applied. The criminal groups have comparable performances in all measures. The control group (in freedom) showed higher performance, with statistical significance, in the Faux-Pas test. Moderate negative correlations were found between the FP and the PCL-R. A distinction between affective and cognitive ToM could be affirmed, with people deprived of liberty presenting deficient functioning in the cognitive ToM test. This difference in performance could be linked to the disruptive event with the social norm and not so much with the violent homicide act itself.

PMID:38466873 | DOI:10.1080/23279095.2024.2326935

Can Urol Assoc J. 2024 Mar 1. doi: 10.5489/cuaj.8673. Online ahead of print.

ABSTRACT

INTRODUCTION: With advancements in laser technology, urologists have been able to treat urinary calculi more efficiently by increasing the energy delivered to the stone. With increases in power used, there is an increase in temperatures generated during laser lithotripsy. The aim of this study was to evaluate the thermal dose and temperatures generated with four laser settings at a standardized power in a high-fidelity, anatomic model.

METHODS: Using high-fidelity, 3D printed hydrogel models of a pelvicalyceal collecting system with a synthetic BegoStone implanted in the renal pelvis, surgical simulation of ureteroscopic laser lithotripsy was performed with the Moses 2.0 holmium laser. At a standard power (40 W) and irrigation pressure (100 cm H₂O), we evaluated operator duty cycle (ODC) variations with different time-on intervals at four different laser settings. Temperature was measured at two separate locations: at the stone and ureteropelvic junction.

RESULTS: Greater cumulative thermal doses and maximal temperatures were achieved with greater ODCs and longer laser activation periods. There were statistically significant differences between the thermal doses and temperature profiles of the laser settings evaluated. Temperatures were greater closer to the tip of the laser fiber.

CONCLUSIONS: Laser energy and frequency play an important role in the thermal loads delivered during laser lithotripsy. Urologists must perform laser lithotripsy cautiously when aggressively treating large renal pelvis stones, as dangerous temperatures can be reached. To reduce the risk of causing thermal tissue injury, urologists should consider reducing their ODC and laser-on time.

PMID:38466866 | DOI:10.5489/cuaj.8673

Can Urol Assoc J. 2024 Mar 1. doi: 10.5489/cuaj.8620. Online ahead of print.

ABSTRACT

INTRODUCTION: The results of the phase 3 ALSYMPCA trial showed that Radium-223 (Ra-223) improves overall survival (OS) and delays onset of first symptomatic skeletal event vs. placebo in patients with metastatic castration-resistant prostate cancer (mCRPC). The purpose of the REACTIVATE study was to inform the optimal placement of Ra-233 in the treatment sequence by evaluating clinical outcomes and healthcare resource utilization using real-world data from multiple Canadian provinces.

METHODS: This retrospective cohort study analyzed patient outcomes according to Ra-223 placement using administrative databases of four Canadian provinces, encompassing 4301 patients with mCRPC who received at least two lines of life-prolonging therapy (LPT) for mCRPC. Outcomes included OS, event-free survival (EFS), and healthcare resource utilization. Each province was analyzed separately.

RESULTS: OS, measured from the start of second-line LPT, differed between provinces: those in Ontario receiving second-line Ra-223 had a longer OS vs. those receiving it in third-line or later (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.66-0.95). There was no difference between lines of therapy in patients in British Columbia (HR 1.165, 95% CI, 0.894-1.518, p=0.2576), and OS was numerically worse but not statistically significant in patients receiving Ra-223 in second-line in Quebec (HR 1.44, 95% CI, 0.93-2.24). Other outcomes also varied across provinces, with second-line use of Ra-223 being associated with longer EFS and reduced healthcare utilization vs. third-line use in Ontario but not in Quebec.

CONCLUSIONS: Significant heterogeneity exists in the management and outcomes of mCRPC between provinces, particularly regarding the placement of Ra-223 in the treatment sequence.

PMID:38466865 | DOI:10.5489/cuaj.8620

Proc Natl Acad Sci U S A. 2024 Mar 19;121(12):e2312252121. doi: 10.1073/pnas.2312252121. Epub 2024 Mar 11.

ABSTRACT

The social system of animals involves a complex interplay between physiology, natural history, and the environment. Long relied upon discrete categorizations of “social” and “solitary” inhibit our capacity to understand species and their interactions with the world around them. Here, we use a globally distributed camera trapping dataset to test the drivers of aggregating into groups in a species complex (martens and relatives, family Mustelidae, Order Carnivora) assumed to be obligately solitary. We use a simple quantification, the probability of being detected in a group, that was applied across our globally derived camera trap dataset. Using a series of binomial generalized mixed-effects models applied to a dataset of 16,483 independent detections across 17 countries on four continents we test explicit hypotheses about potential drivers of group formation. We observe a wide range of probabilities of being detected in groups within the solitary model system, with the probability of aggregating in groups varying by more than an order of magnitude. We demonstrate that a species’ context-dependent proclivity toward aggregating in groups is underpinned by a range of resource-related factors, primarily the distribution of resources, with increasing patchiness of resources facilitating group formation, as well as interactions between environmental conditions (resource constancy/winter severity) and physiology (energy storage capabilities). The wide variation in propensities to aggregate with conspecifics observed here highlights how continued failure to recognize complexities in the social behaviors of apparently solitary species limits our understanding not only of the individual species but also the causes and consequences of group formation.

PMID:38466845 | DOI:10.1073/pnas.2312252121

Orthopedics. 2024 Mar 12:1-6. doi: 10.3928/01477447-20240304-04. Online ahead of print.

ABSTRACT

BACKGROUND: The continuation of long-term warfarin therapy is gaining acceptance in minor surgeries but maintaining therapeutic international normalized ratio (INR) values among patients during major orthopedic procedures raises concern. While bridging therapy with low-molecular-weight heparin is currently recommended for patients receiving anticoagulation, few studies have evaluated the safety of continuing warfarin during total joint arthroplasty. This study evaluated the safety and efficacy of continuous warfarin anticoagulation through total joint arthroplasty with and without prophylactic tranexamic acid (TXA).

MATERIALS AND METHODS: We conducted a retrospective, matched-pair analysis of two experimental groups of patients who underwent primary total hip arthroplasty or total knee arthroplasty performed by a single surgeon. Our first experimental group, warfarin plus TXA (warfarin+TXA), consisted of 21 patients who underwent arthroplasty while receiving therapeutic anticoagulation with warfarin (INR, 2.0-3.0) and who received prophylactic TXA. Our second experimental group, warfarin without TXA (warfarin-TXA), consisted of 40 patients who underwent arthroplasty while receiving therapeutic anticoagulation with warfarin (INR, 2.0-3.0) without prophylactic TXA.

RESULTS: The percent change in hemoglobin value after surgery, red blood cells transfused, surgical site infections, bleeding complications, and thrombotic complications were similar between both experimental and control groups. When comparing the historical group with the warfarin+TXA group, the addition of TXA resulted in a statistical decrease in mean red blood cells transfused and estimated blood loss, with no statistically significant increase in complications.

CONCLUSION: Many factors must be considered when choosing perioperative thromboembolic prophylaxis for arthroplasty candidates with medical comorbidities requiring long-term anticoagulation. This study presents data indicating that it could be safe and effective to continue therapeutic warfarin while using prophylactic TXA. [Orthopedics. 202x;4x(x):xx-xx.].

PMID:38466825 | DOI:10.3928/01477447-20240304-04

Clin Infect Dis. 2024 Mar 11:ciae136. doi: 10.1093/cid/ciae136. Online ahead of print.

ABSTRACT

BACKGROUND: Native joint septic arthritis (NJSA) is definitively diagnosed by a positive Gram stain or culture, along with supportive clinical findings. Preoperative antibiotics are known to alter synovial fluid cell count, Gram stain and culture results and are typically postponed until after arthrocentesis to optimize diagnostic accuracy. However, data on the impact of preoperative antibiotics on operative culture yield for NJSA diagnosis are limited.

METHODS: We retrospectively reviewed adult cases of NJSA who underwent surgery at Mayo Clinic facilities from 2012-2021 to analyze the effect of preoperative antibiotics on operative culture yield through a paired analysis of preoperative culture (POC) and operative culture (OC) results using logistic regression and generalized estimating equations.

RESULTS: Two hundred ninety-nine patients with NJSA affecting 321 joints were included. Among those receiving preoperative antibiotics, yield significantly decreased from 68.0% at POC to 57.1% at OC (p < .001). In contrast, for patients without preoperative antibiotics there was a non-significant increase in yield from 60.9% at POC to 67.4% at OC (p = 0.244). In a logistic regression model for paired data, preoperative antibiotic exposure was more likely to decrease OC yield compared to non-exposure (OR = 2.12; 95% CI = 1.24-3.64; p = .006). Within the preoperative antibiotic group, additional antibiotic doses and earlier antibiotic initiation were associated with lower OC yield.

CONCLUSION: In patients with NJSA, preoperative antibiotic exposure resulted in a significant decrease in microbiologic yield of operative cultures as compared to patients in whom antibiotic therapy was held prior to obtaining operative cultures.

PMID:38466824 | DOI:10.1093/cid/ciae136

PLoS Negl Trop Dis. 2024 Mar 11;18(3):e0012010. doi: 10.1371/journal.pntd.0012010. Online ahead of print.

ABSTRACT

BACKGROUND: Human brucellosis is a neglected, re-emerging, and endemic zoonosis in many countries. The debilitating and disabling potential of the disease is a warning about its morbidity, generating socioeconomic impact. This review aims to update the current evidence on the efficacy and safety of therapeutic options for human brucellosis using the network meta-analysis (NMA).

METHODOLOGY: A systematic search was conducted in four different databases by independent reviewers to assess overall therapy failure, adverse events, and time to defervescence associated with different therapies. Randomized clinical trials (RCTs) evaluating any therapeutic drug intervention were selected, excluding non-original studies or studies related to localized forms of the disease or with less than 10 participants. Data were analyzed by frequentist statistics through NMA by random effects model. The risk of bias and certainty of evidence was assessed, this review was registered at PROSPERO.

RESULTS: Thirty-one (31) RCTs involving 4167 patients were included. Three networks of evidence were identified to evaluate the outcomes of interest. Triple therapy with doxycycline + streptomycin + hydroxychloroquine for 42 days (RR: 0.08; CI 95% 0.01-0.76) had a lower failure risk than the doxycycline + streptomycin regimen. Doxycycline + rifampicin had a higher risk of failure than doxycycline + streptomycin (RR: 1.96; CI 95% 1.27-3.01). No significant difference was observed between the regimens when analyzing the incidence of adverse events and time to defervescence. In general, most studies had a high risk of bias, and the results had a very low certainty of evidence.

CONCLUSIONS: This review confirmed the superiority of drugs already indicated for treating human brucellosis, such as the combination of doxycycline and aminoglycosides. The association of hydroxychloroquine to the dual regimen was identified as a potential strategy to prevent overall therapy failure, which is subject to confirmation in future studies.

PMID:38466771 | DOI:10.1371/journal.pntd.0012010

J Refract Surg. 2024 Mar;40(3):e156-e163. doi: 10.3928/1081597X-20240208-02. Epub 2024 Mar 1.

ABSTRACT

PURPOSE: To assess the performance of the Camellin-Calossi formula in eyes with prior myopic laser vision correction.

METHODS: This was a retrospective case series. Patients included had a history of uncomplicated myopic laser vision correction and cataract surgery. The primary outcome measures were cumulative distribution of absolute refractive prediction error, absolute refractive prediction error, and refractive prediction error. These parameters were estimated post-hoc using the Camellin-Calossi, Shammas, Haigis-L, Barrett True-K with or without history, Masket, and Modified Masket formulas and their averages starting from biometric data, clinical records, postoperative refraction, and intraocular lens power implanted.

RESULTS: Seventy-seven eyes from 77 patients were included. The Camellin-Calossi, Shammas, Haigis-L, Barrett True-K No History, Masket, Modified Masket, and Barrett True-K formulas showed a median absolute refractive error (interquartile range) of 0.25 (0.53), 0.51 (0.56), 0.44 (0.65), 0.45 (0.59), 0.40 (0.61), 0.60 (0.70), and 0.55 (0.76), respectively. The proportion of eyes with an absolute refractive error of ±0.25, 0.50, 0.75, 1.00, 1.50, and 2.00 diopters (D) for the Camellin-Calossi formula was 54.5%, 72.7%, 85.7%, 92.2%, 98.7%, and 100%, respectively. The cumulative distribution of the Camellin-Calossi formula showed the best qualitative performances when compared to the others. A statistically significant difference was identified with all of the others except the Haigis-L using a threshold of 0.25, with the Shammas, Modified Masket, and Barrett True-K at a threshold of 0.50 D and the Barrett True-K and Modified Masket at a threshold of 1.00 D.

CONCLUSIONS: The Camellin-Calossi formula is a valid option for intraocular lens power calculation in eyes with prior myopic laser vision correction. [J Refract Surg. 2024;40(3):e156-e163.].

PMID:38466761 | DOI:10.3928/1081597X-20240208-02

J Pers Soc Psychol. 2024 Feb;126(2):281. doi: 10.1037/pspa0000374.

ABSTRACT

Reports the retraction of “Enacting rituals to improve self-control” by Allen Ding Tian, Juliana Schroeder, Gerald Häubl, Jane L. Risen, Michael I. Norton and Francesca Gino (Journal of Personality and Social Psychology, 2018[Jun], Vol 114[6], 851-876). This retraction follows from a 2023 review of the data reported in the article, which was conducted and reported to the journal by the authors. The authors, who agreed to the retraction, requested a correction after identifying discrepancies between the data analyzed for Study 1 and the data downloaded from Qualtrics. Fifteen participants’ condition codes (i.e., control versus experimental) differed between the data reported originally and what participants in the Qualtrics dataset reported doing (e.g., control participants who reported engaging in a ritual). The remaining 69 participants did not present these discrepancies. The authors’ reanalysis based on what participants reported doing invalidated the previous conclusion that enacting a ritual improved self-control as measured by food diaries. Specifically, the effect of what participants did on reported calorie consumption was not statistically significant (ritual participants M = 1,563.31, SD = 313.15; control participants M = 1,521.74, SD = 367.79, t[83] = 0.56, p = .576). The authors did not identify any discrepancies in the datafiles for Studies 2-16. The Study 1 participants were recruited at the University of Chicago gym under the supervision of Drs. Juliana Schroeder and Jane Risen. The statistical analyses reported in the article were conducted by Dr. Juliana Schroeder. A dataset containing the data with the original condition codes and the newly analyzed participants’ reports in the Qualtrics data appears at https://osf.io/3fk2c. (The following abstract of the original article appeared in record 2018-22169-001.) Rituals are predefined sequences of actions characterized by rigidity and repetition. We propose that enacting ritualized actions can enhance subjective feelings of self-discipline, such that rituals can be harnessed to improve behavioral self-control. We test this hypothesis in 6 experiments. A field experiment showed that engaging in a pre-eating ritual over a 5-day period helped participants reduce calorie intake (Experiment 1). Pairing a ritual with healthy eating behavior increased the likelihood of choosing healthy food in a subsequent decision (Experiment 2), and enacting a ritual before a food choice (i.e., without being integrated into the consumption process) promoted the choice of healthy food over unhealthy food (Experiments 3a and 3b). The positive effect of rituals on self-control held even when a set of ritualized gestures were not explicitly labeled as a ritual, and in other domains of behavioral self-control (i.e., prosocial decision-making; Experiments 4 and 5). Furthermore, Experiments 3a, 3b, 4, and 5 provided evidence for the psychological process underlying the effectiveness of rituals: heightened feelings of self-discipline. Finally, Experiment 5 showed that the absence of a self-control conflict eliminated the effect of rituals on behavior, demonstrating that rituals affect behavioral self-control specifically because they alter responses to self-control conflicts. We conclude by briefly describing the results of a number of additional experiments examining rituals in other self-control domains. Our body of evidence suggests that rituals can have beneficial consequences for self-control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38466335 | DOI:10.1037/pspa0000374

JAMA Intern Med. 2024 Mar 11. doi: 10.1001/jamainternmed.2023.8315. Online ahead of print.

ABSTRACT

IMPORTANCE: Chronic kidney disease (CKD) affects 37 million adults in the United States, and for patients with CKD, hypertension is a key risk factor for adverse outcomes, such as kidney failure, cardiovascular events, and death.

OBJECTIVE: To evaluate a computerized clinical decision support (CDS) system for the management of uncontrolled hypertension in patients with CKD.

DESIGN, SETTING, AND PARTICIPANTS: This multiclinic, randomized clinical trial randomized primary care practitioners (PCPs) at a primary care network, including 15 hospital-based, ambulatory, and community health center-based clinics, through a stratified, matched-pair randomization approach February 2021 to February 2022. All adult patients with a visit to a PCP in the last 2 years were eligible and those with evidence of CKD and hypertension were included.

INTERVENTION: The intervention consisted of a CDS system based on behavioral economic principles and human-centered design methods that delivered tailored, evidence-based recommendations, including initiation or titration of renin-angiotensin-aldosterone system inhibitors. The patients in the control group received usual care from PCPs with the CDS system operating in silent mode.

MAIN OUTCOMES AND MEASURES: The primary outcome was the change in mean systolic blood pressure (SBP) between baseline and 180 days compared between groups. The primary analysis was a repeated measures linear mixed model, using SBP at baseline, 90 days, and 180 days in an intention-to-treat repeated measures model to account for missing data. Secondary outcomes included blood pressure (BP) control and outcomes such as percentage of patients who received an action that aligned with the CDS recommendations.

RESULTS: The study included 174 PCPs and 2026 patients (mean [SD] age, 75.3 [0.3] years; 1223 [60.4%] female; mean [SD] SBP at baseline, 154.0 [14.3] mm Hg), with 87 PCPs and 1029 patients randomized to the intervention and 87 PCPs and 997 patients randomized to usual care. Overall, 1714 patients (84.6%) were treated for hypertension at baseline. There were 1623 patients (80.1%) with an SBP measurement at 180 days. From the linear mixed model, there was a statistically significant difference in mean SBP change in the intervention group compared with the usual care group (change, -14.6 [95% CI, -13.1 to -16.0] mm Hg vs -11.7 [-10.2 to -13.1] mm Hg; P = .005). There was no difference in the percentage of patients who achieved BP control in the intervention group compared with the control group (50.4% [95% CI, 46.5% to 54.3%] vs 47.1% [95% CI, 43.3% to 51.0%]). More patients received an action aligned with the CDS recommendations in the intervention group than in the usual care group (49.9% [95% CI, 45.1% to 54.8%] vs 34.6% [95% CI, 29.8% to 39.4%]; P < .001).

CONCLUSIONS AND RELEVANCE: These findings suggest that implementing this computerized CDS system could lead to improved management of uncontrolled hypertension and potentially improved clinical outcomes at the population level for patients with CKD.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03679247.

PMID:38466302 | DOI:10.1001/jamainternmed.2023.8315