Nevin Manimala

Orbit. 2023 Oct 23:1-9. doi: 10.1080/01676830.2023.2269252. Online ahead of print.

ABSTRACT

PURPOSE: The aim is to increase the understanding of lacrimal gland pleomorphic adenoma’s recurrence rate and the factors that influence it.

METHODS: A systematic search of PubMed, SCOPUS, Cochrane Library, and CINAHL was conducted following PRISMA guidelines. The data in the included studies were extracted and analyzed.

RESULTS: Twenty-two studies were included representing 963 patients from 12 different countries. The pooled analysis of the recurrence rate was 8.83% (95% CI: 5.08-13.50). In the event of recurrence, there was a 75.17% (95% CI: 65.98-82.94) chance of benign recurrence and a 28.35% (95% CI: 19.66-38.41) chance of malignant recurrences, with malignant recurrence occurring almost exclusively after a benign recurrence. The results showed that 47.09% (95% CI: 24.60 to 70.22) of recurrent tumors had a ruptured pseudocapsule and 6.35% (95% CI: 0.82 to 16.54) had an intact pseudocapsule with a significant difference between the two. Of the recurrent tumors, 51.50% (95% CI: 9.28 to 92.39) were biopsied compared to 8.83% (95% CI: 3.40 to 16.49) of the total; the difference between these two proportions was also found to be significant.

CONCLUSION: There was a statistically significant difference in the rates of recurrence between tumors that were either biopsied or had a ruptured pseudocapsule compared to those that did not. This evidence adds additional support for excisional biopsy being the procedure of choice for LGPA and reinforces the importance of keeping the pseudocapsule intact during surgical resection.

PMID:37870812 | DOI:10.1080/01676830.2023.2269252

Surg Infect (Larchmt). 2023 Oct;24(8):692-702. doi: 10.1089/sur.2023.199.

ABSTRACT

Background: Post-operative infections are a substantial cause of morbidity and mortality worldwide. Polyhexamethylene biguanide (PHMB) is an antimicrobial agent that has been used in various surgical settings to prevent infections. However, the literature on its efficacy in reducing post-operative infections remains unclear. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of PHMB in reducing post-operative infections. The risk of bias and methodologic quality of the included studies were also assessed. Results: The systematic review included nine RCTs, and eight were included in the meta-analysis that showed that the use of PHMB was associated with a reduction in the rate of post-operative infections. The overall effect size was statistically significant, with moderate heterogeneity across the included studies (log Peto’s odds ratio [OR], -0.890; 95% confidence interval [CI], -1.411 to -0.369; I² = 41.89%). However, the diversity in the application of PHMB and the potential influence of other factors, such as adherence to infection prevention protocols and organizational-level variables, underscore the need for further primary studies. Conclusions: Polyhexamethylene biguanide appears to be a promising intervention for reducing post-operative infections. However, more high-quality, well-designed RCTs are needed to confirm these findings and to explore the most effective ways to use PHMB within specific infection prevention bundles. Future research should also aim to control for potential confounding factors to provide a more comprehensive understanding of the efficacy of PHMB in reducing post-operative infections.

PMID:37870810 | DOI:10.1089/sur.2023.199

J Comp Psychol. 2023 Oct 23. doi: 10.1037/com0000366. Online ahead of print.

ABSTRACT

A growing body of research demonstrates that humans can accurately perceive the emotional states of animals solely by listening to their calls, highlighting shared evolutionary ancestry. Yet, the cognitive and perceptual mechanisms underlying heterospecific emotion perception have remained open to investigation. One hypothesis is that humans rely on simple acoustic heuristics to make such judgments, for example, perceiving higher-pitched calls as reflecting heightened emotional arousal (the “pitch rule”). This could lead to accurate judgments of emotion since in most mammals, as in humans, vocal fundamental frequency (the acoustic determinant of the pitch percept) does objectively correlate with emotional arousal. In the present study, we used digital pitch manipulation to create pairs of animal calls that were perceptually identical except for pitch, and we measured human perceptions of the caller’s emotional arousal using an online survey. Calls of six phylogenetically diverse species were included as stimuli. Participants attributed slightly but statistically significantly higher arousal to higher-pitched versions of the same calls. Variation in application of the pitch rule across species was not well explained by familiarity, and prior experience with cats did not significantly predict sensitivity to pitch in cat vocalizations. Cross-species variation also did not align with phylogenetic distance from humans, or the hypothetical usefulness of pitch for making accurate judgments. Thus, the pitch rule may be a “mammalomorphic” heuristic leading to accurate emotion judgments in some taxa and call types and erroneous judgments in others, depending in part on phylogenetic distance and the mechanisms of call production. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37870804 | DOI:10.1037/com0000366

Fam Med. 2023 Oct 17. doi: 10.22454/FamMed.2023.919199. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: In 2020, the Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed and piloted a framework to measure diversity, equity, and inclusion (DEI) initiatives in medical residencies across five domains: curriculum, evaluation, institution, resident pathway, and faculty pathway. The objectives were (1) to measure DEI initiatives across multiple domains in family medicine residencies using the DEI milestones and (2) to obtain current national baseline data providing criteria against which to measure effectiveness of initiatives and create tailored benchmarks.

METHODS: We developed a cross-sectional survey of 12 quantitative residency characteristic items and the five DEI milestone ratings, and distributed the survey to program directors of family medicine residencies accredited by the Accreditation Council for Graduate Medical Education in the spring of 2022. We generated descriptive statistics, including item frequencies and cross-tabulations, and completed subgroup comparisons with analysis of variance.

RESULTS: We collected aggregate milestone data for 194 family medicine residencies of 588 eligible programs (33% response rate). Respondents represented 48 states and US territories: 107 community-based, university-affiliated; 48 community-based; 34 university-based; and 5 military/other programs. Overall, the curriculum milestone was rated the highest (mean=2.54, SD=1.03), whereas the faculty pathway (mean=1.94, SD=1.04) and resident pathway (mean=2.02, SD=1.06) milestones were rated lowest.

CONCLUSIONS: DEI milestone data may support residency programs as they assess their institution’s developmental progress across five key domains. Additionally, aggregate data may shed light on collective strengths and areas for improvement.

PMID:37870796 | DOI:10.22454/FamMed.2023.919199

Cultur Divers Ethnic Minor Psychol. 2023 Oct 23. doi: 10.1037/cdp0000618. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study examined the measurement invariance of the Symbolic Racism Scale (SRS) and the Modern Sexism Scale (MSS) across racial/ethnic and gender groups. Previous psychometric evaluations of the SRS and MSS scores have not examined the equivalence across racial/ethnic and gender groups or have been otherwise statistically inadequate. Therefore, this study sought to fill this gap.

METHOD: To establish measurement equivalence across racial/ethnic (Black, Latinx, and white) and gender (women and men) groups, we conducted a measurement invariance analysis of the SRS and the MSS in a large, diverse sample (N = 719).

RESULTS: We found that the SRS and MSS were invariant across gender, and the SRS was invariant across racial/ethnic groups. However, the MSS was noninvariant across racial/ethnic groups. Partial invariance testing revealed nonequivalent factor loadings between Black and Latinx participants compared to white participants on an item of the MSS that referenced “unwarranted” attention that women receive from the government and media.

CONCLUSIONS: Researchers should consider reevaluating the item that reads: “Over the past few years, the government and news media have been showing more concern about the treatment of women than is warranted by women’s actual experiences.” Future research is needed to assess how the item is interpreted by Black and Latinx people so it can be modified for use in these communities. Our findings underscore the importance of assessing the validity of the scores in commonly used scales across diverse groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37870793 | DOI:10.1037/cdp0000618

J Womens Health (Larchmt). 2023 Oct 23. doi: 10.1089/jwh.2022.0482. Online ahead of print.

ABSTRACT

Purpose: This systematic review and meta-analysis aimed to investigate the mean (weighted) prevalence of help-seeking behavior among women with urinary incontinence (UI) in relevant subgroups and the related influencing factors. Materials and Methods: Six English and four Chinese databases were systematically searched between 1996 and July 10, 2022. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies. All statistical analyses were conducted using RevMan 5.4. Results: The mean (weighted) prevalence of help-seeking behavior based on the 41 included studies, including a total of 32,640 women with UI, was 28% (95% confidence interval [CI]: 22%-34%). We performed a subgroup analysis based on UI type, population, region, publication time, case definition of help-seeking, and use of validated tools to determine UI. The results of the subgroup analysis showed that the pooled prevalence of help-seeking behavior was 23% (95% CI: 14%-32%) among pregnant and maternity women, 27% (95% CI: 19%-35%) among menopausal women, 24% (95% CI: 14%-35%) among 20- to 50-year-old women, 31% (95% CI: 25%-36%) among those older than 50 years, 24% (95% CI: 17%-30%) in Asia, and 33% (95% CI: 22%-44%) in Europe. Meanwhile, the pooled odds ratio showed that education level, UI type, UI severity, and quality of life significantly influenced help-seeking behavior among women with UI. Conclusions: This systematic review revealed that the pooled prevalence of help-seeking behaviors among women with UI is 28%. These influencing factors have important implications for adapting to health care and social care systems.

PMID:37870774 | DOI:10.1089/jwh.2022.0482

J Racial Ethn Health Disparities. 2023 Oct 23. doi: 10.1007/s40615-023-01838-5. Online ahead of print.

ABSTRACT

BACKGROUND: Black patients with peripartum cardiomyopathy (PPCM) have disproportionately worse outcomes than White patients, possibly related to variable involvement of cardiovascular specialists in their clinical care. We sought to determine whether race was associated with cardiology involvement in clinical care during inpatient admission and whether cardiology involvement in care was associated with higher claims of guideline-directed medical therapy (GDMT) a week after hospital discharge.

METHODS: Using Optum’s de-identified Clinformatics® Data Mart (CDM), we included Black and White patients’ first hospital admission for PPCM from 2008 to 2021. Cardiology involvement in clinical care was defined as the receipt of attending care from a cardiovascular specialist during admission. GDMT included beta-blockers (BB) for all patients and triple therapy (BB, angiotensin-responsive medications, and mineralocorticoid receptor antagonists) for non-pregnant patients. Logistic regression was used to determine the associations between cardiology involvement in clinical care during admission and (1) patient race and (2) GDMT prescription, adjusting for age and comorbidities.

RESULTS: Among 668 patients (32.6% Black, 67.4% White, 93.3% commercially insured), there was no significant difference in the odds of cardiology involvement in clinical care by race (aOR: 1.41; 95%CI: 0.87-2.33, P=0.17). Inpatient cardiology care was associated with 2.75 times increased odds of having a prescription claim for GDMT (BB) for White patients (aOR: 2.75; 95%CI 1.50-5.06, P=0.001), and the estimated effect size was similar but not statistically significant for Black patients (aOR: 2.20, 95% CI, 0.84-5.71, P=0.11). The interaction between race and cardiology involvement in clinical care was not statistically significant for the receipt of BB prescription. Among 274 non-pregnant patients with PPCM (37.2% Black, 62.8% White), 5.8% received triple GDMT. Of these, none of the Black patients lacking cardiology care had triple GDMT. However, cardiology involvement in care was not significantly associated with triple GDMT for either race.

CONCLUSIONS: Among a commercially insured population within PPCM, race was not associated with cardiology involvement in clinical care during hospitalization. However, cardiology involvement in care was associated with significantly higher odds of prescription claims for BB for only White patients. Additional strategies are needed to support equitable GDMT prescription.

PMID:37870730 | DOI:10.1007/s40615-023-01838-5

Forensic Sci Med Pathol. 2023 Oct 23. doi: 10.1007/s12024-023-00734-y. Online ahead of print.

ABSTRACT

One of the crucial steps in the process of identification of human remains is sex determination of an unknown individual. Sex can be determined using the human skeleton, especially by examining the pelvis and skull. Odontometric analysis and assessment of sexual dimorphism of the human dentition has been less investigated, especially in primary dentition. Hence, this research was designed to verify the presence of sexual dimorphism through odontometric approach in paediatric population of Tamil Nadu, India. The present study was performed on 229 females and 244 males between 3 and 6 years of age. Linear measurements such as maximum mesio distal width, maximum bucco lingual width and clinical crown length were measured in all the primary teeth. Statistical analysis was performed using the Statistical Package for Social Science version 20.0 software (SPSS Inc., Chicago, IL, USA). Mann-Whitney-U test was used to check the statistical significance of the differences observed between males and females. Six equations were derived by discriminant function analysis for practical use. Sexual dimorphism existed in odontometric parameters of primary dentition. The maximum sexual dimorphism was observed in maximum bucco lingual width of 51 and maximum bucco lingual width of 75. The equations derived using discriminant function analysis yielded a jackknife accuracy ranging between 87.5% and 99.8%. These equations may be used to assess the sex from the children of Tamil Nadu, India.

PMID:37870726 | DOI:10.1007/s12024-023-00734-y

J Epidemiol Glob Health. 2023 Oct 23. doi: 10.1007/s44197-023-00154-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the characteristics of C. auris cases, and to describe the interventions applied for improving the diagnosis and controlling the transmission.

METHOD: Medical records of C. auris cases reported between January 2021 until June 2022 at King Saud Medical City (KSMC), Riyadh, Kingdom of Saudi Arabia have been reviewed. We analyzed the demographic and clinical characteristics of the cases to illustrate the possible contributing factors with C. auris infection. A multidisciplinary committee has been formulated to investigate the potential source of the outbreak among clusters of cases in the intensive care units (ICU). A bundle of mitigation measures has been applied which was successful to contain the outbreak.

RESULTS: During the study period, a total of 129 cases of C. auris were identified, their mean age is 47 ± 22.3 SD, and 72.1% are males. 57% of cases were colonized, all of them were identified through active screening. A number of comorbidities were present including 27.9% were having hypertension, 27.1% with diabetes, 22.5% with COVID-19 and 20.2% with respiratory diseases. The average length of stay before reported positive was 36.23 days. 78.3% of those patients were in the critical care unit, 73.6% with vascular catheter, 88% with urinary catheters and 66.7% with mechanical ventilation. The vast majority of patients were using multiple antibiotics (86%). As per the univariate logistic model, risk factors significantly associated with mortality were (Age, Trauma RTA, ICU, Vascular Access, Foley Catheters, Mechanical Ventilation, Tracheostomy and Endotracheal Tubes) with p values (0.0038, 0.0159, 0.0108, 0.0122, 0.0071, <.0001, 0.0148 and 0.0107), respectively. Multivariate logistic regression showed that having a Foley Catheter was the only statistically significant factor associated with mortality.

CONCLUSION: This retrospective analysis highlights the main characteristics associated with C. auris-infected patients. In addition, it highlights the effectiveness of the bundle of mitigation strategies applied to limit the spread of C. auris in healthcare facilities.

PMID:37870721 | DOI:10.1007/s44197-023-00154-9

J Neurovirol. 2023 Oct 23. doi: 10.1007/s13365-023-01176-6. Online ahead of print.

ABSTRACT

The effectiveness of COVID-19 vaccination is still unclear in individuals with underlying diseases such as HTLV-1 infection. This retrospective cohort study aimed to evaluate the humoral response of COVID-19 vaccines among people living with HTLV-1 (PLHTLV) in northeastern Iran. From December 2021 to October 2022, eighty-six HTLV-1⁺ subjects (50 males and 36 females; 47.7 ± 11.2 years) and 90 HTLV-1 seronegative individuals (age- and sex-matched convenient samples) were enrolled. The humoral immune response was evaluated by measuring different COVID-19 Abs in serum samples at least 28 days after receiving 2^nd or 3^rd doses of COVID-19 vaccines. Throughout all three rounds of immunization, Sinopharm was the most commonly used COVID-19 vaccine across all three immunization rounds. Compared to the HTLV-1^– group, a significantly lower frequency of all four Abs activity was observed among PLHTLV:anti-nucleocapsid (66.3% vs 86.7%, p = 0·001), anti-spike (91.9% vs 98.9%, p = 0·027), RBD (90.7% vs 97.8%, p = 0·043), and neutralizing Abs (75.6% vs 95.5%, p < 0·001). Also, the frequency of all Abs in 28 patients with HAM/TSP was higher than that of 58 asymptomatic carriers, although this difference was statistically significant only in the case of anti-spike Abs (p = 0.002). Notably, PLHTLV-vaccinated against COVID-19 demonstrated significantly lower antibody activities, indicating a reduced humoral immune response to COVID-19 vaccines.

PMID:37870718 | DOI:10.1007/s13365-023-01176-6