Nevin Manimala

Indian J Dermatol Venereol Leprol. 2023 May 3:1-5. doi: 10.25259/IJDVL_939_2022. Online ahead of print.

ABSTRACT

Background Plantar keratoderma is a common finding in pachyonychia congenita, significantly impairing ambulation and quality of life. Due to the variation of pain reporting in pachyonychia congenita clinical studies, it is difficult to evaluate the efficacy of treatment outcomes for painful plantar keratodermas. Objectives To objectively analyse associations between plantar pain and activity levels in pachyonychia congenita patients using a wristband tracker. Methods Pachyonychia congenita patients and matched normal controls wore wristband activity trackers and completed a daily digital survey to record their highest and total pain scores (0-10 scale) each day for 28 consecutive days during four different seasons. Results Twenty four participants (12 pachyonychia congenita patients and 12 matched normal controls) completed the study. Pachyonychia congenita patients walked 1801.30 fewer steps/day (95% CI, -3666.4, 64.1) than normal controls (P  0.072) and had greater average total [5.26; SD, 2.10] and highest (6.92; SD, 2.35) daily pain than normal controls [0.11 (SD, 0.47), 0.30 (SD, 0.22), respectively] (P  0.001, both). On average, for each one unit increase in daily highest pain level, pachyonychia congenita activity decreased 71.54 steps/day (SE, 38.90, P  0.066). Limitation The study had a small number of participants, limiting statistical power. Only pachyonychia congenita patients, ages 18 years or older, with keratin 6a, keratin 16, and keratin 17 mutations were included, limiting generalizability. Conclusion Pachyonychia congenita patients were less active with significantly higher pain than normal controls. There was an inverse correlation between pain and activity. Our findings suggest that wristband tracker technology may be used to evaluate treatment efficacy in future trials on severe plantar pain; therapeutic interventions that decrease plantar pain should correlate with significant increases in activity using wristband trackers.

PMID:37317732 | DOI:10.25259/IJDVL_939_2022

Indian J Dermatol Venereol Leprol. 2023 May 3:1-3. doi: 10.25259/IJDVL_871_2022. Online ahead of print.

NO ABSTRACT

PMID:37317731 | DOI:10.25259/IJDVL_871_2022

Aust Vet J. 2023 Jun 14. doi: 10.1111/avj.13264. Online ahead of print.

ABSTRACT

Fasciolosis is an endemic zoonotic parasitic disease with significant impacts on human health and both animal health and production. Early post-infection impacts on the host remain unclear. The objective of this study was to determine the changes, if any, to levels of endotoxin in cattle plasma in response to early-stage infection with Fasciola hepatica. Thirty-six (36) commercial bred cattle were experimentally infected with approximately 400 viable metacercariae. Plasma lipopolysaccharide (endotoxin) levels were examined on 24 occasions from 0 h before infection to 336 h after infection using the Limulus Amoebocyte Lysate chromogenic end point assay and compared with that of six (6) uninfected control animals. Peak lipopolysaccharide levels in infected animals were reached at 52 h after infection and returned to pre-infection levels at time 144 h after infection. Infected animals had significantly elevated lipopolysaccharide levels between 24 and 120 h after infection when compared to uninfected animals. The mean change in endotoxin units (EU)/mL over time after infection was statistically significant in infected animals. Elevations of lipopolysaccharide occurred in all infected animals suggesting a possible repeatable and titratable endotoxemia conducive to therapeutic agent model development.

PMID:37317661 | DOI:10.1111/avj.13264

Ecol Lett. 2023 Jun 14. doi: 10.1111/ele.14274. Online ahead of print.

ABSTRACT

Symbiont diversity can have large effects on plant growth but the mechanisms generating this relationship remain opaque. We identify three potential mechanisms underlying symbiont diversity-plant productivity relationships: provisioning with complementary resources, differential impact of symbionts of varying quality and interference between symbionts. We connect these mechanisms to descriptive representations of plant responses to symbiont diversity, develop analytical tests differentiating these patterns and test them using meta-analysis. We find generally positive symbiont diversity-plant productivity relationships, with relationship strength varying with symbiont type. Inoculation with symbionts from different guilds (e.g. mycorrhizal fungi and rhizobia) yields strongly positive relationships, consistent with complementary benefits from functionally distinct symbionts. In contrast, inoculation with symbionts from the same guild yields weak relationships, with co-inoculation not consistently generating greater growth than the best individual symbiont, consistent with sampling effects. The statistical approaches we outline, along with our conceptual framework, can be used to further explore plant productivity and community responses to symbiont diversity, and we identify critical needs for additional research to explore context dependency in these relationships.

PMID:37317651 | DOI:10.1111/ele.14274

Cancer Med. 2023 Jun 14. doi: 10.1002/cam4.6231. Online ahead of print.

ABSTRACT

BACKGROUND: Choosing the optimal treatment approach for patients with painful bone metastases during the COVID-19 pandemic became challenging. A simple technique, single fraction radiotherapy was recommended for these patients usually referring to bone metastases as a single entity, although it is a very heterogeneous group of patients.

AIM: This study aimed to analyze the response to palliative single fraction radiotherapy in relation to age, performance status, primary tumor, histopathology, and bone localization in the group of patients with painful bone metastases.

METHODS: A clinical, prospective, non-randomized study was conducted at the Institute for Oncology and Radiology of Serbia, which included 64 patients with noncomplicated, painful bone metastases who underwent palliative, pain-relieving radiation therapy with a single tumor dose of 8Gy in a single hospital visit. Response to treatment was patient reported via telephone interview using visual analog scale. The response assessment was based on the international consensus panel of radiation oncologists.

RESULTS: In the entire group of patients, 83% responded to radiotherapy. No statistically significant difference was observed in response to therapy, time to reach the maximum response, degree of pain reduction, nor in response duration depending on the patient’s age, performance status, the primary origin of the tumor, histopathology, or location of the metastasis (bone) that was irradiated.

CONCLUSION: Regardless of clinical parameters, palliative radiotherapy with a single dose of 8Gy can be considered very effective in quick pain relief in patients with noncomplicated painful bone metastases. Single fraction radiotherapy in a single hospital visit, as well as patient-reported outcome for these patients may be considered favorable beyond Covid pandemics.

PMID:37317639 | DOI:10.1002/cam4.6231

Nurse Res. 2023 Jun 15. doi: 10.7748/nr.2023.e1885. Online ahead of print.

ABSTRACT

BACKGROUND: Quantitative methods and statistical analysis are essential tools in nursing research, as they support researchers testing phenomena, illustrate their findings clearly and accurately, and provide explanation or generalisation of the phenomenon being investigated. The most popular inferential statistics test is the one-way analysis of variance (ANOVA), as it is the test designated for comparing the means of a study’s target groups to identify if they are statistically different to the others. However, the nursing literature has identified that statistical tests are not being used correctly and findings are being reported incorrectly.

AIM: To present and explain the one-way ANOVA.

DISCUSSION: The article presents the purpose of inferential statistics and explains one-way ANOVA. It uses relevant examples to examine the steps needed to successfully apply the one-way ANOVA. The authors also provide recommendations for other statistical tests and measurements in parallel to one-way ANOVA.

CONCLUSION: Nurses need to develop their understanding and knowledge of statistical methods, to engage in research and evidence-based practice.

IMPLICATIONS FOR PRACTICE: This article enhances the understanding and application of one-way ANOVAs by nursing students, novice researchers, nurses and those engaged in academic studies. Nurses, nursing students and nurse researchers need to familiarise themselves with statistical terminology and develop their understanding of statistical concepts, to support evidence-based, quality, safe care.

PMID:37317616 | DOI:10.7748/nr.2023.e1885

Disaster Med Public Health Prep. 2023 Jun 15:1-39. doi: 10.1017/dmp.2023.101. Online ahead of print.

ABSTRACT

The rapid onset of COVID-19 created a complex virtual collective consciousness. Misinformation and polarization were hallmarks of the pandemic in the United States, highlighting the importance of studying public opinion online. Humans express their thoughts and feelings more openly than ever before on social media, co-occurrence of multiple data sources becomes valuable for monitoring and understanding public sentimental preparedness and response to an event within our society. In this study, Twitter and Google Trends data were used as the co-occurrence data for the understanding of the dynamics of sentiment and interest during the COVID-19 pandemic in the United States from January 2020 to September 2021. Developmental trajectory analysis of Twitter sentiment was conducted using corpus linguistic techniques and word cloud mapping to reveal eight positive and negative sentiments and emotions. Machine learning algorithms were employed to implement the opinion mining how Twitter sentiment was related to Google Trends interest with historical COVID-19 public health data. The sentiment analysis went beyond polarity to detect specific feelings and emotions during the pandemic. The discoveries on the behaviors of emotions at each stage of the pandemic were presented from the emotion detection when associated with the historical COVID-19 data and Google Trends data.

PMID:37317615 | DOI:10.1017/dmp.2023.101

J Clin Nurs. 2023 Jun 15. doi: 10.1111/jocn.16799. Online ahead of print.

ABSTRACT

AIMS: To explore the implementation of a dementia care pathway in an acute care setting.

BACKGROUND: Dementia care in acute settings is often constrained by contextual factors. We developed an evidence-based care pathway with intervention bundles, and implemented it on two trauma units, with the aim to empower staff and improve quality care.

DESIGN: Process evaluation using quantitative and qualitative methods.

METHODS: Pre-implementation, unit staff completed a survey (n = 72) assessing family and dementia care skills and level of evidence-based dementia care. Post-implementation, champions (n = 7) completed the same survey, with additional questions on acceptability, appropriateness and feasibility, and participated in a focus group interview. Data were analysed using descriptive statistics and content analysis guided by the Consolidated Framework for Implementation Research (CFIR).

REPORTING GUIDELINE: Standards for Reporting Qualitative Research Checklist.

RESULTS: Pre-implementation, staff’s perceived skills in family and dementia care were moderate overall, with high skills in ‘building relationships’ and ‘sustaining personhood’. Evidence-based interventions were delivered seldom to frequent, with ‘individualized care’ scoring lowest and ‘assessing cognition’ scoring highest. Implementation of the care pathway/intervention bundles was overshadowed by the pandemic, and failed due to major organisational- and process-related barriers. Acceptability scored highest and feasibility lowest, with concerns relating to complexity and compatibility of pathways/bundles when introduced into clinical routines.

CONCLUSIONS: Our study implies that organisational and process factors are the most influential determinants to the implementation of dementia care in acute settings. Future implementation efforts should draw on the evolving evidence within implementation science and dementia care research to ensure effective integration and improvement process.

RELEVANCE TO CLINICAL PRACTICE: Our study provides important learning around improving care for persons with dementia and their families in hospitals.

PATIENT OR PUBLIC CONTRIBUTION: A family caregiver was involved in the development of the education and training programme.

PMID:37317613 | DOI:10.1111/jocn.16799

Gan To Kagaku Ryoho. 2023 Jun;50(6):701-705.

ABSTRACT

To date, there are no reports that examine the relationship between geriatric nutritional risk index(GNRI)at the start of chemotherapy for malignant lymphoma and adverse effects. In this study, we investigated the relationship between GNRI at the start of chemotherapy and the incidence of side effects and time to treatment failure(TTF)in(R-)EPOCH-treated patients with relapsed or refractory malignant lymphoma. A significant difference in the incidence of Grade 3 or higher thrombocytopenia was observed between high and low GNRI groups(p=0.043). The GNRI may be an indicator of hematologic toxicity in malignant lymphoma patients treated with(R-)EPOCH. There was a statistically significant difference in TTF between the high and low GNRI groups(p=0.025), suggesting that nutritional status at the start of(R-)EPOCH may affect treatment continuation.

PMID:37317604

JMIR Res Protoc. 2023 Jun 14. doi: 10.2196/47025. Online ahead of print.

ABSTRACT

BACKGROUND: This non-randomized exploratory intervention and feasibility study examines how digital assistive technology (DAT), comprising a Dfree ultrasound sensor, affects nursing care for continence support and evaluates nurses’ willingness to incorporate DAT into the planning and practical implementation of care processes.

OBJECTIVE: The relief provided by DFree in the clinical care setting and the extent it supports nursing care for activities of daily living (ADL) pertaining to “micturition” are unclear. DAT DFree is expected to reduce nurses’ workload in clinical continence-care settings and was designed as a human-technology interaction that ensures a high level of usability for the subjects (i.e. the nurses) and increases user acceptance by at least one level (e.g., from average to slightly above average) during the study.

METHODS: Approximately 45 nurses from neurology, neurosurgery, and geriatric medicine clinics and polyclinics at the University Medicine Halle will be included in the 90-day (3-month) intervention onsite in the respective wards. After the wards are equipped with digital technologies, the participating nurses will be trained to use DFree and will be able to select DFree as a possible patient-care resource if the anamnesis includes bladder dysfunction among only patients who are willing to participate. The willingness of nurse participants to use DFree in planning their care process will be assessed using the Technology Usage Inventory (TUI) at three measurement points. The primary target values include the results of the multidimensional TUI assessment that will be processed using descriptive statistics. Ten participating nurses will be invited to conduct extensive guided interviews that are intended to provide information about the usefulness, feasibility in the specific field of continence care, and possible improvements of the device.

RESULTS: It is expected that the intention to use will be confirmed by nurses and the number of nursing problems, such as bladder dysfunction-induced bedwetting, will be reduced with a high rating of DAT usability.

CONCLUSIONS: First, this study aims to produce multilevel innovative impacts, including practical, scientific, and societal effects. The results will provide practical solutions for workload reduction in the field of nursing support for continence care, where digital assistive technologies are becoming increasingly important. The DFree ultrasonic sensor is a new technical tool for the treatment of bladder dysfunction. Generating feedback to improve technical application can increase the user-friendliness and usefulness of the device.

CLINICALTRIAL: This study was approved by the Ethics Committee of the Faculty of Medicine, Martin-Luther-University Halle-Wittenberg (approval no. 2023-031, dated May 9, 2023). The study was registered in the German Register of Clinical Studies (registration no. DRKS00031483), and the protocol has not been published previously.

PMID:37317590 | DOI:10.2196/47025