Nevin Manimala

Clin Cardiol. 2023 Aug 18. doi: 10.1002/clc.24109. Online ahead of print.

ABSTRACT

BACKGROUND: An unmet need exists to reliably predict the risk of intracranial hemorrhage (ICH) in patients with atrial fibrillation (AF) treated with oral anticoagulants (OACs).

HYPOTHESIS: An externally validated model improves ICH risk stratification.

METHODS: Independent factors associated with ICH were identified by Cox proportional hazard modeling, using pooled data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD-Atrial Fibrillation) and ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registries. A predictive model was developed and validated by bootstrap sampling and by independent data from the Danish National Patient Register.

RESULTS: In the combined training data set, 284 of 53 878 anticoagulated patients had ICH over a 2-year period (0.31 per 100 person-years; 95% confidence interval [CI]: 0.28-0.35). Independent predictors of ICH included: older age, prior stroke or transient ischemic attack, concomitant antiplatelet (AP) use, and moderate-to-severe chronic kidney disease (CKD). Vitamin K antagonists (VKAs) were associated with a significantly higher risk of ICH compared with non-VKA oral anticoagulants (NOACs) (adjusted hazard ratio: 1.61; 95% CI: 1.25-2.08; p = .0002). The ability of the model to discriminate individuals in the training set with and without ICH was fair (optimism-corrected C-statistic: 0.68; 95% CI: 0.65-0.71) and outperformed three previously published methods. Calibration between predicted and observed ICH probabilities was good in both training and validation data sets.

CONCLUSIONS: Age, prior ischemic events, concomitant AP therapy, and CKD were important risk factors for ICH in anticoagulated AF patients. Moreover, ICH was more frequent in patients receiving VKA compared to NOAC. The new validated model is a step toward mitigating this potentially lethal complication.

PMID:37596725 | DOI:10.1002/clc.24109

Plant Genome. 2023 Aug 18:e20374. doi: 10.1002/tpg2.20374. Online ahead of print.

ABSTRACT

Genome-wide association studies (GWAS) are powerful statistical methods that detect associations between genotype and phenotype at genome scale. Despite their power, GWAS frequently fail to pinpoint the causal variant or the gene controlling a given trait in crop species. Assessing genetic variants other than single-nucleotide polymorphisms (SNPs) could alleviate this problem. In this study, we tested the potential of structural variant (SV)- and k-mer-based GWAS in soybean by applying these methods as well as conventional SNP/indel-based GWAS to 13 traits. We assessed the performance of each GWAS approach based on loci for which the causal genes or variants were known from previous genetic studies. We found that k-mer-based GWAS was the most versatile approach and the best at pinpointing causal variants or candidate genes. Moreover, k-mer-based analyses identified promising candidate genes for loci related to pod color, pubescence form, and resistance to Phytophthora sojae. In our dataset, SV-based GWAS did not add value compared to k-mer-based GWAS and may not be worth the time and computational resources invested. Despite promising results, significant challenges remain regarding the downstream analysis of k-mer-based GWAS. Notably, better methods are needed to associate significant k-mers with sequence variation. Our results suggest that coupling k-mer- and SNP/indel-based GWAS is a powerful approach for discovering candidate genes in crop species.

PMID:37596724 | DOI:10.1002/tpg2.20374

Nurse Educ Today. 2023 Aug 11;130:105936. doi: 10.1016/j.nedt.2023.105936. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, there has been increased demand for higher education in nursing and midwifery to support evidence-based practice. It is believed that higher education in nursing leads to improved quality of care. The motivation for pursuing higher education, the choice of institution for learning and the effects of higher education programs have not been given much attention in research literature in Ghanaq OBJECTIVE: To assess the motivating factors, reasons for the choice of institution and the perceived effects of attaining higher educational qualifications among post-diploma graduate nurses and midwives.

STUDY DESIGN: Descriptive cross-sectional study.

SETTING: Kumasi.

PARTICIPANTS: Convenience and snowball sampling were used to select 523 nurses and midwives who had pursued higher education after their Diploma in Nursing or Midwifery education.

METHOD: A researcher-developed questionnaire was used to collect data on motivation, choice of institution and perceived effects of higher education by nurses and midwives. Data were analyzed through descriptive statistics, Pearson correlation and linear regression at 0.05 significance level.

RESULTS: The greatest motivation for higher education by nurses/midwives was to improve clinical judgment. Academic quality and reputation of the institution were the main reasons for the choice of institution (n = 458, 92.7 %). There were weak but positive significant correlations between the perceived effects of higher nursing and midwifery education and pressure from the workplace (r = 0.204, p < .001), and increasing new demands from clients (r = 0.284, p < .001). Increasing demands from clients (β = 0.203, p < .001) and improving social status (β = 0.264, p < .001) were the motivating factors that influenced the perceived effects of higher nursing and midwifery education.

CONCLUSION: The desire for improved professionalism and increased expertise are the reasons nurses and midwives seek higher education. Health managers should support nurses and midwives to attain higher education to improve the quality of care.

PMID:37595323 | DOI:10.1016/j.nedt.2023.105936

Aesthet Surg J. 2023 Aug 19:sjad265. doi: 10.1093/asj/sjad265. Online ahead of print.

ABSTRACT

BACKGROUND: Capsular contracture is a known complication of breast augmentation and is among the top reasons for revision breast augmentation procedures. The use of acellular dermal matrices (ADM) has been shown to reduce the rate of capsular contracture in breast reconstruction and augmentation theorizing that it acts as a protective barrier between the implant capsule and inflammatory process responsible for capsular contracture. The role of ADM in treatment of capsular contracture has been investigated in numerous studies, using a variety of ADM.

OBJECTIVES: The aim of this study was to perform a systematic review of existing literature on the use of ADM for treatment of capsular contracture in aesthetic breast augmentation patients to investigate differences in efficacy between ADM types.

METHODS: PubMed, Embase, and CINAHL databases were systematically reviewed for articles pertaining to capsular contracture, acellular dermal matrices, and breast augmentation. Number of patients, type of ADM, Baker grade, follow-up time, complication rate, and capsular contracture rate were recorded from identified articles. Data was pooled from studies to calculate a capsular contracture rate for each ADM type with Chi-squared test performed for analysis. Identified studies with a comparative group were included in meta-analysis utilizing risk ratio (RR) to assess efficacy of ADM.

RESULTS: Nine articles using ADM for treatment of capsular contracture in breast augmentation met criteria for inclusion with a total of 481 breasts. Strattice (Lifecell Corporation, Branchburg, NJ) was the most commonly used ADM (n=391), followed by AlloDerm (n=57; Lifecell Corporation). There was a statistically significant difference in efficacy of ADM among the studied ADM types (p < 0.001). AlloDerm, FlexHD (MTF Biologics, Edison, NJ), and DermaMatrix have the lowest capsular contracture rates (0%). NeoForm (Mentor Corporation, Irving, TX) and SurgiMend (Integra LifeSciences, Princeton, NJ) have the highest capsular contracture rates (each 25%, but with n=4 and n=8, respectively). Strattice has a capsular contracture rate of 1.53% in the pooled data, and meta-analysis showed that Strattice reduces the risk of capsular contracture (RR 0.14 [95% CI 0.06, 0.31]) compared to conventional treatment.

CONCLUSIONS: Acellular dermal matrices appear to be effective at treating capsular contracture after breast augmentation while maintaining a low complication rate. Overall capsular contracture rates are low with the use of ADM. There is a statistically significant difference in efficacy among ADM type. Meta-analysis shows that Strattice is effective at reducing the risk of capsular contracture in breast augmentation patients compared to conventional treatment. Future research, especially in the form of randomized-controlled trials, is needed to further investigate the efficacy of various ADM in the treatment of capsular contracture.

PMID:37595294 | DOI:10.1093/asj/sjad265

J Cataract Refract Surg. 2023 Aug 14. doi: 10.1097/j.jcrs.0000000000001286. Online ahead of print.

ABSTRACT

PURPOSE: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (ray-trace LASIK) for correction of myopia in everyday clinical practice.

SETTING: Single site private practice.

DESIGN: Retrospective nonrandomised unmasked chart review.

METHODS: Consecutive, myopic eyes (range -8.25D sphere; astigmatism 0 to -4.25 D) treated with ray-trace LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap (Alcon) diagnostic device. The ray-trace based algorithm (InnovEyes algorithm, Alcon) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOA) were evaluated over 3 months.

RESULTS: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent (MRSE) was -3.39±1.58D (OD-3.84±1.63D, OS -3.98±1.75D). At Month 3, UDVA was ≥20/20 in all eyes, ≥20/16 in 89% (OD 90%, OS 89%), ≥20/12 in 51% (54% OD; 47% OS), and 20/10 in 8% (OD 8%; OS 9%) of eyes respectively. UCVA was within 1 line of preoperative CDVA in 98% of eyes (OD 98.5%; OS 98%) and 39% of eyes (OD 38%; OS 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOA (OD 0.06 ±0.133μm; OS 0.057±0.125μm; p<0.001). The spherical aberration decreased (OD-0.047±0.095μm, p<0.001; OS-0.051±0.091μm, p<0.001).

CONCLUSION: Ray-trace LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UCDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOA.

PMID:37595291 | DOI:10.1097/j.jcrs.0000000000001286

Am J Respir Crit Care Med. 2023 Aug 18. doi: 10.1164/rccm.202305-0873LE. Online ahead of print.

NO ABSTRACT

PMID:37595272 | DOI:10.1164/rccm.202305-0873LE

Phys Rev Lett. 2023 Aug 4;131(5):053801. doi: 10.1103/PhysRevLett.131.053801.

ABSTRACT

We investigate the turn-on process in a laser cavity where the round-trip time is several orders of magnitude greater than the active medium timescales. In this long delay limit, we show that the universal evolution of the photon statistics from thermal to Poissonian distribution involves the emergence of power dropouts. While the largest number of these dropouts vanish after a few round-trips, some of them persist and seed coherent structures similar to dark solitons or Nozaki-Bekki holes described by the complex Ginzburg-Landau equation. These coherent structures connect stationary laser emission domains having different optical frequencies. Moreover, they emit intensity bursts which travel at a different speed, and, depending on the cavity dispersion sign, they may collide with other coherent structures, thus leading to an overall turbulent dynamics. The dynamics is well-modeled by delay differential equations from which we compute the laser coherence time evolution at each round-trip and quantify the decoherence induced by the collisions between coherent structures.

PMID:37595237 | DOI:10.1103/PhysRevLett.131.053801

Clin Nurse Spec. 2023 Sep-Oct 01;37(5):237-243. doi: 10.1097/NUR.0000000000000766.

ABSTRACT

PURPOSE/AIMS: Evidence is required to inform effective interventions promoting publication among clinical nurses. This study examined the effect of a mentored writing program on clinical nurse perceptions of writerly self-efficacy and publication.

DESIGN: A mixed-methods, pretest-posttest study design with an education intervention was implemented. The Revised for Nursing Practice – Postsecondary Writerly Self-efficacy Scale (RNP-PSWSES) measured perception of writerly self-efficacy before and after intervention. Manuscripts submitted for publication were counted.

METHODS: The purposive, convenience sample included registered nurses with completed research, evidence-based practice, or quality improvement projects. Subjects participated in a 3-month structured mentored writing program and completed the RNP-PSWSES survey before and after program completion. A Wilcoxon signed rank test was performed to determine the significance of difference between the pretest and posttest, and the number of published manuscripts was reported.

RESULTS: The RNP-PSWSES items identified pretest-posttest Cronbach’s α (.728, .818). Posttest RNP-PSWSES scores were statistically significantly higher than pretest scores (z = -1.96, P = .050) with a large effect size of r = 0.69. Two manuscripts were accepted for publication, and 1 manuscript was withdrawn after the third request for revisions.

CONCLUSIONS: In this study, mentored writing workshops improve nurses’ perceptions of writing ability and increase publications. Generalization of findings is limited by small sample size. Clinical nurse specialists are critical to champion writing and publication.

PMID:37595198 | DOI:10.1097/NUR.0000000000000766

Holist Nurs Pract. 2023 Sep-Oct 01;37(5):E69-E74. doi: 10.1097/HNP.0000000000000599.

ABSTRACT

Psychological problems among nursing students are well documented. Unfortunately, only a minority of these populations seek help related to their psychological distress. Yoga exercises improve individuals’ psychological distress and cardiovascular outcomes. Therefore, we conducted this study to test the feasibility and preliminary efficacy of our health promotion theme-based yoga program to reduce the participants’ stress levels and anxiety symptoms and improve their blood pressure and heart rate. This study has a pre/posttest quasi-experimental design. A convenience sampling method was used to recruit the participants who were 18 years or older and could speak and read English. Individuals with any contraindication to participate in yoga or receiving any medications for their mental health or cardiovascular health were excluded from the study. The Perceived Stress Scale and the Depression Anxiety Stress Scale-21 were used to measure the participants’ stress levels and anxiety symptoms, respectively. Their blood pressure and heart rate were measured by using a standard blood pressure measuring machine. Participants received 50 minutes of weekly yoga sessions in groups and also performed individual yoga sessions 3 times a week for 8 weeks. Descriptive statistics were used to answer our research questions. Our recruitment rate of 47% (n = 19) was lower than our anticipated rate of 80%; however, we had a retention rate of 90%. There was a reduction in participants’ stress levels and anxiety symptoms from the preintervention phase to the postintervention phase. A larger study and a randomized controlled trial are warranted to draw conclusions.

PMID:37595123 | DOI:10.1097/HNP.0000000000000599

Holist Nurs Pract. 2023 Sep-Oct 01;37(5):260-267. doi: 10.1097/HNP.0000000000000602.

ABSTRACT

This study sought to determine complementary and alternative medicine (CAM) methods used by older adults during the COVID-19 pandemic. The sample for this descriptive study comprised 415 adults older than 65 years who completed an online questionnaire between August and October 2020. The study used descriptive statistical methods and a χ2 test for the statistical analysis of data. In the study, 55.4% of participants had used one or more CAM methods during the pandemic. The most frequently used methods were vitamin and mineral supplements (48.5%) and herbal products (37.2%). The study determined that 43.1% of participants did not inform their health care professionals of the method they had used. It is possible that the use of CAM methods by older adults during the pandemic and the decrease in the frequency of seeking care at health care institutions could complicate the management of health problems related to the use of CAMs.

PMID:37595118 | DOI:10.1097/HNP.0000000000000602