Nevin Manimala

Geriatr Nurs. 2023 Aug 2;53:146-152. doi: 10.1016/j.gerinurse.2023.06.025. Online ahead of print.

ABSTRACT

Like other older adults, people living with dementia (PLWD) experience pain, and the task of pain assessment often falls to family caregivers. In this study, we surveyed family caregivers of PLWD to determine the frequency with which they use different elements of pain assessment. We also determined correlations of family caregivers’ characteristics (caregiving self-efficacy, relationship duration and type, mood, education level, and health literacy) with their use of the elements of pain assessment. Participants reported frequent use of many pain assessment elements. Statistically significant correlations were found between caregiving self-efficacy for obtaining respite and asking others about noticed behavior change (rho=.0.41, p=.007); and for responding to disruptive patient behaviors for multiple pain assessment elements including observing pain behaviors (rho=0.49, p<.001), asking others about noticed behavior change (rho=0.54, p<.001) and rechecking (rho=0.56, p<.001). Continued efforts are needed to describe pain assessments by family caregivers of PLWD.

PMID:37540909 | DOI:10.1016/j.gerinurse.2023.06.025

Phys Rev Lett. 2023 Jul 21;131(3):033607. doi: 10.1103/PhysRevLett.131.033607.

ABSTRACT

The emergence of photonic quantum correlations is typically associated with emitters strongly coupled to a photonic mode. Here, we show that semiconductor Rydberg excitons, which are only weakly coupled to a free-space light mode can produce strongly antibunched fields, i.e., quantum light. This effect is fueled by a micron-scale excitation blockade between Rydberg excitons inducing pair-wise polariton scattering events. Photons incident on an exciton resonance are scattered into blue- and red-detuned pairs, which enjoy relative protection from absorption and thus dominate the transmitted light. We demonstrate that this effect persists in the presence of additional phonon coupling, strong nonradiative decay, and across a wide range of experimental parameters. Our results pave the way for the observation of quantum statistics from weakly coupled semiconductor excitons.

PMID:37540885 | DOI:10.1103/PhysRevLett.131.033607

Phys Rev Lett. 2023 Jul 21;131(3):033605. doi: 10.1103/PhysRevLett.131.033605.

ABSTRACT

The many-body decay of extended collections of two-level systems remains an open problem. Here, we investigate whether an array of emitters coupled to a one-dimensional bath undergoes Dicke superradiance. This is a process whereby a completely inverted system becomes correlated via dissipation, leading to the release of all the energy in the form of a rapid photon burst. We derive the minimal conditions for the burst to happen as a function of the number of emitters, the chirality of the waveguide, and the single-emitter optical depth, both for ordered and disordered ensembles. Many-body superradiance occurs because the initial fluctuation that triggers the emission is amplified throughout the decay process. In one-dimensional baths, this avalanchelike behavior leads to a spontaneous mirror symmetry breaking, with large shot-to-shot fluctuations in the number of photons emitted to the left and right. Superradiant bursts may thus be a smoking gun for the generation of correlated photon states of exotic quantum statistics.

PMID:37540884 | DOI:10.1103/PhysRevLett.131.033605

Phys Rev Lett. 2023 Jul 21;131(3):031901. doi: 10.1103/PhysRevLett.131.031901.

ABSTRACT

An amplitude analysis of B^{-}→J/ψΛp[over ¯] decays is performed using 4400 signal candidates selected on a data sample of pp collisions recorded at center-of-mass energies of 7, 8, and 13 TeV with the LHCb detector, corresponding to an integrated luminosity of 9 fb^{-1}. A narrow resonance in the J/ψΛ system, consistent with a pentaquark candidate with strangeness, is observed with high significance. The mass and the width of this new state are measured to be 4338.2±0.7±0.4 MeV and 7.0±1.2±1.3 MeV, where the first uncertainty is statistical and the second systematic. The spin is determined to be 1/2 and negative parity is preferred. Because of the small Q-value of the reaction, the most precise single measurement of the B^{-} mass to date, 5279.44±0.05±0.07 MeV, is obtained.

PMID:37540878 | DOI:10.1103/PhysRevLett.131.031901

Clin Chem Lab Med. 2023 Aug 7. doi: 10.1515/cclm-2023-0540. Online ahead of print.

ABSTRACT

OBJECTIVES: Dysregulation of hepcidin-iron axis is presumed to account for abnormal iron status in patients with chronic liver disease (CLD). Our aim is to determine the effect of specific etiologies of CLD and of cirrhosis on serum hepcidin levels.

METHODS: Pubmed, Embase, Web of Science were searched for studies comparing serum hepcidin levels in patients with CLD to that in controls using enzyme-linked immunosorbent assay. The study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines. Statistical analysis was carried out with STATA using random effects model to calculate the mean difference (MD) between two groups.

RESULTS: Hepcidin levels were significantly lower in subjects with hepatitis C virus (16 studies) [MD -1.6 (95 % CI: -2.66 to -0.54), p<0.01] and alcoholic liver disease (3 studies) [MD -0.84 (95 % CI: -1.6 to -0.07), p=0.03] than controls. Serum hepcidin was significantly higher in subjects with non-alcoholic fatty liver disease (12 studies) [MD 0.62 (95 % CI: 0.21 to 1.03), p<0.01], but did not differ in subjects with hepatitis B and controls (eight studies) [MD -0.65 (95 % CI: -1.47 to 0.16), p=0.12]. Hepcidin levels were significantly lower in patients with cirrhosis of any etiology (four studies) [MD -1.02 (CI: -1.59 to -0.45), p<0.01] vs. controls (CI: confidence interval).

CONCLUSIONS: Serum hepcidin levels are altered in common forms of CLD albeit not in a consistent direction. Additional study is needed to determine how changes in hepcidin levels are related to dysregulation of iron metabolism in CLD.

PMID:37540837 | DOI:10.1515/cclm-2023-0540

Eur J Neurol. 2023 Aug 4. doi: 10.1111/ene.16024. Online ahead of print.

ABSTRACT

BACKGROUND: The Registry of Stroke Care Quality (RES-Q) is a world-wide quality improvement data platform that captures performance and quality measures enabling standardized comparisons of hospital care. The aim of this study was to determine if, and how, RES-Q data are used to influence stroke quality improvement; and identify support and educational needs of clinicians in use of RES-Q data to improve stroke care.

METHODS: A cross-sectional self-administered online survey was administered (October 2021-February 2022). Participants were RES-Q hospital local coordinators responsible for stroke data collection. Descriptive statistics are presented.

RESULTS: Surveys were sent to 1463 hospitals in 74 countries; responses received from 358 hospitals in 55 countries (response rate 25%). RES-Q data were used ‘always’ or ‘often’ to: develop quality improvement initiatives (n=213, 60%); track stroke care quality over time (n=207, 58%); improve local practice (n=191, 53%); and benchmark against evidence-based policies, procedures and/or guidelines to identify practice gaps (n=179, 50%). Formal training in use of RES-Q tools and data were the most frequent support needs identified by respondents (n=165, 46%). Over half ‘strongly agreed’ or ‘agreed’ that to support clinical practice change, education is needed on: i) using data to identify evidence-practice gaps (n=259, 72%) and change clinical practice (n=263, 74%), and ii) quality improvement science and methods (n=255, 71%).

CONCLUSION: RES-Q data are used for monitoring stroke care performance. However, to facilitate its optimal use, effective quality improvement methods are needed. Educating staff in quality improvement science may develop competency and improve use of data in practice.

PMID:37540834 | DOI:10.1111/ene.16024

J Clin Oncol. 2023 Aug 4:JCO2300348. doi: 10.1200/JCO.23.00348. Online ahead of print.

ABSTRACT

PURPOSE: In Canada, some provincial/territorial mammography screening programs include women age 40-49 years, whereas others do not. This study examines the impact of this dichotomy on the 10-year breast cancer (BC) net survival (NS) among women age 40-49 years and 50-59 years at diagnosis.

METHODS: Using the Canadian Cancer Registry data record linked to death information, we evaluated the cohort of Canadian women age 40-49 years and 50-59 years diagnosed with BC from 2002 to 2007. We compared 10-year NS estimates in the jurisdictions with organized screening programs that included women age 40-49 years, designated as screeners (Northwest Territories, British Columbia, Alberta, Nova Scotia, and Prince Edward Island), with comparator programs that did not (Yukon, Manitoba, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador).

RESULTS: BC was the primary cause of 10-year mortality in women age 40-49 years diagnosed with BC (90.7% of deaths). Among these women, the 10-year NS for screeners (84.8%; 95% CI, 83.8 to 85.8) was 1.9 percentage points (pp) higher than that for comparators (82.9%; 95% CI, 82.3 to 83.5; P = .001). The difference in favor of screeners was significant among women age 45-49 years (2.6 pp; P = .001) but not among women age 40-44 years (0.9 pp; P = .328). Similarly, the incidence-based BC mortality rate was significantly lower in screener jurisdictions among women age 40-49 years and 45-49 years, but not for 40-44 years. Provincial/territorial NS increased significantly with higher mammography screening participation (P = .003). The BC incidence rate was virtually identical in screener and comparator jurisdictions among women age 40-49 years (P = .976) but was significantly higher for comparators among women age 50-59 years (P < .001).

CONCLUSION: Screening programs that included women in their 40s were associated with a significantly higher BC 10-year NS in women age 40-49 years, but not an increased rate of BC diagnosis. These results may inform screening guidelines for women age 40-49 years.

PMID:37540825 | DOI:10.1200/JCO.23.00348

Eur J Neurol. 2023 Aug 4. doi: 10.1111/ene.16014. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Prodromal infection is associated with neuromyelitis optica spectrum disorder (NMOSD), but which type of infection had causal relations with NMOSD remains unclear. We aimed to explore the causal relations between four herpesvirus infections (chickenpox, cold sores, mononucleosis and shingles) and NMOSD, as well as other types of infections and NMOSD.

METHODS: For infections, the genome-wide association study (GWAS) summary statistics from the 23andMe cohort were used. For outcomes, the GWAS of participants from European ancestry was used, including 215 NMOSD patients (132 anti-aquaporin-4 antibody [AQP4-ab]-positive patients and 83 AQP4-ab-negative patients) and 1244 normal controls. Single nucleotide polymorphism (SNP) identification and two-sample mendelian randomization (MR) analyses were then performed.

RESULTS: In 23andMe cohort, we identified one SNP (rs9266089 in HLA-B gene) for chickenpox, one SNP (rs885950 in POU5F1 gene) for cold scores, one SNP (rs2596465 in HCP5 gene) for mononucleosis, three SNPs (rs2523591 in HLA-B gene; rs7047299 in IFNA21 gene; rs9260809 in MICD gene) for shingles. The relation of cold sores and AQP4-ab-positive NMOSD reached statistical significance (OR [95%CI] = 745.318 [22.176, 25049.53], P < 0.001, Q < 0.001). The association of shingles and AQP4-ab-positive NMOSD was statistically significant (OR [95%CI] = 21.073 [4.271, 103.974], P < 0.001, Q < 0.001). No significant association was observed between other infections and AQP4-ab-positive or AQP4-ab-negative NMOSD.

CONCLUSION: These findings suggested the positive associations between cold sores, shingles and AQP4-ab-positive NMOSD, indicating there may be causal relations between herpes simplex virus, varicella-zoster virus infection and AQP4-ab-positive NMOSD.

PMID:37540821 | DOI:10.1111/ene.16014

Vascular. 2023 Aug 4:17085381231193494. doi: 10.1177/17085381231193494. Online ahead of print.

ABSTRACT

OBJECTIVES: Peripheral arterial disease (PAD) results from the systemic atherosclerotic process. In this study, we aimed to determine the relationship between plasma atherogenic index (AIP), a ratio of molar concentrations of triglycerides to HDL-cholesterol, and long-term outcomes after endovascular therapy (EVT) in patients with superficial femoral artery (SFA) stenosis.

METHODS: We retrospectively evaluated 673 patients who underwent EVT for PAD in our tertiary center between January 2015 and December 2020. In the receiver operating characteristic (ROC) curve analysis, the AIP value with the optimum cutoff value was determined as 0.576 to detect the presence of major adverse limb events (MALEs). Patients were divided into two groups according to low AIP (<0.576 as group 1) and high AIP (>0.576 as group 2).

RESULTS: Among the major endpoints, long-term restenosis rates were significantly higher in patients in the high-AIP group than in the low-AIP group (p<.001). The lower extremity amputation rate was not statistically significant between the two groups. All-cause mortality rate (54 (31.6) versus 117 (68.4), p<.001) was significantly higher in patients in the high-AIP group than in the low-AIP group. In addition, the MALE rate (94 (29.2) versus 218 (62.1), p<.001) was significantly higher in patients in the high-AIP group than in those in the low-AIP group.

CONCLUSIONS: In conclusion, we found that AIP is a significant independent predictor of long-term MALE in patients who underwent EVT for SFA.

PMID:37540809 | DOI:10.1177/17085381231193494

Psychiatry. 2023 Aug 4:1-8. doi: 10.1080/00332747.2023.2238573. Online ahead of print.

ABSTRACT

ObjectiveFew investigations have focused specifically on engaging Spanish-speaking patients in early post-injury comparative effectiveness trials. The goal of this study was to identify and categorize hospitalized Spanish-speaking injury survivors’ posttraumatic concerns. Method: A secondary analysis of baseline data collected as part of a larger randomized comparative effectiveness trial was conducted. Participants were 22 male and female Spanish, non-English, speaking survivors of intentional and unintentional injuries, ages ≥ 18. At baseline, while hospitalized, each patient was asked to describe the nature and severity of their post-injury concerns. Patient concern narratives were audio-recorded and later transcribed. Raters coded patients’ transcribed concerns into content domains. The associations between patient self-reported concern severity and posttraumatic stress disorder symptoms assessed with the PTSD Checklist and depressive symptoms assessed with the PHQ-9 were also ascertained. Results: The concerns of Spanish-speaking patients were reliably categorized into previously described content domains (i.e., work and finance, physical health, social, psychological, medical, and legal domains). The composite Kappa statistic across domains was 0.83 (95% Confidence Interval = 0.74, 0.92). Spanish-speaking patients also expressed novel concerns, including immigration, discriminatory experiences, and Coronavirus pandemic, related concerns. The number of severe patient concerns was highly correlated with PHQ-9 depressive symptom levels (r = 0.52, p < .05). Conclusions: The concerns of Spanish-speaking trauma survivors can be readily elicited and reliably interpreted. Future research could integrate concern narrative elicitation and amelioration into stepped care intervention procedures in order to engage diverse Spanish-speaking injury survivors and advance equitable trauma care system service delivery.

PMID:37540791 | DOI:10.1080/00332747.2023.2238573