Nevin Manimala

J Holist Nurs. 2023 Aug 22:8980101231193943. doi: 10.1177/08980101231193943. Online ahead of print.

ABSTRACT

Introduction: This methodological study aimed to adapt the Spirituality Instrument-27 (SpI-27©) to the Turkish language and culture. Design: The psychometric study was carried out with 267 individuals who were hospitalized in the cardiology clinic and who were diagnosed with a chronic disease. Data collection tools were the demographic questionnaire and the SpI-27©. The Statistical Package for Social Sciences was used for data analysis and confirmatory factor analysis. Results: The Kaiser-Meyer-Olkin index was 0.848 and Bartlett’s test of sphericity was statistically significant (p = 0.000). The root mean square error of approximation was 0.05, the standardized root mean squared residual was 0.04, the adjusted goodness-of-fit index was 0.87, the goodness-of-fit index was 0.92, the nonformed fit index was 0.91, and the comparative fit index was 0.90. Connectedness with others accounted for 38.24 of the total variance, self-transcendence accounted for 11.71, self-cognizance accounted for 10.56, and conservationism and belief accounted for 9.82 of the total variance (total variance was 70.34%). The highest item factor loading of the scale was 0.812 and the lowest one was 0.398. Cronbach’s alpha coefficient of the scale was 0.927. Conclusion: This measurement tool will enable researchers to plan and implement nursing interventions accurately and effectively by assessing the spiritual needs of individuals with nonmalignant chronic diseases. The use of this tool in different languages can help diagnose the spiritual needs of nurses working with multicultural and multilingual patients.

PMID:37605885 | DOI:10.1177/08980101231193943

BJPsych Open. 2023 Aug 22;9(5):e159. doi: 10.1192/bjo.2023.549.

ABSTRACT

We previously showed that folic acid prescriptions for any indication were associated with lower rates of suicidal behaviour. Given that future randomised clinical trials are likely to focus on psychiatric disorders carrying elevated risk for suicide, we now report on the moderating effects of prior suicidal behaviour, psychiatric diagnoses and psychotropic medications on potential antisuicidal effects of folic acid. Data were obtained from the MarketScan Commercial Claims and Encounters databases that cover 164 million insured persons from 2005-2017, from which a cohort of 866 586 patients was derived. Analysis revealed no significant moderation effects on the antisuicidal effect of folic acid. These findings indicate that the potential benefit of folic acid for preventing suicidal behaviour is comparable in psychiatric populations at higher risk of suicide and that it may be additive to any benefit from psychotropic medications.

PMID:37605842 | DOI:10.1192/bjo.2023.549

BJPsych Open. 2023 Aug 22;9(5):e160. doi: 10.1192/bjo.2023.503.

ABSTRACT

BACKGROUND: The prevalence and patterns of autism spectrum disorder (ASD) symptoms/traits and the associations of ASD with psychiatric and substance use disorders has not been documented in non-clinical students in Sub-Saharan Africa, and Kenya in particular.

AIMS: To document the risk level of ASD and its traits in a Kenyan student population (high school, college and university) using the Autism-Spectrum Quotient (AQ); and to determine the associations between ASD and other psychiatric and substance use disorders.

METHOD: This was a cross-sectional study among students (n = 9626). We used instruments with sufficient psychometric properties and good discriminative validity to collect data. A cut-off score of ≥32 on the AQ was used to identify those at high risk of ASD. We conducted the following statistical tests: (a) basic descriptive statistics; (b) chi-squared tests and Fisher’s exact tests to analyse associations between categorical variables and ASD; (c) independent t-tests to examine two-group comparisons with ASD; (d) one-way analysis of variance to make comparisons between categorical variables with three or more groups and ASD; (e) statistically significant (P < 0.05) variables fitted into an ordinal logistic regression model to identify determinants of ASD; (f) Pearson’s correlation and reliability analysis.

RESULTS: Of the total sample, 54 (0.56%) were at high risk of ASD. Sociodemographic differences were found in the mean scores for the various traits, and statistically significant (P < 0.05) associations we found between ASD and various psychiatric and substance use disorders.

CONCLUSIONS: Risk of ASD, gender characteristics and associations with psychiatric and substance use disorders are similar in this Kenyan sample to those found in Western settings in non-clinical populations.

PMID:37605834 | DOI:10.1192/bjo.2023.503

Thorac Cancer. 2023 Aug 22. doi: 10.1111/1759-7714.15075. Online ahead of print.

ABSTRACT

BACKGROUND: Small cell lung cancer (SCLC) is a neuroendocrine tumor with poor prognosis. Neuroendocrine tumors possess characteristics of both nerve cells and hormone-secreting cells; therefore, targeting the neuronal properties of these tumors may lead to the development of new therapeutic options. Among the endogenous signaling pathways in the nervous system, targeting the glutamate pathway may be a useful strategy for glioblastoma treatment. Perampanel, an antagonist of the synaptic glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR), has been reported to be effective in patients with glioblastoma. In this study, we aimed to investigate the antitumor effects of AMPAR antagonists in human SCLC cell lines.

METHODS: We performed to examine the expression of AMPAR using Western blot and immunohistochemical analysis. The antitumor effects of AMPAR antagonists on human SCLC cell lines were investigated in vitro and in vivo. We also analyzed the signaling pathway of AMPAR antagonists in SCLC cell lines. Statistical analysis was performed by the GraphPad Prism 6 software.

RESULTS: We first examined the expression of endogenous AMPAR in six human SCLC cell lines, detecting AMPAR proteins in all of them. Next, we tested the anti-proliferative effect of two AMPAR antagonists, talampanel and cyanquixaline, using SCLC cells in vitro and in vivo. Both AMPAR antagonists inhibited cell proliferation and mitogen-activated protein kinase (MAPK) phosphorylation in SCLC cells in vitro. Further, we observed reduced proliferation of implanted cell lines in an in vivo setting, assessed by Ki-67 immunohistochemistry. Additionally, using immunohistochemical analysis we confirmed AMPAR protein expression in human SCLC samples.

CONCLUSION: AMPAR may be a potential therapeutic target for SCLC.

PMID:37605807 | DOI:10.1111/1759-7714.15075

Brain Commun. 2023 Aug 20;5(4):fcad199. doi: 10.1093/braincomms/fcad199. eCollection 2023.

ABSTRACT

Registries have the potential to tackle some of the current limitations in determining the long-term impact of multiple sclerosis. Online assessments using patient-reported outcomes can streamline follow-up enabling large-scale, long-term, cost-effective, home-based, and patient-focused data collection. However, registry data are sparsely sampled and the sensitivity of patient-reported outcomes relative to clinician-reported scales is unknown, making it hard to fully leverage their unique scope and scale to derive insights. This retrospective and prospective cohort study over 11 years involved 15 976 patients with multiple sclerosis from the United Kingdom Multiples Sclerosis Register. Primary outcomes were changes in two patient-reported outcomes: Multiple Sclerosis Impact Scale motor component, and Multiple Sclerosis Walking Scale. First, we investigated their validity in measuring the impact of physical disability in multiple sclerosis, by looking at their sensitivity to disease subtype and duration. We grouped the available records (91 351 for Multiple Sclerosis Impact Scale motor and 68 092 for Multiple Sclerosis Walking Scale) by these two factors, and statistically compared the resulting groups using a novel approach based on Monte Carlo permutation analysis that was designed to cope with the intrinsic sparsity of registry data. Next, we used the patient-reported outcomes to draw novel insights into the developmental time course of subtypes; in particular, the period preceding the transition from relapsing to progressive forms. We report a robust main effect of disease subtype on the patient-reported outcomes and interactions of disease subtype with duration (all P < 0.0001). Specifically, patient-reported outcomes worsen with disease duration for all subtypes (all P < 0.0001) apart from benign multiple sclerosis (Multiple Sclerosis Impact Scale motor: P = 0.796; Multiple Sclerosis Walking Scale: P = 0.983). Furthermore, the patient-reported outcomes of each subtype are statistically different from those of the other subtypes at all time bins (Multiple Sclerosis Impact Scale motor: all P < 0.05; Multiple Sclerosis Walking Scale: all P < 0.01) except when comparing relapsing-remitting multiple sclerosis with benign multiple sclerosis and primary progressive multiple sclerosis with secondary progressive multiple sclerosis. Notably, there were statistically significant differences between relapsing-remitting and progressive subtypes at disease onset. Critically, the patient-reported outcomes are sensitive to future transitions to progressive subtypes, with individuals who transition presenting with higher patient-reported outcomes in their relapsing-remitting phase compared to individuals who don’t transition since onset (all P < 0.0001). Patient-reported outcomes capture different patterns of physical worsening over disease length and across subtypes; therefore, they are a valid tool to measure the physical impact of multiple sclerosis over the long-term and cost-effectively. Furthermore, more advanced physical disability manifests years before clinical detection of progressive subtypes, adding evidence to the presence of a multiple sclerosis prodrome.

PMID:37605775 | PMC:PMC10440194 | DOI:10.1093/braincomms/fcad199

Clin Ophthalmol. 2023 Aug 16;17:2405-2412. doi: 10.2147/OPTH.S407705. eCollection 2023.

ABSTRACT

PURPOSE: To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal.

PATIENTS AND METHODS: The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative.

RESULTS: Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= <0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=<0.0001) with 93.96 ± 39.71 seconds. There were no statistically significant differences in postoperative endothelial cell density between groups (p=0.4916).

CONCLUSION: The use of the phaco-chop technique in hard cataract phacoemulsification represents a lower energy expenditure than divide and conquer and ultrachopper techniques; nevertheless, no differences regarding endothelial density loss were evidenced.

PMID:37605764 | PMC:PMC10440113 | DOI:10.2147/OPTH.S407705

Clin Interv Aging. 2023 Aug 16;18:1351-1359. doi: 10.2147/CIA.S411170. eCollection 2023.

ABSTRACT

PURPOSE: Impaired respiratory muscle strength has been associated with some geriatric syndromes. However, no studies have previously evaluated the relationship between respiratory muscle strength and dynapenic abdominal obesity. This study aimed to analyze whether there is an association between respiratory muscle strength and abdominal obesity, dynapenia and dynapenic abdominal obesity (DAO) in community-dwelling older adults.

PATIENTS AND METHODS: Cross-sectional study conducted with community-dwelling older adults (n=382 / 70.03 ± 7.3 years) from Macapá, Amapá, Brazil. Respiratory muscle strength was assessed by measuring maximal inspiratory and expiratory pressures (MIP and MEP, respectively), using an analog manovacuometry. DAO was defined as the combination of dynapenia (grip strength < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). We performed descriptive and inferential statistical analyses using the student’s t-test for independent and related samples and linear regression model.

RESULTS: Older adults with abdominal obesity, dynapenia, and DAO presented lower mean values (obtained and obtained versus predicted; except abdominal obesity versus MIP) for maximal respiratory pressures compared to individuals without these conditions. However, the adjusted analysis only indicated an association between MIP and the following conditions: dynapenia (MIP – β =-0.171; p<0.001), abdominal obesity (MIP – β=0.102; p=0.042), and DAO (MIP – β=-0.101; p=0.028).

CONCLUSION: Older adults with abdominal obesity, dynapenia, and DAO showed impaired maximal respiratory pressures. The results of the adjusted analysis indicate that inspiratory muscle strength may require greater attention by health professionals aiming at preventing respiratory complications and improving respiratory health care in older people with these conditions.

PMID:37605751 | PMC:PMC10440087 | DOI:10.2147/CIA.S411170

PeerJ. 2023 Aug 17;11:e15545. doi: 10.7717/peerj.15545. eCollection 2023.

ABSTRACT

Geometric morphometrics is widely used to quantify morphological variation between biological specimens, but the fundamental influence of operator bias on data reproducibility is rarely considered, particularly in studies using photographs of live animals taken under field conditions. We examined this using four independent operators that applied an identical landmarking scheme to replicate photographs of 291 live Atlantic salmon (Salmo salar L.) from two rivers. Using repeated measures tests, we found significant inter-operator differences in mean body shape, suggesting that the operators introduced a systematic error despite following the same landmarking scheme. No significant differences were detected when the landmarking process was repeated by the same operator on a random subset of photographs. Importantly, in spite of significant operator bias, small but statistically significant morphological differences between fish from the two rivers were found consistently by all operators. Pairwise tests of angles of vectors of shape change showed that these between-river differences in body shape were analogous across operator datasets, suggesting a general reproducibility of findings obtained by geometric morphometric studies. In contrast, merging landmark data when fish from each river are digitised by different operators had a significant impact on downstream analyses, highlighting an intrinsic risk of bias. Overall, we show that, even when significant inter-operator error is introduced during digitisation, following an identical landmarking scheme can identify morphological differences between populations. This study indicates that operators digitising at least a sub-set of all data groups of interest may be an effective way of mitigating inter-operator error and potentially enabling data sharing.

PMID:37605749 | PMC:PMC10440062 | DOI:10.7717/peerj.15545

J Pain Res. 2023 Aug 16;16:2835-2845. doi: 10.2147/JPR.S419682. eCollection 2023.

ABSTRACT

PURPOSE: The primary objective of this study is to determine if ultrasound-guided erector spinae plane blocks (ESPB) prior to thoracolumbar spinal fusion reduces opioid consumption in the first 24 hours postoperatively. Secondary objectives include ESPB effects on administration of opioids, utilization of intravenous patient-controlled analgesia (IV-PCA), pain scores, length of stay, and opioid related side effects.

METHODS: A retrospective cohort analysis was performed on consecutive, adult patients undergoing primary thoracolumbar fusion procedures. Demographic and baseline characteristics including diagnoses of chronic pain, anxiety, depression, and preoperative use of opioids were collected. Surgical data included surgical levels, opioid administration, and duration. Postoperative data included pain scores, opioid consumption, IV-PCA duration, opioid-related side effects, ESPB-related complications, and length of stay (LOS). Statistical analysis was performed using chi-squared and t-test analyses, multivariable analysis, and covariate adjustment with propensity score.

RESULTS: A total of 118 consecutive primary thoracolumbar fusions were identified between October 2019 and December 2021 (70 ESPB, 48 no-block [NB]). There were no significant demographic or surgical differences between groups. Median surgical time (262.50 mins vs 332.50 mins, p = 0.04), median intraoperative opioid consumption (8.11 OME vs 1.73 OME, p = 0.01), and median LOS (152.00 hrs vs 128.50 hrs, p = 0.01) were significantly reduced in the ESPB group. Using multivariable covariate adjustment with propensity score analysis only intraoperative opioid administration was found to be significantly less in the ESPB cohort.

CONCLUSION: ESPB for thoracolumbar fusion can be performed safely in index cases. There was a reduction of intraoperative opioid administration in the ESPB group, however the care team was not blinded to the intervention. Extensive thoracolumbar spinal fusion surgery may require a different approach to regional anesthesia to be similarly effective as ESPB in isolated lumbar surgeries.

PMID:37605744 | PMC:PMC10440116 | DOI:10.2147/JPR.S419682

Int J Mol Cell Med. 2022;11(3):244-259. doi: 10.22088/IJMCM.BUMS.11.3.244.

ABSTRACT

Current cancer therapies include chemotherapy, radiation therapy, immunotherapy, and surgery. Despite these treatment methods, a major point in cancer treatment is early detection. RNAs (mRNA, miRNAs, and LncRNA) can be used as markers to improve cancer diagnosis and treatment. This research examined how radiotherapy affected CCL5, miR-214, and MALAT-1 gene expression in the immune pathway in peripheral blood samples from radiation therapy-treated breast cancer patients. Before and after radiotherapy, peripheral blood was collected from 15 patients in four steps. Blood samples were collected in an outpatient facility from 20 healthy female volunteers with no history of malignant or inflammatory conditions. RNA was extracted from the blood samples and cDNA was synthesized. CCL5, miR-214, and MALAT-1 gene expression were determined by real-time polymerase chain reaction (RT-PCR). CCL5 protein levels in the serum were determined in 80 samples (60 BC and 20 healthy controls) using Quantikine Enzyme-Linked Immunosorbent Assay (ELISA) kits (R&D Systems). The data were then statistically evaluated. There was a significant difference between CCL5 levels in tumoral and adjacent normal blood samples (p < 0.05). The results also show that the level of gene expression and serum concentration of CCL5 protein in different phases of radiotherapy is significantly different. On the other hand, the expression level of the miR-214 gene was significantly decreased in patients compared to the control group, but this decrease was not significant for the MALAT-1 gene (p< 0.05). Also, after each stage of radiotherapy, the expression level of these two genes showed a decrease, but in the fourth week after radiotherapy, this decrease was significant (p< 0.05). Radiotherapy is associated with a decrease in the expression of miR-214 and MALAT-1, as a result, an increase in the expression of CCL5. An increase in the concentration of CCL5 protein is accompanied by an increase in the level of monocytes, which ultimately causes the infiltration of macrophages and can ultimately cause cancer recurrence. It is suggested that these genes can probably be used as diagnostic and therapeutic radiotherapy markers in breast cancer.

PMID:37605739 | PMC:PMC10440003 | DOI:10.22088/IJMCM.BUMS.11.3.244