Nevin Manimala

Am J Cardiol. 2023 Aug 14;205:63-68. doi: 10.1016/j.amjcard.2023.07.162. Online ahead of print.

ABSTRACT

Coronary artery ectasia (CAE) is defined as local or generalized aneurysmal dilatation of the coronary arteries. CAE likely represents an exaggerated form of excessive vascular wall remodeling in different clinical settings such as atherosclerosis, vasculitides, connective tissue disorders, hereditary collagen defects, bacterial infections, and congenital malformations. In the present case-control study, we investigated whether the incidental finding of CAE in patients who undergo coronary angiography is associated with presence of autoimmune reactivity. From 2019 to 2022, we identified all consecutive patients with CAE (n = 319) on elective or emergency coronary angiography (n = 7,458). We furthermore included 90 patients with nonectatic coronary arteries as a control group. Antinuclear antibody (ANA) titer was measured in both groups using the indirect immunofluorescence method from peripheral blood samples. The prevalence of CAE in our study cohort was 4.3%. Among patients with CAE (n = 319), presence of positive Antinuclear antibody (ANA) titer was identified in 128 patients (40%). Only 18 patients (20%) from the control group had positive ANA titer. There was a statistically significant greater percentage of patients with positive ANA titer among patients with CAE than among controls (chi-square = 12.39; p <0.001), with an odds ratio of 2.68. Among patients with CAE, there is an increased prevalence of positive ANA titer, suggesting an underlying autoimmune disease. Screening for autoimmune reactivity could be a reasonable diagnostic strategy in patients who undergo coronary angiography with an incidental finding of coronary ectasia because the number needed to screen for positive ANA titer in this subgroup of patients is only 5.

PMID:37586123 | DOI:10.1016/j.amjcard.2023.07.162

J Crohns Colitis. 2023 Aug 16:jjad138. doi: 10.1093/ecco-jcc/jjad138. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Randomized controlled trials historically underrepresent marginalized racial and ethnic populations. As incidence and prevalence of Crohn’s Disease in these groups rises, it is important to characterize their inclusion in randomized controlled trials on first-line and pipe-line medications.

METHODS: PubMed was searched systematically for randomized controlled trials of biologic and small molecule inhibitor (SMI) medications with a primary outcome related to efficacy following PRISMA guidelines. We used descriptive statistics to summarize demographic variables and meta-regression analyses to estimate temporal trends in racial inclusion.

RESULTS: More than a half of trials did not report any racial/ethnic demographics (53.7%) and several reported racial demographics for only one race (20.9%). When racial data was reported, Whites made up 90.2% of participants. Percentages of Black, Asian, Native American/Pacific Islander and participants considered “Other” averaged 2.9%, 11.6%, 0.5% and 1.6%, out of the total sample sizes of 3,901, 3,742, 828 and 4,027, respectively. Proportional representation of White participants decreased over time (p<0.01), while proportional representation of Asian participants increased over time (p=0.047). In ordinal logistic regression, mean year of trial enrollment significantly increased the number of racial groups reported (p<0.001).

CONCLUSIONS: Half of published randomized controlled trials in Crohn’s Disease contain no racial or ethnic demographics and the remaining often only have limited inclusion of Black, Native American/Pacific Islander and Hispanic patients. Further work should characterize representation in observational and prospective trials. Researchers should work to 1) increase reporting of racial and ethnic demographics and 2) improve recruitment and retention of marginalized populations.

PMID:37586091 | DOI:10.1093/ecco-jcc/jjad138

J Physician Assist Educ. 2023 Aug 15. doi: 10.1097/JPA.0000000000000528. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this novel study was to determine whether any association exists between student well-being and physician assistant (PA) program approaches to teaching provider health and well-being (provider wellness).

METHODS: Data were sourced from 3 PA Education Association surveys. Data from the 2019 Matriculating Student and End of Program Surveys (EOPS) were analyzed to compare student-reported well-being across 6 measures. Next, data from the 2019 Didactic Curriculum Survey were assessed and matched to the 2019 EOPS data. Finally, generalized estimating equation models were used to assess the independent effects of course structure, mode of instruction, and contact hours on well-being scores among end-of-program students (within one month of graduation).

RESULTS: While levels of well-being were generally favorable, except for “level of social activity” (P = .20), across measures, graduating student levels of well-being (P < .05) were statistically significantly lower than matriculating student levels of well-being. No associations were found between levels of student well-being and whether programs reported teaching or not teaching provider wellness. Some aspects of instruction (eg, contact hours) were inconsistently associated with various well-being measures.

CONCLUSION: In this study, no consistent associations between approaches to teaching provider wellness and various measures of student well-being were identified. Further research is needed to determine what approaches to promoting wellness are effective.

PMID:37586068 | DOI:10.1097/JPA.0000000000000528

J Vasc Access. 2023 Aug 10:11297298231186374. doi: 10.1177/11297298231186374. Online ahead of print.

ABSTRACT

BACKGROUND: YouTube™ has become a potential way to integrate technology into nursing curriculum and acquire skills. However, it is important to review the accuracy of the information contained in YouTube™. This study was conducted to evaluate the content validity, reliability and quality of YouTube™ videos on peripheral intravenous catheterization.

METHODS: In this descriptive study, videos were searched using the keyword ‘Peripheral Venous Catheter’. The content validity, reliability and quality of the videos were evaluated using the ‘Peripheral Intravenous Catheterization Insertion Skill Form’, ‘DISCERN Questionnaire’, ‘Global Quality Scale’, respectively. These videos were categorized by their theme, upload source, technical features and analysed statistically.

RESULTS: Of the 48 videos, 38 (79.2%) classified as an useful video, 24 (50%) were uploaded by medical educational platforms and 28 (58.3%) had an average technical feature. There was a statistically significant difference between the reliability, quality, content validity scores by the video theme (p < 0.05). The content validity, reliability and quality score of useful videos were higher than misleading videos. In addition, pairwise comparisons indicated that there was a statistically significant difference between the content validity, reliability and quality scores of Peripheral Intravenous Catheterization demonstrated on a person or a mannequin were higher than those applied with ultrasonography (p < 0.05).

CONCLUSIONS: As a result of the reviewing of the videos, it was determined that these videos provided useful content. Despite this positive result, some videos provide risky information for patient safety due to issues such as ignoring the asepsis principles and not including proper Peripheral Intravenous Catheterization steps. It may be recommended to consider the Peripheral Intravenous Catheterization steps and patient safety principles in international guidelines in the preparation of videos showing the Peripheral Intravenous Catheterization insertion.

PMID:37586014 | DOI:10.1177/11297298231186374

Rev Assoc Med Bras (1992). 2023 Aug 14;69(8):e20230316. doi: 10.1590/1806-9282.20230316. eCollection 2023.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment.

METHODS: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients’ quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used.

RESULTS: There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001).

CONCLUSION: Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire.

PMID:37585993 | DOI:10.1590/1806-9282.20230316

Rev Assoc Med Bras (1992). 2023 Aug 14;69(8):e20230216. doi: 10.1590/1806-9282.20230216. eCollection 2023.

ABSTRACT

OBJECTIVE: This study was planned to examine the factors affecting the decision-making styles of pregnant women in the coronavirus disease 2019 epidemic, their choice of birth environment, and their decision to start breastfeeding.

METHODS: The study was conducted in a cross-sectional descriptive type. The study was conducted with 631 pregnant women who voluntarily participated between January 2020 and April 2021 and met the sample selection criteria. Women aged 18-45 years who had healthy singleton pregnancies were included. Pregnant women with signs or symptoms of coronavirus disease 2019 or suspected or diagnosed with birth were excluded from the study. The data were collected by the questionnaire method through the links shared with the pregnant women. Data Collection Form, Questionnaire for Birth and Breastfeeding in the coronavirus disease 2019 Period, and Melbourne Decision-Making Styles Scale-II were used as data collection tools.

RESULTS: The mean age of the pregnant women was found to be 28.56±6.36 years. Approximately 50.71% of the participants reported that they preferred normal vaginal delivery. It was reported that 56.1% of the pregnant women had a say in the decision-making process of the delivery method. It has been determined that there is a significant difference between the education status, employment status, pregnancy planning, family type, and the person who has a say in deciding the mode of delivery (p<0.05). The results of the analysis of worrying about starting breastfeeding according to the decision-making styles of the pregnant women in the sample group are examined. The difference between the scores of avoidant and procrastinating decision-making style, which is the sub-dimensions of the scale, and worrying about starting breastfeeding is statistically significant (p<0.029 and p<0.029, respectively).

CONCLUSION: The research findings show that situations such as epidemics affect the decisions of pregnant women, and breastfeeding situations and decision-making styles affect each other. For this reason, education programs and guides including guidance services and support systems should be published and pregnant women should be guided correctly.

PMID:37585988 | DOI:10.1590/1806-9282.20230216

An Acad Bras Cienc. 2023 Aug 14;95(suppl 3):e20210692. doi: 10.1590/0001-3765202320210692. eCollection 2023.

ABSTRACT

Active layer and permafrost are important indicators of climate changes in periglacial areas of Antarctica, and the soil thermal regime of Maritime Antarctica is sensitive to the current warming trend. This research aimed to characterize the active layer thermal regime of a patterned ground located at an upper marine terrace in Half Moon Island, during 2015-2018. Temperature and moisture sensors were installed at different soil depths, combined with air temperature, collecting hourly data. Statistical analysis was applied to describe the soil thermal regime and estimate active layer thickness. The thermal regime of the studied soil was typical of periglacial environment, with high variability in temperature and water content in the summer, resulting in frequent freeze-thaw cycles. We detected dominant freezing conditions, whereas soil temperatures increased, and the period of high soil moisture content lasted longer over the years. Active layer thickness varied between the years, reaching a maximum depth in 2018. Permafrost degradation affects soil drainage and triggers erosion in the upper marine terrace, where permafrost occurrence is unlikely. Longer monitoring periods are necessary for a detailed understanding on how current climatic and geomorphic conditions affect the unstable permafrost of low-lying areas of Antarctica (marine terraces).

PMID:37585979 | DOI:10.1590/0001-3765202320210692

An Acad Bras Cienc. 2023 Aug 14;95(suppl 1):e20211188. doi: 10.1590/0001-3765202320211188. eCollection 2023.

ABSTRACT

The increase in Galactic Cosmic Rays (GCR) flux intensity induces the Condensation Nuclei (CN) production, which intensifies rainfall occurrences. Then, the objective of this study was to analyze the rainfall distribution in the NEB and the impact of GCR flux on extreme rainfall events occurred in July 1998 in Natal/RN, Brazil. We used historical rainfall, Sea Surface Temperature (SST) and GCR flux data for Natal/RN. We used R software for statistical analysis. The results indicate that the GCR flux is important for intensifying extremes rainfall occurrences. This fact is observed when analyzing the relationship between rainfall greater than 10 mm and GCR flux above 6,390 counts/min. Pearson correlation coefficient between rainfall and GCR flux was 0.94 (p-value = 0.0005) and SST was -0.76 (p-value = 0.0263), both statistically significant. The rate between GCR flux and rainfall was +2.87 mm/count/min, while the rate between SST and rainfall was -7.91 mm/°C. The variance proportion explained by regression was 94.41%, with relative importance degree corresponding to 62.0% for GCR flux and 32.4% for SST, respectively. The results show that GCR flux had a greater contribution to extreme rainfall occurrence in the metropolitan region of Natal/RN and it is important in climatological studies.

PMID:37585968 | DOI:10.1590/0001-3765202320211188

An Acad Bras Cienc. 2023 Aug 14;95(suppl 1):e20210008. doi: 10.1590/0001-3765202320201459. eCollection 2023.

ABSTRACT

Blast-induced vibration may be harmful to facilities in the vicinity of operating mines, mainly causing structural damage and human discomfort. This study presents an application of multivariate statistics to predict vibration levels regarding their potential to cause structural damage and human discomfort. An extensive seismic monitoring campaign was executed in a large open-pit iron ore mine, near a small village, to gather a dataset for a predictive multivariate analysis. Ten blasting events have produced a dataset of 158 valid measurements. Three classes of vibration peak velocity were adopted from legal standards, which later supported a cluster analysis. Then, it was possible to compare how much these two classification modalities respond to discriminant analysis. The next step was to carry out a principal component analysis (PCA) from the original database, and, comparatively, to plot both the scores concerning the classes derived from the vibration standard and those from the groups obtained from cluster analysis. PCA has considerably explained the data variability, while the three classes from cluster analysis resulted very similar to the corresponding ones from the vibration standards. The results have demonstrated that multivariate statistics may be applied to manage blasting-induced vibration and its deleterious effects with few adjustments and automation.

PMID:37585967 | DOI:10.1590/0001-3765202320201459

An Acad Bras Cienc. 2023 Aug 14;95(suppl 1):e20201317. doi: 10.1590/0001-3765202320201317. eCollection 2023.

ABSTRACT

Learning to anticipate events based on the predictive relationship between an action and an outcome (operant conditioning) is a form of associative learning shared by humans and most of other living beings, including invertebrates. Several behavioral studies on the mechanisms of operant conditioning have included Melipona quadrifasciata, a honey bee that is easily manipulated due to lack of sting. In this work, brain proteomes of Melipona bees trained using operant conditioning and untrained (control) bees were compared by two-dimensional gel electrophoresis analysis within pI range of 3-10 and 4-7; in order to find proteins specifically related to this type of associative learning.One protein was detected with differential protein abundance in the brains of trained bees, when compared to not trained ones, through computational gel imaging and statistical analysis. This protein was identified by peptide mass fingerprinting and MS/MS peptide fragmentation using a MALDI-TOF/TOF mass spectrometer as one isoform of arginine kinase monomer, apparently dephosphorylated. Brain protein maps were obtained by 2-DE (Two-dimensional gel electrophoresis) from a total proteins and phosphoproteins extract of the bee Melipona quadrifasciata. One isoform of arginine kinase, probably a dephosphorylated isoform, was significantly more abundant in the brain of trained bees using operant conditioning. Arginine kinase has been reported as an important enzyme of the energy releasing process in the visual system of the bee, but it may carry out additional and unexpected functions in the bee brain for learning process.

PMID:37585963 | DOI:10.1590/0001-3765202320201317