Nevin Manimala

Ann Intern Med. 2022 May 3. doi: 10.7326/M21-2973. Online ahead of print.

ABSTRACT

BACKGROUND: The real-world protection provided by SARS-CoV-2 messenger RNA (mRNA) vaccines to kidney transplant recipients (KTRs) remains uncertain.

OBJECTIVE: To study the association between mRNA vaccination and SARS-CoV-2 infection rate in KTRs.

DESIGN: Retrospective observational cohort study.

SETTING: The Czech Republic (17 February to 16 May 2021).

PATIENTS: 2101 KTRs followed in the Department of Nephrology at the Institute for Clinical and Experimental Medicine.

MEASUREMENTS: Positive result for SARS-CoV-2 on polymerase chain reaction test and vaccination status of KTRs.

RESULTS: The incidence rate in the vaccinated group was 0.474 per 1000 person-days (33 cases in 69 672 days at risk). The incidence rate in the unvaccinated group was 1.370 per 1000 person-days (79 cases in 57 658 days at risk). The unadjusted incidence rate ratio (IRR; incidence rate of vaccinated/incidence rate of unvaccinated) for KTRs was 0.346 (95% CI, 0.227 to 0.514). The multivariable adjusted IRR for KTRs was 0.544 (CI, 0.324 to 0.876).

LIMITATION: Retrospective observational design, uneven follow-up of patient groups, and different exposition to SARS-CoV-2 stemming from strong temporal trends and differences in clinical and probably behavioral characteristics.

CONCLUSION: Vaccination of KTRs is associated with lower risk for SARS-CoV-2 infection.

PRIMARY FUNDING SOURCE: The Ministry of Health of the Czech Republic.

PMID:35500256 | DOI:10.7326/M21-2973

Genet Epidemiol. 2022 May 2. doi: 10.1002/gepi.22452. Online ahead of print.

NO ABSTRACT

PMID:35500225 | DOI:10.1002/gepi.22452

Prehosp Emerg Care. 2022 May 2:1-7. doi: 10.1080/10903127.2022.2072551. Online ahead of print.

ABSTRACT

Objective: The “Stop the Bleed” campaign was created to educate laypeople about bleeding control and make bleeding control kits available in public locations. Unfortunately, previous research has indicated that up to half of all laypeople cannot effectively apply a tourniquet. The purpose of this study was to determine if laypeople could apply tourniquets more effectively with just-in-time training using combined audio-written instructions versus written-only instructions.Methods: We conducted a prospective randomized study comparing the application of a tourniquet using a simulated bleeding arm. Participants were laypeople 18 years and older and excluded those with any previous tourniquet experience or training. Participants were randomized to just-in-time training using either audio-written or written-only instructions. Time in seconds to tourniquet application and the effectiveness of the tourniquet application was recorded. Effective application was defined as stopping the flow or significantly slowing the flow to a slow drip. Ineffective tourniquet placement was defined as not significantly changing the flow. Statistical analysis was performed using Fisher’s exact, t-test, and linear regression.Results: Eighty-two participants were included; 40 were in the audio-written instructions group, and 58.5% were male. The audio-written group’s effective application rate was 92.5% and that of the written-only group was 76.2%. A significantly higher rate of ineffective tourniquet application was noted for the written-only group, (23.8%), versus the audio-written group (7.5%), p=.04. Regardless of the type of instructions used, time to effective application of the tourniquet decreased as participant age increased (p = 0.02, 95%CI (-1.24, -0.13). There was no relationship between age and effective tourniquet application (p = 0.06). Time for tourniquet placement was not different between the audio-written (mean 100.4 seconds) and written-only (mean 106.1 seconds) groups (p = 0.58).Conclusion: This study suggests that combined audio-written instructions decrease the rate of ineffective tourniquet application by laypeople compared with written-only instructions. Further studies are needed to assess if audio instructions and just-in-time training can further maximize effective tourniquet application.

PMID:35500205 | DOI:10.1080/10903127.2022.2072551

J Clin Lab Anal. 2022 May 2:e24471. doi: 10.1002/jcla.24471. Online ahead of print.

ABSTRACT

BACKGROUND: Nowadays, neonatal screening has become an essential part of routine newborn care in the world. This is a non-invasive evaluation that evaluated inborn errors of metabolisms (IEMs) using tandem mass spectrometry (LC-MS/MS) for the evaluation of the baby’s risk of certain metabolic disorders.

METHODS: This retrospective study was conducted on 39987 Iranian newborns who were referred to Nilou Medical Laboratory, Tehran, Iran, for newborn screening programs of IEMs. We incorporated second-tier tests and secondary biomarkers to improve positive predictive value (PPV).

RESULTS: Statistical data were recorded via call interviewing in 6-8 months after their screening tests. The overall prevalence of IEM was 1:975. The mean age of all participants was 3.9 ± 1.1 days; 5.1% of participants were over 13 days and 7.7% were preterm or underweight. A total of 11384 (29.4%) of the cases were born in a consanguineous family. The type of delivery was the cesarean section in 8332 (51.3%) valid cases. The neonatal screening results had an overall negative predictive value (NPV) of 100% and the overall PPV of 40.2%. The false-positive rate was 0.15%.

CONCLUSION: This study showed a high incidence of metabolic disease due to a high rate of consanguineous marriages in Iran and indicated that incorporation of second-tier tests and secondary biomarkers improves PPV of neonatal screening programs.

PMID:35500172 | DOI:10.1002/jcla.24471

Vet Surg. 2022 May 2. doi: 10.1111/vsu.13817. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare ultrasonographic and computed tomographic findings in neonatal foals prior to surgical repair of rib fractures as well as postoperative outcomes in foals with and without preoperative thoracic computed tomography (CT). Study design Retrospective cohort study. Sample population 43 neonatal foals undergoing surgical treatment of rib fractures between 2013 and 2021.

METHODS: Medical records were reviewed for age, sex, delivery method, comorbidities, presurgical anesthetic time, surgical time, number and location of fractured ribs identified with ultrasound and CT, number and location of ribs surgically repaired, survival to discharge, and post-mortem findings. Statistical analyses were performed using chi-square, Fisher’s exact, and t-tests.

RESULTS: Twenty-two foals underwent surgical repair of rib fractures after preoperative CT from 2019-2021 (median: 4/18/20) and 21 foals were anesthetized (20 underwent repair) for surgical repair of rib fractures without preoperative CT from 2013-2020 (median: 4/9/15). Ultrasound and CT findings differed in number and location of fractured ribs in 13/17 (76%) foals (p = .049). More cranially positioned ribs were identified as fractured with CT than with ultrasonography (p = .035). Survival to discharge was improved when foals underwent CT (20/22, 91%) than when they did not (12/20, 60%, p = .019).

CONCLUSION: Ultrasound findings differed from CT findings in most foals. Foals evaluated with CT were more likely to survive to hospital discharge.

CLINICAL SIGNIFICANCE: When available, CT is recommended prior to surgical repair of rib fractures in neonatal foals.

PMID:35500138 | DOI:10.1111/vsu.13817

Proc Natl Acad Sci U S A. 2022 May 10;119(19):e2120808119. doi: 10.1073/pnas.2120808119. Epub 2022 May 2.

ABSTRACT

SignificanceDeep brain stimulation (DBS) in the subthalamic nucleus (STN) is highly effective for treating the motor symptoms of Parkinson’s disease (PD). However, the neural mechanisms by which DBS acts are unknown. PD symptoms are tied to altered brain rhythms in basal ganglia (BG) and particularly the striatum. We develop a biophysical model of a BG neural pathway and show how beta oscillations can emerge throughout BG in PD. We then establish a mechanism by which DBS in STN can interrupt these abnormal rhythms and restore the brain’s capability to produce and regulate normal rhythms lost with dopamine depletion. Our research suggests mechanisms to leverage striatal gamma and theta oscillations to counter aberrant dynamics and enhance the therapeutic effects of DBS.

PMID:35500112 | DOI:10.1073/pnas.2120808119

J Am Chem Soc. 2022 May 2. doi: 10.1021/jacs.2c02391. Online ahead of print.

ABSTRACT

This Communication describes polarity inversion in molecular rectification and the related mechanism. Using a supramolecular engineered, ultrastable, binary-mixed self-assembled monolayer (SAM) composed of an organic molecular diode (SC₁₁BIPY) and an inert reinforcement molecule (SC₈), we probed a rectification ratio (r)-voltage relationship over an unprecedentedly wide voltage range (up to |3.5 V|) with statistical significance. We observed positive polarity in rectification at |1.0 V| (r = 107), followed by disappearance of rectification at ∼|2.25 V|, and then eventual emergence of new rectification with the opposite polarity at ∼|3.5 V| (r = 0.006; 1/r = 162). The polarity inversion occurred with a span over 4 orders of magnitude in r. Low-temperature experiments, electronic structure analysis, and theoretical calculations revealed that the unusually wide voltage range permits access to molecular orbital energy levels that are inaccessible in the traditional narrow voltage regime, inducing the unprecedented in situ inversion of polarity.

PMID:35500106 | DOI:10.1021/jacs.2c02391

Coron Artery Dis. 2022 Apr 15. doi: 10.1097/MCA.0000000000001148. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to explore the effect of different doses of atorvastatin on collateral formation in coronary artery disease (CAD) patients with coronary atherosclerosis.

METHODS: The study included 218 CAD patients who received treatment between January 2017 and January 2020 at our hospital. They were assigned to the high-dose group (40 mg atorvastatin) and the low-dose group (20 mg atorvastatin) using the random table method with 109 patients per group. The blood lipid levels, TNF-α, hs-CRP, NO, and coronary atherosclerosis collateral formation before and after treatment in the two groups were compared, and favorable factors of good coronary artery collateral circulation were analyzed by multivariate logistic regression analysis.

RESULTS: LDL-C, TG, and TC levels decreased, whereas HDL-C levels increased in the two groups after treatment. The high-dose group had lower LDL-C, TG, and TC levels but higher HDL-C levels than the low-dose group, and the difference was statistically significant (P < 0.05). TNF-α and hs-CRP levels decreased while NO levels increased in both groups after treatment. The high-dose group had lower TNF-α and hs-CRP levels but higher NO levels than the low-dose group, and the difference was statistically significant (P < 0.05).

CONCLUSION: High-dose atorvastatin could blood lipid levels of modulate CAD patients and promote coronary atherosclerosis collateral formation. In addition, hypertension, LDL-C, HDL-C, TNF-α, hs-CRP, and NO were independent determinants of good coronary artery collateral circulation.

PMID:35500098 | DOI:10.1097/MCA.0000000000001148

J Public Health Manag Pract. 2022 Apr 5. doi: 10.1097/PHH.0000000000001527. Online ahead of print.

ABSTRACT

The linking of surveillance data sets has increasingly become an essential public health activity. We compared a traditional method in North Carolina (NC) with a newer collaborative approach when linking Hospital Discharge Data (HDD) and NC Violent Death Reporting System (NC-VDRS) data. We found the collaborative approach to be superior, enabling wider ownership combined with subject matter expertise the traditional method lacked. We used Link Plus and Match*Pro software for linkage, which had similar matching results. However, the collaborative process using Match*Pro resulted in fewer matches requiring review and enabled better case adjudication and collaboration between partners. Of the 1361 unique suicides that matched to HDD, 44% (n = 599) had multiple prior hospitalizations. Public health needs to innovate and enable partners to foster solutions when traditional methods are dated and result in less reliable data. The process outlined builds consensus, increases trust, and ultimately saves time.

PMID:35500087 | DOI:10.1097/PHH.0000000000001527

Sociol Health Illn. 2022 May 2. doi: 10.1111/1467-9566.13476. Online ahead of print.

ABSTRACT

Research has shown a link between gender, violence, and suicide. This relationship is complex, and few empirical studies have explored suicide and family and interpersonal violence perpetrated by men. Drawing on a coronial dataset of suicide cases and a mixed methods design, this study integrated a quantitative analysis of 155 suicide cases with a qualitative analysis of medico-legal reports from 32 cases. Findings showed different types and patterns of family and intimate partner violence for men who died by suicide. Men used violence in response to conflict, but also to dominate women. Cumulative, interwoven effects of violence, mental illness, alcohol and other drug use, socioeconomic, and psychosocial circumstances were observed in our study population. However, the use of violence and suicidal behaviour was also a deliberate and calculated response by which some men sought to maintain influence or control over women. Health and criminal justice interventions served as short-term responses to violence, mental illness, and suicidal behaviour, but were of limited assistance.

PMID:35500037 | DOI:10.1111/1467-9566.13476