Nevin Manimala

PLoS One. 2023 Sep 6;18(9):e0290888. doi: 10.1371/journal.pone.0290888. eCollection 2023.

ABSTRACT

OBJECTIVE: To investigate the prognostic value of preoperative neoadjuvant therapy (NT) compared to upfront surgery (US) in patients with resectable and borderline resectable pancreatic cancer.

METHODS: PubMed, Embase, Web of Science were searched to collect randomized controlled trials on preoperative neoadjuvant therapy versus upfront surgery for resectable and borderline resectable pancreatic cancer before April 7, 2023, and data were extracted after screening according to inclusion and exclusion criteria, and HRs were obtained indirectly using enguage software; Stata 12.0 software was used for data analysis.

RESULTS: A total of 8 randomized controlled trials (RCTs) were included in this study, comprising a total of 1058 cases, including 503 cases in the NT group and 555 cases in the US group. Using an intention-to-treat population (ITT) analysis, the results showed that neoadjuvant treatment improved the R0 resection rate (RR 2.71, 95% CI 1.59-4.62; P = 0.000; I2 = 46.20%) and overall survival (HR 0.66, 95% CI 0.54-0.82; P = 0.000; I2 = 0.00%). In the subgroup of patients with resectable pancreatic cancer, the R0 resection rate in the NT group versus the US group (RR 1.14, 95% CI 0.93-1.39; P = 0.196; I2 = 0.00%) and overall survival (HR 0.89, 95% CI 0.64-1.24; P = 0.489; I2 = 0.00%) were not statistically significant.

CONCLUSIONS: Preoperative neoadjuvant treatment is of prognostic value in patients with borderline resectable pancreatic cancer, as it increases the R0 resection rate and improves overall survival compared to upfront surgery.

PMID:37672511 | DOI:10.1371/journal.pone.0290888

J Nurs Educ. 2023 Sep;62(9):532-533. doi: 10.3928/01484834-20230810-01. Epub 2023 Sep 1.

ABSTRACT

A cursory review of relevant research works published in the Journal of Nursing Education suggests that our community may unnecessarily rely on η² when reporting results of their ANOVA models. Although η² is convenient, the statistic possesses many limitations that warrant our community adopting a wider set of effect size statistics and practices to promote a valid science of nursing education. We specifically call attention in this article to ω². [J Nurs Educ. 2023;62(9):532-533.].

PMID:37672494 | DOI:10.3928/01484834-20230810-01

Arq Bras Cardiol. 2023 Sep 1;120(8):e20220840. doi: 10.36660/abc.20220840. eCollection 2023.

ABSTRACT

BACKGROUND: At the beginning of the COVID-19 pandemic, patients with myocardial infarction (MI) took longer to present to hospitals because of fear of contamination and health care access difficulties.

OBJECTIVES: To assess interventional cardiology procedures performed during the COVID-19 pandemic and its implications for MI approach.

METHODS: Prospective registry of 24 cardiac catheterization laboratories in Brazil, with adult patients undergoing interventional cardiology procedures between May 26 and November 30, 2020. The outcomes were cardiovascular (CV) and non-CV complications, death, and MI. Concomitant COVID-19 was confirmed using RT-PCR. Machine learning techniques were used with nonparametric Classification Trees models, and Simple Correspondence Analysis, with R statistical software package. Significance level adopted of 5%.

RESULTS: This study included 1282 patients, 435 of whom (33.9%) had MI as follows: ST-segment elevation MI (STEMI), 239 (54.9%); and non-ST-segment elevation MI (NSTEMI), 196 (45.1%). Of the 1282 patients, 29 had CV complications, 47 had non-CV complications, and 31 died. The diagnosis of COVID-19 was confirmed in 77 patients (6%), with 15.58% mortality and non-CV complications in 6.49%. Most patients had significant coronary artery disease (63%), and an intracoronary thrombus was more often found in the presence of STEMI (3.4%) and COVID-19 (4%). A door-to-table time longer than 12 hours in NSTEMI was associated with 30.8% of complications, 25% in COVID-19 patients.

CONCLUSIONS: All deaths were preceded by CV or non-CV complications. The presence of COVID-19 was associated with death and non-fatal complications of patients undergoing interventional cardiology procedures during the pandemic.

PMID:37672473 | DOI:10.36660/abc.20220840

Arq Bras Cardiol. 2023 Sep 1;120(8):e20220598. doi: 10.36660/abc.20220598. eCollection 2023.

ABSTRACT

BACKGROUND: Several studies have associated dietary saturated fatty acids (SFAs) with cardiovascular risk but there are still many controversies. Most of these studies have focused on the effects of palmitic acid on circulating lipids. Stearic acid usually shows a neutral effect on blood lipids, however, there is a lack of clinical studies assessing the link with inflammatory and endothelial dysfunction markers.

OBJECTIVE: To evaluate the association of red blood cell (RBC) SFA (palmitic and stearic acids) with circulating inflammatory and endothelial dysfunction biomarkers.

METHODS: Cross-sectional study of 79 adults of both sexes with at least one cardiovascular risk factor but without previous events (acute myocardial infarction or stroke). Plasma biomarkers – lipids, glucometabolic markers, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-α (TNF-α) – and RBC palmitic and stearic fatty acids were analyzed. The associations were assessed by correlation and multiple linear regression analyses, with statistical significance set at p < 0.05.

RESULTS: Palmitic acid showed no significant associations with traditional cardiovascular risk factors or inflammatory markers. Stearic acid, on the other hand, was inversely correlated with blood cholesterol and triglycerides, but independently associated with hs-CRP, IL-6, and TNF-α.

CONCLUSION: Stearic acid is associated with inflammatory and endothelial dysfunction biomarkers in individuals with at least one cardiovascular risk factor.

PMID:37672472 | DOI:10.36660/abc.20220598

Arq Bras Cardiol. 2023 Sep 1;120(8):e20220584. doi: 10.36660/abc.20220584. eCollection 2023.

ABSTRACT

BACKGROUND: Patients admitted with acute decompensated heart failure (HF) are subject to developing worsening episodes that require more complex interventions. The Acute Decompensated Heart Failure National Registry (ADHERE) risk model was developed in the United States to predict the risk of in-hospital worsening HF.

OBJECTIVE: To use the ADHERE risk model in the assessment of risk of in-hospital worsening HF and to determine its sensitivity and specificity in hospitalized patients.

METHODS: This cohort study was conducted at a Brazilian public university hospital, and data from 2013 to 2020 were retrospectively collected. P values < 0.05 were considered statistically significant.

RESULTS: A total of 890 patients with a mean age of 74 ± 8 years were included. The model showed that, in the group of 490 patients at risk, 254 (51.8%) developed in-hospital worsening HF. In the group of 400 patients not at risk, only 109 (27.2%) experienced worsening HF. The results demonstrated a statistically significant curve (area under the curve = 0.665; standard error = 0.018; P < 0.01; confidence interval = 0.609 to 0.701), indicating good accuracy. The model had a sensitivity of 69.9% and a specificity of 55.2%, with a positive predictive value of 52% and a negative predictive value of 72.7%.

CONCLUSIONS: In this cohort, we showed that the ADHERE risk model was able to discriminate patients who in fact developed worsening HF during the admission period, from those who did not.

PMID:37672471 | DOI:10.36660/abc.20220584

Cien Saude Colet. 2023 Sep;28(9):2721-2731. doi: 10.1590/1413-81232023289.20172022. Epub 2023 Jan 12.

ABSTRACT

The object of study refers to the representations of spirituality and religiosity for women who belong to Afro-diasporic religions, specifically those who are faithful to Umbanda and Candomblé. The objective was to analyze the representational structure of spirituality and religiosity for Umbandist and Candomblecist women with the aim of thinking of an explanatory model of this symbolic construction and implications for the practice of care in the area of health. Qualitative study, in the light of Social Representations in its structural approach. Data collected with 207 Umbandist and Candomblecist women through free evocations of the inducing terms “spirituality” and “religiosity”, in addition to the characterization and scale of religiosity. The evocations were submitted to prototypical and similarity analyses with Iramuteq, while quantitative data to descriptive statistics. The results show that the central elements for religiosity are faith, belief, God and love, while for spirituality, they are faith, Orixás, God, peace and love. The tree of similarity explains the centrality of faith for the structuring of this representation. The representations are organized around the idea of ​​a relationship between the human and the divine.

PMID:37672460 | DOI:10.1590/1413-81232023289.20172022

Cien Saude Colet. 2023 Sep;28(9):2677-2688. doi: 10.1590/1413-81232023289.15672022. Epub 2023 Jan 27.

ABSTRACT

The objective of this article is to identify the prevalence and evaluate the factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil. Cross-sectional study with 2,439 adolescents from Sample 2 (2015) of the National School-based Health Survey. Extreme weight loss behaviors, such as self-induced vomiting, laxative use and use of medicines or formulas (outcome) and independent variables were evaluated using a self-administered electronic questionnaire. The statistical analysis was performed following a hierarchical conceptual model. The prevalence of extreme weight loss behaviors in the sample was 12.1%. Among the factors that showed significant association with the outcome, we emphasize the administration model of the private school (PR = 0.62; CI = 0.46-0.84), bullying related to body appearance and for other reasons (PR = 1.62; CI = 1.19-2.20), forced sexual intercourse (PR = 2.65; CI = 1.90-3.69), insomnia (PR = 1.84; CI = 1.43-2.37), and be perceived as fat or very fat (PR = 1.90; CI = 1.50-2.42). Moderate prevalence of extreme weight loss behaviors was identified among adolescents. Socioeconomic factors, exposure to violence, mental health, and body image were associated with the adoption of these behaviors.

PMID:37672456 | DOI:10.1590/1413-81232023289.15672022

Braz J Biol. 2023 Sep 4;83:e274719. doi: 10.1590/1519-6984.274719. eCollection 2023.

ABSTRACT

This article presents the results of the culling of cows of the Simmental and Holstein breeds in the Republic of Kazakhstan. The purpose of the research was to study the actual number of culled cows of dairy productivity in the farms of the Republic of Kazakhstan to determine its norm. The object of research were cows of Simmental (18,462 heads) and Holstein (17,862 heads) breeds in various regions of the republic. The research was carried out according to generally accepted zootechnical methods using statistical data processing using RStudio. The results of the studies showed that the percentage of culling increases in cows of the Simmental and Holstein breeds and amounts to 19.7 and 22.9%, respectively. The analysis of the retirement of full-aged cows of the Simmental breed showed that the main causes are hoof diseases (up to 26%), low reproductive function (up to 21%), low productivity (up to 18%). Holstein cows had an increase in disposals in all categories except for disposals for various reasons, for problems with reproduction, the disposal is up to 21%. The determination of the relationship between productivity and retirement in the Simmental breed cows showed that with age and increased lactation, the proportion of retired cows also increases, in the Holstein breed, with increased productivity, the percentage of culled animals also increases.

PMID:37672436 | DOI:10.1590/1519-6984.274719

Braz Oral Res. 2023 Sep 4;37:e088. doi: 10.1590/1807-3107bor-2023.vol37.0088. eCollection 2023.

ABSTRACT

This study evaluated physicochemical properties of experimental infiltrants after addition of hydroxyapatite nanoparticles (HAp) or 58S bioactive glass (BAG) and diphenyliodonium hexafluorophosphate (DPI). The resin matrix was composed of TEGDMA/Bis-EMA (3:1), 0.5 mol% CQ, and 1 mol% EDAB. The blends received or not 0.5 mol% DPI and 10% wt BAG or HAp. Icon was used as commercial control. The groups were characterized by XRD, FT-IR spectrometry, and SEM before and after simulated body fluid (SBF) immersion for up to 7 days. Polymerization kinetics (n =3 ), water sorption and solubility (n=10), and viscosity (n = 3) were surveyed. For polymerization kinetics, the samples were polymerized for 5 min and the data were obtained from 40 s and 5 min. Statistical analysis was made using ANOVA and Tukey’s test (a = 0.05). After 7 days of SBF immersion, XRD and FT-IR showed that the HAp crystalline phase was present only in the HAp groups. A lower degree of conversion (DC) and polymerization rate were observed for the Icon and BAG groups, whereas HAp showed higher values. For the BAG group, DPI increased polymerization rate and DC in 40 s. After 5 min, all groups presented DC above 80%. In groups with particles, the HAp groups exhibited higher viscosity, whereas DPI groups showed a decrease in viscosity. Icon had the highest water sorption. To conclude, BAG neither improved the physicochemical properties studied, nor did it show bioactive properties. The addition of DPI reduced viscosity caused by particle addition and also attenuated the DC decrease caused by BAG addition. The addition of bioactive particles to infiltrants should be seen with caution because they increase viscosity and may not bring major clinical improvements that justify their use. DPI might be indicated only if any component is added to the infiltrant to act as a compensation mechanism.

PMID:37672421 | DOI:10.1590/1807-3107bor-2023.vol37.0088

JMIR Med Inform. 2023 Sep 6;11:e48693. doi: 10.2196/48693.

ABSTRACT

BACKGROUND: Recent advances in natural language processing (NLP) have heightened the interest of the medical community in its application to health care in general, in particular to stroke, a medical emergency of great impact. In this rapidly evolving context, it is necessary to learn and understand the experience already accumulated by the medical and scientific community.

OBJECTIVE: The aim of this scoping review was to explore the studies conducted in the last 10 years using NLP to assist the management of stroke emergencies so as to gain insight on the state of the art, its main contexts of application, and the software tools that are used.

METHODS: Data were extracted from Scopus and Medline through PubMed, using the keywords “natural language processing” and “stroke.” Primary research questions were related to the phases, contexts, and types of textual data used in the studies. Secondary research questions were related to the numerical and statistical methods and the software used to process the data. The extracted data were structured in tables and their relative frequencies were calculated. The relationships between categories were analyzed through multiple correspondence analysis.

RESULTS: Twenty-nine papers were included in the review, with the majority being cohort studies of ischemic stroke published in the last 2 years. The majority of papers focused on the use of NLP to assist in the diagnostic phase, followed by the outcome prognosis, using text data from diagnostic reports and in many cases annotations on medical images. The most frequent approach was based on general machine learning techniques applied to the results of relatively simple NLP methods with the support of ontologies and standard vocabularies. Although smaller in number, there has been an increasing body of studies using deep learning techniques on numerical and vectorized representations of the texts obtained with more sophisticated NLP tools.

CONCLUSIONS: Studies focused on NLP applied to stroke show specific trends that can be compared to the more general application of artificial intelligence to stroke. The purpose of using NLP is often to improve processes in a clinical context rather than to assist in the rehabilitation process. The state of the art in NLP is represented by deep learning architectures, among which Bidirectional Encoder Representations from Transformers has been found to be especially widely used in the medical field in general, and for stroke in particular, with an increasing focus on the processing of annotations on medical images.

PMID:37672328 | DOI:10.2196/48693