Nevin Manimala

Sci Rep. 2023 Mar 1;13(1):3478. doi: 10.1038/s41598-023-30684-y.

ABSTRACT

The cumulative effects of adversity and unhappiness affect life satisfaction and quality of life in the growing older adult population. Most of the interventions aimed at improving the health and quality of life of older adults have adopted a problem-oriented or weakness-focused approach. However, a positive or strengths-focused approach can also have a virtuous but more effective capacity to contribute to the well-being and life satisfaction of older adults. Therefore, the present study was conducted to investigate the effect of positive thinking training on improving resilience and life satisfaction among older adults. A randomized controlled trial was conducted on 100 older adults with simple random sampling. The intervention group received 90-min weekly sessions for eight weeks on positive thinking training through written homework for reflection, group discussion, and media. The data were collected using Ingram and Wisnicki Positive Thinking Questionnaire, Connor-Davidson Resilience Scale, and Tobin Life Satisfaction Questionnaire at baseline and one week and two months after the training. The collected data were analyzed using descriptive and inferential statistics in SPSS software 26. P values below 0.05 were considered statistically significant. Positive thinking training led to better thinking (p < 0.001), higher resilience (p < 0.001), and greater life satisfaction (p < 0.001). The study’s findings showed the effectiveness of the positive thinking training approach in improving resilience and life satisfaction in older adults. It is recommended to evaluate the long-term outcome in populations with different social, economic, and cultural statuses in future studies.

PMID:36859479 | DOI:10.1038/s41598-023-30684-y

Mol Cells. 2023 Feb 28;46(2):99-105. doi: 10.14348/molcells.2023.2178.

ABSTRACT

Tumors are surrounded by a variety of tumor microenvironmental cells. Profiling individual cells within the tumor tissues is crucial to characterize the tumor microenvironment and its therapeutic implications. Since single-cell technologies are still not cost-effective, scientists have developed many statistical deconvolution methods to delineate cellular characteristics from bulk transcriptome data. Here, we present an overview of 20 deconvolution techniques, including cutting-edge techniques recently established. We categorized deconvolution techniques by three primary criteria: characteristics of methodology, use of prior knowledge of cell types and outcome of the methods. We highlighted the advantage of the recent deconvolution tools that are based on probabilistic models. Moreover, we illustrated two scenarios of the common application of deconvolution methods to study tumor microenvironments. This comprehensive review will serve as a guideline for the researchers to select the appropriate method for their application of deconvolution.

PMID:36859474 | DOI:10.14348/molcells.2023.2178

Sci Rep. 2023 Mar 1;13(1):3495. doi: 10.1038/s41598-023-30535-w.

ABSTRACT

Decreased coherence in electroencephalogram (EEG) has been reported in Alzheimer’s disease (AD) experimentally, which could be considered as a typical electrophysiological characteristic in AD. This work aimed to investigate the effect of AD on coherence in the dorsal visual pathway by the technique of neurocomputation. Firstly, according to the hierarchical organization of the cerebral cortex and the information flows of the dorsal visual pathway, a more physiologically plausible neural mass model including cortical areas v1, v2, and v5 was established in the dorsal visual pathway. The three interconnected cortical areas were connected by ascending and descending projections. Next, the pathological condition of loss of long synaptic projections in AD was simulated by reducing the parameters of long synaptic projections in the model. Then, the loss of long synaptic projections on coherence among different visual cortex areas was explored by means of power spectral analysis and coherence function. The results demonstrate that the coherence between these interconnected cortical areas showed an obvious decline with the gradual decrease of long synaptic projections, i.e. decrease in descending projections from area v2 to v1 and v5 to v2 and ascending projection from area v2 to v5. Hopefully, the results of this study could provide theoretical guidance for understanding the dynamical mechanism of AD.

PMID:36859462 | DOI:10.1038/s41598-023-30535-w

Ann Fam Med. 2022 Apr 1;(20 Suppl 1). doi: 10.1370/afm.20.s1.2748.

ABSTRACT

Context: One-third of American adults have prediabetes. However, only 11% are aware of their condition, and they often do not receive prediabetes education or management. Prior studies have indicated knowledge gaps among primary care providers and patients on prediabetes management. Objective: To understand family medicine providers’ and patients’ attitudes, knowledge, and behaviors regarding prediabetes and its management to inform a prediabetes management intervention. Study Design: Cross-sectional surveys. Setting: A large academic family medicine practice in downtown Philadelphia with 30,000 patients making 80,000 visits annually. Population studied: Family medicine providers (attending physicians, nurse practitioners, residents) and adult patients seen within the last year, with HbA1c in the last 6 months between 5.7-6.4% (excluding pregnant, diabetes diagnosis). Instruments: Provider survey asking demographics, knowledge, attitudes, management, DPP awareness, barriers to prediabetes treatment, and open-ended question on how the practice could improve prediabetes management. Patient survey asking demographics, awareness of diagnosis and risk, knowledge, attitudes, experiences with DPP, prediabetes experiences with PCP, and same open-ended question as provider survey. Provider survey distributed via email; patient survey via Epic MyChart patient portal. Outcome Measures: Descriptive statistics for all quantitative survey items; thematic analysis of open-ended responses. Results: Fifty-four providers and 148 patients completed the surveys (57% and 16.5% response rates, respectively). Nearly all providers (96%) felt that prediabetes screening and management is important but most (74%) prescribe metformin to ≤ 25% of eligible patients. Over half (56%) were unaware of DPP, and 52% of those aware of DPP did not know how to refer a patient. Over half (59%) of patients reported having been told they have prediabetes and 84% thought diet and lifestyle changes were effective treatment, but 65% were unaware of medication options and only 5% had been referred to DPP. In open-ended responses, providers requested more nutrition counseling and an improved DPP referral process; patients also requested nutrition counseling and classes. Conclusions: Providers and patients saw prediabetes as important but reported knowledge and management gaps, particularly for metformin and DPP, and requested additional practice resources.

PMID:36857128 | DOI:10.1370/afm.20.s1.2748

Arch Argent Pediatr. 2023 Mar 9:e202202861. doi: 10.5546/aap.2022-02861.eng. Online ahead of print.

ABSTRACT

Introduction. Worldwide, children and adolescents lead the consumption of ultra-processed foods. The objective of this study was to describe the energy intake by the degree of food processing by age group in the urban population over 2 years of age in Argentina. Population and methods. Cross-sectional study based on data from the 2nd National Survey on Nutrition and Health of 2018-2019 conducted using a multistage probability sample from urban areas of Argentina. Data were collected from a 24-hour recall and were analized, for each age group, the daily energy intake from 1) unprocessed or minimally processed foods; 2) processed culinary ingredients; 3) processed foods; and 4) ultra-processed foods. A descriptive, statistical analysis was performed. Results. In 15 444 individuals older than 2 years, minimally processed foods accounted for 34.5% of daily energy; ultra-processed foods, 26.0%; processed foods, 23.0%; and culinary ingredients, 16.6%. The percentage of energy from ultra-processed foods is higher in children and adolescents than in adults (p < 0.01), while the trend is the opposite from processed foods and culinary ingredients (p < 0.01). Cookies, pastries, sweetened beverage and confectionery accounted for two-thirds of the energy contributed by ultra-processed foods. Conclusion. Children and adolescents in urban areas in Argentina showed the highest energy intake from ultra-processed. Food policies should consider the characteristics of each age group to promote a healthier diet.

PMID:36857126 | DOI:10.5546/aap.2022-02861.eng

Ann Fam Med. 2022 Apr 1;(20 Suppl 1). doi: 10.1370/afm.20.s1.2638.

ABSTRACT

Context: The COVID-19 pandemic continues to be a major socioeconomic disruptor in the U.S. and around the globe. The only intervention that has a far-reaching impact is the adoption of an efficient large-scale vaccination campaign with the highly effective COVID-19 vaccines. While the success of this strategy is predicated on the presence of adequate healthcare systems capacity, it also hinges on the trust and acceptance of the public. Vaccine hesitancy, which varies by the geosocial context, is considered a top obstacle. Objective: The Overton Brooks VA embarked on a survey to explore the demographic patterns and reasons for COVID-19 vaccination hesitancy among cancer patients. Study Design: phone survey. Setting: five Hematology-Oncology clinics across the ArkLATX. Population: random sample of 240 veterans with cancer. Intervention: Veterans were asked whether they are interested in getting vaccinated and to state the reason if they declined. They were asked to categorize the reason as relating to safety, efficacy, inadequate Information, aversion to any vaccine, not wanting to be the first, or other/explain. Outcome Measures: 1. Descriptive statistics of those who want and those who decline the vaccine. 2. Determine the impact of demographic factors on COVID19 vaccine hesitancy. Results: The median age was 71 years. The participants were 92% males and 40% Black vs 59% White. Seventy nine percent wanted to get vaccinated. Among the veterans that declined (21%), the reasons were due to concerns about safety (33%), not wanting to be the first (33%), anti-vaxxer stance (14%), and inadequate information (8%). No one cited concerns about efficacy as a reason. Other reasons (12%) included seeing no reason for the vaccination, citing severe reactions to prior vaccines, and voicing mistrust of the government. There were no statistical differences between veterans that approved or declined the vaccine with respect to demographic characteristics. Conclusions: This survey indicates that the majority of ArkLATX veterans with cancer are willing to be vaccinated against COVID-19. The major reasons behind vaccine hesitancy seem to be information problems consisting of questions about safety, inadequate information, and seeing no reason for the vaccine. Such barriers can be potentially circumvented by providing the appropriate information and counseling.

PMID:36857124 | DOI:10.1370/afm.20.s1.2638

JMIR Med Inform. 2023 Mar 1;11:e43005. doi: 10.2196/43005.

ABSTRACT

BACKGROUND: The accuracy of electronic health records (EHRs) for identifying postpartum depression (PPD) is not well studied.

OBJECTIVE: This study aims to evaluate the accuracy of PPD reporting in EHRs and compare the quality of PPD data collected before and after the implementation of the International Classification of Diseases, Tenth Revision (ICD-10) coding in the health care system.

METHODS: Information on PPD was extracted from a random sample of 400 eligible Kaiser Permanente Southern California patients’ EHRs. Clinical diagnosis codes and pharmacy records were abstracted for two time periods: January 1, 2012, through December 31, 2014 (International Classification of Diseases, Ninth Revision [ICD-9] period), and January 1, 2017, through December 31, 2019 (ICD-10 period). Manual chart reviews of clinical records for PPD were considered the gold standard and were compared with corresponding electronically coded diagnosis and pharmacy records using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Kappa statistic was calculated to measure agreement.

RESULTS: Overall agreement between the identification of depression using combined diagnosis codes and pharmacy records with that of medical record review was strong (κ=0.85, sensitivity 98.3%, specificity 83.3%, PPV 93.7%, NPV 95.0%). Using only diagnosis codes resulted in much lower sensitivity (65.4%) and NPV (50.5%) but good specificity (88.6%) and PPV (93.5%). Separately, examining agreement between chart review and electronic coding among diagnosis codes and pharmacy records showed sensitivity, specificity, and NPV higher with prescription use records than with clinical diagnosis coding for PPD, 96.5% versus 72.0%, 96.5% versus 65.0%, and 96.5% versus 65.0%, respectively. There was no notable difference in agreement between ICD-9 (overall κ=0.86) and ICD-10 (overall κ=0.83) coding periods.

CONCLUSIONS: PPD is not reliably captured in the clinical diagnosis coding of EHRs. The accuracy of PPD identification can be improved by supplementing clinical diagnosis with pharmacy use records. The completeness of PPD data remained unchanged after the implementation of the ICD-10 diagnosis coding.

PMID:36857123 | DOI:10.2196/43005

JMIR Res Protoc. 2023 Mar 1;12:e41230. doi: 10.2196/41230.

ABSTRACT

BACKGROUND: Anxiety is linked to decreased life quality and well-being. Living with an anxiety disorder results in higher personal and societal financial expenditure. Occupational therapists work with people living with anxiety in a variety of settings. A preliminary database search was conducted, and no current or underway systematic or scoping reviews on the topic were identified. Developing an overview of studies of occupational therapy interventions for people with anxiety is a necessary first step to understanding the existing knowledge and to increase the impact of future interventions. This scoping review will build on the findings of a previously conducted systematic review.

OBJECTIVE: This scoping review will identify the following: (1) what occupational therapy interventions exist for adults with anxiety and (2) the intervention characteristics including outcomes used and impact observed.

METHODS: This protocol was reviewed by an occupational therapist as part of a patient and public involvement consultation. The review will consider all studies and publications of occupational therapy that include community-dwelling adults with a diagnosis of anxiety who are aged 18 years and older and diagnosed with an anxiety disorder (Diagnostic and Statistical Manual of Mental Disorders [DSM-5-TR] criteria). Databases to be searched are MEDLINE, CINAHL, Cochrane Library, Science Direct, PsycArticles, Psychology & Behavioural Sciences Collection, Embase, PubMed, TRIP, Proquest, Social Care Online, JBI EBP database, OpenGrey, and OALster. Titles and abstracts will be screened against the inclusion criteria using Rayyan Qatar Computing Research Institute. Potentially relevant studies will be retrieved in full and assessed against the inclusion criteria. Articles published in English will be included. No date limiters will be used. Study selection will be completed by 2 independent reviewers. Data will be extracted using a data extraction tool.

RESULTS: Data will be charted using the Template for Intervention Description and Replication (TIDieR) checklist in alignment with the review objectives. The scoping review will be reported in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols statement.

CONCLUSIONS: This scoping review will produce valuable information about community-based interventions used to improve participation, life quality, and well-being for adults with anxiety to support the development of occupational therapy interventions. The findings will be disseminated through professional and National Health Service bodies, employer organizations, conferences, and research articles. The findings will be of value to health care professionals and researchers working to improve the lives of people living with anxiety.

TRIAL REGISTRATION: Open Science Framework DOI 10.17605/OSF.IO/JS549; https://osf.io/js549/.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41230.

PMID:36857111 | DOI:10.2196/41230

JAMA Dermatol. 2023 Mar 1. doi: 10.1001/jamadermatol.2023.0002. Online ahead of print.

ABSTRACT

IMPORTANCE: Alopecia areata (AA) is characterized by nonscarring hair loss of the scalp, face, and/or body. Alopecia totalis (AT) and alopecia universalis (AU) involve complete loss of the scalp and body hair, respectively. The epidemiology of AA in the US remains unclear, having previously been extrapolated from older studies that were limited to specific geographic areas or clinical settings, or from self-reported data.

OBJECTIVE: To estimate the annual prevalence and incidence of AA and AT and/or AU (AT/AU) in the US.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, population-based cohort study was conducted from January 2016 to December 2019 and included enrollees in the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental databases and their dependents, with plan enrollment during each study calendar year and the year prior.

EXPOSURES: Prevalent cases were identified by 1 or more claims for AA or AT/AU (International Statistical Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes L63.x, L63.0, L63.1) during each year of interest or the year prior. Incident cases were identified by 1 or more claims for AA or AT/AU during a specific year and no diagnosis the year prior.

MAIN OUTCOMES AND MEASURES: Annual incidence and prevalence rates were calculated and stratified by age, sex, and region. National employer-sponsored insurance population estimates were obtained using population-based weights.

RESULTS: Among eligible patients (2016: n = 18 368 [mean (SD) age, 40.6 (17.9) years; 12 295 women (66.9%)]; 2017: n = 14 372 [mean (SD) age, 39.6 (17.7) years; 9195 women (64.0%)]; 2018: n = 14 231 [mean (SD) age, 38.9 (17.3) years; 8998 women (63.2%)]; 2019: n = 13 455 [mean (SD) age, 39.1 (17.4) years; 8322 women (61.9%)]), AA prevalence increased from 0.199% (95% CI, 0.198%-0.200%) in 2016 to 0.222% (95% CI, 0.221%-0.223%) in 2019. Roughly 5% to 10% of prevalent and incident cases of AA were AT/AU. The prevalence of AT/AU increased from 0.012% (95% CI, 0.012%-0.013%) to 0.019% (95% CI, 0.018%-0.019%) from 2016 to 2019. Incidence of AA per 100 000 person-years ranged from 87.39 (95% CI, 86.84-87.96) in 2017 to 92.90 (95% CI, 92.35-93.45) in 2019. Incidence of AT/AU ranged from 7.09 (95% CI, 6.94-7.25) in 2017 to 8.92 (95% CI, 8.75-9.09) in 2016. Prevalence and incidence of AA and AT/AU were higher among female vs male individuals, adults vs children and adolescents, and in the Northeast vs other regions.

CONCLUSIONS AND RELEVANCE: The results of this cohort study suggest that these recent AA prevalence and incidence estimates could help improve current understanding of the disease burden. Further research is warranted to elucidate subpopulation differences and trends in AA in the broader US population.

PMID:36857069 | DOI:10.1001/jamadermatol.2023.0002

JAMA Surg. 2023 Mar 1. doi: 10.1001/jamasurg.2022.7625. Online ahead of print.

ABSTRACT

IMPORTANCE: There is a need for a new, less invasive breast reconstruction option for patients who undergo mastectomy in their breast cancer treatment.

OBJECTIVE: To investigate quality of life (QoL) among patients undergoing a new breast reconstruction technique, autologous fat transfer (AFT), compared with that among patients undergoing implant-based reconstruction (IBR).

DESIGN, SETTING, AND PARTICIPANTS: The BREAST trial was a randomized clinical trial conducted between November 2, 2015, and October 31, 2021, performed in 7 hospitals across the Netherlands. Follow-up was 12 months. Referrals could be obtained from general practitioners and all departments from participating or nonparticipating hospitals. The patients with breast cancer who had undergone mastectomy and were seeking breast reconstruction were screened for eligibility (radiotherapy history and physique) by participating plastic surgeons. Patients receiving postmastectomy radiotherapy were excluded.

INTERVENTIONS: Breast reconstruction with AFT plus expansion or 2-phased IBR. Randomization was done in a 1:1 ratio.

MAIN OUTCOMES AND MEASURES: The statistical analysis was performed per protocol. The predefined primary outcome was QoL at 12 months after final surgery. This was measured by the BREAST-Q questionnaire, a validated breast reconstruction surgery questionnaire. Questions on the BREAST-Q questionnaire are scored from 0 to 100, with a higher score indicating greater satisfaction or better QoL (depending on the scale). Secondary outcomes were breast volume and the safety and efficacy of the techniques.

RESULTS: A total of 193 female patients (mean [SD] age, 49.2 [10.6] years) 18 years or older who desired breast reconstruction were included, of whom 91 patients in the AFT group (mean [SD] age, 49.3 [10.3] years) and 80 in the IBR group (mean age, 49.1 [11.0] years) received the allocated intervention. In total, 64 women in the AFT group and 68 women in the IBR group completed follow-up. In the IBR group, 18 patients dropped out mainly due to their aversion to implant use while in the AFT group 6 patients ended their treatment prematurely because of the burden (that is, the treatment being too heavy or tiring). The BREAST-Q scores were higher in the AFT group in all 5 domains and significantly higher in 3: satisfaction with breasts (difference, 9.9; P = .002), physical well-being: chest (difference; 7.6; P = .007), and satisfaction with outcome (difference, 7.6; P = .04). Linear mixed-effects regression analysis showed that QoL change over time was dependent on the treatment group in favor of AFT. The mean (SD) breast volume achieved differed between the groups (AFT: 300.3 [111.4] mL; IBR: 384.1 [86.6] mL). No differences in oncological serious adverse events were found.

CONCLUSIONS AND RELEVANCE: This randomized clinical trial found higher QoL and an increase in QoL scores over time in the AFT group compared with the IBR group. No evidence was found that AFT was unsafe. This is encouraging news since it provides a third, less invasive reconstruction option for patients with breast cancer.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02339779.

PMID:36857058 | DOI:10.1001/jamasurg.2022.7625