Nevin Manimala

Zhonghua Jie He He Hu Xi Za Zhi. 2023 Jun 12;46(6):572-579. doi: 10.3760/cma.j.cn112147-20221031-00859.

ABSTRACT

Objective: To assess the clinical value of bedaquiline in five dimensions: effectiveness, safety, economics, appropriateness, and social benefits, to provide a reference for medical and health insurance-related decisions. Methods: A total of 792 patients with multidrug-resistant tuberculosis who were hospitalized at Wuhan Pulmonary Hospital, Ganzhou Fifth People’s Hospital and Jiangxi Chest Hospital between January 2018 and December 2020 were included in the study. Based on a retrospective survey of case data, and each evaluation dimension of bedaquiline was statistically analyzed by causal analysis or chi-square test, using linezolid as the reference drug. Results: In terms of effectiveness, bedaquiline significantly increased treatment success by 23.9% (95%CI:4.8%-43.0%) and shortened treatment duration by 64 days(95%CI:18-109 days). In terms of safety, the incidence of adverse reactions to bedaquiline and the discontinuation rate of adverse reactions (5.11%,4.55%) were significantly lower than those for linezolid (22.49%,15.24%), with statistically significant differences (χ²=27.50,P<0.001;χ²=14.09,P<0.001). In terms of economics, patients treated with bedaquiline had a significantly higher anti-TB drug course cost of RMB 48 209.4 Yuan(95%CI: 28 336.0-68 082.8 Yuan). In terms of appropriateness, the proportion of bedaquiline in patients’ initial treatment regimens was lower than that of linezolid (16.7% vs. 86.5%) in the 2020 observation sample, with a statistically significant difference (χ²=238.96,P<0.001). In terms of social benefits, the infection control rate was significantly increased by 27.8% (95%CI:8.2%-47.5%) in patients using bedaquiline. Conclusions: Bedaquiline performed well in terms of efficacy, safety, and social benefits. However, it was less economical and the actual use rate of bedaquiline in clinical practice was lower than that of its counterpart drug, linezolid. Price reductions might be needed to increase the clinical use and performance of bedaquiline in the future.

PMID:37278171 | DOI:10.3760/cma.j.cn112147-20221031-00859

Fam Med Community Health. 2023 Jun;11(2):e001775. doi: 10.1136/fmch-2022-001775.

ABSTRACT

OBJECTIVE: This study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia).

DESIGN: A cross-sectional study was conducted between June and November 2018. First, a translation and back-translation process was conducted by a committee consisting of the researchers, a psychiatrist, a methodology consultant and two translators. Face and convergent validity and test-retest reliability evaluations were conducted. Next, structural validity and internal consistency analyses were performed. An intraclass correlation coefficient (ICC) test evaluated the scale’s test-retest reliability. A Spearman’s rank correlation coefficient was calculated to evaluate the correlation between HADS-Indonesia and Zung’s Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) for convergent validity evidence. Next, a structural validity analysis using exploratory factor analysis (EFA) and an internal consistency evaluation based on Cronbach’s alpha was conducted.

SETTING: This study was conducted in three villages in Jatinangor subdistrict, Sumedang Regency, West Java province, Indonesia; the villages were chosen based on their profiles.

PARTICIPANTS: A total of 200 participants (male: n=91, 45.50% and female: n=109, 54.50%), with a mean age of 42.41 (14.25) years, were enrolled in this study using a convenience sampling method. The inclusion criteria were age ≥18 years old with basic Indonesian language literacy.

RESULTS: The overall HADS-Indonesia’s ICC value was 0.98. There was a significant positive correlation between HADS-Indonesia’s anxiety subscale and Zung’s SAS (r_s=0.45, p=0.030) and between the depression subscale of HADS-Indonesia and Zung’s SDS (r_s=0.58, p<0.001). The Kaiser-Meyer-Olkin statistics (KMO) (KMO=0.89) and Bartlett’s test of sphericity (χ²(91, N=200)=1052.38, p<0.001)) indicated an adequate number of samples for EFA. All items’ commonality was >0.40 and the average inter-item correlation was 0.36. EFA yielded a 2-factor solution explaining 50.80% (40.40%+10.40%) of the total variance. All items from the original HADS were retained, including its original subscales. The adapted HADS-Anxiety subscale consisted of seven items (alpha=0.85), and the HADS-Depression subscale consisted of seven items (alpha=0.80).

CONCLUSIONS: HADS-Indonesia is a valid and reliable instrument for use in the general population of Indonesia. However, further studies are warranted to provide more sophisticated validity and reliability evidence.

PMID:37277187 | DOI:10.1136/fmch-2022-001775

J Nurs Meas. 2022 Jun 3:JNM-2021-0036.R1. doi: 10.1891/JNM-2021-0036. Online ahead of print.

ABSTRACT

Background and Purpose: Adapting cross-culturally the Hospital Ethical Climate Survey to Brazilian nurses. Methods: A methodological study comprising translation, back translation, multidisciplinary committee, expert panel, pilot test and validation of the instrument. The validation was carried out with 269 nurses of a university hospital in the South of Brazil. Results: In the validation step, the quadratic weighted Kappa test-retest and the correlation coefficient ranged from 0.15 to 0.74. All factor loadings were higher than 0.4, ranging from 0.445 to 0.859. The Portuguese version of the instrument had a 0.93 Cronbach’s alpha and the confirmatory analysis demonstrated the model’s suitability with five factors and 26 items validated. Conclusions: The version of the instrument adapted to Brazilian Portuguese was considered valid and reliable in this sample.

PMID:37277157 | DOI:10.1891/JNM-2021-0036

J Nurs Meas. 2022 Jun 3:JNM-2021-0032.R1. doi: 10.1891/JNM-2021-0032. Online ahead of print.

ABSTRACT

Background and Purpose: The Nurses Professional Values Scale-3 (NPVS-3) is an instrument designed to measure nurses professional values. This study aimed to assess the cultural reliability and validity of the NPVS-3 for use in Brazil. Methods: Translation followed the steps: translation, back-translation, Internal consistency was verified using Cronbach’s alpha coefficient and construct validity, by confirmatory factor analysis for the NPVS-3 three-domain model. Results: NPVS-3 applied to 169 nursing students. The culturally and semantically equivalent to the original English version was appropriate. The internal consistency values of each factor represented by Cronbach’s alpha were adequate: Care (0.790), Activism (0.898), and Professionalism (0.763). Conclusion: The analyses showed that the Brazilian version of NPVS-3 has high validity and reliability, being effective in assessing professional nursing values for Brazil.

PMID:37277153 | DOI:10.1891/JNM-2021-0032

Int J Hyperthermia. 2023;40(1):2219436. doi: 10.1080/02656736.2023.2219436.

ABSTRACT

OBJECTIVES: Our study aims at the comprehensive analysis of adverse events (AEs) in patients with symptomatic uterine fibroids (UFs) who underwent magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) in the last 6 years in one of the major Polish centers performing this type of therapy.

METHODS: The presented retrospective case-control study was conducted in the Department of Obstetrics and Gynecology, Pro-Familia Hospital, Rzeszów in cooperation with the Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw. The study enrolled 372 women with symptomatic UFs who underwent MR-HIFU and reported AEs during or after the procedure. The occurrence of particular AEs was analyzed. Statistical comparison of two cohorts (patients with and without AEs) was conducted based on epidemiological factors, UF characteristics, fat layer thickness, the presence of abdominal scars and technical parameters of the procedure.

RESULTS: The overall mean occurrence rate of AEs was 8.9% (n = 33). No major AEs were reported. The only statistically significant risk factor of AEs was the treatment of type II UFs according to Funaki (OR 2.12, CI 95%, p = 0.043). Other investigated factors did not have a statistically significant influence on AE occurrence. Abdominal pain was the most common AE.

CONCLUSION: Our data showed that MR-HIFU seemed to be a safe procedure. The AE rate after the treatment is relatively low. According to the obtained data it seems that the occurrence of AEs does not depend on the technical parameters of the procedure and the volume, position and location of UFs. Further prospective, randomized studies and with long follow-up are necessary to confirm the final conclusions.

PMID:37277102 | DOI:10.1080/02656736.2023.2219436

J Oral Maxillofac Surg. 2023 May 26:S0278-2391(23)00471-8. doi: 10.1016/j.joms.2023.05.010. Online ahead of print.

ABSTRACT

BACKGROUND: In the fall of 2021, granisetron was approved for postoperative nausea and vomiting (PONV) management in Japan. However, the comparative efficacy of droperidol and granisetron in the field of orthognathic surgery has not been determined.

PURPOSE: We compare the efficacy of droperidol and granisetron for PONV prophylaxis following orthognathic surgery.

STUDY DESIGN, SETTING, SAMPLE: We performed a retrospective cohort study of patients who underwent orthognathic surgery at a single institution from September 2020 to December 2022. Patients who had undergone Le Fort I osteotomy with sagittal split ramus osteotomy or isolated sagittal split ramus osteotomy were included. Patients were divided into three groups; the isolated droperidol (D), isolated granisetron (G), and droperidol with granisetron (DG) groups. General anesthesia was performed using total intravenous anesthesia for all patients; however, droperidol and granisetron were administered at the anesthesiologist’s discretion.

PREDICTOR VARIABLE: PONV prophylactic therapy included isolated droperidol, isolated granisetron, and droperidol with granisetron administration.

OUTCOME VARIABLES: Postoperative nausea (PON) and postoperative vomiting (POV) were determined through medical examination within 48 hours following surgery. Secondary outcomes included complications due to droperidol and/or granisetron administration.

COVARIATES: Age, sex, body mass index, Apfel’s score, duration of surgery, duration of anesthesia, intraoperative blood loss, and type of surgery.

ANALYSES: Statistical analysis was conducted using Fisher exact test, Mann-Whitney U test with Bonferroni correction for univariate comparison, and modified Poisson regression for comparison of PON and POV efficacy for multivariate analyses. P values <.05 were considered statistically significant.

RESULTS: Our study included 218 participants. There were no significant differences in covariates between groups D (n = 111), G (n = 52), and DG (n = 55). No significant difference in PON incidence was observed between groups. However, POV incidence was significantly lower in group DG than group D (relative risk, 0.21; 95% confidence interval, 0.05 to 0.86; P = .03). No significant difference in complication incidence was observed between groups.

CONCLUSIONS AND RELEVANCE: Granisetron was as effective as droperidol for PONV management, while droperidol combined with granisetron was more effective than isolated droperidol for POV management. As compared to the use of each drug separately, their combination was considered safe, with no increase in complication rates.

PMID:37277099 | DOI:10.1016/j.joms.2023.05.010

Am J Obstet Gynecol MFM. 2023 Jun 3:101047. doi: 10.1016/j.ajogmf.2023.101047. Online ahead of print.

ABSTRACT

Between 53-79% of women will sustain some degree of perineal lacerations during vaginal delivery. Third and fourth degree perineal lacerations are known as obstetric anal sphincter injuries. Timely diagnosis and prompt treatment of obstetric anal sphincter injuries can help to prevent the development of severe consequences like fecal incontinence, urinary incontinence and rectovaginal fistula. Neonatal head circumference is routinely measured postpartum, but is often not mentioned as a risk factor among clinical guidelines. Thus far, no review article on risk factors for obstetric anal sphincter injuries has discussed the role of neonatal head circumference.

OBJECTIVE: This review aimed to review and analyze the relationship between head circumference and the occurrence of obstetric anal sphincter injuries among previous studies to conclude whether HC should be recognized as an important risk factor.

DATA SOURCES: Through study screening on Google Scholar, PubMed, Scopus and Science Direct for articles published between 2013 to 2023, followed by assessment of eligibility – this study ended up reviewing 25 studies, 17 of which were included in meta-analysis.

STUDY ELIGIBILITY CRITERIA: Only studies which measured both neonatal head circumference and the occurrence of obstetric anal sphincter injuries were included in this review.

STUDY APPRAISAL: Included studies were appraised using the Dartmouth Library risk of bias assessment checklist.

SYNTHESIS METHODS: Qualitative synthesis was based on the study population, findings, adjusted confounding factors and suggested causative links in each study. Quantitative synthesis was based on calculation and pooling of odds ratio and inverse variance using Review Manager 5.4.1.

RESULTS: A statistically significant association between head circumference and obstetric anal sphincter injuries was reported in 21 out of the 25 studies; four studies reported head circumference as a true independent risk factor. Meta-analysis among studies which measured neonatal HC as a dichotomous categorical variable with a cut-off point at 35±1cm yielded statistically significant pooled results (OR=1.92, 95% CI=1.80-2.04).

CONCLUSION: The risk for obstetric anal sphincter injuries increases as neonatal head circumference increases – this should be considered in decision-making during labour and postpartum management to attain the best outcome.

PMID:37277090 | DOI:10.1016/j.ajogmf.2023.101047

Environ Pollut. 2023 Jun 3:121961. doi: 10.1016/j.envpol.2023.121961. Online ahead of print.

ABSTRACT

Inadvertent human exposure to microplastics by the ingestion of microplastic-contaminated processed foods poses health risks and new preventative issues; nevertheless, investigations analyzing microplastic occurrences in commercially dried fish for direct human consumption are scarce. This study assessed the abundance and characteristics of microplastics in 25 commercially sold dried fish products (4 supermarkets, 3 street vendors, and 18 traditional agri-product farmers’ markets) from two widely consumed and commercially important Chirostoma species (C. jordani and C. patzcuaro) in Mexico. Microplastics were detected in all the samples examined, with abundances ranging from 4.00 ± 0.94 to 55.33 ± 9.43 items g^-1. C. jordani dried fish samples had higher mean microplastic abundance (15.17 ± 5.90 items g^-1) than the C. patzcuaro dried fish samples (7.82 ± 2.90 items g^-1); nevertheless, there was no statistically significant difference in microplastic concentrations between the samples. The most prevalent type of microplastic was fiber (67.55%), followed by fragment (29.18%), film (3.00%), and sphere (0.27%). Non-colored microplastics (67.35%) predominated, while microplastic sizes varied from 24 to 1670 μm, with sizes less than 500 μm (84%) being the most common. ATR-FTIR analysis revealed polyester, acrylonitrile butadiene styrene, polyvinyl alcohol, ethylene-propylene copolymer, nylon-6 (3), cellophane, and viscose in the dried fish samples. Overall, this study’s findings are the first in Latin America to demonstrate microplastic contamination in dried fish for human consumption, underscoring the need for developing countermeasures to prevent plastic pollution in fish-caught regions and reduce the risks of human exposure to these micropollutants.

PMID:37277071 | DOI:10.1016/j.envpol.2023.121961

Exp Eye Res. 2023 Jun 3:109519. doi: 10.1016/j.exer.2023.109519. Online ahead of print.

ABSTRACT

Heparanase (HPA) is believed that might mediate histone 3 lysine 9 acetylation (H3K9ac) to regulate vascular endothelial growth factor (VEGF) gene expressions in the hyperglycemia and hypoxia human retinal endothelial cells (HRECs). Cultured human retinal endothelial cells (HRECs) in hyperglycemia, hypoxia, siRNA, and normal medium, respectively. Distributions of H3K9ac and HPA in HRECs were analyzed by immunofluorescence. Western blot and real-time PCR were respectively used to evaluate the expression of HPA, H3K9ac, and VEGF. The differences in occupancies of H3K9ac and RNA polymerase II at VEGF gene promoter among three groups were studied by Chromatin immunoprecipitation (ChIP) combined with real-time PCR. Co-immunoprecipitation (Co-IP) was used to measure the status of HPA and H3K9ac. Re-ChIP was used to verify whether HPA and H3K9ac associate to the transcription of VEGF gene. HPA was consistent with that of H3K9ac in the hyperglycemia and hypoxia groups. And the fluorescent lights of H3K9ac and HPA in siRNA groups were similar to the control group, fainter than that of hyperglycemia, hypoxia, and non-silencing groups. Western blot results showed that the expressions of HPA, H3K9ac, and VEGF in hyperglycemia and hypoxia HRECs were statistically higher than that of the control. HPA, H3K9ac, and VEGF expressions in siRNA groups were statistically lower than hyperglycemia and hypoxia HRECs. The same trends also were found in real-time PCR. ChIP exhibited the occupancies of H3K9ac and RNA Pol II at VEGF gene promoter in hyperglycemia and hypoxia groups were significantly more increased than in the control group. Co-IP revealed that HPA combined with H3K9ac in hyperglycemia and hypoxia groups; while it was not discovered in the control group. Re-ChIP showed that HPA combined with H3K9ac at VEGF gene promoter in the hyperglycemia and hypoxia HRECs nuclear. In our study HPA can influence expressions of H3K9ac and VEGF in the hyperglycemia and hypoxia HRECs. HPA can probably combine with H3K9ac and regulate the transcription of the VEGF gene in the hyperglycemia and hypoxia HRECs.

PMID:37277067 | DOI:10.1016/j.exer.2023.109519

Sci Total Environ. 2023 Jun 3:164624. doi: 10.1016/j.scitotenv.2023.164624. Online ahead of print.

ABSTRACT

Overexploitation, habitat fragmentation, and flow alteration are major threats to freshwater biodiversity that can lead to fisheries collapse and species extinction. These threats are particularly alarming in poorly monitored ecosystems where resource use supports the livelihoods of numerous people. The Tonle Sap Lake in Cambodia is such an ecosystem, supporting one of the world’s largest freshwater fisheries. Tonle Sap Lake fishes are the focus of indiscriminate harvest affecting species stocks, community composition and food-web structure. Changes in the magnitude and timing of the seasonal flood pulse have also been linked to declines in fish stocks. Yet, changes in fish abundance and species-specific temporal trends remain poorly documented. Analyzing 17 years’ time series of fish catch data for 110 species, we show that fish populations have declined by 87.7 %, owing to a statistically significant decline for >74 % species, particularly the largest ones. Despite large variations in species-specific trends – going from locally extinct to >1000 % increase – declines were found across most migratory behaviors, trophic positions or IUCN threat categories, though uncertainty regarding the magnitude of effect precluded us drawing conclusions in some cases. These results, reminiscent of alarming declines in fish stocks in many marine fisheries, provide unequivocal evidence that Tonle Sap fish stocks are increasingly depleted. The consequences of this depletion on ecosystem function are unknown but will undoubtedly affect the livelihoods of millions of people, stressing the need to set-up management strategies aimed to protect both the fishery and its associated diversity. Flow alteration, habitat degradation / fragmentation – especially deforestation of seasonally inundated areas and overharvest – have been reported as major drivers in population dynamics and community structure, highlighting the need for management efforts aimed at preserving the natural flood pulse, protecting flooded forest habitats, and reducing overfishing.

PMID:37277043 | DOI:10.1016/j.scitotenv.2023.164624