Nevin Manimala

BMC Neurol. 2022 Aug 4;22(1):290. doi: 10.1186/s12883-022-02814-y.

ABSTRACT

BACKGROUND: Even with high standards of acute care and neurological early rehabilitation (NER) a substantial number of patients with neurological conditions still need mechanical ventilation and/or airway protection by tracheal cannulas when discharged and hence home-based specialised intensive care nursing (HSICN). It may be possible to improve the home care situation with structured specialized long-term neurorehabilitation support and following up patients with neurorehabilitation teams. Consequently, more people might recover over an extended period to a degree that they were no longer dependent on HSICN.

METHODS: This healthcare project and clinical trial implements a new specialised neurorehabilitation outreach service for people being discharged from NER with the need for HSICN. The multicentre, open, parallel-group RCT compares the effects of one year post-discharge specialized outpatient follow-up to usual care in people receiving HSICN. Participants will randomly be assigned to receive the new form of healthcare (intervention) or the standard healthcare (control) on a 2:1 basis. Primary outcome is the rate of weaning from mechanical ventilation and/or decannulation (primary outcome) after one year, secondary outcomes include both clinical and economic measures. 173 participants are required to corroborate a difference of 30 vs. 10% weaning success rate statistically with 80% power at a 5% significance level allowing for 15% attrition.

DISCUSSION: The OptiNIV-Study will implement a new specialised neurorehabilitation outreach service and will determine its weaning success rates, other clinical outcomes, and cost-effectiveness compared to usual care for people in need for mechanical ventilation and/or tracheal cannula and hence HSICN after discharge from NER.

TRIAL REGISTRATION: The trial OptiNIV has been registered in the German Clinical Trials Register (DRKS) since 18.01.2022 with the ID DRKS00027326 .

PMID:35927616 | DOI:10.1186/s12883-022-02814-y

BMC Bioinformatics. 2022 Aug 4;23(1):315. doi: 10.1186/s12859-022-04853-1.

ABSTRACT

BACKGROUND: Genetic and epigenetic biological studies often combine different types of experiments and multiple conditions. While the corresponding raw and processed data are made available through specialized public databases, the processed files are usually limited to a specific research question. Hence, they are unsuitable for an unbiased, systematic overview of a complex dataset. However, possible combinations of different sample types and conditions grow exponentially with the amount of sample types and conditions. Therefore the risk to miss a correlation or to overrate an identified correlation should be mitigated in a complex dataset. Since reanalysis of a full study is rarely a viable option, new methods are needed to address these issues systematically, reliably, reproducibly and efficiently.

RESULTS: Cogito “COmpare annotated Genomic Intervals TOol” provides a workflow for an unbiased, structured overview and systematic analysis of complex genomic datasets consisting of different data types (e.g. RNA-seq, ChIP-seq) and conditions. Cogito is able to visualize valuable key information of genomic or epigenomic interval-based data, thereby providing a straightforward analysis approach for comparing different conditions. It supports getting an unbiased impression of a dataset and developing an appropriate analysis strategy for it. In addition to a text-based report, Cogito offers a fully customizable report as a starting point for further in-depth investigation.

CONCLUSIONS: Cogito implements a novel approach to facilitate high-level overview analyses of complex datasets, and offers additional insights into the data without the need for a full, time-consuming reanalysis. The R/Bioconductor package is freely available at https://bioconductor.org/packages/release/bioc/html/Cogito.html , a comprehensive documentation with detailed descriptions and reproducible examples is included.

PMID:35927614 | DOI:10.1186/s12859-022-04853-1

Obstet Gynecol. 2022 Aug 3. doi: 10.1097/AOG.0000000000004888. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify factors associated with intrauterine tamponade failure after vaginal or cesarean delivery.

METHODS: This was a nationwide population-based cohort study that used data from the French Programme de Médicalisation des Systèmes d’Information. This study compared the failure and effectiveness of intrauterine tamponade among all women who received the procedure in France from January 1, 2019, to December 31, 2019. Failure was defined as the use of a second-line method (uterine artery embolization, conservative or radical surgery, or death) within 7 days of intrauterine tamponade. Factors associated with intrauterine tamponade failure were identified by univariate analyses and tested using multivariate generalized logistic regression models (with a random intercept on institution) to obtain adjusted odds ratio (aOR) and 95% CI statistics.

RESULTS: A total of 39,193 patients presented with postpartum hemorrhage in 474 French maternity wards. Of these patients, 1,761 (4.5%) received intrauterine tamponade for persistent bleeding. The effectiveness rate of intrauterine tamponade was 88.9%. For 195 women (11.1%), a second-line method was indicated. Patients for whom intrauterine tamponade failed had a higher maternal age, a lower mean gestational age, and more frequent instances of placental abnormalities, preeclampsia, cesarean birth, and uterine rupture. The multivariate analysis revealed that cesarean birth (aOR 4.2; 95% CI 2.9-6.0), preeclampsia (aOR 2.3; 95% CI 1.3-4.0), and uterine rupture (aOR 14.1; 95% CI 2.4-83.0) were independently associated with intrauterine tamponade failure.

CONCLUSION: Cesarean delivery, preeclampsia, and uterine rupture are associated with intrauterine tamponade failure in the management of postpartum hemorrhage.

PMID:35926196 | DOI:10.1097/AOG.0000000000004888

Wound Manag Prev. 2022 Aug;68(8):25-32.

ABSTRACT

BACKGROUND: Many health-related videos are available online. One type of health-related video is related to stoma pouch change. However, a system to evaluate the quality and content of these videos is lacking.

PURPOSE: To evaluate the content and quality of YouTube videos on colostomy pouch change.

METHODS: A descriptive study was carried out by searching for videos on March 15, 2021, using the key words “colostomy care,” “colostomy bag/pouch change,” and “ostomy bag/pouch change.” A 5-point Global Quality Scale was used to evaluate the quality of the videos, and a 10-point scale was used to evaluate the content. The videos were classified as “useful” or “useless” according to their content and quality scores.

RESULTS: A total of 128 videos were found; 94 videos met the criteria and were included in the study. The content of the 94 videos was examined by 2 independent researchers. The overall content score of the videos was 8.24 ± 1.56, and the overall quality score was 3.14 ± 0.97. A total of 66 (70.21%) videos were useful, and 28 (29.79%) videos were useless. The mean scores of useful videos for content (9.09 ± 0.83) and the average Global Quality Scale scores (3.53 ± 0.76) were significantly higher than those of useless videos (6.17 ± 0.90 and 2.25 ± 0.75, respectively; (P < .05). The results showed that 57.6% of the useful videos were uploaded by universities, professional organizations, and health care professionals, and 67.9% of the useless videos were uploaded by patients; the difference was statistically significant (P < .05).

CONCLUSIONS: Results indicated that the majority of online videos evaluated were accurate. Most of these videos were uploaded by universities, professional organizations, health care professionals, or medical advertisers. Although there were many limitations to this study, the authors suggest that health care professionals can direct their patients to these sources after hospital discharge. However, future studies are needed..

PMID:35926146

Nurse Educ. 2022 Aug 1. doi: 10.1097/NNE.0000000000001264. Online ahead of print.

ABSTRACT

BACKGROUND: The Doctor of Nursing Practice (DNP) project is the culmination of DNP education, serving as evidence of knowledge preparation and skill achievement in translating evidence into practice.

PROBLEM: Review of sample DNP projects from 2015 to 2019 revealed that multiple projects had fatal flaws in the Methods and Evaluation sections, rendering the resulting DNP project with diminished value.

APPROACH: We established a collaborative relationship with an educational statistics program and associated consulting center to develop and integrate statistical resources directly into the planning and evaluating stages of the DNP project process. The pilot program included workshops and individual consulting sessions provided to the student aimed at reducing fatal flaws and improving research design and evaluation analyses.

OUTCOMES: Initial and follow-up surveys were adapted from the Course Experience Questionnaire to assess student satisfaction and perceived knowledge gains. Project rigor and value were assessed using the DNP-Project Critical Appraisal Tool (PCAT).

CONCLUSIONS: The pilot program showed a decrease in the number of fatal flaws and an increase in PCAT scores on the targeted Design and Evaluation sections.

PMID:35926107 | DOI:10.1097/NNE.0000000000001264

Ann Am Thorac Soc. 2022 Aug 4. doi: 10.1513/AnnalsATS.202204-328OC. Online ahead of print.

ABSTRACT

RATIONALE: Historically sarcoidosis was described as a restrictive lung disease, but several alternative phenotypes of pulmonary function have been observed. Pulmonary function phenotypes in sarcoidosis may represent different clinical and/or molecular phenotypes.

OBJECTIVE: To characterize the prevalence of different pulmonary function phenotypes in a large and diverse sarcoidosis cohort from a tertiary care referral center.

METHODS: We identified individuals seen between 2005-2015 with a confirmed diagnosis of sarcoidosis. Data were collected from the first pulmonary function test (PFT) performed at our institution which included spirometry and diffusing capacity (DLCO). Demographics and clinical data were collected. Chi-squared analyses and multiple linear regressions were done to assess statistical differences and associations. Global Lung Function Initiative equations were used to calculate percent predicted measurements for spirometry and DLCO.

RESULTS: Of 602 individuals with sarcoidosis, 93% (562) had pulmonary involvement, 64% (385) were female, and 57% (341) were Black. Of those with pulmonary involvement, 56% had abnormal pulmonary function. Lung function impairment phenotypes included: 47% restriction, 22% obstruction, 15% isolated reduction in DLCO, and 16% combined obstructive restrictive phenotype. Restriction was the most common PFT phenotype among Black individuals (41%), while no lung impairment was most common among White individuals (66%) (p<0.001). Males more frequently had obstruction (19%) compared to females (9%) p=0.001, and females had more restriction (30%) compared to males (21%) p=0.031.

CONCLUSIONS: Among individuals with sarcoidosis and pulmonary function impairment, less than half demonstrated a restrictive phenotype. There were significant differences in pulmonary function phenotypes by race and sex.

PMID:35926103 | DOI:10.1513/AnnalsATS.202204-328OC

Dentomaxillofac Radiol. 2022 Aug 4:20220166. doi: 10.1259/dmfr.20220166. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to determine the normal range of masseter muscle thickness by ultrasonographic measurement in individuals over 15 years of age, and to evaluate its relationship with age, gender, facial morphology, body mass index and parafunctional habits.

METHODS: The study was conducted on 115 volunteers whose lateral cephalometric radiography was performed within the indication in Gazi University Faculty of Dentistry, Department of Dentomaxillofacial Radiology. The participants in the study were asked questions about their parafunctional habits, age, height and weight. Individuals were grouped as hypodivergent (n = 28), normdivergent (n = 55), or hyperdivergent (n = 32) according to vertical face morphology by making measurements on lateral cephalometric films. Right and left masseter muscle thicknesses of individuals were measured by ultrasonography while at rest and in contraction.

RESULTS: The mean value of masseter muscle thickness was found to be 13.57 ± 2.57 mm. The rest and contracted muscle thicknesses were significantly higher in males than in females for the right and left masseter muscles (p < 0.05). When the masseter muscle was at rest and contracted, its thickness was higher in individuals with hypodivergent facial morphology, than in the other groups. No statistically significant difference was found in terms of masseter muscle thickness between individuals having parafunctional habits and those who did not have parafunctional habits (p > 0.05).

CONCLUSION: Although masseter muscle thickness varied according to vertical facial morphology, this was not the case for parafunctional habits.

PMID:35926082 | DOI:10.1259/dmfr.20220166

Invest Radiol. 2022 Aug 2. doi: 10.1097/RLI.0000000000000905. Online ahead of print.

ABSTRACT

OBJECTIVES: In spinal cord injury (SCI), the primary mechanical injury is followed by secondary sequelae that develop over the subsequent months and manifests in biochemical, functional, and microstructural alterations, at the site of direct injury but also in the spinal cord tissue above and below the actual lesion site. Noninvasive magnetic resonance spectroscopy (MRS) can be used to assess biochemical modulation occurring in the secondary injury phase, in addition to and supporting conventional MRI, and might help predict and improve patient outcome. In this article, we aimed to examine the metabolic levels in the pons of subacute SCI by means of in vivo proton MRS at 3 T and explore the association to clinical scores.

MATERIALS AND METHODS: In this prospective study, between November 2015 and February 2018, single-voxel short-echo MRS data were acquired in healthy controls and in SCI subjects in the pons once during rehabilitation. Besides the single-point MRS examination, in addition, in participants with SCI, the clinical status (ie, motor, light touch, and pinprick scores) was assessed twice: (1) around the MRS session (approximately 10 weeks postinjury) and (2) before discharge (at approximately 9 months postinjury). The group differences were assessed with Kruskal-Wallis test, the post hoc comparison was assessed with Wilcoxon rank sum test, and the clinical correlations were conducted with Spearman rank correlation test. Bayes factor calculations completed the statistical part providing relevant evidence values.

RESULTS: Twenty healthy controls (median age, 50 years; interquartile range, 41-55 years; 18 men) and 18 subjects with traumatic SCI (median age, 50 years; interquartile range, 32-58 years; 16 men) are included. Group comparison showed an increase of total N-acetylaspartate and combined glutamate and glutamine levels in complete SCI and a reduction of total creatine in incomplete paraplegic SCI. The proton MRS-based glutathione levels at baseline correlate to the motor score improvement during rehabilitation in incomplete subacute SCI.

CONCLUSIONS: This exploratory study showed an association of the metabolite concentration of glutathione in the pons assessed at approximately 10 weeks after injury with the improvements of the motor score during the rehabilitation. Pontine glutathione levels in subjects with traumatic subacute incomplete SCI acquired remote from the injury site correlate to clinical score and might therefore be beneficial in the rehabilitation assessments.

PMID:35926077 | DOI:10.1097/RLI.0000000000000905

PLoS One. 2022 Aug 4;17(8):e0272165. doi: 10.1371/journal.pone.0272165. eCollection 2022.

ABSTRACT

BACKGROUND: Pre-eclampsia can be described as new-onset hypertension (blood pressure ≥140/90 mmHg) together with proteinuria (24-hr urinary protein ≥ 0.3 g) or any indication of end-organ damage after 20 weeks of gestation. Liver and kidney dysfunction, thrombocytopenia, pulmonary edema, and neurologic dysfunction are common manifestations of end-organ damage due to pre-eclampsia. Pre-eclampsia is the most common cause of liver and kidney dysfunction due to hypoxia and endothelial dysfunction. Hyperuricemia indicates kidney dysfunction and is considered a predictor of the severity of preeclampsia. Therefore, the objective of this study is to evaluate the utility of the levels of serum uric acid and liver function tests [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] as biomarkers of preeclampsia-related organ damage.

METHODS AND MATERIALS: An institutional-based comparative cross-sectional study design was conducted, and a total of 102 subjects (51 patients with preeclampsia and 51 normotensive pregnant women) were recruited. The parameters measured were levels of serum uric acid and liver function tests.

RESULTS AND DISCUSSION: There were statistically significant differences in the mean serum uric acid, ALT, and AST levels between preeclamptic pregnant women and normotensive pregnant women (p<0.05). There were no statistically significant differences in the mean total and direct bilirubin levels. There was also a significant difference in mean serum uric acid, alanine transaminase, and aspartate transaminase levels across different gestational age categories.

CONCLUSION: Our study revealed that serum uric acid, ALT, and AST levels were higher in pre-eclamptic pregnant women compared to those of normotensive pregnant women, and the differences were statistically significant. As such, serum uric acid and liver function tests may be considered biomarkers of pre-eclampsia-related end-organ damage.

PMID:35926005 | DOI:10.1371/journal.pone.0272165

PLoS One. 2022 Aug 4;17(8):e0272651. doi: 10.1371/journal.pone.0272651. eCollection 2022.

ABSTRACT

AIMS: This study aimed to examine the association between mental health problems and health-related quality of life (HrQoL) among in-school adolescents 13-19 years in the Harari region, eastern Ethiopia.

MATERIALS AND METHODS: A cross-sectional study was conducted on 3227 in-school adolescents aged 13 to 19 using multistage sampling. The KIDSCREEN-10 questionnaire assessed health-related quality of life (HrQoL), while a self-administered version of the strength and difficulty questionnaire (SDQ) examined mental health issues. Data were double entered, validated, and cleaned using EpiData version 3.1 and analyzed using STATA 14.1. An ordinal logistic regression model investigated the link between the outcome variable and the predictors. The results were reported using an odds ratio with a 95% confidence interval (CI), and a p-value of less than 0.05 was considered statistically significant.

RESULTS: A quarter of the adolescents (23%) reported poor health-related quality of life; adolescents with internalizing and externalizing mental health problems had the lowest health-related quality of life. After controlling for potential confounders, adolescents with abnormal (AOR = 0.48, 95% CI: 0.39, 0.59) and borderline (AOR = 0.59, 95% CI: 0.45, 0.78) levels of internalizing problems had a 52% and 41% lower probability of having high HrQoL than those with normal levels. Furthermore, individuals with abnormal (AOR = 0.59, 95% CI: 0.45, 0.77) and borderline (AOR = 0.64, 95% CI: 0.45, 0.92) levels of externalizing difficulties had a 41% and 36% lower chance of having a high health-related quality of life.

CONCLUSIONS: Nearly a quarter of in-school adolescents had poor health-related quality of life. High scores for internalizing and externalizing mental health problems significantly impacted the adolescents’ health-related quality of life. This emphasizes the need to address mental health issues in the school setting to improve adolescents’ overall quality of life.

PMID:35925999 | DOI:10.1371/journal.pone.0272651