Nevin Manimala

AJOB Empir Bioeth. 2023 Apr 19:1-11. doi: 10.1080/23294515.2023.2201479. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the bourgeoning of digital tools for bioethics research, education, and engagement, little research has empirically investigated the impact of interactive visualizations as a way to translate ethical frameworks and guidelines. To date, most frameworks take the format of text-only documents that outline and offer ethical guidance on specific contexts. This study’s goal was to determine whether an interactive-visual format supports frameworks in transferring ethical knowledge by improving learning, deliberation, and user experience.

METHODS: An experimental comparative study was conducted with a pre-, mid-, and post-test design using the online survey platform Qualtrics. Participants were university based early-stage health researchers who were randomly assigned to either the control condition (text-only document) or the experimental condition (interactive-visual). The primary outcome variables were learning, (measured using a questionnaire), deliberation (using cases studies) and user experience (measured using the SED/UD Scale). Analysis was conducted using descriptive statistics and mixed-effects linear regression.

RESULTS: Of the 80 participants, 44 (55%) used the text-only document and 36 (45%) used the interactive-visual. Results of the knowledge-test scores showed a statistically significant difference between participants’ post-test scores, indicating that the interactive-visual format better supported understanding, acquisition, and application of the framework’s knowledge. Findings from the case studies showed both formats supported ethical deliberation. Results further indicated the interactive-visual provided an overall better episodic and remembered user experience compared with the text-only document.

CONCLUSIONS: Our findings show that ethical frameworks formatted with interactive and visual qualities provide a more pleasing user experience and are effective formats for ethics learning and deliberation. These findings have implications for practitioners developing and deploying ethical frameworks and guidelines (e.g., in educational or employee-onboarding settings), in that the knowledge generated can lead to more effective dissemination practices of normative guidelines and health data ethics concepts.

PMID:37074681 | DOI:10.1080/23294515.2023.2201479

Environ Sci Pollut Res Int. 2023 Apr 19. doi: 10.1007/s11356-023-26511-6. Online ahead of print.

ABSTRACT

The significant increase in the human population and the associated industrial wastes have a widespread impact on coastal areas. It is important to monitor trace elements that affect food safety and pose a potential consumer health threat. All over the Black Sea coast, people enjoy consuming whiting as both meat and roe. In February 2021, whitings were caught by bottom trawling from four different locations on the coasts of Kastamonu, Sinop (Sarıkum, Adabaşı), and Samsun in the southern Black Sea region. The meat and roe extracts obtained from whiting samples were analyzed through an optical emission spectrophotometer (ICP-MS). Trace element concentrations of whiting meat and roe in this study were Zn > Fe > Sr > As > Al > Se > B > Mn > Cu > Hg > Li > Ni > Ba > Pb > Cr > Cd and Zn > Fe > Al > As > Cu > Sr > Mn > Se > B > Ba > Li > Ni > Hg > Cr > Pb > Cd, respectively. These amounts were lower than the acceptable values accepted by the EU Commission. In case of whiting and roe consumption of a maximum of three portions (860.33 g) for Adabaşı, six portions for Kastamonu (1432.37 g), three portions for Samsun (828.55 g), and five portions (1253.04 g) for Sarıkum per month do not pose a health risk.

PMID:37074608 | DOI:10.1007/s11356-023-26511-6

Environ Sci Pollut Res Int. 2023 Apr 19. doi: 10.1007/s11356-023-26865-x. Online ahead of print.

NO ABSTRACT

PMID:37074602 | DOI:10.1007/s11356-023-26865-x

Odontology. 2023 Apr 19. doi: 10.1007/s10266-023-00814-z. Online ahead of print.

ABSTRACT

To investigate the effect of ELVAX polymer subgingival implants incorporated with echistatin peptide on incisor reimplanted tooth in rats. Forty-two male Wistars rats were divided into two groups: echistatin-treated rats (E) and control rats (C). The animals had their right maxillary incisors extracted and treated according to the International Association of Dental Traumatology replantation protocol. The extra-alveolar dry period was 30 and 60 min, and the post-surgical experimental periods were 15, 60, and 90 days. The samples were stained with H&E and analyzed for the presence of an inflammatory response, incidence of resorptions, and dental ankylosis. Results were statistically analyzed (p < 0.05). The presence of inflammatory resorption was significantly higher in group C at 30 and 60 min extra-alveolar time, in the 15-day postoperative period as compared with the E group (p < 0.05). Dental ankylosis was significantly more prevalent in group E in 30 min extra-alveolar time and 15 days postoperative period (p < 0.05). However, in 60 min extra-alveolar time and 60 days postoperative period, dental ankylosis was more prevalent in C group (p < 0.05). The use of ELVAX subgingival implants with echistatin demonstrated therapeutic potential in preventing the experimental resorption process after replantation of maxillary incisors in rats.

PMID:37074599 | DOI:10.1007/s10266-023-00814-z

Eur Geriatr Med. 2023 Apr 19. doi: 10.1007/s41999-023-00779-w. Online ahead of print.

ABSTRACT

INTRODUCTION: Functional status is one of the most important issues of geriatric care. Polypharmacy seems to be a modifiable factor associated with functional decline in older adults. However, the impact of pharmacotherapy optimization on the activities of daily living in patients undergoing geriatric rehabilitation has not been investigated prospectively so far.

METHODS: This post hoc analysis of a subsample of the VALFORTA study included individuals only undergoing geriatric rehabilitation with a length of in-hospital stay of at least 14 days. Medication was modified according to the FORTA rules in the intervention group while in the control group standard drug treatment was applied. Both groups received comprehensive geriatric treatment.

RESULTS: The intervention and control groups consisted of 96 and 93 individuals respectively. They did not differ according to basic data except for age and Charlson Comorbidity Index (CCI) on admission. On discharge, activities of daily living (Barthel index, BI) were improved in both groups. An increase of at least 20 points of the BI was observed in 40% of patients in the intervention group and in 12% of patients in the control group (p< 0.001). Logistic regression analysis with an increase of at least 20 BI-points was significantly and independently associated with patient group (2.358, p< 0.02), BI on admission (0.957, p< 0.001), and the CCI (0.793, p< 0.041).

CONCLUSION: This post hoc analysis of a subsample of older individuals hospitalized for geriatric rehabilitation demonstrates a significant additional improvement in activities of daily living by modification of medication according to FORTA.

REGISTRATION: DRKS-ID: DRKS00000531.

PMID:37074562 | DOI:10.1007/s41999-023-00779-w

Eur Geriatr Med. 2023 Apr 19. doi: 10.1007/s41999-023-00781-2. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim was to determine the incidence of intracranial hemorrhage (ICH) after mild traumatic brain injury (mTBI) in patients aged ≥ 65 years. The secondary aim was to identify risk factors for intracranial lesions and evaluate the need for in-hospital observation in this age group.

METHODS: This observational retrospective single-center study included all patients aged ≥ 65 years who were referred to our clinic for oral and plastic maxillofacial surgery following mTBI over a five-year period. Demographic and anamnesis data, clinical and radiological findings, and treatment were analyzed. Acute and delayed ICH and patient outcomes during hospitalization were evaluated using descriptive statistical analysis. A multivariable analysis was performed to find associations between CT findings and clinical data.

RESULTS: A total of 1,062 patients (55.7% male, 44.2% female) with a mean age of 86.3 years were included in the analysis. Ground-level fall was the most frequent cause of trauma (52.3%). Fifty-nine patients (5.5%) developed an acute traumatic ICH, and 73 intracerebral lesions were radiologically observed. No association was detected between ICH rate and antithrombotic medication (p = 0.4353). The delayed ICH rate was 0.09% and the mortality rate was 0.09%. Significant risk factors for increased ICH were a Glasgow Coma Scale score of < 15, loss of consciousness, amnesia, cephalgia, somnolence, dizziness, and nausea according to multivariable analysis.

CONCLUSION: Our study showed a low prevalence of acute and delayed ICH in older adults with mTBI. The ICH risk factors identified here should be considered when revising guidelines and developing a valid screening tool. Repeat CT imaging is recommended in patients with secondary neurological deterioration. In-hospital observation should be based on an assessment of frailty and comorbidities and not on CT findings alone.

PMID:37074561 | DOI:10.1007/s41999-023-00781-2

Endocrine. 2023 Apr 19. doi: 10.1007/s12020-023-03363-1. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of combination treatment with levothyroxine (LT4) and l- triiodothyronine (LT3) on left atrial volume (LAV), diastolic functions, and atrial electro-mechanical delays in LT4-treated women with low triiodothyronine (T3) levels.

METHODS: This prospective study consisted of 47 female patients between 18 and 65 years old treated at an Endocrinology and Metabolism outpatient clinic between February and April 2022 due to primary hypothyroidism. The study included patients with persistently low T3 levels in at least three measurements, despite LT4 treatment (1.6-1.8 mcg/kg/m²) for 23.13 ± 6.28 months with normal thyrotropin (TSH) and free tetraiodothyronine (fT4) levels. The combination therapy dose was as follows: the fixed LT4 dose (25 mcg) was removed from patients’ usual LT4 treatment [100 mcg (min-max, 75-150)], and a fixed LT3 dose (12.5 mcg) was added. Biochemical samples were taken, and an echocardiographic assessment was performed for patients upon their first admission, and after 195.5 ± 12.8 days of receiving LT3 (12.5 mcg) treatment.

RESULTS: There was a statistically significant reduction at left ventricle (LV) end-systolic diameter (27.69 ± 3.14, 27.13 ± 2.89, p = 0.035), left atrial (LA) maximum volume (14.73 ± 3.22, 13.94 ± 3.15, p = 0.009), LA minimum volume (7.84 ± 2.45, 6.84 ± 2.30, p < 0.001), LA vertical diameter (44.08 ± 6.92, 34.60 ± 4.31, <0.001), LA horizontal diameter (45.65 ± 6.88, 33.43 ± 4.51, p < 0.001), LAVI (50.73 ± 18.62, 41.0 ± 13.02, p < 0.001), total conduction time (103.69 ± 12.70, 79.82 ± 18.40, p < 0.001) after LT3 replacement (respectively pre-post- treatment and p value).

CONCLUSION: In conclusion, the findings of this study suggest that the addition of LT3 to LT4 treatment may lead to improvements in LAVI and atrial conduction times in patients with low T3. However, further research with larger patient groups and exploration of different LT4 + LT3 dose combinations is needed to better understand the effects of combined hypothyroidism treatment on cardiac functions.

PMID:37074560 | DOI:10.1007/s12020-023-03363-1

J Psycholinguist Res. 2023 Apr 19. doi: 10.1007/s10936-023-09944-5. Online ahead of print.

ABSTRACT

The prominent role of allophonic cues in English speech segmentation has widely been recognized by phonologists and psycholinguists. However, very meager inquiry was devoted to analysing the perception of these noncontrastive allophonic cues by Arab EFL learners. Accordingly, the present study is an attempt to examine the exploitation of allophonic cues, mainly aspiration, glottalization and approximant devoicing to English word junctures by 40 Jordanian PhD students. Moreover, it aims to find out which allophonic cues are perceived more accurately during the segmentation process and if there is any evidence for Universal Grammar markedness. The experiment is led through a forced-choice identification task adopted from Altenberg (Second Lang Res 21:325-358, 2005) and Rojczyk et al. (Res Lang 1:15-29, 2016). The results of ANOVA unveiled that there is a statistically significant difference between the three types of allophonic cues, viz. aspiration, glottalization and approximant devoicing. This implies that the participants outperformed in stimuli marked by glottalization than by aspiration and approximant devoicing. This result provided further evidence for the universality of glottalization as a boundary cue in English speech segmentation. Overall, the Jordanian PhD students failed in perceiving the allophonic cues accurately and exploiting them to detect word boundaries. The present inquiry has the potential to provide several recommendations for syllabus designers, and second/foreign language teachers and learners.

PMID:37074538 | DOI:10.1007/s10936-023-09944-5

J Clin Monit Comput. 2023 Apr 19. doi: 10.1007/s10877-023-01010-8. Online ahead of print.

ABSTRACT

The integration of illness severity and organ dysfunction scores into clinical practice, including the APACHE II and SOFA scores, has been challenging due to constraints associated to manual score calculation. With electronic medical records (EMR), score calculation automation using data extraction scripts has emerged as a solution. We aimed to demonstrate that APACHE II and SOFA scores calculated with an automated EMR-based data extraction script predict important clinical endpoints. In this retrospective cohort study, every adult patient admitted to one of our three ICUs, between July 1, 2019, and December 31, 2020, were enrolled. For every patient, an automated ICU admission APACHE II score was calculated using EMR data and minimal clinician input. Fully automated daily SOFA scores were calculated for every patient. 4 794 ICU admissions met our selection criteria. Of these ICU admissions, 522 deaths were recorded (10.9% in-hospital mortality rate). The automated APACHE II was discriminant for in-hospital mortality (AU-ROC = 0.83 (95% CI 0.81-0.85)). We observed an association between the APACHE II score and ICU LOS, with a statistically significant mean increase of 1.1 days of ICU LOS (1.1 [1-1.2]; p = < .0001) for each 10 units increase in APACHE score. SOFA score curves did not discrimate significantly between survivors and non-survivors. A partially automated APACHE II score, calculated with real-world EMR data using an extraction script, is associated with in-hospital mortality risk. The automated APACHE II score could potentially constitute an acceptable surrogate of ICU acuity to be used in resource allocation and triaging, especially in time of high demand for ICU beds.

PMID:37074523 | DOI:10.1007/s10877-023-01010-8

Int J Clin Pharm. 2023 Apr 19. doi: 10.1007/s11096-023-01569-x. Online ahead of print.

ABSTRACT

BACKGROUND: Topical Janus kinase (JAK) inhibitors are being developed for the treatment of mild to moderate atopic dermatitis. However, comparative evidence on their safety profiles is still limited.

AIM: This study aimed to compare the relative safety of topic JAK inhibitors in patients with atopic dermatitis.

METHOD: Phase 2 and 3 clinical trials (RCTs) evaluating the efficacy and safety of topical JAK inhibitors in atopic dermatitis were searched on Medline, EMBASE and clinicaltrials.gov. The following outcomes were considered: any adverse event (AE), serious AEs, AEs leading to treatment discontinuation, any infection, any application site reaction.

RESULTS: Ten RCTs were included in this network meta-analysis. Tofacitinib was associated with a reduced risk of any AE when compared with ruxolitinib (OR 0.18, 95% CrI 0.03-0.92). The analyses for the remaining outcomes did not identify other statistically significant risk differences between the topical JAK inhibitors.

CONCLUSION: Although tofacitinib seems to present a reduced risk of any adverse event compared with ruxolitinib, this was the only statistically significant result found between JAK inhibitors. Therefore, such findings should be interpreted with caution considering the scarce data available and the heterogeneity between the studies, and there is no robust evidence allowing pointing out clinically important differences between the safety profiles of the existing topical JAK inhibitors. Further pharmacovigilance activities are needed to confirm the safety profile of these drugs.

PMID:37074513 | DOI:10.1007/s11096-023-01569-x