Nevin Manimala

PLoS One. 2022 Nov 22;17(11):e0277875. doi: 10.1371/journal.pone.0277875. eCollection 2022.

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, healthcare workers had a high workload and were exposed to multiple psychosocial stressors. However, a knowledge gap exists about the levels of burnout among Bangladeshi frontline doctors during this COVID-19 pandemic. The study investigated burnout syndrome (BOS) among frontline doctors in two public secondary and tertiary care hospitals in Chattogram, Bangladesh.

MATERIALS & METHODS: This cross-sectional study involved frontline doctors working at two hospitals treating COVID-19 and non-COVID patients from June to August 2020. A self-administered questionnaire that included Maslach Burnout Inventory for Human Services Survey (MBI-HSS) was used to capture demographic and workplace environment information. ANOVA and t-test were used to determine the statistical differences in the mean values of the three dimensions of MBI-HSS. Scores for three domains of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were calculated. Post-hoc analysis was done to identify the significant pair-wise differences when the ANOVA test result was significant. Multiple logistic regression was performed to determine the influence of factors associated with BOS.

RESULTS: A total of 185 frontline doctors were invited to participate by convenience sampling, and 168 responded. The response rate was 90.81%. The overall prevalence of BOS was 55.4% (93/168) (95% CI: 47.5% to 63.0%). Moderate to high levels of EE was found in 95.8% of the participants. High DP and reduced PA were observed in 98.2% and 97% of participants. Younger age (25-29 years), being female, and working as a medical officer were independently associated with high levels of burnout in all three domains. EE was significantly higher in females (P = 0.011). DP was significantly higher in medical officers, those at earlier job periods, and those working more than 8 hours per day.

CONCLUSION: During the COVID-19 outbreak, BOS was common among Bangladeshi frontline doctors. Females, medical officers, and younger doctors tended to be more susceptible to BOS. Less BOS was experienced when working in the non-COVID ward than in the mixed ward.

PMID:36413560 | DOI:10.1371/journal.pone.0277875

PLoS One. 2022 Nov 22;17(11):e0277678. doi: 10.1371/journal.pone.0277678. eCollection 2022.

ABSTRACT

OBJECTIVE: To evaluate the sleep quality by self-reported questionnaires and polysomnography (PSG) among early kidney transplant recipients (KTRs) and to further explore their correlation.

DESIGN: This was a prospective and cross-sectional analysis of the sleep characteristics among early kidney transplant recipients through an objective and subjective measurement.

PARTICIPANTS: Patients with end stage renal disease on the transplant waiting list and after kidney transplantation were from a major organ transplantation center in Southern China (n = 83).

PRIMARY AND SECONDARY OUTCOME MEASUREMENTS: Objective outcomes: PSG, noise and light. Subjective outcomes: demographic and clinical questionnaires, self-reported pain and Richards Campbell sleep questionnaire (RCSQ). After agreement with the informed consent, participants first completed demographic and clinical questionnaires, then worn the PSG within 5-10 days after kidney transplantation. Both noise, light and self-reported pain were monitored during sleep. After completion of PSG, the RCSQs were filled out next morning.

RESULTS: A total of 298 patients were recruited and 83 participants were finally analyzed. The total RCSQ mean score was 51.0±18.9mm. The prevalence of poor sleep quality among early KTRs was 45.1%. Most of PSG characteristics were significantly correlated with their corresponding RCSQ items. And the total RCSQ scores were significantly correlated with the number of awakenings, the N2 percentage and the total sleep time (r = 0.79, 0.47 and 0.40, P<0.05) respectively. Noise was a statistically significant factor affecting the subjective sleep quality.

CONCLUSIONS: The sleep quality in early KTRs measured by both PSG and RCSQ exhibits consistency with each other. Sleep disruption always remains a substantial problem and is affected by self-reported noise among early KTRs. The RCSQ is easily applicable and interpretable so that it can be used for future daily clinical practice.

PMID:36413558 | DOI:10.1371/journal.pone.0277678

PLoS One. 2022 Nov 22;17(11):e0278029. doi: 10.1371/journal.pone.0278029. eCollection 2022.

ABSTRACT

Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9-12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32-9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58-9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03-2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12-2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48-4.64). The findings indicate that public policies-including vaccination, early diagnosis, harm reduction strategies, and adequate treatment-should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.

PMID:36413542 | DOI:10.1371/journal.pone.0278029

PLoS Biol. 2022 Nov 22;20(11):e3001809. doi: 10.1371/journal.pbio.3001809. eCollection 2022 Nov.

ABSTRACT

This Formal Comment uses re-analysis after appropriate corrections to claim that the extreme decline effect reported by Clements et al. is a statistical artefact caused by the way they corrected for zeros in percentage data, exacerbated by errors in data compilation, selective data inclusions and missing studies with strong effects.

PMID:36413526 | DOI:10.1371/journal.pbio.3001809

Vascular. 2022 Nov 22:17085381221141118. doi: 10.1177/17085381221141118. Online ahead of print.

ABSTRACT

BACKGROUND: Endovascular aortic aneurysm repair (EVAR) has become the standard procedure for treating infrarenal abdominal aortic aneurysms (AAA). Various associated complications can lead to open conversion (OC). Thorough follow-up after the procedure is mandatory for the early detection of complications. Persisting perfusion of the aneurysm, a so-called endoleak (EL), paired with structural instability because of aortic wall atrophy and impaired cell functionality induced by EVAR, results in a high risk for aortic rupture.

PURPOSE: The goal of this study was to detect the risk factors for elective and urgent OC as a result of EVAR-induced pathophysiological changes inside the aortic wall.

RESEARCH DESIGN: Retrospective data analysis was performed on all open aortic repairs from January 2016 to December 2020.

DATA COLLECTION AND ANALYSIS: Fifty patients were identified as treated by OC for failure of an infrarenal EVAR. The patients were divided into two subgroups, here depending on the urgency of surgery. Statistical analysis of patient characteristics and outcomes was performed.

RESULTS: The most common indications for OC were various types of EL (74%), resulting in an aortic rupture in 15 patients. Patients with insufficient or absent follow-up were treated more frequently in an emergency setting (16% vs. 63%). The mortality rate was higher in cases of emergency OC (3% vs. 26%).

CONCLUSIONS: Particularly in cases of insufficient or absent follow-up, complications such as EL pose an enormous risk for fatal aortic rupture.

PMID:36413465 | DOI:10.1177/17085381221141118

Int Forum Allergy Rhinol. 2022 Nov 22. doi: 10.1002/alr.23115. Online ahead of print.

ABSTRACT

BACKGROUND: The effect of nasal airway surgery on olfaction has not been well established. The goal of this study is to assess changes in olfaction after septoplasty with inferior turbinate reduction through both objective and patient-reported measures.

METHODS: Prospective, observational study of patients with nasal airway obstruction presenting between July 2017 and October 2019 who underwent septoplasty with inferior turbinate reductions. Nasal airflow was characterized with a Nasal Obstruction Symptom Evaluation (NOSE) scale and an 11-point Ease-of-Breathing (EOB) Likert scale and olfaction was assessed with an 11-point Olfactory Likert Scale and a 40 item University of Pennsylvania Smell Identification Test (UPSIT-40), pre- and post-operatively. Pearson correlations were used to assess the relationship between measures of nasal obstruction and olfaction.

RESULTS: Among 80 patients, mean NOSE scores improved from 67.4 preoperatively to 19.6 postoperatively (p<0.001). EOB Likert scores improved from a mean of 3.9/10 to 8.1/10 after surgery (p<0.001). Olfactory Likert scores improved from a baseline of 6.1/10 pre-operatively to 7.9/10 after surgery (p<0.001). No statistically significant difference was noted in UPSIT testing pre and post-operatively. A moderate correlation was noted between degree of change in NOSE scores and improved olfactory Likert scores (r = 0.51, p<0.001) and between the degree of change in EOB Likert scores and improved olfactory Likert scores (r = 0.55, p<.0001).

CONCLUSIONS: Based on our data, subjective tests of olfaction may improve with nasal airway surgery in some patients. Changes in olfaction best correlate with the extent to which surgery can improve subjective nasal obstructive symptoms. This article is protected by copyright. All rights reserved.

PMID:36413461 | DOI:10.1002/alr.23115

Cancer Epidemiol Biomarkers Prev. 2022 Nov 22:EPI-22-0253. doi: 10.1158/1055-9965.EPI-22-0253. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the success of smoking cessation campaigns, lung cancer remains the leading cause of cancer death in the United States. Variations in smoking behavior and lung cancer mortality are evident by sex and region.

METHODS: Applying geospatial methods to lung cancer mortality data from the National Vital Statistics System and county-level estimates of smoking prevalences from the National Cancer Institute’s Small Area Estimates of Cancer-Related Measures, we evaluated patterns in lung cancer mortality rates (2005-2018) in relation to patterns in ever cigarette smoking prevalences (1997-2003).

RESULTS: Overall, ever smoking spatial patterns were generally associated with lung cancer mortality rates, which were elevated in the Appalachian region and lower in the West for both sexes. However, we also observed geographic variation in mortality rates that is not explained by smoking. Using Lee’s L statistic for assessing bivariate spatial association, we identified counties where the ever smoking prevalence was low and lung cancer rates were high. We observed a significant cluster of counties (n=25; p-values ranging from 0.001 to 0.04) with low ever smoking prevalence and high mortality rates among females around the Mississippi River region south of St. Louis, Missouri and a similar and smaller cluster among males in Western Mississippi (n=12; p-values ranging from 0.002 to 0.03) that has not been previously described.

CONCLUSIONS: Our analyses identified U.S. counties where factors other than smoking may be driving lung cancer mortality Impact: These novel findings highlight areas where investigation of environmental and other risk factors for lung cancer is needed.

PMID:36413442 | DOI:10.1158/1055-9965.EPI-22-0253

Can J Diet Pract Res. 2022 Nov 22:1-5. doi: 10.3148/cjdpr-2022-027. Online ahead of print.

ABSTRACT

Ultra-processed foods (UPFs) have become a major contributor to the diets of Canadians, with a recent report from Statistics Canada suggesting Canadians are consuming almost one-half of their calories from UPFs. Research has linked UPF consumption with increased risk for chronic diseases such as cardiovascular disease and type 2 diabetes, among others. This paper sought to investigate the popularity of UPFs, particularly among children and teens, utilizing the socioecological model as a framework to illustrate how influences at multiple levels (i.e., public policy, organizational, community, interpersonal, and individual) have played a role in the proliferation of UPFs. Evidence from previous studies is used to identify how factors at different levels may influence UPF consumption and discuss potential strategies for reducing UPF consumption. To meaningfully reduce UPF consumption among Canadians, all levels should be considered, with the goal of creating a healthier Canadian population.

PMID:36413422 | DOI:10.3148/cjdpr-2022-027

Crit Pathw Cardiol. 2022 Dec 1;21(4):194-200. doi: 10.1097/HPC.0000000000000295. Epub 2022 Jun 22.

ABSTRACT

INTRODUCTION: Atrial fibrillation (AF) recurrence after a successful external electrical cardioversion (ECV) is common. Assessing an individual’s risk of AF recurrence is a critical part of the treatment plan. We aimed to develop a prognostic prediction score to predict AF recurrence in AF patients who underwent successful ECV.

METHODS: A retrospective cohort study that included AF patients who underwent successful ECV was conducted with a primary outcome of AF recurrence at 6 months. Logistic regression analysis was done to identify variables, and a prognostic prediction score was created and internally validated.

RESULTS: Four prognostic predictors were identified, including the type of AF, persistent AF (1 point) and long-standing persistent AF (4 points), previous cardioversion (1 point), stroke/transient ischemic attack (3 points), and left atrial volume index ≥40 mL/m2 (6 points). The total score of 14 was further divided into 3 risk groups; low-risk (0-2 points), moderate-risk (3-7 points), and high-risk (8-14 points). The positive likelihood ratio for a moderate-risk patient was 2.08 (95% CI, 1.64-2.63) and for a high-risk patient was 7.90 (95% CI, 2.48-25.17). The score showed good discrimination power with the c-statistic of 0.74 (95% CI, 0.69-0.79).

CONCLUSIONS: A simple prognostic prediction score for AF recurrence after successful ECV was created with a promising internally validated discrimination power. An external assessment of its usefulness as a tool to identify patients with low, moderate, and high risk for AF recurrence is warranted.

PMID:36413399 | DOI:10.1097/HPC.0000000000000295

Crit Pathw Cardiol. 2022 Dec 1;21(4):191-193. doi: 10.1097/HPC.0000000000000298. Epub 2022 Oct 14.

ABSTRACT

BACKGROUND: Obesity is a risk factor for cardiovascular disease. The goal of this study was to evaluate any association between aortic valve disease and obesity using a very large database.

METHODS: The Nationwide Inpatient Sample database was utilized for statistical analysis using ICD-9 codes for aortic valve disease and obesity in the United States from 2003 to 2007. A 25% random sample of nonobese patients was used for comparison of aortic valve disease prevalence during the same 5-year period.

RESULTS: A total of 1,971,812 patients with obesity were identified from 2003 to 2007. Comparing this population with a random sample of nonobese patients during the same years, there was no significant difference between obese and nonobese patients in regards to the prevalence of aortic valve disease (1.1-1.2% in 2003 and 2004, 1.2% in 2005-2007, P = NS). After adjusting for age, gender, and race, obesity was associated with lower prevalence of aortic valve disease in 2003-2007 (odds ratio 0.81-0.86, P < 0.01).

CONCLUSIONS: Using a very large database, we found a decrease in the prevalence of aortic valve disease in the obese population. This suggests that obesity alone does not pathologically affect the aortic valve.

PMID:36413398 | DOI:10.1097/HPC.0000000000000298