Nevin Manimala

Dermatol Ther. 2022 Apr 14:e15513. doi: 10.1111/dth.15513. Online ahead of print.

ABSTRACT

BACKGROUND: Prevalence of onychomycosis increases in patients with psoriasis and that psoriasis predisposes to onychomycosis.

OBJECTIVES: It was aimed to determine the frequency of onychomycosis and responsible pathogens in patients with psoriasis, to reveal their differences compared to the population without psoriasis, and to determine the factors in this study.

METHODS: The study included 81 patients with nail disorder diagnosed with psoriasis. Clinical findings, psoriasis area and severity index (PASI), nail psoriasis severity index (NAPSI) scores, body mass indexes (BMI) and laboratory characteristics were recorded. Mycological examination by direct microscopy and fungal culture was performed both on nails that were considered onychomycosis and on nails with any of the psoriatic nail findings.

RESULTS: The prevalence of onychomycosis was 27.2% in psoriasis patients. Nail involvement of psoriasis was found in 31.3% of the patients using biologic agents, 5.9% of those receiving conventional treatment, and 31.3% of those receiving topical treatment and 68.8% of the patients who did not receive treatment at all. The difference between the patients who did not receive treatment and those who received conventional treatment was significant (p<0.05). There was growth in the fungal culture in 23.5% of the patients with psoriasis. There was no statistically significant relationship between onychomycosis and PASI, NAPSI score and BMI (p>0.05).

CONCLUSIONS: Since the prevalence of onychomycosis in psoriasis patients receiving conventional and anti-TNF-α therapy is higher than in patients not receiving treatment, nail changes in these patients should be evaluated in more detail for the presence of onychomycosis. In addition, since more than one fungal agent can grow and non-dermatophyte molds are seen more frequently in patients with psoriasis, it should be taken into account that native and fungal culture examinations should be performed together.

PMID:35426221 | DOI:10.1111/dth.15513

J Psychiatr Ment Health Nurs. 2022 Apr 14. doi: 10.1111/jpm.12832. Online ahead of print.

ABSTRACT

INTRODUCTION: Participating in physical activity has many benefits, yet those with severe mental illness (SMI) living in forensic settings are less likely to be active, and more likely to experience ill-health. The aim of this study was to systematically review the effectiveness of physical activity programmes on mental and physical health and specifically on reducing symptoms of SMI in forensic settings.

METHOD: A systematic search of six databases was conducted, in addition to a grey literature search. Studies were included if they: had participants with SMI; were based in a forensic setting; involved a physical activity programme; and reported physical and mental health outcomes.

RESULTS: A total of 112 participants were included in four studies. One study showed a significant improvement in negative symptom scores in the exercise group compared to a treatment as usual group. Two studies reported improvements in psychiatric symptoms with no significant difference between groups, however, statistically significant changes in weight and waist circumference were evident (p <0.001). No adverse effects were reported.

CONCLUSION: Only a small number of studies were included and of limited design and quality, with no follow-up assessments, therefore more research is needed to determine the true effects of physical activity for improving SMI symptoms in a forensic setting. This review highlights the need for further studies exploring the barriers and facilitators of physical activity in secure forensic settings. Studies are required that include a more thorough research design. Furthermore, interventions if designed with patients and caring staff in mind may lead to lowered psychiatric symptoms and increased physical health benefits for all in forensic settings.

PMID:35426209 | DOI:10.1111/jpm.12832

J Magn Reson Imaging. 2022 Apr 15. doi: 10.1002/jmri.28193. Online ahead of print.

ABSTRACT

BACKGROUND: Myocardial first-pass perfusion (FPP) imaging is a useful cardiac MRI method for the diagnosis of coronary artery disease. However, conventional 2D multislice FPP acquisitions usually have gaps between myocardium slices, which limits the overall assessment of myocardial ischemia.

PURPOSE: To increase the anatomic coverage of myocardial FPP imaging at 3 T by implementing both autocalibrated multiband (MB) acquisition and k-t space acceleration with compress sensing (CS) reconstruction, without the need for additional reference scans.

STUDY TYPE: Phantom and prospective human studies.

PHANTOM/SUBJECTS: A T1MES (T1 Mapping and ECV Standardization in cardiovascular magnetic resonance) phantom and 20 subjects (12 healthy subjects and 8 patients, 10 males, age 42 ± 16 years).

FIELD STRENGTH/SEQUENCE: A 3 T/saturation recovery prepared gradient echo sequence with contrast administration.

ASSESSMENT: Phantom experiments were performed to compare the performance of autocalibrated MB-FPP with k-t acceleration using slice-GRAPPA and CS reconstructions. In vivo experiments were performed to compare the performance of conventional FPP (2.5× acceleration) with autocalibrated MB + CS-FPP (6× acceleration). In phantom experiments, the error maps were calculated. In in vivo experiments, the contrast ratio (CR) and blurring were quantitatively measured, while image quality, perceived signal-to-noise ratio (SNR), and artifact level were qualitatively graded by three cardiologists on a 4-point scale.

STATISTICAL TESTS: Wilcoxon signed-rank test, paired t-test. A P value <0.05 was considered statistically significant.

RESULTS: In phantom experiments, residual artifact was reduced using the MB + CS-FPP reconstruction method compared with using the MB + slice-GRAPPA reconstruction method. In in vivo experiments, the proposed autocalibrated MB + CS-FPP method demonstrated significantly higher CR (3.52 ± 0.78 vs 2.91 ± 0.81) and had significantly better perceived SNR (2.69 ± 0.29 vs 2.48 ± 0.31) compared to the conventional sequence. Compared with conventional FPP, MB + CS-FPP doubled the spatial coverage (MB + CS-FPP vs conventional FPP) without compromising the image quality (2.69 ± 0.26 vs 2.60 ± 0.30) or increasing the artifact level (2.60 ± 0.26 vs 2.52 ± 0.31).

CONCLUSION: Autocalibrated MB + CS-FPP improved the myocardial coverage and achieved comparable image quality with the same spatial resolution and scan time as conventional FPP and is a promising technique for clinical myocardial perfusion imaging.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.

PMID:35426192 | DOI:10.1002/jmri.28193

J Environ Qual. 2022 Apr 14. doi: 10.1002/jeq2.20349. Online ahead of print.

ABSTRACT

In the U.S. Corn Belt, annual croplands are the primary source of nitrate loading to waterways. Long periods of fallow cause most nitrate loss but there is extreme interannual variability in the magnitude of nitrate loss due to weather. Using mean annual (2001-2018) flow-weighted nitrate-N concentration (mg NO₃^– -N L^-1 ; FWNC), load (kg NO₃^– -N), and yield (kg NO₃^– -N ha^-1 cropland) for 29 watersheds, our objectives were: 1) quantify the magnitude and interannual variability of 5-year moving average FWNC, load, and yield; 2) estimate the probability of measuring 41% reductions in nitrate loss after isolating the effect of weather on nitrate loss by quantifying the interannual variability of nitrate loss in watersheds where there was no trend in 5-year moving average nitrate loss (Iowa targets a 41% nitrate loss reduction from croplands); and 3) identify factors that, in the absence of long-term trends in nitrate loss, best explain the interannual variability in nitrate loss. Averaged across all watersheds, the mean probability of measuring a statistically significant 41% reduction in FWNC across 15 years should it occur was 96%. However, the probabilities of measuring 41% reductions in nitrate load and yield were only 44%, and 32%. Across watersheds, soil organic matter, tile drainage, interannual variability of precipitation, and watershed area accounted for interannual variability in these nitrate loss indices. Our results have important implications for setting realistic timelines to measure nitrate loss reductions against the background of interannual weather variation and can help to target monitoring intensity across diverse watersheds. This article is protected by copyright. All rights reserved.

PMID:35426153 | DOI:10.1002/jeq2.20349

J Med Virol. 2022 Apr 14. doi: 10.1002/jmv.27781. Online ahead of print.

ABSTRACT

BACKGROUND: The risk of herpes zoster (HZ) increases as cell-mediated immunity declines with age. Even though oxidative stress plays a crucial role in the development of HZ, there are few serum biomarkers of the disease’s antioxidant activity. The purpose of this study is to investigate the blood levels of major antioxidants in HZ patients. To the best of our knowledge, it is the first study on this issue in the literature.

METHODS: The serum levels of antioxidants including uric acid (UA), total bilirubin (TBİL), and albumin (ALB), vitamin D levels, and inflammatory markers such as homocysteine (Hcy) and C-reactive protein (CRP) was retrospectively analyzed in 53 patients with HZ and 53 age-and sex-matched healthy controls (HCs). The relationships between these markers and post-herpetic neuralgia (PHN) and the clinical severity of HZ were also evaluated.

RESULTS: Serum levels of UA, TBIL, and ALB in patients with HZ were significantly lower than those in the HCs (P<0.001), while no statistical differences were found in vitamin D levels between the groups. Hcy and CRP levels were significantly increased in HZ patients compared to HCs. Significant differences were observed in the serum levels of UA, Hcy, CRP, and vitamin D in the PHN group versus the non-PHN group (P<0.001). The presence of inflammatory markers was found to be positively related to disease activity. Furthermore, when compared to the mild or moderate clinical types of HZ, these biomarkers were statistically significant in the severe clinical type.

CONCLUSIONS: These results suggest that uncontrolled VZV reactivation, acute nerve damage, and PHN may all be associated with low antioxidant levels. These biomarkers may be a protective factor for HZ, but more research is needed to clarify the underlying mechanism. This article is protected by copyright. All rights reserved.

PMID:35426146 | DOI:10.1002/jmv.27781

Clin Pharmacol Ther. 2022 Apr 14. doi: 10.1002/cpt.2592. Online ahead of print.

ABSTRACT

Use of hypnotics is often associated with next-morning residual effects and a higher risk of motor vehicle accidents. Measuring next-morning effects on driving performance is therefore advised by regulatory agencies. Here, we examined driving performance following administration of daridorexant, a new dual orexin receptor antagonist developed to treat insomnia. Sixty healthy male and female subjects (50 to 79 years of age) were randomized in a placebo- and active-controlled, 4-way cross-over study. Each subject received evening administration of daridorexant 50 and 100 mg, zopiclone 7.5 mg, and placebo, in separate treatment phases of four days. Simulated driving performance was assessed after initial (Day 2) and repeated dosing (Day 5), 9 h post-dose. Standard deviation of the lateral position (SDLP) was the main outcome. On both days, with zopiclone, SDLP increased significantly compared to placebo, which confirmed sensitivity of the simulator. With daridorexant, on Day 2, the placebo-corrected mean (97.5% CI) SDLP increased by 2.19 cm (0.46, 3.93) and 4.43 cm (2.72, 6.15) for 50 and 100 mg, respectively. On Day 5, SDLP values for both daridorexant doses were significantly below the pre-specified threshold of impairment (2.6 cm) and statistically not different from placebo. Daridorexant showed a lower self-rated driving quality and higher effort compared to placebo on Day 2 but not on Day 5. In non-insomnia subjects, daridorexant impaired simulated driving after initial but not after repeated dosing. Subjects should be cautioned about driving until they know how daridorexant affects them.

PMID:35426136 | DOI:10.1002/cpt.2592

Health Serv Res. 2022 Apr 15. doi: 10.1111/1475-6773.13988. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess changes in local economic outcomes before and after rural hospital closures.

DATA SOURCES: Rural hospital closures from January 1, 2005 to December 31, 2018 were obtained from the Sheps Center for Health Services Research. Economic outcomes from this same period were obtained from Bureau of Labor Statistics, Bureau of Economic Analysis, Quarterly Workforce Indicators, U.S. Federal Reserve Economic Data, RAND Corporation state statistics database, U.S. Social Security Administration, and U.S. Census Bureau.

DESIGN: Difference-in-differences study of 2,094 rural counties.

DATA COLLECTION/EXTRACTION: The primary exposure was county-level rural hospital closures. The primary outcomes were county-level unemployment rates; employment-population ratios; labor force participation-population ratios; per capita income; total jobs; health care sector jobs; disability program participation-population ratios; percent of population with subprime credit scores; total filings for bankruptcies per 1,000 population; and population size.

PRINCIPAL FINDINGS: A total of 104 rural counties experienced a hospital closure, compared to 1,990 rural counties that did not. Rural hospital closures were associated with significant reductions in health care sector employment (-13.8%; 95% CI: -22%, -5.6%; p<0.001), but not with changes in any other economic measure. For unemployment rates, employment-population ratios, per capita income, disability program participation-population ratios, and total jobs, we found evidence of adverse trends preceding hospital closures. Findings were robust to adjusting for county-specific time trends, specifying exposure at the commuting zone-level, and using alternate definitions of rurality to define sample counties.

CONCLUSION: With the exception of a decline in jobs within the health care sector, there was no association between rural hospital closures and county-level economic outcomes. Instead, economic conditions were already declining in counties experiencing closures compared to those that did not.

PMID:35426125 | DOI:10.1111/1475-6773.13988

Biometrics. 2022 Apr 15. doi: 10.1111/biom.13679. Online ahead of print.

ABSTRACT

Multivariate time-series (MTS) data are prevalent in diverse domains and often high dimensional. We propose new random projection ensemble classifiers with high-dimensional MTS. The method first applies dimension reduction in the time domain via randomly projecting the time-series variables into some low dimensional space, followed by measuring the disparity via some novel base classifier between the data and the candidate generating processes in the projected space. Our contributions are two-fold: (i) we derive optimal weighted majority voting schemes for pooling information from the base classifiers for multiclass classification, and (ii) we introduce new base frequency-domain classifiers based on Whittle likelihood (WL), Kullback-Leibler divergence (KL), Eigen-Distance (ED) and Chernoff divergence (CH). Both simulations for binary and multiclass problems, and an EEG application demonstrate the efficacy of the proposed methods in constructing accurate classifiers with high-dimensional MTS. This article is protected by copyright. All rights reserved.

PMID:35426119 | DOI:10.1111/biom.13679

Int J Gynaecol Obstet. 2022 Apr 15. doi: 10.1002/ijgo.14218. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of a previous pregnancy and delivery on perineal trauma rates in the subsequent vaginal birth.

METHODS: Retrospective cohort study. The perineal outcomes of secundiparous women with history of previous (first) delivery in one of three categories: failed operative vaginal delivery (FOVD) and second stage emergency caesarean section (EmCS); elective caesarean section (ELCS), and vaginal delivery (VD) with intact perineum, were compared with a control primiparous group.

RESULTS: The percentage OASIs at first vaginal delivery after prior FOVD+EmCS was 17.3%(n=9), 12.9%(n=18) after previous ELCS, and 0.6%(n=9) after prior VD maintaining an intact perineum, compared with 6%(n=1193) in the control primiparous group of women. Multivariate regression analysis demonstrated prior FOVD+EmCS and ELCS were associated with a statistically significant increased risk of OASIs of 180% and 110% when compared to control (odds ratio (OR): 2.80; 95% confidence interval (CI): 1.35-5.78 and OR: 2.10; 95%CI: 1.27-3.48) respectively. Prior VD with intact perineum was associated with a statistically significantly reduced risk of OASIs (OR: 0.09; 95%CI: 0.04-0.17).

CONCLUSIONS: Previous FOVD+EmCS and ELCS were associated with increased risk of OASIs in subsequent vaginal delivery compared to control, whilst previous VD with intact perineum was associated with decreased risk.

PMID:35426118 | DOI:10.1002/ijgo.14218

Atten Percept Psychophys. 2022 Apr 14. doi: 10.3758/s13414-022-02475-6. Online ahead of print.

ABSTRACT

We examined how object categories and scene contexts act in conjunction to structure the acquisition and use of statistical regularities to guide visual search. In an exposure session, participants viewed five object exemplars in each of two colors in each of 42 real-world categories. Objects were presented individually against scene context backgrounds. Exemplars within a category were presented with different contexts as a function of color (e.g., the five red staplers were presented with a classroom scene, and the five blue staplers with an office scene). Participants then completed a visual search task, in which they searched for novel exemplars matching a category label cue among arrays of eight objects superimposed over a scene background. In the context-match condition, the color of the target exemplar was consistent with the color associated with that combination of category and scene context from the exposure phase (e.g., a red stapler in a classroom scene). In the context-mismatch condition, the color of the target was not consistent with that association (e.g., a red stapler in an office scene). In two experiments, search response time was reliably lower in the context-match than in the context-mismatch condition, demonstrating that the learning of category-specific color regularities was itself structured by scene context. The results indicate that categorical templates retrieved from long-term memory are biased toward the properties of recent exemplars and that this learning is organized in a scene-specific manner.

PMID:35426031 | DOI:10.3758/s13414-022-02475-6