Nevin Manimala

Eur Heart J Cardiovasc Imaging. 2023 Jan 16:jeac262. doi: 10.1093/ehjci/jeac262. Online ahead of print.

ABSTRACT

AIMS: Being born small for gestational age (SGA, 10% of all births) is associated with increased risk of cardiovascular mortality in adulthood together with lower exercise tolerance, but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in adults born SGA. We aimed to assess whether central obesity makes young adults born SGA more susceptible to cardiac remodelling and dysfunction.

METHODS AND RESULTS: A perinatal cohort from a tertiary university hospital in Spain of young adults (30-40 years) randomly selected, 80 born SGA (birth weight below 10th centile) and 75 with normal birth weight (controls) was recruited. We studied the associations between SGA and central obesity (measured via the hip-to-waist ratio and used as a continuous variable) and cardiac regional structure and function, assessed by cardiac magnetic resonance using statistical shape analysis. Both SGA and waist-to-hip were highly associated to cardiac shape (F = 3.94, P < 0.001; F = 5.18, P < 0.001 respectively) with a statistically significant interaction (F = 2.29, P = 0.02). While controls tend to increase left ventricular end-diastolic volumes, mass and stroke volume with increasing waist-to-hip ratio, young adults born SGA showed a unique response with inability to increase cardiac dimensions or mass resulting in reduced stroke volume and exercise capacity.

CONCLUSION: SGA young adults show a unique cardiac adaptation to central obesity. These results support considering SGA as a risk factor that may benefit from preventive strategies to reduce cardiometabolic risk.

PMID:36644919 | DOI:10.1093/ehjci/jeac262

Nutr Rev. 2023 Jan 16:nuac108. doi: 10.1093/nutrit/nuac108. Online ahead of print.

ABSTRACT

Prokopidis et al have conducted a meta-analysis of randomized, placebo-controlled clinical trials to assess the effects of oral creatine supplementation on memory performance of healthy individuals. However, concerns were raised regarding the validity of their statistical analyses, which may have led to misleading conclusions. In this letter, we describe the statistical issue at hand and its potential implications.

PMID:36644917 | DOI:10.1093/nutrit/nuac108

Nutr Rev. 2023 Jan 16:nuac111. doi: 10.1093/nutrit/nuac111. Online ahead of print.

NO ABSTRACT

PMID:36644912 | DOI:10.1093/nutrit/nuac111

Sci Context. 2023 Jan 16:1-17. doi: 10.1017/S0269889722000230. Online ahead of print.

ABSTRACT

In this comparative historical analysis, we will analyze the intellectual tendency that emerged between 1946 and 1956 to take advantage of the popularity of communication theory to develop a kind of informational epistemology of statistical mechanics. We will argue that this tendency results from a historical confluence in the early 1950s of certain theoretical claims of the so-called English School of Information Theory, championed by authors such as Gabor (1956) or MacKay (), and from the attempt to extend the profound success of Shannon’s ([1948] 1993) technical theory of sign transmission to the field of statistical thermal physics. As a paradigmatic example of this tendency, we will evaluate the intellectual work of Léon Brillouin (), who, in the mid-fifties, developed an information theoretical approach to statistical mechanical physics based on a concept of information linked to the knowledge of the observer.

PMID:36644911 | DOI:10.1017/S0269889722000230

Endocr Metab Immune Disord Drug Targets. 2023 Jan 12. doi: 10.2174/1871530323666230112165948. Online ahead of print.

ABSTRACT

BACKGROUND: The Italian population’s habits changed dramatically during the “COVID-19 lockdown” due to physical distancing and self-isolation. Moreover, medical consultations of patients with chronic diseases, such as type 2 diabetes (T2D), were suspended or postponed, unless urgent or semi-urgent, for several consecutive months. Thus, it is expected that the lockdown could have affected glucometabolic control in T2D.

PURPOSE: The aim of the study was to assess changes in glucometabolic control in a cohort of T2D patients before (T1) and after (T2) the COVID-19 lockdown (March-May 2020).

METHODS: The study was approved by the Ethics Committee of the University of Bari, and all patients provided informed written consent to participate. Medical history, complete physical examination, and laboratory assessment were conducted as real-life clinical practice. Changes in clinical and laboratory variables between T1 and T2 were calculated.

RESULTS: In detail, 13 patients were on metformin as monotherapy, 36 on GLP-1RA, 12 on sodium-glucose transporter 2 inhibitors (SGLT-2i), and 2 on dipeptidyl-peptidase 4 inhibitors (DPP4i). The mean age was 65.3 years (43-83). Study participants were mainly men (73%). The body weight (BW) ranged from 56 to 145 kg, and the waist circumference ranged from 88 to 146 cm. The mean HbA1c was 51.0 mmol/mol. At T2, no statistically significant changes were observed from baseline except for BW [-1.6 (-2.60 to -0.62)] and HbA1c [-2.90 (-4.69; -1.12)].

CONCLUSION: We evaluated the effects of the COVID-19 lockdown on glucometabolic control in patients with background well-controlled T2D. We found that the lockdown had no adverse effects on metabolic profile regardless of background clinical characteristics and antihyperglycemic management. Despite limitations due to the nature of this study (sample size, retrospective observation, lack of data on lifestyle changes in our patients’ everyday lives), T2D patients managed in our Diabetes Centers faced the lockdown-related restrictions without any detrimental consequence.

PMID:36644863 | DOI:10.2174/1871530323666230112165948

Expert Rev Respir Med. 2023 Jan 16. doi: 10.1080/17476348.2023.2169138. Online ahead of print.

ABSTRACT

OBJECTIVES: This meta-analysis aimed to establish a clinical evidence base for respiratory rate (RR) as a single predictor of early-onset COVID-19. The review also looked to determine the practical implementation of mobile respiratory rate measuring devices where information was available.

METHODS: We focused on domestic settings with older adults. Relevant studies were identified through MEDLINE, Embase, and CENTRAL databases. A snowballing method was also used. Articles published from the beginning of the COVID-19 pandemic (2019) until Feb 2022 were selected. Databases were searched for terms related to COVID-19 and respiratory rate measurements in domestic patients.

RESULTS: A total of 2,889 articles were screened for relevant content, of which 60 full-text publications were included. We compared the Odds Ratios and statistically significant results of both vital signs.

CONCLUSION: Multinational studies across dozens of countries have shown respiratory rate to have predictive accuracy in detecting COVID-19 deterioration. However, considerable variability is present in the data, making it harder to be sure about the effects. There is no meaningful difference in data quality in terms of variability (95% CI intervals) between vital signs as predictors of decline in COVID-19 patients. Contextual and economic factors will likely determine the choice of measurement used.

PMID:36644851 | DOI:10.1080/17476348.2023.2169138

Curr Med Res Opin. 2023 Jan 16:1-13. doi: 10.1080/03007995.2023.2168418. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examines the relationships between changes in antipsychotic medication (AP) use and acute clinical events (identified with administrative claims data) for patients with FDA-approved indications for APs following transition from the community (eg, home) to a nursing home (NH) in a Medicare population.

METHODS: A retrospective analysis was conducted using 100% Medicare fee-for-service (FFS) research identifiable files (RIF) claims data (2016 – 2018). Medicare beneficiaries with a condition for which APs are approved by the FDA were examined using logistic regression models to determine whether changes in AP use following transition from community to NHs were correlated with the likelihood of experiencing acute clinical events.

RESULTS: We identified 38,448 Medicare FFS beneficiaries meeting our study criteria. A change in AP use after transition to a NH did not have a statistically significant association with acute skeletal events, coronary artery events, or cerebrovascular events (p = 0.55, p = 0.69, and p = 0.59 respectively).

CONCLUSIONS: Between 2016 and 2018, Medicare FFS patients with approved-use indications for APs had lower average AP use following transition to a NH. Changes in the use of other medications of interest largely followed a similar pattern, indicating that these medications did not tend to be used as substitutions for APs. No clear relationship exists between increases or decreases in AP use and adverse events among NH residents who used APs and had FDA-approved conditions in the community setting.

PMID:36644806 | DOI:10.1080/03007995.2023.2168418

J Clin Virol Plus. 2023 Jan 11:100135. doi: 10.1016/j.jcvp.2023.100135. Online ahead of print.

ABSTRACT

OBJECTIVE: Lateral flow assays (LFA) are sensitive for detecting antibodies to SARS-CoV-2 proteins within weeks after infection. This study tested samples from immunocompetent adults, and those receiving treatments for chronic inflammatory diseases (CID), before and after mRNA SARS-CoV-2 vaccination.

METHODS: We compared results obtained with the COVIBLOCK Covid-19 LFA to those obtained by anti-spike (S) ELISA.

RESULTS: The LFA detected anti-S antibodies in 29 of 29 (100%) of the immunocompetent and 110 of 126 (87.3%) of the CID participants after vaccination. Semiquantitative LFA scores were statistically significantly lower in samples from immunosuppressed participants, and were significantly correlated with anti-S antibody levels measured by ELISA.

CONCLUSIONS: This simple LFA test is a practical alternative to laboratory-based assays for detecting anti-S antibodies after infection or vaccination. This type of test may be most useful for testing people in outpatient or resource-limited settings.

PMID:36644774 | PMC:PMC9831968 | DOI:10.1016/j.jcvp.2023.100135

J Obstet Gynaecol India. 2023 Jan 7:1-6. doi: 10.1007/s13224-022-01719-7. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 pandemic led to an alarming rise in sickness absenteeism among the radiologists. Anticipating a continued shortage of experienced radiologists in future COVID waves, it is essential to train the medical professionals in basic skills related to ultrasonography to enable them to perform basic Obstetrics and Gynecology (OG) scans safely in emergencies. Virtual reality simulation training is an alternative to conventional ultrasound training.

METHODS: A cross-sectional study was conducted during 8-day-long workshop to identify the trainees’ basic, after training knowledge and skills in OG ultrasound and to document their perceptions of the training. Statistical analysis was done using descriptive statistics (percentages and mean standard deviations) and paired t test for comparisons.

RESULTS: A total of 80 health care professionals underwent ultrasound simulation training. It was found that the post-test score in the knowledge domain, instrument handling, basic gynecological skills, and first-trimester antenatal ultrasound skills in the practical domain was significantly higher than the pre-test score (P-value < 0.0001). Out of 80 participants, 45 (56.25%) agreed that ultrasound simulation is an ideal method of teaching and training basic OG skills to the novice. Sixty-six out of 80 (82.5%) felt that the principles of handling a human mannequin are the same as those of real patients. Forty-eight participants out of 80 (60.0%) felt that ultrasound simulation can be used as an ideal tool for self-assessment of health care professionals.

CONCLUSION: The study showed that ultrasound-based simulation can provide a realistic setting for training and assessment of novices in learning basic skills.

PMID:36644767 | PMC:PMC9822808 | DOI:10.1007/s13224-022-01719-7

Adv Med Educ Pract. 2023 Jan 7;14:21-30. doi: 10.2147/AMEP.S381760. eCollection 2023.

ABSTRACT

INTRODUCTION: Nursing knowledge, critical thinking ability, and self-perceived confidence are imperative to nursing skills in professional nursing practice. Therefore, nurse educators are required to use teaching strategies that will help promote their knowledge, critical thinking, and self-confidence in complex contents such as the nursing of acute upper gastrointestinal bleeding (AUGIB).

PURPOSE: This study compares the effect of student-led and instructor-led ward-round training methods on knowledge acquisition, critical thinking ability, and self-perceived confidence during AUGIB sessions.

METHODS: Forty nursing students in the first year of the Emergency Nursing Residency Program were randomly divided into a student-led ward round training group (SG) and an instructor-led ward round training group (IG) with a ratio of 1:1. A knowledge quiz, critical thinking ability test, and self-perceived confidence questionnaire were performed before and after the ward round training to assess both groups of students for their knowledge acquisition, critical thinking ability, and self-perceived confidence improvement. Feedback questionnaires were conducted after the training to evaluate students’ perspectives and interests concerning the teaching module.

RESULTS: The scores of the post-training quiz were significantly higher than that of the pre-training quiz in both the SG (44.10±2.92 vs 31.10±4.27, p<0.001) and IG (32.35±2.21 vs 30.55±2.24, p=0.01). In the post-training quiz, scores achieved by the students from the SG (44.10±2.92) were significantly higher than those achieved by the students from the IG (32.35±2.21, p< 0.001). The level of self-perceived confidence improved significantly after ward round training in the SG (p< 0.001). However, there was no statistically significant difference in the IG with respect to the change from pre- to post-training (p=0.43).The students’ critical thinking ability improved significantly in the SG (14.95±2.58 vs 7.10±1.79, p<0.001), while no significant improvement was found in the IG (7.91±2.28 vs 6.52±2.21, p=0.07) after ward round training.

CONCLUSION: The teaching method of SWRT improves nursing students’ knowledge acquisition, critical thinking ability, and self-perceived confidence in AUGIB.

PMID:36644766 | PMC:PMC9832928 | DOI:10.2147/AMEP.S381760