Nevin Manimala

Clin J Oncol Nurs. 2022 Sep 15;26(5):495-501. doi: 10.1188/22.CJON.495-501.

ABSTRACT

BACKGROUND: There is a limited knowledge base about factors affecting advance directives and code status decisions among veterans with malignancy. In addition, few studies have focused on the benefit of palliative care (PC) in goals-of-care discussions among veterans with cancer.

OBJECTIVES: This study examined advance care planning and goals-of-care decisions among veterans with malignancy.

METHODS: Demographic and clinical data were obtained using retrospective chart analysis. Patient characteristics were analyzed using univariate descriptive statistics. To compare patients with and without a do-not-resuscitate (DNR) decision, chi-square test was performed.

FINDINGS: More than half of the patients in the study were referred to PC within one year of their cancer diagnosis. Most had documented metastatic disease at the time of their PC referral. Veterans with prostate cancer were more likely to elect full code status. In this study, White veterans were more likely to choose a DNR order than African American veterans.

PMID:36108205 | DOI:10.1188/22.CJON.495-501

Anesth Analg. 2022 Oct 1;135(4):787-797. doi: 10.1213/ANE.0000000000005853. Epub 2022 Sep 15.

ABSTRACT

BACKGROUND: Some studies have found surgery and anesthesia in children to be associated with neurodevelopmental deficits, but specific reasons for this association have not been fully explored. This study evaluates intraoperative mean arterial pressure (MAP) during a single ambulatory procedure in children and subsequent mental disorder diagnoses.

METHODS: A retrospective observational study was performed including children ≥28 days and <18 years of age with intraoperative electronic anesthetic records between January 1, 2009, and April 30, 2017, at our institution. Eligible children were categorized based on their mean intraoperative MAP relative to other children of the same sex and similar age: category 1 (very low): children with mean intraoperative MAP values below the 10th percentile, category 2 (low): mean MAP value ≥10th and <25th percentiles, category 3 (reference): mean MAP value ≥25th and <75th percentiles, category 4 (high): mean MAP value ≥75th and <90th percentile, and category 5 (very high): mean MAP value ≥90th percentile. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) and ICD, Tenth Revision, Clinical Modification (ICD-10)-coded mental disorders were identified in hospital and outpatient claims, with a median duration of follow-up after surgery of 120 days (interquartile range [IQR], 8-774.5 days). Cox proportional hazards models evaluated the hazard ratio (HR) of time to first mental disorder diagnosis associated with intraoperative blood pressure category between the end of surgery and censoring, with the primary analysis adjusting for demographic, anesthetic, comorbidity, and procedure-type variables as potential confounders.

RESULTS: A total of 14,724 eligible children who received general anesthesia for a single ambulatory surgical procedure were identified. After adjusting for all available potential confounders, when compared to the reference, there were no statistically significant differences in mental disorder diagnosis risk based on intraoperative mean MAP category. Compared to reference, children in the very low and low blood pressure categories reported HRs of 1.00 (95% confidence interval [CI], 0.74-1.35) and 1.10 (95% CI, 0.87-1.41) for a mental disorder diagnosis, respectively, and children in the high and very high categories reported HRs of 0.87 (95% CI, 0.68-1.12) and 0.76 (95% CI, 0.57-1.03), respectively.

CONCLUSIONS: Presence in a predefined mean intraoperative MAP category was not associated with subsequent mental disorder diagnoses within our follow-up period. However, the limitations of this study, including uncertainty regarding what constitutes an adequate blood pressure in children, may limit the ability to form definitive conclusions.

PMID:36108191 | DOI:10.1213/ANE.0000000000005853

ACS Appl Mater Interfaces. 2022 Sep 15. doi: 10.1021/acsami.2c12415. Online ahead of print.

ABSTRACT

Single-walled carbon nanotubes (SWCNTs) are considered to be promising candidates for next-generation near-infrared (NIR) photodetectors due to their extraordinary electrical and optical properties. However, the low separation efficiency of photogenerated carriers limits the full utilization of the potential of pristine SWCNTs as photoactive materials. Herein, we report a novel high-performance visible-NIR SWCNT-based photodetector via interfacial charge-transfer-induced improvement by Au nanoparticle (AuNP) surface doping. Under 1064 nm light illumination, the as-fabricated AuNP/SWCNT photodetector exhibits an excellent photoelectrical performance with a responsivity of 2.16 × 10⁵ A/W and a high detectivity of 1.82 × 10¹⁴ Jones, which is three orders of magnitude higher than that of the SWCNT photodetector under the same conditions. Importantly, the interfacial charge transfer between AuNPs and SWCNTs has been first investigated using Raman shift statistics at room temperature. Experimental results indicate that the interfacial charge transfer induced by AuNP doping can reduce the Fermi level of SWCNTs and effectively improve the generation and transport of photogenerated carriers, thereby enhancing the photoelectric performance of SWCNT-based photodetectors. We believe that our results not only demonstrate a facile route to improve the performance of SWCNT-based photodetectors but also provide a novel methodology to characterize the interfacial charge transfer between dopants and SWCNTs.

PMID:36108153 | DOI:10.1021/acsami.2c12415

Mol Biol Evol. 2022 Sep 15:msac197. doi: 10.1093/molbev/msac197. Online ahead of print.

ABSTRACT

The recent development of artificial intelligence provides us with new and powerful tools for studying the mysterious relationship between organism evolution and protein evolution. In this work, based on the AlphaFold Protein Structure Database (AlphaFold DB), we perform comparative analyses of the proteins of different organisms. The statistics of AlphaFold-predicted structures show that, for organisms with higher complexity, their constituent proteins will have larger radii of gyration, higher coil fractions, and slower vibrations, statistically. By conducting normal mode analysis and scaling analyses, we demonstrate that higher organismal complexity correlates with lower fractal dimensions in both the structure and dynamics of the constituent proteins, suggesting that higher functional specialization is associated with higher organismal complexity. We also uncover the topology and sequence bases of these correlations. As the organismal complexity increases, the residue contact networks of the constituent proteins will be more assortative, and these proteins will have a higher degree of hydrophilic-hydrophobic segregation in the sequences. Furthermore, by comparing the statistical structural proximity across the proteomes with the phylogenetic tree of homologous proteins, we show that, statistical structural proximity across the proteomes may indirectly reflect the phylogenetic proximity, indicating a statistical trend of protein evolution in parallel with organism evolution. This study provides new insights into how the diversity in the functionality of proteins increases and how the dimensionality of the manifold of protein dynamics reduces during evolution, contributing to the understanding of the origin and evolution of lives.

PMID:36108094 | DOI:10.1093/molbev/msac197

PLoS One. 2022 Sep 15;17(9):e0274739. doi: 10.1371/journal.pone.0274739. eCollection 2022.

ABSTRACT

There is a lack of comprehensive instruments for the assessment of compliance with influenza immunization. The purpose of this study was to examine psychometric characteristics of the Health Belief Model Applied to Influenza (HBMAI) among people with chronic diseases. We selected people residing in four municipalities of the Foča region (Republic of Srpska-Bosnia and Herzegovina) who were listed in the official records to receive the recommended influenza immunization in 2017/2018. Participants were interviewed using the HBMAI questionnaire at their homes. The HBMAI is composed of 45 items classified in 7 domains (Susceptibility, Seriousness, Benefits, Barriers, Knowledge, Health Motivation and Cue to Action). The confirmatory factor analysis (CFA) suggested that the Serbian HBMAI did not fit the original structure. The parallel analysis suggested that HBMAI in Serbian had 6 domains, instead of the original 7. The domain of “Knowledge” was removed. The domains of “Barriers”, “Health Motivation” and “Cue to Action” preserved their original structure. The domains of “Susceptibility”, “Seriousness” and “Benefits” were partially modified. The parameters on the CFA for the new modified HBMAI in Serbian were acceptable (goodness of fit index [GFI] = 0.946, comparative fit index [CFI] = 0.967, Tucker-Lewis index [TLI] = 0.963, root mean square error of approximation [RMSEA] = 0.044 and standardized root mean square residual [SRMR] = 0.078). This modified HBMAI version with 6 domains, not including the Knowledge domain, is recommended for use in research about influenza among people with chronic diseases in Serbian language.

PMID:36108085 | DOI:10.1371/journal.pone.0274739

PLoS One. 2022 Sep 15;17(9):e0273183. doi: 10.1371/journal.pone.0273183. eCollection 2022.

ABSTRACT

INTRODUCTION: Tenofovir Disoproxil Fumarate (TDF) is the most widely used Anti-Retroviral Therapy (ART) drug due to its potency, safety profile and World Health Organization (WHO) recommendation. TDF causes proximal tubular renal dysfunction (PTRD) leading to Fanconi syndrome, acute kidney injury and chronic kidney disease. Modest rates (2-4%) of TDF related toxicity based on estimated Glomerular Filtration Rate (GFR) have been described, while TDF-induced PTRD has been reported to be 22%. TDF toxicity is more likely among African patients, it is reversible and TDF may be renal dosed in patients with dysfunction. The objective of this study was to assess proximal tubular renal dysfunction, global renal function, and their determinants among patients on TDF versus TDF-sparing regimen.

METHODS: This was a cross-sectional study among people living with HIV/AIDS (PLWHA) attending the Academic Model Providing Access to Healthcare (AMPATH) program. The primary outcome of interest in this study was PTRD while the secondary outcome of interest was estimated GFR. PTRD was defined as any two of beta-2 microglobulin in urine, metabolic acidosis, normoglycemic glucosuria and fractional excretion of phosphate. Student’s t-test, chi-square and their non-parametric equivalents were used to test for statistical significance. Univariate and multivariate logistic regression analysis was carried out.

RESULTS: A total of 516 participants were included in the final analysis, 261 on TDF while 255 were on TDF-sparing regimens. The mean (SD) age of all participants was 41.5 (12.6) years with majority being female (60.3%). The proportion of PTRD was 10.0% versus 3.1% in the TDF compared to TDF-sparing group (P<0.001). Mean estimated GFR was 112.8 (21.5) vs 109.7 (21.9) ml/min/1.73mm3 (P = 0.20) for the TDF compared to TDF-sparing group. TDF users were more likely to have PTRD compared to non-TDF users, adjusted Odds Ratio (AOR) 3.0, 95% CI 1.12 to 7.75.

CONCLUSION: There was significant PTRD in the TDF compared to TDF-sparing group without significant difference in estimated GFR. The clinical significance of these findings may not be clear in the short term.

PMID:36108078 | DOI:10.1371/journal.pone.0273183

PLoS One. 2022 Sep 15;17(9):e0274602. doi: 10.1371/journal.pone.0274602. eCollection 2022.

ABSTRACT

Intimate-partner factors have a significant effect on the uptake of services that affect maternal reproductive health outcomes. There is limited research on intimate-partner factors associated with cervical cancer screening. Therefore, this article examines the intimate-partner correlates of cervical cancer screening among married women in Central Uganda. We conducted a cross-sectional survey in Wakiso and Nakasongola districts in Central Uganda. A total of 656 married women aged 25-49 participated in the study. Frequency distributions for descriptive statistics and Pearson chi-squared tests were done to identify the association of selected individual explanatory variables and intimate-partner factors with cervical cancer screening. Finally, multivariable complementary log-log regressions were used to estimate intimate-partner factors associated with women’s cervical cancer screening uptake in Central Uganda. About 2 in 10 (20%) of the participants had been screened for cervical cancer. The following characteristics when examined separately in relation to the uptake of cervical cancer screening service and were significant: woman’s age, education attainment, occupation, wealth index, parity, male partner’s age, and male partner’s emotional support. After adjusting for independent factors, cervical cancer screening was significantly associated with women who had; attained secondary (AOR = 2.19; CI 1.18-4.06) compared to none/ primary education, and received partner’s emotional support (AOR = 30.06; CI 13.44-67.20) compared to those who did not receive partner’s emotional support. In Central Uganda, cervical cancer screening among married women was significantly associated with women’s education, and partner’s emotional support. These factors point to the importance of intimate-partner factors. Therefore, more effort should be directed at encouraging men’s participation. This should be supplemented with empowering women through education to increase uptake of screening services.

PMID:36108074 | DOI:10.1371/journal.pone.0274602

PLoS One. 2022 Sep 15;17(9):e0274641. doi: 10.1371/journal.pone.0274641. eCollection 2022.

ABSTRACT

Agave lechuguilla Torr., of the family Agavaceae, is distributed from southwestern United States to southern Mexico and is one of the most representative species of arid and semiarid regions. Its fiber is extracted for multiple purposes. The objective of this study was to generate a robust model to predict dry fiber yield (Dfw) rapidly, simply, and inexpensively. We used a power model in its linear form and bioclimatic areas as dummy variables. Training, generation (80%) and validation (20%) of the model was performed using machine learning with the package ‘caret’ of R. Using canonical correlation analysis (CCA), we evaluated the relationship of Dwf to bioclimatic variables. The principal components analysis (PCA) generated two bioclimatic zones, each with different A. lechuguilla productivities. We evaluated 499 individuals in four states of Mexico. The crown diameter (Cd) of this species adequately predicts its fiber dry weight (R2 = 0.6327; p < 0.05). The intercept (β0), slope [lnCd (β1)], zone [(β2)] and interaction [lnCd:Zona (β3)] of the dummy model was statistically significant (p < 0.05), giving origin to an equation for each bioclimatic zone. The CCA indicates a positive correlation between minimum temperature of the coldest month (Bio 6) and Dwf (r = 0.84 and p < 0.05). In conclusion, because of the decrease in Bio 6 of more than 0.5°C by 2050, the species could be vulnerable to climate change, and A. lechuguilla fiber production could be affected gradually in the coming years.

PMID:36108072 | DOI:10.1371/journal.pone.0274641

PLoS One. 2022 Sep 15;17(9):e0274684. doi: 10.1371/journal.pone.0274684. eCollection 2022.

ABSTRACT

BACKGROUND: The aim of the study was to estimate the prevalence of insomnia symptoms and to examine the associations of body mass index (BMI), chronic diseases, and lifestyle factors with self-reported insomnia symptoms among older people in India.

METHODS: We conducted a cross-sectional study using data from the baseline wave of the Longitudinal Ageing Study in India (LASI) that was collected during 2017-18. A sample of 31,358 older adults aged 60 and above was included in the analyses. Descriptive statistics and bivariate and multivariable analyses were performed to obtain the results.

RESULTS: In this study, insomnia symptoms were reported by around 36 percent of older adults aged 60 and above. After controlling for socio-demographic factors, insomnia symptoms were positively associated with the risk of being underweight [AOR: 1.289, CI: 1.211-1.372] and negatively associated with obesity/overweight [AOR: 0.928, CI: 0.872-0.990] as compared to older adults with normal BMI. The odds of insomnia symptoms were higher among those who reported the following chronic conditions, i.e., hypertension [AOR:1.356, CI:1.278-1.438], diabetes [AOR:1.160, CI:1.074-1.254], chronic lung diseases [AOR:1.485, CI:1.351-1.632], bone-related diseases [AOR:1.561, CI:1.458-1.670] and any psychiatric disorders [AOR:1.761, CI:1.495-2.074]. In addition, older adults who were physically active [AOR: 0.850, CI:0.804-0.900] were less likely to report insomnia symptoms.

CONCLUSIONS: The study suggests a high prevalence of insomnia symptoms among the older population in India. Early identification of the signs of insomnia in older population is crucial, as is timely treatment for any kind of sleep problems. In addition, nutrition-based interventions and individual disease-specific management programs may help minimize the stressful situations in later life and develop a good night’s sleep for the older population.

PMID:36108066 | DOI:10.1371/journal.pone.0274684

Adv Physiol Educ. 2022 Sep 15. doi: 10.1152/advan.00017.2022. Online ahead of print.

ABSTRACT

Misalignment in teaching pedagogies between secondary schools and tertiary institutions have exacerbated educational disparities amongst students from different backgrounds. Given the variation in students’ educational background and competencies there was a need to develop an Anatomy and Physiology (A&P) Foundational Knowledge Assessment to establish the levels of preparedness of first-year medical students. Previous work that focused on the development of the assessment showed it to be effective in measuring students’ foundational knowledge in human anatomy and physiology. ​The aim of this study is to assess the validity of the A&P Foundational Knowledge Assessment in determining students’ prior knowledge and predicting academic performance of first-year students in their anatomy and physiology studies. Three hundred and seventy first-year students, across two cohort years 2017 and 2018, completed the A&P Foundational Knowledge Assessment. Data was analysed using descriptive statistics, analysis of variance, and Pearson’s correlation. Results show that for both cohorts, approximately 30% of students scored less than or equal to 55% and were potentially at risk of performing poorly in their anatomy and physiology studies. Pearson’s correlation showed a significant relationship between students’ performance on the foundational knowledge assessment and their anatomy and physiology assessments. For both cohorts more than 10% of students identified by the A&P Foundational Knowledge Assessment were either at risk of failing the course, entering an extended degree programme, or being excluded from the programme. Results indicate that the assessment is a good predictor for differentiating medical students’ performance in first-year anatomy and physiology.

PMID:36108059 | DOI:10.1152/advan.00017.2022