Nevin Manimala

Arthritis Care Res (Hoboken). 2022 Apr 12. doi: 10.1002/acr.24894. Online ahead of print.

ABSTRACT

OBJECTIVE: Little is known regarding the reactogenicity and related SARS-CoV-2 vaccine response in patients with chronic inflammatory disease (CID). Our objective was to characterize the adverse event (AE) profile of CID patients following SARS-CoV-2 vaccination and understand the relationship between reactogenicity and immunogenicity of SARS-CoV-2 vaccines.

METHODS: CID patients and healthy controls eligible to receive mRNA SARS-CoV-2 vaccines participated in 3 study visits (pre-vaccine, after dose 1, after dose 2) where blood and clinical data were collected. Assessment of AEs were solicited within 7 days of receiving each dose. Serum anti-SARS-CoV-2 spike IgG⁺ antibody titers were quantified following vaccination. Statistical analysis was performed utilizing mixed models and tobit regressions, adjusting for covariates.

RESULTS: 441 participants (322 CID patients and 119 controls) were included. Compared to controls, CID patients reported greater symptom severity after dose 1 (p=0.0001), including more myalgia and fatigue (p<0.05). For immunogenicity, a higher symptom severity after dose 1 and higher number of symptoms after dose 2 was associated with higher antibody titers (p<0.05). Each increase of one symptom was associated with 15.1% increase in antibody titer. Symptom association was strongest with site pain after dose 1 (105%, p=0.03) and fatigue after dose 2 (113%, p=0.004).

CONCLUSIONS: CID patients have a distinct reactogenicity profile following SARS-CoV-2 vaccination compared to controls. Furthermore, there is an association between increased reactogenicity and increased vaccine response. This finding may speak to the more variable immunogenicity in CID patients and may be an important indicator of vaccine response to the novel SARS-CoV-2 vaccines.

PMID:35412029 | DOI:10.1002/acr.24894

ANZ J Surg. 2022 Apr 12. doi: 10.1111/ans.17689. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is associated with the development of knee osteoarthritis (OA). The aim of this study was to examine the incidence of obesity in patients undergoing knee replacement (KR) for OA in Australia compared to the incidence of obesity in the general population.

METHODS: A cohort study was conducted, comparing data from the Australian Bureau of Statistics (ABS) 2017-2018 National Health Survey with data from the National Joint Replacement Registry. The distribution of patients who underwent KR from July 2017 to June 2018 by BMI category was compared to the distribution of the general population, in age and gender sub-groups.

RESULTS: During the study period, 35.6% of Australian adults were overweight and 31.3% were obese. Of the 56 217 patients who underwent primary KR for OA, 31.9% were overweight and 57.7% were obese. The relative risk of undergoing KR for OA increased with increasing BMI category. Class 1, 2 and 3 obese females aged 55-64 years were 4.7, 8.4 and 17.3 times more likely to undergo KR than their normal weight counterparts, respectively. Males in the same age and BMI categories were 3.4, 4.5 and 5.8 times more likely to undergo KR, respectively. Class 3 obese patients underwent KR 7 years younger, on average, than normal weight individuals.

CONCLUSION: Obesity is associated with an increased risk of undergoing KR, and at a younger age, particularly for females. There is an urgent need for a societal level approach to address the prevalence of obesity, to reduce the burden of obesity related KR.

PMID:35412005 | DOI:10.1111/ans.17689

Microsc Res Tech. 2022 Apr 12. doi: 10.1002/jemt.24118. Online ahead of print.

ABSTRACT

Pollen grains of 58 wetland species of angiosperms belonging to 17 families, growing in different wetlands of Sub-Himalayan biodiversity hotspots, Northern Bengal and lower Gangetic plains, India were investigated during a 4-year span of 2015-2019. Freshly collected anthers were processed through the acetolysis method and the obtained pollen grains were accurately studied under LM and SEM and properly photographed. Different attributes viz. shape, size, aperture type and exine ornamentation of pollen grains served as consistent features were used for authentic identification of the studied species. To study the phylogeny of pollen grains, characters like polarity, symmetry, aperture and exine sculpturing were found most significant for species segregation. Investigated pollen grains were mostly prolate-spheroidal, spheroidal or triangular, rarely prolate or elongated, exine psilate, granulate, reticulate or microechinate type. Most of the observable aperture of pollen grains of studied species were colporate, colpate and porate, while ulcerate and inaperturate grains were also observed in the studied aquatic members of the families Cyperaceae and Potamogetonaceae. All the gathered data were further statistically analyzed through ANOVA, PCA and Pearson Correlation Matrix to understand the interrelationship among the species. The permanent slides of identified pollen grains were deposited at the herbarium of North Bengal University [NBU] for future references.

PMID:35411986 | DOI:10.1002/jemt.24118

Cogn Sci. 2022 Apr;46(4):e13124. doi: 10.1111/cogs.13124.

ABSTRACT

Chunking mechanisms are central to several cognitive processes and notably to the acquisition of visuo-motor sequences. Individuals segment sequences into chunks of items to perform visuo-motor tasks more fluidly, rapidly, and accurately. However, the exact dynamics of chunking processes in the case of extended practice remain unclear. Using an operant conditioning device, 18 Guinea baboons (Papio papio) produced a fixed sequence of nine movements during 1000 trials by pointing to a moving target on a touch screen. Response times analyses revealed a specific chunking pattern of the sequence for each baboon. More importantly, we found that these patterns evolved during the course of the experiment, with chunks becoming progressively fewer and longer. We identified two chunk reorganization mechanisms: the recombination of preexisting chunks and the concatenation of two distinct chunks into a single one. These results provide new evidence on chunking mechanisms in sequence learning and challenge current models of associative and statistical learning.

PMID:35411975 | DOI:10.1111/cogs.13124

Skin Res Technol. 2022 Apr 12. doi: 10.1111/srt.13159. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this review is to examine the reliability and measurement error of devices that measure transepidermal water loss (TEWL).

INTRODUCTION: TEWL is a physiological property of skin which increases when the epidermis is damaged. It is, therefore, a commonly utilised measure of skin barrier integrity. Devices measuring TEWL are available as open, semi-open or closed chamber. Studies of reliability examine the consistency of measurement, and/or responsiveness whereas measurement error scores in absolute terms the amount of error due to sources of variation.

INCLUSION CRITERIA: Studies examining the reliability and/or measurement error of TEWL measurement devices were included. Studies that only report on measurement of TEWL outcomes without examination of reliability and/or measurement error were excluded.

METHODS: The search strategy aimed to locate published and unpublished studies. Databases searched included PubMed, Embase, CINAHL and Web of Science, utilising identified keywords and limited to studies in English. Grey literature sources were searched to identify any unpublished documents. Study selection using the inclusion criteria was then assessed by two reviewers for methodological quality utilising the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias tool to assess the reliability and measurement error of outcome measurement instruments.

RESULTS: A total of 22 devices were examined in the 38 included studies. The quality of study design was on average rated as ‘Adequate’ however reliability and measurement error statistical methods were on average rated as ‘Doubtful’.

DISCUSSION AND CONCLUSION: TEWL measurement devices were found to demonstrate good reliability and frequently correlated with other devices. However, measurement error was highly variable but improves under in vitro conditions. Future research should consider risk of bias factors when designing studies.

PMID:35411958 | DOI:10.1111/srt.13159

J Surg Oncol. 2022 Apr 12. doi: 10.1002/jso.26891. Online ahead of print.

ABSTRACT

INTRODUCTION: Co-surgeon approach for bilateral mastectomy may lead to shorter operative times and improved outcomes compared with single-surgeon approach, but cost differences remain unclear. Economic models were applied to determine whether either approach offered a lower cost opportunity.

METHODS: A retrospective review of 409 patients undergoing single-surgeon or co-surgeon bilateral mastectomy between January 1, 2010 through April 30, 2016 was conducted. Outcomes included narcotic and antinausea doses, length of stay (LOS), and operative time. Analyses stratified by reconstruction and no reconstruction included Wilcoxon tests, Poisson regression, generalized linear models, and a cost calculator.

RESULTS: Of 409 patients, 310 had reconstruction and 99 had no reconstruction. Compared with single-surgeon approach, co-surgeon approach was associated with less operative time and shorter LOS (233 vs. 250 min and 1.0 vs. 1.8 days no reconstruction; and 429 vs. 493 min and 2.2 vs. 2.8 days reconstruction). Economic analysis demonstrated less operative time, shorter LOS, and lower average cost for co-surgeon approach ($32,400 vs. $34,400 no reconstruction; and $76,700 vs. $79,400 reconstruction).

CONCLUSION: Compared with the single-surgeon, the co-surgeon approach with reconstruction was associated with a statistically significant decrease in operative time and LOS. Economic analysis estimated the co-surgeon approach could lead to lower costs.

PMID:35411951 | DOI:10.1002/jso.26891

Rev Esp Sanid Penit. 2022 Jan-Apr;24(1):15-22. doi: 10.18176/resp.00045.

ABSTRACT

OBJECTIVES: To describe the clinical and epidemiological characteristics of inmates who were infected and died from COVID-19 in Peruvian prisons from April to October 2020.

MATERIAL AND METHOD: Descriptive, cross-sectional, retrospective study with a secondary data source. All the inmates who were infected and died from COVID-19 in Peruvian prisons during the study period were considered. The information was collected through the validated data collection sheet and was analyzed with descriptive statistics applying the SPSS v26 software.

RESULTS: 37,103 (42.3%) inmates were analyzed out of a prison population of 87,754. All of them reactive to the rapid test, with a mean age of 39.9 ± 12.6 years; 95.5% were male. 60.1% were IgG reactive; 36.1% were IgM/IgG reactive and 3.8% were IgM reactive. 20.1% of reactive inmates had COVID-19 symptoms at the time of testing. The most frequent symptoms were headache (55.6%), general malaise (49.7%), fever (49.0%) and cough (48.0%). Among the risk factors for COVID-19 were: age over 60 years (8.4%), high blood pressure (2.8%) and diabetes mellitus (2.4%). 445 deaths were registered. Total fatality reached 1.2% of the number of infected. The highest number of deaths was recorded in April and May (89 and 162, respectively).

DISCUSSION: The study findings imply different approaches to managing epidemics in the prison context compared to the general population. The short and long term scenarios are uncertain, but the need to reorganize the prison health system, and to prioritise and modernise it are evident. The long-delayed reform of the prison system and the measures that set out to contain the spread of the COVID-19 disease in prisons are related processes in this regard.

PMID:35411908 | DOI:10.18176/resp.00045

Assist Inferm Ric. 2022 Jan-Mar;41(1):6-14. doi: 10.1702/3785.37700.

ABSTRACT

. Measuring the nursing workload in a medical-surgical high dependency unit through nursing activities score (NAS). a prospective observational study.

INTRODUCTION: Measuring the nursing staff workload allows adequate delivery of resources within the intensive care unit and high dependency unit to ensure an adequate nurse to patient ratio.

AIM: Exploring the nursing workload in the medical-surgical high dependency unit (HDU) at Careggi University Hospital (Florence, Italy).

METHODS: Monocentric prospective observational study. We enrolled patients admitted in HDU from 11 February to 13 March 2021. Nursing Activity Score (NAS) was measured every 24 hours.

RESULTS: Patients included in the study were 75. Three groups based on their admission diagnosis were identified (medical, surgical, trauma). The median NAS score was 59.7 (IQR: 53.7-68.2; range 34.7-119.7). Statistically significant differences were found between the median NAS values for the three admission diagnoses: 67.4 (IQR: 54.4-73.4) for medical patients, 60.2 (IQR: 54.4-63.3) for trauma patients and 59.1 (IQR: 55.1-64.7) for surgical patients. These results showed that the items of NAS that mostly affect workload are “monitoring”, “mobilization”, “patient hygiene”, and “admission and discharge procedures”.

CONCLUSIONS: This study confirms that the NAS scoree can be used in HDUs as well as in intensive care units. The ideal nurse-to-patient ratio was equal to 0.6.

PMID:35411878 | DOI:10.1702/3785.37700

Acta Crystallogr B Struct Sci Cryst Eng Mater. 2022 Apr 1;78(Pt 2):223-230. doi: 10.1107/S2052520622001810. Epub 2022 Mar 17.

ABSTRACT

The influence of pressure on the course of [4+4] photodimerization in crystals of 9-methylanthracene is presented. The studies were performed at 0.1 and 0.4 GPa. As a result of the reaction at high pressure, crystals of the pure product were obtained, which allowed for monitoring of the reaction until its completion. The initial increase in the unit-cell volume caused by the reaction under ambient conditions was reduced at high pressure due to the decrease in the void volume. Despite the smaller size of the void volume at high pressure, dimer molecules formed during the reaction changed the orientation of the monomer molecules in the crystal structure. The size of the voids above the terminal rings of the monomers correlates with the position of the terminal rings in the dimer. The reaction rate increased at high pressure, indicating that the decrease in the distance between adjacent monomers caused by pressure dominates over the decrease in the void volume. This distance is statistically constant as the reaction progresses, contrary to the reaction at ambient pressure.

PMID:35411860 | DOI:10.1107/S2052520622001810

J Chemother. 2022 Apr 12:1-5. doi: 10.1080/1120009X.2022.2061183. Online ahead of print.

ABSTRACT

In inoperable pleural mesothelioma, pemetrexed + cisplatin as first line is considered the standard of care, but novel treatments have been recently proposed. Our objective was to comparatively examine the information on overall survival (OS) with these new agents. The Shiny technique was employed for reconstructing individual patient data. Cox statistics was run to estimate hazard ratios (HRs). After a standard literature search, four new treatments were identified (nivolumab + ipilimumab, bevacizumab + pemetrexed + cisplatin, pembrolizumab monotherapy, and durvalumab + pemetrexed + cisplatin). Pemetrexed + ciplatin was the treatment for controls. Nivolumab + ipilimumab and bevacizumab + pemetrexed + cisplatin showed a better OS compared with controls (HR, 0.79 and 0.79, respectively; p < 0.05). Pembrolizumab determined only a numerical improvement (p > 0.05). In contrast, OS worsened with durvalumab + pemetrexed + cisplatin. Our analysis indicates that the novel treatments for inoperable mesothelioma have similar efficacy and, in general, provide a small though significant survival benefit compared with standard of care. Further research is needed to identify agents determining a more substantial OS improvement.

PMID:35411826 | DOI:10.1080/1120009X.2022.2061183