Nevin Manimala

JMIR Res Protoc. 2022 Nov 2. doi: 10.2196/40894. Online ahead of print.

ABSTRACT

BACKGROUND: The consensus of the optimal treatment strategy for chronic Achilles tendinopathy (AT) is still debated and treatment options are limited. This results in a significant medical need for more effective treatment options.

OBJECTIVE: The aim of this study is to investigate the therapeutic effects of percutaneous bioelectric current stimulation (PBCS) on AT.

METHODS: A multi-center, randomized, double-blind, placebo-controlled clinical trial will be conducted. A total of 72 participants with chronic (>3 months) midpoint AT will be randomized and receive 4 PBCS (either verum or placebo) over 3 weeks. Both groups will complete daily Achilles tendon loading exercises in addition to the intervention. Evaluation sessions will be completed at baseline and intervention (weeks 0-3). Self-reported outcome measures will be completed at the follow-up in weeks 4, 12, 26, 52.Primary outcome: Victorian Institute of Sports Assessment – Achilles Questionnaire(Version: VISA-A) score: Statistical evaluation of intraindividual differences between baseline and 12 weeks after initial treatment after verum therapy compared to control. Secondary outcomes will assess pain disability index (PDI), average pain (11-point numeric rating scale – NRS), return to sports, and use of emergency medication.

RESULTS: Study began in May 2021. As of October 2022, we randomized 66 out of 72 participants. We anticipate completing recruiting in the fourth quarter of 2022 and primary data analysis in the first quarter of 2023.

CONCLUSIONS: The study will evaluate the effects of PBCS on pain, physical function and clinical outcomes.

CLINICALTRIAL: DRKS, DRKS00017293. Registered 1. February 2022. Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017293.

PMID:36325808 | DOI:10.2196/40894

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Oct;44(5):815-821. doi: 10.3881/j.issn.1000-503X.14608.

ABSTRACT

Objective To analyze the personality traits and nutrition package feeding behaviors of infant caregivers in remote rural areas of Sichuan province and explore the relationship between them. Methods A multi-stage random cluster sampling method was employed to select the infants of 6-24 months old and their caregivers in the remote rural areas of Sichuan province.A structured questionnaire was designed to collect the basic characteristics of infants and their caregivers,as well as the feeding behaviors of the caregivers.The Ten-Item Personality Inventory in China was used to evaluate the caregivers’ personality traits in five dimensions:extraversion,agreeableness,conscientiousness,emotional stability,and openness.Multivariate Logistic regression was adopted to analyze the relationship between personality traits and nutrition package feeding behaviors of infant caregivers. Results A total of 895 pairs of infants and their caregivers were investigated.The caregivers showed the average scores of 9.01±2.64,10.60±1.99,9.41±2.06,9.01±2.38,and 8.57±2.29 in the dimensions of extraversion,agreeableness,conscientiousness,emotional stability,and openness,respectively.The effective feeding rate of nutrition package was 53.3% (477/895).The results of regression analysis showed that under the premise of controlling for other factors,the caregiver’s conscientious personality (OR=1.08,95%CI=1.004-1.153,P=0.038) was the protective factor for the effective feeding of nutrition package. Conclusion The feeding behavior of infant caregivers in the remote rural areas of Sichuan province remains to be improved,and the caregivers with high conscientious personality are more likely to feed their infants effectively.

PMID:36325779 | DOI:10.3881/j.issn.1000-503X.14608

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Oct;44(5):802-808. doi: 10.3881/j.issn.1000-503X.14695.

ABSTRACT

Objective To understand the prevalence and influencing factors of hypertension among the elderly aged 60 years and above in Mianyang City,Sichuan Province,so as to provide clues for targeted prevention and control of hypertension. Methods A total of 115 775 permanent residents aged 60 and above screened out from Mianyang demonstration sites from October 2017 to April 2019 were investigated by questionnaire and physical examination,and the data of personal basic information,lifestyle,body height,body weight,waist circumference,and blood pressure were collected.SPSS 22.0 was used for descriptive analysis,single factor analysis,and Logistic regression analysis. Results The prevalence rate of hypertension in the elderly aged 60 years and above in Mianyang was 50.60%.Specifically,the prevalence rates of hypertension in men and women were 50.27% and 50.85%,respectively.The prevalence rate of hypertension increased with the increase in age([Formula: see text]=370.199,P<0001).Multivariate Logistic regression analysis showed that the independent risk factors of hypertension included age of 70-79 years(OR=1.327,95%CI=1.292-1.363,P<0.001),the age of 80 years and above(OR=1.455,95%CI=1.386-1.527,P<0.001),widowhood(OR=1.343,95%CI=1.296-1.392,P<0.001),divorce(OR=1.255,95%CI=1.033-1.525,P=0.022),overweight(OR=1.431,95%CI=1.391-1.473,P<0.001),obesity(OR=2.171,95%CI=2.076-2.270,P<0.001),waist-to-height ratio>0.5(OR=1.317,95%CI=1.281-1.354,P<0.001),history of diabetes(OR=1.865,95%CI=1.791-1.941,P<0.001),history of smoking(OR=1.107,95%CI=1.068-1.148,P<0.001),and history of drinking(OR=1.950,95%CI=1.894-2.009,P<0.001).Living in urban-rural fringe areas(OR=0.628,95%CI=0.594-0.664,P<0.001),education background of junior high school and above(OR=0.942,95%CI=0.912-0.974,P<0.001),and low body weight(OR=0.785,95%CI=0.742-0.830,P<0.001) were protective factors for hypertension. Conclusions More than 50% of the elderly aged 60 years and above in Mianyang suffer from hypertension.The elderly with advanced age,widowhood,divorce,overweight,obesity,waist-to-height ratio>0.5,diabetes history,smoking history,and drinking history are the high-risk groups of hypertension.

PMID:36325777 | DOI:10.3881/j.issn.1000-503X.14695

J Korean Neurosurg Soc. 2022 Nov 3. doi: 10.3340/jkns.2022.0200. Online ahead of print.

ABSTRACT

OBJECTIVE: Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution.

METHODS: Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated.

RESULTS: A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p < 0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p < 0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p < 0.001). There was no TXA-related adverse event.

CONCLUSION: The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.

PMID:36325752 | DOI:10.3340/jkns.2022.0200

J Appl Clin Med Phys. 2022 Nov 3:e13820. doi: 10.1002/acm2.13820. Online ahead of print.

ABSTRACT

PURPOSE: To develop an independent log file-based intensity-modulated radiation therapy (IMRT) quality assurance (QA) tool for the 0.35 T magnetic resonance-linac (MR-linac) and investigate the ability of various IMRT plan complexity metrics to predict the QA results. Complexity metrics related to tissue heterogeneity were also introduced.

METHODS: The tool for particle simulation (TOPAS) Monte Carlo code was utilized with a previously validated linac head model. A cohort of 29 treatment plans was selected for IMRT QA using the developed QA tool and the vendor-supplied adaptive QA (AQA) tool. For 27 independent patient cases, various IMRT plan complexity metrics were calculated to assess the deliverability of these plans. A correlation between the gamma pass rates (GPRs) from the AQA results and calculated IMRT complexity metrics was determined using the Pearson correlation coefficients. Tissue heterogeneity complexity metrics were calculated based on the gradient of the Hounsfield units.

RESULTS: The median and interquartile range for the TOPAS GPRs (3%/3 mm criteria) were 97.24% and 3.75%, respectively, and were 99.54% and 0.36% for the AQA tool, respectively. The computational time for TOPAS ranged from 4 to 8 h to achieve a statistical uncertainty of <1.5%, whereas the AQA tool had an average calculation time of a few minutes. Of the 23 calculated IMRT plan complexity metrics, the AQA GPRs had correlations with 7 out of 23 of the calculated metrics. Strong correlations (|r| > 0.7) were found between the GPRs and the heterogeneity complexity metrics introduced in this work.

CONCLUSIONS: An independent MC and log file-based IMRT QA tool was successfully developed and can be clinically deployed for offline QA. The complexity metrics will supplement QA reports and provide information regarding plan complexity.

PMID:36325743 | DOI:10.1002/acm2.13820

Hosp Pract (1995). 2022 Nov 3. doi: 10.1080/21548331.2022.2144066. Online ahead of print.

ABSTRACT

OBJECTIVES: In the United States, approximately 18-25 percent of carotid duplex ultrasound (CUS) studies are ordered to assess patients with non-lateralizing neurological complaints such as syncope, blurry vision, lightheadedness, headache, and altered mental status. The purpose of this study is to evaluate the benefit of CUS in the evaluation of patients presenting with non-lateralizing signs or symptoms.

MATERIALS AND METHODS: We conducted a retrospective analysis to assess the degree and laterality of carotid stenosis among patients with non-lateralizing neurological complaints who underwent CUS interpreted by certified vascular neurologists over a period of three years. The primary endpoint was to identify the prevalence of moderate to severe carotid artery stenosis among 280 patients who met inclusion criteria.

RESULTS: 17.7% of CUS studies were ordered for non-lateralizing symptoms. 261 patients (93.21%) had either normal imaging or mild carotid stenosis of <50%. 19 patients (6.79%) were found to have stenosis of ≥50%. In this subgroup, age and known pre-existing carotid artery atherosclerotic disease were the only variables found to have a statistically significant association with the level of stenosis found on CUS. Two patients with asymptomatic stenosis of >70% underwent a revascularization procedure.

CONCLUSION: At least 17.7% of CUS studies were completed for non-lateralizing symptoms. The study is of low-yield with the prevalence of moderate to severe stenosis being comparable to that in the general asymptomatic population. We conclude that there is minimal clinical value in the use of CUS to investigate non-lateralizing neurological complaints, resulting in unnecessary healthcare costs.

PMID:36325737 | DOI:10.1080/21548331.2022.2144066

J Hum Nutr Diet. 2022 Nov 3. doi: 10.1111/jhn.13110. Online ahead of print.

ABSTRACT

This article reports the development and validation of a measure of parents’ use of baby-led weaning (BLW). Baby-led weaning is a child-centered approach to complementary feeding where the infant is allowed to eat whole foods (rather than purees) and explore a variety of foods and textures.^2,3,5,6 To date, parents’ use of baby-led weaning has been assessed using either single items or a wide variety of measures. In this study, exploratory and confirmatory factor analyses on independent samples supported three BLW subscales: independence, exploration, and family. The final thirteen-item scale showed adequate fit statistics and good reliability (χ2(62) = 115.02, p < .001; CFI = 0.98; TLI = .98; RMSEA = 0.05; SRMR = 0.06; exploration a=.738; family a=.715; independence a=.809). In addition, the scale demonstrated good external validity and related in theoretically expected ways to an infant feeding style measure and parent report of complementary feeding approach. This study was limited as it was mostly white parents, and the scale should be validated on a more diverse sample. Future research can use this scale to examine if BLW relates to infant taste preferences, parenting styles, and child eating behaviors to improve child nutrition and health outcomes. This article is protected by copyright. All rights reserved.

PMID:36325736 | DOI:10.1111/jhn.13110

Eur J Ophthalmol. 2022 Nov 3:11206721221136989. doi: 10.1177/11206721221136989. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the average retinal layer thicknesses in eyes with unilateral acute central serous chorioretinopathy (CSC) (with subretinal fluid (SRF)) and after complete resolution of SRF in these eyes and to compare the results with those obtained in healthy eyes.

METHODS: Fifty-four eyes of 27 patients with unilateral acute CSC (CSC in active phase) who had complete resolution of SRF and 25 eyes of 25 healthy control subjects enrolled in this retrospective study. The average thicknesses of the retinal layers were measured by segmentation analysis of optical coherence tomography at baseline and 6 months after complete resolution of SRF.

RESULTS: The mean outer nuclear layer (ONL) thickness was significantly lower in eyes with CSC than in fellow eyes (p < 0.001). The mean ONL thickness was increased after resolution of SRF, but still low compared to unaffected fellow eye and the increment was not statistically significant (p > 0.05). There were significant strong inverse correlations between visual acuity and ONL thicknesses at baseline and 6 months after complete resolution of SRF (p < 0.001, r = – 0.810; p < 0.001, r = – 0.705, respectively).

CONCLUSION: ONL thickness was thinned in cases with acute CSC, and although there was some increment in ONL thickness 6 months after complete resolution of SRF, it was still thinner compared to unaffected fellow eyes.

PMID:36325684 | DOI:10.1177/11206721221136989

Am J Health Promot. 2022 Nov 2:8901171221137056. doi: 10.1177/08901171221137056. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the percentage of United States adults who accurately assessed their diet quality (DQ).

DESIGN: Observational, cross-sectional, nationally representative.

SETTING: National Health and Nutrition Examination Survey, 2015-2018.

SAMPLE: 9757 (86%) of 11 288 adults aged ≥20 years.

MEASURES: Perceived DQ was assessed by asking participants, how healthy is your diet? The five responses included excellent, very good, good, fair, and poor. Measured DQ was assessed using 24-hours dietary recalls scored with 2015 Healthy Eating Index; scores were categorized using a 10-point grading scale.

ANALYSIS: Matches between perceived and measured DQ that were classified as accurate included: excellent = A, very good = A or B, good = B or C, fair = C or D, and poor = D or F. All others were classified as inaccurate. Analyses included descriptive statistics and multivariable logistic regression for complex survey designs.

RESULTS: 63% of adults perceived their DQ as very good or good while 70% scored DQ grades of F. Overall, 15% of adults accurately assessed their DQ with 96% accuracy in the poor perception group and <23% in the other 4 groups. Overall, 75% of adults overrated their DQ. Females, adults with lower educational attainment, and those with low food security were more likely to accurately assess their DQ.

CONCLUSION: Adults cannot accurately assess their DQ except for those perceiving their DQ as poor, and the majority overrate their DQ.

PMID:36325649 | DOI:10.1177/08901171221137056

Schweiz Arch Tierheilkd. 2022 Nov;164(11):777-788. doi: 10.17236/sat00374.

ABSTRACT

The hay producing plants, concentrate, straw and meadows could be contaminated by the aerosols of glyphosate based herbicide during spraying process of crops and pre-harvest desiccation treatment of cereals. The aim of this study is to investigate the concentration of glyphosate in the duodenal fluid of horses with gastric ulcer syndrome. The stomach and duodenum of referred untreated horse patients (n=92) with colic, weight loss, diarrhoea, anemia or performance intolerance were endoscopically examined right after the admission. Duodenal fluid (40 ml) was collected from the duodenal region where the papilla duodeni major is located. Hematology and clinical chemistry data were examined. The concentration of glyphosate in serum and duodenal fluid samples were analysed using a competitive ELISA and control analysis had also been done with HPLC. Statistical differences between groups were determined by the non-parametric Mann-Whitney-test using a significant level of p≤0,05. Glyphosate was detected in all duodenal fluid (median 12,2 ng/ml; 1st quartile 4,0 ng/ml; 3rd quartile 19,3 ng/ml; min 0,6 ng/ml; max. 192,9 ng/ml) and blood samples (1,79 ng/ml; 1,0 ng/ml; 2,8 ng/ml; 0,2 ng/ml; 3,7 ng/ml) of all horses. Glyphosate concentrations of duodenal fluid samples are significantly higher than in blood samples (Mann Whitney U-test, p≤0,05). The concentration of glyphosate in the duodenal fluid was significantly higher in horses with squamous gastric disease (grade 4/4; n=11/92) compared to horses with normal squamous mucosa (grade 0/4, n=10/92) (median: 19,8 ng/ml versus 8,4 ng/ml). Horses with glandular gastric disease and a grade 4/4 (n=9/92) had higher concentrations of glyphosate in the duodenal fluid than horses with normal glandular mucosa (grade 0/4; n=9/92) (median: 19,2 versus 11,1). The Gamma-Glutamyltransferase (GGT) enzyme activity is significantly higher in the group of horses with lower concentration of glyphosate in the duodenal fluid (≤12,2 ng/ml) compared with the group with higher concentration of glyphosate (>12,2 ng/ml) (median 279,5 versus 101,9 U/L). During autumn the horses had higher concentrations of glyphosate in duodenal fluid (n=18; median 14,3) compared with lower concentrations in spring time (n=34; median 8,1 ng/ml). Horses kept around big cities had significantly higher concentrations of glyphosate in the duodenal fluid in comparison to horses living in the countryside (medians 17,8 ng/ml versus 7,5 ng/ml).

PMID:36325641 | DOI:10.17236/sat00374