Nevin Manimala

Phytopathology. 2022 Nov 1. doi: 10.1094/PHYTO-09-22-0340-FI. Online ahead of print.

ABSTRACT

The apoplast is the first hub of plant-pathogen communication where pathogen effectors are recognized by plant defensive proteins and cell receptors, thus activating signal transduction pathways. As a result of this first contact, the host triggers a defence response that involves the modulation of extra and intracellular proteins. In grapevine-pathogen interactions, little is known about the trafficking between extra and intracellular spaces. Grapevine is an economically important crop that relies on heavy fungicide use to control several diseases, a deeper knowledge on the activation of its immune response is crucial to define new control strategies. In this study, we focused on the first 6 hours post inoculation with Plasmopara viticola to evaluate grapevine proteome modulation in the apoplast. The P. viticola proteome in planta, was also assessed enabling a deeper understanding of plant-pathogen communication. Our results showed that several plant mechanisms are triggered in the tolerant grapevine cultivar ‘Regent’ after inoculation, like oomycete recognition, plant cell wall modifications, ROS signalling and secretion of proteins to disrupt oomycete structures. On the other hand, P. viticola proteins related to development and virulence were the most predominant. This pioneer study highlights the early dynamics of cellular communication in grapevine defence that leads to the successful establishment of an incompatible interaction.

PMID:36318254 | DOI:10.1094/PHYTO-09-22-0340-FI

JMIR Res Protoc. 2022 Nov 1;11(11):e42338. doi: 10.2196/42338.

ABSTRACT

BACKGROUND: Burnout syndrome is a chronic response to stressors in the workplace. It is characterized by emotional exhaustion and physical and mental burnout and may lead to high employee turnover, work absenteeism, and increased occupational accidents. Most studies use the Maslach Burnout Inventory (MBI) to identify burnout and implement preventive actions and treatments.

OBJECTIVE: This study presents a scoping review protocol to identify and map studies that used MBI to assess burnout syndrome in health care professionals working in public health services.

METHODS: This scoping review protocol follows the Joanna Briggs Institute reviewers’ manual, and this protocol consists of 6 stages: identifying the research question, identifying relevant studies, study selection, data extraction and coding, analysis and interpretation of results, and consultation with stakeholders. We will conduct searches in Embase, LILACS, PubMed/MEDLINE, PsycINFO, Scopus, Web of Science databases, and gray literature. The main research question is as follows: how is MBI used to identify burnout syndrome in health care professionals working in public health services? Inclusion criteria will comprise qualitative and quantitative studies using MBI to identify burnout syndrome in health care professionals working in public health services and no restrictions in language and publication dates. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute model. Quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The consultation with stakeholders will be essential for increasing the knowledge about MBI, identifying new evidence, and developing future strategies to guide public policies preventing burnout syndrome in health care professionals working in public services.

RESULTS: This protocol will guide a scoping review to identify and map studies that used MBI to identify burnout syndrome in health care professionals working in public health services. The results of this review may be useful to public health care professionals, managers, policymakers, and the general population because these findings will help understand the validated, translated, and adapted versions of MBI and domains, number of items, Likert scales, and cutoff points or the latent profile analysis most used in the literature. Furthermore, possible research gaps may be identified to guide future studies. All information regarding the stages of the scoping review favor its transparency and allow it to be methodologically replicated according to the principles of open science, thereby reducing the risk of bias and data duplication.

CONCLUSIONS: This study may reveal the multiplicity of scales described in the literature and the different forms of assessing burnout syndrome in health care professionals. This study may help to standardize the assessment of burnout syndrome in health care professionals working in public health services and contribute to the discussion and knowledge dissemination about burnout syndrome and mental health in this population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42338.

PMID:36318252 | DOI:10.2196/42338

JMIR Med Inform. 2022 Nov 1;10(11):e36711. doi: 10.2196/36711.

ABSTRACT

BACKGROUND: Often missing from or uncertain in a biomedical data warehouse (BDW), vital status after discharge is central to the value of a BDW in medical research. The French National Mortality Database (FNMD) offers open-source nominative records of every death. Matching large-scale BDWs records with the FNMD combines multiple challenges: absence of unique common identifiers between the 2 databases, names changing over life, clerical errors, and the exponential growth of the number of comparisons to compute.

OBJECTIVE: We aimed to develop a new algorithm for matching BDW records to the FNMD and evaluated its performance.

METHODS: We developed a deterministic algorithm based on advanced data cleaning and knowledge of the naming system and the Damerau-Levenshtein distance (DLD). The algorithm’s performance was independently assessed using BDW data of 3 university hospitals: Lille, Nantes, and Rennes. Specificity was evaluated with living patients on January 1, 2016 (ie, patients with at least 1 hospital encounter before and after this date). Sensitivity was evaluated with patients recorded as deceased between January 1, 2001, and December 31, 2020. The DLD-based algorithm was compared to a direct matching algorithm with minimal data cleaning as a reference.

RESULTS: All centers combined, sensitivity was 11% higher for the DLD-based algorithm (93.3%, 95% CI 92.8-93.9) than for the direct algorithm (82.7%, 95% CI 81.8-83.6; P<.001). Sensitivity was superior for men at 2 centers (Nantes: 87%, 95% CI 85.1-89 vs 83.6%, 95% CI 81.4-85.8; P=.006; Rennes: 98.6%, 95% CI 98.1-99.2 vs 96%, 95% CI 94.9-97.1; P<.001) and for patients born in France at all centers (Nantes: 85.8%, 95% CI 84.3-87.3 vs 74.9%, 95% CI 72.8-77.0; P<.001). The DLD-based algorithm revealed significant differences in sensitivity among centers (Nantes, 85.3% vs Lille and Rennes, 97.3%, P<.001). Specificity was >98% in all subgroups. Our algorithm matched tens of millions of death records from BDWs, with parallel computing capabilities and low RAM requirements. We used the Inseehop open-source R script for this measurement.

CONCLUSIONS: Overall, sensitivity/recall was 11% higher using the DLD-based algorithm than that using the direct algorithm. This shows the importance of advanced data cleaning and knowledge of a naming system through DLD use. Statistically significant differences in sensitivity between groups could be found and must be considered when performing an analysis to avoid differential biases. Our algorithm, originally conceived for linking a BDW with the FNMD, can be used to match any large-scale databases. While matching operations using names are considered sensitive computational operations, the Inseehop package released here is easy to run on premises, thereby facilitating compliance with cybersecurity local framework. The use of an advanced deterministic matching algorithm such as the DLD-based algorithm is an insightful example of combining open-source external data to improve the usage value of BDWs.

PMID:36318244 | DOI:10.2196/36711

JMIR Ment Health. 2022 Nov 1;9(11):e36496. doi: 10.2196/36496.

ABSTRACT

BACKGROUND: Internet-delivered psychosocial interventions can overcome barriers to face-to-face psychosocial care, but limited evidence supports their cost-effectiveness for people with bipolar disorders (BDs).

OBJECTIVE: This study aimed to conduct within-trial cost-effectiveness and cost-utility analyses of an internet-based intervention for people with BD, MoodSwings 2.0, from an Australian health sector perspective.

METHODS: MoodSwings 2.0 included an economic evaluation alongside an international, parallel, and individually stratified randomized controlled trial comparing an internet-based discussion forum (control; group 1), a discussion forum plus internet-based psychoeducation (group 2), and a discussion forum plus psychoeducation and cognitive behavioral tools (group 3). The trial enrolled adults (aged 21 to 65 years) with a diagnosis of BD assessed by telephone using a structured clinical interview. Health sector costs included intervention delivery and additional health care resources used by participants over the 12-month trial follow-up. Outcomes included depression symptoms measured by the Montgomery-Åsberg Depression Rating Scale (MADRS; the trial primary outcome) and quality-adjusted life years (QALYs) calculated using the short-form 6-dimension instrument derived from the 12-item version of the short-form health survey. Average incremental cost-effectiveness (cost per MADRS score) and cost-utility (cost per QALY) ratios were calculated using estimated mean differences between intervention and control groups from linear mixed effects models in the base case.

RESULTS: In total, 304 participants were randomized. Average health sector cost was lowest for group 2 (Aus $9431, SD Aus $8540; Aus $1=US $0.7058) compared with the control group (Aus $15,175, SD Aus $17,206) and group 3 (Aus $15,518, SD Aus $30,523), but none was statistically significantly different. The average QALYs were not significantly different among the groups (group 1: 0.627, SD 0.062; group 2: 0.618, SD 0.094; and group 3: 0.622, SD 0.087). The MADRS scores were previously shown to differ significantly between group 2 and the control group at all follow-up time points (P<.05). Group 2 was dominant (lower costs and greater effects) compared with the control group for average incremental cost per point decrease in MADRS score over 12 months (95% CI dominated to Aus $331). Average cost per point change in MADRS score for group 3 versus the control group was dominant (95% CI dominant to Aus $22,585). Group 2 was dominant (95% CI Aus $43,000 to dominant) over the control group based on lower average health sector cost and average QALY benefit of 0.012 (95% CI -0.009 to 0.033). Group 3, compared with the control group, had an average incremental cost-effectiveness ratio of dominant (95% CI dominated to Aus $19,978).

CONCLUSIONS: Web-based psychoeducation through MoodSwings 2.0 has the potential to be a cost-effective intervention for people with BD. Additional research is needed to understand the lack of effectiveness for the addition of cognitive behavioral tools with the group 3 intervention.

PMID:36318243 | DOI:10.2196/36496

J ECT. 2022 Oct 20. doi: 10.1097/YCT.0000000000000887. Online ahead of print.

ABSTRACT

OBJECTIVE: The aims of this study were to compare threshold and suprathreshold ictal electroencephalograms (EEGs) in right unilateral (RUL) ultrabrief (UB) electroconvulsive therapy (ECT) and to identify the differences between these EEGs.

METHODS: This study is a retrospective review of 125 pairs EEGs from titration and subsequent sessions across a 2-year period. All EEGs were independently rated for by 2 assessors using a scale based on qualities of an EEG used to guide ECT treatment dose adequacy, for example, midictal amplitude, regularity, interhemispheric coherence, seizure end point, and postictal suppression. The scores of threshold and suprathreshold EEGs were compared within and between groups based on 2 ECT types, that is, RUL UB ECT and RUL brief pulse (BP) ECT.

RESULTS: Paired t tests showed a statistically significant difference in between threshold and suprathreshold EEG scores in RUL UB ECT. There were no statistically significant differences between corresponding scores for RUL UB ECT and RUL BP ECT threshold and suprathreshold EEGs.

CONCLUSIONS: There is a significant difference between the quality of threshold and suprathreshold EEGs in RUL UB ECT when measured with an EEG rating scale. Visual rating of ictal EEGs is as reliable in discriminating between threshold and suprathreshold seizure in RUL UB ECT as it is in RUL BP ECT.

PMID:36318226 | DOI:10.1097/YCT.0000000000000887

JAMA Netw Open. 2022 Nov 1;5(11):e2239485. doi: 10.1001/jamanetworkopen.2022.39485.

ABSTRACT

IMPORTANCE: Alcohol consumption is a leading preventable cause of death in the US, and death rates from fully alcohol-attributable causes (eg, alcoholic liver disease) have increased in the past decade, including among adults aged 20 to 64 years. However, a comprehensive assessment of alcohol-attributable deaths among this population, including from partially alcohol-attributable causes, is lacking.

OBJECTIVE: To estimate the mean annual number of deaths from excessive alcohol use relative to total deaths among adults aged 20 to 64 years overall; by sex, age group, and state; and as a proportion of total deaths.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study of mean annual alcohol-attributable deaths among US residents between January 1, 2015, and December 31, 2019, used population-attributable fractions. Data were analyzed from January 6, 2021, to May 2, 2022.

EXPOSURES: Mean daily alcohol consumption among the 2 089 287 respondents to the 2015-2019 Behavioral Risk Factor Surveillance System was adjusted using national per capita alcohol sales to correct for underreporting. Adjusted mean daily alcohol consumption prevalence estimates were applied to relative risks to generate alcohol-attributable fractions for chronic partially alcohol-attributable conditions. Alcohol-attributable fractions based on blood alcohol concentrations were used to assess acute partially alcohol-attributable deaths.

MAIN OUTCOMES AND MEASURES: Alcohol-attributable deaths for 58 causes of death, as defined in the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. Mortality data were from the National Vital Statistics System.

RESULTS: During the 2015-2019 study period, of 694 660 mean deaths per year among adults aged 20 to 64 years (men: 432 575 [66.3%]; women: 262 085 [37.7%]), an estimated 12.9% (89 697 per year) were attributable to excessive alcohol consumption. This percentage was higher among men (15.0%) than women (9.4%). By state, alcohol-attributable deaths ranged from 9.3% of total deaths in Mississippi to 21.7% in New Mexico. Among adults aged 20 to 49 years, alcohol-attributable deaths (44 981 mean annual deaths) accounted for an estimated 20.3% of total deaths.

CONCLUSIONS AND RELEVANCE: The findings of this cross-sectional study suggest that an estimated 1 in 8 total deaths among US adults aged 20 to 64 years were attributable to excessive alcohol use, including 1 in 5 deaths among adults aged 20 to 49 years. The number of premature deaths could be reduced with increased implementation of evidenced-based, population-level alcohol policies, such as increasing alcohol taxes or regulating alcohol outlet density.

PMID:36318209 | DOI:10.1001/jamanetworkopen.2022.39485

JAMA Netw Open. 2022 Nov 1;5(11):e2239491. doi: 10.1001/jamanetworkopen.2022.39491.

ABSTRACT

IMPORTANCE: During menopause, the levels of estrogen and progesterone decrease and 60% to 70% of women experience menopausal symptoms, including mood disturbances. The latter might be prevented by hormone therapy (HT), yet some studies have suggested that use of HT might be associated with increased risk of depression.

OBJECTIVE: To examine whether use of HT during menopause was associated with a subsequent diagnosis of depression.

DESIGN, SETTING, AND PARTICIPANTS: This nationwide register-based cohort and self-controlled case series study included all women in Denmark aged 45 years between January 1, 1995, through December 31, 2017 (n = 825 238), without prior oophorectomy, breast cancer, or cancer in reproductive organs. Follow-up was completed on December 31, 2018. The statistical analysis was performed from September 1, 2021, through May 31, 2022.

EXPOSURES: Redeemed prescriptions of different types of HT identified by the Anatomical Therapeutic Chemical classification system codes (G03C [estrogen] and G03F [estrogen combined with progestin]) in the Danish National Prescription Registry between 1995 and 2017. Type of administration was divided into systemic (oral or transdermal) and local (intravaginal or intrauterine).

MAIN OUTCOMES AND MEASURES: A hospital diagnosis of depression (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes F32-F33 and International Classification of Diseases, Eighth Revision, codes 296.09, 296.29, 298.0, and 300.49) between 1995 through 2018. Associations were examined in cohort and self-controlled case series analysis using Cox proportional hazards and fixed-effects Poisson regression models.

RESULTS: During follow-up from 45 years of age to a mean of 56.0 (range, 45.1-67.7) years, 189 821 women (23.0%) initiated systemically or locally administered HT and 13 069 (1.6%) were diagnosed with depression. Systemically administered HT was mainly initiated before 50 years of age and was associated with a higher risk of a subsequent depression diagnosis (hazard ratio [HR] for 48-50 years of age, 1.50 [95% CI, 1.24-1.81]). The risk was especially elevated the year after initiation of both treatment with estrogen alone (HR, 2.03 [95% CI, 1.21-3.41]) and estrogen combined with progestin (HR, 2.01 [95% CI,1.26-3.21]). Locally administered HT was initiated across all ages and was not associated with depression risk (HR, 1.15 [95% CI, 0.70-1.87]). It was, however, associated with a lower risk of depression when initiated after 54 years of age (HR for 54-60 years of age, 0.80 [95% CI, 0.70-0.91]). In self-controlled analysis, which efficiently accounts for time-invariant confounding, users of systemically administered HT had higher rates of depression in the years after initiation compared with the years before treatment (incidence rate ratio for 0-1 year after initiation, 1.66 [95% CI, 1.30-2.14]).

CONCLUSIONS AND RELEVANCE: These findings suggest that systemically administered HT before and during menopause is associated with higher risk of depression, especially in the years immediately after initiation, whereas locally administered HT is associated with lower risk of depression for women 54 years or older.

PMID:36318208 | DOI:10.1001/jamanetworkopen.2022.39491

JAMA Netw Open. 2022 Nov 1;5(11):e2239772. doi: 10.1001/jamanetworkopen.2022.39772.

ABSTRACT

IMPORTANCE: Cannabis use is prevalent and increasing, and frequent use intensifies the risk of cannabis use disorder (CUD). CUD is underrecognized in medical settings, but a validated single-item cannabis screen could increase recognition.

OBJECTIVE: To evaluate the Single-Item Screen-Cannabis (SIS-C), administered and documented in routine primary care, compared with a confidential reference standard measure of CUD.

DESIGN, SETTING, AND PARTICIPANTS: This diagnostic study included a sample of adult patients who completed routine cannabis screening between January 28 and September 12, 2019, and were randomly selected for a confidential survey about cannabis use. Random sampling was stratified by frequency of past-year use and race and ethnicity. The study was conducted at an integrated health system in Washington state, where adult cannabis use is legal. Data were analyzed from May 2021 to March 2022.

EXPOSURES: The SIS-C asks about frequency of past-year cannabis use with responses (none, less than monthly, monthly, weekly, daily or almost daily) documented in patients’ medical records.

MAIN OUTCOMES AND MEASURES: The Diagnostic and Statistical Manual, Fifth Edition (DSM-5) Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) for past-year CUD was completed on a confidential survey and considered the reference standard. The SIS-C was compared with 2 or more criteria on the CIDI-SAM, consistent with CUD. All analyses were weighted, accounting for survey design and nonresponse, to obtain estimates representative of the health system primary care population.

RESULTS: Of 5000 sampled adult patients, 1688 responded to the cannabis survey (34% response rate). Patients were predominantly middle-aged (weighted mean [SD] age, 50.7 [18.1]), female or women (weighted proportion [SE], 55.9% [4.1]), non-Hispanic (weighted proportion [SE], 96.7% [1.0]), and White (weighted proportion [SE], 74.2% [3.7]). Approximately 6.6% of patients met criteria for past-year CUD. The SIS-C had an area under receiver operating characteristic curve of 0.89 (95% CI, 0.78-0.96) for identifying CUD. A threshold of less than monthly cannabis use balanced sensitivity (0.88) and specificity (0.83) for detecting CUD. In populations with a 6% prevalence of CUD, predictive values of a positive screen ranged from 17% to 34%, while predictive values of a negative screen ranged from 97% to 100%.

CONCLUSIONS AND RELEVANCE: In this diagnostic study, the SIS-C had excellent performance characteristics in routine care as a screen for CUD. While high negative predictive values suggest that the SIS-C accurately identifies patients without CUD, low positive predictive values indicate a need for further diagnostic assessment following positive results when screening for CUD in primary care.

PMID:36318205 | DOI:10.1001/jamanetworkopen.2022.39772

J Vis. 2022 Nov 1;22(12):1. doi: 10.1167/jov.22.12.1.

ABSTRACT

Previous work has claimed that canonical viewpoints of objects are more readily perceived than noncanonical viewpoints. However, all of these studies required participants to identify the object, a late perceptual process at best and arguably a cognitive process (Pylyshyn, 1999). Here, we extend this work to early vision by removing the explicit need to identify the objects. In particular, we asked participants to make an intact/scrambled discrimination of briefly presented objects that were viewed from either typical or atypical viewpoints. Notably, participants did not have to identify the object; only discriminate it from noise (scrambled). Participants were more sensitive in discriminating objects presented in typically encountered orientations than when objects were presented in atypical depth rotations (Experiment 1). However, the same effect for objects presented in atypical picture plane rotations (as opposed to typical ones) did not reach statistical significance (Experiments 2 and 3), suggesting that particular informative views may play a critical role in this effect. We interpret this enhanced perceptibility, for both these items and good exemplars and probable scenes, as deriving from their high real-world statistical regularity.

PMID:36318192 | DOI:10.1167/jov.22.12.1

JAMA. 2022 Nov 1;328(17):1768-1770. doi: 10.1001/jama.2022.18865.

NO ABSTRACT

PMID:36318139 | DOI:10.1001/jama.2022.18865