Nevin Manimala

JMIR Form Res. 2022 Sep 8;6(9):e32795. doi: 10.2196/32795.

ABSTRACT

BACKGROUND: Exclusive breastfeeding (EBF) at 6 months of age in most low- and middle-income countries, including India, is surprisingly low. There is a relative lack of mobile health apps that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing EBF practices in low- and middle-income countries.

OBJECTIVE: This study aimed to design, develop, and test the usability of Breastfeeding Education Support Tool for Baby (BEST4Baby), a mobile health app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India on optimal breastfeeding practices.

METHODS: A user-centered design process with an agile development methodology was used. The approach involved stakeholders and mothers who were trained to serve as PCs to guide BEST4Baby’s design and development, including the app’s content and features. PCs were engaged through focus groups with interactive wireframes. During the 24-month pilot study period, we conducted a feasibility test of the BEST4Baby app with 22 PCs who supported home visits with mothers residing in rural India. The intervention protocol required PCs to provide education and follow mothers using the BEST4Baby app, with 9 scheduled home visits from the late prenatal stage to 6 months post partum. BEST4Baby’s usability from the PCs’ perspective was assessed using the translated System Usability Scale (SUS).

RESULTS: The findings of this study align with best practices in user-centered design (ie, understanding user experience, including context with iterative design with stakeholders) to address EBF barriers. This led to the cultural tailoring and contextual alignment of an evidence-based World Health Organization breastfeeding program with an iterative design and agile development of the BEST4Baby app. A total of 22 PCs tested and rated the BEST4Baby app as highly usable, with a mean SUS score of 85.3 (SD 9.1), placing it over the 95th percentile for SUS scores. The approach translated into a highly usable BEST4Baby app for use by PCs in breastfeeding counseling, which also statistically increased EBF practices.

CONCLUSIONS: The findings suggest that BEST4Baby was highly usable and accepted by mothers serving as PCs to support other mothers in their EBF practices and led to positive outcomes in the intervention group’s EBF rates. The pilot study demonstrated that using the specially designed BEST4Baby app was an important support tool for mothers to serve as PCs during the 9 home visits.

TRIAL REGISTRATION: Clinicaltrials.gov NCT03533725; https://clinicaltrials.gov/ct2/show/NCT03533725.

PMID:36074546 | DOI:10.2196/32795

JMIR Form Res. 2022 Sep 8;6(9):e34902. doi: 10.2196/34902.

ABSTRACT

BACKGROUND: Previous studies have highlighted gender differences in web-based physician reviews; however, so far, no study has linked web-based ratings with quality of care.

OBJECTIVE: We compared a consumer-generated measure of physician quality (web-based ratings) with a clinical quality outcome (sanctions for malpractice or improper behavior) to understand how patients’ perceptions and evaluations of physicians differ based on the physician’s gender.

METHODS: We used data from a large web-based physician review website and the Federation of State Medical Boards. We implemented paragraph vector methods to identify words that are specific to and indicative of separate groups of physicians. Then, we enriched these findings by using the National Research Council Canada word-emotion association lexicon to assign emotional scores to reviews for different subpopulations according to gender, gender and sanction, and gender and rating.

RESULTS: We found statistically significant differences in the sentiment and emotion of reviews between male and female physicians. Numerical ratings are lower and sentiment in text reviews is more negative for women who will be sanctioned than for men who will be sanctioned; sanctioned male physicians are still associated with positive reviews.

CONCLUSIONS: Given the growing impact of web-based reviews on demand for physician services, understanding the different dynamics of reviews for male and female physicians is important for consumers and platform architects who may revisit their platform design.

PMID:36074543 | DOI:10.2196/34902

J Am Podiatr Med Assoc. 2022 May-Jun;112(3):18-002. doi: 10.7547/18-002.

ABSTRACT

BACKGROUND: Metatarsalgia is a common affliction in rheumatoid arthritis (RA), often requiring aggressive pharmacologic treatment that carries associated adverse effects. The aim of this study was to investigate whether simple insoles would have a beneficial effect on forefoot pain, disability, and functional limitation in participants with RA experiencing forefoot pain.

METHOD: A prospective, quasi-experimental, pretest-posttest trial was performed at a rheumatology outpatient clinic. Participants were supplied with a simple insole comprising a valgus pad and a plantar metatarsal pad and covered with a cushioning material. The Foot Function Index (FFI) was self-administered before and 3 months after insole use.

RESULTS: Reductions in forefoot pain (from 56.78 to 42.97) and total (from 41.64 to 33.54) FFI scores were noted. Statistical significance for this reduction was achieved following the t test (P = .002 and P = .0085, respectively). However, although reductions in mean disability and activity limitation scores were recorded (from 50 to 44.85 and from 18 to 14.57, respectively), these did not reach significance (P = .151 and P = .092, respectively) Conclusions: Simple insoles have been shown to be effective in reducing total and forefoot pain FFI scores in patients with RA experiencing metatarsalgia. This treatment offers advantages because these devices can be fabricated simply and cheaply, thus initiating the patient on an effective orthosis therapy immediately in the clinic without having to wait for prolonged periods until custom orthotic devices can be supplied.

PMID:36074526 | DOI:10.7547/18-002

J Drugs Dermatol. 2022 Sep 1;21(9):968-973. doi: 10.36849/JDD.6875.

ABSTRACT

BACKGROUND: The lips and perioral area play a crucial role in facial aesthetics. Signs of aging, such as wrinkles, decreased muscle tone, and thinning skin, frequently appear first in this anatomical area and, subsequently, in other areas. This may explain why the lips and perioral area are frequently requested focus areas for aesthetic treatments that retain the client’s natural features.

AIMS: To assess the safety and efficacy of the rejuvenation of the perioral area with an injectable product containing high-molecular-weight (HMW) native hyaluronic acid (HA) and a cluster of amino acids (AAs).

PATIENTS/METHODS: In this open-label observational study, 37 female patients underwent 3 monthly sessions of intradermal injections with HMW HA gel with a cluster of AAs. Follow-up investigations were performed after 30, 60, and 180 days. Outcomes were evaluated subjectively using a patient questionnaire, the Global Aesthetic Improvement Scale (GAIS) questionnaire, and objectively using a 3D photosystem.

RESULTS: All patients completed the study. The subjective evaluations made by patients and by the investigator during follow up and at the end of the study were positive, and all patients showed improvement in the perioral area. The objective evaluation showed a statistically significant improvement in pores condition and wrinkles.

CONCLUSIONS: The protocol for rejuvenation of the perioral area with injections of HMW HA gel and AA is safe and effective. J Drugs Dermatol. 2022;21(9):968-973.doi:10.36849/JDD.6875.

PMID:36074513 | DOI:10.36849/JDD.6875

JAMA Ophthalmol. 2022 Sep 8. doi: 10.1001/jamaophthalmol.2022.3473. Online ahead of print.

NO ABSTRACT

PMID:36074497 | DOI:10.1001/jamaophthalmol.2022.3473

Arq Bras Cardiol. 2022 Sep 2:S0066-782X2022005013405. doi: 10.36660/abc.20210843. Online ahead of print.

ABSTRACT

BACKGROUND: The neonatal period is marked by major changes in the cardiovascular system, especially in the first week of life. Unlike the adult population, studies on electrocardiogram (ECG) data in the neonatal period are scarce. This is the first study to describe electrocardiographic changes in a cohort of newborns with normal echocardiograms.

OBJECTIVES: To analyze the electrocardiographic patterns of a population of full-term NB, without any cardiac morphological or functional anomalies, and compare the results with the literature.

METHODS: In this observational study, echocardiograms and ECG results from 94 newborns divided in three age groups (up to 24 hours, between 25 and 72 hours, and between 73 and 168 hours of life) were evaluated and compared with those reported by Davignon et al. A p-value <0.05 was considered statistically significant.

RESULTS: There were significant differences in T-wave direction in leads V1 (p= 0.04), V2 (p= 0.02), V3 (p= 0.008) and V4 (p= 0.005) between the three age groups. There were differences between our findings and the current literature in most of the parameters.

CONCLUSION: Term newborns within 24 hours of life showed significantly more positive T waves than older ones. Many differences from the Davignon’s ECG parameters were found, particularly in the P, Q, R, S amplitudes, QRS duration, R/S and R+S. These findings indicate that more studies are needed for a definitive interpretation of the ECG in newborns.

PMID:36074483 | DOI:10.36660/abc.20210843

Arq Bras Cardiol. 2022 Sep 2:S0066-782X2022005013403. doi: 10.36660/abc.20210796. Online ahead of print.

ABSTRACT

BACKGROUND: In the atherosclerotic plaque microenvironment, oxidized phospholipids expressed in the oxidized low-density lipoprotein (oxLDL) surface bind to scavenger receptors of macrophages eliciting foam cell formation and plaque progression. Auto-antibodies against oxLDL (oxLDL-Ab) interact with oxidative epitopes leading to the formation of immune complexes that are unable to interact with macrophage receptors, thus abrogating atherogenesis. Release of oxLDL-Ab by B cells involves interleukin 5 and Th2 response, which in turn are potentiated by HDL. Thereby, we hypothesized that individuals with higher levels of HDL-C may plausibly display elevated titers of oxLDL-Ab.

OBJECTIVE: To evaluate the relationship between HDL-C and oxLDL-Ab levels.

METHODS: Asymptomatic individuals (n = 193) were grouped according to their HDL-C concentration to one of three categories: low (< 68 mg/dL), intermediate (68 to 80 mg/dL) or high (> 80 mg/dL). P values < 0.05 were considered statistically significant.

RESULTS: Our analysis included 193 individuals (mean age: 47 years; male: 26.3%). Compared to individuals in the lowest HDL-C tertile, those in the highest tertile were older (36 versus 53 years; p = 0.001) and less frequently male (42.6% versus 20.9%; p = 0.001). Mean values of oxLDL-Ab increased as the HDL-C group escalated (0.31, 0.33 and 0.43 units, respectively; p = 0.001 for trend). Simple linear regression found a significant, positive relationship between the independent variable, HDL-C, and the dependent variable, oxLDL-Ab (R = 0.293; p = 0.009). This relation remained significant (R = 0.30; p = 0.044), after adjustment by covariates. Apolipoprotein AI levels were also related to oxLDL-Ab in both simple and adjusted linear regression models.

CONCLUSION: HDL-C and oxLDL-Ab are independently related.

PMID:36074481 | DOI:10.36660/abc.20210796

Arq Bras Cardiol. 2022 Sep 2:S0066-782X2022005013402. doi: 10.36660/abc.20210681. Online ahead of print.

ABSTRACT

BACKGROUND: The right ventricular hypertrophy and dilation observed in pulmonary artery hypertension (PAH) damages the left ventricle (LV) dynamics by flattening the interventricular septum.

OBJECTIVE: To investigate whether low- to moderate-intensity resistance exercise training (RT) is beneficial to LV and cardiomyocyte contractile functions in rats during the development of monocrotaline (MCT)-induced PAH.

METHODS: Male Wistar rats (Body weight: ~ 200 g) were used. To assess the time to potential heart failure onset (i.e., end point), rats were divided into sedentary hypertension until failure (SHF, n=6) and exercise hypertension until failure (EHF, n=6) groups. To test RT effects, rats were divided into sedentary control (SC, n = 7), sedentary hypertension (SH, n=7), and exercise hypertension (EH, n=7) groups. PAH was induced by two MCT injections (20 mg/kg, with 7 days interval). Exercise groups were submitted to an RT protocol (Ladder climbing; 55-65% of carrying maximal load), 5 times/week. Statistical significance was assumed at P < 0.05.

RESULTS: RT prolonged the end point (~25 %), enhanced the physical effort tolerance (~ 55%), and mitigated the LV and cardiomyocyte contractility dysfunctions promoted by MCT by preserving the ejection fraction and fractional shortening, the amplitude of shortening, and the velocities of contraction and relaxation in cardiomyocytes. RT also prevented increases in left ventricle fibrosis and type I collagen caused by MCT, and maintained the type III collagen and myocyte dimensions reduced by MCT.

CONCLUSION: Low- to moderate-intensity RT benefits LV and cardiomyocyte contractile functions in rats during the development of MCT-induced PAH.

PMID:36074480 | DOI:10.36660/abc.20210681

Microbiol Immunol. 2022 Sep 8. doi: 10.1111/1348-0421.13026. Online ahead of print.

ABSTRACT

There are a limited number of studies regarding the involvement of viruses in the development and pathogenesis of renal cell carcinoma (RCC). In this study, we aimed to discover whether human herpesvirus 6A (HHV-6A) and 6B (HHV-6B) and human polyomavirus JC (JCV) and BK (BKV) are associated with RCC and the expression of p53, p16INK4a, Ki-67 and NF-κB in RCC patients. A total of 122 histologically confirmed RCC tissue specimens and 96 specimens of their corresponding peritumoral tissues were included in this prospective study. Nested polymerase chain reaction (nPCR) was performed in order to amplify viral DNA sequences. Restriction endonuclease analysis was carried out to discriminate between HHV-6A and HHV-6B. p53, p16INK4a, Ki-67, and NF-κB immunostaining data of the studied tissue specimens were available from our previous study. Statistical analysis was performed to demonstrate the potential associations. HHV-6B and JCV were detected in 10.7% and 13.9% of RCC patients, respectively. We did not detect HHV-6A and BKV in any of RCC tissue specimens. Moreover, no association was found between either of these viruses and RCC. Our study revealed a significant association between HHV-6B and p53 overexpression. No other associations were found between cellular biomarkers p53, p16INK4a, Ki-67, and NF-κB and the studied viruses. The data of the present study, though very limited, disprove the involvement of HHV-6A, HHV-6B, BKV, and JCV in the initiation or progression of RCC. This article is protected by copyright. All rights reserved.

PMID:36073532 | DOI:10.1111/1348-0421.13026

Electromagn Biol Med. 2022 Sep 8:1-7. doi: 10.1080/15368378.2022.2117189. Online ahead of print.

ABSTRACT

The presence of technological devices in our lives has increased exposure to environmental electromagnetic fields. As a result of this, especially Cancer and Diabetes are increasing.Rats were divided into 3 groups with 12 rats in each group. The 1st experimental group (n = 12) was exposed to a 50 Hz ELF magnetic field of 0.4 mT for 6 hours a day for 5 days, the 2nd experimental group (n = 12) was exposed for 10 days, and the control group (n = 12) was never exposed to a magnetic field. After completing the applications, blood collection from the rats was performed under appropriate conditions, measurements were made in the laboratory, and statistical analysis was performed between the groups. There was no significant difference between the groups in the results of transaminases and lipid profiles and C-Peptide. There was no significant difference in insulin, urea, creatinine, Na, K, Ca, and uric acid parameters between the groups. However, there was a significant increase in glucose, HbA1c, and Hba1 IFCC values between the control group and the experimental groups (p < .001). There was a significant increase in the level of Fetuin-A between the control group and the experimental groups (p < .05). There was an increase in the Fetuin-A, Glucose, HbA1c, and Hba1c IFCC values in both of the experimental groups compared to the control group. We believe that an increase in these values may cause Type 3 diabetes.

PMID:36073511 | DOI:10.1080/15368378.2022.2117189