Nevin Manimala

Int J Older People Nurs. 2021 Oct 30:e12430. doi: 10.1111/opn.12430. Online ahead of print.

ABSTRACT

INTRODUCTION: The aims of the study were to investigate the four-factor structure of the German version of the Aging Semantic Differential (ASD) and to gain initial insights into the attitudes of nursing, medical and humanities students towards older people in Austria.

METHOD: A cross-sectional study design with a convenience sample was chosen.

RESULTS: The ASD was completed by 255 Austrian nursing, medicine, and humanities students, who described their attitudes towards persons who are 80 years of age and older. The applicability of the four-factor structure (instrumentality, autonomy, acceptability and integrity) of the German version was confirmed by performing a confirmatory factor analysis. The mean age of students in our sample was 23.6 years; 79% of these were female. The sample displayed negative attitudes regarding the factors of autonomy and instrumentality, but more positive attitudes regarding the factors integrity and acceptability. The attitudes of the students in the three study programmes differed, with the medical students displaying the most negative attitudes. Students who displayed positive attitudes had statistically significantly higher levels of knowledge about ageism and better possibilities to hold personal conversations with older people (80+) in the family or circle of friends.

CONCLUSION: We conclude that having more knowledge about ageism and close personal contacts to older persons can support positive attitudes towards older individuals.

PMID:34719117 | DOI:10.1111/opn.12430

J Cosmet Dermatol. 2021 Oct 31. doi: 10.1111/jocd.14582. Online ahead of print.

ABSTRACT

BACKGROUND: Monochromatic excimer light (MEL) is a safe and effective treatment for localized stable vitiligo. Previous reports of the combination of platelet-rich plasma (PRP) with narrowband ultraviolet B (NB-UVB) or excimer laser yielded conflicting results.

AIMS: This prospective, self-controlled, randomized, comparative study aimed to assess whether the addition of PRP to MEL therapy would be of an additive benefit in the treatment for localized stable vitiligo. Patients/Methods The current study included 36 patients with at least 2 more or less symmetrical patches of localized stable vitiligo (72 patches). For each patient, each of the 2 vitiligo patches was randomly assigned to receive either MEL therapy (twice weekly) with bi-weekly intradermal PRP (group A) or MEL therapy alone (group B) for a maximum of 4 months or till complete repigmentation. The degree of repigmentation was categorized as absent (0%), poor (1-25%), moderate (26-50%), good (51-75%), or excellent (>75%). Patients were asked about their level of satisfaction (not satisfied at all, partially satisfied, satisfied, or completely satisfied). Side effects were recorded, and follow-up for 3 months was done.

RESULTS: No statistically significant difference was observed between the 2 groups regarding the degree of repigmentation, the patients’ level of satisfaction, and the frequency of side effects (p = 0.504, 0.490, and 0.912, respectively). At the end of the follow-up period, recurrence was observed in only 3 patients.

CONCLUSIONS: The current study showed no statistically significant difference between using MEL alone or with intradermal PRP in the treatment for localized stable vitiligo.

PMID:34719101 | DOI:10.1111/jocd.14582

Br J Health Psychol. 2021 Oct 31. doi: 10.1111/bjhp.12569. Online ahead of print.

ABSTRACT

OBJECTIVES: Digitally-delivered diabetes prevention programmes (DPPs) may improve population health by reversing the escalating trend of type 2 diabetes (T2D) incidence. Understanding the factors which determine digital health acceptability is critical to developing effective interventions. This study aimed to develop and test a digital health acceptability model of the factors influencing the intention of adults living in Ireland to use a digital DPP.

DESIGN: A 61-item cross-sectional survey was issued online or in hard copy to a sample of adults.

METHODS: Participants viewed a brochure for a smartphone-based digital DPP. The FINDRISC assessed their risk of developing T2D, and Likert scale items assessed the personal health, social influence, eHealth literacy, and intervention factors of the model. Structural equation modelling was used to assess the relationships between these factors.

RESULT: Three-hundred-and-sixteen eligible participants (M_age = 36) completed the survey, 42% of which had a slightly elevated T2D risk or higher. Twelve direct factor relationships were statistically significant. Subjective norm had a moderate-to-large impact on T2D risk perceptions. Health status, perceived susceptibility to T2D, eHealth readiness, communicative eHealth literacy and image had significant impacts on use intentions through mediators of perceived ease of use and perceived usefulness. The model explained 65% of the variance in digital DPP use intentions.

CONCLUSION: Personal health beliefs, social influence, and eHealth literacy collectively influence a digital DPP’s acceptability. These findings may inform the development of future digital DPPs and other digital health interventions. Future research should test the model with adults that have a higher T2D risk status.

PMID:34719099 | DOI:10.1111/bjhp.12569

J Cosmet Dermatol. 2021 Oct 31. doi: 10.1111/jocd.14479. Online ahead of print.

ABSTRACT

BACKGROUND: Actinic keratosis (AK) is a precancerous disease, caused by ultraviolet radiation (UV).

OBJECTIVE: To analyze the clinical and pathological characteristics of AK in four areas with different ultraviolet radiation intensities.

METHODS: 1188 diagnosed AK patients, from January 2000 to July 2015, in dermatology department of four hospitals were collected. The UV intensity of hospital located cities from high to low is Kunming, Yinchuan, Shenyang and Nanjing. The information comes from medical records, and the pathological types and Keratinocyte Intraepithelial Neoplasia (KIN) grades were checked by two experienced pathologists. All information was conducted a retrospective multicenter research.

RESULTS: The patients were mainly middle-aged and elderly female, which was in direct contrast to the majority of men in European. The age of onset in Kunming group was lower than that in Yinchuan Group (p = 0.013) and Nanjing Group (p < 0.01). The course of disease in Kunming group was significantly shorter than that in Nanjing Group (p < 0.001). The lesions were almost located in the exposed area. The proportion of unexposed areas in Shenyang group was significantly higher than that in other groups (p < 0.001). There were statistical differences in pathological morphological classification among the four groups. These differences were not affected by age and gender. The number of KIN III grade patients in Shenyang group was significantly higher than that in other three groups (p < 0.05).

CONCLUSION: The Asian patients were mainly female. The clinical characteristics of AK are closely related to UV intensity, and environmental pollution, lifestyle, religious beliefs and other factors are also related.

PMID:34719097 | DOI:10.1111/jocd.14479

Pediatr Diabetes. 2021 Oct 31. doi: 10.1111/pedi.13273. Online ahead of print.

ABSTRACT

AIMS: To determine the glycaemic impact of dietary fat alone consumed without prandial insulin in individuals with T1D.

METHODS: Thirty participants with T1D (aged 8-18 years) consumed a test drink with either 20g glucose or 1, 13, 26, 39, 51g of fat with negligible carbohydrate/protein on 6 consecutive evenings, in a randomised order without insulin. Continuous glucose monitoring was used to measure glucose levels for 8 hours postprandially. Primary outcome was mean glycaemic excursion at each 30minute interval for each test condition. Generalised linear mixed models with a random effect for people with diabetes were used to test for an increase in blood glucose excursion with increasing quantity of fat.

RESULTS: Glycaemic excursions after 20g glucose were higher than after fat drinks over the first two hours (P < 0.05). Glycaemic excursion for the fat drinks demonstrated a dose response, statistically significant from four hours (P = 0.026), such that increasing loads of fat caused a proportionally larger increase in glycaemic excursion, remaining statistically significant until eight hours (P < 0.05). Overall, for every 10g fat added to the drink, glucose concentrations rose by a mean of 0.28mMol L^-1 from 330 mins (95% CI 0.15 to 0.39, P < 0.001).

CONCLUSIONS: Fat ingested without other macronutrients increases glucose excursions from four to eight hours after ingestion, in a dose dependent manner. These observations may impact on insulin dosing for high-fat foods in individuals with T1D. This article is protected by copyright. All rights reserved.

PMID:34719089 | DOI:10.1111/pedi.13273

Eur J Neurol. 2021 Oct 31. doi: 10.1111/ene.15162. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate smartphone keystroke dynamics (KD), derived from regular typing, on sensitivity to relevant change in disease activity, fatigue, and clinical disability in multiple sclerosis (MS).

METHODS: Preplanned interim analysis of a cohort study with 102 MS patients assessed at baseline and 3-month follow-up for gadolinium-enhancing lesions on MRI, relapses, fatigue and clinical disability outcomes. Keyboard interactions were unobtrusively collected during typing using the Neurokeys App. From these interactions 15 keystroke features were derived and aggregated using 16 summary and time series statistics. Responsiveness of KD to clinical anchor-based change was assessed by calculating the area under the receiver operating characteristic curve (AUC). The optimal cut-point was used to determine the minimal clinically important difference (MCID) and compared to the smallest real change (SRC). Commonly used clinical measures were analyzed for comparison.

RESULTS: 94 patients completed the follow-up. The five best performing keystroke features had AUC-values ranging from 0.72 to 0.78 for change in gadolinium-enhancing lesions, 0.67-0.70 for the Checklist Individual Strength Fatigue subscale, 0.66-0.79 for the Expanded Disability Status Scale, 0.69-0.73 for the Ambulation Functional System, and 0.72-0.75 for Arm function in MS Questionnaire. The MCID of these features exceeded the SRC on group level. KD had higher AUC-values than comparative clinical measures for the study outcomes, aside from ambulatory function.

CONCLUSIONS: KD demonstrated good responsiveness to changes in disease activity, fatigue, and clinical disability in MS, and detected important change beyond measurement error on group level. Responsiveness of KD was better than commonly used clinical measures.

PMID:34719076 | DOI:10.1111/ene.15162

Protein Sci. 2021 Oct 31. doi: 10.1002/pro.4215. Online ahead of print.

ABSTRACT

The interactions of proteins with surfaces are important in both biological processes and biotechnologies. In contrast to decades of study regarding the biophysics of proteins in bulk solution, however, our mechanistic understanding of the biophysics of proteins interacting with surfaces remains largely qualitative. In response, we have set to explore quantitatively the thermodynamics of protein-surface interactions. In this work we explore systematically the role of electrostatics in modulating the interaction between proteins and charged surfaces. In particular, we use electrochemistry to explore the extent to which a macroscopic, hydroxyl-coated surface held at a slightly negative potential affects the folding thermodynamics of surface-attached protein variants with different composition of charged amino acids. Doing so, we find that attachment to the surface generally leads to a net stabilization, presumably due to excluded volume effects that reduce the entropy of the unfolded state. The magnitude of this stabilization, however, is strongly correlated with the charged-residue content of the protein. In particular, we find statistically significant correlations with both the net charge of the protein, with greater negative charge leading to less stabilization by the surface, and with the number of arginines, with more arginines leading to greater stabilization. Such findings refine our understanding of protein-surface interactions, providing in turn a guiding rationale to achieve the functional deposition of proteins on artificial surfaces for implementation in, for example, protein-based biotechnologies. This article is protected by copyright. All rights reserved.

PMID:34719069 | DOI:10.1002/pro.4215

Equine Vet J. 2021 Oct 30. doi: 10.1111/evj.13532. Online ahead of print.

ABSTRACT

BACKGROUND: For medication control in several jurisdictions, withdrawal time is the period of refrain from racing after drug administration. It is set by adding a safety period to an experimental detection time. However, there are no reports of statistical analyses of detection time for the determination of withdrawal time in flunixin meglumine-treated horses.

OBJECTIVE: To analyse the population pharmacokinetics of flunixin in horses through the generation of a dataset for detection time statistical analysis and predictions via Monte Carlo simulation.

STUDY DESIGN: Experimental study.

METHODS: Drug plasma and urine concentrations following single intravenous (i.v.) administration of flunixin 1.1 mg/kg bodyweight (BW) in 10 horses and multiple administration of q 24 h for 5 days in 10 horses were measured using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Data were modelled using a nonlinear mixed effect model followed by Monte Carlo simulation. Irrelevant plasma concentration (IPC) and irrelevant urine concentration (IUC) were calculated using the Toutain approach. Detection times were obtained considering the time after the last administration for selected quantiles of 5000 hypothetical horses under the International Screening Limit (ISL) proposed by the International Federation of Horseracing Authorities (plasma: 1 ng/ml, urine; 100 ng/ml) RESULTS: For a regimen of 1.1 mg/kg BW q 24 h, the IPC and IUC values were 2.0 and 73.0 ng/ml, respectively. Detection times in plasma above the ISL for 90% of simulated horses were estimated as 74 h after a single 1.1 mg/kg dose administration, 149 h and 199 h after multiple doses over 5 days at either 24- or 12-h intervals, respectively. Corresponding detection times in urine were 46 h, 68 h and 104 h, respectively.

MAIN LIMITATION: Only female horses were investigated.

CONCLUSIONS: Statistical detection times for different flunixin meglumine regimens indicated a delay of detection time in plasma after multiple administrations under ISL.

PMID:34719043 | DOI:10.1111/evj.13532

Ecology. 2021 Oct 30:e03578. doi: 10.1002/ecy.3578. Online ahead of print.

ABSTRACT

Recently, Nakagawa et al. (2021) provided a timely and insightful comment to our paper on statistical methods for non-independent data in ecological meta-analyses (Song et al. 2020). Their comment highlighted the value of using hierarchical models in meta-analysis to address non-independence, and offered two assertions.

PMID:34719023 | DOI:10.1002/ecy.3578

Thromb Haemost. 2021 Oct 31. doi: 10.1055/s-0041-1736617. Online ahead of print.

ABSTRACT

BACKGROUND: Hip fracture surgeries are associated with considerable blood loss, while the perioperative coagulopathy is associated with the bleeding risk of these patients. We aimed to evaluate the ability of rotational thromboelastometry (ROTEM) to detect patients at high risk for excessive bleeding and increased transfusion requirements.

METHODS: We conducted a prospective observational study of 221 patients who underwent hip fracture surgeries. ROTEM analysis was performed preoperatively and immediately postoperatively. Blood loss parameters including blood loss volume, number of transfused red blood cell (RBC) units, and drop in hemoglobin levels were recorded. ROTEM parameters were compared between patients with and without excessive bleeding, and between patients with and without increased transfusion requirements (i.e., ≥2 RBC units).

RESULTS: The postoperative FIBTEM MCF value ≤15 mm had 66.6% (95% confidence interval [CI]: 59.7-74.1%) sensitivity and 92.0% (95% CI: 80.7-97.7%) specificity to prognose excessive bleeding, and preoperative FIBTEM MCF value ≤15 mm had 80.4% (95% CI: 73.5-86.2%) sensitivity and 91.2% (95% CI: 80.7-97.0%) specificity to prognose increased transfusion requirements. Preoperative FIBTEM MCF ≤11 mm and postoperative FIBTEM MCF ≤15 mm were associated with considerably increased risks of excessive bleeding (odds ratio [OR]: 44.8, 95% CI: 16.5-121.3, p < 0.001; and OR: 23.0, 95% CI: 7.8-67.0, p < 0.001, respectively).

CONCLUSION: ROTEM parameters demonstrated high prognostic accuracy for excessive bleeding and increased transfusion requirements. This can enable implementation of blood sparing strategies in high-risk patients, while blood banks could be better prepared to ensure adequate blood supply.

PMID:34719014 | DOI:10.1055/s-0041-1736617