Nevin Manimala

J Med Virol. 2022 Nov 22. doi: 10.1002/jmv.28316. Online ahead of print.

ABSTRACT

To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May 2021 through December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID-19 severity, the number of manifestations and delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, a smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs. This article is protected by copyright. All rights reserved.

PMID:36412057 | DOI:10.1002/jmv.28316

Pest Manag Sci. 2022 Nov 22. doi: 10.1002/ps.7292. Online ahead of print.

ABSTRACT

BACKGROUND: Sugar beet is threatened by virus yellows, a disease complex vectored by aphids that reduces sugar content. We present an analysis of Myzus persicae population dynamics with and without neonicotinoid seed treatment. We use six years’ yellow water trap and field-collected aphid data and two decades of 12.2 m suction-trap aphid migration data. We investigate both spatial synchrony and forecasting error to understand the structure and spatial scale of field counts and why forecasting aphid migrants lacks accuracy. Our aim is to derive statistical parameters to inform regionwide pest management strategies.

RESULTS: Spatial synchrony, indicating the coincident change in counts across the region over time, is rarely present and is best described as stochastic. Uniquely, early season field populations in 2019 did show spatial synchrony to 90 km compared to the overall average weekly correlation length of 23 km. However, 70% of the time series were spatially heterogenous, indicating patchy between-field dynamics. Field counts lacked the same seasonal trend and did not peak in the same week. Forecasts tended to under-predict mid-season log₁₀ counts. A strongly negative correlation between forecasting error and the proportion of zeros was shown.

CONCLUSION: Field populations are unpredictable and stochastic, regardless of neonicotinoid seed treatment. This outcome presents a problem for decision-support that cannot usefully provide a single regionwide solution. Weighted permutation entropy inferred that M. persicae 12.2 m suction-trap time series had moderate to low intrinsic predictability. Early warning using a migration model tended to predict counts at lower levels than observed. This article is protected by copyright. All rights reserved.

PMID:36412050 | DOI:10.1002/ps.7292

Eval Health Prof. 2022 Nov 22:1632787221141504. doi: 10.1177/01632787221141504. Online ahead of print.

ABSTRACT

This study aims to compare caffeine intake and physical activity levels in university students with severe and ineffective fatigue and examine the relationship between them. A total of 647 (F:527; M:120) university students were included in this cross-sectional study. Individuals’ socio-demographic information, severity of fatigue (Fatigue Severity Scale (FSS)), amount of caffeine intake and physical activity level (International Physical Activity Questionnaire-Short Form (IPAQ-SF)) were evaluated. It was determined that 56.5% of the university students (age: 21.21 ± 2.57) participating in the study had severe fatigue. Caffeine intake and physical activity level of students with severe fatigue were statistically significantly lower than those with ineffective fatigue (p < 0.05). In addition, there was a weak negative correlation between fatigue and caffeine intake (r = -0.157; p < 0.001) and physical activity level (r = -0.096; p < 0.017). There was a significant positive correlation between caffeine intake and physical activity (r = 0.143; p < 0.001). This study showed that a significant portion of university students have severe fatigue. In addition, individuals with severe fatigue have decreased caffeine intake and lower physical activity levels. To reduce fatigue, caffeine intake in safe doses should be encouraged in accordance with the individual’s metabolic and physiological parameters. In addition, physical activity counseling should be given to encourage physical activity.

PMID:36412049 | DOI:10.1177/01632787221141504

J Nurs Scholarsh. 2022 Nov 21. doi: 10.1111/jnu.12841. Online ahead of print.

ABSTRACT

INTRODUCTION: Since the COVID-19 pandemic, an increase in fentanyl-combined drugs has led to a surge in opioid overdose deaths in the United States. Higher opioid overdose mortality rates are problematic in rural communities, and there are few prevention, treatment, and recovery resources for individuals experiencing opioid use disorder.

METHOD: This exploratory project aimed to investigate a hands-on naloxone training for rural clinicians and staff. Rural clinicians and staff at two behavioral health centers were recruited to participate in a 30-min lecture and 30-min hands-on intranasal naloxone training using a low-fidelity mannequin. A pre-post opioid knowledge questionnaire, rubric based on the Substance Abuse and Mental Health Services Administration toolkit, and investigator-generated survey were used to evaluate opioid knowledge and response, demonstration of intranasal naloxone administration, and participants’ perceptions of the training. Enrollment characteristics were summarized using descriptive statistics and paired t-tests were used to assess mean differences.

RESULTS: Of the nine participants in the project, seven (87.5%) were female and six (75.0%) were Black. Four participants assumed a therapist role, attained a MS or MA degree, and had 5 or more years of experience working in healthcare. The total mean rubric score for all participants was 96.0 (SD = 8.8). No significant pre-post mean differences among opioid knowledge, overdose risk, and overdose response categories were found, all p > 0.05. However, post-intervention mean scores were slightly higher in all categories except overdose risk. Most participants (77.8%) responded that they felt comfortable handling an opioid situation and teaching the training to community members. Open-ended responses indicated that participants liked the demonstrations, examples used, hands-on nature of the training, and the presentation materials.

CONCLUSION: A hands-on naloxone training is beneficial for training rural clinicians and staff to respond to opioid overdose. This training may be a promising solution to reduce response time between recognition of opioid symptoms and administration of the life-saving medication, naloxone. Future studies should examine the efficacy of this training in larger samples with the inclusion of rural interdisciplinary teams, trusted community leaders, and family and friends of those impacted by opioid use disorder.

CLINICAL RELEVANCE: This innovative hands-on naloxone training is designed for rural clinicians and residents who are most likely to witness individuals experiencing opioid toxicity. The primary goal is to reduce response time between recognition of signs and symptoms and administration of the life-saving medication, Naloxone.

PMID:36411494 | DOI:10.1111/jnu.12841

Phytother Res. 2022 Nov 21. doi: 10.1002/ptr.7670. Online ahead of print.

ABSTRACT

The mechanism of SARS-CoV-2 spike protein-mediated perturbations of metabolic pathways and modulation of antcin A, a steroid-like compound isolated from Taiwanofungus camphoratus, are not studied. Here, we investigated the metabolic alteration by SARS-CoV-2 spike protein and the regulatory effect of antcin A on SARS-CoV-2 spike protein-induced metabolic changes in the Phorbol 12-myristate 13-acetate (PMA)-induced human monocytes (THP-1) using proton nuclear magnetic resonance (¹ H-NMR) and MetaboAnalyst 5.0 software. The cytotoxic potential of SARS-CoV-2 spike protein, antcin A, and dexamethasone was assessed by MTT assay. The metabolomic perturbations and their relation to human coronaviruses’ receptors were evaluated by qPCR. This study indicated that the altered metabolites mediated by SARS-CoV-2 protein, such as methionine, phosphoenolpyruvic acid, canadine, glutamine, ethanolamine, and phenylalanine, were significantly reversed by antcin A. In addition, antcin A significantly inhibited SARS-CoV-2 spike protein-mediated up-regulation of TLR-4 and ACE2 receptors, while GRP78 inhibition was not statistically significant. This is the first study to use ¹ H-NMR to investigate SARS-CoV-2 spike protein-induced metabolomic changes in PMA-induced THP-1 cells. Antcin A significantly reversed metabolomic alters while dexamethasone failed to fix them. Therefore, we believe that antcin A could be a potential candidate for therapeutic agents for viral infections related to a metabolic abnormality.

PMID:36411492 | DOI:10.1002/ptr.7670

BMC Vet Res. 2022 Nov 21;18(1):412. doi: 10.1186/s12917-022-03513-z.

ABSTRACT

BACKGROUND: Urothelial carcinoma (UC) is the most common neoplasm of the canine lower urinary tract, affecting approximately 2% of dogs. Elderly female patients of certain breeds are predisposed, and clinical signs of UC can easily be confused with urinary tract infection or urolithiasis. Diagnosis and treatment are challenging given the lack of disease-specific markers and treatments. The S100A8/A9 complex and S100A12 protein are Ca²⁺-binding proteins expressed by cells of the innate immune system and have shown promise as urinary screening markers for UC. The neutrophil-to-lymphocyte ratio (NLR) can also aid in distinguishing certain neoplastic from inflammatory conditions. Our study aimed to evaluate the tissue expression of S100/calgranulins and the blood NLR in dogs with UC. Urinary bladder and/or urethral tissue samples from dogs with UC (n = 10), non-neoplastic inflammatory lesions (NNUTD; n = 6), and no histologic changes (n = 11) were evaluated using immunohistochemistry. Blood NLRs were analyzed in dogs with UC (n = 22) or NNUTD (n = 26).

RESULTS: Tissue S100A12-positive cell counts were significantly higher in dogs with lower urinary tract disease than healthy controls (P = 0.0267 for UC, P = 0.0049 for NNUTD), with no significant difference between UC and NNUTD patients. Tissue S100A8/A9-positivity appeared to be higher with NNUTD than UC, but this difference did not reach statistical significance. The S100A8/A9⁺-to-S100A12⁺ ratio was significantly decreased in neoplastic and inflamed lower urinary tract tissue compared to histologically normal specimens (P = 0.0062 for UC, P = 0.0030 for NNUTD). NLRs were significantly higher in dogs with UC than in dogs with NNUTD, and a cut-off NLR of ≤ 2.83 distinguished UC from NNUTD with 41% sensitivity and 100% specificity. Higher NLRs were also associated with a poor overall survival time (P = 0.0417).

CONCLUSIONS: These results confirm that the S100/calgranulins play a role in the immune response to inflammatory and neoplastic lower urinary tract diseases in dogs, but the tissue expression of these proteins appears to differ from their concentrations reported in urine samples. Further investigations of the S100/calgranulin pathways in UC and their potential as diagnostic or prognostic tools and potential therapeutic targets are warranted. The NLR as a routinely available marker might be a useful surrogate to distinguish UC from inflammatory conditions.

PMID:36411489 | DOI:10.1186/s12917-022-03513-z

Inj Epidemiol. 2022 Nov 21;9(1):32. doi: 10.1186/s40621-022-00407-4.

ABSTRACT

BACKGROUND: Up to a third of global road traffic deaths, and one in five in Mexico, are attributable to alcohol. In 2013, Mexico launched a national sobriety checkpoints program designed to reduce drink-driving in municipalities with high rates of alcohol-related collisions. Our study measured the association between the sobriety checkpoints program and road traffic mortality rates in 106 urban municipalities.

METHODS: We leveraged data from the Salud Urbana en America Latina (SALURBAL), which compiles health and environmental data from cities with over 100,000 residents. Death data from 2005 to 2019 (i.e., outcome) were from official vital statistics. Among 106 Mexican municipalities defined as priority areas for intervention, 54 adopted the program (i.e., treatment) in 2013, 16 municipalities did so in 2014, 16 in 2015, 10 in 2016, 7 in 2017, and 2 in 2019. We used a difference-in-difference approach with inverse probability weighting adapted to a context where program adoption is staggered over time.

RESULTS: There was a 12.3% reduction in road traffic fatalities per 10,000 passenger vehicles in the post-treatment period compared to the pre-treatment period (95% Confidence Interval, – 17.8; – 6,5). There was a clear trend of decline in mortality in municipalities that adopted the program (vs. comparison) particularly after year 2 of the program.

CONCLUSIONS: In this study of 106 municipalities in Mexico, we found a 12.3% reduction in traffic fatalities associated with the adoption of sobriety checkpoints. There was a clear trend indicating that this association increased over time, which is consistent with sustained changes in drink-driving behavior. These findings provide support and insight for efforts to implement and evaluate the impact of sobriety checkpoint policies across Latin America.

PMID:36411475 | DOI:10.1186/s40621-022-00407-4

Head Face Med. 2022 Nov 21;18(1):36. doi: 10.1186/s13005-022-00337-y.

ABSTRACT

BACKGROUND: Tooth-colored onlays and partial crowns for posterior teeth have been used increasingly in clinics. However, whether onlays/partial crowns could perform as well as full crowns in the posterior region was still not evaluated thoroughly.

METHODS: A literature search was conducted without language restrictions in Pubmed, Embase, Cochrane Central Register of Controlled Trial and Web of science until September 2021. RCTs, prospective and retrospective observational studies with a mean follow-up of 1 year were selected. Cochrane Collaboration’s tool was adopted for quality assessment of the RCT. The quality of observational studies was evaluated following Newcastle-Ottawa scale. The random-effects and fixed-effects model were employed for meta-analysis.

RESULTS: Four thousand two hundred fifty-seven articles were initially searched. Finally, one RCT was identified for quality assessment and five observational studies for qualitative synthesis and meta-analysis. The RCT was of unclear risk of bias while five observational studies were evaluated as low risk. The meta-analysis indicated no statistically significant difference in the survival between onlays/partial crowns and full crowns after 1 year (OR = 0.55, 95% CI: 0.02-18.08; I² = 57.0%; P = 0.127) and 3 years (OR = 0.65, 95% CI: 0.20-2.17; I² = 0.0%; P = 0.747). For the success, onlays/partial crowns performed as well as crowns (OR = 0.58, 95% CI: 0.20-1.72; I² = 0.0%; P = 0.881) at 3 years. No significant difference of crown fracture existed between the two methods (RD = 0.00, 95% CI: – 0.03-0.03; I² = 0.0%; P = 0.972).

CONCLUSIONS: Tooth-colored onlays/partial crowns performed as excellently as full crowns in posterior region in a short-term period. The conclusions should be further consolidated by RCTs with long-term follow-up.

PMID:36411462 | DOI:10.1186/s13005-022-00337-y

BMC Anesthesiol. 2022 Nov 21;22(1):356. doi: 10.1186/s12871-022-01900-5.

ABSTRACT

BACKGROUND: Video-assisted surgery has become an increasingly used surgical technique in patients undergoing major thoracic and abdominal surgery and is associated with significant perioperative respiratory and cardiovascular changes. The aim of this study was to investigate the effect of intraoperative pneumoperitoneum during video-assisted surgery on respiratory physiology in patients undergoing robotic-assisted surgery compared to patients undergoing classic laparoscopy in Trendelenburg position.

METHODS: Twenty-five patients undergoing robotic-assisted surgery (RAS) were compared with twenty patients undergoing classic laparoscopy (LAS). Intraoperative ventilatory parameters (lung compliance and plateau airway pressure) were recorded at five specific timepoints: after induction of anesthesia, after carbon dioxide (CO₂) insufflation, one-hour, and two-hours into surgery and at the end of surgery. At the same time, arterial and end-tidal CO₂ values were noted and arterial to end-tidal CO₂ gradient was calculated.

RESULTS: We observed a statistically significant difference in plateau pressure between RAS and LAS at one-hour (26.2 ± 4.5 cmH₂O vs. 20.2 ± 3.5 cmH₂O, p = 0.05) and two-hour intervals (25.2 ± 5.7 cmH₂O vs. 17.9 ± 3.1 cmH₂O, p = 0.01) during surgery and at the end of surgery (19.9 ± 5.0 cmH₂O vs. 17.0 ± 2.7 cmH₂O, p = 0.02). Significant changes in lung compliance were also observed between groups at one-hour (28.2 ± 8.5 mL/cmH₂O vs. 40.5 ± 13.9 mL/cmH₂O, p = 0.01) and two-hour intervals (26.2 ± 7.8 mL/cmH₂O vs. 54.6 ± 16.9 mL/cmH₂O, p = 0.01) and at the end of surgery (36.3 ± 9.9 mL/cmH₂O vs. 58.2 ± 21.3 mL/cmH₂O, p = 0.01). At the end of surgery, plateau pressures remained higher than preoperative values in both groups, but lung compliance remained significantly lower than preoperative values only in patients undergoing RAS with a mean 24% change compared to 1.7% change in the LAS group (p = 0.01). We also noted a more significant arterial to end-tidal CO₂ gradient in the RAS group compared to LAS group at one-hour (12.9 ± 4.5 mmHg vs. 7.4 ± 4.4 mmHg, p = 0.02) and two-hours interval (15.2 ± 4.5 mmHg vs. 7.7 ± 4.9 mmHg, p = 0.02), as well as at the end of surgery (11.0 ± 6.6 mmHg vs. 7.0 ± 4.6 mmHg, p = 0.03).

CONCLUSION: Video-assisted surgery is associated with significant changes in lung mechanics after induction of pneumoperitoneum. The observed changes are more severe and longer-lasting in patients undergoing robotic-assisted surgery compared to classic laparoscopy.

PMID:36411445 | DOI:10.1186/s12871-022-01900-5

BMC Geriatr. 2022 Nov 21;22(1):885. doi: 10.1186/s12877-022-03592-5.

ABSTRACT

BACKGROUND: Some older adults with a persistent death wish without being severely ill report having had a death wish their whole lives (lifelong persistent death wish; L-PDW). Differentiating them from older adults without severe illness who developed a death wish later in life (persistent death wish, not lifelong; NL-PDW) can be relevant for the provision of adequate help and support. This study aims to gain insight into the characteristics, experiences, and needs of older adults with a L-PDW versus older adults with a NL-PDW and into the nature of their death wishes.

METHODS: In the Netherlands, in April 2019, a cross-sectional survey study was conducted among a large representative sample of 32,477 citizens aged 55 years and older. Respondents with a L-PDW (N = 50) were compared with respondents with a NL-PDW (N = 217) using descriptive statistics, Kruskal-Wallis tests, and Fisher’s exact tests.

RESULTS: Respondents with a L-PDW were relatively younger and less often had (step)children. They less often looked back on a good and satisfying life with many good memories and more often reported trauma. Older adults with a NL-PDW more often reported loss and bereavement. Overall, the groups showed a lot of similarities. Both groups reported a death wish diverse in nature, numerous health problems, and a variety of needs for help and support.

CONCLUSIONS: Some of the differences we found between the groups might be particularly relevant for the provision of adequate help and support to older adults with a L-PDW (i.e., their past and trauma) and to older adults with a NL-PDW (i.e., their loss and bereavement). The heterogeneity of both groups and the diverse nature of their death wish indicate that careful assessment of the death wish, its background, and underlying needs is required to provide personalized help and support to older adults with a death wish.

PMID:36411442 | DOI:10.1186/s12877-022-03592-5