Nevin Manimala

J Laparoendosc Adv Surg Tech A. 2022 Sep 14. doi: 10.1089/lap.2022.0369. Online ahead of print.

ABSTRACT

Background: To summarize and analyze the application of transvaginal natural orifice specimen extraction surgery (TV-NOSES) in the operation of renal carcinoma, upper tract urothelial carcinoma, and bladder cancer. Methods: Fifty-seven female patients who underwent 3D laparoscopic radical surgery for urinary tumors and TV-NOSES were analyzed retrospectively. The basic clinical data, perioperative-related data, postoperative complications, and related indexes of postoperative functional evaluation were analyzed and evaluated. Results: All 57 operations were successfully performed according to the original plan. One patient developed mild vaginal infection after operation, which was cured after symptomatic treatment. The visual analog scale scores at 24 and 48 hours after operation were 2.5 (1-4) and 1.1 (0-2), respectively. Patient scar assessment questionnaire scores at 3 months after operation were 37.1 (32-48). Pelvic floor distress inventory-short form 20 scores at preoperative and postoperative 3 months were 5.9 (3-9) and 6.3 (3-9), respectively, and the difference was not statistically significant (P = .48). There was no significant difference in female sexual function index scores between preoperative and postoperative 3 months (P = .82). Conclusions: TV-NOSES in urological surgery is feasible and practical. In addition, this technique further reduces wound pain and wound-related complications without affecting postoperative sexual function and pelvic floor function. The successful development of this technique has laid a solid foundation for further clinical application and promotion. Clinical Trial Registration number: 22/141-3342.

PMID:36108338 | DOI:10.1089/lap.2022.0369

J Nerv Ment Dis. 2022 Sep 13. doi: 10.1097/NMD.0000000000001591. Online ahead of print.

ABSTRACT

Since the implementation of “two-child policy” in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and second childbirth remains unclear. We aimed to compare the prevalence and the influencing factors of PPD between the two groups. Postpartum women were recruited at their 6-week postpartum checkups and invited to complete questionnaires. The prevalence rate of PPD was 42.1%. There was no statistical difference found regarding the prevalence of PPD and the total score on the Edinburgh Postnatal Depression Scale between the two groups. The median of the item “self-injury” was significantly higher among women at first childbirth. Women with gestational diabetes in pregnancy, antenatal anxiety and depression, abortion, having babies getting sick occasionally, and deteriorated relationships with partner in pregnancy had much higher risks for PPD. Both primiparous and secundiparous had a high prevalence of PPD. It provides scientific evidence for clinical preventive and nursing care for PPD.

PMID:36108287 | DOI:10.1097/NMD.0000000000001591

J Nerv Ment Dis. 2022 Sep 13. doi: 10.1097/NMD.0000000000001582. Online ahead of print.

ABSTRACT

This cross-sectional study aims to compare pre- versus post-psychiatry course stigma levels toward mental illnesses among King Saud University medical students and identify which factors could affect stigma degree. The sample included 384 randomly chosen students. The overall scores of the used scale, the 15-item Opening Minds Scale for Healthcare Providers (OMS-HC-15), indicated no statistically significant difference between the before- and the after-psychiatry-course groups. The univariate analysis for differences in OMS-HC-15 score according to the sociodemographic characteristics of the pre psychiatry course group indicated that the factors associated with the total OMS-HC-15 score were sex (p < 0.001), being diagnosed with mental illness (p < 0.001), and having a relative diagnosed with mental illness (p = 0.005). Among the post psychiatry course group, the univariate analysis indicated that the same factors, namely, sex (p = 0.001), being diagnosed with mental illness (p = 0.006), and having a relative diagnosed with mental illness (p = 0.007), were associated with the total OMS-HC-15 score. Further studies at a larger scale to confirm generalizability of the results are warranted.

PMID:36108280 | DOI:10.1097/NMD.0000000000001582

J Nerv Ment Dis. 2022 Sep 13. doi: 10.1097/NMD.0000000000001579. Online ahead of print.

ABSTRACT

It is pointed out that the attachment styles of spouses are also very important in terms of coping with the psychological problems experienced in illness and sexual satisfaction. The aim of this study is to investigate the effect of sexual attitudes and attachment styles of spouses of cancer patients on their psychological resilience. The research was carried out as a descriptive study based on the relational screening model between January and November 2021. A total of 429 spouses of cancer patients who met the inclusion criteria were included in the study. The data were collected online using the Participant Information Form, which was prepared by the researcher, Resilience Scale for Adults (RSA), Experiences in Close Relationships Scale (ECR-S), and Hendrick Sexual Attitude Scale (BSAS). Data analyses included descriptive statistics, Mann-Whitney U-test, Kruskal-Wallis, and linear regression using the SPSS 25.0 program. Two hundred forty-six women and 183 men were included in the study, and it has been detected that RSA scores of female participants were higher than male participants. In addition, a positive relation between RSA scores and ECR-S scores (r = 0.247) and a negative relation between RSA and BSAS (r = -0.414) were detected (p < 0.05). It was determined that the psychological resilience of spouses of cancer patients was related to sexual attitudes and attachment styles.

PMID:36108279 | DOI:10.1097/NMD.0000000000001579

JCO Precis Oncol. 2022 Sep;6:e2200237. doi: 10.1200/PO.22.00237.

ABSTRACT

PURPOSE: Ado-trastuzumab emtansine (T-DM1) treatment results in grade 3-4 thrombocytopenia in 8%-13% of patients. Prior in vitro studies reported T-DM1 inhibition of megakaryocyte maturation as the cause of decreased platelet production. The current observational study was initiated to evaluate causes of thrombocytopenia in patients with metastatic breast cancer.

MATERIALS AND METHODS: Patients with human epidermal growth factor receptor 2-positive metastatic breast cancer (N = 11) were enrolled in this postmarket safety study. 111-Indium- radiolabeled autologous platelet recoveries and survivals as well as serial platelet counts, bleeding time assays, and platelet aggregation responses to a wide range of agonists were performed at baseline (BL) and during two consecutive cycles of the drug (3.6 mg/kg IV once every 3 weeks).

RESULTS: Platelet nadirs occurred earlier in cycle 2 than in cycle 1. Average nadir counts (% BL) in cycles 1 and 2 were 116,000/µL (53% ± 6%) and 115,000/µL (51% ± 9%), respectively, with return to BL by D15 in both cycles. BL platelet survival averaged 8.8 (± 0.3) days but progressively shortened to 5.5 (± 0.5) days during cycle 1 and to 4.6 (± 0.3) days during cycle 2 (P < .001 compared with BL for both cycles). Aggregation responses to all agonists decreased during the study, both in cycle 1 and cycle 2.

CONCLUSION: Following T-DM1 administration, we observed statistically significant progressive decreases in platelet survivals and decreased platelet function from BL values. In distinction to published in vitro studies, these unexpected results indicate a direct toxic effect of T-DM1 on patients’ autologous circulating platelets.

PMID:36108260 | DOI:10.1200/PO.22.00237

J Wound Ostomy Continence Nurs. 2022 Sep-Oct 01;49(5):416-427. doi: 10.1097/WON.0000000000000906.

ABSTRACT

PURPOSE: The purpose of this study was to examine pressure injury prevention and management (PIPM) practices in an academic acute care setting. Specific aims were to (1) develop and examine key stakeholder engagement regarding PIPM practices, (2) develop a valid/reliable gap analysis instrument, and (3) conduct a gap analysis of current PIPM practices.

DESIGN: Mixed-methods convergent design and participatory action research.

SUBJECTS AND SETTING: A nurse-led council (Council) of key stakeholders from a large academic university healthcare setting was developed. The gap analysis was conducted in a southern gulf coast level I trauma academic acute care hospital in the Southeastern United States.

METHODS: A multidisciplinary key stakeholder Council with 27 members was developed to accomplish study aims using the participatory action research approach to train, promote, and foster key stakeholder engagement in all aspects of the research process. The Pressure Injury Prevention Gap Analysis Instrument (PIPGAI) was developed and psychometrically tested. A gap analysis of PIPM practices across a level I trauma academic acute care hospital was conducted using the PIPGAI.

RESULTS: The PIPGAI was developed using 2019 Pressure Ulcer/Injury Clinical Practice Guideline recommendations, an integrative literature review/appraisal, a concept map, and Council input. The overall PIPGAI content validity index of 0.95 demonstrated excellent content validity. The individual item content validity index scores ranged from 0.62 to1.0. Low-scoring items (0.62-0.75) were deleted or revised. Interrater reliability was demonstrated by percentage of agreement (62%-79%). Using a modified Delphi approach, items of disagreement were summarized and discussed until 100% consensus was achieved. A gap analysis of PIPM practices was conducted resulting in a cumulative score of 267/553 (48%), indicating gaps in PIPM practices. Fifty (73%) items had content present; 37 of 58 (64%) items had minimal detail, and 36 of 58 (62%) items were difficult or required notable effort to accomplish. Fifty items (63%) had a total score of 4 or less and were identified as a gap (range: 0-7).

CONCLUSIONS: The main outcome of this study was an innovative and evidence-based gap analysis process. The study provides (1) a model for key stakeholder engagement, (2) a valid/reliable gap analysis instrument, and (3) a method to evaluate PIPM practices.

PMID:36108225 | DOI:10.1097/WON.0000000000000906

Clin J Oncol Nurs. 2022 Sep 15;26(5):495-501. doi: 10.1188/22.CJON.495-501.

ABSTRACT

BACKGROUND: There is a limited knowledge base about factors affecting advance directives and code status decisions among veterans with malignancy. In addition, few studies have focused on the benefit of palliative care (PC) in goals-of-care discussions among veterans with cancer.

OBJECTIVES: This study examined advance care planning and goals-of-care decisions among veterans with malignancy.

METHODS: Demographic and clinical data were obtained using retrospective chart analysis. Patient characteristics were analyzed using univariate descriptive statistics. To compare patients with and without a do-not-resuscitate (DNR) decision, chi-square test was performed.

FINDINGS: More than half of the patients in the study were referred to PC within one year of their cancer diagnosis. Most had documented metastatic disease at the time of their PC referral. Veterans with prostate cancer were more likely to elect full code status. In this study, White veterans were more likely to choose a DNR order than African American veterans.

PMID:36108205 | DOI:10.1188/22.CJON.495-501

Anesth Analg. 2022 Oct 1;135(4):787-797. doi: 10.1213/ANE.0000000000005853. Epub 2022 Sep 15.

ABSTRACT

BACKGROUND: Some studies have found surgery and anesthesia in children to be associated with neurodevelopmental deficits, but specific reasons for this association have not been fully explored. This study evaluates intraoperative mean arterial pressure (MAP) during a single ambulatory procedure in children and subsequent mental disorder diagnoses.

METHODS: A retrospective observational study was performed including children ≥28 days and <18 years of age with intraoperative electronic anesthetic records between January 1, 2009, and April 30, 2017, at our institution. Eligible children were categorized based on their mean intraoperative MAP relative to other children of the same sex and similar age: category 1 (very low): children with mean intraoperative MAP values below the 10th percentile, category 2 (low): mean MAP value ≥10th and <25th percentiles, category 3 (reference): mean MAP value ≥25th and <75th percentiles, category 4 (high): mean MAP value ≥75th and <90th percentile, and category 5 (very high): mean MAP value ≥90th percentile. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) and ICD, Tenth Revision, Clinical Modification (ICD-10)-coded mental disorders were identified in hospital and outpatient claims, with a median duration of follow-up after surgery of 120 days (interquartile range [IQR], 8-774.5 days). Cox proportional hazards models evaluated the hazard ratio (HR) of time to first mental disorder diagnosis associated with intraoperative blood pressure category between the end of surgery and censoring, with the primary analysis adjusting for demographic, anesthetic, comorbidity, and procedure-type variables as potential confounders.

RESULTS: A total of 14,724 eligible children who received general anesthesia for a single ambulatory surgical procedure were identified. After adjusting for all available potential confounders, when compared to the reference, there were no statistically significant differences in mental disorder diagnosis risk based on intraoperative mean MAP category. Compared to reference, children in the very low and low blood pressure categories reported HRs of 1.00 (95% confidence interval [CI], 0.74-1.35) and 1.10 (95% CI, 0.87-1.41) for a mental disorder diagnosis, respectively, and children in the high and very high categories reported HRs of 0.87 (95% CI, 0.68-1.12) and 0.76 (95% CI, 0.57-1.03), respectively.

CONCLUSIONS: Presence in a predefined mean intraoperative MAP category was not associated with subsequent mental disorder diagnoses within our follow-up period. However, the limitations of this study, including uncertainty regarding what constitutes an adequate blood pressure in children, may limit the ability to form definitive conclusions.

PMID:36108191 | DOI:10.1213/ANE.0000000000005853

ACS Appl Mater Interfaces. 2022 Sep 15. doi: 10.1021/acsami.2c12415. Online ahead of print.

ABSTRACT

Single-walled carbon nanotubes (SWCNTs) are considered to be promising candidates for next-generation near-infrared (NIR) photodetectors due to their extraordinary electrical and optical properties. However, the low separation efficiency of photogenerated carriers limits the full utilization of the potential of pristine SWCNTs as photoactive materials. Herein, we report a novel high-performance visible-NIR SWCNT-based photodetector via interfacial charge-transfer-induced improvement by Au nanoparticle (AuNP) surface doping. Under 1064 nm light illumination, the as-fabricated AuNP/SWCNT photodetector exhibits an excellent photoelectrical performance with a responsivity of 2.16 × 10⁵ A/W and a high detectivity of 1.82 × 10¹⁴ Jones, which is three orders of magnitude higher than that of the SWCNT photodetector under the same conditions. Importantly, the interfacial charge transfer between AuNPs and SWCNTs has been first investigated using Raman shift statistics at room temperature. Experimental results indicate that the interfacial charge transfer induced by AuNP doping can reduce the Fermi level of SWCNTs and effectively improve the generation and transport of photogenerated carriers, thereby enhancing the photoelectric performance of SWCNT-based photodetectors. We believe that our results not only demonstrate a facile route to improve the performance of SWCNT-based photodetectors but also provide a novel methodology to characterize the interfacial charge transfer between dopants and SWCNTs.

PMID:36108153 | DOI:10.1021/acsami.2c12415

Mol Biol Evol. 2022 Sep 15:msac197. doi: 10.1093/molbev/msac197. Online ahead of print.

ABSTRACT

The recent development of artificial intelligence provides us with new and powerful tools for studying the mysterious relationship between organism evolution and protein evolution. In this work, based on the AlphaFold Protein Structure Database (AlphaFold DB), we perform comparative analyses of the proteins of different organisms. The statistics of AlphaFold-predicted structures show that, for organisms with higher complexity, their constituent proteins will have larger radii of gyration, higher coil fractions, and slower vibrations, statistically. By conducting normal mode analysis and scaling analyses, we demonstrate that higher organismal complexity correlates with lower fractal dimensions in both the structure and dynamics of the constituent proteins, suggesting that higher functional specialization is associated with higher organismal complexity. We also uncover the topology and sequence bases of these correlations. As the organismal complexity increases, the residue contact networks of the constituent proteins will be more assortative, and these proteins will have a higher degree of hydrophilic-hydrophobic segregation in the sequences. Furthermore, by comparing the statistical structural proximity across the proteomes with the phylogenetic tree of homologous proteins, we show that, statistical structural proximity across the proteomes may indirectly reflect the phylogenetic proximity, indicating a statistical trend of protein evolution in parallel with organism evolution. This study provides new insights into how the diversity in the functionality of proteins increases and how the dimensionality of the manifold of protein dynamics reduces during evolution, contributing to the understanding of the origin and evolution of lives.

PMID:36108094 | DOI:10.1093/molbev/msac197