Nevin Manimala

Hernia. 2022 Sep 11. doi: 10.1007/s10029-022-02670-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the safety and effectiveness of a Chinese absorbable tack for mesh fixation in laparoscopic abdominal wall hernia repair compared to a widely used similar imported product.

METHODS: From May 2019 to December 2020, the clinical data of 158 patients with abdominal wall hernias were analyzed. They were divided into two groups: 76 patients underwent surgery with local absorbable tacks for mesh fixation (experimental group) and 82 patients received a similar imported product (control group). Preoperative and postoperative variables, effectiveness of postoperative immediate fixation, and with ease of handling of instruments were analyzed statistically. Complications and adverse events were followed and analyzed statistically. Meanwhile, medical costs were recorded and evaluated.

RESULTS: There were no statistically significant differences between the two groups in terms of demographic data, hernia types, hernia defects, or number of tacks used for mesh fixation during operation. The effect of postoperative immediate fixation and with ease of handling of instruments in both groups were not significantly different. During the follow-up period, no recurrence or adverse events occurred in either group. No significant differences were noted between the two groups for other complications, such as chronic pain, foreign body sensation, infection of the abdominal wall, hematoma and seroma. There was a significant difference in medical costs between the two groups: the costs associated with the experimental group using local tacks were lower.

CONCLUSION: Chinese absorbable tacks for mesh fixation in laparoscopic abdominal wall hernia repair are effective, safe, and economical. They are worthy of clinical application.

PMID:36088587 | DOI:10.1007/s10029-022-02670-2

Health Promot J Austr. 2022 Sep 11. doi: 10.1002/hpja.662. Online ahead of print.

ABSTRACT

ISSUE ADDRESSED: Child and youth participation in physical activity (PA) is fundamental for healthy development and obesity prevention. Government policy requires schools to offer 150 minutes of PA each week, however compliance is low. Race Around Australia (RAA) is a New South Wales (NSW) Department of Education, virtual PA program aimed at assisting schools in meeting the PA guidelines.

METHODS: A pre- and post-intervention, quasi-experimental study was conducted using a mixed-methods approach comprising teacher interviews, a student questionnaire, and a 1.6 kilometre (km) timed run. Data were collected from April-September 2021 among students and teachers in Grades 5-8, from 10 schools in NSW, Australia.

RESULTS: The analytical sample included data from 918 students and 17 teachers. The RAA program was deemed feasible and acceptable in primary schools, whereas there were several systemic and intrapersonal barriers to implementation success for secondary schools. In primary schools, RAA increased PA opportunities and the 1.6 km timed runs revealed a statistically significant treatment by time effect in favour of the intervention group for cardiorespiratory fitness (-36.91 secs, 95% CI [-63.14, -10.68], p=0.006).

CONCLUSIONS: RAA has demonstrated feasibility and potential efficacy in improving cardiorespiratory fitness. We recommend that program refinement be made to deliver an intervention that addresses the unique barriers of the secondary school setting through a multi-level ecological approach.

PMID:36088579 | DOI:10.1002/hpja.662

Brief Bioinform. 2022 Sep 9:bbac399. doi: 10.1093/bib/bbac399. Online ahead of print.

ABSTRACT

Tipping points or critical transitions widely exist during the progression of many biological processes. It is of great importance to detect the tipping point with the measured omics data, which may be a key to achieving predictive or preventive medicine. We present the tipping point detector (TPD), a web tool for the detection of the tipping point during the dynamic process of biological systems, and further its leading molecules or network, based on the input high-dimensional time series or stage course data. With the solid theoretical background of dynamic network biomarker (DNB) and a series of computational methods for DNB detection, TPD detects the potential tipping point/critical state from the input omics data and outputs multifarious visualized results, including a suggested tipping point with a statistically significant P value, the identified key genes and their functional biological information, the dynamic change in the DNB/leading network that may drive the critical transition and the survival analysis based on DNB scores that may help to identify ‘dark’ genes (nondifferential in terms of expression but differential in terms of DNB scores). TPD fits all current browsers, such as Chrome, Firefox, Edge, Opera, Safari and Internet Explorer. TPD is freely accessible at http://www.rpcomputationalbiology.cn/TPD.

PMID:36088546 | DOI:10.1093/bib/bbac399

Int Health. 2022 Sep 10:ihac061. doi: 10.1093/inthealth/ihac061. Online ahead of print.

ABSTRACT

BACKGROUND: Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators’ knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia.

METHODS: A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value <0.05 was used to establish statistical significance.

RESULTS: In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods.

CONCLUSIONS: The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.

PMID:36088530 | DOI:10.1093/inthealth/ihac061

Br J Cancer. 2022 Sep 10. doi: 10.1038/s41416-022-01961-w. Online ahead of print.

ABSTRACT

BACKGROUND: The effect of maternal diabetes on childhood cancer has not been widely studied.

METHODS: We examined this in two population-based studies in Denmark (N = 6420 cancer cases, 160,484 controls) and Taiwan (N = 2160 cancer cases, 2,076,877 non-cases) using logistic regression and Cox proportional hazard regression adjusted for birth year, child’s sex, maternal age and birth order.

RESULTS: Gestational diabetes in Denmark [odds ratio (OR) = 0.98, 95% confidence interval (CI): 0.71-1.35] or type II and gestational diabetes in Taiwan (type II: hazard ratio (HR) = 0.81, 95% CI: 0.63-1.05; gestational diabetes: HR = 1.06, 95% CI: 0.92-1.22) were not associated with cancer (all types combined). In Denmark, maternal type I diabetes was associated with the risk of glioma (OR = 2.33, 95% CI: 1.04-5.22), while in Taiwan, the risks of glioma (HR = 1.59, 95% CI: 1.01-2.50) were elevated among children whose mothers had gestational diabetes. There was a twofold increased risk for hepatoblastoma with maternal type II diabetes (HR = 2.02, 95% CI: 1.02-4.00).

CONCLUSIONS: Our results suggest that maternal diabetes is an important risk factor for certain types of childhood cancers, emphasising the need for effective interventions targeting maternal diabetes to prevent serious health effects in offspring.

PMID:36088507 | DOI:10.1038/s41416-022-01961-w

Nat Commun. 2022 Sep 10;13(1):5328. doi: 10.1038/s41467-022-32847-3.

ABSTRACT

The response of the East Antarctic Ice Sheet to past intervals of oceanic and atmospheric warming is still not well constrained but is critical for understanding both past and future sea-level change. Furthermore, the ice sheet in the Wilkes Subglacial Basin appears to have undergone thinning and ice discharge events during recent decades. Here we combine glaciological evidence on ice sheet elevation from the TALDICE ice core with offshore sedimentological records and ice sheet modelling experiments to reconstruct the ice dynamics in the Wilkes Subglacial Basin over the past 350,000 years. Our results indicate that the Wilkes Subglacial Basin experienced an extensive retreat 330,000 years ago and a more limited retreat 125,000 years ago. These changes coincide with warmer Southern Ocean temperatures and elevated global mean sea level during those interglacial periods, confirming the sensitivity of the Wilkes Subglacial Basin ice sheet to ocean warming and its potential role in sea-level change.

PMID:36088458 | DOI:10.1038/s41467-022-32847-3

Ann Gen Psychiatry. 2022 Sep 10;21(1):36. doi: 10.1186/s12991-022-00413-2.

ABSTRACT

Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: “forensic” AND “Positive and Negative Syndrome Scale” OR “PANSS”. A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021).

PMID:36088451 | DOI:10.1186/s12991-022-00413-2

Arthritis Res Ther. 2022 Sep 10;24(1):218. doi: 10.1186/s13075-022-02903-w.

ABSTRACT

BACKGROUND: Pain is the main concern of patients with rheumatoid arthritis (RA) while reducing disease activity dominates specialist management. Disease activity assessments like the disease activity score for 28 joints with the erythrocyte sedimentation rate (DAS28-ESR) omit pain creating an apparent paradox between patients’ concerns and specialists’ treatment goals. We evaluated the relationship of pain intensity and disease activity in RA with three aims: defining associations between pain intensity and disease activity and its components, evaluating discordance between pain intensity and disease activity, and assessing temporal changes in pain intensity and disease activity.

METHODS: We undertook secondary analyses of five trials and one observational study of RA patients followed for 12 months. The patients had early and established active disease or sustained low disease activity or remission. Pain was measured using 100-mm visual analogue scales. Individual patient data was pooled across all studies and by types of patients (early active, established active and established remission). Associations of pain intensity and disease activity were evaluated by correlations (Spearman’s), linear regression methods and Bland-Altman plots. Discordance was assessed by Kappa statistics (for patients grouped into high and low pain intensity and disease activity). Temporal changes were assessed 6 monthly in different patient groups.

RESULTS: A total of 1132 patients were studied: 490 had early active RA, 469 had established active RA and 173 were in remission/low disease activity. Our analyses showed, firstly, that pain intensity is associated with disease activity in general, and particularly with patient global assessments, across all patient groups. Patient global assessments were a reasonable proxy for pain intensity. Secondly, there was some discordance between pain intensity and disease activity across all disease activity levels, reflecting similar discrepancies in patient global assessments. Thirdly, there were strong temporal relationships between changes in disease activity and pain intensity. When mean disease activity fell, mean pain intensity scores also fell; when mean disease activity increased, there were comparable increases in pain intensity.

CONCLUSIONS: These findings show pain intensity is an integral part of disease activity, though it is not measured directly in DAS28-ESR. Reducing disease activity is crucial for reducing pain intensity in RA.

PMID:36088424 | DOI:10.1186/s13075-022-02903-w

Int Orthop. 2022 Sep 10. doi: 10.1007/s00264-022-05573-0. Online ahead of print.

ABSTRACT

PURPOSE: To study the efficacy of three kinds of surgery for trigger thumb.

METHODS: A total of 60 cases of trigger thumb (Quinnell Grade IV) were randomly divided into three groups. The A1 pulley was disconnected at the middle in Group A, at the extreme radial side in Group B, excised in Group C. The following indicators were recorded pre-operatively (D0), and at one (D1), three (D3), seven (D7), 14 (D14), and 28 (D28) days post-operatively: 1. the pain visual analogue score (VAS) when flexing the affected thumb; 2. range of motion (ROM) of the interphalangeal joint with pain tolerance; 3. the time of pain disappearance when flexing the affected thumb.

RESULTS: The differences of VAS and ROM between D1 and D0, D3 and D1, D7 and D3, D14 and D7, D28 and D14 were statistically significant (P < 0.05). There was no significant difference in changes of VAS (or ROM) at D1 or D28 in contrast to D0 among the three groups. The differences of VAS (or ROM) changes at D3, D7, and D14 in contrast to D0 among the three groups were statistically significant (P < 0.05). The difference of the time when the pain disappearing in the normal range of motion among the three groups were statistically significant (P < 0.05).

CONCLUSION: Disconnecting the A1-pulley at the extreme radial side is better than another two methods for treating the trigger thumb (Quinnell Grade IV). It has been shown to effectively accelerate postoperative pain relief and functional recovery.

TRIAL REGISTRATION: Clinical trial registry number: ChiCTR2100051193.

PMID:36088415 | DOI:10.1007/s00264-022-05573-0

Sci Rep. 2022 Sep 10;12(1):15261. doi: 10.1038/s41598-022-19626-2.

ABSTRACT

Colistimethate sodium (CMS) is the inactive prodrug of colistin, CMS has a narrow antibacterial spectrum with concentration-dependent bactericidal activity against multidrug-resistant gram-negative bacteria, including Pseudomonas aeruginosa and Acinetobacter baumannii. This study aimed to analyze potential correlations between clinical features and the development of CMS-induced nephrotoxicity. This retrospective cohort study was conducted in a tertiary-care university hospital between 1 January 2015 and 31 December 2019. A total of 163 patients received CMS therapy. 75 patients (46%) developed nephrotoxicity attributable to colistin treatment, although only 14 patients (8.6%) discontinued treatment for this reason. 95.7% of CMS were prescribed as target therapy. Acinetobacter baumannii spp. was the most commonly identified pathogen (72.4%) followed by P. aeruginosa (19.6%). Several risk factors associated with nephrotoxicity were identified, among these were age (HR 1.033, 95%CI 1.016-1.052, p < 0.001), Charlson Index (HR 1.158, 95%CI 1.0462-1.283; p = 0.005) and baseline creatinine level (HR 1.273, 95%CI 1.071-1.514, p = 0.006). In terms of in-hospital mortality, risk factors were age (HR 2.43, 95%CI 1.021-1.065, p < 0.001); Charlson Index (HR 1.274, 95%CI 1.116-1.454, p = 0.043), higher baseline creatinine levels (HR 1.391, 95%CI 1.084-1.785, p = 0.010) and nephrotoxicity due to CMS treatment (HR 5.383, 95%CI 3.126-9.276, p < 0.001). In-hospital mortality rate were higher in patients with nephrotoxicity (log rank test p < 0.001). In conclusion, the nephrotoxicity was reported in almost half of the patients. Its complex management, continuous renal dose adjustment and monitoring creatinine levels at least every 48 h leads to a high percentage of inappropriate use and treatment failure.

PMID:36088407 | DOI:10.1038/s41598-022-19626-2