Nevin Manimala

Medicine (Baltimore). 2022 Sep 9;101(36):e30498. doi: 10.1097/MD.0000000000030498.

ABSTRACT

To describe imaging findings of pulmonary contusions (PC) in adults and children using multidetector computed tomography (CT) scanners. We conducted a retrospective single center study. All chest multidetector computed tomography (MDCT) scans of victims of blunt trauma admitted to the emergency unit of a reference trauma center of Brazil between January 2015 and December 2016 were reviewed in search of opacities compatible with PC. The CT images were analyzed in conjunction with medical records, that provided demographic and clinical data. The obtained data were analyzed in the overall population and comparing children and adults. Significant P value was defined as <.05. 52.7% of patients presented bilateral opacities. Middle third, posterior and peripheral portions of the lungs were more frequently affected, in the craniocaudal, anteroposterior and axial axes, respectively. A vast majority of patients (80.6%) presented multiple opacities, whereas a minority showed subpleural sparing (26.9%) and fissure crossing (22.6%), with similar frequencies in children and adults. Children, although, more frequently presented consolidation and more diffuse lesions in the anteroposterior axis compared to adults, with statistically significant differences. PC usually are multiple and predominate in middle, posterior and peripheral portions of the lungs. Subpleural sparing and fissure crossing seems to be infrequent and have similar frequencies between children and adults. Although, there are differences between these age groups, as younger people tend to have more consolidation and diffuse opacities in the anteroposterior axis than older ones.

PMID:36086733 | DOI:10.1097/MD.0000000000030498

Medicine (Baltimore). 2022 Sep 9;101(36):e30469. doi: 10.1097/MD.0000000000030469.

ABSTRACT

Because of the limitations of therapeutic approaches, patients suffering from lung adenocarcinoma (LUAD) have unsatisfactory prognoses. Studies have shown that neurotransmitters participated in tumorigenesis and development. In LUAD, the expression of neurotransmitter release cycle-related genes (NRCRGs) has been reported to be disordered. This study aimed to study the correlation between NRCRGs and LUAD. In this study, based on the Cancer Genome Atlas cohort, consensus clustering analyses were performed on ten neurotransmitter release cycle-related (NRCR) differentially expressed genes. Neurotransmitter release cycle (NRC) scores were derived by the Least Absolute Shrinkage and Selection Operator-Cox regression model constituted by 3 NRCRGs. Univariate and multivariate Cox regression analyses were performed to evaluate the prognosis value of the NRC score. In addition, single-Sample Gene Set Enrichment Analysis and CIBERSORT were conducted in the Cancer Genome Atlas cohort. Finally, gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses were also performed. As a result, the NRC-low group showed a good prognosis instead of the NRC-high group. NRC score was identified to be an independent prognosis factor for LUAD. In general, the NRC score based on the prognostic model was found to be closely correlated with immunotherapy-related anti-cancer immunity and inflamed tumor microenvironment. Functional enrichment results demonstrated that differentially expressed genes between 2 NRC groups were closely correlated with DNA replication, cell-substrate adhesion, Golgi vesicle transport, MAPK signal pathway, and many others. Novel biomarkers were offered for predicting the prognoses of LUAD patients. The NRC score might contribute to guiding LUAD patients with immunotherapy selection.

PMID:36086730 | DOI:10.1097/MD.0000000000030469

Medicine (Baltimore). 2022 Sep 9;101(36):e30547. doi: 10.1097/MD.0000000000030547.

ABSTRACT

CONTEXT: Nursing students experience psychosocial stress in their workplace. Available statistics are at variance, and hence, the need to know the overall prevalence of psychosocial stress among nursing students.

AIMS: This study aimed to determine the prevalence of psychosocial stress among nursing students through meta-analysis.

MATERIALS AND METHODS: PubMed, Cochrane, Web of Science, CNKI, and China Biomedical Literature Service System were searched for articles. Search terms include “psychosocial stress,” “nursing students.” Articles were included if they used validated psychosocial stress assessment instruments. Of the 15 articles with data on stress prevalence, 8 met all inclusion criteria. Each article was independently reviewed by the authors and relevant data were abstracted. Statistical analysis was done using Revman 4.1.

RESULTS: Overall, the average score for stress among nursing students was 3.70 (95% confidence interval [CI]: [3.33, 4.06]) based on the analyzed 15 articles with a sample size of 9202.

CONCLUSION: This study showed that the stress level of intern nursing students was mainly moderate.

PMID:36086725 | DOI:10.1097/MD.0000000000030547

Medicine (Baltimore). 2022 Sep 9;101(36):e30302. doi: 10.1097/MD.0000000000030302.

ABSTRACT

OBJECTIVES: Investigating the efficacy and safety of noninvasive cerebellar stimulation in improving the balance and walking function of patients with stroke.

METHODS: We searched 7 databases for randomized controlled trials (RCTs) related to noninvasive cerebellar stimulation in the treatment of stroke. The Berg Balance Scale (BBS), 6-minute walk test (6MWT), and Barthel Index (BI) were used as the outcome indexes to evaluate balance, walking and activities of daily living (ADL). The quality of the research was evaluated using the Cochrane Risk of Bias Tool. A meta-analysis was performed to evaluate the difference between the noninvasive cerebellar stimulation and control groups. Heterogeneity tests were performed to assess differences in treatment effects across noninvasive cerebellar stimulation modalities. A sensitivity analysis was performed to evaluate the robustness of the results.

RESULTS: Seven studies were included, and 5 articles (71.43%) were rated as having a low risk of bias. Among the primary outcome indicators, 4 of the 7 articles were combined into the fixed effect model (I2 = 38%, P = .18). Compared with the control group, noninvasive cerebellar stimulation improved the BBS score, and the difference was statistically significant (mean difference [MD]: 3.00, 95% confidence interval [CI]: 1.10-5.40, P = .03); the sensitivity analysis showed that the statistical model was still stable after sequentially eliminating each article. Compared with the control group, noninvasive cerebellar stimulation improved the 6MWT results of patients with stroke (MD: 25.29, 95% CI: 4.86-45.73, P = .02). However, noninvasive cerebellar stimulation did not improve the BI (MD: 15.61, 95% CI: -7.91 to 39.13, P = .19). No safety problems or adverse reactions to noninvasive cerebellar stimulation were observed.

CONCLUSIONS: Noninvasive cerebellar stimulation improves balance and walking function of patients with stroke, but its effect on ADL is uncertain. Due to the methodological weaknesses in the included trials, more RCTs are needed to confirm our conclusions.

PMID:36086722 | DOI:10.1097/MD.0000000000030302

Medwave. 2022 Sep 9;22(8):e002517. doi: 10.5867/medwave.2022.08.002517.

ABSTRACT

INTRODUCTION: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members’ perceptions about telephone medical reports.

OBJECTIVE: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital’s emergency room in Lima, Peru.

METHODS: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The “External user satisfaction survey of the Ministry of Health” adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques.

RESULTS: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%).

CONCLUSION: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.

PMID:36084348 | DOI:10.5867/medwave.2022.08.002517

Cancer Epidemiol Biomarkers Prev. 2022 Sep 9:EPI-22-0453. doi: 10.1158/1055-9965.EPI-22-0453. Online ahead of print.

ABSTRACT

BACKGROUND: Multivitamin use is a common health behavior but there is conflicting evidence from prospective studies about whether this behavior increases or decreases prostate cancer (PCa) risk.

METHODS: Associations of multivitamin (MVI) use and PCa risk were evaluated using data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Cox proportional hazards models estimated associations of MVI use with risk of total, low- and high-grade PCa. Longitudinal data were used to evaluate screening and biopsy patterns. To account for differential biopsy patterns, the probability of PCa was estimated for men with a positive screening value but no biopsy. Incidence Density Ratios were used to approximate hazards ratios, and associations of MVI use with predicted PCa risk were compared to observed.

RESULTS: Analyses of data from observed biopsies suggest a respective 19% (95% CI 10-28%) and 21% (12-31%) higher risk of high-grade PCa for current and long-term MVI use, compared to no use. Current and long-term MVI use was associated with a shorter time to first on-study biopsy, indicating the potential for detection bias. After accounting for differential acceptance of biopsy, associations of MVI use with PCa were attenuated and not statistically significant.

CONCLUSIONS: In SELECT, biopsy acceptance patterns differed by MVI use. Estimates of associations of MVI use with PCa risk based on observed biopsy data may be biased by differential acceptance of biopsy.

IMPACT: Differential biopsy ascertainment may impact associations of risk factors and PCa. Detailed screening and biopsy data can be used to analytically minimize such bias.

PMID:36084322 | DOI:10.1158/1055-9965.EPI-22-0453

J Nurs Care Qual. 2022 Sep 8. doi: 10.1097/NCQ.0000000000000648. Online ahead of print.

ABSTRACT

BACKGROUND: Poor leadership and teamwork in cardiopulmonary resuscitation (CPR) are associated with poor patient outcomes.

PROBLEM: Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response.

APPROACH: The Five-4-Life Quality Improvement (QI) program was pilot tested in a pediatric unit within a 510-bed acute care hospital in 2 phases: first, an educational program focused on leadership, team dynamics, and CPR skills, followed by sustaining interventions in the unit. Video recordings of 12 mock codes (4 pre-, 4 post-, 4 follow-up) were analyzed by trained observers.

OUTCOMES: Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program.

CONCLUSION: Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.

PMID:36084315 | DOI:10.1097/NCQ.0000000000000648

JCO Clin Cancer Inform. 2022 Sep;6:e2200066. doi: 10.1200/CCI.22.00066.

ABSTRACT

PURPOSE: To evaluate whether a custom programmatic workflow manager reduces reporting turnaround times (TATs) from a body oncologic imaging workflow at a tertiary cancer center.

METHODS: A custom software program was developed and implemented in the programming language R. Other aspects of the workflow were left unchanged. TATs were measured over a 12-month period (June-May). The same prior 12-month period served as a historical control. Median TATs of magnetic resonance imaging (MRI) and computed tomography (CT) examinations were compared with a Wilcoxon test. A chi-square test was used to compare the numbers of examinations reported within 24 hours and after 72 hours as well as the proportions of examinations assigned according to individual radiologist preferences.

RESULTS: For all MRI and CT examinations (124,507 in 2019/2020 and 138,601 in 2020/2021), the median TAT decreased from 4 (interquartile range: 1-22 hours) to 3 hours (1-17 hours). Reports completed within 24 hours increased from 78% (124,127) to 89% (138,601). For MRI, TAT decreased from 22 (5-49 hours) to 8 hours (2-21 hours), and reports completed within 24 hours increased from 55% (14,211) to 80% (23,744). For CT, TAT decreased from 3 (1-19 hours) to 2 hours (1-13 hours), and reports completed within 24 hours increased from 84% (82,342) to 92% (99,922). Delayed reports (with a TAT > 72 hours) decreased from 17.0% (4,176) to 2.2% (649) for MRI and from 2.5% (2,500) to 0.7% (745) for CT. All differences were statistically significant (P < .001).

CONCLUSION: The custom workflow management software program significantly decreased MRI and CT report TATs.

PMID:36084275 | DOI:10.1200/CCI.22.00066

Anal Chem. 2022 Sep 9. doi: 10.1021/acs.analchem.2c02833. Online ahead of print.

ABSTRACT

The refractive index (RI) is a fundamental physical property of materials. Although measurement of the RI of biological nanoparticles (BNPs) in aqueous media is of great importance to basic research and biomedical applications, it is hampered by their tiny size, large intrinsic heterogeneity, and weak scattering. Here, we report the development of a label-free technique that can determine the RI of individual viruses and small extracellular vesicles (sEVs) with high precision and an analysis rate up to 10 000 particles per minute. This was achieved via the combination of high-sensitivity light-scattering detection by nanoflow cytometry (nFCM) and the Mie theory calculation. With the measured RIs for T7 virions, T7 capsids, and sEVs, the concentrations of nucleic acid in viral particles and protein in the lumen of sEVs were estimated. Furthermore, building upon a simplified core-shell model, the RIs of sEVs ranging from 40 to 200 nm were obtained. By using these RIs, a statistically robust size distribution of sEVs was acquired in minutes with accuracy and resolution matched closely with those of cryo-TEM measurements. Our approach could become an important tool in the RI determination of single BNPs.

PMID:36084271 | DOI:10.1021/acs.analchem.2c02833

J Am Coll Health. 2022 Sep 9:1-9. doi: 10.1080/07448481.2022.2119404. Online ahead of print.

ABSTRACT

Objective: This study describes beliefs held by college students about cannabis use and examines the association between three specific cannabis beliefs and likelihood of use. Participants: 3,720 undergraduate students ages 18 to 25 attending ten colleges in one state. Methods: Data were gathered via online survey. Results: The majority (80%) of the sample was unsure or believed that cannabis was an effective way to reduce stress; 67% were unsure or believed that cannabis was not related to an increased risk for mental health problems; and 62% were unsure or believed that students who use cannabis are not more academically disengaged. Holding these beliefs, which are not supported by scientific evidence, was associated with a greater likelihood of cannabis use, even after statistically adjusting for covariates. Conclusions: These findings suggest that beliefs unsupported by scientific evidence are widespread among college students. Dispelling misinformation about cannabis might hold promise for reducing use.

PMID:36084270 | DOI:10.1080/07448481.2022.2119404