Nevin Manimala

Front Cardiovasc Med. 2022 Mar 2;9:799488. doi: 10.3389/fcvm.2022.799488. eCollection 2022.

ABSTRACT

OBJECTIVES: Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly used to treat high-risk pulmonary embolism (PE). However, its efficacy and safety remain uncertain. This retrospective cohort study aimed to determine whether ECMO could improve the clinical outcomes of patients with high-risk PE.

METHODS: Forty patients with high-risk PE, who were admitted to Kaohsiung Chang Gung Memorial Hospital between January 2012 and December 2019, were included in this study. Demographic data and clinical outcomes were compared between patients treated without ECMO (non-ECMO group) and those treated with ECMO (ECMO group). Appropriate statistical tools were used to compare variables between groups and the survival was analyzed using the Kaplan-Meier method.

RESULTS: The overall in-hospital mortality rate was 55%, in which 65% (26/40) of patients presented with cardiac arrest with a mortality rate of 77%, which was higher than that of patients without cardiac arrest (14%). There was no significant difference in major complications and in-hospital mortality between the non-ECMO and ECMO groups. However, in subgroup analysis, compared with patients treated without ECMO, earlier ECMO treatment was associated with a reduced risk of cardiac arrest (P = 0.023) and lower in-hospital mortality (P = 0.036). A log-rank test showed a significantly higher cumulative overall survival in the earlier ECMO treatment group (P = 0.033).

CONCLUSIONS: In this retrospective cohort study, earlier ECMO treatment was associated with lower in-hospital mortality among unstable patients without cardiac arrest. Our findings suggest that ECMO can be considered as an initial treatment option for patients with high-risk PE in higher-volume hospitals.

PMID:35310966 | PMC:PMC8924067 | DOI:10.3389/fcvm.2022.799488

Plant Genome. 2022 Mar 20:e20200. doi: 10.1002/tpg2.20200. Online ahead of print.

ABSTRACT

The ability to accurately quantify the simultaneous effect of multiple genomic loci on multiple traits is now possible due to current and emerging high-throughput genotyping and phenotyping technologies. To date, most efforts to quantify these genotype-to-phenotype relationships have focused on either multi-trait models that test a single marker at a time or multi-locus models that quantify associations with a single trait. Therefore, the purpose of this study was to compare the performance of a multi-trait, multi-locus stepwise (MSTEP) model selection procedure we developed to (a) a commonly used multi-trait single-locus model and (b) a univariate multi-locus model. We used real marker data in maize (Zea mays L.) and soybean (Glycine max L.) to simulate multiple traits controlled by various combinations of pleiotropic and nonpleiotropic quantitative trait nucleotides (QTNs). In general, we found that both multi-trait models outperformed the univariate multi-locus model, especially when analyzing a trait of low heritability. For traits controlled by either a combination of pleiotropic and nonpleiotropic QTNs or a large number of QTNs (i.e., 50), our MSTEP model often outperformed at least one of the two alternative models. When applied to the analysis of two tocochromanol-related traits in maize grain, MSTEP identified the same peak-associated marker that has been reported in a previous study. We therefore conclude that MSTEP is a useful addition to the suite of statistical models that are commonly used to gain insight into the genetic architecture of agronomically important traits.

PMID:35307964 | DOI:10.1002/tpg2.20200

Cancer Med. 2022 Mar 20. doi: 10.1002/cam4.4665. Online ahead of print.

ABSTRACT

OBJECTIVE: Currently, there is no standard adjuvant treatment protocol for localized uterine leiomyosarcoma (uLMS) as clinical trials to address this question have been retrospective, underpowered, or undermined by slow accrual rates. The aim of this study is to determine the benefit of adjuvant chemotherapy for uLMS.

METHODS: We reviewed the medical records of localized uLMS patients who had underwent adjuvant therapy after upfront surgery between 2000 and 2020. The cases were blinded for review. We evaluated the influence of various clinical characteristics and different types of adjuvant therapies on specific outcomes.

RESULTS: Sixty-eight patients (median age: 50 years) were included for analysis. Forty of 68 (58.8%) patients received adjuvant chemotherapy +/- radiation therapy and 25 patients (38.6%) did not receive any adjuvant therapy. At a median follow-up time of 43.3 months, 45 patients (66.1%) had relapsed disease. The median disease-free survival (mDFS) for all patients was 23.1 months. Patients who received any adjuvant treatment (chemotherapy and/or radiation) trended toward a longer mDFS compared with those who did not receive any adjuvant therapy (29.7 vs. 14.1 months, p = 0.26). Patients who received adjuvant chemotherapy alone had a longer, but nonstatistically significant mDFS compared with those who did not receive any adjuvant treatment (22.2 vs. 14.1 months, p = 0.18). Additionally, univariate analysis found that tumor size large than 10 cm, and a mitotic rate >10/10hpf were independent prognostic factors for worse DFS.

CONCLUSIONS: Though DFS was more favorable among those who received adjuvant therapy, it was not statistically significant, and thus based on this data adjuvant therapy for resected uLMS is still in question.

PMID:35307963 | DOI:10.1002/cam4.4665

Psych J. 2022 Mar 20. doi: 10.1002/pchj.536. Online ahead of print.

ABSTRACT

This study aimed to examine the relationship between gender, anxiety, mindfulness, and theory of mind (ToM). It was also aimed to investigate the mediating role of mindfulness in the relationship between anxiety and ToM. Additionally, the moderating role of gender in the relevant relationships was examined. The sample consisted of 323 people, including 260 (80.5%) females and 63 (19.5%) males, aged between 18-62 years. Data were collected by the Reading the Mind in the Eyes Test, the State-Trait Anxiety Inventory II, and the Mindful Attention Awareness Scale. It was found that ToM and anxiety levels were statistically significantly higher in women than men. In the regression analysis, it was detected that mindfulness predicts the 7% variance in ToM. The second predictor of ToM was found as anxiety, and both predictors explained the 9% variance in ToM. In the mediating analysis, it was found that mindfulness has a mediating role in the relationship between anxiety and ToM. In the moderated mediation analysis, it was determined that the pathway between anxiety and ToM was moderated by gender; the moderating role of gender also was found between mindfulness and ToM. In light of these findings, experimental future studies can be suggested with clinical samples for a better understanding of the relationships between gender, anxiety, mindfulness, and ToM.

PMID:35307962 | DOI:10.1002/pchj.536

Intern Med J. 2022 Mar;52(3):474-478. doi: 10.1111/imj.15712.

ABSTRACT

Admitting male and female patients to the same room compromises the safety of female patients and violates the rights of all patients. We demonstrate that mixed bedding is common (47.22% of admissions), increasing and disproportionately affects vulnerable older patients in a large New Zealand hospital from 2011 to 2019 (n = 160 048). Eliminating mixed bedding should be a priority for our hospital system.

PMID:35307925 | DOI:10.1111/imj.15712

Pediatr Diabetes. 2022 Mar 20. doi: 10.1111/pedi.13335. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetes has been recognized as a major comorbidity for COVID-19 severity in adults. This study aimed to characterize the clinical outcomes and risk factors for COVID-19-related death in a large cohort of hospitalized pediatric patients with diabetes.

METHODS: We performed an analysis of all pediatric patients with diabetes and COVID-19 registered in SIVEP-Gripe, a Brazilian nationwide surveillance database, between February 2020 and May 2021. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk by using cumulative incidence function.

RESULTS: Among 21,591 hospitalized pediatric patients with COVID-19, 379 (1.8%) had diabetes. Overall, children and adolescents with diabetes had a higher prevalence of ICU admission (46.6% vs. 26%), invasive ventilation (16.9% vs. 10.3%), and death (15% vs. 7.6%) (all P < 0.0001). Children with diabetes had twice the hazard of death compared with pediatric patients without diabetes (Hazard ratio [HR] = 2.0, 95% CI, 1.58-2.66). Among children with diabetes, four covariates were independently associated with the primary outcome, living in the poorest regions of the country (Northeast, HR, 2.17, 95% CI 1.18-4.01, and North, (HR 4.0, 95% CI 1.79-8.94), oxygen saturation < 95% at admission (HR 2.97, 95% CI 1.64-5.36), presence of kidney disorders (HR 3.39, 95% CI 1.42-8.09), and presence of obesity (HR 3.77, 95% CI 1.83-7.76).

CONCLUSION: Children and adolescents with diabetes had a higher risk of death compared with patients without diabetes. The higher risk of death was associated with clinical and socioeconomic factors This article is protected by copyright. All rights reserved.

PMID:35307916 | DOI:10.1111/pedi.13335

J Biochem Mol Toxicol. 2022 Mar 20:e23038. doi: 10.1002/jbt.23038. Online ahead of print.

ABSTRACT

Antioxidants may provide a complementary treatment for patients with chronic diseases. Nevertheless, studies that have measured the effects of antioxidant on diabetes complications have provided conflicting results. This study aimed to elucidate the association between antioxidant and diabetic complications and to develop robust evidence for clinical decisions by systematic reviews and meta-analysis. PubMed, Embase, The Cochrane Library, Web of Science, Scopus databases were searched to collect clinical studies related to the efficacy of antioxidants in the treatment of diabetes complications from inception to May 5, 2021. Statistical meta-analyses were performed using the RevMan 5.4 software. Stata16 software was used to detect publication bias. The data of diabetic nephropathy (DN), diabetic nonalcoholic fatty liver disease (NAFLD), and diabetic periodontitis were collected to analyze the effect of antioxidant on diabetes and the above three complications. The meta-analysis results showed that antioxidant treatment was associated with significantly changes in the fasting plasma glucose (FPG) (standardized mean difference [SMD]: – 0.21 [95% confidence interval [CI]: – 0.33, -0.10], p < 0.001), hemoglobin A1c (HbA1c) (MD: – 0.41 [95% CI: – 0.63, -0.18], p < 0.001), total antioxidant capacity (TAC) (SMD: 0.44 [95% CI: 0.24, 0.63], p < 0.001) and malondialdehyde (MDA) (SMD: – 0.82 [95% CI: – 1.24, -0.41], p < 0.001) than the control group. Antioxidant supplements have the potential to treat three complications of diabetes. In conclusion, the meta-analysis results indicate that antioxidant treatment is effective clinically for diabetes mellitus and its complications.

PMID:35307907 | DOI:10.1002/jbt.23038

J Sch Health. 2022 Mar 20. doi: 10.1111/josh.13182. Online ahead of print.

ABSTRACT

BACKGROUND: Failure to complete secondary education often results from a process of educational disengagement. Studies of teen childbearing and high school completion have not adequately accounted for the role of school disengagement prior to conception and may overestimate causal impacts of teen childbearing.

METHODS: We link New York City birth and school records to study a cohort of 22,484 Black and Latina public school students. We measure disengagement with monthly absences from age 12 until the month before conception and identify five preconception attendance trajectories using group-based trajectory modeling.

RESULTS: Preconception absenteeism can account for as much as half the deficit in high school completion associated with a teen birth. This finding is robust to statistical approaches, such as school fixed effects and inverse-probability-weighted regression adjustment.

CONCLUSIONS: Our results suggest that programs intending to increase educational attainment among young women should emphasize attendance and engagement, rather than primarily teenage pregnancy prevention.

PMID:35307839 | DOI:10.1111/josh.13182

J Vet Pharmacol Ther. 2022 Mar 20. doi: 10.1111/jvp.13053. Online ahead of print.

ABSTRACT

Eight horses underwent IVRLP at two occasions through a 23-gauge 2 cm long butterfly catheter. Regional anaesthesia of the ulnar, median and medial cutaneous antebrachial nerves was performed prior, and an 8 cm rubber tourniquet was placed on the proximal radius for 30 minutes following the infusion. The first infusion consisted of 2 g of amikacin sulphate and 10 mg of dexamethasone phosphate diluted with 0.9% NaCl to a total volume of 100 ml. The second perfusion was performed after a 2-week washout period, the same protocol was used but without dexamethasone phosphate. Synovial fluid samples were collected from the metacarpophalangeal joint at T = 0, 0.5, 2, 12, 24 and 36 h post-infusion. Synovial fluid amikacin sulphate concentrations were determined by use of liquid chromatography/tandem mass-spectrometry. All horses (n = 8) remained healthy throughout the study, and no adverse effects associated with the study were encountered. No statistically significant differences were found in synovial fluid amikacin sulphate concentrations between the treatment and the control group at any of the time points. In conclusion, dexamethasone phosphate can be used in IVRLP concomitantly with amikacin sulphate in cases of distal limb inflammation and pain without decreasing the synovial fluid concentration of amikacin sulphate.

PMID:35307838 | DOI:10.1111/jvp.13053

J Dent Educ. 2022 Mar 20. doi: 10.1002/jdd.12919. Online ahead of print.

ABSTRACT

BACKGROUND: The University of Minnesota (UMN) Dental Hygiene (DH) program devotes considerable time developing students’ competency using motivational interviewing (MI). However, the extent to which graduates use MI in clinical practice and their perceptions of MI effectiveness in changing behavior is unknown.

METHODS: A cross-section of UMN dental hygiene classes from 2010-2019 were emailed an electronic survey using Qualtrics^xm software (n = 208). The survey instrument collected demographic information and queried respondents’ current MI use and perceptions of its effectiveness in changing patients’ behavior. Survey questions were aligned with the constructs of the Theory of Planned Behavior (TPB): attitudes, subjective norms, and perceived behavioral control. Data analyses included descriptive statistics, cross-tabulations, and one-way ANOVA tests.

RESULTS: There were 73 responses for a 35% response rate and 58 surveys (28%) included in data analysis. Respondents (95%) used MI, held positive attitudes toward MI and perceived MI to be an effective behavior counseling method (98%). However, respondents expressed concerns about patients’ abilities to change behaviors. The three TPB constructs were found to be predictors of MI use in the clinical environment. A significant association was found between age and the TPB construct: behavioral control (p = 0.02).

CONCLUSION: The majority of respondents reported using MI in clinical practice. According to the TPB, respondents exhibited strong behavioral intentions to use MI. Respondents held favorable attitudes toward MI and believed it to be effective in motivating positive behavior change. Respondents were confident in their MI skills and felt supported to use MI in their work environments.

PMID:35307827 | DOI:10.1002/jdd.12919