Nevin Manimala

Adv Exp Med Biol. 2021;1321:253-260. doi: 10.1007/978-3-030-59261-5_22.

ABSTRACT

Aim The ongoing COVID-19 outbreak has not only had an impact on physical health but also on psychological health. The aim of this study was to measure the prevalence and severity of psychological distress in the community due to the COVID-19 pandemic. Methods This cross-sectional survey was conducted in February and March 2020 in Tehran, Iran. We analyzed demographic characteristics and assessed depression, anxiety, and stress levels in 241 people using convenience sampling and the DASS-21 questionnaire. All statistical analyses were performed using R. Results The study population included 241 community-dwelling participants, of whom 145 were women and 96 were males. The mean age was 49.16 ± 8.01 years. Approximately two-thirds of participants (n = 158) reported no history of comorbid illness. The mean scores of depression and stress were at a “severe” level, while anxiety levels were at an “extremely severe” level. The prevalence of severe and extremely severe depression readings was 51.45 and 38.17%, respectively. In the anxiety subscale, the prevalence of severe and extremely severe depression was 95.90 and 4.1%, and in the stress subscale the prevalence was 48.97 and 4.98%, respectively. Conclusion In this study, people reported experiencing severe and extremely severe psychological distress. Therefore, there is an urgent need to implement mental health intervention policies to cope with this ongoing challenge. We suggest that the incorporation of molecular biomarker tests into the algorithm could aid in assessment of patients and guide the most appropriate therapeutic response.

PMID:33656730 | DOI:10.1007/978-3-030-59261-5_22

Adv Exp Med Biol. 2021;1321:245-251. doi: 10.1007/978-3-030-59261-5_21.

ABSTRACT

Aim The COVID-19 was declared a pandemic in early 2020 and is associated with high public anxiety all over the world. The healthcare community is at the highest risk of infection and thereby prone to most distress. The aim of this study was to explore and evaluate the degree of depression, anxiety, and stress levels among medical college students during the COVID-19 epidemic in Iran. Methods A cross-sectional study was conducted in February and March 2020, 3 weeks after the first reported COVID-19 infection was identified in Iran. All medical college students who entered clinical courses were eligible for the study. Depression, stress, and anxiety were evaluated in these students using the DASS-21 questionnaire. Participants were selected by using availability sampling. All statistical analyses were performed using R version 3.5.1. Results The total number of participants was 207, with 143 males and 64 females. More than half of the participants (57.97%) were married. The mean duration of working experience among students with COVID-19 infection and experience in a medical ward was 3.00 ± 1.27 days and 17.40 ± 7.26 months, respectively. The majority of students had 2 or 3 days working experience with COVID-19 infection. The mean anxiety score of participants was 28.56 ± 4.68, the depression score was 29.36 ± 4.42, and the stress score was 28.99 ± 4.53. Our findings indicated that the mean scores of depression were at an “extremely severe” level, while stress and anxiety were at “severe” levels. The prevalence of “severe” symptoms of depression, stress, and anxiety was 69.57%, 60.87%, and 99.04%, respectively. Conclusions There is a high prevalence of anxiety and depression among medical students who were exposed to COVID-19-infected patients. Our results highlight the need to establish psychological support programs, training, and self-care for medical college students in relation to mental health. We recommend incorporation of molecular biomarker tests into an algorithm to aid in assessments and consideration of the appropriate therapeutic responses.

PMID:33656729 | DOI:10.1007/978-3-030-59261-5_21

Adv Exp Med Biol. 2021;1321:237-243. doi: 10.1007/978-3-030-59261-5_20.

ABSTRACT

AIM: The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran.

MATERIAL AND METHODS: We conducted a cross-sectional survey of HCWs using questionnaires in February and March 2020 in Baqiyatallah Hospital, Tehran. We evaluated depression, stress, and anxiety levels using the DASS-21 questionnaire. Participants were selected by using census sampling. All statistical analyses were performed using R version 3.5.1.

RESULTS: The study population included 217 HCWs (111 male, 116 female) and the mean age of the study group was 39.6 years old. Approximately two-thirds of the HCWs stayed in the hospital for 2-3 weeks. The mean scores of depression and stress were at a “severe” level, while anxiety scores were at an “extremely severe” level. The prevalence of severe scores was 38.71%, 2.30%, and 48.97% for depression, anxiety, and stress, and the prevalence of extremely severe scores was 46.54%, 97.24%, and 4.98% depression, anxiety, and stress, respectively. In stress subscale, moderate stress was 47.46%. Female HCWs reported higher levels of depression compared with males.

CONCLUSION: In this study, HCWs reported experiencing severe and extremely severe psychological burdens. Timely interventions to promote mental health in HCWs exposed to patients with COVID-19 need to be immediately implemented, with female nurses requiring particular attention. This process could be facilitated via tests for molecular biomarkers in accessible body fluids, such as saliva, plasma, and serum.

PMID:33656728 | DOI:10.1007/978-3-030-59261-5_20

Adv Exp Med Biol. 2021;1321:229-236. doi: 10.1007/978-3-030-59261-5_19.

ABSTRACT

AIM: Patients with confirmed COVID-19 infection can develop several psychological consequences. Epidemiological data on mental health and psychological disorder inpatients infected with COVID-19 pneumonia are not available in Iranian patients. The purpose of this study was to evaluate the anxiety, stress, and depression of patients with COVID-19.

MATERIAL AND METHODS: This cross-sectional survey was conducted in 2020. All confirmed patients with COVID-19 were included in the study by census sampling. Assessment of depression, stress, and anxiety was performed using the DASS-21 questionnaire. All statistical analyses were performed using R version 3.5.1.

RESULTS: The questionnaires were completed by 221 patients with COVID-19 infection (204 males, 17 females). The mean age was 45.90 ± 7.73 years. Our results indicated that the mean scores of depression and anxiety were at “extremely severe” levels, while stress levels were “severe.” The prevalence of “extremely severe” symptoms of depression and anxiety was 54.29% and 97.29%, respectively. The prevalence of severe stress was 46.61%.

CONCLUSION: In this study, patients infected with COVID-19 reported severe and extremely severe experience psychological distress. Further studies should focus on the combined use of psychological and molecular biomarker testing to increase accuracy. Overall, the findings demonstrate the necessity of special intervention programs for the confirmed patients with emerging infectious disease COVID-19 to promote mental health needs.

PMID:33656727 | DOI:10.1007/978-3-030-59261-5_19

J Assist Reprod Genet. 2021 Mar 3. doi: 10.1007/s10815-021-02131-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study was to test the hypotheses that compared to IVF cycles undergoing preimplantation genetic testing for aneuploidy (PGT-A) with or without testing for monogenic disorders (PGT-M), IVF cycles undergoing PGT for structural rearrangements (PGT-SR) will have (1) a poorer blastocyst conversion rate and (2) fewer usable blastocysts available for transfer. Secondarily, the study aimed to compare pregnancy outcomes among PGT groups.

PATIENTS: Retrospective cohort study including cycles started from January 1, 2012, to March 30, 2020, with the intent of pursuing PGT-A, PGT-A with PGT-M, and PGT-SR, with trophectoderm biopsy on days 5 or 6.

RESULTS: A total of 658 women underwent 902 cycles, including 607 PGT-A, 216 PGT-A&M, and 79 PGT-SR cycles. When compared with the blastocyst conversion rate for the PGT-A group (59.4%), and after adjustment for patient age, total number of mature oocytes, BMI, and ICSI, there were no significant differences for either the PGT-A&M (69.7%, aRR 1.03, 95% CI 0.96-1.10) or PGT-SR (63.2%, aRR1.04, 95% CI 0.96-1.13) groups. Compared to the PGT-A group, the proportion of usable blastocysts was statistically significantly lower in the PGT-SR group: 35.1% versus 24.4% (aRR 0.57, 95% CI 0.46-0.71) and the PGT-A&M group: 35.1% versus 31.5% (aRR 0.68, 95% CI 0.58-0.81). Implantation, pregnancy, and miscarriage rates were equivalent for all groups.

CONCLUSION: Patients with structural rearrangements have similar blastocyst development but significantly fewer usable blastocysts available for transfer compared to PGT-A testers. Nevertheless, with the transfer of a usable embryo, PGT-SR testers perform as well as those testing for PGT-A.

PMID:33656620 | DOI:10.1007/s10815-021-02131-2

Biol Cybern. 2021 Mar 3. doi: 10.1007/s00422-021-00864-y. Online ahead of print.

ABSTRACT

We investigate a simple model for motor pattern generation that combines central pattern generator (CPG) dynamics with a sensory feedback (FB) mechanism. Our CPG comprises a half-center oscillator with conductance-based Morris-Lecar model neurons. Output from the CPG drives a push-pull motor system with biomechanics based on experimental data. A sensory feedback conductance from the muscles allows modulation of the CPG activity. We consider parameters under which the isolated CPG system has either “escape” or “release” dynamics, and we study both inhibitory and excitatory feedback conductances. We find that increasing the FB conductance relative to the CPG conductance makes the system more robust against external perturbations, but more susceptible to internal noise. Conversely, increasing the CPG conductance relative to the FB conductance has the opposite effects. We find that the “closed-loop” system, with sensory feedback in place, exhibits a richer repertoire of behaviors than the “open-loop” system, with motion determined entirely by the CPG dynamics. Moreover, we find that purely feedback-driven motor patterns, analogous to a chain reflex, occur only in the inhibition-mediated system. Finally, for pattern generation systems with inhibition-mediated sensory feedback, we find that the distinction between escape- and release-mediated CPG mechanisms is diminished in the presence of internal noise. Our observations support an anti-reductionist view of neuromotor physiology: Understanding mechanisms of robust motor control requires studying not only the central pattern generator circuit in isolation, but the intact closed-loop system as a whole.

PMID:33656573 | DOI:10.1007/s00422-021-00864-y

Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):5. doi: 10.1167/iovs.62.3.5.

ABSTRACT

PURPOSE: The purpose of this paper was to study the bilateral choroidal thickness (CT) symmetry and differences in healthy individuals using wide-field swept-source optical coherence tomography (SS-OCT).

METHODS: All participants underwent a wide-field 16-mm 1-line scan using SS-OCT. CTs were measured at the following 12 points: 3 points at 900 µm, 1800 µm, and 2700 µm away from the nasal optic disc margin (nasal peripapillary area), 1 point at the subfovea, 6 points at 900 µm, 1800 µm, and 2700 µm away from the subfovea to the nasal and temporal areas (macular area), and 2 peripheral points at 2700 and 5400 µm from temporal point 3 (peripheral area). Bilateral CTs were measured; their correlations and differences in the corresponding regions were analyzed.

RESULTS: There were no statistically significant differences in CTs between the right and left eyes in all corresponding areas (all P > 0.05); they all showed significant positive correlation coefficients (r) (all P < 0.001). However, the nasal peripapillary and peripheral areas had relatively low correlation coefficients, compared to the macular areas. In addition, the bilateral CT differences were 32.60 ± 25.80 µm in the macular area, 40.67 ± 30.58 µm in the nasal peripapillary area, and 56.03 ± 45.73 µm in the peripheral area (all P < 0.001).

CONCLUSIONS: Overall, the CTs of each region were bilaterally symmetrical. However, the differences in CTs increased from the center to the periphery, which indicated that the anatomic variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.

PMID:33656554 | DOI:10.1167/iovs.62.3.5

Plant Cell. 2021 Feb 2:koab029. doi: 10.1093/plcell/koab029. Online ahead of print.

ABSTRACT

The phenotypic consequences of the addition or subtraction of part of a chromosome is more severe than changing the dosage of the whole genome. By crossing diploid trisomies to a haploid inducer, we identified 17 distal segmental haploid disomies that cover ∼80% of the maize genome. Disomic haploids provide a level of genomic imbalance that is not ordinarily achievable in multicellular eukaryotes, allowing the impact to be stronger and more easily studied. Transcriptome size estimates revealed that a few disomies inversely modulate most of the transcriptome. Based on RNA sequencing, the expression levels of genes located on the varied chromosome arms (cis) in disomies ranged from being proportional to chromosomal dosage (dosage effect) to showing dosage compensation with no expression change with dosage. For genes not located on the varied chromosome arm (trans), an obvious trans-acting effect can be observed, with the majority showing a decreased modulation (inverse effect). The extent of dosage compensation of varied cis genes correlates with the extent of trans inverse effects across the 17 genomic regions studied. The results also have implications for the role of stoichiometry in gene expression, the control of quantitative traits, and the evolution of dosage-sensitive genes.

PMID:33656551 | DOI:10.1093/plcell/koab029

JAMA Netw Open. 2021 Mar 1;4(3):e210469. doi: 10.1001/jamanetworkopen.2021.0469.

ABSTRACT

IMPORTANCE: The associations between long-term treatment of aortic dissection with various medications and late patient outcomes are poorly understood.

OBJECTIVE: To compare late outcomes after long-term use of β-blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or other antihypertensive medications (controls) among patients treated for aortic dissection.

DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study using the National Health Insurance Research Database in Taiwan included 6978 adult patients with a first-ever aortic dissection who survived to hospital discharge during the period between January 1, 2001, and December 31, 2013, and who received during the first 90 days after discharge a prescription for an ACEI, ARB, β-blocker, or at least 1 other antihypertensive medication. Data analysis was conducted from July 2019 to June 2020.

EXPOSURE: Long-term use of β-blockers, ACEIs, or ARBs, with use of other antihypertensive medications as a control.

MAIN OUTCOMES AND MEASURES: The primary outcomes of interest were all-cause mortality, death due to aortic aneurism or dissection, later aortic operation, major adverse cardiac and cerebrovascular events, hospital readmission, and new-onset dialysis.

RESULTS: Of 6978 total participants, 3492 received a β-blocker, 1729 received an ACEI or ARB, and 1757 received another antihypertension drug. Compared with patients in the other 2 groups, those in the β-blocker group were younger (mean [SD] age, 62.1 [13.9] years vs 68.7 [13.5] years for ACEIs or ARBs and 69.9 [13.8] years for controls) and comprised more male patients (2520 [72.2%] vs 1161 [67.1%] for ACEIs or ARBs and 1224 [69.7%] for controls). The prevalence of medicated hypertension was highest in the ACEI or ARB group (1039 patients [60.1%]), followed by the control group (896 patients [51.0%]), and was lowest in the β-blocker group (1577 patients [45.2%]). Patients who underwent surgery for type A aortic dissection were more likely to be prescribed β-blockers (1134 patients [32.5%]) than an ACEI or ARB (309 patients [17.9%]) or another antihypertension medication (376 patients [21.4%]). After adjusting for multiple propensity scores, there were no significant differences in any of the clinical characteristics among the 3 groups. No differences in the risks for all outcomes were observed between the ACEI or ARB and β-blocker groups. The risk of all-cause hospital readmission was significantly lower in the ACEI or ARB group (subdistribution hazard ratio [HR], 0.92; 95% CI, 0.84-0.997) and β-blocker group (subdistribution HR, 0.87; 95% CI, 0.81-0.94) than in the control group. Moreover, the risk of all-cause mortality was lower in the ACEI or ARB group (HR, 0.79; 95% CI, 0.71-0.89) and the β-blocker group (HR, 0.82; 95% CI, 0.73-0.91) than in the control group. In addition, the risk of all-cause mortality was lower in the ARB group than in the ACEI group (HR, 0.85; 95% CI, 0.76-0.95).

CONCLUSIONS AND RELEVANCE: The use of β-blockers, ACEIs, or ARBs was associated with benefits in the long-term treatment of aortic dissection.

PMID:33656527 | DOI:10.1001/jamanetworkopen.2021.0469

J Am Podiatr Med Assoc. 2021 Mar 3:20-172. doi: 10.7547/20-172. Online ahead of print.

ABSTRACT

BACKGROUND: While numerous studies suggest the benefit of electrical stimulation (E-Stim) therapy to accelerate wound healing, the underlying mechanism of action is still debated. In this pilot study, we examined the potential effectiveness of lower extremity E-Stim therapy to improve tissue perfusion in patients with diabetic foot ulcers (DFUs).

METHODS: Thirty-eight patients with DFUs were recruited. Participants underwent 60-minutes of active E-Stim therapy provided on acupuncture points above the level of the ankle joint using a bio-electric stimulation technology® (BEST) platform (Tennant Biomodulator® PRO). As primary outcome, changes in perfusion in response to E-Stim were assessed by measuring skin perfusion pressure (SPP) at baseline, 30-, and 60-min during therapy. In addition, retention was assessed 10-min post-therapy. As secondary outcome, tissue oxygen saturation (SatO2) was measured using a non-invasive near-infrared camera (Snapshot NIR, KENT Imaging Inc).

RESULTS: SPP increased in response to E-Stim therapy (p = 0.02) with maximum improvement observed at 60-min (11%, p = 0.007) compared to baseline. SPP reduced at 10-min post therapy, but remained higher than baseline (9%, p = 0.1). Magnitude of improvement at 60-min was negatively correlated with baseline SPP values (r = -0.45, p = 0.01) suggesting those with lower perfusion could benefit more from E-Stim therapy. Similar trends were observed for SatO2 with statistically significant improvement for a sub-sample (n=16) with moderate-severe peripheral arterial disease (Ankle brachial index &lt; 0.8 or &gt; 1.4).

CONCLUSIONS: This study provides early results on the feasibility and effectiveness of E-Stim therapy to improve skin perfusion and SatO2. The magnitude of benefit is higher among those with poorer skin perfusion. Results also suggest the effects of E-Stim could be washed out after stopping therapy and thus regular daily application may be required for the effective benefit for wound healing.

PMID:33656524 | DOI:10.7547/20-172