Nevin Manimala

Anesth Analg. 2021 Dec 24. doi: 10.1213/ANE.0000000000005844. Online ahead of print.

ABSTRACT

BACKGROUND: Serious mental health conditions (eg, anxiety and depression) are common in surgical patients, yet likely underassessed due to the time-consuming and cumbersome traditional screening process. A recently developed computerized adaptive mental health assessment tool (computerized adaptive test-mental health [CAT-MH]) allows rapid, precise, and accurate assessment of numerous mental health disorders, including anxiety and depression, without the need for a trained interviewer. The goal of this investigation was to determine the feasibility of administering CAT-MH for anxiety and depression in the preoperative setting and to obtain preliminary evidence of the prevalence of anxiety and depression in preoperative patients.

METHODS: In this prospective cohort study, 100 adult patients scheduled for elective surgery were enrolled and asked to complete the CAT-MH in the preoperative clinic. Urgent and emergency surgeries were excluded as were pregnant patients. Primary feasibility outcomes were completion rate and time to completion. Secondary outcomes were prevalence estimates of anxiety and depression.

RESULTS: All 100 enrolled patients completed the study. All patients were able to complete the mental health assessment (mean time: 3.6 ± 1.8 minutes standard deviation). Sixteen patients (16%) screened positive for anxiety (severity: mild, n = 7 [7%]; moderate, n = 7 [7%]); severe, n = 2 [2%]); 12 of 16 (75%) did not have a previous diagnosis of anxiety disorder. Twenty-eight (28%) patients screened positive for depression (severity: mild, n = 26 [26%]; moderate and severe, n = 1 each [1%]); 23 of 28 (82%) had no previous diagnosis of depressive disorder. Nineteen patients (19%) met the screening criteria for major depressive disorder; 14 of 19 (74%) of which had no previous diagnosis of major depressive disorder.

CONCLUSIONS: The results of this pilot study support the feasibility of using CAT-MH in a preoperative evaluation and indicate that there is a substantial prevalence of undiagnosed anxiety and depression in surgical patients.

PMID:34958316 | DOI:10.1213/ANE.0000000000005844

Clin Linguist Phon. 2021 Dec 27:1-22. doi: 10.1080/02699206.2021.2007286. Online ahead of print.

ABSTRACT

Word learning difficulties are often found in children with Developmental Language Disorder (DLD). Lexical patterns of difficulties appear to be well described in the context of DLD but very little research focuses on their underlying causes. Word learning is known to be an inference-based process, constrained by categorization, which helps the extension of new words to unfamiliar referents and situations. These processes appear integrated in Bayesian models of cognition, which supposes that learning relies on an inductive inference process that recruits prior knowledge and principles of statistical learning (detection of regularities). Taken together, these mechanisms remain underexplored in DLD. Our study aims to define whether children with DLD can draw inductive inferences in a word learning context using categorization. Twenty children with DLD (between 6;0 and 12;6), and 20 language-matched and 16 age-matched controls were exposed to a word learning task where they were given exemplars of objects associated with pseudo-words. The objects belonged to six categories spread across three hierarchical levels. For each item, the children chose which one(s), among a set of test objects from the same categories, could be labelled the same way (word extension). Results showed that school-aged children with DLD could extend new words to broader categories as well as their typically developing (TD) peers. Nevertheless, none of the DLD or TD children showed a specification of their categorization of familiar instances that referred to more restricted instances. Our study suggests preserved abilities in using conceptual knowledge in order to learn new words, which could be used as a compensative strategy in the context of therapy. Further studies are needed to investigate this ability in more complex learning contexts.

PMID:34958296 | DOI:10.1080/02699206.2021.2007286

Orbit. 2021 Dec 27:1-8. doi: 10.1080/01676830.2021.1992789. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate lower lid position and tear meniscus in peripheral idiopathic facial nerve palsy (FNP).

METHODS: A prospective study enrolled patients with peripheral idiopathic FNP and epiphora. Data were collected on patient demographics, House-Brackmann (HB) scale, digital photographs of the face, and tear meniscus at the 1st, 30, and 90 day after onset of FNP. Marginal reflex distance to the upper (MRD1) and lower eyelid (MRD2) were evaluated using ImageJ software. Anterior segment optical coherence tomography (OCT) was performed to measure the tear menis- cus. P< .05 was considered statistically significant.

RESULTS: Sixteen patients were evaluated. The HB scale at presentation was grade III in six patients (37.5%). At 90 day, nine patients (56.25%) were grade I-normal. Three (18.7%) had upper lid retraction, three (18.7%) upper eyelid asymmetry and 7 (43.75%), lower eyelid retraction. The difference between MRD2-FNP with MRD2-healthy side was 0.51 ± 1.9 mm at the 1st visit, decreasing to 0.09 ± 1.47 mm at 90 days (P= .877). Tear meniscus measurements were significantly higher in FNP at the 1st visit (P= .001). The decrease in MRD2 was statistically correlated with the reduction of the tear meniscus area (TMA) (r = 0.67; P= .007) at 90 days. No correlation was found between HB and TMA. There is a difference in TMA between age groups at the 1st day(p= .009). Eldest group had higher HB scales.

CONCLUSION: Quantitative evaluation of eyelid position and tear meniscus are effective to document the evolution of FNP and can serve as a clue of orbicularis recovery.

PMID:34958290 | DOI:10.1080/01676830.2021.1992789

Subst Use Misuse. 2021 Dec 27:1-4. doi: 10.1080/10826084.2021.2019786. Online ahead of print.

ABSTRACT

INTRODUCTION: Electronic cigarettes (e-cigarettes) have become increasingly popular in the United States, including among cancer survivors, and the majority of users also endorse conventional cigarette usage. There has been little research on racial disparities of e-cigarette usage among this population.

METHODS: Using data from the National Health Interview Survey (2014-2018), trends in e-cigarette usage by smoking status was estimated among cancer survivors reporting a history of conventional cigarette use. Multivariable logistic regression analyses defined adjusted odds of e-cigarette usage including an interaction term between race*smoking status to assess whether the association between race and e-cigarette usage depended on smoking status.

RESULTS: Among 8,199 cancer survivors with history of conventional e-cigarette usage, 1,422 (17.3%) also reported using of e-cigarettes. The majority (71.3%) of e-cigarette users were current (versus former) conventional cigarette smoking individuals. White race was associated with higher odds of e-cigarette usage (AOR 2.17, 95% CI 2.00-2.33, p < 0.001), however there was a statistically significant race*smoking status interaction term (p < 0.001) such that this association was only seen among current conventional smoking patients (AOR 1.96, 95% 1.67-2.70, p < 0.001; 50.6% vs. 33.7%).

CONCLUSIONS: Among the oncology population, the majority of e-cigarette users also endorsed active conventional cigarette smoking. In particular, dual usage was highest among White cancer survivors suggesting that e-cigarettes may not be an efficacious tool for smoking cessation among this population. Our findings can can help inform targeted screening and counseling efforts among cancer survivors.

PMID:34958287 | DOI:10.1080/10826084.2021.2019786

Langmuir. 2021 Dec 27. doi: 10.1021/acs.langmuir.1c01847. Online ahead of print.

ABSTRACT

Characterization of complex oil emulsions is critical yet challenging both in science and in many industrial applications. Here we demonstrate for the first time the use of flow cytometry as a fast method for characterizing complex, polydisperse oil-water emulsions. Owing to our interest in understanding how the presence of specific ions might affect the properties of oil-water emulsions including size, polydispersity, and complexity, we present a systematic study of oil emulsions in deionized water and various brines of different ionic strength. Forward scatter (FSC) and side scatter (SSC) intensities associated with detailed statistics were judiciously combined to provide a better understanding of these complex systems. We find that the type and concentration profiles of ions around the oil droplets affect significantly the properties of the emulsion. Weakly hydrated cations NH₄⁺ and Ca²⁺ appear to be more effective in screening the charge of oil droplets compared to the monovalent Na⁺ and divalent Mg²⁺ ions, respectively. As a result, coalescence and formation of larger droplets are seen in the case of NH₄Cl and CaCl₂ compared to NaCl and MgCl₂, respectively. In addition, weakly hydrated anions such as Cl^– can come closer to the oil surface and, thus, decrease the effective screening that the Na⁺ ions provide as compared to SO₄^2- ions, which leads to more stable emulsions in NaCl compared to Na₂SO₄. In addition to these specific findings, the work demonstrates the utility of the technique as a new tool for characterizing oil emulsions in a wide spectrum of fields ranging from food to oil and gas applications.

PMID:34958229 | DOI:10.1021/acs.langmuir.1c01847

J Perinat Med. 2021 Dec 24. doi: 10.1515/jpm-2021-0519. Online ahead of print.

ABSTRACT

OBJECTIVES: Chlamydia trachomatis is one of the most common sexually transmitted diseases in the world, but there are limited data on its impact on perinatal outcomes. Our objective was to investigate the association between chlamydia infections and adverse perinatal outcomes.

METHODS: This is a retrospective analysis of the United States Centers for Disease Control and Prevention natality live birth database for the years 2016-2019. The rates of adverse perinatal outcomes were compared between patients with a chlamydia infection during pregnancy and patients without such infection, using Pearson’s chi-square test with the Bonferroni adjustment. A multivariate logistic regression was then used to adjust outcomes for potential confounders.

RESULTS: Chlamydia infections were associated with small, but statistically significant, increased odds of preterm birth (<37 weeks), early preterm birth (<32 weeks), low birthweight (<2,500 g), congenital anomalies, low 5-min Apgar score (<7), neonatal intensive care unit admission, immediate neonatal ventilation, prolonged (>6 h) neonatal ventilation, and neonatal antibiotic treatment for suspected sepsis.

CONCLUSIONS: Chlamydia infections during pregnancy are associated with adverse perinatal outcomes. These results call for increased education regarding the potential risks of pregnancies with a chlamydia infection, as well as for increased antenatal surveillance and post-natal pediatric assessment in these pregnancies.

PMID:34958185 | DOI:10.1515/jpm-2021-0519

Hepatol Commun. 2021 Dec 27. doi: 10.1002/hep4.1886. Online ahead of print.

ABSTRACT

The host genetic background for hepatocellular carcinoma (HCC) is incompletely understood. We aimed to determine if four germline genetic polymorphisms, rs429358 in apolipoprotein E (APOE), rs2642438 in mitochondrial amidoxime reducing component 1 (MARC1), rs2792751 in glycerol-3-phosphate acyltransferase (GPAM), and rs187429064 in transmembrane 6 superfamily member 2 (TM6SF2), previously associated with progressive alcohol-related and nonalcoholic fatty liver disease, are also associated with HCC. Four HCC case-control data sets were constructed, including two mixed etiology data sets (UK Biobank and FinnGen); one hepatitis C virus (HCV) cohort (STOP-HCV), and one alcohol-related HCC cohort (Dresden HCC). The frequency of each variant was compared between HCC cases and cirrhosis controls (i.e., patients with cirrhosis without HCC). Population controls were also considered. Odds ratios (ORs) associations were calculated using logistic regression, adjusting for age, sex, and principal components of genetic ancestry. Fixed-effect meta-analysis was used to determine the pooled effect size across all data sets. Across four case-control data sets, 2,070 HCC cases, 4,121 cirrhosis controls, and 525,779 population controls were included. The rs429358:C allele (APOE) was significantly less frequent in HCC cases versus cirrhosis controls (OR, 0.71; 95% confidence interval [CI], 0.61-0.84; P = 2.9 × 10^-5 ). Rs187429064:G (TM6SF2) was significantly more common in HCC cases versus cirrhosis controls and exhibited the strongest effect size (OR, 2.03; 95% CI, 1.45-2.86; P = 3.1 × 10^-6 ). In contrast, rs2792751:T (GPAM) was not associated with HCC (OR, 1.01; 95% CI, 0.90-1.13; P = 0.89), whereas rs2642438:A (MARC1) narrowly missed statistical significance (OR, 0.91; 95% CI, 0.84-1.00; P = 0.043). Conclusion: This study associates carriage of rs429358:C (APOE) with a reduced risk of HCC in patients with cirrhosis. Conversely, carriage of rs187429064:G in TM6SF2 is associated with an increased risk of HCC in patients with cirrhosis.

PMID:34958182 | DOI:10.1002/hep4.1886

J Nurs Scholarsh. 2021 Dec 27. doi: 10.1111/jnu.12762. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative pain has adverse effects on children after urology treatment, including sleep disturbance, incision dehiscence, bleeding, and delayed recovery. Parents, as the most direct caregivers of children, can make accurate assessments of children´s personal behaviors and responses, which is very important for the management of postoperative pain in children.

PURPOSE: The purpose of the current study was to develop a Parent Participation in Postoperative Pain Management Program for children in a urology ward and to evaluate its effects on children’s postoperative pain scores and other outcome indicators.

DESIGN: This research comprised two phases. The first phase was the development of a Parent Participation in Postoperative Pain Management Program. The second phase was a randomized controlled trial between two groups, and was carried out in a 45-bed inpatient urology ward of a tertiary children’s hospital in China. In the trial, 211 children and their parents were randomly selected as a control group between July 1 and August 15, 2019, and 202 children and their parents were randomly selected as an intervention group between August 16 and September 15, 2019.

METHODS: Following the framework and methods of the Evidence-based Continuous Quality Improvement Model developed at Fudan University Evidence-Based Nursing Center, we systematically gathered evidence regarding parental involvement in postoperative pain management in children to construct the program. To evaluate the program’s effectiveness, the control group performed routine postoperative pain management, while the intervention group underwent the Parent Participation in Postoperative Pain Management Program. The management period was during hospitalization, and generally ranged 3-7 days. The Statistical Table of Pain Assessment for Children after Urology was employed by researchers.

FINDINGS: The results revealed no significant differences in demographic characteristics between the two groups of children and their parents. Children’s pain scores during dressing removal (Z = -3.108, p = 0.002), at discharge (Z = -2.185, p = 0.029) and during catheter removal (Z = -6.553, p = 0.000) were significantly lower in the intervention group compared with the control group.

CONCLUSIONS AND CLINICAL RELEVANCE: The Parent Participation in Postoperative Pain Management Program was found to be effective for alleviating postoperative pain scores among children, and provided useful information regarding postoperative pain management in children involving four aspects of parental involvement: cognition, guidance, documentation and support.

PMID:34958176 | DOI:10.1111/jnu.12762

Asian J Endosc Surg. 2021 Dec 27. doi: 10.1111/ases.13023. Online ahead of print.

ABSTRACT

BACKGROUND: In parastomal hernia (PH) repair, laparoscopic Sugarbaker technique (LS) is considered the best practice; however, meshes specific for LS repairs ceased to be available.

PURPOSE: The aim of the study was to evaluate feasibility of using a physician-modified mesh (tailored mesh: TM) in LS.

METHODS: Thirty-three patients who underwent LS for PH between June 2012 and September 2021 were examined to compare surgical outcomes between LS with TM (n = 11) and with a ready-made specific mesh (SM, n = 22). All meshes were coated plastic meshes. Statistical analysis was performed with the Mann-Whitney U test and Fisher’s exact test. P < .05 was considered to be statistically significant.

RESULTS: We compared the outcomes of TM with SM in LS for similar hernia types during median follow-up periods of 23 (range, 2-29) and 74 (range, 36-110) months (P < .0001), respectively. The median operation times were 146 (range, 45-423) for TM and 193 (range, 65-386) minutes for SM (P = .2301). Perioperative complications were observed in one TM patient (9%) and two SM patients (9%) (P = 1.0000). The lengths of postoperative stay were similar. Recurrence was observed in two cases in the SM group (9%) within 1 year after the operation.

CONCLUSION: In LS, TM seems to be a feasible mesh comparable to SM within short- and mid-term follow-up.

PMID:34958170 | DOI:10.1111/ases.13023

J Magn Reson Imaging. 2021 Dec 27. doi: 10.1002/jmri.28028. Online ahead of print.

ABSTRACT

BACKGROUND: Absolute quantification of metabolites in MR spectroscopic imaging (MRSI) requires a stable reference signal of known concentration. The Electronic REference To access In vivo Concentrations (ERETIC) has shown great promise but has not been applied in patients and 3D MRSI. ERETIC hardware has not been integrated with receive arrays due to technical challenges, such as coil combination and unwanted coupling between multiple ERETIC and receive channels, for which we developed mitigation strategies.

PURPOSE: To develop absolute quantification for whole-brain MRSI in glioma patients.

STUDY TYPE: Prospective.

POPULATION: Five healthy volunteers and three patients with isocitrate dehydrogenase mutant glioma (27% female). Calibration and coil loading phantoms.

FIELD STRENGTH/SEQUENCE: A 3 T; Adiabatic spin-echo spiral 3D MRSI with real-time motion correction, Fluid Attenuated Inversion Recovery (FLAIR), Gradient Recalled Echo (GRE), Multi-echo Magnetization Prepared Rapid Acquisition of Gradient Echo (MEMPRAGE).

ASSESSMENT: Absolute quantification was performed for five brain metabolites (total N-acetyl-aspartate [NAA]/creatine/choline, glutamine + glutamate, myo-inositol) and the oncometabolite 2-hydroxyglutarate using a custom-built 4x-ERETIC/8x-receive array coil. Metabolite quantification was performed with both EREIC and internal water reference methods. ERETIC signal was transmitted via optical link and used to correct coil loading. Inductive and radiative coupling between ERETIC and receive channels were measured.

STATISTICAL TESTS: ERETIC and internal water methods for metabolite quantification were compared using Bland-Altman (BA) analysis and the nonparametric Mann-Whitney test. P < 0.05 was considered statistically significant.

RESULTS: ERETIC could be integrated in receive arrays and inductive coupling dominated (5-886 times) radiative coupling. Phantoms show proportional scaling of the ERETIC signal with coil loading. The BA analysis demonstrated very good agreement (3.3% ± 1.6%) in healthy volunteers, while there was a large difference (36.1% ± 3.8%) in glioma tumors between metabolite concentrations by ERETIC and internal water quantification.

CONCLUSION: Our results indicate that ERETIC integrated with receive arrays and whole-brain MRSI is feasible for brain metabolites quantification. Further validation is required to probe that ERETIC provides more accurate metabolite concentration in glioma patients.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1.

PMID:34958166 | DOI:10.1002/jmri.28028