Nevin Manimala

Cancer Med. 2022 Feb 13. doi: 10.1002/cam4.4608. Online ahead of print.

ABSTRACT

BACKGROUND: Uterine cancer is one of the most common female cancers worldwide, with huge heterogeneity in morbidity and mortality. Although a high body-mass index (BMI) has been linked to uterine cancer, systematic reports about the influence of high BMI and its temporal trends are scarce.

METHODS: The annual morbidity, mortality, and disability-adjusted life years (DALYs) of uterine cancer in 204 countries or territories were retrieved from the GBD 2019 study. To reflect trends in disease burden, we also calculated the estimated annual percentage change (EAPC) based on the age-standardized rates of uterine cancer from 1990 to 2019.

RESULTS: The global incident cases of uterine cancer increased 2.3 times from 187,190 in 1990 to 435,040 in 2019. Although the age-standardized incidence rate (ASIR) of uterine cancer increased worldwide from 8.67/100,000 in 1990 to 9.99/100,000 in 2019, the age-standardized death rate (ASDR) and DALY rate decreased during the same period. High socio-demographic index (SDI) countries tended to have a higher ASIR than developing regions, and their increasing trend in ASIR was also more pronounced. The disease was rare before 40 years old, but its risk rose sharply among women aged 50-70. A high BMI was linked to more than one-third of deaths from uterine cancer in 2019.

CONCLUSIONS: The incidence in developed areas was significantly higher than in developing areas and also increased much more rapidly. Elderly females, especially those with a high BMI, have a higher risk of uterine cancer. Therefore, more health resources may be needed to curb the rising burden in specific populations.

PMID:35156336 | DOI:10.1002/cam4.4608

Nurs Open. 2022 Feb 13. doi: 10.1002/nop2.1193. Online ahead of print.

ABSTRACT

AIM: To describe nursing students’ level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries.

DESIGN: A cross-sectional comparative design across the countries.

METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model.

RESULTS: The nursing students’ (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.

PMID:35156324 | DOI:10.1002/nop2.1193

Clin Implant Dent Relat Res. 2022 Feb 13. doi: 10.1111/cid.13072. Online ahead of print.

ABSTRACT

BACKGROUND: Nonsurgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of nonsurgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort, and patient satisfaction.

METHODS: Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analyzed using a statistical software program.

RESULTS: A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at 1-3 months (mean difference [MD] -0.23; 95% confidence interval [CI] -0.50-0.05; p = 0.10) and 6 months (MD -0.04; 95% CI -0.34 to 0.27; p = 0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant.

CONCLUSIONS: The short-term clinical and radiographic outcomes following nonsurgical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.

PMID:35156296 | DOI:10.1111/cid.13072

Dermatol Ther. 2022 Feb 14:e15379. doi: 10.1111/dth.15379. Online ahead of print.

ABSTRACT

CONTEXT: Psoriasis assessment tools in use presently lack reproducibility and are cumbersome to use. An easily reproducible, objective tool with ability to maintain visual records for follow up is hence desirable. We conducted a study with the aim to assess dermoscopic changes in psoriasis while on treatment by recording the number of hemorrhagic dots (Hemorrhagic Dot Score-HDS) in a representative plaque and comparing it to the PASI score.

SETTINGS AND DESIGN: A longitudinal prospective study was conducted between October 2018 to March 2020 in a dermatology centre of a tertiary hospital on cases of chronic plaque psoriasis on treatment over 6 months, assessed at baseline and thereafter monthly for six months.

METHODS: Hundred consenting patients of chronic plaque psoriasis were assessed, clinically, PASI and dermoscopically. HDS and other dermoscopic features were noted at every visit.

STATISTICAL ANALYSIS USED: ANOVA and F test of testing of equality of Variance; effect size in terms of Cohen were used to report the strength of an apparent relationship.

RESULTS AND INTERPRETATION: Percentage improvement in the mean PASI scores and HDS and percentage improvement of mean was found significant in each month on follow up. Systemic therapy as compared to topical therapy showed higher effect size of 6.1 and 1.7 respectively.

CONCLUSION: Hemorrhagic dot score can be used as an objective, definite assessment tool correlating with clinical severity of psoriasis with more accuracy which shows changes early following institution of therapy. This article is protected by copyright. All rights reserved.

PMID:35156286 | DOI:10.1111/dth.15379

Colorectal Dis. 2022 Feb 13. doi: 10.1111/codi.16092. Online ahead of print.

ABSTRACT

AIM: Metabolic syndrome (MetS) is a cluster of factors including obesity, hypertension, diabetes, hypercholesterolemia and hyperlipidaemia. It has been associated with an increased risk of colorectal neoplasia. This systematic review and meta-analysis assessed the association between MetS and: (i) recurrence of adenomas or occurrence of CRC in patients with prior adenomas; (ii) survival in patients with CRC.

METHOD: MEDLINE, Embase, Scopus and Web of Science were searched up to 22/11/2019. Two authors independently conducted title and abstract screening; full text of eligible studies was evaluated. Where ≥3 studies reported effect measures for a specific outcome, meta-analysis using random effects model was conducted. I² was used to assess between-study heterogeneity. Quality appraisal was undertaken with the Newcastle-Ottawa Score.

RESULTS: The search identified 1764 articles, 55 underwent full text screening, resulting in a total of 15 eligible studies. Five studies reported on metachronous neoplasia, with differing outcomes precluded a meta-analysis. No consistent relationship between MetS and metachronous neoplasia was found. Ten studies reported on survival outcomes. MetS was associated with poorer CRC-specific survival (HR=1.8, 95%CI 1.04-3.12, I² =92.7%, n=3). Progression-free survival was also worse but this did not reach statistical significance (HR=1.12, 95%CI 0.89-1.42, I² =85.6%, n=3). There was no association with overall survival (HR=1.04, 95%CI 0.94-1.15, I² =43.7%, n=7). Significant heterogeneity was present but subgroup analysis did not account for this.

CONCLUSION: MetS is associated with poorer CRC-specific survival, but evidence is inconsistent on metachronous neoplasia. Further research is warranted to better understand the impact of MetS on the adenoma-carcinoma pathway.

PMID:35156283 | DOI:10.1111/codi.16092

Glob Chang Biol. 2022 Feb 13. doi: 10.1111/gcb.16128. Online ahead of print.

ABSTRACT

Thin, hair-like lichens (Alectoria, Bryoria, Usnea) form conspicuous epiphyte communities across the boreal biome. These poikilohydric organisms provide important ecosystem functions and are useful indicators of global change. We analyse how environmental drivers influence changes in occurrence and length of these lichens on Norway spruce (Picea abies) over 10 years in managed forests in Sweden using data from >6000 trees. Alectoria and Usnea showed strong declines in southern-central regions, whereas Bryoria declined in northern regions. Overall, relative loss rates across the country ranged from 1.7% per year in Alectoria to 0.5% in Bryoria. These losses contrasted with increased length of Bryoria and Usnea in some regions. Occurrence trajectories (extinction, colonization, presence, absence) on remeasured trees correlated best with temperature, rain, nitrogen deposition, and stand age in multinomial logistic regression models. Our analysis strongly suggests that industrial forestry, in combination with nitrogen, is the main driver of lichen declines. Logging of forests with long continuity of tree cover, short rotation cycles, substrate limitation and low light in dense forests are harmful for lichens. Nitrogen deposition has decreased but is apparently still sufficiently high to prevent recovery. Warming correlated with occurrence trajectories of Alectoria and Bryoria, likely by altering hydration regimes and increasing respiration during autumn/winter. The large-scale lichen decline on an important host has cascading effects on biodiversity and function of boreal forest canopies. Forest management must apply a broad spectrum of methods, including uneven-aged continuous cover forestry and retention of large patches, to secure the ecosystem functions of these important canopy components under future climates. Our findings highlight interactions among drivers of lichen decline (forestry, nitrogen, climate), functional traits (dispersal, lichen colour, sensitivity to nitrogen, water storage), and population processes (extinction/colonization).

PMID:35156274 | DOI:10.1111/gcb.16128

Addiction. 2022 Feb 13. doi: 10.1111/add.15819. Online ahead of print.

NO ABSTRACT

PMID:35156243 | DOI:10.1111/add.15819

Environ Toxicol Chem. 2022 Feb 13. doi: 10.1002/etc.5306. Online ahead of print.

ABSTRACT

Tests for dose-response trend may be used to support conclusions on the toxicity of a substance in a range of doses evaluated in a comparative experiment. Criteria are proposed for evaluating and comparing alternative tests, and applied in a comparison of some tests applicable with continuous responses, namely a multiplicity-adjusted pairwise comparison procedure, a trend test based on a single contrast, and four multiple-contrast trend tests. Methods considered treat dose as ordinal information. A particular focus is comparison of the simple test of a single contrast, with coefficients proportional to dose rank, to multiple-contrast methods available with modern computing. To explore the role of dose-response curve shape, we generate regular dose response shapes (or profiles), defined by mean response for each dose level, using a simple grid-based algorithm. Power for individual profiles may be used to illustrate the effect of curve shape on the power of alternative tests. To facilitate selection of tests we report average power over profiles, averaging at different levels of granularity, first separately for each of several curve shape categories, then over all profiles weighting shape categories equally. Power results for the six tests evaluated provide at least clear distinctions between some procedures that are more-preferred, versus less-preferred. Our analyses expand the comparisons of tests available and contribute methodology for choice of statistical methods for toxicological data analysis. This article is protected by copyright. All rights reserved. © 2022 SETAC.

PMID:35156237 | DOI:10.1002/etc.5306

J Trauma Stress. 2022 Feb 13. doi: 10.1002/jts.22778. Online ahead of print.

ABSTRACT

Verbal learning deficits are common among sexually traumatized women who have not been formally diagnosed with posttraumatic stress disorder (PTSD). Aberrant resting-state functional connectivity (rsFC) of the amygdala and hippocampus are implicated in PTSD and verbal memory impairment. We tested rsFC between bilateral dentate gyrus (DG) and both centromedial (CM) and basolateral (BL) nuclei of the amygdala as statistical mediators for the effect of sexual trauma-related symptom severity on delayed verbal recall performance in 63 older women (age: 60-85 years) undiagnosed with PTSD. Participant data were drawn from the NKI-Rockland Study. Individuals completed a 10-min resting-state scan, Rey Auditory Verbal Learning Test (RAVLT), and the Sexual Abuse Trauma Index (SATI) from the Trauma Symptom Checklist. Z-scores indicating rsFC of DG with BL and CM amygdala seeds were evaluated in two separate mediation models. Higher SATI scores were associated with lower RAVLT after controlling for age, β = -.23, 95% CI [.48, .03], p = .039. This effect was negated upon adding a negative path from SATI to rsFC of left DG and right CM, β = -.29, 95% CI [-.52, -.02], p = .022, and a positive path from that seed pair to RAVLT List A recall, β = .28, 95% CI [.03, 0.48], p = .015. Chi-square fit indices supported partial mediation by this seed pair, p = .762. In the absence of PTSD sexual trauma symptoms partially relate to verbal learning deficits as a function of aberrant rsFC between left hippocampus DG and right amygdala CM nuclei.

PMID:35156236 | DOI:10.1002/jts.22778

Int J Health Plann Manage. 2022 Feb 13. doi: 10.1002/hpm.3432. Online ahead of print.

ABSTRACT

Ethiopia is an underfinanced country when compared to the Sub-Saharan average. Direct payment has a high account in Ethiopia and inhibits access to health services for the poor. We aimed to identify the factors associated with catastrophic health expenditure (CHE) in the South Wollo Zone, Ethiopia. A community-based cross-sectional study was conducted. A two-stage sampling technique was used to get a total of 494 households. The data were entered using Epi data version 4.6 and analysed using STATA version 14.1 software for binary logistic regression analysis. A multivariable logistic regression analysis was done to identify the factors associated with CHE. The total magnitude of CHE was found to be 33.97% at the 10% threshold of total household expenditure and 14.98% at the 40% threshold of non-food expenditure. Insured households (adjusted odds ratio = 0.02, 95% CI: 0.01-0.10) were statistically associated with CHE with total household and non-food measures. Catastrophic health expenditure was found to be decreased among insured households and increased among households had children less than 5 years of age, members with chronic illness, and poor health status. Therefore, encouraging insurance and health promotion activities to improve the health status of the community are important.

PMID:35156225 | DOI:10.1002/hpm.3432