Nevin Manimala

Eur J Cancer Care (Engl). 2022 Feb 7:e13554. doi: 10.1111/ecc.13554. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this work is to compare posttraumatic stress symptoms (PTSS) between families of children on cancer treatment and families of healthy children in China and to analyse the association among child PTSS, parent PTSS, and depression in the cancer group.

METHODS: Participants were children on cancer treatment (n = 91) and their parents (n = 91), and healthy children (n = 114) and their parents (n = 96). The children were asked to self-report PTSS, and the parents completed self-reported measures of PTSS and depression.

RESULTS: Although the prevalence of probable PTSD in children on cancer treatment was higher than that in comparisons (8.79% vs. 0.88%, P < 0.01), no statistic differences in PTSS levels were found between the two groups (P > 0.05). However, significant differences in PTSS levels and the prevalence of severe PTSS (21.98% vs. 1.04%) between parents of children with cancer and comparisons were observed (P < 0.001). Parent PTSS and depression were positively associated with child PTSS in the cancer group (P < 0.01).

CONCLUSION: The prevalence of probable PTSD in Chinese children with cancer was low, but PTSS was remarkably prevalent in their parents. Greater parent PTSS and depression were related to greater child PTSS. Results underline the importance to provide supportive psychological care for Chinese parents of children undergoing cancer treatment.

PMID:35129840 | DOI:10.1111/ecc.13554

Diabetes Ther. 2022 Feb 7. doi: 10.1007/s13300-022-01212-4. Online ahead of print.

ABSTRACT

INTRODUCTION: The American Diabetes Association (ADA) has identified a target hemoglobin A1c (HbA1c) < 7% as appropriate for most adults with type 2 diabetes (T2D). This research examines US diabetes-related healthcare costs for adults with T2D for individuals with glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%).

METHODS: The Optum Clinformatics^® Data Mart database from 2016 to 2020 was used to identify a cohort of adults with T2D who had a recorded HbA1c test (with first such date identified as the index date) and continuous insurance from 1 year prior through 1 year post index date. Patients with glycemic control were propensity matched to patients with poor glycemic control. Generalized linear models and two-part models examined diabetes-related outpatient, drug, acute care, and total costs over the 1-year post-period.

RESULTS: There were 34,538 propensity matched individuals included in the study. Results indicate that glycemic control (HbA1c < 7%), compared to poor glycemic control (HbA1c ≥ 7%) ,was associated with statistically significantly lower annual diabetes-related acute ($5671 ± $4216 vs $6138 ± $4211), outpatient ($6051 ± $4216 vs $7259 ± $7771), drug ($3739 ± $4581 vs $4288 ± $4788), and total costs care ($13,704 ± $10,635 vs $16,460 ± $10,885) (all P < 0.0001). Sensitivity analyses also examined results based upon alternative HbA1c thresholds which were chosen on the basis of expert guidelines and prior clinical trial thresholds (< 6%, ≤ 6.5%, < 8%, and ≤ 9%). In all cases, being below threshold was associated with statistically significantly lower diabetes-related total costs and component costs. Results also illustrate that, in general, higher HbA1c thresholds are associated with higher diabetes-related costs.

CONCLUSION: Glycemic control was found to be associated with significantly lower annual diabetes-related component and total costs. Results suggest economic benefits associated with having HbA1c at or below target.

PMID:35129822 | DOI:10.1007/s13300-022-01212-4

Braz J Microbiol. 2022 Feb 7. doi: 10.1007/s42770-022-00691-8. Online ahead of print.

ABSTRACT

The study’s objective was to develop a co-fermentation process with appropriate fermentation parameters to produce a sour beer (similar to a Belgium sour beer) with an ethanol content of 6-8% (v/v) using a coculture of Saccharomyces pastorianus and Lactobacillus plantarum. Statistical optimization was conducted to determine fermentation conditions to produce a sour beer with ~ 3 mg/mL of lactic acid, similar to the traditional sour beer levels. Studies were conducted on the microbial dynamics and volatile compounds produced during this fermentation and aging process. GC-MS studies revealed the generation of novel bioactive compounds as well as the depletion of some volatile compounds during co-fermentation. The study detailed a 5-day co-fermentation process of S. pastorianus and L. plantarum and a 21-day aging process to prepare a sour beer with biochemical properties along the lines of traditional lambic beers. The interrelationship between the two microorganisms and the biochemical changes in the sour beer fermentation process was elucidated and the sensorial attributes have been described.

PMID:35129817 | DOI:10.1007/s42770-022-00691-8

Psychon Bull Rev. 2022 Feb 7. doi: 10.3758/s13423-022-02063-7. Online ahead of print.

ABSTRACT

If one friend confidently tells us to buy Product A while another friend thinks that Product B is better but is not confident, we may go with the advice of our confident friend. Should we? The relationship between people’s confidence and accuracy has been of great interest in many fields, especially in high-stakes situations like eyewitness testimony. However, there is still little consensus about how much we should trust someone’s overall confidence level. Here, we examine the across-subject relationship between average accuracy and average confidence in 213 unique datasets from the Confidence Database. This approach allows us to empirically address this issue with unprecedented statistical power and check for the presence of various moderators. We find an across-subject correlation between average accuracy and average confidence of R = .22. Importantly, this relationship is much stronger for memory than for perception tasks (“domain effect”), as well as for confidence scales with fewer points (“granularity effect”). These results show that we should take one’s confidence seriously (and perhaps buy Product A) and suggest several factors that moderate the relative consistency of how people make confidence judgments.

PMID:35129781 | DOI:10.3758/s13423-022-02063-7

Med Biol Eng Comput. 2022 Feb 7. doi: 10.1007/s11517-022-02517-z. Online ahead of print.

ABSTRACT

Comparison between the corpus callosum and different regions of corona radiata in the horizontal plane was tested in the article. A series of flat-punch indentation experiments were conducted on the corpus callosum and different regions of corona radiata with different loading rates on the porcine brain. A linear viscoelastic model with prony series approximation was fitted to the force-time data of all regions. The experiment data from different loading rates demonstrated that both the corona radiata and corpus callosum increased in stiffness with the increasing loading rates. The corona radiata seems to be stiffer than the corpus callosum in the horizontal plane. During the period of relaxation, statistical comparisons among the different regions showed that the posterior region of the corona radiata seems to be stiffer than the anterior and superior.

PMID:35129764 | DOI:10.1007/s11517-022-02517-z

Eur J Pediatr. 2022 Feb 7. doi: 10.1007/s00431-022-04390-2. Online ahead of print.

ABSTRACT

Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL, p = 0.028; platelet count 166 vs. 216 cells × 10³/μL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559).Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD. What is Known: • In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease. • Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C. What is New: • Half of the patients had clinical features that overlapped with Kawasaki disease. • In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal. • Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C patients. • Transient bradycardia was noted in approximately 10% of our patients after initiation of treatment.

PMID:35129668 | DOI:10.1007/s00431-022-04390-2

Aesthetic Plast Surg. 2022 Feb 7. doi: 10.1007/s00266-022-02770-5. Online ahead of print.

ABSTRACT

BACKGROUND: We present our experience on 153 cases of full-thickness anterior blepharotomy with mullerectomy (FTABM) in the treatment of upper eyelid retraction (UER) related to Graves’ ophthalmopathy (GO).

METHODS: We included all the patients who underwent a graded FTABM between 1^st January 2015 and 30^th June 2020 for UER GO-related. The analysis included: pre-/post-operative conjunctival symptoms, epiphora, GO-Quality of Life Questionnaire (QoL), lagophthalmos, marginal reflex distance (MRD-1) index, eyelid symmetry within 1mm. The statistical analysis was designed to detect postoperative improvement in objective and subjective clinical features. Outcomes were analysed through Chi-squared test for dichotomous variables and through Wilcoxon-Mann-Whitney test for continuous variables.

RESULTS: Of the 111 patients, 42 underwent a bilateral procedure, while 69 a monolateral. Conjunctival symptoms were reported in 32% of cases before surgery and in 12.4% after FTABM (p < 0.001). Epiphora was complained by 29.6% of patients preoperatively and in 12.4% postoperatively (p < 0.001). Preoperative lagophthalmos was found in 12.4% (mean value of 0.34 ± 0.76 mm) of eyelids, and in 2.6% (mean value 0.05 ± 0.19 mm) eyelids (p = not significant) postoperatively. Pre-operative GO-QoL was 24.9 ± 4.4 mm; while post-operative GO-QoL was 35.3 ± 5.5 mm (p < 0.001). The MRD-1 varied from 10.12 ± 2.1 mm preoperatively, to 4.3 ± 0.6 mm (p < 0.001) after surgery. Asymmetric palpebral fissure was noted in 94 (84.7%) patients before surgery and in 7 (6.3%) after the procedure (p < 0.001).

CONCLUSION: FTABM is an effective procedure to treat UER GO-related. The technique manages to prevent complications of UER and determine good aesthetics.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Level IV, therapeutic study.

PMID:35129648 | DOI:10.1007/s00266-022-02770-5

Eur Arch Otorhinolaryngol. 2022 Feb 7. doi: 10.1007/s00405-022-07281-2. Online ahead of print.

ABSTRACT

PURPOSE: To determine the long-term outcomes of patients with vestibular schwannomas (VS) after stereotactic radiosurgery (SRS) who experience delayed tumour regrowth.

METHODS: We carried out a retrospective case series in tertiary university settings. We included patients with VS with initial response to SRS and delayed regrowth, assessing a database of 735 patients with VS and 159 patients who had SRS as sole treatment. Following SRS, all patients had clinical follow-up and serial magnetic resonance imaging (MRI). We documented the post-SRS clinical assessment, pre- and post-SRS VS size as per MRI in predetermined time periods, response to treatment and rate of (re-) growth and the final outcome in each case.

RESULTS: We identified six patients with good initial response but delayed VS regrowth at a faster rate than pre-SRS. The mean growth rate for these VS was 0.347 mm/month (range 0.04-0.78 mm/month) prior to treatment; the mean growth rate at the time of delayed re-growth was 0.48 mm/month (range 0.17-0.75 mm/month); this did not reach the level of statistical significance (p = 0.08). This regrowth occurred at a mean time of 42 months (range 36-66 months) post-SRS and stopped 22 months (mean, range 12-36 months) post regrowth detection in all cases.

CONCLUSIONS: Given that delayed post-SRS VS regrowth can occur in approximately 4% of the treated cases, it is important to continue close clinical and radiological follow-up. Despite this abnormal behaviour, VS do stop growing again; still, patients should be made aware of the possibility of this uncommon VS behaviour following SRS.

PMID:35129632 | DOI:10.1007/s00405-022-07281-2

Graefes Arch Clin Exp Ophthalmol. 2022 Feb 7. doi: 10.1007/s00417-022-05570-4. Online ahead of print.

ABSTRACT

PURPOSE: To investigate retinal sensitivity changes in eyes with pure cuticular drusen.

METHODS: Multimodal imaging and microperimetry (37-loci grid) data were examined retrospectively to evaluate functional changes in eyes with pure cuticular drusen. Mean sensitivity in the cuticular drusen cohort was compared to age-matched normals. An age- and loci-specific normative reference was created to analyse localised sensitivity deviation.

RESULTS: The mean number loci with relative scotoma in the cuticular drusen cohort (n = 27, mean [SD] age: 48.5 [12.4] years) referenced to normal eyes (n = 80, 53.5 [14.6] years) was 5.5 (95% confidence interval 3.0 to 8.1). However, mean sensitivity was not statistically different to the age-matched normal cohort (95% CI, – 2.3 to + 3.4 dB). The 37-loci grid was stratified into three rings of the approximately same number of loci, and the percentage of cuticular drusen eyes with pointwise deviation was significantly lower in the inner compared to the middle ring (12.3 [5.3]% vs. 17.3 [5.1]%, p < 0.05).

CONCLUSIONS: Eyes with cuticular drusen demonstrated relative scotoma, but mean sensitivity was not affected. Pointwise sensitivity provides a more robust measure of retinal sensitivity than mean sensitivity in cuticular drusen and should be assessed both in the clinic and in future clinical trials.

PMID:35129629 | DOI:10.1007/s00417-022-05570-4

JAMA Pediatr. 2022 Feb 7. doi: 10.1001/jamapediatrics.2021.6308. Online ahead of print.

ABSTRACT

IMPORTANCE: Most parenting programs target parents of children with severe behavioral problems. There is limited evidence on the effectiveness of universal parenting programs, especially for families with low income.

OBJECTIVE: To evaluate the effectiveness of the KeySteps@JC Parent-Child Interaction Program for low-income families in Hong Kong.

DESIGN, SETTING, AND PARTICIPANTS: A parallel, unblinded, cluster, randomized clinical trial was conducted from September 2018 to June 2019. Eight participating preschools in Hong Kong were randomly assigned (1:1) using an online randomization plan generator into intervention (immediate) and waiting list control (delayed) groups. Intervention participants included the parents of children in kindergarten grade 1. The results were processed by an intention-to-treat analysis.

INTERVENTIONS: KeySteps@JC Parent-Child Interaction program.

MAIN OUTCOMES AND MEASURES: The primary outcome was child behavioral problems, which were assessed using the Strength and Difficulties Questionnaire. Secondary outcomes were parental emotion coaching, involvement in child reading and play, and parent stress levels, which were assessed using Chinese-validated versions of the Parent Reading Belief Inventory, the Chinese Parent-Child Interaction Scale, the Emotion-Related Parenting Styles, and the Parental Stress Scale questionnaires. Parents in the intervention group participated in a training program consisting of 20 weekly 1.5-hour sessions on child behavior management, emotion coaching, dialogic reading, and interactive play. The primary hypothesis was that child behavior problems would be reduced after the intervention. The main analysis was a mixed-method regression with group status as the independent variable.

RESULTS: A total of 267 parents (mean age, intervention group: 33.8 years; 95% CI, 32.9-34.7 years; waiting list group: 35.7 years; 95% CI, 34.5-36.9 years) participated in the program. The intervention group included 153 participants (57.3%), and the waiting list group included 114 participants (42.7%). Among the target children (mean age, intervention group: 3.5 years; 95% CI, 3.4-3.5 years; waiting list group: 3.4 years; 95% CI, 3.4-3.5 years), there were 88 boys (57.5%) in the intervention group and 59 boys (51.8%) in the waiting list group. At postintervention, the intervention group reported a statistically significant improvement in children’s behavior (Cohen d, 0.29; 95% CI, 0.04-0.53); parents’ use of emotion-coaching strategies, including feelings of uncertainty or ineffectiveness in emotion socialization (Cohen d, 0.26; 95% CI, 0.01-0.50) and parental rejection of negative emotion (Cohen d, 0.33; 95% CI, 0.08-0.57); and involvement in child reading (Cohen d, 0.17; 95% CI, -0.07 to 0.41).

CONCLUSIONS AND RELEVANCE: The results of this randomized clinical trial provide promising evidence on the effectiveness of a multicomponent parenting intervention in preparing children from low-income families to be more socially and emotionally ready for school.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03615937.

PMID:35129606 | DOI:10.1001/jamapediatrics.2021.6308