Nevin Manimala

Allergy. 2021 Nov 28. doi: 10.1111/all.15192. Online ahead of print.

ABSTRACT

BACKGROUND: Asthma is a complex, multifactorial disease often linked with sensitization to house-dust mites (HDM). There is a subset of patients that does not respond to available treatments, who present a higher number of exacerbations and a worse life quality. To understand the mechanisms of poor asthma control and disease severity, we aim to elucidate the metabolic and immunologic routes underlying this specific phenotype and the associated clinical features.

METHODS: Eighty-seven patients with a clinical history of asthma were recruited and stratified in 4 groups according to their response to treatment: corticosteroid-controlled (ICS), immunotherapy-controlled (IT), biologicals-controlled (BIO) or uncontrolled (UC). Serum samples were analysed by metabolomics and proteomics; and classifiers were built using machine learning algorithms.

RESULTS: Metabolomic analysis showed that ICS and UC groups cluster separately from one another and display the highest number of significantly different metabolites among all comparisons. Metabolite identification and pathway enrichment analysis highlighted increased levels of lysophospholipids related to inflammatory pathways in the UC patients. Likewise, 8 proteins were either upregulated (CCL13, ARG1, IL15 and TNFRSF12A) or downregulated (sCD4, CCL19 and IFNγ) in UC patients compared to ICS suggesting a significant T cell activation in these patients. Finally, the machine learning model built including metabolomic and clinical data was able to classify the patients with an 87.5% accuracy.

CONCLUSIONS: UC patients display a unique fingerprint characterized by inflammatory-related metabolites and proteins, suggesting a pro-inflammatory environment. Moreover, the integration of clinical and biological data led to a deeper understanding of the mechanisms underlying UC phenotype.

PMID:34839541 | DOI:10.1111/all.15192

Perspect Psychiatr Care. 2021 Nov 28. doi: 10.1111/ppc.12971. Online ahead of print.

ABSTRACT

PURPOSE: This study was conducted to determine the relationship between health anxiety (HA) and healthy lifestyle behaviors (HLBs), and the factors that affect them.

DESIGN AND METHODS: This descriptive, cross-sectional, and relational study was conducted with 1007 voluntary participants between June 1 and September 30, 2020.

FINDINGS: The participants’ mean age was 33.46 ± 15.42 years. A positive-significant relationship was found between the participants’ total HA and HLBs scores (r = 0.06, p = 0.03). The simple linear regression analysis performed by the researchers indicated that the explanatory power of HA as a determinant of HLBs was statistically significant (R² = 0.05).

PRACTICAL IMPLICATIONS: This study determined that health anxiety increased the tendency towards HLBs.

PMID:34839532 | DOI:10.1111/ppc.12971

Risk Anal. 2021 Nov 27. doi: 10.1111/risa.13862. Online ahead of print.

ABSTRACT

Affect can influence judgments of event riskiness and use of risk-related information. Two studies (Ns: 85 and 100) examined the insensitivity-to-probability effect-where people discount probability information when scenarios are affect-rich-applying it to evidence-informed risk communication. We additionally investigated whether this effect is moderated by format, based on predictions from the evaluability and pattern-recognition literatures, suggesting that graphical formats may attenuate insensitivity to probability. Participants completed a prior beliefs questionnaire (Study 1), and risk perception booklet (both studies) that presented identical statistical information about the relative risks associated with two scenarios-one with an affect-rich outcome, the other an affect-poorer outcome. In Study 1, this was presented graphically. In Study 2, information was presented in one of three formats: written, tabular, or graphical. Participants provided their perceptions of the risk for each scenario at a range of risk-levels. The affect-rich scenario was perceived as higher in risk, and, importantly, despite presenting identical relative risk information in both scenarios, was associated with a reduced sensitivity to probability information (both studies). These differences were predicted by participants’ prior beliefs concerning the scenario events (Study 1) and were larger for the single-item written format than graphical format (Study 2). The findings illustrate that insensitivity to probability information can occur in evidence-informed risk communications and highlight how communication format can moderate this effect. This interplay between affect and format therefore reflects an important consideration for information designers and researchers.

PMID:34839529 | DOI:10.1111/risa.13862

Alcohol Clin Exp Res. 2021 Nov 28. doi: 10.1111/acer.14704. Online ahead of print.

ABSTRACT

BACKGROUND: College students affiliated with fraternity and sorority, or “Greek” life represent a known high-risk group for alcohol consumption and related consequences, but little is known about demand for alcohol in this population. The current study examined behavioral economic demand for alcohol in a sample of Greek life-affiliated undergraduate students using the alcohol purchase task (APT) and a novel variation of the APT that included a fixed-price, nonalcoholic alternative (APT Choice).

METHODS: Participants (n = 229) completed the APT, APT Choice, Alcohol Use Disorders Identification Test (AUDIT), and Daily Drinking Questionnaire (DDQ). Group demand indices were calculated for the entire sample and then separately for participants who met or did not meet the legal drinking age (21+ or underage, respectively). Independent-sample t tests assessed whether there were any significant differences between the two age cohorts in the percent change in each behavioral economic index from the APT to APT Choice. Tests of correlation evaluated the construct validity of the demand indices from both hypothetical purchase tasks.

RESULTS: Descriptive statistics on alcohol use in this Greek-affiliated sample revealed “hazardous” drinking scores, with AUDIT-C scores exceeding the threshold of alcohol misuse. These measures were significantly correlated with demand indices from both APT conditions, and demand was inversely related to price; however, demand for alcohol was reduced when a nonalcoholic alternative was available. Both age cohorts reported a reduction in BP₁ (highest price of nonzero consumption) and an increase in α (rate of change in elasticity), but these changes were significantly greater among underage participants.

CONCLUSIONS: Although Greek life-affiliated students demonstrate high demand for alcohol, the concurrent availability of a nonalcoholic alternative reduces alcohol demand, particularly for underage students. These findings suggest that nonalcoholic options may enhance the effectiveness of increasing alcohol prices to reduce alcohol consumption among students at higher risk for alcohol use.

PMID:34839527 | DOI:10.1111/acer.14704

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 Dec 10;38(12):1245-1249. doi: 10.3760/cma.j.cn511374-20200913-00667.

ABSTRACT

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with mental retardation.

METHODS: G-banded karyotyping analysis and single nucleotide polymorphism microarray (SNP array) were used to detect the genetic variants within the family, and the origin of the variants was analyzed using UPDtool Statistics software.

RESULTS: The patient, a 26-year-old female, was found to have a chromosomal karyotype of 46,XX,dup(4)(q28.2q31.3),and SNP array revealed a 25.71 Mb duplication at 4q28.2-q31.3. The duplication was inherited from her father, and her fetus was found to carry the same duplication.

CONCLUSION: The duplication of the patient probably underlay the mental retardation. The gender of the carrier and parental origin of the duplication might have led to the variation in their clinical phenotype.

PMID:34839517 | DOI:10.3760/cma.j.cn511374-20200913-00667

Hu Li Za Zhi. 2021 Dec;68(6):43-52. doi: 10.6224/JN.202112_68(6).07.

ABSTRACT

BACKGROUND: Night-shift work affects the physical and mental health of employees. Early identification of relevant high-risk groups may be referenced in health promotion, job analysis, and job design.

PURPOSE: To explore the differences in workplace fatigue, physiological index of metabolic syndrome, and risk of cardiovascular disease between long-term and non-long-term night-time working nursing staff.

METHODS: The health examination data of 91 long-term and 119 non-long-term night-shift nurses were collected. A sub-data analysis approach was used and t-test, chi-square, Pearson`s correlation, and hierarchical multiple regression were used to conduct statistical analysis.

RESULTS: A positive correlation between cardiovascular risk and workplace fatigue was found in the long-term night-shift working group. Moreover, a lower average duration of sleep was found in the non-long-term night-shift working group. Finally, the participants with workplace fatigue and metabolic syndrome were found to have higher levels of cardiovascular risk.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Nursing staff who work night shifts for long-term and non-long-term periods should all receive regular health check-ups and practice healthy eating, exercise, and sleep habits. Employers should provide regular health checkups to their nursing staff and implement measures to identify health hazards in accordance with laws on labor standards, occupational safety, and health and labor health protection regulations, and then adopt appropriate plans and necessary safety and health measures to achieve a mutually beneficial result for both employers and employees in the healthcare industry.

PMID:34839490 | DOI:10.6224/JN.202112_68(6).07

Am J Perinatol. 2021 Nov 28. doi: 10.1055/s-0041-1740011. Online ahead of print.

ABSTRACT

OBJECTIVE: We sought to characterize the incidence and risk factors associated with developing maternal morbidity following preterm prelabor rupture of membranes.

STUDY DESIGN: Retrospective case-control study of patients with preterm prelabor rupture of membranes at a single institution from 2013 to 2019 admitted at ≥23 weeks gestational age. The primary outcome was a composite of maternal morbidity which included: death, sepsis, intensive care unit (ICU) admission, acute kidney injury, postpartum dilation and curettage, postpartum hysterectomy, venous thromboembolism, postpartum hemorrhage, postpartum wound complication, postpartum endometritis, pelvic abscess, postpartum pneumonia, readmission, and/or need for blood transfusion were compared with patients without above morbidities. Severe morbidity was defined as: death, ICU admission, venous thromboembolism, acute kidney injury, postpartum hysterectomy, sepsis, and/or transfusion >2 units. Demographics, antenatal, and delivery characteristics were compared between patients with and without maternal morbidity. Bivariate statistics and regression models were used to compare outcomes and calculate adjusted odd ratios.

RESULTS: Of 361 included patients, 64 patients (17.7%) experienced maternal morbidity and nine (2.5%) had severe morbidity. Patients who experienced maternal morbidity were significantly (p < 0.05) more likely to be older, have private insurance, have BMI ≥40, have chorioamnionitis at delivery, and undergo cesarean or operative vaginal delivery when compared with patients who did not experience morbidity. After controlling for confounders, cesarean delivery (aOR 2.38, 95% CI[1.30,4.39]), body mass index ≥40 at admission (aOR 2.54, 95% CI[1.12,5.79]), private insurance (aOR 3.08, 95% CI[1.54,6.16]), and tobacco use (aOR 3.43, 95% CI[1.58,7.48]) were associated with increased odds of maternal morbidity.

CONCLUSION: In this cohort, maternal morbidity occurred in 17.7% of patients with preterm prelabor rupture of membranes. Private insurance, body mass index ≥40, tobacco use, and cesarean delivery were associated with higher odds of morbidity. These data can be used in counseling and to advocate for smoking cessation.

KEY POINTS: · 17.7% of patients with PPROM experienced maternal morbidity.. · BMI ≥40 was associated with higher odds of maternal morbidity.. · Tobacco use and cesarean delivery were associated with higher odds of maternal morbidity..

PMID:34839477 | DOI:10.1055/s-0041-1740011

Am J Perinatol. 2021 Nov 28. doi: 10.1055/s-0041-1740062. Online ahead of print.

ABSTRACT

OBJECTIVE: In 2014, the leading obstetric societies published an executive summary of a joint workshop to establish obstetric interventions to be considered for periviable births. Antenatal corticosteroid administration between 22^0/7 and 22^6/7 weeks was not recommended given existing evidence. We sought to evaluate whether antenatal steroid exposure was associated with improved survival among resuscitated newborns delivered between 22 and 23 weeks of gestation.

STUDY DESIGN: We conducted a population-based cohort study of all resuscitated livebirths delivered between 22^0/7 and 23^6/7 weeks of gestation in the United States during 2009 to 2014 utilizing National Center for Health Statistics data. The primary outcome was rate of survival to 1 year of life (YOL) between infant cohorts based on antenatal steroid exposure. Multivariable logistic regression estimated the association of antenatal steroid exposure on survival outcomes.

RESULTS: In the United States between 2009 and 2014, there were 2,635 and 7,992 infants who received postnatal resuscitation after delivery between 22^0/7 to 22^6/7 and 23^0/7 to 23^6/7 weeks of gestation, respectively. Few infants born at 22 (15.9%) and 23 (26.0%) weeks of gestation received antenatal corticosteroids (ANCS). Among resuscitated neonates, survival to 1 YOL was 45.2 versus 27.8% (adjusted relative risk [aRR]: 1.6, 95% confidence interval [CI]: 1.2-2.1) and 57.9 versus 47.7% (aRR: 1.3, 95% CI: 1.1-1.5) for infants exposed to ANCS compared with those not exposed at 22 and 23 weeks of gestation, respectively. When stratified by 100 g birth weight category, ANCS were associated with survival among neonates weighing 500 to 599 g (aRR: 1.9, 95% CI: 1.3-2.9) and 600 to 699 g (aRR: 1.7, 95% CI: 1.1-2.6) at 22 weeks.

CONCLUSION: Exposure to ANCS was associated with higher survival rates to 1 YOL among resuscitated infants born at 22 and 23 weeks. National guidelines recommending against ANCS utilization at 22 weeks should be re-evaluated given emerging evidence of benefit.

KEY POINTS: · Exposure to antenatal steroids was associated with higher survival rates at 22 and 23 weeks of gestation.. · Women exposed to antenatal steroids were more likely to have an adverse outcome.. · The association between steroids and survival was observed among infants with birth weights > 500 g..

PMID:34839472 | DOI:10.1055/s-0041-1740062

Sleep Breath. 2021 Nov 27. doi: 10.1007/s11325-021-02535-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association of sleep duration with type 2 diabetes mellitus (T2DM) in a rural Chinese population.

METHODS: A 1:1 matched nested case-control study was performed based on a cohort that had been established in rural communities in Henan Province, China. T2DM patients and healthy controls (550 pairs) were included in this study.

RESULTS: Abnormal sleep duration significantly increased the risk of T2DM with an approximate U-shaped association (sleep duration ≤ 6 h, OR = 1.742, 95% CI = 1.007-3.011, P = 0.047; sleep duration 8-9 h, OR = 1.462, 95% CI = 1.038-2.060, P = 0.030) compared with participants with a night sleep duration of 7-8 h, after adjusting for multiple confounders. When stratified by gender, only women were sensitive to shorter sleep duration (OR = 2.483, 95% CI = 1.149-5.366, P = 0.021). Abnormal sleep duration (too short or too long) had adverse effects on homeostasis model assessment (HOMA) and blood metabolites, and the effect was more noticeable in people with longer sleep durations.

CONCLUSION: In a rural Chinese population, both too short and too long sleep duration increased the risk of T2DM. Especially women with less sleep duration have a higher risk of T2DM. Abnormal sleep also affects the HOMA index and metabolites; the relationship between HOMA-IR, total cholesterol, and LDL-Cholesterol with sleep duration was U-shaped, while fasting plasma glucose, body mass index, waist circumference, and triglyceride levels increased significantly only with longer sleep duration.

PMID:34839464 | DOI:10.1007/s11325-021-02535-5

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3705-3709. doi: 10.31557/APJCP.2021.22.11.3705.

ABSTRACT

OBJECTIVE: Obesity is known to be a preoperative risk factor for rectal cancer surgery. This study aimed to investigate the influence of obesity on the surgical outcomes of laparoscopic surgery for rectal cancer.

METHODS: The clinical data of 356 patients with rectal cancer from Jan 2012 to Dec 2015 were analyzed retrospectively. Perioperative outcomes were compared between 48 patients with a BMI (body mass index) ≥30 kg/m2 [obese group ] and 308 patients with a BMI≥30 kg/m2 [non-obese group] who underwent laparoscopic surgery.

RESULTS: Operation times were significantly longer for the obese group than for the non-obese group (125.2±30.5 min vs. 180.5±58.2 min, P=0.021). There were no statistically significant differences between two groups in terms of intraoperative blood loss, the number of retrieved lymph nodes, postoperative recovery and postoperative complications (P≥0.05). During the follow-up period, the overall survival rates were not significantly different between the two groups [66.7% (32/48) vs 67.2% (207/308), P=0.787]. The differences in recurrence and metastasis between the two groups were not statistically significant.

CONCLUSION: Our analysis revealed that laparoscopic surgery can be safely performed in patients with BMI≥30. The procedure was considered to be difficult but sufficiently feasible.

PMID:34837930 | DOI:10.31557/APJCP.2021.22.11.3705