Nevin Manimala

J Adv Nurs. 2021 Nov 26. doi: 10.1111/jan.15095. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of PainReApp, an mHealth system, based on physical exercise recommendations for patients with chronic pain (low back pain, fibromyalgia and diabetic neuropathic pain) based on pain intensity, quality of life, anxiety and/or depression, and sleep quality.

DESIGN: Single-blinded randomized controlled trial.

METHODS: One hundred patients from three different chronic conditions (low back pain, fibromyalgia and neuropathic diabetic pain) will be recruited and randomized into two groups to receive the intervention with a physical activity program guided by the PainReApp system (experimental group) or with the program information in paper format (control group). All patients will attend a first face-to-face session in which the smartphone application usage (experimental group) and exercise execution will be explained (both groups). Data will be collected at baseline, 4, 12 and 24 weeks. Nevertheless, the users of the application will have a daily registry of the exercise performed and the self-perceived difficulty. The primary outcomes of the trial will be the intensity of pain and quality of life. Anxiety and/or depression and sleep quality will be also assessed to evaluate the influence of the physical activity at multiple levels.

DISCUSSION: Physical exercise is becoming one of the leading evidence-based interventions to treat chronic pain. It needs to be adapted to the necessities of each pain condition. One of the major problems is the low adherence to the proposed program. New strategies that empower the patients, such as the m-Health, are reliable and useful tools to ease this end.

IMPACT: To the best of our knowledge, this is the first long-term randomized controlled trial researching the impact of an m-health system on chronic pain from different origin. The intervention is based on international physical exercise recommendations and can be performed without specific material, allowing the home-based practice.

TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12621000783820).

PMID:34825739 | DOI:10.1111/jan.15095

J Clin Lab Anal. 2021 Nov 26:e24142. doi: 10.1002/jcla.24142. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a common cause of morbidity and mortality in the ICU patients. Early diagnosis and appropriate patient management is the key to improve the patient survival and to limit disabilities in sepsis patients. This study was aimed to find new diagnostic biomarkers of sepsis.

METHODS: In this study, serum proteomic profiles in sepsis patients by iTRAQ2D-LC-MS/MS. Thirty seven differentially expressed proteins were identified in patients with sepsis, and six proteins including ApoC3, SERPINA1, VCAM1, B2M, GPX3, and ApoE were selected for further verification by ELISA and immunoturbidimetry in 53 patients of non-sepsis, 37 patients of sepsis, and 35 patients of septic shock. Descriptive statistics, functional enrichment analysis, and ROC curve analysis were conducted.

RESULTS: The level of ApoC3 was gradually decreased among non-sepsis, sepsis, and septic shock groups (p = 0.049). The levels of VCAM1 (p = 0.010), B2M (p = 0.004), and ApoE (p = 0.039) were showing an increased tread in three groups, with the peak values of B2M and ApoE in the sepsis group. ROC curve analysis for septic diagnosis showed that the areas under ROC curve (AUC) of ApoC3, VCAM1, B2M, and ApoE were 0.625, 0.679, 0.581, and 0.619, respectively, which were lower than that of PCT (AUC 0.717) and CRP (AUC 0.706), but there were no significant differences between each index and PCT or CRP. The combination including four validated indexes and two classical infection indexes for septic diagnosis had the highest AUC-ROC of 0.772.

CONCLUSION: Proteins of ApoC3, VCAM1, B2M, and ApoE provide a supplement to classical biomarkers for septic diagnosis.

PMID:34825737 | DOI:10.1002/jcla.24142

J Adv Nurs. 2021 Nov 26. doi: 10.1111/jan.15113. Online ahead of print.

ABSTRACT

AIM: To measure the prevalence of compassion fatigue among Chinese clinical nurses and to examine the effects of resilience and self-efficacy on compassion fatigue.

DESIGN: A cross-sectional descriptive survey was conducted in accordance with the STROBE guidelines.

METHODS: Participants were recruited from three tertiary hospitals in central China from October 3 to December 15, 2019, using convenience sampling. Clinical nurses (n = 992) from different nursing departments completed the General Information Questionnaire, Professional Quality of Life Scale, Connor-Davidson Resilience Scale, and General Perceived Self-Efficacy Scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson or Spearman’s correlation analyses, and multiple linear regression models were used.

RESULTS: Nurses experienced moderate levels of compassion fatigue (burnout and secondary traumatic stress). Resilience and self-efficacy were significantly negatively correlated with burnout but not with secondary traumatic stress. Linear regression analysis showed that resilience, self-efficacy, exercise, and physical conditions were the main predictors of burnout. Only physical conditions and marital status significantly predicted secondary traumatic stress.

CONCLUSION: Nurses are vulnerable to compassion fatigue in China. Resilience and self-efficacy significantly negatively predicted nurses’ compassion fatigue. Physical conditions, healthy lifestyles, and social support are also important factors for compassion fatigue.

IMPACT: Our findings can be used to generate targeted intervention and coping strategies for nurses to improve their resilience and self-efficacy to alleviate compassion fatigue.

PMID:34825731 | DOI:10.1111/jan.15113

Magn Reson Med. 2021 Nov 26. doi: 10.1002/mrm.29098. Online ahead of print.

ABSTRACT

PURPOSE: Proton magnetic resonance spectroscopic imaging (1H MRSI) is a noninvasive technique for assessing tumor metabolism. Manual inspection is still the gold standard for quality control (QC) of spectra, but it is both time-consuming and subjective. The aim of the present study was to assess automatic QC of glioblastoma MRSI data using random forest analysis.

METHODS: Data for 25 patients, acquired prospectively in a preradiotherapy examination, were submitted to postprocessing with syngo.MR Spectro (VB40A; Siemens) or Java-based magnetic resonance user interface (jMRUI) software. A total of 28 features were extracted from each spectrum for the automatic QC. Three spectroscopists also performed manual inspections, labeling each spectrum as good or poor quality. All statistical analyses, with addressing unbalanced data, were conducted with R 3.6.1 (R Foundation for Statistical Computing; https://www.r-project.org).

RESULTS: The random forest method classified the spectra with an area under the curve of 95.5%, sensitivity of 95.8%, and specificity of 81.7%. The most important feature for the classification was Residuum_Lipids_Versus_Fit, obtained with syngo.MR Spectro.

CONCLUSION: The automatic QC method was able to distinguish between good- and poor-quality spectra, and can be used by radiation oncologists who are not spectroscopy experts. This study revealed a novel set of MRSI signal features that are closely correlated with spectral quality.

PMID:34825724 | DOI:10.1002/mrm.29098

Laryngoscope. 2021 Nov 26. doi: 10.1002/lary.29963. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: To identify barriers in access to care for head and neck cancer (H&NC) patients in low- and middle-income countries (LMICs), specifically within Dakar, Senegal, using both quantitative and qualitative data.

STUDY DESIGN: Descriptive observational study.

METHODS: Patients with H&NC were selected from two independent university hospitals in Dakar, Senegal. A mixed-methods descriptive study was performed using a specifically tailored questionnaire and a focused ethnographic qualitative approach to identify factors that delay patient presentation, referral, and treatment. Quantitative data were analyzed using descriptive statistics and qualitative using a deductive approach based on a systematic review of the literature.

RESULTS: Thirty-three patients with a mean age of 57.8 years were included. Presentation delay was 5.7 months, mainly attributed to cost of consultation (39%), waiting time at doctor’s office (15%), and distance to healthcare facility (12%). Referral delay greater than 3 months was observed in 60% of participants, secondary to misdiagnosis and lack of appropriate referral. Treatment delay was associated with limited local treatment capacity and securing cost of treatment. Cost of transportation impacted all delays.

CONCLUSIONS: This work used an evidence-based approach to identify barriers in access to care for H&NC patients in sub-Saharan Africa. It suggests the feasibility and transferability of this methodology which combined a quantitative approach based on the literature with a qualitative analysis. Insight provided by this study will be used to guide development of implementation strategies for early detection of H&NC in LMICs.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2021.

PMID:34825710 | DOI:10.1002/lary.29963

Biometrics. 2021 Nov 26. doi: 10.1111/biom.13603. Online ahead of print.

ABSTRACT

In many randomized clinical trials of therapeutics for COVID-19, the primary outcome is an ordinal categorical variable, and interest focuses on the odds ratio (active agent vs. control) under the assumption of a proportional odds model. Although at the final analysis the outcome will be determined for all subjects, at an interim analysis, the status of some participants may not yet be determined, e.g., because ascertainment of the outcome may not be possible until some pre-specified follow-up time. Accordingly, the outcome from these subjects can be viewed as censored. A valid interim analysis can be based on data only from those subjects with full follow up; however, this approach is inefficient, as it does not exploit additional information that may be available on those for whom the outcome is not yet available at the time of the interim analysis. Appealing to the theory of semiparametrics, we propose an estimator for the odds ratio in a proportional odds model with censored, time-lagged categorical outcome that incorporates additional baseline and time-dependent covariate information and demonstrate that it can result in considerable gains in efficiency relative to simpler approaches. A byproduct of the approach is a covariate-adjusted estimator for the odds ratio based on the full data that would be available at a final analysis. This article is protected by copyright. All rights reserved.

PMID:34825704 | DOI:10.1111/biom.13603

Phys Chem Chem Phys. 2021 Nov 26. doi: 10.1039/d1cp03517g. Online ahead of print.

ABSTRACT

Accurate calculation of the solvation free energy of single ions remains an important goal, involving development in the dielectric continuum solvation models, and statistical mechanics with explicit solvent and hybrid discrete-continuum methods. In the last case, many of the research studies involve a quasi-chemical approach using the monomer cycle or the cluster cycle to calculate the solvation free energy of single ions. In this work, a different cluster-continuum approach based on the cluster expansion method was tested for solvation of 16 cations and 32 anions in aqueous solution. The SMD model was used for the dielectric continuum part and three explicit water molecules were introduced in the region of the solute with the highest interaction energy. Harmonic frequency calculations and molecular dynamics sampling of configurations are not required. An empirical γ_N parameter for cations and another for anions is introduced. The method produces a substantial improvement of the SMD model with a mean absolute deviation of 2.3 kcal mol^-1 for cations and 2.9 kcal mol^-1 for anions. The analysis of the correlation between theoretical and experimental data produces a linear regression line with a slope of 1.09 for cations and 1.01 for anions. The good results of this approximated cluster expansion approach suggest that the method could be further improved by including more solvent molecules and sampling the configurations.

PMID:34825676 | DOI:10.1039/d1cp03517g

Curr Med Imaging. 2021 Jul 19. doi: 10.2174/1573405617666210719141831. Online ahead of print.

ABSTRACT

BACKGROUND: Cystic Renal Cell Carcinoma (CRCC) is often challenging to differentiate from complex cysts with sonographic manifestations of renal carcinoma. Contrast-Enhanced Ultrasound (CEUS) is a new technology, and its clinical utility in the diagnosis of renal cystic mass has not been established.

OBJECTIVE: To analyze the characteristics of CEUS of renal cystic masses and to explore the clinical significance and value of CEUS in the diagnosis of CRCC.

METHODS: This study was a retrospective study. A total of 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional ultrasound (US) and CEUS were confirmed via surgical pathology. The routine US was used to observe the location, shape, size, boundary, cyst wall, internal echo, and blood supply of each cystic mass. CEUS observed contrast enhancement of the cyst wall, cystic septa, and solid nodules of cystic masses.

RESULTS: There were 26 cases of CRCC, 5 cases of renal cysts, and 1 case of renal tuberculosis. The enhancement pattern, degree of enhancement, and pseudocapsular sign by CEUS in benign and malignant masses had statistically significant differences (P<.05). In the diagnosis of CRCC, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.3%, 83.3%, 90.6%, 96.0%, and 71.4% for CEUS; 57.6%, 66.7%, 59.3%, 88.2%, and 26.7% for conventional US, respectively. CEUS had a higher sensitivity and accuracy than the conventional US (P<.05). However, the diagnostic specificity, positive predictive value, and negative predictive value of the two methods were not significantly different (P>.05).

CONCLUSION: CEUS is more accurate in the diagnosis of renal cystic masses, and it can be used as an effective imaging method.

PMID:34825641 | DOI:10.2174/1573405617666210719141831

Curr Rheumatol Rev. 2021 Jul 18. doi: 10.2174/1573397117666210719101551. Online ahead of print.

ABSTRACT

INTRODUCTION: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients.

MATERIALS AND METHOD: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups.

RESULTS: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001).

CONCLUSION: The REs could improve weight, functional strength and exercise adherence.

PMID:34825640 | DOI:10.2174/1573397117666210719101551

Acta Otolaryngol. 2021 Nov 26:1-5. doi: 10.1080/00016489.2021.2005256. Online ahead of print.

ABSTRACT

BACKGROUND: We present a new method of diode laser stapedoplasty – high-power short-pulse mode with preliminary carbonization of the waveguide and a single spot of laser ablation.

AIMS/OBJECTIVE: The aim of our research is the safety evaluation of presented mode 0.98 µm diode laser cochleostomy in guinea pigs.

MATERIAL AND METHODS: Guinea pigs (n = 10) received 0.98 µm diode laser cochleostomy on one ear under general anesthesia. The control group was based on untreated ears (n = 10). The assessment of auditory function was performed using the distortion product otoacoustic emission (DPOAE) before and 7 d after surgery. To assess the degree of damage from the laser cochleas were extracted for histological examination.

RESULTS: To evaluate the negative impact of laser energy on OHCs and auditory function, we analyzed DPOAE amplitudes for 6400 and 8000 Hz since high frequency. The paired Student’s t-test showed no statistically significant difference between the two groups. The histological examination yielded no statistically significant difference in the number of intact OHCs in the two groups.

CONCLUSION AND SIGNIFICANCE: Our study confirms that the proposed method of high-power short pulse diode laser stapedotomy is safe for the inner ear. Further prospective and randomized clinical trials are required to evaluate the possible benefits of this method.

PMID:34825632 | DOI:10.1080/00016489.2021.2005256