Nevin Manimala

J Med Internet Res. 2021 Oct 28;23(10):e26886. doi: 10.2196/26886.

ABSTRACT

BACKGROUND: Most older people after a hip fracture injury never return to their prefracture status, and some are admitted to residential aged care facilities. Advancement of digital technology has helped in optimizing health care including self-management and telerehabilitation.

OBJECTIVE: This study aims to understand the perspectives of older patients with hip fracture and their family members and residential aged caregivers on the feasibility of developing a model of care using a personalized digital health hub.

METHODS: We conducted a mixed methods study in South Australia involving patients aged 50 years and older, their family members, and residential aged caregivers. Quantitative data analysis included basic demographic characteristics, and access to digital devices was analyzed using descriptive statistics. Spearman rank-order correlation was used to examine correlations between the perceived role of a personalized digital health hub in improving health and the likelihood of subsequent use. Findings from qualitative analysis were interpreted using constructs of capability, opportunity, and motivation to help understand the factors influencing the likelihood of potential personalized digital health hub use.

RESULTS: This study recruited 100 participants-55 patients, 13 family members, and 32 residential aged caregivers. The mean age of the patients was 76.4 (SD 8.4, range 54-88) years, and 60% (33/55) of the patients were female. Approximately 50% (34/68) of the patients and their family members had access to digital devices, despite less than one-third using computers as part of their occupation. Approximately 72% (72/100) of the respondents thought that personalized digital health hub could improve health outcomes in patients. However, a moderate negative correlation existed with increasing age and likelihood of personalized digital health hub use (Spearman ρ=-0.50; P<.001), and the perceived role of the personalized digital health hub in improving health had a strong positive correlation with the likelihood of personalized digital health hub use by self (Spearman ρ=0.71; P<.001) and by society, including friends and family members (Spearman ρ=0.75; P<.001). Most patients (54/55, 98%) believed they had a family member, friend, or caregiver who would be able to help them use a personalized digital health hub. Qualitative analysis explored capability by understanding aspects of existing knowledge, including willingness to advance digital navigation skills. Access could be improved through supporting opportunities, and factors influencing intrinsic motivation were considered crucial for designing a personalized digital health hub-enabled model of care.

CONCLUSIONS: This study emphasized the complex relationship between capabilities, motivation, and opportunities for patients, their family members, and formal caregivers as a patient networked unit. The next stage of research will continue to involve a cocreation approach followed by iterative processes and understand the factors influencing the development and successful integration of complex digital health care interventions in real-world scenarios.

PMID:34709183 | DOI:10.2196/26886

Rambam Maimonides Med J. 2021 Oct 25;12(4). doi: 10.5041/RMMJ.10451.

ABSTRACT

OBJECTIVES: To study the correlation between the putative cancer stem cell (CSC) markers aldehyde dehydrogenase 1 (ALDH1), cluster of differentiation 44 (CD44), sex-determining region Y-box 2 (SOX2), and octamer-binding protein 4 (OCT4) and human papilloma virus (HPV) infection using p16, the surrogate marker of HPV in oral epithelial dysplasia (OED) and normal mucosa.

METHODS: Five sections each from 40 histopathologically diagnosed cases of different grades of OED and 10 cases of normal oral mucosa without dysplasia were immunohistochemically stained with p16, ALDH1, CD44, SOX2, and OCT4, respectively.

RESULTS: Expression of ALDH1 and SOX2 was significantly increased in OED cases, whereas CD44 and OCT4 expression was increased in normal mucosa. P16-positive OED cases showed upregulation of ALDH1 and OCT4 expression as compared to p16-negative cases, while CD44 and SOX2 expression was downregulated in p16-positive OED cases; however, the results were not statistically significant.

CONCLUSION: The present study indicated a suggestive link between p16 and cancer stem cell marker expression in HPV-associated OED, and that p16 has a significant role in CSC progression in OED. This is the first study to evaluate the expression of putative CSC markers in HPV-associated OED. However, low study numbers are a potential limiting factor in this study.

PMID:34709167 | DOI:10.5041/RMMJ.10451

Inform Health Soc Care. 2021 Oct 28:1-12. doi: 10.1080/17538157.2021.1988955. Online ahead of print.

ABSTRACT

This study examined the association between caregivers’ burdens and their individual characteristics and identified characteristics that are useful for predicting the level of caregiver burden. We successfully surveyed 387 family caregivers, having them complete the caregiver burden inventory scale (CBI) and an individual characteristic questionnaire. When we compared the average CBI scores between groups with a particular individual characteristic (including caring for older adult(s), educational level, employment status, place of birth, marital status, financial status, need for family support, need for friend support, and need for nonprofit organizational support), we found a significant difference in the average scores. From a logistic regression model, with burden level as the outcome, we found that caring for older adult(s), educational level, employment status, place of birth, financial situation, and need for nonprofit organizational support were significant predictors of the burden level of caregivers. The research findings suggest that certain individual characteristics can be adopted for identifying and quantifying caregivers who may have a higher level of burden. The findings are useful to uncover caregivers who may need prompt support and social care.

PMID:34709118 | DOI:10.1080/17538157.2021.1988955

Nat Commun. 2021 Oct 27;12(1):6209. doi: 10.1038/s41467-021-26305-9.

ABSTRACT

Stimulated Brillouin scattering experiments in the ionospheric plasma using a single electromagnetic pump wave have previously been observed to generate an electromagnetic sideband wave, emitted by the plasma, together with an ion- acoustic wave. Here we report results of a controlled, pump and probe beat-wave driven Brillouin scattering experiment, in which an ion-acoustic wave generated by the beating of electromagnetic pump and probe waves, results in electromagnetic sideband waves that are recorded on the ground. The experiment used the EISCAT facility in northern Norway, which has several high power electromagnetic wave transmitters and receivers in the radio frequency range. An electromagnetic pump consisting of large amplitude radio waves with ordinary (O) or extraordinary (X) mode polarization was injected into the overhead ionosphere, along with a less powerful probe wave, and radio sideband emissions observed on the ground clearly show stimulated Brillouin emissions at frequencies agreeing with, and changing with, the pump and probe frequencies. The experiment was simulated using a numerical full-scale model which clearly supports the interpretation of the experimental results. Such controlled beat-wave experiments demonstrate a way of remotely investigating the ionospheric plasma parameters.

PMID:34707115 | DOI:10.1038/s41467-021-26305-9

Nat Commun. 2021 Oct 27;12(1):6210. doi: 10.1038/s41467-021-26369-7.

ABSTRACT

The average location of observed western North Pacific (WNP) tropical cyclones (TCs) has shifted north over the last several decades, but the cause remains not fully understood. Here we show that, for the annual average, the observed northward migration of WNP TCs is related to changes in TC seasonality, not to a northward migration in all seasons. Normally, peak-season (July-September) TCs form and travel further north than late-season (October-December) TCs. In recent decades, related to less frequent late-season TCs, seasonally higher-latitude TCs contribute relatively more to the annual-average location and seasonally lower-latitude TCs contribute less. We show that the change in TC seasonality is related to the different responses of late-season and peak-season TC occurrence to a stronger Pacific Walker Circulation. Our findings provide a perspective on long-term trends in TC activity, by decomposing the annual-average statistics into seasonal components, which could respond differently to anthropogenic forcing.

PMID:34707112 | DOI:10.1038/s41467-021-26369-7

Nat Commun. 2021 Oct 27;12(1):6205. doi: 10.1038/s41467-021-26480-9.

ABSTRACT

Accurate 3D representations of lithium-ion battery electrodes, in which the active particles, binder and pore phases are distinguished and labeled, can assist in understanding and ultimately improving battery performance. Here, we demonstrate a methodology for using deep-learning tools to achieve reliable segmentations of volumetric images of electrodes on which standard segmentation approaches fail due to insufficient contrast. We implement the 3D U-Net architecture for segmentation, and, to overcome the limitations of training data obtained experimentally through imaging, we show how synthetic learning data, consisting of realistic artificial electrode structures and their tomographic reconstructions, can be generated and used to enhance network performance. We apply our method to segment x-ray tomographic microscopy images of graphite-silicon composite electrodes and show it is accurate across standard metrics. We then apply it to obtain a statistically meaningful analysis of the microstructural evolution of the carbon-black and binder domain during battery operation.

PMID:34707110 | DOI:10.1038/s41467-021-26480-9

Sci Rep. 2021 Oct 27;11(1):21206. doi: 10.1038/s41598-021-00483-4.

ABSTRACT

Craniopharyngiomas are rare epithelial tumors derived from pituitary gland embryonic tissue. This epithelial tumor can be categorized as an adamantinomatous craniopharyngioma (ACP) or papillary craniopharyngioma (PCP) subtype with histopathological and genetic differences. Genomic and transcriptomic profiles of craniopharyngiomas have been investigated; however, the proteomic profile has yet to be elucidated and added to these profiles. Recent improvements in high-throughput quantitative proteomic approaches have introduced new opportunities for a better understanding of these diseases and the efficient discovery of biomarkers. We aimed to confirm subtype-associated proteomic changes between ACP and PCP specimens. We performed a system-level proteomic study using an integrated approach that combines mass spectrometry-based quantitative proteomic, statistical, and bioinformatics analyses. The bioinformatics analysis showed that differentially expressed proteins between ACP and PCP were significantly involved in mitochondrial organization, fatty acid metabolic processes, exocytosis, the inflammatory response, the cell cycle, RNA splicing, cell migration, and neuron development. Furthermore, using network analysis, we identified hub proteins that were positively correlated with ACP and PCP phenotypes. Our findings improve our understanding of the pathogenesis of craniopharyngiomas and provide novel insights that may ultimately translate to the development of craniopharyngioma subtype-specific therapeutics.

PMID:34707096 | DOI:10.1038/s41598-021-00483-4

Rev Esp Salud Publica. 2021 Oct 27;95:e202110189.

ABSTRACT

OBJECTIVE: The mobility of workers to other countries in a globalized work world has posed an added risk in the current pandemy of COVID-19 and can carry with it an increased risk of spread and transmission of the disease. The collaboration of the Occupational Health Units of the companies and the Health Authorities has been fundamental in the investigation of COVID-19 outbreaks secondary to international travel of workers on mission. The objective of this study was to describe the process of detection and follow-up of cases in an outbreak of COVID-19 in repatriated workers after a six-month mission in a factory of aircraft components in Poland.

METHODS: A case series study was conducted. Data on sociodemographic, epidemiological and clinical course variables of the cases were collected by telephone clinical interview. Descriptive statistics were used to summarize the data.

RESULTS: The outbreak involved 20 workers who shared the workplace and made the repatriation trip together. The outbreak investigation was initiated after detecting that a worker presented symptoms compatible with COVID-19 during the 4 days prior to the return trip, which was later confirmed by PCR. During follow-up, 40% (n=8) of the workers were considered cases confirmed by PCR. Of these, only 62.5% (n=5) presented symptoms. Fifty percent (n=4) had fever, 25% (n=2) had cough, respiratory distress, general malaise, and diarrhea, and 12.5% (n=1) had anosmia, ageusia, and conjunctivitis. All of them underwent home isolation with outpatient telephone follow-up. At the end of the follow-up, all were asymptomatic and returned to work. The mean close contact was 1.85 per case within the group (SD=3.13), with a range of 0-11, occurring primarily during attendance at extra work social events that were limited to members of the workers’ own group and/or during the return flight. The health authorities were informed through established channels so that they could proceed with the detection and tracking of close contacts with people outside the group of workers that occurred during the flight and after arrival to Spain.

CONCLUSIONS: Early detection of potential cases of COVID-19 with transmission capacity by the Occupational Health and Safety Departments of the companies, in collaboration with the Health Authorities, is essential for more efficient case and contact management of imported cases of COVID-19.

PMID:34707082

Med Sci Monit. 2021 Oct 28;27:e933296. doi: 10.12659/MSM.933296.

ABSTRACT

BACKGROUND The tolerability of high-dose oral corticosteroids in patients with generalized myasthenia gravis (gMG) has not been systematically assessed. We evaluated adverse side effects (ASEs) of corticosteroid treatment in patients with gMG. MATERIAL AND METHODS Retrospective analysis was conducted of ASEs reported as being related to corticosteroid treatment in 39 patients with gMG who were treated with oral corticosteroids for ≥1 year. RESULTS Median (interquartile range [IQR]) age was 60 (21) years, 53.8% of patients were women, and 66.7% were aged ≤65 years. Median (IQR) prednisone treatment duration was 14 (2) months; median (IQR) daily dose was 40 (15) mg. The median number of ASEs reported as corticosteroid-related was 2/patient (IQR, 1). Pre-diabetes and weight gain were most common (each 43.6% of patients). Bruising, insomnia, and osteoporosis were more prevalent in patients aged >65 years, while irritability, osteopenia, and pre-diabetes were more common in patients aged £65 years, although differences were not statistically significant. Irritability and weight gain were more prevalent in women (P=0.010 for irritability); osteoporosis and pre-diabetes more common in men (P=0.015 for osteoporosis). ASEs were generally more common in the high-dose prednisone group (>30 mg/day), but were only statistically significant for irritability (P=0.001). CONCLUSIONS Corticosteroid-related ASEs were common in patients with gMG. Some of these ASEs can have serious medical consequences, and certain ASEs appeared to be associated with specific patient characteristics. Demographics and comorbidities of patients with gMG must be carefully considered before corticosteroid initiation. Potential ASEs, such as unanticipated osteoporosis in men, require extra vigilance.

PMID:34707081 | DOI:10.12659/MSM.933296

Neurol Med Chir (Tokyo). 2021 Oct 27. doi: 10.2176/nmc.oa.2021-0203. Online ahead of print.

ABSTRACT

Flow diverter (FD) therapy using Pipeline embolization device (PED) has become an important alternative to treat internal carotid artery (ICA) aneurysms. Herein, we report the long-term outcome for 3 years after FD therapy using PED for ICA aneurysms in Japan. The patients who underwent angiographical and/or clinical follow-up for 3 years after the FD therapy using PED of large or giant unruptured ICA aneurysms from December 2012 at our university hospital are the subjects of this study. We retrospectively reviewed the in- and outpatients’ medical charts, and written operative and radiological records. There were 84 patients with 90 aneurysms who could be clinically and/or angiographically followed up for 3 years. Of these, 7 aneurysms were only available for clinical follow-up. Of the remaining 83 aneurysms, 6 aneurysms had vessel occlusion due to stent thrombosis or parent artery occlusion, and 60 of the remaining 77 (77.9%) had complete occlusion. In multivariate analysis, older age (>70 years), wide neck, and non-adjunctive coiling contributed statistically significantly to incomplete occlusion. Of the 84 patients, 2 patients (2.4%) had delayed complications between 6 months and 3 years after the initial FD placement. Three patients (3.6%) had poor outcome due to postoperative major stroke complications, 2 of which were acute complications. The long-term results after FD therapy are good both angiographically and clinically. Endothelialization of the aneurysmal neck and intra-aneurysmal thrombosis contribute to complete occlusion. The primary reason for the somewhat low complete occlusion in Japan may be the patients are generally older.

PMID:34707069 | DOI:10.2176/nmc.oa.2021-0203