Nevin Manimala

J Contemp Dent Pract. 2021 Jul 1;22(7):724-729.

ABSTRACT

AIM AND OBJECTIVE: An exploratory study was undertaken to determine the relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments in hospitals in Saudi Arabia.

MATERIALS AND METHODS: We conducted a survey that included six questions designed to measure the overall performance of a supervisor, as well as questions that were related to specific activities involving interactions between supervisors and employees indental departments of 30 hospitals that were randomly selected. At least 35 employees and one supervisor in each dental department were interviewed. Initially, six questionnaire items were chosen as possible explanatory variables. There are two broad types of variables included in this study. Variables X₁ (handles employee complaints), X₂ (does not allow for special treatment), and X₅ (too critical of poor performance) relate to direct interpersonal relationships, i.e., direct connection between the employee and supervisor, whereas variables X₃ (opportunity to learn new things) and X₄ (raises based on performance) are of a less personal nature and relate to the job as a whole, i.e., indirect relationship between employees and their supervisor. Variable X₆ (rate of advancing to better jobs) is not a direct evaluation of the supervisor, but serves more as a general measure of how the employee perceives his or her own progress in the hospital.

RESULTS: Using regression analysis, we observed that only X₁ (handles employee complaints) and X₃ (opportunity to learn new things) have an impact on response Y (overall rating of job being done by supervisor). There is a strong positive relationship between X₁ and Y and also between X₃ and Y.

CONCLUSION: Therefore, when the supervisor listens and handles employee complaints and gives employees the opportunity to learn new things, the supervisor becomes favorable.

CLINICAL SIGNIFICANCE: The relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments has not been studied. An understanding of this relationship is valuable to improve employee-supervisor relations, which can improve the overall functioning of hospitals.

PMID:34615774

Brain Nerve. 2021 Oct;73(10):1139-1147. doi: 10.11477/mf.1416201904.

ABSTRACT

Somatic Symptom Disorder is a specific disorder that is extensively defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5). Although the diagnostic criteria for somatic symptom disorder has archived breakaway from mind-body dualism and simplification for physicians, it remains vague and universally unapplicable. Moreover, despite the DSM-5 removing etiology in diagnosis, there is still a need to determine the etiology for individualized patient treatment. In particular, patients with somatic symptom disorder and relative disorders have psychological pathologies, such as somatization and anxiety about illness, all of which require psychiatric treatment. However, these patients initially visit physicians, not psychiatrists, since their symptoms are somatic, and they are anxious about the possibility of a physical disease. As such, supportive attitude and continuous treatment are important, as they can be performed even without a psychiatric consultation. Furthermore, while the effectiveness of pharmacotherapy is limited for these disorders, psychotherapy has the possibility to bring about a fundamental resolution. Particularly, cognitive behavior therapy or psychoanalytic psychotherapy has been found to be effective; however, they require high motivation and take up much time from the patients. Fortunately, the Morita therapy is especially effective for patients who pay excessive attention to somatic symptoms or are hypochondriacal, which is applicable for outpatients using a comparatively short interview that can even be performed in nonpsychiatric clinical settings.

PMID:34615750 | DOI:10.11477/mf.1416201904

J Sport Rehabil. 2021 Oct 6:1-9. doi: 10.1123/jsr.2021-0103. Online ahead of print.

ABSTRACT

CONTEXT: Volleyball players have shown to be at an increased risk of developing scapular dyskinesis. The kinetic chain exercise approach has gained a lot of attention because of its claims to provide an improved motor control and scapular kinematics. A form of cross exercise, known as mirror therapy, may enhance the effects of a kinetic chain exercise approach in throwing performance.

OBJECTIVE: To examine the effects of mirror cross exercise (MCE), based on a kinetic chain exercise approach in the throwing performance of volleyball athletes with scapular dyskinesis.

DESIGN: Randomized controlled trial.

SETTING: Biomechanics laboratory.

METHODS: 39 volleyball players with scapular dyskinesis were randomly allocated into 3 groups. The first group completed a 6-week kinetic chain approach (KCA group), the second group completed a kinetic chain exercise approach program in addition to MCE group, and the control group followed only their regular training program. Before and after delivering both interventions, throwing accuracy, speed, and force were determined while measuring the ground reaction forces of the drive leg during throwing. Two-way mixed analysis of variance investigated the effects of intervention and time and their interaction.

RESULTS: The results showed intervention × time statistically significant interactions for throwing accuracy, speed, and force for the MCE and the KCA groups. Over the 6-week training period, the MCE and the KCA groups showed significant improvements in throwing accuracy (P < .01) and speed (P < .01), while the ground reaction forces did not change (P > .05). Throwing force increased significantly in the MCE group (P = .01). Between-group comparison showed statistically significant improvements in the throwing accuracy for the MCE and KCA groups against the control group (P < .01) at posttesting. The MCE demonstrated superior results over the KCA in the aforementioned measures.

CONCLUSIONS: This study suggests that the addition of MCE in a KCA program enhances energy transfer throughout the distal and proximal segments, thus improving kinetic chain recruitment and potentially preventing shoulder pathology.

PMID:34615742 | DOI:10.1123/jsr.2021-0103

J Sport Rehabil. 2021 Oct 6:1-7. doi: 10.1123/jsr.2021-0148. Online ahead of print.

ABSTRACT

CONTEXT: Ankle positioning gait biofeedback (GBF) has improved ankle inversion for patients with chronic ankle instability. However, the effects on proximal deficits remain unknown. The purpose of this study was to determine the effects of impairment-based rehabilitation with GBF and without biofeedback on gluteal activity during walking in patients with chronic ankle instability.

DESIGN: Randomized controlled trial.

METHODS: Eighteen patients with chronic ankle instability (14 women and 4 men; age 22 [4] y; height 171 [10] cm; mass 71.6 [13.8] kg) were recruited from a university setting, following International Ankle Consortium guidelines. Patients were randomly allocated to GBF or without biofeedback groups (N = 9 per group). Both groups performed 4 weeks of exercises and treadmill walking. The GBF group alone received feedback on frontal ankle positioning at initial contact during walking. Ultrasound videos of the gluteus maximus and medius were recorded during walking at baseline and follow-up by a blinded clinician. Gluteal activity ratios were obtained at each 10% of the gait cycle. Statistical parametric mapping repeated-measures analysis of variance were used to compare groups and time points.

RESULTS: Both groups demonstrated significantly increased gluteus medius activity across the gait cycle compared with baseline (P < .01, mean differences: 0.13-0.21, Hedge g: 0.97-1.89); however, there were no significant between-group differences. There were no statistically significant changes noted for the gluteus maximus. No adverse events were observed.

CONCLUSIONS: Impairment-based rehabilitation led to increased gluteus medius activity, but GBF did not provide any additional improvement to this parameter. Clinicians may consider implementing impairment-based strengthening interventions to improve gluteus medius function during gait for patients with CAI.

PMID:34615741 | DOI:10.1123/jsr.2021-0148

Proc Natl Acad Sci U S A. 2021 Oct 26;118(43):e2100943118. doi: 10.1073/pnas.2100943118. Epub 2021 Oct 6.

ABSTRACT

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) involves the attachment of the receptor-binding domain (RBD) of its spike proteins to the ACE2 receptors on the peripheral membrane of host cells. Binding is initiated by a down-to-up conformational change in the spike protein, the change that presents the RBD to the receptor. To date, computational and experimental studies that search for therapeutics have concentrated, for good reason, on the RBD. However, the RBD region is highly prone to mutations, and is therefore a hotspot for drug resistance. In contrast, we here focus on the correlations between the RBD and residues distant to it in the spike protein. This allows for a deeper understanding of the underlying molecular recognition events and prediction of the highest-effect key mutations in distant, allosteric sites, with implications for therapeutics. Also, these sites can appear in emerging mutants with possibly higher transmissibility and virulence, and preidentifying them can give clues for designing pan-coronavirus vaccines against future outbreaks. Our model, based on time-lagged independent component analysis (tICA) and protein graph connectivity network, is able to identify multiple residues that exhibit long-distance coupling with the RBD opening. Residues involved in the most ubiquitous D614G mutation and the A570D mutation of the highly contagious UK SARS-CoV-2 variant are predicted ab initio from our model. Conversely, broad-spectrum therapeutics like drugs and monoclonal antibodies can target these key distant-but-conserved regions of the spike protein.

PMID:34615730 | DOI:10.1073/pnas.2100943118

Chronic Obstr Pulm Dis. 2021 Oct 1. doi: 10.15326/jcopdf.2021.0235. Online ahead of print.

ABSTRACT

RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) struggle with respiratory symptoms that impair their daily activities and quality of life. Understanding a treatment’s ability to relieve symptoms requires precise assessment. The Evaluating Respiratory Symptoms in COPD (E-RS^TM:COPD) was developed to quantify respiratory symptoms in clinical trials. This study aimed to better understand how trials use this patient-reported outcome measure as an endpoint, as well as its responsiveness and performance relative to other outcome measures.

OBJECTIVES: To summarize the use of the E-RS:COPD in pharmacological trials since its qualification by regulatory authorities.

METHODS: A rapid systematic literature review, using key biomedical databases to identify English language full-text publications of randomized controlled clinical trials (RCTs) that included the E-RS:COPD as an endpoint (2010-2020). Two investigators independently screened the publications and extracted data.

MEASUREMENTS AND MAIN RESULTS: Of 219 screened records, 28 publications were included, and data from 20 unique double-blind RCTs were synthesized. The E-RS:COPD was positioned as a primary or secondary endpoint in six publications (35%), and served as an exploratory or additional endpoint in 11 (65%). Statistically significant E-RS:COPD treatment effects versus placebo/comparator were found in 13 of the 14 publications reporting symptom results. E-RS:COPD effects corresponded well with other outcome measures (e.g., St. George’s Respiratory Questionnaire [SGRQ] and forced expiratory volume [FEV₁]). Two publications reported the number of responders.

CONCLUSIONS: E-RS:COPD is sensitive to treatment effects in clinical trials testing drug therapies. Presentation of trial results should include responder analyses to facilitate interpretation and application of results.

PMID:34614551 | DOI:10.15326/jcopdf.2021.0235

Emerg Med Australas. 2021 Oct 6. doi: 10.1111/1742-6723.13875. Online ahead of print.

ABSTRACT

OBJECTIVE: This research aims to (i) identify latent subgroups of ED presentations in Australian public EDs using a data-driven approach and (ii) compare clinical, socio-demographic and time-related characteristics of ED presentations broadly using the subgroups.

METHODS: We examined presentations to four public hospital EDs in Queensland from 2009 to 2014. An unsupervised machine learning algorithm, Clustering Large Applications, was used to cluster ED presentations.

RESULTS: There were six subgroups common across the EDs, primarily distinguishable by age, and subsequently by triage category, ED length of stay, arrival mode, departure status and several time-related attributes. Around 10% to 30% of the total presentations had high resource utilisation, with half of these from older patients (55+ years). ED resource utilisation per population was highest among the oldest cohort (75+ years). Children and young adults more frequently presented to the ED outside general-practitioner hours, mostly on Sundays. Older persons were more likely to present at any time, rather than specific hours, days or seasons. ED service performance measured against commonly used access-target indicators were rarely satisfied for older people and frequently satisfied for children.

CONCLUSION: Clustering Large Applications is effective in finding latent groups in large-scale mixed-type data, as demonstrated in the present study. Six types of ED presentations were identified and described using clinically relevant characteristics. The present study provides evidence for policy makers in Australia to develop alternative ED models of care tailored around the care needs of the differing groups of patients and thereby supports the sustainable delivery of acute healthcare.

PMID:34614544 | DOI:10.1111/1742-6723.13875

Diabetes Metab Res Rev. 2021 Oct 6:e3501. doi: 10.1002/dmrr.3501. Online ahead of print.

ABSTRACT

OBJECTIVES: Fulminant type 1 diabetes (FT1D) could present diabetes ketoacidosis (DKA) at early onset. It is crucial to identify FT1D from DKA manifestations in time at clinical practice. This study was aimed at investigating whether the fulminant index (FI), encompassing plasma glucose (PG) to glycated hemoglobin (HbA1c) ratio (PG/HbA1c), serum potassium ion (K⁺ ) to HbA1c ratio (K⁺ /HbA1c), and serum sodium ion (Na⁺ ) multiplied by HbA1c (Na⁺ *HbA1c), is a feasible indicator for early FT1D diagnosis.

METHODS: A total of 78 subjects were enrolled, including 40 FT1D patients and 38 non-FT1D patients with DKA. We utilized receiver operating characteristic (ROC) curve analysis to determine the FI cut-off values between FT1D and non-FT1D groups and examined efficacies of FI based on statistics.

RESULTS: ROC curve analyses showed that the maximum Youden’s index for PG/HbA1c bonding to a cut-off value of 4.389, with the sensitivity of 75.0% and specificity of 81.6% in identifying FT1D from DKA. And optimal K⁺ /HbA1c cut-off value was 0.728 with a sensitivity of 90.0% and specificity of 84.2%. For Na⁺ *HbA1c, the best cut-off value was 923.65, and its sensitivity and specificity were 85% and 73.7%, respectively.

CONCLUSIONS: These results suggested FI could work as a valid and convenient indicator for differentiating FT1D from initial DKA patients. FI (K⁺ /HbA1c) presented the best efficacy as an independent index. This article is protected by copyright. All rights reserved.

PMID:34614535 | DOI:10.1002/dmrr.3501

Respiration. 2021 Oct 6:1-10. doi: 10.1159/000519216. Online ahead of print.

ABSTRACT

BACKGROUND: Benign tracheal stenosis may relapse after management.

OBJECTIVES: This study aimed to assess the value of dyspnea and spirometry in detecting relapse of benign tracheal stenosis.

METHODS: Patients with benign tracheal stenosis were evaluated post-management, at regular follow-up and emergency visits, with the Medical Research Council (MRC) dyspnea scale, spirometry, and flexible bronchoscopy. Patient visits were categorized and compared, in terms of change in clinical and functional parameters, in 2 groups: visits with relapse (case group) and visits with no relapse (control group). The ability of the MRC dyspnea scale and spirometry to predict relapse was evaluated.

RESULTS: Thirty-five patients with benign tracheal stenosis were included. Mean follow-up duration was 3.2 years (standard deviation = 3.3). Spirometry data were analyzed from 43 relapse visits (23 patients) versus 90 nonrelapse visits. The MRC dyspnea score and most spirometric indices were associated with relapse. In the receiver operating characteristic analysis, forced expiratory volume in 1 s, forced expiratory flow when 25% of forced vital capacity has been expired, peak expiratory flow (PEF), and total peak flow were superior to the MRC dyspnea score in predicting relapse. Among spirometric indices, >10.8% of PEF reduction has been very sensitive and specific.

CONCLUSIONS: This study supports the role of dyspnea and spirometry in monitoring benign tracheal stenosis, with spirometry predicting relapse even in clinically stable patients. PEF being a very sensitive index has the additional advantage of being assessed by peak flow meter and could potentially be used for remote monitoring.

PMID:34614495 | DOI:10.1159/000519216

J Affect Disord. 2021 Sep 25;296:224-232. doi: 10.1016/j.jad.2021.09.060. Online ahead of print.

ABSTRACT

BACKGROUND: Previous research has indicated the association of perceived stress with mental health problems. In China, Confucian collectivism and an exam-centered culture encourage parents to have high educational expectations that impose great pressure on their children’s learning. However, limited research has focused on adolescents’ perceptions of the negative consequences of academic stress stemming from their parents’ educational expectations. This study addressed this research gap by examining the direct effect of adolescents’ perceptions of academic stress on their depressive symptoms and the indirect effects of both parent-child communication and interaction. We further explored the pathway differences between overweight and non-overweight adolescents.

METHODS: By using a sample (n = 6,566) from the first two waves of the China Education Panel Survey, moderated mediation analysis was performed to simultaneously analyze the mediating roles of parent-children communication and parent-children interaction and the moderating role of adolescent overweight status.

RESULTS: Adolescents’ perceived academic stress (W1) was positively associated with their depressive symptoms (W2). This association was partially mediated by both parent-child communication (W1) and parent-child interaction (W1). Moreover, adolescent overweight status significantly moderated the paths between the adolescents’ perceived academic stress and their depressive symptoms, between their perceived academic stress and parent-child interaction, and the indirect relationship via parent-child interaction.

LIMITATIONS: Some measurement biases including self-reported, unverified, and single-item measures, alongside not considering all variations in controlled variables should be noted.

CONCLUSION: The study’s findings identify the significant roles of parent-child communication and parent-children interaction in contemporary China and indicate overweight adolescents’ susceptibility to stress.

PMID:34614439 | DOI:10.1016/j.jad.2021.09.060