Nevin Manimala

Hum Mol Genet. 2021 Aug 13:ddab229. doi: 10.1093/hmg/ddab229. Online ahead of print.

ABSTRACT

Alzheimer’s disease (ad) adversely affects the health, quality of life and independence of patients. There is a critical need to identify novel blood gene biomarkers for ad risk assessment. We performed a transcriptome-wide association study to identify biomarker candidates for ad risk. We leveraged two sets of gene expression prediction models of blood developed using different reference panels and modelling strategies. By applying the prediction models to a meta-GWAS including 71 880 (proxy) cases and 383 378 (proxy) controls, we identified significant associations of genetically determined expression of 108 genes in blood with ad risk. Of these, 15 genes were differentially expressed between ad patients and controls with concordant directions in measured expression data. With evidence from the analyses based on both genetic instruments and directly measured expression levels, this study identifies 15 genes with strong support as biomarkers in blood for ad risk, which may enhance ad risk assessment and mechanism-focused studies.

PMID:34387340 | DOI:10.1093/hmg/ddab229

Phys Chem Chem Phys. 2021 Aug 13. doi: 10.1039/d1cp02800f. Online ahead of print.

ABSTRACT

The kinetic behavior of vapor adsorption on a solid surface in an isobaric-isothermal system is investigated by means of molecular dynamics simulations combined with theoretical studies through a statistical rate theory approach. The molecular insights into the formation and evolution of clusters in the adsorbate are presented. Results show that the argon vapor is adsorbed on the silicon surface as different types of clusters. In the initial stage of adsorption, the empty adsorption sites on the surface decrease, and the adsorbed single-molecule-cluster grows rapidly and dominates the interface. The increasing rate of the adsorbed cluster and the declining rate of the empty adsorption site are dependent on the pressure ratio. For a large pressure ratio, the single-molecule-clusters are aggregated to incubate large clusters, and the fraction of a single-molecule-cluster is decreased with time. When the adsorption isotherm is determined, the chemical potential of the adsorbed cluster is expressed from the zeta isotherm model. Then the adsorption kinetics are analyzed through the statistical rate theory. The molecular exchange rate and the instantaneous driving force are calculated. The higher pressure ratio induces the larger chemical potential difference and accelerates the net adsorption rate. The adsorption kinetics derived from MD simulations are in close agreement with the theoretical analysis of the statistical rate theory.

PMID:34387292 | DOI:10.1039/d1cp02800f

J ECT. 2021 Aug 12. doi: 10.1097/YCT.0000000000000800. Online ahead of print.

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has led to reported change in electroconvulsive therapy (ECT) services worldwide. However, minimal data have been published demonstrating tangible changes across multiple ECT centers. This article aimed to examine changes in ECT patients and ECT service delivery during the pandemic.

METHODS: We retrospectively assessed data collected on ECT patients within the Clinical Alliance and Research in Electroconvulsive Therapy and Related Treatments (CARE) Network during a 3-month period starting at the first COVID-19 restrictions in 2020 and compared data with predicted values based on the corresponding 3-month period in 2019. Mixed-effects repeated-measures analyses examined differences in the predicted and actual number of acute ECT courses started and the total number of acute ECT treatments given in 2020. Sociodemographic, clinical, treatment factors, and ECT service delivery factors were compared for 2020 and 2019.

RESULTS: Four Australian and 1 Singaporean site participated in the study. There were no significant differences between the predicted and actual number of acute ECT courses and total number of acute ECT treatments administered in 2020. During 2020, there were statistically significant increases in the proportion of patients requiring ECT under substitute consent and receiving ECT for urgent reasons compared with 2019.

CONCLUSIONS: This multisite empirical study is among the first that supports anecdotal reports of changes in the triaging and delivery of ECT during COVID-19. Results suggest that ECT was prioritized for the most severely ill patients. Further data assessing the impacts of COVID-19 on ECT are needed.

PMID:34387286 | DOI:10.1097/YCT.0000000000000800

JBI Evid Synth. 2021 Aug 12. doi: 10.11124/JBIES-20-00387. Online ahead of print.

ABSTRACT

OBJECTIVE: This review aims to examine the effect of patient activation interventions compared with usual care on health-related behavioral outcomes in adults with chronic kidney disease stages 3-5.

INTRODUCTION: Chronic kidney disease is a global health problem associated with a high mortality, reduction of health-related quality of life, and high health care costs. The chronic nature requires active involvement and self-management of the person with chronic kidney disease. Patient activation is a self-management approach that refers to the knowledge, confidence, and skills of people to enable them to manage their own health needs. However, the effectiveness of patient activation interventions on health-related behavioral outcomes in this population have not yet been systematically evaluated.

INCLUSION CRITERIA: This systematic review will include primary research studies measuring the effect of behavioral change interventions addressing beliefs, knowledge, confidence, and/or skills to optimize self-management in adult patients with chronic kidney disease stages 3-5 who are not receiving dialysis. Studies included in this review will be randomized controlled trials.

METHODS: Published studies will be searched in MEDLINE, Embase, Emcare, and PsycINFO. Unpublished studies and gray literature sources will also be searched. Titles and abstracts of search results published in English from 2005 onward will be screened, and the full text of potentially relevant studies will be assessed in detail. Studies selected for inclusion will undergo critical appraisal. Data extracted will include specific details about population, study methods, interventions, and outcomes. Studies will be pooled in statistical meta-analysis, if possible.

SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020205084.

PMID:34387282 | DOI:10.11124/JBIES-20-00387

JBI Evid Synth. 2021 Aug 12. doi: 10.11124/JBIES-20-00385. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this systematic review was to determine the safety and effectiveness of parent- or nurse-controlled analgesia on neonatal patient outcomes. More specifically, the objective was to determine the effect of parent- or nurse-controlled analgesia on neonatal pain scores, analgesic use, and incidence of iatrogenic withdrawal syndrome, as well as any opioid-associated adverse events.

INTRODUCTION: Despite recent innovations in neonatology leading to significant improvements in short- and long-term outcomes for newborns requiring intensive care, optimal management of pain and distress remains a challenge for the treating multidisciplinary team. The inability of neonates to communicate pain easily, inconsistent practice among health professionals, insufficient analgesic prescriptions, and delays in medical reviews all impact effective pain management. Exploring the effect of parent- or nurse-controlled analgesia may identify a modality that negates these concerns and improves the pharmacological management of pain in newborns.

INCLUSION CRITERIA: This review considered experimental and observational studies evaluating the safety and effectiveness of parent- or nurse-controlled analgesia that included babies born at 23 weeks’ gestation to four weeks post-term. The interventions considered for inclusion were any type of analgesia delivered by an infusion pump that allowed bolus dosing or a continuous analgesic infusion with bolus dosing as required. Studies using algorithms and protocols to guide timing and dosage were eligible for inclusion. Comparators included the standard management of pain for neonates in the newborn intensive care unit. A modification to the a priori protocol was made to include all neonates nursed outside of a neonatal intensive care unit to ensure all studies that examined the use of parent- or nurse-controlled analgesia in the neonatal population were included in the review.

METHODS: An extensive search of six major databases was conducted (CINAHL, Cochrane Library, Embase, PubMed, PsycINFO, and Web of Science). Studies published from 1997 to 2020 in English were considered for inclusion in this review. Databases searched for unpublished studies included MedNar and ProQuest Dissertations and Theses.

RESULTS: Fourteen studies were included in this review: two randomized controlled trials, six quasi-experimental studies, one case-control study, and five case series. There was considerable heterogeneity in the interventions and study outcome measures within the studies, resulting in an inability to statistically pool results. The small sample sizes and inability to distinguish data specific to neonates in six of the studies resulted in low quality of evidence for the safety and effectiveness of parent- or nurse-controlled analgesia in neonates. However, studies reporting neonatal data demonstrated low pain scores and a trend in reduced opioid consumption when parent- or nurse-controlled analgesia was used.

CONCLUSIONS: The use of parent- or nurse-controlled analgesia in the neonatal population has shown some effect in reducing the amount of opioid analgesia required without compromising pain relief or increasing the risk of adverse events. Due to the paucity of evidence available, certainty of the results is compromised; therefore, larger trials exploring the use of parent- or nurse-controlled analgesia in neonates and the development of nurse-led models for analgesia delivery are needed.

SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018114382.

PMID:34387281 | DOI:10.11124/JBIES-20-00385

J Craniofac Surg. 2021 Aug 13. doi: 10.1097/SCS.0000000000008073. Online ahead of print.

ABSTRACT

BACKGROUND: Burr-hole craniostomy (BHC) is considered to be the most effective method for the treatment of chronic subdural hematoma (CSDH), and middle meningeal artery embolization is a new therapy used in clinical practice in recent years to treat CSDH. However, the optimal therapeutic effect of these 2 procedures is still controversial. This study prospectively designed a modified burr-hole craniostomy (mBHC) with drainage to treat CSDH.

METHODS: A total of 101 patients diagnosed with CSDH from January 2019 to April 2020 were prospectively included in this study. They were divided into BHC and mBHC groups. Among them, 40 selected CSDH patients received mBHC treatment. For comparison, 61 CSDH patients who received BHC treatment were used as the control group. Primary outcomes were hematoma recurrence and postoperative complications. Secondary outcomes included midline recovery, hematoma clearance, operation time, and hospital stay. The Chi-square test was used to compare the 6-month follow-up results between the 2 groups.

RESULTS: Among patients treated with mBHC, 39 patients had a good prognosis, and one 87-year-old patient with bilateral hematoma died of postoperative heart failure. Of the patients treated with BHC, 52 patients had good prognoses, and one 53-year-old patient with unilateral hematoma died of postoperative acute intracranial bleeding. During the 6-month follow-up period, no relapse occurred in the patients treated with mBHC, whereas 8 (13%) of the patients treated with BHC relapsed. There was a significant difference in the recurrence rate between the 2 groups (P < 0.05). In addition, midline recovery, hematoma clearance rate, operation time, and complications were found to be significantly different statistically (P < 0.05), and other characteristics of operation and outcome were not significantly different (P > 0.05) between the 2 groups.

CONCLUSIONS: Modified burr-hole craniostomy has a positive therapeutic effect on patients with CSDH and is more effective than conventional BHC therapy.

PMID:34387269 | DOI:10.1097/SCS.0000000000008073

J Craniofac Surg. 2021 Aug 13. doi: 10.1097/SCS.0000000000008081. Online ahead of print.

ABSTRACT

BACKGROUND: Maxillary advancement may affect speech in cleft patients.

AIMS: To examine whether the amount of maxillary advancement and preoperativecephalometric skeletal and dentoalveolar relationships are associated with articulation errors of the Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients.

MATERIALS AND METHODS: Fifty-seven nonsyndromic cleft patients who underwent Le Fort I or bimaxillary osteotomies were evaluated retrospectively. Pre- and post-operative lateral cephalometric radiographs and standardized speech video recordings were analyzed. The Aspin-Welch unequal variance t test, Student t test sign test, intraclass correlation and Kappa statistics were used in the statistical analyses.

RESULTS: The mean advancement of the maxilla (point A) was 4.65 mm horizontally (range -2.80 to 11.30) and -3.82 mm vertically (range -14.20 to 3.90). The overall articulation (especially the sounds /s/ and /l/) improved significantly postoperatively, but the amount of maxillary advancement did not affect the articulation. The preoperative mean percentages of /s/, /l/, and /r/ errors were 32%, 33%, 46% and the postoperative percentages 23%, 19%, 40%, respectively. Preoperative articulation errors of /s/ were related to palatal inclination of the upper incisors.

CONCLUSIONS: Orthognathic surgery may improve articulation errors. The amount of maxillary advancement is not related to the improvement.

PMID:34387267 | DOI:10.1097/SCS.0000000000008081

J Glaucoma. 2021 Aug 12. doi: 10.1097/IJG.0000000000001922. Online ahead of print.

ABSTRACT

PRCIS: Tape sealing of the face mask can prevent fogging artifacts of visual field testing. Here we demonstrate that tape sealing can improve visual field scores even when fogging artifacts are not obvious.

PURPOSE: To demonstrate that visual field scores improve when the face masks are taped in order to prevent fogging artifacts.

METHODS: Single-center, randomized 2×2 cross-over study. Twenty-six visual fields of 13 patients of the glaucoma outpatient clinic were included. Patients were randomized in either sequence 1 (Octopus visual field examination without tape sealing, followed by examination with tape sealing) or sequence 2 (examination with, followed by without tape sealing).

RESULTS: The results for mean defect and square root of Loss Variance (sLV) differ significantly in the examination with and without tape sealing (mean difference (without-with) 0.39▒dB; 95% CI: 0.07 to 0.70▒dB; P=0.018 and 0.49▒dB; 95% CI: 0.19 to 0.79▒dB; P=0.003, respectively). There was no sequence effect (P=0.967) for mean defect nor sLV (P=0.779). A significant effect for period (P=0.023) for mean defect was yielded.

CONCLUSION: Tape sealing of face masks during visual field testing prevented fogging artifacts and improved visual field scores even when fogging artifacts were not obvious, and should be considered in clinical practice.

PMID:34387258 | DOI:10.1097/IJG.0000000000001922

J Patient Saf. 2021 Aug 11. doi: 10.1097/PTS.0000000000000886. Online ahead of print.

ABSTRACT

INTRODUCTION: The second victim phenomenon that occurs after critical events poses a serious factor for patient and workplace safety. These experiences can be evaluated using the Second Victim Experience and Support Tool (SVEST), originally in English, or the translated and validated Korean or Chinese versions. In 2020, a revised version was published (SVESTR) with the addition of resilience items. The aim of this study is the validation of the German version, the G-SVESTR, in a multiprofessional setting.

METHODS: The G-SVESTR questionnaire was designed according to World Health Organization recommendations. This entails translation, test for face validity, back translation, pretest, expert panel evaluation, and a test in a large population for validity and reliability. We provided an anonymous online questionnaire to physicians, nurses, paramedics, medical assistants, and physician assistants to test our developed tool. Statistics were accomplished using XL-Stats.

RESULTS: Altogether, 72% (306 of 428) of the participants completed the survey. The mean time for completion was 9.4 minutes. Physician assistants and medical assistants were significantly younger than other respondents. The analysis revealed satisfactory reliability (Cronbach α = 0.844). A principal component analysis showed 11 factors with eigenvalues greater than 1. Factor loading on distinct dimensions was satisfactory with one exception, the absenteeism item (item 31), which showed cross-loadings and poor factor loading on the absenteeism dimension. The results of the G-SVESTR revealed only some differences between the professional subgroups.

CONCLUSION: The G-SVESTR is a valid and reliable testing instrument for the evaluation of second victim experiences in different medical professions.

PMID:34387250 | DOI:10.1097/PTS.0000000000000886

J Dev Behav Pediatr. 2021 Aug 11. doi: 10.1097/DBP.0000000000000986. Online ahead of print.

ABSTRACT

OBJECTIVE: School readiness is strongly associated with a child’s future school success and well-being. The primary objective of this study was to determine whether meeting 24-hour movement guidelines (national physical activity, sedentary behaviors, and sleep recommendations) was associated with school readiness measured with mean scores in each of the 5 developmental domains of the Early Development Instrument (EDI) in Canadian children aged 4 to 6 years. Secondary objectives include examining the following: (1) the association between meeting 24-hour movement guidelines and overall vulnerability in school readiness and (2) the association between meeting individual physical activity, screen use and sleep recommendations, and overall school readiness.

METHODS: A prospective cohort study was performed using data from children (aged 4-6 years) who participated in a large-scale primary care practice-based research network.

RESULTS: Of the 739 participants (aged 5.9 + 0.12 years) in this prospective cohort study, 18.2% met the 24-Hour Movement Guidelines. Linear regression models (adjusted for child/family demographic characteristics, number of siblings, immigration status, and annual household income) revealed no evidence of an association between meeting all 24-hour movement guidelines and any of the 5 domains of the EDI (p > 0.05). Adjusted linear regression models revealed evidence of an association between meeting screen use guidelines and the “language and cognitive development” (β = 0.16, p = 0.004) domain, and for the sleep guideline, there was a statistically significant association with the “physical health and well-being” (β = 0.23, p = 0.001), the “language and cognitive development” (β = 0.10, p = 0.003), and the “communication skills and general knowledge” (β = 0.18, p < 0.001) domain.

CONCLUSION: Early lifestyle interventions targeting screen use and sleep may be beneficial for improving a child’s readiness for school.

PMID:34387247 | DOI:10.1097/DBP.0000000000000986