Nevin Manimala

Int J Psychiatry Clin Pract. 2021 Jun 7:1-6. doi: 10.1080/13651501.2021.1933043. Online ahead of print.

ABSTRACT

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is associated with impairment in social, academic and job-related functioning in both children and adults. The purpose of this study is to investigate the susceptibility to cardiovascular risk factors in children with ADHD diagnosis through common carotid artery intima-media thickness (cIMT) measurement, to compare cIMT in ADHD and control groups and to evaluate the association between cIMT and ADHD symptom severity.

METHODS: The mean cIMT of 42 children with ADHD, ADHD symptom scales and a semi-structured psychiatric interview, and 42 age and sex matched healthy controls were measured with B-mode Doppler neck ultrasonography.

RESULTS: The median cIMT was significantly higher for the ADHD group compared to the healthy controls. There was a statistically significant, negative, moderate correlation between cIMT and Conners ADHD index score, hyperactivity score, oppositional score and the presence of ODD comorbidity.

CONCLUSIONS: In this study, we found significantly higher cIMT in children with ADHD when compared to healthy controls. Considering that increased cIMT is a sign of atherosclerosis and it can be used as a marker of cardiovascular risk factors, our finding may indicate that children with ADHD are at increased risk for cardiovascular diseases.KeypointscIMT was significantly higher in children with ADHD when compared to healthy controls.Higher cIMT in children with ADHD may indicate that children with ADHD are at increased risk for cardiovascular diseases.cIMT measurement may be studied as a potential tool for risk assessment before a child with ADHD is started on psychostimulant medications.

PMID:34097567 | DOI:10.1080/13651501.2021.1933043

Ann Hum Biol. 2021 Mar;48(2):160-165. doi: 10.1080/03014460.2021.1919205.

ABSTRACT

BACKGROUND: Body composition and types are often considered essential health indicators for lifestyle-related disease. Assessment of body type based on tridosha is regarded as a prerequisite in Ayurveda.

AIM: To correlate body compositions and somatotypes with Prakriti body types.

SUBJECTS AND METHODS: A cross-sectional study on 463 adult individuals was done. Anthropometric and body composition parameters were measured. Heath-Carter somatotypes and Prakriti body types were also determined. Tests of association were calculated. Correlation and concordance analysis was also done to infer the correlation between body composition parameters and Prakriti body types.

RESULTS: Kapha Prakriti have significantly higher body weight, body mass index (BMI), body fat percentage and body fat mass. Vata have the lowest mean values in all body composition parameters with Pitta in the intermediate position compared to the other Prakriti types. There is a strong and positive statistical association between Prakriti body types and body composition parameters, except height. Cohen’s Kappa analysis reveals there is a fair concordance between Prakriti body types and somatotype.

CONCLUSIONS: Prakriti assessment can explain an individual’s fatness as it correlates with body composition parameters and could be used to predict risk susceptibility to various complex disorders.

PMID:34097545 | DOI:10.1080/03014460.2021.1919205

Am J Sports Med. 2021 Jun 7:3635465211016840. doi: 10.1177/03635465211016840. Online ahead of print.

ABSTRACT

BACKGROUND: The use of cannabis is common among athletes and the US population at large. Cannabinoids are currently being evaluated as alternatives to opioid medications for chronic pain management. However, the effects of recreational and/or medical use of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on musculoskeletal injury and healing remain largely unknown.

HYPOTHESIS/PURPOSE: The purpose of this study was to evaluate the biomechanical effects of CBD and THC on tendon-to-tendon healing in a rat Achilles tendon repair model. The hypothesis was that rats administered CBD would demonstrate decreased tensile load to failure of surgically repaired Achilles tendons compared with the THC and control groups.

STUDY DESIGN: Controlled laboratory study.

METHODS: A total of 33 Sprague Dawley rats underwent Achilles tendon surgical transection and repair and were randomized to receive subcutaneous injection of THC, CBD, or vehicle once daily starting on the day of surgery and for 5 total days. After sacrifice, biomechanical tensile load-displacement testing was performed to determine Achilles tendon load to failure and stiffness. Data were analyzed by 1-way analysis of variance.

RESULTS: The THC group demonstrated the highest median load to failure, 18.7 N (95% CI, 15.3-19.2 N); the CBD group had the second highest at 16.9 N (95% CI, 15.1-19.8 N), and the control group had the lowest at 14.4 N (95% CI, 12.1-18.3 N). Stiffness was highest in the THC group at 4.1 N/mm (95% CI, 2.7-5.1 N/mm) compared with 3.6 N/mm (95% CI, 2.9-4.1 N/mm) for the CBD group and 3.6 N/mm (95% CI, 2.8-4.3 N/mm) for the control group. No statistically significant differences for strength and stiffness were observed between the groups.

CONCLUSION: In this pilot study using an animal tendon-to-tendon repair model, neither THC nor CBD resulted in altered biomechanical characteristics compared to control.

CLINICAL RELEVANCE: Cannabinoids do not appear to adversely affect Achilles tendon healing.

PMID:34097540 | DOI:10.1177/03635465211016840

Multivariate Behav Res. 2021 Jun 7:1-16. doi: 10.1080/00273171.2021.1935202. Online ahead of print.

ABSTRACT

Bayesian methods are often suggested as a solution for issues encountered in small sample research, however, Bayesian methods often require informative priors to outperform classical methods in these settings. Specifying accurate priors with respect to the true value of the parameter of interest is challenging and inaccurate informative priors can have detrimental effects on conclusions from the statistical analysis. This paper proposes an objective procedure for creating informative priors for mediation analysis based on a historical data set; the only requirements for implementing the procedure are that the data from the current study constitute a representative sample from the population of interest, and that the historical and current data sets contain measures of the same covariates and independent variable, mediator, and outcome. The simulation study findings show that the proposed method leads to appropriate amount of borrowing from the historical data set, which leads to increases in precision and power when the historical data and current data are exchangeable, and does not induce bias when the historical and current studies are not exchangeable. The proposed method is illustrated using data from the project PROsetta Stone, and we provide rstan code for implementing the proposed method.

PMID:34097538 | DOI:10.1080/00273171.2021.1935202

Health Aff (Millwood). 2021 Jun;40(6):896-903. doi: 10.1377/hlthaff.2020.02464.

ABSTRACT

Prior studies suggest that the COVID-19 pandemic was associated with decreases in emergency department (ED) volumes, but it is not known whether these decreases varied by visit acuity or by demographic and socioeconomic risk factors. In this study of more than one million non-COVID-19 visits to thirteen EDs in a large St. Louis, Missouri, health system, we observed an overall 35 percent decline in ED visits. The decrease in medical and surgical visits ranged from 40 percent to 52 percent across acuity levels, with no statistically significant differences between higher- and lower-acuity visits after correction for multiple comparisons. Mental health visits saw a smaller decrease (-32 percent), and there was no decrease for visits due to substance use. Medicare patients had the smallest decrease in visits (-31 percent) of the insurance groups; privately insured (-46 percent) and Medicaid (-44 percent) patients saw larger drops. There were no observable differences in ED visit decreases by race. These findings can help inform interventions to ensure that people requiring timely ED care continue to seek it and to improve access to lower-risk alternative settings of care where appropriate.

PMID:34097513 | DOI:10.1377/hlthaff.2020.02464

JCO Clin Cancer Inform. 2021 Jun;5:631-640. doi: 10.1200/CCI.20.00191.

ABSTRACT

PURPOSE: Oral chemotherapy challenges providers’ abilities to safely monitor patients’ symptoms, adherence, and financial toxicity. COVID-19 has increased the urgency of caring for patients remotely. Collection of electronic patient-reported outcomes (ePROs) has demonstrated efficacy for patients on intravenous chemotherapy, but limited data support their use in oral chemotherapy. We undertook a pilot project to assess the feasibility of implementing an ePRO system for patients starting oral chemotherapy at our cancer center, which includes both an academic site and a community site.

METHODS: Patients initiating oral chemotherapy were asked to participate. A five-question tool was built in REDCap. Concerning responses triggered outreach within one business day. The primary outcome was time to first symptom assessment. For comparison, we used a historical cohort of patients who had been prescribed oral chemotherapies by providers in the same disease groups at the cancer center.

RESULTS: Twenty-five of 62 (40%) patients completed ePRO assessments. Fifty historical charts were reviewed. Time to first symptom assessment was 7 days (IQR, 4-14 days) in the historical group compared with 3 days (IQR, 2-4 days) in the ePRO group. Time to clinical action was 14 days (7-35 days) in the historical group compared with 8 days (4-19 days) in the ePRO group. No statistically significant differences were detected in 30-day emergency department visit or hospitalization (12% for both groups) or 90-day emergency department visit or hospitalization rates (historical 28% and ePRO 20%).

CONCLUSION: An ePRO tool monitoring patient concerns about adherence, cost, and toxicities for patients with new oral chemotherapy regimens is feasible and improves time to symptom assessment. Further investigation is needed to improve patient engagement with ePROs and evaluate the long-term impacts for patients on oral chemotherapy.

PMID:34097439 | DOI:10.1200/CCI.20.00191

Neoplasma. 2021 Jun 7:210115N67. doi: 10.4149/neo_2021_210115N67. Online ahead of print.

ABSTRACT

Due to tumor heterogeneity, the consistency of programmed cell death-ligand 1 (PD-L1) expression between circulating tumor cells (CTCs) and tissue is controversial. This study aimed to establish a method for detecting CTC PD-L1 expression and exploring the impact of the same on the prognosis of lung cancer. In 32 patients with non-small cell lung cancer, lung cancer cells in the blood were enriched using CD326 immunomagnetic beads. Goat anti-mouse polyclonal CD326 antibody stained the epithelial lung cancer cells and anti-PD-L1 antibody was used to detect the expression of CTC PD-L1. The DAKO Link 48 automatic staining device detected the expression in lung cancer tissue. The consistency of PD-L1 expression was analyzed in lung cancer tissue and CTCs. The effect of plasma interferon gamma, tumor necrosis factor alpha, and interleukin-2 on PD-L1 expression and prognosis was analyzed. The number of CTCs detected in patients was 1-36, with a median of 2. There was no significant difference in PD-L1 expression fractions between CTCs and paired tumor tissue (p > 0.05). The correlation coefficient was 0.20. Regardless of lung cancer tissue or CTCs, there was no statistically significant difference in the blood cytokine levels between the two groups with positive or negative PD-L1 expression (p > 0.05). There was no correlation between CTCs and PD-L1 in 23 untreated patients. The expression of PD-L1 in CTCs and lung cancer tissue is heterogeneous and unaffected by the peripheral cytokines’ levels. PD-L1 expression has no correlation between CTCs and tissues and is not related to prognosis.

PMID:34097427 | DOI:10.4149/neo_2021_210115N67

Aust Endod J. 2021 Jun 7. doi: 10.1111/aej.12537. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the biocompatibility of epoxy-resin-based AHPlus, salicylate-based MTA-Fillapex and calcium silicate-based iRootSP root canal sealers. Cytotoxicity was assessed by XTT test. The extracts from sealers of different setting times were serially diluted. Cell viability was calculated as the percentage of the control group (100%). The optimal concentration of each sealer was used at genotoxicity test, and micronuclei formations were detected. Statistical analyses were done by using Kruskal-Wallis and Dunn post hoc test with Bonferroni correction. AHPlus and MTA-Fillapex showed the lowest percentage of cell viability at higher concentrations (1:1, 1:2, 1:4), especially at first 12 h. iRootSP showed higher viability at all concentrations and times than AHPlus and MTA-Fillapex. At genotoxicity assay, AHPlus increased the number of micronuclei. MTA-Fillapex slightly induced micronucleus formation (not significant) and iRootSP was not increased. In conclusion, calcium silicate-based iRootSP had lowest cytotoxic and genotoxic potential and can be considered as a highly biocompatible material.

PMID:34097343 | DOI:10.1111/aej.12537

Aust Endod J. 2021 Jun 7. doi: 10.1111/aej.12534. Online ahead of print.

ABSTRACT

The aim of this study was to compare the efficacy of UAI with ESI, sonic activation with Eddy^® and syringe irrigation in removing debris, and dentin removal during canal irrigation. Twenty-four mandibular molars containing isthmus type V and with a mean curvature of 32.5º were instrumented and divided into three groups for final irrigation: UAI with ESI, sonic activation with Eddy and syringe irrigation. The samples were scanned in a SkyScan 1172 micro-CT device for pre-, post-instrumentation and post-irrigation images and analysis of dentin removal. Statistical analysis was performed using Wilcoxon, Kruskal-Wallis and Dunn tests. UAI and sonic activation significantly improved debris removal (P < 0.05). No significant difference was observed regarding dentin removal between the groups (P > 0.05), although higher values were found for UAI. Sonic activation with Eddy^® showed to be an effective and safe device since it was able to remove debris without causing damage to the canal walls.

PMID:34097337 | DOI:10.1111/aej.12534

Aust N Z J Public Health. 2021 Jun 7. doi: 10.1111/1753-6405.13122. Online ahead of print.

ABSTRACT

BACKGROUND: The acute effects of alcohol consumption are a major risk factor for suicide. Positive blood alcohol concentrations are present in almost one-third of all suicides at time of death. These suicides are defined as alcohol-related suicides. This cross-sectional study examines the geospatial distribution/clustering of high proportions of alcohol-related suicides and reports on socioeconomic and demographic risk factors.

METHODS: National Coronial Information System (NCIS) data were used to calculate proportions of suicides with alcohol present at the time of death for each level 3 statistical areas (SA3) in Australia. A density analysis and hotspot cluster analysis were used to visualise and establish statistically significant clustering of areas with higher (hotspots) and lower (coldspots) proportions. Subsequently, socioeconomic and demographic risk factors for alcohol use and suicide were reported on for hot and cold spots.

RESULTS: Significant clustering of areas with higher proportions of alcohol-related suicide occurred in northern Western Australia, the Northern Territory and Queensland, as well as inland New South Wales and inland Queensland. Clustering of SA3s with significantly lower proportions occurred in major city and inner regional Sydney and Melbourne. Conclusion and implications for public health: Results from this study identify areas in which prevention strategies should target alcohol use and can be used to inform prevention strategy design. Additionally, hotspots and coldspots identified in this study can be used for further analysis to better understand contextual risk factors for alcohol-related suicide.

PMID:34097331 | DOI:10.1111/1753-6405.13122