Tag: nevin manimala

Hong Kong Med J. 2024 Apr 5. doi: 10.12809/hkmj2210413. Online ahead of print.

ABSTRACT

INTRODUCTION: Early identification and initiation of reperfusion therapy is essential for suspected acute ischaemic stroke. A pre-hospital stroke notification (PSN) protocol using FASE (facial drooping, arm weakness, speech difficulties, and eye palsy) was implemented to improve key performance indicators (KPIs) in acute stroke care delivery. We assessed KPIs and clinical outcomes before and after PSN implementation in Hong Kong.

METHODS: This prospective cohort study with historical controls was conducted in the Accident and Emergency Departments of four public hospitals in Hong Kong. Patients were screened using the PSN protocol between August 2021 and February 2022. Suspected stroke patients between August 2020 and February 2021 were included as historical controls. Door-to-needle (DTN) and door-to-computed tomography (DTC) times before and after PSN implementation were compared. Clinical outcomes including National Institutes of Health Stroke Scale score at 24 hours and modified Rankin Scale score at 3 months after intravenous recombinant tissue-type plasminogen activator (IV-rtPA) were also assessed.

RESULTS: Among the 715 patients (266 PSN and 449 non-PSN) included, 50.8% of PSN patients and 37.7% of non-PSN patients had a DTC time within 25 minutes (P<0.001). For the 58 PSN and 134 non-PSN patients given IV-rtPA, median DTN times were 67 and 75.5 minutes, respectively (P=0.007). The percentage of patients with a DTN time within 60 minutes was higher in the PSN group than in the non-PSN group (37.9% vs 21.6%; P=0.019). No statistically significant differences in clinical outcomes were observed.

CONCLUSION: Although the PSN protocol shortened DTC and DTN times, clinical outcomes did not significantly differ.

PMID:38577838 | DOI:10.12809/hkmj2210413

J Appl Anim Welf Sci. 2024 Apr 5:1-16. doi: 10.1080/10888705.2024.2337935. Online ahead of print.

ABSTRACT

Environmental enrichment may reduce stereotypies in fur-farmed mink. North American mink standards require manipulable enrichment objects within cages. However, mink can rapidly destroy objects inhibiting continuous enrichment presence, which may have negative welfare impacts. This experimental study determined the effects of removing simple cage manipulable enrichments (plastic chains and dumbbells), either short-term or longer-term, on the behavioral expression of welfare in fur-farmed mink. Locomotor stereotypies, normal activity, sub-types of inactivity related to boredom, and tail fur-chewing were recorded across four treatment groups with either (1) no enrichment, (2) continuous enrichment, (3) short (temporary), or (4) long-term enrichment removal. Contrary to predictions, locomotor stereotypies, and scrabbling were not reduced by the enrichments, nor affected by the enrichment removal. Observations at the beginning of the trial showed the non-enriched mink spent the least amount of time lying with their eyes open (i.e., the least bored). The lack of enrichment may have increased fur-chewing on the tail, but larger sample sizes would be needed for statistical confirmation. This research contributes to the literature on evaluating simple, practical enrichments for improving fur-farmed mink welfare.

PMID:38577826 | DOI:10.1080/10888705.2024.2337935

Int Nurs Rev. 2024 Apr 5. doi: 10.1111/inr.12953. Online ahead of print.

ABSTRACT

AIM: This study investigated the levels of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic. We also explored the potential causes of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the pandemic.

BACKGROUND: The COVID-19 pandemic has had a considerable impact on long-term care facilities. The high infection and mortality rates for COVID-19 have resulted in an increased workload for caregivers.

INTRODUCTION: The COVID-19 pandemic exposed caregivers working in long-term care facilities to higher risks of anxiety and depression. Additionally, the high risk of infection in the work environment and concerns about spreading COVID-19 to family members and long-term care facility residents led to various forms of stress among caregivers.

METHODS: The present study was a cross-sectional study. Questionnaires were used to investigate depression and anxiety among regarding nurses and nursing assistants working in long-term care facilities during the pandemic.

RESULTS: The depression and anxiety levels of the nurses were higher than nursing assistants, but had no statistically significant difference (p = 0.551). The factors influencing levels of depression and anxiety in nurses contained facility affiliation and experience working. In terms of nursing assistants, age, marital status, and facility affiliation were correlated with the levels of depression and anxiety.

DISCUSSION: The pandemic has severely impacted caregivers. In the process of implementing pandemic prevention measures and providing care for COVID-19 patients, safeguarding the psychological health of caregivers is also essential.

CONCLUSION: The levels of depression and anxiety in nurses were higher than in nursing assistants working in long-term care facilities during the pandemic.

IMPLICATION FOR NURSING AND HEALTH POLICY: Long-term care facilities managers are recommended to enhance the education and training process for caregivers. Managers are also recommended to ensure provision of sufficient amounts of pandemic prevention equipment and resources.

PMID:38577808 | DOI:10.1111/inr.12953

Andrology. 2024 Apr 5. doi: 10.1111/andr.13637. Online ahead of print.

ABSTRACT

BACKGROUND: Single-cell RNA-seq (scRNA-Seq) has been widely adopted to study gene expression of the human testis. Several datasets of scRNA-Seq from human testis have been generated from different groups processed with different informatics pipelines. An integrated atlas of scRNA-Seq expression constructed from multiple donors, developmental ages, and fertility states would be widely useful for the testis research community.

OBJECTIVE: To describe the generation and use of the human infertility single-cell testis atlas (HISTA), an interactive web tool for understanding human spermatogenesis through scRNA-Seq analysis.

METHODS: We obtained scRNA-Seq datasets derived from 12 donors, including healthy adult controls, juveniles, and several infertility cases, and reprocessed these data using methods to remove batch effects. Using Shiny, an open-source environment for data visualization, we created numerous interactive tools for exploring the data, some of which support simple statistical hypothesis testing. We used the resulting HISTA browser and its underlying data to demonstrate HISTA’s value for testis researchers.

RESULTS: A primary application of HISTA is to search by a single gene or a set of genes; thus, we present various analyses that quantify and visualize gene expression across the testis cells and pathology. HISTA also contains machine-learning-derived gene modules (“components”) that capture the entire transcriptional landscape of the testis tissue. We show how the use of these components can simplify the highly complex data in HISTA and assist with the interpretation of genes with unknown functions. Finally, we demonstrate the diverse ways HISTA can be used for new data analysis, including hypothesis testing.

DISCUSSION AND CONCLUSIONS: HISTA is a research environment that can help scientists organize and understand the high-dimensional transcriptional landscape of the human testis. HISTA has already contributed to published testis research and can be updated as needed with input from the research community or downloaded and modified for individual needs.

PMID:38577799 | DOI:10.1111/andr.13637

J Gerontol B Psychol Sci Soc Sci. 2024 Apr 5:gbae036. doi: 10.1093/geronb/gbae036. Online ahead of print.

ABSTRACT

OBJECTIVES: Hispanic adults display a higher likelihood of early-stage cognitive decline than their White counterparts yet receive fewer clinical diagnoses. This troubling trend highlights the significance of longitudinal surveys like the National Social Life, Health, and Aging Project (NSHAP) in monitoring cognitive changes in aging Hispanics. Using NSHAP’s Rounds 2 and 3, we observed notable cognitive score differences between English and Spanish speakers, as assessed by the survey-adapted version of the Montreal Cognitive Assessment (MoCA-SA). Our study aims to discern if statistical adjustments can reduce measurement variance in global cognition scores between these language groups.

METHODS: We applied modification indexes, two-parameter item response theory models, and split-sample testing to pinpoint items that exhibit resilience to language-related bias among our Hispanic sample. From this analysis, an abbreviated version of the MoCA-SA, termed MoCA-SAA, was introduced. Subsequently, we juxtaposed the performance and predictive validity of both MoCA versions against four consequential outcomes indicative of cognitive decline.

RESULTS: Our refined methodologies enabled the identification of consistent items across both language cohorts. The MoCA-SAA demonstrated a performance and predictive validity in line with the original MoCA-SA concerning outcomes linked to cognitive deterioration.

DISCUSSION: The translated measures ensure the inclusion of Hispanic Spanish speakers in NSHAP, who might otherwise be overlooked. The statistical adjustment outlined in this study offers a means to mitigate potential measurement disparities when assessing overall cognition. Despite these advancements, we acknowledge persistent issues related to the translation of the MoCA-SA into Spanish that warrant further attention.

PMID:38577771 | DOI:10.1093/geronb/gbae036

Int J Offender Ther Comp Criminol. 2024 Apr 5:306624X241240701. doi: 10.1177/0306624X241240701. Online ahead of print.

ABSTRACT

Dynamic risk scales have largely been evaluated using singular assessment scores, including those obtained at the start of supervision. While this approach includes assessment of dynamic factors, it ignores changes with reassessment, failing to examine whether an instrument is truly dynamic in nature. This is problematic, as proximal risk assessments have consistently outperformed baseline assessments in the prediction of recidivism. In the current study, we examined the dynamic properties of the Dynamic Risk Assessment for Offender Reentry (DRAOR) in 4,736 adults on community supervision in Iowa, United States (N = 33,965 assessments). As expected, while clients demonstrated statistically significant changes on the DRAOR domains over time, changes were small in magnitude. We also examined the predictive validity of baseline and proximal DRAOR total and domain scores on criminal recidivism and revocation in a larger sample of 11,421 adults in the same jurisdiction. While DRAOR baseline scores did predict both outcomes, prediction did not improve with proximal scores. This conflicted with expected findings from previous research on the DRAOR in New Zealand. The results of both of these research questions indicate there was an overall lack of change reflected in this sample. Potential issues regarding implementation fidelity are discussed. Additional research is needed to examine the dynamic properties of the DRAOR in Iowa given the importance of reassessment data in community corrections.

PMID:38577767 | DOI:10.1177/0306624X241240701

Ann N Y Acad Sci. 2024 Apr 5. doi: 10.1111/nyas.15126. Online ahead of print.

ABSTRACT

This study aimed to screen antibiotic resistance and virulence genes in carbapenem-resistant hypermucoviscous Klebsiella pneumoniae isolates from an Egyptian hospital. Among 38 previously confirmed carbapenem-nonsusceptible K. pneumoniae isolates, a string test identified three isolates as positive for hypermucoviscosity. Phenotypic characterization and molecular detection of carbapenemase- and virulence-encoding genes were performed. PCR-based multilocus sequence typing and phylogenetics were used to determine the clonality and global epidemiology of the strains. The coexistence of virulence and resistance genes in the isolates was analyzed statistically using a chi-square test. Three isolates showed the presence of carbapenemase-encoding genes (bla_NDM, bla_VIM, and bla_IMP), adhesion genes (fim-H-1 and mrkD), and siderophore genes (entB); the isolates belonged to sequence types (STs) 101, 1310, and 1626. The relatedness between these sequence types and the sequence types of globally detected hypermucoviscous K. pneumoniae that also harbor carbapenemases was determined. Our analysis showed that the resistance and virulence profiles were not homogenous. Phylogenetically, different clones clustered together. There was no significant association between the presence of resistance and virulence genes in the isolates. There is a need for periodic surveillance of the healthcare settings in Egypt and globally to understand the true epidemiology of carbapenem-resistant, hypermucoviscous K. pneumoniae.

PMID:38577761 | DOI:10.1111/nyas.15126

Int J Clin Pharmacol Ther. 2024 Apr 5. doi: 10.5414/CP204406. Online ahead of print.

ABSTRACT

AIMS: Hydroxychloroquine (HCQ) has a high variability and a long half-life in the human body. The purpose of this study was to evaluate the bioequivalence of a generic HCQ tablet (test preparation) versus a brand HCQ tablet (reference preparation) under fasting and fed conditions in a crossover design.

MATERIALS AND METHODS: This was an open-label, two-period randomized, single-dose, crossover study in 47 healthy Chinese subjects who were sequentially and randomly allocated either to the fed group (high-fat meal; n = 23) or the fasting group (n = 24). Participants in each group were randomized to the two arms to receive either a single 200-mg dose of the test preparation or a 200-mg dose of the reference preparation. The application of the two preparations in each patient was separated by a 28-day washout period, regarded as sufficiently long to avoid significant interference from residual drug in the body. Whole blood samples were collected over 72 hours after drug administration.

RESULTS: A total of 23 subjects completed both the fed and the fasting parts of the trial. There were no significant differences in C_max, AUC_0-72h, and T_1/2 between the test and reference preparation (p > 0.05). Food had no significant effect on C_max and T_1/2 (p > 0.05), but AUC_0-72h values were significantly reduced under fed condition compared to fasting condition (p < 0.05). The 90% confidence intervals (CIs) for the geometric mean ratios (GMRs) of C_max and AUC_0-72h were 0.84 – 1.05 and 0.89 – 0.98 in the fed study, and 0.97 – 1.07 and 0.97 – 1.05 in the fasting study, respectively. The carryover effect due to non-zero blood concentrations resulted in higher AUC_0-72h values in the second period for both test and reference formulations and had no effect on the statistical results. No serious adverse events were reported.

CONCLUSION: The investigation demonstrated that the test and reference preparations are bioequivalent and well tolerated under both fasting and fed conditions in healthy Chinese subjects.

PMID:38577751 | DOI:10.5414/CP204406

Can Assoc Radiol J. 2024 Apr 5:8465371241238917. doi: 10.1177/08465371241238917. Online ahead of print.

ABSTRACT

PURPOSE: To assess the diagnostic utility of clinical magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) in distinguishing between histological grading and isocitrate dehydrogenase (IDH) classification in adult diffuse gliomas.

METHODS: A retrospective analysis was conducted on 247 patients diagnosed with adult diffuse glioma. Experienced radiologists evaluated DWI and MRS images. The Kruskal-Wallis test examined differences in DWI and MRS-related parameters across histological grades, while the Mann-Whitney U test assessed molecular classification. Receiver Operating Characteristic (ROC) curves evaluated parameter effectiveness. Survival curves, stratified by histological grade and IDH classification, were constructed using the Kaplan-Meier test.

RESULTS: The cohort comprised 141 males and 106 females, with ages ranging from 19 to 85 years. The Kruskal-Wallis test revealed significant differences in ADC mean, Cho/NAA, and Cho/Cr concerning glioma histological grade (P < .01). Subsequent application of Dunn’s test showed significant differences in ADC mean among each histological grade (P < .01). Notably, Cho/NAA exhibited a marked distinction between grade 2 and grade 3/4 gliomas (P < .01). The Mann-Whitney U test indicated that only ADC mean showed statistical significance for IDH molecular classification (P < .01). ROC curves were constructed to demonstrate the effectiveness of the specified parameters. Survival curves were also delineated to portray survival outcomes categorized by histological grade and IDH classification. Conclusions: Clinical MRS demonstrates efficacy in glioma histological grading but faces challenges in IDH classification. Clinical DWI’s ADC mean parameter shows significant distinctions in both histological grade and IDH classification.

PMID:38577746 | DOI:10.1177/08465371241238917

Eur J Haematol. 2024 Apr 5. doi: 10.1111/ejh.14206. Online ahead of print.

ABSTRACT

BACKGROUND: Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions.

OBJECTIVE: To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16).

METHODS: A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16.

RESULTS: 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning ‘a moderate effect on QoL’. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a ‘very large effect’ (FROM-16 score>16) on their quality of life.

CONCLUSIONS: Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.

PMID:38577720 | DOI:10.1111/ejh.14206