Tag: nevin manimala

J Prim Care Community Health. 2023 Jan-Dec;14:21501319231199014. doi: 10.1177/21501319231199014.

ABSTRACT

BACKGROUND AND OBJECTIVE: Meta-analysis of randomized controlled trials have demonstrated the efficacy of telemedicine in blood pressure (BP) management when compared to conventional care. We initiated a hypertension telehealth clinic in our urban primary care clinic and through this study aim to evaluate the strengths and limitations of telemedicine in hypertension (HTN) control. The primary outcome of the study is to identify the proportion of patients with improved HTN. Secondary outcomes included identifying: predictors for lower BP, predictors of missing telehealth appointments, and comorbid conditions that are more likely to necessitate use of more than 1 antihypertensive medication.

METHODS AND ANALYSIS: Patients seen in the HTN telehealth clinic from May 1st, 2022 to October 31st, 2022 were identified. A retrospective chart review was done to compare the BP during in-person visit prior to first telehealth visit, telehealth visit home BP readings and last recorded in-office BP on chart at end of study period. Descriptive statistical analysis, Chi Square test, and multivariable logistic regression was used to analyze data.

RESULTS: Of the 234 appointments, 83% were conducted and 154 patients were seen. A remarkable decrease in percentage of patients with BP >140/90 was seen when comparing in-office visit BP to first telehealth visit home BP, 72% versus 45% respectively. No remarkable difference was noted in percentage of patients with BP >140/90 when comparing first telehealth visit home BP to last in-office BP recorded on chart, 45% and 41% respectively. Patients with diabetes had lower odds of missing appointments, adjusted odds ratio (aOR): 0.34 ([0.12-0.91], P = .03). Patients with partners were more likely to have lower BP at the telehealth visit, aOR:3.2 ([1.15-9.86], P = .03) while patients with obstructive sleep apnea (OSA) (aOR 0.27 ([0.08-0.77], P = .02) and CAD, aOR 0.24 ([0.06-0.8], P = .03) were less likely to have lower BP.

CONCLUSION: The study demonstrated telemedicine as a great tool to prevent overtreatment of hypertension as significant difference between in-office BP and home BP during telehealth visits was noted. We did not see a significant change in blood pressure when comparing home BP at first telehealth visit to the last in-person clinic BP at end of study period.

PMID:37740500 | DOI:10.1177/21501319231199014

Int J Phytoremediation. 2023 Sep 22:1-15. doi: 10.1080/15226514.2023.2256412. Online ahead of print.

ABSTRACT

In this study, bamboo waste (BW) was subjected to pyrolysis-assisted ZnCl₂ activation to produce mesoporous activated carbon (BW-AC), which was then evaluated for its ability to remove cationic dyes, specifically methylene blue (MB) and crystal violet (CV), from aqueous environments. The properties of BW-AC were characterized using various techniques, including potentiometric-based point of zero charge (pH_pzc), scanning electron microscopy with energy dispersive X-rays (SEM-EDX), X-ray diffraction (XRD), gas adsorption with Brunauer-Emmett-Teller (BET) analysis, infrared (IR) spectroscopy. To optimize the adsorption characteristics (BW-AC dosage, pH, and contact time) of PBW, a Box-Behnken design (BBD) was employed. The BW-AC dose of 0.05 g, solution pH of 10, and time of 8 min are identified as optimal operational conditions for achieving maximum CV (89.8%) and MB (96.3%) adsorption according to the BBD model. The dye removal kinetics for CV and MB are described by the pseudo-second-order model. The dye adsorption isotherms revealed that adsorption of CV and MB onto BW-AC follow the Freundlich model. The maximum dye adsorption capacities (q_max) of BW-AC for CV (530 mg/g) and MB (520 mg/g) are favorable, along with the thermodynamics of the adsorption process, which is characterized as endothermic and spontaneous. The adsorption mechanism of CV and MB dyes by BW-AC was attributed to multiple contributions: hydrogen bonding, electrostatic forces, π-π attraction, and pore filling. The findings of this study highlight the potential of BW-AC as an effective adsorbent in wastewater treatment applications, contributing to the overall goal of mitigating the environmental impact of cationic dyes and ensuring the quality of water resources.

PMID:37740456 | DOI:10.1080/15226514.2023.2256412

J Genet Couns. 2023 Sep 22. doi: 10.1002/jgc4.1792. Online ahead of print.

ABSTRACT

The COVID-19 outbreak in March 2020 resulted in a shift to telemedicine for cancer genetic counseling (GC). The objective of this study was to determine the effect of telehealth (TH) services on patient acceptance of recommended genetic testing, time to test completion, and follow-up test-disclosure GC appointment, as well as compliance with National Comprehensive Cancer Network (NCCN) recommendations for medical screenings when testing positive for a genetic variant. Data for this retrospective cohort study were collected at a tertiary-care academic health center using the electronic medical record and laboratory portal. Patients with traditional in-person visits (the 2019 control group) and date-matched TH visits (2020) were compared. In total, 206 new GC appointments occurred in the in-person group and 184 new appointments occurred in the TH group. The in-person group was more likely to consent to testing than the TH cohort (92.6% vs. 82.1%, p = 0.003) and had increased rates of sample submission (99.5% vs. 93.75%, p < 0.01), as well as a shorter turn-around time between their initial appointment and laboratory result reporting (34.24 vs. 20.32 days, p < 0.01). There was no increase in time from initial to follow-up GC appointments (67.87 days for control, 62.39 days for THs, p = 0.37). With >2.5 years of follow-up for all study participants, there were no statistically significant differences in pathogenic variant (PV) carrier compliance with screening recommendations. During the COVID-19 pandemic, use of TH allowed patients to access GC with no significant differences in time between initial consultation and follow-up. However, in-person visits were associated with increased patient willingness to consent to and complete genetic testing. This work offers a nuanced look at the success of TH GC during the pandemic and follow-up with screening recommendations, while offering future opportunities to address the acceptance of testing as GC is practiced in a virtual or hybrid model.

PMID:37740447 | DOI:10.1002/jgc4.1792

Med Mycol. 2023 Sep 22:myad092. doi: 10.1093/mmy/myad092. Online ahead of print.

ABSTRACT

The skin fungal infection diagnostic workflow currently includes microscopic and culture-based methods as the gold standard. Recent published data described the possible limitations of these conventional techniques documenting the possibility of reducing response time intervals. The present study reports an evaluation of the DermaGenius® (DG) multiplex kit (PathoNostics) for rapid C. albicans and dermatophytes identification directly from skin samples. The investigations involved ninety specimens which underwent DNA extraction and amplification simultaneously to microscopic and culture methods. According to current guidelines, we defined a dermatophytic skin infection as the simultaneous presence of clinical evidence of skin lesions and positive results for dermatophyte elements from microscopy and/or cultures. The collected data remarked on the advantages of the molecular assay, especially in terms of sensitivity and rapidity. A statistical evaluation analysed a comparison between conventional and innovative diagnostic methods. The sensitivity, specificity, positive and negative predictive values of DG PCR in the cutaneous dermatophytosis were respectively 94.7%, 78.8%, 88.5%, and 89.6%. Based on our experience, the molecular technique could represent a diagnostic confirmation in the case of previous antifungal treatment, little biological material available or urgent clinical conditions.

PMID:37740445 | DOI:10.1093/mmy/myad092

Eur J Cardiovasc Nurs. 2023 Sep 22:zvad097. doi: 10.1093/eurjcn/zvad097. Online ahead of print.

ABSTRACT

AIMS: The aims of this study were to evaluate: (I) the short- and long-term effects of the internet-based cognitive behavior (iCBT) program on symptoms of distress and fear disorder in CVD patients, and (II) the association between changes in depression and changes in symptoms of distress and fear disorder from baseline to 12-months follow-up.

METHODS AND RESULTS: Secondary analysis of data collected in a randomized controlled study evaluating the effects on depression of an iCBT program compared to an online discussion forum (ODF) in CVD patients (n = 144). Data were collected at baseline, at post-intervention (nine weeks), and at 6- and 12-month follow-up.The results showed that symptoms of distress disorder were statistically significantly more reduced in the iCBT group than the ODF group. For symptoms of fear disorder, no differences were found except for avoidance, which showed a statistically significant reduction in the iCBT group. The long-term analysis in the iCBT group showed that CAQ total score and fear decreased from baseline to 6- and 12-months follow-up respectively. Avoidance and attention both decreased statistically significantly from baseline to post-intervention, but not between post-intervention and 12-months follow-up.

CONCLUSION: The results suggest that the iCBT program targeted depression in CVD patients successfully reduced symptoms of distress disorder, and to a lesser extent symptoms of fear disorder. Change in depression was more strongly associated with change in distress than change in fear disorder.

REGISTRATION: clinicaltrials.gov NCT02778074.

PMID:37740442 | DOI:10.1093/eurjcn/zvad097

Am J Hum Biol. 2023 Sep 22:e23995. doi: 10.1002/ajhb.23995. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze changes in height, weight, and body mass index (BMI = kg/m² ) from 1986 to 2022 in 3-11 year old children from Dzeal, a rural Maya community in Yucatan, Mexico.

MATERIALS AND METHODS: From October-2022 to February-2023 (third-wave survey), we obtained anthropometric measurements of children (n = 80) and family socioeconomic data and compared them with data obtained in 1986 (n = 38) and 2000 (n = 76). Comparisons of anthropometric parameters by sex between years of measurement were performed graphically and through one-way ANOVA, splitting children into two age groups: 3-7 and 8-11. Bonferroni adjustments for multiple comparisons were used when ANOVAs were statistically significant (p < .05).

RESULTS: In girls, significant increases in height and weight between surveys were found in 3-7 and 8-11 age groups; in boys, significant increases were only found in the 8-11 age group. Regarding BMI, there were increases in 2022 compared with 1986/2000 in both sexes from 8 years onwards. Differences indicate increases of 3.9 and 4.4 cm per decade in girls aged 3-7 and 8-11, respectively, and increases in weight of 1.1 and 3.3 kg per decade, respectively. Increases in boys 8-11 years were 2.3 cm and 2.4 kg per decade.

CONCLUSION: Significant increases in growth parameters were observed in specific-age children in the community studied in the context of changes in livelihoods and improvements in household material conditions.

PMID:37740441 | DOI:10.1002/ajhb.23995

Adv Sci (Weinh). 2023 Sep 22:e2303949. doi: 10.1002/advs.202303949. Online ahead of print.

ABSTRACT

Skin-like flexible sensors play vital roles in healthcare and human-machine interactions. However, general goals focus on pursuing intrinsic static and dynamic performance of skin-like sensors themselves accompanied with diverse trial-and-error attempts. Such a forward strategy almost isolates the design of sensors from resulting applications. Here, a machine learning (ML)-guided design of flexible tactile sensor system is reported, enabling a high classification accuracy (≈99.58%) of tactile perception in six dynamic touch modalities. Different from the intuition-driven sensor design, such ML-guided performance optimization is realized by introducing a support vector machine-based ML algorithm along with specific statistical criteria for fabrication parameters selection to excavate features deeply concealed in raw sensing data. This inverse design merges the statistical learning criteria into the design phase of sensing hardware, bridging the gap between the device structures and algorithms. Using the optimized tactile sensor, the high-quality recognizable signals in handwriting applications are obtained. Besides, with the additional data processing, a robot hand assembled with the sensor is able to complete real-time touch-decoding of an 11-digit braille phone number with high accuracy.

PMID:37740421 | DOI:10.1002/advs.202303949

Hum Mol Genet. 2023 Sep 22:ddad159. doi: 10.1093/hmg/ddad159. Online ahead of print.

ABSTRACT

Breast cancer (bc) risk is suspected to be linked to thyroid disorders, however observational studies exploring the association between bc and thyroid disorders gave conflicting results. We proposed an alternative approach by investigating the shared genetic risk factors between bc and several thyroid traits. We report a positive genetic correlation between bc and thyroxine (FT4) levels (corr = 0.13, p-value = 2.0×10-4) and a negative genetic correlation between bc and thyroid-stimulating hormone (TSH) levels (corr = -0.09, p-value = 0.03). These associations are more striking when restricting the analysis to estrogen receptor-positive bc. Moreover, the polygenic risk scores (PRS) for FT4 and hyperthyroidism are positively associated to bc risk (OR = 1.07, 95%CI: 1.00-1.13, p-value = 2.8×10-2 and OR = 1.04, 95%CI: 1.00-1.08, p-value = 3.8×10-2, respectively), while the PRS for TSH is inversely associated to bc risk (OR = 0.93, 95%CI: 0.89-0.97, p-value = 2.0×10-3). Using the PLACO method, we detected 49 loci associated to both bc and thyroid traits (p-value<5×10-8), in the vicinity of 130 genes. An additional colocalization and gene-set enrichment analyses showed a convincing causal role for a known pleiotropic locus at 2q35 and revealed an additional one at 8q22.1 associated to both bc and thyroid cancer. We also found two new pleiotropic loci at 14q32.33 and 17q21.31 that were associated to both TSH levels and bc risk. Enrichment analyses and evidence of regulatory signals also highlighted brain tissues and immune system as candidates for obtaining associations between bc and TSH levels. Overall, our study sheds light on the complex interplay between bc and thyroid traits and provides evidence of shared genetic risk between those conditions.

PMID:37740403 | DOI:10.1093/hmg/ddad159

Food Funct. 2023 Sep 22. doi: 10.1039/d3fo02579a. Online ahead of print.

ABSTRACT

Aims: convincing evidence is still limited for the validation of associations between the inflammatory potential of diets, based on the dietary inflammatory index (DII), and cardiometabolic outcomes. We aimed to investigate the associations between the DII with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases (CMDs), including stroke, type 2 diabetes mellitus (T2DM) and myocardial infarction (MI). Methods: adults (N = 14 652) from the China Health and Nutrition Survey (1997-2015) were included in the current analysis. Dietary intake data were collected using a combination of 3 day consecutive 24 h dietary recalls and the food weighing method. The DII was calculated with established and validated methods. CMDs were identified using validated self-reported questionnaires. The Cox proportional hazard regression model was used for statistical analysis. Results: during a mean follow-up of 10 years, a total of 404 new-onset stroke, 1051 new-onset T2DM and 280 new-onset MI cases were identified. Lower PDI, hPDI, ERD, WISH and PHDI scores and higher uPDI scores were associated with higher DII scores (all P-trend < 0. 0001). A pro-inflammatory diet, as reflected by relatively higher DII scores, was positively associated with an increased risk of stroke (Q5 vs. Q1: HR = 1.90; 95% CI: 1.26-2.88; P-trend = 0.0006), T2DM (Q5 vs. Q1: HR = 2.08; 95% CI: 1.61-2.69; P-trend < 0.0001) and MI (Q5 vs. Q1: HR = 1.70; 95% CI: 1.04-2.76; P-trend = 0.0114) in the entire cohort. Sex and BMI significantly modified the association between the DII and the risk of T2DM, and sex significantly modified the association between the DII and the risk of MI. Conclusions: lower adherence to healthy and sustainable plant-based dietary patterns and higher adherence to unhealthy plant-based dietary patterns were associated with higher DII scores. With the use of the DII, we reported long-term positive associations between a pro-inflammatory diet and an increased risk of new-onset stroke, T2DM and MI in Chinese adults who were free from CMDs and cancer at the baseline. These findings provided evidence for the validation of associations between the DII and cardiometabolic health, and contributed to the current literature suggesting careful evaluations of whether the DII should be incorporated into dietary guidelines and utilized as an effective tool for improving the diet quality and CMD prevention in the Chinese population.

PMID:37740363 | DOI:10.1039/d3fo02579a

J Commun Disord. 2023 Sep 20;106:106380. doi: 10.1016/j.jcomdis.2023.106380. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examines the Turkish validity, reliability and diagnostic performance of the Voice Handicap Index-Partner (VHI-P-TR), which is used to obtain the perceptions of communication partners of individuals with dysphonia about the functional, physical and emotional handicap resulting from the patient experiencing dysphonia.

METHOD: The study included 160 individuals with dysphonia and their communication partners. First, translation, back translation, expert validity and pilot study were performed in the scale adaptation process. Then, a confirmatory factor analysis (CFA) was conducted to assess the construct validity of the VHI-P-TR. Correlations between the VHI-P-TR and Voice Handicap Index (VHI-TR) scores of dysphonic individuals were examined to evaluate the concurrent validity of the VHI-P-TR. To assess the reliability of the VHI-P-TR, a test-retest analysis was performed, and internal consistency coefficients (α) were calculated. A receiver operating characteristic (ROC) analysis was conducted to determine the cut-off point for the VHI-P scores.

RESULTS: A high positive correlation was found between the participants’ VHI-P-TR and VHI-TR total and subscales mean scores (r’s > 0.782; p < 0.01). The VHI-P-TR had high internal consistency regarding for its subscales and total score (α’s > 0.94; p < 0.01). Factor loadings of all VHI-P-TR items were higher than 0.30 and their error variances were lower than 0.90. In addition, factor loadings were statistically significant for all the items (p < 0.05). The data fit the model well according to all CFA indices except for GFI (scale = 0.69). An adequate sensitivity and specificity were achieved for the VHI-P-TR, and the cut-off point was found as 11.50 for the total score and ranged from 2.50 to 5.50 for the subscales.

CONCLUSION: The VHI-P-TR is a valid and reliable measurement tool with high diagnostic performance in all subscales and total score, and has high levels of agreement with the VHI-TR.

PMID:37738707 | DOI:10.1016/j.jcomdis.2023.106380