Tag: nevin manimala

Worldviews Evid Based Nurs. 2023 May 2. doi: 10.1111/wvn.12649. Online ahead of print.

ABSTRACT

BACKGROUND: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over.

METHODS: Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed.

RESULTS: A total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted.

LINKING EVIDENCE TO ACTION: This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.

PMID:37128953 | DOI:10.1111/wvn.12649

Int Health. 2023 May 2:ihad030. doi: 10.1093/inthealth/ihad030. Online ahead of print.

ABSTRACT

BACKGROUND: The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia.

METHODS: A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV – positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared.

RESULTS: A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire.

CONCLUSION: The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.

PMID:37128936 | DOI:10.1093/inthealth/ihad030

Hand (N Y). 2023 May 2:15589447231167883. doi: 10.1177/15589447231167883. Online ahead of print.

ABSTRACT

BACKGROUND: Scapho-lunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) of the wrist are the most common types of wrist arthritis. We compared the union rate and complication profile of patients with SLAC and SNAC wrist undergoing 4 corner arthrodesis with partially threaded or fully threaded headless compression screws.

METHODS: A single-center retrospective review was conducted to identify all patients treated for SLAC and SNAC with 4 corner fusion using headless compression screws from 2016 to 2021. A total of 33 patients undergoing surgery on 35 wrists were identified and included in the study. Demographics, comorbidities, complication profile, and radiographs were collected and compared between groups.

RESULTS: One hundred percent (16/16) of partially threaded and 84.2% (16/19) of fully threaded screws demonstrated union by minimum 10-week follow-up. The total complication rate (avascular necrosis of lunate, screw loosening, etc.) was 31.4%; 52.6% of wrists implanted with fully threaded screws experienced complications compared with a 6.3% complication rate with partially threaded screws. The difference was statistically significant between the 2 groups (P = .004).

CONCLUSIONS: Four corner arthrodesis using antegrade compression screws is an effective, reproducible method to achieve fusion in the wrist. The use of fully threaded screws was associated with more complications than with partially threaded screws, although union rate was not significantly different. Future studies with larger sample sizes would be useful to fully elucidate differences between these 2 constructs.

PMID:37128854 | DOI:10.1177/15589447231167883

Int J Gynaecol Obstet. 2023 May 2. doi: 10.1002/ijgo.14820. Online ahead of print.

ABSTRACT

OBJECTIVE: The authors aimed to use a large two-sample Mendelian randomization (MR) study to reveal the causality between age at menarche (AAM) and polycystic ovary syndrome (PCOS) incidence.

METHODS: The authors collected summary statistics from the hitherto largest genome-wide association studies conducted in AAM and PCOS in the same ancestry. MR with inverse variance weighting was conducted as the main analysis method, while weighted median and MR-Egger regression were used for comprehensive analysis. As for pleiotropy detection, inverse variance weighting, MR-Egger regression, Mendelian Randomization Pleiotropy Residual Sum and Outlier, as well as leave-one-out analysis were used to detect pleiotropy. Risk factor analysis was conducted to investigate the underlying mechanisms linking AAM to PCOS.

RESULTS: Each standard deviation increment in AAM was associated with a significantly lower incidence of PCOS (odds ratio, 0.86 [95% confidence interval, 0.75-0.98]). After adjustment in horizontal pleiotropy by eliminating four outliers, this pathogenic association was still statistically detected. All pleiotropy indexes were without statistical differences, which suggested the conclusions were robust. It showed the causal association between later AAM and lower body mass index, lower fasting insulin level and insulin resistance.

CONCLUSION: Our MR analysis verified that a slightly later onset age (15 to 18 years) at menarche could reduce the risk of PCOS. A more comprehensive investigation in a prospective setting is strongly advised.

PMID:37128830 | DOI:10.1002/ijgo.14820

Arthritis Care Res (Hoboken). 2023 May 2. doi: 10.1002/acr.25139. Online ahead of print.

ABSTRACT

OBJECTIVE: Some people with systemic sclerosis (SSc) report positive mental health, despite severe disease manifestations, which may be associated with resilience, but no resilience measure has been validated in SSc. We assessed validity, reliability, and differential item functioning (DIF) between English- and French-language versions of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in SSc.

METHODS: Eligible participants were enrolled in the Scleroderma Patient-centered Intervention Network Cohort and completed the CD-RISC-10 between August 2022 and January 2023. We used Confirmatory factor analysis (CFA) to evaluate the CD-RISC-10 factor structure and conducted DIF analysis across languages with Multiple-Indicator Multiple-Cause models. We tested convergent validity with another measure of resilience and measures of self-esteem and depression and anxiety symptoms. We assessed internal consistency and test-retest reliability using Cronbach’s alpha and intraclass correlation coefficient (ICC).

RESULTS: We included 962 participants. CFA supported a single-factor structure (Tucker Lewis Index = 0.99, Comparative Fit Index = 0.99, Root Mean Square Error of Approximation = 0.08, 90% confidence interval 0.07 to 0.09). We found no meaningful DIF. Internal consistency was high (α =0.93, 95% confidence interval 0.92 to 0.94), and we found correlations with other measures of psychological functioning were moderate to large (|r| = 0.57 to 0.78) and confirmed study hypotheses. The scale showed good 1-2 week test-retest reliability (ICC = 0.80, 95% confidence interval 0.75 to 0.85) in a subsample of 230 participants.

CONCLUSION: The CD-RISC-10 is a valid and reliable measure of resilience in SSc with score comparability across English and French versions. This article is protected by copyright. All rights reserved.

PMID:37128826 | DOI:10.1002/acr.25139

J Cosmet Dermatol. 2023 May 2. doi: 10.1111/jocd.15747. Online ahead of print.

ABSTRACT

BACKGROUND: Since there is currently no conclusion on the efficacy and adverse effects of oxymetazoline, this meta-analysis attempts to explore its efficacy and adverse events, so as to provide guidance for clinical medication.

METHODS: We searched PubMed, Embase, and Cochrane Library from the establishment of the database to May 2021. We included studies that patients were randomly assigned to receive oxymetazoline or vehicle, and we excluded duplicate publications, research without full text, incomplete information or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.

RESULTS: The pooled results show that the 3 (RR = 1.76, 95% CI: 1.53-2.03), 6 (RR = 1.71, 95% CI: 1.47-2.00), 9 (RR = 1.63, 95% CI: 1.40-1.90), 12 (RR = 1.41, 95% CI: 1.18-1.67) -hours CEA success rate and the 3 (RR = 1.65, 95% CI: 1.34-2.03), 6 (RR = 1.75, 95% CI: 1.43-2.14), 9 (RR = 1.63, 95% CI: 1.33-2.00), 12 (RR = 1.78, 95% CI: 1.45-2.18) -hours SSA success rate after oxymetazoline treatment for rosacea is significantly higher than that of vehicle. Additionally, the pooled results show that the incidence of TEAEs after treatment with oxymetazoline is significantly higher than that of vehicle (RR = 1.34, 95% CI: 1.10-1.2). However, our analysis of specific adverse events found that the oxymetazoline group was only significantly higher than the vehicle group in the incidence of application-site dermatitis (RR = 8.91, 95% CI: 1.76-45.23), and there was no statistical significance in the difference in the incidence of other adverse events.

CONCLUSION: Oxymetazoline is effective and can be selected for the treatment of persistent facial erythema of rosacea. Additionally, application-site dermatitis was the most important one.

PMID:37128814 | DOI:10.1111/jocd.15747

Rom J Morphol Embryol. 2023 Jan-Mar;64(1):57-63. doi: 10.47162/RJME.64.1.07.

ABSTRACT

Ulcerative colitis (UC), one of the inflammatory bowel diseases, has been reported to increase in recent years. Although the exact cause is unknown, disruptions in the molecular pathways are thought to trigger UC. We aimed to examine the distributions of glycogen synthase kinase-3beta (GSK-3β), nuclear factor-kappa B (NF-κB) and wingless∕int-1 (Wnt-1) in different age groups diagnosed with UC. Patients diagnosed with UC were divided into four groups according to their ages: Group 1, aged 18-30 (n=20); Group 2, aged 31-45 (n=20); Group 3, aged 46-60 (n=20); Group 4, aged 61-75 (n=20). Tissue sections were histochemically stained to examine the parameters of epithelial cell height, length of crypt, thickness of muscularis mucosa and extent of submucosal fibrosis. The immunohistochemistry assay was performed using cell survival and for GSK-3β, NF-κB and Wnt-1 cell growth markers. Immunoreactivities were evaluated using H-score and analyzed using the one-way analysis of variance (ANOVA) test for statistics. It was detected a decrease in the histopathological parameters whereas the immunoreactivities of GSK-3β, NF-κB and Wnt-1 were increased with increasing age. The levels of GSK-3β immunoreactivity were similar in both epithelium and submucosa in all groups. NF-κB immunoreactivity was higher in submucosa of Groups 1, 2 and 3, while Wnt-1 was enhanced in Groups 1 and 3. The results of histopathology showed that the integrity of the epithelial tissue in the colon deteriorated with increasing age. The expressions of GSK-3β, NF-κB and Wnt-1 were detected in all age groups. We thought that there was a synergistic activation between these three markers. Nevertheless, studies are needed to investigate this molecular pathway.

PMID:37128792 | DOI:10.47162/RJME.64.1.07

Aesthet Surg J. 2023 May 2:sjad128. doi: 10.1093/asj/sjad128. Online ahead of print.

ABSTRACT

BACKGROUND: Developed originally as a tool for resident self-evaluation, the Plastic Surgery Inservice Training Examination (PSITE) has become a standardized tool adopted by plastic surgery residency programs. The introduction of large language models (LLMs), such as ChatGPT (OpenAI, San Francisco, CA), has demonstrated the potential to help propel the field of plastic surgery.

OBJECTIVES: The authors of this study wanted to assess whether or not ChatGPT could be utilized as a tool in resident education by assessing its accuracy on the PSITE.

METHODS: Questions were obtained from the 2022 PSITE, which was present on the American Council of Academic Plastic Surgeons (ACAPS) website. Questions containing images or tables were carefully inspected and flagged before being inputted into ChatGPT. All responses by ChatGPT were qualified utilizing the properties of natural coherence. Responses that were found to be incorrect were divided into the following categories: logical, informational, or explicit fallacy.

RESULTS: ChatGPT answered a total of 242 questions with an accuracy of 54.96%. The software incorporated logical reasoning in 88.8% of questions, internal information in 95.5% of questions, and external information in 92.1% of questions. When stratified by correct and incorrect responses, we determined that there was a statistically significant difference in ChatGPT’s use of external information (p <0.05).

CONCLUSIONS: ChatGPT is a versatile tool that has the potential to impact resident education by providing general knowledge, clarifying information, providing case-based learning, and promoting evidence-based medicine. With advancements in LLM and artificial intelligence (AI), it is possible that ChatGPT may be an impactful tool for resident education within plastic surgery.

PMID:37128784 | DOI:10.1093/asj/sjad128

J Biomol Struct Dyn. 2023 May 2:1-20. doi: 10.1080/07391102.2023.2203261. Online ahead of print.

ABSTRACT

Cardiovascular diseases (CVD) such as heart failure, stroke, and hypertension affect 64.3 million people worldwide and are responsible for 30% of all deaths. Primary inhibition of the angiotensin-converting enzyme (ACE) is significant in the management of CVD. In the present study, the genetic algorithm-multiple linear regressions (GA-MLR) method is used to generate highly predictive and statistically significant (R² = 0.70-0.75, Q²_LOO=0.67-0.73, Q²_LMO=0.66-0.72, CCC_ex=0.70-0.78) quantitative structure-activity relationships (QSAR) models conferring to OECD requirements using a dataset of 255 structurally diverse and experimentally validated ACE inhibitors. The models contain simply illustratable Padel, Estate, and PyDescriptors that correlate structural scaffold requisite for ACE inhibition. Also, constraint-based molecular docking reveals an interaction profile between ligands and enzymes which is then correlated with the essential structural features associated with the QSAR models. The QSAR-based virtual screening was utilized to find novel lead molecules from a designed database of 102 thiadiazole derivatives. The Applicability domain (AD), Molecular Docking, Molecular dynamics, and ADMET analysis suggest two compound D24 and D40 are inflexibly linked to the protein binding site and follows drug-likeness properties.Communicated by Ramaswamy H. Sarma.

PMID:37128759 | DOI:10.1080/07391102.2023.2203261

Anal Chem. 2023 May 2;95(17):6996-7005. doi: 10.1021/acs.analchem.3c00495. Epub 2023 Apr 17.

ABSTRACT

Isomeric molecules are important analytes in many biological and chemical arenas, yet their similarity poses challenges for many analytical methods, including mass spectrometry (MS). Tandem-MS provides significantly more information about isomers than intact mass analysis, but highly similar fragmentation patterns are common and include cases where no unique m/z peaks are generated between isomeric pairs. However, even in such situations, differences in peak intensity can exist and potentially contain additional information. Herein, we present a framework for comparing mass spectra that differ only in terms of peak intensity and include calculation of a statistical probability that the spectra derive from different analytes. This framework allows for confident identification of peptide isomers by collision-induced dissociation, higher-energy collisional dissociation, electron-transfer dissociation, and radical-directed dissociation. The method successfully identified many types of isomers including various d/l amino acid substitutions, Leu/Ile, and Asp/IsoAsp. The method can accommodate a wide range of changes in instrumental settings including source voltages, isolation widths, and resolution without influencing the analysis. It is shown that quantification of the composition of isomeric mixtures can be enabled with calibration curves, which were found to be highly linear and reproducible. The analysis can be implemented with data collected by either direct infusion or liquid-chromatography MS. Although this framework is presented in the context of isomer characterization, it should also prove useful in many other contexts where similar mass spectra are generated.

PMID:37128750 | DOI:10.1021/acs.analchem.3c00495