Tag: nevin manimala

Eur J Cardiovasc Nurs. 2023 May 25:zvad050. doi: 10.1093/eurjcn/zvad050. Online ahead of print.

ABSTRACT

AIMS: A nutritional status is related to the length of hospitalisation and in-hospital mortality of patients with heart failure (HF). The aim of this study is to assess the prognostic impact of nutritional status and BMI on in-hospital mortality among patients with HF relative to their sex.

METHODS AND RESULTS: We conducted a retrospective study and analysis of 809 medical records of patients admitted to the Institute of Heart Disease of the University Clinical Hospital in Wroclaw (Poland). Women were statistically significantly older than men (74.67±11.15 vs 66.76±17.78; p<0.001). In unadjusted model significant Predictor of the odds of in-hospital mortality for man are underweight (OR=14.81, p=0.001) and the risk of malnutrition (OR=8.979, p<0.001). In case of woman none of the traits analyzed was a significant. In age-adjusted model significant independent predictor of the odds of in-hospital mortality in the case of men was BMI>18,5 (OR=15.423, p=0.001) and risk of malnutrition (OR=5.557, p=0.002). In case of woman none of the nutritional status traits analyzed was a significant. In multivariable-adjusted model in men, significant independent predictors of the odds of in-hospital mortality were BMI>18,5 (OR=15.978, p=0.007) compared to having normal body weight and the risk of malnutrition (OR=4.686, p=0.015). In case of woman none of the nutritional status traits analyzed was a significant.

CONCLUSION: Both underweight and the risk of malnutrition are direct predictors of the odds of in-hospital mortality in men, but not in women. The study did not find a relationship between nutritional status and in-hospital mortality in women.

PMID:37226867 | DOI:10.1093/eurjcn/zvad050

Integr Environ Assess Manag. 2023 May 25. doi: 10.1002/ieam.4794. Online ahead of print.

ABSTRACT

Cyclic C6O4 (cC6O4, CAS number 1190931-27-1) is a new generation polyfluorinated alkyl substance (PFAS) used as polymerisation aid in the synthesis of fluoropolymers, produced in Italy since 2011. A review of the properties of cC6O4, focused on environmental distribution and ecotoxicology, was conducted. EQC model was applied, using default environmental scenarios, to estimate environmental distribution and fate. In a situation of static thermodynamic equilibrium in a closed system (level I) cC6O4 distributes mainly to water (97.6%) and in a minor amount to soil (2.3%). In a more realistic scenario (level III), with dynamic condition in an open system, with advection in air and water and with equal emissions in air and water, the major amount of the compound is transported through water advection. Monitoring data, mainly referred to surface and groundwater, are available for water bodies close to the production sites (maximum measured concentration 52 μg/L) as well as for a wider area in the river Po watershed with concentrations generally lower than 1 μg/L. Few values are also available for concentration in biota. Effect data indicate low toxicity on all tested organisms with NOEC values always higher than the maximum concentrations tested (100 mg/L for acute tests). Bioaccumulation potential is also very low. A comparison with selected widely used PFAS with five to eight C atoms indicate that cC6O4 is substantially less dangerous to aquatic organisms. At the time being, an ecological risk for the aquatic ecosystem may be excluded even in directly exposed ecosystems. However, for a complete assessment of the suitability of cC6O4 as substitute of other PFAS (namely PFOA), more comprehensive chronic experiments are necessary, to produce realistic NOECs, as well as higher tier experiments (e.g., mesocosms) capable to provide ecologically relevant endpoints. Moreover, a more accurate evaluation of the environmental persistence would be necessary.

PMID:37226845 | DOI:10.1002/ieam.4794

Clin Oral Implants Res. 2023 May 25. doi: 10.1111/clr.14099. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the effects of the cushioned grind-out technique transcrestal sinus floor elevation for simultaneous implant placement with ≤4 mm of residual bone height (RBH).

MATERIALS AND METHODS: This was a retrospective propensity score matching (PSM) study. Five PSM analyses included the confounding variables of Schneiderian membrane perforation, early and late implant failure, and peri-implant apical and marginal bone resorption. After PSM, we compared the difference in five aspects between the RBH ≤ 4 and >4 mm groups.

RESULTS: A total of 214 patients with 306 implants were included in this study. After PSM, the generalized linear mixed model (GLMM) indicated that RBH ≤ 4 mm had no significantly higher risk of Schneiderian membrane perforation and early and late implant failure (p = .897, p = .140, p = .991, respectively). The implant cumulative 7-year survival rate of the RBH ≤ 4 and >4 mm groups was 95.5% and 93.9%, respectively (log-rank test: p = .900). Within at least 40 cases per group after PSM, two multivariate GLMMs indicated that RBH ≤ 4 mm could not be identified as the promotive factor of bone resorption of either endo-sinus bone gain or crest bone level (RBH × time interaction p = .850, p = .698, respectively).

CONCLUSIONS: Within the limitations, 3 months to 7 years of post-prosthetic restoration review data indicated an acceptable mid-term survival and success rate of applying the cushioned grind-out technique in RBH ≤ 4 mm cases.

PMID:37226843 | DOI:10.1111/clr.14099

Inquiry. 2023 Jan-Dec;60:469580231174326. doi: 10.1177/00469580231174326.

ABSTRACT

Mothers’ delivery care satisfaction is one of the indicators used to monitor the quality of health care provision. However, there is paucity of evidence on level of maternal satisfaction and its determinants, in Ethiopia, particularly in Somali regional state. Determining the maternal delivery care satisfaction level and identifying its determinants is important to understand the gap and strengthen the existing strategies. Therefore, the study aimed to determine the level of maternal satisfaction and the associated factors among post-cesarean section delivery care at selected public hospitals in the Somali regional state of Ethiopia. An institutional-based cross-sectional study was conducted on 285 mothers who gave birth in selected public hospitals in the Somali region from June 15 to August 29, 2021. The study subjects were chosen from the hospital using simple random sampling, and data was collected by interviewing newly delivered mothers. The data was entered into EPI DATA version 3, exported and analyzed using the Statistical Package for the Social Sciences (SPSS) 26 statistical package. A multivariable logistic regression was applied to identify the factors related to maternal satisfaction at a 95% confidence interval. Variables with a P-value of less than .05 in the multivariable regression were considered to be significantly related to maternal satisfaction. The overall maternal satisfaction level with cesarean section delivery care service was 61.5% (95% CI: 56.1-66.3). Current planned pregnancy [AOR = 2.793; 95% CI: (1.42, 5.51)], antenatal care follows up [AOR = 2.008; 95% CI: (1.097, 3.67)], time spent obtaining health professionals [AOR = 4.045; 95% CI: (2.12, 7.71)], and gender of healthcare provider [AOR = 7.993; 95% CI: (4.11, 15.53)] were all associated with maternal satisfaction with cesarean. The overall maternal satisfaction level with cesarean section delivery care service was found to be low as per the national standards. Maternal satisfaction with cesarean section delivery care services was significantly associated with current pregnancy planned, antenatal care follow-up, time spent waiting for health professionals, and gender of healthcare provider. Thus, hospital administrators should focus on the cesarean section delivery service quality improvement area, and the care should be client-centered.

PMID:37226839 | DOI:10.1177/00469580231174326

Psychol Med. 2023 May 25:1-11. doi: 10.1017/S0033291723001186. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital-based biobanks are being increasingly considered as a resource for translating polygenic risk scores (PRS) into clinical practice. However, since these biobanks originate from patient populations, there is a possibility of bias in polygenic risk estimation due to overrepresentation of patients with higher frequency of healthcare interactions.

METHODS: PRS for schizophrenia, bipolar disorder, and depression were calculated using summary statistics from the largest available genomic studies for a sample of 24 153 European ancestry participants in the Mass General Brigham (MGB) Biobank. To correct for selection bias, we fitted logistic regression models with inverse probability (IP) weights, which were estimated using 1839 sociodemographic, clinical, and healthcare utilization features extracted from electronic health records of 1 546 440 non-Hispanic White patients eligible to participate in the Biobank study at their first visit to the MGB-affiliated hospitals.

RESULTS: Case prevalence of bipolar disorder among participants in the top decile of bipolar disorder PRS was 10.0% (95% CI 8.8-11.2%) in the unweighted analysis but only 6.2% (5.0-7.5%) when selection bias was accounted for using IP weights. Similarly, case prevalence of depression among those in the top decile of depression PRS was reduced from 33.5% (31.7-35.4%) to 28.9% (25.8-31.9%) after IP weighting.

CONCLUSIONS: Non-random selection of participants into volunteer biobanks may induce clinically relevant selection bias that could impact implementation of PRS in research and clinical settings. As efforts to integrate PRS in medical practice expand, recognition and mitigation of these biases should be considered and may need to be optimized in a context-specific manner.

PMID:37226828 | DOI:10.1017/S0033291723001186

Autism. 2023 May 25:13623613231171980. doi: 10.1177/13623613231171980. Online ahead of print.

ABSTRACT

A vast majority of individuals with autism spectrum disorder experience impairments in motor skills. Those are often labelled as additional developmental coordination disorder despite the lack of studies comparing both disorders. Consequently, motor skills rehabilitation programmes in autism are often not specific but rather consist in standard programmes for developmental coordination disorder. Here, we compared motor performance in three groups of children: a control group, an autism spectrum disorder group and a developmental coordination disorder group. Despite similar level of motor skills evaluated by the standard movement assessment battery for children, in a Reach-to-Displace Task, children with autism spectrum disorder and developmental coordination disorder showed specific motor control deficits. Children with autism spectrum disorder failed to anticipate the object properties, but could correct their movement as well as typically developing children. In contrast, children with developmental coordination disorder were atypically slow, but showed a spared anticipation. Our study has important clinical implications as motor skills rehabilitations are crucial to both populations. Specifically, our findings suggest that individuals with autism spectrum disorder would benefit from therapies aiming at improving their anticipation, maybe through the support of their preserved representations and use of sensory information. Conversely, individuals with developmental coordination disorder would benefit from a focus on the use of sensory information in a timely fashion.

PMID:37226824 | DOI:10.1177/13623613231171980

J Diabetes Sci Technol. 2023 May 25:19322968231176531. doi: 10.1177/19322968231176531. Online ahead of print.

ABSTRACT

BACKGROUND: When launched, FreeStyle Libre (FSL; a flash glucose monitor) onboarding was mainly conducted face-to-face. The COVID-19 pandemic accelerated a change to online starts with patients directed to online videos such as Diabetes Technology Network UK for education. We conducted an audit to evaluate glycemic outcomes in people who were onboarded face-to-face versus those who were onboarded remotely and to determine the impact of ethnicity and deprivation on those outcomes.

METHODS: People living with diabetes who started using FSL between January 2019 and April 2022, had their mode of onboarding recorded and had at least 90 days of data in LibreView with >70% data completion were included in the audit. Glucose metrics (percent time in ranges) and engagement statistics (previous 90-day averages) were obtained from LibreView. Differences between glucose variables and onboarding methods were compared using linear models, adjusting for ethnicity, deprivation, sex, age, percent active (where appropriate), and duration of FSL use.

RESULTS: In total, 935 participants (face-to-face 44% [n = 413]; online 56% [n = 522]) were included. There were no significant differences in glycemic or engagement indices between onboarding methods and ethnicities, but the most deprived quintile had significantly lower percent active time (b = -9.20, P = .002) than the least deprived quintile.

CONCLUSIONS: Online videos as an onboarding method can be used without significant differences in glucose and engagement metrics. The most deprived group within the audit population had lower engagement metrics, but this did not translate into differences in glucose metrics.

PMID:37226777 | DOI:10.1177/19322968231176531

Stroke. 2023 May 25. doi: 10.1161/STROKEAHA.122.040247. Online ahead of print.

ABSTRACT

BACKGROUND: White matter hyperintensities of presumed vascular origin (WMH) are the most prominent imaging feature of cerebral small vessel disease (cSVD). Previous studies suggest a link between cSVD burden and intracerebral hemorrhage and worse functional outcome after thrombolysis in acute ischemic stroke. We aimed to determine the impact of WMH burden on efficacy and safety of thrombolysis in the MRI-based randomized controlled WAKE-UP trial of intravenous alteplase in unknown onset stroke.

METHODS: The design of this post hoc study was an observational cohort design of a secondary analysis of a randomized trial. WMH volume was quantified on baseline fluid-attenuated inversion recovery images of patients randomized to either alteplase or placebo in the WAKE-UP trial. Excellent outcome was defined as score of 0-1 on the modified Rankin Scale after 90 days. Hemorrhagic transformation was assessed on follow-up imaging 24-36 hours after randomization. Treatment effect and safety were analyzed by fitting multivariable logistic regression models.

RESULTS: Quality of scans was sufficient in 441 of 503 randomized patients to delineate WMH. Median age was 68 years, 151 patients were female, and 222 patients were assigned to receive alteplase. Median WMH volume was 11.4 mL. Independent from treatment, WMH burden was statistically significantly associated with worse functional outcome (odds ratio, 0.72 [95% CI, 0.57-0.92]), but not with higher chances of any hemorrhagic transformation (odds ratio, 0.78 [95% CI, 0.60-1.01]). There was no interaction of WMH burden and treatment group for the likelihood of excellent outcome (P=0.443) or any hemorrhagic transformation (P=0.151). In a subgroup of 166 patients with severe WMH, intravenous thrombolysis was associated with higher odds of excellent outcome (odds ratio, 2.40 [95% CI, 1.19-4.84]) with no significant increase in the rate of hemorrhagic transformation (odds ratio, 1.96 [95% CI, 0.80-4.81]).

CONCLUSIONS: Although WMH burden is associated with worse functional outcome, there is no association with treatment effect or safety of intravenous thrombolysis in patients with ischemic stroke of unknown onset.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT01525290.

PMID:37226772 | DOI:10.1161/STROKEAHA.122.040247

Ann Otol Rhinol Laryngol. 2023 May 25:34894231173483. doi: 10.1177/00034894231173483. Online ahead of print.

ABSTRACT

BACKGROUND: Sphenoid and frontal sinuses have narrow ostia and are prone to stenosis. However, their relative rates of patency are not well established, and descriptive rates of sphenoid stenosis have never been reported. The objective is to measure the patency of the sphenoid and frontal sinus ostia postoperatively.

METHODS: A prospective multi-institutional cohort study was performed. Ostial patency was measured at surgery and 3 and 6 months postoperatively. Pertinent clinical history such as the presence of nasal polyps and prior history of ESS as well as the use of steroid eluting stents were recorded. Overall stenosis rates were calculated for both the sphenoid and frontal sinuses, and Wilcoxon-Signed Rank Test was used to compare intraoperative and postoperative ostial areas. Factorial Analysis of Variance (ANOVA) was performed to determine effects of 5 clinical factors.

RESULTS: Fifty patients were included. The mean sphenoid sinus ostial area decreased 42.2% in size from baseline to 3 months postoperatively (T0 55.2 ± 28.7 mm vs T3 m 31.8 ± 25.5 mm, P < .001). The mean frontal sinus ostial area decreased 39.8% in size from baseline to 3 months postoperatively (T0 33.7 ± 17.2 mm vs T3 m 19.9 ± 15.1 mm, P < .001). Neither the sphenoid nor the frontal sinus ostial patency demonstrated statistically significant change from 3 to 6 months postoperatively.

CONCLUSION: Both sphenoid and frontal sinus ostia routinely narrow postoperatively, predominately from baseline to 3 months. These findings can serve as a reference for both clinical outcomes and future studies of these surgeries.

PMID:37226723 | DOI:10.1177/00034894231173483

Oper Dent. 2023 May 23. doi: 10.2341/22-039-L. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable and wear-resistant alternative.

OBJECTIVE: To evaluate and compare the volumetric wear (mm3) of bulk-fill composite resins to a conventional composite resin and enamel after thermo-mechanical loading.

METHODS AND MATERIALS: Five composite resins (n=10) were evaluated: four bulk-fill composite resins (Filtek One Bulk Fill [3M Oral Care], Tetric EvoCeram Bulk Fill [Ivoclar Vivadent], Tetric PowerFill [Ivoclar Vivadent], SonicFill 3 [Kerr Corp]); and one conventional composite resin (Filtek Supreme Ultra [3M Oral Care]). Enamel from recently extracted human teeth was used as a control. Specimens were subjected to a 2-body volumetric wear evaluation using a chewing simulator (CS-4.8, Mechatronik). Disc-shaped specimens (10 mm in diameter × 3 mm in thickness) received 500,000 load cycles against steatite antagonists while simultaneously thermocycled (5000 cycles, 5-55°C). Volumetric wear (mm3) was measured using the Geomagic Control X software (3D Systems) based on digital scans of the specimens obtained before and after thermo-mechanical loading, with a Trios 3 (3Shape) digital scanner. Scanning electron microscopy analysis of wear facets and composite resin filler shape and size was performed. Volumetric wear was statistically analyzed using the one-way ANOVA and Tukey’s post-hoc test (α=0.05).

RESULTS: All tested composite resins wore at rates significantly higher than enamel (p<0.05). The mean volumetric wear of the composite resins ranged from 1.01 mm3 to 1.48 mm3, while enamel had a mean volumetric wear of 0.25 mm3. Bulk-fill composite resins showed higher wear resistance than the conventional composite resin (p<0.05).

CONCLUSIONS: Bulk-fill composite resins showed higher wear resistance than the conventional composite resin, and both types of composite resin were not as wear-resistant as enamel.

PMID:37226712 | DOI:10.2341/22-039-L