Tag: nevin manimala

JAMA Netw Open. 2023 Apr 3;6(4):e236530. doi: 10.1001/jamanetworkopen.2023.6530.

ABSTRACT

IMPORTANCE: The prevalence of antiphospholipid antibodies (aPL) and their association with future atherosclerotic cardiovascular disease (ASCVD) risk has yet to be thoroughly investigated.

OBJECTIVE: To determine the association between measurements of aPL at a single time point and ASCVD risk in a diverse population.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study measured 8 aPL (anticardiolipin [aCL] IgG/IgM/IgA, anti-beta-2 glycoprotein I [aβ2GPI] IgG/IgM/IgA, and antiphosphatidylserine/prothrombin [aPS/PT] IgG/IgM) by solid-phase assays in plasma from participants of the Dallas Heart Study (DHS) phase 2, a multiethnic, population-based cohort study. Blood samples were collected between 2007 and 2009. The median follow-up was 8 years. Statistical analysis was performed from April 2022 to January 2023.

MAIN OUTCOMES AND MEASURES: Associations of aPL with future ASCVD events (defined as first nonfatal myocardial infarction, first nonfatal stroke, coronary revascularization, or death from cardiovascular cause) were assessed by Cox proportional hazards models, adjusting for known risk factors, medications, and multiple comparisons.

RESULTS: Among the 2427 participants (mean [SD] age, 50.6 [10.3] years; 1399 [57.6%] female; 1244 [51.3%] Black, 339 [14.0%] Hispanic, and 796 [32.8%] White), the prevalence of any positive aPL tested at a single time point was 14.5% (353 of 2427), with approximately one-third of those detected at a moderate or high titer; aCL IgM had the highest prevalence (156 individuals [6.4%]), followed by aPS/PT IgM (88 [3.4%]), aβ2GPI IgM (63 [2.6%]), and aβ2GPI IgA (62 [2.5%]). The IgA of aCL (adjusted hazard ratio [HR], 4.92; 95% CI, 1.52-15.98) and aβ2GPI (HR, 2.91; 95% CI, 1.32-6.41) were independently associated with future ASCVD events. The risk further increased when applying a positivity threshold of at least 40 units (aCL IgA: HR, 9.01 [95% CI, 2.73-29.72]; aβ2GPI IgA: HR, 4.09 [95% CI, 1.45-11.54]). Levels of aβ2GPI IgA negatively correlated with cholesterol efflux capacity (r = -0.055; P = .009) and positively correlated with circulating oxidized LDL (r = 0.055; P = .007). aβ2GPI IgA-positive plasma was associated with an activated endothelial cell phenotype as evidenced by increased surface expression of surface E-selectin, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1.

CONCLUSIONS AND RELEVANCE: In this population-based cohort study, aPL detectable by solid-phase assays were present in a substantial proportion of adults; positive aCL IgA and aβ2GPI IgA at a single time point were independently associated with future ASCVD events. Longitudinal studies with serial aPL measurements are needed to further explore these findings.

PMID:37014642 | DOI:10.1001/jamanetworkopen.2023.6530

JAMA Netw Open. 2023 Apr 3;6(4):e236805. doi: 10.1001/jamanetworkopen.2023.6805.

ABSTRACT

IMPORTANCE: Adequate prehospital triage is pivotal to enable optimal care in inclusive trauma systems and reduce avoidable mortality, lifelong disabilities, and costs. A model has been developed to improve the prehospital allocation of patients with traumatic injuries and was incorporated in an application (app) to be implemented in prehospital practice.

OBJECTIVE: To evaluate the association between the implementation of a trauma triage (TT) intervention with an app and prehospital mistriage among adult trauma patients.

DESIGN, SETTING, AND PARTICIPANTS: This population-based, prospective quality improvement study was conducted in 3 of the 11 Dutch trauma regions (27.3%), with full coverage of the corresponding emergency medical services (EMS) regions participating in this study. Participants included adult patients (age ≥16 years) with traumatic injuries who were transported by ambulance between February 1, 2015, and October 31, 2019, from the scene of injury to any emergency department in the participating trauma regions. Data were analyzed between July 2020 and June 2021.

EXPOSURES: Implementation of the TT app and the awareness of need for adequate triage created by its implementation (ie, the TT intervention).

MAIN OUTCOMES AND MEASURES: The primary outcome was prehospital mistriage, evaluated in terms of undertriage and overtriage. Undertriage was defined as the proportion of patients with an Injury Severity Score (ISS) of 16 or greater who were initially transported to a lower-level trauma center (designated to treat patients who are mildly and moderately injured) and overtriage as the proportion of patients with an ISS of less than 16 who were initially transported to a higher-level trauma center (designated to treat patients who are severely injured).

RESULTS: A total of 80 738 patients were included (40 427 [50.1%] before and 40 311 [49.9%] after implementation of the intervention), with a median (IQR) age of 63.2 (40.0-79.7) years and 40 132 (49.7%) male patients. Undertriage decreased from 370 of 1163 patients (31.8%) to 267 of 995 patients (26.8%), while overtriage rates did not increase (8202 of 39 264 patients [20.9%] vs 8039 of 39 316 patients [20.4%]). The implementation of the intervention was associated with a statistically significantly reduced risk for undertriage (crude risk ratio [RR], 0.95; 95% CI, 0.92 to 0.99, P = .01; adjusted RR, 0.85; 95% CI, 0.76-0.95; P = .004), but the risk for overtriage was unchanged (crude RR, 1.00; 95% CI, 0.99-1.00; P = .13; adjusted RR, 1.01; 95% CI, 0.98-1.03; P = .49).

CONCLUSIONS AND RELEVANCE: In this quality improvement study, implementation of the TT intervention was associated with improvements in rates of undertriage. Further research is needed to assess whether these findings are generalizable to other trauma systems.

PMID:37014639 | DOI:10.1001/jamanetworkopen.2023.6805

Aging Clin Exp Res. 2023 Apr 4. doi: 10.1007/s40520-023-02390-2. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative delirium (POD) is a major complication following a surgical procedure. There is evidence that improving knowledge about POD could enhance POD care and patient outcomes.

AIM: The study aimed to evaluate whether the amount of delirium education among registered nurses working in post-anaesthetics care units (PACU) impacts on their self-reported confidence and competence in recognising and managing delirium as well as prior knowledge on factors that influence the risk of delirium onset for older people.

METHOD: The current study utilised an online survey on delirium care practice among registered nurses in PACUs. The survey consisted of 27 items. There were questions about confidence and competence in delirium care, knowledge about delirium risk factors, and ranked responses to two case scenario questions to evaluate the application of POD care. There were also demographic questions, including previous experience with delirium care education.

RESULTS: A total of 336 responses were generated from registered nurses working in PACU. Our findings found substantial variability among the respondents about their delirium care education. The amount of delirium education did not influence the PACU registered nurses’ confidence or competence in delirium care. In addition, previous education did not have an impact on their knowledge about delirium risk factors.

DISCUSSION AND CONCLUSION: These findings suggested that the quantity of prior education about delirium did not improve the confidence, competence, knowledge, or case scenario questions of PACU registered nurses. Thus, delirium care education needs to be transformed to ensure it has a positive effect on delirium care clinical practice by registered nurses in PACU.

PMID:37014618 | DOI:10.1007/s40520-023-02390-2

Aging Clin Exp Res. 2023 Apr 4. doi: 10.1007/s40520-023-02398-8. Online ahead of print.

ABSTRACT

BACKGROUND: Handgrip strength (HGS) is a well-established clinical biomarker that assesses functional capacity in older populations. In addition, HGS is a diagnostic tool that forecasts aging health conditions, such as sarcopenia.

AIMS: This paper provides HGS statistical tolerance regions and presents the need to establish HGS reference values according to patients’ characteristics.

METHODS: For this purpose, we used a conditional tolerance algorithm for HGS, and we observed the tolerances regions in different age strata and sex of non-sarcopenic individuals from the National Health and Nutrition Examination Survey (NHANES, wave 2011-2012).

RESULTS AND DISCUSSION: Our results have critical implications for sarcopenia, since conventional and available HGS cut-offs do not consider age range.

CONCLUSIONS: This paper offers new perspectives on the evolution of traditional definitions of sarcopenia according to the principles of precision medicine.

PMID:37014617 | DOI:10.1007/s40520-023-02398-8

Atten Percept Psychophys. 2023 Apr 4. doi: 10.3758/s13414-023-02703-7. Online ahead of print.

ABSTRACT

The current study aims to explore one factor that likely contributes to these statistical regularities, familiarity. Are highly familiar stimuli perceived more readily? Previous work showing effects of familiarity on perception have used recognition tasks, which arguably tap into post-perceptual processes. Here we use a perceptual task that does not depend on explicit recognition; participants were asked to discriminate whether a rapidly presented image was intact or scrambled. The familiarity level of stimuli was manipulated. Results show that famous or upright orientated logos (Experiments 1 and 2) or faces (Experiment 3) were better discriminated than novel or inverted logos and faces. To further dissociate our task from recognition, we implemented a simple detection task (Experiment 4) and directly compared the intact/scrambled task to a recognition task (Experiment 5) on the same set of faces used in Experiment 3. The fame and orientation familiarity effect were still present in the simple detection task, and the duration needed on the intact/scrambled task was significantly less than the recognition task. We conclude that familiarity effect demonstrated here is not driven by explicit recognition and instead reflects a true perceptual effect.

PMID:37014611 | DOI:10.3758/s13414-023-02703-7

Environ Sci Pollut Res Int. 2023 Apr 4. doi: 10.1007/s11356-023-26578-1. Online ahead of print.

ABSTRACT

PM_2.5 is an important air pollution index, which has been widely concerned. An excellent PM_2.5 prediction system can effectively help people protect their respiratory tract from injury. However, due to the strong uncertainty of PM_2.5 data, the accuracy of traditional point prediction and interval prediction method is not satisfactory, especially for interval prediction, which is usually difficult to achieve the expected interval coverage (PINC). In order to solve the above problems, a new hybrid PM_2.5 prediction system is proposed, which can quantify the certainty and uncertainty of future PM_2.5 at the same time. For point prediction, a multi-strategy improved multi-objective crystal algorithm (IMOCRY) is proposed; the chaotic mapping and screening operator are added to make the algorithm more suitable for practical application. At the same time, the combined neural network based on unconstrained weighting method further improves the point prediction accuracy. For interval prediction, a new strategy is proposed, which uses the combination of fuzzy information granulation and variational mode decomposition to process the data. The high-frequency components are extracted by the VMD method, and then quantified by FIG method. By this way, the fuzzy interval prediction results with high coverage and low interval width are obtained. Through 4 groups of experiments and 2 groups of discussions, the advanced nature, accuracy, generalization, and fuzzy prediction ability of the prediction system are all satisfactory, which verified the effect of the system in practical application.

PMID:37014598 | DOI:10.1007/s11356-023-26578-1

Eur Arch Paediatr Dent. 2023 Apr 4. doi: 10.1007/s40368-023-00794-2. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate and compare the remineralization potential of phosphorylated chitosan nanoparticles (Pchi) and silver diamine fluoride (SDF) compared to sodium fluoride varnish (NaF) on microhardness of artificial carious lesions in a biomimetic minimally invasive approach that is being regarded as the future of preventive dentistry.

METHODS: The sample size included 40 intact extracted maxillary anterior human teeth. Baseline microhardness was recorded using Vickers hardness test and energy-dispersive X-ray spectroscopy (EDX). Artificial caries-like lesions were created on the exposed enamel by suspending all teeth in demineralizing solution for 10 days in a temperature of 37 °C and then the hardness and EDX were remeasured. Samples were then divided into four main groups: Group A (positive control group) n = 10, treated with NaF, Group B n = 10, treated with SDF, Group C n = 10, treated with Pchi and Group D (negative control group) n = 10 that received no treatment. After treatment, samples were incubated in artificial saliva solution at 37 °C in for 10 days and then reassessed. Data were then recorded, tabulated, and statistically analyzed using Kruskal-Wallis test and Wilcoxon signed test. Scanning electron microscope (SEM) was used to analyze the morphological changes of enamel surface after treatment.

RESULTS: Groups B and C showed the highest calcium (Ca) and phosphate (P) content as well as hardness values, while group B had the highest percentage of fluoride. SEM revealed a smooth layer of mineral formed on the surface of enamel for both groups.

CONCLUSION: Pchi and SDF showed the highest increase in enamel microhardness and remineralization potential.

CLINICAL RELEVANCE: The minimally invasive approach for remineralization could be enhanced using SDF and Pchi.

PMID:37014591 | DOI:10.1007/s40368-023-00794-2

Community Ment Health J. 2023 Apr 4. doi: 10.1007/s10597-023-01119-9. Online ahead of print.

ABSTRACT

Individuals with serious mental illness are vulnerable to extreme heat due to biological, social, and place-based factors. We examine the spatial correlation of prevalence of individuals treated at a community mental health center to heat vulnerability. We applied a heat vulnerability index (HVI) to the catchment of the Connecticut Mental Health Center in New Haven, Connecticut. Geocoded addresses were mapped to correlate patient prevalence with heat vulnerability of census tracts. Census tracts closer to the city center had elevated vulnerability scores. Patient prevalence was positively correlated with HVI score (Pearson’s r(44) = 0.67, p < 0.01). Statistical significance persists after correction for spatial autocorrelation (modified t-test p < 0.01). The study indicates that individuals treated at this community mental health center are more likely to live in census tracts with high heat vulnerability. Heat mapping strategies can help communicate risk and target resources at the local scale.

PMID:37014585 | DOI:10.1007/s10597-023-01119-9

Mol Biol Rep. 2023 Apr 4. doi: 10.1007/s11033-023-08387-4. Online ahead of print.

ABSTRACT

BACKGROUND: One of the most common kidney illnesses in developing countries is pediatric nephrotic syndrome (PNS), which is frequently associated with dyslipidemia and edema. The rapid discovery of genes related to NS has aided in the understanding of the molecular mechanics of glomerular filtration. The goal of this study is to determine the relationship between NPHS2 and ACTN4 in PNS youngsters.

METHODS: A study with 100 NS children and 100 healthy matched volunteers was conducted. Genomic DNA was extracted from peripheral blood. Single-nucleotide polymorphisms were genotyped using ARMS-PCR.

RESULTS: A substantial decline in the level of albumin was found in NS cases (P < 0.001) Further on, a significantly difference in T.C and TG level between healthy and NS patient. Molecular study showed a highly significant difference of NS patients from controls regarding NPHS2 rs3829795 polymorphic genotypes as the GA heterozygous genotype shows highly significant difference from controls (P < 0.001) as well as GA + AA genotypes (P < 0.001) in comparison with GG genotype. Regarding rs2274625, The GA heterozygous genotype showed no statistically significant difference between genotypes and alleles with NS (P = 0.246). Association of AG haplotype NPHS2 rs3829795-rs2274625 haplotypes found a significant association with the risk of developing NS (P = 0.008). Concerning the ACTN4 rs121908415 SNP, there was no link between this mutation and NS children.

CONCLUSION: The correlation of AG haplotype NPHS2 rs3829795-rs2274625 haplotypes identified a strong association with the likelihood of getting NS, according to our findings. There was no connection found between the ACTN4 rs121908415 SNP and NS children.

PMID:37014572 | DOI:10.1007/s11033-023-08387-4

Neurosci Bull. 2023 Apr 4. doi: 10.1007/s12264-023-01041-w. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.

PMID:37014553 | DOI:10.1007/s12264-023-01041-w