Tag: nevin manimala

J Oncol Pharm Pract. 2023 Apr 25:10781552231171699. doi: 10.1177/10781552231171699. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the common occurrence of cetuximab (Cmab)-induced skin toxicity, management strategies are not well established. The traditional mainstay method consists of topical steroids, which, if used excessively, may give rise to other concerns. Alternatively, adapalene can activate epidermal growth factor receptor pathways to potentially alleviate these toxicities.

METHODS: We prospectively studied 31 patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who were eligible to use adapalene gel as a reactive treatment for topical steroid-refractory skin toxicity. For comparison, we retrospectively reviewed 99 patients with R/M SCCHN (historical control cohort) whose skin toxicity was mainly treated with topical steroids. We compared the frequency and severity of Cmab-induced skin toxicity, Cmab therapy status (e.g., dose modification), side effects caused by topical steroids and adapalene gel itself, and other medical interventions.

RESULTS: Adapalene gel was used by eight patients (25.8%) in the prospective cohort. Patients in the historical control cohort more frequently required escalation of topical steroid potency (34.3% vs. 12.9%, p = 0.022). Although there was no statistically significant difference in the frequency of grade ≥3 facial skin rash and paronychia between the two cohorts, the prospective cohort showed a significantly shorter time to complete recovery from grade 2/3 paronychia (16 vs. 47 days, p = 0.017). Further, while no skin infections were observed in the prospective cohort, 13 patients in the historical control cohort developed skin infections, especially periungual infection (0% vs. 13.1%, p = 0.024). In addition, no patients in the prospective cohort received a dose reduction of Cmab due to skin toxicities, compared to 20 patients in the historical control cohort (0% vs. 20.2%, p = 0.003). No apparent adapalene gel-related side effects were observed.

CONCLUSIONS: Adapalene gel may be an effective management option for topical steroid-refractory Cmab-induced skin toxicities and could improve compliance with Cmab therapy.

PMID:37098185 | DOI:10.1177/10781552231171699

Environ Sci Technol. 2023 Apr 25. doi: 10.1021/acs.est.2c09299. Online ahead of print.

ABSTRACT

Acrolein is an identified high-priority hazardous air pollutant ubiquitous in daily life and associated with cardiometabolic risk that attracts worldwide attention. However, the etiology role of acrolein exposure in glucose dyshomeostasis and type 2 diabetes (T2D) is unclear. This repeated-measurement prospective cohort study included 3522 urban adults. Urine/blood samples were repeatedly collected for determinations of acrolein metabolites (N-acetyl-S-(3-hydroxypropyl)-l-cysteine, N-acetyl-S-(2-carboxyethyl)-l-cysteine; acrolein exposure biomarkers), glucose homeostasis, and T2D at baseline and a three-year follow-up. We found that each 3-fold increment in acrolein metabolites was cross-sectionally associated with 5.91-6.52% decrement in homeostasis model assessment-insulin sensitivity (HOMA-IS) and 0.07-0.14 mmol/L, 4.02-4.57, 5.91-6.52, 19-20, 18-19, and 23-31% increments in fasting glucose (FPG), fasting insulin (FPI), HOMA-insulin resistance (HOMA-IR), risks of prevalent IR, impaired fasting glucose (IFG), and T2D, respectively; longitudinally, participants with sustained-high acrolein metabolite levels had increased risks of incident IR, IFG, and T2D by 63-80, 87-99, and 120-154%, respectively (P < 0.05). In addition, biomarkers of heme oxygenase-1 activity (exhaled carbon monoxide), lipid peroxidation (8-iso-prostaglandin-F2α), protein carbonylation (protein carbonyls), and oxidative DNA damage (8-hydroxy-deoxyguanosine) mediated 5.00-38.96% of these associations. Our study revealed that acrolein exposure may impair glucose homeostasis and increase T2D risk via mediating mechanisms of heme oxygenase-1 activation, lipid peroxidation, protein carbonylation, and oxidative DNA damage.

PMID:37098180 | DOI:10.1021/acs.est.2c09299

Breastfeed Med. 2023 Apr 25. doi: 10.1089/bfm.2023.0043. Online ahead of print.

ABSTRACT

Background: Donor human milk (DHM) is the recommended feeding for preterm infants when mother’s own milk is unavailable or insufficient. DHM macronutrient’s variability may have significant implications on preterm growth. Different pooling strategies could be used to improve the macronutrient content, facilitating the achievement of nutritional requirements of preterm. Objective: The aim was to compare the impact of random pooling (RP) and target pooling (TP) strategies on the macronutrient content of DHM and to identify which RP practice allows the achievement of a macronutrient composition as similar as possible to that achievable with TP. Methods: The macronutrient content of 1,169 single-donor pools was analyzed, and a TP strategy combining 2,3,4, or 5 single-donor pools was adopted. On the bases of single-donor pools’ analyses, a simulation of 10,000 randomly selected pools for each configuration of donor considered and for different milk volume proportions was performed. Results: Regardless of the type of strategy and milk volume, as the number of donor per pool increases, the percentage of pools with a macronutrient content equal or higher than the reference values for human milk increases. Conclusion: When a TP strategy is not feasible, a RP strategy combining at least five donors should be performed to obtain a better macronutrient content of DHM.

PMID:37098175 | DOI:10.1089/bfm.2023.0043

R I Med J (2013). 2023 May 1;106(4):35-39.

ABSTRACT

Hospital-associated delirium is common in older adults, especially those with dementia, and is associated with high morbidity and mortality. We performed a feasibility study in the emergency department (ED) to examine the effect of light and/or music on the incidence of hospital- associated delirium. Patients aged ≥ 65 who presented to the ED and tested positive for cognitive impairment were enrolled in the study (n = 133). Patients were randomized to one of four treatment arms: music, light, music and light, and usual care. They received the intervention during their ED stay. In the control group, 7/32 patients developed delirium, while in the music-only group, 2/33 patients developed delirium (RR 0.27, 95% CI 0.06-1.23), and in the light-only group (RR 0.41, 95% CI 0.12-1.46), 3/33 patients developed delirium. In the music + light group, 8/35 patients developed delirium (RR 1.04, 95% CI 0.42–2.55). Providing music therapy and bright light therapy to ED patients was shown to be feasible. Although this small pilot study did not reach statistical significance, there was a trend towards less delirium in the music-only and light-only groups. This study lays the groundwork for future investigation into the efficacy of these interventions.

PMID:37098145

J Appl Gerontol. 2023 Apr 25:7334648231169130. doi: 10.1177/07334648231169130. Online ahead of print.

ABSTRACT

Neighborhood support can improve aging in place for older adults, but research on the role of public housing staff in supporting older tenants is lacking. Twenty-nine participants (janitors, n = 11; maintenance staff, n = 18) collected data about critical situations among older tenants residing in apartments in Sweden. Modifying the Critical Incident Technique (CIT) and applying a mixed-methods design, quantitative and qualitative data were collected and analyzed with descriptive statistics and thematic analysis, integrated through narrative. We found that older tenants asked staff for help with daily tasks. The staff identified CI management dilemmas in meeting older tenants’ support needs while following the housing company’s regulations, maintaining professional responsibilities, respecting individual work attitudes and preferences, and experienced a lack of competencies in some situations. Staff members were responsive to offering support in simple, practical, and emotional situations and in addressing matters they perceived as deficits in social and health services.

PMID:37098132 | DOI:10.1177/07334648231169130

Cornea. 2023 Apr 25. doi: 10.1097/ICO.0000000000003293. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the barriers to accessing the crosslinking service in Auckland, New Zealand.

METHODS: This was a prospective 1-year study of patients at Auckland District Health Board. Studied parameters included age, sex, body mass index, ethnicity, New Zealand Deprivation (NZDep; an area-based measure of socioeconomic status, 1 = low deprivation-10 = high deprivation) score of residence, disease severity (maximum keratometry and thinnest corneal thickness), attendance, distance travelled, car ownership, employment status, and visual outcomes. Statistical analysis was performed using independent t tests, Pearson correlation, independent samples ANOVA, MANCOVA, and binomial logistic regression.

RESULTS: Four hundred fifty-four patients with keratoconus were analyzed and had a mean age of 24.1 ± 0.8 years, mean body mass index of 33.0 ± 9.7 kg/m2, and 43% were female. Pacific Peoples consisted 40.2% of the population; Māori 27.2%; Europeans 21.2%; Asian 9.9%; and Middle Eastern, Latin American, and African (MELAA) 1.3%. The mean distance travelled was 12.5 ± 9.5 km, NZDep score was 6.8 ± 2.6, and attendance was 69.0 ± 42.5%. The lowest attendance was observed in Pacific Peoples (58.9%) and the highest was in Asians (90%) (P = 0.019). The mean worst-eye visual acuity at attendance was 0.75 ± 0.47 logMAR (6/35). Unemployment was associated with worse best-eye visual acuity at FSA (P = 0.01) and follow-up (P < 0.05). Māori and Pacific Peoples had the highest NZDep (P < 0.001), were younger at presentation (P = 0.019), had higher disease severity (P < 0.001), and worse visual acuity (P < 0.001).

CONCLUSIONS: Poor attendance was seen in this cohort. Pacific Peoples and Māori presented younger with worse disease severity and visual acuity but also had the highest nonattendance. These results suggest that deprivation, factors associated with ethnicity, and unemployment are potential barriers to attendance.

PMID:37098115 | DOI:10.1097/ICO.0000000000003293

J Pediatr Gastroenterol Nutr. 2023 Apr 25. doi: 10.1097/MPG.0000000000003808. Online ahead of print.

ABSTRACT

This school-based, cross-sectional study aimed to evaluate whether hypohydration is related to functional constipation and physical activity in school-aged children. The study included 452 students aged 6-12 years. Hypohydration, defined as urinary osmolality >800 mOsm/kg, was more prevalent (p=0.002) in boys (72.1%) than in girls (57.5%). The difference in the prevalence of functional constipation according to sex (20.1% in boys and 23.8% in girls) was not statistically significant (p=0.81). In bivariate analysis, functional constipation was associated with hypohydration in girls (odds ratio [OR]=1.93, 95% confidence interval [CI]: 1.07-3.49), and multiple logistic regression did not reach statistical significance (p=0.082). Low proportions of active commuting to school in both sexes were associated with hypohydration. However, there were no associations between functional constipation, active commuting to school, and physical activity scores. In conclusion, multiple logistic regression did not demonstrate an association between hypohydration and functional constipation in school-aged children.

PMID:37098098 | DOI:10.1097/MPG.0000000000003808

PLoS One. 2023 Apr 25;18(4):e0285078. doi: 10.1371/journal.pone.0285078. eCollection 2023.

ABSTRACT

BACKGROUND: Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors.

METHODS: The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022.

RESULTS: The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues).

CONCLUSIONS: Our findings indicate that people’s reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

PMID:37098092 | DOI:10.1371/journal.pone.0285078

PLoS One. 2023 Apr 25;18(4):e0284695. doi: 10.1371/journal.pone.0284695. eCollection 2023.

ABSTRACT

The accelerated progress in artificial intelligence encourages sophisticated deep learning methods in predicting stock prices. In the meantime, easy accessibility of the stock market in the palm of one’s hand has made its behavior more fuzzy, volatile, and complex than ever. The world is looking at an accurate and reliable model that uses text and numerical data which better represents the market’s highly volatile and non-linear behavior in a broader spectrum. A research gap exists in accurately predicting a target stock’s closing price utilizing the combined numerical and text data. This study uses long short-term memory (LSTM) and gated recurrent unit (GRU) to predict the stock price using stock features alone and incorporating financial news data in conjunction with stock features. The comparative study carried out under identical conditions dispassionately evaluates the importance of incorporating financial news in stock price prediction. Our experiment concludes that incorporating financial news data produces better prediction accuracy than using the stock fundamental features alone. The performances of the model architecture are compared using the standard assessment metrics -Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and Correlation Coefficient (R). Furthermore, statistical tests are conducted to further verify the models’ robustness and reliability.

PMID:37098089 | DOI:10.1371/journal.pone.0284695

PLoS One. 2023 Apr 25;18(4):e0284977. doi: 10.1371/journal.pone.0284977. eCollection 2023.

ABSTRACT

AIMS: To assess the effect of cognitive function, performance of activities of daily living (ADLs), degree of depression, and fear of infection among geriatric patients hospitalized in internal medicine wards for COVID-19 on the duration of hospitalization and in-hospital mortality.

METHODS: This observational survey study was conducted during the second, third, and fourth waves of the COVID-19 pandemic. The study included elderly patients of both sexes, aged ≥ 65 years, hospitalized for COVID-19 in internal medicine wards. The following survey tools were used: AMTS, FCV-19S, Lawton IADL, Katz ADL, and GDS15. The duration of hospitalization and in-hospital mortality were also assessed.

RESULTS: A total of 219 patients were included in the study. The results showed that impaired cognitive function in geriatric patients (AMTS) was associated with higher in-hospital mortality among COVID-19 patients. There was no statistical significance between fear of infection (FCV-19S) and risk of death. The impaired ability to perform complex ADLs (Lawton IADL) before the onset of the disease was not associated with higher in-hospital mortality among COVID-19 patients. The diminished ability to perform basic ADLs (Katz ADL) before the onset of the disease was not associated with higher in-hospital mortality in COVID-19. The degree of depression (GDS15) was not associated with higher in-hospital mortality in COVID-19 patients. Statistically, significantly better survival was observed for patients with normal cognitive function (p = 0.005). No statistically significant differences in survival were observed in relation to the degree of depression or independence in performing ADLs. Cox proportional hazards regression analysis showed a statistically significant effect of age on mortality (p = 0.004, HR 1.07).

CONCLUSION: In this study, we observe that cognitive function impairments and the older age of patients treated for COVID-19 in the medical ward increase the in-hospital risk of death.

PMID:37098083 | DOI:10.1371/journal.pone.0284977