Tag: nevin manimala

BMC Med Educ. 2023 Apr 19;23(1):258. doi: 10.1186/s12909-023-04260-x.

ABSTRACT

BACKGROUND: Inherent features in virtual simulation could be utilised to deliver collaborative global education that is inclusive, accessible, and valued by students and facilitators. The aim of this study was to evaluate the impact of the International Eyecare Community (IEC) platform’s virtual simulated international placements (VSIP) in optometric education.

METHODS: An international, multi-center, cross-sectional mixed methods study with Deakin University, Australia, and the Elite School of Optometry, India, was used to evaluate the impact of VSIP in the IEC using pre-existing deidentified data collected from teaching and learning activities within the optometry course curriculum. Data on students and facilitators perceptions of the VSIP were collected through deidentified transcripts from focus group discussions. The data were interpreted using descriptive statistics and qualitative analysis using constant comparison for thematic analysis.

RESULTS: A total of 64 out of 167 student participants completed survey responses (39%) and 46 out of 167 (28%) completed self-reflective inventories. Focus groups with 6 student participants and 6 facilitator participants were recorded and analysed. Student participants reported the IEC was relevant (98% agreement) and motivated them to apply theoretical knowledge to a clinical context (97% agreement). The themes identified through qualitative analysis were: factors inherent to the virtual simulation that enabled learning through VSIP, the VSIP supported cognitive apprenticeship, VSIP enabled clinical learning for optometric education, VSIP’ role in cross-cultural professional identity development in optometry students.

CONCLUSION: The study found that the VSIP platform helped to motivate students to learn and improve their clinical skills. The VSIP was considered a potential supplement to physical clinical placements and could revolutionize global optometric education by offering co-learning across cultures.

PMID:37072745 | DOI:10.1186/s12909-023-04260-x

BMC Public Health. 2023 Apr 19;23(1):707. doi: 10.1186/s12889-023-15380-w.

ABSTRACT

BACKGROUND: Weight loss is a significant improvement for individuals with overweight or obesity, especially for cardiovascular patients. The driving effects of weight self-perception and attempts to lose weight are vital in weight management, yet weight misperception is a direct culprit for the undesirability of weight control and obesity prevention. This study aimed to investigate weight self-perception and misperception and weight loss attempts in Chinese adults, especially among cardiovascular and non-cardiovascular patients.

METHODS: We collected data from China HeartRescue Global Evaluation Baseline Household Survey 2015. Questionnaires were used to assess self-reported weight and cardiovascular patients. We used kappa statistics to check the consistency between weight self-perception and BMI. Logistic regression models were fitted to identify risk factors associated with weight misperception.

RESULTS: A total of 2690 participants were enrolled in the household survey, while 157 respondents were cardiovascular patients. According to questionnaire results, 43.3% of cardiovascular patients thought they were overweight and obese, while the percentage is 35.3% among non-cardiovascular patients. Kappa statistics indicated higher consistency of self-reported weight and actual weight among cardiovascular patients. Multivariate analysis showed weight misperception was significantly associated with gender, education level, and actual BMI. Lastly, 34.5% of non-cardiovascular patients and 35.0% of cardiovascular patients were trying to lose weight or keep weight. The majority of these people adopted combined strategies of controlling diet and exercise to lose or maintain weight.

CONCLUSIONS: Weight misperception was highly prevalent among cardiovascular or non-cardiovascular patients. Obese respondents, women, and individuals with lower education levels were more vulnerable to make weight misperception. However, no difference in the purpose of weight loss attempts was indicated among cardiovascular and non-cardiovascular patients.

PMID:37072724 | DOI:10.1186/s12889-023-15380-w

Pharmaceut Med. 2023 Apr 19. doi: 10.1007/s40290-023-00470-2. Online ahead of print.

ABSTRACT

Aggregate safety assessment involves evaluation of the totality of safety data to characterize the emerging safety profile of a product. The Drug Information Association-American Statistical Association Interdisciplinary Safety Evaluation scientific working group recently published an approach to developing an Aggregate Safety Assessment Plan (ASAP). Creation of an ASAP facilitates a consistent approach to safety data collection and analysis across studies and minimizes important missing data at the time of regulatory submission. A critical aspect of the ASAP is identification of the Safety Topics of Interest (STOI). The STOI, as defined in the ASAP, comprises adverse events (AEs), which have the potential to impact the benefit: risk profile of a product and typically require specialized data collection or analyses. While there are clear benefits to developing an ASAP for a drug development program, multiple concerns may be encountered with implementation. This article uses the examples of two STOIs to demonstrate the benefits and efficiencies gained with implementation of the ASAP in safety planning as well as in optimally characterizing the emerging safety profile of a product.

PMID:37072647 | DOI:10.1007/s40290-023-00470-2

Lasers Med Sci. 2023 Apr 19;38(1):105. doi: 10.1007/s10103-023-03770-w.

ABSTRACT

The current international guidelines identify tumescent ablative techniques such as laser thermal ablation (EVLA) and radiofrequency (RFA) to be the gold standard in varicose vein surgery. New-generation lasers have been introduced, which have high wavelengths (1940 and 2000 nm) and therefore with a greater affinity for water than the old generation (980- and 1470-nm lasers). The purpose of the study was to evaluate the biological effect and the temperatures produced during the use of lasers with different wavelengths (980, 1470, and 1940 nm) and with optical fibers with different emission (radial diverging at 60° and radial with cylindrical mono-ring) on in vitro model. Porcine liver was used as an in vitro model. The laser control units used had 3 different wavelengths: 980, 1470, and 1940 nm. The optical fibers used were 2: the Corona 360 fiber (mono-ring radial fiber) and the infinite fiber (cylindrical mono-ring fiber). The laser operating parameters used included the delivery of 6 W in continuous wave (CW) mode with a standard 10 s/cm pull-back. Eleven measurements were made for each fiber and for each laser, for a total of 66 measurements. We performed measurements of the maximum transverse diameter produced with laser irradiation to evaluate the biological effectiveness of the treatment. During laser irradiation, we performed measurements of both of the temperatures reached on the external surface of the porcine tissue, near the tip of the laser catheter, and the temperatures reached inside the irradiated tissue by using a digital laser infrared thermometer with apposite probe. The calculation of the statistical significance (p-value) was obtained with the ANOVA method with two between factors. The comparison study of the maximum transverse diameter (DTM) of the lesion produced on the target tissue demonstrated the absence of statistically significant differences between the 1470-nm laser and the 1940-nm laser regardless of the type of fiber used. It was not possible to perform measurements of the maximum transverse diameter produced with the 980-nm laser as this produced no visible effect on the model. The comparison study of the temperatures developed during and immediately after the treatment instead showed higher maximum surface temperatures (TSM) and a higher thermal increase (IT) regardless of the type of fiber used in a statistically significant way (respectively, p 0.002 and 0.012) when using the 980-nm laser versus the 1940-nm laser. Comparing instead the 980-nm laser with 1470 nm, there were no differences in TI recorded during the procedure but a significantly higher VTI (p 0.029). The experiment conducted with the new generation laser, compared with those of the first and second generation, shows how this works overall at lower temperatures with the same effectiveness.

PMID:37072644 | DOI:10.1007/s10103-023-03770-w

Funct Integr Genomics. 2023 Apr 19;23(2):129. doi: 10.1007/s10142-023-01057-5.

ABSTRACT

Psoriasis is a complex genetic skin disorder typically manifested by red, scaly, and itchy plaques most commonly over the scalp, trunk, elbows, and knees. Histopathological features include thickening of the epidermal layer due to hyper-proliferation and abnormal differentiation of epidermal keratinocytes along with infiltration of immune cells in the psoriatic skin. It is a chronic inflammatory relapsing disease, and there is currently no permanent cure for psoriasis. Proper medications can reduce the severity of the disease and improve the quality of life of the patients. While the genetic components of psoriasis pathogenesis are well explored, the full understanding of its epigenetic component remains elusive. Non-coding RNAs (ncRNAs) are documented to regulate various epigenetic processes that lead to the pathogenesis of different diseases including psoriasis. In this review, we have discussed the molecular interplay of different ncRNAs in psoriasis pathogenesis. The roles of microRNAs (miRNAs) in psoriasis are pretty well studied, whereas the roles of long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) are emerging. This review provides ideas covering some of the latest findings of different modes of functions played by those different ncRNAs documented in the literature. As an ever-evolving topic, some works are still ongoing as well as there are several fields that need rigorous scientific ventures. We have proposed the areas which claim more explorations to better understand the roles played by the ncRNAs in psoriasis pathogenesis.

PMID:37072609 | DOI:10.1007/s10142-023-01057-5

Pulm Ther. 2023 Apr 19. doi: 10.1007/s41030-023-00222-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Long-term treatment of pulmonary sarcoidosis with glucocorticoids has been associated with toxicity and other adverse events, highlighting the need for alternative therapies. The goal of this study was to evaluate the efficacy and safety of repository corticotropin injection (RCI, Acthar^® Gel) in patients with pulmonary sarcoidosis and to validate endpoints for use in future clinical trials.

METHODS: In this multicenter, randomized, placebo-controlled trial, subjects received subcutaneous RCI (80 U) twice weekly or matching placebo through 24 weeks in a double-blind treatment phase, followed by an optional 24-week open-label extension. Efficacy was measured by glucocorticoid tapering, pulmonary function tests, chest imaging, patient-reported outcomes, and a novel sarcoidosis treatment score (STS). Safety was assessed by adverse events, physical examinations, vital signs, clinical laboratory abnormalities, and imaging. The study was terminated early due to low enrollment caused by the COVID-19 pandemic, thereby precluding statistical analysis.

RESULTS: Fifty-five subjects were randomized to receive either RCI (n = 27) or placebo (n = 28). Mean STS at week 24 showed greater improvement with RCI (1.4) compared with placebo (0.7). At week 48, those who remained on RCI had an STS of 1.8 compared with 0.9 in those who switched from placebo to RCI. More subjects in the RCI group discontinued glucocorticoids at week 24 compared to the placebo group. Glucocorticoid discontinuation was comparable at week 48 for those who switched from placebo to RCI and those who continued RCI. Similar trends in favor of RCI over placebo were observed with the other efficacy endpoints. No new or unexpected safety signals were identified.

CONCLUSIONS: RCI was safe and well tolerated, with trends in efficacy data suggesting greater improvement with RCI compared to placebo in patients receiving standard-of-care therapy for pulmonary sarcoidosis. The study also provided validation of efficacy endpoints that may be used in larger trials for pulmonary sarcoidosis.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03320070.

PMID:37072607 | DOI:10.1007/s41030-023-00222-2

Lasers Med Sci. 2023 Apr 19;38(1):104. doi: 10.1007/s10103-023-03762-w.

ABSTRACT

Photobiomodulation therapy (PBMT) causes stimulatory effects that raise cell metabolism. The study aimed to evaluate the effects of PBMT on the endothelial function of healthy individuals. It was a controlled, randomized, crossover, triple-blind trial with 22 healthy volunteers (female: 77.3%), aged 25.45 years which were randomly divided into three groups. PBMT with gallium-aluminum-arsenide (GaAlAs) diode laser (810 nm, continuous-wave mode, 1000 mW, 0.28 cm²) was applied over the radial and ulnar artery regions in two parallel spots: group 1-30 J (n = 22, 107 J/cm²) per spot; group 2-60 J (n = 22, 214 J/cm²) per spot; and group 3-placebo (n = 22, sham). The endothelial function was measured before and immediately after PBMT by the flow-mediated dilation technique (%FMD) with high-resolution ultrasound. Statistical analysis was made with ANOVA for repeated measures, the effect size was measured by Cohen’s d, and results are presented as mean and standard error (or 95% confidence intervals). A p-value < 0.05 was considered statistically significant. The %FMD increases 10.4% with 60 J (mean difference = 0.496 mm, 95% CI = 0.42 to 0.57, p < 0.001), 7.3% with 30 J (mean difference = 0.518 mm, 95% CI = 0.44 to 0.59, p < 0.001), and 4.7% with placebo (mean difference = 0.560 mm, 95% CI = 0.48 to 0.63, p < 0.001). We found a small effect size (p = 0.702; d de Cohen = 0.24) without statistical difference between interventions. PBMT with the energy density of 60 J and 30 J did not improve endothelial function.Trial registration number: NCT03252184 (01/09/2017).

PMID:37072603 | DOI:10.1007/s10103-023-03762-w

Arch Gynecol Obstet. 2023 Apr 19. doi: 10.1007/s00404-023-06963-4. Online ahead of print.

ABSTRACT

PURPOSE: Fetal growth restriction (FGR) management and delivery planning is based on a multimodal approach. This meta-analysis aimed to evaluate the prognostic accuracies of the aortic isthmus Doppler to predict adverse perinatal outcomes in singleton pregnancies with FGR.

METHODS: PubMed, EMBASE, the Cochrane Library, ClinicalTrials.gov and Google scholar were searched from inception to May 2021, for studies on the prognostic accuracy of anterograde aortic isthmus flow compared with retrograde aortic isthmus flow in singleton pregnancy with FGR. The meta-analysis was registered on PROSPERO and was assessed according to PRISMA and Newcastle-Ottawa Scale. DerSimonian and Laird’s random-effect model was used for relative risks, Freeman-Tukey Double Arcsine for pooled estimates and exact method to stabilize variances and CIs. Heterogeneity was quantified using I² statistics.

RESULTS: A total of 2933 articles were identified through the electronic search, of which 6 studies (involving 240 women) were included. The quality evaluation of studies revealed an overall acceptable score for study group selection and comparability and substantial heterogeneity. The risk of perinatal death was significantly greater in fetuses with retrograde Aortic Isthmus blood flow, with a RR of 5.17 (p value 0.00001). Similarly, the stillbirth rate was found to have a RR of 5.39 (p value 0.00001). Respiratory distress syndrome had a RR of 2.64 (p value = 0.03) in the group of fetuses with retrograde Aortic Isthmus blood flow.

CONCLUSION: Aortic Isthmus Doppler study may add information for FGR management. However, additional clinical trial are required to assess its applicability in clinical practice.

PMID:37072584 | DOI:10.1007/s00404-023-06963-4

Soc Psychiatry Psychiatr Epidemiol. 2023 Apr 19. doi: 10.1007/s00127-023-02476-2. Online ahead of print.

ABSTRACT

PURPOSE: Mental health research has powerfully documented inequities related to characteristics, such as ethnicity and gender. Yet how and where disparities like unmet need occur have been more elusive. Drawing from a now modest body of research that deployed the Network Episode Model (NEM), we examine how individuals create patterns of response to mental health problems, influenced by the culture and resources embedded in their social networks.

METHODS: The Person-to-Person Health Interview Study (P2P; N ~ 2,700, 2018-2021) provides representative, community-based, NEM-tailored data. Both descriptive, latent class and multinomial regression analyses mark mental health care-seeking patterns, including individuals consulted and activities used, as well as the influence of the structure and cultural content of social networks.

RESULTS: Latent class analysis detected five pathways with good fit statistics. The Networked General Care Path (37.0%) and The Kin General Care Path (14.5%) differ only in whether friends are activated in using the general care sector. The Networked Multi-Sector Care Path (32.5%) and The Saturated Path (12.6%) involve family, friends, and both general and specialty care with only the latter expanding consultation to coworkers and clergy. The Null Path (3.3%), or no contacts, is not used as perceived problem severity increases. Network size and strength are associated with the more complex pathways that activate ties, respectively. Trust in doctors is associated with pathways that include specialty providers but not others at work or church. Race, age, and rural residence have specific pathway effects, while gender has no significant impact.

CONCLUSIONS: Social networks propel individuals with mental health problems into action. Tie strength and trust produce care responses that are fuller and more targeted. Considering the nature of homophily, results also suggest that majority status and college education are clearly implicated in networked pathways. Overall, findings support community-targeted rather than individually based efforts to increase service use.

PMID:37072564 | DOI:10.1007/s00127-023-02476-2

Eur Arch Otorhinolaryngol. 2023 Apr 19. doi: 10.1007/s00405-023-07946-6. Online ahead of print.

ABSTRACT

BACKGROUND: At present, it is still controversial whether lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) in papillary thyroid carcinoma (PTC) patients should be dissected. Failure to dissect metastatic lymph nodes results in continued metastasis from the positive lymph nodes to other regions. Our study aimed to establish a predictive model and predict the probability of metastasis of the lymph nodes posterior to the right recurrent laryngeal nerve (LNM-prRLN) in patients.

METHODS: A total of 309 patients underwent surgery for thyroid cancer between May 2019 and September 2022. The risk factors were identified by univariate and multivariate analyses, and statistically significant risk factors identified in the multivariate analysis were included in the nomogram. We used the calibration curve and the receiver operating characteristic (ROC) curve to verify the accuracy of the prediction model.

RESULTS: Multivariate analysis showed that irregular tumor margins (OR: 3.549, 95% CI 1.294-9.733, P = 0.014), extrathyroidal extension (OR: 4.507, 95% CI 1.694-11.993, P = 0.003), maximum tumor diameter > 1 cm (OR: 5.729, 95% CI 2.617-12.542, P < 0.001), overweight status (OR: 2.296, 95% CI 1.057-4.987, P = 0.036), high total cholesterol level (OR: 5.238, 95% CI 2.304-11.909, P < 0.001), and multifocality (OR: 11.954, 95% CI 5.233-27.305, P < 0.001) were independent risk factors for LNM-prRLN. The area under the ROC curve was 0.927. The calibration curve showed good agreement between the predicted and observed rates of LNM-prRLN.

CONCLUSION: The probability of LNM-prRLN could be predicted by a nomogram based on the statistically significant risk factors identified in the multivariate analysis. This nomogram can guide clinicians when preoperatively evaluating the status of the LN-prRLN with regard to LNM-prRLN in PTC patients. For patients at high risk for LNM-prRLN, the preventive dissection of LN-prRLNs can be considered.

PMID:37072557 | DOI:10.1007/s00405-023-07946-6