Tag: nevin manimala

JMIR Form Res. 2022 Nov 30;6(11):e42126. doi: 10.2196/42126.

ABSTRACT

BACKGROUND: The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)-seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers.

OBJECTIVE: Our primary objective was to describe the associations between the use of web-based methods to seek information about one’s own health and the time since last engaging with a health care provider about one’s own health. Additionally, we aimed to assess participants’ trust in health care organizations to contextualize our findings.

METHODS: We analyzed data from US adults participating in the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Survey (N=1034). Bivariate associations between demographic characteristics and health information-seeking methods were assessed with Pearson chi-squared tests. Bivariate associations of Medical Mistrust Index (MMI) scores with each health information-seeking method and time since provider engagement were assessed with F tests and adjusted Wald tests. We fit a multivariable logistic regression model to assess the association between WHI-seeking within the 12 months prior to survey (alone or in combination with provider-based methods versus provider only) and engagement with a provider more than 1 year prior to the time of survey, adjusting for age, race and ethnicity, sex, education, insurance coverage, and MMI.

RESULTS: Age, race and ethnicity, educational attainment, health insurance source, MMI, and time since provider engagement were each significantly associated with the health information-seeking method in bivariate analyses. Compared to using only provider-based health information seeking methods, WHI-based methods alone or in combination with provider-based methods were associated with a 51% lower likelihood (odds ratio 0.49, 95% CI 0.27-0.87) of engaging with a provider within the previous year. Participants who used WHI-seeking methods alone and those who had not engaged with a health care provider within the previous year demonstrated a higher mean MMI score; however, MMI was not a significant predictor of time since engagement with a provider in the multivariable analysis.

CONCLUSIONS: Our findings from a nationally representative survey suggest that for those who use WHI-seeking methods (alone or in combination with provider-based information-seeking methods), there is a statistically significant lower likelihood of engaging with a provider in a year compared to those who only use provider-based methods. Future research should consider the intent of a person’s visit with a provider, trust in health care systems, methods of provider engagement, and specific web-based platforms for health information.

PMID:36449328 | DOI:10.2196/42126

Phys Chem Chem Phys. 2022 Nov 30. doi: 10.1039/d2cp04236c. Online ahead of print.

ABSTRACT

The relationship between protein sequence and its thermodynamic stability is a critical aspect of computational protein design. In this work, we present a new theoretical method to calculate the free energy change (ΔΔG) resulting from a single-point amino acid mutation to alanine in a protein sequence. The method is derived based on physical interactions and is very efficient in estimating the free energy changes caused by a series of alanine mutations from just a single molecular dynamics (MD) trajectory. Numerical calculations are carried out on a total of 547 alanine mutations in 19 diverse proteins whose experimental results are available. The comparison between the experimental ΔΔG_exp and the calculated values shows a generally good correlation with a correlation coefficient of 0.67. Both the advantages and limitations of this method are discussed. This method provides an efficient and valuable tool for protein design and engineering.

PMID:36449314 | DOI:10.1039/d2cp04236c

J Clin Ultrasound. 2022 Nov 30. doi: 10.1002/jcu.23409. Online ahead of print.

ABSTRACT

OBJECTIVE: The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non-invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis.

METHOD: 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography.

RESULTS: Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p < 0.001).

CONCLUSION: Our study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients.

PMID:36449313 | DOI:10.1002/jcu.23409

J Sex Res. 2022 Nov 30:1-12. doi: 10.1080/00224499.2022.2148240. Online ahead of print.

ABSTRACT

Up to 8% of cisgender women meet diagnostic criteria for Female Sexual Interest/Arousal Disorder (SIAD), a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, yet treatment research for SIAD remains scarce, particularly for transgender women and non-binary individuals. The treatment relevance of the Approach-Avoidance Motivation Model for SIAD was tested in a sample of cis- and transgender women, and non-binary individuals, who either met criteria for SIAD (n = 45) or reported no sexual concerns (n = 76). Participants completed an online writing exercise previously found to increase the salience of approach or avoidance sexual motivation, or a control writing task. At baseline, and 72 hours following the writing task, they completed measures of sexual motivation, sexual desire, and partnered sexual behaviors. Participants with SIAD in the approach condition significantly increased in approach sexual motivation immediately following the manipulation but these improvements were not maintained 72 hours later. Compared to baseline, participants who wrote about an approach-motivated sexual encounter experienced a decrease in sexual desire and partnered sexual behaviors, while participants who wrote about an avoidance-motivated sexual encounter had decreased motivation but increased partnered sexual behaviors 72 hours following the manipulation. Overall, findings did not show support for the relevance of the approach-avoidance motivation manipulation for SIAD. Future studies might explore novel ways of targeting sexual motivation to address sexual difficulties.

PMID:36449295 | DOI:10.1080/00224499.2022.2148240

JAMA Netw Open. 2022 Nov 1;5(11):e2244350. doi: 10.1001/jamanetworkopen.2022.44350.

ABSTRACT

IMPORTANCE: To optimize palliative care in patients with cancer who are in their last year of life, timely and accurate prognostication is needed. However, available instruments for prognostication, such as the surprise question (“Would I be surprised if this patient died in the next year?”) and various prediction models using clinical variables, are not well validated or lack discriminative ability.

OBJECTIVE: To develop and validate a prediction model to calculate the 1-year risk of death among patients with advanced cancer.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter prospective prognostic study was performed in the general oncology inpatient and outpatient clinics of 6 hospitals in the Netherlands. A total of 867 patients were enrolled between June 2 and November 22, 2017, and followed up for 1 year. The primary analyses were performed from October 9 to 25, 2019, with the most recent analyses performed from June 19 to 22, 2022. Cox proportional hazards regression analysis was used to develop a prediction model including 3 categories of candidate predictors: clinician responses to the surprise question, patient clinical characteristics, and patient laboratory values. Data on race and ethnicity were not collected because most patients were expected to be of White race and Dutch ethnicity, and race and ethnicity were not considered as prognostic factors. The models’ discriminative ability was assessed using internal-external validation by study hospital and measured using the C statistic. Patients 18 years and older with locally advanced or metastatic cancer were eligible. Patients with hematologic cancer were excluded.

MAIN OUTCOMES AND MEASURES: The risk of death by 1 year.

RESULTS: Among 867 patients, the median age was 66 years (IQR, 56-72 years), and 411 individuals (47.4%) were male. The 1-year mortality rate was 41.6% (361 patients). Three prediction models with increasing complexity were developed: (1) a simple model including the surprise question, (2) a clinical model including the surprise question and clinical characteristics (age, cancer type prognosis, visceral metastases, brain metastases, Eastern Cooperative Oncology Group performance status, weight loss, pain, and dyspnea), and (3) an extended model including the surprise question, clinical characteristics, and laboratory values (hemoglobin, C-reactive protein, and serum albumin). The pooled C statistic was 0.69 (95% CI, 0.67-0.71) for the simple model, 0.76 (95% CI, 0.73-0.78) for the clinical model, and 0.78 (95% CI, 0.76-0.80) for the extended model. A nomogram and web-based calculator were developed to support clinicians in adequately caring for patients with advanced cancer.

CONCLUSIONS AND RELEVANCE: In this study, a prediction model including the surprise question, clinical characteristics, and laboratory values had better discriminative ability in predicting death among patients with advanced cancer than models including the surprise question, clinical characteristics, or laboratory values alone. The nomogram and web-based calculator developed for this study can be used by clinicians to identify patients who may benefit from palliative care and advance care planning. Further exploration of the feasibility and external validity of the model is needed.

PMID:36449290 | DOI:10.1001/jamanetworkopen.2022.44350

J Sports Med Phys Fitness. 2022 Nov 30. doi: 10.23736/S0022-4707.22.14285-4. Online ahead of print.

ABSTRACT

BACKGROUND: Running is a common physical activity of an aerobic nature that is carried out mostly outdoors and presents a healthy lifestyle. However, the positive effect of running often masks the downsides of potential addiction that can compromise an individual’s physical, mental, and social functioning. Most often there is a thin and unclear line separating passionate athletes and running addicts. Thus, it is necessary to educate the running community to raise awareness of the negative effects of over-training, prevent complications and injuries and to seek the necessary help.

METHODS: The study sample consisted of runners from the Croatian population of both genders, aged 18 to 75, who have been running for more than a year. The respondents were divided into groups according to the favorite length of the racing race. Groups were compared in terms of nutritional supplements usage, running-related injuries, as well as the impact of Covid-19 pandemic on their running volume. Difference between groups in Exercise Addiction Inventory (EAI) questionnaire outcome scores was also accessed.

RESULTS: The statistical analysis included the answers of 644 people of both genders, among which 309 (48%) men and 335 (52%) women. The average age of the respondents was 42 years (18-75), and the average age of running was 5 years (1-42). Only among the respondents who started running most recently (1 to 10 years), and those who run the longest races (longer than 100 km) were found to use nutritional supplements significantly more (71.43%, P<0.001) and sustained injuries associated with running more than rest of the groups (100%, P=0.013). Due to the pandemic, only respondents who have been running for the longest time (31-42 years) and prefer to run races from 21 to 42 km significantly reduced the amount of training (75%, P=0.037). The risk for addiction was significantly positively associated with the use of dietary supplements, the favorite length of the race and the frequency of injuries, while there was no association with the length of running.

CONCLUSIONS: Running is a high-risk sport for addiction development. All the benevolent attitudes and positive effects of running often mask the downsides of addiction that can compromise an individual and his or her physical, mental, and social functioning. Due to the high percentage of addiction risk of 25%, it is necessary to educate the racing community to raise awareness of the negative effects of overtraining, prevent complications and seek the necessary help.

PMID:36449271 | DOI:10.23736/S0022-4707.22.14285-4

Ophthalmol Ther. 2022 Nov 30. doi: 10.1007/s40123-022-00611-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Lenadogene nolparvovec is a promising novel gene therapy for patients with Leber hereditary optic neuropathy (LHON) carrying the m.11778G>A ND4 mutation (MT-ND4). A previous pooled analysis of phase 3 studies showed an improvement in visual acuity of patients injected with lenadogene nolparvovec compared to natural history. Here, we report updated results by incorporating data from the latest phase 3 trial REFLECT in the pool, increasing the number of treated patients from 76 to 174.

METHODS: The visual acuity of 174 MT-ND4-carrying patients with LHON injected in one or both eyes with lenadogene nolparvovec from four pooled phase 3 studies (REVERSE, RESCUE and their long-term extension trial RESTORE; and REFLECT trial) was compared to the spontaneous evolution of an external control group of 208 matched patients from 11 natural history studies.

RESULTS: Treated patients showed a clinically relevant and sustained improvement in their visual acuity when compared to natural history. Mean improvement versus natural history was – 0.30 logMAR (+ 15 ETDRS letters equivalent) at last observation (P < 0.01) with a maximal follow-up of 3.9 years after injection. Most treated eyes were on-chart as compared to less than half of natural history eyes at 48 months after vision loss (89.6% versus 48.1%; P < 0.01) and at last observation (76.1% versus 44.4%; P < 0.01). When we adjusted for covariates of interest (gender, age of onset, ethnicity, and duration of follow-up), the estimated mean gain was – 0.43 logMAR (+ 21.5 ETDRS letters equivalent) versus natural history at last observation (P < 0.0001). Treatment effect was consistent across all phase 3 clinical trials. Analyses from REFLECT suggest a larger treatment effect in patients receiving bilateral injection compared to unilateral injection.

CONCLUSION: The efficacy of lenadogene nolparvovec in improving visual acuity in MT-ND4 LHON was confirmed in a large cohort of patients, compared to the spontaneous natural history decline. Bilateral injection of gene therapy may offer added benefits over unilateral injection.

TRIAL REGISTRATION NUMBERS: NCT02652780 (REVERSE); NCT02652767 (RESCUE); NCT03406104 (RESTORE); NCT03293524 (REFLECT); NCT03295071 (REALITY).

PMID:36449262 | DOI:10.1007/s40123-022-00611-x

Jpn J Radiol. 2022 Nov 30. doi: 10.1007/s11604-022-01364-0. Online ahead of print.

ABSTRACT

PURPOSE: Amyloid light chain (AL) and transthyretin (ATTR) are the major subtypes of cardiac amyloidosis (CA). ^99mTc-pyrophosphate (PYP) scintigraphy is used to differentiate ATTR from other CA subtypes. We adapted the standardized uptake value (SUV) for ^99mTc-PYP and proposed two quantitative indices, amyloid deposition volume (AmyDV) and total amyloid uptake (TAU). This study aimed to evaluate the utility of these quantitative indices in differentiating ATTR from non-ATTRs.

MATERIALS AND METHODS: Before the SUV measurement, the Becquerel calibration factor (BCF) of ^99mTc was obtained by a phantom experiment. Thirty-two patients who had undergone hybrid SPECT/CT imaging 3 h after injection of ^99mTc-PYP (370 MBq) were studied. CT attenuation correction for image reconstruction was applied in all. We calculated SUV, AmyDV, and TAU using a quantitative analysis software program for bone SPECT (GI-BONE) and analyzed AmyDV using two methods: threshold method (set 40%); and constant value method (average SUV_max of ribs). We assessed the diagnostic ability of heart-to-contralateral lung (H/CL) ratio, SUV, AmyDV, and TAU to differentiate ATTR from non-ATTR using receiver operating characteristic (ROC) analysis.

RESULTS: Statistically significant differences in all quantitative indices were observed between ATTR and non-ATTR. The area under the curve of each quantitative index for discriminating between ATTR and non-ATTR were as follows: H/CL, 0.997; SUV_max, 0.953; SUV_mean (M1), 0.964; SUV_mean (M2), 0.969; AmyDV (M1), 0.875; AmyDV (M2), 0.974; and TAU, 0.974. The AmyDV (M2) had higher diagnostic ability than AmyDV (M1). Thus, TAU was calculated as AmyDV (M2) × SUV_mean (M2). In the ROC curve, SUV, AmyDV, and TAU had almost the same diagnostic ability as H/CL in distinguishing ATTR from non-ATTRs.

CONCLUSIONS: We propose two novel 3D-based quantitative parameters (AmyDV and TAU) that have almost equal ability to discriminate ATTR from non-ATTR.

PMID:36449252 | DOI:10.1007/s11604-022-01364-0

Environ Sci Pollut Res Int. 2022 Nov 30. doi: 10.1007/s11356-022-24376-9. Online ahead of print.

ABSTRACT

Over the years, the development of marine economy has been an important component of coastal cities’ total economic growth in China. Whether the coastal cities had paid enough attention to the coordination of marine economic development and ecological environment protection in the process of marine development activities needed to be evaluated accordingly. An index evaluation system for the coordination between marine ecological environment protection and marine economic development in coastal cities of China was established in this work by using the analytic hierarchy process. The statistical analysis results from 2006 to 2018 showed that much more attention had been paid on marine ecological environment protection since the year 2012 in China. The evaluated results showed that among all coastal provinces and cities, Shanghai and Shandong Provinces had the best coordination between marine economic development and marine ecological environment protection in the year 2016. Years of data showed that marine economic development and marine ecological environmental protection complement each other and promote each other. At the same time, the analysis results of this indicator evaluation system showed that marine ecological environment protection in China should further strengthen the protection by preventing and controlling marine pollution and carrying out ecological restoration.

PMID:36449239 | DOI:10.1007/s11356-022-24376-9

J Dent Educ. 2022 Nov 30. doi: 10.1002/jdd.13146. Online ahead of print.

ABSTRACT

OBJECTIVES: Oral and maxillofacial surgeons (OMS) treat adult and pediatric patients with obstructive sleep apnea (OSA). Objective 1 assessed sleep apnea-related education, knowledge, and professional behavior of OMS residents in the United States. Objective 2 was to compare the responses of junior versus senior residents and residents in single- versus dual-degree programs.

METHODS: OMS residents in the United States received a recruitment email with a link to an anonymous online survey; 81 residents responded. The survey included 20 questions to assess respondents’ OSA-related education, knowledge, attitudes, and professional behavior.

RESULTS: Respondents generally agreed that they had received OSA-related didactic-based education (5-point scale with “5” = agree strongly: mean = 3.62) and clinical training (mean = 3.75). Clinical and classroom educational gaps were identified in relation to treatment with oral appliances and hypoglossal nerve stimulation. The residents scored on average 10.38 out of 18 (58%) possible correct answer points for the knowledge questions. Findings about pediatric OSA suggest that only 43.8% of residents understand diagnostic criteria for pediatric OSA, with only 26.6% screening pediatric patients for OSA. A case analysis showed that only 1.5% of residents correctly identified an apnea-hypopnea index of 17 as moderate sleep apnea.

CONCLUSION(S): This survey found knowledge gaps in several areas that can be improved upon. It identifies deficiency in objective knowledge about OSA among OMS residents and a specific lack of clinical training and confidence with hypoglossal nerve stimulation and management of pediatric patients with OSA. Junior and senior residents and single- and dual-degree residents showed no statistically significant differences in any category except senior residents in regard to surgical management of OSA, particularly with maxillomandibular advancement.

PMID:36449210 | DOI:10.1002/jdd.13146