Tag: nevin manimala

BMJ Open. 2022 Nov 25;12(11):e060049. doi: 10.1136/bmjopen-2021-060049.

ABSTRACT

OBJECTIVES: Patients with systemic lupus erythematosus (SLE) may experience body image disorders, which can adversely affect their physical and mental health. We aimed to assess the body-image-related quality of life of patients with SLE, explore the influencing factors and determine the potential predictors of body image disturbance (BID) in these patients.

DESIGN: Cross-sectional study.

SETTING: The department of rheumatology and immunology in Nantong.

PARTICIPANTS: A convenience sample of 230 patients with SLE.

INTERVENTIONS: The study survey included an assessment of demographic information and evaluations using the Body Image Disturbance questionnaire (BIDQ), Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory-20 and Body Image Quality of Life Inventory (BIQLI).

PRIMARY AND SECONDARY OUTCOME MEASURES: BID scores and their possible predictors. Data were analysed using descriptive statistics, correlational analysis and stepwise multiple linear regression analysis.

RESULTS: The mean BIDQ score and the mean scores for anxiety, depression and fatigue were 23.04 (SD, SD=11.90), 6.94 (SD=4.53), 6.49 (SD=4.51) and 54.21 (SD=11.63), respectively. The mean BIQLI score was 0.31 (SD=16.59). The findings revealed significant correlations with education level, comorbidities, SLE Disease Activity Index (SLEDAI), anxiety, depression, fatigue and BIQLI. Fatigue, depression, presence of comorbidities and SLEDAI were predictors of worsening BID (p<0.05).

CONCLUSION: In our study, the relationship between BIDQ and anxiety, depression, and fatigue was analysed, and predictors of BID were defined. When formulating interventional measures, the patient’s condition should be evaluated, and effective interventions should be implemented to improve the patient’s body image and ultimately improve the patient’s quality of life.

PMID:36428020 | DOI:10.1136/bmjopen-2021-060049

BMJ Open. 2022 Nov 25;12(11):e064673. doi: 10.1136/bmjopen-2022-064673.

ABSTRACT

OBJECTIVE: Antenatal care (ANC) is crucial to protecting the health of pregnant women and their unborn children; however, the uptake of ANC among pregnant women in low and middle-income countries (LMICs) is suboptimal. One popular strategy to increase the uptake of health services, including ANC visits, are conditional cash transfer (CCT) programmes. CCT programmes require beneficiaries to comply with certain conditionalities in order to receive a financial sum. A systematic review was carried out to determine whether CCT programmes have a positive impact on ANC uptake in LMIC populations.

METHODS: Electronic databases CENTRAL, MEDLINE, Embase, Maternity and Infant Care and Global Health were searched from database inception to 21 January 2022. Reference checking and grey literature searches were also applied. Eligible study designs were randomised controlled trials, controlled before-after studies and interrupted time series analysis. Risk of bias assessments were undertaken for each study by applying the Risk of Bias 2 tool and the Risk of Bias in Non-randomised Studies of Interventions tool.

RESULTS: Out of 1534 screened articles, 18 publications were included for analysis. Eight studies reported statistically non-significant results on all reported outcomes. Seven studies demonstrated statistically significant positive effects ranging from 5.5% to 45% increase in ANC service uptake. A further three studies reported small but statistically significant impact of CCT on the use of ANC services in both positive (2.5% increase) and negative (3.7% decrease) directions. Subanalysis of results disaggregated by socioeconomic status (SES) indicated that ANC attendance may be more markedly improved by CCT programmes in low SES populations; however, results were inconclusive.

CONCLUSION: Our evidence synthesis presented here demonstrated a highly heterogeneous evidence base pertaining to the impact of CCTs on ANC attendance. More high-powered studies are required to elucidate the true impact of CCT programmes on ANC uptake, with particular focus on the barriers and enablers of such programmes in achieving intended outcomes.

PMID:36428017 | DOI:10.1136/bmjopen-2022-064673

BMJ Open. 2022 Nov 25;12(11):e060169. doi: 10.1136/bmjopen-2021-060169.

ABSTRACT

OBJECTIVES: The main objective was to investigate 5-year outcomes in patients with knee osteoarthritis, randomised to one of two non-surgical treatments.

SETTING: Two outpatient clinics.

PARTICIPANTS: At baseline, 100 patients with radiographic and symptomatic knee osteoarthritis not found eligible for knee replacement (KR) were included. Main exclusion criteria were average score above 75 of the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales pain, symptoms, function of daily living and quality of life; KOOS₄ and average knee pain the previous week greater than 60 mm on a 100 mm visual analogue scale.

INTERVENTIONS: Patients were randomised to supervised non-surgical treatment consisting of patient education, supervised exercise, weight loss, insoles, and pain medication (the MEDIC treatment) or written advice. The 12-week MEDIC treatment included patient education, neuromuscular exercise, insoles and a dietary weight loss programme and/or pain medication if needed and written advice consisted of two leaflets.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was 5-year mean change for KOOS₄. Secondary outcomes included KOOS subscales, self-reported health, usage of pain medication and self-reported physical activity.

RESULTS: Thirty-nine (78%) and 36 (72%) from the MEDIC and written advice groups responded at 5 years. There were no between-group differences in KOOS₄ (difference 5.3 (95% CI -1.5 to 12.1) or any secondary outcomes. However, the 95% CI included the minimal clinically important difference for the main outcome.Seventy-six percent of the MEDIC group and 66% of the written advice group experienced clinically important improvements in KOOS₄.Fifteen patients (30%) from the MEDIC group and 17 (34%) from the written advice group received KR in the index knee. Undergoing KR did not result in a statistically significant greater improvement in KOOS₄ (difference 6.1 (95% CI -1.1 to 13.4).

CONCLUSIONS: No statistically significant differences between supervised non-surgical treatment and written advice were demonstrated at 5 years. Most patients experienced clinically important improvements, irrespective of initial treatment strategy or KR.

TRIAL REGISTRATION NUMBER: NCT01535001; ClinicalTrials.gov.

PMID:36428014 | DOI:10.1136/bmjopen-2021-060169

Taiwan J Obstet Gynecol. 2022 Nov;61(6):984-988. doi: 10.1016/j.tjog.2021.01.034.

ABSTRACT

OBJECTIVE: To assess whether chronic endometritis (CE) affects embryo implantation in patients with repeated implantation failure (RIF).

MATERIALS AND METHODS: We retrospectively analyzed 126 RIF patients who were never diagnosed with CE and received no prior antibiotic therapy. Endometrial specimens obtained by endometrial scratching during mid-luteal phase were immunostained by CD138, a hallmark plasmacyte marker, to identify CE. Pregnancy outcome in RIF patients who underwent IVF-ET frozen-embryo within transfers 6 months after endometrial scratching was compared between women with and without CE.

RESULTS: The prevalence of CE in patients with RIF was found to be 11.9% (15/126). Moreover, a significantly reduced clinical pregnancy rate was observed in RIF patients with CE (20% vs. 46.85%; p = 0.04). The live birth rate also exhibited a decreasing trend in RIF patients with CE, although there was no statistically significant difference (20% vs. 41.58%; p = 0.109).

CONCLUSIONS: CE may be involved in the failure of embryo implantation and reduced clinical pregnancy outcome in patients with RIF.

PMID:36428002 | DOI:10.1016/j.tjog.2021.01.034

Taiwan J Obstet Gynecol. 2022 Nov;61(6):960-964. doi: 10.1016/j.tjog.2022.06.013.

ABSTRACT

OBJECTIVE: Our aim in this study is to determine the relationship between TPOAb positivity and pregnancy outcomes in the subclinical hypothyroid patient group.

MATERIALS AND METHODS: This study was started with 21,321 pregnant women, but after the exclusion criteria, 11,387 pregnant women were included int his study. Demographic characteristics of each patient group included in the study, such as age, bodymass index (BMI), and laboratory parameters such as complete blood count (hemogram), liver and kidney function tests, type of delivery, birth weight, neonatal intensive care admission, 1st and 5th minute APGAR scores, glucose tolerance test results, whether there was high blood pressure during pregnancy, whether there was premature rupture of membranes were recorded from the hospital information system and patient files.

RESULTS: Pregnant women with subclinical hypothyroidism were divided into groups according to their TPOAb status. When maternal and neonatal outcomes were evaluated between groups; Among these four groups there was a statistically significant difference only in impaired glucose tolerance (IGT) antibody groups with and without subclinical hypothyroidism according to their positivity (p < 0.01). When the euthyroid TPOAb negative group was taken as reference, the risk of impaired and TPOAb positive groups (OR: 1.210; 95% CI: 0.936-1.563; P = 0.145), impaired in the group with subclinical hypothyroidism but TPOAb positivity glucose tolerance 1.358(OR: 1.358); 95% CI: 1.042-1.770; P = 0.023) fold increased by 3.556 (OR: 3.556) in the group with subclinical hypothyroidism and TPOAb positivity; (95% CI: 2.37-5.343; p < 0,001).

CONCLUSION: In ourstudy, there was a significant difference only in terms of IGT between the Groups with and without subclinical hypothyroidism, depending on whether they were positive for TPOAb or not. Therefore, studies in volving larger patient groups are needed.

PMID:36427998 | DOI:10.1016/j.tjog.2022.06.013

Andrology. 2022 Nov 25. doi: 10.1111/andr.13346. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate biopsy represents one of the most frequently performed urologic procedures worldwide and therefore presupposes knowledge on potential effects like on erectile function, especially in extensive or repeated biopsies. The robotic assisted biopsy system (Mona Lisa) offers a minimal invasive approach via only two incision points ensuring maximal accuracy combined with protection of the neurovascular bundle of the prostate.

OBJECTIVE: Our purpose was to analyse the impact of of robotic-assisted transperineal biopsy of the prostate on erectile function.

METHODS: Our prospective study analyses the outcomes of 210 patients, who had undergone minimal-invasive, transperineal robotic assisted biopsy of the prostate at the University Hospital Basel from January 2020 – March 2023 and provided sufficient data. Of these, 157 (74.8%) were included in final analysis.

RESULTS: Mean (range) age, prostate volume, PSA and IIEF-5 score at baseline were 63.8 years (46.1 – 83.6), 46.4 ml (9 – 310), 13.2 ng/ml (0.2 – 561) and 18.8 points (6 – 25), respectively. EF before and one month after intervention was assessed with the IIEF-5 questionnaire for the whole cohort. No significant change of IIEF-5 was observed for the whole cohort with a mean (± SD) decrease of 0.4 (± 3.1) points. Except for patients > 69 years, subgroup analysis revealed no change of IIEF-5 in statistically significant manner for all subgroups. Number of biopsy cores (< 20 and ≥ 20), previous biopsies and active surveillance showed no significant influence.

CONCLUSION: Our results suggest that the minimally invasive and highly precise robotic technique can spare erectile function without limiting the extent of biopsy and without compromising diagnostic accuracy. This article is protected by copyright. All rights reserved.

PMID:36427333 | DOI:10.1111/andr.13346

Sci Adv. 2022 Nov 25;8(47):eabq4609. doi: 10.1126/sciadv.abq4609. Epub 2022 Nov 25.

ABSTRACT

Tumor vasculature is a key component of the tumor microenvironment that can influence tumor behavior and therapeutic resistance. We present a new imaging biomarker, quantitative vessel tortuosity (QVT), and evaluate its association with response and survival in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor (ICI) therapies. A total of 507 cases were used to evaluate different aspects of the QVT biomarkers. QVT features were extracted from computed tomography imaging of patients before and after ICI therapy to capture the tortuosity, curvature, density, and branching statistics of the nodule vasculature. Our results showed that QVT features were prognostic of OS (HR = 3.14, 0.95% CI = 1.2 to 9.68, P = 0.0006, C-index = 0.61) and could predict ICI response with AUCs of 0.66, 0.61, and 0.67 on three validation sets. Our study shows that QVT imaging biomarker could potentially aid in predicting and monitoring response to ICI in patients with NSCLC.

PMID:36427313 | DOI:10.1126/sciadv.abq4609

IEEE Trans Neural Netw Learn Syst. 2022 Nov 25;PP. doi: 10.1109/TNNLS.2022.3223212. Online ahead of print.

ABSTRACT

The feature representation learning process greatly determines the performance of networks in classification tasks. By combining multiscale geometric tools and networks, better representation and learning can be achieved. However, relatively fixed geometric features and multiscale structures are always used. In this article, we propose a more flexible framework called the multiscale dynamic curvelet scattering network (MSDCCN). This data-driven dynamic network is based on multiscale geometric prior knowledge. First, multiresolution scattering and multiscale curvelet features are efficiently aggregated in different levels. Then, these features can be reused in networks flexibly and dynamically, depending on the multiscale intervention flag. The initial value of this flag is based on the complexity assessment, and it is updated according to feature sparsity statistics on the pretrained model. With the multiscale dynamic reuse structure, the feature representation learning process can be improved in the following training process. Also, multistage fine-tuning can be performed to further improve the classification accuracy. Furthermore, a novel multiscale dynamic curvelet scattering module, which is more flexible, is developed to be further embedded into other networks. Extensive experimental results show that better classification accuracies can be achieved by MSDCCN. In addition, necessary evaluation experiments have been performed, including convergence analysis, insight analysis, and adaptability analysis.

PMID:36427283 | DOI:10.1109/TNNLS.2022.3223212

Rev Esc Enferm USP. 2022 Nov 25;56:e20220146. doi: 10.1590/1980-220X-REEUSP-2022-0146en. eCollection 2022.

ABSTRACT

OBJECTIVE: to identify the rate of reactive treponemal and non-treponemal tests in pregnant women during childbirth and to analyze the factors associated with this seroreactivity.

METHOD: this is a cross-sectional, quantitative study with secondary sources of sociodemographic and clinical data on 2,626 pregnant women treated at a public maternity hospital in the interior of São Paulo, in 2020. For statistical analysis, Fisher’s exact test, Mann-Whitney test and the logistic regression model were used. A difference of p < 0.05 was considered statistically significant.

RESULTS: the rate of seropositivity for syphilis among pregnant women in this series was 2.74%. Among the groups with positive and non-reactive tests, marital status, occupation, place of residence and use of licit drugs indicated significant differences, but, in the final model, only unmarried marital status was associated with reactive tests (Odds Ratio: 0.169; Confidence Interval: 0.04-0.72; and p: 0.016).

CONCLUSION: in this study, unmarried marital status was the only independent factor associated with seroreactivity for syphilis. Therefore, it is necessary to create strategies aimed at women in this condition, potentially reducing the rate of congenital syphilis.

PMID:36427270 | DOI:10.1590/1980-220X-REEUSP-2022-0146en

Brain Behav. 2022 Nov 25:e2829. doi: 10.1002/brb3.2829. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to explore simultaneous brain network responses to electroacupuncture stimulation (EAS) at scalp acupoints by accounting for placebo effects.

MATERIALS AND METHODS: Sixty healthy subjects were recruited and randomly divided into two groups: Group 1 and Group 2. Functional magnetic resonance imaging (fMRI) was performed in Group 1 with sham acupuncture stimulation at acupoints Shenting (GV24) and Touwei (ST8) without EAS. Group 2 underwent verum EAS at the same acupoints during fMRI. Independent component analysis was used to analyze the fMRI data. Full-factor statistical analysis was used to compare the differences in fMRI data between the two groups and evaluate the changes in functional connectivity in brain networks after verum electrical stimulation (Group 1 [after sham electrical current stimulation – before sham electrical current stimulation] – Group 2 [after verum electrical current stimulation – before verum electrical current stimulation]) (p <.001, extent threshold k = 20 voxels).

RESULTS: Six brain networks were identified. Significant increased functional connectivity was observed in the right and left executive control networks, sensorimotor network, and attention network, while decreased functional connectivity was mainly found in the default mode network. There were no statistically significant differences in the salience network.

CONCLUSIONS: fMRI with simultaneous EAS provides a method to explore brain network responses due to EAS at scalp acupoints. The networks responsible for cognition are differentially activated by EAS in a coordinated manner.

PMID:36427258 | DOI:10.1002/brb3.2829