Tag: nevin manimala

Telemed J E Health. 2022 Oct 28. doi: 10.1089/tmj.2022.0193. Online ahead of print.

ABSTRACT

Background: Telehealth has seen breakthroughs in many fields of medicine, but utilization remains limited in orthopedic sports medicine. The purpose of this investigation was to compare patient satisfaction, duration of care, and overall patient experiences with telehealth and in-person clinical visits for sports-related injuries. Methods: A cross-sectional survey study was conducted at an orthopedic sports medicine clinic during the peak of the COVID-19 pandemic between March and November 2020. Anonymous electronic surveys were used to record patient responses and statistical comparisons were drawn through two-sample t-tests. Results: A total of 175 patients (82 telehealth vs. 93 in-person) consented to participate in this investigation, and all were included in the final analysis. The overall composite satisfaction score, when compared between the two groups, did not differ (p = 0.63). Duration of care was significantly longer in the 93 patients who had in-person clinical visits as compared with the 82 patients who had telehealth visits (61/93: >31 min vs. 75/82: <30 min; p < 0.001). Finally, of the 82 patients who had telehealth, 3 respondents said they were “very unlikely” and “unlikely” to request another virtual clinical visit and/or recommend this mode of health care delivery to friends or family. Of the 93 patients had in-person clinical visits, only 15 respondents stated they were uninterested in telehealth under any circumstance. Conclusion: Most patients presenting to an orthopedic sports medicine clinic are open to telehealth, recognize its utility, and believe it to be just as comparable with in-person clinical visits. Level of Evidence: IV.

PMID:36315167 | DOI:10.1089/tmj.2022.0193

J Cardiovasc Surg (Torino). 2022 Oct 31. doi: 10.23736/S0021-9509.22.12437-7. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiac surgery is performed worldwide to treat severe cases of cardiovascular diseases. Statins have shown controversial effects on complications after cardiac surgeries. We aimed to investigate the effect of preoperative statin therapy on the frequency of postoperative mortality, renal, and neurological complications.

METHODS: In a retrospective cohort study, the database of patients operated on in two hospitals in southern Iran during 2008-2019 was used to compare preoperative statin use with no use on the composite outcome of mortality, renal, and neurological complications as well as on each component of the composite, separately. Effects of low dose (<40 mg simvastatin equivalence) vs. high dose (≥40 mg) statins were also evaluated. Confounders that could affect the outcomes were considered in the logistic regression model, and multiple imputation techniques were used to categorize patients with unknown statin dose use as either high or lowdose users.

RESULTS: Of total 7329 patients, 17.6% of statin users and 17% of non-statin users developed the composite outcome (P=0.51). Statin use had no statistically significant association with the composite outcome (aRR 1.01 [95% CI: 0.88-1.16]). There was no significant association with mortality [aRR: 0.75 (95% CI: 0.34-1.69)], neurological [aRR: 1.25 (95% CI: 0.77-2.12)], or renal complications [aRR: 1.03 (95% CI 0.90-1.19)] after surgery. Neither low nor high doses had any statistically significant effect on the composite or any of its components.

CONCLUSIONS: In this large study, preoperative statin use, either high dose or low dose, did not affect short-term postoperative mortality, neurological, or renal complications.

PMID:36315166 | DOI:10.23736/S0021-9509.22.12437-7

JAMA Netw Open. 2022 Oct 3;5(10):e2237600. doi: 10.1001/jamanetworkopen.2022.37600.

ABSTRACT

IMPORTANCE: Preterm birth (PTB) is the leading cause of infant morbidity and mortality worldwide. It has been suggested that vaginal progesterone (VP) treatment may reduce the recurrence of PTB.

OBJECTIVE: To evaluate the association of VP treatment with prevention of recurrent PTB among patients with a singleton pregnancy.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, observational cohort study, set in a public health care system for inner-city pregnant patients, enrolled patients with prior spontaneous PTB (gestational age, ≤35 weeks) receiving VP from May 15, 2017, to May 7, 2019. Patients who delivered between 1998 and 2011 served as a referent cohort matched 3:1 for obesity, race and ethnicity, and individual specific preterm birth history. Statistical analysis was performed from August 19, 2021, to September 2, 2022.

EXPOSURE: Patients received 90 mg of vaginal progesterone, 8%, nightly, initiated between 16 weeks and 0 days and 20 weeks and 6 days of pregnancy until 36 weeks and 6 days of pregnancy or delivery.

MAIN OUTCOMES AND MEASURES: The primary outcome was overall rate of recurrent PTB at 35 weeks or less of patients given VP compared with the 3:1 matched untreated historical controls. Secondary outcomes included assessment of PTB according to adherence (≥80% completing scheduled doses), duration of pregnancy relative to index gestational age, progesterone blood levels, and outcomes for those who declined VP.

RESULTS: A total of 417 patients (mean [SD] age, 30.4 [5.9] years; 64 Black patients [15.3%]; 272 [65.2%] with a body mass index of ≥30) received VP and were matched with 1251 controls (mean [SD] age, 28.8 [5.7] years; 192 Black patients [15.3%]; 816 [65.2%] with a body mass index of ≥30). The overall rate of recurrent PTB was 24.0% (100 of 417; 95% CI, 20.0%-28.4%) for the VP cohort compared with 16.8% (1394 of 8278) expected in the matched historical controls. Adherence was not associated with lower rates of recurrent PTB compared with nonadherence (odds ratio, 0.87 [95% CI, 0.51-1.41]). The mean difference between historical matched controls and those using VP was 0.2 weeks (95% CI, -1.4 to 1.0 weeks) without improvement in the interval of recurrent PTB after the implementation of VP (P = .73). Progesterone blood levels for patients who were adherent compared with those who were nonadherent were not significantly different at either 24 or 32 weeks (24 weeks: 99 ng/mL [95% CI, 85-121 ng/mL] vs 104 ng/mL [95% CI, 89-125 ng/mL]; P = .16; 32 weeks: 200 ng/mL [95% CI, 171-242 ng/mL] vs 196 ng/mL [95% CI, 155-271 ng/mL]; P = .69).

CONCLUSIONS AND RELEVANCE: This cohort study of patients with a current singleton pregnancy suggests that VP was not associated with a reduction in recurrent PTB.

PMID:36315147 | DOI:10.1001/jamanetworkopen.2022.37600

JAMA Netw Open. 2022 Oct 3;5(10):e2239616. doi: 10.1001/jamanetworkopen.2022.39616.

ABSTRACT

IMPORTANCE: Prevalence of childhood parental death varies by race and ethnicity and socioeconomic status, yet whether similar variation persists in the association with lifetime psychiatric disorder is unknown.

OBJECTIVE: To assess whether race and ethnicity and parental educational attainment are associated with the risk of death of a parent; to determine whether the risk for lifetime psychiatric disorder associated with death of a parent was moderated by race and ethnicity and highest parental educational attainment; and to examine a potential intersection of race and ethnicity with parental educational attainment in the risk of lifetime psychiatric disorder associated with death of a parent.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from the National Comorbidity Study: Adolescent Supplement (NCS-A), 2001 to 2004. Participants included youth aged 13 to 18 years, restricted to Black, Hispanic, and White youth due to power limitations. Data were analyzed from February 26, 2021, to April 21, 2022.

EXPOSURE: Death of a parent during childhood.

MAIN OUTCOMES AND MEASURES: The primary study outcome was any lifetime Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) psychiatric disorder, assess via assessed via structured clinical interviews.

RESULTS: Among 9501 youth (mean [SD] age, 15.2 [1.5] years; 50.9% female), including 511 youth who had experienced parental death and 8990 youth who had not, the cumulative hazard of parental death by age 18 years was approximately doubled for Hispanic (10.1%; 95% CI, 6.9%-14.7%) and Black (14.0%; 95% CI, 10.6%-18.4%) youth compared with White youth (6.0%; 95% CI, 4.7%-7.8%). Similar patterns were noted by parental educational attainment: the cumulative hazard of parental death for youth of parents with less educational attainment was nearly double (10.1%; 95% CI, 8.1%-12.6%) compared with youth of parents with more education (6.6%; 95% CI, 5.2%-8.4%). Death of a parent was positively and significantly associated with risk of any lifetime psychiatric disorder (aOR, 1.34; 95% CI, 1.03-1.75) compared with youth who had not experienced death of a parent. However, this association was not moderated by race and ethnicity (aOR, 1.05; 95% CI, 0.58-1.92) or parental educational attainment (aOR, 1.19; 95%, 0.70-2.04), although power analyses suggest that larger sample sizes are needed.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, Black and Hispanic youth experienced elevated parental death compared with White youth, yet the risk for any lifetime psychiatric disorder after parental death was not significantly moderated by race and ethnicity or parental education. Both individual- and population-level interventions may be needed to address the increased risk of psychiatric disorders, although additional studies with larger sample sizes are needed.

PMID:36315141 | DOI:10.1001/jamanetworkopen.2022.39616

J Magn Reson Imaging. 2022 Oct 31. doi: 10.1002/jmri.28504. Online ahead of print.

ABSTRACT

BACKGROUND: Ferumoxytol, an intravenous iron supplement, is commonly used to treat anemia in pregnancy. Ferumoxytol-enhanced magnetic resonance angiography (Fe-MRA) is a viable off-label alternative to gadolinium-enhanced MRA for assessment of pulmonary embolism (PE) in pregnancy.

PURPOSE: To describe our clinical experience with Fe-MRA in pregnant women with suspected PE.

STUDY TYPE: Retrospective, observational, cohort.

POPULATION: A total of 98 Fe-MRA exams (consecutive sample) performed in 94 pregnant women.

FIELD STRENGTH/SEQUENCE: A 1.5 T and 3.0 T, 3D T1-weighted MRA.

ASSESSMENT: After IRB approval including a waiver of informed consent, electronic health records were reviewed retrospectively for all Fe-MRA exams performed at our institution in pregnant between January, 2017 and March, 2022. The Fe-MRA protocol included 3D-MRA for assessment of pulmonary arteries, and T1-weighted imaging for ancillary findings. Fe-MRA exam duration was measured from image time stamps. Fe-MRA exams were reviewed by three cardiovascular imagers using a 4-point Likert scale for image quality and confidence for PE diagnosis (score 4 = best, 1 = worst), and tabulation of ancillary findings.

STATISTICAL TESTS: Continuous data are presented as mean ± standard deviation. The overall image quality and confidence score is given as the mean of three readers.

RESULTS: The 98 Fe-MRA exams were performed in 94 pregnant women (age 30 ± 6, range 19-48 years, gestational week 23 ± 10, range 3-38 weeks), with four undergoing two Fe-MRA exams during their pregnancy. Median Fe-MRA exam durration was 8 minutes (interquantile range 6 minutes). Overall image quality score was 3.3 ± 0.9. Confidence score for diagnosing PE was 3.5 ± 0.8. One subject was positive for PE (1/94, 1%); 42 of the 94 (45%) subjects Fe-MRA had ancillary findings including hydronephrosis or pneumonia.

CONCLUSION: Ferumoxytol enhanced MRA is a radiation- and gadolinium-free alternative for diagnosis of PE during pregancy.

EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 5.

PMID:36315131 | DOI:10.1002/jmri.28504

Clin Exp Dent Res. 2022 Oct 31. doi: 10.1002/cre2.657. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study is to find out the levels of serum vitamin D in periodontitis patients with and without type 2 diabetes and to compare them with healthy subjects.

METHODS: In this study, 48 periodontitis patients with type 2 diabetes mellitus (PDM), 53 periodontitis patients (P), and 42 controls who were in the age ranges of 30-50 years and had the entry requirements were selected. Plaque index, calculus index, modified gingival index, pocket depth, clinical attachment loss (CAL), and tooth loss were measured. Serum 25(OH)D level was estimated by electrochemiluminescence immunoassay, and fasting blood sugar and glycosylated hemoglobin were estimated by biochemical colorimetric assays.

RESULTS: The mean serum 25(OH)D level was 17.06 ± 10.73, 15.12 ± 7.74, and 14.17 ± 11.04 ηg/ml for PDM, P, and control groups, respectively, showing no statistical difference. The mean CAL was significantly high in diabetic patients as compared to other groups. Prediabetes prevalence was significantly high in periodontitis patients as compared to controls.

CONCLUSIONS: The prevalence of vitamin D insufficiency was high in the population studied. Serum levels of 25(OH)D showed no significant difference between groups. Periodontitis patients showed an elevated risk for diabetes.

PMID:36315109 | DOI:10.1002/cre2.657

J Clin Psychopharmacol. 2022 Oct 31. doi: 10.1097/JCP.0000000000001620. Online ahead of print.

NO ABSTRACT

PMID:36315070 | DOI:10.1097/JCP.0000000000001620

Plant Physiol. 2022 Oct 31:kiac509. doi: 10.1093/plphys/kiac509. Online ahead of print.

ABSTRACT

Methyl salicylate imparts a potent flavor and aroma described as medicinal and wintergreen that is undesirable in tomato(Solanum lycopersicum) fruit. Plants control the quantities of methyl salicylate through a variety of biosynthetic pathways, including the methylation of salicylic acid to form methyl salicylate and subsequent glycosylation to prevent methyl salicylate emission. Here, we identified a subclade of tomato methyl esterases, SALICYLIC ACID METHYL ESTERASE1-4, responsible for demethylation of methyl salicylate to form salicylic acid in fruits. This family was identified by proximity to a highly significant methyl salicylate GWAS locus on chromosome 2. Genetic mapping studies in a biparental population confirmed a major methyl salicylate locus on chromosome 2. Fruits from SlMES1 knockout lines emitted significantly (p-value<0,05, t-test) higher amounts of methyl salicylate than wild-type fruits. Double and triple mutants of SlMES2, SlMES3 and SlMES4 emitted even more methyl salicylate than SlMES1 single knockouts-but not at statistically distinguishable levels-compared to the single mutant. Heterologously-expressed SlMES1 and SlMES3 acted on methyl salicylate in vitro, with SlMES1 having a higher affinity for methyl salicylate than SlMES3. The SlMES locus has undergone major rearrangement, as demonstrated from genome structure analysis in the parents of the biparental population. Analysis of accessions that produce high or low levels of methyl salicylate showed that SlMES1 and SlMES3 are the genes expressed the highest in the low methyl salicylate lines. None of the MES genes were appreciably expressed in the high methyl salicylate producing lines. We concluded that the SlMES gene family encodes tomato methyl esterases that convert methyl salicylate to salicylic acid in ripe tomato fruit. Their ability to decrease methyl salicylate levels by conversion to salicylic acid is an attractive breeding target to lower the level of a negative contributor to flavor.

PMID:36315067 | DOI:10.1093/plphys/kiac509

Nurs Forum. 2022 Oct 31. doi: 10.1111/nuf.12817. Online ahead of print.

ABSTRACT

BACKGROUND: Shared governance is a structural framework for operationalizing nursing ownership and accountability for nursing practice. Healthcare institutions are striving to promote healthy and satisfactory work conditions to retain their qualified personnel and achieve organizational stability and high care quality. However, little is known about nurses’ participation in governance in developing countries.

AIM: This study aims to evaluate the levels of shared governance, also known as professional governance, among nurses in Jordan. The demographics of the study participants will also be assessed.

METHODS: The current study used a cross-sectional design implementing an anonymous online survey technique to collect data from 111 nurses on the Index of Professional Nursing Governance (IPNG). Descriptive statistics were performed to evaluate the nurses’ perception of the concept of shared governance in the domains of personnel, information, resources, participation goals and conflict resolution, and practice.

RESULTS: Among the 111 nurses, 55% of the participants were females, 45.5% were affiliated with governmental hospitals, and about half of them worked in critical care units. The analysis showed that the mean score for the total IPNG was 113 (SD = 26.28). The analyses of the mean scores of IPNG domains ranged from 11.5 (SD = 4.6) for goals and conflict resolution to 23.8 (SD = 5.7) for access to information.

DISCUSSION: The results revealed that nurses’ average perception of professional governance demonstrated shared governance, and more specifically, in the lower level of shared governance where decisions are made primarily by management with some staff input. Analysis of the domains of governance revealed that participants’ scores corresponded with shared governance in the areas of information, resources, goals and conflict, and practice, while traditional governance was prevalent in the governance of nursing personnel and participation.

CONCLUSION: There is an agreement on the need of moving the position of frontline nurses to the center of their organizations where equity, accountability, and ownership are the pillars of participative governance. Frontline nurses need further empowerment to be more actively engaged especially in the management of nursing staff and related structures and in the participation in structures connected to governance activities at different organizational levels such as in committees.

PMID:36315058 | DOI:10.1111/nuf.12817

Psychol Health Med. 2022 Oct 31:1-8. doi: 10.1080/13548506.2022.2141276. Online ahead of print.

ABSTRACT

Physical and mental health symptoms can reduce participation in physical activity. The current study assessed the impact of a bout of exercise on mood state in depressed participants with and without current physical pain. We enrolled a community sample of 147 participants (M_age = 45.5; SD = 11.98; 87.1% female) with elevated depressive symptoms. Individuals rated their mood state, completed a 1-mile walk test on a treadmill, and rated their mood state again. Pairwise comparisons between pre- and post-exercise mood ratings were statistically significant (p < .001) and showed improved mood state. People with at least moderate pain showed greater decreases in sadness and irritability from pre- to post- exercise bout. A single bout of exercise was associated with decreased sadness, anxiety, and irritability, and increased energy in a sample of adults with depression. The changes in sadness and irritability were greatest in those who reported at least moderate physical pain.

PMID:36315041 | DOI:10.1080/13548506.2022.2141276