Tag: nevin manimala

Brain Behav. 2022 Sep 20:e2760. doi: 10.1002/brb3.2760. Online ahead of print.

ABSTRACT

BACKGROUND: The number of regular smartphone users has increased dramatically worldwide. Headaches, followed by sleep difficulties, forgetfulness, dizziness, and other ailments, are among the most prevalent complaints among smartphone users during or after use. In addition, migraine is a debilitating disease and is the world’s second leading cause of disability. Hence, we performed this study to determine how smartphone overuse influenced migraine patients’ level of disability, pain intensity, sleep quality, and overall quality of life.

METHODS: In this observational study, the patients were divided into two groups high mobile phone use group (HMPUG) and the low mobile phone user group (LMPUG) using the Mobile Phone Problematic Use Scale. We assessed, for each group, patients’ level of disability, pain intensity, sleep quality, daytime sleepiness, and quality of life through the Migraine Disability Assessment Scale, Visual Analogue Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and 24-h Migraine Quality of Life Questionnaire, respectively.

RESULTS: Our study showed that the respondents’ average age was 27.59 (9.79) years. The average number of family members was 5.98 (2.3251). A total of 65.8% (n = 263) of the 400 participants were female, while 34.3 % (n = 137) were male. Greater pain intensity, poor sleep quality, and reduced medication effectivity were found in HMPUG compared to LMPUG (p < .05). However, increased duration of migraine and medication intake was reported in the LMPUG (p < .05).

CONCLUSION: We observed that smartphone overuse could worsen pain, sleep, and reduce treatment efficacy in individuals with migraine. Therefore, controlled smartphone use is recommended to avoid worsening symptoms.

PMID:36128652 | DOI:10.1002/brb3.2760

Disaster Med Public Health Prep. 2022 Sep 21:1-8. doi: 10.1017/dmp.2022.182. Online ahead of print.

ABSTRACT

As COVID-19 was declared a health emergency in March 2020, there was immense demand for information about the novel pathogen. This paper examines the clinician-reported impact of Project ECHO COVID-19 Clinical Rounds on clinician learning. Primary sources of study data were Continuing Medical Education (CME) Surveys for each session from the dates of March 24, 2020 to July 30, 2020 and impact surveys conducted in November 2020, which sought to understand participants’ overall assessment of sessions. Quantitative analyses included descriptive statistics and Mann-Whitney testing. Qualitative data were analyzed through inductive thematic analysis. Clinicians rated their knowledge after each session as significantly higher than before that session. 75.8% of clinicians reported they would ‘definitely’ or ‘probably’ use content gleaned from each attended session and clinicians reported specific clinical and operational changes made as a direct result of sessions. 94.6% of respondents reported that COVID-19 Clinical Rounds helped them provide better care to patients. 89% of respondents indicated they ‘strongly agree’ that they would join ECHO calls again.COVID-19 Clinical Rounds offers a promising model for the establishment of dynamic peer-to-peer tele-mentoring communities for low or no-notice response where scientifically tested or clinically verified practice evidence is limited.

PMID:36128645 | DOI:10.1017/dmp.2022.182

Scand J Clin Lab Invest. 2022 Sep 20:1-7. doi: 10.1080/00365513.2022.2122075. Online ahead of print.

ABSTRACT

The aim of this study is to reveal the predictive power of biomarkers and SYNTAX (SX) score for short-term mortality in patients diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) in the emergency department. This is prospective observational cohort study. Demographic characteristics of the patients, laboratory parameters on admission, left ventricular ejection fraction (LVEF) percentages, affected vessels in angiography (CAG) and the treatment strategy [medical therapy, percutaneous transluminal coronary angioplasty (PTCA), coronary angio by-pass graft] and SX scores were recorded on the data collection form. ROC curve was used to investigate the predictivity of blood urea nitrogen/albumin ratio (BAR), procalcitonin, C-reactive protein (CRP), high sensitivity cardiac troponin I (Hs-cTnI), CRP to serum albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR) and SX scores in mortality. Multivariate analysis of biomarkers and SX score was performed to estimate the patients’ 30-day mortality. Of the 415 patients were included in the study. ROC analysis of BAR, CAR, CRP, Procalcitonin, Hs-cTnI, NLR and SX score to predict mortality was statistically significant. BAR (OR: 1.280, 95% CI: 1.113-1.472, p = .001) and SX score (OR: 1.071, 95% CI: 1.018-1.126, p = .007) were found to be independent predictors of 30 days mortality. LVEF reduction, SX score, the number of affected vessels and the frequency of LMCA lesions increase were found to be statistically significant in patients with BAR ≥4.8. BAR, which can be calculated easily and quickly on admission to the emergency department and in clinical practice, may be used to predict mortality in patients with NSTEMI.

PMID:36128642 | DOI:10.1080/00365513.2022.2122075

Biometrics. 2022 Sep 20. doi: 10.1111/biom.13760. Online ahead of print.

ABSTRACT

We propose a unified framework for likelihood-based regression modeling when the response variable has finite support. Our work is motivated by the fact that, in practice, observed data are discrete and bounded. The proposed methods assume a model which includes models previously considered for interval-censored variables with log-concave distributions as special cases. The resulting log-likelihood is concave, which we use to establish asymptotic normality of its maximizer as the number of observations tends to infinity with the number of parameters fixed, and rates of convergence of -regularized estimators when the true parameter vector is sparse and and both tend to infinity with . We consider an inexact proximal Newton algorithm for computing estimates and give theoretical guarantees for its convergence. The range of possible applications is wide, including but not limited to survival analysis in discrete time, the modeling of outcomes on scored surveys and questionnaires, and, more generally, interval-censored regression. The applicability and usefulness of the proposed methods are illustrated in simulations and data examples. This article is protected by copyright. All rights reserved.

PMID:36128638 | DOI:10.1111/biom.13760

J Rural Health. 2022 Sep 20. doi: 10.1111/jrh.12713. Online ahead of print.

ABSTRACT

PURPOSE: Considering growing disparities in health outcomes between rural and urban areas of Appalachia, this study compared the incremental Medicaid costs of pediatric concurrent care (implemented by the Patient Protection and Affordable Care Act) versus standard hospice care.

METHODS: Data on 1,788 pediatric hospice patients, from the Appalachian region, collected between 2011 and 2013, were obtained from the Centers for Medicare and Medicaid Services. Incremental per-patient-per-month (PPM) costs of enrollment in concurrent versus standard hospice care were analyzed using multilevel generalized linear models. Increments for analysis were hospice length of stay (LOS).

RESULTS: For rural children enrolled in concurrent hospice care, the mean Medicaid cost of hospice care was $3,954 PPPM (95% CI: $3,223-$4,684) versus $1,933 PPPM (95% CI: $1,357-$2,509) for urban. For rural children enrolled in standard hospice care, the mean Medicaid cost was $2,889 PPPM (95% CI: $2,639-$3,139) versus $1,122 PPPM (95% CI: $980-$1,264) for urban. There were no statistically significant differences in Medicaid costs for LOS of 1 day. However, for LOS between 2 and 14 days, concurrent enrollment decreased total costs for urban children (IC = $-236.9 PPPM, 95% CI: $-421-$-53). For LOS of 15 days or more, concurrent care had higher costs compared to standard care, for both rural (IC = $1,399 PPPM, 95% CI: $92-$2,706) and urban children (IC = $1,867 PPPM, 95% CI: $1,172-$2,363).

CONCLUSIONS: The findings revealed that Medicaid costs for concurrent hospice care were highest among children in rural Appalachia. Future research on factors of high costs of rural care is needed.

PMID:36127766 | DOI:10.1111/jrh.12713

Hu Li Za Zhi. 2022 Oct;69(5):56-67. doi: 10.6224/JN.202210_69(5).08.

ABSTRACT

BACKGROUND: Nursing students with master degrees have the strong potential to serve as future leaders in medical teams. Implementing a well-developed and integrated educational program for nursing leadership at the master’s level can strengthen the leadership of advanced practice nurses and promote a positive nursing practice environment.

PURPOSE: To develop a leadership integrated educational program for master’s nursing students and conduct a preliminary evaluation of the effectiveness of this program in cultivating leadership competencies in these students.

METHODS: Phase 1: A modified Delphi survey conducted on 14 experts with clinical or academic backgrounds was used to identify the teaching objectives and strategies of the leadership integrated educational program. Phase 2: These teaching objectives and strategies were embedded into nine compulsory courses within a current training program for master’s nursing students at a national university. The core elements of the leadership integrated educational program were incorporated into each compulsory course. The objectives of each compulsory course directly reflected the objectives of the integrated program. The leadership integrated educational program was implemented for one academic year, and its effectiveness was evaluated using a quasi-experimental test with a single group pre- and post-test design. A self-developed, 10-item “Master Nursing Student’s Leadership Competence Scale” covering four core elements was applied to measure the self-reported leadership competencies of the participants. A paired sample t-test was applied to analyze the differences in leadership competencies between pre- and post-intervention.

RESULTS: A consensus on the teaching objectives and strategies of the leadership integrated educational program was achieved in the first round of the Delphi survey. The overarching teaching objective of the leadership integrated educational program was to “lead the healthcare team with the leadership and competencies, and demonstrate the advanced nursing practice skills for improving quality of care.” In addition, the four core elements under the overarching goal, i.e., personal characteristics, leading people, business management, and vision building, were proposed. Forty-eight master’s nursing students participated in this study. The results showed the average total score of leadership competency was 42.33 ± 12.16 (potential range: 10 – 70), indicating that the participants had a middle level of leadership competency prior to program participation. After participating in the Leadership Integrated Educational Program for one academic year, the average total score for leadership competency increased to 51.27 ± 9.74, indicating that the participants still had a middle level of leadership competency. Nevertheless, the 8.94 increase in the post-intervention score was statistically significant (p < .01). Moreover, the scores for each subscale (personal characteristics, leading people, business management, and vision building) had all increased significantly increased from 13.52 to 15.71, 12.65 to 15.35, 8.15 to 10.31, and 8.02 to 9.90, respectively (p < .01).

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study offers proactive recommendations for reforming master’s degree programs in nursing. The proposed multidisciplinary-expert-informed leadership integrated educational program may be used to strengthen leadership competencies in this student population. Furthermore, the findings provide a benchmark for developing an effective nursing leadership integrated educational program that may be incorporated into domestic master’s degree programs.

PMID:36127759 | DOI:10.6224/JN.202210_69(5).08

Mov Ecol. 2022 Sep 20;10(1):40. doi: 10.1186/s40462-022-00339-0.

ABSTRACT

Animal behavioural responses to the environment ultimately affect their survival. Monitoring animal fine-scale behaviour may improve understanding of animal functional response to the environment and provide an important indicator of the welfare of both wild and domesticated species. In this study, we illustrate the application of collar-attached acceleration sensors for investigating reindeer fine-scale behaviour. Using data from 19 reindeer, we tested the supervised machine learning algorithms Random forests, Support vector machines, and hidden Markov models to classify reindeer behaviour into seven classes: grazing, browsing low from shrubs or browsing high from trees, inactivity, walking, trotting, and other behaviours. We implemented leave-one-subject-out cross-validation to assess generalizable results on new individuals. Our main results illustrated that hidden Markov models were able to classify collar-attached accelerometer data into all our pre-defined behaviours of reindeer with reasonable accuracy while Random forests and Support vector machines were biased towards dominant classes. Random forests using 5-s windows had the highest overall accuracy (85%), while hidden Markov models were able to best predict individual behaviours and handle rare behaviours such as trotting and browsing high. We conclude that hidden Markov models provide a useful tool to remotely monitor reindeer and potentially other large herbivore species behaviour. These methods will allow us to quantify fine-scale behavioural processes in relation to environmental events.

PMID:36127747 | DOI:10.1186/s40462-022-00339-0

BMC Surg. 2022 Sep 20;22(1):346. doi: 10.1186/s12893-022-01794-7.

ABSTRACT

BACKGROUND: Complex ventral hernias (VHs) represent a real challenge to both general and plastic surgeons. This study aims to compare Sublay Mesh-Only Repair to Posterior Component Separation “PCS” with Transversus Abdominis Release “TAR” in the treatment of complex ventral-wall hernias (VHs).

METHODS: This a randomized, controlled, intervention, including two parallel groups: A; Sublay Mesh-Only Repair and Group B; “TAR”. Consecutive patients of both genders aged between 18 and 65 years old with complex VHs presented at Mansoura University Hospitals including large-sized abdominal-wall hernia ≥ 10 cm in width, loss of domain ≥ 20%, multiple hernial defects, or recurrent hernias. Immuno-compromised patients, patients with liver impairment, or severe heart failure were considered an exclusion criterion. The primary outcome is the recurrence rate after 12-months following the procedure.

RESULTS: Fifty-six patients were recruited in this study. There was no significant difference between both groups regarding recurrence. However, there was significant differences between both groups regarding seroma favoring mesh-only repair.

CONCLUSIONS: Although TAR may be associated with longer operative times and more blood losses, these were not found to be statistically significant. Postoperative complication, except for seroma, and recurrence rates were comparable in both groups. Trail registration The study was registered on clicaltrials.gov “NCT04516031”.

PMID:36127722 | DOI:10.1186/s12893-022-01794-7

BMC Oral Health. 2022 Sep 20;22(1):414. doi: 10.1186/s12903-022-02460-3.

ABSTRACT

BACKGROUND: Skeletal anchorage has made it possible to perform complex orthodontic tooth movements that are difficult or even impossible to achieve with conventional orthodontic treatment. Mandibular buccal shelf miniscrews, used for distalization, play a particularly important role in treatment of Class III malocclusion. Unfortunately, stability of the miniscrews placed in the mandible is still considered at higher risk of failure compared to other intraoral locations. The aim of our study was to determine the influence of the miniscrew size on their long-term stability, occurrence of oral mucosa inflammation and pain lasting over 48 h after implantation.

METHODS: 184 Absoanchor^® miniscrews (Dentos, South Korea) in two sizes: SH2018-10 (length 10 mm, ø 1.8-2.0 mm) and SH1514-08 (length 8 mm, ø 1.4-1.5 mm) were inserted in the mandibular buccal shelf in 92 Caucasians aged 20-50 years, diagnosed with Class III malocclusion that required en-masse distalization of the mandibular dentition. Data was statistically analyzed with the level of significance set at p = .05.

RESULTS: 91.3% of the SH2018-10 and 75% of the SH1514-08 miniscrews were stable, and this difference was statistically significant (p < .05). Inflammation of the oral mucosa was noticed around both types of miniscrews and affected 50% of the SH2018-10 and 26.09% of the SH1514-08 group (p < .05). Pain lasting longer than 48 h after implantation was related to 60.87% and 20.65% of the SH2018-10 and the SH1514-08 miniscrews (p < .05), respectively. Inflammation associated with larger SH2018-10 miniscrews did not affect their stability (p > .05), contrary to the SH1514-08 ones (p < .05). When inflammation was present, the overall success rate declined to 64.29%, from 94.74% noted for TADs without inflammation. According to the log-rank test, smaller TADs failed significantly sooner than the larger ones (p = .002).

CONCLUSION: Larger SH2018-10 miniscrews are the anchorage of choice for the mandibular buccal shelf, despite triggering inflammation and long-lasting pain significantly more often than the smaller ones. Therefore, this issue should be discussed with every patient prior to miniscrew use. Trial registration ID: ClinicalTrials.gov Identifier: NCT05280678 Date of Registration: 15/03/2022. Retrospectively registered.

PMID:36127718 | DOI:10.1186/s12903-022-02460-3

Infect Agent Cancer. 2022 Sep 20;17(1):51. doi: 10.1186/s13027-022-00464-w.

ABSTRACT

BACKGROUND: Nowadays, cancer is the leading cause of death among threats to humanity, necessitating prompt action and preparation. Cervical cancer is one of the most common cancers in women and is currently treated with surgery, radiation, chemotherapy, and immunotherapy, among other treatments. Current oncology approaches focused on the simultaneous development of safe and effective cancer multi-agent therapies. The present study aimed to evaluate the effects of a combined extracts of heated TC1, a heat-killed preparation of Lactobacillus casei, and alpha-galactosyl ceramide (α-GalCer) in a mouse model of cervical cancer.

MATERIAL AND METHODS: Cervical cancer in the mouse model was prepared by TC1 cells subcutaneous injection into the left flank of female C57BL/6 mouse aged 6-8 weeks (n = 80). After the appearance of the palpable tumor, the mice with cervical cancer were randomly devoted to 8 (ten-member) groups. The mice in some groups were treated with PBS, TC1 cell extract, L. casei extract, α-GalCer, and a combination of the mentioned treatments. Then, they were evaluated the splenocytes proliferation, lactate dehydrogenase production and nitric oxide. Moreover, IL-4, IFN-γ, and TGF-β cytokine levels of splenocytes supernatant the mice were measured. In all evaluations, a statistical difference of less than 0.05 (P ˂ 0.05) was considered as a significant level.

RESULT: The findings revealed that the combination therapy group (heated TC1 cell and L. casei extracts with α-GalCer) significantly increases the splenocytes proliferation (MTT) (0.358 ± 0.04 OD), LDH production (45.9 ± 2.3 U/L), NO rate (38.4 ± 2.8 µM), and IFN-γ cytokine level (46.6 ± 3.7 pg/ml) (P < 0.05). Also, observes a significantly reduces the production of IL-4 (11.6 ± 2.5 pg/ml) and TGF-β cytokines levels (7.8 ± 2.5 pg/ml) (P < 0.05) in comparison to the control group.

CONCLUSION: The study showed that combination therapy of L. casei and α-GalCer is an efficient treatment for cervical cancer in the mouse model.

PMID:36127698 | DOI:10.1186/s13027-022-00464-w