Tag: nevin manimala

Anesth Analg. 2021 Dec 28. doi: 10.1213/ANE.0000000000005849. Online ahead of print.

ABSTRACT

BACKGROUND: Pakistan is a lower middle-income country located in South Asia with a population of nearly 208 million. Sindh is its second largest province. The aim of this survey was to identify the current setup of pediatric services, staffing, equipment, and training infrastructure in the teaching hospitals of Sindh.

METHODS: The survey was conducted between June 2018 and September 2018. A questionnaire was designed with input from experts and pretested. One faculty coordinator from each of 12 of the 13 teaching hospitals (7 government and 5 private) completed the form. Information was exported into Statistical Package for the Social Sciences (SPSS) version 22. Frequency and percentages were computed for all variables. Confidentiality was ensured by anonymizing the data.

RESULTS: Anesthesia services are provided by consultants with either membership or fellowship in anesthesia of the College of Physicians and Surgeons of Pakistan (CPSP). All drugs on the World Health Organization (WHO) essential medication list were available, although narcotic supply was often inconsistent. Weak areas identified were absence of standardization of practice regarding premedication, preoperative laboratory testing, pain assessment, and management. No national practice guidelines exist. Pulse oximeters and capnometers were available in all private hospitals but in only 86% and 44% of the government hospitals, respectively. Some training centers were not providing the training as outlined by the CPSP criteria.

CONCLUSIONS: Several gaps have been identified in the practice and training infrastructure of pediatric anesthesia. There is a need for national guidelines, standardization of protocols, provision of basic equipment, and improved supervision of trainees. One suggestion is to have combined residency programs between private and government hospitals to take advantage of the strengths of both. Recommendations by this group have been shared with all teaching hospitals and training bodies.

PMID:34968193 | DOI:10.1213/ANE.0000000000005849

Phys Sportsmed. 2021 Dec 30:1-8. doi: 10.1080/00913847.2021.2020601. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this systematic review was to determine the incidence of injuries among lacrosse athletes and the differences in rates of injury by location and gender.

METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were implemented to conduct this systematic review.[1] The following variables were extracted from each of the included articles: location of injury, gender of patient, and incidence of injury among study population. The methodological quality of the included studies was assessed using mixed-methods appraisal tool (MMAT) version 2018.[2] Estimated rates were reported as pooled proportion with 95% CI. Rates of injury were calculated as a rate per 1000 athletic exposures (AEs), defined as an athlete participating in 1 practice or competition in which he or she was exposed to the possibility of athletic injury.

RESULTS: This study found that the highest injury rate among lacrosse athletes was to the lower leg/ankle/foot with a rate of 0.66 injuries per 1000 AEs (95% CI, 0.51, 0.82). This injury pattern was also found to be the highest among both male and female lacrosse athletes. No statistical significance was detected when comparing rates of injury across gender, regardless of location. The injury pattern with the lowest rates of injury for female athletes being to the shoulder/clavicle and the neck for male athletes.

CONCLUSION: The highest rate of injury among lacrosse athletes was to the lower leg/ankle/foot. As participation in lacrosse continues to rise, there is a greater need for understanding the rate of injury and injury characteristics for physicians and trainers to provide effective care to lacrosse athletes.

PMID:34968164 | DOI:10.1080/00913847.2021.2020601

Bioengineered. 2022 Jan;13(1):876-883. doi: 10.1080/21655979.2021.2014385.

ABSTRACT

This research has developed a method for rapid detection of SARS-CoV-2 N protein on a paper-based microfluidic chip. The chitosan-glutaraldehyde cross-linking method is used to fix the coated antibody, and the sandwich enzyme-linked immunosorbent method is used to achieve the specific detection of the target antigen. The system studied the influence of coating antibody concentration and enzyme-labeled antibody concentration on target antigen detection. According to the average gray value measured under different N protein concentrations, the standard curve of the method was established and the sensitivity was tested, and its linear regression was obtained. The equation is y = 9.8286x+137.6, R2 = 0.9772 > 0.90, which shows a high degree of fit. When the concentration of coating antibody and enzyme-labeled antibody were 1 μg/mL and 2 μg/mL, P > 0.05, the difference was not statistically significant, so the lower concentration of 1 μg/mL was chosen as the coating antibody concentration. The results show that the minimum concentration of N protein that can be detected by this method is 8 μg/mL, and the minimum concentration of coating antibody and enzyme-labeled antibody is 1 μg/mL, which has the characteristics of high sensitivity and good repeatability.

PMID:34968171 | DOI:10.1080/21655979.2021.2014385

Eval Health Prof. 2021 Dec 30:1632787211062660. doi: 10.1177/01632787211062660. Online ahead of print.

ABSTRACT

This study aimed to determine the depression, anxiety and stress levels that have negatively impacted nurses’ mental health during the COVID-19 pandemic. A sample group of 826 nurses working in Turkey were asked to fill in an online questionnaire in order to evaluate their psychological responses and the related factors that have adversely affected their mental health during the COVID-19 pandemic. In total, 696 nurses (84.3%) showed symptoms of depression, 644 (78%) reported anxiety and 543 (65.74%) reported stress. This study also highlighted that the most concerning factor for the nurses was the risk of transmitting the COVID-19 infection to their household members (89.2%). The most important problems faced by the nurses during COVID-19 included equipment shortages (50.7%), administrative problems (38.5%) and issues such as accommodation and nutrition (27.4%). These were found to have a statistically significant correlation with the nurses’ levels of depression, anxiety and stress. The fear of losing a household member, the inability to their household’s social needs and the fear of death were among the factors that concerned nurses during the COVID-19 pandemic, significantly affecting their levels of depression, anxiety and stress. Taking the necessary measures to deal with the aforementioned problems and fears is important to protect the health, productivity and efficiency of nurses during the pandemic period.

PMID:34968162 | DOI:10.1177/01632787211062660

J Appl Psychol. 2021 Dec 30. doi: 10.1037/apl0000991. Online ahead of print.

ABSTRACT

Effect misestimations plague Psychological Science, but advances in the identification of dissemination biases in general and publication bias in particular have helped in dealing with biased effects in the literature. However, the application of publication bias detection methods appears to be not equally prevalent across subdisciplines. It has been suggested that particularly in I/O Psychology, appropriate publication bias detection methods are underused. In this meta-meta-analysis, we present prevalence estimates, predictors, and time trends of publication bias in 128 meta-analyses that were published in the Journal of Applied Psychology (7,263 effect sizes, 3,000,000 + participants). Moreover, we reanalyzed data of 87 meta-analyses and applied nine standard and more modern publication bias detection methods. We show that (a) the bias detection method applications are underused (only 41% of meta-analyses use at least one method) but have increased in recent years, (b) those meta-analyses that apply such methods now use more, but mostly inappropriate methods, and (c) the prevalence of potential publication bias is concerning but mostly remains undetected. Although our results indicate somewhat of a trend toward higher bias awareness, they substantiate concerns about potential publication bias in I/O Psychology, warranting increased researcher awareness about appropriate and state-of-the-art bias detection and triangulation. Embracing open science practices such as data sharing or study preregistration is needed to raise reproducibility and ultimately strengthen Psychological Science in general and I/O Psychology in particular. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34968082 | DOI:10.1037/apl0000991

Psychol Trauma. 2021 Dec 30. doi: 10.1037/tra0001154. Online ahead of print.

ABSTRACT

OBJECTIVE: Research in civilians and women shows negative social support is more deleterious for posttraumatic stress disorder (PTSD) symptoms than are the buffering effects of positive social support. However, this is understudied in male military samples. Moreover, appraisals of social support appear to be the mechanism of the association of social support type and PTSD severity, but appraisals as mediators have not been explored in military samples.

METHOD: Previously deployed male service members/veterans (SM/Vs; n = 333) completed a demographic inventory, the Positive and Negative Social Exchange Scale, which assesses positive and negative social support and their appraisals, and the PTSD Checklist-5. Path analyses examined associations of positive and negative social support with PTSD severity and whether appraisals mediated these associations.

RESULTS: The magnitude of the association of negative social support and PTSD symptom severity (standardized estimate = .33; SE = .06, p < .001) was statistically greater than the association of positive social support and PTSD symptom severity (standardized estimate = -.26; SE = .06, p < .001). Higher positive support was associated with higher appraisals, and in turn, higher appraisals were associated with lower PTSD severity, suggesting mediation. In contrast, the association of negative social support with PTSD was direct.

CONCLUSION: Causality cannot be inferred. Positive support exhibits a weaker relationship with PTSD because its effect is dependent on how an individual appraises the support whereas negative support has a direct relationship with PTSD regardless of appraisals. Findings suggest positive support interventions should focus on individual perceptions whereas negative support interventions should focus on decreasing how often these interactions occur. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34968113 | DOI:10.1037/tra0001154

Diagn Cytopathol. 2021 Dec 30. doi: 10.1002/dc.24925. Online ahead of print.

ABSTRACT

INTRODUCTION: Cervical and anus cancers have similarities: association with HPV infection, epithelial transformation zone, and precursor lesions. However, it is still unclear whether women with cervical cancer should be screened to identify high-grade squamous intraepithelial lesions and anal cancer. We aimed to identify high-risk HPV and cytological atypia in anal samples from women diagnosed with invasive squamous cell carcinoma of the cervix.

STUDY DESIGN: We conducted a cross-sectional study between July 2016 and August 2017 in reference services in oncology in the State of Ceará, Brazil. We studied 59 patients diagnosed with frankly invasive squamous cell carcinoma of the cervix (at least stages IB) and 60 women in a control group. We performed liquid-based cytology (Surepath™) and HPV test (Cobas® 4800 System Test) of anal samples. To determine statistical significance with a confidence interval of 95%, we used Fisher’s exact test and Student’s t-test using the GraphPad Prism 7.0 software.

RESULTS: The mean age in the control group was 56.7 ± 8.5 years, while in the group of women with cervical squamous cancer, it was 54.3 ± 14.8. The liquid-based cytology results of the satisfactory cases were: negative for intraepithelial lesion or malignancy (NLM): 51 cases (85%) in the control group and 38 (64.4%) in the study group (p = .0116). The HPV test was negative more frequently in the control group (n = 56, 93.3%) than in the study group (n = 17, 31.5%) (p < .0001). HPV 16 was the most frequent type (67.6%).

CONCLUSIONS: There is a higher frequency of high-risk HPV and atypical cytology in women with cervical cancer than without lesions. Thus, this group should be considered as a target population for screening.

PMID:34968009 | DOI:10.1002/dc.24925

Transpl Infect Dis. 2021 Dec 30. doi: 10.1111/tid.13784. Online ahead of print.

ABSTRACT

BACKGROUND: Despite multiple studies evaluating the immunological responsiveness to vaccines, clinical effectiveness of the two-dose mRNA vaccine schedule among lung transplant (LT) patients has not been evaluated.

METHODS: We included LT patients who tested positive for SARS-CoV-2 on a nasopharyngeal swab between March 1, 2020, and August 25, 2021 (n = 70). The study group was divided based on their vaccination status.

RESULTS: During the study period, 14 fully vaccinated LT patients with one of the mRNA vaccines tested positive for COVID-19 (median age 54, range 30-62 years, M:F 9:5). The vaccinated cohort was younger with bilateral LT, have suppurative conditions as the transplant indication and present with milder symptoms. However, pulmonary parenchymal involvement was seen among all 12 patients where CT chest was available. The laboratory profile indicated a more subdued inflammatory response among the vaccinated group. A lower proportion of vaccinated patients developed respiratory failure, needed ICU admission or ventilator support, although none of the differences achieved statistical significance. None of the vaccinated patients succumbed to COVID-19 during the study period, while the 4-week mortality among unvaccinated patients was nearly 15% (8/56).

CONCLUSIONS: In this cohort of vaccinated LT patients who developed breakthrough COVID-19, the clinical course, risk of complications and outcomes trended better than unvaccinated patients. However, universal involvement of the allograft demonstrates the continued vulnerability of these patients to significant sequelae from COVID-19. Future studies may evaluate the incremental protection of vaccination after the completion of the third dose of mRNA vaccines among LT patients. This article is protected by copyright. All rights reserved.

PMID:34968012 | DOI:10.1111/tid.13784

Am J Med Genet A. 2021 Dec 30. doi: 10.1002/ajmg.a.62628. Online ahead of print.

ABSTRACT

We studied if clinicians could gain sufficient working knowledge of a computer-assisted diagnostic decision support system (DDSS) (SimulConsult), to make differential diagnoses (DDx) of genetic disorders. We hypothesized that virtual training could be convenient, asynchronous, and effective in teaching clinicians how to use a DDSS. We determined the efficacy of virtual, asynchronous teaching for clinicians to gain working knowledge to make computer-assisted DDx. Our study consisted of three surveys (Baseline, Training, and After Use) and a series of case problems sent to clinicians at Vanderbilt University Medical Center. All participants were able to generate computer-assisted DDx that achieved passing scores of the case problems. Between 75% and 92% agreed/completely agreed the DDSS was useful to their work and for clinical decision support and was easy to use. Participants’ use of the DDSS resulted in statistically significant time savings in key tasks and in total time spent on clinical tasks. Our results indicate that virtual, asynchronous teaching can be an effective format to gain a working knowledge of a DDSS, and its clinical use could result in significant time savings across multiple tasks as well as facilitate synergistic interaction between clinicians and lab specialists. This approach is especially pertinent and offers value amid the COVID-19 pandemic.

PMID:34967985 | DOI:10.1002/ajmg.a.62628

Bratisl Lek Listy. 2022;123(1):37-43. doi: 10.4149/BLL_2022_006.

ABSTRACT

INTRODUCTION: The indications for specific treatment in the cases of inflammatory cardiomyopathy are based on limited data from several small clinical trials.

AIM: A comparison of the effect of two dose regimens of combined immunosuppressive therapy by adding them to conventional heart failure therapy and comparing them with conventional heart failure therapy alone in patients with inflammatory cardiomyopathy.

METHODS AND STUDY POPULATION: We enrolled 20 patients; mean age 46.10±7.33 years, duration of symptoms <6 months, LVEF ≤40 %, NYHA class II-IV, with biopsy‑proven myocarditis. Patients were randomly separated into groups treated with immunosuppressive therapy in addition to conventional heart failure therapy or to a group treated with conventional heart failure therapy alone. Clinical and echocardiographic parameters were evaluated.

RESULTS: The baseline values of LVEF in the group of immunosuppressive therapy (LVEF 22.3±4.7 %) were similar to those in the group treated with conventional heart failure therapy (LVEF 21.7±4.7 %; p=0.757). After twelve months there was no statistically significant difference in LVEF between the two studied groups (LVEF 33.7±9.5 % for the immunosuppressive therapy group and 41.3±13.0 % for the conventional therapy group; p=0.175).

CONCLUSION: In our study population, we proved no positive effect of combined immunosuppressive therapy on the left ventricular function over 12 months. The main limitation of the study is the small number of enrolled patients (Tab. 4, Fig. 1, Ref. 35).

PMID:34967656 | DOI:10.4149/BLL_2022_006