Tag: nevin manimala

Pain Med. 2021 Apr 20:pnab144. doi: 10.1093/pm/pnab144. Online ahead of print.

ABSTRACT

OBJECTIVE: Pain catastrophizing is an important psychological predictor of pain. Recent evidence suggests the relationship between catastrophizing and pain intensity could be bidirectional, but most studies have been conducted on chronic pain patients and using criticized statistical methods. The present study aimed to examine if the relationship between pain intensity and catastrophizing was bidirectional in the context of childbirth.

METHODS: A total of 504 women without chronic pain were recruited on their 32-37 gestational week. They completed measures of catastrophizing and pain intensity on the first encounter and then again at 1, 3, and 6 months postpartum. The temporal relationship between the variables was assessed using a random intercept cross-lagged panel model.

RESULTS: The hypothesis of reciprocal association did not receive support, as pain intensity predicted catastrophizing during the postpartum period, but catastrophizing did not show an effect over pain intensity at any moment.

CONCLUSIONS: Pain intensity predicting catastrophizing is consistent with previous literature, while the lack of effect of catastrophizing over pain intensity is an unexpected result, which may suggest that catastrophizing plays a different role in the postpartum period. These results highlight the importance of timely efforts for pain management during the postpartum period and contribute to the theoretical conceptualization of catastrophizing.

PMID:33876826 | DOI:10.1093/pm/pnab144

Biometrics. 2021 Apr 20. doi: 10.1111/biom.13476. Online ahead of print.

ABSTRACT

In many studies, related individuals are phenotyped in order to infer how their genotype contributes to their phenotype, through the estimation of parameters such as breeding values or locus effects. When it is not possible to phenotype all the individuals, it is important to properly sample the population to improve the precision of the statistical analysis. This article studies how to optimize such sampling designs for pedigrees and association studies. Two sampling methods are developed, stratified sampling and D optimality. It is found that it is important to take account of mutation when sampling pedigrees with many generations: as the size of mutation effects increases, optimized designs sample more individuals in late generations. Optimized designs for association studies tend to improve the joint estimation of breeding values and locus effects, all the more as sample size is low and the genetic architecture of the trait is simple. When the trait is determined by few loci, they are reminiscent of classical experimental designs for regression models and tend to select homozygous individuals. When the trait is determined by many loci, locus effects may be difficult to estimate, even if an optimized design is used.

PMID:33876835 | DOI:10.1111/biom.13476

Sci Rep. 2021 Apr 19;11(1):8432. doi: 10.1038/s41598-021-87777-9.

ABSTRACT

We developed a novel technology using the photoacoustic effect that improve needle tip visibility. We evaluated whether this technology improves needle tip visibility when performing a deep peripheral nerve block in a cadaver model. A photoacoustic needle was developed using a conventional echogenic needle with an intraluminal optical fiber. A pulsed laser sends light from a source through the fiber, which is converted to ultrasound at the needle tip using the photoacoustic effect. A nerve block expert performed deep nerve blocks using the photoacoustic needle and the ultrasound views recorded, with or without photoacoustic ultrasound at the needle tip. Needle tip visibility was evaluated by questionnaire (Likert scale 1: very poor, 5: very good) completed by anesthesiologists evaluating recorded images. The score was presented as median [first quartile, third quartile]. Statistical analysis was performed using the Wilcoxon matched-pairs signed rank test. The scores of needle tip visibility with photoacoustic ultrasound from the needle tip (4.3 [4.0, 4.5]) was significantly higher than that without photoacoustic ultrasound (3.5 [3.2, 3.8]) (p < 0.01). Ultrasound emitted at the needle tip using the photoacoustic effect improves needle tip visibility during deep peripheral nerve blocks.Clinical trial number University Hospital Medical Information Network Center Clinical Trials Registration System (UMIN000036974).

PMID:33875687 | DOI:10.1038/s41598-021-87777-9

Sci Rep. 2021 Apr 19;11(1):8433. doi: 10.1038/s41598-021-87584-2.

ABSTRACT

Endovascular treatment of strokes caused by large vessel occlusion enables the histopathological investigation of the retrieved embolus, possibly providing a novel opportunity to contribute to the diagnostic workup of etiology and to define secondary prevention measures in strokes with uncertain genesis. We aimed to develop a classification rule based on pathophysiological considerations and adjustment to reference thrombi for distinction between cardiac and arteriosclerotic emboli and to validate this classification rule on a patient cohort. From 125 patients with stroke due to large vessel occlusion and thrombectomy, 82 patients with known etiology (55 cardioembolic and 27 arterioembolic strokes) were included. The corresponding emboli were histologically evaluated by two raters blinded to the etiology of stroke by means of a novel classification rule. Presumed etiology and classification results were compared. Agreement concerning cardiac emboli was 72.2% (95% CI: 58.4-83.5) for rater I and 78.2% (95% CI: 65.0-88.2) for rater II. Agreement concerning arteriosclerotic emboli was 70.4% (95% CI: 49.8-86.3) for rater I and 74.1% (95% CI: 53.7-88.9) for rater II. Overall agreement reached 71.6% (95% CI: 60.5-81.1) for rater I and 76.8% (95% CI: 66.2-85.4) for rater II. Within the limits of generally restricted accuracy of histological evaluations, the classification rule differentiates between cardiac and arteriosclerotic emboli of acute ischemic stroke patients. Further improvement is needed to provide valuable complementary data for stroke etiology workup.

PMID:33875717 | DOI:10.1038/s41598-021-87584-2

Sci Rep. 2021 Apr 19;11(1):8435. doi: 10.1038/s41598-021-87713-x.

ABSTRACT

Expansion of COVID-19 worldwide increases interest in unraveling genomic variations of novel SARS-CoV-2 virus. Metadata of 408,493 SARS-CoV-2 genomes submitted to GISAID database were analyzed with respect to genomic clades and their geographic, age, and gender distributions. Of the currently known SARS-CoV-2 clades, clade GR was the most prevalent worldwide followed by GV then GH. Chronological analysis revealed expansion in SARS-CoV-2 clades carrying D614G mutations with the predominance of the newest clade, GV, in the last three months. D614G clades prevail in countries with more COVID-19 cases. Of them, the clades GH and GR were more frequently recovered from severe or deceased COVID-19 cases. In contrast, G and GV clades showed a significantly higher prevalence among asymptomatic patients or those with mild disease. Metadata analysis showed higher (p < 0.05) prevalence of severe/deceased cases among males than females and predominance of GR clade in female patients. Furthermore, severe disease/death was more prevalent (p < 0.05) in elderly than in adults/children. Higher prevalence of the GV clade in children compared to other age groups was also evident. These findings uniquely provide a statistical evidence on the adaptation-driven evolution of SARS-CoV-2 leading to altered infectivity, virulence, and mortality.

PMID:33875719 | DOI:10.1038/s41598-021-87713-x

J Neurosci. 2021 Apr 19:JN-RM-0090-21. doi: 10.1523/JNEUROSCI.0090-21.2021. Online ahead of print.

ABSTRACT

Different species of animals can discriminate numerosity, the countable number of objects in a set. The representations of countable numerosities have been deciphered down to the level of single neurons. However, despite its importance for human number theory, a special numerical quantity, the empty set (numerosity zero), has remained largely unexplored. We explored the behavioral and neuronal representation of the empty set in carrion crows. Crows were trained to discriminate small numerosities including the empty set. Performance data showed a numerical distance effect for the empty set in one crow, suggesting that the empty set and countable numerosities are represented along the crows’ ‘mental number line’. Single-cell recordings in the endbrain region nidopallium caudolaterale (NCL) showed a considerable proportion of NCL neurons tuned to the preferred numerosity zero. As evidenced by neuronal distance and size effects, NCL neurons integrated the empty set in the neural number line. A subsequent neuronal population analysis using a statistical classifier approach showed that the neuronal numerical representations were predictive of the crows’ success in the task. These behavioral and neuronal data suggests that the conception of the empty set as a cognitive precursor of a zero-like number concept is not an exclusive property of the cerebral cortex of primates. Zero as a quantitative category cannot only be implemented in the layered neocortex of primates, but also in the anatomically distinct endbrain circuitries of birds that evolved based on convergent evolution.Significance statementThe conception of ‘nothing’ as number ‘zero’ is celebrated as one of the greatest achievements in mathematics. To explore whether precursors of zero-like concepts can be found in vertebrates with a cerebrum that anatomically differs starkly from our primate brain, we investigated carrion crows. We show that crows can grasp the empty set as a null numerical quantity that is mentally represented next to number one. Moreover, we show that single neurons in an associative avian cerebral region specifically respond to the empty set and show the same physiological characteristics as for countable quantities. This suggests that zero as a quantitative category can also be implemented in the anatomically distinct endbrain circuitries of birds that evolved based on convergent evolution.

PMID:33875573 | DOI:10.1523/JNEUROSCI.0090-21.2021

J Inj Violence Res. 2021 Apr 17;13(2). doi: 10.5249/jivr.v13i2.1406. Online ahead of print.

ABSTRACT

BACKGROUND: Sufficient data should be gathered and analyzed to increase awareness and attention of the community and policymakers in the field of road traffic injury (RTI) prevention. While various organizations and stakeholders are involved in road traffic crashes, there is no clear lead agency for data collection system in RTIs. Exploring stakeholders’ perspective is one of the key sources for understanding this system. The purpose of this study is to identify the process of RTI data collection system based on stakeholders’ experience.

METHODS: This qualitative study was conducted employing grounded theory approach since September 2017 to December 2018 in Iran. Participants in this study were the authorities of the Emergency organizations, police, Ministry of Health and Medical Education, faculty members, as well as executive staff and road users who were involved in collecting and recording data (n=15). Data collection was carried out through face-to-face interviews using purposeful and theoretical sampling. Data analysis was performed based on Strauss and Corbin 2008.

RESULTS: The core category was identified as “separated registration” explaining the process of collecting and recording road traffic injury data. Other variables obtained using the Strauss and Corbin Paradigm model were categorized as context, casual, intervening, strategies, and outcomes factors. The findings were classified into five groups including lack of trust in road safety promotion, process factors, management and organizational factors, failure of quality assurance, and administrative and organizational culture.

CONCLUSIONS: The most important theory is “separated registration” and non-systematic registry system of road traffic injury data which is shown in a conceptual model. The findings of this study will help policymakers for better understanding the collecting and recording of RTI information.

PMID:33875628 | DOI:10.5249/jivr.v13i2.1406

Transl Psychiatry. 2021 Apr 19;11(1):226. doi: 10.1038/s41398-021-01265-2.

ABSTRACT

Psychotic experiences (PE) are associated with poorer functioning, higher distress and the onset of serious mental illness. Environmental exposures (e.g. childhood abuse) are associated with the development of PE. However, which specific exposures convey risk for each type or dimension of PE has rarely been explored. The Oxford Wellbeing Life and Sleep (OWLS) survey includes 22 environmental risk factors for psychosis and was designed to examine how environmental risks are associated with specific dimensions of PE. Multivariate logistic regression models were fit using these risk factors to predict six dimensions of PE (perceptual abnormalities, persecutory ideation, bizarre ideas, cognitive disorganisation, delusional mood and negative symptoms). Models were built using only 70% of the data, and then fit to the remaining data to assess their generalisability and quality. 1789 (27.2% men; mean age = 27.6; SD = 10.9) survey responses were analysed. The risk factors predictive of the most PE were anxiety, social withdrawal during childhood and trauma. Cannabis and depression predicted three dimensions with both predicting bizarre ideas and persecutory ideation. Psychological abuse and sleep quality each predicted two dimensions (persecutory ideation and delusional mood). Risk factors predicting one PE dimension were age (predicting cognitive disorganisation), physical abuse (bizarre ideas), bullying and gender (persecutory ideation); and circadian phase (delusional mood). These results lend support for a continuum of psychosis, suggesting environmental risks for psychotic disorders also increase the risk of assorted dimensions of PE. Furthermore, it advocates the use of dimensional approaches when examining environmental exposures for PE given that environmental risks distribute differently across dimensions.

PMID:33875641 | DOI:10.1038/s41398-021-01265-2

Hosp Pediatr. 2021 Apr 19:hpeds.2020-002345. doi: 10.1542/hpeds.2020-002345. Online ahead of print.

ABSTRACT

OBJECTIVES: Poor communication is a major contributor to sentinel events in hospitals. Suboptimal communication between physicians and nurses may be due to poor understanding of team members’ roles. We sought to evaluate the impact of a shadowing experience on nurse-resident interprofessional collaboration, bidirectional communication, and role perceptions.

METHODS: This mixed-methods study took place at 2 large academic children’s hospitals with pediatric residency programs during the 2018-2019 academic year. First-year residents and nurses participated in a reciprocal, structured 4-hour shadowing experience. Participants were surveyed before, immediately after, and 6 months after their shadowing experience by using an anonymous web-based platform containing the 20-item Interprofessional Collaborative Competency Attainment Survey, as well as open-ended qualitative questions. Quantitative data were analyzed via linear mixed models. Qualitative data were thematically analyzed.

RESULTS: Participants included 33 nurses and 53 residents from the 2 study sites. The immediate postshadowing survey results revealed statistically significant improvements in 12 Interprofessional Collaborative Competency Attainment Survey question responses for nurses and 19 for residents (P ≤ .01). Subsequently, 6 questions for nurses and 17 for residents revealed sustained improvements 6 months after the intervention. Qualitative analysis identified 5 major themes related to optimal nurse-resident engagement: effective communication, collaboration, role understanding, team process, and patient-centered.

CONCLUSIONS: The reciprocal shadowing experience was associated with an increase in participant understanding of contributions from all interprofessional team members. This improved awareness may improve patient care. Future work may be conducted to assess the impact of spread to different clinical areas and elucidate patient outcomes that may be associated with this intervention.

PMID:33875534 | DOI:10.1542/hpeds.2020-002345

RMD Open. 2021 Apr;7(2):e001510. doi: 10.1136/rmdopen-2020-001510.

ABSTRACT

OBJECTIVE: The role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis.

METHODS: Patients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on demographics, alcohol use, smoking habits and disease outcome measures were collected from these patients. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann-Whitney U tests and one-way analysis of variance with Tukey’s honest significant difference (HSD) test.

RESULTS: Of the 979 analysed patients, 62% had rheumatoid arthritis (RA), 26.7% had psoriatic arthritis (PsA) and 11.2% had ankylosing spondylitis. Mean DAS28-CRP (Disease Activity Score 28 – C-reactive protein) in RA and PsA at 1 year was 2.96±1.39, and 64.2% of patients were in remission (DAS28-CRP ≤2.6 or BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) ≤4). Both male gender and risky drinking (>15 units of weekly alcohol) were significantly associated with remission. Compared with women, men had an OR of 1.8 (1.1, 2.5) (p=0.034) for any alcohol consumption and 6.9 (4.7, 9.1) (p=0.001) for drinking at least 15 weekly drinks. When adjusted for gender, there was no association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still significantly influenced disease activity.

CONCLUSION: While it may appear that alcohol is linked to remission in inflammatory arthritis, when adjusted for gender, it is not. Men with inflammatory arthritis drink significantly more than women and have less severe disease activity.

PMID:33875561 | DOI:10.1136/rmdopen-2020-001510