Tag: nevin manimala

J Am Geriatr Soc. 2022 May 19. doi: 10.1111/jgs.17884. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of this study was to determine associations between use of oral anticoagulation (OAC) and stroke and bleeding-related outcomes for older people ≥80 years with atrial fibrillation (AF), and to determine trends over time in prescribing of OAC for this population.

METHODS: A retrospective cohort study was conducted. People aged ≥80 years with AF receiving (1) no OAC; (2) warfarin; or (3) a non-vitamin-K antagonist oral anticoagulant (NOAC) between 2011 and 2019 were included. Propensity score matching was used to balance cohorts (no OAC, warfarin or a NOAC) on characteristics including age, sex, ethnicity, and co-morbidities. Cox proportional hazard models were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS: The proportion of people aged ≥80 years receiving any OAC increased from 32.4% (n = 27,647) in 2011 to 43.6% (n = 110,412) in 2019. After propensity score matching, n = 169,067 individuals were included in the cohorts receiving no OAC or a NOAC. Compared to no OAC, participants receiving a NOAC had a lower risk of incident dementia (hazHR 0.68, 95% CI 0.65-0.71), all-cause mortality (HR 0.49, 95% CI 0.48-0.50), first-time ischaemic stroke (HR 0.87, 95% CI 0.83-0.91), and a higher risk of major bleeding (HR 1.08, 95% CI 1.05-1.11). Compared to participants receiving warfarin, participants receiving a NOAC had a lower risk of dementia (HR 0.90, 95% CI: 0.86-0.93), all-cause mortality (HR 0.74, 95% CI: 0.72-0.76), ischaemic stroke (HR 0.86, 95% CI: 0.82-0.90) and major bleeding (HR 0.88, 95% CI: 0.85-0.90). Similar results were observed when only including people with additional bleeding risk factors.

CONCLUSIONS: The proportion of people aged ≥80 years receiving OAC has increased since the introduction of NOACs, but remains low. Use of a NOAC was associated with improved outcomes compared to warfarin, and compared to no OAC, except for a small but statistically significant higher risk of major bleeding.

PMID:35587227 | DOI:10.1111/jgs.17884

Health Rep. 2022 May 18;33(5):13-21. doi: 10.25318/82-003-x202200500002-eng.

ABSTRACT

INTRODUCTION: Data from the first round of the nationally representative Survey on COVID-19 and Mental Health (SCMH) revealed that the prevalence of recent suicidal ideation in the fall of 2020 in Canada did not differ significantly from that in the pre-pandemic period in 2019. The objective of the present study was to reassess the prevalence of recent suicidal ideation in the spring of 2021.

METHODS: The prevalence of suicidal ideation among adults in Canada was examined using the 2021 SCMH (conducted between February 1 and May 7, 2021), and it was compared with the prevalence in the 2019 Canadian Community Health Survey. Unadjusted logistic regression analysis was used to assess the differential likelihood of reporting suicidal ideation in population subgroups.

RESULTS: Among adults in Canada, the prevalence of suicidal ideation since the pandemic began was 4.2%, which was significantly higher than the pre-pandemic prevalence of 2.7% in 2019. A statistically significant increase in prevalence was observed among females and males, age groups younger than 65, and several other sociodemographic groups, as well as in British Columbia, the Prairie provinces and Ontario. People who were younger than 65 years, were born in Canada, had lower educational attainment, or were never married were significantly more likely to report suicidal ideation than others during the pandemic.

CONCLUSION: As the second year of the pandemic began, the prevalence of recent suicidal ideation in Canada was higher than it had been before the pandemic in 2019. Continuous monitoring of suicide-related outcomes and risks is necessary so that population-level changes can be detected and inform public health action.

PMID:35587219 | DOI:10.25318/82-003-x202200500002-eng

Health Rep. 2022 May 18;33(5):22-33. doi: 10.25318/82-003-x202200500003-eng.

ABSTRACT

BACKGROUND: Canadian and international research has shown that the COVID-19 pandemic has led to changes in health behaviours, including physical activity.

METHODS: The Canadian Community Health Survey asked Canadian youth (12 to 17 years) and adults (18 years and older) to report the amount of time they spent in the past seven days engaged in physical activity across the following domains: recreation, transportation, household or occupation, and school (youth only). The present analysis compares the physical activity from two cross-sectional samples collected during the fall of 2018 (n=13,482) and the fall of 2020 (n=27,234).

RESULTS: Youth reported accumulating, on average, two hours less physical activity per week in the fall of 2020 compared with the fall of 2018 (-129 minutes per week). The percentage of youth meeting the Canadian physical activity recommendation for children and youth dropped from 50.8% in the fall of 2018 to 37.2% in the fall of 2020. Physical activity decreased more among youth living in urban (-135 minutes per week) compared with rural (-86 minutes per week) areas. Physical activity decreased more among youth from Ontario (-168 minutes per week), Quebec (-121 minutes per week) and the Prairies (-106 minutes per week) compared with youth from the Atlantic provinces (-38 minutes per week) and British Columbia (-75 minutes per week). There was no change in the percentage of adults aged 18 and older meeting the Canadian physical activity recommendation between the fall of 2018 (52.7%) and the fall of 2020 (53.3%). Weekly physical activity was stable between fall 2018 and fall 2020 among 18 to 49 year olds, while significant increases were observed among adults aged 50 to 64 years (+41 minutes per week), 65 to 79 years (+55 minutes per week) and 80+ years (+20 minutes per week). Increases in physical activity among adults were statistically significant only among non-immigrant, non-Indigenous, those not designated as a visible minority, those living in urban areas and those with a postsecondary degree.

INTERPRETATION: The COVID-19 pandemic had a detrimental impact on the physical activity of youth but not adults. The findings of this study add to a growing body of evidence that shows the considerable impact the pandemic has had on many aspects of Canadian life, including physical activity.

PMID:35587220 | DOI:10.25318/82-003-x202200500003-eng

Health Rep. 2022 May 18;33(5):3-12. doi: 10.25318/82-003-x202200500001-eng.

ABSTRACT

BACKGROUND: Compared to the general Canadian population, military members exhibit a higher prevalence of depressive disorders, anxiety disorders, and post-traumatic stress disorder. However, there is a paucity of research investigating the extent to which military members experience positive mental health. Validation of positive mental health measures, including the Mental Health Continuum – Short Form (MHC-SF), is necessary to determine whether well-being can be assessed in a valid and reliable manner among Canadian Armed Forces (CAF) military members. The purpose of this research was to assess the internal consistency reliability, convergent validity, factor structure, and measurement invariance of the MHC-SF among CAF Regular Force and Reserve Force military members.

DATA AND METHODS: Data were drawn from the nationally representative 2013 Canadian Forces Mental Health Survey (CFMHS) conducted by Statistics Canada. A random sample of 8,200 CAF military personnel completed the CFMHS, representing 64,400 Regular Force and 4,460 Reserve Force CAF personnel.

RESULTS: As expected, all three MHC-SF subscales (psychological, social, and emotional well-being) correlated positively with life satisfaction, self-rated mental health, sense of belonging, and social support, and correlated negatively with psychological distress and disability due to health conditions. Internal consistency was high. Confirmatory factor analysis supported the three-factor structure of the MHC-SF, and measurement invariance was satisfied.

INTERPRETATION: Findings provided support for the reliability, convergent validity, factorial validity, and measurement invariance of the MHC-SF among both Regular Force and Reserve Force military samples. Therefore, researchers and clinicians can reliably implement the MHC-SF as a tool to assess, interpret, and predict military members’ psychological, social, and emotional well-being.

PMID:35587218 | DOI:10.25318/82-003-x202200500001-eng

Comput Methods Biomech Biomed Engin. 2022 May 19:1-12. doi: 10.1080/10255842.2022.2047952. Online ahead of print.

ABSTRACT

This paper discussed the size of 3 D-printed personalized titanium plates that can gain maximum stability of mandibular fracture and minimize stress shielding through finite element analysis. A 3 D virtual model of mandible with mandibular angle fracture was created from the CT data of patient. 3 D-printed personalized titanium plates varying in length and thickness were designed, and finite element analysis was performed under different loading conditions and fracture healing periods. After that, the stress distribution and deformation of the mandible with gonial fracture could be observed, and the stress shielding rate could be obtained. Finally, SPSS21.0 was used for statistical analysis. The results of finite element analysis indicated that as the thickness of titanium plates and the healing time decreased, the maximum displacement increased, under a certain condition in which the pore size, the width, the hole distance and the bridge spacing were 2.0 mm, 4.0 mm, 6.0 mm, 12.0 mm, respectively. What’s more, in this condition, the thicker the titanium plate and the shorter the healing time were, the higher the stress shielding was at central occlusion. When the thickness of the personalized 3 D-printed titanium plate was 1.0 mm, the maximum displacement tended to be stable and the stress shielding was minimized. It can not only improve the bone stability after tension band fixation, but also minimize the stress shielding, which is expected to expand the indications of tension band fixation.

PMID:35587215 | DOI:10.1080/10255842.2022.2047952

Pediatr Allergy Immunol Pulmonol. 2022 May 18. doi: 10.1089/ped.2021.0229. Online ahead of print.

ABSTRACT

Background and Objective: Although high-flow nasal cannula (HFNC) is widely used in children, there is no consensus on the methods for starting, maintenance, and weaning. The aim of this study was to compare weaning methods in children. Methods: The study included all patients in pediatric intensive care unit (PICU) who were started on HFNC treatment. The respiratory assessment score was used in the decisions for starting, continuing, and weaning from HFNC. The patients who responded and for whom weaning was planned were randomized by month into 2 groups as directly weaned from HFNC and weaned by reducing the flow. Success rates, treatment, and length of stay (LOS) in weaning methods were compared. Results: Of the 145 patients initially included in the study, 32 (22%) were excluded, and analysis was made of 113 patients. Successful weaning from HFNC was obtained in 76.9% of the patients, in 82.1% of flow weaning, and 73.6% of direct weaning, with no statistically significant difference determined between the groups (P = 0.286). The median duration of HFNC and the median LOS in PICU were determined to be statistically significantly shorter in direct weaning than in flow weaning [36 h interquartile range (IQR) 24-48 h] versus 60 h (IQR 60-72 h), P < 0.001 and 6 days (4-14 days) versus 9.5 days (5.25-20.75 days, P = 0.043, respectively). Conclusion: In patients who responded to HFNC in PICU, the responses to direct weaning and flow reduction were seen to be similar. In patients directly weaned off, both the HFNC duration and LOS in PICU were significantly shorter.

PMID:35587212 | DOI:10.1089/ped.2021.0229

Eur J Haematol. 2022 May 18. doi: 10.1111/ejh.13789. Online ahead of print.

ABSTRACT

Disease-specific stress can partly explain Sickle Cell Disease (SCD) healthcare utilization. We developed and validated two measures of adult SCD-specific stress for research and clinical care. A large cohort of adults with SCD completed both a three-item Likert-scale adapted from a previous disease stress measure and a 10-item Likert-scale questionnaire drafted specifically to measure SCD stress. They concurrently completed a psychosocial and health-related quality of life scale battery, then subsequently daily pain diaries. Diaires measured: daily intensity, distress and interference of pain; self-defined vaso-occlusive crises (VOC), opioid use, and types of health care utilization for up to 24 weeks. Analyses tested Cronbach’s alpha, correlation of the three-item and 10-item stress scales with the concurrent battery, with percentages of pain days, VOC days, opioid use days, and healthcare utilization days, and correlation of baseline stress and 6-month stress for the 10-item scale. Cronbach’s alpha was high for both the 3-item (0.73) and 10-item (0.83) SCD stress scales , test-retest correlation of 0.55, expected correlation with the concurrent battery, and correlation with diary-measured healthcare utilization over 6 months. The correlations with the 3-item scale were stronger, but only statistically significant for depression-anxiety. The correlation between the two stress scales was 0.59. Both the 3-item and the 10-item stress scales exhibited good face, construct, concurrent, and predictive validity as well as moderate test-retest reliability. Further scale validation should determine population norms and response to interventions.

PMID:35585659 | DOI:10.1111/ejh.13789

Mol Autism. 2022 May 18;13(1):21. doi: 10.1186/s13229-022-00499-1.

ABSTRACT

BACKGROUND: Neuroimage literature of autism spectrum disorder (ASD) has a moderate-to-high risk of bias, partially because those combined with intellectual impairment (II) and/or minimally verbal (MV) status are generally ignored. We aimed to provide more comprehensive insights into white matter alterations of ASD, inclusive of individuals with II (ASD-II-Only) or MV expression (ASD-MV).

METHODS: Sixty-five participants with ASD (ASD-Whole; 16.6 ± 5.9 years; comprising 34 intellectually able youth, ASD-IA, and 31 intellectually impaired youth, ASD-II, including 24 ASD-II-Only plus 7 ASD-MV) and 38 demographic-matched typically developing controls (TDC; 17.3 ± 5.6 years) were scanned in accelerated diffusion-weighted MRI. Fixel-based analysis was undertaken to investigate the categorical differences in fiber density (FD), fiber cross section (FC), and a combined index (FDC), and brain symptom/cognition associations.

RESULTS: ASD-Whole had reduced FD in the anterior and posterior corpus callosum and left cerebellum Crus I, and smaller FDC in right cerebellum Crus II, compared to TDC. ASD-IA, relative to TDC, had no significant discrepancies, while ASD-II showed almost identical alterations to those from ASD-Whole vs. TDC. ASD-II-Only had greater FD/FDC in the isthmus splenium of callosum than ASD-MV. Autistic severity negatively correlated with FC in right Crus I. Nonverbal full-scale IQ positively correlated with FC/FDC in cerebellum VI. FD/FDC of the right dorsolateral prefrontal cortex showed a diagnosis-by-executive function interaction.

LIMITATIONS: We could not preclude the potential effects of age and sex from the ASD cohort, although statistical tests suggested that these factors were not influential. Our results could be confounded by variable psychiatric comorbidities and psychotropic medication uses in our ASD participants recruited from outpatient clinics, which is nevertheless closer to a real-world presentation of ASD. The outcomes related to ASD-MV were considered preliminaries due to the small sample size within this subgroup. Finally, our study design did not include intellectual impairment-only participants without ASD to disentangle the mixture of autistic and intellectual symptoms.

CONCLUSIONS: ASD-associated white matter alterations appear driven by individuals with II and potentially further by MV. Results suggest that changes in the corpus callosum and cerebellum are key for psychopathology and cognition associated with ASD. Our work highlights an essential to include understudied subpopulations on the spectrum in research.

PMID:35585645 | DOI:10.1186/s13229-022-00499-1

Syst Rev. 2022 May 18;11(1):98. doi: 10.1186/s13643-022-01980-x.

ABSTRACT

BACKGROUND: Increased circulating endocannabinoids levels are typically associated with aerobic exercise. This phenomenon is associated with a “runner’s high,” a state of euphoria and well-being experienced after a long exercise. We will provide in this review a transparent and standardized methodology following the PRISMA-P and Cochrane Handbook for Systematic Reviews of Interventions for conducting a systematic review and meta-analysis for synthesizing the available evidence about the effects of physical activity on the circulating levels of AEA and 2-AG endocannabinoids in healthy subjects.

METHODS: A multi-disciplinary team with basic and clinical expertise in exercise science developed this protocol. PubMed, EMBASE, Web of Science, CINAHL, SPORTDiscus, and Scopus will be the databases. A health sciences librarian was consulted in the development of the research. Search strategies will combine MeSH terms and free text words, including “exercise,” “exercise, physical,” “exercise training,” “physical activity,” “endocannabinoids,” “2-arachidonoyl-glycerol,” “glyceryl 2-arachidonate,” “2-AG,” “anandamide,” “AEA,” “n-arachidonoylethanolamide,” “adult,” “young adult,” and “middle-aged.” We will select experimental or quasi-experimental studies published through December 2021. The selection of studies, data extraction, assessment of the risk of bias, and the quality of evidence will be carried out in a paired and independent manner, and the consistency will be assessed using the statistics of Cohen Kappa. Methodological quality will be assessed using the Revised Cochrane risk of bias tool for randomized trials (RoB 2) and the Risk Of Bias In Nonrandomized Studies of Interventions (ROBINS-I) risk tool. We will use the Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of the evidence, χ² and I² tests for heterogeneity, funnel plots, and the Egger test for publication bias. A meta-analysis for each data comparison will be performed whenever possible to determine the effect of physical activity on endocannabinoids’ circulating levels.

DISCUSSION: This systematic review and meta-analysis will provide an overview of the evidence about physical activity over AEA and 2-AG endocannabinoids, including comparability of variables between studies, critical interpretation of results, and use of accurate statistical techniques. The endocannabinoid is molecules by which muscles communicate with other tissues and organs, mediating the beneficial effects of exercise on health and performance, including increased glucose uptake, improved insulin action, and mitochondrial biogenesis. They are essential to exercise. Thus, this study will review the acute effect of physical exercise on circulating levels of endocannabinoids in healthy individuals. The results of this study will potentially be transferred to doctors, health professionals, and legislators to guide their decision making, as well as will improve future research.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020202886 .

PMID:35585640 | DOI:10.1186/s13643-022-01980-x

Mol Autism. 2022 May 18;13(1):22. doi: 10.1186/s13229-022-00500-x.

ABSTRACT

BACKGROUND: Understanding the development of the neuronal circuitry underlying autism spectrum disorder (ASD) is critical to shed light into its etiology and for the development of treatment options. Resting state EEG provides a window into spontaneous local and long-range neuronal synchronization and has been investigated in many ASD studies, but results are inconsistent. Unbiased investigation in large and comprehensive samples focusing on replicability is needed.

METHODS: We quantified resting state EEG alpha peak metrics, power spectrum (PS, 2-32 Hz) and functional connectivity (FC) in 411 children, adolescents and adults (n = 212 ASD, n = 199 neurotypicals [NT], all with IQ > 75). We performed analyses in source-space using individual head models derived from the participants’ MRIs. We tested for differences in mean and variance between the ASD and NT groups for both PS and FC using linear mixed effects models accounting for age, sex, IQ and site effects. Then, we used machine learning to assess whether a multivariate combination of EEG features could better separate ASD and NT participants. All analyses were embedded within a train-validation approach (70%-30% split).

RESULTS: In the training dataset, we found an interaction between age and group for the reactivity to eye opening (p = .042 uncorrected), and a significant but weak multivariate ASD vs. NT classification performance for PS and FC (sensitivity 0.52-0.62, specificity 0.59-0.73). None of these findings replicated significantly in the validation dataset, although the effect size in the validation dataset overlapped with the prediction interval from the training dataset.

LIMITATIONS: The statistical power to detect weak effects-of the magnitude of those found in the training dataset-in the validation dataset is small, and we cannot fully conclude on the reproducibility of the training dataset’s effects.

CONCLUSIONS: This suggests that PS and FC values in ASD and NT have a strong overlap, and that differences between both groups (in both mean and variance) have, at best, a small effect size. Larger studies would be needed to investigate and replicate such potential effects.

PMID:35585637 | DOI:10.1186/s13229-022-00500-x