Tag: nevin manimala

J Womens Health (Larchmt). 2021 Apr;30(4):492-501. doi: 10.1089/jwh.2020.8974.

ABSTRACT

Background: Smaller studies suggest lower morbidity and mortality associated with coronavirus disease 2019 (COVID-19) in women. Our aim is to assess the impact of female sex on outcomes in a large cohort of patients hospitalized with COVID-19. Materials and Methods: This is a retrospective observational cohort study of 10,630 adult patients hospitalized with a confirmed COVID-19 polymerase chain reaction between March 1, 2020 and April 27, 2020, with follow-up conducted through June 4, 2020. Logistic regression was used to examine the relationship between sex and the primary outcomes, including length of stay, admission to intensive care unit (ICU), need for mechanical ventilation, pressor requirement, and all-cause mortality as well as major adverse events and in-hospital COVID-19 treatments. Results: In the multivariable analysis, women had 27% lower odds of in-hospital mortality (odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.66-0.81; p < 0.001), 24% lower odds of ICU admission (OR = 0.76, 95% CI 0.69-0.84; p < 0.001), 26% lower odds of mechanical ventilation (OR = 0.74, 95% CI 0.66-0.82; p < 0.001), and 25% lower odds of vasopressor requirement (OR = 0.75, 95% CI 0.67-0.84; p < 0.001). Women had 34% less odds of having acute cardiac injury (OR = 0.66, 95% CI 0.59-0.74; p < 0.001; n = 7,289), 16% less odds of acute kidney injury (OR = 0.84, 95% CI 0.76-0.92; p < 0.001; n = 9,840), and 27% less odds of venous thromboembolism (OR = 0.73, 95% CI 0.56-0.96; p < 0.02; c-statistic 0.85, n = 9,407). Conclusions: Female sex is associated with lower odds of in-hospital outcomes, major adverse events, and all-cause mortality. There may be protective mechanisms inherent to female sex, which explain differences in COVID-19 outcomes.

PMID:33885345 | DOI:10.1089/jwh.2020.8974

Photobiomodul Photomed Laser Surg. 2021 Apr 20. doi: 10.1089/photob.2020.4952. Online ahead of print.

ABSTRACT

Background: To identify the most effective time procedure for irradiation to prevent possible harmful pulp temperature rises during diode laser (DL) as an adjunct to scaling and root planning (SRP) treatment. Methods: One hundred fifty freshly extracted human teeth (30 molars, 30 premolars, 30 canines, 30 upper incisors, and 30 lower incisors) were irradiated using a 940-nm DL with a power output at 0.8 W and exposure time of 10, 20, 30, 40, 50, 60 sec per specimen. The thermocouple was used to measure intrapulpal temperature. As an addition, the impact of dark deposits on the root surface was investigated for the intrapulpal temperature rise. The threshold value of 5.6°C is predetermined to damage the pulp. Temperature variations were measured at every 10 sec for five different types of teeth, and statistical analysis was performed. Results: Despite large differences between tooth types, the observed temperature increases for all tooth types were below the threshold of 5.6°C in 20 sec. Dark deposits on the tooth surface reduced the reliable working time of DLs (p < 0.01). Conclusions: DLs as an adjunct to SRP treatment at 0.8 W in molars, premolars, canine, upper incisors, and lower incisors for 42, 37, 38, 27, and 21 sec, respectively, generate acceptable temperature rises for pulp but should be changed as 39, 21, 26, 23, and 13 sec, respectively, in the presence of dark deposits.

PMID:33885354 | DOI:10.1089/photob.2020.4952

JMIR Mhealth Uhealth. 2021 Apr 22;9(4):e27383. doi: 10.2196/27383.

ABSTRACT

BACKGROUND: Regular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife.

OBJECTIVE: This study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years.

METHODS: A single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention satisfaction survey that included multiple-choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic.

RESULTS: Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants’ suggestions for improving the intervention included enhancing the intervention’s provisions of social support for PA.

CONCLUSIONS: The results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.

PMID:33885368 | DOI:10.2196/27383

Anal Chem. 2021 Apr 22. doi: 10.1021/acs.analchem.1c00438. Online ahead of print.

ABSTRACT

This paper compares static (i.e., temporally unchanging) thermal gradient gas chromatography (GC) to isothermal GC using a stochastic transport model to simulate peak characteristics for the separation of C12-C14 hydrocarbons resulting from variations in injection bandwidth. All comparisons are made using chromatographic conditions that give approximately equal analyte retention times so that the resolution and number of theoretical plates can be clearly compared between simulations. Simulations show that resolution can be significantly improved using a linear thermal gradient along the entire column length. This is mainly achieved by partially compensating for loss in resolution from the increase in mobile phase velocity, which approximates an ideal, basic separation. The slope of the linear thermal gradient required to maximize resolution is a function of the retention parameters, which are specific to each analyte pair; a single static, thermal gradient will not affect all analytes equally. A static, non-linear thermal gradient that creates constant analyte velocities at all column locations provides the largest observed gains in resolution. From the simulations performed in this study, optimized linear thermal gradient conditions are shown to improve the resolution by as much as 8.8% over comparative isothermal conditions, even with a perfect injection (i.e., zero initial bandwidth).

PMID:33885280 | DOI:10.1021/acs.analchem.1c00438

Langmuir. 2021 Apr 22. doi: 10.1021/acs.langmuir.1c00624. Online ahead of print.

ABSTRACT

Self-assembled lamellar films of poly(N-dodecyl acrylamide-stat-vinyl phosphonic acid) [p(DDA/VPA)] were formed via the segregation between the hydrophilic main chain and VPA and dodecyl side chains. p(DDA/VPA) copolymers were synthesized by free-radical copolymerization of DDA and VPA with VPA molar concentrations of 19% [p(DDA/VPA19)] and 64% [p(DDA/VPA64)]. Both copolymers exhibited a glass-transition temperature (T_g) and melting temperature for p(DDA/VPA19), but no crystalline or liquid-crystalline phase-transition temperatures, which suggests that both copolymers are amorphous. Thin films of the copolymers were prepared by spin coating, and the structure of the films was studied by X-ray diffraction (XRD) measurements. The as-cast films of the copolymers showed broad diffraction patterns, which suggested the formation of alkyl nanodomains similar to that observed in the pDDA homopolymers. On the other hand, the XRD patterns for both copolymer films showed a sharp Bragg diffraction in the low-q region after annealing at 60 °C. Furthermore, the p(DDA/VPA19) film showed first- and second-order Bragg diffractions with a ratio of 1:2. These XRD patterns suggest that the copolymer films form an ordered lamellar structure. We concluded that the main chain became more hydrophilic by the introduction of VPA, resulting in an increased segregation force relative to the hydrophobic dodecyl side chains, which induces the formation of lamellae. Moreover, doping a p(DDA/VPA64) film with imidazole increased the ordering and uniformity of the lamellar structures due to the increased segregation force by the formation of ion pairs in the hydrophilic comonomer. In their entirety, the results show that statistical copolymerization can be used as a new method to create self-assembled structures.

PMID:33885305 | DOI:10.1021/acs.langmuir.1c00624

Sports Health. 2021 Apr 22:19417381211003515. doi: 10.1177/19417381211003515. Online ahead of print.

ABSTRACT

CONTEXT: There is currently no evidence-based consensus on how to treat a full-thickness, symptomatic articular cartilage injury of the patella, although numerous treatment options are available.

OBJECTIVE: To systematically evaluate the functional outcomes after operative treatment of patellar cartilage lesions. Our secondary purpose was to evaluate radiographic outcomes after treatment.

DATA SOURCES: PubMed, Cochrane, and Embase.

STUDY SELECTION: Studies published between January 1, 1990 and December 31, 2018 that included patient-reported functional outcomes for patients after operative treatment of patellar chondral defects at a minimum 2-year follow-up were included.

STUDY DESIGN: Systematic review.

LEVEL OF EVIDENCE: Level 4.

DATA EXTRACTION: MINORS (Methodological Index for Non-Randomized Studies) score, level of evidence, sample size, demographic data, follow-up data, intervention, functional outcome scores, and magnetic resonance imaging (MRI) data were collected.

RESULTS: The review identified 10 studies and 293 patients receiving cartilage restoration procedures for patellar chondral defects with extractable clinical and radiographic results and data on complications and reoperations. All treatments (autologous chondrocyte implantation [ACI], matrix-induced ACI [MACI], autologous osteochondral transplantation [AOT]) utilized in the management of patellar chondral lesions, with the exception of isolated particulated juvenile articular cartilage, demonstrated statistically significant improvements in functional outcome scores compared with preoperative measurements at a minimum of 2-year follow-up. Postoperative MRIs were obtained in 6 studies and found that regardless of treatment, moderate-to-complete infill of patellar cartilage lesions was seen in the majority of patients. While failure rates were low for the various treatment modalities, rates of reoperation were substantial, with up to 40% to 60% reoperation rate seen after ACI.

CONCLUSION: Patients treated with ACI, MACI, and AOT all demonstrated statistically significant improvements in functional outcome scores with radiographic evidence of healing at minimum of 2-year follow-up. Evidence is insufficient to recommend one particular treatment over another.

PMID:33885342 | DOI:10.1177/19417381211003515

Kardiol Pol. 2021 Apr 16. doi: 10.33963/KP.15956. Online ahead of print.

ABSTRACT

BACKGROUND: Ionizing radiation constitutes a well-known risk factor of carotid artery stenosis. The survival rates of head and neck cancer patients undergoing radiotherapy have risen owing to medical advancements in the field. As a consequence, the incidence of carotid artery stenosis in these high-risk patients has increased.

AIMS: In this study we sought to compare the outcomes of carotid endarterectomy (CEA) versus carotid artery stenting (CAS) for radiation-induced carotid artery stenosis.

METHODS: This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eligible studies were identified through a comprehensive search of PubMed, Scopus and Cochrane Central until July 2020. A random-effects model meta-analysis was conducted, and odds ratios (ORs) were calculated. The I-square statistic was used to assess for heterogeneity.

RESULTS: Seven studies and 201 patients were included. Periprocedural stroke, myocardial infarction (MI) and death rates were similar between the two revascularization approaches. However, the risk for cranial nerve (CN) injury was higher in the CEA group (OR: 7.40; 95% CI: 1.58-34.59; I2 = 0%). Analysis revealed no significant difference in terms of long-term mortality (OR: 0.41; 95%CI: 0.14-1.16; I2 = 0%) and restenosis (OR: 0.69; 95%CI: 0.29-1.66; I2 = 0%) rates between CEA and CAS after a mean follow up of 40.5 months.

CONCLUSIONS: CAS and CEA appear to have a similar safety and efficacy profile in patients with radiation-induced carotid artery stenosis. Patients treated with CEA have a higher risk for periprocedural CN injuries. Future prospective studies are warranted to validate these results.

PMID:33885270 | DOI:10.33963/KP.15956

Clin Nucl Med. 2021 Apr 21. doi: 10.1097/RLU.0000000000003704. Online ahead of print.

NO ABSTRACT

PMID:33883481 | DOI:10.1097/RLU.0000000000003704

Nurs Res. 2021 Mar 22. doi: 10.1097/NNR.0000000000000513. Online ahead of print.

ABSTRACT

BACKGROUND: Despite numerous efforts to create more equitable health care systems, minority populations face long-standing health disparities compared to White populations. Health care research is the necessary foundation for creating equitable health systems and providing patient-centered care. Significant challenges exist, however, with recruiting and engaging underrepresented populations in clinical research.

OBJECTIVES: The purpose of this analysis was to determine how research participant race, trust, and level of education influence participation barriers in clinical research.

METHODS: The study used secondary, cross-sectional survey data that were collected between 2014 and 2016 through the former Mid-South Clinical Data Research Network (CDRN), currently known as the STAR-CRN. Descriptive statistics and Spearman rank correlations were performed between level of education, level of trust, and each attitude statement for each racial category.

RESULTS: A total of 2,190 survey responses were used in the data analysis. The mean age of respondents was 52 years with majority being female, White, insured, and working full time. Overall, the respondents had favorable attitudes towards research participation. Trust was correlated with agreement in many attitude statements for both White and African American respondents, while correlations with education level were more variable depending on racial grouping. Trust level was negatively associated with agreement towards the statement “researchers don’t care about me” in White and Native American respondents.

DISCUSSION: The results support the importance of trust to research participation. Generally, education level was not strongly predictive of research participation, although prediction was influenced by race and attitude.

PMID:33883501 | DOI:10.1097/NNR.0000000000000513

J Clin Gastroenterol. 2021 Apr 21. doi: 10.1097/MCG.0000000000001546. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer and cancer-related mortality worldwide. Studies have suggested that aspirin (ASA) and statins may be associated with a decrease in incident HCC.

GOALS: We aimed to evaluate the effect of ASA and statin use on the incidence of HCC in a prospective cohort of patients with liver cirrhosis and to identify if there was an increased risk of esophageal variceal hemorrhage (VH) in patients with ASA use.

STUDY: We conducted a retrospective study of 521 patients with data collected from July 1, 2012 to December 31, 2017. We used competing risk analysis to assess the association between risk factors and HCC; and the association between ASA and VH.

RESULTS: ASA use alone was associated with a decreased incidence of HCC in the univariate and multivariate models; [hazard ratio (HR) confidence interval (CI): 0.348 (0.124-0.976); P=0.0448] and [HR (CI): 0.266 (0.094-0.755); P=0.0129, respectively]. The combination of ASA and statin use was associated with a decreased hazard of HCC [HR (CI): 0.15 (0.036-0.624); P=0.0090] and this remained statistically significant in the multivariable model [HR (CI): 0.113 (0.026-0.483); P=0.0033]. Among daily ASA users compared with non-users, there was not a significant increase in risk of VH.

CONCLUSIONS: Daily ASA use was associated with a decrease risk of incident HCC. The combination of daily ASA use and statin use decreased the risk of incident HCC suggesting there is beneficial interaction. Finally, no excess VH was observed in daily ASA users compared with non-users.

PMID:33883511 | DOI:10.1097/MCG.0000000000001546