Tag: nevin manimala

J Nutr Educ Behav. 2021 Sep 28:S1499-4046(21)00770-3. doi: 10.1016/j.jneb.2021.08.006. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine infant food preparation practices at age 7, 9, 11, and 13 months overall and by sociodemographic characteristics.

DESIGN: Data from a longitudinal study from the US Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2) were used.

PARTICIPANTS: A sample of 1,904 infants (970 males and 934 females) enrolled in WIC who had been introduced to solid foods and were consuming food prepared at home.

MAIN OUTCOME MEASURES: Food preparation practices included pureeing, mashing, chopping/dicing, and prechewing. Estimates were provided overall and by sociodemographics.

ANALYSIS: Prevalence estimates were calculated for each survey month overall and by sociodemographics. Chi-square tests for independence were used to test for differences.

RESULTS: Food preparation practices changed as infants aged. Pureeing and mashing were common in month 7 (57.8% and 59.6%, respectively), but chopping/dicing were the most prevalent by month 13 (85.4%). Food preparation practices did not vary by education status, but statistical differences were consistently observed by race and ethnicity and inconsistently observed by maternal age at birth.

CONCLUSIONS AND IMPLICATIONS: Exposing children to a range of food textures at an appropriate age is important for developmental progress. Continued culturally relevant efforts by WIC educators and health care providers can emphasize the importance of early experiences with food textures.

PMID:34598893 | DOI:10.1016/j.jneb.2021.08.006

Radiography (Lond). 2021 Sep 28:S1078-8174(21)00134-6. doi: 10.1016/j.radi.2021.09.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Claustrophobia is a major problem experienced by some patients referred for magnetic resonance imaging (MRI). This results in significant costs and delays to healthcare service provision due to appointment cancellations or patients’ inability to complete MRI examinations. Radiographers may use several strategies to effectively manage patients with claustrophobia during MRI. This study aimed to determine radiographer’s confidence in managing patients with claustrophobia and evaluate the perceived effectiveness of the intervention approaches employed.

METHODS: With institutional ethical approval, an online survey was conducted (15th September to 9th November 2020) among Kuwaiti MRI radiographers. The survey was designed to obtain information relating to participant demographics and the perceived confidence of radiographers in their use of interventions to manage claustrophobia during MRI procedures. Data obtained were analysed using the Statistical Package for the Social Sciences (v.26).

RESULTS: A total of 144 valid responses were obtained. Of the respondents, 82% (n = 118) were confident that they could support claustrophobic patients during MRI examinations. Almost all respondents (97.9%, n = 141) employed various claustrophobia reduction and relaxation techniques to improve patient experience and increase scan completion rates. There was a significant association between radiographer’s level of education (r_s = +0.18, p = 0.028) and experience (r_s = +0.33, p < 0.001) with their confidence managing claustrophobic patients. While participating radiographers considered lectures and training the most effective methods to improve their skills in managing such patients, educating claustrophobic patients prior to their MRI scan was the most effective technique for facilitating scan completion.

CONCLUSION: Kuwaiti MRI radiographers are confident in applying different claustrophobic management techniques to improve patient compliance. Patient education, through supportive discussion, prior to their MRI examination was identified as the most effective intervention for managing claustrophobia.

IMPLICATIONS FOR PRACTICE: Patient education before MRI examination is necessary to enhance their experience and optimise scan completion rates. In addition, it is essential that MR radiographers develop their practical competence in supporting patients with claustrophobia during their scans.

PMID:34598898 | DOI:10.1016/j.radi.2021.09.007

Acad Radiol. 2021 Sep 28:S1076-6332(21)00386-X. doi: 10.1016/j.acra.2021.08.025. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: To date, no clinically useful classification system has been developed for reliably differentiating mucinous cystic neoplasm (MCN) from a benign hepatic cyst (BHC) in the liver. The objective was to use machine learning and a multi-center study design to develop and assess the performance of a novel classification system for predicting whether a hepatic cystic lesion represents MCN or BHC.

MATERIALS AND METHODS: A multi-center cohort study identified 154 surgically resected hepatic cystic lesions in 154 subjects which were pathologic confirmed as MCN (43) or BHC (111). Readers at each institution recorded seven pre-determined imaging features previously identified as potential differentiating features from prior publications. The contribution of each of these features to differentiating MCN from BHC was assessed by machine learning to develop an optimal classification system.

RESULTS: Although several of the assessed imaging features demonstrated statistical significance, only 3 imaging features were found by machine learning to significantly contribute to a potential classification system: (1) solid enhancing nodule (2) all septations arising from an external macro-lobulation (3) whether the lesion was solitary or one of multiple cystic liver lesions. The optimal classification system had only four categories and correctly identified 144/154 lesion (93.5%).

CONCLUSION: This multi-center follow-up study was able to use machine learning to develop a highly accurate classification system for differentiation of hepatic MCN from BHC, which could be readily applied to clinical practice.

PMID:34598868 | DOI:10.1016/j.acra.2021.08.025

Int J Obstet Anesth. 2021 Sep 15:103220. doi: 10.1016/j.ijoa.2021.103220. Online ahead of print.

ABSTRACT

BACKGROUND: There is no consensus on optimal anesthetic and analgesic management of patients presenting for cesarean delivery with suspected placenta accreta spectrum disorder. Neuraxial anesthesia is preferred for uncomplicated procedures, but general anesthesia may be indicated for those at risk of hemorrhage and hysterectomy. We compared the effect of anesthesia techniques on postoperative maternal opioid administration and neonatal respiratory distress.

METHODS: A single-center retrospective study from 2016 to 2019 using electronic records to identify singleton pregnancies with a high index of suspicion of placenta accreta spectrum disorder. Patients were categorized by the anesthetic technique they received: general, neuraxial, or neuraxial with conversion to general anesthesia following delivery. Postoperative maternal opioid administration (oral morphine in mg equivalents) and risk of neonatal respiratory distress were compared using linear mixed models.

RESULTS: Thirty-nine records were analyzed. Mean-adjusted oral morphine mg equivalents were 192 for patients receiving general anesthesia vs. 90 for neuraxial anesthesia only (P=0.009) and 104 for neuraxial with conversion to general anesthesia (P=0.052). Neonates delivered under general anesthesia had a 3.5 times relative risk (95% CI 1.3 to 9.8, P=0.017) of respiratory distress compared with those exposed to neuraxial anesthesia alone.

CONCLUSION: Patients receiving general anesthesia alone were administered more opioids than those undergoing neuraxial anesthesia or neuraxial with conversion to general anesthesia. This finding was maintained when accounting for whether or not the patient underwent hysterectomy. Deciding on anesthetic management requires consideration of patient comorbidities, severity of placenta accreta spectrum pathology, and surgical requirements.

PMID:34598859 | DOI:10.1016/j.ijoa.2021.103220

J Craniomaxillofac Surg. 2021 Sep 25:S1010-5182(21)00204-3. doi: 10.1016/j.jcms.2021.09.008. Online ahead of print.

ABSTRACT

The aim of the study was to examine lateral pterygoid muscle (LPM) and temporomandibular joint (TMJ) disc before and after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy (SSRO) in class II and class III patients. Le Fort I osteotomy and SSRO were performed in class II and class III patients. LPM measurements using oblique sagittal computed tomography (CT) images and TMJ disc position using magnetic resonance imaging (MRI) were examined. Statistical comparisons were performed for the LPM and TMJ between class II and class III patients and between those with and without intentional pterygoid plate fracture in Le Fort I osteotomy. The subjects comprised 60 female patients (120 sides), with 30 diagnosed as class II and 30 as class III. Preoperatively, the width of the condylar attachment, width at eminence, length of the LPM, angle of the LPM, and square of the LPM were significantly smaller in the class II group than in the class III group (p < 0.05). After 1 year, the width of the condylar attachment, width at eminence, and angle of the LPM remained significantly smaller in the class II group than in the class III group (p < 0.0001). TMJ disc position was significantly related to the width of the condylar attachment of the LPM, both pre- and postoperatively (p < 0.0001). However, postoperative disc position did not change in all patients. Next, the class II patients (60 sides) were divided into two groups who underwent Le Fort I osteotomy with or without intentional pterygoid plate fracture. Changes in all measurements of the LPM showed no significant differences between these two groups. Our study suggested that TMJ disc position classification could be associated with the width of condylar attachment of the LPM before and after surgery, while the surgical procedure, including Le Fort I osteotomy with intentional pterygoid plate fracture, might not affect postoperative LMP or disc position in class II patients.

PMID:34598864 | DOI:10.1016/j.jcms.2021.09.008

Int J Oral Maxillofac Surg. 2021 Sep 28:S0901-5027(21)00325-8. doi: 10.1016/j.ijom.2021.09.005. Online ahead of print.

ABSTRACT

The purpose of this study was to investigate the relationship between a patient’s residential distance from a tertiary referral regional multidisciplinary team (MDT) and the clinical staging of their head and neck cancer (HNC) at presentation. A retrospective cohort study was performed of all attendees with HNC who had undergone an MDT assessment. The period of study was January 2016 to January 2017. The primary predictor variable was the patient’s residential distance from the MDT. Demographic and clinicopathological factors were recorded. The primary outcome variable was the clinical staging conferred by the MDT. Descriptive and ordinal logistical regression analyses were conducted to examine the data. There were 286 observations; 230 patients were male and 56 were female. The mean age of the cohort was 66.52 years. The average residential distance from the MDT was 68.16 km. Regression analysis, while not statistically significant, indicated that those living more than 100 km (range 102-592 km) from the MDT had a 1.49 times increased risk of being diagnosed with an advanced stage of cancer when compared to those living less than 100 km away. This study provides insights into the potential adverse effect geographic remoteness has on initial staging of HNC and the need for further strategies to serve this at-risk population.

PMID:34598849 | DOI:10.1016/j.ijom.2021.09.005

J Pediatr Nurs. 2021 Sep 28:S0882-5963(21)00286-4. doi: 10.1016/j.pedn.2021.09.018. Online ahead of print.

ABSTRACT

PROBLEM: This systematic review aims to evaluate the effectiveness of user-focused mobile health (mHealth) applications in paediatric chronic disease management.

ELIGIBILITY CRITERIA: Articles were included under the Population Intervention Comparator Outcome Study (PICOS) design framework for (P) children with a chronic disease, (I) mHealth user-focused apps, (C) usual care/control groups, (O) health outcomes related to chronic diseases, and (S) randomised controlled trials. This study followed the guidelines provided by Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and Mobile Health Evidence Reporting and Assessment.

SAMPLE: A comprehensive literature search screening was conducted via CINAHL, PubMed, CENTRAL, ELSEVIER, SAGE, Science Direct, Scopus, Taylor Francis, WoS, and IEEE XPLORE from inception to November 15, 2020.

RESULTS: The review included seven articles, which combined provided data for a total of 755 children. The effects of the mHealth applications on the investigated 31 unique outcomes of five chronic paediatric diseases were mixed, ranging from effective to no effect. The risk of bias in the included studies was mostly either high or concerning according to Risk of Bias tool 2.0. The mobile apps that were evaluated were not standalone apps but were designed to interact with and provide data to healthcare providers.

CONCLUSION: Some mHealth interventions in this systematic review produced clinically meaningful and statistically relevant reductions in health outcomes related to chronic disease management. However, based on the available data, it is not possible to make definitive conclusions concerning the preferred target population of the interventions.

IMPLICATION: mHealth apps may be beneficial in improving selected patient outcomes in chronic disease management. Our results may assist the digital health services of hospitals, paediatric nurses who are interested in mHealth, and children who have a chronic disease.

PMID:34598848 | DOI:10.1016/j.pedn.2021.09.018

J Pediatr Endocrinol Metab. 2021 Oct 1. doi: 10.1515/jpem-2021-0351. Online ahead of print.

ABSTRACT

OBJECTIVES: Insulin resistance may be associated with impaired lung function. The objective of this study was to examine the relationship between insulin resistance and lung function in asthmatic children.

METHODS: We performed a cross-sectional study on asthmatic children aged 6-18 years at Tertiary Care Center, India. Fasting serum glucose and insulin levels were analyzed to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) in 90 children. Lung function tests were performed. Spearman correlation was used to assess the relationship between insulin resistance and lung function. Linear regression was done to adjust the potential confounders.

RESULTS: Insulin resistance was present in 15.5% of patients. We found a statistically significant inverse relationship between HOMA-IR and spirometric parameters such as forced expiratory volume in 1 s/forced vital capacity ratio and forced expiratory flow between 25 and 75% on Spearman correlation. However, adjusted regression for age, gender, and body mass index showed no significant association of lung function parameters with HOMA-IR.

CONCLUSIONS: Insulin resistance may be considered for the decline in lung function in asthmatic children.

PMID:34598376 | DOI:10.1515/jpem-2021-0351

Int J Biostat. 2021 Sep 30. doi: 10.1515/ijb-2020-0043. Online ahead of print.

ABSTRACT

We present in this paper a global methodology for the spike detection in a biological context of fluorescence recording of GnRH-neurons calcium activity. For this purpose we first propose a simple stochastic model that could mimic experimental time series by considering an autoregressive AR(1) process with a linear trend and specific innovations involving spiking times. Estimators of parameters with asymptotic normality are established and used to set up a statistical test on estimated innovations in order to detect spikes. We compare several procedures and illustrate on biological data the performance of our procedure.

PMID:34598374 | DOI:10.1515/ijb-2020-0043

Radiol Oncol. 2021 Sep 27. doi: 10.2478/raon-2021-0037. Online ahead of print.

ABSTRACT

BACKGROUND: All the patients with suspected stroke are directed to whole-brain CT scan. The purpose of this scan is to look for early features of ischemia and to rule out alternative diagnoses than stroke. In case of ischemic stroke, CT diagnostics (including CT angiography) is used mainly to locate the occlusion and its size, while the Hounsfield Units (HU) values of the thrombus causing the stroke are usually overlooked on CT scan or considered not important. The aim of this study was to demonstrate that the HU value is relevant and can help in better treatment planning.

PATIENTS AND METHODS: There were 25 patients included in the study, diagnosed with ischemic stroke in the middle cerebral artery (MCA) territory. In all patients, systemic thrombolysis was not successful and the mechanical recanalization was needed. The retrieved thrombi were also analyzed histologically for the determination of red blood cells (RBC) proportion. CT of the proximal MCA (M1) segment was analyzed for average HU value and its variability both in the occluded section and the symmetrical normal site. These CT parameters were then statistically studied for the possible correlations with different clinical, histological and procedure parameters using the Linear Regression and the Pearson correlation coefficient.

RESULTS: Relevant positive correlations were found between average HU value of thrombus and outcome modified Rankin Scale (mRS), initial mRS, number of passes with thrombectomy device as well as RBC proportion.

CONCLUSIONS: Results of the present study suggest that measured HU values in CT images of the cerebral thrombi may help in the assessment of thrombus compaction and therefore better treatment planning.

PMID:34598375 | DOI:10.2478/raon-2021-0037