Tag: nevin manimala

PLoS One. 2021 Dec 22;16(12):e0261380. doi: 10.1371/journal.pone.0261380. eCollection 2021.

ABSTRACT

Disordered gaming has gained increased medical attention and was recently included in the eleventh International Classification of Diseases (ICD-11) by the World Health Organization (WHO) after its earlier inclusion in the Diagnostic and Statistical Manual of Mental Disorders (fifth revision) (DSM-5) as an emerging disorder by the American Psychiatric Association (APA). Although many studies have investigated associations between personality and disordered gaming, no previous research compared the differential associations between personality and disordered gaming with time spent gaming. Due to the novelty of the WHO diagnostic framework for disordered gaming, previous research focused mainly on the associations between personality and disordered gaming in relation to the APA framework. Beyond that, these studies are generally limited by small sample sizes and/or the lack of cross-cultural emphasis due to single-country sampling. To address these limitations, the present study aimed to investigate the associations between personality and gaming behavior in a large and culturally heterogeneous sample (N = 50,925) of individuals from 150 countries. The results obtained suggested that low conscientiousness and high neuroticism were robustly associated with disordered gaming across both the APA and WHO frameworks. Interestingly, personality associations with weekly time spent gaming were smaller. The findings of the present study suggest that personality is of higher importance to predict disordered gaming compared to weekly time spent gaming.

PMID:34936677 | DOI:10.1371/journal.pone.0261380

PLoS One. 2021 Dec 22;16(12):e0261516. doi: 10.1371/journal.pone.0261516. eCollection 2021.

ABSTRACT

Micronutrient deficiencies are mostly hidden; clinically less visible compared to macronutrient deficiencies. Food fortification with multiple micronutrients (MMN) is provided for children between 6-23 months, daily for two months at three-time points. We assessed the acceptance and adherence of this nutritional intervention in an urban community setting in Sri Lanka. This cross-sectional study enrolled caregivers of children aged 7 to 23 months with a cluster sampling method. Caregivers ‘ acceptance of taste and smell, health gains, ease of use, and need perception (Cronbach’s reliability: 0.801) were assessed. Also, anemia knowledge (Cronbach’s reliability: 0.642), MMN knowledge, and reported adherence (number of sachets consumed per month) were evaluated through a self-administered questionnaire. Adequate adherence was defined as the use of ≥80% sachets. The univariate and multivariate statistical analysis examined the association of acceptability, adherence, and anemia knowledge with independent variables (socio-demographic, household characteristics, and knowledge). The survey included 153 respondents. The Median (range) age of children was 12 months (7-23). The mean (SD) acceptability score was 66.82% (9.78%). Acceptance of sensory qualities (smell/taste) had a lower score than perceived health benefit. Most consumed MMN adequately (72.5%). The mean (SD) anemia knowledge score was 62.20% (25.79%). In multivariate analysis, child’s age (OR: -0.360, 95% CI:-0.510,-0.211) and father’s education (OR: 2.148, 95% CI: 0.439, 3.857) were independently associated with acceptability. Child’s age (OR: -0.108, 95% CI:0.818, 0.985), anemia knowledge (OR:0.016, 95% CI: 1.003, 1.031) and acceptability (OR:0.236, 95% CI:1.140, 1.406) were significant determinants of adherence. Anemia knowledge was significantly associated with the mother’s education and household income when adjusted. In conclusion, unpleasant smell/taste and daily schedule were reported as barriers to MMN use. Yet, perception and trust regarding health benefits were encouraging. Reported adherence was somewhat high. Improving acceptability and anemia knowledge could enhance adherence further in this population.

PMID:34936678 | DOI:10.1371/journal.pone.0261516

PLoS One. 2021 Dec 22;16(12):e0261023. doi: 10.1371/journal.pone.0261023. eCollection 2021.

ABSTRACT

Since the outbreak of Covid-19, the use of digital devices, especially smartphones, remarkably increased. Smartphone use belongs to one’s daily routine, but can negatively impact physical and mental health, performance, and relationships if used excessively. The present study aimed to investigate potential correlates of problematic smartphone use (PSU) severity and the mechanisms underlying its development. Data of 516 smartphone users from Germany (Mage = 31.91, SDage = 12.96) were assessed via online surveys in April and May 2021. PSU severity was significantly negatively associated with sense of control. In contrast, it was significantly positively linked to fear of missing out (FoMO), repetitive negative thinking (RNT), and daily time spent on smartphone use. In a moderated mediation analysis, the negative relationship between sense of control and PSU severity was significantly mediated by FoMO. RNT significantly moderated the positive association between FoMO and PSU severity. Specifically, the higher the RNT, the stronger the relationship between FoMO and PSU. The present findings disclose potential mechanisms that could contribute to PSU. Potential ways of how to reduce PSU severity are discussed.

PMID:34936651 | DOI:10.1371/journal.pone.0261023

PLoS One. 2021 Dec 22;16(12):e0260110. doi: 10.1371/journal.pone.0260110. eCollection 2021.

ABSTRACT

To quickly and efficiently recognize abnormal patterns from large-scale time series and pathological signals in epilepsy, this paper presents here a preliminary RSW&TST framework for Multiple Change-Points (MCPs) detection based on the Random Slide Window (RSW) and Trigeminal Search Tree (TST) methods. To avoid the remaining local optima, the proposed framework applies a random strategy for selecting the size of each slide window from a predefined collection, in terms of data feature and experimental knowledge. For each data segment to be diagnosed in a current slide window, an optimal path towards a potential change point is detected by TST methods from the top root to leaf nodes with O(log3(N)). Then, the resulting MCPs vector is assembled by means of TST-based single CP detection on data segments within each of the slide windows. In our experiments, the RSW&TST framework was tested by using large-scale synthetic time series, and then its performance was evaluated by comparing it with existing binary search tree (BST), Kolmogorov-Smirnov (KS)-statistics, and T-test under the fixed slide window (FSW) approach, as well as the integrated method of wild binary segmentation and CUSUM test (WBS&CUSUM). The simulation results indicate that our RSW&TST is both more efficient and effective, with a higher hit rate, shorter computing time, and lower missed, error and redundancy rates. When the proposed RSW&TST framework is executed for MCPs detection on pathological ECG (electrocardiogram)/EEG (electroencephalogram) recordings of people in epileptic states, the abnormal patterns are roughly recognized in terms of the number and position of the resultant MCPs. Furthermore, the severity of epilepsy is roughly analyzed based on the strength and period of signal fluctuations among multiple change points in the stage of a sudden epileptic attack. The purpose of our RSW&TST framework is to provide an encouraging platform for abnormal pattern recognition through MCPs detection on large-scale time series quickly and efficiently.

PMID:34936654 | DOI:10.1371/journal.pone.0260110

PLoS One. 2021 Dec 22;16(12):e0258348. doi: 10.1371/journal.pone.0258348. eCollection 2021.

ABSTRACT

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.

METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training.

RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a ‘great-extent-of-confidence’ in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors.

INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.

PMID:34936646 | DOI:10.1371/journal.pone.0258348

Plast Reconstr Surg. 2022 Jan 1;149(1):95e-103e. doi: 10.1097/PRS.0000000000008666.

ABSTRACT

BACKGROUND: Antiplatelet agents are typically withheld perioperatively because of bleeding concerns. Dual antiplatelet therapy, such as aspirin and clopidogrel, has significant morbidity and mortality benefits in patients with ischemic heart disease or peripheral vascular disease. This study aims to evaluate the impact of perioperative dual antiplatelet therapy in the lower extremity free tissue transfer population.

METHODS: Lower extremity free tissue transfers performed by the senior author (K.K.E.) from 2011 to 2019 were retrospectively reviewed. Demographics, comorbidities, perioperative dual antiplatelet therapy, and free tissue transfer characteristics were recorded. Outcomes of interest included flap success, hematoma formation, blood transfusion requirements, and cardiac event occurrence.

RESULTS: One hundred ninety-five free tissue transfers were included. Median age at the time of free tissue transfer was 56.5 years. Median Charlson Comorbidity Index was 3. Thirty-four patients were on clopidogrel, which was either withheld (n = 20) or continued (n = 14) on the day of free tissue transfer. Incidence of blood transfusion was significantly higher in both the withheld and continued versus nonclopidogrel groups. Flap success was statistically equivalent between groups (withheld, 90.0 percent; continued, 92.9 percent; nonclopidogrel, 95.0 percent; p = 0.346). Cardiac events occurred most often in the continued group (21.4 percent) compared to the withheld (5.0 percent) and nonclopidogrel (0.6 percent) groups. On multivariate analysis, holding clopidogrel remained significant for increased odds of postoperative transfusion. The clopidogrel group was no longer significant for intraoperative transfusion.

CONCLUSIONS: Despite increases in volume of blood products transfused, free tissue transfer can be performed safely with perioperative dual antiplatelet therapy. Withholding dual antiplatelet therapy on the day of free tissue transfer was not associated with decreased intraoperative transfusion; thus, dual antiplatelet therapy can safely be continued throughout the operative course to minimize cardiovascular risk.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

PMID:34936629 | DOI:10.1097/PRS.0000000000008666

Plast Reconstr Surg. 2022 Jan 1;149(1):253-261. doi: 10.1097/PRS.0000000000008678.

ABSTRACT

BACKGROUND: The Open Payments database was created to increase transparency of industry payment relationships within medicine. The current literature often examines only 1 year of the database. In this study, the authors use 5 years of data to show trends among industry payments to plastic surgeons from 2014 to 2018. In addition, the authors lay out the basics of conflict-of-interest reporting for the new plastic surgeon. Finally, the authors suggest an algorithm for the responsible management of industry relationships.

METHODS: This study analyzed nonresearch payments made to plastic surgeons from January 1, 2014, to December 31, 2018. Descriptive statistics were calculated using R Statistical Software and visualized using Tableau.

RESULTS: A total of 304,663 payments totaling $140,889,747 were made to 8148 plastic surgeons; 41 percent ($58.28 million) was paid to 50 plastic surgeons in the form of royalty or license payments. With royalties excluded, average and median payments were $276 and $25. The average yearly total per physician was $2028. Of the 14 payment categories, 95 percent of the total amount paid was attributable payments in one of six categories. Seven hundred thirty companies reported payments to plastic surgeons from 2014 to 2018; 15 companies (2 percent) were responsible for 80 percent ($66.34 million) of the total sum paid. Allergan was responsible for $24.45 million (29.6 percent) of this amount.

CONCLUSIONS: Although discussions on the proper management of industry relationships continue to evolve, the data in this study illustrate the importance of managing industry relationships. The simple guidelines suggested create a basis for managing industry relationships in the career of the everyday plastic surgeon.

PMID:34936632 | DOI:10.1097/PRS.0000000000008678

Plast Reconstr Surg. 2022 Jan 1;149(1):183-195. doi: 10.1097/PRS.0000000000008645.

ABSTRACT

BACKGROUND: Despite its increasing use in craniofacial surgery, the evidence for piezosurgery over conventional bone-cutting techniques has not been critically appraised. The purpose of this systematic review and meta-analysis was to identify and assess the evidence that exists for the use of piezosurgery in craniofacial surgery.

METHODS: A systematic review was undertaken using a computerized search. Publication descriptors, methodologic details, and outcomes were extracted. Articles were assessed using the methodologic index for nonrandomized studies and Cochrane instruments. Random effects meta-analysis was completed.

RESULTS: Thirty-nine studies were included. Most studies were published within the past 5 years (51.3 percent) and were randomized controlled trials (56.4 percent). The mean age of patients was 27 years (range, 0.2 to 57 years), and the mean sample size was 44 (range, 12 to 180). Meta-analysis revealed that compared to conventional instruments, piezosurgery had a lower postoperative incidence of sensory disturbance, principally in mandibular procedures (OR, 0.29; 95 percent CI, 0.11 to 0.77; p = 0.01) and pain at postoperative day 3 (mean difference, -0.86; 95 percent CI, -1.20 to -0.53; p < 0.01). There was no statistically significant difference in operating room time (mean difference, 8.60; 95 percent CI, -1.27 to 18.47; p = 0.80) or osteotomy time (mean difference, 0.35; 95 percent CI, -2.99 to 3.68; p = 0.84). Most studies were clinically homogenous (92 percent) and of high quality based on the methodologic index for nonrandomized studies instrument (84 percent). Few studies had domains at high risk of bias based on the Cochrane instrument (28.6 percent).

CONCLUSIONS: Piezosurgery has considerable benefits when compared to conventional instruments. Future studies should investigate its cost-effectiveness and benefits in terms of blood loss, edema/ecchymosis, and patient satisfaction.

PMID:34936620 | DOI:10.1097/PRS.0000000000008645

Plast Reconstr Surg. 2022 Jan 1;149(1):15-27. doi: 10.1097/PRS.0000000000008633.

ABSTRACT

BACKGROUND: Racial disparities are evident in multiple aspects of the perioperative care of breast cancer patients, but data examining whether such differences translate to clinical and patient-reported outcomes are limited. This study examined the impact of race on perioperative outcomes in autologous breast reconstruction.

METHODS: A retrospective cohort study including all breast cancer patients who underwent immediate autologous breast reconstruction at a single institution from 2010 to 2017 was conducted. Self-reported race was used to classify patients into three groups: white, African American, and other. The primary and secondary endpoints were occurrence of any major complications within 30 days of surgery and patient-reported outcomes (measured with the BREAST-Q), respectively. Regression models were constructed to identify factors associated with the outcomes.

RESULTS: Overall, 404 patients, including 259 white (64 percent), 63 African American (16 percent), and 82 patients from other minority groups (20 percent), were included. African American patients had a significantly higher proportion of preoperative comorbidities. Postoperatively, African American patients had a higher incidence of 30-day major complications (p = 0.004) and were more likely to return to the operating room (p = 0.006). Univariable analyses examining complications demonstrated that race was the only factor associated with 30-day major complications (p = 0.001). Patient-reported outcomes were not statistically different at each time point through 3 years postoperatively.

CONCLUSIONS: African American patients continue to present with increased comorbidities and may be more likely to experience major complications following immediate autologous breast reconstruction. However, patient-reported satisfaction or physical well-being outcomes may not differ between groups.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

PMID:34936598 | DOI:10.1097/PRS.0000000000008633

Plast Reconstr Surg. 2022 Jan 1;149(1):151-161. doi: 10.1097/PRS.0000000000008670.

ABSTRACT

BACKGROUND: Lymphaticovenous anastomosis, a supermicrosurgical technique, creates bypasses between the lymphatic and venous systems. The quality of lymphaticovenous anastomosis depends on the surgeon’s dexterity and precision, and is subject to imperfections caused by the physiologic tremor of the human hand. A dedicated robot for microsurgery has been created to overcome these limitations (MUSA, MicroSure, Eindhoven, The Netherlands). This study describes 1-year clinical outcomes of the first-in-human trial of robot-assisted and manual lymphaticovenous anastomosis in patients with breast cancer-related lymphedema.

METHODS: In this prospective pilot study, women with breast cancer-related lymphedema were randomized into the robot-assisted or manual lymphaticovenous anastomosis group. Outcomes were quality of life, arm circumference, conservative treatment frequency, arm dermal backflow stage, and anastomosis patency.

RESULTS: Twenty women were included, of whom eight underwent robot-assisted lymphaticovenous anastomosis surgery and 12 underwent manual surgery. In both groups, quality of life significantly improved at 12 months (robot-assisted surgery, p = 0.045; manual surgery, p = 0.001). Arm circumference did not decrease (robot-assisted surgery, p = 0.094; manual surgery, p = 0.240). Daily use of compression garments decreased by 61.9 percent (robot-assisted surgery) and 70.2 percent (manual surgery). The frequency of manual lymphatic drainage remained similar compared with baseline. Arm dermal backflow stage was reduced in one patient in the robot-assisted group and in five cases in the manual group. Overall, 76.5 percent of the anastomoses were patent (robot-assisted surgery, 66.6 percent; manual surgery, 81.8 percent).

CONCLUSIONS: After evaluating 1-year follow-up data, this study confirms the feasibility of robot-assisted lymphaticovenous anastomosis surgery. Clinical outcomes were comparable between robot-assisted and manual lymphaticovenous anastomosis. This encourages further research using the new microsurgical robot MUSA for lymphaticovenous anastomosis and other (super)microsurgical procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

PMID:34936615 | DOI:10.1097/PRS.0000000000008670