Tag: pubmed

Plast Reconstr Surg. 2023 Aug 29. doi: 10.1097/PRS.0000000000011032. Online ahead of print.

ABSTRACT

INTRODUCTION: In advanced lymphedema, lymphovenous anastomosis (LVA) can be a solution based on utilizing the pressure gradient between the high pressure lymphatics and low pressure veins. If the vein pressure in high, the effect affect surgery will be less optimal. This study evaluated the effect of axillary vein perivascular scar release on LVA.

MATERIALS AND METHODS: This is a retrospective study of 40 upper limb stage 2 and 3 lymphedema patients divided into 2 groups with an average follow-up of 33 months (minimal of at least 12 months); scar-released group (n=25) and control group (n=15). All patients underwent LVA with or without lymph node transfer. Demographic data, outcome (volumetric change and bioimpedence analysis (BIA)), and major veins (axillary, basilic and cephalic) diameter changes were evaluated.

RESULTS: Both groups showed significant reduction in volume and BIA parameters after LVA. The scar-released groups (24/25 with lymph node transfer and 1 without) showed statistically higher reduction of BIA analysis compared to the control group at 1, 6 and 12 months after LVA. The changes in the major veins after axilla scar release showed significant changes in all 3 veins. There was a significant correlation between cephailic vein dimeter reduction and BIA measurement.

CONCLUSION: The release of perivascular scar in the axially vein may result in better outcome after LVA. This is based on the finding that scar release shows correlation between cephailic vein dimeter reduction and BIA measurement suggesting reduction of venous pressure in the peripheral vein increasing the pressure gradient between the lymphatic and venous system allowing better outflow after LVA.

PMID:37647513 | DOI:10.1097/PRS.0000000000011032

J Biol Dyn. 2023 Dec;17(1):2244987. doi: 10.1080/17513758.2023.2244987.

ABSTRACT

We provide a procedure for deriving discrete population models for the size of the adult population at the beginning of each breeding cycle and assume only adult individuals reproduce. This derivation technique includes delay to account for the number of breeding cycles that a newborn individual remains immature and does not contribute to reproduction. These models include a survival probability (during the delay period) for the immature individuals, since these individuals have to survive to reach maturity and become members of, what we consider, the adult population. We discuss properties of this class of discrete delay population models and show that there is a critical delay threshold. The population goes extinct if the delay exceeds this threshold. We apply this derivation procedure to obtain two models, a Beverton-Holt adult model and a Ricker adult model and discuss the global dynamics of both models.

PMID:37647506 | DOI:10.1080/17513758.2023.2244987

Int J Psychiatry Med. 2023 Aug 30:912174231199925. doi: 10.1177/00912174231199925. Online ahead of print.

ABSTRACT

OBJECTIVE: Anhedonia is a common symptom of depression, but is also a negative symptom of schizophrenia. The purpose of this study was to examine the effects of vortioxetine on anhedonia in patients with schizophrenia.

METHODS: A total of 120 patients with schizophrenia in remission who met inclusion criteria were randomized 1:1 by the envelope method into intervention and control groups. All participants in both groups were divided into three subgroups based on the antipsychotic therapy (olanzapine or risperidone or aripiprazole) that they were receiving. Vortioxetine was administered to those in the intervention group at a fixed dose of 10 mg per day. The Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Chapman Scale for Social and Physical Anhedonia (CSPA) were administered. The study lasted 12 weeks. Participants were assessed twice: At baseline and at the end of the study. Six participants dropped out, with 114 remaining.

FINDINGS: Vortioxetine treatment had a significant effect on the level of physical anhedonia. The treatment interaction was also statistically significant, but with a relatively small effect (F = 3.17, P < .05; η2 = .061). Vortioxetine treatment had a particularly strong effect on the level of social anhedonia. The interaction between the treatment and the type of antipsychotics was also statistically significant with a small effect (F = 5.04, P < 0. 01; η2 = .091).

CONCLUSION: The combination of olanzapine and vortioxetine was found to be the best option to reduce symptoms of social and physical anhedonia in these patients with remitted schizophrenia.

PMID:37647498 | DOI:10.1177/00912174231199925

Health Rep. 2023 Aug 16;34(8):16-30. doi: 10.25318/82-003-x202300800002-eng.

ABSTRACT

BACKGROUND: The Public Health Agency of Canada monitors the psychological and social well-being of Canadian youth using the Children’s Intrinsic Needs Satisfaction Scale (CINSS). Validation analyses of the CINSS have been conducted, but not in the 2019 Canadian Health Survey on Children and Youth (CHSCY), a more recent and representative national survey with a different sampling frame, collection method and other measured outcomes. This study tested the validity of the CINSS in the 2019 CHSCY.

DATA AND METHODS: Data were collected in all provinces and territories from February 11 to August 2, 2019. The CINSS was administered to respondents aged 12 to 17 years and was designed to assess relatedness, autonomy and competence at home, at school and with friends. Descriptive statistics for CINSS items and subscales were obtained. Confirmatory factor analysis (CFA) was conducted to test how well a correlated traits correlated uniqueness (CTCU) model fit the CINSS data. Associations with mental health and other psychosocial variables were examined.

RESULTS: In general, items within the CINSS were correlated in expected ways, and support was found for a CTCU model in the CFA. While response distributions on the CINSS items were skewed, the CINSS subscales had acceptable internal consistency and were associated with self-rated mental health, happiness, life satisfaction, perceived stress, bullying victimization and behaviour problems in line with expectations.

INTERPRETATION: This study supports the validity of the CINSS. Inclusion of the CINSS in future youth health surveys would allow for continued public health surveillance of the psychological and social well-being of youth in Canada.

PMID:37647459 | DOI:10.25318/82-003-x202300800002-eng

Health Rep. 2023 Aug 16;34(8):3-15. doi: 10.25318/82-003-x202300800001-eng.

ABSTRACT

BACKGROUND: Accessibility of food retail in communities may play a role in shaping the food choices of local residents. However, previous studies have shown mixed results. This study examined associations between the local restaurant environment and the frequency of eating food from restaurants and intake of sugary drinks among Canadian children and youth.

DATA AND METHODS: The study cohort consisted of 23,776 participants (aged 1 to 17 years) in the 2019 Canadian Health Survey on Children and Youth who resided in large urban population centres across the Canadian provinces. Measures of geographic access to various restaurant types within walking distance of participants’ residential areas came from the 2018 Canadian Food Environment Dataset. Poisson regression models with robust standard errors assessed associations between measures of absolute densities (number per km²) of full-service, fast-food and other restaurants, and the relative density of fast-food restaurants (as a percentage of total restaurants) with the frequency of eating food from fast-food or full-service restaurants and sugary drink intake in the previous seven days.

RESULTS: After adjustment for a range of sociodemographic covariates, there were no consistent associations between absolute and relative measures of restaurant access and the frequency of eating food from restaurants or intake of sugary drinks.

INTERPRETATION: Results reveal no consistent relationships between local restaurant exposures and the frequency of eating food from restaurants or sugary drink intake among Canadian children and youth. Efforts to create environments that foster healthy food choices among young people will remain important but will likely need to target multiple activity spaces beyond the local neighbourhood.

PMID:37647458 | DOI:10.25318/82-003-x202300800001-eng

Immun Inflamm Dis. 2023 Aug;11(8):e981. doi: 10.1002/iid3.981.

ABSTRACT

BACKGROUND: Accessibility to the immense collection of studies on noncommunicable diseases related to coronavirus disease of 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an immediate focus of researchers. However, there is a scarcity of information about chronic obstructed pulmonary disease (COPD), which is associated with a high rate of infection in COVID-19 patients. Moreover, by combining the effects of the SARS-CoV-2 on COPD patients, we may be able to overcome formidable obstacles factors, and diagnosis influencers.

MATERIALS AND METHODS: A retrospective study of 280 patients was conducted at DHQ Hospital Muzaffargarh in Punjab, Pakistan. Negative binomial regression describes the risk of fixed successive variables. The association is described by the Cox proportional hazard model and the model coefficient is determined through log-likelihood observation. Patients with COPD had their survival and mortality plotted on Kaplan-Meier curves.

RESULTS: The increased risk of death in COPD patients was due to the effects of variables such as cough, lower respiratory tract infection (LRTI), tuberculosis (TB), and body-aches being 1.369, 0.693, 0.170, and 0.217 times higher at (95% confidence interval [CI]: 0.747-1.992), (95% CI: 0.231-1.156), (95% CI: 0.008-0.332), and (95% CI: -0.07 to 0.440) while it decreased 0.396 in normal condition.

CONCLUSION: We found that the symptoms of COPD (cough, LRTI, TB, and bodyaches) are statistically significant in patients who were most infected by SARS-CoV-2.

PMID:37647450 | DOI:10.1002/iid3.981

Eur J Endocrinol. 2023 Aug 30:lvad120. doi: 10.1093/ejendo/lvad120. Online ahead of print.

ABSTRACT

BACKGROUND: An increased prevalence of depression has been reported in patients with acromegaly. However, most studies included a relatively small sample size owing to the rarity of acromegaly. We aimed to investigate the risk of depression in patients with acromegaly using the Korean National Health Information Database (NHID).

METHODS: The data of patients with acromegaly in 2006-2016 were collected from the rare incurable disease registry of the NHID. Patients with acromegaly were matched with control participants without acromegaly for age and sex in a 1:5 ratio.

RESULTS: Patients who did not receive treatment for acromegaly had a significantly increased risk of depression [hazard ratio (HR): 1.43, 95% confidence interval (CI): 1.12-1.82]. However, the risk of depression did not increase in patients who received treatment for acromegaly. The multiple Cox regression analysis showed that the risk of depression was significantly higher in the untreated group than in the control group during the first three years of observation (HR: 1.829; 95% CI: 1.305-2.563). However, after a time lag of over 3 years, the risk of depression decreased in the untreated group, which is similar to that in the control group.

CONCLUSION: Our nationwide study suggests that patients who did not receive treatment for acromegaly have a higher risk of depression compared with controls. The untreated acromegaly patients should be monitored for the development of depression, especially in the early years after diagnosis. These results could serve as a basis for developing screening strategies to mitigate depression in acromegaly patients.

PMID:37647116 | DOI:10.1093/ejendo/lvad120

J Med Internet Res. 2023 Aug 30;25:e46346. doi: 10.2196/46346.

ABSTRACT

BACKGROUND: Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated.

OBJECTIVE: The study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature.

METHODS: A total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically.

RESULTS: Results indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small.

CONCLUSIONS: This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.

PMID:37647115 | DOI:10.2196/46346

Gerontol Geriatr Educ. 2023 Aug 30:1-17. doi: 10.1080/02701960.2023.2252368. Online ahead of print.

ABSTRACT

Healthy and active aging and age-friendly society frameworks attempt to address the well-documented challenges and opportunities of population aging. To meet the needs of an increasingly older society, there is a demand for professionals with appropriate age-related knowledge and skills. To this end, a master’s in active aging is in development. This study reports on the consultation with prospective students, employers, older people and academics on the knowledge areas to be included in the course. An anonymous online survey gathered data from stakeholders in Ireland, Slovenia, Austria, Portugal, Finland, and Greece. Participants ranked the importance of 14 broad knowledge areas and linked topics. The influence of participant characteristics on decisions was examined using multivariate regression modeling. Across all stakeholder groups (total sample N = 757), health promotion was most often deemed very important (80%), followed by psychology (73%), and social inclusion and engagement (71%). Potential students from healthcare backgrounds were more interested than others in aging physiology, social aspects, and the physical environment. More western-located European countries overall showed more enthusiasm for the topics presented, additional to regional variations between topics. This learning needs analysis provides multi-stakeholder insights into priorities regarding learning in healthy and active aging and age-friendly society.

PMID:37647110 | DOI:10.1080/02701960.2023.2252368

JAMA Netw Open. 2023 Aug 1;6(8):e2331295. doi: 10.1001/jamanetworkopen.2023.31295.

ABSTRACT

IMPORTANCE: Racial disparities in breast cancer (BC) survival arise from multilevel causes, which may exert influence at different stages of BC progression. Clarifying the importance of genetic and social factors could help prioritize interventions.

OBJECTIVE: To jointly examine associations between African genetic ancestry, social environment, and mortality from any cause and BC in Black BC survivors.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study enrolled self-identified Black women aged 20 to 75 years with histologically confirmed BC from June 2005 to May 2019 and followed them up until death or censoring in September 2021. Participants lived in 10 New Jersey counties. Data were analyzed between December 2022 and April 2023.

EXPOSURES: A neighborhood socioeconomic status (nSES) index composed of census tract measures (education, income, wealth, employment status, and occupation) was linked to residential addresses at diagnosis. Percentage African ancestry was estimated using the ADMIXTURE program.

MAIN OUTCOMES AND MEASURES: Sequentially adjusted (age adjusted: age and interview year; fully adjusted: age adjusted with individual SES, lifestyle factors, and comorbidities) logistic regression models were fit to estimate associations with tumor subtypes (estrogen receptor-negative [ER-] vs estrogen receptor-positive [ER+]; triple-negative breast cancer [TNBC] vs luminal A), and Cox models were fit for associations with all-cause mortality (ACM) and breast cancer-specific mortality (BCSM). Models for BCSM were fit using Fine-Gray competing risks models, and robust standard errors were used to account for census tract-level clustering.

RESULTS: Among 1575 participants, median (IQR) African ancestry was 85% (76%-90%), and median (IQR) age was 55 (46-63) years. A 10-percentage point increase in African ancestry was associated with higher odds of ER- vs ER+ (adjusted odds ratio [aOR], 1.08; 95% CI, 0.98-1.18) and TNBC vs luminal (aOR, 1.15; 95% CI, 1.02-1.31) tumors, but not with ACM or BCSM. A 1-IQR increase in nSES was associated with lower ACM (adjusted hazard ratio [aHR], 0.76; 95% CI, 0.63-0.93), and the HR for BCSM was less than 1 but not statistically significant (aHR, 0.81; 95% CI, 0.62-1.04) in age-adjusted models, but associations attenuated following further adjustment for potential mediators (individual SES, lifestyles, comorbidities).

CONCLUSIONS AND RELEVANCE: In this cohort study of Black female BC survivors, higher African ancestry was associated with aggressive tumor subtypes. Compared with genetic ancestry, mediating pathways related to social environments may be more important for survival in these patients.

PMID:37647068 | DOI:10.1001/jamanetworkopen.2023.31295