Tag: pubmed

Acta Orthop. 2023 Oct 31;94:550-544. doi: 10.2340/17453674.2023.24022.

ABSTRACT

BACKGROUND AND PURPOSE: Radiostereometric analysis (RSA) is the gold standard for evaluation of migration of implants. CT-RSA has been shown to have precision at the level of RSA in hip, shoulder, and knee joint replacements. We aimed to assess the impact of dose reduction on precision of CT-RSA on tibial implants, comparing it with previously published data on precision of standard dose CT-RSA on tibial implants.

MATERIAL AND METHODS: We performed a total knee arthroplasty on a porcine knee cadaver, and subsequent CT-RSA with low effective doses (0.02 mSv). We compared the results with previously published CT-RSA data with standard (0.08 mSv) dose. The primary outcome variable was the difference in precision of the maximum total translation (MTT). Secondary variables included ratios of variances and standard deviations, and precision of peripheral point translations, center-of-mass translations, and rotations. A difference of more than 0.1 mm in precision was defined as clinically relevant. Our hypothesis was that precisions of low and standard CT-RSA doses were equal.

RESULTS: Low dose (mean 0.07, 95% confidence interval [CI] 0.06-0.08) and standard dose CT-RSA (0.08, CI 0.07-0.09) achieve similar precision, with difference in precision of MTT of 0.01, CI 0.00-0.02 mm. The F-statistic (0.99, CI 0.63-1.55) and sdtest (1.05, CI 0.43-2.58) also supported this.

CONCLUSION: We conclude that the precision of low dose CT-RSA for tibial implants on a porcine cadaver is equal to standard dose CT-RSA. However, these findings should be confirmed in clinical trials.

PMID:37909103 | DOI:10.2340/17453674.2023.24022

AIDS Care. 2023 Nov 1:1-14. doi: 10.1080/09540121.2023.2275035. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the quality of life (QOL) and adherence to antiretroviral therapy (ART) in people living with HIV (PLWH) in Fortaleza, Ceará, Brazil. A cross-sectional study with a sample of 385 patients followed-up on an outpatient basis. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form, the World Health Organization’s Quality of Life in PLWH Instrument, the Assessment of Adherence to Antiretroviral Treatment Questionnaire and Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed. The odds ratio and confidence interval were calculated, considering P < 0.05 as statistically significant. Of the 385 PLWH, 134 (34.8%) had unsatisfactory QOL which was associated with unemployment (P = 0.0037), monthly income less than the minimum wage (P < 0.0001), sleep disorders (P = 0.0039) and not doing regular exercise (P = 0.0032). Inadequate adherence to ART occurred in 24 patients (6.23%) and was associated with detectable viral load (P = 0.0001) and unsatisfactory QOL (P = 0.0033). QOL was more unsatisfactory for those unemployed and with low income, sleep disorders and sedentary lifestyle. People with detectable viral load and unsatisfactory QOL had more inadequate adherence to ART.

PMID:37909100 | DOI:10.1080/09540121.2023.2275035

Proc Biol Sci. 2023 Nov 8;290(2010):20231554. doi: 10.1098/rspb.2023.1554. Epub 2023 Nov 1.

ABSTRACT

Explaining the maintenance of diverse species assemblages is a central goal of ecology and conservation. Recent coexistence mechanisms highlight the role of dispersal as a source of the differences that allow similar species to coexist. Here, we propose a new mechanism for species coexistence that is based on dispersal differences, and on the geometry of the habitat patch. In a finite habitat patch with complex boundaries, species with different dispersal abilities will arrange themselves in stable, concentric patterns of dominance. Species with superior competitive and dispersal abilities will dominate the interior of the patch, with inferior species at the periphery. We demonstrate and explain the mechanism on a simple one-dimensional domain, and then on two-dimensional habitat patches with realistic geometries. Finally, we use metrics from landscape ecology to demonstrate that habitat patches with more complex geometries can more easily support coexistence. The factors that underpin this new coexistence mechanism-different dispersal abilities and habitat patches with complex geometries-are common to many marine and terrestrial ecosystems, and it is therefore possible that the mechanism is a common factor supporting diverse species assemblages.

PMID:37909079 | DOI:10.1098/rspb.2023.1554

Nurs Older People. 2023 Nov 1. doi: 10.7748/nop.2023.e1455. Online ahead of print.

ABSTRACT

BACKGROUND: In the UK, people with delirium superimposed on dementia may be cared for by mental health nurses, however there is little in the literature about the experience of caring for people with the condition from the perspective of mental health nurses.

AIM: To illuminate the experiences of mental health nurses caring for people with delirium superimposed on dementia and to explore how mental health nurses ‘know’ the people they care for using ‘aesthetic ways of knowing’.

METHOD: A mixed-methods design was used guided by the principles of activity theory. Participants were registered mental health nurses with experience of caring for people with delirium superimposed on dementia within a 24-hour care environment, including an NHS mental health foundation trust and care homes. Data were collected in two ways and at two different time points: first via semi-structured interviews (n=7), second via a questionnaire (n=25). Thematic analysis of the qualitative data was paired with simple descriptive statistics of the quantitative data to describe participants’ experience.

FINDINGS: This article discusses one finding from the larger study, which was undertaken as part of the author’s PhD, in relation to the way in which mental health nurses ‘know’ the people they care for. Overall, participants showed a preference for aesthetic ways of knowing, rather than the use of formal assessment tools or scores. Participants experienced caring for people with delirium superimposed on dementia by valuing the person and concentrating on their behaviours, responses and personality, thus enabling them to anticipate and/or recognise potential triggers, precipitating factors and any changes in behaviours.

CONCLUSION: The ways in which mental health nurses know the people they care for influences their care delivery. Mental health nurses’ use of aesthetic ways of knowing should be recognised and valued as a way of better understanding and supporting the person with delirium superimposed on dementia.

PMID:37909070 | DOI:10.7748/nop.2023.e1455

Pediatrics. 2023 Nov 1:e2023063289. doi: 10.1542/peds.2023-063289. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Youth with either autism spectrum disorder (ASD) or gender dysphoria (GD) alone have also been shown to be at greater risk for mental health (MH) concerns; however, very little research has considered how cooccurring ASD and GD may exacerbate MH concerns. The purpose of this study was to examine associations between ASD, GD, and MH diagnoses (anxiety, depression, eating disorder, suicidality, and self-harm) among US adolescent populations.

METHODS: This is a secondary analysis of a large administrative dataset formed by 8 pediatric health system members of the PEDSnet learning health system network. Analyses included descriptive statistics and adjusted mixed logistic regression models testing for associations between combinations of ASD and GD diagnoses and MH diagnoses as recorded in the patient’s electronic medical record.

RESULTS: Based on data from 919 898 patients aged 9 to 18 years, adjusted mixed logistic regression indicated significantly greater odds of each MH diagnosis among those with ASD alone, GD alone, and cooccurring ASD/GD diagnoses compared with those with neither diagnosis. Youth with cooccurring ASD/GD were at significantly greater risk of also having anxiety (average predicted probability, 0.75; 95% confidence interval, 0.68-0.81) or depression diagnoses (average predicted probability, 0.33; 95% confidence interval, 0.24-0.43) compared with youth with ASD alone, GD alone, or neither diagnosis.

CONCLUSIONS: Youth with cooccurring ASD/GD are more likely to also be diagnosed with MH concerns, particularly anxiety and depression. This study highlights the need to implement developmentally appropriate, gender-affirming MH services and interventions for youth with cooccurring ASD/GD.

PMID:37909059 | DOI:10.1542/peds.2023-063289

Front Neurol. 2023 Oct 16;14:1259737. doi: 10.3389/fneur.2023.1259737. eCollection 2023.

ABSTRACT

OBJECTIVES: The primary objective of the present investigation was to meticulously examine the efficacy of high-quality nursing care (HQN) on neurological restoration, amelioration of adverse psychological states, and augmentation of quality of life in geriatric patients diagnosed with acute cerebral infarction (ACI).

METHODS: A cohort of 240 patients, afflicted by ACI and admitted to our healthcare institution between February 2020 and March 2023, were incorporated into this longitudinal prospective analysis. Employing a random number table methodology, the patient cohort was bifurcated into a control group (n = 120) receiving conventional care and an observation group (n = 120) receiving HQN. Comparisons were conducted between the two cohorts concerning neurological functionality [as quantified by the National Institutes of Health Stroke Scales (NIHSS) and Barthel Index (BI) scores], psychological wellbeing [utilizing the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores], overall quality of life [assessed via the Generic Quality of Life Inventory-74 (GQOLI-74) scores], and self-perceived burden [evaluated through the Self-Perceived Burden Scale (SPBS)]. Further assessments included patient satisfaction and incidence of complications, both in the pre- and post-interventional phases.

RESULTS: Post-intervention, the observation group demonstrated superior outcomes compared to the control group, as evidenced by diminished NIHSS and SPBS scores and elevated BI metrics. Moreover, SAS and SDS scores in both groups manifested a decline post-intervention; however, the decrement was statistically more pronounced in the observation group (P < 0.05). Similarly, all dimensions of GQOLI-74 showed an upward trend in both cohorts, yet the increase was significantly more substantial in the observation group (P < 0.05). Furthermore, the observation group exhibited a reduced frequency of complications coupled with heightened levels of nursing satisfaction.

CONCLUSION: The implementation of HQN in the geriatric population afflicted by ACI markedly enhances neurological recuperation, attenuates adverse psychological states, and ameliorates overall quality of life. The intervention is also associated with a diminution in complication rates and an increase in nursing satisfaction, thereby substantiating its clinical utility.

PMID:37909031 | PMC:PMC10613641 | DOI:10.3389/fneur.2023.1259737

Front Oncol. 2023 Oct 16;13:1276037. doi: 10.3389/fonc.2023.1276037. eCollection 2023.

ABSTRACT

BACKGROUND: A survival benefit has been seen for both adjuvant nab-paclitaxel plus gemcitabine (AG) and S-1 chemotherapy compared to gemcitabine (GEM) for resectable pancreatic cancer in the APACT (2019) and JASPAC01 trials (2016), respectively. However, supporting evidence regarding the effectiveness of AG or S-1 compared to gemcitabine in real-world clinical practice remains lacking.

METHODS: Our study included all 246 pancreatic cancer patients who underwent surgical treatment and received postoperative adjuvant chemotherapy with AG, S-1, or GEM except for those meeting exclusion criteria (R2 resection, neoadjuvant therapy, or synchronous malignancy) at Tianjin Medical University Cancer Institute and Hospital from June 2015 to July 2021. The primary outcome was overall survival (OS) and recurrence-free survival (RFS).

RESULTS: In total, 246 patients were included, of whom 54(22%) received adjuvant AG, 103(41%) received adjuvant S-1, and 89(37%) received adjuvant GEM. Adjuvant S-1 was associated with a prolonged OS compared to GEM (median OS S-1 vs GEM: 27.0 vs 20.0 months; HR: 0.65, P = .016) and a significantly prolonged RFS compared to GEM (median RFS S-1 vs GEM: 20.0 vs 8.2 months; HR: 0.58, P = .002). After adjusting for known prognostic factors in multivariate Cox regression analysis, this survival benefit persists and is consistent in most subgroups in our subgroup analysis. However, no statistically significant differences in OS or RFS were seen between patients treated with AG and patients treated with GEM.

CONCLUSIONS: In this retrospective real-world study, adjuvant S-1 chemotherapy was associated with improved survival compared to GEM while no differences in OS or RFS were observed for AG compared to GEM.

PMID:37909023 | PMC:PMC10613992 | DOI:10.3389/fonc.2023.1276037

Front Pediatr. 2023 Oct 16;11:1247455. doi: 10.3389/fped.2023.1247455. eCollection 2023.

ABSTRACT

PURPOSE: The purpose of this study was to observe whether developmental dysplasia of the hip (DDH) affects the development of the femoral head growth plate and to analyze the risk factors.

METHODS: We selected female patients aged between 11 and 20 years with unilateral DDH and unclosed femoral head growth plate (s). The selected patients underwent anteroposterior radiography of the hip joint to compare the degree of development of the femoral head growth plate on both sides and to identify risk factors that affect the development of the growth plate in the femoral head.

RESULTS: We included 48 female patients with unilateral DDH, with an average age of 14 years (range: 11.1-18.5 years) and an average BMI of 20.4 kg/m² (range: 15.5 kg/m²-27.9 kg/m²). Among them, 23 patients had earlier development of the femoral head growth plate on the affected side than on the healthy side, while the degree of development of the femoral head growth plate in 25 patients was the same as that on the contralateral side. When the Tönnis angle was greater than 29.5°C and/or the Reimers migration index was greater than 48.5%, there was a statistically significant difference in the acceleration of femoral head growth plate development.

CONCLUSION: An abnormal relative position of the acetabulum-femoral head caused by DDH can accelerate closure of the femoral head growth plate in immature female patients. The risk factors are a Tönnis angle greater than 29.5°C and/or Reimers migration index greater than 48.5%.

PMID:37908967 | PMC:PMC10613681 | DOI:10.3389/fped.2023.1247455

Cureus. 2023 Sep 30;15(9):e46263. doi: 10.7759/cureus.46263. eCollection 2023 Sep.

ABSTRACT

Background A dental implant is one of the most commonly used treatments to replace missing teeth. A reasonable number of implant cases necessitate using a bone graft before or at the time of implant placement. This study aims to evaluate the quality and readability of online patient-centered information about implant bone grafts. Methodology This cross-sectional study used Google, Yahoo, and Bing search engines. The keywords were entered to screen 900 websites. The DISCERN, Journal of the American Medical Association (JAMA), and Health on the Net (HON) code tools evaluated the included websites for quality. The Flesch reading-ease score (FRES), Flesch-Kincaid grade level, and simple measure of gobbledygook tests measured readability. Statistical analysis was done using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results A total of 161 websites were included; 65 (40.4%) of the included websites belonged to a university or medical center. Only five (3.1%) websites were exclusively related to dental implant treatments. DISCERN showed moderate quality for 82 (50.9%) websites. There was a statistical difference between commercial and non-profit organization websites. In the JAMA evaluation, currency was the most commonly achieved in 67 (41.6%) websites. For the HON code, four (2.5%) websites were certified. Based on FRES, the most common readability category was “fair difficult,” accounting for 64 (39.8%), followed by “standard” in 56 (34.8%) websites. Conclusions The study findings suggest that English-language patient-centered information about implant bone grafts is challenging to comprehend and of low quality. Hence, there is a need to establish websites that provide trustworthy, high-quality information on implant bone grafts.

PMID:37908962 | PMC:PMC10615150 | DOI:10.7759/cureus.46263

Genome Res. 2023 Oct 31. doi: 10.1101/gr.277864.123. Online ahead of print.

ABSTRACT

Differential polyadenylation sites (PAs) critically regulate gene expression, but their cell type-specific usage and spatial distribution in the brain have not been systematically characterized. Here, we present Infernape, which infers and quantifies PA usage from single-cell and spatial transcriptomic data and show its application in the mouse brain. Infernape uncovers alternative intronic PAs and 3′-UTR lengthening during cortical neurogenesis. Progenitor-neuron comparisons in the excitatory and inhibitory neuron lineages show overlapping PA changes in embryonic brains, suggesting that the neural proliferation-differentiation axis plays a prominent role. In the adult mouse brain, we uncover cell type-specific PAs and visualize such events using spatial transcriptomic data. Over two dozen neurodevelopmental disorder-associated genes such as Csnk2a1 and Mecp2 show differential PAs during brain development. This study presents Infernape to identify PAs from scRNA-seq and spatial data, and highlights the role of alternative PAs in neuronal gene regulation.

PMID:37907328 | DOI:10.1101/gr.277864.123