Tag: pubmed

Circulation. 2022 Nov 5. doi: 10.1161/CIRCULATIONAHA.122.061991. Online ahead of print.

ABSTRACT

Background: Social and psychosocial factors are associated with cardiovascular health (CVH). Our objective was to examine the contributions of individual-level social and psychosocial factors to racial and ethnic differences in population CVH in the National Health and Nutrition Examination Surveys (NHANES) 2011-2018, to inform strategies to mitigate CVH inequities. Methods: In NHANES participants aged ≥20 years, Kitagawa-Blinder-Oaxaca decomposition estimated the statistical contribution of individual-level factors (education, income, food security, marital status, health insurance, place of birth, depression) to racial and ethnic differences in population mean CVH score (range 0-14, accounting for diet, smoking, physical activity, body mass index, blood pressure, cholesterol, blood glucose) among Hispanic, non-Hispanic Asian, or non-Hispanic Black adults compared with non-Hispanic White adults. Results: Among 16,172 participants (representing 255 million US adults), 24% were Hispanic, 12% non-Hispanic Asian, 23% non-Hispanic Black, and 41% non-Hispanic White. Among males, mean (standard error [SE]) CVH score was 7.45 (2.3) in Hispanic, 8.71 (2.2) in non-Hispanic Asian, 7.48 (2.4) in non-Hispanic Black, and 7.58 (2.3) in non-Hispanic White adults. In Kitagawa-Blinder-Oaxaca decomposition, education explained the largest component of CVH differences among males (if distribution of education were similar to Non-Hispanic White, CVH score would be 0.36 [0.04] points higher in Hispanic, 0.24 [0.04] points lower in Non-Hispanic Asian, and 0.23 [0.03] points higher in Non-Hispanic Black, p<0.05). Among females, mean (SE) CVH score was 8.03 (2.4) in Hispanic, 9.34 (2.1) in non-Hispanic Asian, 7.43 (2.3) in non-Hispanic Black, and 8.00 (2.5) in non-Hispanic White adults. Education explained the largest component of CVH difference in Non-Hispanic Black females (if distribution of education were similar to NH White, CVH score would be 0.17 [0.03] points higher in NH Black, p<0.05). Place of birth (US-born versus born outside the US) explained the largest component of CVH difference in Hispanic and Non-Hispanic Asian females (if distribution of place of birth were similar to Non-Hispanic White, CVH score would be 0.36 [0.07] points lower and 0.49 [0.16] points lower, respectively, p<0.05). Conclusions: Education and place of birth confer the largest statistical contributions to the racial and ethnic differences in mean CVH score among US adults.

PMID:36334260 | DOI:10.1161/CIRCULATIONAHA.122.061991

Obes Surg. 2022 Nov 5. doi: 10.1007/s11695-022-06336-x. Online ahead of print.

ABSTRACT

PURPOSE: Subclinical cardiac dysfunction is common in patients with obesity. Bariatric surgery is associated with normalization of subclinical cardiac function in 50% of the patients with obesity. The aim of this study was to identify predictors for a lack of improvement of subclinical cardiac dysfunction 1-year post-bariatric surgery.

METHODS: Patients who were referred for bariatric surgery were enrolled in a longitudinal study. Inclusion criteria were age 35-65 years and BMI ≥ 35 kg/m². Patients with a suspicion of or known cardiovascular disease were excluded. Conventional and advanced echocardiography, Holter monitoring, and blood tests were performed pre- and 1-year post-bariatric surgery. Subclinical cardiac dysfunction was defined as either a reduced left ventricular ejection fraction, decreased global longitudinal strain (GLS), diastolic dysfunction, arrhythmia, or an increased BNP or hs Troponin I.

RESULTS: A total of 99 patients were included of whom 59 patients had cardiac dysfunction at baseline. Seventy-two patients completed the 1-year follow-up after bariatric surgery. There was a significant reduction in weight and cardiovascular risk factors. Parameters of cardiac function, such as GLS, improved. However, in 20 patients cardiac dysfunction persisted. Multivariate analysis identified a decreased heart rate variability (which is a measure of autonomic function), and a decreased vitamin D pre-surgery as predictors for subclinical cardiac dysfunction after bariatric surgery.

CONCLUSION: Although there was an overall improvement of cardiac function 1-year post-bariatric surgery, autonomic dysfunction and a decreased vitamin D pre-bariatric surgery were predictors for a lack of improvement of subclinical cardiac dysfunction.

PMID:36334252 | DOI:10.1007/s11695-022-06336-x

Obes Surg. 2022 Nov 5. doi: 10.1007/s11695-022-06324-1. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity hypoventilation syndrome (OHS) is frequently misdiagnosed and undertreated, increasing the risk of perioperative complications. We aimed to determine the predictors of OHS and to develop and validate a novel nomogram and online calculator for identifying patients at risk of OHS in bariatric surgery candidates.

METHODS: We retrospectively analyzed the data of patients undergoing bariatric surgery between March 2017 and June 2020. Predictors were identified using univariate and multivariate analyses to establish the nomogram. The discriminative ability, calibration, and clinical value of the nomograms were tested using C-statistics, calibration plots, and decision curve analysis. The nomogram was internally validated using bootstrap resampling.

RESULTS: A total of 577 patients were enrolled, and OHS was presented in 17.9% (103/577). Body mass index (BMI) (odds ratio [OR], 1.11; 95% confidence interval (CI), 1.04-1.18; p = 0.001), neck circumference (OR, 1.09; 95% CI, 1.01-1.18; p = 0.035), type 2 diabetes (T2D) (OR, 2.02; 95% CI, 1.17-3.45; p = 0.011), serum bicarbonate (OR, 1.47; 95% CI, 1.30-1.67; p < 0.001), and C-reactive protein (CRP) (OR, 1.03; 95% CI, 1.01-1.06; p = 0.017) were independent risk factors for OHS and incorporated to develop the nomogram. The nomogram revealed good discrimination, with a C-index of 0.830 (95% CI: 0.784-0.876) (0.8227 through internal validation), and good calibration. Decision curve analysis further confirmed the nomogram’s clinical usefulness.

CONCLUSIONS: The novel nomogram and online calculator provided an excellent preoperative individualized prediction of OHS in patients undergoing bariatric surgery, hereby potentially assisting clinicians and surgeons in the early detection and intensive monitoring of OHS.

PMID:36334251 | DOI:10.1007/s11695-022-06324-1

J Cancer Educ. 2022 Nov 5. doi: 10.1007/s13187-022-02227-y. Online ahead of print.

ABSTRACT

American Indians experience disparities in cancer screening, stage at disease diagnoses, and 5-year cancer survival. This study investigates how health literacy and health numeracy may be linked to cancer screening behaviors of Zuni Pueblo members using a survey exploring screening behaviors related to breast, cervical, and colorectal cancers. As part of a larger community-based cancer prevention and control project, Zuni Health Initiative staff conducted surveys from October 2020 through April 2021 of 281 participants (men ages 50-75 and women ages 21-75) from the Zuni Pueblo. Bivariate and multivariable analyses investigated associations between health literacy/numeracy measures and cancer screening behaviors. Bivariate analyses showed some associations between distinct measures of health literacy/numeracy and colorectal cancer (CRC) screening, including both colonoscopy (health literacy) and fecal occult blood testing (FOBT) (health numeracy), as well as cervical cancer screening (health literacy). There were no statistically significant associations between health literacy/numeracy measures and mammogram screening for breast cancer. In multivariable analyses, there were no consistent patterns between health literacy/numeracy and screening for any cancer. There are some individual findings worth noting, such as statistically significant findings for health numeracy and FOBT (those reporting lower health numeracy were less likely to report FOBT). An important finding of this study is that questions used to assess health literacy/numeracy did not identify associations aligned with previous research. We reflect on the ways the “standard” questions may not be sufficiently tailored to the Zuni experience and may contribute to health equity barriers.

PMID:36334245 | DOI:10.1007/s13187-022-02227-y

J Community Health. 2022 Nov 5. doi: 10.1007/s10900-022-01164-7. Online ahead of print.

ABSTRACT

The goals of this study were to determine the completion rates of patient order forms at the Cooper Rowan Clinic, a student-run free clinic, and to implement the use of a post-encounter phone call to improve completion rates, preventive medicine, and medical student clinical involvement. 151 patients completed a pre-intervention questionnaire before their visit. The questionnaire collected information regarding successfully completed order forms. First-year students were trained to perform phone calls and called their patients for five months. 205 patients then completed a post-intervention questionnaire. Dependent variables included completion rates for laboratory studies, specialty referrals, imaging studies and miscellaneous tests. Chi-squared tests were performed. Although the completion rates for laboratory testing (pre = 73.7% vs post = 81.1%), referrals (pre = 50.0% vs post = 65.1%) and imaging studies (pre = 60.9% vs post = 71.7%) increased, the results were not statistically significant. The completion rate of miscellaneous testing (pre = 41.7% vs post = 100.0%) increased following the implementation and was statistically significant. When patients were stratified to those who received a phone call, completion rates of referrals (73.0%), laboratory testing (86.1%), imaging studies (80.5%), and miscellaneous studies (100.0%) substantially increased. Although not statistically significant except for miscellaneous studies, there was an overall increase in completion in all categories. Further evidence to suggest that phone calls improved order completion was the substantial increase in completion rates in patients who received a call. The implementation improves completion of orders which could enhance preventive measures within the clinic. Additionally, it provides an opportunity for earlier student clinical exposure through direct patient contact.

PMID:36334217 | DOI:10.1007/s10900-022-01164-7

Mol Divers. 2022 Nov 5. doi: 10.1007/s11030-022-10559-6. Online ahead of print.

ABSTRACT

Machine learning based statistical models have played a significant role in increasing the speed and accuracy with which the chemical and physical properties of chemical compounds can be predicted as compared to the experimental, and traditional ab initio and quantum mechanical approaches. The transformative impact that these techniques have, in the field of chemical sciences has completely changed the way experiments are designed. The last decade has seen the prominence of computer-aided molecular design based on machine learning algorithms. The major challenge has been the generation of machine-readable data in the form of descriptors and observations for training the model, which can again be time-consuming and computationally expensive if atomic coordinates based molecular encoding approach is used. In this study, we have tried to solve this problem using SMILES representation of molecules for generating various topological, physicochemical, electronic and steric descriptors using open-source cheminformatics packages. With the aid of the data generated using these packages, we have been able to develop a simple and explainable quantitative structure property relationship model using artificial neural network based on 7 numerical descriptors and 1 categorical descriptor for predicting the empirical polarity of a wide diversity of organic solvents. Since polarity is the representation of various solute-solvent and solvent-solvent interactions taking place in an organic transformation, its intuition beforehand will definitely help a chemist in a better experimental design. An ANN algorithm based on 8 descriptors was successfully employed to predict the E_T(30) values of organic solvents.

PMID:36334165 | DOI:10.1007/s11030-022-10559-6

Hernia. 2022 Nov 5. doi: 10.1007/s10029-022-02701-y. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Elective inguinal hernia repair is a ubiquitous procedure that carries risks; chronic pain and impacts on quality of life (QoL) must be considered when advising patients around repair. The length of time from surgery date and impacts on quality of life are often limited to only a few years of follow-up and despite hernia repair being quite common, long-term outcomes are not often reported.

METHODS: A cohort of patients who had received Lichtenstein inguinal hernia repair over the previous 10 years were contacted and surveyed using the Brief Pain Inventory Short Form (BPI) to assess chronic pain and its effects on their QoL. Patient and operative factors were correlated with pain through linear regression and t-test analysis provided statistical significance for mean comparisons (P < 0.05).

RESULTS: The rate of chronic pain was 17.2% with recurrence of 3.1% at an average post-operative interval of 5.84 years. Of the various metrics compared between groups, age was one of the only significant predictors of chronic pain with younger patients reporting higher pain. Further time from surgery also translated to significantly less pain with a difference of 1.3 years. BPI respondents identified pain that interfered to varying degrees in different aspects of life but had relatively low average magnitudes (range: 1.82/10-2.91/10).

CONCLUSIONS: These long-term considerations of post-surgical impact should be considered alongside potential benefits when advising patients about surgery and may help moderate post-operative expectations to optimize the outcome of common inguinal hernia repairs.

PMID:36334162 | DOI:10.1007/s10029-022-02701-y

Metabolomics. 2022 Nov 5;18(11):88. doi: 10.1007/s11306-022-01950-3.

ABSTRACT

INTRODUCTION: Earliness of tuberisation and the quality of potato tubers are important traits in potato breeding. The qualitative traits rely on the metabolite profile of tubers, which are storage organs and net importers of assimilates. Thus, the quality of tubers largely depends on the metabolites transported from leaves to developing tubers.

OBJECTIVES: To test the influence of canopy on the quality of tubers by metabolite profiling of tubers of an early- and a late-maturing potato line and their grafts.

METHODS: Potatoes were grown under greenhouse conditions, grafted and the tubers harvested at the end of the scions’ vegetation period. Metabolite profiling of freshly harvested tubers was performed using gas chromatography coupled with mass spectrometry. Statistical analyses were applied to determine the significant differences between the different tubers.

RESULTS: 99 metabolites were identified and an additional 181 peaks detected in chromatograms, out of which 186 were polar and 94 non-polar compounds. The concentrations of 113 metabolites were significantly different in the tubers from the early-maturing CE3130 and the late-maturing CE3027 line. Hetero-grafting resulted in considerable changes in the metabolite content of tubers. Especially, the effect of CE3027 on the metabolite composition of tubers formed on CE3130 rootstocks was readily apparent. Nevertheless, many compounds were present at similar levels in the tubers of hetero-grafted plants as was found in the tubers of their scion counterparts.

CONCLUSION: Hetero-grafting resulted in many compounds at similar concentrations in rootstock tubers as in scion tubers suggesting that these are transported from the source leaves to tubers.

PMID:36334159 | DOI:10.1007/s11306-022-01950-3

Arch Dermatol Res. 2022 Nov 5. doi: 10.1007/s00403-022-02446-9. Online ahead of print.

ABSTRACT

BACKGROUND: Atrophic post-acne scarring constitutes a troublesome cosmetic concern for both patients and dermatologists. Old and new therapies as well as combinations are being introduced to achieve a satisfactory response. Microneedling has been used either alone or under different combinations for its treatment. The aim was to compare its combination with topical platelet-rich plasma versus its combination with topical Botulinum Toxin-A.

METHODS: 30 subjects with different types and grades of atrophic post-acne scars completed the study. Right side of the face was treated with microneedling and platelet-rich plasma while the left side was treated microneedling and Botox. Response was assessed using two different scales. Patient satisfaction and pain were also assessed.

RESULTS: Regarding response to therapy and according to the quartile grading scale, there was no statistically significant difference between the two sides where (23.4% & 13.3%) of the right and left sides, respectively, had an excellent response. Regarding the difference in the qualitative global scarring grading system before and after treatment, there was a highly statistically significant improvement on both sides with higher improvement on the right side than left side but in a non-statistically significant way.

CONCLUSIONS: Both combinations present efficacious options for treating acne scars with comparable efficacy.

TRIAL REGISTRATION: Registered and approved prospectively by the ethical review board of the faculty of medicine, Zagazig University.

PMID:36334117 | DOI:10.1007/s00403-022-02446-9

Graefes Arch Clin Exp Ophthalmol. 2022 Nov 5. doi: 10.1007/s00417-022-05887-0. Online ahead of print.

ABSTRACT

PURPOSE: To quantify retinal microvascular findings in the acute phase of COVID-19 using multimodal imaging and compare them with healthy, age-matched controls.

METHODS: Hospitalized patients in the acute phase of COVID-19 without known systemic comorbidities (n = 75) and healthy controls (n = 101) aged 18-65 were enrolled in this prospective cross-sectional study. The retinal microcirculation and microvasculature impairments were assessed using fundus photography, swept-source optical coherence tomography, and swept-source optical coherence tomography angiography in the COVID-19 unit and compared with healthy, age-matched controls.

RESULTS: Retinal findings were predominately observed in patients with severe disease (P = 0.006). Patients with severe disease were shown to have increased both mean vein diameter (Coef. = 19.28, 95% CI: 7.34-31.23, P = 0.002) and mean artery diameter (Coef. = 11.07, 95% CI: 0.84-21.67, P = 0.044). Neither blood vessel diameters were correlated with any confounding variables (age, sex, treatment with oxygen, LDH, or ferritin). Patients with severe COVID-19 were shown to have significantly increased retinal nerve fiber layer thickness in the superior and inferior quadrants both in the inner (S: P = 0.046; I: P = 0.016) and outer (S: P = 0.026; I: P = 0.014) ring and significantly increased GCL thickness in the outer temporal quadrant (P = 0.038). There were no statistically significant differences in vessel density or the foveal avascular zone area between the groups.

CONCLUSION: The severity of COVID-19 was significantly correlated with the presence of retinal microangiopathy, which could become a biomarker of angiopathy in patients with COVID-19.

PMID:36334115 | DOI:10.1007/s00417-022-05887-0