Tag: pubmed

Asia Pac J Ophthalmol (Phila). 2022 Sep 1;11(5):417-424. doi: 10.1097/APO.0000000000000552.

ABSTRACT

PURPOSE: To evaluate the presenting radiological features of immunoglobulin G4-related ophthalmic disease (IgG4-ROD) and their associations with IgG4-related optic neuropathy (IgG4-RON), and IgG4-related ocular adnexal lymphoma (IgG4-ROL).

METHODS: A territory-wide, biopsy-proven, Chinese cohort. Masked review of orbital images, medical records, and histopathology reports.

RESULTS: A total of 115 (94%) of the 122 patients in our cohort had preoperative orbital images (computed tomography=105, magnetic resonance imaging=40). Among them, 103/115 (90%) showed enlarged lacrimal glands, and 91 (88%) were bilateral. Nerve enlargement was observed: infraorbital in 31/115 (27%) patients and frontal in 17/115 (15%), 10 and 9 being bilateral, respectively. At least 1 or more extraocular muscle (EOM) enlargement was found in 41/115 (37%) patients, bilaterally in 20. Lateral rectus occurred in 30 (73%) of these 41 EOM patients and inferior rectus in 28 (68%). Two adjacent EOMs (inferior and lateral recti in 11 patients, inferior and medial recti in 7 patients) or multiple EOMs (at least 3) were enlarged in 23/41 (56%) and 13/41 (32%) of the patients, respectively. Intraconal lesions (67% vs 11%, P<0.05), infraorbital (83% vs 23%, P<0.005), or frontal (50% vs 15%, P<0.05) nerve enlargement was significantly associated with IgG4-RON (6 patients) by univariate analyses. Asymmetric lacrimal gland enlargement and discrete orbital mass (both P<0.05) were associated with IgG4-ROL (9 patients) by multivariate analyses.

CONCLUSIONS: In this IgG4-ROD cohort, most patients had bilateral enlarged lacrimal glands, and the lateral rectus is the most frequently involved EOM. For the first time, unique radiological patterns associated with the development of IgG4-RON and IgG4-ROL are found.

PMID:36179335 | DOI:10.1097/APO.0000000000000552

Dimens Crit Care Nurs. 2022 Nov-Dec 01;41(6):321-329. doi: 10.1097/DCC.0000000000000548.

ABSTRACT

BACKGROUND: Despite early revascularization and supportive medical therapies, acute myocardial infarction with cardiogenic shock (AMICS) remains the leading cause of death in patient’s with myocardial infarction. Intra-aortic balloon pump (IABP) has been the device of choice for these patients but has failed to show mortality benefit over medical therapy alone. The Impella (AbioMed, Danvers, Massachusetts) is a more recently developed alternative in bridging patients to recovery.

AIM: The aim of this study was to evaluate available evidence comparing mortality with the use of Impella (2.0 or CP) versus IABP in patients with AMICS.

METHODS: PubMed, CINAHL, EMBASE, and Scopus were searched to find articles comparing the outcomes of IABP versus Impella in AMICS patients. A total of 7 articles met the inclusion criteria.

RESULTS: Thirty-day mortality was the primary outcome observed. Secondary outcomes included myocardial recovery and complications from device implantation. All studies support that there is no statistically significant reduction in mortality when utilizing the Impella over the IABP.

DISCUSSION: Further research in an adequately powered randomized clinical trial is needed to shed light on the clinical characteristics of patients after AMICS who would benefit from 1 type of mechanical circulatory support over another. The therapy chosen is determined by provider discretion and skill set, as well as device availability. It is important for all care team members, including the critical care nurse, to understand the implications and complications associated with each therapy, so care can be catered to the individual patient’s needs.

PMID:36179310 | DOI:10.1097/DCC.0000000000000548

Dimens Crit Care Nurs. 2022 Nov-Dec 01;41(6):295-304. doi: 10.1097/DCC.0000000000000547.

ABSTRACT

BACKGROUND: Self-efficacy is an important psychological construct associated with patient adherence with healthy lifestyle choices. Few studies have focused on the impacts of the type of acute myocardial infarction (AMI), non-ST-elevation myocardial infarction (STEMI) and STEMI, and the different treatment modalities of AMI on changes in cardiac self-efficacy after hospitalization.

OBJECTIVE: This study examined the changes in cardiac self-efficacy based on the type of AMI and aimed to investigate the impact of different treatment modalities on changes in cardiac self-efficacy among post-AMI patients during hospitalization and at the 3- and 6-month follow-ups subsequent to hospitalization.

METHODS: A repeated-measures design was used with a convenient sample of 210 patients diagnosed with first AMI. Patients completed the Cardiac Self-efficacy Questionnaire at the 3 time points. The study was implemented in 3 major hospitals in Jordan. Patients did not have access to cardiac rehabilitation.

RESULTS: There was a statistically significant impact of AMI type on changes in cardiac self-efficacy measured between T1 and T2, between T2 and T3, and subsequently between T1 and T3. Nevertheless, there was no statistically significant impact of treatment modalities of AMI on changes in cardiac self-efficacy measured at the 3 time points.

CONCLUSIONS: Assessment of self-efficacy for post-AMI patients is recommended. Moreover, post-non-STEMI patients need more attention when implementing an intervention to enhance self-efficacy after hospitalization. Health decision makers have to consider establishing cardiac rehabilitation to improve self-efficacy in Jordan. Further research is needed to confirm the study results and to investigate other contributing factors that could influence self-efficacy after hospitalization.

PMID:36179307 | DOI:10.1097/DCC.0000000000000547

Dimens Crit Care Nurs. 2022 Nov-Dec 01;41(6):286-294. doi: 10.1097/DCC.0000000000000552.

ABSTRACT

BACKGROUND: After 3 decades of research, much is understood about the benefits of family presence during resuscitation (FPDR), yet translation into clinical practice has been lagging. This article provides guidance for nurse leaders seeking to advance FPDR by sharing the experience of establishing a multifaceted, hospital-wide program of education and policy development.

OBJECTIVES: This quality improvement project aimed to (1) implement a hospital-wide FPDR program guided by policy, (2) evaluate classroom and simulation educational interventions, (3) examine chart review data for evidence of FPDR practice change, and (4) act on information learned to further improve the FPDR program and increase practice implementation.

METHODS: The Plan-Do-Study-Act (PDSA) cycle provided the model for cyclic evaluation of the FPDR program at a rural Midwestern United States hospital. Interventions were classroom education for existing nursing staff, simulation for new nurses, and implementation of a hospital-wide policy. Outcome measures included nurses’ perceptions of FPDR risks and benefits, self-confidence with FPDR, and evidence of practice change via retrospective chart review.

RESULTS: Pilot data demonstrated a statistically significant improvement in nurses’ perceptions of FPDR benefits and self-confidence post education, and the rate of FPDR practiced in the facility tripled. The PDSA cycle provided a useful paradigm for ongoing process improvement and program sustainability.

DISCUSSION: After the delivery of an FPDR policy along with classroom and simulation education, an increase in the clinical implementation of FPDR occurred. The use of the PDSA cycle resulted in expanded approaches including the addition of FPDR to in situ mock codes.

PMID:36179305 | DOI:10.1097/DCC.0000000000000552

Am J Public Health. 2022 Sep;112(S7):S715-S722. doi: 10.2105/AJPH.2022.307009.

ABSTRACT

Objectives. To design and implement a statistical surveillance system to prospectively identify potential clusters of elevated blood lead levels (EBLLs) in children younger than 6 years in the Denver, Colorado, metro area. Methods. We evaluated the ability of 2 independent statistical surveillance methods to detect synthetic clusters of EBLLs in Denver between 2015 and 2019. Results. Together, the statistical surveillance methods took an average of 9 months to detect the synthetic clusters. This is faster than similar real-world clusters that have been reported in the past. The system was relatively unaffected by changes in the testing rate and to the blood lead reference value. Conclusions. The adequate design of a statistical surveillance system can help increase the rate at which clusters of EBLLs are detected in Denver, but doing so requires an accurate model of the spatial distribution of EBLLs. Earlier detection of clusters can help guide more effective public health interventions at the local level. (Am J Public Health. 2022;112(S7):S715-S722. https://doi.org/10.2105/AJPH.2022.307009).

PMID:36179295 | DOI:10.2105/AJPH.2022.307009

G3 (Bethesda). 2022 Sep 30:jkac224. doi: 10.1093/g3journal/jkac224. Online ahead of print.

ABSTRACT

The fungal kingdom represents an extraordinary diversity of organisms with profound impacts across animal, plant, and ecosystem health. Fungi simultaneously support life, by forming beneficial symbioses with plants and producing life-saving medicines, and bring death, by causing devastating diseases in humans, plants, and animals. With climate change, increased antimicrobial resistance, global trade, environmental degradation, and novel viruses altering the impact of fungi on health and disease, developing new approaches is now more crucial than ever to combat the threats posed by fungi and to harness their extraordinary potential for applications in human health, food supply, and environmental remediation. To address this aim, the Canadian Institute for Advanced Research (CIFAR) and the Burroughs Wellcome Fund convened a workshop to unite leading experts on fungal biology from academia and industry to strategize innovative solutions to global challenges and fungal threats. This report provides recommendations to accelerate fungal research and highlights the major research advances and ideas discussed at the meeting pertaining to 5 major topics: (1) Connections between fungi and climate change and ways to avert climate catastrophe; (2) Fungal threats to humans and ways to mitigate them; (3) Fungal threats to agriculture and food security and approaches to ensure a robust global food supply; (4) Fungal threats to animals and approaches to avoid species collapse and extinction; and (5) Opportunities presented by the fungal kingdom, including novel medicines and enzymes.

PMID:36179219 | DOI:10.1093/g3journal/jkac224

J Clin Oncol. 2022 Sep 30:JCO2200572. doi: 10.1200/JCO.22.00572. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the prevalence of financial hardship among adult survivors of childhood cancer compared with siblings and identify sociodemographic, cancer diagnosis, and treatment correlates of hardship among survivors in the era after implementation of the Affordable Care Act.

METHODS: A total of 3,555 long-term (≥ 5 years) survivors of childhood cancer and 956 siblings who completed a survey administered in 2017-2019 were identified from the Childhood Cancer Survivor Study. Financial hardship was measured by 21 survey items derived from US national surveys that had been previously cognitively tested and fielded. Principal component analysis (PCA) identified domains of hardship. Multiple linear regression examined the association of standardized domain scores (ie, scores divided by standard deviation) with cancer and treatment history and sociodemographic characteristics among survivors.

RESULTS: Survivors were more likely than siblings to report hardship in ≥ 1 item (63.4% v 53.7%, P < .001). They were more likely to report being sent to debt collection (29.9% v 22.3%), problems paying medical bills (20.7% v 12.8%), foregoing needed medical care (14.1% v 7.8%), and worry/stress about paying their rent/mortgage (33.6% v 23.2%) or having enough money to buy nutritious meals (26.8% v 15.5%); all P < .001. Survivors reported greater hardship than siblings in all three domains identified by principal component analysis: behavioral hardship (mean standardized domain score 0.51 v 0.35), material hardship/financial sacrifices (0.64 v 0.46), and psychological hardship (0.69 v 0.44), all P < .001. Sociodemographic (eg, <college education, without private insurance) and treatment factors (eg, received ≥ 250 mg/m² anthracycline chemotherapy, or chest radiation) were statistically significantly associated with increased hardship.

CONCLUSION: Survivors of childhood cancer were more likely to experience financial hardship than siblings. Correlates of hardship can inform survivorship care guidelines and intervention strategies.

PMID:36179267 | DOI:10.1200/JCO.22.00572

Phys Rev Lett. 2022 Sep 16;129(12):121102. doi: 10.1103/PhysRevLett.129.121102.

ABSTRACT

The MICROSCOPE mission was designed to test the weak equivalence principle (WEP), stating the equality between the inertial and the gravitational masses, with a precision of 10^{-15} in terms of the Eötvös ratio η. Its experimental test consisted of comparing the accelerations undergone by two collocated test masses of different compositions as they orbited the Earth, by measuring the electrostatic forces required to keep them in equilibrium. This was done with ultrasensitive differential electrostatic accelerometers onboard a drag-free satellite. The mission lasted two and a half years, cumulating five months worth of science free-fall data, two-thirds with a pair of test masses of different compositions-titanium and platinum alloys-and the last third with a reference pair of test masses of the same composition-platinum. We summarize the data analysis, with an emphasis on the characterization of the systematic uncertainties due to thermal instabilities and on the correction of short-lived events which could mimic a WEP violation signal. We found no violation of the WEP, with the Eötvös parameter of the titanium and platinum pair constrained to η(Ti,Pt)=[-1.5±2.3(stat)±1.5(syst)]×10^{-15} at 1σ in statistical errors.

PMID:36179190 | DOI:10.1103/PhysRevLett.129.121102

Am J Speech Lang Pathol. 2022 Sep 30:1-20. doi: 10.1044/2022_AJSLP-22-00029. Online ahead of print.

ABSTRACT

PURPOSE: Dysphagia impacts many poststroke survivors with wide-ranging prevalence in the acute and chronic phases. One relatively unexplored manifestation of poststroke swallowing impairment is that of primary or co-occurring esophageal dysphagia. The incidence of esophageal dysphagia in this population is unknown despite the shared neuroanatomy and physiology with the oropharynx. We aimed to determine the presence of abnormal esophageal clearance in an acute poststroke sample using the Modified Barium Swallow Impairment Profile (MBSImP) Component 17 (esophageal clearance) as our outcome measure.

METHOD: We performed a retrospective, cross-sectional, cohort study of 57 poststroke patients with acute, first-ever, ischemic strokes. All participants received a modified barium swallow study (MBSS) using the MBSImP protocol and scoring metrics. Swallowing impairment was determined using a combination of MBSImP scores and Penetration-Aspiration Scale scores. Swallowing outcome measures were collected including Functional Oral Intake Scale and International Dysphagia Diet Standardization Initiative (IDDSI) scores. We performed tests of association and logistic regression analysis to determine if statistically significant associations exist between judgments of esophageal clearance and other swallowing impairments and/or swallowing outcome measures.

RESULTS: In our study of poststroke patients who received an MBSS as part of their care, 57.9% had abnormal esophageal clearance. Statistically significant associations were also identified in measures of pharyngeal physiology (MBSImP scores) and swallowing outcome measures (IDDSI scores and alternate means of nutrition).

CONCLUSIONS: Abnormal esophageal clearance was identified in greater than half of our poststroke patients. There is a dearth of scientific research regarding esophageal function poststroke. While esophageal visualization during the MBSS is not diagnostic of esophageal impairment, it may serve as an indicator for those poststroke patients who require dedicated esophageal testing to best determine the full nature of their swallowing pathophysiology and make the most effective treatment recommendations.

PMID:36179218 | DOI:10.1044/2022_AJSLP-22-00029

Phys Rev Lett. 2022 Sep 16;129(12):120501. doi: 10.1103/PhysRevLett.129.120501.

ABSTRACT

Shor’s factoring algorithm provides a superpolynomial speedup over all known classical factoring algorithms. Here, we address the question of which quantum properties fuel this advantage. We investigate a sequential variant of Shor’s algorithm with a fixed overall structure and identify the role of coherence for this algorithm quantitatively. We analyze this protocol in the framework of dynamical resource theories, which capture the resource character of operations that can create and detect coherence. This allows us to derive a lower and an upper bound on the success probability of the protocol, which depend on rigorously defined measures of coherence as a dynamical resource. We compare these bounds with the classical limit of the protocol and conclude that within the fixed structure that we consider, coherence is the quantum resource that determines its performance by bounding the success probability from below and above. Therefore, we shine new light on the fundamental role of coherence in quantum computation.

PMID:36179183 | DOI:10.1103/PhysRevLett.129.120501