Tag: pubmed

Eur J Neurol. 2021 Sep 14. doi: 10.1111/ene.15102. Online ahead of print.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) often remains undiagnosed in cryptogenic stroke (CS), mostly because of limited availability of cardiac long-term rhythm monitoring. There is an unmet need for a pre-selection of CS patients benefiting from such work-up. We therefore developed a clinical risk score for the prediction of AF after CS and evaluated its performance over one year of follow-up.

METHODS: Our proposed risk score ranges from 0 to 16 points and comprises variables known to be associated with occult AF in CS patients including age, NT-proBNP, electro- and echocardiographic features (supraventricular premature beats, atrial runs, atrial enlargement, left ventricular ejection fraction) and brain imaging markers (multi-territory/prior cortical infarction). We prospectively followed all CS patients admitted to our Stroke Unit between March 2018 to August 2019 for AF detection over one year after discharge.

RESULTS: During the one-year follow-up, we diagnosed 24 (16%) out of 150 CS patients with AF (detected via ECG-controls, n=18; loop recorder-monitoring, n=6). Our predefined AF risk score (cutoff ≥4 points; highest Youden’s Index) had a sensitivity of 92% and a specificity of 67% for one-year prediction of AF. Notably, only two CS patients with <4 score points were diagnosed with AF later on (negative predictive value: 98%).

CONCLUSIONS: We here present a clinical risk score for one-year prediction of AF in CS with high sensitivity, reasonable specificity, and excellent negative predictive value. Generalizability of our score needs to be tested in external cohorts with continuous cardiac rhythm monitoring.

PMID:34519135 | DOI:10.1111/ene.15102

Vet Dermatol. 2021 Sep 14. doi: 10.1111/vde.13022. Online ahead of print.

ABSTRACT

BACKGROUND: The pathogenesis of feline allergic dermatitis (FAD) is unclear, with several differences from allergic dermatitis in dogs and humans.

HYPOTHESIS/OBJECTIVES: To survey cytokine expression levels in healthy cats and cats affected with allergic dermatitis or asthma.

ANIMALS: Formalin-fixed, paraffin-embedded skin biopsies from 22 cats with allergic dermatitis and 21 cats without allergic dermatitis were used for cutaneous assays. Serum was obtained from 17 healthy cats, 18 cats with allergic dermatitis, and 18 cats with a presumptive diagnosis of asthma.

METHODS AND MATERIALS: Cutaneous mRNA expression was evaluated with quantitative PCR [interleukin (IL)-31 and IL-31 Receptor A] and RNA in situ hybridisation (ISH) [IL-5, IL-31, IL-31RA, IL-33 and Oncostatin M receptor (OSMR)-β]. IL-31 protein concentrations were evaluated in serum with an enzyme-linked immunosorbent assay. Serum levels of 19 additional cytokines were evaluated using a Luminex panel.

RESULTS: IL-31, IL-31RA, IL-5 and IL-33 mRNA expression were either expressed in low quantities or undetectable in most samples. By contrast, OSMR-β expression was significantly higher in the skin of allergic versus healthy cats (P < 0.0001). Although serum IL-31 was detected in a larger number of cats with allergic dermatitis than healthy cats, and concentrations appeared to be higher in cats with allergies, this difference was not statistically significant. Cats affected by asthma also exhibited insignificantly higher concentrations of IL-31 in the serum.

CONCLUSIONS AND CLINICAL RELEVANCE: Our results suggest that feline allergic diseases may exhibit different pathomechanisms from allergic diseases affecting other species. These findings are useful in guiding further therapeutic development toward targets that may have a role in the pathogenesis of feline allergic skin disease.

PMID:34519120 | DOI:10.1111/vde.13022

Histopathology. 2021 Sep 14. doi: 10.1111/his.14566. Online ahead of print.

ABSTRACT

AIMS: Emerging data support that submucosa-invasive (pT1b) esophageal adenocarcinomas are cured via endoscopic resection provided that invasion measures ≤500 microns (μm), they lack other histologic features predictive of nodal metastasis, and have negative margins. Hence, pathologists’ measurement of depth of submucosal invasion in endoscopic resections may dictate further management (i.e. endoscopic follow-up vs. esophagectomy). In this study, we assessed the interobserver agreement in measuring the depth of submucosal invasion in esophageal endoscopic resections.

METHODS AND RESULTS: Six subspecialized gastrointestinal (GI) pathologists from 5 academic centers independently measured the depth of submucosal invasion in μm from the deepest muscularis mucosae on 37 esophageal endoscopic resection slides (Round 1 scoring). A consensus meeting with a systematic approach for measuring and discussion of pitfalls was undertaken and re-measuring (Round 2 scoring) was done. Interobserver agreement was assessed by the `intraclass correlation coefficient (ICC) and Cohen’s kappa statistics. A lack of agreement was seen amongst the six reviewers with a poor ICC for both rounds: 1 [0.40, 95% CI 0.26-0.56]; 2 [ 0.49 ,95%CI 0.34-0.63]. When measurements were categorized as < or >500 μm, the overall agreement amongst the 6 reviewers was only fair for both rounds: 1[Kappa 0.37, 95% CI 0.22-0.53]; 2 [Kappa 0.29, 95%CI 0.12- 0.46].

CONCLUSIONS: Our study shows a lack of agreement among GI pathologists in measuring depth of submucosal invasion in esophageal endoscopic resections despite formulating a consensus approach for scoring. If important management decisions continue to be based upon this parameter, more reproducible and concrete guidelines are needed.

PMID:34519098 | DOI:10.1111/his.14566

Kidney Blood Press Res. 2021 Sep 10:1-11. doi: 10.1159/000518768. Online ahead of print.

ABSTRACT

INTRODUCTION: Serum uric acid (SUA) has been found correlated with an increased risk of hypertension, but evidence is sparse regarding the association in Gansu Province, especially in Yugur people. This study aimed to explore the nonlinear relationship between SUA levels and hypertension in Han and Yugur people in China.

METHODS: The cross-sectional study samples (n = 5,327) were from the China National Health Survey (CNHS) in Gansu Province. Participants were selected using a multistage stratified cluster sampling method. SUA was measured by enzymatic methods. The restricted cubic spline regression was performed to evaluate the shape of the association.

RESULTS: The overall prevalence of hypertension and hyperuricemia was 28.4% and 17.0%, respectively, in this study. Comparing the highest (>416.4 μmol/L) to the lowest (<254.1 μmol/L) SUA level groups, the multivariable adjusted differences and 95% confidence intervals (CIs) in blood pressure (BP) were 6.15 (4.22, 8.08) mm Hg and 4.87 (3.51, 6.23) mm Hg for SBP and DBP in Han, and 2.22 (-0.73, 5.18) mm Hg and 2.56 (0.38, 4.75) mm Hg for SBP and DBP in Yugur people, respectively. The corresponding odds ratios (95% CIs) for hypertension were 3.16 (2.26, 4.43) and 2.37 (1.46, 3.89) in Han and Yugur people, respectively. The restricted cubic spline regression models illustrated that both BP level and the risk of hypertension increased with elevated SUA levels in Han and Yugur people.

CONCLUSIONS: SUA was significantly and independently associated with an increased risk of hypertension in Han and Yugur people. Prospective studies are needed to confirm these findings.

PMID:34518473 | DOI:10.1159/000518768

ORL J Otorhinolaryngol Relat Spec. 2021 Sep 10:1-7. doi: 10.1159/000518366. Online ahead of print.

ABSTRACT

INTRODUCTION: The anterosuperior portion of the bulla lamella can extend into the frontal sinus and form the supra bulla frontal cell (SBFC) and supraorbital ethmoid cell (SOEC). This can affect the frontal drainage pathway and make surgery more challenging.

OBJECTIVES: The aim of the study was to compare the anatomical characteristics of SBFC and SOEC in Chinese chronic rhinosinusitis (CRS) patients and explore the relationship between the cells and frontal sinusitis (FS). The surgical skills in dealing with these cells were also studied.

METHODS: We prospectively identified SBFC and SOEC in 114 patients with CRS by computed tomography (CT). The sides of the patients were divided into groups A (with FS) and B (without FS). CT scans were analyzed to distinguish the SBFC, SOEC, and the drainage pathway. Statistical analysis was conducted to determine whether the cells were associated with the occurrence of FS.

RESULTS: The prevalence of frontal cells was as follows: SBFC: 9.65%, SOEC: 21.93%. There was an association between the presence of SBFC and FS (p < 0.05). The anterior drainage pathway was present in patients with SBFC and SOEC, anterolateral pathway in those with SBFC/SOEC coexisting with the frontal septal cell, and anteromedial pathway in those with SBFC/SOEC coexisting with the supra agger frontal cell.

CONCLUSIONS: There was an association between the presence of SBFC and the occurrence of FS. Extension of the anterosuperior portion of the bulla lamella into the frontal sinus obstructed the drainage pathway posteriorly. Understanding the anatomy may help surgeons thoroughly dissect the bulla lamella.

PMID:34518488 | DOI:10.1159/000518366

Ann Nutr Metab. 2021 Sep 10:1-9. doi: 10.1159/000518675. Online ahead of print.

ABSTRACT

INTRODUCTION: Obesity and overweight are important public health problems. Mindfulness can promote healthier living and dietary habits, which might support weight loss. This study aimed to evaluate the relationship between eating awareness and body mass index (BMI) and body composition in adults.

METHODS: This cross-sectional analytical study was conducted with 446 volunteers. The heights, weights, and waist circumferences of the participants were measured, and bioelectrical impedance analyses were performed. A sociodemographic information form prepared by the researchers and the Turkish version of the Mindful Eating Questionnaire (MEQ) were administered to the volunteers.

RESULTS: In this study, 31.2% (n = 139) of the participants were overweight and 46.9% (n = 209) were obese. There was no statistically significant relationship between gender and BMI. The total mean MEQ score was found to be 88.26 ± 13.3 (53-144). The awareness scores of women of normal weight were statistically significantly higher than those of women with obesity (p = 0.001). There was no difference between BMI categories and awareness scores among male participants. While participants with obesity had higher scores for eating disinhibition, their eating control, eating discipline, and interference scores were lower than those of participants with normal weight (p < 0.001). A weak statistically significant correlation was found between the awareness subdimension of the scale and the ages, BMIs, waist circumferences, and body fat rates of the participants.

CONCLUSION: It was observed that mindful eating was lower in women with overweight and obesity than that in women with normal weight. We believe that it is important to increase awareness of eating in order to protect against the diseases caused by obesity and for a healthy life.

PMID:34518446 | DOI:10.1159/000518675

Audiol Neurootol. 2021 Sep 10:1-10. doi: 10.1159/000518694. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to illustrate clinical and audiological patterns of hearing impairment in patients with autoimmune hearing loss (AIHL).

METHODS: Fifty-three patients with AIHL were retrospectively recruited, and a tapering schema of steroid treatment was administered in all these patients. The diagnosis of AIHL was essentially based on clinical symptoms, such as recurrent, sudden (sensorineural hearing loss [SSHL]), fluctuating, or quickly progressing (<12 months) SSHL (uni-/bilateral), in association with the coexistence of autoimmune diseases, high antinuclear antibodies (ANA) and the presence of human leukocyte antigen (HLA) B27, B35, B51, C04, and C07. Logistic regression analysis was applied to correlate the clinical data and laboratory features of AIHL with final outcomes.

RESULTS: The onset of AIHL was mainly progressive (49%), followed by SSHL (39.6%) or fluctuating (11.3%). The pure-tone audiogram showed more commonly a downsloping pattern (42.6% of ears), but also an upsloping, flat, cookie-bite, or inverse cookie-bite shape. Bilateral progressive AIHL was more frequently simultaneous (23 patients) than heterochronous (4 patients). Nineteen patients (35.8%) showed a favorable response to steroid therapy. The presence of recurrent, bilateral SSHL versus recurrent, unilateral SSHL had statistically negative effect on hearing recovery (OR = 0.042, p < 0.05). The heterochronous bilateral SSHL may have better prognosis than simultaneous bilateral SSHL (OR = 10.000, p = 0.099). The gender, age, concomitant autoimmune disease, high ANA, HLA alleles, tinnitus, and vestibular symptoms had no statistical effect on a favorable outcome of AIHL.

CONCLUSIONS: A bilateral, simultaneous, and progressive hearing loss combined with downsloping audiogram occurred more often in patients with AIHL. Bilateral simultaneous SSHL with recurrences represents the worse prognostic form of AIHL.

PMID:34518471 | DOI:10.1159/000518694

J Nurs Meas. 2021 Sep 13:JNM-D-20-00115. doi: 10.1891/JNM-D-20-00115. Online ahead of print.

ABSTRACT

Autonomy in nursing practice is one of the recurring fields in literature of research. For nurses to be autonomous is considered to have a great importance on the quality of healthcare services. This study aimed to examine the validity and reliability of the Turkish version of the Attitude Toward Professional Autonomy Scale for Nurses. This methodological study adopted a descriptive cross-sectional design. The study was done in a secondary care hospital. Sample group includes 199 nurses that work at a secondary care hospitals. It was carried out while culturally adjusted and it also included two-way translations of English version of the Attitude Toward Professional Autonomy Scale for Nurses. To evaluate its validity, LISREL statistics software was used to make confirmatory factor analysis. Internal consistency was evaluated by using Cronbach’s α and total-item correlations. Average age of the sample group was found 28.35 ± 6.16. Confirmatory factor analysis yielded t-scores, which were significant for all the 18 items (p < .05). Fit indices of the model, resemblance rate chi-square statistics were identified as 𝜒 ²/df = 198.01/132 = 1.50. The Cronbach’s alpha of the scale (.918) was indicative of strong internal consistency. The scale demonstrated strong validity and internal consistency. This scale can be used to assess perceptions of nursing practices that enhance the quality of nursing care.

PMID:34518429 | DOI:10.1891/JNM-D-20-00115

J Nurs Meas. 2021 Sep 13:JNM-D-21-00035. doi: 10.1891/JNM-D-21-00035. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: This study is aimed to analyze the validity and reliability of the Individual Workload Perception Scale in Turkish (IWPSTR).

METHODS: Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis, test-retest, and descriptive statistics were used to analyze data. The sample group of the study consisted of 569 medical and surgical clinic nurses working in hospitals.

RESULTS: The content validity index was .983. The factor loadings of the IWPS_TR were between .359 and .875, the variance accounted for in this study was 62.86%. Cronbach’s alpha value was found to be .923 for the IWPS_TR, and between .721 and .937 for its subscales. Test-retest reliability correlation was found .826.

CONCLUSIONS: It was concluded that the Turkish version of IWPS_TR, which includes 29 items and 5 subscales, could also be applied to nurses in Turkey.

PMID:34518439 | DOI:10.1891/JNM-D-21-00035

Proc Natl Acad Sci U S A. 2021 Sep 28;118(39):e2021699118. doi: 10.1073/pnas.2021699118.

ABSTRACT

In order to navigate a complex web of relationships, an individual must learn and represent the connections between people in a social network. However, the sheer size and complexity of the social world makes it impossible to acquire firsthand knowledge of all relations within a network, suggesting that people must make inferences about unobserved relationships to fill in the gaps. Across three studies (n = 328), we show that people can encode information about social features (e.g., hobbies, clubs) and subsequently deploy this knowledge to infer the existence of unobserved friendships in the network. Using computational models, we test various feature-based mechanisms that could support such inferences. We find that people’s ability to successfully generalize depends on two representational strategies: a simple but inflexible similarity heuristic that leverages homophily, and a complex but flexible cognitive map that encodes the statistical relationships between social features and friendships. Together, our studies reveal that people can build cognitive maps encoding arbitrary patterns of latent relations in many abstract feature spaces, allowing social networks to be represented in a flexible format. Moreover, these findings shed light on open questions across disciplines about how people learn and represent social networks and may have implications for generating more human-like link prediction in machine learning algorithms.

PMID:34518372 | DOI:10.1073/pnas.2021699118