Tag: pubmed

BMJ Open. 2021 Sep 13;11(9):e047141. doi: 10.1136/bmjopen-2020-047141.

ABSTRACT

INTRODUCTION: Apnoea affects 85% of premature infants under 34 weeks of age and would be an important risk factor for subsequent neuropsychological disorders. Currently, premature children with life-threatening apnoeas receive stimulants such as methylxanthines (mainly, caffeine) or doxapram (an analeptic unlicensed in children under 15). However, these products have undesirable effects (hyperarousal, irritability, sleep disorders, tachycardia) and are not always effective because apnoea does persist in some premature newborns. Previous studies have indicated that odorant stimulation, a non-invasive intervention, may stimulate the respiratory rhythm. The objective of the present protocol is to reduce the occurrence of apnoeic episodes in premature newborns by controlled odorant stimulation added to current pharmacological treatments.

METHODS AND ANALYSIS: The project is a randomised open-label Latin-square trial with independent evaluation of the main endpoint. It will include 60 preterm neonates from two university hospital neonatal intensive care units over 2 years (2021-2023). Each newborn will receive no (S0), sham (S1) or real olfactory stimulation (S2) in random order. During S2, three distinct odorants (mint, grapefruit and vanilla) will be delivered successively, in puffs, over 24 hours. Mint and grapefruit odours stimulate the main and the trigeminal olfactory pathways, whereas vanilla odour stimulates only the main olfactory pathway. A statistical analysis will compare the incidence of apnoeic episodes during S1 versus S2 using a mixed effects Poisson model.

ETHICS AND DISSEMINATION: Ethical approval was obtained from the Comité de Protection des Personnes Île-de-France XI (# 2017-AO13-50-53). The results will be disseminated through various scientific meetings, specialised peer-reviewed journals and, whenever possible, posted on appropriate public websites.

TRIAL REGISTRATION NUMBER: NCT02851979; Pre-results.

PMID:34518252 | DOI:10.1136/bmjopen-2020-047141

BMJ Open. 2021 Sep 13;11(9):e048215. doi: 10.1136/bmjopen-2020-048215.

ABSTRACT

INTRODUCTION: In Aotearoa New Zealand, Māori and Pacific people experience worse health outcomes compared with other New Zealanders. No population-based eye health survey has been conducted, and eye health services do not generate routine monitoring reports, so the extent of eye health inequality is unknown. This information is required to plan equitable eye health services. Here we outline the protocol for a scoping review to report the nature and extent of the evidence reporting vision impairment, and the use of eye health services by ethnicity in New Zealand.

METHODS AND ANALYSIS: An information specialist will conduct searches on MEDLINE and Embase, with no limit on publication dates or language. We will search the grey literature via websites of relevant government and service provider agencies. Reference lists of included articles will be screened. Observational studies will be included if they report the prevalence of vision impairment, or any of the main causes (cataract, uncorrected refractive error, macular degeneration, glaucoma or diabetic retinopathy) or report the use of eye health services in New Zealand among people of any age. Two authors will independently review titles, abstracts and full-text articles, and complete data extraction. Overall findings will be summarised using descriptive statistics and thematic analysis, with an emphasis on disaggregation by ethnicity where this information is available.

ETHICS AND DISSEMINATION: Ethical approval has not been sought as our review will only include published and publicly accessible data. We will publish the review in an open access peer-reviewed journal. We anticipate the findings will be useful to organisations and providers in New Zealand responsible to plan and deliver eye care services, as well as stakeholders in other countries with differential access to eye care.

REGISTRATION DETAILS: The protocol has been registered with Open Science Framework (https://osf.io/yw7xb).

PMID:34518256 | DOI:10.1136/bmjopen-2020-048215

BMJ Open. 2021 Sep 13;11(9):e048550. doi: 10.1136/bmjopen-2020-048550.

ABSTRACT

OBJECTIVES: Medicine is facing a physician-scientist shortage. By offering extracurricular research programmes (ERPs), the physician-scientist training pipeline could already start in undergraduate phases of medical training. However, previous studies into the effects of ERPs are mainly retrospective and lack baseline measurements and control groups. Therefore, the current study mimics a randomised controlled trial to examine the effects of an ERP.

DESIGN: Prospective cohort study with baseline measurement and comparable control group.

SETTING: One cohort of 315 medical undergraduates in one Dutch University Medical Center are surveyed yearly. To examine the effects of the ERP on academic achievement and motivational factors, regression analyses were used to compare ERP students to students showing ERP-interest only, adjusted for relevant baseline scores.

PARTICIPANTS: Out of the 315 students of the whole cohort, 56 participated within the ERP and are thus included. These ERP students are compared with 38 students showing ERP-interest only (ie, control group).

PRIMARY OUTCOME MEASURE: Academic achievement after 2 years (ie, in-time bachelor completion, bachelor grade point average (GPA)) and motivational factors after 18 months (ie, intrinsic motivation for research, research self-efficacy, perceptions of research, curiosity).

RESULTS: ERP participation is related to a higher odds of obtaining a bachelor degree in the appointed amount of time (adjusted OR=2.95, 95% CI 0.83 to 10.52). Furthermore, starting the ERP resulted in higher levels of intrinsic motivation for research, also after adjusting for gender, age, first-year GPA and motivational baseline scores (β=0.33, 95% CI 0.04 to 0.63). No effect was found on research self-efficacy beliefs, perceptions of research and curiosity.

CONCLUSIONS: Previous research suggested that intrinsic motivation is related to short-term and long-term research engagement. As our findings indicate that starting the ERP is related to increased levels of intrinsic motivation for research, ERPs for undergraduates could be seen as an important first step in the physician-scientist pipeline.

PMID:34518257 | DOI:10.1136/bmjopen-2020-048550

Depress Anxiety. 2021 Sep 13. doi: 10.1002/da.23215. Online ahead of print.

ABSTRACT

BACKGROUND: The utility of brain-based biomarkers for psychiatric disorders hinges among other factors on their ability to explain a significant portion of the phenotypic variance. In particular, many small scale studies have been unable to arbitrate whether structural or functional magnetic resonance imaging has potential to be a biological marker for these disorders.

METHODS: This study conducted a meta-analysis to examine the relationship between study power and published effect sizes for the relationship between affective symptoms and structural or functional magnetic resonance imaging measures. The current analyses are based on 821 brain-affective symptom association effect sizes derived from 120 publications, which employed a univariate region-of-interest approach.

RESULTS: For self-assessed affective symptoms published brain imaging measures accounted for on average 8% (confidence interval: 1.6%-23%) of between-subject variation. This average effect size was based mostly on studies with small sample sizes, which have likely led to inflation of these effect size estimates.

CONCLUSIONS: These findings support the conclusion that brain imaging measures currently account for a smaller proportion of the interindividual variance in affective symptoms than has been previously reported. The current findings support the need for both large-sample clinical studies and new statistical and theoretical models to more robustly capture systematic variance of brain-affective symptom relationships.

PMID:34516701 | DOI:10.1002/da.23215

Int J Clin Pract. 2021 Sep 13:e14837. doi: 10.1111/ijcp.14837. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic inflammatory diseases can lead to emergency admissions with various acute complications.Unfortunately,there is limited data on emergency admissions due to rheumatologic diseases.

OBJECTIVES: To evaluate the patients with rheumatic diseases presenting to the ED.

METHODS: 1788 patients with a diagnosis of inflammatory rheumatic disease admitted to the emergency department (ED) of a tertiary university hospital between March 2016 and March 2021 were included.The patients’ sociodemographic and clinical characteristics, diagnosis, and treatments in the ED were recorded. Patients’ complaints were classified as rheumatologic or non-rheumatologic.

RESULTS: Over five years, 1788 patients with an inflammatory rheumatic disease presented to the ED.The mean duration of rheumatologic disease was 7±3.4 years, and the mean number of emergency admissions was 4.4±5.The four most common groups attending the ED were patients with rheumatoid arthritis, ankylosing spondylitis, familial Mediterranean fever, and vasculitis.Of the complaints of the 1788 ED visitors, 1106 (61.9%) were rheumatologic, 681 (38.1%) were non-rheumatologic and other acute or chronic conditions.Twenty-three patients (1.3%) had rheumatic disease and died after admission to the ED.When the univariable model results are examined, the risk of hospitalization increases 1.024 times with increasing age.The risk of hospitalization is 2.318 times higher in those with ankylosing spondylitis and 2.722 times in those with rheumatoid arthritis compared to those with a diagnosis of vasculitis.The risk of hospitalization in patients with comorbid diseases is 1.807 times higher than those without.When the results of the multivariable model are examined, the risk of hospitalization is 2.227 times higher in those with ankylosing spondylitis and 2.615 times in those with rheumatoid arthritis compared to those with vasculitis. Other risk factors were not statistically significant (p>0.050).

CONCLUSION: Patients with rheumatic disease most frequently presented to the ED with musculoskeletal complaints and were discharged from the ED.True rheumatologic emergencies are rare, but ED physicians should be aware of serious and life-threatening conditions.

PMID:34516699 | DOI:10.1111/ijcp.14837

Prostate. 2021 Sep 13. doi: 10.1002/pros.24222. Online ahead of print.

ABSTRACT

BACKGROUND: Inflammation plays critical roles at different stages of carcinogenesis and cancer progression. Several previous studies showed conflicting results for the predictive role of systemic inflammation markers in the detection of clinically significant prostate cancers (CSPCs). We aimed to determine the predictive roles of lymphocyte-to-monocyte (LMR) and eosinophil-to-lymphocyte ratios (ELR) in the detection of CSPC at standard 12-core transrectal ultrasound-guided prostate biopsy (12-core-TRUS-Bx) using our large-cohort database.

METHODS: Clinical and pathological data of a total of 1740 men, who underwent initial standard 12-core TRUS-Bx, were analyzed. LMR and ELR were calculated from the prebiopsy complete blood count. Definitions of CSPC, LMR, and ELR were “Gleason grade group ≥2,” “the lymphocyte counts/the monocyte counts,” and “the eosinophil counts/the lymphocyte counts,” respectively.

RESULTS: Median (interquartile range) of serum prostate-specific antigen (PSA) level and prostatic volume before TRUS-Bx were 7.59 (5.02-13.12) ng/ml and 38.2 (29.0-52.9) ml, respectively. Benign prostatic lesions, clinically insignificant prostate cancers (CIPCs), and CSPCs were detected in 1179 (67.8%), 180 (10.3%), and 381 (21.9%) patients, respectively. The patients with CSPCs had older age, a higher prevalence of diabetes mellitus or hypertension, a higher rate of digital rectal examination abnormality, higher serum PSA level, lower serum testosterone level, and lower LMR than those with benign lesions or CIPCs. However, there was no difference in ELR among the three (benign lesions, CIPCs and CSPCs). In all the patients, multivariate regression analysis showed that lower LMR was an independent predictor of CSPCs compared with ELR. In the subset of men with prostate volume ≥39.3 ml, lower LMR was an independent predictor of CSPCs compared with ELR. In the subset of men with prostate volume <39.3 ml, men with lower LMR showed the tendency of having a higher probability of CSPCs without any statistical significance on the contrary to ELR.

CONCLUSIONS: Our data indicate that LMR can play an independent predictive role in the detection of CSPCs at initial 12-core-TRUS-Bx compared with ELR. The predictive role of the LMR appears to be significant for men with larger prostate volume rather than those with smaller prostate volume.

PMID:34516662 | DOI:10.1002/pros.24222

J Prosthodont. 2021 Sep 13. doi: 10.1111/jopr.13433. Online ahead of print.

ABSTRACT

PURPOSE: This is a systematic review aimed to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed partial dentures (FPDs).

MATERIALS AND METHODS: Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots.

RESULTS: Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: P < .001, 95% CI: 0.96-1.00, I² = 77.84%; 10 years: P < .001, 95% CI: 0.88-0.95, I² = 93.59%; 15 years: P < .001, 95% CI: 0.92-0.96, I² = 94.83%; and 20 years: P < .001, 95% CI: 0.94-0.96, I² = 95.01%.

CONCLUSIONS: The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper. This article is protected by copyright. All rights reserved.

PMID:34516686 | DOI:10.1111/jopr.13433

Ann Work Expo Health. 2021 Sep 13:wxab066. doi: 10.1093/annweh/wxab066. Online ahead of print.

ABSTRACT

Even though the Deepwater Horizon oil spill response and clean-up (OSRC) had one of the largest exposure monitoring efforts of any oil spill, a number of exposure groups did not have sufficient personal data available or there were gaps in days measured to adequately characterize exposures for the GuLF STUDY, an epidemiologic study investigating the health of the OSRC workers. Area measurements were available from real-time air monitoring instruments and used to supplement the personal exposure measurements.

OBJECTIVES: The objective was to present a method that used real-time volatile organic compounds (VOCs) area measurements transformed to daily total hydrocarbons (THC) time-weighted averages (TWAs) to supplement THC personal full-shift measurements collected using passive charcoal badges. A second objective was to develop exposure statistics using these data for workers on vessels piloting remotely operated vehicle (ROV) vessels and other marine vessels (MVs) not at the job title level, but at the vessel level.

METHODS: From hourly vessel averages derived from ~26 million real-time VOC measurements, we estimated full-shift VOC TWAs. Then, we determined the relationship between these TWAs and corresponding full-shift THC personal measurements taken on the same vessel-day. We used this relationship to convert the full-shift VOC measurements to full-shift ‘THC’ TWA estimates when no personal THC measurements existed on a vessel-day. We then calculated arithmetic means (AMs) and other statistics of THC exposures for each vessel.

RESULTS: The VOC-derived estimates substantially supplemented the THC personal measurements, with the number of vessel-days for which we have exposure estimates increasing by ~60%. The estimates of the AMs are some of the highest observed in the GuLF STUDY. As expected, the AMs decreased over time, consistent with our findings on other vessels.

CONCLUSIONS: Despite the inherent limitations of using real-time area measurements, we were able to develop additional daily observations of personal THC exposures for workers on the ROV vessels and other MVs over time. The estimates likely resulted in more representative estimates of the AMs in the GuLF STUDY. The method used here can be applied in other occupational settings and industries for personal exposure estimation where large amounts of area measurements and more limited numbers of personal measurements are available.

PMID:34516617 | DOI:10.1093/annweh/wxab066

Urol J. 2021 Sep 13. doi: 10.22037/uj.v18i.6325. Online ahead of print.

ABSTRACT

PURPOSE: Male infertility accounts for about half of all infertility cases. Asthenoteratozoospermia is a severe form of male infertility. Free radicals play an important role in infertility. In a study we found that asthenoteratozoospermic men had a lower mean percentage of sperm HSPA2+ and higher intracellular anion superoxide than normozoospermia. Antioxidants are thought to be able to counteract the negative effects of free radicals. We explored the efficacy of vitamin E in combination with Se on the level of sperm HSPA2+, intracellular anion superoxide and chromatin integrity in these patients.

MATERIALS AND METHODS: 60 patients entered the study. They were randomized to treatment group of oral Se (200 μg) in combination with vitamin E (400 units) for 3 months (n= 30) or placebo (n= 30). Semen samples were obtained and assessed for sperm parameters, intracellular O2-, protamine deficiency, sperm HSPA2+ and apoptotic spermatozoa at baseline and after treatment phase.

RESULTS: There were no significant differences in baseline semen parameters, intracellular O2- protamine deficiency, sperm HSPA2+ and apoptotic spermatozoa between the treatment and placebo groups. There was a statistically significant decrease in sperm apoptosis and the level of anion superoxide (P=.001) and an increase in sperm motility and viability (P=.001) in the treated group, but no significant difference was found in the percentage of sperm HSPA2+ and sperm protamine deficiency compared with baseline. Moreover, no significant change was found in these parameters in placebo group after 3 months.

CONCLUSION: Our results showed that administration of vitamin E and selenium for three months may improve sperm motility and viability by decreasing intracellular anion superoxide and sperm apoptosis in asthenoteratozoospermic infertile men. We suggest that consuming these supplements before assisted reproductive technology (ART) may improve outcomes in these patients.

PMID:34516655 | DOI:10.22037/uj.v18i.6325

PLoS One. 2021 Sep 13;16(9):e0257358. doi: 10.1371/journal.pone.0257358. eCollection 2021.

ABSTRACT

This study assesses whether final-year undergraduate students at Sana’a University, Yemen intend to start their own business. The study employs the theory of planned behaviour and two environmental factors to explore whether the theory’s behavioural factors and the contextual factors of Lüthje & Franke’s model have an impact on students’ intentions to start their own business. A questionnaire survey with a random sample of 335 final-year university students from the largest public university in Yemen has been conducted. Data has been analysed using descriptive statistics, Pearson’s correlation and structural equation modelling. The findings indicate that students’ perceptions of entrepreneurship have a strong, direct impact on self-employment intention, excluding social norms and entrepreneurial self-efficacy. Students’ self-employment intention is directly affected by perceived barriers and support factors in the entrepreneurship-related context. To increase their entrepreneurial abilities, university students require more training and education to be able to start new businesses. Developing entrepreneurial skills among citizens may improve the societal norms of business. The outcomes provide significant implications for policymakers, academic communities and international bodies.

PMID:34516592 | DOI:10.1371/journal.pone.0257358