Tag: pubmed

Dimens Crit Care Nurs. 2022 Sep-Oct 01;41(5):256-263. doi: 10.1097/DCC.0000000000000539.

ABSTRACT

INTRODUCTION: Patients discharged from the intensive care unit (ICU) suffer from long-term symptoms affecting the physical, psychological, and cognitive well-being and cannot understand memories and dreams. Intensive care unit diaries describe daily events about the patient and may allow them to reconstruct their experience.

OBJECTIVE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ICU diaries on posttraumatic stress disorder (PTSD), depression, and anxiety.

METHODS: Five electronic databases were searched up to May 6, 2022. We included RCTs comparing patients admitted to the ICU who received a diary to those who did not receive a diary. The primary outcome was the rate of PTSD. Secondary outcomes were rates of depression and anxiety.

RESULTS: We included 7 RCTs. Patients who received a diary during the ICU admission had reduced rate of PTSD (78/432 [18%] vs 106/422 [25%]; risk ratio [RR], 0.73; 95% confidence interval [CI], 0.57-0.94; P = .02; I2 = 0%; trial sequential analysis-adjusted CI, 0.55-0.97) when compared with patients who did not receive a diary. We found a non-statistically significant difference toward a reduction in the rate of depression (38/232 [16%] vs 54/224 [24%]; RR, 0.70; 95% CI, 0.49-1.01; P = .06; I2 = 0%) and anxiety (63/232 [27%] vs 70/224 [31%]; RR, 0.64; 95% CI, 0.29-1.40; P = .26; I2 = 67%).

CONCLUSIONS: Providing an ICU diary to patients admitted to the ICU reduced the rate of PTSD symptoms compared with usual care.

PMID:35905428 | DOI:10.1097/DCC.0000000000000539

Clin Transl Gastroenterol. 2022 Jul 1;13(7):e00513. doi: 10.14309/ctg.0000000000000513. Epub 2022 Jun 15.

ABSTRACT

INTRODUCTION: There is increased risk of several malignancies in inflammatory bowel disease (IBD). However, evidence regarding risk of cervical cancer in IBD is conflicting. We aimed to investigate the risk of cervical cancer in IBD by undertaking a systematic review and meta-analysis of unselected, population-based studies.

METHODS: MEDLINE, EMBASE, and Cochrane Library were searched using Medical Subject Heading terms, and 2 reviewers independently screened results. Pooled hazard ratios (HRs) were calculated using random effects model meta-analysis for risk of cervical cancer in IBD. Subgroup meta-analysis was undertaken to assess risk of cervical cancer by IBD subtype (Crohn’s disease and ulcerative colitis), treatment exposure, and grade of lesion.

RESULTS: We screened 1,393 articles to identify 5 population-based studies, including 74,310 patients with IBD and 2,029,087 reference patients, across 5 different countries. Pooled random effects model meta-analysis of these studies did not show statistically significant increased risk for cervical cancer in IBD compared with reference populations (HR: 1.24; 95% confidence interval [CI]: 0.94-1.63). Meta-analysis by grade of lesion showed increased risk of low-grade cervical lesions (HR: 1.15; 95% CI: 1.04-1.28). Meta-analysis by disease subtype indicated no statistically significant increased risk in Crohn’s disease (HR: 1.36; 95% CI: 0.83-2.23) or ulcerative colitis (HR: 0.95; 95% CI: 0.72-1.25) or in patients treated with antitumor necrosis factor (HR: 1.19; 95% CI: 0.64-2.21) or thiopurines (HR: 0.96; 95% CI: 0.60-1.50).

DISCUSSION: This meta-analysis of high-quality, unselected population-based studies shows no statistically significant increased risk of cervical cancer in patients with IBD. There is, however, increased risk of low-grade cervical lesions compared with the general population.

PMID:35905421 | DOI:10.14309/ctg.0000000000000513

Clin Transl Gastroenterol. 2022 Jul 1;13(7):e00508. doi: 10.14309/ctg.0000000000000508. Epub 2022 Jun 7.

ABSTRACT

INTRODUCTION: Intragastric balloons (IGBs) are a safe and effective treatment for obesity. However, limited knowledge exists on the underlying biological changes with IGB placement.

METHODS: This single-institution study was part of an adjustable IGB randomized controlled trial. Subjects with obesity were randomized in a 2 is to 1 ratio to 32 weeks of IGB with diet/exercise counseling (n = 8) vs counseling alone (controls, n = 4). Diet/exercise counseling was continued for 24 weeks post-IGB removal to assess weight maintenance. We used mass spectrometry for nontargeted plasma lipidomics analysis and 16S rRNA sequencing to profile the fecal microbiome.

RESULTS: Subjects with IGBs lost 15.5% of their body weight at 32 weeks vs 2.59% for controls (P < 0.05). Maintenance of a 10.5% weight loss occurred post-IGB explant. IGB placement, followed by weight maintenance, led to a -378.9 μM/L reduction in serum free fatty acids compared with pre-IGB (95% confidence interval: 612.9, -145.0). This reduction was mainly in saturated, mono, and omega-6 fatty acids when compared with pre-IGB. Polyunsaturated phosphatidylcholines also increased after IGB placement (difference of 27 μM/L; 95% confidence interval: 1.1, 52.8). Compared with controls, saturated and omega-6 free fatty acids (linoleic and arachidonic acids) were reduced after IGB placement. The fecal microbiota changed post-IGB placement and weight maintenance vs pre-IGB (P < 0.05). Further analysis showed a possible trend toward reduced Firmicutes and increased Bacteroidetes post-IGB and counseling, a change that was not conclusively different from counseling alone.

DISCUSSION: IGB treatment is associated with an altered fecal microbiome profile and may have a better effect on obesity-related lipidome than counseling alone.

PMID:35905412 | DOI:10.14309/ctg.0000000000000508

J Craniofac Surg. 2022 Jul 28. doi: 10.1097/SCS.0000000000008745. Online ahead of print.

ABSTRACT

BACKGROUND: Spring-mediated cranioplasty (SMC) is an increasingly utilized technique to treat patients with nonsyndromic sagittal craniosynostosis, but variables impacting outcomes are incompletely understood. The purpose of this study was to determine variables most predictive of outcomes following SMC, primarily changes in cephalic index (CI).

METHODS: Patients with nonsyndromic sagittal craniosynostosis undergoing SMC at our institution between 2014 and 2021 were included. Cephalic index was measured from patient computed tomography scans, x-rays, or by caliper-based methods. Parietal bone thickness was determined from patient preoperative computed tomography. Stepwise multiple regression analysis, least absolute shrinkage and selection operator, and random forest machine learning methods were used to determine variables most predictive of changes in CI.

RESULTS: One hundred twenty-four patients were included. Stepwise multiple regression analysis identified duration of spring placement (P=0.007), anterior spring force (P=0.034), and anterior spring length (P=0.043) as statistically significant predictors for changes in CI. Least absolute shrinkage and selection operator analysis identified maximum spring force (β=0.035), anterior spring length (β=0.005), posterior spring length (β=0.004), and duration of spring placement (β=0.0008) as the most predictive variables for changes in CI. Random forest machine learning identified variables with greatest increase in mean squared error as maximum spring force (0.0101), anterior spring length (0.0090), and posterior spring length (0.0056).

CONCLUSIONS: Maximum and total spring forces, anterior and posterior spring lengths, and duration of spring placement were the most predictive variables for changes in CI following SMC. Age at surgery and other demographic variables were inferior predictors in these models.

PMID:35905391 | DOI:10.1097/SCS.0000000000008745

J Craniofac Surg. 2022 Jul 28. doi: 10.1097/SCS.0000000000008737. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to determine factors affecting the survival of pedicled latissimus dorsi (LD) flap.

MATERIALS AND METHODS: Medical records of 20 pedicled LD flap patients for head and neck reconstruction by a single operator from 2015 to 2019 in a tertiary hospital were reviewed. Factors including flap size and pedicle’s length from the most distal end of the flap to the axilla (Fp) and from the most distal end of the defect to the axilla (Dfp) were assessed. Partial flap loss requiring procedures and total loss were considered as failure. Descriptive statistics, the Pearson χ2 test, and linear-by-linear association analysis were performed.

RESULTS: Seventy percent of patients showed success. There was no significant difference in various factors including preoperative body mass index, underlying diseases such as hypertension and diabetes, preoperative treatment either radiation or chemotherapy, lab results, and operation time between the survival and the failure group. Rotation arc (Dfp/Fp) showed significant difference between 2 groups (P=0.001). Unlike Fp, Dfp tend to be shorter on the success group (P=0.053).

CONCLUSIONS: Low rotation arc through shorter Dfp affects survival of pedicled LD flap significantly.

PMID:35905387 | DOI:10.1097/SCS.0000000000008737

J Craniofac Surg. 2022 Jul 28. doi: 10.1097/SCS.0000000000008716. Online ahead of print.

ABSTRACT

The causes of visual impairment following Le Fort osteotomy for syndromic craniosynostosis have not been completely elucidated. The authors investigated the potential causes and means of prevention of optic nerve damage, with particular emphasis on intraoperative blood transfusion volume and operating time. This retrospective study evaluated patients who underwent Le Fort III osteotomy for syndromic craniosynostosis between 2000 and 2020. Data on pupillary reflex, pupil size, operating time, blood transfusion, age at time of surgery, sex, and syndrome type were obtained from medical records. Univariate analysis and multivariate analysis with the level of statistical significance set at P<0.05. For the 86 patients included, the mean values of operating time, amount of blood transfusion based on body weight, amount of blood transfusion per body weight per hour, and age were 6.0 hours (range: 3.5-12.3 h), 30.5 mL/kg (range: 0-322 mL/kg), 5.14 mL/kg/h (range: 0-35.7 mL/kg/h), and 10.0 years (range: 4-38 y), respectively. Crouzon, Apert, and Pfeiffer syndromes were observed in 49, 29, and 8 patients, respectively. Abnormal pupillary findings were observed in 27 patients of whom 25 showed no abnormalities in subsequent visual function and 2 developed blindness. Abnormal pupillary findings correlated with the amount of blood transfused per body weight (P=0.0082) and amount of blood transfused per body weight per hour (P=0.0052). As demonstrated in this study, increased intraoperative bleeding and amount of blood transfused were associated with optic nerve damage, particularly during acute bleeding. Prompt inspection of the pupils following surgery is therefore warranted.

PMID:35905386 | DOI:10.1097/SCS.0000000000008716

Hum Vaccin Immunother. 2022 Jul 29:2099166. doi: 10.1080/21645515.2022.2099166. Online ahead of print.

ABSTRACT

Vaccination for the novel coronavirus disease 2019 (COVID-19) provides an effective approach for the general improvement of social safety and individual health. To date, few studies have analyzed the adoption of COVID-19 vaccines from an entire impact process perspective. Using the health belief model (HBM) and the valence theory, this research evaluates the impact process of vaccine adoption for COVID-19. The respondents in this study were individuals who have been vaccinated in China. The effective sample included 595 individuals. Four valuable and novel findings are identified through this research. First, neither perceived susceptibility nor perceived severity has a statistically significant impact on the benefits from vaccination, threats from vaccination and self-efficacy. Second, benefits from vaccination produce a significant positive effect on self-efficacy and vaccine adoption. Third, threats from vaccination produce a significant negative effect on self-efficacy and vaccine adoption. Fourth, both self-efficacy and cues to adoption produce a significantly positive impact on vaccine adoption. Our theoretical model, which is the main contribution of this research, indicates that individual vaccine adoption is simply a process that leads from behavioral cognition to behavioral intention, rather than from psychological perception to behavioral cognition and then from behavioral cognition to behavioral intention.

PMID:35905384 | DOI:10.1080/21645515.2022.2099166

J Craniofac Surg. 2022 Jul 28. doi: 10.1097/SCS.0000000000008859. Online ahead of print.

ABSTRACT

Fronto-orbital advancement and remodelling (FOAR) has undergone many modifications over the years, aimed at improving outcomes and reducing risks for patients. This work describes 2 techniques for remodelling the neoforehead used by the Oxford Craniofacial Unit since 1995: lateral remodelling and a central S-Osteotomy. Both methods adopt bone from the vertex as a neoforehead, but they differ in their techniques to adapt its shape to that of the newly remodelled orbital bandeau. The novel S-Osteotomy technique can be successfully applied to all FOAR procedures, irrespective of underlying synostosis and calvarial symmetry. It was originally developed for when 2 separate bony panels were required to create a neoforehead in asymmetrical cases, but was adopted for single panel neoforehead designs in metopic synostosis with the idea it may reduce temporal hollowing. An investigation of temporal hollowing in these patients who underwent either of the described methods was undertaken to assess this hypothesis with no statistically significant difference seen (P=0.1111). Both techniques on average resulted in minimal hollowing that was not felt to require any revision, supporting the belief that temporal hollowing is a multifactorial issue. This work describes 2 successful methods of neoforehead remodelling and introduces the S-Osteotomy technique that can be applied in all FOAR procedures.

PMID:35905378 | DOI:10.1097/SCS.0000000000008859

Phys Rev Lett. 2022 Jul 15;129(3):034101. doi: 10.1103/PhysRevLett.129.034101.

ABSTRACT

The present work considers systems whose dynamics are governed by the nonlinear interactions among groups of 6 nonlinear waves, such as those described by the unforced quintic nonlinear Schrödinger equation. Specific parameter regimes in which ensemble-averaged dynamics of such systems with finite size are accurately described by a wave kinetic equation, as used in wave turbulence theory, are theoretically predicted. In addition, the underlying reasons that the wave kinetic equation may be a poor predictor of wave dynamics outside these regimes are also discussed. These theoretical predictions are directly verified by comparing ensemble averages of solutions to the dynamical equation with corresponding solutions of the wave kinetic equation.

PMID:35905369 | DOI:10.1103/PhysRevLett.129.034101

Phys Rev Lett. 2022 Jul 15;129(3):034502. doi: 10.1103/PhysRevLett.129.034502.

ABSTRACT

Processes leading to anomalous fluctuations in turbulent flows, referred to as intermittency, are still challenging. We consider cascade trajectories through scales as realizations of a stochastic Langevin process for which multiplicative noise is an intrinsic feature of the turbulent state. The trajectories are conditioned on their entropy exchange. Such selected trajectories concentrate around an optimal path, called instanton, which is the minimum of an effective action. The action is derived from the Langevin equation, estimated from measured data. In particular instantons with negative entropy pinpoint the trajectories responsible for the emergence of non-Gaussian statistics at small scales.

PMID:35905359 | DOI:10.1103/PhysRevLett.129.034502