Tag: pubmed

J Int AIDS Soc. 2022 Jul;25 Suppl 1:e25931. doi: 10.1002/jia2.25931.

ABSTRACT

INTRODUCTION: To investigate the association between individual and community-level measures of HIV stigma and HIV incidence within the 21 communities participating in the HPTN (071) PopART trial in Zambia and South Africa.

METHODS: Secondary analysis of data from a population-based cohort followed-up over 36 months between 2013 and 2018. The outcome was rate of incident HIV infection among individuals who were HIV negative at cohort entry. Individual-level exposures, measured in a random sample of all participants, were: (1) perception of stigma in the community, (2) perception of stigma in health settings and (3) fear and judgement towards people living with HIV. Individual-level analyses were conducted with adjusted, individual-level Poisson regression. Community-level HIV stigma exposures drew on data reported by people living with HIV, health workers and community members. We used linear regression to explore the association between HIV stigma and community-level HIV incidence.

RESULTS: Among 8172 individuals who were HIV negative and answered individual-level stigma questions at enrolment to the cohort, there was no evidence of a statistically significant association between any domain of HIV stigma and risk of incident HIV infection. Among the full cohort of 26,110 individuals among whom HIV incidence was measured, there was no evidence that community-level HIV incidence was associated with any domain of HIV stigma.

CONCLUSIONS: HIV stigma is often cited as a barrier to the effectiveness of HIV prevention programming. However, in the setting for the HPTN 071 “PopART trial,” measured stigma alone was not associated with the risk of HIV infection.

PMID:35818869 | DOI:10.1002/jia2.25931

Aging Ment Health. 2022 Jul 12:1-9. doi: 10.1080/13607863.2022.2098923. Online ahead of print.

ABSTRACT

OBJECTIVES: I sought to identify racial disparities in visitation and health between Non-White and White older adults incarcerated in prison and to examine the contribution of visitation to health among this vulnerable population.

METHODS: Descriptive and bivariate statistics were calculated to describe the cross-sectional sample and relationships between visitation and health. Independent t-tests, Chi-square tests, and effect sizes were used to identify racial disparities in measures of and relationships between visitation and health. Hierarchical multiple linear regression was used to examine the contribution of visitation to physical functioning, chronic disease, and mental health.

RESULTS: Older adults rated their physical functioning higher than their mental health. Over 70% of older adults received zero visits during their current incarceration (∼13 years) and White older adults received 10 times the number of visits than Non-White older adults. Increased visitation related to decreased physical functioning among Non-White older adults, a relationship distinct from that of White older adults (z=-3.14, p<.001) and visitation contributed to variation in older adults’ mental health.

CONCLUSION: Future scholars are encouraged to examine factors associated with visitation and the quality of such visits for older adults. Further, visitation policies warrant amendment to increase visits and to enhance social support for older adults.

PMID:35818818 | DOI:10.1080/13607863.2022.2098923

Hosp Pediatr. 2022 Jul 12:e2021006459. doi: 10.1542/hpeds.2021-006459. Online ahead of print.

ABSTRACT

BACKGROUND: Clinician documentation is highly variable, and awareness of documentation requirements remains low despite post-training experience. At our hospital, critical care (CC) documentation was inconsistent. Our aim was to increase appropriate CC attestations from 51% to 90% for status asthmaticus, anaphylaxis, and diabetic ketoacidosis in the pediatric emergency department by December 2021.

METHODS: A physician team developed a key driver diagram. Retrospective baseline data using International Classification of Diseases, Ninth and Tenth Revision codes were obtained from January 2018 to September 2020, after which data were followed prospectively in consecutive groups of 20 encounters. Statistical process control charts were used to analyze data. Nelson rules were used to detect special cause variation. Primary outcome was the inclusion of appropriate CC attestations. Interventions included education, CC attestation templates, and provider feedback. We also tracked charges for the 3 diagnoses studied. Process measures included template use. Balancing measure was refusal of payment by insurers.

RESULTS: P-charts were used to analyze primary outcome and process measures. X-bar charts were used to analyze charges. Baseline data represented 706 encounters with 51% including CC documentation. Following clinician education and release of the CC template, special cause variation was detected, and centerline shifted to 88.1% (Fig 2). Average charges per encounter increased from $4527 to $5385. There was no reported refusal of payment.

CONCLUSIONS: We successfully achieved improvements in CC documentation in the 3 diagnoses of interest through education and process changes in documentation, leading over $1 million in new charges over the past 15 months.

PMID:35818843 | DOI:10.1542/hpeds.2021-006459

Folia Morphol (Warsz). 2022 Jul 12. doi: 10.5603/FM.a2022.0066. Online ahead of print.

ABSTRACT

The foramen magnum is the largest opening at the base of the skull. The dimensions of the foramen magnum are of significant clinical importance because of the vital structures that pass through it. The aim of the study was the morphometric analysis of the foramen magnum in children based on head computed tomography. The study was carried out on 84 CTs of the head of children aged 0-18 years; seven age groups were distinguished. The sagittal and transverse dimensions were measured to determine the growth rate, changes between groups, and differences in the foramen size by sex. Statistical analysis of changes was performed. The entire group’s mean transverse and sagittal dimensions were 29.08 mm (SD 3.4 mm) and 35.63 mm (SD 4.23 mm). By sex, the mean transverse dimension in girls was 28.53 mm (SD 3.25 mm), and in boys, 29.6 mm (SD 3.49 mm). The mean sagittal dimension was 35.15 mm (SD 3.76 mm) in girls and 36.09 mm (SD 4.64 mm) in boys. Both dimensions were higher for the male sex. A statistically significant increase in the foramen magnum size was demonstrated up to the age of 36 months in the following age groups; above that age, the increase was statistically insignificant. The dimensions were similar to those described in adults a moderate dependence of the foramen magnum size on age was found.

PMID:35818806 | DOI:10.5603/FM.a2022.0066

Folia Morphol (Warsz). 2022 Jul 12. doi: 10.5603/FM.a2022.0067. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the anatomical characteristics and symmetry of the bilateral glenoid structures of Chinese people and to explore the relationship between the glenoid bone structure and recurrent anterior dislocation.

MATERIALS AND METHODS: The control group included 131 individuals with no history of shoulder dislocation. The dislocation group consisted of 131 patients with a history of unilateral shoulder dislocation. All subjects underwent CT scans. Glenoid shape (pear-shaped, inverted comma-shaped, oval-shaped), width, height, depth, version angle, area, maximum fitting circle area and volume were measured.

RESULTS: There was no significant difference in normal bilateral glenoid of Chinese people (P > 0.05). There were statistically significant differences in depth, height to width ratio, maximum fitting circle area and shape between the dislocation and control groups (P < 0.05). Regression analyses showed that the glenoid depth (odds ratio 0.48; P < 0.01), the glenoid height to width ratio (odds ratio 28.61; P < 0.01), the glenoid maximum fitting circle area (odds ratio 1.01; P < 0.01) and the glenoid shape (P < 0.05; pear-shaped odds ratio 0.432; inverted comma-shaped odds ratio 0.954) were associated with anterior shoulder instability. Pear-shaped and inverted comma-shaped glenoid had lower risk of recurrent anterior shoulder dislocation compared to oval glenoid. ROC curve analysis showed that individuals with anterior shoulder instability had smaller glenoid depth and larger height to width ratio and the glenoid maximum fitting circle area compared with the control group.

CONCLUSIONS: The normal bilateral glenoids of Chinese people are basically symmetrical. The glenoid shape, depth, height to width ratio and maximum fitting circle area are risk factors for recurrent anterior shoulder dislocation. Evaluation of the glenoid bone structure enables more accurate prediction of the risk of recurrent shoulder dislocation.

PMID:35818805 | DOI:10.5603/FM.a2022.0067

Clin Transplant. 2022 Jul 12:e14771. doi: 10.1111/ctr.14771. Online ahead of print.

ABSTRACT

INTRODUCTION: The presence of median arcuate ligament (MAL) during orthotopic liver transplantation (OLT) may cause a significant reduction of the arterial hepatic flow. The aim of the present study is to investigate the impact of MAL on biliary complications in patients who underwent OLT.

METHODS: We performed a retrospective case-control study among patients who underwent OLT in Geneva University Hospital between 2007 and 2017, depending on the presence or absence of MAL. The matching was performed according to age, gender, lab-MELD score at time of OLT and type of donor (living or dead). The presence of MAL was assessed by an expert liver radiologist on the preoperative CT angiographic evaluation.

RESULTS: The incidence of MAL was 6.1% (19 patients). Baseline characteristics were comparable between the two groups. No significant difference in biliary complications was found between patients with and without MAL (37% and 24% respectively). No patient presented hepatic artery thrombosis. After logistic regression, in patients with MAL, the MAL release and gastroduodenal artery preservation compared to no treatment, showed an odds ratio for post-OLT biliary complications of 1.5 and 1.25 respectively. There was no difference in overall graft survival and in hazard for biliary complications between patients with and without MAL.

CONCLUSION: In the present study, we did not find any difference in the prevalence of biliary and arterial complications between patients with and without MAL. The choice of MAL treatment did not influence in a significant way the overall outcome and development of complications. However, if, at the end of arterial reconstruction, the arterial flow is not adequately established, MAL needs to be treated with the least invasive technique. This article is protected by copyright. All rights reserved.

PMID:35818793 | DOI:10.1111/ctr.14771

Clin Oral Implants Res. 2022 Jul 12. doi: 10.1111/clr.13973. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the marginal and bacterial microleakage in zirconia and CAD-CAM or cast Co-Cr implant abutments.

METHODS: Sixty-four conical connection implants with their respective abutments were divided into four groups (Co-Cr (milled, laser-sintered and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured by using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs).

RESULTS: Thirty (47%) implant-abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co-Cr milled, 14 Co-Cr laser-sintered and 14 cast). Seven specimens (1 Co-Cr laser-sintered and 6 cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co-Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/mL). The Co-Cr cast (9.39E+03 CFUs/ml) and laser-sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co-Cr cast and laser-sintered resulted in a statistically significant differences in favor of Co-CrCL (p < 0.05).

CONCLUSIONS: The abutment material and fabrication technique affected the implant-abutment microleakage. Although the CAD-CAM abutments presented favorable results, all tested groups presented microleakage.

PMID:35818785 | DOI:10.1111/clr.13973

Stat Methods Med Res. 2022 Jul 12:9622802221111546. doi: 10.1177/09622802221111546. Online ahead of print.

ABSTRACT

Recently, various methods have been developed to estimate the sample mean and standard deviation when only the sample size, and other selected sample summaries are reported. In this paper, we provide a unified approach to optimal estimation that can be easily adopted when only some summary statistics are reported. We show that the proposed estimators have the lowest variance among linear unbiased estimators. We also show that in the most commonly reported cases, that is, when only a three-number or five-number summary is reported, the newly proposed estimators match the previously developed estimators. Finally, we demonstrate the performance of the estimators numerically.

PMID:35818759 | DOI:10.1177/09622802221111546

Stat Methods Med Res. 2022 Jul 12:9622802221111559. doi: 10.1177/09622802221111559. Online ahead of print.

ABSTRACT

Interval-censored failure time and panel count data, which frequently arise in medical studies and social sciences, are two types of important incomplete data. Although methods for their joint analysis have been available in the literature, they did not consider the observation process, which may depend on the failure time and/or panel count of interest. This study considers a three-component joint model to analyze interval-censored failure time, panel counts, and the observation process within a unique framework. Gamma and distribution-free frailties are introduced to jointly model the interdependency among the interval-censored data, panel count data, and the observation process. We propose a sieve maximum likelihood approach coupled with Bernstein polynomial approximation to estimate the unknown parameters and baseline hazard function. The asymptotic properties of the resulting estimators are established. An extensive simulation study suggests that the proposed procedure works well for practical situations. An application of the method to a real-life dataset collected from a cardiac allograft vasculopathy study is presented.

PMID:35818765 | DOI:10.1177/09622802221111559

Clin Linguist Phon. 2022 Jul 12:1-16. doi: 10.1080/02699206.2022.2096483. Online ahead of print.

ABSTRACT

Adductor spasmodic dysphonia (ADSD) is a neurological dystonia characterised by involuntary adductor spasms of the larynx during speech. Spasm frequency is often reported to increase during syllables that begin with voiced speech sounds, especially glottal stops. Because of its underlying physical and acoustic complexities, the voicing contrast in American English (AE) appears unlikely to interact consistently with a singular physical phenomenon like laryngeal spasm. This retrospective study investigated additional phonetic contrasts and their relationship to spasm frequency. Standardised, 144-word recordings of 36 participants with adductor spasmodic dysphonia were analysed. Productions were coded for rater-perceived syllable stress, voiced/voiceless onset, vowel/consonant onset, and word-onset place and manner of production. Phonetic contexts were compared using independent sample t-tests and Kruskal-Wallis statistics. Contexts in which spasm varied significantly included stressed/unstressed syllables, content/function words, and multisyllabic/monosyllabic words. Study results reaffirm the clinical usefulness of standardised ADSD/ABSD sentences during differential diagnosis but conflict with previous studies that report a connection between ADSD spasm and phoneme voicing.

PMID:35818753 | DOI:10.1080/02699206.2022.2096483