Tag: pubmed

J Orthop Sports Phys Ther. 2022 Jul 8:1-42. doi: 10.2519/jospt.2022.11072. Online ahead of print.

ABSTRACT

OBJECTIVE: to 1) evaluate an injury risk model that included modifiable and non-modifiable factors into an arm injury risk prediction model in Minor League Baseball (MiLB) pitchers; and 2) compare model performance separately for predicting the incidence of elbow and shoulder injuries.

DESIGN: Prospective cohort.

METHODS: A 10-year MiLB injury risk study was conducted. Pitchers were evaluated during preseason and pitches and arm injuries were documented prospectively. Non-modifiable variables included: arm injury history, professional experience, arm dominance, year, humeral torsion. Modifiable variables included: BMI, pitch count, total range of motion, and horizontal adduction. We compared modifiable, non-modifiable, and combined model performance by R², calibration (Best = 1.00), and discrimination (Area Under the Curve (AUC); Higher number is better). Sensitivity analysis included only arm injuries sustained in the first 90 days.

RESULTS: 407 MiLB pitchers (141 arm injuries) were included. Arm injury incidence was 0.27 injuries per 1000 pitches. The arm injury model (Calibration 1.05 (0.81-1.30); AUC: 0.74 (0.69-0.80)) had improved performance compared to only using modifiable predictors (Calibration: 0.91 (0.68-1.14); AUC: 0.67 (0.62-0.73) and only shoulder ROM (Calibration: 0.52 (0.29, 0.75); AUC: 0.52 (0.46, 58)). Elbow injury model demonstrated improved performance (Calibration: 1.03 (0.76-1.33); AUC: 0.76 (0.69-0.83)) compared to the shoulder injury model (Calibration: 0.46 (0.22-0.69); AUC: 0.62 (95% CI: 0.55, 0.69)). The sensitivity analysis demonstrated improved model performance compared to the arm injury model.

CONCLUSIONS: Arm injury risk is influenced by modifiable and non-modifiable risk factors. The most accurate way to identify professional pitchers who are at risk for arm injury is to use a model that includes modifiable and non-modifiable risk factors.

PMID:35802817 | DOI:10.2519/jospt.2022.11072

Ann Noninvasive Electrocardiol. 2022 Jul 8:e12989. doi: 10.1111/anec.12989. Online ahead of print.

ABSTRACT

BACKGROUND: One of the most catastrophic complications of Atrial fibrillation (AF) is thromboembolic stroke. Current guidelines recommend that 3 weeks of anticoagulation is adequate prior to direct current cardioversion (DCCV) to prevent thromboembolism. Here we present data regarding, which anticoagulant is most likely to show a presence of an Left atrial appendage thrombus (LAAT) on trans esophageal echocardiogram (TEE) for DCCV despite 3 weeks of anticoagulation.

OBJECTIVE: To investigate the effectiveness of both vitamin k antagonist (VKA) and direct oral anticoagulants (DOAC) in patients with AF as an anticoagulant for LAAT after 3 weeks of medication.

METHODS: This is a single-high volume tertiary center, where TEE precardioversion is the standard practice. We reviewed data over 10 months where DCCV was intended on individuals with AF who were fully anticoagulated for at least 3 weeks with either a VKA or taking a DOAC.

RESULTS: The data showed a statistical difference between patients who were fully anticoagulated for at least 3 weeks with VKA in comparison to DOACs. Patients on DOACs are significantly less likely to have an LAAT after at least 3 weeks of anticoagulation. OR = 0.04 (CI 95% 0.005-0.42; p-value < .05). Despite anticoagulation for at least 3 weeks, 40% of our patients still had a LAAT.

CONCLUSION: Our data indicates that all patients should be required to undergo a TEE prior to DCCV. This data also adds to the current evidence and supports the use of DOAC in AF to prevent LAAT.

PMID:35802810 | DOI:10.1111/anec.12989

Scand J Gastroenterol. 2022 Jul 8:1-5. doi: 10.1080/00365521.2022.2094723. Online ahead of print.

ABSTRACT

OBJECTIVES: ERCP is essential in managing pancreaticobiliary disease, with well-documented complications. Rates of clinically significant complications are about 10%, approximately half of which is related to post-ERCP pancreatitis (PEP). We aimed to quantify the effect of previous sphincterotomy on post-endoiscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).

MATERIALS AND METHODS: Data were collated from a contemporaneously collected database of 2876 consecutive ERCP procedures of a single operator in a tertiary referral centre. Analysis was conducted using R software, and logistic regression models.

RESULTS: Of 2876 procedures (mean age 63 years, 56% female), 120 (4.2%) developed PEP and 268 (9.3%) had prolonged/unplanned hospital admission. Univariate analysis showed patients with previous sphincterotomy 28/1054 (2.7%) had decreased risk of PEP compared with those without sphincterotomy 92/1822 (5.0%) (OR 0.52, p = .0021). This difference was not evident when multivariate analysis for age, sex and indication was undertaken due to a particularly low risk of PEP in stent change patients (1.4%), which were disproportionately represented in the previous sphincterotomy group. The rate of prolonged/unplanned hospital admission was recorded for a total of 2876 patients, occurring in 184/1802 (10.1%) in the native ampulla group, versus 84/1045 (8.0%) in the previous sphincterotomy group.

CONCLUSIONS: The risk of PEP is halved by prior sphincterotomy. The presence of a biliary stent conferred an even lower risk of PEP (1.4%), but those without an in situ stent at the time of ERCP had a similar risk of PEP (4.6%) of prolonged/unplanned hospitalisation to those with a native ampulla.

PMID:35802803 | DOI:10.1080/00365521.2022.2094723

Qual Manag Health Care. 2022 Jul 8. doi: 10.1097/QMH.0000000000000368. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patient misidentification errors continue to represent a significant risk to patients, health care staff, and hospitals. The study’s purpose was to present a successful quality improvement project implemented in a public hospital in Saudi Arabia. The project focused on increasing staff’s compliance with and awareness of the hospital’s patient identification policy to thus reducing the number of patient misidentification-related incidents.

METHODS: Through a quality improvement project, we employed FOCUS PDSA to address the issue of patient misidentification at outpatient departments. A total of 640 staff members participated in the educational program including physicians, nurses, receptionists, radiologists, physiotherapists, and laboratory staff. Collected data included measures of compliance and awareness levels as well as patient misidentification incidents, before and after the project. Statistical analysis was conducted to measure significant differences in the study indicators before and after the project.

RESULTS: Results from the post-project assessment revealed that the project was successful in achieving its objectives. The overall compliance rate and awareness level increased from 59% to 78% and from 75% to 90%, respectively. Improvement in the levels of compliance and awareness was statistically significant. The average number of patient misidentification errors also reduced after the project’s implementation with an average of 3 errors per month. The mean difference of patient misidentification errors before and after the project was significant (P < .01).

CONCLUSION: This project demonstrated how quality improvement projects can be used to address a critical issue such as patient misidentification. The project furthers efforts made by national and international agencies to improve patient safety. It also highlights the importance of continuous education and training to ensure compliance with patient identification policies that ultimately contributes to a safer hospital environment.

PMID:35802801 | DOI:10.1097/QMH.0000000000000368

Int J Phytoremediation. 2022 Jul 8:1-19. doi: 10.1080/15226514.2022.2090500. Online ahead of print.

ABSTRACT

Artificial Intelligence (AI) is expected to play a crucial role in the field of phytoremediation and its effective management in monitoring the growth of the plant in different contaminated soils and their phenotype characteristic such as the biomass of plants. This review focuses on recent applications of various AI techniques and remote sensing approaches in the field of phytoremediation to monitor plant growth with relevant morphological parameters using novel sensors, cameras, and associated modern technologies. Novel sensing and various measurement techniques are highlighted. Input parameters are used to develop futuristic models utilizing AI and statistical approaches. Additionally, a brief discussion has been presented on the use of AI techniques to detect metal hyperaccumulation in all parts of the plant, carbon capture, and sequestration along with its effect on food production to ensure food safety and security. This article highlights the application, limitation, and future perspectives of phytoremediation in monitoring the mobility, bioavailability, seasonal variation, effect of temperature on plant growth, and plant response to the heavy metals in soil by using the AI technique. Suggestions are made for future research in this area to analyze which would help to enhance plant growth and improve food security in long run.

PMID:35802802 | DOI:10.1080/15226514.2022.2090500

Immunol Med. 2022 Jul 8:1-6. doi: 10.1080/25785826.2022.2094592. Online ahead of print.

ABSTRACT

We examined whether serum B cell activating factor (BAFF) is useful for predicting the remission of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) following rituximab treatment. We used the Birmingham Vasculitis Activity Score (BVAS) 2008 version 3 for the evaluation of 27 patients with AAV 6 months after rituximab treatment. Those with BVAS = 0 achieved remission, whereas those with BVAS score > 0 did not achieve remission. We considered changes in serum BAFF before rituximab treatment, 1 month after treatment, and 6 months after treatment. In the remission group, the serum BAFF increased consistently. In the non-achieved group, serum BAFF was within the normal range. In addition, there was no statistically significant difference between the two groups in terms of serum BAFF before and 1 month after rituximab treatment. However, the serum BAFF level at 6 months after rituximab treatment was significantly higher in the remission group than in the non-achieved group. If serum BAFF does not increase after 6 months of rituximab in AAV, it may be assumed that there are residual B cells and plasma cells in the tissues. Enhanced treatment targeting B cells, including re-administration of rituximab or the addition of other immunosuppressive drugs, should be considered.

PMID:35802795 | DOI:10.1080/25785826.2022.2094592

Birth. 2022 Jul 8. doi: 10.1111/birt.12664. Online ahead of print.

ABSTRACT

BACKGROUND: There is a growing body of literature documenting negative mental health impacts from the COVID-19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well-being among pregnant and postpartum women during the pandemic.

METHODS: This was a cross-sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States. Survey questions explored perinatal and postpartum experiences related to the pandemic, including social support, coping, and health care needs and access. Latent class analysis was performed to identify classes among 13 distinct health, social, and behavioral variables. Outcomes of depression, anxiety, and stress were examined using propensity-weighted regression modeling.

RESULTS: Fit indices demonstrated a three-class solution as the best fitting model. Respondents (N = 616) from both regions comprised three classes, which significantly differed on sleep- and exercise-related health, social behaviors, and mental health: Higher Psychological Distress (31.8%), Moderate Psychological Distress (49.8%), and Lower Psychological Distress (18.4%). The largest discriminatory issue was support from one’s social network. Significant differences in depression, anxiety, and stress severity scores were observed across these three classes. Reported need for mental health services was greater than reported access.

CONCLUSIONS: Mental health outcomes were largely predicted by the lack or presence of social support, which can inform public health decisions and measures to buffer the psychological impact of ongoing waves of the COVID-19 pandemic on pregnant and postpartum women. Targeted early intervention among those in higher distress categories may help improve maternal and child health.

PMID:35802785 | DOI:10.1111/birt.12664

J Food Biochem. 2022 Jul 8:e14314. doi: 10.1111/jfbc.14314. Online ahead of print.

ABSTRACT

In this original article, we aimed to assess the ameliorative role of Cyanus depressus (CD) plant ethanolic extract treatment of streptozotocin (STZ)-induced liver, kidney, and pancreas damage in rats. The rats were divided into five groups (n = 7): control, CD, Diabetes mellitus (DM), DM + CD, and DM + glibenclamide (Gly). The DM groups were injected with a single dose of 50 mg/kg STZ intraperitoneally (i.p.). While the CD and DM + CD groups received 400 mg/kg/day intragastrically for 21 days, the DM + Gly group received 3 mg/kg/day of Gly intragastrically throughout the experiment. Statistically significance was accepted as p < .05. According to our liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) data, quinic acid, cosmosiin, nicotiflorin, apigenin, and protocatechuic acid were the major compounds, in descending order. Weekly blood glucose, serum glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and urea, malondialdehyde (MDA) (liver and pancreas), and blood glycosylated hemoglobin % (HbA1c %) were significantly decreased, whereas finally live body weights (LBWs), reduced glutathione (GSH), glutathione S-transferase (GST) and catalase (CAT) (pancreas), and pancreatic islet diameter and area were increased significantly in the CD-treated diabetic group. Moreover, CD administration was found to be effective in the protection of the histology of the liver, kidneys, and pancreatic islets in the STZ-induced rats. Consequently, we concluded that CD administration reduces hyperglycemia, oxidative stress, and histopathology in STZ-induced experimental rats by improving antioxidant defenses. PRACTICAL APPLICATIONS: Today, the prevalence of diabetes is increasing rapidly throughout the world and it causes complications such as kidney damage, blindness, amputations, and cardiovascular diseases. Despite medical technological advances, people’s interest in medicinal herbal products is gradually increasing. Biochemical and histopathological findings showed that the use of the plant CD at the determined dose (400 mg/kg/day) in rats with DM by STZ had strong antioxidant and antidiabetic effects. CD may have a drug potential in preventing DM and its complications because of its phytochemical content including some phenolic acids such as quinic acid, cosmosiin, nicotiflorin, apigenin, and protocatechuic acid. Isolation of bioactive compounds from CD and investigation of their therapeutic effects could be planned as further studies.

PMID:35802765 | DOI:10.1111/jfbc.14314

PLoS One. 2022 Jul 8;17(7):e0271282. doi: 10.1371/journal.pone.0271282. eCollection 2022.

ABSTRACT

INTRODUCTION: In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care (CEmONC) services is the major bottleneck for perinatal care and results in high maternal and perinatal mortality. From 2015 to 2019, the Accessing Safe Deliveries in Tanzania project was implemented to study how to improve access to CEmONC services in underserved rural areas.

METHODS: A five-year longitudinal cohort study was implemented in seven health centres (HCs) and 21 satellite dispensaries in Morogoro region. Five of the health centres received CEmONC interventions and two served as controls. Forty-two associate clinicians from the intervention HCs were trained in teams for three months in CEmONC and anaesthesia. Managers of 20 intervention facilities, members of the district and regional health management teams were trained in leadership and management. Regular supportive supervision was conducted.

RESULTS: Interventions resulted in improved responsibility and accountability among managers. In intervention HCs, the mean monthly deliveries increased from 183 (95% CI 174-191) at baseline (July 2014 -June 2016) to 358 (95% CI 328-390) during the intervention period (July 2016 -June 2019). The referral rate to district hospitals in intervention HCs decreased from 6.0% (262/4,392) with 95% CI 5.3-6.7 at baseline to 4.0% (516/12,918) with 95% CI 3.7-4.3 during the intervention period while it increased in the control group from 0.8% (48/5,709) to 1.5% (168/11,233). The obstetric case fatality rate decreased slightly from 1.5% (95% CI 0.6-3.1) at baseline to 1.1% (95% CI 0.7-1.6) during the intervention period (not statistically significant). Active engagement strategies and training in leadership and management resulted in uptake and improvement of CEmONC and anaesthesia curricula, and contributed to scale up of CEmONC at health centre level in the country.

CONCLUSIONS: Integration of leadership and managerial capacity building, with CEmONC-specific interventions was associated with health systems strengthening and improved quality of services.

PMID:35802730 | DOI:10.1371/journal.pone.0271282

PLoS One. 2022 Jul 8;17(7):e0271185. doi: 10.1371/journal.pone.0271185. eCollection 2022.

ABSTRACT

In the case of comparing means of various groups, data exploration and comparison for affecting factors or relative indices would be involved. This process is not only complex requiring extensive statistical knowledge and methods, but also challenging for the complex installation of existing tools for users who lack of statistical knowledge and coding experience. Like, the normal distribution and equal variance are crucial premises of parametric statistical analysis. But some studies reported that associated data from various industries violated the normal distribution and equal variance, parametric analysis still involved leading to invalid results. This is owing to that the normal distribution tests and homogeneity of variance test for different variables are time-cost and error-prone, posing an urgent need for an automatic and user-friendly analysis application, not only integrating normal distribution tests and homogeneity of variance test, but also associated the following statistical analysis. To address this, we developed a Shiny/R application, moreThanANOVA, which is an interactive, user-friendly, open-source and cloud-based visualization application to achieve automatic distribution tests, and correlative significance tests, then customize post-hoc analysis based on the considerations to the trade-off of Type I and Type II errors (deployed at https://hanchen.shinyapps.io/moreThanANOVA/). moreThanANOVA enables novice users to perform their complex statistical analyses quickly and credibly with interactive visualization and download publication-ready graphs for further analysis.

PMID:35802729 | DOI:10.1371/journal.pone.0271185