Tag: pubmed

Anesth Analg. 2022 Feb 24. doi: 10.1213/ANE.0000000000005915. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative negative behavioral changes (NBCs) are common among children, but risk for this is thought to be reduced with premedication. Midazolam has for many years been a standard premedication for children. More recently, the alpha-2 adrenergic agonist clonidine has also become popular as a preanesthetic sedative. We hypothesized that clonidine was superior to midazolam for limiting new NBCs in children as assessed using the Post Hospital Behavior Questionnaire (PHBQ).

METHODS: This was a prospective, randomized, controlled, blinded study, including 115 participants aged 24 to 95 months and their parents. The participants underwent ear, nose, or throat outpatient surgery and were randomly allocated to premedication with oral midazolam 0.5 mg/kg or oral clonidine 4 µg/kg. Participants were anesthetized by protocol. At home, later, parents were asked to complete the PHBQ assessment instrument for postoperative NBCs for the participants 1 week, 1 month, and 6 months after the surgery. A secondary outcome, preinduction anxiety, was assessed using modified Yale Preoperative Anxiety Scale (mYPAS).

RESULTS: The primary outcome, more than 3 NBCs in an individual case at 1 week, showed no difference in proportions between treatment in the clonidine group compared to the midazolam group, (12/59 or 20% vs 7/56 or 13%, respectively, odds ratio 1.39, 95% confidence interval [CI], 0.75-2.58; P = .32). A secondary result showed a higher preinduction anxiety level in the clonidine compared to the midazolam group (mYPAS >30, 43/59 or 71% vs 12/56 or 21%, respectively; P < .001).

CONCLUSIONS: These results did not show a clinical or statistically significant difference, with respect to the primary outcome of behavior changes at 1 week, between the cohorts that received midazolam versus clonidine as a premedication.

PMID:35203087 | DOI:10.1213/ANE.0000000000005915

Obes Facts. 2022 Feb 24. doi: 10.1159/000522651. Online ahead of print.

ABSTRACT

INTRODUCTION: Obesity is a global problem incurring substantial health and economic implications. This has been highlighted by the ongoing COVID-19 pandemic which disproportionately affected obese individuals. Most interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. This study explored the relationship between bodyweight and how individuals state they would trade off immediate income for higher amounts in the future (time-preference) Methods: An online survey was conducted targeting adults aged > 16 years in UK from 1/01/2016 to 31/07/2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height and weight and to complete a time-preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents’ characteristics and time preference using Spearman rank-order correlation and Chi-square tests as appropriate. We adopted STROBE guidelines for the reporting of the study.

RESULTS: A total of 561 responses were analysed (female = 293, males = 268). The relationship between time-preference and overweight/obese, using BMI as the measure, is highly significant (Chi-Square = 95.92: P < 0001). Individuals of normal weight have low time preference and more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (Chi-Square = 37.03; P < 0.001), physical activities (P < 0.0001), income levels (Chi-Square = 6.68; P < 0.035), family orientation i.e. with or without children (Chi-Square = 12.88; P < 0.012) and ethnicity (Chi-Square = 18.31; P < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time-preference compared to people from white backgrounds.

DISCUSSIONS/CONCLUSIONS: People’s preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population’s uptake and maintenance of overweight and obesity prevention actions. People who have low time-preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation.

PMID:35203081 | DOI:10.1159/000522651

Folia Phoniatr Logop. 2022 Feb 24. doi: 10.1159/000523686. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this investigation was to assess clinician and patient feedback about voice therapy using a variably occluded face mask (VOFM), and to determine if voice therapy augmented via a VOFM would result in favorable changes in patient self-perceived handicap, as well as acoustic and aerodynamic measures.

METHODS/DESIGN: Pilot, prospective, pre-post single group design. Eleven patients with dysphonia due to primary muscle tension dysphonia (8) or benign vocal fold lesions (3) were recruited. Data collected included patient and clinician feedback of voice therapy using a VOFM, voice handicap index (VHI)-10, acoustic and aerodynamic measures. Data were collected before treatment (baseline) and one-week post therapy. Wilcoxon signed-rank tests were used to compare data pre and post therapy.

RESULTS: Statistically significant improvement was observed for the VHI-10 with a median delta of -7. Clinician feedback generally reported that patients like the VOFM, using the VOFM within the first two sessions of therapy, and within less than 10 minutes of use. All clinicians ranked the conversation level of the hierarchy as the most effective level. Three themes emerged from the Therapy Feedback Form: the SOFM was a 1) “Facilitator for Sensation,” 2) a “Physical Tool”; and that there was 3) “No Program Needed” to use the VOFM in voice therapy. There was a statistically significant improvement in CPP (p=0.0329) and CSID (p=0.0164) in sustained vowels.

DISCUSSION: This pilot study represents the first investigation into clinician and patient perceptions of using a variably occluded face mask (VOFM). Reported measures via patient perception, as well as clinician perceptions, and some acoustic and aerodynamic measures showed that participants got better with VOFM voice therapy. Last, in general, both clinicians and patients liked utilizing a VOFM in voice therapy.

PMID:35203078 | DOI:10.1159/000523686

Epilepsy Behav. 2022 Jan 24;129:108581. doi: 10.1016/j.yebeh.2022.108581. Online ahead of print.

ABSTRACT

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients’ satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients.

METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated.

RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation.

CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child’s behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.

PMID:35203013 | DOI:10.1016/j.yebeh.2022.108581

J Chromatogr B Analyt Technol Biomed Life Sci. 2022 Feb 18;1193:123181. doi: 10.1016/j.jchromb.2022.123181. Online ahead of print.

ABSTRACT

A multiway resolution of incomplete chromatographic separation was presented for spectrochromatographic quantification of echinuline in marine-derived fungi Aspergillus chevalieri. Two-dimensional spectrochromatographic maps of calibration, validation and real samples were recorded as a function of time and wavelength using UPLC-PDA instrument under non-optimized chromatographic conditions, which gave rise to co-elution of echinuline and the constituents of sample matrix. A three-way array was obtained by concatenating the data matrices of the spectrochromatographic maps. Then, parallel factor analysis was applied to the multiway array to extract the individual contribution of echinuline in three modes (time, wavelength and sample). While time and wavelength profiles were used for the characterization of echinuline, the sample profile was used for its quantitative determination of the analyte in validation set and in real samples. Validity of the analytical method was evaluated by analyzing the validation set, which consist of test samples, standard addition samples, intra-day and inter-day samples. The proposed multiway analysis method was then applied to marine-derived fungi extracts and echinuline content was found to be 31.9 µg/g based on the average of ten assay results. The assay results provided by PARAFAC model were statistically compared with those obtained by a newly developed classical UPLC method, which ensured the complete separation of echinuline in a run time of nine minutes. The assay results were found to be comparable due to the fact that there was no significant difference between the analysis results (F = 1.63, F_crit = 3.17; t = 0.69, t_crit = 2.11) at the significance level of 95%). Consequently, the PARAFAC method permitted the accurate determination of echinuline in fungal extracts despite the partial chromatographic separation with a run time of only three minutes.

PMID:35203040 | DOI:10.1016/j.jchromb.2022.123181

Respir Med. 2022 Feb 15;194:106773. doi: 10.1016/j.rmed.2022.106773. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the association between time to active sitting position and clinical features in people with COVID-19 admitted to intensive care unit (ICU) and referred to physiotherapists.

METHOD: Prospective study conducted in the largest temporary ICU in Lombardy (Italy) between April 2020 and June 2021. All individuals with COVID-19 who received physiotherapy were included. Multivariable Cox proportional hazard model was fitted to explore the statistical association between active sitting position and characteristics of patients referred to physiotherapists, also accounting for the different multidisciplinary teams responsible for patients.

RESULTS: 284 individuals over 478 (59.4%) had access to physiotherapy, which was performed for a median of 8 days, without difference between multidisciplinary teams (P = 0.446). The active sitting position was reached after a median of 18 (IQR: 10.0-32.0) days. Sex was the only characteristic associated with the time to active sitting position, with males showing a reduced hazard by a factor of 0.65 (95% CI: 0.48-0.87; P = 0.0042) compared to females. At ICU discharge, nearly 50% individuals increased Manchester Mobility Score by 3 points. During physiotherapy no major adverse event was recorded.

CONCLUSION: Individuals with COVID-19 take long time to reach active sitting position in ICU, with males requiring longer rehabilitation than females.

PMID:35203010 | DOI:10.1016/j.rmed.2022.106773

Nurse Educ Today. 2022 Feb 18;111:105301. doi: 10.1016/j.nedt.2022.105301. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES: To explore undergraduate nursing students’ self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN: A mixed-methods design was adopted.

SETTING: A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS: 155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS: Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students’ learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS: A significant improvement was demonstrated in the students’ attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS: The online self-regulated EBL improved the students’ online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

PMID:35202963 | DOI:10.1016/j.nedt.2022.105301

Res Vet Sci. 2022 Feb 7;145:159-168. doi: 10.1016/j.rvsc.2022.02.002. Online ahead of print.

ABSTRACT

The aim with this study was to use interdisciplinary techniques and visions in order to identify the modulating effect of tannins on adaptive factors in lactating goats with different genetic patterns, through the assessment of digestibility and nutrient intake, ingestive behavior and rumen metagenome. We used in this study 8 of the Repartida ecotype and 6 of the Canindé breed goats, on average five years old, distributed in a completely randomized design, in a 2 × 2 factorial design, with two genetic groups and two diets. The applied diets were: basal diet and inclusion of 5% commercial tannin extract in basal diet. Intake and apparent digestibility of nutrients were evaluated, based on the quantification of the offered feed and refusals, and bromatological evaluation of samples of the offered feed, refusals and feces. Behavioral data were collected in 24-h continuous visual observations. The ruminal fluid was collected and DNA extraction, sequencing, and evaluation of relative abundance of the rumen microbiome were performed. The data obtained were analyzed statistically, through analysis of variance with 5% significance and, when necessary, a comparison of means test was applied. In this preliminary findings was observed that the genetic group factor caused changes in the number of chews and the relative abundance of microorganisms (P = 0.0290 and P = 0.0051). The diet factor influenced digestibility, which better values were observed for the tannin diet (P = 0.0049), in addition, it promoted changes in the rumen microbiota, with a beneficial modulatory characteristic. The inclusion of 5% tannin extract from Acacia mearnsii modulates the rumen microbiome, improving the apparent digestibility of nutrients without affecting the feed intake of goats from the Repartida and Canindé genetic groups.

PMID:35202972 | DOI:10.1016/j.rvsc.2022.02.002

Appl Ergon. 2022 Feb 21;101:103717. doi: 10.1016/j.apergo.2022.103717. Online ahead of print.

ABSTRACT

The aim of this study was to examine the impact of backpack load carriage on lower limb strength and loading rate change in a cohort that match military recruit profiles. Twenty-six participants walked on a treadmill either carrying a military load carriage system (32 kg) or unloaded for 2 h on two consecutive days. Participants ground reaction forces and strength measures were assessed using a force platform and dynamometry, respectively. Testing included assessments before and after treadmill walking on days one and two, and 24 h following day 2. When assessed by mixed methods ANOVA (alpha: 0.05) statistically significant interaction effects were observed for loading peak (p = 0.031), loading rate (p = 0.035) and plantarflexor torque dynamometry variables at 60°s^-1 (p = 0.011) and 120°s^-1 (p = 0.024). Repeated measures correlation highlighted associations between plantarflexor torque at 60°s^-1 and loading rate (r = -0.901, p < 0.001). Load carriage reduced lower limb torque which did not recover between days. Plantarflexor torque reductions were associated with increases in loading rate. Practitioners should consider that load bearers are more likely to experience lower limb injury during multi-day load carriage. Future work should develop protocols to reduce plantarflexor torque loss in order to reduce ground reaction force change.

PMID:35202961 | DOI:10.1016/j.apergo.2022.103717

Seizure. 2022 Feb 11;96:121-127. doi: 10.1016/j.seizure.2022.02.004. Online ahead of print.

ABSTRACT

PURPOSE: Between 16-77% of patients with newly diagnosed epilepsy report seizures before diagnosis but little is known about the risk factors for diagnostic delay. Here, we examined the association between prior seizures and neuroimaging findings in newly diagnosed focal epilepsy.

METHODS: Adults diagnosed with focal epilepsy at First Seizure Clinics (FSC) at the Royal Melbourne Hospital or Austin Health, Melbourne, Australia, between 2000 and 2010 were included. Medical records were audited for seizure history accrued from the detailed FSC interview. Potentially epileptogenic brain abnormality type, location and extent was determined from neuroimaging. Statistical analysis comprised multivariate logistic regression.

RESULTS: Of 735 patients, 44% reported seizure/s before the index seizure. Among the 260 individuals with a potentially epileptogenic brain imaging abnormality, 34% reported prior seizures. Of 475 individuals with no abnormality, 50% reported prior seizures (p < 0.001). Patients with post-stroke changes had lower odds of prior seizures (n = 24/95, OR 0.5, p = 0.005) compared to patients without abnormalities, as did patients with high-grade tumors (n = 1/10, OR 0.1, p = 0.04). Abnormality location or extent was not associated with seizures. Prior seizures were inversely associated with age, patients aged >50 years had lower odds compared to those 18-30 years (OR 0.5, p = 0.01).

CONCLUSIONS: A history of prior seizures is less common in patients with newly diagnosed focal epilepsy associated with antecedent stroke or high-grade tumor than in those without a lesion, and is also less common in older individuals. These findings may be related to age, biological mechanisms or aspects of diagnosis and assessment of these events.

PMID:35202928 | DOI:10.1016/j.seizure.2022.02.004