Tag: pubmed

J Cosmet Dermatol. 2022 Mar 27. doi: 10.1111/jocd.14940. Online ahead of print.

ABSTRACT

BACKGROUND: Tumor Necrosis Factor α (TNFα) is a protein that plays a key role in the pathophysiology of chronic inflammatory disorders like psoriasis.

AIMS: The goal of this study was to see if the TNFα gene -238G>A polymorphism was linked to psoriasis susceptibility.

METHODS: This study comprised ninety psoriasis patients and ninety healthy controls. For the TNFa gene -238G>A polymorphism, genomic DNA was extracted and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) studies.

RESULTS: Psoriasis patients had higher frequencies of the A allele and the AA genotype than the control group, and psoriasis was linked to the AA genotype (OR = 4.25, 95% CI = 1.37-13.1, p = 0.008) and the A allele (OR = 1.55, 95% CI = 1.01-2.34, p = 0.04). Patients with a family history of psoriasis showed an increase in the frequency of the AA genotype compared to GG and GA genotypes (respectively, 46.7%, 36.7%, and 16.7%, p = 0.003). Furthermore, psoriasis patients with the AA genotype were discovered more commonly among those under 30 years old and male patients than those with the GG and GA genotypes, but the differences were not statistically significant.

CONCLUSION: The TNFa gene -238G>A polymorphism has been related to an increased incidence of psoriasis.

PMID:35340111 | DOI:10.1111/jocd.14940

Am J Addict. 2022 Mar 27. doi: 10.1111/ajad.13265. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Congenital syphilis (CS) is increasing in the United States and is associated with intersecting social and structural determinants of health. This study aimed to delineate birthing parent characteristics associated with CS in an adjusted model. METHODS (N = 720): People diagnosed with syphilis during pregnancy from 2017 to 2018 who were interviewed and linked to infants in the California state surveillance system were included (herein, “birthing parents”). Sociodemographic and clinical CS risk factors informed a stepwise multivariable logistic regression model in which the outcome of interest was infants born with CS. CS prevention continuums delineated the proportion of pregnant people with syphilis who completed steps (e.g., prenatal care entry, syphilis testing, treatment) needed to prevent CS; the outcome was delivering an infant without CS. We stratified continuums by homelessness and methamphetamine use to explore differences in CS outcomes.

RESULTS: Of 720 birthing parents, 245 (34%) delivered an infant with CS. Although CS was initially associated with homelessness (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 1.6, 4.0) and methamphetamine use (OR = 2.1, 95% CI: 1.4, 3.1), the addition of prenatal care into a final adjusted model attenuated these associations to not significant. In CS prevention continuums, delivering an infant without CS was less likely for people who reported methamphetamine use (p < .001) and/or homelessness (p < .001). However, when examining only those who received prenatal care, statistical differences for these predictors no longer existed. In the final adjusted model the following were associated with CS: no prenatal care (OR = 16.7, 95% CI: 9.2, 30.3) or late prenatal care (OR = 2.9, 95% CI: 1.9, 4.2); early stage of syphilis (OR = 2.6, 95% CI: 1.8, 3.7); living in Central California (OR = 2.1, 95% CI: 1.1, 4.2).

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This is the first analysis to explore birthing parent characteristics associated with delivering an infant with CS in an adjusted model. We demonstrate that prenatal care, when accessed, can result in effective CS prevention among people who are unhoused and/or using methamphetamine equally well compared to counterparts without these risk factors.

PMID:35340101 | DOI:10.1111/ajad.13265

Pediatr Transplant. 2022 Mar 27:e14258. doi: 10.1111/petr.14258. Online ahead of print.

ABSTRACT

BACKGROUND: Detection of donor-derived cell-free DNA (dd-cfDNA) reliably identifies allograft rejection in pediatric and adult kidney transplant (KT) recipients. Here, we evaluate the utility of dd-cfDNA for monitoring response to treatment among pediatric renal transplant recipients suffering graft rejection.

METHODS: 58 pediatric transplant recipients were enrolled between April 2018 and March 2020 and underwent initial dd-cfDNA testing to monitor for rejection. Allograft biopsy was performed for dd-cfDNA scores >1.0%. Patients with histologically proven rejection formed the study cohort and underwent appropriate treatment. Results of dd-cfDNA, serum creatinine (SCr), biopsy findings, and treatment outcomes were evaluated. Standard statistical analyses were applied.

RESULTS: Nineteen of 58 (31%) patients had dd-cfDNA score >1.0%, of which 18 (94.7%) had biopsy-proven rejection. Median dd-cfDNA value was 1.90% (interquartile range 1.43%-3.23%), and biopsy results showed 11 patients (61.1%) with antibody-mediated rejection (AMR), 2 patients (11.1%) with T-cell mediated rejection (TCMR), and 5 patients (27.7%) with mixed AMR/TCMR. SCr at time of biopsy was 1.28 ± 1.09 mg/dl. Following treatment, dd-cfDNA scores decreased for all types of rejection but still remained >1.0% in both AMR (1.50% [0.90%-3.10%]) and mixed (1.40% [0.95%-4.15%]) groups. Repeat dd-cfDNA values were <1.0% for patients with TCMR (0.20%-0.28%). SCr showed minimal change from pre-treatment levels regardless of rejection subtype.

CONCLUSIONS: Patients with TCMR may be reliably followed by dd-cfDNA; however, it remains unclear whether persistently elevated dd-cfDNA levels in AMR is a reflection of ongoing subclinical rejection or an inherent limitation of the assay’s utility.

PMID:35340104 | DOI:10.1111/petr.14258

Glob Chang Biol. 2022 Mar 27. doi: 10.1111/gcb.16177. Online ahead of print.

ABSTRACT

Coastal methane (CH₄ ) emissions dominate the global ocean CH₄ budget and can offset the “blue carbon” storage capacity of vegetated coastal ecosystems. However, current estimates lack systematic, high-resolution, and long-term data from these intrinsically heterogeneous environments, making coastal budgets sensitive to statistical assumptions and uncertainties. Using continuous CH₄ concentrations, δ¹³ C-CH₄ values, and CH₄ sea-air fluxes across four seasons in three globally pervasive coastal habitats, we show that the CH₄ distribution is spatially patchy over meter-scales and highly variable in time. Areas with mixed vegetation, macroalgae, and their surrounding sediments exhibited a spatiotemporal variability of surface water CH₄ concentrations ranging two orders of magnitude (i.e., 6 – 460 nM CH₄ ) with habitat-specific seasonal and diurnal patterns. We observed (1) δ¹³ C-CH₄ signatures that revealed habitat-specific CH₄ production and consumption pathways, (2) daily peak concentration events that could change >100% within hours across all habitats, and (3) a high thermal sensitivity of the CH₄ distribution signified by apparent activation energies of ∼1 eV that drove seasonal changes. Bootstrapping simulations show that scaling the CH₄ distribution from few samples involves large errors, and that ∼50 concentration samples per day are needed to resolve the scale and drivers of the natural variability and improve the certainty of flux calculations by up to 70%. Finally, we identify northern temperate coastal habitats with mixed vegetation and macroalgae as understudied but seasonally relevant atmospheric CH₄ sources (i.e., releasing ≥100 μmol CH₄ m^-2 day^-1 in summer). Due to the large spatial and temporal heterogeneity of coastal environments, high-resolution measurements will improve the reliability of CH₄ estimates and confine the habitat-specific contribution to regional and global CH₄ budgets.

PMID:35340089 | DOI:10.1111/gcb.16177

Health Expect. 2022 Mar 27. doi: 10.1111/hex.13480. Online ahead of print.

ABSTRACT

BACKGROUND: Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months.

METHODS: A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups.

RESULTS: Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators. Mechanisms of impact concerned (1) a new perspective on mental health, well-being and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users’ thoughts and feelings on recovery, sharing narratives and influencing care and goals.

CONCLUSIONS: The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved.

PATIENT AND PUBLIC CONTRIBUTION: The current study involved stakeholders including a service user organization, the public, first-line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All authors have their own lived experiences of mental health problems as a service user or as a relative.

PMID:35340092 | DOI:10.1111/hex.13480

J Prosthodont. 2022 Mar 27. doi: 10.1111/jopr.13511. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ) and nickel-chromium alloy (NiCr) substructure restorative materials.

MATERIALS AND METHODS: Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness (VHN) was evaluated before preparing the surface for bonding by shot-blasting using 110 μm Al₂ O₃ particles. The surface roughness (Ra) of each sample was determined using a non-contact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following de-bonding were assessed. The data were statistically analysed using ANOVA and Tukey’s post-hoc comparison test (p < 0.05). RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13μm) and NiCr (1.87 ±0.07 μm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01).

CONCLUSIONS: PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness. This article is protected by copyright. All rights reserved.

PMID:35340086 | DOI:10.1111/jopr.13511

Int J Urol. 2022 Mar 26. doi: 10.1111/iju.14866. Online ahead of print.

ABSTRACT

OBJECTIVE: Literature suggests access to robotic surgery varies by race and payer status. We seek to investigate whether disparities exist in robot-assisted laparoscopic surgery among the pediatric urology population at our tertiary academic medical center and, if so, to find plausible reasons why.

METHODS: Retrospective analysis identified patients who underwent open or robot-assisted laparoscopic surgery by a single surgeon at a tertiary care center between 2008 and 2019. Univariate and multivariate analyses determined the relationship of patient demographic and socioeconomic factors to procedure approach.

RESULTS: Among 356 patients, race, age, American Society of Anesthesiologists status, and year of surgery were significant by univariate analysis. Insurance status was not significant (P = 0.066). Multivariate analysis indicated that age, American Society of Anesthesiologists status, and year of surgery were statistically significant (P < 0.001, P = 0.005, P < 0.001). By multivariate logistic regression, Black and Hispanic patient race were not significant with an odds ratio of 0.60 (0.35-1.02) (P = 0.061). In 60.2% of open cases, open approach selection was attributable to complex pathology, limitations of robotic approach, and surgeon’s robot-assisted laparoscopic learning curve.

CONCLUSIONS: Optimal procedure approach was determined by case complexity and surgeon’s robot-assisted laparoscopic learning curve and was independent of patient race and payer status. This study did not find racial or socioeconomic disparities in robotic surgery within pediatric urology at our tertiary medical center, inconsistent with previous literature.

PMID:35340066 | DOI:10.1111/iju.14866

Cytopathology. 2022 Mar 27. doi: 10.1111/cyt.13121. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the performance of different DNA image cytometry (DNA-ICM) ploidy parameters to categorize a DNA-ICM result, and consequently identify high-grade cervical intraepithelial neoplasia or worse (≥CIN2).

METHODS: Cervical samples from 232 women were collected for DNA-ICM analysis and biopsy confirmation. Five DNA parameters were used to define DNA aneuploidy: number of cells with exceeding events (EE) over 2.5cEE, 4cEE, 5cEE, 9cEE, and aneuploid stemlines. DNA-ICM results were categorized as normal, suspicious, and abnormal.

RESULTS: For individual DNA ploidy parameters, sensitivity for 50 cells with 2.5cEE, 45 cells with 4cEE, 1 cell with 9cEE and aneuploid stemline were 72.95%. 54.1%, 69.67% and 54.1%, while specificity were 80.0%, 90.0%, 89.09% and 95.45%, respectively. For 5cEE parameter, sensitivity for 1, 2, 3, 4 and 5 cells were 93.44%, 85.25%, 81.97%, 77.87% and 75.41%, while specificity were 46.36%, 63.64%, 74.55%, 76.36% and 80.91%, respectively. For categorized DNA-ICM results, a suspicious result revealed superior sensitivity to an abnormal result (87.70% vs 82.79%, P = 0.031), but inferior specificity (54.55% vs 75.45%, P <0.001). Both DNA-ICM results were statistically different from a normal result (P <0.05).

CONCLUSION: For prognostic purposes 1 cell with 9cEE, 45 cells with 4cEE and aneuploid stemline are the best parameters to categorize an abnormal DNA-ICM result, followed by 50 cells with 2.5cEE and 4 cells with 5cEE. For screening purposes, 10 cells with 2.5cEE, 10 cells with 4cEE, and 2 cells with 5cEE are suitable parameters to categorize a suspicious DNA-ICM result.

PMID:35340056 | DOI:10.1111/cyt.13121

Int J Health Plann Manage. 2022 Mar 26. doi: 10.1002/hpm.3465. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal and child health is an important component of the Sustainable Development Goals. Pakistan has one of the worst maternal and neonatal health outcomes in the world. This is despite significant health system investments across the country.

AIMS: The objectives of this study are twofold. First, the study estimates the technical efficiency of the public healthcare facilities in Pakistan, defined as the number of obstetric deliveries compared to the number of medical specialists, nurses, and other health and non-health staff members. Second, the study evaluates the relationship between efficiency and quality of care; the latter is measured in terms of maternal and neonatal mortality.

MATERIALS & METHODS: The data were taken from the Pakistan Health Facility Assessment Survey. Efficiency score was calculated for 843 public healthcare facilities, using Stochastic Frontier Analysis. We then used two-stage residual inclusion approach with bootstrapping to evaluate the relationship between efficiency and quality.

RESULTS AND DISCUSSION: The average efficiency score was 0.48 (range: 0-1) and none of the public healthcare facilities were on the frontier, implying that efficiency gains can be made across the board. The relationship between efficiency and quality is found to be positive and statistically significant, that is, more efficient healthcare facilities also had lower rates of maternal and neonatal mortality.

CONCLUSION: We conclude that more efficient public healthcare facilities also had lower mortality rates, probably due to better infrastructure and health system financing.

PMID:35340046 | DOI:10.1002/hpm.3465

Clin Exp Dermatol. 2022 Mar 26. doi: 10.1111/ced.15194. Online ahead of print.

ABSTRACT

BACKGROUND: The term topical steroid withdrawal (TSW) describes an adverse effect that generally occurs with inappropriate prolonged use of high-potency topical corticosteroids (TCS). The presence of user-generated content relating to TSW on social media has not been well-defined to date.

OBJECTIVE: We aimed to explore content relating to topical steroid withdrawal on social media.

METHODS: Using a data analytics platform, we retrospectively analysed the hashtag #topicalsteroidwithdrawal on social media over a 5 year period, from the 8th of February 2016 until the 8th of February 2021. We assessed: interactions, performance, shares, likes, mentions, language and country of origin using descriptive statistics.

RESULTS: Across all social media platforms there was a 274% increase in mentions of the hashtag #topicalsteroidwithdrawal in the year 2020(7992) compared with the year 2016(2138). Top associated hashtags included #TSW, #eczema, and #topicalsteroidaddiction. On Instagram, we found a 288% increase in number of mentions and a 592% increase in performance of #topicalsteroidwithdrawal in 2020(618,354) when compared to 2016(89,390).

CONCLUSION: Our results confirm an increase in the presence of user-generated content relating to TSW on social media and also highlight its extent. Large numbers of patients are exposed to this content which could influence their engagement with TCS.

PMID:35340034 | DOI:10.1111/ced.15194