Tag: pubmed

Am J Otolaryngol. 2022 Apr 5;43(3):103427. doi: 10.1016/j.amjoto.2022.103427. Online ahead of print.

ABSTRACT

PURPOSE: To describe the changes in workforce gender distribution over time and characterize geographically where women are finding job opportunities within the field of otolaryngology.

MATERIALS AND METHODS: The Centers for Medicare and Medicaid Services (CMS) publishes a Physician Compare National Downloadable File, which lists all active providers registered within CMS, as well as specialty, medical school graduation, and current practice location. The file of March 2021 was filtered for all providers that listed “otolaryngology” as their primary specialty. Providers were sorted based on medical school graduation year. Physicians were organized into five-year and ten-year quantiles, based on career experience. For each quantile, the gender distribution was recorded. For each decade of experience, the geographic distribution of gender was recorded at a state-by-state level. Descriptive statistics were conducted to characterize the number of female otolaryngologists per state. The geographic distribution of male versus female physicians was superimposed onto state boundary files as published by the U.S. Census Bureau using R Studio (2020) [13].

RESULTS: The Physician Compare National Database listed 1719 women (19.0%) and 7292 men (81.0%) otolaryngologists actively registered to practice in the United States. By career periods, the following proportions of otolaryngologists were women: 1-5 years, 317/971 (32.6%); 6-10 years, 417/1291 (32.3%); 11-15 years, 299/1159 (25.8%); 16-20 years, 207/1108 (18.7%); 21-25 years, 190/1156 (16.4%); 26-30 years, 138/1141 (12.1%); 31-35 years, 86/968 (8.9%); 36+ years, 60/1212 (5.0%). The linear regression of the male-female distribution data suggests that the proportion of men and women in practice in otolaryngology will equalize nationally in the 2030s. By geographic distribution, the mean and median number of female otolaryngologists per state was 34.3 (19.0%) and 21 (17.2%), respectively. The number of female otolaryngologists by state ranged from 2 (Idaho) to 258 (California). States with the lowest percentage of female otolaryngologists included Idaho (2/51, 3.9%), Oklahoma (5/86, 5.8%), and Utah (6/99, 6.1%). There has been a national increase in the percentage of women practicing in otolaryngology over the last several decades.

CONCLUSIONS: There is a significantly higher proportion of female otolaryngologists within earlier practice years, which suggests that progress has been made toward closing the gender gap within this field. The geographic distribution of female otolaryngologists is highly variable and should be studied further to assess what factors contribute to more females choosing to practice in these regions to continue to build regional support networks for women within the field.

PMID:35429843 | DOI:10.1016/j.amjoto.2022.103427

Mult Scler Relat Disord. 2022 Apr 10;62:103798. doi: 10.1016/j.msard.2022.103798. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the influence of immunoglobulins (Ig) level on the rate of infections in people with multiple sclerosis (pwMS) treated with ocrelizumab.

METHODS: We enrolled 109 consecutive pwMS treated with ocrelizumab with a mean follow-up of 2.69±0.56 (1.36-4.27) years. We have retrospectively searched our electronic database and the following information was collected: age, sex, MS characteristics, number of ocrelizumab cycles, infections, duration of the infection, hospitalization due to infection, treatment of the infection, and COVID-19 characteristics. Ig levels were measured within 14 days before each ocrelizumab infusion.

RESULTS: Number of pwMS with values of IgM and IgG below lower level of normal at baseline was 3 (2.8%) and 2 (2.8%), respectively; and before 6^th cycle of ocrelizumab 5 (13.5%) and 5 (13.5%), respectively. Levels of IgM were steadily decreasing over time, while levels of IgG started to show statistically significant drop only after 5^th cycle of ocrelizumab. 58.7% pwMS experienced infection during treatment, with a median number of infections per pwMS being 1, range 0-4. Female sex increased the risk of any infection (HR 2.561, 95%CI 1.382-4.774, p=0.003). Higher age and smaller drop in IgM before 3^rd ocrelizumab cycle increased the risk for infection requiring hospitalization (HR 1.086, 95%CI 1.018-1.159, p=0.013 and HR 9.216, 95%CI 1.124-75.558, p=0.039, respectively). Longer disease duration increased the risk for COVID-19 (HR 1.075, 95%CI 1.002-1.154, p=0.045).

CONCLUSION: The present findings broaden limited real-world data on infection and COVID-19 risk in pwMS treated with ocrelizumab.

PMID:35429819 | DOI:10.1016/j.msard.2022.103798

Asian J Psychiatr. 2022 Apr 6;72:103103. doi: 10.1016/j.ajp.2022.103103. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to define the clinical characteristics and management strategies of children and adolescents presenting with psychiatric crises to the emergency department (ED) of a tertiary health care facility outside of working hours, and to identify predictors of multiple ED visits among them.

METHODS: From January 2012 to December 2018, retrospective records of patients presenting with psychiatric symptoms to the ED and examined by a child psychiatrist after 5 p.m. on weekdays and for 24 h on weekends and public holidays were analyzed.

RESULTS: Our sample consisted of 1576 visits and 1364 patient (Female:Male=1.8:1, mean age=14.86 ± 2.72). The most common reason for visits was self-injurious thought or behaviors (SITB), and the most common diagnosis was depression. While depression was statistically more common in girls, attention deficit hyperactivity disorder, autism and/or intellectual disability (ASD/ID), psychotic disorders, and bipolar disorder were more common in boys. The forensic evaluation was the most common reason for visits among children younger than 6 years old. Of visits, 23% transferred to hospitalization. A history of mental health contact was the lowest in depression (37.5%), psychosis (34.1%), and substance use disorders (33%). Of patients, 10.8% had multiple visits. A history of mental health contacts, conduct disorder, ASD/ID, bipolar disorder, psychotic disorder, and dissociative disorder were predictors of multiple visits to ED with psychiatric reasons.

CONCLUSION: Emergency mental health care outside of regular working hours can be a critical step in the diagnosis and treatment of serious psychiatric disorders in children and adolescents.

PMID:35429785 | DOI:10.1016/j.ajp.2022.103103

J Infect Public Health. 2022 Mar 25;15(5):526-532. doi: 10.1016/j.jiph.2022.03.013. Online ahead of print.

ABSTRACT

BACKGROUND: Many survivors of COVID-19 have developed symptoms and diseases similar to those observed after severe acute respiratory syndrome (SARS). Therefore, this study aimed to characterize the symptoms that appear after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been eradicated and to determine their relationship with COVID-19 severity.

METHODS: This multicenter, retrospective cross-sectional study was conducted in all eligible confirmed cases of SARS-CoV-2 infection from Saudi Arabia. Study participants were randomly selected using computerized random sampling from a population of 314,821 patients. Descriptive statistics were used to describe baseline demographic data and clinical characteristics. Categorical variables were presented as counts and percentages, while continuous variables were presented as means and standard deviations.

RESULTS: Approximately 70% of patients were found to have five or fewer symptoms simultaneously. Late symptoms (in the ongoing symptomatic COVID-19) occurred in 225 (22·5%) patients with the most common late symptoms being loss of smell, loss of taste, fatigue, shortness of breath, and cough (52·4%, 31·1%, 11·5%, 10·2%, and 8·9% of patients with late symptoms, respectively). We also found that the presence of acute symptoms of COVID-19 and admission to the hospital were significant independent predictors of the post-COVID-19 condition.

CONCLUSION: Saudi patients with COVID-19 develop a wide range of symptoms, similar to those observed and reported in other countries. The loss of smell, the loss of taste, shortness of breath, and fatigue were the main persistent symptoms. Regular follow-up of COVID-19 survivors is highly recommended to minimize the burden of the post-acute COVID-19 condition and improve the quality of life of patients.

PMID:35429791 | DOI:10.1016/j.jiph.2022.03.013

Forensic Sci Int. 2022 Mar 24;335:111281. doi: 10.1016/j.forsciint.2022.111281. Online ahead of print.

ABSTRACT

We discuss how different accelerator-based techniques can be employed synergistically as a powerful analytical tool for forensic studies of foodstuff. Brazilian and Jamaican coffees were chosen as a showcase due to its popularity and potential risk of adulteration and/or falsification. Comprehensive characterization of major and trace elements, age since production and compound contents were achieved using different techniques, including PIXE (Particle-Induced X-ray Emission), FTIR (Fourier Transform Infrared), and AMS-¹⁴C (Accelerator Mass Spectrometry – Radiocarbon Analysis). While PIXE provides information on the elements present in the samples, FTIR probes the types of compounds through their vibrational spectra. Finally, AMS-¹⁴C is capable of dating organic samples regarding their harvesting time. Five different laboratories from research institutions around the world took part in the experiments. The integration of the results obtained with different techniques provided multifaceted perspectives on the coffee under study, thus allowing a direct assessment of the material for forensic purposes such as authentication, determination of provenance, and combat counterfeiting.

PMID:35429777 | DOI:10.1016/j.forsciint.2022.111281

J Mech Behav Biomed Mater. 2022 Apr 9;131:105226. doi: 10.1016/j.jmbbm.2022.105226. Online ahead of print.

ABSTRACT

Zirconia bioceramics has tremendous potential in medical applications owing to biocompatibility and high mechanical properties. Meanwhile, thermal damage and surface defects limit the grindability to achieve the desired properties. Therefore, this research provides an investigation of various grinding parameters on heat generation and surface morphology using a diamond wheel. In addition, a triangular and parabolic moving heat flux is used for heat distribution analysis based on FEM-model. The parabolic model more corresponds to experimental compared to the triangular heat flux, with an average deviation of <5% and 6.5% under dry and MQL, respectively. The response surface methodology is applied to extract a statistical representation of inputs and outputs. Dry grinding temperature obtained in range of 200-540 °C, which by applying MQL, it decreased by 16-35%. Increasing cutting depth would worsen the MQL efficiency in force and temperature. Results indicate the impact of cutting depth on temperature and force is greatest, followed by the effect of feed-rate, and that of wheel speed is the least. Thus, the increasing feed-rate should be utilized to preserve the high removal rate. SEM images indicate material removal mechanism is accomplished by plastic and brittle mode. Furthermore, MQL and a combination of low depth of cut could effectively decline the surface roughness and defects formation by decreasing the brittle material removal mechanism in one step. MQL reduced surface roughness by 46% compared with dry grinding, so that its performance increase in higher cutting depth. Because at higher cutting depths, the MQL changes the prevailing chip removal mechanism from brittle to ductile-regime grinding.

PMID:35429766 | DOI:10.1016/j.jmbbm.2022.105226

Cortex. 2022 Mar 28;151:162-175. doi: 10.1016/j.cortex.2022.03.008. Online ahead of print.

ABSTRACT

Moral conviction has the potential to inspire activism and change, but can also instigate divisiveness and great harm. Moreover, attitudes held with moral conviction are experienced as universal objective truths and are less likely to demonstrate social conformity. Some evidence suggests that holding strong moral views may be a consequence of a cognitive style which includes lower metacognitive sensitivity. This study combined measures of attitudes, moral convictions, psychophysics, and electroencephalography (EEG) to determine how metacognition and moralization influence different stages of information processing during social decision-making, as well as the neural mechanisms underlying these effects. First, 170 participants were asked to indicate their attitudes and moral convictions about specific social issues that are currently important to US college students. Later, a subset of 81 participants completed a perceptual confidence task to assess their metacognition. Then, they underwent EEG while evaluating photographs of protests ostensibly about the same social issues. Prior to each photo, participants were provided with statistical information about social consensus from their peers for each issue. As predicted, stronger moral convictions were associated with lower social conformity. Furthermore, this effect was more pronounced in individuals with lower metacognitive ability. Moralized content was prioritized in multiple stages of information processing, including both early automatic attention and later deliberative stages, with medial frontal negativity (MFN) and early posterior negativity (EPN) predicting reduced conformity. Changes in alpha and high beta power indicated increased attention and engagement for moralized content. Together, results from these complementary methods and levels of analysis both converge to indicate that moralization alters sensitivity to social influence by shifting neural responses to efficiently prioritize information related to moralized beliefs.

PMID:35429765 | DOI:10.1016/j.cortex.2022.03.008

Nurse Educ Today. 2022 Apr 6;113:105361. doi: 10.1016/j.nedt.2022.105361. Online ahead of print.

ABSTRACT

BACKGROUND: Hemorrhage is a frequent complication that nurses and midwives must recognize and manage to avoid life-threatening consequences for patients. There is currently no synthesis of evidence on educational interventions in nursing and midwifery regarding hemorrhage, thus limiting the definition of best practices.

OBJECTIVE: To map the literature on nursing and midwifery education regarding the recognition and management of hemorrhage.

DESIGN: Scoping review based on the Joanna Briggs Institute guidelines.

DATA SOURCES: Quantitative studies evaluating the effect of educational interventions with students, nurses, or midwives published in English or French, with no time limit.

REVIEW METHODS: Study selection, data extraction, and quality assessment were conducted by two independent reviewers. We characterized educational interventions based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching. We categorized learning outcomes using the New World Kirkpatrick Model. Methodological quality appraisal was performed with tools from the Joanna Briggs Institute. Findings were synthesized using descriptive statistics and graphical methods RESULT: Most of the 38 studies used a single-group design (n = 26, 68%) and were conducted with professionals (n = 28, 74%) in hospital settings (n = 20, 53%). Most were of low (n = 14; 37%) or moderate (n = 18, 47%) methodological quality. Most interventions focused on postpartum hemorrhage (n = 34, 89%) and combined two or more teaching strategies (n = 25, 66%), often pairing an informational segment (e.g., lecture, readings) with a practical session (e.g., workshop, simulation). Learning outcomes related to the management (n = 27; 71%) and recognition of hemorrhage (n = 19, 50%), as well as results for patients and organizations (n = 9, 24%).

CONCLUSION: Considerable heterogeneity in interventions and learning outcomes precluded conducting a systematic review of effectiveness. High-quality, controlled studies are needed, particularly in surgery and trauma. Reflection on the contribution of nurses and midwives to the detection, monitoring, and management of hemorrhage could enrich the content and expected outcomes of hemorrhage education.

PMID:35429750 | DOI:10.1016/j.nedt.2022.105361

J Pharm Biomed Anal. 2022 Mar 30;215:114737. doi: 10.1016/j.jpba.2022.114737. Online ahead of print.

ABSTRACT

Acute exacerbation of pediatric asthma (AEPA) has always been one of the most common reasons for children to visit the emergency department, whereas unified diagnostic criteria in the clinic are lacking. The purpose of this study was to determine potential biomarkers, and provide a basis for predictive and diagnostics AEPA. Urine samples were collected from 40 pediatric patients, including 19 patients with AEPA (PA) and 21 healthy controls (HCs). The samples were analyzed by high-performance liquid chromatography-quadrupole orbitrap mass spectrometry (HPLC-Q-Orbitrap-MS), and the data were statistically analyzed by principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Differential metabolites were selected by VIP (variable importance for the projection) > 1, and a p value ≤ 0.05 was used as the standard. The corresponding metabolic pathways of differential metabolites were subjected to analysis by the KEGG database, and further analysis and characterization of differential metabolites were conducted through the HMDB database. A total of 26 potential biomarkers were selected, of which 17 were found to be associated with respiratory diseases. Nine metabolites with obvious fluctuations in patients with AEPA, such as 13-L-hydroperoxylinoleic acid, gentisate aldehyde, L-3-phenyllactic acid, hydrocinnamic acid, and gentisic acid, could be used as potential biomarkers to further explore the prediction and diagnosis of AEPA for the first time. The contents of 3 potential biomarkers showed a positive correlation. Abnormalities in seven metabolic pathways, such as phenylalanine metabolism, tyrosine metabolism and beta-alanine metabolism, are also related to AEPA. This study further confirmed the reliability of this method to detect differences in urine metabolites of patients with AEPA. By monitoring the content of these 26 potential biomarkers and their related metabolic pathways, it provides a basis for further effective prediction and diagnosis of AEPA to avoid further development of this disease.

PMID:35429725 | DOI:10.1016/j.jpba.2022.114737

Heart Rhythm. 2022 Apr 13:S1547-5271(22)01884-7. doi: 10.1016/j.hrthm.2022.04.006. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals with patent foramen ovale (PFO) routinely undergo transcatheter closure (TC) for secondary prevention of recurrent stroke. However, there has been some evidence suggesting that TC may increase the risk of new-onset atrial fibrillation (AF).

OBJECTIVE: To evaluate the risk of new-onset AF following PFO closure and to explore predictors of AF development.

METHODS: We created a retrospective cohort of all Ontarians over 18-years of age who received TC between October 2002 and December 2017 using administrative health data and the CorHealth cardiac registry. A Poisson regression determined event rates of AF and secondary outcomes such as stroke and mortality per 1,000 person-years. A multivariable Cox proportional hazards model identified predictors of new-onset AF following TC.

RESULTS: Of 1,533 patients, 96 (6.26%) developed new-onset AF following PFO closure, over an average follow-up time of 8.2 years. Age >60 years (HR =2.82; CI:1,76-4.51; p < 0.001) and diabetes (HR=2.49; CI:1.48-4.18; p <0.001) were statistically significant, independent predictors of AF according to the Cox model.

CONCLUSIONS: The incidence of new-onset AF after PFO closure was relatively low. Having diabetes and age > 60 years were the most important factors associated with new-onset AF in this population.

PMID:35429648 | DOI:10.1016/j.hrthm.2022.04.006