Tag: pubmed

Int J Clin Pract. 2021 Apr 24:e14269. doi: 10.1111/ijcp.14269. Online ahead of print.

ABSTRACT

AIMS: To assess the effect of oral anticoagulant (OAC) administration on incidence of dementia in patients with atrial fibrillation (AF) with Systematic review and meta-analysis.

METHODS: We systematically searched the electronic databases including Pubmed, Embase, Cochrane library, and ClinicalTrails.gov for relevant articles. The primary outcome was the incidence of dementia. The adjusted risk ratio (RR), odds ratio, or hazard ratio were extracted and pooled by the random-effects models. Subgroup analysis was performed according to the setting observational window. Risk of bias was assessed using the Newcastle-Ottawa Scale, while publication bias was assessed by the Begg’s and Egger’s tests.

RESULTS: Nine studies were included in this review (2 prospective and 7 retrospective observational studies, including 613,920 patients). The results presented the significant association between OAC therapy and the reduced risk of dementia compared with no treatment (RR [95%CI] =0.72 [0.60, 0.86], I² =97.2%; P =0.000). In the subgroup analysis with an observational window, the pooled RR became statistically non-significant (including four studies, RR [95%CI] =0.75 [0.51, 1.10], I² =98.8%; P =0.000). There is no significant risk of bias and publication bias.

CONCLUSIONS: This study indicated the protective effect of OAC therapy for dementia in patients with AF. However, the results are limited because of high heterogeneity, inconsistent direction of effect in subgroup analysis with an observational window. Further prospective well-designed study is needed with longer follow-up duration in younger patients.

PMID:33894031 | DOI:10.1111/ijcp.14269

Sci China Life Sci. 2021 Apr 20. doi: 10.1007/s11427-020-1896-x. Online ahead of print.

ABSTRACT

Evidence about the response patterns of fruit and vegetable consumption with the risk of cardiovascular disease (CVD) and all-cause mortality was inconsistent. These associations were examined using a large-scale, population-based Chinese cohort comprising 100,728 participants. A food-frequency questionnaire was used to assess fruit and vegetable consumption. Outcomes were ascertained by interviewing individuals or their proxies and checking hospital records or death certificates. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). At the 736,668 person-years of follow-up, 3,677 CVD cases and 5,466 deaths were identified. The multivariable-adjusted HRs for CVD across increasing quartiles of total fruit and vegetable consumption were 1 (reference), 0.94 (95%CI=0.85-1.04), 0.89 (95%CI=0.80-0.98), and 0.85 (95% CI=0.11-0.95). Moreover, participants in the highest quartile displayed a 13% lower risk of all-cause mortality (HR=0.81; 95% CI=0.80-0.95). A nonlinear dose-response relation was found for CVD, without additional benefits beyond a consumption of 600 g d^-1, whereas the all-cause mortality risk decreased along with higher consumption, with a linear trend. These associations remained significant for fruit consumption but not for vegetable consumption. Our findings indicated that greater fruit and vegetable consumption was significantly associated with a lower risk of CVD and all cause mortality. Increasing fruit and vegetable consumption, especially fruit, in the general population would prevent CVD and premature mortality.

PMID:33893978 | DOI:10.1007/s11427-020-1896-x

Scand J Caring Sci. 2021 Apr 24. doi: 10.1111/scs.12987. Online ahead of print.

ABSTRACT

BACKGROUND: Care left undone is a worldwide problem for both the quality of health care and the safety of patients. In surgical nursing, care left undone is a critical issue arising from the intensive pace of work, invasive procedures and the pressure for efficiency. Previous knowledge about care left undone in surgical contexts is missing.

OBJECTIVE: To describe care left undone and its relationship to nursing and organisational characteristics in the surgical wards of regional and central hospitals in Estonia.

METHODS: A cross-sectional study with an online questionnaire took place from June to October of 2018. The target population (N = 570) consisted of nurses working in the surgical wards of two regional and three central hospitals at the time of the study. The data were analysed using descriptive statistics and Fisher’s exact test. The open-ended questions were analysed with deductive content analysis.

RESULTS: Nursing care in the surgical wards was reported as having been left undone sometimes or often by 88% of the nurses. Most often, the documentation and evaluation of care plans (33%) were reported as undone and most rarely, disinfection measures were left undone (5%). Nurses with a shorter employment history left care undone more frequently, and when the number of patients per nurse increased, the amount of care left undone increased as well. More than half of the participants (59%) considered work organisation to be the cause of care left undone.

CONCLUSIONS: Work organisation and staffing in surgical wards require more attention at the management level, as nursing care left undone occurred to a significant degree in the investigated wards, and more than half of the nurses considered work organisation to be the reason for care left undone.

PMID:33894008 | DOI:10.1111/scs.12987

Scand J Caring Sci. 2021 Apr 24. doi: 10.1111/scs.12991. Online ahead of print.

ABSTRACT

AIM: To investigate if acupuncture reduces nausea and vomiting in terminally ill patients.

DESIGN: A comparative effectiveness research design was used to generate evidence-based knowledge close to practice for the use of clinicians. The sample size was calculated to 136 patients randomised into an intervention and a control group, respectively. Nausea and vomiting were measured using the EORTC QLQ-c15-PAL (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire, core 15, Palliation).

LOCATION: The trial was conducted among terminally ill patients admitted to three in-bed hospices in Demark.

PARTICIPANTS: Terminally ill patients suffering from nausea and/or vomiting; 95% of patients had cancer.

INTERVENTION: The intervention group received acupuncture in addition to usual care for three days. We used the acupuncture spots: Pericardium-6, Stomach-36, Liver-3 and Yin Tang. The control group received usual care only.

RESULTS: In total, 136 patients were randomised, 24 patients withdrew resulting in a total sample of 112 patients: 52 patients in the intervention group and 60 patients in the control group. In the intervention group, 75% of the patients experienced a reduction of their nausea score after the intervention compared to 55% in the control group. The statistical difference was p = 0.028. In the intervention group, 52% of the patients did not experience nausea at all after the intervention compared to 30% in the control group. In the intervention group, 31% of the patients were still vomiting after the intervention compared to 34% in the control group; no statistically significant difference was found.

CONCLUSION: Acupuncture reduced the experience of nausea among terminally ill patients but did not reduce vomiting. Thus, acupuncture is recommended to reduce nausea among terminally ill patients.

PMID:33894009 | DOI:10.1111/scs.12991

Pharmacoecon Open. 2021 Apr 24. doi: 10.1007/s41669-021-00263-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The type of methods used in economic evaluations of health technology can lead to results that may influence decisions. Despite the potential impact on decision making, there is very little documentation of methods used in economic evaluation in oncology pertaining to key assumptions and extrapolation methods of survival benefits, especially in terms of survival analysis techniques and methods for extrapolation.

OBJECTIVES: The primary objectives of this study were to identify, examine, and describe the methods used in economic evaluations in oncology over a 10-year period, while secondary objectives included examining the use of identified methods across different geographic regions.

METHODS: A systematic search of the published oncology literature was conducted to identify economic evaluations of advanced or metastatic cancers published between 2010 and 2019 using the PUBMED, Ovid MEDLINE, and EMBASE databases. A random sample was taken, and information on type of study, data source, modeling techniques, and survival analysis methods were abstracted and descriptively summarized.

RESULTS: A total of 8481 abstracts were identified and 76 economic evaluations were abstracted and assessed. Most identified studies were from North America (38%), East Asia (21%), continental Europe (18%), or the UK (16%), and most commonly focused on lung cancer (18%), colorectal cancer (16%), or breast cancer (13%). A large majority of studies were based on data from randomized controlled trials (82%), utilized a cost-utility approach (82%), and took a public healthcare system perspective (83%). Common model structures included Markov (49%) and partitioned survival (17%). Fitted parametric curves were the most commonly used extrapolation method (89%) for overall survival and most often utilized the Weibull distribution (64%). Secondary assessments showed modest regional variation in the use of identified methods, including the use of fitted parametric curves, testing of the proportional hazards assumption, and validation of results.

CONCLUSION: A majority of papers in the study sample reported basic characteristics of study type, data source used, modeling techniques, and utilization of survival analysis methods. However, greater detail in reporting extrapolation methods, statistical analyses, and validation of results could be potential improvements, especially across regions, in order to support greater consistency in decision making. Future research could document the diffusion of novel modeling techniques into economic evaluation.

PMID:33893974 | DOI:10.1007/s41669-021-00263-w

J Autism Dev Disord. 2021 Apr 23. doi: 10.1007/s10803-021-04988-9. Online ahead of print.

ABSTRACT

The addition of ‘clinically significant impairment’ (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, Author, 2013) to the diagnostic criteria for autism in DSM-5 attempts to establish a threshold for the condition. However, the increased prominence of the neurodiversity paradigm and social model of disability runs counter to the idea that characteristics of autism are fundamentally impairing. Consequently, diagnostic criteria for autism are becoming misaligned with the contemporary views of ‘disorder’ and ‘disability’. In this commentary, we outline six clinical issues that arise from this misalignment during diagnostic assessment for autism, and the tension this creates in making diagnostic decisions. We conclude by considering ways the ‘clinically significant impairment’ criterion could be changed, and the implications this would have on clinical practice, and the concept of autism.

PMID:33893595 | DOI:10.1007/s10803-021-04988-9

Metabolomics. 2021 Apr 23;17(5):44. doi: 10.1007/s11306-021-01795-2.

ABSTRACT

INTRODUCTION: Manganese is important for the endocarditis pathogen Streptococcus sanguinis. Little is known about why manganese is required for virulence or how it impacts the metabolome of streptococci.

OBJECTIVES: We applied untargeted metabolomics to cells and media to understand temporal changes resulting from manganese depletion.

METHODS: EDTA was added to a S. sanguinis manganese-transporter mutant in aerobic fermentor conditions. Cell and media samples were collected pre- and post-EDTA treatment. Metabolomics data were generated using positive and negative modes of data acquisition on an LC-MS/MS system. Data were subjected to statistical processing using MetaboAnalyst and time-course analysis using Short Time series Expression Miner (STEM). Recombinant enzymes were assayed for metal dependence.

RESULTS: We observed quantitative changes in 534 and 422 metabolites in cells and media, respectively, after EDTA addition. The 173 cellular metabolites identified as significantly different indicated enrichment of purine and pyrimidine metabolism. Further multivariate analysis revealed that the top 15 cellular metabolites belonged primarily to lipids and redox metabolites. The STEM analysis revealed global changes in cells and media in comparable metabolic pathways. Glycolytic intermediates such as fructose-1,6-bisphosphate increased, suggesting that enzymes that utilize them require manganese for activity or expression. Recombinant enzymes were confirmed to utilize manganese in vitro. Nucleosides accumulated, possibly due to a blockage in conversion to nucleobases resulting from manganese-dependent regulation.

CONCLUSION: Differential analysis of metabolites revealed the activation of a number of metabolic pathways in response to manganese depletion, many of which are connected to carbon catabolite repression.

PMID:33893555 | DOI:10.1007/s11306-021-01795-2

Clin Oral Investig. 2021 Apr 24. doi: 10.1007/s00784-021-03949-x. Online ahead of print.

ABSTRACT

OBJECTIVE: Treatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography.

MATERIALS AND METHODS: Saliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey’s multiple comparison test.

RESULTS: In the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups.

CONCLUSIONS: Decontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures.

CLINICAL RELEVANCE: CAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.

PMID:33893556 | DOI:10.1007/s00784-021-03949-x

Biomech Model Mechanobiol. 2021 Apr 23. doi: 10.1007/s10237-021-01456-2. Online ahead of print.

ABSTRACT

The phenomenological model for cell shape deformation and cell migration Chen (BMM 17:1429-1450, 2018), Vermolen and Gefen (BMM 12:301-323, 2012), is extended with the incorporation of cell traction forces and the evolution of cell equilibrium shapes as a result of cell differentiation. Plastic deformations of the extracellular matrix are modelled using morphoelasticity theory. The resulting partial differential differential equations are solved by the use of the finite element method. The paper treats various biological scenarios that entail cell migration and cell shape evolution. The experimental observations in Mak et al. (LC 13:340-348, 2013), where transmigration of cancer cells through narrow apertures is studied, are reproduced using a Monte Carlo framework.

PMID:33893558 | DOI:10.1007/s10237-021-01456-2

Microb Ecol. 2021 Apr 23. doi: 10.1007/s00248-021-01759-y. Online ahead of print.

ABSTRACT

The extraction of commercial minerals is often accompanied by the formation of large areas of quarry and dump technogenic ecosystems. This stimulates the search for measures to reduce their negative impact on the environment, as well as a detailed study of all the constituent elements of ecosystems that spontaneously or after reclamation form on them. Primary stages of syngenesis on the tailing dumps of iron ore mines in Kryvorizhzhia took place involving cyanobacteria and eukaryotic algae. The dynamics of the community structures of algae and cyanobacteria depends on the mineralogical composition of tailings, salinity conditions, pH, and content of particles of physical clay and humus. The assessment of the features of the dynamics of algae communities was carried out based on the ordination procedure because of the method of non-metric multidimensional scaling. The considered environmental variables were statistically significant predictors of community structure and could explain 47-90% of the variation in measurements. Diagnostic signs of the species composition of communities of algae and cyanobacteria tailing dumps were established by physical and chemical parameters. An increase in the content of physical clay particles in the substrate and a pH shift towards the alkaline side increased the species richness of cyanobacteria, while an increase in the humus content increased the total species diversity. Based on the specificity of the type of growth and the species composition of algae communities, when describing the primary successions, it is proposed to allocate the following stages of development of algae and cyanobacteria communities: dispersal aerophyton, stratose epilitophyton, algal crust, mixed moss and algal crust, and edaphone.

PMID:33893532 | DOI:10.1007/s00248-021-01759-y