Tag: pubmed

Intern Med J. 2022 Mar 15. doi: 10.1111/imj.15750. Online ahead of print.

ABSTRACT

BACKGROUND: Telehealth was widely adopted in health services during the Covid-19 pandemic. It is unknown what the attitudes and ongoing needs of healthcare staff are after a rapid implementation of telehealth.

AIMS: To evaluate staff attitudes to telehealth utilisation after a rapid implementation.

METHODS: A health service-wide bespoke survey was sent to all clinicians, managers, and administration staff in June-July 2021. We evaluated attitudes to (i) telehealth application in the model of care and (ii) the barriers and enablers to use of telehealth. Descriptive statistics were used for quantitative data, and content analysis for the textual data.

RESULTS: A hundred and thirty-four respondents completed the survey (response rate = 22.5% of healthdirect users (71/315), and = 3.2% of total healthcare staff population). Most commonly, telehealth was identified as being important (78%) and safe (79%) by clinicians; important (100%) and encouraged (88%) by managers. In contrast, telehealth was identified as not the same as face-to-face (56%, 50%); but easy to add to usual work arrangements (43%, 44%) by clinicians and managers, respectively. The most common enablers of telehealth were: (i) having others use the same telehealth platform (74.3%, 100%), and (ii) completing training (68.9%, 72.7%) by clinicians and managers, respectively. The most common barriers were having (i) reliable internet connectivity (39.2%, 45.5%) by clinicians and managers respectively, (ii) the right equipment (clinician 37.8%), and (iii) a private area (managers 36.3%).

CONCLUSIONS: Despite training and having support from colleagues to implement telehealth, ongoing needs were identified that may promote uptake in specific health settings. This article is protected by copyright. All rights reserved.

PMID:35289486 | DOI:10.1111/imj.15750

J Magn Reson Imaging. 2022 Mar 15. doi: 10.1002/jmri.28151. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetic resonance elastography (MRE) is an imaging technique that can noninvasively assess the shear properties of the intervertebral disc (IVD). Unlike the standard gradient recalled echo (GRE) MRE technique, a spin-echo echo-planar imaging (SE-EPI) sequence has the potential to improve imaging efficiency and patient compliance.

PURPOSE: To validate the use of an SE-EPI sequence for MRE of the IVD compared against the standard GRE sequence.

STUDY TYPE: Cross-over.

SUBJECTS: Twenty-eight healthy volunteers (15 males and 13 females, age range: 19-55).

FIELD STRENGTH/SEQUENCE: 3 T; GRE, SE-EPI with breath holds (SE-EPI-BH) and SE-EPI with free breathing (SE-EPI-FB) MRE sequences.

ASSESSMENT: MRE-derived shear stiffnesses were calculated via principal frequency analysis. SE-EPI derived shear stiffness and octahedral shear strain signal-to-noise ratios (OSS-SNR) were compared against those derived using the GRE sequence. The reproducibility and repeatability of SE-EPI stiffness measurements were determined. Shear stiffness was evaluated in the nucleus pulposus (NP) and annulus fibrosus (AF) regions of the disc. Scan times between sequences were compared.

STATISTICAL TESTS: Linear mixed models, Bland-Altman plots, and Lin’s concordance correlation coefficients (CCCs) were used with P < 0.05 considered statistically significant.

RESULTS: Good correlation was observed between shear stiffnesses derived from the SE-EPI sequences with those derived from the GRE sequence with CCC values greater than 0.73 and 0.78 for the NP and AF regions, respectively. OSS-SNR was not significantly different between GRE and SE-EPI sequences (P > 0.05). SE-EPI sequences generated highly reproducible and repeatable stiffness measurements with CCC values greater than 0.97 in the NP and AF regions and reduced scan time by at least 51% compared to GRE. SE-EPI-BH and SE-EPI-FB stiffness measurements were similar with CCC values greater than 0.98 for both regions.

DATA CONCLUSION: SE-EPI-based MRE-derived stiffnesses were highly reproducible and repeatable and correlated with current standard GRE MRE-derived stiffness estimates while reducing scan times.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 1.

PMID:35289470 | DOI:10.1002/jmri.28151

Catheter Cardiovasc Interv. 2022 Mar 15. doi: 10.1002/ccd.30154. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study is to investigate the viability of transcatheter aortic valve replacement (TAVR) for severe symptomatic aortic stenosis (AS) in patients with prior chest radiation therapy (cXRT).

BACKGROUND: Since patients with prior cXRT perform poorly with surgical aortic valve replacement, TAVR can be a viable alternative. However, clinical outcomes after TAVR in this patient population have not been well studied.

METHODS: From the pooled registry of the placement of aortic transcatheter valves II trial, we identified patients with and without prior cXRT who underwent TAVR (n = 64 and 3923, respectively). The primary outcome was a composite of all-cause death and any stroke at 2 years. Time to event analyses were shown as Kaplan-Meier event rates and compared by log-rank testing. Hazard ratios (HRs) were estimated and compared by Cox proportional hazards regression model.

RESULTS: There was no significant difference in the primary outcome between the patients with and without prior cXRT (30.7% vs. 27.0%; p = 0.75; HR, 1.08; 95% confidence interval, 0.66-1.77). Rates of myocardial infarction, vascular complications, acute kidney injury, or new pacemaker implant after TAVR were not statistically different between the two groups. The rate of immediate reintervention with a second valve for aortic regurgitation after TAVR was higher among the patients with prior cXRT. However, no further difference was observed during 2 years follow-up after discharge from the index-procedure hospitalization.

CONCLUSIONS: TAVR is a viable alternative for severe symptomatic AS in patients who had cXRT in the past.

PMID:35289473 | DOI:10.1002/ccd.30154

J Magn Reson Imaging. 2022 Mar 15. doi: 10.1002/jmri.28156. Online ahead of print.

ABSTRACT

BACKGROUND: Moyamoya is a progressive intracranial vasculopathy, primarily affecting distal segments of the internal carotid and middle cerebral arteries. Treatment may comprise angiogenesis-inducing surgical revascularization; however, lack of randomized trials often results in subjective treatment decisions.

HYPOTHESIS: Compensatory presurgical posterior vertebrobasilar artery (VBA) flow-territory reactivity, including greater cerebrovascular reactivity (CVR) and reduced vascular delay time, portends greater neoangiogenic response verified on digital subtraction angiography (DSA) at 1-year follow-up.

STUDY TYPE: Prospective intervention cohort.

SUBJECTS: Thirty-one patients with moyamoya (26 females; age = 45 ± 13 years; 41 revascularized hemispheres).

METHODS: Anatomical MRI, hypercapnic CVR MRI, and DSA acquired presurgically in adult moyamoya participants scheduled for clinically indicated surgical revascularization. One-year postsurgery, DSA was repeated to evaluate collateralization.

FIELD STRENGTH: 3 T.

SEQUENCE: Hypercapnic T2* -weighted gradient-echo blood-oxygenation-level-dependent, T₂ -weighted turbo-spin-echo fluid-attenuated-inversion-recovery, T₁ -weighted magnetization-prepared-rapid-gradient-echo, and T₂ -weighted diffusion-weighted-imaging.

ASSESSMENT: Presurgical maximum CVR and response times were evaluated in VBA flow-territories. Revascularization success was determined using an ordinal scoring system of neoangiogenic collateralization from postsurgical DSA by two cerebrovascular neurosurgeons (R.V.C. with 8 years of experience; M.R.F. with 9 years of experience) and one neuroradiologist (L.T.D. with 8 years of experience). Stroke risk factors (age, sex, race, vasculopathy, and diabetes) were recorded.

STATISTICAL TESTS: Fisher’s exact and Wilcoxon rank-sum tests were applied to compare presurgical variables between cohorts with angiographically confirmed good (>1/3 middle cerebral artery [MCA] territory revascularized) vs. poor (<1/3 MCA territory revascularized) outcomes.

SIGNIFICANCE: two-sided P < 0.05. Normalized odds ratios (ORs) were calculated.

RESULTS: Criteria for good collateralization were met in 25 of the 41 revascularized hemispheres. Presurgical normalized VBA flow-territory CVR was significantly higher in those with good (1.12 ± 0.13 unitless) vs. poor (1.04 ± 0.05 unitless) outcomes. Younger (OR = -0.60 ± 0.67) and White (OR = -1.81 ± 1.40) participants had highest revascularization success (good outcomes: age = 42 ± 14 years, race = 84% White; poor outcomes: age = 49 ± 11 years, race = 44% White).

DATA CONCLUSION: Presurgical MRI-measures of VBA flow-territory CVR are highest in moyamoya participants with better angiographic responses to surgical revascularization.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 4.

PMID:35289460 | DOI:10.1002/jmri.28156

Lasers Surg Med. 2022 Mar 15. doi: 10.1002/lsm.23537. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: There are limited treatment options for nail psoriasis. It is important to find new therapies and improve existing ones. The aim of this study was to compare the effectiveness of pulsed dye laser (PDL) versus combined PDL and Nd:YAG lasers in patients with nail psoriasis.

METHODS: Fourteen patients (with a total of 126 nails affected by nail psoriasis) were treated with PDL (6 J/cm2, 7 mm, 0.45 milliseconds) on both hands and additionally with Nd:YAG (10 J/cm² , 6 mm, 15 milliseconds) on the right hand. Three treatment sessions were applied at 4-week intervals and patients were followed up for 6 months after the last session. Disease severity was assessed using the Nail Psoriasis Severity Index, both 8- and 32-point variant. Additionally, Dermatology Life Quality Index was assessed before and after treatment.

RESULTS: Overall, there was a statistical difference in 8- and 32-point NAPSI score before and after treatment for both hands. However, there was no statistical difference between the score for the right and left hands based on both scale variants. Some aspects of patients’ lives showed improvement due to the treatment.

CONCLUSIONS: Both PDL in monotherapy and combined Nd:Yag+PDL lasers are safe and effective in treatment of nail psoriasis, although combined therapy shows no advantage over the use of a single laser.

PMID:35289430 | DOI:10.1002/lsm.23537

J Sch Health. 2022 Mar 15. doi: 10.1111/josh.13174. Online ahead of print.

ABSTRACT

BACKGROUND: Breakfast after the bell (BAB), an alternative way to deliver breakfast after the school day begins, has been shown to increase participation in the School Breakfast Program. However, BAB occupies time that could otherwise be used for instruction and may affect academic performance. This study examined whether BAB affects math and literacy scores in third grade, an age not adequately studied in earlier literature.

METHODS: Using data on Arkansas students, we compared schools adopting BAB to corresponding “synthetic” control schools by minimizing preadoption differences in observables that can influence test scores.

RESULTS: We found little evidence of positive or negative effects on test scores. We also found little evidence of meaningful program effects over subsamples of schools by district enrollment size and BAB delivery method. Schools that adopted grab-and-go delivery and schools in districts with small enrollments, less than 600 students, showed statistically negative effects on math after BAB adoption. However, these effects were transitory and no longer present by the time the first fully exposed cohort reached third grade.

CONCLUSIONS: BAB can be incorporated into the school day without adversely impacting academic achievement, especially if adopting schools seek input from educators and nutrition personnel already experienced with BAB.

PMID:35289398 | DOI:10.1111/josh.13174

Am J Community Psychol. 2022 Mar 15. doi: 10.1002/ajcp.12593. Online ahead of print.

ABSTRACT

In the context of global democratic crises and pervasive neoliberal policies, civil society organizations (CSOs) play a critical role in promoting democratic processes and advancing social change on local, national, and transnational scales. However, such organizations also (need to) grapple with how they themselves put social justice and democratic principles into practice, and resist coloniality within. This article examines these questions in the case of People Powered-Global Hub for Participatory Democracy, a recently found transnational CSO that advocates globally for participatory democracy as a mechanism for social change and employs these principles in its own governance and operations. The analysis focusses on the creation of People Powered and its first year of practice. Drawing upon decolonial frameworks-and based on our own experiences as founding members of People Powered and our reading of interviews and documents-we identify concrete practices through which the organization seeks to enact epistemic justice, shift power, and emphasize relationality. We argue that People Powered’s decolonial roots, collectively articulated values and commitments, radical transparency, and its consistent employment of meaningful participation and reflexivity have built and are likely to sustain this transnational solidarity for social change. At the same time and perhaps critical for fostering solidarity and social change in the long term, People Powered embraces, rather than evades, tensions and contradictions that emerge in these efforts.

PMID:35289399 | DOI:10.1002/ajcp.12593

Biometrics. 2022 Mar 15. doi: 10.1111/biom.13662. Online ahead of print.

ABSTRACT

We introduce a time-interaction point process where the occurrence of an event can increase (self-excitement) or reduce (self-correction) the probability of future events. Self-excitement and self-correction are allowed to be triggered by the same event, at different time scales; other effects such as those of covariates, unobserved heterogeneity, and temporal dependence are also allowed in the model. We focus on capture-recapture data, as our work is motivated by an original example about estimation of the total number of drug dealers in Italy. To do so, we derive a conditional likelihood formulation where only subjects with at least one capture are involved in the inference process. The result is a novel and flexible continuous-time population size estimator. A simulation study and the analysis of our motivating example illustrate the validity of our approach in several scenarios. This article is protected by copyright. All rights reserved.

PMID:35289395 | DOI:10.1111/biom.13662

Brief Bioinform. 2022 Mar 14:bbac067. doi: 10.1093/bib/bbac067. Online ahead of print.

ABSTRACT

Over the past decade, statistical methods have been developed to estimate single nucleotide polymorphism (SNP) heritability, which measures the proportion of phenotypic variance explained by all measured SNPs in the data. Estimates of SNP heritability measure the degree to which the available genetic variants influence phenotypes and improve our understanding of the genetic architecture of complex phenotypes. In this article, we review the recently developed and commonly used SNP heritability estimation methods for continuous and binary phenotypes from the perspective of model assumptions and parameter optimization. We primarily focus on their capacity to handle multiple phenotypes and longitudinal measurements, their ability for SNP heritability partition and their use of individual-level data versus summary statistics. State-of-the-art statistical methods that are scalable to the UK Biobank dataset are also elucidated in detail.

PMID:35289357 | DOI:10.1093/bib/bbac067

Dent Mater. 2022 Mar 11:S0109-5641(22)00068-9. doi: 10.1016/j.dental.2022.03.003. Online ahead of print.

ABSTRACT

OBJECTIVES: To study the oxide layer stability of certified dental implants of system “P”, made based on TiO₂ alloy with carbon coating. To perform a comparative statistical analysis of the obtained data with the available data for the dental implants of systems “A” and “B”.

METHODS: X-ray microtomography and X-ray fluorescence analysis were used to study soft tissue biopsy specimens. Supernatants were studied by dynamic light scattering and transmission electron microscopy when simulating free emission of nanoscale metal oxide particles from the surface of dental implants as well as when simulating physical loading. A comparative analysis of three parameters of nanoscale particles was performed by statistical data analysis. The surface of the “P” system dental implant with surface treatment was analyzed by scanning electron microscopy.

RESULTS: Both free emission of nanoscale oxide layer particles and yield of nano- and microscale particles during simulation of physical load were confirmed. Statistically significant differences were noted in a comparative analysis of the size and frequency of occurrence of these particles in the supernatants obtained from the surfaces of three dental implant systems. The elemental composition of the particles and the composition and structure of the “P” system dental implants themselves were analyzed.

SIGNIFICANCE: The developed method of dynamic light scattering can be used to compare the stability of the oxide layer of standardized medical products manufactured on the basis of the TiO₂ alloy.

PMID:35289284 | DOI:10.1016/j.dental.2022.03.003