Category: Nevin Manimala

Dig Liver Dis. 2024 Oct 26:S1590-8658(24)01062-4. doi: 10.1016/j.dld.2024.10.018. Online ahead of print.

ABSTRACT

BACKGROUND: In liver cirrhosis, prognosis is profoundly affected by renal function. This study evaluates the usefulness of renal stiffness measurement by point-shear wave elastography and renal perfusion by duplex.

METHODS: In this case-control study, organ stiffness was quantified using point-shear wave elastography and duplex sonography to calculate the arterial resistive (RI) and pulsatility indices (PI) in 123 patients, including patients with liver cirrhosis with (LC+A) and without ascites (LC-A) and patients without liver cirrhosis (NLC).

RESULTS: PI and RI were significantly increased in LC-A and LC+A compared to NLC (p<0.001) and correlated with MELD and Child Pugh scores. Point-shear wave elastography showed significantly lower renal stiffness in LC+A compared to LC-A (p<0.01) and NLC (p<0.001). Renal stiffness correlated inversely with MELD and Child Pugh scores. Reduced renal stiffness, but not PI or RI, was associated with the presence of hepatorenal syndrome (p<0.001). Reduced renal stiffness was associated with an increased risk of death due to complications of liver cirrhosis within 3 years (p<0.01).

CONCLUSION: Point-shear wave elastography and duplex sonography correlate with progression of liver cirrhosis, but only shear wave elastography represents a valuable prognostic tool for hepatorenal syndrome and mortality in patients with liver cirrhosis.

PMID:39462713 | DOI:10.1016/j.dld.2024.10.018

Animal. 2024 Sep 26:101346. doi: 10.1016/j.animal.2024.101346. Online ahead of print.

ABSTRACT

Due to intensification processes that have had negative impacts on environmental externalities, pastoral farmers, worldwide, are facing increasing scrutiny and pressure from consumers, governments, and the public to reduce the environmental footprint of their operations. Developing tools and systems that farmers can use to maintain profitability and productivity while decreasing the negative externalities of their operations is important for the vitality of rural sectors. Capitalising on individual animal variation has been promoted as an opportunity to increase animal productivity and enhance welfare while decreasing the negative environmental impacts of pastoral farming. Of particular interest are behaviours that are associated with foraging, as these are the primary drivers of variation in animal performance in pastoral farming. Developing a methodology that can identify consistent foraging behavioural variations across individuals is a critical step in making this a practical solution for farmers and herders. As with all behavioural research, the fundamental challenge is selecting the appropriate behaviours to measure. Understanding the contextual drivers of behavioural expression is a major development in this process. Herd management and composition, environmental variables and many more contexts alter the expression of behaviours, so how do we capture behaviours of interest? We propose the use of a systematic methodology to capture behaviours of significance from large groups of foraging ruminants using wearable technology, namely Global Positioning System and accelerometers. This contrasts with traditional reductionist methodologies used in behaviour research and has the benefit of providing large objective datasets from undisturbed animals. Statistical analysis of the data will inform behaviours of interest that are clustered together to inform a three-factor foraging behaviour syndrome model adapted from the animal five-factor model (activity, aggression, boldness, exploration, sociability) of personality. Syndromes, unlike personalities, include correlated suites of behaviours that are expressed across spatial and temporal contexts. By capturing foraging behaviour syndromes, selection can be used to match appropriate syndromes to different pastoral farming landscapes, thereby potentially improving the system’s productivity while reducing their negative environmental impact.

PMID:39462708 | DOI:10.1016/j.animal.2024.101346

Transplant Proc. 2024 Oct 26:S0041-1345(24)00540-2. doi: 10.1016/j.transproceed.2024.10.013. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric hematopoietic stem cell transplantation often results in pulmonary complications, yet limited data exist on pulmonary function in Thailand. This study aims to assess pulmonary function, investigating associated complications and identifying clinical factors linked to pre- and post-transplant pulmonary function defects.

METHODS: In this retrospective cohort study, we focused on children aged 6-18 years who underwent hematopoietic stem cell transplantation between 1999 and 2020, ensuring accessible pulmonary function tests results.

RESULTS: Among 48 patients, abnormal pulmonary function pre- and post-transplant (2-8 years) included a diffusion defect in 16.7% and 18.8%, a restrictive defect in 20.8% and 8.3%, and an obstructive defect in 4.2% and 10.4%, respectively. Pulmonary complications occurred in 16 patients (33.3%), including 15 infections and 1 case of bronchiolitis obliterans. While pretransplant pulmonary function defects were not significantly associated with specific characteristics, post-transplant pulmonary complications correlated with post-transplant pulmonary function defects (aOR = 4.11, 95% CI = 1.23-13.64, P = .02). Among the 6 patients with pre- and post-transplant follow-up, those with pulmonary complications showed a discernible decline in pulmonary function over time, while those without pulmonary complications remained stable or improved. However, the differences between these groups did not reach statistical significance (P = .13-.76).

CONCLUSIONS: Prevalent pulmonary function defects and complications in pediatric hematopoietic stem cell transplantation highlight the importance of close pulmonary function monitoring. Post-transplant pulmonary complications are associated with defects, suggesting a potential trend of a subsequent decline in lung function, warranting further prospective validation.

PMID:39462701 | DOI:10.1016/j.transproceed.2024.10.013

J Pediatr Surg. 2024 Oct 19:162023. doi: 10.1016/j.jpedsurg.2024.162023. Online ahead of print.

ABSTRACT

BACKGROUND: Anterior anus is considered part of the spectrum of anorectal malformations in girls and has been associated with childhood constipation. However, limited literature exists on outcomes and associated malformations.

METHODS: All girls <6 months referred to our centre with suspected anterior anus between January 2015 and December 2022 were identified. Data collected included patient demographics, presence of anomalies, operative management, laxative use and continence. Results are described using descriptive statistics and percentages.

RESULTS: 147 girls were referred with suspected anterior anus of which 95 were confirmed to have an anterior anus. Median age of first assessment was 3 (0-13) months. Median follow up was 24 (1-94) months. 21 (22.1 %) had clinical concern of partial absence of normal circumferential anal corrugation. 10 (10.5%) girls underwent examination under anaesthesia; 4 patients underwent anoplasty with covering colostomy. Laxatives were prescribed in 31 (32.6%) girls. Of the 53 patients followed up to age 4 years and older, 51 (96.2%) achieved continence. On renal ultrasonography significant hydroureteronephrosis was detected in one patient. No significant spinal anomalies were detected on imaging. Two patients had ventricular-septal defects were identified. All significant anomalies were in patients with an ectopic anus/ perineal fistula.

CONCLUSION: This represents the largest reported series of girls with anterior anus. The incidence of identified associated malformations was low. Furthermore, laxative use and continence outcomes are similar to the general infant/childhood population. Screening and routine follow-up should be reserved for individual cases where there is clinical concern.

PMID:39462697 | DOI:10.1016/j.jpedsurg.2024.162023

J Environ Qual. 2024 Oct 27. doi: 10.1002/jeq2.20645. Online ahead of print.

ABSTRACT

The Gulf Atlantic Coastal Plain (GACP) Long-Term Agroecosystem Research (LTAR) Network site is characterized by hot and humid summers with low gradient stream channels surrounded by wetland forests and croplands. Beneath its sandy soils, a confining layer stifles recharge to the deeper aquifer system, so a substantial proportion of streamflow is driven by shallow subsurface baseflow. Agricultural practices in the area consist of forage and livestock production, forestry, and rotational cropping systems dominated by cotton (Gossypium hirsutum) and peanut (Arachis hypogaea). Certain factors impose challenges to the viability of GACP agricultural systems, like changing economics and demographics, as well as pest and disease pressures. The GACP communicates with stakeholders from various backgrounds, who provide their perspectives as agricultural research service scientists execute their research plans. The GACP LTAR common experiment (CE) is carried out via plot- and field-scale studies. The plot-scale CE compares prevailing practices, determined from regional data, with an alternative treatment including winter covers, such as the biofuel feedstock carinata (Brassica carinata, A. Braun), to provide both economic and environmental benefits. The field-scale CE is observational; key variables are monitored for two farms where management practices largely emulate the prevailing treatment. Data collection efforts quantify vegetation, hydrology, soils, and climate data to produce datasets for modeling and statistical analysis. Research teams quantify relationships between land management, environment, and socioeconomic benefits. Ultimately, the GACP LTAR site works to facilitate agricultural system health and wellbeing at local, regional, and national scales by providing long-term science-based solutions.

PMID:39462689 | DOI:10.1002/jeq2.20645

J Orthop Surg (Hong Kong). 2024 Sep-Dec;32(3):10225536241292397. doi: 10.1177/10225536241292397.

ABSTRACT

BACKGROUND: Innovation has in common the promise of benefit for patients; however, past experience has shown that this promise is not always delivered. Instead, low-value innovation might encourage treatment variation and dilute the available body of evidence. This study aims to investigate (1) whether the peer-review process is capable of filtering out low-value innovation appropriately, and (2) whether low-value surgical innovation would be preferred more often than nonoperative innovation by peer-reviewers in the treatment of proximal humeral fractures in the elderly.

MATERIALS AND METHODS: Two duplicated sham scientific abstracts, respectively introducing a low-value surgical innovation and a valuable nonsurgical innovation, were submitted to nineteen peer-reviewed scientific meetings worldwide for orthopedic trauma surgery with submission deadlines between 01/01/2022 and 31/12/2022. Decision regarding abstract acceptance was compared.

RESULTS: There was a high acceptance rate for the abstract introducing low-value surgical innovation (12 out of 19 (63.2 %)), which was higher than that of a nonoperative duplicate (10 out of 19 (52.6 %)), but this difference was not statistically significant (p = 0.5). The majority of the ten meetings that accepted both abstracts placed both in equivalent programmatic tiers (oral presentation (4) and poster presentation (2)). In three meetings, the surgical abstract received superior program placement (oral presentation). In one case, it was the opposite.

CONCLUSION: There is a high acceptance rate for low-value surgical innovation among peer-reviewed scientific meetings. However, we can not conclude that low-value surgical innovation is preferred more often than nonoperative innovation by peer-reviewers as the differences in acceptance rate were small and not statistically significant. The peer-review process may be suitable as value-based medicine emerges. Scientists should be encouraged to pursue value-based innovation.

PMID:39462646 | DOI:10.1177/10225536241292397

Am J Hosp Palliat Care. 2024 Oct 27:10499091241290500. doi: 10.1177/10499091241290500. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate knowledge of Palliative Care (PC) and the impact of systemic and patient-related factors on the use of PC in a diverse population of men and women diagnosed with metastatic breast cancer.

METHODOLOGY: A telephone administered survey was used with patients receiving treatment at a Cancer Center in an urban area of the Northeast US. Descriptive statistics and chi square analysis were used.

FINDINGS: Of the 101 participants, 44% had no knowledge of PC and only 21.78% indicated that they were receiving palliative care. Participants who reported being followed by palliative care were less likely to have been treated in the emergency department in the past year (P = 0.003) or to have been hospitalized (P = 0.042). However, when asked about symptom burden, using the Edmonton Symptom Assessment Scale, patients who reported being followed by PC were more likely to report severe pain as compared to patients not receiving PC (P < 0.001). There were no associations found between race/ethnicity or social determinants of health and knowledge of PC or receipt of services.

CONCLUSIONS: This sample of men and women diagnosed with metastatic breast cancer and being treated in a Cancer Center had limited knowledge and exposure to Palliative Care services across race and ethnicity. While no specific disparity was noted, the utilization of PC was low. Whether a function of a lack of referrals or patient preference, an effort should be made to increase PC referrals for all patients diagnosed with cancer.

PMID:39462642 | DOI:10.1177/10499091241290500

Mycoses. 2024 Oct;67(10):e13808. doi: 10.1111/myc.13808.

ABSTRACT

BACKGROUND: Tinea capitis is an infectious dermatosis frequent in children, causative fungi variable over time and space. The risk factors associated with this disease are still poorly understood. The objective of this study was to estimate the prevalence of tinea capitis among schoolchildren in Lomé (Togo), identify the fungal species involved and assess the associated risk factors.

PATIENTS AND METHODS: It was a cross-sectional and case-control study conducted in primary schools in Lomé from November 2020 to April 2021. All pupils presenting tinea capitis suspected lesions have been sampled, and the scraping and hair were examined by direct microscopy in KOH solution and cultured in Sabouraud dextrose agar with chloramphenicol and cycloheximide. Positive children were matched by age and sex with those without symptoms for case-control study.

RESULTS: Out of the 15,087 pupils enrolled, 465 had positive cultures for dermatophytes, corresponding to the tinea capitis prevalence of 3.08% (95% CI [2.59-3.57]). Trichophyton mentagrophytes (81.86%) and Trichophyton soudanense (13.12%) were the majors isolated dermatophytes. The risk factors were mostly living in households with domestic animals, showering less than twice a day, having a history of ringworm, having similar lesions in the same household and sharing personal hygiene items.

CONCLUSION: This study highlights the low prevalence of tinea capitis in schoolchildren in Lomé (Togo), the causative species dominated by T. mentagrophytes and emphasises the importance of environmental and behavioural factors in the mycosis transmission. Implementing preventive measures addressing the identified factors could help to reduce the prevalence of this disease.

PMID:39462641 | DOI:10.1111/myc.13808

Nurs Health Sci. 2024 Dec;26(4):e13184. doi: 10.1111/nhs.13184.

ABSTRACT

This article aims to describe the methodology for the design, validation, reliability, and pilot testing of a questionnaire aimed at exploring the knowledge and training needs on health inequalities of occupational health nurses (OHNs) and occupational health nursing students in Spain. Working and employment conditions are social determinants that influence the health of workers. The unequal distribution of these factors leads to inequalities. The training and competencies of OHNs need to focus on the social determinants of health to reduce social inequalities. The questionnaire was structured in five sections and 24 closed questions, self-administered and online. It was validated by a panel of experts using Moriyama’s criteria and achieved an average consensus of 93.85%. Internal reliability reached a Cronbach’s alpha coefficient of 0.843 and a McDonald’s omega of 0.953. Participation in the pilot test was 92.5% of the sample recruited. Achieving higher levels of health of the working population requires a consensus among different social actors to integrate social determinants, gender and equity perspectives into the overall health policy of the company.

PMID:39462639 | DOI:10.1111/nhs.13184

Mycoses. 2024 Oct;67(10):e13810. doi: 10.1111/myc.13810.

ABSTRACT

OBJECTIVES: Allergic bronchopulmonary aspergillosis (ABPA) is a complex lung disease associated with significant morbidity. The ABPA Working Group (AWG) of the International Society for Human and Animal Mycology (ISHAM) revised their management guidelines in 2024, but there is currently no standardised tool to assess adherence to these recommendations.

METHODS: We extracted key recommendations from the updated 2024 ISHAM-AWG guidelines, focusing on critical areas: screening and diagnosis of ABPA, managing acute and treatment-dependent ABPA, and monitoring treatment response. Each item was assigned a score ranging from zero to three. We assigned negative scores to interventions not recommended by the guidelines.

RESULTS: We identified 38 items indicative of optimal clinical care for patients with ABPA. The score for screening asthmatics for ABPA was set at three points. For diagnosing ABPA, 16 items were included, with a score ranging from 12 to 16 points, depending on the specific components used (predisposing conditions, serum A. fumigatus-specific IgE and IgG, serum total IgE, blood eosinophil count and chest computed tomography). The management of acute ABPA comprised 11 items, with a maximum score of three points. For treatment-dependent ABPA, there were nine items (scores ranging from -3 to 6). Follow-up care comprised 10 items with a maximum score of 10-13 points, covering imaging, spirometry, testing serum total IgE levels and therapeutic drug monitoring.

CONCLUSIONS: The EQUAL ABPA score has been developed as a comprehensive tool to quantify guideline adherence. Future studies will evaluate to which extent guideline adherence is associated with improved clinical outcomes for patients with ABPA.

PMID:39462638 | DOI:10.1111/myc.13810