Category: Nevin Manimala

S D Med. 2024 Jul;77(7):300-303.

ABSTRACT

BACKGROUND: Rates of neonatal early onset sepsis (EOS) in term infants have recently decreased. The 2018 AAP guidelines for the management of infants at risk for early onset sepsis allows for using a multivariate risk assessment to determine need for empiric antibiotics in infants 35 weeks or greater, including those exposed to chorioamnionitis.

METHODS: A quality improvement (QI) project was undertaken to implement use of EOS calculator in chorioamnionitis exposed infants with an aim to safely decrease antibiotic exposure. Multiple Plan-Do-Study-Act (PDSA) cycles occurred to implement the change. Data regarding antibiotics, labs, length of stay and safety metrics were collected.

RESULTS: Implementing the EOS calculator’s use in chorioamnionitis exposed neonates decreased antibiotic exposure from 100% to 75%, and decreased average duration of antibiotics from 68 to 40 hours. Implementation decreased prolonged courses of antibiotics, lumbar punctures, length of stay and laboratory tests. No cases of early culture confirmed EOS were missed, and none occurred in this well appearing population.

CONCLUSIONS: Quality improvement initiatives to implement evidence-based tools can safely and appropriately decrease antibiotic exposure in neonates.

PMID:39013184

J Phys Chem A. 2024 Jul 16. doi: 10.1021/acs.jpca.4c03259. Online ahead of print.

ABSTRACT

The sulfonylurea herbicide family has been extensively studied using computational techniques. The most stable conformer structures of the 34 molecules analyzed in gaseous, aqueous, and octanol phases have been determined. The study employed CREST conformational search methods along with the CENSO script to explore all possible conformational structures. Additional evaluations conducted at the B3LYP-D3/6-311+G(d,p) level have enabled the identification of intramolecular stability patterns across the various compounds. It has been discovered that stability is primarily determined by two factors: intramolecular hydrogen bonding involving an NH group adjacent to the sulfonyl group with either N donors or the nearby carbonyl group and potential π-π interactions between the aromatic rings of the molecules. These have been characterized through QTAIM and NCI population analyses. Furthermore, with the goal of developing predictive models for the physicochemical properties of pesticides that include the sulfonylurea family, a statistical analysis among the different properties of the studied molecules has been conducted. Significant correlations have been found between various properties, predicting a promising future for the prediction of characteristics that could assist laboratories in selecting among different pesticides.

PMID:39013157 | DOI:10.1021/acs.jpca.4c03259

J Trauma Nurs. 2024 Jul-Aug 01;31(4):E8. doi: 10.1097/JTN.0000000000000805. Epub 2024 Jul 4.

NO ABSTRACT

PMID:39013143 | DOI:10.1097/JTN.0000000000000805

J Trauma Nurs. 2024 Jul-Aug 01;31(4):E7. doi: 10.1097/JTN.0000000000000804. Epub 2024 Jul 4.

NO ABSTRACT

PMID:39013142 | DOI:10.1097/JTN.0000000000000804

JMIR Public Health Surveill. 2024 Jun 13. doi: 10.2196/53331. Online ahead of print.

ABSTRACT

BACKGROUND: This study updates the COVID-19 pandemic surveillance in South Asia we first conducted in 2020 with two additional years of data for the region. We assess whether COVID-19 had transitioned from pandemic to endemic at the point the World Health Organization (WHO) ended the publication health emergency status for COVID-19 on May 5, 2023.

OBJECTIVE: First, we aim to measure whether there was an expansion or contraction in the pandemic in South Asia around the WHO declaration. Second, we use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Third, we aim to provide historical context for the course of the pandemic in South Asia.

METHODS: In addition to updates of traditional surveillance data and dynamic panel estimates from the original study Welch et al. (2021), this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a one-sided t-test for whether regional weekly speed or transmission rate per 100,000 population was greater than an outbreak threshold of ten. We ran the test iteratively with six months of data across the sample period.

RESULTS: Speed for the region remained below the outbreak threshold for over a year by the time of the WHO declaration. Acceleration and jerk were also low and stable. While the 1-day persistence coefficients remained statistically significant and positive (1.168), the 7-day persistence coefficient was negative (-0.185), suggesting limited cluster effects in which cases on a given day predict cases seven days forward. Furthermore, the shift parameters for either of the two most recent weeks around May 5, 2023, did not indicate any overall change in the persistence measure around the time of WHO declaration. From December of 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t-test of speed equal to ten was statistically insignificant across the entire pandemic.

CONCLUSIONS: While COVID-19 continues to circulate in South Asia, the rate of transmission had remained below the outbreak threshold for well over a year ahead of the WHO declaration. COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. Both standard and enhanced surveillance metrics confirm that the pandemic had ended by the time of the WHO declaration. Prevention policies should be a focus ahead of future pandemics. On that point, policy should emphasize an epidemiological task force with widespread testing and a contact-tracing system.

PMID:39013116 | DOI:10.2196/53331

JMIR Public Health Surveill. 2024 Apr 29. doi: 10.2196/52318. Online ahead of print.

ABSTRACT

BACKGROUND: This study updates the COVID-19 pandemic surveillance in Central Asia we first conducted in 2020 by providing two additional years of data for the region. The historical context provided through additional data can inform regional preparedness and early responses to infectious outbreaks of either the SARS-CoV-2 virus or future pathogens in Central Asia.

OBJECTIVE: First, we aim to measure whether there was an expansion or contraction in the pandemic in Central Asia when the World Health Organization (WHO) declared the end of the public health emergency for the COVID-19 pandemic on May 5, 2023. Second, we use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Third, we aim to provide historical context for the course of the pandemic in Central Asia.

METHODS: Traditional surveillance metrics, including counts and rates of COVID-19 transmissions and deaths, and enhanced surveillance indicators, including speed, acceleration, jerk, and persistence, were used to measure shifts in the pandemic. To identify the appearance and duration of variants of concern, we used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID). We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a one-sided t-test for whether regional speed was greater than an outbreak threshold of ten. We ran the test iteratively with six months of data across the sample period.

RESULTS: Speed for the region had remained below the outbreak threshold for seven months by the time of the WHO declaration. Acceleration and jerk were also low and stable. While the 1- and 7-day persistence coefficients remained statistically significant, the coefficients were relatively small in magnitude (0.125 and 0.347, respectively). Furthermore, the shift parameters for either of the two most recent weeks around May 5, 2023, were both significant and negative, meaning the clustering effect of new COVID-19 cases became even smaller in the two weeks around the WHO declaration. From December 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t-test of speed equal to ten became entirely insignificant for the first time in March of 2023.

CONCLUSIONS: While COVID-19 continues to circulate in Central Asia, the rate of transmission remained well below the threshold of an outbreak for seven months ahead of the WHO declaration. COVID-19 appeared to be endemic in the region and no longer reached the threshold of pandemic. Both standard and enhanced surveillance metrics suggest the pandemic had ended by the time of the WHO declaration.

PMID:39013115 | DOI:10.2196/52318

JMIR Public Health Surveill. 2024 Jun 13. doi: 10.2196/53409. Online ahead of print.

ABSTRACT

BACKGROUND: This study updates the COVID-19 pandemic surveillance in Sub-Saharan Africa (SSA) we first conducted in 2020 by providing two additional years of data for the region.

OBJECTIVE: First, we aim to measure whether there was an expansion or contraction in the pandemic in SSA when the World Health Organization (WHO) declared the end of the public health emergency for the COVID-19 pandemic on May 5, 2023. Second, we use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Third, we aim to provide historical context for the course of the pandemic in SSA.

METHODS: In addition to updates of traditional surveillance data and dynamic panel estimates from the original study by Post et al. (2021), this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a one-sided t-test for whether regional weekly speed was greater than an outbreak threshold of ten. We ran the test iteratively with a rolling, six month-window of data across the sample period.

RESULTS: Speed for the region remained well below the outbreak threshold before and after the WHO declaration. Acceleration and jerk were also low and stable. The 7-day persistence coefficient remained somewhat large (1.11) and statistically significant. However, both shift parameters for the weeks around the WHO declaration were negative, meaning the clustering effect of new COVID-19 cases had become recently smaller. From November 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t-test of speed equal to ten was insignificant for the entire sample period.

CONCLUSIONS: While COVID-19 continues to circulate in SSA, the region never reached outbreak status, and the weekly transmission rate had remained below one case per 100,000 population for well over one year ahead of the WHO declaration. COVID-19 is endemic in the region and no longer reaches the threshold of a pandemic definition. Both standard and enhanced surveillance metrics confirm that the pandemic had ended in SSA by the time of the WHO declaration.

PMID:39013111 | DOI:10.2196/53409

Genetics. 2024 Jul 16:iyae100. doi: 10.1093/genetics/iyae100. Online ahead of print.

ABSTRACT

As a result of recombination, adjacent nucleotides can have different paths of genetic inheritance and therefore the genealogical trees for a sample of DNA sequences vary along the genome. The structure capturing the details of these intricately interwoven paths of inheritance is referred to as an ancestral recombination graph (ARG). Classical formalisms have focused on mapping coalescence and recombination events to the nodes in an ARG. However, this approach is out of step with some modern developments, which do not represent genetic inheritance in terms of these events or explicitly infer them. We present a simple formalism that defines an ARG in terms of specific genomes and their intervals of genetic inheritance, and show how it generalizes these classical treatments and encompasses the outputs of recent methods. We discuss nuances arising from this more general structure, and argue that it forms an appropriate basis for a software standard in this rapidly growing field.

PMID:39013109 | DOI:10.1093/genetics/iyae100

S D Med. 2024 Jun;77(6):252-256.

ABSTRACT

INTRODUCTION: Facial lacerations are a common reason for emergency department (ED) visits in the U.S. Proper laceration repair is imperative as poor wound management can lead to functional and aesthetic impairment and significantly impact patient quality of life. For the best outcomes and long-term scar reduction, treatment by and follow-up with a plastic surgeon or facial trauma specialist is recommended. The present study examines variations in facial trauma specialist consultation and referral by ED provider type for adult patients at hospitals within a large rural South Dakota health system.

METHODS: Records for patients above the age of 18 who received treatment for facial lacerations between January 1, 2017 and January 1, 2022 were retrospectively reviewed across multiple hospitals in South Dakota, spanning a large rural catchment area. Multivariable logistic regression and Fisher’s exact test were performed to examine the relationship between ED provider type and the probability of receiving specialty consult and/or referral.

RESULTS: One hundred fifty-four ED visits were included in the analysis. Among these patients, 53 received specialty consult and/or follow-up referral and 101 were treated without consult or referral. ED provider type was significantly associated with the probability of having a specialty consult (OR = 5.11, 95% CI [1.05, 24.96]). When the patients had a certified nurse practitioner (CNP) as their ED provider, they had a significantly higher chance (40%) of receiving specialist consultation.

CONCLUSION: For patients presenting to the ED with facial lacerations, facial trauma specialist consultation and referral for follow up varies based on provider type. CNPs placed specialist consultations more often than other ED provider types.

PMID:39013096

Magy Onkol. 2024 Jul 16;68(2):95-112. Epub 2024 Apr 30.

ABSTRACT

The objective of our study was to map county differences in incidence and mortality by cancers and examine their changes over time. Based on the database of National Cancer Registry and Central Statistical Office, age-standardized incidence and mortality rates per 100,000 person-years were calculated for each county for 15 cancer types and 3 time periods. East-West divide was apparent in incidence and mortality of lung cancer, with larger weight in East (Borsod-Abaúj-Zemplén, Heves, Jász-Nagykun-Szolnok, Békés counties). Concentration of lip and oral cavity malignancies was identified in the northeastern periphery (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg counties). Breast cancer incidence was the highest in Budapest. As a conclusion, changes in cancer incidence and mortality over time were similar to developed countries; however, values were higher. Differences in spatial distribution follow territorial pattern of social deprivation, which correspond to higher prevalence of health risk factors. Our study contributes to planning of public health programs by pinpointing regional inequalities in different cancer types.

PMID:39013084