Category: Nevin Manimala

Analyst. 2023 May 4. doi: 10.1039/d3an00511a. Online ahead of print.

ABSTRACT

A facile and high-resolution enhancement of latent fingerprints (LFPs) has been developed by using a wet nitrocellulose (NC) membrane as a matrix under natural light. A clear fingerprint pattern was presented on the membrane after a fingertip touch owing to the difference in light transmittance between the ridge residues and the wet-NC-membrane background. Compared with conventional methods, this protocol can provide a higher resolution fingerprint image to extract level 3 details accurately. It is also compatible with commonly used fingerprint visualization techniques (magnetic ferric oxide powder and AgNO₃. The modified membrane could be more general to realize the high-resolution visualization of LFP transferred from various substrates, even independent of light projection. Due to the excellent feasibility and reproducibility of level 3 details extracted by the wet NC membrane, the frequency distribution of the distance between adjacent sweat pores (FDDasp) could be used to effectively distinguish the fragmentary fingerprints. Finally, the level 3 features of LFPs from females and males were conveniently extracted by the wet-NC-membrane method for gender identification. The statistical results indicated that females had a higher average sweat pore density (115/9 mm²) than males (84/9 mm²). Taken together, this approach provided a high-resolution, reproducible, and accurate imaging of LFPs, which shows great promise for forensic information analysis.

PMID:37139711 | DOI:10.1039/d3an00511a

Musculoskeletal Care. 2023 May 4. doi: 10.1002/msc.1770. Online ahead of print.

ABSTRACT

BACKGROUND: Musculoskeletal shoulder pain is a common problem and its symptoms often become persistent. The experience of pain is multidimensional, and therefore, a range of patient characteristics may influence treatment response. An altered sensory processing has been associated with persistent musculoskeletal pain states and may contribute to outcomes in patients with musculoskeletal shoulder pain. The presence and potential impact of altered sensory processing in this patient cohort is not currently known. The aim of this prospective longitudinal cohort study is to investigate if baseline sensory characteristics are associated with clinical outcomes in patients presenting to a tertiary hospital with persistent musculoskeletal shoulder pain. If found, a relationship between sensory characteristics and outcome may lead to the creation of more effective treatment strategies and improvements in risk adjustment and prognosis.

METHODS: This is a single-centre prospective cohort study with 6-, 12- and 24-month follow-up. A total of 120 participants aged ≥18 years with persistent musculoskeletal shoulder pain (≥3 months) will be recruited from an Australian public tertiary hospital orthopaedic department. Baseline assessments, including quantitative sensory tests and a standardised physical examination, will be performed. In addition, information will be obtained from patient interviews, self-report questionnaires and medical records. Follow-up outcome measures will comprise information from the Shoulder Pain and Disability Index and a six-point Global Rating of Change scale.

ANALYSIS: Descriptive statistics will be used to report baseline characteristics and outcome measures over time. Change in outcome measures at the primary endpoint of six months from baseline will be calculated using paired t-tests. Associations between baseline characteristics and outcomes at a 6-month follow-up will be reported using multivariable linear and logistic regression models.

DISCUSSION: Understanding the relationship between sensory profile and the variable response to treatment in people with persistent musculoskeletal shoulder pain may enhance our understanding of the mechanisms contributing to the presentation. In addition, through better understanding of the contributing factors, the results of this study may contribute to the development of an individualised, patient-centred approach to treatment for people with this highly prevalent and debilitating condition.

PMID:37139704 | DOI:10.1002/msc.1770

Glob Health Action. 2023 Dec 31;16(1):2203544. doi: 10.1080/16549716.2023.2203544.

ABSTRACT

BACKGROUND: In India, caesarean delivery (CD) accounts for 17% of the births, of which 41% occur in private facilities. However, areas to CD in rural areas are limited, particularly for the poor populations. Little information is available on state-wise district-level CD rates by geography and the population wealth quintiles, especially in Madhya Pradesh (MP), the fifth most populous and third poorest state.

OBJECTIVE: Investigate geographic and socioeconomic inequities of CD across the 51 districts in MP and compare the contribution of public and private healthcare facilities to the overall state CD rate.

METHODS: This cross-sectional study utilised the summary fact sheets of the National Family Health Survey (NFHS)-5 performed from January 2019 to April 2021. Women aged 15 to 49 years, with live births two years preceding the survey were included. District-level CD rates in MP were used to determine the inequalities in accessing CD in the poorer and poorest wealth quintiles. CD rates were stratified as <10%, 10-20% and >20% to measure equity of access. A linear regression model was used to examine the correlation between the fractions of the population in the two bottom wealth quintiles and CD rates.

RESULTS: Eighteen districts had a CD rate below 10%, 32 districts were within the 10%-20% threshold and four had a rate of 20% or higher. Districts with a higher proportion of poorer population and were at a distance from the capital city Bhopal were associated with lower CD rates. However, this decline was steeper for private healthcare facilities (R2 = 0.382) revealing a possible dependency of the poor populations on public healthcare facilities (R2 = 0.009) for accessing CD.

CONCLUSION: Although CD rates have increased across MP, inequities within districts and wealth quintiles exist, warranting closer attention to the outreach of government policies and the need to incentivise CDs where underuse is significant.

PMID:37139686 | DOI:10.1080/16549716.2023.2203544

AIDS. 2023 Jun 1;37(7):1165-1166. doi: 10.1097/QAD.0000000000003550.

NO ABSTRACT

PMID:37139652 | DOI:10.1097/QAD.0000000000003550

Arch Esp Urol. 2023 Mar;76(2):161-168. doi: 10.56434/j.arch.esp.urol.20237602.18.

ABSTRACT

OBJECTIVE: To assess the clinical outcome of 1470 nm diode laser enucleation of the prostate (DiLEP) vs. bipolar transurethral enucleation of prostate (TUEP) for benign prostatic hyperplasia (BPH).

METHODS: One hundred and fifty-seven patients were retrospectively involved in this study. Eighty-two patients underwent DiLEP while 75 underwent bipolar TUEP. Seventy-three patients in DiLEP and sixty-nine in bipolar TUEP completed the 3-year follow-up, respectively. The baseline properties, perioperative data, and postsurgical outcomes were evaluated.

RESULTS: No statistically significant differences were found between DiLEP and bipolar TUEP in preoperative parameters. Significantly shorter operating time was noted in DiLEP group (p = 0.000). No patient suffered dangerous complications, and none in either group required a blood transfusion. No statistically significant differences were found between DiLEP and bipolar TUEP in the decrease in hemoglobin or sodium. During the 3-year postoperative follow-up, ongoing and significant improvements were found in both groups without any difference.

CONCLUSIONS: Both DiLEP and bipolar TUEP can improve low urinary tract symptoms (LUTS) secondary to BPH in a comparable way with high efficacy. Compared with bipolar TUEP, DiLEP with a morcellator required a shorter operative time.

PMID:37139622 | DOI:10.56434/j.arch.esp.urol.20237602.18

Arch Esp Urol. 2023 Mar;76(2):132-138. doi: 10.56434/j.arch.esp.urol.20237602.14.

ABSTRACT

AIM: To compare serum endothelial-specific molecule-1 (ESM-1 or endocan) levels between individuals with primary bladder cancer (BC) who have various pathological features of BC and healthy volunteers.

MATERIALS AND METHODS: 154 consecutive patients with primary BC (Group-1) and 52 healthy volunteers (Group-2) were accepted into this prospective, non-randomized, observational research between January 2017 and December 2018. Peripheral blood samples were obtained from each participant to measure serum ESM-1/endocan levels. Group-1 was further divided into subgroups as Group-1A (pTa), Group-1B (pT1) and Group-1C (pT2) based on the transurethral resection of bladder tumour (TURBT) histopathological results. In addition Group-1 was divided into other subgroups based on pathological features of BC including tumor grade, tumor volume and muscle-invasive status. Groups were compared statistically regarding ESM-1/endocan levels.

RESULTS: Median age of the individuals was 63 (22) years in Group-1 and 66 (11) years in Group-2 (p = 0.051). There were 140 (90.9%) males and 14 (9.1%) females in Group-1 and 30 (57.7%) males and 22 (42.3%) females in Group-2 (p < 0.001). The serum ESM-1/endocan measurements were lower in Group-2 than in Group-1 (p = 0.018). Of the patients in Group-1, 62 (40.3%) had low-grade tumors and 92 (59.7%) had high-grade tumors. When Group-1 was further divided into other subgroups according to different pathological features of BC such as tumor stage, grade, muscle-invasive status and tumor volume it was detected that there was a statistically meaningful difference between all subgroups of Group-1 and Group-2 in terms of serum ESM-1/endocan levels (p < 0.05 for each). The serum ESM-1/endocan cut-off value (3.472 ng/mL) had a specificity of 57.7%, sensitivity of 59.1%, NPV (negative predictive value) of 32.3% and PPV (positive predictive value) of 80.5% for predicting the presence of BC with an AUC (Area Under the Curve) of 0.609 (95% confidence interval (CI) 0.524-0.694; p = 0.018).

CONCLUSIONS: The serum ESM-1/endocan levels can be considered a potentially useful predictor for BC. Higher serum ESM-1/endocan levels are related with poor pathological outcomes in BC.

PMID:37139618 | DOI:10.56434/j.arch.esp.urol.20237602.14

J Med Ethics. 2023 May 3:jme-2023-108916. doi: 10.1136/jme-2023-108916. Online ahead of print.

ABSTRACT

Despite the frequent invocation of ‘false hope’ and possible related moral concerns in the context of assisted reproduction technologies, a focused ethical and conceptual problematisation of this concept seems to be lacking. We argue that an invocation of ‘false hope’ only makes sense if the fulfilment of a desired outcome (eg, a successful fertility treatment) is impossible, and if it is attributed from an external perspective. The evaluation incurred by this third party may foreclose a given perspective from being an object of hope. However, this evaluation is not a mere statistical calculation or observation based on probabilities but is dependent on several factors that should be acknowledgeable as morally relevant. This is important because it allows room for, and encourages, reasoned disagreement and moral negotiation. Accordingly, the object of hope itself, whether or not based on socially embedded desires or practices, can be a topic of debate.

PMID:37137697 | DOI:10.1136/jme-2023-108916

Inj Prev. 2023 May 3:ip-2023-044855. doi: 10.1136/ip-2023-044855. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess implementation fidelity of the Stay One Step Ahead (SOSA), a complex intervention which was delivered by health visiting teams, children’s centres, and family mentors and was aimed at preventing unintentional home injuries in children under 5 in disadvantaged communities.

STUDY DESIGN: A mixed-methods evaluation of the implementation fidelity of the SOSA intervention.

METHODS: A conceptual framework for implementation fidelity was used to triangulate data from questionnaires and semistructured interviews with parents and practitioners, observations of parent and practitioner contacts, and meeting documents. Quantitative data were analysed using logistic regression and descriptive statistics. Thematic analysis was used for qualitative data.

RESULTS: Parents in intervention wards were more likely to receive home safety advice from a practitioner than those living in matched control wards. Monthly safety messages and family mentor home safety activities were delivered with greater fidelity than other intervention components. Content most frequently adapted included the home safety checklist used by health visiting teams, and safety weeks delivered at children’s centres.

CONCLUSION: Consistent with similarly complex interventions, SOSA was delivered with variable fidelity in a challenging environment. The findings add to the body of evidence on implementation fidelity of home injury prevention programmes, providing important information for future intervention development and delivery.

PMID:37137688 | DOI:10.1136/ip-2023-044855

Eur J Hosp Pharm. 2023 May 3:ejhpharm-2023-003738. doi: 10.1136/ejhpharm-2023-003738. Online ahead of print.

ABSTRACT

OBJECTIVE: 24-hour urine creatinine clearance (ClCr 24 hours) remains the gold standard for estimating glomerular filtration rate (GFR) in critically ill patients; however, simpler methods are commonly used in clinical practice. Serum creatinine (SCr) is the most frequently used biomarker to estimate GFR; and cystatin C, another biomarker, has been shown to reflect GFR changes earlier than SCr. We assess the performance of equations based on SCr, cystatin C and their combination (SCr-Cyst C) for estimating GFR in critically ill patients.

METHODS: Observational unicentric study in a tertiary care hospital. Patients with cystatin C, SCr and ClCr 24 hours measurements in ±2 days admitted to an intensive care unit were included. ClCr 24 hours was considered the reference method. GFR was estimated using SCr-based equations: Chronic Kidney Disease Epidemiology Collaboration based on creatinine (CKD-EPI-Cr) and Cockcroft-Gault (CG); cystatin C-based equations: CKD-EPI-CystC and CAPA; and Cr-CystC-based equations: CKD-EPI-Cr-CystC. Performance of each equation was assessed by calculating bias and precision, and Bland-Altman plots were built. Further analysis was performed with stratified data into CrCl 24 hours <60, 60-130 and ≥130 mL/min/1.73 m².

RESULTS: We included 275 measurements, corresponding to 186 patients. In the overall population, the CKD-EPI-Cr equation showed the lowest bias (2.6) and best precision (33.1). In patients with CrCl 24 hours <60 mL/min/1.73 m², cystatin-C-based equations showed the lowest bias (<3.0) and CKD-EPI-Cr-CystC was the most accurate (13.6). In the subgroup of 60≤ CrCl 24 hours <130mL/min/1.73 m², CKD-EPI-Cr-CystC was the most precise (20.9). However, in patients with CrCl 24 hours ≥130mL/min/1.73 m², cystatin C-based equations underestimated GFR, while CG overestimated it (22.7).

CONCLUSIONS: Our study showed no evidence of superiority of any equation over the others for all evaluated parameters: bias, precision and Lin’s concordance correlation coefficient. Cystatin C-based equations were less biased in individuals with impaired renal function (GFR <60 mL/min/1.73 m²). CKD-EPI-Cr-CystC performed properly in patients with GFR from 60-130 mL/min/1.73 m² and none of them were accurate enough in patients ≥130 mL/min/1.73 m².

PMID:37137686 | DOI:10.1136/ejhpharm-2023-003738

Open Heart. 2023 May;10(1):e002224. doi: 10.1136/openhrt-2022-002224.

ABSTRACT

BACKGROUND: Structural changes caused by spinal curvature may impact the organs within the thoracic cage, including the heart. Cardiac abnormalities in patients with idiopathic scoliosis are often studied post-corrective surgery or secondary to diseases. To investigate cardiac structure, function and outcomes in participants with scoliosis, phenotype and imaging data of the UK Biobank (UKB) adult population cohort were analysed.

METHODS: Hospital episode statistics of 502 324 adults were analysed to identify participants with scoliosis. Summary 2D cardiac phenotypes from 39 559 cardiac MRI (CMR) scans were analysed alongside a 3D surface-to-surface (S2S) analysis.

RESULTS: A total of 4095 (0.8%, 1 in 120) UKB participants were identified to have all-cause scoliosis. These participants had an increased lifetime risk of major adverse cardiovascular events (MACEs) (HR=1.45, p<0.001), driven by heart failure (HR=1.58, p<0.001) and atrial fibrillation (HR=1.54, p<0.001). Increased radial and decreased longitudinal peak diastolic strain rates were identified in participants with scoliosis (+0.29, P_adj <0.05; -0.25, P_adj <0.05; respectively). Cardiac compression of the top and bottom of the heart and decompression of the sides was observed through S2S analysis. Additionally, associations between scoliosis and older age, female sex, heart failure, valve disease, hypercholesterolemia, hypertension and decreased enrolment for CMR were identified.

CONCLUSION: The spinal curvature observed in participants with scoliosis alters the movement of the heart. The association with increased MACE may have clinical implications for whether to undertake surgical correction. This work identifies, in an adult population, evidence for altered cardiac function and an increased lifetime risk of MACE in participants with scoliosis.

PMID:37137668 | DOI:10.1136/openhrt-2022-002224