Category: Nevin Manimala

Dermatol Ther. 2022 May 20:e15586. doi: 10.1111/dth.15586. Online ahead of print.

ABSTRACT

INTRODUCTION: Doxycilicine is the second-line treatment of choice for infectious syphilis when treatment with penicillin G is not feasible. To date, difficulties in the penicillin supply chain make it necessary to evaluate and resort to antibiotic therapies which are currently considered a second-line choice. Moreover, systematic studies comparing the two treatments in affected patients are still few, and many do not consider late and indeterminate latent infections.

OBJECTIVES: The objective of this study was to assess the differences in the serological response of the treatment of syphilis infections with benzathine penicillin compared with doxycycline.

METHODS: We built an in-house database with all patients diagnosed with syphilis infection from January 2010 to January 2020 in the STD Centre of the S.Orsola-Malpighi Polyclinic of the University of Bologna, located in the North-east of Italy. We recorded all the principal independent (demographic, social status, reinfection rare, HIV infections, comorbidities, sexual behaviours and initial TPHA values) and dependent variables (RPR values). We then extrapolated all patients treated with doxycycline (100 mg of doxycycline twice daily for 14 days for infections diagnosed within the first year and a 28 days course for infections older than one year or undetermined) and matched in 1:1 ratio numbers with a homogeneous group of patients treated with penicillin G (2.4 million units in a single dose intramuscularly for infections diagnosed within the first year and a cycle consisting in of 2.4 million units administred in a single dose per week for three weeks for infections older than one year or undetermined) We then analyzed the serological trends and outcomes in the primary, secondary and early latent subgroups versus late latent and undetermined infections.

RESULTS: We retrieved 41 patients for each group with homogeneous initial characteristics. At the end of the 24-month observation period, a slight difference in a valid RPR reduction rate emerged, with a greater success rate emerged in patients receiving penicillin than those with doxycycline (26 vs 22, P 0.615). Indeed, patients with latent or indeterminate syphilis treated with doxycycline appear to have a higher rate of serofast than those treated with penicillin. Linear regression analysis showed no strong correlation between the analyzed independent variables and the observed outcomes.

CONCLUSION: Doxycycline had a slightly lower, though not statistically different, success rate when compared with penicillin in treating primary syphilis, but had a lower success rate in attaining resolution in late and undetermined syphilis infection. This article is protected by copyright. All rights reserved.

PMID:35594004 | DOI:10.1111/dth.15586

Environ Sci Pollut Res Int. 2022 May 20. doi: 10.1007/s11356-022-20787-w. Online ahead of print.

ABSTRACT

The present study attempts to delineate wetlands in the lower Tangon river basin in the Barind flood plain region using spectral water body extraction indices. The main objectives of this present study are simulating and predicting wetland areas using the advanced artificial neural network-based cellular automata (ANN-CA) model and water depth using statistical (adaptive exponential smoothing) as well as advanced machine learning algorithms such as Bagging, Random Subspace, Random Forest, Support vector machine, etc. The result shows that RmNDWI and NDWI are the representative wetland delineating indices. NDWI map was used for water depth prediction. Regarding the prediction of wetland areas, a remarkable decline is likely to be identified in the upcoming two decades. The small wetland patches away from the master stream are expected to dry out during the predicted period, where the major wetland patches nearer to the master stream with greater water depth are rather sustainable, but their depth of water is predicted to be reduced in the next decades. All models show satisfactory performance for wetland depth mapping, but the random subspace model was identified as the best-suited water depth predicting method with an acceptable prediction accuracy (root mean square error <0.34 in all the years) and the machine learning models explored better result than adaptive exponential smoothing. This recent study will be very helpful for the policymakers for managing wetland landscape as well as the natural environment.

PMID:35593982 | DOI:10.1007/s11356-022-20787-w

Intern Emerg Med. 2022 May 20. doi: 10.1007/s11739-022-02988-w. Online ahead of print.

ABSTRACT

Early detection of abnormal vital signs is critical for timely management of acute hospitalised patients and continuous monitoring may improve this. We aimed to assess the association between preceding vital sign abnormalities and serious adverse events (SAE) in patients hospitalised with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Two hundred patients’ vital signs were wirelessly and continuously monitored with peripheral oxygen saturation, heart rate, and respiratory rate during the first 4 days after admission for AECOPD. Non-invasive blood pressure was also measured every 30-60 min. The primary outcome was occurrence of SAE according to international definitions within 30 days and physiological data were analysed for preceding vital sign abnormalities. Data were presented as the mean cumulative duration of vital sign abnormalities per 24 h and analysed using Wilcoxon rank sum test. SAE during ongoing continuous monitoring occurred in 50 patients (25%). Patients suffering SAE during the monitoring period had on average 455 min (SD 413) per 24 h of any preceding vital sign abnormality versus 292 min (SD 246) in patients without SAE, p = 0.08, mean difference 163 min [95% CI 61-265]. Mean duration of bradypnea (respiratory rate < 11 min^-1) was 48 min (SD 173) compared with 30 min (SD 84) in patients without SAE, p = 0.01. In conclusion, the duration of physiological abnormalities was substantial in patients with AECOPD. There were no statistically significant differences between patients with and without SAE in the overall duration of preceding physiological abnormalities.Study registration: http://ClinicalTrials.gov (NCT03660501). Date of registration: Sept 6 2018.

PMID:35593967 | DOI:10.1007/s11739-022-02988-w

Environ Sci Pollut Res Int. 2022 May 20. doi: 10.1007/s11356-022-20841-7. Online ahead of print.

ABSTRACT

A growing body of research has investigated the relationship between indoor air pollution from solid fuel and depression risk. Our study aimed to elucidate the relationship between indoor air pollution from solid fuel and depression in observational studies. The effect of indoor air pollution on depression was estimated using pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was evaluated by the I-squared value (I²), and the random-effects model was adopted as the summary method. We finalized nine articles with 70,214 subjects. The results showed a statistically positive relationship between the use of household solid fuel and depression (OR = 1.22, 95% CI = 1.09-1.36). Subgroup analysis based on fuel type groups demonstrated that indoor air pollution from solid fuel was a higher risk to depression (OR = 1.24, 95% CI = 1. 10-1.39; I² = 67.0%) than that from biomass (OR = 1.18, 95% CI = 0.96-1.45; I² = 66.5%). In terms of fuel use, the use of solid fuel for cooking and heating increased depression risk, and the pooled ORs were 1.21 (95% CI = 1.08-1.36) and 1.23 (95% CI = 1.13-1.34). Exposure to indoor air pollution from solid fuel might increase depression risk.

PMID:35593981 | DOI:10.1007/s11356-022-20841-7

J Exp Orthop. 2022 May 20;9(1):47. doi: 10.1186/s40634-022-00482-y.

ABSTRACT

PURPOSE: Patients undergoing knee surgery are at high risk for deep vein thrombosis (DVT), which is infrequent but potentially life-threatening. It has not been identified how to efficiently detect high-risk DVT while minimizing bleeding complications from anticoagulation. We hypothesized that the degree of activation of thrombotic markers may correlate with the size of the thrombus. Therefore, we investigated the correlation between thrombotic markers and DVT thrombus volume in patients after knee surgery.

METHODS: This retrospective study involved 29 patients who underwent around knee osteotomy or total / unicompartmental knee arthroplasty from 2018 to 2020. Fibrin monomer complex (FMC) at 1, and 7 days after surgery, and D-dimer at 4, and 7 days after surgery were investigated. In addition, the volume of DVT was estimated with ultrasonography at the 7 days after surgery. Body mass index, surgical time, and total volume of blood loss were also evaluated. Factors related to thrombus volume were examined statistically.

RESULTS: Nine patients (31.0%) exhibited asymptomatic distal DVT, whereas 1 patient (3.4%) experienced asymptomatic proximal DVT. No patients had pulmonary embolism. Statistical analysis showed that only FMC concentration on postoperative day 1 was significantly correlated with thrombus volume (p < 0.001, 95% confidence interval 0.41 to 0.839, r = 0.679).

CONCLUSIONS: The FMC concentration was a useful early indicator of deep vein thrombosis after knee surgery. Monitoring the FMC concentration could enable selective identification of patients with a high thrombus volume, which is associated with a high risk for pulmonary embolism.

PMID:35593965 | DOI:10.1186/s40634-022-00482-y

Appl Biochem Biotechnol. 2022 May 20. doi: 10.1007/s12010-022-03974-w. Online ahead of print.

ABSTRACT

The present study explores the potential of Brassica juncea as a low-cost substrate for biodiesel production through the growth of oleaginous yeast. Firstly, the selected lignocellulosic biomass, i.e., Brassica juncea, was thermochemically pretreated using dilute sodium hydroxide. Optimization of thermochemical pretreatment resulted in significant removal of lignin and hemicellulose with 8.4% increase in cellulose content. Further, the sugar hydrolysate of pretreated biomass was used as a substrate for the growth of selected oleaginous yeast (Cryptococcus sp. MTCC 5455). Lipid and biomass production was optimized using central composite design (CCD) based on response surface methodology (RSM). Maximum biomass and lipid content of 32.50 g/L and 11.05 g/L, respectively, was obtained at 30 °C temperature, pH 6.0, and after 5 days of incubation. The oleaginous yeast lipid was further transesterified using immobilized lipase. The highest fatty acid methyl ester 15% FAME yield was obtained after 10 h of enzymatic reaction. Next, the results of specific gravity, viscosity, flash points, and cloud point of obtained biodiesels were conformed to the ASTM D975 standard. Overall, the present study put forth the cost-effective approach for lignocellulosic biomass-based oleaginous lipid production toward the green synthesis of biodiesel.

PMID:35593952 | DOI:10.1007/s12010-022-03974-w

Osteoporos Int. 2022 May 20. doi: 10.1007/s00198-022-06431-w. Online ahead of print.

ABSTRACT

Bone Health TeleECHO Moscow is the first Russian-speaking Project ECHO (Extension for Community Healthcare Outcomes) program that is modeled after the original Bone Health TeleECHO created in the USA. Bone Health TeleECHO Moscow was effective (effect size of 0.87 p < 0.001) at improving clinicians’ skills in the management of osteoporosis based on self-evaluation over 3 years.

INTRODUCTION: Bone Health TeleECHO (Extension for Community Healthcare Outcomes) Moscow is the first Russian-speaking ECHO program, modeled after Bone Health TeleECHO at the University of New Mexico, USA. The bone ECHO programs are designed to expand the capacity to deliver best practice skeletal healthcare worldwide through ongoing technology-enabled case-based collaborative learning. To evaluate the impact of the first 3 years of Bone Health TeleECHO Moscow on physicians’ knowledge in the management of bone diseases.

METHODS: Demographic data were obtained, and outcomes were assessed through an electronic blinded self-efficacy questionnaire focusing on competence and skills in 20 domains of osteoporosis care before and after each year of participation in the Bone Health TeleECHO Moscow.

RESULTS: Over 3 years, a total of 296 participants completed the questionnaire. Average attendance for each monthly session increased from 64 in 2019 to 73 in 2020 and to 96 in 2021. Participants were from all regions of Russia and Russian-speaking countries. The mean age of respondents was 43 years with the youngest being 23 and the eldest 74. The most common participants’ primary specialties were endocrinology (n = 263), gynecology (n = 20), orthopedics (n = 3), and other (n = 10). All of our participants were physicians, including 73 MD PhDs. This educational intervention was associated with a statistically significant improvement in each of the 20 domains of osteoporosis care, with an effect size of 0.87 (p < 0.001).

CONCLUSION: Bone Health TeleECHO is effective at improving clinicians’ skills in the management of osteoporosis based on self-evaluation over 3 years.

PMID:35593943 | DOI:10.1007/s00198-022-06431-w

Acta Neurochir (Wien). 2022 May 20. doi: 10.1007/s00701-022-05251-5. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal reconstruction materials for cranioplasty following decompressive craniectomy (DC) remain unclear. This systematic review, pairwise meta-analysis, and network meta-analysis compares cosmetic outcomes and complications of autologous bone grafts and alloplasts used for cranioplasty following DC.

METHOD: PubMed, Embase, and Cochrane were searched from inception until April 2021. A random-effects pairwise meta-analysis was used to compare pooled outcomes and 95% confidence intervals (CIs) of autologous bone to combined alloplasts. A frequentist network meta-analysis was subsequently conducted to compare multiple individual materials.

RESULTS: Of 2033 articles screened, 30 studies were included, consisting of 29 observational studies and one randomized control trial. Overall complications were statistically significantly higher for autologous bone compared to combined alloplasts (RR = 1.56, 95%CI = 1.14-2.13), hydroxyapatite (RR = 2.60, 95%CI = 1.17-5.78), polymethylmethacrylate (RR = 1.50 95%CI = 1.08-2.08), and titanium (Ti) (RR = 1.56 95%CI = 1.03-2.37). Resorption occurred only in autologous bone (15.1%) and not in alloplasts (0.0%). When resorption was not considered, there was no difference in overall complications between autologous bone and combined alloplasts (RR = 1.00, 95%CI = 0.75-1.34), nor between any individual materials. Dehiscence was lower for autologous bone compared to combined alloplasts (RR = 0.39, 95%CI = 0.19-0.79) and Ti (RR = 0.34, 95%CI = 0.15-0.76). There was no difference between autologous bone and combined alloplasts with respect to infection (RR = 0.85, 95%CI = 0.56-1.30), migration (RR = 1.36, 95%CI = 0.63-2.93), hematoma (RR = 0.98, 95%CI = 0.53-1.79), seizures (RR = 0.83, 95%CI = 0.29-2.35), satisfactory cosmesis (RR = 0.88, 95%CI = 0.71-1.08), and reoperation (RR = 1.66, 95%CI = 0.90-3.08).

CONCLUSIONS: Bone resorption is only a consideration in autologous cranioplasty compared to bone substitutes explaining higher complications for autologous bone. Dehiscence is higher in alloplasts, particularly in Ti, compared to autologous bone.

PMID:35593924 | DOI:10.1007/s00701-022-05251-5

J Comput Biol. 2022 May 20. doi: 10.1089/cmb.2021.0536. Online ahead of print.

ABSTRACT

The comparison of DNA sequences is of great significance in genomics analysis. Although the traditional multiple sequence alignment (MSA) method is popularly used for evolutionary analysis, optimally aligning k sequences becomes computationally intractable when k increases due to the intrinsic computational complexity of MSA. Despite numerous k-mer alignment-free methods being proposed, the existing k-mer alignment-free methods may not truly capture the contextual structures of the sequences. In this study, we present a novel k-mer contextual alignment-free method (called kmer2vec), in which the sequence k-mers are semantically embedded to word2vec vectors, an essential technique in natural language processing. Consequently, the method converts each DNA/RNA sequence into a point in the word2vec high-dimensional space and compares DNA sequences in the space. Because the word2vec vectors are trained from the contextual relationship of k-mers in the genomes, the method may extract valuable structural information from the sequences and reflect the relationship among them properly. The proposed method is optimized on the parameters from word2vec training and verified in the phylogenetic analysis of large whole genomes, including coronavirus and bacterial genomes. The results demonstrate the effectiveness of the method on phylogenetic tree construction and species clustering. The method running speed is much faster than that of the MSA method, especially the phylogenetic relationships constructed by the kmer2vec method are more accurate than the conventional k-mer alignment-free method. Therefore, this approach can provide new perspectives for phylogeny and evolution and make it possible to analyze large genomes. In addition, we discuss special parameterization in the k-mer word2vec embedding construction. An effective tool for rapid SARS-CoV-2 typing can also be derived when combining kmer2vec with clustering methods.

PMID:35593919 | DOI:10.1089/cmb.2021.0536

Biomed Phys Eng Express. 2022 May 19. doi: 10.1088/2057-1976/ac7169. Online ahead of print.

ABSTRACT

Objective:To estimate organs’ absorbed dose from the two-phase CT of parathyroid glands, effective dose (ED) based on three different methods, and compare the dose values with those reported by other published protocols.Methods:Volumetric-computed-tomography-dose-index (CTDIvol), dose-length-product (DLP), and the corresponding scan length during each phase of a parathyroid protocol were recorded, for seventy-six patients. One k-factor, and two different k-factors for the neck and chest area were used to estimate the ED from DLP. A Monte Carlo software, VirtualDoseCT, was also used for the estimation of organs’ absorbed dose and ED.Results:Two-phase parathyroid CT resulted in a mean ED of 3.93 mSv, 4.29 mSv and 4.21 mSv according to the one k-factor, two k-factors, and VirtualDoseCT methods, respectively. The two k-factors method resulted in a slight overestimation of 1.9% in total ED compared to VirtualDoseCT. No statistically significant difference was found in ED values between these methods (Wilcoxon test, p>0.05), except for female patients in the pre-contrast phase. The organs inside the SFOV received the following doses: thymus 23.3 mGy, lungs 11.5 mGy, oesophagus 9.2 mGy, thyroid 6.9 mGy, and breast 6.3 mGy. The ED and organs’ dose (OD) values were significantly lower in the pre-contrast than in the arterial phase (Wilcoxon test, p<0.001). A statistically significant difference was observed between male and female patients for the pre-contrast phase (Mann-Whitney test, p<0.05), regarding the ED values obtained with the two k-factors method and VirtualDoseCT software.Conclusions:The two k-factors method could be applied for the ED estimation in clinical practice, if appropriate software is not available. An extensive range of ED values derived from the literature, mainly depending on the acquisition protocol parameters and the estimation method.

PMID:35593909 | DOI:10.1088/2057-1976/ac7169