Category: Nevin Manimala

J Am Soc Cytopathol. 2023 Feb 13:S2213-2945(23)00012-1. doi: 10.1016/j.jasc.2023.02.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Cytology is an option for triaging human papillomavirus (HPV)-positive women. The interpretation of cytologic slides requires expertise and financial resources that are not always available in resource-limited settings. A solution could be offered by manual preparation and digitization of slides on site for real-time remote cytologic diagnosis by specialists. In the present study, we evaluated the operational feasibility and cost of manual preparation and digitization of thin-layer slides and the diagnostic accuracy of screening with virtual microscopy.

MATERIALS AND METHODS: Operational feasibility was evaluated on 30 cervical samples obtained during colposcopy. The simplicity of the process and cellularity and quality of digitized thin-layer slides were evaluated. The diagnostic accuracy of digital versus glass slides to detect cervical intraepithelial neoplasia grade 2 or worse was assessed using a cohort of 264 HPV-positive Cameroonian women aged 30 to 49 years. The histologic results served as the reference standard.

RESULTS: Manual preparation was found to be feasible and economically viable. The quality characteristics of the digital slides were satisfactory, and the mean cellularity was 6078 squamous cells per slide. When using the atypical squamous cells of undetermined significance or worse threshold for positivity, the diagnostic performance of screening digital slides was not significantly different statistically compared with the same set of slides screened using a light microscope (P = 0.26).

CONCLUSIONS: We have developed an innovative triage concept for HPV-positive women. A quality-ensured telecytologic diagnosis could be an effective solution in areas with a shortage of specialists, applying a same day “test-triage-treat” approach. Our results warrant further on-site clinical validation in a large prospective screening trial.

PMID:36922319 | DOI:10.1016/j.jasc.2023.02.001

Injury. 2023 Feb 27:S0020-1383(23)00186-9. doi: 10.1016/j.injury.2023.02.053. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Contact-sports are known to have higher risk of orofacial injuries due to the bodily contact with other players or equipment. Kabaddi is a traditional contact-sport of India that has gained an international recognition. There is a paucity of data regarding prevalence of traumatic dental and orofacial injuries among the Kabaddi players. Hence this study aimed to assess the prevalence, distribution and pattern of orofacial injuries among the Kabaddi players of Delhi and NCR region.

MATERIAL AND METHODS: This observational cross-sectional study was designed as per the best practices of epidemiology and reported as per the STROBE guidelines. The sample size was calculated as 440 and comprised of 10-18 years old players of either gender. Cluster random sampling was performed and the information was collected by one-calibrated evaluator by using a self-designed proforma. The injuries were classified as per standard criteria and the description of each episode was recorded. Statistical analysis was performed using the Statistical software-STATA-version-14(StataCorpLLC,Texas,USA).

RESULTS: Total of 393 players were included in the study (Males-295, Females-98) with majority of them between 15 and 18 years of age. The prevalence of traumatic episode was 49.11% and the prevalence orofacial-trauma was 44.02%.The frequency of extraoral-injuries was higher when compared to the intraoral injuries, with orbit(26.67%) being the commonest-site. Most of the players had not received adequate emergency treatment in the first incident which had improved in the second.

CONCLUSIONS: The prevalence of traumatic orofacial injuries in 10-18 years old Kabaddi players of Delhi-NCR region was found to be 44.02% while the prevalence of traumatic episodes was 49.11%. The prevalence of dental injuries was 5.1%. Majority of the players perceived that Kabaddi can lead to orofacial-injuries.

PMID:36922269 | DOI:10.1016/j.injury.2023.02.053

Chin J Traumatol. 2023 Feb 24:S1008-1275(23)00017-2. doi: 10.1016/j.cjtee.2023.02.003. Online ahead of print.

ABSTRACT

PURPOSE: Electric scooters (e-scooters) have become an increasingly popular mode of public transportation in recent years. As the incidence of related injuries rises, it is important to understand specific fracture patterns unique to e-scooters and electric bikes (e-bikes) to help guide management. The purpose of this study was to review the prevalence and describe specific fracture patterns of e-scooter and e-bike related injuries at the busiest level 1 trauma center in the borough of Manhattan.

METHODS: Chart review to determine mechanism of injury was performed on all patients for whom an orthopedic consult was requested from 1/1/2021 to 12/31/2021. All patients whose injuries were sustained due to an e-scooter or e-bike were further reviewed for demographics, injury characteristics including fracture pattern, and definitive injury management. Any patients who had an orthopedic consult placed for a reason other than an acute injury were excluded. Descriptive statistics are reported as frequencies (percentages) for categorical variables and means for continuous variables.

RESULTS: Of the 1815 orthopedic consults requested, 1357 (74.8%) were for acute injury management. Of those with acute injuries, 119 (8.8%) sustained 136 e-scooter or e-bike related injuries. There were 92 (77.3%) males at an average age of (33.8 ± 15.7) years. Approximately one-fifth of all patients presented in June 2021 (26, 21.8%). There was a 9.2% rate of open fractures. The 136 injuries were evenly split between the upper and lower extremities, with 57 (47.9%) upper extremity, 57 (47.9%) lower extremity injuries, and 5 (4.2%) concomitant upper and lower extremity injuries. The most common fracture patterns were ankle fractures (16, 11.7%), followed by tibial shaft (14, 10.2%), tibial plateau (13, 9.5%), and radial head fractures (11, 8.0%). There was a 33.3% incidence of associated posterior malleolar fractures in the spiral tibial shaft fractures, 31.0% of posterior malleolar involvement and 18.8% of isolated vertical medial malleolar fractures in the ankle fractures, and 61.5% of posterior comminution in the tibial plateau fractures.

CONCLUSION: E-scooter and e-bike related injuries have a high incidence of tibial shaft fractures, ankle fractures, tibial plateau fractures, and radial head fractures. There should be a high index of suspicion for posterior and medial involvement in lower extremity fractures sustained due to e-scooter or e-bikes. Identifying specific fracture patterns seen in e-scooter and e-bike related mechanisms will help guide management of these injuries.

PMID:36922264 | DOI:10.1016/j.cjtee.2023.02.003

Dent Mater. 2023 Mar 13:S0109-5641(23)00063-5. doi: 10.1016/j.dental.2023.03.003. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to assess the influence of immediate dentin sealing (IDS) on the fatigue behavior of laminate occlusal veneers fabricated with CAD/CAM lithium disilicate ceramic and resin composite.

METHODS: Forty sound human molars were prepared and randomly divided into 4 groups (n = 10): RC-IDS+ (IDS and resin composite occlusal laminate veneer); RC-IDS- (resin composite occlusal laminate veneer without IDS); LD-IDS+ (IDS and lithium disilicate laminate veneer); LD-IDS- (lithium disilicate occlusal laminate veneer without IDS). The restorations were obtained using a digital workflow. After surface conditioning and bonding, thermocycling and accelerated fatigue tests (20 Hz, 5000 cycles with an initial load of 300 N, step-size of 100 N for 10,000 cycles, up to 1000 N, and then a step-size of 50 N until failure) were conducted. Fatigue data were recorded for both outcomes (crack or fracture) and statistically analyzed. Fractographic and adhesive interface analysis were conducted.

RESULTS: The indirect resin composite groups showed better fatigue behavior compared to lithium disilicate. IDS only had a positive effect for the survival of resin composite restorations for the ‘fracture’ outcome. Evident presence of micro-gaps at the adhesive interface in the LD-IDS- group could be noted.

SIGNIFICANCE: Immediate dentin sealing improved fatigue resistance behavior of resin composite occlusal veneers. However, this effect was not observed in lithium disilicate veneers.

PMID:36922258 | DOI:10.1016/j.dental.2023.03.003

Huan Jing Ke Xue. 2023 Mar 8;44(3):1686-1697. doi: 10.13227/j.hjkx.202203292.

ABSTRACT

In order to explore the pollution characteristics and health risks of heavy metals in a soil-crop system in the Anhui section of the Yangtze River basin, a total of 338 groups of soil samples from rice, wheat, and their roots were collected, and the contents of eight types of heavy metals were determined. Additionally, the pollution index method, potential ecological hazard, multivariate statistical analysis, and health risk were used to evaluate the heavy metal content in rice and wheat root soil. The results showed that Cd, Cu, Cr, and Ni in the soil had an obvious accumulation effect, and the pollution of rice root soil was more serious than that of wheat soil. The potential ecological risk was mild to moderate, which mainly came from the elements Cd and Hg. Multivariate statistical analysis showed that Cu, Pb, Zn, and Cd were industrial sources and agricultural sources; Cr and Ni were natural sources; and As and Hg were agricultural sources. The absorption and enrichment intensity of heavy metals by rice was in the order of Cd>Zn>Cu>Hg>Ni>As>Cr=Pb, and those in wheat were ordered as Zn>Cd>Cu>Hg>Ni>As=Pb>Cr. The root soil heavy metal health risk assessment indicated that oral intake was the main exposure route of non-carcinogenic risk, and children were more vulnerable to heavy metal pollution. Non-carcinogenic risk assessment showed that wheat root soil posed non-carcinogenic risk to children but no carcinogenic risk. Intake of rice and wheat had some degree of non-carcinogenic risk and unacceptable carcinogenic risk for both adults and children.

PMID:36922229 | DOI:10.13227/j.hjkx.202203292

Huan Jing Ke Xue. 2023 Mar 8;44(3):1657-1667. doi: 10.13227/j.hjkx.202201279.

ABSTRACT

Heavy metal pollution in testing ranges is one of the most widely concerning environmental problems. The ammunition static detonation test area, the bomb falling area, and the living area of a testing range in Jilin were selected as the study objects. The contents of heavy metals (As, Cd, Cr, Cu, Ni, Pb, and Zn) in 112 topsoil samples and two soil profiles were analyzed, and their distribution characteristics and sources were analyzed in detail. After that, the pollution degree and potential ecological risk of heavy metals were investigated using multiple pollution index assessment methods. The results showed that the average contents of As, Cd, Cu, Ni, and Zn in the soil of the ammunition static detonation test area were higher than the soil background values in Jilin province, and the contents of Cu, Zn, As, and Cd showed strong spatial heterogeneity. The average concentrations of As, Cd, and Ni in the soil of the bomb falling area exceeded their background values. The average contents of As and Cd in the soil of the living area were higher than the background values, and the variation coefficients of Pb, Cd, Zn, and Cr were relatively high, indicating that they may have been affected by human activities. In different test areas, the contents of As, Cr, Cu, Ni, and Zn in the soil samples were significantly different (P<0.05). The ammunition static detonation test area was more strongly affected by the test activities than the bomb falling area, and the heavy metal contents in the surface layer of the soil profile were significantly higher. There was no obvious vertical migration of heavy metals in the soil profiles. The results of multivariate statistics and source identification analysis using absolute principal component score-multiple linear regression (APCS-MLR) showed that Zn, Pb, and Cd were mainly affected by pollution sources related to test activities; Cr and Ni were mainly affected by natural sources of soil forming materials; and the sources of As and Cu were more complicated. The geo-accumulation index showed that Cd in the three areas and Ni in the bomb falling area belonged to pollution level 1 (uncontaminated to moderately contaminated). The Nemerow comprehensive pollution index showed that the pollution levels among the different functional areas were:living area>ammunition static detonation test area>bomb falling area, and the three functional areas were slightly polluted. The potential ecological risk index showed that the study area was at moderate ecological risk level, and Cd was considered to be the main soil pollution factor.

PMID:36922226 | DOI:10.13227/j.hjkx.202201279

Huan Jing Ke Xue. 2023 Mar 8;44(3):1620-1635. doi: 10.13227/j.hjkx.202204096.

ABSTRACT

In this study, As, Cd, Cr, Hg, and Pb in the surface soil of cropland in Lanzhou were studied, and the combination of descriptive statistics, single-factor accumulation index, comprehensive accumulation index, geostatistical method, and a geographically weighted regression model (GWR) was used to investigate their accumulation status, spatial distribution, and influencing factors, in order to provide scientific basis for the precise control of heavy metal accumulation risk in the study area. The results showed that:①the single-factor accumulation index showed that the accumulation of Hg and Cd in the study area was the largest, followed by that of Pb and As, and that of Cr was the smallest; the comprehensive accumulation index showed that the accumulation rate of heavy metals was as high as 98.11%, of which 54.81% was mild accumulation and 43.30% was moderate and above accumulation. However, there was no heavy metal pollution in the surface soil of cultivated land in Lanzhou. ② Spatial autocorrelation analysis showed that there was no heavy metal pollution in the surface soil of Lanzhou, but there was accumulation in a few areas. The spatial autocorrelation analysis showed that the spatial autocorrelation of the Cr, Hg, and Pb single-factor accumulation indices was moderate, indicating that they were influenced by both random and structural factors; the spatial autocorrelation of the other two heavy metals was weak, indicating that they were mainly influenced by random factors, among which human factors were more influential. The Hg single-factor accumulation index was high in the middle and low in the fourth; the integrated accumulation index increased from northwest to southeast and decreased from the middle to both sides. ③ Geographically weighted regression (GWR) analysis showed that altitude, slope length, distance from rivers, soil organic matter (SOM) content, precipitation, air temperature, and surface temperature all showed positive driving effects, whereas the rest of the factors showed negative driving effects and significant spatial heterogeneity and instability (P<0.05). The magnitudes of the factor effects were in the order of soil characteristics>topographic characteristics>climate characteristics>location characteristics>socioeconomic characteristics>vegetation characteristics, with the largest contribution of SOM content, followed by that of altitude and air temperature, and the smallest of normalized difference vegetation index (NDVI) values. Compared with the other feature factors, the location feature factors had stronger spatial heterogeneity.

PMID:36922223 | DOI:10.13227/j.hjkx.202204096

Huan Jing Ke Xue. 2023 Mar 8;44(3):1553-1561. doi: 10.13227/j.hjkx.202203270.

ABSTRACT

Farmland is the important soil carbon pool of terrestrial ecosystems and organic nutrient pool for crop growth. To clarify the impact of climate warming on the soil carbon pool, this study analyzed the effects of warming and fertilization on soil organic carbon and its labile components under rice-wheat rotation using a free-air temperature increase system. The variation in soil carbon pool management index (CPMI) was also evaluated. The results showed that the combined effects of warming and fertilization on soil organic carbon content and labile organic carbon components were insignificant. Warming increased the soil organic carbon (SOC) content, and the differences between warming and the ambient control in total organic carbon (TOC) and recalcitrant organic carbon (ROC) reached a statistically significant level. Compared with those under the ambient control, the contents of TOC, ROC, and labile organic carbon (LOC) subjected to warming increased by 7.72%, 7.42%, and 10.11%, respectively. The increased microbial biomass carbon (MBC) content (20.4%) and decreased particulate organic carbon (POC) content (36.51%) may have been the main reason for the variation in SOC. Warming showed no significant effect on soil dissolved organic carbon (DOC) content, whereas it markedly reduced its soluble microbial by-product components (41.89%). The results also showed that fertilization had no significant effect on soil TOC, ROC, and LOC, but it notably reduced the contents of DOC and POC and increased the MBC content. Compared with those under the control without fertilization, the contents of DOC and POC subjected to fertilization decreased by 35.44% and 28.33%, respectively, and the MBC content increased by 33.38%. Additionally, fertilization tended to increase the anthropogenic humus component (5.13%) and soluble microbial by-product component (29.41%) in dissolved organic matter and reduce the terrestrial humus component (13.33%). Warming and fertilization both tended to improve soil CPMI. Affected by SOC and LOC, the increase in soil carbon pool index and soil lability index were the main reason for the increase in soil CPMI under warming and fertilization, respectively. Overall, the results revealed that climate warming can affect the soil carbon pool by changing soil labile carbon components, which are not affected by fertilization.

PMID:36922216 | DOI:10.13227/j.hjkx.202203270

Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Mar 6;57(3):427-432. doi: 10.3760/cma.j.cn112150-20221016-00998.

ABSTRACT

To observe the symptom control, pulmonary function changes and safety of use of omalizumab in patients with moderate to severe allergic asthma for 1 year. A small sample self-controlled study before and after treatment was conducted to retrospective analysis involved 17 patients with moderate to severe asthma who received omalizumab therapy for 12 months in Peking University People’s Hospital and Beijing Jishuitan Hospital from January 2020 to December 2021. The clinical symptoms and pulmonary function changes were compared before treatment, after 6 months and 12 months of treatment, and the clinical data such as the use of other drugs and adverse reactions were observed. Statistical data are collected using the median method, and non-parametric paired Wilcoxon analysis was used for pairwise comparison. Before treatment with omalizumab, the patients’ FeNO value was 79(58, 121) ppb, and the total serum IgE was 228(150.5, 345.5) IU/ml. After 6 months of omalizumab therapy, the percent predicted value of the forced expiratory volume in 1 second (FEV1%) before inhaled bronchodilator increased from 86.70(82.65, 91.35)% to 90.90(87.70, 95.85)% (Z=-3.626, P<0.001). The FEV1%pred after inhaled bronchodilator increased from 92.60(85.75, 96.90)% to 94.30(89.95, 98.15)% (Z=-2.178, P=0.029). The absolute value of improvement in FEV1 decreased from 150(95, 210)ml to 50(20, 125) ml (Z=-2.796, P=0.005), and the improvement rate decreased from 6.60(3.80, 7.85)% to 1.90(0.75, 4.85)% (Z=-2.922, P=0.003). After 12 months of treatment, the FEV1%pred before inhaled bronchodilator further increased to 92.90 (91.60, 98.15)% (Z=-3.575, -2.818, and P<0.001, 0.005 compared with before treatment and 6 months after treatment, respectively). The FEV1%pred after inhaled bronchodilator increased to 96.80 (91.90, 101.25)% (Z=-3.622, -1.638, and P<0.001, 0.008 compared with before treatment and after 6 months of treatment, respectively). The absolute value of improvement in FEV1 was 70 (35, 120) ml (P=0.004, 0.842 before treatment and 6 months after treatment, respectively), and the improvement rate was 3.0(1.0, 5.0)% (Z=-2.960, -0.166, and P=0.003, 0.868, compared with before treatment and after 6 months of treatment, respectively). After 12 months of treatment, ACT increased from 13 (10.5, 18) before treatment to 24 (23, 25) (Z=-3.626,P<0.001). Only 1 patient experienced an injection site skin reaction during treatment. Therefore, after 6 months and 12 months of treatment with omalizumab, the patient’s lung function improved and symptoms were relieved, which could effectively prevent the acute exacerbation of asthma. Omalizumab treatment is safe and well tolerated, and no effect on blood pressure and blood glucose was observed.

PMID:36922178 | DOI:10.3760/cma.j.cn112150-20221016-00998

Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Mar 6;57(3):416-421. doi: 10.3760/cma.j.cn112150-20221118-01121.

ABSTRACT

To explore the clinical distribution and drug resistance characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP), in order to provide reference for the prevention and treatment of CRKP infection. Retrospective analysis was performed on 510 clinical isolates of CRKP from January 2017 to December 2021, and strain identification and drug sensitivity tests were conducted by MALDI-TOF mass spectrometer and VITEK-2 Compact microbial drug sensitivity analyzer. The carbapenemase phenotype of CRKP strain was detected by carbapenemase inhibitor enhancement test. The CRKP strain was further categorized by immunochromogenic method and polymerase chain reaction (PCR) was used for gene detection. The results showed that 302 strains (59.2%) were derived from sputum, 127 strains (24.9%) from urine and 47 strains (9.2%) from blood. 231 (45.3%) were mainly distributed in intensive care, followed by 108 (21.2%) in respiratory medicine and 79 (15.5%) in neurosurgery. Drug susceptibility test result shows that the resistant rate of tigecycline increased from 1.0% in 2017 to 10.1% in 2021, the difference was statistically significant (χ²=14.444,P<0.05). The results of carbapenemase inhibitor enhancement test showed that 461 carbapenemase strains (90.4%) of 510 CRKP strains, including 450 serinase strains (88.2%), 9 metalloenzyme strains (1.8%), and 2 strains (0.4%) produced both serine and metalloenzyme. 49 strains (9.6%) did not produce enzymes. Further typing by immunochromogenic assay showed that 461 CRKP strains were KPC 450 (97.6%) and IMP 2 (0.4%). 7 NDM (1.5%); 2 strains of KPC+NDM (0.4%); PCR results were as follows: 450 strains of blaKPC (97.6%), 2 strains of blaIMP (0.4%), 7 strains of blaNDM (1.5%), and 2 strains of blaKPC+NDM (0.4%). In conclusion, CRKP strains mainly originated from sputum specimens and distributed in intensive care department, and the drug resistance characteristics were mainly KPC type in carbapenemase production. Clinical microbiology laboratory should strengthen the monitoring of CRKP strains, so as to provide reference for preventing CRKP infection and reducing the production of bacterial drug resistance.

PMID:36922176 | DOI:10.3760/cma.j.cn112150-20221118-01121