Category: Nevin Manimala

Nutr Clin Pract. 2021 Jul 10. doi: 10.1002/ncp.10735. Online ahead of print.

ABSTRACT

BACKGROUND: Prevention of extrauterine growth restriction (EUGR) in preterm neonates is one of the biggest challenges to neonatologists. Lack of uniformity and inconsistency in nutrition practices are the most common causes. We started a quality improvement (QI) initiative with an intention to decrease the proportion of EUGR.

METHODS: We performed prospective nonrandomized QI from May 2018 to July 2019. Ninety-six neonates (born at <32 weeks and/or <1.2 kg) were compared with 111 historical controls. A continuous feedback loop was maintained, and changes were analyzed as plan-do-study-actcycle.

RESULTS: Although EUGR was lower after the intervention (93.7% vs 87.5%), this change was not statistically significant. However, other measures of in-hospital neonatal growth showed improvement, including median discharge weight percentile from 1% to 3% (P = .003). Median difference in the z-score for weight from birth to discharge also improved significantly from -1.84 to -1.65 (P = .04). Babies in the intervention group regained birth weight earlier (P = .005) and had better growth velocity (P = .0005). The feeding was started early (P < .0001), and these babies reached full feeds (P < .0001) earlier than the control cohort.

CONCLUSION: Although our QI initiative failed to achieve a significant reduction in EUGR, it did achieve a significant improvement in discharge weight percentile and difference in the z-score for weight at birth and during discharge from hospital. There was a significant improvement in growth velocity and an early regaining of birth weight. The implementation of written nutrition practice guidelines facilitated improved outcomes.

PMID:34245467 | DOI:10.1002/ncp.10735

Adv Gerontol. 2021;34(2):272-276.

ABSTRACT

The aim of the study was to study the frequency and features of albuminuria in patients with chronic bronchoobstructive lung diseases. The prospective study involved 219 patients with COPD (GOLD 1-4) and 201 patients with persistent bronchial asthma (BA) of varying severity, who were examined in 2018-2019. The control group consisted of 48 volunteers, comparable in age and gender. In addition to General clinical studies, all patients were calculated BMI and visceral obesity detection based on the waist-hip ratio (WHR), and the Smoking index (HCI) was calculated. Albuminuria was determined based on the calculation of the albumin / creatinine ratio in a single morning portion of urine. The frequency of optimal / slightly elevated AU (A1) was 28,7% (63) among COPD patients and 9% (18) of BA patients. The number of COPD patients with clinically significant AU (A2, A3) was 24,2% (53) of patients, which is statistically significantly higher than among BA patients (5,5% of patients; χ2=22,3, p=0,01). The factors that make a statistically significant contribution to the development of AU in patients with COPD were the frequency of exacerbations over the previous 12 months, ICP, fibrinogen and CRP levels, FEV1; in BA patients – WHR, ICP. Smoking contributes to the development and potentiation of renal dysfunction in patients with bronchial obstructive diseases. The issue of considering BA as a risk factor for renal dysfunction remains controversial, given the diversity of BA both in terms of disease phenotypes, severity, and variety of therapeutic approaches.

PMID:34245511

J Patient Rep Outcomes. 2021 Jul 10;5(1):55. doi: 10.1186/s41687-021-00324-y.

ABSTRACT

BACKGROUND: To reduce the burden of completing Patient-Reported Outcome Measures (PROMs), PROMIS® Computerized Adaptive Tests (CATs) are being implemented in pediatric clinical practice. We aimed to develop recommendations for visual feedback options for PROMIS CATs on individual item and domain score level as an evidence-based feedback recommendation for PROMIS CATs is lacking.

METHODS: Focus groups were held with clinicians who use the KLIK PROM portal. Literature-based feedback options were provided to initiate group discussion. Data was analyzed using thematic coding method. Additionally, a questionnaire was sent out to assess patients’ (12-18y) and parents’ (child 0-18y) preference for individual item feedback. Data was analyzed using descriptive statistics.

RESULTS: Six focus groups were held (N = 28 clinicians). Regarding individual item feedback, showing the complete item bank, with only responses to administered items in traffic light colors was preferred. For domain scores, line graphs were preferred, including numerical (T-)scores, reference and cut-off lines, and traffic light colors. Separate graphs per domain, ranked in order of importance and harmonization of directionality (‘higher = better’) were considered important. Questionnaire results (N = 31 patients/N = 131 parents) showed that viewing their own item responses was preferred above receiving no item feedback by 58.1% of the patients and 77.1% of the parents.

CONCLUSIONS: Based on the outcomes and after discussion with the Dutch-Flemish PROMIS National Center, recommendations for PROMIS CAT feedback options were developed. PROMIS CATs can now be used in clinical practice to help clinicians monitor patient outcomes, while reducing the burden of completing PROMs for patients significantly.

PMID:34245390 | DOI:10.1186/s41687-021-00324-y

Environ Sci Pollut Res Int. 2021 Jul 10. doi: 10.1007/s11356-021-15264-9. Online ahead of print.

ABSTRACT

The statistical physics modeling is a reliable approach to interpret and understand the adsorption mechanism of both organic and inorganic adsorbates. Herein, a theoretical study of the adsorption mechanism of anionic dyes, namely reactive blue 4 (RB4), acid blue 74 (AB74), and acid blue 25 (AB25), on bone char was performed with a multilayer statistical physics model. This model was applied to fit the equilibrium adsorption data of these dyes at 298-313 K and pH 4. Results indicated that the global number of formed dye layers on the bone char varied from 1.62 to 2.24 for RB4, AB74, and AB25 dyes depending on the solution temperature where the saturation adsorption capacities ranged from 0.08 to 0.12 mmol/g. Dye molecular aggregation was also identified for these dyes where dimers and trimers prevailed at different operating conditions especially for adsorbates RB4 and AB74. Adsorption mechanism of these dyes was multimolecular and endothermic with adsorption energies from 10.6 to 20.8 kJ/mol where van der Waals interactions and hydrogen bonding could be present. This investigation contributes to understand the physicochemical variables associated to dye adsorption using low-cost adsorbents as bone char.

PMID:34245418 | DOI:10.1007/s11356-021-15264-9

J Relig Health. 2021 Jul 10. doi: 10.1007/s10943-021-01336-0. Online ahead of print.

ABSTRACT

This study was carried out to examine the relationship between international students’ health perceptions and their healthy lifestyle behaviors. This descriptive and relational study was conducted with 216 international students studying at a university in Turkey. Study data were collected using the descriptive information form, the Perception of Health Scale (PHS) and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were evaluated using descriptive statistics and Pearson correlation analysis. It was determined that the health perception and healthy lifestyle behaviors of the international students involved in this study were moderately positive. The study found a weak and positive relationship between PHS and the physical activity, nutrition and stress management subdimensions of HPLP, while a moderate positive relationship was identified between PHS and the spiritual growth and interpersonal relations subdimensions of HPLP. No relationship was observed between PHS and the health responsibility subdimension of HPLP. The fact that students have a positive perception of health reflects positively on their healthy lifestyle behaviors. It is important to disseminate education programs aimed at improving the health perception and healthy lifestyle behaviors of international students within the university.

PMID:34245435 | DOI:10.1007/s10943-021-01336-0

Neurol Sci. 2021 Jul 10. doi: 10.1007/s10072-021-05430-9. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to evaluate the effect of metabolic syndrome (MetS) and anthropometric indices on carpal tunnel syndrome (CTS).

METHODS: Forty-three healthy controls and 41 CTS patients were enrolled. Complaints of patients were assessed by Boston Questionnaire (BQ). MetS components were investigated. Wrist circumference, wrist depth, wrist width, palm width, and palm length were measured. Routine nerve conduction studies of median and ulnar nerves as well as the “sensitive” comparison tests were performed. Cutaneous silent period (CuSP) was studied by stimulating both second and fifth digital nerves while recording over thenar muscles.

RESULTS: The vast majority of the participants were female and right-handed. CTS was bilateral in 61% of patients. Data of 109 hands were analyzed. MetS was more frequent in CTS patients. BQ scores were not related to MetS. Waist circumference, serum TG, and fasting glucose levels were higher in CTS patients. CTS hands with MetS had lower median CMAP amplitudes and increased sensory thresholds. Sensory thresholds were increased with both median and ulnar nerve stimulations suggesting a wider spread of peripheral nerve excitability changes in MetS presence. CuSPs were recorded from all 109 hands. CuSP latencies and durations were similar between controls and CTS patients. Wrist ratio was the only anthropometric index that was a statistically significant predictor for CTS development.

CONCLUSION: MetS was more prevalent in CTS patients. Some clinical and electrophysiological features (mainly sensory thresholds) may worsen in presence of MetS, but not the wrist ratio.

PMID:34245382 | DOI:10.1007/s10072-021-05430-9

Brain Struct Funct. 2021 Jul 10. doi: 10.1007/s00429-021-02338-0. Online ahead of print.

ABSTRACT

Healthy human aging is associated with a deterioration of visual acuity, retinal thinning, visual field map shrinkage and increasing population receptive field sizes. Here we ask how these changes are related to each other in a cross-sectional sample of fifty healthy adults aged 20-80 years. We hypothesized that age-related loss of macular retinal ganglion cells may lead to decreased visual field map sizes, and both may lead to increased pRF sizes in the cortical central visual field representation. We measured our participants’ perceptual corrected visual acuity using standard ophthalmological letter charts. We then measured their early visual field map (V1, V2 and V3) functional population receptive field (pRF) sizes and structural surface areas using fMRI, and their retinal structure using high-definition optical coherence tomography. With increasing age visual acuity decreased, pRF sizes increased, visual field maps surface areas (but not whole-brain surface areas) decreased, and retinal thickness decreased. Among these measures, only functional pRF sizes predicted perceptual visual acuity, and Bayesian statistics support a null relationship between visual acuity and cortical or retinal structure. However, pRF sizes were in turn predicted by cortical structure only (visual field map surface areas), which were only predicted by retinal structure (thickness). These results suggest that simultaneous disruptions of neural structure and function throughout the early visual system may underlie the deterioration of perceptual visual acuity in healthy aging.

PMID:34245381 | DOI:10.1007/s00429-021-02338-0

Osteoporos Int. 2021 Jul 10. doi: 10.1007/s00198-021-06046-7. Online ahead of print.

ABSTRACT

Patients with low-energy hip fractures do not follow the obesity paradox as previously reported. In datasets where injury mechanism is not available, the use of age >50 years (as opposed to commonly used >65 years) as a surrogate for a low-energy hip fracture patients may be a more robust inclusion criterion. PURPOSE: In elderly patients with a hip fracture, limited data suggests that obese patients counterintuitively have improved survival compared to normal-weight patients. This “obesity paradox” may be the byproduct of selection bias. We hypothesized that the obesity paradox would not apply to elderly hip fracture patients.

METHODS: The National Surgical Quality Improvement Project dataset identified 71,685 hip fracture patients ≥50 years-of-age with complete body mass index (BMI) data that underwent surgery. Patients were stratified into under and over 75-year-old cohorts (n=18,956 and 52,729, respectively). Within each age group, patients were stratified by BMI class and compared with respect to preoperative characteristics and 30-day mortality. Significant univariate characteristics (p<0.1) were included in multivariate analysis to determine the independent effect of obesity class on 30-day mortality (p<0.05).

RESULTS: Multivariate analysis of <75-year-old patients with class-III obesity were more likely to die within 30-days than similarly aged normal-weight patients (OR 1.91, CI 1.06-3.42, p=0.030). Multivariate analysis of ≥75-year-old overweight (OR 0.69, CI 0.62-0.77, p<0.001), class-I obese (OR 0.62, CI 0.51-0.74, p<0.001), or class-II obese (OR=0.69, CI 0.50-0.95, p=0.022) patients were less likely to die within 30-days when compared to similarly aged normal-weight patients.

CONCLUSIONS: Our data suggest that obesity is a risk factor for mortality in low-energy hip fracture patients, but the appearance of the “obesity paradox” in elderly hip fracture patients results from statistical bias that is only evident upon subgroup analysis.

PMID:34245343 | DOI:10.1007/s00198-021-06046-7

Trop Anim Health Prod. 2021 Jul 10;53(3):395. doi: 10.1007/s11250-021-02824-x.

ABSTRACT

BACKGROUND: Assigning animals to their corresponding breeds through breed informative single-nucleotide polymorphisms (SNPs) is required in many fields. For instance, it is used in the traceability and the authentication of meat and other livestock products. SNPs’ information for several pork breeds are now accessible thanks to the availability of dense SNP chips. These SNP chips cover a large number of molecular markers distributed across the entire genome. To identify the pork breed from a sample of industrial meat, one must analyze a large panel of genetic markers depending on the SNP chip used. The analysis of such large datasets requires intensive work. This leads to the idea of creating less dense chips of breed informative markers based on a reduced number of SNPs. Therefore, the analysis of the data emanating from the genotyping of these reduced chips will require less time and effort.

AIM: The objective of this study is to find the most informative SNPs for the discrimination between four pig breeds, namely Duroc, Landrace, Large White, and Pietrain.

METHOD: The Illumina Porcine 60 k SNP chip was used to genotype SNPs distributed all over the individuals’ genomes. Firstly, we used three different statistical approaches for feature selection: (i) principal component analysis (PCA), (ii) least absolute shrinkage and selection operator (LASSO), and (iii) random forest (RF). These three approaches identified three sets of SNPs; each set corresponds to one approach. Then, we combined the results of the three methods by setting up a final panel containing the SNPs which appear on the three sets altogether.

RESULTS: Separately, each method resulted in a panel with the corresponding most discriminating SNPs. The PCA, the LASSO, and the random forest with Boruta algorithm highlighted 28,816, 50, and 286 SNPs, respectively. The number of SNPs selected by PCA is high compared to Boruta and LASSO because PCA chooses the variables while preserving as much information about the data as possible. The only downside of LASSO regression is that among a group of correlated variables, LASSO tends to select only one variable and ignore the others regardless of their importance. Contrarily to LASSO, the Boruta algorithm considers the interdependence between SNPs and selects informative variables even if they are correlated and have the same effect. The three panels shared 23 SNPs; the distribution of the individuals according to these SNPs showed a grouping of individuals of each breed in well-defined clusters without any overlapping.

CONCLUSIONS: The biological pathways represented by 23 breed informative SNPs resulted by the combination of PCA, LASSO, and Boruta should be explored in further analysis. The results provided by our study are promising for further applications of this method in other livestock animals.

PMID:34245361 | DOI:10.1007/s11250-021-02824-x

World J Surg. 2021 Jul 9. doi: 10.1007/s00268-021-06236-8. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the recently increasing number of elderly patients undergoing liver resection, the impact of advancing age on postoperative infections (PIs) incidence and risk remains unclear. This study aimed to investigate the impact of advancing age on PIs incidence and status.

METHODS: This retrospective study included 744 patients undergoing liver resection without biliary reconstruction or combined resection of other organs. Multivariable analysis with a restricted cubic spline was used to evaluate the impact of advancing age on PIs and to determine its association with PIs risk in patients undergoing open and laparoscopic liver resection (OLR and LLR, respectively).

RESULTS: Multivariable analysis demonstrated that advancing age was significantly associated with increased PIs risk (P = 0.017). The spline curve showed that the odds ratio for PIs sharply increased starting approximately at 65 years of age. Unadjusted restricted cubic splines assessing the subcategories of PIs demonstrated that advancing age was associated with increased risks of organ/space surgical site infection and sepsis (P = 0,064 and 0.048, respectively). Multivariable analysis revealed that LLR was associated with the lower PIs risk compared with OLR (P = 0.025), whereas the lower PIs risk with LLR was not significantly obscured by advancing age (P = 0.29).

CONCLUSIONS: Advancing age was associated with increased risk of PIs, including organ/space surgical site infections and sepsis, after liver resection especially in patients aged ≥ 65 years.

PMID:34244815 | DOI:10.1007/s00268-021-06236-8