Category: Nevin Manimala

Hum Vaccin Immunother. 2021 May 4:1-9. doi: 10.1080/21645515.2021.1914804. Online ahead of print.

ABSTRACT

Objective: A bibliometric analysis was conducted to build an all-inclusive view of the status of research on hepatitis A virus (HAV) for facilitating researchers, health professionals, and policymakers to understand the characteristics of research output in this particular domain.Methods: A comprehensive search was conducted in the Web of Science database. The obtained data were exported into Microsoft Excel 2019, OriginPro 2018 and VOSviewer software for windows.Results: From 1985 to 2019, a total of 5,950 studies on HAV were published, with an overall h-index of 105, and 90,350 total citations. The most cited article on HAV was “Classification of chronic viral hepatitis: a need for reassessment” authored by Scheuer in the Journal of Hepatology with a total of 1,121 citations. The most cited article on HAV vaccine was “A controlled trial of a formalin-inactivated hepatitis A vaccine in healthy children” by Werzberger et al. in the New England Journal of Medicine with 401 citations. The most frequent year of publication was 2019 (n = 250). The largest number of studies were funded by the United States Department of Health Human Services (n = 199). The organization with the highest number of publications was the United States Centers for Disease Control and Prevention (n = 228). The United State of America (n = 1,500) was the country with the most publications. ‘Vaccine’ was the leading journal with 299 publications.Conclusions: The highest numbers of studies were published in developed countries. There is a clear need for interdisciplinary research approaches to evaluate and intervene in HAV endemic areas.

PMID:33945397 | DOI:10.1080/21645515.2021.1914804

J Air Waste Manag Assoc. 2021 May 4. doi: 10.1080/10962247.2021.1923586. Online ahead of print.

ABSTRACT

Light-duty gasoline vehicle (LDGV) tailpipe emission rates can be quantified based on pollutant concentrations measured using portable emission measurement systems (PEMS). Emission rates depend on exhaust flow. For simplified and micro-PEMS, exhaust flow is inferred from engine mass air flow (MAF) and air-to-fuel ratio. For many LDGVs, MAF is broadcast via the on-board diagnostic (OBD) interface. For some vehicles, only indirect indicators of MAF are broadcast. In such cases, MAF can be estimated using the speed-density method (SDM). The SDM requires an estimate of the engine volumetric efficiency (VE), which is the ratio of actual to theoretical MAF. VE is affected by intra-vehicle variability in the engine load and inter-vehicle variability in engine characteristics (e.g., the type of valvetrain). The suitability of SDM-based estimates of MAF in conjunction with simplified and micro-PEMS has not been adequately evaluated. Therefore, the objectives are to: (1) quantify VE accounting for intra- and inter-vehicle variability; and (2) evaluate the accuracy of SDM-based vehicle emission rate estimation approaches. Seventy-seven naturally-aspirated LDGVs were measured using PEMS. For each vehicle, VE was estimated using three approaches: (1) constant VE calibrated to actual fuel use; (2) average estimates of VE for Vehicle Specific Power modes imputed from OBD data; and (3) modeled VE using multilinear regression (MLR). The MLR models were developed based on engine load and engine characteristics. The best model was selected based on various statistical diagnostics. When engines were under load, variability in VE was most sensitive to variations in engine load. During idling, VE differed between engines depending on engine characteristics. The constant and modeled VE estimation approaches enable the accurate estimation of microscale and mesoscale emission rates, with errors typically within ±10% compared to values imputed from OBD data. Thus, accurate emission rates can be obtained from simplified and micro-PEMS. Implications StatementSimplified and micro portable emission measurement systems (PEMS) enable widespread measurement of vehicle exhaust emission. As a cost saving measure, they estimate exhaust flow indirectly rather than via measurement, typically based on engine mass air flow (MAF). For some vehicles, MAF is not reported by the on-board diagnostic (OBD) system but can be inferred from other reported variables and volumetric efficiency (VE). However, VE is typically proprietary. Methods demonstrated here for estimating VE enable accurate quantification of emission rates, thereby enabling use of these PEMS for policy-relevant applications such as technology assessments, trends analysis, and emissions inventories.

PMID:33945402 | DOI:10.1080/10962247.2021.1923586

Genet Test Mol Biomarkers. 2021 May 4. doi: 10.1089/gtmb.2020.0334. Online ahead of print.

ABSTRACT

Aim: The aim of this study was to explore the possible associations between single nucleotide polymorphisms (SNPs) and DNA methylation levels of seven genes in the inflammatory response pathway with susceptibility to chronic periodontitis (CP) among the Uighur population of the Xinjiang Autonomous Region of China. Methods: A total of 444 eligible subjects (279 CP patients and 165 healthy controls) were enrolled in the study. Genomic DNA was obtained from gingival tissue for genotyping eight SNPs and performing methylation measurements of seven genes. Results: SNP rs2070745 in the formyl peptide receptor 1 (FPR1) gene achieved statistical significance in the standard allelic association analysis for CP (p = 0.02). The frequency of the rs2070745 minor allele G was higher in the cases than in controls (0.367 vs. 0.291). Additionally, rs2070745 was significantly associated with CP under the dominant genetic model (p = 0.03). Using logistic regression analysis, rs2070745 was found to be consistently associated with CP under the additive dominant model, and this association remained significant after covariates were taken into account [odds ratio (OR) = 1.49 (1.09-2.05), p = 0.014; OR = 1.58 (1.04-2.40), p = 0.031, respectively]. No significant gene-gene interactions were identified. Although we did not find a polymorphism in interleukin 6 (IL6) associated with CP in our study, the methylation level of a CpG island region located within the promoter region of IL6 was significantly less in CP patients compared with controls (p < 0.05). Conclusions: The genetic polymorphism rs2070745 in FPR1 and the methylation level of the promoter region of IL6 might be associated with CP in the Uighur population of China.

PMID:33945309 | DOI:10.1089/gtmb.2020.0334

Neuromodulation. 2021 May 4. doi: 10.1111/ner.13401. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with pudendal neuralgia (PN) experience long-lasting chronic pain, hyperalgesia, and comorbid emotional disorders, such as depression and anxiety. Treatment via conventional pulsed radiofrequency (PRF) current carries a significantly high rate of failure.

OBJECTIVE: To determine the safety and clinical efficacy of high-voltage, long-duration PRF application to the pudendal nerve in patients with PN.

STUDY DESIGN: Observational retrospective design, self before-after controlled clinical trial.

MATERIALS AND METHODS: We analyzed the records of 70 patients of our hospital with diagnosed PN. Treatment consisted of PRF application to the pudendal nerve, using computed tomography guidance to target the pudendal nerve at the level of the ischial spine or ischial tuberosity of the affected side. PRF was applied with the following parameters: temperature 42°C, frequency 2 Hz, pulse width 20 ms, field intensity ramped gradually from 40 to 90 V, duration 900 sec. The therapeutic effect was evaluated by collecting patient scores for the visual analog scale (VAS), SF-36 health survey questionnaire (SF-36), and patient health questionnaire (PHQ-9) before treatment and at 1-, 4-, and 12-week follow-ups after PRF treatment. Data were analyzed by paired t-test with p < 0.05 considered to be statistically significant.

RESULTS: VAS, SF-36, and PHQ-9 scores at 1, 4, and 12 weeks after high-voltage long-duration PRF treatment were significantly improved relative to their respective pretreatment baseline scores (p < 0.05 for all). The effective rate at 12 weeks after high-voltage long-duration PRF was up to 88.6%.

LIMITATIONS: A small sample size and lack of a control group.

CONCLUSIONS: High-voltage long-duration PRF provided significant short-term (at least 12 weeks) pain relief to most patients with PN; it also improved subjective measures of depression and quality of life over the same duration of time.

PMID:33945192 | DOI:10.1111/ner.13401

Australas J Ageing. 2021 May 4. doi: 10.1111/ajag.12950. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the impact of a Consumer Directed Care (CDC) model of service delivery on the quality of life of older people receiving home care packages.

METHODS: Quality of life was assessed using validated instruments. The relationship between quality of life and length of time exposed to CDC was examined using descriptive statistical and multivariate regression analyses.

RESULTS: Consenting older adults (n = 150) in receipt of home care packages participated. Quality of life and capability scores were higher for older people in receipt of a CDC model of service delivery for <12 months compared to those receiving the model of care for longer, although this difference was not statistically significant. However, older people with more recent exposure to CDC indicated a stronger capability to do things that made them feel valued.

CONCLUSION: Extended longitudinal follow-up is needed to facilitate a detailed examination of the relationship between the evolution of CDC and its longer-term influences on quality of life.

PMID:33945198 | DOI:10.1111/ajag.12950

Orthop Surg. 2021 May 4. doi: 10.1111/os.12960. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical outcomes of oblique lumbar interbody fusion (OLIF) in conjunction with unilateral pedicle screw fixation (UPSF) via the Wiltse approach in treating degenerative lumbar scoliosis (DLS).

METHODS: The article is a retrospective analysis. Twelve patients with DLS who underwent combined OLIF and UPSF between July 2017 and December 2018 were included. The study included 2 male and 10 female patients, with a mean age at the time of the operation of 67.2 ± 9.1 years. The surgical characteristics and complications were evaluated. The clinical and radiological data such as the correction of deformity, coronal and sagittal profile were analyzed.

RESULTS: The mean follow-up time of the study was 26.8 ± 1.8 months. At the final follow-up, all patients who underwent combined OLIF and UPSF achieved statistically significant improvements in coronal Cobb angle (from 19.6° ± 4.8° to 6.9° ± 3.8°, P < 0.01), distance between the C7 plumb line and central sacral vertebral line (from 2.5 ± 1.7 cm to 0.9 ± 0.6 cm, P < 0.01), sagittal vertebral axis (from 4.3 ± 4.3 cm to 1.5 ± 1.0 cm, P = 0.03), lumbar lordosis (from 29.4° ± 8.6° to 40.8° ± 5.8°, P < 0.01), pelvic tilt (from 27.6° ± 10.8° to 18.3° ± 7.0°, P < 0.01), pelvic incidence-lumbar lordosis mismatch (from 23.3° ± 10.5° to 11.9° ± 8.4°, P < 0.01), and cross-sectional area of the dural sac (from 87.33 ± 39.41 mm² to 124.70 ± 39.26 mm² , P < 0.01). The visual analogue score for back and leg pain and Oswestry Disability Index of all patients significantly improved postoperatively (P < 0.01). One case of lumbar plexus injury was found after surgery. During the follow-up period, one patient had cage subsidence. A fusion rate of 100% and good positioning of the pedicle screws were achieved in all patients at the final follow-up.

CONCLUSION: OLIF in conjunction with UPSF is a safe and effective minimally invasive procedure for correcting both coronal and sagittal deformities, as it results in an improved quality of life in patients with DLS.

PMID:33945217 | DOI:10.1111/os.12960

J Morphol. 2021 May 4. doi: 10.1002/jmor.21365. Online ahead of print.

ABSTRACT

The discovery of cryptic biodiversity has blossomed under the advancements of genetic techniques, but species identification via morphology remains crucial to effective conservation efforts. In this study, we tested the use of continuous cranial shape variation in distinguishing the two living species of Mecistops: the West African slender-snouted crocodile (M. cataphractus) and the Central African slender-snouted crocodile (M. leptorhynchus). Using a combination of geometric morphometric characters and ratios of linear measurements, we identified statistically significant variation in cranial bone and overall skull shape of mature individuals that corroborates existing molecular and discrete morphological evidence for two distinct, extant species within Mecistops. Specifically, variation in the shape of the nasal appears particularly diagnostic, while ratios involving metrics of snout length to snout width at the premaxillary notch offer distinguishing features easily measured in the field. Because of the complementary results and applications of the morphometric and cranial ratio analyses, we argue that both methodologies remain relevant to species identification. Moreover, we recommend continued cooperation between geneticists and morphologists in diagnosing species of conservation concern.

PMID:33945166 | DOI:10.1002/jmor.21365

J Clin Lab Anal. 2021 May 4:e23806. doi: 10.1002/jcla.23806. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of fungal infection (FI) in developing countries is high, but the diagnosis of FI is still challenging to determine, so it is needed evaluation of biomarkers other than microbiological culture, because the culture has low sensitivity, high cost, not available in every laboratory and needs a long time. The detection of human galactomannan Aspergillus antigen (GAL) and 1,3-beta-D-glucan (BDG) on the fungal cell wall could be the promising biomarkers for fungal infection. Neutropenia, lymphopenia and CD4T cells in the immunocompromised patients are essential factors, but these cell associations with BDG and GAL levels have not been evaluated yet. The study aimed to evaluate GAL and BDG for detecting fungal infection and their association with total leucocyte count, neutrophil, monocyte, lymphocyte and CD4T cells.

METHOD: A cross-sectional study was conducted among 86 patient with suspected FI. Fungal infection established using EORTC/MSG criteria. Serology test performed using ELISA. Leucocyte cells were measured using a haematology autoanalyser, and CD4T cells were analysed using BD FACSPresto. Statistical analysis obtained using Spearman’s correlation coefficient, ROC curve analysis and 2 × 2 contingency table.

RESULTS: Serum Galactomannan and BDG had a significant correlation with CD4T cells and total lymphocyte count (p < 0.05). The cut-off OD GAL >0.3 had sensitivity 54.6%, specificity 87.5% and AUC 0.71; meanwhile, the BDG cut-off >115.78 pg/ mL had sensitivity 71.2%, specificity 52.4% and AUC 0.63 for detecting fungal infection.

CONCLUSIONS: The immunocompromised patients can undergo GAL for determining the diagnose of FI. The lower the CD4T cells and total lymphocyte count, the higher the GAL and BDG serum levels.

PMID:33945177 | DOI:10.1002/jcla.23806

J Clin Nurs. 2021 May 4. doi: 10.1111/jocn.15800. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To examine mealtime and patient factors associated with meal completion among hospitalised older patients. We also considered contextual factors such as staffing levels and ward communication.

BACKGROUND: Sub-optimum nutrition is a modifiable risk factor for hospital associated decline (HAD) in older patients. Yet, the quality of mealtime experiences can be overlooked within ward routinised practice.

DESIGN: Cross sectional, descriptive observation study.

METHODS: We undertook structured observation of mealtimes examining patient positioning, mealtime set-up and feeding assistance. The outcome was meal completion categorised as 0, 25%, 50%, 75% or 100%. Data were collected on patient characteristics and ward context. We used mixed-effects ordinal regression models to examine patient and mealtime factors associated with higher meal completion producing odds ratios (OR) and 95% confidence intervals (CI). The study was reported as per STROBE guidelines.

RESULTS: We included 60 patients with a median age of 82 years (IQR 76-87) and clinical frailty score of 5 IQR (4-6). Of the 279 meals, 51% were eaten completely, 6% three quarters, 15% half, 18% a quarter and 10% were not eaten at all. Mealtime predictors with a weak association with less-meal completion were requiring assistance, special diets, lying in bed, and red tray (indicator of nutrition risk), but were not statistically significant. Significant patient-level factors were higher values for frailty (OR 0.34 [0.11-1.04]) and Malnutrition Universal Screening Tool (OR 0.22 [0.08-0.62]). The average nurse-to-patient ratio was 1:5.5.

CONCLUSION: Patient factors were the strongest predictors for meal completion, but mealtime factors had a subtle influence. The nursing teams’ capacity to prioritise mealtimes above competing demands is important as part of a comprehensive nutrition strategy.

RELEVANCE TO CLINICAL PRACTISE: Nurses are central to optimising nutrition for frail older patients. It requires ward leadership to instil a culture of prioritising assisted mealtimes, improved communication, greater autonomy to tailor nutrition strategies and safe staffing levels.

PMID:33945183 | DOI:10.1111/jocn.15800

Pituitary. 2021 May 4. doi: 10.1007/s11102-021-01147-2. Online ahead of print.

ABSTRACT

BACKGROUND: Residual tumor tissue after pituitary adenoma surgery, is linked with additional morbidity and mortality. Intraoperative magnetic resonance imaging (ioMRI) could improve resection. We aim to assess the improvement in gross total resection (GTR), extent of resection (EOR), and residual tumor volume (RV) achieved using ioMRI.

METHODS: A systematic review was carried out on PubMed/MEDLINE to identify any studies reporting intra- and postoperative (1) GTR, (2) EOR, or (3) RV in patients who underwent resection of pituitary adenomas with ioMRI. Random effects meta-analysis of the rate of improvement after ioMRI for these three surgical outcomes was intended.

RESULTS: Among 34 included studies (2130 patients), the proportion of patients with conversion to GTR (∆GTR) after ioMRI was 0.19 (95% CI 0.15-0.23). Mean ∆EOR was + 9.07% after ioMRI. Mean ∆RV was 0.784 cm³. For endoscopically treated patients, ∆GTR was 0.17 (95% CI 0.09-0.25), while microscopic ∆GTR was 0.19 (95% CI 0.15-0.23). Low-field ioMRI studies demonstrated a ∆GTR of 0.19 (95% CI 0.11-0.28), while high-field and ultra-high-field ioMRI demonstrated a ∆GTR of 0.19 (95% CI 0.15-0.24) and 0.20 (95% CI 0.13-0.28), respectively.

CONCLUSIONS: Our meta-analysis demonstrates that around one fifth of patients undergoing pituitary adenoma resection convert from non-GTR to GTR after the use of ioMRI. EOR and RV can also be improved to a certain extent using ioMRI. Endoscopic versus microscopic technique or field strength does not appear to alter the impact of ioMRI. Statistical heterogeneity was high, indicating that the improvement in surgical results due to ioMRI varies considerably by center.

PMID:33945115 | DOI:10.1007/s11102-021-01147-2