Category: Nevin Manimala

Nurs Crit Care. 2021 Aug 21. doi: 10.1111/nicc.12706. Online ahead of print.

ABSTRACT

BACKGROUND: Prototype analyses of well-being have identified central characteristics and prototypicality for New Zealand teachers, lawyers, adolescents, and work well-being of nurses. What has not yet been explored is the broad construct of well-being in intensive care nurses.

AIMS AND OBJECTIVES: To identify intensive care nurses’ conceptions of general well-being and investigate whether their general well-being is prototypically organized.

DESIGN: Prototype analysis.

METHODS: Three linked studies conceptualize well-being in this prototype analysis. In study 1, nurses reported features of well-being. Study 2 investigated the organization of these features. Study 3 sought confirmation of prototypical organization.

RESULTS: Sixty-five New Zealand nurses participated. For study 1 (n = 23), the most frequently reported elements of well-being included physical health (n = 26), work-life balance (n = 20), and personal relationships (n = 18). For study 2 (n = 25), the highest rated elements included mental and emotional health, [general] health, work-life balance, and love. Work-life balance, physical health, and personal relationships were in the top five most frequently reported and were rated in the top 12 most central. Overall, ratings of centrality and the number of times reported were positively correlated (r = 0.33, P < .005). For study 3 (n = 17), confirmatory analyses did not reach statistical significance (P = .15).

CONCLUSIONS: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. Mental, emotional, and general health and work-life balance were considered most important for well-being.

RELEVANCE TO CLINICAL PRACTICE: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. These characteristics of the broad construct of well-being are helpful in both defining and identifying conceptual models of well-being that may be used to inform the development and measurement of well-being programmes.

PMID:34418247 | DOI:10.1111/nicc.12706

Mol Ecol. 2021 Aug 21. doi: 10.1111/mec.16133. Online ahead of print.

ABSTRACT

Recent outbreaks of emerging and re-emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that an emergent JEV genotype V (GV) is circulating in Asia, against which current vaccines may not be efficacious. To ascertain if JEV GV and other arboviruses are circulating in East Asia, we conducted next-generation sequencing on 260 pools of Culex tritaeniorhynchus and Culex bitaeniorhynchus mosquitoes (6,540 specimens) collected at Camp Humphreys, Republic of Korea (ROK) in 2018. Interrogation of our data revealed a highly abundant and diverse virosphere that contained sequences from 122 distinct virus species. Our statistical and hierarchical analysis uncovered correlates of potential health, virological, and ecological relevance. Furthermore, we obtained evidence that JEV GV was circulating in Pyeongtaek and, retrospectively, in Seoul in 2016 and place these findings within the context of human and fowl reservoir activity. Sequence-based analysis of JEV GV showed a divergent genotype that is the most distant from the GIII-derived live attenuated SA14-14-2 vaccine strain and indicated likely regions responsible for reduced antibody affinity. These results emphasize recent concerns of shifting JEV genotype in East Asia and highlight the critical need for a vaccine proven efficacious against this re-emergent virus. Together, our one-health approach to Culex viral metagenomics uncovered novel insights into virus ecology and human health.

PMID:34418188 | DOI:10.1111/mec.16133

Zoo Biol. 2021 Aug 21. doi: 10.1002/zoo.21647. Online ahead of print.

ABSTRACT

A variety of insects are fed to insectivorous animals; however, nutritional analyses are often limited to adult life stages. Four species of nymph and adult female and male cockroaches (Blaberus giganteus, Blaptica dubia, Blatta lateralis, and Gromphadorhina portentosa) were analyzed for moisture, crude protein (CP), acid detergent fiber (ADF), fat, ash, and mineral content. The small sample size of this study precluded statistical analyses, however comparatively, CP in adult B. lateralis and B. dubia was greater than the CP in nymphs of the same species. Adult and nymph B. dubia had the greatest CP (96.6% and 65.3%, respectively) compared to the other three species. Inversely, fat content in adult B. lateralis and B. dubia was lower than that of nymphs of the same species. All adults contained similar levels of ADF, yet adult B. giganteus had greater ADF than nymphs; conversely, B. lateralis and B. dubia adults had less ADF than nymphs. There were differences noted in mineral parameters among the four species and life stages. Adult B. giganteus had less Ca than G. portentosa, and the lowest Ca content of the four species of nymphs and adults analyzed. This study underscores the differences in nutrient content with respect to life stage and species in previously understudied cockroaches to improve nutrient intake in captive insectivores.

PMID:34418140 | DOI:10.1002/zoo.21647

Reprod Domest Anim. 2021 Aug 21. doi: 10.1111/rda.13995. Online ahead of print.

ABSTRACT

Artificial insemination (AI) with cryopreserved semen is an important tool to preserve endangered species, including European donkey breeds. Sperm vitrification is an alternative method to conventional freezing using high cooling rates and non-permeable cryoprotectant agents (CPAs). In donkeys, sperm vitrification was firstly developed in spheres by directly dropping the sperm (30 µl) into the liquid nitrogen. The vitrification media contained a combination of sucrose and bovine serum albumin as non-permeable CPAs and resulted in better sperm parameters after warming than extenders containing glycerol. Thereafter, sperm vitrification was optimized using an aseptic protocol, which consists of volumes up to 160 µl vitrified at 300 million sperm/ml using 0.25-ml straws with outer covers, obtaining similar sperm parameters as conventional freezing for total motility (52.7 ± 15.6% versus. 58.2 ± 16.1%), progressive motility (44.3 ± 15.0% versus. 44.7 ± 18.2%) and plasma membrane integrity (49.2 ± 11.2% versus. 55.4 ± 9.0%), respectively. In order to vitrify larger volumes of sperm, a procedure using 0.5-ml straws was evaluated; however, this methodology failed when compared to conventional freezing or other vitrification protocols, obtaining poor sperm quality after warming. Recently, a new methodology was developed for warming 0.25-ml straws in a water bath and after AI using the vitrified sperm, the uterine inflammatory response solved faster, and pregnancy rates were greater (22%) than frozen semen (10%) but not statistically different. In conclusion, all these findings confirm that sperm vitrification can be performed in donkeys as an alternative to conventional freezing for AI in jennies.

PMID:34418185 | DOI:10.1111/rda.13995

J Inherit Metab Dis. 2021 Aug 21. doi: 10.1002/jimd.12428. Online ahead of print.

ABSTRACT

BACKGROUND: Niemann-Pick disease type C (NPC) is a rare, genetic, progressive neurodegenerative disorder with high unmet medical need. We investigated the safety and efficacy of arimoclomol, which amplifies the heat shock response to target NPC protein misfolding and improve lysosomal function, in patients with NPC.

METHODS: In a 12-month, prospective, randomized, double-blind, placebo-controlled, phase 2/3 trial (ClinicalTrials.gov identifier: NCT02612129), patients (2-18 years) were randomized 2:1 to arimoclomol:placebo, stratified by miglustat use. Routine clinical care was maintained. Arimoclomol was administered orally three times daily. The primary endpoint was change in 5-domain NPC Clinical Severity Scale (NPCCSS) score from baseline to 12 months.

RESULTS: Fifty patients enrolled; 42 completed. At month 12, the mean progression from baseline in the 5-domain NPCCSS was 0.76 with arimoclomol versus 2.15 with placebo. A statistically significant treatment difference in favour of arimoclomol of -1.40 (95% confidence interval: -2.76, -0.03; p = 0.046) was observed, corresponding to a 65% reduction in annual disease progression. In the prespecified subgroup of patients receiving miglustat as routine care, arimoclomol resulted in stabilization of disease severity over 12 months with a treatment difference of -2.06 in favour of arimoclomol (p = 0.006). Adverse events occurred in 30/34 patients (88.2%) receiving arimoclomol and 12/16 (75.0%) receiving placebo. Fewer patients had serious adverse events with arimoclomol (5/34, 14.7%) versus placebo (5/16, 31.3%). Treatment-related serious adverse events (n = 2) included urticaria and angioedema.

CONCLUSIONS: Arimoclomol provided a significant and clinically meaningful treatment effect in NPC and was well tolerated. This article is protected by copyright. All rights reserved.

PMID:34418116 | DOI:10.1002/jimd.12428

Equine Vet J. 2021 Aug 21. doi: 10.1111/evj.13498. Online ahead of print.

ABSTRACT

BACKGROUND: Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However few AAD cases are described in the literature.

OBJECTIVES: To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes.

STUDY DESIGN: Retrospective case series.

METHODS: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, intra- and post-operative factors that were considered relevant. Descriptive statistical analysis was performed.

RESULTS: A total of 63 cases of AAD were identified. AAD occurred due to tearing of sutures through the linea alba or rupture of the body wall adjacent to the suture line in 46 horses (73%). AAD occurred at a median of 5 days (0.5-70 days) post-operatively and broodmares accounted for 25% of the cases (n=16). Surgical site infection developed prior to AAD in 28 horses (44%); leakage of peritoneal fluid occurred in 5% of horses prior to AAD being identified. Surgical repair was performed in 27 horses (43%), 10 (16%) were treated conservatively and 26 (41%) were euthanased immediately. Repair was most frequently performed using suture (n=14), wire (n=5) or a combination (n=5). Overall survival to hospital discharge was 39% (24/63). Where surgical repair was performed, 15 horses (56%) survived to hospital discharge; 9 horses (90%) managed conservatively survived to hospital discharge.

MAIN LIMITATIONS: Follow-up was not performed for all cases following hospital discharge and some data were incompletely recorded in hospital files.

CONCLUSIONS: Previously stated causative factors for AAD were not consistent features in the present study. Surgical site infection following laparotomy and pregnant or early post-partum mares may be important risk factors for AAD and warrant further investigation.

PMID:34418125 | DOI:10.1111/evj.13498

J Ultrasound Med. 2021 Aug 21. doi: 10.1002/jum.15814. Online ahead of print.

ABSTRACT

OBJECTIVES: Intussusception is one of the most common abdominal emergencies in early children. Intussusception recurs in 8-20% of children after successful nonoperative reduction. The aim of this study was to explore the ultrasound findings to predict risk of recurrence in pediatric intussusception after air enema reduction.

METHODS: A total of 336 intussusception children were followed up for 1 year after received successful air enema reduction. They were divided into the recurrent group and the non-recurrent group. The differences of clinical characteristics, ultrasonic features, and laboratory tests were analyzed by univariate analyses and the Cox proportional hazard model.

RESULTS: Sixty-five children with recurrent intussusception were identified. There were statistically significances in the diameter of the mass, in the presence or absence of enlarged lymph nodes out of the sleeve, and in the sleeve between recurrent and non-recurrent groups (P < .05). Other ultrasonic features, clinical characteristics, and blood parameters had no differences (P > .05). Multivariate Cox proportional hazard model showed that the diameter of the mass and abdominal lymph nodes may be the risk factors of intussusception recurrence (HR = 1.395, 95% CI: 1.045~1.863 and HR = 2.078, 95% CI: 1.118~3.865, P < .05). The cut-off value of mass diameter was 2.55 cm, above which recurrence is more likely.

CONCLUSIONS: Intussusception recurrence was prone with greater mass diameter (>2.55 cm) and enlarged abdominal lymph nodes. Although these ultrasound findings for recurrence do not necessarily reduce the rate of recurrence, it can predict the recurrent possibility, and help the emergency physicians to be more vigilant in these children and better counsel parents upon discharge.

PMID:34418137 | DOI:10.1002/jum.15814

Med Phys. 2021 Aug 21. doi: 10.1002/mp.15174. Online ahead of print.

ABSTRACT

PURPOSE: The substitution of Computerized Tomography with Magnetic Resonance Imaging has been investigated for external radiotherapy treatment planning. The present study aims to use Pseudo-CT images created by MRI images to calculate the dose distribution for facilitating in the treatment planning process.

METHODS: In this work, following image segmentation with a fuzzy clustering algorithm, an adaptive neuro-fuzzy algorithm was utilized to design the Hounsfield Unit conversion model based on the features vector of MRI images. The model was generated on the set of extracted features from gray level co-occurrence matrices, and the gray level run length matrices for 14 arbitrarily selected patients with brain malady. The performance of the algorithm was investigated on a blind datasets through dose-volume histogram and isodose curve evaluations, using the RayPlan treatment planning system, along with the gamma analysis and statistical indices.

RESULTS: In the proposed approach the mean absolute error within the range of 45.4 HU (Hounsfield unit) was found among the test data. Also, the relative dose difference between the planning target volume region of the CT and the Pseudo-CT was 0.5%, and the best gamma pass rate for 3%/3mm was 97.2%.

CONCLUSION: The proposed method provides a satisfactory average error rate for the generation of Pseudo-CT data in the different parts of the brain region from a collection of MRI series. Also, dosimetric parameters evaluation shows good agreement between reference CT and related Pseudo-CT images. This article is protected by copyright. All rights reserved.

PMID:34418104 | DOI:10.1002/mp.15174

Int J Gynaecol Obstet. 2021 Aug 21. doi: 10.1002/ijgo.13895. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the role of hydrosalpinx in the susceptibility of chronic endometritis (CE).

METHODS: This is a retrospective cohort study, which includes 624 patients with hydrosalpinx (group A) and 789 patients without hydrosalpinx (group B) undergoing laparoscopy and hysteroscopy simultaneously. Endometrial morphology was recorded under hysteroscopy. Endometrial biopsy was obtained after hysteroscopy, and immunohistochemical staining for syndecan-1 (CD138) was carried out.

RESULTS: No significantly statistical differences were found between the two groups when comparing the incidence of endometrial hyperemia or endometrial micro-polyps under hysteroscopy (P>0.05). Hydrosalpinx had a significant impact on the incidence of CE (P<0.05) (plasma cell count: no plasma cells: OR 0.71, 95% CI 0.58-0.88, P=0.002; ≥1/HPF: OR 1.40, 95% CI 1.14-1.74, P=0.002; ≥3/HPF: OR 1.50, 95% CI 1.18-1.91, P=0.001; ≥5/HPF: OR 1.62, 95% CI 1.27-2.21, P<0.001). There were no significant differences in the comparison of plasma cell count between the unilateral hydrosalpinx group (274 patients) and the bilateral hydrosalpinx group (350 patients) (P>0.05).

CONCLUSION: The presence of hydrosalpinx increased the incidence of CE. Bilateral hydrosalpinx did not significantly increase the incidence of CE compared with unilateral hydrosalpinx.

PMID:34418100 | DOI:10.1002/ijgo.13895

Am J Phys Anthropol. 2021 Aug 21. doi: 10.1002/ajpa.24394. Online ahead of print.

ABSTRACT

OBJECTIVE: Frailty is the physiological stress that individuals suffer during their life. In past populations, frailty is conventionally assessed through the occurrence of different biomarkers of biological stress. Some efforts have been made to propose indexes that combine all biomarkers. However, these indices have some critical limitations: they cannot be used on incomplete skeletons, do not consider the severity and/or healing of lesions, and assign equal importance to different biomarkers. To address these limitations, we propose a new index to assess frailty in skeletal individuals.

MATERIAL AND METHODS: By statistically analyzing a large amount of osteological data available from the Museum of London, and using a Logit model, we were able to define a different weight for each reported biomarker of frailty, based on their importance in increasing the risk of premature death for the individuals.

RESULTS: The biological index of frailty (BIF) is the weighted mean of all biomarkers scored on the individuals, according to a different degree of importance assigned to each one. It also considers the severity and healing of the biomarkers when this is relevant to diagnose frailty. We applied BIF on a sample of Monastics and Non-Monastics from medieval England and compared it with the skeletal index of frailty (SFI).

DISCUSSION: BIF is the first frailty index that gives a different weight to each skeletal biomarker of stress, considers both severity and healing of the lesions, and can be applied on partial skeletal remains. The comparison with SFI showed that BIF is applicable to a larger number of skeletal individuals, revealing new differences between the Monastic and the Non-Monastic groups.

PMID:34418072 | DOI:10.1002/ajpa.24394