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Nevin Manimala Statistics

Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals – Results from a cross-sectional study in March-April 2021

J Hosp Infect. 2022 Apr 9:S0195-6701(22)00102-5. doi: 10.1016/j.jhin.2022.03.014. Online ahead of print.

ABSTRACT

BACKGROUND: Patients are at risk of nosocomial COVID-19 infection. The role of accompanying persons/visitors as potential infection donors is not yet well-known, but the risk will be influenced by prevention measures recommended by infection control practitioners.

AIM: The aim of the study is to collect information about COVID-19 infection control strategies for patients and accompanying persons from infection control practitioners in German hospitals.

METHODS: A cross-sectional questionnaire was developed, ethically-approved, pre-tested and formatted as an online tool. We invited infection control practitioners in 987 randomly-selected German hospitals in March and April 2021 to participate. For statistical analysis, the hospitals were categorised as small (0-499 beds) or large (≥500 beds).

FINDINGS: 100 surveys were completed (response rate: 10%). More large (71%) than small hospitals (49%) let patients decide freely whether to wear medical or FFP2 masks. Most hospitals reported spatial separation for COVID-19 patients and non-COVID-19 cases (38%) or additionally for suspected COVID-19 cases (53%). A separation of healthcare teams for these areas existed in 54% of the hospitals. Accompaniment bans were more prevalent in large (52%) than in small hospitals (29%), but large hospitals granted more exemptions.

CONCLUSION: The possibility to separate areas and teams seemed to depend on the hospital’s structural conditions, therefore impairing the implementation of recommendations. Accompaniment regulations differ between hospital sizes and may depend on patient numbers, case type/severity and patient’s requirements. In the dynamic pandemic, it can be difficult to stay up to date with findings and recommendations about infection control.

PMID:35413422 | DOI:10.1016/j.jhin.2022.03.014

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Nevin Manimala Statistics

Prolonged viral shedding identified from external splints and intranasal packings in immediately cured COVID-19 patients with nasal fractures: A retrospective study

J Stomatol Oral Maxillofac Surg. 2022 Apr 9:S2468-7855(22)00092-1. doi: 10.1016/j.jormas.2022.04.003. Online ahead of print.

ABSTRACT

BACKGROUND: Our aim was to measure and compare prolonged viral shedding (PVS) identified from external splints (ES) and intranasal packings (IP) for isolated nasal fracture (INF) repair in immediately cured asymptomatic vs. mildly symptomatic COVID-19 patients (AS-COVID vs. MS-COVID).

METHODS: We designed a retrospective cohort study and enrolled a sample of post-AS-COVID and post-MS-COVID patients, whose INF were treated at a German level 1 trauma centre. The primary predictor variable was COVID severity presurgery (AS-COVD vs. MS-COVID). The main outcome variable was PVS detected in ES/IP. Other study variables were separated into demographic, clinical, and operative. Descriptive, bi- and multivariate statistics were computed, and statistical significance was set at P ≤ 0.05.

RESULTS: The study sample comprised 15 INF patients (53.3% females; 46.7% post-AS-COVID) with a mean age of 42.2 ± 22.7 years (range, 18-85). 13.3% ES and 53.3% IP were contaminated with SARS-CoV-2. However, only IP-contamination between the two cohorts reached statistical significance (P = 0.01; odds ratio, 0.02; 95% confidence interval, 0 to 0.47; Pearson’s r = 0.73; post hoc power = 87.4%). Multiple linear regression models refuted the associations between PVS and the other parameters (i.e. age, gender, time to treatment, length of hospital stay, lengths of ES/IP placement).

CONCLUSIONS: Despite a relative low sample size, our findings suggest PVS via endonasal materials removed from cured COVID-19 patients, especially those healed from MS-COVID. This PVS may trigger re-infection and surgical site infections and/or transmission to other humans, and thereby, require further investigations.

PMID:35413460 | DOI:10.1016/j.jormas.2022.04.003

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Nevin Manimala Statistics

Chairside virtual patient protocol. Part 2: management of multiple face scans and alignment predictability

J Dent. 2022 Apr 9:104123. doi: 10.1016/j.jdent.2022.104123. Online ahead of print.

ABSTRACT

OBJECTIVES: Face scans are currently used in dentistry to obtain a virtual patient. Find stable and repeatable references for their matching is a fundamental step. Aim of this study is to evaluate matching reliability of multiple face scans using frontal adhesives references. Null hypothesis was that no significant discrepancy could be detected between the references position analyzed both with surface analysis and linear analysis.

MATERIALS AND METHODS: Nine patients were enrolled for this study and nine soft tissue adhesives landmarks (APLI Paper S.A.U, 4 mm Ø) placed, equally distributed, on the forehead and glabella. Patients were digitally scanned with a portable scanner (iPad Pro 3rd Gen. Apple Store, Cupertino, CA, USA) using the software Bellus3D (Inc. Campbell, CA, USA) in maximum intercuspation, with a full smile and with a scan reference device. After the scan procedure, a high-definition polygon file format (.ply) was exported, and linear measurements were collected with MeshLab (MeshLab; MeshLab). In order to further evaluate reference accuracy, a surface analysis was performed using a CAD software (GOM inspect, GOM). 3D deviations were calculated as root mean square. Statistical analysis was performed used two repeated-measures ANOVAs.

RESULTS: Results showed non-significant differences both for linear measurements (p=.22) and surface analysis (p=.58). Frontal references showed to be clinical reliable landmarks to be used during face scans alignment even with different facial expressions.

CONCLUSION: The proposed technique seems to be suitable for the clinical use when superimposition of several face scans is required.

CLINICAL SIGNIFICANCE: This study showed the clinical reliability of face scans matching method using adhesives references that have low costs and are easy to use, allowing for a rapid registration of patient anatomy.

PMID:35413410 | DOI:10.1016/j.jdent.2022.104123

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Nevin Manimala Statistics

Socioeconomic inequalities and the surface heat island distribution in Santiago, Chile

Sci Total Environ. 2022 Apr 9:155152. doi: 10.1016/j.scitotenv.2022.155152. Online ahead of print.

ABSTRACT

Surface urban heat islands (SUHIs) are an important socio-environmental problem associated with large cities, such as the Santiago Metropolitan Area (SMA), in Chile. Here, we analyze daytime and nighttime variations of SUHIs for each season of the year during the period 2000-2020. To evaluate socioeconomic inequities in the distribution of SUHIs, we establish statistical relationships with socioeconomic status, land price, and urban vegetation. We use the MODIS satellite images to obtain the land surface temperatures and the normalized difference vegetation index (NDVI) through the Google Earth Engine platform. The results indicate more intense SUHIs during the nighttime in the eastern sector, coinciding with higher socioeconomic status and larger green areas. This area during the day is cooler than the rest of the city. The areas with lower and middle socioeconomic status suffer more intense SUHIs (daytime and nighttime) and match poor environmental and urban qualities. These results show the high segregation of SMA. Urban planning is subordinated to land prices with a structure maintained over the study period. The lack of social-climate justice is unsustainable, and such inequalities may be exacerbated in the context of climate change. Thus, these results can contribute to the planning of the SMA.

PMID:35413353 | DOI:10.1016/j.scitotenv.2022.155152

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The accuracy of post and core fabricated with digital technology

J Prosthodont. 2022 Apr 12. doi: 10.1111/jopr.13522. Online ahead of print.

ABSTRACT

PURPOSE: To compare the accuracy of post and cores created with three different fabricating techniques: direct conventional, machine milling, and three dimensional printing.

MATERIALS AND METHODS: Thirteen extracted single root central incisors were selected. Root canal treatment and tooth preparation for crown were performed on all teeth. Post space preparation of 11 mm was created using prefabricated fiber post drill to standardize post space width and length. Root canal impressions were performed on all teeth using polyvinyl siloxane impression material. Each impression was then three dimensionally scanned using an extraoral lab scanner. The scanned impressions were used to design digital files of post and cores with 3shape CAD software. The digitally designed post and cores were used to fabricate 3D printed and milled post and core resin patterns. The same teeth were used to fabricate post and core with conventional technique (direct duplication of root canal with resin pattern). All posts were then scanned before being invested and then cast using base metal educational alloy. The metal post and cores were tried in with sample teeth and manually adjusted until found to be clinically acceptable. The post and cores were scanned in different stages to perform digital volume measurement using Geomagicࣨ Control X࣪ software to determine accuracy. Pairwise comparisons were accomplished using exact version of the sign test (α = 0.05) RESULTS: These three techniques of post and core fabrication showed different results in the various stages of fabrication. The accuracy of 3D printed resin pattern (26.89 ±11.09 mm3 ) was found to be inferior compare to milled resin pattern (28.20 ±11.41 mm3 , p = 0.0002). However, dimensional stability of the 3D printed resin pattern before and after casting (0.56 ±0.95 mm3 ) was found to be superior to milled resin pattern (0.79 ±0.89 mm3 ) and direct resin pattern (2.51 ±1.38 mm3 , p = 0.00002). All three techniques showed significant volume reduction after adjustment (p = 0.0002). In the final stage, the adjusted metal post and core fabricated with three different techniques showed no statistical different in accuracy (p = 0.15).

CONCLUSION: Digitally fabricated post and cores have the same degree of accuracy as the gold standard direct conventional post and core fabrication technique. This article is protected by copyright. All rights reserved.

PMID:35413146 | DOI:10.1111/jopr.13522

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Nevin Manimala Statistics

Interaction between cigarette smoking and genetic polymorphisms on the associations with age of natural menopause and reproductive lifespan: the Singapore Chinese Health Study

Hum Reprod. 2022 Apr 12:deac075. doi: 10.1093/humrep/deac075. Online ahead of print.

ABSTRACT

STUDY QUESTION: Are there genetic variants that interact with smoking to reduce reproductive lifespan in East-Asian women?

SUMMARY ANSWER: Our study corroborates several recently identified genetic loci associated with reproductive lifespan and highlights specific genetic predispositions that may interact with smoking status to adversely affect reproductive lifespan in East-Asian women.

WHAT IS KNOWN ALREADY: Epidemiological data as well as evaluations on genetic predisposition to smoke indicate on the importance of smoking in adverse effects on reproductive lifespan in women. However, there are no previous smoking and gene interaction studies for reproductive traits in East-Asian women.

STUDY DESIGN, SIZE, DURATION: This population-based prospective cohort study comprised 11 643 East-Asian Chinese women with overlapping genome-wide genotyping and reproductive data.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We performed a genome-wide association study for reproductive lifespan in women (n = 11 643) from the Singapore Chinese Health Study (SCHS) and carried out a genome-wide interaction study to identify loci that interacted with smoking status to affect age of natural menopause and reproductive-time.

MAIN RESULTS AND THE ROLE OF CHANCE: Two known loci associated with menopause, rs113430717 (near HMCES, chromosome 3, Pmeta = 5.72 × 10-15) and rs3020136 (near RAD21, chromosome 8, Pmeta = 1.38 × 10-8) were observed beyond genome-wide levels of association with age at menopause in this study. For reproductive lifespan, the genome-wide association observed at rs79784106 (chromosome 3, Pmeta = 5.05 × 10-12) was in linkage disequilibrium with the menopause lead single-nucleotide polymorphism (SNP) (rs113430717). Four additional loci, first reported to be associated with menopause, were also associated with reproductive lifespan in our study (PAdj between 7.42 × 10-5 to 4.51 × 10-3). A significant interaction was observed between smoking and an East-Asian specific SNP, rs140146885, for reduced reproductive lifespan, per copy of the minor C allele (beta = -1.417 years, Pinteraction = 2.31 × 10-10). This interaction was successfully replicated in additional independent samples (beta = -1.389 years, Pinteraction = 6.78 × 10-3). Another known variant associated with menopause, rs11031006 (near FSHB), was also observed to interact with smoking status to reduce age at menopause in our dataset (beta = -0.450 years, Padj = 0.042).

LIMITATIONS, REASONS FOR CAUTION: The modest sample size of the replication datasets used likely affected the statistical power to firmly replicate all identified novel loci observed in our smoking interaction analyses.

WIDER IMPLICATIONS OF THE FINDINGS: Age of natural menopause and reproductive lifespan have clear genetic predispositions with distinct ethnic differences, and they may be adversely truncated by lifestyle factors such as smoking, which can pose a significant impact on the reproductive lifespan and future health outcomes in women.

STUDY FUNDING/COMPETING INTEREST(S): The Singapore Chinese Health Study is funded by the National Medical Research Council, Singapore (NMRC/CIRG/1456/2016), National Institutes of Health (R01 CA144034 and UM1 CA182876) and National Research Foundation, Singapore (Project Number 370062002). W.-P.K. is supported by the National Medical Research Council, Singapore (MOH-CSASI19nov-0001). The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The authors do not report conflicts of interest.

TRIAL REGISTRATION NUMBER: N/A.

PMID:35413122 | DOI:10.1093/humrep/deac075

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Type and impact of clinical incidents identified by a voluntary reporting system covering 130 small animal practices in mainland Europe

Vet Rec. 2022 Apr 12:e1629. doi: 10.1002/vetr.1629. Online ahead of print.

ABSTRACT

BACKGROUND: Veterinary healthcare can be a complex process and may lead to unwanted, potentially harmful patient safety incidents as a consequence, negatively impacting both the practice team and client satisfaction. The aim of this study was to identify how such incidents impact cats and dogs by analysing reports gathered in a large-scale voluntary incident reporting system.

METHODS: Descriptive statistical analysis was used to study a total of 2155 incident reports, submitted by 130 practices on mainland Europe.

RESULTS: Incidents caused harm in more than 40% of reports. Medication-related incidents were the most frequent type of incident recorded (40%). Treatment-related incidents were the most common type of incident causing patient harm (55%). Anaesthesia-related incidents were the most severe type of incident, resulting in patient death in 18% of these reports. Most incidents were reported from hospital wards, and a significantly higher proportion of cats were harmed by incidents compared to dogs.

CONCLUSION: This study demonstrates that patients are regularly harmed by incidents, with medication-related incidents being most common. In depth understanding of incident data can help develop interventions to reduce the risk of incident recurrence.

PMID:35413131 | DOI:10.1002/vetr.1629

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Nevin Manimala Statistics

De novo mutations in children born after medical assisted reproduction

Hum Reprod. 2022 Apr 12:deac068. doi: 10.1093/humrep/deac068. Online ahead of print.

ABSTRACT

STUDY QUESTION: Are there more de novo mutations (DNMs) present in the genomes of children born through medical assisted reproduction (MAR) compared to spontaneously conceived children?

SUMMARY ANSWER: In this pilot study, no statistically significant difference was observed in the number of DNMs observed in the genomes of MAR children versus spontaneously conceived children.

WHAT IS KNOWN ALREADY: DNMs are known to play a major role in sporadic disorders with reduced fitness such as severe developmental disorders, including intellectual disability and epilepsy. Advanced paternal age is known to place offspring at increased disease risk, amongst others by increasing the number of DNMs in their genome. There are very few studies reporting on the effect of MAR on the number of DNMs in the offspring, especially when male infertility is known to be affecting the potential fathers. With delayed parenthood an ongoing epidemiological trend in the 21st century, there are more children born from fathers of advanced age and more children born through MAR every day.

STUDY DESIGN, SIZE, DURATION: This observational pilot study was conducted from January 2015 to March 2019 in the tertiary care centre at Radboud University Medical Center. We included a total of 53 children and their respective parents, forming 49 trios (mother, father and child) and two quartets (mother, father and two siblings). One group of children was born after spontaneous conception (n = 18); a second group of children born after IVF (n = 17) and a third group of children born after ICSI combined with testicular sperm extraction (ICSI-TESE) (n = 18). In this pilot study, we also subdivided each group by paternal age, resulting in a subgroup of children born to younger fathers (<35 years of age at conception) and older fathers (>45 years of age at conception).

PARTICIPANTS/MATERIALS, SETTING, METHODS: Whole-genome sequencing (WGS) was performed on all parent-offspring trios to identify DNMs. For 34 of 53 trios/quartets, WGS was performed twice to independently detect and validate the presence of DNMs. Quality of WGS-based DNM calling was independently assessed by targeted Sanger sequencing.

MAIN RESULTS AND THE ROLE OF CHANCE: No significant differences were observed in the number of DNMs per child for the different methods of conception, independent of parental age at conception (multi-factorial ANOVA, f(2) = 0.17, P-value = 0.85). As expected, a clear paternal age effect was observed after adjusting for method of conception and maternal age at conception (multiple regression model, t = 5.636, P-value = 8.97 × 10-7), with on average 71 DNMs in the genomes of children born to young fathers (<35 years of age) and an average of 94 DNMs in the genomes of children born to older fathers (>45 years of age).

LIMITATIONS, REASONS FOR CAUTION: This is a pilot study and other small-scale studies have recently reported contrasting results. Larger unbiased studies are required to confirm or falsify these results.

WIDER IMPLICATIONS OF THE FINDINGS: This pilot study did not show an effect for the method of conception on the number of DNMs per genome in offspring. Given the role that DNMs play in disease risk, this negative result is good news for IVF and ICSI-TESE born children, if replicated in a larger cohort.

STUDY FUNDING/COMPETING INTEREST(S): This research was funded by the Netherlands Organisation for Scientific Research (918-15-667) and by an Investigator Award in Science from the Wellcome Trust (209451). The authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER: N/A.

PMID:35413117 | DOI:10.1093/humrep/deac068

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Estimation of mean population salt intakes using spot urine samples and associations with body mass index, hypertension, raised blood sugar and hypercholesterolemia: Findings from STEPS Survey 2019, Nepal

PLoS One. 2022 Apr 12;17(4):e0266662. doi: 10.1371/journal.pone.0266662. eCollection 2022.

ABSTRACT

BACKGROUND: High dietary salt intake is recognized as a risk factor for several non-communicable diseases (NCDs), in particular cardiovascular diseases (CVDs), including heart attack and stroke. Accurate measurement of population level salt intake is essential for setting targeted goals and plans for salt reduction strategies. We used a spot urine sample to estimate the mean population salt intake in Nepal and evaluated the association of salt intake with excess weight, hypertension, raised blood sugar and hypercholesterolemia, and a number of socio-demographic characteristics.

METHODS: A population-based cross-sectional study was carried out from February to May 2019 using a WHO STEPwise approach to surveillance. Spot urine was collected from 4361 participants aged 15-69 years for the analysis of salt intake. We then used the INTERSALT equation to calculate population salt intake. Student’s ‘t’ test, one-way ANOVA and multivariable linear regression were used to assess the association between salt intake and a number of factors. Statistical significance was accepted at P < .05.

RESULTS: The average (±SD) age of participants was 40 (14.1) years. Mean salt intake, derived from spot urine samples, was estimated to be 9.1g/d. A total of 70.8% of the population consumed more than the WHO’s recommended amount of 5g salt per day, with almost one third of the population (29%) consuming more than 10g of salt per day. Higher salt intake was significantly associated with male gender (β for male = 0.98g; 95%CI:0.87,1.1) and younger age groups (β25-39 years = 0.08; 95%CI:-0.08,0.23) and higher BMI (β = 0.19; 95%CI:0.18,0.21). Participants who were hypertensive and had raised blood cholesterol consumed less salt than people who had normal blood pressure and cholesterol levels (P<0.001).

CONCLUSIONS: Salt consumption in Nepal is high, with a total of 70.8% of the population having a mean salt intake >5g/d, well above the World Health Organization recommendation. High salt intake was found to be associated with sex, age group, education, province, BMI, and raised cholesterol level of participants These findings build a strong case for action to reduce salt consumption in Nepal in order to achieve the global target of 30% reduction in population salt intake by 2025.

PMID:35413065 | DOI:10.1371/journal.pone.0266662

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Nevin Manimala Statistics

Depression and stress regarding future career among university students during COVID-19 pandemic

PLoS One. 2022 Apr 12;17(4):e0266686. doi: 10.1371/journal.pone.0266686. eCollection 2022.

ABSTRACT

INTRODUCTION: Students generally struggle to build a good career after their graduation in developing countries like Bangladesh. Due to the COVID-19 pandemic, such struggle increased and faced with stress and depression. We aimed to inquire about the amplitude of depression and stress among university students during the COVID-19 pandemic regarding their future careers and to identify the factors associated with this depression and stress.

METHODS: A total of 516 students at various universities participated in this cross-sectional survey. From October 2020 to February 2021, data was collected through an online survey. An e-questionnaire with socio-demographic, Patient Health Questionnaire (PHQ-9) and Perceived Stress Scale (PSS-10) questions was created using Google Forms and distributed via Facebook, WhatsApp, and other social media platforms. The universities included into the sample were selected randomly from eight divisions of Bangladesh. Descriptive statistics and Pearson chi-square tests were carried out and the association between the risk factors and the outcome (e.g. depression and stress) was assessed by the odds ratio (OR) including 95% confidence interval (CI) obtained from the binary logistic regression model.

RESULTS: Among 516 participants, 380 (73.6%) were male and 136 (26.4%) were female. Around 414 (80.2%) participants had mild to severe depression and 399 (77.3%) reported having low to moderately perceived stress. Female students were 2.1 (95% CI: 1.21-3.76) times more depressed and 3.6 (95% CI: 1.87-6.76) times more stressed than the counterpart. Students, who think delaying graduation due to COVID-19 will reduce the chance of getting a job, were 1.72 (95% CI: 1.07-2.76) times more depressed. Respondents, whose department offers any internship were 36% less depressed (p = 0.053), while skilled students were 46% less stressed though it was not statistically significant (p = 0.43).

CONCLUSION: According to our findings, there is an increasing prevalence of depression and stress among students, particularly among female students and those who do not receive job-related facilities from their institutions or who are unskilled. Universities can provide mental health programs and strive to have enough space for students to participate in internships. In addition, the government and educational institutions should work together to address the growing challenge.

PMID:35413076 | DOI:10.1371/journal.pone.0266686