Nevin Manimala

Parasite. 2021;28:46. doi: 10.1051/parasite/2021042. Epub 2021 May 27.

ABSTRACT

Dicrocoelium dendriticum is a trematode that infects ruminant livestock and requires two different intermediate hosts to complete its lifecycle. Modelling the spatial distribution of this parasite can help to improve its management in higher risk regions. The aim of this research was to assess the constraints of using historical data sets when modelling the spatial distribution of helminth parasites in ruminants. A parasitological data set provided by CREMOPAR (Napoli, Italy) and covering most of Italy was used in this paper. A baseline model (Random Forest, VECMAP^®) using the entire data set was first used to determine the minimal number of data points needed to build a stable model. Then, annual distribution models were computed and compared with the baseline model. The best prediction rate and statistical output were obtained for 2012 and the worst for 2016, even though the sample size of the former was significantly smaller than the latter. We discuss how this may be explained by the fact that in 2012, the samples were more evenly geographically distributed, whilst in 2016 most of the data were strongly clustered. It is concluded that the spatial distribution of the input data appears to be more important than the actual sample size when computing species distribution models. This is often a major issue when using historical data to develop spatial models. Such data sets often include sampling biases and large geographical gaps. If this bias is not corrected, the spatial distribution model outputs may display the sampling effort rather than the real species distribution.

PMID:34047693 | DOI:10.1051/parasite/2021042

Arch Environ Occup Health. 2021 May 28:1-13. doi: 10.1080/19338244.2021.1931796. Online ahead of print.

ABSTRACT

Among health care professionals, dentists are more prone to infection due to their direct contact with blood and saliva. This study highlights the level of compliance with infection control measures among dental students; and linked this to their knowledge and attitudes regarding infection control measures and proper vaccinations. The study is a multi-centre analytical cross-sectional survey. The sample size was 969 clinical years’ students from governmental and private dental colleges in Sudan and Saudi Arabia. A pre-coded, pre-tested, and anonymous questionnaire consisted of seven categories of knowledge, attitude, awareness, and practices, including 40 questions, was answered. The study has linked knowledge, attitude, and practice in dental clinics with possible COVID-19 transmission in dental clinics. The results showed that the use of some Personal Protective Equipment was low in Sudan and moderate in Saudi Arabia (statistically significant, p < 0.001). Moderate percentage of Hepatitis B vaccination status, with low percentage of Post HBV serology, was reported (p < 0.001). The percentages of major causes of percutaneous and/or eye exposure/injury, for examples, were as follows: anesthesia (33.3-62.7%, p 0.006) and suture needle (17.5-39.4%, p 0.037). In conclusion, dental students in the present study had good knowledge and positive attitudes regarding infection control in general, but showed moderate compliance with the recommended infection control guidelines.

PMID:34047677 | DOI:10.1080/19338244.2021.1931796

J Matern Fetal Neonatal Med. 2021 May 27:1-5. doi: 10.1080/14767058.2021.1909560. Online ahead of print.

ABSTRACT

OBJECTIVE: Assess women’s perceptions of the impact of COVID-19 on their health care and well-being, access to and satisfaction with medical care due to the changes in delivery of care triggered by the pandemic.

METHODS: An online survey of women having health care appointments in the outpatient facilities across all divisions of a Department of Obstetrics and Gynecology at a tertiary care referral center in North Central Florida. Patients had outpatient appointments that were scheduled, canceled or rescheduled, in person or by telemedicine, between 11 March 2020 and 11 May 2020, a time during which a COVID-19 stay-at-home order was enacted across our state. A total of 6,697 visits were planned. Patients with multiple visits were unified, leaving 6,044 unique patients to whom the survey was emailed between 20 July 2020 and 31 July 2020. The survey was closed on 21 August 2020. Analyses were focused on simple descriptive statistics to assess frequency of responses. Analyses of variance and chi-square analyses were conducted to compare outcomes when all cells were ≥ 10, based on sub-specialty and insurance status; otherwise, frequencies were examined for the entire sample only. Missing data were excluded listwise.

RESULTS: A total of 6044 patients were contacted. Completed surveys numbered 1,083 yielding a response rate of 17.9%. The most common sub-specialty visit was gynecology (56.7%) followed by obstetrics (31.5%,), pelvic floor disorders (4.8%), gynecological oncology (2.9%,), and reproductive endocrinology (0.5%). A substantial percentage of women had visits canceled (19.2%), rescheduled (32.8%) or changed (42.1%) to telemedicine. In our patient population, 32.6% were worried about visiting the clinic and 48.1% were worried about visiting the hospital. COVID-19 triggered changes were perceived to have a negative impact by 26.1% of respondents. Refusal of future telemedicine visits was by 17.2%, however, 75.2% would prefer to use both in-person and telemedicine visits.

CONCLUSION: During the initial COVID-19 surge with lockdown, the majority of survey respondents were following public health precautions. However, there were significant concerns amongst women related to obstetric and gynecologic medical appointments scheduled during that period. During pandemics, natural disasters and similar extreme circumstances, digital communication and telemedicine have the potential to play a critical role in providing reassurance and care. Nevertheless, given the concerns expressed by survey respondents, communication and messaging tools are needed to increase comfort and ensure equity with the rapidly changing methods of care delivery.

PMID:34044744 | DOI:10.1080/14767058.2021.1909560

Int J Environ Health Res. 2021 May 28:1-10. doi: 10.1080/09603123.2021.1926439. Online ahead of print.

ABSTRACT

The soil is the part of the biosphere where heavy metal pollution is most common. Heavy metals pose a threat to animal and human health through plants. This study aimed to evaluate heavy metal concentrations in the soil of orchards of Bilecik Province and possible human health risks. In 2016, 42 soil samples were taken from peach orchards of Bilecik Province, and Cr, Fe, Ni, Cu, Zn, Cd, and Pb analyzed. Pollution indices (Enrichment Factor, Geoaccumalation Index, Contamination Factor, Ecological Risk Factor) were used to determine heavy metal pollution, and the effects on human health were determined by the hazard quotient (HQ) and hazard index (HI). The study area is moderate contaminated by Cd (3.64), Ni (2.38) and Cu (2.24) in terms of enrichment factor. Similarly, the study area soils were moderately contaminated by Cd (1.72), Ni (1.40) and Cu (1.38) in terms of the contamination factor. Besides, soils had moderate potential ecological risk by Cd (51.54). The principal component and correlation analysis showed Cd and Cu are anthropogenic and Ni is the lithogenic origin. Although soil pollution indexes show moderate pollution, there is no non-carcinogenic health risk for children (0.56) and adults (0.061).

PMID:34044701 | DOI:10.1080/09603123.2021.1926439

J Refract Surg. 2021 May;37(5):331-336. doi: 10.3928/1081597X-20210204-01. Epub 2021 May 1.

ABSTRACT

PURPOSE: To assess enlargement of the clear corneal incision site and functional outcome in patients with cataract, following the use of two preloaded intraocular lens (IOL) injectors.

METHODS: In this prospective, randomized, intraindividual comparative clinical study, 58 paired-eyes were randomly assigned for implantation with two preloaded injectors: AutonoMe with a Clareon IOL (Alcon Laboratories, Inc) and iSert with a Vivinex IOL (Hoya). The size of the corneal incision, 2 mm for the iSert and 2.2 mm for the AutonoMe, was measured before and after phacoemulsification and after IOL implantation. Patients were examined 3 months after surgery to assess keratometry, subjective refraction, and visual acuity.

RESULTS: The incision enlargement was 0.20 ± 0.10 mm for the AutonoMe and 0.29 ± 0.10 mm for the iSert, with a statistically significant difference (P < .05). The final wound size after IOL implantation was 2.41 mm for the AutonoMe and 2.35 mm for the iSert. The mean absolute surgically induced astigmatism (SIA) was 0.50 ± 0.25 diopters (D) in the iSert eyes and 0.45 ± 0.20 D in the AutonoMe eyes (P > .05). The 3-month postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA) were similar in both groups, with a UDVA of 0.10 and 0.12 logMAR and CDVA of -0.04 and -0.03 logMAR, respectively for the AutonoMe and iSert.

CONCLUSIONS: The iSert injector caused more enlargement of the corneal wound during IOL implantation compared to the AutonoMe. Despite the initially different incision sizes, the final incision size and functional outcomes were similar in both groups. [J Refract Surg. 2021;37(5):331-336.].

PMID:34044690 | DOI:10.3928/1081597X-20210204-01

J Refract Surg. 2021 May;37(5):294-302. doi: 10.3928/1081597X-20210121-01. Epub 2021 May 1.

ABSTRACT

PURPOSE: To study the feasibility, safety, comparison of intraoperative ease of dissection, and immediate visual outcomes with standard versus differential small incision lenticule extraction (SMILE) spot settings in eyes undergoing bilateral SMILE for myopia or myopic astigmatism.

METHODS: One hundred eyes of 50 patients (mean age: 25.4 years) were randomized to receive standard settings (4.5-µm spot and track spacing in cap and lenticule interface) in one eye and differential settings (4.5-µm spot and track spacing in cap interface and 4.2 µm in lenticule interface) in the contralateral eye. Opaque bubble layer (OBL) was graded using a new grading system and a surgeon questionnaire was obtained to grade the ease of dissection (from 0 to 5, with 5 being the easiest) at the end of each surgery. Visual results and optical quality were analyzed at 1 day, 2 weeks, and 3 months postoperatively.

RESULTS: The mean OBL score was significantly lower in the differential group (26.3%) compared to the standard group (35.3%) (P < .01). Consequently, the mean dissection score was significantly higher in the differential group (4.01) compared to the standard group (3.57) (P < .01). The uncorrected distance visual acuity, Objective Scatter Index, modulation transfer function cut-off, and higher order aberrations were comparable with no statistically significant difference between both groups at 1 day, 2 weeks, and 3 months postoperatively (P > .05 for all parameters). No eye in either group had any intraoperative or postoperative complication affecting visual recovery.

CONCLUSIONS: Differential spot settings resulted in less intraoperative OBL and easy separability. However, the visual results and optical quality were comparable between groups. [J Refract Surg. 2021;37(5):294-302.].

PMID:34044689 | DOI:10.3928/1081597X-20210121-01

J Gerontol Nurs. 2021 Jun;47(6):27-34. doi: 10.3928/00989134-20210510-01. Epub 2021 Jun 1.

ABSTRACT

The current quality improvement interventional study aimed to determine whether an educational intervention focused on evidence-based practices of sepsis screening for RNs would increase accuracy of sepsis screenings performed among older adult patients in a 32-bed medical-surgical unit of a large urban trauma hospital. A total of 34 RNs participated in this study. Sepsis screenings of participants were collected and audited before and after the educational intervention to determine changes in sepsis screening accuracy. A dependent samples t test was used to assess the statistical difference between pre- and post-intervention sepsis screening scores. Results indicated that the educational intervention effectively increased sepsis screening accuracy in older adult patients at the study center (p = 0.007), with a mean increase of 22.06% accuracy. Accurate sepsis screening is crucial for early sepsis diagnosis and treatment to improve the clinical outcomes of older adult patients with sepsis, reduce health care costs, and decrease resource use. [Journal of Gerontological Nursing, 47(6), 27-34.].

PMID:34044685 | DOI:10.3928/00989134-20210510-01

Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211019511. doi: 10.1177/15330338211019511.

ABSTRACT

OBJECTIVE: In this study, by comparing coplanar and noncoplanar intensity-modulated radiation therapy (IMRT) treatment planning in treating tongue cancer, the significance of noncoplanar fields in the protection of the lip and buccal mucosa was determined, and a reasonable solution was selected.

METHODS: Forty-eight tongue cancer patients treated from June 2019 to February 2021 were selected and randomly divided into a coplanar field group and a noncoplanar field group. The mucosal dose limit changed from 15 Gy to 45 Gy for comparison of the two treatment plans. The evaluation indicators (conformal index (CI); homogeneity index (HI); D5, D50, and D98 of the target volume; and the dose of normal tissues) were calculated under different mucosal dose limits. The clinical observation of the lip and buccal mucosa of 48 cases was monitored and graded carefully according to NCI-CTCAE V4.0. Statistical analyses were performed.

RESULTS: The differences in CI, HI, D98, D50 and D5 between the two groups in the target volume tended to decrease when the mucosal dose limit was less than 30 Gy, with a significant difference (P < 0.05). When the limit exceeded 30 Gy, significant differences in other indicators except CI (P < 0.05) were still noted. In normal tissue, differences in doses between the two groups existed when the mucosal limit was less than 20 Gy, with a significant difference (P < 0.05). When the limit exceeded 20 Gy, no significant difference was noted. Patients in the noncoplanar group showed significantly better results than those in the other group in terms of the radiation-related toxicity of the lip and cheek membrane(P < 0.001).

CONCLUSIONS: Compared with coplanar field radiotherapy, noncoplanar field radiotherapy can effectively reduce the exposure dose to the lip and buccal mucosa. The application of noncoplanar treatment plans exhibits good clinical significance and deserves to be promoted.

PMID:34044671 | DOI:10.1177/15330338211019511

Ann Palliat Med. 2021 May 17:apm-21-840. doi: 10.21037/apm-21-840. Online ahead of print.

ABSTRACT

BACKGROUND: Procalcitonin (PCT) can effectively identify bacterial infections and can be used for risk prediction and antimicrobial treatment in patients with unexplained fever and critically ill patients. In this study, statistical analyses of the literature were performed to clarify the application and research status of PCT in respiratory diseases. Future research directions are discussed.

METHODS: A literature search was conducted using the Science Citation Index Expanded (SCI-EXPANDED) database in the Web of Science Core Collection (WOSCC). Published literature between 1995 and February 6, 2021 were searched using the following strategies: subject term = procalcitonin; and Web of Science categories = Respiratory System. Using the Citespace software, the literature on the application of PCT in patients with respiratory diseases was analyzed in terms of annual publication status, subject distribution, country/institution distribution, journal distribution, author distribution, and keywords.

RESULTS: A total of 542 related research literatures were identified, with the number of published papers and the number of literature citations increasing yearly. Research was mainly concentrated in the United States, China, Switzerland, and other countries, with countries such as the United Kingdom, the United States, and Canada being involved in international collaborations. Research institutions were mainly universities or hospitals such as the University Hospital of Basel, University of Barcelona, and Northwestern University. In particular, the University Hospital of Basel had extensive inter-hospital collaborations. Stolz et al. published many related papers, but the centrality value was low. Authors including Christ-Crain M, Schuetz P, and Stolz D were highly cited. Journals such as the American Journal of Respiratory and Critical Care Medicine, Chest, and the European Respiratory Journal were more influential. Keyword analysis showed that sepsis and pneumonia are the current hot topics.

CONCLUSIONS: Related papers mainly focused on respiratory infections, especially sepsis and pneumonia. There were also a small number of studies suggesting that PCT is related to tumors.

PMID:34044567 | DOI:10.21037/apm-21-840

Chin Clin Oncol. 2021 May 15:cco-20-239. doi: 10.21037/cco-20-239. Online ahead of print.

ABSTRACT

BACKGROUND: The ACOSOG Z0011 trial demonstrated safe omission of axillary lymph node dissection (ALND) in patients with one or two positive sentinel lymph nodes (SLNs) receiving breast conservative surgery, followed by whole breast irradiation and adjuvant systemic treatment. This study aims to evaluate the exportability of the ACOSOG Z0011 criteria in an Asian/Chinese cohort residing in Hong Kong.

METHODS: Retrospective analysis of a prospectively maintained database in a University affiliated tertiary breast centre was performed from June 2014 to May 2019. All breast cancer patients with no palpable adenopathy before surgery, one or more positive sentinel lymph nodes on histological examination and no prior neoadjuvant systemic treatment were recruited. Patients were grouped as eligible or ineligible according to the ACOSOG Z0011 criteria. The eligible group was compared with the sentinel alone group in the ACOSOG Z0011 cohort.

RESULTS: Two hundred and forty-eight patients were recruited into the study. Sixty patients (24%) met the ACOSOG Z0011 criteria and could potentially avoid ALND. A higher percentage of clinical T2 tumors were observed in our eligible group than in the ACOSOG Z0011 trial (P=0.002). The histological subtype, tumor grade, estrogen receptor (ER)/progestogen receptor (PR) status and lymphovascular invasion status did not differ. There was no statistically significant difference in the proportion of SLN micrometastasis and macrometastasis between the two groups.

CONCLUSIONS: This study demonstrated clinical similarities between our eligible cohort and the ACOSOG Z0011 cohort, which confirms exportability of the ACOSOG Z0011 criteria to a subset of population in Hong Kong.

PMID:34044545 | DOI:10.21037/cco-20-239