Nevin Manimala

BMJ Open. 2024 Jul 11;14(7):e085636. doi: 10.1136/bmjopen-2024-085636.

ABSTRACT

INTRODUCTION: The leishmaniases are among the group of neglected tropical diseases that cause significant morbidity and mortality each year. Currently, the East Africa region has the highest visceral leishmaniasis burden in the world. Ethiopia is one of the East African countries that reports both visceral and cutaneous forms of the disease. As part of the Nairobi Declaration, Ethiopia showed commitment to the elimination of visceral leishmaniasis by 2030. In this endeavour, it is important to understand the scope of research conducted on leishmaniases in the country and identify where the research gaps exist. Determining the research landscape is vital in the plan towards leishmaniases control and elimination. It will help to reference conducted research, determine if systematic reviews are warranted and help prioritise future research directions.

METHODS AND ANALYSIS: This protocol was developed with reference to the JBI Scoping Review Methodology Group’s guidance on conducting scoping reviews and the PRISMA-ScR reporting guidelines for scoping reviews. The following databases will be searched: PubMed, Embase via Embase.com, Web of Science Core Collection, Cochrane CENTRAL, Global Index Medicus, ClinicalTrials.gov, the Pan African Clinical Trials Registry and PROSPERO. Locally published literature that may not be indexed in the above-mentioned systems will be identified through team members familiar with the setting. Each record will be dually and blindly reviewed in an abstract-title screen and full-text screen using inclusion-exclusion criteria. Included articles must contain an in-depth discussion of leishmaniasis in Ethiopia. Data extracted will consist of study themes, study types, and categories and subcategories each defined in the developed codebook, in addition to type of leishmania, year of publication, funding source and the number of citations. Results will be reported with summary statistics.

ETHICS AND DISSEMINATION: Individual consenting and ethical approvals are not applicable. We plan to disseminate our findings to the appropriate stakeholders.

PMID:38991674 | DOI:10.1136/bmjopen-2024-085636

BMJ Open. 2024 Jul 11;14(7):e079623. doi: 10.1136/bmjopen-2023-079623.

ABSTRACT

OBJECTIVE: The objective of this study is to determine the pooled prevalence of active trachoma among 1-9 years old children in Ethiopia.

DESIGN: A systematic review and meta-analysis were employed in accordance with the Preferred Reporting Items for Systematic Reviews.

DATA SOURCES: Medline/PubMed, Scopus, Web of Science, African Journal of Online and Google scholar databases were systematically explored to find studies published in English until July 2023.

ELIGIBILITY CRITERIA: The following criteria apply: (1) condition (Co): studies examined the prevalence of trachoma among children (1-9) years old; (2) context (Co): studies conducted in Ethiopia; (3) population (Pop): studies that were done among children (1-9) years old; (4) study type: observational studies and (5) language: studies published in English.

DATA EXTRACTION AND SYNTHESIS: The data were extracted using a Microsoft Excel spreadsheet. DerSimonian-Laird random effect model was used to estimate the pooled prevalence of active trachoma among 1-9 years old children. Cochrane Q-tests and I² statistics were used across studies to assess heterogeneity. To identify possible publication bias, Egger’s test was performed.

PRIMARY OUTCOME: Prevalence of active trachoma among children aged (1-9 years old)”.

RESULTS: Overall, a total of 42 articles with 235 005 study participants were included in the final analysis. The estimated pooled prevalence of active trachoma using random effect model was 24% (95% CI 20% to 27%). The subgroup analysis by region revealed that the highest prevalence of trachoma was 36% (95% CI 13% to 58%) in the Tigray region, and publication year revealed the prevalence of trachoma was decreasing from 32% to 19% after 2015.

CONCLUSION: In this review, the pooled prevalence of active trachoma was found to be high in Ethiopia compared with WHO threshold level. This underscores the need for increased focus on high-risk age groups to decrease trachoma and to achieve the elimination of trachoma from the country by 2030.

PMID:38991673 | DOI:10.1136/bmjopen-2023-079623

BMJ Open. 2024 Jul 11;14(7):e079401. doi: 10.1136/bmjopen-2023-079401.

ABSTRACT

OBJECTIVES: The aim of this study was to a) explore barriers and facilitators associated with medication-taking habit formation, and b) elicit feedback on the components of an intervention designed to help form strong habits for long-term medication adherence.

DESIGN: The study design was qualitative; we conducted semistructured interviews between September 2021 and February 2022.

SETTING: The interviews were conducted online, with 27 participants recruited at the Cedars-Sinai Medical Center in Los Angeles, California.

PARTICIPANTS: A purposive sample of 20 patients who were over 18 years of age, had been diagnosed with hypertensive disorder (or reported high blood pressure; >140/90 mm Hg) and who were prescribed antihypertensive therapy at the time of recruitment, along with seven providers were interviewed.

RESULTS: Contextual factors included frequent changes to prescription for regimen adjustment, and polypharmacy. Forgetfulness, perceived need for medication, and routine disruptions were identified as possible barriers to habit formation. Facilitators of habit formation included identification of stable routines for anchoring, planning, use of external reminders (including visual reminders) and pillboxes for prescription management, and extrinsic motivation for forming habits. Interestingly, experiencing medication side effects was identified as a possible barrier and a possible facilitator of habit formation. Feedback on study components included increasing text size, and visual appeal of the habit leaflet; and imparting variation in text message content and adjusting their frequency to once a day. Patients generally favoured the use of conditional financial incentives to support habit formation.

CONCLUSION: The study sheds light on some key considerations concerning the contextual factors for habit formation among people with hypertension. As such, future studies may evaluate the generalisability of our findings, consider the role of visual reminders in habit formation and sustenance, and explore possible disruptions to habits.

TRIAL REGISTRATION NUMBER: NCT04029883.

PMID:38991671 | DOI:10.1136/bmjopen-2023-079401

BMJ Open. 2024 Jul 11;14(7):e081181. doi: 10.1136/bmjopen-2023-081181.

ABSTRACT

INTRODUCTION: Communicating complex information about haemodialysis (HD) and ensuring it is well understood remains a challenge for clinicians. Informed consent is a high-impact checkpoint in augmenting patients’ decision awareness and engagement prior to HD. The aims of this study are to (1) develop a digital information interface to better equip patients in the decision-making process to undergo HD; (2) evaluate the effectiveness of the co-designed digital information interface to improve patient outcomes; and (3) evaluate an implementation strategy.

METHODS AND ANALYSIS: First, a co-design process involving consumers and clinicians to develop audio-visual content for an innovative digital platform. Next a two-armed, open-label, multicentre, randomised controlled trial will compare the digital interface to the current informed consent practice among adult HD patients (n=244). Participants will be randomly assigned to either the intervention or control group. Intervention group: Participants will be coached to an online platform that delivers a simple-to-understand animation and knowledge test questions prior to signing an electronic consent form.

CONTROL GROUP: Participants will be consented conventionally by a clinician and sign a paper consent form. Primary outcome is decision regret, with secondary outcomes including patient-reported experience, comprehension, anxiety, satisfaction, adherence to renal care, dialysis withdrawal, consent time and qualitative feedback. Implementation of eConsent for HD will be evaluated concurrently using the Consolidation Framework for Implementation Research (CFIR) methodology.

ANALYSIS: For the randomised controlled trial, data will be analysed using intention-to-treat statistical methods. Descriptive statistics and CFIR-based analyses will inform implementation evaluation.

ETHICS AND DISSEMINATION: Human Research Ethics approval has been secured (Metro North Health Human Research Ethics Committee B, HREC/2022/MNHB/86890), and Dissemination will occur through partnerships with stakeholder and consumer groups, scientific meetings, publications and social media releases.

TRIAL REGISTRATION NUMBER: Australian and New Zealand Clinical Trials Registry (ACTRN12622001354774).

PMID:38991670 | DOI:10.1136/bmjopen-2023-081181

J Am Med Dir Assoc. 2024 Jul 8:105145. doi: 10.1016/j.jamda.2024.105145. Online ahead of print.

ABSTRACT

OBJECTIVES: Nursing home (NH) leaders remain challenged to deliver quality care, despite the COVID-19 transition to an endemic phase. This study describes NH leadership perspectives on preparing and maintaining quality care during times of diminishing resources as experienced through the COVID-19 pandemic to gain insight on how best to support NHs moving forward.

DESIGN: This was a cross-sectional, parallel convergent mixed methods study.

SETTING AND PARTICIPANTS: This study reports quantitative data from 5001 NHs across 12 states along with qualitative data from a subsample of NH leaders (N = 15).

METHODS: Publicly reported survey data were analyzed using descriptive statistics. Individual in-depth interviews with NH leaders conducted at 12-month follow-up were analyzed using inductive thematic coding organized by a guiding framework. Data were integrated using convergent analysis and a joint display.

RESULTS: NH leaders (licensed administrators, clinical directors, and managers) reported resident and staff infection rates, and access to resources (such as personal protective equipment and testing supplies) that aligned with national trends. Leaders described their NHs (N = 14; 43% rural; 71% not for profit) to be in varied states of operational readiness (standard, contingency, crisis) to support quality infection prevention and control (IPC) at the transition to the endemic COVID-19 phase. Leadership reported continued challenges in addressing resident and staff vaccinations, securing testing supplies, obtaining financial resources to maintain acceptable levels of personal protective equipment, continued staffing shortages, and issues in implementing isolation practices in current facilities.

CONCLUSION AND IMPLICATIONS: NH leaders continue to struggle delivering quality IPC care post-pandemic and require focused support in several areas. Clinical practice guidelines should include IPC practices to prevent the infection and spread of any COVID-19 variant in this endemic phase. Policies should support continued reporting of IPC-related metrics and adequate funding to account for the long-term financial burden NHs face.

PMID:38991652 | DOI:10.1016/j.jamda.2024.105145

J Hazard Mater. 2024 Jun 15;476:134929. doi: 10.1016/j.jhazmat.2024.134929. Online ahead of print.

ABSTRACT

This study focuses on assessing the hydrogeochemical processes influencing the mobility of dissolved metal and metalloid species during mine effluent mixing. Field samples were collected to characterize effluents at an active gold mine located in the Abitibi Greenstone belt in western Québec, Canada. Controlled laboratory mixing experiments were further performed with real effluents. In situ physicochemical parameters, concentrations of major dissolved ions and trace elements were analyzed. Mineralogical analyses were also performed on precipitates from the laboratory mixtures. The data were used for statistical analyses and for modeling the geochemical evolution of effluents using PHREEQC with the wateq4f.dat database (with modifications). The results suggest that the formation of secondary minerals such as schwertmannite, Fe(OH)₃, and jarosite could significantly affect the concentrations of trace elements in effluents. The precipitation of secondary minerals immobilized trace elements through coprecipitation and sorption processes. The main limitations of the modeling approach used here include the evaluation of the ion balance for low pH samples with high Fe and Al concentrations and the omission of biological processes. The approach provides insights into the geochemical evolution of mine effluents and could be adapted to several mining sites as a tool for improving water management.

PMID:38991645 | DOI:10.1016/j.jhazmat.2024.134929

Surg Oncol. 2024 Jun 28;55:102098. doi: 10.1016/j.suronc.2024.102098. Online ahead of print.

ABSTRACT

BACKGROUND: Minimally invasive techniques have demonstrated several advantages over the open approach. In the field of prostate cancer, the LAP-01 trial demonstrated the superiority of robotic-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) when comparing continence at 3-month after surgery, with no statistically significant differences at 6 and 12 months of follow-up.

OBJECTIVES: Externally validate the LAP-01 study and compare functional outcomes between the two minimally invasive approaches.

MATERIAL AND METHODS: This retrospective study, conducted by a single surgeon (MRB), utilized data from a prospectively collected database, which included patients who underwent both RARP or LRP. Data regarding baseline characteristics, continence (assessed through the 24-h Pad test and ICIQ questionnaire) and potency were collected at multiple time points: 1 and 6 weeks after catheter removal, 3-, 6-, and 12-months post-surgery.

RESULTS: The study encompasses 601 patients, 455 who underwent LRP and 146 RARP. The median age at diagnosis was 64 for LRP and 62 for RARP, while the median PSA levels at diagnosis were 6.7 ng/mL for LRP and 6.5 ng/mL for RARP. Bilateral nerve-sparing procedures were performed in 34.07 % of LRP cases and 51.37 % of RARP cases. RARP exhibited a significant advantage over LRP both in continence and potency. Continence rates at 3-, 6- and 9-month after radical prostatectomy (RP) were 36.43 %, 61.86 % and 79.87 % for LRP, compared to 50.98 %, 69.87 % and 91.69 % for RARP. Potency rates at the same intervals were 0.90 %, 3.16 % and 6.39 % for LRP, and 6.19 %, 9.16 % and 18.96 % for RARP. These rates were more pronounced in patients with bilateral nerve-sparing.

CONCLUSION: Our study demonstrates that RARP results in significantly better continence recovery and superior potency outcomes throughout the entire follow-up period compared to LRP, even at the beginning of the robotic approach learning curve.

PMID:38991627 | DOI:10.1016/j.suronc.2024.102098

Micron. 2024 Jul 8;185:103688. doi: 10.1016/j.micron.2024.103688. Online ahead of print.

ABSTRACT

Iterative phase retrieval is based on minimising a loss function as a measure of the consistency of an initial guess and underlying experimental data. Under ideal experimental conditions, real data contains Poissonian noise due to counting statistics. In this work, we use the Wirtinger Flow concept in combination with four common loss functions, being the L₁ loss, the mean-squared error (MSE), the amplitude loss and the Poisson loss. Since only the latter reflects the counting statistics as an asymmetric Poisson distribution correctly, our simulation study focuses on two main cases. Firstly, high-dose momentum-resolved scanning transmission electron microscopy (STEM) of an MoS₂ monolayer is considered for phase retrieval. In this case, it is found that the four losses perform differently with respect to chemical sensitivity and frequency transfer, which we interprete in terms of the substantially different signal level in the bright and dark field part of diffraction patterns. Remedies are discussed using further simulations, addressing the use of virtual ring detectors for the dark field, or restricting loss calculation to the bright field. Secondly, a dose series is presented down to 100 electrons per diffraction pattern. It is found that all losses yield qualitatively reasonable structural data in the phase, whereas only MSE and Poisson loss range at the correct amplitude level. Chemical contrast is, in general, reliably obtained using the Poisson concept, which also provides the most continuous spatial frequency transfer as to the reconstructed object transmission function.

PMID:38991624 | DOI:10.1016/j.micron.2024.103688

Mar Pollut Bull. 2024 Jul 10;206:116676. doi: 10.1016/j.marpolbul.2024.116676. Online ahead of print.

ABSTRACT

Understanding mercury (Hg) concentrations in mesopelagic and mid-trophic fishes is important for assessing Hg accumulation in oceanic ecosystems and higher-order predators. This study measured total Hg (THg) concentrations in the whole body of 16 abundant mesopelagic fish species sampled in two distinct sites within the Tasman Sea. Across all species, total Hg concentrations ranged from 0.02 to 0.48 μg g^-1 dry weight (0.01 to 0.15 μg g^-1 wet weight). Total Hg concentrations varied with vertical migration patterns, with shallower migrators exhibiting higher THg. Females typically had statistically higher THg concentrations than males. Positive correlations between THg concentration and standard length were observed for some but not all species. At the community level, THg concentrations correlated positively with estimated trophic position and foraging habitat, as inferred by stable isotope values. These findings contribute to our understanding of Hg cycling in oceanic ecosystems and the potential for biomagnification in oceanic top-order predators.

PMID:38991610 | DOI:10.1016/j.marpolbul.2024.116676

J Chromatogr A. 2024 Jul 5;1730:465143. doi: 10.1016/j.chroma.2024.465143. Online ahead of print.

ABSTRACT

The solvation parameter model uses six descriptors identified as excess molar refraction, E, dipolarity/polarizability, S, overall hydrogen-bond acidity, A, overall hydrogen-bond basicity, B, McGowan’s characteristic volume, V, and the gas-liquid partition constant on hexadecane at 25 °C, L to model the distribution of neutral compounds in biphasic systems. Abraham’s version of this model uses all six descriptors with two separate linear free energy relationship models for the transfer of compounds from a gas phase to a condensed phase and between condensed phases. Goss proposed a modification to this model that uses a single calibration model regardless of the physical state for each phase and five of the descriptors employed in Abraham’s model (E descriptor is eliminated). The capability of Abraham’s model and the Goss-modified model to characterize the contribution of intermolecular interaction to retention for gas and reversed-phase liquid chromatographic systems and distribution in liquid-liquid partition systems is evaluated using the WSU compound descriptor database. These more accurate values for the Abraham descriptors have not been utilized previously for the evaluation of the Goss-modified model and should be more capable of discerning subtle differences in model performance. It is shown that model quality defined by statistical parameters favors Abraham’s model over the Goss-modified model with differences in model quality greater for systems in which Abraham’s model indicates a significant contribution from electron lone pair interactions and for systems in which one phase is a solvent containing perfluoroalkyl substituents. There is a small systematic difference for the terms describing the combined contributions of cavity formation and dispersion interactions and for interactions of a dipole-type. The contribution of hydrogen-bonding interactions is virtually identical for the two models. The model intercepts are generally different and potentially assigned to a larger contribution from lack-of-fit for the Goss-modified model. Although the Abraham model descriptors have been routinely employed for applications using the Goss-modified model the possibility that Goss-model specific descriptors should be employed was evaluated. Using the Solver method and Goss-model specific calibration models for chromatographic and liquid-liquid partition systems a new set of Goss-specific descriptors was calculated for 28 varied compounds. These descriptors show good statistical agreement with the Abraham descriptor values with an average deviation of 0.009, -0.003, -0.004, and -0.023, respectively, for the S, A, B, and L descriptors, corresponding to a relative absolute deviation in percent of 2.2 %, 3.9 %, 4.3 %, and 1.2 %, respectively.

PMID:38991600 | DOI:10.1016/j.chroma.2024.465143