Nevin Manimala

Int Wound J. 2024 Mar;21(3):e14666. doi: 10.1111/iwj.14666.

ABSTRACT

Achilles tendon ruptures are common in athletes, requiring surgical intervention. However, the risk of surgical site infections (SSIs) post-surgery poses significant challenges. This study aims to analyse the risk factors and microbial aetiology associated with SSIs in athletes undergoing Achilles tendon repair. A comprehensive retrospective analysis was conducted from May 2021 to July 2023. The study included 25 patients with SSIs (case group) and 50 patients without SSIs (control group) post Achilles tendon repair surgery. Inclusion criteria encompassed patients with medically confirmed Achilles tendon ruptures who underwent surgical repair. Exclusion criteria included prior tendon pathologies and significant chronic illnesses. Diagnostic criteria for SSIs involved symptoms like elevated body temperature and localized tenderness, along with laboratory confirmations such as positive microbiological cultures. The study utilized VITEK® 2 for bacterial identification and involved statistical analyses like univariate and multivariate logistic regression. The study identified Staphylococcus aureus as the primary pathogen in SSIs. Significant risk factors included lack of prophylactic antibiotic use, presence of diabetes, open wounds and prolonged surgery duration. Univariate analysis revealed stark contrasts in these factors between infected and non-infected groups, while multivariate analysis underscored their importance in SSI development. S. aureus emerged as the predominant pathogen in SSIs post Achilles tendon repair. Critical risk factors such as absence of prophylactic antibiotics, diabetes, open wounds and extended surgery duration play a vital role in SSIs. Addressing these factors is essential for better postoperative outcomes in Achilles tendon repair surgeries.

PMID:38420668 | DOI:10.1111/iwj.14666

Adv Physiol Educ. 2024 Feb 29. doi: 10.1152/advan.00126.2023. Online ahead of print.

ABSTRACT

UK university undergraduate programs are compared by independent subject-specific rankings (Complete, Guardian, Times), based upon data from National Student Survey, Higher Education Statistics Agency, Universities and Colleges Admissions Service, Research Excellence Framework, and the universities. The sports and exercise science program at University of Glasgow, has steadily risen to currently rank as the top UK program. This investigation aimed to identify the underlying factors that explain this. Therefore, we obtained underlying scores for entry standard, student satisfaction, research foundation, graduate prospects, staff-student ratio, expenditure/student, continuation, program support to students, and teaching quality from the ranking providers for years 2010-2024, and statistically modelled which factors significantly affected the rankings. We found that entry standard and graduate prospects strongly correlated significantly with ranking results. Principal component analysis indicated that a model of graduate prospects and entry standard explained 66.2% of the variance in ranking results. Multiple linear regression with all underlying factors included in the model indicated they explained 78% (R²=0.78) of the total variance, while stepwise elimination of insignificant factors identified graduate prospects as the sole factor that significantly affected outcome by explaining 71% (R²=0.71) of the variance. Therefore, the primary predictor of ranking success in UK university league tables for sports science is graduates’ professional success (graduate prospects).

PMID:38420665 | DOI:10.1152/advan.00126.2023

Hum Reprod. 2024 Feb 28:deae030. doi: 10.1093/humrep/deae030. Online ahead of print.

ABSTRACT

STUDY QUESTION: How do oocyte donors and recipients perceive the genetic link related to the transfer of nuclear DNA between donors and offspring?

SUMMARY ANSWER: Whether they are donors or recipients, individuals attach great importance to the transmission of their genetic heritage, since 94.5% would opt for the pronuclear transfer method to preserve this genetic link in the context of oocyte donation.

WHAT IS KNOWN ALREADY: Since 1983, the use of oocyte donation has increased worldwide. Performed in France since the late 1980s and initially offered to women with premature ovarian insufficiency, its indications have progressively expanded and now it is proposed in many indications to prevent the transmission of genetically inherited diseases. This has resulted in an increase in the waiting time for access to oocyte donation due to the difficulty in recruiting oocyte donors in French ART centres. Several articles have discussed how to fairly distribute donor oocytes to couples, but few have interviewed women in the general population to record their feelings about oocyte donation, as either the donor or recipient and the importance given to the genetic link between the oocyte donors and the children born. Mitochondrial replacement therapy (MRT) is a technique originally developed for women at risk of transmitting a mitochondrial DNA mutation. Recently, MRT has been considered for embryo arrest and oocyte rejuvenation as it could help females to reproduce with their own genetic material through the transfer of their oocyte nucleus into a healthy donor oocyte cytoplasm.

STUDY DESIGN, SIZE, DURATION: We conducted an opinion survey from January 2021 to December 2021, during which 1956 women completed the questionnaire. Thirteen participants were excluded from the analysis due to incomplete responses to all the questions. Consequently, 1943 women were included in the study.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We specifically developed a questionnaire for this study, which was created and distributed using the Drag’n Survey® software. The questionnaire consisted of 21 items presented alongside a video created with whiteboard animation software. The aim was to analyse whether certain factors, such as age, education level, marital status, number of children, use of ART for pregnancy, video viewing, and knowledge about oocyte donation, were associated with feelings towards oocyte donation, by using a univariate conditional logistic regression model. This statistical method was also used to assess whether women would be more inclined to consider oocyte donation with the pronuclear transfer technique rather than the whole oocyte donation. All parameters found to be statistically significant in the univariate analysis were subsequently tested in a multivariate model using logistic regression.

MAIN RESULTS AND THE ROLE OF CHANCE: Most women were concerned about the biological genetic contribution of the donated oocyte (94.8%). The most common reason for a women’s reluctance to donate their oocytes was their unwillingness to pass on their genetic material (33.3%). Nearly 70% of women who were initially hesitant to donate their oocytes indicated that they would reconsider their decision if the oocyte donation was conducted using donated cytoplasm and the pronuclear transfer technique. Concomitantly, >75% of the respondents mentioned that it would be easier to receive a cytoplasm donation. The largest proportion of the population surveyed (94.5%) expressed their support for its legalization.

LIMITATIONS, REASONS FOR CAUTION: In this study, a substantial portion of the responses came from individuals with medical or paramedical backgrounds, potentially introducing a recruitment bias among potential donors. The rate of missing responses to the question regarding the desire to become an oocyte donor was 13.6%, while the question about becoming an oocyte cytoplasm donor had a missing response rate of 23%. These missing responses may introduce a bias in the interpretation of the data.

WIDER IMPLICATIONS OF THE FINDINGS: This study was the first to demonstrate that, for the French population studied, the combination of oocyte cytoplasm donation with pronuclear transfer could offer a promising approach to enhance the acceptance of oocyte donation for both the donor and the recipient.

STUDY FUNDING/COMPETING INTEREST(S): No external funding was used for this study. The authors have no conflicts of interest.

TRIAL REGISTRATION NUMBER: N/A.

PMID:38420661 | DOI:10.1093/humrep/deae030

Pathog Glob Health. 2024 Feb 28:1-9. doi: 10.1080/20477724.2024.2322800. Online ahead of print.

ABSTRACT

Schistosomiasis and anemia, are one of the leading global public health problem among children between age 5 and 14 years in marginalized settings. In this study, we provide prevalence and intensity data for both conditions in three southwestern states of Nigeria, where such are lacking. Epidemiological assessment involving parasitological analysis of urine and blood samples was conducted among 1783 consenting school-aged children in Ondo, Osun, Ekiti States of Nigeria. Participants’ age and sex data were obtained using field forms, and statistical analysis was performed in R software with a significance level of 95%. An overall prevalence of 26.8% and 29.5% was recorded for urinary schistosomiasis and anemia, respectively. Prevalence varied by location with (40.3% and 29.8%) in Ondo (34.4% and 37.5%) in Osun and (13.4% and 20.9%) in Ekiti for urinary schistosomiasis and anemia, respectively (p=0.00). Schistosoma infections were found among males (28.7%, p=0.05) and children between the age 9-11 years (30.0%, p=0.01). About 36% of children with anemia was also infected with schistosomiasis. Children who were positive for schistosomiasis (OR:1.51; 95% CI: 1.19, 1.93; p=0.001) and between the age category 15-16 years, (OR:1.86; 95% CI: 1.12, 3.09; p<0.05) were twice likely to become anemic. Our findings have shown that children infected with schistosomiasis are twice likely to become anemic than those without infection. It is important to complement ongoing MDA programmes targeted at schistosomiasis with nutrition intervention programs for example micronutrient supplementation for better impact and cost-effectiveness.

PMID:38419138 | DOI:10.1080/20477724.2024.2322800

Pilot Feasibility Stud. 2024 Feb 28;10(1):44. doi: 10.1186/s40814-024-01471-x.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, there was a substantial interruption of care, with patients and workers fearful to return to the dental office. As dental practice creates a highly aerosolized environment, the potential for spread of airborne illness is magnified. As a means to increase safety and mitigate risk, pre-visit testing for SARS-CoV-2 has the potential to minimize disease transmission in dental offices. The Pragmatic Return to Effective Dental Infection Control through Testing (PREDICT) Feasibility Study examined the logistics and impact of two different testing mechanisms (laboratory-based PCR viral testing and point-of-care antigen testing) in dental offices.

METHODS: Dental healthcare workers (DHCWs) and patients in four dental offices within the National Dental Practice-based Research Network participated in this prospective study. In addition to electronic surveys, participants in two offices completed POC testing, while participants in two offices used lab-based PCR methods to detect SARS-CoV-2 infection. Analysis was limited to descriptive measures, with median and interquartile ranges reported for Likert scale responses and mean and standard deviation for continuous variables.

RESULTS: Of the total 72 enrolled, 28 DHCWs and 41 patients completed the protocol. Two patients (4.9%) tested positive prior to their visit, while 2 DHCWs (12.5%) tested positive for SARS-CoV-2 infection at the start of the study. DHCWs and patients shared similar degree of concern (69% and 63%, respectively) for contracting COVID-19 from patients, while patients feared contracting COVID-19 from DHCWs less (49%). Descriptive statistics calculations revealed that saliva, tongue epithelial cells, and nasal swabs were the most desirable specimen collection method; both testing (LAB and POC) protocols took similar amounts of total time to complete; and DHCWs and patients reported feeling more comfortable when both groups were tested.

CONCLUSIONS: While a larger-scale, network study is necessary for generalizability of results, this feasibility study suggests that SARS-CoV-2 testing can be effectively implemented into dental practice workflows and positively impact perception of safety for DHCWs and patients. As new virulent infectious diseases emerge, preparing dental personnel to employ an entire toolbox of risk mitigation strategies, including testing, may have the potential to decrease dental practice closure time, maintaining continuity of dental care services for patients.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT05123742.

PMID:38419131 | DOI:10.1186/s40814-024-01471-x

BMC Nutr. 2024 Feb 28;10(1):37. doi: 10.1186/s40795-024-00843-z.

ABSTRACT

BACKGROUND: Diabetes mellitus is a chronic disease characterized by a wide range of metabolic problems. The current study sought to assess nutritional habits of Saudi patients with type 2 diabetes (T2D) and to propose recommendations to improve these patients’ dietary habits and delay possible disease complications.

METHODS: Over a period of three years, (2017-2019) 577 patients with T2D attending the outpatient’s diabetic clinics at King Fahd Hospital of the University, Al Khobar, Saudi Arabia were invited to participate in this study. Data of dietary intake were collected by trained nurses using a pretested structured validated semi quantitative food frequency questionnaire. The dietary data were collected using 7-day dietary recall questionnaire. A modified score system that associates dietary habits with glycemic control and lipid profile was used.

RESULTS: Overall, a high healthful plant-based diet score was associated with a significant (P = 0.018) reduction in triglycerides (TG) level (mean difference – 3.78%; 95% CI, -0.65% to -6.81%) and a statistically non-significant (P = 0.06) increase in high density lipoprotein (HDL) levels (mean difference 1.87%; 95% CI -0.06-3.84%) in T2D patients from the Eastern Province of Saudi Arabia. Additionally, in our patient group, the prevalence of coronary artery disease, stroke, peripheral artery disease, and chronic kidney disease in T2D patients was 11.3%, 6.2%, 3.3%, and 8.4%, respectively and were higher when compared to the prevalence in the general population.

CONCLUSION: The present study showed that adherence to a healthful plant-based diet, when compared to high glycemic index diet, is associated with a favorable outcome in glycemic control and lipid profile in T2D patients. Prior assessment of total diet quality may be beneficial when giving nutritional advice to T2D patients with the possibility of improving glycemic control and lipid profile.

PMID:38419128 | DOI:10.1186/s40795-024-00843-z

J Ethnobiol Ethnomed. 2024 Feb 28;20(1):29. doi: 10.1186/s13002-024-00672-1.

ABSTRACT

BACKGROUND: The influence of socio-demographic variables was widely explored to evaluate their impact on indigenous and local ethnobotanical knowledge. However, the studies conducted in Ethiopia mainly focused on rural areas. They were limited to exploring and documenting ethnobotanical knowledge and the associated impacts of socio-demographic variables in rural-urban interface areas among ethnic groups. Hence, this study aimed to document plant-based indigenous and local ethnomedicinal knowledge and the associated impacts of socio-demographic variables among selected three ethnic groups in south-central Ethiopia.

METHODS: Ethnobotanical data were collected using semi-structured interviews with 189 key informants, floristic species inventories, and field observations. Quantitative approaches were used to evaluate the use values (UV) of the most important medicinal plants, the informant consensus factor (ICF), fidelity level (FL), relative popularity level (RPL), and rank-order priority (ROP). Statistical tests were applied to evaluate the influences of socio-demographic factors and associations between variables on local ethnobotanical knowledge across ethnic groups in different informant categories.

RESULTS: Statistical analysis revealed significant differences (p < 0.05) in the mean number of medicinal plants reported among age categories. There was also a positive association between the respondent’s age and plant knowledge acquisition. Croton macrostachyus Hochst. ex Delile, Albizia gummifera C.A.Sm., Zingiber officinale Roscoe, Aloe macrocarpa Tod., Gymnanthemum amygdalinum (Delile) Sch.Bip., Calpurnia aurea (Aiton) Benth, and Allium sativum L. had the highest use values among ethnic groups. The highest informant consensus factor values were recorded for circulatory system disorders (0.68) followed by febrile illness and reproductive organ complications (0.66 each) across the three studied ethnic groups. The highest FL, RPL, and ROP values were noted for Lactuca inermis Forssk., Moringa stenopetala (Baker f.) Cufod., Withania somnifera (L.) Dunal, Allium sativum L., Citrus limon (L.) Osbeck, Ricinus communis L., Schinus molle L., Antiaris toxicaria (J.F.Gmel.) Lesch., Brucea antidysenterica J.F.Mill., Echinops kebericho Mesfin, Ocimum jamesii Sebald, Afrocarpus falcatus (Thunb.) C.N.Page, Searsia natalensis (Bernh. ex Krauss) F.A.Barkley, and Ricinus communis L. across ethnic groups in the study areas, which showed the conformity of knowledge on species curing potential and their prevalent uses.

CONCLUSION: The study revealed that the ethnic groups of Gedeo, Oromo, and Sidama have considerable indigenous and local ethnobotanical knowledge practices. Statistical analysis shown high variation in the acquisition of local ethnobotanical knowledge among age groups, which boosted our understanding of the effects of socio-demographic factors on the local ethnobotanical knowledge dynamics. Thus, this finding advocates for efforts to repair the observed generation gap via continued professional support and educating local communities to preserve traditional knowledge and practices through systematic documentation.

PMID:38419117 | DOI:10.1186/s13002-024-00672-1

Addict Sci Clin Pract. 2024 Feb 28;19(1):14. doi: 10.1186/s13722-024-00446-w.

ABSTRACT

BACKGROUND: The prevalence and associated overdose death rates from opioid use disorder (OUD) have dramatically increased in the last decade. Despite more available treatments than 20 years ago, treatment access and high discontinuation rates are challenges, as are personalized medication dosing and making timely treatment changes when treatments fail. In other fields such as depression, brief measures to address these tasks combined with an action plan-so-called measurement-based care (MBC)-have been associated with better outcomes. This workgroup aimed to determine whether brief measures can be identified for using MBC for optimizing dosing or informing treatment decisions in OUD.

METHODS: The National Institute on Drug Abuse Center for the Clinical Trials Network (NIDA CCTN) in 2022 convened a small workgroup to develop consensus about clinically usable measures to improve the quality of treatment delivery with MBC methods for OUD. Two clinical tasks were addressed: (1) to identify the optimal dose of medications for OUD for each patient and (2) to estimate the effectiveness of a treatment for a particular patient once implemented, in a more granular fashion than the binary categories of early or sustained remission or no remission found in The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).

DISCUSSION: Five parameters were recommended to personalize medication dose adjustment: withdrawal symptoms, opioid use, magnitude (severity and duration) of the subjective effects when opioids are used, craving, and side effects. A brief rating of each OUD-specific parameter to adjust dosing and a global assessment or verbal question for side-effects was viewed as sufficient. Whether these ratings produce better outcomes (e.g., treatment engagement and retention) in practice deserves study. There was consensus that core signs and symptoms of OUD based on some of the 5 DSM-5 domains (e.g., craving, withdrawal) should be the basis for assessing treatment outcome. No existing brief measure was found to meet all the consensus recommendations. Next steps would be to select, adapt or develop de novo items/brief scales to inform clinical decision-making about dose and treatment effectiveness. Psychometric testing, assessment of acceptability and whether the use of such scales produces better symptom control, quality of life (QoL), daily function or better prognosis as compared to treatment as usual deserves investigation.

PMID:38419116 | DOI:10.1186/s13722-024-00446-w

Antimicrob Resist Infect Control. 2024 Feb 28;13(1):24. doi: 10.1186/s13756-024-01376-7.

ABSTRACT

INTRODUCTION: The development of colistin resistance in Acinetobacter baumannii during treatment has been identified in certain patients, often leading to prolonged or recurrent infections. As colistin, is the last line of therapy for A. baumannii infections that are resistant to almost all other antibiotics, colistin-resistant A. baumannii strains currently represent a significant public health threat, particularly in healthcare settings where there is significant selective pressure.

AIM: The aim of this study was to comprehensively determine the prevalence of colistin resistance in A. baumannii from clinical samples. Regional differences in these rates were also investigated using subgroup analyses.

METHOD: The comprehensive search was conducted using “Acinetobacter baumannii”, “Colistin resistant” and all relevant keywords. A systematic literature search was performed after searching in PubMed, Embase, Web of Science, and Scopus databases up to April 25, 2023. Statistical analysis was performed using Stata software version 17 and sources of heterogeneity were evaluated using I². The potential for publication bias was explored using Egger’s tests. A total of 30,307 articles were retrieved. After a thorough evaluation, 734 studies were finally eligible for inclusion in the present systematic review and meta-analysis.

RESULT: According to the results, the prevalence of resistance to colistin among A. baumannii isolates was 4% (95% CI 3-5%), which has increased significantly from 2% before 2011 to 5% after 2012. South America had the highest resistance rate to this antibiotic. The broth microdilution method had the highest level of resistance, while the agar dilution showed the lowest level.

CONCLUSIONS: This meta-analysis found a low prevalence of colistin resistance among A. baumannii isolates responsible for infections worldwide from 2000 to 2023. However, there is a high prevalence of colistin-resistant isolates in certain countries. This implies an urgent public health threat, as colistin is one of the last antibiotics available for the treatment of infections caused by XDR strains of A. baumannii.

PMID:38419112 | DOI:10.1186/s13756-024-01376-7

Arch Public Health. 2024 Feb 28;82(1):26. doi: 10.1186/s13690-024-01251-2.

ABSTRACT

BACKGROUND: Although habit-forming risk behaviors frequently co-occur, determinants of concurrent risk behaviors have rarely been investigated. The aim of the present study was to investigate socio-demographic, health status, and lifestyle determinants of single versus concurrent risk behaviors in general-population adults.

METHODS: We analyzed data from 32,622 participants (74.5% female; mean age = 57.9 ± 14.2 years) of the NutriNet-Santé cohort who completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test in 2021-2022. Using established cutoffs, participants were first split into 2 groups (presence versus absence) for each risk variable (alcohol use disorders, nicotine dependence, food addiction, Internet addiction) and were then divided into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥ 2 risk behaviors). The association between socio-demographic, health status, and lifestyle exposures and individual/concurrent risk behaviors were investigated with polytomous logistic regression.

RESULTS: Younger age (Odds Ratio (OR) = 2.04; 95% Confidence Interval (CI: 1.62-2.56), current financial difficulties (OR = 1.29; CI: 1.08-1.54), self-perceived poor health (OR = 1.70; CI: 1.32-2.20), overall poor dietary quality (OR = 2.88; CI: 2.06-4.02), being underweight (OR = 1.46; CI: 1.05-2.04), having obesity (OR = 1.62; CI: 1.31-1.99), lack of affection during childhood (OR = 1.41; CI: 1.18-1.69), and a lifetime prevalence or medication use for a mental disorder (OR = 1.46; CI: 1.24-1.73) were positively associated with having ≥ 2 versus 1 risk behavior (all p < 0.05). The comparison of none versus 1 risk behavior revealed the same determinants in addition to having a higher education, being physically active at work, and being overweight.

CONCLUSIONS: We investigated determinants of concurrent habit-forming risk behaviors among adults in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.

PMID:38419088 | DOI:10.1186/s13690-024-01251-2