Nevin Manimala

Eplasty. 2023 Jul 20;23:e43. eCollection 2023.

ABSTRACT

BACKGROUND: Tracheostomy has been proposed for patients with expected prolonged intubation. This study aims to determine the outcomes of tracheostomy on patients with burn inhalation injuries requiring mechanical ventilation.

METHODS: This study is a retrospective review from 2011 to 2019. Inclusion criteria were recording of inhalation injury, ventilator support (at least 24 hours), and total body surface area of <15%. The patients were stratified into 2 groups: tracheostomy (group 1) versus no tracheostomy (group 2). The outcome measures were in-hospital mortality rate, hospital length of stay, intensive care unit length of stay, ventilator days, and ventilator- associated pneumonia (VAP).

RESULTS: A total of 33 burn patients met our inclusion criteria. Group 1 consisted of 10 patients and group 2 of 23 patients. There was no statistically significant difference in terms of percent total body surface area. There was a higher intensive care unit length of stay at 23.8 days in group 1 compared with 3.16 days in group 2, a higher hospital length of stay at 28.4 days in group 1 compared with 5.26 days in group 2, and higher ventilator days in group 1 with 20.8 days compared with 2.5 days in group 2. There was no statistically significant difference between the 2 groups in terms of mortality. The incidence of VAP was also significantly higher in group 1 than in group 2.

CONCLUSIONS: The ideal timing and implementation of tracheostomy with inhalation injury has yet to be determined. In this study, tracheostomy was associated with much longer lengths of stay and pneumonia. The impact of the underlying lung injury versus the tracheostomy itself on these observations is unclear. The challenge of characterizing the severity of an inhalation injury based on early visual inspection remains.

PMID:37664813 | PMC:PMC10472420

Gates Open Res. 2023 Aug 3;7:69. doi: 10.12688/gatesopenres.14529.2. eCollection 2023.

ABSTRACT

Background: Postpartum haemorrhage (PPH) is responsible for over 50,000 maternal deaths every year. Most of these deaths are in low- and middle-income countries. Tranexamic acid (TXA) reduces bleeding by inhibiting the enzymatic breakdown of fibrin blood clots. TXA decreases surgical bleeding and reduces deaths from bleeding after traumatic injury. When given within three hours of birth, TXA reduces deaths from bleeding in women with PPH. However, for many women, treatment of PPH is too late to prevent death. World-wide, over one-third of pregnant women are anaemic and many are severely anaemic. These women have an increased risk of PPH and are more likely to die if PPH occurs. There is an urgent need to identify ways to prevent severe postpartum bleeding in anaemic women. The WOMAN-2 trial will quantify the effects of TXA on postpartum bleeding in women with anaemia. Results: This statistical analysis plan (version 1.0; dated 22 February 2023) has been written based on information in the WOMAN-2 Trial protocol version 2.0, dated 30 June 2022. The primary outcome of the WOMAN-2 trial is the proportion of women with a clinical diagnosis of primary PPH. Secondary outcomes are maternal blood loss and its consequences (estimated blood loss, haemoglobin, haemodynamic instability, blood transfusion, signs of shock, use of interventions to control bleeding); maternal health and wellbeing (fatigue, headache, dizziness, palpitations, breathlessness, exercise tolerance, ability to care for her baby, health related quality of life, breastfeeding); and other health outcomes (deaths, vascular occlusive events, organ dysfunction, sepsis, side effects, time spent in higher level facility, length of hospital stay, and status of the baby). Conclusions: WOMAN-2 will provide reliable evidence about the effects of TXA in women with anaemia. Registration: WOMAN-2 was prospectively registered at the International Standard Randomised Controlled Trials registry ( ISRCTN62396133) on 07/12/2017 and ClinicalTrials.gov on 23/03/2018 ( NCT03475342).

PMID:37664793 | PMC:PMC10471795 | DOI:10.12688/gatesopenres.14529.2

Open Res Eur. 2022 Feb 4;2:16. doi: 10.12688/openreseurope.14145.1. eCollection 2022.

ABSTRACT

The virtual, digital counterpart of a physical object, referred as digital twin, derives from the Internet of Things (IoT), and involves real-time acquisition and processing of large data sets. A fully implemented system ultimately enables real-time and remote management, as well as the reproduction of real and forecasted scenarios. Under the emerging framework of Precision Fish Farming, which brings control-engineering principles to fish production, we set up digital twin prototypes for land-based finfish farms. The digital twin is aimed at supporting producers in optimizing feeding practices, oxygen supply and fish population management with respect to 1) fish growth performances; 2) fish welfare, and 3) environmental loads. It relies on integrated mathematical models which are fed with data from in-situ sensors and from external sources, and simulate several dynamic processes, allowing the estimation of key parameters describing the ambient environment and the fishes. A conceptual application targeted at rearing cycles of rainbow trout ( Oncorhynchus mykiss) in an operational in-land aquafarm in Italy is presented. The digital twin takes into account the disparate levels of automation and control that are found within this farm, and considerations are made on preferential directions for future developments. In spite of its potential, and not only in the aquaculture sector, the development of digital twins is still at its early stage. Furthermore, Precision Fish Farming applications in land-based systems as well as targeted at rainbow trout are novel developments.

PMID:37664784 | PMC:PMC10472065 | DOI:10.12688/openreseurope.14145.1

Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jul 27;31(3):381-387. doi: 10.5606/tgkdc.dergisi.2023.24329. eCollection 2023 Jul.

ABSTRACT

BACKGROUND: This study aims to evaluate overall survival, diseasefree survival, and prognostic factors in patients undergoing pleurectomy-decortication and hyperthermic intrathoracic chemotherapy with the diagnosis of malignant pleural mesothelioma.

METHODS: Between January 2020 and November 2021, a total of 53 patients (27 males, 26 females; mean age: 58.1±1.3 years; range, 39 to 81 years) who underwent pleurectomy-decortication and hyperthermic intrathoracic chemotherapy with the diagnosis of malignant pleural mesothelioma were retrospectively analyzed. Data including characteristics, comorbidities, postoperative complications, recurrence and mortality status of the patients were recorded. Overall survival and disease-free survival and prognostic factors were evaluated.

RESULTS: The median disease-free survival was 11.67 months and the median overall survival was 24.60 months. The median disease-free survival was 8.80 months in men and 13.17 months in women, indicating a statistically significant difference as it showed that recurrence was detected earlier in male patients (p=0.037). The median disease-free survival and overall survival was 6.13 months and 11.70 in cases diagnosed with biphasic mesothelioma, respectively, while it was 11.67 months and 25.46 months in cases with epithelial mesothelioma, respectively. Pathological subtype was found to be an effective prognostic factor for both survival (p=0.049 and p<0.001, respectively).

CONCLUSION: Hyperthermic intrathoracic chemotherapy following cytoreductive surgery is a preferable and tolerable method in the treatment of malignant pleural mesothelioma. While evaluating surgical indications, it should be kept in mind that cases with epithelial mesothelioma may benefit more from surgical treatment.

PMID:37664769 | PMC:PMC10472464 | DOI:10.5606/tgkdc.dergisi.2023.24329

Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jul 27;31(3):367-373. doi: 10.5606/tgkdc.dergisi.2023.24088. eCollection 2023 Jul.

ABSTRACT

BACKGROUND: This study aims to systematically examine the cardiopulmonary functions in children with pectus excavatum and to compare the obtained findings with the Haller Index.

METHODS: Between September 2017 and June 2018, medical records of a total of 31 patients (27 males, 4 females; mean age: 14.8±2.0 years; range, 9 to 18 years) with pectus excavatum were retrospectively analyzed. The patients were divided into Group 1 (<2.5), Group 2 (2.5 to 3.19), and Group 3 (>3.2) according to the Haller Index. All groups were systematically evaluated based on pulmonary function tests and echocardiography. Forced vital capacity, forced expiratory volume in 1 second, and the forced expiratory volume in 1 second/ forced vital capacity ratio were calculated. Left ventricular enddiastolic diameter, ejection fraction, mitral valve prolapses, and right ventricular cavity in the apical four-chamber position were evaluated with echocardiography.

RESULTS: Of the patients, 19.4% were in Group 1, 38.7% in Group 2, and 41.9% in Group 3. The mean Haller Index value was 3.09±0.64. According to pulmonary function test results, 16.1% of the patients had restrictive disease and 6.5% had obstructive disease. There was a negative correlation between the index and forced expiratory volume in 1 second and forced vital capacity, and there was a statistically significant decrease in these values, as the Haller Index increased (p<0.017). There was a significant difference in the ejection fraction among the groups (p<0.001) and, as the Haller Index increased, ejection fraction statistically significantly decreased.

CONCLUSION: Our study results show a negative correlation between the severity of pectus excavatum and pulmonary dysfunction and, as the severity increases, left ventricular function may be affected by the deformity. As a result, there seems to be a significant relationship between the severity of the deformity and cardiopulmonary functions.

PMID:37664765 | PMC:PMC10472459 | DOI:10.5606/tgkdc.dergisi.2023.24088

Heliyon. 2023 Aug 18;9(8):e19168. doi: 10.1016/j.heliyon.2023.e19168. eCollection 2023 Aug.

ABSTRACT

Beer is a world-famous beverage that is universally popular. This might be as an effect of its sensory, nutritional, and therapeutic qualities. To date, in Côte d’Ivoire, no study has been carried out focused on the eventual health benefits of industrial beer consumption. In this study, the bioactive compounds (total phenols, total tannins, total flavonoids, total anthocyanins) and corresponding antioxidant activities of two industrial beers from maize and rice from two different breweries were investigated. Results showed that for all phenolic compounds, contents were not statistically different (P > 0.05). However, antioxidant activities (antiradical activity and ferric reducing antioxydant power) were more important in industrial beer from rice (57.57 ± 0.62% and 109.46 ± 0.39 μg/mL ascorbic acid irrespectively) than industrial beer from maize (39.19 ± 1.02% and 103.51 ± 0.62 μg/mL ascorbic acid). Total phenols, total flavonoids, and total anthocyanins were mostly responsible for the antioxidant activities (antiradical activity and ferric reducing antioxydant power) of two beers, with correlation coefficients ranging from r = 0.614 to r = 1. Globally, the two industrial beers were similars but differents from local traditional sorghum beer. Occurrence of phenolic compounds in beers coupled with antioxidant activities shows that beer consumption could have health benefits to condition that beers have a low-alcohol content and light-to-moderate consumption. However, further investigations aims health benefis aspect are necessary.

PMID:37664754 | PMC:PMC10468381 | DOI:10.1016/j.heliyon.2023.e19168

Heliyon. 2023 Aug 16;9(8):e19173. doi: 10.1016/j.heliyon.2023.e19173. eCollection 2023 Aug.

ABSTRACT

Costa Rica’s rice production, a large determinant of the country’s food security, is being negatively impacted by frequently increasing periods of intense drought. Costa Rican scientists have applied CRISPR/Cas9 to develop drought resistant rice varieties they believe the country’s rice producers could benefit from. However, would Costa Ricans consume gene edited rice or products derived from this crop? A three-part, 26-question survey administered in-person to 1096 Costa Ricans uncovers their attitudes, knowledge, and perceptions of gene editing technology and crops. Multiple regressions were built where the independent variables were age, gender, education level, and subjective economic situation. No statistically significant relationships were found in the regression coefficients. Moreover, the k-means procedure (cluster analysis) was used to categorize respondents according to their attitudes on the consumption of gene-edited foods: negative, neutral, and positive. Results show that overall, Costa Rican consumers are open to the application of gene editing in agriculture and would consider consuming products derived from the application of the technology. They are also open to gene editing technology being used to address human and animal health issues. However, Costa Rican consumers are not open to gene editing being used to “design” human traits. This study adds evidence to the emerging literature on the acceptance of gene-edited food. It also highlights the importance of informing societies of just how vulnerable agriculture, and therefore food security, is to the increasingly adverse effects of climate change.

PMID:37664745 | PMC:PMC10468379 | DOI:10.1016/j.heliyon.2023.e19173

Heliyon. 2023 Aug 19;9(8):e19320. doi: 10.1016/j.heliyon.2023.e19320. eCollection 2023 Aug.

ABSTRACT

The agricultural sector in Kenya has witnessed a proliferation of marketing platforms in recent years. However, there has been a noticeable reluctance among farmers to adopt and utilize these platforms for marketing their produce. In light of this, the present study aimed to identify the factors influencing access to and utilization of agricultural marketing platforms. Specifically, the study focused on M-shamba as a representative local marketing platform. A sample of 375 potato farmers from Nakuru county participated in the study, responding to semi-structured questionnaires administered through the survey CTO platform. Descriptive statistics and the Heckprobit model were employed for data analysis. The Heckprobit model encompassed both a selection equation and an outcome equation. The results obtained from the selection equation of the Heckprobit model revealed that factors such as age, off-farm income, farm income, years of potato farming, and access to extension services significantly increased the likelihood of accessing M-shamba. Furthermore, the outcome equation indicated that age, gender of the marketing decision maker, household size, farm income, ranking of potato farming as the primary enterprise, and years of potato farming significantly influenced the utilization of M-shamba in potato marketing. Based on the findings, the study suggests that stakeholders involved in the development of digital marketing platforms should prioritize extensive training and knowledge dissemination, particularly targeting older farmers, to facilitate enhanced access and utilization of such platforms. These efforts will contribute to the promotion of efficient digital marketing practices in the agricultural sector.

PMID:37664732 | PMC:PMC10469985 | DOI:10.1016/j.heliyon.2023.e19320

Heliyon. 2023 Aug 19;9(8):e19281. doi: 10.1016/j.heliyon.2023.e19281. eCollection 2023 Aug.

ABSTRACT

Scattering visiometers are widely used to measure atmospheric visibility; however, visibility is difficult to measure accurately because the extinction coefficient decays exponentially with visual range according to the Koschmid’s law. Moreover, models for predicting visibility are lacking due to the lack of accurate visibility observations to verify. This study formulated an artificial intelligence method for measuring atmospheric visibility in five topographical regions: hills, basins, plains, alluvial plains, and rift valleys. Four air pollution factors and five meteorological factors were selected as independent variables for predicting visibility by using three artificial intelligence models, namely a support vector machine (SVM) model, a multilayer perceptron (MLP) model, and an extreme gradient boosting (XGBoost) model. The GridSearchCV function was used to automatically tune model hyperparameters to determine the optimal parameter values of the three models for the five target areas. The predictions of the aforementioned three models underwent considerable considerably scale shrinking relative to observed values. The inappropriately low predicted visibility values might have been caused by the use of inaccurate observations for training. To solve this problem, formulas of scale ratio and downshift were used to adjust the predicted values. Statistical measurements of model performance measures by five quantitative methods (e.g., correlation coefficient, mean absolute error) showed that adjusted predictions were in strong agreement with the observation data for the five target areas. Therefore, the adjusted prediction has high reliability. Because of obvious differences in the topography, weather, and air quality of the five target areas, different models provided optimal predictions for different areas. In densely populated western Taiwan, the MLP model is most suitable for predicting visibility on hills whereas the XGBoost model is most suitable for predicting visibility on basins and plains. In eastern Taiwan, the SVM model is most suitable for predicting visibility on alluvial plains and rift valleys. Thus, the optimal prediction model should be identified according to the conditions in each area. These results can inform decision-making processes or improve visibility predicting in specific areas.

PMID:37664727 | PMC:PMC10469964 | DOI:10.1016/j.heliyon.2023.e19281

Heliyon. 2023 Aug 16;9(8):e19209. doi: 10.1016/j.heliyon.2023.e19209. eCollection 2023 Aug.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has directly affected specially nurses, not only those on the front lines but also nurse managers.

AIMS: To assess and compare stress levels of nurse managers before and during the pandemic, and to identify predictive factors.

METHOD: Cross-sectional studies were carried out in two moments, before and during pandemic. 102 manager nurses were recruited before the sanitary crisis (2018) and 87 during the health crisis (2020). Perceived stress was measured with the Perceived Stress Scale-14 and quality of professional life, job demands, motivation and managerial support were assessed with the Professional Quality of Life Questionnaire. Socio-demographic and job-related variables were also analysed. Statistical analysis was performed using student’s t-test, correlations and multiple regression analysis.

RESULTS: The majority of nurse managers were women, married, who worked the morning shift. 78.2% managed nursing personnel who worked with COVID patients. They suffered a significant increase in both job demands and perceived stress level in the pandemic. Job demands, working in shifts morning, being young and being unmotivated were predictors of perceived stress level according to multiple linear regression analysis.

CONCLUSION: Perceived stress was greatest during the COVID-19 pandemic. Both, before and during the pandemic, job demands are central predictors of nurse managers’ general perceived stress. It is necessary to adapt the workplace to personal characteristics of the nurse manager and increase actions to enhance their motivation and reduce their job demands to prevent stress.

PMID:37664725 | PMC:PMC10469051 | DOI:10.1016/j.heliyon.2023.e19209