Nevin Manimala

PLoS One. 2022 Nov 17;17(11):e0277698. doi: 10.1371/journal.pone.0277698. eCollection 2022.

ABSTRACT

Throughout the world, wetlands have experienced degradation and declines in areal coverage. Fortunately, recognition of the value of wetlands has generated interest in preserving and restoring them. Post-restoration monitoring is necessary to analyze success or failure, thereby informing subsequent management decisions. Restoration of oxbow wetlands has become the focus of targeted restoration efforts to promote recovery of biodiversity and sensitive species, and to enhance ecosystem services. The fish communities of oxbows have been the subject of many monitoring studies. However, a recommended sampling methodology for monitoring the fish communities of oxbows has not been described, thereby limiting our capacity to effectively monitor these ecosystems. We compared four sampling methodologies (backpack electrofishing, fyke netting, minnow trapping, and seining) for fish community data collection with a primary objective of determining an effective method for sampling fish communities in small oxbow wetlands. Seining and fyke netting were determined to be effective methods for sampling oxbow fish communities. Backpack electrofishing and minnow trapping produced low taxonomic richness values and sampled a smaller proportion of species present than seining and fyke netting. Although seining and fyke netting produced similar taxonomic diversity and abundance values, these two gears differ in their ease of implementation and potential habitat disturbance generated by sampling. Therefore, consideration must be given to how species present (especially sensitive species) within the wetland could be impacted by sampling disturbance when choosing between seining and fyke netting.

PMID:36395176 | DOI:10.1371/journal.pone.0277698

PLoS One. 2022 Nov 17;17(11):e0275124. doi: 10.1371/journal.pone.0275124. eCollection 2022.

ABSTRACT

BACKGROUND: In low-income countries out of, 60.7 million unintended pregnancies, 19% of them are subjected to abortion of which 11% of were unsafe. Surprisingly, about 2.5 million occur in women under the age of 20 years. Aim of this study is to measure the level of contraceptive utilization and associated factors among youths in Hosanna town administration.

METHOD: Institutional based cross-sectional study was conducted in Hossana town administration, Hadiya zone, Southern Ethiopia. A multistage sampling procedure was employed by clustering health facilities into reproductive health clubs and health facilities to select 781 study participants. Data was collected by using structured pre-tested, self-administered questionnaires. All coded and cleaned data were entered into EPI-info version 3.5.1 and it was exported to SPSS version 16.0 for recoding and further analysis.

RESULT: Among youths who had been sexually active within the last 12 months, 67.6% had used contraceptives prior to the survey. Multivariate analysis was found statistically significant association between contraceptive utilization and education status of mothers who attained university AOR = 4.57 [95% CI (1.29, 16.19)], utilization of sexual and reproductive health services within last 12 months AOR = 2.26 [(95% CI: 1.33, 3.86)], age initiation of first sex between 15-19 year OR = 2.63 [(95% CI 1.48,4.64)], discussion with sexual partner AOR = 1.99 [(95% CI: 1.27, 3.13)], good knowledge on contraceptive advantage AOR = [1.89 (95%CI: 1.07, 3.32)]. Whereas educational status: being secondary level decrease utilization of contraceptives by 51% AOR = 0.49 [95% CI (0.27, 0.94)].

CONCLUSION & RECOMMENDATION: The findings of our study imply that level of contraceptive utilization is higher than as compared to the previous studies. Discussion with a sexual partner as well as with a spouse, having awareness on contraceptive advantages, early age initiation of sexual intercourse, maternal educational status and getting sexual and reproductive health services recently were identified as predictors of contraceptive utilization.

PMID:36395174 | DOI:10.1371/journal.pone.0275124

Anesth Analg. 2022 Dec 1;135(6):1271-1281. doi: 10.1213/ANE.0000000000006256. Epub 2022 Nov 16.

ABSTRACT

BACKGROUND: Enhanced Recovery After Surgery (ERAS) was first established in 2001 focusing on recovery from complex surgical procedures in adults and recently expanded to ambulatory surgery. The evidence for ERAS in children is limited. In 2018, recognized experts began developing needed pediatric evidence. Center-wide efforts involving all ambulatory surgical patients and procedures have not previously been described.

METHODS: A comprehensive assessment and gap analysis of ERAS elements in our ambulatory center identified 11 of 19 existing elements. The leadership committed to implementing an Enhanced Recovery Program (ERP) to improve existing elements and close as many remaining gaps as possible. A quality improvement (QI) team was launched to improve 5 existing ERP elements and to introduce 6 new elements (target 17/19 ERP elements). The project plan was broken into 1 preparation phase to collect baseline data and 3 implementation phases to enhance existing and implement new elements. Statistical process control methodology was used. Team countermeasures were based on available evidence. A consensus process was used to resolve disagreement. Monthly meetings were held to share real-time data, gather new feedback, and modify countermeasure plans as needed. The primary outcome measure selected was mean postanesthesia care unit (PACU) length of stay (LOS). Secondary outcomes measures were mean maximum pain score in PACU and patient/family satisfaction scores.

RESULTS: The team had expanded the pool of active ERP elements from 11 to 16 of 19. The mean PACU LOS demonstrated significant reduction (early in phase 1 and again in phase 3). No change was seen for the mean maximum pain score in PACU or surgical complication rates. Patient/family satisfaction scores were high and sustained throughout the period of study (91.1% ± 5.7%). Patient/family and provider engagement/compliance were high.

CONCLUSIONS: This QI project demonstrated the feasibility of pediatric ERP in an ambulatory surgical setting. Furthermore, a center-wide approach was shown to be possible. Additional studies are needed to determine the relevance of this project to other institutions.

PMID:36384014 | DOI:10.1213/ANE.0000000000006256

Am J Public Health. 2022 Dec;112(12):1791-1799. doi: 10.2105/AJPH.2022.307095.

ABSTRACT

Objectives. To assess the rate of COVID-19 among in-person K-12 educators and the rate’s association with various COVID-19 prevention policies in school districts. Methods. We linked actively working, in-person K-12 educators in Wisconsin to COVID-19 cases with onset from September 2 to November 24, 2021. A mixed-effects Cox proportional hazards model, adjusted for pertinent person- and community-level confounders, compared the hazard rate of COVID-19 among educators working in districts with and without specific COVID-19 prevention policies. Results. In-person educators working in school districts that required masking for students and staff experienced 19% lower hazards of COVID-19 than did those in districts without any masking policy (hazard ratio = 0.81; 95% confidence interval = 0.72, 0.92). Reduced COVID-19 hazards were consistent and remained statistically significant when educators were stratified by elementary, middle, and high school environments. Conclusions. In Wisconsin’s K-12 school districts, during the fall 2021 academic semester, a policy that required both students and staff to mask was associated with significantly reduced risk of COVID-19 among in-person educators across all grade levels. (Am J Public Health. 2022;112(12):1791-1799. https://doi.org/10.2105/AJPH.2022.307095).

PMID:36383939 | DOI:10.2105/AJPH.2022.307095

Rev Inst Med Trop Sao Paulo. 2022 Nov 14;64:e71. doi: 10.1590/S1678-9946202264071. eCollection 2022.

ABSTRACT

Paracoccidioidomycosis (PCM) may present as an acute/subacute clinical form, characterized by a progressive disease arising from the airborne initial infection, or, most often, as an asymptomatic or subclinical infection that may manifest later during an individual’s life, the chronic form. Epidemiological studies show the existence of a strong association between smoking and the development of the chronic form. Current evidence demonstrates that cigarette smoke (CS) has immunosuppressive properties that could be implicated in the increasing susceptibility to the chronic form of PCM. To address this issue, we developed a murine model of a non-progressive pulmonary form of PCM that was exposed to CS at a magnitude that mimicked a moderate smoker. The chronic CS exposure started after 2 weeks and lasted up until 20 weeks post-infection, with the aim of mimicking human natural history, since it is estimated that individuals from endemic areas are infected early in life. The control group consisted of infected but not CS-exposed mice. We assessed the lung fungal burden (colony forming units [CFU]) and the area affected by the granulomatous inflammatory response, fungal dissemination to spleen and liver, and, by immunohistochemistry, the presence of CD4 and CD8 lymphocytes, CD68 and MAC-2 macrophages, and IFN-γ, IL-10 and TNF expressing cells within the granulomatous response. We detected a CS effect as early as 2 weeks after exposure (four weeks post-infection) when the lung CFU of exposed animals was significantly higher than in their non-exposed counterparts. At 12 weeks, the CS-exposed animals presented a more severe disease, as witnessed by the persistent higher lung fungal load (although it did not reach statistical significance [ p = 0.054]), greater dissemination to other organs, greater affected area of the lung, decreased IFN-γ/IL-10 ratio, and higher TNF expression within the granulomas, compared with CS-non-exposed mice. The number of CD4 and CD8 lymphocytes infiltrating the granulomas was similar between both mice groups, but there was a decrease in the number of MAC-2+ macrophages. No difference was noted in the CD68+ macrophage number. However, the follow-up in week 20 showed that the immunological effects of exposure to CS ceased, with both CS and NCS mice showing the same infectious features, i.e., a trend for resolution of the infection. In conclusion, we show that chronic CS-exposure alters the course of the disease in an experimental model of subclinical pulmonary PCM, confirming the epidemiological link between CS-exposure and the chronic form of PCM. However, we also show that this effect is transitory, being detected between 4- and 12-weeks post-infection but not thereafter. The possible immune mechanisms that mediate this effect and the reasons for its transitory effect are discussed.

PMID:36383893 | DOI:10.1590/S1678-9946202264071

Arq Bras Cir Dig. 2022 Nov 14;35:e1695. doi: 10.1590/0102-672020220002e1695. eCollection 2022.

ABSTRACT

BACKGROUND: Laparoscopic approaches to inguinal hernia repair include transabdominal extraperitoneal and transabdominal preperitoneal, both of which are widely performed and employ mesh. Indicators of success for these surgical procedures include incidence of complications, time to return to daily activities, incidence of postoperative chronic pain, and the long-term postoperative patient satisfaction.

OBJECTIVE: This study aimed to evaluate and compare long-term postoperative incidence of chronic pain and overall quality of life among patients undergoing transabdominal extraperitoneal or transabdominal preperitoneal inguinal hernia repair.

METHODS: This was a retrospective cross-sectional study. Medical records were analyzed, and the SF-36 questionnaire and Visual Analog Scale were applied to assess quality of life and chronic pain in patients undergoing laparoscopic inguinal hernia repair between January 2017 and February 2021.

RESULTS: A total of 167 patients status post laparoscopic inguinal hernia repair, who were 3 months postoperatively or longer, were included in the study. Among the early complications seen, seroma was most common in the transabdominal preperitoneal group (p=0.04). Subsequently, 40 of the initial 167 patients answered to the survey instrument (SF-36 and Visual Analog Scale). Mean patient-reported pain (Visual Analog Scale score) was statistically similar between groups, with 1.29 for transabdominal preperitoneal and 1.68 for transabdominal extraperitoneal (p=0.92). In the domains evaluated by the SF-36, there was no significant difference between the samples.

CONCLUSION: Both transabdominal extraperitoneal and transabdominal preperitoneal techniques for hernia repair have similar results in the late postoperative period regarding quality of life and prevalence of chronic pain. They are also comparable in terms of major early postoperative complications, except for seroma, with a higher incidence in patients undergoing transabdominal preperitoneal.

PMID:36383888 | DOI:10.1590/0102-672020220002e1695

Arq Gastroenterol. 2022 Nov 14:S0004-28032022005001208. doi: 10.1590/S0004-2803.202204000-91. Online ahead of print.

ABSTRACT

BACKGROUND: Bariatric surgery promotes changes in body composition, that can include the loss of bone mineral density (BMD). There is a lack of studies on the evolution of bone health of elderly people who underwent bariatric surgery, in general, and when comparing the gastric bypass (GB) and sleeve gastrectomy (SG) techniques.

OBJECTIVE: To evaluate the bone health of elderly patients with obesity undergoing bariatric surgery.

METHODS: This is a prospective randomized clinical study, that was carried out with individuals of both sexes, ≥65 years, undergoing GB or SG and who met the inclusion criteria. Age, gender and comorbidities (type 2 diabetes mellitus, arterial hypertension, dyslipidemia and osteoarthrosis) were collected and analyzed at baseline. Anthropometric data (weight, body mass index, percentage of weight loss, percentage of excess weight loss), laboratory tests related to bone health and bone mineral density were analyzed before and 24 months after surgery.

RESULTS: A total of 36 patients (GB, n=18; SG, n=18) were evaluated. At baseline, except for sex and preoperative body mass index, which was higher in GB, groups were similar. After 24 months, GB was superior for weight loss (%WL) and excess weight loss (%EWL). Regarding bone health, a significant decrease of BMD was observed in the spine, total proximal femur and femoral neck in all groups, with an average decrease of 5.1%, 10.5% and 15.1%, respectively. In addition, the observed decrease in BMD was up to 25% in the total femur after 24 months, six patients went from normal BMD to osteopenia and one from osteopenia to osteoporosis. There was no difference in parathormone values. However, there was an association between the increase in parathormone and the decrease in BMD in the spine, mainly in the GB group. There was no association between %WL and %EWL with the reduction in BMD.

CONCLUSION: Bariatric surgery was related to the reduction of BMD in elderly patients, but there was no statistical difference between the two surgical techniques.

PMID:36383883 | DOI:10.1590/S0004-2803.202204000-91

Rev Assoc Med Bras (1992). 2022 Nov 14:S0104-42302022005011202. doi: 10.1590/1806-9282.20220662. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the frequency of fatigue in geriatric patients with primary sarcopenia and to evaluate the relationship between fatigue and symptoms such as depression and sleepiness.

METHODS: This case-control study was conducted between December 2020 and August 2021 in the geriatrics outpatient clinic of Istanbul University-Cerrahpasa. The European Working Group on Sarcopenia in Older People 2 criteria were considered for the diagnosis of sarcopenia. Demographic data, accompanying chronic diseases, comprehensive geriatric assessments, and laboratory values of the patients were noted. Scales used to assess fatigue in all participants include Fatigue Assessment Scale, Fatigue Severity Scale, and Fatigue Impact Scale and associated symptoms include Geriatric Depression Scale and Epworth Sleepiness Scale.

RESULTS: The mean (standard deviation) age was 75.3 (7.1) for 51 primary sarcopenia (38 female) patients and 73.5 (5.8) for 51 control (37 female) patients. There was no significant difference between the two groups in terms of gender and age (p=0.822, p=0.171). The prevalence of hypertension was higher, and the level of education was lower in the sarcopenic group than in the nonsarcopenic group (p=0.017, p=0.013). Fatigue Assessment Scale, Fatigue Severity Scale, Fatigue Impact Scale total, Fatigue Impact Scale cognitive, Fatigue Impact Scale physical, and Fatigue Impact Scale social questionnaire scores were significantly higher in the sarcopenic group (all p<0.001). The Geriatric Depression Scale score was statistically higher in the sarcopenic group; however, there was no significant difference in the Epworth Sleepiness Scale score between the two groups (p=0.014, p=0.072). Multivariate analysis was performed on education level, hypertension, fatigue questionnaires, and Geriatric Depression Scale, which were found to be significant in the univariate logistic regression analysis. In the multivariate logistic regression analysis, only the Fatigue Impact Scale total was determined to be associated with sarcopenia [odds ratio 1.161, 95% confidence interval (1.084-1.242)].

CONCLUSION: In primary sarcopenia, there is mental and social fatigue as well as physical fatigue. Therefore, the prevention and treatment of sarcopenia in geriatric patients is important.

PMID:36383875 | DOI:10.1590/1806-9282.20220662

Cien Saude Colet. 2022 Dec;27(12):4467-4474. doi: 10.1590/1413-812320222712.10462022. Epub 2022 Jul 2.

ABSTRACT

This study aimed to quantitatively analyze the results of rapid tests for Human Immunodeficiency Virus (HIV), Syphilis, and Chronic Hepatitis in the prison population in a prison complex in Salvador (BA), Brazil. This cross-sectional study consisted of a sample of men incarcerated from August 2018 to August 2020 submitted to rapid tests. Descriptive statistics and prevalence ratios with respective 95% confidence intervals were employed to analyze data. A total of 6,160 men were studied. Most were black and brown (93.1%) and resided in Salvador (BA), Brazil (65.8%), with predominantly elementary schooling level (65.3%). Five hundred eighty-one (9.4%) people deprived of their liberty were positive for one or more STIs, and Syphilis was the most prevalent (80%). The variables age greater than 25 years [PR = 1.37 95%CI (1.17-1.61)] and schooling level without Higher Education [PR = 2.16 95%CI (1.04-4.49)] were associated with a higher positivity rate in tests, while not sharing drugs was a protective factor for test positivity [PR = 1.28 95%CI (1.07-1.53)]. We concluded that there was a low prevalence of STIs in the sample studied, and Syphilis was the most prevalent.

PMID:36383860 | DOI:10.1590/1413-812320222712.10462022

Cien Saude Colet. 2022 Dec;27(12):4423. doi: 10.1590/1413-812320222712.10212022. Epub 2022 Jun 30.

ABSTRACT

This study aimed to describe Pará’s Prison Health. This ecological time series study was based on secondary data with unrestricted access from Institutional Reports of the Penitentiary System and information from the Pará Transparency Web Portal, the National Register of Health Facilities (CNES), and the Notifiable Diseases Information System (SINAN). As a result, we observed a population with a majority of less-educated young black and brown males. In absolute numbers, we observed an increase of health professionals who did not follow the prison population hike. When entered into statistical control charts, the number of medical, dental, and psychological visits varied randomly and outside the limits. The potential coverage of prison health teams linked to the SUS achieved a maximum of 45.77%. Health task forces did not increase the number of visits. The incidence of tuberculosis was much higher than the mean for the state population, and its notification is adequate. Even with restricted secondary data, we could broadly look at the state’s prison health, raising issues managers and professionals should consider.

PMID:36383856 | DOI:10.1590/1413-812320222712.10212022