Nevin Manimala

Forensic Sci Int. 2022 Mar 20;335:111273. doi: 10.1016/j.forsciint.2022.111273. Online ahead of print.

ABSTRACT

This study illustrated the effects of environmental conditions (i.e., temperature) on the components of a condom lubricant in the presence of vaginal secretion. Understanding the effects of storage is important for the short-term handling of sexual assault kits, that may contain post-coital swabs, prior to chemical analysis. This preliminary three-day investigation utilized gas chromatography-mass spectrometry (GC-MS) to analyze the samples at three timepoints (24, 48, and 72 h). Lubricated and non-lubricated swabs were exposed to five storage conditions. After percent recovery calculation, GC-MS interpretation, and statistical analysis, it was determined that storing swabs at room temperature (22 °C) for up to 72 h best maintained the integrity of the sexual lubricant – in comparison to T0 – as opposed to colder storage temperatures of 4 °C and – 20 °C. Despite the varying degree of changes in the storage conditions and temperatures, PDMS components were persistent in all lubricated samples and can be used to confirm the presence of condom lubricant if initially present in the sample.

PMID:35339023 | DOI:10.1016/j.forsciint.2022.111273

Neural Netw. 2022 Mar 15;150:313-325. doi: 10.1016/j.neunet.2022.03.014. Online ahead of print.

ABSTRACT

Accurate classification of the children’s epilepsy syndrome is vital to the diagnosis and treatment of epilepsy. But existing literature mainly focuses on seizure detection and few attention has been paid to the children’s epilepsy syndrome classification. In this paper, we present a study on the classification of two most common epilepsy syndromes: the benign childhood epilepsy with centro-temporal spikes (BECT) and the infantile spasms (also known as the WEST syndrome), recorded from the Children’s Hospital, Zhejiang University School of Medicine (CHZU). A novel feature fusion model based on the deep transfer learning and the conventional time-frequency representation of the scalp electroencephalogram (EEG) is developed for the epilepsy syndrome characterization. A fully connected network is constructed for the feature learning and syndrome classification. Experiments on the CHZU database show that the proposed algorithm can offer an average of 92.35% classification accuracy on the BECT and WEST syndromes and their corresponding normal cases.

PMID:35339011 | DOI:10.1016/j.neunet.2022.03.014

J Electrocardiol. 2022 Mar 17;72:61-65. doi: 10.1016/j.jelectrocard.2022.02.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the effect of left bundle branch pacing (LBBP) on left ventricular systolic function and synchronization in patients with third-degree atrioventricular block.

METHODS: Fifty patients with third-degree atrioventricular block from 2019- to 01-01 to 2019-6-31 in The Affiliated Hospital of Qingdao University who were eligible for pacing indications were selected. According to different pacing locations, they were randomly divided into LBBP group and right ventricular septal pacing (RVSP) group. Three-dimensional speckle tracking technology was used to collect left ventricular global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) before surgery, 6 months after surgery, 12 months after surgery, and 18 months after surgery. At the same time, the percentage of the standard deviation of the time when the left ventricular 16 segments reach the minimum systolic volume in the cardiac cycle (Tmsv16-SD/R-R) was calculated. And the QRS duration of the two groups was followed up.

RESULTS: 1. GLS in LBBP group and RVSP group after surgery was significantly higher than that before surgery. And GLS in LBBP group and RVSP group showed an upward trend after surgery. However, the increase rate in LBBP group was higher than that in RVSP group. At 18 months after surgery, LBBP group was significantly higher than that in RVSP [(29.92±4.73) vs (26.48±3.80), p<0.05]. GCS in LBBP group increased gradually after surgery. GCS in RVSP group was no significant change after surgery. At 18 months after surgery, GCS in RVSP group was significantly lower than that in LBBP group [(27.92±3.37) vs (29.48±4.40), p<0.05]. There was no significant change in GRS between the two groups(p＞0.05). 2. Tmsv16-SD/R-R in LBBP group and RVSP group after surgery were lower than that before surgery (p<0.05). Tmsv16-SD/R-R in the LBBP group after surgery remained stable (P>0.05). At 18 months after surgery, Tmsv16-SD/R-R was significantly lower than that in the RVSP group [(4.27±0.67) vs (6.34±1.70), P<0.05]. 3. The QRS duration in LBBP group after surgery was significantly lower than that before surgery. And the QRS duration of the patients in the LBBP group remained stable during the 18-month follow-up (P>0.05). The QRS duration in the RVSP group after surgery had no significant change compared with that before surgery.The QRS duration in the LBBP group was significantly lower than that in the RVSP group after surgery (P＜0.05). 4. The LVEF of the LBBP group and the RVSP group remained stable after surgery, and there was no statistical difference between the two groups.

CONCLUSIONS: As an emerging pacing method, LBBP has good postoperative contractility and can maintain good electromechanical synchronization.

PMID:35339004 | DOI:10.1016/j.jelectrocard.2022.02.013

J Surg Res. 2022 Mar 23;275:341-351. doi: 10.1016/j.jss.2022.02.029. Online ahead of print.

ABSTRACT

INTRODUCTION: To determine the accuracy of preoperative modified frailty index (mFI) with or without laboratory values (mFI-labs or labs-continuous) in predicting postoperative discharge destination. Discharge destination is important to providers and patients. The ability to accurately predict discharge destination preoperatively can improve hospital resource utilization and help set patient and family expectations.

METHODS: Cohort analysis of the 2018 American College of Surgeon National Surgical Quality Improvement Project (ACS-NSQIP) Participant Use File of patients undergoing operations with complete data point sets: age, sex, operation work relative-value units; mFI-clinical based on 12 clinical findings, mFI-labs based on seven laboratory values. The nine hierarchical destinations: home, home with assistance, multi-level community, unskilled-care facility, rehabilitation facility, skilled-nursing facility, acute care hospital, hospice, or death, from best to worst outcome. Data were analyzed using univariate analysis, multiple logistic regression and supervised learning artificial neural networks.

RESULTS: Univariate and multivariate in general showed that patients with higher mFI-clinical and mFI-lab scores, as well as older age and more complex operations were more likely to be discharged to facilities other than home. However, these statistical techniques could not predict the exact destination. An artificial neural network analysis demonstrated perfect location prediction in 64.9% of cases and within one level of prefect prediction is 87.4%.

CONCLUSIONS: Using a limited number of preoperative factors, combining the mFI-clinical with laboratory values significantly improves the destination prediction performance significantly better than using the values separately. Preoperative knowledge of the likely discharge destination can benefit postoperative care planning and delivery.

PMID:35339003 | DOI:10.1016/j.jss.2022.02.029

J Surg Res. 2022 Mar 23;275:336-340. doi: 10.1016/j.jss.2022.01.015. Online ahead of print.

ABSTRACT

INTRODUCTION: As of yet, few studies have described the prevalence or rates of assault mortalities involving Asian victims on a national level. This study aimed to describe yearly trends and regional differences in assault mortalities among Asians.

METHODS: This repeat cross-sectional study from 2009 to 2018 used data from the Mortality Multiple Cause-of-Death Public Use Record from the National Center for Health Statistics and the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research. Total and proportion of assault mortalities involving Asians or Pacific Islanders were calculated by year. Total and rates (per 100,000 Asians or Pacific Islanders) of assault mortalities among Asians or Pacific Islanders were stratified by state and county classification where deaths occurred.

RESULTS: In 2009, 344 assault mortalities among Asians or Pacific Islanders accounted for 2.07% of assault-related deaths. In 2018, 366 assault mortalities among Asians or Pacific Islanders accounted for 1.96% of assault-related deaths. Furthermore, there were more assault mortalities from 2009 to 2018 among Asians or Pacific Islanders in California (n = 1116) and large central metropolitan counties (n = 1707). However, the highest rates of assault mortalities were in Alaska and Mississippi (7.1 and 6.8 per 100,000, respectively) and noncore nonmetropolitan counties (2.9 per 100,000).

CONCLUSIONS: These findings emphasize the importance of studying and addressing violence toward Asians in rural regions and Southern states. Future studies should use these results as a baseline to analyze mortality data from 2019 to 2021, when available, to examine the coronavirus disease 2019 pandemic’s impact on assault mortalities among Asian.

PMID:35339002 | DOI:10.1016/j.jss.2022.01.015

Econ Hum Biol. 2022 Mar 13;46:101120. doi: 10.1016/j.ehb.2022.101120. Online ahead of print.

ABSTRACT

We analyze the relationship between abortions and economic fluctuation at the U.S. state level for the 1995-2016 period. We do not find a statistically significant association between the overall abortion rate and the unemployment rate across the full sample period. However, we observe a procyclical association from approximately 2004 to 2010, during which a one percentage point increase in the unemployment rate is associated with a roughly 5% decrease in the abortion rate. This procyclical association is confirmed when we subsample our data to the 2005-2016 period. Our subgroup analysis indicates a procyclical association for the abortion rates for younger women, while we do not observe statistically significant associations when the analysis is stratified by race or ethnicity. The associations we observe for the younger age groups are especially pronounced in states with restrictions on Medicaid funding of abortions. Our analysis suggests that economic conditions may be an important factor in the reproductive choices by women.

PMID:35338909 | DOI:10.1016/j.ehb.2022.101120

Forensic Sci Int Genet. 2022 Mar 21;59:102690. doi: 10.1016/j.fsigen.2022.102690. Online ahead of print.

ABSTRACT

The Sperm X method uses a nanotechnology derived polymer membrane that functions as a separation medium to effectively trap sperm cells while enabling efficient flow through of the digested epithelial cell DNA. This specialized membrane enabled development of a method that could significantly increase a forensic laboratory’s ability to obtain male sperm fraction DNA profiles. The SpermX device provides a rapid, reproducible procedure that is easy to implement in a single-tube format as well as high-throughput truly automated hands-free workflows. Validation studies, performed using the manual SpermX method, include sensitivity, stability, precision (reproducibility and repeatability), mixtures, and a method comparison to the traditional differential extraction. Sensitivity and method comparison studies demonstrated a wide range of sperm cells, from a high of over 2.78 million cells (9158 ng) to a low of 25 cells (83 pg), can be trapped by the SpermX membrane. Stability studies on various substrates (i.e., carpet, cotton, denim, polyester, and silk) and degraded semen gave the expected male DNA profiles. Data from the same operator and a different operator were consistent with low variance. Mixtures, with ratios ranging from approximately 10:1-18182:1, created to simulate real casework type samples including buccal/semen, vaginal epithelial/semen, and post coital swabs at different time intervals, were tested. A comparison of the SpermX method to the conventional differential extraction method resulted in comparable probative male profile allelic data and associated statistical probabilities. For low level sperm samples, down to 25 sperm cells (83 pg), the SpermX method outperformed the conventional differential extraction with more genotypic information and associated probabilities.

PMID:35338894 | DOI:10.1016/j.fsigen.2022.102690

Am J Emerg Med. 2022 Mar 10;55:157-166. doi: 10.1016/j.ajem.2022.03.004. Online ahead of print.

ABSTRACT

INTRODUCTION: The outcomes of large-volume IVF administration to septic shock patients with comorbid congestive heart failure (CHF) and/or end-stage renal disease (ESRD) are uncertain and widely debated in the existing literature. Despite this uncertainty, CMS continues to recommend that 30 ml/kg of an intravenous crystalloid solution be administered to patients in septic shock starting within 3 h of presentation. We performed a systematic review and meta-analysis to assess the relationship between adherence to this guideline and outcomes among patients whose underlying comorbidities present a risk of fluid overload.

METHODS: Our search was conducted on PubMed and Scopus through November 5, 2021 to identify studies that evaluated clinical outcomes among septic patients with CHF/ESRD based on volume of fluid administered. The primary outcome measured was mortality at 30 days post-hospital discharge. Other outcomes included the rates of vasopressor requirements, invasive mechanical ventilation during hospitalization, as well as length of stay in the intensive care unit and/or hospital. We used random effects meta-analysis when two or more studies reported the same outcome.

RESULTS: We included five studies in the final meta-analysis, which comprised 5804 patients, 5260 (91%) of whom received non-aggressive fluid resuscitation, as defined by the studies’ authors. Random-effects meta-analysis for all-cause mortality showed that aggressive fluid resuscitation was associated with statistically non-significant increased odds of mortality (OR 1.42, 95% CI 0.88-2.3, P = 0.15, I² = 35%). There was no statistical association between volume of IVF administration and other outcomes evaluated.

CONCLUSION: Among septic shock patients with CHF and/or ESRD, administration of greater than or equal to 30 ml/kg IVF was associated with a non-significant increase in odds of mortality. All other outcomes measured were found to be non-significant, although there was a trend toward better outcomes among patients in the restricted-volume compared to the standard-volume IVF groups. Since this meta-analysis only included five observational studies, more studies are needed to guide an optimal volume and rate of fluid administration in this patient population.

PMID:35338881 | DOI:10.1016/j.ajem.2022.03.004

Lancet Public Health. 2022 Mar 17:S2468-2667(22)00031-7. doi: 10.1016/S2468-2667(22)00031-7. Online ahead of print.

ABSTRACT

BACKGROUND: In low-incidence countries, tuberculosis mainly affects migrants, mostly resulting from reactivation of latent tuberculosis infection (LTBI) acquired in high-incidence countries before migration. A nationwide primary care-based LTBI testing and treatment programme for migrants from high-incidence countries was therefore established in high tuberculosis incidence areas in England. We aimed to assess the effectiveness of this programme.

METHODS: We did a retrospective, population-based cohort study of migrants who registered in primary care between Jan 1, 2011, and Dec 31, 2018, in 55 high-burden areas with programmatic LTBI testing and treatment. Eligible individuals were aged 16-35 years, born in a high-incidence country, and had entered England in the past 5 years. Individuals who tested interferon-γ release assay (IGRA)-negative were advised about symptoms of tuberculosis, whereas those who tested IGRA-positive were clinically assessed to rule out active tuberculosis and offered preventive therapy. The primary outcome was incident tuberculosis notified to the national Enhanced Tuberculosis Surveillance system.

FINDINGS: Our cohort comprised 368 097 eligible individuals who had registered in primary care, of whom 37 268 (10·1%) were tested by the programme. 1446 incident cases of tuberculosis were identified: 166 cases in individuals who had IGRA testing (incidence 204 cases [95% CI 176-238] per 100 000 person-years) and 1280 in individuals without IGRA testing (82 cases [77-86] per 100 000 person-years). Overall, in our primary analysis including all diagnosed tuberculosis cases, a time-varying association was identified between LTBI testing and treatment and lower risk of incident tuberculosis (hazard ratio [HR] 0·76 [95% CI 0·63-0·91]) when compared with no testing. In stratified analysis by follow-up period, the intervention was associated with higher risk of tuberculosis diagnosis during the first 6 months of follow-up (9·93 [7·63-12·9) and a lower risk after 6 months (0·57 [0·41-0·79]). IGRA-positive individuals had higher risk of tuberculosis diagnosis than IGRA-negative individuals (31·9 [20·4-49·8]). Of 37 268 migrants who were tested, 6640 (17·8%) were IGRA-positive, of whom 1740 (26·2%) started preventive treatment. LTBI treatment lowered the risk of tuberculosis: of 135 incident cases in the IGRA-positive cohort, seven cases were diagnosed in the treated group (1·87 cases [95% CI 0·89-3·93] per 1000 person-years) and 128 cases were diagnosed in the untreated group (10·9 cases [9·16-12·9] per 1000 person-years; HR 0·14 [95% CI 0·06-0·32]).

INTERPRETATION: A low proportion of eligible migrants were tested by the programme and a small proportion of those testing positive started treatment. Despite this, programmatic LTBI testing and treatment of individuals migrating to a low-incidence region is effective at diagnosing active tuberculosis earlier and lowers the long-term risk of progression to tuberculosis. Increasing programme participation and treatment rates for those testing positive could substantially impact national tuberculosis incidence.

FUNDING: National Institute for Health Research Health Protection Research Unit in Respiratory Infections.

PMID:35338849 | DOI:10.1016/S2468-2667(22)00031-7

Arch Argent Pediatr. 2022 Apr;120(2):111-117. doi: 10.5546/aap.2022.eng.111. Epub 2022 Jan 22.

ABSTRACT

INTRODUCTION: Prescription errors are the most common cause of preventable errors. Electronic prescription (EP) systems may help to reduce errors and improve the quality of care.

OBJECTIVES: To assess the effect of EP on the prevalence of prescription errors and related adverse events (AE) among hospitalized pediatric patients. To assess EP adherence, acceptability, and suitability among users.

METHODS: Hybrid, descriptive, and quasi-experimental, before-and-after design. Prescriptions made to hospitalized patients were included, estimating the prevalence of prescription errors and related AE in the pre- and post- EP implementation periods at a children’s hospital (CH) and a general hospital (GH) used as control. Adherence was assessed based on the proportion of EP among all prescriptions registered in the post-implementation period. The acceptability and suitability of EP implementation was assessed via a user survey.

RESULTS: The prevalence of prescription errors pre- and post-EP implementation at the CH was compared and a statistically significant reduction was observed in both hospitals: CH: 29.1 versus 19.9 prescription errors/100 prescriptions (OR: 1.65; 95% CI: 1.34-2.02; p < 0.01). GH: 24.9 versus 13.6 prescription errors/100 prescriptions (OR: 2.1; 95% CI: 1.5-2.8; p < 0.01). The rate of overall adherence to EP was 83%. The implementation of EP was adequately acceptable and suitable.

CONCLUSION: The prevalence of prescription errors reduced 30% after the implementation of EP. The overall adherence to EP was adequate.

PMID:35338815 | DOI:10.5546/aap.2022.eng.111