Nevin Manimala

Am J Emerg Med. 2021 Jul 9;50:111-119. doi: 10.1016/j.ajem.2021.07.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To derive and characterize the performance of various metrics of emergency transport time in assessing for sociodemographic disparities in the setting of residential segregation. Secondarily to characterize racial disparities in emergency transport time of suspected stroke patients in Austin, Texas.

DATA SOURCES: We used a novel dataset of 2518 unique entries with detailed spatial and temporal information on all suspected stroke transports conducted by a public emergency medical service in Central Texas between 2010 and 2018.

STUDY DESIGN: We conducted one-way ANOVA tests with post-hoc pairwise t-tests to assess how mean hospital transport times varied by patient race. We also developed a spatially-independent metric of emergency transport urgency, the ratio of expected duration of self-transport to a hospital and the measured transport time by an ambulance.

DATA COLLECTION/EXTRACTION: We calculated ambulance arrival and destination times using sequential temporospatial coordinates. We excluded any entries in which patient race was not recorded. We also excluded entries in which ambulances’ routes did not pass within 100 m of either the patient’s location or the documented hospital destination.

PRINCIPAL FINDINGS: We found that mean transport time to a hospital was 2.5 min shorter for black patients compared to white patients. However, white patients’ transport times to a hospital were found to be, on average, 4.1 min shorter than expected compared to 3.4 min shorter than expected for black patients. One-way ANOVA testing for the spatially-independent index of emergency transport urgency was not statistically significant, indicating that average transport time did not vary significantly across racial groups when accounting for variations in transport distance.

CONCLUSIONS: Using a novel transport urgency index, we demonstrate that these findings represent race-based variation in spatial distributions rather than racial bias in emergency medical transport. These results highlight the importance of closely examining spatial distributions when utilizing temporospatial data to investigate geographically-dependent research questions.

PMID:34340164 | DOI:10.1016/j.ajem.2021.07.013

Animal. 2021 Jul 30;15(9):100317. doi: 10.1016/j.animal.2021.100317. Online ahead of print.

ABSTRACT

Mosaicism is frequently observed in aquaculture practices, and it adversely affects the production as well as the restoration programme of the sturgeon. The purpose of the present study was the induction of 2n/3n mosaic in sterlet, Acipenser ruthenus L., and compare their embryonic and larval development with diploid control sterlet. Microsatellite DNA loci genotyping was conducted for the identification of the genotypes and parentage analysis. Embryonic development was monitored in experimental groups at every 24 h interval. Identification of individual stages of embryonic development was recorded based on a 36-degree scale of development. Additionally, the BW and body length (LT) of experimental fishes were taken during 110 days of the rearing period. The Fulton’s condition coefficient (F), length-weight parameters, and specific growth rate (SGR) coefficient were calculated. The analysis of embryonic development of the 2n/3n mosaic and the diploid control group did not show differences. However, higher mortality (88%) was observed in 2n/3n mosaic groups in comparison to the diploid control groups (55%). BW and body length of 2n/3n mosaic sterlet were slightly lower than the diploid control sterlet, but the differences were not statistically significant. F analysis did not confirm a lower growth performance of the fishes in the 2n/3n mosaic group. Microsatellite DNA loci genotyping confirmed both the incidence of polyspermy and retention of the second polar body. This paper presents the first report on embryonic development and growth performance of 2n/3n mosaic sturgeons.

PMID:34340140 | DOI:10.1016/j.animal.2021.100317

Comput Biol Med. 2021 Jul 28;136:104705. doi: 10.1016/j.compbiomed.2021.104705. Online ahead of print.

ABSTRACT

Antimicrobial resistance (AMR) in bacterial pathogens is a major global distress. Due to the slow progress of antibiotics development and the fast pace of resistance acquisition, there is an urgent need for effective vaccines against such bacterial pathogens. In-silico approaches including pan-genomics, subtractive proteomics, reverse vaccinology, immunoinformatics, molecular docking, and dynamics simulation studies were applied in the current study to identify a universal potential vaccine candidate against the 18 multi-drug resistance (MDRs) bacterial pathogenic species from a WHO priority list. Ten non-redundant, non-homologous, virulent, and antigenic vaccine candidates were filtered against all targeted species. Nine B-cell-derived T-cell antigen epitopes which show a great affinity to the dominant HLA allele (DRB1*0101) in the human population were screened from selected vaccine candidates using immunoinformatics approaches. Screened epitopes were then used to design a multi-epitope peptide vaccine construct (MEPVC) along with β-defensin adjuvant to improve the immunogenic properties of the proposed vaccine construct. Molecular docking and MD simulation were carried out to study the binding affinity and molecular interaction of MEPVC with human immune receptors (TLR2, TLR3, TLR4, and TLR6). The final MEPVC construct was reverse translated and in-silico cloned in the pET28a(+) vector to ensure its effectiveness. This in silico construct is expected to be helpful for vaccinologists to assess its immune protection effectiveness in vivo and in vitro to counter rising antibiotic resistance worldwide.

PMID:34340127 | DOI:10.1016/j.compbiomed.2021.104705

Chemosphere. 2021 Jul 24;286(Pt 2):131637. doi: 10.1016/j.chemosphere.2021.131637. Online ahead of print.

ABSTRACT

Quantitative image analysis (QIA) was used for monitoring the morphology of activated sludge (AS) during a granulation process and, thus, to define and quantify, unequivocally, structural changes in microbial aggregates correlated with the sludge properties and granulation rates. Two sequencing batch reactors fed with acetate at organic loading rates of 1.1 ± 0.6 kg_COD m^-3 d^-1 (R1) and 2.0 ± 0.2 kg_COD m^-3 d^-1 (R2) and three minimal imposed sludge settling velocities (0.27 m h^-1, 0.53 m h^-1, and 5.3 m h^-1) induced distinct granulation processes and rates. QIA results evidenced the turning point from flocculation to granulation processes by revealing the differences in the aggregates’ stratification patterns and quantifying the morphology of aggregates with equivalent diameter (Deq) of 200 μm ≤ Deq ≤ 650 μm. Multivariate statistical analysis of the QIA data allowed to distinguish the granulation status in both systems, by clustering the observations according to the sludge aggregation and granules maturation status, and successfully predicting the sludge volume index measured at 5 min (SVI₅) and 30 min (SVI₃₀). These results evidence the possibility of defining unequivocally the granulation rate and anticipating the sludge settling properties at early stages of the process using QIA data. Hence, QIA could be used to predict episodes of granules disruption and hindered settling ability in aerobic granulation sludge processes.

PMID:34340113 | DOI:10.1016/j.chemosphere.2021.131637

Eur J Obstet Gynecol Reprod Biol. 2021 Jul 24;264:266-270. doi: 10.1016/j.ejogrb.2021.07.035. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this retrospective case-control study was to analyze the effect of administering indomethacin after triggering final oocyte maturation in patients with poor ovarian response (POR) on the cycle cancellation rate due to premature ovulation (PO), the number of oocytes retrieved and the clinical outcomes of IVF cycles.

STUDY DESIGN: A total of 214 patients with POR, diagnosed according to the Bologna criteria, who underwent fresh IVF cycle via flexible gonadotrophin-releasing hormone antagonist (GnRH-ant) protocol were enrolled in the study. The control group consisted of 100 patients, whereas the indomethacin group included 114 patients who received 100 mg rectal indomethacin administered twice within the same day (twelve hours apart) -starting at twelve hours after triggering. Cycle cancelation rates (CCR), number of oocytes retrieved (nOR), implantation rates (IR), biochemical pregnancy (BP) and clinical pregnancy loss rates (CPL), ongoing pregnancy rates (OPR) and live birth rates (LBR) were compared between the indomethacin and control groups.

RESULTS: The CCR rate was significantly lower in the indomethacin group (1.8%) compared to the control group (1.8% vs %12%, p = 0.01). In the control group, those with cycle cancellation were older than those without cycle cancellation (mean age 42.2 ± 2.3 years vs. 39.36 ± 4.3 years, p = 0.001) and had lower anti-Müllerian hormone levels and lower antral follicle count (0.59 ± 0.2 ng/mL vs 0.79 ± 0.2 ng/mL, p = 0.001 and 4 ± 0.6 vs 5.7 ± 1.7, p = 0.001, respectively). In multivariable analysis, when the dependent variable in the logistic regression model was coded as the absence of cycle cancellation, it was observed that only indomethacin had a statistically significant effect on cycle cancellation (β = -1.931, standard error = 0.832, Exp(B) = 0.145, p = 0.020). nOR was higher in the indomethacin group than control group but the difference did not reach significance (p = 0.07). Moreover, the IR, OPR and LBR, BP and CPL values were similar in the indomethacin and control groups (p > 0.05).

CONCLUSIONS: Based on data from this study, it can be concluded that indomethacin reduces cycle cancelation due to PO in patients with POR -without compromising implantation and pregnancy rates. However, further randomized controlled trials with larger sample sizes are required to clarify the definitive effect of indomethacin in the treatment of patients with POR.

PMID:34340097 | DOI:10.1016/j.ejogrb.2021.07.035

Eur J Obstet Gynecol Reprod Biol. 2021 Jul 21;264:241-246. doi: 10.1016/j.ejogrb.2021.07.027. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the magnitude and the predictors of emotional reactions to an infertility diagnosis, comparing women and men who were clinically diagnosed with an anatomical cause of infertility or non-anatomical cause of infertility.

STUDY DESIGN: Cross-sectional study involving a total of 133 adults waiting for infertility treatment at the IVF and Infertility Unit of the S. Orsola University Hospital in Bologna (Italy). Of these, 107 patients (55 with anatomical causes of infertility and 52 with non-anatomical causes of infertility; response rate: 80%) took part to the study. After providing informed written consent, each participant was asked to complete the Infertility Self-efficacy Scale, the Fertility Quality of Life, and the Brief Coping Orientation to Problem Experienced, which they returned at their second access to the Unit. Differences between the groups were analyzed through a series of univariate ANOVA, whereas a multiple regression analysis was used to jointly examine the predictors of fertility quality of life.

RESULTS: Results showed both gender related and diagnosis related differences. Women had statistically significant lower scores than men on the Infertility Self-Efficacy Scale and on the global, emotional, and mind-body subscales of the Fertility Quality of Life, while they scored significantly higher on the emotion focused and socially supported subscales of the Coping Orientation to Problem Experienced. Independently of gender, patients with non-anatomical causes of infertility scored poorly than patients with anatomical causes of infertility on the relational subscale of the Fertility Quality of Life and on the Avoidant scale of the Brief Coping Orientation to Problem Experienced. Hierarchical multiple regression analyses revealed that higher levels of self-efficacy and a lower use of avoidant coping strategies predicted a more positive quality of life over and above gender and cause of infertility.

CONCLUSION: This study partly confirms data on gender differences in experiencing the psychological burden of infertility and adds some new information, particularly with respect to the prediction of quality of life indicators over and above infertility cause.

PMID:34340094 | DOI:10.1016/j.ejogrb.2021.07.027

Sci Total Environ. 2021 Jul 23;798:148990. doi: 10.1016/j.scitotenv.2021.148990. Online ahead of print.

ABSTRACT

The purpose of this study is to find the key factors of influence for the use and acceptance of Virtual Reality (VR) by tourists visiting National Parks in Costa Rica. The aim is to find whether tourists are willing to use VR to contribute to the eco-friendly performance of the area they visit and to determine whether they are willing to use VR in environmental tourism to protect flora and fauna. This study is quantitative and uses the theoretical Unified Theory of Acceptance and Use of Technology (UTAUT) Model and a survey as the research instrument to obtain data. Data analysis was carried out using a PLS-SEM statistical analysis. The data collection procedure consisted of 50 people being surveyed in the initial pre-test phase and later 455 tourists in the fieldwork phase with national or foreign people over the age of 18 who visit or have visited the national parks of Costa Rica. The results show that there is a positive relationship between eco-friendly performance and the intention to use VR technology, as well as the actual use of VR for the benefit of the environment. The UTAUT2 model was used to find the effect of eco-friendly performance on the intention to use VR, as well as the use of this technology during visits to tourist destinations. The originality of the work is in answering the question of how to develop sustainable tourism in Costa Rica with the use of VR devices and applications that also allow the conservation of flora and fauna.

PMID:34340092 | DOI:10.1016/j.scitotenv.2021.148990

Pediatr Pulmonol. 2021 Aug 2. doi: 10.1002/ppul.25596. Online ahead of print.

ABSTRACT

OBJECTIVES: Kawasaki disease (KD) is an acute, self-limited multisystemic vasculitis of unknown cause. Pulmonary involvement has been reported in case reports and limited small case series, which is not commonly recognized, especially in younger patients <1 year. Here, we describe clinical and radiological features of infants with KD-associated pulmonary involvement (KD-PI).

METHODS: Infants with KD were retrospectively enrolled during the period January 2017 to December 2020 in Shenzhen Children’s hospital. Patients with KD-PI were matched 1:1 based on current age and sex with KD patients without clinically apparent PI. Clinical data were collected from inpatient or outpatient medical records, including clinical manifestations, laboratory parameters, radiological findings, management, and prognosis.

RESULTS: Of 248 infant patients with KD, 34 presented with KD-PI. Of these, 22 had only subtle respiratory symptoms. Compared to KD controls, patients with KD-PI had significantly higher mean Kobayashi score (mean ± SD: 2.85 ± 1.94; p = .004), more had extremely high C-reactive protein (≥10 mg/dl: 11/34, 32.3%; p = .0115) and procalcitonin levels (˃1 ng/ml: 16/34, 47%; p = .039), and more were administered with adjuvant corticosteroids as initial therapy (38.2% vs. 2.9%; p = .0005). Abnormal chest radiological findings included peripheral consolidation (97.0%), localized pleural thickening (73.0%), lobular septal thickening (70.6%), ground-glass opacities (55.9%), linear opacities (35.3%), and pleural effusion (20.6%). No statistical difference was observed in the incidence of coronary artery abnormalities (CAAs) between two groups either in the acute phase or follow-up phase.

CONCLUSIONS: Higher use of adjuvant corticosteroids during initial therapy in our population may result in no difference in CAAs between the two groups despite higher levels of inflammation in KD-PI. Those results suggest that use of adjuvant corticosteroids may be beneficial in this population.

PMID:34339594 | DOI:10.1002/ppul.25596

Am J Primatol. 2021 Aug 2:e23315. doi: 10.1002/ajp.23315. Online ahead of print.

ABSTRACT

This study was designed to (1) characterize the macronutrient composition of olive baboon (Papio anubis) milk, (2) compare baboon milk composition to that of rhesus macaques (Macaca mulatta), and (3) evaluate the association between the proportion of milk energy derived from protein and relative growth rate within anthropoid primates. A single milk sample was collected from each of eight lactating olive baboons ranging between 47- and 129-days postparturition and six rhesus macaques from 15- to 92-days living at the same institution under identical management conditions. Macronutrient composition (water, fat, protein sugar, and ash) was determined using standard techniques developed at the Nutrition Laboratory at the Smithsonian National Zoological Park. Baboon milk on average contained 86.0% ± 0.6% water, 4.7% ± 0.5% fat, 1.6% ± 0.04% protein, 7.3% ± 0.07% sugar, and 0.165% ± 0.007% ash. Baboon milk gross energy (GE) averaged 0.81 ± 0.04 kcal/g with 51.9% ± 2.6% from fat, 11.8% ± 0.7% from protein, and 36.2% ± 2.0% from sugar. Baboon milk demonstrated strong similarity to milk composition of the closely phylogenetically related rhesus macaque (86.1% ± 0.3% water, 4.1% ± 0.4% fat, 1.69% ± 0.05% protein, 7.71% ± 0.08% sugar, 0.19% ± 0.01% ash, and 0.78 kcal/g). There was no statistical difference between baboon and macaque milk in the proportions of energy from fat, sugar, and protein. Baboon milk can be described as a high sugar, moderate fat, and low protein milk with moderate energy density, which is consistent with their lactation strategy characterized by frequent, on-demand nursing and relatively slow life history compared to nonprimate mammal taxa. The milk energy from protein of both baboon and macaque (12.8% ± 0.3%) milk was intermediate between the protein milk energy of platyrrhine (19.3%-23.2%) and hominoid (8.9%-12.6%) primates, consistent with their relative growth rates also being intermediate. Compared to these cercopithecid monkeys, platyrrhine primates have both higher relative growth rates and higher milk energy from protein, while apes tend to be lower in both.

PMID:34339526 | DOI:10.1002/ajp.23315

Nutr Clin Pract. 2021 Aug 2. doi: 10.1002/ncp.10741. Online ahead of print.

ABSTRACT

BACKGROUND: Nutrition status of very preterm infants in the neonatal intensive care unit (NICU) is strongly associated with postnatal growth. This study aimed to develop indicators of nutrition status using growth data of very preterm infants during hospitalization.

METHODS: The data of 596 newborns from eight NICUs were retrospectively analyzed. Inclusion criteria were birth at <32 weeks’ gestation, NICU admission ≤24 h after delivery, and length of hospital stay ≥28 days. Three indicators were evaluated: (indicator I) prevalence of extrauterine growth restriction (EUGR); (indicator II) z-score for change in weight from birth to discharge, adjusted for birth weight z-score and gestational age; and (indicator III) change in weight z-score from birth to discharge, adjusted for birth weight z-score, gestational age, and time to regain birth weight. Using data from NICU 1 as the reference for the latter two indicators, we established linear regression models of the adjusted change in weight z-score from birth to discharge. The difference between the observed value and the baseline value (calculated by the two models) served as the nutrition indices.

RESULTS: The prevalence of EUGR differed significantly between the eight NICUs (P = .009). Statistically significant differences were found between the mean indices calculated by the other two models (all P < .05).

CONCLUSIONS: Indicator III, change in weight z-score from birth to discharge (adjusted for birth weight z-score, gestational age, and time to regain birth weight), appears to be the most accurate for evaluating the quality of nutrition in the NICU.

PMID:34339517 | DOI:10.1002/ncp.10741