Nevin Manimala

Leuk Lymphoma. 2021 Jun 24:1-10. doi: 10.1080/10428194.2021.1907374. Online ahead of print.

ABSTRACT

Breast and ovary have been described as rare but typical sites of presentation of Burkitt lymphoma (BL) in females, particularly after puberty. We revised a historic series of 44 lymphomas of the breast or the ovary in women diagnosed between 1973 and 2014 as BL. Fluorescence in situ hybridization (FISH) was applied to all, and array-based copy number analysis as well as expression profiling to a subset of those cases. Of the 42 cases evaluable for FISH, 19 cases showed an IG-MYC translocation but only 9 of those fulfilled the criteria of the current WHO classification for the diagnosis of BL. Those nine cases resembled BL of other sites with regard to molecular features. Our findings along with literature data suggest that breast and ovarian BL (1) seem to be rarer than hitherto assumed, (2) share typical molecular features with other BL, and (3) predominantly affect women in the fertile age.

PMID:34165048 | DOI:10.1080/10428194.2021.1907374

Glob Health Action. 2021 Jan 1;14(1):1927328. doi: 10.1080/16549716.2021.1927328.

ABSTRACT

Background: Water represents the core of food-energy nexus and is vital for human survival. In developing countries, contaminated water and lack of basic water services undermine efforts to improve nutritional status and related health issues. In the rural areas of Central Africa, a majority of the population lacks access to improved water sources and has to devote considerable efforts to obtain water.Objectives: Using the following definition of water insecurity, i.e. it exists when access to adequate amount of safe and clean water does not occur all the times for the entirety of household members to lead a healthy and active life, the study aimed to develop and test a household-level experiential water insecurity scale for rural households in Central Africa.Methods: The research was conducted in three phases: 1) the formative data collection; 2) the scale development; and, 3) the scale testing. In the third Phase, the scale was tested with 250 women who were water managing person of their households. Statistical analysis included items reduction, reliability, as well as criterion and construct validity assessment. The testing led to a final scale of 17 statements (WATINE-17), covering three domains of water insecurity: 1) psychosocial distress; 2) quantity; 3) quality of water.Results: The scale showed an excellent reliability (Cronbach’s alpha = 0.92) and was significantly associated with lower frequency of water intake among women (p = 0.007, concurrent validity). In assessing WATINE-17’s predictive validity, it was found that water insecurity was positively related to food insecurity (p < 0.001) and the level of water insecurity was the highest among severely food insecure households [F (3, 246) = 22.469, p < 0.001].Conclusion: The WATINE-17 is able to capture key elements of water insecurity and can be used to monitor and evaluate SDG# 6 and water-related programs, such as WASH, in Central Africa.

PMID:34165038 | DOI:10.1080/16549716.2021.1927328

Nat Commun. 2021 Jun 23;12(1):3886. doi: 10.1038/s41467-021-24089-6.

ABSTRACT

Chemical loss of Arctic ozone due to anthropogenic halogens is driven by temperature, with more loss occurring during cold winters favourable for formation of polar stratospheric clouds (PSCs). We show that a positive, statistically significant rise in the local maxima of PSC formation potential (PFP^LM) for cold winters is apparent in meteorological data collected over the past half century. Output from numerous General Circulation Models (GCMs) also exhibits positive trends in PFP^LM over 1950 to 2100, with highest values occurring at end of century, for simulations driven by a large rise in the radiative forcing of climate from greenhouse gases (GHGs). We combine projections of stratospheric halogen loading and humidity with GCM-based forecasts of temperature to suggest that conditions favourable for large, seasonal loss of Arctic column O₃ could persist or even worsen until the end of this century, if future abundances of GHGs continue to steeply rise.

PMID:34162857 | DOI:10.1038/s41467-021-24089-6

Nat Commun. 2021 Jun 23;12(1):3911. doi: 10.1038/s41467-021-24149-x.

ABSTRACT

Empirical measurements of ecological networks such as food webs and mutualistic networks are often rich in structure but also noisy and error-prone, particularly for rare species for which observations are sparse. Focusing on the case of plant-pollinator networks, we here describe a Bayesian statistical technique that allows us to make accurate estimates of network structure and ecological metrics from such noisy observational data. Our method yields not only estimates of these quantities, but also estimates of their statistical errors, paving the way for principled statistical analyses of ecological variables and outcomes. We demonstrate the use of the method with an application to previously published data on plant-pollinator networks in the Seychelles archipelago and Kosciusko National Park, calculating estimates of network structure, network nestedness, and other characteristics.

PMID:34162855 | DOI:10.1038/s41467-021-24149-x

Med Sci Monit. 2021 Jun 24;27:e932109. doi: 10.12659/MSM.932109.

ABSTRACT

BACKGROUND Computed tomography (CT) imaging using iodinated contrast medium is associated with the radiation dose to the patient, which may require reduction in individual circumstances. This study aimed to evaluate an individualized liver CT protocol based on body mass index (BMI) in 126 patients investigated for liver cirrhosis. MATERIAL AND METHODS From November 2017 to December 2020, in this prospective study, 126 patients with known or suspected liver cirrhosis were recruited. Patients underwent liver CT using individualized protocols based on BMI, as follows. BMI ≤24.0 kg/m²: 80 kV, 352 mg I/kg; BMI 24.1-28.0 kg/m²: 100 kV, 440 mg I/kg; BMI ≥28.1 kg/m²: 120 kV, 550 mg I/kg. Figure of merit (FOM) and size-specific dose estimates (SSDEs) were calculated and compared using the Mann-Whitney U test. Subjective image quality and timing adequacy of the late arterial phase were evaluated with Likert scales. RESULTS The SSDE was significantly lower in the 80 kV protocol, corresponding to a dose reduction of 36% and 50% compared with the others (all P<0.001). In the comparison of 80-, 100-, and 120-kV protocols, no statistically significant differences were found in FOMs (P=0.108~0.620). Of all the examinations, 95.2% (120 of 126) were considered as appropriate timing for the late arterial phase. In addition, overall image quality, hepatocellular carcinoma conspicuity, and detection rate did not differ significantly among the 3 protocols (P=0.383~0.737). CONCLUSIONS This study demonstrated the feasibility of using an individualized liver CT protocol based on BMI, and showed that patients with lower BMI should receive lower doses of iodinated contrast medium and significantly reduced radiation dose.

PMID:34162827 | DOI:10.12659/MSM.932109

Med Oral Patol Oral Cir Bucal. 2021 Jun 24:23998. doi: 10.4317/medoral.23998. Online ahead of print.

ABSTRACT

BACKGROUND: Ginger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimed to compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Abbas diabetes clinic (Iran).

MATERIAL AND METHODS: In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied. One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group was only given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. The symptoms and severity of xerostomia were measured before and after the intervention by the questionnaire proposed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test used to measure the normality of variables, and Chi-square and McNemar used to compare the scores questionnaire proposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 was considered as statistically significant in all these tests.

RESULTS: The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35 years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scores of xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the ginger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was 2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severity related to xerostomia, respectively(p<0.001).

CONCLUSIONS: The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloe vera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According to the results of this study, ginger and aloe vera mouthwashes could significantly decrease xerostomia and promote oral health in patients with diabetes.

PMID:34162822 | DOI:10.4317/medoral.23998

Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24677. doi: 10.4317/medoral.24677. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate whether any relationship between local alveolar bone density and maxillary canine impaction using gray values from cone beam computed tomography.

MATERIAL AND METHODS: The cone beam computed tomography images of 151 patients were retrospectively evaluated. Maxillary canine was defined as an impacted tooth when root formation was complete and the patient’s age older than 13 or the other side of the maxillary canine has completely erupted. Similarly, complete eruption was defined as the tooth in its expected occlusion and position. Using the cone beam computed tomography software, the region of interest which was 5 mm2 in area, was placed in the trabecular bone on cross sectional cone beam computed tomography images and the gray value measurements were recorded. After measuring the gray values of all the teeth, the images were grouped according to the field of view size. Comparison of the gray values of impacted and non-impacted teeth was made between images with the same field of view size.

RESULTS: A total of 151 patients, 101 (66.9%) female and 50 (33.1%) male, were included in the study. The mean age of the patients was 24.94 ±13.9. In images with a 40X40 field of view, the gray values of the impacted canine teeth were higher than the gray values of the non-impacted ones and statistically significant difference was found between them (p=0.003). However no statistically significant difference was found between the gray values of impacted and non-impacted canine teeth in 60×60 and 100×50 field of view (p=0.197, p=0.170, respectively).

CONCLUSIONS: We suggest using the smallest field of view size when evaluating bone density using gray values from cone beam computed tomography images and we support the idea that the local increased bone density may influence on impaction.

PMID:34162816 | DOI:10.4317/medoral.24677

MCN Am J Matern Child Nurs. 2021 Jun 18. doi: 10.1097/NMC.0000000000000738. Online ahead of print.

ABSTRACT

Purpose: Neonatal palliative care is widely endorsed as an essential aspect of neonatal intensive care unit (NICU) practice, yet inconsistencies in its use continue to exist. We examined neonatal nurses’ perceptions of barriers and facilitators to palliative care in their NICU setting.Study Design and Methods: A cross-sectional design using the Neonatal Palliative Care Attitude Scale (NiPCAS™©) was administered using an online survey distributed to neonatal nurses through the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and National Association of Neonatal Nurses (NANN). Parametric statistical analyses were conducted to explore relationships between unit policy and neonatal palliative care (NPC) education, and the nurses’ perceptions.Results: Ninety-nine of 1,800 AWHONN members who identified as NICU nurses completed the survey, representing a response rate of 5.5% and 101 of 4,000 NANN members who subscribe to the MYNANN message boards completed the survey, reflecting a 2.5% response rate. N = 200 surveys were completed with minimal data missing, resulting in a final sample of 200. Exploratory factor analysis yielded these subconstructs: Unit Culture, Resources, and Perceived Inappropriate Care. Barriers identified were Perceived Inappropriate Care and Societal Understanding of NPC. A positive correlation was noted for NiPCAS™© scores and unit culture support (r(185) = .66, n = 187, p < .01), unit NPC policy (r(184) = .446, n = 186, p < .01), and NPC education (r(185) = .373, n = 187, p < .01).Clinical Implications: Nurses who work in a NICU with an NPC policy and who have received palliative care education demonstrated more favorable attitudes toward NPC. Policy and educational programs are important strategies to promote high-quality care for high-risk infants and their families.

PMID:34162793 | DOI:10.1097/NMC.0000000000000738

MCN Am J Matern Child Nurs. 2021 Jun 18. doi: 10.1097/NMC.0000000000000743. Online ahead of print.

ABSTRACT

Purpose: The purpose of this study was to determine maternal cotinine levels in saliva at the f.irst (T-1) and third trimesters of pregnancy (T-2), and postpartum (T-3) among women who reported smoking a consistent number of cigarettes. The goal was to generate data to provide suggestions about how nurses can improve patient outcomes for women who smoke.Methods: Saliva cotinine values obtained from the randomized controlled trial (BabyBEEP) were used for this secondary analysis. We examined variations in saliva cotinine between the first and third trimesters of pregnancy and postpartum among light and heavy smokers. Cotinine values for pregnant smokers who were in the control group (not randomized to any intervention) and reported smoking the same range of cigarettes during and after pregnancy were used for the analyses (n = 43). Descriptive statistics and repeated-measures ANOVA were used for analyses.Results: There were differences in maternal saliva cotinine levels across the different time points and between the groups. There was a significant interaction effect between time and group. Cotinine decreased from T-1 to T-2 in heavy smokers and increased from T-2 to T-3 among both light and heavy smokers. Cotinine at T-3 was higher than T-1 among light smokers.Clinical Implications: Findings support accelerated nicotine metabolism during pregnancy and need for smoking cessation efforts throughout pregnancy to help women stay smoke free at postpartum.

PMID:34162791 | DOI:10.1097/NMC.0000000000000743

J Hosp Palliat Nurs. 2021 Jun 22. doi: 10.1097/NJH.0000000000000780. Online ahead of print.

ABSTRACT

Health care providers have an ethical obligation to reduce suffering during a patient’s end of life (EOL), but few receive formal education on EOL care principles. The objective of this project was to determine the feasibility and potential benefits of an education initiative in which the principles of EOL care were taught to senior-level nursing students and practicing nurses. To assess feasibility, data regarding recruitment rates, retention rates, and implementation issues were collected. Workshop effectiveness was evaluated through use of the End-of-Life Nursing Education Consortium-Knowledge Assessment Test survey, which evaluates knowledge levels regarding EOL care principles. A mixed-effects linear model was used to test for changes from the preworkshop to postworkshop scores. Demographic information and satisfaction data were also collected. Nineteen students and 24 nurses participated (total N = 43). There was a statistically significant time difference (P = .0001), with the postworkshop scores being higher (43.5 ± 0.93) versus the preworkshop scores (41.2 ± 0.93). However, no statistically significant workshop date difference (P = .3146) emerged. Satisfaction data were positive. Retention for the second workshop was negatively affected by COVID-19. The unique needs of patients nearing their EOL are significant. This project describes the implementation and outcomes of an education initiative, focused on EOL care principles, that was both feasible and beneficial.

PMID:34162790 | DOI:10.1097/NJH.0000000000000780