Nevin Manimala

Am J Phys Anthropol. 2021 Aug 2. doi: 10.1002/ajpa.24381. Online ahead of print.

ABSTRACT

OBJECTIVE: In this study, we analyze breastfeeding and weaning practices in pre-Columbian complex hunter-gatherers from the lower Paraná River basin (South America).

MATERIALS AND METHODS: We carried out bone isotope analyses concerning δ¹³ C in collagen and apatite, the spacing between both carbon sources and δ¹⁵ N in a sample of 23 subadult and adult individuals of both sexes recovered from Late Holocene archaeological sites, ranging from 1665 ± 45 to 680 ± 80 ¹⁴ C years BP.

RESULTS AND DISCUSSION: The results indicate that exclusive breastfeeding continued until the age of ~2 years, and weaning probably until 4 years of age. Supplementary foods included C₃ plants and probably animal fats and C₄ carbohydrates. A high fractionation of 4.9‰ in δ¹⁵ N values was recognized between breastfeeding infants and adult females, perhaps reflecting episodic hyper-protein diets in women linked to men’s food provisioning during women’s gestational/postpartum period. Additionally, male adults present a higher protein intake than females. Although this difference is not statistically significant with the current sample size, it could be a clue related to a sexual division in food procurement.

PMID:34338320 | DOI:10.1002/ajpa.24381

Acta Anaesthesiol Scand. 2021 Aug 2. doi: 10.1111/aas.13965. Online ahead of print.

ABSTRACT

BACKGROUND: The mini-fluid challenge (MFC) is a clinical concept of predicting fluid responsiveness by rapidly infusing a small amount of intravenous fluids, typically 100 ml, and systematically assessing its haemodynamic effect. The MFC method is meant to predict if a patient will respond to a subsequent, larger fluid challenge, typically another 400 ml, with a significant increase in stroke volume.

METHODS: We critically evaluated the general methodology of MFC studies, with statistical considerations, secondary analysis of an existing study, and simulations.

RESULTS: Secondary analysis of an existing study showed that the MFC could predict the total fluid response (MFC + 400 ml) with an area under the receiver operator characteristics curve (AUROC) of 0.92, but that the prediction was worse than random for the response to the remaining 400 ml (AUROC = 0.33). In a null simulation with no response to both the MFC and the subsequent fluid challenge, the commonly used analysis could predict fluid responsiveness with an AUROC of 0.73.

CONCLUSION: Many existing MFC studies are likely overestimating the classification accuracy of the MFC. This should be considered before adopting the MFC into clinical practice. A better study design includes a second, independent measurement of stroke volume after the MFC. This measurement serves as reference for the response to the subsequent fluid challenge.

PMID:34338314 | DOI:10.1111/aas.13965

Laryngoscope. 2021 Aug 2. doi: 10.1002/lary.29750. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: The objective of this study was to compare ventilation techniques utilized in microlaryngeal surgery.

STUDY DESIGN: Retrospective cohort study.

METHODS: Two-hundred surgeries performed from May 1, 2018 to March 1, 2020 and stratified as intubated, intermittently intubated (AAIV) or apneic. Patient demographics, comorbidities, anesthetic agents, intraoperative parameters/events, and complications were studied and compared across the three groups using inferential analyses.

RESULTS: Median body mass index in the AAIV group was significantly higher (33 vs. 29; P = .0117). Median oxygen nadirs were lower in AAIV cases (81% vs. 91-92%) while CO₂ peak measurements were lower (33 mmHg vs. 48 mmHg) in the fully apneic cohort which were significantly shorter cases (P < .0001). CO₂ peak measurements were comparable between AAIV and intubated cohorts (median 48.5 mmHg vs. 48.0 mmHg). Median apnea times were significantly prolonged by 2-5.5 minutes using nasal cannula and THRIVE/Optiflow in fully apneic cases when compared to no supplementary oxygenation (P = .0013). Systolic blood pressures following insertion of laryngoscope were higher (159.5 vs. 145 mmHg) and postoperative diastolic pressures were lower (68.5 vs. 76.5 mmHg) in fully apneic cases than intubated cases. No differences existed between frequencies of complications.

CONCLUSIONS: This study compares intubated, intermittently apneic, and fully apneic surgeries. No statistically significant differences were noted in comorbid conditions. While intraoperative hemodynamic fluctuations were more pronounced in the fully apneic cohort, and oxygenation distributions were lower in the AAIV cohort, no significant differences existed between events and complications. Apneic techniques are as safe and effective as traditional intubation.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2021.

PMID:34338303 | DOI:10.1002/lary.29750

Indian Pediatr. 2021 Aug 2:S097475591600359. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple studies have documented lower serum zinc levels in patients with febrile seizures in comparison to febrile patients without seizure. However, there is limited evidence comparing the effects of zinc supplementation with placebo on recurrence of febrile seizures in children.

OBJECTIVES: To study the effects of zinc supplementation on recurrence rate of febrile seizures in children less than 60 months of age.

DESIGN: Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.

DATA SOURCE AND SELECTION CRITERIA: We searched PubMed, EMBASE and CENTRAL databases for articles reporting randomized or quasi-randomized controlled trials comparing the effects of zinc supplementation with placebo on recurrence of febrile seizures in children aged less than 60 months. We performed a fixed effect meta-analysis to provide pooled odds ratio of febrile seizure recurrence. Quality of evidence was assessed using GRADE approach.

PARTICIPANTS: Children aged less than 60 months.

INTERVENTION: Zinc supplementation.

OUTCOME MEASURES: Odds of febrile seizure recurrence.

RESULTS: Four clinical trials with a total of 350 children were included in the review. There was no statistically significant difference between odds of febrile seizure recurrence during one year follow up, in children on zinc supplementation compared to those on placebo (OR 0.70; 95% CI 0.41 – 1.18, I2 = 0%).

CONCLUSION: Available evidence is very low quality and thus inadequate to make practice recommendations.

PMID:34338220

F1000Res. 2021 Feb 5;10:77. doi: 10.12688/f1000research.28002.1. eCollection 2021.

ABSTRACT

Background: The giant African snail, Achatina fulica, is an invasive species recognized for being a serious agricultural pest and an intermediary vector for diverse parasites that cause diseases in humans. The knowledge of the state of African snail populations in urban areas is of great ecological and public health importance. Therefore, our objective was to characterize the status of giant African snail populations present in the city of Cartagena, Colombia, including the assessment of nematode parasites in the specimens. Methods. Sites were visited following information from citizens affected by the presence of the African snail. The specimens were collected and transported to the laboratory; subsequently, they were weighed, measured, and classified by size. Dissections of lung tissue and soft organs were performed to search for and identify nematode parasites. Size measurement between the sampled sites was statistically compared and density and biomass indicators were established. Results. In total, 204 snails were collected distributed among four sites within Cartagena city. Of these, 50% were juvenile specimens (10-40 mm). The size of the specimens showed significant differences between the sampling areas. The calculated density was between 0.0019-0.68 ind/m ² and the biomass between 3.92-48.75 kg/ha. No presence of nematode parasites was observed in these specimens. Conclusions. Densities and biomasses of A. fulica in Cartagena do not reach levels considered highly harmful. On the other hand, although no parasites were found in these snails, it is relevant to continue with studies on the human health risks that represent the presence of this invasive species in urban areas of Cartagena.

PMID:34336187 | PMC:PMC8280942 | DOI:10.12688/f1000research.28002.1

Vet Med Int. 2021 Jul 21;2021:9430824. doi: 10.1155/2021/9430824. eCollection 2021.

ABSTRACT

BACKGROUND: In Ethiopia, equines serve in traction power, carting, recreation, festival packing, riding, transportation, and other activities since time immemorial. Strongyles are common equine health problems in Ethiopia though research based data on equine strongyles are limited particularly in the study areas, in and around Mekelle city. Therefore, the present study was intended to estimate the prevalence of common equine strongyles in and around Mekelle city from November 2018 to April 2019 and to assess risk factors associated with infection of strongyle parasites as well. Cross sectional design was used in this study, and the study population consisted of both donkeys and horses of all age and both sex groups. From randomly selected horses and donkeys, approximately 25 grams of faecal samples was drawn with gloved hands from rectum of study equines, labeled, and transported to laboratory for coprological examination. Flotation technique was employed to separate parasitic eggs from faeces, followed by microscopic examination for identification of strongyle eggs based on morphology. Pearson’s chi-square (χ2) was carried out to determine association between risk factors and parasitic infection. Moreover, both bivariate and multivariate logistic regression analyses were computed to assess the strength of association of those risk factors at 95% CI and P < 0.05.

RESULT: Out of 384 samples collected, 204 were found to be positive for strongyles with an overall prevalence of 53.13%. Prevalence of strongyle species in equines was also estimated to be 53% and 53.3% for donkeys and horses, respectively. Accordingly, of the six risk factors considered, only three factors (age, management type, and body condition scores) were found to influence the occurrence of strongyle infection and to be statistically significant as well.

CONCLUSION: The higher prevalence of equine strongyles in the present study might be suggestive of urgent and coordinated actions to be in place.

PMID:34336180 | PMC:PMC8321758 | DOI:10.1155/2021/9430824

Vet Med Int. 2021 Jul 19;2021:2665956. doi: 10.1155/2021/2665956. eCollection 2021.

ABSTRACT

Handheld point-of-care blood analyzers deliver rapid results for biochemical and hematologic parameters, making them very useful in veterinary clinics and in fieldwork applications. This study compared the biochemical and hematologic parameters generated by the novel point-of-care analyzer i-STAT® Alinity V CHEM8+ cartridge between human-managed and free ranging populations of southern white rhinoceros (Ceratotherium simum simum). In addition, a novel reference interval for ionized calcium (iCa), a parameter of diagnostic and prognostic importance, was established for southern white rhinoceros. Blood samples were obtained from 10 managed (6 at NC Zoo and 4 at Busch Gardens Tampa Bay in 2019) and 30 free ranging white rhinoceros (collected in South Africa between 2018 and 2019) and analyzed using the i-STAT. Multiple parameters were higher (P < 0.05) in free ranging versus managed animals including potassium, blood urea nitrogen, creatinine, glucose, hematocrit, and hemoglobin. Conversely, iCa concentrations were higher (P < 0.05) in the managed populations of white rhinoceros. The RI determined for iCa was 1.36-1.56 mmol/L, with a mean of 1.46 mmol/L, and was determined using the guidelines from the American Society for Veterinary Clinical Pathology. There was no difference in anion gap, chlorine, total carbon dioxide, or sodium between the populations. Seasonality and locality of sampling as well as diet may be contributing factors to the higher iCa concentrations in managed rhinoceros. The six elevated parameters in free ranging rhinoceros are likely attributable to dehydration compounded by capture stress. This data provides insight into the state of several biochemical and hematologic parameters in southern white rhinoceros and will allow veterinarians to better assess the health of both managed and free ranging populations.

PMID:34336179 | PMC:PMC8315869 | DOI:10.1155/2021/2665956

J Healthc Eng. 2021 Jul 20;2021:9968451. doi: 10.1155/2021/9968451. eCollection 2021.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has caused serious concerns in pregnant women. Self-care mHealth applications can provide helpful guidelines for COVID-19 prevention or management in case of infection. This study aimed to develop and then assess a self-care smartphone-based application to provide self-care for pregnant women against COVID-19. The present study was conducted in two phases. First, a needs assessment was performed based on the opinions of 30 obstetricians and pregnant women. Then, relying on the results, a smartphone-based application was prototyped and assessed in terms of its usability and user satisfaction. To assess the application, 36 pregnant women (11 infected with COVID-19) were asked to use the application for a week. The QUIS questionnaire 5.5 was used for assessment, and the results were analyzed via descriptive statistics in SPSS 23. According to the obstetricians and pregnant women, of the 41 information requirements, 35 data elements were noted to be essential in the needs assessment. Features of the application were placed in four categories of User’s Profile, Lifestyle, Disease Management and Control, and Application Functions (e.g., introducing high-risk places in terms of COVID-19 prevalence in each city, introducing specialized COVID-19 medical centers to pregnant women to receive services, medication management, stress management and control, nutrition and diet management, sleep management, contacting physicians, doctor’s appointment reminder, searching the available educational materials, and making application adjustments such as text font, size, and color). With an average score of 7.94 (out of 9), pregnant women rated the application at a good level. The application can be used to reduce anxiety and stress about COVID-19 in mothers, provide access to reliable information to answer possible questions, identify high-risk locations, and provide pregnant women with instant access to healthcare facilities and information related to COVID-19 self-care processes.

PMID:34336175 | PMC:PMC8292075 | DOI:10.1155/2021/9968451

J Healthc Eng. 2021 Jul 21;2021:8997915. doi: 10.1155/2021/8997915. eCollection 2021.

ABSTRACT

Esophageal cancer is a common malignant tumor in some countries and regions in the world, which threatens the health of people all over the world. Due to esophageal cancer, about 400,000 people die every year. Among them, the number of cases and deaths of esophageal cancer in our country accounts for about 50% of the world. This article aims to study the clinical efficacy of PICC catheterization in the chemotherapy of advanced esophageal cancer based on the dysfunction module. For patients with advanced esophageal cancer, traditional surgery is still difficult to achieve satisfactory results. Therefore, in order to improve the therapeutic effect of esophageal cancer and obtain a higher clinical effective rate and pathological complete remission rate, it is necessary to explore a new comprehensive treatment model. In this paper, the theoretical knowledge of PICC is described in detail from the concept, advantages, and indications of PICC, and the SPSS statistical method is proposed. The SPSS statistical model, mean test, two-independent sample t-test, and regression analysis jointly explain the application principles and methods of SPSS statistical methods. After selecting the experimental subjects, the 180 eligible patients with esophageal squamous cell carcinoma were divided into two groups, each with 30 patients with stage II esophageal cancer, 30 patients with stage III esophageal cancer, and 30 patients with stage IV esophageal cancer. Grouping according to different variables, real-time recording of data, and SPSS statistical method to analyze the experimental data, the experimental results of this article show that the nursing satisfaction of the observation group is 92.2%, which is significantly higher than the 56.7% of the control group, so it can be seen that PICC plays an important role in the personalized care and treatment of advanced esophageal cancer.

PMID:34336168 | PMC:PMC8321725 | DOI:10.1155/2021/8997915

J Healthc Eng. 2021 Jul 21;2021:7219850. doi: 10.1155/2021/7219850. eCollection 2021.

ABSTRACT

OBJECTIVE: To detect the single nucleotide polymorphism (SNP) of alpha-(1,2) fucosyltransferase 2 gene (FUT2) and the secretion status in the newborns of Chongqing China and explore the relationship between genotype or phenotype of FUT2 and neonatal necrotizing enterocolitis (NEC).

METHODS: Newborns who were hospitalized in Children’s Hospital of Chongqing Medical University from August 2014 to December 2015 and in line with the inclusion criteria were chosen as the research subjects; 34 cases of them in accordance with the diagnostic criteria of NEC stage II or III were NEC group, and 36 other cases of them were the control group. Total DNA was extracted from oral epithelial cells of patients which were collected with cotton buds. FUT2 SNP genotype was detected by gene sequencing. H antigen was detected with saliva samples by saliva agglutination inhibition test. Related clinical data were collected for analysis.

RESULTS: There are three genotypes on the rs1047781 (A385T) allele of the FUT2 encoding sequence: AA, AT, and TT. The number of genotypes AA, AT, and TT in the NEC group was 9 (26.47%), 12 (35.29%), and 13 (38.24%), respectively. In the control group, the number of genotypes AA, AT, and TT was 12 (33.33%), 17 (47.23%), and 7 (19.44%). There were no differences in genotypes between the two groups according to the chi-square test (P > 0.05). There were 22 cases of secretors (64.7%) and 12 cases of nonsecretors (35.3%) in the NEC group. The number of secretors and nonsecretors in the control group was 31 (88.89%) and 5 (11.11%). Statistical difference was found in the phenotype between two groups through the chi-square test (P < 0.05). In addition, no G428A homozygous mutation, which causes nonsecretor phenotype in Caucasians, was seen in all the subjects of this study.

CONCLUSIONS: These findings indicate that secretion status (nonsecretor) was significantly associated with NEC in Chongqing, China.

PMID:34336165 | PMC:PMC8321722 | DOI:10.1155/2021/7219850