Nevin Manimala

Pan Afr Med J. 2021 Feb 12;38:159. doi: 10.11604/pamj.2021.38.159.27143. eCollection 2021.

ABSTRACT

INTRODUCTION: the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model construction, visualization and platform construction among others.

METHODS: we conducted a geospatial analysis to develop a web mapping application using ArcMap and ArcGIS online to guide and support active case search of potential COVID-19 cases, within 500m radius of COVID-19 confirmed cases to improve detection and testing of suspected cases.

RESULTS: the web mapping application tool guides the active case search teams in the field, with clear boundaries on the houses to be visited within 500-meter radius of confirmed positive cases, to conduct active case search of all cases of severe acute respiratory illnesses (SARI), acute respiratory illnesses (ARI), pneumonia etc, to detect and test for COVID-19 towards containing the pandemic.

CONCLUSION: the use of GIS and spatial statistical tools have become an important and valuable tool in decision-making and, more importantly, guiding health care professional and other stakeholders in the response being carried out in a more coherent and easy manner. It has proven to be effective in supporting the active case search process to rapidly detect, test and isolate cases during the process, towards containing the COVID-19 pandemic.

PMID:33995766 | PMC:PMC8077638 | DOI:10.11604/pamj.2021.38.159.27143

Turk J Med Sci. 2021 May 16. doi: 10.3906/sag-2009-323. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: The purpose of this study was to determine the effects of the Supplemental Feeding Tube Device (SFTD) and bottle methods on weight gain, transition to full breastfeeding, breastfeeding success, and duration of discharge in preterm infants.

METHODS: This randomized controlled trial was conducted with a total of 46 preterm infants including 23 infants in study (SFTD) and control (bottle) groups. An information form, an infant follow-up form for feeding, and LATCH breastfeeding assessment instrument were used to collect the data.

RESULTS: The gestation week of the infants in the study group was 31.22 ± 2.76, and in the control group it was 30.52 ± 2.47. The birth weight of the infants in the study group was 1586.3 ± 525.35 gr and 1506.09 ± 454.77 gr in the control group. The daily weight gain of the infants was 24.09 ± 15.21 gr in the study group and 27.17 ± 17.63 gr in the control group. The infants in the study group (4.70±2.44days) transitioned to full breastfeeding earlier than those in the control group (6.00±4.10days). LATCH 2nd measurement scores were significantly higher in both groups than LATCH 1st measurement scores (p <0.01). Although it was not statistically significant (p> 0.05), the infants in the study group (10.22 ± 5.20days) were discharged earlier than those in the control group (13.48 ± 8.78days).

CONCLUSION: The SFTD and bottle methods were determined to be similar in terms of daily weight gain, transition to full breastfeeding, breastfeeding success, and duration of hospitalization.

PMID:33992038 | DOI:10.3906/sag-2009-323

J Knee Surg. 2021 May 15. doi: 10.1055/s-0041-1729967. Online ahead of print.

ABSTRACT

The posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA.

PMID:33992035 | DOI:10.1055/s-0041-1729967

Arch Gerontol Geriatr. 2021 May 4;95:104428. doi: 10.1016/j.archger.2021.104428. Online ahead of print.

ABSTRACT

BACKGROUND: The concurrence of several chronic conditions is a rising concern that poses a serious burden on ageing populations. Analysing how these conditions appear together and how they change through time may provide useful information to design successful multimorbidity-management programs.

OBJECTIVE: To identify multimorbidity patterns and their related characteristics from a longitudinal perspective.

SUBJECTS: 25,931 older adults aged 50+ drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), a population-based longitudinal European study.

METHODS: A sex-stratified Latent Transition Analysis was conducted to fit latent classes based on 15 self-reported chronic conditions across three time points. Health-related and socioeconomic variables were assessed as covariates of those patterns.

RESULTS: We identified 4 time-constant latent classes for each sex. A “severely impaired” class (with a weighted prevalence percentage of 7.24% for females and 3.30% for males at the first time point), a “metabolic” class (26.15% and 23.82%) and a “healthy” class (50.92% and 54.32%). The fourth class was named “osteoarticular” for females (15.70%) and “articular-COPD-ulcer” for males (18.56%). Age, smoke, material deprivation and a high body mass index were associated with worse health patterns, whereas education, being employed and physical activity were related to less multimorbid classes. Few class changes were detected when modelling transitions.

CONCLUSIONS: We reported information of multimorbidity classes and their characteristics that may help to develop targeted health strategies. Within a time window of four years, the identified latent classes were consistent between time points.

PMID:33991948 | DOI:10.1016/j.archger.2021.104428

Surg Oncol. 2021 May 5;38:101595. doi: 10.1016/j.suronc.2021.101595. Online ahead of print.

ABSTRACT

BACKGROUND: There are no clinicopathological criteria or test to predict peritoneal metastasis either in primary or recurrent gastric cancer. The early prediction will help in altering or adding other adjuvant potential therapy modalities like HIPEC and maintenance chemotherapy.

METHODS: Paraffin based blocks of 110 gastric tumor specimens were subjected to IHC staining to assess VEGF, Her 2 neu, E cadherin, bcl 2 and p 53 expression and its association with peritoneal disease evaluated.

RESULTS: Her 2 neu uptake was present in 17.3%, bcl-2 expression in 19.1%, P53 expression in 40.9%, VEGF in 41.8% and E cadherin expression in 49.1% patients. On univariate analysis, a younger age(p = .029), female sex(p = .026), positive VEGF expression (p = .001) and p53 expression(p = .015) were significantly associated with peritoneal disease. A binomial logistic regression was performed to ascertain the effects of independent variables evaluated on univariate analysis. Of the 10 predictors variables, only three were statistically significant: tumor type, P53, and VEGF. Positive VEGF expression had 48.7, E cadherin 2.6 and Her2neu 1.5 times higher odds of exhibiting peritoneal disease.

CONCLUSION: A younger age, female sex, distal 2/3rd, diffuse variant, VEGF staining in >10% cells and decrease p53 expression were associated with peritoneal disease.

PMID:33991942 | DOI:10.1016/j.suronc.2021.101595

Res Dev Disabil. 2021 May 12;114:103984. doi: 10.1016/j.ridd.2021.103984. Online ahead of print.

ABSTRACT

High levels of stress in parents of children with a developmental disability have been extensively documented. These heightened stress levels seem independent of diagnosis and are better explained by the level of challenging behavior of the children. Furthermore, the relationship between stress level and difficult behavior appears reciprocal. The negative impact of stress on parents’ skill development, response to difficult behavior, sense of competence, well-being and the child’s developmental outcomes have also been thoroughly detailed. The Parent Child Relationally Informed – Early Intervention (PCRI-EI) aims to expand the response repertoires of parents to help address the challenges of parenting a child with a developmental disability, including through reducing parental stress. The current study presents a quasi-experimental assessment of the efficacy of PCRI-EI in reducing stress levels and increasing sense of competency and psychological well-being in a sample of 22 parents of children with a variety of disabilities presenting to a community early childhood development service. Statistically and clinically significant changes in overall stress levels (Parenting Stress Index), psychological well-being (K6) and sense of competence (PSOC) were observed across time.

PMID:33991930 | DOI:10.1016/j.ridd.2021.103984

J Forensic Leg Med. 2021 May 8;80:102181. doi: 10.1016/j.jflm.2021.102181. Online ahead of print.

ABSTRACT

of autopsy files at Forensic Science SA was undertaken over a 20-year period (2000-2019) in five representative time periods to determine the average ages for all adults (≥18 years) where methamphetamine was detected. There were 239 cases with statistically significant increased mean ages over the time of the study ranging from 32.6yrs in 2000 to 42.2yrs in 2019 (p < 0.0001). Although methamphetamine use may be considered predominantly a feature of younger individuals this does not appear to be the case. Whether this apparent increase in the age of methamphetamine users was due to natural aging of methamphetamine users, an increase in use of methamphetamine by older individuals, or to an increased capture of older cases due to wider toxicological screening is uncertain. However, the importance of these results is to alert practitioners to the presence of methamphetamine use in older individuals which may predispose to death given the increased incidence of underlying cardiovascular diseases with age. In addition, in clinical settings there exists a cohort of older individuals who may be at risk of exacerbating their heart disease and precipitating cardiac events by using methamphetamine.

PMID:33991928 | DOI:10.1016/j.jflm.2021.102181

Eur J Oncol Nurs. 2021 May 4;52:101972. doi: 10.1016/j.ejon.2021.101972. Online ahead of print.

ABSTRACT

PURPOSE: Although stigma has attracted considerable scholarly attention, few studies have focused on its influencing factors among discharged breast cancer survivors, especially in a Chinese cultural context. The present study therefore explores stigma and its influencing factors among breast cancer survivors in China.

METHOD: Between December 2017 and May 2018, 103 breast cancer survivors at the outpatient clinic of a tertiary cancer center in southern China were enrolled in a cross-sectional study. The research instruments comprised the Social Impact Scale (SIS), the General Self-Efficacy Scale (GSES), the Medical Coping Modes Questionnaire (MCMQ), and sociodemographic and disease-related questionnaires. Descriptive statistics, univariate analysis, and multivariable linear regression were used to explore the current status of stigma and to identify influencing factors.

RESULTS: Of the respondents, 76.7% and 8.7%, respectively, reported moderate and high levels of stigma. The mean SIS score was 55.20 ± 12.15 (moderate), and the SIS subscale with the highest average score was financial insecurity. The results of a multivariable linear regression showed that body image (β = 0.32, P＜0.001), spousal support (β = -0.47, P < 0.001), personal acceptance of the disease (β = -0.22, P＜0.001), coping modes (resignation) (β = 0.14, P < 0.001), support from medical staff (β = -0.23, P < 0.001) and self-efficacy (β = -0.10, P = 0.037) were the main factors influencing stigma among breast cancer survivors (R² = 0.83).

CONCLUSIONS: Stigma, among breast cancer survivors, which is influenced by various sociocultural factors, is a neglected issue requiring attention. Healthcare professionals should therefore formulate effective measures for alleviating stigma in this group by improving their self-efficacy and acceptance of the disease, reducing their poor body image and negative coping mode, and eliciting more support from their spouses and medical staff.

PMID:33991869 | DOI:10.1016/j.ejon.2021.101972

Plant Physiol Biochem. 2021 Apr 28;164:147-159. doi: 10.1016/j.plaphy.2021.04.025. Online ahead of print.

ABSTRACT

The terrestrial fern Pityrogramma calomelanos, a cosmopolitan tropical species, is one of the strongest known arsenic (As) hyperaccumulator plants. This study aimed to determine whether P. calomelanos preferentially forages for arsenite (As³⁺) or arsenate (As⁵⁺) in As-contaminated soils, and whether a positive root response to As enhances accumulation in P. calomelanos. Therefore, an experiment using rhizoboxes divided in two halves were constructed with a control soil (C) and As³⁺ or As⁵⁺ dosed soil at either 50 and 100 μg g^-1 As. Micro-X-ray Fluorescence elemental mapping (μXRF) was employed to analyze the distribution of As in roots and fronds, and Scanning Electron Microscopy with Energy Dispersive Spectroscopy (SEM-EDS) was used to determine As distribution in the reproductive tissues of P. calomelanos. The results showed that Pityrogramma roots do not specifically forage for As-contaminated soil; the area based on pixel counts was similar across all the treatments with no statistical differences. However, frond biomass was slightly higher in the treatments C ǀ As³⁺ and C ǀ As⁵⁺, and the highest accumulation of As in fronds was in the As⁵⁺ ǀ As³⁺ (100 μg g^-1) treatment, with 3418 and 2370 μg g^-1 in old and young fronds respectively. Arsenic cycling across the roots was observed by the μXRF mapping; in C ǀ As⁵⁺ (100) the As was higher and evenly distributed in both sections, whilst in C ǀ As³⁺ (50), the As was higher in the As³⁺ side. The μXRF mapping showed a broader As distribution in older fronds, where As was highest in the rachis and extended into the pinnule through the midrib. Pityrogramma calomelanos does not specifically root forage for As-enriched zones in the soil and grows healthily without signs of toxicity at lower (50 μg g^-1) and higher (100 μg g^-1) concentrations of As³⁺ and As⁵⁺ in the soil.

PMID:33991860 | DOI:10.1016/j.plaphy.2021.04.025

Comput Biol Med. 2021 May 7;134:104430. doi: 10.1016/j.compbiomed.2021.104430. Online ahead of print.

ABSTRACT

Early detection of sepsis can facilitate early clinical intervention with effective treatment and may reduce sepsis mortality rates. In view of this, machine learning-based automated diagnosis of sepsis using easily recordable physiological data can be more promising as compared to the gold standard rule-based clinical criteria in current practice. This study aims to develop such a machine learning framework that demonstrates the quantification of heterogeneity within the tabular electronic health records (EHR) data of clinical covariates to capture both linear relationships and nonlinear correlation for the early prediction of sepsis. Here, the statistics of pairwise association for each hour-covariate pair within the EHR data for every 6-hours window-duration with selected 24 covariates is described using pointwise mutual information (PMI) matrix. This matrix gives the heterogeneity of data as a two-dimensional map. Such matrices are fused horizontally along the z-axis as vertical slices in the xy plane to form a 3-way tensor for each record with the corresponding Length of Stay (L). Tensor factorization of such fused tensor for every record is performed using Tucker decomposition, and only the core tensors are retained later, excluding the 3 unitary matrices to provide the latent feature set for the prediction of sepsis onset. A five-fold cross-validation scheme is employed wherein the obtained 120 latent features from the reshaped core tensor, are fed to Light Gradient Boosting Machine Learning models (LightGBM) for binary classification, further alleviating the involved class imbalance. The machine-learning framework is designed via Bayesian optimization, yielding an average normalized utility score of 0.4519 as defined by challenge organizers and area under the receiver operating characteristic curve (AUROC) of 0.8621 on publicly available PhysioNet/Computing in Cardiology Challenge 2019 training data. The proposed tensor decomposition of 3-way fused tensor formulated using PMI matrices leverages higher-order temporal interactions between the pairwise associations among the clinical values for early prediction of sepsis. This is validated with improved risk prediction power for every hour of admission to the ICU in terms of utility score, AUROC, and F1 score. The results obtained show a significant improvement particularly in terms of utility score of ~1.5-2% under a 5-fold cross-validation scheme on entire training data as compared to a top entrant research study that participated in the challenge.

PMID:33991856 | DOI:10.1016/j.compbiomed.2021.104430