Tag: nevin manimala

BMC Infect Dis. 2023 Nov 23;23(1):824. doi: 10.1186/s12879-023-08830-8.

ABSTRACT

BACKGROUND: The declaration of SARS-CoV-2 as a public health emergency of international concern in January 2020 prompted the need to strengthen infection prevention and control (IPC) capacities within health care facilities (HCF). IPC guidelines, with standard and transmission-based precautions to be put in place to prevent the spread of SARS-CoV-2 at these HCFs were developed. Based on these IPC guidelines, a rapid assessment scorecard tool, with 14 components, to enhance assessment and improvement of IPC measures at HCFs was developed. This study assessed the level of implementation of the IPC measures in HCFs across the African Region during the COVID-19 pandemic.

METHOD: An observational study was conducted from April 2020 to November 2022 in 17 countries in the African Region to monitor the progress made in implementing IPC standard and transmission-based precautions in primary-, secondary- and tertiary-level HCFs. A total of 5168 primary, secondary and tertiary HCFs were assessed. The HCFs were assessed and scored each component of the tool. Statistical analyses were done using R (version 4.2.0).

RESULTS: A total of 11 564 assessments were conducted in 5153 HCFs, giving an average of 2.2 assessments per HCF. The baseline median score for the facility assessments was 60.2%. Tertiary HCFs and those dedicated to COVID-19 patients had the highest IPC scores. Tertiary-level HCFs had a median score of 70%, secondary-level HCFs 62.3% and primary-level HCFs 56.8%. HCFs dedicated to COVID-19 patients had the highest scores, with a median of 68.2%, followed by the mixed facilities that attended to both COVID-19 and non-COVID-19 patients, with 64.84%. On the components, there was a strong correlation between high IPC assessment scores and the presence of IPC focal points in HCFs, the availability of IPC guidelines in HCFs and HCFs that had all their health workers trained in basic IPC.

CONCLUSION: In conclusion, a functional IPC programme with a dedicated focal person is a prerequisite for implementing improved IPC measures at the HCF level. In the absence of an epidemic, the general IPC standards in HCFs are low, as evidenced by the low scores in the non-COVID-19 treatment centres.

PMID:37996811 | DOI:10.1186/s12879-023-08830-8

Bioinspir Biomim. 2023 Nov 23. doi: 10.1088/1748-3190/ad0f32. Online ahead of print.

ABSTRACT

The three-dimensional morphology of swordfish skin roughness remains poorly understood. Subsequently, its importance to the overall physiology and hydrodynamic performance of the swordfish is yet to be determined. This is at least partly attributable to the inherent difficulty in making the required measurements of these complex biological surfaces. To address this, here two sets of novel high-resolution measurements of swordfish skin, obtained using a modular optical coherence tomography system and a gel-based stereo-profilometer, are reported and compared. Both techniques are shown to provide three-dimensional morphological data at micron-scale resolution. The results indicate that the skin surface is populated with spiny roughness elements, typically elongated in the streamwise direction, in groups of up to six, and in good agreement with previously reported information based on coarser measurements. In addition, our data also provide new information on the spatial distribution and variability of these roughness features. Two approaches, one continuous and another discrete, are used to derive various topographical metrics that characterise the surface texture of the skin. The information provided here can be used to develop statistically representative synthetic models of swordfish skin roughness.&#xD.

PMID:37995345 | DOI:10.1088/1748-3190/ad0f32

Rev Med Inst Mex Seguro Soc. 2023 Nov 6;61(6):796-801. doi: 10.5281/zenodo.10064351.

ABSTRACT

BACKGROUND: COVID-19 is associated with multiple complications, in addition to those produced at the pulmonary level. Post-COVID-19 cognitive deficits have been detected in the cognitive domain of attention and executive functions, even 4 months after COVID-19.

OBJECTIVE: to determine the frequency of cognitive alterations in patients recovered from COVID-19.

MATERIAL AND METHODS: A cross-sectional, descriptive and analytical study was carried out. Records of patients in care after infection by SARS-CoV-2 were integrated, the Neuropsi test was applied. Descriptive statistics and association tests were used through the Chi square test, taking p < 0.05 as significant.

RESULTS: Data from 44 files were integrated. The median age, I place them in the sixth decade of life. There was a predominance of men (63.6%). The most frequent comorbidities were systemic arterial hypertension (50%) and diabetes mellitus (40.9%). Most of the patients were managed only at home (61.4%) with a moderate-severe COVID-19 picture (68.2%). The most affected dimensions of the Neuropsi test were attention and concentration (47.7%, mild alteration) and short-term memory (77.3%, mild alteration).

CONCLUSIONS: Cognitive impairment in patients recovered from COVID-19 assessed through the Neuropsi test presented mild alterations in attention and concentration, as well as in short-term memory. These could affect functionality, quality of life and ability to perform work.

PMID:37995338 | DOI:10.5281/zenodo.10064351

Rev Med Inst Mex Seguro Soc. 2023 Nov 6;61(6):788-795. doi: 10.5281/zenodo.10064325.

ABSTRACT

BACKGROUND: Prolotherapy may be a good option in the complementary treatment of knee osteoarthritis (OA) patients, specifically for the increase of functionality.

OBJECTIVE: To determine the effectiveness of prolotherapy in OA grade II – III in the functionality and muscular work of knee flexors and extensors.

MATERIAL AND METHODS: a double-blind randomized controlled clinical trial was conducted. It included patients diagnosed with OA grades II-III. The experimental group was infiltrated in both knees with 6 ml of 25% glucose solution and 0.05% lidocaine; control group with 0.45% saline solution and 0.05% lidocaine. All patients received a comprehensive rehabilitation program. The isokinetic work of the knee flexor and extensor muscles, pain and functionality were measured, prior to infiltration and at 3-month follow-up. To compare the difference in means, the Student’s T test was applied, considering P<0.05 as significant. The project was approved by the local ethics and research committee.

RESULTS: 37 patients were recruited, 17 in the prolotherapy group. There were no intergroup differences in functionality, isokinetic knee flexor/extensor work, and pain at baseline, or during follow-up up to 12 weeks.

CONCLUSIONS: In the present study we identify that both prolotherapy and saline infiltration increased functionality, strength, and decreased pain; however, no statistically significant difference was found between the two group.

PMID:37995333 | DOI:10.5281/zenodo.10064325

Stem Cells Transl Med. 2023 Nov 23:szad067. doi: 10.1093/stcltm/szad067. Online ahead of print.

ABSTRACT

Proximal humerus fractures are common in an aging population. The standard operative treatment is open reduction internal fixation (ORIF) using an angular stable plate. However, this procedure has complications such as a relatively high rate of secondary dislocation, humeral head necrosis or nonunion caused by delayed bony consolidation. Autologous bone marrow mononuclear cells (BMC) combined with a β-TCP scaffold could support bone healing and is considered clinically safe. This multicentric, randomized, open phase IIa clinical trial (Clinical Trials. Gov Identifier: NCT02803177, Eudra CT No: 2015-001820-51) evaluated whether autologous BMC with β-TCP in addition to ORIF reduces the incidence of secondary dislocations in patients with proximal humerus fracture. Ninty-four patients equally divided between verum group (BMC+β-TCP) and control group (ß-TCP only) were targeted and calculated. At the time of planned interim evaluation, ie, enrolment of 56 patients, no statistical difference in secondary dislocations or complications was demonstrated in either group after an observation period of 12 weeks. Radiographic bone healing and DASH score to determine shoulder function were comparable between both groups. Bone marrow harvest and BMC transplantation did not result in any severe adverse events. Therefore, the study was terminated after the interim analysis, as no other result could be expected. From the study results, it can be concluded that the application of autologous BMC is well tolerated, and bone healing can be achieved. Augmentation of bone defects with β-TCP could be shown to be feasible and might be considered in other clinical situations.

PMID:37995325 | DOI:10.1093/stcltm/szad067

Rev Med Inst Mex Seguro Soc. 2023 Nov 6;61(6):728-735. doi: 10.5281/zenodo.10064287.

ABSTRACT

BACKGROUND: The NutrIMSS program is granted to populations with chronic conditions to improve basic health indicators and its effectiveness in this population is unknown.

OBJECTIVE: To analyze the change in the basic health indicators of patients who attended the NutrIMSS Program, at the UMF No. 2 of the IMSS in Mexico City, during the period 2018 to 2019.

MATERIAL AND METHODS: From 105 files of IMSS beneficiaries, a retrospective cohort study was carried out considering two measurements, before and after the NutrIMSS program. To evaluate the average change over time of health indicators, GEE models (Generalized Estimation Equations) and multiple linear regression models were used. Statistical analysis was used using the statistical program StataCorp 2015.

RESULTS: Patients who attended the Program showed changes between the beginning and end of the period with an average of three months of follow-up. They presented a decrease in the following health indicators: body weight of 1 kg, body mass index: 0.8 kg/m2, glucose of 13 mg/dL, triglycerides of 57 mg/dL and cholesterol of 17 mg/dL (p < 0.005 in all cases). There was no difference in the level of blood pressure.

CONCLUSIONS: The NutrIMSS program influenced the improvement of the health indicators of the population of the program and is an ally to improve the health of the IMSS beneficiary population.

PMID:37995283 | DOI:10.5281/zenodo.10064287

Science. 2023 Nov 24;382(6673):941-946. doi: 10.1126/science.adf4915. Epub 2023 Nov 23.

ABSTRACT

Policy-makers seeking to limit the impact of coal electricity-generating units (EGUs, also known as power plants) on air quality and climate justify regulations by quantifying the health burden attributable to exposure from these sources. We defined “coal PM_2.5” as fine particulate matter associated with coal EGU sulfur dioxide emissions and estimated annual exposure to coal PM_2.5 from 480 EGUs in the US. We estimated the number of deaths attributable to coal PM_2.5 from 1999 to 2020 using individual-level Medicare death records representing 650 million person-years. Exposure to coal PM_2.5 was associated with 2.1 times greater mortality risk than exposure to PM_2.5 from all sources. A total of 460,000 deaths were attributable to coal PM_2.5, representing 25% of all PM_2.5-related Medicare deaths before 2009 and 7% after 2012. Here, we quantify and visualize the contribution of individual EGUs to mortality.

PMID:37995235 | DOI:10.1126/science.adf4915

Cell Rep. 2023 Nov 22;42(12):113487. doi: 10.1016/j.celrep.2023.113487. Online ahead of print.

ABSTRACT

During adolescence, the brain undergoes extensive changes in white matter structure that support cognition. Data-driven approaches applied to cortical surface properties have led the field to understand brain development as a spatially and temporally coordinated mechanism that follows hierarchically organized gradients of change. Although white matter development also appears asynchronous, previous studies have relied largely on anatomical tract-based atlases, precluding a direct assessment of how white matter structure is spatially and temporally coordinated. Harnessing advances in diffusion modeling and machine learning, we identified 14 data-driven patterns of covarying white matter structure in a large sample of youth. Fiber covariance networks aligned with known major tracts, while also capturing distinct patterns of spatial covariance across distributed white matter locations. Most networks showed age-related increases in fiber network properties, which were also related to developmental changes in executive function. This study delineates data-driven patterns of white matter development that support cognition.

PMID:37995188 | DOI:10.1016/j.celrep.2023.113487

Ophthalmic Plast Reconstr Surg. 2023 Nov 23. doi: 10.1097/IOP.0000000000002547. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates how Obstructive sleep apnea (OSA) affects the outcomes of ptosis repair. We hypothesized that patients with OSA have an increased rate of reoperation after ptosis repair.

METHODS: This retrospective cohort study included patients age >18 from the Mayo Clinic who underwent ptosis repair by levator advancement or Müller muscle-conjunctiva resection between 2018 and 2021. Outcomes were measured at 1 to 3 months of follow-up with surgical failure defined as asymmetry or unsatisfactory eyelid height requiring revision surgery within 1 year.

RESULTS: A total of 577 patients met the inclusion criteria. There was a statistically significant difference in surgical failure between patients with OSA and those without (20.5% vs. 13.1%, p = 0.02). Patients with OSA showed a statistically significant difference in risk of revision by a factor of 1.70 (95% CI: 1.06-2.07). Revisions were attributed to unsatisfactory eyelid height in 72.6% of patients and eyelid asymmetry in 21.1%. All patients who had revision surgery had satisfactory outcomes. On logistic regression analysis, when adjusting for age and sex, OSA was significantly associated with ptosis revision (p = 0.007).

CONCLUSIONS: OSA increases risk of surgical failure and need for revision surgery in patients undergoing blepharoptosis repair but is not a sole risk factor.

PMID:37995148 | DOI:10.1097/IOP.0000000000002547

Eur J Endocrinol. 2023 Nov 8;189(5):527-536. doi: 10.1093/ejendo/lvad156.

ABSTRACT

OBJECTIVE: We aimed to investigate the associations of body composition and the risk of fracture in postmenopausal women, stratified based on bone mineral density.

METHODS: A population-based cohort study using the database of the National Screening Program for Transitional Ages with women aged 66 years was performed. Bone mineral density was categorized as normal, osteopenia, and osteoporosis. The following body mass index (BMI) categories for general obesity were used: underweight (<18.5), normal (18.5-22.9), overweight (23-24.9), obese (25-29.9), and severely obese (≥30 kg/m2). Waist circumference (WC) used for central obesity assessment was categorized into 5 groups. Newly diagnosed fracture during the follow-up period defined based on ICD-10 codes was the primary outcome.

RESULTS: During 7.7 ± 1.4 years of follow-up, 41 672 (17.9%) participants experienced any fracture, 20 326 (8.7%) experienced vertebral fractures (VFs), and 2883 (1.2%) experienced hip fractures (HFs). The adjusted hazard ratios (aHRs) for any fracture showed a progressive increase with higher BMI and WC categories in individual with osteopenia and osteoporosis. Regarding VF, aHR was highest in severely obese individuals with osteoporosis (aHR [95% CI], 3.45 [2.99-3.97]) and in individuals with WC ≥ 95 cm with osteoporosis (4.79 [4.09-5.60]). The aHR [95% CI] for HF was highest in the underweight group with osteopenia (1.94 [1.16-3.27]) and osteoporosis (2.96 [2.15-4.10]). In central obesity individuals with WC ≥ 95 cm, aHR [95% CI] for HF was 2.80 [1.91-4.91].

CONCLUSIONS: General obesity and central obesity are not protective against any fracture, VF and HF in postmenopausal women with osteopenia or osteoporosis.

PMID:37995142 | DOI:10.1093/ejendo/lvad156