Tag: nevin manimala

Isotopes Environ Health Stud. 2023 Apr 8:1-14. doi: 10.1080/10256016.2023.2195175. Online ahead of print.

ABSTRACT

The authors studied the atmospheric radon concentration with associated meteorological parameters variation during the dust events from July to November 2017. We obtained the meteorological parameters data in weather station of Sulaymaniyah city, Iraq. In the environmental monitoring plan, the atmospheric radon fluctuated from 15 to 48 Bq m^-3 around the mean value of 31.5 ± 7 Bq m^-3 within the summer. In autumn, varied from 22 to 46 Bq m^-3 with a mean value of 34 ± 12 Bq m^-3. We employed this to determine the radon level anomalously. Using the modified statistical coefficients, such as the residual deviation (RD), residual fluctuation ratio (RFR), F-test, and p-value coefficients. Among the atmospheric radon fluctuation values, particularly one anomalous (42 Bq m^-3) on 25 July was determined because the excessive value of the RD was 1.9 σ, and the RFR value was 66 %. Corresponding to our coefficients criteria, the minimum level of atmospheric radon (22 Bq m^-3) does not consider anomalous because of increasing wind speed. Based on this, our method for determining the atmospheric radon anomalies that are influenced by the missed factors beyond the mentioned meteorological parameters is accurate.

PMID:37029986 | DOI:10.1080/10256016.2023.2195175

J Wound Care. 2023 Apr 1;32(Sup4):S5-S13. doi: 10.12968/jowc.2023.32.Sup4.S5.

ABSTRACT

OBJECTIVE: The use of negative pressure wound therapy (NPWT) is ubiquitous in the management of complex wounds. Extending beyond the traditional utility of NPWT, it has been used after reconstructive flap surgery in a few case series. The authors sought to investigate the outcomes of NPWT use on flap reconstruction in a case-control study.

METHOD: Patients who underwent flap reconstruction between November 2017 and January 2020 were reviewed for inclusion in the study, and divided into an NPWT group and a control group. For patients in the NPWT group, NPWT was used directly over the locoregional flap immediately post-surgery for 4-7 days, before switching to conventional dressings. The control group used conventional dressing materials immediately post-surgery. Outcome measures such as flap necrosis, surgical site infections (SSIs), wound dehiscence as well as time to full functional recovery and hospitalisation duration were evaluated.

RESULTS: Of the 138 patients who underwent flap reconstruction, 37 who had free flap reconstructions were excluded, and 101 patients were included and divided into two groups: 51 patients in the NPWT group and 50 patients in the control group. Both groups had similar patient demographics, and patient and wound risk factors for impaired wound healing. Results showed that there was no statistically significant difference between flap necrosis, SSIs, wound dehiscence, hospitalisation duration as well as functional recovery rates. Cost analysis showed that the use of NPWT over flaps for the first seven postoperative days may potentially be more cost effective in our setting.

CONCLUSION: In this study, the appropriate use of NPWT over flaps was safe and efficacious in the immediate postoperative setting, and was not inferior to the conventional dressings used for reconstructive flap surgery. The main benefits of NPWT over flaps include better exudate management, oedema reduction and potential cost savings. Further studies would be required to ascertain any further benefit.

PMID:37029982 | DOI:10.12968/jowc.2023.32.Sup4.S5

J Wound Care. 2023 Apr 1;32(Sup4):S29-S38. doi: 10.12968/jowc.2023.32.Sup4.S29.

ABSTRACT

AIM: To identify the lifestyle factors preventing and predisposing to the development of pressure injuries (PIs) in individuals with spinal cord injury (SCI) living in the community in Bangladesh.

METHODS: A quantitative cross-sectional survey was conducted using a convenient sampling method. An equal number of participants, both with PIs and without, were recruited from the community, and a face-to-face interview was conducted. The standard outcome measure used to identify lifestyle factors in SCI was the Spinal Cord Injury Lifestyle Scale. The odds ratio (OR) was used to measure the associated difference between both groups and with sociodemographic variables. A p-value of ≤0.05 was considered statistically significant.

RESULTS: The study cohort comprised 80 participants-40 with PIs and 40 without. The study findings showed that lifestyle factors that were strongly associated with the occurrence of PIs (p<0.01, OR: <1) were: smoking; regular exercise; weight-bearing activity; body position on wheelchair; joint contracture; skin examination; pressure relief technique; wearing a protective device; accessibility; bladder and bowel management (p=0.03, OR: 0.32). Whereas, bladder incontinence appeared as a strong risk factor (p=0.04, OR: 2.5) for developing PIs in people with SCI.

CONCLUSION: The outcome of this study suggests that people with SCI should be aware of, and review, their lifestyle factors to reduce their chance of developing PIs.

PMID:37029981 | DOI:10.12968/jowc.2023.32.Sup4.S29

J Wound Care. 2023 Apr 1;32(Sup4):S14-S21. doi: 10.12968/jowc.2023.32.Sup4.S14.

ABSTRACT

OBJECTIVES: Diabetic foot ulcers (DFUs) cause high morbidity and mortality despite best treatment. Thus, new products are urgently needed to treat DFUs. Intralesional epidermal growth factor (EGF) (Heberprot-p) is considered to be an adjuvant therapy to standard of care (SOC) in DFUs. In the present study, the effect of Heberprot-p treatment on wound healing is compared to standard treatment.

METHODS: The data of patients with DFUs were retrospectively analysed. The patients who had had DFUs of at least four weeks’ duration and who had been treated in the wound clinic between January 2014 and 2017 were included in the study. The patients were divided into study and control groups. The study group consisted of patients in whom intralesional recombinant human EGF, Heberprot-p 75μg, was applied; the control group consisted of the remaining patients in whom EGF was not applied. The efficacy of Heberprot-p treatment in Wagner 2 and 3 DFUs were retrospectively investigated.

RESULTS: The study group (n=29 patients) who received Heberprot-p treatment was found to have shorter treatment times and higher rates of wound healing than the control group (n=22 patients). Although the amputation rate in the study group was less than the control group, the difference was not statistically significant.

CONCLUSION: Heberprot-p therapy is a promising treatment in DFUs, which can be routinely used as an adjunct to standard care.

PMID:37029977 | DOI:10.12968/jowc.2023.32.Sup4.S14

Port J Card Thorac Vasc Surg. 2023 Apr 4;30(1):31-36. doi: 10.48729/pjctvs.249.

ABSTRACT

OBJECTIVES: In recent years, a correlation between prognosis of various cancers and inflammation has been emphasized in many studies. Uric acid which is a purine metabolite is one of the serum inflammation markers. Albumin is a major component of serum protein and it is used as a parameter reflecting nutritional status and cancer aggressiveness. Here, we have investigated whether preoperative serum uric acid levels, albumin levels, and uric acid to albumin ratio predict lymph node metastasis in non-small cell lung cancer treated surgically by VATS.

METHODS: The medical records of patients underwent VATS lobectomy-segmentectomy for non-small cell lung cancer between January 2015 and December 2020, were reviewed retrospectively. Cut-off values of preoperative serum uric acid, albumin and uric acid to albumin ratio were determined by Receiver Operating Characteristics (ROC) analysis. Groups with and without lymph node metastasis were created according to hilar and/or mediastinal lymph node metastasis. In addition, high and low groups were created according to preoperative uric acid levels and uric acid to albumin ratio. Pearson chi-square test was used investigate whether any significant correlation between the groups.

RESULTS: A total of 115 patients were included in the study. Lymph node metastasis in N1 and N2 stations was detected in 11 and 18 patients, respectively. Cut-off values for uric acid and uric acid to albumin ratio were 5.97 mg/dL and 1.28×10-3, respectively. There was a statistically significant correlation between lymph node metastasis and high uric acid levels (p=0.008, OR: 3.2) and high uric acid to albumin ratio (p=0.03, OR: 2.6).

CONCLUSION: Preoperative serum uric acid and uric acid to albumin ratio can predict the lymph node metastasis in non-small cell lung cancer treated surgically by video assisted thoracic surgery.

PMID:37029947 | DOI:10.48729/pjctvs.249

Infect Dis (Lond). 2023 Apr 8:1-10. doi: 10.1080/23744235.2023.2192287. Online ahead of print.

ABSTRACT

PURPOSE: Streptococcus pyogenes (Group A Streptococcus, GAS) is an important human pathogen that can cause severe invasive (iGAS) infections. Throat carriage has been assumed to possibly lead to hematogenous seeding. Retrospective studies may estimate the incidence of throat carriage in iGAS patients inaccurately. In this study we aimed to gather data on the presence of GAS in the throat among iGAS patients in a prospective setting.

METHODS: We conducted a prospective clinical study covering iGAS infections in adult patients in two university hospitals in Finland from June 2018 to July 2020. Recruited patients’ throats were swabbed for culture and isothermal amplification tests (IAT) to search for GAS. The study was registered at ClinicalTrials.gov as ID NCT03507101.

RESULTS: We enrolled 45 patients. Throat swabs were obtained from 39/45 (87%) patients. Ten patients (22%) had a positive IAT for GAS. They were statistically significantly more likely to be male (9/10 [90%] vs 13/29 [45%], p = .024). Several different emm types caused the iGAS infections.

CONCLUSIONS: GAS was frequently observed in throat swabs of patients with iGAS infection. This may suggest that hematogenous seeding from the nasopharynx is a possible portal of entry.

PMID:37029930 | DOI:10.1080/23744235.2023.2192287

Intern Med J. 2023 Apr 8. doi: 10.1111/imj.16083. Online ahead of print.

ABSTRACT

BACKGROUND: Despite being one of the largest medical specialty training programs in Australasia, there is no standardised method for selection into Basic Physician Training (BPT) and limited data exist regarding current practices.

AIMS: To address existing knowledge gaps, we aimed to create a ‘snapshot’ of current BPT selection practices and explore the perspectives of Directors of Physician Education (DPEs) regarding trainee selection.

METHODS: An electronic survey of DPEs from adult and paediatric medicine BPT sites in Australia and New Zealand was undertaken in January-February 2022. A combination of free text, multiple choice and yes/no answers were analysed using descriptive statistics and qualitative content analysis.

RESULTS: A total of 70 responses were received, achieving a response rate of 35% (70/198). Selection practices were found to be heterogenous across BPT sites. Respondents had varying opinions regarding the utility of selection tools and desirable candidate attributes. A heavy reliance upon interviews and the reported use of subjective assessments raise concern for selection process bias. BPT sites should critically evaluate their selection methods and more research in this field is needed to establish best practice. This article is protected by copyright. All rights reserved.

PMID:37029925 | DOI:10.1111/imj.16083

J Clin Apher. 2023 Apr 8. doi: 10.1002/jca.22051. Online ahead of print.

ABSTRACT

Peripheral blood hematopoietic progenitor stem cells (HPSCs) are the most common source of stem cells for autologous and allogenic transplantation. Currently, systematic reviews comparing the collection efficiency of a continuous to an intermittent method are lacking despite the existence of primary studies. Therefore, the objective of this review was to synthesize the best available evidence to compare the efficiency of the continuous vs the intermittent method for the collection of hematopoietic progenitor stem cells required for HPC transplantation. A search using MEDLINE, CINAHL, EMBASE, Google scholar, and MedNar for both published and unpublished studies was conducted in December 2021. The systematic review was conducted in accordance with JBI methodology. A critical appraisal of the studies was undertaken by two independent reviewers using the JBI quasi-experimental critical appraisal checklist. A total of six studies were included in the review. The findings of this review demonstrated that there was no statistically significant difference in the collection efficiency, length of procedure time, and total blood volume processed between the continuous and intermittent programs. The evidence suggests that the continuous method is as safe and effective as the intermittent method to collect HPSCs. Until further evidence becomes available clinicians should be guided by the policies of their individual hospitals.

PMID:37029921 | DOI:10.1002/jca.22051

J Am Med Inform Assoc. 2023 Apr 8:ocad060. doi: 10.1093/jamia/ocad060. Online ahead of print.

ABSTRACT

OBJECTIVE: The 21st Century Cures Act Final Rule’s information blocking provisions, which prohibited practices likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI), began to apply to a limited set of data elements in April 2021 and expanded to all EHI in October 2022. We sought to describe hospital leaders’ perceptions of the prevalence of practices that may constitute information blocking, by actor and hospital characteristics, following the rule’s applicability date.

MATERIALS AND METHODS: Cross-sectional analysis of a national survey of hospitals fielded in 2021. The analytic sample included 2092 nonfederal acute care hospitals in the United States. We present descriptive statistics on the perception of the prevalence of information blocking and results of multivariate regression models examining the association between hospital, health information technology (IT) developer and market characteristics and the perception of information blocking.

RESULTS: Overall, 42% of hospitals reported observing some behavior they perceived to be information blocking. Thirty-six percent of responding hospitals perceived that healthcare providers either sometimes or often engaged in practices that may constitute information blocking, while 17% and 19% perceived that health IT developers (such as EHR developers) and State, regional and/or local health information exchanges did the same, respectively. Prevalence varied by health IT developer market share, hospital for-profit status, and health system market share.

CONCLUSIONS AND RELEVANCE: These results support the value of efforts to further reduce friction in the exchange of EHI and support the need for continued observation to provide a sense of the prevalence of information blocking practices and for education and awareness of information blocking regulations.

PMID:37029919 | DOI:10.1093/jamia/ocad060

Eval Health Prof. 2023 Apr 8:1632787231167942. doi: 10.1177/01632787231167942. Online ahead of print.

ABSTRACT

The Tracking and Evaluation Core of Rhode Island Advance-CTR conducted an online needs assessment survey at the program’s inception in 2016 and again in 2021. Now dealing with well-established support systems provided by the grant, we were particularly interested in how the perceived needs of the research community in Rhode Island might have changed over five years. Specifically, what barriers have been reduced or eliminated and which have persisted or increased? How do those barriers vary by demographic status and what implications do those differences have for the CTR? An online survey was completed by 199 researchers, who reported the extent to which they perceived the lack of access to a range of research supports as a barrier to conducting research at their institution. Overall, researchers indicated statistically significant changes from 2016 to 2021 such that a lack of pilot project funding and proposal development support had decreased as barriers, while space for research, and advice on commercial development, had increased. Statistically significant differences in the salience of particular barriers by some demographic variables were also noted and the results of this study suggest Centers for Clinical and Translational Research can have salutary effects on the research paradigm within their partnering institutions in a relatively short time.

PMID:37029918 | DOI:10.1177/01632787231167942