Tag: nevin manimala

Front Surg. 2023 Mar 15;10:1112473. doi: 10.3389/fsurg.2023.1112473. eCollection 2023.

ABSTRACT

OBJECTIVES: The inflammatory response caused by gastric cancer surgery and the low nutritional status of patients with gastric cancer can cause growth of tumour cells, reduce immunity, and increase tumour burden. We investigated the effects of different surgical methods on postoperative inflammatory response and nutritional status in patients with distal gastric cancer.

METHODS: Clinical data of 249 patients who underwent radical distal gastrectomy for distal gastric cancer from February 2014 to April 2017 were retrospectively analysed. Patients were divided according to the surgical method (open distal gastrectomy [ODG], laparoscopic-assisted distal gastrectomy [LADG] and total laparoscopic distal gastrectomy [TLDG]). Characteristics of different surgical procedures, including inflammation parameters and nutritional indicators, and different time points (preoperatively, 1 day postoperatively, and 1 week postoperatively) were compared using non-parametric test analysis.

RESULTS: At postoperative day 1, white blood cell count [WBC], neutrophil count [N], neutrophil/lymphocyte ratio [NLR], and platelet/lymphocyte ratio [PLR] increased in the three groups, and ΔN and ΔNLR were significant; the smallest change was observed in TLDG (P < 0.05). Albumin [A]and prognostic nutrition index [PNI] significantly decreased; the smallest ΔA and ΔPNI, which were statistically significant, were noted in TLDG. One week postoperatively, WBC, N, NLR, and PLR decreased, and WBC, N, and NLR showed significant difference. A and PNI of the three groups increased after 1 week, and A and PNI showed significant differences.

CONCLUSION: Postoperative inflammatory response and nutritional status of patients with distal gastric cancer are associated with the surgical technique. TLDG has little influence on the inflammatory response and nutritional level compared with LADG and ODG.

PMID:37009613 | PMC:PMC10050336 | DOI:10.3389/fsurg.2023.1112473

Front Surg. 2023 Mar 16;10:1130919. doi: 10.3389/fsurg.2023.1130919. eCollection 2023.

ABSTRACT

OBJECTIVE: Cardiopulmonary exercise testing (CPET) is currently recommended for all patients undergoing lung resection with either respiratory comorbidities or functional limitations. The main parameter evaluated is oxygen consumption at peak (VO₂peak). Patients with VO₂peak above 20 ml/kg/min are classified as low risk surgical candidates. The aims of this study were to evaluate postoperative outcomes of low-risk patients, and to compare their outcomes with those of patients without pulmonary impairment at respiratory function testing.

METHODS: Retrospective monocentric observational study was designed, evaluating outcomes of patients undergoing lung resection at San Paolo University Hospital, Milan, Italy, between January 2016 and November 2021, preoperatively assessed by CPET, according to 2009 ERS/ESTS guidelines. All low-risk patients undergoing any extent surgical lung resection for pulmonary nodules were enrolled. Postoperative major cardiopulmonary complications or death, occurring within 30 days from surgery, were assessed. A case-control study was nested, matching 1:1 for type of surgery the cohort population with control patients without functional respiratory impairment consecutively undergoing surgery at the same centre in the study period.

RESULTS: A total of 80 patients were enrolled: 40 subjects were preoperatively assessed by CPET and deemed at low risk, whereas 40 subjects represented the control group. Among the first, 4 patients (10%) developed major cardiopulmonary complications, and 1 patient (2.5%) died within 30 days from surgery. In the control group, 2 patients (5%) developed complications and none of the patients (0%) died. The differences in morbidity and mortality rates did not reach statistically significance. Instead, age, weight, BMI, smoking history, COPD incidence, surgical approach, FEV1, Tiffenau, DLCO and length of hospital stay resulted significantly different between the two groups. At a case-by-case analysis, CPET revealed a pathological pattern in each complicated patient, in spite of VO₂peak above target for safe surgery.

CONCLUSIONS: Postoperative outcomes of low-risk patients undergoing lung resections are comparable to those of patients without any pulmonary functional impairment; nonetheless the formers represent a dramatically different category of individuals from the latter and may harbour few patients with worse outcomes. CPET variables overall interpretation may add to the VO₂peak in identifying higher risk patients, even in this subgroup.

PMID:37009610 | PMC:PMC10062454 | DOI:10.3389/fsurg.2023.1130919

IJID Reg. 2023 Mar 1;7:77-83. doi: 10.1016/j.ijregi.2023.02.008. eCollection 2023 Jun.

ABSTRACT

OBJECTIVE: Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) are usually healthcare associated. The aim of this study was to investigate the epidemiology of hospital-acquired CRE and multi-drug-resistant infections, and identify associated risk factors in hospitalized patients in Northeast Ethiopia.

METHODS: This cross-sectional study was conducted in patients admitted with sepsis between January and June 2021. Demographic and clinical data were collected using questionnaires. In total, 384 samples were collected and cultured based on source of infection. Bacterial species identification was performed using biochemical tests, and drug susceptibility testing was done using the Kirby-Bauer disk diffusion method. The modified carbapenem inactivation method was employed for carbapenemase detection. Data were analysed using Statistical Package for the Social Sciences.

RESULTS: The overall rate of CP-CRE infection was 14.6%. Bloodstream infections and urinary tract infections were the predominant hospital-acquired infections (HAIs). The majority of CP-CRE were Escherichia coli and Klebsiella pneumoniae, and accounted for 4.9%. Chronic underlying disease (adjusted odds ratio (AOR): 7.9, 95% confidence interval (CI): 1.9-31.5), number of beds per room (AOR: 11, 95% CI: 1.7-75) and eating raw vegetables (AOR: 11, 95% CI: 3.4-40) were significantly associated with hospital-acquired CRE infection.

CONCLUSIONS: The rate of CP-CRE infection found in this study is concerning. There is a need for further evaluation of risk factors and measures to decrease HAI. Hand hygiene, increased laboratory capacity, improved infection prevention measures, and antimicrobial stewardship programmes are needed in healthcare settings to halt the transmission of CP-CRE.

PMID:37009574 | PMC:PMC10050477 | DOI:10.1016/j.ijregi.2023.02.008

IJID Reg. 2023 Mar 5;7:116-123. doi: 10.1016/j.ijregi.2023.03.001. eCollection 2023 Jun.

ABSTRACT

OBJECTIVE: To investigate the prevalence, intensity, clinical aspects and factors associated with tungiasis infection among primary school children in Northeastern Tanzania.

METHODS: A quantitative school-based cross-sectional study was conducted among 401 primary school children. Participants were assessed through clinical examination to look for embedded Tunga penetrans in their hands, feet, arms and legs. A structured questionnaire was used to enquire about factors associated with tungiasis infection. The data were analysed using descriptive statistics, Chi-squared test and logistic regression, with p<0.05 taken to indicate significance.

RESULTS: The overall prevalence of tungiasis infection was 21.2%. Of the 85 tungiasis-infested children, 54 [63.5%, 95% confidence interval (CI) 53.1-74.1] had mild infection, 25 (29.4%, 95% CI 19.0-39.6) had moderate infection, and six (7.1%, 95% CI 1.2-12.9) had heavy infection. A moderate level of knowledge was significantly associated with high odds of tungiasis infection [adjusted odds ratio (AOR) 3.16, 95% CI 1.50-6.67], while not keeping a dog/cat at home was a protective factor (AOR 0.47, 95% CI 0.25-0.89).

CONCLUSIONS: Moderate prevalence of tungiasis infection was observed among primary school children favoured by factors related to the host, parasitic agent and environment. There is a need for a health education programme in schools encouraging use of appropriate footwear (closed shoes), use of locally accessible repellents (coconut oil), fumigation of households, and washing dogs/cats with insecticides.

PMID:37009573 | PMC:PMC10063396 | DOI:10.1016/j.ijregi.2023.03.001

Soc Sci Humanit Open. 2023;7(1):100486. doi: 10.1016/j.ssaho.2023.100486. Epub 2023 Mar 27.

ABSTRACT

Social, economic, and demographic characteristics influence public disaster risk perception, including the risk of COVID-19. Migrant workers are one the most vulnerable groups to disasters. More than four million Nepali migrant workers are employed abroad, and millions are working in cities and towns in the country. This study analyzes how the social, economic, and demographic conditions of returning Nepali migrant workers determine their risk perceptions of COVID-19. An online national survey was administered from May 10 to July 30, 2020, targeting returning Nepali migrant workers nationwide. A total of 782 responses from migrant workers were recorded, covering 67 of 74 districts. Using descriptive statistics and binary logistic regression models, the results show that migrant workers in blue-collar jobs, female, older than 29 years, with pre-existing health conditions, from low-income families, and from larger families are more likely to perceive higher risks of COVID-19. The migrant workers who believe in non-pharmaceutical COVID-19 control measures, including awareness campaigns and stay-at-home orders, have higher risk perceptions of the virus than other groups. The research contributes to identifying the program and policy priority areas to address the needs and COVID-19 vulnerabilities of returning Nepali migrant workers during and after the pandemic.

PMID:37009546 | PMC:PMC10042459 | DOI:10.1016/j.ssaho.2023.100486

J Vitreoretin Dis. 2022 Jun 9;6(6):437-442. doi: 10.1177/24741264221094683. eCollection 2022 Nov-Dec.

ABSTRACT

PURPOSE: This work aims to assess the quality, accountability, readability, accessibility, and presence of Spanish translation in online material through a Google search of “macular degeneration”.

METHODS: In this retrospective cross-sectional analysis of website results from a Google search of “macular degeneration”, the quality and accountability for each website were assessed using the DISCERN criteria and the Health on the Net Foundation Code of Conduct (HONcode) principles. All 31 sites were independently graded by 2 ophthalmologists. Readability was evaluated using an online tool. The presence of accessibility features on the website and Spanish translation was recorded. The primary outcome measure was the DISCERN and HONcode quality and accountability scores of each website. Secondary outcome measures included the readability, accessibility, and presence of Spanish translation.

RESULTS: The mean ± SD of each criterion across all 15 DISCERN questions was 2.761 ± 0.666 (out of 5). The mean HONcode score for all websites was 7.355 ± 3.123. The mean consensus reading grade level was 10.258 ± 2.49. There were no statistically significant differences in any score between the top 5 websites and the bottom 26 websites evaluated. Accessibility was available on 10 of 31 websites. Spanish translation was available on 10 of 31 websites.

CONCLUSIONS: The top 5 websites that appeared on a Google search did not have better quality or readability of online content. Improving quality, accountability, and readability can help improve patients’ health literacy regarding macular degeneration.

PMID:37009540 | PMC:PMC9954772 | DOI:10.1177/24741264221094683

Information (Basel). 2022 Nov;13(11):547. doi: 10.3390/info13110547. Epub 2022 Nov 19.

ABSTRACT

Many systems for exploratory and visual data analytics require platform-dependent software installation, coding skills, and analytical expertise. The rapid advances in data-acquisition, web-based information, and communication and computation technologies promoted the explosive growth of online services and tools implementing novel solutions for interactive data exploration and visualization. However, web-based solutions for visual analytics remain scattered and relatively problem-specific. This leads to per-case re-implementations of common components, system architectures, and user interfaces, rather than focusing on innovation and building sophisticated applications for visual analytics. In this paper, we present the Statistics Online Computational Resource Analytical Toolbox (SOCRAT), a dynamic, flexible, and extensible web-based visual analytics framework. The SOCRAT platform is designed and implemented using multi-level modularity and declarative specifications. This enables easy integration of a number of components for data management, analysis, and visualization. SOCRAT benefits from the diverse landscape of existing in-browser solutions by combining them with flexible template modules into a unique, powerful, and feature-rich visual analytics toolbox. The platform integrates a number of independently developed tools for data import, display, storage, interactive visualization, statistical analysis, and machine learning. Various use cases demonstrate the unique features of SOCRAT for visual and statistical analysis of heterogeneous types of data.

PMID:37009525 | PMC:PMC10062429 | DOI:10.3390/info13110547

Res Methods Med Health Sci. 2023 Jan;4(1):34-48. doi: 10.1177/26320843221141056. Epub 2022 Dec 13.

ABSTRACT

Studies that investigate the performance of prognostic and predictive biomarkers are commonplace in medicine. Evaluating the performance of biomarkers is challenging in traumatic brain injury (TBI) and other conditions when both the time factor (i.e. time from injury to biomarker measurement) and different levels or doses of treatments are in play. Such factors need to be accounted for when assessing the biomarker’s performance in relation to a clinical outcome. The Hyperbaric Oxygen in Brain Injury Treatment (HOBIT) trial, a phase II randomized control clinical trial seeks to determine the dose of hyperbaric oxygen therapy (HBOT) for treating severe TBI that has the highest likelihood of demonstrating efficacy in a phase III trial. Hyperbaric Oxygen in Brain Injury Treatment will study up to 200 participants with severe TBI. This paper discusses the statistical approaches to assess the prognostic and predictive performance of the biomarkers studied in this trial, where prognosis refers to the association between a biomarker and the clinical outcome while the predictiveness refers to the ability of the biomarker to identify patient subgroups that benefit from therapy. Analyses based on initial biomarker levels accounting for different levels of HBOT and other baseline clinical characteristics, and analyses of longitudinal changes in biomarker levels are discussed from a statistical point of view. Methods for combining biomarkers that are of complementary nature are also considered and the relevant algorithms are illustrated in detail along with an extensive simulation study that assesses the performance of the statistical methods. Even though the discussed approaches are motivated by the HOBIT trial, their applications are broader. They can be applied in studies assessing the predictiveness and prognostic ability of biomarkers in relation to a well-defined therapeutic intervention and clinical outcome.

PMID:37009524 | PMC:PMC10061824 | DOI:10.1177/26320843221141056

Orthop J Sports Med. 2023 Mar 28;11(3):23259671221147896. doi: 10.1177/23259671221147896. eCollection 2023 Mar.

ABSTRACT

BACKGROUND: Recurrent tears of the rotator cuff pose a substantial problem despite advances in repair technique. Biologic augmentation via marrow stimulation or vented anchors may strengthen the suture-tendon junction and improve healing rates of native tissue, thereby enhancing outcomes of primary surgical repair.

PURPOSE: To provide a focused systematic review and meta-analysis of local, intraoperative marrow-derived augmentation techniques in clinical primary rotator cuff repair.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: A systematic review of PubMed, Embase, and Cochrane was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 2131 studies from 2010 to 2022, focused on either marrow stimulation or vented anchors, were isolated and classified as either preclinical or clinical. Meta-analysis was performed for comparative marrow stimulation and vented anchor studies. Heterogeneity was tested through calculation of I ².

RESULTS: A total of 13 clinical studies were included in the review. All 9 comparative studies included in the meta-analysis demonstrated high methodologic quality or a low risk of bias. The pooled retear rate across all 9 clinical studies for patients undergoing marrow stimulation was 11%. For the 5 studies in the meta-analysis, the pooled retear rates were 15% for marrow stimulation and 30% for controls. Meta-analysis demonstrated a significant difference in the overall retear rate that favored marrow stimulation (odds ratio [OR], 0.41; 95% CI, 0.25-0.66; P = .0003; I ² = 0%). Similarly, meta-analysis of the Constant score at final follow-up demonstrated a statistically significant difference between the 2 groups that favored a higher Constant score in the marrow stimulation group (mean difference, 2.84; 95% CI, 1.02-4.66; P = .002; I ² = 29%). Vented anchors demonstrated improved ossification and bone density at the anchor site, but no difference in outcomes or retear. Pooled retear rates were 22.5% for vented anchors and 27.8% for controls.

CONCLUSION: Current evidence demonstrates that marrow-stimulation techniques may have a positive impact on healing and retear rate, while vented anchors have a muted impact relative to nonvented anchors. Although available evidence is limited and more research is needed, findings to date suggest that marrow stimulation techniques may be an inexpensive, straightforward technique to consider in qualifying patients to prevent rotator cuff retears.

PMID:37009491 | PMC:PMC10061649 | DOI:10.1177/23259671221147896

Front Aging Neurosci. 2023 Mar 15;15:1117250. doi: 10.3389/fnagi.2023.1117250. eCollection 2023.

ABSTRACT

BACKGROUND AND OBJECTIVES: Alzheimer’s disease (AD) has an insidious onset, the early stages are easily overlooked, and there are no reliable, rapid, and inexpensive ancillary detection methods. This study analyzes the differences in handwriting kinematic characteristics between AD patients and normal elderly people to model handwriting characteristics. The aim is to investigate whether handwriting analysis has a promising future in AD auxiliary screening or even auxiliary diagnosis and to provide a basis for developing a handwriting-based diagnostic tool.

MATERIALS AND METHODS: Thirty-four AD patients (15 males, 77.15 ± 1.796 years) and 45 healthy controls (20 males, 74.78 ± 2.193 years) were recruited. Participants performed four writing tasks with digital dot-matrix pens which simultaneously captured their handwriting as they wrote. The writing tasks consisted of two graphics tasks and two textual tasks. The two graphics tasks are connecting fixed dots (task 1) and copying intersecting pentagons (task 2), and the two textual tasks are dictating three words (task 3) and copying a sentence (task 4). The data were analyzed by using Student’s t-test and Mann-Whitney U test to obtain statistically significant handwriting characteristics. Moreover, seven classification algorithms, such as eXtreme Gradient Boosting (XGB) and Logistic Regression (LR) were used to build classification models. Finally, the Receiver Operating Characteristic (ROC) curve, accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Area Under Curve (AUC) were used to assess whether writing scores and kinematics parameters are diagnostic.

RESULTS: Kinematic analysis showed statistically significant differences between the AD and controlled groups for most parameters (p < 0.05, p < 0.01). The results found that patients with AD showed slower writing speed, tremendous writing pressure, and poorer writing stability. We built statistically significant features into a classification model, among which the model built by XGB was the most effective with a maximum accuracy of 96.55%. The handwriting characteristics also achieved good diagnostic value in the ROC analysis. Task 2 had a better classification effect than task 1. ROC curve analysis showed that the best threshold value was 0.084, accuracy = 96.30%, sensitivity = 100%, specificity = 93.41%, PPV = 92.21%, NPV = 100%, and AUC = 0.991. Task 4 had a better classification effect than task 3. ROC curve analysis showed that the best threshold value was 0.597, accuracy = 96.55%, sensitivity = 94.20%, specificity = 98.37%, PPV = 97.81%, NPV = 95.63%, and AUC = 0.994.

CONCLUSION: This study’s results prove that handwriting characteristic analysis is promising in auxiliary AD screening or AD diagnosis.

PMID:37009455 | PMC:PMC10050722 | DOI:10.3389/fnagi.2023.1117250