Tag: nevin manimala

Environ Sci Pollut Res Int. 2022 Apr 9. doi: 10.1007/s11356-022-20035-1. Online ahead of print.

ABSTRACT

Risk is associated with every sector of an economy, and the pervasiveness of risk in agriculture is not new to farmers; they have, over the decades, developed ways to minimize and cope with it. The question is whether traditional strategies employed by farmers are adequate to curb unavoidable natural disasters. This study aims to see how crop insurance affects cocoa producers’ incomes in Ghana. A well-structured questionnaire was delivered to a sample of 600 cocoa farmers in Ghana’s Ashanti region, and data was collected using a multi-stage random sampling technique. Tobit and propensity score matching effect estimators were used to examine crop insurance’s impact on cocoa farmers’ income. We found that the age of a cocoa farmer has a negative effect on the farmer’s income and is statistically significant. Our result also shows that the marital status of cocoa farmers has a significant positive impact on their income. The relationship between savings and farmers’ income was positive in our estimation. It indicates that an increase in savings attitude leads to a higher income for the farmers. The result indicates that crop insurance had a significant positive impact on cocoa farmers’ income in the Ashanti region. The study recommends that the government of Ghana, with urgency, design agricultural insurance policy that can capture various farmers in the country to enhance their income and reduce poverty. Again, insurers need to promote publicity through public seminars, training, and media advertising to improve farmer awareness and knowledge of the insurance scheme.

PMID:35397028 | DOI:10.1007/s11356-022-20035-1

Genet Med. 2022 Apr 8:S1098-3600(22)00705-5. doi: 10.1016/j.gim.2022.03.015. Online ahead of print.

ABSTRACT

PURPOSE: Studies conducted primarily among European ancestry women reported 12 breast cancer predisposition genes. However, etiologic roles of these genes in breast cancer among African ancestry women have been less well-investigated.

METHODS: We conducted a case-control study in African American women, which included 1117 breast cancer cases and 2169 cancer-free controls, and a pooled analysis, which included 7096 cases and 8040 controls of African descent. Odds ratios of associations with breast cancer risk were estimated.

RESULTS: Using sequence data, we identified 61 pathogenic variants in 12 breast cancer predisposition genes, including 11 pathogenic variants not yet reported in previous studies. Pooled analysis showed statistically significant associations of breast cancer risk with pathogenic variants in BRCA1, BRCA2, PALB2, ATM, CHEK2, TP53, NF1, RAD51C, and RAD51D (all P < .05). The associations with BRCA1, PALB2, and RAD51D were stronger for estrogen receptor (ER)-negative than for ER-positive breast cancer (P heterogeneity < .05), whereas the association with CHEK2 was stronger for ER-positive than for ER-negative breast cancer.

CONCLUSION: Our study confirmed previously identified associations of breast cancer risk with BRCA1, BRCA2, PALB2, ATM, TP53, NF1, and CHEK2 and provided new evidence to extend the associations of breast cancer risk with RAD51C and RAD51D, which was identified previously in European ancestry populations, to African ancestry women.

PMID:35396981 | DOI:10.1016/j.gim.2022.03.015

Arch Gynecol Obstet. 2022 Apr 9. doi: 10.1007/s00404-022-06552-x. Online ahead of print.

ABSTRACT

PURPOSE: To assess the incidence of MRSA positive patients in pregnancy, as well as the postpartum outcomes in MRSA positive patients.

METHODS: This is a retrospective cohort study of women who underwent universal MRSA universal at a tertiary medical center. A MRSA swab was routinely collected as part of the patient’s prenatal care at 35-37 weeks gestation or on admission to labor and delivery. Demographic information and decolonization antibiotics were collected by electronic medical record review, using ICD-9 codes. Outcome data were collected, including mode of delivery, hospital length of stay, endometritis, wound cellulitis, and wound infection. p < 0.05 was considered significant. A univariate logistic regression and a multivariable binary logistic regression model were used to analyze the strength of association between outcomes and MRSA status. Statistical analysis was performed with SAS, version 9.4.

RESULTS: The incidence of MRSA during the 4 year study period was 1.9% (82 MRSA positive out of 4369 total patients). 90.2% (74/82) of MRSA positive patients received decolonization antibiotics. No difference was noted in mode of delivery. Logistic regression failed to identify any significant differences in other relevant outcomes for MRSA positive women including endometritis 1.1 (0.1-17.5) [positive 0, versus negative 0.6% (n = 24)], wound cellulitis 5.9 (0.4-82.1) positive 0, versus negative 0.1% (Gorwitz et al. in J Infect Dis 197:1226-1234, 2008) and wound infection 3.3 (0.6-16.9) [positive 1.2%, versus negative 0.5% ( in Am J Infect Control 32:470-85, 2004)] when compared to MRSA negative women.

CONCLUSION: When universal MRSA screening was performed at an academic tertiary care center, the overall incidence of MRSA was low. MRSA positive and subsequently decolinzed patients did not have any identified increase in postpartum infectious morbidity, as compared to MRSA negative patients.

PMID:35396975 | DOI:10.1007/s00404-022-06552-x

Arch Gynecol Obstet. 2022 Mar 23. doi: 10.1007/s00404-022-06431-5. Online ahead of print.

ABSTRACT

BACKGROUND: At the time of recurrence, many borderline ovarian tumor (BOT) patients are still young with fertility needs. The purpose of this study is to evaluate the reproductive outcomes and recurrence rate of second fertility-sparing surgery (FSS) in women with recurrent BOTs.

METHODS: Seventy-eight women of childbearing age diagnosed with recurrent BOTs from November 2009 to 2020 whose primary treatment was FSS were included.

RESULTS: The FIGO stage I disease accounted for 46.2% and serous BOT accounted for 87.2% in the study group. Forty-seven patients underwent second FSS, and the remaining 31 underwent radical surgery (RS). Seventeen patients relapsed again after second surgery, but no malignant transformation and tumor-associated deaths were reported. Compared to FIGO stage I, the FIGO stage III tumors were more likely to relapse, but there was no statistical difference in pregnancy rate among patients with different stages. In the second FSS group, recurrence rate was higher in patients who underwent oophorocystectomy compared to patients with unilateral salpingo-oophorectomy (USO), but the pregnancy rate was similar. There was no significant difference in postoperative recurrence risk between USO and RS. The recurrence rate was not associated with operative route (laparoscopy or laparotomy), or lymphadenectomy, or postoperative chemotherapy. Among the 32 patients who tried to conceive, the pregnancy rate was 46.9% and live birth rate was 81.3%.

CONCLUSION: Unilateral salpingo-oophorectomy is a safe procedure for FIGO stage I recurrent BOT patients with fertility needs, and can achieve a high postoperative pregnancy rate and live birth rate.

PMID:35396974 | DOI:10.1007/s00404-022-06431-5

Nurs Crit Care. 2022 Apr 9. doi: 10.1111/nicc.12764. Online ahead of print.

ABSTRACT

BACKGROUND: ICUs follow a restrictive companionship policy, especially after the COVID-19 outbreak. This strategy often limits the time families spend with patients, hinders their knowledge and skills in caregiving, and the sudden transfer of ICU patients to assist with disease monitoring and daily care can be very stressful for families. It is beneficial to use the transition period of transferring ICU patients to help families adjust to the role of caregiver.

AIMS AND OBJECTIVES: To develop and implement a patient- and family-centered transitional care intervention plan for patients transferred to the ICU.

DESIGN: Prospective, pretest and posttest design.

METHODS: The experimental group received an individualized family-centered transition plan led by the ICU liaison nurse that included 1) communication with health care professionals; distribution of a transfer booklet; 2) identification of nursing issues and communication with the ward nurse; invitation of family members to participate in the patient’s rehabilitation; 3) follow-up instruction on bedside range of motion exercises; and provision of a patient rehabilitation diary. Patients in the control group received only routine care. Data were collected using the General Information Questionnaire, Family Satisfaction with ICU Patients (FS-ICU), the Family Relocation Stress Scale (FRSS), and the Stanford Acute Stress Response Questionnaire (SASRQR).

RESULTS: After the intervention, the total family satisfaction score of ICU patients in the experimental group was significantly higher than that of the control group (87.18 ± 8.38 vs 78.74 ± 10.63, p<0.001), and the satisfaction with the care and information provided was significantly higher in the experimental group compared to the control group (p < 0.001), with no significant difference between the two groups in terms of satisfaction with decision making (p>0.001). The level of relocation stress of patients’ families was significantly lower in the experimental group compared to the control group after the intervention (p < 0.001). And there was no statistically significant difference between the two groups in terms of patients’ acute stress disorder scores (p>0.001).

CONCLUSION: The implementation of a family-involved transition care programme significantly improved the satisfaction of ICU patients’ families and reduced the stress of relocation for patients’ families.

RELEVANCE TO CLINICAL PRACTICE: Focusing on the transition of ICU patients to ensure continuity of critical care and improve the quality of care for ICU patient transfers can be accomplished through a family-centered transition care plan led by the ICU liaison nurse.

PMID:35396917 | DOI:10.1111/nicc.12764

World J Urol. 2022 Apr 9. doi: 10.1007/s00345-022-03998-1. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the association between the dietary inflammatory index and lifetime kidney stone prevalence.

METHODS: We performed a cross-sectional study utilizing the 2013-2014 National Health and Nutrition Examination Survey data. Data were available on 2192 participants aged > 20 years with a complete kidney stone history and 24 h dietary intake interview. Weighted multivariable linear regression, subgroup analyses, and interaction terms were employed. Covariates including age, race, sex, energy and protein intake, total serum calcium, serum iron, PIR, phosphorus, serum/urine creatinine, HDL, glucose, diastolic and systolic pressure, education level, eGFR, BMI, albuminuria, diabetes, smoking status, and marital status were hierarchically adjusted in three different models.

RESULTS: The average dietary inflammatory index for 2192 participants was – 0.11 ± 1.73, ranging from – 4.52 to 4.28. In the fully adjusted model, participants in the highest dietary inflammatory index tertile (the most proinflammatory) had 72% higher odds of the lifetime prevalence of kidney stones than those in tertile 1 (OR = 1.72, 95% CI: 1.03, 2.88, P = 0.0367). Subgroup analysis showed that the association between the dietary inflammatory index and kidney stone history was only statistically significant in the younger age (age ≥ 60), female, Mexican American groups, married people or people without diabetes, hypertension, low eGFR, and albuminuria.

CONCLUSIONS: There is a positive association between the dietary inflammatory index and self-reported kidney stones in US adults, which indicates that dietary patterns could greatly impact kidney stone prevalence.

PMID:35396944 | DOI:10.1007/s00345-022-03998-1

Head Neck. 2022 Apr 9. doi: 10.1002/hed.27057. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to identify the strongest predictor of postoperative hypocalcemia following thyroid surgery.

METHODS: Study of patients who underwent total/completion thyroidectomy. No patients received postoperative calcium supplementation. Demographic and perioperative data were collected including preoperative baseline parathyroid hormone (PTH) levels, PTH levels at 30 min and 6 h post-excision, and 18 h post-excision calcium levels.

RESULTS: Of 124 patients studied, 20.2% developed temporary hypocalcemia (Ca <8.5 mg/dL at 18 h post-excision). In multivariate analyses, absolute PTH levels at 30 min and 6 h post-excision as well as change in PTH from baseline at 30 min and 6 h post-excision were statistically significantly associated with postoperative hypocalcemia. Per 10 units decrease in PTH from baseline at 30 min post-excision, the risk of developing temporary hypocalcemia increases by 17%.

CONCLUSION: Absolute PTH levels and change in PTH from baseline at 30 min and 6 h post-excision predict hypocalcemia after total or completion thyroidectomy.

PMID:35396878 | DOI:10.1002/hed.27057

J Burn Care Res. 2022 Apr 9:irac046. doi: 10.1093/jbcr/irac046. Online ahead of print.

ABSTRACT

Lyell’s syndrome, or toxic epidermal necrolysis (TEN) is a rare but life-threatening condition. It manifests with blistering of skin and mucous due to subepidermal bullae and keratinocyte necrosis. In most cases it is an immune response to drugs or their metabolites. The mortality in TEN is high despite optimal infection and wound control. There are no unequivocal treatment guidelines in TEN. Immunosuppressive treatment may increase the wound infection risk and mortality. The aim of the study was to evaluate a 10-year experience with immunomodulatory therapy in TEN. We perform a combination of plasmapheresis and IVIGs to control the disease. There were 35 patients in the group and we performed a post hoc evaluation. 28 patients received the full protocol and there were 7 patients who did not complete the treatment (single therapy group). The mortality in the test group was 14,29%, and the difference reached statistical significance in comparison with the single therapy group (p<0.05). Our protocol reduced the mortality risk 5 times. Our study proved that simultaneous plasmaphereses with IVIGs administration was safe and improved patients’ outcome in TEN.

PMID:35396849 | DOI:10.1093/jbcr/irac046

Nephrol Dial Transplant. 2022 Apr 9:gfac144. doi: 10.1093/ndt/gfac144. Online ahead of print.

ABSTRACT

BACKGROUND: Although cardiovascular disease is known to be one of the leading causes of death after kidney transplantation (KT), evidence on the risk difference of de novo major adverse cardiovascular event (MACE) in kidney transplant recipients (KTRs) compared to that in dialysis patients or the general population (GP) remains rare.

METHODS: We identified KTRs using the nationwide health insurance database in South Korea and then 1:1 matched them with the dialysis and GP controls without pre-existing MACE. The primary endpoint was defined as de novo MACEs consisted of myocardial infarction, coronary revascularization, and ischemic stroke. The secondary endpoint was all-cause mortality and death-censored graft failure (DCGF) in KTRs.

RESULTS: We included 4156 individuals in every three groups and followed up them for 4.7 years. De novo MACEs occurred in 3.7, 21.7, and 2.5 individuals per 1000 person-years in the KTRs, dialysis controls, and GP controls, respectively. KTRs showed a lower MACE risk (adjusted hazard ratio (aHR) 0.16, 95% confidence interval (CI) 0.12-0.20, p < 0.001) than dialysis controls, whereas a similar to GP controls (aHR 0.81, 95% CI 0.52-1.27, p = 0.365). In addition, KTRs showed similar MACE risk compared to GP groups, regardless of age, sex, the presence of comorbidities including hypertension, diabetes, and dyslipidemia. Among KTRs, de novo MACE was associated with an increased risk of all-cause mortality, but not with DCGF.

CONCLUSIONS: De novo MACE in KTRs was much lower than dialysis patients and even similar risk to the GP, while once it occurred it affected elevated mortality risk in KTRs.

PMID:35396847 | DOI:10.1093/ndt/gfac144

J Magn Reson Imaging. 2022 Apr 9. doi: 10.1002/jmri.28194. Online ahead of print.

ABSTRACT

BACKGROUND: Recently, a data-driven regression analysis method was developed to utilize the resting-state (rs) blood oxygenation level-dependent signal for cerebrovascular reactivity (CVR) mapping (rs-CVR), which was previously optimized by comparing with the CO₂ inhalation-based method in health subjects and patients with neurovascular diseases.

PURPOSE: To investigate the agreement of rs-CVR and the CVR mapping with breath-hold MRI (bh-CVR) in patients with gliomas.

STUDY TYPE: Retrospective.

POPULATION: Twenty-five patients (12 males, 13 females; mean age ± SD, 48 ± 13 years) with gliomas.

FIELD STRENGTH/SEQUENCE: Dynamic T2*-weighted gradient-echo echo-planar imaging during a breath-hold paradigm and during the rs on a 3-T scanner.

ASSESSMENT: rs-CVR with various frequency ranges and resting-state fluctuation amplitude (RSFA) were assessed. The agreement between each rs-based CVR measurement and bh-CVR was determined by voxel-wise correlation and Dice coefficient in the whole brain, gray matter, and the lesion region of interest (ROI).

STATISTICAL TESTS: Voxel-wise Pearson correlation, Dice coefficient, Fisher Z-transformation, repeated-measure analysis of variance and post hoc test with Bonferroni correction, and nonparametric repeated-measure Friedman test and post hoc test with Bonferroni correction were used. Significance was set at P < 0.05.

RESULTS: Compared with bh-CVR, the highest correlations were found at the frequency bands of 0.04-0.08 Hz and 0.02-0.04 Hz for rs-CVR in both whole brain and the lesion ROI. RSFA had significantly lower correlations than did rs-CVR of 0.02-0.04 Hz and a wider frequency range (0-0.1164 Hz). Significantly higher correlations and Dice coefficient were found in normal tissues than in the lesion ROI for all three methods.

DATA CONCLUSION: The optimal frequency ranges for rs-CVR are determined by comparing with bh-CVR in patients with gliomas. The rs-CVR method outperformed the RSFA. Significantly higher correlation and Dice coefficient between rs- and bh-CVR were found in normal tissue than in the lesion.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.

PMID:35396789 | DOI:10.1002/jmri.28194