Tag: nevin manimala

Int J Hyg Environ Health. 2023 May 7;251:114184. doi: 10.1016/j.ijheh.2023.114184. Online ahead of print.

ABSTRACT

Human breast milk is an optimally balanced infant food and a suitable tool for assessing the burden of humans with lipophilic persistent organic pollutants. The aim of this study was to investigate the accumulation profile of polychlorinated biphenyls in breast milk of women living in Bulgaria and to assess the health risk to infants. Breast milk samples were obtained from 72 healthy primiparae and multiparae mothers, living in two regions in northeastern Bulgaria – Varna region and Dobrich region, in the period October 2019-July 2021. Important information for the study, such as age, body mass, smoking and dietary habits, was collected through a questionnaire. Fifteen congeners of PCBs, including six indicator congeners, were determined by capillary gas chromatography system with mass spectrometry detection. The lipid content of the tested samples was in the range from 0.5% to 6.7%, with average value 3.25%. The six indicator PCBs in human milk samples formed up to 89% of the total PCBs levels. The most abundant congener was PCB 153, followed by PCB 138 and PCB 180. Five of the 15 PCB congeners (77, 126, 128, 156, 169) were not detected in any of the milk samples. The arithmetic mean PCB levels in milk samples from Varna (32.7 ng/g lw) were found higher than PCB levels in breast milk of mothers from Dobrich (22.5 ng/g lw). The highest PCB levels were found in milk samples from primiparae mothers in 36-40 age group (for both regions). Infant exposure to PCBs present in human milk was estimated using toxic equivalents (TEQ). The health risk to infants was assessed and was compared to the tolerable daily intake (TDI). Positive correlation was found between the arithmetic mean PCBs levels and two important factors – the age and body mass index of the primiparae group. The mean values of the analyzed PCB congeners in breast milk samples from multiparae were lower than in those from primiparae mothers. The regional differences in PCB concentrations were small, suggesting similar exposures in the studied regions. The levels of PCBs in breast milk were found lower than levels from studies in other European countries. Statistical data does not show any association between PCB levels in milk and dietary habits. The results showed that infants are not at risk of any adverse effects caused by PCBs through breast milk.

PMID:37159972 | DOI:10.1016/j.ijheh.2023.114184

J Osteopath Med. 2023 May 10. doi: 10.1515/jom-2022-0232. Online ahead of print.

ABSTRACT

CONTEXT: Osteopathic manipulative treatment (OMT) is utilized by clinicians to diagnose and treat a variety of musculoskeletal conditions including acute and chronic pain, and other medical conditions. Previous studies have examined attitudes of allopathic (MD) residents toward OMT and have implemented residency-based curricula; however, literature is lacking on the attitudes of MD students toward OMT.

OBJECTIVES: The objective of this study was to determine MD students’ familiarity with OMT and to evaluate their interest in an elective osteopathic curriculum.

METHODS: A 15-item online survey was electronically sent to 600 MD students at a large allopathic academic medical center. The survey assessed familiarity with OMT, interest in OMT and in participating in an OMT elective, educational format preference, and interest in pursuing primary care. Educational demographics were also collected. Descriptive statistics and Fisher’s exact test were utilized for categorical variables, and nonparametric tests were utilized for the ordinal and continuous variables.

RESULTS: A total of 313 MD students submitted responses (response rate=52.1 %), of which 296 (49.3 %) responses were complete and utilized for analysis. A total of 92 (31.1 %) students were aware of OMT as a modality in treating musculoskeletal disorders. Among the respondents who indicated “very interested” in learning a new pain treatment modality, the majority: (1) observed OMT in a prior clinical or educational setting (85 [59.9 %], p=0.02); (2) had a friend or family member treated by a DO physician (42 [71.2 %], p=0.01); (3) were pursuing a primary care specialty (43 [60.6 %], p=0.02); or (4) interviewed at an osteopathic medical school (47 [62.7 %], p=0.01). Among those interested in developing some OMT competency, the majority: (1) were pursuing a primary care specialty (36 [51.4 %], p=0.01); (2) applied to osteopathic schools (47 [54.0], p=0.002); or (3) interviewed at an osteopathic medical school (42 [56.8 %], p=0.001). A total of 230 (82.1 %) students were somewhat or very interested in a 2-week elective course in OMT; among all respondents, hands-on labs were the preferred method for delivery of OMT education (272 [94.1 %]).

CONCLUSIONS: The study found a strong interest in an OMT elective by MD students. These results will inform OMT curriculum development aimed at interested MD students and residents in order to provide them with OMT-specific theoretical and practical knowledge.

PMID:37159913 | DOI:10.1515/jom-2022-0232

J Infect Dev Ctries. 2023 Apr 30;17(4):542-549. doi: 10.3855/jidc.17478.

ABSTRACT

INTRODUCTION: Entamoeba histolytica, a protozoan parasite, is the third major contributor to human mortality and morbidity outside of malaria and schistosomiasis. The purpose of this cross-sectional study was to estimate the prevalence of Entamoeba spp. among outpatients of two teaching hospitals in Duhok city who agreed to participate in the study from April 2021 to March 2022 to assess the impact of associated risk variables on the infection rate.

METHODOLOGY: Stool specimens were collected from outpatients suffering from diarrhea and other gastrointestinal symptoms in two teaching hospitals: Azadi and Heevi Pediatric in Duhok city, Kurdistan Region- Iraq. The collected stool specimens were examined macroscopically, followed by microscopic examination using the direct wet mount and zinc sulfate flotation methods, respectively.

RESULT: Infection with Entamoeba species was recorded in 21.68% (562/2592) of the analyzed specimens. Males had a significantly higher infection rate than females (67.43% vs. 32.56%). This difference was statistically significant (p < 0.000). The highest rate was seen in the age group 1-10 years (p < 0.001). Lower levels of education, low incomes, eating unwashed fruits and vegetables, drinking well water, eating frequently outside of homes, not using antidiarrheal medications and living in overcrowded families were risk factors that showed high levels of infection (p < 0.0001).

CONCLUSIONS: The present study concluded that improving living conditions, providing clean water, and promoting health education programs are essential to reduce the rate of this disease among the population.

PMID:37159899 | DOI:10.3855/jidc.17478

J Infect Dev Ctries. 2023 Apr 30;17(4):454-460. doi: 10.3855/jidc.17065.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has disproportionately affected patients with preexisting comorbidities, particularly dialysis patients. The aim of this study was to determine predictors of mortality in this population.

METHODOLOGY: We conducted an observational, retrospective, cohort study collecting data from pre and post-vaccine from the electronic medical records of a single dialysis center at Hygeia International Hospital Tirana, Albania.

RESULTS: Of 170 dialysis patients, 52 were diagnosed with COVID-19. The prevalence of COVID-19 infection in our study was 30.5%. The mean age was 61.5 ± 12.3 years and 65.4% were men. The mortality rate in our cohort was 19.2%. Mortality rates were higher in patients with diabetic nephropathy (p < 0.04) and peripheral vascular disease (p < 0.01). Elevated C- reactive protein (CRP) (p < 0.018), high red blood cell distribution width (RDW) (p < 0.03), and low lymphocyte and eosinophil counts, were found to be risk factors for severe COVID-19 disease. ROC analysis identified lymphopenia and eosinopenia as the strongest predictors of mortality. After the vaccine administration, the mortality rate in the vaccinated population was 8%, in contrast to the 66.7% mortality rate that was found in the unvaccinated group (p < 0.001).

CONCLUSIONS: Our study revealed that risk factors for the development of severe COVID-19 infection were RDW, low lymphocyte and eosinophil counts, elevated levels of CRP. Lymphopenia and eosinopenia were determined as the most important predictors of mortality, in our cohort. Mortality was notably lower among vaccinated patients.

PMID:37159892 | DOI:10.3855/jidc.17065

J Infect Dev Ctries. 2023 Apr 30;17(4):425-431. doi: 10.3855/jidc.17428.

ABSTRACT

INTRODUCTION: Previous studies that identified the prognostic factors for the severity of the new coronavirus disease 2019 (COVID-19) in different populations have generated controversial conclusions. The lack of a standard definition of COVID-19 severity and the differences between clinical diagnoses might make it difficult to provide optimum care according to the characteristics of each population.

METHODOLOGY: We investigated the factors that impacted the severe outcome or death from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients treated at the Mexican Institute of Social Security in Yucatán, México in 2020. A cross-sectional study of COVID-19 confirmed cases was done to know the prevalence and association of the demographic and clinical characteristics with a severe or fatal outcome. Information from the National Epidemiological Surveillance System (SINAVE) database was used and SPSS v 21 was used for statistical analyses. We used the World Health Organization (WHO) and the Centers for Diseases Control and Prevention (CDC) symptomatology classifications to define severe cases.

RESULTS: Diabetes and pneumonia increased the risk of death and having diabetes was a prognostic factor for severe illness following SARS-CoV-2 infection.

CONCLUSIONS: Our results highlight the influence of cultural and ethnic factors, the necessity to standardize the parameters for clinical diagnoses, and to use the same criteria for the definition of COVID-19 severity to establish the clinical conditions that contribute to the pathophysiology of this disease in each population.

PMID:37159885 | DOI:10.3855/jidc.17428

J Infect Dev Ctries. 2023 Apr 30;17(4):477-484. doi: 10.3855/jidc.17212.

ABSTRACT

INTRODUCTION: Enterobacteriaceae that produce extended-spectrum beta-lactamase (ESBL) are quickly spreading, posing a threat to world healthcare.

METHODOLOGY: 138 gram-negative bacteria were collected from different samples (stool, urine, wound, blood, tracheal aspirate, catheter tip, vaginal swab, sputum, and tracheal aspirate) from hospitalized patients. Samples were subcultured and identified in accordance with their biochemical reactions and culture characteristics. Against all the isolated Enterobacteriaceae, an antimicrobial susceptibility test was performed. VITEK®2 system, phenotypic confirmation, and Double-Disk Synergy Test (DDST) had been utilized to identify the ESBLs.

RESULTS: Of the 138 samples studied, the prevalence of ESBL-producing infections among the clinical samples of the present study was 26.8 % (n = 37). E. coli was the commonest ESΒL producer at 51.4% (n = 19) followed by K. pneumoniae at 27% (n = 10). The potential risk factors for the ESBL development that produces bacteria were as follows, patients with the presence of indwelling devices, previous history of hospital admission, and usage of antibiotics. ESBL is statistically (p ≤ 0.05) higher among the patients with indwelling devices, ICU admission, who had a previous hospital admission in the last 6 months as well as who was given antibiotics (quinolones and/or cephalosporins) in the last 6 months. One hundred thirty-two (95.7%) of ESBL isolates were resistant to amoxicillin, while the lowest resistance was for fosfomycin (15.2%).

CONCLUSIONS: ESBL-producing Enterobacteriaceae are highly prevalent in Turaif General Hospital setting with some potential risk factors. A strict policy to be made available on the usage of antimicrobials in hospitals and clinics should be established.

PMID:37159882 | DOI:10.3855/jidc.17212

JCO Clin Cancer Inform. 2023 May;7:e2200174. doi: 10.1200/CCI.22.00174.

ABSTRACT

PURPOSE: Real-world data (RWD) derived from electronic health records (EHRs) are often used to understand population-level relationships between patient characteristics and cancer outcomes. Machine learning (ML) methods enable researchers to extract characteristics from unstructured clinical notes, and represent a more cost-effective and scalable approach than manual expert abstraction. These extracted data are then used in epidemiologic or statistical models as if they were abstracted observations. Analytical results derived from extracted data in this way may differ from those given by abstracted data, and the magnitude of this difference is not directly informed by standard ML performance metrics.

METHODS: In this paper, we define the task of postprediction inference, which is to recover similar estimation and inference from an ML-extracted variable that would be obtained from abstracting the variable. We consider fitting a Cox proportional hazards model that uses a binary ML-extracted variable as a covariate and evaluate four approaches for postprediction inference in this setting. The first two approaches only require the ML-predicted probability, while the latter two additionally require a labeled (human abstracted) validation data set.

RESULTS: Our results for both simulated data and EHR-derived RWD from a national cohort demonstrate that we can improve inference from ML-extracted variables by leveraging a limited amount of labeled data.

CONCLUSION: We describe and evaluate methods for fitting statistical models using ML-extracted variables subject to model error. We show that estimation and inference is generally valid when using extracted data from high-performing ML models. More complex methods that incorporate auxiliary labeled data provide further improvements.

PMID:37159871 | DOI:10.1200/CCI.22.00174

Int J Biostat. 2023 May 10. doi: 10.1515/ijb-2022-0040. Online ahead of print.

ABSTRACT

In case-control studies, odds ratios (OR) are calculated from 2 × 2 tables and in some instances, we observe small cell counts or zero counts in one of the cells. The corrections to calculate the ORs in the presence of empty cells are available in literature. Some of these include Yates continuity correction and Agresti and Coull correction. However, the available methods provided different corrections and the situations where each could be applied are not very apparent. Therefore, the current research proposes an iterative algorithm of estimating an exact (optimum) correction factor for the respective sample size. This was evaluated by simulating data with varying proportions and sample sizes. The estimated correction factor was considered after obtaining the bias, standard error of odds ratio, root mean square error and the coverage probability. Also, we have presented a linear function to identify the exact correction factor using sample size and proportion.

PMID:37159838 | DOI:10.1515/ijb-2022-0040

PeerJ. 2023 May 3;11:e15288. doi: 10.7717/peerj.15288. eCollection 2023.

ABSTRACT

BACKGROUND: The modern lifestyle trend of pet ownership is undoubtedly beneficial for both physical and mental health. Research has shown a connection between pet ownership and staff self-compassion. However, there has not been any evidence linking pet ownership to self-compassion in the nurse population.

AIMS: To investigate the current status of pet ownership among nurses and explore the influence of pet ownership on self-compassion among nurses.

METHODS: An online survey was conducted in July 2022 with 1,308 nurses in China. Data were collected using a general information questionnaire and a self-compassion scale. To compare categorical variables, the independent t test, one-way ANOVA, and multiple linear regression analysis were utilized. SPSS software was used for the statistical analysis.

RESULTS: We found that 16.9% of nurses owned at least one pet, and dogs and cats were the primary pets. The t test for independent samples showed that pet owners and non-pet owners scored differently on self-compassion (t = 3.286, p = 0.001), self-kindness (t = 3.378, p = 0.001), common humanity (t = 2.419, p = 0.016), and mindfulness (t = 2.246, p = 0.025). One-way ANOVA revealed that the highest degree was an influencing factor of self-compassion (χ ² = 1.386, p = 0.019). Multiple linear regression showed that average monthly income, pet ownership, and highest degree were the factors that influenced self-compassion most significantly (F = 8.335, p < 0.001).

CONCLUSION: The results revealed that nurses actually own pets as part of their modern lifestyle, which provides them with social support and potentially enhances their self-compassion. More efforts should be focused on the impact of pet ownership on nurses’ physical and mental health, and pet-based interventions should also be developed.

PMID:37159831 | PMC:PMC10163869 | DOI:10.7717/peerj.15288

Drug Alcohol Depend Rep. 2023 Apr 14;7:100159. doi: 10.1016/j.dadr.2023.100159. eCollection 2023 Jun.

ABSTRACT

BACKGROUND: In the United States, a disproportionate number of persons with HIV (PWH) and opioid use disorder (OUD) are involved in the justice system. Medications for OUD (MOUD) can reduce convictions and incarceration time in persons with OUD. Extended-release naltrexone (XR-NTX) has been shown to reduce craving of opioids, recurrence of use, and overdose and help achieve or maintain HIV viral suppression in PWH with OUD involved with the justice system.

OBJECTIVES: This retrospective study aimed to describe factors associated with reincarceration and to evaluate if XR-NTX was associated with reduced reincarceration among PWH and OUD who were released to the community from incarceration.

METHODS: Data from participants released to the community from incarceration from a completed randomized controlled trial was analyzed using a generalized linear model to estimate odds ratios associated with reincarceration and a Kaplan-Meier survival analysis to determine time to reincarceration and non-reincarcerated individuals were compared.

RESULTS: Of the 77 participants, 41 (53.2%) were reincarcerated during the 12-month study period. The mean time to reincarceration was 190 days (SD=108.3). Compared with participants who remained in the community, reincarcerated participants were more likely to have major depressive disorder at study baseline, increased opioid cravings, longer mean lifetime incarceration, and a higher physical quality of life score. XR-NTX was not significantly associated statistically with reincarceration in this analysis.

CONCLUSION: Reducing reincarceration is a public health priority, given the high proportion of PWH and OUD in the U.S. justice system as well as high degrees of persons returning to the community and having care interrupted due to reincarceration. This analysis determined that potentially identifying depression in recently released individuals could improve HIV outcomes, decrease recurrence of opioid use, and reduce reincarceration.

PMID:37159815 | PMC:PMC10163604 | DOI:10.1016/j.dadr.2023.100159