Tag: nevin manimala

Am J Med Sci. 2021 Aug 15:S0002-9629(21)00281-0. doi: 10.1016/j.amjms.2021.06.018. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of the study was to assess the epidemiology, risk factors and outcomes of native vertebral osteomyelitis (NVO) in patients with Staphylococcus aureus bacteremia (SAB).

METHODS: A retrospective institutional review was conducted at Mayo Clinic, Minnesota. Patients aged ≥ 18 years with SAB who developed NVO from January 1, 2006 to December 31, 2020 were included and 3-month follow-up data were abstracted. Data pertaining to patient demographics, risk factors and outcomes were recorded using REDCap. A 1:2 nested case-control analysis was performed, and controls were matched according to age, sex and year of SAB diagnosis.

RESULTS: A total of 103 patients had NVO. A majority (60.2%) of patients was male, with a median age of 62.0 years. Thirty-one (30.1%) cases were caused by methicillin-resistant S. aureus (MRSA). The lumbar spine was most commonly (57.6%) and the most commonly reported comorbid conditions included diabetes mellitus (36.9%) and coronary artery disease (27.2%). Mortality at three-month follow-up was 18.6%. Nested case-control analysis revealed that injection drug use (IDU) and tobacco consumption were significant risk factors associated with NVO, while chronic hemodialysis and chronic liver disease (CLD) were associated with a decreased risk of NVO.

CONCLUSIONS: Atherosclerotic vascular disease was prominent in our contemporary cohort with NVO in the setting of SAB. Diabetes mellitus, tobacco consumption, older age and male sex likely contributed to this profile. Because IDU was associated with NVO, an increased number of cases should be anticipated among patients with IDU given the ongoing opioid epidemic in the United States.

PMID:34407419 | DOI:10.1016/j.amjms.2021.06.018

J Correct Health Care. 2021 Aug 18. doi: 10.1089/jchc.19.05.0045. Online ahead of print.

ABSTRACT

The prevalence of HIV/hepatitis C virus (HCV) coinfection among justice-involved persons is high. The validity of self-reported HCV status in this population has important public health implications, yet has not been studied. Justice-involved persons with HIV from Washington, DC, were enrolled in a study that investigated a mobile health intervention to support HIV treatment. Self-reported and laboratory-confirmed HCV status was compared. Among 103 participants, chronic HCV prevalence was 13%. Positive predictive value of self-reported positive chronic HCV status was low at 55%, and negative predictive value was 98%. Cohen’s kappa statistic was 0.60 for agreement. Two women who reported negative HCV status were found to have HCV.

PMID:34407381 | DOI:10.1089/jchc.19.05.0045

J Speech Lang Hear Res. 2021 Aug 18:1-16. doi: 10.1044/2021_JSLHR-21-00096. Online ahead of print.

ABSTRACT

Purpose This study examined the accuracy and potential clinical utility of two expedited transcription methods for narrative language samples elicited from school-age children (7;5-11;10 [years;months]) with developmental language disorder. Transcription methods included real-time transcription produced by speech-language pathologists (SLPs) and trained transcribers (TTs) as well as Google Cloud Speech automatic speech recognition. Method The accuracy of each transcription method was evaluated against a gold-standard reference corpus. Clinical utility was examined by determining the reliability of scores calculated from the transcripts produced by each method on several language sample analysis (LSA) measures. Participants included seven certified SLPs and seven TTs. Each participant was asked to produce a set of six transcripts in real time, out of a total 42 language samples. The same 42 samples were transcribed using Google Cloud Speech. Transcription accuracy was evaluated through word error rate. Reliability of LSA scores was determined using correlation analysis. Results Results indicated that Google Cloud Speech was significantly more accurate than real-time transcription in transcribing narrative samples and was not impacted by speech rate of the narrator. In contrast, SLP and TT transcription accuracy decreased as a function of increasing speech rate. LSA metrics generated from Google Cloud Speech transcripts were also more reliably calculated. Conclusions Automatic speech recognition showed greater accuracy and clinical utility as an expedited transcription method than real-time transcription. Though there is room for improvement in the accuracy of speech recognition for the purpose of clinical transcription, it produced highly reliable scores on several commonly used LSA metrics. Supplemental Material https://doi.org/10.23641/asha.15167355.

PMID:34407387 | DOI:10.1044/2021_JSLHR-21-00096

Cell Rep. 2021 Aug 17;36(7):109560. doi: 10.1016/j.celrep.2021.109560.

ABSTRACT

We assess the degree of phenotypic variation in a cohort of 24-month-old male C57BL/6 mice. Because murine studies often use small sample sizes, if the commonly relied upon assumption of a normal distribution of residuals is not met, it may inflate type I error rates. In this study, 3-20 mice are resampled from the empirical distributions of 376 mice to create plasmodes, an approach for computing type I error rates and power for commonly used statistical tests without assuming a normal distribution of residuals. While all of the phenotypic and metabolic variables studied show considerable variability, the number of animals required to achieve adequate power is markedly different depending on the statistical test being performed. Overall, this work provides an analysis with which researchers can make informed decisions about the sample size required to achieve statistical power from specific measurements without a priori assumptions of a theoretical distribution.

PMID:34407413 | DOI:10.1016/j.celrep.2021.109560

J Migr Health. 2021 Jul 7;4:100061. doi: 10.1016/j.jmh.2021.100061. eCollection 2021.

ABSTRACT

BACKGROUND: One in seven people living in the United Kingdom (UK) is an international migrant, rendering migrants an important population group with diverse and dynamic health and healthcare needs. However, there has been no attempt to map contemporary trends within migration health research conducted in the UK. The aim of this scoping review was to describe trends within migration health research and identify gaps for future research agendas.

METHODS: PubMed and Embase were systematically searched for empirical research with a primary focus on the concepts “health” and “migrants” published between 2001 and 2019. Findings were analysed using the UCL-Lancet Commission on Migration and Health Conceptual Framework for Migration and Health.

RESULTS: In total, 399 studies were included, with almost half (41.1%; 164/399) published in the last five years of the study period between 2015 and 2019 and a third (34.1%; 136/399) conducted in London. Studies included asylum seekers (14.8%; 59/399), refugees (12.3%; 49/399), and undocumented migrants or migrants with insecure status (3.5%; 14/399), but most articles (74.9%; 299/399) did not specify a migrant sub-group. The most studied health topics were specific disease outcomes such as infectious diseases (24.1% of studies) and mental health (19.1%) compared to examining systems or structures that impact health (27.8%), access to healthcare (26.3%), or specific exposures or behaviours (35.3%).

CONCLUSIONS: There has been a growing interest in migration health. Ensuring a diverse geographic distribution of research conducted in the UK and disaggregation by migrant sub-group is required for a nuanced and region-specific understanding of specific health needs, interventions and appropriate service delivery for different migrant populations. More research is needed to understand how migration policy and legislation intersect with both the social determinants of health and access to healthcare to shape the health of migrants in the UK.

PMID:34405201 | PMC:PMC8352015 | DOI:10.1016/j.jmh.2021.100061

Pediatr Int. 2021 Aug 18. doi: 10.1111/ped.14882. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is one of the causes of pre-treatment morbidity and mortality in the pediatric age group. In the present study, we investigated the place of the immature granulocyte percentage, (IG) immature reticulocyte fraction (IRF), and immature platelet fraction (IPF) in the diagnosis of sepsis.

METHODS: Complete blood count, C-reactive protein, (CRP) procalcitonin (PCT) and blood cultures were measured in 125 critical patients who were followed-up in the intensive care unit with the suspicion of sepsis and 65 healthy children between 2017 and 2019. In addition to the complete blood counts and routine parameters, IG, IRF, and IPF were examined in the patients.

RESULTS: When the critical patient group and the healthy control group were compared, it was found that the total number of leukocytes (white blood cells), neutrophil count, platelet count, CRP, PCT, IG, IRF, and IPF values were higher at statistically significant levels. When septic and non-septic patients were compared, it was found that the CRP, PCT,IGP, and IPF were higher at statistically significant levels in the septic patients.

CONCLUSIONS: It was concluded that CRP, PCT, IG, and IPF were significant in determining sepsis and that PCT was the most sensitive and specific biomarker in these parameters. We believe that these parameters may be suitable for practical use in determining sepsis because they give faster results and suggest the diagnosis of sepsis.

PMID:34407299 | DOI:10.1111/ped.14882

Pediatr Pulmonol. 2021 Aug 18. doi: 10.1002/ppul.25625. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of human milk and different neonatal variables on tidal breathing flow-volume loop (TBFVL) parameters within three months’ corrected age (CA) in infants born ≤32 wks or weighing <1500 g.

METHODS: We retrospectively studied 121 infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) <1500 gr who had lung function assessment within three months’ CA by TBFVL analysis between June 2009 and April 2018. We investigated the impact of GA, gender, being Small for GA (SGA), sepsis, days of mechanical ventilation (MV) and human milk feeding (HMF) on later respiratory function, both in the entire group and according to BW ( ≤1000 g and >1000 g).

RESULTS: The mean(SD) z-score for tidal volume (Vt) and time to peak expiratory flow to expiratory time (tPTEF/tE) were respectively -4.3 (2.5) and -0.8 (2.0) for the overall population with no significant differences between infants <1000 g or ≥1000 g. The mean(SD) Vt standardized for body weight was 6.2(2.0) ml/kg. Being female was associated with better Vt/Kg, whereas longer MV or being born SGA were associated with worst tPTEF/tE. For infants with BW < 1000 gr, tPTEF/tE was positively associated with HMF.

CONCLUSION: An early TBFVL assessment within three months’ CA already reveals lung function alteration in preterm infants. Being female is associated with better Vt/Kg, while longer duration of MV or being born SGA negatively affect tPTEF/tE. The positive association between HMF and better tPTEF/tE in infants with BW <1000 g has emerged, which deserves further investigation.

PMID:34407314 | DOI:10.1002/ppul.25625

Mol Ecol Resour. 2021 Aug 18. doi: 10.1111/1755-0998.13487. Online ahead of print.

ABSTRACT

Dispersal abilities play a crucial role in shaping the extent of population genetic structure, with more mobile species being panmictic over large geographic ranges and less mobile ones organized in meta-populations exchanging migrants to different degrees. In turn, population structure directly influences the coalescence pattern of the sampled lineages, but the consequences on the estimated variation of the effective population size (Ne) over time obtained by means of unstructured demographic models remain poorly understood. However, this knowledge is crucial for biologically interpreting the observed Ne trajectory and further devising conservation strategies in endangered species. Here we investigated the demographic history of four shark species (Carharhinus melanopterus, Carharhinus limbatus, Carharhinus amblyrhynchos, Galeocerdo cuvier) with different degrees of endangered status and life history traits related to dispersal distributed in the Indo-Pacific and sampled off New Caledonia. We compared several evolutionary scenarios representing both structured (meta-population) and unstructured models and then inferred the Ne variation through time. By performing extensive coalescent simulations, we provided a general framework relating the underlying population structure and the observed Ne dynamics. On this basis, we concluded that the recent decline observed in three out of the four considered species when assuming unstructured demographic models can be explained by the presence of population structure. Furthermore, we also demonstrated the limits of the inferences based on the sole site frequency spectrum and warn that statistics based on linkage disequilibrium will be needed to exclude recent demographic events affecting meta-populations.

PMID:34407294 | DOI:10.1111/1755-0998.13487

Acta Ophthalmol. 2021 Aug 18. doi: 10.1111/aos.15005. Online ahead of print.

ABSTRACT

PURPOSE: To compare the 12 months visual and anatomical outcomes of treatment-naïve neovascular age-related macular degeneration (nAMD) patients diagnosed by optical coherence tomography angiography (OCT-A) compared with fluorescein angiography (FA)/indocyanine green angiography (ICGA), after anti-VEGF treatment in a real-world setting.

METHODS: Monocentric, observational, parallel-group study of nAMD patients diagnosed with either FA/ICGA or non-invasive OCT-A methods. Patients were treated with a fixed dosing regimen of intravitreal ranibizumab or aflibercept and followed up for 12 months. Primary outcomes were the 12 months functional (BCVA) and anatomical (CST reduction) gains between the two groups. The stratification of BCVA and CST gains by type of neovascular lesion and by anti-VEGF treatment was also assessed.

RESULTS: Seventy-two patients received FA/ICGA for the initial diagnosis of nAMD, while 73 received OCT-A. Overall, the mean BCVA gain at 12 months was 11.5 ± 9.6 letters. There were no statistically significant differences between the invasive and non-invasive imaging groups in BCVA gain (p = 0.87) or CST reduction (p = 0.76). No statistically significant outcome differences between different lesion types and the two drugs were observed.

CONCLUSION: In a real-world setting, nAMD patients diagnosed with OCT-A showed meaningful improvements in visual and anatomical parameters during 12 months of treatment, without significant differences with those diagnosed by invasive modalities.

PMID:34407298 | DOI:10.1111/aos.15005

Health Expect. 2021 Aug 18. doi: 10.1111/hex.13347. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, the first UK lockdown (March to May 2020) witnessed a dramatic reduction in children presenting to primary/emergency care, creating concern that fear of the virus was resulting in children presenting late.

METHODS: An online survey was co-developed with UK parents to understand the impact of the lockdown on parents’ help-seeking for, and care of, their sick/injured child(ren). The survey was advertised through social media and snowballing to parents whose children had been ill/injured during the lockdown. Analysis used descriptive statistics, SPSSv25 and thematic analysis.

RESULTS: The survey was fully completed by 198 UK parents. The majority asked for help (144/198): from their family doctor (78), national helplines (48) or an Emergency Department (23). Most reported that their decision-making had not changed, although how they sought help had changed. A few parents reported that the severity and duration of illness had increased because of uncertainty about and/or difficulty accessing services. Parents did not always report seeking help for symptoms rated red or amber by the Royal College of Paediatrics and Child Health. Parents reported accessing information through the internet or using information that they already had.

PARENT CONTRIBUTION: This was a collaboration with parents from survey development to dissemination, with two parents being integral members of our research team.

CONCLUSIONS: Our questionnaire was completed by parents who were not deterred from seeking help for their sick or injured children. Even for these parents, the lockdown changes to services created uncertainty about, and barriers to, accessing medical help for their children.

PMID:34407286 | DOI:10.1111/hex.13347