Tag: nevin manimala

Bol Med Hosp Infant Mex. 2021 Jun 9. doi: 10.24875/BMHIM.20000255. Online ahead of print.

ABSTRACT

BACKGROUND: Unplanned extubations are safety events relatively frequent in the neonatal intensive care units (NICU). This study aimed to describe the frequency and characteristics of unplanned extubations in a NICU.

METHODS: We conducted a retrospective observational study of unplanned extubations in the NICU of a tertiary regional referral hospital. We reviewed medical records for data collection and performed the statistical analysis, comparing the cases of unplanned extubations with those in which it did not occur among all the cases that received intubation and invasive neonatal mechanical ventilation.

RESULTS: A total of 958 newborns were admitted to the NICU, of which 174 required assistance with invasive mechanical ventilation (18.1%) and 28 experienced unplanned extubations (16.1%): 25 patients with one episode, one with two episodes, and two with three episodes. The rate was 2.93 unplanned extubations for every 100 days of invasive mechanical ventilation in 5 years, with a significant decrease in the last three years (p = 0.0158). We found a statistically significant correlation between a weight < 1500 g and unplanned extubation in the multivariate analysis, although sedation appears to affect its interaction.

CONCLUSIONS: Unplanned extubations are a relatively frequent problem, although with a tendency to decrease in recent years. The weight of the patients at birth and sedation during ventilation are important factors in this safety problem.

PMID:34107531 | DOI:10.24875/BMHIM.20000255

Blood Purif. 2021 Jun 9:1-7. doi: 10.1159/000514149. Online ahead of print.

ABSTRACT

AIM: This study aimed to evaluate the efficacy of the resin hemoperfusion device (HA380 hemoperfusion cartridge) on inflammatory responses during adult cardiopulmonary bypass (CPB).

METHODS: Sixty patients undergoing surgical valve replacement were randomized into the HP group (n = 30) with an HA380 hemoperfusion cartridge in the CPB circuit or the control group (n = 30) with the conventional CPB circuit. The results of routine blood tests, blood biochemical indexes, and inflammatory factors were analyzed at V0 (pre-CPB), V1 (CPB 30 min), V2 (ICU 0 h), V3 (ICU 6 h), and V4 (ICU 24 h).

RESULTS: The HP group had significantly lower levels of IL-6, IL-8, and IL-10. Significant estimation of group differences in the generalized estimating equation (GEE) models was also observed in IL-6 and IL-10. The HP group had significantly lower levels of creatinine (Cr), aminotransferase (AST), and total bilirubin (TBil) compared to the control group. The estimation of differences of Cr, AST, and TBil all reached statistical significance in GEE results. The HP group had significantly less vasopressor requirement and shorter mechanical ventilation time and ICU stay time as compared to the control group.

CONCLUSION: The HA380 hemoperfusion cartridge could effectively reduce the systemic inflammatory responses and improve postoperative recovery of patients during adult CPB.

PMID:34107477 | DOI:10.1159/000514149

Med Sci Sports Exerc. 2021 Jun 7. doi: 10.1249/MSS.0000000000002713. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) following prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function and the expression of factors involved in skeletal muscle remodeling.

METHODS: Twenty-six trained individuals were randomly allocated to either a PPDC (n=13) or a HT (n=13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g/kg protein plus 1.0 g/kg carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained prior to and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after and 24 h following the exercise bout.

RESULTS: The changes in glycogen content were similar (P>0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9±34.3 vs. PPDC: 29.6±34 mmol/kg wet wt) and ~210 min (Control: 45.8±40.7 vs. PPDC: 52±25.3 mmol/kg wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9±26.1 vs. HT: 38.7±21.3 mmol/kg wet wt) and ~210 min (Control: 61.4±50.6 vs. HT: 63.4±17.5 mmol/kg wet wt) following local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness and the mRNA expression and protein abundance of select factors were also similar (P>0.05) in both thighs, irrespective of the treatment.

CONCLUSIONS: A single 1 hr session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function following prolonged intermittent shuttle running.

PMID:34107509 | DOI:10.1249/MSS.0000000000002713

Water Res. 2021 May 16;200:117254. doi: 10.1016/j.watres.2021.117254. Online ahead of print.

ABSTRACT

Due to the increased availability of high-frequency measurements of stream chemistry provided by in situ sensors, researchers have gained more access to relationships between stream discharge and constituent concentrations (C-Q relationships) at event-scales. Existing studies reveal that event-scale C-Q relationships are mostly non-linear and exhibit temporal lags between peaks (or troughs) of hydrographs and chemographs, resulting in apparent hysteresis effects. In this paper, we summarize and introduce tools and methods in hysteresis analysis, especially the history and progresses of metrics to quantify hysteresis patterns. In addition, this paper provides a typical workflow to conduct event-scale hysteresis analysis, such as how to obtain the access to high-frequency measurements, existing methods to delineate storm events, approaches to classify and quantify hysteresis patterns, possible features/properties controlling hysteresis patterns, statistical methods to identify features at play, and strategies to deliver the inferences from hysteresis analysis. Lastly, we discuss some potential limitations that arise in the workflow and possible future work to address the challenges, including the development of advanced quantitative hysteresis metrics, generalized and standardized tools to delineate events and the integration of hysteresis analysis with numerical modeling. This paper aims to provide a critical overview of technical approaches for hysteresis analysis for researchers and hopefully foster their interests to advance our understanding of complex mechanisms in event-scale hydro-biogeochemical processes.

PMID:34107427 | DOI:10.1016/j.watres.2021.117254

Health Place. 2021 Jun 6;70:102599. doi: 10.1016/j.healthplace.2021.102599. Online ahead of print.

ABSTRACT

The role of intergenerational geographic proximity in individuals’ migration decisions has been well-established. The circumstances under which parents and their adult children move away from or remain close to each other are, however, less clear. Drawing on Norwegian register data for 2014-2016 and three-level logistic regression models, we examine whether formal care needs of older parents (aged ≥65) deter parent-child geographic divergence and whether variation in the likelihood of divergence is associated with municipal-level characteristics. After accounting for location-specific capital and parents’ and children’s sociodemographic characteristics, parents and children were less likely to diverge after the onset of parental care needs. Utilising in-home nursing decreased the likelihood of divergence for mothers while utilising institutionalised care decreased the likelihood of divergence for fathers. The use of in-home nursing care among single mothers further reduced the likelihood of divergence. Parents and adult children living in central areas were the least likely to diverge geographically. The likelihood of intergenerational divergence was lower for fathers and children living in municipalities with high healthcare spending.

PMID:34107444 | DOI:10.1016/j.healthplace.2021.102599

J Stroke Cerebrovasc Dis. 2021 Jun 6;30(8):105905. doi: 10.1016/j.jstrokecerebrovasdis.2021.105905. Online ahead of print.

ABSTRACT

PURPOSE: In the past years the significance of white matter hyperintensities (WMH) has gained raising attention because it is considered a marker of severity of different pathologies. Another condition that in the last years has been assessed in the neuroradiology field is cerebral microbleeds (CMB). The purpose of this work was to evaluate the association between the volume of WMH and the presence and characteristics of CMB.

MATERIAL AND METHODS: Sixty-five consecutive (males 45; median age 70) subjects were retrospectively analyzed with a 1.5 Tesla scanner. WMH volume was quantified with a semi-automated procedure considering the FLAIR MR sequences whereas the CMB were studied with the SWI technique and CMBs were classified as absent (grade 1), mild (grade 2; total number of CMBs: 1-2), moderate (grade 3; total number of CMBs: 3-10), and severe (grade 4; total number of CMBs: >10). Moreover, overall number of CMBs and the maximum diameter were registered.

RESULTS: Prevalence of CMBs was 30.76% whereas WMH 81.5%. Mann-Whitney test showed a statistically significant difference in WMH volume between subjects with and without CMBs (p < 0.001). Pearson analysis showed significant correlation between CMB grade, number and maximum diameter and WMH. The better ROC area under the curve (Az) was obtained by the hemisphere volume with a 0.828 (95% CI from 0.752 to 0,888; SD = 0.0427; p value = 0.001). The only parameters that showed a statistically significant association in the logistic regression analysis were Hemisphere volume of WMH (p = 0.001) and Cholesterol LDL (p = 0.0292).

CONCLUSION: In conclusion, the results of this study suggest the presence of a significant correlation between CMBs and volume of WMH. No differences were found between the different vascular territories.

PMID:34107418 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105905

Heart Lung. 2021 Jun 6;50(5):714-719. doi: 10.1016/j.hrtlng.2021.04.018. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary hypertension is a progressive, and disabling disease, however, there is little knowledge about impaired sexual function in this population.

AIM: To identify the prevalence of sexual dysfunction and the association between sexual dysfunction level and sociodemographic and clinical characteristics.

METHODS: A cross-sectional study with 71 women diagnosed with pulmonary hypertension without signs of clinical decompensation was carried out. Sexual function was assessed using the Female Sexual Function Index (FSFI) and functional capacity was assessed by 6-minute walk test. The relationships between sociodemographic and clinical characteristics with sexual function was performed using statistical tests. A p-value <0.05 was considered as significant.

RESULTS: 71.8% of patients self-reported sexual dysfunction as indicated as a score of <26.55 points on FSFI. Women with sexual dysfunction were older, higher average age of their last menstruation, had worse functional class, shorter distance covered and worse Borg score at the end of the 6-minute walk test.

CONCLUSION: There is evident impairment of sexual function self-reported by women with pH and the association of this condition with a decline in functional capacity was identified.

PMID:34107396 | DOI:10.1016/j.hrtlng.2021.04.018

Sci Total Environ. 2021 May 30;790:148148. doi: 10.1016/j.scitotenv.2021.148148. Online ahead of print.

ABSTRACT

The increasing salinization in the soil profile by irrigation water and groundwater upheaval is a widespread issue and considered as a major threat to agricultural production in arid and semi-arid regions. The present study aimed to propose a systematic SAR simulation involving the imaginary part of dielectric constant measurements of two consecutive seasons (dry and wet) to quantify and discriminate the irrigation-induced and upheaval-associated salinity from total salinity levels and investigate its impact on crop growth. The Sentinel-1 data of C-band frequency (5.36 GHz) acquired for both the dry and wet spells from 2015 to 2019 was instrumental in the present study. The total soil EC (Electrical Conductivity) was quantified from the imaginary part of dielectric constant (ε″) using semi-empirical microwave simulation “DSDM-SS”. Irrigation-induced salinity (ε_Irrigation″) and upheaval-associated salinity (ε_Upheaval″) were extracted from ε″ by proposing a site-, and climatic-specific novel model. The ε_Upheaval″ and ε_Irrigation″ have shown promising statistical significance with the in-situ soil EC (R² = 0.89, p = <0.001, rMSE = 1.08, Bias = 0.584) and groundwater EC measurements (R² = 0.85, p = <0.001, rMSE = 1.28, Bias = 1.16). The study found that the rate of salinity increase over time due to irrigation (77%) was considerably higher than the upheaval (42%) process. This demonstrated that the intensive use of groundwater for irrigation has a higher impact on vegetation vigor (θ = -0.87) than the upheaval process. The study revealed that crop failure in the dry season was provoked by osmotic stress and waterlogging conditions.

PMID:34107405 | DOI:10.1016/j.scitotenv.2021.148148

Water Res. 2021 May 27;201:117304. doi: 10.1016/j.watres.2021.117304. Online ahead of print.

ABSTRACT

Rising incidence of waterborne diseases including Legionellosis linked to low chlorine residuals in buildings and the availability of inexpensive testing options, create an opportunity for citizen science chorine monitoring to complement sampling done by water utilities. University researchers and Flint residents coordinated a citizen science chlorine surveillance campaign in Flint, Michigan in 2015-19, that helped expose the nature of two deadly Legionnaires Disease outbreaks in 2014-2015 during the Flint Water Crisis and progress of system recovery during the Federal emergency. Results obtained with an inexpensive color wheel were in agreement with a digital colorimeter (R² =0.99; p = 2.81 × 10^-21) at 15 sites geographically distributed across Flint. Blinded tests revealed good agreement between official (n = 2051) and citizen (n = 654) data in terms of determining whether regulatory guidelines for chlorine were met, but a discovery that the citizen data were statistically lower than the city’s (p<0.00001) especially in warm summer months led to recommendations for increased flushing of service lines before measurements. This work suggests that expanded citizen surveillance of chlorine, site specific flushing advice, and guidance on decisions about water heater set point could help consumers reduce Legionella risks in their homes. Citizen science initiatives for chlorine monitoring offer a unique opportunity for mutually beneficial collaborations between consumers and utilities to reduce the main source of waterborne disease in developed countries.

PMID:34107367 | DOI:10.1016/j.watres.2021.117304

Int J Drug Policy. 2021 Jun 5;95:103291. doi: 10.1016/j.drugpo.2021.103291. Online ahead of print.

ABSTRACT

BACKGROUND: Problem drinking and co-occurring depression symptoms affect men at high rates and are associated with increased risk of family violence. In low- and middle-income countries, there is a large treatment gap for services due to a lack of human resources. Moreover, masculine norms are a barrier to men seeking treatment for drinking and depression in healthcare settings. We examined an approach for engaging peer-fathers to deliver an intervention to reduce alcohol use, improve depressive symptoms, and increase family involvement among fathers in Kenya with problem drinking. The intervention-LEAD (Learn, Engage, Act, Dedicate)-combines motivational interviewing, behavioral activation, and masculinity discussion strategies.

METHODS: Community and religious leaders nominated fathers with no mental health training to serve as counselors (N=12); clients were recruited through community referrals. Nominated fathers completed a 10-day training beginning with treatment principles followed by manualized content. Three counselors were selected after training based on quantitative and qualitative assessments of communication skills, intervention knowledge, willingness to learn, ability to use feedback, and empathy. Supervision was tiered with local supervisors and clinical psychologist consultation. During LEAD delivery, counselor fidelity, delivery quality, and general and intervention-specific competencies were assessed. To evaluate acceptability, qualitative interviews were conducted with lay-counselors and clients (N=11). Descriptive statistics were calculated for quantitative outcomes; interviews were analyzed using thematic analysis.

RESULTS: Peer-father lay counselors treated nine clients, with eight completing treatment. Counselors reached high rates of fidelity (93.8%) and high to optimal ratings on quality of delivery, clinical competency, and intervention-specific competencies. Qualitative results suggested high acceptability, with counselors expressing satisfaction and empowerment in their roles. Clients likewise described positive experiences with counselors.

CONCLUSIONS: Findings provide initial support for the acceptability and feasibility of recruitment, selection, and training processes for peer-father lay counselors to deliver LEAD through a lens of masculinity that aligned with clients help-acceptance practices.

PMID:34107387 | DOI:10.1016/j.drugpo.2021.103291