Tag: nevin manimala

PLoS One. 2021 Apr 26;16(4):e0250633. doi: 10.1371/journal.pone.0250633. eCollection 2021.

ABSTRACT

BACKGROUND: Globally, approximately 9 million neonates develop perinatal asphyxia annually of which about 1.2 million die. Majority of the morbidity and mortality occur in Low and middle-income countries. However, little is known about the current trend in incidence, and the factors affecting mortality from hypoxic ischaemic encephalopathy (HIE), in Nigeria.

OBJECTIVE: We assessed the trends in incidence and fatality rates and evaluated the predictors of mortality among babies admitted with HIE over five years at the Lagos University Teaching Hospital.

METHODS: A temporal trend analysis and retrospective cohort study of HIE affected babies admitted to the neonatal unit of a Nigerian Teaching Hospital was conducted. The socio-demographic and clinical characteristics of the babies and their mothers were extracted from the neonatal unit records. Kaplan-Meir plots and Multivariable Cox proportional hazard ratio was used to evaluate the survival experienced using Stata version 16 (StataCorp USA) statistical software.

RESULTS: The median age of the newborns at admission was 26.5 (10-53.5) hours and the male to female ratio was 2.1:1. About one-fifth (20.8%) and nearly half (47.8%) were admitted within 6 hours and 24 hours of life respectively, while majority (84%) of the infants were out-born. The prevalence and fatality rate of HIE in our study was 7.1% and 25.3% respectively. The annual incidence of HIE among the hospital admissions declined by 1.4% per annum while the annual fatality rate increased by 10.3% per annum from 2015 to 2019. About 15.7% died within 24 hours of admission. The hazard of death was related to the severity of HIE (p = 0.001), antenatal booking status of the mother (p = 0.01) and place of delivery (p = 0.03).

CONCLUSION: The case fatality rate of HIE is high and increasing at our centre and mainly driven by the pattern of admission of HIE cases among outborn babies. Thus, community level interventions including skilled birth attendants at delivery, newborn resuscitation trainings for healthcare personnel and capacity building for specialized care should be intensified to reduce the burden of HIE.

PMID:33901237 | DOI:10.1371/journal.pone.0250633

PLoS One. 2021 Apr 26;16(4):e0250466. doi: 10.1371/journal.pone.0250466. eCollection 2021.

ABSTRACT

Sand management is essential for enhancing the production in oil and gas reservoirs. The critical total drawdown (CTD) is used as a reliable indicator of the onset of sand production; hence, its accurate prediction is very important. There are many published CTD prediction correlations in literature. However, the accuracy of most of these models is questionable. Therefore, further improvement in CTD prediction is needed for more effective and successful sand control. This article presents a robust and accurate fuzzy logic (FL) model for predicting the CTD. Literature on 23 wells of the North Adriatic Sea was used to develop the model. The used data were split into 70% training sets and 30% testing sets. Trend analysis was conducted to verify that the developed model follows the correct physical behavior trends of the input parameters. Some statistical analyses were performed to check the model’s reliability and accuracy as compared to the published correlations. The results demonstrated that the proposed FL model substantially outperforms the current published correlations and shows higher prediction accuracy. These results were verified using the highest correlation coefficient, the lowest average absolute percent relative error (AAPRE), the lowest maximum error (max. AAPRE), the lowest standard deviation (SD), and the lowest root mean square error (RMSE). Results showed that the lowest AAPRE is 8.6%, whereas the highest correlation coefficient is 0.9947. These values of AAPRE (<10%) indicate that the FL model could predicts the CTD more accurately than other published models (>20% AAPRE). Moreover, further analysis indicated the robustness of the FL model, because it follows the trends of all physical parameters affecting the CTD.

PMID:33901240 | DOI:10.1371/journal.pone.0250466

PLoS One. 2021 Apr 26;16(4):e0250504. doi: 10.1371/journal.pone.0250504. eCollection 2021.

ABSTRACT

Laminar fMRI at ultra-high magnetic field strength is typically carried out using the Blood Oxygenation Level-Dependent (BOLD) contrast. Despite its unrivalled sensitivity to detecting activation, the BOLD contrast is limited in its spatial specificity due to signals stemming from intra-cortical ascending and pial veins. Alternatively, regional changes in perfusion (i.e., cerebral blood flow through tissue) are colocalised to neuronal activation, which can be non-invasively measured using Arterial Spin Labelling (ASL) MRI. In addition, ASL provides a quantitative marker of neuronal activation in terms of perfusion signal, which is simultaneously acquired along with the BOLD signal. However, ASL for laminar imaging is challenging due to the lower SNR of the perfusion signal and higher RF power deposition i.e., specific absorption rate (SAR) of ASL sequences. In the present study, we present for the first time in humans, isotropic sub-millimetre spatial resolution functional perfusion images using Flow-sensitive Alternating Inversion Recovery (FAIR) ASL with a 3D-EPI readout at 7 T. We show that robust statistical activation maps can be obtained with perfusion-weighting in a single session. We observed the characteristic BOLD amplitude increase towards the superficial laminae, and, in apparent discrepancy, the relative perfusion profile shows a decrease of the amplitude and the absolute perfusion profile a much smaller increase towards the cortical surface. Considering the draining vein effect on the BOLD signal using model-based spatial “convolution”, we show that the empirically measured perfusion and BOLD profiles are, in fact, consistent with each other. This study demonstrates that laminar perfusion fMRI in humans is feasible at 7 T and that caution must be exercised when interpreting BOLD signal laminar profiles as direct representation of the cortical distribution of neuronal activity.

PMID:33901230 | DOI:10.1371/journal.pone.0250504

PLoS One. 2021 Apr 26;16(4):e0250426. doi: 10.1371/journal.pone.0250426. eCollection 2021.

ABSTRACT

BACKGROUND & AIM: Women with HIV/HPV coinfection and cervical lesions are at increased risk of developing HPV related anal cancer. Self-collection of anal swabs may facilitate HPV molecular testing in anal cancer screening, especially in high-risk groups, and yet it is not adequately studied. We evaluated level of agreement between self-collected anal swabs (SCAS) and clinician-collected anal swabs (CCAS) when used for HPV genotyping. We also described the anal HPV genotype distribution and HIV/HPV coinfection.

METHODS: We performed a cross sectional study with participants from a visual-inspection-with-acetic-acid and cervicography (VIAC) clinic, in Harare, Zimbabwe. In a clinic setting, the women aged ≥18 years provided anal swabs in duplicate; first CCAS and then SCAS immediately after. HPV detection and genotyping were performed using next generation amplicon sequencing of a 450bp region of the HPV L1 gene. Level of agreement of HPV genotypes between CCAS and SCAS was calculated using the kappa statistic. McNemar tests were used to evaluate agreement in the proportion of genotypes detected by either method.

RESULTS: Three-hundred women provided 600 samples for HPV genotyping. HPV genotypes were detected in 25% of SCAS and in 22% of CCAS. The most common genotypes with CCAS were HPV52, HPV62 and HPV70 and with SCAS were HPV62, HPV44, HPV52, HPV53 and HPV68. Total HPV genotypes detected in CCAS were more than those detected in SCAS, 32 versus 27. The agreement of HPV genotypes between the two methods was 0.55 in kappa value (k). The test of proportions using McNemar gave a Chi-square value of 0.75 (p = 0.39). Multiple HPV infections were detected in 28/75 and 29/67 women for CCAS and SCAS respectively.

CONCLUSIONS: SCAS and CCAS anal swabs showed moderate agreement, with no statistically significant difference in the proportion of genotypes detected by either methods. Although the differences between the two methods were not statistically significant, CCAS detected more HPV genotypes than SCAS and more HPV infections were detected in SCAS than in CCAS. Our data suggest that self-collected anal swabs can be used as an alternative to clinician-collected anal swabs for HPV genotyping.

PMID:33901223 | DOI:10.1371/journal.pone.0250426

PLoS One. 2021 Apr 26;16(4):e0250204. doi: 10.1371/journal.pone.0250204. eCollection 2021.

ABSTRACT

Understanding the dynamics by which urban areas attract visitors is important in today’s cities that are continuously increasing in population towards higher densities. Identifying services that relate to highly attractive districts is useful to make policies regarding the placement of such places. Thus, we present a framework for classifying districts in cities by their attractiveness to daily commuters and relating Points of Interests (POIs) types to districts’ attraction patterns. We used Origin-Destination matrices (ODs) mined from cell phone data that capture the flow of trips between each pair of places in Riyadh, Saudi Arabia. We define the attraction profile for a place based on three main statistical features: The number of visitors a place received, the distribution of distance traveled by visitors on the road network, and the spatial spread of locations from where trips started. We used a hierarchical clustering algorithm to classify all places in the city by their features of attraction. We discovered three main types of Urban Attractors in Riyadh during the morning period: Global, which are significant places in the city, Downtown, which contains the central business district, and Residential attractors. In addition, we uncovered what makes districts possess certain attraction patterns. We used a statistical significance testing approach to quantify the relationship between Points of Interests (POIs) types (services) and the patterns of Urban Attractors detected.

PMID:33901224 | DOI:10.1371/journal.pone.0250204

PLoS One. 2021 Apr 26;16(4):e0250226. doi: 10.1371/journal.pone.0250226. eCollection 2021.

ABSTRACT

While antimicrobial resistance (AMR) continues to be a major public health problem in Pakistan, data regarding trends of resistance among pathogenic bacteria remains scarce, with few studies presenting long-term trends in AMR. This study was therefore designed to analyze long-term AMR trends at a national level in Pakistan. We report here results of a comprehensive analysis of resistance, among pathogens isolated from blood and cerebrospinal fluid (CSF), between 2011 and 2015. Susceptibility data was obtained from a local laboratory with collection points all across Pakistan (Chughtai Laboratory). Resistance proportions to most commonly used antimicrobials were calculated for each pathogen over a period of five years. While Acinetobacter species demonstrated highest resistance rates to all tested antimicrobials, a sharp increase in carbapenem resistance was the most noticeable (50%-95%) between 2011-2015. Our results also highlight the presence of third and fourth generation cephalosporins resistance in Salmonella enterica serovar Typhi in Pakistan. Interestingly, where rise in AMR was being observed in some major invasive pathogens, decreasing resistance trends were observed in Staphylococcus aureus, against commonly used antimicrobials. Overall pathogens isolated from blood and CSF between 2011-2015, showed an increase in resistance towards commonly used antimicrobials.

PMID:33901205 | DOI:10.1371/journal.pone.0250226

PLoS One. 2021 Apr 26;16(4):e0250298. doi: 10.1371/journal.pone.0250298. eCollection 2021.

ABSTRACT

BACKGROUND: Hospital readmissions place a major burden on patients and health care systems worldwide, but little is known about patterns and timing of readmissions in Germany.

METHODS: We used German health insurance claims (AOK, 2011-2016) of patients ≥ 65 years hospitalized for acute myocardial infarction (AMI), heart failure (HF), a composite of stroke, transient ischemic attack, or atrial fibrillation (S/AF), chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus, or osteoporosis to identify hospital readmissions within 30 or 90 days. Readmissions were classified into all-cause, specific, and non-specific and their characteristics were analyzed.

RESULTS: Within 30 and 90 days, about 14-22% and 27-41% index admissions were readmitted for any reason, respectively. HF and S/AF contributed most index cases, and HF and COPD accounted for most all-cause readmissions. Distributions and ratios of specific to non-specific readmissions were disease-specific with highest specific readmissions rates among COPD and AMI.

CONCLUSION: German claims are well-suited to investigate readmission causes if longer periods than 30 days are evaluated. Conditions closely related with the primary disease are the most frequent readmission causes, but multiple comorbidities among readmitted cases suggest that a multidisciplinary care approach should be implemented vigorously addressing comorbidities already during the index hospitalization.

PMID:33901203 | DOI:10.1371/journal.pone.0250298

J Perinat Neonatal Nurs. 2021 Apr-Jun 01;35(2):188-195. doi: 10.1097/JPN.0000000000000547.

ABSTRACT

The purpose of this randomized controlled study was to determine the effect of 3 positions given to preterm infant during heelstick procedure on the pain and durations of crying and procedure. The sample of the study consisted of 90 preterm infants (30 in each group). The heelstick procedure was video recorded. Data from the pain scores, durations of crying, and procedure were collected watching the video recordings. It was determined that the pain mean score of the infants in the control group (supine on the crib) (5.50 ± 2.13) was statistically significantly higher than that of the infants in the positions of upright (3.00 ± 2.17) and supine on the lap (3.20 ± 2.46) (P < .01), and there was no difference between the positions of upright and supine on the lap (P > .05). Giving the positions of upright or supine on the lap during heelstick is effective in reducing pain, shortening the duration of crying, and calming down the infant. Heelstick in the position of upright on the lap shortened the procedure duration and allowed the infants to be subjected to less painful procedure. It is recommended for nurses to take the preterm infants on their laps during heel lancing and give them the upright position, in particular.

PMID:33900249 | DOI:10.1097/JPN.0000000000000547

J Strength Cond Res. 2021 May 1;35(5):1187-1193. doi: 10.1519/JSC.0000000000004031.

ABSTRACT

Walts, CT, Murphy, SM, Stearne, DJ, Rieger, RH, and Clark, KP. Effects of a flexible workout system on performance gains in collegiate athletes. J Strength Cond Res 35(5): 1187-1193, 2021-Although research on the topic of periodization is abundant, investigations into different flexible periodization strategies in collegiate athletes are limited. Furthermore, how state of readiness (SOR) and workout autonomy affect training improvements is largely unknown. Therefore, the purpose of this study was to determine if a flexible periodization (FP) program would elicit significantly greater performance gains compared with a nonflexible periodization (NP) program (significance set p ≤ 0.05). A total of 32 male and female intercollegiate lacrosse players completed performance measures of vertical jump, sprinting speed, change of direction, and strength in bench press and deadlift. After pretesting, subjects were matched and randomly assigned to either FP (n = 17, age = 19.4 ± 1.4 years, height = 1.72 ± 0.10 m, mass = 72.29 ± 13.73 kg) or NP (n = 15, age = 19.9 ± 1.5 years, height = 1.72 ± 0.08 m, mass = 71.68 ± 13.55 kg) training groups. Both groups trained 3 days per week for 8 weeks. The NP group completed all workout volume and intensity as prescribed by a certified strength and conditioning coach. However, the FP group modified workout volume and intensity based on a daily SOR questionnaire. Although appreciable pretest to posttest improvements were observed for the entire subject cohort, multivariate analysis of variance (ANOVA) and a series of ANOVA tests demonstrated no statistically significant between-group differences for pretest to posttest changes on any of the performance tests (range of p values: 0.17-0.95). Although FP does not seem to be more effective than NP for eliciting performance gains, it may provide greater opportunities for autonomy while eliciting equivalent improvement levels. Therefore, flexible periodization based on SOR may be a viable training strategy.

PMID:33900253 | DOI:10.1519/JSC.0000000000004031

Food Funct. 2021 Apr 21;12(8):3352-3365. doi: 10.1039/d0fo02808h. Epub 2021 Mar 31.

ABSTRACT

BACKGROUND: Radiotherapy-induced mucositis easily arouses oral ulceration, pain and xerostomia. Intense pain, difficulty swallowing and speaking greatly affect the quality of life and the treatment process.

OBJECTIVE: This study aimed to examine the effects of honey in preventing and treating radiotherapy-induced mucositis in patients with head and neck cancer using a different analytical strategy.

METHODS: Articles published until July 2020 were searched across PubMed, Embase, and Cochrane Library databases. Randomized controlled trials that evaluated honey were assessed by two reviewers. The number of mucositis incidences was the primary outcome. Weight loss, pain scale and incidence of severe pain were pooled to be calculated as secondary outcomes. Statistical analyses were conducted using RevMan5.3 software. The funnel plot was used to detect publication bias.

RESULTS: Overall, 11/179 records with 715 patients who received radiotherapy were included. Honey significantly reduced the incidence of grade 2 (OR: 0.43, 95%CI: 0.54-0.98, P = 0.03), grade 3 (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.16-0.35, P < 0.001) and grade 4 mucositis (OR: 0.17, 95%CI: 0.08-0.36, P < 0.001). In grade 1 (OR: 1.54, 95%CI: 1.15-2.06, P = 0.003), and honey was not significant in preventing radiation-induced mucositis. The incidence of unbearable pain was lower in the honey group at all grades (OR: -0.20, 95%CI: -0.33 to -0.07). The effect of honey on weight loss and pain score was not statistically significant.

CONCLUSION: Honey can prevent and alleviate grade 2-4 mucositis, especially in high grade mucositis. Honey also provides some relief from severe pain. But, more evidence is required to prove that honey is an effective substance for relieving pain or minimizing weight loss.

PMID:33900311 | DOI:10.1039/d0fo02808h