Tag: nevin manimala

PLoS One. 2021 Aug 20;16(8):e0256523. doi: 10.1371/journal.pone.0256523. eCollection 2021.

ABSTRACT

In the case of a fire, the choice of exit in the highway tunnel is strictly limited by fire location, which seriously affects the evacuation time. A spontaneous or disorderly exit choice might result in a decreased evacuation efficiency and utilization rate of exits. In this paper, we propose a strategy to obtain the optimal exit choice based on fire location during highway tunnel evacuations. In our strategy, first, the vehicle distributions and locations of evacuating occupants are determined in the traffic simulation program VISSIM. The evacuation simulation software BuildingEXODUS is employed to obtain the corresponding parameters of the evacuation process and analyze the impacts of different fire locations on the evacuation time. During the analysis, the optimal productivity statistics (OPS) is selected as the evaluation index. Then, the feature points of the crowding occupants are captured by the fuzzy c-means (FCM) cluster algorithm. Next, based on the feature points, the relationship between the location of the fire and boundary of the optimal exit choice under the optimal OPS is obtained through the polynomial regression model. It is found that the R-squared(R2) and sum of squares for error (SSE) of the polynomial regression model, reflecting the accuracy estimation, are 98.02% and 2.79×10-4, respectively. Moreover, different fire locations impact the evacuation time of tunnel entrance and evacuation passageway. This paper shows that the location of the fire and boundary of optimal exit choice have a negative linear correlation. Taking the fire 110 m away from the evacuation passageway as an example, the OPS of our strategy can be decreased by 35.6% when compared with no strategies. Our proposed strategy could be applied to determine the location of variable evacuation signs to help evacuating occupants make optimal exit choices.

PMID:34415937 | DOI:10.1371/journal.pone.0256523

PLoS One. 2021 Aug 20;16(8):e0255189. doi: 10.1371/journal.pone.0255189. eCollection 2021.

ABSTRACT

BACKGROUND & AIM: Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan.

METHODOLOGY: From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant.

RESULTS: The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively.

CONCLUSION & RECOMMENDATION: HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.

PMID:34415906 | DOI:10.1371/journal.pone.0255189

PLoS Comput Biol. 2021 Aug 20;17(8):e1009289. doi: 10.1371/journal.pcbi.1009289. Online ahead of print.

ABSTRACT

The epidemic increase in the incidence of Human Papilloma Virus (HPV) related Oropharyngeal Squamous Cell Carcinomas (OPSCCs) in several countries worldwide represents a significant public health concern. Although gender neutral HPV vaccination programmes are expected to cause a reduction in the incidence rates of OPSCCs, these effects will not be evident in the foreseeable future. Secondary prevention strategies are currently not feasible due to an incomplete understanding of the natural history of oral HPV infections in OPSCCs. The key parameters that govern natural history models remain largely ill-defined for HPV related OPSCCs and cannot be easily inferred from experimental data. Mathematical models have been used to estimate some of these ill-defined parameters in cervical cancer, another HPV related cancer leading to successful implementation of cancer prevention strategies. We outline a “double-Bayesian” mathematical modelling approach, whereby, a Bayesian machine learning model first estimates the probability of an individual having an oral HPV infection, given OPSCC and other covariate information. The model is then inverted using Bayes’ theorem to reverse the probability relationship. We use data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry, SEER Head and Neck with HPV Database and the National Health and Nutrition Examination Surveys (NHANES), representing the adult population in the United States to derive our model. The model contains 8,106 OPSCC patients of which 73.0% had an oral HPV infection. When stratified by age, sex, marital status and race/ethnicity, the model estimated a higher conditional probability for developing OPSCCs given an oral HPV infection in non-Hispanic White males and females compared to other races/ethnicities. The proposed Bayesian model represents a proof-of-concept of a natural history model of HPV driven OPSCCs and outlines a strategy for estimating the conditional probability of an individual’s risk of developing OPSCC following an oral HPV infection.

PMID:34415913 | DOI:10.1371/journal.pcbi.1009289

PLoS One. 2021 Aug 20;16(8):e0254870. doi: 10.1371/journal.pone.0254870. eCollection 2021.

ABSTRACT

INTRODUCTION: The concept of death is abstract, complex and has a number of meanings. Thus, its understanding and the approach taken to it depend, to a large extent, on aspects such as age, culture, training and religion. Nursing students have regular contact with the process of death and so it is of great interest to understand the attitudes they have towards it. As we live in a plural society it is even more interesting to not only understand the attitudes of Spanish students but, also, those of students coming from other countries. In the present article, we seek to identify and compare the attitudes held by nursing degree students at Hekima-Santé University (Senegal) and the University of Huelva (Spain) about end of life processes. The study identifies elements that condition attitudes and coping with death, whilst considering curricular differences with regards to specific end of life training.

METHOD: A descriptive, cross-sectional and multi-center study was conducted. The overall sample (N = 142) was divided into groups: Hekima-Santé University (Dakar, Senegal) and the University of Huelva (Huelva, Spain). The measurement instruments used were an ad-hoc questionnaire and Bugen´s Coping with Death Scale.

RESULTS: Statistically significant differences (p = 0.005, 95%CI) were found in relation to overall Bugen Scale scores. We can confirm that specialized end of life training (University of Huelva, Spain) did not lead to better coping when compared with a population whose academic curriculum did not provide specific training and who engaged in more religious practices (Hekima-Santé University, Senegal).

CONCLUSIONS: In cultures where religion not only influences the spiritual dimension of the individual, but acts in the ethical and moral system and consequently in the economic, educational and family sphere, the accompaniment at the end of life transcends the formative plane. Considering the plural society in which we live, the training that integrates the Degree in Nursing with regard to the care of the final process, must be multidimensional in which spirituality and faith are integrated, working emotional and attentional skills, as well as cultural competence strategies in this process.

PMID:34415902 | DOI:10.1371/journal.pone.0254870

J Cataract Refract Surg. 2021 Jul 15. doi: 10.1097/j.jcrs.0000000000000749. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects in cataract surgery using local anesthesia along with a 30% low-concentration nitrous oxide (N2O) anesthesia compared with local anesthesia only.

SETTING: Saneikai Tsukazaki Hospital.

DESIGN: Retrospective, consecutive study.

METHODS: Patients who underwent bilateral cataracts surgeries were enrolled. 37 patients using room air inhalation (Air group) and 45 patients using 30% low-concentration N2O anesthesia (70% oxygen, total 6 L/min) at the surgery’s beginning (N2O group) were retrospectively reviewed. Systolic blood pressure (BPs), diastolic blood pressure (BPd), and heart rate (HR) at the surgery’s beginning and end, and mean intraoperative oxygen saturation (% SpO2) were examined. Immediately following surgery, a questionnaire using the Visual Analog Scale score was done to determine intraoperative pain, anxiety, memory, and nausea.

RESULTS: No systemic symptoms and ocular complications requiring treatment were observed. For the N2O and Air groups, changes in BPs were -5.38 ± 11.07(P = 0.01) and 1.27 ± 13.61 mmHg, and HR were -2.24 ± 6.76 and 0.89 ± 5.18 bpm (P = 0.001), respectively; intraoperative SpO2 was 99.05 ± 0.74% and 97.44 ± 1.31% (P < 0.001), intraoperative anxiety was 21.76 ± 23.2 and 37.17 ± 32.79(P = 0.002), and intraoperative memory was 55.24 ± 36.8 and 68.91 ± 33.81(P = 0.01), respectively. No patients experienced intraoperative nausea. There was no statistically difference in BPd and intraoperative pain.

CONCLUSIONS: Low-concentration N2O anesthesia may not cause respiratory depression, abnormal vital signs, or nausea in cataract surgery. It can suppress intraoperative anxiety and memory and decrease and stabilize vital signs.

PMID:34415864 | DOI:10.1097/j.jcrs.0000000000000749

Am J Audiol. 2021 Aug 20:1-6. doi: 10.1044/2021_AJA-20-00227. Online ahead of print.

ABSTRACT

Purpose The purpose of this study was to investigate the effectiveness of different types of tasking on the measurement of peak slow phase velocity (SPV) for caloric testing and rotary chair testing. Method This study evaluated the peak SPV response for caloric testing and rotary chair across five conditions. Three verbal, one tactile, and one condition without tasking were used for both caloric testing and rotary chair. The subjects consisted of 20 young adults (age range: 22-33 years, M = 26.65, SD = 3.72; seven male, 13 female) with normal vestibular function and no history of ear surgery or vestibular disorder. Study participation consisted of two visits with 24 hr minimum between each, one for caloric testing and one for rotary chair testing. The test completed at each visit was counterbalanced. Caloric Testing: The caloric irrigations were performed 5 times, with the ears randomized and tasking conditions randomized. Rotary Chair Testing: Rotary chair sinusoidal harmonic acceleration testing was performed 5 times at 0.08 Hz with the tasking conditions randomized. Results Tasking of any kind resulted in significantly larger peak SPV responses when compared to the no tasking condition for rotary chair testing. When comparing each type of tasking, no significant differences were noted. No significant difference was noted when comparing the conditions with tasking to the no tasking condition for caloric testing. Conclusions Clinically, either mental or tactile tasking can be utilized as a method to reduce VOR suppression during rotary chair testing. As no difference was found when comparing different verbal tasks to each other, the type of tasking can be catered to the patient. If verbal tasking cannot be completed, the braiding tactile task is a valid substitution. Caloric results varied widely across subjects and did not reach statistical significance, so conclusions on the need for tasking cannot be drawn.

PMID:34415794 | DOI:10.1044/2021_AJA-20-00227

Viral Immunol. 2021 Aug 19. doi: 10.1089/vim.2020.0256. Online ahead of print.

ABSTRACT

Dengue virus and Chikungunya virus are arboviruses that affect thousands of people worldwide annually. The mechanisms involved in viral pathogenesis still need to be better understood. Single nucleotide polymorphisms (SNPs) in immune genes may be involved in the protection, susceptibility, and/or progression of these diseases. This study was performed to investigate the SNP -174 G/C in the interleukin-6 (IL-6) gene in patients with dengue or chikungunya from Northeastern Brazil. A total of 581 blood samples were analyzed, of which 244 were part of the negative control group, genomic DNA was extracted, and the SNP was genotyped using real-time polymerase chain reaction (PCR). The data obtained were used to conduct statistical analyses of the genotype and allele frequencies. We suggest that the G/C genotype and C allele of the SNP -174 G/C in the IL-6 gene are related to protection against dengue in the studied population. No significant differences were observed in chikungunya patients. This is the first study that assessed the association of the SNP -174 G/C in patients with chikungunya. We identified the presence of the C allele as a protective factor against dengue in the studied population.

PMID:34415813 | DOI:10.1089/vim.2020.0256

Lymphat Res Biol. 2021 Aug 19. doi: 10.1089/lrb.2021.0040. Online ahead of print.

ABSTRACT

Background: In patients with secondary upper limb lymphedema, positive correlations have been observed between the dermal back flow (DBF) type and visualization of lymph nodes around the clavicle, between the former and the lymph flow pathway type, and between the latter and the visualization of lymph nodes around the clavicle when using single photon-emission computed tomography/computed tomography/lymphoscintigraphy (SPECT-CT LSG). Methods and Results: We analyzed the associations between the visualization of inguinal lymph nodes, the lymph flow pathway type, and the DBF type using SPECT-CT LSG in 81 patients with unilateral secondary lower limb lymphedema by statistical analysis using Fisher’s exact test. We revealed that the lymph flow pathways in the lower limb can be classified into nine types because the type in the lower leg is not always equal to the type in the thigh. Associations were observed between the visualization of inguinal lymph nodes and types of DBF (p < 0.01), between the types of lymph flow pathway in the thighs and visualization of the inguinal lymph nodes (p = 0.02), and between the lymph flow pathway types in the thighs and lower legs (p < 0.01). Conclusion: Detriment to the superficial lymph flow pathways in the lower limb appears to usually start from the proximal side, and deep pathways are considered to become dominant from a compensatory perspective as lymphedema severity increases.

PMID:34415778 | DOI:10.1089/lrb.2021.0040

Surg Endosc. 2021 Aug 20. doi: 10.1007/s00464-021-08659-9. Online ahead of print.

ABSTRACT

BACKGROUND: Submucosal tunneling endoscopic resection (STER) and endoscopic submucosal excavation (ESE) are less-invasive therapeutic alternatives to surgical resection for the removal of esophageal or gastric submucosal tumors (SMTs). This study aimed to comparing STER versus ESE for the resection of esophageal and gastric SMTs from the muscularis propria.

METHODS: This systematic review and meta-analysis was reported in accordance with PRISMA guidelines through December 2020. Pooled outcome measures included complete resection, en bloc resection, bleeding, perforation, adverse events, recurrence, procedure duration, and length of hospital stay. Risk ratio (RR) and mean difference (MD) was calculated as well as Peto time-to-event analyses to determine recurrence rate.

RESULTS: Five retrospective cohort studies (n = 269 STER versus n = 319 ESE) were included. There was no difference in rates of complete resection [RR: 1.01 (95% CI 0.94, 1.07)], en bloc resection [RR: 0.95 (95% CI 0.84, 1.08)], recurrence [OR: 1.18 (95% CI 0.33, 4.16)], and total adverse events [RR: 1.33 (95% CI 0.78, 2.27)]. Specific adverse events including rates of perforation [RR: 0.57 (95% CI 0.12, 2.74)] and bleeding [RR: 1.21 (95% CI 0.30, 4.88)] were not different between STER and ESE. There was a statistical difference when evaluating procedure time, with the STER group presenting significantly larger values [MD: 24.62 min (95% CI 20.04, 29.20)].

CONCLUSION: STER and ESE were associated with similar efficacy and safety; however, ESE was associated with a significantly decreased time to complete the procedure.

PMID:34415431 | DOI:10.1007/s00464-021-08659-9

Clin Oral Investig. 2021 Aug 20. doi: 10.1007/s00784-021-04132-y. Online ahead of print.

ABSTRACT

OBJECTIVES: A university-based randomized clinical study evaluated the 5-year performance of chairside-fabricated zirconia-reinforced lithium silicate (ZLS)-ceramic partial crowns.

MATERIAL AND METHODS: Forty-five patients were restored with 61 chairside-fabricated ZLS-restorations (Cerec SW 4.2, Dentsply Sirona, Germany; Vita Suprinity, Vita Zahnfabrik, Germany). Deviating from the manufacturers’ recommendations, restorations with reduced minimum material thicknesses (MMT) were fabricated: group 1, MMT = 0.5-0.74 mm (n = 31); group 2, MMT = 0.75-1.0 mm (n = 30). For luting, a self-adhesive cement (SAC) or a total-etch technique with a composite cement (TEC) was applied. Statistical evaluation was performed by time-to-event analysis (Kaplan-Meier). Possible covariates of the survival (SVR) and success rates (SCR), evaluated in a Cox regression model, were MMT, restoration position (premolar/molar), and cementation technique (SAC vs. TEC).

RESULTS: Forty patients (54 restorations, premolars, n = 23; molars, n = 31) participated in the 5-year follow-up. Five losses due to ceramic fractures occurred in group 1 (n = 28) (SVR: 83.0% [95% confidence interval (CI): 0.71-0.96]). Group 2 (n = 26) showed no losses (SVR: 100%). The success rate for partial crowns placed on premolars was 100% and 69% (95% CI: 0.54-0.84) for molar restorations. Recementation was required in 4 restorations with SAC (SCR: 86% [95% CI: 0.73-0.99]; SCR-DC: 100%). Restorations in group 2 showed a significantly reduced risk of material fracture hazard ratio (HR) = 0.09, p = 0.0292) compared with the restorations in group 1. Molar partial crowns showed an increased risk for a clinical intervention (HR = 5.26, p = 0.0222) compared to premolar restorations.

CONCLUSIONS: Material thickness and position of the restoration are risk factors influencing the survival and success rate of ZLS-ceramic partial crowns.

CLINICAL RELEVANCE: Observation of an MMT of at least 0.75-1.0 mm for ZLS-ceramics is essential to avoid material-related fractures.

CLINICAL TRIAL REGISTRATION: German Clinical Trails Register (trial number: DRKS00005611).

PMID:34415434 | DOI:10.1007/s00784-021-04132-y