Tag: pubmed

Int J Radiat Biol. 2021 May 10:1-33. doi: 10.1080/09553002.2021.1917786. Online ahead of print.

ABSTRACT

PURPOSE: Risks of occupational radiation exposures of workers involved in uranium refining and processing (“uranium processing workers“) may be different from risks of other workers from the nuclear fuel cycle. Pooling of individual-level data from published studies and analysis using similar dosimetry and statistical methods might provide valuable insights into risks from occupational uranium and external ionizing radiation exposures.

METHODS: We pooled the data for workers from four uranium processing facilities (Fernald Feed Materials Production Center, Ohio; Mallinckrodt Chemical Works Uranium Division, Missouri; Middlesex Sampling Plant, New Jersey; and the Port Hope Radium and Uranium Refining and Processing Plant, Canada). Employment began as early as the 1930s in Canada and follow-up for vital status was as late as 2017. These facilities used similar methods to process Belgian Congo pitchblende ore which contained high concentrations of uranium, radium, and their decay products. In addition, workers were exposed to elevated levels of gamma radiation, fission product contaminants in recycled uranium and ambient radon decay products. Non-radiation exposures of industrial hygiene concern were silica dust inhalation, heavy metal toxicity from uranium, solvents, acid mists and chemicals associated with uranium processing. Exposure and outcome data were harmonized using similar definitions and dose reconstruction methods. Standardized mortality ratios (SMR) were estimated by comparing mortality in the pooled cohort with age-, sex- and calendar time-specific general population mortality rates for the U.S. and Canada.

RESULTS: Over 12,400 workers will be evaluated for cancer and non-cancer mortality in relation to exposures to uranium byproducts and gamma radiation (including ∼1,300 females). In total, death from 560 lung cancers, 503 nonmalignant respiratory diseases, 67 renal diseases, 1,596 ischemic heart diseases, and 101 dementia and Alzheimer’s diseases (AD) were detected among male workers during follow-up. Mean cumulative doses were 45 millisievert for whole-body external exposures and 172 milligray for lung dose from radon decay products. Of the 16 pooled SMRs, seven were above 1.00, none were significantly low, and only one was significantly high, i.e., dementia and AD among males (SMR =1.29; 95% confidence interval: 1.04,1.54).

CONCLUSIONS: This is the largest study to date to examine health risks in uranium processing workers (excluding uranium enrichment workers). The pooling of uranium processing worker data will address issues of importance today, specifically the concerns for cleanup workers and environmental contamination from the operation of past and present nuclear reactor and radiation facilities, reactor accidents, and possible terrorist events.

PMID:33970767 | DOI:10.1080/09553002.2021.1917786

J Biomol Struct Dyn. 2021 May 10:1-21. doi: 10.1080/07391102.2021.1924271. Online ahead of print.

ABSTRACT

The main-protease (M^pro) catalyzes a crucial step for the SARS-CoV-2 life cycle. The recent SARS-CoV-2 presents the main protease (M^CoV2_pro) with 12 mutations compared to SARS-CoV (M^CoV1_pro). Recent studies point out that these subtle differences lead to mobility variances at the active site loops with functional implications. We use metadynamics simulations and a sort of computational analysis to probe the dynamic, pharmacophoric and catalytic environment differences between the monomers of both enzymes. So, we verify how much intrinsic distinctions are preserved in the functional dimer of M^CoV2_pro, as well as its implications for ligand accessibility and optimized drug screening. We find a significantly higher accessibility to open binding conformers in the M^CoV2_pro monomer compared to M^CoV1_pro. A higher hydration propensity for the M^CoV2_pro S2 loop with the A46S substitution seems to exercise a key role. Quantum calculations suggest that the wider conformations for M^CoV2_pro are less catalytically active in the monomer. However, the statistics for contacts involving the N-finger suggest higher maintenance of this activity at the dimer. Docking analyses suggest that the ability to vary the active site width can be important to improve the access of the ligand to the active site in different ways. So, we carry out a multiconformational virtual screening with different ligand bases. The results point to the importance of taking into account the protein conformational multiplicity for new promissors anti M^CoV2_pro ligands. We hope these results will be useful in prospecting, repurposing and/or designing new anti SARS-CoV-2 drugs.Communicated by Ramaswamy H. Sarma.

PMID:33970798 | DOI:10.1080/07391102.2021.1924271

Afr J Prim Health Care Fam Med. 2021 Apr 30;13(1):e1-e7. doi: 10.4102/phcfm.v13i1.2677.

ABSTRACT

BACKGROUND: Solid waste dump sites have proven to have potentially high risk to human health as it serves as a source of air, soil and underground water pollution.

AIM: This study aimed to assess and compare the knowledge, respiratory disorders and skin disorders between residents living close to and far from landfill sites in Lagos State, Nigeria.

SETTING: Igando (a community within 5 km close to) and Badagry (a community beyond 5 km from) Solous Landfill sites in Lagos state, Nigeria.

METHODS: A comparative cross-sectional study amongst 103 respondents recruited from each of the two study sites by multistage sampling method was carried out. Data were collected using pretested, structured, interviewer-administered questionnaire, and analysed using Microsoft Excel 2007, EPI Info 7 and WinPepi statistical software packages. Student t-test, Fisher’s exact and Chi-square tests were carried out. The p ≤ 0.05 was considered statistically significant.

RESULTS: The mean age of Igando and Badagry respondents was 34.18 ± 10.21 years and 32.62 ± 9.84 years, respectively. The two communities differed significantly (p 0.0001) with respect to distance of workplace from landfill site and duration of stay in the residential location. The mean knowledge score of respondents on respiratory and skin disorders associated with solid waste dump site close to landfill sites (82.53 ± 20.60) was statistically significantly higher than those of respondents far from landfill sites (71.84 ± 20.57) (p = 0.0003). Respiratory and skin disorders experiences of respondents close to landfill sites were statistically significantly (p 0.0001) higher than those of residents far from landfill sites with respect to wheezing, frequent sneezing, unpleasant odour, fever and skin rashes.

CONCLUSION: Respiratory and skin disorders experienced by respondents close to landfill sites are higher than those of residents far from landfill sites. Landfill sites should not be located close to human settlements.

PMID:33970013 | DOI:10.4102/phcfm.v13i1.2677

Sci Prog. 2021 Apr-Jun;104(2):368504211010604. doi: 10.1177/00368504211010604.

ABSTRACT

The outcomes of patient care are improved by adequate knowledge, practical skills, and positive attitude. Currently, there is a lack of data on medical research activities among resident doctors in Saudi Arabia. This study aimed to evaluate the perception, barriers, and research attitudes among various residency programs running in different cities of Saudi Arabia. A total of 434 surgical and medical residents participated in the current study. A cross-sectional study encompassing multiple training centers in the eastern province of Saudi. Convenient sampling technique was used to include all the working training residents. A self-administered questionnaire was formulated for data collection. Descriptive statistics were employed to analyze the data. The mean age of the residents with various specialties was 27.83 ± 2.41 years. Approximately 61.7% had participated in research, while 38.3% had never participated in any research. A total of 26% of junior and 44% of senior residents have one publication only. While 11% of junior and 9% of senior residents have three publications or more. Inadequate facilities for research, lack of baseline research skills, and personal commitments were the reasons which over 60% of respondents had agreed on. Institutional reasons: lack of professional supervisor support and lack of research curriculum in the training program was reported by 308 (71%) and 305(70.3%) residents, respectively. A lack of interest for research was prevailed more in males (19%) compared to females (14%) (OR 1.43, 95% CI: 0.86-2.38, p-value 0.17). A subset of residents had one or three publications, while some had none. A lack of baseline research skills and inadequate facilities for scientific explorations, time, and funds were the main constraints among training residents. However, several residents had a positive attitude toward research but fewer publications. Thus, training in medical research methodology should be obligatory in the residency curriculum in all specialties. Further research is needed.

PMID:33970049 | DOI:10.1177/00368504211010604

Stat Methods Med Res. 2021 May 10:9622802211009265. doi: 10.1177/09622802211009265. Online ahead of print.

ABSTRACT

This functional joint model paper is motivated by a chronic kidney disease study post kidney transplantation. The available kidney organ is a scarce resource because millions of end-stage renal patients are on the waiting list for kidney transplantation. The life of the transplanted kidney can be extended if the progression of the chronic kidney disease stage can be slowed, and so a major research question is how to extend the transplanted kidney life to maximize the usage of the scarce organ resource. The glomerular filtration rate is the best test to monitor the progression of the kidney function, and it is a continuous longitudinal outcome with repeated measures. The patient’s survival status is characterized by time-to-event outcomes including kidney transplant failure, death with kidney function, and death without kidney function. Few studies have been carried out to simultaneously investigate these multiple clinical outcomes in chronic kidney disease stage patients based on a joint model. Therefore, this paper proposes a new functional joint model from this clinical chronic kidney disease study. The proposed joint models include a longitudinal sub-model with a flexible basis function for subject-level trajectories and a competing-risks sub-model for multiple time-to event outcomes. The different association structures can be accomplished through a time-dependent function of shared random effects from the longitudinal process or the whole longitudinal history in the competing-risks sub-model. The proposed joint model that utilizes basis function and competing-risks sub-model is an extension of the standard linear joint models. The application results from the proposed joint model can supply some useful clinical references for chronic kidney disease study post kidney transplantation.

PMID:33970050 | DOI:10.1177/09622802211009265

Afr J Prim Health Care Fam Med. 2021 Apr 28;13(1):e1-e6. doi: 10.4102/phcfm.v13i1.2424.

ABSTRACT

BACKGROUND: Episiotomy was introduced into clinical practice without clear evidence of its benefits.The knowledge and understanding of episiotomy guidelines and practice by healthcare workers is substandard in our setting; hence, the injudicious use of this procedure have led to high rates.

AIM: To assess the knowledge, perception and practice of episiotomy by healthcare workers.

SETTING: Research was conducted in a Pietermaritzburg complex, South AfricaMethods: A questionnaire-based survey was conducted amongst healthcare workers regarding episiotomy practice. In addition to providing demographic data, the participants were requested to respond to 35 proposed statements regarding episiotomy practice. Data were analysed using SPSS (Statistical Package for the Social Sciences) software.

RESULTS: One hundred and forty-two midwives and 66 medical practitioners completed the questionnaires. There were variations in responses to several statements on episiotomy practice by medical practitioners and nurses based on their level of experience. This study found that the majority of HCWs did not have access to a protocol or policy on episiotomy practice in their units; furthermore, nor knowledge of the South African guidelines for maternity care on episiotomy practice. Significantly, more medical practitioners felt a need for more in-service training and an increase in the number of episiotomies performed under supervision. The commonly reported reason for performing an episiotomy by both medical practitioners and midwives was to reduce 3rd – 4th degree perineal tears.

CONCLUSION: Healthcare workers in our setting displayed poor knowledge about the practice of episiotomy and were not aware of existing national guidelines on episiotomy practice.

PMID:33970009 | DOI:10.4102/phcfm.v13i1.2424

Afr J Prim Health Care Fam Med. 2021 Apr 30;13(1):e1-e6. doi: 10.4102/phcfm.v13i1.2664.

ABSTRACT

BACKGROUND: The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosis.

AIM: The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patients.

SETTING: The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the Congo.

METHODS: This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients’ sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p 0.05 level of statistical significance.

RESULTS: The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77-5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95-6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83-3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94-7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35-6.39], p = 0.008).

CONCLUSION: This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment.

PMID:33970011 | DOI:10.4102/phcfm.v13i1.2664

Afr J Prim Health Care Fam Med. 2021 Apr 30;13(1):e1-e7. doi: 10.4102/phcfm.v13i1.2653.

ABSTRACT

BACKGROUND: Umbilical cord infection contributes significantly to neonatal mortality rate in sub-Saharan Africa. Studies have shown low knowledge of chlorhexidine (CHX) gel for umbilical cord management amongst mothers in low-resource settings, including Nigeria.

OBJECTIVE: The objective of this study was to assess the effectiveness of a supportive-educative nursing intervention programme on knowledge of CHX gel amongst mothers in Cross River State, Nigeria.

METHODS: A quasi-experimental study design was used, and study participants comprised 168 expectant mothers, who were purposely selected and assigned to randomised control and intervention groups. The instrument for data collection was a researcher-developed structured questionnaire. The data were analysed using Statistical Package for Social Sciences version 23 for descriptive and inferential statistics at significant level was set at p 0.05.

RESULTS: The result showed that at post-test the knowledge score of mothers on CHX gel improved significantly in the intervention group (t 77 = 24.394; p 0.05). The result showed no significant difference between mothers’ demographic variables and knowledge of CHX gel.

CONCLUSION: A supportive-educative nursing intervention programme could effectively improve knowledge of CHX gel for umbilical cord management amongst mothers. This underscores the need to improve mothers’ knowledge of CHX gel by healthcare personnel.

PMID:33970012 | DOI:10.4102/phcfm.v13i1.2653

Geospat Health. 2021 May 5;16(1). doi: 10.4081/gh.2021.964.

ABSTRACT

This study examines the relationship between the suicide mortality rate and structural covariates in South Korea from 2008 to 2017 under Durkheim’s theory of suicide. It applies the dynamic spatial panel data model to explore both spatial and temporal aspects of the suicide phenomena recognising statistical limitations in previous suicide research based on either cross-sectional or longitudinal methodology. The results demonstrate that the suicide mortality rates in South Korea are spatially and temporally dependent on those of neighbouring units or its own time-lagged suicide mortality rates. Moreover, this study estimates that the divorce rate, unemployment rate and land price index, which are assumed to be proxies of social integration and regulation, significantly impact the suicide mortality rates. The results imply that deteriorating socioeconomic conditions are risk factors for the suicide mortality rate and suggests implementing policies to alleviate the high level of social disintegration caused by Korea’s deteriorating socioeconomic conditions.

PMID:33969967 | DOI:10.4081/gh.2021.964

Geospat Health. 2021 May 5;16(1). doi: 10.4081/gh.2021.966.

ABSTRACT

The number of homicides in Brazil has reached record numbers, and when the race/colour of the victims is considered-an extreme inequality is evident- with a particularly high number of deaths in black and brown populations. The goal of this work was to analyse homicide rates of black people in Brazil from the years 2000 to 2016, using generalized additive regression models, with a geo-spatial component. The statistics were applied to understand the social reasons for homicide risks in the black population in Brazil’s 26 states and Federal District with reference to the human development index and its components (education, longevity and income) as well as social inequality indices (Gini and Theil). This socioecological, epidemiological study to estimate the risk of homicide in the black population with a time series component, shows that this risk has increased linearly over time. Less longevity and low income correlated with a greater risk of homicide-while the Gini and Theil indices showed that in places where there are greater inequalities, there is also a higher risk of homicide in both black and non-black populations. The results – regarding the possibility of relating social indicators to homicide risk in the regional units under study, would support implementation of interventional public policy measures.

PMID:33969968 | DOI:10.4081/gh.2021.966