Tag: pubmed

J Pediatr Nurs. 2021 Jun 23;60:198-206. doi: 10.1016/j.pedn.2021.06.015. Online ahead of print.

ABSTRACT

PURPOSE: During the COVID-19 pandemic, pediatric nurses at one medical center in New York assumed care of COVID-19 adult patients. The purpose of this study was to understand pediatric nurses’ experiences during the peak of the COVID-19 pandemic, when they were caring for patients outside of their usual practice.

DESIGN AND METHODS: A qualitative descriptive study was implemented, and a descriptive survey was sent to all pediatric nurses who worked during the peak of the pandemic, from March 2020 – May 2020. Categorical responses were analyzed using descriptive statistics and free texts were coded to develop central themes.

RESULTS: Four themes emerged from the data: concerns for safety, unprepared to care, nurses’ emotional responses, and persevering together.

CONCLUSIONS: As pediatric nurses adjusted to caring for a new disease and a new population of patients, concerns of safety and preparedness emanated. The need for teamwork and support was emphasized by nurses. The impact that nurses’ experiences had on their emotional wellbeing was also highlighted.

PRACTICE IMPLICATIONS: Exploring pediatric nurses’ experiences during a pandemic is important, as it furthers understanding and guides efforts to enhance preparedness for a future pandemic or public health emergency. Findings from this study illustrate the need to provide nurses with support for both their physical and emotional health.

PMID:34229296 | DOI:10.1016/j.pedn.2021.06.015

Clin Nutr. 2021 Jun 17;40(7):4616-4623. doi: 10.1016/j.clnu.2021.06.012. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Mixed oil intravenous lipid emulsion (MO ILE) that contains 30% soybean oil (SO), 30% medium chain triglycerides, 25% olive oil and 15% fish oil can benefit hospitalized patients receiving parenteral nutrition (PN) but there are very few studies on its long-term use. Our goal was to evaluate the clinical outcomes of adults receiving home PN (HPN) with MO versus those receiving SO ILE over a 2-year period.

METHOD: This is a retrospective analysis of data collected prospectively from a cohort of patients recorded in the Canadian HPN Registry over a 2-year period. HPN patients from academic programs across Canada were entered in the Registry according to a validated protocol. For this study, demographic, nutritional, laboratory and clinical data were extracted from January 1st 2015, when MO lipid emulsion became available in Canada, to July 24th 2019. Clinical data for each patient included: number of hospitalizations, number of hospitalizations related to HPN and number of hospitalization days related to HPN, over a year; incidence of line sepsis per 1000 catheter days and mortality. Data are presented as median (1st, 3rd quartile) for continuous variables and frequency (percentage) for categorical variables. Comparisons between groups were performed using two sample t-test or Wilcoxon Rank Sum tests for continuous variables and Chi-square tests or Fisher’s exact tests for categorical variables. Univariate and multiple linear regressions were also carried out. Statistical significance is set at a p-value <0.05.

RESULTS: A total of 120 patients were included (MO n = 68, SO n = 52). Significant differences at baseline between the two groups were a higher use of Hickman line (62.12% vs 42%, p = 0.038) and more western Canada based hospital care with MO (75% vs 42.31%, p = 0.0002). The MO group had significantly more hospitalizations (p = 0.001), more hospitalizations related to HPN (p = 0.012) and more hospitalization days related to HPN (p = 0.016) per patient per year compared to SO patients. There was no significant difference between groups for line sepsis per 1000 catheter days (MO: 0.05 (0.0, 1.0) vs SO: 0.0 (0.0, 0.22), p = 0.053) or mortality. All other variables, including biochemical variables, were similar between groups. In a multiple regression analysis, the following factors were significantly associated with a greater number of hospitalizations per patient per year: use of MO, high blood glucose from the last recorded value and having died by the end of the study period.

CONCLUSION: This 2-year prospective cohort study suggests an increased risk of hospitalization in HPN patients receiving MO lipid emulsion. The long-term effect of using MO lipid emulsion in HPN patients should be further evaluated using a large randomized controlled trial. THE STUDY WAS REGISTERED IN CLINICALTRIALS.GOV: (NCT02299466).

PMID:34229267 | DOI:10.1016/j.clnu.2021.06.012

Clin Nutr. 2021 Jun 21;40(7):4633-4641. doi: 10.1016/j.clnu.2021.06.009. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Sarcopenic obesity (SO), which refers to the coexistence of sarcopenia and obesity. It can lead to physical disability, morbidity, and even mortality. This systematic review and meta-analysis aimed to estimate the global prevalence of SO in older adults.

METHODS: We searched PubMed, Embase, and Web of Science for studies reporting the prevalence of SO from inception to December 2020. Two researchers independently screened the literature, evaluated study quality, and extracted data. A random-effects model was used to pool the estimates for the prevalence of SO. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed using a funnel plot and the Egger test. All statistical analyses were performed using Stata 15.0 software.

RESULTS: This review included 50 studies, we found that the global prevalence of SO in older adults was 11%. Subgroup analyses showed that the prevalence of SO was higher among studies using diagnostic criteria of muscle mass alone (15%) to diagnose sarcopenia, using dual-energy X-ray absorptiometry (15%) to assess muscle mass, and those focused on age ≥ 75 years old (23%), hospitalized (16%), South Americans (21%) and North Americans (19%). There were no significant differences in the prevalence of SO among studies using body fat percentage (10%), body mass index (13%), waist circumference (16%) to diagnose obesity and in female (14%), male (10%) patients. Sensitivity analysis showed that none of the studies affected the overall pooled results. Meta-regression analysis found that publication year, geographical region, study setting, and the diagnostic criteria of sarcopenia were sources of heterogeneity.

CONCLUSION: This meta-analysis indicated SO affects more than one in ten older adults globally. Therefore, we should attach importance to the screening and early diagnosis of SO in older adults, then selecting appropriate interventions to reduce the occurrence of it and various adverse outcomes in this demographic.

PMID:34229269 | DOI:10.1016/j.clnu.2021.06.009

J Neuroimmunol. 2021 Jul 1;358:577653. doi: 10.1016/j.jneuroim.2021.577653. Online ahead of print.

ABSTRACT

BACKGROUND: Aseptic meningitis can be caused by autoimmune diseases, such as lupus and sarcoidosis. Aseptic meningitis with leptomeningeal enhancement can be the initial presentation of a neuroinflammatory syndrome associated with antibodies to myelin oligodendrocyte glycoprotein (MOG-abs). MOG-abs is a serum biomarker for MOG-associated disorder (MOG-AD), an acquired demyelinating syndrome that includes features of neuromyelitis optica, multiple sclerosis, optic neuritis, and acute disseminated encephalomyelitis. The purpose of this study is to review cases of aseptic meningitis and leptomeningeal enhancement associated with MOG-abs.

METHODS: Systematic review using PubMed, Embase, Ovid MEDLINE, Web of Science Core Collection, and Google Scholar up to December 2020 was performed. Cases of MOG-AD were included if they met the following criteria: 1) Initial clinical presentation of aseptic meningitis; 2) positive leptomeningeal enhancement and 3) MOG-Ab seropositivity. Descriptive statistics were used. This analysis was limited to the cases available in the literature.

RESULTS: 11 total cases of aseptic meningitis and leptomeningeal enhancement in setting of MOG-ab were identified. Demyelinating type T2 lesions were also present at time of presentation in 6/11; however, 5/11 of patients had leptomeningeal enhancement alone without demyelinating lesions. All 5 patients required immunotherapy for improvement, including one patient with symptoms for 28 days, with 4/5 receiving steroids and 1/5 receiving intravenous immunoglobulin (IVIG).

CONCLUSIONS: Aseptic meningitis with leptomeningeal enhancement can be the initial presenting symptom of MOG-AD. MOG-ab testing should be considered in a patient presenting with aseptic meningitis and leptomeningeal enhancement of unknown etiology.

PMID:34229204 | DOI:10.1016/j.jneuroim.2021.577653

J Clin Virol. 2021 Jun 27;141:104904. doi: 10.1016/j.jcv.2021.104904. Online ahead of print.

ABSTRACT

BACKGROUND: Most COVID-19 patients experience non-severe illness. The presence of SARS-CoV-2 antibodies suggest possible protection against re-infections in prior SARS-CoV-2 infected individuals.

OBJECTIVES: The aims of this prospective observational study were to longitudinally assess the antibody response during the first 4-6 months after polymerase chain reaction (PCR) confirmed SARS-CoV-2 infection, and to study the diagnostic performance of four different enzyme-linked immunosorbent assays (ELISAs) and a surrogate virus neutralization test (sVNT) in symptomatic healthcare workers (HCWs) with non-severe COVID-19.

STUDY DESIGN: HCWs in a teaching hospital were included between March 8 and June 15, 2020, when they had a PCR-confirmed SARS-CoV-2 infection in the past 3 months. The performances of four ELISAs (Wantai, Bio-Rad Platelia, BioTrading Immy clarus, and Euroimmun) were evaluated in serum samples obtained at the moment of study inclusion and subsequently at 1, 2 and 3 months thereafter. Furthermore, in the last available serum sample sVNT by GenScript was performed.

RESULTS: 309 samples from 80 positive HCWs were included of whom 70 (88%) were SARS-CoV-2 seropositive. The detection rates of SARS-CoV-2 antibodies by the different ELISAs were heterogenous ranging from 64% for the Euroimmun ELISA to 88% for the Wantai ELISA. The Wantai ELISA had the highest and almost perfect agreement with sVNT (96%, Cohen’s kappa 0.83).

CONCLUSION: SARS-CoV-2 (neutralizing) antibodies were detectable in most symptomatic individuals with non-severe COVID-19. The presence of antibodies remained stable up to six months after initial infection. There is large variability in diagnostic test performance between ELISA tests.

PMID:34229209 | DOI:10.1016/j.jcv.2021.104904

Clin Nutr. 2021 Jun 9;40(7):4535-4536. doi: 10.1016/j.clnu.2021.05.022. Online ahead of print.

NO ABSTRACT

PMID:34229256 | DOI:10.1016/j.clnu.2021.05.022

Med Image Anal. 2021 Jun 8;72:102128. doi: 10.1016/j.media.2021.102128. Online ahead of print.

ABSTRACT

Tracking of particles in temporal fluorescence microscopy image sequences is of fundamental importance to quantify dynamic processes of intracellular structures as well as virus structures. We introduce a probabilistic deep learning approach for fluorescent particle tracking, which is based on a recurrent neural network that mimics classical Bayesian filtering. Compared to previous deep learning methods for particle tracking, our approach takes into account uncertainty, both aleatoric and epistemic uncertainty. Thus, information about the reliability of the computed trajectories is determined. Manual tuning of tracking parameters is not necessary and prior knowledge about the noise statistics is not required. Short and long-term temporal dependencies of individual object dynamics are exploited for state prediction, and assigned detections are used to update the predicted states. For correspondence finding, we introduce a neural network which computes assignment probabilities jointly across multiple detections as well as determines the probabilities of missing detections. Training requires only simulated data and therefore tedious manual annotation of ground truth is not needed. We performed a quantitative performance evaluation based on synthetic and real 2D as well as 3D fluorescence microscopy images. We used image data of the Particle Tracking Challenge as well as real time-lapse fluorescence microscopy images displaying virus structures and chromatin structures. It turned out that our approach yields state-of-the-art results or improves the tracking results compared to previous methods.

PMID:34229189 | DOI:10.1016/j.media.2021.102128

Med Image Anal. 2021 Jun 23;72:102145. doi: 10.1016/j.media.2021.102145. Online ahead of print.

ABSTRACT

PURPOSE: Artificial-intelligence population-based automated quantification of placental maturation and health from a rapid functional Magnetic Resonance scan. The placenta plays a crucial role for any successful human pregnancy. Deviations from the normal dynamic maturation throughout gestation are closely linked to major pregnancy complications. Antenatal assessment in-vivo using T2* relaxometry has shown great promise to inform management and possible interventions but clinical translation is hampered by time consuming manual segmentation and analysis techniques based on comparison against normative curves over gestation.

METHODS: This study proposes a fully automatic pipeline to predict the biological age and health of the placenta based on a free-breathing rapid (sub-30 second) T2* scan in two steps: Automatic segmentation using a U-Net and a Gaussian process regression model to characterize placental maturation and health. These are trained and evaluated on 108 3T MRI placental data sets, the evaluation included 20 high-risk pregnancies diagnosed with pre-eclampsia and/or fetal growth restriction. An independent cohort imaged at 1.5 T is used to assess the generalization of the training and evaluation pipeline.

RESULTS: Across low- and high-risk groups, automatic segmentation performs worse than inter-rater performance (mean Dice coefficients of 0.58 and 0.68, respectively) but is sufficient for estimating placental mean T2* (0.986 Pearson Correlation Coefficient). The placental health prediction achieves an excellent ability to differentiate cases of placental insufficiency between 27 and 33 weeks. High abnormality scores correlate with low birth weight, premature birth and histopathological findings. Retrospective application on a different cohort imaged at 1.5 T illustrates the ability for direct clinical translation.

CONCLUSION: The presented automatic pipeline facilitates a fast, robust and reliable prediction of placental maturation. It yields human-interpretable and verifiable intermediate results and quantifies uncertainties on the cohort-level and for individual predictions. The proposed machine-learning pipeline runs in close to real-time and, deployed in clinical settings, has the potential to become a cornerstone of diagnosis and intervention of placental insufficiency. APPLAUSE generalizes to an independent cohort imaged at 1.5 T, demonstrating robustness to different operational and clinical environments.

PMID:34229190 | DOI:10.1016/j.media.2021.102145

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 20;263:198-204. doi: 10.1016/j.ejogrb.2021.06.022. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of our study was to assess the knowledge and attitudes toward expanded carrier screening (ECS) between the medical staff and general population in China.

STUDY DESIGN: It was a survey-based cross-sectional study in Chinese. We provided an online survey for the general public nationwide. We classified the population into the medical staff and general population to evaluate the knowledge gap and provide a reference for ECS’s education programs. Except for obstetrician-gynecologists and nurses in the department of Obstetrics and Gynecology, other medical staff were not included in our study. A total of 1947 questionnaires were collected from July 11, 2020 to February 10, 2021. Two hundred and eighty-four questionnaires were excluded from further analysis. The remaining 1663 cases were incorporated into the final analysis. Data were analyzed using IBM SPSS Statistics 26. Comparisons between categorical variables were tested by the use of crosstabs and χ2 test.

RESULTS: The total awareness rates of the knowledge about monogenic diseases and ECS in the respondents were low, with 35.7%, 26.1%, 3.3%, 23.3%, 24.1%, 55.2%, and 23.4% for questions Q1-Q7, respectively. Medical staff had more knowledge than general population. Knowledge about monogenic diseases and ECS was positively correlated with educational level. Most respondents showed a positive attitude toward ECS: 54.4% thought ECS was necessary, and 80.5% wanted to know more about monogenic diseases.

CONCLUSION: Although the public had little knowledge about monogenic disease and ECS, most of them showed a positive attitude. Our cross-analysis showed that medical staff had more knowledge compared to general population. Pre-test education for ECS can be carried out by medical staff who are not qualified for genetic counseling. ECS training for medical staff, especially obstetrician-gynecologist and nurse in the department of Obstetrics and Gynecology, can reduce the workload of genetic counseling.

PMID:34229183 | DOI:10.1016/j.ejogrb.2021.06.022

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 25;263:205-209. doi: 10.1016/j.ejogrb.2021.06.029. Online ahead of print.

ABSTRACT

OBJECTIVE: Women undergoing assisted reproductive treatment are usually concerned about the side effects caused by high doses of gonadotropin. A common inquiry of patients is concerning the weight gain as a consequence. The aim of this study was to evaluate if controlled ovarian stimulation increase the weight of women undergoing IVF treatment. Study design This retrospective cohort study included 734 women undergoing IVF treatment between January 2017 and May 2018 and had body weight measured on the day of ovarian stimulation starting (basal-weight) and on the hCG trigger day (hCG-weight). The difference of hCG-weight and basal-weight was calculated and correlated to number of oocytes retrieved and ovarian stimulation protocol. For 358 women, two international validated questionnaires to evaluate the anxiety and binge eating were applied at the end of ovarian stimulation and also associated to the body weight gain.

RESULTS: The basal-weight and hCG-weight were paired compared and demonstrate a statistically significant weight gain from basal to hCG-weight of a mean of 387.7 ± 720.4 g (p < 0.001). The weight gain had a positive correlation with the number of oocytes retrieved (Pearson correlation, r = 0.181; p < 0.001) but no correlation with the ovarian stimulation protocol. Regarding the questionnaires answered by patients, neither anxiety score (Pearson: r = -0,031; p = 0,561) nor binge eating score (Pearson: r = 0,069; p = 0,199) were correlated with weight gain from basal-weight to hCG- weight. However, patients who felt eating more during the treatment had a higher weight gain (p < 0.001) independently of the number of oocytes retrieved.

CONCLUSIONS: The weight gain is possibly a result from edema and is clinically irrelevant despite of the statistical significance and will probably be resolved in some days after oocytes retrieval. A small “weight gain” was observed and associated to the number of oocytes retrieved regardless of protocol and medication used in the ovarian stimulation.

PMID:34229184 | DOI:10.1016/j.ejogrb.2021.06.029