Pulse oximetry as a screening tool for congenital heart disease in neonates: A diagnostic study

Introduction: Many studies have been done for screening of congenital heart disease (CHD) in the neonatal period utilizing pulse oximetry as a screening tool along with routine clinical assessment, but none of them from our province. Objective: The objective of the study was to find out the diagnostic accuracy of pulse oximeter at three different sites as a screening tool to diagnose CHD among neonates. Methods: A diagnostic study was conducted in neonatal intensive care unit of a tertiary care hospital of Odisha from October 2016 to September 2018 after approval from the Institutional Ethics Committee. Three hundred and seventy-four neonates (both inborn and outborn) with gestational age >34 weeks were included in the study. Oxygen saturation (SpO2) in the right hand (RH), right foot (RF), and left foot (LF) was estimated by pulse oximeter among all participants after 10 min of postnatal life. All the study subjects were evaluated by two-dimensional (2D) echocardiography for the detection of CHDs. All the diagnostic accuracy tests (sensitivity [Sn], specificity [Sp], positive predictive value, negative predictive value, and diagnostic odds ratio) were calculated taking 2D echocardiography as the gold standard with software, and for all statistical purpose, p<0.05 was considered statistically significant. Results: Cutoff value of the RH SpO2 was 90.0% with Sn of 68.80% and Sp of 98.20%; area under curve (AUC) 0.851 (0.766 and 0.914), p<0.001, for the RF, SpO2 was 90.0% with Sn 78.0% and Sp 92.1%; AUC 0.865 (0.782 and 0.925), p<0.001, and for LF, it was 87% with Sn 77.1% and Sp 94.0%; AUC 0.864 (0.781 and 0.924), p<0.001. Conclusion: Along with the clinical skills, pulse oximetry can be used as an early screening tool for the detection of CHD in the neonatal period and of three different sites, RF found to be better

The educational use of social networking sites among medical and health sciences students : a cross campus interventional study

Acknowledgements The authors are grateful to all students who actively participated in both phases of the study and provided valuable data for this research. Funding None.Peer reviewedPublisher PD

Industrial heat island: a case study of Angul-Talcher region in India

Most of the urban heat island (UHI) studies are carried out in densely populated cities but core industrial areas are also potential sites of heat island effect despite having a comparatively lower population. In the present study, heat island assessment has been carried out for Angul-Talcher industrial area (ATIA) which is one of the oldest industrial areas of India and is still undergoing a transformation to accommodate more industries and mining operations. As the major contributors towards influencing local meteorology were expected to be industrial (and mining) activities, the heat island was studied as "industrial heat island" (IHI) rather than urban heat island. Industrial and mining sites were the most frequent nighttime canopy-layer heat island intensity (HIN) hotspots due to anthropogenic heat of associated industrial processes as well as built structures. During the daytime, croplands experienced the most frequent canopy-layer HIN hotspots which could be attributed to low moisture of the soils during the non-farming period of the field campaign. Hourly maximum atmospheric heat island intensities were observed in the range of 7-9 degrees C. Monthly maximum HINs ranged from 2.97 to 4.04 degrees C while 3-month mean HINs varied from 1.45 to 2.74 degrees C. Amongst different land use/land cover classes, the highest mean canopy-layer heat island intensity for the entire 3-month-long duration of field campaign during nighttime was assessed at the mining sites (3-month mean 2.74 degrees C) followed in decreasing order by the industrial sites (2.52 degrees C), rural and urban settlements (2.13 degrees C), and croplands (2.06 degrees C). Corresponding daytime canopy-layer heat island intensity was highest for the croplands (2.07 degrees C) followed in decreasing order by the mining sites (1.70 degrees C), rural and urban settlements (1.68 degrees C), and industry (1.45 degrees C)

"Enhancing Perinatal Outcomes In Gestational Diabetes Mellitus: A Midwifery Facilitator Based Approach"

Introduction: Gestational diabetes mellitus, or GDM, is a metabolic disorder that affects both expectant mothers and their developing fetuses. It increases the chance of several pregnancy and delivery complications. Babies born to women with gestational diabetes mellitus (GDM) are at risk for perinatal death, fetal macrosomia, low blood sugar, birth trauma, and congenital malformations. This paper explores the possibility of enhancing perinatal outcomes in GDM by applying a midwifery facilitator-based approach. Objectives: This study's primary objective is to assess the impact of a midwife facilitator-based approach on the management of gestational diabetes mellitus (GDM) and its associated complications in expectant mothers and their babies. Our objective is to create a midwifery facilitator approach model that provides recommendations for clinical practice. Methods: A prospective cohort study involving 111 mothers compared standard care with care led by midwives. The intervention group was chosen based on their preferences, and they received full support, which included education, lifestyle modifications, and assistance for mothers. A certified diabetes educator led the classes, which covered a variety of subjects like multiple pregnancies, chronic illnesses, and absences. Group 1 comprised 62 mothers who attended classes and follow-ups, while 49 mothers in Group 2 did not attend any of them. Consistency and low turnover were assured. Results: The Midwifery Facilitator-Based Approach, which considers psychological, emotional, and physical factors, fully manages GDM. Strict diabetes management, nutritional counseling, promoting a healthy diet, and aiding in stress reduction are all made possible by these midwives. They empower mothers with GDM to take care of themselves and allow informed decision-making, potentially improving perinatal outcomes and the general well-being of GDM-affected families. Conclusion: A promising strategy for improving perinatal outcomes in GDM is the facilitator-based approach used by midwives. It offers a treatment plan that is holistic in nature, taking into account the relationships between various aspects of health. By integrating midwifery into GDM management, we can enhance mothers' empowerment and comprehension, which will ultimately benefit moms and their infants

Altered respiratory microbiota composition and functionality associated with asthma early in life

BACKGROUND: The microbiota of the respiratory tract has an important role in maintaining respiratory health. However, little is known on the respiratory microbiota in asthmatic patients among Middle Eastern populations. This study investigated the respiratory microbiota composition and functionality associated with asthma in Emirati subjects. METHODS: We performed 16S rRNA and ITS2-gene based microbial profiling of 40 expectorated sputum samples from adult and pediatric Emirati individuals averaging 52 and 7 years of age, respectively with or without asthma. RESULTS: We report bacterial difference belonging to Bacteroidetes, Firmicutes, Fusobacteria and Proteobacteria phyla between asthmatic and non-asthmatic controls. Similarly, fungal difference belonging to Ascomycota, Basidiomycota phyla and other unclassified fungi. Differential abundance testing among asthmatic individuals with relation to Asthma Control Test show a significant depletion of Penicillium aethiopicum and Alternaria spp., among poorly controlled asthmatics. Moreover, data suggest a significant expansion of Malassezia spp. and other unclassified fungi in the airways of those receiving steroids and leukotriene receptor antagonists’ combination therapy, in contrast to those receiving steroids alone. Functional profiling from 16S data showed marked differences between pediatric asthmatic and non-asthmatic controls, with pediatric asthmatic patients showing an increase in amino acid (p-value < 5.03 × 10− 7), carbohydrate (p-value < 4.76 × 10− 7), and fatty acid degradation (p-value < 6.65 × 10− 7) pathways, whereas non-asthmatic controls are associated with increase in amino acid (p-value < 8.34 × 10− 7), carbohydrate (p-value < 3.65 × 10− 7), and fatty acid (p-value < 2.18 × 10− 6) biosynthesis pathways in concordance with enterotype composition. CONCLUSIONS: These differences provide an insight into respiratory microbiota composition in Emirati population and its possible role in the development of asthma early in life. This study provides important information that may eventually lead to the development of screening biomarkers to predict early asthma development and novel therapeutic approaches

Exploring the effect of estrogen on Candida albicans hyphal cell wall glycans and ergosterol synthesis

Increased levels of 17-β estradiol (E2) due to pregnancy in young women or to hormonal replacement therapy in postmenopausal women have long been associated with an increased risk of yeast infections. Nevertheless, the effect underlying the role of E2 in Candida albicans infections is not well understood. To address this issue, functional, transcriptomic, and metabolomic analyses were performed on C. albicans cells subjected to temperature and serum induction in the presence or absence of E2. Increased filament formation was observed in E2 treated cells. Surprisingly, cells treated with a combination of E2 and serum showed decreased filament formation. Furthermore, the transcriptomic analysis revealed that serum and E2 treatment is associated with downregulated expression of genes involved in filamentation, including HWP1, ECE1, IHD1, MEP1, SOD5, and ALS3, in comparison with cells treated with serum or estrogen alone. Moreover, glucose transporter genes HGT20 and GCV2 were downregulated in cells receiving both serum and E2. Functional pathway enrichment analysis of the differentially expressed genes (DEGs) suggested major involvement of E2 signaling in several metabolic pathways and the biosynthesis of secondary metabolites. The metabolomic analysis determined differential secretion of 36 metabolites based on the different treatments’ conditions, including structural carbohydrates and fatty acids important for hyphal cell wall formation such as arabinonic acid, organicsugar acids, oleic acid, octadecanoic acid, 2-keto-D-gluconic acid, palmitic acid, and steriacstearic acid with an intriguing negative correlation between D-turanose and ergosterol under E2 treatment. In conclusion, these findings suggest that E2 signaling impacts the expression of several genes and the secretion of several metabolites that help regulate C. albicans morphogenesis and virulence

Altered Composition of the Oral Microbiota in Depression Among Cigarette Smokers: A Pilot Study

Alterations in the oral microbiota composition may influence mental health. However, linkages between compositional changes in the oral microbiota and their role in mental health among cigarette smokers remain largely unknown. In this study, we used shotgun metagenomics data for the oral microbiome of 105 participants. The data showed Bacteroidota, Fusobacteriota, Firmicutes, Proteobacteria, and Actinobacteria to be the most abundant phyla; Streptococcus, Haemophilus D, and Veillonella are the most abundant genera. Then, we clustered our subjects into avoidance and activation groups based on the behavioral activation for depression scale (BADS). Interestingly, the avoidance group exhibited a higher oral microbiome richness and diversity (alpha diversity). Differential abundance testing between BADS avoidance and activation groups showed the phyla Bacteroidota (effect size 0.5047, q = 0.0037), Campylobacterota (effect size 0.4012, q = 0.0276), Firmicutes A (effect size 0.3646, q = 0.0128), Firmicutes I (effect size 0.3581, q = 0.0268), and Fusobacteriota (effect size 0.6055, q = 0.0018) to be significantly increased in the avoidance group, but Verrucomicrobiota (effect size−0.6544, q = 0.0401), was found to be significantly decreased in the avoidance risk group. Network analysis of the 50 genera displaying the highest variation between both groups identified Campylobacter B, Centipeda, and Veillonella as hub nodes in the avoidance group. In contrast, Haemophilus and Streptococcus were identified as hub nodes in the activation group. Next, we investigated functional profiles of the oral microbiota based on BADS avoidance and activation groups and found Lysine degradations pathway was significantly enriched between both groups (ANCOM-BC, q = 0.0692). Altogether, we provide evidence for the presence of depression-related changes in the oral microbiota of smokers and possible functional contribution. The identified differences provide new information to enrich our understanding of oral microbiota-brain axis interplay and their potential impact on mental health

Dynamics of Hot QCD Matter -- Current Status and Developments

The discovery and characterization of hot and dense QCD matter, known as Quark Gluon Plasma (QGP), remains the most international collaborative effort and synergy between theorists and experimentalists in modern nuclear physics to date. The experimentalists around the world not only collect an unprecedented amount of data in heavy-ion collisions, at Relativistic Heavy Ion Collider (RHIC), at Brookhaven National Laboratory (BNL) in New York, USA, and the Large Hadron Collider (LHC), at CERN in Geneva, Switzerland but also analyze these data to unravel the mystery of this new phase of matter that filled a few microseconds old universe, just after the Big Bang. In the meantime, advancements in theoretical works and computing capability extend our wisdom about the hot-dense QCD matter and its dynamics through mathematical equations. The exchange of ideas between experimentalists and theoreticians is crucial for the progress of our knowledge. The motivation of this first conference named "HOT QCD Matter 2022" is to bring the community together to have a discourse on this topic. In this article, there are 36 sections discussing various topics in the field of relativistic heavy-ion collisions and related phenomena that cover a snapshot of the current experimental observations and theoretical progress. This article begins with the theoretical overview of relativistic spin-hydrodynamics in the presence of the external magnetic field, followed by the Lattice QCD results on heavy quarks in QGP, and finally, it ends with an overview of experiment results.Comment: Compilation of the contributions (148 pages) as presented in the `Hot QCD Matter 2022 conference', held from May 12 to 14, 2022, jointly organized by IIT Goa & Goa University, Goa, Indi

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions