Corrigendum: Introducing a healthcare-assistive robot in primary care: a preliminary questionnaire survey.

[This corrects the article DOI: 10.3389/frobt.2023.1123153.].

Introducing a healthcare-assistive robot in primary care: a preliminary questionnaire survey.

A Healthcare-assistive Infection-control RObot (HIRO) is a healthcare-assistive robot that is deployed in an outpatient primary care clinic to sanitise the premises, monitor people in its proximity for their temperature and donning of masks, and usher them to service points. This study aimed to determine the acceptability, perceptions of safety, and concerns among the patients, visitors, and polyclinic healthcare workers (HCWs) regarding the HIRO. A cross-sectional questionnaire survey was conducted from March to April 2022 when the HIRO was at Tampines Polyclinic in eastern Singapore. A total of 170 multidisciplinary HCWs serve approximately 1,000 patients and visitors daily at this polyclinic. The sample size of 385 was computed using a proportion of 0.5, 5% precision, and 95% confidence interval. Research assistants administered an e-survey to gather demographic data and feedback from 300 patients/visitors and 85 HCWs on their perceptions of the HIRO using Likert scales. The participants watched a video on the HIRO's functionalities and were given the opportunity to directly interact with it. Descriptive statistics was performed and figures were presented in frequencies and percentages. The majority of the participants viewed the HIRO's functionalities favourably: sanitising (96.7%/91.2%); checking proper mask donning (97%/89.4%); temperature monitoring (97%/91.7%); ushering (91.7%/81.1%); perceived user friendliness (93%/88.3%), and improvement in the clinic experience (96%/94.2%). A minority of the participants perceived harm from the HIRO's liquid disinfectant (29.6%/31.5%) and that its voice-annotated instructions may be upsetting (14%/24.8%). Most of the participants accepted the HIRO's deployment at the polyclinic and perceived it to be safe. The HIRO used ultraviolet irradiation for sanitisation during after-clinic hours instead of disinfectants due to the perceived harm.

Development and validation of a nomogram for predicting the risk of nursing home-acquired pneumonia.

OBJECTIVE: Nursing home-acquired pneumonia (NHAP) is one of the most frequent infections in nursing homes, with a difficult diagnosis, poor prognosis, and high mortality. The present study was performed to develop and validate a nomogram to predict the risk of NHAP in nursing homes. MATERIALS AND METHODS: Based on a literature review and clinician's recommendations, we identified and collected the possible factors affecting the occurrence of NHAP. Based on the above factors, a retrospective observational study of 620 nursing home residents' medical records was performed from September 2016 to September 2021. Significant risk factors for NHAP were identified by univariate and multivariate analysis successively. A nomogram was constructed based on the binary logistic regression models to visualize the prediction model. The model's performance was determined by the concordance index (C-index), and the prediction accuracy was evaluated using a calibration curve. Clinical effectiveness was evaluated by decision curve analysis (DCA). RESULTS: Finally, 12 independent risk factors were identified and assembled into the nomogram. The nomogram had a C-index of 0.958 (95% confidence interval: 0.943-0.972). The area under the receiver operating characteristic curve (AUC-ROC) value of the nomogram was 0.958 (p<0.05), and the calibration plot showed good goodness of fit. The decision curve analysis and clinical impact curve showed good clinical usefulness of the nomogram. CONCLUSIONS: A nomogram for the early prediction of NHAP, which is easy for nurses to perform in nursing homes, was successfully constructed and validated, and it had a good predictive performance.

Effect of FTO rs9930506 on obesity and interaction of the gene variants with dietary protein and vitamin E on C-reactive protein levels in multi-ethnic Malaysian adults.

BACKGROUND: Individual variations of obesity-related traits can be a consequence of dietary influence on gene variants. METHODS: This cross-sectional study aimed to evaluate (i) the effect of FTO rs9930506 on obesity and related parameters and (ii) the influence of diet on the above association in Malaysian adults. In total, 79 obese and 99 nonobese Malaysian adults were recruited. RESULTS: In comparison with Chinese and Malays, Indians had significantly higher waist circumference (P ≤ 0.001 and P = 0.016), waist-hip ratio (P = 0.001 and P < 0.001), body fat percentage (P = 0.001 and P = 0.042), fasting insulin (P = 0.001 and P = 0.001), homeostatic model assessment-insulin resistance (P = 0.001 and P = 0.001) and lower high-density lipoprotein-cholesterol levels (P < 0.001 and P < 0.001), respectively. Indians consumed significantly lower dietary cholesterol (P = 0.002), percentage energy from protein (P < 0.001) and higher fibre (P = 0.006) compared to the other two groups. Malaysian Indians expressed the highest risk allele frequency (G) of FTO rs9930506 compared to the Malays and the Chinese (P < 0.001). No significant association was found between FTO rs9930506 and obesity (dominant model). Risk allele carriers (G) consumed significantly lower vitamin E (P = 0.020) and had a higher fibre intake (P = 0.034) compared to the noncarriers (A). Gene-diet interaction analysis revealed that risk allele carriers (G) had lower high sensitivity C-reactive protein (hsCRP) levels with higher energy from protein (≥14% day-1 ; P = 0.049) and higher vitamin E (≥5.4 mg day-1 ; P = 0.038). CONCLUSIONS: The presence of the risk allele (G) of FTO rs9930506 was not associated with an increased risk of obesity. Malaysian Indians had a significantly higher frequency of the risk allele (G). Indian participants expressed higher atherogenic phenotypes compared to Chinese and Malays. FTO rs9930506 may interact with dietary protein and vitamin E and modulate hsCRP levels.

Carboxymethyl-ß-cyclodextrin conjugated magnetic nanoparticles as nano-adsorbents for removal of copper ions: synthesis and adsorption studies.

A novel nano-adsorbent, carboxymethyl-ß-cyclodextrin modified Fe(3)O(4) nanoparticles (CMCD-MNPs) is fabricated for removal of copper ions from aqueous solution by grafting CM-ß-CD onto the magnetite surface via carbodiimide method. The characteristics results of FTIR, TEM, TGA and XPS show that CM-ß-CD is grafted onto Fe(3)O(4) nanoparticles. The grafted CM-ß-CD on the Fe(3)O(4) nanoparticles contributes to an enhancement of the adsorption capacity because of the strong abilities of the multiple hydroxyl and carboxyl groups in CM-ß-CD to adsorb metal ions. The adsorption of Cu(2+) onto CMCD-MNPs is found to be dependent on pH and temperature. Adsorption equilibrium is achieved in 30 min and the adsorption kinetics of Cu(2+) is found to follow a pseudo-second-order kinetic model. Equilibrium data for Cu(2+) adsorption are fitted well by Langmuir isotherm model. The maximum adsorption capacity for Cu(2+) ions is estimated to be 47.2mg/g at 25 °C. Furthermore, thermodynamic parameters reveal the feasibility, spontaneity and exothermic nature of the adsorption process. FTIR and XPS reveal that Cu(2+) adsorption onto CMCD-MNPs mainly involves the oxygen atoms in CM-ß-CD to form surface-complexes. In addition, the copper ions can be desorbed from CMCD-MNPs by citric acid solution with 96.2% desorption efficiency and the CMCD-MNPs exhibit good recyclability.

Laparoscopically assisted colectomy: a study of risk factors and predictors of open conversion.

BACKGROUND: Conversion to an open procedure during laparoscopically assisted colorectal resection may be necessary because of technical, patient, or pathologic factors. Recent literature has indicated that converted patients may have poorer outcomes than those undergoing open or completed laparoscopically assisted procedure. This study aimed to audit the authors' experience with laparoscopically assisted colectomy and to assess the clinical outcomes of patients undergoing conversion. METHODS: All laparoscopic right hemicolectomies or anterior resections performed at seven South Australian hospitals from 1997 to 2006 were reviewed. Data pertaining to patient sex, age, American Society of Anesthesiology (ASA) score, pathology, operative outcomes including operating time, conversion, reason for conversion, length of hospital stay, and intra- and postoperative complications were analyzed. RESULTS: Laparoscopic anterior resection had a higher rate of open conversion than laparoscopic right hemicolectomy (18.7% vs 10.4%; p = 0.028). In the right hemicolectomy group, none of the investigated risk factors for conversion were statistically significant, and the morbidity rates for the two groups were similar. The median hospital stay was significantly longer in the anterior resection group (p < 0.001), and the wound morbidity rate was higher in the converted group (12.8% vs 3.0%; p = 0.022). Age older than 75 years and a high ASA status were independent risk factors for conversion in anterior resection. CONCLUSIONS: Conversion of laparoscopic anterior resection to open procedure is associated with higher wound morbidity and a longer hospital stay. The authors recommend that surgeons carefully consider the selection of patients 75 years of age or older and high ASA status for laparoscopic anterior resection.

The WAND local anesthetic delivery system: a more pleasant experience for anal anesthesia.

PURPOSE: The WAND is a computer-controlled local anesthetic delivery system. Its use has been proven to be more comfortable for dental patients. The purpose of this study is to explore its applicability to anal procedures. Our hypothesis is that the WAND will provide greater comfort during anesthesia delivery while achieving the same anesthetic effect as traditional syringe technique. METHODS: Twenty patients with painless anal pathology were randomized to receive anal anesthesia using either the WAND or traditional syringe technique to a randomly selected half of the anoderm (right or left). The opposite side was then anesthetized by the alternate method, allowing patients to act as their own control. Objective and subjective pain scores were obtained from the patient after each mode of delivery. An independent observer interpreted the patient's tolerance by giving a subjective pain score. The volume of anesthetic used was recorded. Adequacy of anesthesia was tested by a pinch test. RESULTS: Sixteen (80 percent) of the 20 patients preferred the use of the WAND. Objective and subjective pain scores per the patients and subjective pain scores per the observer were significantly lower for the WAND than for traditional syringe technique (P < 0.05). The mean volume of local anesthetic used with the WAND was 1.7 ml compared with 3.2 ml for traditional syringe technique (P < 0.005). Anesthesia achieved with the WAND was as good as that achieved with traditional syringe technique when the pinch test was used. CONCLUSION: The WAND is as effective as the traditional syringe technique in the delivery of anal anesthesia while providing a more comfortable experience for the patient.

The effect of lung injury and excessive lung fluid, on impedance cardiac output measurements, in the critically ill.

OBJECTIVES: To investigate the relationship between the attenuation of impedance cardiac output (IC(co)) measurements and lung fluid content in critically ill patients. DESIGN: Observational study. SETTING: Intensive Care Unit of a major teaching hospital in Hong Kong. PATIENTS: Twenty-four critically ill patients who required a pulmonary artery catheter. MEASUREMENTS AND MAIN RESULTS: Triplicate thermodilution cardiac output (TD(co)) and BoMed NCCOM3 (IC(co)) measurements were made simultaneously on a single occasion in each patient. Lung fluid accumulation was assessed by: (a) thoracic impedance (Zo), (b) radiological assessment of chest X-rays using an alveolar consolidation score (0-4) and (c) scoring the degree of hypoxia and use of positive end-expiratory pressure (PEEP). Offsets (TD(co)-IC(co))/TD(co), expressed as percentage, were compared with these indices of excess lung fluid. Patients were divided into those with sepsis (n = 13), fluid balance problems (n = 5) and cardiothoracic problems (n = 6). Mean cardiac output values were: 6.7 l/min TD(co) (range 3.6-12.9) and 5.2 l/min IC(co) (range 2.7-9.0). Overall the TD(co) and IC(co) values showed great variance, with a bias and limits of agreement of 1.49 +/- 4.16 l/min, or +/- 69%. In septic patients, increasing offset was correlated with decreases in Zo (r = 0.73, P = 0.005) and increases in alveolar consolidation score (r = 0.72, P = 0.005). CONCLUSIONS: The BoMed under-estimates cardiac output in critically ill patients. In septic patients the degree of attenuation of IC(co) can be related to the extent of lung injury and fluid accumulation within the thorax.

Isoleucyl-tRNA synthetase of Methanobacterium thermoautotrophicum Marburg. Cloning of the gene, nucleotide sequence, and localization of a base change conferring resistance to pseudomonic acid.

The ileS gene encoding the isoleucyl-tRNA synthetase of the thermophilic archaebacterium Methanobacterium thermoautotrophicum Marburg was isolated and sequenced. ileS was closely flanked by an unknown open reading frame and by purL and thus is arranged differently from the organizations observed in several eubacteria or in Saccharomyces cerevisiae. The deduced amino acid sequence of isoleucyl-tRNA synthetase was compared with primary sequences of isoleucyl-, valyl-, leucyl-, and methionyl-tRNA synthetases from eubacteria and yeast. The archaebacterial enzyme fitted well into this group of enzymes. It contained the two short consensus sequences observed in class I aminoacyl-tRNA synthetases as well as regions of homology with enzymes of the isoleucine family. Comparison between the isoleucyl-tRNA synthetases of M. thermoautotrophicum yielded 36% amino acid identity with the yeast enzyme and 32% identity with the corresponding enzyme from Escherichia coli. The ileS gene of the pseudomonic acid-resistant M. thermoautotrophicum mutant MBT10 was also sequenced. The mutant enzyme had undergone a glycine to aspartic acid transition at position 590, in a conserved region comprising the KMSKS consensus sequence. The inhibition constants of pseudomonic acid, KiIle and KiATP, for the mutant enzyme were 10-fold higher than those determined for the wild-type enzyme. Both the mutant and the wild-type ileS gene were expressed in E. coli, and their products displayed the expected difference in sensitivity toward pseudomonic acid.

Vitamin A reserve of liver in health and coronary heart disease among ethnic groups in Singapore.

1. The vitamin A content of human liver tissue was determined in 363 autopsy samples. The sample comprised a total of 181 subjects dying after accidents and 182 dying from coronary heart disease among Singapore ethnic groups of both sexes. 2. The medium vitamin A reserve was 146 mg/kg in accident victims and 141 mg/kg in those who had died of coronary heart disease. Of all the samples 16% contained less than 40 mg/kg, 45% had 100-300 mg/kg, while 9% contained more than 500 mg/kg liver. 3. Among the accident victims, Indians had the lowest median liver vitamin A reserve (118 mg/kg) compared with that in other ethnic groups (137 mg/kg in Chinese, 191 mg/kg in Malays, 155 mg/kg in Caucasians). 4. The ethnic distribution of vitamin A reserve in coronary deaths was similar to that in accident victims. 5. There was no significant difference between the sexes in hepatic vitamin A reserve. 6. The distribution of vitamin A reserve in all the groups was skewed to the right.

Preparation of bovine blood coagulation factors X1 and X2.

A method is described for the preparation of both Factor X1 and Factor X2 from citrated bovine blood. The proteins from the plasma were first adsorbed on barium citrate by adding barium chloride solution. The precipitate formed was stirred with citrate/NaOH pH 6.9 buffer; barium and other clotting factors were removed by adding ammonium sulphate (up to 30% saturation) to the suspension. The Factor X was then precipitated by 65% ammonium sulphate, after resolution in citrate buffer chromatographed on DEAE-Sephadex and purified by rechromatography on DEAE-Sephadex and DEAE-Sepharose, respectively. This yielded Factor X1 and Factor X2 with respective purifications of about 16 000 and 24 000-fold that of the plasma. The apparent molecular mass of both Factor X1 and Factor X2 was 55 kDa as estimated by the sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Factor X2 had a higher specific biological activity of about 340 000 units/mg compared to that of Factor X1 of about 230 000 units/mg.

Energy balance study in Singapore medical students.

Energy cost of rest and various common daily activities was measured in 7 male and 16 female medical students by using a Max-Planck respirometer and a Lloyd's gas analysis apparatus. The average weight of male and female subjects during the course of the study was 67.3 +/- 14.2 and 51.2 +/- 5.1 kg, respectively. The average energy expenditure per day was estimated from a diary of activities for a period of 7 days. The average daily intake of energy was computed from food tables and based on weighed amounts of raw materials of food consumed over the same 7-day period when energy expenditure was determined. The average energy expenditure of rest and different activities was found to be significantly lower than the figures published for western subjects. The daily energy intake and expenditure were 2,138 +/- 217 kcal (9.0 +/- 0.9 MJ) and 1,894 +/- 168 kcal (8.0 +/- 0.7 MJ), respectively, in male medical students, giving a positive balance of 244 kcal (1.0 MJ). The values of the same in female medical students were 1,711 +/- 292 kcal (7.2 +/- 1.2 MJ) and 1,474 +/- 211 kcal (6.2 +/- 0.9 MJ) with a balance of 237 kcal (1.0 MJ).