Category: Nevin Manimala

J Environ Manage. 2023 Dec 18;351:119809. doi: 10.1016/j.jenvman.2023.119809. Online ahead of print.

ABSTRACT

Anthropogenic land use and land cover changes are major drivers of environmental degradation and declining soil health across heterogeneous landscapes in Central India. To examines the land cover changes and spatio-temporal variations in forest carbon stock and soil organic carbon (SOC) over the past 25 years in central India. Geospatial techniques, coupled with ground measurements were employed to detect changes in land cover, carbon stocks in vegetation, and soil carbon in various vegetation types. The results indicate that forested areas have decreased, while agriculture and habitation have expanded between 1997 and 2022. Vegetation C stocks varied significantly (P < 0.05) from 39.42 to 139.95 Mg ha^-1 and the SOC varied from 7.02 to 17.98 Mg ha^-1 under different soil profiles across vegetation types, which decreased with soil depth, while the pH and bulk density increased. The maximum bulk density in the soil was found at a depth of 40-60 cm (lower profile) in Bamboo Brake, while the minimum was observed under Dense Mixed Forest at a depth of 0-20 cm (top profile). The topsoil profile contributed 33.6%-39%, the middle profile (20-40 cm) was 33.6%-34.4%, and the lower profile was 26.5%-30.8% of soil organic carbon. The study site has experienced rapid carbon losses due to changes in land cover, such as illegal expansion of agriculture, encroachments into forest fringes, and activities like selective logging and overgrazing, which have degraded dense forests. The ecological engineering of degraded ecosystems poses a great challenge and application of complex biological, mechanical and engineering measures is highly cumbersome, expensive, uneconomical and practically not feasible for upscaling. Nevertheless, proposed nature-based solutions mimic natural reparation and processes provide sustainable interventions for the reclamation of ruined landscapes besides improving ecological integrity and rendering many co-benefits to ecosystems and human societies.

PMID:38113791 | DOI:10.1016/j.jenvman.2023.119809

Am J Otolaryngol. 2023 Dec 14;45(2):104197. doi: 10.1016/j.amjoto.2023.104197. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to investigate the effect of a reduction in the prescribed post-operative ibuprofen dosage on frequency of post-tonsillectomy bleeding.

METHODS: A quality improvement study was conducted at a single tertiary care pediatric hospital with patients weighing >40 kg undergoing tonsillectomy. The intervention was limiting the post-operative ibuprofen dosage to a maximum of 400 mg per dose. Data was collected on all patients returning to the hospital with bleeding after tonsillectomy. The primary outcome was the rate of post-tonsillectomy bleeding. Statistical analysis was conducted using nonparametric comparisons and a run chart.

RESULTS: A total of 199 tonsillectomy patients >40 kg were included in the study. There were 119 (59.8 %) females and 80 (40.2 %) males total. The pre-intervention group had a total of 56 patients while the post-intervention group had a total of 143 patients. There was no statistical difference in age, weight, or sex between the pre- and post-intervention groups (p > .05). The post-tonsillectomy hemorrhage rate was 11/56 (19.6 %) before the intervention, and 11/143 (7.7 %) after the intervention (p = .016). Children who experienced a bleeding event were significantly older (mean 15.9 years, 95 % CI 14.5-17.3) than those who did not (13.5 years, 95 % CI 12.9-14.1; p = .011). The run chart revealed that the intervention resulted in a nonrandom decrease in rate of post-tonsillectomy bleeding.

CONCLUSIONS: Post-tonsillectomy bleeding rate decreased with a ceiling post-operative ibuprofen dose of 400 mg/dose in this quality improvement study. Further research is warranted.

PMID:38113775 | DOI:10.1016/j.amjoto.2023.104197

Am J Otolaryngol. 2023 Dec 14;45(2):104177. doi: 10.1016/j.amjoto.2023.104177. Online ahead of print.

ABSTRACT

INTRODUCTION: Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis compared to rhinitis.

GOAL: To investigate the association between autoimmune disorders and rhinosinusitis.

METHODS: We performed a case-control study of patients referred to West Virginia University from August 2020 to October 2022 for rhinologic complaints. Rhinosinusitis patients were diagnosed with either chronic rhinosinusitis (CRS) or recurrent acute rhinosinusitis (RARS). These patients were compared to non-rhinosinusitis patients. Patients’ characteristics, comorbidities, and type of treatment of autoimmune disorders were reviewed.

RESULTS: The sample consisted of 527 rhinosinusitis [184 CRS without nasal polyps (CRSsNP), 263 CRS with nasal polyps (CRSwNP) and 80 RARS patients] patients and 564 non-rhinosinusitis patients. Patients with rhinosinusitis were more likely to be older, males, have asthma, and have current and past smoking history (all with p-value < 0.05). Autoimmune disorders, primary antibody deficiency, and immunomodulator agents were more common in rhinosinusitis patients (16.5 % vs 9.4 %, OR = 1.9, p < 0.001; 5.1 % vs 0.5 %, OR = 10.1, p < 0.001; and 3.8 % vs 1.1 %, OR = 3.7, p = 0.003 respectively). Multivariate logistic regression adjusting for confounders showed that autoimmune disorders were strongly associated with rhinosinusitis [OR = 1.6, 95 % CI = 1.10-2.48], whereas the immunomodulators did not reach statistical significance [OR = 2.4, 95 % CI = 0.87-6.47]. Subgroup analysis showed the autoimmune disorders did not significantly differ between CRS and RARS groups [OR = 1.0, 95 % CI = 0.5-2.1], or between the CRSsNP and CRSwNP groups [OR = 0.9, 95 % CI = 0.5-1.7].

CONCLUSION: Autoimmune disorders are associated with rhinosinusitis, both CRS and RARS, independently of other risk factors.

PMID:38113772 | DOI:10.1016/j.amjoto.2023.104177

J Electrocardiol. 2023 Dec 13;82:100-112. doi: 10.1016/j.jelectrocard.2023.12.004. Online ahead of print.

ABSTRACT

BACKGROUND: The vectocardiogram (VCG) offers a three-dimensional view of the heart’s electrical activity, yet many VCG parameters remain unexplored in diverse clinical contexts.

OBJECTIVES: This study aims to explore the relationships between various VCG parameters and specific patient characteristics.

METHODS: ECG signals from adults were transformed into VCGs utilizing the Kors matrix, yielding 315 parameters per patient from the P, QRS and T loops. Univariable analysis, circular statistics, and stepwise logistic regression were employed to examine the relationships between VCG parameters and factors such as age, sex, BMI, hypertension, echocardiographic ischemic heart disease (Echo-IHD), and left ventricular hypertrophy (Echo-LVH).

RESULTS: We included 664 adults and considered an alpha value of 0.05 and a power of 90%. The study revealed significant associations, such as age with P loop roundness index (RI) (OR = 3.825, 95% confidence interval [95%CI] = 2.079-7.04), male sex with QRS loop RI (OR = 6.08, 95%CI = 1.835-20.153), abnormal BMI with the T loop’s RI (OR = 0.544, 95%CI = 0.325-0.909), hypertension with the T loop planarity index (PI) (OR = 8.01, 95%CI = 2.134-30.117), Echo-IHD with QRS loop curvature at the 4/10th segment (OR = 7.58, 95%CI = 1.954-29.458), and Echo-LVH with the T loop lag-1/10 dihedral angle (OR = 10.3, 95%CI = 1.822-58.101). In the study, several additional VCG parameters demonstrated statistically significant, albeit smaller, associations with patient demographics and cardiovascular conditions.

CONCLUSIONS: The findings enhance our understanding of the intricate relationships between VCG parameters and patient characteristics, emphasizing the potential role of VCG analysis in assessing cardiovascular diseases. These insights may guide future research and clinical applications in cardiology.

PMID:38113771 | DOI:10.1016/j.jelectrocard.2023.12.004

Eur J Oncol Nurs. 2023 Dec 12;68:102490. doi: 10.1016/j.ejon.2023.102490. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of auricular acupuncture combined with pelvic floor muscle training to manage urinary incontinence following radical prostatectomy.

METHODS: This is a randomized clinical trial that was conducted between April 2019 and April 2020 with 60 participants allocated into two groups, namely: control (pelvic muscle training) and intervention (auricular acupuncture + pelvic muscle training). Interventions were carried out during eight weekly sessions. Generalized estimating equations and proportion difference tests were applied in the statistical analysis with a significance level of 0.05.

RESULTS: Urinary incontinence severity decreased between pre-test and post-test in both groups. There was a statistically significant difference of the impact of urinary incontinence on quality of life between the groups at post-test in the domain “severity measures” (p = 0.013), and only in the intervention group between pre-test and post-test in the domains “emotions” (p < 0.001) and “sleep and mood” (p = 0.008). The intervention group was 20.8% (p = 0.007) and 25.3% (p = 0.002) less likely to present nocturia and urinary urgency, respectively.

CONCLUSIONS: Auricular acupuncture combined with pelvic floor muscle training was more effective, compared to pelvic floor muscle training alone, in reducing the impact of urinary incontinence on quality of life and reducing the odds of nocturia and urinary urgency.

PMID:38113770 | DOI:10.1016/j.ejon.2023.102490

Reprod Biomed Online. 2023 Oct 6;48(2):103586. doi: 10.1016/j.rbmo.2023.103586. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Does positive Chlamydia trachomatis serology have an impact on the cumulative live birth rate from IVF?

DESIGN: A retrospective matched cohort study compared women with positive Chlamydia trachomatis serology (group A) who underwent IVF treatment between January 2016 and December 2021 with a control group of women with negative Chlamydia trachomatis serology (group B). The main outcome measures were the cumulative live birth rate per IVF cycle and the live birth rate per embryo transfer. Secondary outcomes were the cumulative rates of clinical pregnancy, ectopic pregnancy and pregnancy loss calculated per IVF cycle and per embryo transfer.

RESULTS: A total of 151 women in group A were matched 1:2 to 302 women in group B, representing 220 and 440 IVF cycles, respectively. Women with a history of Chlamydia trachomatis infection had a significantly higher rate of tubal obstruction (P < 0.001), excluded or operated hydrosalpinx (P = 0.002) and/or history of chronic endometritis (P < 0.001). There were no statistically significant differences between the two groups in the mean number of mature oocytes retrieved, fertilization rate or implantation rate. The IVF cumulative live birth rate per cycle was similar in the two groups (36.7% in group A versus 34.9% in group B, P = 0.692). The cumulative rates of clinical pregnancy, pregnancy loss, biochemical pregnancy and ectopic pregnancy were comparable between the two groups.

CONCLUSION: Positive Chlamydia trachomatis serology has no impact on IVF pregnancy outcomes.

PMID:38113763 | DOI:10.1016/j.rbmo.2023.103586

Braz J Otorhinolaryngol. 2023 Dec 2;90(2):101373. doi: 10.1016/j.bjorl.2023.101373. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate the effect of bilateral sphenopalatine ganglion blockade (SPGB) on the main postoperative complications in septorhinoplasty operations.

METHODS: In this randomized, controlled, prospective study, 80 cases planned for Septorhinoplasty operations under general anesthesia were included in the study. The cases were divided into two groups; SPGB was performed with 2 mL of 0.25% bupivacaine bilaterally 15 min before the end of the operation in the SPGB group (Group S, n = 40). In the control group (Group C, n = 40), 2 mL of 0.9% NaCl solution was applied into both SPG areas. In the recovery unit after the operation; the pain and analgesic needs of the patients at 0, 2, 6 and 24 h were evaluated.

RESULTS: There was no statistically significant difference between the groups in terms of hemodynamic parameters (ASA, MBP, HR) (p > 0.05) All VAS values were statistically lower in Group S than in Group C (p < 0.05). In Group S, the need for analgesic medication was found in 5 cases between 0-2 h, whereas in Group C, this rate was found in 17 cases, and it was statistically significant (p < 0.05).

CONCLUSION: Bilateral SPGB application was determined to provide better analgesia in the early postoperative period compared to the control group, it was concluded that further studies are needed to say that there are significant effects on laryngospasm and nausea-vomiting.

LEVEL OF EVIDENCE: 2, degree of recommendation B.

PMID:38113753 | DOI:10.1016/j.bjorl.2023.101373

Accid Anal Prev. 2023 Dec 18;195:107398. doi: 10.1016/j.aap.2023.107398. Online ahead of print.

ABSTRACT

The increasing number of bicycle crashes leading to injuries in the Netherlands is frequently related (e.g., in the media) to increased use of the electric bicycle. For this reason, policy makers face the challenge of selecting and implementing the most promising countermeasures including those focused on electric bicycles. It may be questioned, however, to what extent the electric bicycle itself is a (direct) cause of crashes leading to injuries or whether other factors are important for explaining the increased number of bicycle injury crashes. On the basis of an abbreviated list of criteria by Elvik (2011), this paper illustrates the potential influence of factor inclusions, analysis selections, and data presentations on the general impression about crash causation with the electric bicycle as an example. The aim is to provide a ‘best practice guide’ by taking into account (1) a theoretical explanation of causal mechanisms, (2) control for confounders, and (3) a statistical association of sufficient strength and consistency in the expected direction. We conclude that an apparent increased risk of electric bicycles may be explained by factors such as age, exposure, health factors, and gender of the cyclist. A relatively simple analysis, by comparing fatality numbers of conventional and electric bicycles, showed that including or excluding these factors may lead to vastly different interpretations of fatality causes and the relative risk of electric bicycles compared to conventional bicycles.

PMID:38113728 | DOI:10.1016/j.aap.2023.107398

J Plast Reconstr Aesthet Surg. 2023 Nov 28;88:524-534. doi: 10.1016/j.bjps.2023.11.036. Online ahead of print.

ABSTRACT

INTRODUCTION: Oncological treatments, such as radiotherapy and surgery, are high-risk factors for the development of secondary lymphedema in the upper and lower limbs, as well as the genitalia. Prophylactic lymphedema surgery (PLS) has previously demonstrated promising results in reducing secondary lymphedema in breast cancer and urogenital cancer patients. We conducted a study to adapt this principle for patients with lower-extremity sarcomas.

MATERIAL AND METHODS: Inclusion criteria included patients with tumors on the medial aspect of the thigh and leg and tumor size larger than 5 cm. Group A (19 patients) comprised a prospective cohort (2020-2023) in which a PLS protocol was executed. Lymphaticovenous anastomosis (LVA) was performed when lymphatic channels were interrupted due to tumor resection, intraoperatively verified by indocyanine green. Lymph node transfer was employed exclusively in cases involving preoperative radiotherapy and inguinal lymph node resection. Measurements were collected both preoperatively and at 1, 3, 6, and 12 months postoperatively. Group B (26 patients) constituted a retrospective cohort (2017-2020) without PLS reconstruction, where the prevalence of lymphedema was determined.

RESULTS: In total, we enrolled 45 patients with soft tissue sarcomas located on the inner aspect of the thigh and leg (26 in the control group vs. 19 in the prophylactic group). In the control group, lymphedema was observed in 10 out of 27 patients (37.04%). In the prophylactic group, two patients exhibited signs of lower-extremity lymphedema (2/19, 10.52%) with a median follow-up of 14.15 months (6 months-33months), demonstrating statistically significant differences between the two groups (p = 0.02931).

CONCLUSIONS: PLS for lower limb soft tissue sarcomas shows promising results, although it is premature to reach solid conclusions. Multicentre studies, standardization of criteria, larger sample sizes and longer-term follow-up are imperative for further validation.

PMID:38113721 | DOI:10.1016/j.bjps.2023.11.036

Proc Inst Mech Eng H. 2023 Dec 19:9544119231214651. doi: 10.1177/09544119231214651. Online ahead of print.

ABSTRACT

The diagnosis of osteoporosis using Dual-energy X-ray Absorptiometry (DXA) relies on accurate hip scans, whereby variability in measurements may be introduced by altered patient positioning, as could occur with repeated scans over time. The goal herein was to test how altered postures affect diagnostic metrics (i.e., standard clinical metrics and a newer image processing tool) for femur positioning. A device was built to support cadaveric femurs and adjust their orientation in 3° increments in flexion and internal/external rotation. Seven isolated femurs were scanned in six flexion postures (0° (neutral) to 15° of flexion) and eleven rotational postures (15° external to 15° internal rotation) while collecting standard clinical DXA-based measures for each scan. The fracture risk tool was applied to each scan to calculate fracture risk. Two separate one-way repeated measures ANOVAs (α = 0.05) were performed on the DXA-based measures and fracture risk prediction output. Flexion had a significant effect on T-score, Bone Mineral Density (BMD), and Bone Mineral Content (BMC), but not area, at angles greater than 12°. Internal and external rotation did not have a significant effect on any clinical metric. Fracture risk (as assessed by the image processing tool) was not affected by either rotation mode. Overall, this suggests clinicians can adjust patient posture to accommodate discomfort if deviations are less than 12 degrees, and the greatest care should be taken in flexion. Furthermore, the tool is relatively insensitive to postural adjustments, and as such may be a good option for tracking risk over repeated patient scans.

PMID:38112093 | DOI:10.1177/09544119231214651