Category: Nevin Manimala

J Mot Behav. 2023 Jul 23:1-10. doi: 10.1080/00222895.2023.2236950. Online ahead of print.

ABSTRACT

The aim of the study was to investigate how high-heeled walking affects the coordination changes of timing of upper trunk muscle activation, and the possible occurrence of health problems in this part of the body of young women. We used surface electromyography (EMG) for data collection. The research group consisted of 30 women. Statistical significance of the changes in muscle coordination was confirmed when evaluating two of the four upper trunk muscles studied. M. trapezius and m. pectoralis major are not subject to changes in gait in high heels (HH) from the point of view of timing on a statistical level, but HH increase the intensity of muscle contraction of all monitored muscles, and therefore we recommend limiting the wearing of HH in case of health problems related to these muscles.

PMID:37482373 | DOI:10.1080/00222895.2023.2236950

Photodiagnosis Photodyn Ther. 2023 Jul 21:103718. doi: 10.1016/j.pdpdt.2023.103718. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common malignant tumor among women, and its incidence is increasing annually. At present, the results of the study on whether optical coherence tomography (OCT) can be used as an intraoperative margin assessment method for breast-conserving surgery (BCS) are inconsistent. We herein conducted this systematic review and meta-analysis to assess the diagnostic value of OCT in BCS.

METHODS: PubMed, Web of Science, Cochrane Library, and Embase were used to search relevant studies published up to September 15, 2022. We used Review Manager, Meta-Disc, and STATA 16 for statistical analysis.

RESULTS: The results displayed 18 studies with 782 patients included according to the inclusion and exclusion criteria. Meta-analysis showed the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the curve (AUC) of OCT in the margin assessment of BCS were 0.91 (95% CI 0.88-0.93), 0.88 (95% CI 0.83-0.92), 7.53 (95% CI 5.19-10.93), 0.11(95% CI 0.08-0.14), 70.37 (95% CI 39.78-124.47), and 0.94 (95% CI 0.92-0.96), respectively.

CONCLUSIONS: OCT is a promising technique in intraoperative margin assessment of breast cancer patients.

PMID:37482370 | DOI:10.1016/j.pdpdt.2023.103718

Sci Total Environ. 2023 Jul 21:165648. doi: 10.1016/j.scitotenv.2023.165648. Online ahead of print.

ABSTRACT

In the context of dual carbon targets, a reliable prediction of China’s carbon dioxide emissions is of great significance to the design and formulation of emission reduction policies by Chinese government. To this end, a novel grey Verhulst model with four parameters is proposed in this paper according to the evolution law and the data characteristics of China’s carbon dioxide emissions. The new model solves the defect of poor structural adaptability of the traditional grey Verhulst model by introducing a nonlinear correction term. Besides, the range of values for the order of the grey generation operator of the new model is expanded from a positive real number to any real number (r ∈ R⁺ → r ∈ R) by expanding the value range of the Gamma function. The new model is used to simulate China’s carbon dioxide emissions, and its comprehensive mean relative percentage error is only 0.65 %, which is better than that of the other three grey models (2.39 %, 2.34 %, 2.35 % respectively). It shows that the proposed new model has better modeling ability. Finally, the new model is applied to predict China’s carbon dioxide emissions, and the results show that it will still increase year by year, reaching 13,687 million tons by 2028 (only 11,420 million tons in 2021). Therefore, some countermeasures and suggestions are proposed to control China’s carbon dioxide emissions in this paper.

PMID:37482363 | DOI:10.1016/j.scitotenv.2023.165648

Spine J. 2023 Jul 21:S1529-9430(23)03281-3. doi: 10.1016/j.spinee.2023.07.014. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Postoperative incisional concerns including non-purulent drainage are relatively common following spine surgery. Evidence-based management protocols are lacking.

PURPOSE: The purpose of this study is to determine if prescribing empiric oral antibiotics for non-purulent wound drainage is beneficial for the prevention of chronic infection or reoperation.

STUDY DESIGN: Retrospective chart review PATIENT SAMPLE: Patients calling the office with post-surgical wound concerns OUTCOME MEASURES: Not applicable METHODS: In a large, multi-surgeon, spine surgery practice, review of the communications log showed that 298 patients called or messaged the office with a concern regarding postoperative non-purulent wound drainage. Patients were prescribed empiric oral antibiotics based on surgeon preference. Patients who received empiric oral antibiotic treatment (AbxTx) were propensity matched to patients who did not (No AbxTx) based on sex, age, BMI, ASA grade, smoking status, prior spine surgery, anatomic location, and number of surgical levels. The number of patients requiring surgical intervention (debridement) and/or developing a chronic infection were determined.

RESULTS: Oral antibiotics were prescribed for 112 of the 298 (38%) of the patients with reports of non-purulent drainage. Demographic and surgical characteristics of the two matched cohorts were similar. Although there were more patients in the AbxTx group who required surgical intervention (n=17, 17%) compared to the No AbxTx group (n=9, 9%), this difference was not statistically significant (p=0.139). The intra-operative culture results showed no growth in 94% (16/17) of the AbxTx group versus 67% (6/9) of the No AbxTx group (p=0.103). One patient in each group required a return to the operating room within the year after the initial surgical debridement for management of chronic infection.

CONCLUSION: In this large series (n=298) of patients with non-purulent wound drainage following spine surgery, 87% resolved without the need for surgical intervention. Empiric oral antibiotics did not reduce the need for surgical intervention or the development of a chronic infection. In addition to added cost, potential adverse reactions, development of resistant organisms, and inaccurate labeling of surgical site infection; empiric oral antibiotics may lead to a negative intra-operative culture for those requiring surgical intervention impacting the ability to prescribe a specific antibiotic regimen.

PMID:37482252 | DOI:10.1016/j.spinee.2023.07.014

J Shoulder Elbow Surg. 2023 Jul 21:S1058-2746(23)00532-3. doi: 10.1016/j.jse.2023.06.022. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to compare clinical and radiological outcomes of two treatment methods of massive and irreparable rotator cuff tears: partial repair (PR) and PR with long head of the biceps tendon augmentation (PRLHBTA). Biceps tendon augmentation is believed to promote better healing at the bone-tendon junction, leading clinical and radiological outcomes.

METHODS: This retrospective and comparative study included patients with chronic, massive and irreparable rotator cuff tears involving both the supraspinatus (SSP) and infraspinatus (ISP) muscles. Only patients who had previously failed non-operative treatment and had at least 1-year follow-up between 2013 and 2018 were analyzed. The patients were divided into 2 groups based on the chosen treatment method. Irreparability was defined intraoperatively as the inability to achieve sustainable repair of the SSP after complete release, typically corresponding to Goutallier classification of ≥ 3 and stage 3 in the Patte classification. The clinical assessment protocol involved measuring of range of motion (ROM), shoulder strength, Constant-Murley Score (CMS) and SST Scores. Radiological assessment comprised measurements of the Acromio-Humeral Index (AHI), the Hamada classification, the Sugaya’s classification and Goutallier classification for both SSP and ISP.

RESULTS: The study included data from 60 patients (30 in each group) with a mean age of 62.5 years and a mean follow-up of 34.5 months. The retear rate for PRLHBTA was 43.3% and 73.3% for PR alone (p=0.036). During the final examination statistically significant differences in favour of PRLHBTA were observed for: CMS 76.2±0.9 vs 70.9±11.5 (p=0.034), Sugaya’s classification 3.5±1.1 vs 4.1±0.9 (p=0.035) and AHI 5.8±2mm vs 4.7±1.3 (p=0.021). There were no significant differences between the groups in patients’ ROM, shoulder strength, the Hamada classification, Simple Shoulder Test (SST) and postoperative Goutallier scales.

CONCLUSION: PR with LHBTA for patients with irreparable MRCT provides a lower retear rate and better humeral head centralization, and improved results measured by CMS compared to PR alone.

PMID:37482246 | DOI:10.1016/j.jse.2023.06.022

Rev Clin Esp (Barc). 2023 Jul 21:S2254-8874(23)00092-9. doi: 10.1016/j.rceng.2023.07.006. Online ahead of print.

ABSTRACT

INTRODUCTION AND AIM: N-acetylcysteine has been proposed for the treatment of COVID-19 thanks to its mucolytic, antioxidant and anti-inflammatory effects. Our aim is to evaluate its effect on patients admitted with COVID-19 in mortality terms.

MATERIAL AND METHODS: Retrospective single-center cohort study. All patients admitted to our hospital for COVID-19 from March to April 2020 have been considered.

RESULTS: A total of 378 patients were included, being 196 (51.9%) men, with an average age of 73.3 ± 14.5 years. 52.6% (199) received treatment with N-Acetylcysteine. More than 70% presented coughs, fever, and/or dyspnea. The global hospital mortality was 26.7%. A multivariate analysis through logistic regression identified the age of patients [older than 80; OR: 8.4 (CI95%:3-23.4)], a moderate or severe radiologic affectation measured by the RALE score [OR:7.3 (CI95%:3.2-16.9)], the tobacco consumption [OR:2.8 (CI95%:1.3-6.1)] and previous arrhythmia [OR 2.8 (CI95%: 1.3-6.2)]as risk factor that were independently associated with mortality during the admission. The treatment with N-Acetylcysteine was identified as a protective factor [OR: 0.57 (CI95%: 0.31-0.99)]. Asthma also seems to have a certain protective factor although it was not statistically significant in our study [OR: 0.19 (CI95%: 0.03-1.06)].

CONCLUSIONS: Patients with COVID-19 treated with N-acetylcysteine have presented a lower mortality and a better evolution in this study. Future prospective studies or randomized clinical trials must confirm the impact of N-Acetylcysteine on COVID-19 patients.

PMID:37482215 | DOI:10.1016/j.rceng.2023.07.006

Chem Biol Interact. 2023 Jul 21:110641. doi: 10.1016/j.cbi.2023.110641. Online ahead of print.

ABSTRACT

Beneficial effects of a natural zeolite clinoptilolite in vivo on mammals, including humans, have been empirically observed and documented in literature. The positive biological activities have been associated to its detoxifying and antioxidative properties, and its immunostimulative and adsorption properties. Herein, we present the in vitro and in vivo study of clinoptilolite zeolite materials adsorption properties for d-glucose. In particular, we present data on the interaction of d-glucose on the tested zeolites’ surface obtained by scanning electron microscope (SEM) and Energy-dispersive X-ray spectroscopy (EDS) and quantification by ultra high-performance liquid chromatography (UHPLC). We also present results on the reduction of blood glucose levels in mice pre-treated with clinoptilolite in vivo upon feeding with d-glucose. In vivo results were in line with the in vitro adsorption and/or interaction properties of tested zeolite materials for d-glucose and were quantified by UHPLC as well (11.34% for TMAZ; 10.82% for PMA and 8.76% for PMAO2). In vivo experiments in mice showed that PMA zeolite reduces blood glucose levels upon 15 min for 13% (at p < 0.05) up to 19.11% upon 120 min (without statistical significance) in clinoptilolite pre-treated mice fed by addition of d-glucose. Due to lack of explicit mechanistic knowledge on zeolite clinoptilolite interactions or adsorption with sugars in vitro and in vivo, presented study provides novel insights into these aspects for researchers in the field. The presented data merit further investigations as the material clearly shows a potential in management of hyperglycemia, such as for example in obese people, people with diabetes and people with metabolic syndrome where it could help regulate blood glucose levels.

PMID:37482210 | DOI:10.1016/j.cbi.2023.110641

Clin Gastroenterol Hepatol. 2023 Jul 21:S1542-3565(23)00543-8. doi: 10.1016/j.cgh.2023.07.008. Online ahead of print.

ABSTRACT

BACKGROUND: Cannabis (^Δ9THC), a non-selective cannabinoid receptor (CBR) agonist relieves nausea and pain. Cannabidiol (CBD), a CBR2 inverse agonist with central effects, also reduces gut sensation and inflammation.

AIMS: To compare effects of 4 weeks’ treatment with pharmaceutical CBD vs. placebo in patients with idiopathic (IG) or diabetic (DM) gastroparesis.

METHODS: We performed a randomized, double-blinded, placebo-controlled study of CBD b.i.d. (Epidiolex® escalated to 20mg/kg/day) in patients with nonsurgical gastroparesis with delayed gastric emptying of solids (GES). Symptoms were assessed by Gastroparesis Cardinal Symptom Index Daily Diary (GCSI-DD). After 4 weeks’ treatment, we measured GES, gastric volumes, and Ensure® satiation test (1kcal/mL, 30mL/min) to assess volume to comfortable fullness (VTF) and maximum tolerance (MTV). Patients underwent specific FAAH and CNR1 genotyping. Statistical analysis compared 2 treatments using ANOVA including baseline measurements and BMI as covariates.

RESULTS: Among 44 patients (32 IG, 6 DM1, and 6 DM2), 5 patients did not tolerate full dose escalation; 3 withdrew before completing 4 weeks’ treatment (2 placebo, 1 CBD); 95% completed 4 weeks’ treatment and diaries. Compared to placebo, CBD reduced total GCSI score (P=0.008), inability to finish a normal-sized meal (P=0.029), number of vomiting episodes/24 hours (P=0.006), and overall symptom severity (P=0.034). Patients treated with CBD had higher VTF and MTV and slower GES. FAAH rs34420 genotype significantly impacted nutrient drink ingestion. The most common adverse events reported were diarrhea (14), fatigue (8), headache (8), and nausea (7).

CONCLUSIONS: CBD provides symptom relief in patients with gastroparesis and improves the tolerance of liquid nutrient intake, despite slowing of GES.

PMID:37482172 | DOI:10.1016/j.cgh.2023.07.008

Int J Radiat Oncol Biol Phys. 2023 Jul 21:S0360-3016(23)07647-2. doi: 10.1016/j.ijrobp.2023.07.015. Online ahead of print.

ABSTRACT

BACKGROUND: Radiation necrosis (RN) secondary to stereotactic radiosurgery is a significant cause of morbidity. The optimal management of corticosteroid-refractory brain RN remains unclear.

OBJECTIVE: To summarise the literature specific to efficacy and toxicity of treatment paradigms for patients with symptomatic corticosteroid refractory RN. To provide consensus guidelines for grading and management of RN on behalf of the International Stereotactic Radiosurgery Society (ISRS).

METHODS: A systematic review of articles pertaining to treatment of RN with bevacizumab, laser interstitial thermal therapy (LITT), surgical resection, or hyperbaric oxygen therapy (HBOT) was performed. The primary composite outcome was clinical and/or radiological stability/ improvement (i.e., proportion of patients achieving improvement or stability with the given intervention). Proportions of patients achieving the primary outcome were pooled using random weighted-effects analysis, but not directly compared between interventions.

RESULTS: Twenty-one articles were included, of which only two were prospective studies. Thirteen reports were relevant for bevacizumab, 5 for LITT, 5 for surgical resection and 1 for HBOT. Weighted effects analysis revealed that bevacizumab had a pooled symptom improvement/stability rate of 86% (95% CI: 77-92%), pooled T2 imaging improvement/stability rate of 93% (95% CI: 87 -98%), and pooled T1-post contrast improvement/stability rate of 94% (95% CI: 87 – 98%). Subgroup analysis showed a statistically significant improvement favouring treatment with low-dose (below median, ≤7.5 mg/kg every 3 weeks) vs. high-dose bevacizumab with regards to symptom improvement/stability rate (P=0.02), but not for radiological T1 or T2 changes. The pooled T1-post contrast improvement/stability rate for LITT was 88% (95% CI 82 – 93%), and pooled symptom improvement/stability rate for surgery was 89% (95% CI 81 – 96%). Toxicity was inconsistently reported but was generally low for all treatment paradigms.

CONCLUSION: Corticosteroid-refractory RN that does not need urgent surgical intervention, with sufficient non-invasive diagnostic testing that favours RN, can be treated medically with bevacizumab in carefully selected patients as a strong recommendation. The role of LITT is evolving as a less invasive image-guided surgical modality, however, the overall evidence for each modality is of low quality. Prospective head-to-head comparisons are needed to evaluate the relative efficacy and toxicity profile amongst treatment approaches.

PMID:37482137 | DOI:10.1016/j.ijrobp.2023.07.015

Int J Radiat Oncol Biol Phys. 2023 Jul 21:S0360-3016(23)07649-6. doi: 10.1016/j.ijrobp.2023.07.017. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study is to report pulmonary function tests (PFTs), clinician-reported and patient-reported QoL outcomes on a cohort of NSCLC patients treated with SABR.

METHODS: 119 patients with NSCLC were treated with SABR in the prospective cohort SSBROC study of patients with T1-T2N0M0 NSCLC. PFTs and quality of life measures were obtained at baseline pre-treatment and 6 monthly. Here we report on the 6- to 18-month time points. ANCOVA methods adjusting for baseline analysed potential predictors on outcomes of PFT and patient-reported dyspnoea at 18 months.

RESULTS: The only statistically significant decline in PFTs was seen in FEV1 at 18 months post-SABR with a decline of -0.11L (p = 0.0087, 95% CI -0.18 to -0.02). Of potential predictors of decline, only a 1 unit increase in smoking pack years resulted in a -0.12 change in DLCO (p = 0.026, 95% CI -0.02 to -0.23) and a 0.003 decrease in FEV1 (p = 0.026, 95% CI -0.006 to -0.0004). For patient reported outcomes, statistically significant worsening in both QLQC30 and QLQLC13 dyspnoea scores occurred at the 18-month time point, but not earlier. No potential predictors of worsening dyspnoea were statistically significant. There was no statistically significant decline in clinician-reported outcomes or global QoL scores.

CONCLUSIONS: We found a statistically significant decline in FEV1 at 18 months post-treatment. Smoking pack years was a predictor for decline in DLCO and FEV1 at 18 months. Worsening of patient-reported dyspnoea scores was observed, consistent with the expected progression of lung co-morbid disease.

PMID:37482136 | DOI:10.1016/j.ijrobp.2023.07.017