Category: Nevin Manimala

Eur J Public Health. 2023 Jun 1:ckad088. doi: 10.1093/eurpub/ckad088. Online ahead of print.

ABSTRACT

Researching mortality during the COVID-19 pandemic has been challenging due to methodological inconsistencies and the limited availability of vital statistics data. At the beginning of the pandemic, the World Health Organization recommended daily data publication to inform policy response, but these data were often poor. Final data on COVID-19 deaths in many countries are not yet available, especially for 2021. This report shows that many countries have significant inconsistencies between the preliminary number of deaths and what vital statistics and excess mortality indicate. The inconsistencies in the mortality data raise concerns about the reliability of analyses and public health recommendations.

PMID:37263603 | DOI:10.1093/eurpub/ckad088

Eur J Public Health. 2023 Jun 1:ckad075. doi: 10.1093/eurpub/ckad075. Online ahead of print.

ABSTRACT

BACKGROUND: Analyses of coronavirus disease 19 suggest specific risk factors make communities more or less vulnerable to pandemic-related deaths within countries. What is unclear is whether the characteristics affecting vulnerability of small communities within countries produce similar patterns of excess mortality across countries with different demographics and public health responses to the pandemic. Our aim is to quantify community-level variations in excess mortality within England, Italy and Sweden and identify how such spatial variability was driven by community-level characteristics.

METHODS: We applied a two-stage Bayesian model to quantify inequalities in excess mortality in people aged 40 years and older at the community level in England, Italy and Sweden during the first year of the pandemic (March 2020-February 2021). We used community characteristics measuring deprivation, air pollution, living conditions, population density and movement of people as covariates to quantify their associations with excess mortality.

RESULTS: We found just under half of communities in England (48.1%) and Italy (45.8%) had an excess mortality of over 300 per 100 000 males over the age of 40, while for Sweden that covered 23.1% of communities. We showed that deprivation is a strong predictor of excess mortality across the three countries, and communities with high levels of overcrowding were associated with higher excess mortality in England and Sweden.

CONCLUSION: These results highlight some international similarities in factors affecting mortality that will help policy makers target public health measures to increase resilience to the mortality impacts of this and future pandemics.

PMID:37263602 | DOI:10.1093/eurpub/ckad075

Orthop Traumatol Surg Res. 2023 May 30:103637. doi: 10.1016/j.otsr.2023.103637. Online ahead of print.

ABSTRACT

INTRODUCTION: The EFAS score is a new recently validated European quality of life score for foot and ankle surgery, comprising 6 questions on activities of daily living (ADL) and 4 on sport. The aim of the present study was to assess the kinetics of functional recovery on the EFAS and SF36 scores, and to assess correlations between the two at 0 to 6 months then 6 months to 1 year in a population of foot and ankle surgery patients, globally and per pathology.

HYPOTHESIS: Hindfoot and ankle surgery requires at least 1 year’s follow-up for assessment of recovery, whereas 6 months is sufficient to assess forefoot recovery.

MATERIAL AND METHODS: A multicenter prospective cohort study included all patients undergoing surgery for foot and ankle pathology between December 2015 and July 2016. Statistical analysis, global and per pathology, was performed preoperatively and at 6 months and 1 year.

RESULTS: 98 patients were assessed at 1 year. In the global population, EFAS ADL score improved by 17.1 ± 22.1 points (hindfoot, 16.9 ± 24.6; forefoot, 19.7 ± 21.4) and global SF36 score by 8.7 ± 17.1 points (hindfoot, 10.2 ± 19.1; forefoot, 9.6 ± 15.9). Both scores progressed between 6 months and 1 year for hindfoot pathologies, whereas they remained constant after 6 months for the forefoot. The EFAS score showed weak correlation with SF36.

CONCLUSION: Recovery kinetics differs according to type of foot and ankle pathology. The EFAS score is more suitable than the SF36.

LEVEL OF EVIDENCE: II.

PMID:37263580 | DOI:10.1016/j.otsr.2023.103637

Environ Pollut. 2023 May 30:121938. doi: 10.1016/j.envpol.2023.121938. Online ahead of print.

ABSTRACT

Per- and polyfluoroalkyl substances (PFAS) have extensively contaminated freshwater aquatic ecosystems where they can be transported in water and partition to sediment and biota. In this paper, three freshwater benthic macroinvertebrates with different foraging modes were exposed to environmentally relevant concentrations of eight perfluoroalkyl carboxylates (PFCA), three perfluoroalkyl sulfonates (PFSA), and three fluorotelomer sulfonates (FTS) at varying divalent cation concentrations of magnesium (Mg²⁺) and calcium (Ca²⁺). Divalent cations can impact PFAS partitioning to solids, especially to sediments, at higher concentrations. Sediment dwelling worms (Lumbriculus variegatus), epibenthic grazing snails (Physella acuta), and sediment-dwelling filter-feeding bivalves (Elliptio complanata) were selected due to their unique foraging modes. Microcosms were composed of synthetic sediment, culture water, macroinvertebrates, and PFAS and consisted of a 28-day exposure period. L. variegatus had significantly higher PFAS bioaccumulation than P. acuta and E. complanata, likely due to higher levels of interactions with and ingestion of the contaminated sediment. “High Mg²⁺” (7.5 mM Mg²⁺) and “High Ca²⁺” (7.5 mM Ca²⁺) conditions generally had statistically higher bioaccumulation factors (BAF) than the “Reference Condition” (0.2 mM Ca²⁺ and 0.2 mM Mg²⁺) for PFAS with perfluorinated chain lengths greater than eight carbons. Long-chain PFAS dominated the PFAS profiles of the macroinvertebrates for all groups of compounds studied (PFCA, PFSA, and FTS). These results indicate that the study organism has the greatest impact on bioaccumulation, although divalent cation concentration had observable impacts between organisms depending on the environmental conditions. Elevated cation concentrations in the microcosms led to significantly greater bioaccumulation in the test organisms compared to the experimental reference conditions for long-chain PFAS.

PMID:37263566 | DOI:10.1016/j.envpol.2023.121938

Contemp Clin Trials. 2023 May 30:107247. doi: 10.1016/j.cct.2023.107247. Online ahead of print.

ABSTRACT

BACKGROUND: Young adults experience high rates of cannabis use and consequences. Cross-sectional work has linked positive psychological constructs (e.g., savoring) to less cannabis use and consequences, and positive psychological interventions (PPIs) have shown promise in targeting other substance use behaviors. This pilot study sought to provide an initial test of PPIs to reduce young adult cannabis use and consequences.

METHODS: Adults (18-25 years old) who endorsed at least weekly past-month cannabis use (N = 59, 69.6% men, 41.1% White) reported their baseline cannabis use and consequences. Participants were randomized to complete one of three daily exercises (Savoring, Three Good Things, or a control) along with daily text message surveys for two weeks, then completed a follow-up survey at the end of the two weeks.

RESULTS: Paired samples t-tests indicated that participants in the Three Good Things group showed medium to large reductions in frequency of weekly cannabis use (p = .08, g_av = -0.57) and cannabis-associated consequences (p = .08, g_av = -0.57) from baseline to follow-up. In the Savoring and control groups, there were not significant changes in frequency of weekly cannabis use (Savoring: p = .39, g_av = 0.20; Control: p = .96, g_av = 0.01) nor cannabis-associated consequences (Savoring: p = .84, g_av = 0.05; Control: p = .45, g_av = -0.18). Participants in both positive psychology conditions reported the exercises were easy to complete, providing evidence for acceptability.

DISCUSSION: Results provide initial support for the feasibility and potential promise of a text-message based PPI as a harm reduction approach for cannabis users. A larger clinical trial is warranted to test the effects of such interventions with adequate statistical power.

PMID:37263491 | DOI:10.1016/j.cct.2023.107247

J Shoulder Elbow Surg. 2023 May 30:S1058-2746(23)00425-1. doi: 10.1016/j.jse.2023.04.030. Online ahead of print.

ABSTRACT

BACKGROUND: Patients undergoing a total shoulder arthroplasty (TSA) through a deltopectoral approach will require repair of the subscapularis tendon. There are no universal postoperative guidelines for rehabilitation of the subscapularis specifically. We hypothesize that the addition of a subscapularis-specific regimen will result in improved subscapularis strength and function.

METHODS: Adult patients undergoing anatomic TSA for the treatment of primary glenohumeral osteoarthritis were included. Patients were randomized into either the traditional rehabilitation (TR) control group or the subscapularis rehabilitation (SR) group, which consisted of the traditional therapy along with early and additional subscapularis exercises. Baseline demographics, patient reported outcome measures(PROMs), range of motion (ROM), provocative tests, and subscapularis strength using a handheld dynamometer were measured preoperatively at the initial clinic visit (ICV) as well as 3-months, 6-months, and one-year postoperatively. The primary outcome of interest was a comparison of subscapularis strength between cohorts relative to preoperative baseline, while secondary outcomes were functional, ROM and PROMs.

RESULTS: Sixty-six patients were included in final analysis (32 TR vs 34 SR). There were no statistically significant differences between cohorts at the ICV with regards to demographics, baseline subscapularis strength, functional testing, or PROMs. All postoperative time points demonstrated similar subscapularis strength testing between TR and SR groups (p>0.05). Additionally, peak and average subscapularis strength testing at 3, 6, and 12 months postoperatively were similar to baseline ICV testing in both groups. Both groups demonstrated improvements across several provocative tests, ROM and PROM outcome metrics at every postoperative timepoint as compared to baseline ICV values (p<0.05).

CONCLUSIONS: Patients undergoing anatomic total shoulder arthroplasty return to baseline internal rotation strength by 3-months postoperatively and demonstrate significant improvements in function, range of motion, and several patient reported outcome measures. The addition of early and focused subscapularis strengthening exercises does not appear to significantly impact any outcomes when compared to traditional rehabilitation programs.

PMID:37263480 | DOI:10.1016/j.jse.2023.04.030

J Shoulder Elbow Surg. 2023 May 30:S1058-2746(23)00415-9. doi: 10.1016/j.jse.2023.04.020. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to report the clinical and radiological outcomes of patients undergoing primary or revision reverse total shoulder arthroplasty using custom 3D printed components to manage severe glenoid bone loss with a minimum of 2-year follow-up.

METHODS: Following ethical approval (ref: 17/YH/0318), patients were identified and invited to participate. Inclusion criteria were: 1) severe glenoid bone loss necessitating the need for custom implants; and 2) patients with definitive glenoid and humeral components implanted more than 2 years prior. Included patients underwent clinical assessment utilizing the Oxford Shoulder Score (OSS), Constant-Murley score, American Shoulder and Elbow Surgeons score (ASES), and quick Disabilities of the Arm, Shoulder, and Hand Score (QuickDASH). Radiographic assessment included AP and axial projections. Patients were invited to attend a CT scan to confirm osseointegration. Statistical analysis utilized descriptive statistics (mean and standard deviation) and paired t test for parametric data.

RESULTS: Eleven patients declined to participate. 5 patients were deceased prior to study commencement, leaving 42 remaining patients in this analysis. Three patients had revision surgery prior to the 2-year follow-up. Of these, 2/3 retained their custom glenoid components. Mean follow-up was 31.6 months from surgery (range 24-52 months). OSS improved from a mean 15 (SD±8.4) to 36 (SD±12) (p < 0.001). Constant-Murley score improved from mean 15 (SD± 11.2) to 52 (SD± 20.1) (p < 0.001). QuickDASH improved from mean 70 (SD ±21) to 31 (SD ±24.8) (p = 0.004). ASES improved from mean 22 (SD± 17.8) to 71 (SD ±23.3) (p = 0.007). Radiological evaluation demonstrated good osseointegration in all but one included patient.

CONCLUSION: The utility of custom 3D-printed components for managing severe glenoid bone loss in primary and revision reverse total shoulder arthroplasty yields significant clinical improvements in this complex cohort. Large complex glenoid bone defects can be managed successfully with custom 3D-printed glenoid components.

PMID:37263477 | DOI:10.1016/j.jse.2023.04.020

Sci Total Environ. 2023 May 30:164505. doi: 10.1016/j.scitotenv.2023.164505. Online ahead of print.

ABSTRACT

Oil-based paint seriously threatens biodiversity due to its complex composition and biocide toxicity. Therefore, it alters the microbial diversity abundance and in modern approaches like metagenomic, a powerful tool to get insight into pollutants effect on soil microbial community abundance. Thus, present study aimed at “exploring community dynamics: cultivable and uncultivable for the microbial-mediated bioremediation of oil-based paints polluted soil from aqueous media by Plackett-Burman statistical designed conditions”. The total DNA from oil-based paints polluted soil was extracted by PowerSoil DNA Isolation Kit. The 16S rDNA genes were amplified using universal primers and PCR amplicons were sequenced for analysis of metagenomes to determine the bacterial microbiome abundance. A total 133,140 sequence reads, 2857 Operational Taxonomic Units (OTUs) of 16S rRNA genes, and 30 bacterial phyla were retrieved from all the oil-based paints polluted samples (C, R498, B698 and G492) with the significant increase in Firmicutes (18.90 %, 52.39 %, 49.75 %, 44.36 %) and Actinobacteria (26.66 %, 28.93 %, 28.17 %, 14.68 %) whereas a decrease in Proteobacteria (19.53 %, 6.32 %, 9.37 %, 16.21 %), Chloroflexi (16.93 %, 8.71 %, 9.78 %, 18.17 %), and Bacteroidetes (8.96 %, 0.36 %, 0.41 %, 0.11 %) was recorded respectively. Additionally, the 100 % removal of oil-based paints (R498, B698 and G492) was achieved by the cultivable microbial consortia in laboratory settings. On the other hand for the R498 single cultivable pure isolates exhibited biodegradation potential as “PDB20, 91 %”, “PDB14, 81 %”, and “PDB16, 87 %” while for the blue B698, “PDB4, 86 %”, “PDB20, 89 %”, “PDB5, and PDB2, 80%”. Moreover, in case of G492, maximum % removal was achieved with “PDB20, 93 %”, “PDB5, 90 %”, “PDB6, 90 %”, “PDB16, 88 %”, “PDB2, and PDB4, 89%”. Conclusively, in comparison to R498 and B698, maximum percent removal was displayed by G492 and this might be attributed due to difference in pigment. Cultivable consortia and individual pure isolates demonstrated >80 % contribution in the % removal of oil-based paints.

PMID:37263438 | DOI:10.1016/j.scitotenv.2023.164505

Sci Total Environ. 2023 May 30:164564. doi: 10.1016/j.scitotenv.2023.164564. Online ahead of print.

ABSTRACT

The Campos de Palmas Wildlife Refuge (CPWR) (Brazil) is a full protection Conservation Unit (CU) formed by private properties, where the use of land and natural resources are allowed sustainably according to the rules of the CU Management Plan. Inadequate practices of land use and occupation within this CU can affect its quality and the organisms that depend on them. Considering the above, the objective of the present study was to biomonitor different land uses and occupations within the CPWR and its surroundings, during the four seasons of a year, using the bioindicators Allium cepa (cytotoxicity and genotoxicity tests) and Eisenia fetida (leakage test). The soil samples were collected in areas of silviculture, agriculture, and native grasslands within the CU and agriculture outside the limits of the CPWR. The use by silviculture (spring) and native grassland (summer) showed cytotoxic effects for A. cepa. The use by agriculture outside the CPWR (spring) showed genotoxic effect and stimulation of mitotic cell division. For the animal bioindicator, the use by agriculture within the CPWR (winter), native grassland (autumn and spring), silviculture (autumn and spring), and agriculture outside the CU (spring) showed a toxic effect. A PCA analysis showed a correlation between the results of toxicity, cytotoxicity, and genotoxicity with the presence of macronutrients and metals in the evaluated soil samples. Possibly influenced by their soil composition characteristics (silviculture and native grassland) or the management of agricultural areas. In addition, samples from the rainy season (spring) showed higher ecotoxicity. These results show that biomonitoring through different organisms is important for evaluating environmental quality and indicate the need for the implementation of preventive measures in the CPWR to avoid the toxic, cytotoxic, and genotoxic effects found. They also ensure the integrity of this CU and the active protection of the environment and biodiversity.

PMID:37263429 | DOI:10.1016/j.scitotenv.2023.164564

J Appl Clin Med Phys. 2023 Jun 1:e14056. doi: 10.1002/acm2.14056. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to reduce scan time in ¹⁷⁷ Lu planar scintigraphy through the use of convolutional neural network (CNN) to facilitate personalized dosimetry for ¹⁷⁷ Lu-based peptide receptor radionuclide therapy.

METHODS: The CNN model used in this work was based on DenseNet, and the training and testing datasets were generated from Monte Carlo simulation. The CNN input images (IMG_input ) consisted of ¹⁷⁷ Lu planar scintigraphy that contained 10-90% of the total photon counts, while the corresponding full-count images (IMG^100% ) were used as the CNN label images. Two-sample t-test was conducted to compare the difference in pixel intensities within region of interest between IMG^100% and CNN output images (IMG_output ).

RESULTS: No difference was found in IMG_output for rods with diameters ranging from 13 to 33 mm in the Derenzo phantom with a target-to-background ratio of 20:1, while statistically significant differences were found in IMG_output for the 10-mm diameter rods when IMG_input containing 10% to 60% of the total photon counts were denoised. Statistically significant differences were found in IMG_output for both right and left kidneys in the NCAT phantom when IMG_input containing 10% of the total photon counts were denoised. No statistically significant differences were found in IMG_output for any other source organs in the NCAT phantom.

CONCLUSION: Our results showed that the proposed method can reduce scan time by up to 70% for objects larger than 13 mm, making it a useful tool for personalized dosimetry in ¹⁷⁷ Lu-based peptide receptor radionuclide therapy in clinical practice.

PMID:37261890 | DOI:10.1002/acm2.14056