Category: Nevin Manimala

Integr Environ Assess Manag. 2023 Apr 25. doi: 10.1002/ieam.4778. Online ahead of print.

ABSTRACT

Wastewater treatment plants (WWTPs) are deemed a major conveyor and point source of per- and polyfluoroalkyl substances (PFAS) to the environment. This statistical meta-analysis of existing literature from the past 15 years focused on the significance of treatment type for PFAS removal efficiencies and the influence of PFAS sources (domestic vs. industrial) on their removal. Different sampling events, WWTPs across the world, different treatment technologies, configurations, and processes, as well as different PFAS classes and compounds were all considered. This study evaluated 13 PFAS analyzed predominately in 161 WWTPs across the world. The statistical test results showed that these 13 frequently detected and reported PFAS can be divided into four groups based on their behavior during wastewater treatment, namely 1) C6-10 perfluorocarboxylic acids (PFCAs), 2) C4,5,11,12 PFCAs, 3) C4,6,8 perfluoroalkane sulfonic acids (PFSAs), and 4) C10 PFSA. Within this study, biological treatments such as 1) membrane bioreactors, 2) combination of two or more biological treatments and 3) biofilm processes showed the highest PFAS removals, while the addition of a tertiary treatment actually had a non-beneficial effect on PFAS removal. Moreover, a strong statistical correlation was observed between industrial wastewater sources and the presence of high influent PFAS concentrations in the receiving WWTPs. This is an indication that industrial sources were the main contributors for the PFAS load in the analyzed WWTPs.

PMID:37096563 | DOI:10.1002/ieam.4778

Am J Hematol. 2023 Apr 25. doi: 10.1002/ajh.26939. Online ahead of print.

NO ABSTRACT

PMID:37096490 | DOI:10.1002/ajh.26939

Int J Technol Assess Health Care. 2023 Apr 25;39(1):e22. doi: 10.1017/S026646232300020X.

ABSTRACT

BACKGROUND: Systematic reviews (SRs) are usually conducted by a highly specialized group of researchers. The routine involvement of methodological experts is a core methodological recommendation. The present commentary describes the qualifications required for information specialists and statisticians involved in SRs, as well as their tasks, the methodological challenges they face, and potential future areas of involvement.

TASKS AND QUALIFICATIONS: Information specialists select the information sources, develop search strategies, conduct the searches, and report the results. Statisticians select the methods for evidence synthesis, assess the risk of bias, and interpret the results. The minimum requirements for their involvement in SRs are a suitable university degree (e.g., in statistics or librarian/information science or an equivalent degree), methodological and content expertise, and several years of experience.

KEY ARGUMENTS: The complexity of conducting SRs has greatly increased due to a massive rise in the amount of available evidence and the number and complexity of SR methods, largely statistical and information retrieval methods. Additional challenges exist in the actual conduct of an SR, such as judging how complex the research question could become and what hurdles could arise during the course of the project.

CONCLUSION: SRs are becoming more and more complex to conduct and information specialists and statisticians should routinely be involved right from the start of the SR. This increases the trustworthiness of SRs as the basis for reliable, unbiased and reproducible health policy, and clinical decision making.

PMID:37096439 | DOI:10.1017/S026646232300020X

Cancer Med. 2023 Apr 25. doi: 10.1002/cam4.5896. Online ahead of print.

ABSTRACT

BACKGROUND: Excess body fatness and hyperinsulinemia are both associated with an increased risk of postmenopausal breast cancer. However, whether women with high body fatness but normal insulin levels or those with normal body fatness and high levels of insulin are at elevated risk of breast cancer is not known. We investigated the associations of metabolically defined body size and shape phenotypes with the risk of postmenopausal breast cancer in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition.

METHODS: Concentrations of C-peptide-a marker for insulin secretion-were measured at inclusion prior to cancer diagnosis in serum from 610 incident postmenopausal breast cancer cases and 1130 matched controls. C-peptide concentrations among the control participants were used to define metabolically healthy (MH; in first tertile) and metabolically unhealthy (MU; >1st tertile) status. We created four metabolic health/body size phenotype categories by combining the metabolic health definitions with normal weight (NW; BMI < 25 kg/m² , or WC < 80 cm, or WHR < 0.8) and overweight or obese (OW/OB; BMI ≥ 25 kg/m² , or WC ≥ 80 cm, or WHR ≥ 0.8) status for each of the three anthropometric measures separately: (1) MHNW, (2) MHOW/OB, (3) MUNW, and (4) MUOW/OB. Conditional logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: Women classified as MUOW/OB were at higher risk of postmenopausal breast cancer compared to MHNW women considering BMI (OR = 1.58, 95% CI = 1.14-2.19) and WC (OR = 1.51, 95% CI = 1.09-2.08) cut points and there was also a suggestive increased risk for the WHR (OR = 1.29, 95% CI = 0.94-1.77) definition. Conversely, women with the MHOW/OB and MUNW were not at statistically significant elevated risk of postmenopausal breast cancer risk compared to MHNW women.

CONCLUSION: These findings suggest that being overweight or obese and metabolically unhealthy raises risk of postmenopausal breast cancer while overweight or obese women with normal insulin levels are not at higher risk. Additional research should consider the combined utility of anthropometric measures with metabolic parameters in predicting breast cancer risk.

PMID:37096432 | DOI:10.1002/cam4.5896

Diabetes Metab J. 2023 Apr 25. doi: 10.4093/dmj.2022.0096. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic kidney disease (DKD) is a risk factor for hospitalization for heart failure (HHF). DKD could be classified into four phenotypes by estimated glomerular filtration rate (eGFR, normal vs. low) and proteinuria (PU, negative vs. positive). Also, the phenotype often changes dynamically. This study examined HHF risk according to the DKD phenotype changes across 2-year assessments.

METHODS: The study included 1,343,116 patients with type 2 diabetes mellitus (T2DM) from the Korean National Health Insurance Service database after excluding a very high-risk phenotype (eGFR <30 mL/min/1.73 m2) at baseline, who underwent two cycles of medical checkups between 2009 and 2014. From the baseline and 2-year eGFR and PU results, participants were divided into 10 DKD phenotypic change categories.

RESULTS: During an average of 6.5 years of follow-up, 7,874 subjects developed HHF. The cumulative incidence of HHF from index date was highest in the eGFRlowPU- phenotype, followed by eGFRnorPU+ and eGFRnorPU-. Changes in DKD phenotype differently affect HHF risk. When the persistent eGFRnorPU- category was the reference, hazard ratios for HHF were 3.10 (95% confidence interval [CI], 2.73 to 3.52) in persistent eGFRnorPU+ and 1.86 (95% CI, 1.73 to 1.99) in persistent eGFRlowPU-. Among altered phenotypes, the category converted to eGFRlowPU+ showed the highest risk. In the normal eGFR category at the second examination, those who converted from PU- to PU+ showed a higher risk of HHF than those who converted from PU+ to PU-.

CONCLUSION: Changes in DKD phenotype, particularly with the presence of PU, are more likely to reflect the risk of HHF, compared with DKD phenotype based on a single time point in patients with T2DM.

PMID:37096376 | DOI:10.4093/dmj.2022.0096

Ann Otol Rhinol Laryngol. 2023 Apr 25:34894231169341. doi: 10.1177/00034894231169341. Online ahead of print.

ABSTRACT

BACKGROUND: No gold standard has been developed for the therapy of intracanalicular vestibular schwannomas (IVS). Options for treatment include a conservative approach, microsurgery, or radiosurgery. Although the efficacy of these treatment has been well-documented, little is known about the determinants of outcome in IVSs following radiosurgery. Therefore, we examined the results in relation to age, gender, tumor volume, distance to fundus, microcyst existence, and radiosensitivity in this group. In addition, we investigated possible predictors of facial nerve function and hearing preservation.

METHODS: Ninety-four patients with unilateral IVS were included in the evaluation (52 women and 42 males). The patients were separated into younger and older age groups based on their median age (55 years). The median IVS volume was 138 mm³, microcysts were identified in 16 tumors, and 63 tumors were adjacent to the fundus. The data were analyzed using Statistica software package ver. 13.3.

RESULTS: At final follow-up, a statistically significant decrease in tumor volume and no statistically significant decline in hearing were noted, but no differences between age groups were found. The sex had no effect on overall tumor growth control, facial nerve preservation, or hearing preservation. Localization of IVS close to the fundus and the presence of tumor microcysts had no effect on the control of tumor growth, preservation of hearing, and sparing of facial nerve following radiosurgery. Cochlear dose had no influence on hearing preservation. Higher tumor volume was associated with its pseudoprogression during early follow-up and a greater risk of hearing loss.

CONCLUSIONS: Age, sex, tumor volume, proximity to the fundus, and the existence of a microcyst were not predictive of radiosensitivity nor preservation of facial nerve function and hearing, based on the findings. There was no effect of cochlear dose on hearing. Initial greater tumor volume was associated with an increased probability of tumor pseudoprogression.

PMID:37096361 | DOI:10.1177/00034894231169341

Med Sci Monit. 2023 Apr 25;29:e939613. doi: 10.12659/MSM.939613.

ABSTRACT

BACKGROUND Despite the increasing number of studies published worldwide focusing on inguinal hernia, a major condition in the surgical field that affects the quality of life of many patients, a bibliometric study on inguinal hernia is yet to be conducted. The present study aimed to analyze the scientific articles published on inguinal hernia using statistical methods. MATERIAL AND METHODS Articles published between 1980 and 2021 on inguinal hernia were downloaded from the Web of Science database and analyzed using statistical methods. RESULTS A total of 11 761 publications were found. The top 5 contributors to the literature were the United States (n=2109, 27%), Germany (563, 6.7%), United Kingdom (595, 5.7%), Turkey (415, 5.3%), and Japan (388, 4.9%). The top 3 most influential journals by average number of citations per article were Annals of Surgery (citations: 67.4), British Journal of Surgery (citations: 49.9), and Surgical Clinics of North America (citations: 43.2). CONCLUSIONS In the current comprehensive bibliometric study on inguinal hernia, which has demonstrated an upward trend in the number of articles published recently, we present a summary of 7810 articles published from 1980 to 2021. According to the results of the analysis conducted to identify trending topics, the keywords studied in recent years are believed to include pediatric, outcomes, minimally invasive surgery, robotic, incisional hernia, umbilical hernia, chronic pain, obesity, bariatric surgery, NSQIP, seroma, surgical site infection, abdominal wall reconstruction, ventral hernia repair, and hiatal hernia repair.

PMID:37095690 | DOI:10.12659/MSM.939613

Womens Midlife Health. 2023 Apr 25;9(1):4. doi: 10.1186/s40695-023-00087-0.

ABSTRACT

BACKGROUND: Loss in ovarian function during mid-life results in adverse changes in the cardiovascular profile of women. The association between CVD risk factors and menopause differ cross-culturally since several modifiable factors play significant roles in explaining CVD mortality in addition to differences in endogenous estrogen. Very few of the studies from the Indian subcontinent have been concerned with the menopause-specific CVD risk factors, particularly among the tribal groups. Thus, we intended to study the variations in body fat pattern and CVD risk factors between Hindu caste and Lodha tribal postmenopausal women and how these risk factors were associated with differential socio-economic, reproductive and menstrual characteristics and lifestyle variables. The Lodha tribal populations is considered a Particularly Vulnerable Group (PVTG) in this country.

METHODS: This cross-sectional study was conducted among the Bengali Hindu caste and Lodha tribal populations of the State of West Bengal, India covering three districts namely Howrah, Jhargram and East Midnapure. A total of 197 postmenopausal participants were recruited for this study (urban caste 69, rural caste 65 and rural Lodha 63). Data on blood glucose and total cholesterol levels, blood pressure, muscle mass, body fat distribution and sociodemographic, reproductive and menstrual history and lifestyle variables were collected following standard protocols. Analysis of variance (ANOVA) was applied to compare blood glucose, total cholesterol and blood pressure levels and body fat measures across the three populations. Stepwise multiple linear regression analysis was performed to find out the factors associated with CVD risk factors. The data were analyzed with the Statistical Package for Social Science version 20.0(IBM corporation, 2011).

RESULTS: This cross-sectional comparison of women at midlife, though exploratory in nature showed significant differences in body fat pattern and CVD risk factors between caste and tribal groups owing to socioeconomic disparities and, differences in reproductive characteristics and lifestyle factors.

CONCLUSION: The caste and tribal populations differed significantly in body fat pattern and CVD risk factors and in the factors associated with CVD risk suggesting interplay between menopause and modifiable factors in explaining CVD risk factors during mid-life.

PMID:37095574 | DOI:10.1186/s40695-023-00087-0

BMC Health Serv Res. 2023 Apr 25;23(1):397. doi: 10.1186/s12913-023-09371-1.

ABSTRACT

BACKGROUND: Globally, the COVID-19 pandemic had a huge impact on patients and healthcare systems. A decline in paediatric visits to healthcare settings was observed, which might have been due to lower incidence of injury and infectious illness, changes in healthcare services and parental concern. The aim of our study was to examine parental experiences of help-seeking for, and care of, a sick or injured child during COVID-19 lockdown periods in five European countries with different healthcare systems in place.

METHODS: An online survey for parents with a child with any kind or illness of injury during COVID-19 lockdowns was circulated through social media in five European countries: Italy, Spain, Sweden, the Netherlands, and the United Kingdom. Parents living in one of these countries with self-identification of a sick or injured child during COVID-19 lockdown periods were eligible to fill in the survey. Descriptive statistics were used for the level of restrictions per country, children’s characteristics, family characteristics and reported help-seeking behaviour of parents prior to the lockdown and their real experience during the lockdown. The free text data was subjected to thematic analysis.

RESULTS: The survey was fully completed by 598 parents, ranging from 50 to 198 parents per country, during varying lockdown periods from March 2020 until May 2022. Parents who completed the survey were not deterred from seeking medical help for their sick or injured child during the COVID-19 pandemic. This finding was comparable in five European countries with different healthcare systems in place. Thematic analysis identified three main areas: parental experiences of access to healthcare, changes in parents’ help-seeking behaviours for a sick or injured child during lockdowns, and the impact of caring for a sick or injured child during the lockdowns. Parents reported limited access to non-urgent care services and were anxious about either their child or themselves catching COVID-19.

CONCLUSION: This insight into parental perspectives of help-seeking behaviour and care for a sick or injured child during COVID-19 lockdowns could inform future strategies to improve access to healthcare, and to provide parents with adequate information concerning when and where to seek help and support during pandemics.

PMID:37095499 | DOI:10.1186/s12913-023-09371-1

Eur Radiol. 2023 Apr 25. doi: 10.1007/s00330-023-09622-z. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the effect of the weighting of input imaging combo and ADC threshold on the performance of the U-Net and to find an optimized input imaging combo and ADC threshold in segmenting acute ischemic stroke (AIS) lesion.

METHODS: This study retrospectively enrolled a total of 212 patients having AIS. Four combos, including ADC-ADC-ADC (AAA), DWI-ADC-ADC (DAA), DWI-DWI-ADC (DDA), and DWI-DWI-DWI (DDD), were used as input images, respectively. Three ADC thresholds including 0.6, 0.8 and 1.8 × 10^-3 mm²/s were applied. Dice similarity coefficient (DSC) was used to evaluate the segmentation performance of U-Nets. Nonparametric Kruskal-Wallis test with Tukey-Kramer post-hoc tests were used for comparison. A p < .05 was considered statistically significant.

RESULTS: The DSC significantly varied among different combos of images and different ADC thresholds. Hybrid U-Nets outperformed uniform U-Nets at ADC thresholds of 0.6 × 10^-3 mm²/s and 0.8 × 10^-3 mm²/s (p < .001). The U-Net with imaging combo of DDD had segmentation performance similar to hybrid U-Nets at an ADC threshold of 1.8 × 10^-3 mm²/s (p = .062 to 1). The U-Net using the imaging combo of DAA at the ADC threshold of 0.6 × 10^-3 mm²/s achieved the highest DSC in the segmentation of AIS lesion.

CONCLUSIONS: The segmentation performance of U-Net for AIS varies among the input imaging combos and ADC thresholds. The U-Net is optimized by choosing the imaging combo of DAA at an ADC threshold of 0.6 × 10^-3 mm²/s in segmentating AIS lesion with highest DSC.

KEY POINTS: • Segmentation performance of U-Net for AIS differs among input imaging combos. • Segmentation performance of U-Net for AIS differs among ADC thresholds. • U-Net is optimized using DAA with ADC = 0.6 × 10^-3 mm²/s.

PMID:37095361 | DOI:10.1007/s00330-023-09622-z