Category: Nevin Manimala

CJEM. 2023 Mar 1. doi: 10.1007/s43678-023-00458-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the agreement between three emergency department (ED) vulnerability screeners, including the InterRAI ED Screener, ER², and PRISMA-7. Our secondary objective was to evaluate the discriminative accuracy of screeners in predicting discharge home and extended ED lengths-of-stay (> 24 h).

METHODS: We conducted a nested sub-group study using data from a prospective multi-site cohort study evaluating frailty in older ED patients presenting to four Quebec hospitals. Research nurses assessed patients consecutively with the three screeners. We employed Cohen’s Kappa to determine agreement, with high-risk cut-offs of three and four for the PRISMA-7, six for the ER², and five for the interRAI ED Screener. We used logistic regression to evaluate the discriminative accuracy of instruments, testing them in their dichotomous, full, and adjusted forms (adjusting for age, sex, and hospital academic status).

RESULTS: We evaluated 1855 older ED patients across the four hospital sites. The mean age of our sample was 84 years. Agreement between the interRAI ED Screener and the ER² was fair (K = 0.37; 95% CI 0.33-0.40); agreement between the PRISMA-7 and ER² was also fair (K = 0.39; 95% CI = 0.36-0.43). Agreement between interRAI ED Screener and PRISMA-7 was poor (K = 0.19; 95% CI 0.16-0.22). Using a cut-off of four for PRISMA-7 improved agreement with the ER² (K = 0.55; 95% CI 0.51-0.59) and the ED Screener (K = 0.32; 95% CI 0.2-0.36). When predicting discharge home, the concordance statistics among models were similar in their dichotomous (c = 0.57-0.61), full (c = 0.61-0.64), and adjusted forms (c = 0.63-0.65), and poor for all models when predicting extended length-of-stay.

CONCLUSION: ED vulnerability scores from the three instruments had a fair agreement and were associated with important patient outcomes. The interRAI ED Screener best identifies older ED patients at greatest risk, while the PRISMA-7 and ER² are more sensitive instruments.

PMID:36857018 | DOI:10.1007/s43678-023-00458-6

J Gastrointest Surg. 2023 Mar 1. doi: 10.1007/s11605-023-05592-1. Online ahead of print.

ABSTRACT

BACKGROUND: Liver transplantation remains the optimal treatment for multifocal hepatocellular carcinoma (HCC). However, due to resource constrains, other therapeutic modalities such as liver resection (LR), are frequently utilized. LR, however, has to be balanced against potential morbidity and mortality along with the risks of early recurrence leading to futile surgery. In this study, we evaluated preoperative factors, including inflammatory indices, in predicting early (< 1 year) recurrence in patients who underwent LR for multifocal HCC.

METHODS: This was a post hoc analysis of 250 consecutive patients with multifocal HCC who underwent LR.

RESULTS: After exclusion of 10 patients with 30-day/in-hospital mortality, 240 were included of which 134 (55.8%) developed early recurrence. Hepatitis B/C aetiology, 3/ > more hepatic nodules and elevated alpha-fetoprotein (AFP) ≥ 200 ng/ml were significant independent preoperative predictors of early recurrence. The early recurrence rate was 72.1% when 2 out of 3 significant predictive factors were present. The conglomerate of all 3 factors predicted early recurrence of 100% with a statistically significant association between number of predictive factors and early recurrence (p < 0.001).

CONCLUSION: Better patient selection via the use of preoperative predictive factors of early recurrence such as hepatitis B/C aetiology, ≥ 3 nodules and elevated AFP ≥ 200 ng/ml may assist in identifying patients in whom LR is deemed futile and improve resource allocation.

PMID:36857014 | DOI:10.1007/s11605-023-05592-1

Environ Sci Pollut Res Int. 2023 Mar 1. doi: 10.1007/s11356-023-25652-y. Online ahead of print.

ABSTRACT

Using the panel data of 284 cities from 2011 to 2020 in China, this research statistically tests the direct impact and internal mechanism of digital finance on urban haze pollution. The results show the following: (1) the development of digital finance can significantly inhibit the concentration of urban haze, and there is a stronger inhibitory effect in areas where the government pays more emphasis to haze pollution and in cities with high levels; (2) after mechanism inspection, it is found that digital finance can indirectly promote urban haze pollution by influencing green innovation, cooperative innovation, industrial structure upgrading, and producer service agglomeration; (3) the results of the spatial econometric analysis show that digital finance can suppress the haze concentration in the region and simultaneously inhibit the neighboring areas through spillover effects; (4) further inspection shows that the spatial spillover effect of digital finance on haze pollution has an obvious spatial attenuation feature, demonstrating that a dense area of spatial spillover is within 310 km. The spillover effect gradually disappears when the threshold is exceeded.

PMID:36857001 | DOI:10.1007/s11356-023-25652-y

Environ Sci Pollut Res Int. 2023 Mar 1. doi: 10.1007/s11356-023-26032-2. Online ahead of print.

ABSTRACT

The present work performs the polyphasic characterization of a novel cyanobacterial species Scytonema ambikapurensis isolated from an Indian hot spring and evaluates its wastewater bioremediation potential. While the physicochemical analyses of the wastewater indicated high load of nutrients and metals, the wastewater bioremediation experiment performed using the test cyanobacterium denoted the removal of 70 and 86% phosphate, 49 and 66% sulfate, 96 and 98% nitrate, 91 and 92% nitrite, 95 and 96% ammonia, 66 and 72% chloride, 79 and 81% zinc, 68 and 80% nickel, 81 and 90% calcium, and 80 and 90% potassium from the autoclaved and un-autoclaved wastewater, respectively, after 20 days of culturing. The kinetics study of zinc and nickel removal from wastewater revealed that the cyanobacterium employed sequential biosorption (by following pseudo-second-order kinetics model) and bioaccumulation methods to remove these two metals. The quality of the autoclaved and un-autoclaved wastewater was further improved by the cyanobacterium through reduction of hardness by 74 and 81%, respectively. In wastewater, the cyanobacterium not only enhanced its biomass, chlorophyll and carbohydrate contents, but also produced small amount of released and high capsular exopolysaccharide (EPS). The FTIR and TGA analyses of capsular EPS unraveled that it was a negatively charged sulfated biomolecule having thermostability up to 240 °C, which suggested its possible use as excellent emulsifying, viscosifying, and biosorption agent. The credibility of this EPS as biosorption agent was ascertained by evaluating its metal chelating ability. Finally, the experimental data denoting the ability of S. ambikapurensis to bioremediate wastewater and simultaneously produce EPS was statistically validated by PCA1-pollutant removal model and the PCA2-cellular constituent model, respectively. Briefly, the study discloses that the cyanobacterium has huge biotechnological and industrial importance as it bioremediates wastewater and simultaneously produces thermostable exopolysaccharide.

PMID:36856995 | DOI:10.1007/s11356-023-26032-2

Obes Surg. 2023 Mar 1. doi: 10.1007/s11695-023-06499-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Parental predisposition and age of onset may be independently associated with 1-year total weight loss (TWL) failure (< 20%) after metabolic-bariatric surgery (MBS).

METHODS: This cohort study includes all cases of the German StuDoQ|MBE register (2015-2019) with data on parental predisposition, obesity onset, and at least 1-year follow up after primary MBS procedures (n = 14,404). We provide descriptive statistics of the cohort in terms of the main outcome and 1-year TWL failure, and provide characteristics of surgery type subgroups. Finally, we provide a multivariate logistic regression model of 1-year TWL failure.

RESULTS: 58.8% and 45.7% of patients reported maternal and paternal predisposition for obesity, respectively. Average onset of obesity was 15.5 years and duration of disease 28.3 years prior to MBS. SG is the most frequently performed procedure (47.2%) followed by RYGB (39.7%) and OAGB (13.1%). Mean 1-year TWL is 32.7 ± 9.3%, and 7.8% (n = 1,119) of patients show TWL failure (< 20%). Multivariate analysis shows independent association of early onset of obesity (< 18 years), male sex, age at operation, pre-operative BMI, pre-operative weight loss, sleeve gastrectomy (SG), and type 2 diabetes (T2D) with 1-year TWL failure (p < 0.001).

CONCLUSION: The proportions of MBS patients that report on paternal and maternal predisposition for obesity are 45.7% and 58.8% respectively, and average age at onset is 15.5 years. 7.8% of patients do not meet current target criteria of successful response to surgery at 1 year. Early onset, male sex, age at operation, pre-operative BMI, pre-operative weight loss, SG, and T2D are independently associated with weight loss failure.

PMID:36856989 | DOI:10.1007/s11695-023-06499-1

Int Ophthalmol. 2023 Mar 1. doi: 10.1007/s10792-023-02661-x. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings.

METHODS: In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD).

RESULTS: In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex (p > 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. (p > 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 (p = 0.036 and p = 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups (p > 0.05).

CONCLUSIONS: Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.

PMID:36856985 | DOI:10.1007/s10792-023-02661-x

Ophthalmol Ther. 2023 Mar 1. doi: 10.1007/s40123-023-00669-1. Online ahead of print.

ABSTRACT

Meibomian gland dysfunction (MGD) is highly prevalent and is the leading cause of evaporative dry eye disease (DED). MGD is characterized by a reduction in meibum secretion and/or a change in meibum composition that results in the disruption of the tear film lipid layer and an increase in the tear film evaporation rate. Excessive evaporation causes tear film instability, desiccation, tear hyperosmolarity, inflammation, and apoptosis of ocular surface cells, resulting in a continuous cycle of DED. The primary treatment goal for DED associated with MGD is to restore the tear film lipid layer and decrease evaporation, thereby reducing ocular signs and symptoms. The management of MGD includes home care options (eyelid hygiene, warming eye masks, ocular lubricants) and office-based treatments (manual expression, microblepharoexfoliation, thermal pulsation, intense pulsed light, intraductal probing). Topical ophthalmic prescription medications attempt to alter various factors that may contribute to DED (e.g., inflammation, bacterial growth, inadequate tear production). In this review, clinical evidence regarding available treatments and emerging therapies from randomized studies in patients with DED associated with MGD is summarized. Although some treatment modalities have been evaluated specifically for DED patients with MGD, large-scale randomized controlled trials are needed to confirm efficacy and safety in this patient population. Currently, there are no approved prescription pharmacologic treatments specifically indicated for DED associated with MGD, and those medications approved for the treatment of DED do not target the key driver of the disease (i.e., excessive evaporation). NOV03 (perfluorohexyloctane; under review with the US Food and Drug Administration) is the most advanced emerging therapy for DED associated with MGD and has demonstrated statistically significant improvements in both signs and symptoms in randomized controlled trials. Development of novel pharmacotherapies will improve therapeutic options and allow for a more individualized approach for patients with DED associated with MGD.

PMID:36856980 | DOI:10.1007/s40123-023-00669-1

Health Commun. 2023 Mar 1:1-13. doi: 10.1080/10410236.2023.2184452. Online ahead of print.

ABSTRACT

Emerging communication technologies have seen the proliferation of misleading claims, untruthful narratives, and conspiracies. To understand how people perceive and act on different types of misinformation, this study examines how health misinformation varying in falsity (fabrication versus misuse) and evidence type (statistical versus narrative) affects sharing and verification intentions. Using COVID-19 vaccines as cases, the results from an online experiment showed that misused misinformation was perceived as less false than fabricated misinformation and resulted in higher sharing intentions for the issue of vaccine efficacy. Misinformation with narrative evidence, as compared to that with statistical evidence, was perceived as less false and led to lower verification intentions. These findings can be explained by psychological processes such as counterarguing and narrative engagement. Our results can help practitioners develop dedicated misinformation literacy programs.

PMID:36856056 | DOI:10.1080/10410236.2023.2184452

J Biomol Struct Dyn. 2023 Mar 1:1-18. doi: 10.1080/07391102.2023.2184172. Online ahead of print.

ABSTRACT

Over the past few decades, various inhibitors of PRMT5 have been developed because of its involvement in a variety of tumor development processes. As of now, no drugs targeting PRMT5 have been approved, and multiple drugs entering clinical trials have proven to have side effects. In this study, PRMT5 was used to perform virtual screening of 52119 marine natural compounds by combining various methods. We constructed 20 pharmacophore models based on multiple ligands. The best pharmacophore model AARR_2 was selected by analyzing the statistical parameters of the pharmacophore model and the binding characteristics of the ligand active site, and then 3552 compounds were screened out. Compared with the positive compound, 46 compounds were selected based on the molecular docking fraction and docking mode analysis. Then, 3D-QSAR was used to analyze the relationship between structure and activity of the compounds. Then, in addition to marine compounds 36404, 36405 and 14436, we selected compound 46 (the positive control compound) and used the CLC-Pred online Web server to predict their cytotoxicity to human cell lines, making cell experiments possible. Finally, we conducted the prediction of ADMET in order to better promote clinical trials. After comprehensive judgment, we screened out the marine natural compounds 36404 and 36405 as candidates for PRMT5 substrate competitive inhibitors.Communicated by Ramaswamy H. Sarma.

PMID:36856049 | DOI:10.1080/07391102.2023.2184172

Otolaryngol Head Neck Surg. 2023 Mar 1. doi: 10.1002/ohn.301. Online ahead of print.

ABSTRACT

OBJECTIVE: Determine if students with severe-to-profound hearing loss with cochlear implants (CIs) mainstream (transition to general education) more than students with hearing amplification at the population level.

STUDY DESIGN: Cross-sectional secondary analysis of data from the National Center of Education Statistics.

SETTING: Special education (SpEd) students in the United States who had severe to profound “hearing impairment” and were 6 to 16 years old at enrollment from 2000 to 2001.

METHODS: We weighted the data to produce national estimates, performed multiple imputations for missingness, and built a multivariate linear regression model, which was cross-validated with a multivariate Poisson regression model. We used a theory-based approach to model-building using a directed acyclic graph to identify the minimally sufficient adjustment set of variables, which included school district urbanicity, student’s age when they started SpEd, other disabilities, home language, and caregiver education.

RESULTS: We identified 7267 students with CIs and 28,794 students with hearing amplification. CI users mainstreamed more than peers using hearing amplification during secondary school (40.29% less daily time in special education, p = .004) but not during primary school (9.19% less daily time in SpEd, p = .155). Additional significant predictors of mainstreaming varied between the primary and secondary school cohorts and included school district urbanicity and the student’s age when they started SpEd.

CONCLUSION: CI status predicts daily time spent in SpEd among a secondary school cohort. These findings do not establish causation. The National Center of Education Statistics should consider linking to clinical databases in future studies.

PMID:36856033 | DOI:10.1002/ohn.301