Category: Nevin Manimala

J Environ Manage. 2021 Mar 10;287:112252. doi: 10.1016/j.jenvman.2021.112252. Online ahead of print.

ABSTRACT

The provision of sanitation services for fast-growing urban populations is one of the world’s urgent challenges. Hutong neighborhoods in Beijing, capital of China, cannot be rebuilt due to the protection of historical heritage, while residents still need to keep the habit of defecating in public toilets. One hundred public toilets with non-sewered sanitation in the Hutong neighborhoods of Beijing were visited to investigate the actual operating status in response to the “toilet revolution” campaign. The fault tree approach was used to identify the barriers toward a decent and environment-friendly public toilet and evaluate potential risks from the malfunction of various components. Four subsystems are defined and elaborated to calculate the fault possibility. These subsystems are environment- and user-friendly, regarded as ancillary facilities, and used for fecal sludge (FS) management. Statistical analysis of targeted cases indicated that fault probabilities of environmental considerations, user-friendly considerations, ancillary facilities, FS management are calculated as 0.79, 0.96, 0.96, and 0, respectively. The subsystems were weighted using a Delphi method concept. Results showed that the well operation ratio of Beijing Hutong public toilets is only 32%, and the sanitation service value chain can be further optimized. This study also provides references for other countries, which are dedicated to promoting urban sanitation and public health.

PMID:33714043 | DOI:10.1016/j.jenvman.2021.112252

Public Health. 2021 Mar 10;193:29-40. doi: 10.1016/j.puhe.2020.12.016. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to estimate the magnitude of acute respiratory infection (ARI) among children younger than 5 years (under-five children) and its association with biomass fuel use for domestic purposes and other behavioural and housing characteristics in Ethiopia.

STUDY DESIGN: Systematic review and meta-analysis.

METHODS: PubMed, Google Scholar, MEDLINE and the Cochrane Library were systematically searched (using the Preferred Items for Systematic Review and Meta-analysis guideline) for studies that reported an association between biomass fuel use for domestic purposes and ARI. Grey literature and other sources of unpublished information, which were subjected to the same extraction methods and quality appraisal as published studies, were also identified. A meta-analysis was performed to combine the quantitative measures from eligible individual studies into a summary estimate. Quality assessment was conducted using the modified Newcastle-Ottawa Scale quality assessment tool for cross-sectional and case-control studies. Funnel and Doi plots were used to detect potential publication bias. Statistical analyses were performed using Comprehensive Meta-Analysis and MetaXL, version 5.3, software.

RESULTS: A total of 21 (18 cross-sectional and 3 case-control) eligible studies with their combined 30,013 participants were reviewed. The overall pooled prevalence of ARI among under-five children in households where biomass fuel was the main source of energy was estimated to be 22% (95% confidence interval [CI]: 17-29). In the subgroup analysis by area of residence, the highest prevalence was found in urban regions 26% (95% CI: 24-28). Based on the preceding 2 weeks before the interview, a significant association was found between biomass fuel use and ARI (odds ratio [OR] = 2.6, 95% CI: 2.05-3.30). In addition to biomass fuel use, being female (OR = 1.57, 95% CI: 1.06-2.33), absence of a window in the kitchen (OR = 2.89, 95% CI: 2.11-3.96), being carried on the back or in lap during cooking (OR = 2.76, 95% CI: 1.96-3.89) and non-separated kitchen from the main house (OR = 1.99, 95% CI: 1.49-2.68) were associated with ARI.

CONCLUSIONS: Based on the results of this review, ARI among under-five children remains high. The present study also revealed that ARI is associated with biomass fuel use, child’s gender, absence of a window in the kitchen, non-separated kitchen and carrying the child while cooking. Improved solid fuel stoves, advanced combustion designs, windows or chimneys, separating the kitchen from the main house are all measures required to reduce ARI in under-five children.

SYSTEMATIC REVIEW REGISTRATION: The review has been registered with PROSPERO (registration number CRD42020181372).

PMID:33713984 | DOI:10.1016/j.puhe.2020.12.016

Clin Res Hepatol Gastroenterol. 2021 Mar 10;45(4):101527. doi: 10.1016/j.clinre.2020.08.005. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the clinical value of kinesin superfamily protein 2A (KIF2A) in hepatocellular carcinoma (HCC) patients.

METHODS: This study retrospectively analyzed 196 HCC patients who underwent hepatic resection, and their preoperative clinical characteristics were collected from the medical records. Immunohistochemical (IHC) assay was performed to detect KIF2A expression, subsequently KIF2A expression was evaluated by a semi-quantitative IHC score (according to IHC staining density and intensity of positively stained cells) and then graded as KIF2A^–/KIF2A⁺/KIF2A⁺⁺/KIF2A⁺⁺⁺ for analysis. Overall survival (OS) was calculated from the date of resection to the date of death.

RESULTS: Compared to adjacent tissue, both KIF2A IHC score and grade were higher in tumor tissue (Both P < 0.001). Tumor KIF2A expression was positively correlated with performance status score (P = 0.001), multifocal tumor nodule (P = 0.018), largest tumor size (P = 0.015) and Barcelona clinic liver cancer stage (P < 0.001). Regarding live function indexes, tumor KIF2A expression was positively associated with aspartate aminotransferase (P = 0.006). As to tumor markers, tumor KIF2A expression showed a trend to be positively correlated with alpha fetoprotein (P = 0.060) and carbohydrate antigen 199 (P = 0.053), but no statistical significance. Kaplan-Meier curve showed that tumor higher KIF2A expression was associated with worse OS (P < 0.001), which was further validated by multivariate Cox’s regression analysis as higher an independent factor predicting shorter OS (P = 0.001).

CONCLUSION: KIF2A is upregulated in tumor tissue than adjacent tissue, importantly, tumor KIF2A is associated with worse liver function, raised tumor stage and poor OS in HCC patients.

PMID:33713978 | DOI:10.1016/j.clinre.2020.08.005

Clin Res Hepatol Gastroenterol. 2021 Mar 10;45(4):101511. doi: 10.1016/j.clinre.2020.07.016. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was to investigate the longitudinal change of post-operative anxiety and depression, their related risk factors and prognostic value in colorectal cancer (CRC) patients after resection.

METHODS: Totally, 302 CRC patients who underwent resection were consecutively recruited. Their anxiety and depression were assessed by hospital anxiety and depression scale (HADS) at Month 0 (M0) and then every 3 months till Month 36 (M36).

RESULTS: Within 36-month follow-up period, HADS-A score (from 8.3 ± 3.3 at M0 to 8.8 ± 3.4 at M36, P = 0.179) exhibited an upward trend with time but without statistical significance; while anxiety rate (from 46.4% at M0 to 52.6% at M36, P = 0.019) was increased steadily with time longitudinally. Meanwhile, both HADS-D score (from 7.4±3.0 at M0 to 9.2±3.5 at M36, P < 0.001) and depression rate (from 33.8% at M0 to 57.9% at M36, P < 0.001) were elevated greatly with time longitudinally. Furthermore, multivariate logistic regression revealed that female and tumor size (≥5 cm) were common independent risk factors for baseline/1-year/2-year/3-year anxiety (all P < 0.05); meanwhile, female, marry status (single/divorced/widowed vs. married) and advanced TNM stage were common independent risk factors for baseline/1-year/2-year/3-year depression (all P < 0.05). As for new-onset anxiety and depression, no independent factor associated with new-onset anxiety was observed; meanwhile, female and TNM stage were independent risk factors for new-onset depression (both P < 0.05). Additionally, baseline/1-year anxiety and baseline/1-year/2-year/3-year depression were associated with lower accumulating OS (all P < 0.05).

CONCLUSION: Post-operative anxiety and depression are highly prevalent and continuously progress, which also correlate with worse survival prognosis in CRC patients.

PMID:33713979 | DOI:10.1016/j.clinre.2020.07.016

Surg Oncol. 2021 Mar 6;37:101538. doi: 10.1016/j.suronc.2021.101538. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the influence of anastomotic leakage (AL) on postoperative survival in patients with colorectal cancer (CRC).

BACKGROUND: Although several studies have compared the postoperative survival of patients with CRC with and without AL, the background characteristics of the two groups were not aligned in most studies.

METHODS: We performed a comprehensive electronic search of the literature up to March 2020 to identify propensity score matching (PSM) studies that compared postoperative survival between CRC patients with and without AL. A meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I (Akiyoshi et al., 2011) [2] statistics.

RESULTS: Four PSM studies involving a total of 1676 patients with CRC undergoing surgery were included in this meta-analysis. Among 234 patients who had AL, 163 (69.7%) survived at 5 years after surgery, whereas among 1422 patients who did not have AL, 1156 (81.3%) survived at 5 years after surgery. Background characteristics of the two groups were adjusted with PSM in all 4 studies. The result of the meta-analysis revealed a significant difference between the two groups (RR, 1.63; 95% CI, 1.09-2.45; P = 0.02; I² = 66%) in 5-year overall survival (OS).

CONCLUSIONS: The results of this meta-analysis demonstrate a significantly decreased 5-year OS in patients with CRC who had AL compared with patients with CRC who did not have AL.

PMID:33713973 | DOI:10.1016/j.suronc.2021.101538

Sci Rep. 2021 Mar 12;11(1):5839. doi: 10.1038/s41598-021-82932-8.

ABSTRACT

Guided by a rigorous mathematical result, we have earlier introduced a numerical algorithm, which using as input the cumulative number of deaths caused by COVID-19, can estimate the effect of easing of the lockdown conditions. Applying this algorithm to data from Greece, we extend it to the case of two subpopulations, namely, those consisting of individuals below and above 40 years of age. After supplementing the Greek data for deaths with the data for the number of individuals reported to be infected by SARS-CoV-2, we estimated the effect on deaths and infections in the case that the easing of the lockdown measures is different for these two subpopulations. We found that if the lockdown measures are partially eased only for the young subpopulation, then the effect on deaths and infections is small. However, if the easing is substantial for the older population, this effect may be catastrophic.

PMID:33712637 | DOI:10.1038/s41598-021-82932-8

Sci Rep. 2021 Mar 12;11(1):5815. doi: 10.1038/s41598-021-85294-3.

ABSTRACT

Patients afflicted with melanoma show lower vitamin D serum levels (VDSL) than the healthy population. This hypothesis agrees with its well-known antiproliferative features. An observational study was carried out to collect VDSL in patients suffering from melanoma. Our aim was to identify a potential connection between low VDSL and the risk to incur melanoma. Furthermore, we studied the association between VDSL at the diagnosis of melanoma and other germane prognostic factors. The population held in regard was composed of 154 patients with a diagnosis of melanoma between 2016 and 2019. These patients were retrospectively collected from our follow-up storage. We compared VDSL to clinical and pathological parameters (age, sex, tumour location, Breslow’s depth, Clark’s level, histological subtype, ulceration, et aliqua). Moreover, we recruited a control group with negative melanoma history. Mean and median of VDSL were significantly lower in the melanoma group. Instead, we found a negative association between melanoma and VDSL > 30 ng/L (OR 0.11; p < 0.0001). No correlation between VDSL and both Breslow’s depth and Clark’s level was discovered, but the VDSL comparison between thin (depth ≤ 1 mm) and thick tumours (depth > 1 mm) revealed a statistically significant difference (21.1 ± 8.2 ng/L vs 17.8 ± 8.1; p = 0.01). Moreover, VDSL were significantly lower in melanomas with mitotic rate ≥ 1/mm² (22.1 ± 8.3 ng/L; p < 0007). Nevertheless, no connection was found between VDSL and both ulceration and positive sentinel nodes (p = 0.76; p = 0.74). Besides, our study revealed no association between VDSL and histological subtype (p = 0.161). Lower VDSL correlate with thick and high mitotic rate tumours. Future prospective studies would investigate if appropriate upkeep of suitable VDSL can decrease the risk of primary and recurrent melanoma diagnosis.

PMID:33712642 | DOI:10.1038/s41598-021-85294-3

Sci Rep. 2021 Mar 12;11(1):5851. doi: 10.1038/s41598-021-85448-3.

ABSTRACT

In this study, the relationship between the brain parenchymal density, the cerebral vessel density, the mean corpuscular hemoglobin (MCH) content, the mean corpuscular hemoglobin concentration (MCHC), and the morbidity associated with lacunar infarction of residents living in either the plains or the plateau regions were analyzed and compared for their potential clinical implications. Clinical data from the brain CT scans of individuals living in either the plain or plateau regions (129 each) were collected. Specifically, the CT values for basal ganglia, the middle cerebral artery, and the superior sagittal sinus, along with the number of patients with lacunar infarction, were collected. In addition, the MCH and MCHC values were measured in blood samples collected within 48 h following the CT scans. For statistical analysis, an independent sample t-test, Pearson’s correlation test (permutation test), and Chi-squared test were employed. The inhabitants of the plateau had a significantly higher CT value of basal ganglia, the middle cerebral artery, and superior sagittal sinus and also higher levels of MCH and MCHC in the blood (ps < 0.001) than the inhabitants of the plains region. Further, there was a significant positive correlation between the three aforementioned CT values and the MCH and MCHC findings. However, no significant differences were found in the morbidity of lacunar infarction between these two regions (p > 0.05). The inhabitants in the plateau have a significantly higher brain parenchymal density, higher CT value for cerebral vessels density, and higher blood MCH and MCHC levels in comparison with individuals occupying the plains. Concurrently, the parenchymal density and the CT values are shown to be positively correlated with the MCH and MCHC content in the blood.

PMID:33712677 | DOI:10.1038/s41598-021-85448-3

Spinal Cord Ser Cases. 2021 Mar 12;7(1):20. doi: 10.1038/s41394-021-00384-8.

ABSTRACT

STUDY DESIGN: Pre-post intervention.

OBJECTIVE: To explore the potential effect of exoskeletal-assisted walking (EAW) on seated balance for persons with chronic motor complete spinal cord injury (SCI).

SETTING: A SCI research center.

METHODS: Eight participants who were over 18 years of age with chronic SCI and used a wheelchair for mobility were enrolled. Seven able-bodied participants were used for normal seated balance comparative values. Participants with chronic SCI received supervised EAW training using a powered exoskeleton (ReWalk^TM) for a median 30 sessions (range from 7 to 90 sessions). Before and after EAW training, seated balance testing outcomes were collected using computerized dynamic posturography, providing measurements of endpoint excursion (EPE), maximal excursion (MXE), and directional control (DCL). Modified functional reach test (MFRT) and the sub-scales of physical functioning and role limitations due to physical health from the Short Form (36) Health Survey (SF-36) were used to identify changes in functional activities.

RESULTS: After EAW training, seated balance significantly improved in total-direction EPE and MXE (P < 0.01 and P < 0.017 respectively). The results of MFRT and sub-scales of physical functioning and role limitations due to physical health improved after EAW training but were not statistically significant.

CONCLUSIONS: EAW training may have the potential to improve seated balance for persons with chronic motor complete SCI. Due to the limitations of the study, such as small sample size and lack of a control group, further studies are needed to clarify the effect of improving seated balance through EAW training.

PMID:33712561 | DOI:10.1038/s41394-021-00384-8

Nat Commun. 2021 Mar 12;12(1):1661. doi: 10.1038/s41467-021-21898-7.

ABSTRACT

CRISPR-Cas9 viability screens are increasingly performed at a genome-wide scale across large panels of cell lines to identify new therapeutic targets for precision cancer therapy. Integrating the datasets resulting from these studies is necessary to adequately represent the heterogeneity of human cancers and to assemble a comprehensive map of cancer genetic vulnerabilities. Here, we integrated the two largest public independent CRISPR-Cas9 screens performed to date (at the Broad and Sanger institutes) by assessing, comparing, and selecting methods for correcting biases due to heterogeneous single-guide RNA efficiency, gene-independent responses to CRISPR-Cas9 targeting originated from copy number alterations, and experimental batch effects. Our integrated datasets recapitulate findings from the individual datasets, provide greater statistical power to cancer- and subtype-specific analyses, unveil additional biomarkers of gene dependency, and improve the detection of common essential genes. We provide the largest integrated resources of CRISPR-Cas9 screens to date and the basis for harmonizing existing and future functional genetics datasets.

PMID:33712601 | DOI:10.1038/s41467-021-21898-7