Category: Nevin Manimala

Environ Monit Assess. 2021 Aug 7;193(9):557. doi: 10.1007/s10661-021-09242-4.

ABSTRACT

Water quality is an extremely important factor as it affects the ecological balance of ecosystems and the development of the social and economic wellbeing of the countries bordering it. Remote sensing multiconcept helps to understand the natural environment, managing water resources and assessing water pollution on local and regional levels. Landsat 8 data were used to monitor coastal water quality in the region of Tangier-Ksar Sghir. The main purpose of the current study is to establish a mathematical relationship between the amount of light emitted from the water bodies and the measured water parameters. The results permit to create a spatial distribution maps for the water quality parameters. The present work study three water parameters: total suspended solids (TSS), dissolved oxygen (DO), and total dissolved sediments (TDS). Thirty-four sampling points were used to represent water parameters measurements along the coastline. The 75% of the in situ measurements were used to build the statistical models by using the spectral characteristics obtained from the sensors, while the remaining 25% were used for testing the accuracy of the developed equations. For the correlation analysis and the regression development, the Statistical Package of the Social Sciences (SPSS) software was used. The final results of the statistical analysis showed a high correlation between the calculated data and the observed ones with R² ˃ 0.713 and p value ˂ 0.001. The obtained values showed a high accuracy as well (RMSE ranging between 0.23 and 0.69 and SEE ranging between 0.01 and 0.47). SNAP software and Qgis were used to do the image processing and to create the spatial distribution maps for the water parameters in the coastline of Tangier-Ksar Sghir region.

PMID:34363536 | DOI:10.1007/s10661-021-09242-4

Interact Cardiovasc Thorac Surg. 2021 Aug 7:ivab218. doi: 10.1093/icvts/ivab218. Online ahead of print.

ABSTRACT

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: In low-risk patients aged >70-75 with severe aortic stenosis, is transcatheter superior to surgical aortic valve replacement in terms of reported composite outcomes and survival? More than 73 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. The only low-risk randomized control trial to date [Nordic Aortic Valve Intervention (NOTION)] regarding an elderly population did not show a statistically significant difference between the 2 approaches regarding the composite endpoint of death, stroke or myocardial infarction. A subgroup analysis of elderly patients in the 2 main low-risk randomized control trials did not yield statistically different results from those of the overall population; the results indicated the superiority of transcatheter aortic valve implantation regarding the composite of death, stroke or rehospitalization at 1 year [The Safety and Effectiveness of the SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic Stenosis (PARTNER 3)] and non-inferiority regarding a composite of death or stroke at 2 years [Medtronic Evolut Transcatheter Aortic Valve Replacement in Low-Risk Patients (Evolut LR)]. The results from lower evidence studies are largely consistent with these findings. Overall, there is no compelling evidence indicating that older age should be an isolated criterion for the choice between transcatheter aortic valve replacement and surgical aortic valve replacement in otherwise low-risk patients. The superiority of either technique regarding the aforementioned composite short-term outcomes in this particular subgroup of patients is unclear.

PMID:34363475 | DOI:10.1093/icvts/ivab218

Knee Surg Sports Traumatol Arthrosc. 2021 Aug 7. doi: 10.1007/s00167-021-06683-9. Online ahead of print.

ABSTRACT

PURPOSE: Kinematic alignment (KA) aligns the femoral implant perpendicular to the cylindrical axis in the frontal and axial plane. Identification of the kinematic axes when using the mini-invasive sub-quadricipital approach is challenging in unicompartmental knee arthroplasty (UKA). This study aims to assess if the orientation of condylar walls may be suitable for use as an anatomical landmark to kinematically align the femoral component in medial UKA. It was hypothesised that the medial wall of the medial condyle would prove to be a reliable anatomical landmark to set both the frontal and axial alignment of the femoral component in medial UKA.

METHODS: 73 patients undergoing medial UKA had pre-operative CT imaging to generate 3D models. Those with osteophytes that impaired visualisation of the condylar walls were excluded. 28 patients were included in the study. The ideal KA was determined using the cylindrical axis in the frontal and axial plane. Simulations using the medial wall of the medial condyle (MWMC) and the lateral wall of the medial condyle (LWMC) were performed to set the frontal alignment. To set the axial alignment, the MWMC, LWMC, medial wall of the lateral condyle (MWLC), and medial diagonal line (MDL) anatomical landmarks were investigated. Differences between the ideal measured KA values and values obtained using landmarks were investigated.

RESULTS: Use of the MWMC let to similar frontal alignment compared to the ideal KA (2.9° valgus vs 3.4° valgus, p = 0.371) with 46.4% (13/28) of measurements being [Formula: see text] 1.0° different from the ideal KA and only 1 simulation with greater than 4.0° difference. Use of the MWMC led to very similar axial alignments compared to the ideal KA (0.5° internal vs 0.0°, p = 0.960) with 75.0% (21/28) of measurements being [Formula: see text] 1.0^o different from the ideal KA, and a maximum difference of 3.0°. Use of the MWLC and MDL was associated with significant statistical differences when compared to the ideal KA (p < 0.001 for both).

CONCLUSIONS: The native orientation of the medial condylar wall seems to be a reliable anatomical landmark for aligning the femoral component in medial KA UKA in both the axial plane and frontal planes. Other assessed landmarks were shown to not be reliable. Clinical and radiographic assessments of the reliability of using the MWMC to set the frontal and axial orientation of the femoral component when performing a medial KA UKA are needed.

PMID:34363490 | DOI:10.1007/s00167-021-06683-9

Paediatr Anaesth. 2021 Aug 7. doi: 10.1111/pan.14269. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Previous blood product exposures may result in the development of antibodies to human leukocyte antigens (HLA). Pediatric heart transplant recipients who have these antibodies experience increased morbidity and mortality after transplantation. In this study, our aims were to confirm the association of previous allogeneic blood product exposures with the formation of anti-HLA antibodies, determine which blood components pose the greatest risk of developing antibodies, and assess differences in outcomes after transplantation between patients who had anti-HLA antibodies and those who did not.

METHODS: This retrospective investigation included all children who underwent cardiac transplantation at Children’s Healthcare of Atlanta from January 1, 2015, through December 31, 2018. Chart reviews were performed to collect pertinent data. Anti-HLA antibodies were detected by single antigen bead testing. Antibody burden was tabulated using the calculated panel reactive antibody (cPRA) score immediately prior to transplantation. Statistical analyses were conducted to examine differences based on HLA antibody status and identify associations with outcomes of interest.

RESULTS: Our results show a significant association between pre-transplant blood product exposures and HLA antibody status. Children with a pre-transplant blood product exposure had 7.98 times the odds of developing an anti-HLA antibody compared to those without a pre-transplant blood product exposure (p=0.01). We also found a significant association between a previous red blood cell (RBC) exposure and HLA antibody status (p=0.01) which was not found for other blood component exposures. Patients who were HLA antibody positive were more likely to develop a donor specific antibody (DSA) after transplantation (p=0.04).

CONCLUSIONS: Exposure to previous allogeneic blood products affects the development of anti-HLA antibodies in children presenting for heart transplantation. Previous RBC exposures resulted in HLA antibody positivity more than other blood component exposures. Importantly, the presence of HLA antibodies was associated with the development of DSAs post-transplantation. Developing transfusion strategies to reduce allogeneic blood product exposures in children who may need future cardiac transplantation should be a high priority.

PMID:34363427 | DOI:10.1111/pan.14269

Khirurgiia (Mosk). 2021;(8):116-124. doi: 10.17116/hirurgia2021081116.

ABSTRACT

AIM: Compare the short and long-term results of traditional duodenum-saving resections of the pancreas head and the original resection-draining method of the surgery of chronic pancreatitis.

MATERIALS AND METHODS: There has been the analysis of the immediate and long-term results of various types of duodenum-saving operations in 48 patients with chronic pancreatitis since 2011 to 2020. The patients were divided into two groups: the control group (n=26) where typical duodenum-saving operations were performed, and the study group (n=22) – the original resection-draining method of surgery.

RESULTS: The groups had no difference in gender, age, clinical manifestations. After typical duodenum-saving operations, the number of postoperative complications was higher than after original resection-draining method (31 [14; 52]% and 23 [8; 45]% respectively). In the control group the incidence of pancreatic fistula 19% [7; 39], hemorrhagic complications 12% [2; 30] was higher. In both groups, one patient died in the early postoperative period. However, these differences were statistically insignificant. 12 (52% [31; 73]; p<0.001) patients have died in the control group for the 9-year observation period, mainly (7 cases) as a result of the progression of chronic pancreatitis against the background of alcoholism. The groups had no difference in the level of pain reduction, development of dyspeptic syndrome and diabetes mellitus.

CONCLUSIONS: The proposed original technique of subtotal resection of the head, ventral part of the body and tail of the pancreas with longitudinal pancreatojejunoanastomosis made it possible to improve the short-term results and reduce the incidence of pancreatic fistula formation. Taking into account the level of compliance the selection of patients permitted to achieve a better quality of life according to the results of the SF – 36 questionnaire and to reduce the lethality to 5 [0; 25]% (p<0.001) in the long-term period. Statistically significant difference was obtained for three of the five criteria, the total value of the physical (PCS, p=0.033) and mental (MCS, p=0.032) health components.

PMID:34363454 | DOI:10.17116/hirurgia2021081116

Electrophoresis. 2021 Aug 7. doi: 10.1002/elps.202100098. Online ahead of print.

ABSTRACT

Electrokinetic micro peristaltic pumps are important biomechanical devices that help in targeted drugging of sick body parts. The current article is written to focus on mathematical modelling and analysis of some important aspect of such flows in a rectangular duct with wall properties. Effects of zeta potential, heat source and deby length are focused. Carbon nanotubes (CNTs) in the Newtonian base fluid is assumed as drugging material. A comparison of single-walled CNTs (SWCNTs) and multiwalled CNTs (MWCNTs) is also presented. It is considered that the walls are flexible and encapsulating the region with limited permeability. The defined flow problem is modelled and analyzed analytically for the transport of CNT-water nanofluid. It is accepted that the flow is steady, nonturbulent and propagating waves do have a considerably longer wavelength when compared to amplitude. The conditions and assumptions lead to a model of coupled partial differential equations of order two. The exact results by Eigenfunction expansion method are procured and shown accordingly. The predictions about the behaviour of important appearing parameters are displayed for SWCNT and MWCNT -water nanofluid behaviour using figures. The impact of sundry parameters is analyzed. The application of the current study involved transporting/ targeted drug delivery system using Peristaltic micropumps and magnetic field in pharmacological engineering. This article is protected by copyright. All rights reserved.

PMID:34363409 | DOI:10.1002/elps.202100098

Mov Disord. 2021 Aug 7. doi: 10.1002/mds.28738. Online ahead of print.

ABSTRACT

BACKGROUND: Objective diagnostic biomarkers are needed to support a clinical diagnosis.

OBJECTIVES: To analyze markers in various neurodegenerative disorders to identify diagnostic biomarker candidates for mainly α-synuclein (aSyn)-related disorders (ASRD) in serum and/or cerebrospinal fluid (CSF).

METHODS: Upon initial testing of commercially available kits or published protocols for the quantification of the candidate markers, assays for the following were selected: total and phosphorylated aSyn (pS129aSyn), neurofilament light chain (NfL), phosphorylated neurofilament heavy chain (pNfH), tau protein (tau), ubiquitin C-terminal hydrolase L1 (UCHL-1), glial fibrillary acidic protein (GFAP), calcium-binding protein B (S100B), soluble triggering receptor expressed on myeloid cells 2 (sTREM-2), and chitinase-3-like protein 1 (YKL-40). The cohort comprised participants with Parkinson’s disease (PD, n = 151), multiple system atrophy (MSA, n = 17), dementia with Lewy bodies (DLB, n = 45), tau protein-related neurodegenerative disorders (n = 80, comprising patients with progressive supranuclear palsy (PSP, n = 38), corticobasal syndrome (CBS, n = 16), Alzheimer’s disease (AD, n = 11), and frontotemporal degeneration/amyotrophic lateral sclerosis (FTD/ALS, n = 15), as well as healthy controls (HC, n = 20). Receiver operating curves (ROC) with area under the curves (AUC) are given for each marker.

RESULTS: CSF total aSyn was decreased. NfL, pNfH, UCHL-1, GFAP, S100B, and sTREM-2 were increased in patients with neurodegenerative disease versus HC (P < 0.05). As expected, some of the markers were highest in AD (i.e., UCHL-1, GFAP, S100B, sTREM-2, YKL-40). Within ASRD, CSF NfL levels were higher in MSA than PD and DLB (P < 0.05). Comparing PD to HC, interesting serum markers were S100B (AUC: 0.86), sTREM2 (AUC: 0.87), and NfL (AUC: 0.78). CSF S100B and serum GFAP were highest in DLB.

CONCLUSIONS: Levels of most marker candidates tested in serum and CSF significantly differed between disease groups and HC. In the stratification of PD versus other tau- or aSyn-related conditions, CSF NfL levels best discriminated PD and MSA. CSF S100B and serum GFAP best discriminated PD and DLB. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.

PMID:34363416 | DOI:10.1002/mds.28738

Acta Paediatr. 2021 Aug 7. doi: 10.1111/apa.16062. Online ahead of print.

ABSTRACT

AIM: This study examined the associations between prenatal smoking and speech and language, scholastic, coordination and mixed developmental disorders in offspring, using sibling and population controls.

METHODS: National Finnish registers were used to identify all 690,654 singletons born between 1996-2007 and any cases diagnosed with speech and language, scholastic, coordination and mixed developmental disorders by the end of 2012. Cases were compared to population controls, biological full-siblings and maternal half-siblings born during the same period. Conditional logistic regression was used to assess any associations between smoking during pregnancy and the selected developmental disorders.

RESULTS: Prenatal smoking was higher in the mothers of the 27,297 cases (21.7%) than the 99,876 population controls (14.5%). The adjusted odds ratio for smoking throughout pregnancy, and any diagnosis of speech and language, scholastic, coordination or mixed developmental disorders, was 1.29 (95% confidence interval 1.24-1.34). However, when we compared a subsample of 15,406 cases and their 20,657 siblings, the association was no longer statistically significant (odds ratio 1.09, 95% confidence interval 0.98-1.21).

CONCLUSION: The sibling comparisons suggested that the associations between prenatal smoking and speech and language, scholastic, coordination and mixed developmental disorders were confounded by familial factors shared by differentially exposed siblings.

PMID:34363238 | DOI:10.1111/apa.16062

Am J Ind Med. 2021 Aug 6. doi: 10.1002/ajim.23282. Online ahead of print.

ABSTRACT

BACKGROUND: Exoskeleton (EXO) technologies are a promising ergonomic intervention to reduce the risk of work-related musculoskeletal disorders, with efficacy supported by laboratory- and field-based studies. However, there is a lack of field-based evidence on long-term effects of EXO use on physical demands.

METHODS: A longitudinal, controlled research design was used to examine the effects of arm-support exoskeleton (ASE) use on perceived physical demands during overhead work at nine automotive manufacturing facilities. Data were collected at five milestones (baseline and at 1, 6, 12, and 18 months) using questionnaires. Linear mixed models were used to understand the effects of ASE use on perceived work intensity and musculoskeletal discomfort (MSD). Analyses were based on a total of 41 participants in the EXO group and 83 in a control group.

RESULTS: Across facilities, perceived work intensity and MSD scores did not differ significantly between the EXO and control groups. In some facilities, however, neck and shoulder MSD scores in the EXO group decreased over time. Wrist MSD scores in the EXO group in some facilities remained unchanged, while those scores increased in the control group overtime. Upper arm and low back MSD scores were comparable between the experimental groups.

CONCLUSION: Longitudinal effects of ASE use on perceived physical demands were not found, though some suggestive results were evident. This lack of consistent findings is discussed, particularly supporting the need for systematic and evidence-based ASE implementation approaches in the field that can guide the optimal selection of a job for ASE use.

PMID:34363229 | DOI:10.1002/ajim.23282

J Clin Ultrasound. 2021 Aug 6. doi: 10.1002/jcu.23052. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate whether corpus callosum length (CCL), corpus callosum-fastigium length (CCFL) and the angle between CCL-CCFL (CCFA) were altered in growth-restricted fetuses.

METHODS: This prospective case-control study was conducted in a tertiary center. A total of 80 singleton fetuses were included in the study, classified as 36 late-onset growth-restricted fetuses and 44 adequate-for-gestational-age fetuses. All biometric measurements and Doppler assessments of umbilical artery, middle cerebral artery, and ductus venosus were performed via the trans-abdominal route. CCL, CCLF, and CCFA were assessed via the trans-vaginal route.

RESULTS: Late-onset growth-restricted fetuses showed significantly reduced CCL and CCFL. There was no statistically significant differences in terms of CCFA. Moderate-high correlations between CCL and biparietal diameter, head circumference, abdominal circumference, FL and gestational age were detected (r: 0.482 p: 0.000; r: 0.537 p: 0.000; r: 0.488 p: 0.000; r: 0.519 p: 0.000; and r: 0.472 p: 0.000, respectively).

CONCLUSION: This study adds to the literature that CCFA has not changed despite the decrease in CCL and CCFL in late-onset fetal growth restriction that might be a result of the redistribution of cerebral blood flow. To clarify the prognostic implications of these results in terms of neural and cognitive functions in postnatal life, there is a need for larger prospective studies.

PMID:34363232 | DOI:10.1002/jcu.23052