Category: Nevin Manimala

Water Res. 2021 May 14;200:117240. doi: 10.1016/j.watres.2021.117240. Online ahead of print.

ABSTRACT

In heavily urbanised areas, groundwater diffuse pollution is recognised as one of the most insidious threats to groundwater quality. Diffuse pollution originates from multiple small sources releasing a low contaminant mass over a relatively large area; the lack of a defined plume in groundwater, the limited leaked mass, and the fact that leakage may have occurred in the past and be now ceased, make these sources difficult to locate and characterise. In addressing this environmental issue, an inverse approach based on the Null space Monte Carlo stochastic method has been applied in the framework of an innovative methodology with the aim to locate potential source areas distributed in a large (120 km²) urban area. To simplify the problem and better understand the limitations and effectiveness of the proposed methodology, the analysis has been performed using a groundwater model with fixed (i.e., determined by a previous calibration) hydraulic conductivity and flow boundary conditions. The only source of uncertainty considered in the study is the PCE mass discharge from all model cells of the topmost layer. After implementing and calibrating a deterministic solute transport model, multiple random realisations of mass discharge fields were generated, all of which are history-match constrained and hydrogeologically plausible. The obtained stochastic parameter sets were used to investigate the statistical distribution of the solute mass discharge and map the areas that are more likely to host unknown sources of PCE. Although the application of the NSMC stochastic method on the synthetic case study has provided promising results, it has also highlighted that multiple sources of uncertainty (e.g., continuity and duration of each source, attenuation processes) could adversely affect the reliability of the results in a real-world context, in which the effect of other uncertain parameters (hydraulic conductivity amongst all) would need to be considered in addition. This study offers new insights to the problem of aquifer diffuse pollution by providing key information on the potential source zones and on the areas that urgently need to be prioritised for further investigations.

PMID:34038822 | DOI:10.1016/j.watres.2021.117240

Contraception. 2021 May 23:S0010-7824(21)00158-X. doi: 10.1016/j.contraception.2021.05.011. Online ahead of print.

ABSTRACT

OBJECTIVES: We sought to quantify the prevalence of ever attendance at a crisis pregnancy center (CPC) among adult, reproductive-age women in Ohio and identify demographic factors associated with ever attendance.

METHODS: We analyzed data from the Ohio Survey of Women, a survey of adult, reproductive-age women (N=2,529) conducted in 2018-2019. We calculated unadjusted and adjusted prevalence ratios (PRs) to evaluate the possible associations between demographic factors and ever CPC attendance. Analyses used statistical weights to be population-representative.

RESULTS: Analyses are based on women reporting ever (n=291) or never CPC attendance (n=2,151). Prevalence of ever CPC attendance was 13.5%. Ever CPC attendance was higher among women of Black, non-Hispanic race/ethnicity (adjusted PR, 2.1; 95% CI, 1.4-3.2) and currently in the lowest socio-economic status (SES) stratum (defined as less than a college degree and annual household income less than $75,000) (aPR, 1.6; 95% CI, 1.1-2.3) compared to those of other race/ethnicity and in the highest SES stratum.

CONCLUSIONS: Disparities exist among adult women in Ohio regarding their ever use of CPCs. Because CPCs typically are not medical facilities and may provide inaccurate information, future studies should evaluate a wider range of correlates of recent CPC attendance.

IMPLICATIONS: Findings from a population-based survey of adult, reproductive-age women in Ohio indicate that ever attendance a crisis pregnancy center for pregnancy-related care is not rare, and this attendance is higher among Black/non-Hispanic women and those of low socioeconomic status compared to other women.

PMID:34038710 | DOI:10.1016/j.contraception.2021.05.011

Am J Hum Genet. 2021 May 20:S0002-9297(21)00185-3. doi: 10.1016/j.ajhg.2021.05.001. Online ahead of print.

ABSTRACT

Identifying the molecular mechanisms by which genome-wide association study (GWAS) loci influence traits remains challenging. Chromatin accessibility quantitative trait loci (caQTLs) help identify GWAS loci that may alter GWAS traits by modulating chromatin structure, but caQTLs have been identified in a limited set of human tissues. Here we mapped caQTLs in human liver tissue in 20 liver samples and identified 3,123 caQTLs. The caQTL variants are enriched in liver tissue promoter and enhancer states and frequently disrupt binding motifs of transcription factors expressed in liver. We predicted target genes for 861 caQTL peaks using proximity, chromatin interactions, correlation with promoter accessibility or gene expression, and colocalization with expression QTLs. Using GWAS signals for 19 liver function and/or cardiometabolic traits, we identified 110 colocalized caQTLs and GWAS signals, 56 of which contained a predicted caPeak target gene. At the LITAF LDL-cholesterol GWAS locus, we validated that a caQTL variant showed allelic differences in protein binding and transcriptional activity. These caQTLs contribute to the epigenomic characterization of human liver and help identify molecular mechanisms and genes at GWAS loci.

PMID:34038741 | DOI:10.1016/j.ajhg.2021.05.001

Orthopedics. 2021 Mar-Apr;44(2):77-84. doi: 10.3928/01477447-20210217-03. Epub 2021 Mar 1.

ABSTRACT

The purpose of this study was to investigate whether preoperative opioid use had any effect on clinical outcomes and patient-reported outcome measures (PROMs) before and after primary, elective total hip arthroplasty (THA). The authors retrospectively reviewed 793 patients who underwent primary THA from November 2018 to March 2020 with available PROMs. Patients were stratified into two groups based on whether or not they were taking opioids preoperatively. Demographics, clinical data, and PROMs (Forgotten Joint Score-12 [FJS-12], Hip disability and Osteoarthritis Outcome Score for Joint Replacement [HOOS, JR], and Veterans RAND 12 [VR-12] Physical Component Score [PCS] and Mental Component Score [MCS]) were collected at various time periods. Demographic differences were assessed with chi-square and independent sample t tests. Clinical data and PROMs were compared using multilinear regressions. Seventy-five (10%) patients were preoperative opioid users and 718 (90%) were not. Preoperative opioid users had a longer stay (1.37 vs 1.07 days; P=.030), a longer surgical time (102.44 vs 90.20 minutes; P=.001), and higher all-cause postoperative emergency department visits (6.7% vs 2.1%; P=.033) compared with patients not taking opioids preoperatively. Preoperative HOOS, JR (46.63 vs 51.26; P=.009), VR-12 PCS (27.79 vs 31.53; P<.001), and VR-12 MCS (46.24 vs 49.33; P=.044) were significantly lower for preoperative opioid users, but 3-month and 1-year postoperative scores were not statistically different. At 3 months and 1 year, FJS-12 scores did not differ significantly. Mean improvement preoperatively to 1 year in HOOS, JR values exceeded the minimal clinically important difference, with preoperative opioid users experiencing a greater improvement (36.50 vs 33.11; P=.008). Preoperative opioid users had a longer stay, a longer surgical time, and higher all-cause emergency department visits compared with preoperatively opioid naïve patients. Although preoperative opioid users reported significantly lower preoperative PROMs, they did not statistically differ postoperatively, which indicates a larger delta improvement and similar benefits following THA. [Orthopedics. 2021;44(2):77-84.].

PMID:34038695 | DOI:10.3928/01477447-20210217-03

Orthopedics. 2021 Mar-Apr;44(2):86-91. doi: 10.3928/01477447-20210217-02. Epub 2021 Mar 1.

ABSTRACT

Parkinson’s disease (PD) is associated with a higher complication rate after common orthopedic procedures, such as spinal fusion, knee arthroplasty, or hip arthroplasty. A few reports have also suggested higher complication rates after reverse total shoulder arthroplasty (RTSA). The aim of this study was to assess the outcome and complication profile of patients with RTSA and PD. A total of 17 patients (mean age, 73.9±9.5 years) with PD and RTSA with a minimum follow-up of 2 years were identified on screening of the authors’ institutional RTSA database. These patients were compared with a 1:4 matched cohort group of 68 patients (mean age, 73.9±7.9 years) without PD. Complications and revisions for all patients were assessed by review of medical records. Outcome scores included the Constant-Murley score and the Subjective Shoulder Value. At a mean follow-up of 49.5±24 months, statistically significant improvements were obtained in postoperative Subjective Shoulder Value, Constant-Murley score, pain, flexion, abduction, internal rotation, and strength for both groups. However, the control group had significantly greater improvements in flexion, abduction, strength, Subjective Shoulder Value, and Constant-Murley score. Postoperative complications (35% vs 6%; odds ratio, 8.7) and reinterventions (29% vs 1%; odds ratio, 27.9) were substantially greater for patients with PD, with the most frequent complications being fractures of the scapular spine and the acromion. Reverse total shoulder arthroplasty is associated with a significantly higher complication rate and revision rate and an inferior outcome in patients with PD compared with neurologically healthy patients. Indications for RTSA should be carefully evaluated and questioned for patients with PD. [Orthopedics. 2021;44(2):86-91.].

PMID:34038696 | DOI:10.3928/01477447-20210217-02

Am Heart J. 2021 May 23:S0002-8703(21)00138-1. doi: 10.1016/j.ahj.2021.05.009. Online ahead of print.

ABSTRACT

BACKGROUND: Right ventricular failure (RVF) remains a major cause of morbidity and mortality after left ventricular assist device (LVAD). Atrial fibrillation (AF) is known for its deleterious effects on cardiac function and hemodynamics. The association of pre-operative AF with the risk of early post-LVAD RVF has not been well described.

METHOD: A comprehensive literature search was performed through April, 9 2021. Cohort studies comparing the risk of post-operative RVF and/or need for right ventricular assist device (RVAD) after LVAD in patients with or without AF were included. Pooled odds ratio (OR) with 95% confidence intervals (CI) and I² statistic were calculated using the random-effects model.

RESULTS: Six studies were included in the analysis. Post-operative RVF was reported in 5 studies (1,841 patients) and RVAD use was reported in 4 studies (1,355 patients). There is a non-significant trend toward a higher risk of post-operative RVF in the AF group (pooled OR=1.25, 95%CI=0.99-1.58). No significant association between AF and RVAD use is noted (pooled OR=1.17, 95%CI=0.82-1.66).

CONCLUSIONS: Pre-operative AF is not significantly associated with higher risks of post-operative RVF and RVAD use after LVAD implantation, although the trend toward higher post-operative RVF is observed in patients with pre-operative AF. Additional research using a larger study population is warranted to better understand the association of pre-operative AF and the development of post-LVAD RVF.

PMID:34038705 | DOI:10.1016/j.ahj.2021.05.009

J Refract Surg. 2021 Apr;37(4):256-262. doi: 10.3928/1081597X-20210209-01. Epub 2021 Apr 1.

ABSTRACT

PURPOSE: To evaluate the clinical outcomes including patient-reported outcome measures in a sample of eyes undergoing bilateral cataract surgery with implantation of a new model of presbyopia-correcting intraocular lens (IOL).

METHODS: This non-randomized prospective case series enrolled 206 eyes of 103 patients undergoing phacoemulsification cataract surgery with bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Vision). High and low contrast visual acuity, refractive, defocus curve, and patient-reported visual performance (Catquest-9SF questionnaire) outcomes were evaluated during a 3-month follow-up.

RESULTS: A total of 96.1% (99 of 103) and 91.3% (94 of 103) of patients achieved binocular postoperative uncorrected distance (UDVA) and near visual acuity (UNVA) of 0.00 logMAR (20/20), respectively. Mean postoperative mesopic UNVA for both eyes was 0.14 ± 0.03 logMAR. Likewise, mean binocular UDVA and UNVA were 0.00 ± 0.03 and 0.04 ± 0.02 logMAR. An almost flat mean defocus curve was obtained, with visual acuities between 0.00 and 0.10 logMAR for most defocus levels in both eyes. A reduction of contrast led to a limited but statistically significant change in UNVA in both eyes (P < .001). The Rasch calibrated scoring of item 2 and the Rasch calibrated mean score of the Catquest-9SF questionnaire increased significantly with surgery (P < .001).

CONCLUSIONS: This new presbyopia-correcting IOL provides a continuous range of functional focus, with a limited deterioration under mesopic conditions, which is perceived as a satisfactory outcome by the patient if proper patient selection is performed. [J Refract Surg. 2021;37(4):256-262.].

PMID:34038663 | DOI:10.3928/1081597X-20210209-01

Sleep. 2021 May 26:zsab027. doi: 10.1093/sleep/zsab027. Online ahead of print.

ABSTRACT

Current approaches to automated sleep staging from the electroencephalogram (EEG) rely on constructing a large labeled training and test corpora by aggregating data from different individuals. However, many of the subjects in the training set may exhibit changes in the EEG that are very different from the subjects in the test set. Training an algorithm on such data without accounting for this diversity can cause underperformance. Moreover, test data may have unexpected sensor misplacement or different instrument noise and spectral responses. This work proposes a novel method to learn relevant individuals based on their similarities effectively. The proposed method embeds all training patients into a shared and robust feature space. Individuals that share strong statistical relationships and are similar based on their EEG signals are clustered in this feature space before being passed to a deep learning framework for classification. Using 994 patient EEGs from the 2018 Physionet Challenge (≈ 6,561 hours of recording), we demonstrate that the clustering approach significantly boosts performance compared to state-of-the-art deep learning approaches. The proposed method improves, on average, a precision score from 0.72 to 0.81, a sensitivity score from 0.74 to 0.82, and a Cohen’s Kappa coefficient from 0.64 to 0.75 under 10-fold cross-validation.

PMID:34038560 | DOI:10.1093/sleep/zsab027

Ann Neurol. 2021 May 26. doi: 10.1002/ana.26131. Online ahead of print.

ABSTRACT

OBJECTIVE: Polygenic risk scores (PRSs) assess the individual genetic propensity to a condition by combining sparse information scattered across genetic loci, often displaying small effect sizes. Most PRSs are constructed in European-ancestry populations, limiting their use in other ethnicities. Here we constructed and validated a PRS for late-onset Alzheimer’s Disease (LOAD) in Caribbean Hispanics (CH).

METHODS: We employed a CH discovery (N=4,312) and independent validation sample (N=1,850) to construct an ancestry-specific PRS (“CH-PRS”) and evaluated its performance alone and with other predictors using the area under curve (AUC) and logistic regression (strength of association with LOAD and statistical significance). We tested if CH-PRS predicted conversion to LOAD in a subsample with longitudinal data (N=1,239). We also tested the CH-PRS in an independent replication CH cohort (N=200) and brain autopsy cohort (N=33). Finally, we tested the effect of ancestry on PRS by employing European and African American discovery cohorts to construct alternative PRSs (“EUR-PRS”, “AA-PRS”).

RESULTS: The full model (LOAD ~ CH-PRS + sex + age + APOE-&ip.eop;4), achieved an AUC=74% (OR_CH-PRS =1.51 95%CI=1.36-1.68), raising to >75% in APOE-&ip.eop;4 non-carriers. CH-PRS alone achieved an AUC=72% in the autopsy cohort, raising to AUC=83% in full model. Higher CH-PRS was significantly associated with clinical LOAD in the replication CH cohort (OR=1.61, 95%CI=1.19-2.17) and significantly predicted conversion to LOAD (HR=1.93, CI=1.70-2.20) in the longitudinal subsample. EUR-PRS and AA-PRS reached lower prediction accuracy (AUC=58% and 53%, respectively).

INTERPRETATION: Enriching diversity in genetic studies is critical to provide an effective PRS in profiling LOAD risk across populations. This article is protected by copyright. All rights reserved.

PMID:34038570 | DOI:10.1002/ana.26131

Int Health. 2021 May 26:ihab020. doi: 10.1093/inthealth/ihab020. Online ahead of print.

ABSTRACT

BACKGROUND: Factors affecting the adoption and use of eHealth applications have been extensively researched from different perspectives in different regions. However, with the changing circumstances (e.g. the coronavirus disease 2019 pandemic), new influencing factors might evolve and can influence the attitudes of consumers towards using eHealth applications. The purpose of this study was to identify and evaluate the evolving factors affecting consumer attitudes towards the use of eHealth applications and provide implications for the future of Neom.

METHODS: An online survey questionnaire was used to collect data from 976 eHealth consumers in Saudi Arabia, which included 527 male and 449 female participants. Findings were analysed using the statistical means and standard deviations for each item in the questionnaire to analyse the role of each factor in depth. Statistical t-tests were used to identify significant differences between the groups categorised by age and gender.

RESULTS: ‘Necessity but not interest’ (mean 4.5 [standard deviation {SD} 1.12]) and fear (mean 4.5 [SD 1.13]) and psychological factors including depression (mean 4.4 [SD 1.54]), stress (mean 4.2 [SD 1.09]) and anxiety (mean 4.3 [SD 1.61]) were identified to be major evolving influencing factors, while other factors including performance expectancy, ease of use, enjoyment and incentives were identified to be comparatively less influential.

CONCLUSIONS: Increasing adoption of eHealth mainly due to necessity but not out of interest can have serious implications for patients and the adoption of eHealth technologies in the future.

PMID:34038551 | DOI:10.1093/inthealth/ihab020