Nevin Manimala

J Community Health. 2024 Aug 10. doi: 10.1007/s10900-024-01388-9. Online ahead of print.

ABSTRACT

Nearly half of heterosexually transmitted human immunodeficiency virus (HIV) infections occur among Black men in the United States. Yet Black heterosexual men (BHM) are largely ignored in HIV programming, policy implementation, and research. This study explores how masculinity, mental health, and socioeconomic factors such as income, education, and insurance (e.g., enrollment and coverage) correlate with the likelihood of BHM having important conversations surrounding HIV with their healthcare providers and family members. Conversations among social networks (e.g., peers, family, and neighbors) create an opportunity to increase comfortability while discussing HIV-related topics around condom use and testing. This study used a cross-sectional survey design and convenience sampling (N = 279) to recruit participants from a community-academic partnership involving a Federally Qualified Health Center (FQHC) in Detroit between June 1, 2020, and July 31, 2020. Descriptive statistics were used to report demographics, socioeconomic information, and sexual health-related behavior variables. Spearman’s correlation test was used to report bivariate correlations between predictor and outcome variables. 49.3% of the study participants disclosed having ever talked to a healthcare provider about HIV/acquired immune deficiency syndrome (AIDS), and 40.9% disclosed having ever talked to a family member about HIV/AIDS and sexually transmitted infections (STIs). The results from this article highlight potential barriers that may inhibit BHM from engaging in conversations about HIV with their healthcare providers and family members. It is important to include BHM in future research that focuses on HIV prevention and education to support community leaders and clinicians who work to address these disparities.

PMID:39126616 | DOI:10.1007/s10900-024-01388-9

Environ Sci Pollut Res Int. 2024 Aug 10. doi: 10.1007/s11356-024-34613-y. Online ahead of print.

ABSTRACT

In the context of the new normal, enhancing digitalization to empower the transition to a green economy is a critical instrument to promote China’s economic transition from virtual to real sectors. It is also a necessary approach to realize the high-quality economic development in China. Based on panel data of 282 prefecture-level and above cities in China from 2011 to 2020, the study employs panel regression, spatial metrics, and other methods to explore the impact of urban digitization on the transition to a green economy from the dimensions of direct and indirect transmission mechanism, as well as heterogeneous effects. The findings reveal that digitalization not only exerts a positive effect on the green transition but also generates significant spatial spillover effects. The influence of digitization level on green economic transition exhibits notable regional heterogeneity. Advancement in digitization can foster green economic transition by catalyzing green technological innovation. While digitalization contributes to the green transition by optimizing the structure of energy consumption, its mediating effect is relatively modest. Therefore, it is essential to fortify the supply of digital innovative technology and strengthen digitalization and green technology innovation to jointly facilitate the transition to a green economy. This necessitates the implementation of differentiated development paths for digitization-enabled green economic transition in various regions.

PMID:39126588 | DOI:10.1007/s11356-024-34613-y

Drug Deliv Transl Res. 2024 Aug 10. doi: 10.1007/s13346-024-01681-z. Online ahead of print.

ABSTRACT

Nanoparticulate drug delivery systems (NDDS) based nanoformulations have emerged as promising drug delivery systems. Various NDDS-based formulations have been reported such as polymeric nanoparticles (NPs), nanoliposomes, solid lipid NPs, nanocapsules, liposomes, self-nano emulsifying drug delivery systems, pro liposomes, nanospheres, microemulsion, nanoemulsion, gold NPs, silver NPs and nanostructured lipid carrier. They have shown numerous advantages such as enhanced bioavailability, aqueous solubility, permeability, controlled release profile, and blood-brain barrier (BBB) permeability. This advantage of NDDS can help to deliver pure drugs to the target site. However, the formulation of nanoparticles is a complex process that requires optimization to ensure product quality and efficacy. Quality by Design (QbD) is a systemic approach that has been implemented in the pharmaceutical industry to improve the quality and reliability of drug products. QbD involves the optimization of different parameters like zeta potential (ZP), particle size (PS), entrapment efficiency (EE), polydispersity index (PDI), and drug release using statistical experimental design. The present article discussed the detailed role of QbD in optimizing nanoformulations and their advantages, advancement, and applications from the industrial perspective. Various case studies of QbD in the optimization of nanoformulations are also discussed.

PMID:39126576 | DOI:10.1007/s13346-024-01681-z

Int J Comput Assist Radiol Surg. 2024 Aug 10. doi: 10.1007/s11548-024-03239-3. Online ahead of print.

ABSTRACT

INTRODUCTION: In robotic-assisted surgery (RAS), the input device is the primary site for the flow of information between the user and the robot. Most RAS systems remove the surgeon’s console from the sterile surgical site. Beneficial for performing lengthy procedures with complex systems, this ultimately lacks the flexibility that comes with the surgeon being able to remain at the sterile site.

METHODS: A prototype of an input device for RAS is constructed. The focus lies on intuitive control for surgeons and a seamless integration into the surgical workflow within the sterile environment. The kinematic design is translated from the kinematics of laparoscopic surgery. The input device uses three degrees of freedom from a flexible instrument as input. The prototype’s performance is compared to that of a commercially available device in an evaluation. Metrics are used to evaluate the surgeons’ performance with the respective input device in a virtual environment implemented for the evaluation.

RESULTS: The evaluation of the two input devices shows statistically significant differences in the performance metrics. With the proposed prototype, the surgeons perform the tasks faster, more precisely, and with fewer errors.

CONCLUSION: The prototype is an efficient and intuitive input device for surgeons with laparoscopic experience. The placement in the sterile working area allows for seamless integration into the surgical workflow and can potentially enable new robotic approaches.

PMID:39126562 | DOI:10.1007/s11548-024-03239-3

Bull Exp Biol Med. 2024 Aug 10. doi: 10.1007/s10517-024-06177-x. Online ahead of print.

ABSTRACT

The parameters of the cytokine profile and functional activity of the complement system in the blood of rats were studied during different time periods of chronic unpredictable mild stress using a model of sequentially alternating low-intensity stress effects for 1, 2, 3, and 4 weeks. In the dynamics of observation, a general tendency towards multidirectional fluctuations in the concentration of cytokines was revealed: an increase in IL-10, but a decrease in IL-4 in comparison with the control. Statistically significant changes in the level of IL-10 were noted after 2, 3, and 4 weeks, IL-4 – after 2 and 4 weeks of stress loads. The percentage of lysis of the C3 component in rats gradually increased by the 2nd week of chronic stress, but then decreased and practically did not differ from the control values (intact animals) by the end of the study. These results illustrate the specificity of changes in the indicators of the C component of the complement system and the cytokine profile of the blood reflecting activity of the cellular and humoral components of the immune response in rats exposed to repeated stress factors of different origins and duration.

PMID:39126541 | DOI:10.1007/s10517-024-06177-x

Aging Clin Exp Res. 2024 Aug 10;36(1):169. doi: 10.1007/s40520-024-02822-7.

ABSTRACT

BACKGROUND: Falls in older adults significantly impact overall health and healthcare costs. Intrinsic capacity (IC) reflects functional reserve and is an indicator of healthy aging.

AIMS: To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study.

METHODS: The Minimum Data Set for Home Care (MDS-HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0-100).

RESULTS: The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (< 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94-0.98, p < 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94-0.98, p < 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93-0.99, p = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16-0.60, p < 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15-0.59, p < 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16-0.82, p = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97-0.99, p < 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96-0.99, p < 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96-0.99, p < 0.001).

DISCUSSION: This is the first study using an MDS-HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain.

CONCLUSIONS: Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians.

PMID:39126523 | DOI:10.1007/s40520-024-02822-7

Ann Hematol. 2024 Aug 10. doi: 10.1007/s00277-024-05701-3. Online ahead of print.

ABSTRACT

This is the first study presenting the overall descriptive epidemiology of multiple myeloma (MM), including incidence, mortality rate, and prevalence, in South Korea between 2010 and 2018 based on nationwide medical insurance coverage and mortality statistics data. The incidence of MM between 2010 and 2018 was obtained from nationwide medical claims data, and mortality data were obtained from the Korea National Statistical Office. The age-standardized incidence rate (ASIR) and mortality rate (ASMR) and one- and five-year survival rates of patients with MM each year were estimated. There were 10,835 patients with MM aged ≥ 20 years in South Korea between 2010 and 2018. The ASIR was 2.42/100,000 in 2010 and increased to 2.71/100,000 in 2018, with an annual percent change (APC) of 1.86% (95% CI = 0.74-2.99%, P = 0.005). While this trend was significant in women, it was not statistically significant in men. The ASMR did not significantly change over time. Furthermore, the median survival time of patients with MM diagnosed between 2010 and 2018 was 3.36 years. Notably, the one-year survival rate of patients was increased from 65.3% in 2010 to 76.2% in 2017. Finally, the proportion of patients with MM who received novel therapeutic agents, such as proteasome inhibitors or immunomodulatory drugs, as first-line treatment increased from 37.7% in 2010 to 97.8% in 2018. The ASIR and prevalence of MM in South Korea increased between 2010 and 2018, especially in women and the survival rate of patients with MM has increased.

PMID:39126522 | DOI:10.1007/s00277-024-05701-3

Eur J Trauma Emerg Surg. 2024 Aug 10. doi: 10.1007/s00068-024-02620-w. Online ahead of print.

ABSTRACT

BACKGROUND: Appendicitis is the most frequent global abdominal surgical emergency. An ageing population, who often exhibit atypical symptoms and delayed presentations, challenge conventional diagnostic and treatment paradigms.

OBJECTIVES: This study aims to delineate disparities in presentation, management, and outcomes between elderly patients and younger adults suffering from acute appendicitis.

METHODS: This subgroup analysis forms part of ESTES SnapAppy, a time-bound multi-center prospective, observational cohort study. It includes patients aged 15 years and above who underwent laparoscopic appendectomy during a defined 90-day observational period across multiple centers. Statistical comparisons were performed using appropriate tests with significance set at p < 0.05.

RESULTS: The study cohort comprised 521 elderly patients (≥65 years) and 4,092 younger adults (18-64 years). Elderly patients presented later (mean duration of symptoms: 7.88 vs. 3.56 days; p < 0.001) and frequently required computed tomography (CT) scans for diagnosis (86.1% vs. 54.0%; p < 0.001). The incidence of complicated appendicitis was higher in the elderly (46.7% vs. 20.7%; p < 0.001). Delays in surgical intervention were notable in the elderly (85.0% operated within 24 h vs. 88.7%; p = 0.018), with longer operative times (71.1 vs. 60.3 min; p < 0.001). Postoperative complications were significantly higher in the elderly (27.9% vs. 12.9%; p < 0.001), including severe complications (6.9% vs. 2.4%; p < 0.001) and prolonged hospital stays (7.9 vs. 3.6 days; p < 0.001).

CONCLUSIONS: Our findings highlight significant differences in the clinical course and outcomes of acute appendicitis in the elderly compared to younger patients, suggesting a need for age-adapted diagnostic pathways and treatment strategies to improve outcomes in this vulnerable population.

PMID:39126520 | DOI:10.1007/s00068-024-02620-w

Eur J Pediatr. 2024 Aug 10. doi: 10.1007/s00431-024-05711-3. Online ahead of print.

ABSTRACT

Fidgety movements provide early information about a potential development of cerebral palsy in preterm neonates. The aim was to assess differences in the combined outcome of mortality and fidgety movements defined as normal or pathological in very preterm neonates according to the group allocation in the randomised-controlled multicentre COSGOD III trial. Preterm neonates of two centres participating in the COSGOD III trial, whose fidgety movements were assessed as normal or pathological at six to 20 weeks of corrected age, were analysed. In the COSGOD III trial cerebral oxygen saturation (crSO₂) was measured by near-infrared spectroscopy (NIRS) during postnatal transition and guided resuscitation in preterm neonates randomised to the NIRS-group, whereby medical support was according routine, as it was also in the control group. Fidgety movements were classified in normal or abnormal/absent at six to 20 weeks of corrected age. Mortality and fidgety movements of preterm neonates allocated to the NIRS-group were compared to the control-group. Normal outcome was defined as survival with normal fidgety movements. One-hundred-seventy-one preterm neonates were included (NIRS-group n = 82; control-group n = 89) with a median gestational age of 29.4 (27.4-30.4) and 28.7 (26.7-31.0) weeks in the NIRS-group and the control-group, respectively. There were no differences in the combined outcome between the two groups: 90.2% of the neonates in the NIRS-group and 89.9% in the control-group survived with normal outcome (relative risk [95% CI]; 0.96 [0.31-2.62]).Conclusions: In the present cohort of preterm neonates, monitoring of crSO₂ and dedicated interventions in addition to routine care during transition period after birth did not show an impact on mortality and fidgety movements defined as normal or pathological at six to 20 weeks corrected age. What is Known • Fidgety movements display early spontaneous motoric pattern and may provide early information about a potential development of cerebral palsy in preterm neonates. What is New • This retrospective observational study of the randomised-controlled multicentre COSGOD III trial is the first study investigating the potential influence of cerebral oxygenation guided resuscitation during postnatal transition period on combined outcome of mortality and fidgety movements up to 20 weeks of corrected age in very preterm neonates. • This study adds to the growing interest of assessing cerebral oxygenation, that monitoring of cerebral oxygen saturation and dedicated interventions during postnatal transition period according to the COSGOD III trial has no significant influence on mortality and fidgety movements defined as normal or pathological in very preterm neonates.

PMID:39126518 | DOI:10.1007/s00431-024-05711-3

Clin Oral Investig. 2024 Aug 10;28(9):479. doi: 10.1007/s00784-024-05871-4.

ABSTRACT

OBJECTIVES: The aim of this retrospective study was to compare the clinical results of two root canal sealers and three obturation techniques used for non-surgical root canal treatment.

MATERIALS AND METHODS: A total of two hundred eighty-three root canal treated teeth in two hundred thirty-seven patients with minimum a 6-month follow-up was included for this study. The canals were filled with three different modes: 1) cold lateral condensation (CLC) and AH Plus Sealer; 2) continuous wave condensation technique (CWC) and AH Plus Sealer, and 3) sealer-based obturation technique (SBO) and AH Plus Bioceramic Sealer. The treatment outcome was analysed based on clinical signs and symptoms, and periapical radiograph (periapical index, PAI).

RESULTS: There were no significant differences in treatment outcome between various sealers and filling techniques applied. The sealer extrusion was found most frequently in the CWC group (60.67%), followed by SBO (59.21%) and CLC (21.19%) with statistically significant differences (p < .05). The initial diagnosis, previous treatment and sealer extrusion (p < .05) were prognostic factors that affected treatment outcome.

CONCLUSIONS: Based on the findings of this study, neither the sealer type nor the filling technique affected the treatment success while preoperative diagnosis, previous treatment and sealer extrusion had significant effect on the outcome.

CLINICAL RELEVANCE: A bioceramic sealant applied along with the single-cone technique might be considered as an alternative method in root canal obturation.

PMID:39126493 | DOI:10.1007/s00784-024-05871-4