Nevin Manimala

Matern Child Health J. 2023 Oct 21. doi: 10.1007/s10995-023-03791-5. Online ahead of print.

ABSTRACT

INTRODUCTION: The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend that expectant parents receive a preventive visit with a pediatrician in the prenatal period (a pediatric prenatal visit, or PPV). Discussing newborn health topics in the prenatal period tends to be more effective than immediately postpartum, and research suggests, for example, that the PPV increases timely childhood immunizations. However, only 22% of expectant parents have these visits, and there are significant disparities by race and income.

METHODS: A 2-min online survey with open-ended questions was emailed to 304 eligible obstetrics providers in Rochester, NY. Simple descriptive statistics and chisquare analysis were applied to survey responses. Responses were organized within the framework of knowledge, attitudes, and practices to identify barriers to guideline adherence resulting in chronic under-utilization of the PPV.

RESULTS: Ninety obstetric providers completed the survey. 66 reported awareness of the PPV, and 45 reported referring patients for a PPV. However, in open-ended questions, respondents expressed confusion between the PPV and a “meet and greet” visit with a pediatrician. Some respondents believed that the PPV is not covered by insurance, even though these visits are covered by Medicaid and marketplace insurance. Providers who had personally received one as a parent expressed positive attitudes.

DISCUSSION: These findings indicate that unfamiliarity with the PPV is one barrier to referral. Educating providers about the guideline recommendations, evidence base, and insurance coverage could overcome this barrier. Doing so could reduce disparities in utilization of the pediatric prenatal visit.

PMID:37864772 | DOI:10.1007/s10995-023-03791-5

Neurol Sci. 2023 Oct 21. doi: 10.1007/s10072-023-07143-7. Online ahead of print.

ABSTRACT

INTRODUCTION: As Hearing loss and dementia affect people with the same profile, several epidemiological studies have evaluated their relationship. However, the link between age-related hearing loss and Alzheimer’s disease is still unclear.

METHODS: We selected subjects with no history of exposure to loud noises, blasts, head trauma with hearing loss, or sudden sensorineural hearing loss from a cohort intended to study preclinical phases of Alzheimer’s disease. Participants are volunteers over 55 years without cognitive impairment. We correlated the results of an objective auditory evaluation with brain amyloid and p-tau181 levels and with the outcomes of a comprehensive neuropsychological assessment.

RESULTS: Fifty-five subjects at different stages of the Alzheimer’s disease continuum were evaluated. There were no statistically significant correlations between amyloid-β and p-tau levels and any of the objective auditory measures. A weak but significant correlation was found between amyloid-β values and the Hearing Handicap Inventory for the Elderly. The neuropsychological domains more correlated to hearing loss were executive function and processing speed.

DISCUSSION: Age-related hearing loss is not linked to any pathological markers of Alzheimer’s disease nor to neuropsychological domains typically affected in this disease. The Hearing Handicap Inventory for the Elderly has an important component of subjectivity and further studies are needed to explore its relationship with amyloid-β levels.

PMID:37864751 | DOI:10.1007/s10072-023-07143-7

Int Orthop. 2023 Oct 21. doi: 10.1007/s00264-023-06009-z. Online ahead of print.

ABSTRACT

PURPOSE: Full-thickness retracted massive supraspinatus tears are a challenge for arthroscopic surgeons where multiple options for treatment exist, but medializing the attachment is a relatively easy procedure for which a decision can be taken intraoperatively. We investigate the viability of MATERIAL AND METHODS: Ten freshly thawed cadavers were taken and dissected. The supraspinatus tendon was resected, and then its attachment was progressively medialized. The range of motion (abduction, internal and external rotation) was recorded and compared. As a result, we noted a statistically significant decrease in abduction, internal and external rotation with progressive medialization of the supraspinatus insertion.

CONCLUSION: Medialized repair of the supraspinatus can be performed only to an extent beyond which it compromises glenohumeral motion. We noted a statistically significant decrease in ROM with even a 3 mm medialization of the tendon, but the acceptable medialization has to be determined on a case-to-case basis.

PMID:37864720 | DOI:10.1007/s00264-023-06009-z

Environ Sci Pollut Res Int. 2023 Oct 21. doi: 10.1007/s11356-023-30125-3. Online ahead of print.

ABSTRACT

Governments and professionals have recently tried to improve public environmental knowledge and laws in order to meet growing environmental concerns. As a result, most nations see corporate environmental initiatives like the circular economy and the green supply chain as important (GSCM) as the best ways to address environmental problems. As a result, this study tries to show how important GSCM and the circular economy are regarding the economy of China’s relationship to environmental sustainability. This study uses the partial least square structural equation model (PLS-SEM) on data to obtain trustworthy results from 387 Chinese manufacturing companies. A favorable and statistically significant correlation between GSCM, environmental performance, and the circular economy was revealed using PLS-SEM analysis. To raise environmental standards, eco-friendly methods like buying and designing green items are widely regarded today. Imagine if manufacturing companies adopt green supply chain management, which would improve their economic performance and increase operational effectiveness. The secret to a successful corporation is having successful operations.

PMID:37864702 | DOI:10.1007/s11356-023-30125-3

Environ Sci Pollut Res Int. 2023 Oct 21. doi: 10.1007/s11356-023-30471-2. Online ahead of print.

ABSTRACT

This study is aimed at utilizing three waste materials, i.e., solid refuse fuel (SRF), tire derived fuel (TDF), and sludge derived fuel (SDF), as eco-friendly alternatives to coal-only combustion in co-firing power plants. The contribution of waste materials is limited to ≤5% in the composition of the mixed fuel (coal + waste materials). Statistical experimental design and response surface methodology are employed to investigate the effect of mixed fuel composition (SRF, TDF, and SDF) on gross calorific value (GCV) and ash fusion temperature (AFT). A quadratic model is developed and statistically verified to apprehend mixed fuel constituents’ individual and combined effects on GCV and AFT. Constrained optimization of fuel blend, i.e., GCV >1,250 kcal/kg and AFT >1,200 °C, using the polynomial models projected the fuel-blend containing 95% coal with 3.84% SRF, 0.35% TDF, and 0.81% SDF. The observed GCV of 5,307 kcal/kg and AFT of 1225 °C for the optimized blend were within 1% of the model predicted values, thereby establishing the robustness of the models. The findings from this study can foster sustainable economic development and zero CO₂ emission objectives by optimizing the utilization of waste materials without compromising the GCV and AFT of the mixed fuels in coal-fired power plants.

PMID:37864701 | DOI:10.1007/s11356-023-30471-2

Environ Sci Pollut Res Int. 2023 Oct 21. doi: 10.1007/s11356-023-30263-8. Online ahead of print.

ABSTRACT

The main hurdle in deploying renewable energy projects is the high initial cost, making it difficult for businesses and individuals to afford it. The fragility of the financial sector and human resource management further slows the pace of renewable energy demand. Therefore, we aim to investigate the impact of financial fragility and human resource management on renewable energy consumption over time horizon 1997-2020. To that end, the analysis employed the ARDL-PMG model. For Asia as a whole and all other sub-regions, including South East Asia, East Asia, South Asia, and Western Asia, the estimates for bank non-performing loans are notably negative. In general, these findings imply that a rise in financial fragility significantly reduces renewable energy consumption in the long run. In the short run, the estimates attached to both bank non-performing loans and bank costs are negatively significant in Asia and sub-regions of Western Asia only. The results for the human resources show that it exerts a significant and positive influence on renewable energy demand in Asia as a whole, South Asia, East Asia, and Western Asia. The estimates attached to human resources are statistically insignificant in all models in the short run. In the end, some important public strategies and their implementations have been discussed.

PMID:37864689 | DOI:10.1007/s11356-023-30263-8

Environ Sci Pollut Res Int. 2023 Oct 21. doi: 10.1007/s11356-023-30388-w. Online ahead of print.

ABSTRACT

Few studies have focused on the effects of multiple metal mixtures on bone health and the underlying mechanisms related to alterations in the gut microbiota. This study aimed to examine the potential roles of gut microbiota alterations in metal mixtures and their association with osteoporosis traits. Adults aged ≥ 55 years were recruited from two community healthcare centers in Wuhan City during 2016-2019. The plasma concentrations of six metals (zinc, iron, selenium, lead, cadmium, and arsenic) were measured using an inductively coupled plasma mass spectrometer. The k-means clustering method was employed to explore the exposure profiles of metal mixtures for all participants. 16S rRNA gene sequencing was used to profile the gut microbiota of participants. Combining these results with those of our previous study, we identified overlapping taxa and evaluated their potential roles. A total of 806 participants (516 females), with an average age of 67.36 years were included. The participants were grouped into three clusters using k-means clustering: Cluster 1 (n = 458), Cluster 2 (n = 199), and Cluster 3 (n = 149). The high-exposure group for iron, zinc, lead, and cadmium (Cluster 3) showed a negative association with lumbar spine 1-4 bone mineral density (BMD). A total of 201 individuals (121 females) underwent sequencing of the gut microbiota. Both alpha and beta diversities were statistically different among the three groups. Bacteroidaceae, Lachnospiraceae, Bifidobacteriaceae, Bacteroides, and Lachnospiraceae_incertae_sedis were identified as overlapping taxa associated with the metal mixtures and BMD. Interaction analysis revealed that Cluster 3 interacted with Bacteroidaceae/Bacteroides, resulting in a positive effect on LS1-4 BMD (β = 0.358 g/cm², 95% CI: 0.047 to 0.669, P = 0.025). Our findings indicate associations between multiple metal mixtures and BMD as well as gut microbiota alterations. Exploring the interaction between metal mixtures and the gut microbiota provides new perspectives for the precise prevention and treatment of osteoporosis.

PMID:37864687 | DOI:10.1007/s11356-023-30388-w

Endocr Pathol. 2023 Oct 21. doi: 10.1007/s12022-023-09788-8. Online ahead of print.

ABSTRACT

Tall cell papillary thyroid carcinoma (TC-PTC) is considered adverse histology. However, previous studies are confounded by inconsistent criteria and strong associations with other adverse features. It is therefore still unclear if TC-PTC represents an independent prognostic factor in multivariate analysis and, if it does, what criteria should be employed for the diagnosis. We retrospectively reviewed 487 PTCs from our institution (where we have historically avoided the prospective diagnosis of TC-PTC) for both the height of tall cells (that is if the cells were two, or three, times as tall as wide) and the percentage of tall cells. On univariate analysis, there was significantly better disease free survival (DFS) in PTCs with no significant tall cell component (< 30%) compared to PTCs with cells two times tall as wide (p = 0.005). The proportion of tall cells (30-50% and > 50%) was significantly associated with DFS (p = 0.012). In a multivariate model including age, size, vascular space invasion, and lymph node metastasis, the current WHO tall cell criteria, met by 7.8% of PTCs, lacked statistical significance for DFS (p = 0.519). However, in the subset of tumours otherwise similar to the American Thyroid Association (ATA) guidelines low-risk category, WHO TC-PTC demonstrated a highly significant reduction in DFS (p = 0.004). In contrast, in intermediate to high-risk tumours, TC-PTC by WHO criteria lacked statistical significance (p = 0.384). We conclude that it may be simplistic to think of tall cell features as being present or absent, as both the height of the cells (two times versus three times) and the percentage of cells that are tall have different clinical significances in different contexts. Most importantly, the primary clinical significance of TC-PTC is restricted to PTCs that are otherwise low risk by ATA guidelines.

PMID:37864666 | DOI:10.1007/s12022-023-09788-8

Langenbecks Arch Surg. 2023 Oct 21;408(1):414. doi: 10.1007/s00423-023-03156-0.

ABSTRACT

PURPOSE: This study aimed to analyze postoperative and 90-day morbidity and mortality and their risk factors in all digestive cancer curative intent resections of a single digestive surgical department in a low-mid income country.

METHODS: All consecutive patients who underwent a surgical resection for digestive cancer with a curative intent between January 1, 2021, and December 31, 2021, were included. This is a retrospective analysis of a prospective cancer surgery database managed during the period. Patterns and factors associated with increased morbidity and mortality were analyzed and presented in tabular and descriptive forms.

RESULTS: Seventy-six patients were included, 38 (50%) were men with a mean age of 59 years (±13.5). Forty patients (52.63%) had tumors locally advanced, staged CT3-CT4 on preoperative imagery. Thirty-three of our population (43.42%) had laparoscopic surgery (conversion rate at 12.12%). In immediate preoperative, the morbidity rate was 36.84%; among each, 7 patients (9.21%) had serious complications (>2 Clavien-Dindo grade), and mortality rate was 5.26%. At 90 days after surgery, morbidity remained the same, and mortality increased to 7.9%. Risk factors for increased morbidity and mortality were female gender, obesity, high levels of carcinoembryonic antigen, hypoalbuminemia, laparotomy approach, hand sewn anastomosis, prolonged operating time, and wide drainage (p < 0.05).

CONCLUSIONS: This study provides figures on mortality and morbidity related to digestive cancer curative surgery in a low-mid income country digestive department and discusses risk factors increasing postoperative complications and death.

PMID:37864631 | DOI:10.1007/s00423-023-03156-0

Int J Clin Oncol. 2023 Oct 21. doi: 10.1007/s10147-023-02425-8. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the impact of different urinary diversion (UD) techniques on the peri- and postoperative complications of robot-assisted radical cystectomy (RARC) with ileal conduit.

METHODS: We retrospectively analyzed 373 patients undergoing RARC with ileal conduit at 11 institutions in Japan between April 2018 and December 2021. Propensity score weighting was performed to adjust for confounding factors such as age, sex, body mass index, performance status, American Society of Anesthesiologists score, previous abdominal surgery, neoadjuvant chemotherapy, and preoperative high T stage (≥ cT3) and high N stage (≥ cN1). Perioperative complications were then compared among three groups: extracorporeal, intracorporeal, and hybrid urinary diversion (ECUD, ICUD, and HUD, respectively).

RESULTS: A total of 150, 68, and 155 patients received ECUD, HUD, and ICUD, respectively. Bowel reconstruction time and UD time were significantly shorter in the ECUD group (p < 0.001), and console time was significantly longer and blood loss was significantly higher in the ICUD group (p < 0.001). For postoperative complications (Clavien-Dindo Classification grade ≥ 3), surgical site infection (p = 0.004), pelvic abscess (p = 0.013), anastomotic urine leak (p = 0.007), and pelvic organ prolapse (p = 0.011) significantly occurred in the ECUD group. For all grades, ileus was more common in the HUD group, whereas anastomotic stricture was more common in the ECUD group compared with the other groups (p < 0.05).

CONCLUSIONS: Severe complications did not increase after HUD and ICUD compared with ECUD; however, console time tended to be longer and blood loss was slightly higher during RARC.

PMID:37864612 | DOI:10.1007/s10147-023-02425-8