Nevin Manimala

J Am Podiatr Med Assoc. 2023 Jul-Aug;113(4):21-145. doi: 10.7547/21-145.

ABSTRACT

BACKGROUND: Surgery is a common setting for opioid-naive patients to first be exposed to opioids. Understanding the multimodal analgesic-prescribing habits of podiatric surgeons in the United States may be helpful to refining prescribing protocols. The purpose of this benchmark study was to identify whether certain demographic characteristics of podiatric surgeons were associated with their postoperative multimodal analgesic-prescribing practices.

METHODS: We administered a scenario-based, voluntary, anonymous, online questionnaire that consisted of patient scenarios with a unique podiatric surgery followed by a demographics section. We developed multiple logistic regression models to identify associations between prescriber characteristics and the odds of supplementing with a nonsteroidal anti-inflammatory drug, regional nerve block, and anticonvulsant agent for each scenario. We developed multiple linear regression models to identify the association of multimodal analgesic-prescribing habits and the opioid dosage units prescribed at the time of surgery.

RESULTS: Eight hundred sixty podiatric surgeons completed the survey. Years in practice was a statistically significant variable in multiple scenarios. Compared with those in practice for more than 15 years, podiatric surgeons in practice 5 years or less had increased odds of reporting supplementation with an anticonvulsant agent in scenarios 1 (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.11-5.18; P = .03), 3 (OR, 2.97; 95% CI, 1.55-5.68; P = .001), 4 (OR, 2.54; 95% CI, 1.56-4.12; P < .001), and 5 (OR, 2.07; 95% CI, 1.29-3.32; P = .003).

CONCLUSIONS: Podiatric surgeons with fewer years in practice had increased odds of supplementing with an anticonvulsant. Approximately one-third of podiatric surgeons reported using some form of a nonopioid analgesic and an opioid in every scenario. The use of multimodal analgesics was associated with a reduction in the number of opioid dosage units prescribed at the time of surgery and may be a reasonable adjunct to current protocols.

PMID:37717233 | DOI:10.7547/21-145

Phytopathology. 2023 Sep 17. doi: 10.1094/PHYTO-08-22-0306-R. Online ahead of print.

ABSTRACT

Bretziella fagacearum (Bretz) Z.W. deBeer, Marinc., T.A. Duong, & M.J. Wingf., the ascomycete fungus causing the “oak wilt” disease, is considered a virulent threat to North American oak forests, but the influence of the physical environment on this pathosystem remains unclear, particularly at the forest scale. This study explored the influence of terrain and soil factors on B. fagacearum infections, applying discrete and continuous spatial models to investigate the question: besides proximity to other infections, which environmental factors influenced B. fagacearum incidence? Locations of infections were recorded from 586 confirmed B. fagacearum sites, identified from 2004 through 2021 in a 76 km2 area of deep, sandy glacial outwash in Chequamegon-Nicolet National Forest, northern Wisconsin. Public datasets derived from remote sensing were incorporated as covariates, describing terrain elevation (USGS 10-m DEM), soil physical and chemical properties (POLARIS), and forest composition (WiscLand2). Spatial models included Generalized Additive Models (GAM) and Neyman-Scott Cluster Process Models (CPM). Results indicated that spatial dependence and the distribution of oak forests were the most important drivers of B. fagacearum distribution in this area, with more minor influence from elevation, hill shade, and drainage patterns. Comparison between modeling approaches indicated that-at this scale and in this area-the most accurate models were those which included host distribution, spatial dependence, as well as quantitative terrain and soil descriptions. However, a close approximation could be attained using nonlinear models (GAMs) which incorporated only host distribution and spatial dependence.

PMID:37717228 | DOI:10.1094/PHYTO-08-22-0306-R

Otolaryngol Head Neck Surg. 2023 Sep 17. doi: 10.1002/ohn.531. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the feasibility, safety, and failure rate of Integra® Bilayer Wound Matrix (Integra) in the reconstruction of oral cavity defects.

STUDY DESIGN: Retrospective cohort study.

SETTING: All study information was collected from a single academic tertiary care hospital.

METHODS: Subjects included adult patients who underwent oral cavity resection and immediate subsequent reconstruction with Integra® Bilayer Wound Matrix at MD Anderson Cancer Center between the years 2015 and 2020. The following variables were collected: patient’s demographics, comorbidities, disease stage, treatment and reconstruction modalities, and surgical outcome from the medical records. Statistical analysis included distribution analysis for all collected parameters and Pearson’s χ² tests to find correlation between variables and take rate of Integra.

RESULTS: Eighty-three patients underwent reconstruction with Integra® Bilayer Wound Matrix dressing. Average age was 66 years old. Thirty-nine patients (47%) had history of previous resections for oral cavity tumors. Fourteen patients (17%) had history of radiation therapy to the Head and Neck region. Most common pathology was invasive squamous cell carcinoma (75%) followed by dysplasia (12%). Complete wound healing with good cellular integration occurred in 83 patients (96%) with only 3 failures requiring additional surgery. Reconstruction of mandibulectomy defects was associated with increased risk of dehiscence and bone exposure (0.66, P = .03).

CONCLUSION: This study shows promising results with high take rate of Integra® Bilayer Wound Matrix dressing in the reconstruction of various oral cavity defects. We encourage surgeons to adopt this technique as a viable and versatile option into the reconstruction ladder of oral cavity defects.

PMID:37717219 | DOI:10.1002/ohn.531

Am J Ind Med. 2023 Sep 17. doi: 10.1002/ajim.23536. Online ahead of print.

ABSTRACT

BACKGROUND: Firefighters are routinely exposed to loud noise that put them at risk for hearing loss. A reliable and valid measure to assess firefighters’ hearing function is important. This study aims to test the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap ((m)AIADH) in firefighters.

METHOD: A cross-sectional study was conducted using a convenience sample of 239 career firefighters from six partnered fire departments in Central Texas and Northern California. The internal consistency, convergent and criterion validity, and the ability to discriminate groups by measured hearing, perceived hearing, and a combination of measured and perceived hearing, were examined using the total score and score for each of the five subscales of the (m)AIADH.

RESULTS: The study participants were primarily men (93%). Satisfactory internal consistency was revealed for the (m)AIADH with Cronbach’s alpha above 0.80 for all five subscales. Criterion analysis presented a moderate correlation between the (m)AIADH and the average of hearing threshold at high frequencies (4, 6, and 8 kHz). For convergent validity, the (m)AIADH was moderately to highly related with perceived hearing. There were statistically significant differences in the total (m)AIADH score and the five subscales for measured hearing thresholds except for “intelligibility in quiet.” The (m)AIADH also showed a discriminative ability to distinguish between the group with good perceived hearing and the group with bad perceived hearing.

CONCLUSION: The (m)AIADH is a reliable and valid measure to assess various dimensions of hearing function among firefighters.

PMID:37717215 | DOI:10.1002/ajim.23536

Sci Rep. 2023 Sep 16;13(1):15351. doi: 10.1038/s41598-023-42327-3.

ABSTRACT

One of the fundamental questions about human language is whether all languages are equally complex. Here, we approach this question from an information-theoretic perspective. We present a large scale quantitative cross-linguistic analysis of written language by training a language model on more than 6500 different documents as represented in 41 multilingual text collections consisting of ~ 3.5 billion words or ~ 9.0 billion characters and covering 2069 different languages that are spoken as a native language by more than 90% of the world population. We statistically infer the entropy of each language model as an index of what we call average prediction complexity. We compare complexity rankings across corpora and show that a language that tends to be more complex than another language in one corpus also tends to be more complex in another corpus. In addition, we show that speaker population size predicts entropy. We argue that both results constitute evidence against the equi-complexity hypothesis from an information-theoretic perspective.

PMID:37717109 | DOI:10.1038/s41598-023-42327-3

NPJ Sci Food. 2023 Sep 16;7(1):51. doi: 10.1038/s41538-023-00222-1.

ABSTRACT

The preferences of consumers for different flavours and aromas in wine are varied and may be explained by inherent factors such as cultural background, wine education and personal taste of the wine consumer. Wine flavour, as perceived in the mouth, includes aroma compounds released through the retronasal pathway, which are shaped by interactions with saliva. Saliva and wine interactions could provide an explanation as to why wine tasters express different preferences for wine. To test this hypothesis, 13 Western and 13 Chinese experienced wine tasters were recruited. Sensory evaluation was performed in formal surroundings to acquire free description-based and perceived sensory intensity data using the Pivot^® Profile and continuous scale assessment, respectively. Participants’ saliva samples were collected before the sensory evaluation and spiked into a wine sample to investigate the impact on the wine’s volatile release using comprehensive two-dimensional gas chromatography-mass spectrometry (GC × GC-MS). Saliva samples were subjected to enzyme activity assays and protein composition profiling by Tandem Mass Tag (TMT) quantitative proteomics. The wine tasters showed differences in wine flavour perception, which was supported by the difference in wine volatile release resulting from the addition of saliva. The two groups of participants did not have significant differences in total salivary protein concentrations or the amounts of esterase and α-amylase. However, statistically significant variations in the concentrations of specific proteins (proline-rich proteins (PRPs) and lipocalin-1 (LCN-1); p < 0.01) were found between the two groups. Significant correlations between perceived intensities of wine attributes and concentrations of PRPs and LCN-1 were observed. These results indicate that the composition of proteins in saliva is a factor that influences wine perception and preference. Our results provide a biochemical basis for understanding preference for food based on interactions between aroma compounds and salivary proteins and could be used to suggest foods or beverages to particular cultural groups.

PMID:37717071 | DOI:10.1038/s41538-023-00222-1

Nat Commun. 2023 Sep 16;14(1):5763. doi: 10.1038/s41467-023-41488-z.

ABSTRACT

CC and CXC-chemokines are the primary drivers of chemotaxis in inflammation, but chemokine network redundancy thwarts pharmacological intervention. Tick evasins promiscuously bind CC and CXC-chemokines, overcoming redundancy. Here we show that short peptides that promiscuously bind both chemokine classes can be identified from evasins by phage-display screening performed with multiple chemokines in parallel. We identify two conserved motifs within these peptides and show using saturation-mutagenesis phage-display and chemotaxis studies of an exemplar peptide that an anionic patch in the first motif and hydrophobic, aromatic and cysteine residues in the second are functionally necessary. AlphaFold2-Multimer modelling suggests that the peptide occludes distinct receptor-binding regions in CC and in CXC-chemokines, with the first and second motifs contributing ionic and hydrophobic interactions respectively. Our results indicate that peptides with broad-spectrum anti-chemokine activity and therapeutic potential may be identified from evasins, and the pharmacophore characterised by phage display, saturation mutagenesis and computational modelling.

PMID:37717048 | DOI:10.1038/s41467-023-41488-z

Trials. 2023 Sep 16;24(1):594. doi: 10.1186/s13063-023-07600-w.

ABSTRACT

INTRODUCTION: Pulmonary segmentectomy, when combined with hilar and mediastinal lymphadenectomy, is currently considered the gold standard treatment for early-stage lung tumors (NSCLC) smaller than 2 cm in diameter. The preoperative planning for segmentectomies usually includes a contrast-enhanced CT with 2D reconstructions (axial, coronary, and sagittal). Recent technological advances allow 3D (volume rendering) reconstructions of preoperative CT scans, intended to improve the surgeon’s understanding of the segmental anatomy. The study aims to investigate the added value of 3D reconstruction in enhancing the surgeon’s understanding of anatomical structures, thus facilitating surgical planning and improving oncological outcomes.

METHODS AND ANALYSIS: This is a prospective, randomized, controlled study. Patients will be randomized into two groups: 1. Group 2D: the preoperative workup for these patients will consist of a contrast-enhanced chest CT with two-dimensional (2D) reconstructions (axial, coronary, and sagittal); 2. Group 3D: the preoperative workup for these patients will consist of a contrast-enhanced chest CT with two-dimensional (2D) reconstructions (axial, coronary, and sagittal) and a 3D reconstruction (volume rendering) of the same chest CT employing dedicated software. The primary endpoints will be negative margin (R0) resection rate, resection margin (staple line-to-tumor distance), and thoracotomy conversions. We will use Fisher’s exact test for binary outcomes and Mann-Whitney U test for continuous outcomes. For subgroup analyses, we will use regression. Multivariable analyses will be based on logistic regression for binary outcomes and linear regression for continuous outcomes.

ETHICS AND DISSEMINATION: The protocol and the model informed consent forms have been reviewed and approved by the ethics committee (N.: 1-2023) concerning scientific content and compliance with applicable research and human subject regulations. A Subcommittee on Publications was established to review all publications and report its recommendations to the steering committee. The anonymized participant-level dataset and statistical code for generating the results will not be publicly available.

TRIAL REGISTRATION: The protocol was registered at ClinicalTrials.gov (ID: NCT05716815; Prospective rAndomized sTudy efficaCy tHree-dimensional rEconstructions Segmentectomy – Full-Text View – ClinicalTrials.gov). Jan 19, 2023.

PMID:37717001 | DOI:10.1186/s13063-023-07600-w

BMC Complement Med Ther. 2023 Sep 16;23(1):324. doi: 10.1186/s12906-023-04131-4.

ABSTRACT

BACKGROUND: Folk medicine is crucial to healthcare delivery in the underdeveloped countries. It is frequently used as a primary treatment option or as a complementary therapy for malaria. Malaria is a deadly disease which greatly threatens global public health, claiming incredible number of lives yearly. The study was aimed at documenting the medicinal plants used for malaria treatment in folk medicine in Kwara State, Nigeria.

METHODS: Ethnobotanical information was collected from selected consenting registered traditional medicine practitioners (TMPs) through oral face-to-face interviews using in-depth, semi-structured interview guide. The ethnobotanical data were analysed, and descriptive statistical methods were used to compile them.

RESULTS: Sixty-two indigenous medicinal plants, including 13 new plants, used for malaria treatment were identified in this study. The TMPs preferred decoction in aqueous solvent (34%) and steeping in decaffeinated soft drink (19%) for herbal preparations. Oral administration (74%) was the main route of administration, while leaves (40%) and stem barks (32%) were the most dominant plant parts used in herbal preparations. The most cited families were Fabaceae (15%) and Rutaceae (6%), while Mangifera indica (77.14%), Enantia chlorantha (65.71%), Alstonia boonei (57.14%) followed by Cymbopogon citratus (54.29%) were the most used plants. Besides, the antimalarial activities of many of the plants recorded and their isolated phytocompounds have been demonstrated. Furthermore, the conservation status of 4 identified plants were Vulnerable.

CONCLUSION: The study showed strong ethnobotanical knowledge shared by the TMPs in the State and provides preliminary information that could be explored for the discovery of more potent antimalarial compounds.

PMID:37716985 | DOI:10.1186/s12906-023-04131-4

BMC Pediatr. 2023 Sep 16;23(1):467. doi: 10.1186/s12887-023-04284-8.

ABSTRACT

BACKGROUND: Regular growth monitoring can be used to evaluate young children’s nutritional and physical health. While adequate evaluation of the scope and quality of nutrition interventions is necessary to increase their effectiveness, there is little research on growth monitoring coverage measurement. The purpose of this study was to investigate socioeconomic disparities in under-5 Rwandan children who participate in growth monitoring and nutrition promotion.

METHODS: We used data from the 2019-2020 Rwanda Demographic and Health Survey (RDHS), which included 8092under-5 children. Percentage was employed in univariate analysis. To examine the socioeconomic inequalities, concentration indices and Lorenz curves were used in growth monitoring and nutrition promotion among under-5 children.

RESULTS: A weighted prevalence of 33.0% (95%CI: 30.6-35.6%) under-5 children growth monitoring and nutrition promotion was estimated. Growth monitoring and nutrition promotion among under-5 children had higher uptake in the most disadvantaged cohort, as the line of equality sags below the diagonal line in Lorenz curve. Overall, there was pro-poor growth monitoring and nutrition promotion among under-5 in Rwanda (Conc. Index = 0.0994; SE = 0.0111). Across the levels of child and mother’s characteristics, the results show higher coverage of under-5 growth monitoring and nutrition promotion in the most socioeconomic disadvantaged cohort.

CONCLUSION: The study found a pro-poor disparity in growth monitoring and nutrition promotion among under-5 children in Rwanda. By implication, the most disadvantaged children had a higher uptake of growth monitoring and nutrition promotion. The Rwanda government should develop policies and programmes to achieve the universal health coverage for the well-off and underserved population.

PMID:37716969 | DOI:10.1186/s12887-023-04284-8