Nevin Manimala

Exp Dermatol. 2023 Sep 16. doi: 10.1111/exd.14937. Online ahead of print.

ABSTRACT

The appearance of actinic lentigines mainly found on face, back of the hands, upper back and décolleté is associated with chronic sun exposure. However, there is no study looking at the role of long UVA specifically in the development of actinic lentigines. This study was conducted in 20 Japanese adult women exposed on the upper back area three times per week for 6 weeks to incremental sub-erythemal UVA1 doses (5 J/cm² at weeks 1 and 2, 10 J/cm² at weeks 3 and 4 and 15 J/cm² at weeks 5 and 6). Clinical assessment, performed on day 0 (before any exposure), and on days 14, 28 and 42, included the evaluation of skin pigmentation (pigmented spots), chromametry of the pigmented skin lesions and measurement of dyschromy. The number of pigmented spots and uniformity of the skin’s pigmentation were clearly increased in comparison with baseline, statistical significance of the difference (p < 0.05) being reached at D 28 and D 42 in both cases. In conclusion, repeated sub-erythemal UVA1 exposure induces the development of actinic lentigines. Thus, a suitable protection including long UVA coverage is also needed to prevent from the damages induced by low, sub-erythemal doses of UV exposure.

PMID:37715544 | DOI:10.1111/exd.14937

Biomol Biomed. 2023 Sep 15. doi: 10.17305/bb.2023.9629. Online ahead of print.

ABSTRACT

High mortality and morbidity rates associated with ST-elevation myocardial infarction (STEMI) and post-STEMI heart failure (HF) necessitate proper risk stratification for coronary artery disease (CAD). A prediction model that combines specificity and convenience is highly required. This study aimed to design a monocyte-based gene assay for predicting STEMI and post-STEMI HF. A total of 1,956 monocyte expression profiles and corresponding clinical data were integrated from multiple sources. Meta-results were obtained through the weighted gene co-expression network analysis (WGCNA) and differential analysis to identify characteristic genes for STEMI. Machine learning models based on the decision tree (DT), support vector machine (SVM), and random forest (RF) algorithms were trained and validated. Five genes overlapped and were subjected to the model proposal. The discriminative performance of the DT model outperformed the other two methods. The established four-gene panel (HLA-J, CFP, STX11, and NFYC) could discriminate STEMI and HF with an area under the curve (AUC) of 0.86 or above. In the gene set enrichment analysis (GSEA), several cardiac pathogenesis pathways and cardiovascular disorder signatures showed statistically significant, concordant differences between subjects with high and low expression levels of the four-gene panel, affirming the validity of the established model. In conclusion, we have developed and validated a model that offers the hope for accurately predicting the risk of STEMI and HF, leading to optimal risk stratification and personalized management of CAD, thereby improving individual outcomes.

PMID:37715537 | DOI:10.17305/bb.2023.9629

Int J Gynaecol Obstet. 2023 Sep 16. doi: 10.1002/ijgo.15138. Online ahead of print.

ABSTRACT

OBJECTIVE: We compared efficacy of weight-based (0.4 IU/kg/h) versus fixed-dose (34 IU/h) oxytocin infusion during cesarean section.

METHODS: The oxytocin infusion in either group (n = 32 each) was initiated upon cord clamping. Primary outcome measure was adequacy of uterine tone at 4 min after initiating oxytocin infusion. Oxytocin associated side effects were also observed.

RESULTS: Significantly less oxytocin was used with the weight-based versus fixed-dose regimen (16.3 [11.2-22.4] IU vs 20.4 [15.8-26.9] IU; P = 0.036). Incidence of adequate uterine tone was clinically greater but not significantly different with the weight-based versus fixed-dose regimen (81.3% vs 71.9%; P = 0.376). The weight-based regimen was associated with clinically lesser, although not statistically significant need for rescue oxytocin (25% vs 46.9%; P = 0.068) and additional uterotonic (9.4% vs 15.6%; P = 0.708); as well as oxytocin associated side effects (hypotension [34.4% vs 46.9%; P = 0.309], nausea/vomiting [18.8% vs 40.6%; P = 0.055], and ST-T changes [0% vs 3.1%; P = 1.000]).

CONCLUSION: Weight-based oxytocin was not significantly different from the fixed-dose regimen in terms of uterotonic efficacy or associated side-effects, despite significantly lower doses being used. Use of weight-based oxytocin infusion (0.4 IU/kg/h) can be considered in clinical practice.

TRIAL REGISTRATION: Clinical Trial Registry of India (ctri.nic.in, number. CTRI/2021/01/030642).

PMID:37715535 | DOI:10.1002/ijgo.15138

Int J Lang Commun Disord. 2023 Sep 16. doi: 10.1111/1460-6984.12952. Online ahead of print.

ABSTRACT

BACKGROUND: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries.

AIMS: The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents’ sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents’ children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents).

METHODS & PROCEDURES: Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen’s d was calculated to determine effect sizes.

OUTCOMES & RESULTS: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons.

CONCLUSIONS & IMPLICATIONS: The effect of geographic region and culture may predict sex-based differences among mothers’ and fathers’ attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents’ attitudes toward stuttering.

WHAT THIS PAPER ADDS: What is already known on this subject The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds This study’s findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non-Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work? In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child’s stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted.

PMID:37715532 | DOI:10.1111/1460-6984.12952

Health Serv Res. 2023 Sep 16. doi: 10.1111/1475-6773.14232. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the national rate of social risk factor screening adoption among federally qualified health centers (FQHCs), examine organizational factors associated with social risk screening adoption, and identify barriers to utilizing a standardized screening tool in 2020.

DATA SOURCE: 2020 Uniform Data System, a 100% sample of all US FQHCs (N = 1375).

STUDY DESIGN: We used multivariable linear probability models to assess the association between social risk screening adoption and key FQHC characteristics. We used descriptive statistics to describe variations in screening tool types and barriers to utilizing standardized tools. We thematically categorized open-ended responses about tools and barriers.

DATA COLLECTION: None.

PRINCIPAL FINDINGS: In 2020, 68.9% of FQHCs screened patients for any social risk factors. Characteristics associated with a greater likelihood of screening adoption included having high proportions of patients best served in a language other than English (18.8 percentage point [PP] increase, 95% CI: 6.0, 31.6) and being larger in size (10.3 PP increase, 95% CI: 0.7, 20.0). Having higher proportions of uninsured patients (14.2 PP decrease, 95% CI: -25.5, -0.3) and participating in Medicaid-managed care contracts (7.3 PP decrease, 95% CI: -14.2, -0.3) were associated with lower screening likelihood. Among screening FQHCs, the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) was the most common tool (47.1%). Among non-screening FQHCs, common barriers to using a standardized tool included lack of staff training to discuss social issues (25.2%), inability to include screening in patient intake (21.7%), and lack of funding for addressing social needs (19.2%).

CONCLUSIONS: Though most FQHCs screened for social risk factors in 2020, various barriers have prevented nearly 1 in 3 FQHCs from adopting a screening tool. Policies that provide FQHCs with resources to support training and workflow changes may increase screening uptake and facilitate engagement with other sectors.

PMID:37715519 | DOI:10.1111/1475-6773.14232

Am J Sports Med. 2023 Sep 16:3635465231195360. doi: 10.1177/03635465231195360. Online ahead of print.

ABSTRACT

BACKGROUND: Arthrofibrosis can limit function and return to sport after anterior cruciate ligament (ACL) reconstruction. Previously reported risk factors for developing arthrofibrosis after ACL reconstruction include female sex, age <18 years, time from injury to surgery <28 days, concomitant meniscal repair, prolonged immobilization, and genetic factors. There is a lack of evidence regarding whether race plays a significant role.

HYPOTHESIS: The risk of undergoing manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) after primary ACL reconstruction with bone-patellar tendon-bone (BTB) autograft in female basketball players is higher in African American players than in White players.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Using a computerized relational database, the authors identified competitive female basketball players who underwent primary ACL reconstruction with BTB autograft by the senior author over a 13-year period. Data previously entered from examinations and surgical findings were reviewed retrospectively. Univariate statistics and multivariable logistic regression were used to assess the relationship between undergoing subsequent MUA and/or LOA and study predictors.

RESULTS: A total of 186 knees (114 African American knees and 72 White knees) met inclusion criteria. The overall rate of MUA and/or LOA was 8.6%. Thirteen African American knees (11.4%) and 3 White knees (4.2%) underwent MUA and/or LOA for treatment of arthrofibrosis. No study predictor was found to have a statistically significant relationship with the rate of MUA and/or LOA on univariate analysis. However, when controlling for body mass index and previously described risk factors (age <18 years, time from injury to surgery ≤28 days, and concomitant meniscal repair) in the logistic regression model, the authors found that MUA and/or LOA was more likely in African American (odds ratio, 4.01 [95% CI, 1.01-15.92]; P = .049) than in White female players and in patients who underwent ACL reconstruction within 28 days of injury (odds ratio, 4.01 [95% CI, 1.18-13.57]; P = .026) compared with those with surgery delayed beyond 28 days.

CONCLUSION: In female basketball players, the present study found a statistically significantly increased risk for undergoing MUA and/or LOA after primary ACL reconstruction with BTB autograft in African American females compared with White females and in patients who underwent ACL reconstruction within 28 days of injury.

PMID:37715518 | DOI:10.1177/03635465231195360

Int J Occup Saf Ergon. 2023 Sep 16:1-32. doi: 10.1080/10803548.2023.2260168. Online ahead of print.

ABSTRACT

OBJECTIVE: Poor health outcomes of Bangladeshi readymade garment (RMG) workers tend to be associated with a variety of occupational factors. The study aimed to investigate the prevalence of, and risk factors associated with, the physical and psychological health outcomes of Bangladeshi RMG workers.

METHODS: Responses to a cross-sectional survey from a convenience sample of 411 adult Bangladeshi RMG workers (mean age = 26.24 years; SD = 6.40 years; female = 80%) were analysed using the bivariate and multivariate (logistic regression models) analyses.

RESULTS: More than half of the participants reported headaches (61.6%) and colds/flu (51.3%), followed by fever (37.2%), diarrhoea (32.8%), bodily pain (29.9%), and respiratory infections (20.9%). For psychological health, stress (69.1%), anxiety (66.2%), and boredom (64.5%) were most prevalent followed by sleeplessness (51.3%) and depression (48.2%), and fear (34.3%). RMG workers from the factories located in Chattogram (a peripheral region compared to Dhaka) reported poorer physical and psychological health outcomes than those working in Dhaka (the capital city of Bangladesh)-based factory workers. Overall, compared to males, female RMG workers were more likely to be vulnerable to both physical and psychological health outcomes.

CONCLUSION: Improvement in workplace conditions and safety programs is needed to safeguard the overall health outcomes of Bangladeshi RMG workers.

PMID:37715515 | DOI:10.1080/10803548.2023.2260168

Radiat Prot Dosimetry. 2023 Sep 15:ncad255. doi: 10.1093/rpd/ncad255. Online ahead of print.

ABSTRACT

Assessment of radionuclides, indoor radon (222RnI), radon exhalation (222Rnex), and soil characteristics in the coastal part of Kpando has been studied using HPGe, CR-39 and sieving techniques. Statistical analysis between radionuclides, radon levels and soil characteristics was done using Pearson’s correlation. The mean radionuclide concentration, radon levels and soil characteristics were obtained as 226Ra (23.1 ± 1.4 Bq per kg), 232Th (34.6 ± 2.9 Bq per kg), 40K (187.1 ± 13.7 Bq per kg), 222RnI (64.70 ± 2.7 Bq per m3), 222Rnex (7.9 ± 0.5 μBq per m2h), sandy (45.9 ± 3.9%), silt (40.7 ± 3.1%), clay (13.5 ± 0.8%), porosity (0.6 ± 0.1) and moisture (7.6 ± 0.8%). Radiological effects estimated were within recommended limits. The maximum positive and negative coefficients exist between 222Ra/222Rnex (1.0) and 222Rnex/MC (-0.9), respectively. Radon exhalation correlates better with soil characteristics. The statistical analysis indicated that soil characteristics have significant effects on radionuclides and radon levels in soils and dwellings.

PMID:37715503 | DOI:10.1093/rpd/ncad255

Am J Sports Med. 2023 Sep 15:3635465231197374. doi: 10.1177/03635465231197374. Online ahead of print.

ABSTRACT

BACKGROUND: The overlapping biomechanical relationship between the lumbosacral spine and pelvis poses unique challenges to patients with concomitant pathologies limiting spinopelvic range of motion.

PURPOSE: To assess the influence of concomitant, symptomatic lumbosacral spine pathology on patient-reported outcome measures (PROMs) after hip arthroscopy for the treatment of femoroacetabular impingement (FAI) and symptomatic labral tears.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: A retrospective query of prospectively collected data identified patients aged ≥18 years with a minimum 24-month follow-up who underwent hip arthroscopy by a single surgeon for the treatment of symptomatic labral tears secondary to FAI. Patients were stratified into cohorts based on the presence (hip-spine [HS]) or absence (matched control [MC]) of symptomatic lumbosacral spine pathology. Inclusion within the HS cohort required confirmation of lower back pain/symptoms on preoperative surveys plus a diagnosis of lumbosacral spine pathology verified by radiology reports and correlating clinical documentation. Patients with previous spine surgery were excluded. PROMs were compared between groups, along with rates of achieving minimal clinically important difference (MCID) thresholds, Patient Acceptable Symptom State (PASS) thresholds, revision arthroscopy, and conversion to total hip arthroplasty (THA).

RESULTS: A total of 70 patients with lumbosacral pathology were coarsened exact matched to 87 control patients without spinal pathology. The HS cohort had preoperative baseline scores that were significantly worse for nearly all PROMs. Follow-ups at 3, 6, 12, and 24 months displayed similar trends, with the HS cohort demonstrating significantly worse scores for most collected outcomes. However, at every time point, HS and MC patients exhibited similar magnitudes of improvement across all PROM and pain metrics. Furthermore, while significantly fewer HS patients achieved PASS for nearly all PROMs at 12- and 24-month follow-ups, MCID thresholds were reached at similar or greater rates across all PROMs relative to the MC cohort. Finally, there were no significant differences in rates of revision or THA between cohorts at maximum available follow-up.

CONCLUSION: After hip arthroscopy to address labral tears in the setting of FAI, patients with symptomatic lumbosacral pathologies and no history of spine surgery were found to exhibit inferior pre- and postoperative PROMs but achieved statistically similar clinical benefit and rates of PROM improvement through 24-month follow-up compared with the MC cohort with isolated hip disease. These findings aid in providing a realistic recovery timeline and evidence that coexisting hip and spine disorders are not a contraindication for arthroscopic hip preservation surgery.

PMID:37715499 | DOI:10.1177/03635465231197374

Addiction. 2023 Sep 15. doi: 10.1111/add.16335. Online ahead of print.

ABSTRACT

AIMS: The aims of this study were to measure whether household bans on vaping were associated with lower odds of youth past-month vaping when compared with (1) otherwise similar youth whose households did not have a vaping ban (using coarsened exact matching); and (2) themselves in waves when their household did not have a ban (using hybrid panel models). We used the same analytical strategies to examine cross-sectional associations between household smoking bans and adolescents’ past-month cigarette smoking.

DESIGN: This was a longitudinal study using data from a nationally representative sample of youth (age 12-17 years) in the Population Assessment of Tobacco and Health Study.

SETTING: United States of America.

PARTICIPANTS: A total of 16 214 adolescents followed over 48 103 total observations (approximately three waves).

MEASUREMENTS: Measurements comprised youth past-month e-cigarette and cigarette use and parent-reported household bans on vaping and smoking. Potential confounders were prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette/cigarette use; parental monitoring; and demographic characteristics.

FINDINGS: Before matching, smoking bans were associated with 46% lower odds of youth smoking [odds ratio (OR) = 0.54; 95% confidence interval (CI) = 0.41-0.70] and vaping bans with 37% lower odds of youth e-cigarette use (OR = 0.63; 95% CI = 0.50-0.80). However, households with and without bans differed significantly on all confounders before matching. After matching, household vaping bans were associated with 56% lower odds of youth vaping (OR = 0.44; 95% CI = 0.33-0.58). Results from hybrid panel models also revealed 37% lower odds of vaping in waves when youth lived in a vape-free household compared to waves when they did not (OR = 0.63; 95% CI = 0.50-0.78). Associations between smoking bans and youth smoking were not statistically significant after matching or when using hybrid panel models.

CONCLUSIONS: Household vaping bans appear to be associated with lower odds of past-month vaping among US adolescents, compared with similar youth whose households did not have a ban and to themselves in waves when their households did not have a ban.

PMID:37715485 | DOI:10.1111/add.16335