Nevin Manimala

J Environ Manage. 2023 Jun 15;344:118398. doi: 10.1016/j.jenvman.2023.118398. Online ahead of print.

ABSTRACT

Surface water pollution has always posed a serious challenge to water quality management. Improving water quality management requires figuring out how to comprehend water quality conditions scientifically and effectively as well as quantitatively identify regional pollution sources. In this study, Xianghai Lake, a typical lake-type wetland on the Northeast China Plain, was taken as the research area. Based on a geographic information system (GIS) method and 11 water quality parameters, the single-factor evaluation and comprehensive water quality index (WQI) methods were used to comprehensively evaluate the water quality of the lake-type wetland in the level period. Four key water quality parameters were determined by the principal component analysis (PCA) method, and more convenient comprehensive water quality evaluation models, the minimum WQI considering weights (WQI_min-w) and the minimum WQI without considering weights (WQI_min-nw) were established. The multiple statistical method and the absolute principal component score-multiple liner regression (APCS-MLR) model were combined to analyse the lake pollution sources based on the spatial changes in pollutants. The findings demonstrated that the WQI_min-nw model’s water quality evaluation outcome was more accurate when weights were not taken into account. The WQI_min-nw model can be used as a simple and convenient way to comprehend the variations in water quality in wetlands of lakes and reservoirs. It was concluded that the comprehensive water quality in the study area was at a “medium” level, and COD_Mn was the main limiting factor. Nonpoint source pollution (such as agricultural planting and livestock breeding) was the most important factor affecting the water quality of Xianghai Lake (with a comprehensive contribution rate of 31.65%). The comprehensive contribution rates of sediment endogenous and geological sources, phytoplankton and other plants, and water diversion and other hydrodynamic impacts accounted for 25.12%, 19.65%, and 23.58% of the total impact, respectively. This study can provide a scientific method for water quality assessment and management of lake wetlands, and an effective support for migration of migratory birds, habitat protection and grain production security.

PMID:37329587 | DOI:10.1016/j.jenvman.2023.118398

J Environ Manage. 2023 Jun 15;344:118379. doi: 10.1016/j.jenvman.2023.118379. Online ahead of print.

ABSTRACT

The Azo dyes are primarily utilized in textile industries. Treatment of textile wastewater because of the presence of recalcitrant dyes using conventional processes is greatly challenging and ineffective. So far, no experimental work has been conducted on the decolorization of Acid Red 182 (AR182) in aqueous media. Hence, in this novel experimental work, the treatment of AR182 from the Azo dyes family was explored using the electro-Peroxone (EP) process. For the optimization of operating factors, including AR182 concentration, pH, applied current, and O₃ flowrate in the decolorization of AR182, Central Composite Design (CCD) was utilized. The statistical optimization presented a highly satisfactory determination coefficient value and a satisfactory second-order model. The expected optimum conditions by the experimental design were as the following: AR182 concentration at 483.12 mg.L^-1, applied current at 0.627,113 A, pH at 8.18284 and O₃ flowrate at 1.13548 L min^-1. The current density is directly proportional to dye removal. However, increasing the amount of applied current beyond a critical value has a contradictory impact on dye removal performance. The dye removal performance in both acidic and highly alkaline environments was negligible. Hence, ascertaining the optimum pH value and conduction of the experiment at that point is critical. At optimum points, the decolorization performance in predicted and experimental conditions for AR182 were 99 and 98.5%, respectively. The outcomes of this work clearly substantiated that the EP can be successfully utilized for the decolorization of AR182 in textile wastewater.

PMID:37329582 | DOI:10.1016/j.jenvman.2023.118379

Cell Mol Biol (Noisy-le-grand). 2023 Apr 30;69(4):16-23. doi: 10.14715/cmb/2023.69.4.3.

ABSTRACT

Today, using elastography and ultrasound images is the best method for diagnosing breast cancer for dense tissues, especially for women under 30 years old, which is used to detect the exact border of masses. Besides, using quantitative microscopic criteria that are less tasteful seems to be useful in predicting the behavior of the tumor and its prognosis. Ki-67 is an antigen corresponding to a nuclear non-histone protein produced by cells in proliferative phases. In this article, ultrasound and elastography images of patients were collected, and breast masses were identified. The proposed algorithm includes pre-processing, feature extraction, and classification. To remove the speckle noise, two pre-processing steps are used, and after segmenting each data with its appropriate color channel, statistical features and features based on the morphology of suspicious areas are extracted. Also, sections of paraffin blocks of samples fixed in formalin were prepared and stained by immunohistochemical staining with Ki-67 monoclonal antibody, and the cell proliferation index was determined in the prepared slides. The relationship between Ki-67 positivity and microscopic grade was studied. The feature extraction results show that elastography is chosen as a more appropriate method than ultrasound due to the separation in terms of color channels. The most appropriate proposed combined methods, namely RBF-Kmeans, MLP-SCG, and RBF-SOM, have been used to classify features. The combined MLP-SCG classifier with an average accuracy of 96% and an average of 98% has improved significantly compared to other methods.

PMID:37329553 | DOI:10.14715/cmb/2023.69.4.3

Ultrasound Obstet Gynecol. 2023 Jun 17. doi: 10.1002/uog.26292. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objective was to perform a systematic review on predictive factors for Obstetric Anal Sphincter Injury (OASI) occurrence at a first vaginal delivery, where the diagnosis was made by ultrasound (US-OASI). The secondary objective was to report on incidence rates of sonographic AS trauma, including trauma that was not clinically reported on at childbirth, among the studies providing data for our primary endpoint.

METHODS: We conducted a systematic search of MEDLINE, Embase, Web of Science, Cinahl, Cochrane library and Clinicaltrials.gov databases. Both observational cohort studies and interventional trials were eligible for inclusion. Study eligibility was assessed independently by two authors. Random-effect meta-analyses were performed to pool effect estimates from studies reporting on similar predictive factors. Summary Odds Ratios (ORs) or Mean Differences (MDs) were reported with 95% CI. Heterogeneity was assessed using the I² statistic. Methodological quality was assessed using the Quality in Prognosis Studies tool.

RESULTS: 2805 records were screened and 21 met the inclusion criteria (16 prospective cohort, three retrospective cohort and two interventional non-randomized trials). Increasing gestational age at delivery (MD 0.34w [0.04, 0.64]), shorter antepartum perineal body length (MD -0.60cm [-1.09, -0.11]), labor augmentation (OR 1.81 [1.21-2.71]), instrumental delivery (OR 2.13 [1.13-4.01]), in particular forceps extraction (OR 3.56 [1.31-9.67]), shoulder dystocia (OR 12.07 [1.06-137.6]), episiotomy use (OR 1.85 [1.11-3.06]) and shorter episiotomy length (MD -0.40cm [-0.75, -0.05]) were associated with US-OASI. When pooling incidence rates, 26% of women who first delivered vaginally, had sonographic evidence of AS trauma (95%CI 20-32%, 20 studies, I² =88%). In studies reporting on both clinical and ultrasound OASI rates, 20% of women had AS trauma on ultrasound, that was not reported on at childbirth (95%CI 14-28%, 16 studies, I² =90%). No differences were found in maternal age, BMI, weight, subpubic arch angle, induction of labor, epidural analgesia, duration of first/second/active second stage, vacuum extraction, neonatal birthweight or head circumference. Also, antenatal perineal massage and use of an intrapartum pelvic floor muscle dilator did not affect the odds of US-OASI. Most studies (81%) were judged at high risk of bias on at least one domain, and only four studies (19%) had an overall low risk of bias.

CONCLUSION: Given there was ultrasound evidence of structural damage to the AS in 26% of women who first delivered vaginally, clinicians should have a low threshold of suspicion. Our systematic review identified several predictive factors for this. This article is protected by copyright. All rights reserved.

PMID:37329513 | DOI:10.1002/uog.26292

Ultrasound Obstet Gynecol. 2023 Jun 17. doi: 10.1002/uog.26291. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance at 35+0 to 36+6 weeks’ gestation of screening for delivery with pre-eclampsia (PE) at various time points, using one of three approaches: placental growth factor (PlGF) concentration, the soluble fms-like tyrosine kinase-1 (sFLT-1) to PlGF concentration ratio, or the competing risks model, which combines maternal risk factors with biomarkers to estimate patient-specific risk.

METHODS: This was a prospective observational study in women attending for a routine hospital visit at 35+0 to 36+6 weeks’ gestation in two maternity hospitals in England (2016-22). The visits included recording of maternal demographic characteristics and medical history, and measurement of serum PlGF, serum sFLT-1, and mean arterial pressure (MAP). The detection rates (DRs) were evaluated for delivery with PE (by 2019 American College of Obstetricians and Gynecologists criteria), within 1 week, within 2 weeks, or at any time after screening, using either: (i) low PlGF (<10^th percentile), (ii) high sFLT-1/PlGF ratio (>90^th percentile), or (iii) the competing risks model, using a combination of maternal factors and multiple of the median (MoM) values of PlGF (‘single’ test), PlGF and sFLT-1 (‘double’ test), or PlGF, sFLT-1 and MAP (‘triple’ test). Risk cut-offs corresponded to a screen-positive rate of 10%. DRs were compared between tests by McNemar’s test, with p<0.05 considered statistically significant.

RESULTS: Of 34,782 pregnancies, 831 (2.4%) developed PE. In screening for delivery with PE at any time from assessment, the DR at 10% screen-positive rate was 47% by low PlGF alone, 54% by the ‘single test’, 55% by high sFLT-1/PlGF, 61% by the ‘double test’, and 68% by the ‘triple test’. In screening for delivery with PE within 2 weeks, the respective values were 67%, 74%, 74%, 80%, and 87%. In screening for delivery with PE within 1 week, the respective values were 77%, 81%, 85%, 88% and 91%. For prediction of PE at any time, the DR difference [95% confidence interval] was significantly higher with the ‘triple test’, compared with PlGF alone (20.1 [16.7-23.0]) or the sFLT-1/PlGF ratio (12.4 [9.7-15.3]). Similar results were seen for prediction of PE within 2 weeks (20.6 [14.9-26.8] and 12.9 [7.7-17.5], respectively) and prediction of PE within 1 week (13.5 [5.4-21.6]) and (5.4 [0.0-10.8]). The double test was superior to the sFLT-1/PlGF ratio and the single test was superior to PlGF alone in the prediction of PE within 2 weeks and at any time from assessment, but not within 1 week of assessment.

CONCLUSION: At 35+0 to 36+6 weeks’ gestation, the performance of screening for PE by the competing risks model ‘triple test’ is superior to that of PlGF alone or the sFLT-1/PlGF ratio for PE within 1 week, within 2 weeks and at any time from screening. This article is protected by copyright. All rights reserved.

PMID:37329494 | DOI:10.1002/uog.26291

Eur J Orthop Surg Traumatol. 2023 Jun 17. doi: 10.1007/s00590-023-03612-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of combined Tranexamic acid (TXA) and dexamethasone (DEX) in total hip and knee arthroplasty.

METHODS: PUBMED, EMBASE, MEDLINE and CENTRAL database were systematically searched for randomized studies that utilized TXA and DEX administration of TXA in THA or TKA.

RESULTS: A total of three randomized studies enrolling 288 patients were eligible for qualitative and quantitative analysis. DEX + TXA group demonstrated statistical significantly lesser usage of oxycodone (OR: 0.34, p < 0.0001), metoclopramide (OR: 0.21, p < 0.00001), lesser incidence of postoperative nausea and vomiting (OR: 0.27, p < 0.0001), better postoperative range of motion (MD: 2.30, p < 0.00001) and shorter length of hospital stay (MD: 0.31, p = 0.03). Comparable results were seen in total blood loss, transfusion rate and postoperative complications.

CONCLUSION: In this meta-analysis, the combination of TXA and DEX has positive impacts on the usage of oxycodone and metoclopramide, postoperative range of motion, postoperative nausea and vomiting and reduces the length of hospital stay.

PMID:37329454 | DOI:10.1007/s00590-023-03612-z

Cancer Causes Control. 2023 Jun 17. doi: 10.1007/s10552-023-01727-6. Online ahead of print.

ABSTRACT

PURPOSE: Older age, risks from pre-existing health conditions and socio-economic disadvantage are negatively related to the prospects of an early-stage cancer diagnosis. With older Aboriginal Australians having an elevated prevalence of these underlying factors, this study examines the potential for the mitigating effects of more frequent contact with general practitioners (GPs) in ensuring local-stage at diagnosis.

METHODS: We compared the odds of local vs. more advanced stage at diagnosis of solid tumours according to GP contact, using linked registry and administrative data. Results were compared between Aboriginal (n = 4,084) and non-Aboriginal (n = 249,037) people aged 50 + years in New South Wales with a first diagnosis of cancer in 2003-2016.

RESULTS: Younger age, male sex, having less area-based socio-economic disadvantage, and fewer comorbid conditions in the 12 months before diagnosis (0-2 vs. 3 +), were associated with local-stage in fully-adjusted structural models. The odds of local-stage with more frequent GP contact (14 + contacts per annum) also differed by Aboriginal status, with a higher adjusted odds ratio (aOR) of local-stage for frequent GP contact among Aboriginal people (aOR = 1.29; 95% CI 1.11-1.49) but not among non-Aboriginal people (aOR = 0.97; 95% CI 0.95-0.99).

CONCLUSION: Older Aboriginal Australians diagnosed with cancer experience more comorbid conditions and more socioeconomic disadvantage than other Australians, which are negatively related to diagnosis at a local-cancer stage. More frequent GP contact may act to partly offset this among the Aboriginal population of NSW.

PMID:37329444 | DOI:10.1007/s10552-023-01727-6

Curr Diab Rep. 2023 Jun 17. doi: 10.1007/s11892-023-01517-z. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Depression is prevalent and common among individuals living with diabetes. The aim of this review is to systematically assess and meta-analyze the treatment effect of cognitive-behavioral therapy for depression (and other affective outcomes) among patients with diabetes.

RECENT FINDINGS: Earlier investigations found both psychosocial and pharmacological interventions, including cognitive-behavioral therapy, were promising in managing depression in patients with diabetes, though these findings remain inclusive due to poor study designs and a small number of trials included, which calls for a comprehensive systematic review and meta-analysis. A total of 33 studies (89 effect sizes) reported a moderate and statistically significant treatment effect of cognitive-behavioral therapy for depressive symptoms among individuals with diabetes (d = 0.301, 95% CI 0.115-0.487, p < 0.001). On average, cognitive-behavioral therapy was effective for psychological stress/distress outcomes but not for anxiety or physiological outcomes. The findings of the study confirmed CBT as an effective treatment option for depression among diabetes patients and identified important areas for future research.

PMID:37329442 | DOI:10.1007/s11892-023-01517-z

Qual Life Res. 2023 Jun 17. doi: 10.1007/s11136-023-03452-8. Online ahead of print.

ABSTRACT

PURPOSE: To identify psychoeducational interventions that target parents of children with congenital abnormalities (CA) and evaluate their impact on quality of life (QoL).

METHODS: The search was conducted in six electronic databases, complemented by references of the studies found, studies of evidence synthesis, a manual search of relevant scientific meetings’ abstracts and contact with experts. We included primary studies on parents of children with CA that studied psychoeducational interventions versus standard care. We assessed the risk of bias using Cochrane Collaboration’s tool.

RESULTS: We included six studies focusing on congenital heart defects (CHD). They described four different psychoeducational strategies. In four studies, statistically significant differences were found. For clinical practice, we considered three interventions as more feasible: the Educational program for mothers, with a group format of four sessions weekly; CHIP-Family intervention, which includes a parental group workshop followed by an individual follow-up booster session; and WeChat educational health program with an online format.

CONCLUSIONS: This review is the first that assesses the impact of psychoeducational interventions targeted at parents of children with CA on their QoL. The best approach to intervention is multiple group sessions. Two essential strategies were to give support material, enabling parents to review, and the possibility of an online program application, increasing accessibility. However, because all included studies focus on CHD, generalizations should be made carefully. These findings are crucial to guide future research to promote and improve comprehensive and structured support for families and integrate them into daily practice.

PMID:37329433 | DOI:10.1007/s11136-023-03452-8

Clin Transl Oncol. 2023 Jun 17. doi: 10.1007/s12094-023-03247-w. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the cost-effectiveness of adding a CDK4/6 inhibitor to standard endocrine therapy in the first-line setting for advanced HR+/HER2- breast cancer in postmenopausal and premenopausal women, from the perspective of the Mexican public healthcare system.

METHODS: We used a partitioned survival model to simulate relevant health outcomes in a synthetic cohort of patients with breast cancer derived from the PALOMA-2, MONALEESA-2, MONARCH-3 trials for postmenopausal patients, and from the MONALEESA-7 study for premenopausal patients. Effectiveness was measured in life years gained. Cost-effectiveness is reported through incremental cost-effectiveness ratios (ICER).

RESULTS: In postmenopausal patients, palbociclib led to an increase of 1.51 life years, ribociclib of 1.58 years, and abemaciclib of 1.75 years, compared to letrozole alone. The ICER was 36,648 USD, 32,422 USD, and 26,888 USD, respectively. In premenopausal patients, ribociclib led to an increase of 1.82 life years when added to goserelin and endocrine therapy, with an ICER of 44,579 USD. In the cost minimization analysis, for postmenopausal patients, ribociclib was the treatment with the highest costs due to follow-up requirements.

CONCLUSION: Palbociclib, ribociclib, and abemaciclib demonstrated a significant increase in effectiveness in postmenopausal patients, and ribociclib in premenopausal patients, when added to standard endocrine therapy for patients with advanced HR+/HER2- breast cancer. At the national stablished willingness to pay, only the addition of abemaciclib to standard endocrine therapy in postmenopausal women would be considered cost-effective. However, differences on results between therapies for postmenopausal patients were not statistically significant.

PMID:37329428 | DOI:10.1007/s12094-023-03247-w