Nevin Manimala

J Racial Ethn Health Disparities. 2022 Mar 21. doi: 10.1007/s40615-022-01280-z. Online ahead of print.

ABSTRACT

Publication in leading medical journals is critical to knowledge dissemination and academic advancement alike. Leveraging a novel dataset comprised of nearly all articles published in JAMA and NEJM from 1990 to 2020, along with established reference works for name identification, we explore changing authorship demographics in two of the world’s leading medical journals. Our main outcomes are the annual proportion of male and female authors and the proportion of racial/ethnic identities in junior and senior authorship positions for articles published in JAMA and NEJM since 1990. We found that women remain under-represented in research authorship in both JAMA (at its peak, 38.1% of articles had a female first author in 2011) and NEJM (peaking at 28.2% in 2002). The rate of increase is so slow that it will take more than a century for both journals to reach gender parity. Black and Hispanic researchers have likewise remained under-represented as first and last authors in both journals, even using the best-case scenario. Their appearance as authors has remained stagnant for three decades, despite attention to structural inequalities in medical academia. Thus, analysis of authorship demographics in JAMA and NEJM over the past three decades reveals the existence of inequalities in high-impact medical journal authorship. Gender and racial/ethnic disparities in authorship may both reflect and further contribute to disparities in academic advancement.

PMID:35312972 | DOI:10.1007/s40615-022-01280-z

J Cardiovasc Transl Res. 2022 Mar 21. doi: 10.1007/s12265-022-10229-w. Online ahead of print.

ABSTRACT

The ability to customize the size and shape of angioplasty balloons may be useful in many clinical and research applications of coronary and endovascular intervention. Fully customizable balloons are outside the reach of most researchers due to their prohibitive cost. A small-scale balloon-forming machine was developed to produce fully customizable balloons. This study describes the creation of this customizable balloon-forming machine and identifies the key components of manufacturing a patient-specific balloon. Using a standard balloon-shaped mold created with a novel application of 3D stereolithography-printed resin, 104 PET balloon formation tests were conducted. A statistical study was conducted in which molding temperature and inflation air pressure were independent variables ranging from 100 to 130 °C and from 3.7 to 6.8 atm, respectively. The criteria for balloon-forming success were defined; pressure and temperature combined were found to have a significant impact on the success (p = 0.011), with 120 °C and 4.76 atm resulting in the highest chance for success based on a regression model.

PMID:35312960 | DOI:10.1007/s12265-022-10229-w

Pain Ther. 2022 Mar 21. doi: 10.1007/s40122-022-00371-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Self-management education is the basis of any intervention for persons with chronic musculoskeletal pain. Given the biopsychosocial nature of chronic musculoskeletal pain, an educational approach based on the biopsychosocial model would seem to be an appropriate educational model for the treatment of these people during coronavirus disease 2019 (COVID-19). The aim of this study was to compare the effect of pain neuroscience education (PNE) and pain biomechanics education, using online and face-to-face sessions on pain and fear of movement, in people with chronic nonspecific neck pain during COVID-19.

METHODS: In this multicenter assessor-blinded randomized controlled trial, 80 patients (both male and female) with chronic nonspecific neck pain (based on the inclusion criteria of the study) participated in educational sessions (face-to-face and online) from the beginning September until the end of October 2021. The participants were randomly divided into two groups (through the selection of numbers from 1 to 80, hidden in a box), with one group receiving PNE (treatment group) and the other group receiving pain biomechanics education (control group). Pain and fear of movement before and after the intervention were measured on the Numerical Pain Rating Scale and the Tampa Scale of Kinesiophobia, respectively. A 2 × 2 variance analysis (treatment group × time) with a mixed-model design was applied to statistically analyze the data.

RESULTS: No significant change in pain (P = 0.23) was observed between the two groups (P = 0.24, Cohen’s d = 0.17, 95% confidence interval [CI] – 0.21 to 0.35), while changes in the fear of movement variable were reported to be significant (P = 0.04, Cohen’s d = 0.34, 95% CI 0.11-0.51), in favor of PNE. Intra-group change was seen only in the PNE group for the fear of movement variable (P = 0.04; 14.28%↓).

CONCLUSION: In our study population PNE did not affect the pain index, leading to the conclusion that PNE should not be used as the only treatment, but possibly in combination with other active/passive therapy to enhance the results for patients with nonspecific chronic neck pain. Moreover, online treatment may help clinicians to increase their interaction with patients during COVID-19 lockdown.

PMID:35312949 | DOI:10.1007/s40122-022-00371-3

Environ Geochem Health. 2022 Mar 21. doi: 10.1007/s10653-022-01242-8. Online ahead of print.

ABSTRACT

Combining environmental isotope analysis with principal component analysis can be an effective method to discriminate the inflows and sources of contamination in mining-affected watersheds. This paper presents a field-scale study conducted at an acid mine drainage (AMD)-contaminated site adjacent to a pyrite mine in South China. Samples of surface water and groundwater were collected to investigate transport in the vadose zone using stable isotopes of oxygen (δ¹⁸O) and hydrogen (δD) as environmental tracers. Principal component analysis of hydrogeochemical data was used to identify the probable sources of heavy metals in the AMD. The heavy metal pollution index (HPI) was applied to evaluate the pollution status of heavy metals in the groundwater. The groundwater associated with the Datai reservoir was recharged by atmospheric precipitation and surface water. On the side near the AMD pond, the groundwater was significantly affected by the soluble metals produced by pyrite oxidation. The concentrations of some metals (Al, Mn, and Pb) in all of the samples exceed the desirable limits prescribed by the World Health Organization (Guidelines for drinking-water quality, 4th edn. World Health Organization, Geneva, 2011). Among them, the concentration of Al is more than 30,000 times higher than the desirable limits prescribed by the World Health Organization (2011), and the concentration of Mn is more than 3000 times higher. The HPI values based on these heavy metal concentrations were found to be 10-1000 times higher than the critical pollution index value of 100. These findings provide a reference and guidance for research on the migration and evolution of heavy metals in vadose zone water in AMD-contaminated areas.

PMID:35312930 | DOI:10.1007/s10653-022-01242-8

Metab Brain Dis. 2022 Mar 21. doi: 10.1007/s11011-022-00964-z. Online ahead of print.

ABSTRACT

The gut microbiota influences brain development and functioning through the gut-brain axis. This is first study regulate maternal gut microbiota and fetal neurodevelopment processes by using probiotics such as Bifidobacterium bifidum (BIF) and Lactobacillus salivarius (LAC) in the prenatal period. In this study, Wistar Albino female rats were divided into five groups; Control, lipopolysaccharide (LPS, 100 µg/kg), LPS + LAC, LPS + BIF and LPS + LAC + BIF (4 × 10⁹ ml CFU). Maternal rats were given probiotics for 21 days. Inflammation was induced by lipopolysaccharide (LPS), on the 17th day of pregnancy. After birth, the brain tissues of the maternal and neonatal rats were removed and their blood was collected. Fecal calprotectin levels of pregnant rats were measured as an important biomarker in determining intestinal flora disruption. Calprotectin levels were high in LPS group (p < 0.05). Aβ 1-42, APP, γ secretase and β- secretase levels were higher in both maternal and neonatal LPS groups (p < 0.05). These levels were statistically decreased in the probiotic groups compared to the LPS group, as demonstrated in both biochemical and histological analyzes (p < 0.05). While BDNF mRNA expression decreased in LPS groups, APP level increased in the same group. The difference between groups in mRNA expressions in the neonatal brain tissues was similar to maternal brain tissues. What’s more, BDNF/actin and APP/actin rates were proven by western blot and the damage caused by neuroinflammation in the brain tissue and the preservation of the intestinal microbiota were visualized histopathologically on the morphological structures in all groups. It will shed light on new therapeutic strategies for the impact of the use of probiotics on the neurodevelopmental processes of the neonatal against LPS-induced inflammatory responses and impaired gut microbiota in the prenatal period.

PMID:35312928 | DOI:10.1007/s11011-022-00964-z

Eur J Epidemiol. 2022 Mar 21. doi: 10.1007/s10654-022-00852-x. Online ahead of print.

ABSTRACT

We aimed to examine the association between exposure to work stress and chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. The study population included 1,592,491 employees, aged 30-59 in 2000 and without prevalent chronic diseases. We assessed work stress as the combination of job strain and effort-reward imbalance using job exposure matrices. We used Cox regressions to estimate risk of incident hospital-diagnoses or death of chronic diseases (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and calculated corresponding chronic disease-free life expectancy from age 30 to age 75. Individuals working in occupations with high prevalence of work stress had a higher risk of incident chronic disease compared to those in occupations with low prevalence of work stress (women: HR 1.04 (95% CI 1.02-1.05), men: HR 1.12 (95% CI 1.11-1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI – 0.10 to 0.60) and 0.84 (95% CI 0.56-1.11) years in women and men, respectively. Additional adjustment for health behaviours attenuated these associations among men. We conclude that men working in high-stress occupations have a small loss of years lived without chronic disease compared to men working in low-stress occupations. This finding appeared to be partially attributable to harmful health behaviours. In women, high work stress indicated a very small and statistically non-significant loss of years lived without chronic disease.

PMID:35312925 | DOI:10.1007/s10654-022-00852-x

Environ Sci Pollut Res Int. 2022 Mar 21. doi: 10.1007/s11356-022-19795-7. Online ahead of print.

ABSTRACT

Adsorption modeling via statistical physics theory allows to understand the adsorption mechanism of heavy metal ions. Therefore, this paper reports the analysis of the mechanism of copper ion (Cu²⁺) adsorption on four activated carbons using statistical physics models. These models contain parameters that were utilized to provide new insights into the possible adsorption mechanism at the molecular scale. In particular, a monolayer adsorption model was the best alternative to correlate the Cu²⁺ adsorption data at 25-55 °C and pH 5.5. Furthermore, the application of this model for copper adsorption data analysis showed that the removal of this heavy metal ion was a multi-cationic process. This theoretical finding indicated that Cu²⁺ ions interacted via one functional group of activated carbon surface during adsorption. In this direction, the adsorption energy was calculated thus showing that Cu²⁺ removal was endothermic and associated with physical interaction forces. Furthermore, these activated carbons showed saturation adsorption capacities from 54.6 to 87.0 mg/g for Cu²⁺ removal, and their performances outperformed other adsorbents available in the literature. Overall, these results provide new insights of the adsorption mechanism of this water pollutant using activated carbons.

PMID:35312916 | DOI:10.1007/s11356-022-19795-7

Cancer Causes Control. 2022 Mar 21. doi: 10.1007/s10552-022-01569-8. Online ahead of print.

ABSTRACT

PURPOSE: Current cervical cancer screening guidelines recommend 3-year screening intervals, in contrast to the previous recommendation of annual screening, to prevent over screening and overtreatment. We evaluated the impact of viewing a tablet-based educational tool prior to seeing a clinician on young women’s knowledge and understanding of cervical cancer screening, HPV vaccination follow-up of abnormal pap smears, and comfort in communicating with their providers.

METHODS: This cross-sectional study was part of a cluster-randomized study of fourteen primary care clinics from January 2015 to December 2016. We developed the cervical cancer education tool in English and Spanish using a community-based approach that included formative work and cognitive interviewing. Clinics were randomized to use the intervention (tablet-based patient education tool) or to participate as a control group. We administered surveys to a convenience sample of 229 English- or Spanish-speaking women aged 19 to 35 years in these clinics. We used descriptive analyses and logistic regression models with cluster-robust standard errors to compare differences among the two groups.

RESULTS: Compared to women seen in control clinics, women seen in intervention clinics demonstrated greater knowledge regarding human papilloma virus (HPV (p = 0.004) and understanding (p < 0.001) of cervical cancer screening. Comfort in communicating with providers was not statistically different (p = 0.053). Women in the intervention group felt that the tool helped them understand that an abnormal Pap smear does not require immediate treatment (61.5%).

CONCLUSION: Innovative online patient education that is offered prior to patients’ interaction with their clinicians can improve their knowledge about cervical cancer prevention and treatment.

PMID:35312891 | DOI:10.1007/s10552-022-01569-8

Egypt Heart J. 2022 Mar 21;74(1):17. doi: 10.1186/s43044-022-00252-2.

ABSTRACT

BACKGROUND: Anemia is a known risk factor for ischemic heart disease and serves as an independent predictor of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). This meta-analysis pools data from randomized controlled trials (RCTs) to better define hemoglobin (Hb) thresholds for transfusion in this setting.

RESULTS: MEDLINE, EMBASE, and Cochrane databases were searched using the terms “Acute Coronary Syndrome” AND “Blood Transfusion” including their synonyms. A total of three randomized controlled trials were included. Restrictive transfusion strategy (RTS) was defined as transfusing for Hb ≤ 8 g/dl with a post-transfusion goal of 8 to 10 g/dl. Liberal transfusion strategy (LTS) was defined as Hb ≤ 10 g/dl and post-transfusion goal of at least 11 g/dl. The primary end point was 30-day mortality. Secondary outcomes included recurrent ACS events, new or worsening CHF within 30 days, and major adverse cardiac events (MACE). The primary analytic method used was random effects model. Out of 821 patients, 400 were randomized to LTS, and 421 to RTS. Mean age was 70.3 years in RTS versus 76.4 in LTS. There was no statistically significant difference for 30-day mortality in LTS compared to RTS [odds ratio (OR) 1.69; 95% CI 0.35 to 8.05]. Similarly, there was no difference in MACE (OR 0.74; 95% CI 0.21 to 2.63), CHF (OR 0.82; 95% CI 0.18 to 3.76), or the incidence of recurrent ACS (OR 1.21; 95% CI 0.49 to 2.95).

CONCLUSIONS: In the setting of ACS, there is no difference between LTS and RTS for the outcomes of mortality, MACE, recurrent ACS, or CHF at 30 days. Further evidence in the form of high-quality RCTs are needed to compare RTS and LTS.

PMID:35312886 | DOI:10.1186/s43044-022-00252-2

EJNMMI Phys. 2022 Mar 21;9(1):21. doi: 10.1186/s40658-022-00447-1.

ABSTRACT

PURPOSE: To perform precision dosimetry in yttrium-90 radioembolization through CT imaging of radiopaque microspheres in a rabbit liver model and to compare extracted dose metrics to those produced from conventional PET-based dosimetry.

MATERIALS AND METHODS: A CT calibration phantom was designed containing posts with nominal microsphere concentrations of 0.5 mg/mL, 5.0 mg/mL, and 25.0 mg/mL. The mean Hounsfield unit was extracted from the post volumes to generate a calibration curve to relate Hounsfield units to microsphere concentration. A nominal bolus of 40 mg of microspheres was administered to the livers of eight rabbits, followed by PET/CT imaging. A CT-based activity distribution was calculated through the application of the calibration curve to the CT liver volume. Post-treatment dosimetry was performed through the convolution of yttrium-90 dose-voxel kernels and the PET- and CT-based cumulated activity distributions. The mean dose to the liver in PET- and CT-based dose distributions was compared through linear regression, ANOVA, and Bland-Altman analysis.

RESULTS: A linear least-squares fit to the average Hounsfield unit and microsphere concentration data from the calibration phantom confirmed a strong correlation (r² > 0.999) with a slope of 14.13 HU/mg/mL. A poor correlation was found between the mean dose derived from CT and PET (r² = 0.374), while the ANOVA analysis revealed statistically significant differences (p < 10^-12) between the MIRD-derived mean dose and the PET- and CT-derived mean dose. Bland-Altman analysis predicted an offset of 15.0 Gy between the mean dose in CT and PET. The dose within the liver was shown to be more heterogeneous in CT than in PET with an average coefficient of variation equal to 1.99 and 1.02, respectively.

CONCLUSION: The benefits of a CT-based approach to post-treatment dosimetry in yttrium-90 radioembolization include improved visualization of the dose distribution, reduced partial volume effects, a better representation of dose heterogeneity, and the mitigation of respiratory motion effects. Post-treatment CT imaging of radiopaque microspheres in yttrium-90 radioembolization provides the means to perform precision dosimetry and extract accurate dose metrics used to refine the understanding of the dose-response relationship, which could ultimately improve future patient outcomes.

PMID:35312882 | DOI:10.1186/s40658-022-00447-1