Nevin Manimala

Water Sci Technol. 2022 Nov;86(9):2071-2088. doi: 10.2166/wst.2022.342.

ABSTRACT

Suspended solids removal is a key performance measure for proprietary stormwater treatment devices. Various technologies are available, with manufacturers claiming hydrodynamic separators offer performance advantages. However, it is important to assess manufacturers’ claims. Accordingly, this study seeks to compare the performance of proprietary devices, by applying dimensional analysis to third-party certification data and experimental data from uncertified devices, and to determine the accuracy of a single parameter estimation (Hazen or Péclet number) of removal efficiency. Statistical analysis indicates that device performance is well described by a single parameter estimation transitioning from Hazen (Nash-Sutcliffe coefficient = 0.81 and root mean square error = 5.1%) at low surface loading rates (SLR) in all technology types (high removal efficiency) to Péclet (Nash-Sutcliffe coefficient = 0.5 to 0.61 and root mean square error = 5.9% to 4.3%) at higher SLR (low removal efficiency) for hydrodynamic separators. This indicates that performance at low SLR is well explained by gravity separation in all technology types, whilst in hydrodynamic separators removal at high SLR is better explained by gravity separation plus advection. Consequently, when high (>80%) removal efficiency is required there is no performance advantage between technology types. However, when low (<50%) removal efficiency is required hydrodynamic separators offer a 33% increase in treatment area.

PMID:36378167 | DOI:10.2166/wst.2022.342

Rev Med Inst Mex Seguro Soc. 2022 Nov 14;61(Suppl 1):65-71.

ABSTRACT

The application of quality and its scope have diversified. From this perspective, quality assurance applied to analytical tests (performed in clinical laboratories or blood banks) for the detection of infectious markers is one of the concepts that has gained strength in the last 10 years. The official Mexican standards require ensuring the quality of the published results and for their compliance it is recommended the use of international guides and guidelines that describe good practices that can be applied when carrying out this activity, without losing sight of the fact that everything related to quality assurance must be supported by the implementation of a quality management system. Thus, by using materials selected correctly and in accordance with official regulatory requirements, a good statistical analysis and the appropriate tools, the quality assurance of the analytical phase of the laboratory process in the screening of infectious markers can bring great benefits to the emission of clinically useful results by monitoring indicators and applying the necessary corrective actions, in order to reduce the risk of unfavorable results for patients and donors.

PMID:36378156

Oral Maxillofac Surg. 2022 Nov 14. doi: 10.1007/s10006-022-01115-5. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the use of fat grafting enriched with platelet-rich plasma through a computerized-assisted mapping for esthetic restoration in progressive hemifacial atrophy (Parry-Romberg disease).

METHODS: This prospective study was conducted on 53 patients presented by Parry-Romberg disease and was corrected by facial fat grafting (FFG) enriched with platelet-rich plasma (PRP). A computerized software program was used to design a detailed map to achieve clinical symmetry with fat grafting application, as the anatomical subunits direct 3-dimensional volumetric symmetric, and compartments direct isolated recipient-specific grafting. Also, volumetric asymmetry was assessed through outlines of facial contour, projection, and proportions for both sides and comparing the mirror image of unaffected side as a template.

RESULTS: Objective ultrasound and photogrammetric measurements showed a significant improvement in facial symmetry postoperatively compared to preoperative (P < 0.05), with no significant differences between 12 and 18 months after surgery. The FACE-Q score regarding comparison before surgery and 18 months after surgery showed a statistically significant improvement in all modules (P < 0.001) with overall satisfaction concerning outcome of 82.7 ± 0.8.

CONCLUSION: Enriched fat grafting with platelet-rich plasma (PRP) is a good alternative to reconstruct soft tissue defects for patients with progressive hemifacial atrophy (Parry-Romberg disease) with a minimally invasive approach and low complications. It provides volumetric replacement, enhancement of skin texture, and improvement of hyperpigmentation with restoration of facial contour for an esthetic pleasing appearance. Isolated replacement in accordance with the anatomical facial subunits and fat compartments allows three-dimensional reconstruction and maximizes fat retention.

PMID:36376747 | DOI:10.1007/s10006-022-01115-5

Arch Sex Behav. 2022 Nov 14. doi: 10.1007/s10508-022-02459-5. Online ahead of print.

ABSTRACT

To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more “normal” (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.

PMID:36376743 | DOI:10.1007/s10508-022-02459-5

J Eur Acad Dermatol Venereol. 2022 Nov 14. doi: 10.1111/jdv.18727. Online ahead of print.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease, and there is increasing evidence that the interleukin (IL)-36 pathway may play a role in the pathogenesis of AD.

OBJECTIVES: To evaluate the efficacy and safety of spesolimab, a novel anti-IL-36 receptor antibody, in adult patients with moderate-to-severe AD.

METHODS: In this phase IIa study, 51 eligible patients were randomized 2:1 to receive intravenous doses of spesolimab 600 mg or placebo every 4 weeks. The primary endpoint was percentage change from baseline in Eczema Area and Severity Index (EASI) score at Week 16.

RESULTS: Decrease in EASI score from baseline to Week 16 was – 37.9% for spesolimab versus – 12.3% for placebo (adjusted mean difference -25.6%, P = 0.149). A predefined sensitivity analysis, excluding data from patients who used restricted corticosteroids, resulted in an adjusted mean difference of -48.3% (nominal P = 0.024). Spesolimab was well tolerated, with no clinically relevant safety signals.

CONCLUSIONS: This is the first study to evaluate the IL-36 pathway inhibition in AD. Although not statistically significant, numerical improvements were observed in the primary endpoint of change from baseline in EASI score. Spesolimab had an acceptable safety profile, with no unexcepted safety concerns.

PMID:36376738 | DOI:10.1111/jdv.18727

Clin Transl Oncol. 2022 Nov 14. doi: 10.1007/s12094-022-03007-2. Online ahead of print.

ABSTRACT

BACKGROUND: Triple-positive breast cancer (TPBC) is a tumor that simultaneously expresses estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). Luminal A-like TPBC is a special subtype with a favorable prognosis but benefits less from HER2-targeted therapy. However, little is known about how to identify luminal A-like TPBCs. Therefore, our study aims to explore a clinically feasible method to identify luminal A-like TPBCs using immunohistochemical (IHC) markers.

METHODS: Our cohort enrolled consecutive 190 patients with early-stage TPBCs diagnosed, treated and followed up in our hospital between 2013 and 2019. Patients whose IHC staining displayed ≥ 50% in both ER and PR scores and B-cell lymphoma 2 (BCL2) positivity were classified as cohort A (n = 64), and the rest were enrolled in cohort B (n = 126). Kaplan-Meier plotter and log-rank test were used to compare the survival difference between cohort A and cohort B and the efficacy of trastuzumab therapy in the two cohorts.

RESULTS: The disease-free survival (DFS) of patients in cohort A was significantly better than in cohort B (p = 0.031). In cohort A, there was no statistically significant difference in DFS between patients treated with trastuzumab and those without trastuzumab (p = 0.663). While in cohort B, patients treated with trastuzumab had significantly better DFS than those without trastuzumab (p = 0.032). Multivariate survival analysis showed that cohort A was associated with better DFS(95%CI 1.046-11.776, p = 0.042).

CONCLUSION: TPBCs consist of heterogeneous subtypes. Detecting the expression of ER, PR and BCL2 via IHC can help identify luminal A-like TPBCs. This study will enable individualized treatment of TPBCs.

PMID:36376700 | DOI:10.1007/s12094-022-03007-2

Environ Sci Pollut Res Int. 2022 Nov 14. doi: 10.1007/s11356-022-24167-2. Online ahead of print.

ABSTRACT

Glyphosate-based herbicides can be harmful to the environment and human health. Especially in developing countries, these herbicides are often used indiscriminately in agricultural and urban areas. Here, we optimized a simple and efficient flow injection-based spectrophotometric method to monitor environmentally relevant glyphosate concentrations in surface waters. The method was then used to assess the environmental mobility of glyphosate in Southeast Brazil by monitoring surface runoff from experimental agricultural soil plots that received glyphosate applications in 2015. Further, water samples from low-order streams were collected in five agricultural, urban, and natural areas, as well as from the 5th-order Rio das Mortes during the rainy season. Finally, 20 drinking water sources were sampled in urban, rural, and agricultural areas. Runoff from reference plots without glyphosate application showed concentrations below the method’s detection limit of 0.49 mg.L^-1, whereas runoff from plots with standard glyphosate application had concentrations between 1.24 and 6.1 mg.L^-1. Similarly, concentrations in natural stream water were below the detection limit, whereas agricultural streams had concentrations of up to 3.7 mg.L^-1 (average: 0.97 mg.L^-1). In an agricultural stream monitored weekly, concentration peaks were observed after glyphosate applications by farmers, and concentrations were correlated to stream discharge. Urban streams had concentrations of up to 5.8 mg.L^-1 (average: 2.6 mg.L^-1), but samples from the catchment’s major river were mostly below detection limits, illustrating the dilution of urban and agricultural runoff in high-order rivers. In the sampled drinking water resources, glyphosate pollution occurred mainly in the rainy season, with detectable concentrations between 0.5 and 8.7 mg.L^-1 in 80% of the sampled drinking water sources. In conclusion, our results suggest considerable environmental mobility of glyphosate in the studied Southeast Brazilian catchment. Substantial pollution, well above national and international limits, was detected in surface runoff, stream water, and drinking water resources.

PMID:36376647 | DOI:10.1007/s11356-022-24167-2

J Gen Intern Med. 2022 Nov 14. doi: 10.1007/s11606-022-07872-z. Online ahead of print.

ABSTRACT

BACKGROUND: Health information exchanges (HIEs) have proliferated over the last decade, but a gap remains in our understanding of their benefits to patients and the healthcare system. In this systematic review, we provide an updated report on what is known regarding the impacts of HIE on clinical, health care utilization, and cost outcomes in the adult inpatient setting.

METHODS: We searched Pubmed, Web of Science, Embase, Cochrane, and Ebsco databases for citations published between January 2015 and August 2021. Eligible studies were English-language experimental or observational studies. We assessed risk of bias via the National Heart Lung and Blood Institute’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS: We identified 11 eligible studies-1 quasi-experimental and 10 observational. Five studies examined readmission rates and 3 found benefits from HIE. Three studies examined mortality with 2 finding benefits from the availability of HIE. Eight studies examined utilization and cost outcomes with 2 finding benefits from HIE, 1 finding poorer outcomes with HIE, and the others finding no impact.

CONCLUSIONS: Evidence for the impacts of HIE remains largely observational with little direct measure of HIE use during clinical care, making causality difficult to assess. The highly variable outcomes examined by these studies limit meaningful synthesis. The strength of evidence is low that HIE reduces unplanned readmissions and mortality and there is insufficient evidence for the impact of HIE on cost or utilization. The increased number of studies specific to inpatient settings that examine objective outcomes with more rigorous statistical methods is a promising development since prior reviews.

TRIAL REGISTRATION: PROSPERO 2021 CRD42021274049 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274049 AMENDMENTS TO PROTOCOL: Initially planned use of the Newcastle-Ottawa quality assessment scale was substituted for the National Heart Lung and Blood Institute’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies as it was better suited to evaluate the primarily retrospective observational cohort studies identified in the review.

PMID:36376635 | DOI:10.1007/s11606-022-07872-z

J Gen Intern Med. 2022 Nov 14. doi: 10.1007/s11606-022-07399-3. Online ahead of print.

ABSTRACT

BACKGROUND: Acute coronary syndrome (ACS) and opioid use are both major causes of morbidity and mortality globally. Although epidemiological studies point to increased risk of ACS in opioid users, in-hospital management and outcomes are unknown for this population when presenting with ACS. We sought to determine whether there are differences for in-hospital outcomes and management of ACS for those with and without opioid-related diagnoses (ORD).

METHODS AND RESULTS: From the National Inpatient Sample database, we extracted patients hospitalized between 2012 and 2016 for ACS. The primary independent variable was ORD by International Classification of Diseases, 9^th and 10^th Revision, codes. The primary outcome was in-hospital mortality; secondary outcomes were cardiac arrest, receipt of angiogram, and percutaneous coronary intervention (PCI). Statistical comparisons were performed using χ² test and Student’s t test. Multivariable logistic regression was performed to determine the independent association between ORD and outcomes of interest. Among the estimated 5.8 million admissions for ACS, the proportion of patients with ORD increased over the study period (p for trend < 0.01). Compared to patients without ORD presenting with ACS, patients with ORD were younger with fewer cardiovascular risk factors. Yet, in-hospital mortality was higher in patients with ORD presenting with ACS (AOR 1.36, 95% CI 1.26-1.48). Patients with ORD were more likely to experience in-hospital cardiac arrest (AOR 1.42, 95% CI 1.23-1.63) and less likely to undergo angiogram (AOR 0.42, 95% CI 0.38-0.45) or PCI (AOR 0.30, 95% CI 0.28-0.32).

CONCLUSION: Despite evidence of increased risk of mortality and cardiac arrest, patients with ORD admitted for ACS are less likely to receive ACS management.

PMID:36376632 | DOI:10.1007/s11606-022-07399-3