Nevin Manimala

J Health Econ. 2021 Oct 24;80:102546. doi: 10.1016/j.jhealeco.2021.102546. Online ahead of print.

ABSTRACT

This paper addresses one of the main empirical problems associated with rational addiction theory, namely, that its derived demand equation is not empirically distinguishable from those of models with forward-looking behavior but with time-inconsistent preferences. Using an encompassing general specification of the rational addiction model we derive a microfounded test of time-consistency. The test allows us to distinguish between time-consistent versus time-inconsistent naïve agents. The results obtained from a panel of Russian individuals conform to the theoretical predictions of the rational addiction model and the proposed test for time-consistency does not reject the hypothesis that Russian cigarette consumers are time-consistent.

PMID:34731726 | DOI:10.1016/j.jhealeco.2021.102546

Epilepsy Behav. 2021 Oct 28;125:108359. doi: 10.1016/j.yebeh.2021.108359. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with brain tumor-related epilepsy (BTRE) are at a higher risk of significant morbidity, lower quality of life, and increased risk of mortality. We surveyed providers regarding anti-seizure medication (ASM) management in pediatric BTRE to determine if practices are standard or markedly variable.

METHODS: An anonymous voluntary online survey was sent to members of the Child Neurology Society. Providers were asked specific questions regarding initiation and wean of ASMs and if this was dependent on multiple factors. Demographic information was collected.

RESULTS: Fifty-one providers responded to the survey. Ninety-four percent of providers would start an ASM after a second seizure. Eighty-four percent chose levetiracetam as the preferred ASM. Management was variable when based on tumor location, extent of surgical resection, pathology, and tumor prognosis. Statistically significant differences in responses regarding management were identified when comparing neurologists and epileptologists, providers with formal neuro-oncology or epilepsy training, providers at large institutions, and years of experience. For patients who underwent a gross total resection of the tumor, neuro-oncology and epilepsy-trained providers were more likely to wean off ASMs (p < 0.049). Providers without formal training in neuro-oncology or epilepsy were more likely to get an EEG prior to making a decision about weaning off ASMs (p < 0.016).

CONCLUSION: These results suggest that ASM management in BTRE varies greatly according to sub-specialty and experience. Further studies and potential development of guidelines are needed to identify the most appropriate management of ASMs for BTRE.

PMID:34731721 | DOI:10.1016/j.yebeh.2021.108359

J Environ Manage. 2021 Oct 30;302(Pt A):113965. doi: 10.1016/j.jenvman.2021.113965. Online ahead of print.

ABSTRACT

The kinetic, isotherm, and thermodynamics of adsorptive removal of fluoride from the real-life groundwater was evaluated to assess the applicability of a green adsorbent, aluminum/olivine composite (AOC). The isotherm and kinetics were demonstrated by the Freundlich and Elovich model indicating significant surface heterogeneity of AOC in favouring the fluoride sorption. The fluoride removal efficiency of AOC was achieved as 87.5% after 240 min of contact time. The diffusion kinetic model exhibited that both the intra-particle and film diffusion together control the rate-limiting step of fluoride adsorption. A negative value of ΔG⁰ (-19.919 kJ/mol) at 303 K confirmed the spontaneous adsorption reaction of fluoride, and its endothermic nature was supported by the negative value of ΔH⁰ (39.504 kJ/mol). A novel framework for a predictive model by artificial neural network (ANN), and support vector machine (SVM) considering the real and synthetic fluoride-containing water was developed to assess the efficiency of adsorbent under different scenarios. ANN model was observed to be statistically significant (RMSE: 1.0955 and R²: 0.9982) and the proposed method may be instrumental in a similar area for benchmarking the synthetic and real-life samples. The low desorption potential of the spent adsorbent exhibited safe disposal of sludge and the secondary-pollutant-free treated water by the efficient and green adsorbent AOC enhanced the field-scale applicability of the green technology.

PMID:34731705 | DOI:10.1016/j.jenvman.2021.113965

Heart Lung. 2021 Oct 29;51:25-31. doi: 10.1016/j.hrtlng.2021.07.005. Online ahead of print.

ABSTRACT

BACKGROUND: Fixed-dose combination (FDC) of Aclidinium (ACL) and Formoterol (FOR) is a maintenance therapy for patients with stable chronic obstructive pulmonary disease (COPD). Although the effect of combination of long-acting beta-agonists (LABA) and long-acting muscarinic antagonists (LAMA) is less compared with the statistical sum of the effects of LABA and LAMA alone, the effect of combination of LABA and LAMA is significantly higher than that of either of the two. Thus, the resulting therapeutic effect in pulmonary function, improvement of dyspnea, quality of life, and incidence of adverse events was analyzed to explore the efficacy of FDC and monotherapy of either ACL or FOR in stable COPD patients.

METHODS: Methods Chronic obstructive pulmonary disease (COPD), aclidinium or LAMA, formoterol or LABA, randomized controlled trials, or RCT were used as keywords in the search for studies in PubMed, EMBASE, Cochrane Library, Reference List, and Clinicaltrails.gov databases. Studies that evaluated efficacy and side effects of Fixed-dose combination of Aclidinium/Formoterol and Monotherapy of Aclidinium or Formoterol in COPD published between the establishment period of the database and June 2020 were retrieved. Two independent reviewers extracted the data; Revman 5.3 software was used for data analysis with dose efficacy and side effects were presented as mean difference at 95% confidence interval. Notably, ACL 400 mg / FOR 12ug and ACL 400 mg / 6ug were used as subgroup analysis.

RESULTS: A total of 6 studies with 7,081 patients were enrolled for analysis. The trough forced expiratory volume in 1 second (FEV1) mean difference (MD) for FDC was 0.01 (95% CI, – 0.01 to 0.03); St George’s respiratory COPD specific questionnaire (SGRQ) MD for FDC was – 0.76 (95% CI, – 1.81 to 0.29); transitional dyspnea index (TDI) MD for FDC was 0.33 (95% CI, 0.06 to 0.60) compared to that of ACL. Furthermore, trough FEV1 MD for FDC was 0.05 (95% CI, 0.03 to 0.06); SGRQ MD for FDC was – 1.52 (95% CI, – 2.57 to-0.47); TDI MD for FDC was 0.43 (95% CI, 0.15 to 0.70) compared to that of the FOR. The evidence for each result was accurate and the results were unaffected by the duration of the study.

CONCLUSION: The findings of this study showed that, unlike monotherapies, FDC significantly improves lung function, dyspnea, and quality of life. In addition, FDC significantly improves dyspnea compared to ACL alone.

PMID:34731694 | DOI:10.1016/j.hrtlng.2021.07.005

Water Res. 2021 Oct 25;207:117797. doi: 10.1016/j.watres.2021.117797. Online ahead of print.

ABSTRACT

The content of fat, oil and grease (FOG) in the sewer network sediments is the key indicator for diagnosing sewer blockage and overflow. However, the traditional FOG detection is time-consuming and costly, and the establishment of mathematical models based on statistical methods to predict the content of FOG fail to provide satisfactory accuracy. Herein, a deep learning algorithm used a data-driven FOG content prediction model is proposed to achieve a more accurate prediction of FOG content. Meanwhile, global sensitivity analysis (GSA) is exploited to evaluate the contribution of input indicators to the output indicator (FOG) in the model, so that some input indicators that have less impact on the prediction performance can be screened out, the best combination of input indicators can be determined, and the operation cost of the model can be reduced. To evaluate the effectiveness of the proposed model, a case study was conducted in a city in southern China. The experimental results indicate that the prediction model obtains good FOG estimations and performs well from a single site to multiple sites with a mean R² of 0.922, showing a good generalization performance. Through GSA, the key input indicators in the model were identified as pH, water temperature (T), relative humidity (RH), sewage flow (Flow), drinking water supply (DWS), velocity (V) and conductivity (σ), and the input indicators such as air pressure (AP), population (Pop.), and liquid level (LV) can be reduced without affecting the prediction accuracy of the model.

PMID:34731668 | DOI:10.1016/j.watres.2021.117797

Eur J Obstet Gynecol Reprod Biol. 2021 Oct 22;267:73-78. doi: 10.1016/j.ejogrb.2021.10.018. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objectives of this study were to estimate blood loss, operation time and cost differences in patients undergoing vaginal hysterectomy (VH) versus laparoscopically-assisted vaginal hysterectomy (LAVH). The secondary objectives were to determine differences in hospital stay, need for postoperative analgesia, intra- and immediate post-operative complications, and the rate of conversion to laparotomy. VH was hypothesized to be the preferred route for hysterectomy for benign uterine conditions.

STUDY DESIGN: A randomized control study was undertaken at the Department of Obstetrics and Gynaecology of the Charlotte Maxeke Johannesburg Academic Hospital and included the women admitted between January 2017 and December 2019 for hysterectomy due to benign conditions, meeting the inclusion criteria (vaginally accessible uterus, estimated uterine size ≤ 12 weeks of gestation or ≤ 280 g on ultrasound examination and pathology confined to the uterus). Surgical procedures were performed by the residents in training under the supervision of specialists with large experience. The patient demographic characteristics, uterine weight, operative time, estimated blood loss(expressed as the difference between preoperative and postoperative day one serum haemoglobin),direct surgery-associated costs, intra- and immediate post-operative complications and the length of hospital stay were recorded and comparatively analysed among patients randomly placed in VH and LAVH group.

RESULTS: A total of 227 women were included (151 patients underwent VH and 76 LAVH, upon 2:1 randomization, performed on this way to reflect the previous pattern of operating of the unit). The patients were matched with respect to age, parity and body mass index. No significant differences between two groups were found in mean uterine weight and also in mean serum haemoglobin shift, intra- and immediate post-operative complications, and convalescence period duration. There were statistically significant differences in operating time and in cost between the two procedures. On average, LAVH took longer than VH to be performed (62.8 ± 9.3 vs 29.9 ± 6.6 min, p < 0.0001) and it was more costly, mainly due to the longer operating time and required disposables. An amount of 15698.20 South African Rand (ZAR) or 1145.85 United States Dollar (USD) more were needed to perform LAVH in comparison to VH. All VHs and LAVHs were successfully accomplished without major complications or conversation to laparotomy.

CONCLUSION: Our data indicate that VH is a feasible and safe alternative for a large group of women with benign pathology and non-prolapsed uteri, being a faster and less costly procedure than LAVH.

PMID:34731640 | DOI:10.1016/j.ejogrb.2021.10.018

J Speech Lang Hear Res. 2021 Nov 3:1-15. doi: 10.1044/2021_JSLHR-20-00651. Online ahead of print.

ABSTRACT

Purpose This study aimed to provide detailed descriptive information about the speech of a heterogeneous cohort of children with autism spectrum disorder (ASD) and to explore whether subgroups exist based on this detailed speech data. High rates of delayed and disordered speech in both low-verbal and high-functioning children with ASD have been reported. There is limited information regarding the speech abilities of young children across a range of functional levels. Method Participants were 23 children aged 2;0-6;11 (years;months) with a diagnosis of ASD. Comprehensive speech and language assessments were administered. Independent and relational speech analyses were conducted from single-word naming tasks and spontaneous speech samples. Hierarchical clustering based on language, nonverbal communication, and spontaneous speech descriptive data was completed. Results Independent and relational speech analyses are reported. These variables are used in the cluster analyses, which identified three distinct subgroups: (a) children with high language and high speech ability (n = 10), (b) children with low expressive language and low speech ability but higher receptive language and use of gestures (n = 3), and (c) children with low language and low speech development (n = 10). Conclusions This is the first study to provide detailed descriptive speech data of a heterogeneous cohort of children with ASD and use this information to statistically explore potential subgroups. Clustering suggests a small number of children present with low levels of speech and expressive language in the presence of better receptive language and gestures. This communication profile warrants further exploration. Replicating these findings with a larger cohort of children is needed. Supplemental Material https://doi.org/10.23641/asha.16906978.

PMID:34731586 | DOI:10.1044/2021_JSLHR-20-00651

J Speech Lang Hear Res. 2021 Nov 3:1-31. doi: 10.1044/2021_JSLHR-21-00176. Online ahead of print.

ABSTRACT

Purpose This study investigated within-language and between-language associations between phonological memory, vocabulary, and grammar in French-English (n = 43) and Spanish-English (n = 25) bilingual children at 30, 36, and 48 months. It was predicted that phonological memory would display both within-language and between-language relations to language development and that these relations would be stronger at the youngest age. Method Bilingual children participated in free-play sessions in both of their languages at each age, from which vocabulary and grammatical information (number of different words and mean length of utterance) was extracted. Vocabulary information was also obtained from parent inventories completed when the children were 30 months and a standardized receptive vocabulary test administered at 36 and 48 months. The children were also administered nonword repetition tests in both of their languages at each age. Results Mixed logistic regression indicated that phonological memory was associated with vocabulary and grammar within the same language and phonological memory in the other language. In two of the four statistical models, phonological memory exhibited positive between-language relations, and in one model, it exhibited negative between-language relations to language development. Results also indicated that within-language and between-languages effects remained constant, or between-language associations decreased during the age range studied. Conclusion Overall, the findings provide some support for cross-language associations between phonological memory and lexical and grammatical skills.

PMID:34731575 | DOI:10.1044/2021_JSLHR-21-00176

J Occup Health. 2021 Jan;63(1):e12288. doi: 10.1002/1348-9585.12288.

ABSTRACT

OBJECTIVES: Excess salt intake is a major risk factor for hypertension and cardiovascular disease. Modifying workplace environments has been recognized to be important for reducing salt intake. However, studies examining the effects of improving the workplace environment regarding salt reduction are limited. This study aimed to evaluate the effects of workplace dietary intervention on employees’ salt intake and sodium-to-potassium (Na/K) ratio.

METHODS: A quasi-experimental study was conducted. Two small business establishments in Saitama Prefecture, Japan, were allocated as the intervention (n = 69) and comparison (n = 68) workplaces, respectively. The 1-year intervention involving healthy lunch and nutrition education was implemented in the intervention workplace. Spot urine samples, physical assessments, and self-administered questionnaire data were collected at baseline, 6 months, and 1 year after the start of the intervention. Analysis of covariance was conducted to investigate differences in the salt intake or Na/K ratio between the study workplaces at year 1. Educational status and rotating work schedules were included as covariates.

RESULTS: Salt intake in the intervention workplace decreased significantly from 10.7 to 9.3 g (-1.4 g change; 95% confidence interval [CI]: “-2.4, -0.5”). The adjusted difference in changes in salt intake between workplaces was statistically significant (-3.7 g change; 95% CI: “-5.2, -2.3”). Although no significant change was observed in the Na/K ratio in the intervention workplace (3.37-3.08; -0.29 change; 95% CI: “-0.59, 0.01”), the adjusted difference in changes between the workplaces was statistically significant (-0.60 change; 95% CI: “-1.03, -0.17”).

CONCLUSIONS: Providing healthy lunch and nutrition education may be effective approaches to reduce employees’ salt intake and Na/K ratio.

PMID:34731526 | DOI:10.1002/1348-9585.12288

J Cosmet Dermatol. 2021 Nov 3. doi: 10.1111/jocd.14555. Online ahead of print.

ABSTRACT

OBJECTIVE: To the knowledge of the authors, no data about the reproducibility and accuracy of 3-dimensional surface imaging of the face using a whole-body scanner are available. Thus, the objective of this investigation was to assess the reproducibility of facial scans acquired using a whole-body imaging device.

MATERIAL AND METHODS: This investigation investigated 220 3-D scans of a total of 22 healthy volunteers (with a mean age of 29.36 years). Two consecutive 3-D images using a Vectra WB360 of the volunteers were obtained utilizing a whole-body imaging device. Predefined distances in the face were performed in each scan and compared. Furthermore, surface deviation between two consecutively captured scans was assessed.

RESULTS: The distance with the smallest statistical significance was found to be at the nose with p = 0.998, while the biggest statistical significance was found in the midface with p = 0.658. The area with the biggest surface deviation between the superimposed scans was the neck with a root mean square (RMS) of 1.62 ± 1.71, and the area with the smallest surface deviation was the forehead with a RMS of 0.17 ± 0.05.

CONCLUSION: The whole-body imaging device investigated in this study can be utilized to capture the face and provides enough accuracy to compare scans. Even though not directly investigated, it can be hypothesized that the error caused by repositioning the patient between a baseline and a follow-up scan will not be too big to consider measurements performed with the whole-body imaging device as impractical.

PMID:34731521 | DOI:10.1111/jocd.14555