Nevin Manimala

JAMA Health Forum. 2023 May 5;4(5):e230960. doi: 10.1001/jamahealthforum.2023.0960.

ABSTRACT

IMPORTANCE: For neonates with very low birth weight (VLBW), randomized clinical trials (RCTs) indicate that probiotic treatment decreases the risk of necrotizing enterocolitis (NEC), with smaller decreases in the risk of sepsis and death. There is little evidence on the rate of probiotic adoption in US neonatal intensive care units (NICUs) and whether the benefits seen in trials have materialized in practice.

OBJECTIVE: To estimate changes in probiotic use among neonates with VLBW and to test whether neonates with VLBW treated at NICUs adopting routine probiotic use experience better outcomes compared with neonates treated at nonadopting NICUs.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used Vermont Oxford Network data on neonates with VLBW in US NICUs from January 1, 2012, to December 31, 2019. Data were analyzed from January 2022 through February 2023.

EXPOSURE: Probiotics adoption vs nonadoption. Adopting NICUs were defined as those that currently or previously treated at least 20% of neonates with VLBW with probiotics.

MAIN OUTCOMES: The primary outcomes were rates of NEC, in-hospital mortality, and sepsis, defined as bacterial or fungal infection occurring after day 3 from birth. A difference-in-differences analysis compared changes in VLBW infant outcomes between adopting and nonadopting NICUs before and after hospital-level adoption of probiotics. Additional analyses used the proportion of neonates treated with probiotics in each neonate’s birth NICU and year.

RESULTS: The analysis included 307 905 neonates with VLBW (mean [SD] gestational age, 28.4 [2.9] weeks; 50.0% male) at 807 US hospitals. The rate of probiotic treatment of neonates with VLBW rose from 1572 of 38 296 neonates (4.1%) in 2012 to 4788 of 37 910 (12.6%) in 2019. Only 123 of 745 NICUs (16.5%) adopted probiotics by 2019, with 4591 of 6017 neonates with VLBW (76.3%) receiving probiotics in 2019 at adopting NICUs. Incidence of NEC declined by 18% at adopting NICUs (odds ratio [OR], 0.82; 95% CI, 0.70-0.95; P = .10) compared with nonadopting NICUs. Probiotic adoption was not associated with a significant reduction in sepsis (OR, 1.11; 95% CI, 0.98-1.25; P = .09) or mortality (OR, 0.93; 95% CI, 0.80-1.08; P = .33).

CONCLUSION AND RELEVANCE: In this cohort study, adoption of routine use of probiotics increased slowly in US NICUs and was associated with lower NEC risk but not with sepsis or mortality among neonates with VLBW. The findings for probiotic adoption and NEC, sepsis, and mortality were smaller than would have been predicted by the totality of RCT evidence but are consistent with a meta-analysis restricted to studies at low risk of bias.

PMID:37171798 | DOI:10.1001/jamahealthforum.2023.0960

Assist Technol. 2023 May 12. doi: 10.1080/10400435.2023.2213762. Online ahead of print.

ABSTRACT

In the current labor market, assistive technology (AT) is vital to employment for people with blindness or low vision (B/LV), yet we know little about their AT use in the workplace. The purpose of this descriptive study was to increase our knowledge in this area. Participants were 314 employed people with B/LV who completed an online or phone survey about AT used on the job and perceived skill level, satisfaction, and challenges experienced with their workplace AT. Two researchers utilized content analysis to code open-ended responses and descriptive statistics were used to analyze quantitative data. Self-perceived skill levels were moderately high to high for each AT. Satisfaction with AT was generally high, but 15% or more of participants expressed dissatisfaction with their AT for five tasks. Dissatisfaction with AT for some work tasks differed noticeably by type of AT being used to accomplish the task. Accessing certain software, websites, or digital documents was the most common challenge experienced, mentioned by 59.1% of participants, representing an ongoing problem in the technological workplace environment for people with B/LV. In addition to websites, specific areas that present access or utilization challenges are slide presentation software, PDFs, spreadsheets, virtual meeting software, and printed material.

PMID:37171786 | DOI:10.1080/10400435.2023.2213762

Neurol Ther. 2023 May 12. doi: 10.1007/s40120-023-00478-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare progressive or relapsing inflammatory disease. Intravenous immunoglobulin (IVIG) is recommended as a first-line therapy. The aim of this study was to describe real-world treatment patterns and outcomes of patients with CIDP in the Define initiating IVIG treatment.

METHODS: This cohort study used health insurance claims data from the Merative MarketScan Research Databases (2008-2018). Adult patients (≥ 18 years old) with CIDP without prior immunoglobulin treatment were identified using International Statistical Classification of Diseases and Related Health Problems (ICD) codes, and patients subsequently initiating IVIG were included in the analysis. Real-world IVIG treatment patterns and treatment and safety outcomes (assessed via ICD codes) were described.

RESULTS: In total, 3975 patients (median age 58 years) with CIDP who initiated IVIG were identified. After the initial IVIG loading period, patients received IVIG at a median dosing interval of 21 days (quartile [Q]1, Q3: 7, 28), and continued treatment for a median of 129 days (Q1, Q3: 85, 271). After the 2-year follow-up period, 55% of patients had discontinued all IVIG treatment; more than one-half of these discontinuations occurred within 4 months. Diagnoses of impaired functional status were evident in more than 30% of patients at baseline, but at lower rates during follow-up. Rates of new-onset safety outcomes after IVIG treatment were low.

CONCLUSION: This real-world analysis of IVIG treatment patterns and treatment and safety outcomes of patients with CIDP who initiated IVIG highlights the unmet need for improved long-term management. Further research is needed to evaluate the use of functional status measures as endpoints for immunoglobulin treatment effectiveness.

PMID:37171778 | DOI:10.1007/s40120-023-00478-5

Reprod Sci. 2023 May 12. doi: 10.1007/s43032-023-01261-5. Online ahead of print.

ABSTRACT

To compare the rate of positive thyroid peroxidase antibodies (TPO Ab) between women with different polycystic ovary syndrome (PCOS) phenotypes and women without PCOS. This is a retrospective cohort study. Women with PCOS at My Duc Hospital between June 1, 2020, and March 27, 2021, were matched with non-PCOS women by age. TPO Ab (cut-off: 34 IU/mL) and thyroid-stimulating hormone (TSH) levels were measured as markers of Hashimoto thyroiditis and thyroid function, respectively. One thousand eight hundred eight infertile women were included, 904 with PCOS (mean age 29.0 ± 3.58 years) and 904 without PCOS (29.1 ± 3.4 years; controls). Women with PCOS had a higher body mass index (22.8 ± 3.84 vs. 19.9 ± 2.23 kg/m², p < 0.001), but most were not overweight/obese. Rates of positive TPO Ab in women with versus without PCOS were 8.2% and 8.4%, respectively (p = 0.932). Rates of positive TPO Ab in patients with PCOS phenotype A, B, C, or D were not statistically different (7.5%, 2.9%, 20.0%, and 7.8%, respectively). Median TSH concentrations were similar in the PCOS and control groups (1.84 mIU/L vs. 1.78 mIU/L, respectively; p = 0.194). Based on a linear regression model, there was no correlation between either BMI or the estradiol to progesterone ratio and TPO Ab status. In a large population of infertile women with PCOS who were mostly lean patients, rates of positive TPO Ab across all four PCOS phenotypes did not differ significantly from those in women without PCOS. These findings did not support the hypothesis that PCOS is a risk factor for Hashimoto thyroiditis.

PMID:37171775 | DOI:10.1007/s43032-023-01261-5

J Occup Rehabil. 2023 May 12. doi: 10.1007/s10926-023-10103-9. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the effect of pain neuroscience education compared to biomedical pain education after breast cancer surgery on (1) work status, (2) time until work resumption, and (3) change in return-to-work expectations up to 18 months post-surgery.

METHODS: Participants were randomly assigned to either pain neuroscience education (intervention group) or biomedical pain education (control group) in addition to a standard physical therapy program after surgery for breast cancer. The first four months following surgery, one to two physiotherapy sessions and three educational sessions were scheduled. After, two educational sessions and two physiotherapy sessions were held at six and eight months postoperatively. All outcomes were assessed at four, six, eight, 12 and 18 months postoperatively.

RESULTS: At 12 months, in the intervention group, 71% of the women returned to work compared to 53% in the control group (18% points difference, 95%CI:-0.1 to 35;p = 0.07). At 18 months, the differences decreased to 9% points, 95%CI:-26 to 7;p = 0.35). Neither time until work resumption (p = 0.46) nor change in estimation of own ability to return to work up to 18 months postoperatively (p = 0.21) significantly differed between both groups.

CONCLUSION: No significant differences were found regarding return to work outcomes between women receiving pain neuroscience education versus biomedical pain education after breast cancer surgery. Further research is warranted to explore the potential role of pain neuroscience education in return-to-work interventions following breast cancer surgery.

PMID:37171771 | DOI:10.1007/s10926-023-10103-9

Appl Biochem Biotechnol. 2023 May 12. doi: 10.1007/s12010-023-04510-0. Online ahead of print.

ABSTRACT

A sudden rise in intra-abdominal pressure that causes the pressure in the bladder to rise during physical movement and/or activity, such as coughing, sneezing, laughing, running, or weightlifting, is known as stress urinary incontinence. This condition causes an uncontrollable overflow of urine. The study’s goal was to determine whether effector molecules, specifically ADP ribosylation factor GTPase activated protein 3, might play a part in the female pelvic floor muscle’s ability to heal after suffering damage during vaginal delivery. Pelvic floor muscle samples were taken from women who had at least one vaginal delivery and were enrolled in either the IU group (n = 45; issue of stress urinary incontinence) or the NL group (n = 85; no issue of stress urinary incontinence) depending on whether they had a problem with stress urinary incontinence. Vesicle transport-related genes in female pelvic floor muscle injury repair were discovered using Gene Expression Omnibus. For gene analysis and screening, RT-qPCR was employed. On the first day following injury, the expression level of ARFGAP3 mRNA increased by 2.8 times (p 0.05) and by 5 times (p 0.01) on the third day. On the first day following damage, STMN1 mRNA expression rose by 0.3 times (p 0.05). On the first day following injury, the expression level of THBS2 mRNA increased by 1.6 times (p 0.01). On the third day following the injury, the expression level of PLXNB2 mRNA increased by 1.2 times (p 0. 01), and on the fifth day following the injury, it increased by 2.5 times (p 0. 01). After pelvic floor muscle damage, the mRNA expression levels of the CSF1R, ANXA4, and EMR1 genes dropped. Between those with and without pelvic floor muscle damage, there was no statistically significant difference in the expression levels of LGARLS3, KDELR3, and KIF20A mRNA (p > 0. 05 for all). The differential expression of genes after pelvic floor muscle injury can identify the target in the process of pelvic floor muscle injury repair and regeneration.

PMID:37171760 | DOI:10.1007/s12010-023-04510-0

Appl Biochem Biotechnol. 2023 May 12. doi: 10.1007/s12010-023-04563-1. Online ahead of print.

ABSTRACT

With the global population explosion, the need for increasing crop productivity is reaching its peak. The significance of organic means of cultivation including biofertilizers and biopesticides is undeniable in this context. Over the last few decades, the use of rhizobacteria to induce crop productivity has gained particular interest of researchers. Of these, several Bacillus spp. have been known for their potential plant growth-promoting and phyto-pathogenic actions. Keeping this background in mind, this study was formulated with an aim to unravel the PGPR and phyto-pathogenic potency of Bacillus sp. isolated from extreme environmental conditions, viz. high-altitude waters of Ganges at Gangotri (Basin Extent Longitude Latitude-73° 2′ to 89° 5′ E 21° 6′ to 31° 21′ N). Based on recent studies showing the impact of biofilm on bacterial PGPR potency, three novel strains of Bacillus subtilis were isolated on basis of their extremely high biofilm-producing abilities (BRAM_G1: Accession Number MW006633; BRAM_G2: Accession Numbers MT998278-MT998280; BRAM_G3: Accession Number MT998617), and were tested for their PGPR properties like nutrient sequestration, growth hormone production (IAA, GA₃), stress-responsive enzyme production (ACC deaminase) and lignocellulolytic and agriculturally important enzyme productions. The strains were further tested for the plethora of metabolites (liquid and VOCs) exuded by them. Finally, the strains both in individually and in an association, i.e. consortium was tested on a test crop, viz. Zea mays L., and the data were collected at regular intervals and the results were statistically analysed. In the present study, the role of high-altitude novel Bacillus subtilis strains as potent PGPR has been analysed statistically.

PMID:37171757 | DOI:10.1007/s12010-023-04563-1

Pain Ther. 2023 May 12. doi: 10.1007/s40122-023-00519-9. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to evaluate the efficacy of esketamine on postoperative recovery quality after laparoscopic bariatric surgery.

METHODS: Patients (n = 74) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.5 mg/kg/h infusion, i.e., 0.2 mL/kg/h) or the control group (group C: 0.2 mL/kg/h normal saline infusion). The infusions were stopped 20 min before the end of the procedure. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day 1 (POD 1). The secondary outcomes included QoR-40 scores on PODs 2 and 7, Numeric Rating Scale (NRS) on PODs 1, 2, and 7, time to extubation, additional postoperative analgesic use, length of hospital stay, and time to first exhaust. Additonally, the safety indices were also recorded, including hemodynamic profile, perioperative anesthesia index (Ai), utilization of vasoactive drugs or urapidil, and side effects.

RESULTS: All in all, 70 of the 74 patients completed the study, 35 in each group. The difference of QoR-40 scores on POD 1 was both statistically and clinically significant [difference 7.21, 95% confidence interval (CI) 5.17, 9.25, p < 0.001]. The difference of QoR-40 on POD 2 was statistically significant but clinically insignificant (difference 4.81, 95% CI 2.69, 6.92, p < 0.001). The difference of NRS scores on POD 1 was statistically significant (difference -1.23, 95% CI -2.36, -0.10, p = 0.033). Compared with group C, group E had a lower utilization rate of phenylephrine and higher Ai values (p < 0.05). There was no statistical difference between the two groups on other measures.

CONCLUSION: Continuous ketamine infusion seems to be safe and well tolerated in laparoscopic bariatric surgery. It improved the quality of postoperative recovery and reduced pain on POD 1. In spite of the increased Ai value during the surgery, it also provided better hemodynamics with less usage of phenylephrine.

PMID:37171754 | DOI:10.1007/s40122-023-00519-9

Environ Sci Pollut Res Int. 2023 May 12. doi: 10.1007/s11356-023-27442-y. Online ahead of print.

ABSTRACT

Globally, as a renewable source of energy, biofuel, wind, solar, and hydro energy have been increasingly valued by a range of businesses. There is no denying the advantages of using renewable energy in terms of preventing climate change and protecting the environment. Therefore, this article investigates the relationship among hydro, solar, biofuel, wind, coal consumption, and CO₂ emissions in 19 G20 member countries between 2000 and 2019. The results of dynamic fixed effects and the system-generalized method of moments suggest that solar energy and biofuel usage have a negative and statistically significant influence on carbon emissions. On the other hand, the impact of wind energy consumption on carbon dioxide emissions is positive and statistically significant. However, hydro energy consumption is statistically insignificant. The significance of this study is to include wind energy, solar energy, and hydro energy as new indicators for a group of 19 G20 member countries. Furthermore, this research paper also includes coal consumption in the existing model to confirm that CO2 emissions may rise if more coal is consumed. Growing the solar-hydro-biofuel-wind industry can reduce nonrenewable energy consumption and has tremendous potential to diminish carbon dioxide emissions.

PMID:37171731 | DOI:10.1007/s11356-023-27442-y

Environ Sci Pollut Res Int. 2023 May 12. doi: 10.1007/s11356-023-27224-6. Online ahead of print.

ABSTRACT

Despite the high importance of coagulation process in drinking water treatment plant (DWTP), challenge remains in effectively linking raw water quality measured at the inlet of the DWTP with coagulant dosage rate. This study proposes an integral modelling framework using hybrid extreme learning machine and Bat metaheuristic algorithm (ELM-Bat) for modelling coagulant dosage rate using water temperature, pH, specific conductance, dissolved oxygen, and water turbidity. The aluminum sulphate (Al₂ (SO₄)₃.18H₂O) coagulant is determined using conventional Jar-Test procedure. Results obtained using the hybrid ELM-Bat were compared to those obtained using standalone ELM, outlier robust extreme learning machine (ORELM), online sequential extreme learning machine (OSELM), optimally pruned extreme learning machine (OPELM), and kernel extreme learning machine (KELM). First, the models have been calibrated during the training stage and in a second stage; they are validated using various statistical metrics, i.e., RMSE, MAE, the correlation coefficient (R), and the Nash-Sutcliffe model efficiency (NSE). We found that the hybrid ELM-Bat was significantly more accurate and it has yielded accuracy higher than all other models. During the validation stage, the R and NSE values calculated using the ELM-Bat were ≈0.959 and ≈0.918 exhibiting an improvement rates of approximately (≈15.26% and ≈33.82%), (≈10.35% and ≈21.92%), (≈14.98% and ≈31.89%), (≈7.63% and ≈16.35%), (≈10.99% and ≈23.05%), compared to the values obtained using the ELM, OPELM, OSELM, KELM and ORELM, respectively. Besides, the new ELM-Bat model has shown to have high predictive capabilities, which can be used optimally for calculating the optimal coagulant dosage with high accuracy.

PMID:37171728 | DOI:10.1007/s11356-023-27224-6