Nevin Manimala

Ying Yong Sheng Tai Xue Bao. 2021 Sep;32(9):3152-3158. doi: 10.13287/j.1001-9332.202109.026.

ABSTRACT

We analyzed the growth dynamic and bolting rate of Angelica sinensis, soil quality and enzyme activities and weed density and control effect in a field experiment under different mulching patterns, to provide theoretical basis for the application of plastic film in genuine producing area of A. sinensis. The planting patterns were conducted as hole seeding under ridging with plastic-film mulching (LS), trenching and slant planting under film-side cultivation (MC) and trenching and slant planting in open field (LD). Our results showed that, 1) compared with LD, soil organic matter content in top layer under the treatments of LS and MC was increased by 4.4% and 14.3%, respectively, with that under MC being statistically significant. Soil bulk density was significantly decreased by 11.6% and 8.5%, while pH was significantly decreased by 4.6% and 1.7%. The activities of soil sucrase, phosphatase and urease were significantly increased by the two mulching methods, but that of catalase was inhibited to a certain extent. 2) Mulching film improved the speed of returning green after transplanting, the early bolting rate, and the individual medicinal quality of A. sinensis. MC showed the fastest, the most uniform, and the highest greening rate. LS bolting rate was the highest, and the fresh mass of MC and LS was significantly increased by 20.4% and 58.4%, respectively. 3) Weed density under the treatment of MC and LS was significantly reduced by 34.0% and 25.8%. Compared with LS, MC significantly increased the control effect of plant and fresh mass by 21.7% and 63.4%, respectively. In conclusion, film cultivation methods could improve the environment for root growth, reduce weed density, improve weed control effect, and promote growth process and substance accumulation, but could promote the bolting of A. sinensis in early phase.

PMID:34658200 | DOI:10.13287/j.1001-9332.202109.026

J Cosmet Dermatol. 2021 Oct 18. doi: 10.1111/jocd.14524. Online ahead of print.

ABSTRACT

BACKGROUND: Cesarean section scars are post-surgical problems in women. Many active ingredients have been found to diminish scar formation. Clinical investigations on the onion extract have gained more attention due to its properties, such as improvement of scar appearance and texture. However, published studies evaluating the usefulness of the onion extract in the treatment of scars are controversial.

METHODS: The three-month study period followed a prospective, randomized, and double-blinded design. Each enrolled subject’s post-cesarean completely sealed wounds were divided into two halves along the closure axis. Each half was randomly assigned to the treatment with either silicone gel containing 5% onion extract or the silicone gel containing vitamin C. All subjects were respectively evaluated at the one, two, and three months of the treatment.

RESULTS: After the three-month follow-up, there was a statistically significant difference in scar improvement between before and after treatment. None of statistically significant difference in the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS) scores and melanin value was found between silicone gel containing 5% onion extract and the control silicone gel. However, the improvement of scar erythema by treatment with the silicone gel containing 5% onion extract was significantly greater than in the control group. No adverse effects were reported in either group.

PMID:34658139 | DOI:10.1111/jocd.14524

J Nurs Scholarsh. 2021 Oct 18. doi: 10.1111/jnu.12718. Online ahead of print.

ABSTRACT

PURPOSE: Visually explore the rates of and relationships between overall physical and mental health, sleep disturbances, and depression rates in a single sample of caregivers of persons with dementia, caregivers of persons with other chronic illness, and non-caregiving adults.

DESIGN: Exploratory descriptive study utilizing data visualization methods.

METHODS: Data were analyzed from the 2017 Behavioral Risk Factor Surveillance System dataset. Multiple graphs and charts were developed to visualize data between groups. Descriptive statistics analyzed the rates of variables of interest across the three groups. One-way analysis of variance assessed relationships between variables.

RESULTS: Caregivers of persons with dementia and of other chronic illnesses reported poorer health outcomes as compared to non-caregiving adults. However, caregivers of persons with other chronic illnesses reported the worst outcomes of all groups. Depression and sleep disturbances were prevalent in all three groups.

CONCLUSIONS: The quality of life of caregivers of persons with dementia and chronic illness is impacted by poorer health outcomes, specifically mental health and sleep.

CLINICAL RELEVANCE: Findings support the need for caregiver-specific interventions that target overall physical and mental health, depression, and sleep disturbances. However, we also found support for mental health and sleep interventions for all individuals.

PMID:34658133 | DOI:10.1111/jnu.12718

Microsurgery. 2021 Oct 17. doi: 10.1002/micr.30820. Online ahead of print.

ABSTRACT

BACKGROUND: While microsurgical breast reconstruction may require multiple planned operations, unplanned reoperations has not been studied. We sought to investigate unplanned reoperations after microsurgical breast reconstruction.

METHODS: We queried the American College of Surgeons’ National Surgical Quality Improvement Program between 2005 and 2018. Current Procedural Terminology code 19364 was used to identify all patients with microsurgical breast reconstruction. Patient demographics, medical comorbidities, preoperative laboratory results, and operative data were analyzed. The primary outcome measure was 30-day unplanned reoperation.

RESULTS: Of 8449 patients meeting inclusion criteria, 1021 required an unplanned reoperation (12.1%). These patients were more likely to be obese, smokers, hypertensive, on steroids preoperatively, needing concomitant mastectomy, and with prolonged operating room time >9 h (p < .05). Multivariable regression model revealed preoperative steroids intake (OR = 1.92, CI 1.09-3.38, p = .03), concomitant mastectomy (OR = 1.45, CI 1.23-1.71, p < .01), and operating room time >9 h (OR = 1.37, CI 1.16-1.62, p < .01) as independent risk factors. Mastectomy was found to be an independent risk factor for early reoperation, that is, ≤2 days (OR = 1.44, CI 1.14-1.82, p < .01), whereas obesity was an independent risk factor for three reoperations (OR = 3.92, CI 1.14-13.46, p = .03).

CONCLUSION: Unplanned reoperations within 30-days after microsurgical breast reconstruction are a significant problem. Mastectomy is an independent risk factor for early reoperation whereas obesity is an independent risk factor for multiple reoperations. Identification of such patients preoperatively may help microsurgeons improve patient safety and quality of care.

PMID:34658057 | DOI:10.1002/micr.30820

Andrologia. 2021 Oct 17:e14275. doi: 10.1111/and.14275. Online ahead of print.

ABSTRACT

The updated meta-analysis was conducted to further verify the effect of varicocele on sperm DNA damage, supplying clinicians and researchers with high-grade evidence. The sperm DNA damage was evaluated by DNA fragmentation index (DFI), associated with the male fertility capability tightly. PubMed, Web of Science and Cochrane Library were searched extensively for eligible studies with the search terms: varicocele, sperm DNA and sperm DNA damage. Finally, a total of 12 studies were included in our meta-analysis with a total of 845 patients diagnosed with varicocele and 2,377 healthy controls. A statistical difference of DFI between varicocele patients and healthy controls was found after pooling the data ((Standardised mean difference) SMD: 1.40, 95%CI: 0.83-1.98, p < .0001), using the random effect model. We conducted subgroup analysis according to study region (Brazil and Other countries), detection methods of DFI (TUNEL, Comet, and SCSA), sample size (<50 and >50) and age (<30 and >30 years), based on substantial heterogeneity among eligible studies. The stability of pooled results was verified by sensitivity analysis. All these statistical analyses were conducted using Stata version 16.0. In conclusion, patients diagnosed with clinical varicocele had higher DFI than healthy controls, which means varicocele could impair sperm DNA, consequently the fertility potential of affected men.

PMID:34658054 | DOI:10.1111/and.14275

Stat Med. 2021 Oct 17. doi: 10.1002/sim.9212. Online ahead of print.

ABSTRACT

Variable screening plays an important role in ultra-high-dimensional data analysis. Most of the previous analyses have focused on individual predictor screening using marginal correlation or other rank-based techniques. When predictors can be naturally grouped, the structure information should be incorporated while applying variable screening. This study presents a group screening procedure that is based on maximum Lq-likelihood estimation, which is being increasingly used for robust estimation. The proposed method is robust against data contamination, including a heavy-tailed distribution of the response and a mixture of observations from different distributions. The sure screening property is rigorously established. Simulations demonstrate the competitive performance of the proposed method, especially in terms of its robustness against data contamination. Two real data analyses are presented to further illustrate its performance.

PMID:34658050 | DOI:10.1002/sim.9212

Med J Aust. 2021 Oct 17. doi: 10.5694/mja2.51306. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the characteristics and population rates of barbiturate-related hospitalisations, treatment episodes, and deaths in Australia, 2000-2018.

DESIGN, SETTING: Analysis of national data on barbiturate-related hospitalisations (National Hospital Morbidity Database, 1999-2000 to 2017-18), drug treatment episodes (Alcohol and Other Drug Treatment Services National Minimum Data Set, 2002-03 to 2017-18), and deaths (National Coronial Information System, 2000-01 to 2016-17).

MAIN OUTCOME MEASURES: Population rates directly age-standardised to the 2001 Australian standard population; average annual percentage change (AAPC) in rates estimated by Joinpoint regression.

RESULTS: We identified 1250 barbiturate-related hospitalisations (791 cases of deliberate self-harm [63%]), 993 drug treatment episodes (195 cases with barbiturates as the principal drug of concern [20%]), and 511 deaths during the respective analysis periods. The barbiturate-related hospitalisation rate declined from 0.56 in 1999-2000 to 0.14 per 100 000 population in 2017-18 (AAPC, -6.0%; 95% CI, -7.2% to -4.8%); the declines in hospitalisations related to accidental poisoning (AAPC, -5.8%; 95% CI, -9.1% to -2.4%) and intentional self-harm (AAPC, -5.6%; 95% CI, -6.9% to -4.2%) were each statistically significant. Despite a drop from 0.67 in 2002-03 to 0.23 per 100 000 in 2003-04, the drug treatment episode rate did not decline significantly (AAPC, -6.7%; 95% CI, -16% to +4.0%). The population rate of barbiturate-related deaths increased from 0.07 in 2000-01 to 0.19 per 100 000 population in 2016-17 (AAPC, +9.3%; 95% CI, +6.2-12%); the rate of intentional self-harm deaths increased (AAPC, +11%; 95% CI, +7.4-15%), but not that of accidental deaths (AAPC, -0.3%; 95% CI, -4.1% to +3.8%).

CONCLUSIONS: While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.

PMID:34658038 | DOI:10.5694/mja2.51306

Stat Med. 2021 Oct 17. doi: 10.1002/sim.9216. Online ahead of print.

ABSTRACT

Time-dependent receiver operating characteristic curves are often used to evaluate the classification performance of continuous measures when considering time-to-event data. When one is interested in evaluating the predictive performance of multiple covariates, it is common to use the Cox proportional hazards model to obtain risk scores; however, previous work has shown that when the model is mis-specified, the estimand corresponding to the partial likelihood estimator depends on the censoring distribution. In this manuscript, we show that when the risk score model is mis-specified, the AUC will also depend on the censoring distribution, leading to either over- or under-estimation of the risk score’s predictive performance. We propose the use of censoring-robust estimators to remove the dependence on the censoring distribution and provide empirical results supporting the use of censoring-robust risk scores.

PMID:34658036 | DOI:10.1002/sim.9216

J Anat. 2021 Oct 17. doi: 10.1111/joa.13550. Online ahead of print.

ABSTRACT

PURPOSE: The current standard in reconstructing defects of the orbital floor, by using the concept of mirroring, is time-consuming and ignores the natural asymmetry of the skull. By using a statistical shape model (SSM), the reconstruction can be automatized and improved in accuracy. The present study aims to show the possibilities of the virtual reconstruction of artificial defects of the orbital floor using an SSM and its potentials for clinical implementation.

METHODS: Based on 131 unaffected CT scans of the midface, an SSM was created which contained the shape variability of the orbital floor. Nineteen midface CT scans, that were not included in the SSM, were manually segmented to establish ground truth (control group). Then artificial defects of larger and smaller sizes were created and reconstructed using SSM (Group I) and the gold standard of mirroring (Group II). Eventually, a comparison to the surface of the manual segmentation (control group) was performed.

RESULTS: The proposed method of reconstruction using an SSM leads to more precise reconstruction results, compared with the conventional method of mirroring. Whereas mirroring led to the reconstruction errors of 0.7 mm for small defects and 0.73 mm for large defects, reconstruction using SSM led to deviations of 0.26 mm (small defect) and, respectively, 0.34 mm (large defect).

CONCLUSIONS: The presented approach is an effective and accurate method for reconstructing the orbital floor. In connection with modern computer-aided design and manufacturing, individual patient-specific implants could be produced according to SSM-based reconstructions and could replace current methods using manual bending techniques. By acknowledging the natural asymmetry of the human skull, the SSM-based approach achieves higher accuracy in reconstructing injured orbits.

PMID:34658032 | DOI:10.1111/joa.13550

Health Serv Res. 2021 Oct 18. doi: 10.1111/1475-6773.13897. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the impacts of the Medicaid expansion on revenues, costs, assets and liabilities of federally funded community health centers.

DATA SOURCES: We combined data from the Uniform Data System, Internal Revenue Service non-profit tax returns, and county level characteristics from the Census Bureau. Our final dataset included 5841 center-year observations.

STUDY DESIGN: We used difference-in-differences model to estimate the fiscal impacts of the Medicaid expansion on community health centers. We employed event study models, state specific trend models, and placebo law tests as robustness checks.

DATA COLLECTION METHODS: Not applicable.

PRINCIPAL FINDINGS: On the revenue side, we found a $2.08 million relative increase (p = 0.002) in Medicaid revenues, offset by a $0.44 million decrease (p = 0.015) in total grants among community health centers in expansion states compared to centers in non-expansion states. On the expenditure side, we found a large but not statistically significant $0.98 million relative increase (p = 0.201) in total expenditures among centers in expansion states. Uncompensated care for health centers in expansion states decreased by $1.19 million (p < 0.001) relative to their counterparts in non-expansion states.

CONCLUSIONS: Community health centers in expansion states benefited from the increased, stable revenue stream from Medicaid expansions. While Medicaid revenue increased as a result of the policy, we find no major evidence of substitution away from other revenue lines, with one notable exception (i.e., substitution away from state and local government grants). From a policy perspective, these results are encouraging as the Biden Administration starts to implement the safety-net enhancements from the American Rescue Plan Act of 2021 and as more non-expansion states are considering opting into Medicaid expansions. It is anticipated that these added revenue streams will help to sustain health centers in the delivery of health care services to the underserved population. This article is protected by copyright. All rights reserved.

PMID:34658030 | DOI:10.1111/1475-6773.13897