Nevin Manimala

Environ Sci Pollut Res Int. 2022 Jul 23. doi: 10.1007/s11356-022-22113-w. Online ahead of print.

ABSTRACT

Healthcare waste (HCW) management is a challenge for establishments that generate this type of waste, especially hospitals, as they are one of the largest generators. A determining factor in waste management is the amount of waste generation, which must be used for management planning. This study aims to compile and evaluate information on the management of HCW generated in Belo Horizonte’s (located in Brazil) hospitals declared in their respective Healthcare Waste Management Plans (HCWMP) sent for approval by the municipality’s Superintendency of Urban Cleaning. Therefore, a comparative analysis of the hospitals’ generations in relation to their characteristics (nature, specialty, and size) was carried out, using the Kruskal-Wallis statistical test with post hoc in Nemenyi. For the study hospitals, a generation rate of 7.18 (6.17-8.23) kg·bed^-1·day^-1 was estimated, a generation rate close to that of developed countries. When comparing the generation according to the specialty of the hospitals, it was identified that the maternity hospitals (9.00 (7.05-10.90)) kg·bed^-1·day^-1 had a significantly higher generation rate than the low-complexity hospitals (4.75 (3.28-6.18)) kg·bed^-1·day^-1. It was also possible to demonstrate that the specialty and size of hospitals influence the structure available for waste storage. Finally, it can be observed that there are few treatment alternatives, with incineration and autoclaving being the technologies most commonly used by hospitals. It is expected that the results presented can serve as a reference for waste managers, in a context where there is little shared information on the subject.

PMID:35871194 | DOI:10.1007/s11356-022-22113-w

Environ Sci Pollut Res Int. 2022 Jul 23. doi: 10.1007/s11356-022-21710-z. Online ahead of print.

ABSTRACT

The Najafgarh drain is the first major drain that joins the Yamuna River at Wazirabad in Delhi, India, and is known to contribute to the maximum pollution load to this river. The drain is originally an extension of the Sahibi River and was intentionally constructed as a canal to carry stormwater, but presently, it is carrying more of sewage, agricultural, and industrial effluents received through various small and large secondary drains. The present study has analyzed the water quality status of this interconnected system, i.e., the Najafgarh drain, its associated secondary drains, and the Yamuna River for physicochemical parameters (n = 16), microbiological parameter (n = 1), and heavy metal concentrations (n = 8). The analysis of the surface water samples collected during pre- and post-monsoon seasons showed that secondary drain discharges significantly impacted the water quality of the Najafgarh drain, which in turn affected the Yamuna River. Out of the eight selected secondary drains for this study, the Goyla dairy outlet came out as the most polluted site in terms of organic pollutants while the Basaidarapur drain was loaded with heavy metal contaminants. Statistical tools comprising hierarchical cluster analysis (HCA), Pearson’s correlation, and principal component analysis (PCA) were further implemented on the water quality dataset for a better understanding of the possible sources of contamination for organic and inorganic pollutants in the selected sampling sites. The present study, thus, might help in providing key highlights to the policymakers for effective regulation and management of the point source discharges in Najafgarh drain, which will ultimately restrict its pollution loadings in Yamuna River, Delhi, and also help in the restoration of this important water body.

PMID:35871193 | DOI:10.1007/s11356-022-21710-z

Int Orthod. 2022 Jul 20:100664. doi: 10.1016/j.ortho.2022.100664. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate in vitro the effect of gastroesophageal reflux, before and after bonding of metal brackets on composite resin surface.

MATERIALS AND METHODS: Two hundred and ten resin discs were divided into 5 groups (n=42), according to the time and medium of storage: 24h, 7- and -30 days in artificial saliva (AS) and hydrochloric acid (HCL). Twelve samples from each group were submitted to surface roughness analysis (n=60). The other one hundred and fifty samples were divided into 3 groups (n=50) according to the bonding material: Transbond™ XT (TXT), 3M™ Filtek™ Z250 (Z250) and 3M™ Filtek™ Z350 XT (Z350). After bonding, the samples were subdivided, one more time, into 5 groups (n=10) according to the time (24h, 7, and 30 days) and medium storage (AS, HCL). Following, the shear bond strength (SBS) analysis was accomplished. Erosive challenge was performed for 7 or 30 days, before and after bonding of orthodontic brackets, for 1min, 4 times a day. SBS was performed in a universal testing machine (Instron) at 0.5mm/min. SBS data were subjected to two-way ANOVA and Tukey’s test (α=0.05).

RESULTS: TXT showed higher SBS values in all conditions (AS – 10.9±2.0 (24h); 10.5±4.9 (7 days); 9.4±2.2 (30 days); HCL – 11.5±3.7 (7 days); 8.0±2.1 (30 days)) – (P<0.0001). No statistical difference was detected in SBS between Z250 and Z350 composite resins (Z250 SBS: AS – 7.1±1.9 (24h), 5.2±1.8 (7 days), 4.5±1.5 (30 days); HCL – 5.2±2.3 (7 days), 5.0±2.5 (30 days)) – (P<=0.063)/Z350 SBS: AS – 7.4±1.0 (24h); 3.7±1.7 (7 days); 3.4±1.7 (30 days); HCL – 3.5±3.3 (7 days); 4.4±1.2 (30 days)) – (P<=0.167), respectively). Storage times and media did not statistically influence the SBS of TXT and Z250 composite resins (P>0.05), but did influence the Z350 SBS (P<0.05).

CONCLUSION: Regardless of time and storage medium, TXT was the best composite resin for bonding brackets. Furthermore, the erosive challenge did not lead to surface changes in the Z250 resin at 7 and 30 days, unlike the Z350 resin.

PMID:35871154 | DOI:10.1016/j.ortho.2022.100664

Pediatr Neonatol. 2022 Jul 8:S1875-9572(22)00143-7. doi: 10.1016/j.pedneo.2022.03.020. Online ahead of print.

ABSTRACT

BACKGROUND: Well-appearing febrile young children discharged from the emergency department (ED) after medical assessment are still at risk for serious bacterial infections (SBI). The incidence of SBI and the effectiveness of laboratory tests in the pneumococcal conjugate vaccine era remain unknown.

METHODS: We conducted a study using Taiwan’s National Health Insurance claims data from 2004 to 2014. Children aged 2-24 months discharged from the ED with a diagnosis compatible with fever without source (FWS) were enrolled.

RESULTS: The study identified 431,884 children from the ED with FWS. 13.53% of the children had revisits, 8.62% needed hospitalization and 1.57% developed SBI. Younger children had a higher SBI rate, but a lower revisit rate. The revisit rate was 12.22% for children aged 2-6 months, 13.61% for children aged 7-12 months and 13.77% for children aged 13-24 months (p < 0.0001). The SBI rate was 4.44% for children aged 2-6 months, 1.85% for children aged 2-6 months and 0.96% for children aged 13-24 months (p < 0.0001). Children with hemogram tests, compared to those without, had a higher revisit rate (16.30% vs. 13.15%, p < 0.0001), and a higher SBI rate in the children aged 13-24 months (1.30% vs. 0.92%, p < 0.0001); furthermore, children with urinalysis had a significantly higher revisit rate (14.42% vs. 13.24%, p < 0.0001) and higher SBI rate (2.10% vs. 1.40%, p < 0.0001).

CONCLUSION: Children with FWS aged 2-24 months who were discharged from ED after blood test and urinalysis were still at risk for SBI, especially those aged 2-6 months.

PMID:35871150 | DOI:10.1016/j.pedneo.2022.03.020

Rev Esp Anestesiol Reanim (Engl Ed). 2022 Jul 20:S2341-1929(22)00114-7. doi: 10.1016/j.redare.2022.07.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Obstructive Sleep Apnea Syndrome (OSAS) or Apnea-Hypoapnea Syndrome (SAHS) is one of the most prevalent sleep disorders in the general population. It is associated with an increase in the prevalence of difficult orotracheal intubation and postoperative complications. The application of validated early detection tests, such the STOPbang test in English (STBC), is recommended; a test of high methodological quality, sensitivity and specificity in the early detection of SAHS in both surgical and general populations.

OBJECTIVE: The validation, translation, cross-cultural adaptation of the STBC to the Spanish population.

MATERIAL AND METHODS: The transcultural adaptation of the STBC to Spanish was carried out and a subsequent validation study with 77 consecutive patients was carried out. The statistical analysis evaluated the reliability, validity and feasibility of the translated and culturally adapted version.

RESULTS: 44% of women and 56% of men were included, with a mean age of 53.58 ± 12.88 years. The reliability results were: a Cronbach’s Alpha Coefficient of 0.767, a Pearson correlation r = 0.777 (P < .001) and a Sperman correlation rho = 0.455 (P = .044). The feasibility of the study was 100%. Criterion validity was evaluated using the Kappa coefficient, which was 0.444. For a score >3 of the questionnaire adapted to Spanish, the results of sensitivity, specificity according to the different cut-off levels of the apnea hypopnea index (AHI) >5, >15, >30) were: Sensitivity 87%, 91% and 100% respectively and Specificity of 50%, 31% and 22%.

CONCLUSIONS: The STBC questionnaire translated, adapted and validated into Spanish, evaluated in the present study, is reliable and valid with respect to the original design of the questionnaire. It is a useful tool that is easy to understand and implement, which can be used rigorously to stratify surgical risk and carry out adequate perioperative planning of those patients at risk of SAHS.

PMID:35871142 | DOI:10.1016/j.redare.2022.07.001

J Math Biol. 2022 Jul 23;85(2):14. doi: 10.1007/s00285-022-01781-9.

ABSTRACT

RNA and protein concentrations within cells constantly fluctuate. Some molecular species typically have very low copy numbers, so stochastic changes in their abundances can dramatically alter cellular concentration levels. Such noise can be harmful through constrained functionality or reduced efficiency. Gene regulatory networks have evolved to be robust in the face of noise. We obtain exact analytical expressions for noise dissipation in an idealised stochastic model of a gene regulatory network. We show that noise decays exponentially fast. The decay rate for RNA molecular counts is given by the integral of the tail of the cumulative distribution function of the degradation time. For proteins, it is given by the slowest rate-limiting step of RNA degradation or proteolytic breakdown. This is intuitive because memory of the chemical composition of the system is manifested through molecular persistence. The results are obtained by analysing a non-standard tandem of infinite server queues, in which the number of customers present in one queue modulates the arrival rate into the next.

PMID:35871109 | DOI:10.1007/s00285-022-01781-9

Biol Sex Differ. 2022 Jul 23;13(1):40. doi: 10.1186/s13293-022-00452-0.

ABSTRACT

BACKGROUND: KDM6A is a demethylase encoded by a gene with female-biased expression due to escape from X inactivation. Its main role is to facilitate gene expression through removal of the repressive H3K27me3 mark, with evidence of some additional histone demethylase-independent functions. KDM6A mutations have been implicated in congenital disorders such as Kabuki Syndrome, as well as in sex differences in cancer.

METHODS: Kdm6a was knocked out using CRISPR/Cas9 gene editing in F1 male and female mouse embryonic stem cells (ES) derived from reciprocal crosses between C57BL6 x Mus castaneus. Diploid and allelic RNA-seq analyses were done to compare gene expression between wild-type and Kdm6a knockout (KO) clones. The effects of Kdm6a KO on sex-biased gene expression were investigated by comparing gene expression between male and female ES cells. Changes in H3K27me3 enrichment and chromatin accessibility at promoter regions of genes with expression changes were characterized by ChIP-seq and ATAC-seq followed by diploid and allelic analyses.

RESULTS: We report that Kdm6a KO in male and female embryonic stem (ES) cells derived from F1 hybrid mice cause extensive gene dysregulation, disruption of sex biases, and specific parental allele effects. Among the dysregulated genes are candidate genes that may explain abnormal developmental features of Kabuki syndrome caused by KDM6A mutations in human. Strikingly, Kdm6a knockouts result in a decrease in sex-biased expression and in preferential downregulation of the maternal alleles of a number of genes. Most promoters of dysregulated genes show concordant epigenetic changes including gain of H3K27me3 and loss of chromatin accessibility, but there was less concordance when considering allelic changes.

CONCLUSIONS: Our study reveals new sex-related roles of KDM6A in the regulation of developmental genes, the maintenance of sex-biased gene expression, and the differential expression of parental alleles.

PMID:35871105 | DOI:10.1186/s13293-022-00452-0

Syst Rev. 2022 Jul 23;11(1):147. doi: 10.1186/s13643-022-02029-9.

ABSTRACT

BACKGROUND: The Measurement Tool to Assess systematic Reviews (AMSTAR) 2 is a critical appraisal tool for systematic reviews (SRs) and meta-analyses (MAs) of interventions. We aimed to perform the first AMSTAR 2-based quality assessment of heart failure-related studies.

METHODS: Eleven high-impact journals were searched from 2009 to 2019. The included studies were assessed on the basis of 16 domains. Seven domains were deemed critical for high-quality studies. On the basis of the performance in these 16 domains with different weights, overall ratings were generated, and the quality was determined to be “high,” “moderate,” “low,” or “critically low.”

RESULTS: Eighty-one heart failure-related SRs with MAs were included. Overall, 79 studies were of “critically low quality” and two were of “low quality.” These findings were attributed to insufficiency in the following critical domains: a priori protocols (compliance rate, 5%), complete list of exclusions with justification (5%), risk of bias assessment (69%), meta-analysis methodology (78%), and investigation of publication bias (60%).

CONCLUSIONS: The low ratings for these potential high-quality heart failure-related SRs and MAs challenge the discrimination capacity of AMSTAR 2. In addition to identifying certain areas of insufficiency, these findings indicate the need to justify or modify AMSTAR 2’s rating rules.

PMID:35871099 | DOI:10.1186/s13643-022-02029-9

Bone Marrow Transplant. 2022 Jul 23. doi: 10.1038/s41409-022-01759-7. Online ahead of print.

NO ABSTRACT

PMID:35871086 | DOI:10.1038/s41409-022-01759-7

Int Breastfeed J. 2022 Jul 23;17(1):54. doi: 10.1186/s13006-022-00496-3.

ABSTRACT

BACKGROUND: Enhancing timely breastfeeding initiation within the first hour postpartum is a goal the WHO’s Early Essential Newborn Care (EENC) and Baby-friendly Hospital Initiative (BFHI) aim to achieve globally. However, many health professionals and facilities have yet to adopt these guidelines in Cambodia, impeding timely initiation progress and maternal-infant health goals.

METHODS: This secondary data analysis used the 2014 Cambodia Demographic and Health Survey (CDHS) data of 2,729 women who gave birth in the two years preceding the survey to examine the association between place of birth and timely breastfeeding initiation. Descriptive statistics, chi-square test and multivariable logistic regression were performed. Pairwise interaction terms between place of birth and each covariate were included in the regression model to examine the presence of multiplicative effect modification.

RESULTS: The prevalence of timely breastfeeding initiation was 62.9 percent. Most women gave birth in public health facilities (72.8%) followed by private health facilities (15.9%) and at home (11.2%). The proportions of timely breastfeeding initiation differ by place of birth (p < 0.001). In the multivariable model, there was a significant interaction between place of birth and household wealth index and between place of birth and residence on timely initiation. Among women who reside in poor households, the odds of timely initiation were lower among women who gave birth at home compared to those who gave birth in public health facilities, adjusted odds ratio (95% confidence interval) 0.43 (0.21, 0.88). For urban settings, the odds of timely breastfeeding initiation were lower among women who gave birth in private health facilities compared to those who gave birth in public health facilities 0.52 (0.36, 0.75). For rural settings, the odds of timely breastfeeding initiation were lower among women who gave birth at home compared to those who gave birth in public health facilities 0.55 (0.31, 0.97).

CONCLUSIONS: Wealth index and residence moderated the association between place of birth and timely breastfeeding initiation in Cambodia. To improve breastfeeding outcomes and eliminate practices impeding timely initiation, breastfeeding advocacy programs need greater integration and follow-up in Cambodia’s health systems, including among home birth attendants and private health facilities.

PMID:35871076 | DOI:10.1186/s13006-022-00496-3