Nevin Manimala

Environ Sci Pollut Res Int. 2022 Jan 31. doi: 10.1007/s11356-021-18262-z. Online ahead of print.

ABSTRACT

The tourism industry is undoubtedly among the largest contributors to economic growth and employment generation in most economies of the world, and Africa is not an exception as outlined by World Tourism Organization (UNWTO). Thus, many countries in sub-Saharan Africa (SSA) are paying more attention to tourism development as alternative growth path to boost their economies. However, the tourism-induced growth is not void of its environmental issues. To this end, this study using recent econometrics analysis explored the nexus between tourism arrival GDP growth, urbanization, carbon dioxide emission, and foreign direct investment for oil and non-oil sub-Saharan Africa (SSA) countries, that is, to ascertain the real impacts of tourism and FDI on the environmental performance of the regions. Empirical results show that tourism, GDP growth, and FDI dampen the quality of the environment. For instance, a 1% increase in tourism activities worsens the quality of the environment by 1.09%. Interestingly, renewable energy shows statistical strength to improve environmental quality. The causality analysis resonates with the outcomes of the regression by giving credence to one-way causality between tourism and carbon dioxide emission. A similar trend of causality is seen between FDI and carbon dioxide emission and urbanization and carbon dioxide emission. Thus, as a policy prescription, strict environmental guidelines and regulations are necessary for controlling the unhealthy and undue economic activities that are suspected to impact environment negatively.

PMID:35098470 | DOI:10.1007/s11356-021-18262-z

Environ Sci Pollut Res Int. 2022 Jan 31. doi: 10.1007/s11356-021-18407-0. Online ahead of print.

ABSTRACT

People might get infected by pathogens found in urban recreational waters during water-contact activities, such as swimming, boating, bathing, and yachting. However, the persistence of pathogenic bacteria in those waters was not well documented. In this study, persistence of E. coli O157:H7 (EcO157) in 48 water samples (24 Spring samples and 24 Autumn samples) from the 3 urban recreational waters was investigated. Multivariate statistical analysis was performed to correlate survival data with water physicochemical properties and bacterial communities. Our data showed that EcO157 survived longer in Spring samples than in Autumn samples regardless of the lakes. Results revealed that recreational water physicochemical properties and bacterial community in Spring samples were different from those in Autumn samples. Mantel and Partial Mantel tests, as well as co-occurrence network analysis illustrated that EC salinity, TOC, and bacterial community were correlated with survival time (ttd) (p < 0.05). Variation partition analysis (VPA) indicated that bacterial community, EC, TOC, and TN explained about 64.81% of overall ttd variation in Spring samples, and bacterial community, EC, pH, and TP accounted for about 56.59% of overall ttd variation in Autumn samples. Structural equation model (SEM) illustrated that EC indirectly positively affected ttd through bacterial community. The correlation between bacterial community and ttd was negative in Spring samples and positive in Autumn samples. TN appeared a direct positive effect on ttd in Spring samples. TP displayed a direct negative effect on ttd in Autumn samples. Our results concluded that there was seasonal variation in environmental factors that directly or indirectly affected the survival of EcO157 in urban recreational waters.

PMID:35098467 | DOI:10.1007/s11356-021-18407-0

PM R. 2022 Jan 30. doi: 10.1002/pmrj.12780. Online ahead of print.

ABSTRACT

INTRODUCTION: Neonatal brachial plexus palsy (NBPP) results in muscle weakness and impaired somatosensory function of the arm. Current functional assessment is primarily based on clinician-elicited measurements including muscle strength and range of motion. To what extent these measures are representative of real-world arm movement is unclear. However, advances in wearable technology have made it possible to monitor real-world upper limb movement.

OBJECTIVE: To determine the feasibility of using body-worn accelerometers to remotely assess arm movements in children with NBPP.

DESIGN: Criterion standard.

SETTING: Academic medical center.

PARTICIPANTS: Nine adolescents with NBPP and nine age- and gender-matched control adolescents participated in the study. All were enrolled in school and participated in community activities.

INTERVENTIONS: Not applicable.

METHODS: Standard clinician-elicited measurements were collected. For assessing spontaneous arm movements, participants wore activity monitors during all waking hours for 7 days. Results were expressed as ratios of affected to unaffected arm motion for duration and magnitude and correlated with traditional clinic-based assessments. Spearman correlations were used to determine relationships between accelerometry results and traditional assessments. P-value <.05 was considered statistically significant.

MAIN OUTCOME MEASUREMENTS: Accelerometry measurements of arm motion and traditional clinical assessments.

RESULTS: Compared to control ratios, duration of arm movement and magnitude ratios were reduced in the NBPP group, particularly for arm magnitude due to reduced affected arm movement and an increase in unaffected arm movement. Ratios were highly correlated with shoulder function and, to a lesser extent, with elbow function.

CONCLUSIONS: Real-world arm use is an appropriate outcome measure that reflects functional recovery. We demonstrate the feasibility of wearable technology to quantify duration and intensity of spontaneous arm movement in children with NBPP. Accelerometry also allows for the association between traditional clinician-elicited assessment measures and spontaneous arm movements, demonstrating the importance of the shoulder as a focus of treatment in NBPP. This article is protected by copyright. All rights reserved.

PMID:35094498 | DOI:10.1002/pmrj.12780

Nurs Open. 2022 Jan 30. doi: 10.1002/nop2.1183. Online ahead of print.

ABSTRACT

AIMS: To explore the risk factors for poor medication adherence in older people with hypertension.

DESIGN: A cross-sectional study.

METHODS: Participants were administered with a self-report questionnaire about their demographic characteristics; additionally, their four-item Morisky Medication Adherence Scale scores were calculated. The STROBE checklist was applied as the reporting guideline for this study (File S1).

RESULTS: Univariate analysis indicated that the following five factors were statistically significantly associated with medication adherence: education level (χ² = 8.073, p = .045), co-living (χ² = 11.364, p = .010), hypertension complications (χ² = 10.968, p = .001), admission blood pressure (χ² = 8.876, p = .003), and falls (χ² = 6.703, p = .010). Multivariable binary logistic regression analysis showed that there were four statistically significant predictors, such as people who lived with spouses and offspring (OR = 3.004, p = .017), and those who had high admission blood pressure (OR = 1.910, p = .003) had a greater risk of poor medication adherence, whereas those without hypertension complications (OR = 0.591, p = .026) and those without falls (OR = 0.530, p = .046) had a lower risk.

RELEVANCE TO CLINICAL PRACTICE: We believe that these findings contribute to the identification of high-risk people with poor adherence, allowing nurses to identify people with poor adherence in a timely manner, and pay attention to the people’s medication.

PMID:35094495 | DOI:10.1002/nop2.1183

J Cosmet Dermatol. 2022 Jan 30. doi: 10.1111/jocd.14695. Online ahead of print.

ABSTRACT

INTRODUCTION: Fibroblasts and fibroblast-like cells (FLCs) are highly distributed in the dermis layer of the skin and gastrointestinal tract. A few studies have investigated the effects of color additives of cosmetic products on human fibroblasts. Therefore, this in vitro study was conducted to investigate the effects of 9 synthetic and natural dyes (indigo carmine, carmine, sunset yellow, tropaeolin, acid green 25, chlorophyllin, tartrazine, lissamine, and amaranth) on human foreskin fibroblast cells.

METHODS: MTT assay was applied to investigate the effects of dyes on human normal fibroblast cells. For investigating the possible mechanism of cytotoxicity, the effect of dyes was evaluated on parameters of cellular oxidative stress including lipid peroxidation and reactive oxygen species (ROS) as well as lactate dehydrogenase.

RESULTS: In the MTT assay, a significant reduction (p ≤ 0.05) was observed in the viability of fibroblast cells by chlorophyllin and indigo carmine at concentrations higher than 10 and 100 (μg/ml), respectively. Acid green 25 caused a significant reduction at very high concentrations (1000 and 2000 μg/ml), which was not toxic. The effect of other investigated dyes was not significant on the fibroblasts. A trend in increased cell proliferation by amaranth and carmine was observed, but this enhancement was not statistically significant. No significant changes were observed in lipid peroxidation or lactate dehydrogenase. Chlorophyllin caused a significant increase in the production of cellular ROS.

CONCLUSIONS: Indigo carmine and chlorophyllin had cytotoxicity on human fibroblasts, and thus, further studies are required on their safety of use in cosmetics and pharmaceuticals.

PMID:35094478 | DOI:10.1111/jocd.14695

Ecol Appl. 2022 Jan 30:e2551. doi: 10.1002/eap.2551. Online ahead of print.

ABSTRACT

Effective conservation requires understanding the processes that determine population outcomes. Too often, we assume that protected areas conserve wild populations despite evidence that they frequently fail to do so. Without large-scale studies, however, we cannot determine what relationships are the product of localized conditions versus general patterns that inform conservation more broadly. Leopards’ (Panthera pardus) basic ecology is well-studied but little research has investigated anthropogenic effects on leopard density at broad scales. We investigated the drivers of leopard density among 27 diverse protected areas in northeastern South Africa to understand what conditions facilitate abundant populations. We formulated ten working hypotheses that considered the relative influence of bottom-up biological factors and top-down anthropogenic factors on leopard density. Using camera-trap survey data, we fit a multi-session spatial capture-recapture model with inhomogenous density for each hypothesis and evaluated support using an information theoretic approach. The four supported hypotheses indicated that leopard density is primarily limited by human impacts, but that habitat suitability and management conditions also matter. The proportion of camera stations that recorded domestic animals, a proxy for the extent of human impacts and protected area effectiveness, was the only predictor variable present in all four supported models. Protected areas are the cornerstone of large felid conservation, but only when the human-wildlife interface is well-managed and protected areas shelter wildlife populations from anthropogenic impacts. To ensure the long-term abundance of large carnivore populations, reserve managers should recognize the ineffectiveness of “paper parks” and promote contiguous networks of protected areas that offer leopards and other large mammal populations greater space and reduced human impacts.

PMID:35094452 | DOI:10.1002/eap.2551

Dermatol Ther. 2022 Jan 29:e15341. doi: 10.1111/dth.15341. Online ahead of print.

ABSTRACT

Trichloroacetic acid-CROSS (TCA-CROSS) or chemical reconstruction of scars is an approved method in the treatment of ICE-PICK scars. Timolol is a blocker of beta-adrenergic receptors that speeds up the healing of skin wounds. In this study, for the first time, the TCA-CROSS technique was combined with the use of saline injection and topical timolol to increase the effectiveness of treatment, and reduce the number of treatment sessions and complications, and thus improve the aesthetic result. In this parallel-group split-face randomized controlled assessor and analyst-blinded study, 45 patients with atrophic acne scars were randomly divided into 3 equal groups. TCA-CROSS treatment was performed on all facial scars of patients. In group 1, before TCA-CROSS, saline was injected under the scars on one side of the face, in group 2, after TCA-CROSS, 0.5% timolol eye drops were applied on the scars on one side, and in group 3, saline was injected before TCA-CROSS. After that, timolol eye drops were applied on the scars of the same side. In all groups, the choice of control side was random. The number of scars and patient and physician satisfaction were the main variables evaluating the effectiveness of the treatment. TCA-CROSS improved scars in both control and treatment sides of all 3 groups. Although the number of scars decreased on the treatment side of groups 2 and 3, the decrease was not statistically significant. In the saline + TCA group, the number of scars on the treatment side was slightly more than on the control side. In the group of patients who used timolol, the severity and duration of scar hyperpigmentation were significantly lower (group 2 P = 0.016, group 3 P = 0.002). No permanent complication was observed in the patients. Patients’ satisfaction in groups 2 and 3 was higher in the treatment side than the control side. The combination of saline injection followed by TCA-CROSS is not recommended. Application of 0.5% timolol after TCA-CROSS caused a slight decrease in scar severity and a significant reduction of post-inflammatory hyperpigmentation (PIH) duration. So, the topical timolol makes a better result of TCA-CROSS for acne scar treatment.

PMID:35094447 | DOI:10.1111/dth.15341

Aust Dent J. 2022 Jan 30. doi: 10.1111/adj.12900. Online ahead of print.

ABSTRACT

The goal of this systematic study was to compare the survival rate (SR), marginal bone loss (MBL), and clinical complications between extra-short implants (≤6mm) and 6mm-longer implants in randomized clinical trials. A systematic electronic and manual search was performed using the PubMed, Web of Science, Scopus, and DOAJ databases. A meta-analysis was conducted to compare the SR and MBL between both groups. We have selected seventeen studies out of 1016 articles for qualitative and quantitative analysis. The data from 956 patients and 1779 implants were used with an overall mean clinical follow-up of 3.88 years ranging from 1 to 8 years. Overall, the SR of extra-short implants (93.12%) was lower than the observed in 6mm-longer implants (95.98%); however, there was no statistical significance on these findings (p>0.10). MBL analysis showed that extra-short implants and the 6mm-longer group presented an average of -0.71mm and -0.92mm after 1-year, respectively. Three years follow-up showed MBL of -0.42mm (≤6mm) and -0.43mm (>6mm); five years follow-up showed an MBL of -0.69mm (≤6mm) and -0.46mm (>6mm); and after 8 years of follow-up, it was found an MBL of -1.58mm (≤6mm) and -2.46mm (>6mm). Within the limitation of this study, the results indicated that SR of extra-short implants was similar to 6mm-longer implants. In contrast, MBL and the presence of clinical complications were observed at a lessened rate on extra-short implants. © 2022 Australian Dental Association.

PMID:35094419 | DOI:10.1111/adj.12900

Med Phys. 2022 Jan 30. doi: 10.1002/mp.15506. Online ahead of print.

ABSTRACT

PURPOSE: Magnetic resonance (MR) imaging is the gold standard in image-guided brachytherapy (IGBT) due to its superior soft-tissue contrast for target and organ-at-risk (OARs) delineation. Accurate and fast segmentation of MR images are very important for high-quality IGBT treatment planning. The purpose of this work is to implement and evaluate deep learning models for the automatic segmentation of targets and OARs in MR image-based high-dose-rate (HDR) brachytherapy for cervical cancer.

METHODS: A 2D deep learning (DL) model using residual neural network architecture (ResNet50) was developed to contour the targets (GTV, HR CTV, and IR CTV) and OARs (bladder, rectum, sigmoid, and small intestine) automatically on axial MR slices of HDR brachytherapy patients. Furthermore, two additional 2D DL models using sagittal and coronal images were also developed. A 2.5D model was generated by combining the outputs from axial, sagittal, and coronal DL models. Similarly, a 2D and 2.5D DL models were also generated for the inception residual neural network (InceptionResNetv2 (InRN)) architecture. The geometric (dice similarity coefficient (DSCs), 95^th percentile of Hausdorff distance (HD)) and dosimetric accuracy of 2D (axial only) and 2.5D (axial + sagittal + coronal) DL model generated contours were calculated and compared.

RESULTS: The mean (range) DSCs of ResNet50 across all contours were 0.674 (0.05-0.96) and 0.715 (0.26-0.96) for the 2D and 2.5D models, respectively. For InRN, these were 0.676 (0.11-0.96) and 0.723 (0.35-0.97) for the 2D and 2.5D models, respectively. The mean HD of ResNet50 across all contours was 15.6 mm (1.8-69 mm) and 12.1 mm (1.7-44 mm) for the 2D and 2.5D models, respectively. The similar results for InRN were 15.4 mm (2-68 mm) and 10.3 mm (2.7-39 mm) for the 2D and 2.5D models, respectively. The dosimetric parameters (D90) of GTV and HR CTV for manually contoured plans matched better with the 2.5D model (P > 0.6) and the results from the 2D model were slightly lower (P < 0.08). On the other hand, the IR CTV doses (D90) for all of the models were slightly lower (2D: -1.3 to -1.5 Gy and 2.5D: -0.5 to -0.6 Gy) and the differences were statistically significant for the 2D model (2D: P < 0.000002 and 2.5D: P > 0.06). In case of OARs, the 2.5D model segmentations resulted in closer dosimetry than 2D models (2D: P = 0.07-0.91 and 2.5D: P = 0.16-1.0).

CONCLUSIONS: The 2.5D deep learning models outperformed their respective 2D models for the automatic contouring of targets and OARs in MR image-based high-dose-rate (HDR) brachytherapy for cervical cancer. The InceptionResNetv2 model performed slightly better than ResNet50. This article is protected by copyright. All rights reserved.

PMID:35094405 | DOI:10.1002/mp.15506

Nurs Forum. 2022 Jan 30. doi: 10.1111/nuf.12698. Online ahead of print.

ABSTRACT

BACKGROUND: It is crucial to evaluate student academic motivation and self-directed learning (SDL) readiness while teaching online or flexibly. During the coronavirus disease 2019 epidemic, there were few investigations on the link between academic motivation and SDL readiness.

AIM: This study investigated the connection between academic motivation and SDL readiness and the three academic motivation domains’ predictive features.

METHODS: This cross-sectional study used convenience sampling to recruit 1187 nursing students from four nursing colleges in three countries. We utilized the Academic Motivation Scale College Version and Self-directed Learning Readiness Scale for Nurse Education to collect data. Descriptive and inferential statistics were employed to analyze the data.

RESULTS: Extrinsic motivation received the highest mean. Most nursing students exhibited SDL readiness, whereas “desire for learning” was rated the highest dimension of SDL readiness. We found significant differences in nursing students’ intrinsic and extrinsic motivation and amotivation between the three countries. Finally, country, gender, and intrinsic motivation were significant predictors of the nursing students’ SDL readiness.

CONCLUSION: Among Filipino, Saudi, and Thai nursing students, their SDL readiness is influenced by the intrinsic motivation domain. Therefore, nursing students with higher levels of intrinsic motivation are proactive learners for SDL.

PMID:35094399 | DOI:10.1111/nuf.12698