Nevin Manimala

Eur J Dermatol. 2021 Aug 1;31(4):538-548. doi: 10.1684/ejd.2021.4100.

ABSTRACT

Preventing sunburn in childhood is imperative in the light of skin cancer prevention. To provide directions for targeted interventions, a better understanding of children’s sunburn and associated parental behaviours is necessary. To explore sun exposure and parent-for-child sun protection patterns and their relationship with sunburn experienced in children. An online survey was conducted among parents (n = 1,299) of children (4 to 12 years). Latent class analysis (LCA) was performed to identify parental subgroups for children’s sunburn, sun exposure and several sun protection behaviours (i.e. applying sunscreen, clothing, seeking shade) in two sun exposure settings (i.e. planned versus incidental). LCA results were validated by assessing predictions of class membership through several socio-demographic characteristics. Reported sunburn in the previous year was frequent (>40%). Four latent classes of sunburn-exposure-protection were identified. Overall, the majority of parents reported fair sun protection behaviours. While a low level of protection behaviour was not strongly reflected in lower sunburn rates among the classes, a high level of planned exposure (e.g. going to the beach) seemed to correspond with higher sunburn risk. Parents of younger children and those with more sensitive skin reported sun protection measures more frequently. Older children and those with more sensitive skin experienced more sunburn. This study contributes to current insight into children’s sunburn, based on parent-proxy reports. Although a clear differentiation in sunburn risk was not found, several variables, relevant for future interventions, were indicated. By further understanding the complexity of children’s sunburn, further research may be directed accordingly.

PMID:34642140 | DOI:10.1684/ejd.2021.4100

Eur J Dermatol. 2021 Aug 1;31(4):493-498. doi: 10.1684/ejd.2021.4121.

ABSTRACT

Psoriasis is an immune-mediated inflammatory disease and its relationship with infection has been extensively investigated. Concern for the increased prevalence of human papilloma virus (HPV) infection in patients undergoing systemic immunomodulatory or immunosuppressive therapies for psoriasis has been gradually growing among clinicians. To evaluate the prevalence of HPV in a cohort of patients with psoriasis treated with currently available systemic, conventional and biotechnological drugs. A multi-centric prospective study was conducted in the main dermatological clinical centres of central and southern Italy. Data from 588 patients (366 males and 222 females) with moderate-to-severe psoriasis, aged ≥18 years and treated with conventional and biological drugs, were collected based on a documented history of HPV infection, a positive Papanicolaou test (Pap-test) when available, and clinical evidence of genital warts reported during consultation. Overall, 18 of 588 patients (3.6% [95% CI: 1.8-4.5]) were positive for HPV or had a history of cervical cancer. Considering anamnestic and demographic data, such as gender, age, smoking, weight and body mass index, no statistically significant differences between HPV+ and HPV- patients were found. Moreover, the eradication of HPV infection was successfully achieved using conventional treatments. The prevalence of HPV infection in patients with moderate-to-severe psoriasis, undergoing systemic treatment with immunosuppressive agents or biologics, appears to be the same as that in the general Italian population, indicating that the level of infection among such patients is acceptable.

PMID:34642139 | DOI:10.1684/ejd.2021.4121

Waste Manag. 2021 Oct 9:S0956-053X(21)00504-3. doi: 10.1016/j.wasman.2021.09.015. Online ahead of print.

ABSTRACT

For the design of Municipal Solid Waste (MSW) landfills, especially in the initial stages of the project, shear strength parameters are often selected from published results or literature recommendations and results of published tests. However, when adopting MSW shear strength parameters of MSW in the literature, a great variability is present, associated with testing procedures and intrinsic regional differences in the samples. Despite the lack of standardization of observations in the literature, statistical techniques results can help identify the main factors that affect this variability and categorize the observations for better inference of the results. This research gathered 313 observations of laboratory direct shear tests results presented in 30 international published researches, addressing results from different countries and testing configurations, in order to assess data statistical behavior and propose a classification. Results showed the factors that most contribute to the observational divergences, being the main factor associated with the mechanical-morphological behavior of waste components. A reorganization of data into classes (A, B and C) according to waste compressible, incompressible and reinforcement compositions was carried out in order to group shear strength parameters in a ternary diagram. The classification of shear strength envelopes for each proposed class and different strain levels enabled the verification of a hardening behavior of MSW and a prediction of mechanical parameters.

PMID:34642074 | DOI:10.1016/j.wasman.2021.09.015

J Voice. 2021 Oct 9:S0892-1997(21)00293-9. doi: 10.1016/j.jvoice.2021.08.014. Online ahead of print.

ABSTRACT

BACKGROUND: Singing is defined as a sensory-motor phenomenon that requires particular balanced physical skills such as respiration, phonation, resonance, and articulation. The long-term average spectrum (LTAS) is widely accepted as a robust and effective tool for the assessment of voice characteristics.

METHOD: Eighty female singers within the age range of 18-30 years were considered for the study. Among 80 participants, 40 were asked to perform one traditional song from Bangla Folk representing the Baul style and another 40 were asked to perform a traditional song from Rabindra Sangeet. Recordings were done and then acoustic (LTAS) analyses were done through PRAAT software. Statistical analyses were done for the analyzed data. software package of social sciences (Version 20.0) was used.

RESULTS: The averaged LTAS curve of Baul style showed a broad peak in the frequency range between 2000 and 3600Hz and its amplitude about 16 dB, Rabindra Sangeet showed a broader peak in the frequency range between 2200 and 3800 Hz and its amplitude about 15 dB. This evidence showed the presence of singer’s formants in both singing styles.

CONCLUSION: It can be concluded from the present study that, there is an acoustical difference between the Bangla Folk and Rabindra Sangeet singing style which can be evidenced using LTAS through PRAAT.

PMID:34642073 | DOI:10.1016/j.jvoice.2021.08.014

Arch Med Res. 2021 Oct 9:S0188-4409(21)00192-2. doi: 10.1016/j.arcmed.2021.09.003. Online ahead of print.

ABSTRACT

BACKGROUND: In the last decades, obesity in general, including severe obesity (BMI ≥40 kg/m²), has increased disproportionately around the world, especially in low-income and lower-middle income regions.

AIMS: To analyze sociodemographic and clinical characteristics of people with severe obesity in Mexico, as well as their associated factors.

METHODS: A secondary analysis was carried out from the 2018-19 National Health and Nutrition Survey. Descriptive statistics and bivariate analyses by sex were used. Logistic models were estimated to identify the main factors associated with severe obesity.

RESULTS: Of the total number of people with obesity in the country (2.2 million people), 3.6% had severe obesity, with an average age of 48.2. There were statistically significant differences by sex in the variables of age group, education, socioeconomic status, health insurance, hypertension, myocardial infarction, and heart failure. Being a woman, having hypertension, and hypertension/diabetes increased the odds of severe obesity. These associations were maintained when comparing people with a BMI <40 kg/m², with those with a BMI ≥30 kg/m² and a BMI <40 kg/m².

CONCLUSIONS: Severe obesity must appear on the Mexican political agenda. Data must be produced that can direct decision-making around the promotion of healthy lifestyles, and obesity prevention, treatment, and follow-up, based in people-centered care and through intersectoral strategies, multidisciplinary management, and holistic approaches.

PMID:34642068 | DOI:10.1016/j.arcmed.2021.09.003

J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00429-0. doi: 10.1016/j.bjps.2021.08.043. Online ahead of print.

ABSTRACT

Soft tissue reconstruction in elderly patients must be rapid and reliable. The keystone island flap (KF) offers an effective solution, with low complication rates and quick recovery. This multi-centric study aims to show authors’ experience with KFs in treating soft tissue defects of trunk and limbs. Patients with soft tissue defects suitable for KF reconstruction were recruited from March 2019 to December 2019. Active inflammation and previous surgeries in the same region were considered exclusion criteria. Complications that occurred during follow-up were recorded, and their incidence pattern was assessed with the Fisher test. Seventy-two patients with mean age of 76.2 years old were selected. They presented lesions in torso (46; 63.9%) or in upper (4; 5.6%) or lower (22; 30.6%) limb regions. Fifteen (20.8%) wounds were non-oncologic lesions, and the others were oncologic lesions, mostly non-melanoma skin cancers. KF type I was carried out in 42 (58.3%) cases, KF type II-A in 13 (18%) cases, double opposed type III KF in 16 (22.2%) patients, and 1 (1.4%) case required partial flap’s undermining (IV KF). Mean post-operative recovery period was 4.3 days (range, 1-9 days). Post-surgical complications occurred in 15 (20.8%) cases, 7 (9.7%) of them were considered major complications. No statistically significant difference in complications’ incidence, nor among different surgical sites nor among KF types, was registered. Reconstructive surgeons have to adapt their work to elderly patients. The KF allows rapid operative times, low morbidity rates, and short post-operative recovery time, thus appearing as a feasible solution.

PMID:34642063 | DOI:10.1016/j.bjps.2021.08.043

Aerosp Med Hum Perform. 2021 Oct 1;92(10):815-824. doi: 10.3357/AMHP.5824.2021.

ABSTRACT

BACKGROUND: Neck pain (NP) is common among high performance aircrew, yet evidence remains insufficient to guide examination, treatment, and prevention. The purpose of this randomized pilot study was to collect baseline data for neck function for F-15E aircrew and determine efficacy and feasibility of two separate exercise protocols in measuring short-term outcomes of subjective and objective neck function in order to inform future study design. METHODS: Randomized to either progressive (PRO) or general (GEN) exercise groups were 41 F-15E aircrew. Data collection occurred at baseline, 3 wk, and 3 mo. RESULTS: At baseline, 39% of the subjects reported current NP, 79.5% reported a history of NP attributed to flying, 12.8% reported being removed from flying duties due to NP, and 10% reported receiving medical care for NP. PRO and GEN group randomization showed similar baseline assessment data. Blinding was successful and exercise logs showed 31.6% compliance with prescribed exercise regimens. There were small but statistically significant increases in neck range of motion in both groups over the course of the study. Aircrew with current NP had significantly higher F-15E flight hours. DISCUSSION: This study supports the high prevalence of NP in aircrew, yet low frequency of seeking care for NP. Future studies to assess NP prevention and treatment in aircrew require an integrated approach that includes operational exercise policy and long-term data collection in flying units with dedicated resources for assessment and analysis. Lee MS, Briggs R, Scheirer V, Kearby G, Young BA. Exercise effects on neck function among F-15E aircrew. Aerosp Med Hum Perform. 2021; 92(10):815824.

PMID:34642002 | DOI:10.3357/AMHP.5824.2021

Aerosp Med Hum Perform. 2021 Oct 1;92(10):780-785. doi: 10.3357/AMHP.5859.2021.

ABSTRACT

BACKGROUND: A growing number of symptom reports suggestive of acceleration atelectasis in fast jet aircrew have raised the question as to whether traditional guidelines on inspired gas composition remain valid. The aim of this study was to assess the effects of inspired O₂ concentration on the development of acceleration atelectasis when wearing modern anti-G garments. METHODS: There were 14 nonaircrew subjects who completed 5 centrifuge exposures to +5 G_z lasting 90 s. During exposures subjects breathed a gas mixture containing 21, 35, 45, 60, or 75% O₂. To assess the extent of atelectasis post-G_z, forced inspiratory vital capacity (FIVC), regional FIVC (EIT_FIVC), shunt, respiratory resistance, reactance, and compliance and peripheral O₂ saturation during a hypoxic exposure were measured. RESULTS: Compared with baseline, FIVC was not statistically significantly altered. EIT_FIVC was 14.4% lower after the 75% O₂ exposure only with a greater symptom reporting with higher F_IO₂ in some individuals. A significantly greater shunt (3>6%) followed the 60 and 75% O₂ exposures. O₂ concentration during G_z had no effect on respiratory resistance, reactance, compliance, or hypoxemia. DISCUSSION: There is evidence of mild acceleration atelectasis present when breathing 60% O₂, particularly in susceptible individuals, with 75% O₂ causing more obvious physiological compromise. An inspired oxygen concentration of <60% will prevent the majority of individuals from developing acceleration atelectasis. Pollock RD, Gates SD, Radcliffe JJ, Stevenson AT. Indirect measurements of acceleration atelectasis and the role of inspired oxygen concentrations. Aerosp Med Hum Perform. 2021; 92(10):780785.

PMID:34641998 | DOI:10.3357/AMHP.5859.2021

Aerosp Med Hum Perform. 2021 Oct 1;92(10):773-779. doi: 10.3357/AMHP.5876.2021.

ABSTRACT

BACKGROUND/OBJECTIVE: The COVID-19 virus has caused over 582,000 deaths in the United States to date. However, the pandemic has also afflicted the mental health of the population at large in the domains of anxiety and sleep disruption, potentially interfering with cognitive function. From an aviation perspective, safely operating an aircraft requires an airmans cognitive engagement for: 1) situational awareness, 2) spatial orientation, and 3) avionics programming. Since impaired cognitive function could interfere with such tasks, the current study was undertaken to determine if flight safety for a cohort of single engine, piston-powered light airplanes was adversely affected during a period of the pandemic (MarchOctober 2020) prior to U.S. approval of the first COVID-19 vaccine. METHODS: Airplane accidents were per the National Transportation Safety Board Access<sup/> database. Fleet times were derived using Automatic Dependent Surveillance-Broadcast. Statistics used Poisson distributions, Chi-squared/Fisher, and Mann-Whitney tests. RESULTS: Little difference in accident rate was evident between the pandemic period (MarchOctober 2020) and the preceding (JanuaryFebruary) months (19 and 22 mishaps/100,000 h, respectively). Similarly, a proportional comparison of accidents occurring in 2020 with those for the corresponding months in 2019 failed to show over-representation of mishaps during the pandemic. Although a trend to a higher injury severity (43% vs. 34% serious/fatal injuries) was evident for pandemic-period mishaps, the proportional difference was not statistically significant when referencing the corresponding months in 2019. CONCLUSION: Surprisingly, using accidents as an outcome, the study herein shows little evidence of diminished flight safety for light aircraft operations during the COVID-19 pandemic. Boyd DD. General aviation flight safety during the COVID-19 pandemic. Aerosp Med Hum Perform. 2021; 92(10):773779.

PMID:34641997 | DOI:10.3357/AMHP.5876.2021

Transl Psychiatry. 2021 Oct 11;11(1):520. doi: 10.1038/s41398-021-01649-4.

ABSTRACT

Polygenic risk for schizophrenia has been associated with lower cognitive ability and age-related cognitive change in healthy individuals. Despite well-established neuropsychological sex differences in schizophrenia patients, genetic studies on sex differences in schizophrenia in relation to cognitive phenotypes are scarce. Here, we investigated whether the effect of a polygenic risk score (PRS) for schizophrenia on childhood, midlife, and late-life cognitive function in healthy individuals is modified by sex, and if PRS is linked to accelerated cognitive decline. Using a longitudinal data set from healthy individuals aged 25-100 years (N = 1459) spanning a 25-year period, we found that PRS was associated with lower cognitive ability (episodic memory, semantic memory, visuospatial ability), but not with accelerated cognitive decline. A significant interaction effect between sex and PRS was seen on cognitive task performance, and sex-stratified analyses showed that the effect of PRS was male-specific. In a sub-sample, we observed a male-specific effect of the PRS on school performance at age 12 (N = 496). Our findings of sex-specific effects of schizophrenia genetics on cognitive functioning across the lifespan indicate that the effects of underlying disease genetics on cognitive functioning is dependent on biological processes that differ between the sexes.

PMID:34635642 | DOI:10.1038/s41398-021-01649-4