Nevin Manimala

J Am Acad Orthop Surg. 2021 May 17. doi: 10.5435/JAAOS-D-20-01056. Online ahead of print.

ABSTRACT

INTRODUCTION: In the proper age group, there is evidence that total hip arthroplasty (THA) has superior outcomes for the treatment of acetabular fractures compared with open reduction and internal fixation. Studies comparing patient demographics and identifying risk factors for either surgical site infections (SSIs) or periprosthetic joint infections (PJIs) are limited. Therefore, the purpose of this study was to (1) compare baseline demographics of patients who did and did not develop infections and (2) identify risk factors associated with developing either SSIs or PJIs.

METHODS: A retrospective study from 2005 to 2014 was done using a nationwide claims database. The inclusion criteria consisted of patients sustaining an acetabular fracture and treated with THA who developed either SSIs or PJIs within 90 days or 2 years, respectively, whereas patients not developing infections served as control subjects. The final study yielded 13,059 patients within the study (n = 988) and control cohort (n = 12,071). Baseline demographics were compared. A multivariate regression model calculated the odds ratio (OR) associated with development of infections. P value less than 0.002 was considered statistically significant.

RESULTS: The study demonstrated significant differences among the cohorts regarding baseline demographics. The greatest risk factors for SSIs within 90 days were morbid obesity (OR: 1.84, P < 0.0001), pathologic weight loss (OR: 1.64, P < 0.0001), and iron deficiency anemia (OR: 1.59, P = 0.001). An increased risk of PJIs was associated with iron deficiency anemia (OR: 1.97, P < 0.0001), pathologic weight loss (OR: 1.72, P < 0.0001), and morbid obesity (OR: 1.70, P = 0.0001).

CONCLUSION: This study found notable differences between baseline demographics of the cohorts and a myriad of risk factors associated with developing infections after THA for acetabular fractures. This study provides insight into orthopaedic surgeons and other healthcare professionals on the need of properly educating these high-risk patients of the potential consequences which they may encounter after their procedure.

LEVEL OF EVIDENCE: Level III.

PMID:33999867 | DOI:10.5435/JAAOS-D-20-01056

Int J Occup Saf Ergon. 2021 May 17:1-18. doi: 10.1080/10803548.2021.1928390. Online ahead of print.

ABSTRACT

We investigated the awareness of occupational hazards, attitudes and practices towards the use of personal protective equipment (PPE) among informal woodworkers of the Sokoban Wood Village in Ghana. Structured questionnaires were used to collect primary data from 355 woodworkers and analysed using descriptive statistics and logistic regression model. The results showed that the workers are aware of PPE and knew about injuries they are exposed to. Most woodworkers had a positive attitude in terms of their perception on the necessity to use PPE but had a low frequency of PPE usage. Educational level, job type, length of service and marital status are the socio-demographic characteristics which significantly influence woodworkers’ compliance with health and safety regulations. We recommend that institutions charged with enforcement of occupational health and safety regulations should extend their monitoring roles to informal workers and liaise with local companies to supply PPE to informal woodworkers at subsidised costs.

PMID:33998973 | DOI:10.1080/10803548.2021.1928390

Scand J Urol. 2021 May 17:1-7. doi: 10.1080/21681805.2021.1917652. Online ahead of print.

ABSTRACT

AIM: To evaluate the use of repeat transurethral resection of the bladder (reTURB) in stage T1 bladder cancer and its impact on treatment and survival in a Norwegian population-based cohort.

MATERIAL AND METHODS: 1130 patients registered at the Cancer Registry of Norway between 2008 and 2012 with primary urothelial T1 cancer were included. Information on surgical and medical procedures was provided by the Norwegian Patient Registry. Descriptive statistics were used to evaluate characteristics of patients receiving reTURB or not within 12 weeks from primary TURB (primTURB). Survival models identified risk factors and estimated cause-specific survival rates (CSS) adjusted for sex, age, WHO grade, concomitant cis and detrusor muscle at primTURB and treatment.

RESULTS: The 648 (57%) T1 patients with reTURB were significantly younger and had more WHO high grade tumors compared to those without reTURB. Of 275 patients without detrusor muscle at primTURB 114 (41%) had no reTURB. Of reTURB patients, 45 (7%) had muscle invasive tumor, 110 (17%) T1 and 378 (58%) Ta, cis or T0. Two-thirds of 81 patients receiving early cystectomy after reTURB had T1 or muscle invasive bladder cancer at reTURB. ReTURB did not impact adjusted CSS, but patients with T1 at reTURB had significantly lower CSS than those with < T1 conditions.

CONCLUSIONS: Almost half of the T1 patients did not undergo reTURB as recommended in guidelines. We show that reTURB makes the histology result more reliable with impact on both treatment and survival. Our results support the use of reTURB as recommended by EAU guidelines.

PMID:33998957 | DOI:10.1080/21681805.2021.1917652

Int J Phytoremediation. 2021 May 12:1-9. doi: 10.1080/15226514.2021.1920571. Online ahead of print.

ABSTRACT

Hyperaccumulator-cash crop intercropping remediation is a research hotspot for heavy metal contaminated farmland, but few studies evaluated its feasibility based on practice. Field experiments and survey statistics were conducted to obtain parameters of Pteris vittata-Citrus reticulata/Zea mays intercropping, and potential of intercropping remediation was evaluated based on remediation efficiency and economic benefits. The results showed that intercropping hyperaccumulator with cash crop (especially herbs) had a certain negative effect on remediation efficiency because of the influence on planting density and harvest times of hyperaccumulator; while trees could partly alleviate this effect. Until achieving the predetermined target, the net remediation cost of P. vittata-Z. mays was 18.2 $/g As, followed by P. vittata monoculture (13.3 $/g) and P. vittata-C. reticulata (8.6 $/g). Based on the proposed evaluation model, nealy half of the P. vittata intercropping modes had low economic benefits, insufficient to compensate the cost of sacrificing remediation efficiency. Based on the data from two soil remediation projects, when net income of cash crops intercropped with As-hyperaccumulators exceeded 5865/1607 $/hm² (herbs/trees), the economic benefit of intercropping will be relatively obvious. Therefore, cash crops should be considered from three aspects: planting conditions, spatial allocation and economic benefits. Novelty statement: This work analyzed remediation efficiency and economic benefits of intercropping remediation. An economic benefit evaluation model was established to evaluate intercropping remediation modes. The selection principle and net income threshold of cash crops in intercropping was put forward for the first time.[Figure: see text]HighlightsThe selection principle of cash crops in intercropping remediation was put forward.An evaluation model of P. vittata intercropping remediation was established.The net cost of extracting 1.0 g of soil As in each remediation mode was proposed.Net income of herb/tree intercropped with P. vittata should exceed 5865/1607 $/hm².

PMID:33998931 | DOI:10.1080/15226514.2021.1920571

J Aging Health. 2021 May 17:8982643211019499. doi: 10.1177/08982643211019499. Online ahead of print.

ABSTRACT

Objective: We explore how upper and lower body functional ability of older adults and their partners relate to affect in later life. Methods: Data regarding own and partner’s upper and lower body functional abilities were reported by 1767 married/partnered persons aged 57-83. Using multilevel modeling to account for nesting within couples, we examined the impact of a respondent’s own functional abilities, their perception of their partner’s abilities, and the interaction of respondent’s and perceived partner’s abilities on respondent’s positive and negative affect. Results: Higher upper and lower body ability of both respondents and partners were associated with higher positive and lower negative affect. Moderating effects demonstrated a protective role of respondents’ ability on affect when their partners experienced lower ability. Discussion: There is a potential compensatory relationship between older couples adapting to functional changes; it is important to support the functional abilities of both partners in couples to maximize psychological well-being.

PMID:33998913 | DOI:10.1177/08982643211019499

Comput Methods Biomech Biomed Engin. 2021 May 17:1-13. doi: 10.1080/10255842.2021.1927000. Online ahead of print.

ABSTRACT

A diffusion tensor imaging (DTI) -based statistical micromechanical model was developed to study the effect of axonal fiber architecture on the inter- and intra-regional mechanical heterogeneity of the white matter. Three characteristic regions within the white matter, i.e., corpus callosum, brain stem, and corona radiata, were studied considering the previous observations of locations of diffuse axonal injury. The embedded element technique was used to create a fiber-reinforced model, where the fiber was characterized by a Holzapfel hyperelastic material model with variable dispersion of axonal orientations. A relationship between the fractional anisotropy and the dispersion parameter of the hyperelastic model was used to introduce the statistical DTI data into the representative volume element. The FA-informed statistical micromechanical models of three characteristic regions of white matter were developed by deriving the corresponding probabilistic measures of FA variations. Comparison of the model predictions and experimental data indicated a good agreement, suggesting that the model could reasonably capture the inter-regional heterogeneity of white matter. Moreover, the standard deviations of experimental results correlated well with the model predictions, suggesting that the model could capture the intra-regional mechanical heterogeneity for different regions of white matter.

PMID:33998911 | DOI:10.1080/10255842.2021.1927000

Cleft Palate Craniofac J. 2021 May 17:10556656211002675. doi: 10.1177/10556656211002675. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify differences between asymptote- and rate-based methods for estimating age and size at growth cessation in linear craniofacial measurements.

DESIGN: This is a retrospective, longitudinal study. Five linear measurements were collected from lateral cephalograms as part of the Craniofacial Growth Consortium Study (CGCS). Four estimates of growth cessation, including 2 asymptote- (GC_asym, GC_err) and 2 rate-based (GC_abs, GC_10%) methods, from double logistic models of craniofacial growth were compared.

PARTICIPANTS: Cephalometric data from participants in 6 historic longitudinal growth studies were included in the CGCS. At least 1749 individuals (870 females, 879 males), unaffected by craniofacial anomalies, were included in all analyses. Individuals were represented by a median of 11 images between 2.5 and 31.3 years of age.

RESULTS: GC_asym consistently occurred before GC_err and GC_abs consistently occurred before GC_10% within the rate-based approaches. The ordering of the asymptote-based methods compared to the rate-based methods was not consistent across measurements or between males and females. Across the 5 measurements, age at growth cessation ranged from 13.56 (females, nasion-basion, GC_asym) to 24.39 (males, sella-gonion, GC_err).

CONCLUSIONS: Adolescent growth cessation is an important milestone for treatment planning. Based on our findings, we recommend careful consideration of specific definitions of growth cessation in both clinical and research settings since the most appropriate estimation method may differ according to patients’ needs. The different methods presented here provide useful estimates of growth cessation that can be applied to raw data and to a variety of statistical models of craniofacial growth.

PMID:33998905 | DOI:10.1177/10556656211002675

Cannabis Cannabinoid Res. 2021 May 11. doi: 10.1089/can.2021.0014. Online ahead of print.

ABSTRACT

Background: Beside others, neuroinhibitory and sedative effects of CBD were documented. Aim and Methods: The aim of the study was to assess the dose-related effects of CBD premedication on the course of isoflurane anesthesia. Wistar rats were pretreated with different doses of CBD 1 h before isoflurane anesthesia. In the pretreatment, animals were given CBD at doses of 100, 20, 10, or 2 mg kg^-1. Before the fifth (control) anesthesia, the animals were given only mid-chain triglyceride oil, which served as a solvent in the CBD formulation. The induction time was determined, and on awakening, the time to appearance of the flexion reflex and the recovery from anesthesia were determined. Results: Statistical analysis showed a significantly shorter induction time if animals were pretreated with 20 mg kg^-1 CBD. In addition, pretreatment with 100 mg kg^-1 CBD resulted in a prolonged induction time, while on awakening, delayed appearance of reflexes and prolonged recovery from anesthesia compared to pretreatment with 20 mg kg^-1 CBD were observed. Conclusions: The results indicate that the influence of CBD on the course of isoflurane anesthesia depends on the dose and can reduce the induction time. Although this study was performed in laboratory rats, in clinical practice, these data should be considered when CBD-treated patients undergo isoflurane anesthesia.

PMID:33998903 | DOI:10.1089/can.2021.0014

Cannabis Cannabinoid Res. 2021 Apr 16. doi: 10.1089/can.2020.0107. Online ahead of print.

ABSTRACT

Background: The endocannabinoid system is present in multiple organ systems and is involved in smooth muscle regulation, immune function, neuroendocrine modulation, and metabolism of tissues. Limited data are available regarding the presence and role of this system in reproductive tissues. Components of the endocannabinoid system have been identified in myometrial and placental tissues. However, no study has investigated differential expression of the endocannabinoid system in labor. Objectives: The purpose of this study was to identify and quantify two components of the endocannabinoid system, the CB₁ cannabinoid receptor and cannabinoid receptor interacting protein 1a (CRIP1a) in uterine and placental tissues, and to determine if there is differential expression in tissues exposed to labor. We hypothesized that CB₁ cannabinoid receptor concentration would be altered in uterine and placental tissue exposed to labor compared with tissues not exposed to labor. Study Design: Uterine and placental tissue samples were collected in nine laboring and 11 nonlaboring women undergoing cesarean delivery. CB₁ cannabinoid receptor and CRIP1a presence and quantification were evaluated using western blot, immunohistochemistry, and real-time quantitative polymerase chain reaction. Statistical comparisons of laboring and nonlaboring subjects were made for uterine and placental tissue using a Mann-Whitney test. Results: Immunohistochemistry demonstrated positive staining for CB₁ cannabinoid receptors and CRIP1a in uterine tissue. The protein abundance of CB₁ cannabinoid receptor in uterine tissue was significantly lower in tissues exposed to labor (p=0.01). The protein abundance of CRIP1a was lower in uterine tissue exposed to labor but did not reach statistical significance (p=0.06). mRNA expression of CB₁ cannabinoid receptor (p=0.20) and CRIP1a (p=0.63) did not differ in labored compared with nonlabored uterine tissues. Conclusions: Our findings of diminished protein density of CB₁ cannabinoid receptor in uterine tissue exposed to labor support the hypothesis that the endocannabinoid system plays a role in parturition. Our data add to the growing body of evidence indicating the endocannabinoid system is of importance for successful reproduction and support the need for additional research investigating this complex system as it pertains to labor. ClinicalTrials.gov ID: NCT03752021.

PMID:33998898 | DOI:10.1089/can.2020.0107

Cannabis Cannabinoid Res. 2021 Feb 15. doi: 10.1089/can.2020.0133. Online ahead of print.

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of mortality in the United States. Due to the ongoing legalization of cannabis, its acceptance, availability, and use in the in-patient population are on the rise. In this retrospective study, we investigated the association of cannabis use with important outcomes in COPD hospitalizations. Methods: The National Inpatient Sample (NIS) data were analyzed from 2005 to 2014. The primary outcome of interest was the trends and outcomes of cannabis use among COPD hospitalizations, including in-hospital mortality, pneumonia, sepsis, and respiratory failure. Results: We identified 6,073,862 hospitalizations, 18 years of age or older, with COPD using hospital discharge codes. Of these, 6,049,316 (99.6%) were without cannabis use, and 24,546 (0.4%) were admitted with cannabis use. The majority of COPD hospitalizations with cannabis use were aged 50-64 (60%). Cannabis use was associated with lower odds of in-hospital mortality (odds ratio [OR] 0.624 [95% confidence interval (CI) 0.407-0.958]; p=0.0309) and pneumonia (OR 0.882 [95% CI 0.806-0.964]; p=0.0059) among COPD hospitalizations. Cannabis use also had lower odds of sepsis (OR 0.749 [95% CI 0.523-1.071]; p=0.1127) and acute respiratory failure (OR 0.995 [95% CI 0.877-1.13]; p=0.9411), but it was not statistically significant. Conclusions: Among hospitalized patients with a diagnosis of COPD, cannabis users had statistically significant lower odds of in-hospital mortality and pneumonia compared to noncannabis users. The association between cannabis use and these favorable outcomes deserves further study to understand the interaction between cannabis use and COPD.

PMID:33998884 | DOI:10.1089/can.2020.0133