Tag: nevin manimala

Int Forum Allergy Rhinol. 2023 Oct 4. doi: 10.1002/alr.23283. Online ahead of print.

ABSTRACT

BACKGROUND: Biologics are effective for chronic rhinosinusitis with nasal polyposis (CRSwNP) by reducing type 2 inflammation. Nonresponders often require functional endoscopic sinus surgery (FESS) and represent a challenging population potentially due to non-type 2 pathophysiology. This study characterizes the histopathologic features of biologic nonresponders.

METHODS: A retrospective review of 257 CRSwNP patients undergoing FESS was conducted. The biologic nonresponder group included patients with prior biologic therapy who exhibited persistent symptoms and polyp burden. Those with CRSwNP not prescribed biologic therapy were selected as controls. Demographics, comorbidities, and structured histopathology consisting of 13 variables were collected.

RESULTS: Of 257 CRSwNP patients, 20 were on biologics prior to FESS. Fourteen patients (70.0%) received dupilumab, one (5.0%) received mepolizumab, one (5.0%) received omalizumab, and four (20.0%) tried multiple biologics. The mean age for the biologic nonresponder group was 45.8 years compared to 50.4 years for the controls. Nonresponders had a significantly increased incidence of reduced tissue eosinophilia, defined as <5 per high power field (55% vs. 31.2%, p = 0.044) and increased basement membrane thickening (100% vs. 78.1%, p = 0.017). The remaining 11 variables did not reach statistical significance.

CONCLUSION: Histopathologic analysis of biologic nonresponders demonstrates decreased eosinophilia and thickened basement membranes. These findings, particularly low tissue eosinophils, are consistent with a non-type 2 CRSwNP that may be recalcitrant to biologic therapies. Histopathologic analysis done in conjunction with FESS may aid clinicians in understanding response to biologic therapies in patients with CRSwNP who have persistent symptom burden necessitating FESS.

PMID:37792287 | DOI:10.1002/alr.23283

Dev Med Child Neurol. 2023 Oct 4. doi: 10.1111/dmcn.15759. Online ahead of print.

ABSTRACT

AIM: To determine the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in improving the occupational performance goals of children and young people with executive function deficits after acquired brain injury (ABI) (e.g. etiologies such as stroke, encephalitis, brain tumor, and traumatic brain injury).

METHOD: A replicated single-case experimental study using a randomized multiple baseline design across participants and goals was used. Three clusters of four participants (12 participants, nine males and three females, aged 8-16 years) were included. The intervention consisted of 14 individual CO-OP sessions. Each participant chose four goals; three goals were trained during the intervention sessions and a fourth goal served as the control. The Goal Attainment Scale (GAS) was used as a repeated measure to determine goal achievement while the Canadian Occupational Performance Measure (COPM) was used to identify the perceived goal achievement of children, young people, and their parents.

RESULTS: For 26 of the 35 trained goals, the intervention led to statistically significant improvements in the GAS. Perceived occupational performance and satisfaction improved significantly for the trained goals (30 out of 35 goals for the COPM performance and satisfaction of participants; 26 out 31 goals for the COPM performance of parents; 24 out of 31 goals for the COPM satisfaction of parents) and were maintained at the follow-up. Almost all COPM control goal results were significant, but these changes were not supported by the GAS measures or the statistical analysis.

INTERPRETATION: The generally positive results of this study provide evidence of the benefits of using the CO-OP approach with this population.

PMID:37792283 | DOI:10.1111/dmcn.15759

Obes Surg. 2023 Oct 4. doi: 10.1007/s11695-023-06853-3. Online ahead of print.

ABSTRACT

INTRODUCTION: After Roux-en-Y gastric bypass (RYGB), the basal metabolic rate (BMR) falls. However, it is important to know how BMR per kilogram of body weight (BMR/kg) varies in the postoperative period. The present study evaluated the changes in the BMR/kg and its correlates over 30 months after RYGB.

METHODS: Eighty adult patients of both genders who underwent RYGB agreed to participate in the study. The following evaluations were performed before surgery (n=48) and 6 (n=27), 12 (n=28), 24 (n=40), and 30 months (n=29) after surgery: anthropometry, body composition (bioelectrical impedance), metabolic analysis (indirect calorimetry), and diet (food recall). Statistical analysis was performed (p = 0.05).

RESULTS: Although BMR decreased after surgery, BMR/kg increased significantly as compared to baseline from 12 months onward, peaking at 24 months and not significantly dipping at 30 months, suggesting stabilization of BMR/kg 2 years after surgery (pre, 10.68 ± 2.33 kcal/kg; 12 months, 12.46 ± 2.85 kcal/kg; 24 months, 18.78 ± 4.81 kcal/kg; 30 months, 18.12 ± 3.69 kcal/kg; p <0.001). Regarding the variables that influenced the BMR/kg, at 12 months, they were %LBM and intake of calcium-source foods (34%); at 24 months, it was protein intake (16%); and at 30 months, it was the intake of calcium-source foods (26.7%).

CONCLUSION: RYGB is associated with a significant increase in BMR when it is adjusted to body weight from 12 to 24 months postoperatively. Among the factors involved in the increase in BMR/kg are body composition and intake of protein-rich foods.

PMID:37792252 | DOI:10.1007/s11695-023-06853-3

J Urban Health. 2023 Oct 4. doi: 10.1007/s11524-023-00785-0. Online ahead of print.

ABSTRACT

How police bias and low relatability may contribute to poor dietary quality is poorly understood. In this cross-sectional study, we analyzed data from 2021 from a cohort of n = 724 adults living in predominantly Black communities in Pittsburgh, Pennsylvania; these adults were mostly Black (90.6%), low-income (median household income $17,500), and women (79.3%). We estimated direct and indirect paths between police mistrust and dietary quality (measured by Healthy Eating Index (HEI)-2015) through perceived stress, community connectedness, and subjective social status. Dietary quality was poor (mean HEI-2015 score was 50) and mistrust of police was high: 78% of participants either agreed or strongly agreed that something they say might be interpreted as criminal by the police due to their race/ethnicity. Police bias and low relatability was associated with lower perceived social status [Formula: see text]= – 0.03 (95% confidence interval [CI]: – 0.05, – 0.01). Police bias and low relatability was marginally associated with low dietary quality β = – 0.14 (95% CI: – 0.29, 0.02). Nineteen percent of the total association between police bias and low relatability and lower dietary quality β = – 0.16 (- 0.01, – 0.31) was explained by an indirect association through lower community connectedness, or how close respondents felt with their community [Formula: see text] Police bias and low relatability may play a role in community connection, social status, and ultimately dietary disparities for Black Americans. Addressing police bias and low relatability is a continuing and pressing public health issue.

PMID:37792250 | DOI:10.1007/s11524-023-00785-0

Ann Surg Oncol. 2023 Oct 4. doi: 10.1245/s10434-023-14345-y. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-reported outcomes (PROs) have become a focus in postoperative surgical care. Unfortunately, studies using PROs can be subject to missing data, which may lead to biases or inaccurate conclusions. Multiple imputation (MI) is a statistical method for addressing missing data in clinical research. The aim of this study was to explore MI as a way to address missing data in PRO research.

METHODS: A working example of MI using real-world data was performed using the BREAST-Q PRO measure in postmastectomy reconstruction. A retrospective review of immediate tissue expander breast reconstruction patients in 2019 was conducted to compare BREAST-Q physical well-being of the chest scores between prepectoral and subpectoral cohorts at 2 weeks postoperatively. The observed dataset and three hypothetical missingness situations were created to assess how increasing missingness affects MI results.

RESULTS: Overall, 916 patients were included in the analysis. When excluding patients with missing information and solely performing analysis on the completed cases, prepectoral patients had significantly higher physical well-being of the chest scores at 2 weeks postoperatively; however, this trend was reversed with increasing missingness scenarios, where subpectoral patients had higher scores. In comparison, all MI results showed that prepectoral patients had higher scores on average compared with subpectoral patients regardless of missingness scenario.

CONCLUSIONS: MI demonstrated consistent results with increasing missingness scenarios, whereas performing analysis in higher missingness scenarios without MI led to varying results. This working example emphasizes the need for missing data methodology to be considered in PRO research.

PMID:37792204 | DOI:10.1245/s10434-023-14345-y

Environ Sci Pollut Res Int. 2023 Oct 4. doi: 10.1007/s11356-023-30147-x. Online ahead of print.

ABSTRACT

Advanced oxidation processes (AOPs) are an available solution for the rapid growth of the water pollution problem. In the present study, the process of UV-LED/WO₃ and plasma was comparatively studied to remove reactive blue 19. The photocatalyst process efficiency was analyzed by statistical Taguchi model. The effect of experimental variables of contact time, pH, catalyst dosage, and pollutant dosage was investigated and found that the model is able to explain the process due to the high value of R > 95%, and the optimum condition was at 10 mg/L of dye concentration, 1g/L of catalyst, and 180 min of detention time in which over 75% of degradation was achieved. Based on the model, the more reaction time would increase the reactor performance, while further excessive increase of catalyst dosage over 1 g/L would deteriorate the performance. Obviously, the least amount of pollutant is the most favorable for the treatment reactor. Using plasma process for dye degradation was the next step of the research. Accordingly, the removal rate achieved over 90% of 10 mg/L of initial industrial dye in durational time of 4 min, input voltage 13.5 kV, and pH = 2. The results showed the higher oxidizing capacity of plasma than the conventional photocatalyst process.

PMID:37792191 | DOI:10.1007/s11356-023-30147-x

Environ Sci Pollut Res Int. 2023 Oct 4. doi: 10.1007/s11356-023-30114-6. Online ahead of print.

ABSTRACT

Ensuring good quality of health and longevity became a topical for policymakers and academicians. Various determinants, including socio-economic factors, have been discussed in the literature. Nevertheless, the empirical studies on this issue are scanty in least-developed countries like Somalia where the health indicators are poor. In this regard, this undertaking examines the impacts of renewable energy, urbanization, environmental pollution, and economic growth on life expectancy in Somalia for the period straddling 1990-2016. The study uses a novelty machine learning method – Kernel regularized least square (KRLS) method. The empirical results indicated that renewable energy, economic growth, and urbanization are statistically significant; whereas, environmental pollution is statistically insignificant. Renewable energy, economic growth, and urbanization exert positive effects on life expectancy in Somalia and have increasing marginal effects. Besides, bidirectional causality between renewable energy and life expectancy, life expectancy and economic growth, and environmental pollution and life expectancy are established. Moreover, unidirectional causality from urbanization to life expectancy is also observed. The study suggests that a budgetary revision be made to sort out health-related concerns resulting from a lack of healthcare services and poor sanitation for improving the longevity of the people. Additionally, investments in clean energy are necessary as will improve health outcomes without compromising economic growth and life expectancy.

PMID:37792183 | DOI:10.1007/s11356-023-30114-6

Environ Sci Pollut Res Int. 2023 Oct 4. doi: 10.1007/s11356-023-30074-x. Online ahead of print.

ABSTRACT

The goal of this work is to evaluate generation and metals recycling potentials of retired mobile phones in Korea. The generation estimation is conducted with the sales&new method and statistic data, such as sales of mobile phones and amount of the subscribers. The result shows that there are 17.99 million of mobile phones retired in 2022, compared 13.12 million in 2001. Accordingly, the deduced lifetime has minimum and maximum values in 2003 and 2020, which are 2.02 and 4.33 years, compared with 4.16 years in 2022 and 2.21 years in 2001. The deduced lifetime trends to increase with the increased values of subscribers and the fluctuated values of sales. The crosscheck testifies to the veracity of the result in comparison with the actual condition. The amount and dynamic of critical metals are also calculated with the content and amount of retired mobile phones.

PMID:37792181 | DOI:10.1007/s11356-023-30074-x

Ann Rheum Dis. 2023 Oct 3:ard-2023-224154. doi: 10.1136/ard-2023-224154. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the risk of adverse events associated with colchicine or non-steroidal anti-inflammatory drug (NSAID) prophylaxis when initiating allopurinol for gout.

METHODS: We conducted two matched retrospective cohort studies in linked UK Clinical Practice Research Datalink and Hospital Episode Statistics datasets. Adults initiating allopurinol for gout with (1) colchicine or (2) NSAID prophylaxis were compared with those initiating without prophylaxis, individually matched by age, sex and propensity to receive the relevant prophylaxis. Weighted Cox proportional hazards models investigated associations between colchicine/NSAID and specified adverse events.

RESULTS: 13 945 individuals prescribed colchicine were matched to 13 945 with no prophylaxis and 25 980 prescribed NSAID to 25 980 with no prophylaxis. Adverse event incidence rates were <200/10 000 patient-years except diarrhoea (784.4; 95% CI 694.0 to 886.5) and nausea (208.1; 95% CI 165.4 to 261.7) for colchicine and angina for NSAID (466.6; 95% CI 417.2 to 521.8). Diarrhoea (HR 2.22; 95% CI 1.83 to 2.69), myocardial infarction (MI) (1.55; 95% CI 1.10, 2.17), neuropathy (4.75; 95% CI 1.20 to 18.76), myalgia (2.64; 95% CI 1.45 to 4.81), bone marrow suppression (3.29; 95% CI 1.43 to 7.58) and any adverse event (1.91, 95% CI 1.65 to 2.20) were more common with colchicine than no prophylaxis, but not nausea/vomiting (1.34; 95% CI 0.97 to 1.85). Angina (1.60; 95% CI 1.37 to 1.86), acute kidney injury (1.56; 95% CI 1.20 to 2.03), MI (1.89; 95% CI 1.44 to 2.48), peptic ulcer disease (1.67; 95% CI 1.14 to 2.44) and any adverse event (1.63; 95% CI 1.44 to 1.85) were more common with NSAID than without.

CONCLUSIONS: Adverse events were more common when allopurinol was initiated with prophylaxis, particularly diarrhoea with colchicine. Other events were uncommon, providing reassurance for patients and clinicians to enable shared decision-making.

PMID:37788904 | DOI:10.1136/ard-2023-224154

J Am Acad Psychiatry Law. 2023 Oct 3:JAAPL.230074-23. doi: 10.29158/JAAPL.230074-23. Online ahead of print.

ABSTRACT

As racial influences on forensic outcomes are identified in every aspect of practice, scholars are exploring methods to disentangle race from its historical, economic, and attitudinal antecedents. Because jurisdictions vary in these influences, definitions and data may differ among them, creating inconsistencies in analysis and policy. This retrospective database review compared differences in racial outcomes among 200 pretrial defendants, 160 Black and 40 White, exploring a wide range of socioeconomic, clinical, and forensic influences before, during, and after hospitalization. Because of the tight relationship of socioeconomic factors and race, investigators hypothesized that it would be difficult to distinguish racial influences alone. Using a confirmatory approach to data collection and a statistical analysis based in logistic regression, only differences in referral for psychological testing were identified. Application of this method based on local demographics and culture may prove useful for institutions interested in evaluating racial influences on forensic outcomes.

PMID:37788863 | DOI:10.29158/JAAPL.230074-23