Tag: nevin manimala

Osteoarthritis Cartilage. 2023 Sep 9:S1063-4584(23)00912-3. doi: 10.1016/j.joca.2023.08.012. Online ahead of print.

ABSTRACT

OBJECTIVE: To forecast the number of primary total shoulder replacements (TSR) in Australia to the year 2035, and associated costs.

METHODS: De-identified TSR data for 2009-2019 were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Population data, including population projections to 2035, were obtained from the Australian Bureau of Statistics. Three forecasting scenarios were used: constant TSR rates from 2019 onwards (Scenario 1, conservative); continued growth in TSR rates using negative binomial regression (Scenario 2, exponential); and continued growth using negative binomial regression with monotone B-splines (Scenario 3, moderate). Healthcare costs were estimated using TSR projections and average procedure costs, inflated to 2035 Australian dollars.

RESULTS: The use of TSR increased by 242% in Australia from 2009-2019 (from 1,983 to 6,789 procedures for people ≥40 years). Under Scenario 1, the incidence of TSR is conservatively projected to rise to 9,676 procedures by 2035 (43% increase from 2019), at a cost of $AUD 312.6 million to the health system. Under Scenario 2, TSR incidence would increase to 45,295 procedures by 2035 (567% increase), costing $AUD 1.46 billion. Under Scenario 3, 28,257 TSR procedures are forecast in 2035 (316% increase) at a cost of $913 million.

CONCLUSIONS: Recent growth in TSR likely relates to prosthesis improvements, greater surgeon proficiency, and expanded clinical indications. Under moderate and exponential scenarios that consider rising TSR rates and population projections, Australia would face three- to five-fold growth in procedures by 2035. This would have profound implications for the healthcare budget, clinical workforce, and infrastructure.

PMID:37696387 | DOI:10.1016/j.joca.2023.08.012

J Equine Vet Sci. 2023 Sep 9:104917. doi: 10.1016/j.jevs.2023.104917. Online ahead of print.

ABSTRACT

The study aimed to assess Apgar scores and collect data on clinical, hemato-biochemical, and venous blood gas parameters in seven mules during their first 48h of life. Apgar scores, heart rate (HR), respiratory rate (RR), body temperature (BT), body weight (BW), time to achieve sternal recumbency, stand, nurse, and pass meconium were recorded. Blood samples were collected at birth (T0), 6 (T6), 12 (T12), 24 (T24), 48 (T48)h of life. Data distribution was verified and differences in laboratory parameters over time assessed. One foal had an Apgar score of 6/8, thus excluded from the statistical analysis. Three foals had an Apgar score of 7/8, three had a score of 8/8. All foals showed suckling reflex within 20 min and raised the head within 1 min; six foals reached sternal recumbency within 2 min. Times to stand and nurse were 38.7±13.4 and 72.3±30.5 min, respectively. Five foals passed meconium spontaneously in 416.3±401.8 min. The mean HR, RR, and BT values were 92±16.1 bpm, 50.2±5.9 bpm, and 37.6±0.3°C, respectively. Creatinine and lactate decreased from birth to 48h. Blood glucose increased from 12h. Mg increased from 12 to 24h. Compared to horses and donkeys, mules showed an intermediate BW, shorter time to stand and nurse, longer time to pass meconium, intermediate HR and lower RR. Compared to donkey mules showed lower BT. Other dissimilarities from the parental species were found in laboratory parameters. Our findings emphasize the need for reference ranges for a comprehensive evaluation of newborn mules.

PMID:37696367 | DOI:10.1016/j.jevs.2023.104917

Ann Thorac Surg. 2023 Sep 9:S0003-4975(23)00932-3. doi: 10.1016/j.athoracsur.2023.08.031. Online ahead of print.

ABSTRACT

BACKGROUND: To assess the safety and efficacy of bronchopleural fistulae closure with Amplatzer occluder devices through our experience of over 14 years.

METHODS: Retrospective data review of patients from Rabin Medical Center who underwent Amplatzer occluder device placement between March 2007 and September 2021 for bronchopleural fistulae closure.

RESULTS: In total, 72 patients had 83 Amplatzer occluder devices implanted for bronchopleural fistulae closure. The median age was 65.5 (Q1, Q3; 56.0, 72.3). The primary diseases were lung malignancy and thoracic infection, 48(66.7%) and 9 (12.5%), respectively. Bronchopleural fistulae developed mainly following pneumonectomy (40.3%) and lobectomy (33.3%) with a median time from surgery to Amplatzer placement of 3.9 months (IQR 1.4 to 16.4). We encountered no procedural or immediate post-procedural complications or deaths. Six months following Amplatzer insertion, there were 7 (8.4%)Amplatzer removals and 11 (15.3%) fistula-related deaths.

CONCLUSIONS: Amplatzer occluders are a safe modality for non-surgical bronchopleural fistulae management with ease of placement under moderate sedation and flexible bronchoscopy with good short- and long-term effectivity.

PMID:37696352 | DOI:10.1016/j.athoracsur.2023.08.031

Environ Res. 2023 Sep 9:117107. doi: 10.1016/j.envres.2023.117107. Online ahead of print.

ABSTRACT

Previous studies found inconsistent associations between ambient temperature during pregnancy and the risk of preeclampsia. If such associations are causal, they may impact the future burden of preeclampsia in the context of climate change. We used a historical cohort of 129,009 pregnancies (5074 preeclampsia cases) from southern Israel that was merged with temperature assessments from a hybrid satellite-based exposure model. Distributed-lag and cause-specific hazard models were employed to study time to all preeclampsia cases, followed by stratification according to early (≤34 weeks) and late (>34 weeks) onset disease and identify critical exposure periods. We found a positive association between temperature and preeclampsia during gestation, which was stronger in the 3rd trimester. For example, during week 33, compared to the reference temperature of 22.4 °C, the cause-specific hazard ratio (HR_CS) of preeclampsia was 1.01 (95% confidence interval (CI): 1.01-1.02) when exposed to 30 °C, 1.05 (95%CI: 1.03-1.08) at 35 °C, and 1.07 (95%CI: 1.04-1.10) at 37 °C. The associations existed with both early- and late-onset preeclampsia; however, the associations with the early-onset disease were somewhat stronger, limited to the first weeks of pregnancy and the third trimester, and with larger confidence intervals. The HR_CS for early preeclampsia onset, when exposed to 37 °C compared to 22.4 °C during week 33, was 1.12 (95%CI: 0.96-1.30), and for late-onset preeclampsia, the HR_CS was 1.09 (95%CI: 1.05-1.13). To conclude, exposure to high temperatures at the beginning and, particularly, the end of gestation is associated with an increased risk of preeclampsia in southern Israel.

PMID:37696321 | DOI:10.1016/j.envres.2023.117107

Psychol Sport Exerc. 2023 Sep 9:102536. doi: 10.1016/j.psychsport.2023.102536. Online ahead of print.

ABSTRACT

BACKGROUND: Children naturally seek risk in play and adventurous play outdoors confers many benefits, including the potential to increase moderate-to-vigorous physical activity (MVPA). This study aimed to investigate the relationship between parent attitudes to risk and injury, and their elementary school-aged child’s daily adventurous play and MVPA.

METHODS: A panel sample of 645 Australian parents/guardians completed an online survey consisting of several validated measures of risk and injury attitudes, and physical activity and play behaviour. Data were analysed via descriptive statistics, univariate and multivariable regressions using Stata 17. A series of exploratory univariate logistic regressions were conducted, followed by a series of multivariable logistic regressions fitted to test the association between parent risk and injury attitudes and (i) children’s MVPA, (ii) active play and (iii) adventurous play, while adjusting for socio-demographic factors.

RESULTS: Most adult participants (81%) were female. The mean age of the child participants (53% male) was 8.6 years (SD = 2.4). On average, parents were positive about children’s engagement with risk, however, 78% of parents had low tolerance of risk when presented with specific play scenarios, and attitudes towards injuries varied, with mothers more concerned than fathers. After adjusting for confounders, children with parents who were tolerant of risk in play were more likely to meet the MVPA guideline of ≥60 min daily (OR 2.86, CI: 1.41, 5.82, p < 0.004) and spend more time playing adventurously (OR 3.03, CI: 1.82, 5.06, p < 0.001). Positive associations for MVPA and adventurous play were observed across all models examining parent attitudes to risk and injury. Younger children engaged in more play and physical activity, however, more positive parent attitudes appeared to moderate the age-related influences.

CONCLUSIONS: We found a divergence between the outcomes parents desire for their children through engagement with risk and the play activities they are comfortable with in practice. Parent attitudes to risk and injury are potentially modifiable factors that may increase children’s affordances for adventurous play and physical activity. Parent education interventions that provide practical approaches to address injury concerns and support children’s risk-taking in play outdoors are recommended.

PMID:37696315 | DOI:10.1016/j.psychsport.2023.102536

Urology. 2023 Sep 9:S0090-4295(23)00778-1. doi: 10.1016/j.urology.2023.08.031. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the risk of persistent opioid use following various urologic procedures in adolescents and young adults.

MATERIALS AND METHODS: The TriNetX LLC Diamond Network was queried for patients aged 13 to 21 years who underwent pyeloplasty, hypospadias repair, inguinal hernia repair, inguinal orchiopexy, hydrocelectomy, or circumcision. Cohorts of patients prescribed and not prescribed postoperative opioids were created and propensity-matched for age, race/ethnicity, psychiatric diagnoses, and preoperative pain diagnoses. The primary outcome was new persistent opioid use, defined as new opioid use 3-9 months after index procedure without another surgery requiring anesthesia during the post-operative timeframe.

RESULTS: Of 32,789 patients identified, 66.0% received a postoperative opioid prescription. After propensity score matching for each procedure, 18,416 patients were included: 197 for pyeloplasty, 469 for hypospadias repair, 1,818 for inguinal hernia repair, 2,664 for inguinal orchiectomy, 534 for hydrocelectomy, and 3,526 for circumcision. Overall, 0.41% of patients who did not receive postoperative opioids developed new persistent opioid use, whereas 1.69% of patients who received postoperative opioids developed new persistent opioid use (p<0.05). Patients prescribed postoperative opioids had statistically higher odds of developing new persistent opioid use for hypospadias repair (RR: 17.0; 95% CI: 2.27-127.2), inguinal orchiectomy (RR: 3.46; 95% CI: 1.87-6.4), inguinal hernia repair (RR: 2.18; 95% CI: 1.07-4.44), and circumcision (RR: 4.83; 95% CI: 2.60-8.98).

CONCLUSIONS: The use of postoperative opioids after urological procedures in adolescents and young adults is associated with a significant risk of developing new persistent opioid use.

PMID:37696308 | DOI:10.1016/j.urology.2023.08.031

JMIR Pediatr Parent. 2023 Sep 11;6:e47035. doi: 10.2196/47035.

ABSTRACT

BACKGROUND: The Structured E-Parenting Support (STEPS) app provides support for parents of children with elevated hyperactivity, impulsivity, inattention, and conduct problems who are awaiting clinical assessment. STEPS will be evaluated in a randomized controlled trial (RCT) within the Online Parent Training for the Initial Management of ADHD Referrals (OPTIMA) research program in the United Kingdom. Phase 1 of the OPTIMA tested the feasibility of participants’ recruitment and the app’s usability.

OBJECTIVE: This study aimed to adapt a digital routine clinical monitoring system, myHealthE, for research purposes to facilitate waitlist recruitment; test using remote methods to screen and identify participants quickly and systematically; pilot the acceptability of the recruitment and assessment protocol; and explore the usability of STEPS.

METHODS: myHealthE was adapted to screen patients’ data. Parents’ and clinicians’ feedback on myHealthE was collected, and information governance reviews were conducted in clinical services planning to host the RCT. Potential participants for the observational feasibility study were identified from new referrals using myHealthE and non-myHealthE methods. Descriptive statistics were used to summarize the demographic and outcome variables. We estimated whether the recruitment rate would meet the planned RCT sample size requirement (n=352). In addition to the feasibility study participants, another group of parents was recruited to assess the STEPS usability. They completed the adapted System Usability Scale and responded to open-ended questions about the app, which were coded using the Enlight quality construct template.

RESULTS: Overall, 124 potential participants were identified as eligible: 121 (97.6%) via myHealthE and 3 (2.4%) via non-myHealthE methods. In total, 107 parents were contacted, and 48 (44.9%) consented and were asked if, hypothetically, they would be willing to participate in the OPTIMA RCT. Of the 28 feasibility study participants who provided demographic data, 21 (75%) identified as White. Their children had an average age of 8.4 (SD 1.7) years and 65% (31/48) were male. During the primary recruitment period (June to July 2021) when 45 participants had consented, 38 (84%) participants agreed hypothetically to take part in the RCT (rate of 19/mo, 95% CI 13.5-26.1), meeting the stop-go criterion of 18 participants per month to proceed with the RCT. All parents were satisfied or very satisfied with the study procedures. Parents (n=12) recruited to assess STEPS’ usability described it as easy to navigate and use and as having an attractive combination of colors and visual design. They described the content as useful, pitched at the right level, and sensitively presented. Suggested improvements included adding captions to videos or making the recorded reflections editable.

CONCLUSIONS: Remote recruitment and study procedures for testing a parenting intervention app are feasible and acceptable for parents. The parents felt that STEPS was a useful and easy-to-use digital parenting support tool.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s40814-021-00959-0.

PMID:37695667 | DOI:10.2196/47035

J Biomol Struct Dyn. 2023 Sep 11:1-19. doi: 10.1080/07391102.2023.2256876. Online ahead of print.

ABSTRACT

Cancer is one of the most prominent causes of death worldwide and tubulin is a crucial protein of cytoskeleton that maintains essential cellular functions including cell division as well as cell signalling, that makes an attractive drug target for cancer drug development. 1,3,4-oxadiazoles disrupt microtubule causing G2-M phase cell cycle arrest and provide anti-proliferative effect. In this study, field-based 3D-QSAR models were developed using 62 bioactive anti-tubulin 1,3,4-oxadiazoles. The best model characterized by PLS factor 7 was rigorously validated using various statistical parameters. Generated 3D-QSAR model having high degree of confidence showed favourable and unfavourable contours around 1,3,4-oxadiazole core that assisted in defining proper spatial positioning of desired functional groups for better bioactivity. A five featured pharmacophore model (AAHHR_1) was developed using same ligand library and validated through enrichment analysis (BEDROC160.9 value = 0.59, Average EF 1% = 27.05, and AUC = 0.74). Total 30,212 derivatives of 1,3,4-oxadiazole obtained from PubChem database was prefiltered through validated pharmacophore model and docked in XP mode on binding cavity of tubulin protein (PDB code: 1SA0) which led into the identification of 11 HITs having docking scores between -7.530 and -9.719 kcal/mol while the reference compound Colchicine exerted docking score of -7.046 kcal/mol. Following the analysis of MM-GBSA and ADME studies, HIT1 and HIT4 emerged as the two promising hits. To verify their thermodynamic stability at the target site, molecular dynamic simulations were carried out. Both HITs were further subjected to DFT analysis to determine their HOMO-LUMO energy gap for ensuring their biological feasibility. Finally, molecular docking based structural exploration for 1,3,4-oxadiazoles to set up a lead of Formula I for further advancements of tubulin polymerization inhibitors as anti-cancer agents.Communicated by Ramaswamy H. Sarma.

PMID:37695635 | DOI:10.1080/07391102.2023.2256876

J Cardiovasc Med (Hagerstown). 2023 Sep 6. doi: 10.2459/JCM.0000000000001536. Online ahead of print.

ABSTRACT

AIMS: Data regarding the risk of incident pericarditis in coronavirus disease 2019 (COVID-19) recovered patients are lacking. We determined the risk of incident pericarditis after COVID-19 infection by performing a systematic review and meta-analysis of available data.

METHODS: Following the PRISMA guidelines, we searched MEDLINE and Scopus to locate all articles published up to 11 February 2023 reporting the risk of incident pericarditis in patients who had recovered from COVID-19 infection compared to noninfected patients (controls) defined as those who did not experience the disease over the same follow-up period. Pericarditis risk was evaluated using the Mantel-Haenszel random effects models with hazard ratio (HR) as the effect measure with 95% confidence interval (CI) while heterogeneity was assessed using Higgins I2 statistic.

RESULTS: Overall, 16 412 495 patients (mean age 55.1 years, 76.8% males), of whom 1 225 715 had COVID-19 infection, were included. Over a mean follow-up of 9.6 months, pericarditis occurred in 3.40 (95% CI: 3.39-3.41) out of 1000 patients who survived COVID-19 infection compared with 0.82 (95% CI: 0.80-0.83) out of 1000 control patients. Recovered COVID-19 patients presented a higher risk of incident pericarditis (HR: 1.95, 95% CI: 1.56-2.43, I2: 71.1%) compared with controls. Meta-regression analysis showed a significant direct relationship for the risk of incident pericarditis using HT (P = 0.02) and male sex (P = 0.02) as moderators, while an indirect association was observed when age (P = 0.01) and the follow-up length (P = 0.02) were adopted as moderating variables.

CONCLUSIONS: Recovered COVID-19 patients have a higher risk of pericarditis compared with patients from the general population.

PMID:37695617 | DOI:10.2459/JCM.0000000000001536

Eur J Gastroenterol Hepatol. 2023 Sep 11. doi: 10.1097/MEG.0000000000002638. Online ahead of print.

ABSTRACT

Restorative proctocolectomy (RPC) is the most common surgical procedure to restore gastrointestinal continuity after surgical resection of the colon and rectum. Pouchitis is a common complication with several different modalities that can be used to aid diagnosis. This systematic review and meta-analysis aimed at exploring the sensitivity and specificity these diagnostic modalities. The medical literature was searched using MEDLINE, EMBASE and EMBASE classic and PubMed from 1978 to June 2022. We calculated descriptive statistics using sensitivity, specificity, and false-positive rate of the primary studies and also their positive and negative likelihood ratios, and their diagnostic odds ratios. The screen found 5477 records with 13 studies being included. Faecal lactoferrin was found to have the highest pooled sensitivity and specificity of 98% and 88% respectively with imaging modalities coming in second and faecal calprotectin third with pooled sensitivities and specificities of 87% and 79% and 74% and 81% respectively. Faecal biomarkers particularly lactoferrin and imaging modalities may have an important role to play in diagnosing pouchitis. Importantly due to delays in availability of pouchoscopy, our data supports early ordering of these tests to help delineate from other causes. Further studies are required with larger cohort sizes to further validate these tests.

PMID:37695613 | DOI:10.1097/MEG.0000000000002638