Tag: nevin manimala

Environ Monit Assess. 2023 Jun 12;195(7):835. doi: 10.1007/s10661-023-11440-1.

ABSTRACT

The rebirth of the Belt and Road Initiative (BRI) programme have necessitated the study as it has a vast potential to promote economic growth, yet, marred with numerous energy use and ecological concerns. The article is the first to comparatively examine the impact of economic variables on consumption-based CO₂ emissions in the BRI and the Organisation for Economic Co-operation and Development (OECD) countries by testing the Environmental Kuznets Curve (EKC) and the Pollution Haven Hypothesis (PHH). The Common Correlated Effects Mean Group (CCEMG) estimates the results. Income (GDP) and GDP² positively and negatively impact CO₂ emissions in the three panels, validating the EKC. Foreign direct investment (FDI) significantly affects CO₂ emissions for the global and BRI panels, supporting the PHH. However, the PHH is refuted for the OECD panel as the impact of FDI on CO₂ emissions is negative and statistically significant. GDP and GDP² decline by 0.029% and 0.0446%, respectively, for BRI countries, compared to OECD countries. It is recommended that BRI countries enact new and stringent environmental laws and use more tidal energy, solar energy, wind power, bioenergy, and hydropower instead of fossil fuels, for the sustainable attainment of higher economic growth, devoid of pollution.

PMID:37306854 | DOI:10.1007/s10661-023-11440-1

AIDS Behav. 2023 Jun 12. doi: 10.1007/s10461-023-04097-x. Online ahead of print.

ABSTRACT

In a randomised trial, we found that integrated maternal HIV and infant health services through the end of breastfeeding were significantly associated with the primary outcome of engagement in HIV care and viral suppression at 12 months postpartum, compared to the standard of care. Here, we quantitatively explore potential psychosocial modifiers and mediators of this association. Our findings suggest that the intervention was significantly more effective among women experiencing an unintended pregnancy but did not improve outcomes among women reporting risky alcohol use. Although not statistically significant, our results suggest that the intervention may also be more effective among women experiencing higher levels of poverty and HIV-related stigma. We observed no definitive mediator of the intervention effect, but women allocated to integrated services reported better relationships with their healthcare providers through 12 months postpartum. These findings point to high-risk groups that may benefit the most from integrated care, as well as groups for whom these benefits are hampered and that warrant further attention in intervention development and evaluation.

PMID:37306847 | DOI:10.1007/s10461-023-04097-x

J Community Health. 2023 Jun 12. doi: 10.1007/s10900-023-01243-3. Online ahead of print.

ABSTRACT

There is a dearth of population studies regarding law enforcement officers (LEOs) use of fatal force against teenagers. The purpose of this cross-sectional study was to characterize the teens most likely to be killed, the methods used to fatally injure teenagers, the geographic distribution of the killings, and the years of potential life lost before the age of 80 years (YPLL80) due to LEO interactions. Data from the Web-based Injury Statistics Query and Reporting System (WISQARS) from the Center for Disease Control and Prevention (CDC) were analyzed for the years 2010-2020. LEOs killed 330 teenagers; most were males (94.2%) and 6 of 7 teens (84.5%) were shot. The teens killed were disproportionately older teens ages 18-19 years (64.2%) and non-Hispanic Blacks (45.8%) who were usually killed in metropolitan areas (90.0%). The rate of teenage killings by LEOs significantly increased (267%) over the time frame studied. A total of 20,575 YPLL80 were lost and they significantly increased over time (263%). Mitigation of teenagers killed by LEOs will require transforming policing through policy changes (e.g. hiring and training) over an extended period of time. Also, the public needs education, (e.g. funding, interactions) regarding policing.

PMID:37306842 | DOI:10.1007/s10900-023-01243-3

Brain Struct Funct. 2023 Jun 12. doi: 10.1007/s00429-023-02659-2. Online ahead of print.

ABSTRACT

The basal ganglia are important modulators of the cognitive and motor benefits of exercise. However, the neural networks underlying these benefits remain poorly understood. Our study systematically analyzed exercise-associated changes in metabolic connectivity in the cortico-basal ganglia-thalamic network during the performance of a new motor task, with regions-of-interest defined based on mesoscopic domains recently defined in the mouse brain structural connectome. Mice were trained on a motorized treadmill for six weeks or remained sedentary (control), thereafter undergoing [¹⁴C]-2-deoxyglucose metabolic brain mapping during wheel walking. Regional cerebral glucose uptake (rCGU) was analyzed in 3-dimensional brains reconstructed from autoradiographic brain sections using statistical parametric mapping. Metabolic connectivity was assessed by calculating inter-regional correlation of rCGU cross-sectionally across subjects within a group. Compared to controls, exercised animals showed broad decreases in rCGU in motor areas, but increases in limbic areas, as well as the visual and association cortices. In addition, exercised animals showed (i) increased positive metabolic connectivity within and between the motor cortex and caudoputamen (CP), (ii) newly emerged negative connectivity of the substantia nigra pars reticulata with the globus pallidus externus, and CP, and (iii) reduced connectivity of the prefrontal cortex (PFC). Increased metabolic connectivity in the motor circuit in the absence of increases in rCGU strongly suggests greater network efficiency, which is also supported by the reduced involvement of PFC-mediated cognitive control during the performance of a new motor task. Our study delineates exercise-associated changes in functional circuitry at the subregional level and provides a framework for understanding the effects of exercise on functions of the cortico-basal ganglia-thalamic network.

PMID:37306809 | DOI:10.1007/s00429-023-02659-2

Urologia. 2023 Jun 12:3915603231179533. doi: 10.1177/03915603231179533. Online ahead of print.

ABSTRACT

INTRODUCTION: Posterior urethral injuries in men commonly occur following pelvic and perineal trauma. Erectile dysfunction (ED), whether brought on by the severity of the initial trauma or the surgery itself, is one of the complications in these patients.

MATERIALS AND METHODS: In this study, we divided candidates of posterior urethroplasty due to traumatic urethral injury into intervention and placebo groups; the former received continuous treatment with tadalafil (10 mg daily), and the latter received a placebo. Other services were provided equally to both groups. Before and after the intervention, both groups completed the International Index of Erectile Function version 5 (IIEF-5) questionnaire, and the findings were analyzed.

RESULTS: Forty patients were studied in groups of 20 with a mean age of 43.87 ± 15.70 years. The patient’s most common cause of urethral injury was a pelvic fracture. Before the intervention, the mean scores of IIEF for patients in the intervention group and placebo group were 14.85 ± 7.39 and 14.77 ± 6.48, respectively with no statistical significance (p = 0.962) and patients of the groups were similar in terms of the severity of ED. The mean IIEF score in the intervention group was 20.12 ± 4.94 and in the placebo group, it was 18.05 ± 4.88 at the three-month follow-up, with no statistically significant difference (p = 0.063). In both the intervention and placebo groups, the IIEF score was significantly increased by 5.27 ± 4.04 (p < 0.001) and 3.27 ± 2.97 (p < 0.001), respectively. The rate of IIEF increase in the intervention group was higher than in the placebo group during the follow-up at 3-month follow-up with statistical significance. (p = 0.022).

CONCLUSION: The findings of this study suggest that tadalafil, in a 3-month treatment course, may improve erectile function in individuals with mild-to-moderate ED, significantly more than placebo. However, more studies, specifically with longer duration of follow-up and larger populations, are necessary for generalizing the current findings.

PMID:37306088 | DOI:10.1177/03915603231179533

Artif Organs. 2023 Jun 12. doi: 10.1111/aor.14596. Online ahead of print.

ABSTRACT

OBJECTIVE: The INTERMACS Events data set contains an expansive collection of temporal evidence of the course of adverse events (AEs) of > 15, 000 patients that have received an left ventricular assist device (LVAD). The chronology of AEs may contain insightful information of the “AE journeys” of LVAD patients. The purpose of this study is to investigate the timelines of AEs within the INTERMACS database.

METHODS: Descriptive statistics were applied to 86,912 recorded AEs of 15,820 patients with a continuous flow-LVAD between 2008 to 2016, extracted from INTERMACS registry. The characteristics of the timelines of AE journeys were investigated by posing six descriptive research questions.

RESULTS: The analysis revealed several time-related characteristics and patterns of the AE journey after LVAD including the most common time of occurrences of AEs after surgery, duration of AEs journeys, the time of first and last AEs, and the time gaps between AEs.

CONCLUSION: The INTERMACS Event data set is a valuable resource for research about the timeline of AE journeys of patients who received an LVAD. It is necessary for future studies to first explore and consider the time-related characteristics of the data set such as diversity and sparsity to effectively choose an appropriate scope of time and time granularity and to acknowledge potential challenges.

PMID:37306077 | DOI:10.1111/aor.14596

Am J Sports Med. 2023 Jun 12:3635465231178831. doi: 10.1177/03635465231178831. Online ahead of print.

ABSTRACT

BACKGROUND: Despite similar published rates of rerupture among patients treated with early functional rehabilitation and open repair for acute Achilles tendon rupture, uncertainty still exists regarding the optimal treatment modality. The reverse fragility index (RFI) is a statistical tool that provides an objective measure of the study’s neutrality by determining the number of events that need to change for a nonsignificant result to be significant.

PURPOSE: The purpose was to utilize the RFI to appraise the strength of neutrality of randomized controlled trials (RCTs) comparing the rerupture rates of acute Achilles tendon ruptures treated with open repair versus early functional rehabilitation.

STUDY DESIGN: Systematic review; Level of evidence, 1.

METHODS: A systematic review was performed including all RCTs comparing the rerupture rates after operative repair and early functional rehabilitation for acute Achilles tendon ruptures. Studies were included that explicitly used early functional rehabilitation, defined as weightbearing and exercise-based interventions initiated within 2 weeks, as compared with open repair and reported a nonsignificant difference in rerupture rates. The RFI, with rerupture as the primary outcome, was calculated for each study (significance threshold, P < .05). The RFI quantifies a study’s strength of neutrality and is defined as the minimum number of event reversals necessary to change a nonsignificant result to statistically significant.

RESULTS: Nine RCTs were included, with 713 patients and 46 reruptures. The median (interquartile range) rerupture rate was 7.69% (6.38%-9.64%) overall, 4.00% (2.33%-7.14%) in the operative group, and 10.00% (5.26%-12.20%) in the nonoperative group. The median RFI was 3, indicating that an outcome reversal of 3 patients was necessary to change the results from nonsignificant to statistically significant. The median number of patients lost to follow-up was 6 (3-7). Of 9 studies, 7 (77.8%) had a loss to follow-up greater than or equal to its RFI.

CONCLUSION: The statistical nonsignificance of studies reporting equivalent rerupture rates in the management of acute Achilles tendon ruptures with open repair versus nonoperative management with early functional rehabilitation can be reversed by changing the outcome status of only a few patients.

PMID:37306060 | DOI:10.1177/03635465231178831

Am J Sports Med. 2023 Jun 12:3635465231178292. doi: 10.1177/03635465231178292. Online ahead of print.

ABSTRACT

BACKGROUND: An increased tibial slope (TS) has been identified as a risk factor for anterior cruciate ligament (ACL) injury and graft failure after ACL reconstruction. However, different imaging modalities are used to determine the TS, resulting in divergent values. Consequently, no reference values and no consensus on thresholds can be reached, which in turn is mandatory for indicating correction osteotomies when facing outlier TS.

PURPOSE: To determine the mean values of the TS and the incidence of their outliers in large cohorts of patients with ACL-injured and noninjured knees and to determine the feasibility of measuring TS on conventional lateral radiographs (CLRs).

STUDY DESIGN: Cross-sectional study; Level of evidence 3.

METHODS: TS of ACL-injured knees (n = 1000, group A) and ACL-intact knees (n = 1000, group B) was measured by 3 experienced examiners. Medial TS was measured on CLRs using the technique of Dejour and Bonnin. Patients with radiographs with poor image quality, osteoarthritis, previous osteotomies, or nondigital radiographs were excluded. The intra- and interrater reliability was calculated using the intraclass correlation coefficient.

RESULTS: The mean TS was significantly higher in group A than in group B (10.04°± 3° [range, 2°-22°] vs 9.02°± 2.9° [range, 1°-18°], respectively; P < .001). Significantly more participants in group A had TS larger than 12° (≥12°, 32.2% vs 19.8%, P < .001; ≥13°, 20.9% vs 11.1%, P < .001; ≥14°, 13.5% vs 5.7%, P < .001; ≥15°, 8% vs 2.7%, P < .001; ≥16°, 3.7% vs 1.4%, P = .0005), respectively. In contrast, significantly more participatns in group B had TS 8° or less (≤8°, 32.1% vs 42.7%, P < .001; ≤7°, 20% vs 30.9%, P < .001; ≤6°, 12.4% vs 19.8%, P < .001; ≤5°, 6.6% vs 12%, P = .0003; ≤4°, 2.8% vs 5.3%, P = .0045). The intraclass correlation coefficient revealed a good to excellent reliability throughout measurements.

CONCLUSION: Median values for the TS were 9° for uninjured and 10° for ACL-injured knees on CLRs. Notwithstanding its statistical significance, this finding might be negligible in clinical practice. However, a significantly larger number of outliers were found in the ACL-injured group exceeding a TS of 12° and demonstrating an incremental proportion with increasing TS, serving as a potential threshold for correction osteotomy. Furthermore, CLRs in the largest cohort to date exhibited high reproducibility, proving the feasibility of CLRs as a routine measurement for TS.

PMID:37306059 | DOI:10.1177/03635465231178292

Chronic Illn. 2023 Jun 12:17423953231181409. doi: 10.1177/17423953231181409. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess characteristics of hospitalized adolescents facing chronic diseases, correlating the perceptions of their illness, quality of life and the prevalence of risk behaviors, considering gender and the diseases’ durations.

METHODS: The sample consisted of 61 adolescents, aged between 10 and 19 years, with chronic diseases, hospitalized at the University Hospital of the State University of Londrina. They answered a questionnaire and the scales World Health Organization Quality of Life (WHOQOL-BREF) and Illness Perception Questionnaire (IPQ). They were divided in groups, according to the durations of the disease: group 1 (up to 4 years) and group 2 (5 years or more).

RESULTS: Group 2 demonstrated higher leisure activity (p = 0.02) and more painful symptoms (p = 0.02). In WHOQOL-BREF, group 2 had a higher quality of life in the domain on environment (p = 0.02) and a higher total score (p = 0.04). Lower scores on the IPQ were associated with higher scores on the WHOQOL-BREF. Positive correlation was found between WHOQOL-BREF total score and years of disease, in which male presented higher scores.

CONCLUSIONS: These findings may alert to the need for more knowledge about the diseases and the importance of encouraging ways to improve quality of life and care to reduce risky behaviors.

PMID:37306058 | DOI:10.1177/17423953231181409

J Dent Res. 2023 Jun 12:220345231169915. doi: 10.1177/00220345231169915. Online ahead of print.

ABSTRACT

Cleft lip and palate have a complex inheritance, and 90% of its variation in the population is due to genetic contributors. The impact of surgical procedures on maxillofacial growth is well known, but the interference of intrinsic factors in these growth outcomes is not elucidated. The present study aimed to analyze genetic polymorphisms and frequency of dental anomalies as predictors of maxillofacial growth in patients born with cleft lip with or without cleft palate. From a cohort of 537 individuals, operated on by the same surgeon, 121 were analyzed 2 times, to define changes in maxillary growth prognosis by occlusal scores in a minimum 4-y follow-up. In a second step, a subset of 360 individuals had maxillofacial growth outcomes evaluated using Wits, nasion perpendicular to point A, and occlusal scores. The markers MMP2 rs9923304, GLI2 rs3738880 and rs2279741, TGFA rs2166975, and FGFR2 rs11200014 and rs10736303 were genotyped, and frequency of dental anomalies and cleft severity were determined to define evidence of overrepresentation of alleles associated with maxillofacial growth outcomes. Age and age at primary surgical treatment, sex, and cleft laterality were variables adjusted in the analysis. We found an association between the frequency of dental anomalies and the maxillofacial growth in unilateral (P = 0.001) and bilateral (P = 0.03) individuals with clefts. MMP2 rs9923304 and maxillofacial growth were associated (P < 0.0001). There was also an association between GLI2 rs3738880 and TGFA rs2166975 and maxillary outcomes in individuals born with unilateral cleft lip and palate (P = 0.003 and P = 0.004, respectively), as well as between FGFR2 rs11200014 and maxillary outcomes regardless of cleft type (P = 0.005). Statistical evidence of an interaction between MMP2 rs9923304 and GLI2 rs3738880 was observed (P < 0.0001). Presence of dental anomalies and genetic variation in MMP2, GLI2, TGFA, and FGFR2 were associated with worse maxillofacial growth outcomes in individuals born with clefts.

PMID:37306019 | DOI:10.1177/00220345231169915