Tag: nevin manimala

CJEM. 2023 Jun 12. doi: 10.1007/s43678-023-00529-8. Online ahead of print.

ABSTRACT

OBJECTIVE: Triage is the process of identifying patients with both the greatest clinical need and the greatest likelihood of benefit in the setting of limited clinical resources. The primary objective of this study was to assess the ability of formal mass casualty incident triage tools to identify patients requiring urgent lifesaving interventions.

METHODS: Data from the Alberta Trauma Registry (ATR) was used to assess seven triage tools: START, JumpSTART, SALT, RAMP, MPTT, BCD and MITT. Clinical data captured in the ATR was used to determine which triage category each of the seven tools would have applied to each patient. These categorizations were compared to a reference standard definition based on the patients’ need for specific urgent lifesaving interventions.

RESULTS: Of the 9448 records that were captured 8652 were included in our analysis. The most sensitive triage tool was MPTT, which demonstrated a sensitivity of 0.76 (0.75, 0.78). Four of the seven triage tools evaluated had sensitivities below 0.45. JumpSTART had the lowest sensitivity and the highest under-triage rate for pediatric patients. All the triage tools evaluated had a moderate to high positive predictive value (> 0.67) for patients who had experienced penetrating trauma.

CONCLUSIONS: There was a wide range in the sensitivity of triage tools to identify patients requiring urgent lifesaving interventions. MPTT, BCD and MITT were the most sensitive triage tools assessed. All of the triage tools assessed should be employed with caution during mass casualty incidents as they may fail to identify a large proportion of patients requiring urgent lifesaving interventions.

PMID:37306923 | DOI:10.1007/s43678-023-00529-8

J Nephrol. 2023 Jun 12. doi: 10.1007/s40620-023-01636-6. Online ahead of print.

ABSTRACT

INTRODUCTION: While the use of different immunosuppressants has been investigated in immunoglobulin A nephropathy, further investigation is needed to assess the effect of a regimen of mycophenolate mofetil combined with a short course of glucocorticosteroids in the subset of patients with histologically active features. We compared the efficacy and safety of a combined regimen of mycophenolate mofetil and glucocorticosteroids to a conventional regimen of glucocorticosteroids alone in patients with immunoglobulin A nephropathy who have active lesions and major urinary abnormalities.

METHODS: This retrospective study involved 30 immunoglobulin A nephropathy patients with active histological lesions, 15 of whom were treated with both mycophenolate mofetil 2 g/day for 6 months and 3 pulses of 15 mg/kg methylprednisolone, followed by a short tapering schedule of oral prednisone. The control group was made up of the remaining 15 clinically- and histologically-matched patients treated with glucocorticosteroids alone according to a validated schedule, i.e., 1 g of methylprednisolone given intravenously for 3 consecutive days, followed by oral prednisone 0.5 mg/kg every other day for 6 months. At diagnosis, all patients had urinary protein excretion > 1 g/24 h and microscopic hematuria.

RESULTS: At the end of the first year of follow-up (30 patients) and after 5 years (17 patients), there were no differences between the two groups in terms of urinary abnormalities and functional parameters. Both regimens achieved a statistically significant decrease in 24-h urinary protein excretion (p < 0.001) and a reduction of microscopic hematuria. However, the mycophenolate mofetil-based regimen allowed a cumulative sparing dose of 6 g of glucocorticosteroids.

CONCLUSION: In this single center study on immunoglobulin A nephropathy patients with active lesions and major urinary abnormalities and at increased risk of glucocorticosteroid-related complications, a mycophenolate mofetil-based regimen demonstrated similar outcomes in terms of complete response and relapse (at 1 and 5 years) compared to a conventional glucocorticosteroid-based protocol, while achieving a consistent reduction of glucocorticosteroid cumulative dose.

PMID:37306917 | DOI:10.1007/s40620-023-01636-6

J Neurooncol. 2023 Jun 12. doi: 10.1007/s11060-023-04360-0. Online ahead of print.

ABSTRACT

PURPOSE: The postoperative period after laser interstitial thermal therapy (LITT) is marked by a temporary increase in volume, which can impact the accuracy of radiographic assessment. The current criteria for progressive disease (PD) suggest that a 20% increase in size of brain metastasis (BM) assessed in 6-12 weeks intervals should be considered as local progression (LP). However, there is no agreement on how LP should be defined in this context. In this study, we aimed to statistically analyze which tumor volume variations were associated with LP.

METHODS: We analyzed 40 BM that underwent LITT between 2013 and 2022. For this study, LP was defined following radiographic features. A ROC curve was generated to evaluate volume change as a predictor of LP and find the optimal cutoff point. A logistic regression analysis and Kaplan Meier curves were performed to assess the impact of various clinical variables on LP.

RESULTS: Out of 40 lesions, 12 (30%) had LP. An increase in volume of 25.6% from baseline within 120-180 days after LITT presented a 70% sensitivity and 88.9% specificity for predicting LP (AUC: 0.78, p = 0.041). The multivariate analysis showed a 25% increase in volume between 120 and 180 days as a negative predictive factor (p = 0.02). Volumetric changes within 60-90 days after LITT did not predict LP (AUC: 0.57; p = 0.61).

CONCLUSION: Volume changes within the first 120 days after the procedure are not independent indicators of LP of metastatic brain lesions treated with LITT.

PMID:37306886 | DOI:10.1007/s11060-023-04360-0

Environ Sci Pollut Res Int. 2023 Jun 12. doi: 10.1007/s11356-023-28019-5. Online ahead of print.

ABSTRACT

The adsorbent MIL-101, a metal-organic framework material, was synthesized, characterized, and tested for removal of relatively low concentrations of benzene and toluene adsorbates (200 ppm) from a gas phase in a continuous flow system. Breakthrough studies were modeled based on Thomas, Yoon-Nelson, Yan, Clark, Bohart-Adams, bed-depth service time, modified dose response, Wolborska, and Gompertz in the continuous fixed-bed operation. Through statistical analysis, it was determined which type of regression is most suitable for the studied models, linear or nonlinear. By comparing the values of error functions, it was possible to infer that the Thomas model is the best match for the experimental breakthrough curves for benzene (with maximum solid-phase concentration q_T=126,750 mg/g) and the Gompertz model for toluene (parameter β=0.01 min^-1). Overall, when compared to the model parameters of the linear regression, those obtained through nonlinear regression show a stronger correlation with the results found experimentally. Thus, this type of regression is more suitable for the adsorption model analysis. The liquid film and intraparticle diffusion analysis was described, and it was suggested that both types of diffusion contribute to the adsorption mechanism of benzene and toluene on MIL-101. As for the isotherms, the adsorption process was better fitted by the Freundlich isotherm. The reusability of MIL-101 after six cycles was 76.5% for benzene and 62.4% for toluene, indicating that MIL-101 was a better adsorbent for the removal of benzene in comparison with toluene.

PMID:37306882 | DOI:10.1007/s11356-023-28019-5

Eur Arch Paediatr Dent. 2023 Jun 12. doi: 10.1007/s40368-023-00809-y. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the taper of root canals of deciduous maxillary and mandibular canines by nano computed tomography (nano-CT).

METHODS: This in vitro study involved CT scan analysis of nine maxillary and five mandibular primary canines. The images of each tooth were reconstructed using OnDemand3D software. Thereon, diameter and taper analyses were performed on the free FreeCAD 0.18 software for the three-dimensional (3D) computer-aided design model. Statistical analysis was conducted using Stata v14.0 software, adopting a significance level of 5%.

RESULTS: 3D image reconstruction was performed, considering the diameters obtained along the entire length of the tooth root, and the conical model was built with a height of 10 mm. The diameters of the maxillary canine at points D0 (0 mm), D5 (5 mm), D7 (7 mm), and D10 (10 mm) were 1.62, 1.07, 0.78, and 0.49 mm, respectively, with a significant difference between the four points (p = 0.0001). Regarding maxillary canine root taper values in the cervical, middle, and apical regions, the values were 12%, 14%, and 10%, respectively. For mandibular canines, the mean diameter values obtained at points D0, D5, D7, and D10 were 1.51, 0.83, 0.64, and 0.45 mm, respectively, with significant differences among the four points (p = 0.005). The inferior canine root tapers in the cervical, middle, and apical regions were 14%, 10%, and 6%, respectively.

CONCLUSION: The detailed knowledge of the root morphology of maxillary and mandibular deciduous canines, as it has been shown in vitro using nano-CT, is critical to achieve accurate and efficient endodontic treatments.

PMID:37306868 | DOI:10.1007/s40368-023-00809-y

J Relig Health. 2023 Jun 12. doi: 10.1007/s10943-023-01853-0. Online ahead of print.

ABSTRACT

The current study investigated the psychometric properties of the Haitian Creole version of the Brief Religious Coping Scale (Brief RCOPE). A total of 256 adult survivors of the 2010 earthquake in Haiti completed the Brief RCOPE and measures of posttraumatic stress disorder symptoms, resilience, general coping, and posttraumatic growth. The results showed the Brief RCOPE to have excellent internal consistency reliability α = .94 and α = .85 for the positive religious coping and negative religious coping, respectively. Confirmatory factor analysis showed construct validity for the Brief RCOPE subscales. The results also showed evidence of convergent validity of the Brief RCOPE in relation to measures of positive spiritual change and religion. Independent t-tests revealed statistically significant gender differences in scores on the positive religious coping subscales as women scored higher than men. These findings suggest that the psychometric properties of the Haitian Creole version of the Brief RCOPE are adequate for the assessment of religious coping with Haitian adults exposed to a natural disaster.

PMID:37306861 | DOI:10.1007/s10943-023-01853-0

J Behav Med. 2023 Jun 12. doi: 10.1007/s10865-023-00422-w. Online ahead of print.

ABSTRACT

Death anxiety is understudied in people with cancer, especially in relation to fear of cancer recurrence (FCR) and fear of progression (FOP). The present study aimed to identify if death anxiety can predict FCR and FOP over and above other known theoretical predictors. One hundred and seventy-six participants with ovarian cancer were recruited for an online survey. We included theoretical variables, such as metacognitions, intrusive thoughts about cancer, perceived risk of recurrence or progression, and threat appraisal, in regression analyses to predict FCR or FOP. We investigated whether death anxiety added to the variance over and above these variables. Correlational analyses demonstrated that death anxiety is more strongly associated with FOP than FCR. The hierarchical regression including the theoretical variables described above predicted 62-66% of variance in FCR and FOP. In both models, death anxiety predicted a small but statistically significant unique variance in FCR and FOP. These findings draw attention to the importance of death anxiety in understanding FCR and FOP in people with a diagnosis of ovarian cancer. They also suggest that elements of exposure and existentialist therapies may be relevant in treating FCR and FOP.

PMID:37306857 | DOI:10.1007/s10865-023-00422-w

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