Tag: nevin manimala

Oral Radiol. 2023 Jun 15. doi: 10.1007/s11282-023-00697-4. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the morphological differences in the articular disc (AD) between hemophilic patients and healthy individuals of the control group for further association with signs and symptoms.

METHODS: Fourteen severe hemophilic patients had their AD evaluated by magnetic resonance imaging (MRI). The morphological findings were compared to those of a control group consisting of 14 healthy individuals. MRI was used to evaluate all the components of the temporomandibular (TMJ), including the AD, resulting in sequential T1-weighted parasagittal images. All the images were acquired with teeth in maximum intercuspation position.

RESULTS: Morphological alterations showed significant statistical differences (P-value = 0.0068), whereas no statistical differences were found in the other variables, including TMJ pain, headache, bruxism and mouth opening limitation. In the group of non-hemophilic individuals, only two (14.29%) presented AD with non-biconcave features, whereas in the group of hemophilic patients, nine (64.29%) presented AD with a morphology other than biconcave.

CONCLUSIONS: In patients with severe hemophilia, there seems to be a pattern of morphological alterations in the articular disc over time. The standard biconcave morphology of AD tends to change into other ones, particularly biplanar, hemiconvex and folded.

PMID:37318743 | DOI:10.1007/s11282-023-00697-4

Environ Sci Pollut Res Int. 2023 Jun 15. doi: 10.1007/s11356-023-28140-5. Online ahead of print.

ABSTRACT

India’s demand-supply imbalance electricity market results from the country’s rapid population growth and extensive industrialization. Due to increased costs, many residential and commercial customers have difficulty paying their electric bills. Households with lower incomes are confronted with the most severe energy poverty in the entire country. A sustainable and alternative form of energy is required to solve these issues. Solar energy is a sustainable energy choice for India; however, the solar industry faces many issues. One of them is managing end-of-life cycle photovoltaic (PV) waste, as massive deployment of solar energy capacity has resulted in generating large amounts of PV waste, ultimately affecting environmental and human health. Therefore, this research employs “Porter’s Five Forces Model” to analyze the factors that significantly impact the competitiveness of India’s solar power industry. The inputs for this model consist of semi-structured interviews conducted with experts in the solar power industry on various solar energy-related issues and a critical analysis of the national policy framework using the relevant literature and official statistics. The impact of five significant stakeholders of the solar power industry on solar power generation in India is evaluated: buyers, suppliers, competitors, substitutes, and potential competitors. Research findings indicate the Indian solar power industry’s current status, challenges, competition environment, and future estimates. This study will help the government and stakeholders to understand the intrinsic and extrinsic factors affecting the competitiveness of the Indian solar power sector and suggest policy recommendations to formulate procurement strategies that promote sustainable development within the solar industry.

PMID:37318728 | DOI:10.1007/s11356-023-28140-5

Clin Exp Nephrol. 2023 Jun 15. doi: 10.1007/s10157-023-02368-4. Online ahead of print.

ABSTRACT

BACKGROUND: Hyperkalemia and hypokalemia are associated with mortality in patients undergoing hemodialysis. However, there are few reports on the association between potassium level fluctuations and mortality. We retrospectively investigated the association between serum potassium level variability and mortality in patients undergoing hemodialysis.

METHODS: This study was conducted at a single center. Variability in serum potassium levels was evaluated using the standard deviation of potassium level from July 2011 to June 2012, and its association with prognosis was examined by following up the patients for 5 years. Serum potassium variability was assessed as the coefficient of variation, and the statistical analysis was performed after log transformation.

RESULTS: Among 302 patients (mean age 64.9 ± 13.3; 57.9% male; and median dialysis vintage 70.5 months [interquartile range, IQR 34-138.3]), 135 died during the observation period (median observation period 5.0 years [2.3-5.0]). Although the mean potassium level was not associated with prognosis, serum potassium level variability was associated with prognosis, even after adjustments for confounding factors such as age and dialysis time (hazard ratio: 6.93, 95% confidence interval [Cl] 1.98-25.00, p = 0.001). After the adjustments, the coefficient of variation of potassium level in the highest tertile (T3) showed a higher relative risk for prognosis than that in T1 (relative risk: 1.98, 95% CI 1.19-3.29, p = 0.01).

CONCLUSIONS: Variability in serum potassium levels was associated with mortality in patients undergoing hemodialysis. Careful monitoring of potassium levels and their fluctuations is necessary for this patient population.

PMID:37318722 | DOI:10.1007/s10157-023-02368-4

J Epidemiol Glob Health. 2023 Jun 15. doi: 10.1007/s44197-023-00130-3. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The impact of multiple risk factors on COVID-19 mortality has been previously reported in multiple systematic reviews and meta-analyses. The aim of this review is to provide a comprehensive update on the association between hypertension (HTN) and mortality in patients with COVID-19.

METHODS: A systematic review and meta-analysis were performed and followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A search was achieved using PubMed, Scopus, and Cochrane Databases for research publications on hypertension, COVID-19, and mortality published between December 2019 and August 2022.

RESULTS: A total of 23 observational studies involving 611,522 patients from 5 countries (China, Korea, the UK, Australia, and the USA) were included in our study. The confirmed number of COVID-19 with HTN cases in each study ranged from 5 to 9964. The mortality ranged from 0.17% to 31% in different studies. Pooled results show that the mortality rate of COVID-19 among the included studies ranges from a minimum of 0.39 (95% CI 0.13-1.12) to a maximum of 5.74 (95% CI 3.77-8.74). Out of the 611,522 patients, 3119 died which resulted in an overall mortality prevalence of 0.5%. Subgroup analyses indicated that patients with COVID-19 who have hypertension and male patients had slightly less risk of mortality than female patients [the percentage of men > 50%; OR 1.33: 95% CI (1.01, 1.76); the percentage of men ≤ 50%: OR 2.26; and 95% CI (1.15, 4.48)]. Meta-regression analysis results also showed a statistically significant association between hypertension and COVID-19 mortality.

CONCLUSION: This systematic review and meta-analysis suggest that hypertension may not be the only risk factor associated with the increased mortality rate during the COVID-19 pandemic. In addition, a combination of other comorbidities and old age appears to increase the risk of mortality from COVID-19. The impact of hypertension on mortality rate among COVID-19 patients.

PMID:37318701 | DOI:10.1007/s44197-023-00130-3

Cardiol Ther. 2023 Jun 15. doi: 10.1007/s40119-023-00320-x. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to determine whether there was any correlation between coronary artery disease (CAD) and retinal artery diameter at an academic tertiary medical center in Trinidad and Tobago.

METHODS: This prospective study evaluated patients (n = 77) with recent invasive coronary angiography (CAG) and the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score who subsequently underwent optical coherence tomography-angiography (OCT-A) at the Eric Williams Medical Sciences Complex (EWMSC) from January 2021 to March 2021. Routine medical history and cardiovascular medications were also recorded. Spearman’s rank correlation coefficient and Mann-Whitney U-tests were used to compare correlations and medians between groups.

RESULTS: The average patient age was 57.8 years old, with the majority being male [n = 55 (71.4%)] and of South Asian ethnicity [n = 53 (68.8%)]. Retinal artery diameter was negatively correlated with the SYNTAX score (-0.332 for the right eye, p = 0.003 and -0.237 for the left eye, p = 0.038). A statistically significant relationship was also demonstrated in females and diabetic patients. There were no serious adverse events (SAEs).

CONCLUSION: A significantly negative correlation was observed between retinal artery diameter and SYNTAX score. This study alludes to the practical use of optical coherence tomography-angiography (OCT-A) as a noninvasive diagnostic modality for patients with cardiovascular disease (CVD). Further large-scale, multicentric studies are required to confirm these exploratory findings.

TRIAL REGISTRATION NUMBER: NCT04233619.

PMID:37318673 | DOI:10.1007/s40119-023-00320-x

Environ Monit Assess. 2023 Jun 15;195(7):845. doi: 10.1007/s10661-023-11438-9.

ABSTRACT

An effective micro-level air quality management plan requires high-resolution monitoring of pollutants. India has already developed a vast network of air quality monitoring stations, both manual and real time, located primarily in urban areas, including megacities. The air quality monitoring network consists of conventional manual stations and real time Continuous Ambient Air Quality Monitoring Stations (CAAQMS) which comprise state-of-the-art analysers and instruments. India is currently in the early stages of developing and adopting economical portable sensor (EPS) in air quality monitoring systems. Protocols need to be established for field calibration and testing. The present research work is an attempt to develop a performance-based assessment framework for the selection of EPS for air quality monitoring. The two-stage selection protocol includes a review of the factory calibration data and a comparison of EPS data with a reference monitor, i.e. a portable calibrated monitor and a CAAQMS. Methods deployed include calculation of central tendency, dispersion around a central value, calculation of statistical parameters for data comparison, and plotting pollution rose and diurnal profile (peak and non-peak pollution measurement). Four commercially available EPS were tested blind, out of which, data from EPS 2 (S2) and EPS 3 (S3) were closer to reference stations at both locations. The selection was made by evaluating monitoring results, physical features, measurement range, and frequency along with examining capital cost. This proposed approach can be used to increase the usability of EPS in the development of micro-level air quality management strategies, other than regulatory compliance. For regulatory compliance, additional research is needed, including field calibration and evaluating EPS performance through additional variables. This proposed framework may be used as starting point, for such experiments, in order to develop confidence in the use of EPS.

PMID:37318651 | DOI:10.1007/s10661-023-11438-9

J Nephrol. 2023 Jun 15. doi: 10.1007/s40620-023-01635-7. Online ahead of print.

ABSTRACT

OBJECTIVES: This umbrella review aimed to review the effects of resistance training on patients with end-stage renal disease and assess the methodological quality of the available literature.

METHODS: An umbrella review and meta-meta-analysis was performed. A systematic search was conducted until May 2022. Article selection, quality assessment, and risk of bias assessment were performed by two independent reviewers. The meta-meta-analyses were performed with a random-effects model and the summary statistics were presented in the form of a forest plot with a weighted compilation of all standardized mean differences and corresponding 95% confidence interval. Twenty-four reviews were eventually included. The protocol was registered in the international registry PROSPERO (CRD42022321702).

RESULTS: Resistance training showed positive effects on functional capacity (g = 0.614), aerobic capacity (g = 0.587), health-related quality of life (g = 0.429), and peak force (g = 0.621). Fifteen of the included studies (63%) presented low risk of bias, and the remaining studies (37%) showed unclear risk of bias.

CONCLUSION: Resistance training in patients undergoing hemodialysis is an intervention that shows positive results regarding physical and functional outcomes. The quality level of the literature is inconclusive, but the included studies present low risk of bias.

PMID:37318646 | DOI:10.1007/s40620-023-01635-7

Arch Orthop Trauma Surg. 2023 Jun 15. doi: 10.1007/s00402-023-04946-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Overcorrection is a possible complication of clubfoot treatment, whose prevalence varies from 5 to 67%. Overcorrected clubfoot usually presented as a complex flatfoot with different degrees of hindfoot valgus, flat top talus, dorsal bunion, and dorsal navicular subluxation. The management of clubfoot overcorrection is challenging, and both conservative and surgical treatments are available. This study aims to present our experience in the surgical management of overcorrected clubfoot and to provide an overview of actual treatment options for each specific sub-deformity.

MATERIALS AND METHODS: A retrospective cohort study of patients surgically treated for an overcorrected clubfoot from 2000 to 2015 at our Institution was conducted. Surgical procedures were tailored to the type and symptomatology of the deformity. A medializing calcaneal osteotomy or subtalar arthrodesis was performed for hindfoot valgus. Subtalar and/or midtarsal arthrodesis were considered in cases of dorsal navicular subluxation. The first metatarsus elevatus was addressed through a proximal plantarflexing osteotomy, sometimes associated with a tibialis anterior tendon transfer. Clinical scores and radiographic parameters were obtained pre-operatively and at the last follow-up.

RESULTS: Fifteen consecutive patients were enrolled. The series included 4 females and 11 males, with a mean age at surgery of 33,1 (18-56) years, and a mean follow-up of 4,46 (2-10) years. Seven medializing calcaneal osteotomies, 5 subtalar arthrodesis, 11 first metatarsal plantarflexing osteotomies, and 7 anterior tibialis tendon transfers were performed. A statistically significant improvement in both clinical and radiographic scores was observed.

CONCLUSIONS: Management of overcorrected clubfoot involves many surgical techniques because of the high interpersonal variability of the deformities. The surgical approach showed positive results, as long as the indication is based on clinical symptoms and functional impairment rather than morphological alterations and radiographic findings.

PMID:37318629 | DOI:10.1007/s00402-023-04946-3

Eur Radiol. 2023 Jun 15. doi: 10.1007/s00330-023-09801-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients.

METHODS: A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyopathy (HCM) patients, 74 idiopathic dilated cardiomyopathy (DCM), and 73 chronic myocardial infarction (MI) patients were retrospectively enrolled in this study. The associations of LA-LV coupling with clinical status were statistically analyzed by correlation, multiple linear regression, and logistic regression. Survival estimates were calculated by receiver operating characteristic analyses and Cox regression analyses.

RESULTS: Overall, moderate correlations were found between LA and LV strain in every phase of the cardiac cycle (r: -0.598 to -0.580, all p < 0.001). The slope of the regression line of the individual strain-strain curve had a significant difference among 4 groups (-1.4 ± 0.3 in controls, -1.1 ± 0.6 in HCM, -1.8 ± 0.8 in idiopathic DCM, -2.4 ± 1.1 in chronic MI, all p < 0.05). During a median follow-up of 4.7 years, the total LA emptying fraction was independently associated with primary (hazard ratio: 0.968, 95% CI: 0.951-0.985) and secondary endpoints (hazard ratio: 0.957, 95% CI: 0.930-0.985) with an area under the curve (AUC) of 0.720 respectively, 0.806, which was significantly higher than the AUC of LV parameters.

CONCLUSIONS: The coupled correlations between the left atria and ventricle in every phase and the individual strain-strain curve vary with etiology. LA deformation in late diastole provides prior and incremental information on cardiac dysfunction based on LV metrics. The total LA emptying fraction was an independent indicator for clinical outcome superior to that of LV typical predictors.

CLINICAL RELEVANCE STATEMENT: Left ventricular-atrial coupling is not only valuable for comprehending the pathophysiological mechanisms of cardiovascular diseases caused by different etiologies but also holds significant importance for the prevention of adverse cardiovascular events and targeted treatment.

KEY POINTS: • In HCM patients with preserved LVEF, LA deformation is a sensitive indicator for cardiac dysfunction prior to LV parameters with a reduced LA/LV strain ratio. • In patients with reduced LVEF, LV deformation impairment is more consequential than that of the LA with an increased LA/LV strain ratio. Furthermore, impaired LA active strain indicates potential atrial myopathy. • Among LA and LV parameters, the total LA emptying fraction is the best predictor for guiding clinical management and follow-up in patients with different statuses of LVEF.

PMID:37318603 | DOI:10.1007/s00330-023-09801-y

J Math Biol. 2023 Jun 15;87(1):8. doi: 10.1007/s00285-023-01934-4.

ABSTRACT

Invasion of the surrounding tissue is a key aspect of cancer growth and spread involving a coordinated effort between cell migration and matrix degradation, and has been the subject of mathematical modelling for almost 30 years. In this current paper we address a long-standing question in the field of cancer cell migration modelling. Namely, identify the migratory pattern and spread of individual cancer cells, or small clusters of cancer cells, when the macroscopic evolution of the cancer cell colony is dictated by a specific partial differential equation (PDE). We show that the usual heuristic understanding of the diffusion and advection terms of the PDE being one-to-one responsible for the random and biased motion of the solitary cancer cells, respectively, is not precise. On the contrary, we show that the drift term of the correct stochastic differential equation scheme that dictates the individual cancer cell migration, should account also for the divergence of the diffusion of the PDE. We support our claims with a number of numerical experiments and computational simulations.

PMID:37318599 | DOI:10.1007/s00285-023-01934-4