Tag: nevin manimala

Glob Chang Biol. 2022 Nov 23. doi: 10.1111/gcb.16513. Online ahead of print.

ABSTRACT

In the Amazon, deforestation and climate change lead to increased vulnerability to forest degradation, threatening its existing carbon stocks and its capacity as a carbon sink. We use satellite L-Band Vegetation Optical Depth (L-VOD) data that provide an integrated (top-down) estimate of biomass carbon to track changes over 2011-2019. Because the spatial resolution of L-VOD is coarse (0.25°), it allows limited attribution of the observed changes. We therefore combined high-resolution annual maps of forest cover and disturbances with biomass maps to model carbon losses (bottom-up) from deforestation and degradation, and gains from regrowing secondary forests. We show an increase of deforestation and associated degradation losses since 2012 which greatly outweigh secondary forest gains. Degradation accounted for 40% of gross losses. After an increase in 2011, old-growth forests show a net loss of above-ground carbon between 2012 and 2019. The sum of component carbon fluxes in our model is consistent with the total biomass change from L-VOD of 1.3 Pg C over 2012-2019. Across nine Amazon countries, we found that while Brazil contains the majority of biomass stocks (64%), its losses from disturbances were disproportionately high (79% of gross losses). Our multi-source analysis provides a pessimistic assessment of the Amazon carbon balance and highlights the urgent need to stop the recent rise of deforestation and degradation, particularly in the Brazilian Amazon.

PMID:36415966 | DOI:10.1111/gcb.16513

Brain. 2022 Nov 23:awac437. doi: 10.1093/brain/awac437. Online ahead of print.

ABSTRACT

More than half of adults with epilepsy undergoing resective epilepsy surgery achieve long-term seizure freedom and might consider withdrawing antiseizure medications (ASMs). We aimed to identify predictors of seizure recurrence after starting postoperative ASM withdrawal and develop and validate predictive models. We performed an international multicentre observational cohort study in nine tertiary epilepsy referral centres. We included 850 adults who started ASM withdrawal following resective epilepsy surgery and were free of seizures other than focal non-motor aware seizures before starting ASM withdrawal. We developed a model predicting recurrent seizures, other than focal non-motor aware seizures, using Cox proportional hazards regression in a derivation cohort (n = 231). Independent predictors of seizure recurrence, other than focal non-motor aware seizures, following the start of ASM withdrawal were focal non motor-aware seizures after surgery and before withdrawal (adjusted hazards ratio [aHR] 5.5, 95% confidence interval [CI] 2.7-11.1), history of focal to bilateral tonic-clonic seizures before surgery (aHR 1.6, 95% CI 0.9-2.8), time from surgery to the start of ASM withdrawal (aHR 0.9, 95% CI 0.8-0.9), and number of ASMs at time of surgery (aHR 1.2, 95% CI 0.9-1.6). Model discrimination showed a concordance statistic of 0.67 (95% CI 0.63-0.71) in the external validation cohorts (n = 500). A secondary model predicting recurrence of any seizures (including focal non-motor aware seizures) was developed and validated in a subgroup that did not have focal non-motor aware seizures before withdrawal (n = 639), showing a concordance statistic of 0.68 (95% CI 0.64-0.72). Calibration plots indicated high agreement of predicted and observed outcomes for both models. We show that simple algorithms, available as graphical nomograms and online tools (predictepilepsy.github.io), can provide probabilities of seizure outcomes after starting postoperative ASMs withdrawal. These multicentre-validated models may assist clinicians when discussing ASM withdrawal after surgery with their patients.

PMID:36415957 | DOI:10.1093/brain/awac437

Brain. 2022 Nov 23:awac440. doi: 10.1093/brain/awac440. Online ahead of print.

ABSTRACT

Despite experimental studies suggesting a disease-modifying role of oestrogens, results from epidemiological studies on the relation of reproductive characteristics and hormonal exposures with Parkinson disease in women are conflicting. We used the data from the E3N cohort study including 98,068 women aged 40-65y in 1990 followed until 2018. Parkinson disease was ascertained using a validation process based on drug claim databases and medical records. Reproductive characteristics and hormonal exposures were self-reported (11 questionnaires). Associations of exposures with Parkinson disease incidence were investigated using time-varying Cox proportional hazards regression with a 5-year exposure lag and age as the time scale adjusted for confounders. We identified 1165 incident Parkinson disease cases during a mean follow-up of 22.0 years (incidence rate = 54.7 per 100 000 person-years). Parkinson disease incidence was higher in women with early (<12y, hazard ratio [HR] = 1.21, 95% confidence interval [CI] = 1.04-1.40) or late age at menarche (≥14y, HR = 1.18, 95% CI = 1.03-1.35) than in women with menarche at 12-13y. Nulliparity was not associated with Parkinson disease, but Parkinson disease incidence increased with the number of children in parous women (P-trend = 0.009). Women with artificial (surgical, iatrogenic) menopause were at greater risk than women with natural menopause (HR = 1.28, 95% CI = 1.09-1.47), especially when artificial menopause occurred at an early age (≤45.0 years). Postmenopausal hormone therapy tended to mitigate greater risk associated with artificial or early menopause (≤45.0 years). While fertility treatments were not associated with Parkinson disease overall, ever users of clomiphene were at greater Parkinson disease risk than never users (HR = 1.81, 95% CI = 1.14-2.88). Other exposures (breastfeeding, oral contraceptives) were not associated with Parkinson disease. Our findings suggest that early and late age at menarche, higher parity, and artificial menopause, in particular at an early age, are associated with increased Parkinson disease incidence in women. In addition, there was some evidence that use of exogenous hormones may increase (fertility treatments) or decrease (postmenopausal hormone therapy) Parkinson disease incidence. These findings support the hypothesis that hormonal exposures play a role in the susceptibility to neurodegenerative diseases. If confirmed, they could help to identify subgroups at high risk for Parkinson disease.

PMID:36415953 | DOI:10.1093/brain/awac440

Curr Cardiol Rev. 2022;18(6):e280422204203. doi: 10.2174/1573403X18666220428115520.

ABSTRACT

INTRODUCTION: Coronary bifurcation lesions (CBL) are one fifth of all coronary lesions and they do not have an optimal strategy for stenting yet. Bioresorbable scaffolds (BRS) are novel inventions proposed to be the optimal solution. The aim of this systematic review was to assess the role of BRS in treating CBL by comparing it to dedicated bifurcation stents (DBS).

METHODS: A systematic review was conducted following the PRISMA guidelines, searching databases such as ScienceDirect, EMBASE, MEDLINE, NIH, TRIP, PUBMED, and ClinicalTrials. gov. The risk of bias was assessed by MINORS and modified Cowley’s criteria. Q statistic was used for heterogeneity testing and a meta-analysis was conducted using the “meta” package in the R software application.

RESULTS: Fourteen studies were included with an average follow-up period of twelve months. Almost 80% of the participants were male (p-value= 0.148) and around two-thirds were smokers. Meta-analysis was performed for myocardial infarction (MI), target lesion revascularisation (TLR), major adverse cardiac events (MACE), and stent thrombosis (ST). These showed statistically nonsignificant differences, with a slight trend favouring BRS except with stent thrombosis.

CONCLUSION: There is a lack of randomised trials on the topic, which may be an area for further research. But the results showed favourable yet statistically insignificant outcomes for BRS except for ST, an issue that can be addressed with technological advancement.

PMID:36415952 | DOI:10.2174/1573403X18666220428115520

J Adolesc. 2022 Nov 22. doi: 10.1002/jad.12123. Online ahead of print.

ABSTRACT

INTRODUCTION: Expressive flexibility, or the ability to both up- and down-regulate emotional expressions in social interactions, is thought as an indicator and a consequence of healthy interpersonal relationships. The present longitudinal study examined bidirectional associations between expressive flexibility and friendship quality in early adolescence. Since prior research found inconsistent results regarding the adaptiveness of expressive flexibility, which indicated the necessity to consider individual variability in the process, we further tested the potential moderating effect of social anxiety in the links from expressive flexibility to friendship quality.

METHODS: Participants from two junior high schools in eastern China (N = 274; 50.4% female; M_age = 13.56) were surveyed at three time points with 6-month intervals. Expressive flexibility, friendship quality, and social anxiety were all assessed via self-reported scales.

RESULTS: According to the cross-lagged model results, friendship quality significantly predicted increased expressive flexibility over time. Conversely, the longitudinal association from expressive flexibility to friendship quality was not significant, but the interaction between expressive flexibility and social anxiety significantly predicted later friendship quality. Further analyses via the Johnson-Neyman technique revealed that expressive flexibility only positively predicted friendship quality for adolescents with lower levels of social anxiety.

CONCLUSION: Our results suggest that expressive flexibility is not always socially adaptive, so practical interventions that aim to improve youths’ social adjustment via expressive flexibility training might need to consider the role of individual characteristics.

PMID:36415946 | DOI:10.1002/jad.12123

Prostate. 2022 Nov 22. doi: 10.1002/pros.24463. Online ahead of print.

ABSTRACT

INTRODUCTIONS: The American Society of Anesthesiologists Physical Status Classification System (ASA) is a validated risk stratification method for patients undergoing surgery. There is an increased prevalence of benign prostatic hyperplasia and comorbidities in our aging population. The role of ASA related to postoperative complications in patients undergoing holmium laser enucleation of the prostate (HoLEP) has not been described.

METHODS: A review of our database was performed for patients who underwent HoLEP from July 2018 to December 2020. Patients were stratified based on ASA score. Preoperative, perioperative, and complication data were analyzed using SAS analytics software.

RESULTS: Of 472 patients undergoing HoLEP, 320 (67.8%) were ASA 3-4 patients. There was a statistically significant difference found in age (72.3 ± 9.8 vs. 69.1 ± 9.0 years, p < 0.001), body mass index (BMI) (29.0 ± 5.9 vs. 27.3 ± 4.2, p = 0.004), and use of antiplatelet/anticoagulant medications (14.6% vs. 2.6%, p < 0.001) in the ASA 3-4 group. There was no significant difference between prostate volume (p = 0.158) or catheter-dependent urinary retention (p = 0.376). No difference was found in enucleation time (52.76 ± 24.8 vs. 54.16 ± 23.7 min, p = 0.587), OR specimen weight (70.24 ± 58.5 vs. 81.53 ± 65.9, p = 0.094). or intraoperative complications (2.8% vs. 1.3%, p = 0.330). There were higher postoperative complications in the ASA 3-4 group (12.8% vs. 7.9%, p = 0.03), but no difference in Clavien ≥3 complications (p = 0.068). ASA 3-4 patients had similar postoperative international prostate symptom score (p = 0.159).

CONCLUSION: HoLEP is feasible and effective in patients who are ASA 3-4. The high-risk cohort had an increased rate of low-grade complications. Patients with an ASA score of 3-4 should be counseled regarding a higher rate of low-grade complications.

PMID:36415930 | DOI:10.1002/pros.24463

J Esthet Restor Dent. 2022 Dec;34(8):1238-1246. doi: 10.1111/jerd.12954. Epub 2022 Aug 17.

ABSTRACT

OBJECTIVE: To compare in vitro the accuracy of fit of a reference prosthesis seated on three-dimensional (3D) printed casts generated from digital implant scans vs stone casts made by conventional implant impressions.

MATERIAL AND METHODS: A partially edentulous maxillary master cast with two internal connection implants was generated, while a reference implant-supported prosthesis was fabricated. Conventional splinted open-tray impressions were taken to create stone casts (n = 10) (control group). A digital scan was taken of the master cast using a white light intraoral optical scanner (IOS) (TRIOS, 3Shape), and a Standard Tessellation Language (STL) file was obtained. Four 3D printers were used to print the casts (n = 10 from each 3D printer): Straumann® P30+, Varseo S, Form 3b+and M2 Carbon. Accuracy of fit of the reference prosthesis on all control and test casts was assessed using the screw resistance test and radiographic test. Additionally, all casts were digitized using the same IOS, and the STL files were superimposed to the master cast STL file (reference) to evaluate the 3D accuracy with inspection Geomagic Control software using the root-mean-square (RMS) error.

RESULTS: The reference prosthesis presented with clinically acceptable fit on all casts. The highest median RMS error was found in the stone cast group (94.6 μm) while the lowest median was in the M2 Carbon group (46.9 μm). The Kruskal-Wallis test revealed a statistically significant difference between the groups (p < 0.001). For post hoc comparisons, Dunn’s test with the Holm-Bonferroni correction resulted in a statistically significant difference in four tests, with M2 Carbon exhibiting lower RMS error than the stone cast (p < 0.001) and P30+ (p < 0.001) groups, Form 3b exhibiting lower RMS error than the stone cast (p < 0.001) group, and Varseo S exhibiting lower RMS error than the stone cast (p = 0.006) group.

CONCLUSION: Using the screw-resistance test and radiographic assessment, the reference prosthesis fit presented with clinically acceptable accuracy of fit on all casts. Printed casts from 3 different printers demonstrated statistically significant lower 3D deviations than stone casts generated using a conventional implant impression for the present partially edentulous scenario with two implants, but this did not affect prosthesis fit.

CLINICAL SIGNIFICANCE: Even though there were 3D deviations between the master cast and all control and test casts generated from conventional impressions and digital scans respectively, the reference prosthesis presented with accurate fit on all casts. This indicates that there is a threshold for clinically acceptable accuracy of fit and that 3D-printed casts may be used as definitive master casts to fabricate implant-supported fixed dental prostheses for the partially edentulous anterior maxilla.

PMID:36415927 | DOI:10.1111/jerd.12954

Acta Orthop. 2022 Nov 22;93:849-853. doi: 10.2340/17453674.2022.5255.

ABSTRACT

BACKGROUND AND PURPOSE: The incidence of primary and revision total hip arthroplasty (THA) has increased over the last decades. Previous forecasts from different healthcare systems have predicted a continuous increase. We present a forecast of both primary and revision surgery from 2020 to 2050 based on 25 years data from the healthcare system in Denmark.

PATIENTS AND METHODS: We retrieved data from the Danish Hip Arthroplasty Register on 198,835 primary and 29,456 revision surgeries. Historical censuses and population forecasts were retrieved from Statistics Denmark. Logistic and Gompertz regression analysis was used to forecast incidence rates (IR) and total numbers in the next 30 years.

RESULTS: Our forecast predicts an increase in IR of 3-9% and an increase in total numbers of primary THA of between 12% and 19% in 2050. For revision THA the IRs have reached a plateau but total numbers are predicted to increase by 19% in 2050.

CONCLUSION: Our forecast shows that both primary and revision THA will increase in total numbers in the next decades, but the IR for primary THA is near its plateau and for revision THA the plateau has already been reached. The forecast may aid in healthcare resource planning for the decades to come.

PMID:36415903 | DOI:10.2340/17453674.2022.5255

J Biol Rhythms. 2022 Nov 22:7487304221134330. doi: 10.1177/07487304221134330. Online ahead of print.

ABSTRACT

Late sleep timing is prevalent in early childhood and a risk factor for poor behavioral and health outcomes. Sleep timing is influenced by the phase of the circadian clock, with later circadian timing linked to delayed sleep onset in young children. Light is the strongest zeitgeber of circadian timing and, in adults, evening light produces circadian phase delay in an intensity-dependent manner. The intensity-dependent circadian phase-shifting response to evening light in children, however, is currently unknown. In the present study, 33 healthy, good-sleeping children aged 3.0 to 4.9 years (M = 4.14 years, 39% male) completed a 10-day between-subjects protocol. Following 7 days of a stable sleep schedule, an in-home dim-light circadian assessment was performed. Children remained in dim-light across 3 days (55 h), with salivary melatonin collected in regular intervals throughout each evening. Phase-shifting effects of light exposure were determined via changes in the timing of the dim-light melatonin onset (DLMO) prior to (Day 8) and following (Day 10) a light exposure stimulus. On Day 9, children were exposed to a 1 h light stimulus in the hour before their habitual bedtime. Each child was randomly assigned to one intensity between 5 and 5000 lux (4.5-3276 melanopic EDI). Across light intensities, children showed significant circadian phase delays, with an average phase delay of 56.1 min (SD = 33.6 min), and large inter-individual variability. No relationship between light intensity and magnitude of the phase shift was observed. However, a greater percentage of melatonin suppression during the light exposure was associated with a greater phase delay (r = -0.73, p < 0.01). These findings demonstrate that some young children may be highly sensitive to light exposure in the hour before bedtime and suggest that the home lighting environment and its impact on circadian timing should be considered a possible contributor to behavioral sleep difficulties.

PMID:36415902 | DOI:10.1177/07487304221134330

Arthritis Rheumatol. 2022 Nov 22. doi: 10.1002/art.42381. Online ahead of print.

ABSTRACT

OBJECTIVES: Few data are available on whether changes in metabolic syndrome (MetS) affect incident gout. We investigated associations among MetS changes and incident gout in a young male cohort.

METHODS: This nationwide population-based cohort study included 20-39-year-old men who participated in serial health check-ups. The outcome, incident gout, was defined by the claims database diagnostic code for gout. Associations among MetS changes and incident gout were analyzed with Cox proportional hazard models.

RESULTS: Among 1,293,166 subjects, 18,473 were diagnosed with gout (incidence rate 3.36/1,000 person-years). Subjects who were MetS-chronic (MetS at all three health check-ups) had nearly four-fold higher risk of incident gout than subjects who were MetS-free (no MetS at all three health check-ups; aHR [95% CI] 3.82 [3.67-3.98]). Development of MetS more than doubled the risk of incident gout (aHR 2.31 [2.20-2.43]). Conversely, recovery from MetS reduced incident gout risk by nearly half (aHR 0.52 [0.49-0.56]). Among MetS components, changes in elevated triglycerides (development, aHR 1.74 [1.66-1.81]; recovery, aHR 0.56 [0.54-0.59]) and abdominal obesity (development, aHR 1.94 [1.85-2.03]; recovery, aHR 0.69 [0.64-0.74]) showed the greatest association with altered risk of incident gout. Associations among MetS changes and incident gout were more pronounced in subjects in their 20s than subjects in their 30s and in subjects who were under- or normal weight.

CONCLUSIONS: Changes in MetS status were associated with altered risk of incident gout. These results suggest that MetS is a modifiable risk factor for gout.

PMID:36415898 | DOI:10.1002/art.42381