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Nevin Manimala Statistics

The association of chronic bronchitis and airflow obstruction with lifetime and current farm activities in a sample of rural adults in Iowa

Int Arch Occup Environ Health. 2022 Apr 28. doi: 10.1007/s00420-022-01866-4. Online ahead of print.

ABSTRACT

OBJECTIVE: Farmers have an increased risk for chronic bronchitis and airflow obstruction. The objective of this study was to investigate the association of these health outcomes with farm activities.

METHODS: We evaluated the Keokuk County Rural Health Study (KCRHS) enrollment data for farm activities and the two health outcomes chronic bronchitis based on self-reported symptoms and airflow obstruction based on spirometry. We used logistic regression to model the health outcomes, yielding an odds ratio (OR) and 95% confidence interval (95% CI) for farm activities while adjusting for potential confounders and other risk factors.

RESULTS: Of the 1234 farmers, 104 (8.4%) had chronic bronchitis, 75 (6.1%) fulfilled the criteria for airflow obstruction, and the two outcomes overlapped by 18 participants. Chronic bronchitis without airflow obstruction (n = 86) had a statistically significant association with crop storage insecticides (OR 3.1, 95% CI 1.6, 6.1) and a low number of years (≤ 3) worked with turkeys (OR 3.3, 95% CI 1.2, 9.4). The latter result should be interpreted with caution because it is based on a small number of cases (n = 5). Airflow obstruction with or without chronic bronchitis (n = 75) was significantly associated with ever working in a hog or chicken confinement setting (OR 2.2, 95% CI 1.0, 4.5).

CONCLUSIONS: These results suggest that work with crop storage insecticides or turkeys may increase the risk for chronic bronchitis and work in hog or chicken confinement may increase the risk for airflow obstruction.

PMID:35482110 | DOI:10.1007/s00420-022-01866-4

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Study on the effect of vehicular pollution on the ambient concentrations of particulate matter and carbon dioxide in Srinagar City

Environ Monit Assess. 2022 Apr 28;194(6):393. doi: 10.1007/s10661-022-09927-4.

ABSTRACT

The present study was carried out to monitor the ambient concentrations of particulate matter and carbon dioxide caused by vehicular pollution in Srinagar City of Jammu and Kashmir, India, for a period of 12 months from June 2019 to May 2020 as the major contributions in these areas are due to vehicular movement. Out of five, four locations (viz. Dalgate, Jehangir Chowk, Parimpora and Pantha Chowk) had highest traffic density in the city and the fifth location (Shalimar) had low traffic volume. The sampling was done on every fortnight using AEROCET 831-aerosol mass monitor and CDM 901-CO2 monitor with each sampling being carried out three times a day, i.e. morning (9:00 am-10:30 am), afternoon (1:00 pm-2:30 pm) and evening (4:30 pm-6:00 pm) with three replications at each site based on the peak traffic hours. The results show that during the whole period, average PM1 concentrations ranged from 15.10 to 108.9 µg/m3, PM2.5 (28.70-577.50 µg/m3), PM4 (44.50-780.87 µg/m3), PM10 (57.13-1225.53 µg/m3), total suspended particulates (77.77-1410.27 µg/m3) and CO2 (332.4-655.0 ppm). The average concentrations of these parameters showed that the maximum PM1 concentration was found at Dalgate (53.77 µg/m3) and PM2.5 had its maximum average concentration at Jehangir Chowk (140.13 µg/m3). Other parameters like PM4, PM10, TSP and CO2 had a maximum average values at Jehangir Chowk (240.23 µg/m3, 633.40 µg/m3, 853.50 µg/m3 and 533.20 ppm, respectively). The pollution load was observed to be maximum during winter season followed by autumn, summer and spring. The lowest concentration of all pollutants except CO2 was observed in April 2020 and this might be due to COVID-19 lockdown observed in the country during the same period.

PMID:35482106 | DOI:10.1007/s10661-022-09927-4

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Single-versus Two-port Video-assisted Thoracic Surgery in Thymoma: 
A Propensity-matched Study

Zhongguo Fei Ai Za Zhi. 2022 Apr 20;25(4):253-258. doi: 10.3779/j.issn.1009-3419.2022.101.15.

ABSTRACT

BACKGROUND: In recent years, with the advancement of minimally invasive techniques, thoracoscopic thymoma resection has experienced a development process from three-port video-assisted thoracic surgery (VATS) to two-port (TP) and single-port (SP) variants. However, the feasibility and safety of SP-VATS have not been generally recognized. This study intends to explore the safety and feasibility of SP-VATS in thymoma resection, in order to provide a reference for clinical surgicalselection.

METHODS: The clinical data of 197 patients who underwent thoracoscopic thymoma resection in Beijing Tongren Hospital from January 2018 to September 2021 were retrospectively analyzed. The patients were divided into SP-VATS group (n=42) and TP-VATS group (n=155). After matching propensity scores, there is no statistically significant difference in preoperative baseline data between SP-VATS group and TP-VATS group. Among them, there were 17 males and 25 females with an average age of 28-72 (48.00±9.43) years in the SP-VATS group, and 20 males and 22 females with an average age of 30-75 (50.38±9.83) years in TP-VATS group. The clinical effects of the two groups were compared.

RESULTS: The operation was successfully completed in both groups, and there was no conversion to thoracotomy or increased surgical incisions. Compared with the TP-VATS group, the chest drainage time and hospital stay in the SP-VATS group were shorter [(2.95±0.76) d vs (3.33±0.85) d; (4.57±0.83) d vs (5.07±1.13) d], and the visual pain score at 24 h and 72 h after surgery were lower [(3.64±0.85) points vs (4.05±0.66) points; (2.33±0.75) points vs (3.07±0.68) points] (P<0.05). There was no statistically significant difference between the two groups in operation time [(130.00±26.23) min vs (135.24±27.03) min], intraoperative blood loss [(69.52±22.73) mL vs (82.38±49.23) mL] (P>0.05).

CONCLUSIONS: SP-VATS in thymoma is a safe, feasible, and less invasive procedure, with less postoperative pain and faster recovery than multi-port VATS.

PMID:35477189 | DOI:10.3779/j.issn.1009-3419.2022.101.15

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The Quick Dementia Rating System and Its Relationship to Biomarkers of Alzheimer’s Disease and Neuropsychological Performance

Dement Geriatr Cogn Disord. 2022 Apr 27:1-7. doi: 10.1159/000524548. Online ahead of print.

ABSTRACT

INTRODUCTION: The Quick Dementia Rating System (QDRS) is a brief, patient-reported dementia staging tool that has approximated scores on the Clinical Dementia Rating Scale in patients with Alzheimer’s disease (AD). However, no studies have examined its relationship with AD-related biomarkers.

METHODS: One-hundred twenty-one older adults (intact, amnestic mild cognitive impairment, mild AD) completed the QDRS, and three biomarkers (amyloid deposition via positron emission tomography, hippocampal volume via magnetic resonance imaging, and apolipoprotein [APOE] ε4 status).

RESULTS: The Total score on the QDRS was statistically significantly related to all three biomarkers (after controlling for age, education, sex, and race), with greater levels of dementia severity being associated with greater amyloid deposition, smaller hippocampi, and having copies of APOE ε4 allele.

DISCUSSION: In participants across the cognitive spectrum, the QDRS showed modest relationships with amyloid deposition, hippocampal volumes, and APOE status. Therefore, the QDRS may offer a cost-effective screening method for clinical trials in AD.

PMID:35477163 | DOI:10.1159/000524548

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Spin-dependent transport in a driven non-collinear antiferromagnetic fractal network

J Phys Condens Matter. 2022 Apr 27. doi: 10.1088/1361-648X/ac6b0b. Online ahead of print.

ABSTRACT

Non-collinear magnetic texture breaks the spin-sublattice symmetry which gives rise to a spin-splitting effect. Inspired by this, we study the spin-dependent transport properties in a non-collinear antiferromagnetic fractal structure, namely, the Sierpinski Gasket (SPG) triangle. We find that though the spin-up and spin-down currents are different, the degree of spin polarization is too weak. Finally, we come up with a proposal, where the degree of spin polarization can be enhanced significantly in the presence of a time-periodic driving field. Such a prescription of getting spin-filtering effect from an unpolarized source in a fractal network is completely new to the best of our knowledge. Starting from a higher generation of SPG to smaller ones, the precise dependencies of driving field parameters, spin-dependent scattering strength, interface sensitivity on spin polarization are critically investigated. The spatial distribution of spin-resolved bond current density is also explored. Interestingly, our proposed setup exhibits finite spin polarization for different spin-quantization axes. Arbitrarily polarized light is considered and its effect is incorporated through Floquet-Bloch ansatz. All the spin-resolved transport quantities are computed using Green’s function formalism following the Landauer-B”{u}ttiker prescription. In light of the experimental feasibility of such fractal structures and manipulation of magnetic textures, the present work brings forth new insights into spintronic properties of non-collinear antiferromagnetic SPG. This should also entice the AFM spintronic community to explore other fractal structures with the possibility of unconventional features.

PMID:35477129 | DOI:10.1088/1361-648X/ac6b0b

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Immunogenicity of the BNT162b2 Vaccine in Patients Undergoing Maintenance Hemodialysis Is Associated with Medical Conditions

Nephron. 2022 Apr 27:1-6. doi: 10.1159/000524292. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patients undergoing maintenance hemodialysis have an attenuated immune response to vaccination. The aim of our study was to determine the predictive factors for humoral response to vaccination with the BNT162b2 mRNA vaccine (Pfizer-BioNTech) in patients on maintenance hemodialysis.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: In this retrospective, single-center study, we included patients on maintenance hemodialysis already vaccinated with two doses of the BNT162b2 vaccine (Pfizer-BioNTech) and with a post-vaccination serological follow-up.

RESULTS: 252 patients were included for study with a mean age of 71.9 (±14.4) years. Twelve patients (4.7%) were under immunosuppressive therapy (calcineurin inhibitors: n = 4; chemotherapy for myeloma: n = 3; last infusion of rituximab over the previous 4 years: n = 2; abatacept: n = 2; adalimumab n = 1). Three of these patients were under immunosuppressive therapy for nonrenal solid organ transplantation. Multivariate analysis identified immunosuppressive therapy (OR 4.73 [1.38-16.17], p = 0.013) and lower baseline albumin levels (OR 1.23 [1.09-1.38], p < 0.001) as independent predictive factors of nonresponse to vaccination. Older age (β = -0.59 ± 0.21, p = 0.006) and immunosuppressive therapy (β = 40.33 ± 13.33, p = 0.003) were significantly associated with lower humoral response to vaccination.

CONCLUSIONS: Approximately 90% of patients under maintenance hemodialysis developed specific antibodies to the BNT162b2 mRNA vaccine. Immunosuppressive therapy, malnutrition, and older age were associated with a higher risk of nonseroconversion or lower humoral response to mRNA-based vaccination against SARS-CoV-2. We strongly recommend serological monitoring after vaccination to determine booster timing, especially for patients with malnutrition or on immunosuppressive therapy.

PMID:35477156 | DOI:10.1159/000524292

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Theophrastus’s “Anaisthetos” (“The Obtuse Man”): the oldest phenomenological description of neurodevelopmental disorders in an adult

Psychiatriki. 2022 Apr 27. doi: 10.22365/jpsych.2022.079. Online ahead of print.

ABSTRACT

Theophrastus (381-278 B.C.), was the first to adopt the term character for the description of distinct inner psychological and moral features of an individual. In his classic book ‘Characters’ in a simple style wording he analyses some of his contemporary individuals. The character “Αναίσθητος” (Anaisthetos) has been translated in English as “The Obtuse Man” and in Modern Greek both as “Αναίσθητος”, meaning lack of appreciation and “Βραδύνους”, meaning slowness of mind. Theophrastus’ description of this particular character is compatible with the co-occurrence in an adult of two Neurodevelopmental Disorders: the Attention-Deficit Hyperactivity Disorder (ADHD) and the Social Pragmatic Communication Disorder (SPCD), according to the 5th Diagnostic and Statistical Manual of Mental Disorders. Ten out of the twelve statements support the possible occurrence of ADHD while five of them the occurrence of SPCD. The description does not justify a diagnosis of an intellectual disability; therefore, we consider that in the Modern Greek vocabulary the original term «Αναίσθητος» (“Anaisthetos”), meaning lack of appreciation, is more accurately corresponding to this particular Theophrastus’s character than “Βραδύνους” (“Obtuse”), which indicates the presence of low intellectual capacities. Also the lack of repetitive and restrictive interests and behaviours excludes Autism Spectrum Disorder as a possible diagnosis. Minor psychiatric disorders and traits according to the Peripatic School were attributed to the lack of rational control over appetites and behavior. Accordingly, «Αναίσθητος» is a phenomenological description of a stigmatizing inappropriate social behavior and the only help that might give is in increasing self-awareness. In our contemporary clinical practice, though, the early recognition and appropriate treatment of Neurodevelopmental Disorders in affected individuals, leads to a better clinical care and may diminish stigmatization. The co-existence of these two disorders in a character in such a different historical context reinforces their validity as diagnostic constructs and provides an example of co-occurrence of Neurodevelopmental Disorders.

PMID:35477088 | DOI:10.22365/jpsych.2022.079

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Anti-Müllerian hormone, an ovarian reserve marker in hypogonadotropic hypogonadism

Eur J Obstet Gynecol Reprod Biol. 2022 Apr 21;273:54-58. doi: 10.1016/j.ejogrb.2022.04.016. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the usefulness of Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) as an ovarian reserve marker in hypogonadotropic hypogonadism (HH) patients and to find a limit value for the gonadotropin levels in the diagnosis of HH patients.

STUDY DESIGN: It is a retrospective cross-sectional single-center study. One hundred ninety-nine women with HH and 171 healthy controls with no cycle disorders were included into this study. Continuous variables were expressed as mean ± standard deviation. Statistical comparisons were carried out according to the intention to treat by Student’s t-test, Mann-Whitney U test, where appropriate. Receiver operating characteristic curve-ROC was used to represent the sensitivity and specificity pair corresponding to decision threshold of FSH and LH levels in HH diagnosis. P < 0.05 was accepted to be statistically significant.

RESULTS: There was not any statistically significant difference between HH and control group regarding the age (23.94 ± 6.56 vs. 23.92 ± 3.01, respectively; p = 0.09). Serum AMH levels didn’t show statistically significant difference between HH and control group (3.26 ± 2.61 ng/mL vs. 3.15 ± 1.46 ng/mL, respectively; p = 0.11). The difference of AFC between HH and control group was statistically significant (6.67 ± 6.33 vs. 10.91 ± 2.92, respectively; p < 0.001). Follicle-stimulating hormone (FSH), Luteinizing-hormone (LH) and Estradiol (E2) levels between the groups were found to be significantly different. Area under the receiver operating characteristic curve-ROC for FSH was 0.98 and for LH was 0.96. For the diagnosis of HH, FSH levels lower than 3.05 IU/L (with a sensitivity of 92% and specificity of 94%) and LH levels lower than 1.55 IU/L (with a sensitivity of 91% and specificity of 92%) can be used.

CONCLUSION: In conclusion, serum AMH levels reflect the follicle cohort in HH cases validly with negligible underestimation of ovarian reserve. FSH < 3.05 IU/L and LH < 1.55 IU/L could be used with high sensitivity and specificity for the diagnosis of HH.

PMID:35477042 | DOI:10.1016/j.ejogrb.2022.04.016

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Comparison of the functional outcomes after treatment of periprosthetic hip fractures with femoral stem loosening: locking plate fixation with or without femoral stem revision

Orthop Traumatol Surg Res. 2022 Apr 24:103300. doi: 10.1016/j.otsr.2022.103300. Online ahead of print.

ABSTRACT

INTRODUCTION: Periprosthetic fractures have become one of the main reasons for revision of total hip arthroplasty, with the treatment strategy guided by the Vancouver and SOFCOT classification systems. The main objective of this work was to compare the functional outcomes and mortality rate in patients who suffered a periprosthetic hip fracture with femoral stem loosening and who were treated either by internal fixation with locking plate only, or in combination with revision of the existing femoral stem with a cemented stem. The secondary objective was to compare the blood loss, procedure duration, length of hospital stay, living arrangements, time to weight bearing and major complications between these two treatment strategies. The starting hypothesis was that there is no difference in the functional outcomes between these two groups.

MATERIALS AND METHODS: This was a single center, retrospective study of patients treated between 2013 and 2019. Thirty-six patients (54%) underwent femoral stem revision (FSR group) and 31 patients (46%) were treated by locking plate fixation only (ORIF group). In this population, 19 of the patients had been residing at a nursing home before the surgical treatment: 12 (33%) in the FSR group and 7 (23%) in the ORIF group (p = 0.33). The mean preoperative Parker score was 7.03 (± 1.48) in the FSR group versus 5.19 (± 1.92) in the ORIF group. The functional outcomes at the final review were evaluated using the Parker score, HHS (Harris Hip score), WOMAC (Western Ontario and McMaster Arthritis Index) and Oxford score. Fracture healing was determined on radiographs centered over the hip joint with the entire femur visible on AP and lateral views. All patients were reviewed at a minimum of 1 year for clinical and radiological assessments.

RESULTS: At a mean follow-up of 28 months [12-85], the Oxford score was 40.4 (± 10.6) in the FSR group versus 37.1 (± 13.5) in the ORIF group (p = 0.34), WOMAC of 45.5 (± 26.9) versus 50.5 (± 32.4) (p = 0.56), and HHS of 62.7 (± 25.5) versus 60.3 (± 28.6) (p = 0.79). The Parker score at the final assessment was 5.14 (± 1.96) in the FSR group versus 4.64 (± 2.17) in the ORIF group (p = 0.33). In the FSR group, 10 patients were at a nursing home (34%), 6 of whom were not there initially, versus 6 in the ORIF group (43%), 5 of whom were not there initially (p = 0.59). The mean operating time was 152 ± 41.4 minutes (minimum: 85; maximum: 254) in the FSR group versus 89.2 (± 44.1) minutes (minimum: 39; maximum: 280) in the ORIF group (p < 0.001). Resumption of full weight bearing occurred at 6 weeks in 21 patients (58%) in the FSR group versus 14 patients (47%) in the ORIF group (p = 0.023). There were 5 major complications (14%) in the FSR group versus 7 (23%) in the ORIF group (p = 0.35). Among the reviewed patients, the union rate was 86% on the latest radiographs in the FSR group versus 78% in the ORIF group.

DISCUSSION: There was no statistically significant difference between groups in the various functional scores, confirming our study hypothesis. Internal fixation with a locking plate appears to be an acceptable solution for treating periprosthetic hip fractures in which the femoral stem has loosened.

LEVEL OF EVIDENCE: III, comparative retrospective study.

PMID:35477038 | DOI:10.1016/j.otsr.2022.103300

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Objective and Subjective Benefit of Direct-to-Consumer Hearing Devices in Middle-Aged Adults

Am J Audiol. 2022 Apr 27:1-11. doi: 10.1044/2022_AJA-21-00171. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this project was to assess subjective and objective benefit provided by several direct-to-consumer hearing devices for middle-aged adults. The primary goal of this study was to determine the extent to which this type of device can yield benefit when users are listening in a range of acoustic conditions, rather than to compare benefit among devices.

METHOD: Participants (M age = 58 years, n = 40) completed a speech perception task with and without one of four direct-to-consumer devices. Stimuli were presented with three types of maskers (steady-state noise, modulated noise, and competing talkers) at two different signal-to-noise ratios and two target levels. Participants also rated the effort required to complete the task with and without the devices and completed a short questionnaire about device comfort and perceived effectiveness.

RESULTS: The amount of objective benefit (in terms of speech recognition accuracy) varied among the four products, with two of the four devices yielding statistically significant benefit with medium-to-large effect sizes. Reduction in self-rated listening effort was noted from the use of all four devices, with a moderate effect size. Degree of hearing loss (4-frequency pure-tone average) was not significantly associated with the amount of either subjective or objective benefit. Responses to the posttask questionnaire indicated that many of the participants would be willing to use these or similar devices in the “real world.”

CONCLUSIONS: Our findings support the concept that direct-to-consumer hearing devices have the potential to improve objective and/or subjective speech recognition in middle-aged adults, at least when fit to prescriptive targets. Benefit from these devices was not related to degree of hearing loss in this sample of participants.

PMID:35476927 | DOI:10.1044/2022_AJA-21-00171