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Nevin Manimala Statistics

Microplastics at Environmentally Relevant Concentrations Had Minimal Impacts on Pelagic Zooplankton Communities in a Large In-Lake Mesocosm Experiment

Environ Sci Technol. 2024 Oct 17. doi: 10.1021/acs.est.4c05327. Online ahead of print.

ABSTRACT

To assess the potential risks of contemporary levels of plastic pollution in freshwater ecosystems, a large-scale experiment was conducted over 10 weeks in a boreal lake at the IISD-Experimental Lakes Area (Ontario, Canada). Fragments of common polymers (polyethylene, polystyrene, and polyethylene terephthalate), each with distinct colors and buoyancies, were added as a single pulse to seven in-lake mesocosms in equal contributions in a range of environmentally relevant nominal concentrations (6-29,240 particles/L). Two additional mesocosms with no added microplastics were used as controls. Zooplankton ingested low levels of microplastics (mean of 0.06 particles/individual ± SD 0.07) and generally their total abundance and community composition were not negatively impacted. Temporary changes were however observed; total zooplankton abundance and abundance of calanoid copepods were temporarily stimulated by increasing nominal microplastic concentrations, and modest, short-term reductions in egg production of the cyclopoid copepod Tropocyclops extensus and abundance of copepod nauplii occurred. Collectively, these results suggest that microplastics could have complex impacts on zooplankton communities, stimulating some species while negatively impacting others.

PMID:39418533 | DOI:10.1021/acs.est.4c05327

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Automated Preoperative Planning Algorithm for Mandibular Angle Osteotomy Based on Anatomical Landmarks Detection: A Retrospective Study

J Craniofac Surg. 2024 Oct 1;35(7):2009-2014. doi: 10.1097/SCS.0000000000010592. Epub 2024 Oct 1.

ABSTRACT

OBJECTIVE: The aim of the study was to develop and evaluate an automated preoperative planning algorithm based on anatomical landmark point recognition for enhancing the efficiency and intelligence of preoperative planning for mandibular angle osteotomy.

METHODS: A retrospective cohort of 34 patients underwent preoperative planning with this algorithm. The present algorithm was developed using a method based on anatomical marker point recognition. The efficiency, symmetry, and safety of the automated preoperative planning and esthetics were statistically analyzed by paired t test and χ2 test.

RESULTS: The results showed that the automated planning algorithm was able to achieve a great improvement in preoperative planning efficiency as well as safety and symmetry. A prospective case report of 2 patients is then reported, illustrating the safety and esthetics of the algorithm with 1-year postoperative follow-up and postoperative esthetic scores.

CONCLUSION: This algorithm can help to improve the efficiency of preoperative planning for surgeons while ensuring safety and esthetics and can be further applied to other craniomaxillofacial personalized design surgeries in the preoperative design in the future.

PMID:39418506 | DOI:10.1097/SCS.0000000000010592

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The Impact of Race and Ethnicity in Microvascular Head and Neck Reconstruction Postoperative Outcomes: A Nationwide Data Analysis

J Craniofac Surg. 2024 Oct 1;35(7):1952-1957. doi: 10.1097/SCS.0000000000010593. Epub 2024 Oct 1.

ABSTRACT

BACKGROUND: Racial and ethnic disparities have been extensively reported across surgical specialties, highlighting existing healthcare inequities. Nevertheless, evidence is lacking regarding their influence on postoperative outcomes after head and neck reconstruction. This study aimed to evaluate the impact of race and ethnicity on postoperative complications in head and neck microvascular reconstruction.

METHODS: The ACS-NSQIP database was used to identify patients who underwent head and neck microvascular reconstruction between 2012 and 2022. Baseline characteristics were compared based on race (White, non-White) and ethnicity (Hispanic, non-Hispanic). Group differences were assessed using t tests and Fisher Exact tests. Multivariable logistic regression models were constructed to evaluate postoperative complications between the groups. A Cochran-Armitage test was conducted to evaluate the significance of trends over time.

RESULTS: A total of 11,373 patients met inclusion criteria. Among them, 9,082 participants reported race, and 9,428 reported ethnicity. Multivariable analysis demonstrated that Hispanic patients were more likely to experience 30-day readmission (OR 6.7; 95% CI, 1.17-38.4; P=0.032) and had an average total length of stay of 5.25 days longer (95% CI, 0.84-9.65; P=0.020) compared with non-Hispanic patients. Additional subgroup analyses revealed higher rates of all readmissions among non-White patients, particularly those indicated by malignancy (OR 1.23; 95% CI, 1.1-1.4; P=0.002). No significant differences were found in mortality, reoperation rates, and operative times between racial and ethnic groups.

CONCLUSIONS: The findings of this study suggest that ethnicity may be a significant risk factor for readmission in head and neck microvascular reconstruction. However, future studies are needed to further clarify the impact of race and ethnicity on longer postoperative outcomes, particularly in head and neck cancer minorities.

PMID:39418505 | DOI:10.1097/SCS.0000000000010593

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Nevin Manimala Statistics

Early Mortality in Cardiac Surgery – Is Lactate Significant?

Braz J Cardiovasc Surg. 2024 Oct 17;e20230245(e20230245). doi: 10.21470/1678-9741-2023-0245.

ABSTRACT

INTRODUCTION: Serum lactate is a consequence of tissue hypoperfusion and has been used routinely for patient management following cardiac surgery. This study aims to determine the association of lactate with early mortality and postoperative morbidity.

METHODS: This is a prospective cohort study carried out in the Department of Cardiovascular and Thoracic Surgery, King George’s Medical University (India), from January 2020 to December 2022. A total of 270 patients were included in this study. Serum lactate levels were measured preoperatively, intraoperatively on-pump, coming off-pump, and at six, 12, 24, and 48 hours postoperatively.

RESULTS: Early mortality was noted in 17 cases (6.3%). While both lactate and lactate clearance correlated with duration of mechanical ventilation, vasopressor duration, and intensive care unit and hospital stay, correlation with early mortality was noted only with lactate at 24 hours. Logistic regression analysis demonstrated that lactate levels at preoperative period (adjusted odds ratio [OR] 4.76 [1.67-13.59], P=0.004) and at 24 hours after bypass (OR 1.21 [1.00-1.47], P=0.046) and vasopressor duration (OR 1.11 [1.04-1.19], P=0.002) are independent predictors of mortality. Receiver operating characteristic curve analysis showed that arterial lactate on-pump, off-pump, and at six, 12, and 24 hours after surgery had significant area under the curve for predicting mortality.

CONCLUSION: Arterial lactate and lactate clearance show good correlation with duration of mechanical ventilation, vasopressor support, and intensive care unit and hospital stay and can serve as a good indicator to guide therapeutic decisions in postoperative period. However, it fails to be a sensitive predictor of mortality.

PMID:39418497 | DOI:10.21470/1678-9741-2023-0245

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Momentary mindfulness versus distraction coping messages to reduce cannabis craving among young adults: A microrandomized trial

Psychol Addict Behav. 2024 Oct 17. doi: 10.1037/adb0001029. Online ahead of print.

ABSTRACT

OBJECTIVE: Rates of problematic cannabis use among young adults are high and increasing. Craving for cannabis varies throughout the day and is an important risk factor for cannabis use, yet no studies to date have tested interventions offered at the moment craving is experienced in the natural environment.

METHOD: This study used an efficient and innovative microrandomized trial design to test two distinct types of coping messages (mindfulness strategy vs. distraction strategy) offering brief coping strategies when moderate to severe craving was reported via ecological momentary assessment (EMA).

RESULTS: Young adults who regularly use cannabis (N = 53) were readily engaged in this 4-week intervention, and EMA completion was high throughout, demonstrating excellent feasibility of this approach. However, results indicated that coping messages did not reduce craving at the next EMA relative to control (thank you) messages, with no significant change in efficacy over time. Furthermore, exploratory analyses found that neither mindfulness nor distraction resulted in reduced craving relative to the control message.

CONCLUSIONS: Despite this outcome, this method of testing digital interventions targeting momentary risks for substance use such as craving holds promise for rapidly and efficiently screening a wide variety of intervention strategies for inclusion in future just-in-time adaptive interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39418443 | DOI:10.1037/adb0001029

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The Family Climate Questionnaire: A general measure of autonomy support from family members

Fam Syst Health. 2024 Sep;42(3):427-437. doi: 10.1037/fsh0000916.

ABSTRACT

INTRODUCTION: The current study examines the psychometric characteristics of the Family Climate Questionnaire (FCQ), which was intended to measure the degree of autonomy-support among family members for a respondent with health concerns.

METHOD: The sample included military veterans (N = 350), a portion of whom had congestive heart failure (N = 86) or diabetes (N = 77), and a portion who were referred from primary care for behavioral health concerns (N = 187). Overall, 92.6% of the participants were male, and 56.7% were Black or African American and 40.6% were Caucasian.

RESULTS: The findings highly supported the factor structure, internal consistency, and construct validity of the Autonomy Support subscale. In addition, there was high support for factorial invariance across subsamples of veterans with chronic medical problems compared to those referred from primary care. The findings for an additional subscale developed for this study, Coercion, were less supportive, with insufficient convergence in factor structure and relatively poorer internal consistency.

DISCUSSION: The FCQ Autonomy Support measure appears to have potential as a useful measure of a family environment that supports autonomy for health among individuals with both medical and mental health conditions, and it is a flexible measure that can be used with a range of family member types. The FCQ Coercion measure received less consistent empirical support and will require additional development and testing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39418426 | DOI:10.1037/fsh0000916

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Structural inequality modifies midlife outcomes of a multisystemic early childhood program

Fam Syst Health. 2024 Sep;42(3):417-426. doi: 10.1037/fsh0000895.

ABSTRACT

INTRODUCTION: The role of structural inequalities in the long-term benefits of early childhood programs has not been assessed. Previous findings in the Chicago Longitudinal Study, an early childhood cohort investigation with low-income families, indicate that Child-Parent Center (CPC) participation beginning in preschool was associated with a variety of positive health behaviors. In this secondary analysis, we assessed if structural inequalities (neighborhood poverty, history of discrimination) modified the magnitude of associations between CPC and health and education outcomes (cardiovascular health, body mass index, educational attainment) 30 years later.

METHOD: The Chicago Longitudinal Study cohort of 1,539 children (93% Black, 7% Hispanic) grew up in high-poverty neighborhoods and attended CPCs or the usual district programs. At midlife (ages 32-37, M = 34.9 years, 2012-2017), 1,073 participants completed telephone interviews on structural inequalities, health, and education. Regression analyses were conducted with inverse propensity score weighting.

RESULTS: After accounting for structural inequality, CPC participation was significantly associated with outcomes. Mean differences on Framingham risk scores, for example, were significant for CPC preschool at ages 3 and 4 (coefficient = -2.15, p = .004, standardized difference = -0.20). Neighborhood poverty moderated (reduced) the association between CPC and cardiovascular health. Neighborhood poverty and perceived discrimination had independent contributions with outcomes.

DISCUSSION: Findings show that structural inequalities, especially poverty, directly influence and/or moderate long-term effects of CPC participation. Increasing neighborhood resources and socioeconomic status may help comprehensive programs sustain their impacts. Early childhood and sociostructural influences reflect the increasing importance of community contexts to health promotion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39418425 | DOI:10.1037/fsh0000895

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Parental incarceration and adolescent food insecurity

Fam Syst Health. 2024 Sep;42(3):386-391. doi: 10.1037/fsh0000909.

ABSTRACT

BACKGROUND: There is a causal relationship between parental incarceration (PI) and childhood food insecurity (FI). This is a pressing policy issue given that public assistance designed to curb hunger (i.e., Supplemental Nutrition Assistance Program) is often revoked due to incarceration which, on top of the removal of a household income source, can significantly alter children’s food access. Yet questions remain regarding the prevalence of FI among youth with incarcerated parents, as well as the interplay of parent-child coresidence, race/ethnicity, and geographic region.

METHOD: Data come from the 2019 Minnesota Student Survey, a statewide sample of adolescents (N = 112,554). Youth self-reported experiences of PI, parent-child coresidence at the time of incarceration, past-month FI, and race/ethnicity. Based on school districts, regions were classified as city, suburb, town, or rural.

RESULTS: Youth with currently and formerly incarcerated parents reported significantly higher rates of FI (18.11% and 10.41%, respectively) compared to peers who never experienced PI (2.84%; ORs = 7.56 and 3.97, respectively). Among youth with currently incarcerated parents, rates of FI were highest among those who lived with the parent at the time of incarceration (21.79%) compared to those who did not (13.98%). Youth of color and city youth were more likely to experience FI in contexts of PI.

CONCLUSIONS: Findings extend the link between PI and child FI. The evidence is concerning given FI’s heightened risk for chronic health conditions, which may be compounded by trauma and systemic injustice. This work has implications for policies that expand, rather than reduce, food access and financial assistance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39418424 | DOI:10.1037/fsh0000909

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Effectiveness of Dexamethasone for COVID-19 in Hospitalized Patients with Diabetes: A Retrospective Cohort Study

J Clin Endocrinol Metab. 2024 Oct 17:dgae734. doi: 10.1210/clinem/dgae734. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with diabetes have higher mortality from COVID-19 compared to the general population. Dexamethasone, a potent glucocorticoid used for moderate to severe COVID-19, can worsen hyperglycemia in patients with diabetes, potentially leading to worse outcomes. The efficacy and safety of use of dexamethasone for COVID-19 in patients with diabetes needs further evaluation.

OBJECTIVE: The study aimed to assess the efficacy and safety of dexamethasone in patients with diabetes hospitalized for COVID-19 infection.

DESIGN: This retrospective study analyzed data from five hospitals in the Johns Hopkins Health System (JHHS) collected between March 3, 2020 and June 25, 2022. Propensity score matching was applied to a cohort of patients with diabetes who received dexamethasone and those who did not (controls), and outcomes were compared using Cox proportional hazards regression models.

OUTCOMES: The primary outcome was time to death within 28 days. The secondary outcome was time to clinical improvement. Additional outcomes included the incidence of hyperglycemic emergencies and subgroup analysis of primary outcomes by clinical severity.

RESULTS: Out of 10,329 patients admitted for COVID-19, 3,679 had diabetes, and 2,361 met the inclusion criteria. After propensity score matching, 529 patients were analyzed in each group. Survival rates between the dexamethasone and control groups during the 0-6 day and 7-28-day periods and time to clinical improvement at 28 days did not differ significantly. There was no difference in the incidence of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) between the groups.

CONCLUSION: Dexamethasone treatment did not significantly improve survival or time to clinical improvement in patients with diabetes and COVID-19 infection. Further prospective studies are needed to confirm these findings and determine potential mechanisms.

PMID:39418352 | DOI:10.1210/clinem/dgae734

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Co-occurrence and correlation of arsenic, cadmium, and lead in processed foods intended for infants and young children: evaluation of two statistical approaches adapted to censored data and their implications for risk management

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2024 Oct 17:1-18. doi: 10.1080/19440049.2024.2414956. Online ahead of print.

ABSTRACT

We evaluated the co-occurrence of arsenic (As), cadmium (Cd), and lead (Pb) in 10 categories of processed foods intended for infants and young children (<2 years old) and adapted methodology to characterise and evaluate the impact of correlations on toxic element (TE) concentrations in these foods. Co-occurrence was assessed by calculating the frequency of samples having concentrations above the limit of detection (LOD) among TE sets (i.e. As-Cd, As-Pb, Cd-Pb, and As-Cd-Pb). Pairwise correlations were evaluated using two statistical approaches adapted to censored data: (i) non-parametric Kendall’s tau and (ii) parametric Bayesian modelling. Nonparametric and parametric correlation analyses showed similar results. We found positive correlations among one or more pairs of the TEs (As, Pb, and Cd) in 9 of the 10 categories of foods intended for infants and young children and a negative correlation for one TE pair for a single food category. Where positive correlations are observed, removing samples with high concentrations of a given TE reduces the mean of the other TEs in that food. We also explored the impact of correlations among TEs on the fraction of the supply below maximum levels. Positive correlations among TEs have the potential to reduce the impact on the supply when setting multiple maximum levels.

PMID:39418344 | DOI:10.1080/19440049.2024.2414956