While impact of heat exposure on human health is well-documented, limited research exists on its effect on kidney disease hospital admissions especially in Texas, a state with diverse demographics and a high heat-related death rate. We aimed to explore the link between high temperatures and emergency kidney disease hospital admissions across 12 Texas Metropolitan Statistical Areas (MSAs) from 2004 to 2013, considering causes, age groups, and ethnic populations.
To investigate the correlation between high temperatures and emergency hospital admissions, we utilized MSA-level hospital admission and weather data. We employed a Generalized Additive Model to calculate the association specific to each MSA, and then performed a random effects meta-analysis to estimate the overall correlation. Analyses were stratified by age groups, admission causes, and racial/ethnic disparities. Sensitivity analysis involved lag modifications and ozone inclusion in the model.
Our analysis found that each 1 °C increase in temperature was associated with a 1.73 % (95 % CI [1.43, 2.03]) increase in hospital admissions related to all types of kidney diseases. Besides, the effect estimates varied across different age groups and specific types of kidney diseases. We observed statistically significant associations between high temperatures and emergency hospital admissions for Acute Kidney Injury (AKI) (3.34 % (95 % CI [2.86, 3.82])), Kidney Stone (1.76 % (95 % CI [0.94, 2.60])), and Urinary Tract Infections (UTI) (1.06 % (95 % CI [0.61, 1.51])). Our research findings indicate disparities in certain Metropolitan Statistical Areas (MSAs). In Austin, Houston, San Antonio, and Dallas metropolitan areas, the estimated effects are more pronounced for African Americans when compared to the White population. Additionally, in Dallas, Houston, El Paso, and San Antonio, the estimated effects are greater for the Hispanic group compared to the Non-Hispanic group.
This study finds a strong link between higher temperatures and kidney disease-related hospital admissions in Texas, especially for AKI. Public health actions are necessary to address these temperature-related health risks, including targeted kidney health initiatives. More research is needed to understand the mechanisms and address health disparities among racial/ethnic groups.

Impact of heat on emergency hospital admissions related to kidney diseases in Texas: Uncovering racial disparities.

The dorsal premotor area (DPM) plays an important role in hand coordination and muscle recruitment for lifting activities. Lesions in the area have demonstrated that the DPM is critical in the integration of movements that require combinations of reaching, grasping, and lifting. While many have looked at its functional connectivity, few studies have shown the full anatomical connectivity of DPM including its connections beyond the motor network. Using region-based fMRI studies, we built a neuroanatomical model to account for these extra-motor connections.
In this study, we performed meta-analysis and tractography with the goal of creating a map of the dorsal premotor network using the Human Connectome Project parcellation scheme nomenclature (i.e. the Glasser Atlas). While there are other possible ways to map this, we feel that it is critical that neuroimaging begin to move towards all of its data expressed in a single nomenclature which can be compared across studies, and a potential framework that we can build upon in future studies.
Thirty region-based fMRI studies were used to generate an activation likelihood estimation (ALE) using BrainMap software (Research Imaging Institute of Texas Health Science Center San Antonio). Cortical parcellations overlapping the ALE were used to construct a preliminary model of the Dorsal Premotor Area. Diffusion spectrum imaging (DSI) based tractography was performed to determine the connectivity between cortical parcellations and connections throughout cortex. The resulting connectivities were described using the cortical parcellation scheme developed by the Human Connectome Project (HCP).
Three left hemisphere regions were found to comprise the Dorsal Premotor Area. These included areas 6a, 6d. and 6v, Across mapped brains, these areas showed consistent interconnections between each other. Additionally, ipsilateral connections to the premotor cortex, sensorimotor cortex, superior and inferior parietal lobule, middle and inferior frontal gyrus, and insula were demonstrated. Connections to the contralateral supplementary motor area and premotor cortex were also identified.
We describe a preliminary cortical model for the underlying structural connectivity of the Dorsal Premotor Area. Future studies should further characterize the neuroanatomic underpinnings of this network.

Parcellation-based modeling of the dorsal premotor area.

Surgical site infection after groin incision is a common complication and a financial burden to patients and healthcare systems. Closed incision negative pressure therapy (ciNPT) has been associated with decreased surgical site infection rates in published literature. This meta-analysis examines the effect of ciNPT (PREVENA™ Incision Management System; KCI, San Antonio, TX) versus traditional postsurgical dressing use in reducing surgical site infection rates over closed groin incisions following vascular surgery.
A systematic literature search using PubMed, OVID, EMBASE, and QUOSA was performed on 3 January 2019, by two independent researchers and focused on publications between 1 January 2005 and 31 December 2018. The review conformed to the statement and reporting check list of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Inclusion criteria included abstract or manuscript written in English, published studies, conference abstracts, randomized controlled trials (RCTs), ciNPT usage over closed groin incisions in vascular surgery, comparison of ciNPT use and traditional dressings, study endpoint/outcome of surgical site infection, and study population of >10. Characteristics of study participants, surgical procedure, type of dressing used, duration of treatment, incidence of surgical site infection, and length of follow-up were extracted. Weighted odds ratios and 95% confidence intervals were calculated to pool study and control groups in each publication for analysis. Treatment effects were combined using Mantel-Haenszel risk ratios, and the Chi-Square test was used to assess heterogeneity. Overall, high-risk patients, normal-risk patients, and Szilagyi I, II, III outcomes were assessed between ciNPT and control groups. The Cochrane Collaboration tool was utilized to assess the risk of bias for all studies included in the analysis.
A total of 615 articles were identified from the literature search. After removal of excluded studies and duplicates, six RCT studies were available for analysis. In these studies, a total of 362 patients received ciNPT, and 371 patients received traditional dressings (control). Surgical site infection events occurred in 41 ciNPT patients and 107 control patients. The heterogeneity test was nonsignificant (
A statistically significant reduction in the incidence of surgical site infection was seen following ciNPT usage in patients undergoing vascular surgery with groin incisions.

A systematic review and meta-analysis of randomized controlled trials for the reduction of surgical site infection in closed incision management versus standard of care dressings over closed vascular groin incisions.

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