Category: Nevin Manimala

JAMA Intern Med. 2024 Jun 17. doi: 10.1001/jamainternmed.2024.1733. Online ahead of print.

ABSTRACT

IMPORTANCE: Recognizing and providing services to individuals at highest risk for drug overdose are paramount to addressing the drug overdose crisis.

OBJECTIVE: To examine receipt of medications for opioid use disorder (MOUD), naloxone, and behavioral health services in the 12 months after an index nonfatal drug overdose and the association between receipt of these interventions and fatal drug overdose.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted in the US from January 2020 to December 2021 using claims, demographic, mortality, and other data from the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and other sources. The cohort comprised Medicare fee-for-service beneficiaries aged 18 years or older with International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes for a nonfatal drug overdose. Data analysis was performed from February to November 2023.

EXPOSURES: Demographic and clinical characteristics, substance use disorder, and psychiatric comorbidities.

MAIN OUTCOMES AND MEASURES: Receipt of MOUD, naloxone, and behavioral health services as well as subsequent nonfatal and fatal drug overdoses.

RESULTS: The cohort consisted of 136 762 Medicare beneficiaries (80 140 females [58.6%]; mean (SD) age of 68.2 [15.0] years) who experienced an index nonfatal drug overdose in 2020. The majority of individuals had Hispanic (5.8%), non-Hispanic Black (10.9%), and non-Hispanic White (78.8%) race and ethnicity and lived in metropolitan areas (78.9%). In the 12 months after their index nonfatal drug overdose, 23 815 beneficiaries (17.4%) experienced at least 1 subsequent nonfatal drug overdose and 1323 (1.0%) died of a fatal drug overdose. Opioids were involved in 72.2% of fatal drug overdoses. Among the cohort, 5556 (4.1%) received any MOUD and 8530 (6.2%) filled a naloxone prescription in the 12 months after the index nonfatal drug overdose. Filling a naloxone prescription (adjusted odds ratio [AOR], 0.70; 95% CI, 0.56-0.89), each percentage of days receiving methadone (AOR, 0.98; 95% CI, 0.98-0.99) or buprenorphine (AOR, 0.99; 95% CI, 0.98-0.99), and receiving behavioral health assessment or crisis services (AOR, 0.25; 95% CI, 0.22-0.28) were all associated with reduced adjusted odds of fatal drug overdose in the 12 months after the index nonfatal drug overdose.

CONCLUSIONS AND RELEVANCE: This cohort study found that, despite their known association with reduced risk of a fatal drug overdose, only a small percentage of Medicare beneficiaries received MOUD or filled a naloxone prescription in the 12 months after a nonfatal drug overdose. Efforts to improve access to behavioral health services; MOUD; and overdose-prevention strategies, such as prescribing naloxone and linking individuals to community-based health care settings for ongoing care, are needed.

PMID:38884975 | DOI:10.1001/jamainternmed.2024.1733

J Exp Psychol Gen. 2024 Jun;153(6):1517-1536. doi: 10.1037/xge0001582.

ABSTRACT

People can report summary statistics for various features about a group of objects. One theory is that different abilities support ensemble judgments about low-level features like color versus high-level features like identity. Existing research mostly evaluates such claims based on evidence of correlations within and between feature domains. However, correlations between two identical tasks that only differ in the type of feature that is used can be inflated by method variance. Another concern is that conclusions about high-level features are mostly based on faces. We used latent variable methods on data from 237 participants to investigate the abilities supporting low-level and high-level feature ensemble judgments. Ensemble judgment was measured with six distinct tests, each requiring judgments for a distinct low-level or high-level feature, using different task requirements. We also controlled for other general visual abilities when examining how low-level and high-level ensemble abilities relate to each other. Confirmatory factor analyses showed a perfect correlation between the two factors, suggesting a single ability. There was a unique relationship between these two factors beyond the influence of object recognition and perceptual speed. Additional results from 117 of the same participants also ruled out the role of working memory. This study provides strong evidence of a general ensemble judgment ability across a wide range of features at the latent level and characterizes its relationship to other visual abilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38884962 | DOI:10.1037/xge0001582

Pharmacogenomics. 2024 Jun 6:1-6. doi: 10.1080/14622416.2024.2355862. Online ahead of print.

ABSTRACT

Background: Previous differences in guideline recommendation strength for CYP2C19 intermediate metabolizers may have limited genotype (PGx)-optimal post-percutaneous coronary intervention antiplatelet prescribing. Results: In this single-center retrospective observational cohort study of CYP2C19 intermediate metabolizers, patients prescribed PGx-optimal therapy were younger and less likely on anticoagulation (2 vs 12%; p = 0.006). More patients prescribed PGx-optimal therapy possessed commercial insurance (36 vs 7%; p < 0.001), which was a predictor for PGx-optimal selection (OR: 6.464; 95% CI: 2.386-17.516; p < 0.001). Conclusion: Anticoagulation use was significantly associated with clopidogrel use (OR: 0.138; 95% CI: 0.026–0.730; p = 0.020). No statistical difference in composite major adverse cardiovascular events (5 vs 14%; p = 0.173) or bleeding (8 vs 6%; Not significant) was observed between PGx-optimal and PGx-suboptimal therapy.

PMID:38884958 | DOI:10.1080/14622416.2024.2355862

Clin Adv Periodontics. 2024 Jun 17. doi: 10.1002/cap.10302. Online ahead of print.

ABSTRACT

BACKGROUND: The gingival biotype (GB) influences treatment planning and clinical outcomes in several dental specialties. This study aimed to investigate the associations between the GB and various clinical crown and periodontal parameters, such as probing depth (PD), papillary height (PH), keratinized tissue width (KTW), crown width/crown length ratio (CW/CL), and gingival thickness (GT). The secondary objective was to evaluate the optimal cutoff values for all parameters to determine the GB in both the maxillary and mandibular anterior teeth.

METHODS: This cross-sectional study included 50 healthy individuals (26 men and 24 women) aged between 20 and 35 years. The GB was determined as a binary variable based on the transparency of a periodontal probe through the buccal gingival margin (TRAN). The clinical crown and periodontal parameters, such as PH, PD, KTW, GT (free gingival thickness [FGT] and attached gingival thickness [AGT]), and the CW/CL ratio were measured. The associations between different variables were evaluated by the chi-square test. Correlations between various clinical parameters and GB were assessed using point-biserial correlation analyses. Receiver operating characteristic (ROC) analysis and the Youden index were used to calculate the optimal cutoff values for the PH, PD, KTW, FGT, AGT, and CW/CL ratio to discriminate GB. The statistical significance level was set at p < 0.05.

RESULTS: The mean age of the males was 28.23 ± 2.81 years, while that of the females was 27.08 ± 2.85 years. Thick GB was present in 56% of individuals, and thin GB was present in 44% of individuals. Compared with females, males had a predilection for thick GB compared with females. According to the ROC analysis, the cutoff values to discriminate GB for mandibular anterior teeth were 3.4 mm for PH, 1.96 mm for PD, 4.21 mm for KTW, 0.98 mm for FGT, 0.43 mm for AGT, and 0.91 for the CW/CL ratio. Similarly, the cutoff values for discriminating the GB for maxillary anterior teeth were 4.02 mm for PH, 1.92 mm for PD, 3.89 mm for KTW, 1.02 mm for FGT, 0.42 mm for AGT, and 0.83 for the CW/CL ratio. PH, PD, and FGT showed strong positive correlations with GB, whereas KTW, AGT, and the CW/CL ratio showed weak positive correlation with GB.

CONCLUSION: Within the limitations of the present study, a significant association between all clinical crown and periodontal parameters with the GB has been confirmed. FGT for mandibular anterior teeth and PH for the mandibular anterior teeth have emerged as the most reliable measurements to differentiate between thick and thin GB based on ROC analysis.

KEY POINTS: All the clinical parameters such as papillary height, probing depth, width of keratinized gingiva, gingival thickness, and crown width/height ratio were significantly associated with gingival biotype. Free gingival thickness for mandibular anterior teeth and papillary height for the maxillary anterior teeth have emerged as the most reliable measurement to differentiate between thick and thin gingival biotypes.

PMID:38884937 | DOI:10.1002/cap.10302

Environ Sci Pollut Res Int. 2024 Jun 17. doi: 10.1007/s11356-024-33896-5. Online ahead of print.

ABSTRACT

Volatile organic compounds (VOCs) have been extensively studied because of their significant roles as precursors of atmospheric ozone and secondary organic aerosol pollution. The research aims to comprehend the current advancements in domestic and international VOC emission accounting. The study utilized the CiteSpace software to represent the pertinent material from Web of Science visually. The hot spots and future development trends of VOC emission calculation are analyzed from the perspectives of thesis subject words, cooperative relationships, co-citation relationships, journals, and core papers. According to the statistics, the approaches most often employed in VOC accounting between 2013 and 2023 are source analysis and emission factor method. Atmospheric environment is the journal with the most publications in the area. The Chinese Academy of Sciences and the University of Colorado System are prominent institutions in VOC emission accounting research, both domestically and internationally. The primary research focuses on the realm of VOC emission accounting clusters, which are “emission factor,” “source analysis,” “model,” “air quality,” and “health.” A current trend in VOC emission accounting involves the construction of a VOC emission inventory using a novel model that combines emission factors and source analysis. This study reviews the progress made in calculating volatile organic compound (VOC) emissions over the past decade. It aims to provide researchers with a new perspective to promote the development of this field.

PMID:38884935 | DOI:10.1007/s11356-024-33896-5

Environ Sci Pollut Res Int. 2024 Jun 17. doi: 10.1007/s11356-024-33977-5. Online ahead of print.

ABSTRACT

Naphthenic acids (NA) are organic compounds commonly found in crude oil and produced water, known for their recalcitrance and toxicity. This study introduces a new adsorbent, a polymer derived from spent coffee grounds (SCGs), through a straightforward cross-linking method for removing cyclohexane carboxylic acid as representative NA. The adsorption kinetics followed a pseudo-second-order model for the data (0.007 g min^-1 mg^-1), while the equilibrium data fitted the Sips model ( $q_m$ = 140.55 mg g^-1). The process’s thermodynamics indicated that the target NA’s adsorption was spontaneous and exothermic. The localized sterical and energetic aspects were investigated through statistical physical modeling, which corroborated that the adsorption occurred indeed in monolayer, as suggested by the Sips model, but revealed the contribution of two energies per site ( $n_1;n_2$ ). The number of molecules adsorbed per site $(n$ ) was highly influenced by the temperature as $n_1$ decreased with increasing temperature and $n_2$ increased. These results were experimentally demonstrated within the pH range between 4 and 6, where both C₆H₁₁COO^–(aq.) and C₆H₁₁COOH(aq.) species coexisted and were adsorbed by different energy sites. The polymer produced was naturally porous and amorphous, with a low surface area of 20 to 30 m² g^-1 that presented more energetically accessible sites than other adsorbents with much higher surface areas. Thus, this study shows that the relation between surface area and high adsorption efficiency depends on the compatibility between the energetic states of the receptor sites, the speciation of the adsorbate molecules, and the temperature range studied.

PMID:38884933 | DOI:10.1007/s11356-024-33977-5

Endocrine. 2024 Jun 17. doi: 10.1007/s12020-024-03925-x. Online ahead of print.

ABSTRACT

PURPOSE: Owing to the absence of the most recent evidence on the efficacy and safety of luseogliflozin, our study aimed to conduct a systematic review and meta-analysis of luseogliflozin in patients with type 2 diabetes mellitus.

METHODS: A comprehensive search of electronic databases like PubMed, Cochrane CENTRAL, and Google Scholar was performed from the inception to the 31^st of August 2023 to identify the randomized controlled trials (RCTs) that examined the glucose and body weight lowering efficacy and safety outcomes of luseogliflozin in comparison with control or other active treatments. The fixed or random-effect model was used based on the heterogeneity identified using the I² statistic and Cochran’s Q test.

RESULTS: Out of 50 non-duplicate articles identified through database searching, 8 RCTs (11 studies) with 1922 patients were included in this study. The efficacy outcomes like HbA1c (MD: -0.59%; 95% CI: -0.90, -0.29; P < 0.001), FPG (MD: -16.01 mg/dL; 95% CI: -19.46, -12.57; P < 0.001), PPG (MD: -36.63 mg/dL; 95% CI: -43.71, -29.55; P < 0.001) and body weight (MD: -1.66 kg; 95% CI: -2.23, -1.12; P < 0.001) were significantly reduced with luseogliflozin compared to the control group. Regarding the safety outcomes, there was no statistically significant difference between the two groups for hypoglycemia (OR: 1.14; 95% CI: 0.70, 1.84; P = 0.60). However, pollakiuria (OR: 4.08; 95% CI: 1.71, 9.69; P < 0.001) and any ADRs (OR: 2.04; 95% CI: 1.33, 3.14; P < 0.001) were significantly higher in the luseogliflozin group compared to the control.

CONCLUSION: The current study identified a significant improvement in efficacy outcomes of HbA1c, FPG, PPG, and body weight in the luseogliflozin group. Non-significant safety results may be due to a smaller population size and fewer studies. Hence, long-term multicentric RCTs are needed to identify the safety and efficacy in a diversified population.

PMID:38884927 | DOI:10.1007/s12020-024-03925-x

Breast Cancer. 2024 Jun 17. doi: 10.1007/s12282-024-01600-7. Online ahead of print.

ABSTRACT

BACKGROUND: In the global phase 3 DESTINY-Breast04 study (NCT03734029), the anti-human epidermal growth factor 2 (HER2) antibody-drug conjugate trastuzumab deruxtecan (T-DXd) demonstrated a statistically significant improvement in progression-free survival (PFS) and overall survival (OS), with manageable safety compared with treatment of physician’s choice (TPC) in patients with HER2-low metastatic breast cancer (mBC) who had received 1-2 prior lines of chemotherapy.

METHODS: This subgroup analysis examined the efficacy and safety of T-DXd versus TPC in 213 patients from Asian countries and regions who were enrolled in the DESTINY-Breast04 trial and randomized to T-DXd (n = 147) or TPC (n = 66).

RESULTS: Median PFS with T-DXd and TPC was 10.9 and 5.3 months, respectively, in Asian patients with hormone receptor-positive mBC, and 10.9 and 4.6 months, respectively, in the overall Asian population. In both populations, median OS was not reached with T-DXd and was 19.9 months with TPC. The objective response rate was higher with T-DXd versus TPC in all Asian patients. Median treatment duration was 8.4 months with T-DXd and 3.5 months with TPC. The most common grade ≥ 3 drug-related treatment-emergent adverse events in Asian patients treated with T-DXd were neutropenia (16.3%), anemia (12.9%), and leukopenia (11.6%); the incidences of neutropenia and leukopenia were higher with TPC versus T-DXd. Adjudicated drug-related interstitial lung disease or pneumonitis with T-DXd was 14.3%; the majority of events were grade 1-2.

CONCLUSIONS: T-DXd demonstrated clinically meaningful survival benefits versus TPC in Asian HER2-low mBC patients, regardless of hormone receptor status, with no new safety signals.

CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT03734029.

PMID:38884900 | DOI:10.1007/s12282-024-01600-7

Gastric Cancer. 2024 Jun 17. doi: 10.1007/s10120-024-01520-7. Online ahead of print.

NO ABSTRACT

PMID:38884884 | DOI:10.1007/s10120-024-01520-7

Daru. 2024 Jun 17. doi: 10.1007/s40199-024-00521-2. Online ahead of print.

ABSTRACT

BACKGROUND: It has been reported that High-Fructose (HF) consumption, considered one of the etiological factors of Metabolic Syndrome (MetS), causes changes in the gut microbiota and metabolic disorders. There is limited knowledge on the effects of metformin in HF-induced intestinal irregularities in male and female rats with MetS.

OBJECTIVES: In this study, we investigated the sex-dependent effects of metformin treatment on the gut microbiota, intestinal Tight Junction (TJ) proteins, and inflammation parameters in HF-induced MetS.

METHODS: Fructose was given to the male and female rats as a 20% solution in drinking water for 15 weeks. Metformin (200 mg/kg) was administered by gastric tube once a day during the final seven weeks. Biochemical, histopathological, immunohistochemical, and bioinformatics analyses were performed. Differences were considered statistically significant at p < 0.05.

RESULTS: The metformin treatment in fructose-fed rats promoted glucose, insulin, Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR), and Triglyceride (TG) values in both sexes. The inflammation score was significantly decreased with metformin treatment in fructose-fed male and female rats (p < 0.05). Moreover, metformin treatment significantly decreased Interleukin-1 Beta (IL-1β) and Tumor Necrosis Factor-Alpha (TNF-α) in ileum tissue from fructose-fed males (p < 0.05). Intestinal immunoreactivity of Occludin and Claudin-1 was increased with metformin treatment in fructose-fed female rats. HF and metformin treatment changed the gut microbial composition. Firmicutes/Bacteroidetes (F/B) ratio increased with HF in females. In the disease group, Bifidobacterium pseudolongum; in the treatment group, Lactobacillus helveticus and Lactobacillus reuteri are the prominent species in both sexes. When the male and female groups were compared, Akkermansia muciniphila was prominent in the male treatment group.

CONCLUSION: In conclusion, metformin treatment promoted biochemical parameters in both sexes of fructose-fed rats. Metformin showed a sex-dependent effect on inflammation parameters, permeability factors, and gut microbiota. Metformin has partly modulatory effects on fructose-induced intestinal changes.

PMID:38884844 | DOI:10.1007/s40199-024-00521-2