Category: Nevin Manimala

Aging (Albany NY). 2024 Jan 9;15. doi: 10.18632/aging.205417. Online ahead of print.

ABSTRACT

BACKGROUND: The causal relationship between gut microbiota and peripheral artery disease (PAD) is still not clear. In this research, we employed the Mendelian randomization (MR) technique to explore the potential causal connection between 211 gut microbiota species and PAD. We also investigated whether the causal effects operate in both directions.

METHODS: We used Genome-wide Association Studies (GWAS) summary statistics data from the MiBioGen and FinnGen consortia to conduct a two-sample MR analysis to explore the causal link between gut microbiota and PAD. Sensitivity analysis is conducted to assess the robustness of the MR results. In addition to that, reverse MR analysis was performed to examine the inverse causal relationship.

RESULTS: The inverse variance weighted (IVW) method provided evidence supporting a causal relationship between 9 specific gut microbiota taxa and PAD. The study findings indicated that family Family XI (OR=1.11, CI 1.00-1.24, P=0.048), genus Lachnoclostridium (OR=1.24, 1.02-1.50, P=0.033), and genus Lachnospiraceae UCG001 (OR=1.17, 1.01-1.35, P=0.031) are risk factors associated with PAD. class Actinobacteria (OR=0.84, 0.72-0.99, P=0.034), family Acidaminococcaceae (OR=0.80, 0.66-0.98, P=0.029), genus Coprococcus2 (OR=0.79, 0.64-0.98, P=0.029), genus Ruminococcaceae UCG004 (OR=0.84, 0.72-0.99, P=0.032), genus Ruminococcaceae UCG010 (OR=0.74, 0.58-0.96, P=0.022), and order NB1n (OR=0.88, 0.79-0.98, P=0.02) may be associated with the risk factors of PAD. Moreover, our analysis did not uncover any evidence of a reverse causal relationship between PAD and the nine specific gut microbiota taxa investigated.

CONCLUSIONS: Our MR research has confirmed the potential causal relationship between gut microbiota and PAD while also identifying specific gut bacterial communities associated with PAD.

PMID:38198148 | DOI:10.18632/aging.205417

JAMA Netw Open. 2024 Jan 2;7(1):e2350511. doi: 10.1001/jamanetworkopen.2023.50511.

ABSTRACT

IMPORTANCE: More than 80% of patients who present to the emergency department (ED) with acute heart failure (AHF) are hospitalized. With more than 1 million annual hospitalizations for AHF in the US, safe and effective alternatives are needed. Care for AHF in short-stay units (SSUs) may be safe and more efficient than hospitalization, especially for lower-risk patients, but randomized clinical trial data are lacking.

OBJECTIVE: To compare the effectiveness of SSU care vs hospitalization in lower-risk patients with AHF.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial randomly assigned low-risk patients with AHF 1:1 to SSU or hospital admission from the ED. Patients received follow-up at 30 and 90 days post discharge. The study began December 6, 2017, and was completed on July 22, 2021. The data were analyzed between March 27, 2020, and November 11, 2023.

INTERVENTION: Randomized post-ED disposition to less than 24 hours of SSU care vs hospitalization.

MAIN OUTCOMES AND MEASURES: The study was designed to detect at least 1-day superiority for a primary outcome of days alive and out of hospital (DAOOH) at 30-day follow-up for 534 participants, with an allowance of 10% participant attrition. Due to the COVID-19 pandemic, enrollment was truncated at 194 participants. Before unmasking, the primary outcome was changed from DAOOH to an outcome with adequate statistical power: quality of life as measured by the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). The KCCQ-12 scores range from 0 to 100, with higher scores indicating better quality of life.

RESULTS: Of the 193 patients enrolled (1 was found ineligible after randomization), the mean (SD) age was 64.8 (14.8) years, 79 (40.9%) were women, and 114 (59.1%) were men. Baseline characteristics were balanced between arms. The mean (SD) KCCQ-12 summary score between the SSU and hospitalization arms at 30 days was 51.3 (25.7) vs 45.8 (23.8) points, respectively (P = .19). Participants in the SSU arm had 1.6 more DAOOH at 30-day follow-up than those in the hospitalization arm (median [IQR], 26.9 [24.4-28.8] vs 25.4 [22.0-27.7] days; P = .02). Adverse events were uncommon and similar in both arms.

CONCLUSIONS AND RELEVANCE: The findings show that the SSU strategy was no different than hospitalization with regard to KCCQ-12 score, superior for more DAOOH, and safe for lower-risk patients with AHF. These findings of lower health care utilization with the SSU strategy need to be definitively tested in an adequately powered study.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03302910.

PMID:38198141 | DOI:10.1001/jamanetworkopen.2023.50511

JAMA Cardiol. 2024 Jan 10. doi: 10.1001/jamacardio.2023.5095. Online ahead of print.

ABSTRACT

IMPORTANCE: The genetic basis of coronary heart disease (CHD) has expanded from a germline to somatic genome, including clonal hematopoiesis of indeterminate potential (CHIP). How CHIP confers CHD risk in East Asian individuals, especially those with small clones (variant allele fraction [VAF] 0.5%-2%) and different genetic backgrounds, was completely unknown.

OBJECTIVE: To investigate the CHIP profile in a general Chinese cohort by deep sequencing and further explore the association between CHIP and incident CHD considering germline predisposition.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from 3 prospective cohorts in the project Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Participants without cardiovascular disease or cancer at baseline were enrolled in 2001 and 2008 and had a median follow-up of 12.17 years extending into 2021.

EXPOSURES: CHIP mutations were detected by targeted sequencing (mean depth, 916×). A predefined CHD polygenic risk score (PRS) comprising 531 variants was used to evaluate germline predisposition.

MAIN OUTCOMES AND MEASURES: The main outcome was first incident CHD.

RESULTS: Among 6181 participants, the median (IQR) age was 53.83 years (45.35-62.39 years); 3082 participants (49.9%) were female, and 3099 (50.1%) were male. A total of 1100 individuals (17.80%) harbored 1372 CHIP mutations at baseline. CHIP was independently associated with incident CHD (hazard ratio [HR], 1.42; 95% CI, 1.18-1.72; P = 2.82 × 10-4) and presented a risk gradient with increasing VAF (P = 3.98 × 10-3 for trend). Notably, individuals with small clones, nearly half of CHIP carriers, also demonstrated a higher CHD risk compared with non-CHIP carriers (HR, 1.33; 95% CI, 1.02-1.74; P = .03) and were 4 years younger than those with VAF of 2% or greater (median age, 58.52 vs 62.70 years). Heightened CHD risk was not observed among CHIP carriers with low PRS (HR, 1.02; 95% CI, 0.64-1.64; P = .92), while high PRS and CHIP jointly contributed a 2.23-fold increase in risk (95% CI, 1.51-3.29; P = 6.29 × 10-5) compared with non-CHIP carriers with low PRS. Interestingly, the diversity in CHIP-related CHD risk within each PRS group was substantially diminished when removing variants in the inflammatory pathway from the PRS.

CONCLUSIONS: This study revealed that elevated CHD risk attributed to CHIP was nonnegligible even for small clones. Inflammation genes involved in CHD could aggravate or abrogate CHIP-related CHD risk.

PMID:38198131 | DOI:10.1001/jamacardio.2023.5095

Clin Rheumatol. 2024 Jan 10. doi: 10.1007/s10067-023-06858-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the relation between cumulative intravenous methylprednisolone dose and disease activity, damage, and mortality among a group of Egyptian SLE patients.

PATIENTS AND METHODS: This is a post hoc analysis of a retrospective multicenter COMOSLE study. Cumulative pulse methylprednisolone dose was abstracted from COMOSLE database. Patients with cumulative pulse dose of ≤ 3.0 g (median dose) were compared to those with cumulative dose of > 3.0 g regarding demographic data, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and The Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC) score as well as treatment received. Additionally, at 1.5, 3, 6, and 9 g of cumulative methylprednisolone, patients were compared regarding SLICC score and risk of mortality.

RESULTS: Patients who received > 3 g of methylprednisolone were statistically significantly younger at disease onset, had longer disease duration, higher SLEDAI score at last visit, and higher SLICC score (p = 003, p = 0.002, p = 0.004 and p = < 0.001, respectively). Additionally, with every gram increase in the cumulative methylprednisolone, there was a significant increase in SLICC score by 0.169 (B = 0.169, CI = 0.122-0.216, p-value = < 0.001) and an increased risk of mortality by 13.5% (hazard ratio (HR) = 1.135, CI = 1.091-1.180, p-value = 0.001). The best cutoff value of methylprednisolone dose at which damage may occur, ranged between 2.75 (with sensitivity of 81.4% and specificity of 33.9%) and 3.25 g (with sensitivity of 48.3% and specificity of 71.5%).

CONCLUSION: With every gram increase in the cumulative methylprednisolone, there may be increase in damage and mortality, especially in doses exceeding the range of 2.75-3.25 g. Key Points • Treatment of systemic lupus erythematosus should be with the least possible dose of steroids to decrease the risk of damage and mortality. • With every gram increase in the cumulative intravenous methylprednisolone there may be increase in damage and mortality.

PMID:38198114 | DOI:10.1007/s10067-023-06858-4

Environ Sci Pollut Res Int. 2024 Jan 10. doi: 10.1007/s11356-023-31819-4. Online ahead of print.

ABSTRACT

Asbestos has been used extensively in the construction industry for its superior insulation properties before its health hazards were discovered and its use eventually banned. It is likely that many residential buildings built before the 2000s in Turkey contain asbestos. Therefore, it is important to raise awareness of the potential danger of asbestos exposure during demolition work and to identify asbestos-containing materials and ensure their safe removal and disposal. This study is executed to determine the residential dwellings containing asbestos in Izmir, Turkey. The research included field studies to determine asbestos presence in the buildings that were damaged during the 2020 earthquake. Air measurements and bulk samples were taken from 50 buildings that would go through the demolition process. Eleven buildings were found to contain asbestos which corresponds to 22%. The detected asbestos type was 60% chrysotile (white asbestos). Results could be helpful for future demolition work, which are conducted in the same region that includes buildings with similar properties. Also, it is expected that the database created for this study could be useful in other studies in Turkey, where accurate statistical data related with asbestos measurements is essentially non-existent.

PMID:38198092 | DOI:10.1007/s11356-023-31819-4

Environ Sci Pollut Res Int. 2024 Jan 10. doi: 10.1007/s11356-023-31670-7. Online ahead of print.

ABSTRACT

Landslides are a natural threat that poses a severe risk to human life and the environment. In the Kumaon mountains region in Uttarakhand (India), Nainital is among the most vulnerable areas prone to landslides inflicting harm to livelihood and civilization due to frequent landslides. Developing a landslide susceptibility map (LSM) in this Nainital area will help alleviate the probability of landslide occurrence. GIS and statistical-based approaches like the certainty factor (CF), information value (IV), frequency ratio (FR) and logistic regression (LR) are used for the assessment of LSM. The landslide inventories were prepared using topography, satellite imagery, lithology, slope, aspect, curvature, soil, land use and land cover, geomorphology, drainage density and lineament density to construct the geodatabase of the elements affecting landslides. Furthermore, the receiver operating characteristic (ROC) curve was used to check the accuracy of the predicting model. The results for the area under the curves (AUCs) were 87.8% for logistic regression, 87.6% for certainty factor, 87.4% for information value and 84.8% for frequency ratio, which indicates satisfactory accuracy in landslide susceptibility mapping. The present study perfectly combines GIS and statistical approaches for mapping landslide susceptibility zonation. Regional land use planners and natural disaster management will benefit from the proposed framework for landslide susceptibility maps.

PMID:38198087 | DOI:10.1007/s11356-023-31670-7

Breast Cancer Res Treat. 2024 Jan 10. doi: 10.1007/s10549-023-07218-1. Online ahead of print.

ABSTRACT

PURPOSE: Polypharmacy is associated with negative health outcomes and decreased medication adherence. Polypharmacy is common in cancer populations, but few studies have evaluated the relationship between polypharmacy and aromatase inhibitor (AI) adherence. No studies have evaluated the relationship between over-the-counter (OTC) supplements and AI adherence. Our primary hypothesis was that polypharmacy would be associated with increased risk of premature AI discontinuation.

METHODS: This exploratory analysis used data from the Exemestane and Letrozole Pharmacogenetics (ELPh) trial, a prospective, multicenter, randomized controlled trial that enrolled participants from 2005 to 2009. Included patients were female, postmenopausal, with stage 0-III breast cancer, who had completed indicated chemotherapy, surgery, and radiation. Participants were randomized to adjuvant exemestane or letrozole and completed serial clinical examinations and questionnaires for two years. Concomitant medication data were collected prospectively. Cox proportion models were used for statistical analysis of the relationship between polypharmacy, OTCs, medication class, and AI adherence.

RESULTS: In the 490 analyzed participants, use of any prescription medications at baseline was associated with decreased risk of premature AI discontinuation (HR 0.56, p = 0.02). Use of selective serotonin reuptake inhibitors (SSRIs) or selective serotonin and norepinephrine reuptake inhibitors (SNRIs) at baseline was associated with decreased risk of premature AI discontinuation (HR 0.67, p = 0.04). Use of any OTCs was not associated with AI discontinuation.

CONCLUSION: Baseline use of prescription medications but not OTCs was associated with increased AI persistence. Future research is needed to understand how this can be utilized to promote AI adherence.

PMID:38198070 | DOI:10.1007/s10549-023-07218-1

Ophthalmol Ther. 2024 Jan 10. doi: 10.1007/s40123-023-00867-x. Online ahead of print.

ABSTRACT

INTRODUCTION: XTEND (NCT03939767) is a multicenter, observational, prospective study of patients with treatment-naïve neovascular age-related macular degeneration (nAMD) in routine clinical practice. The study aims to examine treatment outcomes of proactive intravitreal aflibercept (IVT-AFL) treatment regimens (fixed dosing or treat-and-extend) according to local marketing labels.

METHODS: Study eyes received IVT-AFL injections as per the local label. The mean changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST) from baseline to month (M) 12 and M24 were measured and stratified by baseline factors. Treatment exposure and safety data were evaluated. Statistical analysis was descriptive.

RESULTS: Overall, 1466 patients from 17 countries were treated. For the overall population, the mean ± standard deviation (SD) age was 78.7 ± 8.5 (range 50-100) years, and 891 patients (60.8%) were female. The mean ± SD baseline BCVA was 54.3 ± 20.3 letters and CST was 374 ± 126 µm. At M12 and M24, mean (95% confidence interval [CI]) BCVA change was + 4.3 (3.4, 5.3) and + 2.3 (1.3, 3.3) letters, respectively. Mean (95% CI) CST was – 106 (- 114, – 99) μm and – 109 (- 117, – 102) μm at M12 and M24, respectively. At M24, 41.5% of patients had a BCVA ≥ 70 letters. Patients received a mean ± SD of 7.7 ± 2.7 injections by M12 and 10.8 ± 5.0 injections by M24 (3.1 injections between M12 and M24). Adverse events were consistent with the known safety profile of IVT-AFL.

CONCLUSION: The 24-month results indicate that, in routine clinical practice, a proactive IVT-AFL regimen achieves functional improvements in patients with treatment-naïve nAMD. The proportion of patients achieving ≥ 70 letters at M24 increased, and patients with baseline BCVA ≥ 70 letters maintained vision regardless of the followed IVT-AFL label.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03939767. A video abstract is available for this article. Supplementary file2 (MP4 364624 KB).

PMID:38198053 | DOI:10.1007/s40123-023-00867-x

Plant Foods Hum Nutr. 2024 Jan 10. doi: 10.1007/s11130-023-01138-7. Online ahead of print.

ABSTRACT

Consumers prefer food products that, in addition to nutritional properties, also have effects beneficial to health. Non-conventional food plants such as canary seed (Phalaris canariensis) constitute an alternative in the food industry due to nutritional properties, chemical, and bioactive potential. The aim of this research was to develop pancake formulations with the inclusion of canary seed flour to evaluate their proximate composition, overall score, taste and texture sensory acceptability, and glycemic index. Pancakes based on whole-wheat flour mixed with canary seed flour were developed at four substitution levels (control 0, 10, 30, and 50%). The formulations exhibited attractive nutritional properties, mainly due to the levels of protein (~ 8.7%), minerals (~ 5.1%), and total dietary fiber (4.7-5.9%). The overall score and taste showed a statistical difference (p < 0.05) between the formulations. The flours with 10 and 30% showed high sensory acceptability with scores of 6.22 and 6.67 respect to 7-point hedonic scale, between the categories “I like it” and “I like it a lot”. All formulations presented a low glycemic index (34-39%) that was significantly influenced (p < 0.05) as the level of substitution increased. The findings represent a new approach to the use of canary seed in the development of healthy food products.

PMID:38198039 | DOI:10.1007/s11130-023-01138-7

Environ Monit Assess. 2024 Jan 10;196(2):130. doi: 10.1007/s10661-024-12294-x.

ABSTRACT

Soil serves as a reservoir for organic carbon stock, which indicates soil quality and fertility within the terrestrial ecosystem. Therefore, it is crucial to comprehend the spatial distribution of soil organic carbon stock (SOCS) and the factors influencing it to achieve sustainable practices and ensure soil health. Thus, the present study aimed to apply four machine learning (ML) models, namely, random forest (RF), k-nearest neighbors (kNN), support vector machine (SVM), and Cubist model tree (Cubist), to improve the prediction of SOCS in the Srou catchment located in the Upper Oum Er-Rbia watershed, Morocco. From an inventory of 120 sample points, 80% were used for training the model, with the remaining 20% set aside for model testing. Boruta’s algorithm and the multicollinearity test identified only nine (9) factors as the controlling factors selected as input data for predicting SOCS. As a result, spatial distribution maps for SOCS were generated for all models, then compared, and further validated using statistical metrics. Among the models tested, the RF model exhibited the best performance (R² = 0.76, RMSE = 0.52 Mg C/ha, NRMSE = 0.13, and MAE = 0.34 Mg C/ha), followed closely by the SVM model (R² = 0.68, RMSE = 0.59 Mg C/ha, NRMSE = 0.15, and MAE = 0.34 Mg C/ha) and Cubist model (R² = 0.64, RMSE = 0.63 Mg C/ha, NRMSE = 0.16, and MAE = 0.43 Mg C/ha), while the kNN model had the lowest performance (R² = 0.31, RMSE = 0.94 Mg C/ha, NRMSE = 0.24, and MAE = 0.63 Mg C/ha). However, bulk density, pH, electrical conductivity, and calcium carbonate were the most important factors for spatially predicting SOCS in this semi-arid region. Hence, the methodology used in this study, which relies on ML algorithms, holds the potential for modeling and mapping SOCS and soil properties in comparable contexts elsewhere.

PMID:38198014 | DOI:10.1007/s10661-024-12294-x