Category: Nevin Manimala

Environ Sci Pollut Res Int. 2023 Aug 23. doi: 10.1007/s11356-023-29423-7. Online ahead of print.

ABSTRACT

The results of environmental epidemiological studies regarding the relationship between human exposure to nickel and the risk of diabetes remain controversial. Therefore, we performed a meta-analysis to investigate the relationship between nickel exposure and diabetes. PubMed, Web of Science, and Embase electronic databases were thoroughly searched from their inception to May 2023 to obtain relevant studies. The random-effects model was employed to determine pooled odds ratios (ORs) and 95% confidence intervals (CIs). Stratified and sensitivity analyses were also performed. Cochran Q test and I² statistic were employed to assess heterogeneity between studies. Begg’s and Egger’s tests were employed to evaluate publication bias. The indicated studies were evaluated using the ROBINS-E risk of bias tool. The dose-response relationship between nickel in urine and diabetes risk was estimated by restricted cubic spline. A total of 12 studies with 30,018 participants were included in this study. In this meta-analysis, comparing the highest vs. lowest levels of nickel exposure, the pooled ORs for diabetes were 1.42 (95% confidence interval 1.14-1.78) for urine and 1.03 (0.57-1.86) for blood, respectively. A linear relationship between urinary nickel and diabetes risk was discovered in the dose-response analysis (P _nonlinearity = 0.6198). Each 1 µg/L increase of urinary nickel, the risk of diabetes increased by 7% (OR = 1.07, 95% CI 1.04-1.10). The risk of diabetes was positively correlated with urine nickel exposure, whereas the risk was not significantly correlated with blood nickel. In the future, more high-quality prospective studies are needed to validate this conclusion.

PMID:37612551 | DOI:10.1007/s11356-023-29423-7

J Neurol. 2023 Aug 24. doi: 10.1007/s00415-023-11939-0. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is the fastest-growing neurological condition with over 10 million cases worldwide. While age and sex are known predictors of incident PD, there is a need to identify other predictors. This study compares the prediction performance of accelerometry-derived physical activity (PA) measures and traditional risk factors for incident PD in the UK Biobank.

METHODS: The study population consisted of 92,352 UK Biobank participants without PD at baseline (43.8% male, median age 63 years with interquartile range 43-69). 245 participants were diagnosed with PD by April 1, 2021 (586,604 person-years of follow-up). The incident PD prediction performances of 10 traditional predictors and 8 objective PA measures were compared using single- and multi-variable Cox models. Prediction performance was assessed using a novel, stable statistic: the repeated cross-validated concordance (rcvC). Sensitivity analyses were conducted where PD cases diagnosed within the first six months, one year, and two years were deleted.

RESULTS: Single-predictor Cox regression models indicated that all PA measures were statistically significant (p-values < 0.0001). The highest-performing individual predictors were total acceleration (TA) (rcvC = 0.813) among PA measures, and age (rcvC = 0.757) among traditional predictors. The two-step forward-selection process produced a model containing age, sex, and TA (rcvC = 0.851). Adding TA to the model increased the rcvC by 9.8% (p-value < 0.0001). Results were largely unchanged in sensitivity analyses.

CONCLUSIONS: Objective PA summaries have better single-predictor model performance than known risk factors and increase the prediction performance substantially when added to models with age and sex.

PMID:37612539 | DOI:10.1007/s00415-023-11939-0

Brain Cogn. 2023 Aug 21;171:106073. doi: 10.1016/j.bandc.2023.106073. Online ahead of print.

ABSTRACT

Older adults with and without Parkinson’s disease show impaired retention after training of motor or cognitive skills. This systematic review with meta-analysis aims to investigate whether adding transcranial direct current stimulation (tDCS) to motor or cognitive training versus placebo boosts motor sequence and working memory training. The effects of interest were estimated between three time points, i.e. pre-training, post-training and follow-up. This review was conducted according to the PRISMA guidelines (PROSPERO: CRD42022348885). Electronic databases were searched from conception to March 2023. Following initial screening, 24 studies were eligible for inclusion in the qualitative synthesis and 20 could be included in the meta-analysis, of which 5 studies concerned motor sequence learning (total n = 186) and 15 working memory training (total n = 650). Results were pooled using an inverse variance random effects meta-analysis. The findings showed no statistically significant additional effects of tDCS over placebo on motor sequence learning outcomes. However, there was a strong trend showing that tDCS boosted working memory training, although methodological limitations and some heterogeneity were also apparent. In conclusion, the present findings do not support wide implementation of tDCS as an add-on to motor sequence training at the moment, but the promising results on cognitive training warrant further investigations.

PMID:37611344 | DOI:10.1016/j.bandc.2023.106073

Appl Physiol Nutr Metab. 2023 Aug 23. doi: 10.1139/apnm-2023-0137. Online ahead of print.

ABSTRACT

Many reports describe using a supramaximal verification phase – exercising at a power output higher than the highest power output recorded during an incremental cardiopulmonary test – to validate VO2max. The impact of verification phases on estimating proportion of VO2max response remains an underexplored area of the individual response literature. This analysis investigated the influence of same-day and separate-day verification phases during repeated measurements (incremental tests – INCR1 and INCR2; incremental tests + supramaximal verification phases – INCR1+ and INCR2+) of VO2max on typical error (TE) and the proportion of individuals classified as responders (i.e. the response rate) following four weeks of aerobic exercise training or a no-exercise control period. Incorporation of supramaximal verification consistently reduced the standard deviation of individual response, typical error, and confidence interval widths. However, variances were statistically similar across all groups (p>0.05). Response rates increased when incorporating either one (INCR1 to INCR1+; 24% to 48%, p=0.07) or two (INCR2 to INCR2+; 28% to 48%, p=0.063) supramaximal verification phase(s). However, response rates remained unchanged when either zero-based thresholds or smallest worthwhile difference response thresholds were used (50% and 90% confidence intervals, all p>0.05). In conclusion, supramaximal verification phases reduced random variability in VO2max response. Compared to separate-day testing (INCR2 and INCR2+), incorporation of a same-day verification (INCR1+) reduced CI widths the most. Researchers should consider using a same-day verification phase to reduce uncertainty and better estimate VO2max response rate to aerobic exercise training.

PMID:37611323 | DOI:10.1139/apnm-2023-0137

J Infus Nurs. 2023 Sep-Oct 01;46(5):272-280. doi: 10.1097/NAN.0000000000000516.

ABSTRACT

An observational study was developed with 108 nursing professionals who managed vascular access devices in 4 intensive care units of a university hospital in Rio de Janeiro, Brazil. The objective was to analyze the practice of the nursing staff in performing flushing for the maintenance of vascular access devices in critically ill patients. Data were collected by observing the flushing procedure using a structured checklist and analyzed using descriptive and inferential statistics. In 23% of the 404 observations, there was no flushing. When performed at some point during catheter management (77%), flushing was predominant after drug administration with 1 or 2 drugs administered. There were flaws in the flushing technique applied in terms of volume and method of preparation. Time of professional experience >5 years, knowledge about recommendations, and training on flushing were variables associated with technique performance. It was concluded that the flushing procedure did not meet the recommendations of good practices, with failures that constituted medication errors.

PMID:37611285 | DOI:10.1097/NAN.0000000000000516

ACS Appl Mater Interfaces. 2023 Aug 23. doi: 10.1021/acsami.3c07938. Online ahead of print.

ABSTRACT

Oxygen- and nitrogen-heteroatom-doped, water-dispersible, and bright blue-fluorescent carbon dots (ON-CDs) were prepared for the selective and sensitive determination of 2,4,6-trinitrophenol (picric acid, PA). ON-CDs with 49.7% quantum yield were one-pot manufactured by the reflux method using citric acid, d-glucose, and ethylenediamine precursors. The surface morphology of ON-CDs was determined by scanning transmission electron microscopy, high-resolution transmission electron microscopy, dynamic light scattering, Raman, infrared, and X-ray photoelectron spectroscopy techniques, and their photophysical properties were estimated by fluorescence spectroscopy, UV-vis spectroscopy, fluorescence lifetime measurement, and 3D-fluorescence excitation-emission matrix analysis. ON-CDs at an average particle size of 3.0 nm had excitation/emission wavelengths of 355 and 455 nm, respectively. With the dominant inner-filter effect- and hydrogen-bonding interaction-based static fluorescence quenching phenomena supported by ground-state charge-transfer complexation (CTC), the fluorescence of ON-CDs was selectively quenched with PA in the presence of various types of explosives (i.e., 2,4,6-trinitrotoluene, tetryl, 1,3,5-trinitroperhydro-1,3,5-triazine, 1,3,5,7-tetranitro-1,3,5,7-tetraazacyclooctane, pentaerythritol tetranitrate, 3-nitro-1,2,4-triazole-5-one, and TATP-hydrolyzed H₂O₂). The analytical results showed that the emission intensity varied linearly with a correlation coefficient of 0.9987 over a PA concentration range from 1.0 × 10^-9 to 11.0 × 10^-9 M. As a result of ground-state interaction (H-bonding and CTC) of ON-CDs with PA, an orange-colored complex was formed different from the characteristic yellow color of PA in an aqueous medium, allowing naked-eye detection of PA. The detection limits for PA with ON-CDs were 12.5 × 10^-12 M (12.5 pM) by emission measurement and 9.0 × 10^-10 M (0.9 nM) by absorption measurement. In the presence of synthetic explosive mixtures, common soil cations/anions, and camouflage materials, PA was recovered in the range of 95.2 and 102.5%. The developed method was statistically validated against a reference liquid chromatography coupled to tandem mass spectrometry method applied to PA-contaminated soil. In addition, a poly(vinyl alcohol)-based polymer composite film {PF(ON-CDs)} was prepared by incorporating ON-CDs, enabling the smartphone-assisted fluorometric detection of PA.

PMID:37611222 | DOI:10.1021/acsami.3c07938

Genetics. 2023 Aug 23:iyad157. doi: 10.1093/genetics/iyad157. Online ahead of print.

ABSTRACT

Principal component analysis (PCA) is commonly used in genetics to infer and visualize population structure and admixture between populations. PCA is often interpreted in a way similar to inferred admixture proportions, where it is assumed that individuals belong to one of several possible populations or are admixed between these populations. We propose a new method to assess the statistical fit of PCA (interpreted as a model spanned by the top principal components) and to show that violations of the PCA assumptions affect the fit. Our method uses the chosen top principal components to predict the genotypes. By assessing the covariance (and the correlation) of the residuals (the differences between observed and predicted genotypes), we are able to detect violation of the model assumptions. Based on simulations and genome wide human data we show that our assessment of fit can be used to guide the interpretation of the data and to pinpoint individuals that are not well represented by the chosen principal components. Our method works equally on other similar models, such as the admixture model, where the mean of the data is represented by linear matrix decomposition.

PMID:37611212 | DOI:10.1093/genetics/iyad157

Adv Healthc Mater. 2023 Aug 23:e2300096. doi: 10.1002/adhm.202300096. Online ahead of print.

ABSTRACT

Fibrin provides the main structural integrity and mechanical strength to blood clots. Failure of fibrin clots can result in life-threating complications, such as stroke or pulmonary embolism. The dependence of rupture resistance of fibrin networks (uncracked and cracked) on fibrin(ogen) concentrations in the (patho)physiological 1-5 g/l range was explored by performing the ultrastructural studies and theoretical analysis of the experimental stress-strain profiles available from mechanical tensile loading assays. Fibrin fibers in the uncracked network stretched evenly, whereas in the cracked network, fibers around the crack tip showed greater deformation. Unlike fibrin fibers in cracked networks formed at the lower 1-2.7 g/l fibrinogen concentrations, fibers formed at the higher 2.7-5 g/l concentrations align and stretch simultaneously. Cracked fibrin networks formed in higher fibrinogen solutions are tougher, yet, less extensible. Statistical modeling revealed that the characteristic strain for fiber alignment, crack size, and fracture toughness of fibrin networks control their rupture resistance. The results obtained provide a structural and biomechanical basis to quantitatively understand the material properties of blood plasma clots and to illuminate the mechanisms of their rupture. This article is protected by copyright. All rights reserved.

PMID:37611209 | DOI:10.1002/adhm.202300096

Acta Radiol. 2023 Aug 23:2841851231187078. doi: 10.1177/02841851231187078. Online ahead of print.

ABSTRACT

BACKGROUND: Percutaneous biliary drainage is a frequently used method to provide biliary decompression in patients with biliary obstruction.

PURPOSE: To investigate the between drainage type and infection risk in patients treated with internal-external and external biliary drainage catheterization for malignant biliary obstruction.

MATERIAL AND METHODS: A total of 410 patients with malignant biliary obstruction who underwent internal-external or external biliary drainage catheterization between January 2012 and October 2016 were retrospectively evaluated. We investigated the correlation between percutaneous biliary drainage technique and infection frequency by evaluating patients with clinical findings, bile and blood cultures, complete blood counts, and blood biochemistry.

RESULTS: There was no statistically significant difference between the selected patient groups (internal-external or external biliary drainage catheter placed) in terms of age, sex, primary diagnosis, receiving chemotherapy, catheter sizes, and outpatient-patient status. After catheterization, catheter-related infection was observed in 49 of 216 (22.7%) patients with internal-external and 18 of 127 (14.2%) patients with external biliary drainage catheters, according to the defined criteria. There was no difference in infection rate after the biliary drainage in the two groups (P > 0.05). There was also no difference concerning frequently proliferating microorganisms in bile cultures.

CONCLUSION: Internal-external biliary drainage catheter placement does not bring an additional infection risk for uninfected cholestatic patients whose obstruction could be passed easily in the initial drainage.

PMID:37611191 | DOI:10.1177/02841851231187078

Am J Health Syst Pharm. 2023 Aug 23:zxad193. doi: 10.1093/ajhp/zxad193. Online ahead of print.

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE: To analyze the clinical completeness, correctness, usefulness, and safety of chatbot and medication database responses to everyday inpatient medication-use questions.

METHODS: We evaluated the responses from an artificial intelligence chatbot, a medication database, and clinical pharmacists to 200 real-world medication-use questions. Answer quality was rated by a blinded group of pharmacists, providers, and nurses. Chatbot and medication database responses were deemed “acceptable” if the mean reviewer rating was within 3 points of the mean rating for pharmacists’ answers. We used descriptive statistics for reviewer ratings and Kendall’s coefficient to evaluate interrater agreement.

RESULTS: The medication database generated responses to 194 (97%) questions, with 88% considered acceptable for clinical correctness, 76% considered acceptable for completeness, 83% considered acceptable for safety, and 81% considered acceptable for usefulness compared to pharmacists’ answers. The chatbot responded to only 160 (80%) questions, with 85% considered acceptable for clinical correctness, 65% considered acceptable for completeness, 71% considered acceptable for safety, and 68% considered acceptable for usefulness.

CONCLUSION: Traditional search methods using a drug database provide more clinically correct, complete, safe, and useful answers than a chatbot. When the chatbot generated a response, the clinical correctness was similar to that of a drug database; however, it was not rated as favorably for clinical completeness, safety, or usefulness. Our results highlight the need for ongoing training and continued improvements to artificial intelligence chatbots for them to be incorporated reliably into the clinical workflow. With continued improvement in chatbot functionality, chatbots could be a useful pharmacist adjunct, providing healthcare providers with quick and reliable answers to medication-use questions.

PMID:37611187 | DOI:10.1093/ajhp/zxad193