Category: Nevin Manimala

Environ Pollut. 2023 May 19:121855. doi: 10.1016/j.envpol.2023.121855. Online ahead of print.

ABSTRACT

Coke oven emissions (COEs) exposure leads to oxidative stress, an imbalance between oxidant production and antioxidant defence in the body, which then leads to shortened relative telomere length (RTL) and reduced mitochondrial DNA copy number (mtDNAcn), ultimately leading to ageing and disease. By analysing the relationship among COEs, oxidative stress, RTL and mtDNAcn, we investigated the chain-mediating effects of oxidative stress and telomeres on mitochondrial damage and mitochondria on telomere damage in coke oven workers. A total of 779 subjects were included in the study. Cumulative COEs exposure concentrations were estimated, and the RTL and mtDNAcn of peripheral blood leukocytes were measured using real-time fluorescence quantitative PCR. Total antioxidant capacity (T-AOC) was measured to reflect the level of oxidative stress. The data were statistically analysed using SPSS 21.0 software and discussed using mediation effect analysis. After adjusting for age, sex, smoking, drinking and BMI, generalised linear model revealed dose-response associations between COEs and T-AOC, RTL and mtDNAcn, respectively. (P_trend < 0.05). The results of chain-mediating effect showed that the proportion of the chain-mediating effect of “CED-COEs→T-AOC→ RTL→mtDNAcn” was 0.82% (β = -0.0005, 95% CI = [-0.0012, -0.0001]), and the proportion of the chain-mediating effect of “CED-COEs→T-AOC→ mtDNAcn → RTL ″ was 2.64% (β = -0.0013, 95% CI = [-0.0025, -0.0004]). After oxidative stress is induced by COEs, mitochondria and telomeres may interact with each other while leading further to potential bodily damage. This study provides clues to explore the association between mitochondria and telomeres.

PMID:37211230 | DOI:10.1016/j.envpol.2023.121855

Anaesth Crit Care Pain Med. 2023 May 19:101247. doi: 10.1016/j.accpm.2023.101247. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Brachiocephalic vein is a novel site for central venous cannulation in infants. It becomes useful in patients where the internal jugular vein lumen is small (e.g., volume deficient patient), patients with a history of multiple cannulations, and in whom subclavian puncture is contraindicated.

METHODS: In this randomized double-blinded study, 100 patients, aged between 0 and 1 year scheduled for elective central venous cannulation were recruited. The patients were allocated into two groups (50 patients in each). Group I patients had ultrasound (US) guided cannulation of the left brachiocephalic vein (BCV) by inserting a needle in-plane to the US probe from lateral to the medial direction, whereas Group II patients underwent cannulation of the BCV via an out-of-plane approach.

RESULTS: The first-attempt success rate was significantly higher in Group I (74%) than in Group II (36%) (p < 0.001). The total success rate was higher in group I (98%) than in group II (88%) however the difference was statistically insignificant (p > 0.05). The mean BCV cannulation time was significantly shorter in group I (35.46 ± 25.10) than in group II (65.24 ± 40.26) (p < 0.001). The rate of unsuccessful BCV cannulation (12%) and hematoma development (12%) was significantly higher in group II than in group I (2%).

CONCLUSION: Compared to the out-of-plane approach of left BCV cannulation, US-guided in-plane cannulation of the left BCV increased the first-attempt success rate, decreased the number of puncture attempts, and decreased the time required for cannulation.

PMID:37211216 | DOI:10.1016/j.accpm.2023.101247

Prog Cardiovasc Dis. 2023 May 19:S0033-0620(23)00053-1. doi: 10.1016/j.pcad.2023.05.005. Online ahead of print.

ABSTRACT

BACKGROUND: Dyspnea and fatigue are characteristics of long SARS-CoV-2 (COVID)-19. Cardiopulmonary exercise testing (CPET) can be used to better evaluate such patients.

RESEARCH QUESTION: How significantly and by what mechanisms is exercise capacity impaired in patients with long COVID who are coming to a specialized clinic for evaluation?

STUDY DESIGN AND METHODS: We performed a cohort study using the Mayo Clinic exercise testing database. Subjects included consecutive long COVID patients without prior history of heart or lung disease sent from the Post-COVID Care Clinic for CPET. They were compared to a historical group of non-COVID patients with undifferentiated dyspnea also without known cardiac or pulmonary disease. Statistical comparisons were performed by t-test or Pearson’s chi² test controlling for age, sex, and beta blocker use where appropriate.

RESULTS: We found 77 patients with long COVID and 766 control patients. Long COVID patients were younger (47 ± 15 vs 50 ± 10 years, P < .01) and more likely female (70% vs 58%, P < .01). The most prominent difference on CPETs was lower percent predicted peak V̇O₂ (73 ± 18 vs 85 ± 23%, p < .0001). Autonomic abnormalities (resting tachycardia, CNS changes, low systolic blood pressure) were seen during CPET more commonly in long COVID patients (34 vs 23%, P < .04), while mild pulmonary abnormalities (mild desaturation, limited breathing reserve, elevated V̇_E/V̇CO₂) during CPET were similar (19% in both groups) with only 1 long COVID patient showing severe impairment.

INTERPRETATION: We identified severe exercise limitation among long COVID patients. Young women may be at higher risk for these complications. Though mild pulmonary and autonomic impairment were common in long COVID patients, marked limitations were uncommon. We hope our observations help to untangle the physiologic abnormalities responsible for the symptomatology of long COVID.

PMID:37211198 | DOI:10.1016/j.pcad.2023.05.005

Environ Res. 2023 May 19:116191. doi: 10.1016/j.envres.2023.116191. Online ahead of print.

ABSTRACT

Polycyclic aromatic hydrocharbons (PAHs) are a class of highly toxic pollutants that are highly detrimental to the ecosystem. Landfill leechate emanated from municipal solid waste are reported to constitute significant PAHs. In the present investigation, three Fenton proceses, namely conventional Fenton, photo-fenton and electro-fenton methods have been employed to treat landfill leehcate for removing PAHs from a waste dumpig yard. Response surface methodology (RSM) and artificial neural network (ANN) methodologies were adopted to optimize and validate the conditions for optimum oxidative removal of COD and PAHs. The statistical analysis results showed that all independent variables chosen in the study are reported to have significant influence of the removal effects with P-values <0.05. Sensitivity analysis by the developed ANN model showed that the pH had the highest significance of 1.89 in PAH removal when compared to the other parameters. However for COD removal, H₂O₂ had the highest relative importance of 1.15, followed by Fe²⁺ and pH. Under optimal treatment conditions, the photo-fenton and electro-fenton processes showed better removal of COD and PAH compared to the Fenton process. The photo-fenton and electro-fenton treatment processes removed 85.32% and 74.64% of COD and 93.25% and 81.65% of PAHs, respectively. Also the investigations revelaed the presence of 16 distinct PAH compunds and the removal percentage of each of these PAHs are also reported. The PAH treatment research studies are generally limited to the assay of removal of PAH and COD levels. In the present investigation, in addition to the treatment of landfill leachate, particle size distribution analysis and elemental characterization of the resultant iron sludge by FESEM and EDX are reported. It was revealed that elemental oxygen is present in highest percentage, followed by iron, sulphur, sodium, chlorine, carbon and potassium. However, iron percentage can be reduced by treating the Fenton-treated sample with NaOH.

PMID:37211185 | DOI:10.1016/j.envres.2023.116191

Environ Res. 2023 May 19:116202. doi: 10.1016/j.envres.2023.116202. Online ahead of print.

ABSTRACT

Understanding the community assembly process is a central issue in microbial ecology. In this study, we analyzed the community assembly of particle-associated (PA) and free-living (FL) surface water microbiomes in 54 sites from the headstream to the river mouth of an urban river in Japan, the river basin of which has the highest human population density in the country. Analyses were conducted from two perspectives: (1) analysis of deterministic processes considering only environmental factors using a geo-multi-omics dataset and (2) analysis of deterministic and stochastic processes to estimate the contributions of heterogeneous selection (HeS), homogeneous selection (HoS), dispersal limitation (DL), homogenizing dispersal (HD), and drift (DR) as community assembly processes using a phylogenetic bin-based null model. The variation in microbiomes was successfully explained from a deterministic perspective by environmental factors, such as organic matter-related, nitrogen metabolism, and salinity-related parameters, using multivariate statistical analysis, network analysis, and habitat prediction. In addition, we demonstrated the dominance of stochastic processes (DL, HD, and DR) over deterministic processes (HeS and HoS) in community assembly from both deterministic and stochastic perspectives. Our analysis revealed that as the distance between two sites increased, the effect of HoS sharply decreased while the effect of HeS increased, particularly between upstream and estuary sites, indicating that the salinity gradient could potentially enhance the contribution of HeS to community assembly. Our study highlights the importance of both stochastic and deterministic processes in community assembly of PA and FL surface water microbiomes in urban riverine ecosystems.

PMID:37211183 | DOI:10.1016/j.envres.2023.116202

J Vasc Surg. 2023 May 19:S0741-5214(23)01251-X. doi: 10.1016/j.jvs.2023.05.023. Online ahead of print.

ABSTRACT

OBJECTIVES: The outcomes of patients with premature cerebrovascular disease (age ≤ 55 years) who undergo carotid artery stenting are not well defined. Our study objective was to analyze the outcomes of younger patients undergoing carotid stenting.

METHODS: The SVS VQI was queried for transfemoral carotid artery stenting (TF-CAS) and transcarotid artery revascularization (TCAR) between 2016-2020. Patients were stratified based on age ≤ 55 or > 55 years. Primary endpoints were periprocedural stroke, death, myocardial infarction (MI), and composite outcomes. Secondary endpoints included procedural failure (defined as ipsilateral restenosis ≥80% or occlusion) and reintervention rates.

RESULTS: Of the 35,802 patients who underwent either TF-CAS or TCAR, 2912 (6.1%) were ≤ 55 years. Younger patients were less likely than older patients to have coronary disease (30.5% vs 50.2%, p <.001), diabetes (31.5% vs 37.9%, p < .001) and hypertension (71.8% vs 89.8%, p <.001), but were more likely to be female (45% vs 35.4%, p <.001) and active smokers (50.9% vs 24.0%, p< .001) Younger patients were also more likely to have had a prior transient ischemic attack (TIA) or stroke than older patients (70.7% vs 56.9%, p <.001). TF-CAS was more frequently performed in younger patients (79.7% vs 55.4%, p <.001). In the periprocedural period, younger patients were less likely to have a MI than older patients (0.3% vs, 0.7%, p<.001), but there was no significant difference in the rates of periprocedural stroke (1.5% vs. 2.0%, p = .173) and composite outcomes of stroke/death (2.6% vs 2.7%, p =.686) and stroke/death/MI (2.9% vs 3.2%, p = .353) between our two cohorts. The mean follow-up was 12 months regardless of age. During follow up, younger patients were significantly more likely to experience significant (≥ 80%) restenosis or occlusion (4.7% vs. 2.3%, p= .001) and to undergo reintervention (3.3% vs. 1.7%, p< .001). However, there was no statistical difference in the frequency of late strokes between younger and older patients (3.8% vs. 3.2%, p = .129).

CONCLUSIONS: Patients with premature cerebrovascular disease undergoing carotid artery stenting are more likely to be African American, female, and active smokers than their older counterparts. Young patients are also more likely to present symptomatically. Although periprocedural outcomes are similar, younger patients have higher rates of procedural failure (significant restenosis or occlusion) and reintervention at 1 year follow-up. However, the clinical implication of late procedural failure is unknown given that we found no significant difference in the rate of stroke at follow-up. Until further longitudinal studies are completed, clinicians should carefully consider the indications for carotid stenting in patients with premature cerebrovascular disease, and those who do undergo stenting may require close follow-up given.

PMID:37211144 | DOI:10.1016/j.jvs.2023.05.023

Am J Ophthalmol. 2023 May 19:S0002-9394(23)00206-4. doi: 10.1016/j.ajo.2023.05.014. Online ahead of print.

ABSTRACT

PURPOSE: To systematically assess the ability-to-detect-change and retest-reliability for a panel of visual function assessments in ABCA4-retinopathy DESIGN: Prospective natural-history study (NCT01736293) METHODS: ss SETTING: Tertiary referral center STUDY POPULATION: Patients with at least one documented pathogenic ABCA4 variant and a clinical phenotype consistent with ABCA4-retinopathy OBSERVATION PROCEDURES: Participants underwent longitudinal, multifaceted functional testing, including measures of function at fixation (best-corrected visual acuity, low-vision Cambridge Color Test [LvCCT]), macular function (microperimetry), and retina-wide function (full-field electroretinography (ERG)).

MAIN OUTCOME MEASURES: Two- and five-year ability-to-detect-change based on the Eta-squared statistic RESULTS: A total of 134 eyes from 67 participants with a mean follow-up of 3.65 years were included. In the two-year interval, the microperimetry-derived peri-lesional sensitivity (η² of 0.73 [0.53, 0.83]; -1.79 dB/yr [-2.2, -1.37]) and mean sensitivity (η² of 0.62 [0.38, 0.76]; -1.28 dB/yr [-1.67, -0.89]) showed most change over time, but could only be recorded in 71.6 % of the participants. In the five-year interval, the dark-adapted ERG a- and b-wave amplitude showed marked change-over-time as well (e.g., DA 30 a-wave amplitude with an η² of 0.54 [0.34, 0.68]; -0.02 Log10(µV)/yr [-0.02, -0.01]). The genotype explained a large fraction of variability in the ERG-based age-of-disease-initiation (adj. R² of 0.73) CONCLUSIONS AND RELEVANCE: Microperimetry-based clinical outcome assessments were most sensitive to change but could only be acquired in a subset of participants. Across a 5-year interval, the ERG DA 30 a-wave amplitude was sensitive to disease progression, potentially allowing for more inclusive clinical trial designs encompassing the whole ABCA4-retinopathy spectrum.

PMID:37211138 | DOI:10.1016/j.ajo.2023.05.014

Sci Total Environ. 2023 May 19:164299. doi: 10.1016/j.scitotenv.2023.164299. Online ahead of print.

ABSTRACT

The abundance and distribution of microplastics has largely increased during last years and the respective implications on the environment and human health is an emerging field in research. In addition, recent studies in the enclosed Mediterranean Sea in Spain and Italy have shown an extended occurrence of microplastics (MPs) in different sediments of environmental samples. This study is focused on the quantification and the characterization of MPs in the Thermaic Gulf in northern Greece. Briefly, samples from different environmental compartments such as seawater, local beaches and seven commercially available fish species collected and analyzed. MPs particles extracted and classified by size, shape, colour and polymer type. A total of 28,523 microplastic particles recorded in the surface water samples, with their numbers ranging from 189 to 7714 particles per sample. The mean concentration of MPs recorded on the surface water was 1.9 ± 2 items/m³ or 750,846 ± 838,029 items/km². Beach sediment sample analysis revealed 14,790 microplastic particles, of which 1825 were large microplastics (LMPs, 1-5 mm) and 12,965 were small microplastics (SMPs, <1 mm). Furthermore, beach sediment samples showed a mean concentration of 733.6 ± 136.6 items/m², with the concentration of LMPs being 90.5 ± 12.4 items/m² and the concentration of SMPs being 643 ± 132 items/m². Concerning fish deposition, microplastics were detected in intestines and mean concentrations per species ranged from 1.3 ± 0.6 to 15.0 ± 1.5 items/individual. The differences in microplastic concentrations between species were statistically significant (p < 0.05) and showed that mesopelagic fish contained the highest concentrations, followed by epipelagic species. The most common size fraction found in the data-set was 1.0-2.5 mm, and polyethylene and polypropylene were the most abundant polymer types recorded. This is the first detailed investigation of MPs in Thermaic Gulf, which raises concerns on their potential negative effects.

PMID:37211124 | DOI:10.1016/j.scitotenv.2023.164299

Am J Obstet Gynecol MFM. 2023 May 19:101027. doi: 10.1016/j.ajogmf.2023.101027. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to conduct a systematic review and meta-analysis to assess clinical characteristics related to pathologically proven placenta accreta spectrum (PAS) without placenta previa.

DATA SOURCES: A literature search of PubMed, the Cochrane database, and Web of Science was performed from inception to September 7, 2022.

STUDY ELIGIBILITY CRITERIA: The primary outcomes were invasive placenta (including increta or percreta), blood loss, hysterectomy, and antenatal diagnosis. Additionally, maternal age, assisted reproductive technology, previous cesarean section, and previous uterine procedures were investigated as potential risk factors. The inclusion criteria were studies evaluating the clinical presentation of pathologically diagnosed PAS without placenta previa.

STUDY APPRAISAL AND SYNTHESIS METHODS: Study screening was conducted after duplicates were identified and removed. The quality of each study and the publication bias were assessed. Forest plots and I² statistics were calculated for each study outcome for each group. The main analysis was a random-effects analysis.

RESULTS: Among 2598 studies that were initially retrieved, five were included in the review. With the exception of one study, four studies could be included in the meta-analysis. This meta-analysis showed that PAS without placenta previa was associated with a less risk of invasive placenta (OR, 0.24; 95% CI, 0.16-0.37), blood loss (MD, -1.19; 95% CI, -2.09 to -0.28) and hysterectomy (OR, 0.11; 95% CI, 0.02-0.53), and more difficult to diagnose prenatally (OR, 0.13; 95% CI, 0.04-0.45) than PAS with placenta previa. Additionally, assisted reproductive technology and a previous uterine procedure were strong risk factors for PAS without placenta previa, while previous cesarean section was a strong risk factor for PAS with placenta previa.

CONCLUSIONS: The differences in clinical aspects of PAS with and without placenta previa need to be understood.

PMID:37211089 | DOI:10.1016/j.ajogmf.2023.101027

Am J Obstet Gynecol MFM. 2023 May 19:101026. doi: 10.1016/j.ajogmf.2023.101026. Online ahead of print.

ABSTRACT

BACKGROUND: Induction of labor is a common intervention in obstetrics worldwide. Foley catheter is commonly used mechanical method for labor induction in nulliparous women with an unfavorable cervix at term. We hypothesize that a higher volume of FC (80 ml vs. 60 ml) will shorten the induction-delivery interval for labor induction in nulliparous women at term with an unfavorable cervix with simultaneous use of vaginal misoprostol.

OBJECTIVE: To evaluate the effect of trans-cervical foley catheter (80 vs. 60 ml) with simultaneous use of vaginal misoprostol on the induction-delivery interval in nulliparous women at term with an unfavorable cervix for IOL.

STUDY DESIGN: In this double-blind, single-center, randomized controlled trial, nulliparous women with a term singleton gestation with the unfavorable cervix were randomized to either group 1 [FC (80 ml) simultaneously with vaginal misoprostol 25µg every 4h] or group 2 [FC (60ml) with vaginal misoprostol 25µg every 4h]. The primary outcome was induction-delivery interval. Secondary outcomes were duration of the latent phase of labor, number of doses of vaginal misoprostol required, mode of delivery, and maternal & neonatal morbidity. Analyses were based on the intention-to-treat method. A sample size of 100 women per group (n=200) was selected.

RESULTS: Between September 2021 to September 2022, 200 nulliparous women at term with an unfavorable cervix were randomized to labor induction with either Foley catheter (80 ml vs. 60 ml) & vaginal misoprostol. Induction delivery interval (in min) was statistically significantly shorter in Foley catheter (80 ml) (median [IQR]; 604 [524-719] vs. 846 [596-990], [p<0.001]). Median time to labor onset (in min) (240 [120-300] vs. 360 [180-600], p<0.001) was also shorter in group 1 (80ml). The number of doses of misoprostol required for labor induction was statistically significantly less than with 80ml (mean±SD; 1.4±0.7 vs. 2.4±1.3, p<0.001). There was no statistically significant difference in the mode of delivery (n) (vaginal delivery; 69 vs. 80 OR; 0.55[1.1-0.3], p=0.104 & cesarean section; 29 vs. 17 OR; 0.99[3-9-1], p=0.063 respectively). The relative risk of delivery within 12h with 80ml was 2.4 [95% CI 1.68-3.43], with p-value <0.001. Maternal & neonatal morbidity was similar across the two groups.

CONCLUSION: Foley catheter (80ml) simultaneously with vaginal misoprostol significantly shortens the induction-delivery interval (p<0.001) in nulliparous women at term with an unfavorable cervix, as compared to Foley catheter 60 ml & vaginal misoprostol.

CLINICAL TRIAL REGISTRATION: The trial was registered prospectively in the Clinical Trial Registry of India (CTRI) www.ctri.nic.in (registration number CTRI/2021/09/036921, date; 28-09-2021).

PMID:37211088 | DOI:10.1016/j.ajogmf.2023.101026