Category: Nevin Manimala

J Agric Food Chem. 2023 Mar 20. doi: 10.1021/acs.jafc.2c08654. Online ahead of print.

ABSTRACT

In this study, the soil effect on the micro-component composition of Nero d’Avola wines obtained from different locations was investigated through ¹H NMR-based metabolomics. Two different approaches were applied: the targeted (TA) and the non-targeted one (NTA). The former differentiated the wines by profiling (i.e., by identifying and quantifying) a number of different metabolites. The latter provided wine fingerprinting by processing the entire spectra with multivariate statistical analysis. NTA also allowed investigation of the hydrogen bond network inside wines via the analysis of ¹H NMR chemical shift dispersions. Results showed that the differences among wines were due not only to the concentrations of various analytes but also to the characteristics of the H-bond network where different solutes were involved. The H-bond network affects both gustatory and olfactory perceptions by modulating the way how solutes interact with the human sensorial receptors. Moreover, the aforementioned H-bond network is also related to the soil properties from which the grapes were taken. Therefore, the present study can be considered a good attempt to investigate terroir, i.e., the relationship between wine quality and soil characteristics.

PMID:36940311 | DOI:10.1021/acs.jafc.2c08654

Spine (Phila Pa 1976). 2023 Mar 20. doi: 10.1097/BRS.0000000000004633. Online ahead of print.

ABSTRACT

STUDY DESIGN: Descriptive.

OBJECTIVE: To analyze trends in racial, ethnic, and gender diversity in orthopaedic spine surgery fellowship trainees.

SUMMARY OF BACKGROUND DATA: Orthopaedic surgery has consistently been labeled as one of the least diverse fields in Medicine. While some effort has been made to combat this in recent years at the residency level, it is uncertain if spine fellowships have had any changes in fellow demographics.

METHODS: Fellowship demographic data was collected through the Accreditation Council for Graduate Medical Education (ACGME). Data collected included gender (Male, Female, Not reported), and race (White, Asian, Black, Hispanic, Native Hawaiians, American Indian or Alaskan Native, other, and unknown). Percentage equivalents were calculated for each group from 2007-2008 to 2020-2021. A χ2 test for trend (Cochran-Armitage test) was done to determine if there was a significant change in percentages of each race and gender during the study period. Results were considered statistically significant at P<0.05.

RESULTS: White, Non-Hispanic males represent the largest proportion of orthopaedic spine fellowship positions each year. From 2007 to 2021, there were no significant changes in representation of any race or gender of orthopaedic spine fellows. Males ranged from 81% to 95%, Whites from 28% to 66%, Asians from 9% to 28%, Blacks from 3% to 16%, and Hispanics from 0% to 10%. Native Hawaiians and American Indians remained at 0% for all years included in the study. Females and all races, excluding Whites, continue to be underrepresented in orthopaedic spine fellowship.

CONCLUSION: Orthopaedics spine surgery fellowship programs have not made substantial progress in diversifying its population. To see progression of diversity, more attention is needed to increase diversity in residency programs through pipeline programs, increased mentorship and sponsorship, and early exposure to the field.

LEVEL OF EVIDENCE: 1.

PMID:36940267 | DOI:10.1097/BRS.0000000000004633

Arthritis Rheumatol. 2023 Mar 20. doi: 10.1002/art.42504. Online ahead of print.

ABSTRACT

OBJECTIVES: Gout is associated with a higher risk of fracture; however, the associations of hyperuricemia and urate-lowering therapy (ULT) with the risk of fracture have been inconsistent. We examined whether lowering serum urate (SU) levels with ULT to a target level (i.e., <360 μmol/L) reduces risk of fracture among people with gout.

METHOD: We emulated analyses of a hypothetical target trial using a “cloning, censoring, and weighting” approach to examine the association between lowering SU with ULT to the target levels and the risk of fracture using data from The Health Improvement Network, a United Kingdom primary care database. Individuals with gout who were 40 years or older and initiated ULT were included in the study.

RESULTS: Among 28,554 people with gout, the 5-year risk of hip fracture was 0.5% for the “achieving the target SU level” arm and 0.8% for “not achieving the target SU level” arm, respectively. The risk difference and hazard ratio for “achieving the target SU level” arm was -0.3% (95% confidence interval [CI]: -0.5% to -0.1%) and 0.66 (95% CI: 0.46 to 0.93), respectively, compared with “not achieving the target SU level”. Similar results were observed when the associations of lowering SU level with ULT to the target levels with the risk of composite fracture, major osteoporotic fracture, vertebral fracture, and non-vertebral fracture were assessed.

CONCLUSIONS: In this population-based study, lowering the SU level with ULT to the guideline-based target level is associated with a lower risk of incident fracture in people with gout.

PMID:36940260 | DOI:10.1002/art.42504

Spine (Phila Pa 1976). 2023 Mar 13. doi: 10.1097/BRS.0000000000004581. Online ahead of print.

ABSTRACT

STUDY DESIGN: Matched cohort comparison.

OBJECTIVE: To determine perioperative outcomes of ESP block for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

SUMMARY OF BACKGROUND DATA: There is a paucity of data on the impact of lumbar erector spinae plane (ESP) block on perioperative outcomes and its safety in MI-TLIF.

METHODS: Patients who underwent 1-level MI-TLIF and received the ESP block (Group E) were included. An age- and gender-matched control group was selected from a historical cohort that received the standard of care (Group NE). The primary outcome of this study was 24-hour opioid consumption in morphine milliequivalents (MME). Secondary outcomes were pain severity measured by numeric rating scale (NRS), opioid related side effects, and hospital length of stay (LOS). Outcomes were compared between the two groups.

RESULTS: 98 and 55 patients were included in the E and NE groups respectively. There were no significant differences amongst the two cohorts in patient demographics. Group E had lower 24hr postoperative opioid consumption (P=0.117, not significant), reduced opioid consumption on POD 0 (P=0.016), and lower first pain scores post-surgery (P<0.001). Group E had lower intraoperative opioid requirements (P<0.001), and significantly lower average NRS pain scores on postoperative day 0 (P=0.034). Group E reported fewer opioid related side effects as compared with Group NE, although this was not statistically significant. The average highest postoperative pain score within 3 hours post-procedurally were 6.9 and 7.7 in the E and NE cohorts, respectively (P=0.029). The median LOS was comparable between groups with the majority of patients in both groups being discharged on postoperative day 1.

CONCLUSIONS: In our retrospective matched cohort, ESP blocks resulted in reduced opioid consumption and decreased pain scores on POD0 in patients undergoing MI-TLIF.

LEVEL OF EVIDENCE: III.

PMID:36940258 | DOI:10.1097/BRS.0000000000004581

Spine (Phila Pa 1976). 2023 Mar 13. doi: 10.1097/BRS.0000000000004619. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective review of prospectively collected multi-surgeon data.

OBJECTIVE: Examine the rate, clinical impact, predictors of subsidence after expandable MI-TLIF cage.

SUMMARY OF BACKGROUND DATA: Expandable cage technology has been adopted in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) to reduce the risks and optimize outcomes. Although subsidence is of particular concern when using expandable technology as force required to expand the cage can weaken the endplates, its rates, predictors, and outcomes lack evidence.

METHODS: Patients who underwent 1 or 2 level MI-TLIF using expandable cages for degenerative lumbar conditions and had a follow-up of>1 year were included. Preop and immediate, early, and late postoperative radiographs were reviewed. Subsidence was determined if the average anterior/posterior disc height decreased by>25% compared to the immediate postoperative value. Patient reported outcomes were collected and analyzed for differences at the early (<6 mo) and late (>6 mo) timepoints. Fusion was assessed by 1-year postop CT.

RESULTS: 148 patients were included (mean age 61 y, 86% 1-level, 14% 2-level). 22 (14.9%) demonstrated subsidence. Although statistically not significant, patients with subsidence were older, lower bone mineral density, and had higher BMI and comorbidity burden. Operative time was significantly higher (P=0.02) and implant width was lower (P<0.01) for subsided patients. VAS-Leg was significantly lower for subsided patients compared to non-subsided patients at a>6 m time point. Long-term (> 6m) patient acceptable symptom state (PASS) achievement rate was lower for subsided patients (53% vs. 77%), although statistically not significant (P=0.065). No differences existed in complication, reoperation, or fusion rates.

CONCLUSIONS: 14.9% of patients experienced subsidence predicted by narrower implants. Although subsidence did not have a significant impact on most PROMs and complication, reoperation, or fusion rates, patients had lower VAS-Leg and PASS achievement rate at the>6-month timepoint.

LEVEL OF EVIDENCE: 4.

PMID:36940252 | DOI:10.1097/BRS.0000000000004619

PLoS One. 2023 Mar 20;18(3):e0282946. doi: 10.1371/journal.pone.0282946. eCollection 2023.

ABSTRACT

AIMS AND OBJECTIVES: Studies have shown that the COVID-19 pandemic has taken a toll on individuals who interact with patients with SARS-CoV-2 but focused largely on clinicians in acute care settings. This qualitative descriptive study aimed to understand the experiences and well-being of essential workers across settings during the pandemic.

BACKGROUND: Multiple studies of the well-being of individuals who have cared for patients during the pandemic have included interviews of clinicians from acute care settings and revealed high levels of stress. However, other essential workers have not been included in most of those studies, yet they may also experience stress.

METHODS: Individuals who participated in an online study of anxiety, depression, traumatic distress, and insomnia, were invited to provide a free-text comment if they had anything to add. A total of 2,762 essential workers (e.g., nurses, physicians, chaplains, respiratory therapists, emergency medical technicians, housekeeping, and food service staff, etc.) participated in the study with 1,079 (39%) providing text responses. Thematic analysis was used to analyze those responses.

RESULTS: Four themes with eight sub-themes were: Facing hopelessness, yet looking for hope; Witnessing frequent death; Experiencing disillusionment and disruption within the healthcare system, and Escalating emotional and physical health problems.

CONCLUSIONS: The study revealed major psychological and physical stress among essential workers. Understanding highly stressful experiences during the pandemic is essential to identify strategies that ameliorate stress and prevent its negative consequences. This study adds to the research on the psychological and physical impact of the pandemic on workers, including non-clinical support personnel often overlooked as experiencing major negative effects.

RELEVANCE TO CLINICAL PRACTICE: The magnitude of stress among all levels of essential workers suggests the need to develop strategies to prevent or alleviate stress across disciplines and all categories of workers.

PMID:36940223 | DOI:10.1371/journal.pone.0282946

PLoS One. 2023 Mar 20;18(3):e0283329. doi: 10.1371/journal.pone.0283329. eCollection 2023.

ABSTRACT

BACKGROUND: Social anxiety disorder (SAD) is prevalent among children and adolescents. Cognitive-behavioural therapy (CBT) has been used as the first-line treatment. However, evaluation of CBT conducted in a school setting has been scarce.

OBJECTIVES: This study aims to review the CBT and its effectiveness in the school setting for children and adolescents with SAD or social anxiety symptoms. Quality assessment on individual studies was conducted.

METHODS: Studies were identified through the search in PsycINFO, ERIC, PubMed and Medline targeting CBT conducted in a school setting with an aim to treat children and adolescents with SAD or social anxiety symptoms. Randomised controlled trials and quasi-experimental studies were selected.

RESULTS: A total of 7 studies met the inclusion criteria. Five studies were randomised controlled trials, and two were quasi-experimental studies with 2558 participants aged 6-16 years from 138 primary schools and 20 secondary schools. There were minor effects to reduce social anxiety symptoms for children and adolescents at post-intervention in 86% of the selected studies. Friend for Life (FRIENDS), Super Skills for Life (SSL) and Skills for Academic and Social Success (SASS) conducted in school were more effective than the control conditions.

CONCLUSIONS: There is a lack of quality of the evidence for FRIENDS, SSL and SASS, due to inconsistencies on the outcome assessments, statistical analyses, and the fidelity measures adopted in individual studies. Insufficient school funding and workforce with relevant health background, and the low level of parental involvement in the intervention would be the major challenges in school-based CBT for children and adolescents with SAD or social anxiety symptoms.

PMID:36940221 | DOI:10.1371/journal.pone.0283329

PLoS Pathog. 2023 Mar 20;19(3):e1011230. doi: 10.1371/journal.ppat.1011230. Online ahead of print.

ABSTRACT

In Brazil, Leishmania braziliensis is the main causative agent of the neglected tropical disease, cutaneous leishmaniasis (CL). CL presents on a spectrum of disease severity with a high rate of treatment failure. Yet the parasite factors that contribute to disease presentation and treatment outcome are not well understood, in part because successfully isolating and culturing parasites from patient lesions remains a major technical challenge. Here we describe the development of selective whole genome amplification (SWGA) for Leishmania and show that this method enables culture-independent analysis of parasite genomes obtained directly from primary patient skin samples, allowing us to circumvent artifacts associated with adaptation to culture. We show that SWGA can be applied to multiple Leishmania species residing in different host species, suggesting that this method is broadly useful in both experimental infection models and clinical studies. SWGA carried out directly on skin biopsies collected from patients in Corte de Pedra, Bahia, Brazil, showed extensive genomic diversity. Finally, as a proof-of-concept, we demonstrated that SWGA data can be integrated with published whole genome data from cultured parasite isolates to identify variants unique to specific geographic regions in Brazil where treatment failure rates are known to be high. SWGA provides a relatively simple method to generate Leishmania genomes directly from patient samples, unlocking the potential to link parasite genetics with host clinical phenotypes.

PMID:36940219 | DOI:10.1371/journal.ppat.1011230

J Phys Chem B. 2023 Mar 20. doi: 10.1021/acs.jpcb.2c08631. Online ahead of print.

ABSTRACT

The adenine-thymine tautomer (A*-T*) has previously been discounted as a spontaneous mutagenesis mechanism due to the energetic instability of the tautomeric configuration. We study the stability of A*-T* while the nucleobases undergo DNA strand separation. Our calculations indicate an increase in the stability of A*-T* as the DNA strands unzip and the hydrogen bonds between the bases stretch. Molecular Dynamics simulations reveal the time scales and dynamics of DNA strand separation and the statistical ensemble of opening angles present in a biological environment. Our results demonstrate that the unwinding of DNA, an inherently out-of-equilibrium process facilitated by helicase, will change the energy landscape of the adenine-thymine tautomerization reaction. We propose that DNA strand separation allows the stable tautomerization of adenine-thymine, providing a feasible pathway for genetic point mutations via proton transfer between the A-T bases.

PMID:36939840 | DOI:10.1021/acs.jpcb.2c08631

Birth. 2023 Mar 20. doi: 10.1111/birt.12718. Online ahead of print.

ABSTRACT

BACKGROUND: Cesarean birth (CB) rates have increased over recent years with concerns over differences between these rates in migrant communities compared with the rates among women in their receiving country. This review aimed at summarizing the available literature regarding the incidence of CB among migrants in Europe.

METHODS: A systematic search of four electronic databases was carried out, including CINAHL, MEDLINE, Scopus, and Maternity and Infant Care. Identified studies were screened and their quality assessed. Meta-analysis was undertaken using Rev Man 5.4 where sufficient data were available. Otherwise, data were synthesized narratively.

RESULTS: From the 435 records identified in searches, 21 papers were included. Analysis shows that overall CB rates were significantly lower for Syrian refugee women compared with women in their receiving country (Turkey) and higher for Iranian migrants than women in their host country. Emergency CB rates were significantly higher for migrant women from “Sub Saharan Africa” and the “South East Asia, Asia and Pacific” region than rates in the receiving country. Statistical significance was not found between other populations.

CONCLUSIONS: This review highlights differences between CB rates in certain migrant groups in comparison with women native to their host country, which merits further investigation for potential explanations. We also identified a need to standardize definitions and population groupings to enable more meaningful analysis. This review also highlights a substantial lack of data on CB rates between different population groups that could negatively impact the provision of care.

PMID:36939837 | DOI:10.1111/birt.12718