Category: Nevin Manimala

Med J Aust. 2023 Oct 24. doi: 10.5694/mja2.52132. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine the relationship between vitamin C status and demographic factors in New South Wales on the basis of serum vitamin C test results undertaken at the central pathology laboratory in Sydney, and to assess associations with age, gender, social disadvantage, and geographic remoteness.

DESIGN, SETTING: Retrospective observational study; analysis of vitamin C test results undertaken at the Royal Prince Alfred Hospital, 1 January 2017 – 31 December 2021.

MAIN OUTCOME MEASURES: Vitamin C status (normal, serum concentration ≥ 40 μmol/L; hypovitaminosis C, 12-39 μmol/L; significant deficiency, < 12 μmol/L); associations of vitamin C status with year of testing, age, gender, socio-economic status (Index of Relative Socio-Economic Advantage and Disadvantage quintile), and geographic remoteness (Australian Statistical Geography Standard); rate of hypovitaminosis C or significant deficiency test results (relative to findings of normal levels; per 100 000 estimated resident population) by Statistical Area 3.

RESULTS: Of 17 507 vitamin C tests undertaken during 2017-2021, 4573 were excluded (multiple tests for individuals); of 12 934 included results, 6654 were for women (51.5%), 9402 for people living in major cities (73.5%), and 81 for people in remote or very remote areas (0.6%). In multivariable multinomial regression analyses, significant deficiency (relative to normal test results) was more likely for men than women (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.27-1.52); the likelihood of hypovitaminosis C (IRSAD quintile 1 v 5, aOR, 1.35; 95% CI, 1.19-1.53) or significant deficiency (aOR, 2.07; 95% CI, 1.79-2.40) generally increased with postcode-level socio-economic disadvantage. Several of the population areas with the highest low vitamin C rates were areas of greatest disadvantage in NSW.

CONCLUSIONS: The prevalence of vitamin C deficiency among older people and people living in areas of socio-economic disadvantage indicates that population assessment of vitamin C levels would be appropriate.

PMID:37875282 | DOI:10.5694/mja2.52132

J Sport Rehabil. 2023 Oct 24:1-7. doi: 10.1123/jsr.2023-0139. Online ahead of print.

ABSTRACT

CONTEXT: The aim of this prospective cohort study was to identify whether Y-Balance Test (YBT) performance and asymmetry are associated with lower limb injury in elite adult football athletes.

DESIGN: A prospective cohort study.

METHODS: Preseason YBT measures were obtained from 121 male footballers participating in National League One across the 2021-2022 season. Lower limb injuries were tracked across the season to determine the relationship between YBT variables and injury incidence using logistic regression analysis. The statistical significance level was .05.

RESULTS: The average YBT score was 111.0 (5.8) cm on the left limb and 112.0 (5.5) cm on the right limb, with an average asymmetry of 2.3 (1.4) cm. Athletes with lower YBT scores on both the left (odds ratio = 2.9; 95% confidence interval, 1.7 to 4.8: P ≤ .001) and right (odds ratio = 2.3; 95% confidence interval, 1.6 to 3.2: P ≤ .001) limbs were at a greater risk of injury. Similarly, athletes with greater amounts of asymmetry were also more likely to get injured (odds ratio = 2.1; 95% confidence interval, 1.3 to 3.3: P = .002).

CONCLUSIONS: Results indicate that lower and asymmetrical YBT scores have a significant relationship with future lower limb injuries in professional male footballers. The YBT offers a simple, reliable, and effective screening tool that can be used by practitioners in football to help identify players at a greater risk of injury before the season commences.

PMID:37875255 | DOI:10.1123/jsr.2023-0139

Am J Cardiol. 2023 Oct 21:S0002-9149(23)01118-9. doi: 10.1016/j.amjcard.2023.09.108. Online ahead of print.

ABSTRACT

Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) in patients with failed bioprostheses arose as an alternative to redo surgical aortic valve replacement. There is an increasing interest in exploring the differences between self-expanding valves (SEVs) and balloon-expandable valves (BEVs). Our study aimed to evaluate the all-cause mortality in ViV-TAVI with SEV versus BEV in patients with failed bioprostheses. We performed a study-level meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves of studies published by March 30, 2023. A total of 5 studies met our eligibility criteria and included 1,454 patients who underwent ViV-TAVI (862 with SEV and 592 with BEV). Almost all BEVs were iterations of the Edwards BEVs (SAPIEN, SAPIEN XT, and SAPIEN 3) and almost all SEVs were iterations of the Medtronic SEVs (CoreValve/Evolut). During the first year after ViV-TAVI, 67 deaths (11.8%) occurred in patients treated with BEV compared with 92 deaths (11.1%) in patients treated with SEV (hazard ratio 0.92, 95% confidence interval 0.66 to 1.27, p = 0.632). At 8 years of follow-up, the all-cause death was not statistically significantly different between the groups, with mortality rates of 65.4% in the group treated BEV and 58.8% in the group treated with SEV (hazard ratio 0.91, 95% confidence interval 0.75 to 1.09, p = 0.302). The restricted mean survival time was overall 0.25 years greater with SEV than BEV, but this difference was not statistically significant (p = 0.278), which indicates no lifetime gain or loss with SEV in comparison with BEV. There seems to be no difference in terms of all-cause death in ViV-TAVI with SEV versus BEV. Randomized controlled trials are warranted to validate our results.

PMID:37875248 | DOI:10.1016/j.amjcard.2023.09.108

Int J Radiat Oncol Biol Phys. 2023 Oct 22:S0360-3016(23)08008-2. doi: 10.1016/j.ijrobp.2023.10.004. Online ahead of print.

ABSTRACT

PURPOSE: To compare anatomical and functional dose-volume parameters as predictors of acute radiation-induced lung toxicity (RILT) in patients with lung tumors treated with stereotactic body radiation therapy (SBRT).

MATERIALS AND METHODS: 59 patients treated with SBRT were prospectively included. All patients underwent Gallium-68 lung perfusion PET/CT imaging before treatment. Mean lung dose (MLD) and volumes receiving xGy (VxGy, 5 to 30 Gy) were calculated in five lung volumes: the conventional anatomical volume (AV) delineated on CT images, three lung functional volumes defined on lung perfusion PET imaging (FV50%, FV70%, FV90%, i.e. the minimal volume containing 50%, 70% and 90% of the total activity within the AV), and a low functional volume (LFV = AV-FV90%). The primary endpoint of this analysis was grade ≥2 acute RILT at 3 months as assessed with NCI CTCAE v.5. Dose volume parameters in patients with and without acute RILT were compared. ROC curves assessing the ability of dose-volume parameters to discriminate between patients with and without acute RILT were generated and area under the curves (AUC) were calculated.

RESULTS: Out of the 59 patients, 10 (17%) had grade ≥2 acute RILT. The MLD and the VxGy in the AV and LFV were not statistically different in patients with and without acute RILT (p>0.05). All functional parameters were significantly higher in acute RILT patients (p<0.05). AUCs (CI 95%) for MLD AV, LFV, FV50%, FV70% and FV90% were 0.66 (0.46-0.85), 0.60 (0.39-0.80), 0.77 (0.63-0.91), 0.77 (0.64-0.91), 0.75 (0.58-0.91), respectively. AUCs for V20Gy AV, LFV, FV50%, FV70% and FV90% were 0.65 (0.44-0.87), 0.64 (0.46-0.83), 0.82 (0.69-0.95), 0.81 (0.67-0.96), 0.75 (0.57-0.94), respectively.

CONCLUSION: The predictive value of PET perfusion-based functional parameters outperforms the standard CT-based dose-volume parameters for the risk of grade ≥2 acute RILT. Functional parameters could be useful to guide radiotherapy planning to reduce the risk of acute RILT.

PMID:37875246 | DOI:10.1016/j.ijrobp.2023.10.004

Spine J. 2023 Oct 22:S1529-9430(23)03460-5. doi: 10.1016/j.spinee.2023.10.003. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Lumbar interbody instrumentation techniques are common and effective surgical options for a variety of lumbar degenerative pathologies. Anterior lumbar interbody fusion (ALIF) has become a versatile and powerful means of decompression, stabilization, and reconstruction. As an anterior only technique, the integrity of the posterior muscle and ligaments remain intact. Adding posterior instrumentation to ALIF is common and may confer benefits in terms of higher fusion rate but could contribute to adjacent segment degeneration due to additional rigidity. Large clinical studies comparing stand-alone ALIF with and without posterior supplementary fixation (ALIF+PSF) are lacking.

PURPOSE: To compare rates of operative nonunion and adjacent segment disease (ASD) in ALIF with or without posterior instrumentation.

STUDY DESIGN: Retrospective cohort study.

PATIENT SAMPLE: Adult patients (≥ 18 years old) who underwent primary ALIF for lumbar degenerative pathology between levels L4 to S1 over a 12-year period. Exclusion criteria included trauma, cancer, infection, supplemental decompression, noncontiguous fusions, prior lumbar fusions, and other interbody devices.

OUTCOME MEASURES: Reoperation for nonunion and ASD compared between ALIF only and ALIF+PSF.

METHODS: Reoperations were modeled as time-to-events where the follow-up time was defined as the difference between the primary ALIF procedure and the date of the outcome of interest. Crude cumulative reoperation probabilities were reported at five-years follow-up. Multivariable Cox proportional hazard regression was used to evaluate risk of operative nonunion and for ASD adjusting for patient characteristics.

RESULTS: The study consisted of 1377 cases; 307 ALIF only and 1070 ALIF+PSF. Mean follow up time was 5.6 years. The 5-year crude nonunion incidence was 2.4% for ALIF only and 0.5% for ALIF+PSF; after adjustment for covariates, a lower operative nonunion risk was observed for ALIF+PSF (HR=0.22, 95% CI=0.06-0.76). Of the patients who are deemed potentially suitable for ALIF alone, one would need to add posterior instrumentation in 53 patients to prevent one case of operative nonunion at a 5-year follow-up (number needed to treat). Five-year operative ASD incidence was 4.3% for ALIF only and 6.2% for ALIF+PSF; with adjustments, no difference was observed between the cohorts (HR=0.96, 95% CI=0.54-1.71).

CONCLUSIONS: While the addition of posterior instrumentation in ALIFs is associated with lower risk of operative nonunion compared to ALIF alone, operative nonunion is rare in both techniques (<5%). Accordingly, surgeons should evaluate the added risks associated with the addition of posterior instrumentation and reserve the supplemental posterior fixation for patients that might be at higher risk for operative nonunion. Rates of operative ASD were not statistically higher with the addition of posterior instrumentation suggesting concern regarding future risk of ASD perhaps should not play a role in considering supplemental posterior instrumentation in ALIF.

PMID:37875244 | DOI:10.1016/j.spinee.2023.10.003

Appetite. 2023 Oct 22:107084. doi: 10.1016/j.appet.2023.107084. Online ahead of print.

ABSTRACT

This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants’ anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.

PMID:37875240 | DOI:10.1016/j.appet.2023.107084

Curr Probl Cardiol. 2023 Oct 22:102161. doi: 10.1016/j.cpcardiol.2023.102161. Online ahead of print.

ABSTRACT

ABCG1 is an essential protein involved in the efflux of intracellular cholesterol to the extracellular space, thus playing a critical role in reducing cholesterol accumulation in neighboring tissues. Bibliometric analysis pertains to the interdisciplinary field of quantitative examination of diverse documents using mathematical and statistical techniques. It integrates the investigation of structural and temporal patterns in academic publications with an exploration of subject focus and forms of uncertainty. This research paper examines the historical evolution, current areas of interest, and future development trends of ABCG1 through bibliometric analysis. This study aims to offer readers insights into the research status and emerging trends of ABCG1, thereby assisting researchers in the exciting field to explore novel research avenues. Following rigorous selection, research on ABCG1 has remained highly active over the past two decades. ABCG1 has even started to emerge in previously unrelated fields, such as the field of cancer research. According to the analysis conducted by Citespace, a lot of keywords and influential citations were identified. ABCG1 has been found to establish a connection between cancer and cardiovascular disease, highlighting their interrelationship. This review aims to assist readers who have limited familiarity with ABCG1 research in gaining a rapid understanding of its developmental trajectory. Additionally, it aims to offer researchers potential areas of focus for future studies related to ABCG1.

PMID:37875209 | DOI:10.1016/j.cpcardiol.2023.102161

Sci Total Environ. 2023 Oct 22:167955. doi: 10.1016/j.scitotenv.2023.167955. Online ahead of print.

ABSTRACT

Although there has been a surge of interest in research focused on the presence of pharmaceuticals in the marine environment, study on the distribution and risks of pharmaceuticals in coastal waters remains inadequately documented due to the specific features of the marine environment, such as strong dilution, high salinity, and complex hydrodynamics. In this study, thirty pharmaceuticals with diverse physicochemical properties were analyzed in a coastal sea with low hydrodynamic energy caused by various artificial structures. The results indicate that 14 compounds were detected in seawater, with concentrations ranging from <1 to 201.4 ng L^-1, among which caffeine, metoprolol, and atenolol were detected at high levels. Statistical analysis reveals the prevalence of the most target pharmaceuticals with downward trends in concentrations from estuary to offshore region, demonstrating the significant impacts of riverine inputs on the coastal water. Nevertheless, the distribution patterns of caffeine and atenolol were intricate, suggesting that they may have also originated from other unknown sources. A newly-developed method combining risk quotient (RQ) and species sensitivity distribution (SSD) models was used in ecological risk assessment. The results indicate generally higher risks of target pharmaceuticals in the estuary compared to the offshore region, with caffeine, carbamazepine, and norfloxacin identified as the top three priority pollutants.

PMID:37875199 | DOI:10.1016/j.scitotenv.2023.167955

Int J Antimicrob Agents. 2023 Oct 22:107015. doi: 10.1016/j.ijantimicag.2023.107015. Online ahead of print.

ABSTRACT

AIM OF STUDY: Adjunctive rifampicin for implant associated infections (IAI) is controversial. We investigated the clinical outcomes of rifampicin combination therapy in comparison to monotherapy in treating prosthetic joint infection (PJI) or prosthetic valve endocarditis (PVE) due to staphylococci and streptococci.

METHODS: A systematic search was performed from inception to June 13^th 2022 in Embase, Medline, Cochrane, and Web of Science to investigate the clinical outcomes of rifampicin combination therapy in comparison to monotherapy in treating staphylococcal and streptococcal prosthetic joint infection (PJI) or prosthetic valve endocarditis (PVE). Included were randomized clinical trials (RCTs) and observational studies.

RESULTS: Fourteen studies were included. Moderate quality of evidence was found in favor of rifampicin in patients with staphylococcal PJI who underwent debridement, antibiotic and implant retention (DAIR) procedure (Odds Ratio 2.49 (95%CI 1.93 to 3.23). Including the two RCT’s only, adding rifampicin to the antibiotic regimen after DAIR was also in favor of rifampicin but not statistically significant (Risk Ratio 1.27 (0.79 to 2.04), n=126). Pooling data of patients with staphylococcal PJI that underwent a 2-stage procedure showed that adding rifampicin was not associated with therapeutic success. Limited evidence was found for use of rifampicin for PVE caused by staphylococci.

CONCLUSIONS: Adding rifampicin in staphylococcal PJI treated by DAIR was clearly increase the chance for therapeutic success. The clinical benefit of adjunctive rifampicin to in treatment of other staphylococci and streptococci IAI is still unclear.

PMID:37875179 | DOI:10.1016/j.ijantimicag.2023.107015

G3 (Bethesda). 2023 Oct 24:jkad247. doi: 10.1093/g3journal/jkad247. Online ahead of print.

ABSTRACT

Black spruce (Picea mariana [Mill.] B.S.P.) is a dominant conifer species in the North American boreal forest that plays important ecological and economic roles. Here, we present the first genome assembly of P. mariana with a reconstructed genome size of 18.3 Gbp and NG50 scaffold length of 36.0 kbp. A total of 66,332 protein-coding sequences were predicted in silico and annotated based on sequence homology. We analyzed the evolutionary relationships between P. mariana and five other spruces for which complete nuclear and organelle genome sequences were available. The phylogenetic tree estimated from mitochondrial genome sequences agrees with biogeography; specifically, P. mariana was strongly supported as a sister lineage to P. glauca and three other taxa found in western North America, followed by the European P. abies. We obtained mixed topologies with weaker statistical support in phylogenetic trees estimated from nuclear and chloroplast genome sequences, indicative of ancient reticulate evolution affecting these two genomes. Clustering of protein-coding sequences from the six Picea taxa and two Pinus species resulted in 34,776 orthogroups, 560 of which appeared to be specific to P. mariana. Analysis of these specific orthogroups and dN/dS analysis of positive selection signatures for 497 single-copy orthogroups identified gene functions mostly related to plant development and stress response. The P. mariana genome assembly and annotation provides a valuable resource for forest genetics research and applications in this broadly distributed species, especially in relation to climate adaptation.

PMID:37875130 | DOI:10.1093/g3journal/jkad247