Nevin Manimala

Protoplasma. 2025 Jan 14. doi: 10.1007/s00709-025-02031-7. Online ahead of print.

ABSTRACT

Stay-green (SG) and stem reserve mobilization (SRM) are two significant mutually exclusive traits, which contributes to grain-filling during drought and heat stress in wheat. The current research was conducted in a genome-wide association study (GWAS) panel consisting of 278 wheat genotypes of advanced breeding lines to find the markers linked with SG and SRM traits and also to screen the superior genotypes. SG and SRM traits, viz. soil plant analysis development (SPAD) value, canopy temperature (CT), normalized difference vegetation index (NDVI), leaf senescence rate (LSR) and stem reserve mobilization efficiency (SRE) were recorded. The trial was conducted in α-lattice design, under control and combined heat and drought stress (HD). Analysis of variance and descriptive statistics showed a significant difference across the evaluated traits. The highest mean of SRE (31.7%) and SRM (0.42 g/stem) was reported in HD, while highest SRE in HD and lowest in control was 52.56% and 15.7%, respectively. Genotyping was carried out using the 35 K Axiom R Wheat Breeder’s Array, 14,625 SNPs were kept after filtering. Through GWAS, 36 significant marker trait associations (MTAs) were identified on 16 distinct chromosomes; out of this, 22 MTAs were found under control and 14 MTAs under HD. Candidate genes that code for UDP-glycosyltransferase 73C4-like and protein detoxification 40-like was linked to SPAD and CT respectively. One MTAs was detected for SRM on chromosome 6B that code for wall associated receptor kinase 4 like. These SNPs can be utilized to generate cultivars that adapt to climate change by a marker-assisted gene transfer.

PMID:39808290 | DOI:10.1007/s00709-025-02031-7

Clin Exp Rheumatol. 2025 Jan 13. doi: 10.55563/clinexprheumatol/gskbin. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the efficacy and safety of an intra-articular (IA) CLK/DYRK inhibitor, lorecivivint (LOR), for the treatment of moderate to severe symptomatic knee osteoarthritis (OA).

METHODS: This was a Phase 3, 28-week, multicentre, double-blind, placebo-controlled study evaluating the efficacy and safety of a single IA injection of LOR. Patients with ACR-defined knee OA, Kellgren-Lawrence (KL) grades 2-3, and pain Numeric Rating Scale (NRS) ≥4 and ≤8 in the target knee were randomised (1:1) to receive LOR 0.07 mg or vehicle placebo (PBO) on Day 1. The primary endpoint was the change from baseline in Pain NRS at Week 12 between LOR and PBO. Additional outcomes included the change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Function, WOMAC Pain, Patient Global Assessment and safety.

RESULTS: 498 patients were randomised, and 51.9% had KL Grade 3 severity. In the full analysis set (FAS), LOR failed to meet the primary endpoint when compared to PBO. No significant treatment differences were noted in other efficacy endpoints. A post-hoc analysis demonstrated a positive treatment effect of LOR relative to PBO in the KL Grade 2 subgroup; the difference in weekly Pain NRS between LOR and PBO groups showed nominal statistical significance at Week 4 (p<0.05). Incidences, seriousness, and severity of adverse events were similar across the treatment groups.

CONCLUSIONS: LOR was well tolerated despite not meeting the primary endpoint. Efficacy signals were identified in patients with less severe structural knee OA disease, suggesting earlier intervention may be more effective.

PMID:39808288 | DOI:10.55563/clinexprheumatol/gskbin

Environ Manage. 2025 Jan 14. doi: 10.1007/s00267-025-02112-6. Online ahead of print.

ABSTRACT

This research assesses heavy metal contamination within the riparian zone of the Danro River, a tributary of the Ganges River basin in India, particularly impacted by sand mining activities. The study conducted analyses on major and trace elements in soil samples, focusing on those identified as ecologically hazardous by the Water Framework Directive of India. Utilizing a combination of indices (Enrichment Factor, Pollution Load Index, and Index of geo-accumulation) and statistical techniques such as Principal Component Analysis (PCA), the investigation aimed to evaluate contamination severity, ecological risks, and pollution sources. Results revealed arsenic concentrations ranging from 0.00-0.54 mg/kg to 117-136 mg/kg, and ecological risks for cadmium exceeding 30. PCA identified three dominant factors explaining over 95% of variance. This study also employed the Analytic Hierarchy Process (AHP) method to assess land use suitability. Results unveiled that chromium and nickel predominantly stemmed from natural origins, while arsenic, cadmium, lead, and zinc exhibited a mixed origin. While most sites displayed low to moderate contamination, south-western portion of the basin demonstrated significantly elevated copper concentrations. Cadmium emerged as a particular concern, posing downstream ecological risks alongside chromium, nickel, and zinc, surpassing established thresholds. Further examination using PCA analysis pinpointed three primary pollution sources: traffic emissions, industrial activities, and natural processes. The research concludes by proposing a novel approach for remediation, including the Miyawaki technique alongside traditional methods like electrokinetic remediation and soil leaching. Policy suggestions advocate for collaborative efforts between economic entities and governments to promote sustainable practices that minimize heavy metal pollution.

PMID:39808281 | DOI:10.1007/s00267-025-02112-6

Pediatr Radiol. 2025 Jan 14. doi: 10.1007/s00247-024-06142-w. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric ultrasound (US)-guided percutaneous liver biopsy is a commonly performed procedure in children, and may be performed in a variety of clinical settings. However, there is little research on the relative costs associated with different sedation methods and locations.

OBJECTIVE: This study uses time-driven activity-based costing (TDABC) to identify relevant costs associated with different biopsy sedation techniques and locations to help inform providers and patients as well as guide value-conscious care. This study analyzes the direct costs associated with pediatric liver biopsy performed in an OR versus a dedicated pediatric sedation clinic.

MATERIALS AND METHODS: A single-center retrospective review including data from consecutive procedures all completed by one board-certified interventional radiology physician between June 2021 and April 2024 was performed. Exclusion criteria included procedures with lack of timestamps (N = 3), and multiple procedures being completed causing a deviation from the standard pathway process (N = 19). Direct costs were calculated using cost capacity rates (CCR) and TDABC methodology. Propensity score matching between procedures performed in a sedation clinic versus an operating room (OR) was performed adjusting for age, gender, American Society of Anesthesiologists (ASA) status, and inpatient status, and subsequent matches were analyzed via paired t-test in SPSS.

RESULTS: A total of 111 procedures performed in the OR (N = 71) or sedation clinic (N = 40) were found and considered for analysis (N = 55 male, N = 56 female; mean age = 9.13, SD = 6.69 years). A technical success rate of 100% and a complication frequency of 5% (N = 3, mean = 13.67, SD = 2.05, all grade 1) were observed. Complication frequency was not statistically significant between the sedation clinic (N = 1) and OR (N = 2) groups (P = 0.28). After propensity matching, N = 58 matched procedures (OR, N = 29; sedation clinic, N = 29) were included. Pre-procedure times in the sedation clinic were shorter in duration (62.11 ± 42.25) than in the OR (111.96 ± 62.11, P < 0.001). Total procedure times were also shorter in duration in the sedation clinic (14.07 ± 4.99) than in the OR (21.76 ± 18.22, P = 0.03). In addition, procedures completed in the OR utilized additional anesthesia staff for an average of 72 min, contributing to overall cost. The average total included costs for matched liver biopsy procedures were $1,089.51 ± 384.34 in the sedation clinic and $2,801.36 ± 1,201.52 in the OR (P < 0.001).

CONCLUSIONS: Liver biopsies completed in the sedation clinic were associated with significantly lower direct costs and were not associated with higher complication rates. These findings provide evidence for promoting pediatric sedation clinics as a safe and cost-effective location to perform liver biopsies in appropriate patients.

PMID:39808273 | DOI:10.1007/s00247-024-06142-w

Environ Sci Pollut Res Int. 2025 Jan 14. doi: 10.1007/s11356-024-35817-y. Online ahead of print.

ABSTRACT

Wastewater treatment plant (WWTP) is a sustainable technique for making wastewater reusable for non-potable purposes. However, in developing countries, most conventional WWTPs are not equipped to trap all pharmaceutical residues (PRs) and pharmaceutically active chemicals (PhACs). This study aims to perform non-target screening of these contaminants in wastewater and explore health and environmental hazards and the removal efficiency of a WWTP in Malaysia. At Indah Water WWTP, a total of 28 wastewater samples (i.e., 2 L each of 14 influent and 14 effluent) were collected every day for a week from February to April 2023. The supernatant of the centrifuged sample was analyzed with the LCMS-QTOF system. Chromatographic profiles were analyzed, and the compounds were annotated using the METLIN database. Categorical data were statistically analyzed with SPSS 29.0 using a chi-square test and continuous variables using paired t-test and multiple regression. PRs like micronutrient (9, 2.3%) and PhACs like lipid (83, 20.8%) were more frequent. Detection frequencies of PRs and PhACs were 72 (18%) and 328 (82%), respectively. Efficiency of WWTP was 36.4 to 100% for PRs removal (mean ± SD: 65.85 ± 56.43%) and 20 to 100% for PhACs removal (mean ± SD: 49.30 ± 55.94%). A total of 943 (mean ± SD: 67.36 ± 43.28) and 400 (mean ± SD: 28.57 ± 32.44) unique PRs and PhACs were recorded. A total of 40 (10%) PRs and PhACs had the potential to irritate eyes, skin, and respiratory tract, and 46 (11.5%) chemicals needed to be avoided from being discharged into the environment. Though WWTP was 98.0% compliant with environmental standards, its efficiency should still be increased to remove the full range of PRs and PhACs. The research has implications for SDGs 6 and 14.

PMID:39808258 | DOI:10.1007/s11356-024-35817-y

Clin Toxicol (Phila). 2025 Jan 14:1-9. doi: 10.1080/15563650.2024.2437119. Online ahead of print.

ABSTRACT

INTRODUCTION: Many patients acutely self-poisoned with organophosphorus insecticides have co-ingested ethanol. Currently, profenofos 50% emulsifiable concentrate (EC50) is commonly ingested for self-harm in Sri Lanka. Clinical experience suggests that ethanol co-ingestion makes management more difficult. Therefore, we aimed to determine the relationships between plasma ethanol concentration, plasma profenofos concentration and its toxicokinetics, and clinical outcome in acute profenofos self-poisoning.

METHODS: Demographic and clinical data, including a history of ethanol ingestion and blood samples, were prospectively collected from all cases of acute poisoning with profenofos EC50 presenting to Teaching Hospital Peradeniya, Sri Lanka, over four years. Plasma samples were analyzed by gas chromatography-mass spectrometry to quantify the ethanol (n = 99) and profenofos (n = 30 [15 with ethanol, 15 without ethanol]) concentrations. The PKSolver program was used to calculate the toxicokinetic parameters.

RESULTS: Of 99 patients (male 78/99) with acute profenofos self-poisoning, 50 reported a history of ethanol co-ingestion. Plasma from 44 of 99 profenofos-poisoned patients had detectable ethanol concentrations. No statistical difference was observed between the mortality in the ethanol group and the no ethanol group (5/44 [11.4%] versus 3/55 [5.5%]; P = 0.461). Similarly, the median half-lives of plasma profenofos absorption in the ethanol and no ethanol groups (0.1 h and 0.1 h, respectively; time 0-24 h) were not statistically different (P = 0.6594). However, the median half-life of plasma profenofos elimination was significantly longer in the ethanol group than the no ethanol group (23.1 h and 9.9 h, respectively; time 0-24 h; P = 0.0002). According to the regression analysis, the half-life of plasma profenofos elimination was longer by 29.4 h in the ethanol group (P = 0.013).

DISCUSSION: No significant differences in outcomes, including death and endotracheal intubation rates, were found between those who did and did not co-ingest ethanol. No differences were found in toxicokinetic variables between the ethanol and no ethanol groups, but the ethanol group had a longer elimination half-life.

CONCLUSION: The co-ingestion of ethanol leads to a slowing of the elimination kinetics of profenofos. However, the study did not reveal a significant impact of ethanol co-ingestion on clinical outcomes.

PMID:39807620 | DOI:10.1080/15563650.2024.2437119

Environ Sci Technol. 2025 Jan 14;59(1):103-118. doi: 10.1021/acs.est.4c07753. Epub 2024 Dec 30.

ABSTRACT

Enteropathogens are major contributors to mortality and morbidity, particularly in settings with limited access to water, sanitation, and hygiene infrastructure. To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural-urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection. Most children (89%) carried at least one pathogen, and 72% carried two or more. Bacterial infections (82% of participants) were more common than viruses (58%) or parasites (9.1%). Infants living in the urban site had decreased infection risks compared to those in rural locations. Improved water and sanitation were most predictive of reduced infection risk. Improved water was associated with decreased enterotoxigenic E. coli prevalence, and improved sanitation was associated with lower prevalence of any infection and specifically norovirus. Animal exposure was associated with increased Salmonella prevalence. Children measured during the rainy season had fewer viral and more bacterial infections. Identifying environmental exposures associated with specific pathogen outcomes provides insights into transmission pathways, which contribute critical information for developing effective strategies to improve child health.

PMID:39807583 | DOI:10.1021/acs.est.4c07753

Palliat Support Care. 2025 Jan 14;23:e15. doi: 10.1017/S1478951524001548.

ABSTRACT

OBJECTIVES: Advance care planning (ACP) supports communication and medical decision-making and is best conceptualized as part of the care planning continuum. Black older adults have lower ACP engagement and poorer quality of care in serious illness. Surrogates are essential to effective ACP but are rarely integrated in care planning. Our objective was to describe readiness, barriers, and facilitators of ACP among seriously ill Black older adults and their surrogates.

METHODS: We used an explanatory sequential mixed methods study design. The setting was 2 ambulatory specialty clinics of an academic medical center and 1 community church in Northern California, USA. Participants included older adults and surrogates. Older adults were aged 60+, self-identified as Black, and had received care at 1 of the 2 clinics or were a member of the church congregation. Surrogates were aged 18+ and could potentially make medical decisions for the older adult. The validated ACP engagement survey was used to assess confidence and readiness for ACP. What “matters most” and barriers and facilitators to ACP employed questions from established ACP materials and trials. Semi-structured interviews were conducted after surveys to further explain survey results.

RESULTS: Older adults (N = 30) and surrogates (N = 12) were confident that they could engage in ACP (4.1 and 4.7 out of 5), but many were not ready for these conversations (3.1 and 3.9 out of 5). A framework with 4 themes – illness experience, social connections, interaction with health providers, burden – supports identification of barriers and facilitators to ACP engagement.

SIGNIFICANCE OF RESULTS: We identified barriers and facilitators and present a framework to support ACP engagement. Future research can assess the impact of this framework on communication and decision-making.

PMID:39807567 | DOI:10.1017/S1478951524001548

Palliat Support Care. 2025 Jan 14;23:e14. doi: 10.1017/S1478951524001524.

ABSTRACT

OBJECTIVES: Wishes to hasten death (WTHDs) are common in patients with serious illness. The Schedule of Attitudes Toward Hastened Death (SAHD) is a validated 20-item instrument for measuring WTHD. Two short versions have also been developed based on statistical item selection. However, all existing versions show some limitations with potential for improvement. This study aims to develop and initially validate a theory-driven and statistically sound SAHD short version based on a large multinational sample to advance the WTHD assessment in different countries and with different legislations.

METHODS: A 3-step procedure was carried out including (1) theory-driven item selection, (2) exploratory, and (3) confirmatory factor analysis. We used a data set collected between 1998 and 2020 across 3 different countries (Germany, Spain, USA). Participants were N = 1156 complete cases (n = 181 German, n = 101 Spanish and n = 874 US) of severely ill adult in- and outpatients. They had to be ≥18 years and give informed consent.

RESULTS: The exploratory factor analysis revealed that 10 of 11 items previously selected theory-driven loaded on either of 2 factors: (1) WTHD and (2) internal locus of control. These factors showed good to excellent reliability according to Cronbach’s α and McDonald’s Ω, as well as an excellent fit of our data as an overall model for the total sample.

SIGNIFICANCE OF RESULTS: The developed SAHD-10 represents a reliable and valid alternative to the SAHD and an efficient means to measure and further investigate a WTHD in cross-cultural clinical and research settings.

PMID:39807560 | DOI:10.1017/S1478951524001524

Emergencias. 2024 Dec;36(6):438-446. doi: 10.55633/s3me/061.2024.

ABSTRACT

OBJECTIVE: To evaluate the social, epidemiological, and clinical characteristics of patients brought to Spanish pediatric emergency departments (EDs) after suicide attempts by poisoning. A secondary objective was to identify risk factors for moderate-severe poisoning.

METHODS: Prospective multicenter cohort study. We included patients under the age of 18 years who were brought to 20 Spanish pediatric EDs after attempting suicide between January 2021 and June 2022. Case histories were reviewed and the patients were interviewed. A Poisoning Severity Score of 2 or more was classified as moderate-severe.

RESULTS: A total of 592 episodes were studied; 541 of the patients (91.4%) were girls. The median (P25-P75) age was 14.6 years (13.6-15.7 years). A psychiatric diagnosis had been made in 417 (70.4%), 334 (56.4%) had attempted suicide previously, and 409 (69.1%) had been victims of bullying. Medications were ingested by 584 (98.6%). The most often used were benzodiazepines (used by 222; 37.5%) and paracetamol (by 187; 31.6%). Fifty-three poisonings were classified as moderate-severe. A mental health evaluation was carried out in 585 cases (98.8%). Odds ratios (ORs) indicated that higher risk of moderate-severe poisoning was associated with having an adjustment disorder (OR, 3.2; P25-P75, 1.1-9.0; P = .027), using opioids (OR, 6.4; P25-P75, 1.2-35.4; P = .032), and taking of antidiabetic drugs (OR, 27.6; P25-P75, 1.2-634.9; P = .038). Being a victim of bullying (OR, 0.4; P25-P75, 0.2-0.8; P = .013] and using nonsteroidal anti-inflammatory drugs (OR, 0.3; P25-P75, 0.1-0.8; P = .020) decreased risk.

CONCLUSIONS: Pediatric ED visits for suicide attempts by poisoning occur mainly in adolescent girls, and a majority have a medical history of a psychiatric diagnosis, prior suicide attempts, or self-harm behaviors. They have also often experienced bullying. Characteristics that distinguish patients with moderate-severe poisoning are the presence of an adjustment disorder and the use of opioids and antidiabetic drugs, which confer risk for greater severity.

PMID:39807549 | DOI:10.55633/s3me/061.2024