Nevin Manimala

J Pak Med Assoc. 2026 Feb;76(2):176-180. doi: 10.47391/JPMA.22295.

ABSTRACT

OBJECTIVES: To assess the relationship between light-emitting diode device usage and premature ageing.

METHODS: The cross-sectional, descriptive study was conducted from October 2023 to May 2024 after approval from the ethics review committee of Pakistan Naval Ship Shifa Hospital, Karachi, and comprised individuals aged 27-40 years. Other than demographic characteristics, data was collected about light-emitting diode device usage and indicators of premature ageing based on self-reported and observed features. Data was analysed using SPSS 29.

RESULTS: Of the 450 participants with mean age 32.4±3.7 years, 225(50%) each were males and females. Commonly used devices were mobile phones 400(88.9%), television 350(77.8%) and laptops 300(66.7%). Overall, 200(44.4%) subjects reported 5-7 hours of screen time, and 300(66.7%) did not use ultraviolet protection. Devices were used at a distance of 10- 20cm by 200(44.4%) subjects. In terms of premature ageing signs, the most common was dark circles 325(72.2%), while greying of hair was the least common 200(44.4%). All ageing variables showed a highly significant association with lightemitting diode usage (p<0.01), with the exception of greying of hair which demonstrated a significant association but at a lower level (p<0.05).

CONCLUSIONS: There was a significant link between light-emitting diode device usage and premature ageing.

PMID:41830352 | DOI:10.47391/JPMA.22295

J Pak Med Assoc. 2026 Feb;76(2):167-171. doi: 10.47391/JPMA.22034.

ABSTRACT

OBJECTIVES: To evaluate acute pancreatitis in patients with end-stage renal disease on haemodialysis, and to compare it with patients without end-stage renal disease.

METHODS: The retrospective, cross-sectional study was conducted at Adana City Training and Research Hospital, Turkiye, and comprised data from September 2017 to December 2023 of patients presenting with acute pancreatitis with or without end-stage renal disease. Those with end-stage renal disease who were on haemodialysis were placed in group A, while patients without chronic kidney disease represented control group B. Demographic and laboratory data, the severity of pancreatitis, the aetiology of acute pancreatitis, accompanying diseases, the duration of hospitalisation and the prognosis of the patients in both groups were evaluated and compared. Data was analysed using SPSS 25.

RESULTS: Of the 178 patients, 54(30.33%) were in group A with mean age 56.0±14.5 years (range: 20-85 years) among whom 26(48.1%) were males. There were 124(69.66%) patients in group B with mean age 52.5±16.2 years (19-88 years), and there were 59(47.6%) males. Acute pancreatitis was more severe, and the number of idiopathic cases was higher in group A compared to group B (p<0.05). Significant differences were also noted for aetiological causes, comorbidities, intensive care unit admission, length of hospital stays, and mortality between the groups(p<0.05).

CONCLUSIONS: In patients with end-stage renal disease on haemodialysis, acute pancreatitis was more severe in all respects compared to those without chronic kidney disease.

PMID:41830350 | DOI:10.47391/JPMA.22034

Acta Anaesthesiol Scand. 2026 Apr;70(4):e70221. doi: 10.1111/aas.70221.

ABSTRACT

BACKGROUND: The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is ubiquitous in perioperative medicine and research as a tool for preoperative patient risk stratification. Despite widespread clinical adoption as a predictor of perioperative outcomes, the ASA-PS system is inherently subjective, leading to considerable inter-rater variability. A comprehensive mapping of the literature examining the relationship between ASA-PS scores and patient outcomes is lacking.

OBJECTIVES: To systematically map the extent, range, and nature of peer-reviewed literature examining the relationship between the ASA-PS classification and patient outcomes, and to identify key characteristics, themes, and knowledge gaps in this evidence base.

METHODS: This scoping review will be conducted according to the Joanna Briggs Institute (JBI) methodological framework and reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). The Population-Concept-Context (PCC) framework will guide eligibility assessment. A comprehensive search will be conducted across PubMed, EMBASE, Scopus, LILACS, and the Cochrane Central Register of Controlled Trials, with no language or date restrictions. Study selection will be performed independently and in duplicate by two reviewers in two stages (title/abstract screening, full-text review). If any discordance appears, a third reviewer verdict will be requested. Data will be extracted using a structured charting form and synthesized narratively.

CONTEXT: Any healthcare setting where an ASA-PS score is assigned prior to a procedure (inpatient hospital, ambulatory surgery center, outpatient clinic). Primary research designs, including randomized controlled trials, observational studies (cohort, case-control, cross-sectional, descriptive), and case reports will be eligible; review articles, editorials, letters to the editor, and commentaries will be excluded.

SEARCH STRATEGY: The search will employ controlled vocabulary (MeSH terms) and free-text keywords including: “ASA score,” “ASA Physical Status Classification System,” “American Society of Anesthesiologists,” in combination with outcome-related terms. Supplementary hand searching of reference lists and Google Scholar will be performed.

DATA EXTRACTION: Study characteristics (author, year, country, journal, design), population characteristics (sample size, age, comorbidity), context (clinical setting, specialty, procedure type, urgency), ASA score details, and outcome details (including statistical methods used to derive associations) will be extracted. A preliminary data charting form is provided in Appendix B.

SYNTHESIS: Narrative synthesis supported by descriptive statistics will map study characteristics, outcome categories, clinical contexts, study designs, and temporal and geographical distribution of research. No formal quality appraisal will be conducted.

ETHICS AND REGISTRATION: Ethics committee approval is not required for this protocol-based scoping review.

PMID:41830324 | DOI:10.1111/aas.70221

Pain Pract. 2026 Apr;26(4):e70140. doi: 10.1111/papr.70140.

ABSTRACT

INTRODUCTION: Complementary, alternative, and integrative medicine (CAIM) has gained popularity among patients experiencing pain, used alongside conventional medical treatments. This study aimed to explore the perceptions of pain clinicians and researchers on CAIM interventions.

METHODS: An anonymous, online survey was distributed to 46,223 authors who had published pain-related research in MEDLINE-indexed journals. The survey included multiple-choice questions and open-ended sections to gather detailed opinions.

RESULTS: A total of 1024 participants responded, 900 of which were eligible to participate; most identified as either pain researchers (n = 435/900, 48.33%) or both researchers and clinicians (n = 398/900, 44.22%). Many held senior positions (n = 549/892, 61.55%). Among the CAIM modalities, mind-body therapies such as meditation, yoga, and biofeedback were viewed as the most promising for pain prevention, treatment, and management, with 68.47% (n = 569/831) of participants endorsing these approaches. While (n = 341/777, 43.89%) of the respondents believed that most CAIM therapies are safe, only 25.55% (n = 198/775) disagreed with the idea that such therapies are effective. There was broad agreement on the need for more research into CAIM therapies, with 45.88% (n = 356/776) agreeing and 42.53% (n = 330/776) strongly agreeing that further investigation is valuable. Additionally, many respondents supported the inclusion of CAIM training in clinician education, either through formal programs (n = 361/778, 46.40%) or supplementary courses (n = 409/776, 52.71%).

CONCLUSIONS: Mind-body therapies received the most positive feedback, while biofield therapies were met with the most skepticism. These findings highlight the interest in CAIM among pain researchers and clinicians and emphasize the need for more research and education tailored to this area.

PMID:41830314 | DOI:10.1111/papr.70140

Proteomics Clin Appl. 2026 Mar;20(2):e70042. doi: 10.1002/prca.70042.

ABSTRACT

PURPOSE: Coronavirus disease 2019 (COVID-19) has highlighted significant neurological complications in severe cases. Cerebrospinal fluid (CSF) proteomics could reveal biomarkers related to clinical outcome among critically ill patients.

EXPERIMENTAL DESIGN: We performed high-resolution proteomic analyses of CSF samples from 29 intensive care unit (ICU) patients with severe COVID-19 and 19 controls. Differentially expressed proteins and associated pathways were identified through bioinformatic and statistical analyses.

RESULTS: Proteomic analysis identified 488 significantly altered proteins between COVID-19 patients and controls. Proteins linked to coagulation, inflammation, and blood-brain barrier dysfunction (e.g., SERPINC1, KNG1, PLG) were elevated in patients who survived ICU admission. Conversely, proteins associated with metabolic disruption, cellular stress, and neuroinflammation (e.g., FABP3, PDIA4) were upregulated in non-survivors. Pathway enrichment analyses confirmed involvement of immune activation, inflammatory responses, and coagulation cascades.

CONCLUSIONS AND CLINICAL RELEVANCE: CSF proteomics in severe COVID-19 patients reveals potential biomarkers predictive of patient outcomes. These findings support the involvement of systemic inflammation and blood-brain barrier disruption in COVID-19 pathophysiology, suggesting novel targets for personalized intervention strategies.

PMID:41830303 | DOI:10.1002/prca.70042

Huan Jing Ke Xue. 2026 Mar 8;47(3):1995-2006. doi: 10.13227/j.hjkx.202501083.

ABSTRACT

Heavy metals surrounding waste incineration plants undergo cross-media migration and enrich in the soil-water system, resulting in a systematic deterioration of the physical and chemical properties of the soil and posing potential hazards to the ecological environment and human health. Taking the heavy metals in the soil, sediment, surface water, and groundwater around a waste incineration plant in Jiangxi Province as the research objects, descriptive statistical analysis was conducted on the contents (or concentrations) of heavy metals in multi-media. The spatial distribution characteristics of heavy metals within the soil-water system were analyzed, and the sources of heavy metals in the soil were deciphered by comprehensively using correlation analysis and the Absolute Principal Component Analysis-Multiple Linear Regression (APCS-MLR) model. The results showed that heavy metals around the waste incineration plant were mainly enriched in the soil and sediments. The content of Cd in the soil exceeded the risk screening value, and the contents of Cd and Zn exceeded the soil background values in Jiangxi Province. The average values of As, Cr, Ni, Pb, and Zn in the sediments exceeded the sediment background values in Jiangxi Province. The concentrations of heavy metals As and Pb in the groundwater exceeded the groundwater standard (Class Ⅲ). The variation coefficients of As and Cd in the soil were 53.97% and 39.84%, respectively, which belonged to a strong variation degree and exhibited obvious characteristics of point source pollution. The average content of Zn in the soil samples was higher than that in the sediment samples, while the contents of As, Cd, Cr, Cu, Ni, and Pb in the sediments were higher than those in the soil. The results of the correlation analysis between the distance from the riverbank and the cumulative concentration of heavy metals indicated that the concentration of heavy metals in the groundwater was affected by the recharge of surface water. The contents of heavy metals As, Cd, Ni, and Pb in the soil were higher in the southeast wind direction, which was obviously affected by the perennial dominant wind direction of the waste incineration plant, while Cr, Cu, and Zn were not significantly affected by the wind direction. The contents (concentrations) of heavy metals in the sediments and surface water generally showed a trend of first increasing and then decreasing along the flow direction of the surface water. The contents (or concentrations) of the other six heavy metals except Cr were higher near the sewage outlet and in the lower reaches of the river, among which the influence of As was the most obvious, which may have been related to the industrial activities of the waste incineration plant. The heavy metals in the soil mainly came from industrial sources of waste incineration, agricultural sources of pesticides and fertilizers, and natural sources of parent materials, with corresponding contribution rates of 31.14%, 28.14%, and 40.72%, respectively. The industrial sources of waste incineration had different degrees of influence on the seven heavy metals. The influence on As and Cd was the most significant; the influence on Ni and Pb was general; and the influence on Cu, Cr, and Zn was relatively weak. Among them, As and Cd mainly came from industrial sources, Ni and Pb mainly came from industrial and natural sources, while Cu, Cr, and Zn mainly came from agricultural and natural sources. It can provide data support and scientific basis for comprehensively investigating the heavy metal pollution status of multi-media and developing strategies for the prevention and control of heavy metal pollution around waste incineration plants.

PMID:41830275 | DOI:10.13227/j.hjkx.202501083

Huan Jing Ke Xue. 2026 Mar 8;47(3):1833-1844. doi: 10.13227/j.hjkx.202502182.

ABSTRACT

Henan Province plays a crucial strategic role in maintaining national food security. Exploring the collaborative evolution of water resources and cultivated land resources, as well as their driving factors, is of significant importance for achieving the goal of building up strength in agriculture. Using Henan Province as the study area, this study constructed an evaluation index system for the carrying capacity of water resources and cultivated land resources based on statistical data from 2005 to 2023. The entropy method was employed to determine the weights of the evaluation indices and quantitatively assess the carrying capacity levels. The Haken model was used to analyze the synergistic effect between the two resources, while a modified gravity model and social network analysis were applied to reveal the characteristics of the synergistic network. Additionally, the GeoDetector was employed to explore the driving factors of the collaborative relationship. The results indicate that: ① From 2005 to 2023, the water resource carrying capacity index of Henan Province increased by 0.123, rising from a low capacity level to a higher level, while the cultivated land resource carrying capacity index increased by 0.132, rising from low to high capacity, with Pingdingshan City still maintaining a general capacity level. ② From 2005 to 2023, the synergistic degree between water resource carrying capacity and cultivated land resource carrying capacity increased from 0.424 to 0.557, rising from low-level synergy to high-level synergy. Except for Pingdingshan City, which was at a medium-level synergy, all regions in the province achieved high-level or above synergy. ③ The synergistic effect between water resource carrying capacity and cultivated land resource carrying capacity in Henan Province had formed a complex, multi-threaded spatial network structure. During the study period, the stability and connectivity of the spatial network improved, with the intermediary roles of cities weakening, resource control becoming more decentralized, and the network becoming more balanced. The connections and interactions between regions became more significant. ④ Cultivated land resource carrying capacity, as a sequence parameter, determined the current level of water resource carrying capacity and dominated the path and direction of their synergy. Per capita water resources, residents’ consumption level, agricultural electricity intensity, and per capita net income of rural residents were the core driving forces of the synergy between water and cultivated land resource carrying capacity, which were simultaneously influenced by multiple factors and interactions. The findings provide decision-making references for the collaborative evolution and dynamic adaptation of water and cultivated land resources in Henan Province.

PMID:41830261 | DOI:10.13227/j.hjkx.202502182

Huan Jing Ke Xue. 2026 Mar 8;47(3):1657-1664. doi: 10.13227/j.hjkx.202503326.

ABSTRACT

Alzheimer’s disease (AD) is a common neurodegenerative disease. The usage of its therapeutic drugs is increasing with the intensification of population aging. These drugs cannot be completely metabolized in the human body and enter wastewater systems in the form of the originals or metabolites. In-depth investigation of the occurrence characteristics of these drugs in wastewater is of great significance for effective control and management. The concentrations and associated factors of four main AD drugs (donepezil, rivastigmine, galantamine, and memantine) and their metabolites in the influent of 210 wastewater treatment plants across 31 Chinese provinces were analyzed. The results indicated that detection rates of the above drugs in wastewater were high, with concentrations ranging from 7.47-21.60 ng·L^-1. Among them, the concentration of donepezil was significantly higher in East China and the Northwest and Northeast regions than that in Central China; the concentrations of rivastigmine and galantamine in Southwest China were significantly higher than those in East China; and the concentrations of memantine in Northwest and North China were significantly higher than those in East China. The above results indicated that the occurrence of these drugs showed a significant regional difference. Further, the AD drugs and metabolites with detection rates above 90% and excretion rates exceeding 20% (donepezil, rivastigmine metabolite, galantamine metabolite, and memantine) were chosen as biomarkers to evaluate AD prevalence. The prevalence of AD in different regions was estimated by wastewater-based epidemiology method, and the results were highly consistent with official statistical data. These results showed that the concentrations of AD drugs in wastewater influent were closely related to the AD prevalence. Additionally, correlation analysis also found that socioeconomic factors (such as stress, aging population, level of economic development, and health care services) had a significant positive correlation with the AD prevalence, indicating that socioeconomic factors may influence the occurrence of AD drugs in wastewater by affecting the AD prevalence. These results provide a scientific basis for further understanding of the characteristics of AD drugs in wastewater treatment plants and the development of corresponding control measures.

PMID:41830246 | DOI:10.13227/j.hjkx.202503326

Huan Jing Ke Xue. 2026 Mar 8;47(3):1576-1585. doi: 10.13227/j.hjkx.202502011.

ABSTRACT

As pivotal pillars of China’s national energy security strategy, resource-based cities can leverage the data-sharing capabilities, real-time transmission features, and low marginal cost advantages inherent in digital-real integration to forge new pathways for overcoming the “resource curse” and “transition inertia” dilemmas. Based on panel data of China’s resource-based cities from 2011 to 2022, this study constructs a multidimensional econometric framework incorporating two-way fixed effects models, mediation and moderation effect models, and threshold regression analysis to systematically deconstruct the operational impacts and mechanistic drivers of digital-real integration in propelling green and low-carbon urban transitions. The results showed that: ① Digital-real integration demonstrated statistically significant positive effects on green low-carbon transition in resource-based cities, with robustness confirmed through multiple empirical tests. ② Mechanism tests revealed that digital-real integration significantly facilitated green and low-carbon transition in resource-based cities through innovation-driven effects and environmental regulation effects, whereas industrial optimization effects demonstrated no significant driving force. Concurrently, government intervention exhibited a negative moderating effect on this transition process driven by digital-real integration. ③ Heterogeneity tests revealed significant differential effects across three dimensions: typology of resource-based cities, economic development levels, and digital technology innovation capacities. ④ Threshold effect tests confirmed that higher digital economy policy supply levels intensified the green and low-carbon transition effects of digital-real integration.

PMID:41830239 | DOI:10.13227/j.hjkx.202502011

Huan Jing Ke Xue. 2026 Mar 8;47(3):1433-1448. doi: 10.13227/j.hjkx.202501278.

ABSTRACT

As China’s 2030 carbon peak target approaches, carbon emission reduction efforts have become increasingly urgent and crucial. Resource-based cities, characterized by their reliance on high-carbon industries, play a pivotal role in the nation’s carbon peak progress. This study focuses on 108 resource-based cities from 2000 to 2022, employing the RF-RFECV algorithm to identify key factors influencing carbon emissions in these cities and utilizing the SHAP algorithm to evaluate feature importance. Furthermore, a BO-CNN-BiLSTM-attention prediction model is constructed, combined with scenario analysis to simulate the dynamic pathways of carbon peaking in resource-based cities under low-carbon, baseline, and high-speed scenarios. The results indicate the following: ① From the perspective of influencing factors, energy consumption was the most critical driver of carbon emissions in resource-based cities, reflecting their dependence on energy-intensive industries. The GDP of the primary industry and population density had a negative impact on carbon emissions, while the other six variables exerted a positive influence. ② In terms of city types, the impact of energy consumption on regenerative cities gradually declined, the development of secondary industries varied in its influence across different city types, and urbanization levels had the most significant impact on growing resource-based cities. ③ According to the peak scenario simulations, under the baseline and high-speed scenarios, carbon emissions in resource-based cities will continue to rise before 2040, whereas under the low-carbon scenario, emissions are projected to peak by 2034. Based on these findings, resource-based cities should achieve low-carbon transformation and sustainable development by improving energy efficiency, developing renewable energy, advancing green finance, adjusting industrial structures, and establishing carbon emission trading markets.

PMID:41830227 | DOI:10.13227/j.hjkx.202501278