Nevin Manimala

Inquiry. 2024 Jan-Dec;61:469580241273127. doi: 10.1177/00469580241273127.

ABSTRACT

This study uses secondary data analysis to assess the relationship between social isolation (SI) and population density in the US, as well as any moderating influence that race/ethnicity may have on that relationship. A recent consensus on the measure of SI is that it focuses on the objective absence of social connections, whereas loneliness refers to subjective assessments of one’s social connections. Therefore, while the original study measured both objective and subjective SI may be innovative, it may also be overly ambitious. SI puts older people at risk for health problems, including an increased chance of dying. The AARP Foundation gathered the initial convenience sample, which included 8149 senior citizens. The study determined population density using self-reported zip codes, measured as persons per square mile, and divided the results into tertiles. Linear mixed models were used to investigate the moderating role of race/ethnicity between population density and SI. The findings revealed that greater population density was associated with less SI for individuals residing in zip codes with a higher percentage of the same race/ethnicity, but more SI for those in zip codes with a lower percentage of the same race/ethnicity. These results suggest that race/ethnicity should be considered in future studies or when developing policies and interventions to address SI among older adults in high-population-density areas. For example, when policymakers aim to address SI in a community, they may want to collect data based on zip codes and create targeted interventions for specific racial/ethnic groups within those zip code areas.

PMID:39229676 | DOI:10.1177/00469580241273127

Healthc Policy. 2024 Aug;19(4):55-69. doi: 10.12927/hcpol.2024.27333.

ABSTRACT

AIMS: This study examined the reasons for high emergency department (ED) use among patients with common mental disorders (MDs), substance-related disorders (SRDs) or co-occurring MDs-SRDs.

METHOD: Following content analysis, 42 high ED users (three-plus visits/year) recruited in two Quebec EDs were interviewed.

RESULTS: The reasons included barriers to outpatient care, patient disabilities and professional practices. Patients with SRDs trust outpatient services less, those with MDs had important unmet needs and those with MDs-SRDs faced care coordination issues.

CONCLUSION: Improvements such as ED use monitoring, consolidating MD-SRD practices and continuous training are needed in EDs and outpatient services to enhance access and continuity of care.

PMID:39229663 | DOI:10.12927/hcpol.2024.27333

Food Funct. 2024 Sep 4. doi: 10.1039/d4fo03082f. Online ahead of print.

ABSTRACT

Background: due to the high incidence of liver disease and the severity of adverse outcomes, liver disease has become a serious public health problem, bringing a huge disease burden to individuals, families, and society. Most studies have shown significant differences in serum carotenoid content and dietary carotenoid intake between liver disease patients and non-liver disease patients, but some studies have reported contrary results. This paper aimed to systematically review and analyze all published epidemiological studies on carotenoids and liver disease to quantitatively assess the relationship between serum and dietary carotenoid concentrations and liver disease. Methods: by systematically searching PubMed, Web of Science, Scopus, Embase, and Cochrane databases according to pre-combined search terms from inception to July 23, 2024, 30 studies were found to meet the exclusion criteria. Finally, 3 RCT studies, 6 cohort studies, 11 case-control studies, 9 cross-sectional studies, and 1 RCT-combined cross-sectional study were included in the further analysis. Two reviewers independently scored the literature quality and extracted data, and the results were represented by the standard mean difference (SMD) with a 95% confidence interval. Cochran Q statistics and I² statistics were used to evaluate statistical heterogeneity (defined as significant when P < 0.05 or I² > 50%). When there was insignificant heterogeneity, a fixed effects model was selected; otherwise a random effects model was used. Publication bias was assessed by the Egger test. Results: pooled meta-analysis showed that serum α-carotene (SMD = -0.58, 95% CI (-0.83, -0.32), P < 0.001), β-carotene (SMD = -0.81, 95% CI (-1.13, -0.49), P < 0.001), and lycopene (SMD = -1.06, 95% CI (-1.74, -0.38), P < 0.001) were negatively correlated with the risk and severity of liver disease. However, no significant difference was observed between serum β-cryptoxanthin (SMD = 0.02, 95% CI (-0.41, 0.45), P = 0.92) and lutein/zeaxanthin (SMD = 0.62, 95% CI (-1.20, 2.45), P = 0.502). Dietary β-carotene intake (SMD = -0.22, 95% CI (-0.31, -0.13), P < 0.001) was negatively associated with the risk of liver disease. The Egger test showed no publication bias (P > 0.05). An intake of more than 6 mg of carotenoids on an energy-restricted diet can effectively alleviate the symptoms of NAFLD. Conclusion: lower serum concentrations of α-carotene, β-carotene, and lycopene were associated with a higher risk of liver disease. Meanwhile, dietary intake of β-carotene could reduce the incidence of liver disease. However, for malignant diseases such as liver cancer, it did not show the significant effects of carotenoid supplementation.

PMID:39229651 | DOI:10.1039/d4fo03082f

Geburtshilfe Frauenheilkd. 2024 Sep 2;84(9):837-844. doi: 10.1055/a-2374-2270. eCollection 2024 Sep.

ABSTRACT

INTRODUCTION: The impact of surgical margins on the prognosis of early breast cancer remains uncertain, particularly in the context of modern treatment approaches. This study aimed to investigate whether involved margins after surgery for early breast cancer affect overall survival.

METHODS: We conducted a retrospective analysis of 3767 patients who underwent surgery for primary breast cancer or carcinoma in situ between 2006 and 2022 at Charité – University Hospital Berlin. Survival analysis based on margin status and a subsequent multivariate Cox regression analysis were conducted.

RESULTS: With a median follow-up of 72.2 months, clear margins were achieved in 81.4% of patients (n = 3068) after primary surgery, while 16.2% (n = 610) required re-excision. Only 2.4% of patients (n = 89) had definitively involved margins. Margin involvement was more common in hormone receptor-positive disease, lobular subtype, carcinoma in situ, or locally advanced tumors, but less frequent in patients with previous neoadjuvant chemotherapy or triple-negative breast cancer. The Kaplan-Meier survival curves showed a significant separation with worse outcomes for patients with definitive R1 resections. However, the multivariate Cox regression analysis detected no statistically significant difference in overall survival based on margin status. Breast conserving surgery (HR 0.66; 95% CI 0.54-0.81) and HER2 overexpression (HR 0.65; 95% CI 0.48-0.89) were associated with improved survival.

CONCLUSION: Patients who underwent breast-conserving surgery in our study demonstrated favorable outcomes compared to patients after mastectomy. Although margin status did not significantly affect overall survival, larger multicenter studies are needed to evaluate the prognostic implications of margin involvement in breast cancer treatment in different tumor stages, tumor subtypes and local and systemic treatments.

PMID:39229628 | PMC:PMC11368467 | DOI:10.1055/a-2374-2270

Food Chem X. 2024 Aug 5;23:101705. doi: 10.1016/j.fochx.2024.101705. eCollection 2024 Oct 30.

ABSTRACT

Freezing is one of the most commonly used preservation methods for Bluefin tuna (Thunnus orientalis). However, repeated freezing and thawing would inevitably occur due to the temperature fluctuation, leading to the microstructure damage, lipid oxidation and protein integrity decline of tuna muscle without notable visual appearance change. In this study, we used a rapid evaporative ionization mass spectrometry (REIMS) technique for the real-time determination of the extent of repeated freezing and thawing cycles in tuna fillets. We found significant variance in the relative abundance of fatty acids between bluefin tuna and its fresh counterpart following freeze-thaw cycles. Meanwhile, the difference is statistically significant (p < 0.05). The quality of tuna remains largely unaffected by a single freeze-thaw cycle but significantly deteriorates after freeze-thaw cycles (freeze-thaw count ≥2), and the relative fatty acid content of the ionized aerosol analysis in the REIMS system positively correlated with the number of freeze-thaw cycles. Notably, palmitic acid (C 16:0, m/z 255.23), oleic acid (C 18:1, m/z 281.24), and docosahexaenoic acid (C 22:6, m/z 327.23) displayed the most pronounced changes within the spectrum of fatty acid groups.

PMID:39229614 | PMC:PMC11369502 | DOI:10.1016/j.fochx.2024.101705

F1000Res. 2023 Dec 12;12:180. doi: 10.12688/f1000research.129645.2. eCollection 2023.

ABSTRACT

BACKGROUND: The spectrum of non-alcoholic fatty liver disease (NAFLD), known as non-alcoholic steatohepatitis (NASH), can lead to advanced liver disease. It is known that a variety of diets play a significant role in the development of NAFLD/NASH. The goal of this study was to determine the most appropriate composition of diet to induce NASH in an animal model.

METHODS: This research used Rattus norvegicus strain Wistar (n=27), which were divided into four groups and given each diet for 12 weeks: normal diet (ND, n=7), high-fat diet (HFD, n=6), western diet (WD, n=7), and high-fat-high-fructose diet (HFHFD, n=7). Subjects were monitored for changes in body weight. Blood samples were collected for biochemical analysis, including low-density lipoprotein (LDL), triglyceride, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), hepatic lipase, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and lipopolysaccharide (LPS). Fecal samples were taken for short-chain fatty acid (SCFA) analysis. Liver histology was assessed using NAS (NAFLD activity score). A statistical comparison test was carried out using the one-way ANOVA or Kruskal-Wallis test.

RESULTS: The highest average body weight was observed in the WD group (346.14 g). Liver enzymes, LDL, triglyceride, propionic acid, and acetic acid did not show significantly differences among the groups. TNF-α, IL-6, and hepatic lipase were significant (p = 0.000; p = 0.000; p = 0.004) and the highest level recorded in the HFD group. Butyrate acid level also showed significances (p = 0.021) with the lowest concentration seen in the HFHFD group (4.77 mMol/g). Only WD and HFHFD had a NAS ≥ 5 (14% and 14%). The highest percentage of borderline NAS was found in WD (57%).

CONCLUSIONS: WD feeding is the most appropriate diet type to induce NASH in rats as it influences metabolic, inflammatory, dysbiosis, and liver histology of rats.

PMID:39229607 | PMC:PMC11369591 | DOI:10.12688/f1000research.129645.2

Front Nutr. 2024 Aug 20;11:1426280. doi: 10.3389/fnut.2024.1426280. eCollection 2024.

ABSTRACT

BACKGROUND: This investigation aimed to analyze the association between dietary vitamin E intake and constipation prevalence among United States adults.

METHODS: Utilizing data from the National Health and Nutrition Examination Survey (NHANES), this cross-sectional study assessed vitamin E intake through 24-h dietary recall and defined constipation based on the Bristol Stool Form Scale (BSFS). Logistic regression models were employed to evaluate the relationship between vitamin E intake and constipation, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). Stratified analyses were conducted based on covariates such as age, and restricted cubic spline (RCS) models were generated to explore the potential linear or non-linear association.

RESULTS: Individuals experiencing constipation exhibited lower vitamin E intake compared to those without constipation. Weighted multivariate logistic regression models demonstrated a negative correlation between vitamin E intake and constipation risk, even after adjusting for potential confounding variables. Further RCS analysis revealed a statistically significant non-linear inverse relationship between vitamin E intake and constipation risk (p-value for non-linearity = 0.0473).

CONCLUSION: Our findings suggest an independent inverse association between vitamin E intake and constipation prevalence in United States adults. Prospective research is needed to validate these observations.

PMID:39229590 | PMC:PMC11368839 | DOI:10.3389/fnut.2024.1426280

Front Nutr. 2024 Aug 20;11:1439473. doi: 10.3389/fnut.2024.1439473. eCollection 2024.

ABSTRACT

OBJECTIVE: Both 5:2 IF diet (intermittent fasting) and daily caloric restriction eating had been suggested for management of MAFLD (Metabolic-Associated Fatty Liver Disease), this study aimed to evaluate the effects of 5:2 IF diet on body weight and metabolic parameters in adults with MAFLD, in comparison to daily caloric restriction eating.

METHODS: This single-center, double-blind, prospective, randomized controlled trial included 60 patients with MAFLD, who were administered either a 5:2 IF diet limited calories consumed for 2 days each week with no restrictions on the remaining 5 (Group 5:2 IF diet) or a daily calorie restriction eating (Group daily calorie restriction). Fibrotouch-B instrument assessment, ultrasound assessment of hepatic steatosis, anthropometric indices and body composition analysis, blood sample measurements were conducted during two distinct visits: initially on the day of study commencement (T1), and subsequently at the conclusion of the 12-week intervention period (T2).

RESULTS: In comparison to daily calorie restriction eating, the 5:2 IF diet significantly decreased the proportion of hepatic steatosis ≥moderate (29.6% vs. 59.3%, p = 0.028) and the degree of hepatic fibrosis F ≥ 2 (3.7% vs. 25.9%, p = 0.05), and fewer percentage of patients were diagnosed with fatty liver via upper abdominal ultrasound in the 5:2 intermittent fasting diet group (33.3% vs. 63.0%, p = 0.029). Additionally, the CAP (controlled attenuation parameter) and LSM (liver stiffness measurements) value were significantly lower in the 5:2 IF diet group (p < 0.05). No statistically significant differences were observed between the two groups in terms of weight, BMI (body mass index), WC (waist circumference), HC (hip circumference), and WHR (waist to hip ratio). Similarly, there were no significant differences in lipid profile, glycemic indices and adverse events (p > 0.05).

CONCLUSION: In summary, although both 5:2 IF diet and daily caloric restriction eating achieved similar effect on body weight, liver enzymes, lipid profile and glycemic indices after 12 weeks treatment, 5:2 IF diet demonstrates better improvement in fibrosis and steatosis scores independently from weight regulation. Consequently, it is anticipated to emerge as a viable dietary modality for lifestyle intervention among patients diagnosed with MAFLD.

CLINICAL TRIAL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier ChiCTR2400080292.

PMID:39229586 | PMC:PMC11368853 | DOI:10.3389/fnut.2024.1439473

Ann Gastroenterol Surg. 2024 Apr 16;8(5):896-916. doi: 10.1002/ags3.12803. eCollection 2024 Sep.

ABSTRACT

AIM: We evaluated the morbidity and mortality associated with liver surgery in Japan and developed a risk model for liver resection using information from a national database.

METHODS: We retrospectively reviewed 73 861 Japanese patients who underwent hepatectomy between 2014 and 2019, using information from the National Clinical Database (NCD) registrations. The primary endpoints were 30 days and in-hospital mortality, and the secondary endpoints were postoperative complications. Logistic regression risk models for postoperative morbidity and mortality after hepatectomy were constructed based on preoperative clinical parameters and types of liver resection, and validated using a bootstrapping method.

RESULTS: The 30-day and in-hospital mortality rates were 0.9% and 1.7%, respectively. Trisectionectomy, hepatectomy for gallbladder cancer, hepatectomy for perihilar cholangiocarcinoma, and poor activities of daily living were statistically significant risk factors with high odds ratios for both postoperative morbidity and mortality. Internal validations indicated that the c-indices for 30-day and in-hospital mortality were 0.824 and 0.839, respectively.

CONCLUSIONS: We developed a risk model for liver resection by using a national surgical database that can predict morbidity and mortality based on preoperative factors.

PMID:39229562 | PMC:PMC11368509 | DOI:10.1002/ags3.12803

Heliyon. 2024 Aug 10;10(16):e35676. doi: 10.1016/j.heliyon.2024.e35676. eCollection 2024 Aug 30.

ABSTRACT

This study investigates the critical factors influencing Saudi Arabia’s sustainable human capital development. It primarily aims to explore the correlations among the postulated variables and how each variable influences the development of a skilled, adaptable, and socially conscious workforce, in alignment with the objectives of the Saudi Vision 2030. This study utilizes a quantitative approach, employing partial least squares structural equation modeling to analyze the data collected from 203 public personnel in Saudi Arabia through an online questionnaire. The findings reveal that training, community engagement, institutional support, and technology integration are essential in sustainable human capital development. However, learning, education, and access to resources were not statistically significant and did not improve sustainable human capital development in Saudi Arabia. The findings underscore the significance of an educational framework that transcends traditional perspectives, focusing on not only academic preparation but also the holistic development of individuals. This study contributes to understanding how training, community engagement, institutional support, and technology integration are transformative in shaping the future of Saudi Arabia by nurturing a skilled, adaptable, and socially responsible citizenry.

PMID:39229536 | PMC:PMC11369408 | DOI:10.1016/j.heliyon.2024.e35676