Nevin Manimala

Front Public Health. 2024 Dec 13;12:1448471. doi: 10.3389/fpubh.2024.1448471. eCollection 2024.

ABSTRACT

BACKGROUND: In recent years, the development of telemedicine and eHealth services has led to the rapid worldwide growth of Internet hospitals, which played a significant role during the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about the characteristics and safety of Internet hospital outpatient pharmacy services (IHOPSs), which represent a new model of pharmaceutical services.

OBJECTIVE: This study aimed to reveal the comprehensive characteristics and safety of whole-course-based IHOPSs in a general tertiary hospital in western China.

METHODS: We established a whole-course-based IHOPS model. A total of 373,936 online prescriptions placed from February 1, 2020 to January 31, 2023 were analyzed. These included information on patients, prescriptions, and deliveries; error rates for prescription reviews and medication dispensations; economic value; and degree of patient satisfaction. Over the course of the study, a total of 373,936 prescriptions representing 351,884 patients and 945,172 medications were delivered to 22 provinces, 5 autonomous regions, and 4 municipalities in China.

RESULTS: IHOPSs saved patients more than 320,376 days (7,689,036 h) and RMB (Renminbi) ¥94.05 million in costs. The error rates of prescription review and dispensing were 0.0011% and 0.0008%, respectively. The infectious disease department (n = 63,903; 17.09%) ranked first in the number of prescriptions written for all three consecutive years. Of the 373,936 delivered prescriptions, 90.15% (337,104/373,936) were sent to Sichuan.

CONCLUSION: The IHOPS was found to be efficient, convenient, and safe because it handled the challenge of precisely and safely delivering medications to patients on time during and to the end of the COVID-19 pandemic. It provided patients with safe and convenient pharmaceutical services unlimited by geography or time zones. Widespread use of this service could help alleviate pressure on offline pharmacists, giving them the time and resources to provide other professional services. Our model can therefore serve as a useful reference for policymakers to support the development of Internet pharmaceutical services. Further efforts are needed to regulate and standardize the management of this novel service.

PMID:39735761 | PMC:PMC11671484 | DOI:10.3389/fpubh.2024.1448471

Front Public Health. 2024 Dec 13;12:1485732. doi: 10.3389/fpubh.2024.1485732. eCollection 2024.

ABSTRACT

BACKGROUND: As life expectancy increases, the number of older adults with functional limitations is also increasing. Functional limitations are associated with adverse health outcomes such as reduced independence, diminished quality of life (QoL), and disability. Therefore, identifying which activities of daily living (ADLs) are limiting and understanding the influencing factors are crucial for developing tailored interventions. Although various factors influence ADL limitations, few studies have identified the longitudinal factors associated with each ADL. This study explores the longitudinal trends and factors associated with the ADL total score and functional limitations with each ADL among older adults in Korea.

METHODS: Using data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2020, we analyzed 1,388 people aged 65 and older who had no ADL limitations in 2006. An ADL limitation was defined as partial or complete dependence in any of the following ADLs: getting dressed, washing face and hands, bathing, eating, transferring, toileting, and continence. We used repeated measures analysis of variance and multivariate logistic regression to investigate the trends and predictors of ADL limitations over a 14-year period.

RESULTS: In 2006, the mean age of the participants was 69.88 years (SD = ±4.11), and 60.20% were female. The prevalence of total ADL limitations and limitations in each of the seven ADLs increased gradually during the 14 years of follow up. In 2020, the ADL items with the highest prevalence of limitations were bathing, getting dressed, and washing face and hands. The common significant predictors for total ADL limitations and limitation in the top three ADLs were age and cognitive function.

CONCLUSION: ADL limitations among Korean older adults significantly increase over time, which highlights the need for integrated early intervention and continuous support for bathing limitations, including the application of integrated assistive technologies. In particular, because age and cognitive function were identified as the major predictors for limitations in both total ADLs and the top three ADLs, early assessment and appropriate intervention strategies need to consider those factors to prevent ADL limitations in older adults or to meet the immediate needs of those already experiencing ADL limitations. This approach could enhance the QoL for older adults and contribute to the development of long-term healthcare plans.

PMID:39735760 | PMC:PMC11673221 | DOI:10.3389/fpubh.2024.1485732

Front Public Health. 2024 Dec 13;12:1452730. doi: 10.3389/fpubh.2024.1452730. eCollection 2024.

ABSTRACT

BACKGROUND: Radon, a colorless and odorless radioactive gas, poses serious health risks. It is the second leading cause of lung cancer and notably increases lung cancer risk in smokers. Although previous epidemiological studies have mainly examined lung cancer rates in miners, the effects of radon on genomic stability and its molecular mechanisms are not well understood.

METHODS: This study evaluated chromosomal aberrations (CA) and cytokinesis-block micronucleus (CBMN) in miners’ lymphocytes, investigating the relationship between cytogenetic damage and variables such as exposure duration and age. Additionally, gene expression profiles were compared between radon-exposed miners and a control group to identify genes involved in DNA damage repair.

RESULTS: We observed a significant increase in CA and CBMN among underground miners. Gene expression analysis showed 14 genes were upregulated and four downregulated in the exposed group compared to controls.

CONCLUSION: These findings indicate a strong link between high radon exposure and genomic instability in miners. Improved monitoring of work environments and stronger protective measures are critical to safeguarding miners’ health.

PMID:39735759 | PMC:PMC11681618 | DOI:10.3389/fpubh.2024.1452730

Front Public Health. 2024 Dec 13;12:1502079. doi: 10.3389/fpubh.2024.1502079. eCollection 2024.

ABSTRACT

INTRODUCTION: Time banking, known as “Community/Neighborhood Pension,” instantiates a form of co-creation that can provide a new solution to fulfil the unmet social service needs of community members with idle resources, which is a feasible solution to alleviate pension pressure. The sustainable operation of time banks relies on the co-creation and active participation of community members. Therefore, in this study, we investigate the motivation of members to participate in web-based time banks from a service requirement narrative perspective.

METHODS: We collected data of 21969 service requirement projects from publicly available information on the website of Nansha Timebank (nstimebank.com, a web-based time bank platform in China). Using the data, we built a model to assess how the intrinsic and extrinsic cues underlying service requirement narratives affect the time bank participation decisions of service providers drawing on grounded theory. Then we conducted a regression analysis to test our hypotheses.

RESULTS: We find that participants respond positively to time coins return and narratives highlighting social connection and value fulfilment but respond negatively to service hour costs and empathy-altruism cues.

DISCUSSION: Our findings suggest that people who receive services in web-based time banking platform should utilize different linguistic cues in service requirement descriptions to improve service exchange results.

PMID:39735757 | PMC:PMC11671481 | DOI:10.3389/fpubh.2024.1502079

Breast Cancer Res. 2024 Dec 29;26(1):189. doi: 10.1186/s13058-024-01947-x.

ABSTRACT

BACKGROUND: The 313-variant polygenic risk score (PRS₃₁₃) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS₃₁₃ across different European populations which could influence risk estimation has not been performed.

METHODS: We explored the distribution of PRS₃₁₃ across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank. The mean PRS was calculated by country in the BCAC dataset and by country of birth in the UK Biobank. We explored different approaches to reduce the observed heterogeneity in the mean PRS across the countries, and investigated the implications of the distribution variability in risk prediction.

RESULTS: The mean PRS₃₁₃ differed markedly across European countries, being highest in individuals from Greece and Italy and lowest in individuals from Ireland. Using the overall European PRS₃₁₃ distribution to define risk categories, leads to overestimation and underestimation of risk in some individuals from these countries. Adjustment for principal components explained most of the observed heterogeneity in the mean PRS. The mean estimates derived when using an empirical Bayes approach were similar to the predicted means after principal component adjustment.

CONCLUSIONS: Our results demonstrate that PRS distribution differs even within European ancestry populations leading to underestimation or overestimation of risk in specific European countries, which could potentially influence clinical management of some individuals if is not appropriately accounted for. Population-specific PRS distributions may be used in breast cancer risk estimation to ensure predicted risks are correctly calibrated across risk categories.

PMID:39734228 | DOI:10.1186/s13058-024-01947-x

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):10-13;18. doi: 10.13201/j.issn.2096-7993.2025.01.003.

ABSTRACT

Objective:To explore the trend of hearing changes in infants with GJB2 gene p.V37I mutation at different months. Methods:The subjects were 54 children（108 ears） with p.V37I homozygous or compound heterozygous mutation in GJB2 gene. All the subjects underwent auditory brainstem response, auditory steady-state response, acoustic immittance and other audiological tests. Children were divided into three groups according to their age, 26 cases in group A were ≤3 months old, 17 cases in group B were>3~≤6 months old, and 11 cases in group C were>6 months old. Statistical analysis was performed on the three groups of ABR response threshold, hearing degree, the ASSR average response threshold of four frequencies and the ASSR response thresholds for each frequency of 500, 1 000, 2 000 and 4 000 Hz. Results:Among the 54 cases, 35 were male and 19 were female, with an age rang of 2-27 months and a median age of 4 months. The ABR response threshold of the three groups were ranked from low to high as group A, group B and group C, and the difference was statistically significant（P<0.05）. The ABR response thresholds of the three groups were ranked from low to high as group A, group B, and group C. The comparison between groups showed that the ABR response thresholds of group C was higher than that of group A（P=0.006）. The proportion of confirmed hearing loss in the three groups was 34.61%, 50.00% and 63.64%, respectively, and the difference of hearing level among the three groups was statistically significant（P<0.05）. The comparison between groups showed that the difference between group A and group C was statistically significant（P=0.012）, normal hearing accounted for the highest proportion in group A（65.39%）, while mild hearing loss accounted for the highest proportion in group C（45.46%）. The ASSR average response thresholds of the four frequencies in the three groups were ranked from low to high as group A, group B and group C, and the difference is statistically significant（P<0.05）. The comparison between groups showed that response ASSR thresholds of group C was higher than that of group A（P=0.002）. Response thresholds of ASSR in each frequency in the three groups were all ranked from low to high as in group A, group B and group C, and the differences were statistically significant（P<0.05）. Compared with each other between groups, response ASSR thresholds of group C was higher than those of group A（P=0.003） and group B（P=0.015） at 500 Hz, while response ASSR thresholds of group C was higher than group A at 1 000 Hz（P=0.010） and 2 000 Hz（P<0.001）, and there was no statistical difference at 4 000 Hz. Conclusion:The incidence of hearing loss in GJB2 gene p.V37I mutation increased with age, and the degree of hearing loss increased, the hearing progression was mainly 500, 1 000 and 2 000 Hz suggesting regular follow-up and alert to hearing changes.

PMID:39734165 | DOI:10.13201/j.issn.2096-7993.2025.01.003

Clin Nutr ESPEN. 2024 Dec 27:S2405-4577(24)01569-9. doi: 10.1016/j.clnesp.2024.12.024. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Prehabilitation is a preoperative multimodal program including exercise, nutritional, and psychological support. Little is known about changes in nutritional status during prehabilitation.

METHODS: This secondary analysis of the PREHAB trial aims to assess changes in nutritional status and explore the effectiveness of a four-week nutritional intervention. Data were collected at baseline and preoperatively (end of the program), including body composition with bioelectrical impedance analysis (single frequency, 50kHz), muscle strength (indirect 1RM leg press), three-day food diaries and the scored PG-SGA. Protein requirements were set at 1.5 g/kg body weight.

RESULTS: Sixty-seven participants were enrolled, 34 to standard care and 33 to four-week prehabilitation. Nutritional status improved in both groups: -1 point change in the standard care group (p =, 0.027), and -1.5 point in the prehabilitation group (p = 0.015). Those who received prehabilitation statistically increased fat free mass (0.9kg, p = 0.017) and appendicular skeletal muscle mass (0.5kg, p = 0.007. In contrast, an increase in fat mass (0.6kg, p = 0.016) was observed within the standard care group only. Participants in the prehabilitation group had a substantial increase of 27% muscle strength (p = <0.001). Optimal protein intake was more often achieved within the prehabilitation group (47%, p = <0.001).

CONCLUSION: Our study provides evidence for the positive impact of multimodal prehabilitation on preoperative nutritional status in adult patients with CRC, especially in body composition and muscle strength. Achieving optimal protein intake was challenging, both dietary counseling and supplements are recommended to improve intake.

PMID:39734017 | DOI:10.1016/j.clnesp.2024.12.024

Ann Vasc Surg. 2024 Dec 27:S0890-5096(24)00861-6. doi: 10.1016/j.avsg.2024.12.041. Online ahead of print.

ABSTRACT

PURPOSE: To assess the safety and efficacy of flush endovenous laser ablation (fEVLA) in the treatment of chronic venous insufficiency.

MATERIALS AND METHODS: Following the PRISMA 2020 guidelines, a systematic review aiming to identify studies published from inception to March 2024 was conducted. The investigation covered single-arm studies and studies comparing fEVLA to standard EVLA (sEVLA). The primary endpoint was endovenous heat-induced thrombosis (EHIT) class ≥II.

RESULTS: Eleven studies encompassing 2738 patients and 3147 truncal veins were included. The pooled EHIT ≥II was 1.37% (95%CI:0.57-3.28). Meta-regression identified an association between linear endovenous energy density (LEED) applied at the saphenofemoral junction and EHIT ≥II outcomes (β=0.011,p<0.01). The pooled medium-term GSV occlusion was 97.59% (95% CI:94.89-98.88). The pooled and crude deep vein thrombosis and pulmonary embolism estimates were 0.97% (95%CI:0.64-1.47) and 0.04%. The comparative analysis regarding GSV occlusion, odds ratio (OR) 3.26 (95%CI:0.76-13.97) and refluxing anterior accessory saphenous vein (AASV), RR 0.45 (95%CI:0.11-1.77) suggested a non-statistically significant trend favoring fEVLA. Non-statistically significant differences were identified in terms of EHIT ≥II between the techniques, risk ratio (RR) 1.00(95%CI:0.18-5.53). Statistically-significant differences favoring fEVLA were identified in terms of proximal groin recurrence RR 0.35 (95%CI:0.16-0.80) and stump length (mean difference) MD -7.23 (95% CI:-11.59to-2.88).

CONCLUSION: This review has demonstrated the safety of fEVLA while also suggesting a potentially improved efficacy of fEVLA over sEVLA in terms of proximal groin recurrence. Moreover, the trend indicating fEVLA’s superiority in terms of GSV occlusion and the occurrence of new-onset AASV reflux merits further research.

PMID:39734000 | DOI:10.1016/j.avsg.2024.12.041

Trop Med Health. 2024 Dec 30;52(1):103. doi: 10.1186/s41182-024-00672-7.

ABSTRACT

BACKGROUND: Malaria is a significant public health challenge in Uganda, with Plasmodium falciparum (P. falciparum) responsible for most of malaria infections. The high genetic diversity and multiplicity of infection (MOI) associated with P. falciparum complicate treatment and prevention efforts. This study investigated temporal changes in P. falciparum genetic diversity and MOI across three sites with varying malaria transmission intensities. Understanding these changes is essential for informing effective malaria control strategies for the different malaria transmission settings.

METHODS: A total of 220 P. falciparum-positive dried blood spot (DBS) filter paper samples from participants in a study conducted during 2011-2012 and 2015-2016 were analyzed. Genotyping utilized seven polymorphic markers: Poly-α, TA1, TA109, PfPK2, 2490, C2M34-313, and C3M69-383. Genetic diversity metrics, including the number of alleles and expected heterozygosity, were calculated using GENALEX and ARLEQUIN software. MOI was assessed by counting distinct genotypes. Multi-locus linkage disequilibrium (LD) and genetic differentiation were evaluated using the standardized index of association (I_A^S) and Wright’s fixation index (F_ST), respectively. Statistical comparisons were made using the Kruskal-Wallis test, and temporal trends were analyzed using the Jonckheere-Terpstra test, with statistical significance set at p < 0.05.

RESULTS: Of the 220 samples, 180 were successfully amplified. The majority of participants were males (50.6%) and children aged 5-11 years (46.7%). Genetic diversity remained high, with mean expected heterozygosity (H_e) showing a slight decrease over time (range: 0.73-0.82). Polyclonal infections exceeded 50% at all sites, and mean MOI ranged from 1.7 to 2.2, with a significant reduction in Tororo (from 2.2 to 2.0, p = 0.03). Linkage disequilibrium showed a slight increase, with Kanungu exhibiting the lowest I_A^S in 2011-2012 (0.0085) and Jinja the highest (0.0239) in 2015-2016. Overall genetic differentiation remained low, with slight increases in pairwise F_ST values over time, notably between Jinja and Tororo (from 0.0145 to 0.0353).

CONCLUSIONS: This study highlights the genetic diversity and MOI of P. falciparum in Uganda’s malaria transmission settings, noting a slight decrease in both genetic diversity and MOI overtime. Continued surveillance and targeted control strategies are essential for monitoring the impact of malaria control efforts in Uganda.

PMID:39734236 | DOI:10.1186/s41182-024-00672-7

Diabetol Metab Syndr. 2024 Dec 30;16(1):314. doi: 10.1186/s13098-024-01555-x.

ABSTRACT

OBJECTIVE: Obesity has been recognized as a risk factor for cerebrovascular diseases, with observational studies suggesting a heightened incidence of stroke. However, the genetic epidemiology field has yet to reach a consensus on the causal relationship and genetic overlap between ischemic stroke (IS) and obesity.

METHODS: We utilized linkage disequilibrium score regression, high-definition likelihood, and local analysis of variant associations to assess the genetic correlation between body mass index (BMI) and IS. Bidirectional Mendelian randomization was employed to infer causality. We identified shared risk single nucleotide polymorphisms (SNPs) through cross-trait meta-analyses and estimated heritability using summary statistics. Summary-data-based Mendelian randomization (SMR) was applied to explore potential functional genes.

RESULTS: Our analysis revealed a significant positive genetic correlation between BMI and IS, supporting a causal link from BMI to IS. Cross-trait analysis yielded 9 and 16 shared risk SNPs for IS and small vessel stroke (SVS), respectively. We observed a notable enrichment of SNP heritability for IS and BMI in brain tissues, suggesting tissue-specific influences. The genes shared between the traits were predominantly involved in brain development, synaptic electrical activity, and immunoregulation. Notably, our SMR analysis identified the risk genes CHAF1A, CEP192, ULK4, CYP2D6, AS3MT, and WARS2 across the majority of the 14 enriched tissues shared by both traits.

CONCLUSION: Our study uncovered a significant genetic correlation and identified shared risk SNPs between BMI and IS. The identification of CHAF1A, CEP192, ULK4, CYP2D6, AS3MT, and WARS2 as potential functional genes common to both obesity and IS enriched our understanding of their genetic interplay, potentially advanced our grasp of their pathogenesis and therapeutic targets.

PMID:39734234 | DOI:10.1186/s13098-024-01555-x