Nevin Manimala

JAMA Netw Open. 2024 Jul 1;7(7):e2420259. doi: 10.1001/jamanetworkopen.2024.20259.

ABSTRACT

IMPORTANCE: Recognizing associations between exposure to common environmental toxicants and mental disorders such as depression is crucial for guiding targeted mechanism research and the initiation of disease prevention efforts.

OBJECTIVES: To comprehensively screen and assess the associations between potential environmental toxicants and depressive symptoms and to assess whether systemic inflammation serves as a mediator.

DESIGN, SETTING, AND PARTICIPANTS: A total of 3427 participants from the 2013-2014 and 2015-2016 waves of the National Health and Nutrition Examination and Survey who had information on blood or urine concentrations of environmental toxicants and depression scores assessed by the 9-item Patient Health Questionnaire (PHQ-9) were included. Statistical analysis was performed from July 1, 2023, to January 31, 2024.

EXPOSURES: Sixty-two toxicants in 10 categories included acrylamide, arsenic, ethylene oxide, formaldehyde, iodine, metals, nicotine metabolites, polycyclic aromatic hydrocarbons, volatile organic compound (VOC) metabolites; and perchlorate, nitrate, and thiocyanate.

MAIN OUTCOMES AND MEASURES: An exposome-wide association study and the deletion-substitution-addition algorithm were used to assess associations with depression scores (PHQ-9 ≥5) adjusted for other important covariates. A mediation analysis framework was used to evaluate the mediating role of systemic inflammation assessed by the peripheral white blood cell count.

RESULTS: Among the 3427 adults included, 1735 (50.6%) were women, 2683 (78.3%) were younger than 65 years, and 744 (21.7%) were 65 years or older, with 839 (24.5%) having depressive symptoms. In terms of race and ethnicity, 570 participants (16.6%) were Mexican American, 679 (19.8%) were non-Hispanic Black, and 1314 (38.3%) were non-Hispanic White. We identified associations between 27 chemical compounds or metals in 6 of 10 categories of environmental toxicants and the prevalence of depressive symptoms, including the VOC metabolites N-acetyl-S-(2-hydroxy-3-butenyl)-l-cysteine (odds ratio [OR], 1.74 [95% CI, 1.38, 2.18]) and total nicotine equivalent-2 (OR, 1.42 [95% CI, 1.26-1.59]). Men and younger individuals appear more vulnerable to environmental toxicants than women and older individuals. Peripheral white blood cell count mediated 5% to 19% of the associations.

CONCLUSIONS AND RELEVANCE: In this representative cross-sectional study of adults with environmental toxicant exposures, 6 categories of environmental toxicants were associated with depressive symptoms with mediation by systemic inflammation. This research provides insight into selecting environmental targets for mechanistic research into the causes of depression and facilitating efforts to reduce environmental exposures.

PMID:38958973 | DOI:10.1001/jamanetworkopen.2024.20259

Invest Ophthalmol Vis Sci. 2024 Jul 1;65(8):7. doi: 10.1167/iovs.65.8.7.

ABSTRACT

PURPOSE: To describe and demonstrate sample size and power calculation for ophthalmic studies with a binary outcome from one or both eyes.

METHODS: We describe sample size and power calculation for four commonly used eye designs: (1) one-eye design or person-design: one eye per subject or outcome is at person-level; (2) paired design: two eyes per subject and two eyes are in different treatment groups; (3) two-eye design: two eyes per subject and both eyes are in the same treatment group; and (4) mixture design: mixture of one eye and two eyes per subject. For each design, we demonstrate sample size and power calculations in real ophthalmic studies.

RESULTS: Using formulas and commercial or free statistical packages including SAS, STATA, R, and PS, we calculated sample size and power. We demonstrated that different statistical packages require different parameters and provide similar, yet not identical, results. We emphasize that studies using data from two eyes of a subject need to account for the intereye correlation for appropriate sample size and power calculations. We demonstrate the gain in efficiency in designs that include two eyes of a subject compared to one-eye designs.

CONCLUSIONS: Ophthalmic studies use different eye designs that include one or both eyes in the same or different treatment groups. Appropriate sample size and power calculations depend on the eye design and should account for intereye correlation when two eyes from some or all subjects are included in a study. Calculations can be executed using formulas and commercial or free statistical packages.

PMID:38958969 | DOI:10.1167/iovs.65.8.7

J Cataract Refract Surg. 2024 Jul 2. doi: 10.1097/j.jcrs.0000000000001518. Online ahead of print.

ABSTRACT

PURPOSE: To compare two different datasets, using Eyetemis, an online analytical tool designed for assessing the spherical equivalent prediction errors (SEQ-PE) of intraocular lens (IOL) power calculation formulas following cataract surgery.

SETTING: Institutional.

DESIGN: Retrospective case series.

METHODS: The study was comprised of two distinct datasets of patients who had undergone successful cataract surgery. Dataset-1 includes standard eyes whereas Dataset-2 includes eyes with keratoconus. An online tool was used for SEQ-PE analysis across the 2 datasets, adhering to ISO standards for evaluating accuracy based upon trueness and precision. The tool incorporates robust t-tests for comparing the trimmed-mean of the data, adjusting for heteroscedasticity. IOL constants in Dataset-1 were optimized for the comparison of Hoffer Q, Holladay1, SRK/T, Haigis and Barrett Universal II (BUII) formulas. In Dataset-2, IOL constants from the IOLCon website, were used for the comparison of the BUII and its designated KCN-version: Barrett TrueK Keratoconus (TrueK [KCN]).

RESULTS: For Dataset-1: the trimmed-mean SEQ-PE values of all formulas were not significantly different from zero. BUII had superior precision and accuracy compared to all other formulas except from Haigis (P≤ 0.04). For Dataset-2: BUII’s trimmed-mean SEQ-PE was significantly different from zero (0.59D, P< 0.01), unlike the TrueK [KCN] (0.12D, P= 0.10). Additionally, TrueK [KCN] exhibited enhanced precision and accuracy relative to BUII (P< 0.01).

CONCLUSIONS: The online analysis tool provides a streamlined approach for assessing the prediction accuracy of SEQ refraction following cataract surgery, effectively evaluating trueness, precision, and overall accuracy through the use of advanced statistical methods.

PMID:38958959 | DOI:10.1097/j.jcrs.0000000000001518

JAMA Ophthalmol. 2024 Jul 3. doi: 10.1001/jamaophthalmol.2024.2296. Online ahead of print.

ABSTRACT

IMPORTANCE: Anecdotal experience raised the possibility that semaglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) with rapidly increasing use, is associated with nonarteritic anterior ischemic optic neuropathy (NAION).

OBJECTIVE: To investigate whether there is an association between semaglutide and risk of NAION.

DESIGN, SETTING, AND PARTICIPANTS: In a retrospective matched cohort study using data from a centralized data registry of patients evaluated by neuro-ophthalmologists at 1 academic institution from December 1, 2017, through November 30, 2023, a search for International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code H47.01 (ischemic optic neuropathy) and text search yielded 16 827 patients with no history of NAION. Propensity matching was used to assess whether prescribed semaglutide was associated with NAION in patients with type 2 diabetes (T2D) or overweight/obesity, in each case accounting for covarying factors (sex, age, systemic hypertension, T2D, obstructive sleep apnea, obesity, hyperlipidemia, and coronary artery disease) and contraindications for use of semaglutide. The cumulative incidence of NAION was determined with the Kaplan-Meier method and a Cox proportional hazards regression model adjusted for potential confounding comorbidities. Data were analyzed from December 1, 2017, through November 30, 2023.

EXPOSURES: Prescriptions for semaglutide vs non-GLP-1 RA medications to manage either T2D or weight.

MAIN OUTCOMES AND MEASURES: Cumulative incidence and hazard ratio of NAION.

RESULTS: Among 16 827 patients, 710 had T2D (194 prescribed semaglutide; 516 prescribed non-GLP-1 RA antidiabetic medications; median [IQR] age, 59 [49-68] years; 369 [52%] female) and 979 were overweight or obese (361 prescribed semaglutide; 618 prescribed non-GLP-1 RA weight-loss medications; median [IQR] age, 47 [32-59] years; 708 [72%] female). In the population with T2D, 17 NAION events occurred in patients prescribed semaglutide vs 6 in the non-GLP-1 RA antidiabetes cohort. The cumulative incidence of NAION for the semaglutide and non-GLP-1 RA cohorts over 36 months was 8.9% (95% CI, 4.5%-13.1%) and 1.8% (95% CI, 0%-3.5%), respectively. A Cox proportional hazards regression model showed higher risk of NAION for patients receiving semaglutide (hazard ratio [HR], 4.28; 95% CI, 1.62-11.29); P < .001). In the population of patients who were overweight or obese, 20 NAION events occurred in the prescribed semaglutide cohort vs 3 in the non-GLP-1 RA cohort. The cumulative incidence of NAION for the semaglutide vs non-GLP-1 RA cohorts over 36 months was 6.7% (95% CI, 3.6%-9.7%) and 0.8% (95% CI, 0%-1.8%), respectively. A Cox proportional hazards regression model showed a higher risk of NAION for patients prescribed semaglutide (HR, 7.64; 95% CI, 2.21-26.36; P < .001).

CONCLUSIONS AND RELEVANCE: This study’s findings suggest an association between semaglutide and NAION. As this was an observational study, future study is required to assess causality.

PMID:38958939 | DOI:10.1001/jamaophthalmol.2024.2296

J Cataract Refract Surg. 2024 Jul 2. doi: 10.1097/j.jcrs.0000000000001515. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether standard keratometry (K) or total corneal power (TCP) lead to more accurate refractive outcomes for intraocular lens (IOL) power calculation.

SETTING: Public hospital.

DESIGN: Retrospective evaluation of a diagnostic test instrument.

METHODS: Preoperatively all patients underwent optical biometry with the Anterion (Heidelberg), a swept-source optical coherence tomographer providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision and accuracy were evaluated by means of the robust two-sample t-test. Cochran’s Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied.

RESULTS: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness, due to constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: p = 0.02 and accuracy: p = 0.03) and Haigis formula (p <0.01 for both precision and accuracy). No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold.

CONCLUSIONS: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.

PMID:38958930 | DOI:10.1097/j.jcrs.0000000000001515

Rheumatol Ther. 2024 Jul 3. doi: 10.1007/s40744-024-00678-x. Online ahead of print.

ABSTRACT

INTRODUCTION: We evaluated the impact of gender on disease severity, health-related quality of life (HRQoL), treatment management, and patient-healthcare professional (HCP) interactions from the perspectives of patients with psoriatic arthritis (PsA).

METHODS: Data were collected from a global online patient survey conducted by The Harris Poll (November 2, 2017 to March 12, 2018). Eligible patients were aged ≥ 18 years, with a self-reported diagnosis of PsA for > 1 year, had visited a rheumatologist/dermatologist in the past 12 months, and had reported previously using ≥ 1 conventional synthetic or biologic disease-modifying antirheumatic drug. Data were stratified by gender and analyzed descriptively, inferentially by binomial (chi-square) tests, and by multivariate logistic regression models.

RESULTS: Data from 1286 patients who participated were included: 52% were female, 48% were male. Varying perceptions of disease severity between males and females were indicated by differences in symptoms leading to a diagnosis of PsA, and in symptoms reported despite treatment; more females than males reported joint tenderness, skin patches/plaques, and enthesitis. More females than males reported a major/moderate impact of PsA on their physical activity and emotional/mental well-being. Reasons for switching medication differed between genders, with more females switching because they perceived their medication to not be effective enough related to their joint symptoms. More females than males were very satisfied with their communication with their rheumatologist and were more likely to discuss the impact of PsA on their daily lives, their treatment satisfaction, and treatment goals with their rheumatologist.

CONCLUSIONS: Patients’ perceptions of the impact of PsA on HRQoL, treatment management, and interactions with HCPs varied between males and females. More females than males reported major/moderate physical and emotional impacts of PsA. When treating patients, it is important for HCPs to consider the potential impact of gender on patients’ experience of PsA and its symptoms. Graphical plain language summary available for this article.

PMID:38958912 | DOI:10.1007/s40744-024-00678-x

Environ Sci Pollut Res Int. 2024 Jul 3. doi: 10.1007/s11356-024-34053-8. Online ahead of print.

ABSTRACT

Nanoparticles, owing to their unique physicochemical properties, have garnered significant attention in various scientific disciplines, including materials science, chemistry, biology, and environmental engineering. In recent years, the synthesis of metal oxide nanoparticles, such as NiO, Fe₂O₃, ZnO, SnO₂, and CuO via green routes, has gained attraction due to their diverse applications in fields ranging from catalysis and electronics to medicine and environmental remediation. This study focuses on the green synthesis of copper oxide (CuO) and zinc oxide (ZnO) nanoparticles using Calotropis gigantea (Apple of Sodom) leaf extract as a reducing agent and stabilizer, with zinc nitrate (ZnNO₃.6H₂O) and copper nitrate (CuNO₃.3H₂O) as precursors. The hexagonal phase of ZnO and monoclinic plan structure of CuO with high crystallinity was confirmed by XRD and elemental composition by EDX analysis. With the help of an SEM image, particle size measured for CuO and ZnO using ImageJ software was found to be 56.08 nm and 46.49 nm, respectively. This study investigates the efficacy of nanoparticles in wastewater treatment, particularly focusing on methylene blue dye decolorization using the statistical processing of response surface methodology (RSM) using the Box-Behnken method. Additionally, it explores the impact of synthesized nanoparticles on seed growth enhancement, using Vigna radiata (green gram) seeds immersed in various doses of nanoparticles (0, 0.5, 1, 1.5, 2 mg/30 mL). Furthermore, the antibacterial activity of the nanoparticles against both gram-positive and gram-negative bacteria is evaluated. The results confirm the effectiveness of the materials for methylene blue dye removal, achieving 80.53% with CuO and 78.25% with ZnO. Significant seed growth was observed with a low nanoparticle dosage of 1.5 mg/30 mL, resulting in the highest seedling vigour index and germination percentage. This reduces the need for fertilizers and lessens environmental impact.

PMID:38958855 | DOI:10.1007/s11356-024-34053-8

Int Urol Nephrol. 2024 Jul 3. doi: 10.1007/s11255-024-04127-0. Online ahead of print.

ABSTRACT

PURPOSE: This study compared the effects of calcium oxalate stones and uric acid stones on male sexual function.

METHODS: We enrolled 100 patients with ureteral stones. According to the composition of the stones, they were divided into the calcium oxalate stone group and the uric acid stone group. All patients underwent ureteroscopic holmium laser lithotripsy. General data such as age, body mass index, course of disease, stone diameter, and degree of renal hydronephrosis were compared. Sperm parameters, including sperm density, sperm viability, and sperm deformity rate, as well as International Index of Erectile Function-5 questionnaire (IIEF-5) scores, and Quality of Life (QOL) scores, were measured and compared before and 6 weeks after the surgery.

RESULTS: There were no statistically significant differences in general data and sperm parameters between the two groups before the surgery (P > 0.05). However, there were significantly lower IIEF scores but significantly higher QOL scores in the uric acid stone group. In the calcium oxalate stone group, there were no statistically significant differences in sperm parameters, IIEF score, and QOL score before and after the surgery (P > 0.05). In the uric acid stone group, there were no statistically significant differences in sperm parameters before and after surgery (P > 0.05), whereas there were significantly higher IIEF scores but significantly lower QOL scores after the surgery (P < 0.05). The prevalence of erectile dysfunction (ED) in the uric acid stone group was 38.18% (21/55), which was significantly higher compared to 20.00% (9/45) in the calcium oxalate stone group (P < 0.05). The multivariate binary logistic regression analysis showed that the independent risk factor related to ED was uric acid stones (odds ratio: 2.637, 95% confidence interval 1.040-6.689, P = 0.041). No statistically significant differences were found in sperm parameters between patients with and without ED.

CONCLUSION: Compared with the calcium oxalate stone group, patients with uric acid stones had a higher prevalence of ED and poorer sexual performance.

PMID:38958853 | DOI:10.1007/s11255-024-04127-0

Adv Ther. 2024 Jul 3. doi: 10.1007/s12325-024-02913-x. Online ahead of print.

ABSTRACT

INTRODUCTION: This analysis examined the baseline characteristics and clinical outcomes of patients with chronic kidney disease (CKD) and rapid or non-rapid estimated glomerular filtration rate (eGFR) decline, using retrospective data from DISCOVER CKD (ClinicalTrials.gov, NCT04034992).

METHODS: Data (2008-2020) were extracted from UK Clinical Practice Research Datalink, US TriNetX, US Limited Claims and Electronic Health Record Dataset, and Japan Medical Data Vision. Patients with CKD (two consecutive eGFR measures < 75 mL/min/1.73 m² recorded 90-730 days apart) were included. Rapid eGFR decline was defined as an annual decline of > 4 mL/min/1.73 m² at 2 years post-index; non-rapid eGFR decline was defined as an annual decline of ≤ 4 mL/min/1.73 m². Clinical outcomes assessed included all-cause mortality, kidney outcomes (composite risk of kidney failure [progression to CKD stage 5] or > 50% eGFR decline, and kidney failure alone), cardiovascular events-including major adverse cardiovascular events (MACE; non-fatal myocardial infarction/stroke and cardiovascular death)-and all-cause hospitalization.

RESULTS: Across databases, rapid eGFR decline occurred in 13.7% of 804,237 eligible patients. Mean annual eGFR decline ranged between – 6.21 and – 6.86 mL/min/1.73 m² in patients with rapid eGFR decline versus between – 0.11 and – 0.77 mL/min/1.73 m² in patients with non-rapid eGFR decline. Rapid eGFR decline was associated with increased comorbidity burden and medication prescriptions. Across databases, the composite risk of kidney failure or > 50% decline in eGFR was significantly greater in patients with rapid versus non-rapid eGFR decline (P < 0.01); all-cause mortality, kidney failure alone, MACE, and all-cause hospitalization each significantly increased in two databases (P < 0.01-0.05).

CONCLUSION: Understanding patient factors associated with rapid eGFR decline in patients with CKD may help identify individuals who would benefit from proactive management to minimize the risk of adverse outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT04034992.

PMID:38958839 | DOI:10.1007/s12325-024-02913-x

Trop Anim Health Prod. 2024 Jul 3;56(6):194. doi: 10.1007/s11250-024-04052-5.

ABSTRACT

Seasonal scarcity of quality feed continues to be a bottleneck for agro-pastoralists and is the most important limitation to livestock production in agro-pastoral systems in the West African Sahel. In this regard, diverse promising technologies to increase the production and availability of quality feed have been introduced. Despite the introduction of various feed technologies in the region, the adoption rate by smallholder farmers is very low. The objective of this study was to identify factors affecting the likelihood of using improved livestock feed technologies among agro-pastoral households in two regions of Niger. A logit model was employed using data collected from randomly selected 218 agro-pastoral households between February and April 2023. The study revealed low awareness and use of improved livestock feed technologies among agro-pastoral households. The findings suggested the positive impact of education level, membership of farmer groups and ownership of small ruminant on enhancing the probability of using improved livestock feed technologies. Households’ geographical area was one of the determinant factors in using improved livestock feed technologies. The use of improved livestock feed technologies was also influenced by family size. The study provides guidance to inform strategies by the decision-makers to enhance the utilization of improved livestock feed technologies among agro-pastoral households in the West African Sahel. Suggested strategies may in turn alleviate the current problem of low productivity of livestock, contribute to improving household food security and nutrition among agro-pastoral communities.

PMID:38958837 | DOI:10.1007/s11250-024-04052-5