Nevin Manimala

Mar Pollut Bull. 2024 Nov 19;209(Pt B):117266. doi: 10.1016/j.marpolbul.2024.117266. Online ahead of print.

ABSTRACT

The Baltic Sea highly susceptible to the proliferation of Phytoplankton blooms. Present work examines the long-term trend and spatio-temporal variability of satellite derived chlorophyll concentration (Chl a) in the Baltic Sea during the period 2004-2021. Furthermore, the influence of water quality and meteorological parameters on Baltic Sea primary productivity has been analyzed using robust Generalized Additive Models (GAM) and Granger Causality statistical test. Statistically significant increasing trend in chlorophyll a concentration is observed in the Baltic Sea at the 95 % confidence interval. GAM model reveals that the most significant controlling factor is sea surface temperature (p < 0.0001), followed by nitrate and phosphate. Both GAM and Granger Causality tests confirm that water quality parameters are the major drivers in limiting the growth of Phytoplankton blooms in the Baltic Sea. Summer bloom shows in-phase relationship with Sea surface temperature and out of phase relationship with the phosphate nutrient.

PMID:39566147 | DOI:10.1016/j.marpolbul.2024.117266

Spectrochim Acta A Mol Biomol Spectrosc. 2024 Nov 16;328:125446. doi: 10.1016/j.saa.2024.125446. Online ahead of print.

ABSTRACT

Precise determination of veterinary pharmaceutical concentrations represents a critical foundation for delivering safe and efficacious animal healthcare interventions. Two synthetic glucocorticoids – dexamethasone sodium phosphate (DXM) and prednisolone acetate (PRD) – are extensively employed in veterinary medicine due to their potent anti-inflammatory capabilities. Our research presents a novel, cost-effective, and environmentally sustainable analytical methodology that enables simultaneous quantification of DXM and PRD within binary veterinary formulations. The method synergistically combines UV spectroscopy with dimension reduction algorithms (DRAs), representing a significant advancement in pharmaceutical analysis. A comprehensive evaluation of seventeen DRAs was conducted using four distinct performance metrics: mean squared error (MSE), mean absolute error (MAE), median absolute error (MedAE), and coefficient of determination (R²). Among the assessed algorithms, mini-batch sparse principal component analysis demonstrated superior predictive accuracy for this specific analytical challenge. The developed method was validated using the accuracy profile approach, yielding results that confirm its satisfactory accuracy. An ecological impact assessment was conducted using five greenness evaluation tools: the Green Solvent Selection Tool (GSST), National Environmental Methods Index (NEMI), Green Certificate modified Eco-Scale, carbon footprint analysis, and the Modified GAPI (MoGAPI). In addition, whiteness was evaluated with Red-Green-Blue 12 (RGB 12) algorithms. The proposed method showed elevated GSST scores and a greener profile according to NEMI. The calculated carbon footprint was 0.0006 kg CO₂ equivalent per sample, with a Green Certificate modified Eco-Scale score of 84, a MoGAPI score of 81, and a whiteness assessment of 90.1 by the RGB12 algorithm. Statistical comparison between the proposed spectrophotometric method and a previously reported HPLC method for pharmaceutical dosage form analysis revealed no statistically significant differences at the 95 % confidence level. This study underscores the innovative combination of UV spectroscopy with dimension reduction algorithms, presenting substantial improvements over traditional UV techniques for drug analysis. This method enhances both the efficiency and accuracy of active ingredient determination in pharmaceutical dosage forms while also supporting environmental sustainability.

PMID:39566135 | DOI:10.1016/j.saa.2024.125446

Cortex. 2024 Nov 8;181:233-257. doi: 10.1016/j.cortex.2024.08.011. Online ahead of print.

ABSTRACT

Despite the need for successful navigation, humans vary greatly in their ability to navigate, and these individual differences may relate to variation in brain structure. While prior research provides support for a correlation between hippocampal volume and navigation ability in both navigation experts and in older individuals, this relationship is under scrutiny for healthy, young adults. We assessed 99 healthy young adults’ ability to navigate in a virtual, desktop maze and correlated their performance with total hippocampal gray matter volume. For a subset of these individuals, we further segmented the medial temporal lobe-including regions of the hippocampus-into anatomically-distinct subregions to uniquely examine the association between volumes of hippocampal subfields and navigation. Given the need to distinguish between similar-looking maze hallways and partially overlapping routes, young adults with stronger pattern separation ability may perform better in this task. Thus, we theorized that successful navigation would positively correlate with hippocampal CA3 and dentate gyrus (DG) subfield volumes due to these regions’ role in pattern separation. CA1 and entorhinal cortex (ERC) are both associated with rodent spatial memory, too, suggesting a possible relationship between their volumes and navigation performance. Consistent with our hypotheses, we observed a positive relationship between volumes of hippocampal subfields and wayfinding accuracy, while ERC and parahippocampal cortex volumes correlated with navigation efficiency. However, when analyzing total hippocampal volume, a nuanced interpretation is warranted. We found evidence of Simpson’s Paradox, where total hippocampal volume and navigation accuracy displayed no correlation in males, a negative correlation in females, yet a positive correlation when considering the full sample of males and females combined. Furthermore, no significant relationship was observed between total hippocampal volume and path efficiency. Given these findings, we urge caution in interpreting the results because these associations differ by analysis techniques (including voxel-based morphometry), after sex stratification, and with anterior and posterior hippocampal subdivisions. Overall, this study enhances our understanding of the relationship between brain volume and navigation ability for young adults but also emphasizes the need for methodological consistency across studies with respect to boundary definitions, neuroimaging techniques, statistical methods, and factors that give rise to individual differences.

PMID:39566126 | DOI:10.1016/j.cortex.2024.08.011

Cir Cir. 2024 Nov 20. doi: 10.24875/CIRU.23000090. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to predict the risk of hypotension due to spinal anesthesia (HSA) by measuring the diameter and area of the inferior vena cava (IVC-D, IVC-A) through ultrasound and pleth variability index (PVI) in patients who underwent endovenous radiofrequency ablation under spinal anesthesia (SA).

METHODS: This cross-sectional, observational, and prospective study was completed with 64 patients. Before SA, PVI IVC-D, and IVC-A were measured. Patients were divided into two groups as hypotension group (Group 1) and patients who did not developed hypotension after SA (Group 2). Shapiro-Wilk normality test and student’s t-test were used for statistical analysis.

RESULTS: The mean PVI of Group 1 was higher than Group 2, whereas the mean IVC-D and IVC-A in Group 2 was significantly higher than Group 1 (p = 0.000, p = 0.000, p = 0.001). Cutoff values for hypotension PVI > 15% and IVC-A ≤ 2.98 mm2 (p = 0.001, p < 0.05).

CONCLUSION: PVI and IVC-D and IVC-A measurements are effective and reliable methods that should be used to predict the risk of developing HSA in patients who will undergo surgery under SA.

PMID:39566108 | DOI:10.24875/CIRU.23000090

J Clin Endocrinol Metab. 2024 Nov 20:dgae812. doi: 10.1210/clinem/dgae812. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate serum metabolomic biomarkers associated with incident type 2 diabetes mellitus (T2DM) and evaluate their performance in improving T2DM risk prediction.

METHODS: Untargeted proton nuclear magnetic resonance (1H NMR) spectroscopy-based metabolomics analyses were conducted in the Multi-Ethnic Study of Atherosclerosis (MESA; n=3460; discovery cohort) and Rotterdam Study (RS; n=1556; replication cohort). Multivariable cause-specific hazards models were used to analyze the associations between 23,571 serum metabolomic spectral variables and incident T2DM. Replicated metabolites required an FDR-adjusted P<0.01 in MESA, P<0.05 in RS, and consistent direction of association. Pathway and network analyses were conducted to elucidate biological mechanisms underlying T2DM development. Utility of the replicated metabolites in improving T2DM risk prediction was assessed based on the Framingham Diabetes Risk Score. A 2-sample Mendelian randomization was conducted to assess causal associations.

RESULTS: Nineteen metabolites were significantly associated with incident T2DM. Pathway analyses revealed disturbances in aminoacyl-tRNA biosynthesis, metabolism of branched-chain amino acids (BCAAs), glycolysis/gluconeogenesis, and glycerolipid metabolism. Network analyses identified interactions with upstream regulators including p38 MAPK, c-JNK, and mTOR signaling pathways. Adding replicated metabolites to the Framingham Diabetes Risk Score showed modest to moderate improvements in prediction performance in MESA and RS, with Δ c-statistic of 0.05 (95% CI, 0.04-0.07) in MESA and 0.03 (95% CI, 0.01-0.05) in RS. Genetically increased BCAAs and mannose were associated with T2DM.

CONCLUSIONS: 1H NMR measured metabolites involved in aminoacyl-tRNA biosynthesis, BCAA metabolism, glycolysis/gluconeogenesis, and glycerolipid metabolism were significantly associated with incident T2DM and provided modest to moderate predictive utility beyond traditional risk factors.

PMID:39566105 | DOI:10.1210/clinem/dgae812

Eur J Public Health. 2024 Nov 20:ckae185. doi: 10.1093/eurpub/ckae185. Online ahead of print.

ABSTRACT

This study aims to provide an investigation of the containment and mitigation strategies encompassing the entirety of the pandemic in Taiwan. This descriptive, observational study used COVID-19 data from Taiwan, Japan, and South Korea, and analysed news releases from the Taiwanese health authority. Statistics provided evidence of outbreak severity through infection and mortality rates, while qualitative results from the document review offered insights on the actions taken by the government chronologically from 2 February 2020 to 31 December 2022. All three countries experienced significant infection peaks in 2022. Taiwan had two distinct peaks, one in late May and another in October. South Korea had a single, high peak in late March, while Japan experienced multiple smaller waves, the biggest wave in August. Similarly, weekly mortality rates peaked in 2022 for all three countries after a surge in their infected cases, with Taiwan (5.15/100 000) and South Korea (4.69/100 000) having higher rates than Japan (1.65/100 000). Results from qualitative analysis showed that Taiwan’s early containment measures might have delayed the epidemic curve, allowing time for better preparation and proactive responses. However, the lack of a clear transition plan and the vulnerability of the elderly population contributed to higher mortality and infection rates. Despite ongoing challenges, Taiwan avoided nationwide lockdowns and relied on targeted restrictions to control transmission of the virus. Results of this article offer the narratives, reflections, and experiences from the case of Taiwan which may potentially present promising opportunities for impact in other settings and for future pandemics.

PMID:39566089 | DOI:10.1093/eurpub/ckae185

J Bone Miner Res. 2024 Nov 20:zjae190. doi: 10.1093/jbmr/zjae190. Online ahead of print.

ABSTRACT

Vitamin D dysregulation can occur in people living with HIV, disrupting calcium homeostasis and bone turnover. We aimed to investigate the potential mechanisms by which vitamin D regulates bone turnover in adolescents living with perinatally-acquired HIV (ALWH) in southern Africa. A pre-planned secondary analysis was performed of baseline data from the VITALITY trial [PACTR20200989766029] which enrolled ALWH (11-19 years) taking antiretroviral therapy for ≥6 months, and recorded socio-demographic, clinical and dietary data. After over-night fasting, vitamin D metabolites [25(OH)D, 1,25(OH)2D, 24,25(OH)2D], intact parathyroid hormone (PTH) and bone turnover markers (BTMs) [CTX and P1NP] were measured. Tandem Mass Spectrometry measured vitamin D metabolites, whilst intact PTH and BTMs were analysed by electrochemiluminescence immunoassay. Stratified by 25(OH)D [<75 vs ≥75 nmol/L], associations between standardized concentrations (β = standard deviations) of vitamin D metabolites, intact PTH and BTMs were assessed using structural equations modelling (SEM) adjusted for age, sex and country (Zimbabwe/Zambia). Among the 842 ALWH enrolled, the median dietary calcium intake was 100 mg [IQR:55-145]. The SEM showed PTH was positively associated [β 0.21, 95%CI: 0.1,0.32] with 1,25(OH)2D, only when 25(OH)D was <75 nmol/L vs ≥75 nmol/L [β 0.23, 95%CI: -0.13,0.59], with evidence of an interaction [β -0.11, 95%CI: -0.20,-0.02]. A positive relationship between 25(OH)D and 24,25(OH)2D was seen irrespective of 25(OH)D concentration. 24,25(OH)2D was inversely related to BTMs, particularly when 25(OH)D was <75 nmol/L [CTX: β -0.15, 95%CI: -0.24,-0.06, and P1NP: β -0.14, 95%CI: -0.22,-0.06]. There was interaction between dietary calcium and 25(OH)D on PTH [β -0.15, 95% CI: -0.22,-0.07] suggesting an interaction between low 25(OH)D and low dietary calcium which increases PTH. In conclusion, associations between 25(OH)D, PTH, 1,25(OH)2D and BTMs in ALWH appear dependent upon 25(OH)D concentrations <75 nmol/L and calcium intake. A novel, potentially causal pathway between 25(OH)D, 24,25(OH)2D and BTMs was seen. Findings enhance understanding of vitamin D metabolism in people living with HIV.

PMID:39566074 | DOI:10.1093/jbmr/zjae190

Fam Pract. 2024 Nov 20:cmae065. doi: 10.1093/fampra/cmae065. Online ahead of print.

ABSTRACT

BACKGROUND: When research and management of Dupuytren’s disease (DD) shift from symptom relief to preventing contractures, general practitioner (GP) care may become more central to treatment. However, the presentation and course of DD in GP care are underexplored and this has been recognized as a knowledge gap that hinders effective treatment decisions. This study is the first to map the trajectory of DD patients in GP care.

METHODS: Using electronic health records from Dutch general practices in a regional research network, we conducted a registration-based cohort study in a dynamic population. Descriptive statistics detailed patient demographics, number of contacts, and symptoms per contact. The time and number of contacts before diagnosis were also analysed. Sankey diagrams illustrated the relationship between management options and symptoms.

RESULTS: Over a 16-year period, 84% of patients with a DD diagnosis had visited their GP for this reason, with 73% only having one GP contact. The diagnosis was made at first contact for 93% of patients. Initial contacts often reported a lump (57.3%), but this symptom was less frequent in subsequent visits. ‘Daily life impairment’ increased after the first contact. The most common management options were referral to secondary care (37.7%) and watchful waiting (35.1%).

CONCLUSION: The diagnosis and management of DD in GP care are in line with the current guidelines. Less than half of the DD patients were referred to secondary care during follow-up. This may give room for preventive treatment that limits progression. Future studies should focus on the accuracy of diagnosis and the feasibility of effective treatments in GP care.

PMID:39566072 | DOI:10.1093/fampra/cmae065

Oncologist. 2024 Nov 20:oyae306. doi: 10.1093/oncolo/oyae306. Online ahead of print.

ABSTRACT

BACKGROUND: Biliary tract cancer (BTC) is an aggressive biliary tract cancer, arising from the bile ducts and gallbladder, with a poor prognosis. The TOPAZ-1 trial of durvalumab plus first-line chemotherapy (gemcitabine plus cisplatin) showed improved survival vs chemotherapy alone. This real-world study aimed to confirm the effectiveness of this regimen.

METHODS: This retrospective, multicenter study included patients with advanced BTC treated with first-line durvalumab plus platinum chemotherapy at the Linkou, Taoyuan, and Tucheng branches of Chang Gung Memorial Hospital as well as at Taipei Veterans General Hospital between August 2021 and June 2023.

RESULTS: Among the 45 patients with advanced biliary tree cancer treated with durvalumab plus cisplatin and gemcitabine as first-line treatment, the objective response rate was 31.1% (14 partial responses). An additional 40% (18 patients) had stable disease. The median progression-free survival was 5.6 months (95%CI, 4.4-6.9) and median overall survival was 15.8 months (95%CI, 7.9-23.8). Responders had significantly longer survival than non-responders (15.8 vs 3.3 months). Although higher durvalumab doses (1000-1500 mg) appeared to have improved efficacy compared to lower doses (<1000 mg), the difference was not statistically significant. On multivariate analysis, poor ECOG performance status (≥2) and a high neutrophil-lymphocyte ratio were independent prognostic factors for shorter overall survival.

CONCLUSION: This real-world study demonstrated the comparable efficacy of durvalumab plus chemotherapy to the TOPAZ-1 trial for patients with advanced BTC and identified prognostic factors. There was a trend toward improved efficacy with higher durvalumab dosing (1000-1500 mg) vs lower dosing, though further research is needed to confirm this relationship.

PMID:39566070 | DOI:10.1093/oncolo/oyae306

JMIR Public Health Surveill. 2024 Nov 20;10:e59138. doi: 10.2196/59138.

ABSTRACT

BACKGROUND: Since its introduction, telemedicine for patients with chronic diseases has been studied in various clinical settings. However, there is limited evidence of the effectiveness and medical safety of the nationwide adoption of telemedicine.

OBJECTIVE: This study aimed to analyze the effects of telemedicine on chronic diseases during the COVID-19 pandemic under a temporary telemedicine policy in South Korea using national claims data.

METHODS: Health insurance claims data were extracted over 2 years: 1 year before (from February 24, 2019, to February 23, 2020) and 1 year after the policy was implemented (from February 24, 2020, to February 23, 2021). We included all patients who used telemedicine at least once in the first year after the policy was implemented and compared them with a control group of patients who never used telemedicine. The comparison focused on health care use; the medication possession ratio (MPR); and admission rates to general wards (GWs), emergency departments (EDs), and intensive care units (ICUs) using difference-in-differences analysis. A total of 4 chronic diseases were targeted: hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and common mental disorders.

RESULTS: A total of 1,773,454 patients with hypertension; 795,869 patients with DM; 37,460 patients with COPD; and 167,084 patients with common mental disorders were analyzed in this study. Patients diagnosed with hypertension or DM showed increased MPRs without an increase in GW, ED, or ICU admission rates during the policy year. Moreover, patients in the DM group who did not use telemedicine had higher rates of ED, GW, and ICU admissions, and patients in the hypertension group had higher rates of GW or ICU admissions after 1 year of policy implementation. This trend was not evident in COPD and common mental disorders.

CONCLUSIONS: The temporary telemedicine policy was effective in increasing medication adherence and reducing admission rates for patients with hypertension and DM; however, the efficacy of the policy was limited for patients with COPD and common mental disorders. Future studies are required to demonstrate the long-term effects of telemedicine policies with various outcome measures reflecting disease characteristics.

PMID:39566066 | DOI:10.2196/59138