Nevin Manimala

Mutat Res Rev Mutat Res. 2023 Sep 2:108468. doi: 10.1016/j.mrrev.2023.108468. Online ahead of print.

ABSTRACT

There is concern about human exposure to nanoplastics from intentional use or degradation of plastics in the environment. This review assesses genotoxic effects of nanoplastics, defined as particles with a primary size of less than 1000nm. The majority of results on genotoxicity come from studies on polystyrene (PS) particles in mammalian cell cultures. Most studies have measured DNA strand breaks (standard comet assay), oxidatively damaged DNA (Fpg-modified comet assay) and micronuclei. Twenty-nine out of 60 results have shown statistically significant genotoxic effects by PS exposure in cell cultures. A statistical analysis indicates that especially modified PS particles are genotoxic (odds ratio = 8.6, 95% CI: 1.6, 46) and immune cells seems to be more sensitive to genotoxicity than other cell types such as epithelial cells (odds ratio = 8.0, 95% CI: 1.6, 39). On the contrary, there is not a clear association between statistically significant effects in genotoxicity tests and the primary size of PS particles, (i.e. smaller versus larger than 100nm) or between the type of genotoxic endpoint (i.e. repairable versus permanent DNA lesions). Three studies of PS particle exposure in animals have shown increased level of DNA strand breaks in leukocytes and prefrontal cortex cells. Nanoplastics from polyethylene, propylene, polyvinyl chloride and polyethylene terephthalate have been investigated in very few studies and it is currently not possible to draw conclusion about their genotoxic hazard. In summary, there is some evidence suggesting that PS particles may be genotoxic in mammalian cells.

PMID:37666295 | DOI:10.1016/j.mrrev.2023.108468

Nutr Res. 2023 Aug 4;118:137-145. doi: 10.1016/j.nutres.2023.07.011. Online ahead of print.

ABSTRACT

A diet high in quality is essential for prevention of chronic diseases. Specific healthy eating behaviors may modulate dietary intake. However, these behaviors have been seldomly studied, particularly in Puerto Rico (PR), a population with documented poor dietary quality and high burden of chronic diseases. This study aimed to document self-reported engagement in eating behaviors and examine their associations with intake of nutrients and diet quality. We hypothesized that greater engagement in healthy eating behavior would be associated with greater diet quality. This cross-sectional analysis used data from the PRADLAD study (adults aged 30-75 years residing in the San Juan, PR, area [n = 234]). Frequency (never, sometimes, often, always) of habitual eating behaviors was measured. Dietary intake was assessed with a food frequency questionnaire. Diet quality was measured with the Alternate Healthy Eating Index-2010. Statistical analyses included adjusted linear models. The most common behavior was “controlling intake of salt” (51.7%). Engaging “always” (vs. less frequently) in making healthier meals, reading nutrition facts labels, searching media for healthy eating information, counting calories, buying organic foods, eating a vegetarian diet, and controlling intake of salt, fat, carbohydrates/sugar, and portions were associated with higher Alternate Healthy Eating Index-2010 scores (P < .05). Controlling intakes of fats, carbohydrates/sugars, and portions “always” was associated with lower intakes of trans fats, added sugars, and total food (g), respectively (P < .05). Engagement in eating a vegetarian diet “always” was associated with higher intake of plant-based protein (P < .05). In conclusion, adults following several habitual eating behaviors had greater diet quality and a lower amount of unfavorable nutrients. Encouraging adherence to these behaviors may contribute to healthier dietary intake.

PMID:37666009 | DOI:10.1016/j.nutres.2023.07.011

Ann Intern Med. 2023 Sep 5. doi: 10.7326/M22-3021. Online ahead of print.

ABSTRACT

BACKGROUND: Antipsychotics are commonly used to manage postoperative delirium. Recent studies reported that haloperidol use has declined, and atypical antipsychotic use has increased over time.

OBJECTIVE: To compare the risk for in-hospital adverse events associated with oral haloperidol, olanzapine, quetiapine, and risperidone in older patients after major surgery.

DESIGN: Retrospective cohort study.

SETTING: U.S. hospitals in the Premier Healthcare Database.

PATIENTS: 17 115 patients aged 65 years and older without psychiatric disorders who were prescribed an oral antipsychotic drug after major surgery from 2009 to 2018.

INTERVENTIONS: Haloperidol (≤4 mg on the day of initiation), olanzapine (≤10 mg), quetiapine (≤150 mg), and risperidone (≤4 mg).

MEASUREMENTS: The risk ratios (RRs) for in-hospital death, cardiac arrhythmia events, pneumonia, and stroke or transient ischemic attack (TIA) were estimated after propensity score overlap weighting.

RESULTS: The weighted population had a mean age of 79.6 years, was 60.5% female, and had in-hospital death of 3.1%. Among the 4 antipsychotics, quetiapine was the most prescribed (53.0% of total exposure). There was no statistically significant difference in the risk for in-hospital death among patients treated with haloperidol (3.7%, reference group), olanzapine (2.8%; RR, 0.74 [95% CI, 0.42 to 1.27]), quetiapine (2.6%; RR, 0.70 [CI, 0.47 to 1.04]), and risperidone (3.3%; RR, 0.90 [CI, 0.53 to 1.41]). The risk for nonfatal clinical events ranged from 2.0% to 2.6% for a cardiac arrhythmia event, 4.2% to 4.6% for pneumonia, and 0.6% to 1.2% for stroke or TIA, with no statistically significant differences by treatment group.

LIMITATION: Residual confounding by delirium severity; lack of untreated group; restriction to oral low-to-moderate dose treatment.

CONCLUSION: These results suggest that atypical antipsychotics and haloperidol have similar rates of in-hospital adverse clinical events in older patients with postoperative delirium who receive an oral low-to-moderate dose antipsychotic drug.

PRIMARY FUNDING SOURCE: National Institute on Aging.

PMID:37665998 | DOI:10.7326/M22-3021

Brain. 2023 Sep 4:awad199. doi: 10.1093/brain/awad199. Online ahead of print.

ABSTRACT

Tumour heterogeneity is increasingly recognized as a major obstacle to therapeutic success across neuro-oncology. Gliomas are characterized by distinct combinations of genetic and epigenetic alterations, resulting in complex interactions across multiple molecular pathways. Predicting disease evolution and prescribing individually optimal treatment requires statistical models complex enough to capture the intricate (epi)genetic structure underpinning oncogenesis. Here, we formalize this task as the inference of distinct patterns of connectivity within hierarchical latent representations of genetic networks. Evaluating multi-institutional clinical, genetic and outcome data from 4023 glioma patients over 14 years, across 12 countries, we employ Bayesian generative stochastic block modelling to reveal a hierarchical network structure of tumour genetics spanning molecularly confirmed glioblastoma, IDH-wildtype; oligodendroglioma, IDH-mutant and 1p/19q codeleted; and astrocytoma, IDH-mutant. Our findings illuminate the complex dependence between features across the genetic landscape of brain tumours and show that generative network models reveal distinct signatures of survival with better prognostic fidelity than current gold standard diagnostic categories.

PMID:37665980 | DOI:10.1093/brain/awad199

Pediatr Emerg Care. 2023 Sep 5. doi: 10.1097/PEC.0000000000003044. Online ahead of print.

ABSTRACT

OBJECTIVES: Our objective was to increase human immunodeficiency virus (HIV) screening in adolescents presenting to our community pediatric emergency department with symptoms suggestive of a sexually transmitted infection (STI) and who were being tested for gonorrhea and chlamydia. Specifically, we aimed to increase the monthly average proportion of adolescents concurrently screened for HIV in this target group from 11% to 50% in 6 months.

METHODS: We identified barriers to HIV screening, focusing on physician-related challenges and adolescents’ concerns about confidentiality. We designed interventions targeting these barriers and implemented them in plan-do-study-act cycles beginning in February 2020. We educated physicians and nurses about screening recommendations, emphasized a physician-conducted private interview during which confidential contact information could be obtained, and assured confidentiality on after visit summaries by removing STI results. We also provided regular feedback to physicians on the screening rate. In addition, we implemented an electronic health record quick order set and a documentation tool. Using a statistical process control chart, we measured the average monthly proportion of adolescents in the target group who were offered HIV screening or tested for HIV before and after interventions.

RESULTS: A total of 140 adolescents in the target group presented to our pediatric emergency department from February 2020 through December 2021. After plan-do-study-act cycles, the average monthly screening rate increased to 80%.

CONCLUSIONS: Raising physician awareness of HIV screening recommendations and the importance of conducting a private interview improved screening rates. Assuring adolescent minors of confidentiality in a private interview, removing STI results from the after visit summary, and obtaining confidential contact information were important measures to overcome confidentiality barriers.

PMID:37665966 | DOI:10.1097/PEC.0000000000003044

Pediatr Emerg Care. 2023 Sep 5. doi: 10.1097/PEC.0000000000003041. Online ahead of print.

ABSTRACT

OBJECTIVES: Poisonings constitute an important part of preventable morbidity and mortality in pediatric intensive care units (PICUs) and hospitalizations. However, information on poisoning requiring intensive care is limited. This study aimed epidemiological evaluation of poisoning cases treated in the PICU in a single center.

METHODS: The records of 504 patients admitted to the PICU due to acute poisoning between 2010 and 2022 were retrospectively reviewed. Data were evaluated using descriptive methods and the χ2 test, and statistical differences with P value <0.05 were considered significant.

RESULTS: The age range of the patients ranged from 1 month to 216 months (18 years), and the rate of girls was 53.2% (n = 268), whereas the rate of boys was 46.8% (n = 236). The mean age was 4.4 ± 4.3 years for boys, 6.7 ± 5.8 years for girls, and 5.6 ± 5.3 years for all patients. It was determined that 79.6% of the cases were poisoned by accident and 20.4% by suicide. A total of 76.7% of the patients who were poisoned for suicide were girls and 23.3% were boys. The mean age of these patients was 14.3 ± 3.0 years. On the other hand, 47.1% of the children who were accidentally poisoned were girls and 52.9% were boys, and the mean age of these children was 3.4 ± 2.9 years. Although 79.9% of poisonings occurred at home, the causative agent was oral poisoning in 97.4% of the cases. Approximately two thirds (69.2%) of the cases were drug-related, whereas 30.8% were related to nondrug substances. In drug-related poisonings, central nervous system drugs (35.8%) were the most common agent, followed by analgesic/antipyretic (20.9%) agents, whereas among the nonpharmaceutical factors, insecticides (agricultural pesticides, rat poison, pesticides, etc) were the most common, followed by poisonous herbs (beetleweed, widow’s weed, cannabis, etc). The mean admission time of the patients to the hospital was 6.3 ± 8.4 hours, and the mean length of stay in the intensive care unit was 1.6 ± 1.3 days. In the 12 years of our study, only 3 patients died due to poisoning, and our mortality rate was 0.5%. Four patients (0.7%) were referred to the Alcohol and Drug Addicts Treatment and Research Center.

CONCLUSIONS: In this study, in which we retrospectively analyzed the profiles of poisoning cases hospitalized in the PICU for 12 years, we determined that poisonous weeds were the major factor in accidental poisonings, and suicidal poisonings were above the expected rates even at the young age group such as 8-12 years old. These results show the importance of determining the poisoning profile of the health care service area.

PMID:37665962 | DOI:10.1097/PEC.0000000000003041

Ann Bot. 2023 Sep 4:mcad131. doi: 10.1093/aob/mcad131. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Whole-plant performance in water-stressed and disturbance-prone environments depends on a suitable supply of water from the roots to the leaves, storage of reserves during periods of shortage, and a morphological arrangement that guarantees the maintenance of the plants anchored to the soil. All these functions are performed by the secondary xylem of roots. Here, we investigate whether different growth forms of Fabaceae species from the seasonally dry Neotropical environment have distinct strategies for water transport, mechanical support, and non-structural carbon and water storage in the root secondary xylem.

METHODS: We evaluated cross-sections of root secondary xylem from trees, shrubs, and subshrubs species. We applied linear models to verify the variability in secondary xylem anatomical traits among growth forms.

KEY RESULTS: Secondary xylem with larger vessels and lower vessel density were observed in tree species. Vessel wall thickness, vessel grouping index, potential hydraulic conductivity, and cell fractions (vessels, fibers, rays, and axial parenchyma) were not statistically different between growth forms, due to high interspecific variation within the groups studied.

CONCLUSION: Our results showed that the variability in anatomical traits of the secondary xylem of the root are species-specific. In summary, the cellular complexity of the secondary xylem ensures multiple functional strategies in species with distinct growth forms, a key trait for resource use in an environment with strong water seasonality.

PMID:37665958 | DOI:10.1093/aob/mcad131

Psychol Sport Exerc. 2023 Nov;69:102511. doi: 10.1016/j.psychsport.2023.102511. Epub 2023 Aug 16.

ABSTRACT

Research has recently begun to examine the relationship between multidimensional perfectionism and athletes’ post-competition mood. However, to date, there have been few attempts to examine the interaction between dimensions of perfectionism or model possible explanatory processes. To address these limitations, in the current study we tested a novel conditional process model whereby the relationship between perfectionistic strivings and post-competition affect was mediated by the degree to which goals were considered to have been met (goal-realization) and that this indirect effect was, in turn, moderated by levels of perfectionistic concerns. We tested this model in a sample of 251 athletes who took part in a “Runmageddon” event – a cross-country obstacle race. Athletes completed measures of perfectionism (perfectionistic strivings and perfectionistic concerns) before the race and measures of goal-realization and mood (tense arousal, energetic arousal, and hedonic tone) between 24 and 48 h after the race. Analyses revealed that perfectionistic strivings were indirectly linked to a more unpleasant post-competition mood (higher tense arousal and lower hedonic tone) via perceptions of lower goal-realization. In addition, these two indirect effects were statistically significant only when perfectionistic concerns were medium and high. The results support the proposed conditional model and suggest the interplay between dimensions of perfectionism is important for athletes’ post-competition mood, and the level of perfectionistic concerns, especially.

PMID:37665945 | DOI:10.1016/j.psychsport.2023.102511

Psychol Sport Exerc. 2023 Nov;69:102501. doi: 10.1016/j.psychsport.2023.102501. Epub 2023 Jul 28.

ABSTRACT

OBJECTIVES: This exploratory study aimed to examine the individual, program and environmental (social and physical) characteristics which predict high quality of participation in adaptive snowsports for each dimension of the Quality of Participation in Parasport Framework (QPPF): autonomy, belongingness, mastery, challenge, engagement and meaning.

METHODS: A survey was completed by 133 individuals with disabilities or their representatives on each dimension of the QPPF in adaptive snowsports and on the factors impacting the quality of participation. Descriptive statistics were used to describe the study participants, and a multivariate logistic regression model was constructed for each dimension of the QPPF to evaluate the relative contribution of individual, snowsport-related, program and environmental factors to each dimension.

RESULTS: Individuals with disabilities in this study reported high quality of participation on all dimensions of the QPPF. The individual characteristics only predicted the QPPF dimension of challenge. However, the program and environmental characteristics such as equipment, number of instructors and barriers were robust predictors of quality of participation.

CONCLUSION: Overall, participants experienced high quality participation. Supporting the adaptive snowsports programs while reducing the barriers faced by people with disabilities should be a continued effort to promote quality of participation.

PMID:37665936 | DOI:10.1016/j.psychsport.2023.102501

Psychol Sport Exerc. 2023 Sep;68:102474. doi: 10.1016/j.psychsport.2023.102474. Epub 2023 Jun 7.

ABSTRACT

OBJECTIVES: To contribute further knowledge about symptoms of anxiety, depression, body concerns, and self-worth among young talent development (TD) and mainstream students by exploring the indicators within-person combinations prospectively, aiming to identify distinct profiles.

METHODS: We included 946 students, n = 168 (45% girls) from three TD sports schools and one ballet class, n = 778 (52% girls) from ten mainstream schools. All were 13-14 years at T1 and 15-16 years at T2. Descriptive statistics were examined via variable-centered approaches: ANOVA and cross-tabulations. Mental health profiles were explored via person-centered approaches: latent profile and latent transition analysis, including profile stability over two years and school type, gender, and perfectionism association with profiles.

RESULTS: TD girls’ and boys’ anxiety and depression scores did not differ, but girls reported more weight-shape concerns. Mainstream schoolgirls fared worse compared to all others. Four retained profiles (distressed-body concerned, dissatisfied, moderate mentally healthy, mentally healthy) showed distinct patterns of co-occurring anxiety, depression, weight-shape concerns, and self-worth. Profile stability was high overall (72-93%). The highest proportion of TD boys was in the mentally healthy, TD girls and mainstream boys in moderate, and mainstream girls within the dissatisfied profile. Noteworthy transitions: TD boys who transitioned were likely changing to healthier profiles and girls to unhealthier. Unhealthier profiles were associated with socially prescribed perfectionism.

CONCLUSION: TD students fared relatively better than mainstream students. Still, considerable proportions of girls were identified in the unhealthiest profiles. These findings involving young TD and mainstream students propose a need for specific follow-up measures to promote mental health.

PMID:37665914 | DOI:10.1016/j.psychsport.2023.102474