Nevin Manimala

Am J Ind Med. 2022 Sep 24. doi: 10.1002/ajim.23430. Online ahead of print.

ABSTRACT

OBJECTIVES: Fragmented industry and occupation surveillance data throughout the COVID-19 pandemic has left public health practitioners and organizations with an insufficient understanding of high-risk worker groups and the role of work in SARS-CoV-2 transmission.

METHODS: We drew sequential probability samples of noninstitutionalized adults (18+) in the Michigan Disease Surveillance System with COVID-19 onset before November 16, 2020 (N = 237,468). Among the 6000 selected, 1839 completed a survey between June 23, 2020, and April 23, 2021. We compared in-person work status, source of self-reported SARS-CoV-2 exposure, and availability of adequate personal protective equipment (PPE) by industry and occupation using weighted descriptive statistics and Rao-Scott χ² tests. We identified industries with a disproportionate share of COVID-19 infections by comparing our sample with the total share of employment by industry in Michigan using 2020 data from the US Bureau of Labor Statistics.

RESULTS: Employed respondents (n = 1244) were predominantly female (53.1%), aged 44 and under (54.4%), and non-Hispanic White (64.0%). 30.4% of all employed respondents reported work as the source of their SARS-CoV-2 exposure and 78.8% were in-person workers. Work-related exposure was prevalent in Nursing and Residential Care Facilities (65.2%); Justice, Public Order, and Safety Activities (63.3%); and Food Manufacturing (57.5%). By occupation, work-related exposure was highest among Protective Services (57.9%), Healthcare Support (56.5%), and Healthcare Practitioners (51.9%). Food Manufacturing; Nursing and Residential Care; and Justice, Public Order, and Safety Activities were most likely to report having adequate PPE “never” or “rarely” (36.4%, 27.9%, and 26.7%, respectively).

CONCLUSIONS: Workplaces were a key source of self-reported SARS-CoV-2 exposure among employed Michigan residents during the first year of the pandemic. To prevent transmission, there is an urgent need in public health surveillance for the collection of industry and occupation data of people infected with COVID-19, as well as for future airborne infectious diseases for which we have little understanding of risk factors.

PMID:36151779 | DOI:10.1002/ajim.23430

Brief Bioinform. 2022 Sep 24:bbac373. doi: 10.1093/bib/bbac373. Online ahead of print.

ABSTRACT

Biomedical data preprocessing and efficient computing can be as important as the statistical methods used to fit the data; data processing needs to consider application scenarios, data acquisition and individual rights and interests. We review common principles, knowledge and methods of integrated research according to the whole-pipeline processing mechanism diverse, coherent, sharing, auditable and ecological. First, neuromorphic and native algorithms integrate diverse datasets, providing linear scalability and high visualization. Second, the choice mechanism of different preprocessing, analysis and transaction methods from raw to neuromorphic was summarized on the node and coordinator platforms. Third, combination of node, network, cloud, edge, swarm and graph builds an ecosystem of cohort integrated research and clinical diagnosis and treatment. Looking forward, it is vital to simultaneously combine deep computing, mass data storage and massively parallel communication.

PMID:36151775 | DOI:10.1093/bib/bbac373

Gerodontology. 2022 Sep 23. doi: 10.1111/ger.12657. Online ahead of print.

ABSTRACT

OBJECTIVES: This register-based study on public sector patients aged 60 years and over assessed annual age-specific volume of and reasons for tooth extractions as well as changes in these across the period 2007-2015.

BACKGROUND: Alongside the rapidly ageing population, the demand for public oral healthcare services is growing. Damaged teeth may induce a long-lasting inflammation burden in old age.

MATERIALS AND METHODS: Data used the electronic documentation of oral healthcare procedures recorded according to healthcare regulation. The study population consisted of all patients over 60 years of age (n = 216 059) who were treated 2007-2015 in public oral health care available to all citizens of Helsinki, Finland. Data for the 9-year time series included reasons for tooth extractions and were aggregated by patient age into 5-year groups. Statistical analyses included rates and proportions, mean values, correlation coefficients and linear regression modelling.

RESULTS: Extraction patients (n = 48 623) were more likely in the older age groups: 21.8% in the age group 60-64 and 27.5% in the age group 90+. Mean number of tooth extractions among all patients was 0.4 per patient and 1.7 per extraction patient. Among all tooth extractions (n = 82 677), main reasons were caries 29.5%, apical periodontitis 19.4%, tooth remnant 19.4% and periodontitis 18.0%. Tooth remnant predominated as extraction reason in the oldest age groups, while apical periodontitis displayed an upward trend by calendar year.

CONCLUSION: Tooth extractions attributable to caries were common in all old-age groups, tooth remnant extractions were most common in older age groups, and apical periodontitis abounded as extraction reason during 2007-2015.

PMID:36151752 | DOI:10.1111/ger.12657

Muscle Nerve. 2022 Sep 23. doi: 10.1002/mus.27726. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Epidermal nerve fiber involvement in chronic inflammatory demyelinating neuropathy (CIDP) has been reported in a limited number of patients. We quantified small fiber involvement in a mixed cohort of patients with typical CIDP and CIDP variants to evaluate relationships with clinical outcome measures at different disease stages.

METHODS: Intraepidermal nerve fiber densities (IENFDs) were evaluated by skin punch biopsies of 23 patients with CIDP and 13 healthy controls at the forearm, thigh, and distal leg. Skin sections were optimally interpreted in all three regions in 16 CIDP patients and 10 age- and sex-matched healthy controls. Statistical analysis was performed in those subjects.

RESULTS: The IENFDs in forearm, thigh and distal leg were similar among 7 typical CIDP and 9 CIDP variants. IENFDs in those regions were significantly reduced in CIDP compared to healthy controls, and showed moderate negative correlation with International Neuropathy Cause and Treatment (INCAT) Upper Limb Functional Disability Scores. Reduction in IENFD compared to controls was more remarkable in the distal leg. In clinically unstable CIDP patients, the IENFDs of distal leg and forearm were significantly reduced compared to stable CIDP and controls. Stable CIDP patients had significantly reduced IENFDs in distal leg and forearm compared to controls.

DISCUSSION: In this exploratory study, we confirm that small fibers are also affected in CIDP. Larger studies are needed to explore longitudinal changes of IENFD in CIDP and its relation to disease stage. This article is protected by copyright. All rights reserved.

PMID:36151750 | DOI:10.1002/mus.27726

Phytochem Anal. 2022 Sep 23. doi: 10.1002/pca.3174. Online ahead of print.

ABSTRACT

INTRODUCTION: The presence of chlorogenic acid (CGA) not only imparts a characteristic flavour to foods but also makes them useful against chronic diseases and metabolic syndromes, especially diabetes mellitus and asthma.

OBJECTIVES: The present study was designed to develop a quick, easy, cheap, effective, rugged, and safe (QuEChERS) and pragmatic method to analyse CGA in plant-based products by applying dispersive liquid-liquid microextraction (DLLME) followed by reverse-phase high-performance liquid chromatography under a diode array detector (RP-HPLC-DAD).

METHODOLOGY: The DLLME was carried out using Triton X-100 as a dispersant and ethanol as an extraction solvent, while method development and validation activities were performed on a Shimadzu 10-AT HPLC-DAD system equipped with C-18 columns as stationary phases.

RESULTS: The well-resolved peak for the standard CGA was observed at 2.92 min for the mobile phase comprising 0.1% aqueous formic acid-ethanol (22:78 v/v) of pH 3.0 programmed under an isocratic flow rate of 1.0 mL/min. The developed method was found to be linear (R² = 0.9976) over 1-500 μg/mL of CGA concentration at 328 nm. Moreover, the assay was found to be repeatable with RSD ≤ 5.0, and the limit of detection (LOD) and limit of quantification (LOQ) were 0.0281 and 0.0853 μg/mL of CGA, respectively. The DLLME offered an overall recovery rate between 97.60% and 99.54% at an acceptable level of reproducibility [relative standard deviation (RSD) ≤ 5.0].

CONCLUSION: The developed assay was found to be a QuEChERS and pragmatic choice for the high-throughput analysis of CGA in plant-based products/foods. Finally, the analysis revealed the presence of an ample level of CGA in guava fruit in addition to coffee beans and black tea.

PMID:36151736 | DOI:10.1002/pca.3174

Int J Artif Organs. 2022 Sep 23:3913988221126728. doi: 10.1177/03913988221126728. Online ahead of print.

ABSTRACT

BACKGROUND: Hyperlactatemia is a common complication in critically ill patients with high morbidity and mortality. Hyperlactatemia patients who require continuous renal replacement therapy (CRRT) constitute a subgroup with increased mortality risk. The clinical significance of serum lactate in these patients was not well understood and clearance of lactate using CRRT shown no survival benefits. The aim of this study is to investigate the incidence and non-lactate risk factors for ICU mortality in hyperlactatemia patients who underwent CRRT.

METHOD: Hyperlactatemia patients with a serum lactate level >2 μmol/L who underwent CRRT between January, 2014 and May, 2021 were retrospectively investigated. Demographic characteristics and clinical data were collected from the electronic medical record system. The primary endpoint was predictors for ICU mortality which were identified by using multivariate logistic regression analysis.

RESULTS: A total of 178 eligible patients were finally included with a mean age of 56.6 ± 17.9 years and a median APACHE II score of 18 (IQR (14-22)). The multivariate regression results showed that male gender (OR 0.55 (95%CI 0.27-1.12), p = 0.1), mechanical ventilation (OR 2.60 (95%CI 1.27-5.34), p = 0.008), history of hypertension (OR 2.40 (95%CI 1.12-5.14), p = 0.02), SOFA score (OR 1.16 (95%CI 1.05-1.28), p = 0.002), AST (OR 1.0005 (95%CI 0.99-1.001), p = 0.08), and PT (OR 1.08 (95%CI 0.99-1.17), p = 0.06) were independently associated with ICU mortality. After adjusting for age, illness severity (APACHE II score), and serum lactate level, the statistical significances of SOFA score (OR 1.16 (95%CI 1.04-1.29), p = 0.005), hypertension (OR 2.25 (95%CI 1.02-4.95), p = 0.04), and mechanical ventilation (OR 2.54 (95%CI 1.22-5.25), p = 0.01) were not affected. The overall ICU mortality was 58.4% (104/178).

CONCLUSION: The hyperlactatemia patients who underwent CRRT were at increased ICU mortality. Gender, AST, PT, SOFA score, history of hypertension, and mechanical ventilation were independent predictors for ICU mortality. Future studies with prospectively design, large sample size, and subgroup analyses are warranted to validate these findings.

PMID:36151706 | DOI:10.1177/03913988221126728

J Adv Nurs. 2022 Sep 23. doi: 10.1111/jan.15446. Online ahead of print.

ABSTRACT

AIMS: To assess the impact of community-level characteristics on the role of magnet designation in relation to hospital value-based purchasing quality scores, as health disparities associated with geographical location could confound hospitals’ ability to meet outcome metrics.

DESIGN: This cross-sectional study was carried out between October 2021 and March 2022 using data from 2016 to 2021.

METHODS: Propensity score analysis was used to match hospital and community-level characteristics, implementing nearest neighbour matching to adjust for pre-treatment differences between magnet and non-magnet hospitals to account for multi-level differences. Secondary data were obtained from all operational acute-care facilities in the United States that participated in the Centers for Medicare and Medicaid Services’ hospital value-based purchasing (HVBP) program. Dependent variables were the four value-based purchasing domains that comprise the Total Performance Score (TPS; Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction).

RESULTS: Magnet hospitals had increased odds for better scores in the HVBP domains of Clinical Care and Person and Community Engagement, and decreased odds for having better Safety. However, no statistically significant difference was found for the Efficiency domain or the TPS.

CONCLUSION: Measuring performance equitably across organizations of various sizes serving diverse communities remains a key factor in ensuring distributive justice. Analysing the TPS components can identify complex influences of community-level characteristics not evident at the composite level. More research is needed where community and nurse-level factors may indirectly affect patient safety.

IMPACT: This study’s findings on the role of community contexts can inform policymakers designing value-based care programs and healthcare management administrators deliberating on magnet certification investments across diverse community settings.

NO PATIENT OR PUBLIC CONTRIBUTION: For this study of US hospitals’ organizational performance, we did not engage members of the patient population nor the general public. However, the multi-disciplinary research team does include diverse perspectives.

PMID:36151700 | DOI:10.1111/jan.15446

Anat Rec (Hoboken). 2022 Sep 23. doi: 10.1002/ar.25067. Online ahead of print.

ABSTRACT

The geographic ranges in which species live is a function of many factors underlying ecological and evolutionary contingencies. Observing the geographic range of an individual species provides valuable information about these historical contingencies for a lineage, determining the distribution of many distantly related species in tandem provides information about large-scale constraints on evolutionary and ecological processes generally. We present a linear regression method that allows for the discrimination of various hypothetical biogeographical models for determining which landscape distributional pattern best matches data from the fossil record. The linear regression models used in the discrimination rely on geodesic distances between sampling sites (typically geologic formations) as the independent variable and three possible dependent variables: Dice/Sorensen similarity; Euclidean distance; and phylogenetic community dissimilarity. Both the similarity and distance measures are useful for full-community analyses without evolutionary information, whereas the phylogenetic community dissimilarity requires phylogenetic data. Importantly, the discrimination method uses linear regression residual error to provide relative measures of support for each biogeographical model tested, not absolute answers or p-values. When applied to a recently published dataset of Campanian pollen, we find evidence that supports two plant communities separated by a transitional zone of unknown size. A similar case study of ceratopsid dinosaurs using phylogenetic community dissimilarity provided no evidence of a biogeographical pattern, but this case study suffers from a lack of data to accurately discriminate and/or too much temporal mixing. Future research aiming to reconstruct the distribution of organisms across a landscape has a statistical-based method for determining what biogeographic distributional model best matches the available data.

PMID:36151605 | DOI:10.1002/ar.25067

Alzheimers Res Ther. 2022 Sep 23;14(1):138. doi: 10.1186/s13195-022-01079-4.

ABSTRACT

BACKGROUND: Early detection of individuals at risk for Alzheimer’s disease (AD) is highly important. Amyloid accumulation is an early pathological AD event, but the genetic association with known AD risk variants beyond the APOE4 effect is largely unknown. We investigated the association between different AD polygenic risk scores (PRS) and amyloid accumulation in the Flemish Prevent AD Cohort KU Leuven (F-PACK).

METHODS: We calculated PRS with and without the APOE region in 90 cognitively healthy F-PACK participants (baseline age 67.8 (52-80) years, 41 APOE4 carriers), with baseline and follow-up amyloid-PET (time interval 6.1 (3.4-10.9) years). Individuals were genotyped using Illumina GSA and imputed. PRS were calculated using three p-value thresholds (pT) for variant inclusion: 5 × 10^-8, 1 × 10^-5, and 0.1, based on the stage 1 summary statistics from Kunkle et al. (Nat Genet 51:414-30, 2019). Linear regression models determined if these PRS predicted amyloid accumulation.

RESULTS: A score based on PRS excluding the APOE region at pT = 5 × 10^-8 plus the weighted sum of the two major APOE variants (rs429358 and rs7412) was significantly associated with amyloid accumulation (p = 0.0126). The two major APOE variants were also significantly associated with amyloid accumulation (p = 0.0496). The other PRS were not significant.

CONCLUSIONS: Specific PRS are associated with amyloid accumulation in the asymptomatic phase of AD.

PMID:36151568 | DOI:10.1186/s13195-022-01079-4

Cardiovasc Diabetol. 2022 Sep 23;21(1):194. doi: 10.1186/s12933-022-01619-0.

ABSTRACT

BACKGROUND: Sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of kidney and heart failure events independent of glycemic effects. We assessed whether initiation of the SGLT2 inhibitor canagliflozin guided by multivariable predicted risk based on clinical characteristics and novel biomarkers is more efficient to prevent clinical outcomes compared to a strategy guided by HbA1c or urinary-albumin-creatinine ratio (UACR) alone.

METHODS: We performed a post-hoc analysis of the CANVAS trial including 3713 patients with available biomarker measurements. We compared the number of composite kidney (defined as a sustained 40% decline in eGFR, chronic dialysis, kidney transplantation, or kidney death) and composite heart failure outcomes (defined as heart failure hospitalization or cardiovascular (CV) death) prevented per 1000 patients treated for 5 years when canagliflozin was initiated in patients according to HbA1c ≥ 7.5%, UACR, or multivariable risk models consisting of: (1) clinical characteristics, or (2) clinical characteristics and novel biomarkers. Differences in the rates of events prevented between strategies were tested by Chi²-statistic.

RESULTS: After a median follow-up of 6.1 years, 144 kidney events were recorded. The final clinical model included age, previous history of CV disease, systolic blood pressure, UACR, hemoglobin, body weight, albumin, estimated glomerular filtration rate, and randomized treatment assignment. The combined biomarkers model included all clinical characteristics, tumor necrosis factor receptor-1, kidney injury molecule-1, matrix metallopeptidase-7 and interleukin-6. Treating all patients with HbA1c ≥ 7.5% (n = 2809) would prevent 33.0 (95% CI 18.8 to 43.3 ) kidney events at a rate of 9.6 (95% CI 5.5 to 12.6) events prevented per 1000 patients treated for 5 years. The corresponding rates were 5.8 (95% CI 3.4 to 7.9), 16.6 (95% CI 9.5 to 22.0) (P < 0.001 versus HbA1c or UACR approach), and 17.5 (95% CI 10.0 to 23.0) (P < 0.001 versus HbA1c or UACR approach; P = 0.54 versus clinical model). Findings were similar for the heart failure outcome.

CONCLUSION: Initiation of canagliflozin based on an estimated risk-based approach prevented more kidney and heart failure outcomes compared to a strategy based on HbA1c or UACR alone. There was no apparent gain from adding novel biomarkers to the clinical risk model. These findings support the use of risk-based assessment using clinical markers to guide initiation of SGLT2 inhibitors in patients with type 2 diabetes.

PMID:36151557 | DOI:10.1186/s12933-022-01619-0