Nevin Manimala

Chemosphere. 2023 Jan 9:137796. doi: 10.1016/j.chemosphere.2023.137796. Online ahead of print.

ABSTRACT

Glyphosate-based herbicides (GBHs) are one of the most commonly used herbicides worldwide. Numerous in vitro and in vivo model system studies have demonstrated endocrine-disrupting chemical (EDC) properties associated with glyphosate/GBH exposure. The present hypothesis-testing study evaluated the potential inverse dose-dependent relationship between increasing urinary glyphosate and decreasing concentrations of blood sex hormones. Demographic and newly available lab test data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were analyzed with survey regression modeling (adjusted for age, gender, race, and country of birth) in Statistical Analysis System (SAS) software. A total of 225, 615, 858 weighted-persons (sample n = 2130 persons) were examined for concentrations of urinary glyphosate and the serum sex hormones (including: total testosterone, total estradiol, and sex hormone binding globulin (SHBG)) among males and females, 6 years-old or older. This study revealed about 82% of the population of the United States examined had detectable urinary concentrations of glyphosate. A significant inverse correlation between concentrations of glyphosate and total estradiol and a trend towards an inverse correlation between concentrations of glyphosate and total testosterone were observed. Concentrations of SHBG and glyphosate did not correlate. Ratios of total testosterone:SHBG and total estradiol:SHBG (estimating the fraction of active sex hormones in the blood) were significantly inversely correlated with urinary concentrations of glyphosate. This epidemiological study associates widespread and ongoing glyphosate/GBH exposures with human endocrine-disruptions. Future studies should examine these phenomena in other databases and other endocrine-related disorders.

PMID:36632954 | DOI:10.1016/j.chemosphere.2023.137796

J Infect. 2023 Jan 9:S0163-4453(23)00009-9. doi: 10.1016/j.jinf.2023.01.008. Online ahead of print.

NO ABSTRACT

PMID:36632942 | DOI:10.1016/j.jinf.2023.01.008

Diabetes Res Clin Pract. 2023 Jan 8:110244. doi: 10.1016/j.diabres.2023.110244. Online ahead of print.

ABSTRACT

AIMS: To determine the burden and leading reasons for mental health hospitalisation among Australians with diabetes.

METHODS: We determined incidence of hospitalisation for all mental health disorders in people with type 1 or type 2 diabetes of all ages by linking the National Diabetes Services Scheme to hospital admission datasets from 2010-2017. We compared those with type 2 diabetes aged 15 and above to the general population using excess hospitalisations per 100,000 person-years associated with diabetes.

RESULTS: Depressive disorders were the leading reason for mental health admission in Australians with diabetes, responsible for 6.09 (95% CI 5.78 – 6.42) and 7.05 (6.95 – 7.14) admissions per 1,000 person-years in those with type 1 and type 2 diabetes, respectively. When considering only one admission per person, mental health admission rates were up to 90% lower. Among males with type 2 diabetes, stress and adjustment disorders were the leading cause of excess admissions compared to the general population, while depressive disorders were the leading cause in females.

CONCLUSIONS: We found a substantial burden of psychiatric hospitalisations among Australians with diabetes, reinforcing the importance of mental health awareness among diabetes clinicians, and support by psychiatric teams for those with diabetes to prevent readmission.

PMID:36632938 | DOI:10.1016/j.diabres.2023.110244

Appetite. 2023 Jan 8:106450. doi: 10.1016/j.appet.2023.106450. Online ahead of print.

ABSTRACT

Genetically modified (GM) foods have been assumed to be seen through intuitive and affective routes (i.e., affect heuristics) rather than analytical and deliberative routes. We examined the impact of the graphical presentation of benefits derived from GM or conventionally bred foods on the acceptance of these varieties. In the two experiments (n = 266 for study 1 and n = 402 for study 2), no differences emerged in the estimation of farmers’ benefits resulting from the introduction of improved varieties by the type of improvement. However, there was a statistically significant difference in the magnitude of risk and the degree of acceptance of the improved varieties. Therefore, despite presenting identical benefits as a graphical figure, GM foods were consistently evaluated as providing higher risk and were less frequently accepted than conventionally bred foods. These results suggest that while the graphical presentation of benefits may promote comprehension of some advantages of the introduction of GM varieties, this may not lead to acceptance from the consumer’s point of view. Based on the current findings, as well as previous studies on trust in risk managers, we discuss the specific factors that might promote acceptance of GM products.

PMID:36632936 | DOI:10.1016/j.appet.2023.106450

Contemp Clin Trials. 2023 Jan 9:107082. doi: 10.1016/j.cct.2023.107082. Online ahead of print.

ABSTRACT

BACKGROUND: Early in the pandemic, there were no evidence-based treatments for SARS-CoV-2, creating an urgent need to identify effective therapeutics. However, public participation in medical research is low; trial enrollment in the US is typically 10-20%. Thus, the aim of this study was to identify common themes underpinning patient reasons to decline participation and evaluate the impact of specific contextual factors.

METHODS: This sub-study was conducted in five VISN-1 Clinical Trials Network participating facilities from 4/10/2020-2/3/2021. The trial evaluated the addition of the IL-6-inhibitor, Sarilumab, to the current standard of care for inpatients with moderate-to-severe SARS-CoV-2. Consent procedures varied by site and included fully in-person and fully remote processes. Reasons for declining enrollment were collected among eligible patients who declined to participate but agreed to answer a short follow-up question. Qualitative data were analyzed using directed content analysis. Enrollment rates were assessed using simple, descriptive statistics.

RESULTS: N = 417 COVID-19 positive inpatients were screened and 53/162 eligible patients enrolled. Enrollment varied across study sites and by study period. Prior to identification of effective treatment, the enrollment rate was 10/11 (91%) versus 43/144 (30%) during the later period of the study. N = 85/102 patients who did not enroll answered the follow-up question. The most commonly reported responses were: concerns about the study drug and participation in clinical research in general, comorbidity concerns, competing priorities, external factors, and external advice and influence from family members and clinicians.

CONCLUSIONS: Identifying reasons behind declining to enroll may help investigators develop strategies to increase research participation.

PMID:36632925 | DOI:10.1016/j.cct.2023.107082

J Pharm Sci. 2023 Jan 9:S0022-3549(23)00003-5. doi: 10.1016/j.xphs.2023.01.001. Online ahead of print.

ABSTRACT

For systemically administered monoclonal antibodies (mAbs) with pharmacological targets in the epithelial lining fluid (ELF), information on the partitioning of mAb between plasma and ELF is instrumental for dose predictions. Bronchoalveolar lavage (BAL) combined with measurements of urea as indicator of sample dilution is often used to estimate ELF concentrations of a drug. However, unbalanced extraction of mAb and urea could potentially lead to a systematic bias in the back-calculated ELF concentration. In the present study 0.5, 1, or 4 mL phosphate-buffered saline was instilled to lungs of rats to obtain lavage samples after systemic dosing of mAb and tool small molecule (n≥4/group). Furthermore, extraction of urea, mAb and the small molecule was assessed by repeatedly lavaging the lung (n=4). There was no statistically significant difference in the calculated partitioning into ELF between the evaluated instillation volumes. Repeated BAL demonstrated that urea and the small molecule were extracted from other sources than the ELF. In contrast, there was limited to none in-flow of mAb into the lavage fluid. The unbalanced extraction of urea and mAb could theoretically result in underestimated ELF concentrations and the calculated partitioning of 0.17±0.062 might therefore constitute a lower boundary for the true partitioning.

PMID:36632919 | DOI:10.1016/j.xphs.2023.01.001

Int J Infect Dis. 2023 Jan 9:S1201-9712(22)00683-X. doi: 10.1016/j.ijid.2022.12.044. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had a disruptive impact on tuberculosis (TB) and HIV services. We assessed the in-hospital TB diagnostic care among people with HIV (PWH) overall, before and during the pandemic.

METHODS: In this prospective study, adult PWH admitted at three hospitals in Ghana were recruited if they had a positive World Health Organization four-symptom screen (W4SS), or one or more WHO danger signs or advanced HIV. We collected data on patient characteristics, TB assessment and clinical outcomes after 8 weeks and used descriptive statistics and survival analysis.

RESULTS: We enrolled 248 PWH with a median CD4 count of 80.5 cells/mm³ (IQR 24-193). Of those, 246 (99.2%) patients had a positive W4SS. Overall, 112 (45.2%) patients obtained a sputum Xpert result, 66 (46.5%) in the pre-pandemic and 46 (43.4%) in the pandemic period, p=0.629. The TB prevalence of 46/246 (18.7%) was similar in the pre-pandemic 28/140 (20.0%) and pandemic 18/106 (17.0%) population, p=0.548. The 8 weeks all-cause mortality was 62/246 (25.2%) with no difference in cumulative survival when stratifying for pandemic period, log-rank p=0.412.

CONCLUSIONS: The study highlighted a large gap in access to TB investigation and high early mortality among hospitalized PWH, irrespective of the COVID-19 pandemic.

PMID:36632893 | DOI:10.1016/j.ijid.2022.12.044

Photodiagnosis Photodyn Ther. 2023 Jan 8:103275. doi: 10.1016/j.pdpdt.2023.103275. Online ahead of print.

ABSTRACT

PURPOSE: to detect the effect of various types of COVID-19 vaccine on macular and optic disc microvasculature.

METHOD: one hundred subjects receiving various types of COVID-19 vaccine (AstraZeneca, Sinopharm, Sinovac, Pfizer, and Moderna) were included in this study. A complete ophthalmic examination was done which included best-corrected visual acuity measurement, slit-lamp biomicroscopy, intraocular pressure measurement with Goldmann applanation tonometry, and fundus examination. Optical coherence tomography angiography (OCT-A) was done before and 1 week after receiving the vaccine. Superficial and deep macular capillary densities were measured in the form of the whole image, fovea, parafoveal, and perifoveal capillary density. Optic disc vessel density in the form of the whole disc, inside disc, and peripapillary were also measured.

RESULTS: The superficial macular vessel densities, (whole image, fovea, parafoveal, and perifoveal) showed statistically non-significant changes with P-values (0.269, 0.167, 0.346, and 0.476) respectively. Also, the deep macular vessel densities showed statistically non-significant changes with P-values (0.491, 0.096, 0.724, and 0.386) for the whole image, fovea, parafoveal, and perifoveal respectively. Moreover, RPC (radial peripapillary capillary) density showed no significant changes either (the whole disc, inside disc, or peripapillary) with P-values (0.807, 0.141, 0.883) respectively.

CONCLUSION: various types of COVID-19 vaccines had no statistically significant effects on macular or optic disc microvasculature.

PMID:36632871 | DOI:10.1016/j.pdpdt.2023.103275

Am J Epidemiol. 2023 Jan 11:kwad010. doi: 10.1093/aje/kwad010. Online ahead of print.

ABSTRACT

Ensuring that patients with opioid use disorder (OUD) have access to optimal medication therapies is a critical challenge in substance use epidemiology. The paper by Rudolph et al. (Am J Epidemiol. 2022; XXX(X):XXXX-XXXX) demonstrated that sophisticated data-adaptive statistical techniques can be used to learn optimal, individualized treatment rules which can aid providers in choosing a medication for opioid use disorder (MOUD) treatment modality for a particular patient. This important work also highlights the effects of the mathematization of epidemiologic research. Here, we define mathematization and demonstrate how it operates in the context of MOUD effectiveness research using the paper by Rudolph et al. as a springboard. In particular, we address the normative dimension of mathematization, and how it tends to resolve a fundamental tension in epidemiologic practice between technical sophistication and public health considerations in favor of more technical solutions. The process of mathematization is a fundamental part of epidemiology; we argue not for eliminating it but for balancing mathematization and technical demands equally with practical and community-centric public health needs.

PMID:36632844 | DOI:10.1093/aje/kwad010

Ren Fail. 2023 Dec;45(1):2158103. doi: 10.1080/0886022X.2022.2158103.

ABSTRACT

BACKGROUND: Immune-inflammatory biomarkers (IIBs) have been shown to be correlated with prognosis in patients undergoing peritoneal dialysis (PD). In this study, we aimed to evaluate the relationship between a novel comprehensive biomarker, the pan-immune-inflammation value (PIV), and the prognosis of patients undergoing PD.

METHODS: We retrospectively analyzed data from a multicenter, large-sample PD database. PIV was calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count. The prognostic endpoints in this study were all-cause death all-cause, cardiovascular disease (CVD) and infection-related death. The Kaplan-Meier method, a Cox proportional hazards regression, Fine-Gray competing risk model, smooth curve, and subgroup analysis were used to analyze the independent relationship between PIV and the prognosis of patients undergoing PD.

RESULTS: A total of 2796 cases of PD were included, and the study population was divided into Tertiles 1, 2, and 3, according to the tertiles of baseline PIVs. After adjusting for multiple model factors, patients in the Tertile 3 group had a significantly higher risk of all-cause death, CVD death and infection-related death compared with patients with PIV in the Tertile 1 group. Interaction tests showed no positive correlations for subgroup parameters. Regarding all-cause death, compared with the lowest tertile, the multivariable-adjusted hazard ratios (95% confidence intervals) of the highest and middle tertiles were 1.55 (1.25-1.94) and 1.77 (1.43-2.19), respectively; PIV (log2 processing) was associated with 17% excess of mortality in the continuous model.

CONCLUSIONS: A high PIV at baseline was significantly associated with an increased risk of deaths due to all-causes, CVD and infection in patients undergoing PD.

PMID:36632816 | DOI:10.1080/0886022X.2022.2158103