Nevin Manimala

Int Ophthalmol. 2022 Nov 29. doi: 10.1007/s10792-022-02599-6. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate serum semaphorin 3A (Sema3A) and interleukin 6 (IL-6) levels in pseudoexfoliation syndrome (PXS) patients to determine whether these mediators play a role in the systemic manifestations of PXS.

METHODS: This prospective case-control study included 70 patients divided into PXS (n = 30) and a control group (n = 40). Serum Sema3A and IL-6 levels were analyzed using the enzyme-linked immunosorbent assay.

RESULTS: The PXS group had a statistically higher IL-6 level [3.6(0.64-100) pg/mL], compared to the control group [2.1(0.41-39.93) pg/mL] (p < 0.05). On the other hand, the Sema3A level of the PXS group was lower at [21.55(13.2-67.5) ng/mL] compared to the control group at [29.05(11.5-103.3) ng/mL] (p < 0.05). In the PXS group, there was no correlation between the participants’ IL-6 values and Sema3A, age, and body mass index (BMI) (r = 0.153, 0.000, – 0.103, respectively, all, p > 0.05), and between Sema3A values and age and BMI values (r = 0.048, – 0.133, respectively, all, p > 0.05). In the control group, there was no correlation between the participants’ IL-6 values and Sema3A, age, and BMI values (r = 0.138, – 0.001, – 0.145, respectively, all, p > 0.05) and between the Sema3A and age and BMI values (r = – 0.078, – 0.281, respectively, all, p > 0.05).

CONCLUSIONS: Decreased levels of the anti-inflammatory mediator Sema3A and increased levels of inflammatory mediator IL-6 detected in PXS suggest that these molecules may play a role in systemic manifestations of this syndrome, such as inflammation, atherosclerosis, heart arrhythmia, and Alzheimer’s disease.

PMID:36445548 | DOI:10.1007/s10792-022-02599-6

Int Ophthalmol. 2022 Nov 29. doi: 10.1007/s10792-022-02603-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the ability of the Internet-based Spaeth/Richman Contrast Sensitivity (SPARCS) in assessing the change in contrast sensitivity (both central and peripheral) post-treatment with travoprost 0.004%.

DESIGN: This is a prospective observational study.

METHODS AND PARTICIPANTS: Data of 62 eyes (33 patients) undergoing treatment for naïve POAG patients were analysed. Patients were followed up for a period of six months after starting topical travoprost (Travatan 0.004%, Alcon), and the change in central and peripheral CS was studied.

RESULTS: Mean total SPARCS score at baseline was 69 ± 10.99, improved to 74.62 ± 9.50 after 6 months of therapy (p: 0.001) in all the glaucoma severity groups. Mean SPARCS score at baseline in mild glaucoma group was 72.05 ± 9.87, in the moderate glaucoma group, it was 62.23 ± 9.2, and in the severe glaucoma group, it was 59.36 ± 11.65. After 6 months of treatment with travoprost, the CS improved to 76.05 ± 8.36 in mild group, 76.69 ± 8.82 in moderate group and 67.18 ± 11.15 in severe group (p value: 0.014). The percentage change in the CS from baseline showed significant improvement in the superotemporal quadrant at 1 month (p value: 0.032), superonasal quadrant (p value: 0.049), inferotemporal quadrant at 3 months (p value: 0.003) and 6 months (p value: 0.039). Inferonasal quadrant was affected most by glaucoma. A statistically significant correlation was seen between total SPARCS score with MD and PSD. Correlation was also seen between the percentage change in CS and average RNFL thickness at 3 and 6 months.

CONCLUSION: Both central and peripheral CS improve following IOP reduction with travoprost. Change in the CS has a significant correlation with RNFL thickness and the perimetric indices.

PMID:36445547 | DOI:10.1007/s10792-022-02603-z

J Patient Rep Outcomes. 2022 Nov 29;6(1):120. doi: 10.1186/s41687-022-00520-4.

ABSTRACT

BACKGROUND: Patient engagement is an important tool for quality improvement (QI) and optimizing the uptake of research findings. The Plan-Do-Study-Act (PDSA) model is a QI tool that encourages ongoing evaluation of clinical care, thus improving various aspects of patient care. Ascertaining pediatric patient priorities for a pain questionnaire in the post-acute, or transitional pain, setting is important to guide clinical care since active engagement with the population of interest can optimize uptake. We used the PDSA model to adapt a chronic pain questionnaire for the pediatric transitional pain setting to reflect pediatric patient and parent/guardian preferences and to form an example of how the PDSA model can be used to improve clinical care through patient engagement.

METHODS: This project employed the PDSA model to adapt the pediatric Ontario Chronic Pain Questionnaire for use in the pediatric Transitional Pain Service (pedTPS) setting. Plan: Following reviewing the Ontario Chronic Pain Questionnaire and literature on pain questionnaire development, goal-based questions, questions on pain location, relevant Patient-Reported Outcomes Measurement Information System (PROMIS^®) measures and the Pain Catastrophizing Scale, child (PCS-C) and parent (PCS-P), informed the questionnaire. Do: The questionnaire and a satisfaction survey were sent to patients and families through Research Electronic Data Capture (REDCap™).

STUDY: Results from the satisfaction survey were analyzed. Act: Using descriptive statistics employing ordinal mixed-models with random effects, ANOVA, and double-blinded qualitative thematic coding, questionnaire preferences were analyzed and the questionnaire was adapted accordingly before implementation into the (pedTPS).

RESULTS: Eighty-eight questionnaires and satisfaction surveys were analyzed from 69 respondents (32 patients; 37 parents/guardians). Sixty-six (75.00%) surveys indicated satisfaction with the questionnaire. A combined 77 (87.50%) “strongly agreed” (25/88) or “agreed” (52/88) that the questionnaire language was clear. The application of suggested changes to the questionnaire resulted in four versions across the project timeline, which reflected patient and parent/guardian preferences for questions that reflect the themes, “Story”; “Time-Optimal”; and “Pertinent” (“STOP”). There were no statistically significant differences in satisfaction across the versions due to sample size.

CONCLUSION: Most respondents were satisfied with the questionnaire and prefer “STOP” questions. Future studies will focus on testing the questionnaire for validity and reliability across pedTPS populations.

PMID:36445535 | DOI:10.1186/s41687-022-00520-4

Environ Sci Pollut Res Int. 2022 Nov 29. doi: 10.1007/s11356-022-24347-0. Online ahead of print.

ABSTRACT

Excess surface water after heavy rainfalls leads to soil erosion and flash floods, resulting in human and financial losses. Reducing runoff is an essential management tool to protect water and soil resources. This study aimed to evaluate the effects of vegetation and land management methods on runoff control and to provide a model to predict runoff values. Filed plot data and three machine learning (ML) methods, including artificial neural network (ANN), coactive neuro-fuzzy inference system (CANFIS), and extreme gradient boosting (EGB), were used in a test site in the north of Iran. In this regard, plots with various vegetation and land management treatments including bare soil treatment, rangeland cover treatment, forest litter treatment, rangeland litter treatment, tillage treatment in the direction of slope, tillage treatment perpendicular to the slope, and repetition of treatments under forest canopy were constructed on a hillslope. After each rainfall event, the amount of rainfall and corresponding runoff generated in each plot was recorded. Three ML models (ANN, CANFIS, and EGB) were used to establish relationships between amounts of recorded runoff and its controlling factors (rainfall, antecedent soil moisture (A.M.C), shrub canopy percentage and height, tree canopy percentage and height, soil texture (clay, silt, and sand percent), slope degree, leaf litter percentage of soil, and tillage interval). These data were normalized, randomized, and divided into training and testing subsets. Results showed that the ANN performed better than the other two models in predicting runoff in training (R² = 0.98; MSE = 0.004) and the test stages (R² = 0.90; MSE = 0.95). Statistical analysis and sensitivity analysis of inputs factors showed that rainfall, rangeland cover, and A.M.C are the three most important factors controlling runoff generation. The adopted method can be used to predict the effect of different vegetation and land management scenarios on runoff generation in the study area and the areas with similar settings elsewhere.

PMID:36445518 | DOI:10.1007/s11356-022-24347-0

Eur J Pediatr. 2022 Nov 29. doi: 10.1007/s00431-022-04723-1. Online ahead of print.

ABSTRACT

This study aims to examine if small for gestation age (SGA) status is correlated with alterations in body composition at prepuberty, independently of other factors, comparing SGA-born children with appropriate for gestational age (AGA)-born children. We examined anthropometrics, waist circumference, body mass index (BMI), six skinfold thickness, and body composition using the method of bioelectrical impedance in 636 children aged 7 to 10 years. We also considered age, gender, birth mode, mother’s age, prepregnancy weight, weight gain during pregnancy, social status, parental BMI, type of feeding, and daily exercise. We examined 636 children at a mean age of 9 years: 106 SGA-born and 530 AGA-born children. SGA as compared to AGA-born children had a lower BMI z-score (0.26 ± 0.89 kg/cm² vs 0.46 ± 0.84 kg/cm², p < 0.050) and a lower lean mass, although that was not statistically significant (24.0 ± 6.6 kg vs 25.6 ± 6.4 kg, p < 0.100). SGA-born children presented no difference in waist circumference or fat mass in comparison to children born AGA. Logistic regression analysis revealed a strong independent negative association between SGA status and BMI (beta = – 2.33, OR = 0.70 p = 0.019) and SGA status and lean mass (beta = – 2.43, OR = 0.95 p = 0.010). Conclusion: Our findings suggest that SGA-born children had a lower BMI as compared to AGA-born subjects, whereas SGA status was negatively associated with BMI and lean mass. What is Known: • Deviant birth weight for gestation has been associated with an increased risk of childhood adiposity. • Evidence remains scarce on whether small for gestational age status affects body composition and obesity later in childhood. What is New: • Among school-aged children, small for gestational age subjects had a lower body mass index as compared to appropriate for gestational age counterparts, whereas small for gestational age status was negatively associated with body mass index and lean mass. • A meticulous observation is needed during childhood in children born with deviant birth weight.

PMID:36445515 | DOI:10.1007/s00431-022-04723-1

Environ Monit Assess. 2022 Nov 29;195(1):163. doi: 10.1007/s10661-022-10725-1.

ABSTRACT

Technological advances in water quality measurement systems have provided the potential to expand high-frequency observations into coastal monitoring programs. However, with limited resources for monitoring budgets in natural waters that exhibit high temporal and spatial variability in water quality, there is a need to identify the locations and time periods where these new technologies can be deployed for maximum efficacy. To advance the capacity to make quantitative and objective decisions on the selection of monitoring locations and sampling frequency, we combined high-resolution numerical model simulations and multi-frequency water quality measurements to conduct a power analysis comparing alternative sampling designs in the assessment of water quality in the Chesapeake Bay. Specifically, we evaluated candidate monitoring networks that deployed both conventional long-term fixed station monitoring in deep channel areas and short-term continuous monitoring technologies in near-shore, shallow areas to assess 30-day dissolved oxygen criteria in two Bay tributaries. We conducted a cumulative frequency diagrams analysis to quantify the accuracy of each monitoring scheme in evaluating compliance with respect to the model. We used a Monte Carlo simulation to incorporate the spatial and temporal uncertainty of criteria failure. We found that additional long-term biweekly channel and short-term continuous shallow sampling efforts can lead to statistically unbiased and improved assessments at local spatial extents (less than 0.2 proportion of the assessed water body), especially when additional sampling is added at stations representing hypoxic water areas. Stations that represented seaward regions of the tributaries were more valuable in maintaining unbiased assessments of dissolved oxygen criteria attainment. This analysis highlights the importance of statistical evaluation of ongoing monitoring programs and suggests an approach to identify efficient deployments of monitoring resources and to improve assessment of other water quality metrics in estuarine ecosystems.

PMID:36445501 | DOI:10.1007/s10661-022-10725-1

Environ Monit Assess. 2022 Nov 29;195(1):165. doi: 10.1007/s10661-022-10731-3.

ABSTRACT

The Gushegu Municipality and the East Mamprusi District in Ghana are dominated by the Oti/Pendjari Group within the Voltaian Supergroup. The major rock types found in the area are quartzites, siltstones, conglomerates, and shales with minor occurrences of tillites, silexites, limestones, and barite-rich dolomites. The inhabitants of the area are mainly peasant farmers, and their activities might be influencing the groundwater chemistry, but little is known about the quality of the groundwater. Therefore, this study evaluated the suitability of groundwater resources in the Gushegu Municipality, and some parts of the East Mamprusi District in Ghana for domestic and irrigation uses, employing hydrogeochemical graphing, geochemical modelling, multivariate statistical analysis, and computation of water quality indices. Sodium (Na⁺), with concentrations ranging from 4.93 to 323 mg/L and a mean of 169 mg/L, is found to be the major cation in the groundwater, while bicarbonate (HCO₃^–), with concentrations ranging from 19.9 to 685 mg/L and a mean of 397 mg/L, is the major anion in the area. The dominant hydrochemical facies is the Na-HCO3 type, accounting for about 72.7% of the study area’s groundwater and is influenced by silicate weathering, carbonate mineral dissolution, and ion exchange reactions. Other factors accounting for this dominance may be anthropogenic activities, including the dissolution and leaching of fertilizers from farmlands. Overall, this study reveals that the groundwater in the area is suitable for drinking based on the WQI classification. There are localized contaminations with respect to B and F^–, making the water in those areas unsuitable for drinking. Also, the groundwater in the area is unsuitable for irrigation purposes due to the high Na% values (43 to 99% with a mean of 86%), magnesium hazard values (1 to 312 with a mean of 88), and sodium adsorption ratio (0.57 to 42.4 with a mean of 12.7). All these indices exceed their respective standards for irrigation purposes.

PMID:36445497 | DOI:10.1007/s10661-022-10731-3

Eur J Orthop Surg Traumatol. 2022 Nov 29. doi: 10.1007/s00590-022-03431-8. Online ahead of print.

ABSTRACT

PURPOSE: This study, set in in the Kurdistan region of Iraq, describes the epidemiology and outcomes of anterior cruciate ligament reconstruction (ACLR) followed by home-based rehabilitation alone.

METHODS: A cohort observational study of patients aged ≥ 16 years with an ACL rupture who underwent an ACLR under a single surgeon. Followed by a home-based rehabilitation programme of appropriate simplicity for completion in the home setting; consisting of stretching, range of motion and strengthening exercises. Demographics, mechanism of injury, operative findings, and outcome data (Lysholm, Tegner Activity Scale (TAS), and revision rates) were collected from 2016 to 2021. Data were analysed using descriptive statistics.

RESULTS: The cohort consisted of 545 patients (547 knees), 99.6% were male with a mean age of 27.8 years (SD 6.18 years). The mean time from diagnosis to surgery was 40.6 months (SD 40.3). Despite data attrition Lysholm scores improved over the 15-month follow-up period, matched data showed the most improvement occurred within the first 2 months post-operatively. Post-operative TAS results showed an improvement in level of function, but did not reach pre-injury levels by final follow-up. At final follow-up, six (1.1%) patients required an ACLR revision.

CONCLUSION: Patients who completed a home-based rehabilitation programme in Kurdistan had low revision rates and improved Lysholm scores 15 months post-operatively. To optimise resources, further research should investigate the efficacy of home-based rehabilitation for trauma and elective surgery in low- to middle-income countries and the developed world.

PMID:36445460 | DOI:10.1007/s00590-022-03431-8

Hum Genet. 2022 Nov 29. doi: 10.1007/s00439-022-02507-z. Online ahead of print.

ABSTRACT

Pain often occurs in parallel with neuropsychiatric disorders. However, the underlying mechanisms and potential causality have not been well studied. We collected the genome-wide association study (GWAS) summary statistics of 26 common pain and neuropsychiatric disorders with sample size ranging from 17,310 to 482,730 in European population. The genetic correlation between pair of pain and neuropsychiatric disorders, as well as the relevant cell types were investigated by linkage disequilibrium (LD) score regression analyses. Then, transcriptome-wide association study (TWAS) was applied to identify the potential shared genes by integrating the gene expression information and GWAS. In addition, Mendelian randomization (MR) analyses were conducted to infer the potential causality between pain and neuropsychiatric disorders. Among the 169 pairwise pain and neuropsychiatric disorders, 55 pairs showed positive correlations (median r_g = 0.43) and 9 pairs showed negative correlations (median r_g = -0.31). Using MR analyses, 26 likely causal associations were identified, including that neuroticism and insomnia were risk factors for most of short-term pain, and multisite chronic pain was risk factor for neuroticism, insomnia, major depressive disorder and attention deficit/hyperactivity disorder, and vice versa. The signals of pain and neuropsychiatric disorders tended to be enriched in the functional regions of cell types from central nervous system (CNS). A total of 19 genes shared in at least one pain and neuropsychiatric disorder pair were identified by TWAS, including AMT, NCOA6, and UNC45A, which involved in glycine degradation, insulin secretion, and cell proliferation, respectively. Our findings provided the evidence of shared genetic structure, causality and potential shared pathogenic mechanisms between pain and neuropsychiatric disorders, and enhanced our understanding of the comorbidities of pain and neuropsychiatric disorders.

PMID:36445456 | DOI:10.1007/s00439-022-02507-z

Brain. 2022 Nov 29:awac439. doi: 10.1093/brain/awac439. Online ahead of print.

ABSTRACT

There is a lack of imaging markers revealing the functional characteristics of different brain regions in paediatric dystonia. In this observational study, we assessed the utility of [18F]2-fluoro-2-deoxy-D-glucose (FDG)-PET in understanding dystonia pathophysiology by revealing specific resting awake brain glucose metabolism patterns in different childhood dystonia subgroups. PET scans from 267 children with dystonia being evaluated for possible Deep Brain Stimulation (DBS) surgery between September 2007 and February 2018 at Evelina London Children’s Hospital (ELCH) United Kingdom were examined. Scans without gross anatomical abnormality (e.g. large cysts, significant ventriculomegaly; n = 240) were analysed with Statistical Parametric Mapping (SPM12). Glucose metabolism patterns were examined in the 144/240 (60%) cases with the ten commonest childhood-onset dystonias, focusing on nine anatomical regions. A group of thirty-nine adult controls was used for comparisons. The genetic dystonias were associated with the following genes: TOR1A, THAP1, SGCE, KMT2B, HPRT1 (Lesch Nyhan disease), PANK2 and GCDH (Glutaric Aciduria type 1). The acquired Cerebral Palsy (CP) cases were divided into those related to prematurity (CP-Preterm), neonatal jaundice/kernicterus (CP-Kernicterus) and hypoxic-ischaemic encephalopathy (CP-Term). Each dystonia subgroup had distinct patterns of altered FDG-PET uptake. Focal glucose hypometabolism of the pallidi, putamina, or both, was the commonest finding, except in PANK2, where basal ganglia metabolism appeared normal. HPRT1 uniquely showed glucose hypometabolism across all nine cerebral regions. Temporal lobe glucose hypometabolism was found in KMT2B, HPRT1 and CP-Kernicterus. Frontal lobe hypometabolism was found in SGCE, HPRT1, and PANK2. Thalamic and brainstem hypometabolism were seen only in HPRT1, CP-Preterm and CP-term dystonia cases. The combination of frontal and parietal lobe hypermetabolism was uniquely found in CP-term cases. PANK2 cases showed a distinct combination of parietal hypermetabolism with cerebellar hypometabolism but intact putaminal-pallidal glucose metabolism. HPRT1, PANK2, CP-kernicterus and CP-preterm cases had cerebellar and insula glucose hypometabolism as well as parietal glucose hypermetabolism. The study findings offer insights into the pathophysiology of dystonia and support the network theory for dystonia pathogenesis. “Signature” patterns for each dystonia subgroup could be a useful biomarker to guide differential diagnosis and inform personalised management strategies.

PMID:36445406 | DOI:10.1093/brain/awac439