Nevin Manimala

JAMA Neurol. 2021 Nov 1. doi: 10.1001/jamaneurol.2021.3926. Online ahead of print.

ABSTRACT

IMPORTANCE: The protective effects of physical activity (PA) against Parkinson disease (PD) development have been suggested; however, the association of PA with mortality in PD has rarely been investigated.

OBJECTIVE: To evaluate the association between PA and mortality in individuals with PD and determine how the amount and maintenance of PA are associated with mortality.

DESIGN, SETTING, AND PARTICIPANTS: This nationwide population-based cohort study used Korean National Health Insurance System data. Participants were included from January 1, 2010, and December 31, 2013, and were followed up until December 31, 2017. Data were analyzed from September 2020 to March 2021. Individuals who were newly diagnosed with PD were selected using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code G20 and registration code V124 in the program for rare intractable diseases in 2010 through 2013. Individuals who underwent health checkups within 2 years before and after the PD diagnosis were enrolled. Those aged younger than 40 years or with missing data were excluded.

EXPOSURES: Physical activity levels were collected using self-reported questionnaires.

MAIN OUTCOMES AND MEASURES: All-cause mortality.

RESULTS: A total of 45 923 individuals were identified; 10 987 were enrolled, and 34 individuals younger than 40 years and 254 with missing data were excluded. A total of 10 699 individuals with PD were included; 4925 (46%) were male and 5774 (54%) were female, and the mean (SD) age was 69.2 (8.8) years. During the 8-year follow-up period, there were 1823 deaths (17%). The mortality rate was lower among individuals who were physically active vs inactive at all PA intensities (vigorous: hazard ratio [HR], 0.80 [95% CI, 0.69-0.93]; moderate: HR, 0.66 [95% CI, 0.55-0.78]; light: HR, 0.81 [95% CI, 0.73-0.90]). There was a significant inverse dose-response association between the total amount of PA and mortality (HRs: vigorous, 0.80 [95% CI, 0.69-0.93]; moderate, 0.66 [95% CI, 0.55-0.78]; light, 0.81 [95% CI, 0.73-0.90]; P < .001). Moreover, maintenance of PA was associated with the mortality rate. Individuals with PD who were physically active both before and after the PD diagnosis had the greatest reduction in mortality rate across all PA intensities (HRs: vigorous, 0.66 [95% CI, 0.50-0.88]; moderate, 0.49 [95% CI, 0.32-0.75]; light, 0.76 [95% CI, 0.66-0.89]). Individuals who started PA after receiving the PD diagnosis had a lower mortality rate than those who remained physically inactive (HRs: vigorous, 0.82 [95% CI, 0.70-0.97]; moderate, 0.69 [95% CI, 0.57-0.83]; light, 0.86 [95% CI, 0.78-0.98]).

CONCLUSIONS AND RELEVANCE: This analysis found a dose-response association between PA and all-cause mortality in PD. Reverse causality may exist, and future prospective randomized clinical trials are warranted to determine the effect of PA on mortality in PD.

PMID:34724534 | DOI:10.1001/jamaneurol.2021.3926

Health Aff (Millwood). 2021 Nov;40(11):1731-1739. doi: 10.1377/hlthaff.2021.01135.

ABSTRACT

Although all state Medicaid programs cover children’s dental care, Medicaid-eligible children are more likely to experience tooth decay than children in higher-income families. Using data from the 1999-2016 National Health and Nutrition Examination Survey and the 2003, 2007, and 2011-12 waves of the National Survey of Children’s Health, we examined the association between Medicaid adult dental coverage (an optional benefit) and children’s oral health. Adult dental coverage was associated with a statistically significant 5-percentage-point reduction in the prevalence of untreated caries among children after Medicaid-enrolled adults had access to coverage for at least one year. These policies were also associated with a reduction in parent-reported fair or poor child oral health with a two-year lag between the onset of the policy and the effect. Effects were concentrated among children younger than age twelve. We estimated declines in poor oral health among all racial and ethnic subgroups, although there was some evidence that non-Hispanic Black children experienced larger and more persistent effects than non-Hispanic White children. Future assessments of the costs and benefits of offering adult dental coverage may consider potential effects on the children of adult Medicaid enrollees.

PMID:34724426 | DOI:10.1377/hlthaff.2021.01135

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):485-496. doi: 10.17306/J.AFS.0971.

ABSTRACT

BACKGROUND: In pork colour measurements, the value of each parameter depends on the type of illuminant used. The spectra of D65 and A illuminants show great differences, with illuminant A having greater emission in the red part of the visible spectrum. Therefore, its application in the colour measurements of the pork longissimus muscle should result in larger changes in redness (&Delta;a*) and hue angle (&Delta;h&deg;) and higher correlation between &Delta;a* and &Delta;h&deg; and pH48 and WHC. The purpose of this study was to compare the suitability of the illuminant/observer systems D65/10&deg; and A/10&deg; for colour measurements of pork longissimus muscle, using the CIELAB and CIELCh systems.

METHODS: The study involved 168 samples of longissimus lumborum muscle taken from 168 carcasses (mean weight 90.2 &plusmn;6.0 kg) of pigs slaughtered on an industrial processing line. The moisture content, crude protein, intramuscular fat content, WHC, and pH48 were determined. Colour measurements using CIELAB and CIELCh scales were carried out with both D65/10&deg; and A/10&deg; illuminant/observer systems and reflectance measurements. The chromatic absorbance value at 525 nm (A525p) and the relative amounts of MbO2, MetMb, and Mb were calculated according to methods proposed by Krzywicki (1979) and AMSA (2012). Meat samples were illuminated and differences in the values of colour parameters (&Delta;L*, &Delta;a*, &Delta;b*, &Delta;C*, &Delta;h&deg;), chromatic absorbance at 525 nm (&Delta;A525p), and in the relative amounts of chemical forms of myoglobin (&Delta;MbO2, &Delta;MetMb, &Delta;Mb) were determined. In addition, hue difference (&Delta;H) and total difference (&Delta;E) were calculated.

RESULTS: The values of correlation coefficients between moisture content (especially crude protein and intramuscular fat, and colour parameters) were low and often statistically insignificant. Higher and mostly significant values of correlation coefficients were found between colour parameters and WHC and pH48. The A/10&deg; system resulted in higher values of correlation coefficients than D65/10&deg; between (I) WHC, pH48 and (II) h&deg;, &Delta;a* and &Delta;h&deg;. At the same time, in the A/10&deg; system the combined effect of the relative amounts of myoglobin chemical forms on the variation of h&deg; values and the combined effect of changes (&Delta;) in their amounts on the variation of &Delta;h&deg; and &Delta;H and &Delta;E were greater than in D65/10&deg;, with the greatest effect of these changes (&Delta;) in the amount of MetMb.

CONCLUSIONS: Replacement of the illuminant/observer D65/10&deg; system with the A/10&deg; system in colour measurements of raw pork longissimus muscle changed the proportion of pigments and the relative number of chemical forms of myoglobin in influencing the values of colour parameters, primarily h&deg;. Therefore, using the A/10&deg; system for colour measurements allows us to better capture the differences (&Delta;) in redness &Delta;a* and especially in hue angle (&Delta;h&deg;), as well as hue difference (&Delta;H) and total difference (&Delta;E), with an increase in the relative amount of MetMb becoming the main determinant of these differences (&Delta;). At the same time, measurements using the A/10&deg; system increased the correlation coefficients between WHC and pH48 and changes in redness (&Delta;a*) and hue angle (&Delta;h&deg;). Therefore, the A/10&deg; system compared to the D65/10&deg; system may be more useful for measuring the colour stability of raw pork, especially the determination of &Delta;h&deg; and &Delta;H and &Delta;E. >.

PMID:34724372 | DOI:10.17306/J.AFS.0971

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):465-472. doi: 10.17306/J.AFS.0977.

ABSTRACT

BACKGROUND: The aim of the current study was to assess the antimicrobial and antioxidant potential of ethanol extracts obtained from the fruit of five species of fresh chili pepper, Capsicum (C.) baccatum L. (Aji Amarillo), C. chinense (Fidalgo Roxa), C. annuum (Cherry Chocolate), C. pubescens (Rocoto Orange) and C. frutescens (Peruvian Purple).

METHODS: To obtain the ethanol extracts, accelerated solvent extraction (ASE) was applied. DPPH assay was used to determine the antioxidant activity of the extract samples. The disc diffusion method was used to measure antimicrobial activity against nine investigated microorganism species.

RESULTS: The tested extract samples exhibited DPPH radical scavenging activities ranging from 0.24 &plusmn;0.01 (Peruvian Purple) to 0.72 &plusmn;0.02 (Aji Amarillo) mg TEAC∙g&ndash;1 dw. The differences between all the varieties were statistically significant (P < 0.05; except for the Cherry Chocolate and Rocoto Orange), and the potential of antioxidant capacity increased in the following manner: Peruvian Purple < Fidalgo Roxa < Rocoto Orange < Cherry Chocolate < Aji Amarillo. The results from the antimicrobial evaluation showed that the Capsicum extracts had no uniform inhibition activity against tested gram-negative, gram-positive bacteria, and yeast. Specifically, Aji Amarillo fruit extract revealed the strongest antimicrobial activity against S. pneumoniae (6.33 &plusmn;0.58 mm), followed by Cherry Chocolate against S. pneumoniae (5.33 &plusmn;0.58 mm), Rocoto Orange against S. enterica (5.27 &plusmn;0.58 mm), Fidalgo Roxa against C. albicans (4.67 &plusmn;0.58 mm), and Peruvian Purple against S. pneumoniae (4.57 &plusmn;0.58 mm).

CONCLUSIONS: Considering these results, Capsicum spp. can be used as a source of novel antioxidant and antimicrobial compounds.

PMID:34724370 | DOI:10.17306/J.AFS.0977

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):449-457. doi: 10.17306/J.AFS.0944.

ABSTRACT

BACKGROUND: A statistical model was developed in this study to describe lactic acid production through a fermentation process of carrot in a rice bran bed by Lactobacillus plantarum.

METHODS: Response surface methodology (RSM) based on Box-Behnken design was employed to statistically evaluate and optimize the conditions for maximum lactic acid production.

RESULTS: The significance and interaction of salt concentration, water and initial L. plantarum starter density on final lactic acid content were found. With the use of the developed quadratic model equation, a maximum achieved lactic acid content of 1.35% was obtained in a rice bran bed fermentation process at optimum operating conditions of approximately 2.95% salt, 48.24% water and 2.9 log cfu/g of L. plantarum. After fermentation, the amount of total polyphenol content, antioxidant activity and carbohydrate had increased while the &beta;-carotene in carrot was significantly retained (92.84%).

CONCLUSIONS: The above results could provide a practical basis for the fermentation process in rice bran bed to produce a delicious and reliable product using L. plantarum strain XK 1.4 which could be a significant contribution to the food industry.

PMID:34724368 | DOI:10.17306/J.AFS.0944

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):375-381. doi: 10.17306/J.AFS.0985.

ABSTRACT

BACKGROUND: According to Statistics Poland (GUS, 2021), 15.8% of women and 2.5% of men suffer from thyroid disease. Although pharmacotherapy is the primary treatment, there is evidence that some vitamins and minerals can alleviate the symptoms of thyroid disease. A well-balanced and varied diet should cover the individual demand for energy and all necessary nutrients. However, dietary supplements are prevalent in Poland. This study aims to evaluate the frequency and reasons behind dietary supplementation in patients with hypothyroid diseases.

METHODS: 232 volunteers (203 women and 29 men) from Poland participated in the research. The research was conducted using a questionnaire. Participants were asked to provide information on their diagnosis, clinical manifestations of the disease, their lifestyles, and the use of dietary supplements with the effect on their health.

RESULTS: The medium age of participants was 27 years. Of them, 85% took dietary supplements. The most popular were vitamin D, magnesium, omega-3 acids, selenium, multivitamins, vitamins B, iron, vitamin C, and zinc. In addition, 53% of patients implemented lifestyle changes after a diagnosis of hypothyroidism. There was a correlation between the participants&rsquo; age and the willingness to introduce lifestyles modifications: the younger the participants were, the eager they were to introduce modifications (r = &minus;0.243, p = 0.010, 95% CI: &minus;0.410 to &minus;0.060). In addition, there was a correlation between the participants&rsquo; age and the willingness to change their diets: the older the participants were, the more eager they were to change diets (r = 0.283, p = 0.003, 95% CI: 0.103&ndash;0.445). Patients indicated numerous health benefits of using dietary supplements. The vitamin D and vitamin and mineral complexes were indicated as the most beneficial.

CONCLUSIONS: Dietary supplementation is prevalent in Poland, especially among hypothyroidism patients. Patients take a variety of supplements, claiming that they improve the condition of their skin, nails, memory, and others, which may be controversial. Therefore, it seems advisable to deepen the patients&rsquo; supplementation knowledge (via contact with a physician, dietitian, etc.). Furthermore, reliable guidelines on&nbsp; supplementation for hypothyroidism patients based on clinical trials should be developed.

PMID:34724363 | DOI:10.17306/J.AFS.0985

Nurs Open. 2021 Nov 1. doi: 10.1002/nop2.1119. Online ahead of print.

ABSTRACT

AIM: To measure safety performance, situational judgement test, which is a method composed of job-related situations, can be used. This study aimed to develop and test its psychometric properties by measuring the safety performance of healthcare professionals in German hospitals.

DESIGN: An explorative cross-sectional study.

METHODS: A team of researchers, nurses and physicians developed seven items, which focus on different safety areas. Descriptive statistics were calculated for each item. Cronbach’s alpha was calculated as an indication of internal consistency. Spearman’s correlation between the items was evaluated as analysis of construct validity. A cross-sectional survey with healthcare professionals in three German hospitals was conducted to test the developed instrument.

RESULTS: A total of 168 healthcare professionals participated (response rate: 39.1%). 70.2% were women, and 38.7%, 33.9%, 15.5% and 11.3% were registered nurses, nurses in training, physicians and other healthcare professionals respectively. The situational judgement test demonstrated an acceptable psychometric performance.

PMID:34724359 | DOI:10.1002/nop2.1119

J Cosmet Dermatol. 2021 Nov 1. doi: 10.1111/jocd.14496. Online ahead of print.

ABSTRACT

BACKGROUND: Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd-Yag fractional 1064 plus microinjection of tranexamic acid versus Nd-Yag fractional 1064 plus oral tranexamic acid in patients with melasma.

MATERIALS AND METHODS: This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2-week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q-switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q-switched 1064 laser every 2 weeks per visit.

RESULTS: Twenty-one patients with mean SD 40.52+-4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+-5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p < 0.001). However, patient’s MASI score (p = 0.99) and ∆E (p = 0.53) did not differ significant between the two group over the time. Satisfaction (p = 0.41) and complication during the study period (p = 0.09) were not significantly different between the two group.

CONCLUSION: The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non-invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction. Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q-switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non-invasive methods like microneedling to reduce pain and laser treatment in future studies.

PMID:34724323 | DOI:10.1111/jocd.14496

ANZ J Surg. 2021 Nov 1. doi: 10.1111/ans.17322. Online ahead of print.

ABSTRACT

BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a rare genetic vascular disorder which is characterised by the development of arteriovenous malformations and telangiectasias. A key clinical manifestation is recurrent epistaxis. This study examined the impact of a dedicated HHT clinic in a major Australian tertiary hospital on epistaxis symptoms and subjective quality of life.

METHODS: A multidisciplinary HHT clinic was established in 2015. All patients satisfied either genetic diagnosis or fulfilled Curacao criteria. A protocol based clinical assessment was performed and a standardised treatment regimen was implemented. Patients completed quality of life and epistaxis severity score (ESS) questionnaires at each review.

RESULTS: Participants of the dedicated clinic included 21 females (58.3%) and 15 males (41.7%), with a mean age of 49.0 ± 24.0 years. The ACVRL1 variant was the most common (n = 20, 55.6%). A statistically significant reduction in epistaxis severity was noted between the baseline and second review (P = 0.02) and was maintained to the third visit (P = 0.015). Patients older than 50 years demonstrate a consistently higher ESS than those less than 50 years old (P = 0.03). This trend is noted throughout the follow up period with the dedicated clinic.

CONCLUSION: The introduction of a multidisciplinary, dedicated HHT clinic to provide enhanced assessment, monitored treatment regimen and greater access to care, resulted in improvement in the management of epistaxis and quality of life in these patients.

PMID:34724318 | DOI:10.1111/ans.17322

J Clin Lab Anal. 2021 Nov 1:e24084. doi: 10.1002/jcla.24084. Online ahead of print.

ABSTRACT

BACKGROUND: Alveolar echinococcosis (AE) is a zoonotic disease caused by the larval stage of Echinococcus multilocularis parasitizing in the human liver, causing local pathological changes in the liver and manifesting as hyperplasia, liver fibrosis, atrophy, degeneration, and necrosis. Here, we report a method that can simultaneously isolate hepatocytes and hepatic stellate cells (HSCs) from mice infected with Echinococcus multilocularis.

METHODS: A mouse model of AE was established. Hepatocytes and HSCs were isolated from mouse liver using a two-step method combining in situ collagenase perfusion and gradient centrifugation. Expressions of Alb, Desmin, and α-SMA were detected with immunofluorescence to identify the isolated hepatocytes and HSCs.

RESULTS: The viability and purity of hepatocytes and HSCs both reached 90% or above. For hepatocytes, clear cell boundaries were observed, and the nuclei were round or oval, with clear nucleoli. There was a homogeneous distribution of the hepatocyte marker Alb in the cytoplasm of hepatocytes. Lipid droplets and Desmin expression were observed in the cytoplasm of freshly isolated HSCs. During the activation of HSCs, the lipid droplets gradually decreased and disappeared with a high expression of α-SMA.

CONCLUSION: Hepatocytes and HSCs are simultaneously isolated. This may provide a research tool to investigate the interaction between hepatocytes and HSCs and to investigate the mechanism of Echinococcus multilocularis infection-induced liver pathological changes.

PMID:34724252 | DOI:10.1002/jcla.24084