Nevin Manimala

J AOAC Int. 2022 Sep 14:qsac104. doi: 10.1093/jaoacint/qsac104. Online ahead of print.

ABSTRACT

BACKGROUND: Oxytetracycline, chlortetracycline, and tetracycline are approved antibiotics used to treat bacterial infections in cattle. To ensure human food safety, a tolerance has been established for the sum of these three tetracycline residues as 12 ppm in bovine kidney in the U.S. The current official regulatory method for quantifying these antibiotics in the target organ is a labor-intensive microbiological assay.

OBJECTIVE: Our laboratory developed and validated a fast, selective and less laborious method utilizing liquid chromatography-tandem mass spectrometry for the determination and confirmation of the three tetracyclines in bovine kidney.

METHODS: Briefly, homogenized kidney tissue was spiked with an internal standard, and then was extracted with 1% phosphate buffer. The crude extract was cleaned up using solid-phase extraction cartridges before instrumental analysis.

RESULTS: Accuracies for quantifying these three drugs in fortified kidney homogenate were between 99.9% and 110% at multiple concentrations, with respective coefficients of variation all below 9.5%. Quantitative correlation between the two methods (bridging) was evaluated with incurred bovine kidney samples for each of the three tetracyclines separately. The results were statistically evaluated using a measurement model called Functional Relationship Estimation by Maximum Likelihood.

CONCLUSIONS: A linear quantitative relationship was demonstrated between the two methods within the concentration range of regulatory relevance.

HIGHLIGHTS: This instrumental method is in addition to the established microbial assay for the detection of tetracyclines residue in beef kidney to ensure the food safety of cattle products.

PMID:36103709 | DOI:10.1093/jaoacint/qsac104

Am J Public Health. 2022 Oct;112(10):1416-1420. doi: 10.2105/AJPH.2022.307043.

NO ABSTRACT

PMID:36103697 | DOI:10.2105/AJPH.2022.307043

Sci Med Footb. 2022 Sep 14. doi: 10.1080/24733938.2022.2125170. Online ahead of print.

ABSTRACT

Relative Age Effects (RAEs) appear largely throughout youth soccer. However, little is known about how RAEs at youth levels can impact selection and performance at senior levels. Accordingly, the purpose of this study was twofold: (a) to provide further test of RAEs by exploring the birth quarter (BQ) distribution of 2,030 Italian players born from 1975 to 2001 (both years included) who have played in any of the Youth National Italian Soccer Teams (U15-U21); and (b) to investigate how RAEs influence future career outcomes, by exploring the BQ distribution of players who completed the transition from youth levels to the Senior National Team (n=182) and those who eventually achieved the Super International Achievers (SIA) status (i.e., plating at a senior level in a UEFA European Championship and/or FIFA World Championship; n=58). Chi-square statistics revealed a significantly skewed (all P value <0.0001) BQ distributions for all Youth squads (BQ1=41.4% vs. BQ4=10.8%), and for the cohort of players who completed the transition (P=0.003). In contrast, results from the Odds Ratios (ORs) highlighted how BQ4s are more likely to transition from youth-to-senior compared to BQ1s (ORs from 2.81 to 4.31). Results showed relatively older players remain overrepresented at senior level likely due to a residual bias effect. Whereas relatively younger players who were able to overcome selection process at youth levels had the highest likelihood of competing at senior levels. Therefore, involving players career trajectories in RAEs studies is needed to understand how relative age impacts career outcomes of early selected players.

PMID:36103671 | DOI:10.1080/24733938.2022.2125170

Horm Mol Biol Clin Investig. 2022 Sep 15. doi: 10.1515/hmbci-2022-0020. Online ahead of print.

ABSTRACT

OBJECTIVES: Leptin polymorphism (LEP) has been associated with coronary heart disease (CAD), obesity, and high body mass index (BMI). However, we performed a systematic review and meta-analysis to discover the association because previous studies reached different conclusions.

METHODS: Review Manager, version 5.3.5, and Stata, version 15.0, were used for statistical analysis. We calculated the effect size of the studies using the OR with the corresponding 95% CI, and two-sided (bilateral) p-values of 0.05 were considered significant. To determine heterogeneity among the selected studies, the Q test and I2 statistics were used. Meta-regression was used to examine the disease (heart disease, obesity, and high BMI) and heterogeneity between these subgroups.

RESULTS: Eleven studies with 18,984 subjects were included in this study. The G-2548A (rs12112075), rs7799039, and A19G (rs2167270) polymorphisms of the leptin gene (but not the Lys656Asn (rs1805094) polymorphism) are associated with an increased risk of cardiovascular disease. Our pooled analysis revealed an association between the G-2548A (rs12112075) polymorphism and heart disease, high BMI, and obesity. This indicates that individuals carrying the AA allele are at an increased risk for heart disease, high BMI, and obesity. People with heart failure and coronary artery disease did not have the rs7799039 polymorphism or its alleles linked to them.

CONCLUSIONS: Combined analysis of data from current and published research suggests that the leptin gene polymorphisms G-2548A (rs12112075), rs7799039, and A19G (rs2167270) (but not the Lys656Asn (rs1805094) polymorphism) are associated with an increased risk of cardiovascular disease. Further research is needed to understand this association.

PMID:36103664 | DOI:10.1515/hmbci-2022-0020

Clin Chem Lab Med. 2022 Sep 15. doi: 10.1515/cclm-2022-0656. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to investigate whether combining scoring systems with monocyte distribution width (MDW) improves early sepsis detection in older adults in the emergency department (ED).

METHODS: In this prospective observational study, we enrolled older adults aged ≥60 years who presented with confirmed infectious diseases to the ED. Three scoring systems-namely quick sepsis-related organ failure assessment (qSOFA), Modified Early Warning Score (MEWS), and National Early Warning Score (NEWS), and biomarkers including MDW, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), were assessed in the ED. Logistic regression models were used to construct sepsis prediction models.

RESULTS: After propensity score matching, we included 522 and 2088 patients with and without sepsis in our analysis from January 1, 2020, to September 30, 2021. NEWS ≥5 and MEWS ≥3 exhibited a moderate-to-high sensitivity and a low specificity for sepsis, whereas qSOFA score ≥2 demonstrated a low sensitivity and a high specificity. When combined with biomarkers, the NEWS-based, the MEWS-based, and the qSOFA-based models exhibited improved diagnostic accuracy for sepsis detection without CRP inclusion (c-statistics=0.842, 0.842, and 0.826, respectively). Of the three models, MEWS ≥3 with white blood cell (WBC) count ≥11 × 10⁹/L, NLR ≥8, and MDW ≥20 demonstrated the highest diagnostic accuracy in all age subgroups (c-statistics=0.886, 0.825, and 0.822 in patients aged 60-74, 75-89, and 90-109 years, respectively).

CONCLUSIONS: Our novel scoring system combining MEWS with WBC, NLR, and MDW effectively detected sepsis in older adults.

PMID:36103663 | DOI:10.1515/cclm-2022-0656

Plast Reconstr Surg. 2022 Sep 15. doi: 10.1097/PRS.0000000000009729. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: Breast ptosis as a result of pregnancy and/or breastfeeding, age, genetics and weight loss is a common complaint amongst women visiting a plastic surgeon. This study sought to evaluate the utility, efficacy and safety of radiofrequency assisted lipolysis on the breast and nipple-areola complex position in women with breast ptosis.

METHODS: This was a single center (Maxwell Aesthetics) study of female desiring tightening of the breast envelope and elevation of the nipple areolar complex (NAC). Each patient underwent 1 treatment with RFAL in the operating room. RFAL was applied to each breast with a BodyTite Pro handpiece. Patients were evaluated preoperatively and postoperatively at: 6 weeks, 3 months, 6 months and 12 months via manual and 3D computer generated measurements (Vectra).

RESULTS: 10 female patients were enrolled. Ages ranged from 23-54. Follow up was 12 months. Data was captured for seven measurements from the nipple longitudinally at five time points. The sternal notch to the nipples (SN-N) distance, nipple to inframammary fold (N-IMF) and nipple to nipple (N-N), improved statistically at 6- week follow-up ,which persisted through the 12-month follow-up (p<0.05). Patient questionnaires revealed moderate to excellent satisfaction.

CONCLUSIONS: Radiofrequency assisted Lipolysis with a bipolar device to deliver RF energy to the breast is an effective modality to moderately improve breast ptosis. This study demonstrates that this treatment improves breast measurements across time, regardless of measurement type (manual versus Vectra). This modality affords a minimally-invasive, effective method to improve mild to moderate breast ptosis with minimal scarring and high patient satisfaction.

PMID:36103661 | DOI:10.1097/PRS.0000000000009729

Plast Reconstr Surg. 2022 Sep 15. doi: 10.1097/PRS.0000000000009723. Online ahead of print.

ABSTRACT

BACKGROUND: Sensory recovery of the breast is a compelling frontier in comprehensive post-mastectomy breast reconstruction. This study uses the BREAST-Q Sensation Module to evaluate the differences in women who underwent an alloplastic versus autologous breast reconstruction.

METHODS: Women with a history of breast cancer and post-mastectomy breast reconstruction were recruited through the Love Research Army, United States. Participants completed the BREAST-Q Sensation Module (3 scales: Breast Symptoms, Breast Sensation, Quality of Life Impact). Descriptive statistics and multiple linear regression analyses were used to compare outcomes between women undergoing alloplastic or autologous breast reconstruction.

RESULTS: Of 1204 respondents, 933 were included for analysis, 620 (66.5%) underwent alloplastic reconstruction and 313 (33.5%) underwent autologous reconstruction. The average age and BMI were 59.2 years (±10.1) and 26 (±5) respectively. Autologous reconstruction patients scored an average of 6.1 points (95% CI 3.9-8.4, p<0.001) and 5.3 points (95% CI 2.5-8.1, p=0.001) higher on the Breast Symptoms and Quality of Life Impact scales, respectively. No difference (0.0 points, 95% CI -2.9-3.0, p=0.75) was observed for the Breast Sensation scale. Increased time since reconstruction had a positive impact on Breast Symptoms scores. Radiotherapy negatively affected scores on both Breast Symptoms and Quality of Life Impact scales.

CONCLUSIONS: Autologous breast reconstruction may be associated with fewer abnormal breast sensations and better sensation-related quality of life in comparison to alloplastic reconstruction. This information can be incorporated during preoperative patient counseling when discussing reconstructive options.

PMID:36103650 | DOI:10.1097/PRS.0000000000009723

IISE Trans Occup Ergon Hum Factors. 2022 Sep 14:1-16. doi: 10.1080/24725838.2022.2124325. Online ahead of print.

ABSTRACT

Occupational ApplicationsMilitary personnel are at greater risk of injuries due to frequent load carriage. Novel exoskeleton technology may have benefits for soldiers, such as reduced physical burden through load carriage support that may result in decreased metabolic cost, reduced fatigue, and lower risk of injuries during walking. However, as for most assistive devices, a familiarization period is likely necessary to obtain the full potential of the device. Our results show that the metabolic cost of walking (MWC) was initially increased significantly upon provision of the passive exoskeleton, though it returned to baseline values after a 9-day familiarization period. The exoskeleton remained effective after a three-month pause, with a MCW below baseline. These results suggest that to properly assess the assistance of an exoskeleton, a sufficient familiarization period should be mandatory.Technical AbstractBackground: Military load carriage has been shown to alter gait patterns, resulting in an increased metabolic cost during walking (MCW). Soldiers’ burden could be mitigated by wearing a passive exoskeleton, but the additional payload of the device can alter movement patterns during gait, rendering it detrimental. Integrating principles of motor learning during a familiarization period could allow users to develop adaptive motor strategies, thereby decreasing MCW.Purpose: The aim of this study was to explore the influence of a familiarization period on MCW when soldiers wear a passive, load-bearing, prototype exoskeleton (Exo).Methods: Three male soldiers walked on a treadmill with a 38 kg payload at eight speeds (1.8-6.0 km/h) under five conditions: 1) no exoskeleton (NoExo); 2) exoskeleton pre-familiarization (Exo_Pre); 3) exoskeleton post-familiarization (Exo_Post); 4) no exoskeleton follow-up (NoExo_FU); and 5) exoskeleton follow-up (Exo_FU). Each experimental trial consisted of 10 minutes of standing followed by 10 minutes of walking at a constant speed. Metabolic data were normalized to walking speed (J/kg·m) to obtain the MCW. The familiarization period consisted of 9 days of activities with the exoskeleton using a standardized protocol. Differences in MCW with and without the Exo were compared at the eight walking speeds using a nonparametric analysis of Longitudinal Data.Results: There was a statistically significant decrease in MCW after familiarization with the Exo, particularly during Exo_FU with a relative treatment effect of 0.11 – 0.19. There were also significant reductions in MCW during Exo_FU when compared to NoExo_FU [participant 01 = 0.37; participant 02 = 0.27; participant 03 = 0.35].Conclusions: A first exposure to the exoskeleton increased MCW. After familiarization, however, the MCW with the Exo returned to the NoExo level or below with a payload of 38 kg among three soldiers. A familiarization period of 3 hours per day over 2 weeks of familiarization may optimize the use of an exoskeleton.

PMID:36103636 | DOI:10.1080/24725838.2022.2124325

Oral Dis. 2022 Sep 14. doi: 10.1111/odi.14378. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify and analyze the existing literature on the utility of podoplanin to predict the risk of malignancy development (MD) in patients previously diagnosed with oral leukoplakia (OL).

METHODS: A systematic review and meta-analysis (SR-MA) was performed though a search strategy using several electronic databases and a combination of keywords related to podoplanin and MD of OL, until 15 May, 2022 (PROSPERO CRD42022329326). Evaluation of the risk of bias was performed using the Quality in Prognosis Studies Tool. The meta-analyses were estimated using fixed-effect models.

RESULTS: From 421 articles, 6 studies were finally included, that enrolled 546 patients with OL, of whom 125 presented with an oral cancer during follow-up (32 to 90 months). Some limitations regarding the risk of bias were identified mostly related to small sample sizes, short follow-up times, lack of information on covariables in the included studies and lack of accuracy (including sensitivity and specificity). Meta-analysis of 6 studies revealed a pooled hazard ratio (HR) of 3.72 (95%CI, 2.40-5.76; p<0.00001) for MD without statistical heterogeneity (I² =0%, p=0.53).

CONCLUSION: The results of this SRMA support the role of podoplanin immunohistochemical expression as a potential predictive biomarker to assess the risk of malignancy development in oral leukoplakia.

PMID:36103586 | DOI:10.1111/odi.14378

Physiother Res Int. 2022 Sep 14:e1974. doi: 10.1002/pri.1974. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Ensuring access to high quality services in paediatric physiotherapy (PT) is important to respond to the diverse needs of children. The accessibility and quality of paediatric PT services has however never been explored internationally. The purpose of this study is to explore the perceived strengths, weaknesses, opportunities, and threats (SWOT) of paediatric PT services offered around the world.

METHOD: A cross-sectional survey design method was used with a subsample of physiotherapists (PTs) who had previously participated in an online survey. The survey used for this study included close- and open-ended questions about access to services and the SWOT of PT services within participants’ country. Descriptive statistics were used to summarize quantitative data and a content analysis was performed on open-ended questions.

RESULTS: Overall, 47 PTs from 47 countries completed the survey; 36% of participants reported that free access was available to all children in their country while 34% stated that a referral was always required when accessing services. Lack of direct access, insufficient specialized PT, financial and geographical issues were the main perceived barriers to access services. Access also emerged as one of the nine themes following the SWOT analysis. Other themes included education, quality of PT approaches, PT practices, communication and cooperation, teamwork, government, resources, and attitudes of PTs.

DISCUSSION: Despite variations in accessing services and how services are delivered across countries, some similar themes influencing PTs practices were found. Future opportunities for PTs working with children should aim at optimizing the initial training and professional development of PTs in paediatrics, increasing access to services for all children and advocating for sustainable and well-coordinated models of care building on best practices.

PMID:36103585 | DOI:10.1002/pri.1974