Nevin Manimala

Leuk Res. 2021 Apr 24;107:106586. doi: 10.1016/j.leukres.2021.106586. Online ahead of print.

ABSTRACT

The aim of this study is to determine the power of he international prognostic scoring systems (IPS-7 and IPS-3) and to obtain indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) factors as prognostic indicators in cases with classical Hodgkin lymphoma (cHL). 1012 patients with cHL were evaluated with 2 different IPS-4 scores with four parameters: stage, age, hemoglobin level, and either LLR or PNI. Statistical package SPSS v 22.0 was used. Two different Cox regression models were obtained for OS and PFS. Model 1 showed LLR ≥ 5,8 as the highest risk for OS and anemia as the highest risk for PFS. Model 2 showed PNI ≤ 45,2 as the highest risk for OS and anemia as the highest risk for PFS. IPS-4 scores obtained by integrating either LLR or PNI to IPS-3 integration of a biologic parameter either LLR or PNI need to be determined with clinical risk scoring parameters.

PMID:34082249 | DOI:10.1016/j.leukres.2021.106586

Ecotoxicol Environ Saf. 2021 May 31;220:112383. doi: 10.1016/j.ecoenv.2021.112383. Online ahead of print.

ABSTRACT

Geochemical approaches are popular for evaluations based on heavy metal concentrations in sediments or soils for eco-risk assessment. This study proposes a systematic geochemical approach (SymGeo) to explore six heavy metals in topsoils and bird tissues and organs of the target birds. We assume that the proposed approach based on field-collected heavy metals in topsoils and feathers can predict the areas with the potential risk of the heavy metals in birds. Finite mixture distribution modeling (FMDM) was used to identify background values of the heavy metal concentrations in topsoil. A spatial enrichment factor (EF), potential contamination index (PCI), contamination degree (Cod), and potential ecological risk index (PRI) based on FMDM results for topsoil, and a potential risk index (PRI_bird) of heavy metals in the birds, were utilized for systematic prioritization of high eco-risk areas. Using multiple EF, PRI, and Cod results and multiple PRI-based maps of the heavy metals in feathers, we systematically prioritized risk areas where there is a high potential for heavy metal contamination in the birds. Our results indicate that heavy metal concentrations in the feather, liver, and kidney are not spatially cross-autocorrelated but are statistically significantly correlated with some heavy metals in topsoil due to external and internal depositions. Further, multiple EF, Cod, and RI distributions for topsoil, along with the PRI of the feather, showed that adequate coverages for potential risk for birds were greater than 71.05% in the top 30% and 84.69% in the top 20% potential eco-risk priority area of heavy metals in bird liver and kidney. Hence, our proposed approach suggests that assessments of heavy metals in bird feathers and topsoils without bird organs can be utilized to identify spatially high-risk areas. The proposed approach could be improved by incorporating water and sediment samples to enhance the crowdsourcing and the species-specific data.

PMID:34082242 | DOI:10.1016/j.ecoenv.2021.112383

Environ Int. 2021 May 31;154:106663. doi: 10.1016/j.envint.2021.106663. Online ahead of print.

ABSTRACT

BACKGROUND: Polychlorinated biphenyls (PCBs) are a large family of man-made organic, ubiquitous, and persistent contaminants with endocrine-disrupting properties. PCBs have been associated with numerous adverse health effects and were classified as carcinogenic to humans, but their long-term impact on mortality risk in the general population is unknown.

OBJECTIVE: To conduct a systematic review and meta-analysis in order to assess whether background exposure levels of PCBs increase all-cause and cancer- and cardiovascular-specific mortality risk in the general population.

METHODS: We searched the Pubmed, Web of Science, Cochrane Library, and Embase databases for eligible studies up to 1st of January, 2021. We included cohort and nested-case control studies comparing the lowest vs. the highest background exposure level of PCBs in the general population and reporting data for all-cause mortality and/or cancer-/cardiovascular-specific mortality. Studies reporting occupational and accidental exposures were excluded. Random-effects meta-analysis was used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs). Heterogeneity across studies was assessed by I2 statistics, and publication bias both graphically and using Egger’s and Begg’s tests. Quality of included studies was assessed using the National Toxicology Program/Office of Health Assessment and Translation (NTP/OHAT). Confidence in the body of evidence and related level of evidence were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) based on the NTP/OHAT framework. The protocol was registered in PROSPERO (CRD42020178079).

RESULTS: The initial search led to 2,132 articles. Eight prospective cohort studies met our inclusion criteria, leading to 72,852 participants including 17,805 deaths. Overall exposure to PCBs was not statistically significantly associated with all-cause mortality (SRR = 1.13, 95% CI = 0.90-1.41, n = 7 studies, low certainty); however, dietary exposure to PCBs was associated with an increased risk of cardiovascular-specific mortality (SRR = 1.38, 95% CI = 1.14-1.66, n = 3 studies, moderate certainty), while no association was found with cancer-specific mortality (SRR = 1.07, 95% CI = 0.72-1.59, n = 5 studies, low certainty).

CONCLUSION: Our meta-analysis suggests that background exposure to PCBs is associated with an increased risk of cardiovascular-specific mortality in the general population with a “moderate” level of evidence. These findings should be interpreted with caution given the small number of studies on mortality in the general population.

PMID:34082240 | DOI:10.1016/j.envint.2021.106663

Sci Total Environ. 2021 May 24;789:147983. doi: 10.1016/j.scitotenv.2021.147983. Online ahead of print.

ABSTRACT

Climate change-induced floods in tropical urban areas have presented a serious global challenge because of failed conventional stormwater management practices. This research aims to develop a comprehensive methodological framework for flood damage estimation and mitigation, particularly in a tropical urban city. In this study, interdisciplinary fields were integrated through statistical downscaling, hydrologic-hydraulic modeling, and the development of flood damage curves. Relationships between tangible flood damage and flood-borne outbreak with flood depths were elucidated to predict future damage. Various flood mitigation strategies were evaluated. Herein, Hat Yai Municipality in Southern Thailand was selected as the study area. The flood simulation was conducted for 2010 and the highest flood damage sensitivity was exhibited by non-commercial buildings due to significant commercial stock damage, which was followed by that observed for detached houses. There was a strong linear relationship between the number of patients infected with leptospirosis and flood depth (R² = 0.85). For climate change studies, flood maps for storms with 20-, 50-, and 100-year return periods under the A2/RCP8.5 scenario were generated using hydrological-hydraulic 1D/2D model; these maps were applied with the developed flood damage curves for damage estimation. It was found that reducing flood damage by implementing agroforestry and expanding the main bypass channel provides comparable damage reductions of -25.5% and – 27.5%, respectively, under the worst-case scenario of a 100-year return period in 2040-2059. Therefore, to deal with uncertain climate change situations, the incorporation of structural and non-structural measures is recommended. Such a combination when coupled with an eight-hour flood awareness time can result in a damage reduction of -59.9%. A flood warning system was in high demand by residents in the area; however, damage reduction from this measure alone was not high (approximately -17.0%) when compared to that obtained with other measures; consequently, additional measures were needed.

PMID:34082213 | DOI:10.1016/j.scitotenv.2021.147983

Chem Biodivers. 2021 Jun 3. doi: 10.1002/cbdv.202100241. Online ahead of print.

ABSTRACT

Artemisia fragrans is commonly used as a folk medicine as antispasmodic, anti-pyretic, anti-inflammatory, and abortifacient agents. The villagers use its pungent odor to repel rodents, mites, and pests, as well as its essential oil and smoke after burning to treat lung infections after uprooting the plant. Herein, we extracted the essential oils (EOs) of different parts of the plant and analyzed their chemical compositions and antibacterial activities. The chemical analysis led to the identification of 73, 59, and 57 compounds in the EOs of the stem, leaf, and flower, respectively. All of the EOs exhibited antibacterial activities against both G+ and G- bacteria. The EOs of the leaf and flower were more effective against tested bacteria, except B. anthracis and P. aeruginosa, compared to that of the stem. The binary combination of the EOs (stem and flower) or (stem and leaf) showed a synergistic effect. Statistical analysis indicated EOs of leaf and flower are more potent than that of the stem. These findings suggest the application of leaf and flower of the plant, which not only can prevent its uprooting but also ensure better therapeutic function.

PMID:34081830 | DOI:10.1002/cbdv.202100241

Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14956. Online ahead of print.

ABSTRACT

BACKGROUND: Several modifiable lifestyle factors have been associated with the onset and health outcomes of multiple sclerosis (MS), including clinically significant fatigue. A combined lifestyle score approach represents one method of assessing their relationship with clinical outcomes.

OBJECTIVES: To examine the association of two lifestyle scores with clinically significant fatigue and change thereof over 2.5 years’ follow-up using inverse probability treatment weighting (IPTW).

METHODS: We used data on sociodemographic, lifestyle and clinical characteristics surveyed from an international cohort of people with MS at baseline and 2.5-year follow-up. Fatigue was defined by Fatigue Severity Scale (FSS>5), healthy lifestyle by the Healthy Lifestyle Index Score (HLIS) and the Smoking, Nutrition, Alcohol, Physical Activity (SNAP) score. Analyses were by IPTW accounting for age, sex, MS type, disability, treated comorbidity number, immunomodulatory medication use, prescription antifatigue medication use, and ongoing relapse symptoms.

RESULTS: 1,268 participants completed the FSS at both timepoints, approximately 62% had fatigue. Using doubly robust IPTW, high (>11/20) HLIS (OR=0.90, 95% CI: 0.81-0.98) and high (>3/5) SNAP (OR=0.82, 95% CI: 0.73-0.90) were each associated with lower risk of fatigue at follow-up. Evaluating change in fatigue, higher SNAP score was associated with lower risk of fatigue (OR=0.89, 95% CI: 0.80-0.97) but that for HLIS did not reach statistical significance (OR=0.93, 95% CI: 0.85-1.01).

CONCLUSION: These results suggest a robust role for key lifestyle factors in preventing clinically significant fatigue and may represent a place for lifestyle modification in improving clinical outcomes in MS.

PMID:34081818 | DOI:10.1111/ene.14956

Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14957. Online ahead of print.

ABSTRACT

INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that causes progressive degeneration of neurons in motor and non-motor brain regions, affecting multiple cognitive domains such as memory. We performed a functional magnetic resonance imaging (fMRI) study to explore working memory function in ALS.

METHODS: To contribute to the growing research field that employs structural and functional neuroimaging to investigate the effect of ALS on different working memory components, we explored the localization and intensity of alterations in neural activity using fMRI. Being the first study to specifically address verbal working memory via fMRI in the context of ALS, we employed the verbal n-back task with 0-back and 2-back conditions.

RESULTS: Despite ALS patients showing unimpaired accuracies (p = 0.724) and reaction times (p = 0.0785), there was significantly increased brain activity of frontotemporal and parietal regions in the 2-back minus 0-back contrast in patients compared to controls (using nonparametric statistics with 5000 permutations and a T-threshold of 2.5).

DISCUSSION: Increased brain activity of frontotemporal and parietal regions during working memory performance was largely associated with better neuropsychological function within the ALS group, suggesting a compensatory effect during working memory execution. This study therefore adds to the current knowledge on neural correlates of working memory in ALS and contributes to a more nuanced understanding of hyperactivity during cognitive processes in fMRI studies of ALS.

PMID:34081813 | DOI:10.1111/ene.14957

Transpl Int. 2021 Jun 3. doi: 10.1111/tri.13932. Online ahead of print.

ABSTRACT

BACKGROUND: Hypomagnesemia is common in kidney transplant recipients (KTRs). We sought to explore the relationship between Mg and outcomes in KTRs, which may be associated with mortality and thus, may be a potential intervention target to improve outcomes.

METHODS: We followed KTRs performed between 01/2000 and 6/2016 at a large US transplant center from 6 months post-transplant to graft failure, death, or loss to follow-up. Using Mg as a time-dependent variable, associations between Mg and outcomes any time after 6-months post-transplant were evaluated.

RESULTS: 3,680 KTRs with 50,413 Mg measurements met inclusion criteria. 657 deaths occurred over a median follow-up of 5.1 years. Compared to Mg of 1.5-1.8 mg/dL, both lower (HR 1.17, 95% Confidence interval (CI): 1.07-1.28) and higher (HR 1.16, 95% CI: 1.09-1.23) Mg levels were associated with greater risk of mortality. Similar U-shaped associations were observed for Mg and cardiovascular disease-related mortality (HR for Mg ≤1.5 mg/dL: 1.31; CI: 1.03-1.68) and infection-related mortality (HR for Mg ≤1.5 mg/dL: 1.28; CI: 1.09-1.51), although relationships for Mg >1.8 mg/dL were not statistically significant.

CONCLUSIONS: Mg exhibits a U-shaped association with mortality in KTRs, with levels between 1.5-1.8 mg/dL associated with the lowest risk.

PMID:34081803 | DOI:10.1111/tri.13932

PLoS One. 2021 Jun 3;16(6):e0252703. doi: 10.1371/journal.pone.0252703. eCollection 2021.

ABSTRACT

INTRODUCTION: Mauritius introduced Acute respiratory infection (ARI) syndromic surveillance in 2007. The Moving Epidemic Method (MEM) and the World Health Organization Average Curve Method (WHO ACM) have been used widely in several countries to establish thresholds to determine the seasonality of acute respiratory infections. This study aimed to evaluate the appropriateness of these tools for ARI syndromic surveillance in Mauritius, where two or more waves are observed.

METHOD: The proportion of attendance due to acute respiratory infections was identified as the transmissibility indicator to describe seasonality using the Moving Epidemic Method and the WHO Average Curve Method. The proportion was obtained from weekly outpatient data between 2012 and 2018 collected from the sentinel acute respiratory infections surveillance. A cross-validation analysis was carried out. The resulting indicators of the goodness of fit model were used to assess the robustness of the seasonal/epidemic threshold of both the Moving Epidemic Method and WHO Average Curve Method. Additionally, a comparative analysis examined the integrity of the thresholds without the year 2017.

RESULT: The cross-validation analysis demonstrated no statistically significant differences between the means scores of the indicators when comparing the two waves/seasons curves of WHO ACM and MEM. The only exception being that the Wilcoxon sign rank test strongly supported that the specificity mean score of the two waves/seasons curve for WHO ACM outweighed that of its corresponding wave model for the MEM (P = 0.002). The comparative analysis with 2017 data showed the value of the epidemic threshold remained the same regardless of the methods and the number of seasonal waves.

CONCLUSION: The two waves models of the Moving Epidemic Method and WHO Average Curve Method could be deployed for acute respiratory infection syndromic surveillance in Mauritius, considering that two or more activity peaks are observed in a season.

PMID:34081752 | DOI:10.1371/journal.pone.0252703

PLoS One. 2021 Jun 3;16(6):e0252728. doi: 10.1371/journal.pone.0252728. eCollection 2021.

ABSTRACT

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers’ responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants’ living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03-1.53; p<0.05). Interventions must identify ways-such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology-to address mobile female sex workers’ unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers’ mobility and how and why mobility influences risk environments and experiences of gender-based violence.

PMID:34081739 | DOI:10.1371/journal.pone.0252728