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Nevin Manimala Statistics

Mineral composition in mussel Mytilus galloprovincialis and clam Tapes decussatus from Faro Lake of Messina: risk assessment for human health

Front Toxicol. 2024 Dec 13;6:1494977. doi: 10.3389/ftox.2024.1494977. eCollection 2024.

ABSTRACT

Bivalve are exposed to a wide range of contaminants, some of which may be toxic to human health. The aim of this study was to detect essential and non-essential elements such as Na, Ca, Mg, Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Pb, Hg, Be and Co in water, sediments, and Mytilus galloprovincialis and Tapes decussatus from Faro Lake. It is a lake of marine origin located on the northern coast of Messina (Sicily), where shellfish farming has been practiced for many years. Metals were analysed by a single quadrupole inductively coupled plasma mass spectrometer (ICP-MS), except for Hg, which was quantified using a direct mercury analyser (DMA-80). The study evaluated the nutritional intake of elements through the ingestion of clams and mussels and the potential health risks to consumers. The lead levels found in M. galloprovincialis were below the LOQ, while in T. decussatus the concentrations were below the limit indicated by European Regulation 915/2023. Statistical analysis was carried out on M. galloprovincialis and T. decussatus samples using SPSS 27 and the data showed highly significant differences between the two species (p < 0.001). Cadmium (Cd) and mercury (Hg) concentrations were also below the legal limit in all samples analyzed. This study has shown that clams and mussels are a source of sodium (Na) with a Recommended Dietary Allowance (RDA) of 36% in M. galloprovincialis and 77% in T. decussatus. The percentages obtained for calcium (Ca) and magnesium (Mg) were 17%-19% and 18%-8%, respectively. The RDA of chromium (Cr) was of 191% for M. galloprovincialis and of 405% for T. decussatus. The Fe percentages were 92% and 169% for M. galloprovincialis and T. decussatus, respectively. The concentrations of the other metals observed in the two bivalve species of Lake Faro were generally lower than the Tolerable Weekly Intake (TWI) values estimated as a risk to human health.

PMID:39735886 | PMC:PMC11671395 | DOI:10.3389/ftox.2024.1494977

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Bone and Joint Involvement in Beta Thalassemic Patients: A Cross-sectional Study

Indian J Orthop. 2024 Nov 5;59(1):69-76. doi: 10.1007/s43465-024-01225-0. eCollection 2025 Jan.

ABSTRACT

PURPOSE: There is paucity of guidelines with inadequate data available about the extent and prevention of bone and joint disease in beta-thalassemic patients in Indian population. This study aims to determine bone and joint involvement in beta-thalassemic patients. It evaluates serum biochemical parameters of bone formation and resorption and correlates with the symptomatology in these patients. The study also determines their daily physical activity and find a correlation if any with bone mineral density.

METHODS: The study was carried out on 40 regularly transfused beta thalassemic patients between 5 and 18 years of age under regular follow-up at our centre from June 2012 to June 2014. All patients were interviewed as per a well-structured proforma for symptoms relating to bone and joint disease as described by the patient/parents in past 1 year and physical activity by QAPACE questionnaire. Venous blood samples were drawn under aseptic conditions and used for estimation of biochemical parameters (calcium, phosphorus, alkaline phosphatase, vitamin D, parathyroid hormone and serum ferritin). Enrolled subjects were scanned for bone mineral density (BMD) at femur neck, trochanter and Ward’s angle using dual-energy X-ray absorptiometry.

RESULTS: A total of 40 patients were enrolled in the study (Male:Female = 80:20). Half the patients (n = 20) had symptoms pertaining to bone and joint disease. The most common symptom was leg pain (42.50%), followed by backache (22.50%). Asymptomatic patients had greater mean serum vitamin D as compared to the symptomatic patients (22.2 vs 15.08 ng/ml) (p = 0.225). Five patients were detected to have osteopenia, all above 10 years of age. The mean BMD in symptomatic patients at femur neck, trochanter and ward’s angle was 0.781, 0.639 and 0.735 g/cm2, respectively, as compared to 0.754, 0.635 and 0.722 g/cm2 in asymptomatic patients. The difference was not statistically significant. Patients with low BMD had lower mean pre-transfusion Hb (< 9 g/dl) (p = 0.01). Eighty percent of osteopenic patients had sedentary lifestyle as compared to 44% of patients with normal BMD. Bone mineral density did not have any correlation with vitamin D levels, serum ferritin and type of chelation therapy.

CONCLUSION: Pre-transfusion hemoglobin of more than 9 gm/dL has a protective role in maintaining good bone health and bone mineral density. Engaging thalassemia patients in physical activity has a positive effect on bone mineral density. Low vitamin D levels contribute to symptoms of bone and joint involvement in thalassemia and the same needs to be determined and supplemented.

PMID:39735876 | PMC:PMC11680515 | DOI:10.1007/s43465-024-01225-0

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Do Ultracongruent Inserts Reproduce the Intraoperative Sagittal Plane Kinematics of Posterior Stabilized TKR? Assessment Using a Modern Robotic System

Indian J Orthop. 2024 Nov 30;59(1):108-114. doi: 10.1007/s43465-024-01292-3. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: Ultracongruent (UC) total knee replacement (TKR) designs, serving as alternatives to posterior stabilized (PS) and cruciate retaining (CR) designs, lack conclusive evidence regarding posterior femoral rollback. This study aimed to compare intraoperative posterior femoral rollback and maximal knee flexion between UC and PS inserts, addressing the paucity of literature on femoral rollback achieved with UC designs in total knee replacement.

METHODS: A consecutive cohort of 20 patients undergoing robotic-assisted primary total knee replacement, posterior femoral rollback and maximal intraoperative knee flexion were assessed. Robotic imaging at varying flexion angles (0°, 45°, 90°, and 120°) was conducted after implanting femoral and tibial components with Ultracongruent and Posterior-Stabilized trial inserts. Femoral contact on the tibia was estimated as a percentage of the sagittal dimension of the tibial component with 0 representing the anterior edge and 100 representing the posterior edge of the tibial component.

RESULTS: In extension, UC inserts exhibited a statistically significant posterior contact point versus PS inserts (56.3 + 4.3 vs 53.5 + 5.3, p = 0.003). Between 0 and 45° flexion, 13 of 20 UC inserts showed a paradoxical anterior translation exceeding 5%, unlike the PS group. At 90° flexion, both displayed consistent posterior femoral rollback, with PS inserts having a more posterior contact point (63.5 + 6.2 vs 67.2 + 5.1, p = .008). At 120° flexion, rollback was similar (70.1 + 8.4 vs 71.3 + 8.4, p = 0.128). Mean maximal flexion was 130° (SD = 6.87) and 133° (SD = 6.72) for UC and PS inserts, respectively (p = 0.0001).

CONCLUSIONS: The study indicates UC inserts achieve comparable posterior femoral rollback in deep flexion, supporting their alternative use, despite minor intraoperative flexion differences. However, paradoxical anterior translation in mid-flexion with UC inserts warrants further investigation into wear and clinical outcomes.

PMID:39735874 | PMC:PMC11680524 | DOI:10.1007/s43465-024-01292-3

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Engaging rural communities in Bangladesh to tackle antimicrobial resistance through the Community Dialogue Approach: a process evaluation protocol for COSTAR project in Cumilla, Bangladesh

Front Public Health. 2024 Dec 13;12:1466780. doi: 10.3389/fpubh.2024.1466780. eCollection 2024.

ABSTRACT

INTRODUCTION: Antimicrobial resistance (AMR) is a global problem and is especially threatening for low-and-middle income countries like Bangladesh. The COSTAR (Community-led Solutions to Antimicrobial Resistance) project includes a Randomised Control Trial (RCT) which aims to evaluate the effectiveness of the Community Dialog Approach (CDA) to improve levels of correct and appropriate knowledge and reported practice about antibiotics, antibiotic use, and antibiotic resistance (ABR) from a One Health perspective, among adult community members in 5 selected sub-districts of Cumilla. The CDA is a community engagement approach involving community members in active discussions also known as Community Dialogs (CD), run by local facilitators. The dialogs promote collective action to produce sustainable social change. The trial’s process evaluation will evaluate fidelity, dose, adaptation, reach, mechanisms of impact and the process of knowledge diffusion using the MRC framework for the evaluation of complex interventions.

METHODS AND ANALYSIS: The process evaluation will be implemented in the catchment areas of 25 selected community clinics (CCs) in the intervention group. The key actors involved in the process evaluation are participants from master trainers and trainers training; community dialog facilitators; supervisors; community dialog participants and non-participants; and local and national level government stakeholders. Qualitative and quantitative data will be collected through Focus Group Discussion (FGDs); Case Studies; Key Informant Interview (KIIs); CD observations; monitoring forms; quarterly feedback from facilitators and supervisors, and pre-and-post-test questionnaires administered during the training of facilitators. All qualitative data will be coded using a priori coding framework in NVIVO 14. Quantitative data will be analysed using descriptive statistics.

ETHICS AND DISSEMINATION: Ethical approval was obtained from the Bangladesh Medical Research Council (BMRC): BMRC/NREC/2019-2022/427 and from the University of Leeds Faculty of Medicine and Health ethics board: MREC 20-034. All results will be disseminated through a one pager summary; infographics; peer-reviewed journal articles and national and international conferences.

CLINICAL TRIAL REGISTRATION: https://www.isrctn.com/ISRCTN93756764, identifier ISRCTN93756764.

PMID:39735768 | PMC:PMC11672119 | DOI:10.3389/fpubh.2024.1466780

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The effect of activities of daily living on anxiety in older adult people: the mediating role of social participation

Front Public Health. 2024 Dec 13;12:1450826. doi: 10.3389/fpubh.2024.1450826. eCollection 2024.

ABSTRACT

OBJECTIVE: Anxiety is a serious psychiatric illness in older adult people. Activities of daily living and social participation are important factors influencing anxiety in older adult people. Using social participation as a mediating variable, this study explored the influence of activities of daily living on anxiety in older adult people to provide scientific evidence for improving the psychological health of older adult people.

METHODS: A multistage stratified random sampling method was used in this study to recruit older adult people. T tests and variance analysis were used for single factor analysis, and a multiple linear regression model was used for multifactor analysis. Pearson correlation analysis was used to study the correlation between activities of daily living and social participation and anxiety. The Process program was used to perform the bootstrap test.

RESULTS: The mean anxiety score of the interviewed older adult individuals was 3.028 ± 4.606 points, and 28.66% of the older adult individuals had anxiety. There was a statistically significant difference in the anxiety scores of older adult people across sex, age, marital status, education level, and health insurance status (p < 0.05). After controlling for other variables, each one-point increase in the activities of daily living score significantly increased the anxiety score by 0.122 points (𝛽=0.122, p < 0.001), and each one-point increase in the social participation score significantly decreased the anxiety score by 0.058 points (𝛽= – 0.058, p < 0.001). According to the results of the mediating effect analysis, there was a significant positive relationship between activities of daily living and anxiety, and the total effect was established (𝛽=0.1719, p < 0.001). After controlling for social participation, there was a significant direct effect of activities of daily living on anxiety in older adult people (𝛽=0.1255, p < 0.001). A partial mediating effect of social participation on the relationship between activities of daily living and anxiety in older adult people was found. The indirect effect of social participation was 26.99%.

CONCLUSION: Activities of daily living and social participation are important factors affecting anxiety in older adult people. Health education should be increased to enhance the physical activity of older adult people to improve their activities of daily living, create a good atmosphere for their social participation, improve their motivation for and continuity of social participation.

PMID:39735764 | PMC:PMC11671491 | DOI:10.3389/fpubh.2024.1450826

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Implementation and evaluation of whole-course-based Internet Hospital Outpatient Pharmacy Services: a cross-sectional study in western China

Front Public Health. 2024 Dec 13;12:1448471. doi: 10.3389/fpubh.2024.1448471. eCollection 2024.

ABSTRACT

BACKGROUND: In recent years, the development of telemedicine and eHealth services has led to the rapid worldwide growth of Internet hospitals, which played a significant role during the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about the characteristics and safety of Internet hospital outpatient pharmacy services (IHOPSs), which represent a new model of pharmaceutical services.

OBJECTIVE: This study aimed to reveal the comprehensive characteristics and safety of whole-course-based IHOPSs in a general tertiary hospital in western China.

METHODS: We established a whole-course-based IHOPS model. A total of 373,936 online prescriptions placed from February 1, 2020 to January 31, 2023 were analyzed. These included information on patients, prescriptions, and deliveries; error rates for prescription reviews and medication dispensations; economic value; and degree of patient satisfaction. Over the course of the study, a total of 373,936 prescriptions representing 351,884 patients and 945,172 medications were delivered to 22 provinces, 5 autonomous regions, and 4 municipalities in China.

RESULTS: IHOPSs saved patients more than 320,376 days (7,689,036 h) and RMB (Renminbi) ¥94.05 million in costs. The error rates of prescription review and dispensing were 0.0011% and 0.0008%, respectively. The infectious disease department (n = 63,903; 17.09%) ranked first in the number of prescriptions written for all three consecutive years. Of the 373,936 delivered prescriptions, 90.15% (337,104/373,936) were sent to Sichuan.

CONCLUSION: The IHOPS was found to be efficient, convenient, and safe because it handled the challenge of precisely and safely delivering medications to patients on time during and to the end of the COVID-19 pandemic. It provided patients with safe and convenient pharmaceutical services unlimited by geography or time zones. Widespread use of this service could help alleviate pressure on offline pharmacists, giving them the time and resources to provide other professional services. Our model can therefore serve as a useful reference for policymakers to support the development of Internet pharmaceutical services. Further efforts are needed to regulate and standardize the management of this novel service.

PMID:39735761 | PMC:PMC11671484 | DOI:10.3389/fpubh.2024.1448471

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Longitudinal trends and predictors of limitations in activities of daily living in community-dwelling older adults: evidence from the KLoSA study

Front Public Health. 2024 Dec 13;12:1485732. doi: 10.3389/fpubh.2024.1485732. eCollection 2024.

ABSTRACT

BACKGROUND: As life expectancy increases, the number of older adults with functional limitations is also increasing. Functional limitations are associated with adverse health outcomes such as reduced independence, diminished quality of life (QoL), and disability. Therefore, identifying which activities of daily living (ADLs) are limiting and understanding the influencing factors are crucial for developing tailored interventions. Although various factors influence ADL limitations, few studies have identified the longitudinal factors associated with each ADL. This study explores the longitudinal trends and factors associated with the ADL total score and functional limitations with each ADL among older adults in Korea.

METHODS: Using data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2020, we analyzed 1,388 people aged 65 and older who had no ADL limitations in 2006. An ADL limitation was defined as partial or complete dependence in any of the following ADLs: getting dressed, washing face and hands, bathing, eating, transferring, toileting, and continence. We used repeated measures analysis of variance and multivariate logistic regression to investigate the trends and predictors of ADL limitations over a 14-year period.

RESULTS: In 2006, the mean age of the participants was 69.88 years (SD = ±4.11), and 60.20% were female. The prevalence of total ADL limitations and limitations in each of the seven ADLs increased gradually during the 14 years of follow up. In 2020, the ADL items with the highest prevalence of limitations were bathing, getting dressed, and washing face and hands. The common significant predictors for total ADL limitations and limitation in the top three ADLs were age and cognitive function.

CONCLUSION: ADL limitations among Korean older adults significantly increase over time, which highlights the need for integrated early intervention and continuous support for bathing limitations, including the application of integrated assistive technologies. In particular, because age and cognitive function were identified as the major predictors for limitations in both total ADLs and the top three ADLs, early assessment and appropriate intervention strategies need to consider those factors to prevent ADL limitations in older adults or to meet the immediate needs of those already experiencing ADL limitations. This approach could enhance the QoL for older adults and contribute to the development of long-term healthcare plans.

PMID:39735760 | PMC:PMC11673221 | DOI:10.3389/fpubh.2024.1485732

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Analysis of genetic instability induced by radon exposure in iron mine processing workers in Shandong Province, Northern China

Front Public Health. 2024 Dec 13;12:1452730. doi: 10.3389/fpubh.2024.1452730. eCollection 2024.

ABSTRACT

BACKGROUND: Radon, a colorless and odorless radioactive gas, poses serious health risks. It is the second leading cause of lung cancer and notably increases lung cancer risk in smokers. Although previous epidemiological studies have mainly examined lung cancer rates in miners, the effects of radon on genomic stability and its molecular mechanisms are not well understood.

METHODS: This study evaluated chromosomal aberrations (CA) and cytokinesis-block micronucleus (CBMN) in miners’ lymphocytes, investigating the relationship between cytogenetic damage and variables such as exposure duration and age. Additionally, gene expression profiles were compared between radon-exposed miners and a control group to identify genes involved in DNA damage repair.

RESULTS: We observed a significant increase in CA and CBMN among underground miners. Gene expression analysis showed 14 genes were upregulated and four downregulated in the exposed group compared to controls.

CONCLUSION: These findings indicate a strong link between high radon exposure and genomic instability in miners. Improved monitoring of work environments and stronger protective measures are critical to safeguarding miners’ health.

PMID:39735759 | PMC:PMC11681618 | DOI:10.3389/fpubh.2024.1452730

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Examining the role of intrinsic and extrinsic cues from service requirement narratives in web-based time banking participation decisions

Front Public Health. 2024 Dec 13;12:1502079. doi: 10.3389/fpubh.2024.1502079. eCollection 2024.

ABSTRACT

INTRODUCTION: Time banking, known as “Community/Neighborhood Pension,” instantiates a form of co-creation that can provide a new solution to fulfil the unmet social service needs of community members with idle resources, which is a feasible solution to alleviate pension pressure. The sustainable operation of time banks relies on the co-creation and active participation of community members. Therefore, in this study, we investigate the motivation of members to participate in web-based time banks from a service requirement narrative perspective.

METHODS: We collected data of 21969 service requirement projects from publicly available information on the website of Nansha Timebank (nstimebank.com, a web-based time bank platform in China). Using the data, we built a model to assess how the intrinsic and extrinsic cues underlying service requirement narratives affect the time bank participation decisions of service providers drawing on grounded theory. Then we conducted a regression analysis to test our hypotheses.

RESULTS: We find that participants respond positively to time coins return and narratives highlighting social connection and value fulfilment but respond negatively to service hour costs and empathy-altruism cues.

DISCUSSION: Our findings suggest that people who receive services in web-based time banking platform should utilize different linguistic cues in service requirement descriptions to improve service exchange results.

PMID:39735757 | PMC:PMC11671481 | DOI:10.3389/fpubh.2024.1502079

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Polygenic score distribution differences across European ancestry populations: implications for breast cancer risk prediction

Breast Cancer Res. 2024 Dec 29;26(1):189. doi: 10.1186/s13058-024-01947-x.

ABSTRACT

BACKGROUND: The 313-variant polygenic risk score (PRS313) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS313 across different European populations which could influence risk estimation has not been performed.

METHODS: We explored the distribution of PRS313 across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank. The mean PRS was calculated by country in the BCAC dataset and by country of birth in the UK Biobank. We explored different approaches to reduce the observed heterogeneity in the mean PRS across the countries, and investigated the implications of the distribution variability in risk prediction.

RESULTS: The mean PRS313 differed markedly across European countries, being highest in individuals from Greece and Italy and lowest in individuals from Ireland. Using the overall European PRS313 distribution to define risk categories, leads to overestimation and underestimation of risk in some individuals from these countries. Adjustment for principal components explained most of the observed heterogeneity in the mean PRS. The mean estimates derived when using an empirical Bayes approach were similar to the predicted means after principal component adjustment.

CONCLUSIONS: Our results demonstrate that PRS distribution differs even within European ancestry populations leading to underestimation or overestimation of risk in specific European countries, which could potentially influence clinical management of some individuals if is not appropriately accounted for. Population-specific PRS distributions may be used in breast cancer risk estimation to ensure predicted risks are correctly calibrated across risk categories.

PMID:39734228 | DOI:10.1186/s13058-024-01947-x