Tag: nevin manimala

Environ Res. 2023 Aug 18:116921. doi: 10.1016/j.envres.2023.116921. Online ahead of print.

ABSTRACT

Mobile communication technology has evolved rapidly over the last ten years with a drastic increase in wireless data traffic and the deployment of new telecommunication technologies. The aim of this study was to evaluate the ambient radiofrequency electromagnetic field (RF-EMF) levels and temporal changes in various microenvironments in Switzerland in 2014 and 2021. We measured the ambient RF-EMF levels in V/m in the same 49 outdoor areas and in public transport in 2014 and 2021 using portable RF-EMF exposure meters carried in a backpack. The areas were selected to represent some typical types of microenvironments (e.g. urban city centres, suburban and rural areas). We calculated the summary statistics (mean, percentiles) in mW/m² and converted back to V/m for each microenvironment. We evaluated the distribution and the variability of the ambient RF-EMF levels per microenvironment types in 2021. Finally, we compared the ambient RF-EMF mean levels in 2014 and 2021 using multilevel regression modelling. In outdoor areas, the average ambient RF-EMF mean levels per microenvironment in 2021 ranged from 0.19 V/m in rural areas to 0.43 V/m in industrial areas (overall mean: 0.27 V/m). In public transports, the mean levels were 0.27 V/m in buses, 0.33 V/m in trains and 0.36 V/m in trams. In 2021, mean levels across all outdoor areas were -0.022 V/m lower (95% confidence interval: 0.072, 0.030) than in 2014. Results from our comprehensive measurement study across Switzerland suggest that RF-EMF levels in public places have not significantly changed between 2014 and 2021 despite an 18-fold increase in mobile data transmission during that period. The absence of temporal changes may be owed to the shift to newer mobile communication technologies, which are more efficient.

PMID:37598840 | DOI:10.1016/j.envres.2023.116921

J Ren Nutr. 2023 Aug 18:S1051-2276(23)00129-2. doi: 10.1053/j.jrn.2023.08.007. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effects of supplementation with whey protein combined with vitamins C and E on inflammatory markers in hemodialysis (HD) patients.

DESIGN AND METHODS: This was a pioneer, randomized and double-blinded study. Patients were randomised into two groups and stratified by HD frequency. The supplementation group received 20 g of whey protein, 250 mg of vitamin C, and 600 IU of vitamin E; the placebo group, 20 g of rice flour, and microcrystalline cellulose capsules. The interventions were given after HD, 3 times a week, for 8 weeks. The inflammatory markers were assessed: interleukin (IL) IL-12p70, IL-10, IL-6, IL-8, and tumor necrosis factor alpha. For statistical analysis, the χ2 test, Student’s t-test, Mann – Whitney test, analysis of variance for repeated two-way measurements, paired t test, and Wilcoxon test were performed. P < 0.05.

RESULTS: Twenty-three patients completed the study. No significant differences were found in inflammatory markers when comparing the groups post-intervention. In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (p=0.0382). IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (non-significant) in the placebo group.

CONCLUSION: The supplementation with whey protein combined with vitamins C and E could be beneficial to reduce inflammatory markers in HD patients. Future studies are suggested with a larger sample size, different supplementation doses, and longer interventions.

PMID:37598813 | DOI:10.1053/j.jrn.2023.08.007

J Pharmacol Toxicol Methods. 2023 Aug 18:107469. doi: 10.1016/j.vascn.2023.107469. Online ahead of print.

ABSTRACT

The aim of the recent study was to collect data on the genotype characteristics of the Hungarian self-bred Pannon minipigs by adapting a standardized infarct model procedure. Closed chest AMI was induced by balloon occlusion for 90 min in the left anterior descendent coronary artery (LAD) in 24 adult intact female minipigs followed by reperfusion. To assess the left ventricular (LV) function, serial cardiac magnetic resonance imaging (cMRI) was performed prior to the experimental procedure, on day 3 post-AMI (72 ± 12 h), and at 1 month follow-up (Day 30 ± 2 days). Compared to baseline cMRI scans the end-diastolic volume (EDV) was increased on days 3 and 30 On day 3 the left ventricular ejection fraction (LVEF) decreased significantly but there was no statistical difference between the baseline and day 30 measurements. Cardiac output, stroke volume, and end-systolic volume significantly were increased compared to baseline on day 30 A high percentage (54%) of malignant arrhythmias occurred during the AMI procedure, with a 25% mortality rate. The compensatory capacity of the Pannon minipig heart is excellent therefore the use of different cardiac parameters and invasive measurements is advisable in chronic pharmacological experiments to complement cMRI data.

PMID:37598810 | DOI:10.1016/j.vascn.2023.107469

J Arthroplasty. 2023 Aug 18:S0883-5403(23)00857-4. doi: 10.1016/j.arth.2023.08.045. Online ahead of print.

ABSTRACT

Electronic health records have facilitated the extraction and analysis of a vast amount of data with many variables for clinical care and research. Conventional regression-based statistical methods may not capture all the complexities in high-dimensional data analysis. Therefore, researchers are increasingly using machine learning (ML)-based methods to better handle these more challenging datasets for the discovery of hidden patterns in patients’ data and for classification and predictive purposes. This article describes commonly used ML methods in structured data analysis with examples in orthopaedic surgery. We present practical considerations in starting an ML project and appraising published studies in this field.

PMID:37598784 | DOI:10.1016/j.arth.2023.08.045

J Arthroplasty. 2023 Aug 18:S0883-5403(23)00853-7. doi: 10.1016/j.arth.2023.08.042. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to assess whether there were clinically important differences in functional outcome over regular follow-up intervals up to 10 years after primary TKA.

METHODS: A prospective registry-based observational cohort study was performed in 309 patients older than 60 years at surgery who underwent primary TKA for osteoarthritis. Patients were assessed preoperatively and postoperatively at 1, 3, 5, 7 and 10 years with the Knee Society scores (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Clinically important improvement was defined according to the minimal clinically important difference (MCID). Patient satisfaction was also evaluated. Patients were also categorized as type A (unilateral knee osteoarthritis), type B (bilateral knee osteoarthritis) or type C (various sites of osteoarthritis).

RESULTS: Follow-up was 10 years in all patients. The mean age at the TKA surgery was 69.2 (SD 7.3) years, 197 (63.7%) were women. Maximum postoperative improvements in KSS and WOMAC scores occurred at 3 postoperative years, remained relatively stable up to 5-year. There were significant decreases in all KSS and WOMAC scores at 7-year follow-up (p= 0.001), remained relatively stable up to 10-year. At 10-year, KSS and WOMAC scores were significantly higher than preoperatively (p= 0.001). Differences between maximum scores at 3-year and those at 10-year were significantly lesser than MCID in all scores (p= 0.001). In multivariate analysis, type-C patient at TKA surgery was the only significant predictor of unsuccessful KSS score and dissatisfaction at 10-year follow-up.

CONCLUSION: Primary TKA provides clinically important improvements in functional and quality of life outcomes over 10-year follow-up compared to preoperatively. Although there were statistically significant declines in KSS and WOMAC scores from 3 to 10 years, the differences were lesser than the MCID.

PMID:37598778 | DOI:10.1016/j.arth.2023.08.042

Int J Radiat Oncol Biol Phys. 2023 Aug 18:S0360-3016(23)07781-7. doi: 10.1016/j.ijrobp.2023.08.014. Online ahead of print.

ABSTRACT

PURPOSE: NRG/RTOG 0848 is a two-step randomized trial to evaluate the benefit of the addition of concurrent fluoropyrimidine and radiotherapy (RT) following adjuvant chemotherapy (2^nd step) for patients with resected pancreatic head adenocarcinoma. Real-time quality assurance (QA) was performed on each patient who underwent RT. This analysis aims to evaluate adherence to protocol-specified contouring and treatment planning and to report the types and frequencies of deviations requiring revisions.

METHODS AND MATERIALS: In addition to a web-based contouring atlas, the protocol outlined step-by-step instructions for generating the clinical treatment volume (CTV) through the creation of specific regions of interest. The planning target volume (PTV) was a uniform 0.5cm CTV expansion. One of two radiation oncology study chairs independently reviewed each plan. Plans with unacceptable deviations were returned for revision and resubmitted until approved. Treatment started after final approval of the RT plan.

RESULTS: From 2014-2018, 354 patients were enrolled in the second randomization. Of these, 160 patients received RT and were included in the QA analysis. Resubmissions were more common for patients planned with 3D-CRT (43%) than with IMRT (31%). In total, at least one resubmission of the treatment plan was required for 33% of patients. Among patients requiring resubmission, most only needed one resubmission (87%). The most common reasons for resubmission were unacceptable deviations with respect to the pre-operative gross target volume (60.7%) and the pancreaticojejunostomy (47.5%), CONCLUSION: One-third of patients required resubmission to meet protocol compliance criteria, demonstrating the continued need for expending resources on real-time, pretreatment QA in trials evaluating the use of radiotherapy, particularly for pancreas cancer. Rigorous QA is critically important for clinical trials involving RT to ensure that the true impact of RT is assessed. Moreover, RT QA serves as an educational process through providing feedback from specialists to practicing radiation oncologists on best practices.

PMID:37598723 | DOI:10.1016/j.ijrobp.2023.08.014

J Affect Disord. 2023 Aug 18:S0165-0327(23)01062-5. doi: 10.1016/j.jad.2023.08.086. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to determine whether depressive, anxiety, stress symptoms were associated with the risk of elevated blood pressure by performing longitudinal cohort and Mendelian Randomization (MR) analyses.

METHODS: We used data from the Cohort Study on Chronic Disease of Community Natural Population in the Beijing-Tianjin-Hebei region (CHCN-BTH) from 2017 to 2021. The Depression-Anxiety-Stress Scale was used to evaluate the depressive, anxiety, stress symptoms. The longitudinal associations between depressive, anxiety, stress symptoms and elevated blood pressure were estimated using Cox proportional regression models. Two-sample MR analysis was performed using the Inverse-variance weighted (IVW), weighted median, and MR-Egger to explore the causal relationships between depressive, anxiety, stress symptoms and elevated blood pressure.

RESULTS: In total, 5624 participants were included. The risk of SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was significantly higher in participants with baseline anxiety symptoms (HR = 1.48, 95 % CI: 1.03 to 2.12, P = 0.033; HR = 1.56, 95 % CI: 1.05 to 2.32, P = 0.028), especially in men and individuals with higher educational levels, independent of baseline depression and anxiety at the two-year follow-up. The two-sample MR analysis showed positive associations between depressive, anxiety, stress symptoms and elevated blood pressure.

LIMITATION: Self-reported mental health symptoms, relatively shorter follow-up duration and the European-derived GWAS data for MR analysis.

CONCLUSIONS: Anxiety symptoms were positively associated with higher BPs in the longitudinal analysis independent of depression, stress, and other confounders. The results were verified in MR analysis, providing evidence for causal effects of anxiety symptoms on the risk of elevated blood pressure.

PMID:37598715 | DOI:10.1016/j.jad.2023.08.086

Drug Alcohol Depend. 2023 Aug 9;251:110923. doi: 10.1016/j.drugalcdep.2023.110923. Online ahead of print.

ABSTRACT

BACKGROUND: Illicit stimulant use remains a public health concern that has been associated with multiple adverse outcomes, including cognitive deficits. The effects of stimulant use on cognition may be particularly deleterious in persons with HIV. Stimulant use intensity may be an important factor in the magnitude of observed deficits over time.

METHODS: We completed neurocognitive testing in a sample of people who use stimulants with (n = 84) and without HIV (n = 123) at baseline and up to 4 follow-up time points over approximately 1 year. Participants reported on substance use at each visit, including frequency of use and stimulant dependence. Mixed effects models examined the relationship between stimulant-related factors and neurocognitive function over time.

RESULTS: Participants were mostly male (57%), African American (86%), and 47.41 years old on average. All participants actively used stimulants at enrollment and use remained prevalent throughout the follow-up period, with an average of ≥24 days of use in the past 90 days at all time points. Retention was excellent, with 86% completing all 4 follow-up assessments. Mixed effects models showed that stimulant dependence was associated with lower neurocognitive performance independent of HIV status (p = 0.002), whereas frequency of use had a greater negative impact on performance in participants with HIV compared to those without HIV (p = 0.045).

CONCLUSIONS: Our key finding is that stimulant-related factors are associated with neurocognitive performance over time, but in complex ways. These findings have important implications for harm reduction approaches, particularly those that target cognitive function.

PMID:37598454 | DOI:10.1016/j.drugalcdep.2023.110923

Forensic Sci Int Genet. 2023 Aug 3;67:102915. doi: 10.1016/j.fsigen.2023.102915. Online ahead of print.

ABSTRACT

Obtaining forensically relevant information beyond who deposited a biological stain on how and under which circumstances it was deposited is a question of increasing importance in forensic molecular biology. In the past few years, several studies have been produced on the potential of gene expression analysis to deliver relevant contextualizing information, e.g. on nature and condition of a stain as well as aspects of stain deposition timing. However, previous attempts to predict the time-of-day of sample deposition were all based on and thus limited by previously described diurnal oscillators. Herein, we newly approached this goal by applying current sequencing technologies and statistical methods to identify novel candidate markers for forensic time-of-day predictions from whole transcriptome analyses. To this purpose, we collected whole blood samples from ten individuals at eight different time points throughout the day, performed whole transcriptome sequencing and applied biostatistical algorithms to identify 81 mRNA markers with significantly differential expression as candidates to predict the time of day. In addition, we performed qPCR analysis to assess the characteristics of a subset of 13 candidate predictors in dried and aged blood stains. While we demonstrated the general possibility of using the selected candidate markers to predict time-of-day of sample deposition, we also observed notable variation between different donors and storage conditions, highlighting the relevance of employing accurate quantification methods in combination with robust normalization procedures.This study’s results are foundational and may be built upon when developing a targeted assay for time-of-day predictions from forensic blood samples in the future.

PMID:37598452 | DOI:10.1016/j.fsigen.2023.102915

Geriatr Nurs. 2023 Aug 18;53:255-260. doi: 10.1016/j.gerinurse.2023.07.021. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the accuracy of the 3D-DST for delirium assessment in older adults by the nurse researcher.

METHODS: The 3D-DST was administered by a trained nurse researcher to assess delirium among eligible older adults (aged ≥70 years). The criteria for identifying delirium was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V).

RESULTS: A total of 95 older adults were enrolled in the current study, and 23 patients were identified as positive for delirium by the psychiatrist. The sensitivity and specificity of the 3D-DST were 96% and 94%, respectively. High sensitivities of the 3D-DST were also observed among patients with hypoactive delirium (95%) and those with cognitive impairment (93%).

CONCLUSION: The 3D-DST was demonstrated as an appropriate instrument with highly acceptable sensitivities and specificities for delirium detection in hospitalized older patients.

PMID:37598429 | DOI:10.1016/j.gerinurse.2023.07.021