Tag: nevin manimala

J Pediatr (Rio J). 2023 Aug 14:S0021-7557(23)00089-X. doi: 10.1016/j.jped.2023.07.006. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020.

METHODS: This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student’s t test, and the generalized estimating equation.

RESULTS: Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p < 0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p < 0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p < 0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p < 0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p < 0.001). Children aged 2-4y old had the best QoLscores.

CONCLUSIONS: Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.

PMID:37591484 | DOI:10.1016/j.jped.2023.07.006

Eur J Pharm Sci. 2023 Aug 15:106566. doi: 10.1016/j.ejps.2023.106566. Online ahead of print.

ABSTRACT

The series of conferences of the Global Bioequivalence Harmonisation Initiative (GBHI) was started in 2015 by the European Federation for Pharmaceutical Sciences (EUFEPS). All GBHI meetings so far were co-organised together with the American Association of Pharmaceutical Scientists (AAPS). Beginning with the 3^rd workshop US-FDA joined as co-sponsor – to support global harmonisation of regulatory recommendations for bioequivalence (BE) assessment. At the 5^th GBHI conference the following BE topics were intensively discussed and the following main conclusions were drawn: 1) Statistical considerations for BE assessment in specific situations covering scaling approaches for highly variable drug (HVD) products, two-stage adaptive design and opportunities of modelling and simulation to support BE: Even though special BE study concepts like adaptive designs are not often used in practise so far, a majority of the workshop participants were in favour of a more frequent application of such approaches. The regulatory conditions relevant in this context need further concretisation and harmonisation between the regions. Moreover, modelling and simulation were considered as a promising and evolving approach, also for BE development programmes. 2) Fed versus fasting conditions in BE trials: Findings that BE between generic products could be confirmed only after fasted administration but failed under fed conditions seem more an exception than the rule. Obviously, BCS class IV compounds are most problematic in this context. Differences in critical excipients such as surfactants or pH-modifiers may be relevant reasons for different sensitivity for interactions in fasted versus fed conditions. Consequently, such deviations in composition of generic preparations should be avoided. Moreover, confirmation of BE may be generally difficult comparing different dosage forms, such like capsules versus tablets, especially in fed state. 3) BE assessment of locally acting drug products applied topically to the skin: Appropriateness and potential benefit of in-vitro tests as alternatives to clinical efficacy studies have been comprehensively discussed. In addition to the already well-established in-vitro release and permeation tests, other techniques were suggested, e.g., Raman spectroscopy or dermal open flow microperfusion. Validation of those methods is challenging and, despite significant progress already achieved during previous years, more research is needed before they may be fully accepted for regulatory purposes. 4) BE evaluation of narrow therapeutic index (NTI) drugs: The discrepancies among regulatory agencies in necessity of tighter BE acceptance ranges, the recommendations for inclusion of peak and total drug exposure into BE assessment with more restrictive criteria and the importance of comparison of the product-related within-subject variability for NTI drugs were debated. Arguments in favour and against the different approaches were presented and discussed but need further consideration before harmonisation can be achieved. The highly interactive meeting and extensive exchange between regulators and scientists from industry and academia resulted in useful progress in open BE issues and supported the goal of science-driven harmonisation.

PMID:37591469 | DOI:10.1016/j.ejps.2023.106566

Resuscitation. 2023 Aug 15:109937. doi: 10.1016/j.resuscitation.2023.109937. Online ahead of print.

ABSTRACT

AIM: Assessment of neurologic injury within the immediate hours following out-of-hospital cardiac arrest (OHCA) resuscitation remains a major clinical challenge. Extracellular vesicles (EVs), small bodies derived from cytosolic contents during injury, may provide the opportunity for “liquid biopsy” within hours following resuscitation, as they contain proteins and RNA linked to cell type of origin. We evaluated whether micro-RNA (miRNA) from serologic EVs were associated with post-arrest neurologic outcome.

METHODS: We obtained serial blood samples in an OHCA cohort. Using novel microfluidic techniques to isolate EVs based on EV surface marker GluR2 (present on excitatory neuronal dendrites enriched in hippocampal tissue), we employed reverse transcription quantitative polymerase chain reaction (RT-qPCR) methods to measure a panel of miRNAs and tested association with dichotomized modified Rankin Score (mRS) at discharge.

RESULTS: EVs were assessed in 27 post-arrest patients between 7/3/2019-7/21/2022; 9 patients experienced good outcomes. Several miRNA species including miR-124 were statistically associated with mRS at discharge when measured within 6 hours of resuscitation (AUC=0.84 for miR-124, p<0.05). In a Kendall ranked correlation analysis, miRNA associations with outcome were not strongly correlated with standard serologic marker measurements, or amongst themselves, suggesting that miRNA provide distinct information from common protein biomarkers.

CONCLUSIONS: This study explores the associations between miRNAs from neuron-derived EVs (NDEs) and circulating protein biomarkers within 6 hours with neurologic outcome, suggesting a panel of very early biomarker may be useful during clinical care. Future work will be required to test larger cohorts with a broader panel of miRNA species.

PMID:37591443 | DOI:10.1016/j.resuscitation.2023.109937

Sci Total Environ. 2023 Aug 15:166316. doi: 10.1016/j.scitotenv.2023.166316. Online ahead of print.

ABSTRACT

Hydrated electrons (e_aq^–) exhibit rapid degradation of diverse persistent organic contaminants (OCs) and hold great promise as a formidable reducing agent in water treatment. However, the diverse structures of compounds exert different influences on the second-order rate constant of hydrated electron reactions (k_eaq^–), while the same OCs demonstrate notable discrepancies in k_eaq^– values across different pH levels. This study aims to develop machine learning (ML) models that can effectively simulate the intricate reaction kinetics between e_aq^– and OCs. Furthermore, the introduction of the pH variable enables a comprehensive investigation into the impact of ambient conditions on this process, thereby improving the practicality of the model. A dataset encompassing 701 k_eaq^– values derived from 351 peer-reviewed publications was compiled. To comprehensively investigate compound properties, this study introduced molecular descriptor (MD), molecular fingerprint (MF), and the integration of both (MD + MF) as model variables. Furthermore, 60 sets of predictive models were established utilizing two variable screening methodologies (MLR and RF) and ten prominent algorithms. Through statistical parameter analysis, it was determined that descriptors combined with MD and MF, the RF screening method, and the symbolism algorithm exhibited the best predictive efficacy. Importantly, the combination of descriptor models exhibited significantly superior performance compared to individual MF and MD models. Notably, the optimal model, denoted as RF – (MF + MD) – LGB, exhibited highly satisfactory predictive results (R²_tra = 0.967, Q²_tra = 0.840, R²_ext = 0.761). The mechanistic explanation study based on Shapley Additive Explanations (SHAP) values further elucidated the crucial influences of polarity, pH, molecular weight, electronegativity, carbon-carbon double bonds, and molecular topology on the degradation of OCs by e_aq^–. The proposed modeling approach, particularly the integration of MF and MD, alongside the introduction of pH, may furnish innovative ideas for advanced reduction or oxidation processes (ARPs/AOPs) and machine learning applications in other domains.

PMID:37591396 | DOI:10.1016/j.scitotenv.2023.166316

Sci Total Environ. 2023 Aug 15:166347. doi: 10.1016/j.scitotenv.2023.166347. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Recent cross-sectional studies found that exposure to ambient air pollution (AP) was associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD). The alternation of blood lipids may explain the association, but epidemiological evidence is lacking. We aimed to examine whether and to what extent the association between long-term exposure to AP and incident MAFLD is mediated by blood lipids and dyslipidemia in a prospective cohort.

METHODS: We included 6350 participants from the China Multi-Ethnic Cohort (CMEC, baseline 2018-2019, follow-up 2020-2021). Three-year average (2016-2018) of AP (PM₁, PM_2.5, PM₁₀, NO₂), blood lipids (TC, LDL-C, HDL-C, TG with their combinations) and incident MAFLD for each individual were assessed chronologically. Linear and logistic regression was used to assess the associations among AP, blood lipids, and MAFLD, and the potential mediation effects of blood lipids were evaluated using causal mediation analysis.

RESULTS: A total of 744 participants were newly diagnosed with MAFLD at follow-up. The odds ratios of MAFLD associated with a 10 μm increase in PM₁, PM_2.5, and PM₁₀ were 1.35 (95 % CI: 1.14, 1.58), 1.34 (1.10, 1.65) and 1.28 (1.14, 1.44), respectively. Blood lipids are important mediators between AP and incident MAFLD. LDL-C (Proportion Mediated: 6.9 %), non-HDL (13.4 %), HDL-C (20.7 %), LDL/HDL (30.1 %), and dyslipidemia (6.5 %) significantly mediated the association between PM_2.5 and MAFLD. For PM₁, the indirect effects were similar to those for PM_2.5, with a larger value for the direct effect, and the mediation proportion by blood lipids was less for NO₂.

CONCLUSION: Blood lipids are important mediators between AP and MAFLD, and can explain 5 %-30 % of the association between AP and incident MAFLD, particularly cholesterol-related variables, indicating that AP could lead to MAFLD through the alternation of blood lipids. These findings provided mechanical evidence of AP leading to MAFLD in epidemiological studies.

PMID:37591384 | DOI:10.1016/j.scitotenv.2023.166347

J Affect Disord. 2023 Aug 15:S0165-0327(23)01055-8. doi: 10.1016/j.jad.2023.08.083. Online ahead of print.

ABSTRACT

OBJECTIVE: The external behavioural manifestations and internal neural mechanisms of anhedonia are sexually dimorphic. This study aimed to explore the sex differences in the regional brain neuroimaging features of anhedonia in the context of major depressive disorder (MDD).

METHOD: The resting-fMRI by applying amplitude of low-frequency fluctuation (ALFF) method was estimated in 414 patients with MDD (281 high anhedonia [HA], 133 low anhedonia [LA]) and 213 healthy controls (HC). The effects of two factors in patients with MDD were analysed using a 2 (sex: male, female) × 2 (group: HA, LA) ANOVA concerning the brain regions in which statistical differences were identified between patients with MDD and HC. We followed up with patients with HA at baseline, and 43 patients completed a second fMRI scan in remission. Paired t-test was performed to compare the ALFF values of anhedonia-related brain regions between the baseline and remission periods.

RESULTS: For the sex-by-group interaction, the bilateral insula, right hippocampus, right post cingulum cortex, and left putamen showed significant differences. Furthermore, the abnormally elevated ALFF values in anhedonia-related brain regions at baseline decreased in remission.

CONCLUSION: Our findings point to the fact that the females showed unique patterns of anhedonia-related brain activity compared to males, which may have clinical implications for interfering with the anhedonia symptoms in MDD. Using task fMRI, we can further examine the distinct characteristics between consumption anhedonia and anticipation anhedonia in MDD.

PMID:37591350 | DOI:10.1016/j.jad.2023.08.083

Diabetes Res Clin Pract. 2023 Aug 15:110880. doi: 10.1016/j.diabres.2023.110880. Online ahead of print.

ABSTRACT

Addition of an active surveillance virtual glucose management (VGM) system to usual consultation-based diabetes inpatient care at our hospital was associated with a decrease in hospital-acquired infection from 8.7% (17/196) to 3.5% (6/172) with an adjusted odds ratio of 0.17 (95%CI: 0.05 – 0.61), and a reduction in hypoglycemic and hyperglycemic patient-stay days.

PMID:37591345 | DOI:10.1016/j.diabres.2023.110880

Am J Infect Control. 2023 Aug 15:S0196-6553(23)00572-2. doi: 10.1016/j.ajic.2023.08.011. Online ahead of print.

ABSTRACT

BACKGROUND: Excess mortality occurred in nursing homes during the SARS-CoV pandemic. This study aimed to identify risk factors for COVID-19 infection and mortality in nursing home residents and staff in Hesse, Germany.

METHODS: A retrospective cohort study of 687 nursing homes was performed. We used T-tests and logistic regressions to quantify the role of nursing homes’ size, location, staff qualification, and room occupancy as potential risk factors.

RESULTS: The bivariate statistics show that a higher proportion of infected staff and for-profit operation were associated with an increase in infections among residents and staff, while more single rooms and registered nurses showed protective effects. Our model calculations also show that the presence of a higher ratio of registered nurses was a significant protective factor against resident infection (OR: 0.969, p=.002), resident mortality (OR: 0.973, p=.006), and safeguarded staff (OR: 0.979, p=.034). In contrast, more single rooms (OR: 0.993, p=.029) were protective for residents, while increased risk factors included more beds (OR: 1.006, p=.006 for residents’ infections, OR: 1.008, p<.001 for mortality) and infected staff (OR: 2.363, p<.001 for residents’ infections). For staff, medium population density (OR: 2.322, p=.016) and infected residents (OR: 1.308, p<.001) were associated with elevated risk.

CONCLUSIONS: Preventing infection outbreaks among residents and staff is crucial to reduce mortality. Strategies include increasing single occupancy rooms, improving staff qualifications, and targeting facilities with lower registered nurse ratios and single-occupancy rooms for inspection.

PMID:37591313 | DOI:10.1016/j.ajic.2023.08.011

Int J Nurs Pract. 2023 Aug 17:e13189. doi: 10.1111/ijn.13189. Online ahead of print.

ABSTRACT

AIMS: This study aimed to present national data for children and adolescents requiring hospitalization in Thailand.

BACKGROUND: Feeding and eating disorders can cause life-threatening and negative health impacts. In Asia, the prevalence is rising. Data from children and adolescents in Thailand are limited.

DESIGN: This study is a retrospective study of the national database.

METHODS: Data from the National Health Security Office database on Universal Health Insurance Coverage (2015-2019) of 0-17-year-olds were analysed by diagnosis (anorexia nervosa, bulimia nervosa, vomiting associated with psychological disturbances, other eating disorders and unspecified eating disorders). Descriptive statistics, chi-square test and multinomial logistic regression were used.

RESULTS: There were 163 patients, averaging 9.4 ± 5.2 years old, requiring 205 admissions. Most diagnoses showed stable trends, except for a slight decrease in anorexia and unspecified eating disorders. Most admissions were due to unspecified eating disorders and psychogenic vomiting, followed by anorexia nervosa. The overall prevalence was 3.86 per 100 000 admissions. Anorexia had the highest hospital costs and re-admission rates. Anorexia nervosa was most prevalent in early adolescence and females, while bulimia nervosa was most prominent in middle adolescence and had a male predominance.

CONCLUSION: Early recognition in clinical practice could increase early detection and improve outcomes.

PMID:37591310 | DOI:10.1111/ijn.13189

Nature. 2023 Aug 17. doi: 10.1038/s41586-023-06536-0. Online ahead of print.

ABSTRACT

The integer quantum anomalous Hall (QAH) effect is a lattice analog of the quantum Hall effect at zero magnetic field^1-3. This striking phenomenon occurs in systems with topologically nontrivial bands and spontaneous time-reversal symmetry breaking. Discovery of its fractional counterpart in the presence of strong electron correlations, i.e., the fractional quantum anomalous Hall (FQAH) effect^4-7, would open a new chapter in condensed matter physics. Here, we report direct observation of both integer and fractional QAH effects in electrical measurements on twisted bilayer MoTe₂. At zero magnetic field, near filling factor [Formula: see text] (one hole per moiré unit cell) we see an integer QAH plateau in the Hall resistance R_xy quantized to [Formula: see text] while longitudinal resistance R_xx vanishes. Remarkably, at [Formula: see text] and [Formula: see text] we see plateau features in R_xy at [Formula: see text] and [Formula: see text], respectively, while R_xx remains small. All features shift linearly versus applied magnetic field with slopes matching the corresponding Chern numbers [Formula: see text], [Formula: see text], and [Formula: see text], precisely as expected for integer and fractional QAH states. Additionally, at zero magnetic field, R_xy is approximately 2[Formula: see text] near half filling ([Formula: see text]) and varies linearly as [Formula: see text] is tuned. This behavior resembles that of the composite Fermi liquid in the half-filled lowest Landau level of a two-dimensional electron gas at high magnetic field^8-14. Direct observation of the FQAH and associated effects paves the way for researching charge fractionalization and anyonic statistics at zero magnetic field.

PMID:37591304 | DOI:10.1038/s41586-023-06536-0