Tag: nevin manimala

Int J Spine Surg. 2023 Sep 13:8516. doi: 10.14444/8516. Online ahead of print.

ABSTRACT

Proximal junctional kyphosis and failure are not infrequent complications of adult spinal deformity reconstructions. Efforts to define proximal junctional kyphosis have ranged from expert opinions to statistical analyses of large databases. These approaches fail to recognize that proximal junctional kyphosis/failure/breakdown is likely a spectrum of manifestations secondary to spinal fusions and spinal alignment. The dichotomization (clinically irrelevant vs clinically relevant) of continuous measures will lead to misclassification and misdiagnosis. As adult spinal deformity moves to a precision-medicine-based approach (also known as personalized medicine), work is required to develop probabilistic models to inform patients and surgeons about the likely survivorship of a proximal junctional failure. As such, it is likely better to call proximal junctional segment kyphosis without symptoms “asymptomatic proximal junctional kyphosis” rather than to determine thresholds for “symptomatic” or “clinically relevant.”

PMID:37704378 | DOI:10.14444/8516

Ann Geriatr Med Res. 2023 Sep 14. doi: 10.4235/agmr.23.0132. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals with frailty are susceptible to adverse events. Although a psychological correlation with frailty has been observed, few studies have investigated the link between stress and frailty. This study examined the association between perceived stress and frailty in older adults.

METHODS: This cross-sectional observational study included participants recruited between September 2021 and January 2022. The Korean version of the Perceived Stress Scale-10 was used to measure stress levels, while the frailty status was assessed using the Korean Frailty Index. Loneliness, depression, and satisfaction were measured using the UCLA Loneliness Scale, Centre for Epidemiological Studies Depression Scale, and Satisfaction with Life Scale, respectively. We used multinomial logistic regression to compare the variables between frail and robust participants.

RESULTS: Among 862 study participants (mean age, 73.62 years; 65.5% women), the mean PSS-10 score was 15.26, 10.8% were frail, 22.4% were pre-frail, and 66.8% were robust. Perceived stress was significantly associated with pre-frailty (crude odds ratio [cOR], 1.147; 95% confidence interval [CI] 1.093-1.204) and frailty (cOR, 1.417; 95% CI 1.322-1.520). After adjusting for sociodemographic factors, we examined the associations between perceived stress and prefrailty (adjusted odds ratio [aOR] 1.140, 95% CI 1.084-1.199) and frailty (aOR, 1.409; 95% CI 1.308-1.518). After adjusting for all variables, including loneliness, depression, and satisfaction, perceived stress was significantly associated with frailty (aOR, 1.172; 95% CI 1.071-1.283), however, insufficient statistical evidence was observed for pre-frailty (aOR, 1.022; 95% CI 0.961-1.086).

CONCLUSION: Higher levels of perceived stress were associated with frailty in older adults. Stress management efforts may help improve frailty in this population.

PMID:37704370 | DOI:10.4235/agmr.23.0132

Sex Transm Infect. 2023 Sep 13:sextrans-2023-055900. doi: 10.1136/sextrans-2023-055900. Online ahead of print.

ABSTRACT

OBJECTIVE: Macrolide and fluoroquinolone resistance in Mycoplasma genitalium (MG) is of emerging global concern. Compared with neighbouring countries such as Denmark, Sweden has had lower rates of macrolide resistance while fluoroquinolone resistance rates are less well documented. This study retrospectively examined macrolide, fluoroquinolone and multidrug resistance rates from Dalarna County, Sweden over a 13-year period.

METHODS: MG-positive samples from 2006 to 2018 from patients examined at the Department of Venereology, Central Hospital, Falun, Sweden were tested by sequencing for macrolide resistance mutations (MRM) and fluoroquinolone resistance-associated mutations (QRAM) in the parC and gyrA subunit regions. A subset of these samples from 2006 to 2011 have been reported on previously, although only for MRM.

RESULTS: Of 874 samples, 98 (11.2%, 95% CI 9.1% to 13.6%) had mutations associated with resistance to macrolides and 19 of 828 (2.3%, 95% CI 8.9% to 23.1%) to quinolones. Mutations associated with resistance to both drugs were detected in 5 of 828 (0.6%, 95% CI 0.1% to 1.4%) samples overall. A significant positive linear trend (p=0.004) for an increase in the rate of macrolide resistance was observed (from 0% in 2006 to 31% in 2018) while the increase in QRAM from 0% in 2006 to 12.3% in 2018 was not statistically significant.

CONCLUSIONS: Despite a decrease in macrolide and fluoroquinolone consumption in Sweden, there was an overall increase in MG macrolide, fluoroquinolone and dual resistance from 2006 to 2018, although the difference in fluoroquinolone resistance rates was not statistically significant. In order to maintain comparably low resistance rates, resistance-guided therapy for MG infections will be crucial.

PMID:37704364 | DOI:10.1136/sextrans-2023-055900

J Aging Stud. 2023 Sep;66:101158. doi: 10.1016/j.jaging.2023.101158. Epub 2023 Jul 13.

ABSTRACT

In this study, older characters that appeared in all the episodes of the first seasons of eight most popular Turkish TV series on prime-time televisions in Turkey and those appeared in all the episodes of the first seasons of eight “original” Turkish series on Netflix were submitted to a comparative quantitative and qualitative content analysis. In this sense, the aim of this study was to reveal what kind of old age is promised to viewers by such media environments as TV and Netflix. Findings revealed that, when compared to the Turkish population, older people were significantly underrepresented in prime-time series and that, in other words, they were symbolically eliminated and exposed to age discrimination. Another finding is that older people were portrayed more fairly on Netflix than TV. Although older individuals were inadequately represented on Netflix as well, the difference between the two platforms was not statistically significant. On the other hand, while older women are significantly less represented than older men on both platforms, the study found no significant difference in gender representation between Netflix and prime-time TV. The findings also indicated that no older character, when evaluated qualitatively, was represented as the major character on either platforms and that, especially when it comes to having a profession, older people, specifically older women, were portrayed more negatively on both platforms, which means that older women faced a double jeopardy.

PMID:37704276 | DOI:10.1016/j.jaging.2023.101158

J Appl Gerontol. 2023 Sep 13:7334648231196850. doi: 10.1177/07334648231196850. Online ahead of print.

ABSTRACT

Poor financial and health literacy and poor psychological well-being are significant correlates of scam susceptibility in older adults; yet, no research has examined whether interventions that target these factors may effectively reduce susceptibility. Using longitudinal data from older adults in the Rush Memory and Aging Project (MAP) (N = 1,231), we used microsimulations to estimate the causal effect of hypothetical well-being and literacy interventions on scam susceptibility over six years. Microsimulations can simulate a randomized trial to estimate intervention effects using observational data. We simulated hypotheticalinterventions that improved well-being or literacy scores by either 10% or 30% from baseline, or to the maximum scores, for an older adult population and for income and education subgroups. Simulations suggest thathypotheticalinterventions that increase well-being or literacy cause statistically significant reductions in scam susceptibility of older adults over time, but improving well-being caused a greater-albeit not significantly different-reduction compared to improving literacy.

PMID:37704219 | DOI:10.1177/07334648231196850

J Phys Act Health. 2023 Sep 13:1-8. doi: 10.1123/jpah.2022-0471. Online ahead of print.

ABSTRACT

BACKGROUND: Recent statistical approaches have allowed consideration of the integrated relationships between sedentary behavior (SB) and physical activity (PA) with different health outcomes. The present paper aimed to systematically review the literature and synthesize evidence about associations between hypothetical reallocations from SB to different PA intensities and cardiovascular risk factors in youth.

METHODS: A systematic search of 8 databases was performed. Observational studies with a population of children and/or adolescents and based on statistical analysis that investigated the associations between time reallocations from SB to PA and cardiovascular risk factors were included.

RESULTS: Twenty-eight studies met the inclusion criteria. Level of evidence (derived from cross-sectional studies) indicated that the reallocation from SB to moderate to vigorous PA was beneficially associated with adiposity, cardiorespiratory fitness, and cardiometabolic biomarkers in youth. Reallocation from SB to light PA was not associated with the analyzed outcomes. Associations derived from longitudinal studies were mostly inconclusive.

CONCLUSION: Cardiovascular risk factors could be improved by increasing moderate to vigorous PA at the expense of time spent in SB in pediatric populations. Prospective studies or studies investigating the effects of reallocating sedentary bouts to PA are needed.

PMID:37704195 | DOI:10.1123/jpah.2022-0471

Sci Total Environ. 2023 Sep 11:166930. doi: 10.1016/j.scitotenv.2023.166930. Online ahead of print.

ABSTRACT

Nitrous oxide (N₂O) is a potent greenhouse gas that also contributes to ozone depletion. Recent studies have identified river corridors as significant sources of N₂O emissions. Surface water-groundwater (hyporheic) interactions along river corridors induce flow and reactive nitrogen transport through riparian sediments, thereby generating N₂O. Despite the prevalence of these processes, the controlling influence of physical and geochemical parameters on N₂O emissions from coupled aerobic and anaerobic reactive transport processes in heterogeneous riparian sediments is not yet fully understood. This study presents an integrated framework that combines a flow and multi-component reactive transport model (RTM) with an uncertainty quantification and sensitivity analysis tool to determine which physical and geochemical parameters have the greatest impact on N₂O emissions from riparian sediments. The framework involves the development of thousands of RTMs, followed by global sensitivity and responsive surface analyses. Results indicate that characterizing the denitrification reaction rate constant and permeability of intermediate-permeability sediments (e.g., sandy gravel) are crucial in describing coupled nitrification-denitrification reactions and the magnitude of N₂O emissions. This study provides valuable insights into the factors that influence N₂O emissions from riparian sediments and can help in developing strategies to control N₂O emissions from river corridors.

PMID:37704143 | DOI:10.1016/j.scitotenv.2023.166930

Ophthalmology. 2023 Sep 11:S0161-6420(23)00631-0. doi: 10.1016/j.ophtha.2023.09.006. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the impact of baseline data on psychophysical and morphological outcomes of subretinal Voretigene Neparvovec (VN, Luxturna®) treatment.

DESIGN: Single center, retrospective, longitudinal, consecutive case series.

PARTICIPANTS: Patients with RPE65-IRD treated by one surgeon (FGH) between 02-2020 and 03-2022 with VN and oral immunosuppression according to the manufacturer´s recommendation.

METHODS: Retrospective analysis of surgical and clinical records, ancillary testing and retinal imaging following VN therapy for RPE65-IRD. Descriptive statistics compared data at baseline up to 24 months post treatment.

MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), low-luminance VA (LLVA), Goldmann Visual Fields (GVF), chromatic full-field-stimulus-threshold testing (FST), scotopic and photopic 2-Color-Threshold Perimetry (2CTP), multimodal retinal imaging.

RESULTS: 30 eyes / 19 patients were analyzed (10 pediatric <20y, 20 adult (range 8-40 y, median follow-up 15 months, range 1-32). The fovea was completely or partially detached in 16, attached in 12, and not assessable in 2 eyes on intraoperative imaging. Median BCVA at baseline was better in the pediatric group (p <0.05), and did not change significantly independent of age. Meaningful loss of BCVA (≥0.3 logMAR) occurred in 4/18 adult eyes, meaningful gain (≥-0.3 logMAR) in 2/18 adult and 2/8 pediatric eyes. LLVA and scotopic 2CTP improved considerably in pediatrics. Scotopic blue FST improved at all ages, more in pediatrics (8/8 eyes gain ≥ 10 dB, p<0.05). In pediatrics, median GVF improved by 20% for target V4e and by 50% for target III4e (target I4e not detected). Novel atrophy developed in 13/26 eyes at the site of the bleb and/or peripheral of vascular arcades. FST improvements did not correlate with development of chorioretinal atrophy at M12. Mean central retinal thickness was 166.7 μm (±25.45) at baseline (30 eyes) and 157.69 μm (±30.3) at M12 (26 eyes). Eight adult patients were treated unilaterally. The non-treated eyes did not show meaningful changes during follow-up.

CONCLUSIONS: These real-world data show effectiveness of VN therapy with stable median BCVA and mean retinal thickness, and improvements of LLVA, FST and 2CTP up to 32 months. Treatment effects were superior in the pediatric group. We observed new chorioretinal atrophy in 50% of the treated eyes.

PMID:37704110 | DOI:10.1016/j.ophtha.2023.09.006

Chemosphere. 2023 Sep 11:140146. doi: 10.1016/j.chemosphere.2023.140146. Online ahead of print.

ABSTRACT

As the third largest river in the world, microplastic pollution in the Yangtze River basin is currently attracting worldwide attention. However, fragmented research information is insufficient to reveal the occurrence and driving mechanisms of microplastics throughout the Yangtze River basin. Building on a systematic review of 20 existing publications, this study constructed a dataset including microplastic data from 366 samples in the Yangtze River basin through a data filtering process, and data on natural conditions and anthropogenic activities from 101 basin municipalities. Further, multivariate statistical analysis was utilized to enhance the understanding of the abundance, composition and drivers of microplastics within the basin. Differences in microplastic abundance among the sampling sites were up to 5 orders of magnitude, with the highest abundance value found in the upstream city of Chengdu. The comprehensive diversity index used to describe the composition characteristics of microplastics ranged from 0.31 to 0.68, slightly higher than the national average. Based on a statistical analysis framework, natural conditions and anthropogenic activities were shown to jointly drive the distribution of microplastics, and the dominant driver shifted between the two with spatial variation. In the upstream, anthropogenic activities dominated by GDP (r = 0.85, P < 0.01) were the main positive factor. In the middle and downstream, natural conditions and anthropogenic activities had comparable driving forces as the stability of natural resistance increased, and both were positively correlated with microplastics. Combining the constructed normalized stepwise linear regression model with GIS spatial analysis, the basin-wide application demonstrated that microplastic pollution in the upstream and delta deserved more attention. After coupling the distance factors, microplastic pollution was concentrated in the middle and downstream of the Yangtze River basin, covering important drinking water sources. This study provided important data support for subsequent targeted microplastic reduction and treatment.

PMID:37704083 | DOI:10.1016/j.chemosphere.2023.140146

Ageing Res Rev. 2023 Sep 11:102071. doi: 10.1016/j.arr.2023.102071. Online ahead of print.

ABSTRACT

BACKGROUND: Exercise is a promising nonpharmacological treatment for improving depression in older adults with MCI, but it is unclear which exercises are most effective. The objectives of this study were to compare and rank the effectiveness of various exercise interventions for depression in mild cognitive impairment (MCI) and to investigate the effects of exercise on depression.

METHODS: The PRISMA-NMA guidelines were applied to the development and reporting of review criteria. The Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus databases were systematically searched by combining search terms for randomized controlled trial studies (RCTs) published in English from individual databases with the earliest available date set to March 10, 2023. Two evaluators independently selected and evaluated eligible studies of changes in depression in older adults with MCI after an exercise intervention. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022377052).

RESULTS: A network meta-analysis was conducted on 15 eligible RCTs consisting of 4271 subjects, including aerobic (n = 6), mind-body (n = 6) and multicomponent (n = 3) exercise trials. Compared to controls, mind-body exercise showed the strongest improvement in depressive symptoms (SMD = -0.63, 95% CI: -1.13, -0.14), followed by aerobic (SMD = -0.57, 95% CI: -0.88, -0.26) and multicomponent exercise (SMD = -0.53, 95% CI: -1.02, -0.03). Notably, there were no statistically significant differences between exercise types: aerobic vs. mind-body (SMD = 0.06, 95% PrI: -0.71, 0.84), multicomponent vs. mind-body (SMD = 0.11, 95% PrI: -0.75, 0.97), or multicomponent vs. aerobic (SMD = 0.04, 95% PrI: -0.771, 0.86).

CONCLUSIONS: In this review, we found that mind-body exercise was most effective when compared to conventional controls and that multiple exercise modalities (aerobic, mind-body, and multicomponent exercise) had beneficial and comparable effects in reducing depressive states in older adults with MCI. These findings may guide clinical geriatric stakeholders and allied health professionals in providing more scientifically optimal exercise prescriptions for older adults with MCI. In the future, more high-quality, long-term clinical trials are needed to support the exploration of longer-term dynamic effects.

PMID:37704052 | DOI:10.1016/j.arr.2023.102071