Tag: nevin manimala

Ophthalmol Retina. 2023 Jun 9:S2468-6530(23)00254-3. doi: 10.1016/j.oret.2023.06.003. Online ahead of print.

ABSTRACT

PURPOSE: To compare accuracy, precision, and residual volume of commonly used syringes for intravitreal injections (IVI), and to assess the intraocular pressure (IOP) rise by variations in volumes delivered.

DESIGN: Experimental lab study.

SUBJECTS: No subjects were involved in this study.

METHODS: We tested 8 syringe models with 2 different needle setups, with 2 different solutions (distilled water or glycerin) and target volumes (50 and 70 μL). To obtain the delivered and residual volumes, we weighed the syringe-needle setups with scale before liquid withdrawal, with liquid, and after liquid release. We also created an experimental eye model to determine the transient rise in IOP following stepwise 10-μL increases in injection volumes.

MAIN OUTCOME MEASURES: Delivered and residual volumes, IOP rise.

RESULTS: We tested a total of 600 syringe-needle setups. BD Ultra-Fine (0.34 ± 0.28 μL), Zero Residual (1.53 ± 1.15 μL) and Zero Residual Silicone Oil-free (1.40 ± 1.16 μL) syringes showed the lowest residual volume (p<0.001) in comparison to the others (range: 24.86 ± 1.78 μL for Injekt-F to 51.97 ± 3.37 μL for Omnifix-F). The most accurate setups were (percentage deviation from target volume): Zero Residual Silicone Oil-free (+0.70%), Zero Residual 0.3 mL (+4.49%), BD Ultra-Fine (+7.83%), Injekt-F (9.42%), Norm-Ject (+15.88%), Omnifix-F (+16.96%), BD Plastipak Brazil (+17.96%), and BD Plastipak Spain syringes (+19.41%). There was a statistically significant difference between the Zero Residual Silicone Oil-free syringe and all other syringes (p<0.0001), except for the Zero Residual 0.3 mL syringe (p=0.029). The coefficient of variation was low for all syringes. The modeled IOP rise ranged from 32.3 (SD 1.4) mmHg for 20-μL injection volume to 76.5 (SD 1.0) mmHg for 80-μL injection volume. For the standard 50-μL injection volume, the peak pressure was 50.7 (SD 0.1) mmHg, and the pressure rise duration was 28 (SD 2) minutes.

CONCLUSIONS: There were significant differences in accuracy and residual volume between syringes, whereas they showed a high precision. Volume excess results in a considerable increase in IOP rise following injection. These findings may provide a relevant overview to clinicians and to both device and drug manufacturers regarding pharmacoeconomic, safety and efficacy issues.

PMID:37302655 | DOI:10.1016/j.oret.2023.06.003

J Acad Nutr Diet. 2023 Jun 9:S2212-2672(23)00301-5. doi: 10.1016/j.jand.2023.06.003. Online ahead of print.

ABSTRACT

BACKGROUND: The Child and Adult Care Food Program (CACFP) is the primary national program that enables child care settings to provide healthy meals for children. Associations between CACFP participation and child health and development and health care utilization are understudied.

OBJECTIVE: To assess associations between children’s health, development, health care utilization and food security by meal source (child care-provided versus parent-provided) among children from low-income families with a child care subsidy attending child care in settings likely eligible to participate in CACFP.

DESIGN: The study used repeat cross-sectional surveys (new sample at successive time-points) conducted year-round.

PARTICIPANTS: /Setting: Primary caregivers of 3,084 young children accessing emergency departments (EDs) or primary care in Baltimore, Boston, Little Rock, Minneapolis, and Philadelphia were interviewed between 2010-2020. The sample was limited to children aged 13-48 months, receiving a child care subsidy and attending child care centers or family child care homes >20 hours per week.

MAIN OUTCOME MEASURES: Outcomes included household and child food security; child health, growth, and developmental risk; and admission to the hospital on the day of the ED visit.

STATISTICAL ANALYSES: Meal source and participant characteristics were analyzed using chi-square; associations of outcomes with parent-provided meals were analyzed with adjusted logistic regression.

RESULTS: The majority of children had child care-provided meals (87.2% child care-provided vs. 12.8% parent-provided). Compared to children with parent-provided meals, children with child care-provided meals had lower adjusted odds of living in a food-insecure household (AOR 0.70, [95%CI 0.55, 0.88]), being in fair or poor health (AOR 0.61, [95%CI 0.46, 0.81]), or hospital admission from the ED (AOR 0.59, [95%CI 0.41, 0.83]), with no differences in growth or developmental risk.

CONCLUSIONS: Compared to meals provided from home, child care provided meals likely supported by the Child and Adult Care Food Program (CACFP) is related to food security, early childhood health, and reduced hospital admissions from the ED among low-income families with young children.

PMID:37302653 | DOI:10.1016/j.jand.2023.06.003

Sci Total Environ. 2023 Jun 9:164804. doi: 10.1016/j.scitotenv.2023.164804. Online ahead of print.

ABSTRACT

Exposure to chemical contaminants found in foods has been associated with various adverse health effects. Burden of disease studies are increasingly used to estimate the public health impact of such exposures. The aims of this study were to estimate the burden of disease due to dietary exposure to four chemicals in France in 2019 (lead (Pb), cadmium (Cd), methylmercury (MeHg), and inorganic arsenic (i-As)), and to develop harmonized methods that can be applied for other chemicals and countries. We used national food consumption data from the third French national food consumption survey, chemical food monitoring data from the Second French Total Diet Study (TDS), dose-response data and disability weights from scientific literature, and disease incidence and demographics from national statistics. We adopted a risk assessment approach to estimate disease burden, incidence, mortality, and Disability-Adjusted Life Years (DALYs) attributable to dietary exposure to the chemicals. In all models, we harmonized food classification and exposure assessment. We propagated uncertainty through the calculations using Monte Carlo simulation. We estimated that, among these chemicals, i-As and Pb were responsible for the highest disease burden. i-As was estimated to cause 820 DALYs, or approximately 1.25 DALYs per 100,000 inhabitants. The estimated burden of Pb was 1834 to 5936 DALYs, or 2.7 (lower bound) to 8.96 (upper bound) DALYs/100,000. The burden of MeHg (192 DALYs), and Cd (0 DALY) was substantially lower. The foods contributing most to disease burden was drinks (30 %), “other foods” (mostly composite dishes) (19 %), and fish and seafood (7 %). Interpretation of estimates needs to consider all underlying uncertainties, linked with data and knowledge gaps. The harmonized models are the first to make use of data from TDS, which are available in several other countries. Thus, they can be applied to estimate the burden and to rank food-associated chemicals at national level.

PMID:37302596 | DOI:10.1016/j.scitotenv.2023.164804

Sci Total Environ. 2023 Jun 9:164700. doi: 10.1016/j.scitotenv.2023.164700. Online ahead of print.

ABSTRACT

Geographic location and meteorological factors can affect the content of bioaerosol concentrations. This study was conducted to determine the natural background concentrations of culturable fungal spores and dust particles in three different geographical areas. Focus was given to the dominant airborne genera Cladosporium, Penicillium, Aspergillus and the species Aspergillus fumigatus. The influence of weather conditions on the microorganism concentrations in urban, rural and mountain regions were examined. Possible correlations between particle counts and culturable fungal spore concentrations were investigated. 125 measurements of the air were conducted using the air sampler MAS-100NT® and the particle counter Alphasense OPC-N3. The analyses of the collected samples were based on culture methods using different media. The highest median of fungal spore concentrations was detected in the urban region and was of 2.0 × 10³ CFU/m³ for xerophilic fungi and 1.7 × 10³ CFU/m³ for the genus Cladosporium. The concentrations of fine and coarse particles in rural and urban regions were the highest of 1.9 × 10⁷ pa/m³ and 1.3 × 10⁷ pa/m³, respectively. Little cloud cover and slight wind had a positive influence on the concentration of fungal spores. Furthermore, correlations were observed between air temperature and the concentrations of xerophilic fungi as well as the genera Cladosporium. In contrast, relative humidity correlated negatively with total fungi and Cladosporium and no correlation was found with the other fungi. For the region of Styria in summer and early autumn, the natural background concentration for xerophilic fungi ranged between 3.5 × 10² and 4.7 × 10³ CFU/m³ air. No significant differences were detected between the fungal spore concentrations in urban, rural and mountainous regions. The data of this study could be used as a reference to compare the natural background concentrations of airborne culturable fungi in further studies concerning air quality assessment.

PMID:37302594 | DOI:10.1016/j.scitotenv.2023.164700

J Hepatol. 2023 Jun 9:S0168-8278(23)00399-9. doi: 10.1016/j.jhep.2023.05.027. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Machine perfusion is increasingly tested in clinical transplantation. Despite this success, the number of large prospective clinical trials remains limited. The aim of this study is therefore to compare the impact of machine perfusion on outcomes after liver transplantation versus static cold storage (SCS).

METHODS: A systematic search of MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted to identify randomized controlled trials (RCTs) reporting “posttransplant” outcomes of machine perfused livers compared to SCS. Data were pooled using random effect models. Risk ratios (RR) were calculated for relevant outcomes. The quality of evidence was rated using the GRADE-framework. PROSPERO-registration: CRD42022355252.

RESULTS: Seven RCTs were identified with hypothermic oxygenated (HOPE, n=4) and normothermic machine perfusion (NMP, n=3), including a total number of 1017 patients. Both techniques were associated with significantly lower rates of early allograft dysfunction (NMP: n=41/282; SCS: n=74/253; RR:0.50, 95%CI:0.30-0.86, p=0.01, I²:39%; HOPE: n=45/241; SCS: n=97/241, RR:0.48, 95%CI:0.35-0.65, p<0.00001, I²:5%). The HOPE-approach led to a significant reduction of major complications (Clavien Grade ≥IIIb; HOPE: n=90/241; SCS: n=117/241, RR: 0.76, 95%CI: 0.63-0.93, p=0.006, I²:0%), “retransplantation” (HOPE: n=1/163; SCS: n=11/163; RR:0.21, 95%CI: 0.04-0.96, p=0.04; I²:0%) and graft loss (HOPE: n=7/163; SCS: n=19/163; RR:0.40, 95%CI: 0.17-0.95, p=0.04; I²:0%). Both perfusion techniques were found to likely reduce overall biliary complications and non-anastomotic strictures.

CONCLUSIONS: Although this study provides the highest current evidence on the role of machine perfusion, outcomes remain limited to a one-year follow-up after liver transplantation. Comparative RCTs and large real world cohort studies with longer follow-up are required to enhance the robustness of the data further, thereby supporting the introduction of perfusion technologies in routine clinical practice.

PMID:37302578 | DOI:10.1016/j.jhep.2023.05.027

J Pain Symptom Manage. 2023 Jun 9:S0885-3924(23)00529-8. doi: 10.1016/j.jpainsymman.2023.06.002. Online ahead of print.

ABSTRACT

CONTEXT: There is no current standard-of-care follow-up strategy for patients who receive palliative radiotherapy (PRT) for bone metastases. Within our institution there is currently a heterogenous practice in which some providers schedule routine follow up 1-3 months after initial PRT while others do follow up only as needed (PRN).

OBJECTIVES: Our study aims to compare rates of retreatment based on follow-up strategies (planned vs PRN), explore factors that potentially affect retreatment, and evaluate whether provider follow-up strategy correlates with measurable differences in quality of care.

METHODS: In a retrospective chart review, PRT courses for bone metastases at our single institution were divided by follow-up strategies (planned vs. PRN). Demographic, clinical, and PRT data were collected and analyzed via descriptive statistics. The relationship between planned follow-up appointment and subsequent retreatment was studied.

RESULTS: More patients received retreatment within one year of initial PRT in the planned follow-up group than in the PRN follow-up group (40.4% vs. 14.4%, p<0.001). Retreatment was achieved sooner in the planned follow-up group than in the PRN follow-up group (137 days vs. 156 days). When accounting for other variables, having a planned follow-up appointment remains the most important factor in establishing retreatment (OR = 3.32, 2.11-5.29, p<0.001).

CONCLUSION: Having a planned follow-up appointment after the initial course of PRT improves identification of patients who would benefit from additional treatment, thus improving patient experience and quality of care.

PMID:37302534 | DOI:10.1016/j.jpainsymman.2023.06.002

Chemosphere. 2023 Jun 9:139119. doi: 10.1016/j.chemosphere.2023.139119. Online ahead of print.

ABSTRACT

Heavy metals (HMs) pose ecological and resistome risks to aquatic systems. To efficiently develop targeted risk mitigation strategies, apportioning HM sources and assessing their source-oriented risks are essential. Although many studies have reported risk assessment and source apportionment of HMs, yet few have explored source-specific ecological and resistome risks associated with geochemical enrichment of HMs in aquatic environments. Therefore, this study proposes an integrated technological framework to characterize source-oriented ecological and resistome risks in the sediments of a plain river in China. Several geochemical tools quantitatively showed Cd and Hg had the highest pollution levels in the environment, with 19.7 and 7.5 times higher than their background values, respectively. Positive matrix factorization (PMF) and Unmix were comparatively used to apportion sources of HMs. Essentially, the two models were complementary and identified similar sources including industrial discharges, agricultural activities, atmospheric deposition and natural background, with contributions of 32.3-37.0%, 8.0-9.0%, 12.1-15.9% and 42.8-43.0%, respectively. To analyze source-specific ecological risks, the apportionment results were integratively incorporated into a modified ecological risk index. The results showed anthropogenic sources were the most significant contributors to the ecological risks. Particularly, industrial discharges majorly contributed high- (44%) and extremely high (52%) ecological risk for Cd, while agricultural activities posed a greater percentage of considerable-(36%) and high- (46%) ecological risk for Hg. Furthermore, the high-throughput sequencing metagenomic analysis identified abundant and diverse antibiotic resistance genes (ARGs), including some carbapenem-resistance genes and emerging genes such as mcr-type in the river sediments. Network and statistical analyses displayed significant correlations between ARGs and geochemical enrichment of HMs (ρ > 0.8; P-value <0.01), indicating their important impacts on resistome risks in the environment. This study provides useful insights into risk prevention and pollution control of HMs, and the framework can be made applicable to other rivers facing environmental challenges worldwide.

PMID:37302501 | DOI:10.1016/j.chemosphere.2023.139119

Chemosphere. 2023 Jun 9:139184. doi: 10.1016/j.chemosphere.2023.139184. Online ahead of print.

ABSTRACT

Tailings are waste materials left behind after mineral extraction. Giridih district of Jharkhand, India has the second largest ore of mica mines in the country. This study evaluated the forms of potassium (K⁺) and quantity-intensity relationships in soils contaminated by tailings around the abundant mica mines. A total of 63 rice rhizosphere soil samples (8-10 cm depth) were collected from agricultural fields near 21 mica mines in the Giridih district at different distances: 10 m (zone 1), 50 m (zone 2), and 100 m (zone 3). The samples were collected to quantify various forms of potassium in the soil and characterize non-exchangeable K (NEK) reserves and Q/I isotherms. The semi-logarithmic release of NEK with continuous extractions suggests a decrease in release over time. Significant values of threshold K⁺ levels were observed in zone 1 samples. As K⁺ concentrations increased, the activity ratio (AR_e^K) and its corresponding labile K⁺ (K_L) concentrations decreased. The AR_e^K, K_L, and fixed K⁺ (K_X) values were higher in zone 1 [AR_e^K: 3.2 (mol L^-1)^1/2 × 10^-4, K_L: 0.058 cmol kg^-1, and K_X: 0.038 cmol kg^-1), except for readily available K⁺ (K₀) for zone 2 (0.028 cmol kg^-1). The potential buffering capacity and K⁺ potential values were higher in zone 2 soils. In zone 1, Vanselow selectivity coefficients (K_V) and Krishnamoorthy-Davis-Overstreet selectivity coefficients (K_KDO) were higher, while Gapon constants were higher in zone 3. It was found that AR_e^K was significantly correlated with K₀, K_L, K⁺ saturation, -ΔG, K_V, and K_KDO. Different statistical methods such as positive matrix factorization, self-organizing maps, geostatistics, and Monte Carlo simulation approaches were employed to predict soil K⁺ enrichment, source apportionment, distribution patterns, availability for plants, and contribution to soil K⁺ maintenance. Thus, this study significantly contributes to understanding K⁺ dynamics in mica mine soils and operational K⁺ management.

PMID:37302492 | DOI:10.1016/j.chemosphere.2023.139184

Actas Dermosifiliogr. 2023 Jun 9:S0001-7310(23)00482-9. doi: 10.1016/j.ad.2023.06.011. Online ahead of print.

ABSTRACT

BACKGROUND: Basal cell carcinoma (BCC) is the most prevalent cancer. A minority of BCCs have an aggressive behaviour (laBCC) and may require hedgehog pathway inhibitors such as sonidegib as its treatment.

OBJECTIVE: To describe the use of sonidegib in a large number of patients and provide more data on its real-life efficacy and safety profile.

METHODS: We conducted a retrospective and multicentric study that included patients treated with sonidegib. Epidemiological, effectiveness and safety data were collected.

RESULTS: A total of 82 patients with a mean age of 73.9 years were included. Ten patients had Gorlin syndrome. Median treatment duration was 6 months. Median follow-up duration was 34.2 months. Globally, 81.7% of the patients showed clinical improvement (52.4% partial response and 29.3% complete response), 12.2% clinical stability and 6.1% disease progression. There was no statistically significant difference in clinical improvement between the 24 h and 48 h sonidegib posology. After 6 months of treatment, 48.8% of the patients discontinued sonidegib. Prior vismodegib treatment and recurrent primary BCC were associated with a poorer response to sonidegib. At 6 months of treatment, 68.3% of the patients experienced at least one adverse effect.

CONCLUSION: Sonidegib shows good effectiveness and acceptable safety profile in usual clinical practice.

PMID:37302483 | DOI:10.1016/j.ad.2023.06.011

J Theor Biol. 2023 Jun 9:111557. doi: 10.1016/j.jtbi.2023.111557. Online ahead of print.

ABSTRACT

Species-rich communities, such as the microbiota or microbial ecosystems, provide key functions for human health and climatic resilience. Increasing effort is being dedicated to design experimental protocols for selecting community-level functions of interest. These experiments typically involve selection acting on populations of communities, each of which is composed of multiple species. If numerical simulations started to explore the evolutionary dynamics of this complex, multi-scale system, a comprehensive theoretical understanding of the process of artificial selection of communities is still lacking. Here, we propose a general model for the evolutionary dynamics of communities composed of a large number of interacting species, described by disordered generalised Lotka-Volterra equations. Our analytical and numerical results reveal that selection for scalar community functions leads to the emergence, along an evolutionary trajectory, of a low-dimensional structure in an initially featureless interaction matrix. Such structure reflects the combination of the properties of the ancestral community and of the selective pressure. Our analysis determines how the speed of adaptation scales with the system parameters and the abundance distribution of the evolved communities. Artificial selection for larger total abundance is thus shown to drive increased levels of mutualism and interaction diversity. Inference of the interaction matrix is proposed as a method to assess the emergence of structured interactions from experimentally accessible measures.

PMID:37302465 | DOI:10.1016/j.jtbi.2023.111557