Tag: nevin manimala

Sci Total Environ. 2023 May 26:164432. doi: 10.1016/j.scitotenv.2023.164432. Online ahead of print.

ABSTRACT

Unsustainable human activities have disrupted the natural cycle of trace elements, causing the accumulation of chemical pollutants and making it challenging to determine their sources due to interwoven natural and human-induced processes. A novel approach was introduced for identifying the sources and for quantifying the contribution of trace elements discharge from rivers to soils. We integrated fingerprinting techniques, soil and sediment geochemical data, geographically weighted regression model (GWR) and soil quality indices. The FingerPro package and the state-of-the-art tracer selection techniques including the conservative index (CI) and consensus ranking (CR) were used to quantify the relative contribution of different upland sub-watersheds in trace element discharge soil. Our analysis revealed that off-site sources (upland watersheds) and in-site sources (land use) both play an important role in transferring trace elements to the Haraz plain (northern Iran). The unmixing model’s results suggest that the Haraz sub-watersheds exhibit a higher contribution to trace elements transfer in the Haraz plain, and therefore, require greater attention in terms of implementing soil and water conservation strategies. However, it is noteworthy that the Babolroud (adjacent to Haraz) exhibited a better performance of the model. A spatial correlation between certain heavy metals, such as As and Cu, and rice cultivation existed. Additionally, we found a significant spatial correlation between Pb and residential areas, particularly in the Amol region. Our result highlights the importance of using advanced spatial statistical techniques, such as GWR, to identify subtle but critical associations between environmental variables and sources of pollution. The methodology used comprehensively identifies dynamic trace element sourcing at the watershed scale, allowing for pollutant source identification and practical strategies for soil and water quality control. Tracer selection techniques (CI and CR) based on conservatives and consensus improve unmixing model accuracy and flexibility for precise fingerprinting.

PMID:37245832 | DOI:10.1016/j.scitotenv.2023.164432

Sci Total Environ. 2023 May 26:164495. doi: 10.1016/j.scitotenv.2023.164495. Online ahead of print.

ABSTRACT

Wastewater-based surveillance can be a valuable tool to monitor viral circulation and serve as an early warning system. For respiratory viruses that share similar clinical symptoms, namely SARS-CoV-2, influenza, and respiratory syncytial virus (RSV), identification in wastewater may allow differentiation between seasonal outbreaks and COVID-19 peaks. In this study, to monitor these viruses as well as standard indicators of fecal contamination, a weekly sampling campaign was carried out for 15 months (from September 2021 to November 2022) in two wastewater treatment plants that serve the entire population of Barcelona (Spain). Samples were concentrated by the aluminum hydroxide adsorption-precipitation method and then analyzed by RNA extraction and RT-qPCR. All samples were positive for SARS-CoV-2, while the positivity rates for influenza virus and RSV were significantly lower (10.65 % for influenza A (IAV), 0.82 % for influenza B (IBV), 37.70 % for RSV-A and 34.43 % for RSV-B). Gene copy concentrations of SARS-CoV-2 were often approximately 1 to 2 logarithmic units higher compared to the other respiratory viruses. Clear peaks of IAV H3:N2 in February and March 2022 and RSV in winter 2021 were observed, which matched the chronological incidence of infections recorded in the Catalan Government clinical database. In conclusion, the data obtained from wastewater surveillance provided new information on the abundance of respiratory viruses in the Barcelona area and correlated favorably with clinical data.

PMID:37245831 | DOI:10.1016/j.scitotenv.2023.164495

Sci Total Environ. 2023 May 26:164429. doi: 10.1016/j.scitotenv.2023.164429. Online ahead of print.

ABSTRACT

This cross-sectional study aimed to assess the adverse effects of pesticide use in humans, such as non-communicable diseases, using acetylcholinesterase (AChE) and pesticide concentrations in blood samples. A total of 353 samples (290 exposed and 63 control) were collected from participants with >20 years of experience in agricultural pesticide use. The pesticide and AChE concentrations were determined using Liquid Chromatography with tandem mass spectrometry (LC-MS/MS) and Reverse Phase High Performance Liquid Chromatography (RP-HPLC). Various health risks from pesticide exposure were assessed, including dizziness or headache, tension, anxiety, confusion, loss of appetite, loss of balance, concentration difficulties, irritability, anger, and depression. These risks may be influenced by the duration and intensity of exposure, the type of pesticide, and environmental factors in the affected areas. A total of 26 pesticides were detected in the blood samples from the exposed population, including 16 insecticides, three fungicides, and seven herbicides. Pesticide concentrations ranged from 0.20 to 12.12 ng/mL, and were statistically significant between the case and control groups (p < 0,05, p < 0.01, and p < 0.001). A correlation analysis was performed to determine statistically significance between pesticide concentration and symptoms of non-communicable diseases, such as Alzheimer’s, Parkinson’s, obesity, and diabetes. The estimated AChE levels in exposed and control blood samples were 21.58 ± 2.31 and 24.13 ± 1.08 U/mL, respectively (mean ± SD). The AChE levels were significantly lower in exposed samples than in controls (p < 0.001), which is considered to be an effect of long-term pesticide exposure, and is the cause of Alzheimer’s disease (p < 0.001), Parkinson’s disease (p < 0.001), and obesity (p < 0.05). Chronic exposure to pesticides and low levels of AChE are somewhat related to non-communicable diseases.

PMID:37245816 | DOI:10.1016/j.scitotenv.2023.164429

Sci Total Environ. 2023 May 26:164434. doi: 10.1016/j.scitotenv.2023.164434. Online ahead of print.

ABSTRACT

This study was aimed to describe the chemical traces of air pollution in blood of residents and evaluate the association between ambient pollution and its dose absorbed internally by a human body. The national Magen David Adom Blood Services blood donation collection platform and the National Public Health Laboratory’s testing services were utilized to conduct a human biomonitoring study among blood donors in Israel. The donors’ residential addresses and donations sites’ locations were geocoded and merged with the levels of pollutants recorded by the nearby monitoring stations. Pollutants included nitrogen dioxide (NO₂), sulfate dioxide (SO₂), ozone (O₃), carbon monoxide (CO) and particulate matter of size <10 and 2.5 μm in diameter (PM₁₀ & PM_2.5). Metal concentrations were statistically analyzed by ratio t-test and a lognormal regression, and adjusted to age, gender and smoking (defined based on Cadmium values). The findings indicate an independent positive association between pollutants and metals’ concentrations in blood. Specifically, an increase in interquartile range (IQR) of NO₂ was associated with 9.5 % increase in As in blood. The increase in one IQR of PM₁₀ and SO₂ was associated with an increase in Pb, of 16.6 % and 12.4 %, respectively. SO₂ was also adversely associated with Cd concentrations, by increasing its levels by 5.7 %. The donors’ proximity to quarries was related to the Pb blood levels higher 1.47 times compared to donors without quarries close to their residence (p-value = 0.013). To conclude, ambient pollution levels are associated with internal metals’ concentrations, reaffirming the link between the two in the pathological pathway from air pollution to morbidity.

PMID:37245805 | DOI:10.1016/j.scitotenv.2023.164434

Int J Biol Macromol. 2023 May 26:125068. doi: 10.1016/j.ijbiomac.2023.125068. Online ahead of print.

ABSTRACT

Human Herpesvirus 6A (HHV-6A) is a prevalent virus associated with various clinical manifestations, including neurological disorders, autoimmune diseases, and promotes tumor cell growth. HHV-6A is an enveloped, double-stranded DNA virus with a genome of approximately 160-170 kb containing a hundred open-reading frames. An immunoinformatics approach was applied to predict high immunogenic and non-allergenic CTL, HTL, and B cell epitopes and design a multi-epitope subunit vaccine based on HHV-6A glycoprotein B (gB), glycoprotein H (gH), and glycoprotein Q (gQ). The stability and correct folding of the modeled vaccines were confirmed through molecular dynamics simulation. Molecular docking found that the designed vaccines have a strong binding network with human TLR3, with K_d values of 1.5E-11 mol/L, 2.6E-12 mol/L, 6.5E-13 mol/L, and 7.1E-11 mol/L for gB-TLR3, gH-TLR3, gQ-TLR3, and the combined vaccine-TLR3, respectively. The codon adaptation index values of the vaccines were above 0.8, and their GC content was around 67 % (normal range 30-70 %), indicating their potential for high expression. Immune simulation analysis demonstrated robust immune responses against the vaccine, with approximately 650,000/ml combined IgG and IgM antibody titer. This study lays a strong foundation for developing a safe and effective vaccine against HHV-6A, with significant implications for treating associated conditions.

PMID:37245745 | DOI:10.1016/j.ijbiomac.2023.125068

J Clin Epidemiol. 2023 May 26:S0895-4356(23)00130-0. doi: 10.1016/j.jclinepi.2023.05.018. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the epidemiology, reporting characteristics and adherence to the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement of overviews of reviews (overviews) of interventions in the cardiovascular field.

STUDY DESIGN AND SETTING: MEDLINE, Scopus and the Cochrane Database of Systematic Reviews were searched from January 1, 2000 to October 15, 2020. Updated search was performed in MEDLINE, Epistemonikos and Google Scholar up to August 25, 2022. Overviews of interventions published in English and primarily considering populations, interventions and outcomes pertinent to the cardiovascular field were eligible. Study selection, data extraction and PRIOR adherence assessment were performed by two authors independently.

RESULTS: We analyzed 96 overviews. Almost half (43/96 [45%]) were published between 2020-2022 and contained a median of 15 systematic reviews (SR) (interquartile range 9-28). The commonest title terminology was “overview of (systematic) reviews” (38/96 [40%]). Methods for handling SR overlap were reported in 24/96 (25%), methods for assessing primary study overlap in 18/96 (19%), handling of discrepant data in 11/96 (11%) and methods for methodological quality or risk of bias assessment of the primary studies within SRs in 23/96 (24%). Authors included data sharing statements in 28/96 (29%), complete funding disclosure in 43/96 (45%), protocol registration in 43/96 (45%) and conflict of interest statement in 82/96 (85%) overviews.

CONCLUSION: Insufficient reporting was identified in methodological characteristics unique in overviews’ conduct and most transparency markers. Adoption of PRIOR from the research community could ameliorate overviews’ reporting.

PMID:37245702 | DOI:10.1016/j.jclinepi.2023.05.018

J Clin Epidemiol. 2023 May 26:S0895-4356(23)00133-6. doi: 10.1016/j.jclinepi.2023.05.020. Online ahead of print.

ABSTRACT

OBJECTIVE: Vital signs-based models are complicated by repeated measures per patient and frequently missing data. This paper investigated impacts of common vital signs modelling assumptions during clinical deterioration prediction model development.

STUDY DESIGN AND SETTING: Electronic medical record data from five Australian hospitals (1 January 2019 to 31 December 2020) were used. Summary statistics for each observation’s prior vital signs were created. Missing data patterns were investigated using boosted decision trees, then imputed with common methods. Two example models predicting in-hospital mortality were developed: logistic regression and XGBoost. Model discrimination and calibration were assessed using the C-statistic and nonparametric calibration plots.

RESULTS: The data contained 5,620,641 observations from 342,149 admissions. Missing vitals were associated with observation frequency, vital sign variability, and patient consciousness. Summary statistics improved discrimination slightly for logistic regression and markedly for XGBoost. Imputation method led to notable differences in model discrimination and calibration. Model calibration was generally poor.

CONCLUSION: Summary statistics and imputation methods can improve model discrimination and reduce bias during model development but it is questionable whether these differences are clinically significant. Researchers should consider why data are missing during model development and how this may impact clinical utility.

PMID:37245699 | DOI:10.1016/j.jclinepi.2023.05.020

Adv Nutr. 2023 May 26:S2161-8313(23)00317-4. doi: 10.1016/j.advnut.2023.05.012. Online ahead of print.

ABSTRACT

The high cost of healthy foods makes maintaining a healthy dietary pattern challenging, particularly amongst people with diabetes who are experiencing food insecurity. The objectives of this study were to: 1) review evidence on the impact of providing material benefits (e.g., food coupons/vouchers, free food, or financial subsidies/incentives) to improve access to food on clinical parameters, dietary intake, and household food insecurity in people with diabetes, and 2) review relevant economic evidence. Six databases were searched from inception to March 2023 for longitudinal studies with quantitative outcomes. Twenty-one studies were included in the primary review and two in the economic analysis. Risk of bias was high in 20 studies and moderate in one study. The number of RCTs and non-randomized studies reporting statistically significant improvement, alongside GRADE certainty of evidence was: A1C: 1/6 and 4/12 (very low), systolic blood pressure: 0/3 and 1/8 (very low), diastolic blood pressure: 0/3 and 1/7 (very low), BMI: 0/5 and 2/8 (very low), body weight: 0/0 and 1/3 (very low), hypoglycemia: 1/2 and 1/2 (very low), daily intake of fruits and vegetables: 1/1 and 1/3 (very low), daily intake of whole grains: 0/0 and 0/2 (very low), overall diet quality: 2/2 and 1/1 (low), and household food insecurity: 2/3 and 0/0 (very low). The two studies included in the economic analysis showed no difference in Medicare spending from Supplemental Nutrition Assistance Program participation and cost-savings from medically tailored meals in an economic simulation. Overall, providing material benefits to improve access to food for people with diabetes may improve household food insecurity, fruit and vegetable intake, and overall diet quality but effects on clinical parameters and whole grain intake are unclear. The certainty of evidence was very low to low by GRADE. PROSPERO REGISTRATION NUMBER: CRD42021212951.

PMID:37245685 | DOI:10.1016/j.advnut.2023.05.012

Acad Pediatr. 2023 May 26:S1876-2859(23)00162-6. doi: 10.1016/j.acap.2023.05.013. Online ahead of print.

ABSTRACT

OBJECTIVE: The COVID-19 pandemic resulted in training programs restructuring their curricula. Fellowship programs are required to monitor each fellow’s training progress through a combination of formal evaluations, competency tracking, and measures of knowledge acquisition. The American Board of Pediatrics administers Subspecialty In-Training Examinations to pediatric fellowship trainees annually and board certification exams at the completion of fellowship. The objective of this study was to compare SITE scores and certification exam passing rates before and during the pandemic.

METHODS: In this retrospective observational study, we collected summative data on SITE scores and certification exam passing rates for all pediatric subspecialties from 2018 to 2022. Trends over time were assessed using ANOVA analysis to test for trends across years within one group and t-test analysis to compare groups before and during the pandemic.

RESULTS: Data were obtained from 14 pediatric subspecialties. Comparing pre-pandemic to pandemic scores, Infectious Diseases, Cardiology, and Critical Care Medicine saw statistically significant decreases in SITE scores. Conversely, Child Abuse Pediatrics and Emergency Medicine (PEM) saw increases in SITE scores. PEM saw a statistically significant increase in certification exam passing rates, while Gastroenterology and Pulmonology saw decreases in exam passing rates.

CONCLUSION: The COVID-19 pandemic resulted in restructuring didactics and clinical care based on the needs of the hospital. There were also societal changes affecting patients and trainees. Subspecialty programs with declining scores and certification exam passing rates may need to assess their educational and clinical programs and adapt to the needs of trainees’ learning edges.

WHAT’S NEW: This retrospective observational study is the first to look at summative pediatric subspecialty in-training exam scores and board certification passing rates for first-time test takers, specifically analyzing differences in pre-pandemic and pandemic scores. Program directors can follow trends to consider if adaptions need to be made to their curriculum.

PMID:37245666 | DOI:10.1016/j.acap.2023.05.013

J Gynecol Obstet Hum Reprod. 2023 May 26:102608. doi: 10.1016/j.jogoh.2023.102608. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the association between a combined measure of time-based pregnancy intention and preconception contraceptive behavior and suboptimal prenatal care.

POPULATION AND METHOD: women delivering a live birth in all maternity units during one week in March 2016 were interviewed in the postpartum ward (N=13132). Multinomial logistic regression models were used to assess the association between the indicator of pregnancy intention and substandard prenatal care (late initiation of care and less than the recommended number of prenatal visits (<60% recommended)).

RESULTS: 83.6% of women had timed pregnancies, 4.7% had mistimed pregnancies but discontinued contraception to conceive, 8.0% had mistimed pregnancies without discontinuing contraception to conceive and 3.7% had unwanted pregnancies. Women with timed pregnancies or mistimed pregnancies despite discontinuing contraception to conceive were more socially advantaged than those who had an unwanted pregnancy or a mistimed pregnancy without discontinuing contraception to conceive. 3.3% of women had a substandard number of prenatal visits and 2.5% had delayed prenatal care initiation. The adjusted odds ratios (aOR) of substandard prenatal visits were high among women with unwanted pregnancies (aOR=2.78; 95% confidence interval [1.91-4.05]) and women with mistimed pregnancies who had not discontinued contraception to conceive (aOR=1.69; [1.21-2.35]) compared to women with timed pregnancies. No difference was observed for women with mistimed pregnancies who discontinued contraception to conceive (aOR=1.22; [0.70-2.12]).

CONCLUSION: Using routinely collected information on preconception contraception allows a more nuanced assessment of pregnancy intentions that can help caregivers identify women at greater risk of substandard prenatal care.

PMID:37245644 | DOI:10.1016/j.jogoh.2023.102608