Tag: pubmed

PLoS One. 2024 Aug 28;19(8):e0307376. doi: 10.1371/journal.pone.0307376. eCollection 2024.

ABSTRACT

Among the set of phenological traits featuring mangrove ecosystems, litterfall production stands out with marked intra-annual and longer-term variation. Furthermore, mangrove forests resilience is one of the most important ecological attribute, reconciling the juxtaposed terrestrial and marine environment such transitional systems occupy. However, world’s mangroves are nowadays facing recurrent climatic events, reflected in anomalies depicted by major drivers, including temperature and precipitation. This physical-environmental setting may either constrain or favor overall forest productivity. A combination of time series analysis (spectral density and cross-correlation techniques) and statistical model fitting (General additive model) was implemented to explore trends in total litterfall of a well-developed mangrove forest in southeastern Gulf of Mexico (Celestun Lagoon, SE Mexico) and potential association with the varying behavior of temperature (°C) and precipitation (mm month-1), highlighting their anomalies. The results are consistent with a synchronous response between litterfall production and climatic variables (mean monthly temperature and total monthly precipitation). Concurrent peak litterfall production in Celestun lagoon with high temperatures and precipitation occurred during June and October, featuring a two-month time lag for the response time. More than half of the litterfall anomalies (53.5%) could be reflecting either multiple sources of climatic anomalies (maximum, minimum, and monthly average temperature and monthly total precipitation) or single point events (cyclone landfall). This relationship dynamics showed an interannual persistence (1999-2010). The structure portrayed by the litterfall time-series was not unequivocally related to climatic anomalies. Arguably, climatic anomalies behave with different intensities and even may exhibit complex interactions among them. The study of anomalies provides a baseline for a better grasp of: i) mangrove anomalies responses and ii) their vulnerability to these extremes.

PMID:39197042 | DOI:10.1371/journal.pone.0307376

ACS Nano. 2024 Aug 28. doi: 10.1021/acsnano.4c05249. Online ahead of print.

ABSTRACT

Potential exposure to cobalt nanoparticles (CoNPs) occurs in various fields, including hard alloy industrial production, the increasing use of new energy lithium-ion batteries, and millions of patients with metal-on-metal joint prostheses. Evidence from human, animal, and in vitro experiments suggests a close relationship between CoNPs and neurotoxicity. However, a systematic assessment of central nervous system (CNS) impairment due to CoNPs exposure and the underlying molecular mechanisms is lacking. In this study, we found that CoNPs induced neurodegenerative damage both in vivo and in vitro, including cognitive impairment, β-amyloid deposition and Tau hyperphosphorylation. CoNPs promoted the formation of autophagosomes and impeding autophagosomal-lysosomal fusion in vivo and in vitro, leading to toxic protein accumulation. Moreover, CoNPs exposure reduced the level of transcription factor EB (TFEB) and the abundance of lysosome, causing a blockage in autophagosomal-lysosomal fusion. Interestingly, overexpression of long noncoding RNA NR_030777 mitigated CoNPs-induced neurodegenerative damage in both in vivo and in vitro models. Fluorescence in situ hybridization assay revealed that NR_030777 directly binds and stabilizes TFEB mRNA, alleviating the blockage of autophagosomal-lysosomal fusion and ultimately restoring neurodegeneration induced by CoNPs in vivo and in vitro. In summary, our study demonstrates that autophagic dysfunction is the main toxic mechanism of neurodegeneration upon CoNPs exposure and NR_030777 plays a crucial role in CoNPs-induced autophagic dysfunction. Additionally, the proposed adverse outcome pathway contributes to a better understanding of CNS toxicity assessment of CoNPs.

PMID:39197041 | DOI:10.1021/acsnano.4c05249

PLOS Glob Public Health. 2024 Aug 28;4(8):e0003565. doi: 10.1371/journal.pgph.0003565. eCollection 2024.

ABSTRACT

Climate change poses a significant threat to women’s health in sub-Saharan Africa, yet the impact of climate change on maternal health is rarely reported in the region. Using an existing Maternal Surveillance Platform (MATSurvey), we estimated the immediate impact of Cyclone Freddy on maternal health care service indicators in Malawi. We analysed facility-level data for pregnant women up to 42 weeks post-partum using the national MATSurvey database. We compared incidences of service utilisation before (1 January to 19 February 2023) and after (20 February to 30 March 2023) the cyclone using a negative binomial regression approach. Between 1 January and 30 March 2023, a total of 37,445 live births, 50,048 antenatal clinic attendances, 23,250 postnatal clinic attendances, 84 maternal deaths, and 1,166 neonatal deaths were recorded by 33 facilities in the MatSurvey database. There was an immediate reduction in service utilisation in the post-cyclone period, including the postnatal attendance per week (pre-cyclone median: 355.0 [IQR 279.0-552.0], post-cyclone median: 261.0 [IQR 154.3-305.5], RR 0.56 [95% CI 0.44-0.71, p <0.001]) and the antenatal attendance per week (pre-cyclone median: 860.0 [IQR 756.5-1060.0], post-cyclone median: 656.5 [IQR 486.5-803.3], RR 0.66 [95% CI 0.55-0.78, p <0.001]). Stratified analyses by geographical zones revealed a stronger reduction in postnatal clinic attendance in the Southwest (RR 0.50 [95% CI 0.29-0.85, p = 0.010]) and the North (RR 0.29 [95% CI 0.15-0.56, p <0.001]). Cyclone Freddy resulted in an immediate decline in utilisation of maternal health services in cyclone-affected regions in Malawi. We observe evidence of catastrophic climate events impacting on the healthcare of women and their babies. Policymakers, researchers, and health systems need to ensure that essential women’s health services are maintained during these events and improve measures to support service resilience in the face of climate change.

PMID:39197033 | DOI:10.1371/journal.pgph.0003565

PLoS One. 2024 Aug 28;19(8):e0309417. doi: 10.1371/journal.pone.0309417. eCollection 2024.

ABSTRACT

Quality improvement approaches are increasingly being used to address the problem of healthcare’s climate and ecological impact. While sustainability is increasingly recognized as a domain of quality, consensus is lacking on the most appropriate measures and metrics for those looking to reduce ecological impacts through quality improvement initiatives. We propose a scoping review to summarize approaches for selecting and quantifying ecological impacts in the published quality improvement literature. We will search multiple electronic databases (MEDLINE, EMBASE, CINAHL, and Scopus) from 2000 onwards, to identify published quality improvement initiatives in the human healthcare setting intended to address ecological impact with at least one quantitative measure of ecological impact, such as kilograms of carbon dioxide equivalent greenhouse gas. Two independent reviewers working in parallel will screen studies for inclusion and abstract study data, including publication, study, and ecological impact characteristics. Charted data will be synthesized narratively as well as with descriptive tables, figures, and summary statistics. In doing so, we will map areas of relative focus as well as gaps in the measurement of ecological impact across quality improvement initiatives. This map can in turn be used to raise awareness of ecological impacts requiring broader consideration, encouraging holistic and clinically relevant approaches to measuring ecological impact in future quality improvement work.

PMID:39197032 | DOI:10.1371/journal.pone.0309417

J Clin Endocrinol Metab. 2024 Aug 28:dgae598. doi: 10.1210/clinem/dgae598. Online ahead of print.

ABSTRACT

CONTEXT: Chronic use of proton pump inhibitors (PPIs) has been associated with an increase in bone fragility. However, evidence on the effect of chronic PPI use on bone density is conflicting, and data on bone microarchitectural quality are scarce.

OBJECTIVE: The primary aim of this study was to evaluate whether trabecular bone microarchitecture, assessed by trabecular bone score (TBS), is altered in chronic PPI users. The association between PPI use and bone density was also evaluated as a secondary endpoint.

METHODS: We extracted individual patient data from the 2005-2008 cycles of the population-based National Health and Nutrition Examination Survey (NHANES), in which lumbar spine dual-energy X-ray absorptiometry (DXA) scans were acquired. TBS values were calculated from DXA images using a dedicated software. Multivariable linear regression analyses stratified by sex were performed to evaluate the association of chronic PPI use with TBS and bone mineral density (BMD), adjusting for relevant confounders.

RESULTS: A total of 7478 subjects were included (3961 men, 3517 women). After adjustment for relevant confounders, chronic PPI use was associated with a worse bone health profile in men, with lower TBS (-0.039, 95%CI:[-0.058, -0.020], p<0.001), lumbar spine T-score (-0.27, 95%CI:[-0.49, -0.05], p=0.018), total hip T-score (-0.20, 95%CI:[-0.39, -0.01], p=0.038), and femoral neck T-score (-0.21, 95%CI:[-0.42, -0.01], p=0.045). Notably, the association between chronic PPI use and degraded TBS remained statistically significant even after further adjustment for BMD at lumbar spine and femoral neck (-0.026, 95%CI:[-0.039, -0.012], p=0.001). In contrast, no significant association was observed between chronic PPI use and either TBS or BMD in women.

CONCLUSIONS: Chronic PPI use is associated with degraded trabecular bone quality in men, even after adjustment for BMD. No association was observed in women.

PMID:39197024 | DOI:10.1210/clinem/dgae598

Brain Behav. 2024 Sep;14(9):e70005. doi: 10.1002/brb3.70005.

ABSTRACT

BACKGROUND: Swallowing is a complex process that alters with age and neurological diseases; swallowing disorders can be a consequence of both of them. As an advanced multivariate statistical method, hierarchical cluster analysis (HCA) was utilized to make the dendrograms, which was used to find the relationship between the variables. The purpose of this study is to ascertain the type of clustering exhibited by the variables using HCA and to evaluate the approach to major neurodegenerative diseases (MND) with swallowing disorders based on the results obtained.

METHODS: Data were collected from a total of 173 patients from various neurological diagnoses, such as dementia, Parkinson’s disease, stroke and polyneuropathy, aging between 42 and 104 (mean of age 72.85) by using the Montreal Cognitive Assessment, the Edinburgh Feeding Evaluation Scale (EdFED), the Eating Assessment Tool (EAT-10), and the Modified Mann Swallowing Ability test. From the collected data, dendrograms were formed by using HCA with Ward linkage method.

RESULTS: Based on cluster analysis results, clusters demonstrate statistical significance. They center around EdFED, EAT-10, and age in each MND. In healthy individuals, variables are not clustered as in the patient group. This study holds importance as it can give clinicians a different perspective on determining and managing the elderly population’s swallowing problems.

CONCLUSIONS: The HCA method explicitly proposes which variables should be examined concurrently in the clinic for MND. This research is one of the pioneering studies conducted by using the HCA method.

PMID:39197023 | DOI:10.1002/brb3.70005

PLoS One. 2024 Aug 28;19(8):e0307841. doi: 10.1371/journal.pone.0307841. eCollection 2024.

ABSTRACT

Strength-trained athletes has less trainability in muscle size and function, because of their adaptation to long-term advanced training. This study examined whether resistance training (RT) leading to repetition failure can be effective modality to overcome this subject. Twenty-three male judo athletes completed a 6-week unilateral dumbbell curl training with two sessions per week, being added to in-season training of judo. The participants were assigned to one of three different training programs: ballistic light-load (30% of one repetition maximum (1RM)) RT to repetition failure (RFLB) (n = 6), traditional heavy-load (80% of 1RM) RT to repetition failure (RFHT) (n = 7), and ballistic light-load (30% of 1RM) RT to non-repetition failure (NRFLB) (n = 10). Before and after the intervention period, the muscle thickness (MT) and the maximal voluntary isometric force (MVC) and rate of force development (RFDmax) of elbow flexors were determined. In addition, theoretical maximum force (F0), velocity (V0), power (Pmax), and slope were calculated from force-velocity relation during explosive elbow flexion against six different loads. For statistical analysis, p < 0.05 was considered significant. The MT and MVC had significant effect of time with greater magnitude of the gains in RFHT and NRFLB compared to RFLB. On the other hand, all parameters derived from force-velocity relation and RFDmax did not show significant effects of time. The present study indicates that ballistic light-load and traditional heavy-load resistance training programs, leading to non-repetition failure and repetition failure, respectively, can be modalities for improving muscle size and isometric strength in judo athletes, but these do not improve power generation capacity.

PMID:39197005 | DOI:10.1371/journal.pone.0307841

J Med Internet Res. 2024 Aug 28;26:e50251. doi: 10.2196/50251.

ABSTRACT

BACKGROUND: Profound scientific evaluation of novel digital health technologies (DHTs) is key to enhance successful development and implementation. As such, we previously developed the eHealth evaluation cycle. The eHealth evaluation cycle contains 5 consecutive study phases: conceptual, development, feasibility, effectiveness, and implementation.

OBJECTIVE: The aim of this study is to develop a better understanding of the daily practice of the eHealth evaluation cycle. Therefore, the objectives are to conduct a structured analysis of literature data to analyze the practice of the evaluation study phases and to determine which evaluation approaches are used in which study phase of the eHealth evaluation cycle.

METHODS: We conducted a systematic literature search in PubMed including the MeSH term “telemedicine” in combination with a wide variety of evaluation approaches. Original peer-reviewed studies published in the year 2019 (pre-COVID-19 cohort) were included. Nonpatient-focused studies were excluded. Data on the following variables were extracted and systematically analyzed: journal, country, publication date, medical specialty, primary user, functionality, evaluation study phases, and evaluation approach. RStudio software was used to summarize the descriptive data and to perform statistical analyses.

RESULTS: We included 824 studies after 1583 titles and abstracts were screened. The majority of the evaluation studies focused on the effectiveness (impact; 304/824, 36.9%) study phase, whereas uptake (implementation; 70/824, 8.5%) received the least focus. Randomized controlled trials (RCTs; 170/899, 18.9%) were the most commonly used DHT evaluation method. Within the effectiveness (impact) study phase, RCTs were used in one-half of the studies. In the conceptual and planning phases, survey research (27/78, 35%) and interview studies (27/78, 35%) were most frequently used. The United States published the largest amount of DHT evaluation studies (304/824, 36.9%). Psychiatry and mental health (89/840, 10.6%) and cardiology (75/840, 8.9%) had the majority of studies published within the field.

CONCLUSIONS: We composed the first comprehensive overview of the actual practice of implementing consecutive DHT evaluation study phases. We found that the study phases of the eHealth evaluation cycle are unequally studied and most attention is paid to the effectiveness study phase. In addition, the majority of the studies used an RCT design. However, in order to successfully develop and implement novel DHTs, stimulating equal evaluation of the sequential study phases of DHTs and selecting the right evaluation approach that fits the iterative nature of technology might be of the utmost importance.

PMID:39196643 | DOI:10.2196/50251

JAMA Surg. 2024 Aug 28. doi: 10.1001/jamasurg.2024.3254. Online ahead of print.

ABSTRACT

IMPORTANCE: Wide variations exist in traumatic brain injury (TBI) management strategies and transfer guidelines across the country.

OBJECTIVE: To assess the outcomes of patients with TBI transferred to the American College of Surgeons (ACS) level I (LI) or level II (LII) trauma centers (TCs) on a nationwide scale.

DESIGN, SETTING, AND PARTICIPANTS: In this secondary analysis of the ACS Trauma Quality Improvement Program database (2017 to 2020), adult patients with isolated TBI (nonhead abbreviated injury scale = 0) with intracranial hemorrhage (ICH) who were transferred to LI/LII TCs we re included. Data were analyzed from January 1, 2017, through December 31, 2020.

MAIN OUTCOMES AND MEASURES: Outcomes were rates of head computed tomography scans, neurosurgical interventions (cerebral monitors, craniotomy/craniectomy), hospital length of stay, and mortality. Descriptive statistics and hierarchical mixed-model regression analyses were performed.

RESULTS: Of 117 651 patients with TBI with ICH managed at LI/LII TCs 53 108; (45.1%; 95% CI, 44.8%-45.4%) transferred from other centers were identified. The mean (SD) age was 61 (22) years and 30 692 were male (58%). The median (IQR) Glasgow Coma Scale score on arrival was 15 (14-15); 5272 patients had a Glasgow Coma Scale score of 8 or less on arrival at the receiving trauma center (10%). A total of 30 973 patients underwent head CT scans (58%) and 2144 underwent repeat head CT scans at the receiving TC (4%). There were 2124 patients who received cerebral monitors (4%), 6862 underwent craniotomy/craniectomy (13%), and 7487 received mechanical ventilation (14%). The median (IQR) hospital length of stay was 2 (1-5) days and the mortality rate was 6.5%. There were 9005 patients (17%) who were discharged within 24 hours and 19 421 (37%) who were discharged within 48 hours of admission without undergoing any neurosurgical intervention. Wide variations between and within trauma centers in terms of outcomes were observed in mixed-model analysis.

CONCLUSIONS: In this study, nearly half of the patients with TBI managed at LI/LII TCs were transferred from lower-level hospitals. Over one-third of these transferred patients were discharged within 48 hours without any interventions. These findings indicate the need for systemwide guidelines to improve health care resource use and guide triage of patients with TBI.

PMID:39196585 | DOI:10.1001/jamasurg.2024.3254

JAMA Dermatol. 2024 Aug 28. doi: 10.1001/jamadermatol.2024.2863. Online ahead of print.

ABSTRACT

IMPORTANCE: Although treatment for chronic urticaria (CU) has improved over the past decades, evidence regarding costs and net benefits associated with these treatment strategies have yet to be comprehensively characterized and synthesized.

OBJECTIVE: To summarize the cost and cost-effectiveness of CU management strategies.

EVIDENCE REVIEW: An extensive systematic literature search of 6 databases (MEDLINE, Embase, PubMed Cochrane, Scopus, and CINAHL) and gray literature sources, without language restriction, was conducted and updated to March 23, 2024. Articles that performed cost analysis or full economic evaluation among patients with CU were included. Two reviewers independently extracted data, such as annual costs of health care services or incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY). All monetary values were converted and inflated to 2023 US dollars. Evidence-based synthesis for health benefit was judged using the Evidence Rating Matrix by the Institute for Clinical and Economic Review.

FINDINGS: Seventeen unique studies (11 cost analysis studies and 6 full economic evaluations) were included. With the wide variation in health care resources, services that included biologic omalizumab utilization had higher annual health care cost estimations for CU management than services that did not include omalizumab prescription (median [IQR] cost, $6933 [$5988-$8717] vs $5621 [$2488-$8754]). The biologic omalizumab, 300 mg, for H1 antihistamine-refractory chronic spontaneous urticaria (CSU) (3 studies) was found to have a median (IQR) ICER of $89 005 ($36 058-$145 694) per QALY (evidence rating as incremental or better; moderate certainty with substantial net health benefit). Routine laboratory testing among patients with CSU with otherwise normal histories and physical examination findings (1 study) had ICERs ranging from $1 427 928 to $1 950 524 per QALY (evidence rating as comparable or inferior; moderate certainty that the net health benefit is inferior).

CONCLUSIONS AND RELEVANCE: With limited evidence of cost-effectiveness, biologic omalizumab, 300 mg, for H1 antihistamine-refractory CSU was found to be cost-effective in US health care services at the willingness to pay threshold of $150 000 per QALY. Meanwhile, routine laboratory testing among patients with CSU without compelling indication was not cost-effective. Future studies in more diverse CU populations and resource settings are needed to fill evidence gaps.

PMID:39196583 | DOI:10.1001/jamadermatol.2024.2863