Publications by authors named "Rajib Paul"

80 Publications

An assessment of the rural-urban differences in the crash response time and county-level crash fatalities in the United States.

J Rural Health 2021 Oct 19. Epub 2021 Oct 19.

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.

Purpose: This study aimed to estimate the crash response times in rural and urban counties in the United States, their association with county-level crash fatalities, and identify spatial clusters of crash fatalities across the United States.

Methods: We analyzed data from the Fatality Analysis Reporting System (2010-2019). Data were aggregated at the county level across the contiguous United States. The selected counties (n = 3,108) were categorized as rural, micropolitan-urban, or metropolitan-urban using the 2013 rural-urban commuting area codes. The predictor variable was crash response time, and the outcome variable was county-level crash fatalities. Crash and county characteristics were used as potential confounders. We performed a spatial negative binomial regression analysis and reported the rate ratios of crash fatalities. We estimated the crude and adjusted fatality rates across all counties and identified clusters of crash fatalities across the United States.

Findings: As one migrates from urban to rural areas, crash response times became significantly increasingly longer. The Emergency Medical Service (EMS) notification to scene arrival time was most predictive of crash fatalities. A minute increase in the EMS notification to scene arrival time was associated with a 1%, 2%, and 5% increased fatality rate ratio in rural, micropolitan-urban, and metropolitan-urban counties, respectively. Although crash fatalities were lower in rural counties, the crash fatality rate was 3-fold higher in rural counties compared to metropolitan-urban counties. Significant clusters of crash fatality rates were heterogeneously distributed across the United States.

Conclusion: Reducing crash response time may contribute to reducing crash fatalities across the United States.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jrh.12627DOI Listing
October 2021

Garcinol blocks motor behavioural deficits by providing dopaminergic neuroprotection in MPTP mouse model of Parkinson's disease: involvement of anti-inflammatory response.

Exp Brain Res 2021 Oct 11. Epub 2021 Oct 11.

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, 788011, India.

Although the etiology of Parkinson's disease (PD) is poorly understood, studies in animal models revealed loss of dopamine and the dopaminergic neurons harbouring the neurotransmitter to be the principal cause behind this neuro-motor disorder. Neuroinflammation with glial cell activation is suggested to play a significant role in dopaminergic neurodegeneration. Several biomolecules have been reported to confer dopaminergic neuroprotection in different animal models of PD, owing to their anti-inflammatory potentials. Garcinol is a tri-isoprenylated benzophenone isolated from Garcinia sp. and accumulating evidences suggest that this molecule could provide neuroprotection by modulating oxidative stress and inflammation. However, direct evidence of dopaminergic neuroprotection by garcinol in the pre-clinical model of PD is not yet reported. The present study aims to investigate whether administration of garcinol in the MPTP mouse model of PD may ameliorate the cardinal motor behavioural deficits and prevent the loss of dopaminergic neurons. As expected, garcinol blocked the parkinsonian motor behavioural deficits which include akinesia, catalepsy, and rearing anomalies in the mice model. Most importantly, the degeneration of dopaminergic cell bodies in the substantia nigra region was significantly prevented by garcinol. Furthermore, garcinol reduced the inflammatory marker, glial fibrillary acidic protein, in the substantia nigra region. Since glial hyperactivation-mediated inflammation is inevitably associated with the loss of dopaminergic neurons, our study suggests the anti-inflammatory role of garcinol in facilitating dopaminergic neuroprotection in PD mice. Hence, in the light of the present study, it is suggested that garcinol is an effective anti-parkinsonian agent to block motor behavioural deficits and dopaminergic neurodegeneration in PD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00221-021-06237-yDOI Listing
October 2021

Carbon-based metal-free electrocatalysts: from oxygen reduction to multifunctional electrocatalysis.

Chem Soc Rev 2021 Sep 24. Epub 2021 Sep 24.

Australian Carbon Materials Centre (A-CMC), School of Chemical Engineering, University of New South Wales, Sydney, NSW 2052, Australia.

Since the discovery of N-doped carbon nanotubes as the first carbon-based metal-free electrocatalyst (C-MFEC) for oxygen reduction reaction (ORR) in 2009, C-MFECs have shown multifunctional electrocatalytic activities for many reactions beyond ORR, such as oxygen evolution reaction (OER), hydrogen evolution reaction (HER), carbon dioxide reduction reaction (CORR), nitrogen reduction reaction (NRR), and hydrogen peroxide production reaction (HOPR). Consequently, C-MFECs have attracted a great deal of interest for various applications, including metal-air batteries, water splitting devices, regenerative fuel cells, solar cells, fuel and chemical production, water purification, to mention a few. By altering the electronic configuration and/or modulating their spin angular momentum, both heteroatom(s) doping and structural defects (, atomic vacancy, edge) have been demonstrated to create catalytic active sites in the skeleton of graphitic carbon materials. Although certain C-MFECs have been made to be comparable to or even better than their counterparts based on noble metals, transition metals and/or their hybrids, further research and development are necessary in order to translate C-MFECs for practical applications. In this article, we present a timely and comprehensive, but critical, review on recent advancements in the field of C-MFECs within the past five years or so by discussing various types of electrocatalytic reactions catalyzed by C-MFECs. An emphasis is given to potential applications of C-MFECs for energy conversion and storage. The structure-property relationship for and mechanistic understanding of C-MFECs will also be discussed, along with the current challenges and future perspectives.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1039/d1cs00219hDOI Listing
September 2021

Age of Bottle Cessation and BMI-for-Age Percentile among Children Aged Thirty-Six Months Participating in WIC.

Child Obes 2021 Sep 22. Epub 2021 Sep 22.

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.

Children's age at bottle weaning typically ranges from 12 to 24 months. The recommended age of bottle weaning varies. The American Academy of Pediatrics recommends weaning by 12 months; The American Academy of Pediatric Dentistry recommends 12-15 months; The US Department of Agriculture recommends 18 months. Prolonged bottle use is associated with dental caries, iron-deficiency anemia, and child overweight or obesity. We examined factors associated with age of bottle cessation, and the association between age of bottle cessation and BMI-for-age percentile at age 36 months among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants. Data were from the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2). The ITFPS-2, a longitudinal study of WIC participants (mothers and their children) began in 2013. We used Cox proportional hazards models to identify factors associated with bottle cessation and multivariate linear regression to examine the association between age of bottle cessation and BMI. About 34% of children used a bottle longer than 12 months, and 13% longer than 18 months. Bottle cessation at older ages was associated with Hispanic ethnicity, multiparity, low income, low education, higher caregiver weight, and not initiating breastfeeding. The adjusted children's BMI-for-age percentile at age 36 months increased by 0.47 for each additional month of bottle use. Prolonged bottle use was associated with increased children's BMI-for-age percentile. Future research is warranted to determine the optimal age to recommend bottle cessation for WIC participants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/chi.2021.0119DOI Listing
September 2021

Projected resurgence of COVID-19 in the United States in July-December 2021 resulting from the increased transmissibility of the Delta variant and faltering vaccination.

medRxiv 2021 Sep 2. Epub 2021 Sep 2.

What Is Already Known About This Topic?: The highly transmissible SARS-CoV-2 Delta variant has begun to cause increases in cases, hospitalizations, and deaths in parts of the United States. With slowed vaccination uptake, this novel variant is expected to increase the risk of pandemic resurgence in the US in July-December 2021.

What Is Added By This Report?: Data from nine mechanistic models project substantial resurgences of COVID-19 across the US resulting from the more transmissible Delta variant. These resurgences, which have now been observed in most states, were projected to occur across most of the US, coinciding with school and business reopening. Reaching higher vaccine coverage in July-December 2021 reduces the size and duration of the projected resurgence substantially. The expected impact of the outbreak is largely concentrated in a subset of states with lower vaccination coverage.

What Are The Implications For Public Health Practice?: Renewed efforts to increase vaccination uptake are critical to limiting transmission and disease, particularly in states with lower current vaccination coverage. Reaching higher vaccination goals in the coming months can potentially avert 1.5 million cases and 21,000 deaths and improve the ability to safely resume social contacts, and educational and business activities. Continued or renewed non-pharmaceutical interventions, including masking, can also help limit transmission, particularly as schools and businesses reopen.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1101/2021.08.28.21262748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423228PMC
September 2021

Exploring Feasibility of Multivariate Deep Learning Models in Predicting COVID-19 Epidemic.

Front Public Health 2021 5;9:661615. Epub 2021 Jul 5.

School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, United States.

Mathematical models are powerful tools to study COVID-19. However, one fundamental challenge in current modeling approaches is the lack of accurate and comprehensive data. Complex epidemiological systems such as COVID-19 are especially challenging to the commonly used mechanistic model when our understanding of this pandemic rapidly refreshes. We aim to develop a data-driven workflow to extract, process, and develop deep learning (DL) methods to model the COVID-19 epidemic. We provide an alternative modeling approach to complement the current mechanistic modeling paradigm. We extensively searched, extracted, and annotated relevant datasets from over 60 official press releases in Hubei, China, in 2020. Multivariate long short-term memory (LSTM) models were developed with different architectures to track and predict multivariate COVID-19 time series for 1, 2, and 3 days ahead. As a comparison, univariate LSTMs were also developed to track new cases, total cases, and new deaths. A comprehensive dataset with 10 variables was retrieved and processed for 125 days in Hubei. Multivariate LSTM had reasonably good predictability on new deaths, hospitalization of both severe and critical patients, total discharges, and total monitored in hospital. Multivariate LSTM showed better results for new and total cases, and new deaths for 1-day-ahead prediction than univariate counterparts, but not for 2-day and 3-day-ahead predictions. Besides, more complex LSTM architecture seemed not to increase overall predictability in this study. This study demonstrates the feasibility of DL models to complement current mechanistic approaches when the exact epidemiological mechanisms are still under investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpubh.2021.661615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8287417PMC
July 2021

Accuracy of State-Level Surveillance during Emerging Outbreaks of Respiratory Viruses: A Model-Based Assessment.

Med Decis Making 2021 11 16;41(8):1004-1016. Epub 2021 Jul 16.

Johns Hopkins University Carey Business School, Baltimore, MD, USA.

It is long perceived that the more data collection, the more knowledge emerges about the real disease progression. During emergencies like the H1N1 and the severe acute respiratory syndrome coronavirus 2 pandemics, public health surveillance requested increased testing to address the exacerbated demand. However, it is currently unknown how accurately surveillance portrays disease progression through incidence and confirmed case trends. State surveillance, unlike commercial testing, can process specimens based on the upcoming demand (e.g., with testing restrictions). Hence, proper assessment of accuracy may lead to improvements for a robust infrastructure. Using the H1N1 pandemic experience, we developed a simulation that models the true unobserved influenza incidence trend in the State of Michigan, as well as trends observed at different data collection points of the surveillance system. We calculated the growth rate, or speed at which each trend increases during the pandemic growth phase, and we performed statistical experiments to assess the biases (or differences) between growth rates of unobserved and observed trends. We highlight the following results: 1) emergency-driven high-risk perception increases reporting, which leads to reduction of biases in the growth rates; 2) the best predicted growth rates are those estimated from the trend of specimens submitted to the surveillance point that receives reports from a variety of health care providers; and 3) under several criteria to queue specimens for viral subtyping with limited capacity, the best-performing criterion was to queue first-come, first-serve restricted to specimens with higher hospitalization risk. Under this criterion, the lab released capacity to subtype specimens for each day in the trend, which reduced the growth rate bias the most compared to other queuing criteria. Future research should investigate additional restrictions to the queue.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0272989X211022276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488654PMC
November 2021

Neighborhood disadvantage and the sales of unhealthy products: alcohol, tobacco and unhealthy snack food.

BMC Public Health 2021 07 9;21(1):1361. Epub 2021 Jul 9.

Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.

Background: Individuals may use unhealthy coping mechanisms such as alcohol, tobacco, and unhealthy snack consumption. The purpose of this study was to assess how neighborhood disadvantage is associated with sales of alcohol, tobacco, and unhealthy snacks at stores of a discount variety store chain.

Methods: Alcohol, tobacco, and unhealthy snack sales were measured monthly for 20 months, 2017-2018, in 16 discount variety stores in the United States. Mixed effects linear regressions adjusted for population size, with store-specific random effects, to examine the relationship of weekly unit sales with three outcome variables and neighborhood disadvantage, measured using the Area Deprivation Index (ADI).

Results: The discount variety stores were located in neighborhoods where the median ADI percentile was 87 [interquartile range 83,89], compared to the median ADI percentile of 50 for all US communities, indicating that the stores were located in substantially disadvantaged neighborhoods. For every 1% increase in ADI, weekly unit sales of unhealthy snack food increased by 43 [95% confidence interval, CI 28-57], and weekly unit sales of tobacco products increased by 11.5 [95% CI 5-18] per store. No significant relationship between neighborhood disadvantage and the weekly unit sales of alcohol products was identified.

Conclusions: The positive relationship between neighborhood disadvantage and the sale of tobacco and snack foods may help explain the pathway between neighborhood disadvantage and poor health outcomes. It would be useful for future research to examine how neighborhood disadvantage influences resident health-related behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-021-11442-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272253PMC
July 2021

Dynamics of Covid-19 mortality and social determinants of health: a spatiotemporal analysis of exceedance probabilities.

Ann Epidemiol 2021 10 25;62:51-58. Epub 2021 May 25.

Department of Public Health Sciences, the University of North Carolina at Charlotte, 9201 University City Blvd, NC.

Purpose: To determine the association of social factors with Covid-19 mortality and identify high-risk clusters.

Methods: Data on Covid-19 deaths across 3,108 contiguous U.S. counties from the Johns Hopkins University and social determinants of health (SDoH) data from the County Health Ranking and the Bureau of Labor Statistics were fitted to Bayesian semi-parametric spatiotemporal Negative Binomial models, and 95% credible intervals (CrI) of incidence rate ratios (IRR) were used to assess the associations. Exceedance probabilities were used for detecting clusters.

Results: As of October 31, 2020, the median mortality rate was 40.05 per 100, 000. The monthly urban mortality rates increased with unemployment (IRR:1.41, 95% CrI: 1.24, 1.60), percent Black population (IRR:1.05, 95% CrI: 1.04, 1.07), and residential segregation (IRR:1.03, 95% CrI: 1.02, 1.04). The rural monthly mortality rates increased with percent female population (IRR: 1.17, 95% CrI: 1.11, 1.24) and percent Black population (IRR:1.07 95% CrI:1.06, 1.08). Higher college education rates were associated with decreased mortality rates in rural and urban counties. The dynamics of exceedance probabilities detected the shifts of high-risk clusters from the Northeast to Southern and Midwestern counties.

Conclusions: Spatiotemporal analyses enabled the inclusion of unobserved latent risk factors and aid in scientifically grounded decision-making at a granular level.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annepidem.2021.05.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451980PMC
October 2021

Suggesting 7,8-dihydroxyflavone as a promising nutraceutical against CNS disorders.

Neurochem Int 2021 09 20;148:105068. Epub 2021 May 20.

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar-788011, Assam, India. Electronic address:

7,8-dihydroxyflavone (DHF), a naturally-occurring plant-based flavone, is a high-affinity tyrosine kinase receptor B (TrkB) agonist and a bioactive molecule of therapeutic interest for neuronal survival, differentiation, synaptic plasticity and neurogenesis. In the family of neurotrophic factors, this small BDNF-mimetic molecule has attracted considerable attention due to its oral bioavailability and ability to cross the blood-brain barrier. Recent evidences have shed light on the neuroprotective role of this pleiotropic flavone against several neurological disorders, including Alzheimer's disease, Parkinson's disease, cerebral ischemia, Huntington's disease, and other CNS disorders. DHF also elicits potent protective actions against toxins-induced insults to brain and neuronal cells. DHF shows promising anti-oxidant and anti-inflammatory properties in ameliorating the neurodegenerative processes affecting the CNS. This review provides an overview of the significant neuroprotective potentials of DHF and discusses how it exerts its multitudinous beneficial effects by modulating different pathways linked with the pathophysiology of CNS disorders, and thus proposes it to be a nutraceutical against a broad spectrum of neurological disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuint.2021.105068DOI Listing
September 2021

Mapping diabetes burden by school-district for school-based diabetes prevention interventions in selected cities in Michigan, USA.

Geospat Health 2021 05 14;16(1). Epub 2021 May 14.

Department of Public Health Sciences, University of North Carolina, Charlotte, NC.

To decrease diabetes morbidity and mortality rates, early interventions are needed to change lifestyles that are often cemented early, making school-based interventions important. However, with limited resources and lack of within-county diabetes data, it is difficult to determine which local areas require intervention. To identify at-risk school districts, this study mapped diabetes prevalence and related deaths by school district using geographic information systems (GIS). The 2010-2014 records of diabetes-related deaths were identified for 13 cities in Michigan, USA. Diabetes prevalence was estimated using the weighted average of population by school district from the '500 Cities Project' of the Centres of Disease Control and prevention (CDC). Prevalence and mortality rates were mapped by school district and the correlation between diabetes prevalence and mortality rate analysed using the Spearman's rank correlation. Years of potential life lost (YPLL) were calculated using a 75-year endpoint. The result indicated there were geographic variations in diabetes prevalence, mortality and YPLL across Michigan. Most census tracts in the cities of Detroit, Flint and downtown Grand Rapids had higher diabetes prevalence and mortality rate with rs (628)=0.52, P<0.005. School districts with high mortality rates also had high prevalence with rs (13)=0.72, P=0.002. Flint City School District showed a higher rate of diabetes prevalence, death and YPLL than others and should thus be considered a priority for diabetes prevention interventions. Using school districts as the geographic spatial unit of analysis, we identified local variation in diabetes burden for targeting school-based diabetes prevention interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4081/gh.2021.941DOI Listing
May 2021

Coronavirus testing disparities associated with community level deprivation, racial inequalities, and food insecurity in West Virginia.

Ann Epidemiol 2021 07 2;59:44-49. Epub 2021 Apr 2.

West Virginia Clinical and Translational Sciences Institute, Morgantown, WV; West Virginia University School of Medicine, Morgantown, WV.

Purpose: Social determinants of health and racial inequalities impact healthcare access and subsequent coronavirus testing. Limited studies have described the impact of these inequities on rural minorities living in Appalachia. This study investigates factors affecting testing in rural communities.

Methods: PCR testing data were obtained for March through September 2020. Spatial regression analyses were fit at the census tract level. Model outcomes included testing and positivity rate. Covariates included rurality, percent Black population, food insecurity, and area deprivation index (a comprehensive indicator of socioeconomic status).

Results: Small clusters in coronavirus testing were detected sporadically, while test positivity clustered in mideastern and southwestern WV. In regression analyses, percent food insecurity (IRR = 3.69×10, [796, 1.92×10]), rurality (IRR=1.28, [1.12, 1.48]), and percent population Black (IRR = 0.88, [0.84, 0.94]) had substantial effects on coronavirus testing. However, only percent food insecurity (IRR = 5.98 × 10, [3.59, 1.07×10]) and percent Black population (IRR = 0.94, [0.90, 0.97]) displayed substantial effects on the test positivity rate.

Conclusions: Findings highlight disparities in coronavirus testing among communities with rural minorities. Limited testing in these communities may misrepresent coronavirus incidence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annepidem.2021.03.009DOI Listing
July 2021

Social Support and Religiosity as Contributing Factors to Resilience and Mental Wellbeing in Latino Immigrants: A Community-Based Participatory Research Study.

J Immigr Minor Health 2021 Oct 14;23(5):904-916. Epub 2021 Mar 14.

University of North Carolina at Charlotte, Charlotte, NC, USA.

Latino immigrants are at increased risk for mental disorders due to social/economic disadvantages and stressful conditions associated with migration. Resilience-the ability to recover from stress-may provide protection given its association with lower rates of anxiety and depression. This study examines the relationship between protective factors, resilience, and psychological distress in Latino immigrants. A community-based participatory research study conducted with a Latino agency using in-person surveys to obtain the following data: Brief Resilience Scale, Brief Symptom Inventory, Duke University Religion Index, Multi-group Ethnic Identity measure, and the Interpersonal Support Evaluation List. Linear regression, and mediation analysis was performed using SPSS. There are 128 participants. Resilience was positively related to social support (p = 0.001) and religiosity (p = 0.006); inversely related to psychological distress (p = 0.001); and mediated the relationship between the two (p = 0.006). Promoting social support and religion in Latino communities can improve wellbeing by increasing resilience and reducing distress.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10903-021-01179-7DOI Listing
October 2021

The Association of Social Determinants of Health With COVID-19 Mortality in Rural and Urban Counties.

J Rural Health 2021 03 22;37(2):278-286. Epub 2021 Feb 22.

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.

Purpose: To identify the county-level effects of social determinants of health (SDoH) on COVID-19 (corona virus disease 2019) mortality rates by rural-urban residence and estimate county-level exceedance probabilities for detecting clusters.

Methods: The county-level data on COVID-19 death counts as of October 23, 2020, were obtained from the Johns Hopkins University. SDoH data were collected from the County Health Ranking and Roadmaps, the US Department of Agriculture, and the Bureau of Labor Statistics. Semiparametric negative binomial regressions with expected counts based on standardized mortality rates as offset variables were fitted using integrated Laplace approximation. Bayesian significance was assessed by 95% credible intervals (CrI) of risk ratios (RR). County-level mortality hotspots were identified by exceedance probabilities.

Findings: The COVID-19 mortality rates per 100,000 were 65.43 for the urban and 50.78 for the rural counties. Percent of Blacks, HIV, and diabetes rates were significantly associated with higher mortality in rural and urban counties, whereas the unemployment rate (adjusted RR = 1.479, CrI = 1.171, 1.867) and residential segregation (adjusted RR = 1.034, CrI = 1.019, 1.050) were associated with increased mortality in urban counties. Counties with a higher percentage of college or associate degrees had lower COVID-19 mortality rates.

Conclusions: SDoH plays an important role in explaining differential COVID-19 mortality rates and should be considered for resource allocations and policy decisions on operational needs for businesses and schools at county levels.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jrh.12557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014225PMC
March 2021

Multicentered prospective investigator initiated study to evaluate the clinical outcomes with extracorporeal cytokine adsorption device (CytoSorb) in patients with sepsis and septic shock.

World J Crit Care Med 2021 Jan 9;10(1):22-34. Epub 2021 Jan 9.

Department of Critical Care Medicine, Ruby Hall Clinic, Pune 411001, India.

Background: Sepsis is a severe clinical syndrome related to the host response to infection. The severity of infections is due to an activation cascade that will lead to an auto amplifying cytokine production: The cytokine storm. Hemoadsorption by CytoSorb therapy is a new technology that helps to address the cytokine storm and to regain control over various inflammatory conditions.

Aim: To evaluate prospectively CytoSorb therapy used as an adjunctive therapy along with standard of care in septic patients admitted to intensive care unit (ICU).

Methods: This was a prospective, real time, investigator initiated, observational multicenter study conducted in patients admitted to the ICU with sepsis and septic shock. The improvement of mean arterial pressure and reduction of vasopressor needs were evaluated as primary outcome. The change in laboratory parameters, sepsis scores [acute physiology and chronic health evaluation (APACHE II) and sequential organ failure assessment (SOFA)] and vital parameters were considered as secondary outcome. The outcomes were also evaluated in the survivor and non-survivor group. Descriptive statistics were used; a value < 0.05 was considered to be statistically significant.

Results: Overall, 45 patients aged ≥ 18 and ≤ 80 years were included; the majority were men ( = 31; 69.0%), with mean age 47.16 ± 14.11 years. Post CytoSorb therapy, 26 patients survived and 3 patients were lost to follow-up. In the survivor group, the percentage dose reduction in vasopressor was norepinephrine (51.4%), epinephrine (69.4%) and vasopressin (13.9%). A reduction in interleukin-6 levels (52.3%) was observed in the survivor group. Platelet count improved to 30.1% ( = 0.2938), and total lung capacity count significantly reduced by 33% ( < 0.0001). Serum creatinine and serum lactate were reduced by 33.3% ( = 0.0190) and 39.4% ( = 0.0120), respectively. The mean APACHE II score was 25.46 ± 2.91 and SOFA scores was 12.90 ± 4.02 before initiation of CytoSorb therapy, and they were reduced significantly post therapy (APACHE II 20.1 ± 2.47; < 0.0001 and SOFA 9.04 ± 3.00; = 0.0003) in the survivor group. The predicted mortality in our patient population before CytoSorb therapy was 56.5%, and it was reduced to 48.8% (actual mortality) after CytoSorb therapy. We reported 75% survival rate in patients given treatment in < 24 h of ICU admission and 68% survival rates in patients given treatment within 24-48 h of ICU admission. In the survivor group, the average number of days spent in the ICU was 4.44 ± 1.66 d; while in the non-survivor group, the average number of days spent in ICU was 8.5 ± 15.9 d. CytoSorb therapy was safe and well tolerated with no adverse events reported.

Conclusion: CytoSorb might be an effective adjuvant therapy in stabilizing sepsis and septic shock patients. However, it is advisable to start the therapy at an early stage (preferably within 24 h after onset of septic shock).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5492/wjccm.v10.i1.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805252PMC
January 2021

The Relationship between Patient-Centered Medical Home Characteristics and Patient Dissatisfaction at a Federally Qualified Health Center.

J Health Care Poor Underserved 2020 ;31(3):1364-1378

This cross-sectional study examined the relationship between patients' assessment of patient-centered medical home (PCMH) characteristics and patient experiences at a federally qualified health center. The survey was based on the Consumer Assessment of Health care Providers and Systems (CAHPS) instrument. Patient-centered medical home characteristics include access to care and coordination, provider communication, office staff helpfulness, and discrimination. Outcomes were related to patient experiences reflecting their dissatisfaction and lack of trust. Our sample (N = 257) was 76% female, 39% older than 50, 40% with college education, and 84% African American. We performed multiple logistic regression to examine the association between PCMH characteristics and patient dissatisfaction, adjusting for demographics. Approximately 26% of the participants reported dissatisfaction with at least one outcome. Effective provider communication was the primary contributor to decreased odds of patient dissatisfaction and lack of trust. The study highlights the prominence of provider communication for patients using safety-net providers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1353/hpu.2020.0100DOI Listing
September 2021

Predicting coliform presence in private wells as a function of well characteristics, parcel size and leachfield soil rating.

Sci Total Environ 2021 Mar 23;758:143701. Epub 2020 Nov 23.

Department of Geography and Earth Sciences and Center for Applied Geographic Information Science, University of North Carolina at Charlotte, Charlotte, NC 28233, USA. Electronic address:

Public water systems must be tested frequently for coliform bacteria to determine whether other pathogens may be present, yet no testing or disinfection is required for private wells. In this paper, we identify whether well age, type of well, well depth, parcel size, and soil ratings for a leachfield can predict the probability of detecting coliform bacteria in private wells using a multivariate logistic regression model. Samples from 1163 wells were analyzed for the presence of coliform bacteria between October 2017 and October 2019 across Gaston County, North Carolina, USA. The maximum well age was 30 years, and bored wells (median age = 24 years) were older than drilled wells (median age = 19 years). Bored wells were shallower (mean depth = 18 m) compared to drilled wells (mean depth = 79 m). We found coliform bacteria in 329 samples, including 290 of 1091 drilled wells and 39 of 72 bored wells. The model results showed bored wells were 4.76 times more likely to contain bacteria compared to drilled wells. We found that the likelihood of coliform bacteria significantly increased with well age, suggesting that those constructed before well standards were enforced in 1989 may be at a higher risk. We found no significant association between poorly rated soils for a leachfield, well depth, parcel size and the likelihood of having coliform in wells. These findings can be leveraged to determine areas of concern to encourage well users to take action to reduce their risk of drinking possible pathogens in well water.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.scitotenv.2020.143701DOI Listing
March 2021

COVID-19 reopening strategies at the county level in the face of uncertainty: Multiple Models for Outbreak Decision Support.

medRxiv 2020 Nov 5. Epub 2020 Nov 5.

Policymakers make decisions about COVID-19 management in the face of considerable uncertainty. We convened multiple modeling teams to evaluate reopening strategies for a mid-sized county in the United States, in a novel process designed to fully express scientific uncertainty while reducing linguistic uncertainty and cognitive biases. For the scenarios considered, the consensus from 17 distinct models was that a second outbreak will occur within 6 months of reopening, unless schools and non-essential workplaces remain closed. Up to half the population could be infected with full workplace reopening; non-essential business closures reduced median cumulative infections by 82%. Intermediate reopening interventions identified no win-win situations; there was a trade-off between public health outcomes and duration of workplace closures. Aggregate results captured twice the uncertainty of individual models, providing a more complete expression of risk for decision-making purposes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1101/2020.11.03.20225409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654910PMC
November 2020

Impact of Time to Receipt of Prosthesis on Total Healthcare Costs 12 Months Postamputation.

Am J Phys Med Rehabil 2020 11;99(11):1026-1031

From the Department of Public Health, University of North Carolina at Charlotte, Charlotte, North Carolina (TAM, RP, MF); Department of Clinical and Scientific Affairs, Hanger Clinic, Austin, Texas (TAM, SRW); and Department of Biomechanics, University of Nebraska at Omaha, Omaha, Nebraska (SRW).

Objective: The objective was to assess the impact of a prosthesis and the timing of prosthesis receipt on total direct healthcare costs in the 12-mo postamputation period.

Design: Data on patients with lower limb amputation (n = 510) were obtained from a commercial claims database for retrospective cohort analysis. Generalized linear multivariate modeling was used to determine differences in cost between groups according to timing of prosthesis receipt compared with a control group with no prosthesis.

Results: Receipt of a prosthesis between 0 and 3 mos post lower limb amputation yielded a reduced total cost by approximately 0.23 in log scale within 12 mos after amputation when compared with the no-prosthesis group. Despite the included costs of a prosthesis, individuals who received a prosthesis either at 4-6 mos postamputation or 7-9 mos postamputation incurred costs similar to the no-prosthesis group.

Conclusion: Earlier receipt of a prosthesis is associated with reduced spending in the 12 mos postamputation of approximately $25,000 compared with not receiving a prosthesis. The results of this study suggest that not providing or delaying the provision of a prosthesis increases costs by about 25%.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHM.0000000000001473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547875PMC
November 2020

The Role of Earlier Receipt of a Lower Limb Prosthesis on Emergency Department Utilization.

PM R 2021 08 11;13(8):819-826. Epub 2020 Dec 11.

Department of Clinical and Scientific Affairs, Hanger Clinic, Austin, TX.

Introduction: Adverse events after a lower limb amputation (LLA) can negatively affect the rehabilitation process and may lead to emergency department (ED) visits. Earlier receipt of a prosthesis, as compared to delayed or not receiving a prosthesis, may decrease or moderate the risk of increased ED utilization. In addition, adverse events (ie, fall-related injury [FRI]) may be associated with increased health care utilization as measured by ED use. The implication of the timing of prosthesis provision after amputation and reduced ED use is not well established. Obtaining data about ED utilization early post-LLA could assist the rehabilitation team in ensuring timely and appropriate access to improve outcomes.

Objective: To determine the role that timing of prosthesis receipt has in ED utilization and the association of fall/FRI with health care utilization.

Design: Retrospective observational cohort using commercial claims data. A logistic regression model was used to assess factors that influence ED utilization post-LLA.

Setting: Watson/Truven administrative database 2014 to 2016.

Participants: The study sample consisted of 510 adults age 18 to 64 years with continuous enrollment for 3 years.

Interventions: Independent variables included age, sex, diabetes status, amputation level, fall diagnosis, and prosthesis receipt. Fall was defined as presence of a diagnosis code in any outpatient procedure after the amputation date.

Main Outcome Measure: ED use after amputation was defined as the presence of procedure codes that billed for ED services (99281 to 99285).

Results: Individuals who receive a prosthesis early, within 0 to 3 months, post-LLA were 48% (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.28 to 0.97) less likely to use the ED compared to those who did not receive a prosthesis. Individuals who experienced a fall/FRI had 2.8 (OR 2.86, 95% CI 1.23 to 6.66) times the odds of ED utilization.

Conclusion: Receipt of a prosthesis reduces the risk of ED use. The current study underscores the value of prostheses during the rehabilitation process after LLA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/pmrj.12504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451817PMC
August 2021

Space-Time Conditional Autoregressive Modeling to Estimate Neighborhood-Level Risks for Dengue Fever in Cali, Colombia.

Am J Trop Med Hyg 2020 11;103(5):2040-2053

Department of Geography and Earth Sciences, Center for Applied Geographic Information Science, University of North Carolina at Charlotte, Charlotte, North Carolina.

Vector-borne diseases affect more than 1 billion people a year worldwide, causing more than 1 million deaths, and cost hundreds of billions of dollars in societal costs. Mosquitoes are the most common vectors responsible for transmitting a variety of arboviruses. Dengue fever (DENF) has been responsible for nearly 400 million infections annually. Dengue fever is primarily transmitted by female and mosquitoes. Because both species are peri-domestic and container-breeding mosquitoes, dengue surveillance should begin at the local level-where a variety of local factors may increase the risk of transmission. Dengue has been endemic in Colombia for decades and is notably hyperendemic in the city of Cali. For this study, we use weekly cases of DENF in Cali, Colombia, from 2015 to 2016 and develop space-time conditional autoregressive models to quantify how DENF risk is influenced by socioeconomic, environmental, and accessibility risk factors, and lagged weather variables. Our models identify high-risk neighborhoods for DENF throughout Cali. Statistical inference is drawn under Bayesian paradigm using Markov chain Monte Carlo techniques. The results provide detailed insight about the spatial heterogeneity of DENF risk and the associated risk factors (such as weather, proximity to habitats, and socioeconomic classification) at a fine level, informing public health officials to motivate at-risk neighborhoods to take an active role in vector surveillance and control, and improving educational and surveillance resources throughout the city of Cali.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4269/ajtmh.20-0080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646775PMC
November 2020

Lycopene - A pleiotropic neuroprotective nutraceutical: Deciphering its therapeutic potentials in broad spectrum neurological disorders.

Neurochem Int 2020 11 20;140:104823. Epub 2020 Aug 20.

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, 788011, Assam, India. Electronic address:

Lycopene is a naturally occurring carotenoid found abundantly in red fruits and vegetables. Myriads of literature documented potential health benefits of lycopene, owing to its sublime capacity of suppressing oxidative stress, inflammation, and modulation of various cell survival pathways. Due to its lipophilic nature, lycopene can reach brain adequately by traversing the blood-brain barrier thereby extending it's promising therapeutic benefits in neurological disorders. Lycopene efficiently assists in restoring the characteristic behavioural and pathophysiological changes associated with neurodegenerative disorders, epileptic conditions, aging, subarachnoid hemorrhage, spinal cord injury, and neuropathy. The detrimental impacts of environmental neurotoxins on brain and neuropathological consequences of consumption of high-lipid diet can also be mitigated by lycopene. Apart from its high antioxidant potency, lycopene confers neuroprotection by preventing proteinopathies, neuroinflammation, apoptosis, cerebral edema, and synaptic dysfunction. This review provides a lucid idea on the potential multi-faceted benefits of lycopene in disorders of the central nervous system and elucidates the molecular mechanisms and pathways of its action.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuint.2020.104823DOI Listing
November 2020

Drug repurposing and relabeling for cancer therapy: Emerging benzimidazole antihelminthics with potent anticancer effects.

Life Sci 2020 Oct 8;258:118189. Epub 2020 Aug 8.

Department of Zoology, Cachar College, Silchar 788001, Assam, India.

Origin of drug and radio-refractory clones, cancer stem-like cells, and rapid angiogenesis and metastasis are among the primary concerns that limit the efficacy of anticancer treatments, emphasizing the urgency of developing new therapeutics. Factors like high attrition rates, huge investments, patients' heterogeneity, and diverse molecular subtypes have challenged the rapid development of anticancer drugs. Treatment with repurposing pleiotropic benzimidazole antihelminthics, like mebendazole, albendazole, and flubendazole has recently opened a new window, owing to their easy access, low cost as a generic drug, and long track record of safe use in the human population. This review highlights the outcomes of preclinical and clinical studies of these drugs as a potent anticancer agent(s) conducted in the last two decades. Substantial preclinical studies, as well as limited clinical trials, suggest noteworthy anticancer potency of these pleiotropic benzimidazoles, particularly as potent microtubule disrupting, anti-angiogenic, and anti-metastatic agents, inhibitors of the immune checkpoint, hypoxia-inducible factor, epithelial-mesenchymal transition, cancer stemness, and multidrug resistance protein 1, and inducers of apoptosis and M1 polarization. These anticancer effects are attributed to multiple action points, including intrinsic apoptosis, canonical Wnt/β-catenin, JAK/STAT-3, JNK, MEK/ERK, and hedgehog signaling pathways. The effective anticancer properties of mebendazole, albendazole, and flubendazole either alone or synergistically with frontline drugs, warrant their validation through controlled clinical trials to use them as promising avenues to anticancer therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.lfs.2020.118189DOI Listing
October 2020

Progression of COVID-19 From Urban to Rural Areas in the United States: A Spatiotemporal Analysis of Prevalence Rates.

J Rural Health 2020 09 30;36(4):591-601. Epub 2020 Jun 30.

Department of Mathematics, University of Louisville, Louisville, Kentucky.

Purpose: There are growing signs that the COVID-19 virus has started to spread to rural areas and can impact the rural health care system that is already stretched and lacks resources. To aid in the legislative decision process and proper channelizing of resources, we estimated and compared the county-level change in prevalence rates of COVID-19 by rural-urban status over 3 weeks. Additionally, we identified hotspots based on estimated prevalence rates.

Methods: We used crowdsourced data on COVID-19 and linked them to county-level demographics, smoking rates, and chronic diseases. We fitted a Bayesian hierarchical spatiotemporal model using the Markov Chain Monte Carlo algorithm in R-studio. We mapped the estimated prevalence rates using ArcGIS 10.8, and identified hotspots using Gettis-Ord local statistics.

Findings: In the rural counties, the mean prevalence of COVID-19 increased from 3.6 per 100,000 population to 43.6 per 100,000 within 3 weeks from April 3 to April 22, 2020. In the urban counties, the median prevalence of COVID-19 increased from 10.1 per 100,000 population to 107.6 per 100,000 within the same period. The COVID-19 adjusted prevalence rates in rural counties were substantially elevated in counties with higher black populations, smoking rates, and obesity rates. Counties with high rates of people aged 25-49 years had increased COVID-19 prevalence rates.

Conclusions: Our findings show a rapid spread of COVID-19 across urban and rural areas in 21 days. Studies based on quality data are needed to explain further the role of social determinants of health on COVID-19 prevalence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jrh.12486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361905PMC
September 2020

Trace metals contamination in groundwater and implications on human health: comprehensive assessment using hydrogeochemical and geostatistical methods.

Environ Geochem Health 2020 Nov 29;42(11):3819-3839. Epub 2020 Jun 29.

Department of Chemistry, Tripura University, Suryamaninagar, Tripura, 799 022, India.

Monitoring the groundwater chemical composition and identifying the presence of pollutants is an integral part of any comprehensive groundwater management strategy. The present study was conducted in a part of West Tripura, northeast India, to investigate the presence and sources of trace metals in groundwater and the risk to human health due to direct ingestion of groundwater. Samples were collected from 68 locations twice a year from 2016 to 2018. Mixed Ca-Mg-HCO, Ca-Cl and Ca-Mg-Cl were the main groundwater types. Hydrogeochemical methods showed groundwater mineralization due to (1) carbonate dissolution, (2) silicate weathering, (3) cation exchange processes and (4) anthropogenic sources. Occurrence of faecal coliforms increased in groundwater after monsoons. Nitrate and microbial contamination from wastewater infiltration were apparent. Iron, manganese, lead, cadmium and arsenic were above the drinking water limits prescribed by the Bureau of Indian Standards. Water quality index indicated 1.5% had poor, 8.7% had marginal, 16.2% had fair, 66.2% had good and 7.4% had excellent water quality. Correlation and principal component analysis reiterated the sources of major ions and trace metals identified from hydrogeochemical methods. Human exposure assessment suggests health risk due to high iron in groundwater. The presence of unsafe levels of trace metals in groundwater requires proper treatment measures before domestic use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10653-020-00637-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641953PMC
November 2020

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorization of discount variety stores: leveraging the private sector to modestly increase availability of healthy foods.

Am J Clin Nutr 2020 06;111(6):1278-1285

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.

Background: Many lower-income communities in the United States lack a full-line grocery store. There is evidence that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increases the availability of healthy foods in stores. One national discount variety store chain (DVS) that is often located in low-income neighborhoods became an authorized WIC vendor in 8 pilot stores.

Objectives: The objective of this study was to evaluate how implementing WIC in DVS pilot stores affected sales of healthy, WIC-eligible foods.

Methods: We used DVS sales data and difference-in-differences regression to evaluate how WIC authorization affected sales of WIC-eligible foods in 8 DVS pilot stores, compared with 8 matched comparison stores.

Results: DVS added 18 new WIC-approved foods to become an authorized vendor. Results indicate that becoming a WIC vendor significantly increased sales of healthy, WIC-eligible foods that DVS carried before authorization. WIC implementation in DVS led to a 31-unit increase in sales of the original WIC foods per week on average (P < 0.01). Lower socioeconomic status, assessed using a summary measure, is associated with increased sales of WIC foods. Yet sales of non-WIC eligible foods (e.g., salty snack foods, candy bars, soda, and processed meats) were not affected by WIC authorization.

Conclusions: Encouraging DVS stores to become WIC-authorized vendors has the potential to modestly increase DVS sales and the availability of healthy foods in low-income neighborhoods. If WIC authorization is financially viable for small-format variety stores, encouraging similar small-format variety stores to become WIC-authorized has the potential to improve food access.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ajcn/nqaa097DOI Listing
June 2020

Estimating the prevalence and spatial clusters of coal workers' pneumoconiosis cases using medicare claims data, 2011-2014.

Am J Ind Med 2020 06 9;63(6):478-483. Epub 2020 Mar 9.

Department of Public Health Sciences, The University of North Carolina at Charlotte, Charlotte, North Carolina.

Background: Workers employed in the coal mining sector are at increased risk of respiratory diseases, including coal workers' pneumoconiosis (CWP). We investigated the prevalence of CWP and its association with sociodemographic factors among Medicare beneficiaries.

Methods: We used 5% Medicare Limited Data Set claims data from 2011 to 2014 to select Medicare beneficiaries with a diagnosis of ICD-9-CM 500 (CWP). We aggregated the data by county and limited our analysis to seven contiguous states: Illinois, Indiana, Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. We estimated county-level prevalence rates using total Medicare beneficiaries and miners as denominators and performed spatial hotspot analysis. We used negative binomial regression analysis to determine the association of county-wise sociodemographic factors with CWP.

Results: There was significant spatial clustering of CWP cases in Kentucky, Virginia, and West Virginia. Spatial clusters of 210 and 605 CWP cases representing an estimated 4200 to 12 100 cases of Medicare beneficiaries with CWP were identified in the three states. Counties with higher poverty levels had a significantly elevated rate of CWP (adjusted rate ratios [RR]: 1.15; 95% CI, 1.12-1.18). There was a small but significant association of CWP with the county-wise catchment area. Rurality was associated with a more than three-fold elevated rate of CWP in the unadjusted analysis (RR: 3.28, 95% CI, 2.22-4.84). However, the rate declined to 1.45 (95% CI, 1.04-2.01) after adjusting for other factors in the analysis.

Conclusions: We found evidence of significant spatial clustering of CWP among Medicare beneficiaries living in the seven states of the USA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ajim.23104DOI Listing
June 2020

Natural Products and Their Therapeutic Effect on Autism Spectrum Disorder.

Adv Neurobiol 2020 ;24:601-614

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, India.

Autism is a complex neurodevelopmental disorder that is evident in early childhood and can persist throughout the entire life. The disease is basically characterized by hurdles in social interaction where the individuals demonstrate repetitive and stereotyped interests or patterns of behavior. A wide number of neuroanatomical studies with autistic patients revealed alterations in brain development which lead to diverse cellular and anatomical processes including atypical neurogenesis, neuronal migration, maturation, differentiation, and degeneration. Special education programs, speech and language therapy, have been employed for the amelioration of behavioral deficits in autism. Although commonly prescribed antidepressants, antipsychotics, anticonvulsants, and stimulants have revealed satisfactory responses in autistic individuals, adverse side effects and increased risk of several other complications including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, etc. have compelled the researchers to turn their attention toward herbal remedies. Alternative approaches with natural compounds are on continuous clinical trial to confirm their efficacy and to understand their potential in autism treatment. This chapter aims to cover the major plant-based natural products which hold promising outcomes in the field of reliable therapeutic interventions for autism.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/978-3-030-30402-7_22DOI Listing
February 2020

Neuroprotective attributes of L-theanine, a bioactive amino acid of tea, and its potential role in Parkinson's disease therapeutics.

Neurochem Int 2019 10 27;129:104478. Epub 2019 May 27.

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, India. Electronic address:

Meta-analyses of tea consumption and reduced risk of Parkinson's disease have thrown light in the pathway of exploring beneficial properties of tea components. On the basis of dry mass, a typical black or green tea beverage contains approximately 6% of free amino acids, which impart high quality, taste and distinctive aroma to the tea infusion. L-theanine (chemically known as γ-glutamylethylamide) is a non-proteinogenic amino acid of tea that takes part in the biosynthesis of its polyphenols. Recently discovered neuroprotective effects of L-theanine can be attributed to its structural analogy with glutamate, the principal excitatory neurotransmitter in brain. This unique amino acid also bears a potential to ameliorate the pathophysiological changes associated with Parkinson's disease as it displays antioxidant and anti-inflammatory properties, improves motor behavioral abnormalities, increases dopamine availability and may cause a favorable downshift in neurodegeneration due to glutamate excitotoxicity. To gain an explicit understanding of the role of L-theanine, this review article is the first one to focus on its mechanism of neuromodulatory action and to critically evaluate the possibilities of employing this bioactive amide in the forage of anti-Parkinsonian medication. We also hypothesize the idea of L-theanine being a potent natural agent against L-DOPA induced dyskinesia, since long-term reliance on dopamine replacement therapy is linked with elevation in glutamate receptor activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuint.2019.104478DOI Listing
October 2019

Garcinol, a multifaceted sword for the treatment of Parkinson's disease.

Neurochem Int 2019 09 12;128:50-57. Epub 2019 Apr 12.

Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, 788011, Assam, India. Electronic address:

Garcinol, the principal phytoconstituent of plants belonging to the genus Garcinia, is known for its anti-oxidant as well as anti-inflammatory properties, which can be extended to its possible neuroprotective role. Recent reports disseminate the capacity of garcinol to influence neuronal growth and survival, alter the neurochemical status in brain, as well as regulate memory and cognition. The concomitant neuro-rescue property of garcinol may render it as an effective compound in Parkinson's disease (PD) therapeutics since it is capable of ameliorating the related pathophysiological changes. Emerging pieces of evidence linking histone acetylation defects to the progression of neurodegenerative diseases provide an effective basis for targeting PD. Hyperacetylation of histones has been reported in Parkinsonian brain, which demands the use of pharmacological inhibitors of histone acetyltransferases (HAT). Garcinol serves as a potent natural HAT inhibitor and has unveiled promising results in molecular interaction studies against Monoamine oxidase B (MAO-B) and Catechol-O-Methyltransferase (COMT), as well as in L-DOPA induced dyskinesia. This review highlights the prospective implications of garcinol as a novel anti-Parkinsonian agent, and establishes a bridge between histone acetylation defects and the pathological aspects of PD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuint.2019.04.004DOI Listing
September 2019
-->