Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children: A Critical Narrative Review

Women’s nutritional status during pregnancy can have long-term effects on children’s brains and cognitive development. Folate and choline are methyl-donor nutrients and are important for closure of the neural tube during fetal development. They have also been associated with brain and cognitive development in children. Animal studies have observed that prenatal folate and choline supplementation is associated with better cognitive outcomes in offspring and that these nutrients may have interactive effects on brain development. Although some human studies have reported associations between maternal folate and choline levels and child cognitive outcomes, results are not consistent, and no human studies have investigated the potential interactive effects of folate and choline. This lack of consistency could be due to differences in the methods used to assess folate and choline levels, the gestational trimester at which they were measured, and lack of consideration of potential confounding variables. This narrative review discusses and critically reviews current research examining the associations between maternal levels of folate and choline during pregnancy and brain and cognitive development in children. Directions for future research that will increase our understanding of the effects of these nutrients on children’s neurodevelopment are discussed.

Impact of Povidone-iodine Versus Chlorhexidine for Periurethral Cleaning Before Catheterization on Pyuria and Bacteriuria Among Emergency Department Patients

Background: We aimed to determine the effect of periurethral cleaning before catheterization using chlorhexidine and povidone-iodine on bacteriuria and pyuria. Methods: This study was a single-blind clinical trial on a sample selected by convenience sampling. Demographic and clinical questionnaires were completed, and patients were randomly divided into two groups) 36 patients each of povidone-iodine and chlorhexidine using Minimization Software based on confounding variables including age, consciousness level, triage level, nutritional status, and underlying disease. The periurethral areas were cleaned with the given antiseptics and catheterized using standard and sterile procedures. Then, specimens were taken for urinalysis and urine culture immediately, 72 hours, and five days after catheterization. Then, bacteriuria rate, pyuria rate, and the number of microorganisms were determined through examinations. Data analysis was conducted using SPSS version 19. Results: There was no statistically significant difference in the bacteriuria rate between the two groups immediately (P = 0.76), 72 hours (P = 0.22), and five days (P = 0.50) after catheterization. The positive pyuria rate was not significantly different between the two groups immediately after catheterization. However, it was significantly higher in the povidone-iodine group 72 hours (P = 0.03) and five days (P = 0.004) after catheterization. The Mann-Whitney test compared the mean number of microorganisms between the two groups at different times. This test showed no significant difference in the number of microorganisms immediately (P = 0.93), 72 hours (P = 0.43), and five days (P = 0.61) after catheterization. Conclusions: Due to the lower side effects of chlorhexidine than povidone-iodine, it is suggested that similar studies be performed in other hospital wards with more stable patients to obtain more statistically significant results.

How community forest management performs when REDD+ payments fail

The Reduced Emissions in Deforestation and Degradation (REDD+) initiative uses payments for ecosystem services as incentives for developing countries to manage and protect their forests. REDD+ initiatives also prioritize social (and environmental) co-benefits aimed at improving the livelihoods of communities that are dependent on forests. Despite the incorporation of co-benefits into REDD+ goals, carbon sequestration remains the primary metric for which countries can receive payments from REDD+, but after more than ten years of REDD+, many site-specific programs have failed to complete the carbon verification process. Here, we examine whether the REDD+ social co-benefits alone are sufficient to have slowed deforestation in the absence of carbon payments on Pemba, Tanzania. Using satellite imagery (Landsat archive), we quantified forest cover change for the period before (2001-2010) and after (2010-2018) the launch in 2010-11 of Pemba island’s REDD+ Readiness project. We then compared rates of forest cover change between shehia (administrative units) that were part of REDD+ Readiness intervention and those that were not, adjusting for confounding variables and the non-random selection of REDD+ shehia with a statistical matching procedure. Despite considerable variation in forest outcomes among shehia, the associated co-benefits with the Pemba REDD+ project had no discernible effect on forest cover change. Likewise, we did not detect an effect of socioecological covariates on forest cover change across all shehia, though island-wide human population growth since 2012 may have played a role. These findings are unsurprising given the failure to secure carbon payments on Pemba and indicate that co-benefits alone are insufficient to reduce deforestation. We conclude that better oversight of all-involved parties is needed to ensure that REDD+ interventions satisfactorily conclude the process of securing a mechanism for carbon payments, if slowing deforestation is to be achieved.

Oropharyngeal Dysphagia: A Proposal for an Ecological Theoretical Model

Background: The exponential growth in epidemiological studies has been reflected in an increase in analytical studies. Thus, theoretical models are required to guide the definition of data analysis, although so far, they are seldom used in Speech, Language, and Hearing Sciences. Objective: To propose a multicausal model for oropharyngeal dysphagia using directed acyclic graphs showing mediating variables, confounding variables, and variables connected by direct causation. Design: This integrative literature review. Setting: This was carried out until January 4, 2021, and searches were performed with the MEDLINE, EMBASE,and other bases.

The Association Between Long-Term Exposure to Particulate Matter and Incidence of Hypertension Among Chinese Elderly: A Retrospective Cohort Study

Background and Objectives: Studies that investigate the links between particulate matter ≤2. 5 μm (PM2.5) and hypertension among the elderly population, especially those including aged over 80 years, are limited. Therefore, we aimed to examine the association between PM2.5 exposure and the risk of hypertension incidence among Chinese elderly.Methods: This prospective cohort study used 2008, 2011, 2014, and 2018 wave data from a public database, the Chinese Longitudinal Healthy Longevity Survey, a national survey investigating the health of those aged over 65 years in China. We enrolled cohort participants who were free of hypertension at baseline (2008) from 706 counties (districts) and followed up in the 2011, 2014, and 2018 survey waves. The annual PM2.5 concentration of 706 counties (districts) units was derived from the Atmospheric Composition Analysis Group database as the exposure variable, and exposure to PM2.5 was defined as 1-year average of PM2.5 concentration before hypertension event occurrence or last interview (only for censoring). A Cox proportional hazards model with penalized spline was used to examine the non-linear association between PM2.5 concentration and hypertension risk. A random-effects Cox proportional hazards model was built to explore the relationship between each 1 μg/m3, 10 μg/m3 and quartile increment in PM2.5 concentration and hypertension incidence after adjusting for confounding variables. The modification effects of the different characteristics of the respondents were also explored.Results: A total of 7,432 participants aged 65–116 years were enrolled at baseline. The median of PM2.5 exposure concentration of all the participants was 52.7 (inter-quartile range, IQR = 29.1) μg/m3. Overall, the non-linear association between PM2.5 and hypertension incidence risk indicated that there was no safe threshold for PM2.5 exposure. The higher PM2.5 exposure, the greater risk for hypertension incidence. Each 1 μg/m3 [adjusted hazard ratio (AHR): 1.01; 95% CI: 1.01–1.02] and 10 μg/m3 (AHR: 1.12; 95% CI: 1.09–1.16) increments in PM2.5, were associated with the incidence of hypertension after adjusting for potential confounding variables. Compared to first quartile (Q1) exposure, the adjusted HRs of hypertension incidence for the Q2, Q3 and Q4 exposure of PM2.5 were 1.31 (95% CI: 1.13–1.51), 1.35 (95% CI: 1.15–1.60), and 1.83 (95% CI: 1.53–2.17), respectively. The effects appear to be stronger among those without a pension, living in a rural setting, and located in central/western regions.Conclusion: We found no safe threshold for PM2.5 exposure related to hypertension risk, and more rigorous approaches for PM2.5 control were needed. The elderly without a pension, living in rural and setting in the central/western regions may be more vulnerable to the effects of PM2.5 exposure.

The relationship between dietary sulfur amino acids intake and severity and frequency of pain in Iranian patients with musculoskeletal pains, 2020

Objective Musculoskeletal pain conditions (MPs) are a widespread public problem that can affect 13.5% to 47% of the total population. Dietary changes can have strong effects on person’s health; for instance, Sulfur amino acids (SAAs) can act as a precursor of neurotransmitters, antioxidative metabolic intermediates, such as glutathione, impact inflammation, and play a role in severity and frequency of MPs. We evaluated the relationship between dietary SAAs intake with severity and frequency of pain in patients with MPs. Results This cross-sectional study consisted of 175 men and woman. Anthropometric measurements and pain assessments were conducted via questionnaires. Dietary data were collected using 7 days 24-h recall. ANOVA and Spearman correlation coefficients were used to examine the relationship and correlation, respectively, between exposure and outcome variables. There was a significant correlation between age, weight, waist circumference (WC), waist circumference to height (WHtR), body mass index (BMI), and severity and frequency of MPs among women. There was a correlation between age and severity of pain in men. The present study highlights a positive association between the dietary SAAs and severity of pain, even after adjusting for confounding variables.

A Case-Control of Patients with COVID-19 to Explore the Association of Previous Hospitalisation Use of Medication on the Mortality of COVID-19 Disease: A Propensity Score Matching Analysis

Data from several cohorts of coronavirus disease 2019 (COVID-19) suggest that the most common comorbidities for severe COVID-19 disease are the elderly, high blood pressure, and diabetes; however, it is not currently known whether the previous use of certain drugs help or hinder recovery. This study aims to explore the association of previous hospitalisation use of medication on the mortality of COVID-19 disease. A retrospective case-control from two hospitals in Madrid, Spain, included all patients aged 18 years or above hospitalised with a diagnosis of COVID-19. A Propensity Score matching (PSM) analysis was performed. Confounding variables were considered to be age, sex, and the number of comorbidities. Finally, 3712 patients were included. Of these, 687 (18.5%) patients died (cases). The 22,446 medicine trademarks used previous to admission were classified according to the ATC, obtaining 689 final drugs; all of them were included in PSM analysis. Eleven drugs displayed a reduction in mortality: azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine theophylline acetate, oral rehydration salts, and salbutamol sulphate. Eight final drugs displayed an increase in mortality: acetylsalicylic acid, digoxin, folic acid, mirtazapine, linagliptin, enalapril, atorvastatin, and allopurinol. Medication associated with survival (anticoagulants, antihistamines, azithromycin, bronchodilators, cefuroxime, colchicine, and inhaled corticosteroids) may be candidates for future clinical trials. Drugs associated with mortality show an interaction with the underlying conditions.

Rate of forgetting is independent of initial degree of learning

It is commonly assumed that the rate of forgetting depends on initial degree of learning. Hence, comparison of forgetting across groups is usually carried out equating initial performance. However, these matching procedures add confounding variables. In four experiments, following Slamecka and McElree (1983, Exp 3), we challenge this assumption through manipulating initial acquisition by varying the number of presentations of the material and studying the effect on rate of subsequent forgetting. A set of 36 sentences was presented either visually or auditorily. Different participants were exposed to the material two, four or six times. Forgetting was measured by means of a cued recall test at three time-intervals (30 s, 1 day and 1 week in experiments 1 and 2; 30 s, 1 day, and 3 days in experiments 3 and 4). A different subset of 12 sentences was tested at each delay. The outcome of these experiments showed that the initial acquisition depends on number of learning trials. However, the rate of forgetting proved to be independent of initial acquisition. This pattern remains constant across modalities of presentation and of the number of learning trials. The conclusion is that forgetting does not depend on initial acquisition.

Associations between Physical Activity and Academic Competence: A Cross-Sectional Study among Slovenian Primary School Students

Physical activity has beneficial effects on overall academic performance in children. However, there is a lack of evidence regarding how the individual characteristics of physical activity interact with other confounding variables of academic competence. Leisure-time physical activity with potential confounders—such as developmental, behavioral, family, and school factors, predicting overall, mathematical, and reading academic competence—was studied in a random sample of 1520 Slovenian primary school students in grades 4–6 (51.9% female; mean age = 10.4 years; SD = 0.93). A structured self-reported questionnaire was used to gather data on the children’s leisure-time physical activity and social-demographic variables, while academic competence was measured by teachers using the SSRS Academic Competence Evaluation Scale. The findings showed that children engage in physical activity most days a week, with moderate-intensity and unorganized activities. It was predicted that engaging in physical activity would lead to an increase in academic performance by 4.2% in males (p = 0.002) and 3.2% in females (p = 0.024), but after fully adjusting the model for controlling confounding variables, the prediction increased to 81.1% in females and 84.1% in males (p < 0.001). The frequency and intensity of physical activity, the absence of digital games, and attending sports clubs seem to have the most beneficial effects in terms of academic competence in school children, among other relevant confounders mediating in this complex relationship.

COVID-19 and Air Pollution: A Spatial Analysis of Particulate Matter Concentration and Pandemic-Associated Mortality in the US

In 2019, a novel coronavirus, SARS-CoV-2, was first reported in Wuhan, China. The virus causes the disease commonly known as COVID-19, and, since its emergence, it has infected over 252 million individuals globally and taken the lives of over 5 million in the same time span. Primary research on SARS-CoV-2 and COVID-19 focused on understanding the biomolecular composition of the virus. This research has led to the development of multiple vaccines with great efficacy and antiviral treatments for the disease. The development of biomedical interventions has been crucial to combating this pandemic; additionally, environmental confounding variables that could have exacerbated the pandemic need further assessment. In this research study, we conducted a spatial analysis of particulate matter (PM) concentration and its association with COVID-19 mortality in the United States. Results of this study demonstrate a significant positive correlation between PM concentration levels and COVID-19 mortality; however, this does not necessarily imply a causal relationship. These results are consistent with similar studies in Italy and China, where significant COVID-19 cases and corresponding deaths were exhibited. Furthermore, maps of the data demonstrate clustering of COVID-19 mortality which suggest further investigation into the social determinants of health impacting the pandemic.