24-hour Concentrations Research Articles

Blood Glucose During High Altitude Trekking in Young Healthy Adults.

Reid, Ly-Anh, Jordan L Rees, Miranda Kimber, Marina James, Graeme M Purdy, Megan Smorschok, Lauren E Maier, Normand G. Boulé, Trevor A. Day, Margie H. Davenport, and Craig D. Steinback. Blood glucose during high altitude trekking in young healthy adults. High Alt Med Biol. 00:00-00, 2024. Introduction: High altitude trekking is becoming more popular and accessible to an increased number of people. Simultaneously, there is a worldwide rise in the prevalence of metabolic diseases. The purpose of this study was to examine the impact of a gradual trekking ascent to high altitude on continuous glucose monitoring outcomes including fasting, mean 24-hour, postprandial, and post-75 g modified oral glucose tolerance test. This study also investigated the relationship between physical activity intensity, high altitude, and glucose concentrations. Methods: Individuals (n = 9) from Alberta, Canada participated in a 2-week trek in the Khumbu Valley in Nepal, ascending by foot from 2,860 m to 5,300 m (∼65 km) over 10 days. A standardized 75 g oral glucose load was given to participants at four different altitudes (1,130 m, 3,440 m, 3,820 m, 5,160 m). Physical activity (Actigraph accelerometry) and interstitial glucose (iPro2, Medtronic) were measured continuously during the trek. Results: Fasting and mean 24-hour glucose concentrations were not different between altitudes. However, 2-hour post dinner glucose and 2-hour post lunch glucose, AUC concentrations were different between altitudes. The relationship between physical activity intensity and glucose was not influenced by increasing altitudes. Conclusion: Our findings suggest that glucose regulation is largely preserved at high altitude; however, inconsistency in our postprandial glucose concentrations at altitude warrants further investigation.

Assessment of ambient air quality of Lucknow city post monsoon 2023

This study monitoring and assessment of air pollutants, including lead and nickel trace metals, gases such as sulphur dioxide (SO2) and nitrogen dioxide (NO2), and respirable suspended particulate matter (PM10) and fine particulate matter (PM2.5), were done at nine locations that were divided into three categories: residential, commercial, and industrial of the ambient air quality in the city of the post-monsoon. With an average of 148.9 µg m-3, the 24-hour concentrations of PM10 ranged from 58.5 to 337.8 µg m-3, whereas the 24-hour concentrations of PM2.5 ranged from 32.5 to 118.4 µg m-3, with an average of 70.5 µg m-3. At every location, the mean concentrations of PM10 exceeded the allowable threshold of 100 µg m-3. While PM2.5 levels, with the exception of Aliganj, Vikas Nagar, and Chowk, exceeded the 60µg m-3 national limit. Pb and Ni, which are PM10 trace elements, range from 0.0028 to 0.0370 µg m-3, with an average of 0.0147 µg m-3 for Pb and 1.30 to 11.75 µg m-3, with an average of 6.62 µg m-3 for Ni. During a 24-hour period, the levels of SO2 varied between 7.9 and 57.7 µg m-3, with an average of 20.8 µg m-3. Conversely, the levels of NO2 varied between 9.3 and 89.0 µg m-3, with an average of 37.8. Between µg m-3 the post-monsoon of 2022 and 2023, SO2 concentrations declined by 16.0% and NO2 values increased by 22.0%, respectively. On the other hand, average SO2 and NO2 levels were significantly lower than the 80µg m-3permitted limits set by the CPCB (NAAQS-2009).

An Assessment of the Contribution of Vehicular Traffic to Ambient Air Quality - A Case Study of Nairobi Expressway Corridor

Abstract In this study, the vehicular air pollution from the Nairobi Expressway corridor was estimated by simulation using AERMOD dispersion model. The Vehicle Kilometer Travelled (VKT), emission factors, and traffic data were used to estimate the pollutants from vehicular traffic.. The highest modelled 24-hour and annual concentrations of PM2.5 were 0.274 µg/m3 and 0.152 µg/m3, whereas the highest 24-hour and annual concentrations of PM10 were 0.405 µg/m3 and 0.225 µg/m3, respectively. The maximum 24-hour and annual concentrations of Total Volatile Organic Compounds (TVOCs) were 20.8 µg/m3 and 11.5 µg/m3, respectively, whereas the maximum 8-hour and annual concentrations of carbon monoxide (CO) were 319 µg/m3 and 177 µg/m3, respectively. The highest modeled 24-hour and annual concentrations of NO2 were 28.2 µg/m3 and 15.7 µg/m3, respectively. The 24-hour average measured TVOCs values showed that Nairobi expressway traffic contributed 3.5 percent to the measured TVOCs concentration value, but CO accounted for 55 percent of the measured value. According to the simulated PM2.5 and PM10 concentration values, Nairobi expressway traffic contributed 1.1 and 1.6 percent, respectively, to the 24-hour average measured concentration levels.

Fine particulate matter air pollution and health implications for Nairobi, Kenya

Background: Continuous ambient air quality monitoring in Kenya has been limited, resulting in a sparse data base on the health impacts of air pollution for the country. We have operated a centrally located monitor in Nairobi for measuring fine particulate matter (PM2.5), the pollutant that has demonstrated impact on health. Here, we describe the temporal levels and trends in PM2.5 data for Nairobi and evaluate associated health implications. Methods: We used a centrally located reference sensor, the beta attenuation monitor (BAM-1022), to measure hourly PM2.5 concentrations over a 3-year period (21 August 2019 to 20 August 2022). We used, at minimum, 75% of the daily hourly concentration to represent the 24-hour concentrations for a given calendar day. To estimate the deaths attributable to air pollution, we used the World Health Organization (WHO) AirQ+ tool with input as PM2.5 concentration data, local mortality statistics, and population sizes. Results: The daily (24-hour) mean (±SEM) PM2.5 concentration was 19. 2 ± 0.6 (µg/m3). Pollutant levels were lowest at 03:00 and, peaked at 20:00. Sundays had the lowest daily concentrations, which increased on Mondays and remained high through Saturdays. By season, the pollutant concentrations were lowest in April and highest in August. The mean annual concentration was 18.4 ± 7.1 (µg/m3), which was estimated to lead to between 400 and 1,400 premature deaths of the city’s population in 2021 hence contributing 5%–8% of the 17,432 adult deaths excluding accidents when referenced to WHO recommended 2021 air quality guideline for annual thresholds of 5 µg/m3. Conclusion: Fine particulate matter air pollution in Nairobi showed daily, day-of-week, and seasonal fluctuations consistent with the anthropogenic source mix, particularly from motor vehicles. The long-term population exposure to PM2.5 was 3.7 times higher than the WHO annual guideline of 5 µg/m3 and estimated to lead to a substantial burden of attributable deaths. An updated regulation targeting measures to reduce vehicular emissions is recommended.

Dietary sulfur amino acid restriction in humans with overweight and obesity: Evidence of an altered plasma and urine sulfurome, and a novel metabolic signature that correlates with loss of fat mass and adipose tissue gene expression

BackgroundIn animals, dietary sulfur amino acid restriction (SAAR) improves metabolic health, possibly mediated by altering sulfur amino acid metabolism and enhanced anti-obesogenic processes in adipose tissue. AimTo assess the effects of SAAR over time on the plasma and urine SAA-related metabolites (sulfurome) in humans with overweight and obesity, and explore whether such changes were associated with body weight, body fat and adipose tissue gene expression. MethodsFifty-nine subjects were randomly allocated to SAAR (∼2 g SAA, n = 31) or a control diet (∼5.6 g SAA, n = 28) consisting of plant-based whole-foods and supplemented with capsules to titrate contents of SAA. Sulfurome metabolites in plasma and urine at baseline, 4 and 8 weeks were measured using HPLC and LC-MS/MS. mRNA-sequencing of subcutaneous white adipose tissue (scWAT) was performed to assess changes in gene expression. Data were analyzed with mixed model regression. Principal component analyses (PCA) were performed on the sulfurome data to identify potential signatures characterizing the response to SAAR. ResultsSAAR led to marked decrease of the main urinary excretion product sulfate (p < 0.001) and plasma and/or 24-h urine concentrations of cystathionine, sulfite, thiosulfate, H2S, hypotaurine and taurine. PCA revealed a distinct metabolic signature related to decreased transsulfuration and H2S catabolism that predicted greater weight loss and android fat mass loss in SAAR vs. controls (all pinteraction < 0.05). This signature correlated positively with scWAT expression of genes in the tricarboxylic acid cycle, electron transport and β-oxidation (FDR = 0.02). ConclusionSAAR leads to distinct alterations of the plasma and urine sulfurome in humans, and predicted increased loss of weight and android fat mass, and adipose tissue lipolytic gene expression in scWAT. Our data suggest that SAA are linked to obesogenic processes and that SAAR may be useful for obesity and related disorders. Trial identifierhttps://clinicaltrials.gov/study/NCT04701346.

Effect of Probiotic on Copper Nanoparticle Accumulation in Dreissena polymorpha

Materials with dimensions between 0.1 and 100 nm are called nanoparticle (NP) materials. In recent years, the usage areas and quantities of NP materials have increased in parallel with the development of the industry. The need and usage areas of heavy metals such as Cu have also expanded in NP sizes. All these developments have led to problems on the ecosystem that are becoming more difficult to compensate. In this study, Zebra Mussel (Dreissena polymorpha) was chosen as a model to investigate the effect of probiotics on CuNP heavy metal accumulation. The model organism was exposed to three different concentrations of CuNP (5, 10, 50 mg/L) with probiotics and directly for 24 and 96 hours. CuNP accumulation amounts in D. polymorpha tissues treated directly and with probiotics were compared. The amount of accumulation in the test organism directly exposed to CuNP was higher compared to the groups administered with probiotics, but a statistically significant difference (p&amp;lt;0.05) was found only in the treatment group with the highest 24-hour concentration (50 mg/L). As a result, according to the findings obtained from the study, it has been determined that probiotics have positive developmental effects on aquatic organisms, as well as beneficial in the elimination of their accumulation in the organism.

Factors influencing delayed high-dose methotrexate excretion and its correlation with adverse reactions after treatment in children with malignant hematological tumors.

High-dose methotrexate (HDMTX) is crucial in treating pediatric malignant hematological tumors. However, its use is often complicated by delayed excretion and associated adverse reactions, which can significantly affect treatment outcomes and patient safety. Identifying risk factors is essential for safer, more effective therapy. This study aimed to investigate the influencing factors for delayed excretion and their correlation with adverse reactions in children with malignant hematological tumors after receiving HDMTX chemotherapy. From April to October 2021, the clinical information of children who had undergone HDMTX chemotherapy and had their blood tested for drug concentration was gathered by the Department of Hematology and Oncology at Shanghai Children's Medical Center. Via univariate and multivariate logistic regression, the factors affecting the delayed excretion of HDMTX were examined, and the relationship between delayed excretion and unfavorable effects in children was determined. This study included 99 patients comprising 199 courses of HDMTX. The occurrence rate of HDMTX delayed excretion was 20.1%. Age ≥9 years and a 24-hour methotrexate (MTX) concentration of 64 µmol/L were independent risk factors for delayed MTX excretion according to multivariate logistic regression analysis (P<0.05). Negative side effects, such as fever, infection, mucositis, gastrointestinal response, and decreased platelet count in children with delayed excretion were statistically significant when compared to those of children with normal excretion. White blood cell reduction, hemoglobin levels below 65 g/L, MTX excretion delay, and concomitant etoposide treatment were all independent risk factors for infection in children. To estimate the risk of delayed MTX excretion during HDMTX therapy, patient laboratory data should be scrutinized, especially for patients ≥9 years or those with a 24-hour MTX concentration of greater than 64 µmol/L.

Synergistic observation of FY-4A&4B to estimate CO concentration in China: combining interpretable machine learning to reveal the influencing mechanisms of CO variations

Accurately estimating the concentration of carbon monoxide (CO) with high spatiotemporal resolution is crucial for assessing its meteorological-environmental-health impacts. Although machine learning models have high predictive ability in environmental research, there are relatively few explanations for model outputs. Utilizing the top-of-atmosphere radiation data of China’s new generation geostationary satellites (FY-4A and FY-4B) and interpretable machine learning models, the 24-hour near-surface CO concentrations in China was conducted (resolution: 1 hour, 0.04°). The model improved by 6.6% when using the all-sky dataset (cloud-contained model, R2 = 0.759) compared to the clear-sky dataset (cloud-removed model). The interpretability analysis of the CO estimation model used two methods, namely ante-hoc (model feature importance) and post-hoc (SHapley Additive exPlanations). The importance of daytime meteorological factors increased by 51% compared to nighttime. Combining partial dependency plots, the impact of key meteorological factors on CO was elucidated to gain a deeper understanding of the spatiotemporal variations of CO.

A Pilot Study for the Kidney Effects of Voxelotor in Sickle Cell Anemia

The kidneys are among the most commonly affected organ systems in sickle cell anemia (SCA) and an estimated 15% of deaths in patients with SCA are attributed to kidney failure (PMID 7993409). Angiotensin converting enzyme-inhibitors and angiotensin receptor blockers have been adopted to treat SCA-related chronic kidney disease (CKD) from the non-SCA literature, although demonstrated efficacy in SCA CKD has been marginal in a limited number of small, short-term studies (PMID 28589652). Therapies that directly target the pathophysiology of SCA-related kidney disease may stabilize or improve kidney function. Both the rate of hemolysis and the degree of anemia are associated with the development and progression of CKD in SCA (PMID 24329963, 21523807). Voxelotor inhibits hemoglobin polymerization in SCA red blood cells in the deoxygenated state, leading to a reduction in the rate of hemolysis and an increase in hemoglobin concentration. We conducted a pilot study to determine whether voxelotor can improve kidney function in adults with SCA (NCT 04335721). SCA (HbSS or HbSβ 0-thalassemia) patients ≥ 18 years old and with urine dipstick-defined hemoglobinuria (+ for blood &amp; ≤ 2 red blood cells/high power field), CKD stage 1 or 2 (urine albumin-to-creatinine ratio [ACR] ≥ 30 mg/g &amp; estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73m 2), and hemoglobin concentrations of 5.5 - 10.5 g/dL were eligible. The eGFR was calculated using the CKD-EPI 2009 creatinine-based equation without the race coefficient and the 2012 cystatin C-based equation. Patients were randomized to voxelotor 1,500mg/day for 48 weeks or standard of care, as defined by their primary SCA provider. First or second void urines were collected for urine ACR measurements. The primary endpoint was the change in urine ACR from the mean values at baseline and screening versus the mean values at 47 and 48 week visits. One patient randomized to standard of care was started on voxelotor at week 24 by his provider to improve his hemoglobin concentration. This patient is included in the voxelotor treatment group in combined analysis; the change in laboratory measures in this patient is based upon changes from the mean of values at week 12 and 24 to week 47 and 48 visits. Median and range values are provided. Between 3/2021 and 6/2022, 8 SCA patients with hemoglobinuria and urine ACR &amp;gt; 30mg/g crt observed during routine clinic visits were screened and 6 met the inclusion criteria. The median age of the enrolled cohort was 36 (27 - 63) years, 4 were male, 4 were on stable doses of hydroxyurea (median dose 1000mg/day; 500 - 1500mg/day) and 2 were on stable doses of lisinopril (5, 20mg/day) for at least 90 days before screening. Two other patients had been on lisinopril in the past but developed hyperkalemia prior to enrollment. The median values of kidney function measures at screening and baseline study visits were as follows: urine ACR, 251 (32 - 3132) and 392 (80 - 3101) mg/g crt; creatinine-based eGFR, 109 (93 - 136) and 115 (88 - 137) mL/min/1.73m 2; and cystatin C-based eGFR, 82 (61 - 141) and 85 (61 - 128) mL/min/1.73m 2, respectively. SCA patients who received voxelotor (n = 4) had a median increase in hemoglobin concentration of +0.9 g/dL (-0.4 - +2.6 g/dL) and reductions in indirect bilirubin concentration of -2.2 mg/dL (0 - -4 mg/dL) and reticulocyte % of -2.7% (-1.2 - -4.9%). Urine ACR (-59%, -21% - -100%) improved in SCA patients treated with voxelotor but worsened in those who received standard of care without voxelotor (n = 2) (+86.3%, 64 - 108%) (P=0.009) (Figure 1A). 24-hour urine protein concentrations also improved in those that received voxelotor (-45%, -25% - -100%) but increased in those who did not receive voxelotor (+122%, 113 - 131%) (P = 0.002) (Figure 1B). Changes in creatinine- and cystatin-C based eGFR from baseline were not significantly different between patients who received voxelotor and those who did not. This pilot study demonstrates that SCA patients with hemoglobinuria and early stages of CKD treated with voxelotor may have significant improvements in urine ACR and proteinuria after 24 - 48 weeks of therapy. These preliminary results support the concept that improving hemolytic anemia could be a targeted therapeutic approach to reduce biomarkers of kidney dysfunction, and they warrant larger, prospective clinical studies.

PM2.5 Air Quality Monitoring during COVID-19 Restrictions in Portugal: Key Findings

Abstract Background Particulate matter with or less 2.5 diameters (PM2.5) has deleterious health effects on humans. In 2020, exposure to levels of PM2.5 above World Health Organization Air Quality Guidelines (WHO AQG) caused 238,000 and 2,600 premature deaths in the European Union and Portugal, respectively. During the lockdowns and restrictions periods due to the COVID-19 pandemic, air quality was improved. The aim of this study was to assess the variation of PM2.5 concentrations in Portugal during the years 2020 and 2021, considering COVID-19 restrictions. Methods The daily average (24-hour) concentrations of PM2.5 were calculated based on the hourly values registered at the monitoring stations (Online Database on Air Quality of the Portuguese Environment Agency). Friedman tests were used for paired samples to assess differences between levels of PM2.5 in the months of total lockdown, partial restriction due to the COVID-19 pandemic and months without restrictions, considering a level of significance of 5%. Results The levels of PM2.5 had heterogeneous variation over the months of the two years. The higher levels of PM2.5 in 2020 and 2021 were 21 and 34 µg/m3 in March and February, respectively. Although 2020 did not exceed the EU Air Quality Directive 2008/50 (25 µg/m3), the levels of PM2.5 exceeded the current WHO Guideline (5 µg/m3) during the whole year. Levels of PM2.5 were statistically significant different between the months of lockdown, partial restrictions and without restrictions in the both years (p &amp;lt; 0,001). Conclusions Despite the evidence showing that the lockdown and restrictions due to COVID-19 minimized emissions from anthropogenic activities mainly related with mobility, Portugal still exceeded the WHO AQG highlighting the need for further measures to improve air quality accordingly with the international standards. Acknowledgments This work is funded by FCT/MCTES through national funds to PMCardImpact (EXPL/SAU-PUB/0944/2021). Key messages • Additional environmental policies are required to improve air quality in Portugal. • Air monitoring is the first step to estimate the health impact of air pollution.

Glycemic variability and hypoglycemia before and after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy – A cohort study of females without diabetes

BackgroundRoux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) lead to lower fasting glucose concentrations, but might cause higher glycemic variability (GV) and increased risk of hypoglycemia. However, it has been sparsely studied in patients without preoperative diabetes under normal living conditions. ObjectivesTo study 24-hour interstitial glucose (IG) concentrations, GV, the occurrence of hypoglycemia and dietary intake before and after laparoscopic RYGB and SG in females without diabetes. SettingOutpatient bariatric units at a community and a university hospital. MethodsContinuous glucose monitoring and open-ended food recording over 4 days in 4 study periods: at baseline, during the preoperative low-energy diet (LED) regimen, and at 6 and 12 months postoperatively. ResultsOf 47 patients included at baseline, 83%, 81%, and 79% completed the remaining 3 study periods. The mean 24-hour IG concentration was similar during the preoperative LED regimen and after surgery and significantly lower compared to baseline in both surgical groups. GV was significantly increased 6 and 12 months after surgery compared to baseline. The self-reported carbohydrate intake was positively associated with GV after surgery. IG concentrations below 3.9 mmol/L were observed in 14/25 (56%) of RYGB- and 9/12 (75%) of SG-treated patients 12 months after surgery. About 70% of patients with low IG concentrations also reported hypoglycemic symptoms. ConclusionsThe lower IG concentration in combination with the higher GV after surgery, might create a lower margin to hypoglycemia. This could help explain the increased occurrence of hypoglycemic episodes after RYGB and SG.

24-Hour postnatal total serum protein concentration affects the health and growth performance of female Holstein dairy calves.

Total serum protein (TSP) within the first few days of life in the neonatal calf has predictive value for subsequent growth and production in calves before and after weaning. The objective of this study was to evaluate the effect of TSP concentration 24-h after birth (24-h) on the performance and health of Holstein dairy calves. A total of 152 female calves were enrolled in this study. Blood samples were collected at 24-h, and TSP concentration was measured with a refractometer. Calves based on TSP concentration at 24-h were allocated into three groups: 1 - TSP ≤6.5g/dL, 2 - TSP between 6.6 and 6.9g/dL and 3 - TSP ≥7g/dL. The weighing was done at birth and at days 30 and 60. Starter feed intake was recorded from day 3 to weaning, and body structures were measured at birth and weaning day. Calves with TSP >6.5g/dL had greater body weight at days 30 and 60 than calves with TSP ≤6.5g/dL. Average daily gain during 1-30 and 1-60 days of life increased as TSP increased. Furthermore, starter feed intake during the first 60 days of life was greater in calves with TSP ≥7g/dL than calves with TSP <7g/dL. The TSP concentration influenced structural growth, and >6.5g/dL calves had greater heart girth, hip width and body length than ≤6.5g/dL calves. Moreover, odds ratio for pneumonia decreased as TSP increased, whereas diarrhoea was unaffected. The TSP at 24-h is an important contributing factor for the variation in growth performance and health of preweaning calves, and strategies to improve calf immunity and increase TSP lead to better animal health during preweaning period. These results indicated that TSP ≥6.5g/dL possibly was associated with greater performance, and this concentration could be considered a baseline for future analyses.

The effects of renal dopaminergic system on the development of hypertension with high salt diet and L-NNA administration

Objective: We aimed to investigate the intrarenal dopamine synthesis efficiency, blood pressure changes and the effects of this system on hypertension developed by NOS inhibition and high salt diet. Method: Wistar Albino male rats were administered water containing 50mg/L or 100mg/L concentrations of L-NNA, standard rat feed containing 0.8%salt, or 4%high salt alone or with L-NNA for 7days. Blood pressure measurements were made with the tail-cuff method. 24-hour water intake and urine volume were also measured. Results: Administration of L-NNA or high-salt diet alone for 7days did not cause a change in blood pressure, while their combined administration resulted in a significant increase in blood pressure. Blood pressures were found to be higher in the L-NNA100+HS group compared to the other groups. While the amount of water intake in 24hours did not change, the amount of 24-hour urine was reduced. 24-hour urinary sodium excretion, sodium clearance and GFR was decreased, and 24-hour urine dopamine concentrations were increased. Conclusion: Co-administration of nitric-oxide inhibitor and high-salt diet failed to prevent renal dopaminergic system blood pressure increase. Despite the increase in dopamine synthesis, intrarenal dopamine activity could not be realized by receptor interaction and it is thought that the increase in blood pressure is caused by the development of renal oxidative stress.

Validation of 24-hour trough concentration as a proxy for intensive pharmacokinetic measurements for a combined oral contraceptive pill containing desogestrel

ObjectivesTo confirm that 24-hour steady-state trough measurements (C24) are high-quality proxies for gold standard pharmacokinetic measurements (area under the curve [AUC]) of a combined oral contraceptive pill (COCP). Study designWe conducted a 12-sample, 24-hour pharmacokinetic study in healthy reproductive-age females taking a COCP containing 0.15-mg desogestrel (DSG) and 30-μg ethinyl estradiol (EE). As DSG is a pro-drug for etonogestrel (ENG), we calculated correlations between steady-state C24 and 24-hour AUC values for both ENG and EE. ResultsAmong 19 participants at steady state, C24 measurements were highly correlated with AUC for both ENG (r = 0.93; 95% CI 0.83–0.98) and EE (r = 0.87; 95% CI 0.68–0.95). ConclusionsSteady-state 24-hour trough concentrations are high-quality proxies for gold standard pharmacokinetics of a DSG-containing COCP. ImplicationsUse of single-time trough concentration measurements at steady state provides excellent surrogate results for gold standard AUC values for both DSG and EE among COCP users. These findings support that large studies exploring interindividual variability in COCP pharmacokinetics can avoid the time- and resource-intensive costs associated with measuring AUC. Clinical trial registrationClinicaltrials.gov, NCT05002738.

Normal 24-hour urine calcium concentrations after long-term daily oral intake of vitamin D in doses ranging from 5000 to 50,000 international units in 14 adult hospitalized psychiatric patients

Many controversies exist regarding vitamin D3 supplementation. These include not only diseases that are responsive to vitamin D supplementation, but also the long-term safety of prolonged daily oral vitamin D3 intake above 4000–10,000 International Units (IU). In particular, supplementation levels that do not result in adverse events, and the upper limits of safe serum 25-hydroxyvitamin D (25OHD) concentrations. Adverse reactions reported to occur with excessive vitamin D intake include hypercalcemia, renal failure, calcium crystal formation, undetectable parathyroid hormone concentrations, and hypercalciuria, all of which are reported to be reversible. To address the long-term safety of vitamin D supplementation, we previously reported data from patients in our hospital who have been voluntarily supplemented with vitamin D3 ranging from 5,000 to 10,000 IU/day since July 2011 as a standard of care for the prevention and treatment of vitamin D deficiency. Historically 90% of patients have agreed to daily supplementation, with most taking 10,000 IU/day. These data indicate no evidence for hypercalcemia, renal failure, calcium crystal formation, nephrolithiasis. or undetectable parathyroid hormone concentrations in patients taking 5000 or 10,000 IU/day for extended periods of time. As another measure for potential vitamin D toxicity, we retrospectively assessed 24-hour urine calcium excretion in 14 individuals on long-term daily oral vitamin D intake ranging from 5000 to 50,000 IU/day to further assess the safety of supplementation using these doses. This included patients taking either 5000 (4), 10,000 (9), or 50,000 (1) IU/day. Time on supplementation ranged from 10 to 102 months. A patient taking 400 IU/day and getting frequent sun exposure was also included. All fifteen 24-hour urine calcium measurements were normal. The current findings complement our experience with over 7000 patients in the past 13 years, indicating that prolonged daily oral intake of vitamin D3 ranging from 5000 to 10,000 IU/day is safe.

High levels of indoor fine particulate matter during the cold season in Almaty prompt urgent public health action.

Almaty is the largest city of Kazakhstan with extreme air pollution, mostly in the cold season, but little is known whether staying indoors could lessen the exposure. The aim was to quantitatively characterize indoor fine PM levels and to verify the contribution of ambient pollution to it in a polluted city like Almaty. We collected forty-six 24-hour 15-min average samples of the ambient air and a similar number of paired indoor samples (total 92 samples). Predictors of both ambient and indoor PM2.5 mass concentrations in mg/m3, including ambient concentration, precipitation, minimal daily temperature and humidity, along with the indoor/outdoor (I/O) ratio were tested in the adjusted regression models at eight 15-min lags. Ambient air PM2.5 15-min average mass concentrations were highly variable and ranged from 0.001 to 0.694 mg/m3 (geometric mean (GM) 0.090, geometric standard deviation (GSD) 2.285). Snowing was the strongest predictor of lower ambient PM2.5 24-hour mass concentrations (median 0.053 vs 0.135 mg/m3 (p<0.001)). Indoor mean 15-min PM2.5 concentrations ranged from 0.002 to 0.228 mg/m3 (GM 0.034, GSD 2.254). In adjusted models, outdoor PM2.5 concentration explained 0.58 of all variability of the indoor concentration with a 75-min delay (R2 0.67 at lag8 on snowing days). Median I/O ranged from 0.386 (IQR 0.264 to 0.532) at lag0 to 0.442 (IQR 0.339 to 0.584) at lag8. During the cold season when fossil fuel is burnt for heating, the population in Almaty is exposed to very high fine PM levels even indoors. Urgent public health action is needed.

Handgrip Strength Is Positively Associated with 24-hour Urine Creatine Concentration

Muscle mass evaluation methods are often expensive and therefore limited in their daily use in clinical practice. In this study, we investigated the relationship between hand grip strength (HGS) and other parameters of body measurements with urine creatinine, especially to investigate whether HGS measurement is an indicator of muscle metabolism. In total, 310 relatively healthy people (mean age 47.8 + 9.6; 161 people or 51.9% of the total population were men) who were undergoing preventive examinations were included in this study and given a container to collect 24-h urine, and the amount of creatinine in the urine was determined by a kinetic test without deproteinization according to the Jaffe method. A digital dynamometer (Takei Hand Grip Dynamometer, Japan) was used in the measurement of HGS. There was a significant difference in 24-h urine creatinine (24 hCER) between the sexes, with a mean of 1382.9 mg/24 h in men and 960.3 mg/24 h in women. According to the correlation analysis, the amount of urine creatinine was related to age (r = -0.307, p < 0.001 in men, r = -0.309, p < 0.001 in women), and HGS (r = 0.207, p = 0.011 in men, r = 0.273, p = 0.002 in women) was significant for either sex. However, other parameters of body measurements, such as girth, forearm circumference, and muscle mass measured by bioelectrical impedance, were not related to urine 24 hCER. A correlation between HGS and 24 hCER was observed in age groups. We found that HGS is a potential marker in muscle metabolism assessment that is proven through 24 hCER. In addition, therefore, we suggest using the HGS measure in clinical practice to evaluate muscle function and well-being.

Factors affecting indoor environmental air quality of non-smoking residences in Perth, Western Australia

This study investigated associations between a range of indoor air pollutants with household characteristics in 111 non-smoking residences located in Perth, Western Australia. Overall, the mean 24-hour indoor concentrations for PM10 and PM2.5 were below and above the World Health Organisation (WHO) (ambient) guideline values (GV) of 45 µg/m3 and 15 µg/m3, respectively. Concentrations of measured gases were low, other than nitrogen dioxide (NO2) which recorded a mean 24-hour concentration above the WHO GV (0.013ppm). Higher concentrations of total volatile organic compounds (TVOC) and carbon dioxide (CO2) were observed as the number of household occupants increased. The type of heating and/or cooling appliances used was associated with higher concentrations of TVOC, CO2, carbon monoxide (CO), NO2 and all size fractions of particulate matter (PM). Households that were opened daily for fresh air recorded higher concentrations of all PM size fractions and NO2 when compared to those that were infrequently aired. These findings contribute to a better understanding of household characteristics that influence indoor air quality (IAQ) in homes where cigarette smoke, a significant contributor to residential air pollution, has been eliminated. These results are useful for modifying some behavioural choices by home occupants and can also inform meaningful risk mitigation strategies aimed at improving IAQ in residential settings.

Comparison of a digital iodine-specific dietary screener with 24-hour recall and urinary iodine concentration.

Mild-to-moderate iodine deficiency remains a problem worldwide, including in Norway. Of particular, concern is fertile, pregnant and lactating women. The Norwegian Dairy Council developed a digital iodine-specific dietary screener (I-screener) for the assessment of iodine intake levels but has yet to be validated. The aim was thus to investigate the relative validity of the I-screener by comparing estimates of iodine intake from the I-screener against a single 24-hour recall (24HR) and urinary iodine concentration (UIC) in fertile women. Healthy females were recruited in Bergen in August-December 2021. Six spot-urine samples from six consecutive days were collected into a pooled sample to assess UIC. Each participant completed a single administration of the I-screener and the 24HR. The estimated daily iodine intake from the I-screener was compared with the estimations from the 24HR and UIC. Seventy-two women aged 19-39 completed the study. The median UIC was 76 μg/l. Compared with the 24HR, the I-screener placed 83 % of the participants in the same/adjacent tertial, with a slight agreement between the methods (Cohen's kappa = 0⋅187). The present study shows an acceptable correlation between the I-screener and the 24HR (r = 0⋅318), but not between the I-screener and UIC (r = 0⋅122). Despite its varying iodine estimate abilities, the I-screener may be used as an initial screening tool to rank fertile women on an individual level into deficient inadequate, and sufficient iodine intake. However, due to the relatively high risk of misclassification, further assessment of iodine status should follow.

Correlation between the size of pheochromocytoma and the level of metanephrines.

Objective. Pheochromocytomas (PHEO) and paraganglioma (PGLs) are rare neuroendocrine catecholamine-producing tumors that arise from the chromaffin cells of either the adrenal medulla or extra-adrenal paraganglionic tissues. Despite the recent advances in imaging technologies, biochemical evidence of excessive catecholamine production by the tumor is considered the most important test for the diagnosis of these tumors. The aim of the present study is to investigate the role of the catecholamine metabolites (normetanephrine and metanephrine) levels in the diagnosis of PHEO/PGLs and to evaluate if their levels correlate with the size of these tumors. Patients and Methods. Twenty-five patients were included in the study during the time period of 10 years. Their data were compared with another set of 25 patients to obtain the sensitivity and specificity of metanephrine and normetanephrine in the diagnosis of PHEO/PGLs. The tumor size was reviewed in every patient to obtain the correlation coefficient between the tumor sizes and the plasma/24-hour urinary metanephrine levels. Results. The sensitivity and specificity rates for plasma metanephrine were 80-92% and 92-96%, respectively; while for 24-hour urinary metanephrine were 80-90% and 95-100%, respectively. We found a strong positive relationship between the tumor size and the plasma levels of normetanephrine (r=0.518, p<0.01), and metanephrine (r=0.577, p<0.01). While the relation with the 24-hour urinary concentrations of normetanephrine (r=0.384, p=0.01) and 24-h urinary meta-nephrine (r=0.138, p<0.01) was low. Conclusion. The determination of plasma and 24-hour urinary levels of metanephrines is a reliable test for the diagnosis of PHEO, as they are continuously produced by the tumor cells in contrast to catecholamines.