Category: Nevin Manimala

J Patient Rep Outcomes. 2024 Jul 8;8(1):67. doi: 10.1186/s41687-024-00753-5.

ABSTRACT

BACKGROUND: Patient reported outcomes (PROs) are being used frequently in clinical practice. PROs often serve several purposes, such as increasing patient involvement, assessing health status, and monitoring and improving the quality-of-care at an aggregated level. However, the lack of representative PRO-data may have implications for all these purposes. This study aims to assess the association of non-administration of (not sending an electronic invite to PRO) and non-response to (not responding to PRO) electronically administered PROs with social inequality in a primary healthcare cancer rehabilitation setting. Furthermore, it examines whether the workflows surrounding PRO have an impact on non-administration and non-response.

METHODS: This is a cross sectional study using routinely collected data from electronic health records and registers including cancer survivors (CSs) over 18 years booked for an initial consultation in a primary healthcare cancer rehabilitation setting using PROs for systematic health status assessment. During the study period two different PRO platforms were used, each associated with different workflows. Non-administration and non-response rates were calculated for sociodemographic characteristics for each PRO platform. Crude and adjusted odds ratios were calculated using univariate and multivariate logistic regression.

RESULTS: In total, 1868 (platform 1) and 1446 (platform 2) CSCSs were booked for an initial consultation. Of these, 233 (12.5%) (platform 1) and 283 (19.6%) (platform 2) were not sent a PRO (non-administration). Among those who received a PRO, 157 (9.6%) on platform 1 and 140 (12.0%) on platform 2 did not respond (non-response). Non-administration of and non-response to PROs were significantly associated with lower socioeconomic status. Moreover, the workflows surrounding PROs seem to have an impact on non-inclusion in and non-response to PROs.

CONCLUSIONS: Non-administration of and non-response to PROs in clinical practice is associated with determinants of social inequality. Clinical workflows and the PRO platforms used may potentially worsen this inequality. It is important to consider these implications when using PROs at both the individual and aggregated levels. A key aspect of implementing PROs in clinical practice is the ongoing focus on representativeness, including a focus on monitoring PRO administration and response.

PMID:38976222 | DOI:10.1186/s41687-024-00753-5

Purinergic Signal. 2024 Jul 8. doi: 10.1007/s11302-024-10035-w. Online ahead of print.

ABSTRACT

Medulloblastoma is the most common malignant tumor in the pediatric population. Its classification has incorporated key molecular variations alongside histological characterization. CD39 (also known as ENTPD1) and CD73 (also known as NT5E), enzymes of the purinergic signaling pathway, act in synergy to generate extracellular adenosine, creating an immunosuppressive tumor microenvironment. Our study examined the expression of mRNA of these genes in previously described transcriptome data sets of medulloblastoma patient samples from the Cavalli Cohort (n = 763). Survival distribution was estimated according to the Kaplan-Meier method using a median cut-off and log-rank statistics (p ≤ 0.05). In non-WNT and non-SHH medulloblastoma Group 4 (n = 264), the high expression of ENTPD1 and NT5E was significantly related to a lower overall survival (p = 2.7e-04; p = 2.6e-03). In the SHH-activated group (n = 172), the high expression of ENTPD1 was significantly related to lower overall survival (p = 7.8e-03), while the high expression of NT5E was significantly related to greater overall survival (p = 0.017). In the WNT group (n = 63), the expressions of ENTPD1 and NT5E were not significantly correlated with overall survival (p = 0.212; p = 0.101). In non-WNT and non-SHH medulloblastoma Group 3 (n = 113), the high expression of ENTPD1 was significantly related to greater survival (p = 0.034), while expression of NT5E was not significantly related to survival of patients (p = 0.124). This in silico analysis indicates that ENTPD1 (CD39) and NT5E (CD73) can be seen as potential prognostic markers and therapeutic targets for primary medulloblastomas in non-WNT and non-SHH Group 4.

PMID:38976175 | DOI:10.1007/s11302-024-10035-w

Environ Monit Assess. 2024 Jul 8;196(8):713. doi: 10.1007/s10661-024-12871-0.

ABSTRACT

South Africa faces the urgency to comprehensively understand and manage its methane (CH₄) emissions. The primary aim of this study is to compare CH₄ concentrations between Eastern Cape and Mpumalanga regions dominated by cattle farming and coal mining industries, respectively. CH₄ concentration trends were analyzed for the period 2019 to 2023 using satellite data. Trend analysis revealed significant increasing trends in CH₄ concentrations in both provinces, supported by Mann-Kendall tests that rejected the null hypothesis of no trend (Eastern Cape: p-value = 8.9018e^-08 and Mpumalanga: p-value = 2.4650e^-10). The Eastern Cape, a leading cattle farming province, exhibited cyclical patterns and increasing CH₄ concentrations, while Mpumalanga, a major coal mining province, displayed similar increasing trends with sharper concentration points. The results show seasonal variations in CH₄ concentrations in the Eastern Cape and Mpumalanga provinces. High CH₄ concentrations are observed in the northwestern region during the December-January-February (DJF) season, while lower concentrations are observed in the March-April-May (MAM) and June-July-August (JJA) seasons in the Eastern Cape province. In the Mpumalanga province, there is a dominance of high CH₄ concentrations in southwestern regions and moderately low concentrations in the northeastern regions, observed consistently across all seasons. The study also showed an increasing CH₄ concentration trend from 2019 to 2023 for both provinces. The study highlights the urgent need to address CH₄ emissions from both cattle farming and coal mining activities to mitigate environmental impacts and promote sustainable development. Utilizing geographic information system (GIS) and remote sensing technologies, policymakers and stakeholders can identify and address the sources of CH₄ emissions more effectively, thereby contributing to environmental conservation and sustainable resource management.

PMID:38976163 | DOI:10.1007/s10661-024-12871-0

Bull Math Biol. 2024 Jul 8;86(8):102. doi: 10.1007/s11538-024-01328-7.

ABSTRACT

This study presents a comprehensive analysis of a two-patch, two-life stage SI model without recovery from infection, focusing on the dynamics of disease spread and host population viability in natural populations. The model, inspired by real-world ecological crises like the decline of amphibian populations due to chytridiomycosis and sea star populations due to Sea Star Wasting Disease, aims to understand the conditions under which a sink host population can present ecological rescue from a healthier, source population. Mathematical and numerical analyses reveal the critical roles of the basic reproductive numbers of the source and sink populations, the maturation rate, and the dispersal rate of juveniles in determining population outcomes. The study identifies basic reproduction numbers R 0 for each of the patches, and conditions for the basic reproduction numbers to produce a receiving patch under which its population. These findings provide insights into managing natural populations affected by disease, with implications for conservation strategies, such as the importance of maintaining reproductively viable refuge populations and considering the effects of dispersal and maturation rates on population recovery. The research underscores the complexity of host-pathogen dynamics in spatially structured environments and highlights the need for multi-faceted approaches to biodiversity conservation in the face of emerging diseases.

PMID:38976154 | DOI:10.1007/s11538-024-01328-7

Hernia. 2024 Jul 8. doi: 10.1007/s10029-024-03102-z. Online ahead of print.

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, elective surgeries including hernia repairs, were postponed, or cancelled completely. However, it has been stated previously that the volume of surgical emergency hernia repairs did not drop during this period. Due to the disruption in elective surgeries, waiting lists have increased rapidly, causing a suspected treatment delay. To gain improved insight in preoperative patient prioritization, the aim of this multicenter study was to track volumes of hernia surgery before, during and after the pandemic to investigate for a shift from elective towards emergency hernia surgery.

METHODS: A retrospective study using hernia databases from four regional hospitals to account for altered referral patterns (elective versus emergent), capturing patients’ admissions and surgery times for both groin and ventral hernia repair was conducted. Study period was predefined from March 2019 to March 2023. Data are presented as descriptive statistics.

RESULTS: During the historic period, 106 of 2267 hernia surgeries (4.7%) performed were defined as emergency repairs. During the pandemic, 3864 elective surgeries were executed, of which 213(5.5%) emergencies. During the current period, the portion of emergencies dropped to 4.9% (110 emergency hernia repairs); (p = 0.039). A non-significant increase in emergent incisional hernia repair during the pandemic period was found chronologically 9.9%, 11.8% and 11.6% emergent repairs(p = 0.75). There were no statistically significant differences across the hernia types in elective versus urgent rate.

RESULTS: During the historic period, 106 of 2267 hernia surgeries (4.7%) performed were defined as emergency repairs. During the pandemic, 3864 elective surgeries were executed, of which 213(5.5%) emergencies. During the current period, the portion of emergencies dropped to 4.9% (110 emergency hernia repairs); (p = 0.039). A non-significant increase in emergent incisional hernia repair during the pandemic period was found chronologically 9.9%, 11.8% and 11.6% emergent repairs(p = 0.75). There were no statistically significant differences across the hernia types in elective versus urgent rate.

DISCUSSION: Regionwide data showed a 15% decline in hernia repairs during the pandemic compared to historical levels, with an 0.8% increase in emergent repairs. Surgery rates are still convalescent after the pandemic, with a persistent proportion of emergent surgeries. These numbers emphasize the challenges in selecting patient whose hernia repair should not be postponed.

PMID:38976135 | DOI:10.1007/s10029-024-03102-z

Adv Ther. 2024 Jul 8. doi: 10.1007/s12325-024-02882-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Follicular lymphoma (FL) is an indolent subtype of non-Hodgkin’s lymphoma (NHL), characterized by a long natural course of remissions/relapses. We aimed to evaluate real-world quality of life (QoL) in patients with FL, by line of therapy (LOT), and across countries.

METHODS: Data were drawn from the Adelphi FL Disease Specific Programme™, a cross-sectional survey of physicians and their patients in Europe [France, Germany, Italy, Spain, the United Kingdom (UK)], and the United States (US) from June 2021 to January 2022. Patients provided demographics and patient-reported outcomes via the European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). Bivariate analysis assessed QoL versus NHL, across LOT [first line (1L), second line (2L), third line or later (3L+)] and country.

RESULTS: Patients (n = 401) had a mean [standard deviation (SD)] age of 66.0 (9.24) years, 58.1% were male, and 41.9%/22.9% were Ann Arbor stage III/IV. Patients with FL mean EORTC global health status (GHS)/QoL, nausea/vomiting, pain, dyspnea, appetite loss, and diarrhea scores were statistically significantly worse (p < 0.05) versus the NHL reference values. Mean (SD) GHS/QoL worsened from 1L [56.5 (22.21)] to 3L+ [50.4 (20.11)]. Physical and role functioning, fatigue, pain, dyspnea, and diarrhea scores also significantly worsened across later LOTs (p < 0.05). Across all functional domains, mean scores were significantly lower (p < 0.05) and almost all symptom scores (excluding diarrhea) were significantly higher (p < 0.05) for European versus US patients.

CONCLUSIONS: Patients with FL at later LOTs had significantly worse scores in most QoL aspects than earlier LOTs. European patients had significantly lower functioning and higher symptom burden than in the US. These real-world findings highlight the need for novel FL therapies that alleviate patient burden, positively impacting QoL.

PMID:38976122 | DOI:10.1007/s12325-024-02882-1

Int J Cancer. 2024 Jul 8. doi: 10.1002/ijc.35082. Online ahead of print.

ABSTRACT

The long-term incidence trends of 32 cancers in China remained unclear. Cancer statistics for young population were often presented in aggregate, masking important heterogeneity. We aimed to assess the incidence trends of 32 cancers in China from 1983 to 2032, stratified by sex and age groups. Data on cancer incidence from 1983 to 2017 were extracted from Cancer Incidence in Five Continents Volumes VI-XII. The age-period-cohort model was utilized to assess age and birth cohort effects on the temporal trends of 32 cancers in China, while the Bayesian age-period-cohort model was utilized to project future trends from 2018 to 2032. An increase in cohort effects is observed in some cancers such as thyroid and kidney cancers. Eight of the 12 obesity-related cancers may rise in the 0-14 age group, and nine in the 15-39 age group from 2013 to 2032. Liver and stomach cancers show an increasing trend among the younger population, contrasting with the observed declining trend in the middle-aged population. There has been a significant rise in the proportions of cervical cancer among females aged 40-64 (4.3%-19.1%), and prostate cancer among males aged 65+ (1.1%-11.8%) from 1983 to 2032. Cancer spectrum in China is shifting toward that in developed countries. Incidence rates of most cancers across different age groups may increase in recent cohorts. It is essential to insist effective preventive interventions, and promote healthier lifestyles, such as reducing obesity, especially among younger population.

PMID:38973577 | DOI:10.1002/ijc.35082

J Biopharm Stat. 2024 Jul 8:1-5. doi: 10.1080/10543406.2024.2373449. Online ahead of print.

NO ABSTRACT

PMID:38973566 | DOI:10.1080/10543406.2024.2373449

Rev Esp Quimioter. 2024 Jul 8:malet08jul2024. doi: 10.37201/req/038.2024. Online ahead of print.

ABSTRACT

OBJECTIVE: The Autonomous Community of Galicia has adopted DECREE 216/2011 on health standards for poultry production, in addition to the Spanish national programs. However, no program has yet been implemented to eradicate campylobacteriosis, which shares the same reservoir. The aim of this study was to compare the evolution of Salmonella spp. isolates with respect to those of Campylobacter spp. in faecal samples received by the Microbiology Department.

METHODS: A retrospective descriptive comparative study was conducted through the Laboratory Information System (SIL) of Salmonella spp. isolated against Campylobacter spp. in faeces between 2011 and 2022 at the Lucus Augusti University Hospital (HULA), Lugo, Spain.

RESULTS: A total of 35,704 stool samples were analysed, of which 3,045 were positive. 751 Salmonella spp. were isolated. Statistical differences were observed in the annual distribution (p<0.01), with a clear turning point in 2018. Five hundred and five patients required hospital care, especially in 2014 with 72 patients (69%). On the other hand, 1,587 Campylobacter spp. were isolated. Required hospital care 1,002 patients during the study, with a peak in 2019 with 111 cases (62%).

CONCLUSIONS: The reduction of salmonellosis cases and the maintenance of campylobacteriosis cases are directly related to the implementation of DECREE 216/2011. This, in turn, has reduced the pressure on hospitals in the HULA health area. Therefore, we believe that the ONE Health concept is being strengthened in the area studied.

PMID:38973561 | DOI:10.37201/req/038.2024

Eur J Gastroenterol Hepatol. 2024 Aug 1;36(8):993-999. doi: 10.1097/MEG.0000000000002795. Epub 2024 May 20.

ABSTRACT

OBJECTIVE: Inflammatory bowel diseases are chronic pathologies characterized by a complex interplay of genetic and environmental factors, as well as aberrant immune responses. This study aimed to investigate inflammation markers’ seasonality and association with disease exacerbation episodes in patients with Crohn’s disease and ulcerative colitis.

METHODS: 284 patients were classified based on clinical, endoscopic, and histopathological criteria. Systemic inflammation was evaluated using C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and chitotriosidase, while fecal calprotectin was measured to assess intestinal inflammation. Serum vitamin D levels and the seasonality of an activity score that combines several clinical and biological parameters were also evaluated.

RESULTS: The peak number of patients reporting endoscopic activity occurred in autumn for Crohn’s disease (82%) and spring for ulcerative colitis (95%). Regarding histological activity, spring saw the highest number of patients for both diseases (72% for Crohn’s disease; 87% for ulcerative colitis). Most of the inflammatory markers exhibited lower values during winter. Systemic inflammatory markers follow a slightly different trend than fecal calprotectin and differ in the two pathologies. The maximum values of intestinal inflammation were observed in autumn for Crohn’s disease (784 µg/g) and in spring for ulcerative colitis (1269 µg/g). Serum vitamin D concentrations were consistently low throughout the year. Statistical analysis revealed differences between the seasons for CRP and ESR (P < 0.05).

CONCLUSION: The evolution of flares and inflammatory markers in Crohn’s disease and ulcerative colitis displayed distinct seasonal patterns. Systemic inflammation did not consistently parallel intestinal inflammation.

PMID:38973542 | DOI:10.1097/MEG.0000000000002795