Category: Nevin Manimala

Sci Rep. 2024 Nov 15;14(1):28120. doi: 10.1038/s41598-024-79641-3.

ABSTRACT

Head and neck cancer (HNC) is the seventh most common cancer globally, with 20-60% of patients experiencing nutritional deficiencies. Recent studies indicate that microRNAs (miRNAs) may serve as molecular markers for malnutrition. This study evaluated miR-22-3p as a potential predictor of nutritional deficiencies and a prognostic factor in HNC patients undergoing intensity-modulated radiation therapy (IMRT). From 2014 to 2017, fifty-six advanced HNC patients at the Medical University of Lublin received IMRT, with miR-22-3p levels measured from peripheral blood before treatment. Statistical analysis using MedCalc 15.8 revealed that underweight patients had significantly lower miR-22-3p expression compared to non-underweight patients (0.89 vs. 2.47; p = 0.0233). Moderately or severely malnourished patients also showed reduced miR-22-3p levels compared to well-nourished individuals (1.42 vs. 11.04; p = 0.026). Additionally, patients with critical weight loss (CWL) had significantly lower miR-22-3p levels than those without CWL (0.96 vs. 4.91; p = 0.0015). Weak correlations were found between miR-22-3p levels, cancer stage, body mass index (BMI), and C-reactive protein (CRP), with lower miR-22-3p levels linked to advanced tumor stages and higher CRP levels. This study suggests miR-22-3p as a biomarker for nutritional deficiency risk in HNC patients, though further research is needed to validate its predictive capacity.

PMID:39548174 | DOI:10.1038/s41598-024-79641-3

Sci Rep. 2024 Nov 15;14(1):28161. doi: 10.1038/s41598-024-78609-7.

ABSTRACT

The early microbiota of neonates is crucial for developing the postnatal immune system and establishing normal physiological, metabolic, and neurological functions. This study aimed to investigate the factors influencing the diversity of the neonatal oral microbiome, including mother-to-newborn microbial transmission. The study includes a prospective cohort comprising 73 mothers and 87 neonates and a retrospective cohort comprising 991 mothers and 1,121 neonates. Samples from the maternal cervix and neonatal gastric, bronchial, and oral cavities were analyzed using culture-based methods. Neonatal oral swab samples were also analyzed using 16S rRNA gene sequencing to characterize microbial diversity and composition. Similar genera were detected in the neonatal gastric, bronchial, and oral samples, and the neonatal gastric culture was the most similar to the maternal cervical culture. In addition to mother-to-newborn microbial transmission, various natal factors including birth type, birth weight, delivery mode, maternal chorioamnionitis, maternal diabetes and the presence of microbes in other sites influenced neonatal oral microbiome diversity. Among these factors, the birth type was the most significant, and preterm neonates exhibited decreased oral microbiome diversity, with fewer beneficial bacteria and more pathogens. These findings could serve as a baseline for research on the establishment of the oral microbiota in preterm neonates and its health implications.

PMID:39548168 | DOI:10.1038/s41598-024-78609-7

Sci Rep. 2024 Nov 15;14(1):28177. doi: 10.1038/s41598-024-78271-z.

ABSTRACT

Architect-HIV Ag/Ab combo chemiluminescence assay is globally recognized for its sensitivity but has a notable false-positive rate. In this study, we aim to evaluate the performance of a new cost-effective screening alternative, the chemiluminescence Ag/Ab combo assay (CL-900i-HIV) from Mindray, China. We selected 195 archived samples categorized according to the INNO-LIA™ HIV I/II, the gold standard confirmatory assay. These samples included true positive (n = 38; positive by Architect-HIV & INNO-LIA-HIV), true negative (n = 101; negative by Architect-HIV & INNO-LIA-HIV), false positive (n = 20; positive by Architect-HIV & negative by INNO-LIA-HIV), and indeterminate results (n = 26). We tested all samples using the Mindray CL-900i-HIV and all positive Architect-HIV samples (n = 80) were confirmed by PCR. Compared to INNO-LIA™ HIVI/II line immunoassay confirmatory assay, Mindray CL-900i-HIV demonstrated a sensitivity of 100% (95% CI 90.7-100), specificity of 100% (95% CI 97.0-100), overall percent agreement (OPA) of 100% (95% CI 97.7-100.0), and perfect agreement with the INNO-LIA confirmatory assay (κ = 1.00). Additionally, Mindray’s CL-900i-HIV exhibited a significantly lower false-positive rate (8.75%) compared to Architect-HIV’s (55%). Mindray CL900i demonstrated high sensitivity and very low false-positive rate, thus, has the potential to serve as an excellent, cost-effective surrogate for HIV screening, overcoming the limitations of existing automated assays.

PMID:39548153 | DOI:10.1038/s41598-024-78271-z

Cognition. 2024 Nov 14;254:106002. doi: 10.1016/j.cognition.2024.106002. Online ahead of print.

ABSTRACT

While the visual world is rich and complex, importantly, it nevertheless contains many statistical regularities. For example, environmental feature distributions tend to remain relatively stable from one moment to the next. Recent findings have shown how observers can learn surprising details of environmental color distributions, even when the colors belong to actively ignored stimuli such as distractors in visual search. Our aim was to determine whether such learning influences orienting in the visual environment, measured with saccadic eye movements. In two visual search experiments, observers had to find an odd-one-out target. Firstly, we tested cases where observers selected targets by fixating them. Secondly, we measured saccadic eye movements when observers made judgments on the target and responded manually. Trials were structured in blocks, containing learning trials where distractors came from the same color distribution (uniform or Gaussian) while on subsequent test trials, the target was at different distances from the mean of the learning distractor distribution. For both manual and saccadic measures, performance improved throughout the learning trials and was better when the distractor colors came from a Gaussian distribution. Moreover, saccade latencies during test trials depended on the distance between the color of the current target and the distractors on learning trials, replicating results obtained with manual responses. Latencies were slowed when the target color was within the learning distractor color distribution and also revealed that observers learned the difference between uniform and Gaussian distributions. The importance of several variables in predicting saccadic and manual reaction times was studied using random forests, revealing similar rankings for both modalities, although previous distractor color had a higher impact on free eye movements. Overall, our results demonstrate learning of detailed characteristics of environmental color distributions that affects early attentional selection rather than later decisional processes.

PMID:39546817 | DOI:10.1016/j.cognition.2024.106002

JMIR Form Res. 2024 Nov 15;8:e56006. doi: 10.2196/56006.

ABSTRACT

BACKGROUND: Studying illicit drug circulation and its effects on population health is complicated due to the criminalization of trade and consumption. Illicit drug markets have evolved with IT, moving digital to the “darknet.” Previous research has analyzed darknet market listings and customer reviews. Research tools include public health surveys and medical reports but lack neutral data on drugs’ spread and impact. This study fills this gap with an analysis of the volume of drugs traded on the darknet market.

OBJECTIVE: We aimed to use the dark web data and officially published indicators to identify the most vulnerable regions of Russia and the correlations between the pairs of variables to measure how illicit drug trade can affect population well-being.

METHODS: We web-parsed the Hydra darknet drug marketplace using Python code. The dataset encompassed 3045 individual sellers marketing 6721 unique products via 58,563 distinct postings, each representing specific quantities sold in different Russian regions during 2019. In the second stage, we collected 31 variables from official sources to compare officially collected data with darknet data about amounts and types of selling drugs in every 85 regions of Russia. The health-related data were obtained from official published sources-statistical yearbooks. Maps, diagrams, correlation matrixes, and applied observational statistical methods were used.

RESULTS: In 2019, a minimum of 124 kilograms of drugs circulated daily in small batches on the Russian darknet. Cannabis dominated the market, being 10 times more prevalent than opiates, and cannabis products’ higher availability in the region is correlated with a lower incidence of opiate overdoses. The “grams of opiates in the region” variable is significantly correlated with drug overdose deaths (r=.41; P=.003), HIV-positive cases due to drug use (r=.51; P=.002), and drug court convictions in Russia (r=.39; P=.004). The study identified significant correlations between opiate sales on the darknet and higher rates of HIV among injection drug users (r=.47; P=.003). Conversely, regions with higher cannabis sales exhibited significant negative correlations with indicators of harmful drug use (r=-.52; P=.002) and its prevalence (r=-.49; P=.001). These findings suggest regional variations in drug sales on the darknet may be associated with differing public health outcomes. These indicators accurately reflect regional drug issues, though some official statistics may be incomplete or biased.

CONCLUSIONS: Our findings point to varying levels of risk associated with different types of drugs sold on the darknet, but further research is needed to explore these relationships in greater depth. The study’s findings highlight the importance of considering regional variations in darknet drug sales when developing public health strategies. The significant correlations between drug sales data and public health indicators suggest that region-specific interventions could be more effective in addressing the diverse challenges posed by illicit drug use.

PMID:39546792 | DOI:10.2196/56006

J Neurosurg. 2024 Nov 15:1-10. doi: 10.3171/2024.7.JNS24373. Online ahead of print.

ABSTRACT

OBJECTIVE: There is persistent debate in the literature surrounding the true predictors of biochemical remission after resection of somatotroph adenoma. A multimodal analysis of a large number of patients is needed to better understand which patients may be at higher or lower risk for remission failure after surgery.

METHODS: A retrospective review was performed on patients undergoing somatotroph adenoma resection. Biochemical remission was defined as age- and sex-adjusted normalization of serum insulin growth factor-1 (IGF-1) levels at least 6 months after surgery. Patient case characteristics and clinicopathologic variables were tested for statistical associations with remission and were included in a random forest machine learning model to assess for their importance in determining remission status. Preoperative variables found to be significant remission predictors on statistical testing and important in the random forest model were subsequently assessed via receiver operating characteristic (ROC) analysis to determine numeric thresholds that optimally predicted preoperative likelihood of remission success or failure.

RESULTS: Eighty patients were identified with somatotroph adenoma who underwent transsphenoidal resection, with 60 patients (75%) achieving biochemical remission. Statistical testing found that patients with failed remission were more likely to have larger tumors (1.9 vs 1.6 cm by the largest axis, p = 0.014; and 3.61 vs 2.66 cm3 by 3D volume, p = 0.013) that invaded the cavernous sinus more frequently (70% vs 22% of patients, p < 0.001) and have higher preoperative IGF-1 level (860 vs 660 ng/ml, p = 0.044). An optimized random forest machine learning model with 10,000 iterations found that tumor size, preoperative growth hormone and IGF-1 levels, and cavernous sinus invasion were important preoperative predictors of remission status. ROC analysis revealed that 96% of patients with preoperative 3D tumor volume less than 1.51 cm3 (area under the curve [AUC] 0.691, p = 0.003) and 100% with nonadjusted preoperative IGF-1 level less than 718.5 ng/ml (AUC 0.736, p = 0.002) achieved remission.

CONCLUSIONS: Important preoperative predictors of postoperative remission for somatotroph adenoma resection include serum IGF-1 level, cavernous sinus invasion, and tumor size. Ninety-five percent of patients who achieved postoperative remission had preoperative 3D tumor volume less than 1.51 cm3.

PMID:39546789 | DOI:10.3171/2024.7.JNS24373

J Neurosurg. 2024 Nov 15:1-8. doi: 10.3171/2024.6.JNS232599. Online ahead of print.

ABSTRACT

OBJECTIVE: The authors’ goal was to perform a retrospective audit of all emergency cranial neurosurgery performed at the Royal Darwin Hospital in the first 5 years of the unit and to compile their data in a similar fashion to an earlier study titled “Emergency Neurosurgery in Darwin: Still the Generalist Surgeons’ Responsibility,” which was published in 2015.

METHODS: All emergency cranial neurosurgery performed by a neurosurgeon between 2017 and 2021 was identified. Data were extracted from the National Critical Care and Trauma Response Centre database. Statistical analyses were descriptive logistic regression performed using Stata version 15.1 software to examine factors associated with death.

RESULTS: A total of 320 patients (42% Indigenous) underwent 427 emergency neurosurgeries. There were 35 emergency neurosurgeries in 2017 and 82 in 2021. The most common procedure performed was insertion of an external ventricular drain, followed by craniotomy and removal of intracranial hematoma. Mortality was 7.5% overall and 8.4% among patients with trauma. Only age proved to be a statistically significant independent risk factor for death (t = -2.95, p < 0.0041; OR 1.06, p = 0.02). Location, sex, injury severity, and presenting Glasgow Coma Scale score were not associated with death. Indigenous and non-Indigenous patients had similar outcomes.

CONCLUSIONS: The data illustrate the importance of developing small but sustainable neurosurgical units in rural and remote areas. A dedicated neurosurgical unit at the Royal Darwin Hospital has led to an increase in the amount and variety of emergency neurosurgery performed in Darwin. Interstate transfers have reduced. This has tangible lifesaving and economic advantages.

PMID:39546787 | DOI:10.3171/2024.6.JNS232599

JMIR Res Protoc. 2024 Nov 15;13:e58140. doi: 10.2196/58140.

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a major global public health concern, particularly in low- and middle-income countries where resources and infrastructure for an adequate response are limited. The World Health Organization (WHO) Global Antimicrobial Resistance Surveillance System (GLASS) was introduced in 2016 to address these challenges, outlining recommendations for priority pathogen-antibiotic combinations. Despite this initiative, implementation in Africa remains understudied. This scoping review aims to assess the current state of implementing WHO GLASS recommendations on antimicrobial sensitivity testing (AST) in Africa.

OBJECTIVE: The primary objective of this study is to determine the current state of implementing the WHO GLASS recommendations on AST for priority pathogen-antimicrobial combinations. The review will further document if the reporting of AST results is according to “susceptible,” “intermediate,” and “resistant” recommendations according to GLASS.

METHODS: Following the methodological framework by Arksey and O’Malley, studies published between January 2016 and November 2023 will be included. Search strategies will target electronic databases, including MEDLINE, Scopus, CINAHL, and Embase. Eligible studies will document isolates tested for antimicrobial sensitivity, focusing on WHO-priority specimens and pathogens. Data extraction will focus on key study characteristics, study context, population, and adherence to WHO GLASS recommendations on AST. Descriptive statistics involving summarizing the quantitative data extracted through measures of central tendency and variation will be used. Covidence and Microsoft Excel software will be used. This study will systematically identify, collate, and analyze relevant studies and data sources based on clear inclusion criteria to provide a clear picture of the progress achieved in the implementation of the WHO GLASS recommendations. Areas for further improvement will be documented to inform future efforts to strengthen GLASS implementation for enhanced AMR surveillance in Africa.

RESULTS: The study results are expected in August 2024.

CONCLUSIONS: To our knowledge, this scoping review will be the first to comprehensively examine the implementation of WHO GLASS recommendations in Africa, shedding light on the challenges and successes of AMR surveillance in the region. Addressing these issues aims to contribute to global efforts to combat AMR.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/58140.

PMID:39546786 | DOI:10.2196/58140

J Neurosurg Spine. 2024 Nov 15:1-9. doi: 10.3171/2024.7.SPINE24464. Online ahead of print.

ABSTRACT

OBJECTIVE: Surgical correction of adult spinal deformity (ASD) is associated with a high rate of hardware complication that can be challenging to predict. Hardware integrity and alignment after surgery are typically followed with standing radiography, where pedicle screw loosening may be incidentally identified but the clinical significance of which is often unclear. This study aimed to identify the incidence and implications of pedicle screw loosening at the upper instrumented vertebra (UIV) after surgical correction of ASD.

METHODS: A single-institution retrospective analysis was performed on a cohort of 217 patients who underwent long-segment fusion with pelvic fixation for correction of ASD between September 2013 and November 2021. Cases with a minimum 1-year follow-up were included. UIV pedicle screws were graded on radiographs for evidence of loosening with a 0- to 3-point scale: 0, no loosening; 1, lucency within screw threads; 2, lucency around screw threads; and 3, screw dislodgment/backout. Need for hardware revision surgery was assessed as the primary outcome. Patient-reported outcome measures (PROMIS and Oswestry Disability Index scores) were assessed as secondary outcomes among the patients with available scores.

RESULTS: Low-grade UIV screw loosening (grade 1) was identified in 37 patients (17.1%), and high-grade UIV loosening (grade 2 or 3) was identified in 23 patients (10.6%). Low-grade UIV loosening was not associated with eventual need for hardware revision (OR 0.52, 95% CI 0.17-1.61, p = 0.258); however, high-grade loosening was associated with increased odds of hardware revision (OR 5.17, 95% CI 1.74-15.36, p = 0.003), including specifically surgery for correction of proximal junctional kyphosis (OR 5.73, 95% CI 1.27-25.95, p = 0.024). Among patients with PROMIS T-scores, those requiring hardware revision reported worse Pain Interference (65.0 ± 5.1 vs 59.6 ± 7.7, p = 0.001) and Physical Function (33.3 ± 5.6 vs 37.4 ± 7.4; p = 0.011). Patients with high-grade UIV loosening reported higher Oswestry Disability Index scores than those without high-grade loosening (grade 0 or 1), although this failed to reach statistical significance (44.0 ± 8.5 vs 33.7 ± 18.5, p = 0.101).

CONCLUSIONS: Grade 1 UIV pedicle screw loosening may represent a benign incidental finding, whereas high-grade loosening is associated with significantly increased odds of hardware revision surgery. High-grade loosening may also be associated with worse patient-reported disability. The authors’ findings suggest that while low-grade UIV loosening may often be managed expectantly, identification of high-grade UIV pedicle screw loosening on follow-up imaging warrants increased attention and continued surveillance.

PMID:39546785 | DOI:10.3171/2024.7.SPINE24464

J Med Internet Res. 2024 Nov 15;26:e57628. doi: 10.2196/57628.

ABSTRACT

BACKGROUND: Increasing adoption of sensor-based digital health technologies (sDHTs) in recent years has cast light on the many challenges in implementing these tools into clinical trials and patient care at scale across diverse patient populations; however, the methodological approaches taken toward sDHT usability evaluation have varied markedly.

OBJECTIVE: This review aims to explore the current landscape of studies reporting data related to sDHT human factors, human-centered design, and usability, to inform our concurrent work on developing an evaluation framework for sDHT usability.

METHODS: We conducted a scoping review of studies published between 2013 and 2023 and indexed in PubMed, in which data related to sDHT human factors, human-centered design, and usability were reported. Following a systematic screening process, we extracted the study design, participant sample, the sDHT or sDHTs used, the methods of data capture, and the types of usability-related data captured.

RESULTS: Our literature search returned 442 papers, of which 85 papers were found to be eligible and 83 papers were available for data extraction and not under embargo. In total, 164 sDHTs were evaluated; 141 (86%) sDHTs were wearable tools while the remaining 23 (14%) sDHTs were ambient tools. The majority of studies (55/83, 66%) reported summative evaluations of final-design sDHTs. Almost all studies (82/83, 99%) captured data from targeted end users, but only 18 (22%) out of 83 studies captured data from additional users such as care partners or clinicians. User satisfaction and ease of use were evaluated for 83% (136/164) and 91% (150/164) of sDHTs, respectively; however, learnability, efficiency, and memorability were reported for only 11 (7%), 4 (2%), and 2 (1%) out of 164 sDHTs, respectively. A total of 14 (9%) out of 164 sDHTs were evaluated according to the extent to which users were able to understand the clinical data or other information presented to them (understandability) or the actions or tasks they should complete in response (actionability). Notable gaps in reporting included the absence of a sample size rationale (reported for 21/83, 25% of all studies and 17/55, 31% of summative studies) and incomplete sociodemographic descriptive data (complete age, sex/gender, and race/ethnicity reported for 14/83, 17% of studies).

CONCLUSIONS: Based on our findings, we suggest four actionable recommendations for future studies that will help to advance the implementation of sDHTs: (1) consider an in-depth assessment of technology usability beyond user satisfaction and ease of use, (2) expand recruitment to include important user groups such as clinicians and care partners, (3) report the rationale for key study design considerations including the sample size, and (4) provide rich descriptive statistics regarding the study sample to allow a complete understanding of generalizability to other patient populations and contexts of use.

PMID:39546781 | DOI:10.2196/57628