Category: Nevin Manimala

Front Pharmacol. 2024 Jul 19;15:1378140. doi: 10.3389/fphar.2024.1378140. eCollection 2024.

ABSTRACT

BACKGROUND: Within-day glycemic variability (GV), characterized by frequent and significant fluctuations in blood glucose levels, is a growing concern in hospitalized patients with type 2 diabetes mellitus (T2DM). It is associated with an increased risk of hypoglycemia and potentially higher long-term mortality rates. Robust clinical evidence is needed to determine whether traditional Chinese medicine (TCM) decoctions can be a beneficial addition to the management of within-day GV in this patient population.

METHODS: This retrospective cohort study utilized data from adult inpatients diagnosed with T2DM admitted to the Traditional Chinese Medicine Hospital of Kaifeng. The primary outcome investigated was the association between the use of TCM decoctions and improved stability of within-day GV. Blood glucose variability was assessed using the standard deviation of blood glucose values (SDBG). For each patient, the total number of hospitalization days with SDBG below 2 mmol/L was calculated to represent within-day GV stability. Hospitalization duration served as the secondary outcome, compared between patients receiving TCM decoctions and those who did not. The primary analysis employed a multivariable logistic regression model, with propensity score matching to account for potential confounding variables.

RESULTS: A total of 1,360 patients were included in the final analysis. The use of TCM decoctions was significantly associated with enhanced stability of within-day GV (OR = 1.77, 95% CI: 1.34-2.33, P < 0.01). This association was most prominent in patients with a diagnosis of deficiency syndrome (predominantly qi-yin deficiency, accounting for 74.8% of cases) and a disease duration of less than 5 years (OR = 2.28, 95% CI: 1.21-4.29, P = 0.03). However, TCM decoctions did not exert a statistically significant effect on hospitalization duration among patients with T2DM (OR = 0.96, 95% CI: 0.91-1.01, P = 0.22).

CONCLUSION: This study suggests that TCM decoctions may be effective in improving within-day GV stability in hospitalized patients with T2DM. This effect appears to be most pronounced in patients diagnosed with deficiency syndrome, particularly those with qi-yin deficiency and a shorter disease course. Further investigation is warranted to confirm these findings and elucidate the underlying mechanisms.

PMID:39101135 | PMC:PMC11294233 | DOI:10.3389/fphar.2024.1378140

Front Pharmacol. 2024 Jul 19;15:1369480. doi: 10.3389/fphar.2024.1369480. eCollection 2024.

ABSTRACT

Introduction: Plants have formed the basis of traditional medicine (TM) systems, which have been used for thousands of years. According to reports, one-quarter of the commonly used medicines contain compounds isolated from plants. This study aims to identify and document the plants for ethno-pharmacological use by the indigenous communities of West Shoa Zone, Oromia region, Ethiopia. Methods: The cross-sectional study was conducted from November 2020 to November 2021 in West Shewa Zone, Oromia Region, Ethiopia. The ethnobotanical data was collected from Ejere District, Ada Berga District, Dandi District, Ambo District, Ambo Town, Toke Kutaye District, and Bako Tibe District. A descriptive statistical method (percentage and/or frequency) was employed to summarize ethnobotanical data. Moreover, the informant consensus factor was computed. Microsoft Excel spreadsheet software (Microsoft Corporation, 2016) and SPSS (version 25) were used to organize and analyze the data. Result: In the study area, a total of 51 families of medicinal plants with 108 Species were identified. Fabaceae 8 species, Asteraceae, Solanaceae and Lamiaceae each with 6 species and Cucurubitacieae 5 species were the frequently reported medicinal plants. The leaf (57.2%) was the most widely used medicinal plant parts, and oral administration (56.5%) was the most cited route of administration. In the present study, most of the medicinal plants were used fresh, which was (75%) and the most common disease the healers treated was gastrointestinal disease, followed by skin disease and febrile illness. The major threat to medicinal plants in the study area was agricultural expansion, which was reported by 30.6% of the respondents. The study area was rich in medicinal plants, Fabaceae which commonly used family. Conclusion: Most of the medication prepared by the traditional healers was taken orally and derived from the leaf part of the medicinal plant. Since this research is a preliminary study which will be used as a base for further study. The efficacy and safety of the medicinal plant claim should be studied in the future.

PMID:39101129 | PMC:PMC11294152 | DOI:10.3389/fphar.2024.1369480

J Algebr Comb (Dordr). 2024;60(1):97-126. doi: 10.1007/s10801-024-01321-2. Epub 2024 May 9.

ABSTRACT

In this paper we develop the theory of cyclic flats of q-matroids. We show that the cyclic flats, together with their ranks, uniquely determine a q-matroid and hence derive a new q-cryptomorphism. We introduce the notion of $F_{q^m}$ -independence of an $F_q$ -subspace of $F_q^n$ and we show that q-matroids generalize this concept, in the same way that matroids generalize the notion of linear independence of vectors over a given field.

PMID:39101127 | PMC:PMC11294278 | DOI:10.1007/s10801-024-01321-2

J Adv Vet Anim Res. 2024 Jun 6;11(2):284-290. doi: 10.5455/javar.2024.k774. eCollection 2024 Jun.

ABSTRACT

OBJECTIVE: The present study investigated the effects of Andaliman fruit extract on tumor necrosis factor-alpha (TNF-α) and transient receptor potential ankyrin-1 (TRPA-1) levels in type 2 diabetes mellitus (T2DM) mouse models induced with streptozocin (STZ) and a high-fat diet (HFD).

MATERIALS AND METHODS: In this research, mice were allocated into six distinct groups: normal, negative control (HFD and STZ), positive control (metformin, HFD, and STZ), and three treatment groups (HFD, STZ, and Andaliman extract at varying dosages of 100, 300, and 500 mg/kg, respectively). Body weight and blood glucose levels (BGLs) were recorded at weeks 1 (baseline), 8, 12, and 16. The levels of TNF-α and TRPA-1 were measured during the 16th week.

RESULTS: Phytochemical screening of the Andaliman extract revealed the presence of flavonoids, alkaloids, tannins, saponins, and glycosides. The one-way ANOVA revealed significantly elevated BGL at week 16 in the negative control group in comparison to the other groups (p < 0.05). The Kruskal-Wallis test followed by Bonferroni-corrected pairwise comparisons showed that the negative control had significantly higher TNF-α levels than the Andaliman-groups (z = 22.11, p < 0.01). TRPA-1 was significantly higher in the negative control group compared to the treatment groups (p < 0.05). Furthermore, Spearman’s rho analysis revealed a statistically significant positive association between BGL and both TNF-α and TRPA-1, as well as between TNF-α and TRPA.

CONCLUSION: Andaliman extract potentially serves as a therapy for diabetic neuropathy in T2DM by lowering BGL and inhibiting the expression of TNF-α and TRPA-1.

PMID:39101085 | PMC:PMC11296190 | DOI:10.5455/javar.2024.k774

Scand Stat Theory Appl. 2024 Jun;51(2):672-696. doi: 10.1111/sjos.12695. Epub 2023 Nov 8.

ABSTRACT

This article proposes a distance-based framework incentivized by the paradigm shift towards feature aggregation for high-dimensional data, which does not rely on the sparse-feature assumption or the permutation-based inference. Focusing on distance-based outcomes that preserve information without truncating any features, a class of semiparametric regression has been developed, which encapsulates multiple sources of high-dimensional variables using pairwise outcomes of between-subject attributes. Further, we propose a strategy to address the interlocking correlations among pairs via the U-statistics-based estimating equations (UGEE), which correspond to their unique efficient influence function (EIF). Hence, the resulting semiparametric estimators are robust to distributional misspecification while enjoying root-n consistency and asymptotic optimality to facilitate inference. In essence, the proposed approach not only circumvents information loss due to feature selection but also improves the model’s interpretability and computational feasibility. Simulation studies and applications to the human microbiome and wearables data are provided, where the feature dimensions are tens of thousands.

PMID:39101047 | PMC:PMC11296665 | DOI:10.1111/sjos.12695

JVS Vasc Sci. 2024 Jun 11;5:100211. doi: 10.1016/j.jvssci.2024.100211. eCollection 2024.

ABSTRACT

BACKGROUND: High lipoprotein (a) [Lp(a)] is associated with adverse limb events in patients undergoing lower extremity revascularization. Lp(a) levels are genetically pre-determined, with LPA gene encoding for two apolipoprotein (a) [apo(a)] isoforms. Isoform size variations are driven by the number of kringle IV type 2 (KIV-2) repeats. Lp(a) levels are inversely correlated with isoform size. In this study, we examined the role of Lp(a) levels, apo(a) size, and inflammatory markers with lower extremity revascularization outcomes.

METHODS: Twenty-five subjects with chronic peripheral arterial disease (PAD) underwent open or endovascular lower extremity revascularization (mean age, 66.7 ± 9.7 years; Female = 12; Male = 13; Black = 8; Hispanic = 5; and White = 12). Pre- and postoperative medical history, self-reported symptoms, ankle-brachial indices (ABIs), and lower extremity duplex ultrasounds were obtained. Plasma Lp(a), apoB100, lipid panel, and pro-inflammatory markers (IL-6, IL-18, hs-CRP, TNFα) were assayed preoperatively. Isoform size was estimated using gel electrophoresis and weighted isoform size (wIS) calculated based on % isoform expression. Firth logistic regression was used to examine the relationship between Lp(a) levels and wIS with procedural outcomes: symptoms (better/worse), early primary patency at 2 to 4 weeks, ABIs, and reintervention within 3 to 6 months. We controlled for age, sex, history of diabetes, smoking, statin, antiplatelet, and anticoagulation use.

RESULTS: Median plasma Lp(a) level was 108 (interrquartile range, 44-301) nmol/L. The mean apoB100 level was 168.0 ± 65.8 mg/dL. These values were not statistically different among races. We found no association between Lp(a) levels and wIS with measured plasma pro-inflammatory markers. However, smaller apo(a) wIS was associated with occlusion of the treated lesion(s) in the postoperative period (odds ratio, 1.97; 95% confidence interval, 1.01-3.86; P < .05). The relationship of smaller apo(a) wIS with reintervention was not as strong (odds ratio, 1.57; 95% confidence interval, 0.96-2.56; P = .07). We observed no association between wIS with patient reported symptoms or change in ABIs.

CONCLUSIONS: In this small study, subjects with smaller apo(a) isoform size undergoing peripheral arterial revascularization were more likely to experience occlusion in the postoperative period and/or require reintervention. Larger cohort studies identifying the mechanism and validating these preliminary data are needed to improve understanding of long-term peripheral vascular outcomes.

PMID:39101011 | PMC:PMC11296070 | DOI:10.1016/j.jvssci.2024.100211

J Child Orthop. 2024 May 3;18(4):404-413. doi: 10.1177/18632521241234768. eCollection 2024 Aug.

ABSTRACT

BACKGROUND: Joint range of motion based on the neutral null method, muscle strength based on manual muscle testing, and selective voluntary motor control based on selective control assessment of the lower extremity are standard parameters of a pediatric three-dimensional clinical gait analysis. Lower-limb reference data of children are necessary to identify and quantify abnormalities, but these are limited and when present restricted to specific joints or muscles.

METHODS: This is the first study that encompasses the aforementioned parameters from a single group of 34 typically developing children aged 5-17 years. Left and right values were averaged for each participant, and then the mean and standard deviation calculated for the entire sample. The data set was tested for statistical significance (p < 0.05).

RESULTS: Joint angle reference values are mostly consistent with previously published standards, although there is a large variability in the existing literature. All muscle strength distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 5. The mean number of repetitions of heel-rise test is 12 ± 5. Selective voluntary motor control shows that all distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 2.

CONCLUSION: Since typically developing children do not match expectations and reference values from the available literature and clinical use, this study emphasizes the importance of normative data. Excessively high expectations lead to typically developing children being falsely underestimated and affected children being rated too low. This is of great relevance for therapists and clinicians.

LEVEL OF EVIDENCE: 3.

PMID:39100986 | PMC:PMC11295375 | DOI:10.1177/18632521241234768

J Child Orthop. 2024 Apr 29;18(4):441-449. doi: 10.1177/18632521241244624. eCollection 2024 Aug.

ABSTRACT

PURPOSE: Tibialis anterior tendon shortening combined with tendon Achilles lengthening showed satisfactory short- and long-term outcomes for pes equinus treatment. This retrospective study aimed to evaluate the effectiveness of a single tibialis anterior tendon shortening-tendon Achilles lengthening procedure for treating pes equinus, in a homogeneous unilateral cerebral palsy patient group.

METHODS: Gait analysis was conducted on 22 unilateral cerebral palsy patients (mean age at surgery = 13.3 years, standard deviation = 3 years) before and within 2.5 years (standard deviation = 0.61 years) after the tibialis anterior tendon shortening-tendon Achilles lengthening procedure. Primary outcome measures included foot drop occurrence in swing, foot dorsiflexion and the first ankle rocker presence compared to healthy reference data. Movement analysis profile and gait profile score were also calculated for the entire gait cycle. The clinical exam and the A2 peak ankle power were analyzed. Statistical analysis used the paired Wilcoxon’s sign rank test (p < 0.05).

RESULTS: Post-operatively, significant improvements were observed in ankle dorsiflexion during swing (p = 0.0006) and reduced foot drop in swing (p = 0.0107). The occurrence of a first ankle rocker did not significantly change (p = 0.1489). Significant improvements in gait profile score and movement analysis profile for all joints and planes indicate overall gait quality improvement. The foot progression changed significantly (p = 0.0285), with a greater external orientation. Nineteen out of 22 patients were able to quit wearing their ankle foot orthoses.

CONCLUSION: Tibialis anterior tendon shortening and tendon Achilles lengthening combination yielded positive outcomes, showing increased foot dorsiflexion, first ankle rocker presence, and overall improved gait quality. These findings support the effectiveness of this surgical approach for treating pes equinus in children with unilateral spastic cerebral palsy.

PMID:39100984 | PMC:PMC11295372 | DOI:10.1177/18632521241244624

J Child Orthop. 2024 Feb 14;18(4):393-398. doi: 10.1177/18632521241229978. eCollection 2024 Aug.

ABSTRACT

PURPOSE: Developmental hip dysplasia is a prevalent pediatric musculoskeletal condition that lacks international standardized screening. We sought to characterize developmental hip dysplasia screening practices in countries with the top global health indices. We also explored diverse definitions in reported epidemiologic rates of this condition.

METHODS: We performed a scoping review of developmental hip dysplasia screening protocols utilizing countries ranked in the top 25 of the Bloomberg Global Health Index using a protocolized search strategy, progressing from academic to layperson sources. A reference was eligible for inclusion if it mentioned the countries’ screening program and developmental hip dysplasia was the pathology of concern. Incidence rates, when present, were also recorded. The United States Census Bureau’s International Database tool provided countries’ populations. We compiled the data and performed descriptive statistics and appropriate validation methods.

RESULTS: Twenty countries (80%) had searchable screening programs. Clinical screening with selective universal screening was the most commonly observed (n = 16). Four countries had universal ultrasound screening: Switzerland, Austria, Germany, and Slovenia. Five countries did not have searchable programs. No countries employed radiographic screening. Incidence rates were expressly stated in the literature for nine countries; however, the cohort of interest varied from developmental hip dysplasia versus severity of developmental hip dysplasia versus miscellaneous (e.g. requiring hospitalization).

CONCLUSION: The findings of this investigation highlight international inconsistencies regarding developmental hip dysplasia screening and epidemiologic data. Screening variations exist despite consensus statements calling for uniformity. We agree with prior literature advocating for increasing consistency in developmental hip dysplasia management or, at a minimum, increasing transparency regarding how we manage these young patients.

PMID:39100982 | PMC:PMC11295378 | DOI:10.1177/18632521241229978

J Child Orthop. 2024 Mar 27;18(4):386-392. doi: 10.1177/18632521241240367. eCollection 2024 Aug.

ABSTRACT

PURPOSE: Our purpose was to analyze the impact of Pavlik Harness treatment on children motor skills development, comparing to a control group.

METHODS: A total of 121 children were included: 55 cases (children with Developmental Dysplasia of the Hip) and 66 healthy controls. Cases were recruited from 2017 to 2021 and followed up to 2022. Controls (healthy children without orthopedic pathology) were recruited from 2020 to 2022. The primary endpoint was the time of achievement of three gross motor milestones (sitting without support, hands-and-knees crawling, and walking independently).

RESULTS: The groups had no differences regarding sex distribution, gestational age, birth weight, and rate of twin pregnancy. The prevalence of positive family history of Development Dysplasia of the Hip (20.0% vs 3.0%, p < 0.003), breech presentation (38.2% vs 1.5%, p < 0.001), and C-section delivery (60.0% vs 19.7%, p < 0.001) was significantly higher in Development Dysplasia of the Hip group. Children with Development Dysplasia of the Hip achieved the three gross milestones evaluated 1 month later than healthy controls, although this was not statistically significant (p = 0.133 for sitting, p = 0.670 for crawling, and p = 0.499 for walking).

CONCLUSION: Children with Development Dysplasia of the Hip, treated by Pavlik harness, do not have significant delays in motor skills acquisition.

PMID:39100978 | PMC:PMC11295376 | DOI:10.1177/18632521241240367