Category: Nevin Manimala

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4153-4159. doi: 10.31557/APJCP.2024.25.12.4153.

ABSTRACT

BACKGROUND/AIMS: Variations in cirrhosis management practices and care quality affect patient prognoses and outcomes. We aimed to evaluate the number of successful cirrhosis care processes and the relationship between the quality statement implementation and clinical outcomes in patients with cirrhosis.

METHODS: This retrospective cohort study included hospitalized patients with cirrhosis. Eighteen process-based methods were independently assessed. Measurement indices for each participant were selected per cirrhosis severity. Service quality was determined using standard settings for each process-based gap scale. The optimal care group comprised participants who adhered to all instruction quality indices. Kaplan-Meier survival analysis assessed the 90-day readmission and mortality rates relating to the optimal quality care.

RESULTS: Of the 205 patients (73.2% male; mean age, 62.7±11.8 years), the median Model for End-stage Liver Disease score was 15.35 (9.37-21.37), and the majority were Child-Pugh B/C. Previously set performance gaps were observed for 13/18 quality processes, and 5/13 clinical processes attained the final goal. Paracentesis in ascites patients, antibiotic administration within 12 hours of spontaneous bacterial peritonitis diagnosis, and precipitating factors identification with lactulose therapy were the top three quality index (QI) accomplishments. Out of 205 patients, 84 attained optimal care. Concerning optimal care, although the readmission rate remained same, patients with decompensated Child-Pugh C who received excellent complete QI care had significantly increased both 1-month (100% vs. 43.5%; p=0.022) and 3-month (100% vs. 26.1%; p=0.022) survival in comparison to those receiving incomplete QI care.

CONCLUSION: Using quality metrics for the appropriate stage of individual cirrhosis treatment is advocated as best practice. Adherence to standard practices improves clinical outcomes.

PMID:39733404 | DOI:10.31557/APJCP.2024.25.12.4153

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4145-4151. doi: 10.31557/APJCP.2024.25.12.4145.

ABSTRACT

OBJECTIVE: The objective of this study was to determine the prevalence and spectrum of genetic mutations linked to inherited breast and ovary cancer (HBOC) in the Indian population, and to evaluate the correlation of BRCA mutation types, frequency, and incidence with age, gender, and personal and family history.

METHODS: A retrospective cohort of 500 Indian HBOC patients, meeting NCCN criteria who underwent BRCA1/2 testing from 2017 to 2023 were shortlisted for this study. The anonymized data was retrieved from medical records. Genetic analysis was conducted using Next Generation Sequencing (NGS) on the Thermo Ion GeneStudio™ S5 System, with positive mutations confirmed via Sanger sequencing. Peripheral blood samples were processed for DNA extraction, library preparation, and variant classification following ACMG guidelines.

RESULTS: Out of the 500 patients, 119 (23.8%) were positive for BRCA mutations, and 381 (76.2%) were negative. The prevalence of BRCA pathogenesis, likely pathogenicity, and variants of uncertain significance (VUSs) were 14.8%, 1.6%, and 7.4%, respectively. A total of 128 mutations were detected in the positive BRCA1/2 patients. A statistically significant correlation was found between BRCA mutations with the patient and family history. A total of 38.8% of the patients with mutations had a family history of BC, OC or BC/OC, while 7.6% had other cancers. BRCA mutations were predominant (26.2%) in the age group of 46-65 Y. Among the 128 mutations, 59.3% (76/128) and 40.6% (52/12) of the patients had mutations in BRCA1 and BRCA2, respectively. Missense mutations were the most common in both the BRCA1 (30.26%) and BRCA2 (55.77%) genes, followed by frameshift (22.3%) and nonsense (17.3%) mutations in BRCA1 and BRCA2, respectively.

CONCLUSION: BRCA positivity was detected in 23.8% of the patients. A statistically significant association was shown between BRCA mutations and patient and family history.

PMID:39733403 | DOI:10.31557/APJCP.2024.25.12.4145

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4129-4136. doi: 10.31557/APJCP.2024.25.12.4129.

ABSTRACT

OBJECTIVES: Oral submucous fibrosis (OSMF) is a potentially malignant disorder (PMD) characterized by a high rate of malignant transformation (MT). OSMF exhibits atrophic epithelium yet has a high proliferation rate. Both p53 and Ki67 are nuclear proteins associated with cell proliferation, detectable in the early stages of oral cancer (OC). This study aimed to analyze the efficacy of p53 and Ki67 immuno-expression as tools for predicting malignant transformation in OSMF cases. The objective was to correlate the expression of p53 and Ki67 with demographic and chewing habits data.

MATERIALS AND METHODS: The study group consisted of 60 histopathologically diagnosed cases of OSMF, 60 cases of OC as positive controls, and 60 cases of NOM as negative controls. Immunohistochemistry was performed on neutral-buffered formalin-fixed, paraffin-embedded tissue sections of 3 μm thickness, using ready-to-use anti-human p53 protein (clone DO-7) and monoclonal antibody for Ki67 antigen (clone MIB-1). Statistical analysis was conducted using SPSS software version 21, employing the chi-square test (p < 0.05).

RESULTS: The expression of p53 and Ki67 was significantly higher in OSMF samples compared to NOM samples, but lower than in OC samples. When the expression levels of both p53 and Ki67 were correlated with demographic and chewing habits data, the results were statistically significant.

CONCLUSION: The overexpression of p53 and Ki67 may contribute to the progression of MT in OSM. Early detection of these biomarkers is crucial for preventing MT, which also helps reduce the morbidity and mortality of OC. Therefore, both p53 and Ki67 can serve as predictive biomarkers for the early detection of MT in high-risk OSMF patients.

PMID:39733401 | DOI:10.31557/APJCP.2024.25.12.4129

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4115-4122. doi: 10.31557/APJCP.2024.25.12.4115.

ABSTRACT

OBJECTIVE: Triple-negative breast cancer (TNBC) is a type of breast cancer that does not express the estrogen receptor (ER), the progesterone receptor (PR), or the human epidermal growth factor receptor 2 (HER2). TNBC has limited treatment targets, including the androgen receptor (AR). However, the therapeutic strategies-based AR expression in TNBC remains uncertain. The aim of this study is to compare the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus receptor-negative patients.

METHODS: A systematic search was performed through databases to search for cohort studies that compared the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus TNBC receptor-negative patients. The Mantel-Haenzel and Inverse Variance methods obtained a fixed-effects model of pooled odds or hazard ratios for the primary outcomes.

RESULTS: Fifteen cohort studies, including 2,713 patients with TNBC, were assessed. The effect of neoadjuvant chemotherapy is less superior on AR+ patients than AR- (OR = 0.60, p = 0.02). For survival outcomes, the AR+ subtype is associated with better 3-year DFS (HR = 0.93, p = 0.69) and 3-year OS (HR = 0.71, p = 0.20) compared with AR-. The statistical value is insignificant.

CONCLUSION: The prognostic value of AR expression in TNBC is not fully understood, which is an inconclusive result.

PMID:39733399 | DOI:10.31557/APJCP.2024.25.12.4115

Sleep Breath. 2024 Dec 29;29(1):66. doi: 10.1007/s11325-024-03204-z.

ABSTRACT

PURPOSE: Light is a crucial factor influencing sleep arousal patterns. This meta-analysis investigates the efficacy of light therapy (LT) for insomnia treatment.

METHODS: Five electronic databases were independently searched by two reviewers until August 2024. The literature screening focused specifically on populations with insomnia complaints treated by LT. Weighted Mean Difference (WMD) and 95% Confidence Interval (CI) were used as statistical tools, while the Cochrane Risk of Bias tool version 2 (RoB 2) was employed to assess the quality of evidence. A total of 10 randomized controlled trials (RCTs) were analyzed.

RESULTS: The results demonstrated that LT showed statistically significant improvements in subjective sleep quality, as evidenced by a reduction in Pittsburgh sleep quality scale (PSQI) scores by -2.89 (95% CI = -4.80 to -0.97) and Insomnia severity index (ISI) scores by -2.16 (95% CI = -4.23 to -0.08) post-intervention. Additionally, actigraphy revealed a statistically significant increase in total sleep time (TST) by 16.78 min (95% CI = 0.67 to 32.89) and a decrease in wake after sleep onset (WASO) by -12.91 min (95% CI = -25.62 to -0.20) by LT.

CONCLUSION: The preliminary results of the study suggest that LT has some efficacy in improving sleep quality in insomnia. However, it needs to be validated in future clinical trials with larger samples.

PMID:39733392 | DOI:10.1007/s11325-024-03204-z

Planta. 2024 Dec 29;261(1):22. doi: 10.1007/s00425-024-04598-6.

ABSTRACT

Rhizobacteria and silicon fertilization synergism suppress leaf and panicle Blast, and mitigates biotic stress in rice plants. Association of bioagents and silicon is synergistic for mitigating leaf and panicle blast and low phosphorus (P) levels in upland rice, under greenhouse conditions. This study aimed to evaluate the potential of the bioagents and silicon interaction on blast disease severity suppression in upland rice plants, under field low P conditions. The experiment was conducted during two growing seasons (E1 and E2), in randomized block design with four replications, and consisted of five treatments, combining a mix of three rhizobacteria, BRM 32114 and BRM62523 (Serratia marcescens), and BRM32110 (Bacillus toyonensis), and three application methods (seed treatment, drenching, spraying). Calcium and magnesium silicate (2 t/ha) was applied over a low soil P, 30 days before sowing. Leaf blast (LBS) and panicle blast (PBS), area under the disease progress curve (AUDPC), activity of enzymes related to oxidative stress, pathogenesis-related (PR), biochemical indicators such as hydrogen peroxide, chlorophyll a and b, carotenoids, and grain yield (GY), were assessed. Bioagents and silicon suppressed LBS by 77.93 and PBS by 62.37%, reduced AUDPC by 77.3 (LBS) and 60.6% (PBS). The yield in E1 was 25% higher than in E2. The treatments statistically differ only in E2, the yield with bioagents and silicon (2435.72 kg ha^-1) was 71.95% higher compared to the absolute control. All enzymatic activities related to oxidative stress and PR proteins were modulated by bioagents and silicon association. The association of rhizobacteria and silicon exhibited a synergistic effect, and represents a bioprotective combination to reduce the effects of different stresses and indirectly reduces the use of chemical inputs.

PMID:39733387 | DOI:10.1007/s00425-024-04598-6

J Eval Clin Pract. 2025 Feb;31(1):e14289. doi: 10.1111/jep.14289.

ABSTRACT

AIM: This study aimed to translate the Environmental Health Literacy Scale (EHLS) into Turkish and assess its construct validity and internal consistency.

METHODS: This research employs a methodological design. The research was conducted during the 2022-2023 academic year with a sample of 500 students from the Faculty of Health Sciences. The data were collected via the introductory information form, the EHLS, and the Environmental Awareness Scale of university students. Subsequently, the data were transferred to the IBM SPSS Statistics 23 and IBM SPSS AMOS 23 software programs. Upon evaluation of the research data, frequency distributions for categorical variables and descriptive statistics for numerical variables were provided. Content validity was evaluated through the acquisition of expert approval. Confirmatory factor analysis was employed for scale validity, while Cronbach’s α, test-retest and parallel form analyses were utilized for reliability.

RESULTS: The content validity index of the scale was determined to be 1.00. The scale is constituted of four discrete scales (general, food, air and water), each comprising three dimensions. In consideration of the fit indices, specifically the χ²/df, GFI, TLI, IFI, CFI, RMSEA and SRMR, it can be concluded that the general, food, air and water scales are deemed acceptable. Cronbach’s α coefficients for the scales were found to be 0.70, 0.81, 0.83 and 0.79, respectively. In the parallel form analysis, a statistically significant positive relationship was identified between the scales.

CONCLUSIONS: The findings of this research indicate that the scale is a reliable instrument for assessing the environmental health literacy levels of undergraduate students enrolled in health sciences programs. It is anticipated that the scale will contribute to the advancement of environmental health literacy awareness.

PMID:39733247 | DOI:10.1111/jep.14289

Med Care. 2024 Nov 1;62(11):748-756. doi: 10.1097/MLR.0000000000002057. Epub 2024 Oct 11.

ABSTRACT

BACKGROUND: Practice guidelines recommend patient management based on scientific evidence. Quality indicators gauge adherence to such recommendations and assess health care quality. They are usually defined as adverse event rates, which may not fully capture guideline adherence over time.

METHODS: For assessing process indicators where compliance to the recommended treatment can be assessed by evaluating a patient’s trace in linked routine databases, we propose using restricted mean survival time or restricted mean time lost, which are applicable even in competing risk situations. We demonstrate their application by assessing the compliance of patients with acute myocardial infarction (AMI) to high-power statins over 12 months in Austria’s political districts, using pseudo-observations and employing causal inference methods to achieve regional comparability.

RESULTS: We analyzed the compliance of 31,678 AMI patients from Austria’s 116 political districts with index AMI between 2011 and 2015. The results revealed considerable compliance variations across districts but also plausible spatial similarities.

CONCLUSIONS: Restricted mean survival time and restricted mean time lost provide interpretable estimates of patients’ expected time in compliance (lost), well-suited for risk-adjusted entity comparisons in the presence of (measurable) confounding, censoring, and competing risks.

PMID:39733232 | DOI:10.1097/MLR.0000000000002057

Med Care. 2024 Nov 1;62(11):723. doi: 10.1097/MLR.0000000000002078. Epub 2024 Oct 11.

NO ABSTRACT

PMID:39733231 | DOI:10.1097/MLR.0000000000002078

Nurse Educ. 2024 Oct 9. doi: 10.1097/NNE.0000000000001744. Online ahead of print.

ABSTRACT

BACKGROUND: Nursing students experience significantly more stress related diseases when compared to non-nursing students, and the state of their mental health can result in short-term increased attrition rates and increased nursing shortages.

PURPOSE: A preexperimental pre-post study design was used to examine mental health and healthy behaviors among prenursing students.

METHODS: Cohorts received the MINDSTRONG© program either in-person or virtually. Data analysis included Personal Wellness Assessments completed at both pre- and poststudy for all participants (n = 110).

RESULTS: Both groups postintervention had statistically significant decreases in anxiety, depression, and stress and statistically significant increases in healthy lifestyle behaviors and beliefs. Students with elevated depression and anxiety scores at baseline had greater decreases postintervention than the overall groups.

CONCLUSION: The outcomes for both cohorts were positive and effective in reducing stress, anxiety, and depressive symptoms. Healthy behaviors were improved and align with findings with an in-person format. Findings from this study support implementation of MINDSTRONG in synchronous sessions, either in-person or virtual.

PMID:39733228 | DOI:10.1097/NNE.0000000000001744