Category: Nevin Manimala

Altern Ther Health Med. 2024 Jun 7:AT10359. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to investigate the efficacy of an Internet Plus-oriented 5A home care model in managing complications arising from tumor immunotherapy among patients in the post-epidemic era. Specifically, the study focuses on skin toxicity and gastrointestinal toxicity in patients undergoing tumor immunotherapy.

METHODS: Between January 2022 and March 2023, 80 patients experiencing skin and gastrointestinal toxicities post-tumor immunotherapy in Zhangjiagang Traditional Chinese Medicine Hospital were selected. The patients were divided into two groups: a control group and an experimental group, each comprising 40 patients. The control group received traditional routine nursing and a telephone follow-up strategy. In contrast, the experimental group was introduced to a 5A home care model guided by Internet Plus, involving five key stages of implementation. Nurses utilized the Internet Plus platform to provide timely responses to patient queries and concerns. After the intervention, skin and gastrointestinal toxicity grades were assessed on days 0, 7, 14, and 21. Additionally, the completion rates of immunotherapy follow-up were compared between the two groups.

RESULTS: At day 0, there was no statistically significant difference in skin and gastrointestinal toxicity grades between the two groups (P > .05). However, on days 7, 14, and 21, both groups showed improvements compared to day 0, with the experimental group exhibiting significantly better outcomes and lower toxicity grades than the control group (RR: 0.667, 95% CI (-1.204, 0.394)). The completion rate of immunotherapy in the experimental group (97.5%) was significantly higher than that in the control group (77.5%), with a notable statistical difference (RR:1.258, 95%CI (-0.258, 0.722), P = .004). In the control group, 4 patients refused treatment, and 4 voluntarily terminated treatment, whereas only 1 patient in the experimental group voluntarily terminated treatment.

CONCLUSION: In conclusion, the Internet Plus-oriented 5A home care model enhances patient outcomes, demonstrating improved skin and gastrointestinal toxicities and a higher completion rate of immunotherapy compared to traditional nursing approaches. This model offers a more convenient and personalized health management approach, providing valuable insights for the clinical practice and future advancement of tumor immunotherapy.

PMID:38843414

Am J Drug Alcohol Abuse. 2024 Jun 6:1-11. doi: 10.1080/00952990.2024.2344482. Online ahead of print.

ABSTRACT

Background: This study explored the increased quantity and frequency of alcohol use in the American Indian (AI) population during the COVID-19 pandemic.Objectives: The aims of this study were to explore possible associations between covariables and both binge drinking and alcohol consumption during COVID-19.Methods: This cross-sectional survey study analyzed data from a sample of AI individuals (63% female) residing in California (n = 411) and Oklahoma (n = 657) between October 2020-January 2021. Analysis included summary statistics and multivariable logistic regression, including a variety of socio-economic, COVID-19 concern, and tobacco and marijuana use variables.Results: One or more alcohol binge episodes were reported between October 2020-January 2021 in 19.3% of participants and elevated overall alcohol consumption was reported by 21.6% of participants. Higher odds of elevated alcohol consumption occurred in women and those following more social distancing measures. The odds of binge drinking or elevated alcohol consumption in those using both marijuana and tobacco (aOR/ adjusted odds ratio:18.9, 95% CI = 8.5, 42.2, and aOR:3.9, 95% CI = 1.7, 8.6, respectively) were higher compared to those using neither. Similarly, the odds of binge drinking or elevated alcohol consumption in those using tobacco only (aOR:4.7, 95% CI = 2.9, 7.7 and aOR: 2.0, 95% CI = 1.1, 3.5, respectively) were higher compared to those using neither.Conclusions: This study found high rates of alcohol use and bingeing during the COVID-19 pandemic. Offering collaborative, culturally sensitive, and affordable support services are important components of intervention and preparation for future stressful events on local, as well as global levels.

PMID:38843382 | DOI:10.1080/00952990.2024.2344482

J Bone Miner Res. 2024 Jun 6:zjae082. doi: 10.1093/jbmr/zjae082. Online ahead of print.

ABSTRACT

Although the negative association of tobacco smoking with osteoporosis is well-documented, little is known regarding the shared genetic basis underlying these conditions. In this study, we aim to investigate a shared genetic architecture between smoking and heel estimated bone mineral density (eBMD), a reliable proxy for osteoporosis. We conducted a comprehensive genome-wide cross-trait analysis to identify genetic correlation, pleiotropic loci and causal relationship of smoking with eBMD, leveraging summary statistics of the hitherto largest genome-wide association studies conducted in European ancestry for smoking initiation (Nsmoker = 1 175 108, Nnonsmoker = 1 493 921), heaviness (cigarettes per day, N = 618 489), cessation (Ncurrent smoker = 304 244, Nformer smoker = 843 028), and eBMD (N = 426 824). A significant negative global genetic correlation was found for smoking cessation and eBMD (${r}_g$ = -0.051, P = 0.01), while we failed to identify a significant global genetic correlation of smoking initiation or heaviness with eBMD. Partitioning the whole genome into independent blocks, we observed six significant shared local signals for smoking and eBMD, with 22q13.1 showing the strongest regional genetic correlation. Such a genetic overlap was further supported by 71 pleiotropic loci identified in the cross-trait meta-analysis. Mendelian randomization identified no causal effect of smoking initiation (beta = -0.003 g/cm2, 95%CI = -0.033-0.027) or heaviness (beta = -0.017 g/cm2, 95%CI = -0.072-0.038) on eBMD, but a putative causal effect of genetic predisposition to being a current smoker was associated with a lower eBMD compared to former smokers (beta = -0.100 g/cm2, 95%CI = -0.181- – 0.018). Our study demonstrates a pronounced biological pleiotropy as well as a putative causal link between current smoking status and eBMD, providing novel insights into the primary prevention and modifiable intervention of osteoporosis by advocating individuals to avoid, reduce or quit smoking as early as possible.

PMID:38843381 | DOI:10.1093/jbmr/zjae082

PLoS Genet. 2024 Jun 6;20(6):e1011317. doi: 10.1371/journal.pgen.1011317. Online ahead of print.

ABSTRACT

Evaluation of the apportionment of genetic diversity of human bacterial commensals within and between human populations is an important step in the characterization of their evolutionary potential. Recent studies showed a correlation between the genomic diversity of human commensal strains and that of their host, but the strength of this correlation and of the geographic structure among human populations is a matter of debate. Here, we studied the genomic diversity and evolution of the phylogenetically related oro-nasopharyngeal healthy-carriage Streptococcus mitis and Streptococcus pneumoniae, whose lifestyles range from stricter commensalism to high pathogenic potential. A total of 119 S. mitis genomes showed higher within- and among-host variation than 810 S. pneumoniae genomes in European, East Asian and African populations. Summary statistics of the site-frequency spectrum for synonymous and non-synonymous variation and ABC modelling showed this difference to be due to higher ancestral bacterial population effective size (Ne) in S. mitis, whose genomic variation has been maintained close to mutation-drift equilibrium across (at least many) generations, whereas S. pneumoniae has been expanding from a smaller ancestral bacterial population. Strikingly, both species show limited differentiation among human populations. As genetic differentiation is inversely proportional to the product of effective population size and migration rate (Nem), we argue that large Ne have led to similar differentiation patterns, even if m is very low for S. mitis. We conclude that more diversity within than among human populations and limited population differentiation must be common features of the human microbiome due to large Ne.

PMID:38843312 | DOI:10.1371/journal.pgen.1011317

PLOS Glob Public Health. 2024 Jun 6;4(6):e0001080. doi: 10.1371/journal.pgph.0001080. eCollection 2024.

ABSTRACT

Gender preference often results in low use of contraceptives and parity progression, which can increase the risks of morbidity and mortality for women. This study aimed to identify gender preference and fertility behavior, including contraceptive use and the desire for additional children, among married women. A cross-sectional descriptive study was conducted using systematic random sampling to select280 household, with one respondent interviewed from each household using a semi-structured interview schedule. Descriptive and inferential statistical analysis were performed on the collected data. Of 280 respondents, 44.6% were aged 26-35 years (mean30.23±7.39 years). Most (74.3%) were literate, and 70% were paid worker. Son preference was reported by 53%, with support in old age (87.2%) being the main reason. Gender preference was 60.5% less likely among Bramhin/Chhetri ethnic groups (p = 0.033) and 71.3% less likely if husbands were literate (p = 0.002). Contraception use was 90.7%, but 31.8% desired additional children. Permanent contraceptive method use was 9.387 times more likely above age 30 years (p = <0.001), independent of respondents’ and husbands’ education, sex composition of children, and having a preferred child. Desire for more children was 6.813 times more likely below age 30 years (p = <0.001) and 5.875 times more likely with 1-2 living children (p = 0.001), independent of respondents’ and husbands education.The study concludes that son preference persisted among the illiterate. Contraceptive use was lower among respondents below 30 years. Enhancing educational status may reduce gender bias. Targeting family planning to women below 30 years could improve contraceptive utilization in this age group.

PMID:38843303 | DOI:10.1371/journal.pgph.0001080

PLoS Negl Trop Dis. 2024 Jun 6;18(6):e0012232. doi: 10.1371/journal.pntd.0012232. eCollection 2024 Jun.

ABSTRACT

BACKGROUND: Ocular toxoplasmosis (OT) is the most common cause of infectious uveitis worldwide, including Thailand. This study describes the clinical presentation, visual acuity (VA) outcomes, and factors associated with VA loss in patients with active OT following antiparasitic treatment.

METHODOLOGY/PRINCIPAL FINDINGS: A retrospective chart review of patients with active OT treated with antiparasitic drugs between 2010 and 2020 was performed. Outcome measures included clinical characteristics, interval VA, and predictive factors associated with loss of VA ≤ 20/50 at 6 months post-treatment. Ninety-two patients (95 eyes) were enrolled. The median follow-up time was 10.9 months (IQR 4.9-31.8 months). The median age at presentation was 35.9 years, 51% were male, and 92.4% had unilateral OT. Eleven patients (12%) were immunocompromised (HIV infection, eight patients; receiving immunosuppressive agents, three patients). Patients mainly presented with primary retinitis without previous scar (62%), posterior pole lesion (56%), and lesion size of ≤ 2-disc area (75%). Immunocompromised patients showed a significantly larger size of retinitis than immunocompetent patients. Oral trimethoprim/sulfamethoxazole monotherapy was the primary short-term antiparasitic drug prescribed (85%). At the final visit, 21% of all affected eyes suffered VA ≤ 20/200. The cumulative incidence of recurrent OT at three years was 33.9% (95% CI, 19.7%-54.2%). Immunocompromised patients [adjusted odds ratio (aOR) 4.9, p = 0.041], macular lesion (aOR 5.4, p = 0.032), and initial VA ≤ 20/200 (aOR 9.1, p = 0.014) were predictive of having VA ≤ 20/50 at 6 months post-treatment.

CONCLUSIONS: Ocular toxoplasmosis mainly presents as unilateral primary retinitis within the posterior pole. Severe VA loss was observed in one-fifth of eyes following treatment with lesion resolution. Immunocompromised patients, eyes with macular lesions, and poor initial VA were associated with poor VA outcomes.

PMID:38843299 | DOI:10.1371/journal.pntd.0012232

PLoS One. 2024 Jun 6;19(6):e0303065. doi: 10.1371/journal.pone.0303065. eCollection 2024.

ABSTRACT

The detoxification efflux carriers (DTX) are a significant group of multidrug efflux transporter family members that play diverse functions in all kingdoms of living organisms. However, genome-wide identification and characterization of DTX family transporters have not yet been performed in banana, despite its importance as an economic fruit plant. Therefore, a detailed genome-wide analysis of DTX family transporters in banana (Musa acuminata) was conducted using integrated bioinformatics and systems biology approaches. In this study, a total of 37 DTX transporters were identified in the banana genome and divided into four groups (I, II, III, and IV) based on phylogenetic analysis. The gene structures, as well as their proteins’ domains and motifs, were found to be significantly conserved. Gene ontology (GO) annotation revealed that the predicted DTX genes might play a vital role in protecting cells and membrane-bound organelles through detoxification mechanisms and the removal of drug molecules from banana cells. Gene regulatory analyses identified key transcription factors (TFs), cis-acting elements, and post-transcriptional regulators (miRNAs) of DTX genes, suggesting their potential roles in banana. Furthermore, the changes in gene expression levels due to pathogenic infections and non-living factor indicate that banana DTX genes play a role in responses to both biotic and abiotic stresses. The results of this study could serve as valuable tools to improve banana quality by protecting them from a range of environmental stresses.

PMID:38843276 | DOI:10.1371/journal.pone.0303065

PLoS One. 2024 Jun 6;19(6):e0303354. doi: 10.1371/journal.pone.0303354. eCollection 2024.

ABSTRACT

BACKGROUND: Vietnam is experiencing an increasing prevalence of hypertension in its adult population. In addition to medical therapy, modifying adverse lifestyle practices is important for effective blood pressure control. There are limited data on unhealthy lifestyle practices in patients with chronic diseases, however, particularly among hypertensive patients living in rural Vietnam. Our study objectives were to examine the prevalence of unhealthy lifestyle practices and associated factors among rural Vietnamese adults with uncontrolled hypertension.

METHODS: Data from the baseline survey of a cluster randomized trial among hypertensive Vietnamese adults (2017-2022) were utilized. Information on unhealthy lifestyle practices including smoking, excessive alcohol consumption, physical inactivity, and inadequate fruit and vegetable intake was collected from study participants. The primary study outcome was having ≥2 unhealthy lifestyle practices. A multivariable logistic regression model was used to examine factors associated with the primary study outcome.

RESULTS: The mean age of the 671 patients was 67 years and 45.0% were men. Nearly three out of every four participants had one or fewer unhealthy practices, 24.0% had two, and 3.3% had three or all four unhealthy lifestyle practices. Men, individuals who did unpaid work or were unemployed, and individuals with hypertension level III were more likely to have ≥2 unhealthy lifestyle practices, whereas individuals with higher education were less likely to have ≥2 unhealthy lifestyle practices compared with respective comparison groups.

CONCLUSIONS: We observed a high prevalence of unhealthy lifestyle practices among rural Vietnamese patients with uncontrolled hypertension. Several demographic factors were associated with a greater number of unhealthy lifestyle practices. Newer interventions and educational programs encouraging lifestyle modification practices are needed to control hypertension among adults living in rural settings of Vietnam.

PMID:38843274 | DOI:10.1371/journal.pone.0303354

PLoS One. 2024 Jun 6;19(6):e0304162. doi: 10.1371/journal.pone.0304162. eCollection 2024.

ABSTRACT

BACKGROUND: Pulmonary tuberculosis (PTB) is the most common type of tuberculosis (TB). Rapid diagnosis of PTB can help in TB control. Although the use of molecular tests (such as the GeneXpert MTB/RIF) has improved the ability to rapidly diagnose PTB, there is still room for improvement. Nanopore sequencing is a novel means of rapid TB detection. The purpose of this study was to establish a systematic review and meta-analysis protocol for evaluating the accuracy of nanopore sequencing for the rapid diagnosis of PTB.

METHODS: We completed this protocol according to the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement and registered on the PROSPERO platform. We will screen studies related to nanopore sequencing for diagnosis of PTB by searching through PubMed, EMBASE, the Cochrane Library using English, and Wanfang database, CNKI (China National Knowledge Infrastructure) using Chinese. Eligible studies will be screened according to the inclusion and exclusion criteria established in the study protocol. We will evaluate the methodological quality of the individual included studies using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We will use Stata (version 15.0) with the midas command and RevMan (version 5.3) for meta-analysis and forest plots and SROC curves generation. A p < 0.05 was treated as a statistically significant difference. When significant heterogeneity exists between studies, we will explore sources of heterogeneity through meta-regression analysis and subgroup analysis.

CONCLUSION: To the best of our knowledge, this will be the first systematic review and meta-analysis of nanopore sequencing for the diagnosis of PTB. We hope that this study will find a new and effective tool for the early diagnosis of PTB.

PROSPERO REGISTRATION NUMBER: CRD42023495593.

PMID:38843269 | DOI:10.1371/journal.pone.0304162

PLoS One. 2024 Jun 6;19(6):e0301425. doi: 10.1371/journal.pone.0301425. eCollection 2024.

ABSTRACT

BACKGROUND: The influence of center volume on kidney transplant outcomes is a topic of ongoing debate. In this study, we employed competing risk analyses to accurately estimate the marginal probability of graft failure in the presence of competing events, such as mortality from other causes with long-term outcomes. The incorporation of immunosuppression protocols and extended follow-up offers additional insights. Our emphasis on long-term follow-up aligns with biological considerations where competing risks play a significant role.

METHODS: We examined data from 219,878 adult kidney-only transplantations across 256 U.S. transplant centers (January 2001-December 2015) sourced from the Organ Procurement and Transplantation Network registry. Centers were classified into quartiles by annual volume: low (Q1 = 28), medium (Q2 = 75), medium-high (Q3 = 121), and high (Q4 = 195). Our study investigated the relationship between center volume and 5-year outcomes, focusing on graft failure and mortality. Sub-population analyses included deceased donors, living donors, diabetic recipients, those with kidney donor profile index >85%, and re-transplants from deceased donors.

RESULTS: Adjusted cause-specific hazard ratios (aCHR) for Five-Year Graft Failure and Patient Death were examined by center volume, with low-volume centers as the reference standard (aCHR: 1.0). In deceased donors, medium-high and high-volume centers showed significantly lower cause-specific hazard ratios for graft failure (medium-high aCHR = 0.892, p<0.001; high aCHR = 0.953, p = 0.149) and patient death (medium-high aCHR = 0.828, p<0.001; high aCHR = 0.898, p = 0.003). Among living donors, no significant differences were found for graft failure, while a trend towards lower cause-specific hazard ratios for patient death was observed in medium-high (aCHR = 0.895, p = 0.107) and high-volume centers (aCHR = 0.88, p = 0.061).

CONCLUSION: Higher center volume is associated with significantly lower cause-specific hazard ratios for graft failure and patient death in deceased donors, while a trend towards reduced cause-specific hazard ratios for patient death is observed in living donors.

PMID:38843258 | DOI:10.1371/journal.pone.0301425