Category: Nevin Manimala

J Sep Sci. 2024 Mar;47(5):e2300923. doi: 10.1002/jssc.202300923.

ABSTRACT

Regorafenib is a small-molecule tyrosine kinase inhibitor with severe hepatotoxicity. It undergoes metabolism mainly by CYP3A4 to generate active metabolites regorafenib-N-oxide (M2) and N-desmethyl-regorafenib-N-oxide (M5). Wuzhi capsule (WZC) is an herbal preparation derived from Schisandra sphenanthera and is potentially used to prevent regorafenib-induced hepatotoxicity. This study aims to explore the effect of WZC on the pharmacokinetics of regorafenib in rats. An efficient and sensitive liquid chromatography-tandem mass spectrometry method was developed to quantitatively determine regorafenib and its main metabolites in rat plasma. The proposed method was applied to the pharmacokinetic study of regorafenib in rats, with or without WZC. Coadministration of regorafenib with WZC resulted in a prolonged mean residence time (MRT) of the parent drug but had no statistically significant difference in other pharmacokinetic parameters. While for the main metabolites of regorafenib, WZC decreased the area under the curve and maximum concentration (C_max ), delayed the time to reach C_max , and prolonged the MRT of M2 and M5. These results indicate that WZC delayed and inhibited the metabolism of regorafenib to M2 and M5 by suppressing CYP3A4. Our study provides implications for the rational use of the WZC-regorafenib combination in clinical practice.

PMID:38466147 | DOI:10.1002/jssc.202300923

J Head Trauma Rehabil. 2024 Mar 11. doi: 10.1097/HTR.0000000000000937. Online ahead of print.

ABSTRACT

OBJECTIVE: Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for insomnia, but there is limited evidence on the treatment effect of CBT-I in individuals after a concussion. Therefore, the main purpose of this study was to evaluate the treatment effect of CBT-I on sleep outcomes and postconcussion symptoms.

SETTING: This study was conducted at an academic institution. The CBT-I sessions were conducted using a teleconferencing system (Zoom).

PARTICIPANTS: Participants were eligible to participate if they were at least 4 weeks post- concussion, aged 18 to 64 years, and scored 10 or more on the Insomnia Severity Index. A total of 40 people were enrolled; 32 participants were included in analyses.

DESIGN: This was a randomized controlled wait-list study. Participants were randomized into starting the CBT-I intervention immediately after the baseline assessment or into the wait-list group for 6 weeks before starting CBT-I. Assessments were performed at baseline, 6, 12, and 18 weeks.

MAIN MEASURES: The primary outcome was the Insomnia Severity Index. Secondary measures included the Pittsburg Sleep Quality Index, Post-Concussion Symptom Scale, and Beck Depression and Anxiety Inventories. Statistical analyses included a repeated-measures analysis of variance, t tests, and mixed linear regression modeling.

RESULTS: There was a group-by-time interaction for the sleep outcomes but not for the concussion or mood outcomes. Differences were seen between groups on sleep outcomes, symptom severity, and depression. The treatment effect was maintained following CBT-I for all outcomes. Improvement in sleep outcomes was predictive of improvement in postconcussion symptom severity and number of symptoms.

CONCLUSIONS: CBT-I reduces insomnia in individuals with concussions, and improved sleep was associated with lower postconcussion and mood symptoms. These effects were maintained 6 to 12 weeks following the intervention.

PMID:38466122 | DOI:10.1097/HTR.0000000000000937

Mol Biol Evol. 2024 Mar 11:msae053. doi: 10.1093/molbev/msae053. Online ahead of print.

ABSTRACT

Ancient DNA can directly reveal the contribution of natural selection to human genomic variation. However, while the analysis of ancient DNA has been successful at identifying genomic signals of selection, inferring the phenotypic consequences of that selection has been more difficult. Most trait-associated variants are non-coding, so we expect that a large proportion of the phenotypic effects of selection will also act through non-coding variation. Since we cannot measure gene expression directly in ancient individuals, we used an approach (Joint-Tissue Imputation; JTI) developed to predict gene expression from genotype data. We tested for changes in the predicted expression of 17,384 protein coding genes over a time transect of 4500 years using 91 present-day and 616 ancient individuals from Britain. We identified 28 genes at seven genomic loci with significant (FDR < 0.05) changes in predicted expression levels in this time period. We compared the results from our transcriptome-wide scan to a genome-wide scan based on estimating per-SNP selection coefficients from time series data. At five previously identified loci, our approach allowed us to highlight small numbers of genes with evidence for significant shifts in expression from peaks that in some cases span tens of genes. At two novel loci (SLC44A5 and NUP85), we identify selection on gene expression not captured by scans based on genomic signatures of selection. Finally we show how classical selection statistics (iHS and SDS) can be combined with JTI models to incorporate functional information into scans that use present-day data alone. These results demonstrate the potential of this type of information to explore both the causes and consequences of natural selection.

PMID:38466119 | DOI:10.1093/molbev/msae053

Cereb Cortex. 2024 Mar 1;34(3):bhae065. doi: 10.1093/cercor/bhae065.

ABSTRACT

Mild cognitive impairment plays a crucial role in predicting the early progression of Alzheimer’s disease, and it can be used as an important indicator of the disease progression. Currently, numerous studies have focused on utilizing the functional brain network as a novel biomarker for mild cognitive impairment diagnosis. In this context, we employed a graph convolutional neural network to automatically extract functional brain network features, eliminating the need for manual feature extraction, to improve the mild cognitive impairment diagnosis performance. However, previous graph convolutional neural network approaches have primarily concentrated on single modes of brain connectivity, leading to a failure to leverage the potential complementary information offered by diverse connectivity patterns and limiting their efficacy. To address this limitation, we introduce a novel method called the graph convolutional neural network with multimodel connectivity, which integrates multimode connectivity for the identification of mild cognitive impairment using fMRI data and evaluates the graph convolutional neural network with multimodel connectivity approach through a mild cognitive impairment diagnostic task on the Alzheimer’s Disease Neuroimaging Initiative dataset. Overall, our experimental results show the superiority of the proposed graph convolutional neural network with multimodel connectivity approach, achieving an accuracy rate of 92.2% and an area under the Receiver Operating Characteristic (ROC) curve of 0.988.

PMID:38466115 | DOI:10.1093/cercor/bhae065

Biol Open. 2024 Mar 11:bio.060286. doi: 10.1242/bio.060286. Online ahead of print.

ABSTRACT

Distinguishing clinical subgroups for patients suffering with diseases characterized by a wide phenotypic spectrum is essential for developing precision therapies. Patients with gain-of-function (GOF) variants in the SCN8A gene exhibit substantial clinical heterogeneity, viewed historically as a linear spectrum ranging from mild to severe. To test for hidden clinical subgroups, we applied two machine learning algorithms to analyze a dataset of patient features collected by the International SCN8A Patient Registry. We utilized two research methodologies: a supervised approach that incorporated feature severity cutoffs based on clinical conventions, and an unsupervised approach employing an entirely data-driven strategy. Both approaches found statistical support for three distinct subgroups and were validated by correlation analyses utilizing external variables. However, distinguishing features of the three subgroups within each approach were not concordant, suggesting a more complex phenotypic landscape. The unsupervised approach yielded strong support for a model involving three partially-ordered subgroups rather than a linear spectrum. Application of these machine-learning approaches may lead to improved prognosis and clinical management of individuals with SCN8A GOF variants and provide insights into the underlying mechanisms of the disease.

PMID:38466077 | DOI:10.1242/bio.060286

Altern Ther Health Med. 2024 Mar 8:AT9918. Online ahead of print.

ABSTRACT

BACKGROUND: Colon cancer is a common malignant tumor that often leads to intestinal obstruction, resulting in significant morbidity and mortality. Early and accurate diagnosis of colon cancer and associated ileus is crucial for timely treatment and improved patient outcomes. Various diagnostic methods, including MSCT and MRI, are currently used in clinical practice. However, the optimal imaging approach for accurate diagnosis remains uncertain.

OBJECTIVE: To study the value and accuracy of multi-slice spiral CT (MSCT) combined with magnetic resonance imaging (MRI) in diagnosing colon cancer obstruction.

METHODS: A retrospective analysis was performed on 100 cases of colon cancer and ileus patients admitted to the Hai’an Hospital of Chinese Medicine from January 2019 to July 2020. The cases were randomly divided into control and experimental groups, with 50 cases in each. The control group was diagnosed with MSCT, and the experimental group was diagnosed with MRI based on the control group. The positive and negative detection rates, test accuracy, sensitivity, and specificity were compared between the 2 groups. The area under the curve (AUC), quality of life (QOL) score, and mental status scale in non-psychiatric settings (MSSNS) score were calculated with the receiver operator characteristic curve (ROC) and compared between the 2 groups.

RESULTS: The test accuracy, positive detection rate, negative detection rate, test specificity, sensitivity, and AUC of the experimental group were significantly higher than those of the control group, and the results were statistically significant (P < .05). There was no significant difference in the QOL and the MSSNS scores between the 2 groups (P > .05).

CONCLUSION: MSCT combined with MRI has a high application value in diagnosing colon cancer obstruction patients, and can significantly improve the test’s accuracy, specificity and sensitivity.

PMID:38466066

Altern Ther Health Med. 2024 Mar 8:AT10475. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the effects of geriatric experience training on nurses from multiple primary healthcare units in the context of population aging. The study also evaluated the impact of this training on improving nurses’ cognitive abilities in preventing falls/bedside accidents in elderly patients and implementing safe nursing practices to reduce the incidence of falls/bedside accidents.

METHODS: A total of 302 nurses involved in geriatric care from 18 primary healthcare units in the region were randomly categorized into 2 groups on a 1:1 basis. The control group received regular training on falls/bedside accident prevention for patients, whereas the observation group received additional geriatric experience training along with the regular training. Further, 420 elderly patients who experienced moderate-to-severe falls/bedside accidents between February and July 2022, with a Morse Fall Scale (MFS) score of ≥25 were randomly assigned to either the observation or control group on a 1:1 basis. This study compared the 2 groups in terms of nurses’ awareness of falls/bedside accident risks, incidence of falls/bedside accidents in patients and patient satisfaction with fall/bedside accident prevention care.

RESULTS: No statistically significant differences were observed (P > .05) between the 2 groups of nurses, except in their awareness of the aging population and the increased risk for falls/bedside accidents in elderly patients. However, the observation group nurses scored higher in other aspects of falls/bedside accident risk awareness after undergoing geriatric experience training (P < .05). The incidence of falls/bedside accidents was significantly lower in the observation group than in the control group (P < .05). Patient satisfaction with falls/bedside accident prevention care was significantly higher in the observation group compared with the control group (P < .05).

CONCLUSION: Geriatric experience training for nurses in multiple primary healthcare units in the region could effectively improve the capabilities of primary hospitals in preventing falls/bedside accidents.

PMID:38466065

Altern Ther Health Med. 2024 Mar 8:AT10035. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study aimed to investigate the clinical efficacy of hightibialosteotomy (HTO) posterior plate placement combined with arthroscopic surgery for degenerative injury of the posterior horn of the medial meniscus with poor force lines in the lower extremity, improve joint function or relieve pain.

METHODS: The case data of 98 patients with osteoarthritis of the knee admitted to the Department of Orthopedics in our hospital from January 2019 to January 2023 were selected for retrospective analysis. The patients were divided into 54 patients, each in the study group and the comparison group according to the different treatment regimens. The study group received hightibialosteotomy plate placement combined with arthroscopic surgery, while the comparison group underwent hightibialosteotomy plate placement alone. The differences in knee scores, knee Lysholm scores, Lysholm scores, Healthcare Security and Safety (HSS) scores, Tegner scores, Visual Analog Scale (VAS), lower extremity force lines, femorotibial angles, and tibial plateau were counted and compared between the two groups.

RESULTS: HSS knee function scores, Lysholm scores, and VAS scores of the study group were statistically significant compared with those of the comparison group at the final follow-up of patients, and the postoperative clinical outcomes improved significantly (P < .05). The differences in Hip-Knee-Ankle(HKA) angle andMedial-Pateral Tibial Angle (MPTA) of patients in the study group were statistically significant compared with the comparison group, and the increase in HKA (12.31±2.13)°, MPTA (11.84±2.32)° and lower limb force line was significantly improved (P < .05). Preoperatively, there was no statistically significant comparison between the visual analog scores of the knee joint in the study group and the comparison group. After surgery, the difference between the two groups was statistically significant (P < .05). The relative position of the mechanical axis of the lower limb through the tibial plateau, the femorotibial angle, and the posterior tibial plateau angle increased in patients after surgery, and the differences were statistically significant when compared with the preoperative period (P < .05). Both the tibial posterior displacement distance and the lateral knee gap opening were reduced compared with the preoperative period, and the differences were statistically significant (P < .05).

CONCLUSION: Hightibialosteotomy after plate placement combined with arthroscopic surgery has better clinical efficacy in the early stage and can effectively treat the degenerative injury of the posterior horn of the medial meniscus with poor force lines in the lower limb, improve the joint function, and relieve the symptoms of patients.

PMID:38466058

Altern Ther Health Med. 2024 Mar 8:AT9919. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the risk factors for cancer malnutrition after radical tumor resection.

METHODS: A total of 110 cancer patients who used parenteral nutrition from January 2022 to June 2023 were selected for retrospective analysis and 50 patients who did not need parenteral nutrition support after radical tumor resection were selected as the control group to analyze the general data of the two groups. Univariate and multivariate logistic analyses were used to determine the factors influencing malnutrition in patients supported by parenteral nutrition after radical tumor resection.

RESULTS: The age(P = .032), body mass index(P = .012), education level(P = .025), per capita monthly household income(P = .029), concurrent chemotherapy ratio(P = .035), phobia disease progression(P = .037), and depression(P = .038) of patients who underwent parenteral nutrition after radical tumor resection were all influencing factors, and the differences were statistically significant (P < .034). After undergoing a radical tumor resection, patients with dysphagia grade 2-3, loss of appetite grade 2-3, and nausea and vomiting grade 2-3, as well as diarrhea grade 2-3, require parenteral nutrition support. The risk factors for malnutrition in patients who require such support include age, education, per capita household income, fear of disease progression, depression, pain, and diarrhea.

CONCLUSION: Patients may suffer from malnutrition after radical tumor resection and need parenteral nutrition support, including age, education level, per capita monthly household income, fear of disease progression, depression, pain, diarrhea, etc., so in clinical nursing, nursing staff should pay more attention to such high-risk factors, so as to carry out personalized nursing programs for patients undergoing radical tumor resection and improve the effectiveness of disease treatment.

PMID:38466055

Adv Mind Body Med. 2023 Fall;37(4):4-11.

ABSTRACT

CONTEXT: The use of music in obstetrics increases every day, and it is extensively used in the control of labor pain.

OBJECTIVE: This study was conducted to determine the effect of music on labor pain and duration.

DESIGN AND SETTING: This systematic review and meta-analysis was carried out between October 15 and November 15, 2022. The search was done in the PubMed and ScienceDirect, MEDLINE, Ovid, EBSCO CINAHL Plus, and Cochrane Library databases.

OUTCOMES MEASSURES: According to the inclusion criteria, 12 studies included in the systematic review and meta-analysis were determined. The data were analyzed using Review Manager 5.4. The methodological quality of the studies was assessed with the RoB 2 tool.

RESULTS: Twelve articles were included in this study. According to the study results, listening to music was revealed to be statistically significantly effective in reducing pain intensity in terms of relieving labor pain (SMD:-0.98, Z=8.33, P < .001). Listening to music in the active phase was found to further decrease pain intensity compared to the latent phase (latent phase: SMD:-0.56 and active phase: SMD:-1.26), but it did not affect labor duration (MD:-0.76, Z=1.72, P = .09).

CONCLUSION: Listening to music was determined to be effective in reducing pain intensity. The music genre selected by the researchers was found to further reduce pain intensity during labor compared to pregnant women’s own choices, and it was elucidated that listening to music with headphones was effective in pain control but listening to music did not affect labor duration.

PROSPERO REGISTRATION NO: CRD42022367480.

PMID:38466048