Category: Nevin Manimala

Oncologist. 2024 Mar 2:oyae031. doi: 10.1093/oncolo/oyae031. Online ahead of print.

ABSTRACT

PURPOSE: Male breast cancer (MBC) is a rare, but increasingly common disease, and lacks prospective studies. Collaborative efforts are needed to understand and address MBC, including its prognosis, in different countries.

METHODS: We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data.

RESULTS: We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively.

CONCLUSION: Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.

PMID:38431780 | DOI:10.1093/oncolo/oyae031

Environ Int. 2024 Feb 24;185:108500. doi: 10.1016/j.envint.2024.108500. Online ahead of print.

ABSTRACT

Recent research suggests a link between air pollution and cognitive development in children, and studies on air pollution and academic achievement are emerging. We conducted a nationwide cohort study in Denmark to explore the associations between lifetime exposure to air pollution and academic performance in 9th grade. The study encompassed 785,312 children born in Denmark between 1989 and 2005, all of whom completed 9th-grade exit examinations. Using linear mixed models with a random intercept for each school, we assessed the relationship between 16 years of exposure to PM_2.5, PM₁₀, and gaseous pollutants and Grade Point Averages (GPA) in exit examinations, covering subjects such as Danish literature, Danish writing, English, mathematics, and natural sciences. The study revealed that a 5 µg/m³ increase in PM_2.5 and PM₁₀ was associated with a decrease of 0.99 (95 % Confidence Intervals: -1.05, -0.92) and 0.46 (-0.50, -0.41) in GPA, respectively. Notably, these negative associations were more pronounced in mathematics and natural sciences compared to language-related subjects. Additionally, girls and children with non-Danish mothers were found to be particularly susceptible to the adverse effects of air pollution exposure. These results underscore the potential long-term consequences of air pollution on academic achievement, emphasizing the significance of interventions that foster healthier environments for children’s cognitive development.

PMID:38430583 | DOI:10.1016/j.envint.2024.108500

J Anim Sci. 2024 Mar 2:skae056. doi: 10.1093/jas/skae056. Online ahead of print.

ABSTRACT

To investigate effects of inorganic or complexed trace mineral source (zinc, copper, manganese, and cobalt) on receiving period performance and morbidity, crossbred beef heifer calves (n = 287) arriving on 3 delivery dates were used in a 42-day receiving trial. Heifers were processed after arrival, stratified by d -1 body weights (BW) and allocated randomly to 8 pens (11 to 13 heifers/pen, 24 pens total). Within truckload, pens were assigned randomly to dietary treatment (n = 12 pens/treatment). Heifers were housed on 0.42-ha grass paddocks, provided ad libitum bermudagrass hay and provided dietary treatments in grain supplements fed daily. Treatments consisted of supplemental zinc (360 mg/d), copper (125 mg/d), manganese (200 mg/d), and cobalt (12 mg/d) from complexed (Zinpro® Availa® 4, Zinpro Corp. Eden Prairie, MN) or inorganic sources (sulfates). Heifers were observed daily for clinical bovine respiratory disease (BRD). If presenting BRD symptoms and rectal temperature ≥ 40°C, heifers were deemed morbid and treated with antibiotics. Six heifers/pen were bled to determine serum haptoglobin concentrations on days 0, 14 and 28. Liver biopsies were taken on d 5 ± 2 and 43 ± 1 from 3 calves selected randomly from each pen for mineral status comparisons. Statistical analyses were performed using MIXED, GLIMMIX, and repeated measures procedures of SAS 9.4 with truckload as a random effect and pen within truckload specified as subject. There tended to be a treatment by day interaction for BW (P = 0.07). Heifer BW did not differ on day 0 (P = 0.82) and day 14 (P = 0.36), but heifers fed complexed trace minerals had greater BW on day 28 (P = 0.04) and day 42 (P = 0.05). Overall average daily gains were greater for heifers fed complexed trace minerals (P = 0.05; 0.78 vs. 0.70 kg, SE = 0.03). Heifers supplemented with inorganic trace minerals had greater BRD incidence (P = 0.03; 58 vs. 46%, SE = 3.6). Haptoglobin concentrations decreased throughout the trial (P < 0.001), and heifers fed complexed trace minerals tended to have a decrease in haptoglobin concentrations (P = 0.07). The source of trace mineral supplementation had no effect (P ≥ 0.20) on liver mineral concentrations and there were no treatment × day interactions (P ≥ 0.35). In conclusion, supplementing diets for the first 42 days after arrival with complexed trace mineral sources improved heifer performance as compared to heifers supplemented with inorganic trace minerals.

PMID:38430558 | DOI:10.1093/jas/skae056

Int J Cancer. 2024 Mar 2. doi: 10.1002/ijc.34884. Online ahead of print.

ABSTRACT

Information about the NMR metabolomics landscape of overall, and common cancers is still limited. Based on a cohort of 83,290 participants from the UK Biobank, we used multivariate Cox regression to assess the associations between each of the 168 metabolites with the risks of overall cancer and 20 specific types of cancer. Then, we applied LASSO to identify important metabolites for overall cancer risk and obtained their associations using multivariate cox regression. We further conducted mediation analysis to evaluate the mediated role of metabolites in the effects of traditional factors on overall cancer risk. Finally, we included the 13 identified metabolites as predictors in prediction models, and compared the accuracies of our traditional models. We found that there were commonalities among the metabolic profiles of overall and specific types of cancer: the top 20 frequently identified metabolites for 20 specific types of cancer were all associated with overall cancer; most of the specific types of cancer had common identified metabolites. Meanwhile, the associations between the same metabolite with different types of cancer can vary based on the site of origin. We identified 13 metabolic biomarkers associated with overall cancer, and found that they mediated the effects of traditional factors. The accuracies of prediction models improved when we added 13 identified metabolites in models. This study is helpful to understand the metabolic mechanisms of overall and a wide range of cancers, and our results also indicate that NMR metabolites are potential biomarkers in cancer diagnosis and prevention.

PMID:38430541 | DOI:10.1002/ijc.34884

Sex Transm Dis. 2024 Mar 2. doi: 10.1097/OLQ.0000000000001923. Online ahead of print.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) are at increased risk for human papillomavirus-associated oropharyngeal cancer (HPV-OPC). The objective of this analysis was to create a psychometrically validated scale to measure perception of risk for HPV-OPC.

METHODS: We conducted an exploratory and a confirmatory factor analysis to determine and confirm the latent factor structure. We used a path diagram to evaluate the relationship between the validated scale and perceived risk for HPV-OPC. The model was determined to be a good fit if it met all criteria: Root Mean Square Error of Approximation (RMSEA) ≤0.06; Standardized Root Mean Residual (SRMR) ≤0.08; Comparative Fit Index (CFI) ≥0.90 and Tucker-Lewis Index (TLI) ≥0.90. We report standardized estimates and 95% confidence intervals.

RESULTS: This cross-sectional study recruited 1315 MSM. A majority (73.33%) of MSM had performed fellatio on ≥20 partners, 36.98% had rimmed ≥20 partners, and 5.31% had performed cunnilingus on ≥10 partners in their lifetime.Six sexual history survey items loaded onto two latent factors: Sexual risk behaviors: class 1 and sexual risk behaviors: class 2. The final model statistics indicated good fit: RMSEA = 0.064, SRMR = 0.059, CFI = 0.996, and TLI = 0.993. Sexual risk behaviors: class 1 was associated with greater perceived risk for HPV-OPC (0.217, 95% CI: 0.138-0.295). Age, HIV status, HPV vaccination status, and sexual risk behaviors: class 2 were not associated with perceived risk for HPV-OPC.

CONCLUSION: MSM assessed risk for HPV-OPC based upon their lifetime number of cisgender male sexual partners, rimming partners, and fellatio partners but not other sexual behaviors. MSM may be responsive to future HPV-OPC educational interventions and opportunities for screening.

PMID:38430512 | DOI:10.1097/OLQ.0000000000001923

Health Promot Int. 2024 Apr 1;39(2):daae019. doi: 10.1093/heapro/daae019.

ABSTRACT

Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019-December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as ‘housing first’. Moreover, health information and services should be accessible to people with different degrees of HL.

PMID:38430507 | DOI:10.1093/heapro/daae019

J Allied Health. 2024 Spring;53(1):e49-e53.

ABSTRACT

OBJECTIVE: The main goal of this study was to assess physicians’ and nurse practitioners’ (NPs) perception of the title change from physician assistant (PA) to physician associate.

METHODS: Hospital medicine physicians and NPs were surveyed via a REDCap survey that was created by the researcher. Participants were recruited via emails that were sent to Northwell Health providers as part of a convenience sampling. Statistical analysis using a one-way ANOVA was performed to compare the effect of professional credentials on perception and support for the title change.

RESULTS: There were a total of 103 participants, with a response rate for NPs of 22% and physicians of 27%. Analysis revealed that 73% of physicians and NPs surveyed did not think that PAs changing their title to physician associate would affect their perceptions of PAs.

CONCLUSION: There are some reservations about the title change, but overall PAs changing their title to physician associate will not affect the perception of PAs by their peers/colleagues at Northwell Health.

PMID:38430504

J Allied Health. 2024 Spring;53(1):e27-e35.

ABSTRACT

PURPOSE: This study compared Doctor of Physical Therapy students’ perceived confidence with evaluating/treating complex patients before and after a case-based patient management course. The impact of simulated learning and prior clinical exposure were explored.

METHODS: A longitudinal, pretest-posttest design was used across 4 university campuses. A Physiotherapist Self-Efficacy survey was used to collect student responses before/after the course, related to adequate preparation, verbal/written communication, subjective/objective assessments, interpreting assessment findings, identifying/prioritizing patient problems, selecting appropriate short/long term goals, performing/evaluating treatments, discharge planning, progressing interventions, and dealing with a range of patient conditions. Descriptive statistics, paired sample t-tests, ANOVA tests, and conceptual content analyses were completed.

RESULTS: Eighty surveys were completed (13.88% response rate). Posttest confidence levels were higher compared to pretest values in all survey items. The t-statistics indicated a significant difference (p<0.001) between the pretest/posttest scores across all 80 records. Levene’s statistic revealed p-values >0.001, indicating we met the assumption of homogeneity of variance across different cohort groups.

CONCLUSIONS: Student confidence levels towards complex patients significantly improved after course exposure, for all survey components in all cohorts. Simulated experiences, supplemental course materials, and prior outpatient clinical experience contributed to self-efficacy values. Six themes were identified as useful and/or needing revision to further improve self-efficacy.

PMID:38430501

Eur J Cardiothorac Surg. 2024 Mar 2:ezae069. doi: 10.1093/ejcts/ezae069. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to report on mid-term outcomes after endovascular aortic repair in patients with Marfan (MFS) or Loeys-Dietz (LDS) syndrome.

METHODS: We analyzed data from two European centers of patients with MFS and LDS undergoing endovascular aortic repair. Patients were analyzed based on (1) timing of the procedure (planned vs emergency procedure) and (2) the nature of the landing zone (safe vs non-safe). The primary end-point was freedom from reintervention. Secondary end-points were freedom from stroke, bleeding and death.

RESULTS: A population of 419 patients with MFS (n = 352) or LDS (n = 67) was analyzed for the purpose of this study. Thirty-nine patients (9%) underwent endovascular aortic repair. Indications for TEVAR or EVAR were aortic dissection in 13 (33%) patients, aortic aneurysm in 22 (57%) patients and others (intercostal patch aneurysm, penetrating atherosclerotic ulcer, pseudoaneurysm, kinking of FET) in 4 (10%) patients. Thoracic endovascular repair was performed in 34 patients, abdominal endovascular aortic repair was performed in 5 patients. Mean age at 1st TEVAR/EVAR was 48.5 ± 15.4y. Mean follow-up after 1st TEVAR/EVAR was 5.9 ± 4.4 y. There was no statistically significant difference in the rate of re-interventions between patients with non-safe landing zone and the patients with safe proximal landing zone (P = 0.609). Furthermore, there was no increased probability for reintervention after planned endovascular intervention compared to emergency procedures (P = 0.916). Mean-time to reintervention, either open surgical or endovascular, after planned endovascular intervention was in median 3.9 y [95% CI 2.0-5.9y] and 2.0 y [95% CI -1.1-5.1y] (P = 0.23) after emergency procedures.

CONCLUSIONS: Endovascular aortic repair in patients with MFS and LDS and a safe landing zone is feasible and safe. Endovascular treatment is a viable option when employed by a multi-disciplinary aortic team even if the landing zone is in native tissue.

PMID:38430465 | DOI:10.1093/ejcts/ezae069

Bioinformatics. 2024 Mar 2:btae125. doi: 10.1093/bioinformatics/btae125. Online ahead of print.

ABSTRACT

MOTIVATION: Large-scale gene expression studies allow gene network construction to uncover associations among genes. To study direct associations among genes, partial correlation-based networks are preferred over marginal correlations. However, FDR control for partial correlation-based network construction is not well-studied. In addition, currently available partial correlation-based methods cannot take existing biological knowledge to help network construction while controlling FDR.

RESULTS: In this paper, we propose a method called Partial Correlation Graph with Information Incorporation (PCGII). PCGII estimates partial correlations between each pair of genes by regularized node-wise regression that can incorporate prior knowledge while controlling the effects of all other genes. It handles high-dimensional data where the number of genes can be much larger than the sample size and controls FDR at the same time. We compare PCGII with several existing approaches through extensive simulation studies and demonstrate that PCGII has better FDR control and higher power. We apply PCGII to a plant gene expression dataset where it recovers confirmed regulatory relationships and a hub node, as well as several direct associations that shed light on potential functional relationships in the system. We also introduce a method to supplement observed data with a pseudogene to apply PCGII when no prior information is available, which also allows checking FDR control and power for real data analysis.

AVAILABILITY: R package is freely available for download at https://cran.r-project.org/package=PCGII.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:38430463 | DOI:10.1093/bioinformatics/btae125