Category: Nevin Manimala

Br J Haematol. 2024 Feb 23. doi: 10.1111/bjh.19352. Online ahead of print.

ABSTRACT

We report the outcome of 563 cases of newly diagnosed lymphoma registered in 2019-2021, including 176 cases (31.2%) of Hodgkin lymphoma (HL), 130 (23.1%) of diffuse large B-cell lymphoma (DLBCL), 28 (5%) of follicular lymphoma (FL), 16 (2.9%) of mantle cell lymphoma (MCL) and 20 (3.5%) of peripheral T-cell lymphoma (PTCL). After a median follow-up of 30.1 months (95% CI: 28.8-31.3), the 3-year overall survival rates were 95%, 83%, 86%, 100%, 61% and 42% for HL, DLBCL, CLL, FL, MCL and PTCL respectively. These data offer valuable information on the curability of lymphoma patients in Ukraine, in a real-world setting.

PMID:38400556 | DOI:10.1111/bjh.19352

J Orthop Res. 2024 Feb 23. doi: 10.1002/jor.25816. Online ahead of print.

ABSTRACT

Tendon biomechanical properties and fibril organization are altered in patients with diabetes compared to healthy individuals, yet few biomarkers have been associated with in vivo tendon properties. We investigated the relationships between in vivo imaging-based tendon properties, serum variables, and patient characteristics across healthy controls (n = 14, age: 45 ± 5 years, body mass index [BMI]: 24 ± 1, hemoglobin A1c [HbA1c]: 5.3 ± 0.1%), prediabetes (n = 14, age: 54 ± 5 years, BMI: 29 ± 2; HbA1c: 5.7 ± 0.1), and type 2 diabetes (n = 13, age: 55 ± 3 years, BMI: 33 ± 2, HbA1c: 6.7 ± 0.3). We used ultrasound speckle-tracking and measurements from magnetic resonance imaging (MRI) to estimate the patellar tendon in vivo tangent modulus. Analysis of plasma c-peptide, interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), adiponectin, leptin, insulin-like growth factor 1 (IGF-1), and C-reactive protein (CRP) was completed. We built regression models incorporating statistically significant covariates and indicators for the clinically defined groups. We found that tendon cross-sectional area normalized to body weight (BWN CSA) and modulus were lower in patients with type 2 diabetes than in healthy controls (p < 0.05). Our regression analysis revealed that a model that included BMI, leptin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), age, and group explained ~70% of the variability in BWN CSA (R² = 0.70, p < 0.001). For modulus, including the main effects LDL, groups, HbA1c, age, BMI, cholesterol, IGF-1, c-peptide, leptin, and IL-6, accounted for ~54% of the variability in modulus (R² = 0.54, p < 0.05). While BWN CSA and modulus were lower in those with diabetes, group was a poor predicter of tendon properties when considering the selected covariates. These data highlight the multifactorial nature of tendon changes with diabetes and suggest that blood variables could be reliable predictors of tendon properties.

PMID:38400550 | DOI:10.1002/jor.25816

J Evid Based Soc Work (2019). 2024 Feb 23:1-20. doi: 10.1080/26408066.2024.2320345. Online ahead of print.

ABSTRACT

BACKGROUND: Immigrants comprise a sizable proportion (15%) of the population living in the United States (U.S.). Given these proportions, it is imperative that we understand immigrant experiences of well-being and stress toward improved well-being and integration.

METHODS: To examine the experiences of first- and second-generation immigrants using a comparative approach, we utilized data from two surveys collected under Trump (n = 490) and Biden (n = 306) administrations. Both studies employed non-probability quota and convenience sampling techniques. Questions about experiences of stress (PSS-4), discrimination (Everyday Discrimination Scale), resilience (Brief Resilience Scale), border stress (Border Community and Immigration Stress Scale), immigration policies (general questions) were included in the surveys. Each study sample included diverse racial groups across both immigrant generations. We report frequencies, descriptive statistics, and ANOVAs/post hoc test results.

RESULTS: Findings highlight that levels of both stress and discrimination among non-White participants under the Trump administration were significantly higher than those of White participants, though neither relationship was significant under the Biden administration. Further, White participants exhibited higher resilience under the Trump administration, but not under the Biden administration.

DISCUSSION AND CONCLUSION: To our knowledge, this is the first study to comparatively examine immigrant experiences under the two most recent federal administrations. This study is seminal in highlighting discussions and making policy recommendations to limit immigrant exclusion, curtail exclusionary policies regarding travel bans, and improve pathways to citizenship, enhancing immigrant integration in the U.S. Roles of social workers in supporting immigrant communities and pathways for future research with immigrants are discussed.

PMID:38400548 | DOI:10.1080/26408066.2024.2320345

Am J Hematol. 2024 Feb 23. doi: 10.1002/ajh.27258. Online ahead of print.

ABSTRACT

Women with peripheral artery disease (PAD) have poorer limb salvage outcomes in spite of having lower risk factors for vascular disease than their male counterparts. Mono antiplatelet therapy with aspirin is the cornerstone of medical treatment for PAD to reduce the risk of arterial thrombosis, but platelets in women may have a variable response to this standard of care compared to men. Viscoelastic assays, such as thromboelastography with platelet mapping (TEG-PM), have been utilized to identify prothrombotic states and may provide insight into a patient’s real-time coagulation profile and their response to specific antiplatelet medications. The aim of this prospective, observational study was to delineate the sex differences in platelet function using TEG-PM in patients with PAD on aspirin post-revascularization for PAD. All patients with PAD undergoing revascularization on aspirin monotherapy were prospectively enrolled between December 2020 and September 2023. The cohort was divided by sex, demographics, medications, procedure type, and outcomes were documented. Serial perioperative TEG-PM assays (1, 3, and 6 months) were performed up to 6 months postoperatively and platelet function was evaluated in both groups. Statistical analysis between women and men was performed to identify sex-specific differences in platelet function. Over the study period, a total of 303 patients were enrolled. Of this cohort, 149 patients met the study criteria and 266 samples were analyzed; 52 (34.89%) were women and 97 (65.11%) were men. In the platelet mapping assay, women showed significantly greater MA_ActF and MA_AA , than men (16.66 vs. 14.94, p < .03 and 37.26 vs. 32.38, p < .01, respectively) indicating stronger thrombotic propensity. Additionally, platelet inhibition was significantly lower in women compared to men (52.95% vs. 61.65%, p < .05). In clinical outcomes reported as thrombotic events, women showed significantly higher occlusion in the area of intervention than men (4 vs. 1, p < .05). There is a growing awareness of the variations in the natural course, underlying mechanisms, and resulting outcomes of cardiovascular conditions, including PAD, in relation to sex. In this study, women did not achieve the same levels of platelet inhibition and displayed a procoagulant tendency in comparison to men when administered aspirin. Overall, aspirin monotherapy may be potentially sufficient for men, but women may require increased doses and/or additional antiplatelet medications to achieve an equivalent therapeutic effect.

PMID:38400527 | DOI:10.1002/ajh.27258

Am J Reprod Immunol. 2024 Mar;91(3):e13829. doi: 10.1111/aji.13829.

ABSTRACT

OBJECTIVE: This study investigated whether serum amyloid A (AA) levels can be used as a biomarker in patients with threatened abortion.

MATERIAL AND METHODS: This prospective cohort study was conducted at the Antalya Training and Research Hospital, Department of Obstetrics and Gynecology, Türkiye, between April and October 2023. Eighty-eight pregnant women, 44 diagnosed with threatened miscarriage (Group 1) and 44 healthy individuals (Group 2), were included in the study. Sociodemographic, obstetric, and laboratory parameters were compared between the groups.

RESULTS: No statistically significant differences were observed between the groups in terms of sociodemographic data (age, body mass index, education level, economic status, occupation status, smoking, and alcohol consumption). However, obstetric characteristics (number of pregnancies, living children, miscarriages, dilatation and curettage, gestational age on admission, and fetal crown-rump length) and laboratory values including complete blood count, hematocrit, leukocyte, neutrophil, lymphocytes, platelet, hs-C-reactive protein, neutrophil-lymphocyte and platelet-lymphocyte ratio (p > .05), and serum AA values (7.49 ± 3.07 in Group 1 vs. 9.46 ± 4.80 in Group 2, p = .024) differed significantly. Receiver operating characteristic analysis showed that the area under the curve (AUC: 0.662) was statistically significant for serum AA (p = .032), with a cut-off value of ≥7.51 (95% [confidence interval] 0.516-0.749, sensitivity 65%, specificity 51%). The positive predictive value of serum AA for threatened miscarriage was 56.8%, and the negative predictive value 59.4%.

CONCLUSION: This study shows that serum AA can be used as a biomarker in the diagnosis of threatened miscarriage. Prospective studies involving more participants are now needed to confirm our results.

PMID:38400511 | DOI:10.1111/aji.13829

Injury. 2024 Feb 6;55(4):111413. doi: 10.1016/j.injury.2024.111413. Online ahead of print.

ABSTRACT

BACKGROUND: Increased posterior wall acetabular fractures among older adults, require precise treatment to restore stability to the joint, lower the risk of degenerative arthritis, and enhance overall functional recovery. The purpose of this study was to compare the fixation stability and mechanical characteristics of calcaneal buttress plate and conventional reconstruction plate under different loading condition.

METHODS: Typical acetabular posterior wall fractures were created on twenty synthetic hemipelvis models. They were fixed with calcaneus plate and reconstruction plate. Dynamic and static tests were performed. Displacements of fracture line and stiffness were calculated.

FINDINGS: After dynamic loading, calcaneus plate fixation has significantly less displacement than the reconstruction plate on the superior posterior wall. Under static loading condition, the calcaneus plate group has significantly less displacement than the reconstruction plate group on the inferior posterior part of the fracture. The average stiffness values of the calcaneus plate group and the reconstruction plate group were 265.16±53.98 N/mm and 167.48±36.87 N/mm, respectively and a statistically significant difference was found between the two groups.

INTERPRETATION: The calcaneal plate group demonstrated better stability along the fracture line after dynamic and static loading conditions. Especially when the fragment was on the acetabulum’s superior posterior, inferior posterior, and inferior rim, Calcaneal buttress plates offer biomechanically effective choices.

PMID:38394707 | DOI:10.1016/j.injury.2024.111413

Health Policy. 2024 Feb 16;142:105016. doi: 10.1016/j.healthpol.2024.105016. Online ahead of print.

ABSTRACT

This review draws on over 70 studies spanning 2000 to 2023 to analyze the causal effect of health on educational outcomes. Health and health system interventions during the prenatal, infant, and childhood period impact longer-run educational attainment and performance. The magnitude of these effects is both statistically and economically significant, comparable in size to impacts on educational outcomes of interventions found in the literature. These impacts of health and health system interventions differ across gender and socioeconomic status, illustrating how health and health systems can exacerbate or mitigate educational inequalities. By showing the intertwined nature of health and education, this review highlights the importance of a comprehensive approach in policy-making that aligns with the Sustainable Development Goals.

PMID:38394700 | DOI:10.1016/j.healthpol.2024.105016

J Neurosurg Spine. 2024 Feb 23:1-6. doi: 10.3171/2023.12.SPINE23700. Online ahead of print.

ABSTRACT

OBJECTIVE: Race plays a salient role in access to surgical care. However, few investigations have assessed the impact of race within surgical populations after care has been delivered. The objective of this study was to employ an exact matching protocol to a homogenous population of spine surgery patients in order to isolate the relationships between race and short-term postoperative outcomes.

METHODS: In total, 4263 consecutive patients who underwent single-level, posterior-only lumbar fusion at a single multihospital academic medical center were retrospectively enrolled. Of these patients, 3406 patients self-identified as White and 857 patients self-identified as non-White. Outcomes were initially compared across all patients via logistic regression. Subsequently, White patients and non-White patients were exactly matched on the basis of key demographic and health characteristics (1520 matched patients). Outcome disparities were evaluated between the exact-matched cohorts. Primary outcomes were readmissions, emergency department (ED) visits, reoperations, mortality, intraoperative complications, and discharge disposition.

RESULTS: Before matching, non-White patients were less likely to be discharged home and more likely to be readmitted, evaluated in the ED, and undergo reoperation. After matching, non-White patients experienced higher rates of nonhome discharge, readmissions, and ED visits. Non-White patients did not have more surgical complications either before or after matching.

CONCLUSIONS: Between otherwise similar cohorts of spinal fusion cases, non-White patients experienced unfavorable discharge disposition and higher risk of multiple adverse postoperative outcomes. However, these findings were not accounted for by differences in surgical complications, suggesting that structural factors underlie the observed disparities.

PMID:38394654 | DOI:10.3171/2023.12.SPINE23700

J Appl Clin Med Phys. 2024 Feb 23:e14306. doi: 10.1002/acm2.14306. Online ahead of print.

ABSTRACT

INTRODUCTION: The Philippines is a lower-middle-income island country with over 153 000 new cancer diagnosis each year. Despite many patients needing radiotherapy as part of disease management, there remains limitations to access. Currently, the Philippines has 50 linear accelerator facilities serving a population of 110 million. However, given the recommendation of 1 linear accelerator for every 250 thousand people, it is evident that the demand for accessible radiotherapy resources is significantly underserved in the country. This paper outlines the collaboration between GenesisCare Solutions (GCS) and Fairview Cancer Center (FCC) to address efficiency and access within the radiotherapy department at FCC.

METHODS: Through international collaboration between GCS and FCC, areas for improvement were identified and categorized into four domains: Dosimetry quality, Patient workflow, Data & Reporting, and Information Technology (IT) Infrastructure. Action plans were developed then implemented. A baseline measurement was obtained for each domain, and post-implementation evaluation undertaken at 3 months, 6 months, and 12 months. Data captured within the electronic medical record system was extrapolated, and average treatment times were established for pre- and post-engagement. A paired, 2-tailed t-test was used for statistical analysis of outcome parameters using IBM SPSS version 23 for all statistics.

RESULTS: Twelve months post-initial engagement, all four domains saw positive outcomes. Improved plan quality linked to Intensity Modulated Radiotherapy (IMRT) utilization rates saw an increase from 20% to 54%. A significant reduction in patient average wait times was also observed, from 27 to 17 min (p ≤ 0.001). Prior to engagement, tracking patient demographics and diagnosis was not prioritized, post engagement an average of 92% diagnosis entry compliance was achieved.

CONCLUSION: Through the collaboration of GCS and FCC, objectives in all action plan domains were achieved, highlighting the benefits of collaboration between low-middle-income and high-income institutions.

PMID:38394611 | DOI:10.1002/acm2.14306

Phys Rev Lett. 2024 Feb 9;132(6):061603. doi: 10.1103/PhysRevLett.132.061603.

ABSTRACT

In the infrared limit, a nearly anti-de Sitter spacetime in two dimensions (AdS_{2}) perturbed by a weak double trace deformation and a two-site (q>2)-body Sachdev-Ye-Kitaev (SYK) model with N Majoranas and a weak 2r-body intersite coupling share the same near-conformal dynamics described by a traversable wormhole. We exploit this relation to propose a symmetry classification of traversable wormholes depending on N, q, and r, with q>2r, and confirm it by a level statistics analysis using exact diagonalization techniques. Intriguingly, a time-reversed state never results in a new state, so only six universality classes occur-A, AI, BDI, CI, C, and D-and different symmetry sectors of the model may belong to distinct universality classes.

PMID:38394601 | DOI:10.1103/PhysRevLett.132.061603