Category: Nevin Manimala

Environ Sci Pollut Res Int. 2024 Feb 21. doi: 10.1007/s11356-024-32129-z. Online ahead of print.

ABSTRACT

This paper aims to create a new probability distribution and conducts statistical analysis on air quality dataset from Kathmandu. Using this innovative distribution, we have studied the ground reality of air quality conditions of Kathmandu, Nepal. In our research, we have developed a new probability distribution known as the New Extended Kumaraswamy Exponential Distribution by introducing an additional shape parameter to the Extended Kumaraswamy Exponential (EKwE) Distribution. Statistical characteristics such as cumulative distribution function, probability density function, hazard function, reversed hazard function, skewness, kurtosis, survival function, and hazard rate function are studied. The suggested model is non-normal and positively skewed with increasing and inverted bathtub-shaped hazard rate curves. To assess the model’s suitability, we utilized a real dataset comprising air quality data from Kathmandu, Nepal, during the year 2021. Study shows that the air quality data exhibit an increasing failure rate, but the P_2.5, P₁₀, and total suspended particle concentrations exhibited its lowest levels during the monsoon season and its highest levels during the winter season. Parameters of the model are estimated by using the least square estimation (LSE), maximum likelihood estimation (MLE), and Cramér-von Mises (CVM) approach for P₁₀ at Ratnapark Station, Kathmandu. To assess the model’s validity, P-P plots and Q-Q plots are employed. Model comparisons are carried out using Akaike Information Criterion (AIC), Corrected Akaike Information Criterion (CAIC), Bayesian Information Criterion (BIC), and Hannan-Quinn Information Criterion (HQIC). Furthermore, the goodness of fit of the proposed model is evaluated using test statistics such as Anderson-Darling (A²) test, Cramér-von Mises (CVM) test, and the Kolmogorov-Smirnov (KS) test along with their respective p-values. From the findings, we have found that the air quality status of Kathmandu, Nepal, was found to be poor. Proposed distribution provides a better fit with greater flexibility for forecasting air quality data and conducting reliability data analyses. Dataset is analyzed and visualized using R programming.

PMID:38381289 | DOI:10.1007/s11356-024-32129-z

Int Urol Nephrol. 2024 Feb 21. doi: 10.1007/s11255-024-03958-1. Online ahead of print.

ABSTRACT

BACKGROUND: Hyperuricemia, hyperglycemia, hypertension, hyperlipidemia, and hyperhomocysteinemia are all established risk factors for chronic kidney disease (CKD), and their interplay could exacerbate CKD progression. This study aims to evaluate the potential mediation effects of hyperglycemia, hypertension, hyperlipidemia, and hyperhomocysteinemia on the association between hyperuricemia (HUA) and chronic kidney disease (CKD).

METHODS: We collected electronic medical record data from 2055 participants who underwent physical examinations at the Affiliated Hospital of Qingdao University. The data were utilized to investigate the mediating effect of various factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), homocysteine (HCY), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood glucose (Glu), and hemoglobin A1c (HbA1c) on the relationship between HUA and CKD.

RESULTS: Upon adjusting for confounding variables, mediation analysis indicated that only HCY acted as a mediator in the HUA-CKD relationship (p value < 0.05), exhibiting a statistically significant mediation effect of 7.04%. However, after adjustment for multiple testing, none of these variables were statistically significant.

CONCLUSIONS: Considering the observed associations between hyperuricemia, hyperglycemia, hypertension, hyperlipidemia, and CKD, none of the factors of interest remained statistically significant after adjusting for multiple testing as potential mediators of hyperuricemia on CKD.

PMID:38381286 | DOI:10.1007/s11255-024-03958-1

Drugs Real World Outcomes. 2024 Feb 21. doi: 10.1007/s40801-023-00407-w. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with chronic thromboembolic pulmonary hypertension (CTEPH) in countries with limited resources have, to date, been poorly represented in registries.

OBJECTIVE: This work assesses the epidemiology, diagnosis, hemodynamic and functional parameters, and treatment of CTEPH in Russia, Kazakhstan, Turkey, Lebanon, and Saudi Arabia.

METHODS: A prospective, cohort, phase IV, observational registry with 3-year follow-up (n = 212) in patients aged ≥ 18 years diagnosed with CTEPH was created. Clinical, hemodynamic, and functional parameters were obtained at an initial visit, follow-up visits, and a final visit at the end of 3 years’ observation or end of follow-up. Data were recorded on electronic case report forms. Parameters evaluated included 6-minute walking distance (6MWD), use of pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA), pulmonary hypertension (PH)-targeted therapy, and survival. All statistical analyses were exploratory and descriptive, and were performed in the overall population.

RESULTS: The most common symptoms were typical of those expected for CTEPH. Almost 90% of patients underwent right heart catheterization at diagnosis or initial study visit. In total, 66 patients (31%) underwent PEA before the initial visit; 95 patients (45%) were considered operable, 115 (54%) were inoperable, and two (1%) had no operability data. Only 26 patients (12%) had been assessed for BPA at their initial visit. PH-targeted therapy was documented at diagnosis for 77 patients (36%), most commonly a phosphodiesterase type 5 inhibitor (23%). Use of PH-targeted therapy increased to 142 patients (67%) at the initial visit, remaining similar after 3 years. Use of riociguat increased from 6% of patients at diagnosis to 38% at 3 years. Between baseline and end of observation, results for patients with paired data showed an increase in 6MWD. Survival at the end of observation was 88%.

CONCLUSIONS: These data highlight the current diagnosis and management of CTEPH in the participating countries. They show that early CTEPH diagnosis remains challenging, and use of off-label PH-targeted therapy is common.

CLINICALTRIALS: gov: NCT02637050; registered December 2015.

PMID:38381283 | DOI:10.1007/s40801-023-00407-w

Mol Cell Biochem. 2024 Feb 21. doi: 10.1007/s11010-024-04942-0. Online ahead of print.

ABSTRACT

The recognition of microthrombi in the heart microcirculation has recently emerged from studies in COVID-19 decedents. The present study investigated the ultrastructure of coronary microthrombi in heart failure (HF) due to cardiomyopathies that are unrelated to COVID-19 infection. In addition, we have investigated the role of von Willebrand factor (VWF) and PECAM-1 in microthrombus formation. We used electron microscopy to investigate the occurrence of microthrombi in patients with HF due to dilated (DCM, n = 7), inflammatory (MYO, n = 6) and ischemic (ICM, n = 7) cardiomyopathy and 4 control patients. VWF and PECAM-1 was studied by quantitative immunohistochemistry and Western blot. In comparison to control, the number of microthrombi was increased 7-9 times in HF. This was associated with a 3.5-fold increase in the number of Weibel-Palade bodies (WPb) in DCM and MYO compared to control. A fivefold increase in WPb in ICM was significantly different from control, DCM and MYO. In Western blot, VWF was increased twofold in DCM and MYO, and more than threefold in ICM. The difference between ICM and DCM and MYO was statistically significant. These results were confirmed by quantitative immunohistochemistry. Compared to control, PECAM-1 was by approximatively threefold increased in all groups of patients. This is the first study to demonstrate the occurrence of microthrombi in the failing human heart. The occurrence of microthrombi is associated with increased expression of VWF and the number of WPb, being more pronounced in ICM. These changes are likely not compensated by increases in PECAM-1 expression.

PMID:38381272 | DOI:10.1007/s11010-024-04942-0

J Comput Neurosci. 2024 Feb 21. doi: 10.1007/s10827-024-00866-2. Online ahead of print.

ABSTRACT

The computational resources of a neuromorphic network model introduced earlier are investigated in the context of such hierarchical systems as the mammalian visual cortex. It is argued that a form of ubiquitous spontaneous local convolution, driven by spontaneously arising wave-like activity-which itself promotes local Hebbian modulation-enables logical gate-like neural motifs to form into hierarchical feed-forward structures of the Hubel-Wiesel type. Extra-synaptic effects are shown to play a significant rôle in these processes. The type of logic that emerges is not Boolean, confirming and extending earlier findings on the logic of schizophrenia.

PMID:38381252 | DOI:10.1007/s10827-024-00866-2

J Gen Intern Med. 2024 Feb 21. doi: 10.1007/s11606-024-08678-x. Online ahead of print.

ABSTRACT

BACKGROUND: Recognition of clinically deteriorating hospitalized patients with activation of rapid response (RR) systems can prevent patient harm. Patients with limited English proficiency (LEP), however, experience less benefit from RR systems than do their English-speaking counterparts.

OBJECTIVE: To improve outcomes among hospitalized LEP patients experiencing clinical deteriorations.

DESIGN: Quasi-experimental pre-post design using quality improvement (QI) statistics.

PARTICIPANTS: All adult hospitalized non-intensive care patients with LEP who were admitted to a large academic medical center from May 2021 through March 2023 and experienced RR system activation were included in the evaluation. All patients included after May 2022 were exposed to the intervention.

INTERVENTIONS: Implementation of a modified RR system for LEP patients in May 2022 that included electronic dashboard monitoring of early warning scores (EWSs) based on electronic medical record data; RR nurse initiation of consults or full RR system activation; and systematic engagement of interpreters.

MAIN MEASURES: Process of care measures included monthly rates of RR system activation, critical response nurse consultations, and disease severity scores prior to activation. Main outcomes included average post-RR system activation length of stay, escalation of care, and in-hospital mortality. Analyses used QI statistics to identify special cause variation in pre-post control charts based on monthly data aggregates.

KEY RESULTS: In total, 222 patients experienced at least one RR system activation during the study period. We saw no special cause variation for process measures, or for length of hospitalization or escalation of care. There was, however, special cause variation in mortality rates with an overall pre-post decrease in average monthly mortality from 7.42% (n = 8/107) to 6.09% (n = 7/115).

CONCLUSIONS: In this pilot study, prioritized tracking, utilization of EWS-triggered evaluations, and interpreter integration into the RR system for LEP patients were feasible to implement and showed promise for reducing post-RR system activation mortality.

PMID:38381243 | DOI:10.1007/s11606-024-08678-x

J Orthop Traumatol. 2024 Feb 21;25(1):8. doi: 10.1186/s10195-024-00752-8.

ABSTRACT

BACKGROUND: The network of intermediate filament proteins underlying the inner nuclear membrane forms the nuclear lamina. Lamins have been associated with important cellular functions: DNA replication, chromatin organization, differentiation of the cell, apoptosis and in maintenance of nuclear structure. Little is known regarding the etiopathogenesis of adhesive capsulitis (AC); recently, a dysregulating fibrotic response starting from a subpopulation has been described within the fibroblast compartment, which suddenly turns on an activated phenotype. Considering the key role of A-type lamins in the regulation of cellular stability and function, our aim was to compare the lamin A/C expression between patients with AC and healthy controls.

MATERIALS AND METHODS: A case-control study was performed between January 2020 and December 2021. Tissue samples excised from the rotator interval were analysed for lamin A/C expression by immunohistochemistry. Patients with AC were arbitrarily distinguished according to the severity of shoulder flexion limitation: ≥ 90° and < 90°. Controls were represented by samples obtained by normal rotator interval excised from patients submitted to shoulder surgery. The intensity of staining was graded, and an H-score was assigned. Statistical analysis was performed (Chi-square analysis; significance was set at alpha = 0.05).

RESULTS: We enrolled 26 patients [12 male and 14 female, mean age (SD): 52.3 (6.08)] and 15 controls [6 male and 9 female, mean age (SD): 57.1 (5.3)]. The expression of lamin A/C was found to be significantly lower in the fibroblasts of patients with adhesive capsulitis when compared with controls (intensity of staining: p: 0.005; H-score: 0.034); no differences were found regarding the synoviocytes (p: > 0.05). Considering only patients with AC, lamin A/C intensity staining was found to be significantly higher in samples where acute inflammatory infiltrate was detected (p: 0.004). No significant changes in levels of lamin A/C expression were documented between the mild and severe adhesive capsulitis severity groups.

CONCLUSIONS: Our study demonstrated that the activity of lamin A/C in maintaining nuclear structural integrity and cell viability is decreased in patients with adhesive capsulitis. The phase of the pathogenetic process (freezing and early frozen) is the key factor for cell functionality. On the contrary, the clinical severity of adhesive capsulitis plays a marginal role in nuclear stability.

LEVEL OF EVIDENCE: III.

PMID:38381214 | DOI:10.1186/s10195-024-00752-8

Ann Surg Oncol. 2024 Feb 21. doi: 10.1245/s10434-024-14998-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Implementing perioperative interventions such as enhanced recovery pathways (ERPs) has improved short-term outcomes and minimized length of stay. Preliminary evidence suggests that adherence to the enhanced recovery after surgery protocol may also enhance 5-year cancer-specific survival (CSS) in colorectal cancer surgery. This retrospective study presents long-term survival outcomes and disease recurrence from a high-volume, single-center practice.

METHODS: All patients over 18 years of age diagnosed with rectal adenocarcinoma and undergoing elective minimally invasive surgery (MIS) were retrospectively reviewed between February 2005 and April 2018. Relevant data were extracted from Mayo electronic records and securely stored in a database. Short-term morbidity and long-term oncological outcomes were compared between patients enrolled in ERP and those who received non-enhanced care.

RESULTS: Overall, 600 rectal cancer patients underwent MIS, of whom 320 (53.3%) were treated according to the ERP and 280 (46.7%) received non-enhanced care. ERP was associated with a decrease in length of stay (3 vs. 5 days; p < 0.001) and less overall complications (34.7 vs. 54.3%; p < 0.001). The ERP group did not show an improvement in overall survival (OS) or disease-free survival (DFS) compared with non-enhanced care on multivariable (non-ERP vs. ERP OS: hazard ratio [HR] 1.268, 95% confidence interval [CI] 0.852-1.887; DFS: HR 1.050, 95% CI 0.674-1.635) analysis.

CONCLUSION: ERP was found to be associated with a reduction in short-term morbidity, with no impact on long-term oncological outcomes, such as OS, CSS, and DFS.

PMID:38381207 | DOI:10.1245/s10434-024-14998-3

Eur J Trauma Emerg Surg. 2024 Feb 21. doi: 10.1007/s00068-024-02470-6. Online ahead of print.

ABSTRACT

BACKGROUND: PANELVIEW is an instrument for evaluating the appropriateness of the process, methods, and outcome of guideline development and the satisfaction of the guideline group with these steps.

OBJECTIVE: To evaluate the guideline development process of the German guideline on the treatment of patients with severe/multiple injuries (‘German polytrauma guideline’) from the perspective of the guideline group, and to identify areas where this process may be improved in the future.

METHODS: We administered PANELVIEW to the participants of the 2022 update of the German polytrauma guideline. All guideline group members, including delegates of participating medical societies, steering group members, authors of guideline chapters, the chair, and methodological lead, were invited to participate. Responses were analysed using descriptive statistics. Comments received were categorised by domains/items of the tool.

RESULTS: After the first, second, and last consensus conference, the guideline group was invited via email to participate in a web-based survey. Response rates were 36% (n/N = 13/36), 40% (12/30), and 37% (20/54), respectively. The mean scores for items ranged between 5.1 and 6.9 on a scale from 1 (fully disagree) to 7 (fully agree). Items with mean scores below 6.0 were related to (1) administration, (2) consideration of patients’ views, perspectives, values, and preferences, and (3) the discussion of research gaps and needs for future research.

CONCLUSION: The PANELVIEW tool showed that the guideline group was satisfied with most aspects of the guideline development process. Areas for improvement of the process were identified. Strategies to improve response rates should be explored.

PMID:38381190 | DOI:10.1007/s00068-024-02470-6

Int J Clin Oncol. 2024 Feb 21. doi: 10.1007/s10147-024-02473-8. Online ahead of print.

ABSTRACT

BACKGROUND: In Japan, comprehensive cancer statistics data have been collected through national cancer registries, but these data are rarely summarized and reported in research articles.

METHODS: Here, we compiled the national registry data on malignant tumors originating from gynecologic organs (ovary, corpus uteri, cervix uteri) in Japan.

RESULTS: The number of new patients in 2019 was 13,380, 17,880, and 10,879, respectively, and the number of deaths in 2021 was 5081, 2741, and 2894, respectively. Compared with 40 years ago, the incidence of ovarian cancer has tripled, the incidence of uterine corpus cancer (mainly endometrial cancer) has increased eightfold, the mortality rate of uterine corpus cancer has tripled, and the incidence of cervical intraepithelial cancer has increased ninefold in data standardized by the world population. Compared with the United States, the incidence rate of ovarian cancer has overtaken and the mortality rate of uterine corpus cancer is the same, while both the incidence and mortality rates of cervical cancer are higher in Japan.

CONCLUSION: The incidence of gynecologic cancer is increasing significantly in Japan.

PMID:38381162 | DOI:10.1007/s10147-024-02473-8